Sitting of 30 November 1959

Preamble
The House met at half-past Two o'clock
PRAYERS
[Mr. SPEAKER in the Chair]
PRIVATE BUSINESS

  STANDING ORDERS
  Ordered,
  That the several Amendments to Standing Orders relating to Private Business hereinafter stated in the Schedule be made.

  SCHEDULE
  Standing Order 29, line 8, leave out "and Civil Aviation".
  Standing Order 31, line 6, leave out "and Civil Aviation".
  Standing Order 34, line 10, leave out "and Civil Aviation".
  Standing Order 39, line 7, leave out "and Civil Aviation".
  Line 8, leave out "Supply" and insert "Aviation".
  Standing Order 45, line 33, leave out "and Civil Aviation".
  Standing Order 146, line 5, leave out "and Civil Aviation".
  Line 8, leave out "and Civil Aviation".
  Standing Order 147, line 7, leave out "and Civil Aviation".
  Line 9, leave out "and Civil Aviation".
  Standing Order 154, line 11, leave out "and Civil Aviation".
  Line 24, leave out "and Civil Aviation".
  Standing Order 155, line 5, leave out "and Civil Aviation".—[The Chairman of Ways and Means.]

ORAL ANSWERS TO QUESTIONS
  ELECTRICITY

    Rural Electrification
    Mr. Bullardasked the Minister of Power, in view of the need to speed the provision of electricity to those rural houses which are still without a supply, if he will authorise area boards to undertake further additional work on rural electrification.
    The Minister of Power (Mr. Richard Wood): As I told the hon. Member for Islington, East (Mr. Fletcher) last week, the possibility of increasing the present high rate of area boards' capital expenditure on rural electrification is governed by their revenue position rather than their capital allocations.
    Mr. Bullard: Despite the good progress that has been made in many areas with rural electrification, will my right hon. Friend again have consultations with the area boards to see whether this matter can be speeded up? It is quite a time now since the rural electrification plans were drawn up and electricity has become much more important in daily life since then. Will my right hon. Friend see whether some of these really bad areas, which are there by chance of district, can be given some better hope than at present?
    Mr. Wood: I look forward to further talks with the Eastern Electricity Board, but I notice that the connections which the board estimate will be made in my hon. Friend's area by 1963 include 93 per cent. of all the farms there and 96 per cent. of other rural premises.
    Mr. Wilkins: May I ask the Minister whether, if he responds to the request of his hon. Friend to speed up rural electrification, at considerable cost, he will take steps to ensure that his hon. Friends behind him will then not malign this highly successful nationalised industry?
    Mr. Wood: I am sure that my hon. Friends will be most helpful, as they always are.
    Mr. G. Brown: In view of this remarkably great success in bringing rural electrification forward at this quick pace,

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    will the right hon. Gentleman pay a tribute to the fact that this could not have happened without the nationalisation of the industry?
    Mr. Wood: My hon. Friend spoke about this very problem last week, and I think that the right hon. Gentleman will probably read his remarks.

  MINISTRY OF POWER

    Ministerial Directions
    Mr. Shinwellasked the Minister of Power by what criteria he is guided in exercising his powers of general direction to the National Coal Board, the Central Electricity Authority and the Gas Council.
    Mr. Wood: It has not been necessary so far to give general directions to the National Coal Board or to the Electricity or Gas Councils. The criterion of national interest prescribed in the statutes remains unchanged.
    Mr. Shinwell: If that is so, would it not be an excellent criterion to start with to ensure that the Gas Council does not import quantities of methane which are detrimental to the interests of the nationalised coal industry, and, equally, that the Government should direct the Central Electricity Authority to switch over as rapidly as possible from oil burning to coal burning so as to help the National Coal Board?
    Mr. Wood: On the second part of the right hon. Gentleman's supplementary question, I am sure he will be aware of the action already taken. On the first part, I am in some difficulty because it raises hypothetical circumstances in the future. I notice that when the right hon. Gentleman was making his speech at the beginning of nationalisation he warned us:
    "It depends on the circumstances, but beyond that it would seem to me to be improper to proceed."—[OFFICIAL REPORT, 14th May, 1946; Vol. 422, c. 1822.]
    Mr. Shinwell: To what is the right hon. Gentleman referring when he speaks about "circumstances in the future" and to "it would be improper to proceed"? Is he taking something out of its very rational context?
    Mr. Wood: The right hon. Gentleman mentioned the importation of liquid methane and I was merely saying—[Interruption.] I thought the right hon. Gentleman mentioned this just now and I took it to be a foreshadowing of possible events in the future. I was merely drawing his attention to his own speech, which seemed to reflect rather relevantly on this matter.

    Oil
    Mr. Warbeyasked the Minister of Power what sums have been, or will be, expended on the purchase of oil for stocking purposes in each of the financial years 1958–59 and 1959–60.
    Mr. Wainwrightasked the Minister of Power the separate amounts of crude oil and fuel oil which are stored in this country by Her Majesty's Government; the value of this oil; the cost of storage; and where the storage places are situated.
    Mr. Wood: Capital expenditure by my Department on the supply, storage and distribution of petroleum products was £7.7 million in 1958–9 and is expected to be about the same in this financial year. In the public interest I am afraid I cannot give all the details asked for.
    Mr. Warbey: Is the Minister aware that it is really nonsense to suggest that the defence of the country would be harmed in any way if the Government were to disclose exactly how much they are paying to the oil companies for this oil? Are we not entitled to know just how much more help the Government are giving to the oil industry than to the coal industry?
    Mr. Wood: I am afraid that no Government have been able to go further than I have and to disclose other figures. Therefore, I am afraid that I am prevented from giving the hon. Member all the information which he would like for the comparisons which he wants to make.
    Mr. Wainwright: Would the right hon. Gentleman explain to the House why it is that the Government of the day support private industry by spending £7·7 million a year when we have a nationalised industry which has huge stocks of coal and is made responsible for its own stocking? Would the right hon.

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    Gentleman see to it that the Government are also responsible for the stocking of coal?
    Mr. Wood: The hon. Member seems to be ignoring the fact that only last week I moved an Order in the House, which the House approved, in order to increase the borrowing powers of the National Coal Board so that it can finance stocks—which the hon. Member wants.
    Mr. Finch: Does not the right hon. Gentleman agree that coal is of a strategic importance equal to that of oil? That being so, will the Government give assistance, apart from borrowing powers, for the stocking of coal so as to help the Board in the present emergency?
    Mr. Wood: I do not want to be unduly controversial, but the hon. Member will appreciate that the reason for the present level of coal stocks is not strategic. It is that production has been exceeding demand. Therefore, I do not think that any valid comparison can be made between the two.
    Mr. Wyattasked the Minister of Power by how much the consumption of fuel oil increased between 1953 and 1958; and how much of the increase came from refineries in this country.
    The Parliamentary Secretary to the Ministry of Power (Mr. J. C. George): Seven million tons. During the whole period home production exceeded inland consumption.
    Mr. Wyatt: How does the Minister work that out? The increase in production in oil refineries in the United Kingdom has been only 1½ million tons in the period, according to Board of Trade statistics?
    Mr. George: If the hon. Gentleman looks up the figures of production at home he will see that a very large increase took place in 1953. By 1958 annual production had increased by a further 2 million tons. I would repeat that in the whole period home production has exceeded demand.
    Mr. Wyattasked the Minister of Power the net fuel oil imports in the first nine months of this year; and the cost of such imports.
    Mr. George: None, Sir. Our exports, including bunkers, supplied to oceangoing ships exceeded imports by about 1 million tons valued at about £6 million.

  COAL

    Coal Industry (Reorganisation and Development)
    Mr. McKayasked the Minister of Power if he is aware that for several years coal miners took only one week's holiday instead of the two to which they were entitled, that they worked a six-day week instead of the five days agreed upon, and that they agreed to the importation of foreigners to get output increased, and to increase the supply of coal in view of national necessity; and if he will now consider making a grant instead of a loan during the period of reorganisation of the pits.
    Mr. Wood: The Government appreciate the contribution miners made towards increasing coal production in time of shortage. I am satisfied that the present methods, as laid down by Statute, are adequate and appropriate to finance the National Coal Board's programme of reorganisation and development.
    Mr. McKay: Would it not be true to say that if the extra wealth produced out of the sacrifices of the miners were calculated it would probably amount to £1,000 million? Is the right hon. Gentleman aware that, in the way of advances to various industries, subsidies to farmers, and investment allowances, others all over the country are making profits? Is he aware that they are getting what the miners cannot get because there are no profits after the payment of interest and because the investment allowances are no good? Is the Minister aware that the interest charges are equal to 3s. per ton? Is it not rather ungrateful that the country should ignore the position of the mining industry by refusing a grant?
    Mr. Wood: As the hon. Member will remember, I initiated steps last week which I hope the House will approve, to provide the necessary finance for the Coal Board's operations in the near future. I took the view then, and I take it now, that that will be the best way to provide the finance which the Coal Board will need.

    Opencast Mining
    Mr. McKayasked the Minister of Power if he is aware that the stocking

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    of 50 million tons of coal is largely due to the continuation of opencast production introduced to meet a scarcity of coal and now continued in a time of over-production thus causing unemployment in the mining community; and if he will terminate opencast production within twelve months.
    Mr. George: I have nothing to add to my right hon. Friend's reply on 23rd November to a similar Question by the hon. Member for Don Valley (Mr. Kelley).
    Mr. McKay: Can the Parliamentary Secretary say how much it would take to finish the contracts for opencast coal at the moment so that the miners would have a better opportunity of placing more coal on the market?
    Mr. Nabarro: That comes under Question 16. This has nothing to do with it.
    Mr. George: There is a Question on that very point later on, and perhaps the hon. Member will await the reply.
    Mr. Fitchasked the Minister of Power how many acres of agricultural land in Lancashire as still requisitioned for opencast coal operations.
    Mr. George: Four thousand acres, of which 2,600 acres are under agricultural restoration.
    Mr. Fitch: Will not the Parliamentary Secretary agree that it is almost idiotic to close down seven mines in Lancashire, due to excessive coal stocks, and at the same time churn up good agricultural land? Will he guarantee that opencast mining will cease in Lancashire, at least by the end of 1960?
    Mr. George: I have no information about the reason for the closures, but I certainly do not accept that the mines are being closed because of stocks of coal on the ground. Secondly, it has been considered inadvisable and unwise to bring the opencast coal industry to an abrupt finish. The extent of opencast working is being rapidly diminished and will be only 2 million tons at the end of 1965.
    Dr. Stross: Is the Parliamentary Secretary aware that in the matter of extractive industries Lancashire suffers
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    more than any part of Britain? Could not a good example be set by doing matters in reverse now and sparing land in Lancashire?
    Mr. George: The hon. Member will agree that the Board is running down opencast mining as fast as it reasonably can.
    Mr. Ross: The hon. Gentleman is running down the whole industry as fast as he can.
    Mr. Nabarroasked the Minister of Power, having regard to opencast coal output of 14 million tons in 1958, 11 million tons estimated in 1959, 7 million tons estimated in 1960, reducing to 2 million tons in 1965, and the present coal stocks of 53 million tons, distributed and undistributed, worth approximately £230 million, what steps he has taken to ascertain the cost of compensation for cancellation of all opencast contracts early in 1960, and total cessation of opencast coal mining.
    Mr. George: None, Sir. It would have been quite unreasonable to bring this large industry to such an abrupt end, and the National Coal Board has not negotiated with its contractors on that basis. I would not in any case accept that distributed stocks should be brought into the picture.
    Mr. Nabarro: That is an academic argument anyway but, as my hon. Friend neglected to observe that under his rundown plans for opencast coal mining—which I have been opposing in this House since my maiden speech ten years ago—he proposes in 1960 to mine by opencast methods 7 million tons of coal, practically all of which is going into stock at huge cost, I ask him again whether he would not consider outright cancellation of all opencast mining contracts, on the premise that it would be cheaper to pay compensation now rather than mine this coal—which ought to be a strategic reserve anyway—and put it all into stock? Cannot we have some realism in these matters?
    Mr. George: My hon. Friend has again failed to notice the estimates for next year. He says that the 7 million tons of opencast coal to be mined in 1960 will go to stock. The estimates of production are 188 million deep-mined

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    and 7 million opencast, making a total of 195 million. The sales are estimated at 196 million. Therefore, all the opencast coal mined next year is expected to be sold.
    Mr. Oliverasked the Minister of Power whether, having regard to Her Majesty's Government's declared policy on prospecting for opencast coal, the fifty-four prospecting proposals for which applications have been made to the Derbyshire County Council during 1959 will not now be pursued.
    Mr. George: As my right hon. Friend explained on 23rd November, the National Coal Board has decided to make big reductions in its opencast prospecting programme. It is for the Board to work out the details of these reductions and I am asking the Chairman to write to the hon. and learned Member.
    Mr. Oliver: In analysing the fifty-four prospecting sites to which I have referred in my Question, will the Parliamentary Secretary be good enough to deal with cases where sanction has been given to bore but they have not entered the site; where they have entered the site but have not commenced to bore; and sites where boring is in operation?
    Mr. George: The general programme has already been given by my right hon. Friend. It would be foolish—and I think the hon. and learned Gentleman would agree—to cancel contracts and pay compensation if those contracts could be carried out with very little, if any, damage and yield valuable information.

    By-products (Committee)
    Mr. Fitchasked the Minister of Power if the Wilson Committee set up to examine the prospects for a coal-based chemical industry has yet reported its findings; and if he will make a statement.
    Mr. Wood: No, Sir. The Committee is pressing on urgently with its very detailed investigations, but it may be some months yet before it is ready to report. The chairman tells me the Committee has reached a stage where it would welcome further written memoranda from people interested in research
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    and development on processes making chemicals, gases and oil from coal and in the organisation of such work.
    Mr. Fitch: Is the right hon. Gentleman aware that there is considerable disquiet at the apparent lack of progress in research in the use of coal as a byproduct? Cannot he get the Committee to speed things up a little?
    Mr. Wood: As the hon. Member knows, the Committee was appointed only in April this year and I think that it is working with considerable dispatch. I hope that it will report as early as possible. I do not honestly believe that it can be accused of delay or lack of urgency in its proceedings.

    Production and Consumption
    Mr. Nabarroasked the Minister of Power whether he will now state his revised estimate of total coal production for 1959 and total coal consumption; and by how much in tons the former exceeds the latter.
    Mr. George: The outcome should not be very different from that forecast in the reply given on 2nd November to the hon. Member for Ashfield (Mr. Warbey).
    Mr. Nabarro: The production of coal this year is likely to exceed consumption by a figure of about 15 million tons, subject to what occurs in the next four weeks until the end of the coal year. Having regard to the rising output per manshift from the mines—all of which will be projected into next year—is it realistic for my right hon. Friend to insist that these coal stocks shall be reduced by only 1 million tons in the next thirteen months? Cannot we have a more realistic assessment in the interests of our taxpayers?
    Mr. George: The forecast made by my right hon. Friend is a realistic assessment based on the opinions of those who are expert in assessing consumption and demand for coal in this country.
    Mr. Nabarro: I disagree entirely with what has been said.

    Power Stations
    Mr. Nabarroasked the Minister of Power the coal equivalent of oil burned at power stations in 1958; the

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    estimate for 1959; and how his policy of oil to coal will affect matters in each of the years 1960 and 1961.
    Mr. George: The coal equivalent of the oil burned at Central Electricity Generating Board power stations in 1958 was approximately 4 million tons. The estimate for 1959 is 7 million tons. I would prefer not to offer an estimate for later years until the current discussions between the Generating Board and the oil companies are concluded.
    Mr. Nabarro: As we are mining 7 million tons of coal this year—both opencast and deep-mined—and putting it into stock at a huge cost to the nation, would not it be more realistic to cancel all the power station oil contracts outright and pay compensation, all of which would be much cheaper than mining next year a further 7 million tons of coal and putting it into stock? Cannot we have some realistic plans in these important matters?
    Mr. George: I am afraid that the hon. Member has overlooked the estimate made by the National Coal Board that all opencast coal mined next year will be sold. With regard to the change-over from oil to coal at the power stations, I have said, and I would not wish to go beyond that statement, that negotiations are now proceeding and I would prefer to say nothing more in case they are prejudiced in any way.
    Mr. Holt: In view of the fact that these experts who have been making these forecasts have nearly always been wrong before—
    Mr. Nabarro: They have always been wrong.
    Mr. Holt: —will the Parliamentary Secretary have another look at this and get advice from some other experts?
    Mr. Nabarro: Including me.
    Mr. George: An expert who has been wrong is a better estimator thereafter.
    Mr. Nabarro: Has my hon. Friend observed that I have consistently been right in these matters? A study of what I have said in this House in the past will bear me out. Will the Parliamentary Secretary bring these negotiations to an early conclusion? Is he aware that his predecessor but one told me two years
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    ago that the same negotiations were going on about burning oil at power stations? Surely we can expect some finality soon?
    Mr. George: I hope for some finality soon, but these are delicate negotiations and the less said the better.
    Hon. Members: No.

    Oil Extraction
    Mr. Fitchasked the Minister of Power if he will make a statement on the possibilities of extracting oil from coal as a commercial proposition.
    Mr. Wood: I cannot yet make a statement. This subject is being reviewed by the Wilson Committee.
    Mr. Fitch: Is the right hon. Gentleman aware that this process has been carried out successfully on a commercial basis in South Africa? Is he further aware that the firm of John Brown, civil engineers, has a plant which it claims can do this process on a commercial basis? Will the right hon. Gentleman look into this?
    Mr. Wood: I certainly will. I observe at the moment only that I think that the conditions to which the hon. Gentleman is drawing our attention in South Africa are very different from the conditions that would obtain here.

    Research
    Mr. Wyattasked the Minister of Power the amount spent annually on research into the uses of coal, as distinct from coal-winning methods; how this research is co-ordinated; and what steps are being taken to increase the amount spent on research in this field by the various nationalised industries for which he is responsible.
    Mr. Wood: The Government, the nationalised industries and the research associations are spending about £1·6 million a year on research, as well as increasing amounts on the development of new processes. It is my responsibility to co-ordinate these research programmes. In doing so, I have the advice of my Scientific Advisory Council under the Chairmanship of Sir Alexander Fleck.
    I have no figures for research expenditure by private firms. I know of no

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    promising field of investigation which is being neglected for lack of funds, but it is possible that the report of the Wilson Committee on Coal Derivatives may suggest directions in which the research could usefully be intensified.
    Mr. Wyatt: As the oil companies are spending about six to seven times as much on research into the use of oil, is it not a pitiful amount that the Government are spending through their nationalised industry on the research into the use of coal, our basic industry?
    Mr. Wood: I do not see any point in spending money unless we can find something to spend it on.

  GAS

    Charges, Scotland
    Mr. Rankinasked the Minister of Power if he has studied the letter, a copy of which was sent to him by the hon. Member for Govan, on the subject of charges for gas; and whether he will give the Scottish Gas Board a general direction to give consumers more details of charges imposed by the Board.
    Mr. Rossasked the Minister of Power (1) whether any representations have been made to him by the Scottish Gas Consultative Council under Section 9 (6) of Gas Act, 1948;
    (2) whether he is aware that the charging system of the Scottish Gas Board is not being operated in accordance with Section 53 (4) of the Gas Act, 1948; and if he will accordingly give a general direction to the Board to review it.
    Mr. Dempseyasked the Minister of Power whether he will give a general direction to the Scottish Gas Board to review the operation of its charges system.
    Mr. Willisasked the Minister of Power what general directions have been given to the Scottish Gas Board in connection with fixing its tariff of charges.
    Mr. Wood: It is the duty of the Gas Consultative Councils to consider complaints which arise from variations of gas tariffs. I have asked the Chairman of the Scottish Gas Consultative Council to consider the letter sent to me by the
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    hon. Gentleman the Member for Govan (Mr. Rankin), and I will draw his attention also to the points raised by other hon. Members. If representations were made to me by the Council under Section 9 (6) of the Gas Act I would naturally consider them.
    Mr. Rankin: While thanking the right hon. Gentleman for that reply, may I ask whether he would not also agree that when the Scottish Gas Board issues its accounts, the charges should be clearly specified and a description of the new charge made? Is the right hon. Gentleman aware that because of that lack a great deal of confusion has been caused in Scotland by this new charge? Is he aware that some officials say that it is a meter charge and others that it is a new type of tariff and that members of the public just say it is an imposition? Which is correct?
    Mr. Wood: This is a matter for the Scottish Gas Consultative Council to discuss with the Board. That seems to be the obvious steps to take, and if the Council feels that there are difficulties of the kind which the hon. Member mentioned it should then take action.
    Mr. Ross: Should not the Minister be aware that there is a considerable outcry in Scotland, and certainly in West Scotland, about the new charge? Has not the right hon. Gentleman an obligation under Section 53 of the Gas Act, 1948, without reference to the Consultative Council, and does not Section 53 (4) provide that
    "… tariffs shall be so framed as to show the methods by which and the principles on which the charges are to be made … and shall be published in such manner as in the opinion of the Area Board will secure adequate publicity for them?"
    Is not it a fact that people knew nothing about these charges until they read about them in their bills and even after that they could not understand them? Does not that show that Section 53 has not been carried out, and will the Minister do his duty without reference to any other body at all?
    Mr. Wood: It is not for me to determine the legality or otherwise of matters under Section 53 (4). If the hon. Member takes the view that the Act has not been carried out, the obvious remedy is open to him.

    Gasification Plant, Coleshill
    Mr. Matthewsasked the Minister of Power whether he will state his policy with regard to approval of the West Midlands Gas Board's general programme of capital development which would empower the Board to proceed with the erection of the Lurgi Complete Gasification Plant at Gorsey Lane, Coleshill.
    Mr. Wood: I have approved this programme, which includes the Lurgi plant at Coleshill.
    Mr. Matthews: Can the Minister tell us how much coal this new plant is expected to consume, and what quality of coal it will use?
    Mr. Wood: It will use about 400,000 tons a year. I must be quite frank and tell the House that that will not be a complete addition to the coal requirements, because there will be a certain shutting down of capacity. The coal used will be non-carbonising coal, supplied from pits in the Midlands.

  MINISTRY OF AVIATION

    Aircraft Accident, Spain
    Mr. Hunterasked the Minister of Aviation what progress has been made by the Spanish authorities in their investigation into the accident to the British owned Transair Dakota aircraft in the Pyrenees on 19th August; when there will be a public inquiry; and when he expects to make a statement as to the cause of the accident.
    The Parliamentary Secretary to the Ministry of Aviation (Mr. Geoffrey Rippon): I understand that the investigation into this accident by the Spanish authorities is nearly complete. I am advised that no public inquiry is contemplated. Until my right hon. Friend receives the Report he cannot of course make any statement about the cause of the accident.
    Mr. Hunter: Does not the Minister agree that a considerable time has now elapsed since the crash, when many young students unfortunately lost their lives? Is he aware that anxiety exists among students' organisations because of this great delay in proceeding with the investigation?
    Mr. Rippon: We certainly appreciate the concern which exists about this tragic accident.

    Aircraft, London Airport (Height Regulations)
    Mr. Gresham Cookeasked the Minister of Aviation whether, in cases where civilian aircraft, leaving from or approaching London Airport, break the height regulations over residential areas, he will take action against the airline operators concerned.
    The Minister of Aviation (Mr. Duncan Sandys): Yes, Sir. I have recently issued a special warning on this subject, and I will circulate the text in the OFFICIAL REPORT.
    Mr. Gresham Cooke: I thank my right hon. Friend for that reply, but is he aware that it is generally admitted that many aeroplanes are breaking the height regulations? If this is consistently done by one or more companies, will it be possible to take legal action against them?
    Mr. Sandys: I have no evidence that this is going on. If my hon. Friend has proof that aircraft are breaking the regulations I shall be glad if he will let me have it. Recently we carried out a series of spot checks on the height of aircraft over Willesden—which is about ten miles from London Airport—and the results did not reveal that any breach of regulations was taking place.
    Mr. Gresham Cooke: Could my right hon. Friend have some spot checks taken over Twickenham and surrounding districts, including Feltham, over which it is alleged that many aircraft are flying very low and making a great deal of noise?
    Mr. Sandys: I cannot give an undertaking that we will make observations at those particular spots, but it is a regular part of the routine to make these observations at suitable places.
    Following is the text:

    Aircraft, London Airport (Height Regulations)

      NOISE IN THE VICINITY OF AIRPORTS
      As air traffic over the United Kingdom increases, the noise of aircraft tends to become an ever-growing nuisance particularly to those who live near airports.
      The noise heard on the ground decreases considerably as an aircraft's height is increased,

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      and as a result it is in general true that at heights above 3,000 feet little disturbance results. The noise problem is thus in the main concerned with aircraft taking-off or approaching to land.
      In furtherance of the Minister's policy of reducing disturbance from aircraft noise to a minimum, noise and height surveys are now being carried out regularly, and especially around London Airport. Whilst the results of these surveys provide convincing evidence that aircraft do not in general fly lower than necessary, pilots are nevertheless reminded that every effort should be made to cause as little disturbance as possible, particularly when landing or taking off.
      Pilots should in general:—

      (a) when approaching to land maintain an altitude of at least 1,500 feet above the aerodrome until within five miles of the threshold and thereafter not deviate substantially from the angle of approach they would follow when using ILS or GCA.

      (b) when taking-off, climb as soon as possible to at least 1,500 feet above aerodrome level.

      The climb technique which will result in the least disturbance will depend on the aircraft concerned, and pilots should therefore be fully conversant with the optimum flight path to be followed for their particular aircraft.
      Pilots are warned that legal proceedings may be instituted if there is evidence that the Rules of Air and Air Traffic Control have been contravened.
      Ministry of Aviation,
      11th November, 1959.

    Staff (Former Ministry of Supply)
    Mr. Shinwellasked the Minister of Aviation how many of the staff formerly employed at the Ministry of Supply have been transferred to his Department.
    Mr. Sandys: The non-industrial civilian staff of the Ministry of Aviation totals about 25,000, of whom about 20,000 have come from the Ministry of Supply. In addition there are about 23,000 industrial staff.
    Mr. Shinwell: In view of the fact that the War Office has had transferred to it about 40,000 from the Ministry of Supply, and the right hon. Gentleman's statement that over 40,000 have come from the Ministry of Supply to his Department, is there to be no redundancy as a result of this reorganisation? What was the point of abolishing the Ministry of Supply unless there was some redundancy, and unless we could get rid of some of the waste material that has been at the Ministry of Supply?
    Mr. Sandys: I explained this point to the right hon. Gentleman at consider-
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    able length in the debate we had the other day. I said that the same amount of work has still to be done, and that unless we reduce the work we cannot reduce the staff. What has happened is that certain sections of work have been transferred, with their appropriate staff, to the other Departments.

    Aircraft (Research and Development)
    Mr. Shinwellasked the Minister of Aviation the amount contributed by Her Majesty's Government to aircraft firms since 1951 for the purposes of research and development; and how much has been returned by aircraft firms to the Government.
    Mr. Sandys: From April, 1951 to March, 1959, payments made by the Government to industry for research and development on airframes and aero engines have amounted to £430 million. Most of this was for military aircraft for our own Forces; and the special prices paid for them took into account the contributions made by the Government to the cost of development. Some £24 million has been received from the industry in respect of royalties on aircraft developed with Government assistance and sold to other customers.
    Mr. Shinwell: Is not this a vast—indeed, an extravagant—subsidy provided to the aircraft industry? Over £400 million has been supplied and only £24 million has been returned by way of royalties. Can we have an assurance from the Government that the subsidisation of this industry—which is a waste of taxpayers' money—will cease?
    Mr. Sandys: I do not think the right hon. Gentleman listened to my Answer. I explained that the overwhelming majority of that money was spent on the development of military aircraft for our own Forces. We do not expect to get back a royalty on that—and the price that was paid to the firms for those military aircraft, developed with Government money, was lower than that which would have been charged by the firms if they had developed the aircraft with their own money.
    Sir W. Wakefield: How much money has been returned to the Government by way of taxation because of the exports

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    of these aero engines and airframes, which has been of such great advantage to our taxpayers?
    Mr. Sandys: I cannot answer that supplementary question without notice, but it would be a considerable sum.
    Mr. Paget: Can the Minister tell us how the cost to the taxpayer of the private aircraft industry compares with the cost to the taxpayer of the Coal Board, or nationalised transport?
    Mr. Sandys: I should think it compares very favourably.
    Mr. G. Brown: Can the Minister say how much of that £430 million was spent in respect of aircraft which were never subsequently ordered and put into service?
    Mr. Sandys: Not without notice. The only aircraft I can think of, straightaway, is the Swift, which was ordered by the right hon. Gentleman's party when it was in power.

    London Airport—Central London
    Mr. Straussasked the Minister of Aviation what consultations he has had with the Minister of Transport with a view to making London Airport more accessible to passengers travelling to and from central London.
    Mr. Sandys: I am in close touch with my right hon. Friend on this subject.
    Mr. Strauss: Is there any chance of a decision being arrived at on this matter? Is the Minister aware that discussions have been going on for years about the possibility of having a rail link, or monorail, or something of that sort? Are not we as far off as we ever were from arriving at a conclusion on this urgent problem? Is there any hope of a conclusion being reached?
    Mr. Sandys: I should think that the discussions will go on for a long time yet. I shall be surprised if they do not. As the right hon. Gentleman knows very well, the first task is to improve the road, and it is being progressively improved, as anybody travelling along it can see. I am told that when the work is completed the journey between the Cromwell Road terminal and the airport will not take more than about 23 or 25 minutes. If we were to introduce a
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    monorail or a similar system we might cut ten minutes off that time. I am not saying that it is not desirable, but up to now these schemes have foundered owing to their high cost, and to the fact that other schemes have claimed priority in the expenditure of Government money.
    Mr. Awbery: Is the Minister aware that it takes passengers longer to travel from London to the airport than to fly from the airport to Paris? Will he give some thought to the possibility of establishing helicopter stations?
    Mr. Sandys: The trouble is that aircraft fly so fast nowadays.

    Commonwealth Air Services (Co-ordination)
    Mr. Straussasked the Minister of Aviation what steps he is taking to bring about an agreed co-ordination of Commonwealth air services.
    Mr. Sandys: Within the framework of inter-Governmental Agreements pooling and other arrangements for co-ordination are being operated between the British Overseas Airways Corporation and a number of Commonwealth airlines. These include the Australian Qantas Line, South African Airways and Ghana Airways; and also Central African Airways, East African Airways and Nigeria Airways. Similar arrangements were concluded last week with Trans-Canada Airlines and negotiations are going on at the moment with Air India.
    Mr. Strauss: When the former Minister of Transport and Civil Aviation spoke a little time ago about developing a co-ordinated system with the Dominions, did he not mean something more than having passenger and other arrangements with the various companies or organisations running the airways now? Did he not mean in fact some big imaginative scheme, or did he mean the continuation of the present policy?
    Mr. Sandys: I do not know, Sir. The right hon. Gentleman will exercise his imagination. I do not know, but I would have thought that the pooling arrangements went a very long way.
    Mr. Farey-Jones: Will my right hon. Friend undertake to give his most serious consideration to calling, as early as possible in 1960, a Commonwealth air

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    transport conference in London with a view to setting up a permanent council for air transport development in the Commonwealth on economic, cultural and educational grounds?
    Mr. Sandys: I believe that at the right moment there would be an advantage in calling such a conference. What the precise agenda should be, I should like to leave open.

    Air Traffic Control
    Mr. de Freitasasked the Minister of Aviation what steps he is taking to co-operate with the other military and civil aviation authorities in Europe in establishing an automatic electronic system of air traffic control to reduce the risk of collision of military and civil aircraft especially at high altitude.
    Mr. Sandys: Her Majesty's Government and the Governments of the six European countries of the Common Market have agreed in principle upon the desirability of setting up a joint system of air traffic control above the height of 20,000 feet, and we are together studying the technical and other problems involved.
    Mr. de Freitas: Can the Minister say at this stage whether he envisages civil control or military control and, if the latter, are the Government in touch with other non-N.A.T.O. countries which have military air forces?
    Mr. Sandys: That is one of the questions which is at present being studied.
    Mr. Rankinasked the Minister of Aviation what reply he has made to the letter from the British Air Line Pilots Association containing the recommendation of the International Federation of Air Line Pilots Association that air traffic control should be exercised by a single civil agency.
    Mr. Sandys: I have received a letter from the Association in which it said that it was writing to me at the express request of the hon. Member. [HON. MEMBERS: "Oh."] Since the letter was written only last Friday, I have not yet had time to send a reply.
    Mr. Rankin: There is no objection, I hope, to taking precautions. While the right hon. Gentleman is thinking about the reply he will send, will he note that
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    very soon in America 2,000 military aircraft control systems will come under the Federal Airways Administration, which is America's civil agency for the control of aircraft? If that is possible in America, what difficulties exist to prevent a similar application in this country?
    Mr. Sandys: As I have already explained, I share the hon. Gentleman's interest in this question, but I cannot usefully add today to the Answers which I have given to the hon. Gentleman in the last two or three weeks.

  SCIENTIFIC AND INDUSTRIAL RESEARCH

    Space Satellites
    Mr. Gresham Cookeasked the Minister of Aviation, as representing the Minister for Science, what arrangements he has made with the Governments of the Union of Soviet Socialist Republics and the United States of America for the receipt of detailed technical and scientific information obtained from their space satellites; and through which organisations is such information transmitted.
    Mr. Sandys: In addition to our close contacts with the United States there is a regular exchange of information on this subject between scientists through various channels, including the three "World Data Centres" established after the International Geophysical Year. One of these is in the United States, one in the Soviet Union, and one in Britain.
    Mr. Gresham Cooke: Does that imply that information of a scientific nature is coming through freely both from Russia and the United States?
    Mr. Sandys: Yes, Sir.

  MINISTRY OF HEALTH

    Private Patients (Drugs)
    Mr. John Hallasked the Minister of Health what representations he has received from the British Medical Association in connection with the provision of drugs for private patients under the National Health Service; and what his reply has been to these representations.
    Dr. D. Johnsonasked the Minister of Health what is the nature of the administrative difficulties that prevent the provision of drugs to private patients under the National Health Service; and if he will make a statement.
    The Minister of Health (Mr. Derek Walker-Smith): The British Medical Association has represented that drugs should be supplied to private patients on the same terms as to National Health Service patients. This raises considerations wider than those of administration and I have conveyed to the Association the substance of my reply of 4th November to my hon. and gallant Friend the Member for Arundel and Shoreham (Captain Kerby), to which I would refer my hon. Friends.
    Mr. Hall: Is my right hon. and learned Friend aware that his reply to my hon. and gallant Friend was extremely unsatisfactory? His predecessors in office stonewalled on this question for a number of years, first on the ground of cost, then on the ground that certain safeguards were necessary. Now that the profession has agreed to all the safeguards required, my right hon. and learned Friend finds another reason for doing nothing. If he has no intention at all of allowing private patients to obtain drugs under the National Health Service, would it not be much more honest of him to say so, rather than to find one fresh excuse after another?
    Mr. Walker-Smith: The implications of my hon. Friend's somewhat lengthy supplementary question fall below his usual standard of accuracy in these matters. Is it not a fact that excuses are being found in this context. Discussions on administrative procedures were quite clearly made without commitment on the question of principle. On the question of principle, our position is that people have a right to resort to private practice if they so desire and, therefore, the preservation of private practice is a matter of concern to the Government. If the present position endangers the existence of private practice or prevents any substantial number of people availing themselves of it who would otherwise do so, we shall certainly consider the question of drugs. At the moment we have no evidence of that.
    Dr. Summerskill: Is the right hon. and learned Gentleman aware that his attitude is approved by many doctors in this country and also by the whole of the public?
    Mr. Partridge: Is it approved in Norway?
    Dr. Summerskill: If the hon. Member is so interested in the question of heredity, I suggest that he reads Darwin's Origin of Species, which should interest him. I will send him a copy.
    The right hon. and learned Gentleman's attitude is entirely correct, for these reasons. If he gives way to the pressure that is continually applied to him, he will in fact be establishing two classes of sick people in this country and he will undermine the National Health Service. Does he recognise that if he accepts the suggestions of the hon. Member for Wycombe (Mr. John Hall) the drug bill will be increased tremendously?
    Mr. Walker-Smith: I do not think that the word "pressure" is particularly felicitous to describe the conscientious efforts of some of my hon. Friends to put forward considerations in the public interest. I think that the principle is quite clear. People are entitled to resort to the National Health Service and all that goes with it. They are also entitled, if they so prefer, to go to private practice. It does not necessarily and logically follow that if they do the second they should have drugs on the same terms as the first. It is important to preserve the right of private practice and, therefore, if the evidence is forthcoming we shall certainly consider it, but so far the evidence has not been forthcoming.
    Dr. D. Johnson: Is my right hon. and learned Friend aware that the opinion of many of those in private practice is as he stated? They fear that their position as private practitioners is endangered by this. May I ask my right hon. and learned Friend if he is also aware that at the outset of the National Health Service it was clearly stated then, by no less a person than the right hon. Member for Ebbw Vale (Mr. Bevan), that all the service or any part of it is to be available to anyone in England and Wales, and does he not think that his present statement is contrary to the expression of intention?
    Mr. Walker-Smith: I think not, because the provision of drugs is not a separate element but an ancillary part of the general practitioner service. As to the first part of my hon. Friend's supplementary question, there is, of course, a wealth of assertion to the effect that private practice is endangered and people are debarred from entering into it who would otherwise do so, but, as he knows, there is a difference between assertion and evidence and it is the evidence for which we look to be supplied. The British Medical Association has ample opportunities to supply that evidence if it is available and I shall certainly consider it most carefully and sympathetically.
    Mr. Hall: In view of the extremely unsatisfactory nature of the reply, I beg to give notice that I will raise the question again at the earliest opportunity.

    Prescription Charges (Old People)
    Brigadier Clarkeasked the Minister of Health if he will abolish health charges for all old-age pensioners suffering from a complaint certified to be chronic by a National Health medical practitioner.
    Mr. F. Noel-Bakerasked the Minister of Health what representations he has received regarding the unnecessary cumbersomeness and expense of the method now employed to refund the cost of medical prescriptions to old people; and if he will now arrange to exempt them from these charges altogether.
    Mr. Walker-Smith: No general representations have been received against the procedure for refunds which is simple, puts the applicant to no extra expense and is not costly to administer.
    As regards remission, I would refer to my statement in the House on the future of prescription charges generally on 15th July last.
    Brigadier Clarke: Does my right hon. Friend appreciate that the health charges put on by hon. Members opposite cause great hardship to the chronic sick? Will he do something to relieve this by allowing old-age pensioners to get their medicine free if they are invalids? Is he aware that many old-age pensioners will not draw National Assistance and consequently cannot get their medicine free?
    Mr. Walker-Smith: There would be difficulties about exempting categories, more particularly because of the possibility of comparable circumstances existing in categories which were exempted and those which were not. There is a scheme in operation for the refund of charges to those in need and my information is that this is working satisfactorily.
    Mr. Noel-Baker: Are we to understand from the Minister's reply that he is unaware of the great difficulty faced by many old people in receipt of National Assistance who have to pay for their prescriptions and wait for many days for reimbursement owing to certain bureaucratic formalities? Will not the right hon. and learned Gentleman have talks with old people's welfare committees and bodies of that kind who could do a great deal to enlighten him? Is he saying that he has had no representations from my constituency on this subject, because if he has not, I can assure him that he will get some very soon?
    Mr. Walker-Smith: What the hon. Gentleman refers to as "bureaucratic formalities" does not deserve that pejorative description. Persons receiving National Assistance can get a refund by presenting the form with the allowance book at the post office when drawing the National Assistance. The procedures are simple and we have had no representations that they are not working satisfactorily.
    Dr. Summerskill: Is it not a fact that large numbers of chronic sick receive National Assistance and is not the simple answer to the administrative difficulties, which I recognise, that all these charges should be abolished in view of what we are told is the improved financial state of the country?
    Mr. Walker-Smith: A person not in receipt of a regular grant from the National Assistance Board can apply for a refund by sending or taking the form, which he receives from the chemist supplying the drug, to the local office of the Board, and again that is a simple procedure. I stated the policy of the Government on the second point raised by the right hon. Lady during the debate on 15th July, and she and the House will recall that we will consider the

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    question of prescription charges in the light of the position at the end of the two-year trial period of the voluntary limitation of drugs recommended by the Hinchliffe Committee.
    Mr. Noel-Baker: In view of the unsatisfactory nature of the Minister's reply, and in order—
    Brigadier Clarke: On a point of order, Mr. Speaker. The replies were the result of my Question.
    Mr. Noel-Baker: —to provide an opportunity for the discussion of this specific problem, I beg to give notice that I shall endeavour to raise the matter on the Adjournment at the earliest opportunity.
    Mr. Speaker: I shall be obliged if hon. Members who wish to give notice of their intention to raise a matter on the Adjournment would do so by using the traditional formula and no more, as a departure from it is liable to give rise to difficulties.

    Food Handling (Codes of Practice)
    Mr. Doddsasked the Minister of Health if he will announce the first two of a series of official codes of practice on the hygienic handling of food.
    The Parliamentary Secretary to the Ministry of Health (Miss Edith Pitt): Yes, Sir. The first two of these codes, dealing with hygiene in the retail meat trade and the hygienic transport and handling of meat, were published on 17th November. I am sending copies to the hon. Member.
    Mr. Dodds: Can the hon. Lady state when the next series will be coming out?
    Miss Pitt: Yes, Sir. There are two more in preparation in connection with the fish trade. They have been circulated to interested parties and are now being revised in the light of their comments.

    Unfit Food (Disposal)
    Mr. Doddsasked the Minister of Health, in view of the special health risks connected with unsound meat, what precautions he has laid down for regulating generally the treatment and disposal of food unfit for human consumption.
    Miss Pitt: The law requires the justice who condemns food intended for human
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    consumption to order it to be destroyed or so disposed of as to prevent it from being consumed.
    Mr. Dodds: Is the hon. Lady aware that since 1954 the disposal of unfit meat from slaughter houses and knackers' yards has been the subject of discussion? Formerly it was either sterilised or steamed. Is she aware that several Ministers have spoken about the urgency of this matter but even now in 1959 discussions are still taking place? What is holding matters up?
    Miss Pitt: Unfit meat from knackers' yards is the responsibility of my right hon. Friend the Minister of Agriculture, Fisheries and Food, but on the question of health there is a joint responsibility. My right hon. Friend the Minister of Agriculture, Fisheries and Food and my right hon. and learned Friend have this matter under consideration at the moment.

    Ambulance Service, Willenhall
    Mr. Stonehouseasked the Minister of Health what arrangements he is making for an efficient ambulance service in the Willenhall area of Staffordshire.
    Miss Pitt: This is primarily a matter for the responsible local health authority. I am informed that the Staffordshire County Council proposes to review the arrangements in the area when its new ambulance and radio control station at Tipton is functioning.
    Mr. Stonehouse: Will the Parliamentary Secretary ask her right hon. and learned Friend to have a look at this matter? Is she aware that there is widespread public anxiety at Willenhall in connection with the ambulance service in that area?
    Miss Pitt: I am told that the ambulance cover in the area is regarded by the council as adequate. It is provided from the nearby station at Darlaston which provides a 24-hour service. The distance from this station to Willenhall is only three miles and it takes ten minutes by ambulance. There is liaison with Wolverhampton and Walsall to cover emergencies. The Staffordshire County Council is satisfied with the ambulance service at the moment.
    Mr. K. Robinson: Would not the hon. Lady agree that it might be easier to

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    provide an efficient ambulance service if the control were invested in the authority using the ambulances, namely, the regional hospital boards? Has her right hon. and learned Friend given consideration to that matter?
    Miss Pitt: I am too new at my job to be able to say whether my right hon. and learned Friend has given consideration to that matter, but so far as I am aware the system works well in the hands of local authorities. I promise, however, to take note of the point which the hon. Gentleman has put to me.

    Leukaemia
    Mr. Edelmanasked the Minister of Health whether he will invite the World Health Organisation to study the rise in the incidence of leukaemia in relation to man-made radiation.
    Mr. Walker-Smith: I understand that there is already liaison between the World Health Organisation and the United Nations Scientific Committee on the Effects of Atomic Radiation, which has this subject under review.
    Mr. Edelman: Has the attention of the right hon. and learned Gentleman been drawn to the world-wide anxiety about this matter and the statement by Mr. Perrin, the French High Commissioner for Atomic Energy, who stated that as a result of the 1957–58 tests 1,000 people will die of leukaemia and a thousand children will be born deformed? Will he recall his own figures which show that since 1948 deaths in this country from leukaemia have risen from 1,000 to over 2,000 last year? Does not that indicate an association between leukaemia and man-made radiation? Will he draw the attention of Governments, now contemplating either making new tests or reinstating old tests, to the danger to public health from such nuclear tests?
    Mr. Walker-Smith: The rise in the death rate from leukaemia has been general in the world and has been going on for the last thirty years or so, long before these tests to which the hon. Gentleman refers. This is, of course, an important subject and at the next session of the United Nations Committee there is to be further discussion of the connection between radiation and leukaemia. The hon. Gentleman will
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    have in mind that the nuclear aspect is relatively small compared with the natural background radiation and the radiation from medical and diagnostic radiology.
    Dr. Summerskill: In view of the figures given by my hon. Friend and those given in Question No. 50 will the right hon. and learned Gentleman consider including in the OFFICIAL REPORT the latest statement from his advisers on the subject?
    Mr. Walker-Smith: I will certainly pay attention to what the right hon. Lady has said, but I might be in trouble with you, Mr. Speaker, if I anticipate my Answer to Question No. 50

    HOSPITALS

      Maternity Beds, Swindon
      Mr. F. Noel-Bakerasked the Minister of Health what further provision of maternity beds has been made in Swindon; and when such beds will be available at the Princess Margaret Hospital.
      Miss Pitt: The Oxford Regional Board intends to provide a maternity unit in the third stage of the new Princess Margaret Hospital and the present proposal is to have a unit of fifty-eight beds. Work is expected to start on the second stage early next year, but I am unable to say when work on the third stage will start.
      Mr. Noel-Baker: Is the Parliamentary Secretary aware that her Answer will give rise to great misgivings in my constituency? Will she refresh her memory by looking at the OFFICIAL REPORT for 29th October, where she will see that during an Adjournment debate she promised that she would look into the whole question which I had raised? I am still waiting to hear from the hon. Lady on the subject.
      Miss Pitt: I remember that Adjournment debate and my promise. A letter to the hon. Gentleman was in draft at the time when he put down his Parliamentary Question, and I will write to him in full. In the meantime may I say, as the hon. Gentleman himself confirmed in that debate, that twenty additional beds are available in the Royal Air Force hospital in his constituency.

    SIR WINSTON CHURCHILL (85th BIRTHDAY)
    Mr. Hugh Gaitskell: I hope that it will be in order, Mr. Speaker, if I offer to the right hon. Gentleman the Member for Woodford (Sir W. Churchill) our warm congratulations and best wishes and affectionate greetings on his eighty-fifth birthday.
    The Secretary of State for the Home Department (Mr. R. A. Butler): May I support the Leader of the Opposition, Sir, and, on behalf of the whole House, including the right hon. Gentleman and his hon. Friends, offer our most heartfelt good wishes to my right hon. Friend?
    Sir Winston Churchill: May I say that I most gratefully and eagerly accept both forms of compliment.

ORDERS OF THE DAY

  PROFESSIONS SUPPLEMENTARY TO MEDICINE BILL
  Order for Second Reading read.
  3.32 p.m.
  The Minister of Health (Mr. Derek Walker-Smith): I beg to move, That the Bill be now read a Second time.
  In its own context, this is an important Bill. It is not, of course, a Bill of the stature or social significance of the Mental Health Act, which I had the privilege to commend to the House earlier in the year, and, fortunately, I shall not need 70 minutes to explain it, as I did on the occasion of the introduction of the other legislation.
  This is an important Bill in its own sphere; it will probably affect at least 30,000 people. It is also important in the general development of professional status and standards. Parliament has several times interested itself in providing an appropriate professional structure for callings which, in their diverse ways, contribute to the well-being of the nation. For example, arrangements have been made in respect of doctors by medical Acts from 1858 onwards, and last year we celebrated the centenary of the General Medical Council.
  With chemists, the process started even earlier with Pharmacy Acts from 1852 onwards. There have been Dentists Acts from 1878 onwards, the most important being in 1921 and the most recent in 1956. The Midwives Acts date from 1902 onwards and the Nurses Acts from 1919 onwards. The most recent was the Opticians Act of last year, due to the enterprising initiative of my hon. Friend the Member for Wembley, South (Mr. Russell).
  The examples which I have given are drawn from the health field, but there are others. For example, there are the Acts relating to architects in 1931 and 1938. I recall that in connection with the 1938 Act my father played some part. All this represents a massive contribution to diverse professions extending over the years. Now, in this Bill, we are doing it on an unprecedented scale, for eight professions at once. They are all making a distinctive contribution, but they are making it in the same general

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  sphere, of the promotion of health. These are not old-established callings, but their techniques have advanced and the scope of their activity has expanded significantly in recent years.
  Perhaps the best known of these bodies, though not the most numerous, are the chiropodists. Their services are in big demand, and I was glad to be able to say, last March, that I was now able to approve schemes under Section 28 of the National Health Service Act in respect of chiropody. Dieticians are a small but useful body of people. Medical laboratory technicians work under the direction of pathologists. They are employed in the National Health Service laboratories and also in the National Blood Transfusion Service and in the Public Health Laboratory Service.
  Occupational therapists are concerned with furthering recovery from disease or injury by recreational activity or work, including craft work, the activities of daily living and graduated industrial work. Physiotherapists are the most numerous of the eight and do valuable and important work, both in the hospitals and in rehabilitation centres. They treat disease and injury by means of massage and exercise and also by electro-therapy.
  Radiographers are also a fairly numerous body, doing useful work, both of diagnostic and of therapeutic radiography. The latter involves treatment of patients by means of X-rays, radium or radioactive isotopes, in which the radiographer assists the radio-therapist or gives the treatment prescribed by him, under his supervision. The remaining two categories—remedial gymnasts and speech therapists—are relatively small, though the attitude of the latter is not as yet finally decided, but both make a useful contribution in their respective spheres.
  The fact that there are eight professions, not linked in any common organisation, is one reason why it has taken rather long to bring the Bill before Parliament. It was better to wait for a Bill which represents the highest common factor of agreement and fairness to all than to have rushed forward with a Bill founded on less deliberate preparation, a less thorough examination of points of view and a less patient effort to promote agreement. Short cuts in such
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  matters may lead later to difficulty and dissension in the operation of the scheme.
  There is a further conflicting factor in this case. In most schemes of this sort there are, I suppose, three main interests to be borne in mind. There is the interest of the general public, as potential consumers, clients or patients, whatever it may be; secondly, there is the interest of the already qualified practitioner; and, thirdly, there is the interest of the practitioner without degree, certificate or the like, whose only qualification is his practical expertise. In these eight callings we have those three interests to consider, but we also have a fourth interest, as, indeed, the name of the Bill implies; we have, in this case, to consider the medical profession, because these are professions supplementary to medicine.
  Broadly, the position is that the doctor is responsible for the diagnosis of a patient's condition and for the prescription of appropriate treatment and the general supervision of that treatment. The members of the supplementary professions have specialised skills, gained from special training, in strictly limited parts of those fields, either in the performance of diagnostic tests or in carrying out particular forms of treatment. Such investigations or forms of treatment may, of course, form only a part of the general management of a particular case, and that general management must remain a medical responsibility, however completely parts of it may be delegated.
  These considerations—the number and the diversity of the professions and their relationship with medicine—have necessarily complicated the formulation of our scheme. We have, however, been at pains to evolve a structure at once carefully balanced and workable. It has involved some delicate legislative engineering but we believe that the end product is good, satisfying alike tests of fairness and practicality.
  Work has in fact been going on for a number of years. In 1951 the reports of the Cope Committees recommended that there should be a unified system of statutory registration. Subsequently a Working Party was set up to evolve a scheme acceptable to the supplementary professions. Both the Cope Committees under the distinguished chairmanship of

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  Sir Zachary Cope, as he now is, and the Working Party put in long periods of hard work resulting in valuable Reports, and I am sure that the House wishes to join in a warm tribute to their disinterested and useful labour.
  Professional status gives added honour, but carries enhanced responsibility. It involves adherence to general standards and submission to common procedures. It requires, to support it a scheme of registration. This, in turn, requires approved qualifications and approved courses and examinations in respect thereof, for those seeking to enter the profession; and it requires a code of conduct for observance by those practising the profession, together with disciplinary procedures to enforce it.
  All this the Bill provides for these eight professions, with the machinery to operate it. The right to use the title "State Registered" and the restriction of its use by those not so entitled, with the appropriate penalties for so doing is provided in Clause 6. We intend that the Bill should make it possible to distinguish people eligible for employment in the public service—health, welfare, school health and education—but I should like to make it clear that the Bill does not seek to ban the employment of other than registered people. The desired result can be achieved either by administrative means or by making regulations under existing powers, for example the powers in Section 66 of the National Health Service Act.
  Similarly, the Bill does not prohibit private practice by unregistered people but merely protects the title "State Registered". Most of the professions concerned do not, in fact, engage in private practice. There is not, across the whole field, uniformity in the matter of prohibition amongst professions, but these supplementary professions will, under the provisions of the Bill, be in the same position as the medical profession, in which an unregistered practitioner is prohibited from using certain titles, such as "doctor", but is not prohibited from practising medicine as such.
  I come, then, to the mechanics of registration. These are dealt with in Clause 2. The main burden of registration necessarily falls on the boards, of which there is to be one for each profession,
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  but certain functions also fall to the Council, which the Bill sets up to coordinate and supervise the work of the boards, and to the Privy Council, too. The functions of the Council and the boards are defined in Clause 1. Clause 1 (1) defines the general function of the Council and Clause 1 (2) defines the general function of the boards. Clause 1 (3) gives details of the general functions of the Council, broadly by way of advice, suggestion, recommendation and guidance. Its specific powers are set out later in the Bill. We feel that, by reason of its membership, the Council should be well adapted for its task of coordinating and supervising the work of the Boards and generally bringing a broad view to bear.
  In respect of registration, and the matters requisite for it and leading up to it, the Council and boards have defined and complementary functions. The Council, after consultation with all the boards, makes rules with regard to the form and keeping of the registers, the making of applications, the prescription of fees, and so on. These rules, however, under Clause 2 (3) are subject to confirmation by the Privy Council. This done, the board receives and considers the applications for registration, prepares and maintains the register—Clause 2 (1)—and arranges for its printing, publication and so on under Clause 2 (4).
  To achieve registration in the future, an aspirant will have to apply after the appropriate date to the board under the provisions of Clause 3 (1) and to satisfy the board that he has the appropriate qualifications set out therein. These will be broadly that he has attended an approved course of training and holds an approved qualification.
  There is also the important matter of who shall be entitled to admission to the register initially. The applicants entitled to this will be those who have, at the material date, one or other of the qualifications set out in Clause 3 (2). Such qualifications are, in effect, eligibility for employment in the National Health Service under the regulations of 1954, or an appropriate qualification accepted by the board, or a combination of a qualification and practical experience. An applicant who is refused initial admission to the register will have a right of appeal to the Council. That deals with initial registration.

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  A future registration will depend on attendance at approved courses at approved institutions and the attainment of approved qualifications. This is dealt with by Clause 4, which is the longest and most difficult Clause of the Bill. Clause 4 provides separate machinery for the approval, first, of institutions and, secondly, of courses of training and qualifications. Institutions can be approved by boards, subject to an appeal, in the case of refusal, to the Privy Council.
  Courses of training and qualifications are matters of major importance, because they provide, in effect, the basis of registration and entitlement thereto. The Council and the Privy Council, therefore, have vital parts to play, and the consent of the Privy Council is a necessary part of the machinery of approval and of withdrawing approval.
  Mr. Kenneth Robinson: Will the Minister give examples of other registration Bills under which the Privy Council has the same kind of powers of approval and appeal as under the Bill?
  Mr. Walker-Smith: Not in detail. I have here copies of some of the Acts which I have mentioned, but not all of them. The Privy Council has some part to play. For example, I think that I am right in saying that an appeal lies from the General Medical Council to the Privy Council in the case of a doctor struck off the register. It would be wrong to make an attempt at an "off-the-cuff" assessment of the exact part played by the Privy Council in these matters, but I will certainly bear in mind the hon. Member's interest in that aspect.
  I was about to deal with withdrawals of existing approvals. Since the withdrawal of an existing approval is a particularly serious matter, the machinery for it has to be somewhat complex. Our intention is that the matter of withdrawal should not be embarked on without proper cause and that the body or person from whom approval is proposed to be withdrawn should know in detail the case he has to answer.
  Coming to a little more detail, the procedure in the case of approvals of training courses and qualification, will
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  be this. The applicant—that is, the professional organisation applying for approval—will send the application to the board, which will send it together with its recommendations to the Council. The Council, in turn, will send it, together with its own recommendations, to the Privy Council which, after referring again to the applicant if it is minded to refuse, will determine the issue.
  Withdrawal of approval can, under the provisions of the Bill, stem from the initiative either of the board or the Council. If it is the board's initiative, it must refer to the Council. If it is the Council's initiative, it must consult with the board. In either case, it is for the Privy Council to decide if there is a prima facie case to proceed. If it so decides, it will afford an opportunity to the person or body concerned to submit representations and to comment on the observations of the board and the Council. It is the Privy Council which makes the final decision in this important question of the withdrawal of an existing approval. If it decides that there is not a prima facie case, the matter lapses.
  Having dealt with registration, I come to another matter to which I referred when I said, earlier, that one of the requisites of professional status is a code of conduct with disciplinary procedures to enforce it. The necessary safeguard of a disciplinary code and power to remove from the register is contained in Clauses 7 and 8. The mechanics of this comprise two committees under the provisions of Clause 7 (1), whose constitution and procedure are defined in the Second Schedule. The committees are committees of the board, but the rules regarding them require consultation with the Council and approval by the Privy Council.
  Lord Balniel: My right hon. and learned Friend said that the procedure of the investigating committee is laid down in the Second Schedule. Will he tell us where? I can find the procedure of the disciplinary committee, but not of the investigating committee.
  Mr. Walker-Smith: My hon. Friend is wrong, or more probably I am wrong, because if I said what he thinks I said I inadvertently misled him.
  The constitution of both bodies is provided in Part I of the Second Schedule.

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  The procedure of the disciplinary committee is set out in Part II of the Second Schedule. It is not necessary to have a statutory code for the functioning of the investigating committee. The procedure of the disciplinary committee includes various safeguards to assure the appropriate judicial requisites of a fair hearing, and so on. Paragraph 3 of the Second Schedule provides those necessary procedural safeguards to ensure a fair hearing—that is to say, the right to be heard and represented, normally in public session.
  Each committee will have a legal assessor, as provided for under paragraph 4 (1) of Part II of the Second Schedule. Under Clause 8 (3) an appeal will lie to the Judicial Committee of the Privy Council against "striking off". This, as I mentioned earlier, in answer to the hon. Member for St. Pancras, North (Mr. K. Robinson), is the same procedure as in the case of doctors dentists and opticians.
  I come now from the disciplinary code to the important question of the membership of these bodies. The membership of the Council is dealt with in Part I of the First Schedule and that of the boards in Part II of the same Schedule. Provision as to tenure, expenses and other ancillary matters is dealt with in Part III, the supplementary provisions.
  The Council is to have 23 members, composed in this way. Eight will be representatives of the supplementary professions—that is to say, one chosen by each of the eight boards. There will be eight medical practitioners and seven laymen, including a lay chairman.
  Appointing will be done in this way. Of the 23 members, the Privy Council will appoint four laymen, including the chairman. The Health Ministers will appoint two laymen and two doctors, and the Governor of Northern Ireland will appoint one layman. Employing authorities—that is, hospital authorities and local authorities in the context of their health, welfare and education functions—have a proper interest in the affairs of the supplementary professions. In making the appointments for which they are responsible, Ministers will have regard to the desirability of securing
  880
  the representation of the interests of employing authorities.
  On all the boards the supplementary professions will have a majority of one. Hon. Members can see that set out in a visually easy and graphic form in the table on page 16 in the First Schedule. They will see from the numbers listed in column 3 that in each case they represent a bare majority of the number given in column 2. This seems reasonable in view of the intimate concern of the boards with the affairs of the professions and their members. The minority—that is, those other than the supplementary professions—will consist of doctors, experts in professional education, and such additional specialists as are appropriate to the individual board.
  Dr. Barnett Stross: Have all these professions now agreed to the table and to inclusion in the scheme and the Bill? Most of us have been circularised by the speech therapists, who appear not to be willing to come in.
  Mr. Walker-Smith: The position of the speech therapists, as I indicated earlier when I referred to the work that they do, is still an open one. I have received an official letter from the Speech Therapists' Association asking that I should receive a deputation to discuss the suggestion that the Bill should not, after all, apply to them. The hon. Gentleman may have seen the letter in The Times this morning setting out certain views, but he will also perhaps have seen the comment in The Times' leader that there seems to be no conflict between statutory registration, on the one hand, and these appropriate academic courses, and so on, on the other.
  That is a view which might well commend itself, and I hope that in the event the speech therapists will themselves agree with the editor of The Times that there is no such conflict and will remain in the Bill, where they are at present. I do not think that I can comment further on it now, having received that letter from them.
  So far as the other professions are concerned, the representatives of the supplementary professions met together at the Ministry last week, a reasonable interval after the publication of the Bill, and they are substantially in agreement with it.

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  The medical profession, as the hon. Gentleman may know, took the view that there should be either equality of representation between doctors and the supplementary professions on the boards, or that the Council should have over-riding powers.
  As the hon. Gentleman will see from the Bill, I have not been able to meet either of those requests; but, on the other hand, I have strengthened the provisions in the Bill relating to the Privy Council, which, I think, should in another way meet the points that the medical profession has in mind. I am encouraged by a perusal of the leader in the British Medical Journal this week which, while still taking those points, does accord quite a warm welcome in principle to the Bill.
  Mr. Arthur Holt: I wish very much to ask the Minister's help about remedial gymnasts. Perhaps I am under a misapprehension in thinking that all those modern teachers of physical education deal with remedial work in the ordinary course of their duties. Are not remedial gymnasts a specialised branch of those who teach physical education and may not there be some conflict between the work of these two groups if remedial gymnasts are classified purely as a branch of the medical service?
  Mr. Walker-Smith: I do not think that the hon. Gentleman is quite right in what he is putting forward. All the professions with which we are dealing in the Bill were known formerly as "medical auxiliaries" and under that title they were inquired into by Sir Zachary Cope's Committee. They are supplementary to medicine, to use the contemporary term, in the sense in which I sought to describe their relationship with medicine.
  The Bill is not designed to interfere with the inherent relationship between medicine and these professions. Clearly, no Bill either could do that or should set out to do it. The Bill is concerned with giving proper professional status and all that goes with it, by way of added honour and also added responsibility, to these professions. If the hon. Gentleman is still in doubt, perhaps he would seek an occasion to amplify his point when we have proceeded a little further.
  Dame Irene Ward: Will my right hon. and learned Friend deal with what will happen if he is unable to persuade speech therapists to come into the Bill? Would not it alter the whole basis of the argument in the House today if there were to be someone going out of the group specially mentioned in the Bill? Will my right hon. and learned Friend deal with that before he reaches the end of his speech, but not at the moment?
  Mr. Walker-Smith: When it is possible, I always like to deal with my hon. Friend's points as soon as I can. I do not think that it would alter everything. My hon. Friend is quite right in saying that if they do withdraw from the Bill—if I may put it in that way—it will have certain consequential results on the membership of the boards and of the Council, but I do not think that that would be any basic detriment, because, my hon. Friend will see that in Clause 9 we make provision for changes, either by increase or by diminution, in the number of boards once the scheme is in operation and the Measure is on the Statute Book.
  That, of course, does not apply to the speech therapists. If they withdraw while the Bill is still going through the House, the convenient course would obviously be to amend the Bill both in relation to the specific references to speech therapists and to those consequential passages to which I have referred. That would be a decision for the the House to take. However, as I have said, I hope that on further consideration the speech therapists will decide to remain in the scheme and that we shall not need to make those amendments.
  Before those helpful interventions, I was dealing with the membership of these boards and of the Council, and perhaps I should add that there are special arrangements in the Bill both to provide alternate members for the representatives of the supplementary professions and to deal with the transitional period before the registers are established. Alternate representation is important to the supplementary professions, whose individual members may well be prevented from time to time from attending because of, for instance, hospital duties, and they are, naturally,

  883
  anxious that their representation should not be jeopardised by any personal difficulties of that sort. Before the registers are established, the representatives of the supplementary professions will normally be elected by the registered members of the profession, but, in the transitional period, they will have a special arrangement.
  It is right that I should refer to the medical interest in this matter. While it seems right that the supplementary professions should be in a small majority on the boards, for the reasons I have given, special consideration has been given to the position of the medical profession in view of its great interest in the training of the supplementary professions whose members assist in diagnosis and treatment. The Bill gives the medical profession a better position than that which it normally now has. At present, it is a purely informal one, in the sense that it has no statutory basis, and doctors are often weaker numerically on bodies dealing with educational matters than they will be on these boards.
  I ought to make some reference to the financial position. Clause 2 (3) gives the Council power to prescribe registration fees, after consultation with the boards and subject to the approval of the Privy Council. Paragraph 17 of the First Schedule puts the financial aspect mainly in the hands of the Council. There will be a central secretariat, serving all nine bodies, to be appointed by the Council.
  Not only is this administratively convenient, but it is economically advantageous that these matters should be dealt with centrally rather than by each body piecemeal. Economy is important in this connection as, indeed, it is in most contexts, because although, as a professional scheme, this must be self-supporting we are anxious that the fee should not be too high—an anxiety, I may say, fully, and perhaps principally, shared by members of the professions themselves.
  In answer to my hon. Friend the Member for Tynemouth (Dame Irene Ward), I referred to Clause 9. The House will see that although the Bill sets up machinery for the professions listed in Clause 1 the position is not thereby frozen, because Clause 9 makes it pos-
  884
  sible for the application of this Measure to be extended—or, indeed, restricted, if need be—by order of the Privy Council on the initiative of the Council. This provides, for example, for the possibility that a new profession might develop sufficiently to merit registration, and also covers the possibility of the amalgamation of any two of the professions at present listed, thereby reducing the number of boards required.
  I have dealt with the various activities, and the part to be played by a Privy Council in this procedure, so I need refer only briefly to Clauses 10 and 11. Clause 10 gives default powers to the Privy Council. This, of course, is common form, but I do not envisage the probability that these powers will, in fact, ever have to be used.
  I think that I have given a sufficient, but, I hope, not too tediously long, explanation of the purposes and provisions of the Bill. It is a Measure that serves a useful purpose, and one that we hope will give a good deal of satisfaction to those primarily concerned. I do not think that it is a Bill that invites party difference, but that, I know, does not mean that it is necessarily and in all respects a non-contentious Measure. Indeed, I have enough experience of such Bills to know that they often give rise to keen debate on differences of views sincerely and often strongly held.
  It is certainly my view that the Government should pay full attention to the views expressed in Committee, and should seek to strengthen and improve the Bill by incorporating all suggestions, from whatever quarter, that will have that effect. I think that I have given some practical evidence of this approach in two long and complex Measures—on the Mental Health Bill during the last Session of the last Parliament, and on the Copyright Bill, in 1956—in both of which, I remember, I had the constructive and sometimes critical help of the hon. Gentleman the Member for St. Pancras, North,
  I do not anticipate a Committee stage on this Bill of more than a fraction of the length of the Committee proceedings on the two Bills that I have just mentioned, but I shall certainly approach my task in this case in the same spirit as I did then. I would just add that the Bill as we now have it represents the highest

  885
  common factor of what is appropriate and acceptable, worked out after close consultation and long endeavour. I hope, therefore, that hon. Members will recognise that, and will, after the appropriate scrutiny that it is their duty to give to the Bill, agree to its main essentials in the form in which I now commend it.
  4 15 p.m.
  Dr. Edith Summerskill: It has been said on many occasions in the House that the House of Commons is at its best when discussing social Measures. I think that we can include this Bill as an important social Measure, and I thank the Minister for going into considerable detail and explaining some of what I might call the cumbersome machinery that it has been thought necessary to inject into this piece of legislation. The Minister will probably agree with me when I say that any Amendments relating to administration are suitable for discussion in Committee, so I propose to postpone to that stage anything that I have to say on detailed Amendments.
  The right hon. and learned Gentleman reminded the House of legislation for the registration of other professions and supplementary professions. Although this is a short Bill, it is a significant one, because it will always represent a landmark in the progress of medicine. While we pride ourselves on our scientific advances and our increased expectation of life, we sometimes fail to recall that doctors themselves were only registered under the Medical Acts of 1858 to 1886.
  In his opening remarks, the Minister recalled the part that his father had played in the framing of those Acts. My father was one of the first to be registered under them. Indeed, his first assistantship as a registered doctor followed on an unqualified practitioner who, besides making the pills and doing a little medicine, drove the coach and went to see how the confinement was progressing.
  Then came the Medical Registration Acts. Later, midwives and nurses were registered, and it was, I think, in 1924 that the unqualified woman was finally prohibited from conducting a confinement and we said "goodbye" to the
  886
  Mrs. Gamp. I suppose that it is impossible to estimate how many lives have been lost or shortened by the ministrations of the well-meaning but unqualified dabbler in medicine who was free to practise in a chosen field without adequate training and control.
  Although we now propose to register eight professions supplementary to medicine, the unqualified practitioner will still be allowed to practise. However, the Minister will probably agree that our experience in this respect is that when State registration is established those who are anxious to enter into one of these professions aspire to be State registered, and the unqualified man or woman gradually disappears.
  The Bill also emphasises the diagnostic and therapeutic advance in medicine which calls for increasing specialisation in more and more limited fields. There is a tendency for members of the public sometimes to become a little irritated with the number of examinations that have to be undergone when their doctor suspects that they are suffering from a certain condition. The fact is that in medicine today more and more specialisation is being introduced. That is a mark of our progress, and I have no doubt that there will be more of these professions subject to the provisions of the Bill.
  According to the Reports of the Committees on Medical Auxiliaries set up in 1949 under the chairmanship of the gentleman who was then Mr. Zachary Cope, all the professions then concerned accepted statutory registration as a desirable objective, and I feel quite sure that, despite the speech therapists whom we shall also probably discuss in Committee, all those engaged in these professions recognise that a State-registered qualification is the only way to avoid confusion and danger caused by large numbers of people professing to have some kind of qualification to practise.
  I do not want to digress, but I only wish that we could somehow control drugs, or those who prescribe them, by means of a Bill like this. It is very necessary to protect the public. Medicine is progressing. New drugs, new methods of diagnosis and new approaches to therapeutics are almost daily being discovered, and it is more than necessary

  887
  to protect the public who have no means of evaluating the training or the skill of any individual.
  It seems that so far as the broad principles are concerned, seven of the professions accept the Bill. The exception of the speech therapists I will leave to my hon. Friend the Member for St. Pancras, North (Mr. K. Robinson) to deal with later. I have a letter from Professor Court on this subject. The speech therapists brought a deputation whom my hon. Friend saw, and I am sure that he will raise the matter. No doubt, hon. Members in all quarters of the House saw in The Times a letter which went into some detail on this subject.
  May I say, in parenthesis, to the Minister that he knows this question has dragged on for years, and I was a little surprised and very disappointed that he gave us only a week between the presentation and the Second Reading of the Bill. Some of us who have had engagements over two weekends have found ourselves literally with only five days in which to study the Bill, and these excellent people, quite understandably, wanted to see us and bring their deputations. They wanted also to discuss with their members before they came to see us. It is difficult to understand why the time has been so limited. I ask the right hon. and learned Gentleman, when the Committee stage comes along, to be a little kinder and to give us a little more time in which to consider the details of the Bill.
  I wish to grasp a nettle which the Minister has failed to grasp. I must confess that, having been a Minister myself, I would have adopted a different approach and grasped this nettle strongly, because it is very important. The fact is that the strongest objections to this Measure come from the British Medical Association. I understand that these objections have been conveyed to the Minister and to the organisations of the professions represented in the Bill. As this is a Government Measure, with a powerful majority prepared to go into the Lobby to support it, objections to the Bill from whatever source could be totally disregarded and the Bill put on the Statute Book. However, it would not be in the traditions
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  of this House or in the best interests of the professions concerned if we did not carefully examine the opposition coming from representatives of the medical profession.
  As I have said, these negotiations with the medical profession and with these other professions which are mentioned have been going on for a long period. It appeared at one time as though all the difficulties had been resolved. However, there seems to be a change of heart by the British Medical Association at the eleventh hour, and a change of heart on a fundamental principle. I feel that this calls for some clarification when the hon. Lady the Parliamentary Secretary winds up the debate. The Minister, to my surprise, treated it a little lightly in saying that he thought, in view of the article in the British Medical Journal last week, that the British Medical Association was now placated.
  I have received a communication from the spokesman of the British Medical Association and I think I should read it, at the risk of boring the House, because it does not convey to me what the Minister has endeavoured to convey to the House. The letter says:
  "We are very disturbed to find that the constitution of the Council and boards proposed in the First Schedule is quite contrary to the carefully considered advice given by the medical profession. In the individual boards the supplementary professions have an overall majority. In the Council the supplementary professions have parity with the medical profession and even a majority of one should the General Medical Council representative not be a doctor. In the vast majority of cases the members of the supplementary professions work in association with medical practitioners. The General Medical Council permits such association subject to the guidance of paragraph 5 d (3) of the Notice of its Disciplinary Committee:
  '… provided that the medical practitioner concerned exercises effective supervision over any person so employed and retains personal responsibility for the treatment of the patient.'
  Thus the doctor must bear responsibility for the actions of these members of the supplementary professions. Yet in this Bill the medical profession may well be denied the last word in deciding standards of education and professional conduct of these same people. The position could in our view become dangerous for all concerned, especially the patient, and calls for profound alteration of the terms of the Bill."

  889
  I consider this to be very strong language which cannot be lightly dismissed.
  Furthermore, the British Medical Journal, on 28th November, in an article on registering medical auxiliaries, stated:
  "The medical profession is right to claim that professions supplementary to it should remain under its wing, because the ultimate responsibility for treatment must lie with the doctor."
  Having given the opinion of the British Medical Association I would say to their spokesman that there, in the British Medical Journal of this week, is the fallacy. The Bill does not deal with treatment. It deals only with the task of promoting high standards of education and conduct. From the point of view of the treatment of the patient, the relationship between the conscientious doctor and his colleagues working in one or other of these fields will not change. The regional hospital boards, the hospital management committees, even the house committees, exercise the greatest vigilance over the relationship of the staff and the treatment offered. Apart from the high sense of duty of those who work in the field of medicine, it must not be forgotten that the patient also has powers which he can invoke if he believes that he has not been given proper care and attention.
  It is implied in the article in the British Medical Journal that, unless doctors predominate on the registering bodies, the standard of work will deteriorate. Hon. Members generally attend health debates and have considerable knowledge of hospitals and the world of medicine, either from their own professional experience or from the experience that they have gained from administration, and I would say to them: does any radiologist believe that a radiographer would be less conscientious in her work if she were given the right to determine the educational and ethical standards of her profession? I cannot believe that she would.
  The control which is now demanded by certain representatives of the British Medical Association cannot reflect the opinion of all fair-minded doctors who work in harmony with these other professions. Indeed, the original Report on which the Bill is based proved this. The Zachary Cope Committee presented a
  890
  majority and a minority Report, and in both it is recommended that medical auxiliary members should be in a majority on the professional committees. This, perhaps, might have been disregarded if the medical profession had not been represented or consulted, but it had a distinguished surgeon in Mr. Cope—now Sir Zachary Cope—as the chairman, and doctors were represented on every one of those committees.
  It certainly took plenty of time to consider the aspects which the British Medical Association presents in its protest. The Committee was set up in May, 1949, and reported in April, 1951, and eight years have now elapsed before we have this Bill before us. I believe that the Minister, last March—and, again, perhaps the hon. Lady will tell us more about this when she winds up the debate—heard the opinion of the joint consultants' committee with representatives of certain specialised medical associations. I should like to hear whether the Committee reiterated what it said previously, or whether this year it adopted an entirely different attitude.
  I ask this question because, five years after the Cope Committee had reported, in 1956 the association of the professions mentioned in this Bill were given permission to publish the provisional scheme for the statutory registration of professions supplementary to medicine. The composition of the co-ordinating Council and the registration boards was explained in the various journals, and this was all known, no doubt, to the right hon. and learned Gentleman's Department. Of course permission was given to these professions to give this publicity in their journals. It appears that, after the professions had agreed on what was thought to be the final draft, they have now been asked by the right hon. and learned Gentleman to consider one of two proposals put forward by the British Medical Association.
  I have here the proposal that was circulated by the Joint Council of the Associations of Occupational Therapists of Great Britain. After all these discussions for years, the Minister asked them to put to their members these proposals:
  "That the number of medical members on each Registration Board should be equal to the number of members of the Supplementary profession concerned, and that each Board should have an independent lay chairman; or

  891
  That the Co-ordinating Council would be given overriding powers in relation to the Registration Boards."
  Those professional bodies which have had time to communicate with me are extremely disappointed, after all these years of negotiation, to be asked to reverse a previous decision.
  The Minister explained in detail the purposes of the Bill, and has made it clear that he proposes to go forward with it, but, in the profession of medicine, it is extremely important that there should be harmonious relations. With this history, which I have tried to abbreviate, it is unfortunate that suspicions should now have been injected into the minds of members of these professions. I think that this is a time—because HANSARD will be very well read tomorrow—when the Minister and the Parliamentary Secretary should endeavour to remove all these suspicions, and, indeed, should endeavour to explain to the British Medical Association why its fears are unfounded.
  For instance, this question should be posed to the British Medical Association from this House. Would it suggest that doctors should control the nursing profession? Of course not. Has it even been suggested that the nursing of patients suffers because of a lack of control of nurses by the doctors outside the wards, so far as their ethical code and their education are concerned? If nurses are fitted to make decisions concerning the conduct of their profession, are not radiologists, occupational therapists and others, who work so closely with the nurses?
  May I now deal with some of the fears of the doctors about the composition of the boards, having myself served on a number of committees on which are represented various groups with some interests in common. I have observed that there is no guarantee that these individuals will act in concert when a vote has to be given. The doctors need have no fear that the representatives of these different professions with such differing functions—the laboratory technicians, the chiropodists and the occupational therapists—will necessarily conspire together. On the contrary, they may have entirely different approaches to their problems.
  892
  Furthermore, in the composition of the Council, it seems to me that the eight doctors on the Council will tend to vote together, but on a serious matter of principle they will have the support of the persons appointed by the Privy Council and the Ministry. I cannot believe that these representatives will give their votes without very careful consideration of whatever principle is involved.
  Having given this matter very careful consideration, having examined the objections—and I am very glad to have had the opportunity of ventilating those objections—I believe that it is right for my right hon. and hon. Friends to support this Bill. The professional bodies mentioned in the Bill should be given the right and the responsibility which goes with it to decide matters closely affecting their professional lives. I should like any hon. Members who entertain any doubts about the capacity of these men and women to control their own affairs to examine the syllabus of their training. I have found that many of these people, formerly known as medical auxiliaries, have a true vocation and a deep interest in medical matters. On further inquiry, one often elicits the information that only limited financial resources have denied them an opportunity of studying medicine.
  In my day—and hon. Members on both sides of the House who are members of the medical profession will agree—parents had to be prepared to spend a fairly large capital sum before they could allow one of their children to enter a medical school, but here, in these auxiliary professions, we sometimes find people who are more dedicated to medicine than even the doctor who went into medicine because his parents were able to afford a medical education. It is true that a doctor has a more extensive education, which takes a longer time, but, because of that, doctors cannot claim a moral superiority. The doctor with a superior education is not necessarily a more worthy person. His liability to err, as we often see in our newspapers, is not known to be any less than that of those people who are devoting themselves to these auxiliary tasks.
  I believe that the fears which have been expressed by the British Medical Association are unfounded and that we look forward to the medical profession giving a helping hand to the men and

  893
  women in the younger professions—the people whose skill and industry are so helpful to the doctors and so beneficial to the public.
  4.39 p.m.
  Sir Hugh Linstead: I have taken part in many health debates in the House in which the right hon. Lady the Member for Warrington (Dr. Summerskill) has also participated, and it is, to me, a particular pleasure to find an occasion when, at long last, I can endorse wholeheartedly every word that she has spoken. I only wish that her eloquence today could have been mine.
  The professions which are concerned in the Bill rather rapidly formed themselves into a committee in the hope that they could deal with these things together, and I had the honour of acting as chairman of that committee. I think that I can say, on behalf of all of them, to my right hon. and learned friend that they thank him very warmly for the way in which he has been able, after a good many months of very complicated negotiations, to meet their point of view and to give them what I believe to be an excellent hope of development in the future.
  It is a pity that there are three doubts connected with the Bill, one being related to the position of the speech therapists, another being about the attitude of the British Medical Association towards the Bill, and a third being concerned with finance, which, I know, still causes concern in the minds of members of the professions.
  Before I come to those three matters, I wish to refer to the position which the Privy Council and the Judicial Committee of the Privy Council are given under the Bill. It is, I think, particularly valuable that the Privy Council, which has gathered under its wing over several centuries the professions incorporated by Royal Charter, should now take under its wing these professional people who are just reaching statutory standing.
  I notice that there is, in Clause 11 (1), a provision—my right hon. and learned Friend did not refer to it—which lays down that the quorum of the Privy Council shall be two. I suspect that that is probably my right hon. and learned Friend and the Secretary of State for Scotland. But, at any rate, they will be wearing their top hats; in
  894
  other words, when they are acting as the Privy Council for the purposes of this Bill, they will be a little divorced from the day-to-day Departmental hurly-burly in which they decide things as Departmental Ministers. I am very glad that, even with that slight nuance, which, perhaps, not everyone has yet noticed, it is the Privy Council and not Departmental Ministers who are to be concerned here.
  The hon. Member for St. Pancras, North (Mr. K. Robinson) was justified in raising a question about the very substantial powers which the Privy Council is given. They are quite unusual. Like my right hon. and learned Friend, I have not had an opportunity of looking back over other registration Measures, but I have the impression that nowhere will we find such heavy additional powers, nor will find so many matters reserved for the approval or disapproval of the Privy Council. Nevertheless, when one considers that we have brought together in this Bill a substantial number of professions, not all yet at the same level of development, it is probably wise that the Privy Council should have a general co-ordinating power over and above that of the proposed Council. One expects that those powers will never need to be used, but they are there, and they are unusual.
  There are about 1,000 speech therapists today, and it is curious that, at the very last moment, a professional body of people, so far from asking for statutory registration, should actually be backing away from it. I am glad to hear the speech therapists have asked my right hon. and learned Friend whether he will meet them. I assume that, if a meeting can take place, a discussion will follow, completely free and without commitment on either side. I hardly think it possible to bring a profession within the ambit of the Bill against its will. It would be a grave error to try to find certain people who would serve on boards and councils against the wish of the bulk of the profession.
  Dr. Stross: The hon. Gentleman has said that there are about 1,000 speech therapists. Has he the up-to-date figures for those in the hospital service? In the Report which we have all studied it is said that, in 1950, there were 20 whole-time and 92 part-time.
  Sir H. Linstead: That is relevant to the next point I wish to make.
  If the speech therapists maintain their position, that will be, I am sure, because they regard the natural area for the great bulk of their work as being education rather than health. My understanding is that over 80 per cent. of speech therapists today act through the local education authorities, not within the hospitals or the National Health Service. In a sense, they have a good and logical ground for saying that they do not fit into the picture of which the Bill is part. Nevertheless, there is the opportunity for statutory registration. If they do not take it now, they could, conceivably, take is later on, under the provisions of the Bill, and I hope that they will find, when they meet my right hon. and learned Friend, that it is possible to reach an understanding with him.
  After what the right hon. Lady the Member for Warrington has just said about it, with which I entirely agree, there is very little I wish to add about the attitude of the British Medical Association. It is a very great pity that, on the one side, these auxiliary professions should have reached the stage when they could say, "If we are to have medical superiority on the boards, we are not going to work the Bill"—they took as extreme a view as that—while, on the other side, the British Medical Association should, in effect, have said, "This is a bad Bill because we have not a numerical majority."
  It seems to me that both these extreme points of view are really untenable. The Bill will work, if it is to work at all, not on the numerical basis but on the basis that doctors want to help the professions and the professions recognise only too well their position in relation to the medical profession. Neither extreme point of view is tenable.
  I am quite certain that my right hon. Friend is right here. We are trying to set these professions on their statutory feet and give them an opportunity to develop their own future. By and large, that can be done only if they feel that they are mistress in their own house, under the guidance of doctors but not under their direct control.
  The claim of the doctors to have responsibility for what is done by the members of the supplementary profes-
  896
  sions was entirely answered by what the right hon. Lady said. The analogy with the nursing profession does, I am sure, provide the final practical test. Nobody would suggest that nurses act otherwise than in accordance with the instructions of medical practitioners, but, equally, no one will concede that the work of the nursing profession suffers at all or is, indeed, other than advantaged by the fact that its registration and its examinations are controlled by the best members of the profession itself.
  The question of finance is causing much concern to the professions at the moment. They estimate that about 20,000 of their number will be registered under the Bill. My right hon. and learned Friend gave 30,000 as the figure. A sum of £2 10s. has been mentioned as the registration fee for the first year, the initial registration, and £2 for subsequent years. Those figures are regarded by the professions as being high, and what concerns them is that there is, apparently, no other way of financing the working of the whole scheme except by the fees which they will have to pay.
  In other words, they envisage, in theory at any rate, a limitless call upon the professions. They are not highly paid professions by any means. Each of the professions has its own professional association, and they are afraid that, if the registration fee is too high, the effect will be that members of the professions will seek to economise on their subscriptions to their own professional associations.
  It would be a very great loss if that happened, because nothing is so revivifying to the professional man as membership of a live professional association. We must, for example, think of the start of this scheme. There will, presumably, have to be an office building somewhere, and office buildings, and all that goes with them, are by no means cheap.
  I should like to ask my right hon. Friend why he did not accept the recommendation of the Cope Committee that the original cost of setting this machine on foot should be borne, if not by the National Health Service, by the Ministry. If that could be done, it might not be unreasonable for the professions to carry on the current expenditure year after year. I hope that when my hon. Friend the Parliamentary Secretary

  897
  replies she will say whether that recommendation can still be accepted and, in particular, whether the Minister has power to help if it becomes really necessary. Has he barred himself completely from giving a subsidy if the cost is found to be too high? After all, as Minister of Health, he has an interest in getting these professions on their feet.
  A small question which my hon. Friend may be able to answer is this: in the first year, does a practitioner have to pay a registration fee and a retention fee for that year? I think not, but there are those who hold a contrary view, saying that a person pays a fee to get on the register and immediately becomes liable for the retention fee for the first year of registration. It would be helpful if my hon. Friend could clear up that small point.
  I have only two further points, one of which I think is important. If my right hon. Friend would look at page 8 of the Bill he will see that by Clause 6 (1) we are giving the persons we are discussing entitlement to use the title
  "state registered chiropodist or state registered dietitian."
  The people concerned are very happy about that. Subsection (2) lays down descriptions that may not be used by people who are not registered. There is no prohibition clearly set out in Clause 6 (2) upon the use of the word "Registered" without the word "State." It is possible that that is caught under subsection (2, b) by a person pretending that his name is on a register established under the Act, but it is not by any means certain. It was interesting to note that my right hon. and learned Friend said that the scheme does not seek to ban from employment persons other than registered people. He used the phrase "registered people" because it came naturally to his tongue. I think that the word "registered" should be clearly and specifically barred from being used by those not registered under the Act.
  The other point to which I want to refer, perhaps a little lightheartedly, seeing that it is St. Andrew's Day, concerns paragraph 5 in Part II of the First Schedule. It will be seen that it is provided that there shall be at least one representative of Scotland and one of Wales on the Council and, I think, two representatives on the boards. There is
  898
  no provision for a representative of England. Surely it will be occasionally necessary for a representative of England to have a place on the Boards. What would happen on the Occupational Therapists Board if all the representative members came from the West Coast of Scotland, I shall leave my right hon. and learned Friend, in horror, to contemplate.
  Mr. George Lawson: Would not the hon. Gentleman agree that then English would be spoken as it should be spoken?
  Sir H. Linstead: Having listened to the hon. Member, I cannot agree.
  Finally, I should like to commend the Bill to the House and to thank and congratulate my right hon. and learned Friend on having brought it before us.
  4.55 p.m.
  Dr. Barnett Stross: I heartily agree with the fears of the hon. Member for Putney (Sir H. Linstead) about the lack of financial provision for assisting the setting up of a group of organisations ancillary to medicine. As the hon. Member rightly pointed out, 50s. for registration for the first year and 40s. for each and every other year is a fairly large sum for professional people whose salaries are rather mean, since the Ministry of Health is acknowledged not to pay very well. If the Minister will accept what was urged on him by the hon. Member, namely, that assistance should be given in setting up the organisation, I am sure that we on this side would agree wholeheartedly.
  The Bill, which we have had with us for only a short time, has given me an opportunity to read something which I had not read before, namely, the Cope Report. I am delighted to have had the opportunity of reading this Report, because I found it full of most interesting information, and was well worth while perusal. When I first looked at the Bill, I thought that it was a narrow, small Bill which would not evoke much interest in the House, that it was a piece of machinery for registering members of the profession and for regulating their educational and professional conduct.
  Having heard the Minister and my right hon. Friend the Member for Warrington (Dr. Summerskill), however, I accept completely that it is a triumph

  899
  to have brought these organisations together. I hope very much that none of them will secede but will stay under this vast umbrella, for reasons which I propose to give.
  I was shocked by something that the Minister said about dietitians. I took down his words. He referred to them as a small but useful group of workers. It is the word "useful" which I find objectionable, for this reason. The Minister, of all people, should be the greatest enthusiast for preventive medicine. If he wants to save the country money, and to preserve the nation's health, he must want to prevent disease, and, of course, dietitians and their knowledge, which is available in greater measure compared with pre-war years, are a very powerful therapeutic weapon. The right hon. Gentleman should give them great priority and not merely dispatch them as a small but useful body. I shall gladly give way to the right hon. and learned Gentleman if he wants to say that he did not wish to cast any aspersions upon this remarkable group of people.
  Mr. Walker-Smith: I certainly did not mean to cast any aspersions. After all, in the vocabulary of politics, with which we are all familiar here, we would take the description "a small but useful body" as being reasonably laudatory. I certainly think that they do valuable work. It is not a large body numerically and that is what I meant when I used the epithet "small". As I say, they do very valuable work, and I am grateful to the hon. Member for supplementing any deficiences of mine in giving them due recognition.
  Dr. Stross: On behalf of anyone who is dietetically interested, I am sure that that is a handsome reparation.
  As a rule, we in this House use carefully-controlled words. We are rather like the Royal Fine Art Commission, of whom it is said that a tepid criticism means that its members dislike a project lock, stock and barrel and do not want anything to do with it, as must be true about Piccadilly Circus, concerning which they made a tepid criticism which really meant that they could not bear the sight of the project.
  I will follow the Minister's tribute by quoting what was said about dieting a
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  little over 200 years ago by a famous Frenchman, Lemery. He said:
  "In the mean Time, if Foods contribute so necessarily, to the Preservation of Life and Health; they also produce the greatest Part of those Distempers, to which we are subject, and many Times, by the ill Use of them, cause even Death itself. All which being set together, we may easily see, that the Groundwork of our Preservation, consists chiefly in a knowledge of suiting Foods to every Constitution, as it best agrees with it; and so the Knowledge we ought to be most desirous of, should be that of Foods."
  Having made that quotation from an old authority, I will go on with my speech.
  In the machinery of the Bill, it is absolutely right that each of the professions should be, as they are now, represented on the Council. Originally, in the Cope Report, that was not to be the case and the professions with which we are dealing found it objectionable to be left out. The way that they behaved to each other in their discussions is interesting For example, the physiotherapists were a very large body; there were many thousands of them on the register and at study. The remedial gymnasts, on the other hand, were a tiny body. The physiotherapists said, "For the sake of unity, we will accept that they should have the same representation as we have, one representative for them and one for us."
  With that attitude and with that desire for unity, I again feel that it would be a great mistake for speech therapists to break away and not take advantage of what they may well get out of these proposals in more ways than one.
  Colonel Sir Malcolm Stoddart-Scott: The hon. Member spoke about the remedial gymnasts as being a tiny body. He did not say that they were a useful body, too.
  Dr. Stross: The hon. and gallant Member ought to know that I shall make a considered speech. I hope to discuss the question of remedial gymnasts in Athens and Rome in olden days and make comparison with our knowledge now and I hope that before I sit down, I shall have satisfied the hon. and gallant Member and the House.
  At the date of the Cope Report, in 1950, there were 200 remedial gymnasts and the figure for the physiotherapists,

  901
  including those at study and those in practice throughout the country, was roughly 13,000. This adds point to what I have said about the desire for unity. In an intervention, I have pointed out how few speech therapists there are in hospital practice. It is true that most of them find their work in the education departments of local authorities and this, I think, will always be so, but that is no reason why they should not come in with the other seven organisations.
  In the letter in The Times this morning, which we have all read, and which is signed by Muriel Morley, lecturer in speech pathology, Donald Court, and so on, all eminent people, there are one or two sentences which I must quote, because behind their feeling of disagreement this may be playing an important part. They write of their organisation that it has maintained a high standard
  "in spite of the failure of the Whitley Council to give adequate recognition to the status and responsibilities of the profession—an indifference reflected in a salary scale from £455 to £815 per annum. This inadequate remuneration excludes men in this country from entering the profession, induces many speech therapists to seek employment oversea, and creates a serious problem of understaffing for many education authorities and hospitals."
  If this be true—and I am sure it is—I would have thought that this was an added reason for them coming in and accepting State registration with all the additional power that it would give them; for it will have been noticed that whenever the affairs of one of these organisations is to be considered, it will not only be their one representative on the Council who will be present, but two others may be brought in without voting power on to the Council while discussion takes place. Surely, therefore, the very argument in the letter which I have quoted is a good reason why they should come in.
  In the letter and the circular that we have had from the speech therapists, they speak of the fact that there is not by any means complete knowledge about speech mechanism, that a good deal of physiological and pathological work must be done at the universities and that they are looking forward if we leave them alone and do not ask them to come in, to having diploma and, I suppose, later, degree courses in speech therapy. Why not?
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  There again, the article in The Times—not the letter but the leader—is quite right. The speech therapists can do all this and still have State registration and do nothing but gain by it. If, however, as a last resort, they refuse, we cannot help it. They will be free if they insist upon it. I can only say that I hope they will listen to what some of us in this House are saying and to what we shall say in Committee and realise that they can do nothing but gain. We cannot see how they could possibly lose.
  Concerning the medical practitioners, I listened with great care to my right hon. Friend the Member for Warrington. I am sure that she is right. I was interested that the hon. Member for Putney agreed with her, too, and I am glad he did. I do not give second place to anyone in my pride in the profession in which I was trained and practised for so many years. If, however, there is one thing that can do us harm in the profession, it would be to make excessive demands upon organisations similar to our own who, according to the Cope Report, must have a high standard of education before they are allowed to start training and who, before they are allowed to begin, must have two or three gruelling years and then only get their full registration after further years of practice. At the end of it, radiographers, for example, will start at £10 a week, after many years when they have a senior position they may get £14 a week and, perhaps, they will never be able to reach £1,000 a year.
  We in the medical profession must be a little careful. In any case, my right hon. Friend was absolutely right when she asked what there was to be afraid of. On the Council, there is to be parity and after parity the Privy Council is to be responsible for four nominations, the different Ministries for two and the Governor of Northern Ireland for one. So there are eight medical and seven non-medical members. I cannot imagine the rest not being influenced by these learned medical men and women who will be sitting and advising on the medical aspects whether of education or of ethical conduct.
  I think that the Minister has gone as far as he need or should go in this matter, and I would strongly support him. I think that it is well known, from the fifteen years I have been in this House, that I have always supported my

  903
  own profession. I have always thought most highly of it, and I am very proud that I was ever allowed to train in it, but I think that in this case something has gone wrong in its thinking. I think that it is mistaken, just as, on the other hand, I think that the speech therapists are entirely mistaken in taking exactly the opposite lines. They say they will not come in at all unless they have absolute autonomy.
  Both sides in this matter seem to be wrong. After all, the Privy Council is just as likely to think of the interests of the patients as doctors are, and really it is the patients we are talking about here, for this Bill is a piece of machinery to assist patients through all time wherever they need it.
  When we look at this list of professions we have to be honest with ourselves and ask, "How much do they owe to medicine pure in their own evolution?" The Minister said they are not very old. I think that he said that the chiropodists were the oldest.
  Mr. Walker-Smith: I said that they were the best known.
  Dr. Stross: Yes, the best known. They are the best known and have been established a long time. I think that they started in the eighteenth century in separate practice.
  The dietitians, I think, evolved originally without a tremendous amount of assistance from medical practitioners as such. The work of dietitians depended, I think, in the main, upon a handful of devoted and skilled physiologists, both medically trained and non-medically trained, and chemists. It is a quite recent science. The old world knew a good deal about nutrition, but knew it only through practice, through trial and error, rather than by scientific method. Yes, apart from chiropodists, the remainder of the others are less than a century old.
  I was asked a question about remedial gymnastics, and I think that I have got to say that any physician in Rome 2,000 years ago knew much more about it than any practising medical practitioner does today—any medical man practising as a general practitioner. For obvious reasons. We know they used them extensively and that they had very great experience.
  904
  As for the dietitians, there is a note on page 49 of the Cope Report which is extremely interesting. It says:
  "Even as recently as 1939 it was the usual practice in hospitals to provide for patients but one full meal each day."
  I know that this is true. My right hon. and learned Friend knows it is true. For breakfast and supper patients who could afford it arranged for eggs, butter and fruit to be brought in. There was one full meal each day, and for it there was bread and tea, or bread and jam and scrape—for supper and breakfast; and if one wanted additional things one had to have them brought in. That was as late as 1939 and yet by 1950, the Minister knows, we had only 134 whole-time and five part-time dietitians in the National Health Service.
  This is an extraordinary thing, and this accounts for my outburst at the beginning of my speech because the Minister used, I thought, a rather patronising term about the dietitians, although he has given them an amende honorable already. Compare diet and the way we treated people in hospitals before 1939 or in 1939 with the way they were treated hundreds of years ago in Britain. I have looked up the sort of diets they had in St. Bartholomew's in 1550, quite a long time ago. I found out only today in whose reign that was. I asked in the Library. Nobody knew. We had all to look it up together.
  Mr. Walker-Smith: Edward VI.
  Dr. Stross: It was Edward VIth's. [HON. MEMBERS: "Hear, hear."] I am not taking any credit. I thought that it was in the early days of Elizabeth I. I was wrong. In the accounts for 1550 at St. Bartholomew's they ordered meat, salt fish, cheese, beer, bread, pork, mutton, ribs of beef, barrels of herring both salted and pickled This was regularly the central part of the diet. The annual accounts at Christ's Hospital show that in or about the same year they were ordering mutton and beef, whiting and plaice, herring and other fish, and, of course, beer.
  Mr. Brian Harrison: Would the hon. Gentleman tell us whether, from his researches, he has discovered whether all this was for the doctors and staff, or for the patients?
  Dr. Stross: I can assure the hon. Gentleman, in answer to his most important question, that it could not have been for the doctors, because in January, 1554, Christ's Hospital ordered 154 gallons of milk at 3d. a gallon, and I am sure that the doctors drank beer rather than milk.
  So, all in all, we may take it that there was an attitude towards patients which was good in those days. There may have been wrong ideas about nutrition scientifically, but they certainly did their best for their patients in those days.
  May I, if I do not bore the House, and to keep the debate going a little, quote to the House what was said in 1797 by Sir Frederic Eden on this matter? He, in turn, was talking about the state of the poor. This is what was going on not at St. Bartholomew's or Christ's, but in a similar sort of institution. They called it a house of correction. It was rather similar in a way. It is really amazing to see how thoughtful and up to date people were. This was at a house of correction in Suffolk and the year was 1588. That is a date we all know. I think that it was that of the Armada.
  This was an order at that house of correction in 1558:
  "Item, It is ordered, that every person committed to the said house, shall have for theire dietts, theis portions of meate and drinke followinge, and not above, (viz). At every dynner and supper on the fleshe daies, bread made of rye, viij ounces troye waight, with a pynte of porredge, a quarter of a pound of fleshe, and a pinte of beare, the rate of iijs. a barrell, every barrell to conteyne xxxvj. gallands"—
  which, I presume, means "gallons"—
  "and on every fyshe daie at dynner and supper the like quantitie, made eyther of milk or pease or such lyke, and the thurd part of a pound of chese, or one good heringe, or twee white or redd, accordinge as the keper of the house shall thinke meete."
  Very good. It is interesting to see that people who did their work were to have extras in between meals, but if they did not work—it is quite obvious that we were all of us Socialists in those days, and they were great days—
  "It is ordered, that they which will not worke shall have noe allowance but bread and beare onley, untill they will conforme themselves to worke."
  It is very interesting. I hope that the Minister will be encouraged to see that more money is spent in hospitals on
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  food, particularly—and I think he has already done this in part—in the mental health service, where it is more important, I should imagine, to spend an extra few shillings each week on the diet of the patients.
  I know that I have mentioned beer twice already, but I have not said how much of it was given in hospitals. The Minister may think that they were extravagant in those days. It was three pints except on Sundays when an extra pint of strong beer was given, making four pints in all. I know very well that water was not considered a very safe drink in those days, and that is why they drank beer.
  As a young medical man I once had 200 beds under my care in a local hospital. Most of the patients were chronics. I could not do much for them, but I found that there was a plentiful stock of brandy in the cellars. Before I left that hospital there was not much brandy left. My patients received 2 fluid ozs. of brandy every night, and I was very popular with them.
  The Minister, of course, will accept from me that where preventive medicine is concerned—of the type about which I am speaking, how to nourish people and how to prevent disease by a suitable type of nutrition—we owe a great deal to the women of this country and, strangely enough, to the women's magazines who have made this thing popular, to American women who started it and to the handful of doctors and technicians who showed them the way. That is why we drink tomato juice and other fruit juices and why we have milk bars, although I suppose that we are now going over to coffeee bars.
  Up till recently slimming diets consisted of fruits and vegetables. These diets were far better than the wretched, miserable slimming drugs which are foisted on to people today. Some people think that they can take their appetites away and that they lose weight by swallowing certain types of pills. Slimming by that method is certainly not as safe as the act of slimming was ten years ago, when people went on good diets to slim. In Britain, we have learned our lesson on that score.
  I know that I am now going a little wide of the Bill, perhaps even on this subject, but it is interesting because we

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  are concerned with dietitians in the Bill. We have learned to control our appetities. We eat less than people did a century or two ago and we eat much more selectively. We stay young much longer. We do not need procaine to be injected into our muscles to rejuvenate ourselves. We do not dig our graves with our teeth, as our ancestors tended to do at one time.
  I have used this rather long illustration to show how much all of us, including the medical profession, owe to those non-medical experts who very often have paved the way. I welcome the Bill wholeheartedly. It will be most interesting to see if we can improve it in Committee. I do not know whether we shall, because it is a bit early to consider a Committee stage.
  As I said at the begininng of my speech, I hope that all these eight bodies will remain in the Council. I am delighted that the Minister has left the door open ultimately for others to come in.
  I would say, lastly, that we have made a great mistake in not recognising that the remuneration we are offering is insufficient. It is up to those organisations to accept State registration. If they did they would be much more vocal and would have much more influence.
  5.25 p.m.
  Lord Balniel: It is a great pleasure to follow the hon. Member for Stoke-on-Trent, Central (Dr. Stross), although I find it a little difficult to compete with him in references to the changes in diet. He may know, perhaps, that in Fife, the county from which I come, it was not so very long ago that the unofficial trade union of domestic servants insisted in their terms of contract that they should not be fed on salmon more than three times a week. I think that situation has changed.
  Dr. Stross: I think that was a very proper thing to strike about. It was not a wildcat strike. No one can eat salmon three times a week throughout the whole season without feeling sick.
  Lord Balniel: I wish to return more directly to the contents of the Bill. It is true that the controversy in Committee will centre around the point which the right hon. Lady the Member for Warrington (Dr. Summerskill) commented
  908
  upon and to which my right hon. and learned Friend referred—the composition of the professional boards and of the Council. I do not wish to comment on this matter in any detail except to say that I entirely agree with the right hon. Lady. It seems reasonable to me that if we are establishing professional boards and laying down codes of conduct for the professions the majority of members of those boards should be members of the professions themselves.
  Like my right hon. and learned Friend I agree with the contents of the Bill rather than with the views which have been expressed by the British Medical Council. I welcome the Bill. I do not wish to appear to be at all churlish in welcoming it, but, like the right hon. Lady, I think it slightly regrettable that only eleven days have elapsed between its publication and its Second Reading. After all, the Cope Committee reported in 1951. There has been a whole sequence of discussions behind the scenes leading up to the Bill.
  I can only think that, rather luckily, I do not have a very voluminous correspondence with speech therapists and remedial gymnasts. Indeed, in the eleven days which have elapsed I have not received a single communication from any of my constituents in these professions, who, in normal circumstances, would wish to communicate with me and who, I am quite sure, will do so before we reach the Committee stage.
  My hon. Friend the Member for Putney (Sir H. Linstead) said that three doubts had arisen in connection with the Bill. My doubts in connection with the Bill are not those which have been mentioned so far. My doubts arise in connection with the disciplinary provisions laid down in the Bill, and I hope that we may be able to dispel these doubts—perhaps my right hon. and learned Friend will be able to assuage the doubts or in winding up my hon. Friend will be able to do so—in the course of the Committee stage.
  Clause 7 lays down that each of the professional boards shall establish an investigating committee and also a disciplinary committee. My right hon. and learned Friend has clearly thought it necessary that originally these two committees should be separate in membership. Indeed, I think the whole House

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  would agree that there should be separate membership of these two committees. One of them virtually undertakes the work of the police force, a detective force, and the other corresponds to a judicial committee. It would be extremely undesirable if to all intents and purposes the police, the detective and the judiciary were all co-ordinated in one committee.
  My right hon. and learned Friend has laid it down that the membership of both committees shall be different. Of course, it looks very nice on paper, but, in practice, this differentiation in the composition of the two committees will be extremely vague and it will be extremely difficult to create a real differentiation in membership. Take, for instance, the example of the board of remedial gymnasts. This board is to be composed of eleven people. They will be people who will know each other professionally and who, professionally, will meet each other frequently. They will presumably meet as a board, say, once every month. They will meet socially extremely frequently. Out of this tiny number of eleven people have got to be set up two committees, one to do the investigating work and the other to act as the judicial body.
  It is really stretching the imagination a long way to assume that when they have a particularly lurid case to investigate, members of the investigating committee will not mention any of its contents to their close colleagues on the Remedial Gymnasts Board. Even if there is no gossip between the members of the two committees, I do not think that this complies with one of the basic if very hackneyed tenets of justice—that is should be not only done but patently seen to be done. I think that any practitioner summoned before the disciplinary committee will automatically assume that conversations have taken place between members of the investigating committee and members of the disciplinary committee.
  What are the powers of the investigating committee? I know that the Bill provides that rules will be laid down for the membership of the investigating committee. Rules will be made setting down die quorum and the times and places of meetings, and that kind of thing, but there is not a word in the Bill about the
  910
  procedure of the investigating committee, although a whole section is devoted in the Second Schedule to the procedure of the disciplinary committee. Not only is there no word about the investigating committee's procedure but there is no word about its powers. I hope that my hon. Friend the Parliamentary Secretary will refer to these powers when she winds up the debate. I hope that the investigating committee has no powers at all. If it has not, it will be merely a body of snoopers with no powers, unpleasant but quite harmless.
  Mr. Charles Doughty: When complaints are made to professional bodies, they are not examined by snoopers but by a small committee to find out whether there is a prima facie case. These people are not in any sense people who will investigate on their own initiative. It might be that members of the public lay a complaint and then the investigating committee inquires whether the complaint is sufficiently serious and in accordance with the truth to lay before a disciplinary committee. That committee then decides whether disciplinary action is required.
  Lord Balniel: To some extent, my hon. and learned Friend is making the point which I am trying to make, but I am not sure that this procedure is adopted by all other bodies.
  Mr. Doughty: In my profession the complaint is investigated by an investigating committee in the profession which, if necessary, will forward it to a disciplinary committee.
  Lord Balniel: I intended to refer to the law in a moment.
  Section 32 of the Medical Act, 1956, establishes a disciplinary committee. No investigating committee is established. I was trying to make the point that I hope that the investigating committees under this Bill will have no powers at all. If, for instance, they have powers to take statements from parties in dispute they are virtually inquisitorial committees which, to some extent, are conducting a trial of their own to establish whether there is a prima facie case to be answered. My own case is that this preliminary investigation and the actual adjudication should be conducted by one body only—the disciplinary committee.

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  Clause 8 (1, a) and (1, b) contain further disciplinary provisions—
  Mr. Walker-Smith: Before my noble Friend leaves that point, has he got in mind the provisions already contained in Section 37 of the Medical Act, 1956, which refers to the disciplinary committee making rules and in particular requiring that before any matters are referred to the committee
  "they shall, in such manner as may be provided by the rules, have been brought before and investigated by a committee of the General Council constituted in accordance with the rules …"
  Therefore, it seems that my hon. and learned Friend the Member for Surrey, East (Mr. Doughty) was right in the generalisation that the pattern of these procedures is broadly the same.
  Lord Balniel: I am, of course, prepared to accept such distinguished legal opinion from my right hon. and learned Friend. I would not dream of disputing it, but in my opinion original statements from parties in dispute should be taken, and then considered for the purposes of deciding whether there is a prima facie case, by the disciplinary committee itself. Two bodies should not be established virtually to conduct two trials—one to establish whether there is a prima facie case, and another, the disciplinary committee, to adjudicate on it.
  Mr. Doughty: It happens in cases before the courts. Magistrates investigate and take statements to decide whether there is a prima facie case to go before a superior court. They investigate it by taking statements from witnesses and, if necessary, from the accused person and decide whether there is a prima facie case to go to trial. In every criminal case the matter then goes before a superior court. That is exactly the same thing as is suggested in the Bill but on a larger scale.
  Lord Balniel: I should have thought that was a different situation. A magistrate is very different from a body of four remedial gymnasts who have no qualifications whatsoever in law.
  My criticism of Clause 8 (1, a) and (1 b) arises from the wording, which I hope we can correct in Committee. Clause 8 (1, a) is perfectly clear. It says:
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  "Where—
  (a) a person who is registered by a board is convicted by any court in the United Kingdom of a criminal offence which, in the opinion of the disciplinary committee set up by the board, renders him unfit to be registered …"
  Then if the disciplinary committee considers him to be unfit to be registered, he can be struck off the register. I have no objection to that at all.
  On the other hand subsection (1, b) provides that where
  "such a person is judged by the disciplinary committee to be guilty of infamous conduct in any professional respect …"
  he can be struck off the register.
  If the words "such a person" refer to the whole of subsection (1, a), that is to a person registered by a board and who is convicted by a court, there is no objection. If, on the other hand, the words "such a person" refer only to the first few words of subsection (1, a), which read
  "a person who is registered by a board …"
  there is considerable objection to giving such unique powers to a disciplinary committee, particularly since that committee is a very small one when compared, for instance, with the disciplinary committee of the B.M.A. which consists of eighteen people.
  My third point in connection with the disciplinary provisions arises out of Part II of the Second Schedule, which provides that it is open to any party to the proceedings to sue out writs of subpoena. I think that my right hon. and learned Friend will confirm that not only any party to the proceedings but the disciplinary committee itself will be able to sue out writs of subpoena. Therefore, under the Bill, we are setting up eight and possibly twelve courts which will have the right to subpoena any citizen to attend before them.
  We are also setting up eight courts which will have the right to administer oaths. The administration of oaths is an important function in disciplinary proceedings. For example, it is not even granted to the General Council of the Bar. It means that any citizen of this country can be subpoena'd to attend any of these courts. He can be forced to give evidence on oath. Should he refuse to do so he is in danger of perjuring

  913
  himself. He can be forced to give evidence which will render him liable to legal proceedings outside these courts.
  I hope that in Committee my right hon. and learned Friend will look at the disciplinary provisions. The general effect of the Bill is beneficial. I wonder if it is necessary to give such strong disciplinary provisions to people who are not in the slightest way qualified to exercise disciplinary provisions of this kind.
  5.41 p.m.
  Dame Irene Ward: I am very glad that the House is in general support of the Bill. Statutory registration has been discussed for a long time and it is always satisfying to realise that a large number of people are interested in matters of this kind and that at last their desires are coming to fruition. I am, therefore, glad to offer to my right hon. and learned Friend my warmest support for the Bill.
  There are one or two points only that I should like to make. I sit on the Council of the Chartered Society of Physiotherapists and I am delighted to tell my right hon. and learned Friend that this society is fully behind him. It has, however, asked me to raise one or two small matters, and in particular the financial commitments. Several hon. Members and right hon. Members have referred to that point and I want to reinforce the view held by the Chartered Society of Physiotherapists.
  As the Cope Committee suggested, it seemed that, at any rate in the initial stages of the setting up of a council, there should be made available finance for its establishment. The society wishes me to say that it is entirely desirous of standing on its own feet. I cannot speak for any other body mentioned in the Bill, but the society feels that in the initial stages only there should be a financial gift to arrange the general housing of the various registers and to make provisions for establishing and setting up the appropriate machinery.
  I hope that my right hon. and learned Friend will realise from the various speeches that have been made that it appears to be the general view of the House that such an arrangement, which has the support of the Cope Committee, should be made. I hope that when my hon. Friend the Parliamentary Secretary
  914
  winds up the debate she will be able to say that that position has been accepted. If the hon. Lady cannot give us the information tonight, I hope that she will do so before we reach the final stages of the Bill.
  The other point on which I want to spend some little time is the position of speech therapists. I have had a number of letters from, and telephone conversations with Dr. Morley, who, as my right hon. and learned Friend knows, is concerned with the position of speech therapists, and who speaks for their interests.
  In addition to the letter which has been circulated, and the one which appeared in The Times this morning, I have had a personal letter from Dr. Morley which I think ought to be placed on record. I might add that I have no particular reason for speaking for speech therapists, because I wholeheartedly believe in the principle embodied in the Bill, but this is the House of Commons and it is right that everybody's point of view should be heard.
  Dr. Morley comes from my part of the world, though she is not a constituent of mine. She has played a leading part in putting forward the professional side of speech therapy and she asked me to mention the speech therapists' point of view today.
  Having heard the speeches of the hon. Member for Stoke-on-Trent Central (Dr. Stross) and my hon. Friend the Member for Putney (Sir H. Linstead), I feel that it is the wish of everybody that we should seek to persuade speech therapists to remain within the ambit of the Bill. However, I am a little perturbed that they have found themselves included in the Bill without having agreed that they should appear in it. It is a little difficult to understand how it has happened except that, as several hon. Members have pointed out, the last stages seem to have gone with a gallop after years of pressure for a Bill of this kind.
  These are the paragraphs to which I want to draw my right hon. and learned Friend's attention:
  "When the Minister of Health 'took over' the profession in 1948 there were probably not more than four or five speech therapists employed full-time in hospitals, and even now less than twenty per cent. of our profession are so employed, that is under the National Health Service, whether full or part time.

  915
  "Because we have increasingly felt that the Minister of Health has not understood our professional position, in spite of many efforts on our part, we resigned from the Board of Medical Auxiliaries some years ago. Since 1957, when we also resigned from the Whitley Council, we have repeatedly told the Minister of Health, or his representatives, that we wished to be excluded from statutory registration as proposed in the drafts, and now in the Bill before the House.
  "This failure to understand the professional status of the profession would seem to be apparent in one clause of the Bill, page 17, lines 29–31. I know of no one who is 'expert in the field of speech disorders and their treatment' who is not on the Register of Speech Therapists of the College. This would therefore increase the number of speech therapists on the Board to nine. In this country there is no professional body other than speech therapists who has this knowledge."
  What perturbs me is that I had a long conversation on the telephone yesterday with Dr. Morley and she told me that the Ministry had been told specifically that they did not want to be included in the Bill. That is why I am intervening in the debate on their behalf. It seems extraordinary that a professional body of this importance should suddenly have found itself included in a Bill in which it did not wish to be included. I understand from my right hon. and learned Friend that in Committee it will be possible to remove this body from the Bill, but at the same time its inclusion is regrettable because it sounds as if there was some opposition to the Bill, which I do not believe is the case.
  I do not know how this trouble has arisen. Until Thursday night, when I received a telephone message here at the House, I had no idea that it had arisen. Perhaps my right hon. and learned Friend or my hon. Friend the Parliamentary Secretary will be able to go into a little more detail. When I questioned Dr. Morley as definitely as I could, it seemed to me that at a much earlier stage than the collecting together of the deputation, which we understand is now to be received by the Minister, it ought to have been possible to explain the advantages that the speech therapists would derive from being included in the Bill. If we all work together to try to persuade them that they would find support and help in the objectives of their own profession by being in the Bill we might be able to persuade them to change their minds, but it was obvious
  916
  to me from what Dr. Morley said that they resigned from the Whitley Council because of their claim that the salary scales were not satisfactory. They thought that they were not in the right group.
  In the short notice available I have not been able to get to the bottom of their difficulties, but it must be on the cards that when my right hon. and learned Friend considered their problem they had the feeling that the whole national machinery, including the Whitley Councils and the proposals contained in the Bill, were unacceptable to them. The more I consider the matter the more I feel that, somehow or other, either the Ministry or the House of Commons has failed to make sufficiently close contact with the speech therapists, in order to convince them that they are not out on a limb and that their interests and objectives are of very great importance to all hon. Members interested in their profession. If my right hon. and learned Friend can find any way of convincing them that they would derive strength and advantage from coming within the ambit of the Bill, I should be much more satisfied than I am at present.
  There is another point which flows from this problem. If the speech therapists finally decide that they do not want to come within the terms of the Bill, thus reducing from eight to seven the number of professional bodies cited in it, will the balance of representation on the Council be altered? The Chartered Society of Physiotherapists is satisfied with the proposed balance, but it wants to be sure that that present balance will be maintained whether or not, finally, fewer or more professional bodies are covered by the Bill. I hope that my hon. Friend will be able to confirm that later this will be so. The society also asked me to emphasise how glad it was that the Privy Council had been associated with the Bill.
  Like all hon. Members who have spoken, I wish the Bill well, and I hope that the professions which are to be associated with it will go from strength to strength, and continue the valuable work which they are carrying out in their own fields.
  5.54 p.m.
  Mr. Arthur Holt: I should like the Parliamentary Secretary to tell us why the Bill has been produced at such short notice. I should also like to raise a point in connection with speech therapists. Unlike the hon. Member for Hertford (Lord Balniel), I have had some communication, at very short notice, from one of my constituents. This week I had a lady—a dietician—coming in to see me, and I thought that there would be plenty of time to hear what she said about the Bill before it came up. I was forestalled. I also had a telephone call from a speech therapist who was concerned about the Bill.
  Will the Minister make it quite clear that if the accredited representatives of the College of Speech Therapists tell him that they do not wish to be included in the Bill he will take them out of it? I hope that it will not be a case of pressure having to be exerted by the House.
  Mr. Walker-Smith: Once a Bill is before Parliament any such question would be a matter for the House. The House would decide what should happen. I agree with my hon. Friends that we would not want to compel any organisation to come within the terms of the Bill. If we are not able to persuade the speech therapists of the advantages of remaining covered by the Bill I will take the responsibility of moving an Amendment to exclude them. But the decision is for the House, and not for me.
  Mr. Holt: The right hon. and learned Gentleman could not have put the position more clearly. Perhaps the Parliamentary Secretary will tell us why the speech therapists have been included, apparently without their agreement, while the other seven bodies have been included with their agreement.
  Again because of the early date at which the Bill has been placed before the House, I have been unable to inform myself of all the arguments for and against its proposals. Having listened to the speech of the hon. Member for Hertford and collected my own thoughts during the debate, however, it seems to me that the Bill is a very cumbersome affair. I can appreciate that there is sometimes a necessity to set up this kind of organisation, but I would have thought that if the various professional
  918
  bodies were adequately serving the needs of their professions and were also serving the medical requirements of the nation, it was unnecessary to bring in this extra machinery for carrying out disciplinary measures.
  Can the Minister tell us what kind of offence a speech therapist is likely to commit that would require this cumbersome machinery? What sort of offence is liable to be committed by medical gymnasts, or dieticians? Are they going to go around poisoning people? If so, surely they can be dealt with under the ordinary law. There may be some professional sins which they can commit and which cannot be dealt with adequately by their professional colleagues but, if so, I should like to know what they are. If I had had a little more time I might have been able to find out for myself. I hope the Parliamentary Secretary will clear up some of these difficulties, which have been caused by the short time we have had to prepare ourselves for an examination of the Bill.
  5.59 p.m.
  Mr. Charles Doughty: In the course of the debate we have wandered over the centuries. I am sorry that the hon. Member for Stoke-on-Trent, Central (Dr. Stross) is no longer in his place. He took us back to the days of the Armada and before. He drew a happy picture of conditions, from the point of view of dieticians, in hospitals and houses of correction in those days.
  I hope that hon. Members do not believe that everything was as rosy as the hon Member painted it. He would have been appalled if he had investigated some of the conditions in hospitals and houses of correction. In some cases, they were such that not only were the inmates wiped out in large numbers, but the infections also spread to judges.
  I should like to bring the House back to the Bill. It is an excellent one, because it comes at the right time—a time when these bodies have reached a position in which they are entitled to professional status. When one talks of professional status, what does one mean by it? It means that a body of people interested or trained in a particular subject are entitled to form themselves together, and to have professional rules.

  919
  A professional body has, first, to decide upon entry into its profession, to deal with the conduct of the members in it and their qualifications, and, if necessary, to strike their names off the list of that profession.
  It must be an independent body not under the control or influence of anybody outside it. That is why I agree with my hon. Friend the Member for Tynemouth (Dame Irene Ward), and do not agree with hon. Members who spoke in the contrary sense. It would be quite wrong for any Government Department to give any money at all, however small it might be, to help any of these bodies to set up and influence any professional organisation. No professional organisation as such ought to accept money from any outside body, whether the Government or anybody else.
  So far as qualifications are concerned, I think that we are in a position, as we always are when any body of people demand professional status to which they are entitled, to say that it must first take in those already practising, and that from then on those who desire to be admitted must produce professional qualifications and prove to the professional body that they have them.
  It may be that some of these bodies are not large enough to have their own teaching curriculum and examining body, but I think that as soon as it is possible each board should set up its own examining body to examine the qualifications and professional knowledge of each person presenting himself for registration. If that is done, we shall then increase the professional value of the expression "State registered", whether it is an occupational therapist, or whoever it may be.
  I must cross swords with my hon. Friend the Member for Hertford (Lord Balniel) who, I regret to say, displayed some ignorance upon the workings of professional disciplinary bodies. All people who have any charge brought against them of any kind—I am not referring to minor matters, which can be dealt with in the magistrates' courts summarily—in the criminal courts, or professionally before their own body, have the matter examined first by an investigating committee.
  920
  Many complaints against professional people have no foundation at all. It is quite wrong that a professional person should be brought before the disciplinary body of his profession—a very large and powerful body—upon a trivial and trifling complaint, and for that reason the matter is inquired into by an investigating committee, a small body, first. In many cases, the matter goes no further—the complaint has no substance in it at all. The investigating committee has no decision which it can make. It can only refer the matter and say that there is a prima facie case which requires investigation by the full investigating body.
  Mr. Brian Harrison: I should like my hon. and learned Friend to make clear whether the investigating committee presents the case to the disciplinary committee, or whether it is presented by someone else.
  Mr. Doughty: If the investigating committee says that there is a prima facie case to go forward, then the details of a charge of unprofessional conduct are sent forward to the disciplinary committee to inquire into. In all probability it may have taken statements, as happens in a magistrates' court before a case goes for trial. This is the usual procedure and there is nothing in the Bill that is out of the ordinary at all.
  There is one matter on which I should like to have my mind set at rest. That is the power which the disciplinary committee has to strike off—that is to say, to remove a person's name from the list. It may be that that is too drastic a remedy and I should like an assurance that in appropriate cases it has the power to suspend, maybe for six months or a year, to caution, or to take whatever it may think the appropriate remedy. To strike a person's name off the register is a very severe penalty and it may not meet a particular case, although some form of minor punishment, if only a caution, is required.
  I think that my hon. Friend the Member for Putney (Sir H. Linstead) was right about Clause 6. He has found a slip there, which I am sure my right hon. and learned Friend will put right in Committee. Clause 6 (2, a) states that any person who
  "takes or uses any such title (either alone or in conjunction with any other words) when he

  921
  is not registered in respect of the profession to which the title relates; …"
  He could excuse himself by saying that he was registered with a quack body which had been set up to collect registration fees. I think that this is only a slip in wording, and I am sure that it will be put right in Committee.
  I shall refer briefly to speech therapists, because they have sent a document to all hon. Members. One can see that they are anxious to come within the provisions of the Bill, but they have their own college, syllabus and examining body and their own committee. They are not anxious that it should be abolished, and I do not think that it will be. They would, in any case, have a majority and there is not the slightest reason for supposing that members of the board would vote unanimously against them. I am sure that the Minister will be able to give them the assurance for which they have asked. It would, of course, be in their interests that their professional status should be regularised and that they should be able to describe themselves as State registered speech therapists rather than just speech therapists.
  I am sure that we shall all welcome the setting up of these boards, enabling people to be State registered. In time, although it is not yet the time, it may be possible to prevent people practising these professions if they have not the necessary qualifications and are not State registered. That must be the ultimate object of whatever Government is in power. It can be done when the professional bodies concerned consider that the time is ripe. I am glad that the Bill has had such a happy passage so far and I do not propose to delay its progress by speaking any longer.
  6.9 p.m.
  Mr. W. A. Wilkins: Although my hon. Friends have commented that the Bill has been sprung upon us, nevertheless it is a welcome Measure and we congratulate the Minister on reconciling the difficulties existing between the different organisations sufficiently to make him feel confident in bringing the Bill before the House.
  I wish to refer to Clause 3 which deals with qualifications for registration. It is easy to understand the qualifications set out in subsection (1). They will be
  922
  obtained from the approved institutions and therefore we need have no anxiety about that. We believe that the standards required will prove adequate to meet the needs of the professions. Subsection (2), as I understand it, makes provision regarding people who would be practising in various services indirectly connected with the National Health Service. I have chiropodists particularly in mind. Up to the present there are a number of people who provide this service and I believe it true to say that in the past some have been able to obtain qualifications by means of a postal course. I am not suggesting that they are inefficient because they obtain their qualifications in that way, although it seems to me rather an indirect method of obtaining a professional training.
  In Clause 3 (3) there is a provision, which the Minister elaborated to us, for people to appeal if for any reason the board has already refused to grant qualifications to them. The period of twelve months which is mentioned seems to me rather a long one, although it may be all right, and I am not arguing about it. They may be accepted if they hold necessary qualifications granted outside the United Kingdom if the board so requires, and they have sufficient practical experience in the profession.
  If I remember rightly, the Minister said that if for any purpose the board refused to register these people, they would still be free to practise. I realise that this House is hesitant about taking any action which might imperil the possibility of anyone in this country being able to earn a living. But Clause 3 appears to be drawn very widely, and I do not think that it will prove too difficult for someone who has been practising chiropody for two years, five years or ten years to become registered. However, that only increases my anxiety about the position of those people the board may refuse to register. If they cannot be accepted and registered under what appear to be wide provisions, one wonders whether they are sufficiently efficient to be allowed to continue to practise.
  I am endeavouring to phrase by remarks in cautious terms because I am the last person who would wish to deprive anyone of the means of earning a living, but we know that unless people

  923
  are skilled even, for example, in removing corns, serious trouble may result. There may be trouble if the work is not properly done or unclean instruments are used. I am, therefore, anxious about this matter, especially as I understood the Minister to say that these people would still be allowed to continue to practise. I should have thought that if it were possible to allow them to continue to practise, they ought to have the qualifications required for registration by the board.
  The hon. Member for Putney (Sir H. Linstead) suggested that some members of professional bodies were anxious about the registration fee which would be initially £2 10s. and afterwards £2. I have been trying to find that figure in the Bill. He suggested that if they were called upon to pay £2 a year they would seek to reduce the quality of their service in order to cover the fee.
  Sir H. Linstead: The point I was trying to make was that if these people had to pay a heavy registration fee, they might try to economise by stopping their subscription to their professional association. I did not suggest in any way that they would cut their service to the public.
  Mr. Wilkins: I apologise to the hon. Member. I misunderstood what he said. I did not think there would be any dispute about having to pay 9 3/5d. per week in order to be registered under the scheme. Perhaps the Minister will clarify that point later.
  6.16 p.m.
  Mr. R. H. Turton: I wish to congratulate my right hon. and learned Friend on bringing in this Bill though I do not congratulate him on its Long Title. Most Bills have a Long Title and a Short Title. This Bill has two Long Titles. I had hoped that during his clear opening speech my right hon. and learned Friend would give some reason why the Bill did not bear the name by which it was referred before its birth—the Medical Auxiliaries Bill. I can understand that the members of the profession represented by the right hon. Lady the Member for Warrington (Dr. Summerskill) may not have liked to be mixed up with some of the remedial professions which are mentioned.
  Dr. Summerskill: I am sure that the righ hon. Member for Thirsk and Malton (Mr. Turton) will recall our exchanges some years ago. But I think that the Title is an improvement. It shows that we have moved on. In the past we regarded these people as auxiliaries but now they have reached professional standards.
  Mr. Turton: I am grateful to the right hon. Lady. I think that in that case the Bill should be called the Medical Supplementaries Bill. I should like to call it the Healthy Professions Bill.
  The Minister made one remark which was not absolutely clear. He said that the majority of these people were not in private practice. I wish to follow what was said by the hon. Member for Bristol, South (Mr. Wilkins) about chiropodists. They are nearly all in private practice and that will raise problems about which I wish to question my right hon. and learned Friend.
  There are about 4,500 chiropodists belonging to the Society of Chiropodists and the Institute of Chiropodists and there are probably another 3,500 to 4,000 who do not belong to either body. Some of the latter have been trained by means of the S.M.A.E. correspondence course. At the moment in the National Health Service only half of the members of the society and institute have qualified under the 1954 Medical Auxiliaries Regulations. I wish to ask whether, after the Bill becomes law, those Regulations will be amended in order to permit those who are qualified and registered under the provisions of this Bill, to take part in the National Health Service.
  In my view this is an important matter because we are desperately short of chiropodists in this country. Not only that, but the number of chiropodists varies between town and country and between town and town. I have the honour to serve on the Advisory Council of the National Corporation for the Care of Old People. We have been working with the profession to see whether it is possible to provide a chiropody service for the old people. We had difficulty in discovering where chiropodists practice. We conducted a survey to find out whether there was an adequate number of chiropodists in the country. We assessed that the minimum number of chiropodists needed

  925
  to treat the old people in the population was one for every 10,000.
  We found that of 770 areas, in about 450 the supply was adequate, which was encouraging. But there were 137 areas where there were no chiropodists at all—that is, not members of the society or the institute. The other fact of interest which we discovered was that in a town of 100,000 inhabitants, like South Shields, there were only two chiropodists, whereas in a town of a similar size like Blackburn there were 14.
  There is such a shortage of chiropodists that it would be a great pity to dissuade people from practising chiropody. We ought to encourage more people to enter the profession and to go in for the full training which is so necessary in order to carry out this work properly. I wish to ask the Minister whether the Board will have power to encourage recruiting.
  When we were discussing legislation relating to dentists we spent some time debating how we could get more dentists. Now that chiropodists are to have a professional status it will encourage more people to enter the profession and the number of chiropodists may be spread more evenly over the country. There is also the problem of the rural areas which is a difficult one because they are worse served than are the urban areas. It is also more difficult to give treatment in the rural areas.
  The National Council has recently been conducting an experiment in Dorset, which is limited to two years. This is giving a full domiciliary service in chiropody in a rural district. It has been working with three chiropodists and the results have been most encouraging. Patients have been treated in their own homes. Starting with about 370 the number has gone up to 450 patients. The chiropodists travel to the homes of the patients, we find that this is a more economic method than bringing the patients to a clinic or a surgery.
  I wish to ask my right hon. and learned Friend to ask the board to consider the whole question of chiropody in the rural areas. I am sure that hon. Members are anxious to ensure that a full chiropody service is provided for old people in all parts of the country. The National Council has been helping about 123 schemes on a promise from the Nuffield Trust of assistance for three years. We
  926
  have carried only eight of those on for another two years. Most of the other schemes have lapsed or will shortly lapse, and I find that the number where work is being continued is very small. I hope that the Minister realises that.
  I believe that even from the point of view of chiropody alone the Bill is an urgent and necessary Measure, and it has my full support.
  6.25 p.m.
  Colonel Sir Malcolm Stoddart-Scott: I want to add a few words of welcome to the Bill and to assure the Minister of my support for it. We have been waiting a long time for such a Measure to be brought before the House. It is eight years since the Cope Committee reported, and it may be that some of the delay is due to the Cope Committee itself, in that it recommended that a comprehensive Measure should be brought before the House. I know that some people feel that this problem should and could have been dealt with more appropriately and satisfactorily by separate Measures dealing with each of the supplementary professions, but it has probably been wise to wait and to bring before the House this one comprehensive Measure.
  It is a little difficult to include in one Measure such different professions. They have in common the fact that they look after the welfare of the patient and that they help with preventive medicine, but some of them are wholly employed in the Health Service, some have a majority of their members serving the educational service and some, like the chiropodists, to whom my right hon. Friend the Member for Thirsk and Malton (Mr. Turton) referred, are mostly employed outside the Health Service.
  Wherever they are employed, their work is vitally important, and it is important that we should have a Measure such as this. I do not agree with the description given by one of my hon. Friends, who said that it was cumbersome. The work of these professions is vital to the medical profession. I am sure that without their assistance the doctors could not have achieved so much or have done so much work.
  The medical profession is legally responsible for the action of all these auxiliaries. I agree with the right hon.

  927
  Lady the Member for Warrington (Dr. Summerskill) that the Measure does not deal with medical treatment. As well as being responsible for their action, however, the doctors are to a great extent responsible for the education of these auxiliaries, and it is therefore of significance that the doctors wish to be well represented upon the boards and upon the Council.
  I am glad that my right hon. and learned Friend has given them a parity upon the Council, but they have a parity on the Council only if the representative from the General Medical Council, whose appointment is laid down in the First Schedule, is a member of the medical profession. The General Medical Council has many lay members, and I hope that in Committee we shall be able to obtain an assurance, if not an Amendment to this effect, that the General Medical Council will send a medical representative to this new Council.
  I am glad that the Minister has made a decision about these boards, because there is no doubt that the delay in bringing the Bill before the House is due to the lack of agreement on the composition of the boards. I am also extremely glad that he said that he will welcome suggestions and improvements in Committee. I believe that we can strengthen and improve the Bill without upsetting the balance of the boards as laid down in the Second Schedule.
  The radiographers' board is to have four medical representatives from the colleges and Scottish corporations. I hope that we shall be able to ensure that some of these medical representatives know something about radiography and radiology, and it may be better to look to the Faculty of Radiologists and the British Institute of Radiology to make sure that we have medical representatives on that Board who are expert in radiography.
  I welcome the Bill most wholeheartedly, and I feel that it will be of great assistance to these supplementary professions who, unfortunately, are probably the least well-paid members of the Health Service. I am sure that the Bill will help them enormously, but I would not try to persuade the speech therapists to come into the scheme if they do not
  928
  wish to come into it. It should be a great privilege to have the words "State registered" added to their names, and it would be a great help to them in the future. As long as we leave some opportunity open to them when they have their second thoughts, in order that they may then come into the scheme, I would not at the moment use any undue persuasion on them or hold up the Bill for a single moment for them, if they do not wish to join in willingly.
  The Bill will make an important contribution to the Health Service—and that is what matters most—for it will help the patient. That should be the chief consideration of any medical Measure before the House.
  6.33 p.m.
  Mr. Brian Harrison: I have been in the hands of most of these professions at one time or another.
  Sir M. Stoddart-Scott: Including the speech therapists?
  Mr. Harrison: With the exception of the speech therapists. I therefore feel that I have an interest in the Bill.
  I welcome the fact that it is felt that these professions can be brought within the category of state registration. I do not want to detain the House long, but I want to make a few points to follow my noble Friend the Member for Hertford (Lord Balniel) and my hon. and learned Friend, the Member for Surrey, East (Mr. Doughty), particularly about the disciplinary committees. My right hon. and learned Friend said that in a number of cases these boards would consist of eleven people. The disciplinary committees will be formed from the boards, and they will be working together with the other members of the boards.
  As my hon. and learned Friend said, a disciplinary committee can bring forward written evidence to the other half of the board. It seems to me that such close liaison between the two parts of a small board creates a dangerous situation when disciplinary action is being taken which might deprive someone of his livelihood. I know that my hon. and learned Friend the Member for Surrey, East drew the analogy that this kind of thing went on in the magistrates' court, but that is completely different from a professional organisation

  929
  which has to investigate unethical practices and other matters to do with a profession.
  Secondly, the disciplinary committees have powers under the Bill to subpoena witnesses and to administer oaths. It seems to me that it is a ludicrous situation that professional status now seems to be tied up with the ability to administer oaths, to subpoena witnesses and to take disciplinary action against one's fellows and colleagues.
  Mr. Holt: To get the record clear, I would point out that the hon. Member is not correct to say that this is tied up with professional status. As far as I know, it does not apply to accountants, architects or civil engineers.
  Mr. Harrison: I agree that this is not so in all cases. I was trying to make the point that it looked as though it was now regarded as desirable, if we were to set up a new professional status, that there should be this form of disciplinary action. The hon. Member was right to correct me. Even the Bar Council cannot administer oaths or subpoena witnesses, although I think that I am right in saying that the General Medical Council, the General Dental Council and the General Optical Council have the right to administer oaths and subpoena witnesses.
  I do not think that it is desirable that there should be eight new disciplinary committees, with possibly another four to be set up, all with these additional powers to drag any person in the country before them in the same way as the courts of law. It is just possible that this power could be confined to a disciplinary committee of the Council rather than extended to each of eight or twelve boards. That would greatly limit the extension of this power.
  I hope that my right hon. and learned Friend will very carefully consider those two points, which are the only two points I want to make, because we need to watch them. With those reservations I welcome the Bill. I may not be quite so uncontroversial in expressing the hope that it may not be long before some of the vacancies on the Council are filled by other organisations and groups of people such as osteopaths and chiropractors, who may well have proper recognition in the near future.
  6.38 p.m.
  Sir Colin Thornton-Kemsley: I shall not detain the House for more than two minutes or, at most, three minutes, but I want to say a few words about the speech therapists, about whom other hon. Members have spoken. I do that because I know a number of speech therapists, a member of my family was trained and qualified as a speech therapist, and to some extent I know their feeling about the Bill and about the proposal that they should come into this scheme. I was very glad to hear my right hon. and learned Friend say that he is to meet a deputation from the College of Speech Therapy.
  I was in agreement with my hon. Friend the Member for Putney (Sir H. Linstead), who said that it would be a great mistake to compel the speech therapists to come into the scheme if they did not want to do so. As I understood the indication which he gave at that time, my right hon. and learned Friend was also in agreement about that. He did what in Parliamentary language is called indicating assent. It is clear that they will not be compelled to come into this scheme.
  Like my hon. and gallant Friend the Member for Ripon (Sir M. StoddartScott), I feel that State registration is worth having and I hope that the speech therapists will feel that, too, when they have discussed the matter round the table with the Minister. Everyone knows that they do magnificent work. Their training is sound and thoroughly approved by both medical and educational authorities.
  In brief, their case rests on the fact that 75 to 80 per cent. of them are employed not in the National Health Service, but by local education authorities. I do not need to make their case for them; they can make their own case to the Minister who is, indeed, fully aware of it. Indeed, they have been good enough to provide many hon. Members with a statement of their case.
  I am glad that there is no suggestion that they should be compelled to come into the scheme, and I am even more glad that their case will be considered personally by the Minister.
  6.40 p.m.
  Mr. Kenneth Robinson: As my right hon. Friend the Member for Warrington (Dr. Summerskill) made clear when opening the debate for the Opposition, we welcome the Bill very warmly. We have certain reservations and criticisms, some of which will no doubt emerge as Committee points later.
  Like the right hon. Member for Thirsk and Malton (Mr. Turton), I, too, dislike the Title of the Bill very much indeed. It is the most cumbersome Title of any Bill that I can remember. I know that there have been difficulties with the professions themselves about a collective description, and it is true that the Title started off as "Medical Auxiliaries". That was what these people were called by the Cope Committee, and indeed that name was enshrined in the National Health Service (Medical Auxiliaries) Regulations, 1954. Then the professions thought again and there was a suggestion that they should call themselves "Non-Medical Professional and Technical Staff". This was the suggestion in the Minority Report of the Cope Committee. Then there was a third suggestion that they should be called "Professions Associated with Medicine". That suggestion came through the Departmental Working Party. Finally, we arrive at the very unhappy conclusion, "Professions Supplementary to Medicine".
  I do not like being merely destructive in my criticism and I wish to offer a suggestion for consideration by the right hon. and learned Gentleman. Has he thought about the possibility of "Para-Medical Professions"—professions that work alongside the medical profession? That is exactly what all these people do. I throw that suggestion out to him for consideration between now and the Committee stage.
  The Minister in opening used what I can only call staggering meiosis when he congratulated himself and his Department on not having rushed into a Bill without adequate preparation. As many hon. Members have reminded the House, the Zachary Cope Committees reported in April, 1951, which is nearly nine years ago. I do not think that any hon. Member so far has reminded the House that more than four years ago there was
  932
  a solemn promise by the party opposite in its 1955 election manifesto. It read as follows:
  "We shall introduce legislation to give effective status to those, known as medical auxiliaries, who assist doctors in investigation and treatment."
  That is on page 25 of "United for Peace and Progress". [HON. MEMBERS: "Hear, hear."] The 1955 Parliament ran its full course, yet nothing was done. It is being done now, but that pledge was not honoured, and it does not stand alone in that respect. We know that there have been difficulties with the various professions involved, and with the medical profession; there have been complicated negotiations; but there has been a deplorable lack of urgency in considering the problem.
  My right hon. Friend mentioned the objections of the British Medical Association to the Bill. I do not want to repeat what she said. I agree with every word of it. I want to make only one observation in this connection arising out of something which the hon. and gallant Member for Ripon (Sir M. Stoddart-Scott) said. He said that doctors are responsible in law for all the actions of these auxiliaries. I wonder whether he is right, because the letter which the British Medical Association sent to some hon. Members quoted only from its own disciplinary code. It is quite clear that that is what their professional code states. I should like the hon. Lady the Parliamentary Secretary, when winding up, to clear up the legal position about whether in law doctors are responsible for all the actions of these auxiliaries. I have my doubts about it.
  Having charged the right hon. and learned Gentleman with procrastination, I now propose to have it both ways and charge him with indecent haste. Having waited nine years for the Bill, why was it necessary to rush through Second Reading a mere week or ten days after its publication? I must protest about this. It is a fairly complex Bill and this haste has allowed us virtually no opportunity to have consultations with the interested parties. There are many separate interested parties concerned in the Bill, which deals not only directly with eight different professions, but more indirectly with the entire medical profession. There has been one further

  933
  difficulty. I do not know whether the Minister knows this, but the Bill went out of print almost immediately it was published. Members representing these professions were unable to procure copies of it for several days, and that also made for further difficulties.
  I have heard rumours that it is intended to start the Committee stage before Christmas. I profoundly hope that the rumours are incorrect because, having given us no time to have consultations between publication and Second Reading, the least the Minister can do is to give us ample time to have our discussions before the Committee stage opens. If he cares to deny that rumour now, I will gladly give way to him.
  Mr. Walker-Smith: The Parliamentary timetable is not a matter for me, as the hon. Gentleman knows. However, I will take full notice of what he has said about the desirability of not starting the Committee stage until after Christmas. In a Bill such as this the time for consultation comes, in a sense, more appropriately between Second Reading and the Committee stage, because the sort of points which will be raised by individual organisations are, of necessity, Committee points. I will certainly bear in mind what the hon. Gentleman says and convey it to the appropriate quarters.
  Mr. Robinson: I am very grateful to the Minister. It is pleasant at any rate to know whether the bodies concerned agree in principle with the Bill, which one would like to know before Second Reading. We have only just had time to discover that. However, I hope that there will be no undue haste in starting the Committee stage.
  We should have liked time before today's debate to have obtained up to date figures about the establishments and vacancies in each of these categories, both in the hospitals and in the employment of local health authorities. We all know that there is a serious shortage in almost all the categories. In this connection I wish to quote the observation in paragraph 3 of the Cope Committee's Report, which draws a distinction between "demand" and "need":
  "By 'need' is meant the numbers required by the National Health Service to give the public a full service in all parts of the country. To distinguish it from 'need', 'demand' must
  934
  be related to a particular time or period of time and may accordingly be defined as the number of vacancies that employing authorities are likely to seek to fill at present or—say—within the next five years."
  For all these skills the demand is very great, but I think that the House will agree that the need is infinitely greater and far in excess of these supplies or the likely supply in the near future.
  I come now more particularly to the Bill itself. The noble Lord the Member for Hertford (Lord Balniel) expressed anxieties about the procedure of the investigating and disciplinary committees. I do not know that I share all his anxieties, but certainly if the membership of those two committees is to be drawn exclusively from the membership of the professional board concerned he is justified in feeling anxious about being able to keep the two committees separate and independent from one another, particularly in the case of a small board like that of remedial gymnasts. I hope that the Parliamentary Secretary will be able to tell us that it will be open to these boards to draw members for these two committees from outside or to co-opt them.
  In this connection I wish to draw the attention of the House to Clause 8 (6), which I do not think has been mentioned and which worries me. The subsection makes it a duty for each disciplinary committee to prepare a statement as to the kind of conduct which it considers to be infamous conduct in a professional respect. It then goes on to say:
  "but the fact that any matters are not mentioned in such a statement shall not preclude the disciplinary committee from judging a person to be guilty of infamous conduct …"
  That is very dangerous indeed. Either one draws up a comprehensive statement which will let people know precisely where they stand or one does not draw up a list or statement at all. To draw up a half-statement saying, "These things are infamous, but so are a whole lot of other possible causes of action", is to get the worst of both worlds. I am inclined to think that this is rather more a Committee point, so I will not pursue it any further today.
  I have two questions for the Parliamentary Secretary. First, the House might be told why almoners are excluded from the Bill. I appreciate that their

  935
  affinities are probably more with the social work field than with the medical. After all, they were considered by the Cope Committee and, so far as one can tell, the Committee recommended a similar form of organisation and machinery to those recommended for the other supplementary professions. Somewhere during the protracted discussions following the Cope Committee almoners have slipped out. I wish to know when this happened and whether the explanation that I have suggested is correct.
  Secondly, we might be told at what point remedial gymnasts separated themselves from physiotherapists. My reading of the Cope Report suggests that it favoured an inclusive board embracing the remedial gymnasts. Even the minority Report, which was signed by the representatives of the physiotherapists, thought that both physiotherapists and remedial gymnasts would be covered by the same board.
  I want to deal now with a matter which has been very widely discussed in the course of the debate, namely, the problem of speech therapists. Much reference has been made to the letter in The Times and the leader. I had the opportunity on Friday of discussing the whole matter with four leading members of the profession who undoubtedly spoke for the profession as a whole. So far as I can gather, the profession is unanimously opposed to being in the Bill at all. Various objections have been mentioned in the course of the speeches, but I should like to run through them as they were made to me. They add up to at any rate a good case for reconsideration.
  The members of the profession believe that they already have a properly organised body, namely, the College of Speech Therapists, which maintains high standards of training and professional conduct. Those standards are comparable with those of the United States and countries of Europe. The College compiles and publishes a Register of Speech Therapists, which is recognised by the right hon. and learned Gentleman's Department and by the Ministry of Education. The members of the profession state, quite justifiably, that they are concerned only marginally with the National Health Service, in that more than 80 per cent. of them are employed
  936
  in schools by local education authorities. One or two hon. Members asked what the up-to-date figures are. I understand that there are only 82 whole-time speech therapists in the hospital service out of 670 practising in the United Kingdom at the moment.
  As the hon. Lady the Member for Tynemouth (Dame Irene Ward) reminded us, the speech therapists have opted, not only out of the board of medical auxiliaries—about two years ago, I think—but, more recently, out of the National Health Service Whitley machinery, where they were represented on Professional and Technical Council A. They formed their own Association of Speech Therapists which is now negotiating with the local education authorities before the Soulbury Committee. Lastly, they pointed out, as they did in the letter referred to, that there is already a Department of Speech Pathology in Durham University, and they cannot see how the Bill would help them to develop their links with universities. Indeed, some think that it might hinder that development.
  I understand, as did the hon. Member for Tynemouth, that the speech therapists suddenly woke up to find themselves included in the Bill; and that they made it quite clear to the right hon. and learned Gentleman and his Department some time ago that they did not wish to be so included. I know that they reluctantly approved of the draft scheme produced by the Department and the Working Party at some point of the negotiations. However, since that reluctant approval, changes have been made in the constitution of the boards and in the methods of selecting and appointing them that have served to increase the anxieties of the speech therapists to the point at which they definitely wish to contract out.
  I am glad that the Minister has said that he will not press this profession into the terms of the Bill if they do not want to be included. There was a saying in the Navy that one volunteer is worth ten pressed men, and in the context of this Bill I would have thought that one pressed man would rather tend to unsettle the seven volunteers who are happy to accept the provisions of the Bill.
  The College of Speech Therapists and the Association are responsible representative bodies which have made out a strong case for exclusion. They are

  937
  perfectly aware of the advantages that the Bill would convey but, at present, at any rate, they feel that the disadvantages outweigh the advantages. I am pleased that the Minister is to hear their views from a deputation. I am sure that he will listen carefully and sympathetically and that, if he is not able to persuade them, he will move to exclude them during the Committee stage.
  The other professions all welcome the Bill. I am glad, because I believe, as they do, that it will enhance their status and qualifications, and will be a recognition of the very important rôle they are playing in the health services. I am very glad that they have been given an 'overall majority on the boards, and parity with the medical members on the Council.
  I turn to the rôle of the Privy Council. Was it necessary to have quite so complex a three-tier structure? I rather gathered that the extensive powers of the Privy Council were inserted partly to placate the medical profession for not having a majority on the boards and on the Council, but the rôle of the Privy Council must detract from the authority of the Council. It is surely very unusual to have so many decisions made subject to the approval of the Privy Council—to give the Privy Council such powers of direction—although we know that, under other registration Acts, appeals can be made to the Privy Council. If there are any precedents for such an extensive rôle for the Privy Council, the House would be glad to hear of them from the Parliamentary Secretary.
  The Bill conforms to a trend in the health services which, for my part, at least, I welcome. That trend is the increasing attention and emphasis that has been given to training on many fronts. We have recently seen the Report of the Younghusband Working Party on Social Workers, on which we hope to see action from the right hon. and learned Gentleman's Department in the near future. The General Nursing Council has recently undertaken a reappraisal of nurse training, and has published conclusions that have been hotly debated in some quarters, and it is a good thing that they have been.
  The investigation made into administrative staffs by Sir Noel Hall recommended the importance of training in
  938
  order to provide a proper career structure. A good deal more could be done here. We know that the Administrative College of the King Edward VII Fund is doing well, but that is not large enough to do the job that has to be done on the scale required.
  In the most important field of all, the medical field, there is little or no sign of any re-thinking on training at all. Medical curricula are, in one respect, not basically different from those of half a century ago. The medical student is still taught within the straitjacket of what one might call the mechanistic theory of disease. He is taught all about the body, but nothing about the mind, and therefore finishes his training not properly equipped to recognise the complex inter-relationship between the mind and the body, or the interdependence of the one on the other. It is not too much to say that at present the teaching on psychiatry received by the undergraduate medical student is cursory in the extreme. We must not forget that mental patients occupy 48 per cent. of our hospital beds.
  There is no sign that the leadership of the medical profession will do anything about this without some stimulus from outside, and it is the Minister's job to provide that stimulus. Has not the time now come for a Royal Commission or some other kind of high-powered inquiry into medical education? This is not the occasion to develop that idea in detail, but it is something that the Minister should give thought to in the months to come.
  However, I say once again that we welcome the Bill, and shall do our best in Committee to make what improvements are necessary.
  7.3 p.m.
  The Parliamentary Secretary to the Ministry of Health (Miss Edith Pitt): I am glad to find—as, indeed, I expected to find—that there is general support for the Bill on all sides of the House, but one of my difficulties in a Bill that is not politically controversial is that it stimulates interest in other directions. Hon. Members seek further information or add their particular knowledge, and I am left with such a crop of questions that I doubt whether I have time to answer them all in a winding-up speech—

  939
  [HON. MEMBERS: "Three hours."] If hon. Members do not mind my keeping them here, I shall be very happy, but as many have been kind enough to suggest that theirs are Committee points, I hope that any with which I do not deal this evening may be dealt with then.
  Going back to my expression of pleasure at the reception of the Bill on Second Reading, I think that the members of the professions concerned in these proposals should be very gratified by the appreciation of their services that has been expressed by hon. Members on both sides, and by the recognition of the essential part that members of the supplementary professions play in the care and treatment of the health of the community.
  The debate has emphasised the contribution made by the increasing number of persons engaged in these professions, which has been a very marked feature of social service in recent years. They are regarded as an accepted and valuable part of our social services. Indeed, the right hon. Lady the Member for Warrington (Dr. Summerskill) said that there was a call for increasing specialisation in this limited sphere.
  The debate has also emphasised what the Bill's Title implies; that the prime responsibility for these professions rests with the doctors, and that though part of the treatment or care may be delegated to members of the supplementary professions who have special skill and training in individual branches, nevertheless, it is essential that it should remain under the control and general supervision of medical practitioners. The hon. Member for St. Pancras, North (Mr. K. Robinson) asked me categorically: Are the doctors responsible in law for what the supplementaries do? I am assured, both on my right and on my left, that the answer is "No."
  As has been said so often in this debate, the medical profession has a considerable interest in the training and standards of work of these professions, which has been recognised by the scale of representation of medical interests on the Council and on the boards. As my right hon. and learned Friend said, this delicate balance of interests, together with the large number of professions concerned, has meant a very long period of work and consultation, to take account
  940
  of all the views, to reconcile different views, and to reach a broad agreement that is both acceptable and workable.
  As we have been reminded so often today, the preparatory work has been going on for some years, and, in part, accounts for the delay since 1955 when, as the hon. Member for St. Pancras, North pointed out, this Measure was promised in my party's manifesto. It is only now that we are putting this Bill before the House, but we are keeping our promise—
  Mr. K. Robinson: Five years late.
  Miss Pitt: Better late than never. The hon. Gentleman is well aware—probably better aware than I—of the reasons for the delay.
  The right hon. Lady mentioned the attitude of the doctors to these proposals—not only that but gave the answer—which relieves me of the responsibility of developing that point, except, for the benefit of hon. Members who have shown such a genuine interest in this subject, and for the record, to go into the background of this legislation.
  It began in 1949 with a series of eight Committees set up under the chairmanship of one who is now Sir Zachary Cope, to consider the supply, demand, training and qualifications of certain medical auxiliaries employed in the National Health Service. The Reports were published in 1951, and included a recommendation that there should be a unified system of statutory registration for medical auxiliaries. Broadly speaking, the Committees had in mind a registration council representing doctors, medical auxiliaries and others in approximately equal numbers, with advisory committees of the various medical auxiliaries concerned.
  In view of the differing opinions as to the form this statutory registration should take, a working party was set up by Health Ministers in 1954 to find out what agreement could be reached among the medical auxiliaries themselves. That working party produced a Report in the form of a draft scheme for the statutory registration of eight classes of medical auxiliaries. The scheme provided for the establishment of registration boards—on which the medical auxiliaries were to be in the

  941
  majority—for each of the eight professions and for a co-ordinating council which would have the power to veto the boards' proposals but not the power to direct them. The aim was to provide a measure of self-government for medical auxiliaries, and the main emphasis was therefore placed on the registration boards.
  There followed a long period of negotiation between the Minister and the representatives of the medical auxiliaries and the medical profession to try to reach agreement. The medical profession wanted equality of numbers on the registration boards and that the coordinating council should have overriding powers over the boards. The medical auxiliaries were not prepared to accept either as denying them their proper position.
  There was considerable discussion, too, about the Title to be adopted. My right hon. Friend the Member for Thirsk and Malton (Mr. Turton) said that he did not like the Title, and the hon. Member for St. Pancras, North said the same. I think I can understand their point. It is perhaps a clumsy phrase. But agreement was finally reached on these words "professions supplementary to medicine", and at least they adequately describe the groups that we are considering.
  After a number of amendments, the revised scheme was discussed at a conference in 1958 between representatives of all the medical auxiliaries and the medical profession. At that stage the scheme provided for each registration board to have a majority of one medical auxiliary and the co-ordinating council to have only powers of veto over the boards The medical profession agreed to accept the scheme so long as provision was made for disputes to be referred to an independent arbitrator assisted by expert assessors appointed by both sides. That provision has now gone because the Privy Council has been brought in. Subsequently the British Medical Association returned to the line that either there should be equal numbers on the boards or that the co-ordinating council should have overriding powers over the boards. The suggestions they then made were put to the medical auxiliary bodies who rejected them almost unanimously.
  942
  In the circumstances, the Government decided that the proper solution would be to leave the supplementary professions with a majority of one on each of the registration boards and to leave the Council without overriding powers, but to provide that decisions on certain matters, in particular courses of training and qualifications, shall be subject to the final approval of the Privy Council. Thus there is a third stage if the Council and the boards reach a deadlock, and on important matters the Privy Council is brought into the decision-making process to avoid any deadlock arising. The Privy Council already has wide experience in exercising similar powers in other registration schemes, relating to doctors, opticians, pharmacists and so on, and thus is well acquainted with the kind of problem which can arise. I hope that this explanation answers some of the doubts which have been expressed.
  Meantime, pending the formation of the statutory registration scheme, something had to be done and in 1954 the then Minister made Regulations under Section 66 of the National Health Service Act, governing the qualifications of medical auxiliaries for employment in the National Health Service. I think the debate has shown that there is general agreement that the time has now come for the provision of a statutory registration scheme. The Bill is based on the scheme agreed at that July conference to which I referred, with two main departures, both a consequence of the introduction of the Privy Council as the approving body.
  On the question of fees, which has been raised by several hon. Members, Clause 2 gives the Council power to prescribe registration fees after consultation with the boards and subject to the approval of the Privy Council. The scheme must be self-supporting but, as my right hon. and learned Friend said, everyone, particularly the professions, is very anxious that the fees should not be too high. I think the scheme must be run as economically as possible, and to help to ensure this it is desirable that finances be dealt with centrally rather than by nine separate bodies. Paragraph 17 of the First Schedule puts financial matters generally into the hands of the Council.
  My hon. Friends the Members for Putney (Sir H. Linstead), and Tynemouth

  943
  (Dame Irene Ward) and the hon. Member for Stoke-on-Trent, Central (Dr. Stross) raised the point whether the administrative expenses could be met from the National Health Service itself, as recommended by the Cope Committee, and the expense of maintaining the register met from the fees. I think it is doubtful whether it is practicable to apportion the cost in this way. In fact, professions are always expected to meet the full cost of their registration machinery, and there is not usually any provision made for the Government to meet any part of the cost.
  I am indebted to my hon. and learned Friend the Member for Surrey, East (Mr. Doughty), who said very firmly, as a professional man, that no professional body ought to take outside money. It is the same principle as applies in all recent Acts. The Council, after consulting the boards, may make rules about the amount of fees, and these rules may make different provision for different circumstances. For instance, there could be one rate for initial registration and another for retention on the register.
  My hon. Friend the Member for Putney asked whether the practitioner has to pay the registration and the retention fee for the same year. Whether this is so would be determined by the rules made by the Council under Clause 2 (3, c) and approved by the Privy Council, but it seems very unlikely that any rule would require both fees to be paid. I would emphasise, on this question of fees, that the rules cannot come into force until they are confirmed by order of the Privy Council.
  The amount of fees in practice will largely be determined by two factors—the number of people admitted to the initial register, and the economy with which the Council and the boards operate the schemes.
  Questions have been asked about the inclusion or exclusion of professions. We thought it right to include only those professions which are the subject of the Cope Reports, but that does not preclude additions, because the Bill provides under Clause 9 for additions up to a total of twelve boards. I think it is reasonable that this question should be considered initially by the Council, the body specifically constituted and quail-
  944
  fied for so doing. But again I would stress that a change could be effected only by an order made by the Privy Council.
  As to whether any of the bodies already named wishes to opt out, my right hon. and learned Friend explained about the speech therapists and said that they had asked to see him. Since they have featured largely in this debate, I should perhaps add a few more words particularly to deal with the point raised by my hon. Friend the Member for Tynemouth who said that the speech therapists had specifically told the Minister that they did not want to be included in the Bill. I think that point was echoed by the hon. Member for Bolton, West (Mr. Holt).
  I am advised that the facts are that the College of Speech Therapists has been concerned in all past negotiations. In 1956 it indicated that the scheme in its then form was unacceptable to the College but not that it was opposed to statutory registration in principle. At the conference to which I have referred, held in July, 1958, the speech therapists said that there was no support for the scheme in its then form amongst the profession, but this was not to be taken as an announcement of their wish to withdraw from the scheme. Since then they have indicated much uneasiness about the scheme on a number of occasions but they have not said specifically that they wish to withdraw. In any event, the Bill differs in some respects from the scheme, as I have pointed out, due to the introduction of the Privy Council, and it seems right that the speech therapists should see it and make up their minds whether they wish to be included.
  Dame Irene Ward: I apologise for interrupting my hon. Friend, but I should like to point out that it was made perfectly plain to me on the telephone by Dr. Morley—and I can only repeat what she said—that the Ministry had been informed quite recently that they did not wish to be included in the Bill and that they had had no acknowledgement of their representations. I can only say what she said to me. I cannot say whether, in fact, the communication has been received or not, but I think this ought to be put on the record.
  Miss Pitt: That is the information I have, from what is available in the

  945
  Ministry, and I am sure that both my hon. Friend and I can both agree that we hope that the speech therapists will have second thoughts before they decide deliberately to exclude themselves from the provisions of a Bill which will give them status and authority in the work to which they have to make a contribution, and that is very important.
  The initial register provides that people qualified for employment in the National Health Service under the 1954 Regulations, which as I have mentioned, were made by the then Minister, shall automatically be entitled to admission to the initial register now, but the boards may also admit people holding qualifications approved by them or having a qualification and practical experience. This is a matter for the discretion of the boards, but there is a right of appeal to the Council on admission to the initial register only. This is a reasonable arrangement, as the Bill does not prohibit unregistered persons from engaging in private practice. What it does do is to give protection to State-registered persons, both the professional persons themselves and the public who make use of their services. It will not prevent anyone earning a living in private practice, though, in fact, as my right hon. and learned Friend said in opening the debate, except for chiropodists and physiotherapists, none of these professions engage in private practice to any great extent.
  My right hon. Friend the Member for Thirsk and Malton, and the hon. Member for Bristol, South (Mr. Wilkins), were concerned particularly about chiropodists and the position of those who were not qualified, or were perhaps not in-chided in the 1954 Regulations. The position is that the precise standards to be laid down for the admission of existing chiropodists to the register will depend on the judgment of the board, under Clause 3 (2, c), but it may be that more chiropodists will be admitted to the register than are now qualified under the 1954 Regulations. When the Bill is law and the register is being drawn up, the intention is that revised regulations should be made to allow for any State-registered chiropodists to be employed in the National Health Service. This I think answers the point which so concerned my hon. Friend.
  946
  To deal with another point which my hon. Friend the Member for Putney raised, I was asked about the use of the word "registered", as distinct from "State registered". It will be an offence for the persons concerned to use the words "State registered". The Clause does not specifically prohibit the use of the title "registered", but using this title in such circumstances as to imply that the practitioner was State registered would be an offence, and I hope that in that direction we have given sufficient protection to the public.
  I was asked about the disciplinary procedure by my noble Friend the Member for Hertford (Lord Balniel), my hon. and learned Friend the Member for Surrey, East and my hon. Friend the Member for Maldon (Mr B. Harrison). The Bill follows the procedure adopted for doctors, dentists, and opticians. The investigating committee has to consider only whether there is a prima facie case, like a magistrates' court. Since this committee is concerned only with this and not with deciding whether disciplinary action is needed or not, its procedure is not prescribed in the Bill, but standing orders may be made under paragraph 16 of the First Schedule. The investigating committee would be small in number, and there should be no difficulty in constituting both it and the disciplinary committee under the provisions of paragraph 1 (2, a) of the Second Schedule.
  The hon. Member for St. Pancras, North also asked me one other question on disciplinary powers. Could the investigating committee members be outside the board? The answer is "No," because it is specifically provided in the Bill that they must be members of the board concerned. My hon. and learned Friend the Member for Surrey, East asked me whether the powers of the disciplinary committee—this is my own phrase—could be used in such a way as to give degrees of punishment. He thought that it might be rather severe for a man to be struck off. My right hon. and learned Friend has asked me to say that he is prepared to consider this, but the usual provision—and this is certainly so in the medical Acts—is to allow for restoration to the register. However, we are grateful for the suggestion, and it will be considered.

  947
  I was asked by the hon. Member for St. Pancras, North what had happened to the almoners, and how had they disappeared. I asked this question myself when I started work on the Bill. I am told that, in the course of the long discussions leading up to the preparation of the Bill, the views of the almoners were generally accepted—that they belong to the field of social work, and had no real connection with auxiliaries or the supplementary professions, to give them their new title. They have dropped out of the scene. Remedial gymnasts have always wanted to be treated separately, and this was agreed in the course of the negotiations. Therefore, we are still back at eight professions, having lost one and gained another.
  Trying to sum up, I think the Bill is in line with other registration Acts. It is on the same principle as the registration Measures we have passed here, particularly the Opticians Act, 1958, with only such modifications as we have had to introduce owing to special circumstances. It is complex—a word that I prefer to "cumbersome", which was used by the right hon. Lady—because it covers eight professions, and it is necessary to provide co-ordinating machinery, which means that it has led to a two-tier, or rather a three-tier arrangement, if we include the Privy Council. We have been conscious of the need to establish a proper balance between the supplementary professions and the medical profession. It means, for example, that the Privy Council has a rather larger part to play and does not merely have to approve certain sets of rules and exercise default powers, but must also have final approval in connection with training courses and qualifications.
  I believe that in this Bill we have achieved the balance which we have been working for, and that the Bill will provide status and give responsibility to these professional bodies. It recognises also the importance of the relationship of these bodies with medicine, and therefore provides for the inclusion of medical
  948
  views in every phase of their professional organisation. The hon. Member for Bolton, West, as well as the right hon. Lady, both said that the Bill had been presented and debated on Second Reading at short notice, with very little time for hon. Members to consider it. There was no ulterior motive in that. My right hon. and learned Friend and I do not control the Parliamentary time-table, but we assure hon. Members that we wish the Bill to be fully discussed. It is our hope that we shall have contributions in Committee from those hon. Members who have taken part in the debate today. What we must not lose sight of—and I think we have succeeded in this—is our responsibility to the people who are receiving the services that we are talking about—the members of the public. We want to make sure that those who will benefit from these professions will receive the best possible services. I think that the Bill will help to ensure that, and for that reason I commend it to the House.
  Mr. Holt: For the future benefit of the House, can the hon. Lady clear up one point? From the statement in her last remarks, is she suggesting that the Minister, knowing that he was to present a Bill to this House and take it through Second Reading, has not been consulted through the usual channels of communication, or are the channels between the Minister and the usual channels which organise the business of this House so blocked that he has not been consulted in any way whether he would like to have the Bill taken this week or next week?
  Miss Pitt: The business of the House is arranged through the usual channels, which includes co-operation with everybody concerned, but there is a time-table, and if we want to get the work done, we must try to keep to it.
  Question put and agreed to.
  Bill accordingly read a Second time.
  Bill committed to a Standing Committee pursuant to Standing Order No. 38 (Committal of Bills).

  PROFESSIONS SUPPLEMENTARY TO MEDICINE [MONEY]
  [Queen's Recommendation signified.]
  Considered in Committee under Standing Order No. 84 (Money Committees).
  [Sir GORDON TOUCHE in the Chair]
  Resolved,
  That for the purposes of any Act of the present Session to provide for the establishment of a Council, boards, and disciplinary committees for certain professions supplementary to medicine, it is expedient to authorise—

  (1) the payment out of moneys provided by Parliament of any expenses of the Privy Council under the provisions of the said Act relating to default powers of the Privy Council; and

  (2) the payment into the Exchequer of any sums received by the Privy Council under those provisions.—[Miss Pitt.]

  Resolution to be reported.
  Report to be received Tomorrow.

  NATIONALISED INDUSTRIES
  Select Committee appointed to examine the Reports and Accounts of the Nationalised Industries established by Statute whose controlling Boards are appointed by Ministers of the Crown and whose annual receipts are not wholly or mainly derived from moneys provided by Parliament or advanced from the Exchequer:
  Mr. Albu, Sir John Barlow, Mr. Blyton, Mr. Fitch, Colonel Lancaster, Sir Toby Low, Mr. Peyton, Mr. Popplewell, Mr. J. Enoch Powell, Sir Alexander Spearman, Mr. Steele, Mr. Thorpe, and Dame Irene Ward:
  Power to send for persons, papers, and records:
  Power to report from time to time:
  Five to be the Quorum.—[Mr. Gibson-Watt.]

  Mr. Peyton discharged from the Committee of Public Accounts Mr. Storey added.—[Mr. Gibson-Watt.]

  HOUSING, BIRMINGHAM
  Motion made, and Question proposed, That this House do now adjourn.—[Mr. Gibson-Watt.]
  7.32 p.m.
  Mr. Victor Yates: I am glad tonight to have the opportunity of raising a matter which is of vital importance to Birmingham and. I believe, of considerable interest to the country generally. I refer to the continued existence of houses in the City of Birmingham which are unfit for human habitation.
  For over thirty years, I have been associated with a constituency in Birmingham in which there has been a very large number of back-to-back, unfit-to-live-in houses. It has been my hope and dream that, within my lifetime, these houses would be demolished and that new estates arise to take their place. In some places this has occurred, and, although my remarks tonight may imply some criticism of the local authority, I am, nevertheless, grateful for the work which has been done by the City Council of Birmingham through its redevelopment schemes and its rehousing of very many people.
  According to official records and a statement by the Minister in answer to a Question, there are 45,000 unfit houses in Birmingham today. I very much regret that it seems that these houses will not be entirely removed within ten or thirteen years. The housing problem of Birmingham is still very far from solution.
  I wish to deal now with a special problem which arises in connection with some of these very bad houses. I previously told the local authority and the Minister of the added danger of very considerable fire risk in these houses. I have, for that reason, looked at the houses in a somewhat different light. I am informed by the Minister that there are, in Ladywood, 3,000 houses similar to the seven which I have particularly in mind. If that were right, I could only express my great alarm that such a situation could exist in Birmingham; but I could not, of course, accept that there are 3,000 houses as dangerous as the houses to which I am specifically calling attention.

  951
  In May last, in the vicinity of one courtyard in Birmingham, a few yards from the houses, there was a fire in a factory which caused the deaths of four people. Naturally, people there were horrified when they realised that there could be a fire so near to their homes and that the risk to them was very great because of their inability to have access to the street from their houses. They put their complaints before their local councillor, Councillor Raybone, and he put all the facts before the housing manager. He was, however, unable to obtain special consideration for these particular families because the housing manager considered that there were so many more similar cases.
  Since it appeared, Mr. Speaker, that I should not be able to put an Oral Question to the Minister before Christmas, I thought it right to take the alternative of raising the matter in the House. Therefore, I put the matter to the Minister for him to investigate.
  When the housing manager was asked about this matter, he made two statements. First, he said that the fire risk is no greater, and it is possibly less, than in many other central area houses located in similar circumstances. That, of course, is one of the things which I am questioning. He went on to say that four of the families in these seven houses were accommodated as a result of their becoming homeless and they had no entitlement to a transfer at the present time.
  Thus, it appears that in the seven houses to which I am calling attention there were four families who had gone there as a result of having been put out on to the street. It is a horrifying thought to me that a family with no roof over their heads could be placed in a house in which it seems possible that they could very easily be burned to death. If that was the best arrangement that Birmingham could make for homeless families, it leaves very much to be desired.
  I question the housing department's view that these houses are no more dangerous than many thousands in the city. In a letter to the Minister dated 17th August, to which I had a reply in two months—I suppose that as the General Election came during that
  952
  period it probably is not so bad, but it is enough time for the Ministry to make inquiries—I said:
  "If the fire had occurred at the front of 26 Great Hampton Street"—
  that is, the street in which these houses are situated—
  "instead of at the rear all the lives of the tenants would have been gravely in danger. The passage leading to the street is so narrow that a successful attempt to get the people away in an emergency would be in considerable doubt. I have not seen property so dangerous in Birmingham and cannot accept the Housing Manager's assertion in a letter dated 20th July as follows: 'I am satisfied that the fire risk here is no greater than it is in many Central Area houses'."
  My colleagues in the House and outside will know that I have had considerable experience in this matter. I am not a Member of Parliament who is absent from his constituency very much. I have my eyes fixed on all the dangers and difficulties that beset the people. I am trying, and I am prepared to go on trying, to find houses in the City of Birmingham which are in such a dangerous conditions as those to which I am referring.
  Let me tell the House the condition of these houses. I think that I can best explain the matter by quoting from a letter sent by the medical officer of health for Birmingham, Dr. Burn, to the housing manager, Mr. J. P. Macey, on 16th June, after this fire had occurred. I call the Minister's attention to this paragraph:
  "The houses are in such condition, so situated and so arranged, internally and externally, that had they been in private ownership I should have recommended their early demolition under Section 16 of the Housing Act, 1957. As it is, although they are the last remaining houses on an industrial block, I understand that they come within Phases 16 to 19 of the Redevelopment Scheme and therefore have an expected life of 10 to 13 years. A contract for their repair has been placed and the work is now in hand."
  He must have been misinformed about the last point, because I do not think that those repairs have been put in hand. The medical officer went on:
  "The houses are, of course, unfit for human habitation."
  Naturally, I asked the Minister to inquire into this matter, and he did so. He wrote a letter to me explaining the great programme of redevelopment and slum clearance in Birmingham, saying that he had given his approval to the reconditioning of houses. He was kind

  953
  enough to send me a letter which he had received from the town clerk of Birmingham. I was, therefore, able to see what the town clerk had to say. I think that he was quite inaccurate certainly in one of the points in his letter to the Minister. This is what the letter stated:
  "… there are still 45,000 unfit houses in the City and a very large proportion of these are in courtyards with no direct access from the street. In such cases it is possible for the occupants, if they cannot escape via their own normal tunnel entry to the street, to gain access into adjoining courtyards or other premises and thus to find alternative means of escape if the necessity arises."
  That does not apply to the houses about which I am talking, because there is no means of escape to other places.
  The town clerk goes on to say that the houses are blocked in by walls. I was astonished to read these words:
  "As both walls are in perfect condition it is unlikely that a fire in either factory would spread to the houses or endanger people in the open yard. Occupants of all houses should be able to leave and walk down the tunnel into Great Hampton Street in safety."
  I went to the scene to see whether this was correct. I found that the large wall to which the town clerk referred was in a dangerous condition, with bricks falling off the top. Even the cats at night knock the bricks off. In fact, the families inform me that they fear that these bricks may fall upon children.
  Did an officer of the health department or housing department examine this wall? Have officials of the Birmingham Corporation seen this wall, which is in such a dangerous condition? A number of families are boxed in by high walls. Not only is this unhealthy, shuts out the light, and causes a lack of air, but there is in their minds the terrible danger that now arises as a result of the severe fire which took place on the other side of this wall, in which four people were killed. Smoke could come through the wall. How can the town clerk say that these walls are in perfect condition? It just is not true. I should like to ask the Minister whether someone could go to see that wall.
  The town clerk states:
  "No difficulty should be experienced by the occupants of any house in making their way to the open yard. Once there they are in comparative safety".
  But he goes on to establish the point that I have tried to make on a number of occasions. I quote:
  954
  "As fire might well involve the tunnel leading to Great Hampton Street this route could be blocked, and although persons in the yard would be in no immediate danger their removal, whilst not impossible, might be difficult."
  I ask the Minister to imagine houses blocked in by a wall, with a tunnel 34 in. wide, a polishing shop on one side of the tunnel, stores on the other and over the top and the houses only 15 ft. from the wall.
  If fire escapes or escape hatches were put in the houses the people might have to go one way or the other through each house to get to the ground. When they reach the ground they realise the enormous danger. I would like the Minister to see a photograph of the tunnel which was printed in the Birmingham Evening Despatch. It shows this narrow tunnel through which the people are expected to go. If it were a question only of the unfit houses, I should not have to say that they were vastly different from many of the other houses. There is, however, the added fact that the people have become conscious that they are in danger. In these circumstances, I have the greatest sympathy for them.
  The tenants, I understand, have refused to have the fire escape hatches put in. I advised them to have them installed. It is not wise not to take every precaution. The people's fear, however, is not the houses themselves, but that the tunnel puts them into the trap. They feel that they are in a death trap and it is natural that they should ask to be taken from it. We have, therefore, established special circumstances.
  It is said that there are 3,000 people in my constituency and several thousand in the City of Birmingham who are in this danger. I have never seen anything like it. Can the Parliamentary Secretary tell me how many courtyards there are in the City of Birmingham which are no wider than 34 in.? The answer is that he cannot say and neither can the housing manager.
  Even to put in escape hatches and to recondition these houses at a cost of £795 is not satisfactory. In the circumstances, it is a waste of money. It is wasting the ratepayers' and taxpayers' money to put these houses into a condition in which danger still might occur at any time and which, when it happens, would lead to a far greater cost. There

  955
  is, therefore, a case for early demolition of these house, and the sooner the better. When the medical officer himself states that if the houses were in private enterprise ownership he would recommend their early demolition, we should not be content to sit by and allow houses which belong to the corporation to remain in this condition for another ten or thirteen years, causing danger to the people.
  That is my case; I appreciate that much has been done to rehouse the families from unfit accommodation in Birmingham. If it takes all these years to remove more people from the slums, it will be an extremely serious matter. Can the Minister tell us of any way in which he can assist to get these houses demolished earlier? He has turned down a number of suggestions for possible developments that might produce more houses, but the city finds it extremely difficult to extend its boundaries. It has very little land—we appreciate the difficulties—but are we to wait all this time and to wait even for houses of this nature, which not only are unfit for human habitation, but which, even when reconditioned, still lack light?
  People complain daily about the fumes and the noise from the factories which are bang up against the houses. This should never be allowed. I cannot believe that there are worse conditions than these. I therefore appeal to the Minister to give further consideration to this matter. I ask him to have an inquiry into it. Let us go into it fully so that we may get justice for these people but, above all, so that we might remove their ever-present nightmare. They are conscious of this tremendous nightmare that overshadows them.
  I hope that the Minister will say something tonight that will enable us to go to the Birmingham City Council and say, "You have done extremely well, but why not look at this problem again? Why not examine it again on the spot to see whether these conditions are so dangerous that the people should be removed?" Homeless families should not be taken from the streets and put into conditions of this kind. I trust that the Minister has made careful note of what I have said and that we shall have from him tonight something that
  956
  gives light and hope to the people concerned.
  7.58 p.m.
  Mr. W. E. Wheeldon: As one who has spent many years in Birmingham, who was, for many years, a member of the Birmingham City Council, and who, today, represents a constituency which has many thousands of unfit houses in it, I should like to add a few words to what my hon. Friend the Member for Birmingham, Ladywood (Mr. V. Yates) has said.
  Towards the end of his speech, my hon. Friend said that there was a strong case for the early demolition of what we in Birmingham call back-to-back houses. I certainly agree. There is a very strong case. At the same time, we should keep in mind what has already been done in Birmingham, so that we may get the matter in perspective. I shall return presently to the question of the unhealthy houses. First, I want to point out some of the things that have been done in this connection in the past few years.
  In Birmingham, the post-war slum-clearance programme started in 1947. In June of that year, we got from the Ministry an order which allowed us to get on with the job.
  The city council started the job by taking under review five redevelopment areas comprising about 30,000 houses most of which were unfit for human habitation, and those houses occupied an acreage of about 1,000. By the end of 1953 practically the whole of those houses were vested with the corporation. At the same time, while that process was in being, the corporation built approximately 18,000 houses. Despite that background there are, of course, as my hon. Friend said, very many unfit houses in Birmingham. I think the present-day figure is about 45,000.
  The most distressing thing about these houses is, I think, that they have been there for so many years. It was only this weekend that I received from the medical officer of health for Birmingham a copy of his report for 1958, and I should like to quote a short paragraph from that report. Our present medical officer refers to the fact that in 1918 one of our most eminent medical officers of health, Sir John Robertson, penned these

  957
  words in his annual report for that year. He was speaking of the back-to-back house and he said:
  "Its chief defect, in addition to its lack of size, its dampness and its dilapidation, is that it is not self-contained. There is no water supply inside the house, no adequate provision for discharging slop water, and the only sanitary convenience is often some distance from the house and usually common to two or more houses. This convenience is frequently in a revolting condition because of its common user."
  There is no bath or means of taking a bath in many of the houses.
  "The whole outlook from these houses is sullied by soot besmirched in a soot-laden atmosphere."
  Sir John Robertson went on to say:
  "It is impossible to imagine a rising generation of young people being able to improve in health or self-respect even even if the best of educational facilities are provided when everything they come into contact with is sullied by dirtiness and squalor. In my opinion there is only one remedy—the replacement of these slums by decent houses in a pleasant environment."
  Now for a significant comment. Although that attack on our slums in Birmingham was made in 1918, nevertheless, as our present medical officer of health pointed out in his report, published only last week:
  "Many of those houses referred to are not only occupied today but are likely in many cases to remain so for up to another twenty-five years."
  Surely that is a damning indictment of whoever has been responsible for housing legislation in this country.
  Many of those houses, I am sorry to say, are in my constituency. They are houses from which men went out more than forty years ago to fight in the 1914–1918 war. They were told that they were to have homes for heroes, yet the sons of those men went out from the same houses in 1939 to fight for their country, and many of those houses are still standing today.
  I come back to the question of demolition mentioned by my hon. Friend. If demolition were the only Cling it would be comparatively easy to do, but, unfortunately, it is not. We have to rehouse those people, and that is one of the most serious aspects of the problem of unfit houses in Birmingham today, as, indeed, I suppose it is in other large cities. I can illustrate that by figures for 1958. In Birmingham, the
  958
  total number of new dwellings provided was 3,526, but the total demolitions were 1,578, so that the net increase in housing accommodation was only 1,948 dwellings.
  It has to be remembered that the number of demolitions, if the medical officer could have his way and if the corporation could have its way, would be even greater than the number I mentioned a moment ago, but they cannot proceed at a greater rate of demolition because they know that they cannot build the houses to accommodate the people who are displaced We must keep these figures in mind when we are talking about the problem of unfit houses.
  Birmingham, as I said at the beginning of my remarks, has already done a great deal towards solving this problem. I notice that last year—these are the latest figures available, I understand—96 clearance areas were represented by the city council and those areas comprised 4,322 houses. In addition—this refers to houses taken aver by the corporation, under their redevelopment schemes—it renovated over 2,000 of them and spent on the average about £250 in repairing those houses. So it has done a considerable amount of work to make conditions of life generally better for the people who are compelled to stay there for, perhaps, another five, ten, fifteen or, in some cases, even twenty years.
  One other figure which will help to put this matter in perspective is that for ordinary house inspections undertaken by the health department. I notice that last year there were over 93,000 house inspections made by the public health inspectors and that over 10,000 statutory notices were served on the landlords of those houses.
  That is the background, but it does seem to me that the key to the solution of the problem submitted to us by my hon. Friend is that we must have an increasing number of municipal houses. I say "municipal houses" advisedly. That brings me to the point also mentioned in the speech of my hon. Friend, that, here, the Minister himself must take a considerable measure of blame for this condition in Birmingham. We have approached him on a number of occasions, and so has the city council, in the attempt to get him to agree that there

  959
  should be a new town for Birmingham. This is not a problem of hundreds of people; it is a problem of thousands of people who want accommodation and want it urgently.
  We have at present a waiting list of well over 70,000 people, many of whom are living in these unhealthy back-to-back houses, yet the Minister, in my opinion very stubbornly and without good reason, turned down the question of a new town for Birmingham
  There is one other thing for which the Minister is responsible and that is the question of the ability of the corporation to develop land outside the city boundaries for housing purposes. I hope that the Parliamentary Secretary will be able to tell us—I know he has had no notice of this—what is happening to the application made by the city council in July this year for additional land outside the borough boundaries. I am speaking from memory, but the inquiry was, I think, concluded in July, four months ago. So far as I know, word has not yet come from the Ministry. It is a matter of very great urgency. One sits week by week listening to the complaints and stories of people who are living in intolerable conditions. Something—indeed, everything—ought to be done, and as quickly as possible.
  All these things have been with us for very many years. They were the legacy of private enterprise landordism which failed to repair houses even when the landlords had the money to do it, so the Birmingham Corporation, as the councils in other cities have had to do, has had to step in. I believe that we shall not solve the problem, although we can, here and there, make things a little better, till Birmingham Corporation, as well as other corporations, are given the right to take over the whole of this working-class housing accommodation. Only in that way can we solve the problem.
  8.10 p.m.
  Mr. John Stonehouse: I congratulate my hon. Friend the Member for Birmingham, Ladywood (Mr. V. Yates) on his initiative in raising this question on the Adjournment. Lady-wood is very well served by its representative in this House, and his initiative in raising this subject will be valued not only by those constituents who are deeply
  960
  and directly affected by this case, but also by all his other constituents.
  The position in Birmingham, to which he has referred, is shared by the surrounding constituencies. The problem of our unfit housing is one not only for Birmingham, but for Wednesbury, which lies on the outskirts of that city—or perhaps I ought to say that Birmingham lies on the outskirts of Wednesbury. The problem of very bad housing in industrial conurbations is one that we think the Minister should take special pains to correct. We owe a very deep debt to those who live in our industrial areas. They have created the prosperity which is enjoyed by people in other parts of the country, who certainly could not enjoy it unless, in the industrial areas, the hard, grinding work was carried on.
  These people have to live in unhealthy and in many cases squalid surroundings, because in the days of the Industrial Revolution heed was not paid to the social conditions of the people. Heed was paid only to the profits to be made by the adventurers who set up factories in the Black Country and elsewhere. The people who live there have had to pay the price—not only the people of those days, but their children and grandchildren. They have all had to pay the price of living in miserable, squalid houses, because the guts were taken out of a very healthy and pleasant part of Britain in the interests of the Industrial Revolution.
  The whole country owes a debt to these areas, and I hope that the Minister and the Parliamentary Secretary will be pressing their priority on their colleagues. We recognise the abilities of the Parliamentary Secretary, and we congratulate him upon his appointment. We know that he has a very progressive outlook and that he wants to make a mark in the field to which he has been appointed. One of the ways in which he can do so is to use his influence among his colleagues to see that greater priority is given to the very serious question of housing. People cannot have a healthy family life or a better cultural outlook unless they have decent homes to live in. In the industrial conurbations of the West Midlands we want more and more better houses. That means that we must help the local councils to solve the problem.

  961
  I am very fortunate in having, in my constituency, three authorities which have all done a good job in helping to solve the problem. In particular, the Wednesbury Borough Council has been able to build many attractive council estates, and is now engaged upon a very fine slum clearance programme. But that council, like many others, is severely embarrassed by the restrictions placed upon it by the Government. We appeal to the Parliamentary Secretary to use his influence to get these restrictions removed so that the Wednesbury Borough Council and other local authorities can engage not only in slum clearance programmes, but also in building for general needs.
  Many of the filthy and squalid houses should be torn down. In the twentieth century it is a disgrace that these houses should continue to be lived in, with the occupants having no prospects of obtaining new accommodation in the foreseeable future. Like my hon. Friends, I have my attention drawn almost weekly to cases of really severe housing hardship. I have been to many homes which are absolutely deplorable. A few months ago I went into one where I found an old lady sleeping in a bed, almost unable to get up because she was so sick, but having to have her bed moved because there was a hole in the ceiling through which the rain came. A pail had to be put by her bed to catch the water coming through the roof.
  I have also been into homes in which there were young children, where the damp, on wet days like today, gradually climbs up the walls until it reaches the height of a man. It can be felt if the hand is placed on the wall. These homes are, unfortunately, to be found in their hundreds, or even thousands, in the Black Country, and I hope that the councils in that area, as elsewhere, will be assisted by the Government to deal with this very urgent problem. We beseech the Parliamentary Secretary to use his endeavours to influence his colleagues to give greater priority to its solution.
  8.16 p.m.
  Mr. Edward Short: I support my hon. Friends the Member for Birmingham, Ladywood (Mr. V. Yates) and Wednesbury (Mr. Stonehouse). The city a part of which I represent is facing one of
  962
  the worst housing situations in the whole country, and I make no apology for intervening in a debate on Birmingham's housing problem to talk about housing conditions in Newcastle-upon-Tyne. At the moment, in a city of 280,000 people, there is a waiting list of 10,000, not including all those living in unfit houses. Many people living in slum areas are not included in the corporation's waiting list.
  The slums of Newcastle and many of our great cities are a reproach to a Christian community, and I do not think that we should tolerate their continuance very much longer. My constituency is probably one of the worst housed in the country. People there are living in squalid, dilapidated hovels, which are not fit for human beings to live in. One house which I recently visited—No. 1 Cambridge Street, Newcastle-upon-Tyne—is the worst house that I have ever been in. It has five or six rooms, and two attics. The landlord collects between £6 and £7 a week in rent, but no self-respecting farmer would keep his animals in it.
  There is no light of any kind on the stairway or in the passages. There is no glass in the windows on the stairway. The front door will not shut. The rooms have to be seen to be believed. There is one tap on a landing without a proper sink, and if the tap runs and nothing is placed underneath it the water soaks through to the room below. The toilet is disgusting. It is not fit to use. Nevertheless, the house contains five or six families, including young children. In the two attics, which have only dormer windows, two old men live, each in a separate room, in the most appalling conditions.
  It is quite common in my constituency for seven, eight, nine, ten or even fifteen families to share one toilet. The House of Commons ought to be told about these matters. In the second half of the twentieth century no fewer than fifteen families have to share one toilet. In some cases there is no toilet, and the occupants of the house must go along the street to their neighbours. In others the toilets are so broken down that they cannot be used. I should be failing the people who sent me here if I did not intervene in the debate to say a word on their behalf.

  963
  During the General Election, in one of our political broadcasts, we spotlighted a street in Newcastle called Elswick East Terrace. One of our Conservative friends from Newcastle said that it was despicable to make political capital out of housing difficulties. I make no apology for doing so. I shall continue speaking about Elswick East Terrace in this House and in my own city until the wretched place is demolished.
  In that street, 36 families are living in conditions that have to be seen to be believed. I went into one house—I think that it was No. 23—where a woman was lying ill in bed in a room smaller than the one described by my hon. Friend the Member for Wednesbury (Mr. Stonehouse). The walls were so damp that the wetness could be seen on them. This, of course, is the picture throughout the whole of my constituency. It is a vivid illustration of the failure of landlordism. In the days when the rents were adequate they spent nothing whatever on these streets. They took the rent from those houses year after year until the property decayed and has now become unfit for human habitation, but they still collect the rent.
  In May, 1958, we had for the first time in Newcastle a housing committee which really began to make an assault on the slums and plan their clearance. It has had to go to certain people living in the slum area and tell them that their turn for houses will not come for ten years. Imagine going to people living in the conditions I have described and saying, "Your turn will not come for ten years, seven years, or five years. You may have got to stick it for another decade."
  Our greatest difficulty—this is why I have intervened, as I suspect the hon. Gentleman knows—is the shortage of land. We have used up, or are using up, every inch of building land within the city. Almost all our building since the war has been outside the city boundaries. Recently, we submitted a compulsory purchase order for one of the few remaining open spaces outside the city boundaries, and three weeks ago the Minister turned it down in favour of private building. This was a terrible disappointment to us. I wrote to the Minister immediately and told him how terribly disappointed we were. I hope
  964
  that as we submit compulsory purchase orders for slum clearance the Minister will as he has promised me, try to reduce the time by at least half the normal period to help us keep up the impetus of our slum clearance.
  This shortage of land means that the Corporation of Newcastle-upon-Tyne cannot give a house to anyone unless it can get the land on which the old house was built. That, together with the Government's withdrawal of subsidy for non-slum clearance houses, means that anyone who does not live in a slum clearance house cannot have a house. It is virtually impossible to give anyone a house in Newcastle unless he is living in a slum clearance area. We have reached a point—I wish that the hon. Gentleman's Ministry and officials would realise this, but they do not—at which we cannot give anyone a house unless we can get the land on which the old house was built. Because of this, many people, even in the slums, will have to wait ten years.
  I support the closing remarks of my hon. Friend the Member for Wednesbury, because I believe that the Government's present housing policy is quite inadequate to deal with the older industrial towns. They must look at it again. Towns of this kind should have more consideration than they are getting. The Government's policy may be adequate for some areas, but it is not adequate for Birmingham, the Black Country and Newcastle, and I do not believe that it is adequate for Leeds. I hope that the Government will reconsider their policy on housing and see if something extra cannot be done for these old industrial towns where we are faced with such tremendous problems.
  8.25 p.m.
  The Parliamentary Secretary to the Ministry of Housing and Local Government (Sir Keith Joseph): The debate, very understandably, has widened a little from the Birmingham area with which the hon. Gentleman the Member for Birmingham, Ladywood (Mr. V. Yates) started. I should like to apologise to the last two speakers, the hon. Members for Birmingham, Small Heath (Mr. Wheeldon) and Newcastle-upon-Tyne, Central (Mr. Short), for saying that—although they had no obligation at all under the circumstances to give me notice—I cannot

  965
  give a detailed reply to what they have said.
  The subjects which they have raised are enormously important. In all the areas to which the hon. Member for Newcastle-upon-Tyne, Central referred there is a desperate shortage of land, but extremely vigorous local authorities, to whom hon. Members have all paid tribute, are trying to tackle this problem.
  There is, as the House knows, a choice of weapons which can be used together. There is the building in central areas at a higher density, the policy of seeking Yelp from neighbouring areas by expanding towns and the policy of improvement grants which the Government have pioneered and supported so strongly, but when all this has been said it remains true that there are areas where the problems of urban renewal, as the hon. Member for Newcastle-upon-Tyne, Central has said, are vitally important and deserve the most careful thought.
  I was sorry to hear the hon. Gentleman the Member for Wednesbury (Mr. Stonehouse) refer to restrictions. I do not know of any. If his own local authority wants to propose the building of more houses I know that my right hon. Friend will consider any proposal sympathetically.
  Mr. Stonehouse: Will the hon. Gentleman also press for a reduction in interest rates to enable council housebuilding to go ahead?
  Sir K. Joseph: Interest rates rise and fall. Local authorities are borrowers over a long period of time, which evens interest rates out, and many local authorities by applying differential rent schemes are spreading the burden among all their tenants. I should like to look with much more care into the case which the hon. Gentleman makes.
  Coming to the problem raised by the hon. Gentleman the Member for Lady-wood, I can try to answer him in more detail. I was glad that his hon. Friend, the hon. Member for Birmingham, Small Heath, saved me from setting out the background to the tragic fire, which originated this Adjournment debate. As we all know, Birmingham has a very large housing problem and is tackling it in a way which deserves the tributes voiced by the two hon. Gentlemen. I was asked what had happened to the
  966
  application of July, 1959. I hope that the hon. Gentleman will understand that I cannot answer as there is now an appeal before my right hon. Friend. We are trying to speed up decisions wherever possible and I am sure that will be true of this case as well.
  I wish now to come on to the subject of the back-to-back and courtyard houses and the fire risk involved. I must say emphatically that, although deeply interested in matters of housing, my right hon. Friend has absolutely no status whatsoever in those circumstances. It is entirely a local authority matter. Anything I say now is really a quotation from the local authority representatives. I shall cover the subject of the fire risk, but I cannot cover the questions about the four families resident in four of the seven houses to which the hon. Gentleman referred. Nor can I cover the question of the quality of the walls adjoining the houses. These are matters for the local authority and I can do no other than rely on what has been said by the local authority.
  The hon. Gentleman has an understandable concern in this matter. He is absolutely right to concern himself carefully regarding the danger to his constituents. But I am sure he is equally aware that it would not serve them well if he exaggerated in any way their understandable fears which have been set at rest by the reassurances of highly responsible technical officials, the chief fire officer, the town clerk and the housing manager, whose job it is to be, and whose future reputation depends on their being, right in these matters.
  Of course, the fire in Great Hampton Street was a tragic occurrence. It is completely understandable that the residents in the houses concerned were extremely frightened at the time. It is all very well for me to say now that it appears that they were in no real danger. But I am not for a moment denying that had I been in that situation I, too, would have been very frightened. However, the fact is that the chief fire officer says that when the fire occurred they were in no danger, and they would have been in no real danger if the fire had occurred at 26, Great Hampton Street, which adjoins their houses.
  We have heard something of the size of the housing problem in Birmingham,

  967
  and it has become necessary for the authority to seek the approval of my right hon. Friend, which has been given, to retain a large number of its unfit dwellings for a number of years and to patch them so as to make them tolerable to live in meanwhile. There was a quotation by the hon. Member for Lady-wood from the medical officer of health that if these seven houses had been in private occupation, he would have condemned them. The fact is that a private landlord is not entitled to keep an unfit house standing. But Parliament has given power to local authorities to keep unfit houses standing, provided that the authority patches them; and, as the hon. Member knows, it is the intention of the Birmingham authority to patch these houses which it is proposed shall remain in occupation for at least ten years.
  As both the hon. Members representing Birmingham constituencies have said, there are too many back-to-back and blind-back houses in Birmingham and everyone would like to see them wiped away overnight. I know that those of my hon. Friends who represent Birmingham constituencies and who are listening to this debate share that wish as ardently as anyone. But it is utterly impracticable to demolish these houses without denying new housing to other constituents of the hon. Gentleman's who are equally deserving. If a house is dealt with out of order, it can happen only at the expense of another house, because there is a limit to the amount of housing which may be done even by so large a local authority as Birmingham. Therefore, we return to the question of fire risk. Is it such that these houses ought to be given priority treatment?—and here, of course, my right hon. Friend and I can only rest upon the technical view of the chief fire officer.
  He has gone on record, or he is quoted by the town clerk in a letter of 6th October, 1958, as being of opinion that there is no strong case for regarding these houses as subject to abnormal fire risk such as would make it imperative to rehouse the families—
  Mr. Charles Loughlin: I venture to intervene only because I have some experience of back-to-back housing. It may well be that there is no greater danger of these houses being set on fire, but usually they are
  968
  premises with one room up and one down and there is only one exit and entrance. A fire usually starts in the bottom room and, assuming that the people upstairs are in bed when it starts, they have no exit whatever. It is obvious, therefore, that there is a greater fire risk in this type of house, and I cannot see the point of quoting the opinion even of a chief fire officer when the physical nature of the building is such that it presents a greater fire risk.
  Sir K. Joseph: I am grateful for the intervention from the hon. Gentleman. That is the point I am coming to, and I am glad to have his co-operation. The really dangerous feature of these houses is the fact that they consist of one room up and one down with a blind back. Anybody who is trapped on the top floor can, therefore, descend only through the flames. That is the main risk. It is not necessarily the presence of a tunnel at all. Because there is this risk the Birmingham authority has made an offer to the tenants of such houses of the free installation of an alarm bell, which rings when the temperature of a room reaches a danger point, and hatches giving horizontal communication to the house next door. Already 6,000 of these hatches and 7,000 alarm bells have been fitted, and the residents of these seven houses have been offered hatches and alarm bells, as was made clear by the hon. Member for Ladywood.
  Mr. V. Yates: The letter which has been mentioned contains points which I have said are inaccurate. Do I understand that in such cases the Minister has no status whatever even to inquire into whether facts are correct? I was referring to the wall in this case, which is in a dangerous condition. Will the Minister tell me whether he can inquire into this matter?
  Sir K. Joseph: There would be certain circumstances, I believe, if I may reply without notice of the question, in which it would be possible to inquire, but those circumstances certainly do not exist here.
  The hon. Member threw doubt upon two passages in the town clerk's letter. He said that the walls are not perfect. It may be that a brick or many bricks at the top of the wall are insecure, but the town clerk is talking about whether they

  969
  are solid enough to stop the spread of fire, and the hon. Member has given me no evidence this evening that the walls are not solid for their main height.
  Mr. Yates: During my speech I said that smoke could come through certain parts of the wall. People have complained about this. To go and to see the wall is to say that it is not perfect. The town clerk says that it is perfect. I challenge him, and I challenge the Minister, to prove that it is perfect.
  Sir K. Joseph: The hon. Member has done service to his constituents if that is so, because I am sure that the Birmingham officials will read the report of this debate. We can only rely upon their judgment. I have here a letter saying that for the purpose of preventing the spread of fire, the walls are perfect. No doubt the officials concerned will read the report of the debate and take any action that they think fit.
  As the hon. Member for Gloucestershire, West (Mr. Loughlin) said, the risk in the back-to-back and blind-back houses is that of being trapped upstairs and having to jump or to come down through the flames. Consequently, I very much regret that the residents in these houses in Birmingham have refused the hatches which so many thousands of their fellow citizens in Birmingham have already accepted. It may well be that they feel that in some way they would commit themselves to a permanent occupation of the houses if they accepted these installations.
  I was glad to note that the hon. Member himself tried to persuade them to accept them. I am sure that they would be most misguided not to accept this help. After all, it is the only thing which the chief fire officer says is necessary in their situation, and 6,000 of their fellow citizens have already accepted these hatches. It is only proper for me to say here that there is no evidence known to me that the local authority has any intention to demolish their houses earlier or to move them sooner according to whether they accept these hatches. They cannot alter their prospects of rehousing by refusing to accept these hatches, and I very much hope that they will accept them.
  I am afraid that I must leave the matter there. Despite all the interest in the world which my right hon. Friend
  970
  has in housing as a whole, this is a local authority concern. It is true that there are circumstances, where houses are three storeys high, with an upper floor more than 20 ft. above the street, and where the dwellings are let in tenements, in which certain fire precautions can be required, but that is not so in these houses, because they are not let in tenements. We are not entitled on an Adjournment debate to discuss any amendment to legislation.
  I have noted most carefully all the comments which hon. Members have made on the general housing need. If I may say so with respect to them, they are not new; they are known and deeply felt by my right hon. Friend and are being most vigorously studied. Apparently the hon. Member for Gloucestershire, West mocks at the word "study", but as the problem of urban rehousing becomes acute, it becomes a field for study. My right hon. Friend and his Government have a great record in rehousing many millions of people in this country, but as the easier parts of the housing problem are dealt with, the remaining problem becomes harder, and it is not to be sneered at if I say that this matter is given the most concentrated study.
  I repeat that the fire which led to this debate was a tragedy. I very much hope that the residents in these houses will take the advice of the chief fire officer, accept the installation of these hatches and live in tranquillity.
  Mr. Short: Before the hon. Member sits down will he reply to the specific point which I made, that it would be a great help to us in our slum clearance programmes if the Ministry could halve the time which it is taking over compulsory purchase order procedure at the moment?
  Sir K. Joseph: I apologise to the hon. Member. I had a note of that. If I may reply with the permission of the House, it is one of my right hon. Friend's main intentions to shorten the time in which either planning or C.P.O. applications are decided.
  8.43 p.m.
  Mr. Charles Loughlin: The Minister said that housing development in certain areas is becoming easier. At the same time, we have to

  971
  accept a statement from him that the only possible solution to the rehousing of slum tenants—and that is the issue with which we are dealing this evening—is through the local authority, not merely in the City of Birmingham, but in every town and city in the country. Gloucestershire, West is a three-part type of constituency—industrial, dormitory and rural area. In all those three parts we have precisely the same problem.
  Mr. Deputy-Speaker (Major Sir William Anstruther-Gray): Order. The hon. Member is not out of order in broadening the debate, but the Minister was given notice only that Birmingham would be discussed, and it is a little hard to raise instances of other towns when the Minister is not briefed to reply.
  Mr. Loughlin: I must bow to your Ruling, Mr. Deputy-Speaker.
  In the City of Birmingham—
  Mr. Short: On a point of order. Would you not make it clear, Mr. Deputy-Speaker, that my hon. Friend was not debarred from discussing Gloucestershire. It may be hard on the Minister—and I am sure that my hon. Friend is sorry about that—but under the rules of procedure my hon. Friend is entitled to talk about Gloucestershire if he wishes to do so.
  Mr. Deputy-Speaker: What the hon. Member for Newcastle-upon-Tyne, Central (Mr. Short) has said is absolutely correct. I do not think that in my intervention I suggested that it would be out of order. It is only that if the Minister has not been warned that the subject is to be raised on the Adjournment, it is in vain to expect a satisfactory and fully briefed reply.
  Mr. Loughlin: I had not intended to develop the argument about the position in West Gloucestershire or in rural areas. I was about to deal with the Parliamentary Secretary's statement that housing development has become easier in some areas. That was the statement which he made. I was pointing out to the Parliamentary Secretary that in a constituency such as I represent, with industrial, dormitory and rural areas, we have precisely the same problem as cities and
  972
  towns. I do not know just what the Parliamentary Secretary means by saying that the housing situation has become easier in some areas.
  I was going on to say that the only possible solution to rehousing from slum clearance areas is under the local authority. If I am not mistaken, we were told in the House only a few days ago that the number of houses built by local authorities had decreased, although the number of houses built by private builders had increased. There is no salvation for those people in slum property to have the number of houses built by private speculators going up. The Government should take urgent action.
  I say "the Government" very sincerely, because I was being literal when I said to the Minister that I had had experience of back-to-back houses. Some of my family have lived in back-to-back houses. It is only by living in them that one knows their true evils. I have stayed with some of my relatives living in back-to-back houses. I have risen in the morning and had to walk half-way down the street in the most atrocious weather to perform the most ordinary functions of nature, for which, no doubt, the Minister has facilities in his own home.
  There are 60,000 back-to-back houses in the City of Leeds, a figure duplicated in the City of Birmingham. We cannot piously talk about improvements having been made, because the problem is duplicated in every town and city of Britain. Speaking in terms of human beings, it is something for which any Government worthy of their name would institute a real wartime programme. We can utilise the whole resources of the nation when war comes along. It is of equal importance to utilise the resources of the nation to rid the country of its slums and provide decent housing for ordinary men and women. They cannot afford to pay the inflated prices of private speculators and then be faced with repairing their houses because of the shoddy nature of a great deal of speculative building going on today. They cannot afford to pay those prices, and unless the Government direct their policy of rehousing on the lines of municipal building, and as the curve is going down on municipal building—
  Mr. Deputy-Speaker: Order. I am becoming a little disturbed at the course of the debate. The hon. Member will realise that the Minister has already exhausted his right to speak and he cannot, therefore, give a reply. It is not satisfactory to speak when a Minister is not available to reply to what the hon. Member is saying.
  Mr. Loughlin: I hope that you will forgive me, Mr. Deputy-Speaker, because I am rather inexperienced on these benches.
  Mr. Yates: On a point of order. What you are now ruling, Mr. Deputy-Speaker, is entirely new. It has always been the practice that in an Adjournment debate hon. Members may continue to speak until 10.30 p.m. if necessary. It is unfortunate if the Minister is not present, or if he is not prepared to sit and listen, but it does not prevent an hon. Member discussing the whole field of housing—not that I wish to do that. If the Minister is there and is listening, is it not perfectly in order for my hon. Friend to make a speech even over the whole field of housing tonight, if necessary?
  Mr. Deputy-Speaker: What the hon. Member says is perfectly correct. The debate can go on until 10.30 p.m. It is usual in Adjournment debates to make speeches before the Minister rises to reply, and then the Minister can give an answer. What has happened tonight—I am in the recollection of all hon. Members who were present—is that, after the Minister made a full reply and resumed his seat, having exhausted his right to reply, the hon. Member for Gloucestershire, West (Mr. Loughlin) rose to make this fresh speech. That is leading us to a situation which I think is to be deprecated, but certainly it is not out of order.
  Mr. Yates: Is it not within the rules of order, Mr. Deputy-Speaker, for a Minister to be able to make a second speech in a debate with the permission of the House?
  Mr. Deputy-Speaker: I do not think that that happens very often in an Adjournment debate, and I do not think that what has happened tonight makes for the general convenience. The Minister rose and gave a full reply. No hon. Member intervened. The Minister
  974
  having resumed his seat, off we go again on a different subject which was not mentioned in the original notice for the Adjournment debate. It is not out of order, and I have not ruled it out of order. I have endeavoured to point out that it leads to an unsatisfactory course of debate.
  Mr. Loughlin: Mr. Deputy-Speaker, I shall respect your Ruling—
  Mr. George Lawson: On a point of order. When an hon. Member speaks, even in circumstances such as those, can he not rightly assume that the Minister concerned will read his speech and that, if not able to give a reply in the House, the Minister will give a written reply to the points that have been made? On this basis, although it is understood that the Minister may not reply on the spot, my hon. Friend is not wasting his time in making his contribution, knowing that what he says will be studied and that probably a satisfactory answer will be given at a later date.
  Mr. Deputy-Speaker: Again, what the hon. Member for Motherwell (Mr. Lawson) says is quite in order, technically, but it seems to me to outrage the sense of fair play that ensures that each side should be heard in debate. It means, in fact, that only the side complaining is heard, and that the side replying to the complaint is debarred from replying. Although it might not be out of order, it does not seem to me to be a convenient or satisfactory way for an Adjournment debate to be carried on.
  Mr. Stonehouse: With great respect, Mr. Deputy-Speaker, while fully agreeing with your last point, may I say that the Minister said that he could not reply to the general points on housing that have been raised? Therefore, my hon. Friend is merely asking that the hon. Gentleman should make a note of the points he is making so that the Minister concerned may consider them at some future date. But may we, for the benefit of the House, have a Ruling from you, Mr. Deputy-Speaker, that when a Minister has spoken in an Adjournment debate it is perfectly in order for hon. Members to continue the debate until half-past ten?
  Mr. Deputy-Speaker: I hoped that I had made it clear that it was not out

  975
  of order. Nothing has happened that is out of order. What I said related only to the general convenience of the House in conducting Adjournment debates.
  Mr. Yates: It will be within your recollection, Mr. Deputy-Speaker, that we have had Adjournment debates that have lasted for a considerable time even when there has not been a Minister present. Although I raised a specific matter in connection with Birmingham's housing, hon. Members have been able to raise other points. Surely, if the Minister is present and is willing, with the permission of the House, to reply to the matters put forward, he may do so: or even say to hon. Members that he will give consideration to those points, and write a reply later. I think that he is entitled to do that, with the permission of the House, in an Adjournment debate.
  Mr. Deputy-Speaker: If a Minister asks the House for permission to speak again, it is for the House to decide whether or not that permission is granted If it is granted, the Minister can, of course, speak again. I have tried to be very clear in not ruling anything out of order. I have studied to maintain what I believe is best for the general convenience in conducting debates on the Adjournment. Mr. Loughlin.
  Mr. Loughlin rose—
  Sir K. Joseph: With the permission of the House, I may say that I will, of
  976
  course, take very careful note of anything that is said, and will try to send a reply on any specific points raised.
  Mr. Loughlin: It seems, Mr. Deputy-Speaker, that my second baptism is one of hot water. I must make it clear that I appreciate the way in which you are trying to conduct the debate, and I apologise to you. I shall not be awkward in any way. To some extent, I had made up my mind not to say anything in the debate, but the Minister provoked me by his remarks. I shall terminate my remarks within a matter of seconds.
  I was speaking about the necessity to mobilise the nation's resources to resolve a problem which results in an enormous number of people not only having to drag out their lives in squalid housing conditions but, more important, to bring up children in those conditions. I think that the Minister was wrong in his attitude of sheer complacency. When we have literally hundreds of thousands of people living in slum conditions in our industrial centres and rural areas, simply to say that things are going well, that something is being done—when it is recognised that rehousing is not keeping pace with the increasing number of slums—is itself an indictment of the Minister's approach to the problem.
  Question put and agreed to.
  Adjourned accordingly at one minute to Nine o'clock.

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