HL Deb 07 March 1972 vol 329 cc34-57

4.0 p.m.

BARONESS TWEEDSMUIR OF BELHELVIE

My Lords, I beg to move that this Report be now received.

Moved, That the Report be now received.—(Baroness Tweedsmuir of Belhelvie.)

On Question, Motion agreed to.

Clause 6 [Medical and dental inspection, supervision and treatment of pupils and young persons]:

LORD HUGHES moved Amendment No. 1: Page 3, line 28, after ("gives") insert ("notice").

The noble Lord said: My Lords, when we were discussing this Bill in Committee I spoke to Clause 6 and suggested that it might be simplified if it spoke of parents "giving notice to the authority" instead of parents "giving to the authority notice". The purpose of Amendments 1 and 2 is to give effect to what I then suggested. I beg to move Amendment No. 1.

BARONESS TWEEDSMUIR OF BELHELVIE

My Lords, I should like to thank the noble Lord, Lord Hughes. I think these Amendments improve the Bill and I am very glad to accept them.

On Question, Amendment agreed to.

LORD HUGHES

My Lords, I beg to move Amendment No. 2:

Amendment moved— Page 3, line 28, after ("authority") leave out ("notice").—(Lord Hughes.)

On Question, Amendment agreed to.

Clause 9 [Educational and research facilities]:

LORD HUGHES moved Amendment No. 3: Page 4, line 25, leave out ("having it in contemplation") and insert ("intending").

The noble Lord said: My Lords, during Committee stage I commented that the rather extraordinary phrase was used in Clause 9 of "having it in contemplation". The Amendment that I am putting forward seems to be even better, at a second and third reading, than it did when I first contemplated it. When I looked at this I could not possibly see why there should be any obligation placed on the Secretary of State to provide facilities for people who were only contemplating doing something. It seemed to me that they should be either performing the service or, at the very least, intending to provide it. It seemed to me extraordinary to provide any facilities for a person to do something who only "had it in contemplation". I suggest that the wording I am proposing firms up the language and firms up the Bill. It also has the advantage of doing it in fewer words. I beg to move.

BARONESS TWEEDSMUIR OF BELHELVIE

My Lords, it is said that great minds think alike. I intended to put down a similar Amendment, so the noble Lord will not be surprised to hear that I am very glad to accept his Amendment.

On Question, Amendment agreed to.

Clause 13 [Health Boards]:

LORD HUGHES moved Amendment No. 4: Page 5, line 35, after ("may") insert ("by order").

The noble Lord said: My Lords, the real author of this Amendment is the noble Baroness, Lady Tweedsmuir of Belhelvie. At the last stage she pointed out that I was making Amendments to render it necessary to have orders in relation to Clause 19 and that as I had accepted that the Secretary of State would have the right to determine the functions to be carried out by Health Boards it was unreasonable to suggest that the agency should have the stricter procedure of an order in relation to its functions. I then said that the noble Baroness had in fact accused me of an error of omission rather than commission. On looking at this further, I must confess that I misread Clause 13.

The clause reads as follows: The Secretary of State shall by order constitute, in accordance with Part I of Schedule 1 to this Act, boards, to be called Health Boards, for such areas as he may by order determine, for the purpose of exercising functions with respect to the administration of such health services provided by him as he may determine, and for the purpose of making arrangements on his behalf for the provision of the services mentioned in Part IV of the Act of 1947. I must confess that having twice read the reference to the Secretary of State making orders, I assumed, wrongly, that the whole of this clause was to be the subject of orders. There are in fact three things being done here. The Secretary of State is to constitute Boards; he is to say in which areas these Boards are to function, and he is to state the functions which they are to carry out. It seems to me that it cannot correctly be stated that the functions to be carried out by the Boards are less important than the membership of the Boards or the areas in which they are to operate. The Secretary of State having accepted the obligation to make an order for the constitution of the Boards, and for the areas in which they will operate, it is quite wrong that this third and vital part, concerning the functions to be carried out by the Boards, should not be the subject of the same procedure. I therefore beg to move my Amendment. It will mean, if it is accepted, that in each case the constitution of the Boards, their areas and their functions will be governed by order instead of by simple determination by the Secretary of State. I beg to move.

BARONESS TWEEDSMUIR OF BELHELVIE

My Lords, the noble Lord, Lord Hughes, is of course quite correct: I did almost suggest this Amendment to him. I think it could be argued that it is unnecessary to make the allocation of functions a matter for a statutory instrument. On the other hand, I have given some thought to this and, particularly in relation to the Common Services Agency, I think there is some substance in the point that the functions are just as important as the constitution of the Boards and the areas in which they will operate. That being so, I am very glad to accept this Amendment.

On Question, Amendment agreed to.

Clause 16 [Local Consultative Committees]:

LORD HUGHES moved Amendment No. 5: Page 10, line 3, leave out ("shall defray the reasonable expenses") and insert ("may pay to members").

The noble Lord said: My Lords, I have four Amendments to Clause 16—Nos. 5, 6, 7 and 8. They cannot all be successful, because Amendments 5, 6 and 8 represent one way of dealing with what I regard as a defect in the clause, and Amendments 7 and 8 provide alternative means of dealing with this. I should like to go back to the remarks made during the Second Reading of the Bill by the noble Earl, Lord Cromartie, and my noble friend Lady White about the difficulties in which women may find themselves as members of Boards but not entitled to loss of remuneration because they are not regarded as gainfully employed. I put down an Amendment at Committee Stage to deal with the point. The noble Baroness pointed out that she could not accept the Amendments but said that they were not strictly necessary because the clause provided for the payment of allowances and would cover the various points and instances to which the noble Earl and my noble friend Lady White had both referred. I thought that the answer she gave was completely satisfactory and I had no hesitation in withdrawing the Amendments as being unnecessary. However, when I came to look at Clause 16 I feared that the wording used here might in fact diminish the value I was attaching to the words in Clause 14(6) because the wording in Clauses 16 and 18 differs from that used in Clause 14.

Clause 14(6) reads: The Secretary of State may pay to members of a local health council and committees thereof such travelling and other allowances … and these were the important words to which the noble Baroness, Lady Tweedsmuir, directed my attention. It then goes on: … including compenstion for loss of remunerative time … If we may look at that phrase for a moment it seems that a lady member of a committee will not be entitled to payment for the loss of remunerative time because her time is not regarded as remunerative, but will receive instead other allowances to compensate her for expenditure on which she may have embarked in pursuing these duties. When we go to Clause 16 we find that the wording is: Health Boards shall defray the reasonable expenses of committees recognised under this section, including such travelling and other allowances and compensation for loss of remunerative time, I am afraid that if the language is not the same it may detract from the very high value which the noble Baroness, rightly, has placed on the use of these words in Clause 14. I want to see the same language used in Clauses 16 and 18. Amendment No. 5, which I am now moving, taken with Amendments Nos. 7 and 8, would make the subsection read: Health Boards shall pay to members of committees recognised under this section such travelling and other allowances including compensation for loses of remunerative time …"; in other words making the language exactly the same as that in Clause 14.

However, after I had worked this out and looked at it it seemed to me that by deleting the words, "shall defray the reasonable expenses", I might be going further than I had intended and would defeat part of the object of the clause, because there would be at least a possibility that a committee of this kind might have other expenditure—perhaps on the provision of stationery or accommodation—which would not be met if the words "shall defray the reasonable expenses" were moved. Therefore I had a second shot at the wording. If Amendments Nos. 7 and 8 were accepted then the subsection would read: Health Boards shall defray the reasonable expenses of committees recognised under this section, and may pay to members of such committees travelling and other allowances including compensation for loss of remunerative time.

It is my hope that the noble Baroness will find it possible to accept Amendments Nos. 7 and 8, in which case I will withdraw Amendment No. 5 and not move Amendment No. 6. Having said that, it also seems to me that in common with the Amendments which I moved to Clause 6 and Clause 9, the language which I propose is an improvement on that in the Bill because Clause 14 recognises that it is members of committees who are involved in travelling expenses. It is members of committees who may lose remunerative time and who have to be compensated for it, it is members of committees who may have to receive allowances. But the wording in the Bill says: Health Boards shall defray the reasonable expenses of committees recognised under this section, including such travelling and other allowances and compensation for loss of remunerative time, … I suggest that that language is not acceptable because committees, as bodies, are not involved in travelling time; committees as such do not lose remuneration. It is the individual members of committees who do this and the language, therefore, in Clause 14 is correct. The language in Clause 16 not only could throw doubt on the purposes of Clause 14, but it also is defective in itself.

I hope therefore that with that longer explanation than I thought at first might be necessary the noble Baroness will find it possible to agree that there is advantage in using the same type of language throughout the Bill. I beg to move.

4.25 p.m.

BARONESS TWEEDSMUIR OF BELHELVIE

My Lords, I am sorry to say that on this occasion I do not think that the language which the noble Lord has used in his Amendment is preferable to what is there already, for this reason: if he takes the first Amendment to which he spoke, Health Boards would be empowered to pay only travelling and other allowances et cetera. But their wider duty under the Bill at present is: "shall defray the reasonable expenses". This is wider because it could cover, as I think the noble Lord recognised in his remarks, certain other matters; and in this case it would, for example, be the payment of secretarial expenses or postage, which I think he mentioned, or telephone bills.

The new wording also only provides for the payment of travelling and other allowances to members of committees recognised under this subsection, and it would not cover such allowances to members of sub-committees which are appointed under subsection (8) of the clause. This is very important. I should like to suggest to the noble Lord that he might perhaps reconsider what he has said, because surely it is better to ensure that the payment of such expenses is a duty rather than a power of a Health Board. It is for this reason that this particular subsection was so worded.

The noble Lord, Lord Hughes, also spoke to his alternative Amendments which are not quite so wide as the first Amendments. Here our main feeling is that it is not made clear that travelling and other allowances are a part of the reasonable expenses which Health Boards are under a duty to provide. They do not just have a power to do so, they have a duty to do so; and the same approach applies to members of sub-committees as to members of the main committees. Therefore while I am entirely in sympathy with what he is trying to do, I suggest that on this occasion the subsection is correctly worded.

BARONESS WHITE

My Lords, can the noble Baroness tell me whether the words now in the Bill cover the points I made at an earlier stage about the expenses of women in public life?

BARONESS TWEEDSMUIR OF BELHELVIE

My Lords, they do not cover the question which the noble Baroness raised as to whether women have to either buy more hats or have more hair-do's because they are in public life. That is not as yet considered in our society to be a reasonable expense. It covers such matters as having to provide, for example, someone to look after a child and, under certain circumstances, possibly a home help.

LORD HUGHES

My Lords, if I may have the permission of the House to speak again, I am very disappointed at the response of the noble Baroness because I think the language in the subsection is defective. Committees do not lose remunerative time, it is the members who do. In Clause 14 the wording is set out specifically to pay to members of Health Boards, not to Health Boards, not to compensate Health Councils for loss of remunerative time, but to compensate the members of these councils. Here this wording is not correct. I hope that on a reconsideration of this matter the noble Baroness may yet find my wording improves the Bill. I am going to give notice that I will withdraw these Amendments but I intend to come back even yet, unless the noble Baroness speaks a third time to say that she has had better thoughts. I will come back at Third Reading. It is something I do not like to do, but it is important that we should try to finalise the matter here where the discussion has taken place.

I certainly recognise the noble Baroness's point that, by seeing that the Health Boards may pay allowances, I am altering it from a duty to a power. That is rather simply remedied. I could do it now by a Manuscript Amendment, if that were acceptable, to substitute the word "shall" for the word "may", so that it is reinstated as a duty to pay these allowances. I must admit that it seems to me, as I think it is implied in other parts of the Bill where the possibility of people being co-opted to sub-committees is recognised, that the power to pay committees or the expenses of committees would include the power to pay members of sub-committees. If the legal interpretation is that a sub-committee of a committee would not be covered in this way, then it becomes quite a simple matter to use the words: "Pay to members of committees and sub-committees". So I can meet all these points of objection which the noble Baroness has raised by subsequent Amendment at Third Reading.

What the noble Baroness has not done in any way is to remove my belief that the language used in this clause is defective in that it is proposing to make payments to a body which does not incur the expense; and I think on a strict interpretation of the wording of this provision the members would not get anything, because the power was not to pay them individually but to pay the body collectively. If people were going to take things at their face value—and we are supposed to take legislation at its face value—it might conceivably be that compensation to, say, three members of the committee is added up and then is divided among the total six members of the committee, each of them having a share.

LORD STRATHCLYDE

My Lords, in view of the importance of the matter to which the noble Lord has just spoken, I hope that my noble friend Lady Tweedsmuir will have another look at this question.

BARONESS WHITE

My Lords, as my previous intervention was merely an interrogation of the noble Baroness, I hope that I may now be allowed to say that I am deeply disappointed in her reply to my question. This would be a very good opportunity for her as a woman Minister, if I may say so, to look seriously at the problem I raised. I raised the point partly facetiously but basically very much in earnest. She has not, for example, satisfied me on the woman who is doing a part-time job. At the moment she is not allowed, as I understand it, to claim for loss of remunerative time if what she is doing is part-time work. Some very capable women who have domestic responsibilities do part-time work. Because their work is part-time, they may be able somehow to organise it so that they can attend a committee. But who is to say that they are not in fact losing something by it?

Similarly, there is the question of domestic help. As I said before, it is not always by any means the most useful or convenient way of organising it to have the help at the very time when you yourself are engaged away from home on a committee. It may be much more effective to have the domestic help when you are home to supervise it. I believe that at the moment in comparable situations the regulations provide that a domestic help must be in the home when one is in the committee. Any intelligent woman knows that that is nonsense. I have much too great a respect for the Minister not to believe that she could not somehow, if she really set her mind to it, try to set an example in this Bill by altering it in these two specific ways, at any rate—on the question of domestic help and the question of part-time work. These conditions could be altered in favour of capable women, whom I am sure we all hope will be enabled to serve on these bodies. The reason why I put this point to her in the form of a question was that I had hoped that other allowances might be interpreted to cover such situations. If she can assure me of that, then I would not trouble her further. But if she cannot, we may have to try to do things at later stages.

LORD HOY

My Lords, during the Second Reading debate on this Bill, when my noble friend Lady White raised this point, I omitted to deal with it at the end, but I raised the question of women who are members of local authorities. As I understand it, at the present time they can be compensated for having to engage domestic help because of their municipal responsibilities. What I am certain we should all like to know is that under these proposals women members of these committees are not going to be less favourably treated than the present members of local authorities. That point should not be difficult to answer. If we know that they are not going to be less favourably treated, then we can go to the other two points. Should not we, when we are making this change, change the conditions to meet the points raised by my noble friend Lady White? Before we move from this Amendment (I do not know what my noble friend Lord Hughes proposes to do) I think the House would be grateful if the noble Baroness could assure us on those two particular points.

BARONESS TWEEDSMUIR OF BELHELVIE

My Lords, as the noble Baroness, Lady White, asked me a question before I had sat down I believe that I can technically, with the leave of the House—this is not my Amendment—speak twice and therefore take the opportunity of trying to reply to the points made. Lady White is quite right in drawing attention to the words "other allowances" in the subsection, which of course cover the question which I mentioned earlier on home helps and perhaps on somebody to mind a child while the lady in question is serving on a committee or a sub-committee.

In direct reply to the noble Lord, Lord Hoy, the provisions made here are no less favourable than those he mentioned concerning those who serve on local authorities. On the much wider question raised by Lady White, I feel that we should have great difficulty in trying to define what was a reasonable expense for a woman in public life. I am very sympathetic to the point because one could, for example, say that because one was in public life one had to have a new garment, which otherwise one would not normally have had. But to try to define "reasonable expenses" to that extent is really beyond the scope of this particular Bill, and it does not seek to do so.

LORD HUGHES

My Lords, I beg leave to withdraw Amendment No. 5.

Amendment, by leave, withdrawn.

4.28 p.m.

LORD HUGHES moved Amendment No. 7: Page 10, line 4, leave out ("including") and insert ("and may pay to members of committees").

The noble Lord said: I beg to move Amendment No. 7, which gives me the opportunity of speaking again quite properly and without obtaining special leave. I hope that, reinforced as I have been by the noble Lord, Lord Strathclyde, the noble Baroness will undertake to have another look at this matter, because the clause as it stands is defective. It could detract from the value of what the noble Baroness said at the last stage on the words "and other allowances". I must confess that I am rather surprised at the way in which the noble Baroness has replied to my noble friend Lady White on some of these points.

The Bill does not lay down exactly what is covered by "other allowances". It is a matter on which presumably the Secretary of State and his advisers give advice and take decisions in due course. Even if at some time in the past, when the Scottish Office were not blessed with a woman among their Ministers, they took the line that a home help, for instance, was not going to be paid for unless she was employed when the woman was attending a committee, I see no reason now why the Secretary of State, with the benefit of the guidance of the noble Baroness, Lady Tweedsmuir, should not alter that ruling. It does not need something specifically put in the Bill to enable the Secretary of State to decide that if a woman is away for three hours at a committee and has a home help, when she is at home, she may be compensated. It is a perfectly easy thing for the Secretary of State to do. I should have thought that the noble Baroness could have assured my noble friend that her point would be taken care of. I am not so certain about the "hair-do", and so on, and my noble friend Lord Hoy merely asked for an assurance that women should not be less favourably treated than men in this regard. Of course no woman would be satisfied with the sort of "hair-do" that would be perfectly satisfactory to me, for example; it would not be of the slightest use to her that she could get equal treatment to myself. It may be that what the noble Baroness said about other allowances does not cover all the points which my noble friend would like to see covered; but there is no reason why it should not cover a great many of them, and I think this is the sort of field which could he made a little wider each time it is looked at, and expenses for women which were previously not considered reasonable might be brought in at the next stage.

However, what I propose to do in this connection is to have a word with my noble friend Lady White after this Report stage, but I hope that, after she herself has had a word with the noble Baroness, Lady Tweedsmuir, if it should prove to be necessary to do something further we might have our "Women's Lib" Amendment on Third Reading also. In the meantime I beg to move Amendment No. 7 (to be followed in due course by Amendment No. 8) and I hope the noble Baroness can now take the advice tendered to her by her noble friend and my old friend, Lord Strathclyde. I beg to move.

BARONESS TWEEDSMUIR OF BELHELVIE

My Lords, I feel that have covered this point thoroughly, and I think the noble Lord, Lord Hoy, and the noble Baroness will realise that of course I entirely agree with the purpose they had in mind. But I think it necessary to say that compensation and allowances to members of a committee are in fact part of the committee's expenses, and therefore it is not necessary to refer in a particular subsection to "members of a committee" because it is assumed that their expenses are part of the expenses of a committee.

On the other point put by the noble Baroness, about having a home-help in the house when the member who is serving on this committee is present or when the member is not present, the noble Baroness expressed the view that it was much more helpful to have a home-help when she was under supervision. Of course this is entirely a matter of opinion. I happen to disagree with the noble Baroness. If I had a home-help I would rather have somebody come to help when I was not present, because when I was present I could perfectly well do it myself, and in actual practice a great number of home-helps are also at the same time looking after the children. They combine the two jobs. Therefore in that way I fail to agree with the noble Baroness. None the less, I agree that there should be the flexibility to permit this if it is necessary. On that point I think it is possible, although I am not absolutely certain and I will make sure about it.

LORD HUGHES

My Lords, the noble Baroness, on her first line of attack on my Amendments, put forward points which I felt had some validity in that I was altering a duty to pay these allowances to a power to do so; and I indicated that if that was the objection it was easily remedied. The second line was that it might not cover members of subcommittees if I referred only to committees, and I said that I could easily alter that on a subsequent Amendment. In my view, the third line of attack with which the noble Baroness has been furnished is a poor one by comparison with her first one and I do not find it necessary to make any alterations in what I would do in order to meet that. It has been the regular procedure in your Lordships' House that when attention is drawn to the fact that a different form of language appears in one Part of the Bill from that contained in another Part, if it is possible to accomplish the purpose by using the same language throughout, Amendments to use the same language are almost invariably accepted. For some reason best known to the Minister's advisers, they are on this occasion departing from what is almost a principle, and it is only because of the fact that I accept the remarks made by the noble Baroness about sub-committees and the Amendment changing something from a duty to a power that I am now prepared to withdraw the Amendment. But as this will be the second occasion when I shall be submitting an Amendment in the light of guidance which I have received from the noble Baroness I shall on Third Reading put this Amendment down again, strengthened in the way she has indicated. I hope that her advisers will make a better job of it at the fourth attempt than they did at the first, second and third attempts. Meantime, I beg leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Clause 18 [National Consultative Committees]:

4.35 p.m.

BARONESS TWEEDSMUIR OF BELHELVIE moved Amendment No. 9: Page 11, line 2, after ("may") insert (",with the agreement of a national consultative committee,").

The noble Baroness said: My Lords, I hope it will be for the convenience of the House if we consider with this Amendment the next one, No. 10. The effect of these Amendments would be to alter Clause 18(3) to read: Where the Secretary of State considers it necessary, he may, with the agreement of a national consultative committee, appoint additional persons to be members of that Committee. It was during the debate at the Committee stage that the noble Lord, Lord Platt, sought to delete subsection (3) altogether, and at that time I undertook to reconsider the position. It is as a result of that debate that we now have these two Amendments for the consideration of the House. I should just like to say that this power would of course be rarely used, but it could, for example, be used in relation to a medical committee to appoint one of the consultant advisers to the Secretary of State in a particular specialty, and as it is unthinkable that any person would be appointed without the agreement of the committee I hope that these Amendments will prove acceptable and will improve the Bill. I beg to move.

LORD PLATT

My Lords, I am grateful to the noble Baroness for her reconsideration of these paragraphs.

On Question, Amendment agreed to.

BARONESS TWEEDSMUIR OF BELHELVIE

My Lords, I beg to move Amendment No. 10.

Amendment moved— Page 11, line 2, leave out ("a national consultative committee")and insert ("that committee")—(Baroness Tweedsmuir of Belhelvie.)

On Question, Amendment agreed to.

LORD HUGHES

My Lords, Amendments Nos. 11, 12, 13 and 14 comprise the same set of Amendments in relation to Clause 18 as Nos. 5, 6, 7 and 8 in relation to Clause 16. At Third Reading I shall put down an improved Amendment to Clause 18, and therefore I do not intend to move Amendment No. 11.

Clause 19 [Common Services Agency]:

4.40 p.m.

LORD HUGHES

My Lords, these are the Amendments which gave rise to the comment of the noble Baroness in relation to Clause 13. They are I think a natural parallel to what has now been done to Clause 13. I put the case for them at Committee stage and I think it would be abusing the patience of your Lordships if I were to state the arguments again. All I need to say is that the case for them has now been strengthened by the Amendment to Clause 13, and I hope that the noble Baroness will find it possible now to accept Amendments Nos. 15 to 25. I beg to move Amendment No. 15.

Amendment moved— Page 11, line 34, leave out ("shall have power to") and insert ("may by order").—(Lord Hughes.)

BARONESS TWEEDSMUIR OF BELHELVIE

My Lords, when these Amendments were originally put down on the Committee stage I said then that in view of the large number of regulations and orders contained in the Bill I doubted that it was necessary to make the content of Clause 19 subject to orders. On the other hand, the Agency is a very important body and of course it is a new body. While at the time I said that I thought that Parliament had many means of finding out which functions would be transferred, nevertheless I feel that perhaps the arguments made then had real substance and I have great pleasure in accepting all the Amendments to which the noble Lord has spoken.

On Question, Amendment agreed to.

LORD HUGHES

My Lords, with the permission of the House, I would move Amendments Nos. 16 to 25 en bloc.

Amendments moved—

Page 11, line 39, leave out ("may")

Page 11, line 41, leave out ("direct") and insert ("may by order provide")

Page 11, line 42, leave out ("from time to time")

Page 12, line 3, leave out ("may")

Page 12, line 5, leave out ("direct") and insert ("may by order provide")

Page 12, line 6, leave out ("from time to time")

Page 12, line 12, leave out ("may")

Page 12, line 14, leave out ("direct") and insert ("may by order provide")

Page 12, line 15, leave out ("from time to time")

Page 12, line 18, after ("may") insert ("by order").—(Lord Hughes.)

On Question, Amendments agreed to.

Clause 20 [Co-operation between Health Boards and local authorities]:

LORD INGLEWOOD moved Amendment No. 26: Leave out Clause 20.

The noble Lord said: My Lords, I owe your Lordships an apology for not being able to be here at the Committee stage, when the noble Baroness, Lady Elliot of Harwood, moved an Amendment in my name to which my noble friend replied that the words adding to the field of consultation adjacent authorities in England were not necessary because consultation in fact already happened, which seems a good reason for not putting it in the Bill. Since the Minister says that so precisely, I feel that there must be full consultation between authorities in Scotland, too. I can hardly believe that this is not so and that consultation does not in fact take place. Therefore it seems to me that if there were no purpose for my words at an earlier stage there can be no purpose in leaving the clause in the Bill. All of us, from our earliest days as Parliamentarians, have had it rubbed into us that not only is nothing to be gained but that it is a mistake to add words to a Bill which only recite something which already happens or which add nothing to the Bill in general. Since I cannot believe that there is not already consultation between authorities in Scotland, I feel we might very well leave this clause out of the Bill.

I put in the additional words because I found it was an advantage that there should be consultation with the authorities in England, where, owing to the slightly different systems, it might be all the more difficult for it to be carried out. Furthermore, the final words refer to the health of the people in Scotland, and I thought it of advantage to have closer connections with the authorities on the English side of the Border, not least since we have had recent cases of tetanus and smallpox. Since I cannot believe that consultation with authorities in Scotland is not already complete I can think of no good cause for leaving this clause in the Bill. I beg to move.

BARONESS TWEEDSMUIR OF BELHELVIE

My Lords, while I certainly appreciate the help of my noble friend Lord Inglewood from South of the Border in trying to assist in organising our Scottish affairs, nevertheless I fear I cannot accept his Amendment. This particular clause, as he rightly says, makes it quite clear that the purpose is to secure and advance the health of the people of Scotland, and we feel it is necessary to have this co-operation as a statutory duty because the absence of any formal obligation to co-operate in the provision of health services until now has been recognised as one of the weaknesses of the present system. Therefore, in the years since 1948 there have been many attempts in various ways to overcome the tendency to operate in separate compartments, and it is for that reason, which is the background of the whole of this Bill, that we are trying to bring about a united Health Service and that we have this particular Clause 20, which seeks co-operation between the various health services within the borders of Scotland.

So far as co-operation over the Border into England is concerned, my noble friend particularly drew attention, for instance, to a notifiable disease. Of course, if it were a disease of a serious character there is no doubt whatsoever that the medical officers of health in my noble friend's country would certainly instantly acquaint the Department concerned over the Border in Scotland. It is also a fact that if it were a serious disease the Health Board itself would of course instantly be aware of this fact. As at the Committee stage I instanced the various ways in which co-operation does take place over the Border, I do not think I can accept this particular Amendment, which seeks to delete a clause which we believe is necessary to draw attention to something which is very important to us in Scotland. Therefore, I hope my noble friend, on reflection, will withdraw his Amendment.

LORD HUGHES

My Lords, the procedure under which we operate at Report stage I thought deprived me of the opportunity of saying to the noble Baroness how grateful I was for her having accepted the Amendments to Clause 19. If I now do so, and now come to her support on Clause 20, I hope the noble Lord, Lord Inglewood, will not think that in supporting the noble Baroness I am merely repaying a debt on Clause 19. That is not so. If the noble Lord refers to the Committee stage discussion, or the Second Reading debate—I do not remember which it was—he will find that I expressed the view that Clause 20 was rather vague and was a pious aspiration, and that if people did not in fact do what it was suggesting there was no way of enforcing it. But it seems to me that what the noble Lord is doing is going the wrong way about it. If he had been seeking to strengthen the clause, I might have found myself supporting him.

LORD INGLEWOOD

My Lords, at the Committee stage I did seek to strengthen the clause, but my noble friend would not have it, and I find in this case half a loaf no better than no bread.

LORD HUGHES

My Lords, if the noble Lord had been here he would have realised that he was seeking to amend the clause in a hopelessly impossible way. He was inviting local authorities and education authorities to co-operate with their opposite numbers on the other side of the Border in order to secure and advance the health of the people of Scotland, when in fact he made it perfectly clear at Second Reading that what he wanted to do was to advance the health of the people on the other side of the Border. He therefore did not amend it in the proper way. Now he is seeking to amend it by taking out the clause altogether. How on earth can you promote co-operation by removing from the Bill the clause which requires co-operation between Health Boards and local authorities? It may sound very good logic when you get to the other side of the Border, but a long time ago the noble and learned Lord who normally sits on the Woolsack used an expression which I think could appropriately be ascribed to that sort of reasoning. I think this clause is weak in that it is merely a rather pious statement, but to take it out altogether certainly does not improve the Bill. I am therefore very glad that the noble Baroness has found it possible not to succumb to this raid from over the Border.

LORD INGLEWOOD

My Lords, in view of the great feeling, even if not the logic, of noble Lords who have spoken, I beg leave to withdraw the Amendment. When it comes to the English Bill, I shall move a further Amendment requiring co-operation with the authorities on the Scottish side of the Border, in order to secure advance in the health of the people of Scotland and of England.

Amendment, by leave, withdrawn.

Clause 21 [Designated medical officers]:

4.50 p.m.

LORD HUGHES moved Amendment No. 27:

Page 13, line 2, at end insert— ("() The Health Board concerned, with the consent of the Secretary of State, may give to the post of a designated medical officer a title appropriate to the functions he exercises or the district or area in which he exercises them.")

The noble Lord said: My Lords, at the last stage quite a little disquiet was expressed both by Lady Tweedsmuir and by myself about this rather cumbersome description, "designated medical officer". Because of what the noble Baroness then said, I tried to find a way of getting round this. I started off by seeking to remove from the Bill every reference to "designated medical officer", and when I got up to, I think, 47 Amendments in different places without knowing when I was ever going to reach the end of the road, I decided to try another line altogether. I decided to leave in the reference to "designated medical officer", but making it quite clear, by adding the words in Amendment No. 27, that no one was to be described in everyday life as the "designated medical officer".

I gave the noble Baroness prior notice of the Amendment which I intended to table, and I received a letter from her. I wonder whether I may have her permission to read what she said to me about the "designated medical officer", because if her words go into the Record and she also says something about the point, that will suffice, and I will withdraw the Amendment. I am moving it merely in order to get these words in. The noble Baroness wrote to me as follows: Secondly, there is the matter of the designated medical officer' in Clause 21. Since the debate I have thought about this a good deal. I fear, however, that I cannot offer either a better expression or a better way of securing the necessary objective. The trouble is, I think, that the Bill gives more prominence to the 'designated medical officer' than his functions as such perhaps justify. And the words "as such" are underlined. The term is not intended to be an alternative to 'medical officer of health': there will be no appointments advertised for a 'designated medical officer', nor is this a title by which the doctors concerned will ordinarily be known. These factors will no doubt be known by whatever title best describes their total range of responsibilities in an area or district, and I understand that no statutory provision to that effect on the lines of the Amendment you have proposed is needed to secure that result. What will happen is that from among its team of medical officers with relevant experience the Health Board will 'designate' particular officers for the purposes of carrying out (on the now comparatively rare occasions on which the need arises) certain specific functions imposed on the present medical officer of health by existing statutes. (It seems unlikely that there will be much need for identifying a specific officer in this way in future legislation.) These particular officers may be given the responsibility of advising the local authority in other matters as well, but they will be doing this as medical officers of the Health Board with appropriate qualifications and experience, not specifically as 'designated medical officers'; and they will not be the only officers of the board available to advise the local authority. To refer to them as 'designated medical officers' in relation to their specific statutory functions as such (which are contained in Schedule 5 to the Bill) seems to convey what is intended more neatly than the many other possibilities I have considered. The expression has not, so far as I know, occasioned adverse comment from the profession, nor did the local authority associations or the members of the working party on co-operation with local authorities object to it or suggest any alternative. In the circumstances I have concluded that, unlovely though it may be, the expression is the most convenient one for the fairly limited purposes which it serves.

I took the opportunity between stages of talking to a medical officer of health expressing to him my views about the term, "designated medical officer". He said to me, as the noble Baroness has said in her letter, that they had accepted this language for use in the Bill not because they expected that anyone would be officially described as a "designated medical officer" but because it was a convenient way of transferring to someone on the Health Board functions which at the present time are exercised by medical officers of health. He informed me that the term which was being used among the medical people themselves, and I believe among the universities, was "community physicians", and this term has already crept into some university courses. Therefore it became quite obvious to me that the titles, if any, which might emerge in the course of the years which lie ahead may produce something just as descriptive of the functions as "medical officer of health" was, and may produce descriptions which are just as acceptable to the community as the title "medical officer of health" has proved to be.

It seems to me that my Amendments have served a useful purpose, in that they have made it quite clear that there is no intention that someone should have conferred upon him for daily use the unlovely title "designated medical officer". I now move the Amendment (and shall subsequently beg leave to withdraw it) in the hope that the noble Baroness may be willing to take the opportunity of adding a few words.

BARONESS TWEEDSMUIR OF BELHELVIE

My Lords, the noble Lord, Lord Hughes, has really said everything there is to say about this particular provision of "designated medical officer", because he read from my own letter to him. I agree with him that the term "designated", even in legislation is, as I called it, "an unlovely term", and I searched about. I even went so far as Roget's Thesaurus to see what other terms there were. I saw that we could have had "an appointed medical officer, a selected, a nominated" or even one "destined or devoted to a purpose or a fate", which I hope will not be the work of the "designated medical officer". However, I think that in practice the officer concerned will attract a name to himself, as the noble Lord has said already, and this term is merely for the purpose of legislation. I am glad that he has put my letter on the Record, and I think we shall just have to leave the matter where it is.

LORD HUGHES

My Lords, I beg leave to withdraw this Amendment.

Amendment, by leave, withdrawn.

Clause 23 [Assistance to voluntary organisations]:

BARONESS TWEEDSMUIR OF BELHELVIE moved Amendment No. 28: Page 14, line 14, leave out ("furniture") and insert ("goods, materials,").

The noble Baroness said: My Lords, I beg to move Amendment No. 28. I cannot help noticing that there are two other Amendments to which I might perhaps speak at the same time, although they are not going to be moved by me. I think that Amendments Nos. 28, 29 and 30 all seek to do exactly the same thing. But I suggest that my Amendment is perhaps the most acceptable, because the Bill would then read: "goods, materials, vehicles or equipment". The point of this Amendment is that vehicles and equipment are not covered by the expression "goods or materials", but furniture is covered and should therefore be deleted if goods and materials are included in this clause. As we are all trying to do the same thing, I hope the noble Lord will agree that this is a good Amendment. I also hope that the House will accept it. My Lords, I beg to move.

LORD HUGHES

My Lords, as the noble Baroness said. Amendment No. 28 seeks to accomplish the same purpose as Nos. 29 and 30 which are in my name. Amendment No. 28 has the merit of accomplishing the same object in less words and I am delighted to support the noble Baroness. This is a useful Amendment, because in course of time it may be that the most useful help which the Secretary of State can provide to some voluntary bodies is to give them goods or materials rather than more major items, and it might have been doubtful whether he could properly do that under the Bill's original drafting. I therefore support Amendment No. 28.

On Question, Amendment agreed to.

Clause 33 [Transfer of certain sun, to the employment of the Agency]:

LORD HUGHES

My Lords, I beg to move Amendment No. 31 which is consequential on Amendments already accepted.

Amendment moved— Page 20, line 24, leave out ("a direction") and insert ("an order").—(Lord Hughes.)

BARONESS TWEEDSMUIR OF BELHELVIE

My Lords, I am very glad to accept this consequential Amendment.

On Question, Amendment agreed to.

Clause 53 [Regulations, orders and local enactments]:

BARONESS TWEEDSMUIR OF BELHELVIE

My Lords, I beg to move Amendment No. 32, which is consequential on the noble Lord's Amendment to Clause 13(1).

Amendment moved— Page 30, line 33, leave out from beginning to ("may") in line 34.—(Baroness Tweedsmuir of Belhelvie.)

On Question, Amendment agreed to.

Schedule 5 [Minor and Consequential Amendments of Enactments]:

BARONESS TWEEDSMUIR OF BELHELVIE moved Amendment No. 33: Page 56, line 46, at end insert—

("The Immigration Act 1971

157. In paragraph 7 of Schedule 2 (medical examination after entry), for the words 'such medical officer of health' there shall be substituted the words 'the chief administrative medical officer of such Health Board' and the words 'of health' shall be omitted.")

The noble Baroness said: My Lords, in moving this Amendment, may I also refer to Amendment No. 34? Both Amendments are necessary to replace a reference in the Statute to the medical officer of health, as that post will no longer exist. My Lords, I beg to move.

On Question, Amendment agreed to.

Schedule 6 [Repeal of Enactments]:

BARONESS TWEEDSMUIR OF BFLHELVIE

My Lords, I beg to move Amendment No. 34.

Amendment moved—

Page 63, line 36, at end insert—

("1971 c.77. The Immigration Act 1971. In paragraph 7 of Schedule 2, the words "of health", where second occurring.")

—(Baroness Tweedsmuir of Belhelvie.)

On Question, Amendment agreed to.