Sitting of 7 May 1951

Preamble
The House met at Half past Two o'Clock
PRAYERS
[Mr. SPEAKER in the Chair]
PRIVATE BUSINESS
  LONDON COUNTY COUNCIL [MONEY] BILL
  Read the Third time, and passed.
  UNIVERSITY OF EDINBURGH (ROYAL (DICK) VETERINARY COLLEGE) ORDER CONFIRMATION BILL
  Read the Third time, and passed.
ORAL ANSWERS TO QUESTIONS
  MINISTRY OF SUPPLY

    Motor Industry (Raw Materials)
    Mr. Blackburnasked the Minister of Supply what steps he is taking to ensure that the automobile and ancillary industries are supplied with sufficient raw materials to enable them to work to full capacity.
    The Minister of Supply (Mr. G. R. Strauss): These industries receive their due share of controlled materials. I regret that there is unlikely to be an early improvement in the supply of these materials.
    Mr. Blackburn: Does not the right hon. Gentleman agree that it is absolutely vital that these important industries should work to maximum capacity? In view of that, will he immediately reconsider the export of iron castings, and perhaps also of some forms of steel, so that the maximum amount of steel may be made available to these industries?
    Mr. Strauss: Yes, Sir. The maximum amount is made available to these industries, but they have not been working to capacity at any time since the war. We very much regret that, owing to the falling-off in imports of sheet steel, we cannot supply these industries with all the steel they require.
    Mr. Geoffrey Lloyd: Is the Minister making any special arrangements about the supply of steel for that part of the automobile industry which is working for re-armament?
    Mr. Strauss: The difficulty with the automobile industry is mainly the inability to get sheet steel, owing to lack of imports. There are also some other difficulties; some non-ferrous metals are scarce.
    Mr. Lloyd: May I ask the Minister whether, in addition to the difficulty about sheet steel, he would be prepared to receive representations from me about the shortage of tubular steel which I found in the King's Norton factory centre on Saturday, and which is required for jeeps being made to the order of the Government under the re-armament programme?
    Mr. Strauss: I should be very happy to look into any representations which the right hon. Gentleman may make to me.
    Sir Ralph Glyn: In view of the urgency of the re-armament programme, will the right hon. Gentleman consider those industries which are not working to full capacity, and do whatever he can to see that what is not required by them is diverted to the armaments programme?
    Mr. Strauss: Yes, Sir; so far as it is possible to do so. We have asked all major contractors to do as much subcontracting as they can, in cases where there is vacant capacity and available labour.
    Mr. George Ward: What does the Minister expect will be the production of the new mill at Margam? How soon will it be in production and what difference will that production make to the automobile industry?
    Mr. Strauss: I cannot give exact figures; it should be in full production at the end of the year, and should relieve the situation to some extent.

    Testing Station, Woodmansterne
    Mr. Nugentasked the Minister of Supply whether he is aware of the nuisance from the noise of the aero-engine testing station at Woodmansterne, Carshalton; and what arrangements he is making to move the testing station to some more suitable location.
    Mr. G. R. Strauss: I am aware of complaints of noise from the operation of these test beds. It is hoped to make arrangements to transfer the beds to a more suitable site in the near future.
    Mr. Nugent: Is the Minister aware that in this densely populated area the noise is spread some three or four miles and is very disturbing? When will he implement the undertaking given by his right hon. Friend the Minister of Civil Aviation, three years ago to shift this station to some other place?
    Mr. Strauss: We are trying to make arrangements to shift these beds, and I hope we shall be able to do so within a short time. Various alterations and repairs have to be made, but I am hopeful that, within three or four months, the change will have taken place.
    Mr. Vane: Can the Minister tell us to which hon. Member's constituency this nuisance will be shifted?

    Dakota Aircraft (Disposal)
    Mr. Geoffrey Cooperasked the Minister of Supply how many D.C. 3 Dakota ex-Royal Air Force aircraft have been broken up by his Department, or by contractors, during the last five years; how many of these aircraft are still held ready for breaking up; what consideration has been given to these aircraft being sold for use by the British European Airways Corporation, or any charter companies, instead of being broken up;] and if he will make a statement of Government policy on this matter.
    Mr. G. R. Strauss: One Dakota aircraft was broken down at a Ministry depot before 1948 and none is awaiting breakdown. Since June, 1946, 128 beyond economical repair have been broken down at the request of the Air Ministry, under contracts placed by my Department, for the recovery for the R.A.F. of components and spares, which would otherwise have to be bought for dollars. Dakotas declared surplus are normally disposed of by competitive tender and 20 have been sold in the last five years. Both British European Airways Corporation and charter companies were invited to tender.
    Mr. Cooper: Has my right hon. Friend any information that these aircraft, which
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    he says were not worth recovering, have been flown into some of the aerodromes, or at least one of them, where the breaking down was taking place? Would it not have been worth while, and more advantageous, to have sold them, in view of the high prices they have been fetching?
    Mr. Strauss: Those which were saleable were put up for auction. It is only those which are not saleable and which are in such a bad condition that they have to be broken down, which are broken down.
    Sir Herbert Williams: Will the Minister say what he means? The Question says, "broken up," and he says "broken down." Is he thinking of His Majesty's Government?

    Anglo-U.S. Conversations
    Mr. George Thomasasked the Minister of Supply whether he has any statement to make concerning his conversations with the American representative, Mr. Wilson.
    Mr. G. R. Strauss: At the meeting which I attended with a number of my colleagues, we discussed with Mr. Wilson how best our two countries could co-operate to ensure that the United Kingdom received sufficient raw materials and machine tools to enable it to carry out its re-armament programme and maintain essential civil production. Mr. Wilson said he would do all he could to further United States co-operation with us in both these tasks.
    Mr. Watkinson: Would the right hon. Gentleman add to that statement by saying whether Mr. Wilson said anything as to the effect which this American aid to ourselves and the general gearing up of the American war potential would have on that country's production of civilian goods?
    Mr. Strauss: I think it would be unwise if I went into too much detail and repeated our conversations. I have given the effect of the discussion in my answer.

    Scrap Iron
    Mr. G. Cooperasked the Minister of Supply in view of the shortage of scrap iron, whether he is aware of the large

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    quantity of scrap available from obsolete plant in industry awaiting collection as scrap; and what steps he is taking to stimulate merchants in tapping this source.
    Mr. G. R. Strauss: I would refer my hon. Friend to the replies which I gave to the hon. Member for Altrincham and Sale (Mr. Erroll) on 19th February last and to the hon. and learned Member for Brigg (Mr. E. L. Mallalieu) on 23rd April. Special attention is being given to securing as much scrap as possible from this source.
    Mr. Cooper: In view of the undertaking which my right hon. Friend gave in the House to the effect that he would consider subsidising the recovery of such things as tramlines, would he consider giving similar help in the recovery of the scrap described in this Question, in view of the fact that the present controlled price of scrap makes it uneconomic to recover some of this material?
    Mr. Strauss: I cannot accept that. The information that I have is that the present price is reasonable, and that any increase in the price of scrap would not bring in any more. In special circumstances, such as the raising of tramlines, the industry has agreed to make some special arrangement, but I would not like to expand that very far.
    Sir R. Glyn: Will the Minister consult the Iron and Steel Federation, who feel that the present prices do not sufficiently remunerate the scrap merchants for collecting the metal?
    Mr. Strauss: Yes, Sir. I am in consultation with the Federation, and they agree that the present basic price should not be raised.
    Mr. Nabarro: Can the Minister say to what extent local authorities are participating in this scrap iron drive, in view of the fact that nearly all of them now have organisations for salvaging waste paper, to which, of course, scrap iron is complementary?
    Mr. Strauss: Yes, Sir, the local authorities are being consulted by those responsible, for the scrap iron campaign.
    Mr. Geoffrey Lloyd: The Midlands area, as I think the right hon. Gentleman knows, is a prolific source of this
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    scrap, and would he consider allowing a larger proportion of it to be used locally, thus avoiding the charges involved in its transportation?
    Mr. Strauss: I would like to consider with those responsible whether that is feasible.

    Iron Fencing, Brighton
    Mr. William Teelingasked the Minister of Supply whether his regulations entail the procurement from his Department of a permit for the erection of an iron railing to fence in a field of about nine acres; and, in view of the scarcity if iron, what policy he follows with regard to its use for such purposes.
    Mr. G. R. Strauss: No, Sir. At present, only the distribution of sheet steel and tinplate is controlled. Consideration is being given to possible arrangements for controlling distribution of general steel.
    Mr. Teeling: Does not the right hon. Gentleman think that in this particular case, of which he has already had details, it is rather a shocking thing that iron railings should be used to close an open space very much needed by the local inhabitants?
    Mr. Strauss: That is a matter of opinion, and one for which my right hon. Friend the Minister of Education, and, I understand, the Brighton Council, are responsible. My answer to the Question which the hon. Gentleman puts to me is that I have no responsibility and no control in the matter.
    Lieut.-Colonel Lipton: Can my right hon. Friend give any information about the latter part of his first answer, namely, the general distribution of steel supplies?
    Mr. Strauss: That matter is still being considered, and I propose to consult certain representatives of industry in the matter. I cannot say exactly when I can make an announcement, but it will certainly not be before Whitsun.

    Machine Tools
    Mr. James Johnsonasked the Minister of Supply whether in view of the large number of machine tools required for defence and other essential purposes,

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    he now has any further statement to make in assurance that they will be used to the best advantage.
    Mr. G. R. Strauss: Yes, Sir. I have consulted my Engineering and Machine Tool Advisory Councils about arrangements for ensuring that all machine tools on order are used to best advantage for the defence programme and other essential purposes. I am happy to say that my Department's proposals for this have been accepted by both machine tool users and manufacturers represented on these bodies. I would like to acknowledge the public spirit in which these proposals were received and to thank the machine tool industry for so willingly placing their services at my disposal. As the explanation of the arrangements is rather long. I will, with permission, circulate it in the OFFICIAL REPORT.
    Mr. Cooper: Can my right hon. Friend say whether, in view of recent reports that we are exporting rather a lot of machine tools to satellite countries, he will take that into account in the light of the statement he has just made?
    Mr. Strauss: I do not think that that report is accurate.
    Mr. Watkinson: In view of the Minister's statement the other day that the credit for the acquisition of machine tools in America was due to the Government because of their policy of bulk buying, would he take this opportunity to tell the House that it was entirely a question of private enterprise co-operating with the Government?
    Mr. Strauss: We acknowledge the help and co-operation which we have received from private enterprise in this matter. I have never questioned that.
    Following is the explanation:
    Arrangements have been made for machine tool manufacturers to provide my Department with detailed schedules of their proposed deliveries. On the basis of this information and expert advice from industry, my Department will be in a position to ensure, in co-operation with the users, that machine tools from all sources are deployed to the best advantage for defence and other essential purposes. This expert advice will be provided by advisory panels which are being set up in consultation with the Machine Tool Trades Association and the Institution of Production Engineers. These panels will advise my Department on questions referred to them concerning the utilisation of
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    machine tools, and, in particular, will advise, after consultation with all concerned, as to possible alternative methods of meeting demands. The panels will be advisory only; action will be my responsibility.
    Although I regret the need to ask some firms to accept deferment of deliveries, I am afraid that the defence programme is bound to entail diversion of some machine tools from civil uses. I hope, however, to have the co-operation of the firms concerned in arranging this by voluntary agreement.

  NATIONAL INSURANCE

    Children (Allowances)
    Mr. Maudlingasked the Minister of National Insurance what arrangements are made for the payment of family allowances in respect of children placed under the care of local authorities, in local authority homes and foster homes, respectively.
    The Minister of National Insurance (Dr. Edith Summerskill): Allowances are not payable for children committed by the courts to the care of a local authority or to an approved school or for children over whom a local authority has assumed parental rights. Other children in the care of local authorities are counted in the parent's family for allowances so long as the parents contribute at least 5s. a week towards the maintenance of each child.

    Savings Certificates (Interest)
    Mr. Maudlingasked the Minister of National Insurance (1) why applicants for National Assistance are assumed to receive a notional income in respect of any National Savings Certificates they may hold;
    (2) whether she will now reduce the assumed rate of interest on any savings possessed by applicants for National Assistance, in view of the fact that the present assumed rates are much greater than the yield on trustee securities.
    Dr. Summerskill: The treatment of capital for assistance purposes, which is prescribed by statute, does not turn on the interest actually earned: the material point is the extent to which the capital itself is to be regarded as available for the person's need.
    Mr. Maudling: In view of the fact that the Chancellor of the Exchequer will

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    ignore interest on National Saving Certificates for the purposes of taxation, cannot this also be done for the purposes of computing National Assistance, and, if an element of capital spending is involved in this 5 and 10 per cent. interest rate, should not that be made quite clear?
    Dr. Summerskill: I think the hon. Gentleman, would agree, if he thought a little more about this subject, that, although it is a good debating point, it would take more than 50 years for an old age pensioner with a capital of £400 to reduce it to £125.

    Benefit Claims
    Captain Duncanasked the Minister of National Insurance when the National Insurance Advisory Committee will have completed their review of the time limits for claiming benefit under the National Insurance scheme; and whether she will publish their report.
    Dr. Summerskill: I understand from the chairman of the Committee that their examination of this difficult question is now far advanced, but he cannot yet say when the report will be completed. I think I must await the report before deciding whether to publish it.
    Captain Duncan: Can the Minister say whether this Committee are taking into consideration the special conditions obtaining where railwaymen are involved? They have to submit certificates to the railway authorities and those certificates have then to be returned and sent to the National Insurance authorities.
    Dr. Summerskill: I cannot give an affirmative reply to that, but I will certainly bring the point to the attention of the Committee.
    Miss Burtonasked the Minister of National Insurance if, as the trade unions in Coventry have expressed strong opinions that the provisions of Section 13 (1) (a) and (b) of the National Insurance Act, 1946, cause hardship in many cases, she will reconsider her decision not to promote amending legislation.
    Dr. Summerskill: I am afraid I cannot add to the answer given to my hon. Friend's Question on this subject on 9th April.
    Miss Burton: As my right hon. Friend was obviously misinformed when she
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    gave that answer—because both the A.E.U. and the Confederation of Shipbuilding and Engineering Unions have made representations on this—may I ask whether she will receive a deputation so that we may enlighten her on the matter, particularly as last month at Brighton—I quote her words—she said, "Legislation, however good, can always be improved"?
    Dr. Summerskill: I think my hon. Friend underestimates the efficiency of my staff. I am never misinformed, at least by my staff. But I suggest that if my hon. Friend examines the figures more carefully she will find she has not been given the latest information. The number of claimants for benefits in this case which were initially disallowed were 393; the number since allowed is 351 and the number now under consideration is 35, which, I think, alters the position altogether. The terms of this Section are exactly the same today as they were in 1924, and although I accept the fact that she is vigilant on behalf of these men she must realise that the T.U.C. have also been vigilant since 1924 on their behalf.
    Miss Burton: Will my right hon. Friend reconsider her reply as the Confederation of Shipbuilding and Engineering Unions and the A.E.U. in Coventry have made representations to the T.U.C.? They are not misinformed and I am not discussing one particular case. Will my right hon. Friend therefore receive a deputation, so that we can discuss it?
    Dr. Summerskill: I am sure that if the industrial representatives of the men want to bring a deputation to me they will do so and I am quite prepared to receive them.
    Mr. Godfrey Nicholson——
    Mr. Speaker: I should deprecate a mere man taking part in this.

    Retirement Pensions (Reciprocity)
    Miss Hornsby-Smithasked the Minister of National Insurance if she will consider making arrangements whereby when a person goes to live abroad, and consequently is unable to obtain payment of his retirement pension, the pension can be paid into the person's bank or Post Office account in Britain, so that if he

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    returns to this country he can draw on it, or if he dies without utilising it this money will form part of his estate.
    Dr. Summerskill: Retirement pensions awarded in this country are payable in any part of His Majesty's Dominions. As regards other countries, I think this is a matter which is best dealt with on the basis of reciprocal agreements, a number of which are being negotiated at the present time.
    Miss Hornsby-Smith: In view of the fact that, as the right hon. Lady says, reciprocal arrangements have been made with some Dominion and foreign Governments to allow payment of these pensions abroad, would she not agree that it is only just that some arrangement should be made for people living in countries not so covered, in order that they can regain the contributions made under the scheme?
    Dr. Summerskill: The hon. Lady has forgotten one important point, that without reciprocal arrangements we have no guarantee, unless we have another Government observing the matter for us, that the recipient is observing our regulations.

  FUEL AND POWER

    Coal (Supplementary Allowances)
    Sir Ian Fraserasked the Minister of Fuel and Power what are the conditions as regards age, health or other circumstances which are taken into consideration by local fuel officers in determining whether an extra ration of coal should be granted.
    The Minister of Fuel and Power (Mr. Philip Noel-Baker): I would refer the hon. Member to a speech made by my right hon. Friend the Minister of Labour on 19th February, when he gave a general account of the system which the local fuel overseers apply.
    Sir I. Fraser: But that Minister is no longer there, is he? Would the right hon. Gentleman make sure that the parties concerned know what these rules are so that they may be equally interpreted with the same sympathy in different parts of the country? Will he publish in the OFFICIAL REPORT what the rules really are?
    Mr. Noel-Baker: The rules have been built up by administrative practice over a long period and I think they are administered fairly in all parts of the country.
    Mr. John Rodgersasked the Minister of Fuel and Power if he will take steps to see coal is available to merchants in the Sevenoaks area so that they can honour medical priority certificates.
    Mr. P. Noel-Baker: As I have said in answer to earlier Questions, priority needs are given a first claim on house coal supplies. The current supplies to Sevenoaks, as to other areas, are being well maintained, and I am advised by the local fuel overseers in the Sevenoaks area that they know of no case in which a priority need has not been met. If, however, the hon. Member will let me have particulars of any case of hardship which he has in mind, I will cause inquiries to be made.
    Mr. Rodgers: Is the right hon. Gentleman aware that I shall be very happy to furnish him with a case of a husband and wife, both suffering from serious lung trouble, who have had no coal for a fortnight? Does he not think that local fuel overseers, before issuing a licence against a certificate, should find out whether coal is available?
    Mr. Noel-Baker: If the overseer issues a permit and the coal is not supplied by the merchant, then the overseer will give immediate instructions that it should be supplied by another merchant. Perhaps the hon. Gentleman will so advise his constituents.

    Coal Output
    Mr. Tom Brownasked the Minister of Fuel and Power if he is now in a position to state the total output the miners have produced in response to the Prime Minister's appeal some three months ago.
    Mr. P. Noel-Baker: The average number of workers in the pits during the first four months of this year was 6,500 less than in the corresponding period a year ago. During January and February there was the worst epidemic of influenza for many years. In spite of these handicaps, the output of deep-mined coal was 3,078,000 tons more than were produced in the first four months of 1950. I am

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    sure the House will agree that this result reflects great credit on the National Coal Board, on the divisional boards, and on the managements and men.
    Mr. Brown: Is my right hon. Friend aware that his answer contains conclusive evidence which gives the lie direct to statements made in certain quarters in January and February that the miners were not pulling their weight? Is he further aware that it reveals the active patriotism of British miners?
    Mr. Noel-Baker: I am fully in agreement with my hon. Friend.
    Mr. Geoffrey Lloyd: While agreeing very much with what the hon. Member for Ince (Mr. T. Brown) and the Minister have said about the miners, may I ask the right hon. Gentleman whether his statement does not also conclusively show that it would have been much wiser to have made this appeal earlier and not to have waited until January, when the shortage was already causing hardship?
    Mr. Nicholson: Does the right hon. Gentleman agree that this is a very important question and should not be a mere cockshy of party politics? Can he tell the House how much of this welcome increase is due to extra hard work on the part of the miners, how much is due to reorganisation by his Department, and how much is due to mechanisation, and so on?
    Mr. Noel-Baker: I hope and believe that the investment programme of the Coal Board is giving constantly increasing results. Saturday working is certainly giving a large part of the additional coal; and the output per man shift, although it tends to be reduced by Saturday working because of the short shift, has, nevertheless, been 3 per cent. higher than last year.
    Sir Peter Macdonald: Is it now necessary to import coal from America at £8 a ton, occupying a great part of our shipping space?
    Mr. Noel-Baker: That is another question.
    Mr. Nicholson: Will the right hon. Gentleman break these figures up into districts?
    Mr. Noel-Baker: There is another Question on that on the Order Paper.
    Mr. T. Brownasked the Minister of Fuel and Power the output of coal from each region separately in response to the Prime Minister's appeal some three months ago; and the output for the same period in 1950.
    Mr. P. Noel-Baker: Every division, and, to the best of my knowledge, every area, has made its contribution to the increased output of deep mined coal which there has been this year. With my hon. Friend's permission, I will circulate the detailed figures in the OFFICIAL REPORT.
    Following are the figures:

    DEEP-MINED OUTPUT FOR FIRST 17 WEEKS OF YEAR

    Tons

    Division

    17 weeks ended 28th April, 1951

    17 weeks ended 29th April, 1950

    Increase 1951 over 1950

    Scotland

    8,043,600

    7,788,100

    +255,500

    Northern (N. & C.)

    4,429,200

    4,333,500

    +95,700

    Durham

    9,170,800

    8,742,000

    +428,800

    North-Eastern.

    14,973,900

    14,396,300

    +577,600

    North-western.

    5,218,300

    4,869,500

    +348,800

    East Midlands.

    14,326,900

    13,402,500

    +924,400

    West Midlands.

    6,110,500

    5,915,000

    +195,500

    South-Western.

    8,453,000

    8,228,900

    +224,100

    South-Eastern.

    595,500

    568,200

    +27,300

    Great Britain.

    71,321,700

    68,244,000

    +3,077,700

    Mr. Shepherdasked the Minister of Fuel and Power the extent to which the miners have been able to fulfil their undertaking of an extra 3,000,000 tons of coal made to the Prime Minister.
    Mr. P. Noel-Baker: I would refer the hon. Member to the answer which I have made this afternoon to Question No. 20.

    Coal and Coke Supplies
    Commander Nobleasked the Minister of Fuel and Power whether extra supplies of household coal will be sold this summer at a price lower than in winter.
    Captain John Crowderasked the Minister of Fuel and Power if there is to be a reduction in the price of coal during the summer months.
    Mr. P. Noel-Baker: As I said in answer to a Question last week, I have arranged that between now and the end of October the National Coal Board shall supply to the merchants about 800,000 tons more house coal than they received during the summer months last year. The merchants have undertaken that, if the coal is made available to them, they will build up their stocks by the end of October to 2½ million tons.
    The National Coal Board, the Coal Merchants' Federation and the Co-operative Union have put forward proposals for lower summer prices, based on the scheme which worked so well last year. I am confident that these proposals will again encourage domestic users to stock more coal during the summer months, and thus to lighten the burden of distribution during the winter, when the weather is hard. I hope that the details of this year's scheme will shortly be announced.
    Commander Noble: Could the Minister say what arrangements are being made for those people who have very small storage space and, therefore, are not able to take advantage of this extra coal?
    Mr. Noel-Baker: Merchants will be willing to repeat the pledge made last year that they will ensure that people without stocking space get priority in winter. I think they have fulfilled that pledge.
    Captain Crowder: Can the Minister say whether his statement includes anthracite and domestic boiler fuel, because my Question does not mention domestic coal?
    Mr. Noel-Baker: It does not include anthracite. I think there will be a little more anthracite, but not much.
    Commander Noble: Will this extra coal they are able to buy in winter be at summer prices, because that is the point?
    Mr. Noel-Baker: No, Sir. Unfortunately, we cannot work it that way.
    Mr. Harrison: If there are increased stocks to be held by the merchants, will it be permissible for people without stocking capacity to have extra supplies next winter?
    Mr. Noel-Baker: They will get the normal supply and if they need more they will be licensed to have it, if it is a case of hardship.
    Mr. W. Robson-Brown: The Minister said he hoped that at the end of October stocks would be 2½ million tons. Can he say what the stock of domestic coal was in October last year?
    Mr. Noel-Baker: It was 2,020,000 tons. This year, I hope it will be about 500,000 tons more.
    Mr. Hugh Fraserasked the Minister of Fuel and Power whether, in view of shortfalls of coal delivered to householders during the coal year just ended, and of shortfalls announced to come, he will adjust maximum permitted quantities in the various regions to a more realistic figure to mitigate sudden hardships and allow more accurate anticipation by merchants and consumers.
    Mr. P. Noel-Baker: With respect, I do not think that a reduction in the maximum quantities of coal which householders may buy would have the advantages which the hon. Member suggests. On the contrary, I think it might cause some hardship and much additional administrative work.
    Mr. Fraser: Is the right hon. Gentleman aware that in parts of the country, certainly in the Midlands, there is a current shortfall of 12 per cent. in maximum permitted quantities, and that the proposed increase of 800,000 tons to the home market will only mean a 3 per cent. increase? Is he further aware that maximum permitted quantities are regarded as a ration by the majority of the public, with automatic results of hardship and miscalculation?
    Mr. Noel-Baker: The figure given by the hon. Member is the overall average. Many consumers take much less than the permitted quantity. Some take none at all. Therefore, merchants are able to give the full permitted quantity to many people who need it. If that were not the case, that is, if the permitted quantities were reduced, it would be necessary to issue hundreds of thousands more licences, which, I think, would cause a lot of trouble to no useful purpose.
    Mr. Nabarroasked the Minister of Fuel and Power whether the domestic coal

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    allocation applicable heretofore will be increased strictly pro-rata 30,000,00: 30,800,00 during the coal year 1951–52; and by how much, expressed in hundredweights, the domestic coal allocation for the north of the country and the south, respectively, will be increased in the coal year 1951–52.
    Mr. P. Noel-Baker: The extra coal to be supplied this summer by the National Coal Board to the house coal market will be allocated to the various regions by the house coal distribution scheme, in consultation with the officers of my Department. The allocations will be fixed in the light of the requirements of the various regions for summer consumption, and of their capacity and need for building up their stocks during the summer months.
    I cannot yet say how much coal can be given to the house coal market during the winter; I regret, therefore, that I am unable to make the calculations for which the hon. Gentleman has asked.
    Mr. Nabarro: On a point of order. May I say, first of all, Sir, that there are two typographical errors in the Question? A nought has been left off both the figures, and the Question should read "30,000,000: 30,800,000 during the coal year 1951–52."
    May I now ask my supplementary? Can the right hon. Gentleman tell the House what will be the effect of the increased allocation which is made upon last year's standard house coal allocation of 34 cwt. per annum in the south of the country, and 50 cwt. in the north? He must have an idea of approximately what the increase will be.
    Mr. Noel-Baker: As I have said, I propose not to change the maximum permitted quantity.
    Brigadier Prior-Palmer: Will the right hon. Gentleman bear in mind that in the case of horticulture the extra allocation of coal made in the summer cannot be taken up because horticulturists cannot afford to take it up? Will he bear that point in mind when making allocations to horticulturists, particularly in the southwest?
    Mr. Noel-Baker: I will bear the point in mind.
    Mr. Paget: Can we be told what difference it makes to the ratio if half a dozen noughts are added to the end of the figures in the Question?
    Mr. Geoffrey Lloyd: I understood the right hon. Gentleman to say that he was proposing to look at this situation again later in the year. Would he bear in mind the possibility of increasing the amount that can be given to householders, because that is the fundamental cause of all the difficulties over the priority certificates and of most of the hardship?
    Mr. Noel-Baker: I shall add as much as it is possible to give during the winter, but I cannot now say what that will be.
    Mr. Rentonasked the Minister of Fuel and Power what steps he has taken to secure adequate supplies of coke for domestic users for next winter.
    Mr. Nabarroasked the Minister of Fuel and Power whether he proposes to arrange an increased supply of coke for domestic consumption, commensurate with the recently announced increase in allocation of household coal, during 1951–52; and what special facilities will be provided to householders for summer purchase of coke.
    Mr. P. Noel-Baker: I hope that there will be rather more coke for the domestic market than there was a year ago. As the hon. Members know, the sale of coke is not now subject to restriction; this has led to certain difficulties, and I am now considering what measures can be taken to improve the distribution of the available supplies.
    Mr. Renton: Is the right hon. Gentleman aware that for many months past domestic consumers who are dependent upon coke for both cooking and heating have been suffering great inconvenience, particularly in the Eastern regions? Does his answer mean that he can hold out no hope of this awkward situation being improved by next winter?
    Mr. Noel-Baker: Merchants have endeavoured to give priority to people who were entirely dependent on coke for cooking and heating. But in the absence of statutory restrictions, it does happen that some people build up large stocks and that others consequently get less than they need.
    Mr. Nabarro: Is the right hon. Gentleman aware of the acute hardship caused last winter when there were long queues of women and children at gas works trying to secure half cwts. of coke?
    Mr. Noel-Baker: There was a lot more coke available last winter than there was the year before, but unfortunately the demand had increased even more.
    Mr. Nabarro: They were not given any coal.
    Captain Duncan: Would the right hon. Gentleman answer the last part of Question No. 33, dealing with summer stocking?
    Mr. Noel-Baker: I think that will have to be as it was last year. No new special arrangements will be made.
    Mr. Renton: With reference to the right hon. Gentleman's statement that people have been building up large stocks of coke, is he aware that it is quite impossible even if anyone had wished to do so because the coke has not been available?
    Mr. Noel-Baker: I am speaking of last summer, when some people took very large amounts.
    Captain Crowderasked the Minister of Fuel and Power whether adequate supplies of coke are now available to meet all demands during the summer months; and if he will make a statement.
    Mr. P. Noel-Baker: As I have said in answer to Questions Nos. 29 and 33, I hope that there will be rather more coke for the domestic user this summer than there was a year ago. I am arranging that industrial consumers shall receive the coke they need for current use during the summer months. In addition, I propose that, so far as the supply of the various qualities permits, supplies shall also be provided to enable them to build up their stocks by the end of October to an average of six to eight weeks' winter consumption.
    I propose, further, to arrange that the Armed Forces, local authorities and essential non-industrial consumers, such as hospitals, schools and bakeries, shall be provided with enough coke to build up their stocks by the end of the summer to an average of 12 weeks' consumption.
    Captain Crowder: Will the quality be a little better than what we are getting now, because it is very difficult to burn it properly in domestic boilers?
    Mr. Noel-Baker: That is another question.
    Mr. Geoffrey Wilsonasked the Minister of Fuel and Power whether he can give an assurance that there are sufficient supplies of Group II fuel available to the public to maintain in service existing appliances designed for its use.
    Mr. P. Noel-Baker: I regret that I have no statistics which would justify me in giving the hon. Member the assurances for which he asks.
    Mr. Wilson: Is the right hon. Gentleman aware that the Coal Utilisation Joint Council have been encouraging people to buy appliances which use this type of fuel, particularly anthracite? Is he satisfied that the supply will meet the increasing demand, especially in view of exports of anthracite?
    Mr. Noel-Baker: I do not know how many appliances there are in use and I do not know what is their average requirement. I cannot, therefore, give the assurance which the hon. Member seeks.

    Gas and Electricity (Cooking)
    Mrs. Jean Mannasked the Minister of Fuel and Power how far the researches made by his Department establish whether the use of gas or electricity for cooking is the more economical in the use of coal; and what steps he is taking to encourage the more economical method.
    Mr. P. Noel-Baker: I would refer my hon. Friend to the answer which I made to the hon. Member for Shrewsbury (Mr. Langford-Holt) on 9th April, when I gave him the results of research work done by the Department of Scientific and Industrial Research. I am at present discussing these complex problems with the chairmen of the national boards concerned.
    Mrs. Mann: Will my right hon. Friend bear in mind, during the discussions, that the Electricity Authority are charging local authorities £15 per house per installation, if gas is used for cooking purposes, and that the charge to local

    1577
    authorities is reduced to £3 if no gas is used at all? As that is contrary to the national interest will he remember it during the negotiations?
    Mr. Noel-Baker: Every nationalised board must adopt business principles in order to make its business pay, and the electricity and gas authorities have both been making money. The hon. Lady has raised a very difficult question on which I am at the moment engaged in consultation with the nationalised boards.
    Mr. Renton: Is the right hon. Gentleman aware that the system of charging for electricity, including the domestic two-part tariff, is calculated to encourage the consumption of electricity and, therefore, indirectly, the consumption of coal? Will he advise the Electricity Authority to use a system of charging which will encourage economy of coal while at the same time not relinquishing any profit that they can reasonably get?
    Mr. Noel-Baker: The hon. Member will realise that before the Authority took over, a great variety of different tariffs were in operation all over the country. They have been endeavouring, more or less to standardise them, and they are now engaged in considering the principles of the long-term tariff policy which they should adopt. They are bearing in mind the very point which the hon. Member has raised. It is a most complex matter.
    Mrs. Mann: Will my right hon. Friend impress on the boards that the national interest must come before profit making, and that it is very much against the national interest to waste our fuel reserves and to import coal from America?
    Mr. Noel-Baker: Yes, I have spoken in that sense with great force to the nationalised boards.
    Mr. John Hynd: Does not the Minister realise that a great number of his hon. Friends will be shocked to learn that he proposes to allow the principles of cutthroat competition and waste of overhead expenditure in uneconomic advertising, which is a burden upon the nationalised boards?
    Mr. Noel-Baker: I have just said that that is what I propose not to do.

    Coal Consumers' Council (Representations)
    Miss Irene Wardasked the Minister of Fuel and Power what representations he has received from the Domestic Coal Consumers' Council on the quantity and quality of coal supplied to consumers; and what reply has been sent.
    Mr. P. Noel-Baker: In March the Domestic Coal Consumers' Council told me that, in their view, there had not been enough house coal this winter to enable all domestic users to keep their homes reasonably warm. They urged on me that, in future, sufficient coal should be provides to allow domestic users to get the coal they want, up to the permitted quantities, together with extra coal authorised for special needs.
    I discussed the matter with the Council on 2nd May; I told them of the extra provision of solid fuel made in 1950; of the further provision made for this summer; and of the greatly increased domestic use of electricity and gas. On the question of the quality of house coal, I would refer the hon. Lady to my reply to her Question on 19th March, to which I have nothing to add.
    Miss Ward: Is the right hon. Gentleman aware that the Domestic Coal Consumers' Council also gave that answer to the Housewives' League? I have the letter here. In view of the Council's answer, how can the right hon. Gentleman say that last year the scheme worked satisfactorily?
    Mr. Noel-Baker: I have always said that we need more coal for the house coal market. This year we have increased output and cut exports very heavily in order to provide it.
    Mr. Harrison: Irrespective of the other demands on the coal supplies, will my right hon. Friend accept the responsibility of providing more domestic coal so as to avoid the hardship which took place last winter? Could we have a categorical answer?
    Mr. Noel-Baker: I have already said three times this afternoon, that I am trying to do that.
    Miss Ward: In view of the very terse communication from the right hon. Gentleman to the National Coal Board, will he publish the Coal Board's answer to that communication in HANSARD.
    Mr. Noel-Baker: I do not understand to which communication the hon. Lady refers.
    Miss Ward: In reply to one of my hon. Friends the right hon. Gentleman said he had communicated with the National Coal Board in very strong terms on the need for greater coal production. I want to know whether the Coal Board have replied to his communication.
    Mr. Noel-Baker: In the answer to which the hon. Lady refers I was talking about the comparative efficiency of the use of coal in the form of electricity and the use of coal in the form of gas.

    Coal (Quality)
    Miss Wardasked the Minister of Fuel and Power how many applications have been received from coal merchants for compensation for replacement of bad quality coal; what was the total sum applied for; and the total amount paid.
    Mr. P. Noel-Baker: The hon. Lady is no doubt referring to the procedure described in the annual reports of the National Coal Board whereby, in cases where complaints about quality of coal are well-founded, the Board give the merchants a price allowance which they can pass on to their customers. I am sure the hon. Lady will understand that, as these are day-to-day commercial transactions between the coal merchants and the National Coal Board, it would not be right for me to ask for the information she desires.
    Miss Ward: Am I to understand from that reply that the Minister has never measured the quality of coal supplied by coal merchants by inquiring how much compensation the merchants have had to pay to their customers? If I am right in my observation, I think the right hon. Gentleman has failed in his duty concerning the quality of coal.
    Hon. Members: Answer.
    Mr. Speaker: That is a hypothetical matter. The hon. Lady said, "If I am right in my observation," and so on. That is purely hypothetical.

    Mines (Safety)
    Miss Wardasked the Minister of Fuel and Power how far the recommendations
    1580
    of the Royal Commission on Safety in Mines appointed in 1938 are now operative.
    Mr. P. Noel-Baker: The Royal Commission made numerous recommendations on safety precautions in the mines; statutory effect has been or is being given to most of them by General Regulations made under the Coal Mines Act, 1911. Statutory effect has also been given or will shortly be given to most of their recommendations about management and the qualifications of officials by General Regulations made under the Coal Industry Act, 1949.
    The Commission's recommendations on matters of administration have been carried out; for example, the Inspectorate of Mines has been re-organised. Numerous other recommendations, for example, those on dust suppression, the provision of pithead baths, the safety organisation, and other matters, are being voluntarily carried out by the National Coal Board.
    Miss Ward: As it appears to have taken a very long time to put all these recommendations into operation, could the right hon. Gentleman say what Government were in power when the Commission was set up, who was the Prime Minister and who was the Secretary for Mines?
    Mr. Noel-Baker: It was a Conservative Government. They got the report, but they did not manage to pass any legislation.
    Mr. Geoffrey Lloyd: Would the right hon. Gentleman, in fairness, bear in mind that a draft Bill based upon these recommendations had been prepared after most painstaking work by my right hon. and gallant Friend the Member for Gainsborough (Captain Crookshank) and that it was to be my duty to introduce it if war had not broken out in 1939?
    Mr. Noel-Baker: Yes, Sir, but we could not take up that Bill after the war because the conditions of the industry had changed, and they are still changing.
    Mr. J. Hynd: So that we may get the time factor clear, will the Minister tell us how long the conditions which gave rise to the Commission were in existence before the Commission was set up and what Governments were in office during that time?

    Fuel Efficiency
    Mr. Nabarroasked the Minister of Fuel and Power the nature and composition of the advisory services, maintained or sponsored by his Department, to secure optimum industrial fuel utilisation and economy, with special reference to coal; whether reports are published periodically of the activities of such advisory services; and whether, in view of the urgent need for coal conservation, any expansion or re-organisation of these advisory services is now contemplated.
    Mr. P. Noel-Baker: I am advised by a Central Fuel Efficiency Advisory Committee and by 12 regional committees; their members are prominent engineers, scientists and other experts. I have a service of fuel technicians to advise industry and to improve the standard of stoking in industrial plants; their numbers have been increased in the last few months from 117 to 144.
    I have mobile testing units to measure the heat and power produced in industrial plants, and to detect waste; their numbers have been increased from four to 16 since September last. Educational courses in fuel technology have been provided. Reports of this work appear in the Board of Trade Journal; and in "Fuel Efficiency News," a monthly publication issued by my Ministry. Numerous textbooks and bulletins are also published. All these services are being expanded, as suitable experts can be found.
    Mr. Nabarro: In view of the diverse character of the services to which the right hon. Gentleman refers, and the urgent need for impressing upon all industrial undertakings the requirement of the conservation of solid fuel, will he now consider the consolidation of these services and providing a wider measure of publicity for them?
    Mr. Noel-Baker: I think the services are already consolidated by my Ministry. I am constantly encouraging publicity for them, both educational and by propaganda. I am glad to say that I am having the full co-operation of the F.B.I, and the trade associations.
    Sir Waldron Smithers: Will the right hon. Gentleman change the title of the paper to which he referred from "Fuel Efficiency News" to "Fuel Inefficiency News"?

  FOOD SUPPLIES

    Fish Prices
    Mr. Arthur Lewisasked the Minister of Food the wholesale and retail price of fish over the last 12 months during the period of price control; and whether he will now reintroduce price control.
    Mrs. Mannasked the Minister of Food if, in view of his undertakings dating from the time of the decontrol of fish prices to continue to keep these prices under review, he will now give the prices of fish landing, wholesale and retail for the last three months of control; and for the same period since.
    The Parliamentary Secretary to the Ministry of Food (Mr. Frederick Willey): The prices of fish at all stages of distribution during the last year of price control were set out in the schedules to the Fish (Maximum Prices) Order, 1948, S.I. No. 2610). I have sent copies of this Order to my hon. Friends. As regards the first hand wholesale and retail prices during the past three months, I am circulating a table in the OFFICIAL REPORT.
    On the question of reintroducing price control I would refer my hon. Friend to my reply to my hon. Friend the Member for Coatbridge and Airdrie (Mrs. Mann) on 2nd May. I am glad to state, however, that there were increased landings of fish last week, and landings today are again heavy. This has brought down prices generally and the average price of cod at Hull is now, in fact, below the level under control. Retail prices last week reflected this fall and our reports indicate that the prices of cod fillets and haddock are falling sharply towards the former control prices.
    Mr. Lewis: I do not know where the Parliamentary Secretary gets his information about falling prices, but if he will consult his wife and any housewives on this side of the House, he will find that prices have not fallen. [HON. MEMBERS: "Speech."] Will my hon. Friend now reintroduce price control of all types of fish as speedily as possible?
    Mr. Remnant: And weather control?
    Mr. Willey: The prices upon which we rely are based on samples covering large numbers of towns in different parts of the country.
    Mrs. Mann: Is my hon. Friend aware that there is a report today that 700 tons of white fish were landed at a port last week, about two-thirds of which was from foreign boats? Can he explain how it is that whenever a Question is asked about the re-imposition of controls there is always a big landing and prices fall, which situation is reversed again immediately we forget all about it?
    Mr. Willey: I can assure my hon. Friend that as far as my researches show there is no relationship between Questions and increased landings.
    Air Commodore Harvey: Will the hon. Gentleman inform his hon. Friends that as a result of landings by German trawlers last Saturday and this morning hundreds of tons of white fish have gone for manure?
    Mrs. Braddock: Has my hon. Friend's attention been drawn to the statement on the front page of the "News Chronicle" this morning that very many tons of fish are to be destroyed because there is no way of getting the price which those who are bringing in the fish need? Is it not time that his Department had some machinery to prevent private enterprise from throwing fish back again into the sea or sending it for manure because they cannot get the price they require?
    Mr. Willey: I have seen the report to which my hon. Friend draws my attention, but I have no further information.
    Mr. J. J. Robertson: Is my hon. Friend able to tell us that in all cases where the landing price of fish is low that is reflected in retail prices in the shops?
    Mr. Willey: It is impossible to give an assurance in all cases because it is impossible to trace different parcels of fish, but general inquiries show that the average prices in the retail shops do reflect the average prices of landings.
    Mr. Leslie Hale: Will my hon. Friend bear in mind that it is authoritatively stated in the Press today that in view of heavy landings it is impossible to pass on the reduction in price to the consumer?
    1584
    If we are to have what is called economic prices in times of glut and inflated prices in times of scarcity, is that not an obvious argument for the re-imposition of control?
    Mr. Willey: As I have already informed the House, as far as our limited inquiries show retail prices at present are reaching about control prices.
    Mr. Douglas Marshall: In view of the supplementary questions which have been asked, can the Minister say whether any fish have been thrown back into the sea?
    Mr. Willey: I have no further information, apart from that to which my attention has been drawn.
    Mr. A. Edward Davies: From the experience of many housewives in the country, and from a good deal of the ex-experience of the Ministry, would my hon. Friend not agree that the prices now running are very much more than they were last year when we had control? Has my hon. Friend given up all idea of controlling the prices of fish?
    Mr. Willey: With regard to the latter part of that supplementary, this matter is still under review. With regard to the first part, if we have competitive retailing then we must expect price variations.
    Mr. McAdden: Can the hon. Gentleman say whether there is any obstacle being placed by his Department in the way of Co-operative societies purchasing the fish and selling it at a lower price?
    Mrs. Mann: Would it help my hon. Friend to do a little tracing if I tell him that 1,000 cwt. were landed at Aberdeen on Saturday and realised 21s.—that is, 2d. per lb.? Would my hon. Friend try to trace what the housewife paid per lb. on Saturday?
    Mr. A. Lewis: Can my hon. Friend tell us where we can go to find this fish—[HON. MEMBERS: "The Savoy."] Those frequenting the Savoy do not care what it costs. Can my hon. Friend tell us where housewives can go to find the fish that is supposed to be cheaper than it was last week?
    Following is the reply:

    RANGE OF WEEKLY AVERAGE FIRST-HAND AND RETAIL PRICES AND RANGE OF ACTUAL INLAND WHOLESALE PRICES

    (January 14th to April 14th, 1951)

    —

    First-hand

    Inland Wholesale

    Retail

    (a)

    (b)

    (c)

    per lb.

    per lb.

    per lb.

    Cod, whole

    …

    …

    …

    3¼d. to 6¾d.

    4¾d. to 1/-

    (e)

    fillets

    …

    …

    …

    —

    6½d. to 1/6¾d.

    1/3½d. to 1/9½d

    Haddock, whole

    …

    …

    …

    3¾d. to 9¾d.

    3½d. to 1/3½d.

    1/3d. to 1/6d.

    Hake, whole

    …

    …

    …

    1/2¼d. to 1/8½d.

    5¼d. to 2/6d.

    2/9½d. to 3/2½d.

    Plaice, whole

    …

    …

    …

    1/0½d. to 1/6¾d.

    4¼d. to 2/3½d.

    1/10d. to 2/1½d.

    Herrings, whole

    …

    …

    …

    2¼d. to 4½d. (d)

    3½d. to 9d.

    7½d. to 10d.

    (a) Average of first-hand prices reported from Aberdeen, Hull, Grimsby, Fleetwood and Milford Haven.

    (b) Range of prices at Billingsgate, Glasgow, Birmingham and Manchester inland markets on Tuesday of each week.

    (c) Average retail prices based on samples collected in certain towns in Great Britain weekly, usually Tuesday.

    (d) British—caught herrings only.

    (e) No retail price available for whole cod.

    India (Loan of Wheat)
    Mr. Leslie Haleasked the Minister of Food whether he will now make a full statement of the steps taken by his Department, by diversion of supplies and otherwise, to relieve the threatened famine in the Province of Bihar.
    Mr. F. Willey: I would refer my hon. Friend to the replies given by my right hon. Friend the Secretary of State for Commonwealth Relations to the hon. Members for Hornsey (Mr Gammans) and Jarrow (Mr. Fernyhough) on 5th and 19th April. The Government of India have since been informed that, notwithstanding our own need, we are prepared to agree to the deferment of repayment for the time being of the loan of 43,000 tons of wheat that we made in November last. We share in the feeling of sympathy for the people of India in their difficulty and would like to give more assistance if that were possible; but we are dependent for the greater part of our grain upon imported supplies, and the prospects for home-grown wheat this year are not good.
    Mr. Hale: The answer was not very clearly audible. I understood my hon. Friend to say that every effort had been made, and I also understood him to refer me to a previous answer to two hon. Members. Would my hon. Friend realise
    1586
    that this effort the Government have made to assist in relieving famine is one which ought to have the widest possible publicity that the person who drafted this answer might have given all the information for publication in the Press, and the fullest news about the effort we have made, which has impaired, to some extent, our own economy? Would my hon. Friend accept the assurance that any further effort we can make will receive the fullest support of all hon. Members on this side?
    Mr. Nicholson: Do I understand that the sum total of the help this country is able to give to India is to forgo the repayment of this loan of grain?
    Mr. Willey: The help we gave was both the grain we diverted to India and the shipping we placed at India's disposal to ensure that other grain reached her in time.
    Captain Duncan: I understood the hon. Gentleman to say we had lent 43,000 tons of wheat to India. Is the repayment of that loan to be in kind or in cash?

    Argentine Beef
    Mr. Keenanasked the Minister of Food at what date he now expects the meat from Argentina to be on sale in the United Kingdom.
    Mr. F. Willey: Argentine meat should begin to arrive later this month, but because of the need to build up stocks I cannot say when or in what quantities it will be on sale to the public.
    Mr. Keenan: Is my hon. Friend aware that his right hon. Friend stated recently that its sale would begin in August? Would my hon. Friend give an assurance that, as the time between the loading of the meat in the Argentine and its appearance on the market here should not exceed six weeks, shipments will reach this country and be marketed in that time?
    Mr. Willey: I think the statement to which my hon. Friend refers related to an increase in the ration in August.
    Sir H. Williams: Will the hon. Gentleman say how the price will compare with the present price of meat?
    Commander Noble: Does the Parliamentary Secretary's answer mean that the greater ration of 1s. 8d. in August is now in jeopardy?
    Mr. Willey: No, Sir. The answer means no more than that the Argentine meat will arrive later this month; and that I am not able to say when it will be on sale to the public.
    Major Legge-Bourke: Would the hon. Gentleman say what he means by building up stocks, in view of the fact that chilled beef does not keep long enough to build up stocks with it?
    Mr. Willey: I am not referring especially to chilled beef in this answer.
    Mr. C. S. Taylor: Will the hon. Gentleman consult with the Prime Minister to see when the most appropriate time is—politically—to increase the meat ration?
    Mr. H. Fraser: Will the Parliamentary Secretary give the House an assurance that the 200,000 tons will be delivered in the coming year?
    Mr. Speaker: That does not seem to arise out of the original Question, which asks when the meat will be on sale in this country. Sir Hartley Shawcross.

  QUESTIONS TO MINISTERS
  The following Question stood upon the Order Paper:
  60. Lieut.-Colonel Sir THOMAS MOORE,—To ask the Secretary of State for Foreign Affairs whether he proposes to
  1588
  put a time limit on the discussions in Paris between the Foreign Ministers' Deputies, after which he will order his representative to return to this country.
  Sir T. Moore: On a point of order. May I direct your attention, Mr. Speaker, to Question No. 60, and suggest that possibly the House may like to have an answer to it and that the Foreign Secretary may like to give that answer?
  Mr. Speaker: That has nothing to do with me. Possibly the House may like to, or it may not; but it has nothing to do with me.
  Sir T. Moore: I thought that if I raised it with you, Mr. Speaker, that would give an opportunity to the Secretary of State to answer the Question.
  Mr. Speaker: It is no good raising it with me. I have no authority in the matter whatever. If a Minister wishes to answer a Question because he, and not other people, thinks it is of public importance, then he can ask leave to do so, and I can give my permission; but otherwise it has nothing to do with me at all.
  Mr. Blackburn: On a point of order. May I ask, Mr. Speaker, whether you would be so kind as to say something about the fact that Questions to the Prime Minister today have not been reached, because this is important to those of us concerned about trade with China?
  Mr. Speaker: If the hon. Gentleman has seen his daily newspapers he will know that a statement is to be made about trade with China. Indeed, I have already called the President of the Board of Trade. He is about to make that statement, which, I gather, will answer the hon. Gentleman's question.
  Sir T. Moore: Further to my point of order. In view of the fact that we are apparently having a farce in Paris, which is highly detrimental to this country——
  Mr. Speaker: The hon. and gallant Gentleman must not take the opportunity to discuss his own Question. That would be highly improper. If the Foreign Secretary wishes to answer the Question now, he can do so. If he does not, then the hon. and gallant Gentleman will get a written answer, and he must be satisfied with that.

EXPORTS TO CHINA
The President of the Board of Trade (Sir Hartley Shawcross): Arising out of the Questions which were asked in the House on Wednesday and Thursday of last week about the export of goods of strategic value to China, I desire, with permission, to make a fairly full statement about the policy of His Majesty's Government and practice in this matter which I recognise to be of the greatest importance.
The total exports from the United Kingdom to China of goods of all types during 1950 and during the first quarter of 1951 were £3.6 million and £1.3 million respectively. During the first quarter of 1951 the value of goods imported from China into the U.K. totalled £2.7 million. Since the start of fighting in Korea last June careful watch has been kept on our trade with China and various restrictions have been imposed to ensure that she should not receive from the United Kingdom goods which would be of value to her in connection with her military operations in Korea.
All goods of direct military importance and many other goods which might directly assist her military operations are totally prohibited. This prohibition of exports already covers all military equipment, aircraft of all types, specialised motor vehicles, copper, zinc and their alloys and a wide range of industrial goods, including all machine tools. Supplies of many other goods are restricted to what we regard as normal quantities for civilian use in China.
This control is exercised in part by statutory orders and in other cases through the co-operation of the trade associations concerned. Certain goods, although not necessarily of strategic importance, are not exported to China because all supplies are needed to meet our own requirements and those of friendly nations.
We have not imposed a total embargo on trade with China as the U.S.A. have done. It has not so far been the policy of the United Nations to impose economic sanctions against China, and we have not ourselves prohibited all trade. We are, however, naturally in close consultation with other friendly powers and our present practice is certainly not less restrictive than that of other friendly countries except the U.S.A.
1590
In a written answer to a Question by the hon. Member for Northfield (Mr. Blackburn), on Monday, 30th April, I gave figures of the total United Kingdom exports to China showing the amounts under the main categories. These categories are ones used in the Trade and Navigation Accounts and as hon. Members would see from examination of the export list, each of these categories covers a wide range of goods.
As there have been a number of references to those figures and a certain amount of misapprehension as to their significance, I should like briefly to comment on the main items contained in the total trade and to say that these small exports of goods—which include no arms, explosives, or other items of direct war value—have to the best of our knowledge been absorbed in the Chinese civilian economy and indeed fall far short of her normal civilian needs, aggravated as these have been by years of internal warfare. It is nonsense to suppose that they have been a factor of any significance in the Korean campaign.
Under the heading IRON AND STEEL AND MANUFACTURES THEREOF our total exports to China in the first three months of 1951 amounted to £230,000. This included the following main items:

£

Tons

Tubes, pipes and fittings

95,000

1,170

Tinplate

53,000

628

Wire cable and rope

34,000

293

Bars and rods

20,000

494

The tubes, pipes and fittings were largely for use in connection with repair and maintenance of the Shanghai Power Station and we regarded this export as unobjectionable. The tinplate is exported exclusively for use in packing liquid eggs for import into the United Kingdom.
NON-FERROUS METALS AND MANUFACTURES THEREOF, totalling £57,000 comprised:

£

Tons

Lead sheet

…

53,500

338

Copper wire

…

2,200

10

Copper tubes and strip

…

1,600

4½

ELECTRICAL GOODS AND APPARATUS totalled £163,000, and the principal items were:

£

Insulated cables and wires

64,000

Electro-medical apparatus

30,000

Insulating materials

14,000

House service meters

12,000

X-ray apparatus

11,000

Radio and telecommunications apparatus including valves

9,000

1591
MACHINERY to the total value of £225,000 consisted chiefly of:

£

Textile machinery

51,000

Boilers and boilerhouse plant

91,000

Mechanical handling equipment

14,000

Pumps

13,000

Electrical generators without prime Movers

12,000

Portable Dower tools

12,000

The boilerhouse plant, like the boiler tubes, were required for the Shanghai Power Station.
CHEMICALS, DRUGS, DYES AND COLOURS to the total value of £105,000 consisted mainly of:

£

Coal tar dyes

…

28,000

Iodides

…

12,000

Sodium compounds

…

10,000

Acids (sulphuric acid nil)

…

10,000

Other chemicals

…

21,000

Paints and colours

…

10,000

Penicillin

…

4,000

Other medicines and drugs

…

8,000

VEHICLES, a category which in our Trade Returns, includes locomotives, ships and aircraft, on which there has been most comment, totalled £71,090, made us as follows:

£

Cycles

38,000

Pneumatic rubber tyres and tubes

32,000

Axles, tyres and wheels for railway vehicles

1,000

Apart from two motor cars no motor vehicles, ships or aircraft were exported to China during the whole of 1950, or during the first quarter of 1951.
It is not the case that the United Kingdom has been increasing its exports to Hong Kong in order that they might be re-exported to China from that Colony. United Kingdom total exports to Hong Kong in the first quarter of 1951 were in fact less than in the previous quarter and less than they were in the first quarter of last year.
Trading between Hong Kong and China is a matter falling within the Department of my right hon. Friend the Secretary of State for the Colonies, but it might be convenient for me to indicate here the general position. Despite Hong Kong's special position, her economic dependence on her entrepôt trade with China and the high proportion of her population who are Chinese, the Hong Kong Government have taken measures to prevent supplies of goods of military importance going to China and
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to limit the flow of other goods which might be of value to the Chinese forces fighting in Korea. Determined efforts are also made to suppress smuggling although I would not wish anyone to underestimate the difficulties of doing so.
Exports from Hong Kong to China are subject to a similar pattern of legal and administrative controls to those operating in regard to direct exports to China from the United Kingdom. In regard to exports not subject to absolute prohibitions, however, the exports of certain items, notably rubber, have shown in recent months increases which have already led to action to strengthen the restrictions and controls on trade with China and make them more stringent, further action being under consideration.
The total exports from Hong Kong to China in the first quarter of this year amounted to approximately £43 million as compared with approximately £91 million in the previous year. They included no petroleum products or other items of direct strategic importance such as aircraft or munitions.
The amount of rubber exports from the Federation of Malaya and Singapore which included exports through Hong Kong to China was given by the Under-Secretary of State for the Colonies, in reply to a Question by the hon. Member for Wokingham (Mr. Remnant, on 12th April). Earlier in April His Majesty's Government in the United Kingdom and the Governments of the Federation of Malaya and Singapore announced their intention to control exports of rubber as from 9th April to the estimated civilian requirements, about 2,500 tons per month to China.
There have been exchanges of view between His Majesty's Government and the Government of the United States, and in view of the failure so far of the Good Offices Committee of the United Nations to secure a settlement in Korea, the question of further action in regard to exports to China is under consideration both in the Additional Measures Committee of the United Nations and between the Governments concerned, particularly His Majesty's Government and the Colonial Governments.
Moreover, since the 30th March, in addition to the control on crude rubber, export controls have been imposed on all

1593
tyres with a cross section of seven inches or more, including tyres for load-carrying vehicles, or heavy passenger cars, and since that date no tyres have been licensed for export to China. Licensing control has also been imposed, or is in course of being imposed, on bars, rods, sections, wire and cable of alloy steel and on other types of iron and steel and on insulated copper wire.
Mr. Churchill: We are indebted to the President of the Board of Trade for the full and elaborate statement which he has made to us upon this question which is, as His Majesty's Government are no doubt aware, a topic of controversial discussion in the United States and elsewhere. Is it not—to adopt the interrogatory form—rather a pity that when this burning question was raised and indeed broke out among us, as to what was going on in the world last week, and various questions were asked, the Prime Minister and the Minister of Defence and those who advise them had not got a more clear idea of what was going on; and might not some trouble and misunderstanding have been avoided if this business, which ought to have been vigilantly watched by the Government, could have been laid plainly and clearly before the House when it was first raised? We cannot ourselves attempt to pronounce upon this statement until we have looked into it, but should we find it necessary to ask the Leader of the House to arrange for a change of business for part of Thursday, that will be put forward by us through the usual channels.
Sir H. Shawcross: I can assure the right hon. Gentleman that the matter has been the subject of vigilant consideration by His Majesty's Government. I do not think that a direct question was put to my right hon. Friend the Minister of Defence, but I will at once concede that for my own part it would have been better if the detailed return that I gave had been broken down into further categories. Hon. Member would not then have been misled into thinking that any ships or aircraft or vehicles had been exported, although the sum of £71,000 involved might have led them to the conclusion that the amount of ships or aircraft involved could not have been very great.
Mr. Paget: Would the President of the Board of Trade agree that the policy of an embargo or blockade on Hong Kong
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would be just about as likely to bring about the invasion of that territory as General MacArthur's other policy in respect of the Yalu River brought about invasion there; and would he, therefore, see that a general arrangement as to the defence of Hong Kong on an effective basis was agreed with the Americans before any such policy was adopted.
Mr. Walter Fletcher: Would the President of the Board of Trade answer, firstly, the question as to what steps His Majesty's Government are taking to see that alternative sources of supply such as Indonesia, Ceylon and India, who have openly expressed their unwillingness to co-operate, shall be brought into line; and, secondly, what steps have been taken to see that the exports from Japan of very considerable quantities of material, including metal and metal manufactured goods, is stopped; and, thirdly, would he consider possibly sending immediately a Parliamentary mission to inquire into these matters on the spot in view of the growing disquiet that does exist in spite of his reply?
Sir H. Shawcross: I cannot, of course, answer for the action of other countries in exporting strategic materials to Hong Kong, but these will no doubt be matters which will be under consideration by the United Nations in the discussions that are taking place, or are about to take place, before the Additional Measures Committee. I think I used the expression "exports to Hong Kong" in my last answer. I meant, of course, exports from foreign countries to China.
Nor can I answer in regard to the position of exports from Japan to China, although I understand it is a fact that some goods were exported from Japan to China in exchange for essential goods such as coal, exported from China to Japan. As concerns the last part of the question, I would have thought that the general circumstances were sufficiently known to make it unnecessary to have a special Parliamentary mission to inquire into them on the spot.
Mr. Mikardo: If strategic materials are going to China from the United States colony in Japan, what are the grounds for American complaints against us?
Mr. R. A. Butler: Is the right hon. and learned Gentleman aware that in the

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answer to which he referred in relation to the Under-Secretary of State for the Colonies on the subject of Malayan exports of rubber, the figure given for the first quarter of 1951 is 46,500 tons, and that the figure for the whole of the preceding year is 77,624 tons. Does that not show a very remarkable increase for that first quarter?
Sir H. Shawcross: I entirely agree with the right hon. Gentleman that the increase was significant and it was for that reason that we decided to impose a control which has cut down the exports of rubber to China through Hong Kong, or otherwise, to a figure which is considered to be much below her civilian requirements, namely, 2,500 tons a month.
Mr. Churchill: Is there any means of making sure that this import of 2,500 tons a month is in fact used for civilian consumption—[HON. MEMBERS: "Oh."]—and has not been commandeered by the military authorities, as would happen in time of war in a great many countries? Is the right hon. and learned Gentleman quite sure of that, because it appears to be on a small scale as it is now cut down, and it seems a pity to have misunderstandings on that point?
Sir H. Shawcross: It is quite difficult to ensure that rubber is not misused when it gets to China. We are doing our best to keep a watch on the purposes for which it is required and we shall consider whether other measures are necessary. Nor can we prevent China obtaining supplies in quantity of rubber from other countries.
Mr. Frederick Elwyn Jones: What was the nature of the goods that China has exported to the United Kingdom and Hong Kong in the last 12 months? Is my right hon. and learned Friend aware that on this side of the House we fully support His Majesty's Government in opposing an economic blockade of China?
Sir H. Shawcross: The imports of goods from China into this country during the first quarter of this year were very varied in their nature, the main item consisting of liquid eggs in tins. The total amounted to £2,700,000. There was four tons of tungsten. In addition, there were very considerable imports, largely of food supplies, into Hong Kong itself.
Mr. Blackburn: Is the President of the Board of Trade aware, in the first place, that so far as the comparatively minor matter was concerned of exports from the United Kingdom to China, I warned his office—[HON. MEMBERS: "Oh."]—specifically about the importance of it on the Saturday before he answered the Question. He has admitted today that he answered it misleadingly. In so far as anything misleading has come out, it is his responsibility and not anybody else's. In the second place, does not the Minister appreciate that the figures which he has given to this House, and which I venture to say have not yet been assimilated, show that no less than £100 million of exports have gone to China since the start of this war in Korea, and that we have supplied, on his own figures, about 10 times as much rubber to the Chinese as is their normal civilian requirement, month after month? Is it not high time that His Majesty's Government woke up and gave up making vast profits out of people against whom our boys have been fighting?
Sir H. Shawcross: I am afraid that I am quite unable to accept either the figures or the conclusion put forward by the hon. Gentleman. The reference which I made in my original statement to the nature of these exports is true, that they have in fact made no significant contribution to the Chinese war potential against our forces in Korea. The only exception that it occurs to me to make at the moment in regard to that, is the increase in rubber exports at the beginning of this year, which we have already taken steps to control.
Mr. Chetwynd: In view of the current misunderstanding and misstatement in the United States of our export policy towards China, can my right hon. and learned Friend see that our information services over there give the fullest publicity to his statement?
Sir H. Shawcross: I certainly hope that that will be done.
Sir Ralph Glyn: May I ask the Secretary of State for the Colonies whether, in order to straighten out opinion expressed in the United States and elsewhere, he can inform the House what has been the policy of the Governor in Hong Kong in providing employment for the

1597
large number of refugees who have gone into the Colony, and the importance of importing into the Colony raw materials on which they can work?
The Secretary of State for the Colonies (Mr. James Griffiths): As I believe I have informed the House on more than one occasion, there has been a very substantial increase in the population in Hong Kong in recent years. We have afforded asylum in Hong Kong to all the refugees who have come there, and this has created an enormous problem. We thought that it was the right thing to do. It will be realised that Hong Kong is very largely dependent upon supplies coming from China.
Earl Winterton: In view of the very genuine feeling over this question in the United States—whether it is right or wrong—in quarters by no means hostile to this country—feeling which is in many respects the most dangerous there has been since the Anglo-American Alliance—will the right hon. and learned Gentleman, through the Foreign Secretary, instruct His Majesty's Ambassador in the United States to give the fullest publicity to his statement, and not merely through the information services, so that the Americans may have an opportunity of judging the rights or wrongs of the matter? Is the right hon. and learned Gentleman also aware that on this side of the House we do not feel—unlike many hon. Members on that side—that this is a laughing matter?
Sir H. Shawcross: I am glad to give the noble Lord that assurance. I said at the commencement of my statement that we regarded it as an important matter. We hope that the United States will now be better informed of the true position.
Mr. James Hudson: Was not my right hon. and learned Friend perhaps a little generous to the Opposition when he suggested that they were excused by the fact that he had not broken down the original figure, especially when he sees now that, after the most explicit denial by the Prime Minister and others, the Opposition continue to make this impression of a very large trade with China, and carry it on for the purpose of encouraging the Americans to make similar wrong conclusions?
Mr. Spenee: Can the right hon. and learned Gentleman give a little more information about the £43 million of our exports from Hong Kong to China in the first quarter? Can he say whether that figure is of total exports, or whether it is only the British total, of goods from Hong Kong to China.
Sir H. Shawcross: It represents the total exports of trade from Hong Kong into China.
Sir Herbert Williams: What does it consist of?
Mr. Driberg: In view of one supplementary question today and several the other day, would my right hon. Friend agree that the best way of saving the lives of British and American soldiers is to prevent any major extension of the war in the Far East, and that a general embargo on trade with the Chinese is not the best way of trying to persuade them to open negotiations?
Mr. Peter Thorneycroft: The right hon. and learned Gentleman said that he had in mind that we should export 2,500 tons a month of rubber, making a total of 30,000 tons a year. In view of the fact that we have already, in the first quarter, exported 46,000 tons, or more than half as much again as the total figure for the full year, would he not think it rather unreasonable to go on at that rate, which would mean that the yearly figure would be 70,000 tons, or more than twice the amount he thinks is appropriate?
Sir H. Shawcross: I have said that we were looking at the whole of this question very carefully, and we are continuing to look at it.
Mr. Churchill: Having regard to the immense importation of rubber in the last year into China, would it not be better to stop it altogether now, completely, and thus reach a satisfactory solution with our great Ally?
Sir H. Shawcross: The right hon. Gentleman will appreciate that this question and all other questions relating to exports to China is now receiving or about to receive the fullest consideration not only in the Additional Measures Committee of the United Nations, where concerted action must be agreed to, but

1599
also in discussions between His Majesty's Government and the colonial Governments involved.
Mr. Emrys Hughes: If Hong Kong does not import rice, fresh meat, vegetables, food, oils and eggs from China what is likely to be the food position in Hong Kong if that trade disappears?
Sir H. Shawcross: We cannot, of course, disregard the geographical situation of Hong Kong, or the fact that it depends in the main for food supplies, and entirely for water supplies, on the mainland of China.
Sir H. Williams: For exports from Hong Kong into China the right hon. and learned Gentleman has given a figure of £44 million in three months. As that is more or less the figure given by General MacArthur during the United States Congressional investigation, ought there not to be a real examination of what the £44 million consists of?
Sir H. Shawcross: The whole returns for the first quarter have not yet been broken down, but we are breaking them down——
Mr. Churchill: "Analysing" is the better word.
Sir H. Shawcross: I am obliged to the right hon. Gentleman, who is a great authority on these matters. We are analysing the various details which we have for the first two months in connection with the strengthening of the system of controls and increasing their stringency in particular cases.
Mr. Scholefield Allen: Will His Majesty's Government go very carefully on this question of sanctions against China, particularly having regard to the fact that it was a Conservative Prime Minister who described sanctions as "mid-summer madness"?
Mr. Pickthorn: In view of the right hon. Gentleman's expression about China's military operations, are we to assume that China is at war with the United Nations and the United Nations with China, but that the separate nations have not yet got to the point of economic sanctions? If so, is it not more difficult than ever to understand international law?
Sir H. Shawcross: That is a question which might perhaps be more appropriately put to the Attorney-General.
Mrs. Jean Mann: Can my right hon. and learned Friend give us some idea of the quantity and value of the exports which our great Ally is allowing to seep through via Japan?
Mr. Thomas Reid: Will my right hon. and learned Friend ask the United Nations to see that in the case of rubber and other things not merely this country but countries like Indonesia play the game?
Air Commodore Harvey: Is the right hon. and learned Gentleman aware that considerable quantities of raw materials and equipment reach China from Hong Kong via the Portuguese colony of Macao, which is side-tracking all the rules and regulations? Does the statement made by him apply to exports to Macao, to prevent them going on to China?
Sir H. Shawcross: I am not certain what the hon. and gallant Gentleman has in mind. If he is referring to goods which are discharged on a through bill of lading and not really imported into Hong Kong at all, it may be so, but we have no control over that. I am not in possession of the figures. There is a certain amount of trans-shipping from larger ships into sampans and smaller ships in the port of Hong Kong, and that is not a matter which goes into the export trade of Hong Kong.
Air Commodore Harvey: If I may make it clear, is the right hon. and learned Gentleman aware that merchants in Macao buy goods which are prohibited from being exported from Hong Kong to China, ship them to Macao and then send them over the border into China? Will he look into that?
Sir H. Shawcross Sir H. Shawcross indicated assent.
Several Hon. Members Several Hon. Members rose——
Mr. Speaker: We cannot debate this further by question and answer. We had better wait to see if we are to have a debate about it on Thursday.

BUSINESS OF THE HOUSE
Proceedings on the National Health Service Bill exempted, at this day's Sitting, from the provisions of Standing Order No. 1 (Sittings of the House).—[The Prime Minister.]
ORDERS OF THE DAY

  NATIONAL HEALTH SERVICE BILL
  Order read for consideration, as amended.
  Bill re-committed to a Committee of the whole House in respect of the Amendment to Clause 1, page 1, line 15, standing on the Notice Paper in the name of Mr. Marquand.—[Mr. Marquand.]
  Bill immediately considered in Committee.
  [Colonel Sir CHARLES MACANDREW in the Chair]

  NATIONAL HEALTH SERVICE BILL

    Clause 1.—(CHARGES IN RESPECT OF CERTAIN DENTAL AND OPTICAL APPLIANCES.)
    4.9 p.m.
    The Parliamentary Secretary to the Ministry of Health (Mr. Blenkinsop): I beg to move, in page 1, line 15, to leave out from "patient," to end of line 16, and to insert:
    "who is resident in a hospital at the time when the appliance is supplied and has been continuously so resident since the examination or testing of sight under the said Part II leading to the supply of that appliance."
    On the Committee stage there was a great deal of discussion on the provisions of Clause 1 (2) of this Bill which sought to exempt hospital in-patients from these charges. Two main issues were raised in the discussion. One was whether greater clarity could be obtained in the wording of this provision as to precisely where and at what moment of time the charge would lie; and a second point was raised by my hon. Friends, who sought to extend this provision beyond the exemption proposed in the Bill for in-patients in hospital to the wider categories of those who may be under treatment from their own doctor in their own homes, and other cases of that kind.
    I said on the Committee stage that the provision as it stood in the Bill meant that where an appliance, either glasses or teeth, was supplied to a hospital in-patient while he was in hospital, the patient would be exempted from the charge. There was some doubt whether that was the case, but after taking further advice on the matter I can say that that is the position as the subsection is drafted.
    1602
    That still means that those who are in pay-beds or in disclaimed hospitals are not exempt from the charge; the charge would fall upon them as I explained in Committee.
    After very careful consideration, we have put forward this Amendment which, we feel, somewhat clarifies the position. It has the effect, of course, of restricting the exemption to the category described by many hon. Members as "comparatively long-stay patients in hospital." It provides that the exemption would apply to a patient who is resident in hospital at the time an appliance is supplied and has been so resident since the examination or testing of sight under Part II which led to the supply of an appliance.
    What we have sought to do is to make quite clear that the categories of patients which we are attempting to exempt completely and automatically from the charge are those I mentioned during the Committee stage, namely, those for whom the provision of spectacles or dentures is a natural part of treatment in hospitals and all those who are long-stay patients, such as chronic patients in hospitals or mental hospitals, most of whom, as I said in Committee, would in all probability anyhow be exempt under the provisions through which the National Assistance Board takes account of personal hardship. We have attempted to meet at least some of the points raised by hon. Members on both sides of the Committee in order to make as clear as possible the position of the hospital in-patient and avoid creating large numbers of anomalies as between an in-patient and a patient who is treated at home. After careful examination of all alternative ways in which anomalies might be reduced we have come to the conclusion that this is the only proposal we could put forward which really makes the position clearer, having regard to the fact that the categories we were most anxious to exempt were the two I have mentioned, the group whose treatment is being provided in hospital, including the provision of the appliance, and also the long-stay chronic patient for whom we obviously have very special and real sympathy.
    With regard to other categories of cases of which we would wish to take special care, we discussed during the Committee stage the work of the National Assistance Board and we have broadly agreed that

    1603
    that is the proper instrument for dealing with the possibly many other hardship cases that may arise.
    4.15 p.m.
    Dr. Hill: The purpose of the definition is obvious and, I think, agreed; at least, the purpose of the definition. I should like to ask the Parliamentary Secretary to answer certain questions. The words "under the said Part II" govern the Amendment. I believe I am right in saying that if the treatment is given by a dentist appointed to the staff of the hospital in which the treatment is given or to the group of which that hospital is a part, all will be well under the Amendment. What will be the position when the dental treatment is given by a dentist not on the staff of the hospital but called in for the purpose? As I read it, the words "under the said Part II" will exempt the recipient of dental treatment from the charge if he is receiving the treatment in a hospital to which a dentist has been appointed as a member of the staff but will not do so where the dentist is called in ad hoc from outside to undertake the work. I should be grateful for the observations of the Parliamentary Secretary on that point.
    The Committee will wish the Amendment to be as fair and reasonable as possible. Another point which occurs to me, taking dental care as the example, is that where the teeth are removed in hospital and the dentures arrive, with reasonable speed, while the patient is in hospital, the exemption is complete, but that where for one reason or another the patient, possibly because of his or her condition and possibly because of the tardiness with which the dentures arrive, goes home for one or two days between the extraction and the treatment, the exemption disappears.
    Perhaps that is a point which can be applied with even greater force in the case of spectacles. Where the examination takes place and, because of the ordinary character of the optical defect, the spectacles can be speedily procured, there is no charge, but where, as may happen in a number of cases, the spectacles are slow in coming because of the complexity of the defect—the greater the need for the spectacles—it may well be that the exemption is of no value at all.
    1604
    So while approving the object in defining this, I should like the Parliamentary Secretary to consider whether the words do not involve a gamble, a gamble in which the patient is innocent; a gamble, firstly, whether there is a dentist appointed to the staff, so bringing the case within Part II, and secondly, a gamble whether the appliance arrives during the stay of the patient in hospital. Will the Parliamentary Secretary say what will happen in circumstances in which the delay beyond the patient's control is so great that the appliance arrives after the person has left hospital or where, under the ordinary commonsense arrangements there is an interval in which the patient goes home.
    I am very concerned—I do not state any of these matters as debating points—lest there should be anything which encourages the relatives to prolong the stay of an old person in hospital for a material advantage. One of the difficulties of our day—let it be plainly stated—is that there is a reluctance on the part of some people to take the old people home, for reasons which we can readily understand. Let there not be added another and a financial inducement to leave old persons in hospital occupying valuable beds when, on medical and humanitarian grounds, they should be returned to their families at the earliest possible moment.
    Mr. Leslie Hale: I do not wish to import any heat into this matter because my doctors have told me that I must not get excited; otherwise I should feel a little tempted to try the experiment. I want to make the point that on the Committee stage of this discussion, speaker after speaker from this side of the Committee criticised this Clause. From this side of the Committee from 3.30 in the afternoon until 2 o'clock the following morning there were only three speakers who tried to say that, on the whole, they had some sympathy with His Majesty's Government. I am told that I put it 50 per cent. too high but, so far as I know, all of them said they did not like the Bill and, furthermore, that they did not like the Clause. I said I did not, and I voted for it on what I think were constitutional grounds. [Laughter.] I did not expect hon. Gentlemen opposite to understand the workings of democracy.
    What is the reply from His Majesty's Government to this criticism? The reply

    1605
    to this criticism of the Clause as being too narrow is to bring, on recommital, an Amendment that narrows it down still further. I say we have a right to resent that and a right to ask for an explanation. As the Clause was drawn without the Amendment, the position is admittedly an anomalous one. A man who goes into hospital with a broken leg could get false teeth while in hospital. I do not defend that, but I do find myself, to my amazed surprise, in complete agreement with the hon. Member for Luton (Dr. Hill) on this matter.
    So far as ophthalmic cases are concerned, people who go into hospital for an ophthalmic operation of any kind are normally not in for long. It is the kind of treatment—maybe the removal of a cataract—which, unless it is for a serious ophthalmic condition, may very well take a comparatively short time. On the whole it is exceedingly unusual for very complex types of lenses to be available before the patient leaves hospital. Yet the Government come along to the Committee today and say "We want to cut that out." They want to say to the people, "If you go into hospital and are ordered to have your teeth out because you are suffering from a gastric condition, you will have to pay the money if you are discharged from the hospital before the teeth arrive."
    That is a really serious point. I do not want to use a single word out of place because it was suggested in a highly humorous column that I did not regard His Majesty's Ministers as being in the brotherhood of man. I did not say that. I was only wondering if they had departed from the Socialist brotherhood. With respect, we ought not to have a proposal of that sort from these benches.
    What is the difficulty? It is that His Majesty's Ministers, with the Parliamentary draftsmen, have considered the difficulty of prescribing a form of words making it clear that the Clause was limited to the sort of case for which it was intended. I think I shall have both sides of the Committee with me on this when I say that the sort of case we have in mind here is the case of the man who goes into hospital for treatment for gastric trouble or facial or jaw trouble involving dental treatment or extraction; or the case of the man who goes into hospital for ophthalmic treatment which
    1606
    may involve the prescription of special lenses or glasses for his use. I should have thought both sides of the Committee would agree in saying that they, at least, would be provided for and that there should not be any exception based upon the date of discharge from hospital.
    We were in difficulty on recommittal in tabling an Amendment to an Amendment moved by His Majesty's Government, because the Committee stage itself took place only two or three days ago. So far as I know, it has not been on the Order Paper long enough for anyone to table an Amendment. However, while I was listening with great attention to the speech of my hon. Friend on this matter, I wrote out a form of words which I suggest would meet the case, and which might easily be accepted as a manuscript Amendment provided the Chair were prepared to accept it. I appreciate, Sir Charles, that is entirely within the discretion of the Chair, but I respectfully suggest that there are ample precedents for accepting a manuscript Amendment on re-committal if it is the general wish of the Committee and if His Majesty's Government are willing. I ask my hon. Friend to say what is wrong with the following words which I suggest, to make the matter clear, we should add:
    "or who is supplied after his discharge from hospital with an appliance prescribed whilst in hospital and so prescribed as part of the medical treatment for the ailment which necessitated his hospital treatment."
    I have tried to limit it as far as possible.
    Mr. Iain MacLeod: I am very interested in this suggested Amendment, but would the hon. Member mind reading it again?
    Mr. Hale: I will read it slowly so that it may get across.
    The Deputy-Chairman (Colonel Sir Charles MacAndrew): Order. Would the hon. Gentleman try to put it as an Amendment to the Amendment? I cannot accept it as a new Amendment since the Bill is only re-committed in respect of the one Amendment on the Order Paper.
    Mr. Hale: It is an addition to the Amendment, Sir Charles. In other words, if I were putting it on the Order Paper as a manuscript Amendment, I would start by saying, "at end add" and then go on with those words I have read out. In other words, if the patient goes in for treatment with a broken leg and has his

    1607
    teeth extracted, he does not get free teeth, but if he goes in with gastric or jaw trouble and, as part of his treatment it is necessary to take his teeth out, and order dentures, he gets them paid for.
    Mr. Angus Maude: I am sorry to interrupt the hon. Member, but I should like to get at the reasons in his mind because I find it difficult to understand what is behind this. I appreciate that he disapproves of the principle of charges for appliances but, given the fact that the Bill is designed to introduce them, I do not see why a man should have to pay for appliances which are prescribed in the case of, say, ophthalmic trouble which does not require surgery but, if his case does not yield to treatment without surgery and he has to have an operation, he should then get them free. There is not sufficient difference——
    Mr. Hale: I agree entirely. I have said before that I would prefer to see the Bill withdrawn altogether, but we are now considering a limited Amendment by the Government and a simple point made by my hon. Friend the Parliamentary Secretary or the Minister—I forget who it was who opened the discussion—[Laughter.] I was not trying to be funny. I forgot for a moment, and I apologise. What was said from the Front Bench was that the difficulty had been to draft a Clause which would open the door to the proper case but would not open the door so wide that improper cases could come in.
    I have concerned myself with trying to draft a form of words which would remove the anomaly to which the hon. Member for Luton drew attention, namely, the man who leaves hospital before the appliance prescribed for him is delivered. My Amendment suggests a tightening—I do not like the tightening, but I am trying to be fair about it—that that should apply only to a prescription which is made for the disease for which the hospital treatment was incurred. If the man goes into hospital for eye treatment and is prescribed spectacles, then he gets them. If he goes into hospital for treatment for gout and decides whilst there to have a pair of spectacles, he will not get them paid for under the Amendment.
    1608
    4.30 p.m.
    I suggest that that is a perfectly reasonable Amendment. It covers completely the point made by my hon. Friend the Parliamentary Secretary and, as a test of his sincerity on this matter, I say that it is widening the gate only a little.
    Mr. Blenkinsop: Oh!
    Mr. Hale: I am not questioning the individual sincerity of my hon. Friend. We are speaking now on behalf of collective sincerity; this is a collective approach.
    The words I have suggested would merely mean that a man who is prescribed an appliance as part of the treatment of the disease for which he went to hospital, would not have to pay for it merely because the appliance was not supplied until after he had left the hospital. I suggest, Sir Charles, that you might perhaps consider whether you would accept a manuscript Amendment on that point. It may be that you will consider this after hearing——
    The Deputy-Chairman: If the hon. Member submits his Amendment in writing, I will look at it. In any case, of course, it could not be moved until after the Motion "That the words proposed to be left out," had been negatived.
    Mr. Alport: The only reason which prompts me to suppose that there was some error in the argument put before the Committee by my hon. Friend the Member for Luton (Dr. Hill) was the immediate agreement which his views received from the hon. Member for Oldham, West (Mr. L. Hale). It struck me particularly that the hon. Member's constitutional theories were obviously at fault. It may be that his logic in this matter is equally at fault, and when I heard him taking to task his hon. Friend the Parliamentary Secretary and the Government for narrowing down the scope of the subsection, and then heard him solemnly propose an Amendment which would narrow down the scope of the subsection a good deal further, I thought that possibly he was becoming a little confused.
    Mr. L. Hale: My Amendment does not narrow down the subsection at all—it extends it. It extends it, quite clearly, to people who get their appliances after leaving hospital. That is the only effect which it has.
    Mr. Alport: It has that effect, I agree, but as far as I can see—I may have misinterpreted the purpose of the Amendment which the hon. Member read out——
    Mr. Hale: The hon. Member has misinterpreted it.
    Mr. Alport: —it would exclude those who were chronically sick in hospital——
    Mr. Hale: No.
    Mr. Alport: —and would apply only to that category to which my hon. Friend referred: that is, to those who were to receive dentures or spectacles as part of their treatment.
    I emphasise the point made by my hon. Friend the Member for Luton, that as the matter stands, it is impossible to ensure that those who really need and deserve spectacles as part of their treatment—or, indeed, for any other reason of principle that may be advanced either from this side or from the other side of the Committee—should get those spectacles. My hon. Friend says that the matter becomes a gamble—it depends upon the efficiency either of the dental mechanics concerned with the production of dentures, or of the opticians concerned with the production of spectacles.
    If, as might quite easily happen, there were a considerable decrease in the speed with which, for instance, spectacles were being produced—as a result, say, of rearmament—then it might happen that the Amendment which the Government propose would have no effect whatever. I cannot believe that that was their intention when they put it forward. It does not get to the heart of the problem of definition.
    The real problem, as I see it, is to define the meaning of "resident in a hospital." What does this term mean in the context of the subsection? Does it mean chronically ill? Does it mean those who are resident for a fortnight, or three months, or three years? If it is to apply equally to everyone who enters hospital, and if this is the definition of "resident," it will leave it open for anybody who is lucky enough, not only to be examined whilst in hospital for his teeth and to have them extracted, but to be examined whilst he is there for spectacles and to get them. I cannot believe that that is the intention of the Amendment.
    1610
    I feel that the reason why we have the Amendment in this form is that the Parliamentary Secretary, when this question was put to him from these benches during our earlier debates on the Committee stage, improvised, not knowing the answer, and then had to produce an Amendment which conforms as nearly as possible to the answer he gave to the Committee. Not only is that most unsatisfactory, but it is adding to the anomalies which already exist in the Bill.
    Mr. Emrys Hughes: I want to deal with the application of the Amendment and the Clause to Scotland. I am sorry that the Secretary of State for Scotland is not present, but perhaps the Minister of Health will be able to deal with this point. When the Clause was under discussion during the earlier Committee stage, the Secretary of State for Scotland justified the charges for dentures under the Clause by the argument that there had been a very considerable and sensational rise in the supply of dentures in Scotland. Hon. Members who were then present will remember that I put some questions to my right hon. Friend about those figures. I suggest that if they are wrong, the argument of my right hon. Friend was wrong.
    The argument of the Secretary of State for Scotland, as I understand it, was that the cost of dentures had gone up considerably in the first quarter of this year. I quoted from figures from the report of the Department of Health dealing with dental treatment, which showed that far from a rise in the first quarter of this year, there was actually a considerable decrease.
    The Deputy-Chairman: That may be so, but the hon. Member is going beyond the scope of the Amendment.
    Mr. Hughes: If you will allow me to expand my case a little, Sir Charles—I will not take up much time—you will understand it is a problem that I should like to have cleared up. If the figures of the Secretary of State for Scotland were correct, that would make a difference to our understanding of the Clause.
    The Deputy-Chairman: We are not dealing with the Clause but with an Amendment.
    Mr. Hughes: We are dealing, as I understand it, Sir Charles, with an Amendment to the Clause. During the week-end I have checked these figures in the county of Ayr and I find that they completely contradict the argument of the Secretary of State for Scotland, which would influence me in the way I would view the Amendment. Far from a sensational increase in the cost of dentures in the county of Ayr, I find that for the first quarter of this year there was a decrease of £18,618. If this is right, then the whole argument brought forward by the Secretary of State for Scotland to justify the figures in the Clause disappears.
    Mr. Iain MacLeod: This Amendment came as a surprise to some of us after the debate initiated by the hon. Member for Tottenham (Mr. Messer). It is quite clear from the wording of the Amendment and it was clear from the speech of the Parliamentary Secretary, that, whether desirable or not, it will normally reduce the value of subsection (2) of Clause 1. I find it surprising that the Government, which reacted with considerable sympathy to the Amendment put forward by the hon. Member for Tottenham, should have so soon and deliberately marched firmly in the opposite direction. The Parliamentary Secretary said that the Amendment proposed by the hon. Member for Tottenham would create more anomalies than the Bill itself. There was certainly truth in that. We knew when we were debating that Amendment that additional anomalies would be created, but precisely the same objection can be made to the Amendment now before the Committee. There is no question that a number of anomalies would be created as a direct result of this Amendment.
    It is now proposed that the exemption under subsection (2) should be only in effect for those chronically sick. But last Wednesday a very different story was told from the Front Bench. I will quote a word or two from the Parliamentary Secretary:
    "I want to make quite clear that it will apply to any patient under the hospital service who is resident in hospital, whether he is there for a short period or for a longer one."—[OFFICIAL REPORT, 2nd May, 1951; Vol. 487, c. 1298.]
    I need not labour the point, but merely say that we have gone a very long way and, in my view, a long way backwards,
    1612
    as a result of the Amendment now before the Committee.
    I want to raise one other slightly different consideration. That is the question, which I have not heard answered, of what is a hospital. The question of what is a hospital is not defined in this Bill, and if we read it as defined in the 1946 Bill, we find an extremely wide definition. I will not read it all, but there it is said to mean:
    "any institution for the reception and treatment…and any institution for the reception and treatment of persons during convalescence or persons requiring medical rehabilitation, and includes clinics, dispensaries and out-patient departments"
    and so on. If that definition is implied in this Amendment, we shall have very considerable difficulty reasonably to apply the suggestion put forward.
    My hon. Friend the Member for Luton (Dr. Hill) called it a gamble, and so it is. It is a gamble whether the appliance will be finished in time, a gamble whether the appliance needed—and this is of the first importance—is one easily obtainable or not. We have of course the very difficult position in which an appliance may be specially needed, a particular form of bifocal glasses, for instance, which take longer to supply and may, therefore, because of the length of time which such special appliances take to supply, not be available by the time the person leaves hospital. Also, no doubt, it is a regional gamble, for supplies of these appliances vary considerably in different parts of the country.
    I do not propose to enter what is to a large extent a private war on the other side of the Committee, but I do say that beyond any doubt at all, the Government, who have attempted to define in this matter, have only succeeded in narrowing.
    Mr. Messer: I do not often find myself in agreement with the hon. Member for Enfield, West (Mr. Iain MacLeod), but I do agree with him about this Amendment. Although I suppose I have not very much influence, if I were able I would go to any length to persuade the Minister to withdraw his Amendment. I can only see difficulties arising from it. It would appear that there is an intention in the Amendment, but it is difficult to understand how that intention can be carried out without greater difficulties arising as a result of it I would prefer

    1613
    to see the Bill in its original form, and such difficulties as may be inherent in it, dealt with administratively.
    4.45 p.m.
    Anyone who knows the sheaves of circulars, memoranda, instructions, directions and advices that the administrative body receive from the Ministry, would realise that there is very little the Minister cannot do by administrative action, unless strictly prevented by the Act itself. When we get to the position where so much depends on the particular circumstances of the case as to what should be done, it is properly a matter for administration.
    What is going to happen if the Amendment is carried? It may well be that somebody suffering from a condition is advised by a general practitioner to go to a hospital and there they say, "We will have to draw your teeth, but you are the type of case we cannot ask to go to a dental surgeon; it is necessary for you to come into hospital to have it done." If they merely want their teeth out they can have their dentures supplied later and, under the proposed manuscript Amendment, such a patient would get away with it. Under the Amendment they would have to remain in hospital until the dentures were supplied, although the dentures are part of the treatment of the condition.
    One has sympathy with the long-term case which would be covered by the Amendment, but what type of case would be in hospital when there is the examination of the mouth and then that very long period before the teeth are delivered? There would be very few to benefit from that, but there might be particular types of cases of those who go into hospital, have teeth out and are then discharged and go back to work. They would get an advantage over others.
    These things cannot be dealt with by Act of Parliament and one of the difficulties of Acts of Parliament determining treatment of this description is the rigidity of the law. Someone has to be vested with a measure of discretion and an Act of Parliament is an instrument which does not itself imply discretion, unless there is power given to certain bodies to use it. I suggest that the Minister should withdraw the Amendment, let the Bill stand as it is and consider by what administrative
    1614
    means he can deal with the difficulties which will arise.
    I make no apology for having moved an Amendment which created further anomalies. I think the simplest way out, would be to withdraw the Amendment altogether and have everyone treated alike. Strictly speaking I cannot see why someone who is ill at home should not get the benefit which people get when they are ill in hospital. The only way of dealing with these things is to have that degree of elasticity which can be vested in the administrative machine. I beg the Minister, if he does not want to make things more difficult for those managing the job, to withdraw the Amendment.
    Mr. Blenkinsop: It might be as well if I intervened at this point, because it seems to me that there are one or two matters which have been raised by my hon. Friends and by hon. Members opposite which should be taken into account. The hon. Member for Luton (Dr. Hill) raised the question of what the position would be of a dentist brought in from outside, presumably someone under contract under the National Health Service. If he were under contract under the National Health Service, even though he might not be full-time but only part-time in the hospital, I understand that the position would be that he could provide the service required.
    Dr. Hill: Under Part II?
    Mr. Blenkinsop: Part II applies to the hospital itself and to the patient in the hospital. We realise perfectly well the anomalies created as between the patient who is diagnosed for treatment which includes a set of dentures and gets them fitted while in hospital, and one who gets them fitted after he has left hospital and is at home. Then, of course, if we consider the further Amendment suggested in manuscript by my hon. Friend the Member for Oldham, West (Mr. Leslie Hale), we find a further anomaly, and no doubt he had this in mind, as between the person who had been in hospital and had received his dentures, completely free, at home, and someone else, living next door, who had been at home all the time and who had received dentures for which a charge was made.
    Mr. Leslie Hale: Let us have this point quite clear. That anomaly is created either by the original Clause or the Minister's Amendment. It has nothing to do with my Amendment. My object was to clear up one obvious anomaly and not to create another.
    Mr. Blenkinsop: I am trying to point out that, having made it possible for someone at home, but who had been in hospital, to secure completely free dentures, my hon. Friend would no doubt take the opportunity of insisting on the stupidity of having done that and of leaving out the person who was at home throughout the period of his treatment.
    In view of the comments which have been made, including that of my hon. Friend the Member for Tottenham (Mr. Messer) during the discussion on this Amendment, which we have put down quite sincerely as an effort to try to get greater clarification, we feel, on balance, that it might be as well to accept the suggestion put forward by my hon. Friend the Member for Tottenham and for us to withdraw the Amendment and leave the proposal as it stands in the Bill. As I explained, the Bill as it Stands does, in our view, make quite clear the position that any dentures supplied while a patient was in hospital would be free even though his period of stay might have been very short. In view of the comments both of my hon. Friends and hon. Members opposite, I suggest that, by leave of the Committee, I should withdraw the Amendment.
    Mr. McGovern: The anomaly that has been created is only a small one compared with the many anomalies which the Bill is creating. While the Minister may withdraw the Amendment, I can only say that to my mind what has happened here is most discreditable. Members have referred to the speeches made in last Wednesday's debate on the Clause about just this type of case that we have tried today to rectify. It shows the mean and contemptible frame of mind—some one was going to get through in the process, and then there was to be a re-examination to make sure that if possible no one got through by any process—that is shown all through the Bill.
    Even though the Minister is withdrawing this Amendment, it is not because of any generosity on his part. It is
    1616
    only because he sees that the whole thing is so unworkable—that a patient going into hospital with stomach trouble, whose teeth are taken out on doctors' orders, would be deprived of free teeth if he went home before the dentures were ready. Although this Amendment is withdrawn, it has shown all through that mean contemptible kind of attitude, and it is shown right through the whole of the Bill.
    Lieut.-Colonel Elliot: I am sure that by this time the Minister is asking to be saved from his friends. The result of a great deal of talk on the occasion when we last considered this Measure was that the Minister brought forward an Amendment. His hon. Friends, having examined it, say that it is not satisfactory to them, and they ask that the Amendment should be withdrawn, whereupon the Minister asks leave to withdraw it, leaving all the anomalies of which his hon. Friends originally complained. All of those anomalies are still in the Bill. The whole of that long argument was a beating of the air and meant nothing at all. Hon. Members say: Sooner than accept the Amendment we resile from the position we urged with so much length and eloquence on the House—[HON. MEMBERS: "No."] Indeed they did.
    Mr. Messer: Does the right hon. and gallant Member mean that it is giving way, if an alternative suggestion, which is worse than the original one, is offered, to say that we will have the better of the two?
    Lieut.-Colonel Elliot: Surely it is giving way, if after all the arguments brought forward by the hon. Member for Tottenham (Mr. Messer) and the rest, they now lie down to the whole thing and say, "Let us have the Bill as it stood"——
    Mrs. Braddock: No.
    Lieut.-Colonel Elliot: Yes. The hon. Lady who makes rebel speeches and then votes for the question, has no locus standi in this matter. I can sympathise with the fighting rebels and with the sitting rebels, but the rebels who rebel and then vote for what they rebel against, have really no place in this discussion at all.
    The Minister is now in the position of remaining completely the master of the

    1617
    stricken field. All the arguments brought forward have gone for nothing. Hon. Members say, "In spite of the mean and contemptible attitude of the Minister, we hand over all this power entirely to him. Parliament cannot define anything, ought not be asked to define anything, is not to be asked to define anything but the same people against whom we launched these denunciations are the people to whom we leave the authority." I hope those hon. Members are proud of the result of their efforts.
    Mrs. Braddock: I had intended to leave the matter where it was, until the hon. and gallant Gentleman the Member for Kelvingrove (Lieut.-Colonel Elliot) made a washerwoman's speech about it. There is no question that in the case of the Amendment which is now being withdrawn we are submitting to any of the proposals suggested to which we take exception. We have taken the steps that we thought necessary to draw the attention of the Minister to what we considered would be the inability to administer this Clause. The suggestion in the Amendment would make its administration more difficult than ever. Now that proposal is being withdrawn, we still say that it is almost impossible to administer this matter on the basis of the Clause as it will be without the Amendment.
    The hospital service is experiencing difficulty over beds, and the question of deciding who is going to remain in hospital or who shall obtain the dentures under this Clause by remaining in hospital is still one that requires a good deal of administrative explanation. Many of the matters referred to which might have been discussed if consideration of this Amendment had been continued, have never yet been answered by the Government Front Bench. The anomalies which this Bill creates, and the difficulties which the Bill will create have been raised in debate, but the points have never been answered. We shall require answers when regulations are made dealing with matters arising out of the Bill.
    Mr. Leslie Hale: I wish to reply to the unnecessary and unprovoked attack made by the right hon. and gallant Gentleman the Member for Kelvingrove (Lieut.-Colonel Elliot), which showed clearly that he has not heard the discussion to which both sides of the Committee have contributed, or, if he has, that he has completely
    1618
    misunderstood it. The hon. Member for Luton (Dr. Hill) might have the right to resent the remarks made by his right hon. and gallant Friend because the hon. Member for Luton first put to the Committee the point now accepted at the request of almost everyone on both sides of the Committee who has spoken.
    The right hon. and gallant Gentleman has been in this House for a long time but he does not appear to understand the Rules of the House. We have had the Bill re-committed to us in Committee and we are discussing only the Amendment which is before the Committee. We can discuss only that, and the only question before the Committee is whether we accept the Minister's Amendment. Scotland is famous for its bracken but the right hon. and gallant Member seems to be aspiring to be called the Brendan of the North, without the ability to sustain that modest part. Every Member who has spoken has merely suggested that, on the whole, this Amendment would have meant a limitation of the benefits of the Clause. I desire to thank the Parliamentary Secretary for taking the course he has indicated. I appreciate it.
    Lieut.-Colonel Elliot: One has now and again to correct the hon. Member for Oldham, West (Mr. L. Hale), who has the reputation of speaking faster than anybody in the House and thinking slower. The fact is that we are now dealing with an Amendment brought forward by the Minister to deal with objections raised by hon. Members opposite. My hon. Friend the Member for Luton (Dr. Hill) drew attention to the difficulties which this Amendment would create, as indeed he did on previous stages of the Bill. But it was hon. Members opposite who made all the fuss about this matter and eventually forced a Division on the Clause itself. The result of all their talk is, as I say, that the Minister remains master of the field, all the talk has gone for absolutely nothing and the hon. Member for Oldham, West, thanks the Minister as a result.
    Amendment negatived.
    Clause ordered to stand part of the Bill.
    Bill reported, without Amendment.
    As amended (in the Committee), considered.

    New Clause.—(DURATION OF CERTAIN PROVISIONS.)
    (1) Subject to the provisions of this section, the following provisions of this Act, that is to say sections one and two, section four (except so far as it relates to expenditure under section three) and the Schedule, shall continue in force until the first day of April, nineteen hundred and fifty-four and shall then expire.
    (2) If at any time while the said provisions are in force, an Address is presented to His Majesty by each House of Parliament praying that the said provisions be continued in force for a further period of one year from the time at which they would otherwise expire, His Majesty may by Order in Council direct that the said provisions shall continue in force for that further period.
    (3) Subsection (2) of section thirty-eight of the Interpretation Act, 1889, shall apply upon the expiry of the said provisions as if they had then been repealed.—[Mr. Marquand.]
    Brought up, and read the First time.
    5.0 p.m.
    The Minister of Health (Mr. Marquand): I beg to move, "That the Clause be read a Second time."
    In my speech in moving the Second Reading of the Bill I said that the charges which the Bill proposes need not be regarded as a permanent part of the National Health Service. Further representations were later made, in Committee. Quite naturally and understandably anxieties were expressed by various hon. Members. I undertook to meet those representations by moving a Clause of the kind which is now before the House.
    The effect of the Clause is quite simple—that unless this House so determines by expressly so resolving, the Act will expire on 1st April, 1954. In other words, if the Government at that time decide that they need for a longer period than that the savings which are being made by the instrumentality of this Bill, they must come to the House and ask for another year's currency of the proposal. I have already explained to the House that in the year in which we now are, the year between the coming into force of this Bill and the end of March, 1952, we cannot make the full savings which we shall need to keep the hospitals going, and that we have, therefore, very reluctantly had to make for this year—ending March, 1952—a very substantial reduction in the hospital estimates. That was done only reluctantly and with great difficulty.
    1620
    In the following year, however, from March, 1952, to April, 1953, we have deliberately planned to have available for the use of the most essential parts of the Health Service, of which the hospital service is by far the principal, the full year's saving of £25 million. If towards the end of the second year, the first full year of the operation of these charges, people thought that the Measure would be coming to an end in 1953, I doubt whether we would get the full savings that we require. In any event, long before April, 1954, the Government will have to review the position, will, as I said in Committee, have to consider all the effects of this Measure and how far the general financial situation enables us to produce some amelioration in these charges. Therefore, it is reasonable and sensible to say that the Act should come to an end in April, 1954, and that thereafter if any Government thinks it is necessary to continue the charges they should come to the House with an affirmative resolution and ask for express renewal for another year.
    Lieut.-Colonel Elliot: This indeed might be called scorpions' day. The Minister, having chastised the rebels with whips and they having squealed, comes down to the House and chastises them with scorpions. This Clause prolongs the Bill until 1954. Again, the rebels have not won anything at all of any kind.
    Mr. Manuel: The right hon. and gallant Gentleman should speak for himself.
    Lieut.-Colonel Elliot: The rebels desire the Bill to be weakened or, as they have said, withdrawn. The Minister has said that by 1954 whatever Government is then in office will have to review the situation; another Government will have to review the situation.
    Mr. Manuel: This is the organised hypocrisy that the right hon. and gallant Gentleman was talking about.
    Lieut.-Colonel Elliot: According to the description of the hon. Member for Ayrshire, South (Mr. Emrys Hughes), this Government is an organised hypocrisy.
    Mr. Emrys Hughes: The right hon. and gallant Gentleman attributed to me remarks made by one of my hon. Friends. His quotation about organised hypocrisy

    1621
    was one originally used during a Conservative Government by the present Leader of the Opposition.
    Lieut.-Colonel Elliot: I apologise to the hon. Member for South Ayrshire. It was the hon. Member for Glasgow, Shettleston (Mr. McGovern) who referred to organised hypocrisy.
    Mr. McGovern: I do not mind the right hon. and gallant Gentleman quoting anything I say. I will never run away from it, but I do not remember having said that. If he can quote my remark and if it is in HANSARD, I am prepared to accept it.
    Mr. Deputy-Speaker (Major Milner): Now that he has made these few preliminary observations, I hope that the right hon. and gallant Gentleman will confine himself to the question of the new Clause.
    Lieut.-Colonel Elliot: Certainly, Sir. I am not unwilling to take up any challenge from whatever part it comes, but I will leave that question. This Clause which has been put forward as a concession represents no concession of any kind whatever. I think that the hon. Member for Shettleston will agree with me. Hon. Gentlemen opposite are getting nothing whatever out of the Government.
    Anybody knows that the position would have to be reviewed before 1954. The Act does not come to an end then, because this matter is not left to come before King, Lords and Commons, but merely to be subject to an affirmative Resolution. It may be continued indefinitely by affirmative Resolution. Obviously, that is not a concession of any great moment. Furthermore, the Minister said that he required this Bill in order to keep the hospitals solvent. Is he bringing forward the suggestion that a great reduction in the cost of the hospitals or of the other parts of the Service will take place before 1954? Is that the proposal which he puts to the House? If not, what is the advantage of the review he offers?
    Mr. Marquand Mr. Marquand indicated dissent.
    Lieut.-Colonel Elliot: The Minister says, "I need £25 million in order that hospital treatment may be continued, and I will review this matter in 1954." But he has just said that he has no reason to suppose that in 1954 he will be able to
    1622
    dispense with the £25 million asked for. Again, it seems that the so-called concession is entirely nugatory.
    This Clause is simply a piece of crystal gazing. I am always willing to quote the right hon. Gentleman the Member for Ebbw Vale (Mr. A. Bevan). Of some of the remarks he makes, one was most pertinent. He asked, "Why trouble to look in the crystal when you can read the book?" When one sees the Estimates today and considers the course of events, one appreciates that it is possible that the Government in 1954 may take some step which the Minister is not able to divulge at present. The fact is that this Clause does not mean anything one way or the other, and might just as well be added to the Bill as left out.
    5.15 p.m.
    Mr. McGovern: I entirely agree that this Clause gives no concession of any kind. It is more hard and fast than was anticipated when the Bill first came before us. I do not intend to take part in any of the further discussions on this Measure. I said all I had to say on Clause 1. I said that I regarded this as an evil Bill which would have disastrous effects on the common people of this country. I say to the right hon. and gallant Member for Kelvingrove (Lieut.-Colonel Elliot) that his antics in opposing a Clause of this kind are not shared by all the Members of the Opposition. I believe in dividing the House when I am sincere. Other hon. Members do not believe in the same policy, but they are as sincere as I am, though their tactics are different.
    If I had my way, I would divide the House on every Clause and on the Third Reading of the Bill. I can only say that I regard not only this Clause but the whole Measure as being evil. If this is a sample of democracy when the overwhelming mass of the Members of my party are against this Bill and the executive insist on putting it through the House, I maintain that it is nearer to totalitarianism than to any form of democracy.
    Mr. Edward Davies: I dissent most violently from the view expressed by my hon. Friend. We can have the same interests of the people at heart and yet take a different view, as he readily agrees.

    1623
    But to say that it is a negation of democracy or something totalitarian, that we should have different views upon a controversial matter does not make complete sense to me. When my hon. Friend the Member for Stoke-on-Trent, Central (Dr. Stross) put down an Amendment during the Committee stage he had another date in mind. He was thinking of March, 1952. The Minister was unable to accept the Amendment, but he promised to introduce a new Clause, and this is it.
    While it is not acceptable to many of my hon. Friends we think that it has the advantage that it sets a limit in time and to the intentions of this Government, or any other, to dismantle the Health Service. The great apprehension which my hon. Friend has in mind was that this was a first stage upon what they thought might be a slippery slope. Here, they thought, we are beginning with teeth and spectacles and later we might hear that the whole Health Service was being tackled by a reactionary Tory Government.
    My hon. Friends had in mind that a limit should be set to this process, and 1952 was suggested. When the right hon. and gallant Gentleman the Member for Kelvingrove (Lieut.-Colonel Elliot) charges us with welcoming something which has no value, he merely misunderstands our position. He seeks to bait us and divide us, and my hon. Friends who are astute politicians recognise that he seeks to make trouble. We can have our several views about this matter. However, I welcome the assurance that while it is in the view of the Government impossible to give us a nearer date when than 1953, there is a date and an intention to put an end to this practice of charging for spectacles, teeth or some other service.
    Reference has been made to an opportunity to consider the position later to see how the system is working. I do not want to go into the larger context of the national situation, but I would point out that there may be developments in relation to defence and our general budgetary position which might make it possible for this or any other Government to reconsider the whole position. In that event, I take it that it would be the intention not to prolong this scheme any later than 1954—not for one day longer than was considered necessary.
    1624
    I hope that in 1952 and 1953, if it continues so long, we shall have opportunities to review the position and improve the scheme. This is a matter of compromise and, for myself, I am thankful that the Government have appreciated what we had in mind. Although it does not meet the case completely, I have no difficulty in supporting this Clause and considering that it is a real step in democratic procedure.
    Mr. Iain MacLeod: The hon. Member for Stoke-on-Trent, North (Mr. Edward Davies) has justly said that hon. Members on his side of the House can have differing views on this matter. An Amendment was tabled during the Committee stage saying that 1952 would be a good date; a further Amendment said that 1953 would be a good year, but the Front Bench have now decided that 1954 should be the year. This Clause gives the benches behind the Front Bench nothing whatever. The Government have once more merely danced in the face of their supporters, and their supporters are now lying down.
    Mr. Bowles: I have not spoken in any of the discussions leading to this stage of the Bill, but I cast my mind back to the General Election of 1931. I remember that various cuts were being made in the social services and in the salaries of people who were dependent upon the Government. I remember well that the salaries of teachers and the police, for instance, were cut by 15 per cent. and then, under pressure, the Government of the day decided that those cuts should be made in two bites. I remember also that Mr. Frank Owen, then a young Liberal Member for Hereford, asked Ramsay MacDonald, the Prime Minister, a question. He asked whether, in view of the fact that the cuts in the salaries of teachers and police had been eased by making the cuts in two bites, the Prime Minister would not also ease the cuts on unemployment insurance benefit. Mr. MacDonald said that the cuts in unemployment insurance benefit were a condition of borrowing from America, and they must remain.
    That was very important. There we were accepting dictation from America as a condition of a loan to keep us on the gold standard. Anyone who reads American newspapers will know that the

    1625
    American medical profession are very much against having a free health service there. I know that the Chancellor of the Exchequer went over there in 1950, and when he returned he said, "We have to continue with rearmament and we are expecting some aid from the United States of America."
    I think a precedent took place in this House some 20 years ago. I should like to understand whether the millions which have been subscribed by the American Medical Association—which I noticed, incidentally, was referred to in passing by my right hon. Friend the Member for Ebbw Vale (Mr. Bevan) as the A.M.A. and I think that several hon. Members did not spot the point—for the purpose of lobbying American Congressmen, have been put to use in some way to bring pressure to bear upon our Chancellor of the Exchequer and the Government here in order to bring about this cut in a free service which is abhorred so much on the other side of the Atlantic? I feel that we are entitled to an answer. I am sure that the Secretary of State for Scotland, if he knows, will give an assurance that the history of 20 years ago is not being repeated now.
    When we were worried about the situation in 1931, when it was a question of wholesale unemployment and so on, the Government of the day thought that the best thing to do was to reduce the salaries of people; and they started doing that among many of those people dependent upon them. Now we have another crisis, a re-armament crisis, and I should like to know whether they are really going willingly away from their Socialist principles—because clearly they are going away from them—in imposing this charge upon the free Health Service of which we are all so proud and whether that is being done as a condition of American help towards our re-armament. We have a precedent, and I am entitled to ask that question. I hope that the Secretary of State for Scotland will give us an assurance on this most important matter.
    Mr. Fort: Do I understand the hon. Member aright? Is he implying that the Americans—the American Medical Association—have given a direct inducement to the British Chancellor of the Exchequer? Is that what he is implying?
    Mr. Bowles: I would beg the hon. Gentleman not to misinterpret me like that. What I said was that I know perfectly well, and he probably does too, because he is a big business man—[Laughter.]—I think he has something to do with I.C.I. which sounds international. He may have some knowledge—especially of he reads the American newspapers, because it is clear to anyone who does—that the medical profession in the United States have subscribed masses of millions of dollars for the purpose of lobbying Congressmen against the starting there of a free national Health Service, such as we have here. In 1931 we were told by the Prime Minister of the day that cuts in the Unemployment Insurance benefit were conditions of the borrowing from America, and that they must remain. I am asking my right hon. Friend to tell us whether or not, or to reassure us, that kind of thing did not happen last September or since.
    Mr. Poole: Throughout the years we have become so accustomed to hearing the right hon. and gallant Member for Kelvingrove (Lieut.-Colonel Elliot) making a minute matter appear like the giant Colossus, that we are not surprised that today he has so easily reversed the position, and is trying to make what is a valuable concession appear to mean, to use his own words, nothing at all. I agree that 1954 is not the date that many of us would like to see in this Bill. I confess that I hoped that at the latest we might have a review of the position in 1953. At any rate, it is a recognition of a point which many of us were putting forward, that this Bill should not be put upon the Statute Book with power to operate indefinitely, and that at some future date we should have the right to review the position.
    What the right hon. Gentleman did not mention, and no other hon. Member has mentioned, is that not only is 1954 the date of the first review, but any extension of this Bill after 1954 is for 12-monthly periods only; that in every year after 1954, the Government of the day, whatever its political complexion, has to justify the continuance of these charges. To me that is the most valuable concession in this new Clause, and if the right hon. and gallant Member for Kelvingrove does not

    1627
    recognise that, then someone ought to tell him what it is all about. The position which he is setting up is that there is no value at all in the divorce laws of this country, because they give power to terminate the contract of marriage. Because of that they are quite valueless. But no one would suggest that that is so.
    Here we are being given the right to divorce ourselves in 1954, and at yearly intervals after 1954, from the provisions of this Bill. I admit that I would prefer to divorce myself from them at this very moment, but I shall now continue in an honourable matrimonial state with the Government, and with this Bill, until 1954. True, I shall do so with much anguish of spirit, but it will be in the sure and certain knowledge that, by 1954, if I do not like the partnership any more than I do now, I shall be free to break the association. And if there is any attempt made to continue it, I shall, every year, have the right to break my association with this Measure. I regard that as a very valuable concession and I am pleased that the Government have been wise enough to meet, if not in full at least to some extent, the points which some of us made.
    Mr. Emrys Hughes: I presume the purpose of this Clause is to enable the Bill to be reviewed in 1954, and I can quite imagine what hon. Members of this House will be saying then. I am quite convinced that from these benches will come the very definite statement that this Clause was one of the most stupid and badly thought out Clauses ever put into a piece of legislation by a Labour Government. I believe that the more we go into the nature of this Bill, the more we examine it in detail, the more we are fortified in that assumption. I am glad to see the Secretary of State for Scotland in his place, because I wish to ask him if he still believes in the argument which he advanced on the Committee stage, that this Bill was justified on the grounds that in the first three months of this year there had been a somewhat unusual increase in the cost of dental services in Scotland.
    The Secretary of State for Scotland (Mr. McNeil): I am delighted that my hon. Friend continues the argument, but let us get it correct. I did not argue; I submitted facts to show that the cost
    1628
    of supplying dentures in Scotland in the first quarter of this year was higher than in any quarter since the scheme was introduced.
    Mr. Hughes: I am very glad that the Secretary of State for Scotland has now limited it to this definite point. I will now proceed to examine his contention, because if he fails in regard to my county of Ayr, then surely I am not justified in supporting this Bill, and all my previous arguments are valid. The Secretary of State referred to denture costs. I should like him to explain this mystery. The figure for denture costs——
    Mr. Deputy-Speaker: The only point in this new Clause is whether a limit in point of time should be applied to certain provisions of the Bill. The question of the cost of dentures and details of that kind cannot arise.
    Mr. Manuel: As I understand it, the fact of fixing a date of 1954 was simply because the saving in this year is only £13 million. The saving on a full year is £25 million and in order to get the full saving it is necessary to take 1954. If the point which my hon. Friend the Member for South Ayrshire (Mr. Emrys Hughes) is trying to make is that there is not going to be the on-cost for dentures in that period, then the implications of the first quarter of this year have a bearing on that actual point; but I will take the Ruling from the Chair.
    Mr. Emrys Hughes: I shall not waste the time of the Committee, but I do submit that this argument is relevant to the argument put up by the Secretary of State for Scotland. I have taken the trouble to get out some figures for the county of Ayr, which is a typical Scottish county, and they show that in the first quarter of 1950, the cost of dentures was £58,932, and, in the first quarter of this year, £40,334, a decrease of £18,618. If that picture is right and these figures are correct—and I could give further figures in support of my argument—I submit that the Secretary of State for Scotland has been misleading the House and that his argument falls.
    5.30 p.m.
    Mr. Eric Fletcher: The only point which really arises on this Clause is that of the duration of the Bill. I do not think the Minister was at all

    1629
    happy in the reasons which he gave for his argument that the Bill ought to continue at least until April, 1954. A great many of us think that that date is too far advanced, and that the Bill ought to come to an end much earlier.
    What did the Minister say in giving reasons why he could not bring this Bill to an end before April, 1954? He suggested that if the Bill were to end in 1953 or even in 1952, then, of course, if it were only to be in operation for a short period, a whole lot of people who wanted either teeth or spectacles during that period would wait until the end of that period hoping that the Bill would come to an end, and that they would be able to get these appliances free instead of having to pay half the cost if the Bill was still in operation. By inference, the Minister has said that if they have to wait until 1954, they will have to put up with some inconvenience and hardship, or, alternatively, they will have to pay half the cost. It seems to me that when he said that he did two things.
    First, he admitted that there will be a certain amount of hardship, because if this Bill continues in force a certain number of people will be forced into the unhappy position either of having to go without spectacles or dentures they ought to have, or being obliged to pay half the cost. That is the sort of inconvenience that people might well be expected to put up with for a few months or even a year or so, but it is not the sort of inconvenience which they would put up with for two and a half or three years. I can understand that, but the Minister, having made that argument, also denied that there will be real hardship caused by the Bill.
    The other fallacy in the Minister's argument is that precisely the same position will arise in a year or a year and a half from now. When we come to the beginning of 1953, the position will then be that there will be equally a lot of people who ought to have teeth and spectacles but cannot afford to pay half the cost, who will be placed in the embarrassing position either of having to make sacrifices they cannot afford to get them, or postponing their acquisition of teeth and spectacles until April, 1954. They will be in precisely the same position as other people would be in if this Bill were now limited to one year or a year and a half.
    1630
    Therefore, the position will be that in 1952 or 1953 there will be a large number of people who will have to gamble on the Bill coming to an end in 1954 and putting off the spectacles and dentures which they ought to have in the hope that the Bill does come to an end, and that they will not, therefore, have to pay half the cost. Whatever date is chosen, it seems to me, from the Minister's own argument, that it will mean that the Government will have to make a decision—and, I should hope, long before April, 1954—about bringing this Bill to an end.
    The Secretary of State for Scotland (Mr. McNeil): There are one or two points with which I should like to try to deal, and I will follow the very excellent example of my hon. Friend the Member for South Ayrshire (Mr. Emrys Hughes), and be brief indeed. I do not know the figures for Ayrshire, but I would be reluctant to accept the argument that Ayrshire is a typical county in Scotland. After all, there is only one county that could claim my hon. Friend.
    The figures which I give are unambiguous and unmistakable, and they are a complete refutation of the argument that there has been a downward trend in the demand for dentures. The figures for Scotland of the number of approvals for dentures show that, in the first quarter of 1948, they were 92,000; in the first quarter of 1949, 110,000; in the first quarter of 1950, 109,000; and, in the first quarter of 1951, 126,000. I repeat, for the benefit of my hon. Friend, that 126,000 is the highest approvals figure given in any one quarter, and these are the figures of approvals for dentures.
    Mr. Emrys Hughes: In what parts of Scotland are these figures drawn up, because in Ayrshire the figures have gone down.
    Mr. McNeil: I would be reluctant to accept the conclusion that these figures differ from those of Ayrshire. I do not know the reputation of Ayrshire, but, at any rate, I cannot see how my hon. Friend can escape here. I have been trying to recall who was the distinguished Member for Bristol who once argued the difference between a delegate and a Member of Parliament. My hon. Friend must not think that, by regarding himself as a delegate from his constituency, he may be able thereby to escape from support of this proposal. I hope that my

    1631
    hon. Friend and the House will see quite clearly that I never have at any time attempted to mislead hon. Members on this point. There are the figures, and they are a complete refutation of the claim, that, nationally, the figures are showing a downward movement.
    Mr. Manuel: I am very grateful to my right hon. Friend for giving way. I would like some reasonable explanation for the divergence in these figures, because, in the county of Ayr there are five constituencies, which represent a good cross-section of Scotland from right to left of its population and its interests, both from the completely rural to the highly industrial belt stretching right along the coast from Ardrossan. These figures are culled from the Ayrshire Executive Council and they are completely accurate, and they show a steep drop in the first quarter of this year as against last year. I wonder if there is some different method of collecting these figures in the areas of other executive councils, because it does seem to me that there is something wrong. We do not differ from the rest of Scotland in this matter—we may be better in some other respects—but we surely make up our figures in the same way.
    Mr. McNeil: These figures come from the Scottish Dental Estimates Board, and there is only one Scottish Dental Estimates Board. The figures are strictly comparable and highly reliable. My hon. Friend the Member for Central Ayrshire (Mr. Manuel), if I may say so bluntly, talks so much nonsense when he tries to persuade himself that Ayrshire is not different from the rest of Scotland. We are not asked to accept the conclusion that Ayrshire is, for all purposes, a typical cross-section of Scotland, because, if the incidence of tuberculosis in Scotland was reflected by Ayrshire, we should have no tuberculosis problem on our hands.
    Mr. Manuel: Why?
    Mr. McNeil: Because there is in Ayrshire air, sunshine, light, milk, a much better history and not the dreadful background of the appalling concentration of slumdom such as we find in Glasgow and in Dundee. I would therefore expect to find a higher incidence of tuberculosis in the over-populated, overcrowded and less well-fed districts than in Ayrshire.
    1632
    At any rate, I have not attempted to prove that the Ayrshire figures are typical. I have attempted to prove nothing more than the assertion that there has been a downward tendency in the demand for dentures in the first quarter of this year.
    Mr. Rankin: Is the simple inference to be derived from my right hon. Friend's figures that more and more people are requiring dentures and that we are now going to make it more difficult for the people who need them to get them?
    Mr. McNeil: No. I should have thought that if my hon. Friend had any care for statistics at all, he would not rush to such a complex and rash conclusion. I have merely offered the figures for the number of approvals this quarter.
    Mr. Poole: Would my right hon. Friend clear up something that has created dismay in my mind? I presume that during my absence for tea or dinner one evening, this House did not concede Home Rule to Ayrshire, and that therefore this will apply to England as well as Ayrshire?
    Mr. McNeil: It is, of course, a United Kingdom Bill, but I must defend my hon. Friend and say that he has exactly the same rights in this House as the most distinguished hon. Member for any English constituency.
    Mr. Manuel: May I assure my right hon. Friend that I am grateful to him, and will not follow his bad example by being offensive? Will he oblige me by getting the figures from the Executive Councils throughout Scotland, in the same way as he got them from the Ayrshire Council, and give us an opportunity to examine them?
    Mr. McNeil: I hope my hon. Friend did not find me offensive. If I may say so, I have had a little longer experience in this House than he has, although it is a relatively short experience. If people throw their weight about, they must expect to be tripped, even by the kindest persons. I shall be delighted to ask the Scottish Estimates Board for such a break-down of the figures in relation to the different counties of Scotland, and to furnish my hon. Friend with that information as quickly as possible.
    A much more important question was addressed to me by my hon. Friend the

    1633
    Member for Nuneaton (Mr. Bowles). I hope he will forgive me if I say quite frankly that I was absolutely astounded that such a question had to be put, because, whatever precedents there may have been, they were not drawn from our party. I want to say quite flatly that neither the Government nor my right hon. Friend the Chancellor of the Exchequer were ever either offered advice or, much less, subjected to pressure from the Government of the United States, or from anywhere else.
    Mr. Bowles: What does my right hon. Friend mean by saying that I was not drawing a precedent from our party? I certainly was. Ramsay MacDonald and Philip Snowden borrowed money in order to keep us on the gold standard. A condition of that was, as Frank Owen was told, that those cuts had to remain in the Unemployment Insurance benefits. That is precisely what happened. When the majority of the Labour Government could not stand the cuts any longer, Ramsay MacDonald resigned and formed the National Government overnight. Then, of course, we went off the gold standard, but the cuts remained. Ramsay MacDonald himself answered Frank Owen's question.
    5.45 p.m.
    Mr. McNeil: The operation was effected and justified by a Government which was called "National."
    Mr. Bowles: May I ask the Minister this question? When were the last millions borrowed from the Americans? Was it when the Labour Government were in office, or not?
    Mr. Ellis Smith: I do not want to become involved in this, but I happen to know a bit about it. The split came about as a result of the stand taken by Arthur Henderson.
    Mr. McNeil: I affirm flatly, and without qualification of any kind, that there was no pressure from the United States or elsewhere, and neither was there advice. They did not seek to impose any conditions regarding any military arrangement in which we are partners.
    Mr. Bowles: I am much obliged.
    Mr. Butcher: The right hon. Gentleman said that these proposals were entirely the responsibility of His Majesty's Ministers.
    Mr. McNeil: Who else would be responsible? Who defends them, and who operates them? His Majesty's Government, of course. We have neither sought to shelter behind any one else nor to deny that these are our decisions. We have given reasons for them, and we will defend them.
    I would say to my hon. Friend the Member for Shettleston (Mr. McGovern) that it is really a little arrogant of him to claim all this righteousness for himself, and to assert without the slightest evidence, that he has an overwhelming majority to support him.
    Mr. McGovern: I did not say that. I said there was evidence that an overwhelming majority of hon. Members on this side would have voted against it had they been given a free vote. Therefore, I say it is undemocratic and should not be pursued.
    Mr. McNeil: A Government does not function by a free vote. However, that is quite apart from the assertion which my hon. Friend makes, that there is a majority of hon. Members who support him in this. I plead with him not to pull a cloak of righteousness around his shoulders and to decide that everybody else is a miserable sinner for no other reason than that they do not share his point of view.
    Mr. McGovern: I did not say that. I said that my means of approach was not that employed by the majority of hon. Members of this party. We have different methods, and I conceived the method of voting against it. Others did not do so. I only claim that, in my estimation, I more nearly represent the working classes on this matter.
    Mr. McNeil: That is a very different thing. That is a matter of judgment, and I would not deny my hon. Friend the right to make such a claim, although I would not necessarily agree with him. What I disagreed with him about, was when he said that this was an authoritarian Government—I believe he called it a totalitarian Government—because we disagreed with his point of view. That is the kind of view which in another office I used to hear frequently from some gentleman whom I know my hon. Friend dislikes very much. [An HON. MEMBER: "Mr. Gromyko."]
    The right hon. and gallant Member for Kelvingrove (Lieut.-Colonel Elliot) has

    1635
    every right to try to make a political occasion of this and try to foment such division as he may discern or think he discerns on the benches behind me, but it is nonsense to contend that this is not a concession. After the debate developed in Committee many of my hon. Friends indicated that while they did not approve of the principle they would be less unhappy if a term could be put to the procedure. A term has been put to the procedure. My hon. Friend the Member for Islington, East (Mr. E. Fletcher) thinks it is too long and so do some others, but there is a fair reason for carrying it to this length.
    It is the same term as that identified with our abnormal defence commitments. It is also, as my hon. Friends will agree on reflection, the shortest period which could give us an opportunity of reviewing and debating a full financial year's working, because we would have to debate it, if we were going to do so, before the Budget in April, 1953. This fits in with our general budgetary policy. This will give us an opportunity to review it when we have had a reasonable experience of its working. It is offered as a concession to my hon. Friends and I am fairly confident it is a concession most of them will accept and many welcome.
    Mr. Carmichael: Like some of my hon. Friends, I disagree with this Clause. It has been argued by my right hon. Friend the Secretary of State for Scotland, that this is a concession and that the date might have been much earlier than 1954 had that been possible. I understood that the strong point for 1954 was to give an opportunity to examine the working of this new scheme. That is a reasonable deduction to make.
    I say, however, as I said in Committee, that if the opinion is that there is justification for examination of the scheme, then surely the proper course would have been to make a complete examination of the National Health Service. It is bad organisation and bad administration to establish a free National Health Service and suddenly to discover that there is one section of that Service which requires special examination while the rest is left completely out of account. On that basis it is quite possible to introduce a
    1636
    Bill later on restricting the rights under some other part of the Service and to argue again, "We shall only continue this until 1956 because we desire to make an examination of this new branch of the Service." I think a completely wrong approach was made to this matter and that there should have been an examination of the entire National Health Service.
    We are told that this is a concession, but does anybody suggest that subsection (2) of the Clause encourages us to believe we have a concession? That subsection takes all the necessary precautions to give the Government power to continue these provisions permanently. All they require to do is to pray each year that the Act continues. I say that if the Government put that in, it is obviously because they have in mind the idea that in future there may be justification for continuing these charges. [Interruption.] I do like speaking when people who have already spoken are quiet. Surely there is nothing unreasonable in that.
    There is evidence in subsection (2) of this Clause that these provisions will be continued permanently. Therefore, it confirms the point we made at the beginning that the Government are making an encroachment on the National Health Service which, two years ago, they would have rigidly denied. They then would have opposed anybody who suggested such a thing. I have no doubt the figures submitted by my right hon. Friend the Secretary of State for Scotland are quite accurate, but we know from long experience that all figures of that kind can be extremely misleading. The figures may be for a single tooth or denture repair. We are entitled to have more detailed information about those figures.
    One of the strong arguments put forward in favour of these charges is that they are justified because the figures are going up. That is the finest evidence of a means test I can think of. Because there is likely to be a greater demand from people for these services, the Government are going to make a charge. I heard that argument in the old days when it was argued that National Assistance Board scales must be cut down because more people were making demands upon the funds. That is exactly the case made out here—that the Government must be cautious and impose charges because

    1637
    more people are making demands upon the service.
    I dislike the Bill and the date has not helped me in the slightest degree. I have already made my protest on the appropriate stage in Committee; and when the Bill is passing through the House, I cannot be as happy as some of my hon. Friends—in fact I deeply regret that it is being passed.
    Question put, and agreed to.
    Clause read a Second time, and added to the Bill.

    Clause 1.—(CHARGES IN RESPECT OF CERTAIN DENTAL AND OPTICAL APPLIANCES.)
    Mr. Iain MacLeod: I beg to move, in page 1, line 16, at the end, to insert:
    "Provided that this subsection shall not apply to any appliance supplied to a patient from whom charges are recovered under section five of the National Health Service Act, 1946, or of the National Health Service (Scotland) Act, 1947."
    I think this Amendment to add a proviso will detain the House only for a minute or two. It was originally designed as a peg on which to discuss Clause 1 (2), but that peg was provided by the Government's Amendment and it is now withdrawn. There is a small point of substance on which I should like to have an assurance which I expect to receive from the Front Bench. The short point is whether patients occupying pay-beds under Section 5 of the principal Act are or are not covered by Clause 1 (2) of this Bill.
    Quite clearly, there is no doubt about those occupying free beds under Section 3 of the parent Act, and little doubt about those occupying amenity beds under Section 4. It seems to me, however, that Section 5 is not so clear. It is true the full cost of services, accommodation, and other things provided, is paid. These services seem to me to be no less part of the hospital services because they are paid for. It may be that there is a conflict between Section 5 of the parent Act which says full charges should be made, and this subsection which might imply that patients in that category receive free treatment. If there is that conflict the matter should be resolved, because nobody on either side of the House would take it as reasonable that somebody occupying a pay-bed under Section 5 of the parent Act
    1638
    should be able at the same time to obtain exemption or partial exemption of payment for the balance under this Bill.
    6.0 p.m.
    If there is a conflict it should be resolved in some such manner as my Amendment suggests. It may be, on the other hand, that the words in line 14, "under this section" are the key to the question I have raised. It may be that although that brings in a new principle in regard to Sections 3 and 4 of the parent Act, it does not, however, affect the proviso in Section 5 of the 1946 Act whereby the full charges should be made. It is in order to have that point cleared up that I have put down this Amendment.
    Mr. J. Enoch Powell: I beg to second the Amendment.
    Mr. Blenkinsop: As I think the hon. Member suspected, it is the case—and I can give him the assurance—that this Amendment is quite superfluous. In fact, I understand that its effect would be one which no one would wish to see—the effect of making the occupant of a pay-bed pay twice for these appliances.
    Clause 1 enables the new charges to be made notwithstanding Section 1 of the 1946 Act, and that Section at present requires all services to be free of charge except where the 1946 Act expressly provides otherwise. Section 5 of the 1946 Act expressly provides for charges to be made to paying patients, which should in the aggregate cover the full cost of the accommodation and services. Therefore, I think that, with that quite definite assurance that this point is already fully covered, the hon. Member will be able to withdraw his Amendment.
    Mr. Iain MacLeod: I have no wish to detain the House, and in view of that explanation, I beg to ask leave to withdraw the Amendment.
    Amendment, by leave, withdrawn.

    Clause 4.—(CONSEQUENTIAL PROVISIONS.)
    Mr. Powell: I beg to move, in page 3, line 19, at the end, to insert:
    (3) Regulations made for the purposes of subsection (1) of section one of this Act may provide that there shall be afforded to every person from whom a charge is recovered in pursuance of this Act upon the occasion of the recovery of the said charge the opportunity

    1639
    to apply for an assistance grant to meet his requirement for the service in respect of which the said charge is recovered.
    This proposed subsection stands on the Order Paper in pursuance of notice which I gave during the Committee stage that I should table an Amendment on these lines. It seeks to implement and to carry a stage further—a stage to which I hope the Government will agree—an assurance which was given by the Parliamentary Secretary in Committee, to which perhaps I might refer the House. The Parliamentary Secretary said:
    "It is important that we should make sure that all those who receive attention from a dentist or an optician are fully aware of the way in which they can make their claim"—
    that is, a claim for relief under Clause 4—
    "and of how they can get relief in case of hardship. That is a matter which we must very carefully bear in mind as we proceed with this Measure."—[OFFICIAL REPORT, 2nd May, 1951; Vol. 487, c. 1227.]
    The proposed new subsection which I am asking the House to insert in the Bill requires two things. It requires that upon the occasion of a patient being called upon to pay the charges that can be imposed under the Bill that patient should not only be informed in the clearest possible way that he has a right to apply to the National Assistance Board for partial or complete repayment of that sum, but also that the means of doing so should be automatically afforded to him at the time.
    The manner in which I would conceive such a provision being put into effect is that a simple form of application to the National Assistance Board for repayment would be included in the document by which the charge is made and is receipted. It might be possible, indeed, to achieve the two objects with the same piece of paper so that all the patient had to do was to fill in the form, tuck in the flaps and post it.
    This provision, if inserted, will, I believe, meet a large part, though not the whole of the anxieties which were expressed at an earlier stage of the Bill about the operation of the means test under the Assistance Board. When a proposal was made to substitute for the Assistance Board as the reimbursing authority some other machinery there was almost universal agreement on both sides of the Committee that the Board was in
    1640
    many respects unsatisfactory, and the chief objection that was taken was to the alternative machinery proposed.
    Under this Amendment, although the work of assessment will still fall upon the Board, all those difficulties which were apprehended from the necessity of the patient making a separate, direct and personal application to the Board will be neutralised. Thus I feel that this subsection goes a long way to meet the anxieties which were expressed repeatedly by hon. Members in all parts of the Committee on the last stage of the Bill.
    That is why I was particularly disappointed to hear that the hon. Member for Shettleston (Mr. McGovern) intended to take no further part in the proceedings on this Bill, because I have been promising myself valuable support and encouragement from him. In the Committee stage, referring to the operation of the National Assistance Board which by this Amendment I propose to modify, he said:
    ".…all I say in connection with this is that for some people to have to go to the Assistance Board is a humiliation. Therefore, they will not go there, with the result that their standard of health and eyesight will deteriorate because there is no guarantee they will get their teeth or spectacles."—[OFFICIAL REPORT, 2nd May, 1951; Vol. 487, c. 1356.]
    Under the subsection which I am proposing they will not have to go to the Assistance Board. The making of the application will be an automatic operation which will have no stigma attaching to it, and which will be carried out by the patient if he desires to do so at the time when he is called upon to pay the charges.
    Perhaps the strongest arguments in favour of this Amendment were advanced during the Committee stage by the hon. Member for Reading, South (Mr. Mikardo), who pointed out that, rather than go to the Board, many persons who were in real need of these appliances would either defer having them altogether or else would resort, as in the past, to purchasing them from quacks. It is precisely that band—if I may so describe it—of demand for these appliances which lies between the regular recipient of National Assistance on the one hand, and, on the other hand, the type of patient who will unquestionably be called upon properly to meet these charges, which this Amendment is designed to meet.

    1641
    I hope that the Government will not resist the object of the Amendment on the ground that the deterrent effect of these charges would thereby be reduced. The only deterrent effect which will be reduced is the deterrent effect upon precisely the type of person whom we do not want to deter. I must say that the information which we have been given on this subject so far has been defective in itself and tends to make one rather uneasy. This matter was raised earlier by my hon. Friend the Member for Luton (Dr. Hill), and I thought he received a most unsatisfactory reply. It is difficult from the information that we have so far received to ascertain exactly what dimensions the Government imagine the deterrent effect of these charges will assume, but I venture to calculate them briefly as follows: I will take the dental service rather than deal with both the dental and the optical services.
    Taking into account the effect of the Bill, the estimates for dental charges this year for Great Britain are approximately £38 million. We know that the Government estimate that in the current year the savings resulting from the operation of the Bill will be about £8½ million—half what is anticipated in a full year. Thus, the full cost of the dental services in the year 1951–52, without this Bill, would be approximately £46½ million. On Second Reading, we were told by the Minister that about 60 per cent. of the cost of the dental services is referable to dentures, and if that proportion holds good then £28 million would be the cost of the provision of dentures in a full year, without this Bill.
    In that case, £14 million is the amount which will be saved simply by charging a patient half. In fact, the expected saving is £17 million, so that at least £3 million per annum is expected to be saved by the Government as a result of dentures which are not provided because these charges are imposed. That is to say, there is roughly a 10 per cent. deterrent effect. I suspect, however, that it may be that the calculation has been a higher one; and here I turn to another point on which I feel the House has not had the fullest possible guidance. During the Committee stage the Secretary of State for Scotland was asked whether these calculations——
    Mr. Deputy-Speaker: I am sorry to interrupt the hon. Gentleman, but I am not clear as to the relevance of this matter to his Amendment, which seems to me to deal with the application for an assistance grant in certain circumstances.
    Mr. Powell: I am sorry if I have not made it clear. The connection is this—that the effect of the subsection which it is proposed to insert in the Bill will undoubtedly be to enable certain persons to obtain dentures and spectacles who otherwise would not do so because it was necessary for them to make a separate and direct application to the Assistance Board. From information which has been given so far, it appears to me that the Government are actually counting upon that deterrent effect in the calculations upon which the Bill is based.
    If, of course, they can tell the House that they have no such intention, then a consideration which is relevant to my Amendment will disappear; but so long as we suspect that part of the object of the Bill is to deter persons from obtaining dentures and spectacles by reason of the fact that if they wish to avoid a charge they will have to go to the National Assistance Board, then we have a right to attend to the case of those persons who ought not to be so deterred. I was endeavouring to estimate the rough dimensions of this element of deterrent effect which the Government anticipates. I think that in so far as that consideration is germane, the Government should be able to indicate the weight which they attach to it, for it is a material consideration.
    I conclude by saying that this Amendment, or certainly the object which it has in view—namely, that a patient should have the opportunity automatically and without stigma of ascertaining whether his means are such that he is entitled to a refund—goes a long way to meet many of the objections to the Bill which have been raised on both sides of the House. The Minister and the Parliamentary Secretary have already shown themselves at any rate partly aware of the difficulties and I hope they will accept the principle which is enshrined in the Amendment.
    Mr. Iain MacLeod: I beg to second the Amendment.
    I think everybody would agree that it is most undesirable that a dentist should

    1643
    know which of his patients goes and which does not go to the Assistance Board for help under the Bill. Two categories already exist—the private patient and the National Health patient; but the main category of 97 per cent. or 98 per cent. of the population must not be subdivided in the way which many people fear will take place.
    The solution offered by my hon. Friend the Member for Wolverhampton, South-West (Mr. Powell), is that the receipt itself should carry on the back a simple extract of the rights given under the Bill, and I think that would meet the objection which has been raised that the dentist would know the circumstances of his patient. It would also do something to remove the fear which exists in the minds of many people that some of those who most need this help will not go to the Assistance Board for it.
    Those people who have been to the Assistance Board before will no doubt go again. Those who can afford to pay for the appliances will not go to the Board whether they receive a notice on the receipt or not. But those with whom the House is no doubt particularly concerned—those in full-time employment—except in most exceptional cases will not go to the Board where they are earning a reasonable wage which is yet sufficiently low to entitle them to a certain amount of refund from the Board under the Bill. If something on the lines of this Amendment were adopted, we should make it easier for those people to obtain the relief which the Bill affords.
    6.15 p.m.
    Mr. Blenkinsop: We have every sympathy with the intention behind the Amendment and, indeed, in Committee I said that we were anxious that everyone should know how he could claim assistance towards meeting these charges in the event of hardship. But we are by no means certain that this Amendment would help us very much in gaining that end.
    This is really an administrative matter and I can assure the hon. Member for Wolverhampton, South-West (Mr. Powell) and my hon. Friends, who I am sure are interested, that we shall take administrative steps to see that those who go to the dentist or to the optician, know how they can make their application for assistance.
    1644
    Already we have drafted a form of words which can be included in a notice to be available in the dentist's waiting room and in the optician's premises or in similar places so that everyone may see just how he can make an application if he desires to do so.
    The hon. Member for Wolverhampton, South-West, suggested that, in addition, forms of application might be made available at the same place That straightaway raises the danger that the dentist will get to know precisely who is making an application to the National Assistance Board and who is not.
    Mr. Iain MacLeod Mr. Iain MacLeod rose——
    Mr. Blenkinsop: I appreciate that hon. Members may say that the man could take the form away, fill it up and send it to the Assistance Board without anyone knowing. But this is purely an administrative matter. There is no difference between us on this. We all want everyone to know how they can make their applications. We have already gone some way in making preparations to ensure that everyone shall know about it, and we are prepared to consider whether we should provide administratively for some application forms to be available. We will consider whether it will be advisable and helpful or not.
    I cannot go beyond that. In fact, the Amendment does little more than say that those who go to an optician or a dentist should have the opportunity to apply for assistance. They already have that opportunity. The Amendment does not help us at all. I appreciate the point of view which has been expressed by hon. Members and which, I am sure, is shared generally in the House. We will take account of it in the administrative arrangements which we make.
    Mr. Powell: I appreciate the spirit shown in the hon Gentleman's reply, but I would ask him not to reject out of hand the possibility of providing the patient with the means of preferably a postal application to the Assistance Board. I think he will find that he can do that without there being any possibility of the practitioner getting to know. I agree that this is an administrative matter. We have had a substantial assurance that there is an intention to deal with the matter administratively. Consequently, I beg to ask leave to withdraw the Amendment.
    Amendment, by leave, withdrawn.
    Motion made, and Question proposed, "That the Bill be now read the Third time."—[Mr. Blenkinsop.]
    6.22 p.m.
    Mr. Bing: I hope the House will excuse me for intruding in the debate for the first time at so comparatively late a stage, but there are one or two general observations which I think are shared on this side of the House and which I may perhaps put briefly to my hon. Friend on the Front Bench. On this side of the House we feel that one of the troubles with the Bill has been that we have so much concentrated on this departure from the Health Service that we have done a great deal to obscure to the world as a whole the very great benefits which still remain. For that reason it is necessary to say, in passing, that we have been looking at this in only a limited sphere and that, however much the Bill may affect the Health Service in a particular degree, at any rate it leaves untouched an immense field of that Service.
    Secondly, and on the same theme if I may, my right hon. Friend the Minister of Health throughout the Committee stage and other stages appealed to us all to judge him by his speech on Second Reading. I prefer to judge him not by that speech, to which I shall turn in a moment, but to judge him by his very great and humane work as Minister of Pensions. With a Minister who has acted so ably and so well in those circumstances, it would be very wrong for anyone on this side of the House to suggest that he has not the interests of the service at heart.
    When I come to look at the details of his speech and the reasons he gave for the Bill, I honestly feel that my right hon. Friend is like a very able and courteous advocate who, out of sheer inadvertence, has accepted two briefs from rival solicitors and then, to his embarrassment, has found that they both relate to the same case, but has nevertheless determined to go ahead and to present both the arguments as well as he could in the same speech.
    If we look at the arguments which are advanced for the Bill we see that they fall into three categories, each of which seems to be quite distinct. Before we decide to pass the Bill we ought to decide exactly what is the principle upon which the Bill is based.
    1646
    As I understand it, the first point made is that these charges are necessary because there must be some ceiling to the Health Service. We ought to know a little more about the reason why a particular point was chosen for that ceiling. Why was every expenditure held to be satisfactory until we reach precisely the point where we have to pay for teeth and spectacles.
    Why was that the ceiling which was fixed? What are the principles on which it was determined? To take the second point. If it is alleged that we have to charge for some illnesses to make up for the additional cost in the Service as a whole, or alternatively, as the Secretary of State for Scotland suggested, in order to pay for the excess cost of re-armament, why should we not charge the tuberculosis patients, say, for the cost of re-armament? Why should that fall on the people who need spectacles or false teeth?
    Mr. Ellis Smith: On the poorer people most.
    Mr. Bing: To take the third point made. How will these proposed charges prevent abuses in the dental and optical services and improve the school dental service? Those are the three main problems which I hope my right hon. Friend will deal with when he replies to the Debate.
    Mr. Deputy-Speaker (Major Milner): The hon. and learned Gentleman will, I hope, relate his remarks to the contents of the Bill. He appears to be going back to the earlier stages of the Bill.
    Mr. Bing: With great respect, the point which I was on, was the reason why we should pass the Bill in the form in which it is amended now. This is a Bill which will impose certain charges. Why are those charges necessary? There are three reasons given, one, that there may be a ceiling; second, that spectacles and teeth are the appropriate things to charge; third that these particular charges will prevent abuses. It is to each of these three points that I was directing my argument.
    The first point I want to ask my right hon. Friend is this. Why—on what basis—was it decided to place this ceiling? If we are to have a comprehensive Health Service it does not seem to me that £8 a head is a very big sum to choose for it,

    1647
    but if £8 a head is not the right sum what is, in fact, the right sum to charge for the whole thing from the global point of view? Because under £8 per head we have to include the chronic sick, we have to include maternity and child welfare, we have to include epidemics, and we have to include preventive medicine.
    The Secretary of State at an earlier stage reproved everyone for not going to the statistics. It is always a little difficult for back bench Members to have access to all the statistics, but I should have thought that, when dealing with the reasons for this ceiling, he would at least have referred to the figures contained in the Registrar-General's report for the last quarter of 1950, which takes a sample of the population and gives the number of times this sample go to their doctors. Unless we know what is the number of times the population as a whole have to go to their doctor we cannot say whether we are paying too much for the whole service or not. If one looks at the sample figures one sees, for example, that in September out of every 100 people 40 men under 65 were going to the doctor in that particular month, and 67 men over 65; of the women over 65, 76 were going out of every 100 in one particular month.
    What are the causes, then, of this rising cost of the Health Services with which we have to deal? Because it is no use at all passing this Bill unless we deal with the root difficulty—no use saying we make these charges and do not then find a final solution, because, in fact, the rising costs are due to other factors.
    Mr. Speaker: We must deal with what is in the Bill and not the general background. That was dealt with on Second Reading. Now we are dealing only with what is in the Bill. Therefore, the general aspect of the background and of the cost of the Health Service and so on is strictly out of order on Third Reading.
    Mr. Bing: I appreciate that very clearly. The point I was attempting to deal with was this. If we are to pass the Bill in this form, in which we have provision to review the matter after a number of years, it is proper to know at that time, when we come to review it, whether we shall have to deal with additional charges, and so, whether this will meet the situation put before us. However, I will leave
    1648
    that particular point and come to the second question with which I should like my right hon. Friend to deal.
    Why are these charges placed on these particular appliances? Who, in fact, wear false teeth? I do not know what degree of inquiry has been made into this, but just recently, speaking on the Report stage, the Secretary of State for Scotland, answering an argument dealing with the incidence of the need for dentures in Ayrshire, said that: Of course, there were many more dentures needed in Glasgow because people there were not so healthy as they were in Ayrshire. If that, in fact, is so, then, of course, it is true that the people who need them most are——
    Mr. McNeil: I am sure my hon. and learned Friend is not one to misrepresent me. I think that what I said was that the incidence of caries was unlikely to be higher in Ayrshire than in Glasgow.
    Mr. Bing: I appreciate that, and the reason for caries is that the people in Glasgow do not, or have not in the past, because of poverty, been able to go to the dentists as much as the people in Ayrshire.
    Sir William Darling: Water supplies.
    Mr. Bing: There may be a number of local factors, but, generally speaking, that is so, and I think that if one searches one's own experience one does find that, generally speaking, the poorer people are those who earlier require false teeth. Let me give one personal example. During the war I happened to be concerned with parachuting. In parachuting it is necessary to remove one's false teeth before leaving the aircraft. As one may be in difficulties on reaching the ground, it is necessary in some form, to retain teeth and be able to replace them when one arrives.
    Generally speaking, the average age of the people taking part in this was under 30, and yet in the particular units I had to deal with there were amongst the other ranks quite a number of people who had to apply for special celluloid boxes in which to place their dentures. I think that all of us would find, if we searched our own experience, that in a great many cases the people who have false teeth are the poorer people of the community, and that

    1649
    is due to general social maladjustment that we are trying to overtake, though we cannot overtake it all at once.
    Turning from teeth to the spectacles position, again I do not speak with the medical knowledge of some of my hon. Friends, but I would say that there are a great many defects of vision which are hereditary; and, therefore, if a husband and wife both have to go to the oculist for glasses, the chances are that their children will have to go, too; thus when their children reach a working age, they will form a group upon whom disproportionate burdens will fall. The matter is made the worse because, as I understand the Bill, the figures which we are charging, which the House is now imposing, are average figures, and, therefore, the charge of 10s. a lens may be more than the total cost of any of the particular lenses which may have to be fitted for any member of that particular family. In those circumstances we may be imposing more than the total cost of the spectacles upon a whole family of people who have a hereditary but a simple defect of sight. That does not seem to me, on the face of it, to be a very reasonable way in which to approach this problem.
    The third argument for the Bill, as I understand it, is that it will check abuses. How will it do that? That is a question to which no answer has been given yet. If a person is advised by his dentist that he needs a set of dentures or by his oculist that he needs glasses, will the fact that he cannot afford to pay for them turn him into an expert who knows whether he needs them or not? That really is the proposition which is put before us, and the test of skill is transferred from the skilled man—from the oculist and from the dentist—to the patient.
    The only basis upon which the patient is supposed to judge is that the poorer he is, the more strict he will make the test. Other things being equal the poorer a man is, the less able he is to make the test, the less experience he has had of oculists and dentists the more he is likely to be taken in by the type of advice he is given. If he is somebody brought up with a long history of dentist attending, then he may have a hearty contempt for them, but the ordinary person who goes just once in a way has
    1650
    the utmost respect for my hon. Friend the Member for Wolverhampton, North-East (Mr. Baird) and his professional colleagues and is much more likely to take their advice.
    If, in fact, it is true that there are such great abuses in the supply of dentures and in the supply of spectacles, then this Bill does nothing to check them by placing a charge in this way. Surely there are equal abuses in all the other respects? If there are dentists who are prepared to extract teeth or oculists who are prepared to prescribe glasses when they are not required, surely this is the wrong approach to the whole problem, and we ought to be employed in examining the whole conduct of the people doing these things—and doing these things in respect of other things as well.
    Mr. Speaker: The other things do not come within the Third Reading of the Bill.
    Mr. Bing: I appreciate that. I was merely using that as an illustration for judging the validity of the arguments given to us.
    My final point is on—if I may call it so—the total cost argument. It is the argument which we have had advanced in favour of making all sorts of charges—and, of course, in favour of making a charge for prescriptions when we were dealing with that matter previously; and it has been said that this is going to effect some sort of saving. The general argument which we very often have in this House when discussing this sort of difficulty is that we can afford to use a certain amount of the national product, a certain amount of labour, a certain amount of material for a particular thing. Therefore only by imposing a charge upon it to discourage people from doing this particular thing and to encourage them to do something else, can we restrict its use.
    Let me take one example which was very familiar to the Parliamentary Secretary in the days of the wider responsibility of the Ministry of Health. He often had to deal with the question of the making-up of roads. There the test was not who were going to pay for it, or whether the money was coming out of the public funds or not, but whether the money should be spent or not. In this case, is

    1651
    it suggested that by imposing these charges we shall ensure that there will be fewer spectacles and that there will be fewer teeth? Is that the argument?
    Is the argument that there are now people who are wearing teeth and wearing spectacles who have no right to wear the one or the other? Because if that is the argument, it ought to be stated far more clearly than it has been stated up to the present. Is the object of this Bill, in short, to remove abuses of that sort, to prevent people for some unknown reason of obtaining false teeth or glasses when they do not require them? That is generally the reason advanced for imposing charges which discourage use.
    To continue my illustration from the point of view of roads, it is said that it does not matter whether the charge for roads comes out of the pockets of the people whose houses front on to the roads or out of taxation or from the rates. A limit is set on the amount of money spent on roads. In this case is it suggested that £x is the limit to be spent on teeth and spectacles and that by imposing a charge, it will keep it down to that amount?
    I think that it is right that, as I am speaking on this side of the House, I should say that whatever may be our view on this, in view of the vociferous way in which we have plunged into this discussion, it would have been better if we had consulted—I hesitate to say it—even with the British Medical Association, because we know from the speech made by the hon. Member for Luton (Dr. Hill) that what they suffered from was not taking the very good advice, which, no doubt, they had throughout all their discussions, of their secretary. A practical approach to these problems and discussions with the profession might have saved us all the heart-searching that we have had on these benches.
    The Bill now, thanks to the activities of many of my hon. Friends, is a great deal improved, but it does not do away with the lesson that when technical matters of this sort are to be brought forward, we should study them in leisure and with care before we submit them to the rough and tumble of debate in the House.
    6.42 p.m.
    Mr. Linstead: I am glad that it falls to the Minister of Health and not to me to give a detailed answer to the criticisms of the Bill which have been made by the hon. and learned Member for Hornchurch (Mr. Bing). I believe that there is a detailed answer to many of the criticisms which he has put forward with the skill of an advocate, and they have, I think, sought to find a greater amount of reason in the Bill than its rough and ready provisions admit.
    I would, however, make this one comment upon one of the last points made by the hon. and learned Gentleman. He inquired why it was that we had been thrown into the passage of this Bill so rapidly and with so few consultations with the people concerned. It seems to me that if there is to be legislation of this kind, it must be rapid legislation, because, if the Bill is not passed quickly, we shall at once get people who had notice that charges are to be imposed seeking to avail themselves of the services so long as they are free. Whatever criticism there may be, I do not think that there can be proper criticism of the speed with which the Minister is seeking to get the Bill on the Statute Book.
    I am one of those who support the Third Reading of the Bill, but, frankly, I do so with no particular enthusiasm. I regard this as an unpleasant public duty which, I think, we on both sides of the House, have to assume. It has for a long time been obvious that there are differences of opinion among the party on the other side of the House on many subjects. It has been obvious that there has been a split, but I think that it is regrettable and unfortunate that these differences should have crystallised around the subject matter of this Bill. The result has been that it is the patients of the National Health Service who have been made the shuttlecock in a political quarrel.
    Mr. Rankin: Nonsense.
    Mr. Linstead: That is the result of the circumstances in which the Bill has come to be brought before the House. To me the question which is presented by this Bill is whether this particular charge is necessary in order to keep the Health Service going for the next three years. I say for the next three years because that is the change which has

    1653
    been introduced into the Bill, and I would suggest, Mr. Speaker, that its introduction allows us on Third Reading to go perhaps a little wider than would otherwise be the case.
    I have some knowledge of certain parts of the Health Service. I have considered very carefully whether there are not other ways by which the sum of money which this Bill is to secure, could be made available. That the money is needed, I have no doubt at all, because in every direction under the Health Service, the need is infinitely greater than any resources which have yet been put at the disposal of the service. Looking at the administration of the Health Service on merit, I am bound to say that I could find nowhere economies of any size which would compensate for the charges which will be forthcoming if this Bill becomes law. I think that it is perhaps worth quoting a remark—and I hope, Mr. Speaker, that I shall not be out of order in doing so, having regard to the fact that this Bill now refers to the period of three years—which was made by the right hon. Gentleman for Huyton (Mr. H. Wilson), when he made his resignation speech in the House. Referring to the relationship of this particular charge to the total Government expenditure he said:
    "I should have thought that it would be possible to examine even the current expenditure that is now going on on re-armament. Who can say there is no possible wasteful expenditure there which cannot be pruned without injuring the effectiveness of the programme?"
    He also said, in another part of his speech,
    "Thirteen million pounds out of a budget of £4,000 million is well within the margin of error on any possible series of estimates."—[OFFICIAL REPORT, 24th April, 1951; Vol. 487, c. 229.]
    I think that it is significant that these two obvious sources of obtaining the money needed for the Health Service—sources which must have been examined by the Cabinet—had been rejected by them. I think we must assume that the Cabinet came to the conclusion that over the next three years either the economies could not be made, or, I would prefer to say, ought not to be made in the opinion of the Cabinet, and, therefore, that readjustment of the Budget figures——
    Mr. Speaker: We are not discussing the Budget figures now. The hon. Member is getting too wide in his remarks.
    Mr. Linstead: I will do my best to keep within the rules of order, Mr. Speaker, but may I respectfully draw your attention to the fact that we have now imported a period of three years into the Bill, and that possibly we are now entitled to look at the cost of the Bill in relation to the national expenditure over that period? I appreciate your ruling, however, and will do my best to keep within it.
    A point which I want to make is that the fact that this Bill has been proceeded with in the light of the considerations that were advanced by the right hon. Member for Huyton must mean that the Cabinet had come to the conclusion that the Health Service had been getting, shall I say, financially out of hand, that it could not be cut, and, therefore, it must help to pay its own way. I would suggest that it is important that that should go on record—that they recognised that the Health Service had been attracting to itself too large a part of the country's resources. Personally, I can draw no other conclusion than that for the presentation of the Bill. Certainly, it is not too large an amount in comparison with the needs of the service, but too large a proportion in comparison with what is available. I think the reason for that state of affairs is that in the introduction of this Service, the right hon. Gentleman the Member for Ebbw Vale (Mr. Bevan) took a chance—it may well have been a justified chance—in offering a Service which was based on demand——
    Mr. Speaker: We are now discussing the Health Service as a whole. The Bill does not deal with the Service as a whole, but with spectacles, false teeth and sanatoria. The Third Reading limits us, in the main, to that.
    Mr. Linstead: I will do my best to keep to that, Sir, but I submit again that the amount of income which the Bill seeks to provide is to be used for the general purpose of the Health Service. I will conclude my argument on this particular point by saying that the need for this Bill has arisen from the fact that the original conception of the Health Service was an unlimited demand on limited resources.
    I would add, in agreement with the hon. and learned Gentleman the Member for Hornchurch, that it is a pity that the

    1655
    charges could not have been more widely spread over all those to whom the service applies. Where they do fall they fall heavily, and if one looks over the whole field one suspects that the charges could really have been more fairly shared. But it is difficult, when one looks at the operation of the Health Service, to see just where the charges could have been made, and I come to the conclusion, regretfully, that this is a rough and ready way of obtaining within the service certain resources which the service undoubtedly needs if it is to continue, let alone expand. For that reason we have got to accept this as rough justice on that basis.
    I will sum up my remarks by saying that, as I see them, these charges are a recognition by the Cabinet that the Health Service up to now has had more than its proper share of our resources; that they recognise that it is right that the excess should be met by the user and not by the general body of taxpayers. I would emphasise that it is unfortunate that the charges fall so heavily on two sections only, but in the circumstances I accept that as an unpleasant necessity. In my view these charges are the inevitable result of the policy which has been pursued since the Health Service was introduced.
    6.54 p.m.
    Dr. Barnett Stross: I do not find myself in agreement with the hon. Member for Putney (Mr. Linstead) in his last statement, when he said that the Cabinet had come to a decision that the Health Service was taking too large a share of our national resources. It has worked out at about £8 per head per annum for man, woman and child, and looked at in that way I cannot agree that it is too large a share for important and vital aspects preventive and curative medicine.
    However, if I may leave that for a moment, may I say that I listened with great sympathy and with broad agreement to many of the points made by my hon. and learned Friend the Member for Horn-church (Mr. Bing). There is, however, one aspect of his statement which I think should be qualified. He said that poverty and caries ran side by side and that there is an association between them. That is quite true in this country since about 1860, or perhaps since the Industrial Revolution, but it is not true in all parts
    1656
    of the world and should not be used as a dictum for ourselves for all time.
    New Zealand has a very high standard of life and its children have the worst teeth in the world. That is because of the large quantities of white flour which are used as well as the large amount of sweets made out of sugar. So with a much higher standard of life than almost anywhere else in the world we get the worst teeth. The peasants of Britain in the time of Henry VIII had very excellent teeth, and it will be recalled that Henry VIII was very disturbed when he sought a wife from abroad, because the people in the aristocracy both abroad and in Britain had very bad teeth. He particularly asked his Ambassador to make sure that she did not suffer from halitosis and that comfits were not used to conceal that possibility. That never occurred among normal, ordinary common folk who lived on the produce of the land. It is not only poverty of money which counts, but poverty in legislation that does not understand nutrition.
    Mr. E. Fletcher: As a matter of interest, would my hon. Friend not confirm that in those days there were no such things as false teeth and dentures?
    Dr. Stross: In those days, looking at the skeletons of our forefathers, there was little need for false teeth, because so many had teeth in very good condition. The expectation of life was not great; it was about 28, but those who survived and did not die from infectious disease and who lived to a ripe old age had very good teeth. It is true that there was no protection, such as we have now, against infectious disease. I do not want to make too great a point of this, but I am sure my right hon. Friend the Member for Ebbw Vale (Mr. Bevan) must agree broadly with what I am saying here.
    I have been favourably influenced by the way in which the Bill has been amended. I think two points were of great importance. The first was that there should be inserted in the Bill what is now provided—that the charges cannot be varied in an upward direction. We think that very important, and I am sure we are all grateful to my right hon. Friend the Minister of Health for it. The other point, which is more debatable, is when should the charges be brought to an end. Personally, I think that the term is a year

    1657
    too long, but it may well be that times will improve and we shall get some amelioration before 1954. What we were most anxious about was that the principle should be safeguarded, and we have some safeguards here. There were people like myself, who, in the first place, were really frightened that a Government of another complexion might use this as an excuse for destroying what we think is important in the service.
    Mr. Ellis Smith: So they will.
    Dr. Stross: My hon. Friend says, "So they will." All the more reason, therefore, to see that they never get a chance. We cannot disguise from ourselves that right hon. and hon. Gentlemen opposite for years past have criticised this Service throughout, and they think that there should be charges in more than one direction—perhaps in all directions. We shall see, if the time ever comes when we have to change sides, what they are going to do about it.
    Mr. Ellis Smith: We cannot forget the Anomalies Bill.
    Dr. Stross: At the moment we have some protection that by 1954 these charges will come to an end.
    Lastly, may I mention those affected by tuberculosis who will go abroad. We all welcome that provision, but at the same time let us not place too great a reliance in the efficacy of this. I believe the advantage of the scheme lies in the fact that there are beds, nurses, and doctors, who are not fully engaged abroad in treating their own cases as our medical services are here, and in that respect it is a good thing that we are able to take advantage of the sanatoria, hospital beds and personnel. But we should not run away with the idea that other countries have a better technique in treatment than our own. It would not be true to say so. I heard someone say on Second Reading there would be days of extra sunshine. I am not at all certain that this is an advantage in treating pulmonary tuberculosis. Nothing causes a flare up in quiescent tuberculosis more quickly than excessive sunbathing.
    So far as the operative treatment is concerned, I do not think that many countries are better in that respect than we are. Perhaps there is Sweden. We
    1658
    have used in the Bill the words "treatment outside Great Britain." I am glad that we are not limiting ourselves to any specific country. There is a certain variant of pulmonary tuberculosis that can be well treated in some of the great sanatoria and hospitals in Sweden. I remember someone who was very experienced in the treatment of this disease telling me when I was younger that he could treat pulmonary tuberculosis successfully in a cellar if he had certain things like the right kind of food and an incentive in the patient to live. It is not where we treat but how we treat an ailment that is often most important.
    This Bill has a number of advantages, although in the House of Commons we are apt to get somewhat myopic about these problems, and sometimes we cannot see the wood for the trees. I have done my best to try to find out outside what people think about these charges. I do not think they are excessively worried, on condition that the principle of the Service is not being tampered with. I feel that we have some safeguard there, and I am very glad of it.
    7.3 p.m.
    Sir Hugh Lucas-Tooth: The hon. Member for Stoke-on-Trent, Central (Dr. Stross), finished his speech by referring to the advantages of the Bill, but I did not notice in the course of his speech any description of those advantages. He probably feels, with the hon. and learned Member for Hornchurch (Mr. Bing), that the greatest problem which the Bill raises is, "Are people wearing teeth and spectacles that they do not need?" That is an oversimplification of the problem which we have to face this evening in considering whether or not to pass the Bill. It is quite true that people do not wear false teeth and spectacles unless they need them. If we put the problem in that way and we accept that answer, we may say, "That disposes of the matter. The Bill is bad and there is an end of it."
    The truth is that a good many people who get false teeth and spectacles can perfectly well afford to pay for them, and indeed are both anxious and willing to do so. I do not think it lies with hon. Gentlemen opposite to suggest that there is a very substantial proportion of people in this country who cannot afford the amount of money which we are here

    1659
    considering, since we have had six years of Socialist Government. The question is grossly over-simplified. While nobody wears spectacles that he does not need, he may very well get himself a new pair before there is any real necessity to do so. The trouble with the Health Service arrangements up to date is that they encourage a person to get new spectacles as quickly as possible when there is the slightest alteration in his sight, without any regard to genuine need, especially when looked at in the whole context of national finance.
    Mr. Rankin: Surely the decision in getting new spectacles does not lie with the person himself but with the registered medical practitioner. It is only on the practitioner's prescription that the spectacles can be obtained.
    Sir H. Lucas-Tooth: The hon. Member is quite mistaken. It is true that in the first place, before getting spectacles, the person has to get a medical certificate, but when he has got it, the matter does not rest with the doctor any longer but with the person himself and with the optician who supplies the spectacles. I do not know whether the hon. Gentleman is suggesting that opticians do not act honestly in the matter.
    Mr. Manuel: It is what the hon. Member himself is suggesting.
    Sir H. Lucas-Tooth: The truth is that after he has received a certificate from a doctor that he needs spectacles, the person can get new spectacles every time there is the least variation in his sight, and there is no further check upon him.
    Mr. Manuel: The hon. Member is certainly right in his statement about the medical inspection and the certificate the first time. If the person then feels that he needs another pair of glasses he goes direct to the optician. Surely it is the duty of the optician to see whether he needs new spectacles or not. If he does not, then an abuse is connived at by the optician merely to make more profit than he should do out of the Service.
    Sir H. Lucas-Tooth: In the ordinary way, a pair of spectacles lasts a person a fairly long time. In my own case, I have not had my eyes tested for a matter of five years. I strongly suspect that if I had them tested I should be advised at
    1660
    once to get a new pair of spectacles, but the pair I have in my pocket are adequate to my needs and I have not done so. I have to pay for my spectacles. I believe that if the same were true of people in general there would be a definite falling off in the demand for spectacles, without any burden being placed upon the people.
    Mr. Goronwy Roberts: How far would the hon. Member go over the whole range of the Health Service, in regard to the principle of payment? Would he and his party extend it to the whole range of the Health Service?
    Sir H. Lucas-Tooth: If I attempted to do so, Mr. Speaker would call me to order very smartly. We can only deal with spectacles and teeth. I have given a good reason for putting a charge on spectacles at the present time.
    Different considerations apply to teeth, but hon. Members know perfectly well that the 10,000 or so dentists in this country are entirely insufficient for our needs. To cover the teeth of the people of this country properly we should need something like 15,000 dentists. We are about 5,000 short. If we are 5,000 short, someone must suffer. It is obvious that someone has to suffer, and the choice which the House has to face is whether we are to continue to allow 61 per cent. of the whole of the activities of the dental profession in this country, as has been the case under the scheme, to be devoted to the provision of false teeth, or whether we are to try to direct those activities to the dental care of the children and nursing mothers, and the general conservative treatment of the teeth of our people. That is the problem, and I have no hesitation in saying that the right choice is to try to divert the treatment away from dentures and towards conservative treatment.
    Mr. W. Griffiths: The Minister said that 61 per cent. of the cases were for dentures, not that 61 per cent. of the time of the dentists was occupied with dentures. Would the hon. Member tell the House how on earth imposing a charge for dentures is going to help the school dental service?
    Sir H. Lucas-Tooth: If imposing a charge will not reduce the number of dentures supplied to people, the whole of the case of hon. Members opposite falls to the ground. If it will bring a reduction,

    1661
    it will relieve a certain number of dentists to do the other more urgent work.
    A Bill in some way to impose a limit on the Health Service has been inevitable for a long time past. In his Budget speech two years ago Sir Stafford Cripps indicated that it was essential that there should be no further Supplementary Estimates. That represented the first rumblings of the storm from the Treasury. A year ago Sir Stafford Cripps, in a passage which has been referred to a great many times in our debates on this Bill, laid down quite definitely that there was to be no further increase in the cost of the Health Service. In spite of the Chancellor's firmly declared policy and in spite of the power that the Treasury has over the other Departments, it has not been possible to check in any way the growth in cost of the Health Service——
    Mr. Aneurin Bevan: I am quite sure that the hon. Gentleman would not wish to misrepresent the situation. The expenditure on the National Health Service for the year 1950–51 was the first year's expenditure based upon the first year's estimates of the first year's full experience of the Service, and in 1950–51 the expenditure was not only within the estimate but was actually very nearly £11 million less than the original estimate. Therefore, it is quite wrong to say that the finances of the Health Service were out of control. They were kept within the limit—well within it—in the first full year's experience of the Service.
    Sir H. Lucas-Tooth: The estimates cover the whole range of the Service and during the course of last year a number of things were done within the Health Service which effected economies in certain directions——
    Mr. Bevan: I have not been anxious to intervene in the debate very much because I do not want to raise the temperature, but perhaps I may be allowed to say this. The two services upon which the charge is now being made were the two services where the expenditure has been progressively reduced.
    Sir H. Lucas-Tooth: But reduced for this reason, that in each of those services very heavy cuts were made during the course of the years in question, cuts in the emoluments of those concerned——
    Mr. Bevan: And reduced use.
    Sir H. Lucas-Tooth: —but it was beginning to be apparent that the real trouble was not essentially the overpayment of the professions concerned by the right hon. Gentleman but that the scheme itself was wrong in giving the wrong emphasis to the patients' demand for the treatment provided.
    Mr. Bevan: I do not wish to interrupt the hon. Gentleman again, but he is inaccurate. From last year's use of the optical side of the service it was quite clear that the demand for spectacles in Great Britain was beginning to reach the level of the pre-Health Service demand. In the case of the dentists, in some parts of the country dental technicians have been put off because the demand for dentures has been falling. The fact of the matter is that hon. Gentlemen opposite have not had enough faith in the service to nurse it through its initial period.
    Sir H. Lucas-Tooth: I hope very much that the right hon. Gentleman will develop these lines of argument in a speech after I have sat down. To return to the point at which I was interrupted, in spite of all the efforts of the Chancellor of the Exchequer and the Treasury it has not been possible to control the great increase in the cost of the service. I do not wish to go into details, but the rise in cost in the last year, as stated by the Chancellor of the Exchequer, was of the order of £30 million, apart from economies to be effected by this Bill. That was the situation, and something had to be done about it, and that is the reason why the Government introduced the Bill.
    I want to say straight away that, although the Bill represents a reversal of policy, I regard a reversal of policy in this connection as a bad thing in itself. The one thing we want in the Health Service is a continuous policy so that the professional men, the hospital administrators and the others concerned will know where they stand. I do not wish to use this as an opportunity for attacking the right hon. Member for Ebbw Vale (Mr. Bevan), but I believe that the scheme was fundamentally at fault because it contained in itself the seeds of a great many reversals of policy.
    Mr. Manuel: That was its value.
    Sir H. Lucas-Tooth: My complaint about the Bill is that it is a "hit and miss" affair which deals with only two branches of the Service which are not the largest branches, and I believe that there will inevitably be other Measures of this kind whoever is sitting on the benches opposite. I am quite certain that under the policy as laid down by the right hon. Member for Ebbw Vale the increasing demands will inevitably drive any Government to take steps to see that the Service is not abused and not over-used.
    Mr. Frederick Elwyn Jones: Will the hon. Gentleman give an indication of the other Measures he has in mind? We are most anxious to know what he is contemplating.
    Sir H. Lucas-Tooth: I am afraid that the hon. Member is inviting me to go outside the bounds of order. When an opportunity for this kind of argument occurred on Second Reading, the hon. Member did not make points of this sort. As I see it, the objections are that the Bill is piece-meal legislation, that it does not deal with the problem as a whole and that it is in its nature something of a temporary one. Although it is part of an inevitable process, it is only a small part, and sooner or later some Government will have to consider the problem as a whole, and until we get it reviewed as a whole we shall find constant difficulty over the Health Service.
    7.17 p.m.
    Mr. Messer: I feel sure that every hon. Member sitting on this side will have listened with very great care to what has been said by the hon. Member for Hendon, South (Sir H. Lucas-Tooth), for, if anything, he has confirmed some of us about the dangers that the Bill exhibits. What it does is to open a door.
    I admit right away that when at some future date, if they care to do so, hon. and right hon. Gentlemen opposite come along and say, "We have reached a ceiling, and within that ceiling we shall have to spend just what we can afford, which means that we shall have to make charges," that will be quite logical. They may ask what the difference is between glasses and glass eyes; what the difference is between false teeth and false hair; if it is true that dentures are a form of
    1664
    treatment, what the difference is between that form of treatment and a surgical boot; and what the difference is between a calliper splint and any other form of splint.
    If that principle is accepted, we shall have two types of patient, those who can make a contribution to the Health Service and those who are unable to do so. If there was any merit in the Service at all it lay in the fact that everybody was treated alike, whether he was a duke or a dustman, a bank clerk or a road sweeper. No matter what his social position was, everybody could come through the wide open door of the National Health Service. It is impossible for us to accept the statements made that this is not any infringement of principle. When once we single out any section of the service for payment, we destroy the Socialist basis of the Service. In the past, under the old educational service, we differentiated between those who were unable to afford to pay for a real education and those who could. We have got away from that. We have evolved a Health Service where everybody whatever they were suffering from, could get treatment without any question as to whether they could afford to pay. No longer was there a premium placed on human suffering. Now there is.
    We cannot accept everything that is said unless we accept the fact that a charge on dentures means that fewer dentures will be supplied. That can only mean that people who otherwise would have dentures, will no longer be able to get them. Indeed, the hon. Member for Hendon, South, referred to the alarming situation which arose on the destruction of the priority dental service. I agree with him. Everybody deplores the fact that the basis of payment attracted dentists away from the school dental service and from the maternity dental service.
    I am not sure that we shall get what we want by this method. During the Second Reading debate the Minister of Health referred to the advice given by the Dental Advisory Committee to the effect that by some means there should be a reduction in the supply of dentures. The actual wording of the advice did not mention a charge, although they meant that. They referred to payment. What assurance is there that in making a charge we shall divert dentists to the priority

    1665
    dental services? The hon. Member said that because there are not sufficient dentists to go round, let them go where people can afford to pay for the services of a dentist. Is there not some other way? Is it not possible for even that highly specialised profession to be diluted? Cannot some attention be given to the oral hygienists? I know that some are employed; but cannot there be investigation with a view to seeing how much of the dentist's job can be done by somebody not so skilled as the dentist?
    Mr. Bevan: It has been started.
    Mr. Messer: Yes, but cannot steps be taken to expand that service so as to make available a larger number of people? Recognising that there is a limited number of dentists, would it not be possible to control the dentists so that they will be used where they are most needed? Perhaps we have given too great a freedom to those who have gone out of a full time service into a service which pays them better.
    I hope that my forebodings will not be realised, but I know that a service representing £400 million is the finest target that any Chancellor of the Exchequer can have. Looking to the future, I cannot fail to see that that target will be always there for any Chancellor, and the sooner we take it out of the hands of the Treasury and finance it by other means, the better. I think there is the possibility of that being done. When we can do it, we shall be able to organise this service without always being faced with the fact that here is a ready pool from which the Chancellor can draw.
    We have been told that £500 million is the ceiling of the service, as though that was a completely new charge. It is not. We forget what the local authorities used to pay before this became a national service. We do not subtract from that £400 million the amount which would be paid if it went back to the local authorities. I am not suggesting that it should, but we must not let it go out that this is £400 million of the taxpayers' money which, if it were not paid for by the taxpayer, would have to be paid by the community in any event. There are considerations which rise superior to the economics of the situation. Those considerations are the well-being of the people. I hope that
    1666
    the principle of a completely free service which this Bill is undermining will be restored.
    With regard to tuberculosis, my hon. Friend the Member for Stoke-on-Trent, Central (Dr. Stross) referred to treatment that can be obtained abroad. I am glad to have that Clause in the Bill and that we have been able to take advantage of what is offered abroad, but I have no illusions about the extent to which we shall be able to take advantage of it. I realise some of the difficulties. I realise, too, that limiting it, as the Bill does, to pulmonary tuberculosis in not making the best use of those facilities. It would be wrong of me on Third Reading to go outside the terms of the Bill. I hope that if there is one thing we have started in this Bill which is bad, that there is another which is good, and we should expand that which is good in the interests of the people who can take advantage of it.
    7.27 p.m.
    Mr. Angus Maude: I do not wish to detain the House longer than is necessary to comment briefly on one or two points raised by hon. Members opposite. The hon. Member for Tottenham (Mr. Messer) said one thing which I thought was significant, namely, that once we admit the principle of charges in the National Health Service, we at once eliminate the Socialist basis of the scheme. That is perfectly true. It is precisely the reason why the Government have been forced now to make this charge. At last it has become apparent to them what I always knew, that a scheme based upon a purely Socialist theory would never work.
    The hon. Member for Tottenham said he wanted to see a wide open door through which duke and dustman alike could enter into the Health Service. I do not. I have never done so. I want to see a door which will be wide open to the dustman but, when the duke comes along, I want to see a turnstile with an admission charge. I will tell the hon. Member why. It is because, until we are prepared to recognise that under the present financial system we cannot conceivably provide a decent service for the dustman if we are to provide a free service for everyone else as well, we shall never get a decent free service for the dustman.

    1667
    Surely it must be realised at this stage by all hon. Members that we must face the principle which this Bill introduces. I have never accepted the assurance of the Minister that it did not introduce a new principle. The new principle is a recognition of the fact that the resources available will not provide a proper service for everyone. The hon. and learned Member for Hornchurch (Mr. Bing), in applying himself to the provisions of the Bill, said it was rendered necessary, in the submission of the Minister, by the fact that the resources available could not be increased any further, but the hon. and learned Member said that that could not be true because the resources were only £8 per head of the population.
    Mr. Speaker: I have been doing my best to keep the debate within some kind of bounds. The Bill deals, as I said before, with teeth, spectacles and sanatoria. Its general principles are really Second Reading points and not Third Reading points.
    Mr. Maude: I fully appreciate that, Mr. Speaker. I was only doing my best to address myself to some of the observations which have been allowed as being in order from the other side of the House.
    Mr. Speaker: I did my best to limit them.
    Mr. Maude: I appreciate that, Mr. Speaker. I will therefore remove myself from the border line of the rules of order and confine myself simply to observations on the Bill as it has been amended.
    In my submission, right from the beginning of the service the Bill was bound to come, in view of the principles on which the right hon. Member for Ebbw Vale (Mr. A. Bevan) started the service. The rate at which the increases went on made it inevitable. This new principle is dangerous in many ways, and we shall have to watch very carefully to see where it takes us. I do not believe that it makes any particular difference to the sheer financial necessity with which the Minister will be faced, whichever party is in power next year, the year after or in five years' time. The way things are going at present, this problem will face a Chancellor of the Exchequer and a Minister of any party which is in office.
    1668
    This is a belated recognition of necessity. I think it has been introduced without due regard to the merits and needs of the Health Service as a whole. I think it is a money-saving measure, and it ought to have been something much more. It ought to have been something deliberately and precisely conceived to ensure the best Health Service for the people who need it most. I hope that if hon. and right hon. Gentlemen opposite find themselves in power long enough to have to face this question again, as I think they will, they will bear in mind when that occasion arises that the only reason for departing from their principle is to make the Health Service better. They may do so this time by accident. Next time, I hope they will do so on purpose.
    7.33 p.m.
    Mr. Michael Foot: Before the Bill goes through, it is worth recognising that the debate which we are having on the Third Reading today is a somewhat different kind of debate, and conducted in a somewhat different atmosphere, to a previous debate in the House on a National Health Service Bill. In this debate we have been spared the reasoned Amendment which was put down by the party opposite when we were discussing the previous Bill, and we have been spared the violent speeches which we had from hon. Members opposite when the original Bill went through.
    Although we have had no reasoned Amendment from hon. Members opposite, however, it is only fair to say that we have had a number of reasoned speeches from them. They have argued very powerfully that they are strongly in favour of the Bill precisely because they strongly opposed the original Bill when it went through the House. Nobody could say that that is an unfair interpretation of at least the last two speeches we have had from the opposite side of the House, because both hon. Members who have spoken on behalf of the Opposition in the last two speeches have emphasised that they regard the Bill as a first taste, which merely whets their appetite; they are expecting something much bigger and better in the future.
    I was particularly interested in the speech of the hon. Baronet the Member for Hendon, South (Sir H. Lucas-Tooth), because we have a right to recall that he

    1669
    speaks officially on behalf of the Conservative Party on this matter. On the Second Reading of the Bill, he was put up on the Front Bench to speak officially on behalf of his party. I presume, therefore, that when he was speaking today he was again speaking officially and giving us some indication of what would be Conservative policy on these matters. I was particularly interested also because I remembered that at the time of the last General Election, the hon. Member's leader, the right hon. Member for Wood-ford (Mr. Churchill), came to my constituency, when we asked the right hon. Member precisely what kind of National Health Service Measure he would favour. We did so because the right hon. Member had sought to give the impression to my constituents that the National Health Service Act had been brought into operation by himself in the face of rigid and stubborn opposition from my right hon. Friend the Member for Ebbw Vale (Mr. A. Bevan). We were particularly eager, therefore, to know exactly the sort of National Health Service of which the Conservative Party would be in favour. We did not get an answer from him.
    We owe a debt of gratitude to the hon. Member for Hendon, South, who has given us some indication of the answer. He said quite clearly that he thinks that if some people can afford to pay for spectacles and teeth, they ought to pay for them. That is the principle in which he believes. Of course, he would apply the same principle to Medresco aids, hospital services, and all the other services which are applied under the National Health Service Act. We are grateful to the hon. Member, because he said that in his view the Bill was only a piecemeal and temporary Measure. He made it quite clear that the official policy of the party for whom he was speaking officially was that they would extend these charges very much further and would apply the same principle to other parts of the Service as the hon. Member, in his argument, applied them to spectacles and teeth.
    Sir H. Lucas-Tooth: In case the hon. Member should think I am agreeing with what he says, may I say that I totally disagree with the views he has taken of my speech? If he reads it carefully, he will see that I said nothing of the kind whatsoever.
    Mr. Foot: Everyone listened to what the hon. Member said. He said that he thought it was quite right that people should pay for spectacles and teeth if they could afford to do so. If that principle is applied to the rest of the Health Service, we arrive at exactly the same point which I have been making. My complaint against the Government is that they have given hon. Members opposite the opportunity for the first time of supporting a National Health Service Bill going through the House. This is the first main Bill which hon. Members opposite have ever plucked up courage to support, and they do so for the principles which the hon. Member for Hendon, South, has outlined.
    The hon. Member made another interesting point when he based a large part of his support of the Bill on grounds which, I admit, have never been advanced as the main arguments by the Government Front Bench: that is, the ground of abuse. The hon. Member made some of this argument during the Second Reading and has continued it on the Third Reading, in which he has claimed that these charges are necessary in order to prevent some form of abuse, although when he is cross-examined from this side of the House he cannot explain how the abuses arise. But the Government have never based their main case on that point.
    My right hon. Friend the Minister of Health, on Second Reading and when describing very clearly the Clauses which we have been discussing, gave as the main reason for introducing the Bill the fact that he was presented by the Chancellor of the Exchequer with a demand that a ceiling must be provided for National Health Service expenditure. The story, however, was finished too early, because when my right hon. Friend discovered that the ceiling involved what my hon. Friend the Member for Tottenham (Mr. Messer) described as the destruction of the principle of the Health Service, why did my right hon. Friend not go back to the Chancellor of the Exchequer and say, "There is a conflict. You say I must apply a ceiling to the Service. This means that I must depart from the principle for which this party stood at the General Election and ever since the Bill was introduced"? If on previous occasions we had had a Minister of Health who never wished to argue with the Chancellor of

    1671
    the Exchequer on these matters, we would not have had the National Health Service introduced in the last Parliament and an Act which we could defend on every platform in the country at the last election.
    I do not believe that the explanation which has been given for the introduction of this Bill by the Government holds any water at all. The only explanations for the introduction of the Bill which would hold any water at all have been given to us by the Opposition. They are enthusiastically in favour of this Bill for precisely the same reason that they were enthusiastically opposed to the National Health Service Act when it was originally introduced.
    When the Government introduced the Bill they had to put some proposal into it which, they hoped, would mitigate the opposition which might arise. We have had one Amendment since. I do not quite agree with my hon. Friend who seems to imagine that the Amendment makes a great deal of difference to the Bill. It apparently proposes that in three years' time when, according to the Government's estimate, expenditure on armaments will be at its greatest, the whole of our expenditure on the Health Service shall be reviewed. I would not call that a cast iron guarantee that we are to get back to the full principles of the National Health Service and I am not very much enamoured of the new Amendment we obtained.
    There was one Clause put into the original Bill obviously to mitigate such opposition as might be certain to arise. It was put into the Bill in order that the Chancellor of the Exchequer might be able to say in his Budget speech and the Minister of Health could say in his Second Reading speech that despite the imposition of these charges there was going to be no real hardship or distress imposed. That is Clause 4 and in particular as it relates to the possibility that the National Assistance Board might be able to give assistance to people who need spectacles or artificial teeth, even people in full employment.
    I believe the explanation of this Clause which we have had so far from the Government in the Second Reading and the Committee stage is totally inadequate, for the reason that if the Bill
    1672
    goes through the House of Commons today, as it probably will, no hon. Member will be able to tell his constituents at the week-end whether they will be able to get assistance from the National Assistance Board or not. No one will know. What about my constituents, a large number of whom get about £5 a week, even after a recent wage increase? They are getting nothing else out of the Budget, indeed they are getting further hardships in my view. What am I to say to them supposing they ask, "Am I allowed to go to the Assistance Board and get assistance?" I shall not be able to tell them as the Minister has not yet told us.
    Regulations are to be issued to safeguard people who might have hardship or distress imposed on them because of these charges, but when the Bill goes through the House of Commons not one hon. Member will be able to say how it applies to his constituents earning £5 a week.
    Mrs. Jean Mann: May I quote from HANSARD a statement by my right hon. Friend the Secretary of State for Scotland:
    "A married man with two children, earning around five guineas a week, would not be expected to make any contribution to the cost of dentures."—[OFFICIAL REPORT, 2nd May. 1951; Vol. 487, c. 1353.]
    Mr. Foot: That is the one statement we have had. I went through the Committee stage debate very carefully. What about my constituents earning £5 a week with one child or with no child? We cannot answer such persons yes or no. I say it is a miserable way to bring in a miserable Bill to bring it in in such a manner that we are to vote on it on Third Reading without being able to tell our constituents how it applies to them and how the regulations are to operate. Why was that necessary?
    Would it have hurt the Government so much to have waited two or three weeks to work out the regulations so that we could have had an idea on Third Reading what the regulations were about? If the Secretary of State for Scotland is able to raise one corner of the veil and give half a hint of how the regulations are to apply, would it not have been possible for us all to know how they were to apply to a man earning £5 with one child, or with no child? Today no hon. Member will

    1673
    know exactly for what he is voting, and on Clause 4 we are asked to go into the Lobby and vote for the Government in this respect and wait very kindly to see what regulations they will bring in later on.
    In fact Clause 4 introduces an entirely new and entirely dangerous principle. It introduces the principle of subsidising wages according to particular needs. This is something we have not had in our legislation for many years. It is something which we have under the old Elizabethan Poor Law and under the Speenhamland system. But it is not a principle we have or expect in our social legislation in this House of Commons or a principle we would have expected when we were debating the National Assistance Act in the House of Commons.
    Supposing someone had said then, "We will have a new special provision whereby subsidies can be given to people whose wages fall below a certain level." Every trade unionist would have got up and protested and said, "This is a scandalous situation and is not what the National Assistance Board is meant for at all. The Board is there to protect the people who are not protected properly by the system of general insurance." The idea that we should protect the wages of people by a subsidy and say whether they should be penalised or not is a principle which this House——
    Lieut.-Colonel Elliot: The hon. Member is developing an argument and I take it he will say why he supported this principle in the last Parliament on the question of legal aid?
    Mr. Foot: I think that a very valid point. I am against the National Health Service of this country being run on the same principle as the legal aid service, and certainly every hon. Member on this side of the House would be opposed to that as well. I think it is a perfectly valid interruption. Therefore, if the right hon. and gallant Gentleman's defence of what the Government are doing—and I know he has been passionately supporting the Government throughout the whole Bill—is that he does not mind if this transforms the situation into the same as that of the legal aid service, it is the most damning attack on the Government even from the right hon. and gallant Gentleman.
    Lieut.-Colonel Elliot: Of course we do not mind. The hon. Member does not know the arguments. He was not in the discussions on legal aid in Committee upstairs and did not hear us protesting against this principle in legal aid, but if he consults with his hon. Friend the Member for West Ham, South (Mr. Frederick Elwyn Jones), next to him and if he intervenes he will be——
    Mr. Deputy-Speaker (Colonel Sir Charles MacAndrew): Perhaps before discussing legal aid further, I should remind the House that the discussion must be concerned with matters in the Bill.
    Mr. Foot: I have not discussed the matter of legal aid, although I am perfectly prepared to pursue it. But I do not imagine that the right hon. and gallant Member for Kelvingrove (Lieut.-Colonel Elliot) is trying to persuade us that upstairs, or here, he was arguing for a full legal aid service provided free for everyone, or there would be some point in his interruption. Without that I cannot see the point at all.
    Lieut.-Colonel Elliot: Of course, I should be perfectly willing to continue the argument, but I would be ruled out of order, and therefore I say that until the hon. Gentleman reads the debate he is not entitled to say any of these things because he will find he is totally in error in the assumptions he is making.
    Mr. Foot: If the right hon. and gallant Gentleman is able to make interruptions which are out of order, I am entitled to make replies which are out of order. We will leave it there, but I notice that the interruption, irrelevant or not, came from the right hon. and gallant Gentleman and not from the Government Front Bench.
    Mr. Blenkinsop: If my hon. Friend will allow me, perhaps I might put a relevant point. What was his attitude to the same principle in regard to the National Assistance Board determining need cases on travelling allowances within the National Health Service?
    Mr. Foot: I do not think the same principle applies at all. The hon. Gentleman is proposing under this Bill that there should be subsidies from the National Assistance Board for low wages, and he is proposing that on terms which he is not even prepared to explain to the House of Commons before the Bill goes through.
    Mr. Blenkinsop: The same question of payments to those who may be employed arises in connection with travelling allowances.
    Mr. Foot: It may be that the hon. Gentleman has a valid point and a valid statement there, but it does not alter the fact, which he will surely recognise, that it would be a highly dangerous principle to have the National Assistance Board coming along at a whole series of points in our economy and saying, "We will subsidise wages, here, there and at some other point." That is what is being proposed under this Bill. It is that the National Assistance Board should give subsidies to people who happen to suffer from particularly low wages. But nobody knows how the test of low wages is to be applied. The hon. Gentleman is still working out the regulations. If the Government knew what the regulations were, they could tell us, but they do not know what they are.
    It is not only that we are to vote for this Measure without knowing how it is going to work out; the Government do not know either. The reason that the Government have got into this difficulty is that it is a terribly difficult thing, once they start injuring and breaking the mechanism of a free Health Service, to know where they get to next. That is the difficulty in which the Government are at the present time. They are in a particular difficulty because when they decided to embark upon a new principle in relation to this service which involved them in complicated difficulties about the National Assistance Board they decided that not merely would they do that but that they would do it with all possible speed for purely political reasons.
    That is why they have got themselves in difficulty today. So we shall have to wait to see what these new regulations are to discover whether a man getting £5 per week will have to pay or not, or whether it depends on whether he is to have a child next month or next year as to whether he gets his dentures free. That is a miserable Clause in a miserable Bill, and it should not be introduced in that fashion.
    The main objection to the Measure, which has been voiced by my hon. Friend the Member for Tottenham (Mr. Messer) and which has come from almost every
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    hon. Member who has spoken on this side of the House during Second Reading, the Committee stage and Third Reading, and a view which has been confirmed by the attitude taken by hon. Gentlemen opposite, is that of course once we have started and put these Measures into operation we do not know how far we shall go in the future. My hon. Friend the Member for Tottenham used a very significant phrase when he spoke of what a target this would be for a Chancellor of the Exchequer who next year and the year after will be faced with possibly greater economic difficulties than those which the Chancellor is facing today: what a target to enable him to say, "If we can tax spectacles and teeth, why cannot we next year tax Medresco aids, etc.?"
    A Chancellor of the Exchequer, looking at this situation without any principle to guide him as to how to deal with it might, looking at the National Health Service in future, state as General Blücher said, when he looked at London, "What a city to sack." But at least we can say this. The protest that has been made about this Bill on Second Reading, on the Committee stage and on the Third Reading, and which will no doubt be continued when the Government have thought out the regulations under which they are to operate the Bill, may at least be sufficient to protect the Health Service from further inroads being made in future years.
    7.55 p.m.
    Dr. Hill: I cannot and will not attempt to compete with the vehemence of the hon. Member for Devonport in attacking His Majesty's Government. It fills me with astonishment that he did not find it possible to join that small group of bandits who during the Committee stage voted against Clause 1. It astonishes me also that there is no reasonable expectation of the hon. Member being found in the Lobby against the Government on the Third Reading of the Bill.
    In the main part of his speech, he attacked the association of the Bill with National Assistance. He might, with charitable intent to the Opposition, if he can find such charity in his heart, have said that that issue was raised by my hon. Friends on this side of the House. Although I do not find myself in agreement with their conclusion, it is right that

    1677
    we should pay tribute to them for drawing attention to that very important element in the proposals.
    When he referred to the hon. Member for Tottenham (Mr. Messer) the hon. Member for Devonport supported him in his assertion that a big principle is involved here, that a door is opened. But when one of my hon. Friends says the same thing, virtue becomes vicious. What for the other side of the House is a revelation and an astonishment becomes a wickedness when the same words are used and the same significance is attached to them on this side of the House.
    I wish to refer to one aspect of the Bill, namely, that of the expected saving or income from these proposals. I should welcome an intervention from the Minister or the Parliamentary Secretary early in my remarks, so that I shall not waste the time of the House. I should like to know at the outset whether the estimate—contained in the Civil Estimates published on 16th February—for the expenditure on the dental services in 1951–52 takes account of the economies or savings which are alleged to be made. I hope that it will be found possible to save me from error or the House from unnecessary words, if I could be told now, in the form of an intervention, whether that published estimate takes into account the economies or savings under this Bill.
    Mr. Blenkinsop: As has been said before, if I am not mistaken, the Chancellor made it quite clear in his Budget speech that account was taken of these savings.
    Dr. Hill: I am grateful for the intervention. I am about to develop my point, arising from that answer, despite any visible discomfort to the hon. Gentleman, that so early as February the calculation was made of the savings from this service.
    I noticed that as between 1950–51 and 1951–52 a saving of approximately £8 million for England, Wales and Scotland is shown. Part of that saving is due to something quite different—the cutting of the remuneration of the dentists. Am I then told that although in the financial memorandum it is estimated that in the current financial year, the saving will be of the order of £8½ million, that adding up the
    1678
    savings by the cuts in dental remuneration, and the £8½ million calculated in the Financial Memorandum, the total saving from the lot is in the region of £8 million?
    It seems to me that something has gone wrong in this calculation. If it be true that allowance has been made in the £38 million estimate for the £8½ million saving referred to in the Financial Memorandum, then it was expected that next year there would be an expenditure of £46½ million. If the expenditure on the dental service be estimated at £46½ million the 60 per cent. to be devoted to dentures would amount to £28 million. A half of £28 million, if the repayment is to be approximately half, is £14 million. Yet the money to be saved in a full year is £17 million, a difference of £3 million.
    I suggest that we are now coming to the measure of the saving or the repayment to be effected by the deterrent effect of the charges. I do not pretend to any accomplishment in mathematics, but I think that the House should be told to what extent that calculation is wrong and what is the accurate calculation, for as matters now stand, it seems that, taking a full year, the savings will be considerably less, and are calculated to be considerably less, than the £17 million contained in the Financial Memorandum to the Bill. I would ask that that matter be resolved.
    Mr. Ellis Smith: I cannot see how the hon. Member can estimate accurately, because there may be increased expenditure by the National Assistance Board, which may affect the figures.
    Dr. Hill: I appreciate that point. I have made allowances on the basis of the payments amounting to half, but to the extent to which the saving turns out to be less than half it becomes difficult to understand. I knew that one half would be recovered, and I knew that I was ignoring mothers and children and the repayments that will go elsewhere as a result of National Assistance.
    The hon. Member for Devonport spoke of the enthusiasm on these benches. I suspect that he was counterfeiting an enthusiasm which he purported to see for his own political purposes. The principle involved here is that of a ceiling on National Health Service expenditure. I will not weary the House by repeating what I said on Second Reading, but I am

    1679
    convinced that unless other social services are to suffer it is absolutely essential to create a ceiling related to what the nation can afford on this form of social service. If that principle of a ceiling be accepted, it then becomes necessary, if the scope of the service is not to be touched, to impose charges. But that is no justification, as I said earlier, for any particular set of charges imposed in a slap-dash financial way unrelated to the needs of the service and to the defects of the service.
    I shall not weary the House by going over the dental field once again, but I wish to thank the hon. Member for Tottenham for the candour with which he faces the dental position. I agree with him that on the one hand there is the method of imposing barriers between the dental service and some sections of the population in order to secure it for others. On the other hand there is, apart from the training of new dentists, the problem of dilution of the dental service. I offer no comment on that now, but I would say that no financial proposal should be put forward without being related to the need so to recast and reorganise the dental service in order to secure once more priority for children and for expectant and nursing mothers.
    I believe that this proposal goes some way, in a rough and ready way, to do this. What I regret is that it seems to me that the Government have taken hasty decisions and selected two places in the service to slap on a charge in what seems to me to be a Bill put forward by the Chancellor of the Exchequer rather than out of a steady desire, if charges must be made, so to apply them as to secure the best possible service.
    8.5 p.m.
    Mr. E. Fletcher: I will not follow the argument of the hon. Member for Luton (Dr. Hill), although I agree with very much of what he has said. I hope that the Minister will deal with his argument tonight. I want to return to the speech of my hon. Friend the Member for Devon-port (Mr. Foot). In my opinion, the position is far worse than he indicated. He assumed that some new Regulations would be made by the National Assistance Board. I do not know why he assumed that. There is nothing in Clause 4 which indicates that any new Regulations are authorised or will be made and nothing
    1680
    has been said since the inception of this Bill to suggest that any new Regulations will be made by the National Assistance Board.
    I agree that this is an important point. It is most unsatisfactory that, as a result of the almost indecent haste with which this Bill has been rushed through the House we are in complete ignorance of what the true position will be in this respect. I agree with everything said by my hon. Friend the Member for Tottenham (Mr. Messer) about the real objections to this miserable Bill, which in my opinion is totally unnecessary and need never have been introduced. The real objections to it are, of course, that it violates the whole conception of a free National Health Service. But it is justified by hon. Members opposite on the ground that there are some people benefiting from the National Health Service who can afford to pay and who can therefore make a contribution to the Exchequer. That is not a reason acceptable to many hon. Members on this side of the House.
    I return to the other and equally serious criticism of the Bill. I would remind the House that, both in the Budget Speech of the Chancellor of the Exchequer and in the speech of the right hon. Gentleman the Minister of Health on Second Reading, the Ministers sought to make the Bill palatable to the House by saying specifically that it would create no hardship. These were the words of the Chancellor of the Exchequer in his Budget statement:
    "Those for whom the charge involves hardship will receive reimbursement, in whole or in part, from the National Assistance Board in the ordinary way."—[OFFICIAL REPORT, 10th April, 1951; Vol. 486, c. 852.]
    On Second Reading the Minister of Health said much the same thing. He said:
    "Finally—and this is important—to safeguard against the imposition of any hardship upon any deserving person, the National Assistance Board is to be empowered to make grants towards meeting these charges to any person who suffers hardship thereby, even though such a person is in work. This may be particularly valuable to lower paid workers who have a number of children."—[OFFICIAL REPORT, 24th April, 1951; Vol. 487, c. 244.]
    The principle on which it was sought to justify this Bill was that there would be no hardship, and certainly no hardship to the lower paid workers.
    When we came to the Committee stage of the Bill, and my right hon. Friend the

    1681
    Secretary of State for Scotland was here, we were told a different story. He at any rate had the merit of candour. He said:
    "I am not saying to the Committee that there will be no hardship. That is nonsense…."
    That is very different from what the Chancellor of the Exchequer and the Minister of Health said. I welcome the presence of the Secretary of State for Scotland on the Front Bench, because we have come in this House to admire the great candour and honesty with which he treats us. He recognised that the Bill would create hardship. I think he was rather optimistic at one stage when he said:
    "There will not be any kind of hardship visited upon the most hard-up of the community."—[OFFICIAL REPORT, 2nd May, 1951; Vol. 487, c. 1312.]
    Then at a later stage, in the early hours of last Thursday morning, the Secretary of State was pressed a little more about this, but not at any great length. He was asked why the position about National Assistance appeared still so obscure. Part of what the right hon. Gentleman said has just been quoted by my hon. Friend the Member for Coat-bridge and Airdrie (Mrs. Mann), but not all of it. This is what he said:
    "I cannot be expected to answer for the Assistance Board—and I have no right to do so—but I ask the Committee to believe that we have looked at this very carefully, and where National Assistance scales are involved, and hardship is caused, there will be no charge."
    What are the facts about this mysterious Clause 4 from which it was assumed by my hon. Friend the Member for Devon-port that some entirely new scales would be introduced? As I read it, there will be no new scales. All Clause 4 does is to deal merely with people who are at present in receipt of National Assistance benefits, because they come within the existing scales. Hitherto, those people getting assistance from the National Assistance Board have not been able to get any additional assistance because they required any medical necessities. There is a provision in the National Assistance Act excluding from the operation of the relief given by the National Assistance Board financial assistance for medical requirements. When there was a free National Health Service, no such assistance was required.
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    Now that these 50 per cent. charges for spectacles and false teeth are to be imposed, it follows as a corollary that those who are in receipt of National Assistance benefit are entitled to get reimbursement for the 50 per cent. charges which they would have to pay and which obviously they cannot afford. In addition, Clause 4 does one other thing. If I am wrong I hope the Minister of Health or the Secretary of State for Scotland will correct me, because this is essentially a matter on which constituents not only in Islington and Devonport but everywhere throughout the country, will want guidance. Unless satisfaction is given by the Front Bench on this matter, I fail to see how they will be able to redeem the condition on which the Bill was introduced—that it did not impose any hardship.
    As I understand Clause 4, it does one other thing. It brings within the class of recipients of National Assistance people who are working full time. Those people who cannot have assistance in the ordinary way can get reimbursement for the half charges for their teeth and spectacles. But it seems abundantly clear to me that the existing scales will apply, and it only means that, whereas at present only people out of work, whether temporarily or permanently, can get relief, in the case of these half charges, people who are within the existing scales, although in full time occupation, will also be able to get this kind of relief.
    I invite the Minister of Health or the Secretary of State for Scotland to correct me if I am wrong, but there is nothing whatever in the Bill, or in any statement yet made, to suggest that any new special or specific scale will be laid down by the National Assistance Board to deal with the charges imposed by this Bill. If corroboration of that is required, I think that it is to be found in a further sentence which I wish to quote from what the Secretary of State for Scotland said in answer to a question by an hon. Member for one of the Glasgow constituencies. The hon. Member put this pertinent question when asking where the scales started. He said:
    "Does it start with the railway porter earning £4 15s.?"
    The Secretary of State for Scotland said:
    "Let me give my hon. Friend an approximate example."

    1683
    The right hon. Gentleman was careful to repeat what he said earlier. He said:
    "I have no right to speak for the Assistance Board, but I offer the example in good faith"—
    I do not challenge his good faith. The right hon. Gentleman said:
    "A married man with two children, earning around five guineas a week, would not be expected to make any contribution to the cost of dentures."—[OFFICIAL REPORT, 2nd May, 1951; Vol. 487, c. 1353.]
    That was the guess of the right hon. Gentleman who had no right to speak for the Assistance Board.
    Since the right hon. Gentleman made that statement, I have taken the trouble to verify the facts from the Assistance Board to find out what they think about the matter. It is most unfortunate, but they do not share the view of the Secretary of State for Scotland. I am told on the highest authority that a married man with two children, paying an average amount of rent and earning £4 15s. a week, will not get any benefit under this Bill but will himself either have to pay the half charges for teeth and spectacles or—which, of course, is much more likely—go without them.
    Mr. Ellis Smith: Does this mean that the Ministry have been in touch with the Assistance Board and that the Assistance Board have given consideration to the question? If so, have they replied to the Ministry, and why has not an announcement been made in this House?
    Mr. Fletcher: I cannot answer that. I do not know whether the Ministry have been in touch with the Assistance Board or not. All I know is that the Secretary of State for Scotland attempted to deal with this matter in Committee and, from his own words, I do not think he had been in touch with the Assistance Board. He went out of his way to repeat to the Committee that he could not be expected to answer for the Assistance Board.
    As far as I know, there has been no consultation about this subject between the Ministry and the Assistance Board. That may be a good thing or it may be a bad thing, but the result is that this House is left in complete ignorance and complete mystery about the matter. Perhaps we shall be told before this debate concludes. Apart from the abrogation, the departure, from the principle of a free
    1684
    National Health Service, what worries me is that unless we can get some more satisfaction about this before the Third Reading is concluded, I shall not be satisfied that there has been any fulfilment of the specific promise given both by the Chancellor of the Exchequer and the Minister of Health that these charges will not create any hardship.
    As I understand it, under the Bill as it stands, a person in work earning £4 15s. a week with two children, and paying a normal rent, will not get any benefit at all if he has to have spectacles and dentures. He will be required either to pay the charges under the Bill or go without the spectacles and teeth. It is obvious that he will go without, because a person in that position cannot be expected to make—either for himself or for his family—the sacrifices that he would otherwise have to make in order to get the spectacles and the teeth which he requires. Therefore, there will be no gain to the Revenue. It is for that reason that I am so strongly opposed to this Bill. I think that it will defeat the only object which it has really put forward. It is put forward as part of the general budgetary provisions for raising further money.
    We all know that the whole framework of the Budget depends on the basic assumption that we have, if we can, to increase our national production by 4 per cent. this year. We can do that only if the people of this country have the best possible health, which includes, where necessary, the best possible sight and best possible teeth. If people have need of spectacles we cannot expect them to do a proper day's work without spectacles. It is obvious that, as matters stand, in view of this provision in the Bill, that a number of people who are expected to do a full day's work with the maximum efficiency and contribute to the national productivity effort which we are trying to increase by 4 per cent. will not be able to do so, because they will go without spectacles.
    Although I am not qualified, like the hon. Member for Luton, to speak on medical matters, I know from experience that to a person in need of spectacles they are not a luxury. If a person has bad sight spectacles are a necessity.
    Mr. Ellis Smith: They are a tool.
    Mr. Fletcher: They are a necessity for his work, which is of national importance, and not a mere matter of luxury or convenience to himself. I have every reason to believe that what is true of spectacles is equally true of teeth. If a person has bad teeth and is entitled to have them out free, as he is entitled to have them out under this Bill, I believe that the best medical advice is that it is much better for him to have a new set of dentures than to do without teeth; although I am quite sure that, as things stand, a lot of people will go without teeth and spectacles.
    I beg, whichever Minister is to reply, to do the House the courtesy of giving us the most detailed information as to precisely what provision will be made, if this Bill is enacted, to relieve the very real hardship which will be imposed on people of the class I have mentioned—the lowest paid workers earning £5 a week, or thereabouts—who will be faced with the miserable choice either of having to do without something and make sacrifices from other sources which they cannot afford, or of being deprived of spectacles and dentures which they need.
    8.23 p.m.
    Mr. Iain MacLeod: I think the main point which concerned the hon. Member for Islington, East (Mr. E. Fletcher) was the amount of hardship this Bill would cause. Of course, no precise answer can be given to that, but I suggest that there is a clue in the figures put forward more than once from this side of the House on the question of the deterrent effect. The figures show that the difference is between £14 million and £17 million.
    There is therefore, calculated by the Government a deterrent effect of £3 million. That £3 million appears to compare with the twice £14 million—£28 million—and is therefore something rather more than 10 per cent. So the Government are calculating that the deterrent effect of this Measure is about 10 per cent., and hon. Members should make their own calculations within that figure of £3 million as to how much hardship there will be. I think that is probably the only guide we have, unless some more intricate calculation is to be presented later for deciding the very important question on which the hon. Member for Islington, East, has been addressing the House.
    This Bill is of great importance, apart from the civil war which it has caused on
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    the benches opposite. I have no doubt at all that the main importance of this Bill was indicated quite clearly on Second Reading by my hon. Friend the Member for Wolverhampton, South-West (Mr. Powell). What really matters is that a new principle—I believe it to be that—puts the National Health Service Bill for the first time into the category of a means test social service. I think that is the essential point, and almost everybody who has spoken took up that point, including the hon. and learned Member for Horn-church (Mr. Bing), the hon. Member for Devonport (Mr. Foot) and many others.
    The hon. Member for Tottenham (Mr. Messer) said that this Measure would destroy Socialism or the Socialist basis of the Social Services. I think that he is quite right. Some hon. Members on this side of the House tried to remove—although the hon. Member for Devon-port did not seem to be aware of it—the National Assistance Board from the Bill, but we have it in the Bill in Clause 4, and I am not going over those arguments again.
    It may be right to have the National Assistance Board in the Bill if it is to be a very temporary Measure—to be torn up soon and forgotten. But is it so temporary? The Government Front Bench have indicated that it should be reviewed again, in so far as one can bind Parliament in these matters, in 1954. I would have thought it surely wrong, if it is to go on for that length of time, or even longer as it may well be, that we should not seek to find an alternative method. I believe the logic to be unanswerable, that while re-armament, or any other such special strain on our resources remains, this Bill has come to stay.
    Once we accept the ceiling—I think this is the real point—then the Bill follows. I know perfectly well that what one might call the "Opposition" to the Bill from the Government back benches does not accept the ceiling at all. But once that point is given up; once we accept a ceiling for the National Health Service, beyond the slightest doubt this sort of Bill follows absolutely automatically. The hon. Member for Reading, South (Mr. Mikardo), either on Second Reading or during the Committee stage, and many other hon. Members have recognised that.
    This discussion touched off last Wednesday in Committee as joyous a

    1687
    piece of political "nuts in May" as we have ever seen from those benches opposite. Let me say quite frankly that I believe that those on the other side of the House who object to a ceiling in this Measure are putting forward a genuine Socialist point of view, with which I completely disagree. But let us remember that this ceiling to which so many references have been made—why it should be £400 million——
    Mr. Deputy-Speaker (Colonel Sir Charles MacAndrew): References may have been made, but they were all out of order.
    Mr. MacLeod: I am sorry. In that case I will not pursue this question of the ceiling, except to say that it is not a new matter which is now being introduced. It has been said of this Bill that it is a Tory Bill. Let me say quite frankly that I do not consider that an unfair description at all. It may be that some of us think it incoherent and muddled, but still a Tory Bill. That is why so many hon. Members opposite hate it so much. It is not surprising that some of us on this side of the House heard with a modified degree of hilarity the declarations of indestructible party unity alternating with fierce denunciation of the Front Bench, sometimes above and sometimes below the Gangway.
    Of course we on this side of the House want to see the Bill on the Statute Book. Of course we are delighted that the Chancellor of the Exchequer and the Minister of Health and the Secretary of State for Scotland are at last plodding down the right road. Of course we are quite prepared, now we have them on that road, to urge them on.
    Mr. Foot: Since the hon. Gentleman is so delighted about the Bill, would he mind taking the matter up with the hon. Member for Luton (Dr. Hill), who protested so strongly to me when I said there was enthusiasm about the matter on the other side of the House?
    Mr. MacLeod: If the hon. Member has not read any of the earlier proceedings of the Bill, he should consult my Second Reading speech, if he can bear to do so, where he will find that point dealt with. Let me say, quite frankly, that I think the Bill is full of anomalies.
    1688
    In many ways its approach is quite wrong. I think it is ill-considered. As hon. Members have said, I welcome these charges; I have pressed for them for a long time. [HON. MEMBERS: "And written about them."] Yes, I have even written about them. If these charges can be the means of taking money from less urgent sectors of the National Health Service to reinforce and renew the fight against ill-health in the most important sectors of the Health Service, then I not only welcome the charges but also welcome the Bill. It is only on those grounds that the Government Front Bench can justify seeking a Third Reading today.
    8.32 p.m.
    Mr. Crossman: I think those of us sitting below the Gangway will be more grateful for the speech of the hon. Member for Enfield, West (Mr. Iain MacLeod) than will those sitting on the Government Front Bench. One might almost describe the hon. Member as an agent provocateur from the Left Wing of the Socialist Party, for he has put the real facts about the Bill with an extraordinary clarity. The difference is that the Government Front Bench are seeking to disguise the implications of the Measure whereas he has sought to bring them out in the fullest possible way.
    I must say I was surprised to hear my hon. Friend the Member for Stoke-on-Trent, Central (Dr. Stross), say that in his view the back benchers on this side of the House have done a great deal to improve the Measure on the Committee stage. If we are frank with ourselves, all we have achieved is a Clause which limits the duration of the Bill to the next three years. It is not an accident that the next three years are the three years of the rearmament plan. What it comes to is that in this Clause, with a candour unusual in the Front Bench on this Bill, the Bill has now been re-named the Rearmament Bill. It is the Bill which openly cuts the social services for the duration of the re-armament programme. To have achieved a certain candour from the Front Bench is, of course, some advantage to one's knowledge but not, I think, anything to the credit of the party to which all of us belong. We now know that for the length of the re-armament period people will pay for dentures and spectacles, as a first instalment.

    1689
    We shall face the Budget of next year very much dependent upon the attitude which the House takes to the debate on this Bill. Many hon. Members opposite and a few poor Front Bench speakers from this side of the House have tried to defend the Bill as a Measure to curb extravagance in the Health Service. I have been very strongly in favour of some sort of Measure for curbing what undoubtedly exists—extravagance in the Health Service; but this Bill, as defended by the Minister, has not been introduced, as some hon. Members suggest, to curb extravagance in the Health Service. There would be quite a different Bill for that purpose. This is openly a money-raising Bill and not an extravagance-curbing Bill.
    That is precisely the reason why we have so passionately objected to the Bill from below the Gangway. There might have been a case for a Bill to introduce measures of economy into the Health Service. Indeed, I myself have often wondered whether a small token payment has not a great deal to be said for it as a way to encourage people to think twice before they let a dentist take out their teeth. But a 50 per cent. charge is something totally different from a charge designed to discourage extravagance.
    A 50 per cent. charge has one purpose and one purpose only—to obtain money for re-armament, as we now know from the new Clause, which tells us openly that for the three years of re-armament the money will be taken out of dentures and out of spectacles. If we want to have it confirmed we find it in the Clause dealing with spectacles, as was pointed out by my hon. Friend the Member for Manchester, Exchange (Mr. W. Griffiths), who has great experience of this and whose speech I checked over the week-end. If this was an economy measure, would the Front Bench have decided to make those who need spectacles pay more than the full cost of the lens which will be used? That is not a measure of economy; that is even making a profit out of the unfortunate people.
    If I calculate correctly, a large number of those who pay what is called a 50 per cent. charge will, in fact, be paying for the cost of the lens, the cost of the frames and the cost of the testing as well. That is not an economy measure; that is a charge designed to make as much money
    1690
    as possible in the easiest possible way out of the most vulnerable section of the Health Service. It is not the best way of curbing extravagance in the Health Service, as the hon. Member for Luton (Dr. Hill) has already very cogently argued. To make a savage charge for the sole purpose of raising money to pay for the rearmament programme is not the best way to get economy or wise spending.
    I want now to turn to Clause 4. I think the House should be deeply grateful to my hon. Friend the Member for Islington, East (Mr. E. Fletcher) for being the first fully to ventilate what I also regard as a scandal. We are passing the Bill without knowing clearly what we mean. An hon. Member opposite pointed out that we have a precedent already in that the National Assistance Board are responsible for giving free what otherwise people would have to pay for; they provide travelling expenses to hospitals. I understand the Minister has also said that. Let us assume that we can take that as a precedent and that people will be given free dentures and spectacles in the same way as they are given free journeys to a hospital.
    How does the free journey to the hospital work? There is no special scale as my hon. Friend the Member for Devon-port (Mr. Foot) seemed to think necessary. National Assistance is provided under the subsistence level. It is based on a calculation that if a man's or a family's standard of living sinks below a certain level, that man or that family are destitute, and, therefore, in order to bring the family's income up to that level the Assistance Board is empowered, and entitled, indeed, to pay the amount which is necessary to bring the family's income up to a certain basic minimum below which people starve.
    In the case of travel to hospitals—the Minister will correct me if I am wrong—unless a man can prove that with his weekly wage, when the charge for the journey to the hospital is added to his other expenses, he will be destitute, he gets not a penny—not a penny. He must prove destitution by National Assistance standards.
    Hon. Members: No.
    Mrs. Mann: Who introduced this iniquitous business of charging for payment going to and from hospitals? And was there an outcry against it?
    Mr. Deputy-Speaker: I do not think we should pursue this point. It is not in the Bill.
    Mr. Crossman: With great respect, Sir, Clause 4 is concerned with the National Assistance Board and its being entitled on certain occasions to relieve hardship by providing free spectacles. I am providing the only instance we know of. My hon. Friend the Member for Coatbridge and Airdrie (Mrs. Mann) asked me who introduced it. I think it is perfectly correct in the case of travelling expenses, because I doubt whether we should have allowed travelling expenses to be paid in the Health Service. This was an abuse in the Service before this provision was introduced. But it is the only precedent we have got. If it is true we have got one case where the National Assistance Board is entitled to pay, and to enable people to have the service free, I am concluding—unless the Minister tells me no—that in the case of men in factories, for instance, it means that a means test will be applied to know whether somebody is indigent or not—which is already provided for to obtain free travelling expenses to hospital.
    Mr. McAllister: I am sure my hon. Friend does not want it to get on the record that it is his view that to obtain assistance from the National Assistance Board one has got to prove destitution.
    Mr. Crossman: I am very sorry. We are dealing with the problem of the subsistence level; but do not let us pretend that the subsistence level we have achieved in this country is very elevated with the present cost of living. I accept my hon. Friend's correction. I should have said, "minimum subsistence level." It is unfair to the Board not to make that correction. But what I am pointing out is that one will have to prove that one's income falls below the minimum subsistence level in order to obtain free dentures and free spectacles, and it seems to me grievous that we have to do this because we shall have two scales—National Assistance for the old age pensioners and another for those in work.
    It is clear that no Assistance Board could produce a new scale and say, "This is for those in work, and the standard of minimum subsistence, where a man is
    1692
    working in a factory, shall be a bad weekly wage; and somebody who is an old age pensioner or a widower with children shall have something else." Only one subsistence level can be applied in the country. This means that if, having to pay this charge, a man's total income falls below that under which one is entitled, if he is out of work or aged, to National Assistance, an employed man may, in those circumstances, receive National Assistance. On this point I agree with my hon. Friend the Member for Devon-port.
    This, of course, is subsidising low wages. [Interruption.] Of course it is. If we say that this will be the basic minimum that we provide for men in work, then, of course, we are subsidising those who pay insufficient wages to people to enable them to earn their living. We have the food subsidies, of course, but they are subsidies for everybody; but in this particular case we are saying that somebody who is not earning sufficient wages is able to pay for his spectacles and keep on the subsistence level shall have assistance.
    I am sorry that capitalists should be subsidised in that way. It is a very striking thing that we do that. In my experience people are still—I think, rightly—reluctant to rely on National Assistance. By and large the scrounger will go to get it. [HON. MEMBERS: "Oh."] Thousands of decent people will not. [Interruption.] I am very sorry, but I would point out that there are many people who will not, in fact, get what they are entitled to under this Bill because they are too proud to do so. I still think it is a grave mistake to impose a means test on men at work before they can get—[HON. MEMBERS: "It is not a means test."] But it is a means test. They will have to submit to a national means test in order to be able to get free spectacles and free service.
    I say with great respect that this means test exists—but, of course, we have to have it—in National Assistance. What we are doing here is to extend the principle to men in work, and that seems to me a grievous violation of principle. I agree with hon. Gentlemen opposite that this is, in fact, having two health services, one for the top level, and one for the others, and I think that having two services is fundamentally a bad thing even in this beginning with teeth and spectacles.

    1693
    The last point I want to make is this. I cannot believe that many people on this side of the House are proud of this Bill. The only argument in favour of it—the only argument—is that we must have this Bill as a help towards payment for re-armament. It is the only argument that can be introduced, now that we have this new Clause saying that the period shall be at least three years. I do not believe that there was no other way of paying for it. I do not believe that this Bill, enthusiastically received by the other side, is a precedent. I do not pretend that this is what the other side would have done. I say that it is a small example of what they would have done on an enormous scale.
    Because I do not like our Front Bench doing on a small scale what the other side would do on a big scale, I do not happen to like this Bill. I do not think that anyone else does. If the Bill is a precedent for what might happen in future legislation, a much healthier precedent is the reaction of the benches on this side of the House. I hope that in future it will not be the actions of the Front Bench but the reactions of the Labour back benchers which will be the precedent for future Socialist policy.
    8.47 p.m.
    Mrs. Mann: I have listened with very great interest to the contributions made in this Debate, and I cannot profess to have the intellectual training of the hon. Member for Coventry, East (Mr. Crossman), as an economist who bestrides the world like a Colossus. I wish I were as cocksure of anything as he happens to be of everything. I read his contributions to various journals, and I read in regard to re-armament—and I introduce this, Sir Charles, because the hon. Member has talked very much about it—a contribution which went like this—of course, he was writing for the popular Press: "If we can afford to spend £800 million this year on re-armament, therefore, I say that we can afford to give £50 million to the railways for subsidies." I confess I would have taken an entirely opposite view. If we are thinking of increasing the amount of re-armament, that, I think, would be one reason why we cannot afford this other service.
    I should like also to follow up the hon. Member's remarks on re-armament because he said that the amount in the
    1694
    Bill is being taken from the people who need dentures and spectacles to pay for re-armament. Last year without gasping he swallowed the bottles of prescriptions that "cascaded" down the throats of the patients, and he did not protest about the terrific hardship to many of my constituents and others which caused them to pay for travel across Lanarkshire—one woman paying 6s. each visit, three times a week. He and the others swallowed that without a word of protest.
    In my opinion, they swallowed the camel and strained at the gnat because they have only now raised their objection to something which, I would remind the hon. Member for Islington, East (Mr. E. Fletcher), the Minister himself admitted was a hardship. When the hon. Member for Islington, East, was reading the Secretary of State's remarks that a married man with two children earning about £5 5s. a week would not be expected to make any contribution to the cost of dentures, he stopped there, and he omitted to read on:
    "Let me take this argument a stage further. I have previously admitted that this scheme does mean hardship for some people. It is bound to."—[OFFICIAL REPORT, 2nd May, 1951; Vol. 487, c. 1353.]
    We are all agreed that it means hardship for some people but we disagree very much on the degree of hardship of the measures introduced last year without a murmur of dissent and the ceiling accepted last year without a murmur of dissent and without there being a Bill of £1,400 million for armaments that year. Why was that accepted? Was it because this poor body in my constituency had no Colossus on the Front Bench to lead a revolt? If he had led it, would we have had all these speeches made about the prescriptions, because when we swallowed the camel last year instead of the gnat this year we were hitting every family and every mother whose child in the middle of the night took a pain. We did not think then of the difficulty of getting public assistance lines. Why did nobody get up then? All that was swallowed last year, is rejected this year because of a certain type of leadership.
    It is said that this BUI is for the first time introducing an appeal to the Public Assistance Committee. It is nothing of the kind. It was introduced last year with complete silence on the part of those

    1695
    Members who have so much to say about it today. It is also said that this is opening the way to the Tories. Do hon. Members on this side of the House never listen to the party political broadcasts? Do they not realise that the Tories had their policy on this formulated years ago? Only little more than a year ago there was a party political broadcast made by the right hon. Lady the Member for Moss Side (Miss Horsbrugh), who is not in her place tonight. She frankly admitted to the people of Britain that it was the Tory policy only to give dentures and spectacles to mothers and children. It is utter nonsense to say that the Tory Party were waiting on this lead. I wish they were as frank about the other items of their policy as they are about this.
    I deplore this charge. I deplore much more the principle fixed last year without the excuse of our re-armament commitments and which imposed hardship on the people in my constituency. I deplore and regret that no one then had the courage to stop it, or to say where in the Health Service we should fix a ceiling. The sky is not the limit. Do not let us be hypocrites about that. If someone said, "Where can we introduce economy?" I could think of no one on whom it would fall less hard than on the people who have to wait at least nine months for their gums to harden before they get new teeth. We are fixing a limit of 10s. per lens and 7s. 6d. for the frames, a sum of £1 7s. 6d., and we should compare that with what we know is charged for testing alone without glasses, namely, a minimum of £2 2s. The Government Front Bench deplore that there should be a limit, but if there have to be charges I know of nowhere where they would fall less harshly than they do under these proposals.
    8.55 p.m.
    Mr. Dye: I do not wish to say very much in this debate. I have listened to most of it with a very great deal of interest, and to some of it with utter amazement. I heard my hon. Friend the Member for Coventry, East (Mr. Crossman) say when he was referring to the manner in which there will be a means test for the new spectacles or false teeth, that this Bill will subsidise wages. He can only justify some such statement if he knows of any body of
    1696
    workers in the country whose normal wages are on the level of the National Assistance Board scale. If he does not know of any body of workers whose wages are as low as that, he cannot make such a statement and get away with it. Such statements do harm to the party to which he belongs and do no justice to the people who sent him here.
    I am amazed, too, that my hon. Friends the Members for Islington, East (Mr. E. Fletcher) and Devonport (Mr. Foot) should make the statement that the Bill introduces the principle of payment in relation to the National Health Service. Why was it that last year there was stopped the payment of travelling expenses for people in rural areas who had to go to hospital to get specialist treatment? If the question of principle depends upon the amount that it costs the patient, why is it that £2 breaks the principle when the wife of an agricultural labourer in my constituency has to pay £2 each time to go to the hospital for treatment? She has had to go many times.
    For one single payment of £2 patients will be able to get false teeth, or glasses for a less amount. Why is that breaking the principle, when it was not breaking the principle in the case in which it was vital to a woman's continued existence that she should be treated for something wrong internally which, if not treated, would bring her to her deathbed? Why did not hon. Members who represent industrial areas and have hospitals on their doorsteps, protest against the breaking of the principle last year? It is quite untrue to say that we are breaking the principle now.
    It is true, as the hon. Member for Coatbridge and Airdrie (Mrs. Mann) has said, that when the principle was broken last year we had not before us the great cost of armaments which we have for this year and next year. I fail to see why hon. Friends of mine on this side of the House are making such an attack upon the Government as they are doing today, giving hon. Gentlemen in the party opposite a stick with which to beat us in the country.
    Mr. Baldwin: We have plenty without that one.
    Mr. Dye: My hon. Friends should consider very carefully before they use such

    1697
    extravagant statements as they have used. After all, at rock bottom, in spite of the Bill more will be spent on the National Health Service in the coming year than was spent last year. That is essentially true. Of all the services which are of importance to our people the greatest is the hospital service, rather than those which provide teeth and spectacles.
    Therefore, while I should be only too glad if the country was in a position to implement in full the principle of a free National Health Service, as long as we are faced with other financial burdens, which it is vital to the defence and welfare of our country that we should meet, I believe that the Government have been wise in limiting some aspects of the Health Service so that others, which I believe to be of vital importance to many of our people, may be extended.
    9.0 p.m.
    Dr. Broughton: There is an angle from which this embarrassing problem may be viewed which has been neglected in the debate so far, and I wish to draw the attention of the House to it. The Schedule to the Bill lays down the scale of charges for dental and optical appliances, and we have been told that these contributions towards the cost of the National Health Service will provide about £13 million this year. We heard previously from the Chancellor of the Exchequer that he would furnish £400 million. Therefore, with the aid of the Bill, £413 million will be spent on the service this year. Each successive year the National Health Service has shown a considerable rise in cost. If we take into account the £13 million to be raised by the contributions detailed in the Schedule we find that this year we shall be spending at a rate approximately 50 per cent. above that when the service began.
    This afternoon the House accepted a new Clause laying down that the provisions in the Bill shall continue in force until 1954 and that they shall then expire unless the House passes an affirmative Resolution that their operation shall be prolonged. I am pleased that the House accepted that Clause because I believe it is wise that the measures contained in the Bill should be reviewed within a reasonably short time. But when the House comes to reconsider the matter in 1954 I hope that the Chancellor of the Exchequer will find himself able to offer
    1698
    more money towards the cost of the Health Service. If he is unable to do that the measures in the Bill will have to continue in operation, or else alternative economy methods will be required because I am sure that the Minister of Health will be asking for not less but more money for the Service. I believe that next year the Minister of Health will go to the Chancellor of the Exchequer and plead for more money and the year after for still more, and I believe that that will be so no matter who is Minister of Health and no matter which political party is in power.
    Mr. Ellis Smith: Is it not possible to reduce costs by increasing efficiency? Has not my hon. Friend read the Civil Appropriations Account and the Report of the Comptroller and Auditor-General in which it is suggested that economies and increased efficiency will reduce costs?
    Dr. Broughton: I am sure all hon. Members deplore waste in the National Health Service, and wish to have brought into operation all reasonable and possible economies. My hon. Friend intervened a little prematurely because I had not reached the point I desired particularly to stress. I was about to say that my hon. Friend the Member for Tottenham (Mr. Messer) said this evening that he wished the finances of the National Health Service could be divorced from the Treasury, and he considered that this was a possibility. It would have been out of order for him to give us the details on the Third Reading of this Bill, but I hope we shall have an opportunity before long of hearing his views.
    Perhaps, Mr. Deputy-Speaker, I may be permitted to mention that there is a school of thought which hopes that rising national production and increasing national income will keep pace with expanding social services and allow the full cost of the service to be borne by the Exchequer. I know that those high hopes spring from faith in the British people and confidence in the future of Great Britain.
    There is one factor that has not sufficiently been taken into account and it is the point I wish to stress, namely, the accelerating rate of progress in the science of medicine. Recent new discoveries are likely to be followed by others giving more efficient treatment for a number of diseases.

    1699
    We cannot abstain from giving patients the benefits of new aids to diagnosis, new drugs, new methods of treatment. Many of these are expensive. For some time I have held the view, shared by others, that the cost of the National Health Service would rise to such a height that sooner or later a ceiling figure for expenditure would have to be imposed. The moment that a financial limit is fixed we are faced with the disagreeable problem of arranging a system of priorities.
    We have reached that stage now. A ceiling has been fixed and this Bill is consequential upon that. The Bill allows more money to be spent on cases of respiratory tuberculosis and it cuts down on dentures and spectacles. If this Bill were now to be rejected this House would not have maintained a free for all health service for all time. The House would merely have deferred the issue; it would only have postponed the unpleasant hour.
    Mr. Manuel: Would my hon. Friend give way? Does he not agree that, taking a long view of the National Health Service, ultimately there is bound to be an immense saving because of its curative nature?
    Dr. Broughton: We should all like to believe that is correct, and we hope it is correct that ultimately a considerable saving will be effected in this way. That is a very long way ahead, however, and in the meantime new treatments are coming along, many of which are expensive, and the cost has to be met. The Chancellor of the Exchequer has not got a bottomless pocket and a ceiling has to be fixed sooner or later. A ceiling may vary from year to year, depending on the state of the national finances.
    I believe that the question we have to ask ourselves now is not whether we shall accept the Bill, but when shall we accept it. The Government hold the view that we should accept it now, and I think they are right. The Chancellor of the Exchequer is making a generous contribution towards the cost of the service. His contribution will include the cost of the life-saving measures, which are mentioned in the Bill, for sending persons suffering from respiratory tuberculosis to Switzerland for treatment. That is a progressive step which we all welcome. The provisions in the Bill for imposing charges for
    1700
    dentures and spectacles are forced upon us by the steeply rising cost of the service.
    Mr. Ellis Smith: Would the charges stop it? I do not speak of my own personal experience, which has resulted in medical science saving my life, but yesterday afternoon I was sitting in a bedroom in my constituency where it was a treat to see all that medical science could place at our disposal in order to save a man's life. What concerns me is where this thing will stop.
    Dr. Broughton: This is a difficult problem which the House will have to consider most carefully each financial year. It will have to look carefully upon the amount of money which the Minister of Health desires to have for the Service, and into the amount of money which the Chancellor of the Exchequer offers. If the Chancellor of the Exchequer is able to provide the amount which the Minister of Health feels that he needs, the problem that is worrying my hon. Friend does not arise. On the other hand, if the Chancellor feels that he cannot meet the full demand of the Minister of Health, some economies will have to be effected. The Bill is considering those priorities consequential upon a ceiling having been fixed to the expenditure this year for the National Health Service. I think that the Government are acting wisely, for if I had the misfortune to be edentulous, myopic and tuberculous, I should regard the eradication of the tuberculosis as of much more importance than the provision of dentures and spectacles.
    We all dislike the provisions of the Bill for the charges for dentures and spectacles, but I think we have reached a stage in the rapid development of the National Health Service when they have become necessary. We must face up to the fact that the service is costing more than the Exchequer can at present afford. This medicine is bitter to swallow, but I think it is right that the Bill should be given its Third Reading.
    9.13 p.m.
    Lieut.-Colonel Elliot: We have had a long debate, in which, contrary to usual experience, there has been an approximation of views towards its end. I do not think any of us could have listened to the speech which has just been delivered by the hon. Member for Batley and Morley (Dr. Broughton)

    1701
    without realising that he was a man, not grappling with the Opposition—which, Heavens above, is easy enough to do—grappling with the other side of the House, or even grappling with his own Front Bench, which in this debate has taken the part of an unhappy row of Aunt Sallies, subject to slings and arrows of every kind of outrageous fortune. Instead, the hon. Member was grappling with himself, and with the facts of the situation, which is much the most difficult thing to do. One of our poets wrote that:
    "Because that two and two make four
    And neither five nor three,
    The heart of man has long been sore
    And long is like to be."
    That is the position in which the House finds itself tonight. We have been entertained by the interlude of a special party meeting staged apparently for the benefit of the public and of His Majesty's Opposition, in which we have been most interested. We have had the vitriolic incursion of the hon. Member for Devonport (Mr. Foot), who came amongst us like Satan in great fury knowing his time was but short.
    We suffer from shortage of sulphuric acid, but I never understand why. If some one would only bottle the hon. Member for Devonport we could export enormous quantities all over the world. He spent a certain amount of time in inventing a speech for my hon. Friend the Member for Hendon, South (Sir H. Lucas-Tooth), and denouncing it, but he rapidly got on to the much more congenial topic of denouncing his own Front Bench. I will not go into details on that. It is neither desirable nor, indeed, is it necessary when every so often they produce this vitriolic and very valuable publication the "Tribune," of which I have no doubt people in future years will say that it must have been produced by the Woolton Fund, because no other source of quotations half so valuable has been discovered by us at any time.
    He did not address himself to the question at all, nor indeed did the hon. Member for Coventry, East (Mr. Crossman), as the hon. Member for Coat-bridge and Airdrie (Mrs. Mann) said in the robust fashion in which love talk is begun north of the Border. There were denunciations, for instance, against the introduction of the Assistance Board into our social system at all, which was
    1702
    described by these hon. Members as if it were an unheard of crime. Yet, if the hon. Member for Devonport had listened to the debate and had been here on 2nd May, he would have heard the hon. Member for Widnes (Mr. MacColl) attacking those of us on this side of the House who proposed that the Assistance Board should be taken out, on the ground that it was a very mischievous Amendment and that the older generation had these prejudices but the younger generation had adopted a more sensible attitude in this matter.
    The fact is that either side of the House finds it easy enough to hurl denunciations at the other. I do not propose to do that at this stage of this long, difficult and painful debate. It is nonsense and ridiculous to say that this Bill has been accepted with enthusiasm by hon. and right hon. Members on this side. Not at all, hon. Member after hon. Member on this side has pointed out with what reluctance we accept it. Of course we would all prefer that these disagreeable decisions did not have to be made; but they have to be made; and the necessity for these decisions—and it is not necessary to do more than mention it, though it has to be mentioned again and again—was accepted before the intensified re-armament drive began, and before the Korean War.
    It was then that the Chancellor of the Exchequer said that a ceiling would have to be put on, and the Prime Minister said that the late Minister of Health and the Secretary of State for Scotland had been troubled in their minds because of the abuses of the Health Service, "the cascades of medicine," as the Minister of Health put it in his picturesque way, "pouring down the throats of the British public" which he "shuddered to think about." The Government introduced the charge of 1s. per prescription which was accepted by all hon. Members on the other side of the House, including the Minister of Health who commended it to the House.
    The fact is that it is useless for some hon. Members below the Gangway to try to score points off hon. Members on this side of the House about the Measure. It was the Secretary of State for Scotland who said, tonight, "These are His Majesty's Government proposals"—so they are—and "we shall defend them.

    1703
    We shall operate them." There is a declaration of paternity pretty solid and difficult to get away from; there is a declaration of paternity which is uncompromising.
    Nor is it true, as the hon. Lady the Member for Coatbridge and Airdrie said, that these matters have been adumbrated with even greater ferocity by hon. and right hon. Gentlemen on this side of the side of the House. She contended that my right hon. Friend the Member for Moss Side (Miss Horsbrugh) had said in a broadcast that dentures ought to be confined to expectant mothers. If the hon. Lady looks up what my right hon. Friend said, she will find that my right hon. Friend pointed out that the Coalition Government, of which most of the Members of the hon. Lady's Front Bench were members, brought out a White Paper in which it was stated that dentures should go to expectant mothers and that dental care should be given to children, and that these should be the first priorities.
    The difficulty in all this is the question of priority. My complaint against the approach which the Government have made to this problem is that they have tried to drive three buses abreast through Temple Bar, and now that they are banging and scratching the paint off each other, the Government feel upset and unhappy. Many mistakes were made in the introduction of the National Health Service. I think, and I am sure that the hon. Lady the Member for Coat-bridge and Airdrie would agree with me, that, for instance, to snatch all the hospitals in Glasgow and elsewhere away from the local authorities who were managing them very well and economically was a step that was altogether premature, which has led to an exaggeration of the charges and the expenses in the hospital service, of which this Bill is a direct result.
    I am sure that far more than £13 million has gone in expenditure which was not really necessary. Had the problem been approached step by step, and not with this desire to produce the whole thing at one blow and hand it out to the nation, and indeed to the world, as the great achievement of Socialist Britain before which all other nations should bow down. These are difficult
    1704
    matters and they cannot be taken at the pace at which Ministers and hon. Members have tried to take them. When the Secretary of State for Scotland was defending the proposals, he used an argument which struck near to my heart. He was asked what we would get out of the Bill. He replied that the money would pay for 50,000 hospital beds.
    That is a great and important consideration, and it cannot be brushed away merely by saying that these matters will be difficult to administer, which they will be, that they will lead to anomalies, which they will, and that they will lead to hardships, which they may very well do. I say that the first requirement for a sick man or woman is a bed on which to lie, and until beds can be provided freely for all comers, without their waiting, I do not believe that other priorities really count in comparison.
    I am sure that many of the arguments which have been brought forward by Ministers will not commend themselves to Members in all parts of the House. Their actual proposals certainly do not commend themselves to us on this side of the House. This is certainly no Tory Bill in the sense that if the Tories had been responsible we should have introduced a very different and we believe a much better Bill. [Laughter.] Hon. Members need not laugh. I have had the responsibility for bringing in a medical service, the Emergency Medical Service, a universal medical service which had nearly 50,000 more beds in it than has the present service.
    Mr. Manuel: Does not the right hon. and gallant Gentleman think it complete nonsense to talk about an extra 50,000 beds when we cannot staff the beds we have with the number of nurses we have today? How then would we provide the 50,000 beds?
    Lieut.-Colonel Elliot: If that is true, that is a counsel of despair—that we shall never get these extra beds. That is not so. Ministers say, and rightly, that the number of nurses is increasing. Steps can be taken, and some have been. I think that more imagination could be shown. There are ways in which that process could be speeded up.
    Mr. Follick: On the old-fashioned salaries?
    Lieut.-Colonel Elliot: Does the hon. Gentleman expect anybody will now work for the payment they received when the pound was worth double what it is worth today?
    Mr. Follick: It was perfectly disgraceful before.
    Lieut.-Colonel Elliot: The difficulty now, as the hon. Member for Batley and Morley said, is the rising cost of living; and there is also the falling value of the pound. Everyone knows that to be true. That is another problem which the Government will have to face but I do not want to embark on its discussion today.
    I say that there is a shortage of staffed beds and that if the weight of administration, thought and finance of this country were concentrated more on that problem, we could speed up a solution of that problem. The Government are taking one step towards speeding it up in this Bill by the removal of the weight of tubercular patients, not merely from the sanatoria but from the general hospitals, because the weight of that list extends to the general hospitals. Even if it is only by 150 in the case of Scotland and 150 in the case of England, that contribution will at all events diminish the waiting list by that number.
    I am sure that if imagination and thought were devoted to these matters, something more rapid could be done than is now being done. But first it is necessary to get away from the taboo which the late Minister of Health placed on the Health Service. The Health Service is sacrosanct; it cannot be touched; anyone touching it is committing a crime against humanity, a crime against Socialism and a crime against the Labour Party—to put it in an ascending scale of horror. These seemed to him terrible and unthinkable ideas.
    Of course we must adopt a more realistic attitude towards the Health Service. We must see where the resources of the country can best be expended. Even in this Bill we must see how we can rebuild again the shattered school dental service. Nothing could be worse than finding that we were providing the raw material for the future by producing dentures for the grandmothers and grandfathers of the present. This is not the last word.
    1706
    This is a reform in a service to which the whole country contributed many years of thought and hard work, to which all parties have contributed a certain amount of thought and to which, however, there has now come a need for revision and reform. Here is a step in revision and reform. To that extent it is desirable. It is certainly necessary that some reform and revision should be carried out and that a start should be made. We do not welcome this particular start. We are reluctant to accept the Bill and the specific steps proposed here, but I am sure that the whole House is agreed on the necessity for a review of the Health Service on a realistic basis and without regarding it as sacrosanct. For that reason we certainly shall not divide against the Bill.
    I shall be very surprised if the hon. Member for Devonport divides against the Bill. I shall be surprised if he finds it possible to go down to his constituency and denounce the Tory Party in the unbridled terms which he would like to use. If he did so, his opponent would be able to say, "The hon. Member for the Devonport Division did not divide against the Second Reading, against the operative Clause or against the suspension of the Ten o'Clock Rule on the first occasion or the second occasion. He protested on all these occasions. He said that there was undue haste and that the matter was being rushed, but he confined himself to protests." I am neither a prophet nor the son of a prophet, but it may well be that this remarkable consistency will be exemplified again when, in a short time, Mr. Speaker puts the Question to the House.
    Mr. Foot: Has the right hon. and gallant Gentleman thought that I might escape from this dilemma by telling my constituents that although I dislike this Tory Bill, I dislike the whole of the Tory Party even more?
    Lieut.-Colonel Elliot: I do not think that the hon. Gentleman will be able to escape in that way. If he tries, he will find it most difficult to explain why another course of action commended itself to his hon. Friend the Member for Shettleston (Mr. McGovern), and to his hon. Friend the Member for South Ayrshire (Mr. Emrys Hughes), unless his contention is that they love the Tory Party really, and that he, and he alone, is the man who dislikes it and who is really

    1707
    willing to go to the stake against it. But his way of going to the stake showed itself by his remaining in his seat when the other hon. Members to whom I have referred went through the Division Lobby.
    He may be able to explain that to the constituents of the Devonport division of Plymouth. Plymouth is, I believe, inhabited by a great number of marines. They are supposed, perhaps, unjustly, to be credulous folk, and he may get away with it there. I would not recommend him to try that line of argument in Shettleston or in South Ayrshire. But I only turned aside to reason with the brethren in the shape of the hon. Member for Devonport, because he is a bonny fighter and a skilled fencer, and I should not like him to think that his remarks had gone unnoticed on this side of the House.
    What we have to say, and what, it seems to me, is the view that we all have to take, is bound up in the question whether we believed, with Sir Stafford Cripps, with the present Chancellor of the Exchequer, with the late Minister of Health and with the present Minister of Health, that a ceiling will have to be put upon expenditure on the Health Service. If we do, then I do not see how we can escape from the logic that something must be done to implement that view. Something is being done here. We may not like it. We may think that we would tackle the matter in another way. But that at some time, somewhere, in some measure, some step will have to be taken of some kind, is an absolutely inescapable conclusion. That being so, neither I nor my hon. and right hon. Friends will divide against the Third Reading of this Bill.
    9.34 p.m.
    Mr. Marquand: I think that all hon. Members who have taken part in this debate have found it a little difficult to keep within our rules and yet to discuss all the aspects of this matter which they would have liked to discuss. I think this is because essentially it is a machinery Bill. It is a Bill which provides rather distasteful machinery to accomplish a useful purpose. The right hon. and gallant Member for Glasgow, Kelvingrove (Lieut.-Colonel Elliot) said it has been a difficult and painful debate and in those words I feel sure he commanded the assent of everyone in the House. It is a distasteful
    1708
    piece of machinery, of which we have been obliged to make use in very difficult circumstances indeed, in order to save money from one side of our National Health Service, so as to spend it on a much more important side.
    My hon. and learned Friend the Member for Hornchurch (Mr. Bing) referred—and I was glad he did so; I think it was right to do so—to the other very important parts of our National Health Service. It is with those other parts of our service in mind, although I know it is out of order to talk about them too much, that we have to approach this discussion tonight; not only the treatment of tuberculosis, which is provided for in this Bill in a new way not hitherto provided, but all the hospital services generally. I wish I could be permitted to make a speech entirely on hospitals, because I think hon. Members might have been surprised at some of the information which I could have given them. It is perfectly true, as the right hon. and gallant Gentleman has just said, that we needed the money which will be saved by this Bill in order, not to open 50,000 new beds, but to keep open 50,000 beds which are open now.
    If my right hon. Friend and I could have cut hospital estimates for this year by £23 million there would have been no necessity to bring forward this Bill at all. We could not do so. We considered as carefully as we possibly could what less essential parts of the hospital service might be postponed in the current year in order to see us through a difficult period, but we could not recommend a reduction of so large an amount in the estimates presented to us by the regional hospital boards. We could, if we had the money, spend very much more than we are budgeting to spend this year on the hospitals—yes, and the year after—without waste at all.
    Sometimes perhaps the seriousness of the hospital position may be overestimated. I think it has perhaps been done in the last couple of days since in answer to a Question on Thursday of last week I said that the waiting list was 550,000. The number of beds appropriate to the waiting list is 440,000 in round figures. That means the situation is perhaps not quite so serious as some might imagine by the use of large figures like 550,000. But when we come to specific waiting lists, the aged and chronic sick,

    1709
    the tuberculosis patients and other groups of that kind, it is a serious position; and it is our duty to ensure, not for this year only but for the next year, the possibility of keeping up with the additional recruitment of nurses, which will enable us to open beds as we go along to reduce these waiting lists.
    Much of the argument in this debate, rightly or wrongly, was directed against placing a ceiling at all on the National Health Service. I cannot enter into that argument. I feel it would be out of order, and in any case this is hardly the point at which to discuss it. All I would say is that in my view the only hon. Members who can logically take the view that no ceiling at all should have been placed at this time on the National Health Service are those who both voted against and objected to the Budget last year, which imposed a ceiling on the Health Service, and those who have resisted rearmament this year. If there be any hon. Members, and I believe there are one or two who sincerely held that point of view on both occasions, I admit that they are in a logical position to use this argument, but nobody else is.
    It was suggested again, as I knew it would be when I made my Second Reading speech, that in some way or other, by other sorts of economy not involving charges on anybody, we could have made the savings which are necessary to keep hospital beds open. But that sort of argument ignores altogether the very substantial economies in the service which have already been made during the past three years. It under-estimates the value of the economies and the searching scrutiny which my right hon. Friend who preceded me has undertaken in the National Health Service.
    My right hon. Friend the Secretary of State for Scotland and I were faced with the necessity of finding £23 million, somehow or another, out of an expenditure in round figures of £98 million on sections of the service outside the hospital and general practitioner service. In such a situation it would not be prudent to say, "We will take a gamble on making that amount of economies by a further scrutiny of methods of administration and expenditure." We could not safely undertake to find that amount of money out of the very small total available to us. It would not have been honest to pretend
    1710
    that within nine or ten months we could in that way find economies which have not been found within three years.
    Had we decided to do that, we should have found ourselves, before long, closing beds in the hospitals—and that we were not prepared to do. Of course, during the year we will scrutinise our expenditure and our administration wherever we can. An immense amount of scrutiny of this kind is going on, with the help of very valuable bodies like the King Edward Hospital Fund and with the help of skilled accountants and other professional experts who are reviewing hospital expenditure at the moment. We need all the economies we can prudently and reasonably make without sacrificing the quality of the service, and in making our calculations we reckoned on some revenue from that source.
    So much for the general need for saving money from other parts of the service to make possible the continuation of the hospital service. We have been asked, quite reasonably, why, if we found that we could not get the saving we needed from economies in the existing administration, and if we concluded that we must have charges, did we choose to levy those charges in the way announced. I thought I had explained that carefully and thoroughly when I introduced the Bill and I certainly do not want to qualify or alter the explanation which I gave at that time. Hon. Members who did not notice it or have forgotten it may like to read it again.
    I do not agree for one moment with the criticism of the hon. Member for Luton (Dr. Hill) who said we have done this in a slap-dash manner. In fact, we used the four criteria which I set out in my Second Reading speech and we came to the conclusion that the points we have chosen would inflict less hardship than others, consistently with making the savings large enough for the purpose we had in mind. I thought my hon. Friend the Member for Coatbridge and Airdrie (Mrs. Mann) made some very wise remarks, based on her wide experience of the way in which the ordinary people of this country live and work, about the wisdom of the choice which has been made.
    I could not help feeling that far too many of my hon. Friends, both in Committee and on Third Reading, have

    1711
    spoken as though the charges for teeth and spectacles were to be frequent and recurrent, as though people were for ever—once a week or once a month—requiring this type of appliance. They might reflect that, after all, these things are not so frequently required as all that. Indeed, that was one of the main reasons why we rejected the idea of resurrecting the charge on prescriptions, which would have fallen at frequent intervals upon people who were sick and ill. We have tried in the Bill, for example by the subsection concerning in-patients, to shield from hardship, so far as we possibly can those who are sick and ill. In discussing hardship I do not think we should allow ourselves to get the thing completely out of proportion. I think that my hon. Friend the Member for Stoke-on-Trent, Central (Dr. Stross)—and if I am right in my interpretation of his speech I agree with him—felt that the discussion was getting a little out of proportion because of the very fact that these are not appliances frequently needed even by poor people.
    To complete our protection of the poor and needy from hardship we put into the Bill not merely that the Assistance Board might help those who might suffer hardship through these charges but that they should be empowered for the first time, exceptionally, to give assistance to persons in full-time employment. There has been a good deal of discussion tonight about precisely how those arrangements will work. It is a little late in the day to raise the question, for we had a very long discussion in the Committee stage about the arrangements which the Assistance Board would make for this purpose and my hon. Friend the Parliamentary Secretary to the Ministry of National Insurance attended to deal with any questions that might be raised. Those questions were not put to him at the time and it is a little late in the day to raise them now.
    It is a little difficult for me, not having a special responsibility for the Assistance Board, to go into a lengthy discussion as to how they will carry on their operations under the powers given by the Bill. But I can say that of course—and I think this has already been mentioned by the Parliamentary Secretary—there will be no special regulations needed under the Bill to enable the Assistance Board to do this work. Its assessment of hardship will be determined by the application of its
    1712
    existing methods, to which, after all, on numerous occasions in this House and on the platform hon. Members on my own side of the House as well as opposite have paid tribute for their kindness, their humanity, their understanding. The Board will apply its regulations to people whether in work or out of it who go to the Board and say that a payment of this magnitude, whichever it may be—27s. for spectacles, or it may be as high as £4 5s. for dentures—will involve hardship.
    I do not wish to seem to be evading anything when I say it is very difficult, possibly even misleading, in this matter to go into a whole lot of hypothetical examples, because the assessment made by the Board's officers of the circumstances of an individual or of a family does depend upon a great variety of factors—the age of the children and the rent to be paid, and so on; and it has power in reserve—discretionary power—to make an adjustment even beyond the scales specifically laid down. I would say to my hon. Friends, "Do not cry havoc about this. Do not go about the country persuading people they are never going to get any help from the Assistance Board in this way." Let us wait and see what the Board does.
    I believe that the Minister of National Insurance—I have been so pre-occupied with this particular Bill that I did not have the time to do my other work at the same time and did not have the pleasure of hearing her speech on the National Insurance Bill—did indicate that certain adjustments or changes might take place in the future in regard to the Assistance Board. Without saying anything more than that—and I hope I have not said anything indiscreet in saying that—I would say that the figure which the Secretary of State for Scotland gave, having in mind a charge of £4 5s. for dentures, having in mind a man and wife and two children, having in mind a reasonable sort of rent, will not prove to be so very wide of the mark. When we come to the working out of the proposals themselves it will, of course, be open to my hon. Friends, when the charges come into operation, to put Questions, and so on, and get some further elucidation from the Minister of National Insurance and from the Board itself, if there are further doubts about the matter.

    1713
    There was some talk during the Debate about the make-up of the charges themselves. As to the amount of the charges stated in the Schedule to the Bill, I will say in passing, since some doubt has been thrown upon these estimates, that, after all, my right hon. Friend and I get our estimates in the same way as every Minister standing at this Box ever has received estimates, and that, in general, these estimates made by the Departments do not normally turn out to be so very far wrong. [Interruption.] Well, these are estimates of savings and not of expenditure, and perhaps that may make a little difference.
    The charges have been reckoned so as to give an immediate saving thought to be necessary to allow the necessary expansion of the hospital services. They have not been calculated on the principle of trying to ensure rigidly that they never exceed 50 per cent. of the cost to the Exchequer. In the case of the spectacles charge, for instance, it happens to be roughly half of the total cost to the Exchequer of supplying the spectacles, including the sight testing that goes with supplying spectacles; and similarly with the charge for the dentures. They have been so calculated not because we thought there was something magical about 50 per cent. but because we thought a charge of this amount should not be too heavy to be borne at the very infrequent rate it has normally to be borne, and because we were satisfied on the estimates presented to us that it would yield the necessary saving which we needed to make.
    Dr. Hill: Will the right hon. Gentleman permit me? I want to get this quite clear. Did I understand him to say that a proportion of the charge is in respect of sight testing as distinct from the appliances?
    Mr. Marquand: When we say that the charge for spectacles is approximately half the cost to the Exchequer of supplying them we are taking into account the payment of 14s. for the test as well; but it does not alter the fact that the total payment by the patient does not exceed the cost of the dispensing fee and the appliance itself.
    Dr. Hill: I am grateful to the right hon. Gentleman, because I understood that what was being done here was merely to
    1714
    charge for the appliances, and not to open the door for the charging for items of professional services. I now appreciate that I was wrong.
    Mr. Marquand: There will be, of course, no charge for examinations when they result in no provision of spectacles, and there will be, as we have said—all too frequently, perhaps—no charge for treatment for dental caries, no charge for filling teeth, no charge for the extraction of teeth, no charge for children's spectacles, and so on.
    Reference has been made during this debate to an event that took place in 1931. There has been a suggestion that the Government in deciding——
    Mr. Powell: This is a very important point that the Minister has just disclosed, I think for the first time to the House. [HON. MEMBERS: "No."] May I ask him how he reconciles the statement which he has just made with the Financial Memorandum presented with the Bill, which states in paragraph 3,
    "In the ophthalmic service the charges proposed are 10s. for each lens plus the actual cost of spectacle frames. There will be no charge for testing sight…?"
    Are we to understand that means that there will only be charges for testing sight that result in the supply of spectacles?
    Mr. Marquand: If a person goes to an optician and after his sight is tested is found to need spectacles, he will be asked to pay the charges laid down in the Schedule. That is stated in the Bill. If a person goes to an optician and is found not to be in need of spectacles, he will pay nothing. That is also provided for in the instructions and notices which will be put up in the opticians' consulting rooms and in the dentists' waiting rooms.
    I was going to say, in attempting to sum up the position, that those hon. Friends of mine who have referred to the events of 1931, which so many of us remember with distaste and horror, seem to have forgotten that there are in the Government men who at that time refused to follow MacDonald, Snowden, and Thomas into the adventure of 1931. Do they really believe that my right hon. Friend the Prime Minister and other colleagues of mine are suggesting now to the House anything comparable to the events of 1931?

    1715
    I myself—if I may allude to myself for a moment, because the hon. and learned Member for Hornchurch (Mr. Bing) very kindly referred to the work which I did as Minister of Pensions, and I would be ungracious if I did not acknowledge that kindly reference—in 1931 was a person of no importance. I was at that period out canvassing and working for my local Labour candidate. We are not going back on what we always believed in by introducing this Bill to the House. We introduce it because we believe that, in the emergency that confronts us, it is necessary that there should be a re-adjustment within the service because of the immediate necessity of the moment, and because we accept our responsibility in these difficult times to shoulder the burden of Government and not to shrink from difficult decisions merely because they are unpopular.
    That is the reason why I ask my hon. Friends and the House to support us tonight, not because we want to betray Socialism, not because we are planning a desertion or betrayal of our party, but because we believe that the people of this country will respond to a Labour Party which can prove that it is not afraid of responsibility, and is not afraid to make awkward and difficult decisions merely because they are unpopular. It is in that spirit that I ask my hon. Friends behind me and the rest of the House to give this Bill a Third Reading tonight.
    I well understand the misgiving that this proposal has aroused, and so do my colleagues in the Government. We have shown, I think, our understanding of these misgivings and our appreciation of the feelings that inspired them at this time by the adjustments which we have made in the Bill during its passage through the House. We have made it absolutely clear that the charges now to be imposed are to be maximum charges. We have arranged that the Bill shall expire in 1954 unless the circumstances of the moment make the Government of the moment ask the House for fresh powers; they will have to ask the House. I am sorry that I did not hear the speech of my hon. Friend the Member for Devonport (Mr. Foot) and I apologise, but it was due to the necessity of having refreshment that I happened to be out of the House when his name was called in the debate. I
    1716
    believe that my hon. Friend—or was it my hon. Friend the Member for Coventry, East (Mr. Crossman)—said that this would expire just as the bill for re-armament was at its height. That may be, but it will expire, I hope and trust, just as the Chancellor of the Exchequer of the day is able to see the clouds breaking on the horizon and the possibility of removing these burdens from the body politic and going forward again to an improvement and expansion of our National Health Service.
    I ask my hon. Friends to take no notice of the fly so skilfully cast by the right hon. and gallant Member for Kelvingrove (Lieut.-Colonel Elliot) and his hon. Friends today. Let them not believe that we are retreating or betraying the cause in which we have so often proclaimed our trust. I ask my hon. Friends to look forward with some confidence to the end of the three years and the possibility, if our policy is successful, that a more peaceful world will confront us at that time, that the great burden may be lessened and that we may be able to go forward to an improvement and expansion of our great National Health Service.
    Question put, and agreed to.
    Bill accordingly read the Third time, and passed.

MINERS (X-RAY SCHEME)
Motion made, and Question proposed, "That this House do now adjourn."—[Mr. Sparks.]
10.2 p.m.
Mr. Leather: I am extremely pleased to have the opportunity of raising the subject tonight, because it is one which has not received recognition in the House for a very long time. My principal ally on this subject—I have always been glad to acknowledge it—was the Parliamentary Secretary's predecessor, the present right hon. Gentleman the Minister of Labour. I should like to begin by saying that if I can work and co-operate on this subject with the hon. Gentleman as happily as I did with his predecessor, I shall be pleased, and I hope very much that he will be too.
The matter of the annual X-ray examination for coalminers has been raised very periodically in the House. I

1717
raised it first in a speech in March, 1950, and again three weeks ago in a Question to the hon. Gentleman's right hon. Friend when I was pleased to have the assurance that the Minister would give this matter top priority in his Ministry. The background of the problem is something which has cursed the mining industry probably more than anything. Above all the vicissitudes and tribulations of that industry is the curse of dust.
Dust disease with miners everywhere, especially in the soft coalfields and particularly in South Wales and my own constituency, is one of the biggest problems, psychological fears and curses which the miner has to face. It is responsible for not only a colossal and frightful wastage in the finest manpower we have in the pits but also for a dreadful psychological fear, a curse which causes great moral harm to many of our miners. Being a disease which is cumulative, it gets worse year after year and takes its heaviest toll of the oldest and most experienced and skilled craftsmen.
Five days ago I had down a Question on the subject of compensation in connection with this matter, and the Minister of National Insurance said that the problem had been well known to medical science for many years. That came as a complete surprise to my humble self, as it did to the hon. Member for Luton (Dr. Hill) who is reputed to have certain knowledge of these matters. If the right hon. Lady the Minister of National Insurance meant that for many years the doctors have known about such dust diseases as pneumoconiosis and all their causes she is right. If the right hon. Lady can be taken to mean that the doctors knew how to control and cure this disease, she is dangerously wrong and very misleading.
The tragedy is that to this day, despite all the progress made in the last five years, the doctors have no cure or treatment for this disease, which causes distress, agony, incapacity and fatality among miners. In the last four or five years Dr. Fletcher of the Pneumoconiosis Board and his colleagues have made great strides. This report of the Medical Research Council in Memorandum 25 to Which I referred in my question to the right hon. Lady, puts forward clearly, decisively and definitely statements of fact which, so far as I
1718
know, have never appeared in any Government publication until that date.
The point of this annual X-ray scheme is that we must find some way of capitalising on the work of Dr. Fletcher and his colleagues. They have gone much farther in the last five years than has been accomplished in medical history, but they have still found no cure and no treatment. I do not care who is responsible for what Dr. Fletcher has done. I give them full credit for a magnificent and worthy job. The important thing is to capitalise on their work and to make use of the knowledge which they have acquired and the scientific researches that they have carried out.
This can only be done if the work is used as a preventative, and the only way in which it can be used is in the compulsory annual X-ray scheme which I have been urging in this House ever since I was fortunate enough to come here some 12 months ago. The disease is progressive. If it is caught in its initial stages when a man is only 5 per cent. or 10 per cent. affected, he can be removed to the surface and given a surface job, when he will be sound and fit like any other man.
If, as has often happened in the past the man's condition was not discovered until be was 40 per cent., 50 per cent. or 60 per cent. affected, then one day that man will drop down in his tracks and will be thrown on the scrap heap. The tragedy is that that happens to the older men. A man may be aged 40 or 50 and have been in the industry for 20 years. He is suddenly unable to do anything but light work, but what can he do? We cannot teach a man of that age to become a clerk or to learn a skilled trade. He is only capable of doing heavy work, but if he does it he will kill himself, as many honest and decent men have done.
The psychological case is one of fear and terror. I do not know which is worse—the disease itself, or the terror which men can have from seeing what happens to other men. At the first sign of difficulty with breathing, of bronchitis or any other respiratory disease, they have become haunted by this fear. If we took these men and forced them once a year to go before a unit and have their chests X-rayed as a matter of form and routine, we would catch all these cases very quickly. After the first year or two we

1719
would have weeded out all the unfit and then we should catch cases at the 5 per cent. or 10 per cent. stage. We should eliminate not only the psychological curse but a tremendous amount of human and economic waste.
There are the two sides. If we are going to be human and philanthropic we will eliminate human suffering. If we are going to be purely material and statistical we will eliminate a dreadful wastage of manpower. There is this awful problem of recruiting men for our pits, but this dust disease is constantly taking away some of the best and most experienced manpower from the pits. Therefore, I suggest that for a minute amount of money, with which I will deal in a moment, a compulsory X-ray scheme for miners would be an investment which, in human suffering and £ s. d., would yield colossal dividends in a short time to the National Coal Board and to the nation.
If I may I should like very briefly to give one or two figures which I have been able to get. No doubt the Parliamentary Secretary with all the information and statistics at his disposal will have more accurate figures than mine, but these are the best figures I could get to give a measure of this problem. I am informed that the finest X-ray equipment, a mobile vehicle, with all the most modern scientific equipment would not cost more than £15,000. That equipment has been tried in other countries and is dealing with 100,000 men per year. If we take an industry of 700,000 men, that gives us seven units, but let us be on the safe side and allow nine units to cover such things as replacements and break-downs.
For nine units the capital investment would be £135,000 in an industry, which has a capital investment of several hundred million pounds. The figure is proportionately so small as to be almost negligible. If I may say so, it would not be noticed in the National Coal Board budget if it were not pointed out to the people dealing with these matters. A staff of 36 people, who would be fully trained, would be necessary to take the initial pictures and weed out all the suspicious cases, which would be sent to Dr. Fletcher and his expert staff, who would then deal with those cases and decide on questions of compensation, treatment and so on.
1720
It is the initial diagnosis which is the vitally important thing, and it could be done at a capital cost of a mere £135,000, and there would be a staff of 36 trained technicians. There is no need for skilled doctors at this point. Skilled technicians, of whom we had hundreds and thousands in the Armed Forces during the war, would do the job, and it is right to say that if this were done the problem of dust disease could be eliminated in our mines in from five to six years. It is a curse which has haunted the mining villages in South Wales, throughout the country and in my constituency for 50 to 100 years and it could be eliminated. It has been done elsewhere and I am prepared to give the Parliamentary Secretary, as I gave to his predecessor, details of that or even to bring people here who have experience of these matters.
It could be done; it can be done. The Minister of Fuel and Power assured me that he would give it top priority, and I hope that, in raising this topic tonight, I am giving every possible encouragement to Dr. Fletcher, and his colleagues in the vital work that they have done, and that we will be able in this House to make some small contribution to bringing about this reform. I hope the hon. Gentleman will be able to tell us that some progress has been made since I last raised this subject and that a pilot scheme will be started soon. In conclusion, I only plead with him that in starting this scheme he will not forget the small corner of North Somerset.
10.15 p.m.
The Parliamentary Secretary to the Ministry of Fuel and Power (Mr. Neal): May I first thank the hon. Member for Somerset, North (Mr. Leather), for the kind things he has been led to say about my appointment? I am sure he would agree that in following my right hon. Friend in this office, I have a high tradition to maintain, and that in saying now that I hope to follow his record of service, I am setting myself no easy task.
I thank the hon. Gentleman also for the interest he has taken in this subject and the courteous manner in which he has presented his case. I hope to answer some of the points he has raised and to assure him that not only are the Government deeply concerned with all aspects of the problem of pneumoconiosis, but

1721
that we are dealing with the question of X-rays as quickly and as expeditiously as possible.
Pneumoconiosis represents by far the greatest hazard to health to which coal miners are subject in the course of their employment. And amongst those concerned with the many-sided attack now in progress on this problem there is no conflict of opinion about the potential usefulness of periodic X-ray examinations. The main object of such examinations on a routine basis is to detect the disease in its earliest, and usually symptomless stages, so that special measures may be taken to protect those affected from working in an atmosphere containing dangerous quantities of air-borne dust.
The National Joint Pneumoconiosis Committee has for some time had the matter of a scheme of periodic X-ray examinations under consideration. As the hon. Member was advised in the reply made to him in the House on 19th March, that committee has now decided that an experimental scheme is required before any general plan can be drawn up to cope with the formidable objective of the periodic X-ray examination of more than half a million mine workers. This decision had the full agreement of the National Union of Mine Workers' representative who is on that committee. I am sure the hon. Member will agree that it is essential, in order to get a scheme on a right basis, to learn from the pilot scheme, which could easily be expanded if the original scheme were successful. Indeed, I wish profoundly that it was as easy to undertake this scheme as the hon. Gentleman pretends——
Mr. Leather: Thinks, not pretends.
Mr. Neal: Thinks. It is, of course, fundamental to the success of any scheme that the X-ray used shall be able to detect the disease in an early enough stage to protect the man concerned from any progression of the disease. If the labour saving, and more easily operated, mass miniature radiography is found to be sufficiently reliable to detect early pneumoconiosis, the introduction of the experimental scheme will be much easier, compared with the situation with which we shall be faced if large X-ray films have to be taken with the more complicated
1722
equipment required for large X-ray pictures.
This important question has therefore been remitted to a committee of experts presided over by the Deputy Chief Medical Officer of the Ministry of Health. The completion of arrangements for the experimental scheme must await the conclusions of this expert committee, the first meeting of which is to be called shortly.
Mr. Leather: Will the hon. Gentleman ask that Committee to study the experience of the Aluminum Corporation of America who have had great success with these miniature X-ray schemes?
Mr. Neal: I am afraid I cannot be led into that diversion because time is always the enemy on these occasions and there is much more I want to say. At present it is impossible to say how soon this Committee will be able to report on this highly technical question, but every endeavour will be made for the Committee to reach decisions as quickly as possible.
It is clearly impossible to form a precise scheme until the basic question of what X-rays must be used has been decided. It is anticipated, however, that the National Coal Board medical service, together with the Ministry of Health, will exercise a general responsibility. The Ministry of Health have, of course, gained considerable experience of such surveys through the operation of the mass-radiography units of the regional hospital boards. The experience of the Ministry of National Insurance medical boards will also be available.
The National Joint Pneumoconiosis Committee have advised that the experimental scheme is more likely to succeed if it is not linked directly with the various X-ray and dust environmental surveys which are being carried out by, or under the auspices of, the Pneumoconiosis Research Unit of the Medical Research Council. Instead, it is aimed to confine the experimental scheme to the routine detection of pneumoconiosis by X-rays and to build up a technique of safeguarding men found with the disease by confirming that they work in, or are given every opportunity to work in, approved dust conditions underground. The scheme will, naturally, not undertake the assessment of disability on

1723
account of the disease. That is the function of the Pneumoconiosis Medical Boards set up by my right hon. Friend the Minister of National Insurance under the National Insurance (Industrial Injuries) Act, 1946, and any miner may apply to appear before them at any time.
To attempt at the outset to relate the comparatively simple objectives of the scheme to research such as that already referred to, would introduce complications from which it is best kept free. Both the experimental scheme and the research surveys are, however, expected to provide useful information for each other, and ample opportunity for the exchange of information and ideas exists in the National Joint Pneumoconiosis Committee and its sub-committees.
I now turn to the subject of previous experience in this field. I have said that in the first experimental scheme our aim must be to secure the main objective of detecting the disease in its early stages. This does not mean that the scheme will operate without reference to previous experience in this field. Full account will be taken of the invaluable work done by the Pneumoconiosis Research Unit and also of similar schemes abroad. In regard to other countries, which the hon. Member has mentioned, such schemes as are in operation in any case cover a comparatively small number of men compared with the many hundreds of thousands eventually to be dealt with here. Moreover, our scheme will be operating on a basis of a standard of early radiological diagnosis of coalminers' pneumoconiosis, which is at least equal to, and probably in advance of, any standards elsewhere.
I have discussed, first, the Government's proposals to introduce a scheme of periodic X-ray examinations, but, as hon. Members are aware, extensive facilities for X-ray examinations are already available in the industry. Under the Industrial Injuries Act and its provisions for pneumoconiosis, every miner who feels that he may be suffering from the disease can make a claim for benefit. If he makes a claim, he is automatically X-rayed. Full-size films of his chest are taken as a preliminary to clinical examination by the Pneumoconiosis Medical Board. If, after scrutiny of the film by the doctors of the Pneumoconiosis Panels, it is decided that the claimant is not suffering from the
1724
disease, the clinical examination is not proceeded with. A man is quite free to make another claim to benefit should he feel doubtful about his condition; he is X-rayed on every subsequent application.
In the two-and-a-half years ended 31st December, 1950, about 31,000 X-ray films have been taken under this procedure. During the same period 10,000 miners were diagnosed as having pneumoconiosis. All of these, whether or not they have decided to remain in the coalmining industry, are required to report periodically for re-examination by a Pneumoconiosis Medical Board. Each re-examination involves a new X-ray film of the man's chest. The interval between examinations may be up to three years. The average interval is well under two years, but the boards frequently recall men for re-examination at much shorter intervals. Many of the men in whom the disease has been diagnosed are found to be only slightly disabled. For example in South Wales which in recent years has accounted for the bulk of all diagnosed cases, about two-thirds are now found to have 10 per cent. or less disability from the disease.
Mr. George Thomas: At what age?
Mr. Neal: I could not tell my hon. Friend that. The increased confidence of the men in the arrangements for advice from these boards and in the advancing dust suppression technique is shown by the fact that at the end of 1950 about 5,500 of the 10,000 cases diagnosed had remained at work in the industry. The current annual number of X-ray examinations taken by the Pneumoconiosis Medical Boards is approximately 12,500 in respect of first applications under the regulations and 11,000 in respect of cases already diagnosed and recalled periodically for further X-ray. In South Wales, every new entrant to coalmining employment has to undergo X-ray examination. This is a special requirement in view of the particularly high incidence of pneumoconiosis in that coalfield. The average annual number of men X-rayed is approximately 3,500.
As the hon. Member was advised on 19th March, some 50,000 miners, an average of about 12,000 per annum, have in addition been examined in recent years by miniature

1725
radiography under the National Health Service. At present nearly 40,000 X-rays of coalminers are taken annually in this country under one procedure or another. This of course is not enough and does not remove the need for a systematic scheme of periodic X-ray examinations, but it does enable the experimental scheme to be fully considered from all aspects before it is put into operation.
I do not think it would be right to leave this subject of X-ray examination without referring to the general campaign against pneumoconiosis. The most effective measure against this disease is, of course, to prevent and suppress the dust which causes it. I am glad to say that His Majesty's inspectors of Mines and the National Coal Board are taking all steps towards this end. It can truly be said that at no time have greater efforts been made to combat this disease. The hon. Member can be assured that not only shall we introduce a scheme of X-ray examination as quickly as possible, but that we shall continue to take all possible measures to remove pneumoconiosis from the industry.
10.29 p.m.
Mr. Geoffrey Lloyd: I only intervene for a moment after the hon. Gentleman's interesting remarks because I was Under-Secretary of State at the Home Office before the war and later Secretary for Mines. Curiously a Question on the subject of the Safety in Mines Measure, came up this afternoon. When I was working
1726
to prepare that Bill the right hon. Member who is now Colonial Secretary and the father of the present hon. Member for Stechford (Mr. Jenkins) very kindly took me to South Wales. I was shown cases of silicosis as it was called in those days, as the hon. Member for Gower (Mr. Grenfell) will remember. I had never seen a case of silicosis. It is undoubtedly an extremely tragic disease, At that time it appeared to be largely localised in South Wales and was not very well known, but now it is prevalent not only in the hard coal and anthracite districts, but is spreading into other coalfields, because machine mining is becoming more widespread.
I think it is valuable that my hon. Friend brought up this subject tonight. I have only one thing to say. I remember the difficulties of obtaining sufficient medical knowledge of the disease in those days to make a sound diagnosis on which compensation and other important matters could be based. The Departments were somewhat slow in advancing from one step to another. I think hon. Members who study this Report will find that progress has been slower perhaps than technical knowledge would justify. I have only one plea to make tonight. Let us not wait too long in this matter, but let us press on as hard as we can. There is a real job to be done.
Question put, and agreed to.
Adjourned accordingly at Twenty-Nine Minutes to Eleven o'Clock.

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