§ 4.25 p.m.
§ Debate on Second Reading resumed.
LORD HAWKEMy Lords, one might almost say that "a slight thunderstorm interrupted play." When I came to your Lordships' House to-day I was not expecting to speak on this Bill, because I anticipated that there would be a long and formidable list of speakers. But, taking advantage of the shortness of the list, I hastily thrust myself forward. Sometimes, to listen to noble Lords opposite, one would imagine that they had a monopoly of care for the health of the people; just as sometimes from the cross-Benches we hear views about more particular elements of health. On this side we are never given any credit at all for wishing to see the people well. I can assure noble Lords that we do, and that nothing pleases us better than the sight of a healthy and happy nation. I personally have always been in favour of a National Health Service—not necessarily completely free—because I realised that it would do away with that positive nightmare of the middle classes, the crippling doctor's bill. As any of your Lordships who has been brought up in circumstances of that sort knows, the idea that an operation or serious illness may lead to heavy bills has been the nightmare of the professional and middle classes for many years. The poorer people in this country have for many years had a free health service, but the middle classes have never had one, except under such arrangements as insurance schemes, and the like. The present scheme gives them that protection.
There are difficulties which naturally arise in connection with a National Health Service. First of all, we must admit that the idea is entirely alien to most of the rest of the world. Foreigners just do not understand a free Service, and when we instituted one they had serious doubts, both about our solvency and about our sanity. There were various elements in the Service which naturally gave rise to those doubts. The fact that we were treating foreigners free was, to them, stark lunacy, and made them think that we had taken leave of our senses. The fact that we were providing free wigs—not a big item—was one which 637 loomed out of all proportion to its monetary cost on the minds of the outside world. Then again, there were stories that went round that foreign coloured seamen were getting free sets of teeth in every port and selling them in the bazaars on their return. These stories may have been entirely untrue, but they went all the way round the world and they undermined the confidence in the future of Britain.
The second difficult, which is inevitable in a Service of this kind is the march of science. The doctors will not stand still: every day they are thinking out some new and wonderful cure for some fresh disease. The result is that a Service of this kind is bound, in the very nature of things, if it is entirely free and there are no practical limits on its expenditure, to cost more and more. I believe that a member of your Lordships' House and a leader of the medical profession is reported to have said in public the other day that the cost might well double in fifteen years. I myself, speaking in a different part of the country on the same night, used practically the same words. We may well take it that an enormous and inevitable increase in expenditure is bound to come about. To take the case of cortisone, if all the sufferers from rheumatoid arthritis are to be treated free with cortisone the bill might go up by millions of pounds in a year from that one new remedy alone.
The other difficulty is the human desire to get money's worth. The population of our country never realised that the stamps which they stuck on their insurance card every week represented only to a very small extent money for the Health Service. Some years ago I put down a Question in your Lordships' House, because I thought that the Service was being abused, and I wanted to give publicity to the fact that only a few pence out of each stamp went towards this Service. His Majesty's Government (as it was in those days) gave me an answer to the effect that the fact I sought to publicity was very well known already, and that fresh publicity was quite unnecessary. Of course, I do not agree with that answer. There is no doubt about it that the people of this country—particularly the more ignorant of them—think that the very heavy weekly expenditure which they make on their stamp largely goes towards financing 638 this Health Service. Of course, they want to get their money's worth out of it. When they see 4s. 9d., 5s. or whatever it is a week going out, they want to see something coming back, and there is no doubt that that has driven them to ask for things which otherwise they would not have required.
Another difficulty, not endemic to a National Health Service at all, is the increasing drug consciousness of our people as a whole. If your Lordships refer to an article in the weekly magazine Everybody's this week, you will see that the medical profession are getting seriously alarmed at the fact that enormous numbers of our population seem to think that they cannot be kept in health unless they are constantly imbibing either sleeping draughts, tonics or sedatives. The fact that there has been this demand for these drugs has led to the doctors' surgeries being overcrowded and to doctors becoming certificate-issuing machines, instead of being able to diagnose, and so on. I submit that there is only one possible thing to do when you are faced with an ever-expanding public service, and that is to set a limit on the total amount of the national income you are prepared to see devoted to that purpose. You then say: "If you people want more, in order to provide it for yourselves you must forgo some spending power that you would otherwise exercise."
A broad decision on these lines was inevitable, and it has been taken. It was taken by the last Government and it has been reaffirmed by this Government. Of course, within that broad decision there is considerable room for argument. It is extremely difficult to say how you are going to keep anything at your, specific limit. You can say: "We will make some charges on everything," or you can say, "We will charge on certain things which we regard as less, important," and so on, and so forth. Here, on the whole, I think the greatest things remain free—when I say "here," I am talking about both this Bill and the existing Act, with its regulations, which provide for the prescription charges. Here, if people think themselves ill, or have trouble with their teeth, they can go to the doctor or the dentist to find out what is wrong with them; and they do not pay. That is a great principle. It is when the treatment starts that some charges become 639 payable. Of course, one cannot have everything in this world. If the Almighty visits one with some plague, it is only reasonable human nature to think that one may have to give up something else to be able to cure that plague.
It would be very interesting to know what the Opposition would do in these circumstances. I believe that they support a ceiling. How would they keep the charges within that ceiling? They strongly disapprove of the methods we intend to use, but it would be interesting to hear exactly how they would do it. I was hoping that the noble Lord, Lord Shepherd, would give us that information, but he did not seem to do so. I understood him to say that if noble Lords opposite came into power, they would immediately insert a time limit, so that any charges would automatically come to an end after a certain time. I do not know whether I misunderstood him, but I gathered that he was promising an entirely free Service very shortly after return to power—I hope that I am not putting words into his mouth. It would be interesting to know how he suggests that would be done. I think the words he used, roughly, were that they would provide a Health Service without charging in the way of this Bill. Does he mean that there would be a Health Service without any charges or that the charges would be a different sort of charges?
§ LORD SHEPHERDMy Lords, if I may intervene, at the invitation of the noble Lord, I should like to put the matter in this way. We look upon illness generally as coming under the responsibility of the community. It is not the Almighty who sends all these illnesses to us. It may be, as my noble friend has suggested, bad drains. There may be many other reasons which cause these illnesses. If the community is very largely responsible for ill-health, the community must be responsible for the cure. As we are all subject to ill-health we all pay, and because we all pay, we take what we pay for.
§ LORD MATHERSBefore the noble Lord, Lord Hawke, resumes, may I ask him whether he would be prepared to apply to his own family, if they were met with a large measure of disease, the principles he has been urging?
LORD HAWKEThat is precisely the principles which do apply. If one has a doctor's bill, one cannot have another bill of the same sort. From the reply of the noble Lord, Lord Shepherd, I take it that when they return to power, the Service is going to be free regardless of its cost.
§ LORD SHEPHERDNo. What I said was that the charges in this Bill would be done away with.
LORD HAWKEIn other words, there will be no ceiling. I have invited the noble Lord to say whether there is some other method by which he would apply the ceiling. He does not reply, but tells me that these charges would be "done away with." I can only conclude that he is going to provide an entirely free Service, regardless of its cost. Of course, one does not know the circumstances of three or four years ahead, which is the earliest the noble Lord can hope to get back into power, but statements of that kind to-day will not inspire confidence abroad in the future of sterling and so on, which this Bill is tending to help. The noble Lord also led me to believe that he did not think it worth while spending Parliamentary time on checking small expenditure.
§ LORD SHEPHERDNo. I said that it was not worth spending Parliamentary time on a Bill which could do so little in connection with the purpose for which it was introduced—namely, the saving of this nation from bankruptcy.
LORD HAWKEExactly the same thing. In other words, it is not worth while spending Parliamentary time on small savings and, therefore, expenditure is sacrosanct. What I cannot understand about Lord Shepherd's argument—and I think Lord Mathers intended the same thing in his interruption a minute or two ago—is that they assume there can be no health unless the State provides it. That seems to me a most cynical view. After all, if there are any charges under the Health Service, anybody who is unable to pay can go to the National Assistance Board and get the wherewithal to pay. If such people cannot get anything out of the National Assistance Board one can only assume that they have some means to pay. Therefore, they come into the category of those millions and millions who are spending the hundreds 641 of millions about which the noble Lord, Lord Mathers, was talking, on drink, tobacco, betting and so on, or the very many of the humblest means who are proudly hoisting the television aerials in the air, but who, apparently, in the view of noble Lords opposite, are too stupid to pay anything for their health, even if they want it. That, I submit, is a most cynical view. The noble Lord, as all of us know, carried on for many years the profession of an election agent. It has been his business to know the minds of the people. As Chief Election Agent of his Party he must have been in contact with millions of the people; and if that is what he believes—that millions of our countrymen think to-day, that health is worth having only if they can get it entirely free—then I suggest that that is a most cynical view to take.
I was very pleased to hear the speech of the noble Lord, Lord Mathers. It is a great pleasure to congratulate any Scotsman on a maiden speech in this House for he always brings to it that bit of pawky humour for which the northern—and perhaps I may say the more important—half of our Island is so well renowned. But I assure the noble Lord that neither this Bill nor our actions are intended as discrimination. As I have just said, it is perfectly possible for all people in the country to obtain the treatment they desire under this National Health Service by going to the National Assistance Board, if they are without means, and by forgoing some of their other expenditure if they have means; so that, in effect, there is no discrimination. We are telling the people in effect, "If you are ill you are increasing your claim on the national resources by a very large amount, because the treatment is very Costly; and in return, unless you are destitute we are asking you to decrease your claim on the national resources Slightly in other directions by an amount far less than what you are getting in the shape of your treatment and so on."
This is a small Bill, but I believe that it is a Bill of very considerable importance, because it tells the world that the British Government are prepared to limit the free bounty which they hand out to the electors to an amount which they believe the national income can afford. And the fact that a democratic Government are prepared to stand up to their own electors and deny them the free 642 benefits which are so beloved by democratic electors all over the world is, I believe, something of a landmark in democracy.
§ 4.43 p.m.
§ VISCOUNT BUCKMASTERMy Lords, I had not intended to intervene in this discussion, and it is only by your Lordships' courtesy that I venture to do so now for a moment. I should like to pay a tribute to the noble Lord, Lord Mathers, on his maiden speech. We all hope to hear him again. May I personally express the hope that when I do hear him again I shall be able to find myself a little more in agreement with him than I do this afternoon? I hope the noble Lord will not feel that we on this side have any desire whatever to deny to the indigent and needy the full benefit of the Health Service. Noble Lords opposite will appreciate that to introduce a Bill of this kind is not calculated to enhance the Government's popularity. It requires a good deal of courage to introduce such a Bill, and it would not have been done had not the necessity been urgent. I will not repeat the remarks which I ventured to make on a Motion in my name on the Health Service some weeks ago; but I think it right to point out that the Service had reached a cost of £400,000,000 when the predecessor of the present Chancellor of the Exchequer had to endeavour to impose a ceiling, and that since then the £44,000,000 allocated to the doctors has been added to the £400,000,000. One noble Lord said that it was unfortunate that we had not started the health centres. They would have involved the expenditure of a further £370,000,000. I ask noble Lords opposite, what is the ceiling to be? The predecessor of the present Chancellor of the Exchequer declared that there should be one. I would also ask noble Lords how they would propose to impose any such ceiling.
To turn to the charges themselves, my criticism would be one which I believe is present in the minds of the Government and others, and that is the extreme difficulty of collecting the charges on a bottle of medicine from doctors who dispense the medicine themselves. It would he very difficult. No doubt some arrangement may be arrived at, but when one considers that every man, woman and child in this country, on paper at any rate, has four bottles of medicine a year, it seems to me that the moment for some 643 control and self-restraint has been reached. There is a further point. These charges are not designed merely to achieve economy—which is not, in itself, a very large economy. They are designed to prevent further waste, to keep down the ever-rising cost of the Service. I believe, from conversations I have had with those who might be expected to feel the force of these charges, that it will have this effect. Many working men with whom I have spoken feel that some charge should be made. Any noble Lords who like to venture to the local chemist's shop will see some most glaring examples of waste in the Health Service going on day after day under their very eyes. I believe that this Bill will in no way damage the Service. If it did I would not support it. I believe it will tend to improve the Service, a Service which is essential to the nation.
§ 4.48 p.m.
§ VISCOUNT STANSGATEMy Lords, when I looked at the list of speakers to-day I noticed that there was not one single unofficial member of the Conservative Party who was prepared to defend the Bill. The Leader of the Liberal Party spoke about Lords Reform but not of exercising the primary duty of using the powers we still have in this House. The noble Lord, Lord Hawke, attacked the Bill with regard to—
§ VISCOUNT STANSGATEI beg pardon. The noble Lord was defending the Bill. His reason was such as might be suited to a village meeting. He said that foreigners thought it was crazy that we should give these free Health Services. We have done many things which the foreigner may have thought foolish but we have survived them. He spoke of a coloured seaman, perhaps a Lascar, who might have toothache—and who, incidentally, might be a member of the British Commonwealth—and seemed to think it was a mistake that such a man should get free dental treatment.
LORD HAWKEI suggest that before the noble Lord goes any further he had better read in the OFFICIAL REPORT tomorrow what I said. That will save my remaking his speech for him now.
§ VISCOUNT STANSGATEI will certainly do so. Having made these points, he said that the march of science was making treatment much more expensive. If the march of science is going to raise the standard of health of the people, surely we ought to rejoice and save something, perhaps from the "atom," which may be devoted to eliminating human pain and saving human life. He said that people wanted their money's worth and therefore we ought to make them pay. But has he ever thought that the sort of person who can pay is not necessarily the sort of person who is really ill? The man who has won money on the football pools can afford a bottle of medicine, but the poor woman—and this is a real example; I had many instances of this when I was a Member of the House of Commons—the mother of a family, is the last person to spend money on medicine for herself, because that is the thing she thinks she can economise on. She sends her children to the doctor but she will not go to the doctor herself.
§ VISCOUNT STANSGATEThat is an attack on the medical profession. I should have thought that such discrimination penalises the poorest.
§ VISCOUNT STANSGATEIt does penalise the poorest. People with money can pay for medicine. Surely there is a much better system of economy than the one that is proposed? But what is really surprising about the Conservative attitude is this. We hear of the need for maximum productivity. We want more people to work harder. The question of national productivity is closely connected with health; and yet noble Lords opposite do everything they can to belittle it and deny the glorious principle which was proclaimed by the last Labour Government, by which I think its reputation will live—namely, that health, like fresh air or pure water, is something which, so far as the State can do, it should provide, because such things not only make for human happiness but also are good for our health and strength.
§ VISCOUNT STANSGATEUp to a certain ceiling. It depends whether the ceiling is going to be over the whole national field or not. Of course, you cannot spend more than you get in the long run. What you can do is to discriminate between the useful things and the unuseful things, and of the things that are primarily and vitally useful, I should have thought that the Health Service was the best. One really has to re-read Oliver Twist to understand that the attitude of the Conservative Party in these matters is practically unchanged in the course of the last hundred years.
§ 4.52 p.m.
§ THE MARQUESS OF SALISBURYMy Lords, we have had a characteristically breezy intervention from the noble Viscount, Lord Stansgate. I do not intend to follow him, except to make one or two references to certain observations which he made, partly because what he said seems to me so far from the realm of reality that it is hardly worth mentioning. The real reason why I have risen—I did not intend to speak when I came into this House—is because of one or two remarks made by the noble Lord, Lord Shepherd, in his opening speech, and one remark that has been made by the noble Lord, Lord Milner of Leeds, in the speech he has just delivered to us. The noble Lord, Lord Shepherd, as he always does, made a closely reasoned and moderately-worded speech, of which no one could complain. But he did say in the course of it one or two things to which I feel some reply ought to be given from this side of the House.
First of all, he said that no reasons had been given for the introduction of this Bill. If there was any shortcoming in that respect, I must say I thought he supplemented pretty well what might have been said from the Government Benches. I thought he made some very strong arguments for the introduction of this Bill. He began by saying, honestly and fairly, that he wished to stand in a white sheet and explain the position of the Party to which he belonged. He said, as I understood him, that in 1950, as a result of the balance of payments position which existed at that time and which was not nearly so acute—as he himself said—as the situation that developed later on, Sir Stafford Cripps, who was then 646 Chancellor of the Exchequer, fixed a ceiling of £400,000,000.
§ LORD SHEPHERDMay I correct the noble Marquess on a point? In the year 1950 we had a favourable balance of payments between ourselves and other countries. The deficit came in 1951.
§ THE MARQUESS OF SALISBURYThat, in my view, makes the noble Lord's argument even odder, because the need to restore confidence was obviously not so great at that time as it is now. Then he went on to say that in 1951, when Sir Stafford Cripps had been replaced, after his unhappy illness, by Mr. Gaitskell, the new Chancellor felt he could afford only—I do not want to misrepresent the noble Lord—£7,000,000 extra, although the demands for increases were very much greater. Therefore, he introduced, as a purely temporary charge, a charge on dentures. He went on to say that the whole point of this measure was that it was temporary. I understood, too, that, in his view at any rate, whether the position improved or continued to deteriorate after that period was over, the charge would be removed, whatever the situation of the country was. That was the only conclusion one could draw from the remarks made by the noble Lord.
§ LORD SHEPHERDThe point was that we had put into the Bill a date beyond which the Act should not go. My point was that this Government, in introducing their Bill, are omitting a date.
§ THE MARQUESS OF SALISBURYI am just coming to that point. Then, turning to the present Bill, he said in shocked terms—and I understand he is still shocked—that there was no limit of time in the present Bill; that the charges would continue, and that nobody would know when they would come off. With all deference to the noble Lord, I still think our position, our attitude, our policy—whatever you like to call it—is more realistic and more honest than that of the Government which the noble Lord supported at that time. After all, how were they to know that the situation would improve by a given date? As a matter of fact, it steadily deteriorated, and deteriorated more and more. Why were they to suppose then that on a given date they could remove these 647 charges that they had put on? With all deference to the noble Lord, that does not seem to be a reasonable case to put before the House.
If I may say so, in our view on this side of the House we were equally shocked at the noble Lord's words, because it appears to us that the situation of the country is still extremely precarious; yet he and his Party are already beginning what we can only regard as a discreditable process of bribing the electorate with a view to the next Election. I do sincerely think that. I am not making a mere Party point. We all know what the national position is. It is improving, but it is still very bad. But already the Party opposite are beginning (I hope the noble Lord will let me say what I want to say without interrupting) to pledge themselves—they did it last week—that, whatever the situation is, they will remove these charges if the electorate will only put them back into power. The only conclusion that we can come to is that the noble Lord and his Party, now that they are out of power, feel that they can fairly let themselves go, and they are lending themselves to promises which I do not think are justifiable, in our present economic situation—promises which I am quite certain they will bitterly regret at a later date if they ever come back to power.
§ LORD SHEPHERDThe noble Marquess will at once admit that we are not the only Party that makes promises. I hope he has reached the conclusion that we may be the only Party that never breaks a promise.
§ LORD SHEPHERDMay I say this: that during my speech I gave an instance of what we have done for the country, better than screwing £9,000,000 of money out of the people.
§ THE MARQUESS OF SALISBURYThe noble Lord really must let me answer. I sat quite silent throughout his speech and it is difficult to construct a consecutive argument if I am constantly being asked to sit down. To return to what I was saying, he undoubtedly did tell the House that his Party had pledged themselves to remove these charges if they came back to power, and he made no qualification about the economic or the financial situation of the country when 648 that happened. It is not only the noble Lord himself; I know that there are others who have done it. He is not the original offender. But I cannot imagine anything more blatantly irresponsible at the present time. The noble Lord quoted the Leader of the House of Commons, and he said, with great astonishment, that my right honourable friend appeared to be less concerned with the condition of the Health Service than with the prospect of national bankruptcy. Well, who would not be? If we had national bankruptcy we should not only not be able to maintain the present Health Service; we should have a catastrophic fall in the whole of our standard of life; the greater includes the less.
My Lords, the noble Lord returned to the words of the Chancellor of the Exchequer, who had said that there had been a steady deterioration in the situation over the last fifty years, and that though at one time we were the largest creditor in the world, now we are the largest debtor. It is perfectly true that our national situation has been steadily deteriorating for fifty years. The two wars, plus a period of not frightfully thrifty house-keeping, has steadily made the situation worse than it was in those days. But that is not an argument for spending more money; that is an argument for exercising a certain decent measure of thrift. After all, why have our gold reserves been falling? I speak with great diffidence on this subject. I see the noble Lord, Lord Pakenham, who is a trained economist, preparing to jump in in support of his Party, as he is quite entitled to do. But why have our gold reserves been falling? Why have foreigners to a great extent been withdrawing their money from this country? It is because they no longer have the confidence in us that they formerly had.
The noble Lord will say that that does not apply merely to us; it applies, too, to the other members of the sterling bloc. But we are its most important member. You have only to read foreign newspapers to see that the confidence of foreigners in Britain has been very largely impaired. The noble Viscount, Lord Stansgate, said: "Why should we care what foreigners think? They have often thought us crazy before, and we have turned out to be right." But to-day we are depending on them for our very existence. Our existence depends on whether 649 these foreigners will allow their money to stay here, will send more money here, and will close the dollar gap. It depends upon them whether we have a decent standard of living here at all. They have seen the Labour Party year by year spending more and more. They have seen them borrowing on a vast scale from the United States and Canada, and they have seen money being poured out. They have concluded that this is not the type of country in which they want to keep their money.
My Lords, the fact that we have balanced our internal budget, as the noble Lord, Lord Pakenham, is always telling us, does not make any difference to this position. What they see is a country which is living, or has been living, at a standard which it cannot afford; and, as a result, they have become more and more sceptical about our future. Eventually, last autumn, a point was reached when our reserves began to lessen; the drain on them became greater and greater, and at such an increasing speed that even the late Government could not ignore it. Then what did they do? Instead of standing their ground, facing up to the situation and asking the people to cooperate, they went to the country—at that vital moment
§ VISCOUNT STANSGATEEven at the risk of incurring reproof from the noble Marquess, I must point out that it was Mr. Churchill who did nothing but plead for an Election.
§ THE MARQUESS OF SALISBURYProbably Mr. Churchill felt that that was the only hope for the country, and I have no doubt he was quite right. But the fact remains that the Labour Party ran away in a desperate attempt to escape the consequences of their improvident policy of the last six years.
That was the situation which faced the new Government when it came in. The country was moving nearer and nearer to the precipice. The noble Lord, Lord Pakenham, will not be able to deny that. All through the months of last year, the drain was increasing. But now there are signs of a turn. I do not put it higher than that. I am not going to try to overstate our case. As your Lordships know very well—the noble Lord, Lord Shepherd, did not mention these figures—the monthly deficit which was 229,000,000 650 dollars in January fell to 70,000,000 dollars in March; and there are signs of a further improvement. We may be wrong; we may be right. Noble Lords may not believe what we say. But we believe that that is the result of the policy that we have adopted. We have had to do a lot of unpopular things; we have had to do a lot of unpleasant things; we have had to do a lot of very drastic things—things which the people of this country do not like. I am quite certain that there are a number of people who voted for us at the last Election who would not vote for us to-day. They would not do so because they think that, as the result of our measures, they are worse off than they were. But in fact that is the only way in which this nation can be brought back to solvency; and, taken as a long-term policy, we believe that what we have done is in the interests of the country. That is why we have gone in for it, and I think it shows a fair measure of courage.
My Lords, at this moment, when the turn is beginning, what does the noble Lord, Lord Shepherd, say? He says: "If you only let the Labour Party back, there will be an end of any economy. There will be no more charges for the Health Service; there will be unlimited spending." What sort of effect is that going to have on the foreigner who is just beginning to regain confidence in this country? I do not think any noble Lord could have said anything more unfortunate from the national point of view at the present moment. If the noble Lord and his friends are shocked by this Bill, we on this side of the House are equally shocked by the levity of the announcement he has made. He said that the sum which would be saved by this Bill was "a drop in the bucket." That was the very phrase he used. But it is by innumerable drops that the bucket is ultimately tilled; and, psychologically, in a matter of this kind—a matter of confidence—each economy which the Government are able to make and which the country will accept is worth far more on the credit side than the intrinsic amount which is involved. The only result of what the noble Lord has said will, I am afraid, be to retard the recovery of sterling.
Now I should like to say a word about a quite different point that was raised 651 by the noble Lord, Lord Milner. He complained of the time given by the Government for the consideration of this Bill. I do not think that there is any valid ground for that complaint. This is not a long Bill. It is not like one of the great nationalisation Bills, with clause upon clause. In all, there are only nine clauses, of which six are what I may call operative. It is a Bill very easy to assimilate, very easy to consider, and it has been before another place for some weeks. One might assume that noble Lords, like other people, have paid full attention to what has happened in another place, with the assistance of Hansard. Therefore, if they have Amendments to put down, no doubt they have already been turning them over in their minds. We have the Second Reading today; then there will be a week's pause, followed by the Committee stage.
§ LORD MILNER OF LEEDSI am afraid that the noble Marquess has misunderstood me. My complaint was about the short time available between Friday last and to-day, with the week-end intervening, especially having regard to the fact that a considerable number of substantial Amendments were passed in another place on Thursday last. I thought it unreasonable, with the week-end intervening, that the Second Reading should be at such an early date.
§ THE MARQUESS OF SALISBURYThe last thing we want to do is to hustle noble Lords; but as I will explain later, there are reasons for the course we have adopted. In any case, there will be a week before any Amendments are put down in this House, and we hope that the period we have allowed for the Committee stage will be adequate. If it is not, no doubt the Committee stage will go on. We are not supplied in this House with all sorts of facilities, such as are available to all Parties in another place. Therefore, if there are more Amendments, no doubt they will be put down and debated. When the noble Lord has been here a little longer, I think that he will see that it is our experience that the Committee stages of Bills take rather less time here than they do in another place. Finally, of course, there will be the Report stage and the Third Reading.
I said that I would give the reason why we were in rather a hurry. The 652 reason is, of course, that there is a very large amount of revenue involved. If the purpose of a Bill—the regrettable purpose, for we all regret it—is to make certain economies, it is not much use delaying those economies beyond a certain period. If you have made up your minds that you have got to do an unpleasant thing it is better to do it and have done with it. It is for that reason, quite simply and frankly, that we want to get the Bill through as soon as practicable. I can assure the noble Lord—and I am sure that others will tell him the same thing—that in this House, on both sides, we do our utmost to cooperate with each other. Never is it our object in any way to restrict the proper facilities and rights of debate. I think that is really all that I have to say to your Lordships. I am sorry to have intervened at such length in this debate; I did not intend to do so when I came to the House this afternoon. But certain things were said which I thought called for a reply on my part, and therefore I have made this contribution to your Lordships' discussions.
§ 5.12 p.m.
LORD PAKENHAMMy Lords. I also had not intended to take part in this debate to-day. I am not quite clear whether the noble Earl. Lord Onslow, intends to reply later. He intimates that he does—good. I hope that your Lordships will all derive as much pleasure from my intervention as we have derived from the intervention of the noble Marquess. If I may say so without impertinence, he is a Leader very much after the hearts of those of us who sit on this side of the House, because he is ready to take off his coat and descend into battle without in any way standing on his dignity. He will forgive me, I am sure, if I speak rather bluntly, because he accused us of discreditable bribery of the electorate, and that merits a few mild observations in return. I have never heard from anyone in this House a more exhilarating outpouring of genial hysteria than that which we have just heard from the noble Marquess. He was challenged by my noble friend Lord Shepherd to produce some good reasons for the Bill. I do not think that, when we study Hansard, we shall feel that he has complied with that request—I presume that the onus of doing so has been handed on to the noble Earl, Lord Onslow.
653 The noble Marquess brought forward one pseudo-economic argument, so far as could follow him—and one only. He often assures us that he is no economist. As a matter of fact he seems to understand economic processes better than most of us. Perhaps on this occasion, when he did not make that disclaimer, if he had done so it might have been more justified than it usually is. He indulged in a very familiar form of economic emphasis. He based his whole argument on the necessity far securing the confidence of the world. He did not argue that these charges would do any actual good in themselves, but he appeared to believe that the world at large would be reassured; and he used an extraordinary sentence which I venture to think perhaps he would not have employed if he had spoken with more premeditation—I dare-say that I shall use words to-day which I should not use if I had given more time to thinking over what I proposed to say. The noble Marquess said that we were dependent on foreigners for our existence; that the question was whether foreigners would allow their money to stay here or would send more money here. Does the noble Marquess really take the view that everything depends to-day on the movements of capital? We know that there are occasional leaks; people do not always pay as rapidly as they might do, and there are one or two other marginal factors of that kind. But surely the noble Marquess does not claim that the economic position of this country is affected in a major degree by movements of foreign capital. If so, the system of restraining capital movements must have deteriorated greatly in the last few months. It seemed to me that he advanced it as a primary factor, when, in theory, movement should not be taking place at all. That was his only economic argument, and I am bound to say that it seems to me very flimsy.
§ THE MARQUESS OF SALISBURYMay I intervene just to ask the noble Lord this? Does the noble Lord believe that the credit of this country—of any country—is of any importance in regard to the balance of payments position?
LORD PAKENHAMI certainly agree that the credit of a country is of importance, but I refuse to agree that we have to impair the health of our own people in order to reassure foreign speculators.
§ THE MARQUESS OF SALISBURYThe argument I used—the noble Lord may not accept it—was that the late Government, against the protests of both the other Parties, continued to spend at a rate which was above what we believed the country at that moment could afford. It may be a queer coincidence, but in fact our international position, our balance of payments position, steadily deteriorated during that period, whereas now that firm action is being taken the balance of payments position is steadily improving. The noble Lord may think that that is just odd.
LORD PAKENHAMI hope that our position is improving. It certainly did not steadily deteriorate during our six years of rule; otherwise it would have been very bad indeed. As the noble Marquess knows, substantial measures have been taken, many of which we should have had to take ourselves. I refer to import cuts.
§ THE MARQUESS OF SALISBURYBut you did not take them—that is the point. We have taken them.
LORD PAKENHAMThe noble Marquess knows that if we had been returned to power we should have had to take them. Mr. Gaitskell made it plain when lie spoke at the Mansion House that unpleasant measures were, on the way. The noble Marquess cannot have much doubt in his own mind about that.
§ THE MARQUESS OF SALISBURYif the noble Lord really says that the Labour Government, had they been returned, would have taken measures which we have taken, why on earth is he complaining of our action?
LORD PAKENHAMThe noble Marguess is interrupting me at a fairly rapid rate. I make no objection to that. But the House will recall that in regard to interjections he rather tended to cry, "Hold! enough!" when the noble Lord, Lord Shepherd, was putting some questions. But I do not complain. As I was saying, these substantial import cuts were essential, but not this playing about with the health of the sick, No one on this side, or, I think, anywhere, supposes that that has improved our position in the world. Does the noble Marquess think that these foreign speculators or merchants have been fortified in their confidence in us because of the few millions which may be saved in this way?
§ THE MARQUESS OF SALISBURYDoes the noble Lord want an answer to that? I do not want to interrupt him unnecessarily, for he has been extremely kind to me. What I think is this. Foreigners want to know whether we in this country are determined that while our income is as it is at present, there is a degree of expenditure above which we shall not go. When we give them evidence of that, it increases their confidence in us.
LORD PAKENHAMI simply cannot agree that we ought to make irrational cuts to please or encourage foreigners. Rational cuts—yes. Those have been made and they would have been made by us. But irrational cuts will do no good and, on the contrary, will, in fact, do a great deal of harm. The noble Marquess did not provide any economic argument at all except this rather pathetic wooing of the foreigners. He did not explain why this step to make people pay for these appliances, and for getting their teeth stopped, would have any beneficial results. We say it will have no beneficial results at all.
The noble Marquess said that we had been living too well. I should like to draw his attention specially to this. He is very quick in argument on his best days and this may be one of those days. The noble Marquess said that we were living too well. Here is an essential point. When we discussed these matters during the general economic debate in February, I argued then, even in advance of Mr. Butler's Budget, that in no way should we benefit the balance of payments position by making rather squalid cuts of this kind. The case then was not as strong as it is now, because at that time most of us thought that Mr. Butler's Budget would impose some reduction on the consumption of the country. The Budget came along and Mr. Butler argued—I am not going to question whether he is right or wrong—that no reduction in general consumption was necessary. That was a substantially new factor introduced in Mr. Butler's Budget, and therefore the case against cuts is much stronger since the Budget than it was before. I hope that the noble Earl who is going to address himself to some of these questions, and who is obtaining assistance from the noble Viscount, Lord Swinton, will try to reply to that point. I put this question to the noble Earl, who can secure the assistance of the noble 656 Viscount and then reply. If there is to be no cut in the general consumption of the country, why should a special penalty be imposed on the sick? I put it as plainly as that to the noble Earl, and perhaps he will tell us why, since the Budget, there is any justification on economic grounds for these regrettable impositions.
I do not want to say much more, except to reply to one charge of the noble Marquess. It is a broad political charge, but we are a political assembly, and to some extent, within the usual limits of your Lordships' House, it is a "free for all" this afternoon. The noble Marquess accused us of running away. Where did we run away to? We faced the electorate in the General Election. Mr. Churchill was bellowing away because we continued to be so coy and refused to trust ourselves to public judgment, and then, because we did so, we are now accused of running away. We did not try to run away. I do not want to introduce personalities, but talking about running, I, for one, spent my time during the Election running up and down the country, and Mr. Attlee broke all records for activity during the Election. Was he trying to be defeated? That is carrying the accusation too far. I am bound to say that probably never in history has there been an Election in which a Government made so much progress. The polls moved our way the whole time. Were we trying to be defeated, but the public insisted in supporting us all the time? Again, that would defeat credulity.
§ VISCOUNT SWINTONMy Lords, that is a charge which has frequently been made, but never by the noble Marquess or by myself. Nobody doubts that the noble Lord ran about the country during the Election, but the charge of running away is this. All the Labour Government had to do was to come to Parliament in September for one day and by a single executive action put on the cuts, which would have probably been fixed at £150,000,000, in October. Then they could have gone to the country. That is what we call running away.
LORD PAKENHAMThat is not what the noble Marquess called running away. I challenge the noble Viscount to dispute my statement. He said something quite different just now.
§ THE MARQUESS OF SALISBURYMy Lords, what I meant, though the noble Lord may not accept it, was that the late Government ought to have faced up to the steadily deteriorating position, but they did not do that. There was nothing to prevent them—because they had a majority—from going on during that period and taking the measures they thought necessary to restore the credit of the country. They went to the country instead. That policy lost valuable time, and it was a mistake, because the position was far worse when we took over than it might have been.
LORD PAKENHAMIf the noble Marquess said it was a mistake at the time, he must be the only Conservative who thought at the time that it was a mistake for the Government to face the electors. I argued the other point with the noble Viscount and I expect we shall argue it again. The noble Marquess said there was something cowardly in calling a General Election last year. We resent that suggestion. We had to go to the country because we had to introduce important new and unpleasant measures. The Party opposite would have been the first to complain that the electorate had been ignored, if we had introduced these measures without a mandate. We very nearly obtained a mandate and I am certain we shall obtain one the next time. The next time I hope it will not have to be a mandate for measures of the kind we are discussing this afternoon, because, when all is said and done, this measure, though small in tent, is sordid and unworthy. I hope that when he replies the noble Earl will produce some economic arguments for a Bill which seems to us petty, mean and altogether lamentable. We have not had any economic arguments this afternoon and in their absence we can only conclude that they do not exist.
§ 5.26 p.m.
THE EARL OF ONSLOWMy Lords, when I came to the House I thought we were to discuss the National Health Service Bill, but it seems that we have diverged along every possible channel. Before I make my few remarks, I should like to add a few words of congratulation to the noble Lord, Lord Mathers, on his maiden speech. Like other noble Lords, I hope that we may often hear him and have his wise counsel. It is almost customary that he who winds up 658 a debate in your Lordships' House should open his speech with the words, "This has been a very interesting discussion." I think I can say that to-day with more than usual polite formality, because something of great interest has come to light during the course of the discussion—the attitude of the medical profession to this Bill. The noble Lord, Lord Webb-Johnson, has spoken from the Cross-Benches. I do not think that any one would accuse the noble Lord of any Party instinct, nor do I think any noble Lord would dare suggest that members of the medical profession who are also members of your Lordships' House would not put their profession first and Party politics second, whatever their politics might be. The noble Lord welcomed the Bill and this welcome from an eminent member of the medical profession shows that people like him consider that the Bill will do no harm to the health of the country as a whole. It would seem that medical opinion is that the Bill will not interfere in anything so far attained in the promotion of the health of the country.
The Bill has been almost violently attacked by noble Lords opposite. But they did not have among their speakers their medical colleagues. There is an old adage which I do not think is out of place here: that "Silence gibes consent." I think we might possibly use that adage to-day in regard to the attitude of noble Lords of the medical profession who sit on the other side of the House.
LORD PAKENHAMMy Lords, I have no mandate to speak for my noble friends, but, to the best of my knowledge, I think the noble Earl would be making a very great mistake in forming any such conclusion.
THE EARL OF ONSLOWI think it fair to say that their absence indicates that, as the Party opposite are so violently against the Bill, if their medical colleagues had been strongly of the same view they would have taken steps to advertise their opposition, particularly from the medical point of view. The medical profession, like many other great professions, is loyal to the profession first, and to politics next. I am quite certain that, if they had felt as strongly as some noble Lords feel, they would have indicated whether or not they were in agreement with what the noble Lord, Lord Webb-Johnson, has said to your Lordships this afternoon.
659 I have been asked by the noble Lord, Lord Pakenham, about the reason for these charges, and this has been the gist of all the arguments of noble Lords opposite. I am not an economist, but I shall do my best to reply to the noble Lord. Your Lordships will remember that in the recent economic debate, we enjoyed a phenomenal passage of arms between the noble Viscount, Lord Swinton, the noble Lord, Lord Pakenham, and the noble and learned Earl, Lord Jowitt. I think I am right in saying—the noble Lord will correct me if I am wrong—that the gravamen of their argument was that it was wrong for the noble Viscount, Lord Swinton, to say that they did not know how serious our financial situation was at the time of the General Election, and that they had said so as frankly as the noble Viscount himself was saying. If that is so, is it not right to try to economise by every possible means within our power in order to rectify the position?
LORD PAKENHAMMy Lords, I do not want to re-open an earlier discussion now that, as I like to think, most amicable relations have been resumed, but I should like to say quite briefly that I cannot accept the noble Earl's account of the particular point at issue. However, I do not want to deter him from further development of his argument.
THE EARL OF ONSLOWI am glad that all is happy now. But assuming that the situation is as serious as was agreed at that time, or shortly afterwards, I maintain that it was the duty of the Government by all possible means to economise in order to meet the situation. It was the Labour Government who found it necessary to impose a ceiling on the health services. As has already been said by the noble Lord, Lord Woolton, and the noble Lord, Lord Hawke, the service of the medical profession, like any other live service, does not stand still. Every day new treatments and new medicines are coming in which are much more expensive; and, if you are to retain a ceiling, you must continue to economise somewhere to meet them. That, in fact, is what Sir Stafford Cripps said when it was introduced. We are trying to economise with this Bill and with the Bill brought in by the Socialists when they were in power. They did not bring it into force, and I believe that Mr. Aneurin Bevan said that the only reason 660 why he agreed to it was that it could not be implemented—which seems an odd way to legislate. However, we seem to have been slightly cleverer than Mr. Aneurin Bevan, and we have found a means of implementing it.
Through the steps now proposed we estimate that we shall save about £20,000,000. I do not think in these days that you can "sneeze" at £20,000,000. For far too long we have been saying: "What do these few odd millions of pounds here and there matter? "We have been saying that until the pot is nearly dry. If noble Lords care to add up a few of these odd millions, they will see that they come to a colossal sum. The time has come when we have got to collect these few odd millions. That gives, in a nutshell, the reason for this Bill. If your Lordships look at the Bill, I think you will find that it will not cause great hardship; and Clause 7 (2) gives power to the Assistance Board to help anybody who cannot pay. As I said earlier, I am not an economist, but I do not believe that it is wrong for a man to pay for what he can afford when his country is in a jam. I have taken a great deal of trouble in studying this Bill over the week-end, and I may say that even if I were not a member of the Government, or a member of any Party, inside or out of Parliament, I should be prepared to support the Bill.
§ On Question, Bill read 2a, and committed to a Committee of the Whole House.