Sitting of 23 November 1979

Preamble
The House met at Eleven o'clock
PRAYERS
[Mr. SPEAKER in the Chair]
NEW WRIT
For Hertfordshire, South-West, in the room for Geoffrey Hugh Dodsworth, Esquire (Chiltern Hundreds).—[Mr. Jopling.]

PETITIONS
Mr. Speaker: I have a brief statement to make. On Friday last, the hon. Member for Normanton (Mr. Roberts) presented a petition for leave to produce certain documents in a court of law and, in the usual way, moved a motion for such leave to be granted immediately thereafter. In rising to oppose this motion, the hon. Member for Lewisham, West (Mr. Price) suggested that his single objection was sufficient to prevent the matter being proceeded with further.
Although I disagreed with him at the time, subsequent research has convinced me that the hon. Member is correct in his contention. There are clear precedents to show that if objection is taken at the outset to a motion of this kind moved without notice, even if it is done at a time when opposed business can be taken, the motion cannot then be proceeded with, and can be debated only on a future day after notice has been duly given. I assure the House that on any future occasion precedent will be followed. I have no power to annul what
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was done last week. This can be done only by an order of the House. However, in view of the substantial support that the House gave to the motion, I do not think it likely that the House will be disposed to make such an order.
Mr. Christopher Price: On a point of order, Mr. Speaker. I thank you for that statement. I should like to make it clear that I would not wish to be a party to the annulment of the order, but it is important that hon. Members should know that the House has now reverted to its previous practice and that, if a petition of this kind is presented, a single objection is sufficient.
Mr. Speaker: I am much obliged to the hon. Gentleman. He has stated the position correctly.

THE RT. HON. MEMBER FOR BRIGHTON, PAVILION (PERSONAL STATEMENT)
Mr. Amery: With your permission, Mr. Speaker, I should like to make a personal statement.
I understand that there has been criticism of remarks which I made in a television interview with Mr. Robin Day after the Blunt debate on Wednesday night.
I tried, for greater accuracy, to secure a transcript of what I said, but the BBC advised me that it did not have one.
I wish to make it clear that it was never my intention to suggest that any hon. Member was guilty of any illegal action, such as treason or espionage.
Nevertheless, I quite understand that some of the words I used have had the effect of reflecting on the honour of the House and of individual Members. For that reason I am very glad to withdraw them, and I do so without hesitation.

ORDERS OF THE DAY

  SOCIAL SECURITY (MATERNITY GRANT) (AMENDMENT) BILL
  Order for Second Reading read.
  11.10 am
  Mr. Kevin McNamara: I beg to move, That the Bill be now read a Second time.
  As a Back-Bench Member I am in somewhat of a difficulty when constituents ask why, after 30 years, I am for the first time introducing a Private Member's Bill on a Friday. It is difficult to explain to them that the privilege of standing here on a Friday is the result of getting the fifth prize in a raffle. The prize is to have a full debate, possibly to get the Bill into Committee, and for it eventually to receive the Royal Assent.
  To Members of other legislatures and other democratic systems it seems nonsense, and perhaps in some ways it is, because the measures that are introduced in this way depend not on any scale of values—social, economic, political or philosophical—but on the luck of the draw and the Member's attitudes. Fortunately, many of the measures—if not all of them—introduced by this method have been of social or administrative importance, but it is still a rum way of doing things.
  The reasons why I chose this Bill are in some ways interesting. Initially, I suppose, any Member who is successful in the ballot for a Private Member's Bill allows his imagination to run to flights of fancy. Some hon. Members might have in mind a Bill requiring Treasury Ministers to go back to their constituencies for re-election six months after every Budget. In the case of my right hon. Friend the Member for Leeds, East (Mr. Healey), that would have meant having an election every two weeks. One could perhaps introduce a Bill seeking to abolish the other place. There are many possibilities that may enter hon. Members' minds. Private Members are limited by time, money and Government attitudes. In my own case, I have to add both Christian and Socialist convictions when considering the nature of any measure that I might seek to introduce. Those are not necessarily two criteria that other hon. Members would accept, but we all have our own ways of approaching things.
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  The time element with a Bill such as this is difficult. Being fifth in the ballot, it is not unreasonable for me to hope that with a small non-contentious measure—as I submit that this is—it should be possible to get it into Committee and back to this Chamber very quickly.
  For any Private Member's Bill, the money element presents another major difficulty. This has stymied many hon. Members seeking to introduce important measures, particularly when they have sought to move them from the Opposition Back Benches, because a Royal recommendation is needed and a Minister has to give his consent to the spending of the money. However, in this instance, by one of our procedural quirks, as what is proposed here is merely a reallocation of money within the national insurance fund, it is possible for Back-Bench Members to seek to arrange for a redistribution of the funds without the necessity of a Royal recommendation. I hope, therefore, that on that ground alone Back Benchers in all parts of the House will feel able to rally to the support of the Bill.
  The next matter of importance is the attitude of the Government. I wrote to the right hon. Lady the Prime Minister, trusting that she would support the measure. In a letter to me, which I received this morning, she states, among other things:
  "However, there are many things we might wish to do but cannot at the present time since resources are not available. Increases in a maternity grant would involve substantial expenditure and I am afraid that, as Patrick Jenkin explained to you, it is just not available at present. In view of this the Government feel it is necessary to oppose your Bill this Friday. We are studying the question of making the grant non-contributory but it is too soon to indicate our conclusions."
  I find it difficult to understand that although £55 million can be given as a special grant to send children to public schools we cannot find £45 million to help the most under-privileged in our society. But perhaps we can deal with that later.
  When one is placed high up in the ballot for Private Members' Bills, one receives many letters from innumerable worthy causes asking that one should introduce a Bill to meet their interests. One reason why I have chosen this subject is that other subjects that I might have chosen have already been introduced by other hon. Members above me

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  on the list. Another reason is that I regard the subject of the Bill as of fundamental importance, the more so as this is the International Year of the Child. It would be a tremendous help if we in this House could give assistance to those most under-privileged members of our own society and their mothers.
  I place on record my grateful thanks to the many bodies which have helped me in producing the Bill, such as the Money for Maternity campaign, the Child Poverty Action Group, the National Council for One Parent Families, the Labour Party, the Trades Union Congress, my own trade union, and the community health councils throughout the country, which have rallied to support the measure and have written on many occasions to their members urging them to support it. I should like to say a special word of thanks to my former colleague, Helene Hayman, who has done so much of the work on the Bill outside the House.
  This is a small Bill, but it seeks to do some important things—four in particular. First, it seeks to make the maternity grant non-contributory. Secondly, it seeks to uprate it to £85. Thirdly, it seeks to have it index-linked. Fourthly, it seeks to make arrangements for the Secretary of State for Social Services to be empowered to make regulations for the payment of the grant in instalments.
  The reason for making the maternity grant—at present £25—non-contributory is as follows. Maternity grant is at present payable to an expectant mother on either her own or her husband's national insurance contributions. This means that a small but significant number of expectant mothers gain no advantage and gain no maternity grant. These are perhaps some of the most vulnerable mothers within our society.
  The common law wife, even where there is a stable relationship, obtains no maternity grant. The wives of students, or students themselves, receive no maternity grant. Sometimes immigrant mothers receive no maternity grant. People who have exhausted their other national insurance benefits—unemployment or sickness—and are on supplementary benefit receive no maternity grant.
  From figures supplied by the Department, it is estimated that about 60,000
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  mothers do not benefit from the small basic grant that is paid at the moment. These mothers are those who get into debt during pregnancy and are often not able to afford basic items, such as clothing and cots. Often they are on an inadequate diet. Often they give birth to handicapped children. These are the mothers for whom we should have particular concern. We should also have a particular concern for their children in this International Year of the Child.
  When one puts this case outside the House, people say "Of course, they could go to the Supplementary Benefits Commission, and they would obtain an exceptional needs payment." I would that that were so. Many of us know from our constituency surgeries that when we have had such cases we have been able to write to our local officers and sometimes we have been able to arrange an exceptional needs grant. Generally, of course, if such local officers receive a letter from a Member of Parliament they automatically give an exceptional needs grant.
  Miss Jo Richardson: Good for you.
  Mr. McNamara: I have quite a happy relationship with my local department, but very frequently this is much a chance of lot, as is the chance of drawing a place in the ballot for Private Members' Bills.
  The National Council for One Parent Families has done a survey, and this is what it found:
  "Twenty of the 26 mothers who failed to receive maternity grant applied for help from the Supplementary Benefits Commission. Nine received an exceptional needs payment, seven were refused and four were still waiting for a decision. The amount of help received by those who were successful in claiming the exceptional needs payment varied enormously. Individual sums ranged from £15 to £150. There were no obvious differences in the financial circumstances of the women receiving and refused exceptional needs payments which would explain either the different decisions or the variance in amounts granted.
  The payment of an exceptional needs payment is purely discretionary, which leads not only to different offices assessing need quite differently but to long delays in reaching a decision."
  In many ways the delay in reaching a decision is the most harrowing part of the whole matter.

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  The report continues:
  "Of the four women still waiting for a decision on their application, all had been waiting for at least six weeks, and in every instance, their babies had already been born. Although in the past the Supplementary Benefits Commission has agreed that the grant ought to be paid before the baby's birth, only two of the mothers in our survey actually received any money from an exceptional needs payment before their confinement, and three were actually told that they wouldn't be paid until the baby was actually seen to have been born alive and well.
  Those who applied for exceptional needs payments were not limited to the women who had been refused maternity grant. Eight of the women in our survey who had already received the £25 national insurance grant were supplementary benefit claimants, and also asked for an exceptional needs payment … Only one was successful however and the extra help she received was £8."
  It is to get away from that rather sad lottery that we seek to make the benefit non-contributory. We estimate that at this level the expenditure at current prices would be £1·3 million.
  I now turn to the second provision within the Bill—the uprating element. The Bill proposes that the grant should be based on 1969 values—which were not the most generous. Based on those values, it should be £85 instead of the current £25. It is an amazing fact that the maternity grant was introduced in 1911 at the rate of £1·50 and that in September of this year, in real terms, it was worth 91p less than it was when it was introduced. That says a lot for the criteria for which we in this House are responsible. One appreciates that cakes have to be divided and priorities have to be put before the people for decisions to be made, but that single stark fact, that the grant is now worth less than it was in 1911, should make us all seek to rectify the situation and uprate it to what we are suggesting—£85.
  The history of this matter can be found in a paper entitled "Mothers and Babies First?" by Mr. Ian Kendall, who wrote and did his research on this subject—although he is a lecturer in sociology—when his wife was being confined. He took the £25 maternity grant and tried to ascertain the cost of buying a layette. This spurred him on to doing his research. I understand that my hon. Friend the Member for Rother Valley (Mr. Hardy) has some interesting facts on
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  the cost of a layette to put before the House, if he catches the eye of the Chair.
  We propose to increase the amount to £85. We also wish to enable the Secretary of State, under clause 3(2), to introduce regulations enabling the money to be paid in two or more instalments. This is because we wish to encourage mothers to have an early medical check-up, to make sure that they are properly examined and that this is not left until the last minute, in order to achieve the birth of healthy, non-handicapped children, so far as that is possible.
  The need for the research and the payment to mothers from a poor background is necessary to encourage them to go for an early medical check-up. That is self-evident from the infant mortality rate. It is a sad thing to say that 68 years after 1911, when this grant was introduced to try to mitigate the circumstances of infant mortality, perinatal deaths are still a class issue. The figure for stillbirths in 1977—I am dealing only with legitimate births—in social class 1, per 1,000 births, was 7, but in social class 5 the figure was 12. For perinatal deaths, the figure for social class 1 was 12; for social class 5 it was 22. For neonatal deaths, the figure for social class 1 was 6; for social class 5 it was 12. For postnatal deaths, the figure for social class 1 was 3; for social class 5, it was 8. For infant deaths in social class 1 the figure was 9; for social class 5, it was 20. The figures go through the various classes in ascending order. This is very much a class issue.
  This is something that affects the least privileged in our society. They are the most affected by this tragedy. It is for this reason that we believe both that we should have the £85 grant and that mothers should be encouraged to visit their doctors early, and the encouragement should be an inducement of £25 and then one of £60. But we also believe that this grant should be index-linked. I understand that this would create problems for the Government.
  Mr. Sydney Chapman: I think that the House will congratulate the hon. Gentleman on the persuasive and eloquent way in which he is introducing his Bill. I for one am absolutely with him on the need, as a matter of necessity, to make the maternity grant

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  non-contributory. However, when the hon. Gentleman talks about the need to increase the maternity grant, does he not think that it is only equitable to consider the maternity grant in relation to the maternity allowance? Will he confirm that in the last decade the 18-week maternity allowance has been increased from £5 a week to £18·30? By my calculations, that means that mothers get an additional £200 or more to help them. Does he feel that he ought to look at the need for the maternity grant in relation to the maternity allowance?
  Mr. McNamara: There are a number of matters in that regard. First, not everyone necessarily gets a maternity allowance, which is fundamental to the matter. Secondly, I admit that the amount of money has increased, but I do not believe that it compensates for the cost of having a child. In fact, I believe that more money should be paid in maternity allowance for the first child than for the second child. I understand that that creates all sorts of problems, but within the normal family the first child is always the most expensive. That is why we persuaded the previous Government to introduce family allowances for the first child. It is then that the sudden drop takes place in the family income, for example, if the mother stops working. It is then that many of the additional pressures in the household begin.
  I hope that if the Bill goes into Committee we can look at these matters, because they are important. I understand and appreciate that there is sympathy among Conservative Members for the principle of the Bill but that they feel that there are public expenditure constraints. I understand that argument, although it is not one that I would support or adopt. I therefore hope that we can get the Bill into Committee so that we can examine these questions.
  Mr. Lewis Carter-Jones: Is my hon. Friend aware that work carried out in France reveals that the priority of priorities should be perinatal care? It is now well documented that as a result of spending such money vast sums were saved, and I am sure that the Treasury would be grateful for such a saving.
  Mr. McNamara: My hon Friend has just quoted what I had hoped would be
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  my most persuasive point. That was a point that I made when I wrote to the Prime Minister, because I believed that if we had a moral imperative with a direct financial inducement that combination would be a working majority in any trinity and that the right hon. Lady would support the Bill. Unfortunately, I was not quite as successful as I had hoped. However, this is an important matter that should be looked at.
  I return to the question of the index-linking of the grant. There are a number of arguments about it. It is obviously self-evident that if the grant goes up to £85 we should keep it at a proper value and level so that it is not allowed to fall back in the way that it has done in the past. There are also arguments—again these are things that we can look at in Committee—that we might be wise to have almost a special prices index for expectant mothers, because the nature of their costs and charges is very different from the normal type of index-linking that one might have for a pensioner or someone else. That is something that we could look at in Committee.
  My hon. Friend the Member for Eccles (Mr. Carter-Jones) drew the French experience to our attention. That is a good example, but I would not want hon. Members to think that we planned to introduce some of the penalties that exist in the French system. We are not suggesting that if mothers go twice, or fail to register early, they should lose money. We have a number or reasons for this. First, it would be nonsense if, having made the grant non-contributory, we introduced further conditions about its payment. Secondly, if the grant were raised to £85 a lot of it could be lost in transport and other charges, merely in order to attend baby-care clinics. Thirdly, there is the real question of the provision of baby care and pre-birth clinics as well as the associated problems. Nevertheless, those who support the Bill believe that the prevention of handicap, the provision of a proper diet and early care for the mother can do a great deal to improve the health of the nation as well as saving a considerable amount of expense in the future.
  Some people have estaimated that it costs as much as £250,000 to see through life a child who is born badly deformed. That is not an expense to which we as a House would object. But how much

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  better it would be if we could prevent the birth of 160 such children and if we could get the £40 million that we need for this measure. Therefore, we do not seek either to penalise the mother who does not go early or in any way to inhibit mothers. We believe that there should be an inducement to encourage them to attend.
  The Bill has the added advantage for Labour Members in that for us it was a manifesto commitment. It was one of those issues in respect of which the NEC and the parliamentary leadership were joined together in happy harmony. In view of some of the articles in today's press, that is one reason why the House should solidly support the measure.
  There is one argument about which I am especially keen. It is one that I know does not carry the support of all of my hon. Friends. Nevertheless, for me it is of fundamental importance. I was one of those Labour Members who voted for the Abortion (Amendment) Bill. It seems to me, in conscience, that I cannot vote for a limit in the number of abortions and yet not come to the help of those expectant mothers who are most disadvantaged—who are put under the most pressure socially and economically to have an abortion—as well as the health of those coming from the most underprivileged areas in our society. If hon. Members supported the "Corrie" Bill, I believe that they should support my Bill in order to give help to many of these mothers.
  This is basically a question of putting our money where our mouths are. I believe that we should do so. Therefore, I commend the Bill as a piece of social justice, as a measure that seeks to get rid of an anomaly and as a measure which through the non-contributory element can bring in a good deal of help to a number of expectant mothers who are in difficult circumstances. I also commend its other principle—to uprate the value of the grant and to ensure that as a nation we have more healthy children, less handicapped children and children of whom we can all be proud.
  11.38 am
  Mr. John Farr: I congratulate the hon. Member for Kingston upon Hull, Central (Mr. McNamara) not only on his good luck in coming, I think, No. 5 in the ballot but on his good sense
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  in introducing—with the support of hon. Members on both sides of the House—this important Bill, which I support almost entirely without reservation.
  The hon. Gentleman, in his usual clear manner, has given the House a resumé of the Bill as he sees it. I stress right away that I am here because of the number of letters that I have received from different parts of my constituency supporting the Bill in general and certain parts of it in particular.
  It seems to me that the Bill falls into three main parts. Dealing with them in reverse order, the third point relates to the inflation-proofing, or index-linking, of the maternity grant. The hon. Gentleman's proposal that a review should take place each year is an important principle to seek to establish. There are, unfortunately, many other major benefits and major grants whose values are eroded rapidly from year to year, as inflation grows apace, which do not receive such protection. These benefits include the death grant, the age addition and the new child benefit. I applaud the hon. Gentleman for seeking to introduce inflation-proofing for the maternity grant, but I am not sure that it is a general principle that I should like to see established, unless in time of absolute necessity.
  Inflation-proofing is already established for the incomes of civil servants and certain other people employed in various State categories, such as teachers. A situation is rapidly arising in which industry cannot offer similar inflation-proofing protection. Inflation-proofing was an agreed measure introduced by the House a few years ago for certain State employees. Many of the better people who might have been attracted to industry are tipped towards a career in the Civil Service or a State occupation because of the advantage of inflation-proof pensions.
  I would much prefer to see the rate of inflation brought to heel and curbed to such an extent that there was no need for the inflation-proofing of pensions. If that happy situation were ever to arise, there would be no need for inflation-proofing in matters such as the maternity grant. I welcome without reservation the hon. Gentleman's recommendation that the maternity grant should be increased from £25 to £85. As he explained in his usual clear and lucid manner, it was last raised

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  in 1969 and is hopelessly out of line with present-day values.
  I also welcome the hon. Gentleman's initiative and hope that he seeks to preserve in Committee the idea of paying the maternity grant in two or more instalments. Both sides of the House, I believe, welcome this novel and sensible idea. The hon. Gentleman made the case most clearly. But we face the cost of implementing the increase. The latest figures that I have obtained show that the increase would cost between £40 million and £50 million a year. In these days of stringent Government economy, while I support the hon. Gentleman in what he is trying to do, I emphasise that we must be realistic and recognise the difficulty of getting Government support for these extra payments.
  As my hon. Friend the Member for Chipping Barnet (Mr. Chapman), who intervened in the hon. Gentleman's speech, said, we must also take into account the maternity allowance that has made a sizeable contribution to those involved in maternity matters. We also have to bear in mind that the death grant has not been raised since 1967. The age addition has not been raised since it was introduced in 1971. The difficulties in relation to maternity benefits, outlined so forcefully by the hon. Gentleman, are shared in many other fields of almost equal importance. I welcome unreservedly, however, what he seeks to do in raising the level of the benefit from £25 to £85 in the middle part of the Bill.
  The first and probably the most important intention of the Bill, described in the long title, is to remove the requirement that contribution conditions shall be satisfied in order to enable women to receive the maternity grant.
  Mr. Peter Bottomley: It is worth remembering that the age addition is a matter of 25p rather than £25 and that the underlying element of the retirement pension is increased with inflation. Whatever the argument for increasing the death grant, which I support, it cannot have any effect on future health.
  Mr. Farr: I accept what my hon. Friend says. He will no doubt later seek to elaborate on those points. Although the part of the Bill that lays down that there shall be no contribution conditions
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  for maternity benefit would probably be the least costly of the hon. Gentleman's proposals, I am not sure that I can agree entirely with this recommendation. It has important social implications.
  I understand from the Bill and from a document issued by the National Maternity Grant Campaign that if the conditions are removed altogether a number of new categories will be brought under the ambit of the Bill. They include young unmarried mothers, who have not been in paid employment long enough to qualify. I believe that they should be included in the Bill. It is nonsense that they should be excluded. But the Bill goes on to remove other barriers that have existed to prevent receipt of maternity benefits by other categories, among which are all mothers under 16, female students, non-employed wives of students, wives of long-term prisoners and common law wives who are not in paid employment. My fear about allowing this measure to be introduced, requiring no contribution conditions, is that there is a risk that even more children will be born of mothers who are under age. All hon. Members have had such cases brought to their attention from time to time where children of 15 or 16 have given birth. They are unmarried. They do not receive maternity grant—
  Mr. McNamara rose—
  Mr. Farr: I should like to finish this point before giving way. One refers these young mothers to the social security department for it to attend to their needs. But a main complaint is that they do not receive maternity grant. I believe that if we sought to remove this barrier it would probably encourage girls to have children before they are married and before they have left school.
  Mr. McNamara: Does the hon. Member really believe that, as a matter of course, girls of 14, 13 and 16 will deliberately set out to have sexual intercourse simply in order to get £85, and nine months later be left holding the baby?
  Mr. Farr: The hon. Member for Kingston upon Hull, Central seeks to raise the grant to £85, which is a considerable sum of money for anybody. I was simply trying to give the House my own experience. In my part of the world there

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  have been several cases recently of children at school having had children. As a result, they have been in great financial difficulty, because they have not been able to get the maternity grant. I believe it is wrong that those children should receive the grant, paid by the State. The fact that they do not get the grant in many cases leads to considerable financial difficulties, and at another time their example might be remembered by others, who will not make the same mistake.
  Miss Richardson: Will the hon. Member spell out his argument? Is he not saying that if we extend this principle of non-contributory benefit to girls under 16 they should be punished? That is what he appears to be saying. He is saying to these girls "Naughty, naughty, you must not do it before you are 16, and if you do we will withhold your £85." That is really extending the principle of staying in after school and writing out 100 lines.
  Mr. Farr: I am not saying that they should be punished; I am simply saying that the State should not give them a handout of nearly £100 every time they make this mistake. Without these conditions, the children who make mistakes will not be deterred from doing so again.
  The Bill provides that there should be no conditions in relation to the payment of the maternity grant. I urge the hon. Member for Kingston upon Hull, Central to look at a slightly wider picture—that of the number of children being born in Britain at present. Today the birth rate is at replacement level. Britain is one of the few countries in the Western world that is not increasing its population. The world population is multiplying itself and by the year 2000 it will have almost doubled. With the number of people in the world steadily increasing, Britain's example of maintaining a stable population—it is now at about the maximum that this country and its resources can support—is the right one. Most other countries, particularly those in Asia, have not yet reached our level of stability, and populations, particularly in the Third world, are increasing at an alarming rate. If we want to maintain a stable population in Britain, it would be wrong to introduce a maternity grant of this nature without conditions, as this
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  would probably encourage the birth rate to climb again.
  Dr. Oonagh McDonald: I find the implication of the hon. Member's remarks most extraordinary. Does he really believe that people have babies in order to get money? If that is his underlying view, what is his attitude to child benefit? Would he like to see that abolished?
  Mr. Farr: No; I have said that I welcome the child benefit scheme, and earlier I expressed the hope that child benefit would be increased in line with the maternity grant. All I am trying to say is that we must try to look at the world population level through British eyes. We have a good example to set the rest of the world, in that we have reached population stability. I want to see it maintained. Unless other countries get into a similar situation, in a short time the world will run out of raw resources and will have an excess of population, and before long we shall have a world famine. Anything that touches the delicate mechanism that has preserved the balance in Britain, including the conditions that are attached to the level of maternity grant, should be tampered with only after very careful thought.
  Mr. Stanley Orme: I am following the hon. Gentleman's argument closely, but is it not a fact that in the countries where there is still a population explosion benefits of this sort do not exist? In our society the introduction of child benefit and maternity grant is to help a stable society and it has, indeed, proved helpful. In Asia and other parts of the world, where there is a problem, it is not a question of money. Other social factors are involved.
  Mr. Farr: The right hon. Gentleman's knowledge of this subject is deep, and he is absolutely correct. There are many reasons why the populations are continuing to soar in many countries in the Third world, and these have nothing whatever to do with money. All that I was trying to say is that I think that it is wrong that a maternity grant of nearly £100 should be made available, without conditions, to any mother in Britain. I agree that the level should be increased to £85 and that it should be a two-stage payment, but I have grave reservations

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  about supporting a grant without reasonable conditions along the lines that we have at present.
  11.57 pm
  Mr. Peter Hardy: I am delighted to speak after the hon. Member for Harborough (Mr. Farr). I was about to do so last Friday when he successfully presented a Bill, but lack of time prevented my offering my congratulations on his Bill and his speech. I welcome his comments today, and I very much welcome his approval of the broad principles of the Bill, but he will forgive me if I disagree with some of his interpretations of the Bill and the matters with which it deals.
  I congratulate my hon. Friend the Member for Kingston upon Hull, Central (Mr. McNamara), whose record in this area of care for children is substantial and consistent. Only last month he and I took part in debates in the Council of Europe on reports and recommendations concerning the care of children. We were delighted that those reports were approved and that the Conservative delegation at Strasbourg gave substantial support to the recommendations and amendments for which we were responsible. I hope that in due course the Conservatives in this House will show the same consistency and carry out the very things that their delegates at Strasbourg called for last month.
  I have three reasons for strongly supporting the Bill. It is a just measure, because those who are denied this assistance are largely those who most need it. In my view, we do not need to see any baby born in deprivation in this country. Governments have a responsibility in the last half of the twentieth century to see that childhood and infant deprivation is avoided.
  It is bad enough for a girl of 14 or 15 to have to have a baby, for all sorts of reasons, perhaps not least of which is the nature of the society in which that child—and a girl of 14 is still a child—is brought up. I do not believe that she should be punished because society has differing values and inherent weaknesses which have created the conditions in which her pregnancy occurred. Justice demands that this Bill secures support.
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  The second reason why it should be supported is economic. Even with the uprating which my hon. Friend quite properly calls for, the amount involved can cover only a portion of the costs involved. However, since the costs have risen enormously the contribution provided by the State is of increasing relevance. Where there is great need, the delevance of and the welcome that the contribution will receive are important.
  The third reason follows on the point made by the hon. Member for Harborough, which is that we need to secure continued stability in our population structure. The Government's fiscal policy and social provisions have a relevance in this context. The birth rate was falling very sharply in the early 1970s. It may well have bottomed out in 1977–78, but I believe that that stability is now seriously in peril. The matter is important, and I think that it does this country no service for Governments and politicians to take too shortsighted a view of social problems.
  Governments have the obligation to look at the long-term implications of population structure. Since the Government are in a position to influence the population structure, they ought not to hold their hand and ignore the issue because the problem may not arise for 20, 30 or 40 years. A severe decline in the birth rate, or the population, of the United Kingdom in the next few years could cause great difficulty at the end of the century and beyond. If I use this argument, it is because it may well appeal to the Conservatives rather than to Labour Members.
  I recall taking part in a discussion two years ago at the Brooking institute in Washington. One of the problems discussed was the effect of a declining population on military recruitment and how the forces of NATO could be maintained, given an appealling fall in the birth rate and its effect on the balance of population.
  Mr. Peter Bottomley: My studies show that most Governments who pursue a pro-natalist policy and increase benefits in order to increase the population find that their measures appear to be associated with a reduction in the birth rate. The more one raises the standard of living, the fewer children people tend to

  757
  have. That is a broad generalisation, but it seems to be true and does not seem to be an argument for an increase in the maternity grant.
  Mr. Hardy: I shall refer to that matter shortly. The fact remains that if Governments feel that they must have enough doctors, nurses or—particularly given the nature of the present Government—enough soldiers, sailors and airmen, they must have concern for the number of people who will be 18 years old in 18 years' time. The Government cannot dodge that responsibility, though there are problems to which I shall refer.
  If we are to have a balanced population, the Government cannot ignore the problems. They must first ensure that we have a balanced population—in so far as they can ensure that—and, secondly, that it is a healthy population, particularly in infancy. Governments must be involved at that stage. We are seeing the start of a sharp decline in the birth rate.
  This is not a party point, but I believe that mortgage interest rates of 15 per cent., domestic rates of 40 per cent., the ending of support for school meals, and all the social restraint and repression currently being launched upon the country are likely to have a severe effect on the birth rate in 1980–81.
  I visit large housing estates—private and public—in my constituency and find hundreds, if not thousands, of young couples who want a baby next year. They will now defer having that baby because the wife will need to continue to work for a little while longer. I believe that the Government should understand the social effects of their economic policy. If the Government understand that, my hon. Friend's Bill is particularly relevant.
  Mr. Peter Bottomley: I am sorry to keep on intervening, because it interrupts the flow of debate, but the birth rate has dropped by 25 per cent. during the last 16 years, two-thirds of which period was under Labour Governments. It cuts both ways.
  Mr. Hardy: When the Labour Government were in office they were seeking to establish that model for the world for which the hon. Member for Harborough quite rightly called. I entirely agree with him. We need to provide and maintain that balance. Having achieved that balance
  758
  in the population structure, we are likely to see it severely threatened as a result of the policies inflicted on the country by the Government.
  I want to talk about the needs and the justice of the situation. I asked my wife the other day to look into the costs of maternity. I have two small children. The result of my wife's investigation was quite astonishing. As few of us have any recent experience of the care of small children, it may well be right for the House to look—
  Mr. Anthony Kershaw: Does the hon. Gentleman realise that I have three small grandchildren, and that I am having a hell of a time?
  Mr. Hardy: I am sure that the hon. Gentleman will be as satisfactory an influence on small children as all grandparents are. The principal occupation of grandparents seems to be to make the behaviour of their grandchildren less tolerable for their parents before sending them home to their parents.
  The House might like to take note of the initial costs involved in the care of a baby. They are substantial. The initial clothing required for a baby—my wife obtained these prices from a chain store, so I am not talking about the kind of shop supported by some well-to-do hon. Members on the Government Benches—such items as rompers, rubber pants, bibs, vests, and nappies, cost £63·86 last week. In addition, a great deal of equipment must be bought. I speak only of initial equipment, not about high chairs, playpens, cots, cot mattresses and items of that kind. A baby in its first weeks of life does not require them. There will, however, be a need for a bath, a carrycot with blankets and rubber sheets and a rug as well as a bath and a stand of the simplest and cheapest kind. The cost of those items of equipment this week was £56·95. If one adds to that soap, talcum powder, cream, cotton wool, a hair brush and items of that kind, the total comes to £124. That is the cost of the initial equipment and clothing.
  That is a substantial amount, particularly for an adolescent girl who may still be a pupil at school, and in a very short time those costs will further increase. I am not suggesting that the mother will need to buy a perambulator. I take a

  759
  modest view, because a carrycot and a transporter can be substituted for a pram. However, I see no reason why people should not have a pram, because, to some extent, it is still a status symbol. Reins, a pushchair, a playpen, a cot with mattresses and bedding and a high chair will be needed. Those items will add at least another £100 to the bill.
  We are talking about substantial items of expenditure. If, when the mother has her baby—it is usually with the first baby that the need is greatest—she has no resources, if there is no grant, and if at the same time she has to face the trauma of a paternal or social castigation, her difficulties are very great. Her baby is not born into a particularly pleasant climate.
  Since the costs to which I have referred are already substantial, and since the implications of current inflation and Government policy are particularly adverse, there is an absolute need, and great urgency, for the Government to reconsider their attitude to my hon. Friend's Bill.
  A further aspect is that we need to consider how we see our society. Some countries may have great pride in the number of golf courses they have per thousand of the population. Other countries may measure their standing by the number of battalions they can maintain. Other may measure their success by material provision—how many hundreds of pounds a week they can knock off the income tax of entrepreneurs. Conservative Members may find that criterion acceptable. For me, however, an essential criterion is the health and condition of the babies in a society. The basic and fundamentally important measurement of the success or health of a society lies in the infant mortality rate.
  Mr. Tristan Garel-Jones: Being a new Member, I should be grateful if the hon. Member for Rother Valley (Mr. Hardy) would give me some advice. I understood this to be a Private Member's Bill. It is supported by two of my hon. Friends, whose names appear with those of the other sponsors. I came to the House today with the intention of supporting it. In view of that, I am a little surprised to hear the hon. Gentleman
  760
  consistently make so many party political points. He has already accused my side of the House of reducing the birth rate. He is now suggesting that people are worried that Conservative Members might purchase the requirements for their children at Harrods and other such stores. I shall be grateful for some clarification.
  Mr. Hardy: I welcome that. I must make it clear that whilst I have been extremely critical of the Conservatives, my criticism is concentrated not on the hon. Member for Watford (Mr. Garel-Jones), who, I recognise, is prepared to depart from his party's official policy, but on the Government Front Bench, which has expressed disapproval of my hon. Friend's Bill. I think that my comments, while to some extent partisan, will demonstrate to Conservative Back Benchers that the Government are unfortunate in their position and unwise in their policy.
  I certainly would not wish to inject too partisan a note into this debate. I have fresh in my mind, however, the memory that only yesterday a Conservative Member of this House was seeking in Strasbourg to ensure that the Council of Europe gave a high priority to reducing further the tax burden on the entrepreneur. I nearly did not get back from Strasbourg last night, so bad are industrial relations in France. I suppose that I ought not to let that slight irritation from yesterday's experience colour my remarks this morning. But I stress that I am criticising Ministers, not Conservative Back Benchers.
  Mr. Martin Flannery: Does my hon. Friend agree that no matter how much we want Conservatives to support us, we cannot ignore hard economic facts? When the hon. Member for Harborough (Mr. Farr) said that the Bill would cost another £40 million, he neglected to say that the Conservative Party is to give £55 million to private education. I should much prefer that money to be spent on the purposes of the Bill.
  Mr. Hardy: I entirely agree with my hon. Friend. Spending that money on private education will be a scandalous waste of resources. It would certainly be better used in support of babies.

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  There is no better way of measuring a society's standing than by the infant mortality rate. The rate in this country has not been improving rapidly enough. It does not bear comparison with some other countries of a similar social and economic condition, and the Government should pay careful attention to that fact.
  I fear that my next remark may please some Conservative Members while causing dissent among my hon. Friends. It is fashionable for people in Britain to be critical of Hong Kong. We are all sensitive to the political, economic and social conditions in that country, and some of my hon. Friends are extremely worried about them. However, I am concerned at the fact that in Hong Kong the infant mortality rate next year will be lower than in the United Kingdom. If the Government are concerned that a country such as Hong Kong can achieve a better mortality rate than that for which the Government here will next year be responsible, they must accept that this is a matter requiring urgent concern and action, and that that will dictate for them an entirely different attitude towards this Bill, which, in terms of population, economic policy and social justice, ought to be approved.
  12.15 pm
  Mr. R. A. McCrindle: I shall refrain from following the general tone of some of the remarks of the hon. Member for Rother Valley (Mr. Hardy), because I do not believe that this Bill will benefit in any way from the undue introduction of partisan attitudes. I must tell the hon. Member for Kingston upon Hull, Central (Mr. McNamara) that with friends on his side like the hon. Member for Rother Valley he need have far less concern than he might imagine about enemies across the Floor of the House.
  Mr. McNamara: I must tell the hon. Member for Brentwood and Ongar (Mr. McCrindle) that if I had to choose between any one of the 300 or so Conservative Members and my hon. Friend the Member for Rother Valley (Mr. Hardy), my choice would always go to my hon. Friend.
  Mr. McCrindle: Yes, but I would have thought, in view of the all-party approach that lies behind the Bill, that with the
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  tiniest bit of luck the hon. Member will be seeking the support of both, and that remarks such as those of the hon. Member for Rother Valley do not make it easier for him to obtain the cross-party support that he would prefer.
  I have a srong inclination to support the Bill and I am prepared to go on record as approving the measure in principle. Although I shall be indicating some reservations—I imagine that that will not surprise the hon. Member for Kingston upon Hull, Central—I am able to give the Bill a greater degree of personal support than is normally possible with a social security measure emanating from the Labour side.
  Perhaps my initial, one may assume rather tetchy, reaction to the hon. Member for Rother Valley can be better understood in the context of the increasing difficulty that his remarks place upon hon. Members such as myself who are anxious to support the principles of the Bill. I repeat, therefore, that I shall support it—although with reservations—with a touch of realism—
  Mr. Flannery: And in the Lobby?
  Mr. McCrindle: If the hon. Member will hear me out, he may be surprised at what I shall say.
  I shall probably be approaching the Bill with a greater degree of realism than has been evident in some of the speeches and interventions from the Labour Benches. I wish to deal with the timing of the introduction of various parts of the Bill.
  Mr. Donald Stewart: In view of the all-party support for the Bill, does the hon. Member not feel that some Conservative Members are being unduly sensitive? Surely they can recognise that there is all-party support for this civilised measure but that that does not imply that the basic clash of opposing philosophies has to be stilled.
  Mr. McCrindle: I agree with that eminently sensible observation. It is perhaps a pity that others who have intervened did not have the benefit of the right hon. Member's recommendation before choosing to make the remarks that they have made.
  I hope that I shall persuade the House that the line I take will be more realistic

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  than that adopted by the hon. Member for Kingston upon Hull, Central. In the process I shall be saying something about the timing of the introduction of various provisions. I shall probably take a more controversial view than has been expressed so far, and not all of my hon. Friends will necessarily agree with some of my observations.
  The Bill provides that the grant should be payable without reference to contributions. The present rules exclude from benefit schoolgirl mothers, common law wives and the wives of long-stay prisoners. In passing, it is fair to repeat that although they are excluded by the contribution conditions they are not excluded from the supplementary benefit exceptional needs payments. I take the point made by the sponsor of the Bill that that is not a directly comparable situation, and that application for such assistance is not universally successful. If pressed, I would have to concede that it is a selective provision of assistance.
  Nevertheless, to put the matter in perspective, we have to weigh the exclusion of those categories in the balance with what I have just said about the availability of special benefits under the supplementary benefits scheme.
  I direct the attention of the House to a much more fundamental question. Should we really be concerned about those categories of person who are excluded by the present contribution rules? Here I touch on the matter raised by my hon. Friend the Member for Harborough (Mr. Farr) which resulted in interjections from across the Floor.
  To those hon. Members who may be inclined to ridicule the point that my hon. Friend made, I say that many hundreds of thousands of our fellow citizens outside this place would heartily endorse his approach, namely, that the idea of legislating by implication so that the veil of respectability is drawn over the schoolgirl mother, the common law wife, and so forth, should be rejected. I do not take that line. I do not believe that the people whom we should principally consider in our approach to the Bill are the mothers.
  I believe that the Bill is concerned infinitely more with children. I do not agree with my hon. Friend on that point. I genuinely
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  believe that if the interests of the child are our principal concern we should be less inclined to examine morality and should direct our attention to the interests of the children. Sixty thousand of the most vulnerable births in this country do not qualify under the present regulations. An illegitimate child is half as likely again to die within one year as a child born within wedlock, and that tendency is growing. That fact is incontrovertible from the statistics that I have been able to lay my hands on.
  Secondly, children of unsupported mothers or—putting it more prosaically—one-parent families are twice as likely to die within one week of birth as those born where husbands are present. There are special mortality risks attending the category to which at present the grant does not apply.
  As a result, I am inclined to believe that contributions that prohibit help being given to those in need require to be re-examined by the House. The part of the Bill that would change the contribution conditions has my support and that of many of my hon. Friends. I cannot leave it like that. I am bound to proceed from considering whether all those in need of the benefit receive it to considering whether all those who receive it require it. The percentage of those people who are entitled to the grant who claim it is high. However, I have my doubts whether the £25 means much to a sizeable number of people who are perfectly entitled to it.
  This is not the occasion to argue the pros and cons of selective benefits. However, I have held a consistent view, which is not shared by every hon. Member on the Government Benches, that, when Government allocation of money is tight, if we are to consider great assistance to those who need it we are being dishonest with ourselves if we do not consider whether the universality of such benefits continues to be justified.
  I said that my approach was controversial. I suggest that the use of the tax system might well be a reasonable price to pay for producing increased assistance to those who need it and are not getting it. If we lived in an ideal world, universality of benefit would be totally acceptable, but nobody would pretend that we live in an ideal world. We could afford the total expenditure involved in the Bill, and we

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  could afford it now, if it were part of a more comprehensive reform of the payment of social security benefits.
  I do not expect my hon. Friend the Minister to be so persuaded by my eloquence that she will immediately announce a change in Government policy but, as a humanitarian, I hope that she will indicate a personal reaction. If we espouse the cause of those in greatest need, unless we are being totally dishonest with ourselves and the people whom we represent is there not a case for looking at the continuing necessity for paying even where it is a provable fact that the receipt of the benefit makes little or no difference to those receiving it?
  I repeat that we could afford the change in the contribution benefits if we were to do that. More importantly, we could afford the increase from £25 to £85 or £90, which is the financial crux of the hon. Gentleman's Bill. I believe that in the present economic circumstances we can afford that only if a degree of selectivity is introduced.
  There is a clear case for increasing the benefit from £25 to £85 or £90, based on inflation, if nothing else. The maternity grant was increased seven times between 1953 and 1969 and has not been increased at all in the past 10 years. Both Governments must take equal blame for that.
  I do not wish to weary the House with a long dissertation on the cost of baby goods, and we have already had an adequate summary. Perhaps I may be forgiven for putting it another way. In 1979, £25 buys either two dozen nappies or a secondhand perambulator. That is a strong reason for looking for an increase towards the £85 outlined. If the sponsor of the Bill is realistic and accepts that the Goverment, like all others, must speak the language of priorities when, in terms of expenditure, we are in a difficult situation, perhaps he will consider the wisdom of my approach. We can afford the total of his Bill immediately, but only as part of a more comprehensive reform.
  Mr. Frank Field: Are there not two issues here? The hon. Gentleman made a powerful case for saying that in social security terms there is a case for a more selective approach if that
  766
  can be done through the tax system. When previously in Government the Conservative Party put forward the most comprehensive views that we had so far heard in their Green Paper on tax credits. Some Opposition Members would go a long way with that argument. However, today we are dealing with a slightly separate point—a grant to mothers. I can see no mechanisms at all, even if that tax credit system were working, whereby we could automatically pick up the most vulnerable mothers through the tax system, for the simple reason that they are not in the tax system.
  The hon. Gentleman made a good case for looking afresh at our social security provision over a wide area, but it may well be that the case that we are debating today is the exception to the rule that the hon. Gentleman puts forward.
  Mr. McCrindle: That is a fair observation. However, I doubt whether today's debate is the correct occasion on which to argue the merits of the tax credit system. Many others who were stout supporters of the tax credit scheme in 1972 have not yet been convinced that a better system exists. I am attempting to be a realist. The hon. Gentleman knows, as I know, that there is no immediate opportunity for the full introduction—or even, dare I say, the introduction in large measure—of the tax credit scheme.
  As to the hon. Gentleman's second point, the people who could be picked up via the tax system are those in the standard rate and above who, I suggest, are not always in need of what to them is a relatively paltry £25. If we were able to do that and at the same time afford an alteration in the contribution conditions, we could—by withholding the grant from those to whom it means nothing, or relatively so, by means of the double operation—direct it to the very people who are now outside the orbit of the system.
  I apologise for that rather long response to an intervention. I hope that it gives the hon. Gentleman some indication that I am approaching this matter in as realistic a fashion as I conceivably can, given the circumstances in which the Government find themselves.
  Mr. Peter Bottomley: Surely the simplest way of picking out those who need the money most is to consider those who do not qualify—as they clearly do need

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  it most by reason of their circumstances. Secondly, the easiest way of withdrawing it, if necessary, on a temporary basis, from those who do not need it, would be to withdraw it from those who receive maternity allowance, which pays more money anyway.
  Mr. McCrindle: I am prepared to examine further my hon. Friend's suggestion. However, it does not eliminate the need that I have always seen. I appreciate that consistency is not a virtue in this place. I have been saying the same thing about this need for quite a long time now. Unless this country suddenly produces the necessary wealth, of which I see no immediate sign—although I am hopeful, with the change of Administration in May—I genuinely believe that there is a powerful case to be made for some kind of selectivity.
  I hope that I can now deploy a much interrupted case which, the hon. Member for Kingston upon Hull, Central will be surprised to be reminded, is actually broadly in favour of the Bill that he introduced.
  I want to turn now to index-linking. I have an inherent suspicion of index-linking, not least because I was a supporter—some would now say a culprit—of the introduction of the index-linking of public service pensions. What was introduced at a cost of £6 million will cost £150 million in 1985. Not only that. It created two classes of society—the people who, by the press of a Government button, are protected against inflation and those who, no matter how good their occupational pension scheme may be, suffer because there simply are not the investments available to allow a return, at the level of inflation that has been in evidence under both Governments.
  Index-linking is something of which I am inherently suspicious. However, I am quite prepared to concede that it really is ludicrous to pay this social benefit at the level of 1969, or the death grant at the 1967 level, and still expect it to be meaningful in terms of the recipients. I should be prepared to agree to some kind of annual uprating. People may ask what the difference is between that and index-linking. I believe that it permits a better and more intense yearly study of the circumstances with which a
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  Goverment are confronted. I suggest that there should be an annual obligation to review the level of the maternity grant.
  Mr. Kershaw: It is there already.
  Mr. McCrindle: My hon. Friend anticipates me slightly. I say that it should be there. In fact it is already there under section 13 of the Social Security Act 1979.
  I wonder whether the hon. Member for Kingston upon Hull, Central would reconsider the pressure for index-linking on the basis that it puts a Government into a situation over which in future they will have no control. Index-linking is unnecessary, as there is an obligation to take all the circumstances of the nation into account in the annual uprating. I suggest that the hon. Member may well be prepared to think again on that—I hope he will not mind my saying—relatively minor part of the Bill.
  I move on to the question of payment by instalments. By any yardstick, that seems to me to make sense. If there were a system under which a first instalment would be paid to encourage early ante-natal care and the remainder, say, in the seventh month of pregnancy, that would seem to me to present a case so persuasive that one would be inclined to ask why it had not been done in the past. I support that proposal. I remind the House that a similar system appears to exist in France.
  I accept the qualifications of the hon. Gentleman, who summed up the conditions attaching to the French system by saying that they might not be particularly acceptable in this country. I am sorry to take advantage of that comparison with one of our EEC neighbours to bring in a comparison with another EEC neighbour. If we think that France has something to offer us in the shape of the payment of the maternity grant by instalments, perhaps some of my hon. Friends and some Opposition Members would care to consider the situation in Germany where the payment of the maternity grant is dependent upon the level of income of the individual. If that is not selectivity, I really do not know what is.
  To sum up: first, there is a strong case for moving to a non-contributory basis; secondly, I believe that there is a case for an annual uprating; thirdly, there is a case for an early increase, taking

  769
  account of inflation since 1969; fourthly, there is a case for selectivity through the tax system; fifthly, there is a case for payment by instalments.
  I beg the House, and especially the sponsors of this acceptable Bill, not to overlook the fact that it is being introduced on the very day when an announcement has been made about increased national insurance contributions by wage earners. It is the easiest thing in the world to act as the great philanthropist from this place without realising that many of our constituents will not thank us unless we take into account the fact that these things must be paid for. The cost has been conceded at between £40 million and £50 million. I believe that that could be met, but only in the circumstances that I have tried to place before the House.
  12.40 pm
  Mr. Lewis Carter-Jones: The speech that I am about to make is one that I have made from both sides of the House on numerous occasions. The trouble is that the Under-Secretary of State will reply to this debate, and it should really be replied to by someone from the Treasury, because it has been established that this modest Bill, which has been introduced by my hon. Friend the Member for Kingston upon Hull, Central (Mr. McNamara) is acceptable to the Department of Health and Social Security. If it is not, I have been told 320 lies in answers to parliamentary questions.
  Clearly, there are immense benefits to be derived from improving prenatal care. If we could make our figures as good as those for Sweden, and we should be able to, 4,000 babies per annum would not die and 10,000 babies would be born without the handicap that they have because of bad perinatal care. Ten thousand babies born with an unnecessary handicap represent, in cold, stark terms, a heavy economic burden to the country, and a handicapped baby imposes upon the family a lot of unnecessary hardship and suffering. My hon. Friend has clearly identified a section of our community in which babies will be born with a handicap.
  I am not happy about some aspects of the French experiment. I am not sure about the compulsory element. The reason why I said that I should have
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  liked to see a Treasury spokesman on the Government Front Bench is that in the 1960s the French Treasury decided that if it had to have a priority of priorities, it would have to be better perinatal care. The French have demonstrated, without a shadow of doubt, that their experiment has paid off over and over again in economic returns. One can imagine all the families that might have suffered but did not and all those babies who might have been handicapped but are not.
  It is a terrifying indictment of our National Health Service that we have the worst perinatal mortality rate among the European countries. It is a figure that I could scarcely believe when I first heard it. What worries me intensely is the correlation between the perinatal death rate—that is, between the twenty-eighth week of pregnancy and the first week of life—and the disablement rate. I shall put it the other way round. The disablement rate is two and a half times greater than the death rate. As I said, if our figures were as good as those for Sweden 4,000 babies would now be living and 10,000 babies would not be handicapped.
  My hon. Friend referred to the fact that the cost of supporting the severely handicapped child is about £250,000 in current terms. That really is a startling figure. What we have not realised and appreciated is that the disabled child now has an expectation of life virtually as long as that of hon. Members. Therefore, if a baby is born with a very severe handicap, that will cost the State £250,000. When I talk in these cold, economic figures, let me add that the greatest cost will be to the family and in the loss of opportunities for the child.
  What can be done? Here I come to the non-contributory element. It is not a new element. I noticed that there was some bickering across the Floor of the House earlier. At one time I was grateful for the support of Conservative Members, which allowed my non-contributory pension for the disabled housewife to become law. I hope that those hon. Members will do the same today and allow my hon. Friend's modest Bill to become law, because, for the class at greatest risk, the perinatal mortality rate has just about doubled. It was 17 per 1,000 in the country

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  as a whole in 1977. I think that the 1978 figure was a little better, but for those at great risk it is now about 33 or 34 per 1,000, which is double the previous rate.
  The other case that I want to put is one that everyone seems to have approved of, with one possible exception. It is important that the pregnant woman should receive prenatal attention and care earlier rather than later. The experience in Europe has been that where such inducements as are proposed in the Bill have been offered expectant mothers have attended clinics earlier and received the benefit of early care and advice. When it comes to short waits for dates, there is no doubt that the advice given at these clinics is of fundamental importance to the quality and health of the baby when born. Therefore, the instalment factor is vital.
  I shall not go into the problem of the size of the grant, but there is no doubt that the whole House is agreed that the present grant is totally inadequate. I appeal to the Minister—despite the fact that she has a bad arm and cannot sign her letters; I wish her a speedy recovery—to put pen to paper now and ask the Treasury to send somebody of importance to listen to the arguments. What we are talking about all the time is morally right, technically possible and economically sound. I hope that the Government will have second thoughts about the Bill, which would benefit the worse off in our society and give them a better start in life. We are talking about mothers and babies.
  12.47 pm
  Mr. Bill Walker: I say right at the outset that nothing would give me greater pleasure than to say that I could support the Bill without reservation. Unfortunately, I am unable to do so. There can be few Members in the House who cannot think of individuals or groups of individuals in need of assistance for whom the funds available from the Department of Health and Social Security are not adequate. Indeed, there are many deserving cases that could be said to have a need as great as that of the women and the children whom the present Bill seeks to help.
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  The problem that we face is not the lack of deserving cases; it is not a shortage of need but a shortage of adequate funds. I draw attention to those who are severely handicapped, severely disabled, mentally retarded, elderly, or blind. All are deserving cases, and all can be presented as individuals or groups of individuals with a need. The world today is racked by economic confusion and rapid inflation. It is torn by wars and strife, and in many areas there are acute starvation problems.
  The only funds available to this Government, or to any Government, are raised by taxation or borrowing. We cannot continue to delude ourselves by recognising that there is a need and yet make no attempt to create the means to provide for that need. The end result will be that more and more deserving people will face an ever-declining share of an ever-decreasing financial cake. Until we in Britain face these truths, until we improve our productivity and until we can compete with our overseas competitors, we cannot hope to provide any of the necessary extra funds to meet the costs of this Bill or, indeed, other such Bills that I should dearly love to bring forward.
  Since 1945 Governments of all complexions have been well-intentioned. They have all in their different ways tried to help those in need. Some of them have been accused by the more cynical of buying votes. They have borrowed heavily and printed money. That, in turn, has produced an ever-increasing endemic rate of inflation, increased unemployment, low investment in many sectors of industry, high interest rates and penal rates of direct taxation.
  The sponsors of the Bill seek to raise the level of the maternity grant from £25 to £85. In principle, I do not oppose that proposal, but I wonder where the Department of Health and Social Security is to find the money to pay that increase, which I understand will be between £40 million and £50 million per annum. Is it to be funded by savings elsewhere? I have looked in vain to the sponsors of the Bill, particularly the hon. Member for Kingston upon Hull, Central (Mr. McNamara), to say from where the savings are to come from, where economies are

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  to be made, and how they can be achieved.
  In our present economic climate, when the country is meeting and facing, possibly for the first time since the war, the reality of the cost of previous spending and borrowing, it is unrealistic to propose an increase for this one group of deserving individuals, because there are other deserving groups. Hon. Members mentioned pensioners over 80 and the death grant. We must accept that the maternity grant is not alone in falling in real value.
  A previous Labour Minister in another place is on record as having said:
  "Therefore, with the maternity grant and the maternity allowance, it really does not seem to be too bad."—[Official Report, House of Lords, 16 June 1978; Vol. 393, c. 773.]
  I should make my own position clear. I do not deny that the women and children in question have a need. I do not deny that there is merit in the proposal that the maternity grant should be non-contributory and paid in two instalments, because there is a need. There is also a good argument for inflation-proofing. However, inflation-proofing raises wider issues, as has been mentioned by previous speakers.
  This is a well-intentioned and humane Bill, but we cannot afford it as an additional on-cost to DHSS expenditure at this time. The resources and funds of the DHSS are already severely stretched. It is not surprising that the Government cannot support the call to provide these extra funds to meet in full the cost of implementing the Bill.
  I spent some months this year as a customer of the National Health Service. Before the election I was in an NHS hospital for some time. I was able to study at first hand the many tragic cases brought in from serious accidents. I also saw many from all social classes who were severely crippled and maimed—people who were trying to create and carve out new lives for themselves. They, too, desperately need help. There is a strong argument for help to go in that direction, because such people need assistance. Unfortunately, until we as a nation can pay our way, they, too, will have to wait for the funds that are not available at this time. Our hospitals need funds desperately to assist these individuals' recovery.
  774
  I am able to stand before you today, Mr. Deputy Speaker, largely because I was extremely fortunate. My injuries were sustained whilst on service with the Royal Air Force. Therefore, the RAF had a responsibility to help with my recovery. I was fortunate to receive remedial treatment at the RAF special treatment centre at RAF Headley Court. Many others who were in hospital when I was first injured were not fortunate enough to have the benefit of the expensive and wonderful services that only the RAF has in this country. The RAF has those services because it is necessary to repair damaged aircrew to get them back on active service in as short a time as possible. That is why I am able to walk and to stand here today within the limited time since the date of my accident.
  Of course it is wise to consider saving money on perinatal care and to consider how we can help individuals again to become active in normal life. That is sensible. Many of the similar claims that I have mentioned can be made for other groups who also wish to call on the funds of the DHSS.
  I suggest that we should look at this matter not in isolation but in conjunction with the many aspects of others in need, and that NHS expenditure should be considered from that angle. No case should be looked at in isolation. One can always make a very good argument in isolation. I suggest that there should be a comprehensive review of social security payments to local groups. National Health Service expenditure should be carefully reviewed to consider what can be done to make the best use of available funds for those in greatest need. There are many in great need. As a humane and caring society, we should help those who are in greatest need, not select isolated cases.
  I am in sympathy with the sponsors of the Bill and in better times would willingly champion their cause, but we just do not have the resources to pick at these needs piecemeal. We must carry out a comprehensive review. I hope that the Government will do just that.
  12.58 pm
  Miss Jo Richardson: I am grateful for the opportunity to support what has been said by my hon. Friend the Member for Kingston upon Hull, Central (Mr. McNamara), and I join hon. Members on both sides of the House in

  775
  congratulating him on bringing forward this measure.
  The hon. Member for Perth and East Perthshire (Mr. Walker) said that he was in sympathy with the need for prospective mothers to receive a larger maternity grant, but he insisted that the money was not available. I apologise to the hon. Gentleman for not hearing his opening remarks, but he seemed to indicate that the amount was enormous. According to him it would appear to be £500 million, £600 million or £1,000 million.
  I remind the House that the estimated cost of increasing the maternity benefit to £85 per applicant would be only £39 million. My hon. Friend the Member for Sheffield, Hillsborough (Mr. Flannery) said in an intervention that that figure is less than the amount given by the Government to support private education. If the hon. Member for Perth and East Perthshire wishes to find the £39 million needed to implement the Bill, that would be a good place to start looking.
  Mr. Bill Walker: I said that the figure, as I understood it, was £40 million to £50 million. That sum could be found in a comprehensive review of expenditure within the present National Health Service budget. I said that there were many other deserving cases that could be taken in isolation. It is when they are added together that a horrendous figure is reached.
  Miss Richardson: I am grateful to the hon. Gentleman for that explanation. I am sorry that I missed his earlier remarks. If we are to wait for the results of a comprehensive review—and I recognise that a good deal of work has already been carried out—I am afraid that poor prospective mothers will have to wait for another decade before they receive an increase in the modest, indeed ludicrous, £25 maternity grant.
  The provisions of the Bill would be of great service to pregnant mothers, not only by increasing the grant but by introducing the real necessity of an annual review and uprating. In the House we too often fall into the trap of setting a figure, not realising that inflation will catch up during the following 12 months and that money will fall in value. That has happened to the £25 maternity grant
  776
  introduced in 1969. If the grant were to be increased to a level that took inflation into account it would be more than £85, as that figure brings the grant only to the level of inflation of 10 years ago on the previous figures.
  Many hon. Members have referred to the necessity of the maternity grant because of the expenses involved, and I make no apology for repeating one or two of the expenses faced by pregnant women. In present day terms £25 is an appallingly low figure when a pregnant woman starts to assess all that she will need. My hon. Friend the Member for Rother Valley (Mr. Hardy) asked his wife to cost some of the items needed by a pregnant woman—we all recognise that the first child is important in terms of cost—and I was grateful to hear of the research that she carried out.
  The National Council for One Parent Families produced a document listing some items to which my hon. Friend did not refer. They come into the budget or, as a well-known department store calls it, "the basket of goods" needed by every pregnant mother as the minimum essential. Not only are there the carrycot, the carrycot transporter, the cot and the mattress, but a layette of 36 nappies—12 muslin and 24 Terry—six nappy pins, nappy sanitising powder, plastic pants, 200 nappy liners, two blankets, three vests, three baby stretch suits, three gowns—after all, the mother has to be clothed as well—two packets of dry nappies, three pairs of scratch mittens, two pairs of outdoor mittens, two pairs of bootees, three matinee jackets, two hats and two bonnets. That might sound a vast amount of clothing and equipment. I am sure that those who have had children will recall that that is a modest number of items of clothing and equipment and should be regarded as the minimum to enable a mother to look after her new baby. It is virtually impossible for £25 to cover anything but a fraction of the items listed by myself and my hon. Friend.
  Reference has been made to extending the principle of maternity grant to those who do not make any national insurance contributions. It is appalling that there should be any suggestions that girls under 16 and common law wives—the hon. Member for Brentwood and Ongar (Mr. McCrindle) called them "that class

  777
  of individual"—should not have the same qualification for a maternity grant as every other woman. I become offended when we try to classify people in that way.
  Women should continue with pregnancies if they are able to do so in a medical, psychological and social sense, and I hope that it is the view of the House that if someone is pregnant we wish her to be as happy as possible. It misses the point of the exercise to try to categorise and say that one group is more deserving of the maternity grant than another.
  Many hon. Members have the document provided by the National Council for One Parent Families. I was interested in the table comparing the level of maternity grants in Britain and other countries in 1977, which is important and relevant to the debate. It is difficult to compare one country with another in exact terms, and if the figures for other countries were closer to ours I should consider the table to be not worth the paper it is written on. Single mothers in Norway receive a maternity grant of £573. Compared to that, the £25, or the proposed £85, grant is seen in its proper and most realistic context. Norway pays the highest maternity grant. The grant decreases progressively through Austria, France and other countries down to poor old United Kingdom, and only a few countries are in a worse position. The proposer of the Bill is not suggesting, and nor am I, that we should allocate a maternity grant of £573, although I wish that we could. We should try to achieve a balance for the United Kingdom in payment of maternity grants.
  Most of the issues raised by my hon. Friends cover those that I had intended to raise, and I do not wish to take up the time of the House by repeating them. Some months ago there was a debate about abortion which aroused great passions on both sides of the argument, and I do not intend to enter into that argument at this stage. However, the general theme from those who supported the Bill, which is now in Committee and seeks to restrict the 1967 Act, was that women should be women—with young girls included—and that they should be encouraged to have their babies.
  The theme was to encourage them in every conceivable way not to have an abortion but to have the child. We can
  778
  all argue about the rights and wrongs, and the pros and cons of those who support or do not support the 1967 Act. I agree with those who say that women should continue their pregnancies and have their children. The corollary is that the State and society will in every way support them by giving them some modest means to enable them to do so in the proper way.
  I have been in the Chamber since 11 o'clock, apart from one absence of about five minutes. I have not heard one Conservative Member or one of my hon. Friends who is a member of the Standing Committee that is considering the Abortion (Amendment) Bill, the purpose of which is to restrict the 1967 Act, expressing an interest in increasing the maternity grant so that women can continue their pregnancies in a proper and decent way and have happy, bonny and beautiful babies.
  If this modest measure is enacted it will take some pressure off those, especially young mothers, who find life difficult in the present economic circumstances. I make no apology for saying that life is difficult for those receiving social security benefits, for those with low levels of income and for those who are not working. Many of the women about whom we are talking are in the last category. The pressures will continue to become more severe. Almost every day statements are made in the House on increasing the mortgage rate and on other topics that lead to an increased cost of living. This is a modest measure. An expenditure of less than £40 million would give some help to many women. I hope that the Bill will be welcomed and that it will be enacted.
  1.12 pm
  Mr. Peter Bottomley: I agree with the hon. Member for Barking (Miss Richardson) that the Bill is a modest measure. Its most important feature is to get rid of the contributory qualification for the maternity grant. That feature is so insignificant in financial terms that I do not think that the Department has worked out the net cost.
  We are talking about 60,000 births—about 10 per cent. of the births in Britain. Many of those who have children and who do not qualify for the maternity grant receive supplementary benefit or

  779
  the exceptional needs grant at the time of birth.
  We do not know the cost of the maternity grant. We can only estimate that the gross cost is likely to be about £1½ million. In net terms it will probably be less than £1 million. We may assume that there will be substantial administrative savings by getting rid of the need to check qualifications. Those savings will be substantial, although they may not amount to £1 million.
  I hope that through the introduction of the Bill it will be possible to get rid of the contributory qualification. It seems ludicrous that births that do not qualify for grant at present will, when they have taken place, qualify the mother on behalf of the child to receive the child benefit, which is not a contributory benefit.
  It has already been established by earlier contributors to the debate—it has been made plain by all the supporting evidence from the interest groups, whether part of the maternity grant campaign or those involved in child and infant health services—that if the Bill receives a Second Reading, as I hope it will, the Government should be persuaded at once or in time to ensure that the maternity grant is non-contributory.
  I join in the general congratulations that have been offered to the hon. Member for Kingston upon Hull, Central (Mr. McNamara) on using his opportunity having taken fifth place in the House of Commons raffle or lottery, to introduce the Bill. It is an important step, not only because of the money that it may bring to some families but because it will demonstrate that one element of family policy is receiving consideration at a time when we are facing economic difficulties.
  Those who have been around for a little longer than I have will remember that it was at about the time of my birth—1944—that many social advances and additional means of help for families were introduced. That was done when Britain's economic difficulties were far greater than they are now. When we consider the level of Government spending, it may be pointless to be over-concerned if it increases or decreases by 3 per cent. or 4 per cent. over a number of years. We should always be looking for opportunities
  780
  to raise more money to give to those who are in greatest need.
  I am pleased to know that some ex-Members of Parliament are using their time to help us to make progress in these areas. I am sorry that Helene Hayman is not with us today, although I am not sorry, in political terms, that she is unable to take part in the debate. She may feel that some of her briefing notes are being used and referred to in the Chamber more often than they would have been had she been here to put them before the House herself.
  I am sorry that the hon. Member for Rother Valley (Mr. Hardy) was suffering so much from jet lag that he harmed the case that has been advanced from both sides of the Chamber.
  We must accept that Ministers in the Department of Health and Social Security of this Government, the Labour Government, and the Government before that are sat on by the Treasury. Those who want to talk about money for mothers or for children tend to have less well organised pressure groups behind them than those who are asking for money for steel workers, for miners, for reducing tax allowances, or for increasing tax relief. Over the next few years we must ascertain what institutions we can create within the Government and outside that will make it possible for those who speak for underprivileged families and families as a whole to get their mouths close to the microphone and to speak as loudly and persuasively as those who represent the interests of the members of those families when they are at work.
  At present we do not have the right balance. We do not have the three-dimensional picture of family life, family responsibilities and family resources. The fault is our own, within government. It is our own fault within the political process and within the institutions outside the House.
  It is important to spend a moment considering population policy. Apart from one or two minor aberrations, we have not been concerned about the desirable level of population. That has been right. When we were last concerned about the issue we established a Royal Commission, at a time when there was a direct change in the trend of the birth rate. It had been decreasing, but it

  781
  started to increase dramatically. That happened even before the Commission reported. Indeed, one of the commissioners had twins while the report was being concocted.
  Since the report, the population has increased. The Government started planning for 1 million births a year. During the past five or 10 years the number of births has reached not the anticipated 1 million but between 600,000 and 700,000. When it is said that we should increase maternity grants and maternity benefits to avoid a catastrophic reduction in the level of the population, I can only repeat my earlier intervention, namely, that the level of funds and the amount of help and public conscience developed by providing help for those who are having children, at the time of birth and afterwards, appear to be associated with increased standards of benefit and an increased standard of living. It may be said that these matters turn in a complete circle and that countries with an increased standard of living can afford increased benefits.
  My argument for increased maternity benefits and child benefits has nothing to do with population policy. It is based on social equity and family benefits as a whole. Some East European countries provide many years of paid employment at home. That may have an effect on the employment market and on the question when people have their children. The most important factor to remember about population trends is that we cannot control all the factors. We do not know the nature of them all. Many of them are non-financial. Housing is an associated factor, although it is probably best left out of this debate. We must try to examine the implications of other aspects of Government policy.
  I return to the short-fall in the anticipated rate of births. If 400,000 or 300,000 babies each year are not joining our population, there is a simple answer to the question "Where is the money to come from?" During the next 16 years, for each child that has not been born the reduction from 1 million to, say, 700,000 will mean a saving of £4 a week on child benefit. That is a saving of £200 a year. If we consider the 10 or 11 years of education, at an average cost of £800 a year, there is money there which could be made available for the children
  782
  who are born, and especially for those in greatest need.
  When we consider the increased burden on the Department of Health and Social Security and on local authorities, and the increased number of people over 75 who will cause additional expense, it is quite clear that if we also take into account the declining demands of the rising generation and dependants under 16—and especially those under 5—the net cost to the Exchequer for the present level of services to the total number of individuals in each category will not be rising.
  When we talk about a one-off payment of £85 as a maternity grant, as suggested in the Bill, we are talking of one week's average wage per birth, yet the on-cost of each birth, in terms of child benefit, education and national insurance alone, is so substantially greater that already we have to start to look at the other effects of the payment of £85, which we hope will be index-linked.
  The greatest reason for having a substantial level of maternity grant is that it helps to remind the people who are having children that what they are doing is important. Even more than that, the way in which they do it matters, for bearing and rearing children is vitally important to this country. One can take the argument put forward by the hon. Member for Kingston upon Hull, Central that there is a class bias to birth injury and perinatal mortality. Clearly, there is. Much of this is associated with resources.
  A significant part of the differential factors is not just resources but the way in which people behave. We know from evidence that, in general, those mothers-to-be who do not at present qualify for the maternity grant are those who do not declare their pregnancy at an early enough stage to be counselled on nutrition and to be advised about any exceptional needs they may have, and who do not get the medical or other services that they, more than any other group, require.
  To have a maternity grant at a reasonable level and made non-contributory will encourage more and more people to come forward at an earlier stage. That is important in terms of avoidable handicap. We are not concerned at the moment with the question whether, by producing a higher level of maternity grant, we can affect directly the numbers of pregnancies

  783
  of wives of long-term prisoners, or of the under-16s or students. It is a relevant subject for discussion, but not today. The important thing is to get people to declare themselves earlier and to recognise what they can do by their own behaviour to take advantage of the medical and other services which are available. This, in its turn, can help to reduce the number of handicapped children—a subject on which the hon. Member for Eccles (Mr. Carter-Jones) spoke so eloquently on this occasion, as he has done on others.
  We ought to be asking ourselves whether we can start to look at this kind of income transfer—which is, in effect, what it is—not as one between the childless and the reckless, the feckless or the fecund people who have had children but as a transfer within the life cycle.
  The news about the increase in mortgage rates reminds us that many of us have the opportunity to take out a mortgage that will help us to pay for our housing costs over 20 or 25 years of our working life. We can get hold of community resources, sums of £8,000, £12,000 or £24,000, and repay them over a long term. We all know that through the national insurance fund and through income tax we pay, during our working lives, for the moneys that we hope to receive in retirement. This is institutionally organised, whether through the State or through pension funds or through building societies, as mentioned in my earlier example. We get the opportunity of paying forward for what we are to receive later on, or of paying in the future for what we receive at the present time.
  I look on our social security contributions and our taxation as ways of paying back what we or our parents had when we were born. Some people may ask "Why should we be involved in giving mothers in the present generation more than we had?" The answer is that it is the right thing to do. That is also the reason why we have been having increasing pensions.
  I do not want to go on talking about making the grant non-contributory. I hope that that argument has been accepted by the House. If it has not yet been accepted by the Treasury, it is time that Treasury Ministers came here to be
  784
  educated about it. I want to talk instead about the increase in the maternity grant. The question arises whether a higher level of grant would give substantial help to those who do not need it. The answer, of course, is "Yes", because any benefit that is universal by circumstance could be giving help to those who are richer. The big advantage of having a cash sum is in not giving greater help to the rich than is given to the poor. One of the reasons why people such as myself argued for a substitution of the old child tax allowance by a child benefit allowance is that it does not give greater help to the richer than to the poorer people in our society.
  It might be said that there may be some mothers with a family income of £20,000 a year and that they should not get an increase in maternity grant from £25 to £85. The answer is that that is a small price to pay in order to make sure that the grant goes to everyone who needs it. In the case where the family income is £20,000 a year—even at the marginally reduced rates of taxation, which I fully support—the family will be paying that much more in taxation than other families. It will be paying it not only when it receives the £85 but in the years when the family is not having children. Certainly the family will be contributing more. It could also be said that members of the family will be spending much more of their money on goods subject to VAT, and therefore paying more in that way as well.
  It is possible to argue that there is a limit to what the Government can do in any particular year and that this year may be more particular than most years. I could suggest—as I indicated to my hon. Friend the Member for Brentwood and Ongar (Mr. McCrindle)—a way of doing it. It is necessary, first, to refute the argument about the relevance of maternity allowance. It was Lord Wells-Pestell who, when a Minister at the Department of Health and Social Security said:
  "On reflection, I am not really very worried about the maternity grant of £25, for this reason. One has to take into account that there is a maternity allowance which goes on for something like 18 weeks, and that maternity allowance…is quite substantial. Therefore, with the maternity grant and the maternity allowance, it does not seem too bad."—[Official Report, House of Lords, 16 June 1978; Vol. 393, c. 773.]

  785
  That quotation may be taken out of context. The noble Lord may have said other things that would make the quotation seem not quite so bad. What is relevant is that, although the maternity grant is paid on nearly all births—but does not always go to those who are in the greatest need—the maternity allowance goes to a far smaller proportion of mothers. It tends to go to those who have not only had jobs but have also been paying the higher rate of contribution. Those who have not been paying the higher rate of contribution tend to be those who started working some time ago and those who have been in lower-income jobs and have not switched on to the fact that they might become pregnant in two or three years' time and might not be qualified to receive the maternity allowance.
  However, I do not want to be too unfair to the noble Lord. Let us consider the point that, if someone is getting the maternity allowance, the maternity grant is not too important. I am willing to accept that there is something in what he said. It is not a total case, but there is something in it. I should be happy if the Ministers were to consider the matter and say that they are willing not only to make the maternity grant non-contributory—that is an obvious need, and not expensive—and to increase the maternity grant but that during the transitional period of two or three years they will knock the increased maternity grant off the maternity allowance. That way would be redistributing in part from among those having children, so that to get the universal benefit we would withdraw some from those who are getting greater advantage.
  It may be that that is not possible under the rules of the national insurance scheme. I do not know. I have not gone into it in great detail. I would not be very keen on it, because it is important not to start just redistributing among those who have children in any particular year. It is far more important to redistribute between those who have children this year, next year, and so on. Again, the transfer over the family income cycle seems to be substantially more important.
  The provision in the Bill making it possible to have split payments—payments by instalments—is important. It
  786
  has been said that some do not want to see the system as it was in France, where it was possible to lose some of the maternity grant benefit if people did not arrive for a clinic appointment on time. I have done a little research on this matter and I have not yet found one case in France where that has happened. It may be that because it has got so far into public consciousness that that could happen, so many turn up for their clinic appointments that it has never been needed, although no doubt some families do not turn up on time. But it has so sunk into the consciousness, not only in France but in this country, that so many more turn up.
  It is worth reinforcing the view already given that it was the French Treasury that encouraged the French Government attack on perinatal mortality and handicap. It is also worth noting that it was not the carrying out of the plan that made the difference. It was because the Government gave a commitment and organised so much public awareness and family awareness of the fact that much handicap and death was avoidable that the French figures started to improve dramatically in the first year of the plan rather than the improvement being delayed until the whole of the seven-year plan had been carried out.
  We need much more of that in this country. That is why I say to my right hon. and hon. Friends on the Government Front Bench that it is not just the money we are after that will make the difference. It is the public commitment—not just a Government commitment but a public commitment, and a public awareness—that will be just as effective as making the money available.
  But if this House said "We are sorry, we shall not make the maternity grant non-contributory, to show that we hold those giving birth to the rising generations in such low esteem", many people would say that having a baby does not matter and that people do not care. It seems to me very odd that 15 years after the white heat of the technological revolution we should be still giving such haphazard care to those who will be running the silicon chips or the white-hot revolution, or whatever else may come—depending on how the Labour Party sorts out its troubles in the years to come—and that we are not giving sufficient attention

  787
  to this vital aspect of family policy, which is where the family life cycle starts—at birth.
  There are many other things that could be said, but so that other right hon. and hon. Members may contribute to the debate I finish by quoting from two publications. The first is from the issue of spring 1978 of One Parent Times, which is produced by the National Council for One Parent Families, in which, admittedly in a book review, it says:
  "'family policy' is rarely more than hot air".
  I think that this bipartisan Bill gives the present Conservative Government the opportunity of showing that it is not just hot air and, that if sufficient Members of Parliament are willing to back it by their presence, their voices and their votes, they will get a willing response, perhaps in time, from the Government.
  The other quotations that I should like to bring forward come from a publication of the United Kingdom Association for the International Year of the Child. It is called "UK Children OK?" It is produced as a combined effort by ATD, the British section of the International Fourth World Movement, whose purpose is to combat social exclusion—and social exclusion is exactly what we are talking about when discussing those families at present do not qualify for maternity grant—the Child Poverty Action Group and the family service units that exist to serve disadvantaged families in communities unable to achieve their full potential because they lack adequate resources.
  I think that we all ought to congratulate Mary Rabagliati, of the ATD Fourth World, Ann Kerr of the family service units and Jo Tunnard and Harriet Wilson of the CPAG. What, in effect, they are doing is trying to focus attention on the needs of the poorest families in the community, and, more than that, it is intended to lead to action. We here are the people who must take the action. They are building on the 1959 Declaration of the Rights of the Child, put forward by the General Assembly of the United Nations. Twenty years after that, in the International Year of the Child, it is important that we should all consider what programmes we can bring forward that
  788
  will give benefit to those in extreme poverty.
  In the section on health there is a quotation that is nine years old. It says that
  "Good ante-natal care, obtained early in pregnancy, is a crucial factor in preventing difficulties at birth, as well as death or handicap amongst babies. The lower down the social scale and the poorer the family, the more difficult it is for women to take time off work to go to hospital, to pay for travel to and from hospital, and to have their other children minded while they do so. The latest national study on British births reports that one quarter of unsupported mothers and just under one third of mothers from social class five receive little care during their pregnancy."
  Clearly, if they come forward earlier there will be some on-costs. We shall not be able to close as many mother and baby clinics or whatever, but, as mentioned earlier in the debate, the savings will be substantial. It is very important that the Government pay attention to the arguments put forward in this debate and that they do all that they can, outside the Bill, to build up the other aspects of family policy, on which not only they and I were elected but which are also important to Opposition Members.
  One of the most important things that one can do in this House is to try to bridge the gap between those who have no real voice outside of politics and both sides of the House of Commons. Rather than just be involved in a battle between one side and the other, we should never lose hold of any opportunity to go forward.
  In conclusion, I believe that the Government have opportunities to monitor the effects of their general policies. Although it may come slightly outside the terms of the debate on the Second Reading of this Bill, I hope that the Government Departments involved will think very seriously about giving more help to longitudinal studies which will show not only the effect of income on families but also family circumstances. If we can continue to follow up the cohort studies that the National Children's Bureau and the university of Bristol child health department have been carrying out, we shall be able to come back year after year, or every five years, to put forward arguments in the House which are concerned not just with money but also with behaviour, habits and attitudes.

  789
  As it happens, the Bill is mainly concerned about money for those who do not get it at present and the attitudes of those of us who have the opportunity of getting it for them.
  1.38 pm
  Mr. Jack Ashley: The House will have listened with great interest to the hon. Member for Woolwich, West (Mr. Bottomley), who is an authority on this subject. I hope to deal with some of the points that he has raised shortly, but I should like first to add my congratulations to my hon. Friend the Member for Kingston upon Hull, Central (Mr. McNamara) on introducting the Bill eloquently and very persuasively. I hope that the House will support the Bill as a necessary measure.
  A few weeks ago the Chief Secretary to the Treasury stood at the Dispatch Box and announced expenditure cuts. He was asked a simple, straightforward question—what he would do if evidence were given to him of great deprivation among the most vulnerable sections of our society. He was asked whether he would give them hard cash to deal with their problems or whether he would say "Hard luck." The right hon. Gentleman nearly had hysterics. I do not know whether the cap fitted, but he wore it. He went on to say that no party had a monopoly of compassion and that the Conservative Party was a compassionate party. No one had alleged that it is not. It is important that we should not seek to make party political capital out of a Bill of this kind.
  My hon. Friend said that he had written to the Prime Minister. As the Chief Secretary assured the House that the Government were not lacking in compassion and that they would feel concerned if evidence were produced of hardship among the most vulnerable sections of our society, I should have thought that the Prime Minister would have given an affirmative reply, but apparently she has told my hon. Friend that the Government cannot support the Bill. Where do we stand?
  The hon. Member for Woolwich, West rightly referred to Helene Hayman, who has done wonderful work in this field. We have all received the brief that she prepared. The facts are indisputable.
  790
  They are that the most vulnerable sections of our society are suffering—young girls who are pregnant, very poor women who are pregnant and unsupported mothers-to-be and people in great need. They are the most vulnerable sections, and they have a greater claim than anyone else to be helped in view of the erosion of the maternity grant. Despite that, the Prime Minister has said "No, we cannot do it." There is something wrong with our priorities. I am not making a party political point. The Bill is proper, necessary and vital, yet we cannot get Government support for it.
  One element that has not been touched on, but which is rather important—again this is not a party political point—is that the failure for many years by successive Governments to uprate the maternity grant is one more mosaic in a vast and ugly pattern of sexual discrimination. If men received maternity grants, if by some transformation of biology men became pregnant, there would be uproar because of the erosion of the grant. But because it is women who are concerned, it does not seem to matter quite so much. There is an element of sex discrimination in the indifference shown by both sides of the House, and I regret that very much indeed.
  In addition to this sex discrimination, there is the class aspect. It is that aspect that I believe is of profound importance in this debate. We must see the failure to operate the maternity grant in two senses of class. We must look at the question of the background to perinatal mortality, and some reference has already been made to that. The figures are staggering. I have checked on the most recent figures, although many hon. Members who are experts in this area are already well aware of them. However, it is as well to remind the House of some of the more outstanding figures. In Oxfordshire the figure is 9 per 1,000, and in Kingston and Richmond it is 9·2 per 1,000. But in North Tyneside the figure is 21·2 per 1,000 and in Dudley, in the West Midlands, 24·1 per 1,000. Therefore, a child in North Tyneside or Dudley stands approximately one-third the chance of surviving and of not becoming one of these terrible perinatal statistics as does a child in Oxfordshire, or Kingston and Richmond.

  791
  I am not suggesting that the increase in the maternity grant will solve the problem, but it will make a major contribution towards reducing the perinatal rate of mortality. These figures ought to be borne in mind. It is true that some social classes are suffering far more in terms of perinatal mortality than others. These wide variations are reflected in socio-economic factors.
  For example, women in social class 1 have a perinatal mortality rate of 8 per 1,000—that is less than half the national rate—but 27 out of every 1,000 babies born to women in social class 5 will die. That is a tragedy. As well as a regional discrepancy, it is also a social class discrepancy, which is intolerable. I do not know how those hon. Members who represent constituencies with these bad figures do not lead marches to the House of Commons. The situation in Staffordshire is not wonderful, but it is nothing like as bad as it is in North Tyneside or Dudley, which have perinatal mortality rates of 21 and 24 per 1,000. These are shattering figures and the great social tragedy is that children are dying unnecessarily.
  It is against that background that one must see the need for this measure. These figures have been carefully prepared by the Spastics Society. My hon. Friend the Member for Eccles (Mr. Carter-Jones) has asked thousands of questions on this subject. One of the people who used to work for the Spastics Society and now works for the Royal Association for Disability and Rehabilitation, Peter Mitchell, is a great authority on this subject, because he has pushed forward the frontiers of knowledge. He is a man who refuses to accept the handouts of Governments of either party, and he has been responsible for pressing these issues very strongly. The House should be grateful to him.
  The Bill offers the Government a great economic bargain. The Government strongly insist on the economics of any measure that is brought forward. This one is an economic bargain. If they say that they are concerned with the state of the economy and that they cannot afford the provisions in the Bill—which will cost a mere £45 million—I hope that they
  792
  will bear in mind that the estimate of keeping a handicapped child throughout its life is £¼ million. If as a result of the Bill only 180 children are saved from severe disability, the measure will have paid for itself. This is the bargain of a lifetime for the Government.
  Raising the maternity grant will not only prevent 180 children from being severely disabled but will help to prevent thousands of children from being severely disabled and some of them from dying. It will not solve the problem, but it will make a major contribution towards meeting basic needs and encouraging pregnant women to go for ante-natal care. The claims for the Bill are far too modest. It is a major step forward. The cost of the Bill is modest. The gains are out of all proportion to the cost.
  I hope that the Government will think again. Ministers speak of incentives. If the Bill is passed, it will help fit and healthy babies to be born. There is no greater incentive than good health. If the Government are concerned with the economy and incentives, they should support the Bill.
  I promised to make a brief speech. I want to keep that promise, although there are many points to be made. If the Bill is passed, it will represent a major step forward in helping the most vulnerable sections of our society whose needs have been carefully documented by those campaigning for the grant. There are thousands of figures to show the necessity for the Bill. I shall not weary the House by giving them again.
  I hope that the Prime Minister will think again of the sex discrimination, of the benefit to the Government, and of the benefits to the country. I hope that she will think, above all, of the benefit to the women and children concerned. Let us have a change of mind. Let us have a U-turn that will be warmly applauded, for once, by Opposition Members. Instead of laughing cynically, we would applaud a change of mind. I ask the Prime Minister to think again and to show that she is a big person, able to admit that she is wrong in opposing the Bill. Let her win the applause of the House and the thanks of pregnant women, especially very poor pregnant women.
  1.52 pm
  Mr. Tom Hooson: The right hon. Member for Stoke-on-Trent, South (Mr. Ashley) made a powerful point when he referred to the considerable cost of keeping a disabled child in the course of his or her life. That is a point to which I should like to return.
  The House is indebted to the hon. Member for Kingston upon Hull, Central (Mr. McNamara) for having used his high place in the ballot for Private Members' Bills to draw attention to the subject of disadvantaged children in relation to maternity grants. I have followed clearly the argument of my hon. Friend the Member for Perth and East Perthshire (Mr. Walker), who referred to the considerable cost implications of the Bill. Private Members' Bills that involve cost implications have a way of running into trouble. I do not want to refer specifically to the proposed increase in the maternity grant but, rather, to concentrate on what seem to be two powerful features—the proposal that the maternity grant should be available on a non-contributory basis and the principle that the payment should be made in two instalments.
  The cost implications are modest. My hon. Friend the Member for Perth and East Perthshire has drawn legitimate notice to the fact, in relation to overall financing, that there are other compelling cases. It is understandable, in a period of budgetary stringency, that we should look at what are the most cost-effective of the proposals within the Bill. The two that I have identified seem to be highly intelligent and compassionate proposals within that context.
  I should have thought that it was common ground in the House that when one can identify considerable needs, felt by a relatively small element of society, the case for action is particularly strong. It is estimated that 8 per cent. of mothers do not qualify, on a contributory basis, for a maternity grant. They tend to be those facing the worst possible circumstances in which to give birth to children. Among them are all mothers under 16 years of age, unmarried mothers who have not been in paid employment long enough to qualify in their own right for maternity grants, female students and non-employed wives of students, wives of long-term
  794
  prisoners, and common law wives who are not in paid employment. Children brought up in these circumstances begin life at a considerable disadvantage.
  A number of hon. Members have referred already to the higher-than-average incidence of perinatal mortality that occurs among these groups. The proportion of babies of low birth weight is about 6 per cent. of the population as a whole. I have no doubt that these groups contribute considerably to that disadvantaged element. Both compassion and good sense in identifying a cost that pays for itself, as the right hon. Member for Stoke-on-Trent, South pointed out, make the case for removing the contributory requirement one that I hope the Government will study carefully, even if they should decide that the cost implication of raising the maternity grant may be too difficult at this time. I strongly endorse the view expressed by the right hon. Member on that point.
  1.56 pm
  Mr. Stanley Orme: I intervene briefly in the debate to support my hon. Friend the Member for Kingston upon Hull, Central (Mr. McNamara) and the Bill that he has presented to the House. In a previous incarnation I had some responsibility for benefits and the problem that any Government face in regard to benefits. The previous Government had a system of priorities. The priorities were, initially, retirement pensions and then child benefit. But we were aware, especially in periods of high inflation, that many other benefits, not index-linked, were being reduced in value and in effectiveness. If action is not taken on some of these benefits, they become completely ineffectual. The 25p for the over-80s is an indication of what I am talking about. One can talk, in the same sense, about the death grant and the maternity grant as examples of benefits that are not index-linked.
  I know from my experience that advocating index-linking is different from getting it. Chancellors are averse to giving away what they see as part of their control of the finance within our economy. But this issue has to be faced. I want to refer to the Labour Party's attitude and where the party stands in relation to this Bill.

  795
  I congratulate my hon. Friend the Member for Kingston upon Hull, Central on the case that he presented today. Having heard most of the debate, I think that the standard has been exceptionally high. Every speech has been well informed and every Member who has taken part has understood the issue and addressed himself to it. That is not always common in our debates.
  Up to now we have been free of any opposition to the Bill. There appears to be a unanimous feeling in this House that something should be done. Therefore, it would be a great pity if the Government attempted to use any parliamentary device to prevent the Bill from going into Committee. There is an overwhelming case for having a Committee stage. The Government can come to the Committee, express their views and criticisms of the detailed points and then suggest alterations which the House can have another look at on Report stage and Third Reading. I hope that we will not see the Bill threatened at the eleventh hour.
  Several hon. Members have referred to the fact that during the period of the last Labour Government these benefits were not increased. I have made clear that we had a list of priorities. I have stated that we were aware of pressure in relation to these benefits. Before the election the Labour Party had a meeting when the manifesto was drawn up, and on this issue there was complete unanimity. We said in the manifesto that in the next Parliament we would abolish the contribution principle and raise the maternity grant. Not only did we say that we would do that; we made similar references to the death grant and other key areas of concern.
  When I was a Minister I received about six times as many letters on the death grant as on the maternity grant. No doubt the Minister will be able to tell us whether that ratio has been reduced. Certainly, I received a lot of correspondence from various well-informed pressure groups.
  In terms of national insurance and expenditure, these are quite modest proposals. I believe that the cost will be about £45 million a year. I see that the Minister confirms that. There is always the question of a Government finding that expenditure and saying that any case must have priority above all others.
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  The increases in national insurance contributions announced yesterday are considerable for those in the higher income levels. For example, a man earning £165 a week will pay a 25 per cent. increase. His contribution will be £2·37 a week more from next April. I know that the increases are scaled down for the lower income groups, but the ceiling has been raised from £135 to £165. Therefore, I do not know what some of the Southern region commuters must have thought when they were travelling home last night. On the front page of their evening papers was the news about 15 per cent. mortgages and on the inside page there was the announcement about national insurance contributions. Today we have had the news about television licences.
  We come to the question of finance. The only way in which a private Member can deal with this is to link it to the national insurance fund. Even allowing for the Government's estimate of other benefits and the rise in unemployment, the increase that has been announced will lead to a marginal increase in the surplus of the national insurance fund. It might be interesting to know the extent of the fund when this increase comes into effect because this Bill is linked to the fund. Therefore, there will be money available to meet the £45 million needed to implement the Bill.
  Mr. McCrindle: Does the right hon. Member agree that during the period when he had some responsibility for these matters, although the level of the surplus was frequently given as evidence for increasing this or that benefit, his Government solidly refused to do so? Has the right hon. Member changed his approach?
  Mr. Orme: No, I have not. We increased benefits during our period in office. The introduction of child benefit was a major factor. I know that that did not come out of the national insurance fund, but I was very anxious, as a Minister, to ensure that the fund should not be too large and that the Government should not keep too big a surplus. Arguments are put forward about unforeseen circumstances, unemployment, sickness and disaster throughout the winter and the heavy burden that this would impose on the fund. But, allowing for such eventualities, here is an instance in which the Government

  797
  are deliberately increasing the national insurance fund. Therefore, they should take that factor into account. But in my opinion one does not have to go to the national insurance fund for this money; it could come from other moneys that the Government raise.
  As a result of the Government's public spending cuts, people will be severely affected if some adjustments are not made in favour of the lower income groups. Let us take the question of families particularly. The child benefit now stands at £4. It would have been increased to £4·50 this month had a Labour Government been returned last May. The child benefit will be worth only £3·20 by next April, allowing for the current rate of inflation. It may be worth even less. Therefore, family support will be reduced.
  Also, we must take account of the fact that the Budget proposals for tax relief favoured the husband and wife without children. The largest increases went to childless couples. The Government must consider this matter, especially when there are no means of adjusting income other than that of child benefit.
  Mr. Field: Is my right hon. Friend not being a little too kind to the Government in saying that those with children did not get their fair share of the Budget? We know that taxation was cut by £4·5 billion and that children, whether from rich or poor families, received only £8 million in benefits. Does my right hon. Friend not further agree that had families received their share of the tax cuts in increased child benefits we would not be talking, as he is talking, of real reductions in child support in the coming year, but of child benefit of around £8 a week?
  Mr. Orme: My hon. Friend is an expert in this field—if I may use the term—and I acknowledge what he says. When he says that I am being kind to the Government, I am addressing myself, in bland terms, to the Government. I am pointing out the problems that families are experiencing and will experience in future and that this measure, modest though it may be, is one way of assisting them. This Bill goes some way to that end, even though my hon. Friend the sponsor of the Bill has not uprated the Bill's financial provisions in relation to current prices. He has put forward a
  798
  sensible proposal, and I hope that the Government will not oppose the Bill.
  Mr. McCrindle: So that there may be no doubt in the House and in the country of precisely where the Labour Party stands on this issue, may I say that when the right hon. Gentleman says that something can be done by not allowing the national insurance surplus to go too high—and says that that was his view during his time as a Minister—I presume that he is conceding that the corporate view of the then Government was to the contrary? Secondly, when taking the discussion into the realm of child benefits and saying that, if we chose, we could find the means to increase child benefit from other sources, will he make it absolutely clear that the only other sources available are either increased national insurance contributions or, more likely, substantially increased taxation?
  Mr. Orme: I do not object to the hon. Gentleman's intervening twice. I was coming to the very points that he raised. The Labour Party is officially supporting this Bill, and I speak officially for the Opposition. As to my views, and what was done, or not, during our period in Government. I have explained that we did not raise the benefit while we were in Government. However, my views prevailed because our intention to do so was firmly stated in our manifesto. That was a manifesto commitment, and I can assure the hon. Gentleman that we would have carried it out. I am sure that he has read that commitment in our manifesto.
  As to where we might get the money, we could argue for the national insurance fund or for direct taxation. The hon. Gentleman said that it would mean increased taxation. Perhaps some of the recent tax reliefs that have been given unnecessarily could have gone in this direction. Perhaps the unnecessary grant of £65 million to the private schools could have gone in this direction.
  Mr. Robert Rhodes James: The right hon. Gentlemen refers to grants of £65 million. Surely he is aware that under the assisted places scheme—which does not begin until 1981–82—the sum allocated is £6 million. It is not £65 million or £55 million; it is £6 million out of a Budget of £8,000 million.
  Mr. Orme: I have heard figures quoted in the House—figures that have not been contradicted—of over £60 million. The hon. Gentleman, for all his persuasion, is not at the moment on the Treasury Bench. Neither am I, but a Minister will shortly be speaking on behalf of the Treasury. Our understanding is that the assisted places scheme will be extremely expensive and has been costed at £65 million.
  Mr. Hardy: My right hon. Friend will be aware that it is proposed that 15,000 young people will be able to take advantage of the assisted places scheme. Fifteen thousand young people in private education would be getting an astonishing bargain if, in a normal year's expenditure, the cost was only £6 million. I think the hon. Member for Cambridge (Mr. Rhodes James) will agree that that figure refers to the operation of the scheme in the first year and not a normal year.
  Mr. Orme: I thank my hon. Friend for that intervention. It is obviously one of the Government's priorities to increase that sum and also to increase the number of assisted places in private schools. Those increases will come out of public expenditure. Nobody in this House can deny that.
  I have taken longer than I intended, and I did not intend in any way to be controversial. I conclude by hoping that, as a result of the concern expressed on this issue, in House of Commons terms, the House will reflect upon that concern at 4 pm. I hope that my hon. Friend's Bill will receive a Second Reading.
  2.16 pm
  The Under-Secretary of State for Health and Social Security (Mrs. Lynda Chalker): I think that it might be for the convenience of the House If I intervene at this stage. I have listened with great interest to the discussion, and I welcome the opportunity that it has given to the House for a wide-ranging debate. As the right hon. Member for Salford, West (Mr. Orme) said, there has been a well-informed discussion on many aspects of the maternity services. It has been valuable for the Government to hear the views that have been expressed, and I am grateful to the hon. Member for Kingston upon Hull, Central (Mr. McNamara) for providing the chance for
  800
  hon. Members to debate this important topic.
  It would be easy to go over many of the points that have been made, but what is interesting about the Bill is that the support for it is well considered and comes from a number of independent voluntary bodies. In particular, I mention the campaign Money for Maternity, which is organised by the National Council for One Parent Families and the Child Poverty Action Group. They have been pressing for some time for the improved measures contained in this Bill, as well as for others. The Bill is also supported by the Spastics Society, which, as hon. Members will know, has been running its Save a Baby campaign for some time.
  The eloquent contribution of the hon. Member for Eccles (Mr. Carter-Jones) made us realise how important all that work has been. The arguments put forward by those and other important bodies for an improvement in the maternity grant provisions have been echoed throughout the debate. I do not doubt for a moment that on both sides of the House there is genuine concern about perinatal mortality. It is this concern that inspired the Bill, and I fully respect the objectives behind the proposals contained in it.
  The other noticeable feature is that this is not a party matter. I know that the right hon. Member for Salford, West said that he had persuaded his colleagues and his party to include the provisions of an increased, non-contributory, maternity grant in the Labour Party manifesto, but I have a horrible feeling that the right hon. Member for Heywood and Royton (Mr. Barnett) must have been doing something else at that moment because, regrettably, I cannot find any provision in the Estimates for paying for that pledge. Therefore, I am in some difficulty in knowing just how far the Labour Government had committed resources to this proposal. This is not a party matter. However, for every good idea that we, in Government or in Opposition, may produce there has to be—this applies to social security above all other subjects—the money to back up those ideas. It was not in the Estimates.
  Let me turn to the whole question of perinatal mortality. It has been a personal

  801
  concern of mine for many years. Let me give the latest figures. While deaths in the perinatal period and during the first year of life are still much too high, there were welcome reductions in perinatal and infant mortality rates in England last year. In 1977 the perinatal mortality rate was 16·9 per 1,000. By 1978 it had dropped to 15·5 per 1,000. The infant mortality rate had dropped from 13·7 per 1,000 in 1977 to 13·1 per 1,000 in 1978. While those figures can give us no cause for complacency, they show a continuing trend in the right direction. There is evidence that the chances of death in the perinatal period are higher when there are no pre-natal visits to clinics. Early tests are essential to check the health of the mother and to determine whether a child is developing normally. Improved and, above all, early pre-natal care offers the greatest hope for increased prevention of perinatal mortality and morbidity. I therefore have no hesitation in saying that the Government's aim remains that health authorities should provide the highest standards of maternity neonatal care.
  We recognise the problems of perinatal mortality, and the Government have indicated not only that they want to see improvements in the figures but that they want to see women receiving the care at a much earlier stage. I fully understand, therefore, that the hon. Member for Kingston upon Hull, Central and everyone else who has spoken in its favour, see the Bill as one way to achieve progress in this area. However, they must recognise that the proposals before us are designed to improve a benefit paid under social security legislation. They cannot be divorced from all our other social security legislation.
  We must be careful, therefore, not to take a blinkered look at social security provision. The benefits available are intended to provide help in certain circumstances, whether it be unemployment, sickness, old age, disability, or to help the mother-to-be. The maternity grant paid under the national insurance scheme is intended to make a contribution, and no more, to the costs of having a baby.
  The grant is not a difficult benefit to qualify for, and about 92 per cent. of all mothers receive the £25. There are two contribution conditions, which can be
  802
  satisfied either by the mother or her husband. First, contributions must have been paid on earnings of at least 25 times the lower earnings limit in any one year, and for this purpose class 2 and class 3 contributions count. Secondly, contributions on the same earnings limit must have been paid or credited in the relevant tax year. These conditions are among the easiest to satisfy in the whole of our complicated contributory system. In 1977, the latest year for which firm figures are available, 587,000 grants were paid at a total cost of £15 million. About 56,000 births did not attract the grant.
  What we have before us today are proposals to make the grant non-contributory, so that all mothers resident in the country will receive it, and to make a substantial increase in the amount of grant. We must look at these proposals in context. Hon. Members have already identified the wider background of services for pregnant women and each has, in his or her way, put forward a case for improving the provisions of the grant in that context. The Government must take an even wider view. Any improvement in social security means greater expenditure, and this Bill is no exception We must, therefore, consider it against the background of the present economic situation.
  The Government published their White Paper on public expenditure to 1980–81 only three weeks ago. That paper made it clear that the Government's main objective is to strengthen the economy. For too many years we have been paying out money from the public purse when the purse has been empty. To revitalise the economy, profligate spending must cease and the Government have committed themselves to stabilising public expenditure at the 1978–79 level until the economy is strong enough to support further improvements in public services.
  Mr. Andrew F. Bennett: Does not the Minister accept the argument, which has been made from the Labour Benches at least, that the cost of these measures could be recouped if fewer children were born severely handicapped? Does not she agree that there is a strong argument that the Bill might not incur any additional cost for public expenditure? What figures has the Minister

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  put to the Treasury to support that argument?
  Mrs. Chalker: I well understand that argument, which was advanced by the right hon. Member for Stoke-on-Trent, South (Mr. Ashley). He said that the Bill was a great economic bargain for the Government because the £45 million that it would cost should be set against the estimated cost incurred with a child handicapped for life. We realise—and the hon. Member for Eccles and many other hon. Members on both sides have made the point—that there is a preventive element in this expenditure. A difficulty that we face is that we do not have the money to make the investment. I find that a particular difficulty. We have to look further and as fast as possible at what needs to be done.
  My hon. Friend the Member for Perth and East Perthshire (Mr. Walker), in a most realistic speech, said that there never was a right time to ask for more. I believe that that is true. It is with regret that the Government have to say, therefore, that the present moment is not the right one. We say "with regret" not only because we would like to see improvements in services and benefits but also because we know that behind the statement lies the fact that the economy is in a very poor state. The economic situation dictates stringent constraint on public expenditure, and we are determined to limit what we spend to what the country can afford. Against that background, we simply cannot now contemplate the increased expenditure required by the Bill. It would be a significant sum. Full implementation would cost about an additional £43 million a year at current prices.
  The Government cannot give their blessing to the Bill because of the cost, but finance is not the only problem. When my colleagues and I have been asked our intention about maternity grant, we have had to make it clear that it is a question not only of resources but of priorities. Even if the money were available to improve such security provision, we would have to ask ourselves, as the Labour Government did before us, and as every Government must in time, whether the grant is the best way to spend the money which is available. As my hon. Friend the Member
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  for Brentwood and Ongar (Mr. McCrindle) said, a greatly increased grant would go to all mothers irrespective of their need. We could not justify a non-selective approach of that nature when resources are so scarce.
  Since taking office I have heard a number of arguments for improvements in the social security system. I hear them daily. Many hon. Members taking part in the debate have themselves been advocating other courses. There have been representations about the blind, various different types of disablement and one-parent families. All those groups are in a certain degree of need, some worse than others. I have heard arguments for extending the mobility allowance to the elderly, for increasing child benefit and for giving further help to one-parent families. One of the most difficult tasks that faces us when resources are available is to decide where the balance between those arguments must lie.
  Mr. Hardy: I appreciate the hon. Lady's argument, but will she accept that because of inflation the VAT yield over the next three or four years will be enormously greater than that calculated by the Government six months ago? For example, the switch to convenience foods, most of which will attract VAT, could, as a result of the reduction in the school meal provision, increase the VAT yield by as much as £25 million in a full year. That increase could go some way towards meeting the causes that I and my hon. Friends are advocating.
  Mrs. Chalker: I shall pass on the hon. Gentleman's remarks to those who should note that perhaps extra money will become available, but, whatever the extra resources coming in, we still have a major problem. The public sector borrowing requirement is far too high and we cannot afford it. Last year alone, to finance the interest on the money borrowed for this country we spent more than was spent on the entire National Health Service, and that emphasises the size of the problem.
  Mr. Frank Haynes rose—
  Mrs. Chalker: If the hon. Gentleman will forgive me, I shall get on. There are many other hon. Members who wish to speak.

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  I do not minimise the case for increasing the grant, but I cannot accept that we should look at the proposals in the Bill in isolation. We have to consider them together with the other demands for resources as soon as they become available.
  Mr. Orme: We have had the Treasury lecture from the hon. Lady, and it is not her best suit. She is much better when dealing with social security as such. The Government appear to be doing nothing in any of the fields mentioned. We have made modest proposals. What are the Government's priorities?
  Mrs. Chalker: Even with all the paperwork at my side, I do not have the Government White Paper that was published a couple of weeks ago. I know that the right hon. Gentleman has read it many times, but if he reads it again he will see that bringing inflation under control must be the Government's overriding priority. I cannot start putting up my bids until we know how the economy is responding to the measures that the Chancellor has had to take.
  Mr. Field rose—
  Mrs. Chalker: I regret that I must get on.
  One of the Bill's objectives is to raise substantially the value of the grant. It was fixed at its present level in 1969. As was pointed out, it would need to rise to £85 to restore the purchasing power that it had 10 years ago.
  The fact that an improved grant would go to all women, whatever their social and economic circumstances, makes me take cognisance of the fact that we ought to investigate the matter further, as suggested by my hon. Friend the Member for Brentwood and Ongar. That view is widely held in the House. From time to time, in order to give those in desperate need the help that they deserve, we have to look at the means of the people involved, although I do not like that any more than does the right hon. Member for Salford, West.
  Since the maternity grant first became payable under the national insurance scheme in 1948 there have been dramatic changes in the economic circumstances of families. There has been a substantial increase in real income, and that has been
  806
  higher for young people. Moreover, more women have taken advantage of the greater opportunities available to them to go out to work. That has meant that the great majority of parents find themselves able to bear the cost of a new baby and are happy to do so.
  In those circumstances, the decision has been taken by successive Governments to use available money for those in greatest need. We must accept that social conditions were very different when Beveridge drew up his plans for a national insurance system in the 1940s. Benefits that were of importance then do not necessarily have the same priority today.
  The maternity grant is one example of a benefit the general need for which is less than it was 30 years ago. That is not to suggest that it is not necessary. It still provides modest help at a time when family expenditure is higher than average. It is intended only as a contribution to the expenses of a new baby, and the present level is judged to be what we can afford, given the severe economic situation that we face.
  Mr. Haynes: It is said that we cannot afford this, that or the other. If the Government found that they needed a further £45 million for defence, would they find it?
  Mrs. Chalker: The House will be well aware that I have no brief to speak on defence matters.
  Mr. Haynes: The hon. Lady can answer the question because she is part of the Government.
  Mrs. Chalker: From the figures that I have seen, I know that there is no way at present in which we can find the £45 million required to implement the Bill. I remind Labour Members that that is not simply a view taken by this Government. In February of this year the right hon. Member for Salford, West, who was then Minister for Social Security, said that
  "the question of any increase in the grant must depend on the availability of resources at the time and the priority which then attaches to this in relation to the many competing claims for resources."—[Official Report, 14 February 1979; Vol. 962, c. 572.]
  The right hon. Gentleman was absolutely right, and I agree with him. I know that his view is not very different from

  807
  mine. The only difference is that at long last we have a Government who recognise the appalling state of the economy and the measures that have to be taken to put it right.
  Mr. Orme: The hon. Lady accurately quoted what I said in February. However, in our May manifesto we carried the proposal which I and my colleagues supported and which a Labour Government would have implemented.
  Mrs. Chalker: I understand the right hon. Gentleman's views. I explained at the beginning of my speech that although the proposals were in the Labour manifesto there was no provision for them in the Estimates.
  The national insurance fund and the raising of contribution rates has been mentioned. The result of yesterday's increase will be that by the end of 1980–81 the balance in the national insurance fund will be equivalent to only 16 weeks' benefit outgoing. I state from memory that the surplus could be about £5 million. In terms of the weekly benefit outgoing the balance is declining, and that is why the Government have to take action. The right hon. Gentleman will understand that.
  The Bill seeks to ensure that the grant is uprated annually in line with the movement in prices. I well understand the reason for including that provision. It would ensure that the value of the grant in real terms remained constant. In considering whether the grant should be increased, we have to take account of all the relevant factors, not least of which is those resources to which we have all referred. At the present time we cannot commit the Government, or future ones, to annual increases in public expenditure which cannot at present be afforded. I understand the arguments for this change, but they do not reflect the economic background against which we have to work.
  The other aspect of the Bill is that of paying the grant by instalments. Over the years I have taken a great interest in the activities of other countries and how they have arranged their payment of benefits for maternity. It can be argued—and it was argued—that it would be a positive encouragement for the woman to make early contact with the health services.
  808
  This is obviously something that we have to do, whether through this measure or by other means. In France, where the pre-natal allowance is paid in three parts, there are some, I think, hesitations—as the hon. Member for Eccles pointed out—because it requires attendance during the third, sixth and eighth months of pregnancy. Whilst I see the attractions, as do many right hon. and hon. Members, of such a scheme, we must remember that the amount of grant in payment in France is very much greater—nearly £200. If we could afford a grant of that size, it would be sensible to consider how to use it as an incentive to get women to attend the pre-natal clinics, but the harsh fact is that we cannot afford even the £85 suggested in the Bill.
  We are discussing a benefit of £25, and to split that sum into two would not offer any encouragement to women. In fact, there would be a number of problems in operating the scheme. We should have to consider whether we would refuse financial help to a woman who did not avail herself of the help and services to which she was entitled. In fact, doing this would, in one sense, be inconsistent with the Bill's other aim. Often it is the very women who are most in need of money when they have a child who do not contact the health services, or who do not do so at an early enough stage.
  Mr. Carter-Jones: The point that I wanted to make was that the financial inducement was required because we are cutting back on pre-natal clinics. Part of the problem is that where the perinatal rate is extremely high it is due to the fact that the clinics are out of date, out of place and a long way off. That is a disadvantage. If the money is not given as an inducement, there is a double disadvantage.
  Mrs. Chalker: I fully understand what the hon. Gentleman said, and I am grateful to him for his intervention. I am by no means negative about the proposal. It is something that must be studied at the right time. However, it must be clear to the House that the present level of grant makes the splitting of the grant into two an impracticality. I made it clear that we cannot find the substantial sums needed to raise the level of the grant. In

  809
  the current economic circumstances, therefore, we cannot pursue this argument, however interesting and however fruitful I believe that it can be.
  I turn now to the remaining proposal in the Bill, that the grant should be made non-contributory. I have left this to the last as it is the most attractive proposition that we have before us today.
  This year about 60,000 women will not get the grant. Even those least arithmetically minded have calculated that with a benefit worth about £25 the increase in expenditure would be about £1·5 million a year. My hon. Friend the Member for Woolwich, West (Mr. Bottomley) questioned the offset. I can tell him that the extra money required would, in fact, be less than £1·5 million, as the Supplementary Benefits Commission pays out about £0·3 million every year, in lieu of the grant, to women who do not qualify for it. An earlier speaker in the debate commented that the figure was £0·2 million. It is, in fact £0·3 million, according to the latest available figures.
  The cost of the change is not high, but it is still a cost. The Government cannot make provision for it next year. As I said earlier, we are committed to restraining public expenditure at the level of last year. The Government are not prepared to breach that commitment, by however little. I think that the Prime Minister said this week that pennies did not fall from heaven but were made here on earth. We must certainly make more pennies. The cost of the change is pennies compared with the totality of social security spending. That I accept, but, be that as it may, it is still money—and money is not available next year. I shall certainly take away with me the comments made by my hon. Friend the Member for Brentwood and Ongar and others in the debate. Each in his own way added to the information, and it certainly bears more examination.
  My argument against this part of the Bill is, however, not limited to the cost of implementing it. There are one or two other problems at which we must look. All except one of today's well-argued speeches were in favour of making the grant non-contributory. We were told that women who did not receive the grant were the most deserving cases. There are women without a stable home background or long work experience. Often they are women who have reasons
  810
  for not availing themselves of the health and social services. The case for making the grant available to them has been presented as a small social advance. I have sympathy for that case, but I have a duty to look at the wider considerations. There is a cost, albeit a small one, attached to the improvement.
  There is also the question of how the change would impinge on the social security system as a whole. The grant is a contributory benefit. It is paid for out of the national insurance fund, which is made up of contributions from the insured population. The contributory principle says that national insurance benefits should be available to those who have paid for them. That principle lies at the heart of our national insurance system. Successive Governments have subscribed to its importance and refused under pressure to abandon it. We cannot abandon it in the case of one benefit, however compelling the arguments may appear to be, until we have satisfied ourselves that it would be the right thing to do.
  The implications of making the maternity grant non-contributory must be looked into very carefully. We should be certain that in changing the rules for this benefit we do not set a precedent which could be very costly and lead to the erosion of the contributory principle that is central to our national insurance system.
  Mr. McNamara: Does the hon. Lady recall the campaign, with which she was concerned, for the housewives' non-contributory pension to come out of the national insurance scheme?
  Mrs. Chalker: Any Back Bencher who eventually becomes a Front Bencher remembers. When the campaign for the non-contributory and invalidity pensions took place, I was indeed a Back Bencher. I have in no way sold out, but I do say, and have always said, that we cannot provide benefits when we do not have the money to pay for them. I have said that on many occasions in the past, and I repeat it now.
  Returning to the subject of the Bill, the administration of the non-contributory grant—
  Mr. Carter-Jones: I remember, when the Minister was a dear ally of mine, that

  811
  she used the words "They can always find money for a good cause".
  Mrs. Chalker: It may be that the hon. Member for Eccles is assisting me in explaining this to other hon. Members.
  Mr. Ronald Bell: Would it not be better for my hon. Friend simply to reply that then she was a shop steward but now she is a works manager?
  Mrs. Chalker: I am very openhanded, as the hon. Member for Eccles knows well. He would not describe me in normal circumstances as tight-fisted. Though we cannot accept with open arms the Bill before us today, that is not because we do not understand the arguments that have been put forward but because the country's economy is in such a bad state.
  I want to come back to the whole question of the administration of a non-contributory maternity grant. The Bill suggests a simple residence test, and no doubt this could be made effective, but it has been argued that an amendment to the rules would simplify the administration and reduce the number of civil servants. It is true that a residence test is, in essence, simpler, but a rule still has to be applied by departmental officials and checks would have to be made on each and every claim. I should have to be convinced that a workable and efficient system could be devised for a non-contributory grant. The Department will have to do more work on the problems. Indeed, much study is needed if—
  Mr. McNamara: I am sorry to keep pestering the Minister. It is obvious that she has been fighting with the Treasury over something, but, when she talks about this test being a problem, surely this is applied anyway and will continue to be applied whether or not it is contributory. This test exists now for other benefits.
  Mrs. Chalker: The point that I was seeking to make was that many people have assumed that if we have a non-contributory maternity grant, it will sweep away all the tests and all the checks. That is not so, and I was trying to make that understood.
  Mr. McNamara: That is not in the Bill.
  Mrs. Chalker: It may not be in the Bill, but it has been argued on many occasions.
  Finally, I believe that much study is needed before we can accept that the maternity grant should be made non-contributory. However, on this one specific issue I have every sympathy with the case put forward today. The implications of it need to be studied and I assure right hon. and hon. Members that we shall give careful consideration to the proposition that the grant be made non-contributory. However, I stress once more that it is a question not only of resources but of priorities. If there is to be any improvement in the maternity grant provisions, it must be in the wake of a general economic improvement, and achieving that remains the Government's highest priority.
  In expressing the Government's opposition to the Bill, I am well aware that I am giving a disappointing answer to the House. Hon. Members will know that I share the objectives that inspired the Bill. We all have deep concern for the health of the children of this country and know that that can best be secured by a healthy economy. A strong economy is what the Government are determined to establish. If we were not so determined to achieve a strong economy, many of the dreams of many hon. Members would never be possible. Paradoxical though it may seem, by opposing the measures in the Bill the House will probably do more to achieve its aims than if we were to agree the increased expenditure that would be involved.
  2.53 pm
  Dr. Oonagh McDonald: I have great pleasure in speaking today in support of the Bill sponsored by my hon. Friend the Member for Kingston upon Hull, Central (Mr. McNamara). I have listened with great disappointment to the Minister's remarks. Looking at her, with greatest sympathy because of her present injury, we thought that she had been engaged in a tough fight with the Treasury. Tough fight it may have been, but the Minister certainly lost all along the line. Whether that is because, as her hon. and learned Friend the Member for Beaconsfield (Mr. Bell) suggested, she has become a works manager, I do not know. It seemed to me, listening to some of her

  813
  remarks, especially those about the economy, that the hon. Lady was speaking with her mistress's voice. Many who are listening to this debate must be deeply disappointed, and, indeed, perturbed, at hearing a woman Government Minister replying to this debate and, knowing that we have a woman Prime Minister, that there is so little sympathy and feeling for the provisions which this Bill would produce
  Mr. Peter Bottomley: I think that it is probably unnecessary to bring the sexist element into this debate. Surely the fact remains that the normal Friday procedure applies, and if there are enough of us here to support the Bill it gets through to the Committee, which is the crucial point.
  Dr. McDonald: Indeed, I hope that is the crucial point and that things will turn out as the hon. Member for Woolwich, West (Mr. Bottomley) hopes. However, we have to wait a little while for that outcome.
  What was being expressed was the Government's view and my reaction to the total lack of sympathy by the Government on a Bill such as this.
  I wish to speak on two or three of the provisions of the Bill. First, I shall refer to the provision that seeks to increase the value of the grant to £85. Some hon. Members have suggested—indeed, the hon. Member for Woolwich, West played with this idea in his remarks—that the maternity allowance may have removed the need, in some cases at least, for the maternity grant.
  That is a dangerous path to tread, for two reasons. First, as the hon. Member for Woolwich, West rightly pointed out, not even in the case of the birth of the first child do all women receive maternity allowance, for various reasons. But certainly in the case of the second child very many more women do not receive the maternity allowance, either because they are not eligible or because they do not know the rather complicated rules that apply to eligibility for it.
  We should not see the allowance and the grant as in contradiction to each other; we should see them as an award on the birth of the first child to make up for—in the case of most families and lone parents—the woman's loss of her own income. It is not simply a question
  814
  of the cost involved in the birth of a first child that is important. My hon. Friends have quite rightly stressed this, and I will not repeat the details they gave. It is not merely a question of the cost of the layette and equipment—though they are, of course, an immediate and quite heavy cost; we have been told today that these costs are well over £100 for the first child—but a question of the loss of the mother's income. We should see the grant and the allowance as helping the family over this transition. Obviously, in these circumstances, the grant needs to be increased as its value has fallen so much both in real terms and in relation to the needs of families. So that part of the Bill I heartily endorse.
  I want to raise once more the issue of the maternity grant being made non-contributory. For me this was the most disappointing part of the Minister's speech, because it indicated that, however much we may struggle to get the Bill through the House ourselves, the Government have a lack of sympathy with this provision, which would cost just over £1 million. That is a small price to pay to assist many women—young women, divorcees, widows and so on—who may, for one reason or another, not be able to obtain the maternity grant.
  It has been suggested that many of these women can appeal to social security, when they would be given the assistance that they needed. In some cases that assistance would, of course, be more than the automatic maternity grant. But it is not as simple as that. Not all these women receive assistance from social security. Their appeals for help are rejected. Indeed, some of them find that, though they may eventually be given assistance, it is long delayed.
  I take an example from the briefs that have been prepared for us—"Born Poor". This concerns a young woman named Deborah whose baby was born in August this year. She was single and did not qualify for the maternity grant. She applied for extra help from her local supplementary benefits office but was turned down. She was advised about the appeals procedure. However, she felt that, being seven and a half months pregnant, she did not want to subject herself to the strain of an appeal. She still needs about £90 for clothes, a cot and bedding. She had been, and still is, living on supplementary

  815
  benefit and she finds that it is insufficient to meet her needs.
  To suggest that recourse can be made to supplementary benefit and that all problems are thereby smoothed out is not an adequate answer. Too many women may find that they are refused help or that the money eventually given to them is long delayed. Indeed, it may be delayed until after some time after the birth of the child. Having finally produced the child as a lone parent, after the birth is hardly a time when a woman wants to hassle about getting money and going out and buying the equipment that she needs. It seems vital that, at such small cost, the Government should rethink their attitude, fulfil their promise and make this a non-contributory benefit. It is a question not only of extra strains and anxieties for the mothers concerned—all the figures have been given, so I shall not repeat them—but of those babies which we know are at most risk.
  The Minister spoke about the need for a healthy economy. In part, a healthy economy depends both on healthy children and mothers. Therefore, putting it in terms that the hon. Lady will understand in her fight with the Treasury, this is a proper investment in this country's present and future.
  I want to refer briefly to the provision that seeks to ensure that by phasing the payment of the maternity grant mothers attend ante-natal clinics. I entirely endorse all that my hon. Friends have said on this matter. They have rightly argued that by raising the grant and distributing it in this manner we can improve health and reduce the rate of handicap and perinatal death. They have referred to France as an example and argued that in the longer term this would be a saving, not an expenditure. I think that they were right to put the argument in those terms.
  I want to put the argument in more human terms. Anyone who has ever been near parents who have suffered the shock, grief and trauma of a cot death would not hesitate either to raise the grant or to phase it in this way to ensure that mothers obtained proper antenatal care. That would avoid much suffering and grief for so many families.
  Mr. Michael Brotherton: Will the hon. Lady give way?
  Dr. McDonald: No, I do not want to give way. Instead, I want to make one last remark. As my hon. Friend the Member for Barking (Miss Richardson) pointed out, Parliament is currently discussing another Private Member's Bill, sponsored by the hon. Member for Bute and North Ayrshire (Mr. Corrie), which seeks to amend the Abortion Act 1967. I am surprised, as was my hon. Friend the Member for Barking, that no member of the Standing Committee who supports that Bill has been here today to speak in support of this Bill.
  Mr. McNamara: Perhaps I may point out that my hon. Friend the Member for Leeds, South-East (Mr. Cohen) has been attending the debate.
  Dr. McDonald: I am surprised that no member of the Standing Committee has been here to speak in support of this Bill. Obviously, all those who feel that a woman should be given the choice whether to go ahead with her pregnancy or not want to ensure that, if she does, society gives every possible support in financial and other ways to ensure a healthy pregnancy and a healthy child.
  3.4 pm
  Mr. Anthony Kershaw: I confess to being a little fed up with hon. Members on either side of the House who start a paragraph by saying "I want to approach this problem in human terms". It always means that they are about to adopt a "holier than thou" attitude as though they are the only Members who care for people outside and that others are money-grabbing, hard-hearted and flint-faced. The hon. Member for Thurrock (Dr. McDonald) is no exception. I ask her to accept that there are others besides herself who care about mothers and children in this context. Indeed, many of us have laboured in that vineyard for a great deal longer than she has yet been able to do.
  We approach the Bill in the uncomfortable knowledge that the United Kingdom perinatal mortality rate is higher than it should be. It is higher than that of Holland, Canada, France, Scandinavia and Japan. It must be borne in mind that the numbers of malformed babies have been rising since 1971 and in 1976

  817
  reached a figure of 21–2 per 1,000 live births. That is an unsatisfactory situation for the House to consider. We have always been proud—although some of us are worried—of our Health Service. It is deplorable that the figures have escalated over 40 years of the Health Service, and something must be done about that.
  It is the duty of the House to give a special welcome to the Bill introduced by the hon. Member for Kingston upon Hull, Central (Mr. McNamara). Whether or not we support all its provisions, it gives the House an opportunity to cover ground in this important area. It may help to push forward measures that are clearly needed.
  I support especially those aspects of the Bill that seek out pockets of deprivation. That is a sensible way to proceed. Britain has large blanket provisions designed to fend off the worst disasters that might befall an individual or a family, although most agree that those provisions often fall short of our desires. There are also a few who are specially deprived, and they deserve our attention.
  Clause 1(2) provides that girls who come forward for the benefits should not have to satisfy conditions of national insurance contribution. Those who have not paid or do not pay the contribution, and are therefore unable to take advantage of the maternity grant, clearly suffer hardship and need our special consideration. I make no moral judgment on that. They are poor and they are harassed. We are speaking of young unmarried mothers, mothers under 16 years of age, female students, non-employed wives of students, wives of long-term prisoners, and common law wives who are not in paid employment. They are not numerous when added together, but they are in a special position of difficulty. If we can reach them, we shall be doing a worthwhile job.
  It is no accident that among those categories the incidence of difficult births, of babies malformed or in other ways disadvantaged and handicapped, is higher than among other mothers. It is double the national average. Clearly, there is a job to be done. The cost is important, and in the present economic atmosphere it is necessary—my hon. Friend the
  818
  Minister was justified in doing so—to call attention to financial considerations.
  The cost of the non-contributory clause would not be high—the total cost is estimated at £1½ million—but it would no longer be necessary to check with the same care about 600,000 national insurance records a year. Civil servants' time would be spared, and that must be counted as an economy. We have also heard from the Minister that about £300,000 would be saved by not paying supplementary benefit. That form of payment would not be necessary if the girls qualified for the grant. Even in today's circumstances, I should find no difficulty in supporting this change.
  In the long term, there would be a real economy. As the hon. Member for Kingston upon Hull, Central said, handicapped children cost over the years of their life a tremendous amount to support and sustain. If that cost is avoided there is a net gain financially, if we must consider such matters in that way. That would be a saving for the country as a whole. I hope that when the Bill is considered in Committee it will be possible to find a way in which the clause may take effect.
  I move from an area in which we try to identify specially deprived groups. The Bill also seeks to give extra benefit to much larger groups without considering whether the family concerned needs it. We must forgive the hon. Member for Kingston upon Hull, Central if in his Private Member's Bill he does not seek to reorganise the whole social service system, but in coming to a conclusion about his Bill it is inevitable that the House will bear in mind the dilemma between selectivity and universality of benefit.
  If we want selectivity, the first method that occurs to most people is individual scrutiny of each case. That is extremely expensive. It involves a heavy bureaucratic input and to some extent erodes the quality of freedom. That must necessarily take place when many questions have to be asked of those who want to receive a State-paid benefit. I know that that is done frequently in other spheres. To some extent, the problem is taken care of by our system of taxation. Although we do not like taxes and wish to reduce them, no one suggests that income tax is not a way in which such

  819
  difficulties and problems may, to some extent, be ironed out. It is an expensive system.
  One of the difficulties, and one of the reasons for the complexity of our tax system, is that we are always introducing complications by a desire to be fair. Every all-embracing tax throws up several anomalies. In Finance Bills we are used to the process whereby this or that class which has been caught in a general enactment is relieved of responsibility or given some form of benefit. That is all very good and fair, but it is expensive, and it is an area in which we should proceed cautiously. I accept that it would not be right to go into the tax credit system in any depth. However, that system would get rid of many of the difficulties to which I have referred. I hope that we have not lost sight of the system, notwithstanding the pressure of events that are upon us.
  Clauses 3 (4) seeks to make the maternity grant inflation-proof. That will not cost us a great deal in the first year, and it is something that we should consider. Clearly it cannot stand by itself. There are other payments that are not inflation-proofed. There is the death grant, which has been alluded to today. There is the age addition grant received by men and women over the age of 80. It is only 25p, but, nevertheless, it is not inflation-proofed. There are also many other payments which are not inflation-proofed.
  I, like my hon. Friend the Member for Brentwood and Ongar (Mr. McCrindle), am suspicious of inflation-proofing. Any hon. Member who says that he disapproves of inflation-proofing should be a little embarrassed, because not long ago we made our own pensions inflation-proof. If all pensions, whether in the private or the public sector—were inflation-proofed—the private sector cannot possibly afford it—there would have to be a growth in the GNP of about 15 per cent. compound. That is impossible. Therefore, anyone who sets his cap at extending inflation-proofing in any way must realise the ultimate financial consequences of doing so if it were widespread. It is totally impossible for it to be done.
  There is, of course, the mechanism in the 1979 Act which gives the Minister the obligation to review—but not necessarily
  820
  to act upon that review—the level of maternity grants.
  My last point concerns the size of the grant proposed in the Bill. A grant of up to £85 would cost £43 million. Clearly, that is a matter on which there is not much to be said at present. I could not vote for that clause now. I am heartened to know that there is a maternity allowance which has risen to £18 a week, which to some extent takes the place of the maternity grant, or at least mitigates the position. Clearly, that allowance has been going up regularly and has made the position better.
  There was what seemed to be a little spat of temper between the two Front Benches this afternoon, when the right hon. Member for Salford West (Mr. Orme) sought to excuse the fact that when he was a Minister he did nothing about the matter. He said that that was excused because the subject was included in his party's manifesto. I do not think that that is a realistic approach. The Labour Party's manifesto did the Labour Party no good then, and its approach to public expenditure is doing it no good now. I hope that Labour Members will realise that, and that they will be honest and behave in Opposition with some sort of correlation with the way that they behaved in Government.
  3.19 pm
  Mr. Frank Haynes: I congratulate my hon. Friend the Member for Kingston upon Hull, Central (Mr. McNamara) upon introducing the Bill.
  I have been particularly impressed with the contributions which have been made—I have sat here almost throughout the debate—except for the contribution of the Minister herself. It was so obvious that her attitude was defeatist. She does not want the Bill to go through, because the Government cannot afford it. I suggest that the Government have got themselves into a position where they cannot afford to do what they should be doing for the lower income groups.
  The Government say that they cannot find the money. I chose to intervene while the Minister was speaking to ask whether, if the Government got their figures wrong on defence, the money would be found. The hon. Lady would not answer the question, but let us make no mistake. The money would be found. If it can

  821
  be found for defence, it can be found for maternity grants, and I believe maternity grants to be more important.
  Mr. Garel-Jones: I know that the hon. Gentleman has been in the House for a good part of the debate. Was he in the House when my hon. Friend the Member for Woolwich, West (Mr. Bottomley) quoted from a speech made by Lord Wells-Pestell on 16 June 1978, in which he explained why the previous Government were not able to bring this matter forward?
  I wonder also whether the hon. Gentleman was in the House when my hon. Friend the Minister commented that it is one thing to make a commitment in a manifesto but that when the Conservatives took office they did not find any provision made for it by the previous Labour Government.
  Mr. Haynes: I was not in the House at that time. It is a pity, because if I had heard it—
  Mr. Garel-Jones; The words quoted from the speech of Lord Wells-Pestell were:
  "On reflection, I am not really very worried about the maternity grant of £25, for this reason. One has to take into account that there is a maternity allowance which goes on for something like 18 weeks, and that maternity allowance…is quite substantial. Therefore, with the maternity grant and the maternity allowance, it does not seem too bad."—[Official Report, House of Lords, 16 June 1978; Vol. 393, c. 773.]
  Mr. Haynes: The hon. Gentleman does not seem to understand that there are 60,000 people who do not enjoy the things that we are talking about today.
  Mr. Garel-Jones: That was a Labour Minister.
  Mr. Haynes: Then he did not understand, either. [Interruption.] May I continue with my speech, Mr. Deputy Speaker?
  Mrs. Chalker: It might help the hon. Gentleman if I explain that when the Labour Government were in office this issue was raised on a number of occasions in another place. It was in another place that the speech quoted by my hon. Friend the Member for Watford (Mr. Garel-Jones) was made. Lord Wells-Pestell was then a Minister at the DHSS.
  Mr. Haynes: I am not ducking the question, Mr. Deputy Speaker, but it happens that when that statement was made I was working in the bowels of the earth. I could not possibly hear it there.
  I congratulate in one sense—God forbid—the present Secretary of State for Industry. When he reorganised the National Health Service he did one very important thing. It was the right thing; all the rest was wrong. He set up community health councils. The National Health Service, from its inception, was a secret society. The people in the community did not know what was going on. But as a result of the setting up by the right hon. Member for Leeds, North-East (Sir K. Joseph) of community health councils, they were able to become the ears, the eyes and the mouth of the community. I was a member of a CHC right from the inception, until I came to this House. It is in the deprived areas that this help is so desperately needed.
  I agree with some of the comments made in the debate about the fact that well-off people would receive the grant. That is fair comment. I hope that there will be a Committee stage in which something can be done about that problem. But we must look at the position of the people who are in desperate need of the sort of finance that is proposed in the Bill.
  I welcome what the Minister said in reply to the Labour Front Bench spokesman on the question of facilities in the locality, such as health centres and clinics. In my own area we have pockets of deprivation. In such areas, when a woman becomes pregnant it is sometimes most difficult to get her to go to the ante-natal clinic. In my CHC we pressed the area health authority very hard to provide local clinics and health centres, so that they were more or less on the doorstep and women could receive, in the interests of the baby, the sort of health education they needed.
  In view of what the Minister has said today, I am hoping that there will be some effort to provide finance in the community for that kind of provision, because it would help us in this respect. What has been said earlier is quite correct. Yes, it costs £45 million to start with—but one recoups and finds that one has made a profit. I am sure that that will be the situation and that that should be attractive to the Conservative Benches.

  823
  I finish on one very important point. It is important to me and to the people outside this House. It is the question of index-linking. It is a good idea in this respect. Hon. Members do not have to take their minds back very far to the announcement on Members' salaries. I well remember it, and I am one of the 16 who voted against the increase. I well remember the furore on the Conservative Benches. When the announcement was made from the Dispatch Box, hon. Members were saying "We want the lot now, and index-linking as well". I am not arguing about that. I am trying to make the point about index-linking. If index-linking is good enough for the salaries of Members of Parliament, it is good enough in this respect. But I suggest that this matter should come first, because we represent here not ourselves but those out in the community.
  Mr. James Wellbeloved: On the very point of Members' pay, I wonder whether my hon. Friend will also take into account the fact that the Prime Minister has allowed ministerial colleagues to accept pay rises ranging up to £136 a week and yet cannot find it in her heart to allow this measure to pass today.
  Mr. Haynes: It is so obvious. Very often my hon. Friend the Member for Bolsover (Mr. Skinner) makes a few quips during debates, and some of the things he says are not liked on the Conservative Benches. When he refers to what Ministers and the Prime Minister herself are doing—
  Mr. Carel-Jones: Will the hon. Gentleman give way?
  Mr. Haynes: I am answering my hon. Friend the Member for Erith and Crayford (Mr. Wellbeloved). The hon. Member can intervene later. I have not yet finished with the previous intervention. This is not on, Mr. Deputy Speaker, is it?
  But it fits some of the comments of my hon. Friend the Member for Bolsover. It fits with what my hon. Friend the Member for Erith and Crayford has just said, in reference to that heartless woman. It fits, and it is correct. Conservative Members could not care less. They say that the Conservative Party is a caring party. I know that my party,
  824
  the Labour Party, is a caring party. I have experienced Conservatives in my own county council, and they look after only the people that they represent.
  Mr. Deputy Speaker (Mr. Bryant Godman Irvine): Order. I think that the hon. Member would do better to devote his time to the Bill.
  Mr. Haynes: I shall now give way to the hon. Member for Watford (Mr. Garel-Jones).
  Mr. Garel-Jones: I am very grateful to the hon. Gentleman. I do not think that this is a point, as you rightly indicate, Mr. Deputy Speaker, that we need pursue, but I am sure that the hon. Gentleman is aware that my right hon. Friend the Prime Minister has declined to take her own salary increase.
  Mr. Haynes: With respect, Mr. Deputy Speaker, the hon. Member has taken me on the same thing, and I cannot help it, can I?
  Mr. Deputy Speaker: I hope that the hon. Member will not follow up that one.
  Mr. Haynes: I am obliged for your guidance, Mr. Deputy Speaker. I shall have a word with the hon. Gentleman later.
  Perhaps I may finish on this note. [HON. MEMBERS: "Hear, hear."] I can carry on if that is wished. However, I realise that I have a big mouth. I also realise that I have a heart. [HON. MEMBERS: "Oh."] And I use it regularly, and that is more than I can say for those on the Conservative Benches.
  I do not wish to be disrespectful in anything that I have said today. It has all come from the heart. I hope that Conservative Members will join us at the appropriate time to support the Bill.
  3.29 pm
  Mr. John G. Blackburn: It has been truly said that society can be judged by the way in which it treats its old people. I want to turn that expression on its head by saying that this society can easily be judged by the way in which it treats our children and, indeed, our unborn children.
  No one in the House is more sad than I, because I represent a Dudley constituency and, as has already been explained

  825
  by the right hon. Member for Stoke-on-Trent, South (Mr. Ashley), my constituency has the highest infant mortality rate in the country.
  Mr. Field: Does that mean that the hon. Gentleman will be voting with us?
  Mr. Blackburn: The Minister of State said that the 1977 figure for infant mortality was 18·5 per 1,000 births and that it had dropped to 15·5 in 1978. That is no comfort to me, because the figure for my constituency is now 24·1 per 1,000 births. Naturally, I can do nothing else but applaud the Bill and the manner in which it was presented by the hon. Member for Kingston upon Hull, Central (Mr. McNamara).
  The debate gives me the opportunity to dwell upon two or three aspects relating to the Bill. One relates to the country's greatest asset—our children. Our future as a nation lies in the hands of those children. It is important that if we are to have life we have the best quality of life as those children enter not only the family home and the nation but also the fellowship of the brotherhood of man. If the Bill goes any way towards helping to reduce the figure of 24·1 per 1,000 births in my constituency, I shall publicly thank God and I shall be a contented man. If it goes any way towards increasing the quality of life, our time in this Chamber today debating the Bill will have a rich reward indeed.
  If in any way it leads—in this connection I refer to the question of a payment at various times of the pregnancy, as has been introduced in France—to pregnant women receiving medical attention, that in itself will be a blessing. Indeed, we can have as many paediatricians and obstetricians as we want, but unless the pregnant woman seeks medical advice all the medical welfare that any State can provide will be of little value.
  We would be foolish not to spend a moment thinking about the figure in my constituency of 24·1 per 1,000, because behind that figure is an emotional experience that one cannot understand unless one has gone through it. I refer to the tragedy that settles upon a home in those circumstances. The big problem relates to the birth of the first child. The hon. Member for Ashfield (Mr. Haynes), who has now left the Chamber, and I have two matters in common. For the last
  826
  10 years, in my local government work, I have been either chairman of the social services committee or spokesman on that subject. I also serve to this day as a vice-chairman of a community health council.
  It is remarkable that on this aspect the hon. Gentleman and I are in entire agreement. It seems foolish that a local authority can spend £259 a week in keeping one child in an observation and assessment centre when we cannot afford to implement the Bill produced by the hon. Member for Kingston upon Hull, Central.
  The social consequences resulting from lack of finance in these circumstances are outweighed by the amount of social service that will eventually have to be put into the case load to set matters right. It is possible that, on this issue, I am persuaded and constrained, like the right hon. Member for Stoke-on-Trent, South, to say that it is perhaps the bargain of a lifetime.
  The Bill has produced a bridge between the two Benches. I am happy that it should be a bridge of compassion for young people. No party and no person has a monopoly on compassion. We could perhaps use that expression more in the House.
  3.37 pm
  Mr. James Wellbeloved: The hon. Member for Dudley, West (Mr. Blackburn) has made a most eloquent and appealing speech. I hope that those who have heard him and those hon. Members, outside the Chamber, who will be coming in to vote will follow his example in walking through the Aye Lobby in favour of the Bill having a Second Reading. The hon. Gentleman said that no one who has not experienced the trial and tragedy of losing a baby or young child can begin to understand the agony of the parents. He is so right. Hon Members know from the experience of constituents the truth of that statement and of the terror and the agony involved for parents. I welcome very much the speech he has made from the Government Benches. The hon. Member is right to say that this is not a matter of party politics. It is a matter of common humanity and of compassion.
  I know that the Minister, in her private life, is a compassionate person. In

  827
  her duties in this House she has demonstrated, time and again, her understanding and compassion on many issues. Today, however, she is in the straitjacket of instructions that have been given to her by the Prime Minister and senior Ministers. It is a fate that often befalls an Under-Secretary of State. I am sorry that it has befallen the hon. Lady today. But that is life.
  Mr. Field: Does my hon. Friend not agree that although many of us on the Labour Benches share his views about the Minister, we are getting a little tired of her coming to the Dispatch Box and singing the same old story about old Mother Hubbard with a huge heart going to the cupboard and finding it bare? She always claims that the Tories came into office wanting to give all these benefits but found no money available. Many of the examples that the Minister quoted this afternoon, such as child benefit, have always been paid for from the contingency reserve fund. If the Government looked at the public expenditure White Paper for last year and the year before, they would see that there was an allocation of £800 million for child benefit and other benefits like the one we are discussing today.
  Mr. Wellbeloved: I agree with my hon. Friend 100 per cent. I have not entirely finished with the hon. Lady; I shall come back to her later. I thought that it was right to start off by directing a few words to her because, although one can never be confident, one always lives in hope. I live in hope that before long the hon. Lady will be compelled to do the honourable thing and perhaps leave the present Administration. However, I do not want to push the point too far this afternoon.
  I add my congratulations to those already given to my hon. Friend the Member for Kingston upon Hull, Central (Mr. McNamara) on his good fortune in winning a place in the ballot and having the good sense and great humanity to choose this measure as his Private Member's Bill. He can be sure that if it gets a Second Reading today it stands a good chance of getting into Committee, where many of the points that have been raised could be ironed out.
  828
  I am particularly indebted to my hon. Friend—I hope I am not spilling the beans on a personal secret—because I know that he is here today at considerable personal cost. He should have been in hospital, but he decided to delay some essential treatment in order to be here to move the Second Reading of his Bill. We are all indebted to him for his sacrifice. He did such a good job in explaining his Bill that there is very little left to say about it.
  I believe that I am the seventeenth person to contribute to this debate. Apart from the Minister only one speaker, the hon. Member for Perth and East Perthshire (Mr. Walker), has expressed any serious reservations about the measure. There have been some qualifications but these are all matters that can be ironed out in Committee. I would be staggered, and so would many people outside this House who have taken an interest in the Bill, if it failed to get a Second Reading today because of pressures being put upon Members.
  Mr. Bob Cryer: Does my hon. Friend accept that Conservatives are always talking about compassion? The Chief Secretary to the Treasury said recently, in relation to the expenditure cuts, that there was no monopoly of compassion on either side of the House. Would my hon. Friend not agree that it would be a change if, in addition to expressing words of compassion, the Tories also came forward with some action? It would be a change if they were more like my hon. Friend the Member for Kingston upon Hull, Central (Mr. McNamara), who came here to move the Second Reading under considerable difficulty. Words of compassion are not enough. These must be backed up by hon. Members walking through the Lobby to demonstrate their support.
  Mr. Wellbeloved: That is a fair judgment of the situation. I, too, wonder whether feet will follow voices into the Lobby. Seldom has there been an occasion on which a Private Member's Bill has had such overwhelming support from both sides of the House. I am slightly worried, because I have just seen the sinister figure of the Government Chief Whip come into the Chamber and I must admit that that fills me with concern. I wonder whether his all-seeing eye—I was

  829
  going to say "malignant eye" but I will not use an unparliamentary term—is going to look at the Benches behind him and deter hon. Members from following the right course to the Lobby. I hope that I might even persuade the Chief Whip to join us in giving a fair wind to the Bill.
  Before I turn to my main points, I want to note the presence of someone—not too far from here—whose attendance at Westminster I am sure hon. Members on both sides of the House will welcome. I refer to Helene Hayman, who was a most distinguished Member of this House. She has played a vital part in enabling this Bill to reach its present stage and in ensuring that all hon. Members were fully briefed on its implications.
  I consider it a great honour to have been asked by my hon. Friend the Member for Kingston upon Hull, Central to wind up the debate on behalf of the all-party supporters of his Bill. The hon. Member for Harborough (Mr. Farr) supports the Bill, although he has reservations about one or two matters. He said that he had received a great volume of correspondence from constituents which urged him to support the Bill. That has probably been the typical experience of every Member of the House. We have all had a substantial volume of correspondence from our constituents. Some of them are suffering because maternity grant has not been paid to them. Some of them have felt the reality of their inability to apply for the grant or been disappointed at the smallness of the benefit even were they eligible for it.
  I have received strong representations, as has my hon. Friend the Member for Ashfield (Mr. Haynes), from my local community health council, the very body set up to consider the operation of the Health Service. Many of those councils, very wisely, go beyond their strict remit and consider many of the social services provided by local authorities. Strong and urgent representations were made to me on behalf of the Bexley and Greenwich community health council that I should support the Bill today. The support for the Bill is demonstrated by the number of Members in the Chamber at this time on a Friday afternoon and their presence is a measure of the strength of
  830
  the requests for support put out by community health councils.
  Mr. Field: May I ask my hon. Friend, before he completes his comprehensive summing up, whether he can comment on the one point of substance mentioned by a number of hon. Members on the Government Benches, namely, that they were worried that the contributory principle of our national insurance scheme would be ruined if one gave way on this benefit? I was surprised, and wonder whether my hon. Friend was surprised, that it should have been hon. Members on the Government side who voiced that worry. In the early 1970s, when the Conservative Party published its proposals for a tax credit scheme as a Green Paper, it constituted the biggest scrapping of the insurance principle that we have seen. Many of us welcomed that advancement. Will my hon. Friend comment on whether the insurance principle is relevant in today's circumstances compared with the attachment demonstrated to that principle by those of us in the Labour movement in the inter-war and post-war period? We were faced with a choice—
  Mr. Deputy Speaker (Mr. Bernard Weatherill): Order. The hon. Gentleman cannot make a speech on an intervention. It was a good try.
  Mr. Wellbeloved: One of the unfortunate consequences of a short debate on a Friday is that it is not always possible for hon. Members who have the necessary depth of knowledge, understanding and experience to take part. I am delighted that my hon. Friend has had the opportunity, in such a brief intervention, to put forward very important points. The matters to which he referred were mentioned by the hon. Member for Brentwood and Ongar (Mr. McCrindle), and I intend to deal with some of them.
  I turn next to the speech of my hon. Friend the Member for Rother Valley (Mr. Hardy), who made a most important contribution to the debate. He brought it into terms of reality which we could all understand. He gave details of the cost of acquiring items that are essential when a baby is to be born. The startling cost of all the objects that he enumerated has been in many cases dramatically increased by the Government's policies.

  831
  My hon. Friend said that his wife had carried out the research. I hope—and I am sure that the House will join with me in expressing this sentiment—that the terrible costs that his wife has uncovered will in no way deter him from contributing to the growth in our population necessary, as he described, to provide a future generation of men and women to serve in the Armed Forces of 15 to 20 years hence. I am indebted to my hon. Friend. He takes from this Chamber this afternoon all good wishes in whatever joint endeavour he is about to undertake.
  I listened carefully to the speech of the hon. Member for Brentwood and Ongar. It took me some time to come to the firm conclusion that he was supporting the Bill. However, support it he did, and I hope to see him in the Lobby with us in a few moments' time. He produced a vital statistic for the debate when he told us that some 60,000 births a year did not qualify for the maternity grant. He said that those births were in the very areas of greatest vulnerability—to women whose husbands had died or who had been divorced or to unmarried mothers. They are all areas of deep concern to us. I think that that fact must have made the Minister blush when she knew that she had to read the brief that had been printed for her for replying to the debate.
  The hon. Member for Brentwood and Ongar said that the maternity grant was paid to all those who had made the necessary contribution. I do not use his precise words, but their theme was that it was wrong that rich people who did not need the grant should have it thrust upon them.
  I issue an invitation to the hon. Gentleman and other hon. Gentlemen who take that view that we should all go back to our constituencies. I have no doubt that in my constituency I can find one or two well-heeled people to whom I could appeal, and most hon. Gentlemen will find many thousands in their constituencies. Let us jointly make an appeal to them not to claim the maternity grant if they are well heeled and do not need it. Let the Minister use the money left in the fund by the well heeled who repudiate the grant because they do not want
  832
  to be scroungers on the State to implement this modest measure for those who desperately need it and who ought to receive it.
  The hon. Member for Perth and East Perthshire was the only hon. Member to speak against the Bill. If I may follow his aside, he said that he wanted to pay tribute to RAF Hedley Court, which had enabled him to recover from a devastating accident. As a former Minister for the Royal Air Force, I welcome that tribute. The hon. Gentleman went on to say that it was a well-intentioned Bill. If he thinks that, why does he not join with the well-intentioned hon. Members on both sides of the Chamber and vote for it? Many of the hon. Gentleman's points and those of other hon. Members are matters for Committee and can be argued then.
  Perhaps some sensible—I nearly used the word "compromise" but "arrangement" is perhaps better—legislative arrangement could emerge that would meet legitimate objections and allow the Bill and its basic principles to go forward and give great help to many.
  The hon. Member for Perth and East Perthshire said that there were doctrinaire grounds for resisting the measure. I do not know what they are, he did not explain them and I do not think that we should give much weight to such arguments.
  My hon. Friends the Members for Barking (Miss Richardson) and Thurrock (Dr. McDonald) made most important speeches, but as time is creeeping on I hope that they will forgive me if I do not enlarge on them.
  The hon. Member for Woolwich, West (Mr. Bottomley) made a plea that was echoed by the hon. Member for Dudley, West, which was directed at the Treasury Bench. Unfortunately the Patronage Secretary was not here so I shall remind him of his hon. Friends' plea for the Government to allow the Bill to have a Second Reading and to go to Committee.
  Mr. McNamara rose in his place and claimed to move, That the Question be now put.
  Question put, That the Question be now put:—

  The House divided: Ayes 95, Noes 0.

  Division No. 109

  AYES

  3.58 pm

  Archer, Rt Hon Peter

  George, Bruce

  O'Neill, Martin

  Ashley, Rt Hon Jack

  Ginsburg, David

  Orme, Rt Hon Stanley

  Barnett, Guy (Greenwich)

  Graham, Ted

  Pendry, Tom

  Bidwell, Sydney

  Grant, John (Islington C)

  Penhaligon, David

  Bottomley, Rt Hon Arthur (M'brough)

  Hardy, Peter

  Powell, Raymond (Ogmore)

  Campbell, Ian

  Harrison, Rt Hon Walter

  Race, Reg

  Canavan, Dennis

  Hattersley, Rt Hon Roy

  Richardson, Miss Jo

  Carter-Jones, Lewis

  Haynes, Frank

  Roberts, Ernest (Hackney North)

  Cocks, Rt Hon Michael (Bristol S)

  Hogg, Norman (E Dunbartonshire)

  Rooker, J. W.

  Cohen, Stanley

  Homewood, William

  Ross, Ernest (Dundee West)

  Cook, Robin F.

  Huckfield, Les

  Sandelson, Neville

  Cox, Tom (Wandsworth, Tooting)

  Hughes, Robert (Aberdeen North)

  Shore, Rt Hon Peter (Step and Pop)

  Cryer, Bob

  Janner, Hon Greville

  Silkin, Rt Hon S. C. (Dulwich)

  Cunningham, George (Islington S)

  Jay, Rt Hon Douglas

  Skinner, Dennis

  Davies, Rt Hon Denzil (Llanelli)

  Johnson, James (Hull West)

  Soley, Clive

  Davis, Clinton, (Hackney Central)

  Kaufman, Rt Hon Gerald

  Spearing, Nigel

  Davis, Terry (B'rm'ham, Stechford)

  Kerr, Russell

  Stallard, A. W.

  Deakins, Eric

  Lamborn, Harry

  Stewart, Rt Hon Donald (W Isles)

  Dean, Joseph (Leeds West)

  Leighton, Ronald

  Taylor, Mrs Ann (Bolton West)

  Dixon, Donald

  McDonald, Dr Oonagh

  Thomas, Dr Roger (Carmarthen)

  Dobson, Frank

  McKay, Allen (Penistone)

  Tilley, John

  Douglas-Mann, Bruce

  McKelvey, William

  Urwin, Rt Hon Tom

  Dunwoody, Mrs. Gwyneth

  McNally, Thomas

  Walker, Rt Hon Harold (Doncaster)

  Edwards, Robert (Wolv SE)

  McNamara, Kevin

  Wellbeloved, James

  Ellis, Raymond (NE Derbyshire)

  McWilliam, John

  Whitehead, Phillip

  English, Michael

  Magee, Bryan

  Whitlock, William

  Faulds, Andrew

  Meacher, Michael

  Willey, Rt Hon Frederick

  Field, Frank

  Mikardo, Ian

  Winnick, David

  Flannery, Martin

  Mitchell, R. C. (Soton, Itchen)

  Wright, Sheila

  Fletcher, L. R. (Ilkeston)

  Moyle, Rt Hon Roland

  Foot, Rt Hon Michael

  Newens, Stanley

  TELLERS FOR THE AYES:

  Freeson, Rt Hon Reginald

  Ogden, Eric

  Mr. Andrew F. Bennett and

  Garrett, John (Norwich S)

  O'Halloran, Michael

  Mr. Peter Bottomley.

  Garrett, W. E. (Wallsend)

  NOES

  NIL

  TELLERS FOR THE NOES:

  Mr. Ronald Bell and

  Mr. Michael Brotherton.

  Whereupon Mr. DEPUTY SPEAKER declared that the Question was not decided in the affirmative, because it was not supported by the majority prescribed by Standing Order No. 31 (Majority for Closure).
  It being after Four o'clock, the debate stood adjourned.
  Debate to be resumed upon Friday 30 November.

  TOBACCO PRODUCTS (CONTROL OF ADVERTISING, SPONSORSHIP AND SALES PROMOTION) BILL
  Order for Second Reading read.
  Hon. Members: Object.
  Second Reading deferred till Friday 8 February.

  GROUND GAME BILL
  Order for Second Reading read.
  Hon. Members: Object.
  Second Reading deferred till Friday 7 December.

  MINERAL RIGHTS BILL
  Order for Second Reading read.
  Hon. Members: Object.
  Second Reading deferred till Friday 30 November.

  HEARING AID COUNCIL ACT 1968 (AMENDMENT) BILL
  Order for Second Reading read.
  Hon. Members: Object.
  Second Reading deferred till Friday 8 February.

  RETIREMENT BILL
  Order for Second Reading read
  Hon. Members: Object.
  Mr. Greville Janner: On a point of order, Mr. Deputy Speaker.

  835
  When will it be possible for the sole objector from the Government Benches to identify himself and give his reasons for blocking parliamentary consideration of a Bill—
  Mr. Deputy Speaker (Mr. Bernard Weatherill): Order. The hon. and learned Member is very experienced. He knows the form about objections on Friday afternoons. That is not a point of order.
  Second Reading deferred till Friday 22 February.

  GAMING (AMENDMENT) BILL [Lords]
  Order for Second Reading read.
  Hon. Members: Object.
  Second Reading deferred till Friday 7 December.

  MARRIED WOMEN'S POLICIES OF ASSURANCE (SCOTLAND) (AMENDMENT) BILL
  Order for Second Reading read.
  Hon. Members: Object.
  Second Reading deferred till Friday 7 December.

  REPRESENTATION OF THE PEOPLE BILL
  Considered in Committee.
  [Mr. BERNARD WEATHERILL in the Chair]

  REPRESENTATION OF THE PEOPLE BILL
    Clause 1

      REGISTRATION OF WIVES AND HUSBANDS OF MEMBERS OF THE FORCES
      Amendment made: No. 1, in page 2, line 7, at end insert—
      '(1A) In section 10 of the said Act of 1949 (service qualification)—

      (a) in subsection (5) there shall be inserted immediately before the words "shall be attested" the words ", except where the declarant is a member of the forces or the wife or husband of such a member,"; and

      (b) in subsection (7) there shall be inserted immediately before the word "attested" the words "(where required)".'—[Mr. Onslow.]

      Clause 1, as amended, ordered to stand part of the Bill.
      Clauses 2 and 3 ordered to stand part of the Bill.
      Schedule agreed to.

      TITLE
      Amendment made: No. 2, in line 2, leave out from first 'of' to 'and' in line 3 and insert:
      'persons having a service qualification'.—[Mr. Onslow.]
      Bill reported, with amendments; as amended considered.
      Motion made, and Question, That the Bill be now read the Third time, put forthwith pursuant to Standing Order No. 56 (Third Reading) and agreed to.
      Bill accordingly read the Third time and passed.

  CONCESSIONARY TRAVEL FOR MENTALLY HANDICAPPED PERSONS (SCOTLAND) BILL
  Order for Second Reading read.
  Hon. Members: Object.
  Second Reading deferred till Friday 7 December.

  HOUSING (HOUSES IN MULTIPLE OCCUPATION) BILL
  Order for Second Reading read.
  Hon. Members: Object.
  Second Reading deferred till Friday 30 November.

  HIGHWAYS (ROAD HUMPS) BILL
  Order for Second Reading read.
  Hon. Members: Object.
  Second Reading deferred till Friday 7 December.

  FREE PORTS BILL
  Order for Second Reading read.
  Hon. Members: Object.
  Second Reading deferred till Friday 30 November.

  STATUTORY INSTRUMENTS, &c.
  Mr. Deputy Speaker: In order to save the time of the House, I propose to put together the Questions on the six motions to approve the statutory instruments.
  Motion made, and Question put forthwith pursuant to Standing Order No. 73A (Standing Committee on Statutory Instruments, &c.).

  STATUTORY INSTRUMENTS, &c.
    FOOD AND DRUGS
    That the draft Milk (Extension of Period of Control of Maximum Prices) Order 1979, which was laid before this House on 25th October, be approved.

    LEGAL AID AND ADVICE (SCOTLAND)
    That the Legal Aid (Scotland) (Financial Conditions) (No. 2) Regulations 1979, a copy of which was laid before this House on 1st November, be approved.
    That the Legal Advice and Assistance (Scotland) (Financial Conditions) (No. 4) Regulations 1979, a copy of which was laid before this House on 1st November, be approved.

    RATING AND VALUATION
    That the Gas Hereditaments (Rateable Values) (Amendment) Order 1979, a copy of which was laid before this House on 6th November, be approved.
    HOUSING
    That the draft Housing Corporation Advances (Increase of Limit) Order 1979, which was laid before this House on 6th November, be approved.

    NURSING PROFESSION
    That the draft Nursing Qualifications (EEC Recognition) Order 1979, which was laid before this House on 6th November, be approved.—[Mr. Newton.]
    Question agreed to.

  SELECT COMMITTEES
  Mr. Deputy Speaker: Would it be for the convenience of the House if I were to put en bloc the Questions on the motions relating to Select Committees?
  Motion made,

  SELECT COMMITTEES
    AGRICULTURE
    That Mr. Richard Body, Sir William Elliott, Mr. Alastair Goodlad, Mr. Douglas Hogg, Mr. Mark Hughes, Miss Joan Maynard, Mr. John Spence, Mr. Roger Stott and Mr. Tom Torney be members of the Agriculture, Committee.
    DEFENCE
    That Sir Frederic Bennett, Mr. John Cartwright, Mr. Bernard Conlan, Mr. Bruce George, Dr. John Gilbert, Sir Timothy Kitson, Sir John Langford-Holt, Mr. Allen McKay, Mr. Michael Mates, Mr. Cranley Onslow and Mr. Patrick Wall be members of the Defence Committee.
    EDUCATION, SCIENCE AND ARTS
    That Mr. Timothy Brinton, Mr. Patrick Cormack, Mr. Harry Greenway, Mr. David Madel, Mr. John McWilliam, Mr. John Osborn, Mr. Christopher Price, Mr. Dafydd Thomas, and Mr. Stan Thorne be members of the Education, Science and Arts Committee.
    EMPLOYMENT
    That Mr. Jonathan Aitken, Mr. Andrew Bowden, Mr. Jim Craigen, Mr. John Golding, Mr. John Gorst, Mr. Raymond Powell, Mr. Giles Radice, Mr. John Townend, and Mr. Keith Wickenden be members of the Employment Committee.
    ENERGY
    That Mr. Michael Ancram, Mr. David Crouch, Mr. Ednyfed Hudson Davies, Mr. Michael Latham, Mr. Ted Leadbitter, Mr. Mark Lennox-Boyd, Mr. Ian Lloyd, Mr. Arthur Palmer, Mr. Peter Rost, Mr. David Stoddart, and Mr. Edwin Wainwright be members of the Energy Committee.
    ENVIRONMENT
    That Mr. Donald Anderson, Mr. David Atkinson, Mr. Frank Dobson, Mr. Bruce Douglas-Mann, Mr. Jim Marshall, Dr. Brian Mawhinney, Mr. Norman Miscampbell, Mr. Nicholas Scott, Mr. Robin Squire, Mr. Malcolm Thornton and Mr. David Winnick be members of the Environment Committee.
    FOREIGN AFFAIRS
    That Miss Betty Boothroyd, Mr. Christopher Brocklebank-Fowler, Mr. Eric Deakins, Mr. Anthony Grant, Mr. Eldon Griffiths, Mr. Frank Hooley, Mr. Anthony Kershaw, Mr. Kevin McNamara, Mr. Peter Mills, Sir Anthony Royle and Mr. Nigel Spearing be members of the Foreign Affairs Committee.
    HOME AFFAIRS
    That Mr. Arthur Davidson, Mr. George Gardiner, Mr. John Hunt, Mr. Robert Kilroy-Silk, Mrs. Jill Knight, Mr. Alexander Lyon, Mr. R. Graham Page, Miss Jo Richardson, Mr. William Waldegrave, Mr. John Wheeler, and Mr. Philip Whitehead be members of the Home Affairs Committee.

    INDUSTRY AND TRADE
    That Mr. Kenneth Carlisle, Mr. Eric Cockeram, Mr. Stan Crowther, Mr. Peter Emery, Mr. Derek Foster, Sir Donald Kaberry, Mr. Russell Kerr, Mr. Thomas McNally, Mr.

    839
    Robin Maxwell-Hyslop, Mr. Ian Mikardo and Mr. Donald Thompson be members of the Industry and Trade Committee.

    SOCIAL SERVICES
    That Mr. David Ennals, Mrs. Sheila Faith, Mr. Frank Field, Mr. Ralph Howell, Mr. W. R. Rees-Davies, Sir Brandon Rhys Williams, Mrs. Renėe Short, Mr. William Whitlock and Mr. Nicholas Winterton be members of the Social Services Committee.
    TRANSPORT
    That Mr. Sydney Bidwell, Mr. Tom Bradley, Mr. Neil Carmichael, Mr. Robin F. Cook, Mr. Harry Cowans, Mr. Stephen Dorrell, Mr. Denshore Dover, Mr. Peter Fry, Mr. George Porter, Mr. David Price and Mr. Gary Waller be members of the Transport Committee.
    TREASURY AND CIVIL SERVICE
    That Mr. Kenneth Baker, Mr. Anthony Beaumont-Dark, Dr. Jeremy Bray, Mr. Edward du Cann, Mr. Timothy Eggar, Mr. Michael English, Mr. Terence L. Higgins, Mr. Robert Sheldon, Mr. Richard Shepherd, Mr. Richard Wainwright, and Mr. Ken Woolmer be members of the Treasury and Civil Service Committee.

    SCOTTISH AFFAIRS
    That Mr. Norman Buchan, Mr. Donald Dewar, Mr. Peter Fraser, Mr. Barry Henderson, Mr. Norman Hogg, Mr. John Home Robertson, Mr. Robert Hughes, Mr. Ian Lang, Mr. Albert McQuarrie, Mr. Martin O'Neill, Mr. Alex Pollock, Mr. Iain Sproat and Mr. Allan Stewart be members of the Committee on Scottish Affairs.—[Mr. Philip Holland.]
    Mr. John Farr: I object.
    Mr. Deputy-Speaker: Is the Hon. Gentleman objecting to each of these motions or to the motions en bloc?
    Mr. Farr: I object to the motions en bloc.
    Mr. Deputy-Speaker: In view of the hon. Gentleman's objection it would be a manifest waste of the time of the House to put the motions individually, and I do not propose to do so.

  WELSH AFFAIRS
  Motion made,
  That Mr. Keith Best, Mr. Ioan Evans, Sir Raymond Gower, Mr. Tom Hooson, Mr. Geraint Howells, Mr. Roy Hughes, Sir Anthony Meyer, Mr. Geraint Morgan, Dr. Roger Thomas, Mr. Alan Williams, and Mr. Delwyn Williams, be members of the Committee on Welsh Affairs.—[Mr. Philip Holland.]
  Mr. Deputy-Speaker: There is an amendment to this motion.
  The Question is, That Mr. Keith Best be a member of the Committee on Welsh Affairs.
  It is in order for hon Members to object to individual names.
  Mr. Farr: I object to the motion being considered.

  JOINT COMMITTEE ON CONSOLIDATION, &c., BILLS
  Ordered,
  That the Standing Order of 5 July relating to the nomination of the Joint Committee on Consolidation, &c., Bills be amended, by leaving out Sir Anthony Meyer and inserting Mr. James Hill.—[Mr. Newton.]

  CUMBERLAND HOSPITAL, MITCHAM
  Motion made, and Question proposed, That this House do now adjourn.—[Mr. Newton.]
  4.18 pm
  Mr. Bruce Douglas-Mann: I wish to raise the subject of the lack of consultation over the proposed closure of the Cumberland hospital, Mitcham, next Friday, 30 November. It is a small, modern, well-equipped hospital in surroundings which give a rural atmosphere but within a few minutes' walk from Mitcham town centre. It is in an ideal position for the treatment of chest and geriatric cases, with which the hospital deals.
  The hospital staff has an excellent morale, and the hospital is strongly supported by the local community. Over 17,000 signatures were collected within a few weeks to a petition protesting against the proposed closure. That petition was presented to No. 10 Downing Street by nurses from the hospital who marched for nearly six hours in pouring rain, many of them straight from night duty, to show their concern.
  That indicates the way that the staff feel about the vital job they are performing at the hospital. That view—that the hospital is doing an outstandingly good job—is shared by all the patients in the hospital to whom I spoke during a lengthy visit on 19 October. That view

  841
  is shared even by the Conservative-controlled Merton council. Like most who foolishly voted Conservative at the last election, they favour reduction in public expenditure, but never did they imagine that the axe could fall on such a healthy limb of the National Health Service, one which was doing such an excellent job for the local community. Nor did anybody else.
  The consultant chest physician who is in charge of the hospital, Dr. Berry, first heard of the plan to close the hospital on 10 September, and the hospital is to close on 30 November. It is evident how little consultation must have taken place to enable compliance with that timetable. The consultant was not informed. Indeed, not even the staff, the patients, the local general practitioners or the community health council were informed of what was proposed. Since they have known, I have been deluged with letters of protest. It is a hospital that serves the local community well. It is strongly supported by local general practitioners who believe that they cannot do their job as effectively as they have in the past without the hospital.
  Not only was there no planning or consultation with any of the groups or bodies that I have mentioned, but the area health authority was taken by surprise. It had had no intention of closing the hospital until it took a panic decision at the last moment. It is clear that that decision was taken under pressure from the Secretary of State.
  The area health authority, which is now closing the hospital, has in the current year spent large sums on redecoration, double glazing and other improvements to the hospital. When I visited the hospital—it was effectively under sentence of death—on 19 October, the decision having been taken to close it about four weeks or five weeks previously, I found electricians still working on the rewiring. From the end of next week it will be exposed to wrecking by vandals. That is the sort of lunacy that results from panic decisions taken without proper consultation.
  Both the local authority, which is Conservative-controlled, and the community health council believe that with proper planning and consultation the alleged saving of £268,000 which closing the hospital is expected to produce could have been
  842
  achieved in far less damaging ways. I am far from conceding that such proposed reductions in spending are desirable, but if they have to be made they must be planned. If that were done, far less serious harm would result.
  Even the Minister of State, Department of Health and Social Security is on record as opposing such decisions. On 9 October, at the Conservative Party conference, he said:
  "Small local hospitals which are efficient and vital to local communities must not be closed."
  That description ideally fits Cumberland hospital. It is an efficient small local hospital which is vital to the local community. Consequently, it is not surprising that neither the Minister nor the Secretary of State has replied to the letter that I wrote to the Secretary of State on 23 October protesting at the proposed closure and presenting the evidence that justified a reconsideration of the decision. It was only this week, after I had obtained the approval of Mr. Speaker to initiate a debate on the Adjournment, that I heard from the Under-Secretary of State that he would reply to my letter orally during the debate. I shall listen to the hon. Gentleman's reply with great interest. I shall be surprised if he is able to meet the case set out in my letter.
  It is true that it is called a "temporary" closure. However, when the staff have been dispersed, and when the empty building has been wrecked by vandals, the cost of reopening will more than cancel out any saving that will possibly be achieved. It is extremely improbable that, with or without any subsequent reopening, the saving estimated by the area health authority can possibly be achieved.
  The London community health councils have collectively been carrying out a research project into the closures in London. It is an alarming piece of information that emerges from the project. By next March London will have lost nearly 3,000 beds as a consequence of panic closures that have been forced on area health authorities by the Secretary of State. As a consequence of the way in which the closures have been approached, it is extremely unlikely that, in practice, the savings that are contemplated will be achieved. For example, the staff will have to be dispersed, as will the patients. The cost of ambulance

  843
  services to take patients to and from the further points where they will receive treatment will be much greater and the cost of repairs to neglected, empty hospitals will be great.
  I am told that the commissioners who are currently running the Lambeth, Southwark and Lewisham health area have estimated that they will save £640,000 as a consequence of saving St. Olav's hospital. The community health council, with probably rather greater knowledge of the local circumstances, estimates that the real saving is likely to be no more than about £60,000. I suspect that the same reasoning, the same calculation and the same consequences will arise in regard to cost in the case of the Cumberland hospital, Mitcham and that any financial saving will be negligible in relation to the harm and suffering caused.
  There has been no consultation, because the area health authority calls this closure a "temporary closure". It is called a temporary closure in order to achieve a clear and blatant evasion of the statutory duty imposed on area health authorities by Statutory Instrument No. 2217 of 1973, which requires area health authorities to consult community health councils before closures which would significantly affect the Health Service provision in the area.
  This is a device—it is almost acknowledged to be that—recommended by the Secretary of State to area health authorities in his now notorious "Dear Betty" letter of 27 August 1979, which quite blatantly invites maladministration by the area health authority; and because the Secretary of State also summarily demanded, in August this year, that Merton, Sutton and Wandsworth area health authority should cut £4 million from its budget by March 1980, he gave it little choice but to use the shabby weapon that he put into its hands.
  One might have thought that that was precisely the kind of issue that the Health Service Commissioner was created to investigate and to expose, for if that is not maladministration, it is difficult to imagine what is. The local community health council most certainly thought that it was maladministration, and so did I. The council asked me to refer the matter to the Health Service Commissioner, and
  844
  I did so. But I am afraid that neither in his capacity as Parliamentary Commissioner nor in his capacity as Health Service Commissioner did the Ombudsman consider that he could look into the matter. He rejected it on the ground that the community health council could sue the area health authority in the courts, and because it had a remedy in the courts he was not prepared to look into it.
  That was an issue that had already been explored by the Lewisham community health council, which sought to bring proceedings to establish that the area health authority in its area was acting ultra vires in failing to consult it about the closure of hospitals. Those proceedings—it is not for me to say—might well have been successful, but they had to be nipped in the bud because the AHA said that it would not provide funds to community health councils to bring proceedings against it. The community health council therefore had to abandon proceedings.
  It is really a farce for the Health Service Commissioner to say that he is not prepared to look into an alleged issue of maladministration because the CHC could sue the area health authority in the courts, when the community health council is itself dependent on the area health authority for its funds. The area health authority would scarcely be justified in spending its funds to sponsor litigation against itself.
  I hope that the Parliamentary Commissioner—or the Health Service Commissioner—will reconsider his views as to the exercise of discretion in circumstances of this kind, because what we have as a result of his decision is a classic Catch 22 situation. The Commissioner cannot investigate it because one can sue in the courts; but one cannot possibly sue in the courts because one has no money to do so. I trust that this issue will be reconsidered by the House and by the Health Service Commissioner.
  At the very last moment I appeal to the Under-Secretary to allow reason, common sense and the rule of law—the law which requires consultation—to take their course and to save an excellent hospital—the Cumberland—and allow it to continue to serve the local community.
  4.30 pm
  The Under-Secretary of State for Health and Social Security (Sir George Young): The hon. Member for Mitcham and Morden (Mr. Douglas-Mann) spoke cogently in support of the Cumberland hospital, which is clearly a popular institution. I well understand the concern that he expressed and the concern of his constituents. He made it quite plain that the closure of a valued small local hospital such as the Cumberland cannot be contemplated lightly. He also argued that consultative safeguards are needed to ensure that proposals to close or change the use of such a hospital cannot be railroaded through without regard for local interests. The Government share these views.
  In replying to the hon. Member, I am grateful for the opportunity to confirm the importance that we attach to small hospitals and to consultation about changes in health services generally. Although I shall also seek to show that the application of these two principles must be tempered by the financial context, I hope to dispel some of the worst anxieties about the future of the Cumberland, and I shall also give details of further guidance to health authorities about the role of consultation.
  The hon. Member knows that recent events in the Merton, Sutton and Wandsworth area health authority, including the proposal to close the Cumberland temporarily, are a direct consequence of the financial situation facing the National Health Service and that that, in turn, is a consequence of the national economic situation. We have to face facts. Expectations must be kept within the limits of what the country can reasonably afford. Our predecessors failed in this respect. Our intention is to fulfil our undertaking that future growth in services is based on the resources made available by a strong and expanding economy. As the economy improves, therefore, we shall be able to do more for the National Health Service.
  Meanwhile, we have made clear that, despite the difficulties, health authorities must stay within their budgets and that no more money can be made available this year. It is the responsibility of the regional health authority to see that the total expenditure within its region, by the area health authorities and by the regional
  846
  health authority itself, remains within the cash limits given to it. In order to do this, each area health authority must take whatever action is necessary to keep its expenditure within the funds allocated to it by the regional health authority and to ensure that it is able to contain next year's expenditure within the allocation it can reasonably expect in that year.
  Merton, Sutton and Wandsworth is one of the London health authorities that faces particular difficulties this year. Like all health authorities, it has had to cope with increased costs. Although the Government have honoured previous undertakings and have provided additional money to meet pay awards, this has proved insufficient for the authority to meet the full extent of inflation and other rising costs. No more money can be made available.
  In addition to this immediate difficulty, Merton, Sutton and Wandsworth is one of the London health authorities which for some time has been running a level of services which, judged by the objective criteria established by the Department's Resource Allocation Working Party, is more generous than that found througout the country generally. As a result of attempts to rectify this situation in recent years, Merton, Sutton and Wandsworth has attracted a lesser share of the growth available to the NHS than those areas away from London which are relatively poorly endowed with services.
  At the same time, however, development of services in Merton, Sutton and Wandsworth has not stood still. As a result, the area health authority faces this year not only a squeeze on strictly enforced cash limits but also the necessity to correct an inbuilt over-commitment to a level of services it cannot afford. If the authority does not correct this over-commitment, it will continue to amass an ever-accumulating deficit which could be supported only at the cost of sacrifices by other areas in the South West Thames region, all of which have their own pressing needs. Corrective action cannot be postponed. The deficit at the end of this year has been estimated at £5·6 million, and any delay will mean that the eventual and inescapable antidote will be even more painful.
  Accordingly, the authority established a working party last summer which included representatives of the medical staff

  847
  and observers from the three community health councils to consider how the necessary savings might be made. In October, the AHA accepted the proposed package of economy measures aimed at saving an estimated total of £5·8 million in a full year. We have urged on authorities the need to do everything they can to make savings without affecting patient services, and I am glad to see that the AHA has indeed sought to reduce administrative costs among its economies. But administration had previously been pruned, and more administrative cuts could not possibly provide savings of the order which this authority requires. Regretfully, we have to accept that savings must be found in patient services. My right hon. Friend the Secretary of State made this clear in the House when he said:
  "some health authorities—this applies especially to those in London—are faced with the need to make real cuts this year so as to remain within their cash limits".—[Official Report, 17 July 1979; Vol. 970, c. 1435.]
  The authority's economy measures include reduction in services at both large and small hospitals. I understand that the authority included the temporary closure of the small hospitals rather than concentrating solely on ward closures in the main district hospitals because of the generally lower bed occupancy in the small hospitals; because of the wider range of clinical facilities available in the larger hospitals; and because the temporary closure of small hospitals also helps to save on overheads through the complete cessation of support services such as catering. The authority's view is that, in the short term, the savings to be made by the temporary closure of small hospitals are less damaging to patient care than the equivalent financial savings in the main district hospitals.
  The Government have taken the line that they should not intervene in properly taken decisions by health authorities on the short-term measures necessary to live within cash limits. This is right because these are decisions best taken by local management. Some critics have tried to drive a wedge between this policy and the Government's commitment to small and valued hospitals such as the Cumberland, which in some instances have been the chosen means of making savings. The hon. Gentleman did that this evening. To these critics, I would answer
  848
  that we expect health authorities to behave responsibly and not to make administratively convenient savings at the cost of greater hardship to patients and lasting damage to the Health Service. I would therefore expect an authority that proposes to close a small hospital to satisfy itself that this was indeed the most immediately effective source of economies and that it would not cause lasting damage.
  In this connection, I would emphasise that the present decision to close the Cumberland hospital can only be temporary in effect. My right hon. Friend has made clear to health authorities that any proposal affecting the long-term future of the units involved in short-term economies must be referred to full consultation. If local interests express this through the CHCs, and they disagree with this proposal, it has to come to Ministers for resolution. We shall examine such cases very carefully in the light of the now widespread conviction that small local hospitals have a vital role to play in the provision of the wide range of services that are needed.
  Mr. Douglas-Mann: I am pleased to hear the assurance that it is likely that the closure of Cumberland hospital will be only temporary. Can the hon. Gentleman give an indication of the cost involved in reopening a hospital that has been closed, and also the cost of the damage to the services involved in dispersing the staff and gathering them together again to re-establish what was a viable and effective unit?
  Sir G. Young: Indeed, the area health authority expects to save about £300,000 by the temporary closure. I understand that very little additional cost should arise elsewhere, because no extra beds or staff are being provided in other hospitals. I note what the hon. Gentleman said about vandalism. I understand that security will be provided by the staffing which it is necessary to maintain because of the continuing out-patient services. I also understand that the grounds are to be used temporarily by the Metropolitan Police dog team training unit—surely a formidable deterrent to local vandals.
  I said that unless the authority made savings it faced an estimated deficit of £5·6 million at the end of this year. To

  849
  wipe out this deficit by economies introduced half-way through the year, as was necessary in this case, would require cuts whose total value in a full year would amount to £11·2 million. As the hon. Member knows, the economy programme that the authority has, in fact, adopted was estimated to save £5·8 million in a full year, and some of the measures which take time to introduce will not produce even a half-year's savings in the current financial year. The authority must therefore find other means at least to mitigate its immediate cash problem this year.
  It is possible within accounting practice to make some adjustments to the cash flow, but there are limits on how far this is technically feasible. Moreover, these adjustments do not enable the authority to continue living beyond its means by accounting wizardry. They merely extend the period in which to solve the underlying problem of over-expenditure. Another possible short-term palliative arises from the fact that the overriding requirement is for regions to deliver their cash limit. I understand that the South West Thamas RHA may be able to accommodate some of the area health authority's cash deficit this year but this, too, merely buys time in which to cope with the underlying problem.
  Since these are only partial and temporary expendients, it was therefore essential that the AHA took an urgent decision on the proposals submitted by its working party in October. I should like to explain how the statutory consultation procedure applies in these circumstances and why the action taken by the authority is not illegal or an abuse of its powers, as has been alleged.
  Statutory Instrument No. 2217 of 1973 requires that an AHA should consult local interests in the form of CHCs about any substantial variation in services in the council's district and lays down a procedure for doing so. The regulations contain a proviso, however, that this requirement shall not apply to any proposal on which the authority is satisfied that, in the interests of the Health Service, a decision has to be taken without allowing time for consultation.
  There are various reasons why an AHA may consider that it does not have time to consult and that any delay while consultation took place would be against the
  850
  best interest of patients and staff. As a matter of law, as well as good management practice, the degree of urgency and the reasons for it are properly left to the authority to decide. There are some obvious reasons, such as the danger to staff or patients, through infection or the physical condition of the building, which might require an urgent decision without consultation. But, in adidtion, there are authorities like Merton, Sutton and Wandsworth, which face the prospect of running out of cash before the end of the financial year. In these circumstances, it is inescapable that financial stringency should be cited as a reason for urgent decisions to proceed with the temporary closures without prior formal consultation.
  Quite clearly, it would not be in the interests of patients or staff for the authority to find itself, towards the end of the financial year, without the money to run any of its services. The hon. Gentleman will be aware that the need for urgent economies as a reason for waiving consultation was recently tested and upheld in the High Court in the case brought by the London borough of Lewisham against the commissioners for Lambeth, Southwark and Lewisham.
  This is not to say that there was no consultation of any kind. As I have mentioned, the authority's working party, which met through the summer to consider possible economy measures, included representatives of the medical staff and of the three CHCs. Nor does it mean that what has happened is now permanently a fait accompli, on which there will be no further consultation. My right hon. Friend wrote in affectionate terms in August to Mrs. Betty Paterson, chairman of the North West Thames regional health authority, about consultation in circumstances of financial stringency. His letter has been widely circulated in the Health Service—widely quoted, but sometimes misunderstood.
  My Department will shortly be issuing further guidance to health authorities to clarify the formal requirements for consultation. This will re-emphasise the point made in the earlier letter: that the area health authority is required to notify CHCs of urgently taken decisions, and the reasons for not submitting these to consultation. It will also re-emphasise our view that any permanent changes

  851
  should continue to be subject to the appropriate consultation process, including cases where action has already been taken on a temporary basis.
  Shortly after the authority took its decision on economies, the chairman wrote to the three CHCs, with the necessary explanation and promising further consultation. Some of the measures taken represent the bringing forward of proposals which would have arisen in due course as a result of strategic plans. In those where the change or closure will be permanent, the authority intends to proceed with formal consultation as quickly as administrative resources allow. For the rest, the authority's action will largely depend on the financial situation next year. But there will, in any event, shortly be consultation on the likely effects of the decisions taken and canvassing of the CHCs' views on the long-term future of the units and the services concerned.
  I understand that the Cumberland hospital is one of the hospitals not affected by existing proposals in the AHA's strategic plans. As the hon. Member pointed out, it is in good repair, has good facilities, and fulfils a genuine local need. It is generally reckoned to be a splendid hospital, admirably supported by a loyal and active League of Friends. Naturally the authority wishes to put it back into use as soon as resources permit. Recent reports in the press implying that current maintenance work is a waste of money
  852
  are therefore ill founded. The form in which the authority hopes eventually to reopen the hospital will depend on the discussion and consultation described in the chairman's letter to the CHCs. I do not want to prejudge these, but I shall ensure that the area health authority is aware of the points that the hon. Member and his constituents have made in the letters he has sent to my right hon. Friend.
  The financial situation within the NHS as a whole is unavoidably the backdrop to the situation at the Cumberland hospital. I do not want to leave the impression that this is a setting of unremitting gloom. Spending in the Health Service next year will remain at the level previously planned. Though there has been a tight squeeze this year because of cash limits and the economic situation, the planned volume of spending for the next year is in line with last year's White Paper—a 3 per cent. increase over the latest estimate for the current year. The impact in Merton, Sutton and Wandsworth will depend on the allocations yet to be determined for the regional health authority and by those, in turn, for the area health authorities. But, nationally, these figures mean that the planned increase will restore this year's squeeze and add the future ½ per cent. real growth previously planned.
  Question put and agreed to.
  Adjourned accordingly at fifteen minutes to Five o'clock.

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