§ Resolution reported, "That for the purposes of any Act of the present Session to provide for Insurance against loss of 1484 Health, and for the prevention and cure of Sickness, and for Insurance against Unemployment, and for purposes incidental thereto, it is expedient:—
- (1) To authorise the payment out of moneys provided by Parliament of—
- (a) Sums not exceeding two-ninths (or in the case of women one-quarter) of the cost of providing the benefits specified in Part I. of such Act, and of the administration of those benefits, together with—
- (i.) as respects medical benefit, one-half of any excess expenditure on medical treatment and attendance (including the provision of medicines) for insured persons which may be sanctioned by the Treasury;
- (ii.) as respects sanatorium benefit, including research work in connection therewith, a sum not exceeding one penny a year for every insured person;
- (iii.) as respects benefits for persons who have been in the naval or military service of the Crown such additional sums as may be provided by the said Act;
- (b) A contribution not exceeding one-third of the total contributions received from employers and workmen in any year towards the cost of unemployment benefit and other payments to be made out of the unemployment fund established under Part II. of the said Act, and of a contribution by way of repayment to associations of persons of a part (in no case exceeding one-sixth) of the aggregate amount expended by such associations in payments to persons while unemployed, and
- (c) The salaries and remuneration of any commissioners, umpires, referees, and other officers and servants appointed in pursuance of such Act, and other expenses incurred in the execution thereof;
- (2) To authorise the Treasury to make for the purposes of Part II. of the said Act advances out of the Consolidated Fund, and to borrow money for such advances by the issue of Treasury bills or Exchequer bonds, the principal of and interest on such Exchequer bonds to be charged on and payable out of the Consolidated Fund."
§ Motion made, and Question proposed, "That the House doth agree with the Committee in the said Resolution."1485
§ Mr. HAYES FISHER
It is not my intention to make a Second Reading speech on the general finances of the Bill, but if I were to do so I should like to take the line that if the country can afford a sum of something like twenty-five millions, that if we had time we might devise a scheme by which far greater benefits might be given for that sum. I shall certainly point out that there are some classes of contributors, and those the most needy and deserving, and those for whom we ought to have the greatest care, who will be making contributions out of all proportion to their means and obtaining benefits which are far inferior to those which are to be enjoyed by the more prosperous classes in the community. It has been pointed out, and will be pointed again, that the post-office contributors, those who have to operate through the post-office, are the most sickly portion of the community, and that most sickly portion of the community obtains very little for their contributions compared with the benefits obtained by the more healthy portion of the community. It has been pointed out again and again that domestic servants as a class will have to contribute very largely to this scheme, whereas the benefits which they are to obtain will be very small indeed, and that—
§ Mr. CHIOZZA MONEY
May I ask if the hon. Member is entitled to discuss the merits of the Bill as if we were on the Second Reading stage of the measure. The hon. Member is discussing the position of domestic servants.
§ Mr. HAYES FISHER
Certainly. The few speeches to which I listened yesterday took the nature of a Second Reading debate. However, I have not the slightest wish to be out of order, and I will say nothing more at the present moment which can be in the least danger of being ruled out of order, even by the most fastidious Member of this body. I will confine my attention to remarks made at the close of yesterday's Debate, which I have gathered from "The Times," as they are not at present officially reported, by my hon. and learned Friend, the Member for the Exchange Division of Liverpool (Mr. Leslie Scott). In answer to my hon. and learned Friend who raised the question whether, if we pass this Resolution, it would be possible to place upon the Exchequer the whole of any deficiency caused 1486 by any local health body—by any of those bodies that will be set up as local health bodies—the Chancellor of the Exchequer said: "It would not be possible to increase 50 per cent. of that excess to be paid by the Treasury." I want to know if he agrees with that? Well, it is an important point. The right hon. Gentleman said it would not be possible, if we passed this Resolution as it stands now, to increase the 50 per cent. excess to be paid by the Treasury. That, as the right hon. Gentleman knows perfectly well, is the excess evidently contemplated under Clause 14. In that Clause it says—if this Resolution is carried by the House in its present form—that that excess will be divided between the Treasury and the county council. The right hon. Gentleman does think so? Then how will he provide for the excess? Certainly in Clause 14—
§ The CHANCELLOR of the EXCHEQUER (Mr. Lloyd George)
I know exactly what the right hon. Gentleman alludes to. What I object to is that he is assuming that that excess must be found by the county councils—by the local authorities—and by the Treasury. That is not the case at all. The matter was discussed very fully with the important deputation that waited upon me. It is true that they suggested that there should be some amendment in order to make the thing still more clear. That is my interpretation of the Clause as it stands. If there is any doubt about it I should be prepared to make it clear. It is left to the Treasury and to the county councils as to whether or not they will accept the arrangement.
§ Mr. HAYES FISHER
What the right hon. Gentleman says is this: If any of these local health committees frame schemes with the doctors for medical benefits to be given to the Post Office contributors, and yet these schemes are so extravagantly or so badly managed that there will be an excess of expenditure over the money provided by the various contributors, that it will be "within the option" of the Treasury to pay one-half, and "within the option" of the county councils to pay the other half? What, then, is going to be the position if this Resolution is passed? The right hon. Gentleman admits that it will not be possible to increase the 50 per cent. excess to be paid by the Treasury. Suppose the Committee when it comes to examine the Bill takes up on behalf of the county councils the position that the right 1487 hon. Gentleman took up in Debate yesterday, and which he repeats in the Debate to-day. These are his words:—County councils should not be compelled to pay the half unless they were willing to do so.They will always say: "Unless we get control we will not pay half." I believe that is exactly the position that county councils will take up. They will say, "Unless we get control of this expenditure we certainly shall not allow these local health committees to dip their hands into the pockets of the ratepayers." Supposing the Bill goes through Committee, unless some champion of the county councils and the ratepayers succeed in persuading the House otherwise, then, under Clause 14, no control is given to the county councils over these financial schemes. So far as no control is given to them, suppose it is urged that the county councils and the ratepayers ought not to be compelled to find any portion of this excess expenditure for which they are not in the least responsible?
§ Mr. HAYES FISHER
Very well, who is to find the excess? Under this Clause, supposing a county council were to say: "Oh, but that excess ought to be found by the Exchequer, it is a national health matter; it is a matter that, so far as it is not put on the contributories, ought to be placed on the Exchequer and the general taxpayer." The right hon. Gentleman would be able to get up and say, must get up and say: "However much I may agree with you about that, I am precluded by the Financial Resolution from accepting more than half of the responsibility on behalf of the Treasury for any excess that is caused by that position." I would like the right hon. Gentleman to elucidate that position. For my own part I shall certainly contend later on—not now, because I should probably be out of order—that as the county councils have practically no representation on these local health committees—well, a miserable representation of one-third.
§ Mr. HAYES FISHER
Perhaps the hon. Gentleman will allow me to finish my sentence? Miserable representation of one-third, "not necessarily chosen from themselves"—indeed, people not chosen by them at all; for as I understand it, they must be chosen from the Public Health Committees. These in London are not the county council at all. They are the borough councils. Therefore, it is quite possible that the great county council, on whose behalf I sometimes have the honour to speak, might not have one single representative on the body. Yet it might have various health committees sending up large bills for excess expenditure which it strongly objects to, whilst the bodies sending these Bills could say, "There you are, we have made these arrangements; it is quite true they are in excess of any moneys we are bound to receive, but we think in the interests of the people that these schemes ought to go through; now then you must pay the bill." The right hon. Gentleman hardly thinks that is so? All that under Clause 14 you would have would be the "option" of doing this! Sir, we know a great deal of what is and what is not optional! We know a great deal about the meaning of the word "may" in connection with medical benefits, particularly to children and in regard to the medical inspection of children. Their Act says you "may" medically treat children. The Government says: "We will scold you very well if you do not; we will take good care to hold you up to obloquy if you do not, although we will not give you a penny towards it." That is the kind of pressure that will be put upon the local health authorities hereafter. The health committees on which the county councils will be very inadequately represented, if at all, have to make schemes for England. Perhaps I had better deal with London, and say all over London. The health committees will have to make schemes for these medical benefits for the most sickly portion of the community.
Suppose the doctors strike and say: "You may make what scheme you like, but we are not going to doctor these Post Office contributors at 6s. per head." The local health committee replies, "Very well, what are your terms?" And the doctors say, "Eight and sixpence per head, with special fees for special cases, and extra pay for extra visits." I am bound to say that from my point of view the doctors would only be taking up a very reasonable attitude if they were to adopt a line something like that. 1489 The local health committees may very rightly say: "We will make a different bargain with you. We have the rates behind us, and we shall make our scheme regardless of the contributions that we receive, regardless of the nimble 9d. we receive, we shall make a scheme which must create a deficiency, and that deficiency can be found half by the Treasury and half by the county council." I say that there will be scarcely a great town or county council who will find that money. I do not say that the county councils would be unwilling to find any money at all towards these schemes, particularly towards the sanatorium benefit, but I am quite sure that if the county councils are wise they will say: "If there is going to be taxation of the ratepayer there ought to be proper representation of the ratepayer on all the bodies that make these schemes."
This is a matter of national concern, and it ought to be met by the National Exchequer, and not by the local authorities. The right hon. Gentleman will find that those local bodies are most certainly adverse to taking on any new charges on the rates until he has settled with them the account which they have against the National Exchequer for services recently imposed upon the ratepayers by this House, and which are taking a great deal of money out of their pockets. Suppose the House of Commons took that view.
§ Mr. LLOYD GEORGE
I am sorry to interrupt the right hon. Gentleman, but as the Cabinet meets at a quarter-past twelve, and as I have to be present I will be unable to answer his questions unless he gives me an opportunity very soon now.
§ Mr. HAYES FISHER
If I had known that I would have compressed my remarks into a very much shorter space. I hope the right hon. Gentleman does not think I am wasting time. I ask him to clear up that point, that, supposing the House should be of opinion that these local bodies ought not to have to pay any excess expenditure, but, that the scheme should be self-supporting without having to rely upon the rates—a most dangerous thing— would it not be precluded by the terms of this Resolution from acceding to an Amendment which would place the whole of the excess expenditure upon the Exchequer. One more question. The right hon. Gentleman promised me about a fortnight ago that he would give the House 1490 some rough estimate of the amount of money the machinery would cost the country for carrying out the Bill. We have not yet had such information, and I hope upon some future occasion the right hon. Gentleman will give it to us.
§ Mr. LLOYD GEORGE
I hope the right hon. Gentleman will not imagine that I thought he was taking up too much time, when I pointed out to him that I should like to answer his questions before I left. I shall address myself at once to the more important points he raised with regard to this Resolution. I was under the impression I had given in substance the amount which the administration would cost. I have already answered most of the questions which the right hon. Gentleman put to me. This Resolution undoubtedly precludes the House from moving an increase in the charge put upon the Exchequer that is the direct answer to that question. When I come to the argument which the right hon. Gentleman addressed to the House and to the Government as to the desirability of putting the whole charge upon the Exchequer, let me point out this. The right hon. Gentleman himself supplied the best answer when he referred to the case of the medical inspection of children which he said was optional.
§ Mr. LLOYD GEORGE
The right hon. Gentleman is quite right. He said "we were scolded by our constituents in regard to it." Well, if every time you are scolded you are to run away as if you are doing something that was wrong, the position of a Member of Parliament, and especially a Member of the Government, would be perfectly intolerable. One must exercise one's judgment in the face of all these scoldings, otherwise we would not be fit for responsible positions. We are doing more here. We do not say we will scold you unless you find half the money. We say we will find half ourselves, which is a very different position from that adopted with regard to the medical treatment of children. In that case you simply write minutes and complain. In this case we say "If you will find half the money we will find the other half." It is the first time the Exchequer has ever done that in regard to matters of this kind.
The right hon. Gentleman is rather in the habit, if I may say so, with every scheme of the Government, whatever it may be, of just dwelling upon the debit 1491 side and never upon the credit side. That is not strictly fair. After all, he is speaking now, not so much as a member of the Unionist party; he is speaking of the affairs of the county council and of the ratepayers and as a responsible leader of London municipal government, and he should give the whole facts. What are the facts? We are undertaking a responsibility which is very largely charged upon the rates at the present time. I had a deputation of employers before me the other day, and what was the request they made? They asked "Why should we be called upon to contribute to a matter which was very largely for the relief of the rates?" They said: "Why should you put upon us an obligation that ought to be put upon the ratepayers and taxpayers, because it is for the relief of the ratepayers. We will take our share as ratepayers, but why should we be asked to take more than our share?" I had one or two deputations which took up the same line. The right hon. Gentleman has not thought fit to point that out. After all this enormous scheme of £20,000,000 or £25,000,000, as it will eventually be, for the purpose of undertaking the care of the health of that class by means of this joint scheme must, in the long run, and, indeed, in the short run, be an enormous benefit to the ratepayers as a whole. The right hon. Gentleman never put that view of the case. Take the sort of case to which he has referred— the Post Office contributor. He suggested that the Post Office contributor would be made up very largely of the sort of person whom no insurance company would take up. They are persons who do not wish to join the societies, and whom a society would not take on. The sort of persons who become Post Office contributors are the very sort of persons whose state of constant ill-health prevents them being taken into societies. They go straight on to the rates, and up to the present there is no fund between them and the rates. In respect of these persons 2d. is already found by the State; there is no accumulation, and it becomes a practical 2d. There is 2d. in the case of the Post Office contributor, and there is 3d. in the case of the employer, and still more there is the contribution, which is a very considerable contribution, that comes from the fund in respect of sanatoria. They get the benefit of the whole sanatoria fund, which is raised out of the national fund, and which would otherwise come out of the rates; the whole cost of the cure, maintenance, 1492 and buildings would otherwise come out of the rates. Why did the right hon. Gentleman ignore all these facts? All this will be done in relief of the obligation now cast upon the rates. We are finding £1,500,000 for that out of the Exchequer.
I think I am entitled to ask the right hon. Gentleman when talking to the county council and to others outside that he should really put fairly before them not merely the debit side, not merely the fact that half the cost will be paid by them, but that up to now the whole of the cost is paid by the ratepayers, and that in the future half the cost only will be so paid. The right hon. Gentleman said if £25,000,000 was placed at his disposal he could frame a very much better scheme. It is quite open to the right hon. Gentleman to frame a scheme now. We have so far only discussed two Clauses and I have accepted several Amendments and I have indicated the intention of the Government to accept many more drastic Amendments, and I hope to get the help of hon. Gentlemen not merely in debating these Amendments but in framing these Amendments. I am perfectly open to accept any alternative that any hon. Member can show will confer greater benefits.
There is one thing I would point out, that out of the whole of the expenditure not one penny goes in payment of bureaucracy, the whole of the expense is borne by the State outside this Fund, and therefore every penny goes to the benefit of the people insured and to the Post Office depositors. I wonder how much time and thought the right hon. Gentleman has given to this Bill. The problem has been before the country for years. I cannot imagine a person in the position of the right hon. Gentleman the Member for Fulham would come here and ask to have a better scheme framed unless he had some idea as to how to do it. I shall look for his Amendment which is to confer greater benefit, for I assume he has got such an Amendment, and if he puts down the superior scheme he has got in his mind, I can assure him I will pay the most careful attention to it, and if it is better than my scheme, nothing will prevent me from accepting it and acknowledging it, and he will earn the credit not merely of the Government and the House of Commons, but the grateful thanks of the country if he can devise a better scheme.
§ Mr. CASSEL
The speech which the right hon. Gentleman has just made did not deal at all with the position taken up 1493 by the right hon. Gentleman the Member for Fulham. The hon. Member for Fulham did not take up the position that, under no circumstances was any part of this to fall upon the rates. The position he took up was that no such deficit ought to fall upon the rates unless there is some adequate control upon the part of the ratepayers. He also took up the position that whether it be right or wrong that any part should fall upon the rates, this Resolution precludes the possibility of any discussion in the House of Commons upon that point. That is the position in which we stand. It has been argued that part of these charges ought to fall upon the rates if the ratepayers were allowed to have control. Personally I think there is a good deal to be said for that view. Some of us thought no part of it ought to fall upon the rates, because it is a national scheme which ought to be paid for out of national funds. I think it would be out of order if I attempted to discuss these two points of view. The line we are entitled to take up is that the House of Commons by the form of this Resolution is precluded, at any point, from even discussing that question. As a new Member perhaps I may appeal to you, Mr. Speaker, to inform me at what stage of the Bill, if any, the opportunity will arise when we can discuss the question as to whether it is proper that any part of this expenditure should come out of the rates? So far as I can see there is no such part. The House of Commons ought not by this Financial Resolution, or by the form in which it is drawn, to be precluded at any stage of the Bill from ever discussing that question at all. My hon. Friend did not pin himself to the proposition that no part ought to come out of the rates, but he said that the House of Commons ought to have an opportunity of discussing whether, if any part is to come out of the rates, at all events an opportunity of having some control should be given to the ratepayers.
To say that this is an optional proposal is wholly illusory. Upon that point I can speak with the short experience I had on the London County Council when dealing with the Provision of Meals Act. We had to see whether voluntary funds would not be sufficient to find the money for those in need, and we were branded in all our constituencies as being wholly callous and indifferent to the wants of the children, and with being regardless of their welfare and 1494 prepared to starve them. [HON. MEMBERS: "Hear, hear."] Well, some of us got damages for those libels.
§ Mr. CASSEL
Electorally there is no doubt we suffered from it. [An HON. MEMBER: "Never."] Therefore to speak of this being an optional matter for the county council is wholly illusory. If such a deficit arose and anyone were to vote against making it good out of the rates I can imagine what would happen. It really is in substance and in fact a compulsory Clause, and it is because we want to have an opportunity of discussing the question before it is finally adjudicated upon that we are asking for some change to be made in the form of the Resolution. It is not competent for any private Member to move such a change, but it would be competent for the Government to so alter it as to give us an opportunity for discussion. I think I may congratulate the Government upon the ingenuity, the fiendish ingenuity with which they have drawn up this Res6lution, Because it places people like myself in a position of great embarrassment. Personally I am in favour of the principles of this Bill. I supported the Second Reading of the Bill, and I suppose I shall be bound to support this Resolution, because, if I do not it will be taken that I am against the principles of the Bill. I am in favour of many Amendments to the Bill which will be shut out by this very Resolution, which in consequence of the method of procedure adopted, I am bound to support. In other words, I am bound to turn the key in the lock which will keep out the very Amendments I was hoping to bring forward.
It was said that we might move Amendments which would increase the benefits under this Bill. I believe that any Amendments which increase the benefits under this Bill vary the conditions of those benefits, or indirectly increase them would be at once ruled out of order. Under the terms of the Resolution only two-ninths of the benefits are to be found out of the Treasury, and anything which increases the benefits would increase that two-ninths. Speaking as a new Member, I may misapprehend the terms of the Resolution, but as I read it any Amendment which directly or indirectly by varying the conditions upon which benefits are given alters the terms of those benefits would be ruled out of 1495 order because it would increase the two-ninths to be found by the Government. Supposing we thought the waiting periods were too long. If we attempt to alter them we shall be out of order. If we attempt to define more specifically what medical benefit is and attempt to introduce some Amendment to extend it to surgical benefit again we should be out of order, because we should be increasing the benefit of which the Treasury has to find two-ninths, and therefore we should be increasing that two-ninths. I am only interpreting the answer given by the Chancellor of the Exchequer yesterday, and the rulings of the Chairman of Ways and Means, when I say if we attempted to extend the number of persons—if we thought that some who had been left out ought to come within the provisions of the Bill we should be precluded by the terms of this Resolution from bringing forward any Amendment which had that effect. If we brought in more persons the two-ninths of the benefit which has to be found by the Treasury would be increased. The result of bringing in a larger number of persons would be to increase the benefits and consequently the amount the State has to find. Personally I have given up hopes of a holiday, but at the same time I am grateful to the Government for introducing this drastic Resolution, because more than half of the Amendments will, as a result, be out of order, and I shall be able to remake the holiday arrangements I had unmade. But we are bound to look at this matter, not from a mere personal point of view but from the point of view of national interest, and I think it is a national calamity that the Government should have chosen this expedient for ruling out and absolutely precluding us from bringing forward the Amendments we wish to advance. Under these circumstances we can take no responsibility for the details of the Bill. We have approved the principle, but in regard to details we are precluded from moving those Amendments which we wish to. Take the case of women. Personally I should like to see an Amendment introduced which would enable women when they marry to get some part of the surrender value. It is done under the German scheme, and it is a misfortune that under the terms of the Resolution I should be precluded from moving that. On these grounds, and on these grounds alone, I regret the position in which I am placed. I must reluctantly abstain from voting for the Resolution or 1496 I must support it knowing I shall be precluded from moving Amendments which I wish to.
§ Mr. ROWNTREE
I am in sympathy with some of the remarks of the last speaker. But he has, I think, taken a too discouraging view, because it is reasonable to expect that with a State contribution of two-ninths there will be a considerable reserve, and it may be possible to encroach on that reserve. But I rose to ask the Chancellor of the Exchequer two or three questions, which in his absence perhaps the Financial Secretary to the Treasury can reply to. The first point I wish to raise is as to whether I am right in thinking that in the way in which this Resolution is drawn and in which the Bill is drafted, supposing there was a large body of opinion in this House in favour of bringing doctors within the purview of the unemployed part of the Bill, we should be able to do that. I think from the way in which the Bill is drafted we should be able to. I simply want an assurance on that point.
In the same way I see that the definition of the word "workman" in the second part of the Act excludes all persons under the age of eighteen. I do not wish to argue that for a moment, but it is clear that it gives an inducement to the employer to employ persons under eighteen. I want to ask whether if an Amendment was placed on the Paper to reduce the age to sixteen, or even a lower age, it would be in order. I quite think, from the way in which the Bill is drafted, it would be so. I hope, in connection with Sub-section (c) of Clause 1, that the Government will be very careful to try and work economically from the great centres, One of the points on which friendly societies have prided themselves is their economical management, and one of the criticisms that many of us must have heard from members of the societies has been: "Now you are going to staff a great central bureau—now you are coming into our life, you will largely increase the cost of management." There will, of course, be a certain increase, but I do think it is very important that the Government should be careful to see that there is proper economy in the working from the centre. I do not say I want cheap officials. I want the best officials that can possibly be got, but there is an impression in the country that the Government very often does not manage its affairs so economically as business men, but if the same care is taken as the local societies undoubtedly do take it may 1497 avoid the retort on the part of the latter: "We try to be as economical as possible in the management of our part of the business, but there is great extravagance in the centre."
I want to thank the Chancellor of the Exchequer for what he said last night in answer to a question by the hon. Member for Hoxton. No part of the scheme has excited the imagination, I might even say the enthusiasm, of the country as that which deals with consumption, and I hope that the Government will try to do this part of the work of the Bill thoroughly. If you are going to give sanatorium treatment to insured persons in the interest not only of health, but of the fund itself, you ought to give that treatment to the wives of insured persons. I believe, indeed you ought to go a step further and give it to the dependents of the insured persons. What we have to do is to keep in mind that we must take this preventive measure. On a very small sum of money the cure of young persons in the incipient stage of phthisis may be effected, but if you let it go on for a few years the amount to be spent on that person will be many fold. I believe it would be not only in the interest of the health of the people but really in the final interests of the economical working of this scheme to take in the wives and dependents of insured persons. That may probably mean an enlargement of the State Grant, but then we have been told that if a case is made out it will be possible to recommit this Resolution in order to deal with this point. I do not want to argue how that can be done. I hope the Chancellor of the Exchequer, with the open and receptive mind which he has, will try and see this case is met. I believe it would receive the almost unanimous assent of the country. Personally, I would far rather see a smaller capital sum spent upon the erection of buildings and a larger grant year by year from the State to deal with the sanatorium benefit in other ways, but I do not wish at this stage to suggest how the matter should be met, except to urge very strongly that it should receive sympathetic attention from the Chancellor of the Exchequer.
I think the great value of the Resolution which provides the money for the Insurance Bill is that, after the Bill passes, the mind of the nation is going to be centred on the health of the nation. It will in future be to the interest of individuals and of communities to keep health, and with that thought in mind I cannot help feeling the most telling criticism that has 1498 been urged against the Bill, and therefore against this Resolution, is that we do not provide for that section of the community in which there is most untreated sickness, and in which the deficiency has been most clearly revealed. This Resolution provides no money for the 7,000,000 of children of school age, where the lack of medical attendance is known to be responsible for an excessive death rate, and for the enfeeblement of many. You cannot, in the case of those children, say the disease has been brought on by moral fault or by personal shortcoming, and you cannot say that in curing that disease you will have trouble with malingering, and so forth. I do feel strongly this Bill would be strengthened if in some way it could deal with that branch of the question. The Bill is going to be administered by thousands and thousands of people in the country, and it is immensely important they should feel that the statesman who drafted the measure not only gave them the power to relieve sickness and suffering in the way that has been suggested, but, far more than that, has given them every encouragement and help in preventing those diseases and sicknesses which this Bill is to cure. I therefore hope the Chancellor of the Exchequer will not altogether close his mind yet on this question of dealing in some way with the children. I believe nothing would so strengthen the Bill on the hold of the people than to know this point has been effectively met.
§ Sir PHILIP MAGNUS
The Chancellor of the Exchequer, in replying to my right hon. Friend the Member for Fulham (Mr. Hayes Fisher), took occasion to say that members of local authorities and indeed Members of Parliament must expect occasionally to be scolded for their acts by their constituents. I think he went further, and scolded very strongly my right hon. Friend for his own individual action, not only as a Member of Parliament, but also as a member of the London County Council. He gave my right hon. Friend a lecture, which I have no doubt he will take to heart. I find myself in the same position as almost every speaker on either side of the House with regard to this Resolution. It has been said over and over again that we are all in favour of the Bill. We all want to do all we possibly can not only to cure, but also to prevent illness among the people of this country, but we are heavily handicapped in the opportunities afforded us of dealing with this important subject. The first difficulty has been pointed out by every speaker. It arises 1499 from the way in which the Clauses of this Resolution have been placed before us. Personally, I was very anxious when I came to the House to-day to move an Amendment to Clause 1, Sub-section (a), paragraph (1):—
"As respects medical benefit, at least one-half of any excess expenditure on medical treatment and attendance … for insured persons which may be sanctioned by the Treasury."
I was told at once by my own friends that would be immediately regarded as out of order. Therefore, one is pre vented from suggesting almost any improvement in the administration of this fund by the manner in which these particular Clauses have been drawn up. I can only hope the Chairman of Committees, as this Bill comes to be more thoroughly discussed in detail, will show a larger amount of latitude than I venture to think he is disposed to do in the consideration of the various Clauses. My hon. Friend the Member for the Glasgow and Aberdeen Universities (Sir Henry Craik) was called to order several times last evening for making suggestions which were of urgent importance in connection with this Bill, and I am glad to say my right hon. Friend (Mr. Hayes Fisher) has fully justified many of the remarks which were then made. The point he raised has not yet been answered. Supposing, as appears to be the case, the Treasury is unable, after this Resolution has been passed to contribute more than one-half of the excess expenditure, and supposing, as has been suggested, the local authorities decline, except under conditions which will not be easily fulfilled, to contribute the other half, who is going to suffer? Surely, the insured persons, those for whose benefit this Bill is being introduced. Yet under the Clauses of this Resolution in cases where the local authorities absolutely refuse to contribute as they are required to contribute one-half of the excess expenditure it will be impossible for the Treasury to make good that half, and the poor persons who are sick or the doctors must inevitably suffer in consequence. Surely, some alteration ought to be capable of being made in order to avoid a great evil of that kind. The Chancellor of the Exchequer, instead of answering the point which was made last night by my hon. Friend, turned round and said the local authorities need not contribute unless they 1500 like. I think it is very desirable under these circumstances they should contribute, but the difficulty in which they will be placed under this Bill is very great. If we look at the Clause to which this refers we shall see:—
"If in any year the amount payable to a local health committee in respect of all persons for the administration of whose medical benefit it is responsible is insufficient to meet the estimated expenditure thereon, the committee may, through the Insurance Commissioners, transmit to the Treasury and to the council of the county or county borough an account showing the amount so payable and the estimated expenditure, and the Treasury and the county council or the council of the county borough shall, if satisfied that the amounts so payable and the proposed expenditure are-reasonable and proper in the circumstances, sanction the expenditure."
If they do so then each is liable, not only the Exchequer, but also the county authority, to make good half of the cost.
It will be an extremely difficult position for any county borough or county authority to say that the expenditure recommended by the health committee is unreasonable, even although they may think in many respects it is excessive, and under these circumstances they will absolutely be compelled to pay one half even, although it falls very heavily upon the ratepayers. The local authority might, of course, state that they will be willing to pay this extra sum if they could have any responsibility in regard to the expenditure, and they might make the condition which has been suggested by the Chancellor of the Exchequer, that they shall have a large amount of control over the expenditure. I should be glad to know when this and other Clauses of the same kind are brought before the Committee, that it will be held to be in order to move-that the local authority shall have the larger amount of control, which it is suggested it is desirable should be placed in their hands. As is well known, the medical profession, as a body, is absolutely united in refusing to allow the administration of these benefits to be placed in the hands of 'friendly societies, and it is understood the Chancellor of the Exchequer has-made some arrangement to meet this, case. I think it quite possible, though I am not in a position to speak in their name, that the members of the 1501 medical profession might be more disposed to allow the administration of the fund to be placed in the hands of the local authorities concerned.
That brings me to another point on which I want information in order that we may be better able to discuss later, in detail, the Clauses of this Bill. The Chancellor of the Exchequer has met a large number of deputations, some, I believe, in private. He has promised all sorts of Amendments. He has promised Amendments to one set of persons which are a little inconsistent, as far as I can understand, with the Amendments which he has promised to another set of persons who have interviewed him. It would be a great advantage to us if we could know, as we do not know at present, what are the Amendments which the Chancellor of the Exchequer has already promised to introduce. It is almost impossible for us to discuss the Bill and to place on the Paper, as we are doing, Amendments which we think may prove of great advantage in making this a really workable measure until we know the decision of the right hon. Gentleman with regard to his own Amendments. The night before last, in reply to a speech by the hon. Member (Mr. Lansbury), he said he had already substantially satisfied all the criticism that had been made by the doctors. Only yesterday afternoon I presided over a meeting of nearly 200 doctors brought together from all parts of the country, and I read to them that statement and there was one unanimous cry of "No." We should like to be informed whether any fresh communications have taken place between the Chancellor of the Exchequer and any persons who profess to represent the medical profession, and as to the promises which he may have made. I regret very much that the Chancellor of the Exchequer is not here in person to be able to reply to the points I have raised, but I am sure you, Sir, will recognise that at this stage of the Bill, when we are about to consider the third Clause, dealing with most important matters, we should desire to know what the Bill is, and what Amendments the Chancellor of the Exchequer has already promised to introduce. I sincerely trust that what I have said may be communicated to the Chancellor of the Exchequer so that he will let us know as soon as possible what those Amendments are.
§ Mr. LEES SMITH
I wish to say a few words in support of the very special appeal which has been made in regard to sanatorium benefits. The hon. Member for Hoxton (Dr. Addison) last night at the request of a great many Members on this, side of the House, put to the Chancellor of the Exchequer a question to which the answer was not very clear. We are asking firstly that medical sanatorium benefits, should be extended to the wives of insured men. It appears to us that half the good will be lost if you merely send a man away and leave his wife at home. It is quite-clear that now that sanatorium benefit has once been introduced it will be impossible' permanently to confine it merely to insured' people. It will inevitably in course of time have to be extended, not only on behalf of the victims but for the safety of the public, to include every man, woman, and child. The Chancellor of the Exchequer indicated that he thought this was a charge which might be borne by the societies. If he means that most of this charge is to be borne by the societies that is an end of the matter, because if they were to undertake this charge they would most dangerously diminish their margin. If it is to be done at all it must be done by special State grant. We know that many appeals have been made to him for extra, expenditure in connection with sanatorium treatment, and a better claim can be made out for special. expenditure on that than on any other benefit under the-scheme. It is the one benefit which I believe the majority of the House would be in favour of extending outside the range of the insured people. That can only be done by special State grants. What we suggest to the Chancellor of the Exchequer is that he should begin now. Let him take a very practical step to make peace with the women by including married women in the sanatorium benefit. He will have to set aside the sum of 1s. 4d. in each case. There will be about six million women brought into the scheme. This will represent a sum of less than £400,000, and; I believe no sum of money set aside in this Bill will give a greater return in the alleviation of suffering. My, experience has been exactly the same as that which was related by the hon. Member (Mr. Rowntree). I believe-all Members of the House who have addressed public meetings on the subject will give the same report, that the mention of sanatorium benefit gives rise to a demonstration of greater gratitude and applause than anything else in the Bill. 1503 If the Chancellor of the Exchequer would now, at an early stage, announce that this benefit is to be extended to include men's wives, I believe he would go far to capture the public imagination. There are mixed views in this House as to what the public reception of the Bill is going to be. I hope he will take a really signal step to make it a popular success.
§ Dr. HILLIER
I think the House will agree with me in the opinion that it is extremely unfortunate this Financial Resolution should have to be taken at this early stage of the Bill. We began with a second reading Debate which was closured after what was very inadequate time to discuss the Bill, and the effect of that was to exclude from the second reading debate many hon. Members on both sides of the House who have given the whole subject very great study. Now we are confronted with this Financial Resolution which, it is perfectly clear, will jeopardise, if it does not actually destroy, many of the most important Amendments on the Paper. I observe, with considerable interest, that, in a speech last night, the Chancellor of the Exchequer made a statement of a distinctly encouraging character with regard to the latitude which he himself would extend, but it is somewhat in conflict with an observation which was made shortly afterwards by the Chairman of Ways and Means. I should like to call the attention of the House to some statements of the Chancellor of the Exchequer on the subject of the Amendments now on the Paper. He said:—I do not wish to rule out anything which the House really wants in the form of an Amendment of the Bill, of course excepting the proposal of the hon. Member for Blackburn."—[OFFICIAL REPORT. (6th July, 1911, col. 1453.]That was reassuring. The hon. Member for Bow and Bromley (Mr. Lansbury) then asked the Chancellor of the Exchequer whether one of his Amendments would be in order, and the Chairman intervened, and said:—That is a question for me. Clearly it would not be in Order."— [OFFICIAL REPORT, 6th July. 1911, col. 1453.]His ground was that it would be in conflict with this Financial Resolution. Therefore it is perfectly obvious, however benevolent the expressed intentions of the Chancellor of the Exchequer may be, that in the course of the Committee Debates a good many of these Amendments will be regarded by the Chairman of Commit- 1504 tee as in conflict with this Resolution, and for that reason out of order. Under these circumstances I venture to think that the least we are entitled to expect from the Chancellor of the Exchequer at this juncture is a definite assurance on some of the vital parts of the Bill.
I think that before we are asked to finally sanction this Financial Resolution we are entitled to more explicit assurances than we have yet had on certain vital points. I do regret extremely that the Chancellor of the Exchequer is, unfortunately, unable to be in the House at the present time. I must say that I find myself in very considerable agreement with certain portions of the speeches of two hon. Members who have spoken on the other side. I refer to the hon. Member for Northampton (Mr. Lees Smith) and the hon. Member for York (Mr. Rowntree). I agree with them in thinking that this measure is before anything else a great public health measure, and that if it is to be a genuine public health measure it should be one which will address itself to the prevention of disease at least as much, and, if possible, even more than to the treatment of disease. I notice that the Chancellor of the Exchequer, with that cheery poetic optimism which so distinguishes him, has chosen to describe his Bill as one for the cure of disease. That is a sanguine view to take. I can assure him, as a physician, that it is not always possible to cure disease, as he may find to his cost at a later stage. But we are all agreed that we are able to introduce measures of prevention, and that from the public health and national point of view it is those measures of prevention which are of the highest possible value. I cannot help feeling considerable misgiving as to whether some of those Amendments which we have put on the Paper may not be ruled out, and that discussion on this important branch of the Bill will be excluded by virtue of this Resolution. I have myself put down an Amendment, which I am already feeling some doubt about. It is to Clause 15, which deals with sanatorium benefit. At any rate, as this is a question which undoubtedly has a financial aspect to it, I should like to take this opportunity of referring to it as there may be a chance of the Amendment not being in order later on.
I attach the very greatest importance to the sanatorium benefit and still greater importance to the manner in which that benefit is going to be administered under 1505 the Bill. I notice that, according to Clause 15 as it stands, it is practically left to the discretion of the local health committees to decide what cases of phthisis shall go to the sanatoria and what cases shall not. That will lead to the greatest possible diversity of practice, and also to considerable confusion. I have no hesitation in saying that if the State is going to address itself to this question of tuberculosis, as I am glad it is doing, it must address itself to the treatment of the advanced cases with even greater assiduity than it does to the earlier ones. The Bill speaks of special benefits and of leaving it to the local committees to decide as to what cases are suitable and what are not. I can foresee a contingency in this which I should very much deprecate. I can foresee the possibility that advanced cases of phthisis will not be sent to these sanatoria at all.
§ Mr. SPEAKER
The hon. Member is arguing a matter which is not relevant to this Financial Resolution. It seems to me that his argument might be relevant to an Amendment of the Clause. Perhaps the hon. Gentleman will explain that.
§ Dr. HILLIER
I ventured to question whether Amendments of that character might not be ruled out of order, because it would be held that they might involve increased expenditure. That is a misgiving which I have, and I have referred to my Amendment as an illustration. I will not labour the point further. I am srrry if I am not in order. I merely mentioned that as one of the Amendments— there are many similar ones—which might come in conflict with this Resolution.
§ Mr. SPEAKER
I do not see that any insured person would be affected. How does the money advanced by the State affect what the local committees are to consider suitable, or unsuitable cases?
§ Dr. HILLIER
I ventured to refer to Section 15, which leaves it to the discretion of the local health committees to decide which cases should be admitted. I think it should be obligatory to make provision for all insured cases of consumption in sanatoria. But it might be argued that that would involve further expenditure. It would be very reassuring to many of us if we could have from the Chancellor of the Exchequer, before the Resolution is finally passed, an assurance on this point and many similar points raised by Amendments of which notice has been given.
§ Mr. LEIF JONES
The hon. Member who has just spoken tells us we must give up all hope of really curing this disease and concentrate on its prevention. I agree with him in emphasising more the preventive than the curative powers of the treatment which may be applied. But I do not want to discuss the particular benefits of a particular form of expenditure at this moment. I wish to express the same sense of the difficulty which I think every Member who has spoken in this Debate has as to what we really can do once we pass this Resolution. I am very doubtful of the wisdom of the Chancellor of the Exchequer in tieing up the hands of the House so tightly at this very early stage of our proceedings, and I think that the Secretary to the Treasury will realise that there is a real doubt in the mind of almost every Member as to what we can do. For instance, the hon. and learned Member for St. Pancras seemed to think that it would be impossible to increase any individual benefit under the Bill. I ventured to' interrupt him and say I thought it would be all right so long as we did not increase the total benefits. But I am not so exceedingly confident of my own interpretation the more I look at the Resolution. I have really risen to receive authoritative information from my right hon. Friend in regard to the position in which we shall be placed. Of course I realise that it is much more comfortable for the Chancellor of the Exchequer to tie our hands now. He will have a complete answer when we try later on to increase benefits. But we do wish to be free to deal with such sums of money at our disposal as we please.
He has already told the House that subject to the limitations we shall do what we please in the way of benefits. If the Resolution is passed as it stands with in (a) the words "sums not exceeding two-ninths of the cost of providing the benefits," can we increase the total benefits to be given under this Act? Does that mean two-ninths of the benefits that are at present in Part I., or of the benefits which will be put in Part I. when we have finished with it? That is the first question I wish to ask. It does seem to me that if we increase the total benefits we increase the two-ninths to be paid by the State and therefore an Amendment having that effect would be out of order. The words, "cost of providing the benefits" do not seem to me quite clear. I understood from the Chancellor of the Exchequer that he had a margin in hand. Does he mean the esti- 1507 mated cost in the Resolution or the actual cost, because if he means the actual cost he is not entitled to spend his margin under the rules of the House, as I understand them. It is nice to have a margin of 10 or 12 per cent. upon which we could make gradual raids until we reduced it to proportions which we thought more adequate. But the terms of the Resolution seem to me to mean the actual cost of the benefits. My right hon. Friend says it may mean that. Then what becomes of the margin which has been provided by the Chancellor of the Exchequer? We can no longer use that margin. He has been led to hope for certain extra benefits, but we can deal only with the benefits actually present in the Bill, or such total amount as is represented by the actual cost of those benefits. I would like my right hon. Friend to explain what becomes of the margin to which the Chancellor of the Exchequer referred, and which he has a hope of using in certain other benefits not at present in Part I? If I am right in my interpretation, he cannot use that margin, because to use that margin would be to increase the total cost of benefits which are at present under Part I. of the Bill. I daresay I may be quite wrong on these points. I should be thankful if I am. What I desire is that whatever the sum of money which the Chancellor has got to place at our disposal we should be free to spend it as we please in the best way possible for those people who will be benefited.
§ Mr. MOUNT
Like every other hon. Member who has spoken, I do feel that there will be great difficulty, tied up as we shall be by this Resolution, in discussing this Bill later on. This Bill depends altogether on finance, and as the hon. Member for Rushcliffe (Mr. Leif Jones) has just pointed out, if our hands are tied in the early stages of the Bill we shall be unable to make alterations at a later stage. What I specially desire to refer to is a matter which was referred to by my right hon. Friend the Member for Fulham (Mr. Hayes Fisher). I feel, like him, that the proposals which are made in the Bill with regard to local finance are hard, and are not, fair to the ratepayers or the local exchequer. I am rather surprised at the attitude which has been adopted by the Chancellor of the Exchequer in regard to this matter, especially when we remember the promises which have been made and 1508 the hopes which have been held out of some reform in the question of local taxation within a very short time. When the Chancellor of the Exchequer says that the local ratepayers got certain benefits and therefore they ought to pay, I do not think he realises what is to my mind the fundamental objection against imposing this sort of charge on the rates instead of putting it on the taxpayer. When we approach the burden which has to be met by the taxpayers of the country, there is some possible way of apportioning it fairly among the different classes of the community. But when you have to place the burden on the ratepayers of a district you can only do it by increasing the present rates, and the result is that you have two men of equal wealth paying very unfairly towards the burden of local rates. If this is as, surely we ought not to have a further burden placed on the local exchequer, unless a very clear case is made out for such a proceeding. In this particular case I do not think that any case has been made out. What is the charge which there is a danger will be placed upon the local ratepayer T It is the excess of expenditure over the medical benefits as administered by the local health committee. I have studied this Bill with great care, and I have been utterly unable to find any indication of the amount which that medical benefit is to be. Everyone who has followed the negotiations which the Chancellor of the Exchequer has had to carry on with the many different interests affected by the Bill must have realised the different hopes that have been held out with regard to the. amount of medical benefit, and it is clear that it is an enormous experiment and a great gamble. It is so especially with regard to the local health committees. They are going to administer the benefits for these people who do not and cannot come into the approved societies. That is a very serious burden, because they are the worst part. The only statistics which the Chancellor of the Exchequer, so far as I understand, has been able to rely upon in drawing up his proposals with regard to this part of the Bill are the statistics provided by the friendly societies. You have got some guide there with regard to the medical benefits of the friendly societies, but that is no guide to the medical benefit, and would be required by those who are outside the benefit societies and are under the local health committees. If these medical benefits are to be tried as a great experiment, the cost of the failure of that experiment, if it 1509 is a failure, should fall upon the Chancellor of the Exchequer and the Treasury, and not in any degree upon the local ratepayer or the local authority. The Chancellor of the Exchequer, in some remarks which he made last night, pointed out that the local authorities need not incur any expense at all unless they sanctioned the expenditure of the money. I would urge that this is not a question of getting sanction from the local authorities before you place a new burden upon them. It is a question of control, and these county councils and borough councils are not in a position on these committees in which they can control them.
It has been stated that the proportion which they will have on these local health committees is to be one-fourth, and that is rather striking when we turn to the Clause relating to Ireland, where we see that their proportion on the local health committees is to be three-fourths. In England their proportion will be only one-fourth, and the others will make up the three-fourths. In Ireland three-fourths are to be members appointed by the councils and one-fourth from outside. I should like to got some explanation of that from the right hon. Gentleman who is representing the Chancellor of the Exchequer today. The Chancellor of the Exchequer last night dealt with the question of the control of the local authorities, the county councils and borough councils, over the expenditure of these local health committees and medical benefits, and he said—I am quoting from "The Times": "They can always say, unless we get control we will not pay half." I venture to say that that is a most unsatisfactory position for the Chancellor of the Exchequer to take up, and he cannot have realised exactly the full meaning of the temptation which he held out to these local authorities. You might have in any one of these districts an urgent need for some extra expenditure upon medical benefits, and yet you may get a council saying, "We are not going to sanction that expenditure unless you give us control on the health committee." I do not think that the Chancellor of the Exchequer would ever have got the friendly societies or the doctors to agree to allow the county councils to be put into control of the local health committees. For myself, I say at once I do not think they ought to be. I would prefer no expense thrown on the local ratepayer, and no control by the councils. I dare say there are some Members who do not agree 1510 with me, but I believe that this, being a national scheme, it ought to be upon an entirely national basis with national funds.
With regard to people who are over sixty-five years of age, I do not think that sufficient provision can be made under the terms of this Financial Resolution for the men of sixty-five who belong to approved societies. The Chancellor of the Exchequer, when this question came up, held out some hopes that at a later stage of the Bill it would be possible to allow these men of sixty-five, and the men between sixty-five and seventy, to come in as deposit contributors. That, I suppose, is all that is provided for in this Financial Resolution. But it would be, to my mind, a very great hardship upon old men who belong to friendly societies, and to small societies especially, if all we can hold out to them in this Insurance scheme is a possibility or the compulsion—I am not clear which it is—or the necessity of joining as deposit contributors. The Chancellor of the Exchequer, in the remarks he then made, used arguments which show how little real value the position of a deposit contributor would have for one of these old men. When a man gets to sixty-five or seventy he expects to get then the real benefit from his friendly society, and I am afraid it will be a great hardship if we can only give him the very small advantages of the position of a deposit contributor. Just at the time when he would join as a deposit contributor he would naturally get a good deal of sickness, and it would take a very short time, indeed, before that wiped out all the contributions he would be able to make as a deposit contributor. I hope that in passing this Resolution we shall not be shut out from the possibility of making further provision in the Bill for the old men, the very best men of the working class, who belong to these small societies. I hope the Chancellor of the Exchequer has realised the importance of this point, and also enter a protest with regard to my first point, the impossibility, as a result of this Resolution, of doing away with the contribution from the local exchequers towards the medical benefits.
§ The FINANCIAL SECRETARY to the TREASURY (Mr. Hobhouse)
Before I answer the questions put by hon. Members on both sides of the House I should like to say a word or two as to the remarks of my hon. Friend. He seems to be under some misapprehension lest a person over 1511 sixty-five years of age may be penalised by the proposals of the Chancellor of the Exchequer. I do not think he need be under any fear of that sort. The proposals of my right hon. Friend will take away from them nothing that they have, will not in any way impede or injure any insurance which they have now made for themselves; it will give an opportunity to persons who have not hitherto insured themselves to gain some, though not the full, yet some considerable measure of assistance from the provisions of the Bill. I was asked three or four definite questions which I think it would be in the interests of the House that I should answer as explicitly and as freely as I can. My hon. Friend, the Member for York (Mr. Butcher), who is not here at present, asked me whether, by the terms of the Financial Resolution, dockers and similar classes of unemployed persons could be brought within the operation of the Bill. There is nothing in the Financial Resolution, as I read it, which would prevent dockers being brought within the operation of the Bill, if that was the clearly expressed wish of the House. I would point out in answer to the question raised by the hon. Member for Rushcliffe (Mr. Leif Jones), who asked whether under Sub-section (a) of the Resolution there can be an increase of the total benefits under Part I. of the Bill. My answer to that is very clear. It would not be in the province of a private Member to increase the charge. It would be perfectly within the province of the Government to increase the charge and to increase the total benefit under Part I. if clearly it was the wish of the House that should be done.
§ Mr. LEIF JONES
Supposing the House increased the charge: We are voting two-ninths of the total benefit. What is the meaning of "total benefit?" Is it the total benefit that may be put in Part I. by the benefit that may be put in Part I. by the House before we have finished?
§ Mr. HOBHOUSE
As I read the Resolution it is open to the Government to increase the total number of benefits under the Bill. What the Resolution does is to provide that the State shall pay under Sub-section (a) of the Resolution in respect of Clause 3, two-ninths, or, in the case of women, one-fourth of the cost of providing the benefits; in respect of medical benefit 1512 in reference to Clause 45, one-half of the excess expenditure; and in connection with Clause 15, a penny a year for every insured person. Under Clause 36 there are certain payments in respect of persons in naval or military employment.
§ Mr. A. MacCALLUM SCOTT
Take an extreme instance. Would it be in order— I do not propose to move it myself—for a private Member to move to increase the sick benefit from 10s. to 20s. a week? The Financial Resolution provides that Parliament will pay two-ninths of the benefits provided, not by the Bill but by the Act, and I take it that this applies to such benefits as may be inserted in the Act.
§ Mr. HOBHOUSE
Yes, but they would be benefits that must be moved by the Government, and not by a private Member. That is my reading of the Resolution.
§ Mr. HOBHOUSE
No. I do not think there is any limitation to the action of the Government. The Government are dealing with the Bill in no party spirit. Already my right hon. Friend the Chancellor of the Exchequer has said that he is open to receive, and indeed has received, suggestions from every part of the House. A question was asked by the hon. Member for Northampton whether the age of eighteen could be reduced to sixteen in Clause 81. There will be no difficulty in that being moved. A great deal of the speeches made ranged over the principles of the Bill and did not closely apply to the question before the House. It has been assumed by hon. Gentlemen on both sides of the House that this measure is going to be used for the charitable relief of a great number of people. That is not so; it is a business proposition in connection with insurance. My hon. Friend the Member for Northampton spoke truly, and, if I might say so, touchingly, of the evils which fall upon many working classes due to the ravages of phthisis. The ravages of that disease are brought home to me in the particular part of the world where I live, and where a sanatorium exists at no great distance from my home. The establishment is always full of patients, who in many cases belong to the poorer classes, and who have been unable to protect themselves and their families against the ravages of that disease. It has been brought home to me 1513 as an individual what the almost unrestricted spread of this disease means both to breadwinners and the families dependent upon them. This Bill really grapples in a tentative form with that problem. It is a beginning of an attack upon the disease in a tentative manner, and it does not pretend to be the final word in relation to the subject. Therefore, in respect of persons who are ready to protect themselves, to assist in protecting themselves against the disease, this Bill merely aids them in doing so. I think my hon. Friend must not regard the Bill as one for charitable relief, but rather a business proposition, by which the resources of the State are brought in to aid thrift, and in many cases the small, and regrettably too small, resources of individuals.
§ Mr. LEES SMITH
It is really an open question whether sanatorium treatment is not more properly a Budget charge altogether than an insurance charge. I think it will have to be a Budget charge, and that it would never be regarded as a business proposition.
§ Mr. HOBHOUSE
As my right hon. Friend has repeatedly explained to the House, his means are limited to a definite amount. I believe the House can see that were we to divert some portion of the resources of the State which are now devoted to one form of benefit, and apply them to another form of benefit in a greater degree, that might be a wise provision, but I think it must be clearly understood by the House that under this Financial Resolution the resources of my right hon. Friend are limited, and are absolutely for the assistance of the class of persons to whom the Bill deals, and cannot in fact be really extended. I think I have given a clear and explicit answer to various questions which have been put to me.
§ Sir ARTHUR GRIFFITH-BOSCAWEN
It is perfectly clear from the answer of the right hon. Gentleman that this Resolution entirely takes away from private Members the opportunity of moving Amendments increasing the benefits. So long as the proportion to be paid by the State was not definitely fixed by the Resolution we could, in the interests of our constituents, move Amendments increasing the benefits or giving additional benefits, because it might always be supposed that the State contribution would be less in respect of other matters. But now that the Government are taking upon themselves this 1514 fixed proportion, whenever we move such Amendments they will increase the total charge on the State; therefore the Government are taking away from private Members the opportunity which they thought they would have. The hon. Member for the Rushcliffe Division (Mr. Leif Jones) said that he doubted the wisdom of the Government in bringing in this drastic Resolution. I certainly do not doubt their wisdom in bringing it in from the point of view of limiting discussion, but it is only right to say that it must make a very profound difference to the attitude of many Members towards the Bill. For my part, I have always supported the general principle, by which I mean the principle of compulsory insurance. I think it is most important, when we regard the fact that such a comparatively small proportion of the working classes insure now, that you should have the principle of compulsion. But if we are to be strictly limited in this way as to the method in which the benefits are to be administered and the administrative machinery, it makes it far more difficult for Members on both sides to support the Bill as they have done in the past.
I wish to say a word on the point of view of the employer. I represent a district where there are many small employers. There are people who just make both ends meet, and they employ a lot of labour. You are putting upon them a very heavy contribution. Under the terms of this Resolution it will be impossible to vary in any way the proportion of the payments to be made by the employers and the State. What will be the result? Knowing as I do the character of these employers, and also the sort of business they are doing, I say that the result will simply be less employment. in many trades. I am all in favour of compulsory insurance, but surely it is very unwise so to bring it about that you lessen the chances of employment and thereby put a much greater burden on the working classes.
§ Mr. LEIF JONES
On a point of Order. The whole Debate is really proceeding on a point which you, Sir, can instantly decide, as you will be in the Chair in Committee. The point is this. What is your understanding of the phrase "two-ninths of the cost of the total benefits?" Are we to understand by that the cost of the total benefits at present in the Bill, or the cost of the total benefits as they will be in the Act when the House has 1515 done with it? That is to say, will it be in order for any Member of the House to move Amendments in the way of increasing the total benefits.
§ Sir ARTHUR GRIFFITH-BOSCAWEN
Does the hon. Member suggest that I am out of order? If not, is he entitled to interrupt me in the middle of my speech?
§ Mr. LEIF JONES
I owe the hon. Member an apology, but he is interested in the same point as we all are, and I thought the ruling of the Chair would settle it.
§ 2.0 P.M
I think the hon. Member interrupted merely because he thought it might be a convenience to Members generally, and not in any way because he thought the hon. Member for Dudley was out of order. In reply to the question put to me, the Resolution states: "sums not exceeding two-ninths (or in the case of women one-quarter) of the cost of providing the benefits specified in Part I. of such Act" shall be paid. The "benefits specified in Part I. of such Act" must refer to the Act when it becomes an Act of Parliament. As I read the Resolution, the Committee will not be prevented from increasing the benefits given by Clause 8, so long as they do not go beyond the terms of the Financial Resolution. The State will have to find two-ninths of that cost. So far as concerns those benefits of which the State finds two-ninths of the cost, they can be increased without going beyond the terms of the Financial Resolution. It does not rest merely with Members of the Government. Any private Member may move such Amendments.
§ Mr. CHIOZZA MONEY
If the Committee decided to increase the benefits by say 100 per cent., would the Government's contribution be correspondingly increased by two-ninths of the increase? Would that be within the terms of the Financial Resolution?
The first part of the question is merely a matter of arithmetic, which the hon. Member is as well able to answer as I am. As regards my ruling, its meaning is that it would be in Order to increase the contribution of the Government so long as it remained at two-ninths of the total.
§ Mr. JAMES HOPE
Would it be in Order to move an entirely new benefit 1516 which is not at present specified in the Bill, such, for instance, as a dowry on marriage?
I would rather decide a question of that sort when I see the terms of the Amendment.
§ Mr. HOBHOUSE
I am not quite clear. What I understand is that you rule that under the terms of the Financial Resolution it will be in order for any Member to propose such an Amendment as will increase the ultimate cost of the Act to the Government. I have always understood that it was the Prerogative of the Crown to propose to the House through the responsible Ministers the expenditure which it was lawful for the House to authorise. I would submit to you whether the ruling which you have now given would not interfere with the practice which has obtained in this House for a very long time past.
The Prerogative of the Crown is exercised in this Re solution which we are now considering. When the Resolution is passed we are bound by its terms, and the ruling I have given is that it would not be transgressing the terms of that Resolution to increase the benefits proposed by Clause 8.
Hon. Members who remember the Old Age Pensions Act will remember that the Financial Resolution in that case was drawn in very wide and general terms, and a great part of the Committee stage was taken up in dealing with Amendments increasing the benefits.
Sir ARTHUR GRIFFITH BOSCAWEN
I think the House will be very much obliged to you for the ruling you have given, because it removes a great difficulty out of our path. I now understand that it will be in order to move either additional benefits, or an increase of an existing benefit, or a variation of the terms which may impose an additional burden on the State, provided always that the proportion is not changed. If that is the position, it obviates a great deal of the difficulty, because many of us want to move Amendments in the interests of friendly societies, of the deposit contributors, and of the 1517 women. If those Amendments were all ruled out of order, unless moved by the Government it would make our position practically impossible. However, as I clearly understand that those Amendments will be in order, it will certainly shorten what I have to say, and probably what other Members have to say, on this occasion.
When the hon. Member interrupted me I was referring to the case of the employers, especially the small employers, and pointing out that practically, under the terms of the Resolution, it would be impossible to change the proportion contributed by the employer, because nobody would propose that additional burdens should be put on the workmen. The only chance would be to put an extra amount of the burden on the State. What I was pointing out was that the employer was really hit twice over by this Bill. He is hit in his contribution as a taxpayer, and because he happens to be an employer. He is the person who, in my opinion, is doing the greatest amount of good for the country, because he is employing labour in our own country. Because he is doing so, he is compelled to pay twice over in respect of this measure. I certainly could have wished, at all events in certain trades where the labour bill forms a very large proportion of the total cost of production, that the State should have taken a heavier burden, and put less on the employer. I wish that, not so much in the interests of the employer, but in the interests of the working men, because I am perfectly convinced that if you put a burden on those trades that employ a great deal of labour, and in which the margin of profit is very small, as it certainly is in many cases I know of in the Midlands, the result will inevitably be less employment. I certainly do not want in a measure, one part of which aims at insurance against unemployment, to increase the amount of unemployment by the other part of the measure.
I was anxious that we should have had an opportunity of taking part of the burden off the employer and of putting an additional burden on the State. That, however, is rendered quite impossible by the terms of this Resolution, and certainly, while I think the Government have been wise in moving it from their point of view of getting the Bill through quickly, at the same time, I think it is very unfair on many members, and it must very much alter the general attitude we take up towards the measure when we are precluded from discussing so many points. I hold exactly the same point of view as the 1518 Labour party which, I believe, wishes to put on the State part of the burden put on the working men. In both cases we are cut out from this discussion by the terms of this Resolution. I will not, after the ruling of the Chairman of Committees, deal with other points I wished to speak about with regard to increasing the benefits given by friendly societies, as I understand that will be in order in Committee, nor will I say anything about deposit contributors, except that when proposing to increase the proportion given by the State many of us will be bound to take a strong line in urging that something more is done for deposit contributors. I really think the right hon. Gentleman can hardly consider the treatment he metes out to deposit contributors to be insurance at all. The deposit contributor pays fifty-two weeks before he can get anything. He will then only get, I believe it is calculated, what is the equivalent of 2½ weeks benefit. At the end of that he drops out. What becomes then of your compulsory insurance? In my opinion a great many will drop out very soon after this Bill has been started and that instead of sweeping everybody into the net you will, owing to the vast number of lapses in the case of deposit insurers, find that you are several millions short of the number you expect.
I think that under the ruling you have just given we cannot move any really substantial Amendment in Committee to improve the position of the deposit contributor. We certainly cannot get any more out of the deposit contributors. They are the very poorest class, and the class for whom especially the Bill was brought in in the first instance. I do not think the right hon. Gentleman would suggest that in this case we should get any more out of the employer, and as a matter of fact they are a class who are constantly unemployed in many cases. The only way we could get anything more for this poorest class of all and the class we all wish, without distinction of party, particularly to benefit would be to increase the contribution from the State. But by the terms of the Resolution, and even under the ruling just given, we cannot vary the proportion even in the case of deposit contributors, and therefore so far as that part of the Bill goes it seems to me that this Resolution entirely precludes any substantial Amendment to improve the condition of the deposit contributors, unless it happens to be moved by the Chancellor himself. Under those circumstances I 1519 would appeal to the Chancellor to take this matter carefully into account, because I venture to predict to him that unless something more is done for the deposit contributor his Bill to a large extent will be a dead letter, and will not have anything like the effect that he intended it to have when he brought it in. I desire to say a word on the question of the local authorities. By the ruling just given, whatever else may be moved it is perfectly clear that we cannot suggest, in the case of a deficiency under Clause 14, that more than one-half is to be paid by the Treasury, and if not more than one-half by the terms of the Bill, the remaining half has to be paid by the local authority. I think the Chancellor of the Exchequer stated, in reply to my hon. Friend, the Member for Fulham (Mr. Hayes Fisher) that the local authority was not compelled to pay half. Is that so?
§ Mr. LLOYD GEORGE was understood to indicate assent.
§ Sir A. GRIFFITH-BOSCAWEN
But it is the fact that they will be compelled to pay one half. Does anybody think that a popularly elected local authority is going to hold up the operations of this Bill because they refuse to pay half of the deficiency? I think that in practice that would be found to be a perfectly impossible position. Therefore, in practice, we are driven to this, that the local authority which has only got a small representation on the Health Committee may be compelled to find one-half of the deficiency. As a member of the local authority, and a very important one, the London County Council, I object to that principle altogether. Our case in the London County Council is worse than it is in other local authorities, because we do not really get as much representation as they do. The Bills lays down that the local committees shall consist, as regards one-third, of the members of the county councils, and of that third a part must be members of the local sanitary committee. The local sanitary committee or authorities in London are the metropolitan borough councils. Consequently we on the London County Council will have to find one-half of a deficiency for which we are in no way responsible, when the only representation that we shall get on the Health Committee that makes the demand is part of one-third of the total. I venture to say, on behalf of the London County Council, that 1520 we shall protest very strongly against that provision, and I protest now that we are precluded from altering the proportion of the amount that we have to pay by the very strict terms of this Resolution.
§ Sir A. GRIFFITH-BOSCAWEN
I am speaking of what I know, but I do not think it does. In London the county council is not the sanitary authority. The metropolitan borough councils are.
§ Sir A. GRIFFITH-BOSCAWEN
Let the hon. Member make his point as re-regards the West Riding. My point is this, that we in the London County Council, out of the county rate, have got to pay one-half of the deficiency, and we only have part of one-third of the representation. That is the position. The Chancellor of the Exchequer says it is not so. He says they are "not compelled to." I venture to say that no self-respecting county council under the provisions of this Bill will agree to the position suggested. The Chancellor of the Exchequer knows that and intends that the county councils shall. We do protest very strongly agains two things. First of all the composition of the health committees, and secondly to the fact that by this Financial Resolution we are precluded altogether from throwing on the Treasury a greater proportion than half—which is the amount mentioned in the Financial Resolution. I must say in conclusion that, as a whole-hearted supporter of the Bill, I regret very much that the Government have chosen to tie us up so closely to the terms of the Resolution. It may shorten discussion, but I do not think it will conduce to the easy passage of the Bill in Committee, and I am sure it will not conduce to improve the Bill, as we all wish to do, before it finally becomes law.
§ Mr. SHERWELL
Mr. Whitley, I wish to make a further reference to an exceedingly important point to which reference has already been made. I wish to make that reference more directly in response to some observations which have fallen from the right hon. Gentleman, the Financial Secretary. The right hon. Gentleman, in reply to my hon. Friends around me, who expressed gratitude for the statement made by the Chancellor of the Exchequer last night in reference to the possible ex- 1521 tension of sanatorium benefits to the wives and dependents of insured persons, stated that he would like to remind hon. Members that, after all, the proposals in this Bill represented a business proposition; they were not a charitable deal. No doubt that is true. But I venture to say in respect of meeting certain needs that are represented in the proposals of the Bill, particularly in the case of sanatorium benefit, that the proposal of sanatorium benefits is not strictly a business proposition in the sense in which the right hon. Gentleman spoke. It is really a benefit proposed because of a partially recognised grave social need. I join my hon. Friends around me in believing that this proposed benefit is from its very need, and because of its hopeful effects, a charge which is properly chargeable upon the central Exchequer, upon the Budget, and not particularly upon the funds of the insurance scheme.
The right hon. Gentleman the Chancellor of the Exchequer gave great pleasure to many Members in Committee last night when he intimated his readiness at the proper time, and in connection with the proper Clause, to consider a possible extension of this sanatoria benefit to the wives and dependents of insured persons. We are very grateful to him for that declaration, but so far as I listened to the right hon. Gentleman he confined the prospect of the possibility of making such extension in connection with Sub-section (1), paragraph (a) of the Financial Resolution. I would remind the right hon. Gentleman —there is probably no need to remind him —that if that extension is to be dependent upon the provisions of Sub-section (1), paragraph (a), it will be, conferring a benefit on a number of uninsured persons at the expense of insured persons under the scheme. I am afraid the Committee may find itself when it comes to face the practical consideration of the matter in the position of recognising a very awkward difficulty in Amendment. Therefore, it is the view of my hon. Friends and myself, that if any extension of sanatorium benefit is to be made to the wives and dependents of insured persons, it can only be made by means of an additional grant from the Treasury in consideration of such benefits.
Although I do not wish to commit the Chancellor to a specific pledge now, it would very greatly relieve the minds of very many hon. Members on this side of the House if he can assure us that if it is found, in consideration of such proposed Amendment, that the money to provide 1522 for such extension can only be found from the Treasury, he would be willing to recommit the Bill, or to introduce a new Financial Resolution, for the purpose of providing the necessary funds. I do not wish to ask him to give a pledge which might in any way determine the decision he may be called upon to make at a later stage of the discussion of this Bill. But I do wish he could find himself free today to give at least an expression—to go so far as to say that he would not be unwilling—should a case be made out, to take even the special step of recommitting the Bill, or reintroducing a fresh Financial Resolution, in order to provide for this very greatly needed benefit. I hold very strongly that the most important object which the Chancellor of the Exchequer has in view in proposing this sanatorium benefit at all will be largely defeated if there are to be a largo class of people in the nation who remain outside its scope and benefit. I think myself, and I think that all students of social facts will agree, that if any person does need the benefit of sanatoria treatment it is particularly the woman, the mothers or the wives, who may easily become vehicles for the transmission of the disease to others. In common with most Members of the Committee, I should have wished that the Bill itself could have been so drafted as to make it unnecessary for us to discuss this Financial Resolution at this precise stage, because I cannot help thinking that when we get into closer contact with some of the positive proposals of the Bill, there may be a very strong case made out for revision, for reconsideration, and for possible readjustment of some of the proposed benefits.
I am very sorry that, for instance, as I understand the terms of the Financial Resolution—although it is possible that the decision recently given by the Chairman of Ways and Means may cover this point—I personally should very much like to have had a free hand at a later stage in the discussion of the scheme, to ask the Committee to consider whether the scheme might not be so reconstituted and reconstructed as to throw the weight of benefit upon the really needy classes of the community, rather than, as I am afraid the scheme as at present tends to do, throw the weight of benefit, the help, the reinforcement of the State, upon that class of the community whose economic circumstances give them a measure of independence not possessed by others of the community. I say quite frankly that my own 1523 view is that I believe a better scheme might have been constructed, which would have drawn a very rigid income limit, and given more substantial benefits to those classes included in the scope of the scheme, than can be the case in regard to the most needy and destitute classes of the community, when so much of the resources and aid of the State are to be given to those of higher income. After all, although this is not a charitable scheme, that it is a scheme which is primarily aimed at giving the relief to a most necessitous portion of our community is emphatically my own view. It is a most important point that when the State does come to the aid of any needy class in the community, it ought to give to that class a substantial measure of benefit and relief. I conclude by expressing the strong hope that the Chancellor of the Exchequer will give myself and my hon. Friends some assurance in regard to the points of sanatoria benefit to which I have referred at the opening of my remarks.
I rise to endorse and to support the last hon. Gentleman, and also the hon. Gentleman the Member for Northampton who has brought forward this question of sanatoria, a question that there has not been sufficient attention given to, either in this House or by the public at large. It is of very great importance that when we start sanatoria treatment that it should be on a very large Scale. It appears to me that the Financial Resolution that limits us to 1d. per head of the insured people—
§ Mr. LLOYD GEORGE
The hon. Member is perfectly wrong. It is not exact to say that the contribution of the State is limited to 1d. It is 1d. in addition to the portion which the State pays for other benefits specified to the men and women. In this respect the men are perhaps suffering a little injustice.
The point I want to raise is not really affected by that. I understand the right hon. Gentleman has made provision which will admit a number of people to sanatoria for free treatment. There is no provision for married women, and for that very much larger class of young women who will become married women, and if you treat this measure as a really determined attempt if not to exterminate at least to allow a great deal to be done towards exterminating this disease 1524 which is so disastrous to the health of the nation at large it is absolutely necessary that everybody, especially among the poorer classes who are unable to make proper provision, and have not suitable houses for the treatment of that disease, that that class of people should be brought in. This Bill, as it stands is on a par with bringing in a Vaccination Act which would say you are to vaccinate every second child. This Bill, as at present framed, only touches the fringe of the disease. The Chancellor of the Exchequer may say "Where am I to get the money to do all this?" I entirely agree with the last hon. Member that if you are going to give benefits, and to try and improve the health of the masses of the people, and you are limited to a certain amount of money it is these people who suffer the most, and who have the greatest necessity for treatment, and who are unable to obtain nourishing food, which is absolutely necessary to check and to prevent disease, it is these people whom we should in the first place consider.
If afterwards the scheme is successful, and if we have a large balance, as I believe we shall, to our credit under the estimate of the Chancellor—because the benefits are very small considering the amount of the contribution—and if at the end of the first year or two it is found that you can bring in people with higher limit of income to the benefits of the Act then it can be done. But it is a most disastrous thing, in my opinion, to start a national scheme of sanatorium treatment if you leave out of that treatment hundreds of thousands of people who are a local focus of infection. This disease is not brought on by individuals through their own carelessness. Where such disease is brought on there may be some excuse for saying that the State cannot interfere. But in this matter the State are bound to see that future generations are not affected with this disastrous disease. Therefore I make an appeal to the Chancellor if he cannot find the money this year, even by deleting some portions of the Bill—and we cut out on Wednesday night a considerable number of people by excluding from the voluntary Clauses people of £160 a year, I hope the right hon. Gentleman will admit these people to sanatorium benefits.
I think it is a most disastrous thing to keep them out. I am speaking now entirely of those who are in need of sanatorium treatment. A man may have £170 a year, but he may have a large family, of whom three or four may be consump- 1525 tives. I say it is a most disastrous thing for the State that these people should not be treated in the sanatorium with a view to wiping out their disease. I am not making this appeal solely on behalf of these people or on behalf of that particular man, but I am making it in the interests of the people who live round about them, and who are in danger of infection.
No provision has been made in this financial Clause for the treatment of disease that may be brought on by a man himself. That is a great blot upon the Bill. They will have free medical attendance and medicine, but I do not see why it should not go a step further. Medical attendance and medicine is of very little use if a man has not food and good nourishment. I am not pleading whether a man is right or wrong in his indiscretion which may have possibly brought disease upon him. But it is a monstrous thing that, because a man has sinned and become unfortunate, to suggest that it should become the duty of the State to handicap him and cut him out of the benefits of this Act. We know perfectly well, if a man is suffering from disease brought on by his own misconduct he did not go out on purpose to contract it, and I say it is vital that the State should try and stamp out all such forms of disease. I hope the Chancellor of the Exchequer will see his way to allowing such people to take advantage of the 10s. a week; and if not that at least some portion would be paid to a man if he is unable to work if he happens to be a married man so that his children may have some help. There is one other point and that is in reference to the question asked by the hon. Member for the London University (Sir Philip Magnus). He represents a large number of the medical profession. I think it is rather unfair to ask the Chancellor to give the House the facts that led him to make a statement in connection with the settlement with the medical profession. It is perfectly well known that there have been deputations to the Chancellor of the Exchequer and interchange of views, and it is also well known by those who are studying this question that no arrangements could possibly be made between the medical profession and the Chancellor until such time as they were submitted on 21st July to the representative medical meeting. Therefore, I think, it is hardly fair to press the Chancellor of the Exchequer at this stage to make any further statement in reference to that question.
§ Mr. HARWOOD
I want to say a word or two with regard to the proposal which has been urged by hon. Members as to the extension of sanatoria treatment. I do so because I have been treasurer for some time of the National Association for the Prevention of Consumption and have taken an active part in its proceedings. Although I do not claim to have scientific knowledge upon this question, I am, nevertheless, acquainted with a great many of the facts connected with it. I want to put this matter from a business point of view. The statistics prove beyond all doubt that it is not much use treating this disease of consumption by taking away one member of a consumptive-stricken family, putting him in a sanatorium, and afterwards sending him back to his home. The whole family should be dealt with. Statistics prove this, and it is beyond all doubt that this is the proper business way of doing it. To take away the leading member of a family and not touch the wife and the children affected is really not good business. We have many statistics in support of this view, not only from this country, but from France and Germany, and there is no doubt that if you are really to do any good in regard to this evil you must deal with it completely.
One hopeful lesson we gather from all these statistics is that if you really do tackle this disease properly you are able to to exterminate it. Where you really grapple with this disease properly you may exterminate it altogether. Reference has been made to the imagination of the Chancellor of the Exchequer. The right. hon Gentleman quarrelled with me the other day because I said he was really a poet. It is the first time I have heard a statesman object to being compared with Shakespeare and Milton, but what I had in mind, after all, was that the connection between the poet and politician is much closer than many people imagine. The real gift of the statesman is imagination, and it is the possession of that gift, dashed with sentiment, which, if I may say so, gives this peculiar power to the Chancellor of the Exchequer. It is a combination of imagination with passion which gives the Chancellor of the Exchequer his power. Here is a field for the exercise of that imagination It is not merely that he may doctor a few consumptive stricken workers, but that he may go forth as a St. George and kill the dragon altogether, which I think he may accomplish if he will rise to the height of this imagination. After all, it is said we 1527 are not engaged on charity. No, but I believe in this Bill we are engaged upon the most businesslike enterprise that this House has ever entered upon during the sixteen years I have been a Member of it. We are engaged upon what will pay the Slate better than anything it has ever done, that is, to make the people healthy. Employers and the public are going to gain and we ought to take a large view of this matter. The greatest element against our success is this disease against consumption. I speak as an employer of a great many people, and I see a good deal of its evil effects. It saps industry and energy from the people and diminishes their health. Therefore, I appeal to the Chancellor of the Exchequer, now that the public has had its imagination fired, and had its attention called to this matter, to deal with it properly. Let us at any rate mark this year and our history by having really attacked the greatest disease that is weakening our strength and diminishing our resources.
§ Mr. AUSTEN CHAMBERLAIN
I am not going to quarrel with the observations which have just been made by the hon. Member for Bolton (Mr. Harwood) that imagination, is one of the most essential parts of the equipment of a statesman, hut if imagination is required to deal with these problems, so severe common sense is required in judging the means by which we can give effect to our ideas. I confess that I am myself a little alarmed at the suggested extension of sanatoria treatment which has been advocated and pressed upon the Chancellor of the Exchequer from certain quarters of the House. There is something to be said for the sanatorium treatment benefit dealt with in this Bill. It is dealt with in this Resolution and in the Bill quite separately apart from the question of general sickness. I think, however, that a campaign against consumption rests upon an altogether different footing from what is the main purpose of the first part of this Bill, namely, insurance against sickness and invalidity. What has been suggested is a public health campaign and is much more germane to the action of the State through its central authority or local authority in stamping out disease than it is germane to insurance. I recognised that the State may be called upon, if this campaign is to be undertaken, to do more in respect of it than it is called upon to do in connection with the ordinary scheme for sickness and 1528 insurance which is embodied in this Bill. I hope the House in its desire to deal with this fearful scourge will not be induced to invest vast capital sums. In this matter we must proceed by experiments, for if we waste large sums of money through ignorance and through imperfect information it will be a misfortune. Do not let us sink large sums of money in providing sanatoria until we are satisfied that that is not only an effective way of dealing with it, but that it is the most effective way having regard to the cost per head of the people treated.
I do not want to develop that subject now, but I invite the Chancellor of the Exchequer to make special inquiry into what has been done in the City of Edinburgh. I daresay he has done so already. I have been much struck by what I have heard of the action taken by that city from colleagues of my own and from persons outside. I believe I am right in saying that in Edinburgh they have found that by treatment of this disease in the home, undertaken, I suppose, at a sufficiently early stage, and with great watchfulness of the cases in the home, they can, with a given sum of money produce a much greater effect upon the total number of deaths from consumption than by treatment in sanatoria. I do not speak dogmatically on this point, and I do not pretend to have the knowledge necessary to bring this subject fully before the House. I have, however, been much impressed by what has been told me by others whose knowledge of the subject is much greater than my own, and who have had special reasons for inquiring into it. I do not want the House to pledge itself to this sanatoria treatment until it is satisfied that the money spent in this way will go further and achieve better results than if it was spent in some other way which might more effectively combat the disease. That is my point.
This leads me directly to another subject about which very little has yet been said, and it directly concerns the finance of the Bill. Most questions do. I think the House must seriously consider the question of the hospitals. It is possible and I think it is even probable, though there is a difference of opinion among hospital authorities, that the hospitals may benefit to a certain extent by being relieved of that class of out-patient against whom they are always struggling and who ought to provide for themselves and not go to the hospital for treatment, but it is quite 1529 clear there will be a vast work still remaining to be done by them even if this Bill goes through. I am seriously concerned lest their power to continue their work should be diminished, as I am afraid it may be unless the provisions of the Bill are altered. I think the Chancellor of the Exchequer must be ready to at least give the hospitals a contribution for such insured persons as require hospital treatment and are treated in the hospitals, because I am quite certain the present revenue of the hospitals cannot be maintained when this Bill becomes law.
§ Mr. DEPUTY-SPEAKER (Mr. Whitley)
I do not in the least object to the right hon. Gentleman putting that question, but I must enter a caveat and say we cannot have a further Debate on it. Otherwise all sorts of questions relating to benefits and not to the raising of money by the State would be raised.
§ Mr. AUSTEN CHAMBERLAIN
I am afraid that is so. I must admit I have transgressed. I was thinking more of the subject than the actual form of the Resolution. I will say no more about it.
§ Mr. DEPUTY-SPEAKER
I do not object to a question of that kind, but I must take precaution against any further debate.
§ Mr. AUSTEN CHAMBERLAIN
I will not dwell upon it. I will come to matters which are pure finance. The first relates to a matter which was debated yesterday, when the Chancellor of the Exchequer was not able to be present, and I want to invite him to correct a statement which has been circulated on his authority, which is inaccurate, and which I think he ought not to allow to go out with his authority behind it. He has talked —and colloquially there may be little objection to it— of the contribution of the State being 2d. for every individual. Ho has put that statement into print in his explanation of the Bill, which I believe is on sale at all the bookstalls. The statement is not correct. It is not a fact that the State gives 2d. for every individual. It gives two-ninths in the case of the men. That is not 2d. per individual. The difference, when you come to deal with the years 1927-8, the later years taken from the actuarial figures, is not small or unimportant. It is a difference of millions. Even in the first year it means a difference, I think, of something over £2,000,000, as shown by the actuarial calculation. It 1530 diminishes thereafter year by year, but for many years the State does not give 2d. per individual, though long after many of us have left the House it may be called upon to pay more than 2d. At any rate, this is a misleading and a wrong statement. It appears to say the House has money to deal with under the Resolution which it will not have. I have no doubt it crept into the written words of the right hon. Gentleman by inadvertence, and was used in his spoken words in a short and colloquial way in referring to a rather complicated thing. It is a thing which he ought to correct. He ought not to allow a document to be circulated under his name with a false statement of such importance in it.
I confess I am myself very uneasy about the financial calculations upon which this Bill rests. The right hon. Gentleman has been obliged to found himself upon the figures of the friendly societies. They were practically the only figures available. He has gone on the best figures he could, and his advisers have left a margin in addition to what is shown to be necessary by such experience of the friendly societies as they have before them. I am very doubtful whether the experience of the friendly societies is a true guide of what we may expect under this Act and whether the margin that is left is sufficient. I say that for two reasons. In the first place, in a very interesting, very lucid, and really very valuable contribution to the Debate yesterday evening, my hon. Friend the Member for Salisbury (Mr. Godfrey Locker-Lamp-son) pointed out that the experience of the friendly societies has been much worse from this point of view in the last few years than it was previously, and that the figures which Mr. Watson, of the Manchester Unity, extracted from the experience of his society has not continued to be true. They were true up to 1906, but since 1906 there has been a material variation for the worse from the point of view of the society. There has been a material rise in the sickness. It is not confined to the Manchester Unity. It is apparently, according to my hon. Friend, the experience of all the great societies and the experience of almost purely agricultural societies as well as of urban societies. That is a very serious matter. If the very figures upon which the Bill is based on no longer hold good according to the latest experience, of course the calculations that are made on the assumption that they do can no longer be trusted.
1531 That is not the only point which leads me to doubt whether we can rely upon these estimates. Assuming that the old calculations of the friendly societies did hold good absolutely up to the very latest information we had, would it be true that they would be at all a safe guide for a universal insurance scheme? The societies will have their numbers very much swelled. They will, no doubt, have to make many medical examinations of new applicants. They will have to make them in a great hurry, and very great numbers of them. People will and must come in after very perfunctory examination, and the class of life with which they will deal will, I think, be materially changed. Not only so, but I think the duration of sickness is likely to be changed. When every man is insured, I think men will be much more likely to claim sick pay and to stop from their work. I am not now talking of pure malingering or pure shirking. I am talking of men who are ill and who are not malingering, but whose illness is not necessarily such that they could not go to work. It may be better they should not go to work. It is quite possible that their chance of a healthy life is better if they do not go to work, but, when you have a universal scheme of State insurance, I think many men of that class, quite apart from the increased danger of malingering, will claim sick pay who would not under present circumstances claim it, or will claim it for a longer period than they would do at the present time. Doctors will have an entirely novel authority under this Bill, and I think that in many cases they will insist that a man shall take much longer sick leave than they have hitherto done. Take the case of a man who stays away from work because he is ill. The doctor tells him he thinks he is fit to go back, but if he does so he is likely to become ill again within six months. A week at the seaside or in the open-air, however, might prevent that. In days gone by, in a great number of cases, the patient would have replied, "I cannot afford to do that; I have no resources." In other cases, the doctor would not make the recommendation, knowing that the circumstances of his patient render it impossible for him to act on the advice. But under this Bill the man will be bound to obey the doctor's orders. He will not be allowed to go back to work until the doctor gives him leave, and I think you will find that, in many cases, in 1532 consequence of this, the expectations as to the length of sickness will be altogether falsified by the mere fact that the doctors will insist that a man shall stay away to make a complete recovery, instead of going back to work imperfectly cured. Nobody can possibly say what will be the effect of these forces upon the total estimate of the cost of administering the Bill. My own impression is that they will lead to a very considerable increase of sickness, or nominal sickness, as compared with the present experience of friendly societies. Of course, a private Member has no means of framing a trustworthy estimate on such a question as this. The Government can get estimates, but even their calculations may be liable to very considerable errors. I am afraid that in this case they have taken too sanguine a view of the probabilities of the claims upon their funds, and that the cost will, as a matter of fact, prove to be much greater than they anticipate.
§ 3.0 P.M.
§ Mr. LLOYD GEORGE
I can only speak again, of course, by leave of the House, but as several interesting questions have been raised, perhaps I may be allowed to intervene for a few moments. The right hon. Gentleman has put a point of view which I think it is very necessary to press on the House, but he will find that, as far as he has gone, the discussion has rather been directed to another point of view. Everyone has assumed we have made a too generous bargain, but I think the points put forward in that respect are mutually destructive. But they ought to be a warning to the House not to incur, at this stage, before we have gained some experience of the way in which the Bill will work, any further liability. We must wait until we see if the money at our disposal will enable us to meet the liabilities already incurred. The right hon. Gentleman said we have based our estimates on Mr. Watson's figures for the year 1906, and that since then sickness has become very much worse. There is one explanation of that, and that is not that the health of the community is worse, but that the Compensation for Accidents Act accounts for an enormous proportion of the increased sickness. Some mention has been made of the question of malingering; I do not suggest anything of the kind; I know that the friendly societies make a real stand against paying twice over. Those who are at the head of the friendly societies of England realise that the percentage of sickness has increased owing to the Compensation Act. Clearly, if a man can 1533 get full pay during the time he is sick, it is difficult for him to resist the temptation to stay at home, and I think such a temptation should not be put in the way of any class. A study of the actuarial figures in this matter of sickness, which represents a very considerable proportion of the sick benefit paid in this country, shows that it represents something like 10 per cent., at any rate it is a substantial amount to eliminate.
The right hon. Gentleman went on to say that we were about to deal with a different class of lives. But that is one of the reasons why I retain the Post Office depositors—the bad lives in the sense of lives already attacked by disease, and therefore deprived of the opportunity of securing club benefits. The moment you eliminate those who cannot pass the medical examination and put them into a separate class there is no reason why the lives should not be as good as those in friendly societies. Take the case of the agricultural labourer. There is a very large proportion, I am not sure it would not amount to 50 per cent., who have not been insured at all; they are very good, healthy lives. The same thing applies to others engaged in a good many open-air pursuits, although they cannot possibly secure high wages. So there will be a very large percentage of very good lives, which will come in, and I doubt, from the purely physical point of view, whether the lives which will come in will be much worse, if at all, than those which are to be found within the four walls of some society or other. The calculations of the Government actuaries are based upon the experience of people who are insured, and who know that they will get not 10s., but very often 15s. or 18s. Therefore, there is from that point of view nothing in the right hon. Gentleman's argument. Indeed, the right hon. Gentleman gave a very effective answer to his own argument. No doubt it is the very worst thing for a man to go on when he is thoroughly out of sorts, and anyone drawing on his own experience will find the same thing, that for every day he goes on working, when he ought to be resting, he has to pay at least seven days afterwards in real and probably much more serious sickness. It is, therefore, much better from the point of view of this class that they should have some guarantee as to provision for their family and medical treatment for them-selves, which will persuade them not to go to work when it is much better that they should have a doctor and be cured. With regard to the right hon. Gentleman's next 1534 point, of course, the State cannot accumulate against its own liabilities. It has to meet them as they come. You could not pay the 2d., not to reap benefits, but to meet deficiencies. That would be an absolutely new method of finance, which no Government has undertaken, and which we cannot afford to make a precedent in respect of. Spread over these years, the Government has undertaken a liability of 2d. against the 3d. of the employer and the 4d. of the workpeople.
My hon. Friends behind me have asked me a question about sanatoria. I should like to consider it very carefully before I can give an answer. I will agree with them to this extent, that if this experiment is a success and it becomes perfectly evident that it is effectively stamping out consumption, it will be a great mistake for the State not to face any liability within reason in order to effectively stamp out this scourge altogether. It would be thoroughly bad economy, because the loss inflicted upon the community by consumption is quite out of proportion to any contribution which we might be called upon to pay. I appeal to my hon. Friends from this point of view. I am a believer in sanatoria, as my hon. Friends are, but it is an experiment. There are doctors in this country of great experience who are not quite so confident as to this being the best method of stamping out consumption. I think it is worth while making the experiment, and it is worth while making it well. I think we have done that. We have set aside £1,500,000 in order to build not necessarily expensive buildings, and I hope we shall not spend it upon expensive buildings, but you must have some sort of structure. It is all very well to say home treatment may be the best, but there are some poor consumptives who have no homes of any sort. Someone suggested that the danger was that this provision will be for the better class. As a matter of fact, ft is for the wretched people who have no homes where they can be cured that these sanatoria will be most useful. I agree that for a man who has a cottage in the country or a decent house in town it may be much cheaper and much more effective, at least it will cover a wider area and produce greater results if you attempt to cure them in their own homes in the majority of cases, but there are many cases in which the only possible way you can cure them is to send them to these sanatoria. I invite the House to try the experiment on this very considerable scale— 1535 £1,500,000 towards building and £1,000,000 a year towards maintaining them.
It is on a very gigantic scale as compared with anything which has been done in this or any other country, and for the moment it is just as much as we can prudently embark upon. It will take some time to build. It will take a great deal of time to organise, and it will take a good deal of time to discover whether it is a success, and therefore, before we commit ourselves to something which is very much greater, and which may involve an expenditure of money and nothing else, it would be reasonable and prudent on our part that we should just begin on this scale, and I have not the faintest doubt if it turns out to be a success that there will be no difficulty in persuading any Chancellor of the Exchequer or any Government to spend much more money upon extending the experiment, making it universal, and completely stamping out the frightful scourge which is ravaging so many homes in this country. We hope to have the advantage of the advice of eminent medical men on our Advisory Committee, who will be able to advise us from time to time as to the best way of expending this money, and otherwise of encouraging efforts for the purpose of stamping out consumption, but it is a mistake for the House of Commons to decide questions of that kind.
§ Mr. AUSTEN CHAMBERLAIN
Do I understand the right hon. Gentleman to say that medical treatment will be available in the home if the local health committee think that it is not necessary to send a case to a sanatorium?
§ Mr. LLOYD GEORGE
I should rather like to take time before answering the right hon. Gentleman to consider whether it would be possible to spend anything on home treatment. The idea was to spend the money on treatment on the open-air principle, and that we should use other funds rather for the purpose of curing in the homes of the patients. My hon. Friend the Member for Huddersfield (Mr. Sherwell) pleaded for a free hand. There, again, I would utter a word of warning. It is precisely in order to prevent a free hand being given in matters of expenditure that this rule was devised, and very wisely devised, that no expenditure should be incurred except upon the initiative and responsibility of the Government, which is bound to take into account the whole field of expenditure, and which knows that it is 1536 face to face not merely with promising the money, but with the possibility of having to find it. Therefore, I am strongly opposed to what my hon. Friend calls a free hand.
§ Mr. SHERWELL
My point was really that there should be freedom of action which would make it possible, not to increase the expenditure, but to reconstruct the scheme so as to give more substantial benefits within the limits of the expenditure the Government are willing to allow.
§ Mr. LLOYD GEORGE
If that is what my hon. Friend means I am entirely with him. I have always taken that view. The right hon. Gentleman the Member for East Worcestershire (Mr. A. Chamberlain) put that point, and so far as he is concerned he is in agreement with the Government that we should not incur larger financial responsibility. He agreed with us also that there should be opportunity for the readjustment of this scheme within the limits of the amount the Government are allowing. I think that the House of Commons ought, within those limits, to have a free hand, and if hon. Members want to alter the scheme of the Bill, subject to that limitation, it can be done. I am not aware of any other point which was put to me, and I would make an appeal now to the House to pass this Resolution, and to get on with the discussion of the Bill. After all this is the Report stage, and it would not be competent for me to move an Amendment now. We have had three-and-a-half hours' discussion on the Report stage to-day, and we had several hours' discussion yesterday. We are only discussing matters which will be discussed and rediscussed at every stage later on. There is not a single point which has been brought before the House in my hearing on this Resolution which cannot be raised later on in the course of the Committee Debates.
§ Mr. LLOYD GEORGE
Not merely can it be discussed once, but, as one of my hon. Friends said, it can be discussed many times, because it will be continually cropping up. It will come up on the question of the relations of the doctors to the finance of the scheme.
Mr. EDGAR HORNE
May I mention a case which has not been discussed at all? It. is a case which has been very much in our thoughts, namely, that of the doctors.
§ Mr. LLOYD GEORGE
That is one of the questions which is engaging the attention of the Government, and I can say also that it is receiving a very great deal of attention. There is no difficulty in connection with it raised by us. It is rather a difficulty in regard to the doctors themselves. I have told the House of Commons that what we want is general criticism of the whole Bill without going into matters of detail on the Report stage of the Financial Resolution. We will have other opportunities for dealing with the different points.
§ Mr. RUPERT GWYNNE
I wish to put a point to the Chancellor of the Exchequer with a view to his giving an explanation in regard to the sanatoria. Are we to understand that the sanatoria accommodation for building purposes is limited to a million and a half plus the expenditure of such sums as the county councils may choose, and is the amount for the upkeep limited to £1,000,000 a year? If that is so, although I think the House will appreciate the Chancellor of the Exchequer's statement that we are wise not to start on too large a scale, clearly, if the benefits to be derived are to be limited, we ought to know what accommodation for treatment in sanatoria will be available. It should be inserted in the Clause.
§ Mr. R. GWYNNE
There is no question of limitation in the Bill. It is no more limited than the contributions each week are limited. It is one of the benefits under the Bill which an insured person is entitled to expect. Surely the right hon. Gentleman should be perfectly frank with those who are going to enter into this legal contract and state that they will get the benefits only if accommodation is available.
§ Mr. LLOYD GEORGE
I am only acting upon the advice of those who advise me, and I am told that the amount provided will be sufficient. If anything further is required, then those who are the Government of the day can extend the accommodation. My own opinion, based upon the advice obtained from competent persons who have studied the question for many years, is that what is to be provided will be adequate to meet all the cases. I am told that only a proportion of those suffering from consumption will be sent to sanatoria at all. The hon. Gentleman is proceeding 1538 on the assumption that everybody suffering from consumption will be sent to sanatoria.
§ Mr. LLOYD GEORGE
The hon. Gentleman is perfectly wrong. The treatment to be provided for persons suffering from tuberculosis does not mean compulsory treatment in sanatoria. That is where the hon. Gentleman is wrong. We are dependent for advice upon the health committees, who will decide. The hon. Gentleman assumed that every man suffering from tuberculosis must necessarily go to a sanatorium.
§ Mr. LLOYD GEORGE
Not at all. They will be sent to sanatoria only if the health committees think it is better that they should go. An insured person has not the right to demand to be sent to a sanatorium against the advice of the doctor and the local health committee. I believe there will be accommodation for all those whom it is necessary to send to sanatoria.
§ Mr. HARRY LAWSON
May I ask the Chancellor of the Exchequer a general question, namely, whether in his financial calculations he has allowed for the increased and the increasing duration of life as shown by the Registrar-General's returns with the consequent increase of liability which has done so much to upset the friendly societies' finance?
§ Mr. LLOYD GEORGE
I certainly think that is a question to be borne in mind. It was constantly borne in upon us that life insurance was becoming more profitable while sickness insurance was becoming less profitable. That is one of the things to be arranged within the limits of our finance. That is why we have provided a considerable margin here. We have realised that that is the case, and I think we are entitled to allow for the health provisions in the Bill, because I believe the health of the community will be infinitely better as the result of the operation of some of the provisions of this Bill. We did take that into account, and made certain allowance for it. It is clear in the words of the Bill itself. An insured person shall not be entitled to sanatorium benefit unless the local health committee 1539 considers that the case is suitable for sanatorium treatment. We have provided sufficient accommodation for all those who would be likely to be sent to a sanatorium. If it turns out in the course of the operation of the Bill that the accommodation is not adequate, then there will be a good case for coming to any Chancellor of the Exchequer, who happens to be here, for State assistance. But at any rate that cannot arise for several years to come.
§ Sir F. BANBURY
My right hon. Friend below me advised the House to be careful about entering into all sorts of schemes which are ostensibly for the good of the community, but which are in an experimental stage and involve the expenditure of very large sums of money. I have listened for some hours to this Debate, but with the possible exception of the hon. Member for Pontefract (Mr. Booth), who may express his views later on, I have not heard a single Member counsel moderation in expenditure. Every single Member has said he was sorry that there should be a limitation in the Resolution of the Chancellor of the Exchequer because he would have liked to do something or other to benefit various people who are in his constituency, or who are friends of his. Well, I hope that there are a few economists still left in the House. I should not like the Resolution to be disposed of without expressing the views of one economist at any rate on this subject. Instead of joining hon. Members who have spoken in blaming the Chancellor of the Exchequer, the whirligig of time has brought me into the constrained position of congratulating the Chancellor of the Exchequer on this limitation. If I have any fault to find with him, it is that the Resolution is too wide and that there are excessive facilities for spending the money of the nation in a way which I think should not be possible, except, as the Chancellor said, on the initiative of a Member of the Government who has the responsibility, not only of obtaining the credit, which I admit always attaches to people who spend other people's money, but the obligation of finding the money which has to be spent.
In view of the very great burden which is going to be cast upon the nation I would earnestly implore all hon. Members to pause before they desire to add to this great burden. I have been informed—I have not seen it for myself, and I have made no calculation to test whether the statement is accurate or not—that a few 1540 weeks ago a statement was made that within fourteen years from now the burden on the State arising from this Bill and from the old age pensions will be something like £42,000,000. I do not know whether that is correct or not. In all probability there must be some foundation for that statement. Even hon. Members opposite who do not attach very much importance to statements in "The Times" will agree that a journal of that description would not have made the statement without having some reason for making it. If there is any foundation for the suggestion that these two items of expenditure are in less than fourteen years going to amount to £42,000,000, I would urge upon hon. Members to follow the counsel of the hon. Member for Bolton, who seems to consider that the sole attributes of the statesman are passion and imagination; but that they should remember that the real attributes of the statesman are commonsense and a facility for forecasting the future and providing for expenditure which is to come out of the revenue of the moment.
Holding the views I do, and bearing in mind the enormous burden which has already been incurred by the State, I could not sit quiet without expressing my opinion that the House would be running a very serious danger if, owing to the kind-heartedness which distinguishes hon. Members on both sides of the House, they are going, without counting the cost, or considering the responsibilities which they are incurring, to counsel the Chancellor of the Exchequer to incur fresh expenditure. I am not objecting to the hon. Member for Bolton, who described him as being influenced by passion and imagination. But hon. Members will run a serious risk if they are going to encourage him to let those two feelings run away with him and place burdens on the State, which after all is ourselves. Every single individual in this room and in the country is the State. There is no people, apart from ourselves, whom we can use as a milch cow. As the State, we are putting our hands into our own pockets all the time. I am afraid that my remarks will not have much effect upon the House. The other day in the Lobby the Chancellor of the Exchequer told me that there were only two economists in the House: one was myself, and the other was himself. I am very proud indeed that I succeeded in convincing the Lord Advocate last Friday, and that I induced him to withdraw an Amendment. May I point out to the right hon. 1541 Gentleman that it is never too late to mend, even at the last moment, and that he can inculcate the principle of economy in addition to passion and imagination, and if he puts economy first I shall not have spoken in vain.
Mr. EDGAR HORNE
I shall address myself almost entirely to the question of the expenses of the administration of this Act. They come in under three Clauses. Clause 3 is the one which has been principally spoken about. We have the words "defraying the expenses of the administration of these benefits." I should be very glad if the Chancellor of the Exchequer could give us some assurance as to certain expenses which are going to be thrown upon the shoulders of the smaller benefit societies of this country. They will have the expenses not only of valuation, but also the cost of fresh schemes of benefits and the printing of new rules and regulations. Many of them are small in membership, their funds are limited, and this means to them a very serious cost, and one which, as they have put it to me, might fairly be borne by the State. In the same way, at the end of the Second Part of this Act, the expenses are put forward under the unemployment heading. As I understand that the Treasury—I want to put it courteously—are going to job the expenses. They are going to take 10 per cent. of the gross receipts, and to pay the expenses out of that 10 per cent., whatever they are. The Treasury may be a little bit in pocket or a little bit out of pocket. In Clause 41 we get the part referring to the Insurance Commisioners. They may "appoint such officers, inspectors, referees, and servants" as they think right, and the money shall be provided by Parliament in respect to such officers, inspectors, referees and servants. No sum of money has been allocated to that, and I should like to draw attention to the enormous central offices that there will have to be in future.
I think many of us do not realise the enormous scope of this Act and the enormous number of people who are going to be brought in, and the wonderful counting of the people that is going to take place under the Act. It far exceeds what has been done by the Census with regard to these particular people. You must have the name of the insured person, his address, his age, whether he is married or single, the name of his employer, the address of his employer, the class of work he is engaged upon, particulars of the wages he receives, and of other benefits he may 1542 also receive. Very often you will also want to know the state of the man's health. That will all have to be put upon cards and carefully tabulated and kept. Then that central office will have to bear the cost of checking these weekly contributions. There will be more than one contribution, two at least. The head office will have to verify the man who possesses the cards and the stamps upon it as the actual man who is insured in respect to that card. There will be the great question of removals, because I think I am speaking what is correct when I say that probably in every 100 members of an approved society five of them will have moved away to another approved society at the end of the year. There will have to be a valuation made for every man, and fresh valuations when he has to go to a fresh approved society. The Post Office contributor would have to have a particular valuation, very carefully made. This is one of the biggest ledger accounts that has ever been owned by any firm. It will require the very greatest care. It will be an account of great difficulty, and the cost I am afraid will be very large if the work is properly done. I should have liked to have had some idea of what the whole of this cost is going to be. My own idea is that it would be some hundreds of thousands of pounds when this office gets into proper order. Passing away from that, we will not be able to alter Clause 9 in one particular respect. As the Bill stand if there are two men in a society, two brothers entering at the age of forty-three, and one falls sick at the end of twenty-six weeks he will get 10s. for his sickness pay. But if the other man does not fall sick until he is just over fifty he will not get 10s. a week, he will only get 7s. a week.
Mr. EDGAR HORNE
The only point was that it would increase the benefits, and I understand we cannot increase the benefits when we reach the Clause.
Mr. MONTAGUE BARLOW
There are two points which have not already been referred to on which I think the Chancellor of the Exchequer might give assurances which would relieve the minds of people in the country. I join with those on both sides of the House who have expressed the difficulty which they feel upon voting upon this Resolution. It is quite obvious it is 1543 very difficult to vote either for or against it. But turning to another point, the Chancellor of the Exchequer said that, giving the maximum benefit, the maximum State assistance, which is calculated for in the Bill, it is within the province of the House to deal with it in these Resolutions. I would ask him really whether that is so. Whether it would be within the purview of the House to deal with and allocate the whole amount which is provided for in the Bill, and the adjustment of it? Because the Resolutions, as it seems to me, allocate the amounts in such a way that it is impossible for the House to deal with the whole allocation after the Resolutions are passed. With regard to local authorities, their case has been fully put this afternoon. The Chancellor has repeated, more than once, his statement that it is absolutely within the discretion of the local authorities whether they will grant the half or whether they will not. The words of the Section are that the local authority is to be satisfied that the amounts payable as well as expenditure are reasonable and proper. There is no doubt that the Treasury would have to satisfy themselves, and I do not think pressure could be brought to bear upon them. But supposing the local authority refused absolutely to pay any portion of the half. Then, speaking as a lawyer, I think there would be no difficulty in taking such steps as would compel the local authority first of all to consider the question as to whether some expenditure would not be reasonable and proper, and, eventually I think, the Courts would take upon themselves to decide, not directly probably, but indirectly—
§ Mr. LLOYD GEORGE
I have considered this question as to the county councils and I have undertaken to agree to any words that will make the point perfectly clear, and this may meet the object of the hon. Gentleman.
Of course it is one of the difficulties, as was pointed out by the hon. Member for London University, that we do not know the arrangements that have been made. There is complete discretion given in Clause 45 of the Bill, while Clause 15 does not give a complete discretion, but if "words have been drafted to meet my point, then the matter is settled. Then there is the question of the doctors in regard to Part II. It is a very serious and, if I may say, Sir, a very difficult question. We have got an assurance— 1544 and I am very glad we have got it—from the Chancellor of the Exchequer that we are not to be precluded from raising the question of unemployment benefits as far as dock labourers are concerned. I should like, if I may, to respectfully call the attention of the right hon. Gentleman to the words of the Resolution. I should have thought there would be great difficulty in discussing this question in view of the way in which the Resolution is framed. The words are:—
"A contribution not exceeding one-third of the total contributions received from employers and workmen in any year towards the cost of unemployment benefit and other payments to be made out of the unemployment fund established under Part II. of the said Act, and of a contribution by way of repayment to associations of persons of a part (in no case exceeding one-sixth) of the aggregate amount expended by such associations in payments to persona while unemployed."
That means the unemployment fund is provided for with all the conditions and liabilities and arrangements as made under Part II. of the Bill. That must be Part U. of the Bill, I take it, as at present drafted. If that be so, I cannot see how we shall be in a position at a future stage to submit Amendments. I have an Amendment down as one representing a constituency where there is an enormous number of dock labourers, who—I think this is common ground—feel somewhat aggrieved that their case has never been put to the House; either in debate or otherwise. I have an Amendment down, and I hope I shall have an opportunity of bringing it to the attention of the House, but I do not want to be shut out by the Resolution as drafted. I trust the Chancellor of the Exchequer will give me an assurance that I shall have an opportunity of submitting my Amendment.
§ Mr. LLOYD GEORGE
I have already consulted with the authorities of the House, and I am advised that there is no difficulty about moving an Amendment; but if there should be any difficulty the Government will put the matter right.
I do not wish to go into the case of dockers now, because that does not arise on the Resolution. With the assurance of the right hon. Gentleman, I hope that when my Amendment comes to be moved, it may have some support.
§ Mr. AMERY
I do not think the Chancellor of the Exchequer quite appreciates 1545 the nervous apprehension and uncertainty with which a great many Members who are interested in this Bill approach the Resolution before the House. I note in the speeches I have heard from a great many Members during the last few days a note like the bleatings of a flock of lambs driven along some unknown and unfamiliar way which they surmise may lead to the butcher. We have no doubt most pleasant assurances from the right hon. Gentleman, but we still feel a certain anxiety that we may be in a trap, that it may be found impossible after the Resolutions are passed to bring forward some Amendments of the greatest importance. The right hon. Gentleman opposite on a previous occasion boasted that he had caught some large rats elsewhere, so that some of the small mice on these benches do feel that they may be caught too. I mean that there are Amendments dealing with questions of importance, such as that of women for instance, which it may not fall within our power to move after the Resolution has been passed. We may some of us wish to move in the case of married women a small contribution for them, added to a corresponding small contribution from the State, providing a certain limited benefit only. That may mean some addition, I trust not a heavy one, to the expenditure, but I doubt whether we should be free to move those Amendments. Again, there is the question of the young person under sixteen, and the question of altering the nature of the deposit fund into one for real insurance. The Chancellor of the Exchequer has invited us to help him in making the Bill the best measure possible; therefore, I do not think he ought to do anything that would preclude us from moving Amendments. As he has appealed to us, I think we can respond and be reasonable on questions of finance. If he objects on grounds of expenditure, I think Members will take full cognisance and be reasonable. What we do feel is that he has introduced a measure of a certain character, an immensely contentious measure, and that no Amendment which can improve that measure should be left out of account. The hon. Gentleman the Member for the City (Sir F. Banbury) has impressed upon us the need of economy, but I am not sure that even certain proposals for economy would be in order. It might be possible to increase the proportion of benefits under this scheme, and yet to diminish the total expenditure under the scheme. We might either reduce the income limit severely, which would 1546 enable the State to contribute proportionately a much larger amount, and yet not incur a greater gross obligation. There are even more drastic Amendments for which there is a great deal to be said. The scheme might be made to apply to the younger generation only, limiting it to from twenty-five years of age up to thirty years of age, and to let the scheme grow up gradually. I think a number of proposals might be made with the object of getting an improved, uniform and more equitable scheme, giving greater benefit to those who come under it. For that reason I should like to ask the Chancellor of the Exchequer not to tie the hands of a friendly House too early on a measure which we all desire to make the best measure possible—a measure of immense difficulty and complication, which only a small fraction of the House have studied accurately, and which even three-fourths of those who have attempted to study it are still very far from fully comprehending. It is undesirable in the case of a measure like this that anything should be introduced at this early stage to fetter the freest discussion and the amplest powers of remodelling or remoulding the whole measure.
I had not the advantage of hearing the Chancellor of the Exchequer when he spoke just now, but I understand that he said he had never stated that the State contribution would be 2d., but that what he actually said was that it was equivalent to 2d. I do not want to repeat what I said yesterday, but if the Chancellor of the Exchequer thinks I misrepresented him I should like to make it quite clear.
§ Mr. LLOYD GEORGE (was understood to say)
I said in the House that it was the equivalent of 2d., but I may have often said in the course of speaking, "2d.," "3d.," "4d."
I do not know if the Chancellor of the Exchequer read the report of what I said in the OFFICIAL REPORT yesterday, but, unfortunately, it is not quite clear there. It will be within the recollection of the House that I said that the Chancellor of the Exchequer, when speaking on the subject in the House, said the contribution was equivalent to 2d., and that conversationally he called it 2d. I do not object in the least to that method of talking in the House, but in the country it is a totally different thing. When the Liberal Publication Department keeps on repeat- 1547 ing that it is 2d. it is time that we drew attention to the difference between 2d. and the amount actually to be contributed.
§ Mr. PRINGLE
His point was in reference to publication by the Liberal Publication Department, for which the Chancellor of the Exchequer and the Government are not responsible.
§ Mr. SPEAKER
The Government are not responsible, but that does not prevent the hon. Member from referring to it.
As long as I have made my point clear I do not wish to elaborate it. As the Chancellor of the Exchequer does not think that I intended to misrepresent him I need not refer to the point further. But I should like to ask whether it will be in order for us in Committee to move that the contribution by the State should be 2d. instead of two-ninths. Seeing that the Chancellor of the Exchequer states that it is exactly the equivalent of 2d., it would not increase the cost to the State in the long run, though I agree that it would make a material difference to the amount which the State would have to find in the early years. As this is not an annual Budget, but a Bill creating an actual guaranteed charge of two-ninths of the cost of the benefits, which will mean a large liability, I wish to know whether it would be in order for us to move that the liability shall be met in the form of weekly contributions instead of subsidised benefits. It is not a point which arises immediately upon this Financial Resolution, though I suppose it is open to us to discuss the whole question whether it ought to be contributions or subsidised benefits. There is an Amendment dealing with the subject on the Paper, and it is most desirable, if it is in order, that we should have an opportunity of discussing the point. I do not know whether Mr. Speaker could give a ruling upon it now, or whether he would desire that it should be raised later on when the Clause is before us.
§ Mr. PICKERSGILL
Is the hon. Gentleman in order in asking you a question as to what may be done in Committee?
§ 4.0 P.M.
§ Mr. SPEAKER
I cannot anticipate the ruling of the Chairman of Committees. I have no control over the Committee. In fact, officially, I do not know that it exists until it reports to me at the conclusion of the proceedings. Therefore I cannot say anything which would tie the hands of the Chairman of Ways and Means, who no doubt will deal with the matter, and deal with it adequately, when it arises.
§ Sir GEORGE DOUGHTY
I wish to associate myself with those who think that this Resolution seriously curtails the opportunities of many of those who are interested in this scheme. I have an Amendment on the Paper which I am afraid this Resolution will make out of order. Personally, I think that no married woman with dependents ought to be called upon to contribute anything towards this particular scheme. In my judgment it will bring a serious hardship upon a large number of people, who have never been consulted as to whether they are desirous of making any contribution whatever. Seeing that a great hardship must ensue to the very poor, especially those receiving wages of less than 16s. or 17s. a week, I was hoping to bring before the House a proposal to exclude all persons in receipt of such small wages from any contribution whatever. I know that that would add considerably to the cost of the scheme, and I am afraid that this Resolution will prevent me from putting before the House the reasons why I think these people should be excluded, and the sources from which I believe the money could be obtained. I would rather the State were required to find the money for these very poor people than that there should be exacted from them in the way proposed a sum of money which will largely increase the extreme poverty in which they are living at the present time. I regret that no Member of the Labour party has endeavoured to put this aspect of the question before the House. There is no doubt whatever that this Bill will confer great advantages upon the working classes generally, but I feel very strongly that sufficient attention has not been given to the position of those who are exceedingly poor, and upon whom the Bill will press much more heavily than upon any other section of the community.
If this Resolution is passed, it will not be possible for anyone to propose an Amendment which would mean throwing an additional £3,500,000 upon the public funds. My hon. Friend (Sir. F. Banbury) 1549 said that he would not. From his point of view ho is right. He represents the City of London. But those who represent exceedingly poor people know that there are hundreds of thousands of persons living by casual employment who are receiving 15s. or 16s. a week, and women with dependents requiring assistance who are not drawing more than 8s., 9s., or 10s. a week. Out of the small earnings of these people, you are going to take what is to them a very large sum. Rather than that the extremely poor should be called upon to pay it, I would prefer that the hon. Baronet and his friends were required to do so. That is the difference of view between him and me on this particular subject. I am sorry that there will be no opportunity of moving a Resolution which would exempt altogether all those poor people from being required to pay a contribution that they are not in a position to pay, and that means to them great suffering if you insist by Parliamentary law that they shall become contributors to this scheme. If the people had been consulted about it it would be quite another matter, but you are going to impose on them for the first time by law that they shall pay a workman's Income Tax on which they have never been consulted in any way. While I am quite willing to exact a charge from men who can afford it, I say that the House of Commons ought to hesitate before they press the poor in the way this Bill will unquestionably press on those persons who cannot earn sufficient for the daily necessities of life. I hope that the Chancellor of the Exchequer will see that I may have the opportunity of raising this question in its entirety before the House of Commons, and I believe that not only in the House but in the country there will be a very strong volume of opinion to reduce this contribution from the poor, as it will press on those at the bottom of the ladder, and to see that those who have great wealth will assist those who are comparatively poor.
§ Question put, and agreed to.