Sitting of 1 May 1946

Preamble
The House met at Half past Two o'Clock
PRAYERS
Mr. SPEAKER in the Chair
ORDERS OF THE DAY

  NATIONAL HEALTH SERVICE BILL
  Order read for resuming Adjourned Debate on Question [30th April], "That the Bill be now read a Second time."—[Mr. Aneurin Bevan.]
  Question again proposed.
  3.39 P.m.
  Sir Henry Morris-Jones: At the adjournment of the Debate last night, I had to sit down after a few disjointed remarks. I hope the House will now allow me to finish my speech. Despite great temptation to the contrary after the night's repose, in view of the large number of right hon. and hon. Gentlemen who wish to take part in this Debate, I promise to be as short as possible in finishing what I have to say. I was speaking about the terms of service under the Bill. It is very unfortunate that the Spens Report, about which we hear so much, is not available to hon. Members now. Neither the public nor the doctors nor the dentists know the terms of service on which practitioners will have to work under this Bill. The Minister did give an indication of his trend of mind. He spoke on the question of capitation and salaries. I was very glad to notice that he laid more emphasis on capitation than on salaries.
  He may be interested to know that at the conference in London last night the panel doctors expressed themselves unanimously against any salary at all, and I think they came to a wise decision. It is to their credit that they came to that decision, and I ask the right hon. Gentleman now, whether he will not drop the salary altogether from the terms of service, because the whole medical profession, and those associated with them,

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  regard the salary as placing them immediately in the position of State servants. And so it does. Under these terms the Minister, or any other Minister who comes after him, will have power to vary the salary if he likes. He may make the capitation fee less and the salary more. He may in time make the salary 90 per cent. and the capitation fee 10 per cent., with the result that medical men become more and more tied as State servants. They have a very genuine fear in regard to this matter, and I hope the right hon. Gentleman will give it his consideration.
  After all, a salary is not altogether fair in its distribution, because it is given to the inefficient as well as to the efficient. Suppose there are three or four men practising in a small town. There are "dud" practitioners in the medical profession as in every other, and if you give a basic salary to a man who is inefficient or takes no interest in his work, and who may have not more than 100 on his panel, you have to give the same salary to another man in the same town, who may have 2,000 people on his list because of his energy, initiative, resource and interest in his work. The same basic salary is paid to the inefficient and to the efficient. It is not without reason that the medical profession prefer the capitation system. It gives them more interest in their patients, and more incentive to work. It gives them a feeling of a closer personal association with the people themselves. You cannot change human nature. I am told that the world is still very young, and that civilised man has only been on this planet some 10,000 years, but you cannot alter human nature, which demands a personal interest and incentive in work. I trust that the right hon. Gentleman will reconsider the whole question of salaries and capitation fees from that point of view.
  Members of the medical profession, the dental profession and similar professions are not sacrosanct. They come into their professions, many of them, on economic grounds. Even a clergyman, I understand, when he takes a living, makes a calculation of what he is likely to get out of marriages and indeed out of funerals as well, so I do not think that a doctor would be unreasonable to take an interest in his capitation fees. The right hon. Gentleman has suggested in the White Paper that, on a number of patients, over a certain figure, it is his intention to make the capi-
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  tation fee smaller. That would be a very dangerous thing to do. The people who came in under this lower figure would be a separate category, different from the main body of the doctor's patients—I presume they would be considered small "capitationists"—and I hope the right hon. Gentleman will consider that point.

  I think the right hon. Gentleman was quite wrong on the question of the sale of practices. The medical man, like every other professional man in this country, whether he is an accountant, a lawyer, an architect or anything else, has a complete right to sell his practice, which is the fruit of his endeavour, and represents the goodwill which he has built up. I think it is nonsensical on the part of the right hon. Gentleman to call it a shameful thing. What is it, after all? It is nothing more or less than an introduction. A doctor going to a new district may be many months before he knows anybody, but if he buys a practice, he buys the goodwill and gets an introduction to the people. Under the panel system, when a panel practice is sold, every person on that doctor's list is notified of the change in the practice, and he or she has the right to change. What do they do? They wait to see what sort of a man the new doctor is. They try him, find out what good he is, and if he is not good they change. In describing this free choice as the sale of patients I do not think the right hon. Gentleman is using terms which bear any relation to the facts.
  On the question of compensation, I do not wish to say anything about the amount; I do not think anybody could quarrel about the amount, but I understand that the doctors are against compensation altogether. Therefore, I am not for the moment questioning the amount of compensation. What I am questioning is the suggestion that there is any need for compensation. Doctors prefer to retain their practice asset.
  Mr. Percy Wells: Is the hon. Member suggesting that the doctors prefer to give their practices?
  Sir H. Morris-Jones: What I am trying to say is that the medical profession, as a whole, prefer to retain their goodwill and the right to sell their practices, rather than be given compensation. They hold that view by an overwhelming majority. What is to happen to the man

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  who has bought his practice only a year or so ago? I know one case, a youngish man, only 28, I think he has a small family, and he paid £2,400 for his practice. Under this Bill he will be compensated, probably on the basis of two years' purchase, and he will be compensated by a forced loan. It is a forced loan in the sense that he receives the interest on that money for the rest of his life or until he retires but has no control over the capital—his own—to use it as he thinks fit. It may be 30 or 40 years before he gets the capital. This is the first occasion on which we in this country have seen the establishment of a forced loan on one class of the population without the opportunity of touching the capital.
  On the question of the distribution of practices, in my submission the right hon. Gentleman did not establish his case. I have seen the figures. The right hon. Gentleman quoted the differences as between industrial towns and seaside towns, but the figures are equally striking between industrial towns themselves. There are two adjoining towns in Lancashire where there is a great disparity in the number of doctors. But take a town like Bournemouth. I am told that during the war, when they were calling up medical men, the committee set up by the Government to recommend people for selection, received complaints that Bournemouth was over-populated with doctors. They went into the matter and found that a large number of the medical men in Bournemouth were old and retired men and that quite a number of them were men who were sick—suffering from tuberculosis and things of that character—and who had gone to Bournemouth to rehabilitate themselves and get cured of their own ailments. The figures are quite fallacious and if I am able to establish to this House that there is at the present moment a fair distribution of medical men in the country then I submit that the right hon. Gentleman is taking a very serious step in imposing direction on the whole medical profession.
  Dr. Stephen Taylor: Surely, as the hon. Gentleman has himself said, there is great disparity between the industrial towns?
  Sir H. Morris-Jones: I am trying to establish my case to the House. I know
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  there is disparity between the industrial towns, but the point emphasised by the Government and the right hon. Gentleman is that all doctors are flocking to the seaside and residential resorts. [HON. MEMBERS: "No"] I am saying that that is not the case—
  The Minister of Health (Mr. Aneurin Bevan): The hon. Gentleman ought not to say that. The only seaside town I quoted was Hastings. The others were Bath, Dartford, Bromley and Swindon.
  Sir H. Morris-Jones: The distribution of doctors, on the whole, in this country is a fair one. When all is said and done, there is the law of supply and demand, and if the right hon. Gentleman left that law alone the people of this country would be much happier. It is a very salutary law and has been in existence for thousands of years.
  Mr. Percy Wells: It is not satisfactory in the case of food.
  Sir H. Morris-Jones: I must be brief, because I promised to be. Because of this alleged maldistribution of medical men the right hon. Gentleman is imposing directions under this Bill. There is direction under this Bill both negative and positive. It is the first time that direction has been imposed, under a Statute of this country, on any body of its people as a permanent measure. The negative direction is that no medical man or woman will be allowed, except by the consent of the committee—which will be the Minister —to remove from the place where he or she happens to be when the Act comes into force. They will not be able to remove from that locality without the consent of the committee. Not only that, but no one fresh to the profession will be allowed to go into any area without the consent of the Committee or the Minister.
  Dr. Taylor: That is not true.
  Sir H. Morris-Jones: Those are the facts.
  Dr. Taylor: There is only one ground on which the committee can withhold consent, and that is that there are too many doctors in the area already.
  Sir H. Morris-Jones: That does not make any difference to my contention, that it is within the power of the Minister and the committee to refuse consent to any medical man or woman to remove from where he or she may be.
  Dr. MorganThat has always been so in this country. May I ask a question?
  Sir H. Morris-Jones: No. I am exceeding my time. I want to come to the conclusion of what I have to say on this Bill. I have very considerable misgivings about the Government's taking over sickness as a national matter. It will be the death knell of the family doctor as we have known him in this country for generations. I do not think that that is a matter for rejoicing by any hon. Member in any quarter of this House. I am afraid of the dull uniformity that runs through this whole scheme. It may very possibly become a utility scheme with a utility service under which doctors will sign and certify more and more, and be treating less and less and curing less and less, while signing more That is the danger of it. I want the House to remember that here we are not dealing with such nationalisation as, for instance, the nationalisation of the mines. Here we are dealing with the most individual thing in the whole world, the sick and ailing man or woman. We cannot deal with them except on the basis of individual personal interest.
  Having said that, I also want to say that we all agree with the aim of the Bill, to bring about a comprehensive health service for everybody in this nation irrespective of class or income. The right hon. Gentleman showed yesterday clear signs that he has benefited very considerably from his study of this matter. He has gained by closer acquaintance with the very great difficulties involved. I was very glad to see him much more conciliatory than I had expected him to be. If he will bring some considerable Amendments into this Bill, to do away with this direction, which is a diabolical thing; to bring about a greater share in the administration of the Bill by the people who will have to work it; to encourage more interest in the voluntary and local hospitals, by allowing them a greater measure of control over their finances, with less central direction; and if he can create a general medical practitioner service, comprising a body of people who will work happily and with enthusiasm, then, I think, he may be able to endue this Bill with life, and so make his mark on the future of this country and make even this Bill
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  workable. If he is unable or unwilling to make concessions I prophesy that the Bill will be unworkable, and that it will not become the Measure which we all desire to see, one which will achieve a real improvement in the dealing with the health of the people.
  3.57 P.m.
  The Parliamentary Secretary to the Ministry of Health (Mr. Key): Rarely, if ever, in a first day's Debate on a Measure of this magnitude can the Opposition in this House have stated so weak a case as that which was stated yesterday from the benches opposite. Rarely, if ever, has a poor Parliamentary Secretary, destined to reply, and seeking material on which to build his speech, listened so eagerly and been rewarded so meagrely as was my case yesterday. I have gone very carefully through my notes; I have looked up the OFFICIAL. REPORT; and I have tried to find, in the objections that were raised, material for the sort of answer I ought to make.
  I shall deal with this subject in three sections: hospitals, practitioners and local authorities. First, with regard to the hospital service; what we have to do is to evolve a real hospital service that will give all our people, irrespective of their occupations, irrespective of the area in which they live, the benefit of all kinds of hospital and institutional care necessary to meet their needs. We have got to create a really integrated service. There are those who have said that what we should have done was further to develop our voluntary hospital system, and extend our municipal hospital system. There is no such thing. We have no hospital system. What we have is a number of separate hospitals, voluntary and municipal. Rarely can we find any real coordination between them. Rarely, if ever, can we find the separate units functioning in an integrated service. Overlapping, competition, rivalry—these, in the hospital surveys, have been shown to be common. Cooperation and mutual assistance have been shown to be rare. Such faults as these can be remedied only by the establishment of a nationwide service which will bring within the reach of all, irrespective of their ability to pay, the best possible hospital and medical service we can devise.
  We are told that in doing this we ought not to interfere with the individual

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  voluntary hospitals, that they should be left to do their work in their own admirable way, cooperating as far as they wish by providing the type of hospital service they themselves desire, and receiving, if they come up to the minimum standard laid down, appropriate payment from national funds per patient treated, or per bed provided. On that basis, a real hospital system can never be built up. To get a real hospital system it must be planned, and planned not only quantitatively, but geographically and functionally. Moreover, if the service is to be realised, the planning authority must be the executive authority as well. No really efficient hospital service can be provided by the units concerned having the power to determine their own functions within a so-called system, or to decide for themselves the extent to which they will participate. If the planning authority is made the ultimate executive authority, then, having settled the functions of a particular hospital or group of hospitals in the area organisation, it can pass over to smaller managing bodies the direction and control of the institutions concerned. That is the set-up of this Bill.
  What, then, are the main objections which have so far been raised against it? First, there is the charge of what has been styled the "mass murder" of the voluntary hospitals, and the confiscation, conscription, or what other question-begging epithets can be coined, of the property of these voluntary organisations. Supposing these terms are right—which I deny—what then? It is right to conscript the labour and lives of men in a war against evil abroad, but it is wrong to conscript buildings and institutions in a war against disease at home. Men may suffer and die in both conflicts, but it will be all right so long as private property and private practices are preserved. We are not standing for that. For whom, and for what, I ask, were these places built and this money given, but for the service of the people of this country in general?
  Vice-Admiral Taylor: Have they not served the people of this country?
  Mr. Key: It is not the opinions of those who are often the self-appointed governors of these institutions which can decide their proper and correct use in the interests and
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  welfare of the people for whom they were provided. It is the will of the people which must decide, and that wish and that will have been definitely made known, and will find proper expression in the Division Lobbies tomorrow. Next, it has been said that what we are here proposing will destroy the local spirit, the local character and the local interest in these hospital services. It has been said, for example—and here I quote:
  The effectiveness of the hospital, its responsiveness to public feeling, its susceptibility to public criticism, the maintenance of its position as a centre of local interest and welfare and affection—all of which are things essential to human hospital administration—all this will be lost"
  that is, lost under the scheme we propose. I deny that. Every hospital or group of hospitals so related as to form a hospital unit is to have its own committee of management, and the members of that committee will not be black-hearted, black-hatted bureaucrats from Whitehall. They are to be appointed, not, mark you, by the Minister, but by the regional board of the area concerned, and after consultation with a number of local authorities. These local authorities include the local health authority, the local executive committee in charge of the practitioner service, the existing voluntary hospitals and the senior professional staff in the hospitals themselves. You can hardly have a more local body than that. Why should these local citizens, with greater means at their disposal, and greater opportunities for development, do less than their predecessors have done? I am convinced that they will do more. With the growing sense of social responsibility which is so evident in our people today, greater interest, greater initiative and greater participation in the development of our social service will become more potent than ever before.
  It is also said that we shall have restricted the powers of local initiative and robbed them of the means of meeting local needs by the confiscation of their local funds. That is the exact opposite of the truth. This scheme provides that the regional boards with their local management committees are to enjoy a high degree of independence and autonomy within their own field. Each of the regional boards will have at its disposal an appropriate share of the present endowments of the voluntary hospitals, which are to be transferred into a central hospital endowments fund and redistri-

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  buted according to the need of each region. The regional boards will be able to spend this money, or hand it over to local management committees to spend as they think best, without any kind of detailed instruction or restrictive regulations from the centre.
  Commander Maitland Commander Maitland (Horncastle): rose—
  Mr. Key: It is my statement which I am making. I will have clarified it by the time I have finished. I have had a great deal of experience in teaching youths who are not ready to understand and appreciate. Before I have finished, I think that I shall have given my class the sort of lesson they are wanting.
  Mr. Peter Thorneyeroft: Is it in Order to describe the Chair as an inexperienced youth?
  Mr. Speaker: I do not think the Parliamentary Secretary said that the Chair was an inexperienced youth.
  Mr. Key: I have an appreciation of the English language, and I should not apply those words to the Chair. In addition, as the White Paper states, the regional boards can receive gifts or legacies and hold property in trust for any purpose connected with the hospital services which they control. Moreover, the boards, and under them the hospital management committees, will have a very considerable amount of financial freedom so far as administration is concerned. At the beginning of each financial year they will prepare their annual estimates. Their budget of course will have to secure approval, but when once it has been approved, it will be for the Board to spend the money, put at their disposal by the Exchequer, as they think best, up to the limit of the sum that has been approved. There will be a wide discretion concerning that global sum, and not, as some critics tell us, central control over the detailed items of financial expenditure.
  On the other hand, it has been asked, "Why not take over the local authority hospitals? Why not use the local government geographical distribution, the local government managerial machine, for what, in fact, would become a greatly improved local government service?" I answer: Because of existing geographical areas and the functional distribution that
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  is administratively impossible. I have been a keen participater in local government for many years. and yield to no one in my admiration for its services and my desire to see them extended, but we must not blind ourselves to the fact that, whatever else has been done in local government, as an administrative machine, particularly in so far as its area basis is concerned, it has not kept pace with developments in communications and transport. We have not made its sphere of operations grow with the character of the services we have developed nor with the means and needs for wider areas of administration. This, however, is not the time to deal with the reorganisation of local government.
  What we have to consider is the proper planning and provision of a hospital service, and I say, definitely, that the present local government machine cannot provide that service. The areas are normally not adapted to it. We need much wider catchment areas, now that specialised institutions and consultant services are to be made available to all the people. The present separation of the county and county borough services, particularly the separation of the county borough services from those of the county in which it is situated, means that in any hospital service, based upon existing areas of local government, the real focal centre of such a hospital service for the county would not be really available because it would be under separate, and definitely segregated, county borough control. It is said that by the creation of elected joint hospital boards these difficulties can he overcome. I do not agree at all. Greater difficulties would, in fact, be created, because of all bodies the indirectly elected joint board is in my opinion administratively the most hopeless.
  Mr. Willink: Would the Parliamentary Secretary say why an indirectly appointed regional hospital board is better?
  Mr. Key: Yes. I propose to give the reasons for that as I go along. As I say, local differences, local jealousies, local rights and claims are intensified by joint boards. Unified needs, unified advantages are minimised by them. The attention of the members is centred purely on local interests and not upon the general development of a wider service. People

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  appointed to the regional hospitals boards will not be there merely as representatives of local authority interests, but will be selected for their knowledge of hospital needs and hospital problems and will, therefore, be interested in hospital development, and not retarded, all the time, by considerations of a local character, particularly the incidence of local taxation.
  That leads me to a further most important point. This hospital service is to be a national service, available to all, and to develop such a service dependent, if administered through the local government machine, at least in part on local taxation, would either place an undue burden on those areas where the needs for this service are greatest—the most poverty stricken, the most highly rated and the most lowly assessed areas in the country—or it would be insuring that in those areas the standard of service provided would not be equal to that in the more financially favoured districts. To that we cannot agree. We are pledged to a general national service, available to all upon equal terms, irrespective of individual needs or local financial ability. Geographically and administratively, functionally and financially, the local government machine is not equal to our task. Hence our need to make one which will fill the big purpose which we have in view. What, ultimately, may become of the local government set-up I do not know, but of this I am perfectly convinced, that we cannot allow our hospital service to be crippled by making it conform to the present restricted areas of local administration, nor can we make its evolution wait on some, as yet undetermined, re-organisation of local government.
  I turn to the question of the general practitioners. Here, again, none of the arguments put up yesterday seems to me to be at all new. We have been told, again and again, that such is the character of the service which doctors give, that they ought not to be directed to districts to which they do not wish to go. Doctors, like other workers, should be free to choose the form, place and type of work which they prefer, without governmental or other direction. Well, they are so free and so will they remain. What is the truth of the matter so far as this Bill is concerned? All doctors now in
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  practice in any area before the appointed day are enabled, on making application, to be included in the list of medical practitioners undertaking to provide a general medical service in the area in which they are. There is nothing to prevent any of them from being so included in that list. If a change to a new area is desired, or a new application to share in the service is made, then that matter has to be referred to the local executive council.
  What is the composition of the local executive council? Half of it consists of professional representatives, appointed by special practitioner committees, which are wholly professional bodies. They are to be appointed, not nominated, by these practitioner committees. The executive council is the employing authority, but it is not the selecting authority for the doctors in the area. Before the name of the applicant can be placed upon the local list in any area, and he can thus become employed by the local executive council, the matter has to be referred to the national medical practices committee to determine whether or not, in the view of the general profession there, there is need for extra medical practitioners to go to the area. If the medical practices committee say that, in relation to other areas, the one under consideration is well served, then no addition to the local list can be made. If the number of applications that are made exceeds the number of places that ought to be filled, then it is the medical practices committee which will select the applicants whose names are to be added to the list.
  What is the composition of this medical practices committee, vested with all these powers? It is to consist of a chairman who must be a medical practitioner and eight members, six of whom must be medical practitioners. Of those six, five or a majority of the committee must be actually actively engaged in medical practice. That is called direction. What then, in the name of conscience, would be the definition of professional self-government? Where, may I ask, is there any other service paid out of local funds or out of national funds where anything approaching that amount of self-government exists?
  That some control of the distribution of doctors must be established is, I think, obvious, because so far that distribution has been chancy and very uneven. The

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  areas where the need is greatest have often been most badly served, yet the claim is made that no matter what the superfluity of doctors in any area may be, or the dearth in any other area, any individual doctor is to be empowered to decide for himself whether he is to be included in the National Health Service in that particular area. For, say the B.M.A., not only shall doctors like other workers be free to choose the form, place and type of work which they prefer—to which we all agree—but having decided their preference, whilst other workers may but seek and obtain it only if the need exists, the doctors shall be empowered to demand it, whether or not their services are required. Again, say the B.M.A., in addition to the claim already made:
  Every registered medical practitioner should be entitled as a right to participate in the public service
  That is an impossible, impertinent claim. Who has a right to participate in a particular section of public service in a self-selected area? Neither town clerks, city engineers, school-teachers, postmen, dustmen, nor any class of public servants have that right.
  Mr. Henry Strauss: Is it not obvious that the claim of the B.M.A. is that doctors shall have the chance to find out whether the public does want a doctor? If the B.M.A. claim that capitation should be the basis is allowed, does it not follow that a doctor would be taking a certain risk in asking the public to decide whether he is needed?
  Mr. Key: What the hon. and learned Gentleman must appreciate is this. We are here talking about setting up a public service for which the public pay, through public money. This is not some private arrangement between a private practitioner and a private individual. As I have said, none of the people who receive money now from national or local funds has the right claimed by the B.M.A. If a dustman cannot find a job with a particular local authority because no vacancy exists, he does not start to howl about being subject to bureaucratic direction because he has to go and seek work elsewhere. Why must doctors do it too? The interests of the community demand that the distribution of medical services shall be organised with the claims and needs of patients and not the whims and fancies of practitioners as the guiding factor. I
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  wonder what would be said of teachers if as a body, they claimed that any individual teacher, having obtained the Ministry of Education certificate, should be empowered to decide what school he would serve in and as a right obtain a post in it, irrespective of the fact that the school he selected was already adequately staffed, whilst neighbouring schools were so devoid of teachers that classes were of such a size as to prevent the proper education of the children. Doctors would be among the first to say that that was all wrong, and that the best interests of education and of the pupils were being sacrificed thereby. That is equally true of the medical service and of patients if the doctors' claim is going to be allowed.

  It is said that, if the Government limit the doctor's freedom of movement in this way, we limit the patient's freedom of choice thereby. None of us wishes to destroy the freedom to choose and the freedom to change. I want to say that for a very large number of people that freedom does not and never has existed. Firstly, there is within their means very often no choice at all. There is only one practitioner available in their area, at any rate to them, because they cannot afford to pay for the other fellow. Secondly, if they choose there can, of course, be no guarantee that the doctor of their choice will choose to take them. However, in so far as choice exists now it will go on and the doctor of our choice will go on looking after us as personal patients, visiting us at our homes, or we visiting him as need may be just as it is done now. He will prescribe the medicine we need and we shall get it made up just as we are doing now. We are not going to be told that we have to go to some new State doctor. We are not going to have our little secrets revealed to some State department without our consent. We are not going to be treated by a lot of civil servants acting under State orders. The fundamental relationship between doctor and patient will remain what it is now. The great difference will be that we shall not pay fees for attention. We shall pool our resources as a community and pay doctors for our general care, irrespective of our individual needs.
  Another great difference will be this, that behind our individual doctor and through him we shall be able to get on the same conditions as to payment, all

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  the specialist hospital, X-ray and other modern facilities that we need. In so far as choice can be exercised, this Bill facilitates it What we have to ensure is that what is largely pretence in actual experience, is not used as an excuse to frustrate the foundation of a real medical service and result in the superabundance of doctors in well-to-do areas and a dangerous scarcity in areas mainly inhabited by the less fortunate. "The Lancet" of 6th March puts this matter of doctor-patient relationship quite fairly. "The Lancet" said:
  The truth is that the doctor-patient relationship in modern form needs improvement rather than preservation; it can never be wholly satisfactory while the doctor (as someone has put it) is not only a friend in need, but also a friend in need of his patient's money; nor while there is competition rather than cooperation between him and his colleagues.
  The great fact about the service we desire as outlined in this Bill is that it will provide the opportunity for the development of real cooperation and thus help to do that which as "The Lancet" in the same article claims is one of the outstanding features of our new hospital scheme:
  remove from medical practice much of the mercenary element that has been growing more conspicuous for 50 years or more.
  That leads, not unnaturally, to consideration of the questions of the sale of practices and the basis of remuneration of the general practitioner. What is it that doctors claim they should have the right to buy and sell? It is not now goodwill dependent on the ability of patients, as heretofore, to pay for attention, nor on the extent to which, no matter what that ability, they did or did not pay. What is claimed that doctors now shall have the right to sell is a definite guaranteed income dependent on payments from national funds. There are in this no uncertainties, no bad debts; indeed, it is, as the saying goes, "as safe as the Bank of England"—and that is safer now than it ever used to be. Is that privilege something which the medical practitioner should have the right to sell? If it is to be right for doctors why is it not also right for others whose incomes are guaranteed from national funds? If for doctors why not for medical officers of health, school teachers, health visitors and sanitary inspectors?
  Sir Wavell Wakefield: Would a sanitary inspector have a capitation fee?
  Mr. Key: I do not think it necessarily follows that he ought to have a capitation fee, or that the doctor ought to have a capitation fee. All I am saying is that remuneration comes out of national funds, is guaranteed by national funds, and that the guarantee of this nation is not something which individuals should barter between themselves. If we are to have power to secure better distribution of doctors, which is essential to the future service, the sale of practices must cease. Whether its prohibition logically involves compensation I am not concerned to argue. Whether anyone should have the right to compensation because he is not to be allowed to sell the part he is to play in some new national service is highly questionable. But this is true: the establishment of that new service will destroy a considerable part, if not the whole, of the value of existing practices, upon which some have based provision for their old age, and in the purchase of which others have landed themselves into considerable debts. Difficulties of no mean dimensions will, therefore, be created for those whose participation, whose willing cooperative participation, is essential to the success of our service. We therefore think it wise, in the interests of that service, that they should be compensated for the loss they will suffer, and we are seeking powers under this Bill to do that. It has been agreed with the profession—and I want to emphasise that—what shall be the sum total of that capital value. We shall agree with the profession on the basis on which that capital value is to be distributed.
  Mr. Scollan: Could my hon. Friend tell us the number of doctors involved?
  Mr. Key: The number on which this was based was 17,900. Another point I ought to mention is this: Our scheme involved the setting up of superannuation arrangements, and if the sale of practices was abolished, and no compensation given, I think that in justice we should have been bound to take into consideration the past service, particularly under the National Health Insurance Scheme, of the practitioners concerned. if we did that the capital sum involved would have

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  been £35 million, and that must be off-set against the £66 million which is being paid in compensation under this Bill.
  What of remuneration? What about the slavery of the salaried service? I have been asked, why not make this into a salaried service and have done with it? Doctors in hospitals and medical officers of health receive salaries. Why not general practitioners? The education service is a salaried service, and has become more and more efficient. Why not the medical service? It is because the medical profession is not yet ripe for such a service and that some check of payment, in proportion to output, is still needed if we are to get from it the efficiency and the effectiveness which the community has a right to expect. That is not my statement. It is the statement of the Secretary of the British Medical Association, who said in a letter to "The Times," on 17th April, that a salaried medical service
  …might tend to replace competition for patients by competition to avoid them.
  Second, and more important, a full salaried service is inconsistent with the free choice of doctor, to which we have agreed. A large salary cannot be paid irrespective of the work done, and the basis of fairness cannot be introduced into a wholly salaried service under existing conditions without compulsory allocation of the work, that is, distribution of patients among doctors. We regard the free choice by the patients as being the more important principle, and, therefore, we put forward a compromise. We propose that general practitioners' remuneration shall be partly basic salary and partly capitation fee. What the general range of remuneration shall be, what the proportion of salary to fee shall be, what the fee per head shall be are problems which remain to be determined. As has been said, we appointed the Spens Committee, consisting of half doctors and half others, to examine what the range of doctors' remuneration should be under the new conditions, and, just as we agreed the composition of that committee with the profession, so, when we have their full report, we feel we shall be able to settle with the profession the range of remuneration and the component parts of that remuneration. Opinions will differ as to what ought to be done. Some will claim that the salary part will be more
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  important, particularly if we make the profession attractive and give young entrants a good chance in the early years of their practice, and we are able to develop the service as we ought. On the other hand, we shall, with a free choice of patient, need to look to adequate capitation fees to secure that each practitioner pulls his full weight in the new service therefore. With good will on both sides, I see no reason why we should not be able to settle that business.
  Now, I turn to the question which was raised with regard to private patients and pay beds in hospitals. We felt that to prohibit altogether the private practice of doctors joining the service would only have the effect, at any rate in the early stages of its development, of keeping out of the service a great many good doctors who would otherwise have joined it. Doctors, of course, will not be allowed to charge fees to health service patients on their own lists, but if a patient who has seen his own doctor feels that he would like the opinion of another general practitioner—not, of course, a specialist, who is available within the service without charge—we felt that it was reasonable to say that that person should be asked to pay a special fee for so doing. There is also the related problem of pay beds in hospitals. We are making special provision, it is said, for privileged patients who can afford to pay for private accommodation, a practice which is really alien to a real public social service.
  On that I would like to make two observations. The first is that within the public service which, by the proposals of this Bill, we shall set up, if there are any who on medical grounds need special privacy, single rooms, and so on, they will have them, whenever available, free of cost as part of the normal service. What we propose is that when private rooms are available and are not wanted for the time being on such priority medical grounds. it shall be open to people to pay for this extra amenity, if they so desire; but no one will be deprived thereby of services of which they are in need.
  Secondly, I am convinced that, as our hospital specialist service builds itself up, the use made of existing private specialist services will decrease; but in the meantime we have a transitional problem of a serious character to face. At the present

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  time, specialists are grouped in particular areas, and are not as readily available to the people generally as is needed. Their work, particularly in voluntary hospitals, is usually honorary, and naturally they group themselves in areas where paying private practice predominates. Apart from their private practice and advice, treatment from them can be obtained only at certain hospitals—all too limited in number—and it is practically impossible to get the specialists into the patient's home, however great the need may be. The dearth of specialists in given areas is not the fault of the specialists, but it is a difficulty that we are bound to try to overcome, and to meet the problem we feel it is wise that no ban should be placed on private specialist practice. We want the specialists to assist in our hospital services widely over the country, but we must prevent specialists who are giving part-time to the services from putting in a minimum routine attendance at the hospitals, and then rushing off to deal with their private cases in a private nursing home service. Therefore, we want to encourage the specialists to regard the hospitals more and more as their professional bases, and for that reason we are certain it will be best—on the distinct understanding that the needs of the ordinary service are fully met—to allow specialists to bring in some of their private work to pay-bed blocks within the hospitals. Two conditions will definitely be laid down with regard to that service. The specialist who is to have the privilege of doing it must be acting part-time in the national service, and secondly, his charges for his services must be subject to control to prevent the sheer abuse of the hospital facilities placed at his disposal.
  May I now turn to the Amendment on the Order Paper? I listened very carefully to the Debate yesterday in the hope that I might find, not merely an explanation of the terms of the Amendment, but also some arguments in support of the statements it contains, statements which, to say the least, are surprising, for on the face of them there are three or four that are demonstrably false. Let me take, first, the statement about doctors. The Amendment says that the Bill "prejudices the patient's right to an independent family doctor." That is not true. The patient's right is not pre-
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  judiced; it is safeguarded by this Bill. In fact, for a very large number of our people, such a right is created for the first time, for, despite inability to pay, the mere fact that any individual is a member of this British community will in future give him a right to the services of a general practitioner or specialist at a hospital or at home without payment of a fee. The statement, therefore, is pretty wide of the truth. It may be said that the governing word in that statement is the word "independent"; that the doctor whom the patient may choose is not independent. What does that mean? Independent in the sense of being free to take up the job as he pleases? He is so free. The Bill places no obligation on any medical practitioner. He may stay outside the service altogether if he wants to do so. He may come in with his present practice if he so desires, and with his present patients if they will come in with him. He is free to take any particular patient or not from among them if he wishes, for the Bill says that the consent of the practitioner has to be obtained. Not only does a patient choose his doctor, but the doctor chooses the patient, too.
  I come next to the statement about hospitals, namely, that the Bill "retards the development of the hospital services by destroying local ownership." It does nothing of the kind. It promotes the development of the hospital services by ensuring that that development shall not be hampered by local poverty, by low rateable value, by the cheeseparing opposition of local Tory ratepayers' associations, or so-called Conservative Municipal Reform societies. By making hospital provision a national service, the Bill secures an adequate service for all, irrespective of local financial ability or local political opposition. Mere local ownership cannot ensure hospital development. That depends upon the ability to foot the bill, an ability which many of the most needy areas do not possess at the present time.
  As far as purely local services are concerned, the Amendment says that the Bill "weakens the responsibility of the local authorities." Again, it does nothing of the kind. It increases their responsibilities. Optional powers are by this Bill made duties, and a direct responsibility is placed upon local authorities to provide services of a quality and standard in keeping with a real national service. It be-

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  comes the duty, and not the option, of the local authority to make arrangements for the care of nursing and expectant mothers and children under the age of five. It becomes their duty, and not their option, to provide a free and full health-visitor service for all in their area who are sick, and a home nursing service for all who need nursing in their homes. It becomes their duty to provide an efficient ambulance service and health centre service for their own activities and for those of the general practitioners; and so, step by step, through the Bill, in these and many other directions, the responsibilities of local authorities are being strengthened, and not weakened.
  I felt, while the Bill was being drafted, that we had in this Bill a really good Measure. Since seeing this Amendment on the Order Paper, and particularly since listening to what hon. Members opposite have had to say about the Bill, I am more convinced than ever that I was right, for if the reasons here stated for the rejection of the Bill are the strongest that its opponents can conjure up, it must be an excellent Measure indeed. Lastly, it has been claimed that the Bill is misnamed, that it is not a health service but a disease service that we are setting up. The health promotion and preservation services are, it is true, those which provide good housing, sound sanitation, proper conditions of work, economic security, adequate leisure and sufficient food. It is upon those that good health is to be built. It is those services that the great social programme of this Government will ensure to this country, but the service which this Bill will provide is not merely a curative service. It is, for many, a great preventive service as well. Much of the ill health of our people would have been prevented if they had been able to get proper professional advice in the early stages of their trouble. Much of it can be traced to the failure in these early stages, in the days of childhood, for example, to take those simple precautions and to adopt those simple practices upon which the preservation of health depends. This has not been done in many cases because of ignorance of their character, arising from inability, through poverty, to seek the expert advice necessary to their understanding. Because of experiences of that kind, I am sure no one will welcome this Measure more than the poorer housewives of this country, who, in many cases, have seen the health
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  of members of their family sacrificed and their own health undermined by care and worry because of their inability, through poverty, to seek the early help and advice of doctor and of nurse.
  This Bill will abolish that evil and by making assistance and advice available to all, irrespective of means, it will prevent much of that illness and disease which one finds among the poorer people today, and for them the day on which it becomes law will be a red letter day indeed. The Bill does not, of course, stand alone; it is part of that great social programme which the people of this country have so positively approved and which this Parliament, Session by Session, will resolutely fulfil. Nevertheless the Bill, of itself, will, I am convinced, do more than any other single Measure to lift from the minds of our people a load of care and worry that has added very much to the burden of their existence. May the knowledge of that certain resultant benefit serve to expedite its passage through this House and hasten the day of its administrative accomplishment.
  4.53 P.m.
  Mr. Willink: I beg to move, to leave out from "That", to the end of the Question, and to add instead thereof:
  this House, while wishing to establish a comprehensive health service, declines to give a Second Reading to a Bill which prejudices the patient's right to an independent family doctor; which retards the development of the hospital services by destroying local ownership, and gravely menaces all charitable foundations by diverting to purposes other than those intended by the donors the trust funds of the voluntary hospitals; and which weakens the responsibility of local authorities without planning the health services as a whole.
  This Amendment stands on the Paper in the name of my right hon. Friend the Member for Woodford (Mr. Churchill) and of others of my hon. and right hon. Friends. The Parliamentary Secretary has just been making some uninstructed comments upon it, but when he has heard some exposition of the Amendment he will have to revise certain of his opinions. I could understand it being said that the Amendment was a poor thing, if its statements of fact were demonstrably false, but I cannot understand the contention that the grounds set out in it are bad grounds for moving the rejection of the Bill, if they are true.

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  If it is true that this Bill does, in fact, prejudice the patient's right to an independent family doctor; if it is true that the scheme in this Bill retards instead of hastening the development of our hospital services, and if it is true that this Bill menaces all charitable foundations and weakens the responsibilities of local government without putting up a proper plan in their stead, then this Amendment states most serious grounds of objection to the Bill, and that is what I must seek to examine.
  I was sorry that I unavoidably missed the first few minutes of the speech of the Parliamentary Secretary, and I was equally sorry when I came in to hear him gladly and voluntarily allocating to himself the position of school master in this House. Perhaps I may remind him that the last time that that position was taken up on those benches it was by his right hon. Friend the President of the Board of Trade when, I believe, the hon. Gentleman was sitting on this side of the House. I shall endeavour to avoid behaving in that way though I realised when I began to prepare these observations that, having studied this matter for so long when acting as Minister of Health before the right hon. Gentleman, I was in grave peril of myself being magisterial. I shall endeavour to avoid it, however much the Parliamentary Secretary likes talking of His Majesty's Opposition as his "class."
  The House will understand and forgive me when I claim a very deep personal interest in and concern with the subject matter of this Bill. For 21 months there was no subject to which I gave more thought and attention than the comprehensive health service which was being planned, for the first three of those months, collaborating with Ministers of all Parties in the final formulation of the White Paper of 1944, and then for 12 months in the discussions which I was enjoined by the White Paper itself, and by my colleagues, to undertake with all those interested. The right hon. Gentleman the Minister yesterday made play with the word "negotiations." I have always understood that negotiations were transactions intended to lead to bargains. These were not negotiations, but discussions and true consultations. So little did I know of the result of these discussions
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  and consultations, that it was only a short time ago that I saw the reports issued by the local authority associations with whom I had the discussions. The right hon. Gentleman has taken quite another course, and I venture to say that he would have come to this Debate better informed and better instructed, if he had had some such measure of humility as I had and had sought to learn the difficulties of those whom this legislation will affect.
  Mr. Bevan: I had the benefit of the right hon. and learned Gentleman's experience and could improve upon it.
  Mr. Willink: I never thought the right hon. Gentleman would use a Conservative Minister's experience without seeking to obtain his own information.
  Mr. Bevan: Why not?
  Mr. Willink: It is most important in matters of this kind where bodies so various, so ancient, and so honourable are concerned, that Ministers of the Crown, before they put forward proposals, should know how such proposals are going to affect those institutions and bodies. I feel certain that the very serious faults that I find is this Bill could have been avoided, and that they may yet be mitigated when the Minister has discussed them more fully with us on this side of the House.
  I am not claiming in the least that my interest in this great Measure—the proposal for a comprehensive health service—is any deeper than anyone else's. I have merely tried to show that I was closely connected with it. It has, of course, been a most widespread interest, over the whole of the last four years in particular. During the darkest days of the war, in 1942 and the early months of 1943, the whole of this nation, so far as there was time to think about domestic matters, was considering educational reform, health reform, and social insurance reform. Just as with education, I am sure that the country as a whole felt that we were ready for a great Measure of comprehensive progress in the field of personal health. Hon. Gentlemen opposite know that those on this side of the House were with them in being resolute in favour of a 100 per cent. service. We resisted any criticism of that, and we were at one with them.
  Why was this? We all realised that the progress of medical science, and also

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  the immense increase in the cost of medical services, made it essential that there should be great development in governmental and Exchequer assistance of those services. Not only so—I remember making this obvious remark in the course of the Debate on the Beveridge Report—but all of us wanted to see the mothers and the children with medical attention available to them just as much as the insured population. That was the point which stuck out as being most necessary. In addition, it was most urgently desirable that consultant and specialist services should be available. Wherever we looked, in the field of maternity and child welfare, or in a field which has not so far been mentioned in the Debate, the care of the old, in which immensely more needs to be done than has been done in the past, there was room for development. I dissent from not one single syllable of the first few lines of the Bill. I think it is right that it should be, in future,
  the duty of the Minister of Health…to promote the establishment in England and Wales of a comprehensive health service designed to secure improvement in the physical and mental health of the people of England and Wales and the prevention. diagnosis and treatment of illness.
  I hoped and believed for a very long period, in fact until about December of last year—December, not July—that in this great field of personal health, we should proceed in the same spirit as we had proceeded in educational reform. I agree very much with what was said by the hon. Member for Abingdon (Sir R. Glyn) that this is a matter not for acute political controversy, if it can possibly be avoided. This is a matter for co-operation and an agreed basis for progress. It is a field of personal service in which scientific progress should be assured.
  I knew that the Party opposite had declared their view—with which we are in total disagreement—on the medical profession in these words:
  In the Labour Party's opinion it is necessary that the medical profession should be organised as a national, full-time, salaried, pensionable service.
  I shall be asking before I sit down, in view of some observations made by the Parliamentary Secretary on the consequences of the application of that doctrine, in destruction of freedom of choice, whether it is still the policy of the Labour Party. I remember hearing—
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  and then indeed the cat came out of the bag—from the hon. Lady who is now the Parliamentary Secretary to the Ministry of Food, that her idea of the general practitioner service was that it should be clinically supervised by the local authority. If anybody doubts that she said that, let me add that she said it on 26th April, 1945. I cannot begin to understand such a theory of general medical practice. I knew, too, the Labour Party's doctrinal preference for State as opposed to voluntary institutions, and for remote as against local control.
  But in spite of these doctrinal differences, what was the position? The Socialist Ministers, my colleagues and seniors in the Coalition Government, had, in the words of the White Paper, declared their adherence to this principle:
  The sense of personal association which is at the heart of family doctoring must be preserved.
  I say that it is endangered by this Bill. They said, also in that White Paper, that it was not their wish to destroy or to diminish the voluntary hospital system. What has happened? What is this baleful influence of the Minister of Health which has overthrown the judgment of those so far more experienced? I recall a forthright statement by the Minister of Town and Country Planning, in these words:
  I agree with those who feel that the voluntary hospitals should be autonomous. I think they ought to have freedom in the general policy and the management of the hospitals.
  What has happened to the strength of will of the Minister of Town and Country Planning? He, too, has been beaten down.
  As the discussions proceeded, the area of agreement became wider and wider. The Lord President of the Council, as he now is, got his way, and the idea of joint boards for local authorities was abandoned. Why the Parliamentary Secretary should knock on that door today I do not know. The Lord President got his way. He had resisted amalgamation of local authorities for hospital services. In the course of the discussions it became obvious that that proposal was going to be dropped. Then my colleague Mr. Tom Johnston joined me in representing to my colleagues that it was desirable—and the decision was announced in this House on behalf of himself and myself—that there

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  should be no change in the early years after the war with regard to the practice of buying and selling goodwill, in view of the extreme difficulty, which is obvious in the Clauses of the Bill, in enforcing something so novel as prohibition.
  I am bound to say that, until December last year, when one first heard rumours of the Government's intentions, I believed and hoped that we were going forward on this basis of cooperation. I had good ground for doing so. There was not a hint in the Labour Party's programme that they proposed to confiscate hospital endowments and destroy the voluntary hospitals. If that was their intention, it was most dishonestly concealed; as dishonestly as the hospital policy of the London County Council was put forward at a time when they knew they had agreed to give up their hospitals altogether.
  As it has been brought forward, the Bill has very many good proposals, which I shall not detail because, in such time as one has, one can mention only major points of principle. Many of the good points emerged during the discussions of which the right hon. Gentleman has been so contemptuous. The local executive councils, which he has accepted wholly from the revised scheme which emerged in the course of last year, would never have been invented but for those discussions.
  Mr. Bevan: May I interrupt the right hon. and learned Gentleman? I have never, in my Parliamentary experience, listened to a statement of the character we are now having. [Interruption.] Let me put my point. We had a White Paper, which was published and the contents of which are known to everybody. We have now had from the right hon. and learned Gentleman a series of statements purporting to describe departmental arrangements which were made by the last Government in modification of that White Paper and which have never been published; and which, if the right hon. and learned Gentleman proposes to go on with the statement, I imagine, ought to be published.
  Mr. Willink: The right hon. Gentleman is entirely inaccurate. The most important matter which I have mentioned, the question of the sale of goodwill, was announced in this House.
  Mr. Bevan: When?
  Mr. Willink: I had no idea that the right hon. Gentleman would challenge me on that point. I will let him have the reference tonight. The dropping of the proposal for joint boards has been referred to again and again in published documents, including those issued by local authority associations. So far as local executive councils are concerned, if the right hon. Gentleman says that it is improper for me to suggest what is undoubtedly the fact that the constitution of local executive councils, on which the Parliamentary Secretary, and I think the Minister himself, have prided themselves, has not been announced, it is so clear that the position is different from what it was in the White Paper that I should not have thought it was improper to disclose when the idea first arose.
  Mr. Bevan: It is a point of considerable constitutional importance. I understand that the only announcement which was made of the proposals which were then in process of being formulated was the one relating to the sale and purchase of practices. All the other proposals were still under suspense and have not actually been approved in the form of a Bill.
  Mr. Willink: The right hon. Gentleman has interrupted me again. It will be in the recollection of the House that I only referred to one announcement as having been made in the House. That is all I ever said. What I went on to say was that these other matters had been stated in public documents. However, I do not want the House to be delayed by a wrangle between the right hon. Gentleman and myself on such a trivial matter.
  I was about to embark on what I consider the disastrous changes in these proposals from what appeared in the White Paper and what was emerging in the course of the discussions which I was asked by the House to undertake. The first and greatest of all these changes is the proposal to vest in the Minister and his successors every hospital in the country, and to violate or to abrogate—whatever word is preferred—every hospital trust, to administer every hospital through regional hospital boards appointed by himself, who in their turn appoint hospital management committees who, in their turn, appoint house committees. I am sorry to see that the right hon. Gentleman is unable to

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  tolerate this speech because I wanted to ask him a specific question. Is it a fact, or it is not, that when he sent for the representatives of the voluntary hospitals, he immediately said to them. "I am not prepared to discuss the question of the extinction of the voluntary hospital system"? If so, and the statement was made by their representatives in a letter to him and not contradicted in his private secretary's answer, it seems to me a monstrous way of treating bodies which have been promised that they should continue to survive in undiminished vigour. The same attitude was adopted with the representatives of the profession and of the local authorities. We are all in agreement with hospital planning and with amalgamation of hospitals: we agree that where there is a large measure of Exchequer finance, public representation on Boards of Governors is necessary but it must, I should have thought, be significant to all, except possibly the Minister, that his over-simple solution of wholesale nationllisation was never suggested to me by a single soul, political or professional, during the whole of those 21 months—not even by Lord Moran who, during the last few weeks, has been so favourable to the Government's proposals.
  I know that the Minister refers to everyone who disagrees with him as a clamorous, sectional interest, but why should he refer to the County Councils Association and the Association of Municipal Corporations as a sectional interest? They represent bodies of all political complexions. They cover between them the whole of the country. They are much less sectional than hon. and right hon. Gentlemen opposite. They have both said that they do not think this scheme of the Minister's as good as what was being proposed before, and I respect, and think that the House should take note of, their opinion. I can best sum up my observations under two heads by attempting to answer two questions. The first is this: it sounds technical, but the whole matter is very largely a question of administrative structure: Does this Bill provide that measure of integration and harmony which we all want to see running right through the personal health services? The second is this: Is the Bill going to preserve and develop what we rightly value in these services today?
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  In my view, two disastrous changes have been made in this matter of harmonising the system as a whole. I was told by all concerned that the essence of this matter would be that the personal health services should be planned as a whole in all their varied forms over appropriate areas. The essential importance of this was always stressed by the late Lord Dawson of Penn who did a very great deal in the original thought with regard to the bringing together of all our personal health services. Indeed it is obvious, that in these developments it is essential that clinics, general practice, consultants and hospitals of all kinds should be considered as forming an interlocking organism. That is of first rate importance—an appropriate lay-out as between the hospitals and the local authority clinics, which have been sadly out of touch with the hospitals, as between the general practitioners and the clinics and the hospitals with their specialists, and perhaps most of all when the provision of the new and wholly untried health centre is under consideration. This harmony and integration seem to me to be of the greatest importance, and the whole of this essential idea has been abandoned in the Bill. It was in the White Paper and continued throughout the discussions but it has been abandoned because the Minister wants to nationalise hospitals and dares not nationalise the local authority clinics.
  What do I mean by appropriate areas? I mean areas in which it is due to the people that they should find at their disposal all the services except the most highly specialised, such, perhaps, as neuro-surgery or deep-ray cancer treatment, because whatever regions are devised there will always be services which cannot fit into every region, services of which only one example may be wanted in the country or others of which only four may be wanted. But what one wants is an area which can have a life of its own and in which 90 to 95 per cent. of the services will find their place. Such areas could be far smaller than those regions of the Minister, apart altogether from my point that they are not regional boards but only regional hospital boards. There is no reason why these smaller areas could not have the full help and guidance of the universities.
  Dr. Morgan: What about the B.M.A. and regions?
  Mr. Willink: I am not appearing for the B.M.A. I am expressing my view.
  Dr. Morgan: But the right hon. and learned Gentleman uses them to support his case.
  Hon. Members: Why not?
  Mr. Willink: I thought I heard the hon. Gentleman who has just sat down using "The Lancet" in support of his case. [HON. MEMBERS: "Why not?"] I agree, except that I thought that as one of his hon. Friends sitting behind him was so closely associated with "The Lancet" perhaps it is not entirely independent support. It is the hon. Member for one of the Islington Divisions. There is no reason why he should not be associated with it. Apart from this point, with regard to the planning of the service as a whole, may we look at the regional hospital boards and this form of regionalisation? I so fully agree with much that was said by the hon. Member for South Tottenham (Mr. Messer). They seem to me to be regionalism at its very worst. I can understand regionalisation of the mechanical and impersonal services, electricity, for example, which was referred to. There one would have a statutory authority with defined responsibility of its own, not subject to directions from the Minister, not acting under delegated powers, but with its own autonomous authority. Here not only is there the objection expressed by the hon. Gentleman that it is regionalising what is essentially personal, but it is a bad form of regionalising when it establishes a non-elective body subject to the directions of the Minister whenever he chooses to give them and covering an area so large that there will have to be two further sub-delegations from it—three bodies, each of which will be able to say, "This is not my responsibility. I have been told to do that by the hospital management committee," or when you go to the hospital management committee, "I am so sorry. I have been told to do that by the regional hospital board." How will these regional hospital boards work? I believe the theory put about by many experienced medical men that all that is necessary is to get the right men on the regional hospital boards is a hopeless and fatal delusion. The sort of men we want, and can get, to plan and guide a service will have neither the
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  time nor the inclination to administer the huge organisation which there will be in one of these vast regions stretching, perhaps, from Bristol to Lands End.
  The Minister will find himself forced to rely on, and the public will find themselves forced to submit to the administration of junior civil servants, unable to take the necessary decisions themselves and unable to get meettings of these very distinguished regional boards gathered from these huge areas. I do not believe the Minister has the slightest idea how he is going to staff these regions, any more than he knowsx2014;and this he has told the House—the principles on which the regions are to be defined. I have never heard anything more ridiculous than what he said yesterday, that this Bill would not create a single additional civil servant. The Ministry of Health has not got the civil servants to staff these regional hospital boards. Is it that all these eminent representatives of the universities will sit there day by day administering them? Each one of them will need a large staff of civil servants, and I do not believe they will be there for years to come.
  Those are negative criticisms, but I venture to think they have some validity. Let me look at the other side. To give us this, what will the Minister destroy? In our view, this fancy of the Minister's, this idiosyncracy of the Minister's—because no one ever thought of it before him—will destroy so much in this country that we value. I will not continue to speak of the voluntary hospitals and what they have done. I was surprised and distressed that the Minister yesterday should be so arrogant—except that he is often arrogant—as to say that he was not concerned with the voluntary hospital authorities. I am referring to the countless people—and we all know that this is so—who feel today that under this Bill they are losing what they call "our hospitals." There is no doubt about that whatever. There will be a great loss to this community if the habit of giving to the local hospital disappears from our midst.
  And how absurd it is to suggest that any harm whatever would be done by leaving the endowments—after all, only a little over £1 million a year in value in relation to a service which is to cost £152 million. It is ridiculous to suggest, as the Minister did yesterday, that the

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  planning of this service would be prejudiced by leaving endowments where their donors meant them to be. I am not suggesting for one moment that if the purpose of the gift has now gone because the gift is unnecessary, or because the particular small hospital ought to be amalgamated with a larger hospital in the district, that that should be prevented and the endowment should remain with the individual cottage hospital, but I do press—and I think my hon. and right hon. Friends all think with me in this direction—and I urge the Minister to reconsider it, that gifts left or given, not all by Surtax payers, but by thousands and thousands of quite small people in memory of members of their families and so forth, should be left in the town and in the district which these folk meant should benefit. It could not do any harm, and it is very cruel indeed to do what the Minister proposes to do. With a developing service of this kind there will be a use everywhere for these endowments. It is ridiculous to suggest with this mounting cost that £1,000,000 a year spread over the country cannot be used in the districts where it was intended to be used, and how immensely valuable that there should be on top of the Government provision something which will enable a measure of freedom, and a measure of adventure, to exist in each of these units.
  I urge the Government to consider the points made so cogently in a letter, not from a sectional interest, not from a doctor—who, to judge from some things said in this House, is a most suspect person; I cannot think why—but by Sir William Goodenough, the Chairman of the Nuffield Provincial Hospitals Trust. I urge the Minister to consider the points made in that letter which appeared in "The Times" of 6th April. Its salient features were that not the regional board but the hospital management committee should be the body, the real unit in the hospital service; that it should in every case, after proper constitution of the hospital, be called a "board of governors" and not a mere "managing committee"; that it should be endowed with legal personality, with its own staff, both medical and nursing, with its own income, and a right, which in the Bill as it stands no hospital is to have in future in the whole of this country, to attract gifts and legacies. Surely, even within their
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  own scheme, the Government can save for us so much that the scheme as at present drawn up is destroying.
  But I must add to what has been said about the municipal hospitals. I was really amazed by the Parliamentary Secretary. Every word he said about the unevenness of finance in different counties and county boroughs would defeat the whole of the Education Act, which is based upon counties and county boroughs with varied contributions from central funds. There is no reason in the world, if they are the right units, why the proper financial arrangements could not be made.
  I may be unusually fortunate in the fact that the county borough with which I am most familiar is that which I have the honour of representing, namely, Croydon. In the report of the Royal College of Obstetricians and Gynaecologists, which has been referred to, Croydon has been picked out, with Guy's Hospital, as a conspicuous example of an integrated maternity service. The whole of that will be split in two by the Minister's scheme. Let me take another case, the matter of mental health. In Croydon we have a first rate and most progressive mental hospital, run in the closest conjunction with clinics in the town, to which people can go in exactly the way the Minister suggested, without any feeling that they are going to a mental hospital or anything of that kind. Now that mental hospital is to be entrusted to a region. Will it be the London region? We have heard nothing about the character of the London region. If the London region is to be one based on the University of London, and covering all the area for which the University of London is the natural university, it will contain about 14 million people. Is that the London region? If so, what is to happen to a place like Croydon which at present, both in the field of mental health and in the field of maternity services, has an integrated service which has won great admiration?
  But do not let me rely on my own amateur observations. Let me first remind the House that none of these local authorities, who have been criticised rather unkindly by some who speak for the voluntary hospitals, have ever had a duty put upon them by Parliament to this day to provide general hospitals. All they have been given is a power, and they have

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  only had that for less than 9½ years before the war. I fancy the Minister has as great respect as I have for Professor Henry Cohen. Let me read four lines of what Professor Cohen said in a recent speech:
  The more progressive local authorities availed themselves of their opportunity and made such strides in the 10 years preceding the war, since when building has ceased, that there were, in many areas, public hospital services which equalled, if indeed they did not occasionally surpass the voluntary hospitals of the area.
  It is all nonsense for the Parliamentary Secretary to suggest that if you made a plan, let us say for the County of Nottingham with its county borough, or the county of Derby with its county borough, you could not adjust and arrange entry into the hospital which might be geographically in the county or might be in the county borough.
  Indeed the county councils and county borough councils have come to an agreement about that very point and as to how they should deal with it. That is taken as an argument in favour of taking away from the major authorities one of the functions they have valued greatly, where they have developed it, and it would be scientifically of the greatest advantage for this integration to which I have referred in the borough I represent, to continue.
  Let me quote Lord Moran. Lord Moran says:
  It is perfectly true that doctors are working perfectly happily under municipal administration under the Middlesex and Surrey County Councils, and I think that proves that there is nothing inherent in the municipal system which would make doctors discontented.
  There is nothing exceptional, so far as I know, about the citizens of Middlesex or Surrey, and what is done there could be emulated elsewhere. It is only that many of the counties and county boroughs have had insufficient means. They have been burdened with unsatisfactory buildings which they could not alter in the four years before the war. The London County Council are a typical example. They are saddled with old buildings, although I think they could have got on with the matter very much more quickly. I do resent the jeering tone in which the Parliamentary Secretary referred to those who think they should be careful about the expenditure of public funds, ratepayers associations and the like. Let the House note that the two counties which
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  have made outstanding achievements in this field are two counties which had Conservative administration throughout the period.
  Mr. Kenneth Lindsay: May I ask a question? The right hon. and learned Member for North Croydon (Mr. Willink) says there is no difference between citizens of Middlesex and Surrey and elsewhere. Will he not also admit that, irrespective of political complexion, they are two of the richest counties, and also that the Education Act is likely to break down because they have not sufficient finances in the local authorities to implement it without more from the centre?
  Mr. Willink: I would be very reluctant to embark in this speech on the question whether the Education Act is likely to break down. My point is that where there was sufficient money available, local authorities could do the job and now that we are undertaking the provision of services of a comprehensive kind this House can see that they have enough for the purpose. The question is, are the local authorities the correct instrument? What I have said in regard to Middlesex and Surrey is that they are good counties and that other counties are equally as good. It is for this House to see that the possibilities of running a good service are not frustrated, just as it is for this House to see that the Education Act does not break down for the same reason.
  How childish it was, if the Minister will forgive me for saying so, for him to refer to the smallest county and county borough, Rutland and Canterbury, in considering this case. These major authorities are just as capable of running a hospital once they are told what sort of hospital it is necessary for them to run as the regional hospital boards the Ministry is setting up.
  I turn to the proposals in Part IV of the Bill. Do these proposals give us any feeling that there will be an improvement, an enrichment, in the field of general practice? We on this side of the House are bound to remember at all times the view of the Party opposite, not yet called back or revoked, that general practice should be a full time, salaried, pensionable, national service. The Parliamentary Secretary has today admitted that that is inconsistent with free choice of doctor, because it will be necessary in such a

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  service to see that the same amount of work is done by doctors whether patients want to see them or not. We are bound to note that this Bill is one under which regulations could be made under which full time salaried service could be introduced and free choice of doctor destroyed, as the Parliamentary Secretary admits.
  There are all sorts of things we want to see developing in general practice. We want to see the development of group practice and partnership with men of varied qualifications. But we believe a man should choose his own partner. For this Bill and the White Paper to talk about developing partnership and at the same time to set up this fantastic medical practices committee—on which I shall have something to say—means that when four people wish to go to a place where there is a vacancy, the medical practices committee in London is going to decide which of the four is going to be the doctor there. We do not want medical practice to be what the hon. Member for Edge Hill (Dr. Clitherow) said this Bill offered to the medical profession—a life like that described by King Henry VI:
  So many hours must I tend my flock.
  That is our fear. Not one good doctor I have ever met took that view of his work, yet it was expressed from the Benches opposite yesterday.
  While Minister of Health, I examined most closely this proposal to control and regulate the distribution of doctors. I was not impressed by the examples the Minister gave yesterday and the towns he spoke of as so-called "over doctored" places; Bath, where the number of invalids is notorious, Hastings, where the number of elderly retired people, including doctors, is notorious, and Bromley, where doctors live but practice in various parts of London.
  Mr. Sparks: What about Kensington?
  Mr. Willink: The same thing could be said of Kensington. The hon. Member for Acton (Mr. Sparks) probably knows that practices are not localised in London as they are in other places. I was very much more impressed by the comparisons which were drawn, and which have not been challenged, by the British Medical Association. Surely, it is more significant that Barrow-in-Furness, Darlington and Macclesfield had more doctors before the
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  war than such salubrious places as Rich mond and Winchester? The truth is that the instrument has not been invented which could measure with any reasonable accuracy the extent of over doctoring or under doctoring. I remember Mr. Tom Johnston saying that he had been told that Bridge of Allan was terribly over doctored. It was thought that that was true because it was said so many times, but it was found, when he investigated it, that there were a large number of elderly doctors there who had gone there for a little part-time work and to spend the last years of their life there. And, of course, it was a place like Bath, full of invalids.
  We are told that it may be something like two years before the Bill comes into operation. One of the great objections is that the changes it makes have delayed the coming into operation of the comprehensive health service. I am convinced that with the prospect of 100 per cent. service the doctors will in fact be most evenly distributed over the country. In any event I am quite sure that the risk of their not being evenly distributed is not sufficiently great to justify setting up this most unsatisfactory machinery with a large and most unsatisfactory addition to the criminal law and an expenditure of £66 million.
  Why do I say the machine is unsatisfactory? I am really surprised that the Ministers can put forward the idea of a central practices committee with a serious face. Here is one committee sitting in London, consisting, it is said, of so many doctors, five of whom are to be in active general practice. They are to decide the succession to every single practice in England and Wales. Do the Ministers really think that the five doctors will remain in active general practice for long if they are doing that? It is mere camouflage for bureaucracy, as in the case of the regional hospitals' board. It is clear that there can be no effective professional majority on this central committee doing the work of an effective majority. It is certain that the decision between four applicants such as I have mentioned will be made simply on paper material by junior civil servants, with no knowledge of the particular problems of the place—
  Dr. Haden Guest: Does the right hon. and learned Gentleman think that the decisions of the Central

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  Medical War Committee are made in that way?
  Mr. Willink: No, Sir. The Central Medical War Committee was in this far superior position: in the first place, everyone knows it is easier to get busy people to undertake that kind of work in wartime. The comparison is that the Central Medical War Committee has done its work with 145 local committees. This one committee is to do the work for the whole country. I believe it will need a staff of 40 or 50 civil servants.
  Mr. Bevan: I am sure that the right hon. and learned Gentleman does not wish to misrepresent the situation. After the scheme has been started the number of doctors required to be appointed will be under 1,000 a year. In fact, the executive councils will appoint them, and they will be referred to the medical practices committee solely on the question whether that particular area is under-doctored or over-doctored. I should not have thought that that would be an oppressive job.
  Mr. Willink: We were told by the Parliamentary Secretary that it would be one of their jobs to decide between applicants—only when there are a number of applicants, an hon. Member says.
  Mr. Bevan: The right hon. and learned Gentleman's hearing is as bad as his understanding of the Bill. I said no such thing. I said that there would only be 1,000 changes a year in practices.
  Mr. Willink: Would the Minister answer the specific question: If there are four applications and one vacancy, who will decide between them?
  Mr. Bevan: The executive. All that the central practices board will be called upon to decide is whether a particular appointment is to be made in the light of whether the area is over- or under-doctored.
  Mr. Willink: I am grateful to the Minister for that explanation. I shall look to see whether the White Paper and the Bill are in contrary terms. That seems to establish, in my submission to the House, that if it is done in the way the Minister has now defined, it will never be done by five practising general medical men. I see no advantage in it.
  Mr. Key: Did not the right hon. and learned Gentleman propose to set up a central medical board under his scheme? May I be excused for asking him whether he did or did not say in this House in March, 1944, giving an illustration of the operations of the Board, that that central board would say to a young doctor:
  …before we authorise you to take up public work in Wakefield we wish to tell you there is a great shortage of public service practitioners, and we feel that for five years you should give your whole time to that service and should not have any private patients.'—[OFFICIAL REPORT, 16th March, 1944; Vol. 398, c. 434–5.]
  Did he say that?
  Mr. Willink: I thought I had made that position perfectly clear. I told the House, and if I did not make it clear, I intended to, that the examination which I certainly told the House I had given to the question, was subsequent to the publication of the White Paper. I took the responsibility in February, 1944, of suggesting something very similar to this—in fact, identical. It was in the examination of it I discovered how difficult and unsatisfactory it would be. [Laughter.] Hon. Members opposite seem to laugh when someone looks at something and finds it unsatisfactory. The Minister has gone back to my original proposal, which I discovered, I believe correctly, was most unsatisfactory.
  May I now see whether the Minister was right about his own Bill and the central medical board? Clause 34 (3) says that the medical practices committee may refuse any such application on certain grounds…
  and, if in the opinion of the Committee additional practitioners are required for any area or part but the number of persons who have made applications exceeds the number required, the Committee shall select the persons whose applications are to be granted.…
  I do not know whether the right hon. Gentleman will have the grace to withdraw.
  Mr. Bevan: That would not be inconsistent with what I said. In the event of it being decided that one of four persons should be permitted in a particular area, there is nothing inconsistent in that with the actual individual doctor being appointed by the executive. At any rate it is a point that does not confirm the right hon. and learned Gentleman's statement, because I said, and I still adhere

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  to it, that only about 1,000 new practices will change hands in any given year, and that is not an oppressive task for the central committee.
  Mr. Willink: I do not know whether the House will agree with me that the right hon. Gentleman is a little evasive on this matter. He was quite specific in stating that where there are several applicants and only one vacancy, the decision between the applicants will be made by the local executive council. Thinking that he knew his Bill I was a little modest about my own knowledge of it. Is the Minister now saying that he is right?
  Mr. Bevan: I am now saying that the medical practices committee would be in the position of determining who would be appointed. I will at once admit that I see no fundamental objection to the local executive appointing the doctors so long as the central committee decides the number.
  Mr. Willink: The right hon. Gentleman has conceded my point.
  Mr. Bevan: Certainly.
  Mr. Willink: It is said that there is no interference in the freedom of choice of doctor. I am convinced that, the medical profession being rightly independent in spirit, there will be quite a substantial number of doctors who, in the early stages of the scheme, while they are watching what the Minister's regulations are to be, will say "I will practice on my own; I will not go into this service until I see what it is." I believe that some of those who are refused admission to an area will go and practice there none the less They may be the best doctors in the area. but the Minister will not let any patients go to them under the public service. The system under which they will have to work will be a definite limitation on the freedom of the choice of doctor. If an independent doctor goes to a place without permission, no one will be able to go to him however good he is without paying a fee.
  To me the fundamental objection to the whole of this general practitioner set-up lies in the matter of salaries. I have never heard three more flimsy reasons given for something which the Minister knows is obnoxious to the profession as a whole than the three he gave for this basic part-time salary. He said that in
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  the first place, when this service starts, a lot of men will be coming back from the Forces unable to earn any money. The difficulty in getting a young man of small means into the medical profession has nothing whatever to do with his making a living once he is qualified. Every qualified medical practitioner of good repute will be able to earn a good income for a long time to come. The difficulty is to enter the profession. The second reason the Minister gave was that there must be a salary so that the Minister can have something to add to in the case of unattractive areas. Why is something needed to be added to in the case of unattractive areas? Is it a metaphysical idea? I do not begin to understand it. His third reason is that it would be something to add to in the case of special qualifications. Why not give a man £100 a year extra if he has taken some particular qualification? He can be given an extra £100 a year although he has not already got £100 a year.
  The Minister has introduced a Bill in which he can turn the general practitioners of this country into what his party still wish them to be—a full whole time salaried pensionable service. There is no reason why the profession should become part-salaried at the moment except as a concession to Socialist doctrine. The doctors do not want it. It destroys pro tanto, and the Bill allows to be destroyed altogether the feeling that what the doctor is getting in respect of his medical work is in respect of his patients and not in respect of a salaried service to somebody else. I feel that these matters taken together—I have not mentioned the health centres—threaten, as we say in this Amendment, the right of the patient to an independent family doctor. He is in peril under this Bill of having a doctor who is not his but the local executive council's or the Minister's. Until this Bill safeguards that position, I could never vote for it or indeed abstain from voting against it, whatever its merits or demerits. Before I sit down, may I as a matter of personal explanation, apologise to the Minister of Health for attributing to him a remark which was in fact made by the hon. Member for South Tottenham (Mr. Messer)
  5.52 p.m.
  Mrs. Ganley: This is an extremely important Bill. I regard it as the third of a series of legislative

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  proposals which will give security and much more protection at a time when people need security and protection most. We have had the National Insurance (Industrial Injuries) Bill and the National Insurance Bill. Now we have this Bill which is a positive Measure—the National Health Services Bill. Those three will coordinate activities which have been voluntary in origin, but patchy in development. The Debate of the last two days has shown that in all areas there has been a patchy development of the services which are essential to poor people. These Measures, however, will bring the largest amount of security to all. As a past member of a local authority, I am disturbed at the prejudice that is being expressed at the present moment. Many people are saying that they are going to be deprived of the services of the doctor they have known. I am glad that the Parliamentary Secretary has assured us that that certainly is not contemplated under the Bill. In the Bill, as far as I have been able to see, there is a safeguard against that.
  Older people feel about this very keenly. Apart from the loss of the doctor to whom they have been accustomed, some of them feel the change of service in hospitals. The amazing thing about it is that people are not so concerned about the fact that the voluntary hospitals are now to become a State service for the nation, as about the suggestion that they are not going to be able to get the service in the hospital which they have had previously. It seems to me amazing that people should express prejudice of that kind. The Debate has shown that doctors are still to be the people who will serve and that nurses will still be trained for nursing, either in hospitals or in homes wherever they are needed. There is nothing in the Bill to interfere with the training either of the doctor or the nurse. There is nothing to prevent the most extensive and particular training that can be given and which has been given in the past. What happens under this Bill is an extension of the opportunities for research and closer working over the whole nation, so that services which hitherto have been extremely good in parts, can now be available for the whole.
  Local authority experience has provided an excellent service in maternity and child welfare work. I recall the early
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  days when the local authorities had power to being into being maternity and child welfare services after the 1918 Act. They had the power to initiate maternity homes, to encourage midwives, and to make the service comprehensive. When those services first came into being there was, very unfortunately, an enormous amount of prejudice. It was said at that time that the public authority must not be allowed to do work which, in the past, the private practitioner had in his own hands. We know perfectly well that the result since those days has been an enormous improvement in the health of the people of the country. Mothers and children have greatly benefited from the service given by progressive authorities. We entirely agree with the right hon. and learned Member for North Croydon (Mr. Willink) in his remarks about progressive authorities, whatever their opinions may be. The progressive authorities took the opportunities given to them and brought into being a comprehensive service in their own neighbourhoods, which has been most beneficial to the whole people.
  Again, we have the general hospital services organised through the county council. Would anyone say that the standard of the hospital services under the county councils was any lower than the standard of service in voluntary hospitals? We all know of services in local authority hospitals which have been of the highest standard and which have been intensely appreciated by all who had the opportunity, or necessity, of taking advantage of them. We appreciate, of course, the difficulties in the rural areas where it is not always possible, because of the scattered population, to put within reach of the ordinary person the services of the hospital, the nurse and the clinic. We therefore hope that under an organisation of this kind, the rural areas will be considered.
  I particularly welcome the proposed health centres visualised in the Bill. Their main value will be the prevention of the development of disease by earlier diagnosis and treatment. It is only in health centres of this kind, where it is possible for all people to go, that we can follow up the work done by the maternity and child welfare organisations, with the advantage of the knowledge that has been gained. If we can persuade the people fully to use the health centres, we shall have information which has never been avail-

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  able before and we can use it in such a way as to bring increased benefit to the persons concerned as they are growing up.
  I have a very strong belief in the development of preventive organisation. One of the most useful books ever written was an outline of preventive medicine by Sir George Newman, published immediately after the last war. I am sure that it induced a large number of workers under local authorities to get on with the job which was there outlined and to adopt the various suggestions which were there made, with very real benefit. When we come to consider the work to be done by the local authorities, if all imaginative local authorities establish health centres, we might very well see carried out the suggestion of making available all the documents that can be gathered together at the centre, dealing with the health, growth and development of each person. If this were done, in conjunction with nutritional considerations, the examination of which has been going on for some time, all these activities affecting the welfare of the people could be coordinated in the health centre. Is it a very big hope that this will prove to be a really constructive health Measure, which will use preventive organisation and preventive medicine in promoting the better health of the nation, and combine it with the study of such questions as housing, education and sanitation?
  The growth of maternity homes, antenatal and post-natal clinics, led to an enormous drop in infant mortality and in maternal mortality, and that was the result of the work undertaken in these local centres. There was a very strong prejudice against these institutions in the early days, and it was quite a long time before it was broken down. It was a long time before people stopped saying, "We do not want to go to these places and mix with all sorts of people." When the war came, and it was a question of saving the health of the nation, the antenatal and post-natal clinics were used to a greater extent to the great credit and benefit of the country. The maternity service was never better than it was during war time, and it was very much extended, not only in regard to local authorities, but in other directions as well, to the benefit of the nation. It is suggested that these voluntary organisations, which have rendered yeoman service in recent years, will not be fitted successfully into the new
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  scheme. I was grateful to hear the Parliamentary Secretary say that representatives of the voluntary hospitals will have a part in the constitution of hospital management committees or whatever term is used for those who will be responsible for the organisation. There certainly ought to be on such bodies some representatives of the voluntary hospitals. The Minister has not disregarded the value of voluntary hospitals at all. He has everywhere recognised that here is a valuable service, conducted in the interests of the people. It has been the conception of service to the nation which has altered, and I wonder sometimes, when we are talking about the glory that comes to a man who has left his kindred and gone into the Forces of the Crown, whether we have any measure at all of the praise that ought to be given to the people who have conducted these services in the past.
  We are seeing today the creation of a new national health service. There is no question of compulsion about it; it is only a question of the encouragement and coordination of various different activities which hitherto have grown up piecemeal. Yet, when we think of the wonderful service which has been given to the nation in the past by these men and women, who have spent long hours in close research in the service of the people, using their natural gifts and the opportunities afforded to them to bring those gifts to the service of the nation, we recall that, when these people brought their new ideas into being, those ideas were as hotly contested as this new national health service is being contested today. Surely, the changing circumstances demand that the wider vision which recognises the greatest good for the greatest number, shall be the determining factor, and that we shall recognise and welcome the opportunity of using all that is available for the service of the whole country.
  Reference has been made to the rights of patients. There are some of us who realise that there has been a strong determination that the hospitals should be made ready for the doctors. I was glad to hear the Minister say that the patient was the person who mattered, and, in future, we hope that the patient will be the person who will have all the rights in the hospital. When we think of the position facing us we must appreciate very much indeed that the difference of outlook between this side of the House

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  and the other, is bound to cause a clash occasionally. Opinions are obviously different. I cannot accept the idea of this Bill as a Juggernaut car which is to crush every atom of initiative and every independent thought in the minds of doctors and those who run our hospitals. It seems to me that the present position is an opportunity to encourage our young people to take part in, and derive great benefit from, a national health service. Such a service will give doctors and nurses the opportunity of satisfying their ideals. It will give them chances for research work which will result in achievements even greater than the wonderful progress made in the past. More glorious service to humanity will be the result of this coordination of the activities of our health services and hospitals and those who are trained in them will gain a very much wider understanding of service to the country, so that there will no longer be any question of fear of the future for many people but on the contrary a certainty of the benefits that the future is going to bring.
  6.10 p.m.
  Mr. Clement Davies: It falls to my lot to be in the fortunate position of congratulating the hon. Lady the Member for South Battersea (Mrs. Ganley) upon a speech made with knowledge, understanding and, if I may say so, with great charm. I think it is only right that Lady Members should take more part in our discussions with regard to health than we of the other sex, for from the time of the creation of man or, at any rate, from the time that our two ancestors left Eden compulsorily, in times of distress the cares have fallen upon the women rather than upon the men. I most sincerely congratulate the hon. Lady on her speech.
  Health is no longer a question merely for the individual or even for the family. It has now become a question which concerns us all. But this is a new conception for, until recently, it was a matter which concerned merely the individual and those who were nearest and related to him. Except for such charity as they might receive, those who were incapable of paying for medical attention and advice had to go without. It is almost within our own memory that the new conception that the health of each individual con-
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  cerns us all has come about. We now realise that the wealth of a nation depends upon the health of the individual, but we also understand that we have a responsibility towards anyone suffering from ill-health and that we have to share with him the benefit of our production until such time as he can be restored to health. Therefore, it has become a matter of concern for the nation as a whole. In time of war we realised that more than at any other time because wherever men or women happened to be, we in this House said that we had complete control over them for the service of the country. From an economic, a safety and certainly from a human point of view we realise that we are responsible for one another and must come to each other's assistance.
  Therefore, the first question I put to myself is whether the present service given to the people is satisfactory, and its seems to me that the answer given by everyone is that it is far from satisfactory. The next question I have to put to myself is, Will the service be better under the Bill that is now being introduced by the Government than it is at the present time? Quite obviously, again the answer is in the affirmative. Now, for the first time, it does not matter where the individual may be. Hitherto that has been a tremendous handicap. Whether or not there are any means of paying for the medical service does not matter. All the medical science of this country will be available to rehabilitate the individual at the earliest possible date. That is one of the greatest steps forward that we have taken.
  It is a matter of deep regret to me that we have had to wait until 1946 before tackling this question of a national medical service. I have listened to nearly every speech which has been delivered during this two days' Debate and I, like the Parliamentary Secretary, was at a loss to understand what is the position of hon. Members above the Gangway. They say that they are in favour of a national health service and that they wish to establish a comprehensive service. If that is their wish, why do they put down an Amendment, the only object of which is to wreck this Bill? Every one of the reasons given by the right hon. and learned Member for North Croydon (Mr. Willink) were not questions of principle against a comprehensive medical and health service; at best they were Committee points which could be raised during

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  the Committee stage. But the Opposition have seen fit to put down this Amendment and I take it that they are going to carry it to a Division. If they succeed, the country will have to go for a further time without a comprehensive national health service. Let us make no mistake about that. This is a wrecking Amendment, but the extraordinary thing is that somehow or other, they can never get out of a habit, however bad it is. The right hon. and learned Gentleman kept on referring to statements made previously by the Parliamentary Secretary and by the hon. Lady the Parliamentary Secretary to the Ministry of Food, and various others. Let me remind him and some of his hon. Friends that this Amendment is almost exactly in the same terms as those which were moved against the Third Reading of the National Insurance Bill of 1911, which was the predecessor of this Bill.
  It seems rather unfortunate that the right hon. Gentleman the Member for South Kensington (Mr. Law) should have had to open for his party yesterday because I am sure he will recollect the part played by his revered father who led the Opposition to the 1911 Bill. Exactly as this Amendment is today, so it was then. They could not say "Yes" and they did not dare to say "No," so they invented a sort of new, middle Conservative way of trying to get the best of both worlds. Obviously, the intention was to wreck the then Bill while paying lip service to the necessity of creating a new medical service available to the poor of this country. I have listened again to the words that have been uttered here and they have certainly been rather mild in their criticism.
  Fortunately, a constituent of mine has retained the kind of document which they were issuing in 1911. It was well worth preservation because the language that is now being used by the national Press which supports the Opposition bears a great similarity to the language in the document which was issued from St. Stephen's House, Westminster, in 1911. I will quote one or two phrases:
  The State Insurance Bill must be killed—
  Why?
  because we cannot afford it.
  The reason why we could not afford it was that under that "iniquitous" Liberal Government that started all social
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  reform, the annual expenditure in the Budget had gone up from the amazing sum of £150 million to £172 million. The next slogan was:
  The State Insurance Bill must be killed—
  remember their anxiety for the people—
  because it will ruin the British workers.
  Another one was:
  State insurance must be killed because it will severely tax the British manufacturer and subsidise the foreign manufacturer.
  I would like to give two other quotations, because history will repeat itself. We have heard so much today about the breaking of the relationship between the family doctor and the patient and about the freedom of choice of doctor, to which matter I will come in a moment. Listen to this, which is rather similar:
  The ill-feeling that is going to be created in every British home by this Act cannot be over-estimated—
  and then, horror of horrors:
  Servants and mistresses will become deadly enemies.
  That is the sort of language which we find, in another form, used against this Bill by which it is proposed to bring in a comprehensive health service.
  Let me deal with this matter under three heads. First, the patient. Undoubtedly, there are not only in industrial areas but certainly in the rural areas, in the smaller villages and in the remote districts, people who have not been able to obtain proper medical service. They have been so remote that very often they could not consult even a doctor but had to rely upon their own home services such as they are. Think of the suffering and the loss that that must have caused. An hon. Member referred yesterday to the fact that the cost of medical service in this country, the amount that we are spending upon the maintenance of health, on doctors, nurses, hospitals and so on, totals the enormous sum of £300 million. I do not know whether that figure is correct, but I am certain that the loss which the country has suffered in the past through our inability to give proper medical service, bearing in mind the number of people who have died or who have become chronics, can never be estimated. In the arguments objecting to this Bill to which I have listened, little attention seems to have been paid to the patient. Most of the arguments have been directed to the position of the doctor and those

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  estimable people, the governors of the voluntary hospitals. Surely, the one consideration should be: What is likely to give the best and fullest service to the people, wherever they may be?
  I would like to turn for a moment to the question of the doctors. A great deal of nonsense has been talked about the freedom of choice of doctor. In country districts we do not have to take the doctor of our choice, but the one who happens to settle within that rural area. If I may give my own personal experience, the old doctor who saw to my advent into this world sold his practice to A. A sold it to B, B sold it to C, C to D and D to E, and I think it is now F to whom I go when I am in the country. I did not choose him. He was chosen by his predecessor who sold his practice to him. This applies to the whole of the countryside. If I go to an industrial area, even to London, what choice have I of a doctor? What we often see is the plate on a corner house—doctors usually choose a corner house because it is the best site and the most likely to attract—which happens to be nearest to us, and we go there without any knowledge at all of the doctor. Let us be real in this matter. Much is talked about direction. What amazes me is the fact that the right hon. Gentleman has given so much freedom to the doctors. They have never had as much freedom as they have now, neither have the patients in the past. I am not talking about well-circumstanced people but about the ordinary, everyday people. Never have they had so wide a choice as they will get when this Bill is functioning fully and properly, and when there is a better distribution of the medical services.
  May I now turn to the hospitals? Undoubtedly, they have been badly sited and badly equipped. What advantage is there to be obtained in a voluntary hospital which is not to be found in any other hospital? I do not understand it. Are the doctors better because the money which is used in the hospital has been begged on the streets and not paid by the Government? Are the nurses better? Is there more humanity in such a hospital because of the source from which the money has come? Are we going to slander the medical men and the nurses in that way? I was glad to hear the right hon. Gentleman refer to the way in which this money has been
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  collected in the past. It made me blush with shame, as it made the right hon. Gentleman blush, to think that our nurses and young medical students should have to dress up and go about the streets of London begging in order to give the necessary medical service and keep the research going which is needed by the millions in this greatest city in the world. One has to get a complete picture of what is wanted in this country. If health is a national matter there must be a national system and a complete system. It is suggested that that could be undertaken by the local authorities. The germ knows no boundary. I defy anybody to say where one county boundary begins and another ends, and certainly the germ knows no boundary.
  What we have to do is to get the hospitals, equipment, medical men, nurses and necessary staff so placed as to be able to deal with all the diseases and accidents which will arise, wherever they may be, instead of, as at the present moment, having a hospital put up not so much for the benefit of the people as for the glorification and happiness of some particular person who has been able to give money for that purpose—I see an hon. Member shake his head. I do not know why—I can speak of that in my own county. I can assure hon. Members they would be treated very differently should they need hospital treatment in either of two places, one in the North West of the county and the other in the South West of the county, where two charitably minded families set up two small hospitals. For the generality of the people we have to do with what we have, which is very little.
  We have to have a broad general scheme. It has to be planned from the centre. As the Minister has said, it cannot be worked from the centre; we have to decentralise. Decentralise in what way? I cannot see any way other than the way in which he has done it, namely, by regional boards. If it is done by regional boards it is suggested that charity will dry up. I am surprised that so far nobody has referred to the fact that in Wales we are fortunate enough to have had experience of a regional board. [An HON. MEMBER: "Oh?"] Does it surprise the hon. Member that we are fortunate in having had charitably minded persons who have put down £1 million to support the voluntary hospitals, to deal with the most dreaded disease of tuberculosis? It

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  was due to my predecessor as Member for Montgomery and his two sisters that that was started.
  Soon afterwards the National Health Insurance Bill was introduced into this House, and Wales was turned into one complete unit; the 13 counties and four county boroughs were made into one region. It was fortunate that they were made into one region, because the incidence of tuberculosis is higher in Wales, unfortunately, than in any other part of the United Kingdom. We were much more fortunate than England, because in England the duty of caring for those suffering from tuberculosis, and providing the sanatoria, medical staffs and nurses fell upon the county authorities, as if the county boundary was something sacred. The National Memorial of Wales, which is now a Government institution and will be incorporated into this Bill, is the envy of all the English counties, and the envy of Scotland. What is more, it is the place to which continental countries and America apply for information with regard to the latest treatment of tuberculosis. More has been done in research under that regional board than has been done anywhere else. What, therefore, can be the objection to a regional board carrying on in this way?
  Hon. Members have referred to the drying up of charity. Do they really think that will happen? That regional board in Wales is financed partly by the Government and partly by the county councils. But that has not prevented people from making contributions towards the local sanatoria, not for the absolute necessities but for those little items of attention that make all the difference to the patients in the hospitals. There are cases where those little gifts and little attentions, mean far more than the general matters which are dealt with in ordinary hospitals. I would ask my hon. and right hon. Friends above the Gangway to study again and think over the words uttered by the hon. Gentleman the Member for Abingdon (Sir R. Glyn). He, with his great experience of hospital work, began his speech by saying he would find it very difficult to vote against this Bill. He very rightly commented upon the attitude of the Minister and the delightful way in which he introduced this Bill, and asked for cooperation in order to make it a success, so that we might being benefit to those
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  who have hitherto had to go without, and so that we may have a complete medical service available for all, from the greatest specialist to the ordinary general practitioner. This is a great thing. I am sure the Minister himself regards this as only one instalment. In the Bill unfortunately the phrase "comprehensive health service" is used. It is a comprehensive health service from the curative point of view, but the right hon. Gentleman is also the head of the Ministry which will be responsible for the local authorities carrying out the preventative side, which is so important.
  When we can abolish slums, when we can make pure water available to all houses, when we can abolish cesspools and bad sewerage systems, when we can have better feeding of the people, when we can have better feeding and better schools for the children—it is appalling that at a time like this, even now after the war, less than 40 per cent. of the school children are being properly fed—and when all that can be coordinated with the three great services, prevention, cure and maintenance of health in a new charter of health which I hope the Minister will introduce, then, indeed, we can look forward to a happier, healthier country. There are many other questions which we will have to discuss in the Committee stage, and it is not worth while dealing with them now. Let us now deal with the general principles. I am proud indeed that a fellow countryman of mine has introduced this Bill, planned it and brought it forward. In many ways he reminds me of our fellow countryman who introduced the first Bill dealing with health. Just as the right hon. Gentleman and I would have wished him well in those days, introducing a new hope to the people wherever they may be, so do I, from the bottom of my heart, wish the Minister well in carrying out this Bill.
  6.38 p.m.
  Mr. Ungoed-Thomas: May I carry on where my fellow countryman, the Leader of the Liberal Party, left off and add my congratulations to my other fellow countryman, the Minister, on this Bill? It is a matter of great pride to us in Wales that the great social services of national insurance and national health should both have been introduced by our fellow countrymen. Whatever trepidations the Minister may

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  have had before the Bill was introduced, he can have little doubt now of the strength of his position, or that the Bill is acceptable to the House and to the country. I hope that in due course, taking heart from this, when the Bill goes through the Committee stage, he will take every possible opportunity, not of yielding to pressure from the other side, which I am sure he will not do, but of strengthening the Bill in precisely those ways which he himself would most welcome. If this Bill had nothing else in it at all apart from the structure which has been attacked by the right hon. and learned Gentleman the Member for North Croydon (Mr. Willink), namely, the structure of the regional boards, it would be a great Bill deserving of the support of this House. There are, of course, various points of detail in the Bill which one would like to see adjusted here and there; the general structure however, of the regional boards, executive councils and so on is excellent. Here and there perhaps the line of demarcation could be drawn a little differently; there have been references to the maternity service and clinics, and it may be a matter for consideration whether it would not be better to bring the professional personnel of those services directly under the regional boards instead of leaving them with the local authorities. Still, that is a matter of detail which can be worked out.
  Another matter in the Bill is the constitution of the regions. I do not know exactly how these regions are to be constituted. I hope that the right hon. Gentleman will not follow the precedent which—so rumour has it—his predecessor had in mind when he was considering some larger regions than those we favour in the House today. I should have liked to see it laid down in this Bill that Scotland and Wales should be two of those regions. My own view is that these 16 or 20 regions throughout the country will provide the pattern for the future development of local government, and that local government—regional government—will approximate more and more towards the regions which will be established under this Bill. When that time comes, of course, we shall have a democratisation of the regions in the way which my hon. Friend the Member for South Tottenham (Mr. Messer) envisaged last night. If my view is correct, then quite apart from this
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  Health Bill altogether, the constitution of the regions will be a matter of vital concern, and I hope that we shall have an opportunity of discussing it in this House. If My view is correct, it is not merely a matter of health administration, it is a matter which affects the life, in all its aspects, of the people living in the regions, and as far as Scotland and Wales are concerned at any rate it is obviously a matter of tremendous importance.
  I now come to one aspect of the Bill which has given me very considerable concern and which really accounts for my seeking to intervene in the Debate today. It is a matter that has been referred to by more than one hon. Member on this side of the House, namely, the arrangement whereby medical practitioners not only practice under the service provided by the Bill, but can also take paying patients. This is a matter which affects administration and medical practice throughout the country. It affects it in the hospitals and amongst the general practitioners. The Minister in his opening speech said that he had taken the welfare of the patient as his one criterion in drawing up this Bill, and it is indeed most welcome to know that it is only by having that criterion constantly in mind that he could have drawn up the structure presented in the Bill. He has shown the greatest courage in dealing with local authorities, voluntary hospitals and other vested interests, and I hope he will continue to strengthen his position as far as he can in relation to all vested interests affected by this particular Bill.
  If, however, the patient is the sole criterion, why then are we having a paid service as well as the national service? Why are we having the private fee system as well as the State system? A considerable number of doctors themselves are opposed to this dual system, and obviously, a doctor who is interested in his practice and his profession, who wants to be free from financial considerations and concentrate upon his work and his patients, does not want to have in his practice a dual system whereby some will be fee-paying patients and others will come in under the general system. He does not want to serve one patient because he is interested in him and another because there is a financial consideration involved. It is the old story of serving God and mammon. It is undesirable to preserve this system under

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  the present National Health Scheme. It is a flaw which runs through the whole system; it is not merely a matter of detail. There is scriptural authority for winking at minor transgressions, but this is not winking at minor transgressions, it is not compromising, it is capitulating; it is not winking, it is "Willinking."
  I appreciate the practical difficulty which the Minister is up against, and I will not here, today, press the case in regard to hospitals; the same consideration does not apply in the case of general practitioners. The right hon. Gentleman himself, in introducing the Bill, put it very apologetically. He did not attempt to defend the dual system in principle. He apologised for it, and said that unless we had it, we should be faced with the cry that there is no freedom of choice, and there would be a black market. These arguments do not really bear examination. The Minister himself forbids a patient to pay fees to a doctor on whose panel he is, but if black marketing is to take place, it is most likely to take place between a patient and the doctor on whose panel he is. Yet the Minister himself forbids black marketing in that particular instance. The freedom of choice of doctor, as my hon. and learned Friend the Member for Montgomery (Mr. C. Davies) and other hon. Members have emphasised, is almost entirely an illusion, an illusion which has been fostered by the B.M.A. bureaucracy, which so largely misrepresents the interests and the views of doctors. I agree that although it is an illusion, and as far as it can be done without jeopardising other matters, we can afford to pander to it, but not to the extent of bringing into this Bill the dual system which we had before and which has been proved to be pernicious.
  It can be limited in various ways. It could, for instance, be provided that patients should go to, and pay for, a doctor outside a certain area, so as to prevent the scheme existing within, say, a small town. If a patient wants to go from a small town to a larger town to see a general medical practitioner, as happens in various parts of the country, it could be limited in that way. There would not be the same evil involved. The question of a free choice of doctor could be solved by providing that a person on a panel should be free to go to another
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  doctor. That can be solved either by transferring from one to another or, in special circumstances, by an ad hoc arrangement. The payment of a fee should be regulated; it should be paid by the State out of insurance funds, or paid by the patient himself but not left to be settled between the doctor and the patient It should be settled on the same principle as are medicines under the panel scheme, by an ad hoc payment.
  The disadvantages of the dual system for those on the panel, for the working classes, are obvious and well known to everybody. What are not equally obvious and real are the disadvantages of this scheme to the middle classes in whose name the argument that this dual system is needed is put forward. The relationship between doctor and patient is not jeopardised in any way by not having payments by contract. The middle classes, the professional classes, whose susceptibilities are considered in some quarters as an argument why the dual system should be put forward, go to their public schools and go into the Army. In the public schools they have a doctor to whom they are sent, to whom they go willy-nilly, and they are well drilled in the system of no free choice of doctor.
  Consider the danger that will follow from a regular system of payment of doctors by private patients. I do not mean an exceptional instance or occurrence here or there, but the development of a whole regular system such as there is at the present time. Look at what has happened in education. We have, unfortunately, in this country a system of education by private schools where fees are paid and by other schools, and we find that the middle classes, considering that the private schools provide advantages—I do not say a better education, but advantages of one kind or another which the other schools do not provide—strain themselves in order to send their children to those schools. That is a perfectly proper human urge—to give their children the best education they can provide for them. But these very people would be the happiest at having the advantage of being deprived of this urge to send their children to private schools. This is one of the big factors, undoubtedly, limiting the population in this country. I certainly consider that the development of

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  a dual system in medicine, comparable with a dual system in education, would be something that would be inimical to the interests of the middle classes themselves, and would be resented by them.
  I myself represent what is largely a middle class constituency, and I should be far happier going down to that constituency to defend a Bill providing one all-in system, without doctors having patients who pay private fees, and, at the same time, patients on the panel.
  Mr. Bevan: May I point out that the argument that the hon. Gentleman is advancing is of great cogency, but that it is impossible to legislate for snobbishness? As doctors can claim to remain outside the public service entirely, those middle class people to whom he refers can pay them fees.
  Mr. Ungoed-Thomas: Certainly——
  Sir Arthur Salter: May I put this question to the hon. Member? Supposing that patients—and we know many such instances—are not quite satisfied with their doctor, and feel themselves getting worse and worse, if they feel they can get alternative advice, and, whether wisely or not, can change their doctor, surely it is an alleviation for them?
  Mr. Ungoed-Thomas: I entirely agree. That is one strong point which, I appreciate, is in the Minister's case. But that can be made good, as I endeavoured to illustrate, not necessarily by private contract paying arrangements between the patients and doctors directly, but by a system analogous to the system of payments for medicines—by a fee for a particular service. That can be done by fixing the fee, perhaps, through the National Health Service committees.
  Sir A. Salter: Any such system as the hon. Gentleman suggests would render practically impossible the practice of private consultation which, when the patient is growing doubtful of his doctor, is essential.
  Mr. Ungoed-Thomas: It would not break down private consultation in that case any more than it would break down private consultation between the patient and the doctor on whose panel he was. As regards the Minister's point about the system, I entirely agree. It is perfectly possible to go to such doctors as remain
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  outside the service, but that does not bring them into the service. It is a very pernicious system—he will fully appreciate this, I am sure—having two standards of service provided by the same doctor.
  Mr. Bevan: It would be, if I unfortunately adopted that principle. It would encourage a large number of doctors to remain outside the public service entirely on the assumption that they would get a great deal of practice.
  Mr. Ungoed-Thomas: Now, I think, we are getting down to the root of the matter. I suggest that the Minister has underestmated his own position. If, in fact, a very large number of doctors remain outside the service, or if there is really a danger of that, I would at once agree with him. I do not think he appreciates the strength of his own position, either with the middle classes or with the profession itself. I know perfectly well that he is of exactly the same mind as I am in this case. I am not criticising the Minister adversely, but I am hoping that he will take the opportunity, as this Bill goes through its various stages, to strengthen it in precisely the way in which I know he would like to see it strengthened. The Minister's courage is at least equal to his pugnacity, and I am sure that he will not miss any opportunity to strengthen the Bill wherever he sees the chance of doing so.
  The alternative proposal put up by the Opposition in their Amendment, is really based upon sectional interests of one kind or another. The right hon. and learned Member for North Croydon made an astonishing statement when he said that because county councils and borough councils cover the whole country, they are therefore not sectional. That really is an astonishing statement. Of course they are sectional interests, not within their own areas, but in relation to the country as a whole. When we consider the chaotic conglomeration of voluntary hospitals and local government hospitals, and compare that with the scheme proposed in this Bill, one realises how very fortunate one is to have the present Minister and the present Government.
  7.2 p.m.
  Mr. Sidney Marshall: I looked forward with deep interest to the time when I could hear

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  the Minister make his introduction of this Bill. I expected that he would be rather frightening but I was encouraged by the very smooth manner in which he proposed what is obviously a very carefully prepared measure of highway robbery. I am very glad indeed that even the Minister has not such predatory instincts as the hon. Member for Llandaff and Barry (Mr. Ungoed-Thomas). At least the Minister has left a little of something which is worth having, although unfortunately, in the particular aspects in which I am most interested, namely the hospitals, there are two great blemishes in the Bill.
  I do not know why it has become the custom, during these last two days, suddenly to discover that the voluntary hospital system is entirely bad. Very few appear to have anything to say in praise of the voluntary hospitals, in spite of the fact that hon. Members opposite have for years applauded and praised them. Now we find that the voluntary hospital system is too bad for words, and there is not a good word to be said for it on the other side of the House. I cannot believe that Members who deride the generosity and philanthropy of our forefathers are really speaking from their hearts. I cannot believe that the great efforts which our forefathers made to alleviate sickness throughout the years in a voluntary manner, have now become so unfashionable and obsolete as to call for the strongest condemnation possible. I hope that we shall see in this Bill some of the voluntary hospitals receiving consideration which at present, unfortunately, it is not proposed to give them.
  I imagine that the Minister was confronted with a great problem when he had to decide the exact position of voluntary hospitals. His position is somewhat similar to that of the promoters of the Education Act who had to deal with voluntary schools, independent schools, and the dual system of the Church schools and the State schools. I think it was gratifying to the country that such a fine Education Act was produced, providing means by which independent schools could continue, and also the old grammar schools with grants in aid. It was a matter of gratification that they could still maintain their independence and carry on. If the Minister had considered the system which was adopted in the
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  Education Act, in deciding the position of voluntary hospitals, he might have shown a little more mercy than at present appears to be the case. I agree that the small hospital is outdated and outmoded. It is obvious that for many years they have not had sufficient wealth to enable them to provide the adequate equipment required in the modern medical interest. I should have thought that the Minister could have preserved some of the larger voluntary hospitals in the same way as the schools have been preserved, allowing them to carry on in the same way as at present. They could have had their boards strengthened by Government representatives in the same way as the schools, and they could have been aided each year by deficiency grants from the State. In that way some famous voluntary hospitals could have been allowed to continue their great traditions, and all that they have stood for during many centuries in regard to the health of the people. I am hopeful that when the Bill reaches the Committee stage the Minister will be accommodating in many ways towards suggestions that larger voluntary hospitals should be allowed to carry on.
  Dr. Guest: Would the hon. Member state the names of the voluntary hospitals he is referring to?
  Mr. Marshall: I could not quote the names at the moment, because I have not brought my papers with me. I know the numbers of hospitals and beds in the country. There are 924 voluntary hospitals, which include a few sanatoria—probably one similar to that mentioned by the hon. and learned Member for Montgomery (Mr. C. Davies). The total number of hospitals with over 150 beds is only 185, and these are probably fairly efficient hospitals, otherwise they would not have been able to continue, nor would they have had beds of that number. I am afraid that the smaller hospitals cannot expect to receive consideration under a comprehensive health system such as we are aiming at today, because their equipment and efficiency will certainly be below par. I consider that the larger voluntary hospitals might have been allowed to carry on with State assistance by means of deficiency grants. I think it will come as a great shock to the people of this country, that some voluntary hospitals will not be allowed to continue under the

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  proposals in this Bill. The proposals would, in some measure, be alleviated if the larger hospitals could be maintained and kept in their present form.
  What I am more concerned about are the proposals in regard to local authority hospitals. I think that it is the desire of everyone in this House that we should provide the most comprehensive medical service possible. We have gone a long way towards that in some counties. As the right hon. and learned Member for North Croydon (Mr. Willink) said, there are at least two counties which have provided an example of that by setting up efficient hospital services and coordinating them and also the domiciliary services. An hon. Member opposite said that the two counties of Surrey and Middlesex were very wealthy counties, and were, therefore, able to do this. I accept that; but I am sure that the Minister could have provided a scheme whereby the county authorities could have given an equally efficient service to the people of their areas by some means of special grants as distinct from the ordinary Exchequer grants. I am sorry to think that the joint authorities appear to have "gone west." I had hoped that we should not see these regional hospital boards set up. An hon. Member opposite said that he could foresee in the principle of joint regional hospitals boards an indication of what was to come with regard to local government in the future. I hope that this does not mean that the Minister of Health, in considering the future of local government, will follow these lines. They seem to me to be the direct opposite of the democratic principles which the Government are supposed to follow.
  Mr. Ungoed-Thomas: If the hon. Gentleman is referring to me, I said that in my personal view local government would tend towards the bigger regions, and, if that development took place, it would, of course, be democratised at the same time.
  Mr. Marshall: That is not my experience. About three years ago, there arose the question of the reform of local government and many conferences were held.
  Mr. Speaker: We had better not get into a discussion on the reform of local government, but confine ourselves to this Bill.
  Mr. Marshall: I was referring to regional authorities. The Minister proposes to set up regional hospital boards.
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  I think that regional authorities would be equally democratic. The members of these boards are not to be elected by the ratepayers or taxpayers, but selected and appointed by the Minister. I realise that he suggests that these regional hospital boards shall contain a certain number of people selected from the local authorities, but these people, I take it, will not be answerable to the local authorities, but to the Minister, because the regional hospital boards will come directly under the Minister or his Advisory Council. I cannot see that it is an advance in government to appoint these selective boards directly under the control of the Minister, and not under the control of the elected representatives of the people. That is a very serious blemish.
  In my own county of Surrey we had, in anticipation of the desires of the Minister of Health, worked out very clearly a comprehensive health service, called the Surrey plan, in which the county borough of Croydon was ready and anxious to take part. This comprehensive scheme for Surrey received very high commendation, and my view is that a scheme such as that would meet all the needs which the Minister is providing under this Bill. It would make our public health services one coordinated unit. Under the Bill, the public health services, in regard to the general hospitals and the mental hospitals, will now be taken away from the local authorities. They will not administer these services but only the domiciliary services and the health centres, which will be under the direction of the public health authorities and, apparently, of the Executive Council.
  The Parliamentary Secretary made great play with the statement that, under this Bill, the local authorities, instead of having duties and powers taken from them, would have additional duties and powers. I cannot see in what way the duties and powers of the local authorities are being added to. I certainly agree that, under the Bill, what are now the powers of local authorities will become no doubt duties, but I cannot see that there is anything new in the Bill which gives the local authorities more powers than they have today. Therefore, it is wrong to say that their borders of government are enlarged or that their duties are increased under this Bill. The truth is that we lose a large part of our powers of governing our own districts. These powers are

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  passed, not to someone elected by the popular vote of the people, but to a board which is appointed by the Minister. Therefore, I cannot see how the Minister can say that this is a democratic Bill. To my mind it is the very reverse, and, from that point of view, I think that there is much to be said against it.
  I had hoped that a system of joint authorities would be set up. I see nothing against that, where the districts are large enough. The county of Surrey and the county borough of Croydon have a total population approaching 1½ million, and are, perhaps, big enough to be almost a region. If there are to be 16 to 20 regions, some of them will be very scattered in order to embrace the population of a region. The system could have been worked equally well by joint authorities. We know that there are county districts which could not maintain and support a comprehensive health service as we would wish it to be, but, in cooperation with other counties and districts, they could provide all that was necessary and still retain their identity as local government authorities. This was done under the Education Act of 1944, where, in the case of two county districts in which there was not a sufficient number of educatonal institutions within the ambit of each, they could combine to form a joint education authority. I do not see why the same principle cannot be applied to the hospital system, and I cannot understand why the Minister now desires to introduce these regional hospital boards. I view this with very great alarm from the point of view of the local authorities. It is a distinct weakening of the local government position. It was not so long ago that members of the Government were all in favour of joint authorities. They certainly were not in favour of regional councils, and I cannot imagine those who belong to local authorities being in favour of giving up their municipal hospitals to the State. I do not know from where this gymnastic turnabout comes, but their opinion now seems to have turned right round, and they appear very anxious to hand over their hospitals to the State. I do not understand why the great County of London so readily wishes to hand over the whole of its wonderful hospital system—and I think that it must be conceded that it is a very fine and wonderful system—lock, stock and barrel to the Ministry of Health.
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  The Minister is smiling with the gratifying smile of one who has got something from somebody else for nothing. I hope he will be accommodating enough when the Bill gets to Committee to deal with some of these points regarding the hospitals. I know he is adamant, or appears to be adamant, on some of the facts on the hospital side of the Bill, and some of his supporters have requested him to be more adamant still. However, I hope that when we come to the matters of major detail we shall find the Minister more soft hearted than he appears to be, not only in regard to the voluntary hospitals, but in regard to the hospitals now managed by the local authorities whose efforts in some cases are praiseworthy. Certainly they are rendering the very highest public service in public health. I know that there are other aspects of the Bill such as that concerning the medical practitioners, but I do not propose to deal with them. I am content if what I have said about the hospitals receives some consideration. I shall be very happy if I have achieved something towards making this Bill a better Bill and the service more comprehensive, in order that the health of the people may be properly safeguarded and carefully nurtured.
  7.31 p.m.
  Mrs. Corbet (Camberwell, North-West): Some of the remarks that I propose to make on this Amendment may seem irrelevant but were it not for the fact that I have the opportunity now, at last, to make my maiden speech, were it not for the fact that I realise that in such circumstances Members are particularly kind, and were it also not for the fact—and this I say particularly to the Minister—that I believe the point I am going to raise is a very important one I should not have stood up this evening. Before I proceed might I congratulate the Minister on his excellent Bill and speech and also the Parliamentary Secretary on his equally excellent effort this afternoon? I would venture to say one controversial word—although I should not do so—in reply to the last speaker. I happen to be a member of the London County Council and it may be that some of my colleagues on that body are anxious to participate in the Debate this evening but will not manage to do so. Therefore, I want to say that it was not with any pleasure that the London County Council gave up their great system of hospital ser-

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  vice. We have a great pride in that service, but we have an enormous desire for a comprehensive health system throughout this country. We feel that the sacrifice that we have made is in the interest of the nation, and we are proud and indeed glad to do its We only say to the regional boards following us, that we hope they will have as much interest and pride in that service as we ourselves have always felt.
  The aspect of this Bill to which I wish to refer this evening is the provision of a comprehensive dental service. The Minister himself said that the state of the teeth of the nation was disgraceful. If those were not his actual words they were to that effect. The Minister is correct. The hon. Member for Abingdon (Sir R. Glyn) referred to the enormous difficulties which people in country districts had in securing dentures. He also talked about the necessity of providing openings for ex-Service men in new trades, and mentioned the possibility of such men becoming dental mechanics. I hope that point will be borne in mind by the Minister of Labour. I would also say a word about the inspection of teeth. To begin with, in my view it is essential that everybody's mouth should be inspected at least every six months. Schoolchildren in particular, nay, children before school age, should have the same inspection. It ought to be possible to conserve the teeth of young children so completely that they do not lose any until the time comes for them to get their new set. I have some figures here. In Cambridgeshire, in 1938, it was found possible in the case of schoolchildren to conserve 13.6 teeth, to each one that was extracted. At the Eastman dental clinic in London, which children from 16 schools attend, they conserved 19.7 teeth to every one extracted. However the overall figure for the country is three teeth preserved for one extracted. We have details which show us that when children just under school-leaving age are examined for entry into school, they have an average of 4.8 teeth decayed.
  With regard to the rest of the population I have not any figures here. I can only say I reached the age of 16 before anybody ever looked at my teeth. Then they looked at them before the Dentists Act of 1921 was passed and they lugged out any that had little bits of black on them, so that I lost a number of teeth which should never have gone. My re-
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  maining teeth were subsequently preserved and have lasted me until this day. What is the possibility of satisfying the demand that is going to be infinitely multiplied as soon as people find that they have a right to dental treatment and dentures without having to pay for them? The demand will be increased many times. I hope that not only will the demand increase naturally, but that every step will be taken to encourage that demand, in the interests of the health of the people of this country. If I know my people, and I think I do, I tell this House quite frankly that nothing but the best that they can get will satisfy them in the years to come. We can see it only too plainly in the demand for the standard of housing. I assure the House that dental treatment will be no exception.
  What are the chances of meeting the demand? The Minister himself has said—and this is what is agitating me—that during the coming years priorities will have to be given to school children, and expectant mothers and so on. These are very important categories, and must be seen to first, but the rest of the population is entitled to treatment, too, and it is going to be a serious thing, which I hope this Government will not tolerate, if the people in this country have to go without proper attention to their teeth and the comfort and health which ensue from that attention. The Teviot Committee in its report said that the number of recruits to the dental profession was somewhere under 300, and that it would have to be raised to 900 if, in 20 years' time, we were to get the 20,000 dentists needed for the comprehensive dental service. We know what building is, and we know the difficulty of the training of teachers in any subject at all. We realise the difficulty there will be in increasing the number of dendists. I cannot say that I know the remedy, but I can say that we ought to pay very careful attention indeed to the reservation to the report of the Teviot Committee by Major-General Helliwell, a distinguished dental surgeon and officer of the London County Council. He said:
  Perhaps one of the most surprising customs pertaining to the dental profession is the combination and practise, by the same person, of dental surgery and preventive dentistry with the supply of artificial teeth. On the one hand, we have that side of dentistry in which the one great aim of the dental surgeon should be the preservation of the natural teeth and their associated tissues, to prevent, so far as possible, the need for

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  artificial dentures, but, on the other hand, it is in the provision of artificial dentures that he makes his greatest profit. In no other branch of medicine does such a practice exist, and in my view, unless there is a radical change, the progress to the best type of dentistry will continue to be severely hampered.
  Members will remember that the Dentists Act of 1921—although a very necessary reform—gave dentists the monopoly not only of the care of the mouth, which required medical qualifications, but also gave them a monopoly in the making of the impressions necessary before dentures are fitted. The dentist not only gives advice on the care of the teeth and conserves them; he also pulls them out, and he has the greatest incentive to pull them out because, if he can fit dentures, he makes more profit by doing so than by keeping the teeth in the patient's mouth. That is the position, and it must cause us seriously to think. A dentist's training is long and expensive, and it is not right that his skill and knowledge should be wasted in this time of national stress. If he can have help in his work—and Major-General Helliwell and I contend that he ought—then his skill and knowledge might be made to go much further. I ask the Minister to take the necessary steps to see that that help is given to the dentist, with proper safeguards of course, and that the best possible use is made of the dentist's skill and knowledge.
  There are ancillary workers, who can clean and polish teeth and teach oral hygiene, often described as dental hygienists. The Teviot Committee advocates the training of such workers to assist dentists, and I hope we shall push ahead with this. A training period of two years is suggested, but they were used in the Royal Air Force after a very short period of training—a few months—and were quite satisfactory. They are used in the United States. In New Zealand they go much further—school medical services are run by dental nurses. Each nurse has the care of about 450 children. She stops teeth, gives instruction in oral hygiene, and, in addition, extracts teeth. I am not saying that we should go as far as that. I think that probably the filling of teeth should be the dentist's work, although I do not quite know where his work begins and stops. Then there are dental mechanics who are capable of taking better impressions than some of
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  the dentists themselves, because of their long years of practice. The dental mechanic needs to see the patient in order to fix his smiling or lugubrious countenance, but under the present law, he cannot do it himself, unless the patient goes to the dentist, so wasting the time of both men. What I am suggesting today is the possibility of making the dentist's skill go as far as possible. I also want to call attention again to the minority Report of the Teviot Committee, and ask the Minister to see whether he cannot do more than we have been led to expect from what has been said in the past.
  7.35 p.m.
  Sir Harold Webbe: It gives me peculiar pleasure to congratulate the hon. Member for North West Camberwell (Mrs. Corbet) on her first contribution to our Debates. I have had the privilege of knowing her and working with her for many years on a great local authority, and I can assure the House that if she brings to the House—and I am sure she will—the same solid work and keen attention to her job as she has shown there, we shall have gained a very valuable recruit. I noticed that many Members were a little alarmed by her exposé of the state of mind of the dentist. In my own particular case, that left me cold because I know that the field for his future operations is now strictly limited. None the less, I am sure that the House, in spite of the alarming character of some of the hon. Lady's remarks, listened to her with pleasure, and will look forward to hearing her again.
  Having passed that rather pleasant stage, I feel I must now accept a criticism made by the hon. Member for South Tottenham (Mr. Messer) towards the end of yesterday's Debate. The hon. Member made a speech with more than 90 per cent. of which I found myself in agreement, as I usually do, and made a complaint, or a comment, that up to that point, at least, there had been little real opposition to the Bill. I am encouraged to endeavour to fill any deficiency there may be in that particular regard. Earlier today, we listened to an informative and vigorous lecture from the Parliamentary Secretary, delivered to the class then assembled, with the exception of yourself, Mr. Speaker, and that has encouraged me also to be a little vigorous in what I have to say about the Bill.

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  I say, quite bluntly, that I find it difficult to imagine that there has ever been a Bill presented to this House, the purpose of which was so generally accepted by the House, which contained in its provisions so many deplorable, reactionary, and destructive proposals as the one which is now before us. When one is faced with a Bill, a large percentage of which one regards as utterly pernicious, it is not easy to make a choice of the matters with which one wishes to deal, and I therefore feel obliged to restrict myself to one aspect, to which reference has been made, and which, I think, cannot be too strongly stressed. I refer to the inevitable effect of the provisions of this Bill on the structure of local government. The transfer of the hospitals, which is the major effect to which I refer, has been described in these terms:
  The transfer represents an encroachment of the first magnitude on local government, and is the most serious loss it has been called upon to sustain.
  Those are not my words; they are not the words of a Tory local authority; they are the words of the great Socialist London County Council, appearing over the signature of the Noble Lord who, under the Minister, is now responsible for the affairs of London. It is true that, having given that opinion, the Socialist County Council promptly declared their complete, ready and cheerful acceptance of the proposals, and I have no doubt the Minister could give us an imposing list of Socialist local authorities which also accept them in the same full openhearted spirit. That is not in the least surprising. It is exactly what would happen in any dictatorship country. The local gauleiters have had their orders, and in fact the leader of the London County Council was in such a hurry to carry out his orders that he actually announced in the public Press the decision of his party to support unanimously the Minister's proposals before it was conceivably possible that any one of its members could have had even the White Paper in his possession. That was a fine example of intelligent foresight.
  But the phrases used by the London County Council are an under-statement. For the last 50 or 60 years, the local authorities in this country have built up, on the humalistic side of their work, a great health service, a health service
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  which, as we have been reminded more than once in this Debate, goes a long way beyond those purely medical services which are referred to in the Bill. It includes housing, drainage, the supply of water, the control of the quality of food, sanitation—the whole group of services which form virtually the whole of the local authorities' occupation and purpose, with the exception of education, and even education is involved through the school medical services. When, in 1929, the Local Government Act gave to the counties and county boroughs the power to take over the poor law hospitals and they became hospital authorities, the major local authorities were able to complete the picture of their health services, and they found in the hospitals a natural focus for the whole of the health services which they provided for their citizens.
  What does this Bill do? It tears the very heart out of the whole of the local authorities' health services, it takes away from them the administration of their hospitals, and it leaves them emasculated, truncated, deformed and completely open to the future attacks on the autonomy of local authorities of which we have already heard the rumblings in recent statements by Ministers and others. This Measure marks the beginning of the end, even of the major authorities. But what of the minor authorities, to whom during recent years have been confided all the domiciliary health services, the maternity services, and so on? The minor authorities are to lose them altogether. They are to be transferred to the counties and county boroughs. The counties, as some consolation for losing a job which they did admirably, are to be entrusted with a job which a very large number of people believe they cannot perform, simply because those domiciliary services are so close to the individuals who need them.
  I am well aware that an exactly similar proposal was included in the White Paper issued by the Coalition Government. If my right hon. and learned Friend the Member for North Croydon (Mr. Willink) were here, he would be able to confirm that my opposition to those proposals is not of recent growth, but that I opposed them when they were made in the Coalition Government's White Paper. Although the Socialist County Council at County Hall were most anxious to take the chance of grabbing anything they could get, I fought them and I beat them,

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  but I did not have to fight alone. I had behind me every borough in London. I had behind me the unanimous support of the Standing Joint Committee of the London boroughs, and I had as my most doughty, able, competent and vigorous colleague the hon. Gentleman who is now the Parliamentary Secretary to the Ministry of Health. I shall not insult my hon. Friend—I call him that because I have known him so long—by asking whether he has changed his mind. I have known him long enough to know that he is always sincere, that he believed what he said then, and I am convinced he believes it today. I shall not ask him whether he has troubled to put these views before the Minister. He is an old hand, and he knows how hopeless it is to argue with a man who does not know what you are talking about and who has already made up his mind; but if any hon. Member has any doubt as to the wisdom of this particular transfer, I commend him to have a private talk with the Parliamentary Secretary to the Ministry of Health, and he will get the complete and convincing case against the transfer which is proposed in the Bill.
  Those are the things that are going to happen to local authorities. What is being put in the place of this highly organised, highly specialised and highly efficient local authority health service which the country has enjoyed for years past? The hospitals, the whole control of medical services within the local authorities, are to be transferred to regional boards, consisting of men nominated by the Minister, his creatures, serving on sufferance and subject at any moment to direction and regulation by him. It is to me an amazing piece of irony that it should be left to a Socialist Minister in a Socialist Government to kick over the local authority ballot box and deprive the people of this country of any voice in the management of services of such vital importance and of such intimate concern to them. It would be fantastic if it were not true. Why is this being done? I have been asked by many people why the Lord President of the Council, that great apostle of local government, who made such heart-tearing speeches, at the time the Local Government White Paper was under discussion, about the dignity of the local authorities, about the way they could do things that no central government could
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  do—including, of course, the whole of the services which the Minister of Health now takes away from them—I have been asked why he does not protest against this crippling of local government. I have known the right hon. Gentleman the Lord President of the Council for many years. It may well be that local government, which has served him not too badly and has carried him quite a long way, has now served its purpose, and may go. What is the real reason, what is the positive reason, why we have these proposals before us? It is that, by the accident of our electoral system, less than half of the voters have put into power a Socialist Government with a very large majority.
  Mr. Messer: It was not an accident.
  Sir H. Webbe: I said it was an accident of the system. The right hon. Gentleman now finds himself, I dare say as much to his surprise as to that of anyone else, the Minister of Health. He finds himself faced with serious problems in a field in which he has had virtually no experience and the result is this hotchpotch of political prejudice, political idealism, and a very large measure of intuition. My right hon. Friend the Member for South Kensington (Mr. Law) stressed that more than once. I do not want to remind the Minister that the last leader of men who relied on his intuition is dead and his country in ruins. I do not wish that fate for the Minister of Health, but I do hope that his Bill will be thrown out.
  I have spoken strongly because I feel strongly; I believe in local government, I believe our Constitution is based on local government, and I believe it is in the practice of local government that our people have learned how to govern themselves in the way no other people in the world have done. I beg the House to consider the implications of this Bill on that local government structure. If the Bill in its present form reaches the Statute Book, at that very moment the Minister will have signed the death warrant of local government as we know it and will have made a laughing stock of our claim to be a democratic country.
  7.51 p.m.
  Mr. Somerville Hastings: I hope the hon. Member for the Abbey Division (Sir H. Webbe) will excuse me

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  if I do not follow him in his attack on the London County Council. At another time and place I should be delighted to do so, but tonight I would rather talk about the Bill. I should like to explain to the hon. Member in a few words why, in my opinion, the Minister has found it necessary to take over the hospitals as he is proposing. This Bill cannot be looked at in isolation; it is part of a broad scheme for ironing out some of the inequalities and uncertainties of life. It is made necessary, I think, by the National Insurance Bill which is before Parliament, because, according to the terms of this Bill, all will have to pay and therefore it is the interest of all that there should be as few demands as possible on the National Insurance Fund. One of the main claims will be probably for sickness, so that it is up to the Minister to do all he can for the prevention and cure of sickness. Further, contributions will be the same in all parts so that the Minister must provide not only a good service but one which will be equally good everywhere. I think these facts must have been in the Minister's mind when he framed the Bill because to get equally good service everywhere he must have a good deal to do with the appointment of committees governing the service and take over the hospitals which will provide the hospital part of that service.
  What other possibilities were open to the Minister? The Minister and the Parliamentary Secretary have shown very clearly today that it would have been quite impossible to leave the new hospital service in the hands of either the voluntary or municipal hospital authorities. The only other alternative to taking them over was to try to control them by monetary grants. I think all who have considered the matter realise how important it is that there should be a unified and integrated service and how each of our hospitals must be given its proper place in that service according to the sort of work for which it is most suitable. Would the Minister, by means of monetary grants, get what might be considered a prosperous but small hospital to take a minor place and become a convalescent home or a hospital merely for the chronic cases? Supposing that hospital belonged to a large and powerful local authority, would they toe the line
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  merely because of the withdrawal of a monetary grant? The hon. Member for the Abbey Division knows very well the history of Waterloo Bridge, and how when the local authority wished to rebuild it the Government then in power said, "No, we will not give you the necessary grant," to which the L.C.C. replied, "Very well, we will do it without that grant." Exactly the same would be the reply of the voluntary hospitals. Some of the smallest of the voluntary hospitals are exceedingly well endowed, and what they would say is, "Very well, we can manage quite well without the monetary grant."
  I should like, if I may, to deal with this necessity for a unified and integrated hospital service. I have had the very good fortune to be a member for the last 16 years of a committee that has had in its charge some 70-odd hospitals. The L.C.C. took these over in 1930, when many of them were working as isolated units. In the intervening 16 years the committee has been endeavouring to weld these hospitals into a unified system. I do not suggest that the work is entirely complete even yet, but we have had sufficient experience to show us the extraordinary advantages of such a system. May I mention just a few? First there is the bulk purchase of supplies; not only can we get supplies cheaply but we get better quality because by sampling we can make sure that they are up to standard and it is quite clear that no dealer would willingly offend one of his largest customers. Then there is the standardisation of equipment—beds, bed tables, and so on—which can be secured in a unified system. But much more important than that is the easy transference of both patients and staff when this is found to be necessary. I will give one example from the experience of London. Early in 1937 there was a very bad epidemic of influenza. The municipal hospitals were filled and the voluntary hospitals refused to take influenza cases. What could the L.C.C. do in the face of the many hundreds of cases needing admission to hospital? Just then, fortunately, many of our wards in the fever hospitals were empty. They were rapidly disinfected, and within a few days 500 patients were admitted into the fever hospitals. Although there were cases of influenza which are not generally token into such hospitals, there were fortunately, no cases of cross-infection.

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  A greater advantage than that and one which would be secured from an integrated and unified hospital system in each region, such as is contemplated by the Bill, is the possibility of specialisation and of the segregation of patients in hospital wards where they would be under the care of doctors and nurses and other workers with special experience in the treatment of their particular diseases. I say advisedly "other workers" because, for example, in Queen Mary's Hospital, Carshalton, there is a lay worker, who is neither doctor nor nurse, but who is obtaining in cerebral diplegia, as it is called, extraordinary results. By this system in London, we are able to segregate cases where they can be best looked after. We put cancer cases, who need X-Ray and radium treatment, in two hospitals. In another hospital we put plastic cases, who need operation on the face. While in still another hospital we put cases needing surgical treatment of the chest, and so on. Not only do patients get great benefit from this segregation, but research is facilitated also. Before the war, the London County Council had some 900 cases of rheumatism in children in three hospitals. That gave extraordinary opportunity for research on this disease, the etiology of which is little known.
  I would like to refer to the hospital management committees proposed in the Bill. The right hon. and learned Member for North Croydon (Mr. Willink) pointed out that letters have appeared in "The Times" and elsewhere putting up a very strong case for granting more power to the hospital management committees, powers almost, but not quite, equal to those of the committees which will be in charge of the teaching hospitals. I look upon that as a very dangerous proposal. Anything that would limit the far sighted planning of the regional hospital committees, or would limit the influence of the universities and teaching schools, one of which it is proposed should be, as far as possible, situated in each region, would be a real disaster. I am well aware that to secure the right sort of people to take their places on these hospital management committees, we must give them a good deal of power. They must have power to spend a certain amount of money, to make rapid decisions and to experiment, but their power must be strictly limited. If we give these committees power to appoint doctors and senior staff, as is proposed, they are very liable to follow
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  the voluntary hospitals into that inbreeding which has been the curse of the system. Most of us prefer the devil we do know to the devil we do not know and most hospital committees dealing with a single hospital are all too ready to promote one of their own staff rather than to appoint a better man or woman from outside. The suggestion is also made that these hospital management committees should be permitted to receive legacies. I also look upon that as dangerous within the national system, and sectional interests in the hospital system must be restrained
  Nevertheless, there is very much in local interest, local patriotism and local pride in a hospital, and I do not see why they should not be developed and continued under a municipal or national system as much as under the present voluntary system. However good the public provision may be, there will always be opportunity for voluntary effort and for experiment in social service. Not only will it be necessary to have hospital management committees, but in all hospitals there should be Samaritan committees, aftercare committees, library committees, and amusement committees for hospital and staff. These can to a large extent be voluntary committees. I would like to show that voluntary effort is just as necessary and as important and just as easy in a municipal hospital as in a voluntary. In the East End of London, in Mile End, there is a hospital owned by the London County Council. It was much damaged in the blitz, but it is much beloved by the local people. Only a couple of weeks ago, in order to show appreciation of the services of the nurses of that hospital, a local concert was arranged, and £300 was raised for a fund for the welfare of these nurses.
  I come to the question of paybeds in hospitals and payment for the services of doctors in these paybeds. I hope that as our hospitals are rebuilt and brought up to date, there will be provided between every pair of beds a curtain, which can be pulled as the patients desire. I hope that there will be a sufficiency of single bedded wards, so that anyone can have a single ward not only if he needs it on medical grounds but even if he desires it. People vary very much. Some people like solitude when they are ill and some desire just the reverse. Meanwhile I consider that a very strong case can be made for

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  permitting those who wish to buy privacy to pay for a single bedded ward, provided, of course, and the Bill is explicit in this, that it is not needed for a case that requires it for medical reasons. If the Minister or the Parliamentary Secretary, which God forbid, should need hospital treatment, they will be quite justified in making use of one of these paywards because in them they could discuss matters with their officers without the B.M.A. learning of everything that was said.
  But when we come to consider payment for treatment in these wards, an entirely different question arises, and here I can speak from direct and personal experience, as for many more years than I care to say I have been on the staff of one of our teaching hospitals which some 10 or 12 years ago provided a block of paybeds. I am quite sure that I and my colleagues do as good an operation for our public patients as for our private, but I am equally sure that we pay more visits to our private patients and leave the care of our hospital patients much more to our registrars and house surgeons. And in so far as the senior staff are more experienced than the junior, I suppose that the patients in the private wards are getting better treatment. However that may be, I am perfectly sure that those patients believe they are getting better treatment, and it will be exactly the same in the national hospitals. The patients who pay for their treatment will believe they are getting something better, and it will be in the interests of the surgeons and physicians concerned to keep up that delusion, if indeed it is one. I feel that this is most undesirable. All of us want the best possible treatment given under our new national hospital system, and we want the patients to realise that they are getting the best treatment also. But is that likely when the patients in the wards know that there are two sorts of wards and two sorts of treatment in the same hospital? It is a convenience to the doctors to have all their patients, private and public, under the same roof or in the same curtilage but I appeal to the Minister that important as doctors are—I would be the last to deny that—the patients in the hospital are even more important.
  8.14 p.m.
  Lieut.-Colonel Gage: I feel that I shall command a large measure
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  of agreement in this House when I say that the only point of view from which this Bill should be approached is the point of view of what is the best for the patient. It does not matter—and it is not the case here—what best suits the medical profession or what suits any particular party, and it is with that in mind that I shall try to make three criticisms, which I hope I shall be able to make quite briefly. I could make them in three minutes, but I shall be a little longer—certainly not very long. My first criticism is with regard to the method, or the principle underlying the method, of remuneration of the general practitioner. I cannot help feeling there is something wrong here because, as I understand it, the general practitioner is to be remunerated by means of a part-salary and by capitation fees which will diminish as his patients increase. That is not the right method. It is bound to produce a general levelling in the standard of remuneration paid to the general practitioner, and it is not really suitable to any profession, and least of all to the medical profession. Let us assume that in a small community there are two doctors practising: one of them is an idle and not very competent fellow, while the other is a vigorous and zealous young man. They will start by getting a small salary that will not vary, however good the one may be or however bad the other may be. The zealous young man will attract many patients to himself but he will find that with every additional patient, the remuneration gets less. He will find that while he is practising alongside a man whom he knows to be his inferior, that man will be getting practically as much remuneration. There will be a difference in the remuneration but it will not be a very large one, and the principle seems to me to be quite wrong. I do not say that good work should be disproportionately rewarded or that idleness should be harshly punished, but with the capitation fee alone we have a fair method of rewarding the practitioner, and, as the Minister of Health said yesterday, by keeping the capitation fee lower we are getting a proper reward for zeal and a proper punishment or penalty for idleness.
  Let us consider the two main arguments put in favour of the part-time salary. First of all, it is said that there

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  are places in these islands where the population is so scattered and so small in numbers that a doctor could not make a livelihood out of it on a capitation basis. Surely, that could be put right simply by increasing the capitation fee in that sort of place. Secondly, it was said, I think more cogently, by the Minister yesterday, that we want to give some security to young men starting out in the profession. Security is all very well for people who deserve it—the old, the infirm and the children—but surely a young, vigorous man starting out on the profession of his choice is the last person who would ask for security. Indeed, I have always felt that it is the very insecurity of all professions, and particularly the medical profession, that attracts the young, adventurous, vigorous and fit people with incentive. When I started in my own profession I was told that three qualities were required for success. The first was that one must be very poor; the second, that one must be very industrious; the third, that one must be very much in love. I think that that also applies to the medical profession. The feeling of insecurity, and being very poor and keen, helps one along and tides one over the worst part.
  That brings me to the second point of criticism, which is with regard to the buying and selling of practices. There again, as I understand it, the keynote is security for the young man starting in his profession. I should have thought that the same argument would apply to that, but I would not have thought that the burden of borrowed money which is hung like a millstone round the neck of the young man starting in practice, as the right hon. Gentleman said, was really so very great. I do not know the figures, but after all, many young men with no more capital than their brains, and with no other asset than their industry, have started and made a success on borrowed money. I would have preferred to have seen the global sum of £66 million, which is to be spent in the compensation of elderly practitioners, used for providing security for the young man at a time when he needs it, which as my right hon. and learned Friend the Member for North Croydon (Mr. Willink) said, is before he is qualified. It is not after he is qualified. If some of that money could have been devoted to the provision of scholarships and other aids for getting the young man
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  through those two or three years of study, then indeed a great deal would have been achieved.
  Finally, I would like to deal shortly with the question of health centres. I have never understood why they should not have been equipped and started by the local hospitals. That may be due to my ignorance of the subject, but I have always understood that one of the objections to connecting the hospital scheme with the local authorities was that doctors, as a rule, do not get along well with local authorities. I entirely agree with the right hon. Gentleman the Minister that the health centre should be a place where there is equipment which the general practitioner cannot get normally. I should have thought that hospitals could have supplied such equipment, with the dual result of connecting general practice more closely with the hospitals. There may be a difficulty about that of which I do not know, but I should have thought it was a better method of dealing with the health centre.
  Yesterday the right hon. Gentleman the Minister spoke very feelingly and eloquently about the shudder of revulsion which he felt when he saw nurses and medical students collecting money on the streets for their hospitals. I feel also a shudder of revulsion whenever I go into a surgery or into the outpatients' department of a big hospital and see queues of people waiting patiently for their turn. It is a dreadful thing to see these unfortunate people, obviously suffering, having to wait in a very patient row for their turn to go in to see the doctor. I hope that these health centres will not have the effect of removing the queues from the surgeries to the health centres, and making them longer queues, because more people will be attending. I hope that doctors will be encouraged to go into the homes of the people and see them there. It has been said that one of the reasons why people pay fees to doctors is to obtain privacy. Of course, that is true. It would be mere hypocrisy for myself or for any other person to say that they did not like privacy with their medical man. Of course they do and, if they can afford it, they will pay for it. The tragedy is not that there are a few people who can afford it, but that there are so many who cannot afford it. I hope, therefore, that under this scheme the doctors will be en-

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  couraged to go into the homes of the people and will not simply use the health centres as glorified surgeries where they expect everyone to go and wait in rows. If the health centres accomplish what I have suggested, they really will have gone a long way towards the goal which, after all, every hon. Member of this House is striving towards, which is to try and raise the standard of our health services throughout the country.
  8.26 p.m.
  Mr. Boardman: I want to make one or two observations on the Bill and on the Amendment. First a word about hospitals and their charities. I think it ought to be underlined, for it does not seem very clear from the discussion I have heard in this Chamber, that we on this side do not regard charity as being an end in itself. It ought to be understood throughout the country, and certainly by the Opposition, that the one increasing purpose of the present Government is not to perpetuate charity but to eliminate the need for it, or at least to minimise it.
  A picture has been presented of how the hospitals are financed. I do not think sufficient stress has been laid on the fact that a very substantial part of the hospital incomes is derived from the weekly contributions of the working man and working woman. But that is not all, and that is not the only way in which the worker pays. There is a case known to me of an industrialist, a large employer of labour, in whose factories trade union organisation was taboo, and trade union wages and conditions also were taboo. As a direct consequence of this embargo on the free association of his people, his wages bill was little more than two-thirds of what it would have been had he observed trade union agreements. However, he was a big-hearted fellow and he had built and equipped at his expense an operating theatre. He had built at his expense a hospital ward, and he equipped that. That man will not be remembered in local history because he was a bad employer; he will be remembered as a philanthropist.
  These fillibustering philanthropists are pretty common just now. We are not concerned about them, because I am satisfied, if I know anything at all about
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  working men and working women, that they do not want charity whether the source is good or bad. Charity at its best humiliates. What an absurdity it would have been in September, 1939, had someone suggested then that we should limit our expenditure on the war to the charity of patriotic people. If that had been the position, we would not have been meeting here tonight in the British House of Commons. It was proper that we should use the financial resources of the State, it was proper that we should accept a certain measure of State control, and it seems to me to be just horse sense that if you harness the resources of the State for the purpose of destroying life, it is more in keeping with 20th century civilisation that we should harness those same resources for the purpose of saving life. That is precisely the purpose of this Bill.
  If existing facilities were adequate probably there would have been a different story to tell. It may be that in some places they are adequate; I can only speak of those places which I know. I have the honour to represent Leigh in Lancashire a mining community which comprises a non-county borough and two urban districts. The whole of the area is a coalfield. The population is about 85,000, of which approximately 13,000 people get their living in the dirtiest and most dangerous occupation we have—in the pits.
  There is one hospital catering for the whole constituency, the Leigh Infirmary, a small hospital completely inadequate to the needs of the district. In the outpatients department it is cruelly inadequate. The hon. and gallant Member for South Belfast (Lieut.-Colonel Gage) spoke of being moved when he saw queues of people waiting inside hospitals. At Leigh he would find at this hospital, catering for 85,000 people, a waiting room for the outpatients which will not hold more than 40 people. The people waiting for treatment go into the corridors, overspill outside, and wait there whatever the weather. It is so easy, too easy, to pat hospital staffs and boards of management on the back and say, "Well done, a magnificent job done under difficult circumstances." It is humbug, cant and hypocrisy, unless we are going to do something to alter those circumstances. It has been in the power of Parliament for a very long time to do something, but nothing has been done.

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  I welcome this Bill as strongly as I deprecate the Amendment. I am, however, very unhappy about one section of the Bill, that concerning the family doctor service. I have every reason to believe, from what I heard the Minister say yesterday, that he is no more happy about it than I am. It so happens that before I came into the House I was for 10 years a trade union official, and throughout that time I was taking part in negotiations. I know how heartbreaking it is when one is asking for something to which one thinks one is justly entitled, to realise the price that must be paid for it. I have the greatest respect for the Minister, for his ability and sincerity, but I am bound to be frank about this—I think he has paid too high a price.
  He has paid too high a price by allowing the concession that a doctor who participates in the service can also take fees for his doctoring. I have spoken of the ability of the Minister, but I think it would require someone far more able than the Minister—if such a person can be found—to convince a miner in my constituency that he will get the same treatment as the mineowner who can pay for it. It is said that the relationship between doctor and patient is a psychological one. That is where psychology will come into the problem. There will be people who by reason of social snobbery or plain ignorance will go to the doctor who prefers to remain outside the service. These people are going to create the impression among those who remain in the service that in this Bill we have simply an enlargement of the panel system. I notice that the Minister said that it will probably help to clamp down the black market in the medical service. I am interested in this matter. I am also interested in the retail trade. I do not know of any such concession being made to retailers. Yet if some of these people are caught engaging in the black market they are clamped down pretty heavily.
  Another point which disturbs me is in regard to the major authorities, the county councils and county borough councils and the powers they are given under some Clauses of this Bill. When Bills sponsored by the Lancashire, Cheshire and Nottinghamshire county councils were presented to the House recently, Members in all parts of the House took strong objection and the Minister said that
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  if those Bills were withdrawn he would insert a Clause in another Bill coming before the House. It seems to me that here is the fundamental principle again in this Bill and I see no reason why non-county boroughs should be left out. I know a great deal is said about the size of the non-county boroughs but it is a fact that many non-county boroughs are bigger numerically than county boroughs. It seems that the only fault of the non-county boroughs is that they have refused to grow up into oversized, ugly, sprawling townships. It ought to be said, in fairness to non-county boroughs, that many of them have shown initiative, enterprise, and, what is more important, have demonstrated efficiency which would do credit to many major authorities.
  One final comment on the Amendment. I am one of those who believe that whichever party sits on this side of the House, it is necessary, in the interests of healthy Parliamentary government, that we should have sitting on the other side a virile Opposition. Therefore, I welcome an active interest, even to the point of seeing the Opposition put down Amendments. But so far as I can see the only purpose of this Amendment is that it cries "stinking fish" on behalf of its sponsors.
  8.36 p.m.
  Lord Willoughby de Eresby: It falls to my lot to be the first to have the honour and privilege of congratulating the hon. Member for Leigh (Mr. Boardman) on his maiden speech. It is rather an odd coincidence, that this is the third time running I have congratulated someone on a maiden speech, although I do not think I have myself spoken more than three times during the 12 years I have been a Member of this House. If my remarks are somewhat drab and commonplace, I hope the hon. Member will believe me when I say that they are none the less sincere. We one and all congratulate him on an interesting, informative and eloquent speech. Now that he has come through the ordeal with flying colours, I hope that it will not be long before we again have the value of his contributions to our Debates.
  I realise that I speak in this Debate on sufferance, on sufferance from you, Sir, and the strict understanding that I do not speak for more than five minutes: on sufferance, possibly, from the House be-

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  cause I am afraid I speak with no great authority or knowledge from a medical point of view. The only excuse, which I can offer to the House for taking part in this Debate, is that I am, possibly, one of the few people in this House who have spent many months in one of the right hon. Gentleman's own hospitals. I even remember an occasion when I was in a Ministry of Health hospital when I had to button up my pyjama top, because the hon. Member for North Islington (Dr. Guest) was coming to inspect us.
  Dr. Guest: I hope the Noble Lord did it properly.
  Lord Willoughby de Eresby: Unfortunately the hon. Member did not do me the honour of inspecting my ward, though I remained with my pyjama top buttoned on a very hot summer afternoon.
  My first point, before I make any more general observations, is a special point to the Minister in regard to voluntary hospitals. We in Rutland happen to be in a unique position, as our small voluntary hospital is also our county war memorial. I am certain that it is not the intention of the Minister, that it is not the policy of the present Government, and is not even covered by that all-embracing electoral mandate of which we hear, that war memorials in this country should be nationalised. We in Rutland recognise the difficulties of the Minister's position. We wish to play our part. We recognise that it is impossible today for the small voluntary hospitals to carry on in their completely independent position when they are in future to receive the larger portion of their funds and equipment from the State. The future plan for the hospital services for the county of Rutland, in spite of what the hon. Member for South Tottenham (Mr. Messer) said last night, is obviously a question which one of the regional boards will have to decide. I think the Minister quoted the figure of 1,000 beds as being the ideal unit. That is obviously rather exceptional for Rutland——
  Mr. Bevan: Not in one building, of course.
  Lord Willoughby de Eresby: The future of the hospital will have to be decided. In regard to whether our particular hospital is to be enlarged to embrace a larger
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  district or whether Rutland is to go in with Leicester, or some other area, I would not press the Minister for any direct answer now. I am quite sure he understands the point I am trying to make. Money has been subscribed for this hospital which consists of only 24 beds and one operating theatre. It will not make or mar the whole scheme if it can be kept as a memorial of the dead of the county of Rutland who gave their lives in the last war.
  I would now refer to the Minister's own hospital, a hospital run by the Ministry of Health. I happen during the past year to have spent most of my time in a Ministry of Health or a State hospital, in a voluntary hospital and also in a Canadian Red Cross hospital. Comparisons are odious especially when one has received nothing but kindness in all three types of hospital and when one's treatment has been free; but it is a matter of such importance that I feel I can say, without any prejudice and in all honesty, that if I were given a free choice of which type of hospital I would select for further treatment, the Ministry of Health hospital would be the last choice I would make. I say that, not because the surgeon the doctors, the sister, or the nurses were any less skilful, obliging, helpful, or considerate in the Ministry of Health hospital than many of the other types of hospital in which I have been. I myself am eternally grateful to them. I probably owe my life, I certainly owe the fact that I can walk at all today, to the service which was given me in the Minister's own hospital. I wrote to his predecessor and thanked him for all that was done for me there, for which I shall be eternally grateful.
  To my mind, it is the system that is wrong. The system, unfortunately, does not enable the surgeons, the doctors, and the various members of the staff to give of their best or to give—this is most important—just that extra bit of treatment, that extra bit of comfort, those one or two things extra which are so important when one is lying on one's back for months on end. It may seem unreasonable but anyone who has been ill for a long period of time, I am sure, will agree with me, that it makes all the difference. We all know that the right hon. Gentleman the Minister is himself of an extremely volatile and effervescent disposition, with an active and energetic brain. I happen to be of a

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  rather placid and extremely lazy disposition. He may need much more dope to keep him quiet than I would possibly need myself. The trouble is that in these hospitals they do try to prescribe for the general rather than the particular case. If the bills are particularly heavy in one week, for, shall we say, some modern dope, questions are asked. Not only are questions asked by the Minister of Health, as the right hon. Gentleman well knows, but possibly by the Treasury, and so on. That may be rather an exaggerated example. The point I wish to make is that in a voluntary hospital, one can pay, as a private patient, for those little extras which make all the difference. If one is in there as a non-paying patient, someone just goes a few doors away and asks whether permission can be given and it usually is given, but, unfortunately, in a State hospital, there may be questions which are ultimately asked right back to Whitehall, and possibly in the Treasury, about the extra expense.
  I have also been in a Canadian Red Cross hospital, which, as I saw from a picture in "The Times" the other day, was recently handed over to the right hon. Gentleman himself by the Canadian Red Cross. In that hospital, it certainly was not a question of what extras you wanted. One was given everything; their only concern was whether anything more could be given. I am certain that if the right hon. Gentleman keeps his State hospitals up to the standard prevailing in that hospital at the time when I was there, he will do a great thing for the people of this country, and I am also certain that that is his aim and object. All I would say to the right hon. Gentleman is that he has a very long way to go to get all the hospitals up to that standard. But I know that is what he wishes to do, and I am certain that he will work to that end.
  8.47 p.m.
  Dr. Haden Guest: I should like to say at once to the Noble Lord who has just sat down that I apologise for not having visited the ward in which he was at the hospital to which he referred. Had I known he was there, I should, of course, have done so, but I confess I am still in the dark as to where it was.
  Lord Willoughby de Eresby: Worcester.
  Dr. Guest: I have visited a great many hospitals to acquaint myself with what was going on, and I rather gather that the Noble Lord was in an Emergency Medical Service hospital during the war. It may have been in any type of building which had been taken over; it might even have been, originally, a lunatic asylum.
  Lord Willoughby de Eresby: A Ministry of Pensions hospital.
  Dr. Guest: Well, that is a particularly good one, in my opinion. The hon. Member compared it with what one might call a super-equipped Canadian hospital with the whole resources of the Canadian Army and the Canadian nation behind it. That is not quite fair. It is rather like comparing the Dorchester with a small hotel in a back street off the Strand, so far as equipment goes.
  Lord Willoughby de Eresby: No. The point I was trying to make was that we are going to be contented with standardised mediocrity. Surely, we must aim at the very best, and, if we go in for a lower standard, we are going to fail?
  Dr. Guest: I agree, and I am sure that is what, in fact, we are going in for, but, in the war we had to take certain standards and had to do the job, and, in fact, did it most effectively and on a very large scale. I do not want to extend this personal interchange of pleasantries with the hon. Member opposite, but I want to say that I hope the Minister is going to adhere very closely to the Bill in its present form. I believe that there is a very strong case for the Bill, and I hope that it is not going to be modified out of recognition. Its two main provisions are those of a complete hospital service and a personal medical service for all persons of all ages, insured or uninsured, without exception. That is the foundation of all future building, which can extend and grow as our resources and our knowledge extend and grow, and if the national health service, in fact, did nothing more than provide this complete hospital service and complete personal medical service at home for all persons, it would be of the very greatest benefit to the health of this country.
  I take the personal medical service first, although I will not go into details. The extension to all means that a large number of people, self-employed, uninsured

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  people very often, and poor people who are not in the scope of the panel service will now come into the service and get treatment. It also means that the service extends at once to women and children. I know from personal experience that in the old days of the panel system there was a very large number of women who were not insured and who were afraid to consult the doctor for some woman's illness because, at the end, they might have a bill which their husbands could not face. This health service will extend treatment to them and will prevent a very large proportion of women's chronic internal complaints, which is going to be of immense advantage in improving the health of the nation. With regard to the so-called minor infectious diseases of children, like measles and whooping cough, in the past—and, indeed, at the present time—some mothers did not take their children to the doctor for these complaints. The result is that among the members of the manual working classes, the death rate from the complications of measles and whooping cough is very considerable, whereas among those in better circumstances it is practically negligible. Proper treatment will make an immense difference in that respect, and save many children's lives.
  I welcome this Bill for another reason. I remember, years ago, seeing the coming into existence of the Act for the medical inspection of school children. I said at the time that it would shine a light into all kinds of dark places where there was ill health and bad conditions, which had not previously been seen, and would make a great change in the condition of children because it would direct attention to troubles which up to that time had been overlooked and had not had adequate attention. As all hon. Members of this House know, the statistics show that in the last generation—this has gone on for about a generation—the health of children has improved enormously. Nowadays, children are very much better in health, in height, in growth, in development and in activity than they were a generation ago, which is the result of the application of medical knowledge to the life of children. When this Bill comes into operation and attention is directed into all the holes and corners of our social system, so that there will no longer be
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  unilluminated places in which disease can hide, there will at once be an immense change for the better in the health of the nation, even though this is only called a "curative" service.
  I believe that the hospital service will have an immense effect and one which will be very far reaching. But before the hospital system can be effective it must, of course, be brought into existence. That can and will be done, but I suggest to some hon. and right hon. Members opposite—I do not include the right hon. and learned Gentleman the Member for North Croydon (Mr. Willink) in this—that they do not understand what an extraordinarily complicated matter this is. It is not only a question of the voluntary hospital versus the municipal hospital, or one kind of hospital against another; it is a matter which varies from area to area in the country. Even in a particular area like the London survey area, to which I will refer in a moment, there is much variation.
  When the right hon. Gentleman the Member for South Kensington (Mr. Law) was speaking yesterday, he said that the object of this scheme was
  to sweep away the voluntary hospitals …
  Nothing could be more absurdly untrue than that. The idea of sweeping away hospitals is not in this scheme; the idea is to coordinate the hospitals and to make them work together in a scheme for providing a hospital service for the nation as a whole. Then the right hon. Gentleman went on to ask:
  Why is the Minister determined to take over the ownership of the hospitals?—[OFFICIAL REPORT, 30th April. 1946; Vol. 422, c. 68, 69.]
  He implied that it was a fad of nationalisation for nationalisation's sake. Of course, it is nothing of the sort. The coordinated hospital plan arises from the logic of the facts. The national control of all hospitals in the hands of the Minister is the way of efficiency and gives the best human service to the community. I would mention in passing that no less conservative an authority than "The Times," in a leading article, said that of all the schemes produced on this matter my right hon. Friend's scheme is the best one up to date. I cannot quote what goes on in another place, but I would draw the attention of the House to the fact that so far from the voluntary system being

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  abolished, a Member in another place, who happens also to be the President of the College of Physicians, uttered words to the effect that by preserving the teaching hospitals, this new scheme preserves the essence of the voluntary system. He also said an interesting thing which the right hon. Gentleman the Member for North Croydon might like to know. He said that this scheme presented the medical profession and the country with a regional scheme which they had demanded without success from the right hon. Gentleman and that they wanted a regional scheme. The right hon. Gentleman can find that statement if he looks up the reference.
  I said that the necessity for a hospital scheme on a national basis arises not from any desire for nationalisation for its own sake, but from the facts of the case. The facts to which I refer are to be found in the reports in a series of hospital surveys, one of which I have in my hand, which have been instituted following a statement made by Mr. Ernest Brown when he was Minister of Health in 1941, when he said that in order to provide for a proper portwar hospital service, the Government of that time were instituting a series of surveys to be made by medical experts all over the country. Those surveys have been made. It is also a fact that those surveys—the one which I have deals with London and the surrounding area—were only published in 1945. I suggest to hon. Members opposite, including the right hon. and learned Gentleman the Member for North Croydon, that one of the reasons why opinions on this side as well as on the other side of the House may have changed in this matter, is because we now have a very large and important body of facts drawn practically from all over the country, on which to base our conclusions, instead of just general opinions which may not be quite so useful. When we get a factual view of the hospital system we get a very different view from that which has been presented by some hon. Members during the course of the Debate yesterday and today.
  The London Survey area covers a very large expanse of country. It covers London, Middlesex, Kent, Surrey, Sussex, the Isle of Wight, part of Berkshire, Hampshire, Dorset, Essex, Hertford, Bedford and part of Bucks. That is the area, I think, to which the right hon. Gentleman the Member for North Croydon referred when he spoke of a population of
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  14,000,000. It is about that size. In this area there are voluntary hospitals, municipal hospitals, and hospitals of every kind, but they are by no means all of equal importance and of equal value to the country. Inside the London area itself, we have the great teaching hospitals.
  Perhaps I ought to remind some hon. Gentlemen opposite that voluntary teaching hospitals will retain their independence and their leading position in the medical world and in the world of healing. They will, in fact, be in an improved position to that in which they are at present, because they will be freer from any financial anxiety. The voluntary system in regard to them is being maintained, entirely and completely unimpaired. They will, of course, be correlated into the general system and will, in effect, take an important part in developing it.
  Mr. Willink: Has the hon. Gentleman taken account of the fact that the teaching hospitals will be subject to any direction the Minister may give, the limit to this direction being in no way defined in the Bill?
  Dr. Guest: I have taken that fully into account. I know my own profession. I know the anxiety in regard to the working of the emergency medical service, having participated in it during the early part of the war when I was on the Staff in Eastern Command. I think I know the anxiety, and I have not the least fear in the world of any domination by the right hon. Gentleman the Minister of Health. I do not think he is in the least degree likely to do that Things done by agreement among equals are not the subject of unnecessary fears, and I do not think the Minister is to be feared as a tyrant. I believe he is to be cooperated with as a friend. In regard to the hospital area, I wanted to draw attention to the outline of the conclusions drawn by the very distinguished gentlemen, whose names I need not mention, who drew up this Report, which is entirely non-political and professional. They were asked to report on the area with a view to ascertaining what was the best means of organising cooperation between the voluntary and the municipal hospitals. What did they find as a general picture? Not at all a rosy coloured picture. They found that there is in the area a deficiency of beds for acute medical and acute surgical cases; a deficiency of

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  beds for tuberculosis; a deficiency of beds for maternity; very bad provision indeed for the clinic sick, and only a very small amount of provision for the clinic sick from voluntary sources. I would emphasise that the amount of provision for the chronic sick from voluntary sources is always very small indeed, if it exists. I quite understand that that does not follow. The distribution of hospitals over this area is very haphazard. I will give one or two facts with regard to this Speaking of the voluntary hospitals the writers of this Report say, under the heading "Uncoordinated effort":
  The majority of the voluntary hospitals are distinguished (in the London area) by their independent spirit, initiative and power of inspiring local loyalty,
  [HON. MEMBERS: "Hear, hear."]
  but their fruits—
  I hope hon. Members will cheer this too—
  are not always conducive to fully efficient and satisfactory hospital services.
  They give the example of the tendency to
  enhance the importance of the individual hospital rather than arrange the best facilities for the patients.
  They give the instance of hospitals competing with each other in the same field of work, regardless of the needs of the patients. The voluntary hospitals are very human bodies, not coordinated, and very badly in need of coordination among themselves, as well as with the municipal hospital services The municipal hospital services in this area are a very recent growth. A good general municipal hospital is a comparatively new creation, even in the London area. London, Surrey and Middlesex are very advanced, but in some areas, such as Dorset and Hampshire, the survey reports that little or nothing has been done to develop municipal hospital services. We have, therefore, in one part of London, Middlesex and Surrey, good municipal services and good voluntary services, but in two other counties very little is done. In fact, there is a terrible patchwork all over this very large area. The general conclusion of the gentlemen making this report is that in quantity and quality there are deficiencies of all types of accommodation all over this area.
  The problem is not one of buildings at all. As they say, a good hospital consists not of buildings, but primarily of an
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  expert medical and nursing staff. In the London area we are fortunate in having a large number of consultants, because under the existing system consultants having unpaid appointments at voluntary hospitals have to support themselves by private fees. There is, therefore, a concentration of specialists in an area such as London, where there is an opportunity for specialised practice from which specialists can earn a substantial living. But in the surrounding areas, even in the London district, there is a very small and inadequate number of specialists, for the simple reason that no specialist can at the same time discharge his duty as a volunteer and unpaid adviser in a voluntary hospital and live in an area where he cannot have a specialist practice.
  It is much worse than that in certain other parts of the country, and in some cases it is extremely bad. For instance, in the South-West of England, which contains Devon and Cornwall, there are very few hospitals and a very bad service. Sometimes there is even definite competition between adjoining municipal authorities. There may be a boundary down the middle of a street which divides them geographically, and because they are different authorities it is difficult for them to combine. The question of combining voluntary and municipal hospitals is so complicated when considered from the standpoint of the country as a whole that, unless it is done on a national scale, I am convinced it cannot be done at all. We simply cannot get hold of the problem except on this big national scale. In these conditions, nothing but bold national planning, and the coordination of municipal systems on a national scale, will solve the problem.
  The difficulties are enormous, but it can be done, and we shall do it. The need for increased accommodation is very great, not only for tuberculosis but for acute medical and surgical cases and for maternity, and the number of specialists is not adequate for a large service. I was discussing this matter the other day with one or two of the leaders of the medical schools in our universities, and we came to the conclusion that under this scheme we should need at least double the number of specialists we now have. That is because in some places, at the present time, there is practically no specialist

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  attention at all. In the Devon and Cornwall survey area—that includes the Bristol area—there is only one hospital, in Bristol, which has a full staff of specialists. In three or four others there are some specialists, but the remainder have no specialists at all. They are general practitioner hospitals carrying out major surgery for which general practitioners are not fitted, as they themselves know, but they have to do it because it is not organised. It needs organising; the hospital system is not only disorganised but it is, in some sense, almost chaotic. I want to make a suggestion about this, how to tackle it.
  Mr. Willink: Will the hon. Gentleman allow me? Do I understand him to say there were substantially no specialists, for example, at Exeter?
  Dr. Guest: I was endeavouring to make myself clear. [An HON. MEMBER: "Look it up."] I will. Let me take this area, the South-Western area, Gloucester, Somerset, Wiltshire, Devon and Cornwall, with a population of 2,600,000. There are about 300 hospitals, voluntary. Only the British Royal Hospital has a complete staff of specialists. The Gloucester Royal Infirmary, the Cheltenham General Hospital, the Royal United Hospital. Bath, the Royal Devon and Exeter Hospital, the Prince of Wales Hospital, Plymouth, and the Torbay Hospital, Plymouth, have specialist staffs, but all the rest have not. This is an extract from the South-Western area survey which, no doubt, the right hon. and learned Gentleman has seen. There is not the slightest doubt that these hospitals are without specialists. But it is much worse than that. The right hon. and learned Gentleman has drawn my attention again to this issue. I thought I was wearying the House, and I did not want to go on with it, but now I may say some of the things I had thought of saying. I will now mention them to encourage hon. and right hon. Gentlemen opposite.
  One of the evils of the voluntary hospitals in this area—and it is reported in very great detail, and any hon. Member can get the report in the Library, if he does not wish to purchase it—is that in these small hospitals there is failure to keep adequate case notes. Also, the midwifery accommodation is very unsuitable; and that for the chronically sick, in a good many of these areas, is seriously overcrowded in the institutions with un-
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  trained nurses; and the majority of the public institutions have so many defects as to be unsuitable for the aged and chronically sick persons. I did not want to bring all this out, but I give that as an example of the conditions which are found in different areas all over the country. The conditions are very much worse than the right hon. and learned Gentleman has given the House to understand. They are much worse than a great many people in this House do understand, and they cannot be tackled adequately except on a national line.
  I want us to take a lesson from our war experience with the Emergency Medical Service, not because the right hon. Gentleman and the noble Lord with whom I had a pleasant interchange just now, reminded me of the Emergency Medical Service, but because I want to refer back to it, and to remind the House that with our inadequate number of specialists, and with our inadequate number of doctors—the number is certainly inadequate—we did manage during the war period, by coordinating the work of the voluntary and municipal hospitals, to create an Emergency Medical Service which did most valuable work for the Armed Forces. It acted as the medical base for the whole of our expeditions overseas. It saved us thousands of lives. It saved us many hundreds of doctors.
  If we can do that in war we can do the same kind of thing in peacetime. There is not the slightest reason why we should not. We have the Central Medical War Committee doing valuable work, mostly members of the B.M.A.—we must say a good word for the B.M.A sometimes—with another committee, the Medical Personnel Priority Committee, of which I am now chairman, undertaking the general work of the principal allocations of medical priorities. There is no reason why those two Committees should not go on with their work in peacetime. I appeal not only to this House but to the medical profession to help in this peacetime reorganisation, and to coordinate the hospitals on the lines carried out in the war, not this time for war casualties, but for T.B. cases and chronically sick people. Members of the House will remember that in the war, when we thought we should have thousands of casualties, from bombing—which fortunately, we did not have—we made provision for those casualties. I should like to see the House make

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  provision for thousands and thousands of casualties from tuberculosis which, unfortunately, we already know exist. I think that we could do it. I believe that by putting our backs into this matter we could make provision for some of the more serious things which we have not got at the present time. I believe that a central medical peace committee might do very valuable work in the same way as the Central Medical War Committee have done very valuable work during the war.
  It has been said by various Members opposite that the prospect offered to medical officers under the new scheme would not appeal to them, that this was not the kind of thing which would appeal to men of vigour and of adventure. I do not for one moment believe that. I have a suggestion to make, which, perhaps, will make the attractions of the service greater. I want to make our National Medical Service a service as wide as the British Commonwealth of Nations. I want to make medical officers within the Colonial Medical Service, which is at present one service interchangeable from Colony to Colony and interchangeable with medical officers within the national service of this country. I want doctors in this country to have the opportunity to go out to the Colonies, and come back enriched by their new experiences. I should like to see this done not only with our Colonies, but with the Dominions. I should like to see men go out to Australia, New Zealand, Canada and Newfoundland and come back enriched by their experience. I believe that we are now organising in this country a service for all without distinction of income or occupation, age or sex. We should provide those who are to give this service with the widest possible experience of the world, which our British Commonwealth, extending over one quarter of the world's surface can give, and which is large enough in which to gain this experience. We are organising something more than a National Medical Service. It is nothing less than the turning of the knowledge and wisdom and practice of the medical profession, and of all the sciences on which it rests, to the service of our common humanity. Nothing less than that is the objective of this Bill. I believe that this medical service should be given to our common
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  humanity, without restriction and without barrier, save only the claims of human needs. It is an objective within the grasp of the Bill. It can be done; it should be done, and I believe that when this House votes tomorrow night, it will be done.
  9.17 p.m.
  Mr. Wilson Harris: This Debate has by this time covered a wide field. That is not surprising when we are dealing with a Measure which extends to over 70 pages. But when all is said that has been said I believe that whatever anxiety still exists—and I think it does exist—centres around two main questions, the future of the family doctor and the treatment of the voluntary hospitals. I subscribe, as I am certain every Member subscribes, to everything which has been said by way of tribute to the family doctor, the general practitioner. There is no more devoted or more disinterested body of men in this country than the general practitioners. If I thought that these men who ease our entry into the world and our departure from it, who mitigate our pains and cure our diseases and would prevent many of them if we gave them the opportunity, would suffer any serious detriment as a result of the passage of this Measure, nothing would induce me to cast my vote in favour of it. But I believe, in spite of all that has been said, that if this Measure is passed, the lot of the ordinary general practitioner in many respects will be easier, and in only a few respects more difficult, than it is today. That opinion, I recognise, is not the view of all the medical profession. It will not have entirely escaped the notice of the right hon. Gentleman opposite that some of the members of the medical profession entertain slight reservations in regard to the proposals which he has brought forward. He will not be unduly depressed by that if he remembers, as I do, the events of 35 years ago, already referred to by my hon. and learned Friend the Member for Montgomery (Mr. C. Davies), when the Queen's Hall was packed by vociferous medical practitioners, denouncing the Bill which was introduced by my right hon. Friend's illustrious compatriot and vowing they would not work it. Well, that storm blew itself out in about a month, and, as was said earlier in another connection, history does sometimes repeat itself.

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  As I have studied the criticisms of this Bill, and the hostility manifested towards it in certain quarters, I have come to the conclusion that it springs largely from two sources. There are psychological reasons, and there are misunderstandings and misapprehensions. In accordance with the tradition of Parliamentary draftsmanship, the executive authority in this Bill is invariably referred to as "the Minister." That means, in effect, "the Ministry," and how much less disturbing it would be if "Ministry" were used instead of "Minister." For it is a hard but painful fact that the forceful and occasionally provocative personality of the present incumbent of that office has not evoked from the medical profession precisely that wholehearted and enthusiastic admiration which he, no doubt, desires and, no doubt, deserves. Therefore, it can be well understood that an agitated medical practitioner, conscientiously working through this Bill, and finding on every page a reference to "the Minister"—the Minister may do this, prescribe that, may provide this regulation, may change that regulation—should be found exclaiming with some frequency and some vigour, "That man again!"
  But even there, I think that the medical profession may take some comfort. We are legislating tonight not on the short term but on the long term. In the course of nature, the right hon. Gentle man will give place to a successor, and, in the course of politics, that may be sooner rather than later. In any case, I cannot help thinking that even the most hostile members of the medical profession, if they had read the speech which the right hon. Gentleman delivered yesterday, may feel that like one of his habitual associates, he is not so entirely black as he is sometimes painted. There have been many misapprehensions in regard to this Measure—misapprehensions which will be hardly entertained by any one who has read the Measure carefully. Many of them have been dissipated in the course of this Debate. There is the perfectly untenable charge that, under this Bill, a doctor may be directed to go to a certain place and practise there, and nowhere else. That idea was dispelled by the Minister in his speech yesterday, and by the Parliamentary
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  Secretary in the essay which he read so fluently this afternoon.
  There is further a great deal of misapprehension, as it seems to me, on the subject of health centres. That was illustrated by the speech of the Noble Lady the Member for Hemel Hempstead (Viscountess Davidson) yesterday, when she gave a picture on the working of the health centres which I will not pursue here, since it seemed rather more imaginative than realistic. This has to be remembered about the health centres. In the first place no health centre exists as yet, and unless the right hon. Gentleman's health centre building programme wins by a very long head over his house building programme, it may be some time before any health centre appears. Secondly, when there are health centres there will be nothing to require any member of the medical profession to go near one. He can still see patients in his own surgery if he prefers to exactly as he does today. Thirdly, if he is wise enough to use the centre and take advantage of the equipment which will be there supplied, he will have his own hours for consultation, his surgery hours just as is the case today, and patients will naturally go and see him at those hours, not dropping in at any odd time expecting him to attend them, because it is a place at which he occasionally functions.
  One comment frequently made about this Bill is that it will destroy the relationship between the doctor and patient. All I have to say about that is that as I understand it the relationship between doctor and patient is made by two people—the doctor and the patient. I do not flatter the Minister of Health sufficiently to suggest that he is capable of coming between a doctor who cares for his patient, and a patient who has respect for his doctor. If the relationship between doctor and patient does break down it is the fault of those two, and not the result of any Measure introduced into this House. I must confess I am a little more concerned with the observations made on both sides of the House today and yesterday in regard to the free choice of doctor. The suggestion was made in one case that no real freedom of choice existed, and in another case that no freedom of choice, in fact, is desirable. The right hon. and learned Member for North Croydon (Mr. Willink), if I may say so with great respect, seemed to me to be a little less

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  than ingenuous in his observations when he said that because certain doctors would not come in under this service, preferring private practice, it could not be said that there was free choice of doctor. But, after all, words must be read in their natural context. What I take them to mean and what I think most hon. Members take them to mean is that free choice of doctor is a free choice of doctor within the National Health Service, and that will certainly exist when the national health service is established.
  What I was more concerned with was the remark made by the hon. Member for Silvertown (Dr. Comyns), when he suggested that because the average patient did not know enough about medicine to decide which doctor was skilful and which was not he did not see why there was any reason for that freedom of choice at all. From that thesis I must vigorously dissent. Skill is not the only quality required in a medical man. There is no profession in which personality is rated higher and plays a greater part. Let me illustrate. There are some seven or eight medical practitioners sitting on the opposite side of the House. What degree of medical skill, if any, they possess I have no idea, but as I sit here and scrutinise them at leisure I have reached very definite conclusions on whose ministrations I would and whose I would not welcome, if I were seized with sudden indisposition in the House, and they came hurrying to my assistance as I have no doubt they would. As a matter of fact if the hon. Lady the Parliamentary Secretary to the Ministry of Food were in the vicinity, I trust I should have sufficient strength left to beckon appealingly to her.
  Now I come to the question of voluntary hospitals. I must frankly confess that this is the part of the Bill about which I have entertained the greatest misgivings. They have to a great extent been dispelled by the Minister yesterday, because the conclusion does seem inescapable that in the necessary redistribution, coordination and reorganisation of hospitals, the hospital buildings at least must pass into the possession of the State. After all, we do not perhaps always realise the relation to this question of the revolution in transport in the last 40 or 50 years. When I was a boy and went occasionally to the Methodist chapel—they were Wesleyan chapels then—in a Devonshire
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  village it was common to hear the local preacher, who was a little weak in his aspirates but none the worse for that, announce that the collection that day was for the "'orse' ire" fund. The horse of course was hired to bring the preacher from the nearest town to the village. I quote that because the hospitals which have to be dealt with now are survivors of the horse-hire age. Patients could not then be transported any distance, and so there had to be hospitals for every small community built by the pounds of the rich and the pennies of the poor and often offering services for which they were not really competent. Those hospitals must have a new place, or sometimes no place at all, in the reorganisation of the hospital world which is necessary today. But one point on which I still feel unhappy is with regard to voluntary hospital endowments. The right hon. Gentleman said yesterday that they amounted to £32 million——
  Mr. Bevan: That would be the figure after setting aside the endowments of the teaching hospitals. The global figure is about £45 million.
  Mr. Harris: I am much obliged, but the actual figure is immaterial. Whatever the sum is, it will, I understand, remain in the possession of the hospitals, their basic normal needs being supplied by the Exchequer. It would not remain in the possession of the individual hospitals, but would go into the general fund and be redistributed. Now I ask the right hon. Gentleman whether that process is really necessary; whether the hospitals could not be allowed to keep their endowments, particularly as he is paying the basic necessary costs of management and operation. On the grounds of justice and humanity, and as the line of least resistance, it would, I suggest, be the wise and statesmanlike course if the right hon. Gentleman left the endowments to the individual hospitals, and merely took their buildings and fitted them into the general scheme. If the right hon. Gentleman will give some thought to that matter before the Bill goes to Committee I think he would be doing a great service to the community.
  With regard to the suggestion about the annexation, as it has been called, of the voluntary hospitals, and the statement that this will destroy the local patriotism, local spirit, and local support on which we all set so much store, that will only be the case if the people who should be sup-

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  porting the hospitals decide not to support them. Why should not that support continue in future, just as it has in the past? I agree that there would not be the same need for financial support, but it has never seemed to me that the warmest and the most humane form of charity consists merely of signing a name at the bottom of a cheque which someone else has drawn. Surely, visits to patients and the gifts of flowers, gifts of books, gifts of games, gifts of wireless sets, with all the little thoughtfulnesses which go with them, introduce warmth and humanity into this sometimes sad and sombre atmosphere. Therefore, I dismiss entirely from my mind suggestions that because voluntary hospitals are being taken over these qualities, on which we set so much store, will disappear in the future.
  Finally, speaking as one who is attached to no party, I confess to great disappointment that this great Measure will not have, on its Second Reading, the support of a united House. It is impossible not to draw a contrast between the wise, generous and statesmanlike speech which we heard last night from the hon. Member for Abingdon (Sir R. Glyn), and the general tone of the criticisms which have come from the Opposition Front Bench. Of course the Opposition are perfectly justified in opposing this Measure, and in putting down an Amendment, but I wish they could have found it possible to support the Second Reading without reservation, while holding themselves free to make whatever proposals they desired on the Committee stage.
  The Amendment will be defeated, the Measure will get its Second Reading, and we shall pass to the Committee stage; and that will be a period of immense importance, because there are obviously changes which could be made in this Bill to the general advantage, and I hope they will be made. But there is something a little more than that. If the right hon. Gentleman the Minister of Health shows himself, as I believe he will, ready in Committee to accept reasonable suggestions and to listen to constructive criticism from his opponents, I think two most desirable objects will be achieved. Not only will the Measure be substantially improved, but what is even more important, confidence will be created that, under the right hon. Gentleman's administration of the Bill when it becomes an Act, the doctors, the
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  public, the patients, can count on just and generous treatment at his hands.
  9.36 p.m.
  Captain Baird: As a fairly new Member of the House, I feel rather reluctant to follow the hon. Member for Cambridge University (Mr. Wilson Harris) and the hon. Member for North Islington (Dr. Guest), who have made excellent speeches, but I should like to deal further with the question of the hospital system, which was raised by the hon. Member for North Islington. I should like also to associate myself with the tribute which the Minister paid yesterday to the great work which the voluntary hospitals have done in the past. In my opinion, the reason this reorganisation of the voluntary hospitals is necessary is simply that they no longer fulfil their function in a modern society. In estimating this matter, we must look into the history of the growth of voluntary hospitals as we know them at present.
  The voluntary hospitals first became a power for good in the land at the time of the industrial revolution. At that time industrialists and capitalists had the foresight to recognise and utilise the new forms of power which had recently been discovered. Rural workers were then flocking to the towns in tens of thousands. Housing conditions were abominable. Sanitation was non-existent. Women and children were forced to work in the factories and pits for long hours and in bad conditions. Ill health was rampant. Therefore, it is not to be wondered at that the new industrialists, who were mostly deeply religious men, should have had some qualms of conscience. Conscience money flowed into the now hospitals, and we can only hope that it bought the necessary marble halls on high. However, with the development of modern industry and modern capitalism, surplus profits have dwindled, and the subscriptions to the voluntary hospitals from wealthy sources have also dwindled. Today, contributions from wealthy philanthropists make up only a small proportion of the income of these institutions. Some 60 years ago, in an attempt to find new sources of income, the hospital contributory associations and the hospital Saturday funds were founded to organise new sources of income from the working classes. It is rather interesting to note the history of

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  the Birmingham Hospital Saturday Fund, published recently, in which we read:
  In 1873, the inspiring suggestion was made by a Mr. Gamgee, a well known surgeon of that time, that everyone should be asked to work overtime for the hospitals on a particular Saturday afternoon, that day to be called 'Hospital Saturday,' a fine idea, and though found eventually to be somewhat impracticable from the point of view of systematic organisation, it was decided to go for ward with the scheme.
  From that day to this, the great majority of the income of the voluntary hospitals has come out of the pockets of the working classes.
  The point I want to make before going any further is that even with the contribution of the Hospital Saturday Fund the voluntary hospitals in many parts of the country are facing bankruptcy at the present time. Take the case of one typical provincial town, Birmingham, in which I happen to have lived for some considerable time, and of whose hospitals I have some knowledge. What is the position there? In 1939 the voluntary hospitals in Birmingham, which are organised in what is called the United Hospital Board, were faced with a loss of £56,600. In 1940, the next year, the loss was only £32,600, but upon going into the question further one finds that in 1940, during a year of war, the voluntary hospitals in Birmingham received a donation of £63,000 from the State, through the emergency hospital service. Therefore, in 1940, if it had not been for the war, the Birmingham voluntary hospitals would have been faced with a loss of almost £100,000.
  I will take the question of this same town still further. Some years ago the voluntary hospitals decided to complete a new hospital because of the lack of hospital beds in the town, and they built one of the most modern hospitals in the country, the Queen Elizabeth Hospital. It was only after the hospital was complete that the organisers of the voluntary hospitals realised that they would have to finance it and that they had not the wherewithal to do so. They therefore set up a committee to find out where the money was to come from. The committee reported that in this new 600-bedded hospital, one of the most modern in the country, they could only afford to open 200 beds, after which other beds would be opened only as beds were closed in the
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  older hospitals, in this a city where there was a great shortage of hospital beds. I want to submit to the House tonight that the reason why it is necessary to bring the voluntary hospitals into this scheme is because they are facing bankruptcy, and because we cannot get efficiency except under a new system.
  May I give one other example from my own constituency, Wolverhampton? In the Royal Hospital there it was recently found necessary to cut down the expenditure in the radiological department. The way this was done was by saying that no medical practitioner should have direct access to the radiological department; he could only use it at the whim of one of the consultants employed by the hospital. That is entirely against modern medical practice and theory; today we want to keep the practitioner in the closest touch with the hospitals. There are many other examples, but my time is limited.
  My main reason for intervening tonight was to deal with some of the dental aspects of the Bill as one of the few dental surgeons in the House. On the subject of dentistry I want to say—and this is a point we must bear in mind—that in the past, before the war, the dental services of this country were entirely adequate for the restricted number of people who could buy conservative dental treatment. Indeed, many dentists were under-employed before the war. The reason was, first of all, as was said by an hon. Lady opposite last night, that dental education was very lacking in the past in this country, but the chief reason why the dental services were not more used was lack of financial means of the working classes to buy dental treatment. In the past the working classes as a whole knew nothing about conservative dental treatment, by which I mean fillings and so on. They thought of dentistry as what we dentists call "blood and vulcanite"—waiting until it was necessary to have their teeth pulled out and then having dentures. That was dentistry for the working classes in the past. I am very pleased to think that that era is passing.
  Today there is a great need of dental surgeons. First of all we must pay a compliment to the work of the dental surgeons in the Forces. That work has laid the foundations of dental education for the masses of this country. Young men and young women are coming out of the Forces today

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  convinced of the necessity of conservative dental work. Also with the changes now proposed, there will be free dental treatment for everybody in the near future. Those two factors have created a shortage of dentists. There are not enough dental surgeons to go round. The dental profession have criticised the Bill to some extent. The reasons for the weakness of the dental side of the Bill is the shortage of dental surgeons. Our problem in future will he to discover how we can get more young men and young women to enter the dental profession. Dentists themselves could do something about this matter because, in the past, they have been disunited. This is a very young profession, only about 25 years old. If only dentists would get together and unite themselves into one organisation they would be able to do a lot to raise the status of the profession.
  The medical profession and the public do not always realise the good job which this branch of the medical profession are performing. Dental surgeons play a very important part in modern medicine. Much of the surgical treatment which they carry out is very responsible. Taking four, five or six teeth out is a major surgical operation. [Laughter.] Some hon. Members may laugh, but it really is the case. Further, most dental surgeons carry out many more general anaesthetics than do doctors. Speaking generally, the dental surgeon is the partner of the doctor in the medical services of this country. That fact must always be recognised.
  I believe that the Minister can do much to raise the status of the dental profession. He has not so far done it. In the First Schedule to the Bill, in the constitution of the Central Council, the Minister makes provision for the chairmen and secretaries of various medical organisations, but I suggest that there should be a place upon that Council for the chairman of the British Dental Board. I do not think that that would alter the constitution of the Board, but it would help to raise the standard of the profession and get it recognised by the public and profession as a whole. Further, in the past, dental surgeons employed by local authorities have been given a very lowly place in the medical system. Hon. Members interested in local work will know that a dental officer employed by a local authority cannot, in most cases, approach his medical committee direct but must do
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  so through the senior medical officer. That should be finished with. The senior dental officer should be able to approach his committee direct.
  An even more important question is the appointment of public dental officers. In a copy of "The British Dental Journal" which I have here, there are some advertisements. One is for a senior senior dental officer, a man of great responsibility. The salary offered is £650, rising, subject to satisfactory service, by £25, to a maximum of £800. Another is for an assistant dental officer at a salary of £450 rising to £650. I believe that hon. Gentlemen opposite and the country as a whole have not recognised in the past the good work which the doctors and dentists of this country have done. The general practitioner, both in dentistry and medicine, has been under-paid. I am confident that we will not be stingy when it comes to the question of discussing salaries for medical or dental officers, and as far as dentists are concerned, for increasing the salaries of our public dental officers.
  I attended a meeting organised by the British Dental Association recently, and I heard various criticisms of the Minister in regard to the Bill. We were told that if the Bill went through dentists would not work as they have done in the past. There is much talk in the House and in the country about the need for dilution of the dental profession. If the dentists talk about not working so hard under a State scheme, they are asking for dilution, whether it is right or wrong. Some remarks were made earlier this evening by the hon. Member for North West Camberwell (Mrs. Corbet). I do not like to criticise a maiden speech, but her remarks should not go unchallenged. She referred to the minority report of the Teviot Committee on Dentistry, signed by Major-General Helliwell, for whom I have a high regard. Let me say here that, with regard to the question of the dilution of the dental profession, I think he has oversimplified the problem. It was suggested by the hon. Lady that there was a great incentive at the present time for dentists to make dentures, but the present panel scale of pay is much better for conservative work, than for dentures.
  The hon. Lady also referred to the question of dental hygienists and said what a great contribution they could make to dentistry. The idea of dental

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  hygienists, smartly dressed young ladies ushering you into the surgery and carrying out work there is all very well. The hon. Lady also suggested that in New Zealand or Australia these hygienists pull and fill teeth and do all sorts of treatment. She also suggested that dental mechanics could make dentures. I began to wonder what job would be left for the dentist to do. As a dental surgeon, I would say that dental hygienists cannot make any great contribution to the problem of the lack of dentists in the country. The amount they can do is of a very restricted nature, and it does not include fillings or extractions. With regard to the question of dental mechanics entering the profession, this is very important. The argument is used that dental mechanics can carry out the mechanical side of this profession and supply dentures. That may be necessary in time, but I will not go into that argument tonight. The dental mechanics have only been organised in a trade union during the last three or four years, and at the present time there is no way of judging who is a dental mechanic and who is not. The trade union movement is pressing for a course at various technical schools for dental mechanics, and in three or four years' time we may get registered dental mechanics who may do some of that work. However, in relation to the problem of the shortage of dentists at the present time, that is not very satisfactory. The only solution is the solution recommended in the majority report of the Teviot Committee, that we should open the profession to the working boys and girls of this country.
  I come from a working-class household. I managed to get to the university chiefly as a result of sacrifices by my parents. With me went other working-class boys and girls, and I remember that during the years of the depression when we went to the university together without large financial means, I saw many boys and girls as able as or abler than I drop by the wayside because their fathers became unemployed and they were forced to go down the pit or into the factory. After a few years all ambition was knocked out of them. Others, because of bad housing, were forced to give up owing to ill-health. I believe that if we can provide the financial incentive to the working-class boys and girls of this country, we shall get the
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  dentists we require, and, therefore, I hope the Minister will implement the Teviot Committee's Report.
  There are, however, one or two weaknesses in the Bill. I think there was one very apparent weakness in the Minister's argument when he attempted to justify the pay beds in our new hospitals, and also the right of consultants to have private patients. The argument he used was that if we did not allow consultants to have private patients, and if we did not allow pay beds in our hospitals, we would have a black market in nursing homes. Surely, with the great Government we have, we can register—[HON. MEMBERS: "Hear, hear."] I am not worrying about what hon. Members opposite say; I am thinking about what the people of the country say. Surely, with the great support the Government have from this side of the House, we can control the nursing homes by registering them, and we can easily control the black market. I think that when the Committee stage comes along we shall have to take such steps.
  This Bill is only the beginning. By itself it can do little. It is like a skeleton which has yet to be clothed with flesh. The whole gamut of industrial medicine, prevention and research and medical education, has yet to be tackled. We on this side of the House are awake to the demands for legislation to deal with all these ancillary problems. We have been waging this fight for a generation. It is a fight to take the profit out of ill health and to give to the whole community that access to the best medical and surgical treatment which has in the past been so often denied them. Under our present day system of medical private enterprise, there are two standards of treatment, one for the rich and one for the poor. While the wealthy patient can, if he requires it, be carried direct to a private bed in a voluntary hospital, the working class patient has to put his name on the waiting list or queue up in the out-patients' department. In country districts it is quite common for a local medical man to have a special side entrance where his panel patients can call and consult him at a given time, but for the private patients there is a front door and consultation by appointment. The Labour Government are determined that this two standard system of medical treatment shall be abolished and, therefore, we shall

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  support this Bill. I repeat that this is not the end, but the beginning of our fight for better health for the people of this country.
  Motion made, and Question, "That the Debate be now adjourned"—[Mr. R. J. Taylor]—put, and agreed to.
  Debate to be resumed Tomorrow.

  NATIONAL HEALTH SERVICE BILL
    ESTIMATES
    Mr. Benson and Mr. Thurtle discharged from the Select Committee; Mr. Hector Hughes and Mr. Mayhew added."—[Mr. R. J. Taylor.]

    GAS (SPECIAL ORDERS)
    Resolved:
    That the Draft of the Special Order proposed to be made by the Minister of Fuel and Power under the Gas Undertakings Acts, 1920 to 1934, on the application of the Cowes Urban District Council, which was presented on 21st March and published, be approved.
    Resolved:
    That the Draft of the Special Order proposed to be made by the Minister of Fuel and Power under the Gas Undertakings Acts, 1920 to 1934, on the application of the Stirling Gas Light Company, which was presented on 2nd April and published, be approved."—[Mr. William Foster.]

  PUBLIC ASSISTANCE INSTITUTION, HOWDEN
  Motion made, and Question proposed, "That this House do now adjourn.—[Mr. R. J. Taylor.]
  9.59 p.m.
  Mr. Glossop: I wish first to apologise to the Parliamentary Secretary of the Ministry of Health for keeping him on the Front Bench for another 20 minutes or so. He and the Minister have obviously been fully occupied during the last two days on the Bill which the House has been considering, but the hon. Gentleman will know that, having had the luck of the ballot and the opportunity to raise this matter on the Adjournment, I could not arrange it to suit the convenience either of the Minister or the Parliamentary Secretary. I make no apology whatsoever for raising the question of the closing of Howden Public Assistance Institution.
  It being Ten o'Clock, the Motion for the Adjournment of the House lapsed, without Question put.
  Motion made, and Question proposed, "That this House do now adjourn."—[Mr. Pearson.]
  Mr. Glossop: This is purely a local matter. It is now becoming the custom to raise matters of major importance on the Adjournment, but the Adjournment provides the only opportunity for an hon. Member to raise a grievance registered by a large number of constituents. The Howden Public Assistance Institution was built 100 years ago. Some say that because the building is 100 years old it is out of date, but I assure the Parliamentary Secretary that although the building was built 100 years ago, it is of brick, has 40-inch walls, plenty of windows, water, electric light, and is situated in extremely pleasant surroundings. Prior to the second world war, suggestions were made by the East Riding county council that the institution should be closed, and an entirely new building erected at Market Weighton, 12 miles to the North East of Howden. I think the Parliamentary Secretary will agree that at a time when there is such pressing need for housing and such a shortage of bricks, this institution should not be closed and bricks used to build a new institution which could be better used in building houses for Service men coming home after fighting for their country.
  The county council propose to close the present institution at Howden and move the inmates, not into another brick building 100 years old, but into wooden huts at Driffield. Hon. Members who are interested in the timber trade might allege that timber buildings are equally suitable for such a purpose but another aspect has to be considered. Driffield is 25 miles away from Howden, the other side of the Yorkshire Wolds. It is almost a foreign country. There is no bus service between Howden and Driffield, and the only means of communication is by way of one of the stations in the Howden rural district area, thence to Hull, where one has to wait for some time for a connection to Driffield. It is a very expensive journey, and it would be almost impossible for a relative or friend of some one in the institution at Howden to make the journey to Driffield, see the inmate, and get back to Howden during the same day. This is not a political matter. A large number of protests have gone to the county council and to the Minister of Health in

  315
  this matter. They number nine from parish councils, 13 from local doctors and one even from a political organisation which is not unfriendly to the party which the Parliamentary Secretary represents in this House.
  I wish to put one or two questions to the Parliamentary Secretary. There are 115 beds in the present institution at Howden, and they are generally fully occupied. I will return to that question in a moment. The public assistance institution at Howden has for some time been providing in that building a very efficient and well-equipped maternity ward. During 1945 there were no fewer than 74 confinements in that maternity ward. I know it is said that there is a stigma, perhaps I should say an alleged stigma, on any child who is born in a public assistance institution. Will there be any less stigma on the child who in future is to be born in a State hospital as opposed to a voluntary hospital in the past? Surely, it does not matter where the child is born. When a child is born all we are anxious about is that the mother shall have the easiest confinement possible, and that the child shall be born in the best possible conditions. I am assured by the 13 doctors who are regularly attending Howden Institution, and dealing with the maternity cases there, that they have all the most modern equipment and that they are satisfied that no mother and no child could have better treatment than they are having at the present time. If this institution is to be closed I would ask the Parliamentary Secretary what is to happen to those women in the Howden district who are to have confinements in the future.
  Again there is the question of antenatal advice. We have been told during the past two days not only of the importance of the National Health Service Bill, and of dealing with the treatment of disease, but that the Bill will enable people to get treatment and advice before illness gets a hold. Surely, then, the House and the Government are only too anxious that every possible facility shall be provided for the giving of ante-natal advice. That is being provided at Howden at the present time. I would ask the Parliamentary Secretary what is to happen when the institution is closed, in order to provide the people in the Howden district with the ante-natal treatment and
  316
  advice which they are getting at the present time.
  Let me return to the question of the old people who are at present in this institution at Howden. We are dealing with a human problem. No high sounding scheme of centralisation should be undertaken at the expense of the happiness and well being of the aged and often bedridden people in this hospital. I wish to quote a letter which was written by a Mrs. Watson, the wife of the Methodist minister at Howden, to the Minister of Health. The Parliamentary Secretary, no doubt, has read this letter. I quote it to the House because it conveys in language very much better than I could hope to use the sentiments and feelings of the people in this area. The letter says:
  I am writing to bring to your notice a fact which is causing real distress and heartburning among the people in our little town. As I go about visiting and chatting with people in all walks of life I hear on all sides the same anguishing question, 'Can nothing be done? What shall we do? Isn't it dreadful?'
  Mrs. Watson further says:
  This building has served as institution, hospital and maternity home for a long period and has been the source of help and blessing for the people of Howden, primarily because of its nearness to our homes. It is here in our midst, and the haunting dread of becoming an inmate of an institution (a source of poignant agony to old, lonely and infirm) has been softened and lessened by the fact that relatives and friends may visit on three days a week. This fact makes all the difference.
  I suggest that that is the letter of a Christian woman on a human problem. I quote the reply which was sent to that lady on behalf of the Minister. It is couched in the official terms of Whitehall. Neither she nor I complain of that. This is the reply:
  The Minister of Health is awaiting a statement by the East Riding County Council of detailed proposals for the alternative treatment of inmates of the Howden institution in the event of its closure. Your letter will then be considered in connection with these proposals.
  The satisfactory part of the reply sent on behalf of the Minister is that the last word with regard to the continuance of the present institution or its closure is the word of the Minister of Health himself. I suggest to the hon. Gentleman the Parliamentary Secretary that he should convey to the Minister that here is an opportunity not only to be a great social legislator, as he has tried to demonstrate to the House during the last day or two, but a human legislator. That is even more

  317
  important, and it is by that he will be judged in the future.
  I always feel great sympathy with the Home Secretary of the day. I understand that every day when he goes to the Home Office he sees a calendar on which are marked the day and the names of men who are to be executed. He has to decide whether or not he will advise His Majesty to grant a reprieve. That is a very great responsibility. If these old people are transferred from Howden into an entirely foreign district, away from their relatives and friends, who, through lack of means of transport, cannot visit them, their hearts will be broken, their days will be numbered and death will come upon them more quickly than if they remained as they were. It might well be that, when death ultimately claims these old people—if they are removed to Driffield—perhaps in the hours of darkness in the early morning, the Minister of Health will awake with a start and will wonder at that time why it is that his sleep has been disturbed.
  I suggest that the sensible solution is to keep open the present Public Assistance Institution at Howden, and to build, it may be, a new building, perhaps more centrally situated within the Howden rural district, at a time when bricks, mortar and men are available. We have been told of the great shortage of hospital accommodation. Why, then, close down this public assistance institution? Why move the people into huts at Driffield? If these huts are so much better than a brick building built 100 years ago, why not use them for the extension of the overtaxed hospital accommodation in the country at the present time?
  I can only say in conclusion that, if the Minister has the final word on this question, if he will decide that this institution must remain open until building conditions are more normal, until an opportunity provides itself for building a more modern building still within the area of the Howden rural district, he will earn the gratitude of all those who wish that these 115 old people, who have served their country and their time as useful and valuable citizens, shall spend their last years in comfort, near to their friends and relatives and in the locality where, for years gone by, they have toiled and striven, where they have enjoyed their happiness, where they have endured their sorrows, and where, now, they only ask

  318
  the Minister that they may end their days in peace.
  10.19 p.m.
  The Parliamentary Secretary to the Ministry of Health: This institution was one of a number which the East Riding of Yorkshire inherited from the public assistance authorities as a result of the Act of 1929, and the institution at Howden has for many years been regarded as absolutely unsatisfactory and would have been abandoned before now, at any rate, if the war had not intervened. When it was token over in 1930, its total number of inmates was 73. The number gradually fell before the war, but then, as the result of conditions during the war, its use increased and the number of occupants during the war was certainly rather larger. But as an institution, from the reports given to us, it seems to me to be absolutely unsuited, particularly for anything like a maternity home and ante-natal treatment. Some of the reports that I have had about this place are really astounding. In 1933, for instance, it was described as:
  A small, old-fashioned institution of the mixed sort built of stone and brick in 1839. The buildings face north …there is no separate infirmary…the water supply is not satisfactory and rainwater is stored and used for all purposes. There is a piped supply, but it is very hard water and unfit for drinking. The sewage arrangements are not at present satisfactory…The sick have no sanitary conveniences apart from"——
  Mr. Glossop: The hon. Gentleman is quoting from a report in 1933. Has he had a report as regards water, heating and lighting in 1946?
  Mr. Key: The hon. Gentleman must not be too impatient. I said this was 1933. [Interruption.] If hon. Members are patient I shall be able to get on; if they are not I shall not be able to finish. That was the condition in 1933. It was recognised that Howdenshire was rather isolated, and attempts were made to try to improve the institution. Certain improvements were made and the conditions were a little better. But even now we find report after report emphasising the fact that, even with the improvements, the institution is not one which can be regarded as adequate for the purpose. Another report said:
  I am sure it would be an advantage it maternity cases could be diverted to an in-

  319
  stitution where more suitable facilities are available and where staff arrangements are easier.
  Then, later, the general inspector said that the defects were very numerous indeed, that the place was not suitable for the accommodation of the sick and could not be made suitable except at a cost which would be almost prohibitive in view of the age, condition, etc. of the building. A special committee——
  Mr. Jennings: What date is that?
  Mr. Key: It is 1935. A special committee was appointed to consider the future of the institution and kindred matters. Closure was held to be the only solution. In present conditions the institution is not held to be one that is suitable particularly for the accommodation of maternity cases.
  Lieut.-Colonel Thorp: By whom?
  Mr. Key: By the people responsible for inspecting and reporting with regard to the institution on our behalf. Before the war, as far as maternity was concerned, there was only one maternity bed at this institution. During the war, the accommodation was increased to nine lying-in beds. The county council have never considered setting up a permanent maternity unit at the institution. In 1944 the council put forward proposals to provide institutional maternity accommodation to serve all parts of the East Riding, and whilst these schemes——
  Mr. Glossop: Might I ask what the alternative proposals were? There are geographical features about this matter.
  Mr. Key: If the hon. Gentleman will be patient I will give him that information. The county council put forward, as I say, their general proposals. These included the setting up of a unit of 12 beds at Balby three to four miles North-West of Howden. A unit at the Howden Institution was not contemplated. Then a scheme to convert the first floor of the infirmary at Beverley, 20 miles Nort-East of Howden, to make it into an efficient maternity unit, was under consideration. For that the necessary building work was authorised on 19th February, 1946, and should be completed by July of this year. That will provide 14 lying-in and five ante-natal beds.
  320
  Further, the county council are actively considering setting up a new unit at North Ferriby, 14 miles East of Howden, and on this we are at present awaiting firm proposals. That provision will serve the Eastern part of the Howden rural district. The county council are now actively considering what provision can be made in respect of the Western area when the unit at Howden is closed. The point I want to emphasise is that no date has yet been agreed for the closing of the Howden Institution, and that the Ministry will require to be satisfied that adequate alternative maternity accommodation is available before agreeing to any closure.
  Mr. Glossop: Might I interrupt once more? The Parliamentary Secretary has made it clear that no decision has yet been reached. Might I ask him whether, before the Minister reaches a final decision, he is prepared to hold an inquiry in the locality in which he can meet the local county council, the chairman of the guardians committee, the nine parish councils and 13 doctors?
  Mr. Key: No, Sir, I cannot do that.
  Lieut.-Colonel Thorp: Why not?
  Mr. Key: I can report to the Minister all that the hon. Gentleman has requested, but I cannot undertake on behalf of the Minister to make any promise one way or the other.
  Mr. Glossop: On a point of Order. Surely, the hon. Gentleman is speaking on behalf of the Minister? If he has no authority, why is not the right hon. Gentleman the Minister of Health himself here?
  Mr. Key: We are getting rather excited this evening, are we not?
  Mr. Glossop: On a further point of Order——
  Mr. Speaker: The hon. Gentleman has risen several times, and his last point was not a point of Order.
  Mr. Key: I have tried to explain what the situation is. I have emphasised that no date has been fixed for the closing of this institution. I have said that before the Minister will agree to its closure he has got to be satisfied that adequate alternative maternity accommodation has been provided. I cannot pledge the Minister as to the means which he will adopt to satisfy himself with regard to

  321
  the adequacy of that accommodation. I can only undertake to report to the Minister the request which the hon. Gentleman has made about it, and, surely, to expect me to do more than that is to expect me to exceed the position which I hold at the moment. I do emphasise that the conditions in this institution are not such as to warrant us being satisfied that it should continue normally to be used as maternity accommodation, and I also emphasise that it is rather a misstatement to say that it is an establishment where any ante-natal work of any character is really done, because we feel that the Howden area does not warrant the establishment of an ante-natal clinic. Adequate service is being and will be provided for ante-natal cases by
  322
  domiciliary midwives and by general practitioners The impression that ante-natal work was done there arose when people registered for the use of maternity accommodation and a visit was paid to the people concerned, but that is not the establishment of an ordinary ante-natal clinic. We certainly could not agree that this should be regarded as a satisfactory institution for carrying on ante-natal work, but before we agree to the closure of this institution, we must be satisfied that adequate alternative accommodation has been provided.
  Question put, and agreed to.
  Adjourned accordingly at Twenty-nine Minutes past Ten o'Clock.

ROYAL AIR FORCE

  Ex-Prisoners of War (Asiatics)
  Sir J. Lucas
  asked the Under-Secretary of State for Air if he is aware that there are in England serving with the R.A.F. a number of ex-prisoners of war of Asiatic origin who were imprisoned in Japanese hands from such units as the Singapore Technical Corps of the R.A.F., Singapore, who have been wrongfully sent to this country and should be repatriated to Malaya; and what steps are being taken for their immediate return.

  Mr. Strachey:
  Thirteen of these men were brought here by mistake last autumn. Twelve of them were repatriated by air within a fortnight. The remaining man who has been all the time in hospital, will go back as soon as he is fit to travel again.

  Demobilisation
  Mr. Callaghan
  asked the Under-Secretary of State for Air if he is aware of the dissatisfaction among R.A.F. electricians because of the delay in their demobilisation programme, in view of the fact that certain trades to which remustering took place are now ahead of electricians; what is the average length of postponement of release; and how soon he expects this trade to be level with the general releases.

  Mr. Strachey:
  It is quite true that whereas at the beginning of the release programme last June we had a surplus of electricians, and actually remustered some of them to help, for instance, the clerks, we now have a deficiency, and that they are this month, three groups behind—though this only means from one to two months delay in release. This is an instance of the successive speed-ups of release having upset our re-training programme. I cannot yet give a date when we expect to get them level with the general rate again, but we are now hard at work training electricians.

  Mr. Carson
  asked the Under-Secretary of State for Air whether the release rate in the accounts branch of the R.A.F. is still behind the normal rate; and, if so, how many groups behind.
  16
  Mr. Strachey:
  Airmen in the accounting trades are seven groups behind the general level of release this month. This will be reduced to five groups in June and to four groups in July. Officers in the accounts branch are now six groups behind and I am afraid that this will increase to nine groups next month. For the reasons which I have previously given to the House, the speed up in the general rate of release from group 28 to group 37 as of 30th June next has hit the accountant trades particularly hard. We must keep the accountant trades up to strength or the whole release programme will be thrown into confusion. But we are actively training both officers and airmen, re-mustering, commissioning airmen and generally doing everything we can to help this unlucky trade. I do not want to hold out expectations but we should be over the worst by the autumn.

  JAMAICA (STRIKE)
  Dr. Morgan
  asked the Secretary of State for the Colonies whether he is aware that the members of certain sections of the Bustamante Industrial Trade Union in Jamaica, British West Indies, have threatened to go on strike, especially the wharf workers, if the charge of manslaughter against Bustamante is proceeded with; and what steps he is taking to protect the public in Jamaica from such illegal action.

  Mr. George Hall:
  After an appeal to the strikers by Bustamante himself, work was fully resumed on 15th April.

  HONG KONG (PROPOSED CONSTITUTIONAL CHANGES)
  Mr. Driberg
  asked the Secretary of State for the Colonies whether he has any statement to make on constitutional changes in Hong Kong.

  Mr. George Hall:
  Yes, Sir. His Majesty's Government have under consideration the means by which, in Hong Kong as elsewhere in the Colonial Empire, the inhabitants of the territory can be given a fuller and more responsible share in the management of their own affairs. One possible method of achieving this end would be by handing over certain func-

  17
  tions of the internal administration, hitherto exercised by the Government, to a Municipal Council constituted on a fully representative basis. The establishment of such a Council and the transference to it of important functions of Government might, it is believed, be an appropriate and acceptable means of affording to all communities in Hong Kong an opportunity of more active participation through their responsible representatives in the administration of the territory. But before a decision is taken on the method of giving effect to the intentions of His Majesty's Government it is considered essential that the important issues involved should be thoroughly examined in Hong Kong itself, the fullest account being taken of the views and wishes of the inhabitants. The Governor has accordingly been instructed to examine the whole question in consultation with representatives of all sections of the community and to submit a report at an early date, bearing in mind the policy of His Majesty's Government that the Constitution should be revised on a more liberal basis as soon as possible. The aim will be to settle and to announce not later than the end of this year the principles on which that revision should be based.

  GERMANY (BRITISH NEWSPAPERS AND PERIODICALS)
  Mr. Edelman
  asked the Chancellor of the Duchy of Lancaster whether he will now authorise the admission of British newspapers and magazines to Germany for sale or loan to Germans.

  Mr. J. Hynd:
  Yes, Sir. Under arrangements already in hand British newspapers and periodicals will shortly be made available to certain German newspaper editors, politicians and officials.

ROYAL NAVY

  Auxiliary Hospital, Yarmouth (Staff)
  Dr. Morgan
  asked the First Lord of the Admiralty (I) whether he has considered the rates of pay of the different sections of the male mental nursing staff at the Royal Naval Auxiliary Hospital, Yarmouth, Norfolk, especially the lowest rate of 58s. per week for a 54 hour working week and whether in face of the present
  18
  nursing shortage and the difficulty of obtaining recruits to this staff at this scale of remuneration, he will consider revising the present rates;

  (2) whether it is the intention of his Department to accept immediately the recommendations, made in 1944, of the Rushcliffe Committee regarding the remuneration, etc., of the male mental nursing staff at the Royal Naval Auxiliary Hospital, Yarmouth, Norfolk; what is the reason for the delay in implementing either these recommendations or the promise of his Department to accept them; whether he is aware that representations on these points have been made continuously by the staff or their trade union representatives since August, 1944; that the staff is dissatisfied at the unnecessary delay; and will an announcement as to their acceptance or refusal be made at once.

  Mr. W. Edwards:
  I am aware that representations have been made from time to time on behalf of the staff concerned, and regret that it has not hitherto been possible to provide them with the assurance which they were anxious to receive. I can now say, however, that, subject to certain necessary and reasonable modifications, it is the intention of the Admiralty to apply the recommendations of the Rushcliffe Committee to the staff of this Hospital, and it is hoped that the arrangements to be made for this purpose will be communicated to the authorities concerned in the very near future.

  Motor Dories, Richborough
  Mr. Carson
  asked the First Lord of the Admiralty how many motor dories are now lying idle at Richborough harbour; to what purpose it is intended to put these craft; and whether they will be made available to fishermen in need of this type of vessel.

  Mr. W. Edwards:
  Thirty motor dories, approximately half of which have already been re-allocated, were placed in storage at Richborough as a reserve for training requirements. These particular craft constitute an essential reserve and, I regret, cannot be made available for fishing.

  Falmouth Shipyard (Additional Work)
  Mr. King
  asked the First Lord of the Admiralty if he will divert any craft in

  19
  need of repair to the Falmouth shipyard, in view of the increasing danger of unemployment in the area and of the debt owed by His Majesty's Navy to the workers of that yard for the devoted service they gave throughout the war.

  Mr. Dugdale:
  I have written to my hon Friend on this subject. Enough additional work to keep the labour force at this shipyard properly employed is being provided.

MINISTRY OF WORKS

  Sanctuary Buildings, Great Smith Street
  Brigadier Low
  asked the Minister of Works whether there is sufficient room in the Sanctuary Buildings, Great Smith Street, S.W.I, to house the 550 of the Ministry of Pensions staff who were evacuated to Blackpool in 1939 and who were then promised to return to their home station on the cessation of hostilities; and, if there is no room there or in Government Buildings, Bromyard Avenue, Acton, what steps he has taken to find room for these 550.

  Mr. Tomlinson:
  There is at present insufficient room in Sanctuary Buildings to House the whole of the staff referred to in the Question, but I am arranging by the removal of some of the Ministry of Works' staff to make room there for 100 Ministry of Pensions staff whose early return from Blackpool has been approved. I hope to find room later in Sanctuary Buildings or in Government Buildings, Acton, for a further 200 staff from Blackpool whose subsequent return has also been approved.

  Requisitioned Houses, Cardiff
  Mr. G. Thomas
  asked the Minister of Works how many houses in Cathedral Road, Cardiff, are still occupied by the Welsh Regional Office of his Department; whether alternative accommodation has been obtained; and the number of persons employed at these regional offices.

  Mr. Wilson:
  Six houses in Cathedral Road, Cardiff, are at present occupied by the Regional Office of the Ministry of Food. The staff, which numbers 288, will be removed to a temporary office building, now in course of erection, which is expected to be ready during June.

  Government Buildings, Acton
  Brigadier Low
  asked the Minister of Works which Departments or branches of Departments are, at present, in occupation of the Government Buildings, Bromyard Avenue, Acton; the number of staff in each case; to what extent any part of the buildings is at present unoccupied; and how many persons could be accommodated.

  Mr. Tomlinson:
  The Government Buildings, Bromyard Avenue, Acton, are occupied by the following Departments, the number of staff being shown in each cases:

  Ministry of National Insurance

  2,625

  Ministry of Labour

  264

  Post Office

  505

  Ministry of Pensions

  4

  Canadian Military Authorities

  477

  Ministry of Fuel and Power

  224

  Inland Revenue

  10

  War Damage Commission

  294

  Customs and Excise

  10

  The building is now occupied by 4,413 staff and is being used to full capacity.

NATIONAL FINANCE

  Customs Import Duties (Drawback) Order
  Mr. Lennox-Boyd
  asked the Financial Secretary to the Treasury what is the purpose of the Customs Import Duties (Drawback) Order of 8th April, 1946, Statutory Rules arid Orders, 1946, No. 493; and why no explanatory memorandum was attached to it.

  Mr. Glenvil Hall:
  This Order brings the rate of drawback payable on exported textile bobbins into line with the average amount of duty chargeable at present day values on the imported material used in making them. No explanatory memorandum is considered necessary.

  University Institutions (Recurrent Grants)
  Major Beamish
  asked the Chancellor of the Exchequer what amount of the recurrent grant, excluding the medical grant, was spent by the universities in the last financial year; and what recurrent grant, excluding the medical grant, will be available for the universities to spend in this financial year and the next financial year.

  Mr. Dalton:
  Recurrent grants to university institutions are made in respect

  21
  of the academic year ending 31st July. Excluding the grants for medical education, those so far approved for the academic year 1945–46 amount to £3,739,350. It is not possible to say how much of these grants had been spent by the universities by 31st March, 1946. The amount provided in the Civil Estimates for 1946 for these recurrent grants is £4,150,000, in addition to which a sum of £1,200,000 has been revoted. I cannot yet say what recurrent grants will be provided in the financial year 1947–48.

  VIVISECTION (CANCER RESEARCH)
  Mr. Peter Freeman
  asked the Secretary of State for the Home Department the total number of experiments performed on living animals in connection with cancer research during 1945.

  Mr. Ede:
  The figure for 1945 is not yet available. In 1944 the number was 21,571.

FOOD SUPPLIES

  Cold Storage Facilities, Cardiff
  Mr. G. Thomas
  asked the Minister of Food if he has considered the communication from the Cardiff City Council concerning the cold storage facilities at Cardiff; and whether he will make a statement.

  Sir B. Smith:
  Yes, Sir. The issue is somewhat involved and I therefore attach a copy of the communication and of the reply which I caused to be sent to it on 26th April.

  Following are the communications

  City of Cardiff

  S. Tapper Jones, LL.B., Town Clerk, Clerk of the Peace.

  City Hall, Cardiff. 30th March, 1946.

  SIR,
  South Wales Ports Cold Storage Facilities.Upon instructions from the City Council I have sent a letter to the Cardiff Members of Parliament setting forth a resolution of the Development Committee relating to the South Wales Ports. The resolution is as follows:—"That, in view of the serious position at the South Wales Ports, the Cardiff City Council urges the Minister of Food to take immediate steps to ensure that all imported food supplies for consumption in
  22
  South Wales and its distributive areas are imported through the South Wales Ports, thus utilising the Cold Storage facilities already in existence."My Committee are hoping that the Members of Parliament will be communicating with you as naturally this matter, which has caused concern for such a long time, is one of great anxiety to my Council.A reply at your earliest convenience, giving particulars of the present position would he appreciated.
  I am, Sir, Your obedient Servant,

  S. Tapper Jones Town Clerk.

  Sir Ben Smith, M. P. Minister of Food, London.

  26th April, 1946.

  Dear Sir,
  Sir Ben Smith has asked me to reply to your letter of the 30th March.He has given careful consideration to the resolution of the Cardiff City Council and he has every sympathy with the spirit in which it was adopted.The primary consideration which determines port of discharge must be to make the best use of inland transport facilities and avoid delays in transit. The consumption of refrigerated produce in the South Wales area is low and the distribution of imports to the large consuming areas is more effectively dealt with through other ports To import solely through South Wales ports "for consumption in South Wales and its distributive areas" would, because of steamer tonnages, involve considerable transport movements in areas in proximity to other ports or alternatively heavier cold storage holdings with the possibility of subsequent movements from South Wales Cold Stores to areas which are served more economically from ports.In this matter Sir Ben Smith feels he must consider the wider national interest, but the claims of South Wales are always in mind and in the past when suitable shipments have been available for distribution there they have been discharged at South Wales ports.Yours faithfully,G. S. Bishop,Private Secretary.S. Tapper Jones, Esq., LL B.,Town Clerk,City Hall, Cardiff.

  Pilchards
  Mr. King
  asked the Minister of Food what steps he proposes to take with regard to the sale of pilchards bought at Mevagissey at 2S. a stone for bait and sold in Newlyn at 6s. a stone.

  Sir B. Smith:
  A sale of pilchards for bait at 6s. per stone would infringe the Fish Maximum Prices Order. No reports of such dealings have reached my Depart-

  23
  ment, but, if my hon. Friend will send me details, I will have the matter investigated.

  Mr. King
  asked the Minister of Food if the operations of U.N.R.R.A. in the purchase of pilchards at Mevagissey are likely to continue or what other buying agency he proposes to set up in order to ensure that there is a ready market for surplus fish caught

  Sir B. Smith:
  U.N.R.R.A. has given notice that it will not be able to accept cured pilchards delivered after 30th November next; I am at present considering other means of marketing the surplus pilchard catch after that date.

  COLONIAL TERRITORIES (EMERGENCY POWERS)
  Mr. De la Bâre
  asked the Secretary of State for the Colonies whether, in connection with the Emergency Laws (Transitional Provisions) (Colonies, &c.) Order in Council, 1946, he has issued any instructions to Colonial Governors stressing the desirability of revoking as soon as possible all regulations the continuance of which is not essential to good government.

  Mr. Georǵe Hall:
  Since 1943 the power taken under emergency legislation in Colonial territories have been kept under constant review and instructions have from time to time been issued to secure the revocation of regulations no longer required. This was emphasised in September, 1945, when instructions were issued that all regulations not required after the end of hostilities should be revoked. It was not necessary to repeat the earlier instructions specifically when the Order in Council referred to in the Question was made.

TRADE AND COMMERCE

  Newsprint
  Major Legge-Bourke
  asked the President of the Board of Trade if he aware that supplies of newsprint destined for Britain from Canada and Newfoundland may be diverted to the U.S.A. or account of exchange difficulties; whether this is likely to affect the present allocation of newsprint to British journals; and what steps he is taking to ensure that such supplies are not diverted.
  24
  Mr. Marquand:
  For exchange reasons we cannot afford as much newsprint as we should like, but there is no reason to suppose that sufficient will not be available to maintain the present allocation.

  Works of Art (Export Licences)
  Viscount Hinchinǵbrooke
  asked the President of the Board of Trade how many licences for the export of works of art and articles more than 75 years old were applied for in each of the years 1940 to 1945, inclusive; and what values were assigned to these applications.

  Mr. Marquand:
  The answer to the first part of the Question is given in the following table:

  year

  Number of applications.

  1940

  2,520

  1941

  5,710

  1942

  4,390

  1943

  4,840

  1944

  5,600

  1945

  7,310

  I regret that the information sought in the second part of the Question is not readily available and could not be obtained without an undue expenditure of time and labour.

  Viscount Hinchingbrooke
  asked the President of the Board of Trade what was the value in each of the years 1940 to 1945 inclusive, of licences granted for the export of works of art and articles more than 75 years old, without reference to gallery and museum authorities, and after reference, respectively; and what was the value of applications for licences to which objection was taken by gallery and museum authorities.

  Mr. Marquand:
  I regret that the information sought is not readly available and could not be obtained without an undue expenditure of time and labour.

  American Cotton (Imports)
  Sir W. Smithers
  asked the President or the Board of Trade how many bales of United States cotton were imported in each 12-monthly period since Lend-Lease began; what was the total loss to the taxpayer between the purchasing price and selling price including cost of freight, insurance, administration and all other costs; and if he will show the profit on the 600,000 of barter cotton, separately.
  25
  Mr. Marquand:
  The United State Government is not calling upon His Majesty's Government to pay for any of the cotton imported since Lend-Lease began, other than that part which remained in our stocks on 2nd September 1945; and there is no loss to the taxpayer The number of bales of American cotton imported under Lend-Lease is as follows:

  Year ended

  31st March, 1942

  506,574

  31st March, 1943

  607,909

  31st March, 1944

  1,140,800

  31st March, 1945

  562,333

  Six months ended 3oth September, 1945

  326,154

  With regard to the last part of the Question, profits on the sale of barter cotton amounted to about £1000,000.

  AIRCRAFT PRODUCTION (TUDOR II)
  Mr. Douglas Marshall
  asked the Minister of Supply when the Tudor II will be put into operation; and at what rate will these machines he delivered up to 31st December, 1946.

  Mr. Woodburn:
  Various technical difficulties have delayed the production of the Tudor II. Trials are now being carried out with the prototype model and if, as we hope, these are satisfactory, the first production aircraft is expected to be handed over in September next. From then on, the production rate will progressively increase. I am assured by my Noble Friend, the Minister of Civil Aviation, that these aircraft will be brought into service without delay after the necessary training and development flights by the operators.

  NATIONAL FIRE SERVICE (PERSONAL CASE)
  Mr. Norman Smith
  asked the Secretary of State for the Home Department whether he is aware that an application to join the N.F.S. has been refused to Mr. F. W. Smith, of 20, Park Street Nottingham, on the ground that he wears glasses; and if he will reconsider the application in view of Mr. Smith's long and satisfactory service as a fireman, including the period of the Normandy beachhead.
  26
  Mr. Ede:
  I have again carefully considered this case but I regret that, for the reasons which I have explained in correspondence with my hon. Friend, it is not possible to accept Mr. Smith's application.

  FIRST POLICE RESERVE (WAR SERVICE)
  Mr. Renton
  asked the Secretary of State for the Home Department whether he will consider making some financial provision whereby recognition may be given to the war service rendered by members of the First Police Reserve, apart from the ordinary pay which they were receiving while serving.

  Mr. Ede:
  I have considered the question of paying a war gratuity to members of the First Police Reserve, but I have felt bound to adhere to the principle adopted for the civilian Services, under which payment of war gratuity is limited to those who served under Civil Defence conditions and whose rates of pay were consequently related to Army rates. The First Police Reserve were not so employed and do not, therefore, qualify for the gratuity.

PUBLIC HEALTH

  Rural Water Supply, Norfolk
  Mr. Medlicott
  asked the Minister of Health how many and which parishes in each rural district in the county of Norfolk are without a pressure piped water supply; and whether he is satisfied with the water supply to the rural areas of Norfolk, generally.

  Mr. Bevan:
  I append a statement showing how many and which parishes in the rural districts of Norfolk are without, or substantially without, a piped water supply. The statement shows how unsatisfactory the water supply position in the rural areas of the County is, and I am encouraging the local authorities to press forward as urgently as possible with schemes for the provision of piped supplies in these districts.

  Following is the statement
  27 28

  COUNTY OF NORFOLK.

  Name of Rural District

  Parishes without, or substantially without a piped supply.

  Number

  Names

  Blofield and Flegg

  26

  Acle, Ashley-with-Obey, Beighton, Blofield, Brundeh, Burlingham, Caistor West, Cantley, Fleggburgh, Freethorpe, Halvergate, Hemblington, Martham, Mantley, Plumstead, Potswick, Reedham, Repps with Bastwick, Ralsby, Somerton, Stakesbey, Strumpshaw, Thurne, Upton with Fishley Walsham South Woodbastwick.

  Depwade

  33

  Aldburgh, Ashwellthorpe, Asbaston, Bressingham Brockdish, Bunwell, Burston, Carleton Rode, Denton, Dickleburgh, Earsham, Formsett, Gissing, Hempnall, Morning Thorpe, Maulten St. Michael, Needham, Pulham St. Mary Magdalen, Pulham St. Mary the Virgin, Royden, Scarle, Shelfanger, Shilton, Sharston, Tackalneston, Tasburgh, Thurston, Tibenham, Twitshall St. Margarets, Twistshal St. Mary, Wacton. Winfarthing Wartwell.

  Docking

  23

  Anmer, Bagrhorpe-with-Barmer, Barwick, Bircham, Brancaster, Burnham Market, Burnham Norton, Burnham Overy, Burnham Thorpe, Chaseley, N. Creake, S. Creake, Holme, Haughton, Hunstanton, Ringstead, E. Radham, W. Radham, Shurnborne. Stanhoe. Syderstone, Thornham, Titchwell.

  Downham

  Barton-Beamish, Boughton, Runcton, Shouldham, Shouldham Thorpe. Southey Stradsett Tottenhill West Derham.

  Erpingham

  44

  Alby-with-Thwaite, Aldborough, Artingham, Aylmerton, Baconsthorpe, Bodham, Colby, Corpusty (with Saxthorpe), Cley-next-the-Sea, Edgefield, Erpingham, Felbrigg, Gimingham, Gresham, Hanworth, Hemstead, Ingworth, Itteringham, Kelling, Letheringbett, Glandford, Plumstead, Roughton, Salthouse, Southrepps, Stody, Suffield, Sustead, Thornage, Thorpe Market, Trirmingham, Upper Sheringham, Weybourne, Wickmere and Wolterton, Bessingham, Banningham, Banningham Little, Banningham Norwood, Banningham Winter, Beckham East, Beckham West Calthorpe Gunton, Mannington, Matlaske.

  Forehoe and Henstead

  36

  Barford, Barham Broom, Bawburgh. Bixiey, Braconash, Braemerton, Caistor St. Edmunds, Colney, Deopham, East Carleton, Easton, Flardon, Framingham Pigot, Great Melton, Hetherskett, Holverston, Keswick, Ketteringham, Kimberley-Carleton-Forehoe, Kurley Bedon, Little Melton, Marlingford-Calton, Marley, Mulbarton, Newton Flatman, Rockland St. Mary, Runhull, Saxlingham Nethergate, Shatcheham, Stoke Holy Cross, Surlingham, Swainsthorpe, Swardeston, Wicklewood, Wramplingham, Wreningham.

  Freebridge Lynn

  15

  Bawsey, Castleacre, Congham, Gayton, Grimston, Harpley, Little Massingham, Middleton, Pentney, Roydon, North Runcton, East Waltson, Westacre East Winch West Winch.

  Loddon

  37

  Turton, Ashby St. Mary, Bergh Apton, Ditchingham, Woodton, Loddon, Chedgrave, Seething, Norton Sub-course, Thurston, Hales, Haddiscoe, Tuft Monks, Topcroft, Bedlingham, Broome, Kirby Caen, Ellingham, Geldestone, Gillingham, Burgh St. Peter, Howe, Aldeby, Alpington, Carleton, Claxton, Heckingham, Hedenham, Hellington, Langby-Hardby, Mundham, Raveningham Sisland. Stockton Thwaite. Wheatacre. Yelverton.

  Marshland

  Walsoken.

  29 30

  Name of Rural District.

  Parishes without, or substantially without a piped supply

  Number.

  Names.

  Mitford and Launditch

  47

  Bawdeswell, Beeston, Bootley, Billingford, Bintree, Brisley, Bylaugh, Colkirk, Cranworth, Dunham Great, Dunham Little, Elmham North, Elsing, Foxley, Framsham, Garvestone, Gateley, Gressenhall, Guist, Hardingham, Hockering, Hoe, Horningtoft, Kimpstone, Lexham, Litcham, Longham, Lyng, Mattishall, Miliham, Rougham, Searning, Shipidham Sparham, Stanfield, Swanton Rarley, Littleshall, Tuddenham East, Tuddenham North, Twyford, Weasenham St. Peter, Weasenham All Sts., WeHingham. Wendling, Whenburgh, Whessonseth Yaxham

  Smallburgh

  33

  Ashmonhaugh, Bacton, Barton Turl, Brunstead, Catfield, Dilham, East Ruston, Felmingham, Happisburgh, Haviton, Hickling, Honing, Horning, Horsey, Ingham, Lessingham, Ludham, Nealishead, Palling, Paston, Potter Heigham, Scatton, Skeyton, Staley, Smallburgh, Sutton, Swalfield, Swanton Abbott, Trunch, Tunstead Westwick, Witton, Worstead.

  St. Faith's and Aylsham

  38

  Aldeford, Attlebridge, Belaugh, Buston St. Andrew Blickling, Booton, Brampton, Brandiston, Buxton with Lamas, Cawston, Crastwick, Felthorpe, Faulsham, Frettenham, Guestwick, Hainford, Harsford, Harstead Haveringland, Heydon, Honingham, Marton, Ou1ton, Rackheath, Rupham, Rugland, Salhouse, Sall, Shatton Strawless, Spixworth, Swarrington, Taverham, Themelthorpe, Tuttington, Weston, Lernguille, Witchingham Great, Witchingham Little, Wood Dalling.

  Swaffham

  29

  Ashill, Beechamwell, Bradenham E., Bradenham W. Cockley Cley, Cranwich, Cressingham Great, Cressingham Little, Didlington, Foulden, Gooderstone, Holem Hale, Ickburgh, Lynford, Milborough, Mundford, Narborough, Narford, Necton, Newton-by-Castleacre, Oxborough, Packenham W., Packenham S., Saham Toney, South-acre, Sparle, Stanford, Sturston, Weeting.

  Walsingham

  35

  Barsham, Binham, Birningham, Blakeney, Brinton Briston, Dunton, Field Dalling, Fulmodestone, Gunthorpe, Helhaughton, Hindalvestone, Hindringham, Hulkham, Kettlestone, Langham, Marston, Pudding Norton, Raynham, Gt. Ryburgh, Little Ryburgh, Sculthorpe, Great Snoring, Little Snoring, Stibbard, Stiffkey, Swanton Novers, Tattersett, Thurning, Gt. Walsingham, Little Walsingham, Warham, Wighton Wiveton, Wood Norton.

  Wayland

  24

  Great Ellingham, Little Ellingham, Rocklands, Caston Griston, Carbrooke, Ovington, Besthorpe, Hockham, Bridgham, Stow Bedon, Merton, Wretham, Tuttington, Eccles, Shrepham, Roudham, Kilverstone, Scaulton, Snitterton, Thompson Riddlesworth Brettenham B'o' Norton

  Cancer (Statistics)
  Mr. Peter Freeman
  asked the Minister of Health the number of deaths from cancer in England and Wales during 1945; and the proportion of the crude death rate from cancer per 1,000,000 living persons during 1945.

  Mr. Bevan:
  The number of deaths from cancer in England and Wales during 1945 was 73,754; this represents a crude death rate of 1,945 per million living. These figures are provisional and relate only to civilians.

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

LONDON MIDLAND AND SCOTTISH RAILWAY BILL. [H.L.]
Read 3a, and passed, and sent to the Commons.

VICTORY PROCESSION.
EARL HOWE: My Lords, I beg to ask the question standing in my name.
[The question was as follows:
To ask His Majesty's Government whether it is intended to make any special arrangement to enable the children of members of both Houses of Parliament to see the Victory procession.]
THE LORD CHANCELLOR (LORD JOWITT): My Lords, no special arrangements are being made to enable children of members of either House to see the Victory procession. A certain amount of accommodation in the small reserved enclosures in the Mall has been allocated to both Houses of Parliament, and special standing places in Bridge Street will also be reserved for them. It will be open to members of the Legislature who receive tickets to utilize one of these for a child.

RECOGNITION OF U.S.A. MILITARY LEADERS.
LORD CROFT: My Lords, I beg to ask the question which appears in my name on the Paper.
[The question was as follows:
To ask His Majesty's Government whether the Government of the United States has given any special recognition to the successful Generals and Admirals in the United States Forces in the recent war and whether such recognition involves full pay for life
1010
in the grade in which they were serving at the conclusion of hostilities.]
THE PARLIAMENTARY UNDER-SECRETARY OF STATE FOR WAR (LORD NATHAN): My Lords, His Majesty's Government have no information beyond that contained in the report of a Press conference by the President of the United States which was to the effect that it was proposed to grant the permanent rank of General of the Army to four American General Officers and the permanent rank of Fleet Admiral to four American Admirals. One other General Officer and one Admiral had been proposed for four-star rank. It was not stated whether or not these appointments will carry full pay for life.
LORD CROFT: My Lords, in view of the reply of the noble Lord, may I ask if it is not possible to inquire from our Ally, the United States, whether it is a fact—because it appears to be generally understood in the United States of America—that five-star Generals and Admirals who were the great leaders in the war, are granted permanent rank. Could not that point be clarified, and if it is so, could not we also reconsider the decision recently made with regard to our own victorious war leaders?
LORD NATHAN: It is assumed that the statement of the President of the United States means that what we should regard as substantive rank has been granted as distinct from temporary rank, but I will certainly cause the inquiries, for which the noble Lord asks, to be made.

N.A.A.F.I. SUPPLIES.
VISCOUNT SWINTON: My Lords, I beg to ask the question in the name of my noble friend Viscount Stonehaven.
[The question was as follows:
To ask His Majesty's Government whether the value of goods, materials and supplies sent to N.A.A.F.I. establishments overseas are included in the Board of Trade monthly export figures in addition to similar figures for U.N.R.R.A.; if this is so, what was the value so included for the months of January, February and March, 1946; what is the reason for including among commercial export

1011
figures the value of such supplies sent to, and consumed by, our own Forces and goods, etc., sent for relief of distressed persons which have no normal commercial significance.]
LORD PAKENHAM: My Lords, shipments of goods to N.A.A.F.I. establishments abroad are included in the export statistics. These goods are not at present recorded separately, but the question of keeping a separate record is being considered. A precise figure of their value in any month cannot be given, but it is understood from N.A.A.F.I. that in the first three months of 1946 the average monthly value of such export was about £5,000,000. These supplies are regarded as exports of United Kingdom produce, since they form part of the United Kingdom production and are sold abroad. As regards U.N.R.R.A. supplies from this country, shipments now are primarily for rehabilitation, and not for the relief of distressed persons. As such they can be treated as similar in kind to other exports.

TRADE DISPUTES AND TRADE UNIONS BILL.
2.41 p.m.
Debate resumed (according to Order) on the Motion of the Lord Chancellor, made yesterday, That the Bill be now read 2a.
LORD LLEWELLIN: My Lords, I am one of those who had the privilege of listening to practically the whole of our interesting debate on this 'matter yesterday, which started, if I may say so, with two brilliant speeches—one from the noble and learned Lord Chancellor and the other from one of his predecessors from this Bench. I also had the privilege of hearing the noble Lord, Lord Walkden, speak at the end of the debate. Anybody who knows him, as I have had the privilege of doing for some years now, and who heard his speech yesterday, cannot fail to be impressed with his sincerity. He feels, as do other trade union leaders who were concerned with the General Strike of 1926, that some stigma was cast upon them by the Act which it is now sought to repeal. I must say that I, for one, have never felt that any stigma attached to them, or that they were in any way branded as the result of the action that they took in 1926.
1012
I pride myself that I have many friends in the trade union movement. There are many, indeed, with whom I have been glad and proud to work. In my first Government job as Civil Lord of the Admiralty it was my duty to preside over the Admiralty Industrial Council, and when I went, in the early days of the war, to the Ministry of Supply, I happened to be the prime mover in starting the Trade Union Advisory Committee to that body. Nor could anyone need better support than I had from the trade union leaders throughout the difficult days when I was at the Ministry of Aircraft Production. The same applies to the Ministry of War Transport and the later period when I relied on a Trade Union Advisory Committee at the Ministry of Food to advise me—and good advice they always gave—on the feeding of industrial and agricultural workers. Never, when I met these men or, indeed, when I sat at the Cabinet table with some of my colleagues in the Coalition Government, did I have in my mind any such thought as: "Oh, there is some stigma upon you." I believe this stigma is realy a fiction of their own imagination. It may be—who knows?—that it is just a slight stirring of a guilty conscience. But at any rate, if stigma there is—I do not know that there is—it is a stigma because the Courts of Law of that time declared that this strike in which they had been the leaders was an illegal strike. It does not matter, so it seems to me, what the noble and learned Lord Chancellor or ex-Lord Chancellors may say, nor what Professor Holdsworth nor Professor Goodhart, nor any of those eminent legal luminaries, may say: the decision remains. It is the only decision that can decide the matter, the decision of a Court of Law, and a decision which was never appealed against and which remains, therefore, an abiding decision as to what that strike in fact was. The repeal of a subsequent Act in no way removes that stigma, if stigma there be.
I myself think that the action taken at that time was an error of judgment, perhaps a grave error of judgment. I do not know that I would use such strong words as the Lord Chancellor used about it in his speech to us yesterday. I think perhaps their hearts ran away with their heads, and that they did not really realize what the constitutional effect would be. It was quite clear that it was a failure.

1013
It was a failure because we are a democratic country, and we believe in Parliamentary government. The people were not going to be held up by the dictates of a few men, whether they included Mr. Cramp or not. They were not going to be prevented from getting to their work. They were not going to be starved into submission. Indeed, they showed the same spirit as the people of this country showed in the days of Dunkirk, and in the days when we were expecting an invasion of our shores.
I was in no way concerned with this legislation of 1927. I myself, as many good citizens did, worked during the General Strike. I remember that one of the efforts made by the strikers was to prevent petrol coming up from Thames Haven to London. It was essential, of course, if food and milk deliveries were to be made, that petrol supplies should be available. I joined up with a fairly tough gang of Rugby football players. We went down, and we soon assaulted the barricade. It is quite true there were a number of bricks and stones thrown at us, but that was nothing compared with the rifle and machine gun fire that a few of us had been through a year or two before, in the European war. At any rate we cleared the place, and I would do it again against anyone who attempted to prevent essential supplies reaching the people of this country.
I do not believe that these supplies should only reach the people, as we saw on some of the lorries at that time, "by kind permission of the T.U.C.", any more than I believe we should be dependent on their getting through by kind permission of Hitler, Mussolini or any other dictator. The T.U.C. has a great part to play in this country, but it is not that of holding the country up to ransom. Indeed, I believe that the present—and I underline the word "present"—holders of responsible positions in the T.U.C. realize that full well. I was rather surprised at the speech which we heard yesterday from the noble Lord, Lord Lindsay. As far as I can understand him, he was advocating the revolutionary strike on certain occasions. He instanced that it might have been effective in 1933, when Hitler came into power in Germany.
LORD LINDSAY OF BIRKER: May I just ask the noble Lord, does he not think the people ought to have struck against Hitler?
LORD LLEWELLIN: I was just coming, of course, to that. We must realize that Hitler's original movement had the great support of the Left in Germany. There was no leader in the Hitler organization who was a leader from the old Prussian Right and they were, it is quite true, a set of gangsters. But the main support that they received was at that time from the extreme Left, rather than from the Right.
LORD LINDSAY OF BIRKER: May I just interrupt the noble Lord again? The original and early support for Hitler came from what people call suburbia, the lower-middle classes and the peasants. It was not from the trade unions at all. That really is the case.
LORD LLEWELLIN: Do not let us ignore the peasants at all. They are a very big factor in the life of any country.
THE SECRETARY OF STATE FOR DOMINION AFFAIRS (VISCOUNT ADDISON): They were not trade unionists.
LORD LLEWELLIN: Of course not. Certainly not trade union leaders. They were shortly afterwards abolished. What I was saying was this, that it was at that time largely based on the reaction of the Germans who wanted the kind of place in the sun which Hitler his movement promised them, and it was at that time a very big movement in Germany, springing quite largely perhaps from suburbia as well, but at any rate from large sections of Left opinion in the German nation.
VISCOUNT ADDISON: No.
LORD LLEWELLIN: Anyway, let me come to the French case, which the noble Lord also took, with regard to why you could not have had a revolutionary strike in France in 1940, as I understood it. That seemed to me, if I may say so, to be quite an absurd suggestion. In the midst of the war, when we were doing our best to keep France in the war, the worst thing for the French nation at that time, when things were just in the balance, would have been to have had a General Strike taking place which would have paralyzed all movement in France in the midst of the German invasion.
LORD LINDSAY OF BIRKER I am sorry—LORD LINDSAY OF BIRKER I am sorry—
SEVERAL, NOBLE LORDS: Order, order.
LORD LINDSAY OF BIRKER: I quoted a distinguished Frenchman who deplored the fact that there was not a General Strike in France after the Pétain Government had resolved not to go to Africa, and the war was over. It may have been my fault.
LORD LLEWELLIN: The noble Lord did not make it clear.
LORD LINDSAY OF BARKER: I beg your pardon.
LORD LLEWELLIN: The noble Lord did not quote a date at all. I thought he was referring to the crucial moment just before the surrender of France. Be that as it may, at any rate if I may say so, do not let us in this county have responsible people advocating revolutionary strikes. We have here a Constitution which can provide for the kind of thing the noble Lord had in mind. We always have had a constitutional monarchy in this country, and it is still the prerogative of the Crown to dissolve Parliament and to dismiss the Government of the day should occasions arise of such a nature as was envisaged by the noble Lord in his speech yesterday. That is the outlet that we have in our Constitution. It is a very valuable one. It obviously would not be exercised except in the last resort, but it is a great thing that we still have it in our Constitution.
Before I digressed slightly to refer to the noble Lord's speech yesterday, I was saying that I believe the present holders of responsible positions in the T.U.C. realize full well that the General Strike is not a weapon which they wish to use. But let me see where we stand in this matter. Their tenure of office is by no means secure. The numerous unofficial strikes which we have been having in industry give a clear indication of that to those who like to see it. Many of them, I suspect, are slightly apprehensive as to what is going to happen at the Trades Union Conference at Whitsuntide. I know there are doughty opponents quoted by the noble Lord, Lord Walkden, who will be there to fight against the Communist dictation of the trade union movement. This time they may succeed. I hope they will. But how do any of us know what lies ahead in the future? They hope to frustrate the Communist Party by passing a resolution saying, as I understand it, that there is to be no more affiliation by any outside
1016
body with the Trades Union Congress. But if they succeed this time, what is to prevent that resolution being over-ruled later on? The trade union movement may, for all one knows, quite properly, get sick to death of those who are associated with the present Government if they go on as they are at present. I just throw out that thought, and leave it in the minds of noble Lords opposite.
In my view the Government are making a great mistake from their own point of view in introducing this Bill. They may consider that it removes a stigma, if there was one; if there was not, the Bill could not remove it. If the Bill is brought in because Mr. Clynes, speaking in the House of Commons in 1927 said that they would repeal the 1927 Act when they got a chance, it does of course show commendable conservative instinct to adhere to that declaration of 1927, but it does not appeal to me as a progressive Tory, as I claim to he. If it is said that it is because there is strong pressure for it in the country, I do not believe it. Lord Walkden said (and I know that it is true) that the general number of those whom he meets—he probably meets no more working men than I do, because I meet a lot—are in favour of this repeal. But, of course, he will meet active Labour Party organizers in the movement, who naturally are in favour of it. Actually, as one sums up the country, there is not much interest whether this Act is repealed or not. It has not caused any great stir in the countryside.
We had an interesting speech yesterday from Lord Chorley. He told us that the 1927 Act destroyed very many privileges of the trade unions. It is just as well to look at the Act and see what those privileges are which it is said to have destroyed. First, there is Section I. That enables a man to know whether or not a contemplated strike will or will not be illegal. The noble Lord, Lord Walkden, said that we all know what is and what is not an illegal strike. I am going to be the first to disagree with him, because I am convinced that he did not himself know in 1926 that he was taking part in an illegal strike, and vet the Court—did he?
LORD WALKDEN: I thought I was doing right.
LORD LLEWELLIN: And yet the Court, and the only Court which made a declaration with regard to that strike, said that he was doing something illegal. The Lord Chancellor told us, talking about the General Strike of 1926, that he believed that the judgment of posterity would be that before the 1927 Act the question whether a man was acting illegally, or was liable in damages, depended upon the answer to a comprehensive question of fact as to whether he was or was not acting in furtherance of a trade dispute. One man might have been found guilty, having regard to speeches he made, whilst another one would not. It is to that position that we are returning by the repeal of this 1927 Act. So it seems that the first privilege we are going to give back to trade union leaders is that of not knowing, as they did not know in 1926, whether they are doing anything illegal or not. To me that does not seem much of a privilege to give back to them.
Moreover, at the same time we are repealing a valuable little provision of Section 1 of the Trade Disputes Act, 1927, which says this:
"Provided that no person shall be deemed to have committed an offence under this section or at common law by reason only of his having ceased work or refused to continue to work or to accept employment."
By repealing the 1927 Act, we are taking away a protection given to the mere striker who does not instigate the strike. And now let us find out what Section 2 does. What privilege does this take away? It takes away from the man who refuses to do an illegal act the privilege of not being expelled from his union and of not being fined by his union because he fails to take part in an illegal act. So the only privilege taken away from the trade unions under this section is the privilege of expelling or fining the man who refuses to do an illegal act at their behest. What an odd privilege to seek to restore to the trade unions.
When we come to Section 3, we are all agreed that Section 3 (1) merely codifies the existing law in regard to the prevention of intimidation. So after the repeal of the 1927 Act, all that will happen is that the people will have to look through the Statutes to find out what the law is in regard to subsection (1), instead of the pickets being able to refer to it in a convenient consolidated form. That is all we are doing by repealing Section 3 (1) of this
1018
Act. Now I come to Section 3 (4). There seems to be some dispute as to exactly what that subsection, when it is repealed, will leave behind it. It will leave behind the words in the Act of 1875 which, if the House will allow me, I will read. Section 7 says:
"Every person who, with a view to compel any other person to abstain from doing or to do any act which such other person has a legal right to do or abstain from doing, wrongfully and without legal authority,—…
"watches or besets the house or other place where such other person resides…"
But that was altered by the Act of 1906. Section 2 of that Act said, in subsection (1):
"It shall be lawful for one or more persons, acting on their own behalf or on behalf of a trade union or of an individual employer or firm in contemplation or furtherance of a trade dispute, to attend at or near a house or place where a person resides or works or carries on business or happens to be, if they so attend merely for the purpose of peacefully obtaining or communicating information, or of peacefully persuading any person to work or abstain from working."
Subsection (4) of Section 3 of the 1927 Act absolutely prohibited a person from attending at a house or place to persuade a person at his home. So by doing away with this subsection (4) we are restoring to pickets the doubtful privilege of not knowing whether or not they are doing something lawful in going to a man's house.
I must say I have no idea, putting together those two sections which I have quoted, what exactly it is lawful to do, and what it is not. I am one of those who think that it should be said quite clearly to be wrong, without a shadow of doubt, to go and badger a man or his family at his own home. I frankly could not understand Lord Lindsay's remark about this 1927 Act being a totalitarian Act. The repeal of this section savours to me much more of the methods used by the Gestapo than anything to which we are accustomed in this country. If the cause is not good enough of itself to show a man that he should cease work, surely the method of going to his home and trying to persuade him there, standing outside, round about the house, is not one to which we should resort in a free country of this sort.
Of course, when we come to Section 4 of the 1927 Act, there is something in Lord Chorley's complaint that we are

1019
taking a privilege away. And what privilege is it that we are taking away? The privilege of getting from unwilling subscribers subscriptions to the political funds of one party to which a trade union is affiliated. That is the privilege that is taken away and which it is sought to restore. Lord Walkden told us that the contracting-in procedure was very troublesome. Troublesome, I would like to ask, to whom? To the trade union secretary and the shop stewards who have to collect the money. But the method of contracting out will be troublesome to a far larger number of men than that. They will be approached and told, "Oh, now you have to pay." The man may ask, "Why?" The reply will be, "Because you have not filled up a form; you have not filled up the form to contract out." He then says, "What? another form?"—with that instinctive horror of filling up forms to which the noble and learned Lord on the Woolsack has referred. He says: "Another form to sign? Why is this?" And if they are honest they will say: "Because this is the jolly provision that a Socialist Government has imposed upon you."
That is certainly so, because at the present moment a man who does not want to pay has not to fill up any form—and we have heard that there are hundreds of such men. After all, it has been estimated on two sides of the House that the amount of these subscriptions, which are not, perhaps, very large, is £25,000 and that represents a good number of men who, if they still do not want to pay, will have to fill up the forms—I repeat—because of the action of the Socialist Government in this country. And although the people in the country may be indifferent now, a number of them will, I think, he properly indignant when it comes to taking hard cash out of their reluctant pockets.
And what is the principle behind it? I think Lord Calverley touched upon it in our debate yesterday. The contracting-in method is the voluntary system; contracting out is conscription with a conscientious objector's clause. It is odd to me, when I look back over the years, to find that a Party which voted en bloc in the House of Commons, only four months before the late war broke out, against compulsory military service because they objected to it on principle, do not object
1020
to that principle when it comes to collecting money for their own funds.
I would like to ask one other thing. When were these resolutions passed by these trade unions affiliating them to the Labour Party? In many cases they were passed before the birth of many of the existing subscribers. That, at any rate, cannot have happened to Lord Lindsay with regard to his subscription to the Automobile Association. What is to prevent any of the trade unions, especially those which are going to vote for the admission of the Communist Party to the TALC., passing a resolution saying that they will in future be affiliated to the Communist Party rather than owe allegiance to the very friendly but perhaps in the main somewhat elderly noble Lords whom I see sitting opposite me? Then indeed my noble friend Lord Walkden might have the troublesome job of getting people to contract out because the shop stewards would not then be around the works doing the job for him. This is a privilege which the passing of this Bill may ultimately confer upon the noble Lord, and I wish him good luck if it does so.
When I come to Section 5 I see clearly what privilege its repeal gives to the civil servants. It gives them the privilege of serving two political masters. We have it on the highest authority that the serving of two masters is impossible, so this seems to me to be a doubtful privilege, to say the very least of it. Let us look at Section 6. The repeal of Section 6 will accord a privilege to the trade unions, but a privilege hardly known outside a dictator country—namely, the privilege of putting pressure on a local authority to employ none but members of a trade union. What jolly scenes does that envisage between the Municipal Workers Union and the Transport and General Workers Union! I know from experience the difficulties involved in some of these demarcation problems. If I may digress for a moment, we found at the Admiralty, when we wanted to build or repair a ship, that a bit of tubing which was so much in diameter had to be laid by the members of one union, but if it narrowed down, then, as it lost more of its electrical leads, some other union had to come in. What an awful row there would have been if one union member had followed that tube all the way through! At any

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rate, we may see quite a healthy competition springing up between various unions in the nomination of local Labour councillors—the nomination, not the election—in order that one union or other may have the privilege of the membership and the subscriptions of the employees of the local authority, who will lose their jobs unless they join the designated union.
The repeal of this section gives another privilege. It gives the trade unions the privilege of putting pressure on local authorities to put pressure on independent prospective contractors to put pressure on their reluctant employees to join this great spontaneous, free-will, trade union movement. That is one of the privileges which will be restored by the repeal of the 1927 Act. The noble and learned Lord, the Lord Chancellor, said that Section 5 of the 1927 Act, which demanded undivided loyalty to the State, seemed to him to savour too much of the Führer principle, but to any impartial man does not the repeal of Section 6 look mighty like the Hitler Labour Front? I would remind your Lordships that under Hitler's plan nobody could be certain of a job unless he belonged to the Nazi Labour Organization, and nobody in this country in future can perhaps be certain of a job unless he joins a trade union. Take my own case at home, where, if I may so say, the gardeners I employ are perfectly happy, as no doubt are those employed by other noble Lords. They are not members of a trade union; they do not need to be. As a patriotic action during the war we ploughed up our tennis courts, we increased the size of our garden and we sold the produce to the local British restaurant and for the feeding of the school children. If the local authority had a Labour majority and said to me: "You must force your gardeners to belong to a trade union, which can give them no benefit whatever," I should say: "Certainly not, I would sooner put my tennis courts back to grass and put the herbaceous plants back where the cabbages now grow." Do not let us try to force the people of this country all into one mould. It is against the instinct of the country and any tendency to do it is, in my view, completely wrong.
So these are the privileges that this movement demands to have returned to
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it. These are the privileges which the noble Lord, Lord Chorley, complained it had been deprived of by the Act of 1927. I think it was the noble Lord, Lord Lindsay, who said that the 1927 Act was based on a unity of fear. I do not think it was; I think it was based on a commonsense view of where the trade unions, without at all hampering their proper activities, should take their place in the State. But if that Act were based on a unity of fear, it seems to me that it is a unity of gratitude which is prompting its repeal to-day, because there is not the slightest doubt that the trade union movement did a great deal to put noble Lords opposite into power. Complaints may be made that a compromise solution was not agreed to by the Conservative Party when it was in a position to make that compromise. I do not know whether that is a just criticism or not; it is sufficient to say that some very good solutions were reached in the days when all were working together, and this might well have been one of them.
But if that criticism is just, it applies equally to-day to the attitude of the Government on this measure. They are in the position, if they wish, to make those compromise solutions, which might be lasting. The repeal of the Act, the repeal of the whole Act, and nothing but the repeal of the whole Act, seems to be the motto. In these circumstances, let no one complain if this is not the last word in trade union legislation. But that will not depend mainly on political majorities in one House or the other. It will remain to be seen how, with this new freedom given to them, the trade union leaders conduct themselves in the management of their affairs. There is no doubt that at the recent Election this measure had quite a foremost place in the thoughts and minds and speeches and writings of the Party now in power. There is no doubt that they were pressing for it, or some part of it, as we all know, for two or three years before the Election took place. If there is a mandate given in respect of any particular item of a programme at an Election, this is clearly one which comes within that claim. It would be wrong of us to stand up here and to try to oppose the will of the people because that is not our function in this House. I hope that it will not be necessary to have future trades union legislation, but I fear that it may

1023
be. As I say, it will all depend on the way in which the affairs of these great trades unions are in future conducted.
3.22 p.m.
VISCOUNT LEVERHULME: My Lords, there was a war time slogan which I am sure your Lordships will remember, which in fact is still with us—a slogan bidding us to make do and mend. A new suit of clothes is a question of waiting, saving up coupons, and then probably waiting again. This Bill does not offer us a new suit of clothes, but it bids us cast off the suit made in 1927 and go back to a suit designed in the fashions of 33 years ago. In fact, when we take off the 1927 suit, we find the 1913 suit underneath it. It is a kind of strip-tease act, if I may use that expression, or if not a strip-tease act, at any rate a strip-tease Bill. I should have thought that the 1927 suit might have been made to do a little longer, or at any rate made to do with a little mending. Perhaps we are to assume that just as cloth for new suits is in short supply, so time for carefully considered new measures is too scarce a commodity for His Majesty's Government to be able to spare any for this particular problem, when it can be dealt with by the quicker but less constructive method employed in this Bill.
The noble Lord, Lord Chorley, yesterday referred to this time factor. I cannot help feeling that if the Government, after nationalizing one industry, were to pause for a while to see how the experiment worked out in practice before rushing at the next, they might use the breathing space thus provided for directing their minds to the devising of some measure more constructive than the process now being adopted. My own impression, gathered from the industry with which I am connected, is that all the problems which arise from time to time affecting working conditions and rates of pay are, in the long run, satisfactorily settled by the Joint Industrial Council, and I wonder whether the issues raised by this Bill are present in the minds, or at any rate in the forefront of the minds, of any of those, on one side or the other, who meet round the table of the Joint Industrial Council.
The Bill, however, does raise points of vital importance, points of principle, which affect all of us whether we are con-
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cerned with industry or not. I will refer only to one of them, and that is the question which has already been frequently referred to, of contracting in as against contracting out. Contracting out, it seems to me, is based on the assumption that a preponderating majority of members of a union are almost as a foregone conclusion supporters of the Labour Party. I often wonder what would happen if political parties, in order to secure the exclusive use of a particular name or party label, had to apply to the Registrar of Trade Marks in the way a manufacturer has to apply before he can obtain the exclusive use of a particular brand name and label for his product. I very much doubt whether the name "Labour" would get past the Registrar. I question whether a word of such wide and extensive application would be given as a monopoly to one user.
There is much to be said for the old names of Whig and Tory. They had no implication or meaning except as names to describe the political parties to which they were applied. It is very different in regard to the name "Labour." Under this large and generous umbrella called "Labour", Socialists preach Socialism. Many of your Lordships, I have no doubt, will have heard of incidents where canvassers at election time have asked individual voters if they believed in Socialism, in the nationalization of the means of production, distribution and exchange and other tenets of the Socialist faith, and the reply has very frequently been in terms such as this: "Well, I don't know about Socialism, but you see we're labouring folk and so we vote Labour."
In 1913 Socialism was not heard so much of by the population as a whole. The early Labour Members of Parliament were essentially trade unionists concerned primarily in advancing the cause of trade unionism, and in the improvement of the working conditions of the people. Under the interpretation given to the term Labour in 1913 there was far more justification for contracting out than there is to-day, when a contribution to the funds of the Labour Party is largely a contribution towards the advocacy in Parliament of a set of doctrines known as Socialism. This Government, as fast as it can drive along that road, is introducing Socialist measures.

1025
First one industry and then another is being nationalized, and there is obviously a possibility, if not a probability, that when an industry is operated, directly or indirectly, by the State, membership of a trade union may be made a compulsory condition of employment in that industry. Now, couple with that contracting out and it will mean that the vast majority of those employed in State industries will be contributors to the funds of one political party. The more this grows—as the number of undertakings which, in one form or another, are nationalized, becomes greater—the nearer we shall be to the reality of a One-Party State—that dream of so many Socialists the world over. These are the implications we have to take into account if, in this year 1946, we are to go back in its entirety to an Act passed in 1913 and designed to meet the needs of an age in which the conception of a One-Party State was not in the picture at all.
But is there no alternative to the two methods of contracting out and contracting in? Must a man be assumed to want to contribute to the political fund unless he expressly states that he does not, or assumed to want not to contribute unless he expressly states that he does? Why should not the question be put definitely and clearly to each member: "Do you, or do you not, wish to contribute to the political fund?" Let him face the issue, think it over and make up his own mind, and let him do it in a way resembling, as nearly as possible, the secrecy of the electoral ballot. Let every existing member of a union and every newly-joining member be given a paper on which he can indicate his choice of two alternatives: "I do wish, I do not wish, to contribute to the political fund. Strike out the words which do not apply, or indicate your choice by a cross." And let the paper be handed personally, or sent by post, to the appropriate authority.
The noble and learned Lord who sits on the Woolsack referred to the general dislike of filling up forms. I fully share that dislike, and I was glad to hear this reference, from one in a position of such high authority, to the modern mania for form-filling. But this suggestion of mine is perhaps the simplest kind of form-filling that there can be. We are all familiar with it, and how often, in fact, it saves our time. We are asked to attend a meeting or a public dinner—some
1026
people like public dinners; some people do not—and enclosed with the invitation is a card on which is printed: "I am able, I am unable, to accept. Strike out the words which do not apply." It is true that we may decide to do nothing about it, and put the card in the wastepaper basket. But, if we ignore the card, we do not turn up at the meeting or the dinner expecting a place to be reserved for us.
Why should a movement stand to gain by the inertia of its members? Machines are not, as a rule, propelled forward by the inertia of their component parts. An election is often lost through the inertia of people who will not take the trouble to vote. Why, in this particular instance, should inertia be allowed to produce a result the opposite of its usual one? I would like to see consideration given to an alternative on these lines.
There have been many references to the General Strike. I cannot believe that anyone in his senses wants to give legality to any strike or lock-out—not much has been said about lock-outs in this debate, but this measure, I think, applies to lock-outs as well as to strikes—deliberately contrived to force the hand of Government and Parliament. Not all strikes are authorized by the officials of the unions concerned, and, whatever may happen in times of stress and strain, when emotions run high, I should have thought that it would have been in the best interests of all parties to have no uncertainty about what is legal and what is illegal. The General Strike of 1926 was an event unique in our history, and I hope that it will remain unique. In the middle of the seventeenth century we had our Civil War, and, in that way, we, as a nation, got something out of our system which otherwise might have developed in a more catastrophic form later on. It may well be that the events of 1926 served for us the same purpose. We have a way of getting over these crises, of having our fevers in a mild form, which makes us the envy of less happy lands.
What brought us through the General Strike successfully in the end? With all respect to noble and learned Lords who have contributed with such authority to this debate, it was not solely the legal pronouncements made upon the strike at the time. Equal credit must be given to the individualism and innate love of

1027
liberty of the British people. We do not want to re-kindle the passions of twenty years ago, but when we look back in retrospect upon painful crises, now long past, we can often recall incidents, not without their amusing side, from which we can draw inspiration and profit. A story is told of an incident in the General Strike which illustrates what I mean. Pickets were outside the London clocks. The gates opened and out came a great high-powered lorry—the kind of lorry to which the noble Lord, Lord Llewellin, referred in his speech. It bore the notice "By authority of the T.U.C." A little while later the gates opened again and out came a little man in a billycock hat, smoking a clay pipe and driving his own pony and cart. This cart also had on it a notice, bearing these words "By authority of my own blooming self." (My Lords, I substitute the word "blooming" as being more Parliamentary than the original.) He passed through the gates unmolested and amid cheers. And thus was asserted the right of the individual to go about his lawful occasions. Whatever the future may bring, it will, I feel sure, be that innate love of individual freedom which will preserve us from all threats to our essential liberties, whether they come from without or arise from within.
3.42 p.m.
LORD AMMON: My Lords, the debate so far, on the second day, has certainly progressed with good humour and fair statement. In fact, I could not help feeling that the noble Lord, Lord Llewellin, dubbing himself, rightly I believe, a progressive Tory found himself in real difficulties because of his progressiveness. Again and again he had to concede a little more than others had been prepared to do in the course of this debate. I will try, first of all, to deal with some of the points he raised before I turn to particular points with regard to the debate as a whole. The noble Lord dwelt on the question of stigma. Surely there is a stigma when a certain set of people are differentiated, in some way or other, from the rest of the community and special legislation is passed in order that they may be prevented from exercising their full rights and functions as citizens. The noble Lord went on to say that the General Strike of 1026 failed because we are a democratic country. Exactly. That
1028
is our whole case. There was no need for this legislation. There was no need for the 1927 Act, because always the good sense of this country, as has been manifested again and again, will ultimately assert itself and prevent anything that is unreasonable—or shall we say illegal?
I am surprised that the noble Lord, Lord Llewellin, should have objected in any way to the remarks of my noble friend Lord Lindsay on the subject of revolutionary strikes. I think the only revolutionary act of that nature that has ever taken place in this country was that of the friends of the noble Lord, Lord Llewellin. That was, when they tried to hold up the whole government of this country and event plunge it into civil war. That was a good many years ago, in regard to the Irish question. They were prepared to bring—and did bring—this country to a very grave issue. It was only the intervention of a larger issue which prevented the other from developing to a very serious extent. To charge the Labour Party or any one associated with it with that sort of thing is quite an unfair accusation.
LORD LLEWELLIN: I did not accuse the Labour Party of that. I was only referring to the speech which the noble Lord, Lord Lindsay, made in this House yesterday, in which he clearly advocated, in certain circumstances, a revolutionary strike. I said I thought that was wrong.
LORD AMMON: I was merely referring to the noble Lord's objection to a revolutionary strike when the record of his own Party is still very fresh in the memory of many of us. He is still totally wrong with regard to the position of the Left in Germany. The Nazi movement, from the very beginning, was subsidized by the large business and capitalist concerns in Germany. Thyssen and Krupps were amongst those at the bottom of it. The people who were liquidated were the trade unionists and others who followed the same line of thought. It is that sort of thing we are guarding against in calling for the repeal of this particular Act, which does seem to impose certain conditions which place the State in a position of legal authority over and above the right of individuals.
The noble Lord went on to talk of the future and the possibility of the Communists gaining accession to the Council of the T.U.C. This 1927 Act will not

1029
prevent that. The 1927 Act will not prevent anything of that description. Against that we have the common sense of the mass of trade unionists, and ordinary men and women, and we must rely on that to see that it does not happen. That is the sort of thing on which we have to rely, in the last resort, in every phase of our trade union experience. Then the noble Lord quoted part of the 1875 Act, to say that it was repealed by the 1927 Act. Might I call the attention of the noble Lord to an exchange which took place yesterday between my noble and learned friend the Lord Chancellor and the noble and learned Viscount, Lord Simon? In the course of that discussion the noble Viscount indicated that there would be something lost if the 1927 Act were repealed, and that there would be no power to deal with intimidators. The Lord Chancellor interrupted to say: "I had thought that there was provision in the Act of 1875 to deal with cases of anyone watching or besetting houses." The noble Viscount's reply to that was "I do not think so." Naturally it is not for me to interfere, or venture on ground where great legal pundits differ, but it aroused my curiosity and induced me to look up the 1875 Act. And for purposes of accuracy I think it would be as well that that should be on record.
Section 7 of the Conspiracy, and Protection of Property Act, 1875, provides that a person guilty of an offence—that is a person
"who, with a view to compel any other person to abstain from doing or to do any act which such other person has a legal right to do or abstain from doing, wrongfully and without legal authority

(1) uses violence to or intimidates such other person or his wife or children, or injures his property; or

(2) persistently follows such other person about from place to place; or

(3) hides any tools, clothes or other property,…or

(4) watches or besets the house or other place where such other person resides or works…or

(5) follows such other person with two or more other persons in a disorderly manner in or through any street or road "—

shall be liable to pay a penalty or to be imprisoned. That Act still stands.
VISCOUNT MAUGHAM: It has been amended.
LORD AMMON: During the course of the debate on the Trades Disputes Bill
1030
in another place those years ago—and I envy the noble Lord, Lord Llewellin, inasmuch as he was not able to be present; I have the doubtful advantage of age in that respect—Sir William Joynson-Hicks, who was then Home Secretary, said that: "peaceful picketing for the purposes of peaceful persuasion or imparting information was permissible, and that the Act of 1926 did not do away with the Act Of 1875."
LORD LLEWELLIN: It should have been 1906.
LORD AMMON: What was illegal under the Act of 1875 is still illegal to-day, except in so far as it was modified by the simple words—which Sir John Anderson was not able completely to understand—
"for the purpose of peacefully obtaining or communicating information or peacefully persuading any person to work or abstain from work."
The Home Secretary of that day said that under the old Act any form of violence or intimidation was illegal. Therefore, my Lords, there is no fear that the powers existing in Acts of Parliament for dealing with cases of intimidation such as those which have already been referred to in our discussion, are cancelled.
LORD LLEWELLIN: Perhaps, if I may interrupt the noble Lord, while he is explaining this, he could tell me the difference between watching and besetting a house, which is prohibited by Section 7 of the 1875 Act, and attending at or near a house or place where a person resides for the purpose of peacefully persuading him. I do not know where one ends and the other begins.
LORD AMMON: I am afraid I am in the same position as the noble Lord. I would point out that even the legal authorities have found that a subject of difficulty.
THE LORD CHANCELLOR: May I help? The words "watch or beset" involve some sort of continuity—the sort of action which would be a nuisance at Common Law. "Attending" of course may be on one occasion. May I add that the prohibition in the 1927 Act is a prohibition not against attending but against watching and besetting?
LORD AMMON: We are both grateful to the noble and learned Lord Chancellor

1031
for clearing up that difficulty for us. In the course of the debate yesterday Lord Simon said that it was not right to change the law and to make the position again as obscure as it was in 1926. If one may judge by the variety of legal opinions which we have heard quoted, the law is certainly not a bit clear. At any rate, I venture to say it is far better to go back to that than to have laws which cannot be operated or put into effect. That is the position in which we are at the present time. It is ruled that it is quite illegal to have strikes under the existing regulations and laws. But strikes go on. I have been spending some time in an endeavour to find ways and means to stop a big strike which is threatened in one of our large industries at the present time. If the strike breaks out, this 1927 Act will not be able to do anything to prevent it, and no action will be taken against those who participate. Therefore I say it brings the law into contempt to have laws, which we are unable to operate.
May I turn to the question of the so-called General Strike? Firstly, I have always contended that it was not a General Strike; that is to say it was not a strike in which there was a deliberate conspiracy planned by people meeting together for the purpose of holding up the community and endeavoring to gain their ends in that way. That is why, if he will pardon me, I took slight objection to the words of my noble and learned friend the Lord Chancellor when he said that in some senses the strike was ill-advised and ill-considered. I quite appreciate what he meant. But this so-called General Strike was one of the greatest and one of the proudest moments in the whole history of trade unionism and of the working class of this country. What was it? It was simply that people of all ranks and sections of society, mainly from the trade unions, rallied together to support the miners in their protest against conditions, which were positively inhuman, when the whole conditions of life were being forced down to an unreasonable level. No doubt it was feared that such a state of affairs might be extended to other quarters.
For that reason alone, no one has any reason whatever to be ashamed or to express any regrets for being in sympathy with that object. That was followed by an Act, which was really conceived in fear
1032
and born in reprisals. Such was the Act of 1927. The so-called General Strike was a great up surging of human feeling. I venture to say, and I know the noble and learned Lord, the Lord Chancellor, will agree with me, that, even if sometimes this does lead to actions which in later years might be considered to have been not wholly wise, it would not be altogether a good thing if we subordinated those feelings of indignation and sympathy to strict logic. This human feeling was really the basis of what took place on that occasion.
Under this 1927 Act all strikes, whether sympathetic or otherwise, designed or calculated to force the hand of the Government either directly or by inflicting hardship on the community, are illegal. It is an impossibility, I think, to draw the line and say that there is hardship or even pressure brought to bear upon a Government and therefore that a strike is legal or illegal. You are bound to have hardship and distress in cases of strikes, and the wider the strike the greater the hardship. Difficult as it is, it has got to be met in some way. I, in common with anybody else who has had anything to do with organized labour, deprecate strikes. We look upon them as wasteful, as stupid, and altogether harmful. On the other hand, however, we have to remember that it is, unfortunately, only by those methods that men have been able to obtain any decent standard of life. The whole history of the working-class movement is built up on that fact, that men had to fight for every concession, even for the ordinary decencies of life. That is the trouble, I respectfully submit, with which we are faced at the present time. Since I have come into this House I must frankly confess I have been tremendously impressed with what I might call the high standard of impartiality and consideration which has permeated the atmosphere of this Chamber. I have found an absence of what I would call Party bickering and Party division which one met with in other places. That is due to a variety of reasons. Therefore I am sorry that this Bill should be opposed by some of your Lordships who by so doing would seek to return to conditions which we have long since hoped had gone for ever.
I do not require to bring forward any evidence to show that again and again in the history of progressive advance in this country there has been resistance from the

1033
side that has been represented in opposition to the repeal of this Act. In recent years, while the two parties were co-operating, a real attempt was made to find a compromise solution of this question in order that another way out might be found. That compromise was resisted and rejected. Thus you reach the position, as happens again and again in regard to most other things, not only on the industrial side but on the political side as well, where, having rejected one claim, you find that a fuller and bigger claim is pressed and has to be conceded. That is not good for right and proper development.
I turn now to the point raised by the noble Viscount, Lord Leverhulme, with regard to the political fund. The only answer I can give to the matter he has raised is that in a measure it is met in the Schedule of the Bill itself. It says there, on the assumption that this Act will be repealed, that:
"…notice shall, in accordance with the rules, be given to the members of the union acquainting them that each member has a right to be exempt from contributing to the political fund of the union and that a form of exemption notice can be obtained…"
That is one of the first things that will have to be done, and the rules to that effect will have to be agreed to by the Registrar-General himself. The Schedule goes on to say:
"Notwithstanding anything in this Act, no member of a trade union shall, until the expiration of one month after notice has been given to members in accordance with the provisions of the last foregoing paragraph, be required to contribute to the political fund …"
Therefore certain provision is made both for consideration and for opportunities for people to signify their willingness or unwillingness to contribute.
But noble Lords must bear in mind that a political fund is never established until after a ballot of the members has been taken, and a secret ballot at that. Therefore the fund cannot be established unless it is established by the wishes of the majority of members of that particular union. After all is said and done, we decide most things that way. We decide the government of our country by a majority of the votes of the persons concerned, and the taxes that are levied under the Government have to be paid by all, whether they agree in accepting them or not. There are some unions where they have
1034
not been able to carry that resolution and where the members have decided against the setting up of a political fund. Where a fund is established, the rules have to be submitted to the Registrar-General to see that they deal fairly with all persons concerned.
VISCOUNT LEVERHULME: May I intervene for one moment to ask the noble Lord whether the secret ballot to which he has referred is taken at a meeting of the trade union or whether it is spread over a period of time so that all members of the union have ample opportunity of giving their secret vote?
LORD AMMON: As a matter of fact a separate notice has to posted or given to every member, who himself will, in most cases, return it at a given date. So there is not any case of a meeting being packed, or anything like that. The question has to be decided by the whole membership of the union. I hope that answers the noble Viscount's point. I would point out that even under the 1927 Act there are two lists. There are bound to be two lists, whether members contract in or contract out, and if there is any intimidation or pressure brought to bear upon people it is just as likely to be done under the system of the 1927 Act as any other.
I turn from that to the position of the civil servants, about which I know something. I see sitting opposite me the noble Viscount, Lord Samuel, who was once my chief and whom I used to meet in quite different circumstances when he was Postmaster-General from those in which I meet him now. I make bold to say that he would not dissent from the statement that he did not find the men more disloyal when they were affiliated to the Trades Union Congress, or that they carried out their duties any less efficiently because of that fact. How did that affiliation come about? The Civil Service carried on an agitation foe a long while. The agitation arose mainly through the Post Office workers, who formed the largest number and who to a great extent were brought in contact with the public outcry. They felt they had a right, like other workers, to be associated, to organize and to get the moral support—for that is all they could get—of other trade unionists in pushing forward claims for better conditions of life. To a certain extent they succeeded.

1035
What were the conditions? The conditions, as I remember, were described a good many years ago by Air. Punch in a cartoon which bore the question: "Why are pillar boxes red? Because they blush for the postman's pay." The late Mr. Will Crookes, at a time when the noble Viscount, Lord Samuel, was a Minister in the other House, answering the case which was always put up as a defence for poor pay, that civil servants had security of tenure, said: "Yes, it is quite true that in the Civil Service they have security of tenure. It is starvation, but, thank God, it is constant!" Out of that came the desire and the striving to affiliate to the Trades Union Congress. They did affiliate, and by the moral support they gained they very greatly improved their conditions. Long before any Act of Parliament was passed dealing with the matter, there were, and there still remains and always will be, conditions of service in the Civil Service which limit to a large extent certain actions by civil servants that might be detrimental to their duties as public servants. I do not suppose for a moment that any noble Lord who has served in a Government Department has thought at any time about what were the politics of the civil servant who had been advising him. He has had perfect confidence that he is getting the best advice and service possible. But we all know, because we sometimes meet them on other occasions, that these civil servants have politics and political allegiances. We are not concerned about the fact, and do not think they will discharge their public duties any less efficiently because of it.
The curious thing about it is that this 1927 Act, which makes it impossible for the Post Office people or other civil servants to join up with trade unionists, applies only to established civil servants and not to the unestablished, who are the larger number and who are performing duties quite as important. I remember the time when even so humble a person as a postman was ostracized and punished for belonging to a political club or for attending a political meeting. That is the sort of thing which makes one determined that we are not going to hark back to such conditions. It has been the Post Office servants and the civil servants as much as any, who have kept up the agitation for the repeal of this Act—not
1036
that they want to strike, but because they feel it is a reflection upon and a restriction of their dignities and rights as individual citizens. It may be that there are civil servants in certain positions and performing special duties upon whom there would have to be some restriction, which they themselves would no doubt quite willingly bear.
The only strike there has ever been in the Post Office occurred long before there was any thought of the Post Office workers being able to join up with any outside organization,, and it was occasioned by sheer desperation owing to the disgraceful conditions under which they lived. I remember that when I was still in the employ of the Post Office as a civil servant, I came under discussion in another place because I had spoken at a meeting organized by the Civil Service Socialist Society. Some of the remarks I made were reported in the Press and were brought to the attention of my superiors by a member of the House of Commons. I had been speaking on the Temperance Bill that was then being brought forward by the Liberal Party, and I was called upon by the then Mr. Sydney Buxton, who was Postmaster-General at the time, to explain my actions. I do not think I am giving anything away, because that gentleman has now passed to his rest, but after he had admonished me he said: "Look here, you have been speaking in the country, how is the Bill going?" Then he assured the House, which was quite true, that the officer had been suitably reprimanded. That shows the difficulty and the absurdity of trying to cut off large bodies of men who want to contribute and who have something to contribute to the councils of the State in matters such as this. I suggest that that in itself is a very good reason why this sort of thing should be wiped away. If my memory serves me rightly, there are about 320,000 established civil servants who are brought under this ban, for which there can be no justification whatever.
Then I would point out the absurdity of the 1927 Act. It does not penalize, and cannot penalize, the organization for any action it might take. The penalty must apply to the individual. If there were some trouble, to deal with every individual person in a big service like this would hold up the whole of the communications and the business of the State.

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It is because this is legislation which cannot be implemented, and because it has many absurdities in it and infringes the rights of the people that we are pressing for its repeal.
I want to say a word as to the suggestion that has been made about undivided loyalty to the State. This is, I should say, the very last place in which that ought to be pressed as a doctrine that is sacrosanct because the very walls of this building cry out against it. Again and again there are occasions when there have to be protests, when there are involved higher loyalties than the State can demand from its citizens, and when things which affect the consciences and the higher moral duties of men are bound to come into conflict with mere legalities. To say that undivided loyalty to the State is a reason for the retention of this Act is not likely to commend itself to the majority of the people.
There is no suggestion that on the whole people are willing to be or want to be law-breakers. Let me for a moment deal with the position as to whether the General Strike was illegal. I was then an official of the Post Office employees. We were especially warned that, whatever happened, nothing should stop the telegraph or postal services. The strike leaders were careful to see that that should not happen. I had a very unpleasant task at that time-one which brought upon me great unpopularity. The news came that the employees at Woolwich were corning out on strike and I was deputed to go down to Woolwich to see that they did not. At a mass meeting on Plumstead Common, where I was anything but a popular figure, I am glad to say I succeeded in preventing that happening. That is an instance which proves there was every intention to try to keep the strike a purely industrial dispute.
One can only conclude that this Act was born out of fear and a spirit of reprisal. In fact I venture to say that had it not been for a certain prominent member of the Government who has lately been able to exercise, to the advantage of us all, his great capacity and liking for a fight and his ability to lead it, things might have gone differently at that particular time. It was a fight; it did not matter to him whether it was against a trade unionist or a German so long as a light was to be fought. He went into it and, I believe, pushed his rather quiet and
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slow-going Prime Minister very much farther than he would have gone otherwise. That led to the trouble which has been brewing ever since.
I suggest to your Lordships that, not on mere grounds of expediency—I should be sorry if that were the case—but on the merits of the case itself this Act should be repealed. By its repeal we show that we trust our people, that we know they are to be relied upon to do the right thing to exercise their judgment and wisdom on the right lines, and to use the liberties that they have won not for themselves only but for the good of the State. If your Lordships will do that you will have indeed proved that this House is what I believe it has shown itself to be, a real Council of State, not only recognizing that the majority of the electorate have already declared themselves in regard to this but recognizing also that it is useless and stupid to keep Acts of Parliament on the Statute Book which cannot be operated and which to a very large extent are a stigma on and an insult to many of our citizens.
4.18 p.m.
VISCOUNT MAUGHAM: My Lords, I find it very difficult to speak on this topic and very difficult to be silent. I find it difficult to speak because the questions involved are very largely questions of law which call for so much detailed thought and examination of the words of the Statute that one can hardly discuss them here. I find it difficult to be silent because I have been connected with these problems for half a century. As a member of the Bar I fought in many industrial disputes, both on the side of the men and on the side of the employers, and as a Judge I have taken part in the decision of many cases, including, I think, the last which dealt with somewhat cognate matters—namely, the case relating to the Harris crofters, in which it so happened that Mr. Ernest Bevin's views were of great importance. I should feel I was taking a rather cowardly course if I abstained from expressing my opinion, for what it is worth, and from endeavouring, as far as I can, to clear up some of the matters which apparently remain obscure in the minds of a good many noble Lords opposite.
The first thing to note is that the Bill before us is a Bill to restore the legal position which existed nineteen years ago, and the obvious question which one asks to begin with is this. Is there any case of

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injury, hardship or disadvantage which any human being has suffered during the last nineteen years because the Act of 1927 is on the Statute Book? We have heard of none. Nobody has told us of what hardship has been suffered, and although I am going to deal at some length, I am afraid, with the sort of things that are said about the Act, I cannot find that anybody has been any the worse for that Act. Noble Lords opposite wish to take us back, by the passing of the present Bill, to the state of uncertainty and confusion which, by the admission of everybody, existed in the year 1926. That is not in dispute. I am a lawyer, and have been a lawyer practically all my life. I know how difficult these questions are and I, of course, like others, have formed a view upon them. But I am not discussing what is the right view to take, the strict legal view to take, of how the law stood in 1926. I am saying that it was doubtful, and I none the less say it was doubtful although a Judge who was my friend, Mr. Justice Astbury, expressed an opinion which had a great effect in guiding the general views of mankind at that time, followed as it was by a most powerful speech by a gentleman who was then Sir John Simon.
THE LORD CHANCELLOR: Preceded by.
VISCOUNT MAUGHAM: One preceded and one followed. There were two speeches. I am obliged to my noble friend. When you have Lord Hailsham, Lord Simon, Sir Frederick Pollock, the greatest jurist of his day, Lord Haldane, the present Lord Chancellor and Professor Goodhart and other professors express different views on the position as it was when the General Strike was going on, or immediately after it had come to an end, who is going to say that my opinion is so valuable that I should decide amongst all these great men and tell you what was the law? I certainly will not. I hold the view, for what it is worth, that what Sir Frederick Pollock, who was a personal friend of mine, said was right, but I am not saying that the view which has been expressed either by the present Attorney-General or by my noble and learned friend on the Woolsack is wrong. I can only say that this is a case where opinions differ, and it may be that the elaborate opinion
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which my noble and learned friend on the Woolsack gave us yesterday is right.
I am here to say that you cannot tell which is right and which is wrong in such a case. As a lawyer, having had to sit for so long deciding cases, what I loathe and detest most when sitting as a Judge is the uncertainty of the law. I think the law ought to be certain. This is a matter where people's liberty is involved, where freedom is involved, where we want to know whether large numbers of people are acting rightly or wrongly, and I am convinced that one ought to have that perfectly clear. Noble Lords opposite wish to take us back into a state of uncertainty and confusion and doubt. Why? Well, I will come to "why" later on, but I do ask them to accept that my view has some force in it, and at any rate is made with a personal conviction, that the law on this subject ought not to be left doubtful and that it should be stated in the clearest terms.
My noble friend Lord Ammon who addressed us with a very interesting and, if I may venture to say so, very able speech, said, among other things, that we should bear in mind the fact that since the Act of 1927 there have been, notwithstanding the Act, a number of strikes, some official and some unofficial, some therefore prima facie right from his point of view and some from his point of view absolutely wrong. This Act has not stopped them in any way and they have gone on as merrily, if a strike ever continues merrily, as before. This is one of the most remarkable statements made in the whole debate, and it shows how different a view a lawyer on this side must take of the whole matter from that which noble Lords on the other side, who are laymen, are inclined to adopt. The Act of 1927 was never intended to stop strikes in the general term. Had it been in fact a reprisal, as some noble Lords and some gentlemen in another place seem to think, of course it might well have interfered with strikes as a whole. There are a number of things it might have done. For example, it would have been quite easy to restore the results, or most of the results, of the Taff Vale decision, but the Government of the time never touched it. It is moonshine to suppose that the object of this law was in the nature of a reprisal. The law was affected by the 1926 strike because that

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strike had shown the necessity for a definition in this matter of what a General Strike was, and that definition was called for on ordinary common-sense grounds and in order to prevent people acting illegally in such a case. But that is not the only way in which Section 1 of the Act of 1927 seems to be misunderstood. It is extraordinary to me, although I can well understand the layman being in that position, to hear it stated as if it was an obvious fact that this Act of 1927 made sympathetic strikes illegal.
LORD AMMON: Would my noble friend permit me to interrupt? I hate doing so, but he has rather misunderstood me. What I did point out was that strikes had gone on in spite of emergency legislation. That was the point I was making. Now with regard to the other point, I will meet that right away. It does prevent it because it brings the extent of a strike within very much narrower limits.
VISCOUNT MAUGHAM: If I have done an injustice to the noble Lord, I need not say that I heartily regret it. I fully understand what he now says. It is not quite what I understood him to have said before, but that was probably my fault. I am cooling now to the question of what Section I means. It is not true that it stops sympathetic strikes, and it is not true that it was ever intended to stop them, as far as we can judge from this Act. Let me tell your Lordships what is the truth. It is not a matter of doubt at all. There are two things which make a strike illegal, two conditions which have to obtain before a strike is an illegal one. I may mention here that "General Strike" is not a phrase used in the Act at all; it is only a compendious way of saying "Such strikes as are referred to in Section 1."
These are the two things that have got to be proved if anyone says that a strike-or a lock-out for that matter-is illegal. A strike is illegal if two things happen. Section 1 (1) (a) (i) declares that any strike is illegal if it
"has any object other than or in addition to the furtherance of a trade dispute within the trade or industry in which the strikers are engaged."
For instance, I have known strikes to have for their objects the getting of an unpopular person out of a village, or the obtaining of some political advantage which was not directly connected with
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the particular trade concerned at all. That is the first condition. I will ask the noble Lord, Lord Ammon, to listen carefully to this because I am so anxious, as a matter of courtesy, to explain to him where he was wrong. Paragraph (i), which I have just read, and paragraph (ii) are connected by the word "and," which is a common English word, and to a lawyer it means that both these conditions must be complied with. The second condition is that a strike is illegal if it
"is a strike designed or calculated to coerce the Government, either directly or by inflicting hardship upon the community…"
So, if there is a sympathetic strike of, shall we say, people engaged in the shipping trade, to help the miners, and if it can be shown that that strike is a strike "designed or calculated to coerce the Government directly or by inflicting hardship upon the community," the strike will be illegal.
There is a definition of a lock-out with which I need not trouble your Lordships. Nobody cares, apparently, about the employers for the purposes of this debate. We are concerned only with the work-men, and it is quite right that we should be. Half the things that are said on the other side of the House are wrong, because noble Lords there do not understand the real legal meaning of the Act. To say that so limited an object as that in the section is something which indicates-that this Act was intended as a reprisal for the General Strike—I shall use the popular phrase—seems to me a preposterous conclusion to draw from the facts.
LORD AMMON: May I ask the noble Viscount if he will explain this matter a little further? I still say that a sympathetic strike is prohibited by this. If he will read further he will find that it says that a trade dispute must be limited within certain areas, that is, within the same trade or industry or Industrial Council. That is where the limitation comes in. The ship-builders could not come out in support of the miners under this, because they would not be under the same Industrial Council. That is the limitation.
VISCOUNT MAUGHAM: Indeed, that is not so. To make a strike illegal both the conditions which I have quoted have got to be fulfilled. I wish that I could persuade the noble Lord that that is plain as a matter of English. I do not think

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that the noble and learned Lord who sits on the Woolsack will contradict me upon this. It has been recognized by lawyers for a long time, and I confess that as a question of law I think the matter is unarguable here. Whether before this Act there was agreement as to what is and what is not an illegal strike is a very different matter, and a matter of legitimate doubt. But here it is absolutely certain that a declaration that the strike is illegal can only be made if both conditions obtain. A sympathetic strike not designed or calculated to coerce the Government is not illegal—you may be as sympathetic as you like. The Government of the time were very anxious to confine this to a limit, and I feel absolutely convinced that what I have said to your Lordships is right as a matter of law.
THE LORD CHANCELLOR: May I say a word upon this? I quite agree with what the noble and learned Viscount said about the word "and". Both these conditions have to be fulfilled. But I think it is plain that any large-scale sympathetic strike must be illegal because it would tend to coerce the Government. Would the noble and learned Viscount contend that the railwaymen could come out in support of the miners? Could coastal shipping men come out in support of the miners? Is the noble and learned Viscount not introducing a tremendous element of uncertainty where no uncertainty existed before?
VISCOUNT MAUGHAM: I am glad that the noble and learned Lord Chancellor is with me that both conditions have got to be fulfilled. But he glozes rather over the important word in what he says. When he says that any large-scale sympathetic strike is bound to be a strike designed or calculated to coerce the Government, that is perfectly true. The strike has only got to be large enough and it will be designed or calculated to coerce the Government. But in my time—and I am afraid that that means a longer time than that of almost anybody on the Benches opposite—I have known sympathetic strikes which did not coerce the Government in the smallest degree. And it is fair enough to point out that a large-scale sympathetic strike which affects a number of trades will be bound to affect the Government. I admit that
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at once. But that is not what noble Lords here have been contending. That is a new consideration. Of course, it is the object of this section—another phrase might be used (only it would be much too vague): "A large-scale sympathetic strike which would have the result of coercing the Government," to state one of the conditions which would make a strike illegal.
VISCOUNT SAMUEL: That is the idea of the General Strike.
VISCOUNT MAUGHAM: Yes, precisely—it is what we mean by calling it "General." If it is sufficiently large-scale, it has the effect of being designed or calculated to coerce the Government. I am hoping that I am now in complete accord with the noble and learned Lord who sits on the Woolsack. But both in another place and here a wholly contrary expression has been used, or a wholly contrary view of what this Act does has been taken. Let us consider the position of noble Lords who want to remove that section from the Statute Book. I am not going to argue to-night—because I do not want to keep you here too long—that there could not be a doubt as to the meaning of this question, although I am not aware that any doubt has arisen in the minds of juries or that they have particularly criticized this section on the ground that it was obscure. That is not my point at all. I would say the same with regard to the sections we are corning to. If it is doubtful, and that is the objection to the section, I say "Come forward with an Amendment," which you know perfectly well, with the huge majority you possess in the other place, you will be able to pass. The contest between us is this. The interests of the country are far more important than the interests of Tory, Labour or Liberal Party. We have to ask which is the better course, having regard to the interests of the country, to take—to go back to the law as it was nineteen years ago (which admittedly was doubtful and obscure) or to amend the Act of 1927 to make it just and equitable to everybody and capable of being easily understood. That is the question which the noble Lords opposite, in my view, ought to put to themselves. It seems to me that the grounds on which they are supporting the present Bill—as I shall hope to demonstrate—are not based on any such consideration as that.

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Doubt will exist, and the doubt which existed in 1926 was not only in reference to the precise meaning of a General Strike,—an illegal strike I should have said—but there may also be doubts on some other matters, and if your Lordships will allow me I should like shortly to go through one or two of the other subjects in debate, in particular the other sections which have to be considered. I would first like to say something on a point just touched upon by the noble and learned Lord on the Woolsack. The noble Lord, Lord Lindsay, who is I think no longer here and who takes the view which nobody can understand, that the Act of 1927 is totalitarian, was in favour of revolutionary strikes. If he is alone in that I need not trouble about it; but it is quite clear that the noble and learned Lord Chancellor took a very different view, for he said that as soon as a strike was revolutionary it must be illegal. Let us accept that. I accept it to the full. It does not seem to me, if you want to alter the Constitution of the country, that the law can possibly provide any step—any legal step—for the alteration, other than that of turning out the Government and establishing a new one, and getting the new Government to pass legislation which the country as a whole considers to be proper. The law cannot approve of a revolution, which is contrary to the law. That being so I am utterly unable to understand how an argument can be based on the footing that we ought to repeal the law of 1927 in order that we may have greater liberty to embark on a revolutionary strike.
The noble and learned Lord Chancellor at the end of his (if I may say so) extremely clear and interesting speech referred to the Emergency Powers Act, 1920. It is curious that so little reference has been made to that Act, which was an Act passed by a Coalition Government when Mr. Lloyd George was the Premier. That Act, reading it shortly, provides that:
"If at any time it appears … that any action has been taken or is immediately threatened … of such a nature and on so extensive a scale as to be calculated, by interfering with the supply and distribution of food, water, fuel, or light, or with the means of locomotion, to deprive the community … of the essentials of life, His Majesty may, by Proclamation … declare that a state of emergency exists."
Where a Proclamation has been made, and so long as it remains in force, there
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is power for His Majesty in Council, by Order to make regulations to secure the essentials of life. And there are certain particulars as to the regulations to be made.
I think the noble Lord in referring to that was well aware that if that was to be any use at all it would require some amendment, because, although you may make regulations of that kind, if half the workmen in the country a re striking under a General Strike you have no power to take a man by the scruff of his neck and force him to deliver goods or run a boat or drive an omnibus. Therefore there is nothing in that Act, as it stands, which will help you if a General Strike should break out. Accordingly. I do not think this Act will help us very much. I would like to point this out. People who have never been engaged in the law so often think that if they can put a nice well-drawn section in an Act of Parliament on the Statute Book they have solved the problem, because they think the section will be ultimately enforced by the law. I know from large experience that that is a great mistake, and that the one thing you have to consider—almost the most important thing of all, if there is an illegal strike—is how long it will take you to enforce the law.
The noble and learned Lord, the Lord Chancellor, has incidentally touched on this matter, because he and the Attorney-General in another place both said they did not in the least think that an indictment for a breach of the law of this kind—as to the illegality of any particular strike—was a course which they would recommend to a particular Government. Of course it would be useless. We are only dealing with a General Strike. The offence therefore is according to the definition, something which is designed directly or indirectly to coerce the Government by inflicting hardship upon the community. That may be amended, but that is the substance of it. How long can such a strike last, without either the country being half ruined or the people -engaged in the General Strike declining to go on? Any action taken, if there is such a strike, must be swift. It was swift in ro26. When my friend Mr. Justice Astbury had before him a motion for an injunction to restrain the use of the funds of a particular trade union from being applied in support of the strike, he was using a legal power which could

1047
be obtained in two or three days after the issue of a writ. It could be done very rapidly. There was no reason for any delay at all. If you are going to indict a man for some offence under this Act, it may very well take six months or even a year before he is charged, before it is proved that the act which he did was illegal, and even then there might be an appeal to the Court of Criminal Appeal. Therefore, if you are dealing with machinery to stop a General Strike, it must be rapid, and it must be capable of being exercised by injunction without delay. That is why in this Act of 1927 there is a section—Section 7—which, enables the Attorney-General to apply for an injunction restraining any application of the funds of a trade union in contravention of the provisions of Section 1.
I do not think that has been appreciated by noble Lords opposite. I think they are of opinion that if we left things as they were under the Act of 1875 everything would be all right and the strike could be stopped. That is not so. It simply is not true. It is true that there are people who might be held to be liable under the Act for damages, or who might be liable to be subjected to certain penalties—that is something, at any rate—but the Act was not really designed to deal with a General Strike. It was designed to deal with conspiracies, but, it did, incidentally, deal with ordinary strikes and in Section 7 made illegal certain acts in support of ordinary strikes. If I have misstated the title of the Act, I state now that the Act was the Conspiracy, and Protection of Property Act, 1875.
So much for the necessity for the Act if you want to be able to stop a General Strike, and to know whether a particular act is legal or illegal. I rather echo what has already been said, I think by my noble friend Lord Simon, or rather I echo the question which he asked—why do noble Lords opposite want to make it impossible, if there is a wide-spread strike which involves half the means of production in the country, transport, lighting, and all the rest of it, to stop that in the way in which it could have been stopped, and in the way which was partially responsible for stopping it in the year 1926? That is a thing which I think we ought to be told, and which we have not yet been told.
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With regard to Section 2, which relates to the protection of persons refusing to take part in illegal strikes or lock-outs, I quite agree that, as framed, the section is intended to deal with the illegal strike as defined in Section 1, and, if Section 1 were to come out or to be amended, it would be necessary to amend slightly Section 2. But do noble Lords opposite really want persons who refuse to take part in an illegal strike to be subjected to the tyranny mentioned in the section which in the past sometimes has been employed to punish them for not joining what is supposed to be the majority? The actions which are prevented are, in particular, expulsion from any trade union; fine or penalty; deprivation of any right or benefit to which the man or his legal personal representatives would otherwise be entitled; or in any respect, directly or indirectly, placing a man under any disability or disadvantage—merely because he has refused to do something illegal, admittedly illegal. Do they want to have that removed from the Statute Book? Again I think they ought to explain why they do.
Section 3 deals with the prevention of intimidation. There is a clause with regard to intimidation in Section 7 of the Act of 1875 which has been partially amended by Section 2 of the Trade Disputes Act of 1906. I am afraid my noble friend Lord Ammon takes a view of those sections with which I do not agree. The Act of 1875 is altered in respect of that particular matter of intimidation by the Act of 1906. They have got to be read together, and the 1906 Act must be taken as meaning pro tanto that section in the Act of 1875.
The Attorney General's view of the law, as given on the Second Reading in another place, surprised Sir John Anderson, to whom it was particularly addressed, and I would add that it also surprised me. I do not think it was quite accurate. He said this:
"Suppose you had a strike that made men stay out. Supposing one of the strikers goes along to a friend in a perfectly friendly and peaceable manner, to a man who thought it right to remain in work, and supposing he said 'Look here, Tommy, if you stick it we shall be beaten, and if we are beaten they would bring all our wages down and you would lose money in the end, the same as the rest of us.' Perhaps honourable members may think there is nothing very terrible in that, but that is intimidation under the terms of the 1927 Act, and that conduct would be punishable."

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I am afraid I do not agree. I do not think any Court would hold that to be intimidation. But I would add, at the risk of repeating what I have been saving, that if you think that section goes a little too far in regard to intimidation, amend it. I am sure none of the noble Lords on the Front Bench opposite are in favour of intimidation properly so-called being used in support of a strike. I am perfectly certain they are candid, and their word in that respect can be relied upon. They do not want it.
I am also equally certain that there is not one of them who, with the Act of 1927 out of the way, can tell me what are the limits of intimidation. I do not believe they can, and I would observe that I was not very greatly impressed with the criticism of the section which was made by my noble and learned friend on the Woolsack. It does not seem to me that the words used to define "intimidationx"—
"a reasonable apprehension of injury to him or to any member of his family or to any of his dependants or of violence or damage to any person or property "—
are really capable of much misconstruction, if you read the sentence in which the words appear. The words are not applied to a single person who tries peaceably to persuade somebody to stop work. They apply to a number of persons "if they so attend in such numbers or otherwise in such manner as to be calculated to intimidate." If a hundred people, or it may be fifty people, appear at a man's house or the place where he resides or works and intimate to him that they have come for the purpose of obtaining or communicating information or of persuading or inducing him to work or abstain from working, it does not seem to me they will so appear in a body unless they are intending pressure which, for this purpose, is intimidation.
I would observe that I did not invent that view. It was a view which was expressed by the Commission, consisting of some of the most distinguished people in connexion with a matter of this kind, and I think they were undoubtedly right. The Commission of 1906 consisted of Lord Dunedin, Mr. Arthur Cohen, K.C. and Mr. Sidney Webb, and talking about watching and besetting a house they said:
"It is to be observed that the Statute places no limit to the number of persons attending for the purpose only of obtaining or communicating …information"
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and picketing therefore of that kind
"is always and of necessity in the nature of an annoyance to the person picketed. As such it must savour of compulsion and it cannot be doubted that it is because it is found to compel that trade unions systematically resort to it."
Who is there with a reasonable mind who can doubt that that is true? And who is there that can say that since that part of Section 3 is confined only to cases of attending in numbers—"such numbers or otherwise in such manner as to be calculated to intimidate"—it is unfair, although one may be able to say that there is some slight obscurity as to numbers which might be cleared up?
I am afraid I have been rather longer than I had intended. I might perhaps refer to the "rough music" to which Sir John Anderson referred in another place. There is one other thin I should like to say with regard to the exact effect of the Act of 1927 which I do not think has been said yet. Sir John Anderson was, as your Lordships know, permanent Under-Secretary of State at the Home Office at one time, and he told the people in another place:
"As the matter was left by the Act of 1906, no distinction was drawn between watching and besetting a workman's place of business and watching and besetting a workman's house. I can assure the House that the records of the Home Office bristle with instances where the practice of besetting a workman's home was attended by oppressive conduct of the most outrageous description, and it is significant that there was no proposal in the Bill of 1931 to modify that particular provision of the Act of 1927."
That has never been denied. These outrageous instances are to continue unless a change comes over the spirit of the strikers' world. Will noble Lords opposite really feel comfortable when some years hence they read that these instances of oppressive conduct of the most outrageous description are being continued and that there is the gravest doubt whether any Government action or other action will be taken to stop them?
I could go on, but it is late, and I do not want to keep your Lordships here. I should like to observe this in conclusion, however: that it does not seem to me that noble Lords opposite, or the majority in another place, bother themselves about arguments in any way at all. I have carefully read all they have said, and it seems to me it may be summarized under four heads. They say that the 1927 Act was passed in the wrong spirit, and this Bill

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will improve the atmosphere in industry. Well, that may be a reason for considering an Act and amending it, but if you are going to say an Act is passed in the wrong spirit, you might go back, I suppose, to the Reform Bill. The second contention is that the Secretary of State for Foreign Affairs intends to remove a stigma which the Tory Party put upon him in 1927 as the leader of the trade unions. Well, various noble Lords have already mentioned that strange contention, but it is absolutely without foundation. No stigma whatever was attached either to Mr. Ernest Bevin or to any other person who was a leader of the trade unions or connected with them.
It came upon me as a complete surprise. I know very well that if anybody in this country requires a testimonial from the Tory Party to say how greatly they have appreciated his conduct during the recent months and that any notion of stigma which he ever thought had attached to his name was removed, that testimonial could be obtained for Mr. Ernest Bevin and I should be very glad to put my name at the very head of it. The suggestion is entirely without foundation. Have noble Lords opposite any idea of the mentality of the people with whom they are sitting here if they believe that anybody thinks, some nineteen or twenty years afterwards, that Mr. Ernest Bevin's reputation is still, if it ever has been, affected in the smallest degree by the position he occupied in the strike of 1926, or, I might add, that the reputations of my noble friends Lord Ammon and Lord Walkden are in the smallest degree affected?
That is the second ground. The third is the assertion—I suppose one may call it the contention—that the Bill will establish good will and that there is a mandate for it. Is it really supposed that if one establishes ill will it becomes doubtful whether Acts such as these we have been discussing here are lawful or unlawful? I should think that would sow suspicion and people would not know what they could do properly and what they could not do. Finally, it is said that the Act of 1927 was a reprisal for the General Strike. If so, it was the strangest sort of reprisal I have ever seen, because, as I have shown—and I do not hesitate to say I have shown it—the definition of a General Strike is of the
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narrowest kind and the Act can only be operated in defence of the State. If anybody thinks that is a reprisal for what was done, in the words of the noble Lord on the Woolsack, "with not enough consideration and care," they must be content to hold that view, and I must be content to say that I think it is absolutely unfounded.
The fact is that the Government have been rather affected in this matter by the arrogance due to their possessing a great majority in the other place. At the end of his eloquent speech my noble and learned friend Viscount Simon reminded us of a quotation, of which we were all of us aware, in reference to a "giant's strength." It came, as noble Lords opposite and on this side will know, in the great speech of Isabella in the play Measure for Measure when she was addressing some remark to Angelo. Perhaps I might be permitted to say that ten lines further down Isabella added something which may also be properly quoted. I will omit one line which might be thought to be a little rude to the other side. Isabella said:
"…but man, proud man,
Drest in a little brief authority,
Most ignorant of what he's most assured,
Plays such fantastic tricks before high heaven
As make the angels weep …"
That, I think, might be a description, and not a very unfair one, of the way in which the Government have forced this measure through the other House and of the way in which they are compelling us to accede to it here.
5.16 p.m.
LORD HATHERTON: My Lords, I will not apologize for bringing your Lordships down to earth after that very brilliant exposition from the noble and learned Viscount, Lord Maugham. One of the amenities derived from speaking late in a long debate in this House is that so much has been said before which will not stand repetition. I will not detain your Lordships for more than a few minutes and I will pay attention solely to Section 3. As I see it, there are two assumptions on this section. One is that the Law Officers of the Crown at the time satisfied themselves that the Acts of 1875 and 1906 did not provide sufficient protection for workmen wanting to work during a strike—I do not mean a General

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Strike, but any strike—and that they therefore drafted Section 3 in the Act of 1927, which does in fact give them that protection. On the other hand, in the Committee stage in another place the Attorney-General, in resisting an Amendment for the exemption from repeal of subsection (4) of Section 3, described the argument in favour of it as "the purest political bunkum".
That gives rise to the assumption, in my mind, that those same Law Officers had completely wasted their time and had drafted this long and very difficult section to no good purpose at all. It would take the most powerful peaceful persuasion to make me adopt that latter assumption. On February 12, moving the Second Reading of this Bill in another place, the Attorney-General, dealing with the legal implications, said that at bottom the matters involved in this legislation were matters of common sense and policy. I venture to suggest that common sense and policy do not always go hand in hand. Policy can in fact sometimes try to make the purest political bunkum into common sense, and of course vice versa. I will, however, try to limit myself to the two matters he recommends. On the common-sense point of view, I believe that the Law Officers discovered, with all the facts and evidence in front of them, that the existing legislation contained loopholes legalizing various forms and acts of intimidation—riot any particular form, but various forms of it—and that they set themselves the very humane task of drafting this section to make all those acts in future clearly illegal, thus preserving the right to strike and at the same time preserving the right to work for those who wished to do so without fear of any harm to themselves, their wives or their families.
I do not put much trust in what is normally called persuasion. In times of industrial crisis, when mass meetings are addressed by fiery orators, passions become inflamed, tempers roused, and I do not believe that men under those circumstances will calmly go away, sit down and talk over the merits or demerits of any particular situation. It is at those times that mobs will collect, and when mobs do collect very ugly incidents follow and sometimes even the rule of mob law gets under way. I am quite sure that no responsible trade union leader would ever agree with such acts as hooliganism and
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tyranny, but who can say, human nature being what it is, that these things will not inevitably occur again unless most stringent measures are used to prevent them?
On the question of policy, the Government are continually asking now for greater production, larger output, greater effort for supplying the markets of the world, and urging that our economic position must be made stable. Surely, therefore, the more sensible and, in fact, the obvious thing to have done, instead of repealing this Act would have been to have seen whether it could not have been made even more tight and more protective so that those who wanted to work during the period of a strike could do so in perfect safely and keep up at least some production, because if they have no protection we are going to have no production at all. Moreover, I cannot understand any justification for leaving on the Statute Book Acts which are so loosely drawn as to permit of even one man being forcibly prevented from earning his daily bread in a Christian country. Sorely, to earn one's daily bread is one of the basic rights of Christianity.
We have been fighting for six long years with everything we possess. We have been fighting an ideology which not only permitted but encouraged the oppression of man by man. We have been fighting for another ideology, that which was expressed in the Atlantic Charter by those four famous freedoms, the freedom of speech, the freedom of worship, the freedom from want and the freedom from fear. I think that sets out in the clearest possible terms our conception of democracy. I believe sincerely that if in consequence of the repeal of Section 3 of this Bill such bad forces of human nature are put in motion and let loose with consequent tyranny, history will condemn this Government as having broken faith with that Charter and dishonoured those who died for it, because for countless numbers of people in this country we shall be abolishing one of those freedoms—namely, freedom from fear.
5.25 p.m.
VISCOUNT SWINTON: My Lords, I think everyone will agree that it has not only been right that we should have had this very full debate in this House, but that it has contributed, in the speeches which have been delivered with great

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knowledge and great sincerity on all sides of the House, much of material value. A very respected Member of this House, Viscount Cecil of Chelwood, who is now not a member of my Party—I am not sure whether he is yet a member of the party opposite—speaking recently in a debate here on the functions of this House said:
"There is a strange and, as I think, altogether unhistorical opinion, that Parliamentary debates are of very little importance…. Parliament means etymologically, and it ought to mean, a place where its members talk, for it is by talk that questions can be elucidated, confusion can be clarified, and that fundamental agreement reached which is really the foundation of the whole of our Constitution.… I would submit that this House affords special advantages for a discussion of that kind."
That was reinforced to-day in that interesting speech from Lord Ammon in which he said how much he had been impressed by the sincerity and the dispassionate character of the debates in this House. It is indeed valuable that we should debate a measure of this kind. We were all touched by Lord Ammon's story of his old fights against the noble Lord for the betterment of Post Office conditions.
VISCOUNT SAMUEL: There was no fight.
VISCOUNT SWINTON: It must be a consolation to him to feel to-day that his colleague the Postmaster-General is going to have his sweated salary of £3,000 raised to £5,000. I have listened to nearly the whole of this debate and certainly the first reflection which occurs to me after studying the Bill and hearing the debate is that the time of the Government and of Parliament might be much better occupied than with this Bill. There are plenty of Bills and plenty of problems in front of us. In these frightfully difficult times I would honestly test all proposed measures, legislative or administrative, by this question: Are these measures going to help us to achieve those results which the whole country needs and which we would all wish to join in achieving?
I cannot see how this Bill is going to help the economic condition of the country or the restoration of our trade. The best and indeed the only argument the Government can produce—I want to put the case quite fairly—is that they have constantly advocated the repeal of the 1927 Act, and that in the early days they made it plain that if ever they were in a position to do so they would do
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their best to repeal it. I admit that they have what my noble and learned friend Viscount Simon called yesterday "a sort of mandate" for doing it. I think it is perfectly fair to admit that. Personally I think this is a bad Bill. I hope we shall not be compelled to have other legislation, but I shall be surprised if in the future we do not. Indeed, the noble and learned Lord, the Lord Chancellor, himself in a very powerful and persuasive speech, in which he introduced the Second Reading of this Bill, said that they had not had time to think of what ought to be put in its place, but that the time would come when some new trade union legislation would have to be introduced. I think the Government have got an authority to do this thing if they think it right to take the responsibility for doing it. I go further, and say that this Bill, which is either a good Bill or a bad Bill, is not a Bill which is susceptible of amendment, unless it were desired—and that would be the responsibility of the Government—to produce the kind of amendment to Clause 1 which would substitute for the uncertainty that is going to be created a new certainty. But, as I say, I do not think that this Bill is really susceptible of amendment in this House. I know I speak on both these points for all my colleagues on these Benches. That is why I think it so important that we should consider this Bill fully on the Second Reading.
When I say that the Government have a right—as I think they have—to present this Bill to Parliament, that does not at all mean that if you have a right to do a thing you are necessarily wise in doing it. The real test is whether this Bill is fair. What is it desired to do which cannot be done at present, and which is fair and reasonable and in the national interest? Is it desired to make legal—I will not talk about a General Strike—a political strike, a strike to force the Government, as a Government, to do something? The Lord Chancellor left us in no doubt where he stood in that matter. He was perfectly definite that there was not such an intention. But there was another speech, also made by an eminent lawyer, to which I think I must draw attention. I refer to the speech of the noble Lord, Lord Chorley. I think I am right in saying that he is himself a Professor of Law, a lawyer of high standing, and, in contrast to the Lord Chancellor,

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he advocated most strongly the legalizing of the most extreme form of political strike.
In order that I might not at all misrepresent him I have refreshed my memory from the report of yesterday's debate. I quote from Column 986. Speaking about the speech of the noble and learned Viscount, Lord Simon, Lord Chorley said:
"… he went on from reading Mr. Cramp's statement that the object was to obtain the resignation of the Government—"
there can be no doubt that that was a political motive—
"—and surely it is a perfectly legitimate object—"
I was so surprised at that curious contrast with the Lord Chancellor's speech that I ventured to interrupt, and so this is how the Report continues:
"VISCOUNT SWINTON: By a strike?
"LORD CHORLEY: To make it go to the country in order that the country might pass a verdict on this business. We are all occupying ourselves the whole time trying to bring pressure to bear on the Government.
"VISCOUNT SWINTON: Is that what the present Government are seeking to do and to legalize by this Bill?
"LORD CHORLEY: My contention is that pressure on a Government, provided it is of a legitimate kind—"
I do not quite know what that means. I presume it may mean provided you do not: shoot them. You may remove, but you must not liquidate them.
"—is quite common. To withhold one's work is perfectly legitimate; anybody can withhold his work. The whole time the people are trying to bring pressure to bear on Governments to do this—"
I do not know whether he means to withhold their work. Oh, no, I beg his pardon, I see that the latter part of the sentence runs:
"to do this, that and the other; it is the whole business of politics."
That really is very extraordinary, and it does show what difficulties we get into when we begin to tamper with this legislation. The Lord Chancellor says that the last thing in the world his Government would seek to do would be to make a political strike legal. Lord Chorley suggested that it ought to be the everyday work of every trade union in the country. Now both noble Lords are eminent lawyers—one of them sits on the Woolsack and the other on the Back Benches oppo-
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site. No doubt with his characteristic tact and acumen, the Leader of the House will be able to reconcile their statements. With his characteristic, lucidity he will, I am sure, explain to us what it: is that the Government intend to do, But what he certainly will not be able to explain is what will, in fact, be the legal result when this Act is passed.
I leave aside the quite extraordinary argument by the Attorney-General in another place—that what is wrong should not be made illegal if the relevant law is difficult to enforce. The Lord Chancellor was very careful to steer clear of any such argument in commending this Bill to your Lordships. I do him the justice to say that doubtless he not only realized that it is argumentatively untenable, but he would not himself profess, as head of the judiciary, any such extraordinary faith. And it really is most amazing—I speak in the presence of eminent lawyers who have held office as Lord Chancellor and have been leaders of the Bar—that the leader of the Bar of England should address an argument of that kind to the House of Commons. What becomes of the "Rule of Law" which is what we are holding up as a mirror and an example to all the world? International right may be a difficult thing to define and a difficult thing to enforce, but that has not prevented us from insisting on trying to validate and fortify international justice and equity as International Law. We are a law-abiding people, most surprising persons have professed that we are, and we want to keep the law—at least I suppose we do.
We, at any rate, want to know what are the laws which it is our legal duty to keep. That is a ten t to which we can all subscribe. We all want to keep the law, and to do it we must know what the law is. If the law is wrong, it should be amended. If it is not clear, it should be clarified. The worst amendment that any Legislature can make to the law, is to make it more obscure. And there is no doubt at all that this is what this Bill does. We have listened to some of the greatest lawyers in England in this debate—it is our advantage to have them in this House—and they do not agree as to what the law will be when this Act is passed. Not only do they not agree, but every one of them, even the highest authorities, say that so difficult and obscure will the position be that they would not venture

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to give a final opinion—even for an adequate fee.
The noble and learned Lord Chancellor, in commending the Bill to the House, said that he commended its clarity. The only clarity in the Bill is in its drafting. I have the highest possible respect for Parliamentary draftsmen, but even I could draft in fairly simple language the one necessary clause of a Bill to say that the whole of the Act of 1927 is repealed. That did not tax the draftsman very much. What is not clear is the effect of passing this Bill. In distinction from the noble Lord, Lord Chorley, it is not claimed by the noble and learned Lord, the Lord Chancellor, that a political strike would be made legal. But can anybody deny that when this Bill is passed it will be more difficult for a trade union member to know what is an illegal strike and what is a legal strike? That cannot be right. Is this a wise time to make the position more obscure, to repeal the Act and put nothing in its place? The noble and learned Lord, the Lord Chancellor, was feeling his way towards what ought to be the amendment of the law but the Government have not had time to think that out. It might have been better to delay this legislation until they had had time to think it out. One speaker, from the Benches opposite, asked us to face up to present realities. Honestly, I try to do that. I wonder if the Government are doing that in this Bill. Let me ask them for one moment to face some of the realities.
I am not going to argue the merits of nationalization now. We shall have plenty of opportunity of doing that, on measures which will come to us. But the Government are proposing to nationalize a series of industries and one of the dangers—even the keenest supporter of nationalization will admit this I think—is that you immediately put the State in the direct relation of employer to a great number of workmen, instead of putting the State in the position of the impartial, independent third party who can come in and see justice done, and if necessary do justice. We have had extraordinarily good and most convincing speeches to-day and yesterday from trade union leaders such as the noble Lords, Lord Ammon and Lord Walkden, with all their experience, and (if I may say so), with all
1060
their very highly respected record in the way they have conducted their respective unions over decades of time. They said that what is required is a solution, the right approach to the problem, arbitration—no, I will not say that—conciliation machinery. I cannot say how much I agree with that, but so far you have always had the Government standing aside. Whether people thought the Government were right or wrong the Government were in a position to appoint a conciliation tribunal. Yet every time you nationalize an industry you make that almost impossible, because you put the Government directly in the position of the employer and the row, the dispute, is a dispute between the industry and the Government.
Sir Stafford Cripps, in another place—and it was quite interesting to hear it—talked about strikes and said: "Yes; that weapon, although not to be encouraged is certainly to be safeguarded, so long as capitalism and private enterprise persist." The problem he has to face up to is, what is going to be the position vis-a-vis the Government in the nationalization of industries? Some industries have gone on very well. The Post Office, for instance, as the noble Lord, Lord Ammon, said, has continued for a great many years without a strike. There was one a long time ago. Some industries have been equally fortunate. The iron and steel industry, which it is proposed to nationalize, has gone on for forty years without industrial dispute. The mere fact that the State is the employer or a private individual is the employer does not bring industrial peace. There have been plenty of strikes in municipally-owned industries, some authorized, some unauthorized. I hope we shall avoid strikes. I shall not talk about Bills for "bigger and better strikes." Let nobody suppose that anybody on any side of the House wishes to make trouble. But we legislate, and we have to take into consideration what are the possibilities that may arise from legislation.
Take the case of the mines where, under the Bill which has been introduced, the whole of the big decisions about wages and industrial conditions are reserved to the Minister. I am not arguing that that is right or wrong, but it is a fact. When an industry is nationalized and a Cabinet Minister made directly responsible for

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industrial conditions and wages in that industry, and when the industry strikes against the Minister who has taken the matter to the Cabinet for their decision, is that or is it not a political strike? These really are the issues, and the difficult issues, which we ought to be considering, not whether somebody thought twenty years ago that there was a slur on his name—a slur of which most of us were not conscious. I was concerned with the trouble at the time. When that unwise action was taken one had to fight it; but there was very little ill-will. That is one of the remarkable things in this country. Certainly, until I heard the speeches, made by some who were my colleagues, about slurs and stigmas—or stigmata—I had never thought they applied to any of those with whom we had our little difficulties in the General Strike twenty years ago, and who were so happily our colleagues for years afterwards.
The Government, as the noble and learned Lord, the Lord Chancellor, has said, will have to govern. That must be recognized and powers will have to be taken. If their powers were inadequate they would have to be increased. I agree. We had to accept the challenge in 1926, and it was expected that we should accept it. It was hoped to beat us. It so happens that I was responsible for creating the organization for keeping going the food supplies of this country. One of the things the other side gambled on—I know, because we talked about it after-ward—was that this organization would break down, and the real charge would then have been brought against us that we as a Government had failed to govern. That was really what made it a political strike.
I reveal no secret when I say that after we went out of office, and the Labour Government came in in 1929, that Government for the whole of that time maintained at full strength, and in immediate readiness for action, the whole of the organization which I had created to combat the General Strike in 1926. I know that, because when I went back to the Board of Trade in the Coalition Government of 1931 I said to my Chief of Staff, although did not expect a strike: "I suppose that organization has all gone to pot." His reply was: "Not at all. It is all ready. All the people who did such good work are ready, and every post is filled." I am not imputing blame
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because this was so. Of course it was right to keep it up to concert pitch. It may have been thought likely that even with a Labour Government in power a General Strike was not improbable. But is it not better to try and avoid the possibility? Because we are a law-abiding people, if the country knows—if everybody in the country knows—what is the law and what is not the law, we are much more likely to keep out of this trouble and much more likely to avoid these political strikes.
I will only say one word about one other aspect. There is a compulsory levy. I am not saying you have not the right to bring in this clause. But is it wise, is it fair, is it reasonable.? Why should a man be forced to contract in? Does it not savour rather of the one-party system, the one thing which all over Eastern Europe you are trying to avoid? You are saying you will not recognize the Polish Government—perfectly rightly—unless they allow absolutely free elections. When they come along and say: "Well, of course, we are going to have a nice set of elections; there is only goring to be one list of candidates you can vote for; they will be nicely compounded like a Christmas pudding, of different elements, but only one list"—you repudiate that and you say it is not democracy. And it is not. You protest against it. But is not this compulsory political levy rather like it? Lord Calverley's speech has been referred to already to-day. He said: "What have you got to object to in this?" I am not misquoting him. I will read him his words, if he likes.
LORD CALVERLEY: I am not ashamed.
VISCOUNT SWINTON: No, I know you are not. I wish you were. As a fellow-Yorkshireman, I blush for you. But, after all, said he, you can be a conscientious objector if you want to! Well, is that really the way of democracy? Is it really the democratic way to recruit a Party and to collect your Party funds by conscription, with a conscientious objector clause? That, incidentally, will not be quite so simple. I think a conscientious objector will sometimes be asked questions, just as he is by a tribunal to-day. We must be frank about this. The man who does not subscribe is a marked man—not by you, but when you go into the pits or into the factory, particularly some-

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where where feeling has been running pretty high, it will be found that in many cases such an individual is a marked man.
At any rate, he thinks he may be. The checkweighman or somebody may be quite easily saying something. Anyway, the man thinks he will be, and he does not fill up the form. I do not say there is a tremendous lot of money in it. I should have thought, unless the rate of the levy is very small, that it is more than £25,000. But I am not going to argue about it; whether it is £25,000 or £250,000 is not the point. It is the principle of this thing that matters. We ought to collect our political allegiance and our political funds by a system of voluntary enlistment and not by conscription with a conscientious objector clause. I can understand the Communists supporting this one-party conscription plan. What I am surprised at is the Labour Party supporting it, and I wonder whether you are going to support it quite so enthusiastically if you find that one of the unions—perhaps one of the largest of the unions—decides that the whole of the levy, minus the conscientious objectors (and there will be a bit of a row as to who is a conscientious objector), is to go to the Communist Party.
Then there is intimidation. I think it is a strange commentary, on the aftermath of a war for freedom and freedom from persecution, that you should alter this. It is an illusion to suppose that physical violence is the only form of intimidation or indeed the worst form of intimidation. A man will stand up to a great deal of physical violence, but the intimidation, the coercion, that can be applied to a man indirectly by besetting or by attending frequently at his house, and that of his wife and family, may be much more pressing, much more oppressive, much more un-English than a free fight could be. I must say I think that such a stipulation is a pity. I do not think you need it.
What should be our action? I have no doubt about it at all. We should not reject this Bill, but we are wise to have debated it. Whether in terms there is a mandate or not, I think that it can be fairly claimed that you have power to repeal or amend the Act of 1927, but that
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does not deprive us of our right and duty to debate it fully, as we have done. I think that this debate has been very valuable, and I think, if I may respectfully say so, your Lordships have exercised with judgment, with restraint, and with characteristic ability, your right and your duty to scrutinize this Bill, to expose its barrenness and the difficulties which it will create. The right time to have done this was in this full debate on Second Reading, and I am sure that that dispassionate examination will be valuable now and hereafter.
5.59 p.m.
VISCOUNT ADDISON: My Lords, I should like to join the noble Viscount who has just spoken in his tribute to the value and character of this debate. I agree with him that it is fully worthy of the traditions that this House has established and maintained.
I listened as a layman with great respect to the legal examination of the Bill and some of its implications which was made by the noble and learned Viscount, Lord Maugham, and, to be quite frank, it left me with the feeling that they were very remote from the realities of the case. I think some of the remarks and good-humoured animadversions of the noble Viscount who has just spoken were much closer to the realities than the analysis of the noble and learned Viscount, and I will try, in a short time, in summing up, to refer to some of them. In effect, of course, the decision of the Labour Party years ago to repeal the Act of 1927, if they were ever able to, was made because they felt this was an act of political injustice. That is why they took that decision, and not because of any particular form of words in any particular section. It was because it entered into their souls that it was unjust that they decided that that injustice should be removed if they were ever able to remove it.
I notice that the noble and learned Viscount exhorted us ever so many times, in different forms of words, to refrain from repealing this present Act because it was so necessary that the law should be perfectly clear and certain. Those are the word he used. Well, I am a layman and I do not pretend to say that I am competent to decide whether the law is perfectly "clear and certain." But I

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think, whatever we may say about the Act we are seeking to repeal, it is not perfectly clear and certain as to what it means. Certainly it is not perfectly clear and certain as to what a General Strike means. I do not mind telling your Lordships that at the time of the so-called General Strike I risked a certain measure of unpopularity as a member of the Labour Party in telling a meeting of workmen that in my view the wiser course would have been to have levied themselves so much a week to support the miners. I thought they would have done more to help the miners that way than by the course they took. As a matter of fact, that meeting took it very well. It consisted of Britishers, and as such they recognized that I was saying what I thought. When all is done and said, only about 20 per cent. of the workers of the country joined in the strike, which was called a General Strike, and I am still casting about in my mind as to what exactly is a General Strike. It is not defined in the Act of 1927, and I do not wonder at that; it would be very difficult to define.
Just imagine this case! We are often exhorted by noble Lords to consider a national wages policy. I have never yet been able to get the advocates of this formula to tell me exactly what they mean by it. As it is a highly complicated and technical subject we will leave that point on one side. It is quite conceivable, however, that some Government or other might inaugurate what is described as a national wages policy, and it might well happen—pray God it never will, but it might happen—that the bulk of the people so affected might say, "This is not fair; we will down tools." Well, that would be connected with an industrial dispute, but it would be "general" enough to affect the life of the community exceedingly disastrously if it were persisted in. Let me say, in parentheses, that we fully recognize the necessity to which the noble Viscount referred of the Government safeguarding the life of the community in any emergency. Of course that is the duty of any Government, and it is not affected by whether we repeal this Act or whether we do not. It is, as I have said, the duty of the Government of the country, and, so far as that is concerned, we are not in the least any worse off, as the noble and learned Viscount represented, if we repeal this Act.
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Now I come to another point where I find an absence of that clearness and certainty which the noble and learned Viscount exhorts us to maintain. It is in the clause dealing with intimidation. I would like to say a word about that matter. Let me remind your Lordships that "intimidation" is defined as follows:
"… the expression 'to intimidate' means to cause in the mind of a person a reasonable apprehension of injury to him or to any member of his family or any of his dependants, or of violence or damage to any person or property, and the expression 'injury' includes injury to a person in respect of his business, occupation, employment, or other source of income, and includes any actionable wrong."
If that is an example of the clear and certain definition of what intimidation means, all I have to say is that English to me has ceased to have any meaning.
VISCOUNT MAUGHAM: I am loath to interrupt the noble Viscount, hut, out of fairness to me, he really ought not to suggest that I said any of these things were perfectly clear.
VISCOUNT ADDISON: I beg your pardon. I cannot admit that.
VISCOUNT MAUGHAM: I said amend them and make them clear.
VISCOUNT ADDISON: What the noble Viscount said was that one of the reasons we should not repeal this Act was because it was so necessary that it should be perfectly clear and certain what things meant. Therefore it is a fair and proper assumption to make from that that the Act of 1927 does make it perfectly clear and certain. That is how I understood him. I am sorry if I misunderstood him. I do not wonder, however, that he does not defend the clarity and certainty of that definition of "intimidation," because anything more muddled and confusing it is impossible to imagine. Let us look at this matter a little further Several years ago it was my duty to appoint a Committee which dealt with Trusts, and they provided me with a most illuminating report. I regret that no Government up to the present has been able fully to give effect to some of the recommendations. That is not the point, however. I want to look at this "apprehension of injury" business for a minute. It was proved quite clearly that there were certain associations—I am not going to mention names; it is not

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necessary—which, if a distributor of their goods did not do precisely as he was told in respect, say, of prices, or something else, would put him out of business completely, because they would refuse to supply him with any more goods to sell. That is still the case. But it is not defined as illegal, so far as I know, under this Act. Do you wonder that the workman said: "Why should I, as a trade unionist, be subjected to this type of interpretation of intimidation when this other kind of action goes scot-free, without any condemnation?"
I could multiply these instances easily enough. Take my own profession—the medical profession. We do not deal at all leniently with black-legs. Neither should we; it is quite right that we should not. Many a time I have exhorted students and others who were once under (shall I say my influence?) strictly to maintain the traditions of professional honour and discipline, and I would have had no sympathy whatever—and, as a matter of fact very often no sympathy was displayed—with people who, as we say in common language, would not "play the game." But surely, a person who was so treated would certainly have "a reasonable apprehension of injury" to his business. That applies to many cases, particularly in the professions, and I have no doubt that in the legal profession, if only I knew their secrets, it is the same. Happily these days have gone by, but every noble Lord in this House of the same age or younger even than myself will have vivid recollection of the way in which in our country districts people were informed: "If you vote for So-and-so I have no further use for you," or were threatened in an even more direct manner. I am not going to make too much of that, but it has happened thousands of times, and everybody who has lived close to the life of the people in some districts where there are stupid people knows that it is true. Is not that creating "a reasonable apprehension of injury" to their business? Of course it is. But that, I suppose, is to be left on one side.
VISCOUNT MAUGHAM: Those are not cases of strikes at all.
VISCOUNT ADDISON: I know, but there is "a reasonable apprehension of injury." I am talking about something
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that is made illegal, and this is to be made illegal for a workman.
VISCOUNT MAUGHAM: No, it is not.
VISCOUNT ADDISON: It is under this Act.
VISCOUNT MAUGHAM: That is a wholly inaccurate statement, if the noble Lord will pardon me. This is something that may not be done in a strike which is on behalf of, or in contemplation of or furtherance of a trade dispute. There you have a special rule.
VISCOUNT ADDISON: It does not affect my case in the least. The point is that this is made an offence punishable by law with regard to a trade unionist, and the trade unionist does not quite see the point that he should be singled out in this conspicuous manner for this special treatment.
Let us take another point. The noble Viscount, Lord Swinton, in a very, shall I say, lenient way, dealt with this question of funds. But it is not a "compulsory political levy"—I am using his words. It never was a compulsory political levy; it was a levy which was imposed when, voting by ballot, the members of the union voted that it should be imposed. That is the first point. Now the next point. Here the noble Viscount for once strayed away from reality and spoke of how a man would be a marked man if he did not subscribe, or words to that effect. Years ago it was my privilege, when I was a Labour candidate for a constituency, to lodge, when I went to that constituency, with a man who was the branch secretary of a union—a very responsible official. I remember that on certain days in the week he used to sit, so to speak, at the receipt of custom, and the members came in and paid their subscriptions. Many a time, over a period of certainly not less than three years, he told me how tired he was of so many of the fellows who would not pay into the political fund. They just would not pay in; but for all that they were not marked men. Not a bit of it! I should think it is very doubtful whether half a dozen members of the union apart from the branch secretary knew whether they were paying into the fund or not. For my part, I have never heard of a single case where a man was boycotted or ill-treated because he did not in fact

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pay into the fund, and I think the noble Lord there was being a little bit misled by his case.
There is one other point. There was another principle which was made much of in connexion with this Act of 1927, and that was the principle on which it was based. Let me quote it. "Any person entering the established Civil Service "this was said by the then Attorney-General in introducing the Bill—" must give his undivided allegiance to the State". That is a doctrine that deserves attention. The Post Office employees did not strike and the Civil Service did not strike in the General Strike. I am perfectly certain that nobody recognizes the duty of allegiance of a public servant more honourably and sincerely than, say, the employees of the Post Office, but it is a very different matter to say they must give their undivided allegiance to the State. The people who supported Oliver Cromwell did not take that view; neither did the people who supported the agitation for the Reform Bill nor those poor fellows down in Dorset who were sent into exile because they wanted to associate with their fellows in forming a union for the betterment of their own conditions. I suggest that if you press it as hard as that, so that people have necessarily to disregard their own consciences, their own religious feelings and their own sense of personal obligation, you are landed into Hitlerism straight away. That is where that doctrine leads to. Let us be sensible about it. The whole of British history and the whole course of the development of our free institutions has largely been, in a sense, a revolt against too stringent an interpretation of that sort of doctrine. Everyone of us who has been a Member of Parliament is well aware of the kind of pressure which is applied from time to time.
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Those are the four main principles of the Act which is now on the Statute Book and which it is now proposed to remove. It is not, as the noble and learned Viscount, Lord Maugham, said, that this Government is arrogant about it. This has been the declared intention of the Labour Party for twenty years, and nobody recognizes that more fully than the noble Viscount, Lord Swinton, who has just spoken. He says it is not wise, and I could not expect him to think so, sitting where he does, but that is not the point. This is not some new ebullition of arrogance: this has been the declared and deliberate intention of the Labour Party for twenty years, mainly because the bulk of the people who support us feel, for the reasons which I have indicated and for many more, that the Act which it is now sought to repeal is unfair. I could use stronger language and still be expressing the feelings entertained by hundreds of thousands, in fact, millions, of decent trade unionists about this Act of 1927. That being so, in my judgment the reasons for the repeal of this Act are sound and sufficient reasons, and I hope your Lordships will give it a Second Reading.
On Question, Bill read 2a, and committed to a Committee of the Whole House.

GAS LIGHT AND COKE COMPANY BILL. [H.L.]
Referred to the Examiners.

BUCKS WATER BOARD BILL. [H.L.]
Returned from the Commons, agreed to, with Amendments.
House adjourned at twenty minutes past six o'clock.