In page 66, line 5, leave out the word "quinquennium," and insert instead thereof the words "fixed grant period."?—[Mr. Chamberlain.]
§ Sir LESLIE SCOTT
I beg to move, in page 66, line 5, after the word "quinquennium," to insert he words "after consultation with approved voluntary associations."
Very shortly the point is this. Under Clause 83 the essence of the scheme obviously is that the local authority should consult with the voluntary associations doing maternity and child welfare work. The manuscript Amendment which I have handed in imposes a statutory duty upon the local authorities to consult with the approved voluntary associations before framing the scheme. I suspect the Minister's reply will be that it is of the essence of the scheme that the local authority shall in every case consult the voluntary association before forming the scheme to submit to the Minister, but we all know that local authorities vary in outlook, and perhaps even vary in quality, and that some take more interest-in the subject than others, while some may even be indifferent. It occurred to me that probably, if that was expressed as a statutory obligation upon local authorities, it might be an advantage and it would certainly allay some degree of anxiety felt to-day by a good many of those who are really interested and keen in this work. I therefore move this Amendment, and the approved voluntary associations referred to in it will be defined by a later Amendment.
I am much obliged to my right hon. and learned Friend for giving me notice that he proposed to move this Amendment. I note his prescience in anticipating the answer I shall give him. It is perfectly true that it is unnecessary to put these words in here, because it is quite impossible—I think it must be obvious—for any county 676 or county borough to prepare a scheme of this kind without consulting the voluntary associations. They are to have a scheme in which they are to secure the payment by the councils of contributions towards the expenses of the voluntary associations. They must find out what those expenses are going to be, and they can only do that by consulting the voluntary associations. They must know, not merely what the voluntary associations have been doing, but also what they propose to do and are capable of doing. I cannot conceive the possibility of the submission of a scheme without their having first consulted the voluntary associations. There is an additional security, for the voluntary association has always the power of making representations to the Minister, and these schemes cannot become operative until the Minister has given his approval Therefore, if the impossible were to happen, and a county council or county borough council were to submit a scheme without having consulted the voluntary associations, who were the subject of the scheme, it would be quite open to them to represent to the Minister that they had not been consulted, and that in the scheme proper account had not been taken of their purpose or their finance. I am quite certain that the Minister would at once send the scheme back for consultation. I hope my right hon. Friend will not think it necessary to press this Amendment.
§ Sir JOSEPH NALL
I appreciate what my right hon. Friend has said, but I do not think it quite answers the case. It is conceivable that some authorities will make their schemes without adequate consultation with voluntary organisations. May I give my right hon. Friend an instance in which an obvious case for consultation has been provided for? The relief of freights was to be carried out in consultation with the railway companies, with no consultation at all with the shipping interests interested in these rebates. Now that representations have been made, my right hon. Friend is ready to go back on what has been done. We 677 do not want these voluntary associations to be in the same position with the local authority when, in due course, it frames its scheme and either forgets or neglects to consult the people who are most particularly concerned. If the Amendment only emphasises what my right hon. Friend thinks ought to be done, I cannot see any objection to putting it in the Bill.
§ Sir L. SCOTT
After what the Minister of Health has said, I beg to ask leave to withdraw the Amendment.
§ Amendment, by leave, withdrawn.
§ Mr. GERALD HURST
I beg to move, in page 66, line 28, at the end, to insert the words:and shall have power to include in the scheme provisions whereby—The object of this Amendment is to widen the ambit of the scheme provided in Clause 83. As it now stands, the assumption is that the scheme is a narrow local one. The rates affected are the rates of the county or county borough, and the benefits are the benefits of the people living in the county or county borough. Prima facie the whole ambit of this Clause is local. According to the information I have, a large number of maternity homes are not run on local lines at all, and it seems to be essential, if the scheme is to meet their needs, that it should be based on a wider foundation than consultations and the making of schemes between the Minister and the county or county borough. To illustrate how very wide is the influence of these maternity homes, I have had figures given to me by the Manchester branch of the Society for the Unmarried Mother and her Child, with regard to one of the Manchester homes, and of the last 60 eases which have come to that home only 15 are 678 local. Twelve have come from Cheshire, 12 from Derby, four from Nottingham, three from Shropshire, and there are also cases from Wolverhampton, Birmingham, Wales, Leeds and Lincoln.
- (a) contributions towards the costs of inmates in a maternity home within any county or any county borough may be required from and enforced against the council of any other county or county borough where any inmate normally resided before entering the maternity home;
- (b) arrangements can be made for the exchange by and between two or moro counties or county boroughs of the liability to take inmates into maternity homes; and
- (c) the duty of periodical inspections of maternity homes may be vested in officers of the Ministry of Health in lieu of or in conjunction with officers of the council of any county or county borough."
The reason is that people with a view to secrecy prefer to go to maternity homes long distances away, and that seems to me to be a very sound idea with a view to the proper use of maternity homes. If that is so, and if it is important for maternity homes that a much wider area than that of a mere town should be considered, then the language of this Clause seems to be narrow, and in order to enable the Minister in proper cases to form a scheme on larger lines my Amendment would give him power to include in the scheme paragraph (a), whereby contributions towards the cost of maternity homes in any county or county borough may be required and enforced against the council of any other county or county borough. It is a matter of doubt whether the language of the Clause is sufficiently wide to cover contributions from areas other than the area of the county or county borough mainly concerned. That is the object of paragraph (a) of my Amendment. The object of paragraph (b) is to provide for the exchange of patients between distant areas, the main motive, being to encourage women to go to these homes without incurring the scandal of local publicity.
Paragraph (c) of the Amendment means this. Assuming, as I think is the fact, that the working of these maternity homes is not local in any sense, but national, it does not seem unreasonable to ask that the scheme should lay emphasis upon visits by representatives of the Ministry of Health rather than visits by members of a local authority. I have been told by those in charge of these maternity homes that they would prefer to be under the direct supervision of the Ministry of Health. Probably under the Bill they would have to put up with inspection by officers of the local authority, and it seems right, therefore, that, if possible, the duty of periodical inspection should be on the Ministry of Health in lieu of or in conjunction with the officers of the county or county borough. I do not think the Amendment in this respect is in any way out of harmony with the object of Clause 83. I am 679 not absolutely certain that the language of the Clause is wide enough to cover these particular points. It is doubtful whether it covers paragraph (a) and paragraph (c) of the Amendment, but, whether that is so or not, it seems right that this particular aspect of maternity homes should be emphasised, and that the Minister should be empowered to make provision for the wants which have been expressed by a large number of these maternity homes.
§ Miss LAWRENCE
I recognise fully the excellent intentions of the hon. And learned Member who has moved this Amendment. He is trying to meet a difficulty which has distressed these charitable societies more than any one thing I can remember, but I am very doubtful whether his proposal goes far enough. I am going to give my reasons why I think the Amendment, though very well-intentioned, will not remove the fears which have been expressed by these charitable organisations. Charitable organisations interested in voluntary health services have been besieging hon. Members to help them from the operation of this Clause. I have in my hand a resolution from the Council for the Welfare of the Unmarried Mother and her Child. It could not be more strongly worded. I have also resolutions from various other charitable associations all over the country, from Shrewsbury, from Shaftesbury Home, in London, and from other places, and also a resolution from the British Council for Social Hygiene. I leave the view of those societies interested in the question of venereal disease to other hon. Members. I want to put to the Committee what it is that distresses so much those who have the care of these maternity homes, and to explain why the Amendment does not really meet the situation.
There are a great number of charitable societies concerned in the care of the mother and her child. They deal mainly with that class of mother who does not go to the workhouse, that class of person where the fear of discredit is so great that the danger of child murder or abortion is very serious and real. The central feature of their work in dealing with this class of patient is secrecy. At the present time they have homes in 680 different parts of the country, and the essence of their practice is to send people from one part of the country to another part right out of their own circle and home, as far away as possible, and they do this in order to enable the mother to get over her period of distress and make a fresh start in life, and have a little quiet time in which to learn to love her baby. The important thing is to get her away from local gossip, very often to get her away especially from the family itself. I cannot put it more strongly than it has been put in the words of some of these maternity homes. They give particulars of various cases in which they emphasise two things. First, they put the case that where the father is a married man it is necessary to get away from the locality; and, secondly, the fear of the girl of her own relations and even her own father.
In the case of maternity homes conducted on these lines there is no such thing as a local association. They are more in the way of national homes, and the last thing they want is to come under a scheme made by the local authority. At present they get their grant very often 50 per cent. direct from the Ministry. If they come under the local authority there would be raised immediately such questions as whether the institution did serve this or that local authority. The Minister of Health has had a long correspondence with the Association. They give many cases similar to that given by the hon. and learned Member who has moved the Amendment. He gave cases from Manchester. There are cases in London, institutions in London, where the bulk of the patients come from outside. They come from all over the country. These maternity homes say that if they come under the local authorities they would have to prove that their institution was of value to the ratepayers of that or some other locality, and the idea that the local authority in the area might make inquiry from other local authorities with a view of getting some scheme put forward would, they say, be the deathblow to their institutions. They say quite frankly that local authorities are not sympathetic enough, and give reasons for saying that they are not the property or the protege of any local authorities. The number of these institutions is not large. Accord- 681 ing to the last figures there are only about 100 or 150 of these homes.
We cannot here discuss what is proper and necessary in cases which are so difficult; and where only the actual practice can show what is wanted. The work is very much more difficult and more complicated than is imagined. It is much more difficult than any work which local authorities commonly do. It is not a thing which you or I or any amateur can argue. It is not a small thing that these people, who are as opposed to politics as any set of people in the world should be are now running into politics as it were. Some time ago, the Minister, speaking of other women's associations, said that such associations often passed resolutions on the first sight of a Measure; and that to use his words they "did not stay put." Here those interested in the mothers and children have had a long correspondence with the Minister, and after hearing all that he has to say, and after acknowledging that he has spoken to them in an extremely sympathetic way, have said that they are still of opinion that the provisions of the Clause will upset their work. Cannot the Minister reconsider the matter and put down a new and separate Clause to meet the claims of these societies? Let him take this little scrap of work, which is not very much in terms of money, right out of the Bill and give it a separate grant. Charitable people are alarmed, and they know their own business best.
After the speech to which we have listened my hon. Friend the Member for Moss Side (Mr. Gerald Hurst) will realise that his Amendment is not altogether appropriate to the circumstances and the particular cases which he desires to assist. It could come into operation only where the council had failed to submit a scheme. The most important paragraph of the three in his Amendment is the first, which provides thatcontributions towards the cost of inmates in a maternity home within any county or any county borough may be required from and enforced against the council of any other county or county borough where any inmate normally resided before entering the maternity home.It is true, as the last speaker has said, that the homes which my hon. Friend has particularly in mind are the homes 682 which are carried on by the Society for the Unmarried Mother and her Child— homes which are frequently filled, to a large extent, with inmates who do not come from the locality in which a home is situated. That is not accidental but deliberate, and for reasons which have been stated. They are reasons which would appeal to anyone who knows the peculiar circumstances of these very distressing cases. It is desirable that these cases should not be attended to in their own immediate neighbourhood, but should be got away as far as possible from their surroundings and from all the disadvantages and handicaps which must be present so long as they remain in their own area. Therefore it would be a mistake to make it more difficult in any way for these homes to take in inmates from other localities and to do anything which would tend to cause them to take only the inmates from their own districts. But it would be a tall order to lay it down that the council of a county or county borough must make a contribution towards the cost of maintenance of someone who had resided in that county and had chosen to go into a home. That is going rather far.
While I could not accept the Amendment, because I do not think it would carry out the purpose my hon. Friend had in view, I would like to say a word about the suggestion that we should take these homes right out of the scheme. What I think the hon. Member opposite has not appreciated is this: In the past a direct grant has been given by the Ministry to the homes or to a society in respect of them. That grant is to be discontinued, and is to be given to the council of the county or county borough in which the home is situated. There-fore, it is not for that county or county borough to say, "We ought not to contribute to this home, because it is taking people who do not belong to our own area." They are to be given the money which previously had been given direct to the home. I do not see why the county and the county borough should go to some other locality and ask it to contribute to the cost of the inmates in their home. They have been given the money, and they should recognise that the whole scheme of not taking in one locality people who come from that locality is a good one; and they should recognise, further, that the people in 683 their area should not be accommodated in their home but should go somewhere else. It must be a reciprocal arrangement between the various authorities. I do not see any reason for making a change in this particular case.
Let me say a word on the second paragraph, which says that power shall be given to make arrangements for the exchange by and between two or more counties or county boroughs of the liability to take inmates into maternity homes. This is unnecessary, because there are these powers already. With regard to the third paragraph of the Amendment, which refers to "periodical inspections of maternity homes being vested in officers of the Ministry in lieu of or in conjunction with officers of the council of any county or county borough," I cannot help wondering whether my hon. Friend is under the impression that the inspection of the Ministry is to be stopped. The inspection by the Ministry of Health officers will not be dispensed with. These visitations will continue, and any scheme will certainly provide that the Minister will send his inspectors from time to time to inspect these homes, if he thinks fit.
Suppose some of these authorities do not want these homes. That is very likely, because they are very peculiar homes and are not things in which local authorities are particularly interested. They are almost entirely run by voluntary associations. Suppose that the authorities do not want the homes. What is to happen then? The Minister, I think, takes too rosy a view of the local authorities.
§ Miss LAWRENCE
Let me read what the Minister of Health stated in a letter to a voluntary association:At the same time it is clearly desirable that the local authorities of other areas from which women are admitted to the home should contribute towards their maintenance, and it may be expected that the local authority responsible for the supervision of the home will endeavour to secure that such contributions are made.
Let me try first to answer the Noble Lady the Member for the Sutton Division of Plymouth (Viscountess Astor). If she will read the Clause carefully, she will see that the situation she refers to cannot arise. However much I trust the local authorities, I am not leaving them with entire discretion to 684 support or not support these homes. Every local authority must make a scheme. The Clause goes on to say that the scheme shall provide for the payment to any such association, whose services were immediately before the appointed day approved by the Minister, of such annual contribution in respect of those services as may be specified in the scheme. It is impossible for a local authority to say: "This home has gone on very comfortably hitherto without a grant from the Minister, and we are not proposing to give any grant, because we do not care about these homes and would rather spend the money somewhere else." That discretion is not given. There is really no ground for apprehension on that score. That is not the policy of the Government. I cannot say that one local authority may not, by agreement with another local authority, receive a contribution from it in respect of people who are coming into its home. If it chooses to do that and the other authority is agreeable, there is nothing to prevent it. It would be a much better policy if each local authority were to carry on the home in its district without regard to whether the people in that home come from the locality or from any other locality.
§ Mr. KELLY
I hope the hon. Member who has proposed the Amendment will not press it for the reasons which he has himself given for it. If he presses his Amendment, and any case arises from another district, then he is to give all the publicity to the case. The moment they have one of these cases entering the home, the local authorities would have power by the Amendment, to ask for a contribution from another authority. Without dealing with any other point in his Amendment, I hope that, in order to prevent such publicity, he will not press this Amendment.
I must say that I share with the hon. Member for East Ham, North (Miss Lawrence) some of the apprehensions which she expressed. I know that people who are engaged in this work are afraid that their efforts are to be hampered in two ways, partly by the loss of the help they have hitherto received from the Ministry, and partly by the alteration of procedure which will make it necessary to indicate the local authorities from which patients come. They are afraid of what may occur, and 685 I hope the Minister of Health will take into serious consideration that aspect of the matter. I did not entirely follow his answer, because he was suggesting that, this being a discontinued grant, it would be replaced to the authority which previously had the spending of it. That, I think, is not so. It would be hardly fair to say to any particular authority that they were receiving an equivalent of this particular grant. I could conceive very serious objections being raised, for instance in the case of Highgate, where one of the homes is situated. Supposing a local authority there is called on to provide for maintaining unmarried mothers who do not come from Highgate at all, there may be very serious and reasonable objections from that authority. If there were objections from the local authority, the only way in which the society could get its funds would be by communicating possibly with the many different areas from which these mothers were drawn.
For my part, I confess I think their apprehension that the secrecy which they have hitherto enjoyed will be lessened is a reasonable one. I am sure the Minister will agree that the problem of reducing infant mortality in this country is very largely the problem of dealing with illegitimate children. The illegitimate infant death-rate is, of course, very much higher than the legitimate infant death-rate, and to that extent the problem of infant mortality is interlocked with the problem of dealing with illegitimate children. I hope that the Minister will regard this as being in the nature of an exceptional case for which he ought to find a corner within the Bill.
§ Mr. OLIVER STANLEY
I should like to support what my hon. and learned Friend has said about this Amendment. I too rather misunderstood the reply of the right hon. Gentleman the Minister of Health. It gave me the impression that this was primarily a book-keeping transaction; that the county council merely had to hand over to the home in another area a portion of the money which they would receive from the national Exchequer. But that really is not quite the case. Whether or not there is a home in that particular area is not taken into account. It would not have got a penny less if the home were not there.
§ Mr. HARRIS
I hope this matter will be cleared up. I was very much impressed by the statement of the Minister of Health. Apparently, he is fully conversant with the needs of these homes, and the necessity of taking a large view of their functions, irrespective of the district where they are located. I have mentioned already on another Clause one of those homes, situated in Bethnal Green, which is a very poor borough, and, as I pointed out, the bulk of the women who go there come from all parts of the country. I do think it ought to be made clear in this Clause that the county council or local authority should be under the obligation to take a large view of its responsibilities, and not to feel that its obligations are limited to look after patients from their own area.
Mr. LESTRANGE MALONE
There seems to be general unanimity that something more ought to be done by the Government for these homes, and I suggest to the right hon. Gentleman the Minister of Health that the simplest way would be to accept the Amendment which stands in my name to the Second Schedule of the Bill. In the Second Schedule there is a list of discontinued grants, and there are certain grants which are excluded from that list. I do not suppose that more than £20,000 or £30,000 are spent in these homes. I am thinking of a certain maternity home in the suburbs of Northampton. I have not been able to ascertain what the block grant in Northampton is to be. For some reason, the Ministry of Health has not made any estimate of that grant. When I turn to the White Paper which was published by Mr. Collins, the accountant to the Association of Municipal Corporations, I see that Northampton loses £56,275. I want to know what guarantee we are to have that this money which is lost is not to affect the maternity homes.
Something which I have said appears to have given rise to some misapprehension. Of course, it is not true to say that this is a bookkeeping transaction, but, on the other hand, it is equally untrue to say that it makes any difference to the grant to the county or county borough whether they have a home which shall receive a grant from the Ministry or not. For seven 687 years they will get 75 per cent. of the grant; for another five years 50 per cent., and for a further five years 25 per cent. Therefore, while it is quite true that they will not for all time get the full amount of grant which is given to the home direct, for seven years they will get 75 per cent., and I think that will go a long way to supply the services which have hitherto been supplied.
§ Question, "That those words be there inserted," put, and negatived.
§ Sir K. WOOD
I beg to move, In page 66, line 36, to leave out the words "so provides," and to insert instead thereof the words:provides for such contributions being made by the council of any district, a copy thereof shall be sent to that council by the county council when the scheme is submitted to the Minister and.This and the next Amendment are machinery Amendments to facilitate the process of completing schemes. The object is to secure that in the case of county council schemes where any district councils will contribute towards the maternity and child welfare association, the district councils shall have notice. The following Amendment gives the district councils three months' notice in which to prepare a statement of their claim.
The Northampton County Council has prepared a scheme which presumably it is about to submit to the Minister of Health for an increase in the maternity services commencing next year, that is, after the end of this financial year. I believe the estimated cost of this scheme is something like £10,000. If that expenditure had already been incurred, it would be provided for under the scheme, but it is an estimate for the future, and I should like to know how provision is to be made for it.
Yes. I pointed out on an earlier Amendment that the county of Northampton is losing £56,000 odd under the scheme. How are they to provide for this extra £10,000 that they have made tentative provision for next year?
§ Sir K. WOOD
As I understand it, it is a voluntary association which desires to go in for extended work or to start new work, and I think the hon. Member will find that that is dealt with in a later Amendment.
§ Amendment agreed to.
§ Further Amendment made:
In page 66, line 38, after the word "Minister," insert the words:
within three months after the receipt of the said copy."—[Sir K. Wood.]
§ Sir K. WOOD
I beg to move, in page 66, line 41, at the end, to insert the words:(5) If upon representations made by any voluntary association it appears to the Minister that the association proposes to provide or to extend maternity and child welfare services in or for the benefit of a county or county borough subject to contributions or increased contributions being made to the association under any scheme for the time being in operation under this Section and that it is, therefore, expedient that any such scheme should be altered, the Minister may, after considering the representations in consultation with the council of the county or county borough, so alter the scheme as to provide for such contributions or increased contributions, as he considers just and may also make such consequential alterations, if any, as he considers desirable in any scheme mode under this Section by the Council of any district affected.This is a new Amendment, which I think will meet the case put by the hon. Member for Northampton (Mr. Malone). It has been represented to my right hon. Friend that there may be cases where a voluntary association starts during a particular period such as that mentioned by the hon. Member or desires in some way to extend its work. The association would only be able to appeal to the local authority during the grant period and would really be dependent on the authority as to whether or not it should receive financial assistance in respect of its scheme, and there was no provision in the Bill in such a case for the Minister to act in the matter at all. Therefore, we are providing in this Amendment, in order to meet the desires of the voluntary associations concerned, that if they should desire to start or to extend their work it should be open to them to make an application to the Minister of Health and to say, "We want to start work in this district," or "We want to do something further in connection with our scheme." In such a case, power is given in this 689 Amendment for the Minister, after consultation with the local authority concerned, to say, "Satisfy me that this is work which ought to be done and that some contribution ought to be made in connection with it," and then the Minister can say to the local authority, "Amend the scheme so as to give the necessary financial assistance." This is a matter which has been pressed very strongly upon the Ministry, and this Amendment, so far as I can judge, meets the case satisfactorily. I believe it does give satisfaction to the associations concerned. With this Amendment and the original Clause in the Bill, we give a very strong position to the voluntary associations that are carrying out this work.
§ Miss LAWRENCE
These voluntary institutions are not local associations; they are national. You have an association, in a locality, but taking its inmates from perhaps 60 other authorities. Supposing the grant is increased by 75 per cent., the association then wants to extend its work, and it is work which ought to be very much extended to make any impression upon the death-rate of illegitimate children. Every penny of the new money will have to come out of the money given to local authorities for their own health work, for their own roads, for their own share of the fixed revenue, and for their own loss of rates. Local authorities are very jealous of their own funds, and I would remind the Committee that the bulk of the new money given to them is by way of compensation. They have their own work to do, and they will be much more zealous in pushing their own work than in supporting work which has nothing to do with them and with which they are not themselves really concerned. It is obvious, therefore, that every extension will meet with opposition from the local authorities and that instead of being able to go to the local authorities and prove their case and get 50 per cent., it will be a case of forcing schemes upon reluctant local authorities, and it may well he that the Bill will prove to be the death-knell of many of these voluntary associations. I am not yet satisfied with what the Minister said with regard to the one authority communicating with another. I cannot but think that these associations are in a desperately dangerous condition, and their work is so peculiar that I beg that even now the Minister might consider 690 whether he cannot possibly move this business altogether out of the grant, take it away from the amount granted from the council which has never had it before, and administer it centrally as before.
§ Sir K. WOOD
Anyone who gives fair and impartial consideration to this proposal must know that the voluntary associations are amply secured under this Clause and Amendment, and I should say —Sand I will submit it to the arbitrament of any impartial person—that they are in a much stronger position under the Bill than ever they were in their lives before. I have only attempted to continue this discussion because of the speech which has just been made by the hon. Member for East Ham North (Miss Lawrence). Her fears have no foundation whatever in fact, because under this Clause and under the Amendment which I have just moved the voluntary associations are not left in the hands of the local authorities at all. Incidentally, I do not assent for a moment to the indictment of local authorities up and down the country which has been implied by the hon. Member. The voluntary associations, I say, are amply secured under this Clause. Under the original proposal of my right hon. Friend, which was perhaps abold and extreme step to take, it is left to the Minister of Health himself to determine the assistance which should be given to these homes and associations which are already in existence and doing their work, and to secure to them, at any rate, the grant which they are receiving at present from my right hon. Friend; and when an hon. Member gets up and talks about the associations being in jeopardy, and ignores altogether the large sums of new money which is being given them to carry on their work, I say it is a travesty of the Clause and an insult to my right hon. Friend.
These associations said, "Suppose we start new work, where shall we be? We might in such a case be left in the hands of these local authorities," of whom we hear so much; and it was in order to meet that case that we said, "If you do start new work, we will not leave you in the hands of the local authorities, but we will give you power to go to the Minister of Health and say, We are about to start new work, and we want to make representations to you about it, and we want you, if you are satisfied that our 691 new work is going to be valuable from the point of view of the locality to have power to alter the scheme.'" Really, I wonder that the local authorities have not got up and said that this is a very considerable power to give to the Minister of Health, because we are giving him power under this Clause actually to alter the scheme, to revise it, and to say that if an association begins new work, he will direct that it shall receive assistance. Under these circumstances, I say that it is ridiculous for anyone to get up and say that it is the death-knell of voluntary associations and that they are in great jeopardy. I quite agree with what my hon. Friend below the Gangway on this side and the Noble Lady behind me have said with regard to the proposals in this Bill relating to voluntary associations which are carrying on this excellent and noble work, that they have no reason to complain of the proposals made by the Government.
I only want to say that I am very grateful to the Minister for moving this Amendment, which does meet a fear on the part of the voluntary societies. All of them with which I have had to deal have told me that their fears have been met, and I am deeply grateful. I think that what the hon. Lady the Member for East Ham, North (Miss Lawrence) was talking about was the previous Amendment, not this one at all: I think she was talking about the homes for unmarried mothers. I am certain that the voluntary societies with which I have been in touch feel that their fears have been removed, because they have now a chance of extension under the block grant, which they had not got until this Amendment was put down.
I agree entirely with the Parliamentary Secretary that this Clause is a tremendous weapon in the hands of the Minister. The voluntary associations have not realised how much power the Minister has taken to himself under this Clause. Local authorities may realise this when it is too late, and when an advanced Socialist Government comes in and tries some wild schemes and invokes Clause 83 to give them sanction. This is also an important concession by the Minister and carries things a very long way, but, agreeing with all that, and partly because I agree with it, I do 692 not think that the particular case of the Unmarried Mothers' Society is met under this Amendment because of the formidable nature of the innovation introduced by this Clause, which must depend to a very large extent upon the goodwill of the local authority. You will not be able to strain that goodwill unduly, and I submit that you would be unduly straining it if you said to the local authorities, "Here is a maternity home in your midst which is maintaing, not your illegitimate children, but illegitimate children from all over England; this useful work is expanding, and, simply because it is situated in your midst, you have to prepare a scheme which provides for an increased sum of money to meet its requirements in the coming year." That would indeed be straining the goodwill of the local authorities and for that reason, if for no other, I think that the Minister ought once again to take heed to counsel and consider whether the very narrow requirements of this particular society, which I do not think can be met under the Bill, ought not to be met in some separate way such as was suggested by an hon. Member from the other side.
§ Mr. ROBERT HUDSON
So much apprehension regarding the future of the maternity and child welfare services in this country has been expressed by voluntary societies that, even at the risk of wearying the Committee, it is desirable before we leave this Clause and this particular Amendment, to indicate again to what an enormous extent the Minister has met all apprehensions that might have been expressed. Voluntary societies were apprehensive in the early stages of the discussion on the Bill that although Clause 83 might be useful in securing adequate consideration for a scheme in regard to the services that were in existence at the date of the passage of the Bill, it did not provide for extensions. The Minister has explained that by the concession that he has made, and which we are now discussing, apprehension has been removed. What has been the result? Voluntary associations, when discussing this matter, are very apt to give the impression that they are not very numerous, but, when one comes to look at the position in the country, if I am not misinformed, one finds that with the possible exception of one, every county in the Kingdom has a voluntary 693 association at work dealing with maternity and child welfare. That being so, it means that every county, with this possible exception, will have to put up a scheme covering the whole of the county for maternity and child welfare services. As the Clause has been amended, it provides for a further extension of the services, and, therefore, every county will be covered. In regard to the county boroughs, with the possible exception of 20, they all have voluntary associations. Therefore, every county borough with the possible exception of those 20, will have to put up a scheme to the Minister covering not only present services but future extensions.
Does not the hon. Member agree that under the Bill the Minister has the chance of bringing up those county boroughs that were only doing a half of what they should do, and that he has a chance that he really never had under the percentage grant system?
§ Mr. HUDSON
That is precisely what I am trying to point out. There are three sets of people to deal with. There are the counties, and I have shown that those, with one exception, are covered by Clause 83, under which they have to put up a definite scheme. Then there are the county boroughs which, with the exception of 20, have voluntary associations and, therefore, every county borough, with the exception of these 20, has to put up a definite scheme dealing not only with the present service but future increases of the service, and the Minister has power to say that the increase shall be granted by the council. The only people with whom we are concerned are the remaining county boroughs, 20 in number, which have not associations. Almost every one of these boroughs have maternity and child welfare services, and they will come under Clause 86. With the Amendments which the Minister has put on the Paper, he will have power under that Clause to see that these county boroughs carry out their work adequately and efficiently with due regard to the welfare of the inhabitants. We may sum up the position by saying that the whole of the counties and the county boroughs will be adequately dealt with under the extremely great powers which the Minister has taken, powers quite unprecedented so far as voluntary associations are con- 694 cerned, and that as regards the remaining 20 county boroughs, we can leave the question until we come to the discussion of Clause 86.
§ Lieut.-Colonel FREMANTLE
I only want to add a word to say that my name and that of the hon. and gallant Member for Ripon (Major Hills) were down to an Amendment earlier on this Clause, but I purposely did not move it because this Amendment covered the same ground. I tabled the Amendment because the Clause did not provide for the future expansion of this service. It was put down on behalf of the Midwives' Institute and the Queen Victoria Jubilee Institute for Nurses. These professional bodies, which are largely neglected by public opinion, are at the bottom of the working of these maternity associations, and they will, I believe, be abundantly satisfied by this Amendment, which seems to me to cover the substance of the Amendment which I was moving, and also other points which I had in mind. I hope there will be a possibility of covering now for the first time the whole of the counties with the work of the County Nursing Associations in nursing and midwifery, work which has been extending, but extending slowly, and I hope, speaking on behalf of the midwives that the Clause as amended will be successful.
§ Mr. SIDNEY WEBB
I do not want to join in the chorus of apprehension or the chorus of praise, but I rise to ask a question, because I do not quite understand how this is going to work. My question relates to one of these homes which is not local, but receives inmates from all over the Kingdom. Under the Amendment to Clause 83, the Minister, assuming that the home is going to be extended, has the power to call upon the council of the county or county borough to pay the necessary increased grants to this enlarged home. I am still not quite clear how this power is to be operated. Is the Minister taking power to call upon the county council or the county borough council within whose area the home happens to be situated to give an increased grant which may be necessary to provide for inmates who may come from 50 different counties, or is he going to call upon each of those counties and county boroughs to pay an increased grant in proportion to the number of inmates from their counties who are in the home? If 695 it means that the Minister will call upon the particular county or county borough to pay that extra grant, it seems to me to be a very strong power to give him. I see the wording speaks ofservices in or for the benefit of the county,and that leads me to wonder whether a more equitable plan may not have been in the Minister's mind, and that he is going to call upon each of the counties and county boroughs, and I do ask the right hon. Gentleman to tell me which it is proposed to do. It would be a simple matter to make a particular county pay for the whole of the services, but it would be rather a strong measure to take. This may seem rather a quibbling point to raise, but it is the basis of the apprehensions which the non-local institutions are feeling.
§ Sir K. WOOD
The answer is that the call will he made upon the county or county borough in whose area the home is situated. I would say in answer to the arguments which the right hon. Gentleman has put forward that all these matters are very largely in the nature of reciprocal arrangements. If a home in one county is serving people who come from another area., so it will be found that there are homes in other areas which are being used by people from that particular county, and thus one gets a fairly good working arrangement between the different counties. The reason why people from one locality go to a home in another locality is quite an understandable one connected with a desire to avoid exposure and to secure a certain amount of secrecy. I think that on the whole it will be found that the arrangement will be fair.
§ Captain MACMILLAN
While a number of the points which have been raised have been satisfactorily met, I feel I must agree that this arrangement does represent the excise of a very stringent power by the Minister. After all, the number of non-local institutions is limited to these particular services. It is not as if there were a great number of these non-local services. I wish the Minister would consider whether some provision should not be made to avoid the dilemma out by the right hon. Gentleman the Member for Seaham (Mr. Webb). I feel there will be dissatisfaction if an authority 696 has to provide more money in order to secure benefits for people coming from other parts of the country. The Parliamentary Secretary says that these obligations will cancel one another out among the counties. That might be so if the incidence were the same in all cases, but it appears to me to be almost inconceivable that that should be so, because there will not be as many homes as there are authorities. I think the Minister might consider whether a service of this limited and rather peculiar character might not be dealt with separately.
§ Amendment agreed to.
Further Amendment made:
In page 67, line 2, leave out the word "quinquennium" and insert instead thereof the words "fixed grant period." —[Sir K. Wood.]
I beg to move, in page 67, line 3, after the word "councils" to insert the words "and voluntary associations."
This is a manuscript Amendment. Its effect, if it were adopted, would be to require the Minister to consult with voluntary associations as well as with councils. It has been put down at the request of some of the voluntary associations. I do not put it forward as an Amendment of very radical importance, because I feel that in practice such consultations will take place, but I am informed that voluntary associations are apprehensive that they will be excluded from the consultations and I submit it in order to get the Minister's views on the subject.
§ Sir K. WOOD
As my hon. and gallant Friend knows, I have had no opportunity of considering this Amendment. It is one which affects only the London Sub-section, but if the voluntary associations are to be taken into consultation that will have to be done in other parts of the country as well as in London. I suggest to the hon. and gallant Member and to the Committee that it would be more convenient if I were allowed time to consider his suggestion between now and the Report stage. I could not take the responsibility of accepting the Amendment without giving it more consideration than has been possible up to now.
§ Amendment negatived.
§ Consequential Amendment made.697
§ Question put, "That the Clause, as amended, stand part of the Bill."698
§ The Committee divided: Ayes, 194; Noes, 84.699
|Division No. 130.]||AYES.||[8.35 p.m.|
|Albery, Irving James||Gilmour, Lt.-Col. Rt. Hon. Sir John||Nelson, Sir Frank|
|Alexander, Sir Wm. (Glasgow, Centr'l)||Glyn, Major R. G. C.||Neville, Sir Reginald J.|
|Applin, Colonel R. V. K.||Graham, Fergus (Cumberland, N.)||Newman, Sir R. H. S. D. L. (Exeter)|
|Apsley, Lord||Grattan-Doyle, Sir N.||Nuttall, Ellis|
|Astor, Viscountess||Greaves-Lord, Sir Walter||Oakley, T.|
|Atkinson, C.||Greene, W. P. Crawford||O'Connor, T. J. (Bedford, Luton)|
|Baldwin, Rt. Hon. Stanley||Gunston, Captain D. W.||Ormsby-Gore, Rt. Hon. William|
|Balniel, Lord||Hacking, Douglas H.||Percy, Lord Eustace (Hastings)|
|Banks, Sir Reginald Mitchell||Hall, Capt. W. D'A. (Brecon & Rad.)||Perkins, Colonel E. K.|
|Barnett, Major Sir Richard||Hamilton, Sir George||Peto, G. (Somerset, Frome)|
|Beamish, Rear-Admiral T. P. H.||Hanbury, C.||Pilcher, G.|
|Benn, Sir A. S. (Plymouth, Drake)||Hannon, Patrick Joseph Henry||Power, Sir John Cecil|
|Bennett, A. J.||Harrison, G. J. C.||Preston, William|
|Betterton, Henry B.||Hartington, Marquess of||Price, Major C. W. M.|
|Bevan, S. J.||Harvey, G. (Lambeth, Kennington)||Reid, D. D. (County Down)|
|Boothby, R. J. G.||Harvey, Major S. E. (Devon, Totnes)||Remer, J. R.|
|Bowyer, Captain G. E. W.||Haslam, Henry C||Rhys, Hon. C. A. U.|
|Brass, Captain W.||Henderson, Lieut.-Col. Sir Vivian||Rice, Sir Frederick|
|Bridgeman, Rt. Hon. William Clive||Henn, Sir Sydney H.||Richardson, Sir P. W. (Sur'y, Ch'ts'y)|
|Brittain, Sir Harry||Hennessy, Major Sir G. R. J.||Ropner, Major L.|
|Brocklebank, C. E. R.||Hills, Major John Waller||Ruggles-Brise, Lieut.-Colonel E. A.|
|Brooke, Brigadier-General C. R. J.||Holbrook. Sir Arthur Richard||Rye, F. G.|
|Broun-Lindsay, Major H.||Hope, Sir Harry (Forfar)||Salmon, Major I.|
|Brown, Col. D. C. (N'th'I'd., Hexham)||Hopkins, J. W. VV||Sandeman, N. Stewart|
|Brown, Brig.-Gen.H.C. (Berks, Newb'y)||Hudson, Capt. A.U. M.(Hackney, N.)||Sandon, Lord|
|Buckingham, Sir H.||Hurst, Gerald B.||Savery, S. S.|
|Burman, J. B.||Hutchison, Sir Robert (Montrose)||Scott, Rt. Hon. Sir Leslie|
|Butler, Sir Geoffrey||Inskip, Sir Thomas Walker H,||Shepperson, E. W.|
|Cassels, J. D||Iveagh, Countess of||Simms, Dr. John M (Co. Down)|
|Chadwick, Sir Robert Burton||Jackson, Sir H. (Wandsworth, Cen'l)||Sinclair, Col.T.(Queen's Univ.,Belfast)|
|Chamberlain, Rt.Hon. N. (Ladywood)||James, Lieut.-Colonel Hon Cuthbert||Skelton, A. N.|
|Christle, J. A.||Jones, Henry Haydn (Merioneth)||Smith, R.W.(Aberd'n & Kinc'dine, C.)|
|Churchman, Sir Arthur C.||Jones, W. N. (Carmarthen)||Smith-Carington, Neville W.|
|Clarry, Reginald George||Joynson-Hicks, Rt. Hon. Sir William||Somerville, A. A. (Windsor)|
|Clayton, G. C.||Kennedy, A. R. (Preston)||Spender-Clay, Colonel H,|
|Cobb, Sir Cyril||Kindersley, Major G. M.||Storry-Deans, R.|
|Cochrane, Commander Hon. A, D.||King, Commodore Henry Douglas||Stuart, Crichton-, Lord C.|
|Cohen, Major J. Brunei||Knox, Sir Alfred||Thompson, Luke (Sunderland)|
|Colfox, Major Wm Phillips||Lamb, J. Q.||Thomson, F. C. (Aberdeen, South)|
|Conway, Sir W. Martin||Leigh, Sir John (Clapham)||Thomson, Rt. Hon. Sir W. Mitchell-|
|Cowan, D. M. (Scottish Universities)||Loder, J. de V.||Tomlinson, R. P.|
|Crookshank, Col. C. de W. (Berwick)||Lougher, Lewis||Wallace, Captain O. E.|
|Crookshank, Cpt- H.( Lindsey, Gainsbro)||Lumley, L. R.||Ward, Lt.-Col.A. L. (Kingston-on-Hull)|
|Cunliffe, Sir Herbert||Lynn, Sir R. J.||Warner, Brigadier-General W. W.|
|Davidson, Rt. Hon J. (Hertford)||MacAndrew, Major Charles Glen||Waterhouse, Captain Charles|
|Davies, Maj. Geo F. (Somerset, Yeovil)||Macdonald, Capt. P. D. (I. of W.)||Watson, Rt. Hon. W. (Carlisle)|
|Davies, Dr. Vernon||Macdonald, R. (Glasgow, Cathcart)||Watts, Sir Thomas|
|Dawson, Sir Philip||McDonnell, Colonel Hon. Angus||Wayland, Sir William A.|
|Dean, Arthur Wellesley||Maclntyre, Ian||Wells, S. R.|
|Dixon, Captain Rt. Hon. Herbert||McLean, Major A.||White, Lieut.-Col. Sir G. Dairymple-|
|Drewe, C.||Macmillan, Captain H.||Wiggins, William Martin|
|Eden, Captain Anthony||Macquisten, F. A.||Williams, A. M. (Cornwall, Northern)|
|Edmondson, Major A. J.||MacRobert, Alexander M.||Williams, Com. C. (Devon. Torquay)|
|Edwards, J. Hugh (Accrington)||Maitland, A. (Kent, Faversham)||Williams, Herbert G. (Reading)|
|Erskine, James Malcolm Monteith||Margesson, Captain D.||Windsor-Clive, Lieut.-Colonel George|
|Evans, Capt. Ernest (Welsh Univer.)||Marriott, Sir J. A. R.||Winterton, Rt. Hon. Earl|
|Everard, W. Lindsay||Meller, R. J.||Withers, John James|
|Forestler-Walker, Sir L.||Meyer, Sir Frank||Wolmer, Viscount|
|Forrest, W.||Milne, J. S. Wardlaw-||Womersley, W. J.|
|Foster, Sir Harry S.||Mitchell, S. (Lanark, Lanark)||Wood, Rt. Hon. Sir Kingsley|
|Frece, Sir Walter de||Mitchell, W. Foot (Saffron Walden)||Woodcock, Colonel H. C|
|Fremantle, Lieut.-Coloe Francis E.||Monsell, Eyres, Com. Rt. Hon. B. M.||Young, Rt. Hon. Sir Hilton (Norwich)|
|Galbraith, J. F. W.||Moreing, Captain A. H.|
|Ganzoni, Sir John||Morrison, H. (Wilts, Salisbury)||TELLERS FOR THE AYES.—|
|Gates, Percy||Morrison-Bell, Sir Arthur Clive||Major Sir William Cope and Mr. Penny.|
|Gault, Lieut.-Col. Andrew Hamilton||Nall, Colonel Sir Joseph|
|Adamson, W. M. (Staff., Cannock)||Cluse, W. S.||Greenwood, A. (Nelson and Colne)|
|Alexander, A. V. (Sheffield, Hillsbro')||Compton, Joseph||Groves, T.|
|Ammon, Charles George||Connolly, M.||Grundy, T. W.|
|Barnes, A.||Cove, W. G.||Hall, F. (York, W.R., Normanton)|
|Batey, Joseph||Dennison, R.||Hall, G. H (Merthyr Tydvli)|
|Bowerman, Rt. Hon. Charles W.||Duncan, C.||Hardle, George D.|
|Broad, F. A.||Dunnico, H.||Harris, Percy A.|
|Bromley, J.||Gillett, George M.||Hayday, Arthur|
|Henderson, T. (Glasgow)||Malone, C. L'Estrange (N'thampton)||Stamford, T. W.|
|Hirst, G. H.||March, S.||Stewart, J. (St. Rollox)|
|Hirst, W. (Bradford, South)||Morris, R. H.||Sullivan, J.|
|Hore-Bellsha, Leslie||Morrison, R. C. (Tottenham, N.)||Sutton, J. E.|
|Jenkins, W. (Glamorgan, Neath)||Mosley, Sir Oswald||Thurtie, Ernest|
|john, William (Rhondda, West)||Murnin, H.||Tinker, John Joseph|
|Junes, J. J. (West Ham, Silvertown)||Naylor, T. E.||Townend, A. E.|
|Jones, Morgan (Caerphilly)||Oliver, George Harold||Wallhead, Richard C.|
|Jones, T. Mardy (Pontypridd)||Palin, John Henry||Watts-Morgan, Lt.-Col. D. (Rhondda)|
|Kelly, W. T.||Paling, W.||Webb, Rt. Hon. Sidney|
|Kennedy, T.||Pethick-Lawrence, F, W.||Wedgwood, Rt. Hon. Joslah|
|Kenworthy, Lt.-Com. Hon. Joseph M.||Potts, John S.||Wellock, Wilfred|
|Lansbury, George||Purcell, A. A.||Williams, Dr. J. H. (Llanelly)|
|Lawrence, Susan||Ritson, J.||Wilson, C. H. (Sheffield, Attercliffe)|
|Lee, F.||Scrymgeour, E.||Wilson, R. J. (Jarrow)|
|Lowth, T.||Scurr, John||Windsor, Walter|
|Lunn, William||Sexton, James||Wright, W.|
|Mackinder, W.||Shepherd, Arthur Lewis||Young, Robert (Lancaster, Newton)|
|MacLaren, Andrew||Short, Alfred (Wednesbury)|
|Maclean, Nell (Glasgow, Govan)||Smith, Ben (Bermondsey, Rotherhithe)||TELLERS FOR THE NOES.—|
|MacNeill-Weir, L.||Smith, Rennie (Penistone)||Mr. Allen Parkinson and Mr. Charles Edwards.|