HL Deb 10 December 1935 vol 99 cc128-30

Order of the Day for the Second Reading read.


My Lords, last Session the House passed this Bill as it is now reintroduced. It received its Second Reading in the other House last July, but there was no time available for its later stages. In moving the Second Reading again to-day, I desire merely to clarify the considerations which animated those responsible for its introduction and to remove certain misconceptions. The object of this Bill is to put all hospitals on a level, as far as possible, in their power to meet certain present-day needs. Voluntary hospitals with modern trust deeds have no legal hindrance to prevent them providing for all classes who need hospital treatment. Their primary function is to provide beds for the sick poor in the ordinary sense of the term. They often provide a comparatively small number of pay beds for the blackcoated poor of the middle and professional classes, who are able to pay a moderate weekly charge, but cannot afford what they would have to pay elsewhere. They sometimes also provide a still smaller number of beds for patients who need treatments which, however well-off they may be, these patients are often unable to obtain anywhere except at a hospital, and who are charged at rates proportionate to their means, thus yielding the hospital a profit which helps it to pay for its poorer patients.

The need for these new services results partly from the modern developments of elaborate and expensive methods of diagnosis and treatment, and partly from recent economic changes which have produced what are called the new poor. These new services have been provided in addition to, and not in diminution of, the maintenance and extension of the ordinary beds. But at some hospitals the trust deeds were settled long ago, when medical treatment was a very simple and inexpensive affair and hospital accommodation was only needed by the very poor. The result is that, at some hospitals, these ancient trusts are so worded that the hospital cannot legally provide for any patients, other than the sick poor in the original sense of the term, even with money specially collected or received for the purpose; and, if the hospital has occasionally to treat any other patients, because the treatments are unobtainable elsewhere, it has no legal power to charge them what they are able to pay. Nor can it provide special accommodation for them, even if it could do so at a profit. It is certainly hard on the older hospitals not to be able to provide these modern facilities which some other hospitals can provide. It is also hard on particular neighbourhoods not to be able to enjoy these modern facilities which other neighbourhoods can enjoy.

The object of this Bill is to give the Charity Commissioners power, in suitable cases, to remove these anomalies, by enabling such hospitals to provide pay beds so long as this is not done at the expense of, or to the detriment of, the primary work which they are doing, of providing for the sick poor. The Bill contains ample precautions against any risk that trusts for the direct benefit of the sick poor will be disregarded. In addition to the control given to the Charity Commissioners, there are special safeguards, introduced into the Bill last Session by the Government, to ensure that funds and property acquired under the original trusts cannot be diverted to any other purpose. In actual practice experience shows that fie provision of pay beds benefits the whole community, including the sick poor themselves. The hospital with pay beds serves patients who would otherwise be unable to obtain the latest treatments and who often become grateful supporters. Patients who can afford to pay can be charged what they can afford; and there is often an actual profit which helps the hospital to carry on its ordinary work. There need be no fear that anything in this Bill would enable hospitals to diminish their work for the sick poor, even if they wanted to do so. The safeguards in the Bill would prevent them from reducing their ordinary work: the powers given by the Bill would assist them to increase it. I beg to move that the Bill be now read a second time.

Moved, That the Bill be now read 2a.—(Lord Luke.)


My Lords, I only desire to say on behalf of the Government that when this Bill was first introduced the Government, as your Lordships may recollect, intimated that provided certain changes were made in the text, to ensure that the objects of existing trusts would be maintained, they would support the Bill. Various Amendments to secure that the objects of the original trust should be maintained and the rights of poorer patients safeguarded were agreed between the promoters and the Government and they reappear in this Bill. In those circumstances the Government fully support, the Bill.

On Question, Bill read 2a, and committed to a Committee of the Whole House.