Lords Sitting of 23 October 1946

Preamble
The House met at two of the clock, The LORD CHANCELLOR on the Woolsack.
Prayers.

VISCOUNT MOUNTBATTEN OF BURMA.
Acting Admiral Sir Louis Francis Albert Victor Nicholas Mountbatten (commonly called Lord Louis Francis Albert Victor Nicholas Mountbatten), G.C.V.O., K.C.B., D.S.O., having been created Viscount Mountbatten of Burma, of Rornsey in the County of Southampton—Was (in the usual manner) introduced.
The Lord Heneage—Took the Oath.

GLASGOW CORPORATION BILL.
Read 3a, with the Amendments, and passed, and returned to the Commons.
BANBURY CORPORATION BILL.
Read 3a, with the Amendments, and passed, and returned to the Commons.
NORTHMET POWER BILL.
Read 3a, and passed.
ABERDEEN HARBOUR ORDER CONFIRMATION BILL. [H.L.]
Read 3a, according to Order, and passed, and sent to the Commons.

ATOMIC ENERGY BILL.
2.18 p.m.
Order of the Day for the Second Reading read.
THE SECRETARY OF STATE FOR DOMINION AFFAIRS (VISCOUNT ADDISON): My Lords, as your Lordships are aware, the matter of this Bill deals
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with what might fairly be described as a revolutionary development, which marked the last year of the war and which is unique in its military potentialities, power and dreadfulness, as well as in the economic possibilities to which it might give rise, if properly guided and developed. The world is naturally concerned about the possibilities of frightfulness to which the release and the use of atomic energy might give rise, and I do not propose to detain your Lordships by enlarging on that aspect of the matter. But it is clear that the whole thing is of such prodigious importance that steps must be taken, so far as humanly possible, to safeguard humanity against the danger.
As your Lordships are aware, the United Nations Organization has already set up an Atomic Energy Commission to study the possibilities in this direction, and I need scarcely say that this Government are participating, have participated, and will participate with the utmost goodwill to make the issues of the deliberations of this Commission successful, and to secure that in some way the international agencies that are set up are efficient. At the same time, the possibilities of the case are so great that clearly adequate national safeguards must be taken not only to enable us to play our part in whatever is ultimately desired and agreed upon in consequence of the work of the Atomic Energy Commission, but also to see that, as far as possible, good use is made of the possibilities of these discoveries in the economic sense. I understand that in that respect there are already certain products which may be potentially of great value in many directions. Clearly, therefore, we must provide for and encourage the proper type of developments. The Government have already undertaken, and are already setting up, a research establishment at Harwell, and your Lordships are already aware that in general charge of production is Viscount Portal of Hungerford who, I am sure, receives the confidence of every one of us.
I understand that at the present moment the immense costs which this kind of work is likely to involve are counted as £30,000,000; how much more they will prove to be no one can tell, but I think it would be idle to pretend that the costs of the work may be limited to that figure. This Bill does not—using the term in its

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usual sense—"nationalize" atomic energy. It gives the Minister power to promote and control developments under the best advice that he can obtain, and the Government are aided and assisted now, and have been for some time past, by a very responsible and expert committee over which Sir John Anderson presides. I am sure that on that account alone it will receive the confidence of every one of us.
I do not think I need take your Lordships in detail through the Bill. I will just indicate some of its provisions. It nominates the Minister of Supply as the Minister responsible for the conduct of the work such as there is at Harwell and elsewhere, gives him general charge over that work and the general duty to provide, promote, and control development and research. In that respect it enables him and authorizes him to provide money to encourage and carry out research, to call for information, if need be, in various matters, to inspect premises where research of vital consequence may possibly endanger the safety of the State or of individual persons. It empowers him to search for materials, and if he does any damage in searching for materials it authorizes him to pay the proper compensation. It authorizes the Minister to acquire the right to develop certain minerals which are related to the work in question, and it enables him to enter into arrangements with private persons who are doing work on related subjects and to make appropriate arrangements with them. Particularly in regard to research, we are only at the beginning of the possible developments of this immense topic, but already grants are being provided at universities and elsewhere for research work in many directions which I need not enlarge upon.
There was one particular clause—Clause 11—which was very difficult to draft and which may involve certain difficulties in its administration, but it is quite clear that in a matter of this kind steps must be taken to prevent the disclosure of information and to ensure the necessary secrecy. At the same time, it is of course quite evident that you cannot do anything, and ought not to do anything, which would prevent scientists quite properly exchanging ideas and developing scientific experiments on
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sound lines. In that respect I might refer, speaking of the precautions about the disclosure of information, to the declaration of the President of the United States and the Prime Ministers of Canada and the United Kingdom, which was issued on the 14th of November last. They laid down the principle that basic scientific information essential to the development of atomic energy for peaceful purposes should be made available to the world, but that detailed information concerning practical industrial application should be deferred until effective reciprocal and enforceable safeguards, acceptable to all nations, have been devised. That formula was accepted by the nations concerned, and I am sure it is one that is sound and should be adhered to. At the same time, I recognize the great difficulties, without crippling scientists, of drafting a form of words that would be workable and would be sufficient. I believe that the noble Lord, Lord Cherwell, will have some comments to make on this subject, which he was good enough to inform me of beforehand. Therefore I will keep for my reply, if the House will allow me to make one, any observations I have to make on the comments which he will bring before your Lordships.
There are safeguards of like character relating to inventions, and provisions with regard to the acquisition of inventions, and generally, we have sought to cover the case as far as it is foreseeable at the present time. The Bill has been carried through the other place, as your Lordships are aware, without any adverse criticism, but with proper comments, and I hope that your Lordships will be willing to give it a Second Reading.
Moved, That the Bill be now read 2a.—(Viscount Addison.)
2.27 p.m.
LORD CHERWELL: My Lords, for rather more than a year now one of the most distressing afflictions which has plagued citizens of this unhappy country has been the atomic energy bore. Many people who know something about nuclear physics, and a great many more who know even less, have been expatiating, often dogmatically and almost always at interminable length, and inflicting their views upon anyone who would listen. I have endeavoured myself to avoid this pitfall, but on this occasion I trust that the House will forgive me if I say one or

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two general words before coming to the Bill itself.
Whether or not the possession of atomic bombs will decide future wars, their use will certainly render them infinitely more horrible from most points of view. The blast effect, even of the earliest types of atomic bombs, exceeded that of our ten-ton bombs in much the same proportion as the ten-tonners in this war exceeded the very first twenty-pound bombs which were dropped from aircraft thirty years ago. In addition, we have the heat radiation searing all exposed organic matter within about half a mile of the explosion, and the even deadlier gamma rays blighting the marrow of all living creatures within much the same distance, not to mention the lethal radio active products which would poison the whole neighbourhood for a considerable time if such a bomb were detonated on the ground.
The more the effect of these bombs is studied, and the more that is known about possible improvements, the more vital does it seem to reach some work able agreement to prevent the use of this weapon in war. Yet although fourteen months have elapsed since the first nuclear bombs detonated, we seem very little nearer achieving this end. Our failure is not because it is inherently impossible to think out methods of control. On the contrary, the Baruch Plan indicated a perfectly feasible approach. The difficulty is that any workable scheme inevitably involves a certain surrender of that complete sovereignty which some nations are so insistent to preserve. It is perfectly clear that without international inspection there can be no security against individual countries developing and producing and perfecting these bombs. A mere under taking to refrain from their use will give, no more security against their being used than the Kellogg Pact undertaking to refrain from war prevented the war which broke out a few years later. Nor will a mere exchange of such information as a country chooses to divulge carry us much further.
Either an international authority with the powers and the will to act in the case of recalcitrance must be allowed to inspect all the countries of the world and to insist on the stopping of any obnoxious activities concerned with nuclear weapons,
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or we must make up our minds to an international arms race which will almost certainly culminate in the most disastrous war in human history. To accept such an international authority implies a certain surrender of sovereignty, but I cannot understand why any reasonable country should refuse this when the dread alternative is atomic war. It is almost inconceivable that the nations should stand upon punctilio in such a matter when the stake is so great. I venture to hope that this country at any rate will place no obstacle in the way, always provided that the rest of the countries of the world will accept this essential preliminary to any form of inter national control. I also venture to hope that we shall resist anything calculated to extend the knowledge of how to make and use these bombs unless and until all other nations have shown by deeds as well as by words that they accept the international authority with all its powers of inspection and control. Clearly we cannot have international control and regulation without national control and regulation. One of the main reasons why I welcome this Bill is that it is an essential step which may make the achievement of some form of international control feasible.
Whilst welcoming the Bill in broad outline there are, however, one or two important points which I think I should mention so that the Government may consider them and I hope may be prepared to satisfy us on the Committee stage. In this matter I feel sure that all of us in the House are aiming at the same thing. I also feel sure that the noble Viscount the Leader of the House will believe me when I assure him that any Amendments I may suggest are intended to be constructive and helpful. In the first place, I am a little disappointed, although this is a Bill "to provide for the development of atomic energy", to see how little is said about this aspect of the Minister's duty. We are told in Clause 1 that it will be his general duty to promote and control the development of atomic energy and in subsequent clauses we find set out in great details all the various powers which he shall have to control other people's property and activities. But there seems to be rather a dearth of detail concerning his own constructive activities. I dare say it is unusual to go any further than this in a Bill, but I must confess I was a little uneasy to find so much stress laid upon the powers

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the Minister has to prevent other people working freely on this topic and how little stress is laid upon the methods he shall use to promote research and development himself.
Few people who have not tried it realize how hard it is to carry out research under Treasury auspices. Rules and regulations hamper advance even on well-defined and old-fashioned lines, but nuclear research is so much in its infancy that it really cannot be treated on ordinary Civil Service lines. It is so closely related to fundamental research as opposed to mere technical developments that it will be stifled in the strait jacket of closely-knit red tape which the Treasury so fondly weaves when it has an opportunity. All the rules and procedure very proper in administrative departments must of necessity handicap all Government research. But we are dealing here with a subject so novel and so important that precedent must go by the board. It will be absolutely overlaid if we cannot break through the ordinary restrictions. When we discussed these matters two or three years ago it was universally agreed that nuclear work could only be handled effectively if dealt with on university lines. I do not mean to say in a university, but the head of the department should be allowed the same sort of freedom a university professor enjoys to engage his own staff, to fix their salaries within reasonable limits, and to direct their activities according to their particular aptitudes and interests. He must be allowed to incur expenditure within the ambit of his budget without constant reference to the Treasury or the Ministry, to make his own arrangements about hours of work, leave, and so on.
Above all, it is quite impossible in work of this sort to have scientists selected and appointed by the Civil Service Commission in the ordinary way. Nothing will be done if the head of a research department has to waste his time arguing, as all too often happens in Government establishments, for weeks and months about engaging extra typists or computers or junior men. It is absurd to demand that men who have to advise on matters involving millions of pounds should have to go cap in hand to some minor official in order to be allowed to spend a few hundred or even a few thousand pounds for purposes which, rightly or wrongly,
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they consider necessary, and about which in any event they are bound to be the best judges. Developments are so rapid that every month counts. I say without hesitation that unless Civil Service regulations are relaxed months may be wasted arguing and explaining instead of getting on with the job. I will give one instance. One of the most important instruments of research in nuclear physics is the "Geiger counter." There may be half a dozen men in England who have had experience in making and using these, and probably most of them are tied up at universities. If the head of one of the departments dealing with atomic energy requires a man of this type, surely it is absurd to ask him to advertise the post, to put an applicant through the regular Civil Service examination, to have a selection board and all the rest of the rigmarole, when it is known from the very beginning that there is only one man who is suitable and available, who he is and on what terms he can be got. Unless we insist upon considerable deviation from ordinary Treasury practice, I am certain that work on atomic energy under Government auspices in this country is condemned to atrophy. We cannot get ahead with research in this way.
For this reason I hope the Government will state quite clearly in this Bill that there is no intention of proceeding on these stereotyped lines and that the Minister shall have the power, and even the duty in suitable cases, to treat this question without any regard to normal Civil Service procedure. Unless progress is to be hamstrung we must see that the heads of the various establishments are given a certain budget at the beginning of the year, for which, of course, they have to account, and are allowed to dispose of it without constant reference back, with the same freedom as is enjoyed in general by the heads of departments in universities.
In the American Act dealing with these matters—the McMahon Act—there is a special clause to take care of this aspect. It provides that the Commission—which corresponds to the Minister in our case—shall appoint and fix the compensation of officers and employees, and so on, according to their Classification Acts, and then comes a notable phrase saying that to the extent that the Commission deem such action necessary in the discharge of its responsibilities personnel may be employed and their compensation fixed without

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regard to such laws. I hope it may be possible to insert a provision of a similar nature in this Bill, presumably in Clause 2. I know, of course, that in Part II of the Civil Service Regulations, paragraph 3, section 10, power is given to the Commissioners in making appointments to dispense with the normal procedure in cert in conditions. If the Civil Service Commissioners would undertake to accept the advice of the Minister, who would presumably be guided by the senior officials in charge of the various atomic energy establishments, this power, if used comparatively freely, might suffice to meet my difficulty as far as the appointment of officials is concerned. I do not think it would be required in more than a few dozen or perhaps a few score of cases. But when it is necessary, some mechanism of this sort ought to be provided which would enable long-term appointments to be made rapidly and irrespective of normal Civil Service regulations. The sort of men we need for this work are all too rare; they are being offered lucrative posts else-where, at home and abroad., and unless we are to risk losing them the various departments ought to be able to act almost as swiftly and decisively as ordinary industrial concerns.
As to the financial side, I do not think there should be any great difficulty in arranging to give freedom to the heads of the various establishments. This, I imagine, is merely an administrative matter, but if I am wrong and it can only be done by inserting a clause in the Bill, I trust the Government will agree to some such Amendment. I hope the House will not think I am being fussy or pernickety in this matter. I have really had a great deal of experience in this sort of work, both in universities and Government Departments, and I feel that in those circumstances it would be wrong for me to allow to pass without protest a Bill in which no attention appears to have been paid to this very important aspect. The Government are here trying to do something quite unlike anything they have ever attempted before, and I can assure the House that some such break with precedent will have to be made unless we are to jeodardize the future of nuclear work in this country.
I do not wish to criticize at this stage the general organization projected for this work, though it does seem to me to be
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a little sketchy as it stands. As I understand it, the present arrangements are that research and development should be the responsibility of Professor Cockcroft, whilst production is to be dealt with by Lord Portal of Hungerford. What is to be done about the all-important ordnance side has, so far as I know, not yet been stated, although there have been rumours. It would be an impertinence for me to congratulate the Minister on having selected Lord Portal, but perhaps I might be allowed to say how we must all congratulate him upon having selected Professor Cockcroft. No better man could be found for this particular work. But I must say that I am a little anxious about the apparent, I do not know whether it is dichotomy or dichotomy in a subject which is in its infancy, as this is. I think: it is probably too early to expect these things to have been sorted out. I under stand there is an Atomic Energy Council under the chairmanship of Lord Portal, and I hope this may be a first step towards securing the directed drive which will be essential if this very difficult project is to come to fruition within a reason able time.
Another point is the question of priority. The work here is realty urgent; every month counts. Can we be assured that its priority is recognized and not overridden by sudden ad hoc decisions. I saw in the war how easy it is for some priority to be granted to meet some special need; such as steel for coal mines, or something like that. But with every ton of material controlled as it is today, such a decision may set back atomic energy work, at any rate, the research side of it, by months, although very small Quantities, a few tons of steel, may be involved.
As the noble Lord who introduced the Bill said, most of its clauses call for very little comment. There is, however, as he said, one totally new departure contained in Clause 11 about which I think I should say a few words. In my view, this particular clause can only be justified by the unprecedented measure of the danger which confronts us. The clause is drawn in very sweeping terms. Roughly speaking, it declares that anyone who, without the consent of the Minister, knowingly communicates anything concerning existing or proposed atomic energy plant, its purpose or method of operation or any processes operated therein, shall be guilty of an offence. When we see the extremely

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broad definition of the word "plant" in Clause 18—namely, "any machinery, equipment or appliance,"—it is clear that if rigidly applied this clause would ham string all discussion or communication, and probably all progress.
The clause, as I understand it, is designed—and properly designed, in my view—to safeguard our vital secrets against three types of indiscretion. In the first place, it is quite possible that individuals might root out a number of secrets by collating indiscretions, cross-examining people who had access to plants, and generally, if I may use the expression, snooping around. Clearly, the publication of that sort of material ought to be prohibited. In the second place, people who have a great deal of knowledge owing to their official connexion with these plants, which they are prevented from disclosing by the Official Secrets Act, might make a perfectly genuine independent invention unconnected with the official secrets, but of great importance in the manufacture or use of fissionable material. Clearly, they should not be at liberty to publish such an invention. Of course, the likelihood of anyone entrusted with these official secrets making such an invention is considerable, but I think we may hope that in general the people in that sort of position would not be likely to disclose it irresponsibly.
Finally, there is the possibility that some person remote from all Government work might, quite independently, in his own laboratory or elsewhere, think out some novel process or plant for producing or using substances important for atomic energy work. That is not very likely, and even if it did happen the odds are that the man would be a decent person who would in the first instance communicate his invention to his own Government. But I really do not think it is wrong to lay down that this is an obligation and to make it plain that failure to do so is an offence. There is, however, no denying the fact that it is a totally new departure. Hitherto, if a man discovered or invented something in his own laboratory or elsewhere, he was entitled to publish it or to communicate it to anyone he pleased. Clause 11 prohibits this as regards discoveries or inventions concerning plant, or methods of operation or processes in plant used or proposed to be used for producing atomic energy.
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This clause, of course, as the noble Lord said, has been subject to a good deal of criticism and it was, I think, even proposed in another place to delete it altogether. I do not myself go so far as this. It is quite true, of course, that anything preventing the interchange of ideas tends to hamper the progress of science, and as scientists we are therefore bound to regret it.
We must not forget that there is another side of the picture. The man in the street will say, not without justice, that the main thing Clause 11 will impede and delay will be the construction of still bigger and still better atomic bombs. As he does not know who is going to get them first he may well consider that such a delay is not entirely a matter of regret. There may be many noble Lords in this House who will agree with him. After all, supposing it became plain that processes might be evolved for producing easily from common substances an absolutely deadly poison, whose use could never be detected, would anybody claim that it should be permissible to publish that sort of knowledge in the newspapers in the interests of science? Some people say, of course, that it will be intolerable for scientists to have to obtain permission to publish discoveries in nuclear physics which might well have a bearing on deference. Of course, it is a nuisance. Every physiologist has to get permission before he is allowed to carry out vivisection experiments, and no doubt he considers that a nuisance and would prefer to do what he liked. Parliament has insisted on certain restrictions on physiologists in order to save unnecessary suffering to animals. Therefore, it seems to me that Parliament is entitled to impose restrictions on physicists for the sake of saving suffering to humanity.
In broad principle, therefore, I do not contest the need for something on the lines of Clause 11. It does seem to me, however, to require certain modifications in wording. As it stands it seems to me that it would completely inhibit any discussion on these matters at all, since any communication to any person requires the consent of the Minister. It is perfectly true that the procedure is laid down by which the Minister can by order grant exemption from this to certain classes of cases. For example, he might exempt cyclotrons or Geiger counters, or a whole

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class of similar instruments. What causes anxiety to my scientific friends and colleagues is that there does not seem to be any mechanism for exempting certain persons from the operation of this clause in the case of highly secret material which has not been exempted under the general clause. Some people hold that this can be done under the clause as it stands. I must say I am very doubtful whether this is correct. In any event, it is by no means evident to anyone who reads the clause, and a great deal of the concern of my scientific colleagues arises, I think, because they read this clause, as I do—namely, as meaning that discussion amongst bona-fide colleagues will be inhibited except in so far as particular topics exempted by the Minister are concerned.
I hope very much that the Government will see their way to relieve this anxiety either by rewording part of the clause or perhaps by adding another proviso saying that it shall not be an offence to communicate to authorized individuals information concerning secret non-exempted material. I hope that the noble Viscount, the Leader of the House, will recognize that this is a reasonable request, and that he will examine with his advisers the possibility of framing some Amendment which would take care of this aspect. This would, I am sure, remove a great deal of the objection felt against this clause in scientific circles.
Perhaps I should refer to one other point. It was suggested in another place that a special committee should be set up by the Bill, whose advice the Minister should hear before deciding certain points. I do not press for this myself. There is such a shortage of nuclear physicists in the country that I am sure that practically all of them will be roped in on one or other of the various committees or panels which have been or will be formed. No Minister in his senses could dream of acting without considering their advice, and I shall be very much surprised if in scientific matters he ever goes against it. In certain circles, especially abroad, there has been a tendency to claim that as the physicists discovered and invented these bombs, they ought to have a predominant voice in determining how they should be handled and what should be done about them. I do not think any reasonable physicist in this country takes
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this view. Indeed, it would be absurd that he should. If a man invented a particularly effective contraceptive, that would not give him the right to decide the country's birth-rate.
My view is that the people who run the country should have some knowledge of science, not that scientists should run the country. As we cannot at this stage count upon this, I think it is very important, especially in a matter of this kind, that the Minister should fortify himself with scientific advice. I am confident he will do so. Although they may be few and far between, there are still enough people in Parliament with sufficient scientific knowledge to make the Minister's life a burden to him if he takes a line in any scientific or technical matter which is repugnant to scientific opinion. On the whole this is a good and necessary Bill. I hope the Government will be able to meet us on the points I have mentioned, and possibly some small Committee points. That being so, I trust the House will give the Bill a Second Reading.
2.56 p.m.
VISCOUNT SAMUEL: My Lords, the purpose of this Bill, as stated by the noble Lord who hs just spoken, is to impose upon the Minister of Supply a general duty to promote and control the development of atomic energy. Those purposes, how ever, are not parallel, and they may be sometimes contrary. The more you promote these developments of atomic energy, the more difficult it may be to control it, and the more strictly you control it the more difficult it may be to promote it. In the short run what we are at present thinking of mostly is control, but in the long run it may prove to be that promotion is for the more important of the two. The term "epoch-making" is often used and abused, and in reference to some quite secondary matters, but literally it may prove that this discovery of the way to utilize atomic energy does open a new epoch, and that the atomic age may be even more different, both in economics and social organization, from the present age as the steam age was from the age of hand labour which preceded it.
The noble Lord, Lord Cherwell, in previous debates was inclined to rate some what low the prospects of any immense economic or industrial development following from the use of atomic energy. He pointed out that in effect it was only

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the substitution of one kind of motive force, one kind of fuel as it were, for another, that this might prove to be more costly than coal, and that in the long run it would have very little effect upon industrial developments. But that view is, I believe, not shared by most of those whose scientific reputation is as high even as that of the noble Lord, Lord Cherwell, and I refer to those who have been specially concerned with this development. There was a conference held in London a few months ago on the subject of science and world welfare, which was organized by the Association of Scientific Workers, in co-operation with other bodies, and enjoyed the presence and co-operation of a number of leading scientists from other countries. I was privileged to receive an invitation. I attended the three-day sittings of the conference and heard all the discussions. Among the principal speakers was Professor Oliphant, who is, of course, one of those most prominently concerned with the development of atomic energy. He said that he thought it was reasonable to anticipate that the practical application of atomic energy—at all events in experimental form—might be achieved within five or ten years. If that is so, and if this motive force is made available practically or experimentally within that comparatively short time, we may be sure that international competition and emulation between different countries, and the immense objects to be attained will bring about its development with extreme speed.
Toil, brute labour, has always been the oppressor of mankind, and the machine has come as the great liberator. The machine, however, depends upon motive force and so long as industries are limited by the considerations of the accessibility of coal or oil or hydraulic power then development must be limited, and some countries or vast areas of countries can hardly be developed industrially at all. The moment you have this new form of energy which can be derived from matter and utilized anywhere you may effect an immense revolution in the industrial organization of the world. And once you have, if you do have, this exceedingly cheap and plentiful motive force anywhere you may be sure that the development of machinery will proceed with extreme speed. All that opens up a prospect for the
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next and succeeding generations of a supply of the necessaries, comforts and amenities of life in abundance, with very much less labour, and gives a prospect of the enjoyment of leisure carried to a point which has never been conceived as possible in previous ages. The amount of energy involved is, of course, quite unlimited. Sir James Jeans a good many years ago pointed out that the amount of energy existing in a piece of coal the size of a pea, if it could all be utilized by scientific methods, would be enough to drive a great liner from Southampton to New York and back again. The power resources of this new force are on that scale.
Here, in this country the only great resource for power that we have lies in our coal, while the other two great empire countries, the United States and Russia, have an abundance of other forms of natural resources for the production of energy which we here have not. It is in the highest degree necessary, therefore, even from a narrow national standpoint, that this motive force should be developed to the utmost in this country. After all, this idea originated here. It came from British scientists such as Thomson and Rutherford in the first instance, and it would be hard if, in the future, as in so many cases in the past, with regard to ideas that have originated here, it should be left to be developed elsewhere and conduce chiefly to the prosperity of other countries.
It should be the object of Ministers of Supply in this country to endeavour to the utmost degree possible to promote the development of atomic energy. Incidentally it is greatly needed also for the sake of research both in physics and in medicine. The essence of scientific progress has always been freedom of communication, the interchangeability of ideas. Secrecy is wholly antipathetic. Therefore, from one point of view any additional restriction is disadvantageous. The Prime Minister, introducing this Bill in another place a few days ago, said:
"The Government must not hinder the freedom of scientists, indeed they must facilitate it."
That is one side of the picture, the side of promotion. But then there is the other side, and the Prime Minister said in the same speech, and quite rightly:
"The Government must have adequate powers of control."

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The terrific effects of the atomic bomb must bring home to every one of us, as a matter of the utmost urgency, that such control, and effective control, is absolutely vital. The Minister of Supply, Mr. Wilmot, in another place, giving an example, said that the release of energy weight for weight of an atomic bomb was a million times greater than that from a bomb filled with such an explosive as T.N.T.
The Government sent a Commission to Japan to make a scientific report on the results of the bombing of Hiroshima and Nagasaki. At the end of that report the Commission summarize the casualties that were inflicted, and they tell us that in Hiroshima the number killed was between 70,000 and go.000 and in Nagasaki about 40,000. 7Fhey mention that during the whole of the six years of the war throughout Great Britain, the casualties in killed in all the air raids totalled 60,000. So that means that in a moment in Hiroshima nearly half as many again were killed compared with the total of fatal casualties in this country throughout the war. They mention also that the German V2 rocket, which was the latest engine of destruction launched against this country, had an average casualty effect of some fifteen killed for each rocket. They estimate that in the conditions of the British towns, the average casualties from an atomic bomb similar to those used in Japan would be about 50,000 from a single bomb. This weapon is now only in its infancy, and there is very little doubt that its destructive effects will be quickly increased if the nations set them selves to that end. Consequently, it is obvious that control and effective control is absolutely vital to the future of mankind. The United Nations Organization has come into existence just in time to be the authority that should endeavour to establish, and let us hope will succeed in establishing, that control. If there is any one matter which is proper for the United Nations to deal with it is this matter of atomic energy.
My noble friend the Earl of Perth drew my attention to the fact that in our debate last week on the subject of the control of defence not a word was said by any speaker—including myself—on the effect on national defence of the discovery of atomic energy. I think that that must have been in the case of most speakers—
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it certainly was in mine—because it is useless at this stage to consider the relation of atomic energy to national defence. We must wait to see whether the United Nations can devise means of establishing the necessary control. If they do then we can make modifications in our plans on that basis. Even if they do, it will still be necessary to maintain ordinary defensive measures by means of the Army, Navy and Air Force and the necessary Governmental organization at the centre. For clearly the atomic weapon is such a terrific weapon that it could not be used for ordinary international police purposes and the general objects for which a defence organization is maintained.
In the United States there has been the most intense public interest and discussion on this matter; far more than in this country. Fresh organizations have been established to carry on propaganda with regard to the matter, which has been discussed in the Press throughout the land. There have also been numbers of committees created, and there have been two admirable reports, the Lillenthal Report and the Baruch Report, which make practical proposals for the control of atomic energy. Those Reports are admirable not only for their practical suggestions but because of the spirit, the regard for human welfare in general which inspires them.
It is clear, therefore, that a Bill of this character is essential. We must have national control, if only as a means of contributing to international control, to honour or enforce any international agreement to which we may become parties. This control is a question of the greatest possible difficulty. I do not know of any Minister who has had a more difficult task thrust upon him than that of drafting a Bill which will on the one hand establish adequate control and yet not interfere with the proper development. Plants now in use for the production of atomic bombs are, as we all know, vast and necessarily conspicuous, but it may be that the processes will be greatly simplified. In fact, that is generally anticipated by scientists—perhaps "generally" may be an exaggeration; it is certainly anticipated by some scientists.
The raw materials are now somewhat rare; certainly that is true of the isotopes of uranium and thorium and other rare substances. But theoretically it can be derived from almost any elements, and it

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may be that in the future entirely different methods, much simpler and less conspicuous, will be adopted. In another place, the Minister of Supply said that he had been advised that "it may prove, later on, not to be necessary to use the nuclear fission method at all, and we may find means to liberate atomic energy by different methods altogether." That may make control even more difficult than it is at this moment. When we discussed this matter very briefly a year ago, soon after the discovery of atomic energy and its use, I raised the question of the establishment of world-wide inspection of the plants. The noble Viscount, Lord Addison, who replied in that debate, rather brushed that aside and said that it was not practicable in any circum stances.
VISCOUNT ADDISON: I do not think that I said "in any circumstances."
VISCOUNT SAMUEL: The noble Viscount said that we must depend upon the goodwill and the sense of obligation of the foreign countries. Now, as the noble Lord, Lord Cherwell, said, I think it is realized that inspection is the very essence of the matter. But if you are to have inspection with a view to detecting the illicit or unauthorized manufacture of atomic bombs and similar weapons, is that inspection to extend to the ordinary military establishments of the country, all the dockyards and the industrial establishments which are concerned with the manufacture of submarines, aeroplanes, artillery rockets, and all the instruments of war? In other words, will the agents of other countries be admitted into the most secret military engineering establishment of any other country. If they are, that may be regarded as a serious invasion of national sovereignty. If they are not, how can the world at large be assured that illicit manufacture is not being carried on in the more secret establishments? That is a problem of very great difficulty, which I have not yet seen discussed. It is quite obvious that when the United Nations come to deal with this matter it is one of the first issues which they will be obliged to investigate. We shall all watch with extreme anxiety the course of discussions on this question when it comes before the United Nations.
These two purposes, one of promotion and the other of control, are cross-
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purposes. They are dealt with in Clause 11 the Bill, to which the noble Lord, Lord Cherwell, has referred. That is the clause which deals with the restriction of disclosure. That has been discussed at great length, both in another place and outside Parliament, and various changes were made in the Bill as it was first drafted, in order to meet criticisms from the standpoint of the scientist. The noble Lord, Lord Cherwell, said that control was somewhat resented by the scientist. Yet control must be drastic, if it is to be effective. Even in such matters as putting down illicit stills or stopping smuggling laws have to be drastic, and the penalty has to be heavy. Here, the difficulty is far greater and the possibilities of evasion are far more formidable than in any other case. It is true that this clause imposes a penalty of five years penal servitude for wrongful disclosure, but scientists concerned an always go to the Minister to obtain permission for communication.
The Minister has given undertakings in another place which I have no doubt will be given here—that he will not interfere with the normal work of the physicists who are discussing the problems that arise here. Indeed, the clause itself does impose very strict limitations upon the Minister, and it seeks to guarantee, so far as possible, that pure scientific investigation shall not be unduly hampered. As I have mentioned, the Prime Minister himself has said that the Government must give to the scientist the greatest freedom, consistent with national and international safety. These are matters which will, no doubt, be dealt with in Committee, when we come to Clause 11. For the rest, I have no points of detail to raise, and nothing further to add. I am certain that your Lordships will give to this measure on Second Reading a unanimous assent.
3.18 p.m.
VISCOUNT ADDISON: My Lords, may I add a few words, particularly with regard to the comments and questions of the noble Lord, Lord Cherwell? I will not follow the noble Viscount, Lord Samuel, into his discourse on the character of this danger, and what may be involved in this Bill and the international obligations which everybody will have to assume if we are to be successful in restraining the dangers. I was, however, struck by one phrase which the noble Viscount used, and to which I cannot resist referring. I do so with considerable

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trepidation, because the noble Viscount is much more learned in philosophy than I am. I noticed that he said "toil has always been an oppressor of mankind." I am not a philosopher, but I know something about physiology, and I do not agree with him at all. I have found that if had not dug in my garden, and done a little useful work whenever I had a chance, I should not be as healthy a man as I am at my age. I will refrain, how ever, from discussing that.
VISCOUNT SAMUEL: You might not feel the same if it were for ten hours a day for 350 days a year.
VISCOUNT ADDISON: It is only a question of the amount; that would be excessive toil. I should have said that toil was an essential part of human physiology. If you do not exert yourself, you will not live very long. However, I will not go into that fascinating theme.
I thank noble Lords for the general welcome which I am sure that the Bill will receive. I have spent some consider able time going into the points which the noble Lord, Lord Cherwell, informed me beforehand he would raise, and I may say that I have very much sympathy with him. First, it is quite evident that the ordinary rules regarding the employment of the high experts and scientists who will be required for this work could not be rules which would be applicable to the ordinary procedure of the Civil Service Commission. I entirely agree. It is manifest that that would have to be so. Also the number of men who would be sufficiently expert is very small. I am informed that the total number that might be expected to be required within the near future is quite small. I will not give it. It is evident, if you are waiting to recruit a physicist or other person who is already eminent in some branch of work, that you cannot expect him to come into this work without receiving a security as good as any he had before. You cannot expect a man of that kind to go through, and com ply with, all the regulations of the Civil Service Commission.
As a matter of fact, I heard a story of one of the chief professors employed in Canada, who voluntarily submitted to the Civil Service Commission examination. He was, as a matter of fact, the head of the whole thing, but he came out bottom in the examination! That is an
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excellent illustration of the fact that regulations of this kind are not applicable to such appointments. I will say this. Matters are now being discussed between the Civil Service Commission, the Treasury and the Minister, and I hope that when the Bill reaches Committee I shall be able to give the noble Lord a detailed and explicit assurance which would completely satisfy him on this matter.
On the point of secrecy, there again I have great sympathy with the views ex pressed. The provisions about secrecy cannot be interpreted in such a way as to make it a crime for one roan in a laboratory to discuss freely with another man in a laboratory; that would be stupid. Nor can we restrain proper research and discussion of a bona-fide character where-ever it may be. We have given some considerable thought to this matter, too, and, as the noble Viscount, Lord Samuel, pointed out, the provisions in Clause 11 are very generous in their scope, and, on the whole, we should be inclined to think that they would provide adequate safe guards as they are. We are very anxious that scientists should be reassured, and I am hoping—I trust the noble Lord will not press me any further to-day—that, when we get into Committee, I shall have a suggestion to make, perhaps in the form of a further proviso, which will really cover the point he ha; in mind. But I am quite sure that we are all desirous of reassuring scientists that they will not be liable to petty persecution for bona-fide conversation or anything of that sort. I think I shall be able to meet the noble Lord's point when we get to the Committee stage.
LORD CHERWELL: I thank you very much.
On Question, Bill read 2a, and committed to a Committee of the Whole House.

NATIONAL HEALTH SERVICE BILL.
House again in Committee (according to Order):
[THE EARL OF DROGHEDA in the Chair.]
Clause 42, as amended, agreed to.
Clause 43:
Powers of Minister where services are inadequate.
43. If the Minister is satisfied, after such inquiry as he may think fit, as respects any

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area or part of an area of an executive council that the persons included in any list prepared under this Part of this Act—

(a) of medical practitioners undertaking to provide general medical services;

(b) of persons undertaking to provide pharmaceutical services; or

(c) of dental practitioners undertaking to provide general dental services,

are not such as to secure the adequate pro vision of the services in question in that area or part, or that for any other reason any considerable number of persons in any such area or part are not receiving satisfactory services under the arrangements in force under this Part of this Act, he may authorize the executive council to make such other arrangements as he may approve, or may himself make other arrangements, and for the purpose of such other arrangements he may dispense with any of the requirements of regulations made under this Part of this Act.
3.25 p.m.
LORD LLEWELLIN LORD LLEWELLIN moved to leave out "and for the purpose of such other arrangements he may dispense with any of the requirements of regulations made under this Part of the Act," and insert "provided that such other arrangements are within the authority conferred by this Act or any amendment thereof." The noble Lord said: My noble and learned friend Viscount Simon is unable to be here this afternoon; he is detained on an official engagement. Therefore, I beg leave to move the Amendment that stands in our joint names.
If your Lordships will look at Clause 43, you will see that it says:
"If the Minister is satisfied … as respects any area … that the persons included in any list prepared under this Part of this Act … are not such as to secure the adequate provision of the services in question … he may authorize the executive council to make such other arrangements as he may approve or may him self make other arrangements."
With that we should all be in complete agreement. But when the clause goes on to say:
"and for the purpose of such other arrangements be may dispense with any of the requirements of regulations made under this part of this Act."
then, in the view of some of us, that is going a bit too far. Because, after all, what would be the effect of that? As the Bill is drafted, there are provisions in it for regulations to be made which, in some cases, have to have the affirmative assent of each House of Parliament. In all the other cases they are liable to
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be negatived by Resolution in either House of Parliament.
And, of course, if these words are left exactly as drafted, the effect is that the Minister, if the arrangements were not thought adequate under the regulations, could quite well make a new regulation. There is nothing whatever to prevent his doing that, but, it seems to us to be a little steep that when perhaps the regulation has received the assent of each House of Parliament, the Minister should have power, the next week, if he likes, to alter that regulation. Surely the proper thing would be for him to come down and present to each House of Parliament a new regulation which would cover the point.
I fancy that these words may be rather wider than those who are sponsoring the Bill would wish them to be. Draftsmen are admirable people and they like to make the whole thing as watertight as possible. That is the reason why my noble and learned friend and I have put down an Amendment to leave out from "arrangements" to the end of the clause and to insert instead:
"provided that such other arrangements are within the authority conferred by this Act or any amendment thereof."
That is our Amendment. I am not particularly wedded to its wording, but I do think, and I hope that the Government will think, that the words in the Bill as drafted are too wide for their purpose. Nobody will disagree that the Minister should make adequate arrangements. It is only a question of the method he ought to adopt. The Minister ought not to adopt a method which might allow him to go right outside the provisions of this Bill or right outside regulations assented to by both Houses of Parliament. For those reasons I beg to move.
Amendment moved—
Page 39, line 36, leave out from ("arrangements") to the end of the clause and insert the said new words.—(Lord Llewellin.)
VISCOUNT MAUGHAM: I want to support this Amendment in a very few words. I have spoken with my noble and learned friend Lord Simon, who is, unfortunately engaged in public duty at the present moment, and he is strongly of the opinion that the words at the end of Clause 43 would have an effect which, as my noble friend Lord Llewellin has said, could not have been intended. It cannot be right

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that, inasmuch as regulations under the Act have to be made pursuant to a number of requirements, the Minister who makes them can under the provisions of Clause 43, if he thinks fit, without the authority of Parliament given either by a negative or by a positive Resolution, disregard—the current word is "scrap"—all the requirements which have been laid down under the Act and can do anything he pleases. Accordingly I support the Amendment which my noble friend has proposed.
THE MARQUESS OF READING: May I add one word in support of this Amendment? We are entirely in favour of as much elasticity as necessary being given to the Minister charged with carrying out the scheme proposed by the Bill, but this is really elasticity run riot. There must be some modification of the present words be fore we can entrust to any Minister the power to ride roughshod over regulations made under the powers contained in the Bill.
THE POSTMASTER-GENERAL (THE EARL OF LISTOWEL): I think it would be as well to explain to the House the exact situation which the Minister had in mind when he included these words in Clause 43 which the noble Lord opposite is moving to omit. He is asking for an emergency power to meet certain exceptional circumstances. What sort of circum stances has he in mind? There might be, in a remote part of Wales or Scotland or in some remote country district in Eng land, an area without any dentist at all. In such an event the Minister would either himself or through the executive council have to supply a whole-time salaried dentist to serve the people living in that neighbourhood. He cannot do that by making a regulation under the Bill. I should like to emphasize the fact that this emergency power would obviously not be used except on the rarest occasions and would be limited to this specific purpose. I should also like to point out to the noble Lord that a provision of this kind is not without precedent. It has existed in a slightly different form for the past thirty-five years in relation to national health insurance. I do beg the noble Lords not to look at this thing from the point of view of giving the Minister arbitrary power to act without the authority of Parliament. That is not what is intended. It is solely desired by this provision, in the clause to
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enable the Minister to fill a gap which might occur in the health service.
LORD LLEWELLIN:I am afraid I do not quite follow the noble Earl's explanation. To take the instance he quoted, that if there was no dental practitioner in a particular area the Minister could not supply him by regulation. Of course he cannot because he would have to find a dentist and get him to go there, but I do not see that in order to get a dentist to go there he would have to dispense with any requirements of any regulation under this Bill. Of course the executive council ought to be able to make this known. It would be part of its function to do so. I cannot conceive why these last words overriding the regulations under this Bill are necessary if it is merely to see that there are enough medical officers or enough chemists or enough dentists in a particular area. I do not know what regulations you would have to get them there, but surely the regulations would all be designed to get the people there.
VISCOUNT MAUGHAM: May I add one word because the noble Lord, the Leader of the House, is going to reply and I want to say something for him to deal with? To my mind, speaking for my self, what I think is so dangerous in the last few words in Clause 43 is that the House of Commons and this House have no authority whatever to object. If the state of emergency which my noble friend Lord Listowel has mentioned arises it would be quite right that power should be given to the Minister to deal with the matter as one of emergency. If that were done it might be done under regulations which would be subject to the approval of each House of Parliament under Section 74. If you will give the Houses the right to criticize and, if necessary, to suggest Amendments in these emergency regulations, that would pacify most of us in this House. Where the regulations might extend beyond some thing previously authorized in the Bill and leave it entirely to the Minister with out enabling Parliament to express an opinion, that seems to me to be entirely wrong. I will only add this. There is nothing in the clause which seems to make the power one only exercisable in the case of an emergency. The word "emergency" does not occur in the clause and under this clause as it stands some thing might be done by which the Minister

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would authorize an executive council to make arrangements which might last for half a century.
VISCOUNT ADDISON: I was going to make a suggestion which I hope will meet your Lordships. I quite recognize the misgivings that these somewhat comprehensive words promote. The illustration which my noble friend gave is quite right because the Minister can only make regulations in accordance with the powers conferred on him under the Bill. In the appointment of a whole-time dentist he has no power in the Bill and could not do anything of that kind by regulation. However, I am very anxious to meet the misgivings of the noble Lord if we can, and the point he has raised is that these powers are very comprehensive. They enable the Minister to dispense with the requirements of regulations made in this Part of the Bill. What is desired is that he should be able to take action to deal with a particular shortage or emergency that has been discovered. I think we might perhaps consider whether we can frame words on Report which would meet the needs of this particular emergency other than by general application. That is really what is wanted. If the noble Lord will allow us to look into it, I hope he will withdraw the Amendment on that understanding.
LORD LLEWELLIN: I am very much obliged to the Leader of this House. Of course I will withdraw. Nobody wants the Minister not to have the power to deal with an immediate emergency of this sort. We certainly would be glad to avail our selves of his offer to look into the words and to meet us.
Amendment, by leave, withdrawn.
Clause 43 agreed to.
Clause 44 [Recovery of charges in respect of certain appliances and dental treatment]:
3.33 p.m.
LORD LLEWELLIN LORD LLEWELLIN moved to add to the clause:
"(3) Regulations may provide that a person providing general dental services who, with the full knowledge and consent of the patient renders treatment or provides appliances at a cost in excess of the prescribed charges, shall receive a grant equivalent to the amount of the charges prescribed for corresponding treatment and appliances upon satisfactory proof of services rendered and appliances provided in accordance with such regulations."
The noble Lord said: My noble friend Lord Teviot cannot be in the House, and he has asked me to move this Amendment, which is to insert the words on the Order Paper. As I understand it, this Amendment means that as all of us will be contributors under the scheme, which, among other things, will entitle us, if we reasonably require them, to false teeth, we shall be able to get the teeth we want. People have to have utility sets of false teeth, as they have had utility furniture and utility other things during the course of the war. Some people may like to have, and reasonably like to have, the teeth in perhaps a colour to match the ones on their left wing, or some detail of that sort. For that reason they go to the dentist and say: "I would like not just this utility set, but something a little better." If the dentist says he can supply what is asked for, this Amendment purports to say that, although the patient who wants this extra refinement, if it can be called a refinement, naturally has to pay the extra, he should be able to get the grant in aid to cover what the utility set, if I may so call it, would have cost.
That is the point of the Amendment. I do not think we want everybody going around looking quite the same, whether in the matter of teeth or in any other respect, because that would make us a very dull-looking nation. The people who want the small extra should be able to get the grant in aid to such an amount as the set would have cost if they had not wanted that particular refinement. That is the purport of the Amendment, moved perhaps on behalf of the large number of people who have been subscribers to these health schemes and rightly ought to have that little consideration. I beg to move.
Amendment moved—
Page 40, line 15, at end insert the said new subsection.—(Lord Llewellin.)
THE EARL OF LISTOWEL: I think if the noble Lord reads the clause carefully he will see that his point is already met. The clause provides for regulations permitting the dentist to make additional charges for (1) expensive appliances, which I imagine would include a luxury set of false teeth; and (2) such special dental treatment as may be prescribed—if, for instance, a person desires a gold filling. What happens in that case is that the dentist is authorized to make the

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extra charge which covers the cost of the article or treatment and the additional cost is recovered from the patient; but the cost of the standard treatment or appliance is recovered by the dentist from public funds. That is what is proposed under the clause, which is, I think, precisely what the noble Lord requires. The Amendment to which he is speaking in fact goes very much further, but if the noble Lord does not wish to support the Amendment as it stands I will not weary your Lordships by replying to it.
LORD LLEWELLIN: If the noble Earl assures me that it is already achieved in the wording of the Bill, I am quite content.
VISCOUNT CRANBORNE: Could the noble Earl say exactly where it is?
THE EARL OF LISTOWEL: It is sub section (2) of this clause.
LORD LLEWELLIN: The words are, "may be…recovered by the person providing the services." Does that mean recovered from the funds or recovered from the patient? That is the point.
THE EARL OF LISTOWEL: What is recovered from the funds is the standard cost of the standard treatment or appliance. That is, so to speak, the utility treatment which every one will get. If they want luxury treatment they will have to pay for it out of their own pockets, and the cost of the luxury treatment is recovered by the dentist from the patient.
LORD LLEWELLIN: I beg leave to withdraw the Amendment.
Amendment, by leave, withdrawn.
Clause 44 agreed to.
Clauses 45 to 47 agreed to.
Clause 48:
Provision of courses for medical and dental practitioners.
48. For the purpose of affording opportunities for practitioners providing any ser vices under this part of this Act to keep themselves informed of the latest developments in professional knowledge, the Minister may enter into arrangements with universities, medical schools and dental schools, and any other persons for the provision of courses which such practitioners may attend, and may, with the approval of the Treasury, make payments towards the cost of the provision of such courses and the expenses of practitioners attending such courses.
3.45 p.m.
THE MARQUESS OF READING THE MARQUESS OF READING moved, after "Act," to insert "and for nurses employed in connexion with services pro vided under any Part of this Act." The noble Marquess said: This clause, as your Lordships will observe, makes arrangements for the provision of courses for medical and dental practitioners. No doubt those practitioners will be grateful for the appearance of that clause in this Bill, because it will enable them to keep themselves up to date and to exercise the highest degree of skill and efficiency in the interests of their patients. Those practitioners would surely be the first to agree that their skill, and consequently their reputation and the recovery and comfort of their patients, depends to a very large extent upon the quality of the nursing service which is available for the assistance of the doctors themselves and for the actual direct care by the nurses of the patients. It cannot be expected that the nurses will maintain their standard of efficiency unless they too are given the chance to bring themselves up to date and to keep themselves up to standard by attending such courses as may be made available.
The purpose of this Amendment is the very simple one of including within the scope of the provisions for brining and keeping up to date the knowledge of medical practitioners a similar provision embracing the nursing service. I am encouraged in putting down this Amendment by the sight immediately following it on the paper of an Amendment in the name of the noble Lord, Lord Horder, who can speak on these matters, and I hope will speak on them, with far greater knowledge and experience than I can. However, I suggest that it is right in principle and it is something which not only would be welcomed by the nurses but to which they are entitled. If it seems to the Government representatives that the Amendment would not be most happily contained in this particular clause and could better be inserted in some other part of the Bill, that is a matter to which I attach no particular importance, but that it should appear at some point in this Bill I do think is of real moment to the nursing profession. I beg to move.
Amendment moved—
Page 40, line 44, after ("Act") insert ("and for nurses employed in connexion with

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services provided under any Part of this Act").—(The Marquess of Reading.)
VISCOUNT MAUGHAM: I rise only to point out that it is purely permissive. If the Minister does not like to do it be need not do it. It simply gives him the power.
LORD HORDER: As the noble Marquess indicated, I am entirely with him in this Amendment; indeed, I think it is possible that if this Amendment were allowed, or some assurance equivalent to it were given, I need not move the Amendment which stands in my name. However, this does give me the opportunity of endorsing what the noble Marquess has said, and what we all surely know, in respect of the importance attaching to the nurse's work. Next to the doctors it will be the nurses upon whom the success of working this scheme will fall. It has struck many of us that there is totally inadequate reference to the work of nurses throughout this Bill. It is assumed that there will be a standing advisory committee in respect of nursing and regulations will no doubt be framed which deal with the nurse's contribution to the working of this scheme. All the same, bearing in mind the very great importance attaching to the nurse's contribution and the fact that here was one place at least where reference could be made to the nurse's training I was emboldened to put down the Amendment which follows that of the noble Marquess. The nurse is very keen upon her training; she is as keen upon being kept up to date with her work as is the doctor himself.
When this matter came up for discussion in another place the Minister—who was, I think, very tired and perhaps a little provoked, if I may judge by the context—said that this matter would adjust itself quite easily because there was always the hospital for the nurse to go back to "The hospitals are there," said the Minister, "and if a nurse wishes she can go into a hospital; there is no reason against it." That is a totally in adequate means of dealing with this very important question of the post-graduate training of nurses. At this moment there are courses for the training of nurses prepared under the aegis of authoritative in situations such as the Royal College of Nursing.
I know that the Minister was sympathetic towards the opticians in this respect, because, being pursued through
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this mood of aggravation by some dominant person on behalf of the opticians, he said, "I will look into this thing again"—"this thing" being the question of opticians being included amongst those practitioners rendering hospital services whose post-graduate (if I may use that word in respect of the opticians) studies should receive some attention. If the Minister can be sympathetic towards the opticians, I think he can be as sympathetic, if not more sympathetic, to wards the nurses. Although I am perfectly willing to leave the question of whether my Amendment is adequately dealt with by the noble Marquess's Amendment to the noble Viscount or the noble Earl, I do press that in this clause a specific reference should be made to the help which the Minister can give in the matter of refresher courses and other training studies for the qualified nurse.
VISCOUNT ADDISON: This short discussion has caused me to reflect how badly the Government are treated. For the first time in my life, here is the State going out of its way to make provision for medical men to have post-graduate training and to get refresher courses, and not even one noble Lord says, "Thank you." It is amazing! In our view, London offers a unique opportunity for developing post-graduate training. There is no place in the world which has equal facilities, and it is our intention to do whatever we can to help the medical profession and the teaching colleges so to develop. That is one of the reasons why this clause is in the Bill. I should have thought it would have evoked some sentiments of appreciation. But it has not, and that shows how badly our Public Relations Department seems to function! The only thanks we get is that we are asked to do something more.
LORD HORDER: The noble Viscount says the Government have not been thanked. I should like to repair that omission in order that more can be accomplished.
VISCOUNT ADDISON: These belated thanksgivings rather lose their spice! However, I will take it as read. Nurses are different from the practitioners dealt with in Part IV of the Bill. The practitioners under Part IV of the Bill are those who are paid, notwithstanding the Amendment yesterday, partly, I hope, by

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basic salary and partly by capitation fees. But however they may be paid, they are not whole-time servants and it is in order to help men who are not whole-time servants to get this training that this provision is inserted. Those who are whole-time servants, such as nurses and any medical men who are employed whole-time, will be provided with facilities and will be expected to undergo regular refresher courses. That is a very proper condition of the tenure of office of people of that kind.
What the noble Marquess is referring to is the nurses who are whole-time servants and who are not the type of part-time person meant to be helped by this provision, and who will in fact be helped. I can assure him that in the ordinary way it is the intention that those who are full-time employees of this character will be required to have refresher courses and that the same facilities will be made available for them. So far as this particular Amendment is concerned, it relates to a clause dealing with medical practitioners under Part IV of the Bill who are part-time and not employed whole-time. It is in order to assist that class of person that this provision is made. Therefore the noble Marquess's Amendment really is not appropriate, but the spirit of it will be carried out just the same.
THE MARQUESS OF READING: I confess I am much more concerned with the spirit than with the actual wording of the Amendment, and as the noble Viscount, the Leader of the House, gives us an assurance that it is the intention to provide adequate courses for the whole-time, fully-employed nurse, I do not propose to press this Amendment.
Amendment, by leave, withdrawn.
3.58 p.m.
LORD HORDER LORD HORDER moved at the end of clause to insert: "(2) For the purpose of this clause 'practitioners' to include certain classes of nurses not otherwise covered in this respect." The noble Lord said: I am not satisfied that the purpose of this Amendment is covered by the assurance given by the noble Viscount, the Leader of the House. The noble Viscount speaks of the provisions for medical practitioners referred to in Clause 48, which is the clause under discussion, but it will be noted that Clause 48 refers to "practitioners" and not to "medical
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practitioners." There is obviously an intention to distinguish between practitioners and medical practitioners, because Clause 48 is to some extent consequential upon Clause 43, which refers to three classes of persons rendering services. The first is the medical practitioner, the second is the person undertaking to provide pharmaceutical services, and the third is the dental practitioner, who may or may not be a qualified medical man.
Coming back to Clause 48, it is quite obvious that it is not only medical practitioners to whom facilities are to be given for post-graduate teaching. That is all the more necessary, I think, especially as I referred to the half promise which the Minister made to include opticians amongst these practitioners providing any service under this Part of the Bill. The possibility of opticians being included with dispensers and dental practitioners makes it, I think, all the more important that a distinct reference should be made in this clause to similar facilities being afforded to nurses. I beg to move.
Amendment moved—
Page 41, line 7, at end insert—
("(2) For the purpose of this clause 'practitioners' to include certain classes of nurses not otherwise covered in this respect.").—(Lord Horder.)
VISCOUNT MAUGHAM: I rise to support this Amendment and to add one word in reference to the clause itself. The clause provides that:
"the Minister may.… with the approval of the Treasury, make payments to wards the cost of the provision of such courses and the expenses of practitioners attending such courses."
That will enable provision to be made for the cost of doctors and dentists in relation to their expenses of attendance. Unless the Amendment proposed by my noble friend Lord Horder is accepted, the Treasury cannot make payment towards the cost of expenses of nurses attending such courses, however specialized the nature of their occupation may be and how ever desirable it may be that they should have the instruction to be obtained from such courses.
VISCOUNT ADDISON: We shall look into the question of definition raised by the noble Lord, but this relates to "practitioners"—however that word may be subsequently defined—who are not wholly employed, but who are partly employed—
VISCOUNT MAUGHAM: What makes it so limited?
VISCOUNT ADDISON: Do allow me to finish my sentence.
VISCOUNT MAUGHAM: I apologize humbly to the noble Lord for interrupting him, but when he is saying something as to the effect of a clause which seems to me, with all my experience of construing documents of this sort, to be inaccurate, the kindest thing I can do is to interrupt him there and to say that I humbly submit he is wrong. I am very sorry if it annoys him, but I think it is part of my duty.
VISCOUNT ADDISON: The noble Viscount did not in the least annoy me, and I am sorry if it seemed that I was annoyed, but I was, I thought, half way through a sentence. I accept, of course, that the noble Lord is infinitely more expert than I can ever hope to be in construing these documents, but I am advised that the word "practitioner" here relates to those who are employed part time under Part IV of the Bill, and the scope of the word will require to be defined. You will notice it says in the margin, "medical and dental practitioners." In any case, it clearly does not include nurses who are employed whole time by any board or hospital management committee; they are not included in this part of the Bill at all. As I have already assured noble Lords, the provisions of engagement for that type of person will be that they are required to have refresher courses periodically, and that will be carried out in a bona-fide manner. I think that really meets the point.
LORD HORDER: I would like to ask if I am not correct in saying that "medical and dental practitioners" in the margin is a misprint, and that it should be "provision of courses for practitioners." I was informed that "medical and dental" should be deleted.
VISCOUNT ADDISON: That may be so. As I have promised, I am going to look into this question of definition, and I will certainly do so, especially in the light of the admonition of the noble Lord below the gangway.
LORD HORDER: I am very reluctant to withdraw this Amendment, because I think there is still a good deal of confusion. If I could be assured that on
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the Report stage some of this confusion would be cleared up, I should perhaps be more willing to withdraw the Amendment. The confusion to which I have already referred, and would refer again, is the use of the term "medical practitioners" in some clauses and "practitioners" in others. As I say, I was informed that "medical and dental practioners" in the margin is a misprint, from which I conclude that recognition is given to practitioners who may not be medical practitioners but who are persons rendering services under the Bill. At present those practitioners not registered include a good many dentists and, I presume, most dispensers and persons undertaking to provide pharmaceutical services. Possibly when the Minister thinks again, as he has promised to do, he will include opticians. In view, therefore, of the building up of that group of non-medical persons rendering services under the Act, if that group still remains and is referred to in Clause 48, I think my Amendment should stand. But if this point could be brought up again at a later stage I am prepared to withdraw the Amendment.
VISCOUNT ADDISON: I can quite see there is confusion in the use of the word "practitioner," and I think it ought to be cleared up.
LORD HORDER: That is all I wanted to establish. I beg leave to withdraw my Amendment.
Amendment, by leave, withdrawn.
Clause 48 agreed to.
Clauses 49 to 52 agreed to.
Clause 53:
Grants to local health authorities.
(4) The council of every county and county borough, the Common Council of the City of London and the council of every metropolitan borough shall pay to the Minister in respect of the period beginning with the appointed day and ending with the thirty-first day of March next following, and each subsequent period of twelve months during the third fixed grant period within the meaning of the Local Government Act, 1929, a sum equal to the loss on account of the grants mentioned in paragraph 2 of the Second Schedule to the Local Government Act, 1929, discontinued by virtue of Section eighty-five of that Act, as determined in accordance with Part II of the Fourth Schedule to that Act, less such part of that loss as is attributable to grants for the welfare of the blind:
Provided that—

(a) where the said loss on account of the said grants has, in the case of the council of any county or county borough, the Common Council of the City of London or the council of any metropolitan borough, been increased or reduced by an amount certified by the Minister under regulations made under paragraph (b) of subsection (1) of Section one hundred and eight of the Local Government Act, 1929, the payment to be made by the council under this sub section shall be increased or reduced by such part of the amount so certified as is attributable to the said grants other than grants for the welfare of the blind;

(b) in the case of a county or county borough or metropolitan borough constituted since the thirty-first day of March, nineteen hundred and twenty-nine, the amount to be paid by the council thereof under this section shall be the amount certified by the Minister under the said regulations as the loss of that county or county borough or metropolitan borough on account of the said grants, less such part of that amount as is attributable to grants for the welfare of the blind;

(c) if the said third fixed grant period ends during the period beginning with the appointed day and ending with the thirty-first day of March next following or during any subsequent period of twelve months, the payments to be made by councils under this subsection in respect of that period shall bear the same proportion to the sums that would be payable in respect of a complete period of twelve months as that period bears to a complete period of twelve months.

4.8 p.m.
LORD ADDINGTON LORD ADDINGTON moved to leave out subsection (4). The noble Lord said: This is an attempt to see that the interim financial provisions of subsection (4) of Clause 53 are deleted and replaced by something which is a good deal simpler and much more generous to local authorities. I understand that the Government hope the new block grant arrangements will be in operation before the appointed day for the National Health Service Bill. Therefore, the interim financial provisions of subsection (4) will not be brought into operation at all. In that event this Amendment would not apply. But it does seem necessary to have a clause of some sort in the Bill in case it may not be possible to keep the time-table which the Government have in mind.
The serious objection to the present proposal is that in some areas of low financial resources the hospital facilities are not highly developed. It follows, therefore, that reduction in their rate of expenditure will be correspondingly small when the hospitals transfer to the Government.
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On the other hand, the block grant is weighted somewhat heavily in favour of those poorer local authorities. Therefore, any major reduction in the block grant I think will accordingly fall with particular severity on authorities who are really least able bear it. If, therefore, there is to be some adjustment the local authorities do suggest that it should be one which does substantial justice to all the parties affected. If there is to be an interim period it will be very short. It is suggested that it would have been a generous gesture and one which would perhaps bring some financial benefit to the local authorities if the Government had been prepared to ignore the fact that there was reflected in these block grants during the interim period some assistance towards the rate-borne expenditure which would no longer fall on the local authorities. This course would have avoided much work and many calculations. These block grants are very complicated and they are by no means easy to work out. That is what my Amendment proposes. I have rather gathered that the matter is still under discussion between the representatives of the local authorities and the Government, and I hope, there fore, that noble Lords opposite will be able to obtain some more satisfactory arrangement than the one which is at present in force.
Amendment moved—
Page 4, line 40, leave out subsection (4).—(Lord Addington.)
THE EARL OF LISTOWEL: The object of the subsection in Clause 53 which the noble Lord wishes to leave out, is to prevent local authorities from being paid twice for the same service. That, I think, puts the position in a sentence. A sum equal to the total amount of the old specific grants towards the health services which were discontinued by the Local Government Act, 1929, is included in the present block grant. There will be again under this Bill a specific health service grant towards the health services run by the local authorities, and those authorities would clearly be receiving double grant during any period in which both the new grants under the Bill and the existing block grants were being paid. If this should happen it seems only common sense that they should be asked to pay back the additional amount. We hope, as the noble Lord said, that this Bill and

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a Bill terminating the old block grant will come into force on the same date. In that case the subsection which he wishes to leave out will not be operative. But we do wish to keep it in the Bill because if the time-table were to go wrong the Exchequer would lose a sum of something like £4,000,000 a year. I should have thought that the proper procedure if certain health authorities feel that they are not receiving enough would be to negotiate with the Ministry with a view to new grants being made.
LORD ADDINGTON: The proposition is that under the clause some of these small authorities have to pay back a lot more than they are saved. Whether it is possible to adjust the amount so that what they pay back in respect of block grant is not greater than the amount they are saved on their services is a matter which I suggest should receive consideration. I think that a great deal of work and calculation would be saved if something could be done in this connexion.
THE EARL OF LISTOWEL: I think it is certainly a matter for discussion between the authorities concerned and the Ministry.
LORD ADDINGTON: In view of what the noble Lord has said I beg leave to withdraw my Amendment.
Amendment, by leave, withdrawn.
Clause 53 agreed to.
Clause 54:
Payments to Regional Hospital Boards, boards of governors, executive councils and other bodies.
54.—(1) There shall be paid out of moneys provided by Parliament to—
(b) every board of governors of a teaching hospital such sums as may be necessary to defray the expenditure of the board being expenditure approved as aforesaid.
4.15 p.m.
THE EARL OF MUNSTER THE EARL OF MUNSTER moved, at the end of subsection (1) (b), to add "by means of block grants based on an annual budget." The noble Earl said: This is a very simple Amendment. Clause 54 provides that there shall be paid out of moneys provided by Parliament to "every board of governors of a teaching hospital such sums as may be necessary to defray the expenditure of
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the board," as aforesaid. I want to amend that so as to provide for the payment to the boards of governors of teaching hospitals of the necessary finance by means of block grants based on an annual budget as was suggested in the White Paper. It seems to me that freedom to spend within the budget would ensure a very much easier way of going about the matter. It would also avoid frequent references not only to the Minister but also to the Treasury. I think it is the intention of the Government to do this but instead of having it done by regulation I would myself much rather see it put into Clause 54.
Amendment moved—
Page 46, line 4, at end insert ("by means of block grants based on an annual budget").—(The Earl of Munster.)
THE EARL OF LISTOWEL: I think that the object which the noble Earl and the Government desire to achieve is the same, and the only matter about which they differ is the best way of achieving it. We have already accepted the principle laid down by the noble Earl. It is the intention of the Government that the finances of the boards of governors of teaching hospitals (and, incidentally of hospital management committees) should be based on an approved annual budget within which they would have complete discretion to spend as they thought fit. In other words, the hospital authorities would be free to allocate their income to purposes of their own choosing so long as they adhered reasonably closely to their annual budget. I am not saving that one of them might not overspend to a small degree in a particular year or that in another year they might not spend slightly less, but that would be the frame work within which they would work. We consider that our procedure is more proper. Arrangements for the preparation and submission of these budgets will be extremely complicated, and instead of overloading the Bill with detail, we think that it will be more convenient to deal with the matter in the regulations to be made under subsection (6) of this clause. I assure the noble Earl that regulations are really more convenient when the matter is one of great complexity and detail. And the Bill would become extremely voluminous and unwieldy if we were to put all these matters into the actual wording of its clauses.
THE EARL OF MUNSTER: I cannot say that I agree but nevertheless I will withdraw my Amendment.
Amendment, by leave, withdrawn.
Clause 54 agreed to.
Clause 55:
Accounts of councils of county boroughs, Regional Hospital Boards, boards of governors and executive councils.
55.—(1) Every local health authority being the council of a county borough shall keep account of the sums received and expended by them in the exercise of their functions as such an authority, whether under this Act or under any other enactment, and those accounts shall be made up and audited in like manner as the accounts of a county council and shall be kept separately from their other accounts; and the enactments relating to the audit of accounts by a district auditor and to the matters incidental to such audit and consequential thereon shall have effect in relation to the accounts which the council of a county borough are required to keep under this section as they have effect in relation to the accounts of a county council.
4.18 p.m.
LORD ADDINGTON LORD ADDINGTON moved, in subsection (1), to leave out "a county council" and insert "the council under the Local Government Act, 1933." The noble Lord said: This Amendment deals with the audit of the accounts of county boroughs. Some of these accounts such as those relating to education and public assistance are at present audited by the district auditor. But as regards other accounts, including the accounts covered by the service of the block grant, such as the present health service, the county borough has the choice of three methods of audit—the borough or elective audit, the professional audit, and audit by the district auditor. Out of eighty-three county boroughs, only nine have selected audit by the district auditor. And it cannot be said that these county boroughs have chosen that method entirely voluntarily. The vast majority appoint professional auditors, because elective audit is going out of existence in the larger towns, and they certainly will continue to do so.
These county boroughs are towns with large populations. The councils are in close touch with the electors, and are not given to extravagance. At the same time, by reason of the fact that they are the elected representatives of the people they desire to exercise reasonably wide discretion in the performance of their duties, and this discretion a district audit tends
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to confine within unnecessarily narrow limits. There are various examples of unnecessary fettering of discretion which, a district audit imposes, but I will not trouble your Lordships by citing any of them now. The services in relation to public health that are to remain with these local authorities are now to be limited in their scope.
We see no reason why the existing discretion of the county boroughs in regard to their audit should be taken away. There was a similar attempt to impose a district audit for the housing accounts of these county boroughs in the Housing (Financial and Miscellaneous Provisions) Bill, but at the request of the municipal associations the Government agreed to delete that provision. I hope that the noble Lords in charge of the Bill will be willing to follow that precedent, and take the provision out of this Bill also. I think that the question of imposing any particular form of audit on such important bodies as county boroughs, if it is to be tackled at all, should be dealt with as a whole, and not service by service, piecemeal in different fields. I beg to move.
Amendment moved—
Page 46, line 41, leave out ("a county council") and insert ("the council under the Local Government Act, 1933").—(Lord Addington.)
THE EARL OF LISTOWEL: I am sure that the first point which will strike your Lordships is that in this Bill district audit is imposed alike on county boroughs and county councils. The noble Lord is pleading for special treatment for the county boroughs. It is the duty of the local health authorities to provide an important part of the national service, and towards this a substantial contribution is received from the Exchequer. In the case of similar services provided by the local authorities—for example, education services, including elementary schools, secondary schools and all schools financed out of public funds—the accounts are subject to audit by independent district auditors. What the noble Lord is suggesting is that county councils should be subject to district audit, while the councils of county boroughs which are doing exactly the same work should be exempted, and should have, I imagine, professional auditors of their own choosing. Surely that is undesirable because the councils would be in a different position

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from other authorities doing precisely the same work, and because as they are the people who are spending large sums of public money, this type of independent audit is appropriate. I hope very much that the noble Lord will reconsider his Amendment in the light of these considerations.
LORD ADDINGTON: I will not say that I am satisfied. It is a point about which these important bodies feel very strongly. They feel that they are important enough and possess sufficient discretion, to have their accounts audited in the way they think best. There are other services—I believe housing, for one—which are subject to similar grants and where the accounts may be professionally audited. In some ways, they do retain their independence. I am in the hands of the House, and as I do not seem in a position to press my Amendment, I will withdraw.
Amendment, by leave, withdrawn.
Clause 55 agreed to.
Clauses 56 to 59 agreed to.
Clause 60:
Power of trustees to make payments to Regional Hospital Boards and boards of governors.
60.—(1) Where property, other than property transferred to the Minister or to the board of governors of a teaching hospital under Section six or Section seven of this Act, is held on trust immediately before the appointed day … the trust instrument shall be construed as authorizing or, as the case may be, requiring the trustees to apply the trust property, to the like extent and at the like times, for the purpose of making payments whether of capital or income—
(b) in the case of any other hospital, to the Regional Hospital Board for the area in which the hospital is situated.
4.25 p.m.
THE EARL OF MUNSTER THE EARL OF MUNSTER moved, at the end of subsection (1) (b), to add "or to the hospital management committee of that hospital or of the group within which that hospital is comprised." The noble Earl said: I think that this Amendment is of some importance, but it is almost a drafting Amendment. Under Clause 59, as I understand it, the hospital management committees have power to receive gifts for purposes relating to hospital ser vices. It seems to me also that the power
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of trustees should be delegated in subsection (1) (b) of Clause 60 down to the hospital management committees. I beg to move.
Amendment moved—
Page 50, line 22, at end insert the said words.—(The Earl of Munster.)
THE EARL OF LISTOWEL: The noble Earl said that his Amendment was based on the desire to make an improvement in the drafting of the Bill. I can assure him that we will look at it from all angles, and see, between this and the Report stage, whether any improvement can be made.
THE EARL OF MUNSTER: To give power to trustees, under Clause 60, to delegate not to Regional Boards but to the lower level of hospital management committees. With that assurance, I beg leave to withdraw.
Amendment, by leave, withdrawn.
Clause 60 agreed to.
Clauses 61 to 64 agreed to.
Clause 65:
Qualifications, remuneration, and conditions of service of officers.
65. Regulations may make provision with respect to the qualifications, remuneration, and conditions of service of any officers employed by any body constituted under this Act or employed by a local health authority or by any such voluntary organization as is referred to in the last but one foregoing section, and no officer to whom the regulations apply shall be employed otherwise than in accordance with the regulations.
4.27 p.m.
LORD HENLEY LORD HENLEY moved to leave out "a local health authority or by." The noble Lord said: Clause 65 is a very wide one. It authorizes the Minister to make regulations with respect to the "qualifications, remuneration and conditions of service of any officers employed by any body constituted under this Actor employed by a local health authority." The object of this Amendment is to exempt from the action of this clause a county council or county borough council. The County Councils' Association feel very strongly about the subject matter of this Amendment. They feel that the Minister already has powers under the Local Government Act, 1933, to deal with the qualifications possessed by medical officers of health for counties or county boroughs. The Association also feel that adequate machinery

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exists for negotiations between local government bodies and all classes of their employees.
There are a great many regulations laid down as to the salaries of various employees. The Asquith Agreement controls the salaries of medical officers, and national joint councils for administrative professional, technical and clerical services of local government authorities govern the salaries of all employees earning more than £700 a year. In addition to this, there are scales laid down for employees engaged in hospitals, and for the subordinate staff in hospitals. Recently, the National Joint Council for administrative and technical staffs have prescribed a national scheme of salaries and conditions of service for local government staffs. From the county council of which I am a member, I know that a great deal of trouble has been taken to implement these regulations. Negotiations have taken place between the county council and all the representatives of the employees under them. We have consulted, in the most friendly manner, the representatives of the National Association of Local Government Officers and the other bodies concerned. After a great deal of trouble, scales of salaries have been satisfactorily decided for all these employees.
And let me say here, that it is a very difficult problem to make these salaries fit in with one another. When you have settled the salaries of the health workers, you find that workers in other departments may not be satisfied, and alterations have to be made to bring them into line. These negotiations have been carried out by a very large number of the local government bodies throughout the country. Out of 1,530 local authorities, 1,232—that is, about 80 per cent.—have already adopted these scales and conditions of service. It seems to me that that is a very remarkable figure.
I think it is possible that the noble Lord in charge of this Bill may say that the object of Clause 65 is to deal with those few authorities who fail to comply with these regulations. I would point out, in answer to that, that machinery exists, and will no doubt continue to exist, whereby the authorities who do not conform to these scales and conditions of service may be brought before the National Arbitration Tribunal, and have the scales compulsorily
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imposed upon them. It seems to me that with all these regulations and arrangements the employees are very carefully safeguarded against the unfair or niggardly authority, and it also seems to me that no further regulations are necessary to enable the Minister to step in and interfere with the arrangements made by these authorities and the various negotiating bodies. It appears to me that the tendency of this clause is to go against: the principle adopted in the Whitley Councils of negotiating between employers and employed, and I think it would be very much better, in the case of the local health authorities, if this provision in this clause were removed. I beg to move.
Amendment moved—
Page 51, line 25, leave out ("a local health authority or by").—(Lord Henley.)
LORD ADDINGTON: On behalf of the municipal authorities of the country who feel very strongly about this matter, I very warmly support this Amendment. I need not go over again the points so adequately dealt with by my noble friend Lord Henley. There are statutory requirements and negotiating machinery that already fully cover all the class of officers who come under this Bill. The clause extends the control of the Minister to a number of officers—practically nearly all the officers of the council—some of whose duties during part of the time would be concerned with some of the services rendered under this Bill. It would only be part of their duties. So that if the Minister could not fix their salary and conditions of service for a very small part of their time, it would make the position of the employing authority almost unworkable. I think these pro visions are quite unnecessary and extremely unwise, and I hope that the Government will be able to accept this Amendment.
THE EARL OF LISTOWEL: The effect of the Amendment in the name of the two noble Lords opposite would be to omit from the category of persons employed by health authorities under the Bill, and whose qualifications, remuneration and terms of service will be fixed by the Minister, those officers who are in the employment of local heath authorities. I should like to remind the noble Lord opposite that his Amendment applies also to their qualifications although I think in

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his speech he was dealing either exclusively, or almost exclusively, with their remuneration and conditions of employment generally.
As the noble Lord quoted some opposite instances, I think I ought to point out that the qualifications of the health officers of local health authorities are very often prescribed by the Minister. This happens now in the case of tuberculosis officers, maternity and child-welfare officers and venereal disease officers, and it has been found to be a convenient and useful practice for the standard of qualification to be settled centrally. There is no reason that I can see to suppose that it would not be equally efficacious in the case of people employed by local authorities as health officers under this Bill. I think there is great advantage in having a standard of qualifications laid down centrally.
To come to the question of remuneration and terms of service, with which I think the noble Lord opposite was mainly concerned, I do ask him to believe that there is advantage to the staff of local authorities in uniformity of pay and other conditions of service, which you would not get, of course, if the local authorities were fixing their terms separately or even by agreement, without having a complete agreement covering the whole field of the local authorities, because this uniformity facilitates transfer and promotion. I do not want any misunderstanding to arise about the actual part that the Minister would play in arriving at these conclusions. The Minister would not, of course, decide on the rates of pay or other conditions affecting the employment of officers by a local authority without the fullest consultation with the authorities concerned. I think the noble Lord imagines that that is a very small step in the right direction. I agree, but I am going further. The usual way in which such questions would be dealt with would be by negotiation between both sides through machinery of the Whitley Council type, which has very generally been used by Government services with the most satisfactory results and, of course, the local health authorities would be directly represented on the negotiating bodies. I do think, when all things are considered, that this would be the most satisfactory way of giving a fair deal to
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the staff of these local authorities, in so far as they are concerned with the health services, and I hope that your Lordships will agree.
LORD LLEWELLIN: There is one remark I should like to make on this particular clause, and it is that, perhaps as a pure matter of drafting, the clause has been drawn rather too wide. It says:
"Regulations may make provision with respect to the qualifications, remuneration and conditions of service of any officers employed by … a local health authority."
That is extremely wide and means that you are giving the Minister power, under this Bill, to make regulations with regard to any officer employed by a public health authority. That is too wide. It ought to be limited to persons who are mainly so employed for the purposes of this Act. Then I think it would be quite proper, and it would run along the lines of "all persons employed by any body constituted under this Act," for which of course regulations will have to be made. I think it is far too wide if under this clause of this Bill you take power to provide by regulations for the qualifications, remuneration and conditions of service of everybody employed by what is termed a public health authority. For my part, I should like the noble Earl for the Government to look into that point and to see whether he could not largely meet the purposes for which this Amendment was put down by putting these words in with regard to the officers employed by local authorities.
THE EARL OF LISTOWEL: I think I can meet the noble Lord about that point. It is clearly the intention of the clause only to cover the health officers of local authorities, and, if it is too widely drawn, we will try to narrow it down.
LORD ADDINGTON: If I may make one observation, the noble Earl talked about qualifications. I think the qualifications of the health officers are distinctly laid down in the Local Government Act as at present. One of the points is that you have already got regulations somewhat statutory; in other words, negotiating machinery which covers these officers, and negotiating machinery which deals with them along with many other officers in a comparative position in the service of local authorities. A new set of regulations dealing with one class of officer only may upset the whole of the comparative salaries

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of those in the health service and other services in the same category. I leave that to the noble Lord who moved the Amendment.
LORD HENLEY: I am very glad to hear that this clause is confined only to the health workers of the local health authority, but I feel, even after that concession has been made, that the principle involved in this clause is a wrong one. After all, previously we have tended to rely upon Whitley Councils and arrangements similar to Whitley Councils for negotiations between employers and employed, and I do not see why we should go away from our adherence to that principle. It seems to me that we should stick to this Amendment very strongly. We should press it because, even with the restrictions that have been made, it is giving the Minister too much power to interfere in the business of the county councils. As has been already said, it is not that it will only apply to public health, but directly you begin to change the salaries and wages of the public health workers you immediately upset the balance of the whole of the scale that you have carefully arranged with all the employees of the county council.
On Question, Amendment negatived.
Clause 65 agreed to.
Clause 66:
Superannuation of officers.
(2) If the Minister and a Secretary of State are satisfied that any Act for the time being in force in Scotland or in Northern Ireland makes provision with respect to the superannuation of persons employed in health services in Scotland or Northern Ireland which is substantially similar to the provision made under this section, they may make regulations with respect to the rights and liabilities of any person so employed who leaves his employment and enters into employment in respect of which superannuation benefits are provided under regulations made under subsection (1) of this section or into the employment of a local health authority in respect of which superannuation benefits are provided under the Local Government Superannuation Act, 1937, as extended or modified by the regulations or under a local Act scheme as so extended or modified, and vice versa, and with respect to the rights and liabilities of the Minister, the Secretary of State and other authorities concerned.
4.42 p.m.
THE EARL OF LISTOWEL THE EARL OF LISTOWEL moved, in subsection (2), to leave out "so employed who leaves his employment" and insert
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"who leaves employment in Scotland or Northern Ireland entitling him to participate in superannuation benefits (whether provided under the said Act or otherwise)" The noble Earl said: The object of this Amendment is to confirm the pension rights of cert in health officers which would otherwise be prejudiced. The intention of subsection (2) of Clause 66 is that when the Scottish National Health Service Bill has been passed regulations shall provide for the preservation and safe guarding of the superannuation rights of the health officers in Scotland who transfer to England. As drafted at the moment, the subsection only enables this to be done in relation to officers employed in the health services in Scotland. It is hoped, however, that suitable entrants to the health services in England, whether central or local, might come also from the Scottish local government service and this Amendment has been drafted to cover these people.
Amendment moved—
Page 53, line 26, leave out ("so employed who leaves his employment") and insert ("who leaves employment in Scotland or Northern Ireland entitling him to participate in superannuation benefits (whether provided under the said Act or otherwise)").—(The Earl of Listowel.)
LORD LLEWELLIN: This seems to us correct and in order, so far as I could hear the noble Lord above the hubbub that seemed to be taking place.
On Question, Amendment agreed to.
Clause 66, as amended, agreed to.
Transfer and Compensation of Officers.
67.—(1) Regulations shall provide—
(a) for the transfer of officers employed immediately before the appointed day solely or mainly at or for the purposes of any hospital transferred to the Minister by virtue of this Act, to the Regional Hospital Board for the area in which the hospital is situated or, in the case of a teaching hospital, to the Board of Governors of that hospital, subject, in the case of honorary officers, to such exceptions and conditions as may be prescribed;
4.44 p.m.
LORD COZENS-HARDY LORD COZENS-HARDY moved, in subsection (1) (a), to leave out "hospital," where that word first occurs, and insert "one or more hospitals." The noble Lord said: Your Lordships are aware that in recent years a large part of the regular income of the voluntary hospitals has been obtained by contributory

619
schemes. Where such a scheme is confined to a single hospital its staff will, under the Bill, be transferred under Clause 67. Where a group of hospitals has been associated in a contributory scheme its staff is not covered by the wording of the clause. I think it is generally agreed that the grouping of hospitals in contributory schemes has been the most efficient plan, and it has been adopted by the most progressive hospitals. I speak of these matters from personal knowledge as I happen to have been Chairman of one of the largest of these schemes for the first ten years of its existence. It had a life of seventeen years and had an income in that period of £4,500,000. That scheme, and all these schemes, have very experienced staffs and much of the time of these staffs is employed not on the actual organization of the collection of contributions but on personal touch with contributors and their needs.
The experience of such staffs should be of inestimable value to the bodies which, under the Bill, it is to be hoped will continue that close personal touch with the insured contributor and his requirements which is so valuable in cases of illness. No body of men or women, whether employed by a single hospital or by a great body to which a group of hospitals have delegated the work, could be more suitable for transfer under the new arrangement set up in the Bill. In another place the Minister has attempted to excuse the exclusion of officers of grouped hospitals by dwelling on the difficulty of drawing a line between those who can fairly claim to be solely or mainly employed for the purpose of these hospitals and those who cannot so claim. But the Minister has drawn the line, and I submit he has manifestly drawn it in the wrong place, a view in which I was very glad to have the support of my noble friend Lord Beveridge, in his able Second Reading speech. The Minister's reference in another place to the absurdity of giving the protection of this clause to such people as lawyers' clerks, who may from time to time be engaged on documents relating to endowments, seems to me to be very wide of the mark. The officers I refer to are employed on a whole-time basis solely or mainly for the purposes of a group of transferred hospitals. No one can seriously doubt that if not transferred to a new authority the officers of a
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single hospital scheme and of a multi-hospital scheme will be in the same position in suffering loss of employment, a loss directly attributable to the passing of this measure, and it seems impossible to justify giving the protection of this clause to the one set of officers and denying it to the other.
The grounds for this differentiation seem to be that technically the latter set are not officers of a transferred hospital but are officers of a body which a group of hospitals has joined in forming in order to exercise collectively the functions of a contributory scheme. If the hospitals in the group had continued to operate separate contributory schemes in competition with one another the officers employed on the competing schemes would have had the protection of Clause 67. In another place the Minister, whilst declining to entitle officers to transfer under this clause unless they were employed by a single hospital, promised to do his best to absorb them. I submit that they should be entitled to something more definite, and the object of my first Amendment is to give them a statutory right to transfer.
In another place also the Minister made great play about the cost of compensating such people, but in my submission their special experience and abilities, coupled with the Minister's assurances as to their future employment, should reduce to negligible proportions the number to be compensated under my second Amendment. In any event, surely the case should be dealt with on the basis of equity and not on a question of costs. I hope very much that noble Lords in charge of the Bill will feel able to accept the Amendment standing in my name, or to bring forward at a later stage wording to the same effect more acceptable to their advisers. I beg to move.
Amendment moved—
Page 53, line 39, leave out ("hospital") and insert ("one or more hospitals").—(Lord Cozens-Hardy.)
LORD BEVERIDGE: I should like to support this Amendment, to which I referred in speaking on the Second Reading. When I was engaged in making the report on social insurance and allied services, which had something to do with bringing this matter forward, I saw representatives of these contributory associations a number of times. I was very much impressed

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with the excellent work they were doing, and also with their readiness to accept the probable extinction of what they were doing when it was merged into this much larger scheme. It is clear that what they did was of great value in accustoming the people of this country to the idea of paying for their hospital treatment before hand when they had the money. Certainly those associations did a great deal of valuable work. I suggest that those who were working not for one hospital alone, or for each of a number of competing hospitals, but were working for a group of hospitals who had decided to give up competition in favour of co-operation should not be penalized. That is the whole point of this Amendment, whether we are to going to draw the line between the people who work for one hospital only, and all the rest, or between the people who work for a group set of hospitals and all the people who are indirectly damaged by this Bill.
We realize that you cannot compensate everybody who suffers indirectly by every Act of Parliament, but the point of this Amendment is that the people employed by four hospitals together to raise money am as directly affected as the people who work for one hospital. I do not think I need go over again all the things that were said on this point in the other place. Those things have all been adequately covered by my noble friend Lord Cozens-Hardy. I very much hope the Government will feel able to show a conciliatory spirit on this small point. It is a small point, but it is one which gives the Government a great opportunity of showing a conciliatory spirit in drawing the line rather differently from where they have drawn it in the past.
LORD LLEWELLIN: May I just say one word on this? I do not think any body would want so far to extend this compensation as to compensate part-time officers, but I think, at any rate throughout the course of recent Parliamentary history, it has always been accepted that where by Act of Parliament you destroy a man's job you give him some compensation for it. It seems to me that that compensation ought to be given to these men, whether they have done this collecting work full time on behalf of one single hospital or whether, for reasons of economy and so forth, hospitals have grouped together and they have done it
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for the group of hospitals. There does not seem to me to be that distinction which should rule out one class of person from this compensation which the Government are quite willing to give to the other class. That seems to me to be the whole point of this Amendment.
I suppose the Amendment raises a question of Privilege. Other noble Lords will know more about that than I do, but I assume it will put an increased charge upon the Treasury. It is therefore an Amendment about which this House has to be careful. It is, however, a case where I think the Government can come forward and see that justice is done, not to a whole body of people who do not deserve it but to people who have been full time in this work and who will be losing their employment because of this Bill. For those reasons I wish to give support to the noble Lord who has moved this Amendment.
THE LORD CHANCELLOR (LORD JOWITT): As the noble. Lord who has just spoken has said, this is, of course, a Privilege Amendment, not that that in any way precludes this House from acting. It is, however, a matter in regard to which this House always thinks twice before it does act. I think there is some slight misapprehension about this Amendment. It has been discussed as though the issue were that a man serving one hospital got compensation and a man serving four hospitals did not get compensation. That is not so. Under the Interpretation Act the singular includes the plural. Wherever you get the word "hospital" you may read, according to the Interpretation Act, "or hospitals."
The real point underlying this Amendment, if I may venture to say so, is not that at all; it is whether you should extend the power of transfer and compensation to persons who are not the servants or officers of any hospital at all. That is the real point. You have these voluntary associations and the problem is: ought you to extend to the officers of those associations, which are not hospitals, the same concessions and privileges as you extend to the officers of hospitals? We say you should not, and I think I can give your Lordships cogent reasons why you should not. In the first place, see how different are the two positions. The associations who have funds do not lose any of their funds. The hospitals do; the associations

623
do not. Secondly, the associations, unlike the hospitals, do not in practice devote their money exclusively to hospitals; in fact they devote their money to various other schemes as well—schemes such as home nursing, ambulance services, convalescent homes, the supply of spectacles and all sorts of beneficial and useful purposes of that sort. They are not in any way limited to supporting hospitals. Further, a meeting of one of these associations in recent months adopted a report, if what I read in the Press was right, suggesting that they would continue to provide services supplementary to those provided under the new scheme. I have already used the word "trimmings," which I am afraid got me into some trouble—and it was an unfortunate word—but I would like to say that even after this scheme comes into operation there will be a very great need for these additional services to go on, and I sincerely hope they will. It will make all the difference if they do.
Therefore, I have got here an association, which does not lose its funds, which does not contemplate extinction and which is not going to be transferred to anybody. The problem is whether the servants of such an association as that—an association not being taken over—are to be placed in the same category as the servants of a hospital which is being taken over. We say they should not be. We say that the only principle upon which you can decide this matter is this. You must confine your compensation to those who are directly affected by the transfer and you cannot grant it to those who are indirectly affected, because once you attempt to grant compensation to those who are indirectly affected you may have to grant compensation to the employees of a business which, as things are to-day, supplies a hospital with all sorts of commodities and which, in days to come when there is some kind of central purchase, will not supply anything at all and which may have to discharge some of its employees. That is another illustration of an indirect loss.
What the Minister has said, and what I repeat, is this. He realizes there may in some exceptional cases be hardship and he has said that he will extend to those people the benefits of some priority in employment in those many spheres of activity which, either under this scheme
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or under the other scheme—the insurance scheme—will be available for people trained in this sort of work. But I think it would be—and I am really talking on the two Amendments, this and the succeeding one, rather than on this one, because this one does not matter a bit—a bad example to extend compensation to persons who are not servants of hospitals, who are not directly affected by any transfer but only indirectly affected and who, in view of the fact that the work of the Association is going on and that it will not suffer any diminution of its funds, should not be entitled to draw compensation as they would be if they were the direct servants of either one or more hospitals, who, of course, will be transferred to the Minster. Therefore I regret to say we really do not think it right—and this was gone into very carefully in another place—to extend the benefit of compensation to those persons who are only indirectly affected.
THE MARQUESS OF READING: May I ask the noble and learned Viscount a question? On what grounds does he say these associations will suffer no diminution of their funds?
THE LORD CHANCELLOR: There is no transfer of their funds under this Bill. There may, of course, be a diminution if the subscriptions fall off, but I have already said that I very much hope subscriptions on a substantial scale will continue.
LORD LUKE: The subscriptions are likely to fall off as a result not only of this scheme but of the other scheme contained in the National Insurance Act. These officers of the contributory schemes will be affected very greatly and will be out of employment. I had not intended to speak on this particular Amendment, but as the noble and learned Lord, the Lord Chancellor, has, as it were, taken them both together, perhaps I may now say a few words on them. The object, of course, is compensation. I would point out that these schemes are an integral part of the voluntary hospital system and that if the voluntary hospital system goes, these schemes will also go. There are a great number of very worthy people involved who will lose their employment, not only through the operation of this Act, when it becomes an Act, but through the operation of the National Insurance Act. I consider that it is unreasonable to leave them out when the

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employees of hospitals are catered for. Of course, I know there is the argument that there is no knowing where this may end, but if a line is to be drawn, then I agree with the noble Lord, Lord Beveridge, that it should be drawn below these people and not above them.
I think I am right in saying that in another place the Minister expressed rather more sympathy than the noble and learned Viscount did just now. He said that every effort would be made by the Minister and by the Minister of National Insurance to absorb these people into the new services, but surely that does not go very far. There will be some of them who will not be so absorbed and surely it is only common justice that those who are not absorbed should be compensated. These contributory schemes have been administered very ably and have been of immense benefit to contributors up and down the country and to the hospitals; they have looked after their contributors. I consider that they deserve better treatment at the hands of the Government than they are getting in the Bill as it now stands.
LORD COZENS-HARDY: I am sorry that the noble and learned Lord Chancellor has not felt able to go further in regard to this and to give a definite right of compensation to the class of officer I have referred to. If the scheme should, as is very unlikely to my mind, continue in the way in which the noble and learned Viscount has mentioned, then there would be no case for compensation at all; they would still he employed. I regret that the Government have not felt able to go further and I beg leave to withdraw my Amendment.
Amendment, by leave, withdrawn.
LORD LUKE LORD LUKE moved, in subsection (1) (e), to insert:
"(iii) devoted the whole of their time to the governing body of a contributory scheme serving a group of hospitals for the purposes of functions which cease in consequence of the Act."
The noble Lord said: On behalf of the right reverend Prelate, the Bishop of Sheffield, who is unable to be here because he is in Germany, I beg leave to move this Amendment. Having made my remarks on the other Amendment, I will say nothing further. I formally move the Amendment.
Amendment moved—
Page 54, line 31, at end insert the said words.—(Lord Luke.)
THE LORD CHANCELLOR: I made my remarks also on the other Amendment, and I do not propose to say anything further.
LORD LUKE: In view of those remarks, and in view of the discussion that we have just had, I beg leave to withdraw the Amendment.
Amendment, by leave, withdrawn.
Clause 67 agreed to.
Clauses 68 to 71 agreed to.
5.10 p.m.
LORD LLEWELLIN LORD LLEWELLIN moved, after Clause 71, to insert the following new clause:
"Notwithstanding any privilege, custom or rule of law the Minister and any council, board, committee or other authority constituted under this Act and their officers shall be compellable to produce in any action brought by any person or by the personal representatives of any deceased person against the Minister or such council, board, committee or other authority or officers, all such records, communications, memoranda and other documents as relate to such person or such deceased person or to the treatment or ser vices provided in respect of them."
The noble Lord said: This, in my view, is an important Amendment. By this Bill, we are vesting the whole of the hospitals in the Minister; they are henceforth going to be Crown property. From that it follows, as I understand the law, that the Minister, or any of the officers acting under the Minister, will be able in respect of them to claim the privileges and prerogatives of the Crown. I have looked at Clause 13 of this Bill, and that clause, it is quite true, makes the Regional Board, or the board of governors of the teaching hospital, the body who will be liable in respect of any liabilities, notwithstanding that they are exercising functions on be half of the Minister. Therefore, if a patient or anybody else has a cause of action against the hospital itself, then the Regional Board or the board of governors are made a party to the case. So far as that is concerned, I am correct, because the words of Clause 13 are Quite explicit—that despite the fact that they are exercising powers on behalf of the Minister they shall be liable as though they were acting as principals. I think that completely covers that point, but I do not

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think it covers the point with which my Amendment itself deals, and that is why I put it down.
My Amendment reads as follows:
"Not withstanding any privilege, custom or rule of law the Minister and any council, board, committee or other authority constituted under this Act and their officers shall be compellable to produce in any action brought by any person or by the personal representatives of any deceased person against the Minister or such council, board, committee or other authority or officers, all such records, communications, memoranda and other documents"—
I believe I thought to have added here the words "in their possession, custody or power," which are the normal words—
"as relate to such person or such deceased person or to the treatment or services pro vided in respect of them."
I do not believe that is covered by Clause 13 as drafted. I assume a case where a patient thinks there has been negligence on the part of a doctor and sues the doctor for negligence. I am one of the people who want to see that the patient has just as much chance in that action as he would have had had the hospital not been taken over by the Minister. I think that will be the view on all sides of the House.
I believe that if we do not have some such words, whether in a new clause or as additional words to Clause 13, when an action of that sort is brought it may be found that the hospital cannot be compelled to produce the records and memoranda relevant in the case. I ask only for the ones which relate to such persons or deceased persons or to their treatment, such as are produced in a normal action for negligence—the case record book and other records which are kept by the hospital and which are vital to the case being properly tried. I believe this is not covered by Clause 13. I am not seeking, of course, to go inside Ministries or do anything of that kind. All I am seeking is the production of the kind of document which the court could have compelled a hospital to produce, and which I think they should still produce although they may be part of the Ministry's hospital records. I think that is a point on which we shall all be completely agreed.
Between us we should make quite certain that some words—I do not say particularly mine—are included to safeguard
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patients who may have suffered from the negligence of some servant of the hospital. If there is a gap, I think it is a gap which we should all wish to bridge, and I believe nobody is keener than the noble and learned Lord, the Lord Chancellor, to see that in cases against the Crown there is much more facility for the subject than there has been in the past. He has adumbrated to us that he hopes to bring in a measure, but I think we ought not to wait for that; we ought to put words into this Bill. I beg to move.
Amendment moved—
Page 57, line 9, at end insert the said new clause.—(Lord Llewellin.)
VISCOUNT MAUGHAM: The object of this Amendment is merely to secure that a plaintiff against one of the per sons mentioned in the Amendment shall have full discovery in an action or a proceeding against any one of these numerous bodies or persons who, as he imagines, has treated him wrongly in some way, so that he is entitled to legal redress. I am very unwilling to express an exact or reasoned opinion as to the effect of this clause and its necessity, but I think I am reasonably clear that it is very desirable to remove doubts in respect of the rights of the supposed plain tiff in one of the categories mentioned in the clause. Having regard to the curious nature of the position which the patient may occupy when this Bill has become law, the question as to precisely who is liable in a particular case, and the question of the nature of the discovery to which he is entitled, it would be just and reasonable that the Government—who have told us that their desire is that even after this Bill there should be justice—should consent to this clause or some modification of it, if necessary, being inserted in the Bill. Having said that, I will repeat that I think the clause is desirable, but at the same time I am not pledging myself to the extent to which it is strictly necessary.
THE LORD CHANCELLOR: This subject is one which I confess is rather near my heart. I entirely agree with the noble Lord who has moved this Amendment. I think it is very desirable that in proceedings against the Crown the litigant should have a very full measure of discovery, and I am inclined to think that there have been cases in the past

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where the litigant has not had such a generous measure of discovery as he should have had. I frankly hope that I shall live to be able to introduce the Civil Proceedings against the Crown Bill, and that I shall be able to give a very wide right of discovery when that Bill is introduced. Having said that, I must also say that I think we should realize at the same time that there is this to be considered. You may here get a conflict of private interest with the public interest. I think it is of the utmost importance that those who are concerning themselves with Government business, with public affairs, should have the right to communicate with each other on those affairs, in the ordinary course of events, freely and without fearing that the reports which they make to their superiors may be dragged out and examined in a Court of Law. I am sure the noble Lord opposite will agree with me about that.
I think that this is a matter of public interest. Only the other day I happened to have to consider a point with regard to reports in connexion with the Air Ministry. There was litigation between two individuals and one of them, quite properly, had certain of these reports in his possession. I had to consider whether we should or should not claim privilege for those reports. I advised the Minister as to what sort of principles he ought to apply, principles laid down judicially by the House of Lords, in quite recent times, in a judgment given by the noble and learned Viscount, Lord Simon. One wants to be very careful to balance these two points of view. This actual Amendment as it stands would not do. As drafted, it is so wide that it is in no sense limited to the purposes of this Bill. It would apply to any action brought against the Minister under a Housing Act or almost any sort of procedure. I am very willing to listen to, and to consider, arguments which may be put forward upon this matter. But really I venture to think that there is no danger of any trouble of the sort that seems to be feared occurring under this Bill as drafted.
There are four points in connexion with which a person who brings an action against the Crown may find himself in difficulty. First, instead of issuing a writ in the ordinary way he may find himself obliged to resort to a certain rather obscure form of proceedings. Second, he
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may find himself in difficulty because there is no action for tort against the Crown. Third, there is the difficulty about discovery. With regard to these three points I would ask the noble Lord to look at Clause 13, and to realize that the party who is responsible here as the employer of these various officers is the Regional Hospital Board. I do not think that there would be any difficulty in the ordinary way in bringing your action for tort against the Regional Hospital Board, and getting discovery from the Board. I think that the difficulty does arise, and always must arise, under what I now enumerate as my fourth head—the Crown's power to claim privilege for documents which are properly certified as documents which cannot be produced without detriment to the public interest. I think that is the only point upon which difficulty arises, and I consider that the Crown ought to retain that power.
I think that this is one of the matters which a Minister ought to look into himself. He ought to instruct his mind as to what the point is and see whether he is satisfied that it is against public interest that these documents should be produced either by reason of something which they contain, or owing to the fact that they may be documents of the class which ought not to be introduced because if they did come to be disclosed they would tend to prevent that free expression of opinion which is necessary in the public interest. That is my view. There was a well-known case against the Anglo-Persian Oil Company. They had in their possession some document which came from the Admiralty in which opinions were expressed as to the state of affairs in Persia. Now, although the litigation was between two private individuals—the company and somebody else—they were ordered by the Admiralty not to disclose that document, because the Admiralty took the view that its disclosure would be against the public interest.
This particular topic being the topic of health and of actions being brought against doctors and that sort of thing, may I say that I do not think that that sort of consideration is likely to arise. I think it is almost inconceivable that there would be any document of that kind which by it very nature it would be against the public interest to disclose. I think that there might be documents in

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the second category, documents belonging to the class which in the wider public interest ought not to be disclosed because it would tend to prevent people communicating freely and expressing opinions. I think that, in that connexion, it is right that the Crown should still have the right to claim privilege. I am very ready to do what I can if the noble Lord thinks that there is a special case and will tell me whether there is something I can do which, while safeguarding that broad general principle, will secure that in actions of this special character, confined to this Bill, there shall be as complete a measure of disclosure as possible. I shall be pleased to meet him, as I say, but I do feel that until I deal with this matter in a General Act—we shall of course have to review the whole subject when we come to the Bill to which I have referred—this right ought to be retained.
I say this whilst having sympathy with the noble Lord's object, while feeling it right that a man who is going to bring an action against a hospital after the appointed day, when it has been transferred, shall be in no worse position than a man who brings an action today before the hospital has been transferred. If it is suggested to me that there is some simple Amendment which I can make, I shall be glad to do so. On the other hand this Amendment is too wide. I feel that in the public interest I must retain that right which I have indicated.
LORD LLEWELLIN: I am sorry but I am not really satisfied with the noble and learned Lord's answer. I quite agree with him on the matter of the broad policy, but I am only dealing with a very small matter. If he will look at my Amendment, he will see that it is not very wide. It runs:
"Notwithstanding any privilege, custom or rule of law the Minister and any council, board, committee or other authority constituted under this Act and their officers shall be compelled to produce in any action brought by any person or by the personal representatives of any deceased person against the Minister or such council, boar committee or other authority or officers, all such records, communications, memoranda and other documents as relate to such person or such deceased person or to the treatment or services provided in respect of them."
You will see that it is limited to "all such records" and so on. I want to add "in
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their possession, custody or power" and then go on "as relate to such person" and so on. It is limited only to the documents that arise in respect of one particular patient. It is very narrow if you look at the last part of it. I am certain that this is not covered by Clause 13.
THE LORD CHANCELLOR: Supposing that a document relating to some particular person was a report by one of the officials of the Ministry of Health to the Minister, made in the course of his duty. The noble Lord's Amendment would say that as a matter of course that must be produced. I would say that this is a matter where the Minister ought to consider whether the public interest demands that that type of document should be produced.
LORD LLEWELLIN: I do not think that that is satisfactory from the point of view of the patient. I would not be prepared to leave it that this should be a matter for the exercise of the general discretion given to the Minister. If you say a report made ad hoc after a case has been made to the Minister, we accept that. Perhaps he sent an inspector to a hospital where there has been a death. I am not suggesting a post-mortem document, which is perhaps much the same as a solicitor gets, but I am suggesting that we are not safe in leaving the right of a patient to be subject to the discretion of somebody who may say: "In this case we do not think that we will disclose the medical history sheets. They are, normally, to be kept in the hospital." It may well be that there is an action against a very popular surgeon, and the attitude taken may be: "Let us not disclose that document; it does not read too well," or something like that. That kind of thing is wrong and I am not prepared to leave the position like that. If the noble and learned Lord is prepared so to strengthen Clause 13 that the old rights of the Act not the new rights of a man from the Ministry, are upheld, that the documents that are properly there, and were there before the passing of this Act, shall still he held to be produced as be fore, he will meet my point. We consider this extremely important.
THE LORD CHANCELLOR: I thought that I had said that. I regard it as quite certain that that sort of medical history sheet can be, and must be, produced

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after this Bill is passed. If an action is brought against a Regional Hospital Board, the history sheet would be one of their documents. As a litigant, the Board would have to produce it. I am unwilling, however, to use words to cover the exceptional instance which I quoted. If the sort of case which the noble Lord has in mind is not covered—I believe it is—then I will gladly see that it is.
LORD LLEWELLIN: With great respect, take rather a different view. The clause only says that the Board shall be liable as though they were principals and that all proceedings for the enforcement of such rights or liabilities shall be brought by or against the Board in their own name. I do not think that this enforcement of a right or liability does include the disclosure of documents. And that is the only way my point would be covered. I want words put in, whatever the appropriate words are, which would mean that these documents which had previously always been compellable out of the hospital authorities shall still be compellable. I do not want it to extend to the doctor making a confidential report to the Minister. That will probably have nothing to do with the death of the patient, or the injury that the patient suffers. It may be a report on his death afterwards. I want the history, to see whether there has been negligence in the treatment of the patient, and whether an action lies against the Hospital Board or the surgeon or any other officer of the Board. I think that the noble and learned Lord wants to meet me, if he can.
THE LORD CHANCELLOR: I will gladly meet the noble Lord. If these provisions are not already here, I will put them there. The only reason I he state is that I think they are there now, and that nothing further is needed.
VISCOUNT SIMON: Would the noble and learned Lord, the Lord Chancellor, look into that a little further, and possibly consult with my noble friend and any other noble Lord whom he desires? The feeling that the patient should be fully protected in this matter is universal. I know, and the noble and learned Lord knows, that there are cases—border-line cases—in which official documents ought not, on genuine public grounds, to be produced.
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I will quote an instance, which is different from the one he has given. In the Army it is the invariable practice that a Commanding Officer annually makes a report in respect of junior officers in his battalion. I well remember taking the view that such a document ought not to be produced, on the ground that you could not expect a Commanding Officer to give an absolutely candid account of the shortcomings of Captain "So-and-so," if there were a prospect of a libel action by Captain "So-and-so" if the document were produced. I took that view, and it was adopted by the Courts; it is plain common sense.
But, in my humble opinion, there is no ground on earth to justify the Minister saying: "You had better claim privilege for that document, because if it is produced it will be rather unpleasant for you or for the Department. It will be much safer if it is kept out." That would be utterly wrong. I know that a great deal of trouble is taken in these cases to see that the Minister is properly advised, but I think that the point made by my noble friend is one of great public importance. The change in these organizations connected with hospitals should not result, almost by a side wind, in the man who believes that he has been aggrieved, and is perhaps harmed for life, losing what he is undoubtedly entitled to, full proof of what happened. Could not my noble and learned friend's ingenuity devise something to make that clear beyond doubt? In a concluding sentence perhaps I may be allowed to say that I am sorry that the noble and learned Lord, the Lord Chancellor, talked about the possibility of introducing the Civil Procedure Bill "some day." A good many people want it rather more urgently and definitely than that.
THE LORD CHANCELLOR: I am amongst them.
LORD LLEWELLIN: I think we all agree. For myself, however, I am quite convinced that this position is not covered by Clause 13. If I am wrong I should like to be shown where it is covered. I understand from the noble and learned Lord, the Lord Chancellor, that he will look into the matter, and that if he finds that it is covered, he will show me where. If not, we may try to speak together, and to find words that will cover it beyond

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a shadow of doubt. On that understanding, I beg leave to withdraw.
Amendment, by leave, withdrawn.
Clauses 72 and 73 agreed.
Clause 74:
Regulations.
74.—(1) No regulations shall be made under Section sixty-six or Section sixty-seven of this Act unless a draft of the regulations has been laid before Parliament and has been approved by Resolution of each House of Parliament.
5.38 p.m.
THE EARL OF MUNSTER THE EARL OF MUNSTER moved, in subsection (1), after "under," to insert "subsection (1) of Section eleven of this Act such as determine the areas for which the Regional Hospital Boards are to be constituted, or".
The noble Earl said: I apologize for referring again to this question of the setting up of the Regional Boards. This Amendment and the next in my name seek to enable Parliament to approve the regulations setting up the Regional Boards by affirmative Resolution and not by negative. These Regional Boards, to which I attach so much importance, must be the basis of the whole future administration of the hospitals. At the present time, we do not know, and the noble and learned Lord says that he is unable to tell us, the type or size of the regions, or the number of people who will be living there. All we know about the regions is that they will each be attached to one of the university medical schools in the country. There are eleven of these schools, and it appears that many of the Regional Boards will be attached to the university schools. It is for that reason that we attach such importance to these Boards. I think we should be enabled to see them brought into operation by an affirmative Resolution.
There is one further point. We can be pretty certain that there will be only one set of these regulations which will come before Parliament, except when the Minister decides to amend them in any particular manner. It is important that Parliament should have the right to discuss these things fully, rather than that a prayer should be made in another place at a very late hour of the night when the matter will be inadequately discussed. It is for that reason that I beg to move this Amendment which I hope will appeal to the Lord Chancellor.
Amendment moved—
Page 57, line 30, after ("under") insert ("subsection (1) of Section eleven of this Act such as determine the areas for which the Regional Hospital Boards are to be constituted, or").—(The Earl of Munster.)
THE LORD CHANCELLOR: I think I can satisfy the noble Earl when I tell him that the regulations about the Regions will be made separately. That being so, it really does not matter whether the Resolution is positive or negative. I think as a matter of general principle the negative procedure is right in this sort of case. I follow what the noble Earl says, that if it is embedded in a mass of other stuff it is difficult to get proper discussion. But it will not be. We shall have separate regulations dealing with this matter and that being so I think it better to adhere to the normal procedure of dealing with it by a negative Resolution.
THE EARL OF MUNSTER: I quite agree. On general questions I do not attach much importance to the difference between a negative and an affirmative Resolution. The only reason in respect of which I attached importance to this matter was that these Regional Boards are going to be the whole basis of the administration of the hospitals. They are really of vital importance. Naturally, in view of what the Lord Chancellor has said I shall not press this Amendment, but I hope that between now and the next stage of the Bill he may again consider this point. I beg leave to withdraw my Amendment.
Amendment, by leave, withdrawn.
5.44 p.m.
LORD LLEWELLIN LORD LLEWELLIN moved, in subsection (1), after "under" to insert "subsection (7) of Section forty-two." The noble Lord said: This is rather a similar point in that it seeks to call for an affirmative Resolution and not a negative one. This concerns the provision of Clause 42 which we were discussing yesterday, and the regulations about which the noble and learned Lord and myself were going to have a talk. It is important that we should see how this Tribunal is going to act, and it is very important for the people whose whole livelihood may depend on how it is going to act. We should carefully scrutinize these regulations when they come to be made. I must admit it makes not a great deal of difference in this House whether an affirmative or a negative Resolution is

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needed because there is always ample time for us to put down a Motion negativing a regulation and have it called on at a quite reasonable hour. Were I still ill another place I should find some considerable inconvenience in the negative debate coming on at a very late hour—usually at night. In this House, of course, it does not really make a great deal of difference, except that when you are including some things which need an affirmative Resolution, surely one of them is the working of this Tribunal on which the whole livelihood of some of these medical practitioners will ultimately depend. I beg to move.
Amendment moved—
Page 57, line 30, after ("under") insert ("subsection"(7) of Section forty-two").—(Lord Llewellin.)
THE LORD CHANCELLOR: This is really the sort of point about which we used to get very excited in another place. It does not matter very much here. I think the general principle in deciding whether a Resolution should be positive or negative is the one with which I have already dealt, and that is this. If it deals with matters of substance, especially one affecting some change in a Statute or something of that sort, I take the view that it ought to fall on to the positive side of the line. But if the matter is procedural I think the Resolution ought to fall on to the negative side of the line. That is a very rough division, however, and may not be final. Although this is important, it is essentially a matter of procedure. That being so, I should say that I think it properly falls on to the negative side. It would be a bad example if we started putting procedural regulations on to the positive side of the line.
LORD LLEWELLIN: I put this down before we had our discussion yesterday. I put it down because in the medical profession there is considerable apprehension as to the procedure under Clause 42 which we were discussing and I thought we might get some Amendments on that. In view of the noble and learned Lord's explanation, I beg leave to withdraw my Amendment.
Amendment, by leave, withdrawn.
Clause 74 agreed to.
5.7 p.m.
LORD ADDINGTON LORD ADDINGTON moved to insert as a new clause:
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"It is hereby declared that no provision of this Act conferring any power or imposing any duty upon a Region-al Hospital Board, a board of governors of a teaching hospital or an executive council, authorizes the disregard by any of those bodies of any enactment or rule of law."
The noble Lord said: This is a matter that concerns local authorities, both those municipal councils and the county councils on whose behalf Lord Henley put it down. It again concerns quite ordinary contingencies. For instance, if the chimney stack attached to the boiler house of a hospital emits smoke and creates a nuisance, surely it is not reasonable that the Regional Hospital Board should be immune from the ordinary procedure regarding nuisances of this nature? Or if the vehicles that are owned by the Regional Board are found on the road to be in an unworthy condition, and so constitute an offence against the Motor Vehicles (Construction and Use) Regulations, surely it is undesirable that the Board should be above the procedure of the ordinary law? For example, if the Board wishes to lay a pipe across the highway, is it again not liable in the ordinary way to comply with the procedure of the highway authorities? I think this clause is one which follows a similar one in the Civil Aviation Bill, and I hope that the noble Lord will be able to include it in this Bill. I beg to move.
Amendment moved—
Page 58, line 15, at end insert the said new clause.—(Lord Addington.)
THE LORD CHANCELLOR: In my view this new clause is wholly unnecessary, because—and this may be some consolation to the noble Lord—as I see it, beyond any argument, if a Regional Hospital Board has a smoking chimney, or if it puts on the road some improperly-constructed vehicle, then by reason of the provisions in Clause 13 it is quite plainly liable in tort in the ordinary way, and would certainly be liable for any criminal offence. That being so, I do assure the noble Lord that this clause is really wholly unnecessary and I do not very much like putting this sort of clause into a Bill if it is unnecessary.
LORD ADDINGTON: If I have the assurance that it is covered in Clause 13, I withdraw the Amendment.
THE LORD CHANCELLOR: Yes.
Amendment, by leave, withdrawn.
Clauses 75 to 77 agreed to.
Clause 78 [Interpretation]:
5.49 p.m.
THE EARL OF LISTOWEL THE EARL OF LISTOWEL moved to insert in subsection (1):
"'dispensing optician' means a person having the prescribed qualifications for the fitting and supply of optical appliances."
The noble Lord said: This is consequential upon the Amendment your Lordships have already accepted in Clause 41. It is a question of definition. It defines a "dispensing optician." I beg to move.
Amendment moved—
Page 60, line 5, at end insert the said words.—(The Earl of Listowel.)
On Question, Amendment agreed to.
THE EARL OF LISTOWEL: The next Amendment is consequential to an Amendment in Clause 41. It defines an "ophthalmic optician."
Amendment moved—
Page 61, line 13, at end insert—
("'ophthalmic optician' means a person having the prescribed qualifications in optics, including the measurement of errors of refraction, in orthoptics and in the fitting and supply of optical appliances.")—(The Earl of Listowel.)
VISCOUNT MAUGHAM: Before this is put may I make a suggestion to the Gov ernment—it is only a suggestion, and there is no Amendment down with regard to it. It is that the word "specialist" should also be defined. It occurs constantly in the Bill, and it will often be necessary to know whether a man is a specialist or not. I am a little uneasy on that point because I have known, more than once in my life, of general practitioners who have started as general practitioners and who have gradually become well known as skilled in particular operations or in particular branches of the medical profession, and have ultimately become specialists. But there is a period of seven years or more during which they are both general practitioners and specialists. I would suggest that in order to avoid that state of affairs there should be some definition which makes it reasonably clear that it is only if they do not undertake ordinary general practitioner's work that they are to be treated as specialists. However, that is only for
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consideration. I do not know what my noble friend, Lord Horder, would say as to the meaning of the word.
LORD MORAN: I think it would be very difficult indeed to define "specialist" There is not a definition. I am sure that what the noble Lord suggested would not be practicable, because it is certain that as there are only about half the specialist consultants we need for this purpose, there will be a long interim period—it may be ten years—during which a man will be both general practitioner and consultant. It has been suggested there should be a register of medical consultants. The General Medical Council went very closely into it, but I do not think it is likely to be pressed, because I consider it to be impracticable.
On Question, Amendment agreed to.
Clause 78, as amended, agreed to.
Remaining clause agreed to.
First Schedule:

CENTRAL COUNCIL AND ADVISORY COMMITTEES.
Constitution of Central Council.
1. The number of members of the Central Council shall be forty-one of whom six shall be persons for the time being holding the offices of the President of the Royal College of Physicians of London, the President of the Royal College of Surgeons of England, the President of the Royal College of Obstetricians and Gynaecologists, the Chairman of the Council of the British Medical Association, the President of the General Medical Council and the Chairman of the Council of the Society of Medical Officers of Health, respectively; and of the remaining thirty-five members, who shall be appointed by the Minister,—
5.52 p.m.
LORD ADDINGTON LORD ADDINGTON moved, in paragraph 1, to leave out "forty-one of whom six shall be the persons for the time being holding the offices of the" and insert "forty-two, of whom seven shall be persons for the time being holding the offices of the Chairman of the Council of the Association of Municipal Corporations, the". The noble Lord said: This is an attempt to provide that there should be direct representation of the local health authorities on the Central Council. These authorities have a place and a responsibility in the affairs of the Council which seem to justify my submission for ex officio representation no less than that

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which has been given to some of the other bodies mentioned in the paragraph. While the Society of Medical Officers of Health have ex officio representation it is some what anomalous that the bodies whom there serve, and to whom they are responsible for carrying out their duties, have not been accorded the same privilege. If there is a case for giving ex officio representation to the societies mentioned in the paragraph, there is no less a case for the inclusion of the local health authorities. I have referred only to the municipal corporations in this Amendment, but if it would be acceptable I should be quite ready, after consultation, to add county councils and other bodies concerned.
Amendment moved—
Page 63, line 5, leave out from ("be") to ("President") in line 7, and insert the said new words.—(Lord Addington.)
THE EARL OF LISTOWEL: I am sure the noble Lord will agree that the local health authorities are going to be directly represented on the Minister's Central Council. In the First Schedule, to which he moves this Amendment, subsection (c) of paragraph 1 reads:
"five shall be persons not being medical practitioners with experience in local government."
What the noble Lord is proposing in his Amendment is to include among the ex officio members of the Central Health Service Council the Chairman of the Council of the Association of Municipal Corporations.
LORD ADDINGTON: That is the point of my Amendment.
THE EARL OF LISTOWEL: Let me, if I may, put this point in reply. No doubt the Chairman of the Council of the Association of Municipal Corporations would be an eminently appropriate member of the Council. There is no question of that at all, and of course he would attend as representative of those whose experience is based on local government mentioned in paragraph 1 (a) of the Schedule but surely he should be included among the five members to whom I have already alluded, and not as an additional ex officio member. I really think there are strong objections to adding to the representation of the local authorities in this way. In the first place, your Lordships will have noticed the Central Council is to be regarded primarily as an expert professional
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group of advisers representative of doctors, dentists, nurses, etc. In the second place, I think your Lordships will agree that any alteration in the composition of the Central Council will upset a very carefully balanced body in which all the different elements have been designed in relation to the bodies they represent. Finally, it seems perfectly clear, and in deed the noble Lord in his speech suggested it, that alterations in one direction can only lead to a demand for alterations in another. That, of course, would still further upset the balance and increase the size of a body which I think is about right at the moment. I very much hope that the presence of this eminent gentleman in local government may be secured in the way that I have suggested.
LORD ADDINGTON: I understand there is a possibility that this gentleman and the most responsible people in local authorities will be among those chosen. I am willing to withdraw the amendment.
Amendment, by leave, withdrawn.
5.58 p.m.
LORD WOLVERTON LORD WOLVERTON moved, in paragraph 1, to substitute "forty-two" for "forty-one" The noble Lord said: On behalf of my noble friend Lord Teviot who cannot be here, I beg to move this Amendment. If I may, I would like to move his Amendments as one because if this is not accepted it does not mean we do not need the others. The object of the Amendment is to secure representation of the dental profession on the Central Council of the Minister. We think it is very necessary that the Chairman of the Dental Board should be a member of that Central Council. The noble and learned Lord Chancellor in an admirable speech in the Second Reading debate pointed out that Clause 1 states:
"It shall be the duty of the Minister of Health … to promote the establishment in England and Wales of a comprehensive health service designed to secure improvement in the physical and mental health of the people of England and Wales and the prevention, diagnosis and treatment of illness, and for that purpose to provide or secure the effective provision of services in accordance with the following provisions of this Act.
We all agree with that. When it was discussed in another place the Minister, in Standing Committee on the nineteenth day of proceedings, said: "I earnestly hope in this Committee there will be no auctioning of seats in this Council." We

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do not think on this side of the House that it is asking for the auctioning of seats if you have got the President of the College of Physicians, the President of the Royal College of Surgeons of England, and the Chairman of the Council of the British Medical Association, and we do think it is a very important thing that the President of the Dental Board who, after all, is a very important man, should be on this Council. The teeth of this nation are not nearly as good as they should be. I think it is admitted they are not as good as in the United States. If we want to improve them it is important the Dental Board should be allowed to have direct representation on this Central Council of the Minister. I beg to move.
Amendment moved—
Page 63, line 5, leave out ("forty-one") and insert ("forty-two").—(Lord Wolver ton.)
THE EARL OF LISTOWEL: I think it is perfectly simple to satisfy the desire of the noble Lord opposite that the Chairman of the Dental Board should be one of the representatives of the dental profession on the Central Council. The noble Lord will have observed that among those who will be appointed to sit by the people whom they represent on the Central Council will be three dental practitioners. That is sub-paragraph (d) of paragraph 1 of the First Schedule. It will be quite open to the Chairman of the Dental Board to be included in that way if he and his colleagues so desire. What the noble Lord wants in his Amendment is to add three more dental representatives to the Central Council. However, as I have already said, the constitution of the Council has been carefully worked out so as to provide adequate representation of all the interests that should sit there, and also so as to give a majority of medical members.
LORD WOLVERTON: I would like to say one thing. There is a misprint in the paper. It says: "Page 63, line 5, leave out 'forty-one,' and insert 'forty-four'." That should be "insert 'forty-two')." Has that been rectified?
THE EARL OF LISTOWEL: I have not got it.
LORD WOLVERTON: It is a misprint. That should be "forty-two." We want to add one more.
THE EARL OF LISTOWEL: I see what the noble Lord wants. He only wants to increase the representation of the dentists by one and not three.
LORD WOLVERTON: Yes.
THE EARL OF LISTOWEL: I will gladly discuss it on that basis. If, as the noble Lord desires, the Chairman of the Dental Board were added in addition to the representation already provided for in the Schedule the medical proportion would certainly expect to have an additional member to swell their representation. I am afraid it is quite impossible, as has already been shown by the terms of the noble Lord, Lord Addington's Amendment, to satisfy everyone's desire for what they consider to be adequate representation without making the Council much too unwieldy a body. However, I hope this may be some consolation to the noble Lord, and to the noble Lord, Lord Teviot. It is the Minister's intention to have a standing advisory committee on dentistry to be constituted under Clause 2, subsection (3) of the Bill. On this Committee, of course, dentists will be fully represented, and the Chairman of the Dental Board could also be a member of the committee if he and his colleagues so desire. I can assure the noble Lord—and I think this was a point which the noble Lord, Lord Teviot, had in mind, although it was not mentioned by the noble Lord opposite—that of the three dental practitioners to be appointed to the Central Council under the Schedule one will be a dentist of the 1921 class, if that is in accordance with the views of his professional colleagues. The noble Lord has put these Amendments together—I am very glad he did so—and he will have noticed that one of the objects of the noble Lord, Lord Teviot, was to get a dentist of this class included in the representation.
LORD WOLVERTON: I understand that.
THE EARL OF MUNSTER: I fully agree with the noble Earl that the Central Council should be a very carefully balanced body, but when all is said and done the dentists are a very important element in the whole of the medical life of this country. I should have thought myself that after having included the president and the chairman of the six principal associations in this country, in

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view of the work that dentists are going to be called upon to undertake under this Act, it might have been possible for the Minister in the first place to include the Chairman of the Dental Board. I think it is a great pity that the dentists should be in a small minority on the central Council. There is a great demand for more dentists, as the noble and learned Lord, the Lord Chancellor, has pointed out on previous occasions during our discussions on this Bill, and I think it is a mistake to exclude the Chairman of the Dental Board from this central council.
THE EARL OF LISTOWEL: He will not be excluded.
THE EARL OF MUNSTER: He is not on it.
LORD WOLVERTON: I must say I am not at all satisfied. I am moving this Amendment on behalf of the noble Lord, Lord Teviot, and I do not know what he would have done in the circumstances. I do not know whether the Minister can give me any assurance that he will look into it between now and the next stage, but if not I beg leave to withdraw.
Amendment, by leave, withdrawn.
First Schedule agreed to.
Second Schedule agreed to.
Third Schedule:
REGIONAL HOSPITAL BOARDS, HOSPITAL MANAGEMENT COMMITTEES AND BOARDS OF GOVERNORS OF TEACHING HOSPITALS.

PART I.
Constitution of Regional Hospital Boards.
A Regional Hospital Board shall consist of a chairman appointed by the Minister and such other members so appointed as the Minister thinks fit, and the members shall include—
(c) persons appointed after consultation with the local health authorities in the said area; and
(d) persons appointed after consultation with such other organizations as appear to the Minister to be concerned;
and the original members of the Board shall also include persons appointed after consultation with such organizations as the Minister may recognize as representative of voluntary hospitals in the said area.
At least two of the members of the Board shall be persons with experience in mental health services.

PART II.
Constitution of Hospital Management Committees.
A Hospital Management Committee shall consist of a chairman appointed by the Regional Hospital Board for the area in which the hospital or group of hospitals is situated and such other members so appointed as the Board thinks fit, and the members shall include—
(a) persons appointed after consultation with any local health authority whose area comprises the area or any part of the area served by the hospital or group;
(c) persons appointed after consultation with the senior medical and dental staff employed at the hospital or the hospitals of the group, as the case may be; and

PART III.
Constitution of Boards of Governors of teaching hospitals.
The Board of Governors of a teaching hospital shall consist of a chairman appointed by the Minister and such number of other members so appointed as the Minister thinks fit, and if those members—

(a) not more than one-fifth shall be nominated by the university with which the hospital is associated;

(b) not more than one-fifth shall be nominated by the Regional Hospital Board for the area in which the hospital is situated;

(c) not more than one-fifth shall be nominated by the medical and dental teaching staff of the hospital; and

(d) other persons shall be appointed after consultation with such local health authorities and other organizations as appear to the Minister to be concerned, including, in the case of the original members of the Board of Governors of a teaching hospital designated before the appointed day, the governing body of any voluntary hospital comprised or to be comprised in the teaching hospital.

LORD ADDINGTON LORD ADDINGTON moved, in Part I, to leave out "and such other members so appointed" and insert "members appointed by local authorities as herein after provided and such other members appointed by the Minister." The noble Lord said: This is one of a series of Amendments. It is designed to provide that local health authorities should have a power of direct nomination to the Regional Hospital Boards, and to certain others set out in the Bill. One representative for each local authority would be unfair representation as between the authorities themselves, or impracticable owing to the numbers involved to select from the

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nominated persons those who are to represent the authorities on those Regional Boards. The difference between this proposal and that of the Bill is this. Under the Bill the Minister would presumably invite local authorities to submit the names of suitable representatives. He can appoint few of all such persons, and he may choose to go outside the ranks of those persons altogether. We heard from the noble Lord, Lord Horder, on the Second Reading of this Bill an interesting but somewhat disquieting account of the way in which the present Minister conducts consultations. We cannot, therefore, rely altogether on that leading to members whom the local authorities want being upon the very important bodies.
Under this proposal the Minister must choose from the persons nominated by the local health authorities, but he is nevertheless free to refuse a nomination, in which case a further name would be submitted. The practice of appointment by the Minister on the nomination of interested bodies is already in this Bill, and is already accepted in the case of boards of governors in this Schedule, and in the case of executive councils under Schedule 5, where the eight members are directly nominated by the local authorities concerned. The plea for direct representation can be pressed, I think, owing to the fact that these elected representatives of the local authorities will be really the only representatives of the public and those who use the hospitals themselves. They would, therefore, be the main representatives of the consumer interest. So that in a particular locality those who are concerned with the provision of the hospital accommodation, or who want some further provision, can raise the point at the local elections and see that their representatives are thoroughly well informed as to the position of those who are appointed to these boards and to these other bodies. It is therefore suggested that, having regard to the experience of the local health authorities in hospital administration, they should be very strongly represented on these Regional Boards. These Boards are completely new bodies, and the Schedule gives no indication of the number they should contain. It is suggested that it would be very reasonable if the local authorities had at least one-third of the full number. I beg to move.
Amendment moved—
Page 65, line 29, leave out ("and such other members so appointed") and insert the said new words.—(Lord Addington.)
THE LORD CHANCELLOR: The noble Lord has conveniently discussed this matter rather widely, and I am grateful to him for having done so. The broad issue here is how these people should be appointed. Should you have persons selected by the Minister after consultation with persons skilled in local government; should you have persons nominated by the local government organs; or should you have a kind of half-way house where the Minister selects from a panel so nominated? As a result, I am sorry to say, of a good deal of experience of this matter I have definitely come to the conclusion that where you have anything like a joint board on which there are people nominated by conflicting local authorities you tend to get a body which is not coherent, which is fissiparous, and which does not work happily together. That is because, as I said the other day, all its various members tend to look too much to the rock from which they are hewn; they tend to represent competing and conflicting interests rather than to try to do a job of work with that esprit de corps which is so necessary for any body. There is that tendency; I do not put it higher than that.
Of course, where you are appointing a body which is intentionally appointed to represent a particular interest, as, for instance, in the Fifth Schedule, to which the noble Lord referred, there the point is that you do want to get a body of people who represent, as he said, the consumer interest; you want to have the producer interest equally represented and you want a neutral chairman. We think it is right to do it in that case, that is why we do it in the Fifth Schedule and do not do it in the Third Schedule. Of course I appreciate that whenever you entrust a Minister with discretion you run the risk of indiscretion, but at the same time I feel quite sincerely that you are more likely to get a good and harmonious Board (and it is of the essence of the success of this scheme that the Regional Hospital Board should be a good and happy one) if, you entrust the Minister with the responsibility for selecting people whom he thinks to be suitable after consultation with various

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interests. For that reason I do not think I ought to accept this Amendment.
LORD ADDINGTON: In those circum stances I do not propose to pursue this Amendment, but I do hope the Minister will really select those people who are in touch with the local authorities and in touch with the people themselves. We want to get it as democratic as possible; we want as much interest as possible taken by the people where the hospital services are. These members representative of local authorities are the main means of getting local opinion and local wishes represented on the Regional Hospital Board. It is also important that they should be in touch because they are the sole means of achieving that liaison with which we dealt earlier when discussing Clause. In the circumstances, I agree to withdraw the Amendment.
Amendment, by leave, withdrawn.
6.14 p.m.
LORD LUKE LORD LUKE moved, in Part I, paragraph (c), after "area" to insert:
"(d) persons experienced in hospital management appointed after consultation with such organizations as the Minister may recognize as representative of such persons;"
The noble Lord said: With this Amendment I seek to improve the constitution of these Regional Boards. I think it will be agreed that the members of the Boards should be drawn from the widest sphere possible in connection with the health service. At the present moment, members are drawn from the universities, from the medical profession, from local health authorities, and then, rather as an after thought, it looks as if somebody said: "I suppose we ought to have somebody from the hospitals." I agree, of course, that hospital representatives may be included in paragraph (d)—"persons appointed after consultation with such other organizations as appear to the Minister to be concerned." The Schedule refers only to the original members of the Board. It rather looks as if representatives of the voluntary hospitals will be chosen in order to set up the Board and will be dropped again very quickly. I consider that there ought to be on these Regional Boards persons with experience in hospital management, not just in the first place but always, for surely there will be people who will gain that experience after the operation of the Act.
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As constituted in this Schedule, the Board is shorn of representatives from that most important element, the hospitals them selves. In view of the functions which the Boards are to perform in respect of hospitals, I consider this ought to be remedied. I beg to move.
Amendment moved—
Page 65, line 38, after ("area") insert the said words.—(Lord Luke.)
THE LORD CHANCELLOR: I understand the noble Lord wants to add a fur-them specific category to the present categories of members of Regional Boards, that is to say, persons experienced in hospital management. They are to be appointed after consultation with organizations representative of such persons. I am not quite clear what the intention of the Amendment is, because the Schedule says that the original members of the Board are to be appointed after consultation with local health authorities and the voluntary hospitals, and those two between them cover all the persons experienced in hospital management. The reason we use the word "original" is that as time goes on the only persons having such experience will be those who have served on management committees or board of governors.
I do not think we ought to contemplate dealing with the associations of management committees. The noble Lord might have in mind, of course, associations of officers like the Institution of Hospital Administrators, but once we start dealing with one particular organization we get into the position of having a lot of other organizations with which we ought to deal. I certainly agree with the noble Lord that it would be a lamentable thing if on a Regional Hospital Board we did not have persons who had very great experience of the work, who had rendered valuable services to hospitals for very many years; I think, however, that they come into the two categories. Not only do they come under (d) but they come specifically under the rest of the clause—"… the original members of the Board shall also include persons appointed after consultation with such organizations as the Minister may recognize as representative of voluntary hospitals in the said area." I think that having done that we are sure of getting the services of that valuable class of people—and most valueable

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they are. That being so, I do not think there is any need for this Amendment.
LORD LUKE: I thank the noble and learned Lord Chancellor for his explanation. I felt that the Amendment rather strengthened the whole constitution, but in view of his remarks on it and his explanation I beg leave to withdrawn the Amendment.
Amendment, by leave, withdrawn.
6.20 p.m.
LORD WOLVERTON LORD WOLVERTON moved, in Part I, at the end of paragraph (d) to add "including those representing the dental profession." The noble Lord said: This Amendment is very much the same as the one I moved just now on behalf of the noble lord, Lord Teviot. Its object is to secure representation of the dental profession on the Regional Boards. I think perhaps we shall be luckier with this one than we were with the last Amendment. Here again they are not specifically mentioned. In paragraph (b) the medical profession is specified, in paragraph (c) the local health authorities, and then paragraph (d) reads:
"persons appointed after consultation with such other organizations as appear to the Minister to be concerned;"
After that I seek to add the words: "including those representing the dental profession". We feel on this side of the House that this important body should be represented directly, and the clause should be strengthened by saying that they should be represented on the Regional Boards. I beg to move.
Amendment moved—
Page 65, line 40, at end insert ("including those representing the dental profession")—(Lord Wolverton.)
THE LORD CHANCELLOR: I have tried to make plain in the general discussion on this Bill the tremendous importance which His Majesty's Government attach to the work of the dental profession, and I have said that if only people were more conscious of the necessity of looking after their teeth, our health as a nation would be much better than it is. On the other hand, I am very anxious not to extend the categories of people to be represented, because the Minister does not want to appoint members as representative of particular interests;
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he wants to select people in their individual capacity. It will always be open to him to consider whether a dentist would, or would not, be a useful member of a particular hospital board, and no doubt in very many cases he ought to have one. On the other hand, if I put dentists down as one of the class of people who must be consulted, then would the noble Lord consider what answer I would have when the nurses came along? He would agree with me that the nurses play an equally important part. Then the midwives—if it were not for them where would any of us be? Then there are the pharmacists, radiographers and goodness only knows who else. I do not think, therefore, that it is wise to extend the categories. If it is left to the Minister to select a wide range of people, I can assure the noble Lord that in selecting them he will not forget something of which we are all very conscious, the immense importance of the dental profession.
LORD WOLVERTON: In view of the assurances from the noble and learned Lord, I beg leave to withdraw my Amendment.
Amendment, by leave, withdrawn.
6.22 p.m.
LORD LUKE LORD LUKE moved in Part I, after "hospitals in the said area," to insert: "Before making appointments to fill vacancies the Minister shall also consult the Board." The noble Lord said: This is an Amendment to provide the machinery which seems to be absent for filling vacancies on the Board. It would appear that the Minister has a direct interest, and should therefore be in consultation with the Board when the filling of vacancies becomes necessary. As was said in another place, there would of course be consultation, but I would rather like to know what objection there is to providing for that in the Bill. The Minister will surely want to know the views of the Regional Board as a whole. I beg to move.
Amendment moved—
Page 65, line 44, at end insert ("Before making appointments to fill vacancies the Minister shall also consult the Board.").—(Lord Luke.)
THE LORD CHANCELLOR: Your Lordships have all been very kind and we are getting to the end of our proceedings,

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so I will adopt rather a novel course in this case: I will ask your Lordships to decide whether you would like me to accept this Amendment. The Amend-merit requires the Minister to consult the Board, but I do not doubt that the Minister, as a matter of good sense, would normally consult the Board. If, on the other hand, you require him to consult the Board—and I am quite ready for him to do so—may you not put the Board, in certain cases, in a rather difficult position? Is it not better that this sort of thing should be done very informally with certain individual members of the Board, the Minister getting their reactions over a cup of tea, rather than put upon the Minister a duty to consult them formally? I quite see that the Regional Board might be in some difficulty. My own view is that I would prefer not to have the Amendment, but I have authority to say that if the noble Lord and other members of the House press me in regard to it, I may accept it. Having said that, it is up to the noble Lord to say what he wants done.
LORD LLEWELLIN: I cannot speak for my noble friend, but I should presume that as he put the Amendment down and proposed it, he would like it accepted. From my point of view I should.
LORD LUKE: I must thank the noble and learned Lord for this very welcome surprise, and I should be very grateful if he would accept the Amendment.
THE LORD CHANCELLOR: Then I accept it.
On Question, Amendment agreed to.
6.25 p.m.
THE EARL OF MUNSTER THE EARL OF MUNSTER moved in Part II to leave out "a chairman appointed by the Regional Hospital Board for the area in which the hospital or group of hospitals is situated and such other members so appointed," and to insert "such number of persons appointed by the Regional Hospital Board for the area in which the hospital or group of hospitals is situated." The noble Earl said: This Amendment is one of four which stand in my name, and perhaps it will be convenient if I dispose of them together. It deals, of course, with the hospital management committee and the board of governors. I am very anxious that both the committee and the board should have the opportunity of appointing their own
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chairman. That is to say, the hospital management committee should discuss among themselves as to which person would be the most appropriate to become the chairman of their committee. Exactly the same case applies in the board of governors. They would, as soon as they are set up, consult with one another, perhaps over a cup of tea, and decide who should become their chairman. Practically throughout the whole of life, in every branch of industry, in trade unions, or in political parties, the person who is head or chairman can be appointed only by agreement amongst his colleagues in that particular organization. I believe by that method in most cases you get the best man—certainly the most popular man—and one with whom generally the rest of the committee (in this case the board of governors) are prepared to work whole heartedly and in full co-operation. This is not a wrecking Amendment, but merely one to make quite certain that the committee and the board function smoothly and happily. I beg to move.
Amendment moved—
Page 66, line 3, leave out from ("of") to ("as") in line 6, and insert the said new words.—(The Earl of Munster.)
THE LORD CHANCELLOR: I am afraid I take rather a stronger view about this Amendment than I did the last one. I do not believe this is a good proposal. I very often wondered whether the system whereby a bench of magistrates elect their own chairman was a very good one. I believe this is typically a case where you ought to have those soundings which I have suggested, and you ought to do this thing informally. I would be most sorry to see this proposal carried. Of course, so far as the management committee is concerned, when there is a vacancy or the chairman goes, in nine cases out of ten his successor more or less appoints himself. I mean there is one obvious man. But when that is not so, then the Regional Board must have the last word. If the Regional Board can have a cup of tea—I do not know whether a board can—they can discuss with the other members who is the right person to appoint. After all, he is their servant, he is doing their work, and the last word must lie with them, and they must be able in the last resort to give him that authority. There fore, I suggest to the noble Lord that

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really his Amendment would not be in the best interests of the happy working of this Bill.
THE EARL OF MUNSTER: The noble and learned Lord I gather was talking about the hospital management committee. For what purpose is it necessary for the Minister to appoint the chairman of the board of governors of a teaching hospital? I would let the first Amendment go by willingly if the noble and learned Lord would give me the second. I cannot see why the Minister should come in and appoint the chairman of the board of governors, with whom the rest of the board may disagree. He can appoint anybody who is nominated in paragraphs (a), (b), (c) or (d). Like most other persons, they are going to be appointed to the board of governors in consultation with local health authorities. But I am very nervous about this, for I fear that you will find that the chairmen of these boards of governors will not be the people who have functioned for many years. It is possible that they will not be the existing deputy chairmen, but as I said on the Second Reading, some trusty local political colleagues appointed by the Minister.
THE MARQUESS OF READING: As one who is a member of the board of governors of a teaching hospital, I should like to say a word upon this, though I am saying it purely on my own behalf. I should feel very much more confident as to the happy working of that hospital board in the future if I knew that we were going to continue to appoint our own chair man, rather than have one imposed upon us. It might be that the person imposed upon us would be perfectly acceptable. On the other hand, it might be that he would be anything but acceptable, then there would be all sorts of friction, pro tests would perhaps be made to the Minister and the situation, generally, would be very unpleasant. If the matter is left where it is, the appointment would be in the hands of the responsible and experienced board of governors of a teaching hospital, and they could surely be trusted to appoint as chairman a person who was both congenial to themselves and acceptable to the Minister.
THE LORD CHANCELLOR: I think the reason for this provision is to be found in the fact that the Minister, after all, is the person who is to be responsible for
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this health service. One of the chief organs by which he is going to carry out his responsibilities is this hospital service, and one of the chief organs of that service will be the teaching hospitals—they are vitally important. The Minister must, therefore, have control. As I said just now wherever you give a man discretion, there is a risk of indiscretion. If the Minister is going to fill all these appointments—and there is a great number of them—with a lot of old, incompetent political cronies then the whole scheme is sunk and finished.
It depends absolutely, in this connexion, on getting a man of first-class intelligence and, I need hardly say, of integrity, representing that section of the community who will devote themselves to this work. I do not think it is really useful to consider that the Minister may (of course it is possible that a Minister might) make a whole lot of wholly unworthy appointments. I suggest that as responsibility for this service has been placed upon the Minister by the first clause of the Bill, he must have to his hand an instrument which satisfies him, and he will have very close and direct dealings, of course, with the governors of teaching hospitals. I think it is of the utmost importance that the chairman of such a board should be a man who is likely to get on well with the Minister, a man who will be amenable, one having the necessary time to discuss problems and able to discuss them.
I repeat that I do not think the Minister would be foolish enough to lump anybody on a committee without taking soundings from the various members to see who they would like to have. In the interests of the work of the hospital the Minister would obviously wish to get someone who is persona grata to the other members of the committee and also person grata to himself. In the last resort, we must assume that the Minister would exercise his discretion wisely. The choice must be left to him.
THE MARQUESS OF READING: May I make this suggestion? Will the noble and learned Lord consider between now and the next stage of this Bill whether he would accept a proposition that the chairman of a board of governors should be appointed by the board with the approval of the Minister?
THE LORD CHANCELLOR: I will certainly get instructions about that, and I will consider it.
THE EARL OF MUNSTER: I was going to make a similar suggestion. In view of what the noble and learned Lord has said I now desire to withdraw this. I did not intend to suggest that the Minister was a fool or would be so foolish as to appoint some ridiculous political colleague. I can, however, picture him appointing the Chairman of the Hospitals Committee of the L.C.C. to the Chairmanship of the board of one of the teaching hospitals. That is what I want to prevent. I beg leave to withdraw my Amendment.
Amendment, by leave, withdrawn.
6.35 p.m.
LORD ADDINGTON LORD ADDINGTON moved, in paragraph (a) of Part II to leave out "appointed after consultation with" and insert "selected by the Board from per sons nominated by." The noble Lord said: We have discussed the main part of this Amendment already. As hospital management committees are more local in character and only deal with the area of one local authority, I suggest that the precedent of the executive council should be followed rather than the precedent of the Regional Boards. If the noble and learned Lord Chancellor is not prepared to accept this Amendment I will not move arty more, but now I beg to move this one.
Amendment moved—
Page 66, line 7, leave out ("appointed after consultation with") and insert ("selected by the Board from persons nominated by")—(Lord Addington.)
THE LORD CHANCELLOR: I am afraid the same observations which I made before apply here only perhaps rather more forcibly. I do not think we ought to adopt this suggestion.
LORD ADDINGTON: In the circumstances I beg leave to withdraw my Amendment.
Amendment, by leave, withdrawn.
THE EARL OF MUNSTER THE EARL OF MUNSTER moved, in Part II, paragraph (c), to leave out "the senior and insert" a committee representing the." The noble Earl said: I understood the noble and learned Lord to intimate when we were discussing Lord Moran's Amendment to Clause 12 that he would be in favour of setting up the committees. He said: "I entirely agree that it is essential to have these medical committees." I beg to move.
Amendment moved—
Page 66, line 14, leave out ("the senior") and insert ("a committee representing the").—(The Earl of Minister.)
THE LORD CHANCELLOR: I should like to have heard from other noble Lords before I replied to this. I entirely agree of course that you have got to consult the medical and dental staff. But I should have thought the people you would want to consult would be the senior people. I must say that I look hopefully towards my noble friend Lord Moran about this. He may be able to advise me upon his. I should be very glad if he would.
LORD MORAN: I think that what this Amendment really means is that the medical staff should be consulted; not the senior members of the medical staff, but the medical staff as a whole. The medical staff because it is a very democratic body does not recognize any distinction between senior and junior members. It does not mind at all that resident officers or house officers should be consulted. It desires simply that the medical staff should be consulted ad hoc and not merely a section of the staff.
LORD LLEWELLIN: I understood it was likely that there would be medical committees in these hospitals. It was thought that they would be the people to consult as to who should be on the hospital management committees. I should have thought that if you had a medical committee that was the right body to consult rather than pick oat any particular senior persons, and that it is desirable that you should have this organization recognized as speaking for the doctors and ex pressing the doctors' views. I should have thought that this was a subject on which they were eminently fitted to give their views.
THE LORD CHANCELLOR: I agree that where you have a medical commit tee you ought to consult the whole body. Where there are not medical committees the Minister intends to encourage their formation. He wants to get them everywhere. But where there is not one consultation ought none the less to take place. The Minister's intention is, I am told, to consult with the senior staff who ought to be consulted, that is, the consultants and specialists, not the house men. It is for that reason that we pat in the word

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"senior". I gladly give an undertaking, however, that where there is a medical staff committee the staff committee will be consulted as an entity without simply picking out the older and more distinguished members of a distinguished galaxy. In other cases, we shall have to consult the consultants and specialists, as opposed to the house men.
THE EARL OF MUNSTER: I am very much obliged to the noble and learned Lord, and I beg leave to withdraw my Amendment.
Amendment, by leave, withdrawn.
LORD LUKE LORD LUKE moved to add to Part II: "Before making appointments to fill vacancies the Board shall also consult the committee" The noble Lord said: This is a similar Amendment to the last, that the Board shall consult the committee before filling any vacancies. I beg to move.
Amendment moved—
Page 66, line 23, at end insert the said words.—(Lord Luke.)
THE LORD CHANCELLOR: I have been so kind to the noble Lord already that he does not deserve any more, but he has been very kind to me, and there fore I will accept this Amendment.
LORD LUKE: I suppose that I am allowed to rise and thank the noble and learned Lord?
On Question, Amendment agreed to.
6.43 p.m.
LORD MORAN LORD MORAN moved, in Part III, paragraph (a) to leave out "one-fifth" and insert "two-fifths". The noble Lord said: I need not detain your Lordships long on this Amendment. It is concerned with vulgar fractions. It is possible that the noble and learned Lord may say that if he accepted this Amendment, it would alter the composition of the whole committee. When matters concerning major local authorities or local management committees, or even lesser local authorities, come before your Lordships' House they are warmly supported from many quarters, but the university is the Cinderella of these proceedings. I want to stress this Amendment simply because it increases the influence of the university on a committee which is fundamentally concerned with research and teaching and
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these, after all, are the functions of a university. There are two other reasons why I think that the position of the universities should be strengthened. In the first place, that is the only way you can obtain harmoniously decentralization of specialists. In the second place, to have a university service is the only way you can bring up the standards of the periphery to that of the centre. The purpose of this Amendment is to strengthen the influence of the universities.
Amendment moved—
Page 66, line 29, leave out ("one-fifth") and insert ("two-fifths").—(Lord Moran.)
THE LORD CHANCELLOR: I must say that I thought we had treated the universities pretty handsomely, but they are like Oliver Twist: they want more. Under the Third Schedule as it stands, one-fifth of the members of the commit tee are to be nominated by the appropriate university. The same proportion—that is another one-fifth—are to be appointed by the medical and dental teaching staff. This means that something like two-fifths will be academic members. The Amendment, if adopted, would mean that the academic element might be as much as three-fifths. That is a substantial majority, and I think it would be overweighting the academic representation. Three-fifths is a higher proportion than is usually found on the governing bodies of teaching hospitals at the present time. Of course, a teaching hospital has a dual function, treatment of patients, and research and teaching doctors. We must not have an undue emphasis on the teaching side for the future; we must have due regard for the patients. I suggest that the university influence, which I agree is of fundamental importance, is already adequately assured by the not ungenerous provision which I have described.
LORD LLEWELLIN: It does not seem to matter very much whether this reads "not mare than one-fifth," or "not more than two-fifths," because, strangely enough, it does not say a minimum number. Is it the intention that normally the proportion will be one-fifth?
THE LORD CHANCELLOR: I under stand the intention is that one-fifth shall be university members. We have adopted these words; otherwise, we should have had complications with vulgar fractions.
LORD MORAN: At this late hour, I will not take up very much time in explaining to the noble and learned Lord opposite that patients' interests are always looked after. That is admitted in the whole profession, and in the last twenty-five years I have seen the gradual weaning of public opinion from the idea that a teaching hospital does not exist for the care of the sick but for the teaching of knowledge. However, I beg leave to withdraw my Amendment.
Amendment, by leave, withdrawn.
LORD MORAN LORD MORAN moved to leave out paragraph (c) in Part III and insert:
"(c) not more than one-fifth shall be per sons nominated by the medical staff committee of every hospital in the group; and"
The noble Lord said: This is a verbal alteration, necessitated by the fact that a teaching hospital is not always one in stitution. In the provinces, it is often two or three. Where that is the case, this Amendment aims at seeing that each hospital is represented.
Amendment moved—
Page 66, line 33, leave out paragraph ("c") and insert the said new paragraph.—(Lord Moran.)
THE LORD CHANCELLOR: If your Lordships will allow me not to deal with this now, and if the noble Lord will with draw his Amendment, I will see if I can not insert suitable words on the Report stage. I am rather out of my depth.
LORD MORAN: I thank the noble and learned Lord, and beg leave to with draw.
Amendment, by leave, withdrawn.
LORD MORAN LORD MORAN moved in Part III, paragraph (d), after "with" to insert: "the university with which the hospital is associated and with". The noble Lord said: This is really another step to add to university influence, and in view of the fate of the former I have not great hopes. It is simply to add the university to the bodies which the Minister will consult for the remaining two-fifths in the composition of this committee.
Amendment moved—
Page 66, line 35, after ("with") insert the said words.—(Lord Moran.)
THE LORD CHANCELLOR: I am sorry that I cannot help my noble friend about this, but I am glad to think that in
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refusing him I am not destroying his hopes for the universities.
LORD MORAN: I beg leave to with draw.
Amendment, by leave, withdrawn.
6.48 p.m.
LORD LUKE LORD LUKE moved, at the end of Part III, to insert: "Before making appointments to fill vacancies the Minister shall consult the board." The noble Lord said: This is another Amendment similar to the other two, and I do not know whether the indulgence of the noble and learned Lord will extend to this, as well as to the others. I hope that it may.
Amendment moved—
Page 66, line 41, at end insert the said words.—(Lord Luke.)
THE LORD CHANCELLOR: I do not think that I ought to go further. I know that it is said that good things go in threes, but on its merits I really do not think that this ought to be accepted.
LORD LLEWELLIN: Is that right? If you consult each of the others, ought, you not to consult the board of governors before filling a vacancy? You pay the original board the compliment of consulting them; you pay the hospital management committee the compliment of consulting them; but when you are filling a vacancy of the board of governors of a teaching hospital you say—as I under stand it—that because the noble Lord, Lord Luke, has had two successes the board of the teaching hospital will not be consulted. I should have thought that it would be logical, if you consult one in this way, to consult all three. Possibly the noble and learned Lord had not his brief before him when he replied, and I hope that he will reconsider this matter and put the three in the same category.
THE LORD CHANCELLOR: I had better look at all three. If the noble Lord desires it, I will look into this matter. If I am putting in the other two, I will consider putting in the third. In the meantime, perhaps the noble Lord, Lord Luke, will withdraw and I will see how deeply my neck is in the noose.
LORD LUKE: I think the noble Lord will find it is rather logical, but, never the less, I beg leave to withdraw my Amendment.
Amendment, by leave, withdrawn.
Third Schedule, as amended, agreed to.
Fourth Schedule:

FOURTH SCHEDULE.
PART II.
Health Committees.
3. A local health authority may authorize the health committee to exercise on their be half any of their functions as a local health authority, except the power to borrow money or to levy or issue a precept for a rate.
4. At least a majority of the health committee of a local health authority shall be members of the authority.
5. The minutes of proceedings of the health committee shall be open to the inspection of any local government elector for the area on payment of a fee not exceeding one shilling and any such local government elector may make a copy thereof or extract therefrom.
6. The health committee of a local health authority may, subject to any restrictions imposed by the local health authority, establish such sub-committees as the health committee may determine, and any sub-committee established under this paragraph shall be constituted in such manner as may, subject to any restrictions imposed by the local health authority, be determined by the health committee, and at least a majority of every sub-committee shall be members of the local health authority or of a local authority for any area forming part of the area of the local health authority.
7. The health committee of a local health authority may, subject to any restrictions imposed by the local health authority, authorize any sub-committee to exercise on their behalf any functions of the health committee.
6.51 p.m.
LORD ADDINGTON LORD ADDINGTON moved, in Part II, to leave out paragraphs 3 and 4 and insert
"The provisions of the Local Government Act, 1933, (except subsection (5) of Section 85) shall apply to every health committee as if that committee were appointed under the said Section 85."
The noble Lord said: This raises a different point. As I see it, there are two conflicting codes for the health committees of the county and county borough councils. Section 85 of the Local Government Act 1933 is the section under which local authorities are given a general power to appoint committees. This section gives power to delegate; it authorizes a local authority to fix the number of the committee and the terms of office; it includes power to add members who are not members of the local authority, pro vided that at least two-thirds of every
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committee shall be members of the local authority. The Schedule in the Bill as drawn purports to set up a separate code for the appointment of a health committee and this appears to be quite unnecessary and really quite unworkable. The main difference between the terms of Part II of the Fourth Schedule of the Bill and Section 85 of the Local Government Act is contained in paragraph 4, which says that at least a majority of the health committee shall be members of the local authority, whereas the Local Government Act requires that two-thirds of the committee shall be members of the local authority. I think that the Association feel that the Local Government code is to be preferred and that the two-thirds majority should apply to the health committee as to other committees.
The acceptance of the Amendment would further have the effect of applying Sections 94 and 95 of the Local Government Act, 1933. As the Bill stands, those sections would not apply to those health committees. Section 94 is the one that applies the rules relating to disqualification for office as a member of a local authority, that is due to bankruptcy and conviction for certain offences. Section 95 applies the disability against voting on account of interest in a contract to members of committees. In other words, co-opted members of a committee would be made subject to both of these sections in the same way as elected representatives if this Amendment is accepted. I think it is very necessary. I hope that I may be included among the recipients of the kind nesses which have been shown, if the noble Lord, Lord Luke, has not received all the kindnesses that are available. I beg to move.
Amendment moved—
Page 68, line 37, leave out from ("3") to ("authority") in line 42 and insert the said new words.—(Lord Addington.)
THE EARL OF LISTOWEL: I hope that I shall not be outdone in generosity by my noble and learned friend, but the noble Lord opposite will remember that there are other colleagues of his on the Benches opposite whose Amendments have still to come. What I think the noble Lord wants is for the provisions of the Local Government Act of 1933 to apply to the appointment of health committees by local health authorities, instead of the provisions of the Fourth Schedule of this Bill. Let us see what alterations this

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would make. First of all, it would mean that at least two-thirds of the members of the health committees would have to be members of the authority instead of simply being a majority. The second change this would mean is that the health committees would not be able to set up sub-committees, to which some of their powers could be delegated. Finally, the third change would be that the health committees would not be able to set up sub-committees, as they otherwise could under this Schedule, with outside persons—health experts—who were not members of the local authority, or members appointed to the committee. I do think these would be definite disadvantages.
For some time I worked on the committees of the London County Council, and I always found it was a good thing to be able to co-opt a certain number of outside experts. That certainly applied to all the committees on which I served, and I think that the health committee of a local health authority under this Bill would be in exactly the same position as any of the important committees of the London County Council. Surely it is desirable that the main health committee should be able to include a fair number of outside experts. Surely it is also desirable that this committee should be able to set up sub-committees to deal with a particular area or particular subjects, and to delegate to these committees certain functions, for instance, maternity and child welfare or mental health. I do think these advantages accruing to the health committees under the procedure in the Schedule with which the noble Lord is dealing would be definitely lost if the old procedure under the Act of 1933 were adopted.
LORD ADDINGTON: I do not think that the noble Earl is quite accurate. As far as I am advised, the section of the Local Government Act does give power to appoint, to delegate, and to appoint sub-committees. The main difference is that the co-opted members cannot exceed one-third. I think it is very inconvenient if the public health authorities have to work on two different codes. If there were one code governing them, it would be a very great convenience in working. Perhaps the noble Earl would again see whether he is quite accurate in what Section 85 of the Local Government Act does say.
THE EARL OF LISTOWEL: I will certainly go into that.
LORD ADDINGTON: Perhaps he will look it up again. I will not press my Amendment at this stage.
Amendment, by leave, withdrawn.
Fourth Schedule agreed to.
Fifth and Sixth Schedules agreed to.
Seventh Schedule [Constitution of Tribunal]:
THE EARL OF LISTOWEL: There is on this Schedule a consequential Amendment following an Amendment the Committee has already accepted in Clause 41. I beg to move.
Amendment moved—
Page 71, line 10, leave out from the first ("an") to ("and") in line 11 and insert ("ophthalmic optician and a dispensing optician").—(The Earl of Listowel.)
On Question, Amendment agreed to.
Seventh Schedule, as amended, agreed to.
Eighth Schedule agreed to.
Ninth Schedule [Amendment and repeal of enactments relating to persons of unsound mind and mental defectives]:
THE EARL OF LISTOWEL: There is a drafting Amendment to exclude the words "fourteen days" and to insert the words "after which."
Amendment moved—
Page 74, line 46, leave out ("fourteen days") and insert ("after which").—(The Earl of Listowel.)
On Question, Amendment agreed to.
7.0 p.m.
THE EARL OF LISTOWEL THE EARL OF LISTOWEL moved to add to the reference to Section 55 of The Lunacy Act, 1890:
"in subsection (3) the word 'private' where it last occurs shall be omitted; and for subsection (6) there shall be substituted the following subsection:
'(6) Where any patient detained in a registered hospital in pursuance of a contract with a Regional Hospital Board is permitted under this section to be absent upon trial two members of the managing committee of the hospital may make an allowance to the patient during the period of his absence not exceeding the amount payable under the contract for his maintenance in the hospital and the allowance shall either be paid to him or for his benefit as the members of the managing committee may direct.'"
The noble Earl said: This is the first of a series of Amendments, and I think it would probably be convenient to your Lordships if I were to explain the point on the first one. What we are doing under this Bill is to transfer certain powers governing mental health to the Minister of Health. There will be some registered hospitals, and by the expression "registered hospital" I think that what is meant is a hospital run privately, and one which is independent from any public authority which will not transfer to the Minister under Clause 6 of this Bill. What will have to be done is for hospital accommodation for persons suffering from mental illness to be arranged by means of contracts between the management of these hospitals and the Ministry. All the various Amendments that are tabled here are a means of making these arrangements practicable. The first is to enable the medical superintendent of a registered hospital to allow a patient received there under contract to be sent out on trial. I beg to move.
Amendment moved—
Page 75, line 35, at end insert the said words.—(The Earl of Listowel.)
LORD LEWELLIN: I think we are all much obliged to the noble Earl for his explanation in regard to this and subsequent Amendments. I do not think they raise any matter at issue, and unless any other noble Lord suggests otherwise, I suggest that the noble Earl moves them formally.
On Question, Amendment agreed to.
Amendments moved—
Page 75, line 44, at end insert—
("For section sixty-one there shall be sub stituted the following section:—
'61. Where a patient is detained in a registered hospital in pursuance of a contract with a Regional Hospital Board, the Board may make an order for the removal of the patient and may direct the mode of removal and on production to the manager of the hospital of a copy of the order he shall forth with remove the patient or permit him to be removed in accordance with the order.'")
Page 76, line 16, after ("detained") insert ("in any such institution or under such care")
Page 76, line 21, after ("detained") insert ("in any such institution or under such care")
Page 76, line 33, at end insert—
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("For Section seventy-three there shall be substituted the following section:—
'73. Where any patient is detained in a registered hospital in pursuance of a contract with a Regional Hospital Board, the Board may make an order for the discharge of the patient and may direct the mode of discharge, and on production to the manager of the hospital of a copy of the order he shall forthwith discharge the patient or permit him to be discharged in accordance with the order.'")
Leave out lines 34 and 35.
Page 83, line 10, leave out ("sixty-one and")
Page 83, line 11, after ("omitted") insert ("for the words 'that Act', where they first occur, there shall be substituted the words the principal Act'")
Page 83, line 20, after ("seventy-five") insert ("of the principal Act")
Page 83, line 21, after ("seventy-seven") insert ("of that Act")
Page 83, line 38, leave out ("subsection (6) of Section fifty-five")
Page 83, line 40, leave out ("61")
Page 83, line 41, leave out ("73").—(The Earl of Listowel.)
On Question, Amendments agreed to.
Ninth Schedule, as amended, agreed to.
Tenth Schedule [Consequential amendments and repeals]:
THE EARL OF LISTOWEL: The first Amendment to the Tenth Schedule is con sequential upon Amendments already accepted. I beg to move.
Amendment moved—
Page 85, line 5, at end insert—
("The Children and Young Persons Act, 1933 23 & 24 Geo. 5. C. 12.
In Section ninety-two, for the words 'Board of Control' there shall be substituted the words 'Minister of Health'.")—(The Earl of Listowel.)
On Question, Amendment agreed to.
THE EARL OF LISTOWEL: This Amendment is consequential upon a previous Amendment. I beg to move.
Amendment moved—
Page 88, leave out lines 29 to 34.—(The Earl of Listowel.)
On Question, Amendment agreed to.
Tenth Schedule, as amended, agreed to.

STATE EMPLOYEES.
7.7 p.m.
LORD BROUGHSHANE: My Lords, I beg to ask the question standing in my name on the Order Paper.
[The question was as follows:
To ask His Majesty's Government, what is now the total number of persons in the employ of the State as compared with the number employed before the war; what additions have been made in the number of such persons during the current year; and what further additions to State employees it is estimated will be required when the increased staffs now being recruited for the Ministry of National Insurance, the Ministry of Health and other Government Departments have been engaged.]
LORD WALKDEN: The non-industrial staff of the Civil Service totalled just under 400,000 on April 1, 1939, the date nearest to the beginning of the war for which firm figures are available. The number employed at July 1, 1946, was just under 709,500. Since January 1, 1946, the number has increased by 18,500 over the whole Service. In 1939 the number of staff employed on work now performed by the Ministry of National Insurance (other than the Family Allowance Scheme) was about 7,000. Since the beginning of 1946 the numbers employed by the Ministry of National Insurance have increased from 7,900 to rather more than 12,000. The ultimate number to be employed by this Ministry may be of the order of 32,000 to 33,000, distributed as follows: London headquarters 500, regional and local offices 25,000, Newcastle office 7,000.
To the extent of about 15,000 to 16,000 persons, this increase of staff will represent the transfer of functions from approved societies and the replacement of staff now engaged on work arising from the Workmen's Compensation Acts. No corresponding increase is expected in the numbers of staff to be employed by the Ministry of Health. There only about 500 additional staff will be needed
670
in the next few years to handle the Ministry's increased duties. No firm estimate of the future overall size of the Service can be made at the present time.
LORD BROUGHSHANE: Do I under stand from what the noble Lord has just said and the figures which he has given that, speaking generally, the number of persons estimated to be in Government employ in the immediate future will be in the neighbourhood of 1,000,000, and, having regard to the urgency of finding persons to engage in industry and the lack of people available for industry, may I ask the Government to take into consideration the desirability of getting this vast number of civil servants reduced as much as possible in the early future, especially as similar increases in unproductive labour have taken place in local government?
LORD WALKDEN: The noble Lord must not take it that I indicated that the persons employed in the Civil Service would approximate to one million. I do not think that at all. I can add nothing to the figures I have already given, and the further supplementary question goes a long way beyond the original question.

SUNDAY ENTERTAINMENTS ACT, 1932.
Orders made by the Secretary of State for the Home Department extending Section 1 of the Act to the

County Borough of Great Yarmouth;

Borough of Chesterfield;

Borough of Daventry.

Laid before the House (pursuant to Act) for affirmative Resolutions and ordered to lie on the Table.
House adjourned at nine minutes past seven o'clock.