§ 7.1 p.m.
§ Lord Balniel (Hertford)
I beg to move,That this House regrets the muddle which has surrounded the proposed introduction of higher charges for dentures and spectacles.In this debate, regretting the muddle which has surrounded the proposed introduction of higher charges for dentures and spectacles, we want a few straightforward answers to some questions. The points which we wish to put and on which we need answers are quite simple.
Why has there been this confusion? When will the Regulations be introduced? When will the new charges come into force? What will the money be used for? Is the principle of charges to be kept as a permanent feature of the financing of the National Health Service, or is it to be temporary? Is this proposal still expected to bring in about £ 1.7 million during the current financial year?
Recently, in debate, I said that, just as there was a Beaufort scale for wind forces, so the Government are creating a Crossman scale for chaos. Optimistically, I went on to say that I imagined that the happy period of farce which had characterised the administration of his Department so far would soon be coming to an end. I must confess that I had seriously underestimated the right hon. Gentleman's ability to cause chaos. Within a few days of that speech, the national newspapers were full of reports that the Government had decided to defer the increased charges on dentures and spectacles.
The Secretary of State reminds me of one of those old Russian tumbledown dolls which one tries to stand upright but which always rolls over on one side or the other. I believe that they have a weight at the bottom, but are light in the head. Whatever the personal characteristics of the Secretary of State, the policy in relation to the proposed new charges for dentures and spectacles has rolled wildly from one course to the other. The House has a duty to deplore the muddle of his administration and to demand an explanation today as to what is the reason.
1025 I do not want to spend too much time on the distant past, but it is right that we should look at this matter in its proper perspective. It was the decision of the late Hugh Gaitskell—and I quote from his own words—… to introduce a modest charge in respect of some dental work and optical services."—[OFFICIAL REPORT, 10th April, 1951; Vol. 486, c. 852.]It was a decision which precipitated a Cabinet crisis. It was then that the right hon. Gentleman the present Prime Minister summoned up his principles and resigned from the Cabinet.
I will not weary the House with multitudinous quotations from the Prime Minister's speeches, both at that time and subsequently. But the right hon. Gentleman the Secretary of State stood at the Prime Minister's right hand in those days to defend him. It will be interesting to see whether the Prime Minister records his vote when these Regulations are introduced.
During those important debates on Mr. Gaitskell's decision, the Secretary of State said that the people… will have to submit to a national means test in order to be able to get free spectacles and free services … What we are doing here is to extend the principle to men in work, and that seems to me a grievous violation of principle.It is not my job to act as agent-provocateur for the Left wing of the Labour Party.
§ Lord Balniel
In their absence, perhaps I might remind them of the peroration of the Secretary of State on this great issue of principle in 1951:I hope that in future it will not be the actions of the Front Bench but the reactions of Labour back benchers which will be the precedent for future social policy."—[OFFICIAL REPORT, 7th May, 1951; Vol. 487, c. 1692–3.]
§ Mr. Kenneth Lewis (Rutland and Stamford)
Has my hon. Friend noticed that there are only eight Front Benchers and only eight back benchers present on the Government side to deal with this very important subject?
§ Lord Balniel
It is kind of my hon. Friend the Member for Rutland and Stamford (Mr. Kenneth Lewis) to call that matter to my attention, but it is blatantly apparent to every hon. Member 1026 present that the Left wing prefers to be absent from this most inconvenient debate.
Of course, that quotation was a long time ago. Much has happened since then. Many deeply-held principles have been abandoned. But it is right that the House should remember the promises on which the Government were elected and which was contained in their election manifesto, "New Britain". Referring to the prescription charges in particular, the manifesto said:These charges will be abolished.Referring to the general policy, it said:Our aim is to restore as rapidly as possible a fully free Health Service.The Government have deviated slightly from these promises on which they were elected. Prescription charges have been reintroduced. Indeed, the Government now are walking precisely in the opposite direction from the policy on which they were elected.
I want to tell hon. Members opposite, or those who have bothered to attend the debate, that I like the generosity of spirit which enabled most if not all hon. Members opposite to believe that they could provide a free Health Service, a Service free of charge at the point of use. This seems to me to be a kind, warm, humane approach to those who are sick. But, of course, the policy has collapsed in total ruin. It has irretrievably, irrevocably and unalterably collapsed. The dream world on which they were elected to office and on which they have lived for so many years has now come to an end.
While I have sympathy, and, indeed, feel rather sorry for a number of hon. Members opposite, my sympathy evaporates when I look at the shiftiness with which the present proposals have been introduced.
§ Dr. Shirley Summerskill (Halifax)
Would the noble Lord not agree that, at the last General Election, the Conservative Party would not commit itself to the fact that it supported Health Service charges?
§ Lord Balniel
The hon. Lady should read previous speeches made by Conservative spokesmen. She is living continuously under a delusion. I thought that the dream world had come to an end. She is mistaken in her facts.
§ The Secretary of State for Social Services (Mr. Richard Crossman)
The noble Lord was not present last week at our debate on financing the Health Service, when his hon. Friend the Member for Farnham (Mr. Maurice Macmillan), when challenged about charges, said that he was not prepared to commit himself on the matter.
§ Lord Balniel
I read the right hon. Gentleman's speech and my hon. Friend's admirable speech, and I intend to refer to them.
As I said, my sympathy for hon. Members opposite evaporates when I consider the way in which the present proposals have been introduced. On 14th April, the Secretary of State said at Question Time:If my hon. Friend is asking me whether I expect further charges to be imposed on the Health Service, the answer is 'No'."—[OFFICIAL REPORT, 14th April. 1969; Vol. 781, c. 771.]The right hon. Gentleman says that he was answering a question about the principle of selectivity. Indeed he was. That is one of the most astonishing Answers to a question about selectivity that I have ever heard. To say the very least, that was a thoroughly disingenuous answer to give the House. The House at that time was very crowded, and I wonder whether one hon. Member who heard the right hon. Gentleman make that statement imagined that, within a few days, he would be coming before the House to announce that he would be introducing higher Health Service charges.
Twice, also on that same day, I and my hon. Friend the Member for Somerset, North (Mr. Dean) asked whether it was the right hon. Gentleman's intention to increase prescription charges. The Secretary of State replied, "The answer is 'No'." Carefully, with a most exquisite precision of words, by slithering through some absolutely straightforward questions, the right hon. Gentleman did not tell a lie. Unfortunately, he just created an impression that no further charges would be imposed.
I wonder whether it was worth it. Now, only the most gullible fool in the country will listen to the right hon. Gentleman without examining the small print under a microscope. On 5th May, he announced that the increased charges 1028 were to be made. From then onwards, there was a sheer blizzard of chaos.
My hon. Friend the Member for the Cities of London and Westminster (Mr. John Smith) is resigning in order to call attention to the lack of facilities in the House. I must say that I have a certain amount of sympathy with him. My own filing system is collapsing under the strain of statements made by the right hon. Gentleman. Government statement contradicts Government statement, the morning editions of the newspapers are contradicted by later editions, and, in the middle of it all, sits the Secretary of State—to use the words of the hon. Lady the Member for Halifax (Dr. Shirley Summerskill)—whose left hand does not know what his other left hand is doing.
First, it was hinted in c. 47 of HANSARD, 5th May, that the £3½ million which was to be raised would be used to finance the psychiatric and geriatric services. Then we had the blazing headlines that the Secretary of State had informed the Parliamentary Labour Party that the money was to be used to finance the comprehensive schools in the key areas. That was on 15th May. Then he said that any such suggestion would be folly—that was on 19th May, in column 10—and he told us not to believe the report. Then the chairman of the Parliamentary Labour Party said that he was astonished that the accuracy of his report was doubted. That was on 21st May.
Equal confusion surrounds the timing of the Regulations, when they will be laid and when they will come into force. The decision to increase these particular Health Service charges was taken last January. It was to be in the Budget. The Secretary of State, in his B.B.C. broadcast on "The World at One", on 6th May, said:This was a statement which we have had for a long time and I had hoped to see it in the Budget.I can quite understand why he hoped to see it in the Budget, but it was not there. But lots of things which should have been there were not included in the Budget. It is only gradually, in debate after debate, that we have been able to extract the information from the Government.
The Chancellor of the Exchequer, that now rather tarnished Sir Galahad of the 1029 Labour Panty, has treated the right hon. Gentleman very badly. He announced the increased benefits, but forgot to announce how they would be paid for. He announced that there was a substantial deficit on the National Insurance Fund, but forgot to tell us how he would correct it. And he completely forgot to include this announcement, which the Secretary of State had expected would be in the Budget, that the charges for dentures and spectacles would be increased.
But it is not only the Chancellor who has behaved badly in this. The Secretary of State's own sense of timing is also rather haphazard. On 14th April, as I said, he announced that there would be no further charges. On 5th May, he announced that regulations would be laid "shortly". But weeks passed. Then, on 24th June, the B.B.C. and The Times and other newspapers said that there were reports that the increased charges were to be deferred.
On the same day, the Department of Health and Social Security issued an official statement that the references by The Times and the B.B.C. were "purely speculation". But it went on:The timing of the Order has not even been discussed.Is there one hon. Member who believes that? Indeed, a week later, on 1st July, the Secretary of State said that the regulations would be laid "at an early date".
I suppose that there is some charm about amiable incompetence, but I am not sure that this is amiable. It is certainly incompetence. What I believe is happening is something quite different. The right hon. Gentleman is desperately thrashing around for an escape. He wants a formula of words which will fool his colleagues and get them into the Lobby. He wants a form of words. Normally, of course, the Labour Party will swallow absolutely anything. Of course, as always, on this occasion the payroll vote, the multitudinous place-men of the present Government, will go into the Lobby behind the Government. Normally, of course, the Left wing are content with a mere Motion on the Order Paper and then flake out before it comes to a vote, but on this occasion I think that it is rather different.
They have tasted blood. They have thrown out the Parliament (No. 2) Bill, 1030 the jewel of the Queen's Speech, the very centrepiece of the present parliamentary programme. They have caused a reversal on the Industrial Relations Bill, and this time the Secretary of State has seen their Motion opposing the Regulations, signed by 138 hon. Gentlemen opposite and, rather surprisingly, also by my right hon. Friend the Member for Brighton, Pavilion (Mr. Amery). I have no doubt that that is a misprint, but his name appears in the list.
This time they really will vote. This is the last of their sacred cows which still remains alive and they are determined not to see it butchered by the right hon. Gentleman. He is seeking an expedient. He is seeking a formula of words which will fool his hon. Friends and get them to vote for his Regulations. He says, "This is not a violation of a principle; it is an extension of a practice". I wonder whether he knows what General Burgoyne said when he surrendered his troops at Saratoga. He said that he was signing a convention and not a capitulation.
It is widely believed that the right hon. Gentleman will capitulate. It is widely believed that he is trying to smooth down his critics on the benches behind him by pretending that the charges are only temporary. He will remember that when they were introduced in 1951, they were only temporary. They were to last for only the period of rearmament and then be removed. It is widely believed that this is the tactic which he will employ. For instance, the headline of The Guardian on 2nd July was:Increased health charges may be temporary.What the right hon. Gentleman is trying to do is to encourage his hon. Friends to look forward to an election which they can once again fight with the words, "These charges will be abolished. Our aim is to restore as rapidly as possible a completely free Health Service". Such an attitude may be altruistic, but it is utterly unrealistic and the Government Front Bench, to its credit, knows this to be so.
We shall discuss the merits of the Regulations when they are published, but at this stage I should like to make two points. Probably the delay in publishing the Regulations has lost completely the saving which the right hon. Gentleman 1031 intended to obtain in the current financial year. His intention was to raise £3.5 million during a full year and £1.7 million during the current financial year. I am told that there has been a substantial increase in demand in recent weeks. It does not require much brilliance to see that it is wiser to buy now rather than await the increased charges which will come later in the year. I admit that I cannot substantiate this, but I suspect that, far from achieving a saving during the current financial year, the dawdling will have resulted in increased expenditure.
Secondly, I want to make a general comment about charges in the Health Service. So long as there are proper and effective exemptions for poor people, I accept that some charges are necessary. If I had been a Socialist Minister, I would have avoided these charges, because such deep issues of principle are felt by hon. Members opposite. Luckily, I am not a Socialist Minister and I recognise, as do many hon. Members opposite, that the Health Service simply cannot afford to discard a source of revenue which does not cause unreasonable hardship.
Today, 85½ per cent. of its finance comes from taxation; 9½ per cent. from contributions and 5 per cent. from charges. We know that even to sustain the parlous state of Health Service finances, let alone secure an improvement, let alone implement Lord Todd's report calling for an expansion in the training of doctors, let alone raising the proportion of the gross national product spent on health to the figure which applies in many other European countries, or in the United States, or in Canada, purely to maintain the existing services expenditure on the Health Service will be increased from £1,900 million now to £2,500 million by 1974–75. To place full responsibility for financing the Health Service on taxation would be to condemn the Service to an ever deepening financial crisis.
I would try to avoid placing over-much reliance on charges. It is a pity that the Government are just maintaining the old pattern of finances as it was in 1948 and are not attempting to diversify the sources of finance, are not attempting to encourage private insurance to relieve 1032 the strain on the Service, not attempting to encourage local fund raising for the use of local hospital projects, not, for instance, following through the thinking behind the suggestions made by my hon. Friend the Member for Farnham (Mr. Maurice Macmillan) in his extremely interesting speech last week.
When one walks around hospitals, around wards for the subnormal, or long-stay wards for senile, geriatric confused persons, when one sees the strain on the nurses and staff as a result of overcrowding and understaffing, I fail to understand how one can seriously argue that one should aim to destroy one of the financial props of the Health Service.
When he introduces these Regulations, the right hon. Gentleman will be doing something which is unpleasant, but not unreasonable. All we ask is that he should cast aside this confusion which he appears to be deliberately creating and stand up like a man and explain to the House what are his intentions.
§ 7.27 p.m.
§ The Minister of State, Department of Health and Social Security (Mr. David Ennals)
I hope that the noble Lord the Member for Hertford (Lord Balniel) will not be embarrassed when I tell him that I have a great respect for him because of many things he does in the House and in Standing Committees which I share with him. But I thought the Motion unworthy of him. This sort of knockabout debate is not his style.
There are practitioners of the art who sometimes appear on the Opposition Front Bench. I am thinking of the sort of synthetic anger and frenetic fury sometimes produced by the right hon. Member for Altrincham and Sale (Mr. Barber) whom we rarely see these days. This is not the sort of job for the noble Lord. As he was speaking, I was reminded of the advice that Confucius gave to young dragons, when he said, "If you try to breathe fire through a paper mask, you will scorch only yourself".
In this debate the Opposition are behaving like a pack of end-of-term public schoolboys, except that they have kept it up for several months. It is a sort of Billy Bunter stuff. At one stage they cry, "Let's get Wilson", and off they rush, M.P.s, Tory journalists, commentators, script writers, and truth gets 1033 lost in the chase. Then, when they either get tired of that, or find that they are defeated, they try another tack, "Let's get Castle", they say, "If you cannot win the argument, shout them down". We heard them doing that in the debate last Thursday when they did not win the argument, but simply shouted down the other side, and brought disgrace to the House in the course of doing so.
But for a few weeks it has been a different theme. "Let's get Crossman", they say, and off they have rushed on this tack. Nor does it matter what is thrown into the charge. Truth is expendable in the sort of adolescent foray which we have had from the Opposition. If I may coin a phrase, they have spoken in half truths, quarter truths and no truths—mainly no truths in the story that they have told.
One wonders what is the brain process which produces this type of time-wasting, trivial Motion when there are important issues which I would have thought the noble Lord in particular would have wanted to bring before the House. Why are they so worried about the date of the Regulations? One might suppose that they wished to oppose them. But I gather that they do not. Is it perhaps that they want to increase Health Service charges? Perhaps they will say that the figure ought to be higher. I do not know. We have not heard from anything said by the noble Lord today or from anything said last week by his hon. Friend the Member for Farnham (Mr. Maurice Macmillan). Perhaps they have in mind other Health Service charges. Certainly that has not been suggested.
We had hoped to get the answer to that question when the hon. Member for Farnham opened the debate on Health Service charges. He made a long speech which the noble Lord said was extremely interesting. Certainly it was a monumental list of questions and an accumulation of arguments that could lead to one conclusion only: that the Tory Party is wedded to a substantial extension of health service charges.
When this point was made, up jumped the hon. Gentleman in the middle of my right hon. Friend's speech to say that he was not advocating Health Service charges. I have read through his speech, as, no doubt, have many other hon. Members—
§ Mr. Ennals
I will give way in a moment. If he was not advocating Health Service charges, I do not know what he was saying.
§ Mr. Chataway
My hon. Friend is reported as saying:I was not advocating increased charges, but was putting forward the view that they could be significant."—[OFFICIAL REPORT, 1st July, 1969; Vol. 786, c. 263.]
§ Mr. Ennals
The hon. Gentleman has been away from the House for some time. It is nice to see him back and helpful to have this sort of clear, pungent, biting statement of precisely where the Tory Party stands on this issue.
The noble Lord said that the speech of the hon. Member for Farnham was very interesting. I do not know whether he read the Daily Telegraph the next morning, which panned it—and I am not surprised—saying that it would have liked the hon. Gentleman to have got up and boldly said that the Tory Party was in favour of the extension of Health Service charges.
I said that I thought that this Motion was not worthy of the noble Lord. I go further. The noble Lord is not worthy of the Motion. Some of my hon. Friends—the hon. Member for Willesden, West (Mr. Pavitt) and others who are here—opposed my right hon. Friend's decision. They made it clear that they opposed on principle any Health Service charges. I respect the sincerity of their views in doing so. For them, these are matters of deep conviction. These are issues on which they have a right to come to the House and ask my right hon. Friend to justify himself, and no doubt they will do so at the right time. But there was not an ounce of sincerity in what the Opposition had to say, and they are not worthy of their own Motion.
I think that this is a deplorable waste of the time of the House of Commons, when one thinks of the major issues that now confront us in the Health Service such as developments within psychiatric hospitals and subnormality hospitals. I mention this first because it is a subject in which the noble Lord is interested. But the Opposition do not wish to bring this subject before the House. I should 1035 think that the hospital building programme was also a subject on which they would care to spend three hours in debate or the Todd Report on Medical Education. The noble Lord mentioned it, but apparently the Opposition do not wish to debate it. There is the whole question of Health Service reorganisation which is under tremendous debate and discussion throughout the country and the Seebohm Report. I could go on with countless issues of fundamental importance. But the Opposition have decided to come along with this petty mouse of a Motion to waste the time of the House of Commons.
I am reminded of John Ciardi's words:In the long run, a man is defined by what he gives his attention to.That is very fair. In this case, it is trivia and, as I will go on to prove, misrepresentation.
Is there any substance in the list of tittle-tattle—that is all it is—and garbled Press reports which made up the noble Lord's speech? My right hon. Friend made his statement on 5th May. He said that the Regulation would be laid shortly. He did not say that they would be laid this month or next month, but that they would be laid shortly. The Regulations will in fact be laid tomorrow and will come into effect from 11th August. We will then see what the noble Lord and his hon. Friends have to say if there is any challenge.
It has been said that my right hon. Friend chose his announcement date badly. I was glad that this point was not emphasised by the noble Lord, though it has been much emphasised in the Press. It may be that my right hon. Friend chose his date badly as far as my hon. Friends and the Labour Party are concerned. This was the beginning of the week in which local elections were taking place throughout most of the country. The noble Lord did not suggest that it would have been better had the announcement been made after the local elections. But had my right hon. Friend done that, I can imagine the uproar that would have come from the Opposition.
Had the Opposition done that, it would have been within their tradition. The House might be interested in the time- 1036 table of an historic event which occurred in 1963—about a year before, happily, the Opposition went out of office. On 11th March, 1963, the Government announced that two builders would be selected from a list of three for the contract for Polaris submarines. The three were Vickers of Barrow, Cammell Laird of Birkenhead and Scotts of Greenock. Tuesday, 7th May, was the date of the Scottish local elections. The Scots on Clydeside were no doubt hopeful that the contract would come their way. Certainly nothing had been suggested that this would not be so. Therefore, they went to the polls in hope. The very next day, Wednesday, 8th May, the Government announced that the orders were going to Vickers of Barrow and Cammell Laird of Birkenhead. So the Scots, who had gone to vote in hope were disillusioned the next day. Of course, the day after the announcement there were elections in Barrow and in Birkenhead. I do not know of any better example of rigging a time to suit their convenience. This was really pretty smart work.
The noble Lord has accused my hon. Friend of misleading the House in his answer to Questions on 14th April. There were, as the hon. Gentleman said, two questions. One was put by my hon. Friend the Member for Sheffield, Heeley (Mr. Hooley) who asked my right hon. Friend whether he would resist Opposition demands for the application of the principle of individual selectivity by imposing further charges. My hon. Friend said "No." It was not a slide; it was a statement that he had no intention of extending the range of health service charges. I can confirm that he has no intention of extending the range.
My right hon. Friend was then asked by the noble Lord whether it was his intention to increase prescription charges. My right hon. Friend said, "The answer is 'No'." Both answers were correct. There was no slide in either case.
The noble Lord raised the question of my right hon. Friend's statement about a link between these charges and the school building programme. This matter was raised by his hon. Friend the Member for Farnham in a Question to the Prime Minister who gave a long and absolutely clear statement of the position. But the noble Lord dragged it up again and again, just as he does his purple passage about the 1037 timing of the National Insurance Bill. Having gone through the debates in this House and in Committee, I could give, though not with all the skill of the noble Lord because he has no doubt rehearsed it, his little passage about the timing as between the Chancellor's statement and the publication of the Bill, and so on.
What about the hundreds of column inches of Press rumours that the Secretary of State had changed his mind? The noble Lord in his speech quoted all sorts of Press reports as if somehow every Press report was true, or even that any of them were true.
The first was the The Times front page headline of June 24th:Charges for glasses and teeth deferred.Then, day after day, oblivious of denials by my Department, we had political writers, radio and television commentators and gullible politicians letting their minds run riot on this prospect. One could picture behind the scenes a tremendous gladiatorial struggle, one Minister against another, the Cabinet wrought and involved as to whether the decision should be taken.
The Leader of the Opposition, who will believe anything which seems to offer party advantage, fell for it hook, line and sinker. There were no "ifs" or "buts" when, on 25th June, he went on television and told Robin Day, and, no doubt, a few million listeners who had not by then switched over to the other channel:Now, the increases in charges for teeth and spectacles. They were announced and have been abandoned.One must have thought that a special authority had given him that secret information which was not available to anyone else.
There may have been some who believed what the Leader of the Opposition said. No doubt, he hoped that they would and, no doubt, they have been warned. I can say that there was not a scrap of truth in any of those rumours. The rumour was flatly denied by the Department but, nevertheless, it was sustained day after day. It was a rumour without any foundation and yet hon. Members opposite, and even right hon. Members, fell for it. Perhaps it offers them some advantage, and off they go running after the pack.
1038 How did it start? Was it a politician's story? Did they, perhaps, start this hare running themselves? Certainly, it would not be the first time they had dreamed up something and made it into a story. I do not know whether we should be accusing them of spreading falsehoods or only of sheer gullibility—I do not mind which the accusation is; but whichever the case, they certainly ignored Cato's very sound advice. He said:Avoid gossip, lest you come to be regarded as its originator.If I may continue the classical reference, my right hon. Friend stands firm and unscathed by the Opposition's attacks. To quote Ovid,A mind conscious of right laughs at the falsehoods of rumour.During most of the noble Lord's rumour-mongering speech, we saw my right hon. Friend, conscious of right, laughing.
My own conclusion is that the Motion is nothing but a smokescreen. First, it is a smokescreen to conceal the total lack by the party opposite of any constructive policy in facing the future of the Health Service. We might have imagined last week, when they took the initiative on Tuesday to open the debate on the financing of the Health Service, that we would get some constructive ideas. But no. Perhaps, if they had constructive ideas on any aspects of the Health Service, we would have been debating them now, and we would have been much happier to do so.
I shall quote what the Daily Telegraph said about the noble Lord. On 3rd July, it plaintively wrote:The Opposition has surely had ample time to do its homework on the social services and to make some specific constructive suggestions for both improving their efficiency and containing their escalating costs.But no; they have nothing to show for their spell in the wilderness.
§ Lord Balniel
The hon. Gentleman refers to homework done in opposition. The homework done by hon. Members opposite when in opposition ended in a promise to abolish prescription charges and to move to a free Health Service.
§ Mr. Ennals
If the noble Lord will be patient, I shall come on to some of the results of what my right hon. Friends did when they were in opposition. The old battle cry that we had heard often of 1039 13 wasted years can now be uprated. It is 18 wasted years, 13 in Government and five in Opposition.
The Motion is a smokescreen, first, to conceal the lack of a constructive policy by right hon. and hon. Members opposite. Secondly, however, it is a smokescreen to conceal the substantial achievements of the Government in their administration of the Health Service. I heard the noble Lord talking about the parlous state of the Health Service. Certainly, we have had to accept some heavy burdens and there are heavy burdens and challenges that have to be met. I want, however, to give a few short, sharp facts to break a way through the smokescreen that the Opposition have tried to create.
First, total expenditure on health and welfare was up from £1,254 million in 1964–65 to £1,942 million 1969–70, an increase of over 50 per cent. If we look at it in terms of a percentage of the gross national product, in 1964, when the Opposition were in power, 4.16 per cent. of the gross national product went to finance the Health Service. Today, it is about 5 per cent., a not inconsiderable increase.
Secondly, the hospital building programme has nearly doubled since 1964 and is now five times as great as it was 10 years ago. I will repeat that: five times as great as it was 10 years ago. New projects to the value of £116 million are planned for 1969–70. The annual average for the 16 years to 1964 was only £17 million. These are real achievements, which were vitally necessary, because when the present Government came to power we inherited hospitals which were in many cases far too old for their purpose and not modernised, and we have had to plunge in with a much more substantially expanded programme.
Thirdly, the number of qualified nurses and midwives has risen by 32,000, or 30 per cent., since 1964. The number in training has increased by 11.6 per cent. If we look at health centres, by 1964 only 20 such centres had been opened in all parts of the country, or slightly more than one a year—a tremendous achievement during those 13 constructive years when the noble Lord and his friends were in Government. Now, 93 health centres have been opened, 69 are being built, a further 64 have been approved for building 1040 and 100 are in course of planning. That is a dramatic move forward in providing the sort of services which are needed to improve the standard of general practice and service to our people.
The noble Lord is very much concerned, as I am, with the problems of the mentally disordered. In 1964, there were 150 hostels for the mentally disordered. There are now 260 hostels, providing more than double the number of places which existed when we came into office. In 1964, there were places in the small homes for the elderly for 66,338 people. The number of places has gone up from 66,000 to 110,000, and the programme goes ahead.
If we look at the services provided for people in their homes—meals on wheels; that is, meals supplied to people in their homes and in their clubs—we find that in 1964, 6.5 million meals were provided and that in 1968 the number was 18.5 million, an increase of more than 300 per cent. on the figures which we inherited. I could go on—
§ Mr. Tim Fortescue (Liverpool, Garston)
Is not this dramatic increase in the provision of meals on wheels due entirely to the fact that there is now a Conservative administration in practically every city in the country? The councils are now Conservative-dominated and they have increased these services out of all proportion.
§ Mr. Ennals
I am sorry. I can only laugh at the joke of one of my hon. Friends—[HON. MEMBERS: "Answer."] It is absolute nonsense. If the hon. Gentleman likes, I will look up some figures and give them to him.
As I said, I could go on with this sort of list of achievements, but there is a danger in doing so, because one can sound complacent, and none of us in the Government from my right hon. Friend down is in the least complacent about any of the problems which we face in the Health Service.
§ Mr. Raphael Tuck (Watford)
My hon. Friend said earlier that he was disappointed with the Opposition's Motion and that they could have discussed many other matters like the hospital building programme. But does he not realise that they could not have discussed any of them, because the Government's record has been so splendid?
§ Mr. Ennals
I am grateful to my hon. Friend for saying what I should like to say myself. It is quite true.
There is a danger of sounding complacent, but I believe that we have a record of which we have good reason to be proud, in terms not only of our achievements to date, but of the plans which have been made for the future.
I have not mentioned the supply of doctors both for the hospital service and for general practice. No one can doubt that this is an extremely important question, and that we have a very substantial shortage of doctors. But why? It is precisely because of the Tory muddle in the late 1950s. I would ascribe it to the decision taken by the party opposite at that time, and I am surprised to see that none of the former Health Ministers is here to listen to the debate. Obviously, they do not feel strongly about this issue. They listened to the noble Lord and cheered him. As soon as he finished, out they went.
What happened in the 1950s was not simply because right hon. and hon. Gentlemen opposite were faced with economic difficulties. Nor was it because they could not get round to making a plan. They consciously took the decision to cut back on the number of places for doctors trained in this country. Between 1955 and 1961, the average output of medical schools was 1,825. That is a pitifully inadequate number. By 1961 it had gone down to 1,690. By 1962, it had gone down to 1,631. By 1964, when we came to power, it had gone down again to 1,511. The country was being starved of doctors because of conscious decisions taken by right hon. and hon. Gentlemen opposite when they were in office. This is one of the main reasons why we have been short of doctors and more dependent upon the services of doctors from the Commonwealth.
In 1968, the figure rose substantially. The output in 1968 was over 2,000 doctors. By 1975, there will be places for at least 3,700 doctors in our medical schools. This takes many years. Doctors do not come like manna from heaven. It is taking us many years to put right the result of the muddle left by right hon. and hon. Gentlemen opposite when they were in power. We on this side of the House do not accept from them accusations of muddle.
1042 To return to the Motion, although, unlike right hon. Gentlemen opposite, I do not believe everything that I read in the Press, I read that originally the Opposition intended to debate this Motion on Tuesday, 1st July. Presumably in a censure Motion on a Secretary of State, they would have imposed a three-line Whip. That is the normal tradition for a censure Motion. However, the date was Investiture Day—
§ Lord Balniel
To save the hon. Gentleman having to develop the point, it was a mistake on our part. We had not foreseen that the Prime Minister would be at Caernarvon Castle. We felt that he should be given an opportunity to be present for this debate on an issue on which he himself had resigned.
§ Mr. Ennals
Is the noble Lord really saying that it was the intention of the Opposition, consciously thought out, that they would impose a three-line Whip on the House on Investiture Day? Was it simply that they were worried about the Prime Minister? What about the Leader of the Opposition? Was it not supposed that perhaps there might have been representation from the Opposition benches at an event of this historic significance? The noble Lord's interjection shows that he admits that it was a mistake on their part. It was an infernal mistake, and it would not have been discovered had it not been for the assistance of my right hon. Friend the Patronage Secretary, as a result of which right hon. and hon. Gentlemen opposite were reminded that 1st July was Investiture Day. So, instead of having this censure Motion then, we had the little Motion, and the unfortunate hon. Member for Farnham had to dream up a quite different speech. It may be that that explains the emptiness of the content of that speech. As an example of muddle, that is about the limit.
Having made that absurd mistake, I should have thought that right hon. and hon. Gentlemen opposite would themselves have buried their petty, stupid little Motion. But, no. This was the only issue in their minds, so here it is today. Since they will not bury it themselves, we shall have to bury it for them.
§ 7.57 p.m.
§ Mr. Christopher Chataway (Chichester)
As this is the first occasion on which I have had the opportunity to 1043 address the House since my return, perhaps I will be allowed to refer to my predecessor, Mr. Walter Loveys. He was deeply interested in the social services. He was widely admired in the constituency and, although it is an honour for me to follow him, I know that both here and in the constituency there will be very many who mourn his passing.
I want to deal with a number of the points raised by the Minister of State in what I thought was a speech principally remarkable for the very few occasions on which it touched upon the Motion. I intervene in the debate not primarily because I have any claim to be an expert on the Health Service, but because I have a deep interest in what I take to be the core of the debate, and that is the means by which Governments can finance improvements in our social services.
For the past two years, I have had some responsibility for another social service—the education service in London. I find that some of my own experiences there are closed mirrored by the experiences of those who are faced with the administration of the Health Service in the regions. I find in both health and education that there is a tremendous demand for improvements and continual pressure from the Government to introduce them.
The other day, my hon. Friend the Member for Farnham (Mr. Maurice Macmillan) pointed to a number of instances where regional hospital boards were complaining about being subjected, week after week, to demands from the Ministry of Health for improvements. A very large number of circulars have been issued by the Ministry during the past 12 months to that effect. On the other hand, the Government, in health as in education, are unable to provide funds, and they show an obsessive reluctance to raise them in any way other than taxation.
That is the cause of today's debate. It is the rather tortured attempt of the Secretary of State to raise modest sums by an increase in the health charges which has led to the astonishing muddle which has been unfolded during the last few weeks.
The Minister of State pooh-poohs the suggestion that there has been any 1044 muddle. The whole debate, he says, is an appalling waste of time. The whole matter, he says, is trivial. I wonder whether the Minister of State agrees with his hon. Friend the Member for Willesden, West (Mr. Pavitt), for whose contributions I always had great respect when I was last in the House and whose contribution to the debate the other day I read with interest. In urging the Government to restore the basic principle of his party on health matters, the hon. Member said:This has been a trump card at every General Election right the way through my political history."—[OFFICIAL REPORT, 1st July 1969; Vol. 786, c. 291.]I wonder whether the Minister of State agrees that the promise to restore a free Health Service has been a political trump card for the Labour Party in recent elections. If so, then surely so dramatic a departure from it should hardly be described by him as a trivial matter.
The Minister failed to answer any of the questions put to him by my noble Friend the Member for Hertford (Lord Balniel). Is it the case that these charges are to be permanent or are they temporary? In the debate the other day the hon. Member for Willesden, West revealed that he had received a letter from the Prime Minister about prescription charges in which the Prime Minister had written:It would be wrong for you to assume that these charges, reluctantly introduced to meet a serious economic situation, carried the implication of a permanent change in the Government's policy or of its approach to Health Service financing.Are these increased charges temporary or are they to be regarded as a reflection of a permanent change of philosophy by the Government? That question was put by my noble Friend, but it was not answered.
The confusion about comprehensive schools remains. It does not do for the Minister of State to pooh-pooh all that and to pretend that the Government have always had both their intentions and their arguments for increasing these charges clear in their minds. Those who follow events are bound to recall the statements of the Secretary of State. We have the evidence of the right hon. Member for Sowerby (Mr. Houghton) that according to the Secretary of State the money from increased charges was to be spent on comprehensive schools.
§ Mr. Ennals
The hon. Member is holding a heavy volume of documents in his hands. Has he troubled to read the reply given by the Prime Minister to his hon. Friend the Member for Farnham (Mr. Maurice Macmillan) as reported in HANSARD of 20th May at column 63? That set the matter out clearly.
§ Mr. Chataway
Of course I have read that reply, but the point with which the Prime Minister did not deal—nor did he deal with it on television, and I also watched that—is the evidence of the right hon. Member for Sowerby that at a party meeting it was stated that the money saved in this way was to enable increases in the comprehensive school building programme.
I do not want to dwell on this point, because the Minister of State knows as well as I do that that was a nonsense. The very idea that increases in a capital building programme two or three years' hence could be dependent on an increase in revenue income now is obviously inherently absurd.
Very few will have failed to notice that there has been a considerable struggle on the Government's part to increase these charges. Does it matter? I believe that it does, for two broad reasons. First, I believe that charges have a significant part to play in the financing of the Health Service, as of other social services. The Minister of State quoted my hon. Friend the Member for Farnham, but he stopped at mid-sentence in the quotation. I pointed out that my hon. Friend had said—and here I entirely agree with him—that increased charges may have a significant part to play. Do they, in fact, have a significant part to play? Is it necessary to increase charges or is there an alternative means of financing the improvement?
We can look only to four possible sources. The first is taxation. My noble Friend pointed out that over 85 per cent. of the Health Service is financed out of taxation. The hon. Member for Ashfield (Mr. Marquand), with commendable honesty in view of the arguments which he was adducing, said in the debate the other day:… we cannot possibly hope to achieve the kind of health expenditure we need without a massive increase in taxation."—[OFFICIAL REPORT, 1st July 1969, Vol 786, c. 276.]1046 That is clear, and it is a position which I take to be consistent with the policy favoured by the Labour Party. All that the Secretary of State could offer in that debate was the suggestion that another form of taxation—contributions—might be increased, particularly the employers' contributions, after 1972. That is the second possible source.
It is common ground in all parts of the House that in the years immediately ahead there is no prospect of substantially increasing taxation. The hon. Member for Ashfield may like the idea, but I do not believe that even he, when speaking the other day, believed it to be possible. Certainly, no hon. Member is anxious to point to the sectors of the population which are capable of withstanding any increase in taxation. There is general agreement that those in the lowest income groups cannot stand it, and the move from varieties of poll tax to earnings-related contributions stems, I understand, from the desire to lessen the burden of taxation upon the poorest sectors of the community.
There would be general agreement, too, with the hon. Member for Salford, West (Mr. Orme), when he spoke in the debate the other day of those on £20 to £30 a week being subjected to a "terribly heavy burden". Further up the incomes scale, as we are beginning to realise, we in this country tax those in the upper income groups more heavily than almost all of our competitors and the crying need is for a reduction in direct taxation on the upper income groups.
Therefore, while there is general recognition of the fact that improvements in our social services are needed, and while we can all give our lists of priorities—within the Health Service, for my part, I hope that the severely disabled will be early candidates for improved services—virtually everybody now recognises that there is precious little room for financing improvements out of taxation.
Only two alternatives are left: expanding the private sector or increasing charges. For the Government, of course, there is only one alternative, for expanding the private sector is doctrinally impossible for them. The Secretary of State dealt with this briefly in the debate the other day, when he pointed out that there had been some increase in the private sector. His arguments against 1047 encouraging any further increase I found singularly unconvincing. He said:At present, virtually all the leading doctors treat Health Service patients, and the majority of their time is contracted to the Service. Health Service patients know that they can obtain medical care from our leading doctors, or at least from those doctors' firms. If the private sector or insurance became dominant, there might well be a considerable number of leading consultants who treated only private patients. Some might work only in private hospitals. We could no longer claim that all citizens, whatever their means, were able to obtain the same standard of medical care."—[OFFICIAL REPORT, 1st July, 1969; Vol. 786, c. 260.]But how important is it to be able to claim that all citizens are able to obtain the same standard of medical care, if one can provide a better standard of medical care for all?
The right hon. Gentleman drew an analogy with private education, where 6 per cent. of children—the figure has remained fairly constant over the post war years—go to private schools. I cannot believe that an increase from the present 3 per cent., the number in the private health sector, would, to use his word, "destroy" the Health Service.
If one can bring in fresh resources to the Health Service by encouraging the private sector, the result is more resources for everybody. With the relatively few choices open to us, it is foolish to dismiss the private sector and the apparently increasing preparedness of individuals to pay their own way.
§ Mr. Ennals
Does not the hon. Gentleman see that if there is a limitation on the supply of doctors and if one increases the private sector, which is able to demand a better service—[Interruption.] That must be so, or people would not pay for it—to get, for example, more rapid treatment, that reduces the standard for the rest of the population and produces a category of first and second-class citizens in this respect?
§ Mr. Chataway
The Minister does not apparently realise—he is not alone in this because his right hon. Friend the Secretary of State appears to share his view—that if one increases the amount of money spent on health generally, by increasing private contributions, one thereby produces more resources. It is not a question of saying out of the present given resources for health should be 1½ per cent. 1048 go to the private sector and 981 per cent. to the public sector, or some other proportions. If we enlarge the resources available to health in the way I have described, more resources can be available for the public generally. Inequality there may be, but if there is improvement for all, then surely that is right.
However, this alternative is not open to the Government. If there is to be any improvement in any sector of the Service it is unlikely to come about without increases in charges such as those which the Government are reluctantly now introducing. We should consider the possibility of increasing charges in many spheres. I would be out of order in going into the whole question of education, but we need only consider the case for introducing charges for nursery schools. This case is overwhelming. The other day the Secretary of State said that charges for day nurseries were not controversial. If they are not controversial for day nurseries, they should be acceptable for nursery schools.
Then, again, we should look at the question of charges, in the shape of loans, for higher education. And increased charges for school meals makes sense. In health, we should look carefully at the possibility of charging for hospital beds in certain hospitals and even, perhaps, for visits to the doctor. But both suggestions were dismissed the other day by the Secretary of State as "outrageous".
It is sad that the Government should be demonstrating publicly that it is only with the utmost difficulty that they are just able modestly to increase these charges. This may mark the last attempt by the present Government to alter the status quo in a manner that is distasteful to the Parliamentary Labour Party. One of the big changes one notices on returning to this place after three years is the general realisation of the potential strength of the House of Commons. Three years ago there was a great deal of talk about the omnipotence of the Prime Minister and the relative strength of the Executive in a modern legislature.
The Government have publicly demonstrated a very different picture. Now that the Parliamentary Labour Party has succeeded in defeating the Government on Lords reform, industrial reform and, in a sense, on the prices and incomes policy, and has subjected them to such a 1049 humiliating series of explanations and circumlocutions in this matter, I doubt whether in this Parliament we will see a further attempt to defy Government back benchers. This may be the last angry flap of a lame duck Administration.
§ 8.13 p.m.
§ Mr. Douglas Houghton (Sowerby)
The House will wish me to congratulate the hon. Member for Chichester (Mr. Chataway) on his first speech since his re-election. On personal grounds we welcome him back. We have missed him for the last couple of years or so, because he is a man of progressive views on many questions about which his lion. Friends tend to be reactionary. I am sure that he will contribute some constructive thought on matters about which he must have gained valuable experience during his absence from the House.
I congratulate the hon. Gentleman the more because he has taken a good deal of nonsense out of the debate. It really is a silly debate and one wonders how it can be kept going relative to the Motion until ten o'clock. I will deal with some of the more serious thoughts which the hon. Gentleman expressed later, but, first, I had better refer to the remarks of the noble Lord the Member for Hertford (Lord Balniel), who opened the debate, and some of the comments that have been made on this subject by his hon. Friend the Member for Farnham (Mr. Maurice Macmillan), who, I understand, will wind up for the Opposition.
I am sure that the noble Lord enjoyed teasing my right hon. Friend the Secretary of State. Certainly, he had plenty of support from his hon. Friends while his speech was in progress, though as my hon. Friend the Minister of State pointed out, as soon as the noble Lord had finished, his hon. Friends trooped out to have their dinner and did not even bother to stay to hear the Minister's reply.
The noble Lord is held in mixture of respect and scorn in the House, because sometimes he is so good and at others so petty. I thought that this afternoon he was almost at his worst. I once described him as the "Billy Graham of the Conservative Party". He then had fervour and evangelical oratory to support his case, but this afternoon he was only indulging in a boyish prank. There he sits: the son, I believe, of an earl. On his right is the son of a former 1050 Prime Minister. All they are indulging in this afternoon is a boyish prank. It is not worthy of the House of Commons. We often hear of the House of Commons at its best. I think that today the House of Commons is at its worst, because this really is not a worthy subject to occupy the valuable time of the House for several hours.
The noble Lord realises that on this side we have many difficulties of principle in relation not only to social services but to other matters. In a rash moment, I said once that the trouble with the Labour Party is that it has so many principles that it cannot live up to them all at once. That is a grief not shared by the Opposition, because they have so few of them.
This afternoon we have heard from the hon. Member for Chichester a continuation of last Tuesday's debate. As my hon. Friend the Minister of State has said, if one wants to see Opposition muddle we surely saw it last Tuesday. They had arranged to have a censure debate on that day. I was warned of it. We knew that it would be very difficult to hold people from the Investiture to obey a three-line Whip in order to defeat this nonsense at the end of the day. Then the Opposition awoke to the fact that the Investitute was on that day, and it was not the Prime Minister they were worried about but the Leader of the Opposition—and probably the noble Lord himself, because he was not here last Tuesday during any part of the debate. Perhaps he would like to say where he was last Tuesday.
§ Lord Balniel
The right hon. Gentleman describes me as the "Billy Graham of the Conservative Party", but he is now behaving like the dyspeptic Santa Claus of the Labour Party. I had a perfectly good and valid reason for not being here. I regret that I could not be here, but I had a very good reason.
§ Mr. Houghton
I have no desire to suggest that the noble Lord was absent without reason—or, indeed, absent without leave. I am just commenting that on that important day when we were discussing the financing of the National Health Service, for which he is shadow Minister, he was not present. I make the comment, and that is enough.
1051 On that day we had a very constructive debate on the financing of the National Health Service. I thought that it was a good debate—probably better because I did not take part in it. The hon. Member for Farnham made a constructive though interrogatory opening speech, and from the my right hon. Friend the Secretary of State for Social Services we had an extremely illuminating survey of the finances of the National Health Service and of the various methods of raising the money. It was a most useful debate in presenting to the public the options of how the Health Service could be financed.
It would have been more seemly had the noble Lord said this afternoon that the Opposition wanted to continue with that debate now, because it was so interesting that he and others wanted to take part in it. But no—he indulges in these playful references to my right hon. Friend and calls it muddle. Surely he understands that the root of the problem is curbs on public exenditure. We are always being asked by the Opposition to reduce public expenditure, but they rarely say in which direction it should be reduced.
In a debate such as this, what is conspicuously absent is anything from the Opposition about their policy for financing the Health Service. In fact, we have not heard from them anything of their policy for social services as a whole. We have not heard their official view of the White Paper on the future of the social services. We have not heard what they would put in its place—if they would put anything in its place at all. On the Health Service, all we heard the noble Lord say was that while some charges would be justified he doubted whether, if he were a Socialist Minister of Health, he would introduce these particular charges. That leaves us just nowhere. We have not heard what the Opposition would do.
The events in the Parliamentary Labour Party have received a good deal of publicity. All I would say about that is that it would be a very good thing if the 1922 Committee would adopt the same practice that we have followed for quite a long time in the Parliamentary Labour Party and have a full official briefing of the meeting afterwards. Then we should 1052 get to know something about which we know so little, and that is the muddle in the minds of right hon. and hon. Members opposite about the social services. They are in a dilemma, even if not in a muddle. They do not know what to say about the future of the social services. Let them be honest about it: as of now, they do not know what to say about the future of the social services; still less, what to say about the financing of the Health Service.
My right hon. Friend last Tuesday, without any doctrinal overtones, said, "Here you are. We have looked at this from the point of view of the total cost of the Health Service. This is the part which, perhaps, at the maximum charges could play. Would that be a significant contribution to the financing of the Service? Here is the maximum part which, perhaps, contributions could play. Will that be a significant contribution to the finances?" He then examined the much greater rôle of general taxation.
I have no doctrinal difficulties about charges in the Health Service provided that they are the sort of charges I think should be related to the capacity of people to pay. In this respect I differ, no doubt, from some of my hon. Friends who hold tenaciously to the view that there should never be any charges in the Health Service at the time of needing the Service. That is their view, and it is heard in every debate. The large number of my hon. Friends who put their names to the early day Motion shows how strongly this view is held in the Parliamentary Labour Party. My right hon. Friend knows that and has known it all along.
We had serious difficulties over the earlier introduction of prescription charges after we had abolished them in 1965, but the Opposition played very little part in that debate if I remember rightly. When we were in serious internal difficulties about that proposal I believe the Opposition walked out and abstained from voting in the Division. They left it to us and expressed no view on prescription charges. We shall see, when the House debates my right hon. Friend's new proposals for prescription charges, what the Opposition says about them.
§ Dr. M. P. Winstanley (Cheadle)
Surely it is on the record that my hon. Friends on this bench precipitated that debate, not the right hon. Gentleman's 1053 hon. Friends, although we were very glad to have their support in the Lobby?
§ Mr. Houghton
I so rarely reckon the hon. Member for Cheadle (Dr. Winstanley) and his hon. Friends as among the Opposition that I was not taking them into account.
§ Mr. Laurence Pavitt (Willesden, West)
I remind the House that it was my Prayer and that I divided the House.
§ Mr. Houghton
Now we have competing claims for the honour of having moved the Prayer and dividing the House. At least, the noble Lord does not make a claim on his own behalf. He knows well that he played no part in the Division on the Regulations that time.
I suppose that we must have a few constructive and serious thoughts in this debate; otherwise, it will be a completely empty occasion. As to the future of the Health Service, I think that we shall now have a combined contribution to social security and the Health Service and that one has to recognise the limit to the principle of a proportionate contribution. It is very important to recognise that when a proportionate charge becomes too high there is bound to be a demand that it should be made progressive. Then one is in the field of direct taxation. We cannot have a percentage of earnings as a contribution carried too far without raising the question of whether those who are asked to pay have domestic circumstances and demands—a wife, children and the rest—which would make it fairer for a progressive charge and not a proportionate charge to be levied. There is a limit to the amount of a contribution levied on conventional social security lines. This is something to be borne in mind.
It may be that one could develop the idea of a social security tax or a social services tax which would be progressive. I know the objection of Governments and Chancellors of the Exchequer to having a form of taxation which is identified with a particular purpose and a particular object, but in certain circumstances we would be justified in having a progressive levy for social services. This, I know, would infringe the traditional contributory principle where, in the past, everyone has contributed alike and everyone has had benefits alike. That was a tenable proposition in relation to the flatrate 1054 scheme, but it becomes less tenable under a graduated scheme.
However, there will be plenty of time for these debates to be carried further. I think the last word on financing social security has not yet been said by a long way. As the cost of social security rises we shall have more opportunities to debate how the money should be levied. I think it certain that it will not be raised in any substantial amount by charges on the Health Service. But we are discussing the alleged muddle and not the wider issue, however desirable it is to widen the scope of the debate. My right hon. Friend was surely faced with the difficulty this time, as on the previous occasion, that money had to be raised beyond the provision made by the Chancellor of the Exchequer for the social services if the services themselves were not to suffer.
This was the least objectionable way that the additional money could be raised. I see nothing of a muddle in that. If my right hon. Friend has had regard to the susceptibilities and feelings on my hon. and right hon. Friends on this side of the House, it just shows that he is sensitive to our feelings and convictions.
I conclude by saying that nothing the noble Lord said this afternoon can possibly harm my right hon. Friend. His stature, his standing, his compassion, his capacity for taking a broad sweep of the concept of the social services, is far beyond the range of the noble Lord, or at least of anything we have heard from him. Therefore, my right hon. Friend will come out of this debate unscathed, as big a man as he was before the debate began.
§ 8.36 p.m.
§ Dr. M. P. Winstanley (Cheadle)
The right hon. Gentleman the Member for Sowerby (Mr. Houghton) began his speech by commenting on the relative merits of the speech of the noble Lord the Member for Hertford (Lord Balniel) as against certain other speeches. Since the right hon. Gentleman has set the example, I would comment that I have heard the right hon. Gentleman himself make more significant contributions, or contributions to which I have had greater pleasure in listening.
We have heard much about wasted time. Indeed, the Minister said that we 1055 had wasted a great deal of time and that it could have been far better spent. I agree that the noble Lord is not particularly adroit at exhibiting synthetic indignation. He could scarcely conceal his delight that the Government had given slight support to his own party's policy on charges. Therefore, there was some ambivalence in his attitude from the Opposition Front Bench.
The one speech which certainly did not waste time was that made by the hon. Member for Chichester (Mr. Chataway). I did not agree with what he said, but it was relevant to the point. One would not, of course, expect him to take up a great deal of time, since his activities were at one period connected with the running track where his time was used most economically. He certainly used his time economically today. We have not a great deal of time before us in this debate which is supposed to be a short one. We have had only four speeches in one and a half hours, and I will try to be quick.
The views of the Liberal Party on this subject are fairly well known. Those hon. Members on both sides of the House who do not yet know them have perhaps reached a stage when they no longer wish to improve their knowledge. I summarise our views by saying that, with proper organisation and proper use of existing resources and the avoidance of duplication and waste, it ought to be possible to organise and maintain a comprehensive, efficient and human Health Service on a non-paying basis.
I do not delude myself into thinking that the Health Service can be free, since it has to be paid for somehow. The question is whether it is to be paid for at the time of need, or by a spread-over method of taxation, or on an insurance basis. This is what the argument is about. I do not think anybody would now suggest that we should move wholly to a method of payment only at the time of need. Nobody on this side or, I am sure, on the Conservative side, would recommend that. Does one go to payment at the time of need at all, and, if so, how far? This is a complex argument—and we could take a good deal of time over it.
I was interested in the hon. Member for Chichester's remarks about private 1056 practice, but his argument shared some of the fallacies advanced by hon. Members opposite about private practice. One hears supporters of the Government saying that private practice is somehow plundering the Health Service and using up resources in some curious way. On the other hand, we heard the hon. Member for Chichester imply that, somehow or other, private practice could of itself create new resources. In fact, neither is true. A patient who has his appendix removed, whether it is removed under the National Health Service or privately, occupies only one bed, probably is in hospital or clinic for the same number of days, and takes up the time of only one surgeon. Therefore, I do not agree with the view that is sometimes expressed that the private sector consumes resources in some way. People do not have operations for fun. They do not suddenly decide to have something done because they can have it done privately.
I do not believe that the abolition of the private sector would restore the deficiencies in the public sector, and neither do I take the other view. The deficiencies in the National Health Service are due to shortage of premises, shortage of personnel, shortage of materials, and so on, and one does not suddenly create those merely by creating private practice. It is a long argument, and I should welcome an opportunity to go into it on another occasion.
I come now to the Motion itself. It regrets the muddle. No one can doubt that there has been muddle. I cannot imagine that any hon. Member opposite will seriously suggest otherwise. If there has been muddle, we should regret it. Muddle cannot be regarded as desirable even when it delays the undesirable. Therefore, although I am not sorry if muddle may result in a change of heart on the benches opposite, I cannot commend the muddle. Accordingly, I support the Motion.
I support the Motion also in condemning the Government for a further reason. We regret the muddle and, what is more, we regret the decision which led to the muddle and which could produce even further muddle. The increased charge is illogical. Why suddenly decide to raise this charge?
I have discussed this matter consistently on two previous occasions. I say that 1057 to put the record straight. One Motion was moved by the hon. Member for Willesden, West (Mr. Pavitt). The other was a Prayer which I moved against the Regulations raising the prescription charges. At that time, I said that, if we are to have charges, they ought to be logical and properly considered. A random charge on prescriptions is illogical. Why should a person who takes two minutes of his doctor's time to have some iron and vitamin tablets pay 5s. when a person who takes half a hour of the doctor's time to discuss his or her matrimonial difficulties pays nothing? If there is to be a charge, we should apply it to the use of the service. Similarly, it is illogical to pick on these two items as the ones on which the charge should be increased. Why not glass eyes? Why not artificial limbs?
There is another illogicality. Now that we are changing the age of majority, we should recall that exemption from certain of these charges operates up to the age of 21. It might have been logical if the right hon. Gentleman had said that the age of exemption should stop at 18. If his idea was to tidy up anomalies and remove illogicality, there is a real illogicality which one could have considered.
What are the increased charges for? I do not imagine that they are to provide additional money for the National Health Service. In fact, we know that they are not. If the purpose were to provide additional money, the Secretary of State could say that there will be another £½ million and it will all go to the Service as extra money, not to replace other money. That would at least have been arguable, though, again, I should not agree. But that is not the intention.
It cannot be the purpose—as was argued by some people with regard to prescription charges generally—to discourage frivolous or extravagant use of the Service. I did not agree with that argument when it was used about prescription charges. I take the view that, by and large, people visit their doctors because they are ill, not for some frivolous or extravagant reason. I do not accept the view that prescription charges discourage the hypochondriac. My experience of the hypochondriac is that, once a charge is introduced, he or she regards it as cheap at the price and then makes even more use of the Service.
1058 One could not possibly regard these increased charges as being introduced to act as a disincentive to those who would otherwise seek to make frivolous or extravagant use of the Service. People do not choose to wear spectacles for frivolous reasons, and neither do they choose to have their teeth out and be fixed up with dentures for frivolous or extravagant reasons. We can dismiss that.
We must come to the conclusion that the increased charges are being introduced merely as an extraordinary and capricious method to raise funds for the Exchequer or marginally to reduce purchasing power. The sum involved is so negligible that in either case one could hardly justify the proposals. We cannot justify them even if it could be argued that this is a very small thing and that people will manage.
Let us look at the other side and see what possible ill effects there will be. If there are no very good reasons for doing this, are there any good reasons for not doing it? There are. Both teeth and spectacles can be done without, but they are things that should not be done without. I have had experience, not once but over and over again in different phases of my professional life, of people who have done without one or the other, or even both, purely for financial reasons. I do not think that people are often deterred from obtaining the necessary prescription for penicillin or other antibiotics because of the half-crown prescription charge, but I have known many cases of people who were deterred from obtaining spectacles.
For many years I was a part-time industrial medical officer at a big heavy engineering factory, where I had to examine people for crane driving and similar jobs. If a man's vision was not up to standard I had to have him removed from crane driving and put him on other work. I would tell him that if his vision was all right with spectacles he would be able to resume his original work, but often there were long delays before men obtained their spectacles, because they waited until a convenient financial time. It was not that they were desperately hard up, but spectacles are things that people can do without, and if one provides people with encouragement to do without them there can be undesirable consequences. There can even be 1059 undesirable consequences on production if, for example, a productive worker is put on clearing up work while waiting for his spectacles, which often happens because he waits until he feels that he can afford them.
In general practice I, like every other general practitioner, have had experience of a medical condition, such as a gastric complaint, resulting from dental caries. We tell the patient that it would be better if he had his teeth out, but he will often say, "I cannot afford it until I have come back from Majorca." Patients say this quite seriously, because teeth are something people can do without, and they will be pm off obtaining false teeth by the increase. The Secretary of State makes a mistake if he provides a financial disincentive to people's obtaining spectacles or teeth.
There is nothing much else I want to say. I am opposed to the increases. I think this is unnecessary; it is a mistake. It will have ill effects. Merely to raise a trivial amount of money for national funds or to have a negligible effect on purchasing power the Secretary of State intends to introduce a measure which, however marginally, may cause some suffering and result in accidents and ill health, and could marginally have a deleterious effect on production. I hope that as a result of this debate the right hon. Gentleman will think again.
§ 8.49 p.m.
§ Mr. Laurence Pavitt (Willesden, West)
The hon. Member for Cheadle (Dr. Winstanley) and I agree on so many matters that I want to raise only one point on which I disagree with him. He suggested that the private sector does not greatly absorb resources which could be used for the National Health Service, but I profoundly differ. When one has in an area of unlimited demand only a certain amount of resources, it is inevitable that if people can pay for resources privately those important resources are used by the people who can afford it, and, therefore, people dependent on the Health Service cannot command those resources. This was seen during our short exchanges at Question Time on the way in which the Abortion Act is working.
I agree with the hon. Gentleman's major points, and I do not differ on the support we have both given in the past 1060 to trying to maintain the basic principles of the Health Service.
The slight difference I have with my right hon. Friend the Member for Sowerby (Mr. Houghton) is not about ultimates, but about the intermediate stage. The Labour Party's hope has always been that eventually, in the ideal society, we would be able to provide a system whereby those who were not in need should be able to provide for those who were. We have reached only the first step towards that. In 1948, we succeeded in reaching the stage when we could say, "At this time in our health services we are able to say that a person in need shall not have additional anxiety and a financial burden at the time of illness or disability."
I agree with my right hon. Friend that we hope to get to the stage where we can extend that principle further and, indeed, over the whole of social security. One of the reasons for my great concern about the Government's new proposal is that it represents a step backward on something that we have achieved. If we go further along the road of imposing charges on people at the time they need to use the Health Service, we are confirming a principle to which I have been opposed all my political life.
But, in reply to the Motion, I could not agree more with the speech of my hon. Friend the Minister of State. It is something of a tragedy for me that, although I have participated during the last 10 years in every debate on health in the House, and have often either followed or been preceded by the hon. Member for Hertford (Lord Balniel), this is the first time that we have ever had a debate on this level. Usually, those of us on both sides who take an interest in health have had constructive contributions to make, but this debate is just a vehicle for a personal attack on my right hon. Friend the Secretary of State.
Passionately as I feel against the Government's proposal, I bow to no one in my tribute to my right hon. Friend the Secretary of State for the way in which, coming to the Department as an expert on pensions, he has also taken what was for him an entirely fresh field of activity, has grasped some of the great intricacies of the subject, and has brought fresh air into something which was inclined to be rather impersonalised and 1061 sophisticated in many ways. In his new approach, he is opening all kinds of doors on things which had been fusty for a long time. Of course, he will make mistakes. Everyone makes mistakes. But the idea of moving a Motion of this kind is so much nonsense. I hope that my right hon. Friend will laugh at it as much as I laugh at it.
However, the Motion has given us the opportunity of a debate. I am grateful for the revealing contribution of the hon. Member for Chichester (Mr. Chataway). He and I came into the House in 1959, and it was some cause of embarrassment to be in those days, before time had taken its toll of my looks, because I was sometimes mistaken for him. I was sometimes asked for my autograph on the ground that I had run a mile in four minutes, and I could only say that that was not, of course, the case.
The hon. Gentleman made a plea not only for this proposal, which I do not like, but for something even more. He claimed that the present level of taxation was sacrosanct and that taxes must not be raised. I remember well in 1961 that £65 million was raised on prescription charges and on charges for cod liver oil and orange juice. Within a short time, because of the arguments the hon. Gentleman used tonight in relation to taxation, the Government gave back £83 million to the surtax payers because they thought they must give them incentives. The idea that we cannot possibly increase taxation because we have now reached the utmost limit is sheer financial nonsense. We have a position in which 60 per cent. of the wealth of the country is owned by 5 per cent. of the population, so there is a whole area where people could afford to pay more and would not be under great hardship if they were so charged.
My right hon. Friend is facing the problem of how far a comprehensive service can be comprehensively paid for. His argument of last Tuesday was irrefutable. As he said, if 85½ per cent. of the cost of the Service is to come from taxation, the remaining amounts must be perpheral. But any extension of the margin which causes difficulty will increase the problem of persuading people to accept the reality that taxation must meet the main part of the burden, and will, therefore, be a step in the wrong direction; in the long run, counter-productive.
1062 We spend about 5¼ per cent. of our gross national product on the Health Service and the figure should be at least 6 per cent. The only way in which we shall be able to persuade people to accept a comprehensive Health Service is to get them to understand what it is all about. When the average father of a family spends more on tax and insurance for his car than on the health of his family in a year, when more is spent on each of three sectors of spending, on tobacco, on wines and spirits, and on gambling, than is spent on the Health Service, our approach is entirely wrong. It cannot be said that the expenditure of £1.5 million is a major issue.
I blame the Press, especially the "heavies", which, in the week before last, set the world's record for reporting non-events. On the Tuesday they said that my right hon. Friend was facing a major confrontation between the Government and back benchers and that the Government had given way. On the Thursday, The Guardian announced more great news about what was to happen. It was all guesswork.
My right hon. Friend is to be commended for not having taken decisions isolated and removed from Parliament and for permitting us as a House of Commons to debate these issues. He has listened to views and joined in discussions and has forcefully argued his own case, and for that he should be commended. He is constantly trying to understand what the opposition to his proposals is about and to assess the right course.
The Motion is irrelevant. The Opposition should be praising my right hon. Friend for not having dashed in with a proposal which was bound to cause controversy on his own side of the House and for being prepared, rationally, quietly and coolly, to assess the likely consequences, not just the political consequences for his own party, something which has never been a major consideration with my right hon. Friend, but the consequences for the people and for the Health Service, which has a unique place in the world.
So many other subjects could have been debated this evening—whether integration of the Administration of the Health Service could be achieved, whether we could have community health service councils, and so on, all subjects 1063 of much greater importance. The Opposition accuse my right hon. Friend of muddle. These increased charges for teeth and spectacles are important because they represent a consolidation of a change of direction. No one can claim that one-third per cent. of our entire expenditure in the Health Service is a matter of confidence in the Government, or its credibility that the expenditure of £1.5 million this year or £3.5 million in a full year is of such major importance that the country is waiting to see whether the Government will fall.
The issue has always been peripheral. However, the Motion has been moved because of the political climate and because July is always a mad month for Parliament. A story had to be found and this was built up so that it could be said that there was a great revolt among the serried masses behind me. The Opposition have said, "If we cannot find a fight, let us create one".
I have made it clear to my right hon. Friend that I shall oppose these charges. I am clear about that, and my right hon. Friend is clear about it, too. The idea that this issue should be reduced to the kind of political knockabout resulting from the Motion is foreign to the character of both the noble Lord and the hon. Member for Farnham (Mr. Maurice Macmillan), who made a serious contribution to last Tuesday's debate. It is foreign, too, to my right hon. and hon. Friends and those few hon Members opposite who believe that the Health Service is one of the greatest achievements of the century in showing how people can care for those who are sick and disabled.
This country is unique in that. Other countries have health services and provisions of one kind or another which are admirable and well worth while, but this country has tried to put into operation a principle by which those who are able care for those who are sick and disabled. With the maximum amount coming from taxation, we are all paying for it. The biggest nonsense of all is to call it a free service. The important question is when and how we pay for it. People think that they are covered comprehensively. If we impose a second charge only on those who are in need of a certain part of the Health Service at 1064 the time of that need arising, we shall go back on a great and unique achievement.
With the Health Service, we have taken a great step forward in our whole approach to human relations, community contact and the brotherhood of man. It is because of those principles that I hoped and believed that it would be possible to avert my right hon. Friend's Regulations. Once they were blown up by the Press as a major cause of conflict, however, that was no longer possible. A number of hon. Members have talked about the possibility of their being temporary. It is my sincere hope that, because it is irrelevant financially and economically and because there are better ways of achieving the same end, the Government will reach a decision eventually that economic circumstances force them to do what they do not want to do, but, when those circumstances improve, they will find other ways and means of ensuring that those of us who are healthy look after those who are ill and that those of us who have good eyes, teeth and ears bear the burden for those who do not.
The obvious corollary is that if we intend to move to preventive medicine, the people who do without are those who end up needing to have hospital treatment, whereas if, in the absence of any financial barrier, their complaints had been dealt with in time a great deal of expense to the taxpayer and suffering for the patient would have been saved.
I shall support my right hon. Friend tonight because of his tremendous achievements in the Health Service in a very short time, but it is my hope that the Government will change their mind and their approach to the financing of the Health Service and get back to what is one of the greatest achievements of the Labour Government of 1945 to 1950.
§ 9.4 p.m.
§ Mr. Paul Dean (Somerset, North)
I am sure that the House recognises the strenuous battle which the hon. Member for Willesden, West (Mr. Pavitt) has always fought against prescription charges and against any other type of charge proposed for the Health Service. Hon. Members acknowledge that whether they agree with him, as some of his hon. Friends do, or, like me, take the contrary view.
1065 It is interesting that the Minister of State and the right hon. Member for Sowerby (Mr. Houghton) both attempted to laugh off the debate as a waste of time for the House of Commons. They resorted to abuse of the Opposition and the Press. Those are the classic arguments used by a Government who realise that they have a weak case, as the present Government have on this issue.
The justification for this debate came in the speech of the Minister of State when he announced that the Regulations for the increase in charges of 25 per cent. for teeth and spectacles would be laid tomorrow and would come into operation on 11th August. It has taken this debate to get the Government to announce their policy and the timing of it.
§ Mr. Crossman
Perhaps I should explain that the debate postponed the announcement. We decided, in order not to put the debate out of order, to announce the date for the laying of the Regulations immediately after the debate rather than at the end of last week as we intended.
§ Mr. Dean
I am obliged to the right hon. Gentleman. All we are differing about now is a few days. In other words, we are in very much the same position on these Regulations as we were a few weeks ago on how the contributions would be raised to secure the substantial sum of money which was required. It required an Opposition Motion on that occasion for the ugly truth to come out that £430 million was required, which was a substantially higher sum than the Chancellor of the Exchequer announced in his Budget speech. It required a debate initiated by the Opposition to elicit the ugly truth from the Government on that occasion. Today, it has required another debate initiated by the Opposition to elicit from the Government when the Regulations are to be introduced and from what date the new charges are to operate. That, in itself, is ample justification for the debate. But it is a great pity that the Opposition have to use their valuable time to get matters announced which the Government should have announced a great deal earlier.
The Government are now getting the worst of all worlds. On 5th May the right hon. Gentleman announced that these charges were to be increased. But 1066 he has waited two months before laying the Regulations and saying when they will come into operation. The result is that he must inevitably have lost valuable revenue for the National Health Service which at that time he said was urgently required.
What were the two main reasons which the right hon. Gentleman gave on 5th May? The first was that the increased revenue,will help to keep total public expenditure within the limits set out in the White Paper `Public Expenditure 1968–1969 to 1970–1971'—Cmnd. 3936".That was the first and very important reason that he gave: to keep public expenditure within bounds.
The second reason was that,this method of saving £3.5 million is far less damaging than would be cutting back one of the increases in the Service to which we are committed."—[OFFICIAL REPORT, 5th May, 1969; Vol. 783, c. 42–4.]It is perfectly clear that, owing to the delay and the confused statements that we have had, the right hon. Gentleman has almost certainly lost, for this year at any rate, most of the revenue which he would otherwise raise. By introducing the new charges from the beginning of August he has lost a good deal of the time. It is quite certain that a lot of people have, quite naturally, bought their glasses and their teeth in anticipation of these charges being introduced. This is an example of muddle and confusion which means that two important objectives which the right hon. Gentleman set himself in May are very unlikely to be achieved this year.
The right hon. Gentleman may try to laugh this off as a small issue, simply because a small sum of money is involved. But in our view this raises very much larger issues. Here is a classic example of a Minister who has failed and made a muddle on small issues and on small sums of money. Inevitably, one asks: can he be entrusted with the larger sums of money which are involved in the Department over which he has charge?
The muddle over these Regulations is merely the most striking recent example of confusion in the financial stewardship of the very substantial sums of money over which the right hon. Gentleman has charge. I thought that my noble Friend the Member for Hertford (Lord Balniel) 1067 was being very kind to the right hon. Gentleman when he referred to his "amiable incompetence". We are dealing here with the biggest spending Minister of the lot. According to the figures for 1969–70, for health, welfare, and social security, the right hon. Gentleman is responsible for the expenditure of £5,314 million a year, far and away greater than for education, far and away greater than for defence, and far and away greater than for any other Ministry.
The right hon. Gentleman is not only the major spending Minister, but also the major taxing Minister, because, through the National Insurance Scheme, through the health stamp, through contributions of various kinds, and through charges of various kinds, he has power to raise very substantial sums of revenue by what are, in effect, forms of tax. At the moment the right hon. Gentleman is seeking authority from Parliament to raise £430 million extra for pensions and other benefits.
When one considers the burden involved for the employers—just to give one example—one finds that between November, 1964, and November of this year, on the flat rate stamp alone, plus S.E.T., which today is going up by 28 per cent., plus redundancy contributions, the employer's stamp is going up from 9s. 8d. to 65s. 11d., an increase of no less than 620 per cent. When one considers some of the other elements for which the right hon. Gentleman is responsible, one can see why we are disturbed over the muddle which he has made over this matter of £31 million on charges.
We are told that in the next Session the right hon. Gentleman is to come forward with another expensive Bill for the future of pensions and other benefits, and the right hon. Gentleman hinted during the debate last week that he may well, in due course, if he is still in his Ministry, be asking the workpeople of this country and their employers to pay additional sums through the National Health Service contribution for the service which we are now discussing.
These things add up to formidable sums of money for which the right hon. Gentleman is responsible. How can we be expected to have confidence in his financial stewardship over these substantial 1068 sums when he cannot even avoid the hopeless muddle and confusion that we have had over the increase of £¼ million in charges for teeth and spectacles?
We are dealing in the National Health Service, as indeed in all the other services for which the right hon. Gentleman is responsible, with services which, inevitably, have a substantial built-in growth factor. Advances in medical science are, happily, bringing possibilities of cure and alleviation of disease and suffering which were unheard of a few years ago, but the cost of these is growing year by year, and substantial additional sums of money have to be made available somehow merely to ensure that we stay where we are, let alone try to take full advantage of the new techniques which are becoming available to us.
What we on these benches fear, and what no speech either from the Treasury Bench, or from the back benches opposite, has answered, is that the right hon. Gentleman is piling burden on burden without looking at the thing as a whole, and without sufficiently assessing the effect which these burdens are having on industrial costs and on the individual who, as he becomes more prosperous, may well wish to have more choice for himself in the way that he spends his money.
Why has the Chancellor of the Exchequer of the day the continuing problem of trying to cut down on consumer demand, which often involves the sucking in of imports? One of the reasons is that the compulsory contributions of various kinds which the right hon. Gentleman is piling on the individual are making it much more difficult for him to exercise that freedom of choice in the expenditure of his own money which we on this side of the House want to see.
I fear that this applies particularly to pensions, although to some extent in this field, too. The right hon. Gentleman is increasingly getting into a position where he is writing cheques which he expects and intends that our children will honour in the next generation. That is the height of financial irresponsibility. It is that ugly background of no confidence in the right hon. Gentleman's ability to manage this vast spending Ministry which amply justifies our Motion.
§ 9.16 p.m.
§ Mr. Ted Leadbitter (The Hartlepools)
I intend to be brief so that the Front Bench speakers can wind up the debate in proper time. I am rather puzzled, each time I listen to hon. Members opposite on the subject of the Health Service, about what exactly they want. They seem to complain bitterly about the costs of the Health Service and then they complain bitterly if the Minister seeks a method by which these costs shall be met, no matter how slight. What is rather significant is that at no time will hon. Members opposite say what they would do. This is a matter of importance on which the public are entitled to an answer, because we are now celebrating the twentieth anniversary of the Health Service.
Three days ago, the Health Service reached its twentieth birthday. I understand that in 1949 expenditure on the Health Service was about £455 million. Today, it is approximately £2,000 million, a record of great growth and expansion. When hon. Members opposite charge the Minister with incapacity to deal with the financial affairs of the Service, they have to bear in mind, as my right hon. Friend said last Tuesday, that it is the Service itself which demands more and more of the resources to meet more and more of the expenditures involved in servicing and equipping the Health Service.
The hospital programme has doubled during the past five years. Wherever one looks in the Health Service, there is a story of success and growth. It is because of this success and growth that I must underline the concern of hon. Members who have held dearly to the principles of the Service over many years. We see here an unreasonable attempt to deal with the financing of a highly marginal position, which in terms of health cannot be measured, by introducing Regulations of the kind which my right hon. Friend has suggested that he will be introducing at an early date.
I must confess, with my hon. Friend the Member for Willesden, West (Mr. Pavitt), that much as I applaud my right hon. Friend for all he has done in social security and the Health Service, for all that he has created in terms of encouraging improvements in these services, I cannot absolve myself from the responsibility 1070 to adhere to the principles which were fought for long years ago.
When the Regulations are placed before the House, I, like my hon. Friend, will not support them. I shall fail to support them with great regret, not in a sense of rancour, the kind of language used in the national Press, or the cheap opportunism which has developed in the nature of the subject of the debate, but with regret that my right hon. Friend, who has possibly done more than any other—and there are many—for the Health Service, should, unhappily, be placed in a situation in which one of his supporters and others would have to disagree with him.
It is not with a question of muddle that I am concerned, but with a slight, unimportant interference in something in which I have believed for a long time. When I say, "unimportant" I am not talking about the principle, I mean that the increases will produce no results, but might even prove far more expensive to deal with, leading to the waste of the time of officials and many others. The prescription charges have already shown this.
Today's debate does not appear to have been necessary. We shall deal with the principle on another day when the Regulations are placed. It is absolutely necessary to debate them so that those hon. Members who are concerned about where they stand may show their hand. But all the time that I have listened to this evening's debate I have been dismayed to feel that, after all, it was not necessary.
§ 9.22 p.m.
§ Mr. Maurice Macmillan (Farnham)
As my hon. Friend the Member for Somerset, North (Mr. Dean) pointed out, the right hon. Member for Sowerby (Mr. Houghton) and the Minister of State joined in the classic defence of those whose case is too thin to stand upon its own of abusing the other side's lawyer and accusing us of being frivolous, of moving the Motion and having no policy to put before the House.
I am deeply touched by the Secretary of State's dependence on us for any form of constructive policy for Health Service finances, a dependence which was clearly recognised by the Daily Telegraph in its leading article. The Minister of State 1071 forebore to mention that although it was critical of the Opposition and myself for not bringing forward our ideas at present, it was even more critical of the right hon. Gentleman for not having any.
The tone of the admirable Opposition speech from the Government benches add point to the case. The hon. Member for Willesden, West (Mr. Pavitt) took a slightly different view. He appeared to defend not only the Opposition's lawyer, but also his own side's, while damning everybody's case, which perhaps shows the niceness of his nature, if not the logic of his approach.
The right hon. Gentleman has accused me of asking too many questions. "I have never heard so many questions asked in one speech", he said. He should not be very surprised. I have never known a Minister who left so many questions unanswered, a planner with so many plans incomplete, frustrated or quietly abandoned, or with so little idea of how to pay for them. He has been asked some more questions tonight. As my hon. Friend the Member for Somerset, North pointed out, the answer we received is a justification in itself, if any other were needed for this debate.
Just as it took a Motion from this side of the House to force out of the Government any details of how they would finance the increase in pensions, so it has taken a Motion from this side to force them to come to a decision on the timing and content of the Regulations. The right hon. Gentleman has not yet answered the question as to whether it will be permanent or temporary, how much he has lost in the delay, or other minor details of that kind. This constant embarking on programmes with no idea of how they are to be financed and how the expense is to be met is the height of irresponsibility.
The criticism from these benches has been mainly of the muddle which this method has shown, although we respect, particularly, the criticisms of the hon. Member for Willesden, West on the charges themselves as a matter of principle. He put his case with his usual sincerity and passion. Although we disagree with him, at least we can respect his consistency and his sense of purpose.
1072 Our Motion describes the method which the Government have adopted as a muddle. So it is—although admittedly on a relatively small scale. It is not the grandiose conception which we have come to expect from the great compositions of these artists of muddle—the Prime Minister, the Chancellor of the Exchequer and the First Secretary. It is not even typical of the Secretary of State at his best. Nevertheless, in a small way it is a work of art, a minature of a muddle, typical because it shows in microcosm the whole of the principle underlying this muddle, not so much unrealist as anti-realist. It is worth examining because in that sense it is typical of the Government's handling, not of spending—they do that well enough—but of paying the bill. That is one of the main points to the debate—the irresponsibility of embarking not only for the present but also for the future on a course of spending with very little idea of where the money is to come from.
We know that the right hon. Gentleman can do better, especially when collaborating with the Chancellor of the Exchequer on raising money for pensions. But even the present miniature muddle shows all the characteristics which we have come to expect from this great master of double think and double talk. We had the announcement of the increases and the justification of the charges in his statement that they were better than cutting back the Health Service. There was a reference especially to mental hospitals and to hospitals for the mentally subnormal. Later, this was apparently changed, according to the Press report of the Labour Party meeting of 14th May, at which it was stated that the increased charges were to pay for comprehensive schools.
My hon. Friend the Member for Chichester (Mr. Chataway) referred to that and rightly said that it could not be laughed off in the way in which the Minister of State attempted to laugh it off. In passing, may I tell my hon. Friend the Member for Chichester how pleased we are to see him back, and congratulate him on this second edition of his maiden speech.
The final confusion in this incident rested on the timing. It is no good the hon. Member for Willesden, West referring to a great non-event in the newspapers and criticising newspapers for 1073 printing events which had not happened and could not have happened. This confusion arose in the minds of the Press not because of their own fallibility, but because of the muddle and confusion created by the Government not only in this but in many other matters. Even the second part of the Department's statement could be held to be at least open to doubt as to what it meant when taken in conjunction with the first half.
On 21st June the Department denied very firmly that there was any doubt about the timing or any question of the Regulations being postponed. It was dismissed by the Department as mere speculation. We accept that. But the statement went on to say that the timing of the Regulations had not even been discussed. Surely no one is to be blamed for taking that to mean that there was as yet no question of their being laid before the House.
§ Mr. Pavitt
Would not the hon. Gentleman agree that the confusion was added to by the kite flying which went on in the Press and that if that kite flying had not occurred there would not have been so much confusion?
§ Mr. Macmillan
If, not for the first time, the Government make an announcement and give it a sense or urgency and then nothing is done or said for a considerable time, can one blame the newspapers and commentators, in the face of known opposition to such charges by hon. Gentlemen opposite, for speculating on the possible outcome?
It was known that a "No" lobby existed and that 100 names supported a Motion calling for the Government not to take this step. They were the names of hon. Gentlemen opposite. No wonder the Press speculated about the outcome of the operation because of the success of Government back benchers in deflecting their Government from the task in hand. The Press were bound to wonder whether, once again, the Government would climb down and run away.
I congratulate the Secretary of State on being the first among his colleagues to stand firm against the pressure of his back benchers. [Interruption.] I gather that my hon. Friends think that it may be a little early to say that he is standing firm; but, for the time being, the congratulations stand.
1074 All this is being done for £3½ million in a full year. Is it worth it—to inflict what Professor Abel Smith has called a bitter blow for Labour supporters? No wonder the hon. Member for Willesden, West talked about a change of direction and pointed out that nobody had claimed that this was necessary to restore confidence in the Government. In this connection, this quotation is interesting:That is prescisely the reason why we have so passionately objected … from below the Gangway. There might have been a case … to introduce measures of economy into the Health Service. Indeed, I myself have often wondered whether a small token payment has not a great deal to be said for it as a way to encourage people to think twice before they let a dentist take out their teeth. But a 50 per cent. charge is something totally different from a charge designed to discourage extravagance."—[OFFICIAL REPORT, 7th May, 1951; Vol. 487, c. 1689.]That was said by the right hon. Gentleman the present Secretary of State for Social Services when he was on the back benches and occupying a seat below the Gangway. He said that in the debate of 1951, but are we not discussing a charge of about 50 per cent.? However, things have changed since then. Now he is faced with the realities of government and he has had to come to terms with the truth.
Perhaps the tragedy of the party opposite, and particularly those who support the hon. Member for Willesden, West, is that it is always too late. Hon. Gentlemen opposite have had some noble aspirations. They have been noble in the past, but their efforts have always been frustrated by economic circumstances. They always will be because of the economic muddle—[Interruption.]—which even the protestations of the hon. Member for The Hartlepools (Mr. Leadbitter) cannot disguise.
We can see how it happened. The debts were mounting, the pressures were growing, as they always grow, the brokers were on their way and the I.M.F. meeting was about to take place. Cuts had to be made and the Secretary of State and the Prime Minister accepted—the Prime Minister made this clear in a long Parliamentary Answer—that the cuts had to be shared among the various Departments. All Ministers had to make a contribution.
We must not forget that the Ministry of Defence has had to give up carriers and aeroplanes. The Foreign Office has 1075 given up everything east of Suez. The Ministry of Education has had to take action on school milk and school meals. It was the time for the Ministry of Health, and teeth and spectacles were selected, although the right hon. Gentleman had said that there would be no further charges.
The Minister of State was rather disingenuous in his defence of what has happened, because he mentioned, as if it had been said in the course of Question and Answer, that his right hon. Friend had been referring to a range of charges. But the word "range" was not mentioned throughout the supplementaries and answers to the Government on this subject.
The last sentence of the Question which the right hon. Gentleman was asked, and the rest does not alter the sense, was:Will he in future resist this individual selectivity principle which is so urgently demanded by hon. Members opposite?The Secretary of State replied:If my hon. Friend is asking me whether I expect further charges to be imposed on the Health Service, the answer is No.' ".—[OFFICIAL REPORT, 14th April, 1969; Vol. 781, c. 771.]I am sure that all of us on this side accept the right hon. Gentleman's explanation. After all, if the Chancellor of the Exchequer were to say that he did not intend to put any further taxation on smokers, it would be quite clear that he did not intend to tax pipes, cigarette holders, lighters, or cigarette cases. No one would have the smallest excuse for believing that the intention was not to increase tobacco duty.
But this use of words cannot be anything but confusing. It is quite clear that in his own mind the Secretary of State meant that there would be no extra charges, but he did not make it clear to the House that he was referring entirely to widening the range, and not to raising the charge. He speaks like Humpty Dumpty:When I use a word it means just what I choose it to mean—neither more nor less.One can see how it happened. It always happens like this. It has happened like this before, and it illustrates one of the great differences between the two parties. We are willing to take the measures 1076 sometimes when we can foresee them before economic necessity dictates; in anticipation of difficulties. Right hon. Gentlemen opposite have never yet done anything of this sort except under the pressure of events which take matters outside their control and force them to go further in the end than they would have done in the beginning had they acted with sense and wisdom.
One can have great sympathy with the hon. Member for Willesden, West, and other hon. Members who agree with him. They seem to be in a minority in clinging to the old Socialist belief in universal free benefits at the point of use, in nationalisation, and in the great doctrines of the Labour Party. But the Labour Government have abandoned these, and they have nothing to put in their place. They have no policy, no principles, no honour left—nothing except expediency.
It happened last time: the debts mounting—they were less then than they are now—aspirations frustrated, and the late Mr. Gaitskell forced to bring in prescription charges, against his will, no doubt, and against the will of the majority of the party. Then, of course, the right hon. Gentleman the Prime Minister, regardless of the fact that their majority was but six, resigned, and attacked the Government mercilessly, to the loud applause and with the enthusiastic support of the right hon. Gentleman the Secretary of State.
We shall not, when they come, vote against the Regulations, because we have always believed in a balance, in how people pay for the social services, including health. As my hon. Friend the Member for Somerset, North pointed out, it is to attempt to get this balance that our policies will be directed. But the right hon. Gentleman has so far done nothing but add piecemeal to his social spending, and its financing. We had the prescription charges—first abolished and then brought back higher. There was muddle, if ever there was.
We had the same sort of thing with school meals—changes proposed and, seven months later, dropped. We had family allowances: two separate announcements within six months—and, of course, devaluation in between them—up 7s., up 3s., and then clawing back more in taxation. We had the 1077 same thing with means tested unemployment benefit for occupational pensioners, which the Government accepted. Draft Regulations were laid—what has happened to them? There has been no further action and no further action, either, on the Government's proposal to save £17 million by putting sickness benefit on to the employer for the first three days.
Now there are these extra charges. This does not add up to a serious attempt to solve the problems of financing the Health Service. This is not an attempt to grapple seriously with the problem of who pays what and how and when. It does not add up to a Socialist policy, or even a social policy. It is nothing but a muddle by men without a philosophy, without principles and without a policy.
§ 9.40 p.m.
§ The Secretary of State for Social Services (Mr. Richard Crossman)
This has been a strange little debate, very strange and even littler. I agree with my hon. Friend the Member for The Hartlepools (Mr. Leadbitter) that the only thing to say about it is that it is not necessary. However, I have enjoyed listening to it and I shall enjoy replying to it, but with regret when I compare it to the days when I was at the Ministry of Housing and Local Government and had opponents who attacked me on issues which really mattered. We had two censure debates then, one about public sector housing and one about owner-occupation and we fought out the real issues, but the striking fact about the Opposition when debating health and social security under the merged Ministry is that they funk, evade and crawl round every issue.
One of the features of this debate has been that the issue was so narrow and pitably small that nearly everyone who has spoken from the back benches has been forced to discuss subjects which are miles away from the Motion of censure. We had an interesting speech from the hon. Member for Cheadle (Dr. Winstanley) about the Regulations bringing in prescription charges, and my hon. Friend the Minister of State moved well away from the Motion and spoke about all that the Government are doing in this field. I was grateful to the hon. Member for Somerset, North (Mr. Dean) who gave up 1078 discussing the Motion after four or five minutes and gave us an interesting disquisition.
My right hon. Friend the Member for Sowerby (Mr. Houghton) tried to keep to the Motion, but it was obviously as exhausting and tiring for him to do that as it will be for me to fill in the time between now and 10 o'clock talking about this contemptible, pitiable, ridiculous, little Motion. I shall do my best, and I deal first with the speech of the hon. Member for Farnham (Mr. Maurice Macmillan), who told us that the decision to have this great, powerful Motion was that it would force the Government into action. Without the Tory Motion of censure we would not have tabled the up-rating Bill. This exaggerates the importance of the spoken word in the House of Commons. Having once announced that we were to pay a 10s. benefit, we were going through with the Bill even despite this delightful censure Motion debated for three-and-a-half hours before we go into Recess.
We have now had three debates on the new merged Ministry. One was last week, an Adjournment debate on financing the Ministry. I now understand that it was taken then because the Prime Minister was absent at the Investiture or it would have been a Motion of censure, according to the noble Lord the Member for Hertford (Lord Balniel). This was an example of Tory chaos and muddle, but it was a nice debate because, although we got nothing out of the Opposition, it gave hon. Members on the Government side the chance to make serious speeches about how to finance the Health Service. We hardly expected anything serious—nor did the Daily Telegraph—from hon. Members opposite. Apart from these two delicious procedural Motions there was the Motion to have an uprating Bill.
The whole complaint of hon. Members opposite was why did we delay between the announcement in the Budget and the uprating Bill? When we came to the Bill and waited for constructive opposition, hon. Members opposite came in late and tiddled away. They have been tiddling along upstairs ever since, with no constructive, serious opposition at all.
I waited to hear the clear Opposition view on charges. We got it in the last debate when I thought that the hon. 1079 Member for Farnham had meant something definite. When I thought that he believed in charges, he leapt to his feet and what did he say? He said he was not advocating increased charges but was putting forward the view that they could be significant. That went down badly with the Daily Telegraph. Then we had the hon. Member for Hertford today saying that he believed passionately that charges were the important thing. We can take our choice in the Opposition, as between Powellite and Heathite, not knowing on which side we shall find anybody.—[HON. MEMBERS: "Answer the debate."] I am answering the debate, but it has been pitiable stuff to listen to.
However, I will get down to answering the specific charges. It will embarrass the hon. Gentlemen. I take charge No. I among the items on the indictment. It is alleged firstly that before I announced the increased charges I gave an assurance that no charge would be increased, secondly that between the announcement and the laying of the Order there had been delay, and thirdly it is alleged that between the announcement and the implementation of the Order there had been vacillation and change of plan. I will take each of these and give them the serious consideration which each deserves.
I will take the first, namely, that I gave assurances before the Order that there would be no increases. Here I will simply read a passage to the House, because I was a little resentful about what the noble Lord said. He did not exactly say that I told a lie, but he said that I had slithered through. Here we have the actual passage. This was in a supplementary on prescription charges when I was asked whether I would agree thatthis exercise in the principle of individual selectivity in the social services is not useful in terms of money or manpower.Would I in futureresist this individual selectivity principle which is so urgently demanded by hon. Members opposite?I replied:If my hon. Friend is asking me whether I expect further charges to be imposed on the Health Service, the answer is 'No.'It is clear that when I am asked the question, "Did I think that the selectivity principle would be extended to other charges?", I said that, of course, it would not.
§ Mr. Crossman
After this, the noble Lord got up and said:Is there any intention to increase prescription charges?"—[OFFICIAL REPORT, 14th April, 1969; Vol. 781, c. 770–1.]and I said, "No" I should have thought that it was perfectly clear what I said, so we can get rid of the accusation that the assurances had been given before.
We come to the major issue, the issue of the charge of delay. The hon. Member for Somerset, North, who said today that between the announcement of the Regulations and the carrying out of them there was a serious delay. He said that as a result of that delay we had lost most of the revenue we could have raised this year. I tell him that he has miscalculated. It is true that I am an optimist and aimed at £1.7 million in 1969–90 and £3.5 million in the following year. But it is also true that we are now laying the Regulation to come into effect on 11th August, and I reckon that we shall obtain £1.4 million in Great Britain in that year. So we have lost that difference in those two months.
We have to allow four weeks between the laying of a Regulation and bringing it into effect because of the need to consult the professions, arranging for the documents to be printed and distributed, and so on. So the operative date is 11th August and the calculation we make is that we should get out of it £1.4 million.
I now want to deal with the major charge, the charge by the noble Lord that I had caused chaos in the Department—"chaos", "unconditional surrender", "muddle" and "destruction". He said that there had been constant changes of mind to and fro during this disastrous period and that they had created chaos. I thought that I would take that seriously and go through it to see what the chaos was. He quite rightly said that he had read it in the Press. I admit that it makes a rollicking serial. One day, the Secretary of State announces his firm decision. Then on 24th June, after a week or two of parliamentary punishment and a fortnight's holiday, he suddenly changes his 1081 mind, forgets to tell the Cabinet, and gets rapped for his pains. That is the description in the Press.
On Thursday 26th, he changes his mind again and tells the Leader of the House to announce the laying of the Regulations in the next week's business. The Leader of the House says nothing, proving that the Secretary of State has changed his mind again. On Sunday, the Government finally sweep the plans to raise the charges under the carpet, but two days later they are going to announce them on the day of the Investiture.
That is the Press report of those 10 days. I shall tell the House what happened, relating it to what was said, because it is an interesting example of what was called news creation in the good old days of psychological warfare. It is interesting to a psychological warrior to have his techniques applied against himself and to see what happens.
It all started on the evening of 23rd June, when Mr. George Clark told me that he had an absolutely red-hot tip from a source which was bound to be taken seriously that the charges were definitely deferred. I had very little time, and I said that there was not a word of truth in the story. Not unexpectedly, on reading The Times next day, after my categorical denial, The Times lead headline on the front page, was:Charges for glasses and teeth deferred.The Government is delaying the introduction of higher charges for spectacle lenses and false teeth to avoid … a clash"—and the subheadline was:Crossman grows cautious".I read that with enormous interest. I felt that I was starting on the history of the greatest non-event in my public life. Absolutely nothing had happened in fact. The Times had done it. Naturally, the B.B.C., which always follows The Times, put it out as the day's first item, and in the Evening News that day John Dickinson wrote under the headline,Teeth and specs—Crossman forgot to tell Cabinet".Here was something we did not know about. It seems that the Cabinet had not been told and the news had been received with astonishment in other parts of Whitehall because there has been no Ministerial meeting to discuss the non-event, and once again it was concluded that I had 1082 been acting off my own eccentric bat. It was a delicious feeling—here I was in fairy-land, seeing myself in a Tory spectacle of non-eventual action.
Then, in the Evening Standard:Crossman sets new specs, teeth puzzle".Then, in the Daily Sketch we had:Tories get teeth into Crossman. The original plan to have the new charges operating in June has been dropped.Next, there was a rather nice one on the Thursday 26th, with a firm announcement in the Financial Times, which had been fairly respectable up to then, but had to say something, telling us that the Leader of the House would make a firm statement that day that the Regulations for the charges would be laid, and then, when he did not make a firm statement, the next day another paper said, "No statement made".
That is how it went. Then on 27th June, the Daily Express had a headline:Those charges for teeth and specs stay a mystery for M.P.s.".It was growing in importance by then. Saturday, 28th June, was a blank day. Sport prevailed over serious politics and we were pushed out of the headlines and out of the papers. No reference to teeth and spectacles. No reference to my growing non-event. I felt sad, until Sunday, 29th June. On Sunday, of course, one always goes back to fiction somewhere or other. I read in the News of the World a most categorical new start to the story:Wilson backs down on specs.Government plans to raise charges for National Health false teeth and spectacles are being shelved. … the proposals are being swept under the carpet along with other moves unpopular in the Parliamentary Party.That was interesting to me.
I close this little, happy story of the nicest non-event in my life by saying that the Communist Morning Star, which had been very quiet until then, celebrated 1st July by announcing that with my infallible sense of timing I had chosen Investiture day to lay the Regulations for the increased teeth and spectacle charges. When I did not lay them that day, the Daily Telegraph commented. On the front page, it said:Teeth & Specs Order For Next Weekwhile on the back page it said:Crossman Vague On Teeth And Glasses Charges.1083 It was getting it both ways, with our happy Lobby correspondent on one side and the sketch writer on the other.
§ Dr. Winstanley
Since the right hon. Gentleman has told us that the charges are so slender, and that he has time on his hands, will he ensure that he leaves himself time to explain why it is necessary to increase the charges, and what purpose is to be fulfilled?
§ Mr. Crossman
I shall have ample time for the substance of this debate when we come to the Regulations. I agree with right hon. and hon. Members opposite that I must take their Motion seriously. It is not on the substance. It is on the muddle, the chaos, the unconditional surrender.
Since there are just a few minutes that I can fill in before the Division, I would say one thing more to hon. and right hon. Members opposite. I have mentioned psychological warfare, and I remember that during the Russian campaign, when we were in a very weak position and the Russians were retreating 100 miles a day, the only thing we could do in propaganda was to commit the enemy to advancing
§ so far by a certain date and announcing a defeat because they did not get there. We used to say that unless the Germans reached the Dnieper by 15th November or were not across the Bug by 20th December they would be sunk in the Russian snow. It was a tremendous success, at least with our listeners, and it raised our own morale by keeping us busy, because we did not dare deal with the substance.
§ I find the Opposition very silly. If they were serious they would deal with the substance of the Health Service, its administration and the crisis. They are not a serious Opposition and are not united. They keep their options open—to use a phrase they should have come to like—and while they are keeping them open they indulge in a little news creation. I advise the Press not to take its tips so gullibly from the Opposition benches next time.
That this House regrets the muddle which has surrounded the proposed introduction of higher charges for dentures and spectacles:—
§ The House divided: Ayes 244, Noes 290.1087
|Division No. 308.]||AYES||[9.58 p.m.|
|Alison, Michael (Barkston Ash)||Chataway, Christopher||Glyn, Sir Richard|
|Amery, Rt. Hn. Julian||Chichester-Clark, R.||Godber, Rt. Hn. J. B.|
|Astor, John||Clark, Henry||Goodhart, Philip|
|Atkins, Humphrey (M't'n & M'd'n)||Clegg, Walter||Goodhew, Victor|
|Baker, Kenneth (Acton)||Cooke, Robert||Gower, Raymond|
|Baker, W. H. K. (Banff)||Corfield, F. V.||Grant, Anthony|
|Balniel, Lord||Costain, A. P.||Grant-Ferris, Sir Robert|
|Barber, Rt. Hn. Anthony||Craddock, Sir Beresford (Spelthorne)||Gresham Cooke, R.|
|Batsford, Brian||Crouch, David||Grieve, Percy|
|Beamish, Col. Sir Tufton||Crowder, F. P.||Griffiths, Eldon (Bury St. Edmunds)|
|Bell, Ronald||Cunningham, Sir Knox||Grimond, Rt. Hn. J.|
|Bennett, Dr. Reginald (Gos. & Fhm)||Currie, G. B. H.||Gurden, Harold|
|Berry, Hn. Anthony||Dalkeith, Earl of||Hall, John (Wycombe)|
|Biffen, John||Dance, James||Hall-Davis, A. G. F.|
|Biggs-Davison, John||d'Avigdor-Goldsmid, Sir Henry||Hamilton, Lord (Fermanagh)|
|Birch, Rt. Hn. Nigel||Dean, Paul||Hamilton, Michael (Salisbury)|
|Black, Sir Cyril||Deedes, Rt. Hn. W. F. (Ashford)||Harris, Frederic (Croydon, N.W.)|
|Blaker, Peter||Digby, Simon Wingfield||Harris, Reader (Heston)|
|Boardman, Tom (Leicester, S.W.)||Dodds-Parker, Douglas||Harrison, Brian (Maldon)|
|Body, Richard||Doughty, Charles||Harvey, Sir Arthur Vere|
|Bossom, Sir Clive||Drayson, G. B.||Harvie Anderson, Miss|
|Boyd-Carpenter, Rt. Hn. John||du Cann, Rt. Hn. Edward||Hastings, Stephen|
|Boyle, Rt. Hn. Sir Edward||Eden, Sir John||Hawkins, Paul|
|Braine, Bernard||Elliot, Capt. Walter (Carshalton)||Hay, John|
|Brewis, John||Emery, Peter||Heald, Rt. Hn. Sir Lionel|
|Brinton, Sir Tatton||Errington, Sir Eric||Heseltine, Michael|
|Bromley-Davenport, Lt. -Col. Sir Walter||Eyre, Reginald||Higgins, Terence L.|
|Brown, Sir Edward (Bath)||Farr, John||Hiley, Joseph|
|Bruce-Gardyne, J.||Fisher, Nigel||Hill, J. E. B.|
|Bryan, Paul||Fletcher-Cooke, Charles||Hirst, Geoffrey|
|Buchanan-Smith, Alick (Angus, N&M)||Fortescue, Tim||Hogg, Rt. Hn. Quintin|
|Buck, Antony (Colchester)||Foster, Sir John||Holland, Philip|
|Bullus, Sir Eric||Fraser, Rt. Hn. Hugh (St'fford & Stone)||Hordern, Peter|
|Burden, F. A.||Galbraith, Hn. T. G.||Hornby, Richard|
|Campbell, B. (Oldham, W.)||Gibson-Watt, David||Howell, David (Guildford)|
|Campbell, Gordon (Moray & Nairn)||Gilmour, Ian (Norfolk, C.)||Hunt, John|
|Carlisle, Mark||Gilmour, Sir John (Fife, E.)||Hutchison, Michael Clark|
|Carr, Rt. Hn. Robert||Glover, Sir Douglas||Iremonger, T. L.|
|Irvine, Bryant Godman (Rye)||Montgomery, Fergus||Sandys, Rt. Hn. D.|
|Jenkin, Patrick (Woodford)||Morgan, Geraint (Denbigh)||Scott, Nicholas|
|Jennings, J. C. (Burton)||Morgan-Giles, Rear-Adm.||Scott-Hopkins, James|
|Johnson Smith, G. (E. Grinstead)||Morrison, Charles (Devizes)||Sharples, Richard|
|Jopling, Michael||Mott-Radclyffe, Sir Charles||Shaw, Michael (Sc'b'gh & Whitby)|
|Joseph, Rt. Hn. Sir Keith||Munro-Lucas-Tooth, Sir Hugh||Silvester, Frederick|
|Kaberry, Sir Donald||Murton, Oscar||Sinclair, Sir George|
|Kerby, Capt. Henry||Nabarro, Sir Gerald||Smith, Dudley (W'wick & L'mington)|
|Kershaw, Anthony||Neave, Airey||Smith, John (London & W'minster)|
|Kimball, Marcus||Nicholls, Sir Harmar||Speed, Keith|
|King, Evelyn (Dorset, S.)||Nott, John||Stainton, Keith|
|Kirk, Peter||Onslow, Cranley||Steel, David (Roxburgh)|
|Kitson, Timothy||Orr, Capt. L. P. S.||Stodart, Anthony|
|Lane, David||Orr-Ewing, Sir Ian||Tapsell, Peter|
|Langford-Holt, Sir John||Osborn, John (Hallam)||Taylor, Sir Charles (Eastbourne)|
|Legge-Bourke, Sir Harry||Osborne, Sir Cyril (Louth)||Taylor, Edward M.(G'gow, Cathcart)|
|Lewis, Kenneth (Rutland)||Page, Graham (Crosby)||Temple, John M.|
|Lloyd, Rt. Hn. Geoffrey (Sut' nC' dfield)||Page, John (Harrow, W.)||Thatcher, Mrs. Margaret|
|Lloyd, Ian (P'tsm'th, Langstone)||Pardoe, John||Tilney, John|
|Lloyd, Rt. Hn. Selwyn (Wirral)||Pearson, Sir Frank (Clitheroe)||Turton, Rt. Hn. R. H.|
|Longden, Gilbert||Peel, John||van Straubenzee, W. R.|
|Lubbock, Eric||Percival, Ian||Vaughan-Morgan, Rt. Hn. Sir John|
|McAdden, Sir Stephen||Peyton, John||Vickers, Dame Joan|
|MacArthur, Ian||Pike, Miss Mervyn||Waddington, David|
|Mackenzie, Alasdair (Ross & Crom'ty)||Pink, R. Bonner||Walker, Peter (Worcester)|
|Pounder, Rafton||Walker-Smith, Rt. Hn, Sir Derek|
|Maclean, Sir Fitzroy||Powell, Rt. Hn. J. Enoch||Walters, Dennis|
|Macleod, Rt. Hn. Iain||Price, David (Eastleigh)||Ward, Dame Irene|
|McMaster, Stanley||Prior, J. M. L.||Weatherill, Bernard|
|Macmillan, Maurice (Farnham)||Pym, Francis||Wells, John (Maidstone)|
|McNair-Wilson, Michael||Quennell, Miss J. M.||Whitelaw, Rt. Hn. William|
|McNair-Wilson, Patrick (NewForest)||Ramsden, Rt. Hn. James||Wiggin, A. W.|
|Maddan, Martin||Rawlinson, Rt. Hn. Sir Peter||Williams, Donald (Dudley)|
|Maginnis, John E.||Rees-Davies, W. R.||Wilson, Geoffrey (Truro)|
|Marples, Rt. Hn. Ernest||Renton, Rt. Hn. Sir David||Winstanley, Dr. M. P.|
|Marten, Neil||Rhys Williams, Sir Brandon||Wolrige-Gordon, Patrick|
|Maude, Angus||Ridley, Hn. Nicholas||Woodnutt, Mark|
|Maudling, Rt. Hn. Reginald||Ridsdale, Julian||Worsley, Marcus|
|Mawby, Ray||Rippon, Rt. Hn. Geoffrey||Wright, Esmond|
|Maxwell-Hyslop, R. J.||Robson Brown, Sir William||Wylie, N. R.|
|Mills, Peter (Torrington)||Rodgers, Sir John (Sevenoaks)||Younger, Hn. George|
|Mills, Stratton (Belfast, N.)||Rossi, Hugh (Hornsey)|
|Miscampbell, Norman||Royle, Anthony||TELLERS FOR THE AYES:|
|Mitchell, David (Basingstoke)||Russell, Sir Ronald||Mr. R. W. Elliott and|
|Monro, Hector||St. John-Stevas, Norman||Mr. Jasper More.|
|Abse, Leo||Cant, R. B.||Edelman, Maurice|
|Albu, Austen||Carmichael, Neil||Edwards, Robert (Bilston)|
|Allaun, Frank (Salford, E.)||Carter-Jones, Lewis||Edwards, William (Merioneth)|
|Alldritt, Walter||Castle, Rt. Hn. Barbara||Ellis, John|
|Anderson, Donald||Coe, Denis||English, Michael|
|Archer, Peter||Coleman, Donald||Ennals, David|
|Ashley, Jack||Concannon, J. D.||Ensor, David|
|Ashton, Joe (Bassetlaw)||Conlan, Bernard||Evans, Albert (Islington, S.W.)|
|Atkins, Ronald (Preston, N.)||Corbet, Mrs. Freda||Evans, Fred (Caerphilly)|
|Atkinson, Norman (Tottenham)||Craddock, George (Bradford, S.)||Evans, Ioan L. (B rm'h'm, Yardley)|
|Bacon, Rt. Hn. Alice||Crawshaw, Richard||Faulds, Andrew|
|Bagier, Cordon A. T.||Cronin, John||Fernyhough, E.|
|Barnett, Joel||Crosland, Rt. Hn. Anthony||Fitch, Alan (Wigan)|
|Baxter, William||Crossman, Rt. Hn. Richard||Fletcher, Rt. Hn. Sir Eric(Islington,E.)|
|Bence, Cyril||Dalyell, Tam||Fletcher, Raymond (Ilkeston)|
|Benn, Rt. Hn. Anthony Wedgwood||Darling, Rt. Hn. George||Foley, Maurice|
|Bidwell, Sydney||Davidson, Arthur (Accrington)||Foot, Michael (Ebbw Vale)|
|Binns, John||Davies, Ednyfed Hudson (Conway)||Ford, Ben|
|Bishop, E. S.||Davies, Dr. Ernest (Stretford)||Forrester, John|
|Blackburn, F.||Davies, Rt. Hn. Harold (Leek)||Fowler, Gerry|
|Blenkinsop, Arthur||Davies, Ifor (Cower)||Fraser, John (Norwood)|
|Boardman, H. (Leigh)||de Freitas, Rt. Hn. Sir Geoffrey||Freeson, Reginald|
|Boston, Terence||Delargy, Hugh||Gardner, Tony|
|Bottomley, Rt. Hn. Arthur||Dell, Edmund||Garrett, W. E.|
|Boyden, James||Dempsey, James||Ginsburg, David|
|Bradley, Tom||Dewar, Donald||Gordon Walker, Rt. Hn. P. C.|
|Bray, Dr. Jeremy||Diamond, Rt. Hn. John||Gray, Dr. Hugh (Yarmouth)|
|Brooks, Edwin||Dickens, James||Greenwood, Rt. Hn. Anthony|
|Broughton, Sir Alfred||Dobson, Ray||Gregory, Arnold|
|Brown, Bob (N 'c'tle-upon-Tyne, W.)||Doig, Peter||Grey, Charles (Durham)|
|Brown, Hugh D. (G'gow, Provan)||Driberg, Tom||Griffiths, Eddie (Brightside)|
|Brown, R. W. (Shoreditch & F'bury)||Dunn, James A.||Griffiths, Will (Exchange)|
|Buchan, Norman||Dunnett, Jack||Hamilton, James (Bothwell)|
|Buchanan, Richard (G'gow, Sp'burn)||Dunwoody, Mrs. Gwyneth (Exeter)||Hamilton, William (Fife, W.)|
|Butler, Herbert (Hackney, C.)||Dunwoody, Dr. John (F'th & C'b'e)||Hamling, William|
|Butler, Mrs. Joyce (Wood Green)||Eadie, Alex||Hannan, William|
|Harrison, Walter (Wakefield)||McNamara, J. Kevin||Roberts, Rt. Hn. Goronwy|
|Hart, Rt. Hn. Judith||Mahon, Peter (Preston, S.)||Robertson, John (Paisley)|
|Haseldine, Norman||Mallalieu, E. L. (Brigg)||Robinson, Rt. Hn. Kenneth (St. P'c' as)|
|Hattersley, Roy||Mallalieu, J. P. W. (Huddersfield, E.)||Rodgers, William (Stockton)|
|Hazell, Bert||Manuel, Archie||Roebuck, Roy|
|Healey, Rt. Hn. Denis||Mapp, Charles||Rogers, Goorge (Kensington, N.)|
|Heffer, Eric S.||Marks, Kenneth||Ross, Rt. Hn. William|
|Henig, Stanley||Marquand, David||Rowlands, E.|
|Herbison, Rt. Hn. Margaret||Marsh, Rt. Hn. Richard||Ryan, John|
|Hilton, W. S.||Mason, Rt. Hn. Roy||Shaw, Arnold (Ilford, S.)|
|Hobden, Dennis||Maxwell, Robert||Sheldon, Robert|
|Hooley, Frank||Mayhew, Christopher||Shinwell, Rt. Hn. E.|
|Houghton, Rt. Hn. Douglas||Mellish, Rt. Hn. Robert||Shore, Rt. Hn. Peter (Stepney)|
|Howarth, Harry (Wellingborough)||Mendelson, John||Short, Rt. Hn. Edward (N'c'tle-u-Tyne)|
|Howarth, Robert (Bolton, E.)||Millan, Bruce||Short, Mrs. Renée (W'hampton, N.E.)|
|Howell, Denis (Small Heath)||Mitchell, R. C. (S'th'pton, Test)||Silkin, Rt. Hn. John (Deptford)|
|Howie, W.||Molloy, William||Silkin, Hn. S. C. (Dulwich)|
|Hoy, Rt. Hn. James||Moonman, Eric||Silverman, Julius|
|Hughes, Rt. Hn. Cledwyn (Anglesey)||Morgan, Elystan (Cardiganshire)||Skeffington, Arthur|
|Hughes, Hector (Aberdeen, N.)||Morris, Alfred (Wythenshawe)||Slater, Joseph|
|Hughes, Roy (Newport)||Morris, Charles R. (Openshaw)||Small, William|
|Hynd, John||Morris, John (Aberavon)||Snow, Julian|
|Irvine, Sir Arthur (Edge Hill)||Moyle, Roland||Spriggs, Leslie|
|Jackson, Colin (B'h'se & Spenb'gh)||Mulley, Rt. Hn. Frederick||Steele, Thomas (Dunbartonshire, W.)|
|Janner, Sir Barnett||Murray, Albert||Stonehouse, Rt. Hn. John|
|Jay, Rt. Hn. Douglas||Neal, Harold||Strauss, Rt. Hn. G. R.|
|Jenkins, Hugh (Putney)||Newens, Stan||Summerskill, Hn. Dr. Shirley|
|Jenkins, Rt. Hn. Roy (Stechford)||Noel-Baker, Rt. Hn. Philip||Symonds, J. B.|
|Johnson, Carol (Lewisham, S.)||Norwood, Christopher||Taverne, Dick|
|Johnson, James (K'ston-on-Hull, W.)||Oakes, Gordon||Thomas, Rt. Hn. George|
|Jones, Dan (Burnley)||Ogden, Eric||Thomson, Rt. Hn. George|
|Jones, Rt. Hn. Sir Elwyn (W.Ham, S.)||O'Malley, Brian||Thornton, Ernest|
|Jones, J. Idwal (Wrexham)||Oram, Albert E.||Tinn, James|
|Jones, T. Alec (Rhondda, West)||Orme, Stanley||Tomney, Frank|
|Judd, Frank||Oswald, Thomas||Tuck, Raphael|
|Kelley, Richard||Owen, Dr. David (Plymouth, S'tn)||Urwin, T. W.|
|Kenyon, Clifford||Owen, Will (Morpeth)||Varley, Eric G.|
|Kerr, Mrs. Anne (R'ter & Chatham)||Padley, Walter||Wainwright, Edwin (Dearne Valley)|
|Kerr, Dr. David (W'worth, Central)||Page, Derek (King's Lynn)||Walker, Harold (Doncaster)|
|Lawson, George||Palmer, Arthur||Wallace, George|
|Leadbitter, Ted||Pannell, Rt. Hn. Charles||Watkins, David (Consett)|
|Lee, Rt. Hn. Frederick (Newton)||Park, Trevor||Weitzman, David|
|Lee, John (Reading)||Parker, John (Dagenham)||Welibeloved, James|
|Lestor, Miss Joan||Parkyn, Brian (Bedford)||Wells, William (Walsall, N.)|
|Lewis, Arthur (W. Ham, N.)||Pavitt, Laurence||Whitaker, Ben|
|Lewis, Ron (Carlisle)||Pearson, Arthur (Pontypridd)||White, Mrs. Eirene|
|Lipton, Marcus||Peart, Rt. Hn. Fred||Whitlock, William|
|Lomas, Kenneth||Pentland, Norman||Wilkins, W. A.|
|Luard, Evan||Perry, Ernest G. (Battersea, S.)||Willey, Rt. Hn. Frederick|
|Lyons, Edward (Bradford, E.)||Perry, George H. (Nottingham, S.)||Williams, Alan (Swansea, W.)|
|Mabon, Dr. J. Dickson||Prentice, Rt. Hn. R. E.||Williams, Alan Lee (Hornchurch)|
|McBride, Neil||Price, Christopher (Perry Barr)||Williams, Mrs. Shirley (Hitchin)|
|McCann, John||Price, Thomas (Westhoughton)||Williams, W. T. (Warrington)|
|MacColl, James||Price, William (Rugby)||Willis, Rt. Hn. George|
|MacDermot, Niall||Probert, Arthur||Winnick, David|
|Macdonald, A. H.||Pursey, Cmdr. Harry||Woodburn, Rt. Hn. A.|
|McGuire, Michael||Randall, Harry||Woof, Robert|
|McKay, Mrs. Margaret||Rankin, John||Wyatt, Woodrow|
|Mackenzie, Gregor (Rutherglen)||Rees, Merlyn|
|Mackie, John||Rhodes, Geoffrey||TELLERS FOR THE NOES:|
|Maclennan, Robert||Richard, Ivor||Mr. Joseph Harper and|
|McMillan, Tom (Glasgow, C.)||Roberts, Albert (Normanton)||Mr. Ernest Armstrong.|