HOSPITAL ENDOWMENTS (SCOTLAND) BILL [H.L.] (Hansard, 18 February 1953)

§ THE EARL OF SELKIRK
My Lords, on behalf of my noble friend Lord Home I beg to move the Second Reading of this Bill. Perhaps I should explain its origin. The Hospital Endowments Commission made certain recommendations to the Secretary of State, and it is on those recommendations that the Secretary of State has brought forward this Bill. I should perhaps explain that, under the National Health Service (Scotland) Act, all endowments were transferred on the appointed day to the hospital boards of management. At the same time the Hospital Endowments Commission was set up to prepare schemes which would eventually regulate the management of these endowments. This is different from the system in England where, as I understand it, endowments were transferred to the Endowments Fund and then distributed by the Minister of Health.
The Endowments Commission is under the chairmanship of Sir Sydney Smith. Sir Sydney Smith is very well known in Scotland. He was acting Principal of Edinburgh University, and I had the great pleasure of learning at his feet the subject of forensic medicine, on which he lectures with such great authority. He has recommended that part of these funds should be devoted to research, but although the individual hospital boards can, in fact, use their funds for research, he has felt that this can be more usefully done by an independent body of trustees acting for the whole country. He thinks that adequate funds are available—he estimates them at somewhere in the order of about£120,000 a year. So there is a fairly substantial sum which he considers can be made available for a research trust of this character. It is proper to say that this scheme has been fairly widely canvassed in Scotland, and it is understood that there is a wide 564 measure of support for it, both from the hospitals and from the universities. In proposing this arrangement Sir Sydney has, of course, borne in mind the fact that adequate funds must be available to provide reasonable amenities at individual hospitals, and he has said that even when a fund of this character has been provided, the hospitals will be reasonably catered for.
I should perhaps explain the procedure under which the Endowment Commissioners have to operate. It is laid down in the National Health Service (Scotland) Act, and is as follows. They have, first of all, to consult all those whom they consider to be interested in the endowment, including, of course, the endowment trustees. They then draft a scheme; they hear objections, and, if necessary, they hold an inquiry. That is the first step in the formation of the scheme. The next step is to submit the scheme to the Secretary of State, who may approve it with or without modification. The third step is that the scheme is submitted to Parliament, which may annul the scheme if it disapproves of it. I want to emphasise this point, because it is obviously of great interest to people that endowment funds should not be entirely used for what the Endowment Commissioners may think fit, until there has been proper consultation. I have therefore elaborated the procedure, so that it may be clear that there is a very careful system, and that there are regular steps whereby objection can be taken. But over and above all that, it is laid down in the Act that in the working of the Endowment Commissioners regard must be had to the spirit of the intention of the original founders of an endowment. In many cases it is known that the purpose of the founder was to run the hospital. That work is now being carried on by the Exchequer, so that the purpose of the original founder is now defeated and some other purpose has to be found. In this case, it is proper to divert the trust.
The Bill itself is a simple one. It does two things. On the one hand, it sets up a Trust, and then it empowers the Endowment Commissioners to transfer funds to the Trust, which they had not previously the power to do. So far as the Trust itself is concerned, the chairman and members will be appointed by 565 the Secretary of State, and it is considered that a small body will be adequate for this purpose—probably about seven people. Not only can they receive funds transferred to them, but they can also receive legacies or gifts, should they become available. They have the task of consulting an advisory committee, as designated by the Secretary of State. The Bill does not say which advisory committee will be consulted, but the Committee to be designated in the first place will be the Advisory Committee on Medical Research, under the distinguished chairmanship of Sir Edward Appleton who is now Principal of Edinburgh University. I should add that this body has links with the Medical Research Council, so that, as far as possible, there will be no overlapping or difficulty. Information gained will be circulated as widely as possible.
The Schedule lays down that accounts shall be kept. There will be submitted an annual report, which will be laid before Parliament. Clause 2 simply gives power to the Endowments Commission to transfer to the central fund. Clause 3 is procedural. I do not think that I need add anything more, except to say that this will be an independent body of Trustees—men of standing. They will have the funds at their disposal, and though they will be authorised to borrow or use capital if they should think fit, in each case the capital will have to be repaid over thirty years. If they wish to extend that period they must obtain the approval of the Secretary of State. May I end, on behalf of Her Majesty's Government, by thanking the Endowment Commissioners for the valuable Memorandum which they have submitted? They have said that to set up a Research Trust for Scotland would be an act of imagination and a constructive step at the present time. I believe that to be the view which your Lordships will take. I beg to move that the Bill be read a second time.

§ LORD INMAN
My Lords, after the reference in the debate earlier this afternoon to the intrusion of Englishmen into Scottish affairs, I feel a little diffident about dealing with this particular matter. As the noble Earl has pointed out, this is the Hospital Endowments (Scotland) 566 Bill, and he has given a clear exposition of its provisions. We shall certainly not oppose the Second Reading, though it is quite likely that there will be certain points that we shall wish to deal with on the Committee stage, I was particularly glad to hear the noble Earl give certain safeguards. I have made a note of some of the questions I should have liked to ask; in some cases, he has already answered them. I lay particular stress on money donated for definite purposes being used, if at all possible, for that purpose. This afternoon I looked up the Industrial Health Service (Scotland) Act, 1947, and there it refers to: the spirit of the intention of the founder or donor of the endowment to which the scheme relates and in particular to conditions intended to preserve the memory of any person or class of persons…. I am not an anti-vivisectionist; I can well understand there are those who believe in vivisection, and it would be a gross betrayal of any trust if money which had been left for that particular purpose were used for some other purpose of an entirely opposite character. So I am grateful to learn that a strong committee is to be formed to investigate and listen to complaints of that character.
The second thing I was particularly pleased to hear was that consultations were being held with the other research bodies. I find that there is a danger of overlapping, and this ought to be provided against as far as possible. With regard to these surplus funds which would be taken over, I assume that adequate funds will be left in the hands of the particular committees now existing for maintaining hospitals in Scotland. These are some of the points that have occurred to me in reading through the Bill. We can, of course, deal with matters of detail when we come to the Committee stage. In the meantime, we on these Benches shall not oppose the Second Reading of this Bill.

LORD KINNAIRD
My Lords, I should like to add my voice to those which have been used to congratulate the Department of Health for Scotland—I think it was that Department which conceived this notion. I also wish to congratulate Sir Sydney Smith and the Hospital Endowments Commission whose labours have resulted in this Bill being brought before us. It is of fundamental 567 importance. We are glad to hear that it is acceptable to hospital boards, and I am certain that it will be given a tremendous welcome by all the people of Scotland. As the noble Earl, Lord Selkirk, has said, a great deal of this money which is always given for specific purposes in connection with maintaining and running hospitals, cannot now be used for that purpose. I think the idea of giving a large part of that money to research is of immense value to every single member of the community of the country. Everyone stands to gain by it.
I should like to refer for a moment to Clause 1 of the Bill and to ask the noble Earl this question: is it clear that the trustees will be able to take into consideration applications for grants for research work carried on in hospitals outside the National Health Scheme? As the noble Earl knows, there are still voluntary hospitals in Scotland, and as I read the Commission's memorandum most of the references seem to be to regional hospital boards and to hospitals that would be within the National Health Scheme. I would mention hospitals such as those run by the Scottish Branch of the British Red Cross in Scotland. They have two hospitals in the neighbourhood of Aberdeen, at Tor-na-dee and Glen-o'-dee, and research work is done there in connection with tuberculosis. Research work is definitely being carried out, and I think I could say without any fear of being contradicted by the Department that it is research work of great value in the fight against tuberculosis. To run these hospitals at the present time means finding some£30,000 a year in addition to the grants we get. It is a considerable sum, and it is not becoming any easier to get it in these days. So I should like to ask the noble Earl whether he can give me an assurance that voluntary hospitals not in the National Health Scheme may make applications, which will be considered, for grants. There is a further point one might make. In the Explanatory Memorandum, I notice it is stated that the trustees are empowered to accept new gifts and legacies. I would suggest to the noble Earl that if he can give us the assurance that money given by donors will be available for voluntary hospitals, as well as for State hospitals, then I think people 568 will be still more willing to give and to leave money to the Trust. I should like, in conclusion, to congratulate the noble Earl on the exposition which he has given of this Bill.

§ THE EARL OF SELKIRK
My Lords, I should like to thank noble Lords for the warm welcome they have given to this little Bill. I should also like to take this opportunity of welcoming Lord Inman—whom we have not seen here for quite a long time—back to this Chamber. I hope we shall see him frequently in the future. He asked me some specific questions. First, he emphasised—and quite properly—the question of purposes. There is nothing more discouraging to any donor than to see funds diverted to purposes directly antagonistic to the purposes for which they were originally intended. It is implicit in the Bill that this should not be done. I take it that, in some sense, the idea is to find the next best object when the one for which funds were originally intended has, for some reason or other, been superseded. The noble Lord mentioned the question of overlapping. It will obviously be the purpose, not only of the Research Council in Scotland but of the Trustees, to avoid that type of difficulty. Looking at the Report, which the Endowment Commissioners who, after all, are in the best position to judge, have made, I think it is clear that there will in each case be adequate funds available for the hospital management boards. The total capital of the funds amounts to about£13 million, which is a fairly considerable sum, and it was thought that some substantial part, at least, of that should be made available for research.
May I say to the noble Lord, Lord Kinnaird, that I am sure the Scottish Office will appreciate very much what he said about the imaginative understanding with which this Bill has been put forward? I can assure him that the purpose of the Bill is to enable the Trustees to assist any medical purpose that may be brought to their attention if they think it worthy of assistance. It matters not whether the establishment concerned is connected with the National Health Service, or is a private hospital, a university, or any other organisation, if they consider it most useful to promote a 569 particular type of research. I have nothing further to add. I hope that your Lordships will agree to give this Bill a Second Reading.