§ The following Question stood upon the Order Paper:
§ 90. Mr. BLENKINSOP
TO ask the Minister of Health whether he will make a statement regarding the report by the Guillebaud Committee on the National Health Service.
§ The Minister of Health (Mr. R. H. Turton)
With permission, I will answer Question No. 90.
The Guillebaud Committee, which was appointed by my right hon. Friends the present Minister of Labour and the Secretary of State for Scotland to review the present and prospective cost of the National Health Service and to make recommendations, has now submitted its Report. The Report has been printed and will be available in the Vote Office this afternoon. It covers Scotland as well as England and Wales and the Secretary of State has asked me to make clear his agreement with what I am about to say.
The Committee's main conclusion is that it would be premature at this point of time to make any fundamental alteration in the structure of the National Health Service. Their view is that what is most needed at the present time is the prospect of a period of stability in order that the various authorities and representative bodies can think and plan ahead with the knowledge that they will be building on firm foundations. The Committee specifically indicate their support by and large of the main administrative features of the various services, including, for example, the present method of making Exchequer money available for 208 the hospital service. With the Committee's general conclusion and approach on these matters the Government are in agreement.
The Committee point out that the aim must be to provide the best service possible within the limits of the available resources; and that it must be for the Government to determine as a matter of policy how much of the national resources, in terms of finance, manpower and materials, can be made available for the Health Service, regard being had to the competing claims of other social services and national commitments. Subject to these general propositions the Committee make a number of recommendations about the organisation and management of the Service.
These include a recommendation about the desirable rate of capital expenditure in the hospital service. As the House knows, the Government decided some time ago that the present level of expenditure should be increased in the years up to 1957–58. The Committee propose that, after that, if the resources can then be made available, £30 million annually would be a desirable level at which to aim over the seven succeeding years.
The Committee further recommend that when financial circumstances permit, the existing Exchequer grant towards the capital cost of providing residential accommodation for the aged should be replaced by a 50 per cent. grant on the net total expenditure of local authorities on such accommodation. This proposal would involve legislation and will also require consideration in the wider context of the relationship of local government finance with the Exchequer.
There are a number of recommendations either for continuation or for development of measures already in hand or contemplated or for detailed adjustments in the present arrangements. These recommendations will require careful consideration. I must, moreover, make it clear that in view of the economic situation the Government cannot undertake any additional financial commitments in respect of the Health Services at the present time. The Committee's final comment includes a tribute to the Service's record of performance and a finding that any charge of widespread extravagance is not borne out by the Committee's evidence.
209 It is clear that this document is of great value. I am sure that all right hon. and hon. Members of this House will wish to join with the Secretary of State and me in expressing our gratitude to Mr. Guillebaud and his colleagues for the important task they have completed and for this very valuable analysis of our National Health Service.
§ Mr. Blenkinsop
While welcoming the announcement of the publication of this Report and of the very important and undoubtedly very valuable recommendations it is making, may I ask the Minister whether he does not agree that the Report provides a full vindication of the work that has been done in building up the National Health Service against all the attacks that have been made? Will he not also accept that this should provide him with a good opportunity for fresh approaches to the Chancellor of the Exchequer to ensure a more effective use of the resources of the country than is possible today in the cramped surroundings of financial limitation, especially in regard to mental hospital provision? Will he not also agree that it is highly desirable that the House should have a full opportunity fairly shortly to debate what is obviously an extremely important Report?
§ Mr. Turton
The Report is a well-deserved tribute to the great deal of voluntary work that has been done all over the country to help the National Health Service. I am sure that the whole House can join in that tribute. The question of a debate is for the Leader of the House.
§ Mr. A. Woodburn
While associating myself with my hon. Friend's remarks, may I ask whether the Government are bearing in mind that real economy will come when the hospitals can be made more efficient by new capital expenditure? A great deal of the waste arises from old buildings and appliances and the difficulties of doctors and nurses carrying on their work in proper surroundings. Will the Government bear in mind that cutting down capital expenditure is not necessarily the way to economy and that it may be a greater economy to spend a little more now in order to save over the years? When he examines this Report, I hope that the right hon. Gentleman will not close his mind to further expenditure, if that is necessary in order to restore sick 210 people to work. It is not economy to delay people's recovery to health. It is greater economy to the nation that people should be in hospital as little as possible and that when they are they should be restored to working life as soon as possible.
§ Mr. Turton
The Government appreciate those points very much. That is why, in this programme for 1956–57 and 1957–58, there is provision for plant replacement, the very point touched on by the right hon. Gentleman.
§ Dr. Stross
May we interpret what the Minister has said as meaning that as soon as there is an acknowledged improvement in the economic situation of our country the essential recommendations in this valuable Report will be given the highest priority?
§ Mr. Turton
First we must study this Report and I must have consultations with the local health authorities on many of its detailed recommendations. Until we have all studied the Report, which is a very long one, it would be quite wrong of me to make any commitment.
§ Mr. Mikardo
Are not the broad conclusions of the Report a snub to Government supporters who are critics of the Health Service, and who hoped that the Guillebaud Committee would recommend slashing reductions of the Service?
§ Mr. Turton
When the hon. Member reads the Report I think that he will not come to that conclusion. The Report says that substantial improvements have been made in recent years and that those improvements have been undertaken without putting a very large increased cost on the Health Service. I should have thought that that was a matter in which all sides of the House could take pleasure.
§ Mr. Blenkinsop
Would the Minister say something, if possible, to allay the very great public anxiety there is about our mental hospital provision and what action he proposes to take in that field?
§ Mr. Turton
As I think the hon. Gentleman is aware, there is in the programme for 1956–57 and 1957–58 provision for new mental hospitals. I am as concerned as he is about the whole question of mental and mental deficiency hospitals, but I think that the House should not go into detailed discussion until hon. Members have read this very large and voluminous Report.