§ 2.46 p.m.
§ Order of the Day for the House to be put into Committee read.
§ Moved, That the House do now resolve itself into Committee.—(Lord Woolton.)
§ On Question, Motion agreed to.
§ House in Committee accordingly:
§ [The EARL OF DROGHEDA in the Chair]
§ Clause 1:
§ Charges for certain drugs, medicines and Appliances
§ 1.—(1) Subject to the provisions of this section, regulations may provide for the making and recovery, in such manner as may be prescribed, of such charges as may be prescribed in respect of the supply, as part of the hospital and specialist services under Part II of the principal Act, of drugs, medicines or appliances.
§ (2) No charge shall be made under this section in respect of—
- (a) the supply of any drug, medicine or appliance for a patient who is for the time being resident in a hospital;
- (b) the supply of any drug or medicine for the treatment of venereal disease;
- (c) the supply of any appliances for a person who is under sixteen years of age or is undergoing full time instruction in a school within the meaning of the Education Act, 1944, or the Education (Scotland) Act, 1946; or
- (d) the replacement or repair of any appliance in consequence of a defect in the appliance as supplied;
§ (3) Any reference in this section to the supply of appliances shall be construed as including a reference to the replacement and repair of appliances.
LORD MILNER OF LEEDS moved to insert as a new subsection (1):
(1) Notwithstanding anything in section sixteen of the National Health Service (Amendment) Act, 1949, or the following provisions of this section, no charge shall be made in respect of drugs or medicines supplied to a person who is under sixteen years of age or is undergoing full-time instruction in a school within the meaning of the Education Act, 1944, or the Education (Scotland) Act, 1946.
§ The noble Lord said: In moving the first Amendment on the Marshalled List, 800 I venture to remind your Lordships that this was one of those Amendments which, owing to the operation of the rather rigid timetable in the other place, was not discussed there. For that reason your Lordships may well consider that it is all the more important to discuss it here. The short point of the Amendment is that under this clause of the Bill it is proposed to make a charge for drugs and medicines, and the Amendment seeks to provide that such charges shall not he made in respect of drugs or medicines to be supplied to a person under sixteen years of age or undergoing full-time instruction in a school. I would call attention particularly to the fact that this Amendment would cover drugs or medicines in respect of which authority to charge was given by the Act of 1951; that is to say, it is not limited to charges in respect of hospital or specialist services, but includes the charges which it is proposed to make in respect of prescriptions given by general medical practitioners. I do not think I need labour that point, but I would mention that the Act authorising the imposition of those charges was never implemented, and that, in any event, that Act stated that those charges, if and when they were imposed, would operate for only a temporary period.
§ Obviously if drugs or medicines are prescribed for a child or young person, that child or young person must be ill, and the prescribing physician must think it necessary for that child or young person to have the medicine. I have not heard any suggestion of abuse in connection with medicines supplied to children and young persons; and, so far as I am aware, no evidence was given in another place of any such abuse. As your Lordships will appreciate, this charge of 1s. would have to be paid by the parent, who naturally would wish to carry out the doctor's prescription and do the best he or she can for the child. That parent would have to pay the amount of 1s. in respect of each form filled up. It may be said by noble Lords opposite that there would be no great hardship here, and that it would be quite competent for any parent to go to the Assistance Board if he or she could not afford to pay for the prescriptions. I should have thought—and I hope your Lordships may agree—that it would be very humiliating for a parent, whose child had to have medical 801 attention and prescriptions, to have to go to the Assistance Board, where, one knows, evidence as to means and so on has to be given, and to ask for a reimbursement of the 1s. (or it may be more). The result will be, therefore, that many parents will not go to the Assistance Board; they will prefer to go short in some necessity of life themselves.
§ I would remind your Lordships that there are many people in this country who have quite a number of children. There are instances where not one but may be two or three children of a family are ill at the same time. As I understand it, in respect of each of those children it will be necessary to pay 1s. for every prescription. That, clearly, is, or may be, a very great hardship indeed. I gather that one of the reasons, if not the principal reason, for imposing this charge in this Bill is to do away with abuse. As I say, there has been no evidence of abuse, and it would seem to me that where a charge is to be made for a particular article (in this case a drug or medicine) the natural tendency will be to endeavour to get as much as possible for one's money. The parent will say: "Give me a large bottle of medicine or sufficient to last not only for a week or two weeks—"but perhaps for quite an extended period. In that way there is, I submit, more possibility of abuse, because more medicine will be asked for than would be the case if the parent could take his or her child to the doctor every week. The tendency will be, when one has to pay 1s. on every occasion when a prescription is made up, to make the medicine last as long as possible and to get the largest quantity possible. In that way, I submit, there may well be substantial abuse. I invite noble Lords opposite—the Lord President of the Council, perhaps—to indicate how that possibility is to be dealt with.
§ Finally, I call your Lordships' attention to the fact that the lack of the provision embodied in the Amendment makes this part of the Bill inconsistent with the rest, because your Lordships will see that there is elsewhere in the measure a provision that persons under sixteen requiring appliances are freed from the charge. Similarly, children or young persons (in this case persons under twenty-one) are freed from any charge if they require dental treatment. It seems to me—and I submit the point to your Lordships with 802 some confidence—that it is quite inconsistent to free a young person from a charge for an appliance and free a person under twenty-one in respect of a charge for dental treatment, and not similarly to free a child from paying for a prescription The Amendment would make the Bill more uniform, more harmonious and more consistent. It must be obnoxious to all of us to think that a charge is to be made in respect of medicine or drugs used for the benefit of little children. I do not think there is one of your Lordships here who, in your own affairs, would wish to put such an imposition on the parent of a young child. Having regard to all those facts, which I submit are indisputable, I invite your Lordships to approve this Amendment, which I beg to move.
§ Amendment moved—
§ Page 1, line 5, at beginning insert the said subsection.—(Lord Milner of Leeds.)
§ THE LORD PRESIDENT OF THE COUNCIL (LORD WOOLTON)
I think I might reasonably assure the noble Lord at the outset that none of us likes the idea of imposing extra charges on any body; but I cannot follow his line of argument that a child is necessarily a necessitous person, even although I appreciate that the family may have quite a large number of children. There is no real logical argument to lead us to think that, because people have a large number of children, they are therefore unable to pay 1s. for a prescription when the doctor thinks it is necessary. As the noble Lord is fully aware, we have already made provision under the Family Allowances Act to help people with more than one child. I have been through all these Amendments which have been put down by noble Lords opposite. Very many of them, let me frankly admit, nave a very strong sentimental appeal, because they deal with people who are suffering. Let me say at once that we are not unsympathetic to the needs of the several distressed classes of people, but surely it is quite a simple point at issue: if a person is in such a state of financial need that 1s. will debar him from getting the necessary medicine, then indeed he must be in a state where he has other hardships, too.
The Government are already taking steps to relieve those hardships by increasing insurance benefits and pensions 803 If, however, additional help is needed—and this is really what I want to submit for the consideration of your Lordships—the principle on which the Government propose to work is to deal with the indigent family as a whole, not on the basis of each separate need, and to try to deal with it from one source—namely, the National Assistance Board. By that means, we aim to enable each person to use, on a parity with the rest of the community, the services which the State is providing. In this way, we shall avoid, what I think your Lordships all recognise, the demoralising effect of an individual having to seek relief in one form or another from a number of different places. We shall certainly reduce the cost of the administration and—although I do not for a moment suggest that this point arises in the case of children under sixteen—we shall reduce the risk of fraudulent application for relief. I thought it well to make this general statement of our position at the beginning under this particular Amendment, because it will save me repeating it on many occasions as the individual Amendments come up.
I am sorry that I cannot accept the Amendment. I do not think it is a good thing to try to place upon the chemists and the doctors the administrative burden of deciding whether a person is or is not of school age. I think we shall get a very much better result if we follow the line that I have suggested. May I add this? In the exceptions which we are making under the Bill we do not propose that the persons concerned should be exempt from the charges but that they should obtain repayment of the charges from the National Assistance Board. That, of course, could not apply to children. I hope your Lordships will not think it necessary to press this Amendment. I am sorry that I am unable to accept it.
§ EARL JOWITT
I must say to the noble Lord that I think he made a most singularly unconvincing reply. He has not attempted to deal with the point which the noble Lord made in moving the Amendment. The noble Lord said that, for some reason or other, you have treated children specially from the point of view of appliances—I think rightly—and you have treated children specially from the point of view of dental treatment, 804 again for good reasons. The noble Lord was asked: When you treat children specially from the point of view of appliances and dental treatment, why do you not treat them specially from the point of view of drugs and the like? I listened to the noble Lord, Lord Woolton, and I do not think he attempted to answer that question. He has given no answer at all. I very much hope that the noble Lord will do better than that. He can defeat us quite easily in the Division Lobbies, but that is not the point. What we want is that he should make some reply which satisfies us that he has a case and has considered the matter. At the present moment, he has not attempted to answer our point. I do beg the noble Lord to have a second innings presently and to attempt to make some sort of reply to the case which is put up.
The next thing I want to ask is this. The noble Lord talks about the charge of 1s. Now I may have this Bill completely wrong, and the noble Lord may correct me, but I understand that there is no limitation of the charge to 1s. under this Bill. No doubt the Minister will say: "At the present moment all we have in mind, and all we contemplate, is that the charge shall be 1s." As I understand it, we are asked to pass a Bill under which, if he were so minded, he could charge 2s., 5s., 10s. or any sum. Am I right on that, or am I wrong? When I was in the Government I had some six years of this from noble Lords opposite, Time after time they said to me—and I appeal to them now, because they heard it often—"Put it in the Bill". If I introduced a Bill which gave me power to make all sorts of charges, and then I said: "Well, I am only going to charge 1s." I should have been told: "Put that in the Bill." I ask the noble Lord this question: Am I right in supposing that, if we pass this Bill, the charge will not necessarily be limited to 1s.? That is the figure the Government have in mind at the present moment but next year, without passing any new Act, they could make it 2s. or 4s. I want a categorical answer to that question. If that is the position, and I understand the matter aright—and the noble Lord, of course, knows—then it is no good saying: "This is a very small matter. This is only 1s. and surely people can pay that."
805 It seems to me a lamentable thing that the sort of reply we have just had should be regarded as sufficient, because it is not. Of course, we know that the children's allowances are going up. May I ask the noble Lord whether he has considered the difference between a childless couple and a couple with two children? Does he really think that that difference is surmounted by the payment of 8s.? Let me assure him that you cannot keep one child on 8s. a week; and if the noble Lord does not know that I shall be very much surprised. I suggest that the greatest service the citizens can render this country at the present time is to have children. I suggest that a wise policy for this country is to see that people are not penalised because they have children. If the children get ill, and require appliances or dentists' treatment, or doctors' treatment in the form of drugs, then I suggest that this great community ought to see that that is not a charge on the parents. To my mind it does not meet the point to say that the parents who have to pay the money can go running round to the Assistance Board. In a great many cases they will not do that, and we all know it. I suggest there is a case for continuing for drugs what has already been done in the case of appliances and dentures. Therefore, I ask the noble Lord this question: Why have you treated children differently in regard to appliances and in regard to teeth, and why do you not extend that differentiation to drugs? The other question I ask is this: Am I right or wrong in saying that we are here asked to pass a Bill which confers upon the Government the right to impose whatever charges they think proper in their discretion, or is this merely a matter of 1s.?
§ 3.6 p.m.
§ THE SECRETARY OF STATE FOR COMMONWEALTH RELATIONS (THE MARQUESS OF SALISBURY)
Perhaps it would be useful if said a word in answer to what has been said by the noble and learned Earl. He asked a number of questions, and I will try to answer them to the best of my ability. First of all, the noble Earl asked: Why was a differentiation made between drugs for children and appliances for children? There is a definite medical 806 reason for that. Children, as we know, grow, and appliances which might be quite adequate for them at, say, the age of six would prove to be totally inadequate at the age of nine or ten. Therefore, the expenditure which might be involved by the parents is very much greater than in the case of supplying drugs. Somebody has a cold or influenza, whatever it may be. That is not a continuing and enlarging expenditure. That is expenditure to meet the single disease or emergency which has arisen. The noble Earl may not agree with that, but that is the argument which is produced and, to my mind, it is a valid one. Appliances and drugs do not come into the same category at all.
Then there is the question of the 1s. charge. The noble and learned Earl is perfectly right when he says that the Is. charge is not in the Bill. It is a matter to be settled by regulation. I would remind the noble Earl (perhaps the noble Viscount, Lord Stansgate, will forgive me for one moment) that exactly the same device was used by his own Government in the Act of 1947. At the present moment, at any rate, it is not the intention to consider any increase in the 1s. charge, any more than I am sure it was the intention of the Government of the noble Earl's Party, when they produced their Bill, regularly to increase the charge then proposed. This method is adopted merely for convenience, and it is certainly much less rigid. The noble Earl said: "You may put it up to 2s. or 3s." Equally, the Government might wish to reduce it to 6d. It might go either way, and in that case it would require an amendment of the Act. That is the reason why it is to be done by regulation. The noble Earl's own Party thought it the right way to do it, and we followed their example in that respect.
§ EARL JOWITT
May I suggest that if you put a limitation in the Bill, "Not to exceed 1s.," that would not in the least prejudice reducing the charge to 6d.? If you like it could be "not to exceed 2s." The mere fact that my Government did it does not mean that two wrongs make a right. I think it was wrong, because I think it is always wrong to confer upon a Government by Act of Parliament far greater powers than they say they want to use. I believe that is a perfectly genuine principle, which I 807 learned in the last six years, and whether or not my Government did it does not enter into the question.
§ THE MARQUESS OF SALISBURY
All I can say is that the noble and learned Earl used a very different argument when he was on this side of the House. I do not think he can have any complaint against this Government for doing exactly what his Party did in similar circumstances.
The noble Lord also asked why we did not differentiate for children. He said that people might have one child, or two or three children, and might be involved in far greater expenditure on that account. Of course, it is true that people may have small families or large families but it is not necessary to assume—and it is a far too general assumption in many quarters—that because people have children those people are always ill. In fact, the number who are ill is normally very small. This charge of 1s. is regarded almost as a kind of constant charge on the weekly income of the wage earner; but that is not so. The charge, as it will apply, year in and year out, to the average family, is not a heavy one. I have seen this argument used again and again. The assumption appears to be that in any large family the children are always ill and that therefore the parents are very hardly treated by this Bill. That is not true. A 1s. charge, for the average healthy family is, in fact, a very small one indeed.
I must point out again that children were not differentiated in the case of the Labour Government's Bill, no doubt for the same reason that I am urging now. I do not think that it would be possible to make this differentiation. The only effect would be to defeat the whole object of the Bill. That object is, without causing undue hardship, to reduce the national expenditure at a time of great national danger. And if I am told—as I am constantly told—that this saving will be a very small one, I can only urge, as I have urged constantly in this House, in Opposition and when my Party have been in power, that the only way you can make economies at all is by making a number of small economies. It is no good trying to make single economies of £150,000,000 or £200,000,000, because that cannot be done. You have to make 808 small economies where it can be done—limiting, as far as ever you can, the hardship which may be caused. Therefore, I make no apology on behalf of the Government for not making an exception in this case. I am quite certain that the exception would not have been made by noble Lords opposite if they had had to deal with these same circumstances.
§ VISCOUNT STANSGATE
I venture to intervene because the unofficial members of the Conservative Party opposite seem remarkably and unanimously reluctant to defend this Bill. We are considering the position of children under sixteen years of age at school. The object of the Bill is either to prevent abuses or to save money. Does anyone allege that there have been abuses in the prescribing of drugs of children under sixteen? I cannot imagine that anyone would say that the drugs prescribed for children have led to abuses. That is a point which must be answered, for it is one of the legs on which the Bill stands. There is another point. The noble Marquess spoke of economy. He said that we must have economy. Has he any information how much we are contributing, to the rearmament drive by taxing pills and medicines for these young people? There must be some idea of how much we are saving: is it to be £10,000, £15,000, £20,000? I do not know, but I think some answer ought to be given. Another question was that concerning regulations. The noble Marquess says that these things can be done by regulation. I think my noble and learned friend's point about the charge "not exceeding" a certain sum was a perfectly sound one. It is hard to put in the Bill a definite sum of pounds, shillings, and pence, but suppose that the Government were to introduce a regulation fixing, say, 4s. We could not amend the regulation. We could reject it, but this House would be very reluctant to do that, and so would another place. What is to be the position?
The whole tone and temper of this Government, and their whole approach to this problem, are difficult to understand. We on this side have always said that many and healthy children are the true wealth of a country. Yet the noble Lord, Lord Woolton, spoke of the "demoralising effect" of not having a charge. It is true that he hastened to say that he was not referring to the charge 809 in relation to children. But how can anyone speak of giving medicine to a sick person as being "demoralising"? I remember that in the year 1910 or 1911 (I ant not sure which), at the time when the old-age pension was being discussed, leading Conservative statesmen in Opposition said that a payment of 5s. per week to an old man of seventy would have a shameful and demoralising effect. Whatever may be the truth of that, certainly it is an argument that cannot possibly apply to a sick child. We do everything to assist a child from birth; we attend to its health in its early years; we see that it is sent to school, in a bus if necessary, and so on; but when the child is sick we say "we shall have to charge you 1s.; it would be demoralising for your parents not to have to pay something." I assure the noble Marquess that this Bill can produce very little money and that it will have a damaging effect upon the reputation of the Conservative Party.
§ THE EARL OF LUCAN
The noble Marquess said that children are not likely to be ill. Would he deny that it is just in the years up to about the age of sixteen that nearly all children have all kinds of diseases?
§ THE MARQUESS OF SALISBURY
I do not deny that children, like other people, are sometimes ill. I said merely that the assumption among opponents of this Bill was that all children were always ill and that, for instance, if a man had twelve children he would be paying 12s. per week. In fact, we all know that the children are not always ill at the same time. In any case, as I pointed out, this 1s. charge is not a weekly charge for each child. It is a sporadic charge for each child. One or two children may get a bad cold—or even more if there is an epidemic If there is a serious infectious disease, the children will be sent to hospital. But in the ordinary case the charges would be sporadic ones. That was all I said; the noble Earl could not quite have understood it.
I should think the right way to look at this matter is that tax allowances and children's allowances are given in order to compensate for these payments. The bachelor might well have a serious complaint if he had to pay 1s. for his prescription, when the man next door, who has children, gets it free.
§ LORD MILNER OF LEEDS
Perhaps I may be allowed to say a word or two. The noble Lord and the noble Lord who has just spoken seemed to think that allowances were given on income tax for people who have children. That is so, but allowance is not made in respect of this particular imposition, which is to be imposed by regulations to be made by this Government. Secondly, the noble Lord, Lord Woolton, seemed to think that everybody should be running to the Assistance Board. He seemed to imply that there were other sources to which they might go and that it was desirable, in the case of all these who are entitled to repayments—
§ LORD MILNER OF LEEDS
Indigent people. Is there any other place to which indigent people can go, except to the Assistance Board?
§ LORD MILNER OF LEEDS
I speak subject to correction, but so far as know there is no other place to which people can go for relief in one form or another except the National Assistance Board. Therefore, the noble Lord's argument seems to me to fall to the ground. He spoke about the demoralising effect of going to numbers of other sources. There is only the National Assistance Board. Therefore, the noble Lord's argument was a completely false one. There would be no saving in administrative costs, about which he spoke. Surely the very fact that these medicines and drugs are going to be paid for at 1s. a time will increase the administrative charges. It will increase charges tremendously to ensure that all those who want medicines and prescriptions have to pay 1s. on every prescription. That is going to be a tremendous administrative question indeed. It was mainly on that very point that the previous Government felt it was not desirable or practicable to proceed with their proposals. Here the noble Lord comes along and implies, for reasons which I cannot follow, that there will be a great saving in administration. In my view the imposition of these charges will effect hardly any saving at all. We have not been informed what the prospective saving is. Probably, it 811 will run the administration into a great deal of expense.
Then I noticed that the noble Marquess, if he will give me his attention for a moment, mentioned the differentiation between the prescription and the appliance, but carefully avoided saying anything about the dental treatment. Where does the differentiation come in there? What is the difference between taking one's child to the dentist and having its teeth out or having it dealt with in some form or other, and giving it medicine on a prescription? Why do the Government propose to exempt the child in the one case of dental treatment, and not to exempt the child in the other case of medicine and drugs? I submit to your Lordships that all these impositions are—I will not say designed, but will have a deterrent effect on parents and on children. Principally, of course, the effect will be on parents, who will not take their children to the doctor as frequently as they might otherwise do, and as frequently as necessity requires, because there is this charge. To some noble Lords it may be a very small amount, but to poor people in some of the congested streets which I represented for many years, it will be a very serious charge indeed. It will mean that the housewife out of her small monies will have to find at least 1s. or 2s., or it may be much more, in respect of these prescriptions. In my view, the result of these impositions will be to exercise a deterrent effect, to prevent children from being medically attended to as they should be, with the result that the health of our young children, which for some years past has been the admiration of the world, is likely to be seriously affected.
Finally, I would reinforce what the noble Viscount said as to the saving that will be effected. I shall be glad to hear from the Benches opposite what savings will be effected by the imposition of this charge for drugs or medicines on children or young persons under the age of sixteen. How much is going to be saved by the refusal of this Amendment and the insistence upon this charge? Is it going to be £50,000, £100,000 or £1,000,000? Cannot some estimate be given, or is it, like so many of these proposals of the Government, rather a leap in the dark? I hope the noble Lord will give us the answer to that question.
§ 3.25 p.m.
§ LORD SILKIN
Before the noble Lord replies, I should like to summarise, if I can, the case that has been made so far against this Amendment. First, I gather it is that the Government are doing exactly what the Labour Government proposed, and, therefore, they are perfectly right and justified in what they are doing. I wonder whether they are going to accept that kind of case as a precedent in everything they do? If they can do no better than the Labour Government did, what happens to all the representations that the noble Lord, Lord Woolton, made during the Election, that he could do so much better in every possible respect? We are expecting that the present Government will use their own intelligence, will rectify whatever may have been wrong in the work that the Labour Government did in the past, and will improve upon it; but over and over again we are hearing here that "This is what the Labour Government did, and therefore we are justified in doing exactly the same."
§ THE MARQUESS OF SALISBURY
We do not say we are justified in doing exactly the same, but, if we do so. noble Lords opposite complain that we have no right to do so.
§ LORD SILKIN
Oh, no. Surely we are entitled to consider on its merits every measure which the Government introduce, and the mere fact that a year or two years ago a certain line was taken by the Labour Government does not debar the present Opposition from considering this measure on its merits. The case that is made for this measure to-day is not the case that was made by the Labour Government two years ago, when circumstances were quite different. Nor is this measure the same. The other point that was made, both by the noble Lord, Lord Woolton, and by the noble Marquess, is that in practice there will be no hardship on the parent if a charge is imposed on the medicine of the child. "No hardships," says the noble Lord, Lord Woolton, because the parents can pay, and then, if they are indigent or they qualify under the regulations of the Assistance Board, they can get their money back. "No hardship," says the noble Marquess, "because the Opposition have grossly exaggerated what is likely to happen in representing that all 813 children are ill all the time." So far as I know, nobody has ever suggested that that is the case. Of course, children are not ill all the time nor are all children ill at the same time. Noble Lords opposite are very fond of putting up a case which we on this side have not made, and then answering that instead of answering the case that we do make.
The case that I make is this: that this charge is going to fall particularly hardly on parents with a number of children. It is quite a common thing for a number of children in a family to suffer from illness at the same time. I happen to be a grandfather and have gone through this phase in the last six months with one of my sons, who has three young children. It happens that almost continuously for the past few months the children have been ill with whooping cough, with measles, with German measles or with mumps: one thing has followed another. The fact is that, when that happens, a parent does hesitate to go to the doctor and get medicine, if he has to pay these shillings at a time for the medicines. If the charge operates as a deterrent, it is surely undesirable. It is surely in the national interest that parents should seek a doctor's advice when their children are ill, and not be deterred by the thought of having to pay for medicines, possibly regularly over a few weeks. In so far as it acts as a deterrent, I say that this Bill will have a very serious effect on the health of young people.
Then the noble Lord, Lord Woolton, says that if things are as tight as that—they are not tight with every family, but they are tight in a number of cases—the parents concerned can get their money back from the Assistance Board. With great respect, I doubt if they can. I doubt if they would qualify. The noble Lord has referred to the indigent family, but the families I am thinking about are not indigent in the sense that they would be eligible under any conditions that the Assistance Board are likely to make. There is the normal family where the husband is at work and earning a normal wage, of six pounds a week if you like, with two or three children. Such a family may just about manage with a tight squeeze, and every additional penny that the housewife has to pay out can be met only by sacrificing some other small thing which is really a necessity or a tiny comfort. They may sacrifice their summer 814 holiday. They would not be regarded as qualifying for assistance from the Assistance Board by reason of that sacrifice. Suppose a family has saved up seven or eight pounds to enable them to take a summer holiday, and then one or two children become ill. They have no reserves out of which to meet these charges, so they dip into their summer holiday money, and they are not able to take a holiday. They could not go to the Assistance Board and say that they are indigent or destitute. But is it really desirable that people should be pressed as tightly as that? I can assure the noble Lord that that is the position of a large number of families in this country.
This Bill will be regarded with terror by parents who have young children and who, in addition to the rising cost of living, will now have to meet these charges—not all the time and in respect of all the children, but quite often, and particularly in the case of younger children. Therefore, in spite of what the noble Lord, Lord Woolton, has said, I hope the Government will reconsider this matter. They have not met the case that my noble friend Lord Milner has put, distinguishing this from the case of dental treatment. I see the point of what the noble Marquess has said about appliances, but he has not met the case of dental treatment, which is on all fours. If the Government could see their way to reconsider this mater, it would do a good deal to mitigate the great hardship which otherwise this Bill is going to impose.
§ 3.35 p.m.
§ VISCOUNT SAMUEL
As I understand that the Opposition propose to divide the House on this Amendment, the Committee will perhaps permit me to say a few words to explain the course which will be taken by my noble friends and myself on these Benches. We shall vote for the Amendment, and for these reasons. In the first place, we think that the Bill is rightly framed in its other clauses in exempting children from the charges under the Bill, not only in the case of appliances, but also in regard to dental treatment. In dealing with the point with regard to surgical appliances, the noble Marquess did not, as I think, give a very convincing answer, saying merely that children grow and therefore they need the appliances to be renewed. I do not think that that is convincing on the whole 815 matter, and it certainly does not apply to dental treatment. The reason why children have been exempted from these charges is that the charges are very costly, especially in regard to surgical appliances for which the parents could not afford to pay. That applies less powerfully with regard to prescriptions, but it does hold good, and I think that from the beginning the Government would have been well advised to lay down a rule that this should not be an addition to the cost of bringing up a family.
Everyone knows that the class in the whole community who are the most hard pressed financially are the working people in the early years of their married life, when a number of children are coming along. Very often they are the most poverty-stricken of all and, wisely, the State has, on the one hand, tried to exempt that particular class from the new charges and, on the other hand, to help them by means of family allowances. This is a case in point; and when a poor working class family is put to extra cost owing to the illness of a child—and there are all sorts of indirect costs—it does not seem to be a reason for imposing a charge for prescriptions, and so forth, from which they are at present exempted.
That is the main reason why we shall vote for the Amendment. We do not think that a sufficient answer has been given by saying that family allowances are the means by which such charges should be met, and that family allowances have recently been increased. Those increases have been given owing to the rise in the cost of living, and of course are much more than consumed by the fall in the value of the pound.
The noble Lord, Lord Woolton, said that if the allowance is not adequate, the family can go to the Assistance Board for assistance. I understood him to say that we ought to treat the family as a whole, and that if they are as badly off as all that the time has come for them to go to the Assistance Board. But consider how that works out in practice. There are tens of thousands of prescriptions in these cases. Are a family expected at any one moment, on the first prescription, to say, "We cannot afford to pay this shilling. We are going through all the formalities of applying to the Assistance Board and having our case heard"—for the sake of a shilling? They 816 would not do it. They will get into the habit of paying a shilling as a matter of course, and if there are several children and several illnesses, those additional charges will come at the very moment when they are least able to pay. In general, in all these matters, the right way, in our opinion, is not to impose extra charges on the sick at the time when they are sick, but rather, if it is necessary to raise fresh funds to limit excessive charges on the Health Service, to increase the general insurance charge. The people themselves pay a huge proportion of the millions that are spent upon the National Health Service, and if that is not enough, and if it is necessary to go to the people for more, then charge them at the time when they are in good health, and not at the time when either the bread winner or one of the dependants is sick. Therefore, we shall vote for the Amendment.
§ LORD WEBB-JOHNSON
The noble Viscount has thought it incumbent upon him to explain why he is supporting the Amendment. Perhaps I may be allowed to explain why I am not supporting it. I think that the Amendments we have to consider this afternoon are all designed to put before the Committee situations which, in many circumstances, can be distressing. The variety is very great. We have heard arguments about the young and about children, and particularly about medicines. The reactions of individuals to prescriptions and medicines vary greatly. I generally seek the first opportunity to empty the medicines down the sink. But, of course, with modern medicine, there are drugs and prescriptions which are specific and which are essential to a cure, or even to the continuance to life. Those cases, however, will not apply particularly to children. If they are requiring treatment with expensive specific drugs, they will almost certainly be in hospital.
§ VISCQUNT STANSGATE
Yes. I asked that because of my own experience. People come to me and tell me that they have been kept waiting for weeks and weeks because there is no room in the hospitals.
§ LORD WEBB-JOHNSON
That is very largely the result of the legislation which was passed and which threw the doors of the hospitals open to everybody, from the richest to the poorest in the land. Now, in many instances, a patient who could well afford to pay for treatment outside, is occupying a bed which in the old days would have been occupied by someone who could not afford to pay. But I do not want to enter into an argument. All I wish to do is to justify my attitude on this particular Amendment—an attitude which will apply to many other Amendments, because these distressing situations are going to be paraded during the next few hours. We have heard about the young; we are going to hear about those who have cancer; we are going to hear about the chronic sick; we are going to hear about
§ persons who are out-patients after they have been in-patients; we are going to hear about the disabled; we are going to hear about those who are getting assistance already under the Workmen's Compensation Act; we are going to hear about people suffering from tuberculosis and we are going to hear about those who have diabetes. That is the programme. In every case argument can be advanced to show that there is special need. But provision is made to meet the special need, either in this Bill or in other enactments. For these reasons I shall not support the Amendment.
§ 3.45 p.m.
§ On Question, Whether the said subsection shall be there inserted?
§ Their Lordships divided: Contents, 35; Not-contents, 70…817
|Baldwin of Bewdley, E.||Greenhill, L.||Ogmore, L.|
|Jowitt, E.||Hare, L. (E. Listowel.)||Pakenham, L.|
|Henderson, L.||Pethick-Lawrence, L.|
|Hall, V.||Kenswood, L.||Rea, L.|
|Mersey, V.||Kershaw, L.||Rochester, L.|
|Samuel, V.||Lawson, L.||Sempill, L.|
|Stansgate, V.||Layton, L.||Shepherd, L.|
|Lucas of Chilworth, L.||Silkin, L.|
|Bingham, L. (E. Lucan) [Teller.]||Macdonald of Gwaenysgor, L.||Sinha, L.|
|Burden, L. [Teller.]||Milner of Leeds, L.||Terrington, L.|
|Cawley, L.||Morrison, L.||Winster, L.|
|Douglas of Barloch, L.||Nathan, L.||Wise, L.|
|Douglas of Kirtleside, L.|
|Simonds, L. (L. Chancellor.)||Buckmaster, V.||Dormer, L.|
|Davidson, V.||Fairfax of Cameron, L.|
|Woolton, L. (L. President.)||Furness, V.||Gifford, L.|
|Hudson, V.||Greville, L.|
|Sutherland, D.||Long, V.||Hampton, L.|
|Margesson, V.||Hawke, L.|
|Maugham, V.||Hindlip, L.|
|Cholmondeley, M.||Monsell, V.||Kinnaird, L.|
|Reading, M.||Swinton, V.||Leathers, L.|
|Salisbury, M.||Templewood, V.||Llewellin, L.|
|Albemarle, E.||Aberdare, L.||Mancroft, L.|
|Alexander of Tunis, E.||Ailwyn, L.||Milverton, L.|
|Beauchamp, E.||Audley, L.||Palmer, L.|
|Bessborough, E.||Baden-Powell, L.||Remnant, L.|
|De La Warr, E.||Belstead, L.||Rochdale, L.|
|Dundonald, E.||Bethell, L.||Saltoun, L.|
|Fortescue, E. [Teller.]||Brassey of Apethorpe, L.||Sandford, L.|
|Howe, E.||Broughshane, L.||Sandhurst, L.|
|Lindsay, E.||Cherwell, L.||Schuster, L.|
|Onslow, E. [Teller.]||Clanwilliam, L.(E. Clan-william.)||Somers, L.|
|Rothes, E.||Teviot, L.|
|Scarbrough, E.||Courtauld-Thomson, L.||Teynham, L.|
|Selborne, E.||Cranworth, L.||Webb-Johnson, L.|
|Selkirk, E.||De L'IsIe and Dudley, L.||Wolverton, L.|
|Shaftesbury, E.||Dorchester, L.|
Resolved in the negative, and Amendment disagreed to accordingly.
§ 3.53 p.m.
LORD MILNER OF LEEDS moved, in subsection (2), after the words "in respect of," to insert:
drugs, medicines or appliances authorised to be supplied before the commencement of this Act, or in respect of".
§ The noble Lord said: I beg to move the second Amendment on the Marshalled List. Its object is to ensure that these charges for drugs, medicines and appliances, are not made retrospectively. I need hardly remind the Committee that it is very rarely that taxes or charges are made retrospective, and there are no special circumstances, so far as I know, why the charges proposed to be imposed by this Bill should be made retrospective. The contrary is the case. There are instances where, especially in the matter of appliances, a prescription or order has been given by a responsible medical practitioner or specialist for an abdominal belt or surgical boot and, through no fault of the patient, delivery of the appliance has been delayed, it may be for many months. Your Lordships know that many of these appliances are only now being manufactured in quantity, and for some time past there have not been sufficient appliances available. The consequence is that the patient has to pay for something for which he never anticipated paying. That is an additional hardship on the patient or his family. It is almost in the nature of a breach of contract.
Six months ago I was examined and my specialist ordered me a surgical boot. I anticipated getting it for nothing and entered into the transaction on that basis, and when delivery time comes I have to pay £3 for it. That seems to me almost a breach of contract, certainly a breach of the spirit of the arrangements provided in the first Act. Ex hypothesi, the individual concerned is an injured or disabled man, possibly unable to work or only able to work at some ill-paid occupation; but notwithstanding, he has to pay in the case of appliances up to £3, a large sum to such a man. This position has been recognised in connection with dental treatment. Clause 2 (3) of the Bill says:
No charge shall be made under this section in respect of any services provided in pursuance of a contract or arrangement under which the first examination took place before the commencement of this Act.
Clearly, before a person could obtain a prescription for an abdominal belt or surgical boot, he must have been examined by a qualified surgeon or physician. Why should a person who requires dental treatment be exempted from retrospective payment when the person who requires a surgical boot or abdominal belt has to pay? It seems to me that in this respect again the Bill is inconsistent, and I ask for the same concession to the person who has been examined for such appliances before the commencement of the Act as is given by the Bill to the person who requires dental treatment. I submit that otherwise injury is likely to be done to national health. Anyone who requires one of these appliances and thought he was going to have it free now has to pay for it. But he may not be able to pay for it, and the result is that he may struggle on with an old appliance which is dirty or insanitary or does not fit and is dangerous. Here, again, the terms of the Bill, without the exemption for which I ask, form a considerable deterrent to those who require any of these appliances.
§ There is also the point which I mentioned on Second Reading. The Government have sent out instructions to hospitals, and the hospitals in turn are communicating with persons who have appliances on order requiring them to sign forms to the effect that they know they will have to pay for the appliances when they are delivered. Surely that is anticipating that the decision of your Lordships' House will be in favour of the Bill, that your Lordships will not be willing to give any exemption to retrospective claims. I submit that your Lordships may properly think it right to support this Amendment and ensure that charges are not made in respect of appliances supplied before the commencement of the Act.
§ Amendment moved—
§ Page 1, line 10, after "of" insert the said words.—(Lord Milner of Leeds.)
§ THE LORD CHANCELLOR
I had not intended to interpose, but my noble friend who is in charge of the Bill, having heard mention of breach of contract, thought it would be appropriate for me to deal with that point. There is no question of breach of contract and no similarity between the case we are now discussing and that which arises in respect 821 of dental treatment. In respect of dental treatment, there is a dental estimate form, and the dentist and patient enter into a written contract. If there is such a contract, it is right that it should not be broken, and if there is a contract in this case, it is equally right that it should not be broken. But the noble Lord has not referred to any contract or suggested with whom the contract has been made. If there is a contract, the contracting party will have his remedy; but I do not think there is any contract being entered into here. There may be some kind of informal arrangement and authority. I notice that the words of the Amendment are:appliances authorised to be supplied before the commencement of this Act.Those words are wholly inappropriate if a contract has been entered into. The analogy of the dental treatment on which the noble Lord relies really has no application to this case. If that has no application, and if there is no contract, why should the differentiation be made between the man who wants an abdominal appliance and orders it tomorrow, and one who ordered it yesterday? Both have the same need, and both are required under the Bill to make some contribution. I venture to submit that there is no foundation for the proposed Amendment.
§ VISCOUNT STANSGATE
I should like to ask the noble and learned Lord a question. The purpose of this Bill is to prevent people from abusing the National Health Service. A man goes and says, quite lightly, that he will have a surgical boot, because he will not have to pay for it; and then he suddenly finds when this Bill is passed that he is going to be charged for it. Is that not essentially a breach of understanding? He entered into the arrangement, but he then says: "I shall do without the boot. It will not help me, and I shall have to limp; but, inasmuch as it is my having a boot or the children or family having something, I will go without it. "Is that not reasonable? What is the objection to putting in words such as we suggest? One hardly imagines that a person goes to a surgeon, has an appliance, and says:" I have a form of contract. Will you have this signed in the presence of witnesses?" He orders the boot because this is the Health Service and he expects 822 to get it free, and then he finds that he is going to be charged perhaps a substantial sum. My noble friend asks that in such a case, if it can be shown that the appliance was ordered under the old Act, that the man shall not be charged under the new Act. That seems to me a reasonable case, and I do not think the Lord Chancellor has adequately dealt with it merely by dealing with a signed and sealed contract.
§ THE LORD CHANCELLOR
The contrasts are simply between the case put by the noble Lord, Lord Milner, where there is a case, and the present case, where there is not. An authority to supply does not amount to a contract between the parties. The unfortunate man to whom the noble and gallant Viscount has referred is in no different position because he had authority before to have an appliance supplied from the man who goes to-day. One is very sorry for them both, if it means pressure on their finances. But why should a man who, if you like, had one promised before this Bill be placed in a better position than a man who suffers from an abdominal complaint to-day? They are both in the same position. I feel that it would be unfair to provide the appliance free for one and not the other.
§ VISCOUNT STANSGATE
Perhaps I might ask this question. Supposing a man has said that he will have the appliance, which is worth £5 or £10, and then says: "I entered into this on the basis of it being a free gift from the State. I cannot afford it." Who then bears the loss?
§ VISCOUNT STANSGATE
Then, does the practitioner who ordered it bear the loss? Who pays the man for making the wooden leg?
§ THE LORD CHANCELLOR
That is going rather far. I do not think for a moment that the man will be placed under any obligation to take that which was authorised to be supplied to him, But one would have to look at the whole of the circumstances of the case.
§ EARL JOWITT
I agree that there is no contract involved, but I feel that this is a very hard case. There are many cases where you have the alternative put 823 to you of either having an operation or of having some sort of appliance. Take the case of a man who, in the old days, before the Act was passed, went to the surgeon and was examined, and the surgeon said that he had better have a boot, belt, or whatever it might be. In the circumstances as they then existed the man was entitled to get it free, and said: "Very well; that is what I will do. I will carry on, give up the idea of an operation and look forward to the day when I get this appliance." Owing to delay—for which no one is to blame—the appliance does not come as quickly as it might have; and it so happens that the delay extends over so that the appliance is not delivered until after this Bill has become an Act of Parliament. The proposal here is that this man should not be penalised because of the delay that has occurred. If a man has had authority from the surgeon, who said that the appliance should be supplied, and all that has happened has been a delay, it seems very hard that the man should pay. I should like to ask the noble Lord in charge of the Bill to consider this matter between now and the Report stage to see whether there is not some way in which he can meet what is certainly a disappointment, and something which may in some cases, it seems to me, create hardship. I should be quite satisfied if the noble Lord would say now that he will look into it to see if there is a case, without in any way making any sort of promise. I understand that at the present time he thinks there is not a case, but I would ask him not to bang the door to-day, but to consider it and find out if there is any more in the matter than he seems to think at present.
§ THE MARQUESS OF SALISBURY
I do not seek to anticipate the answer which my noble friend will give. I rise on a point of elucidation. I am not clear what the noble and learned Earl means. Does he want us to look into the Amendment again with a view to seeing whether we can meet the intention of the noble Lord, Lord Milner; or is he concerned with the limited point of whether a man who had ordered a surgical boot, and afterwards found that it was going to cost him £3 or £4, should shoulder the burden? Clearly, nobody wishes the unhappy man to have to pay for the boot, he having said that he cannot afford it, 824 and having refused to take it. That clearly would not be fair to him. On the other hand, there is, as I am sure the noble and learned Earl will agree, considerable force in the argument put by my noble and learned friend the Lord Chancellor, that there is, in fact, no contract, and that if you give this man a special advantage you will, in comparison, be penalising other people in the same position. What the Government intend is that, if the person wants the boot and is prepared to pay, he should pay the £3 or £4, or whatever it is, but that if he does not want the boot, he should not pay at all. That seems a practical proposition. But the more limited question of who, in fact, over the interim period, between the time just before and the time just after the Act is passed, pays for the boot which the man no longer wants, merits consideration.
§ EARL JOWITT
Of course there is force in what the noble and learned Lord, the Lord Chancellor, says—there is force in everything that he says. But I should like the noble Lord in charge of the Bill to look generally into the problem that my noble friend Lord Milner has advanced. It may be that as a result of looking into it the only thing that can be done is something on the narrower lines suggested by the noble Marquess. All I should like is some sort of assurance that he will look into the matter.
§ LORD PETHICK-LAWRENCE
There is one point that I should like to raise, before we leave this question. The Lord Chancellor said, very properly, that when you fix a date it quite clearly brings a hardship on one man who falls on one side of the date and not on the other. That must be so. I venture to suggest that there is involved here between two people a hardship which is very notable. Two men go to a surgeon who is considering giving them an artificial appliance—one man goes in January, let us say, and another man in March. The man who goes in March goes to some place where surgical boots are made quickly; he gets it before the Act and he gets it free. The man who goes in January may have to wait five months before he gets it, and it comes after the Act. In that case, you get a much greater hardship in comparison between the two cases under this Act. I support my noble friend's 825 suggestion that the Government should at least promise to look into this matter, without necessarily giving any undertaking.
§ LORD WOOLTON
Let me relieve the House. I shall be very glad indeed to look into this matter again.
§ LORD DOUGLAS OF BARLOCH
I hesitate to disagree with anything the Lord Chancellor said, but I think that my noble friend Lord Milner was correct in drawing attention to the contrast between the provisions of Clause 1 and Clause 2 of this Bill. Clause 2 is not confined to cases in which the dental treatment is supplied under contract. Clause 2 deals also with cases in which the dental treatment is supplied by arrangement, and I do not think, with all respect to the noble and learned Lord, that the word "arrangement" is intended to be synonymous with "contract". It is much more likely to be synonymous with the word "authorised", which my noble friend has used in his Amendment. If there is a good case for exempting people from paying for dental treatments which are to be provided under an arrangement made before this Bill becomes an Act of Parliament, then why should not precisely the same apply in the case of other treatments which have been arranged or authorised before this Bill becomes an Act of Parliament?
Let me put one other point to the noble Lords opposite. This Amendment deals, among other things, with the supply of appliances. It must be well known to noble Lords that thee are cases in which the supply of an appliance is an alternative to having an operation. It is not proposed under this Bill that anybody should be obliged under the National Health Service to pay for an operation. What is the effect of this proposal, as the Bill stands, to charge for appliances? It means that people will be inclined to have operations, where that is the alternative, instead of having an appliance. I am not certain that that will be a good thing for the National Health Service. Nor do I think it is a good thing that a financial compulsion should be imposed upon any person to have an operation rather than to have an appliance supplied to him. I beg the noble Lords to reconsider this matter.
§ THE MARQUESS OF SALISBURY
I must say that I have never heard a more extraordinary argument advanced by anyone. An appliance would cost, perhaps, two or three pounds, and he puts forward a proposition that people would rather have a severe operation than have an appliance.
§ THE MARQUESS OF SALISBURY
Well, an operation. I should have thought that the charges which are to be made for these appliances, even under the present arrangement, are of the most moderate character. To suggest that people would rather go, to the detriment of the country and the Health Service, into operations than to pay a moderate charge, is not, think, a serious argument to put before the Committee. I would point out to the noble Lords that my noble friend has already said he is very ready to look into this question. He said that he would look into all the arguments that have been raised and considerations that have been urged. I do not think that the Government can go further to meet the Opposition.
§ LORD DOUGLAS OF BARLOCH
Let me make myself quite clear about this matter. I am glad to know that the undertaking which has been given is an entirely comprehensive one, to look at the whole of the proposal which my noble friend Lord Milner has made. I thought it was a more limited one than that. If it covers the whole of the Amendment, then it is satisfactory.
§ VISCOUNT STANSGATE
I just want to clarify one small point. Lord Milner pointed out that people were being asked to sign in advance a form undertaking to recognise certain charges. If they sign these forms, will they be indemnified in any way in respect of pledges and promises which the noble Marquess has been good enough to make?
§ THE MARQUESS OF SALISBURY
"Pledges and promises" are a slight exaggeration. What I said was that the whole matter will be looked into. I must say here and now to the noble Viscount that I made no pledges and promises except that the matter would he looked into.
§ Amendment, by leave, withdrawn
§ 4.18 p.m.
§ LORD KERSHAW moved, in subsection (2) (a), after "patient" to insert "who is suffering from malignant disease or." The noble Lord said: I am rather hopeful, now that the House has resumed a more friendly atmosphere, that the noble Lord, the Lord President of the Council, will not be unsympathetic with the case I present to him. Before I do present the case for those suffering from malignant diseases, I should like to say that this Amendment refers only to Clause 1 and therefore refers strictly only to people who are out-patients at hospitals and not to the generality of insured people.
§ Two reasons for the Bill have been submitted and have been mentioned again to-day, both by the Lord President and by the noble Marquess. Those reasons are that it is necessary from an economy standpoint and because there are abuses. Let us take abuses first. It has already been stated that no evidence whatever has been produced to show that there are abuses. I am entitled to remind the House that some years ago, in the early thirties, there was considerable agitation in the Press about the alleged abuses of Unemployment Insurance, and Lord Blanesburgh, who was at that time Chairman of a Committee sitting on the subject, declared at their first meeting that before they went any further in this matter they should discover whether, in fact, there was any truth in the agitation about abuses. An Inquiry was set afoot and, I think, some 400,000 claims were sifted; and at the end of it all, if my memory is right, less than eight cases were found to justify any sort of action against the people.
§ I have been looking up the last Annual Report of the Ministry of National Insurance. I find there that the average new claims amounted to 137,700 weekly, in the year with which I am dealing. That means, if my arithmetic is correct, that well over 7,000,000 people come every year under the sickness benefits scheme. Then, if I turn to table 30 at the end of the Report, I find that in only 503 cases were legal proceedings instituted. In other words, this terrible abuse which 828 has been spoken of, and which is supposed to justify a Bill of this kind, so far as legal proceedings are concerned, amounts to seven cases in 100,000. I suggest that the excuse that there will be abuse in respect of the whole of the insured population is entirely unfounded, and if we apply it only to those people with whom I am especially concerned in this Amendment, obviously to suggest that anyone would pretend to be suffering from a malignant disease is an argument impossible to justify.
§ On the question of economy, again I looked up the Report of the Ministry of National Insurance. What do we find there? The Insurance Fund increased last year by £138,000,000 to a total for the Fund and the Reserve Fund of £1,120,000,000. Now I suggest to your Lordships that if economy is really the reason for this Bill, an easy and a sensible way of dealing with the matter would be to increase the 10d. which is deducted from the contributions and credited to this Fund by 1d. or 2d. for the period of the rearmament programme. There would then be no need from the point of view purely of economy to do anything of this nature. There is a very good precedent for such an action. I may remind noble Lords that many years ago—perhaps twenty years ago—the present Prime Minister, when he was Chancellor of the Exchequer, made a raid, as I call it in this case, by reducing the State grant under the National Health Insurance Fund from 2/9ths to 1/7th. From an economy standpoint, therefore, it is perfectly clear that quite a modest rearrangement of the allocation of the moneys from the stamps would do all that is necessary.
§ Now let me come to the particular section of the community with which the Amendment is concerned. Having regard to what the noble Lord, Lord Woolton, said and to my knowledge of him as a man, I am entitled to assume that he will approach this subject with the humane outlook of which I believe he is capable. I hope that at the end he will be able to assure us that a case has been made out for a review of the Bill in this connection. The Amendment with which I am dealing relates only to people with malignant diseases—cancer and the like. Obviously, similar considerations would apply to quite a number of other classes of people—to tubercular people and the 829 other classes mentioned in some of the Amendments to follow. It must he known, at any rate to those who consider this problem, that some 94,000 to 96,000 people die every year from cancer. The estimated duration of the disease has been given to me—I did not know it myself—as probably ten to twelve months. Again it is estimated that people with this disease will require prescriptions at the very least of about one a month. The, one a month on those figures would cost about £2,500,000, and the amount saved if the 1s. were charged in respect of these unfortunate people could not possibly be more than £100,000 a year.
§ I know full well that this Bill, as it stands, does not apply charges to the whole class of sick people, but it is reasonable to suggest that great numbers of those suffering from cancer will be hospital out-patients. One of the greatest factors in dealing with people suffering from cancer is the follow-up service after they have been in hospital—the post-operative service to those people. It would seem that 55 per cent. of these people require dressings or drugs. It is important to point out tint a medical officer of health stated that all his nurses had said that people suffering from cancer were suffering unnecessary pain because they were not getting enough sedatives. If you are going to charge for every prescription for sedatives, dressings and things of that kind, you are going to add to the difficulty of dealing with these people. The noble Viscount, Lord Buckmaster, initiated a debate on the Health Service a few weeks ago, and I mentioned that a survey of the social conditions of people suffering from cancer had been conducted. I shall be very glad to give the noble Lord a copy of that report, which shows a condition of things which is really terrible. It would he harrowing to your Lordships if I were to read from that report. It shows without question that if any sort of impediment is placed in the way of these poor people getting all they want in the way of drugs, appliances or dressings, greater suffering will be entailed for them.
§ There is another point which I wish to stress in connection with this matter. This Amendment is different from the one upon which we divided, because that was concerned with young people and this is concerned very large)/ with old people. It was found that 70 per cent, of the 830 people suffering from cancer were of the age of sixty or over, and that 24 per cent. were over seventy-five years of age. All these people require drugs and dressings. There is another factor which is of some importance in this matter. The inquiries show that the degree of suffering endured by these people—and, remember, the inquiry was conducted under the general direction of the medical officers of health throughout the whole country, together with the Queen's Institute of District Nurses—in the case of 27 per cent. was "slight" or "none at all"; in the case of 37 per cent. was "moderate"; in the case of 31 per cent. was "severe," and was "not known" in the case of 5 per cent. Therefore, some 70 per cent. of the people suffering from cancer were enduring great pain. And these are the people who, for the sake of what I call "fake" economy, are to be called upon to pay 1s., or whatever it may be, for the prescription. I cannot believe that any noble Lord who goes into this subject will be able to justify doing anything to discourage those people from getting all they need
§ I should like to go to the other end, as it were, of this dreadful scourge. We are doing all we can to encourage education—it is the only term I can use—in cancer treatment. We know the difficulty of avoiding creating what I may call cancer-phobia; and, therefore, the education that is needed in this connection is most carefully arranged and conducted. But is it helping us in our campaign to deal with this dreadful problem if we have a charge of Is. on prescriptions? Obviously, however little effect it may have on the educational side of things, it militates, to some extent, against that education. I hope the noble Lord will be able to give an undertaking that this matter will be considered. It is, I assure him, well worth his further consideration. I feel, too, that it will be quite possible to devise some scheme whereby the difficulties I have mentioned may be avoided.
§ What I am saying now will apply not only to malignant disease, but perhaps to a few other disabilities that may be mentioned later. I realise the difficulty and danger of excluding charges merely on the grounds of a particular disease. It is possible that information will be conveyed to the patient that might otherwise be regarded as better not communicated 831 to him. But would it not be possible to exclude from this Bill the people I have metioned? We have been asked already to exclude people up to the age of sixteen years; I am now asking the Committee to exclude people over sixty years of age, in order that those who are excluded will not be able, by reason of that fact, to assume that they suffer from a particular disease of whose nature it is better not to let them know. I hope the noble Lord, Lord Woolton, will be able to help us in this matter. I am putting the case very imperfectly, but I assure him that I am putting it from a very long survey of a good deal of work which has been done in connection with people suffering from cancer. I can assure the noble Lord that the imposition of a charge of 1s. in those cases will have a very deleterious effect, not only economically but psychologically, on people who certainly ought not to be caused any further worry in addition to that which they already have by reason of their illness. I beg to move.
§ Amendment moved—
§ Page 1, line 12, after ("patient") insert ("who is suffering from malignant disease or").—(Lord Kershaw.)
§ 4.35 p.m.
§ LORD WOOLTON
The noble Lord has, of course, been dealing with a disease of which we are all frightened and which I think, more than any other human ill, commands our sympathy. He was good enough to say that he thought I would give the Amendment humane consideration. Perhaps he will not mind my mentioning the fact that for over twenty-five years I have been associated with endeavours to find some cure for this terrible scourge. There is, then, no question, I assure the noble Lord, of any lack of sympathy on my part. When I received the brief in connection with this Amendment which was provided for me by the Department which I am representing, the thing that went straight to my mind was the question of notification. I know, from personal experience, the fear that comes into a person's mind if he or she is told that he or she has cancer—or if any doubt is left in the person's mind about it. It is on those grounds that I would ask the noble Lord not to press this Amendment. Let the person who has this terrible disease remain, as long as 832 nature will allow it, in ignorance of the fact.
Many will immediately say: "But will the person be able to get the necessary medicine?" Well, I think we have provided for that. I am not trying to make any Party point in this matter: this question moves me personally so much that I could not do that. But I think I may say that we have made provision that will enable these persons to get the necessary medicine even if they have not the means to pay for it themselves. I beg the noble Lord not to press this matter and thus put people with cancer in such a position that they will be told about it. I am sure that they are very much better left in ignorance—always provided that the State has made some provision whereby they can get the necessary medicine. That is a matter about which I talked for some time with the Department, because on this particular issue I was moved as the noble Lord has been moved. I have stated the conclusion I reached. I hope the Committee will think that it is the right conclusion, and that the noble Lord will not press his Amendment. I have not dealt with the other issue which the noble Lord raised, the question of whether there were abuses or not. Perhaps I can deal with that later on, in connection with other Amendments, so that we can keep this matter of the malignant disease separate from the rest.
§ VISCOUNT HALL
I am sure we all sympathise with the noble Lord in his very difficult task, but I must say that I cannot for a moment consider that he answered the case so ably put by my noble friend. We all agree that these persons who are suffering from this terrible disease are deserving of all the sympathy and assistance that it is possible to give them. Why the noble Lord suggests that they would be informed of their complaint if they were exempted from the payment of this fee for prescriptions, I cannot understand.
§ LORD WOOLTON
I thought the point was that these people should be told that they did not have to pay for 833 their prescriptions because they were suffering from a particular disease. That, I thought, was the point which the noble Lord was putting to me.
§ VISCOUNT HALL
I did not understand that. There is no reason whatsoever why they should be informed. The only thing is that they would not be charged. They would be an exception. I dare say that every noble Lord sitting in this House has been faced with the tragic situation of having a member of his family who has suffered from this dread disease. When Her Majesty's Government say they cannot consider for a moment the exemption of a very small proportion of the population, it cannot be argued that the charge is to be imposed upon because of any abuse. There is no abuse whatsoever. It is simply a question of not in any way giving way, for fear that other cases might be argued as strongly as the case can be argued in this case. Much of what can be said in relation to the case which was argued by my noble friend Lord Kershaw can be said about other cases, but nothing nearly as strong as can be said about this particular disease.
May I quote one point to the noble Lord and other noble Lords opposite? What justification is there for exempting a person who is suffering from venereal disease and not a person who is suffering from a malignant disease? Can you justify such an exemption? I should be very surprised if you could justify it on its merits, or indeed if you could convince anybody that such a distinction was justified. It may be true that there is an international agreement which asks that tolerant treatment should be given to persons who are suffering from the latter type of disease, to which I have referred, but I beg the Government to show something more than sympathy in relation to this particular case. The amount of money which will be saved is infinitesimal. Let it not be said that there is any Party in this country that is going to impose what I consider a very unjust charge upon the people who are more deserving of our sympathy than almost any other section of the population.
§ 4.42 p.m.
§ LORD LLEWELLIN
I shall take up only two or three minutes of your Lordships' time. I cannot: see any way out of the dilemma which has been put to us by the noble Lord, the Lord President 834 of the Council. Everyone in future will be charged unless he comes under the exceptions which we find in Clause 1, subsection (2). If, therefore, somebody gets off without a charge, and he is not in hospital and not suffering from a venereal disease and is not a school child, why will he be getting off? If the only exception made is this one, with which we all sympathise, of people suffering from a malignant disease, that will be the only reason why they are not charged by their medical practitioner or whoever else certifies this charge. A patient may go along and speak to a neighbour who, although he or she may not know the terms of the Bill (or the Act when it becomes an Act), may ask, "What did you have to pay for your prescription?" The patient will say: "Nothing." "Oh—have you really got that? How awful for you!"—because immediately that person will be put in the cancer class. Let us realise that that is what is going to happen if this disease is made the only exception.
The noble Viscount asked: "Why except people suffering from venereal disease and not these people, because, as we all know, anyone who is suffering from veneral disease has himself or herself taken the risk arid contracted the disease, which cannot be said to be the case with anyone suffering from cancer?" But the difference is surely that people suffering from cancer are, more likely to cure themselves if they have not the worry of knowing that they have the disease. I know of a case where a person thought that an operation had been successful. The doctors knew that it had not, but they never told that particular patient. She thought it had been a completely successful cure. From that moment, although the doctors had failed, the thing disappeared the cancer left her. That would not have happened unless she had had in herself the faith to think that she had been cured.
On the other hand, if you do not let people off in the case of venereal disease, they may be likely not to go for early treatment—and that is the very worst thing that can happen to anybody who catches a venereal disease. The whole idea there is to make treatment as easy and as anonymous as possible. I think it is quite right that the charge has been remitted in that particular case, but I 835 honestly believe that we might be doing more harm than good if we were to treat as the only exception, out of hospital (I leave out venereal disease, because everybody knows whether or not people have that disease), people suffering from the most grievous complaint of all, people with whom we all have the utmost sympathy. Until it is necessary for them to know, and by that time they are probably in hospital, they should surely be relieved of the anxiety of knowing the truth and should not get the news in the roundabout way in which they would if no charge were made upon them for any medicine. From the practical point of view—I am not a doctor, of course—I do not quite know what medicine or drug peculiar to cancer can be given. If there is one, I do not know of it, but I do not believe that there is any cure of that sort for this disease, so that it is not as though we are dealing with a drug that is specific to the disease itself. For those reasons, I hope that, although we have the greatest sympathy with the people suffering from this complaint, we shall not make them the only exception.
§ LORD BURDEN
I am sure that everyone who listened to the moving speech of my noble friend and colleague Lord Kershaw must be aware of his knowledge of this problem and that he speaks with a wealth of understanding of what is involved. Speaking for myself, and I think for everybody on these Benches—and. I hope, for some noble Lords on the opposite Benches—I feel that they must be profoundly disappointed with the reply given by the noble Lord, Lord Woolton, particularly as my noble friend Lord Kershaw had foreseen the point which the noble Lord made and pointed out a way in which it could be met. The noble Lord said in that speech, as in his previous speech, that those who really were in need could be provided for. That was the tenor of what was said by the noble Lord in his introductory speech. But before I come to that point, may I just deal with what was said by the noble Lord, Lord Llewellin. Is there any reason to suppose that those who ask people who attend for cancer, and would know that they had cancer if they were exempted from the charge, would not ask those attending for treatment for venereal disease? Is it not just as likely that people suffering from venereal disease 836 may be asked whether or not they have paid for their prescription, and on saying that they had not, would be asked, "Are you _suffering from that?" Is not that rather indulging in logic-chopping?
§ LORD LLEWELLIN
The whole difference between the two is surely that the neighbour knows that the patient has been to the doctor only by the fact of the patient coming back and saying "I went to the doctor and got some medicine." A person suffering from venereal disease is not likely to start that conversation.
§ LORD BURDEN
I have never heard such a weak and ineffective argument in my life, particularly when it may concern areas where this may possibly develop. I will not pursue that point, because one realises that it is a matter of logic-chopping, and logic-chopping only.
To get back to the point raised by the noble Lord, Lord Wootton, may I suggest to the noble Lord, in all seriousness, that in basing his case on need he is departing from a principle which has been operative in this country for forty years? He is departing from the principle laid down in the Act introduced by Lloyd George in 1911, and embodied in the 1925 Act. The noble Lord, Lord Webb-Johnson, said that we are putting forward these proposals on sentimental grounds. There is a good deal to be said for these claims on sentimental grounds. But apart from the grounds suggested in the moving speech of my noble friend Lord Kershaw, I would put this forward from another point of view. These charges mean that persons are being deprived, not of what they could expect under a contract but certainly of what they had reasonably hoped for after many years of contribution to the National Insurance Fund and in National Health contributions.
For many years—in fact since 1925—people have been voluntarily contributing towards their expectations at the end of their time. They may have paid 4s, and something a week for benefits, including medical treatment. After that, if they were prudent people, and were self-employed, they would pay 6s. and something a week. They had reason to expect that if these troubles arose in their old age they would receive medical care and 837 attention without further cost to themselves. They were making reasonable provision for that. But the noble Lord says: "No; those who have made reasonable provision for themselves and do not come within the scope of the help which can be given under the National Assistance scale must pay; but those who have not, those who are within the National Health scale, will get help and will not pay." That may not be a breach of contract, but I put it to the noble Lord, Lord Webb-Johnson, that there are hundreds of thousands of people in this country in the category that I have described, who have been deprived of what was a reasonable expectation to them—namely, that in their declining years they would have medical care because they have paid for it. I put it to Lord Woolton that he is introducing once again, and for the first time in this Administration, the Poor Law test. He is bringing back again the principle that help will be given in cases of necessity, but that those who have paid for it are not to have it.
Apart from the moving speech put forward with a wealth of knowledge of the circumstances by my noble friend Lord Kershaw, I suggest, on grounds of equity and reasonable treatment for people who over a number of years have paid in the hope of not having to contribute for any sickness in their declining years—and particularly for this disease which is the dread disease of old age—that the shadow should be lifted from their lives in a way possible without any fear of letting them know. Let the line be drawn at 60, 65, or what you will, but give this help to people who have contributed towards it and who had a reasonable hope of expecting that treatment and help would be given to them in the last days of their lives.
§ LORD DOUGLAS OF BARLOCH
I gathered from the speech which was made by the noble Lord, Lord Woolton, that he would like to accept this Amendment but for the fact, which has been reiterated by the noble Lord, Lord Llewellin, that it would mean identifying the people who suffer from this particular kind of disease. If that is so, I would suggest that that is all the stronger reason why, when we come to it, the noble Lord should be willing to accept an Amendment in the name of my noble friend Lord Lucan, which would exempt those 838 who are certified as "chronic sick." That would be a means of escaping this difficulty of identification. and of enabling to be done what it seems every member of this Committee would like to see done.
§ LORD WEBB-JOHNSON
I had not intended to intervene again in these discussions, but the noble Lord, Lord Burden, has more or loss challenged me to take some part. I would take this opportunity to try to keep a better balanced view in regard to the matter dealt with in this Amendment, and to remember that the only effective treatment for this disease is to be obtained in hospital. Treatment that can be given outside hospital, unfortunately, is only palliative. Many people have the idea—I should like to put this crumb of comfort into the debate—that cancer is a painful disease throughout its course, and they paint lurid pictures of the agonies of pain accompanying death from cancer. That is not a true picture. I have had half a century of work particularly with cancer, and I have had to work with cancer patients who were kept in hospital to the very end. It is not the outstanding clinical picture—that picture of pain. It may be great discomfort. Pain can be relieved in various ways, not only by medicine but by nerve section, and so on, so that the part affected is made insensitive. The noble Lord, Lord Burden, suggested that people were going to be deprived of medical care. They are not being deprived of medical care. The only suggestion is that when they require some medicaments they should pay, like other sufferers.
I wish to make only one other remark to the Committee, and that is in order to reinforce the view of the Lord President of the Council with regard to the undesirability of giving to the patient any idea that he has a malignant disease. He must be guarded from that, I think. I know some people take a different view, but my experience has been that it has never done a patient any good to be told, and almost invariably it has done serious harm by undermining morale. I would give the Committee just one illustration. In the whole of my surgical career, when I have had to suggest an exploratory operation, on many occasions the patient has said: "I insist on knowing what you find." If you do not go into their room the next day, or that same evening, and say: "Well, you have 839 nothing to worry about; all is well," they do not ask you. In the course of half a century of practice I was asked only once, and then by a very strong-minded man, and he did not ask me directly. The day before he left the nursing home he said, "I have a lot of loose credits lying about; would you advise me to buy an annuity? I said: "If you cannot manage your own money you are a different type of man than I take you for." I mention that only because to me it has been a most striking fact that in all that time only one man should have asked, and then only indirectly. So I beg your Lordships not to do anything which would make it more likely that the patient would realise that he had a malignant disease.
§ LORD KERSHAW
With the permission of the Committee, I should like to deal with a few points that have been raised. In the first place, I should like to say that I never thought I should live to hear an eminent surgeon declare that cancer is not a painful disease. I think it is shocking that an eminent surgeon should declare that we are exaggerating the painful nature of cancer.
§ LORD WEBB-JOHNSON
If the noble Lord, Lord Kershaw, will give way to me for a moment, I should like to explain that I did not go so far as to say that cancer is not a painful disease. I said that that is not a predominant feature of the clinical course throughout the progress of cancer.
§ LORD KERSHAW
I thank the noble Lord for his intervention. If an ordinary person reading Hansard to-morrow does not get the impression that the noble Lord would place other factors in connection with the disease as being of more importance than the physical suffering of the patient, then I cannot understand the English language. I wonder whether the noble Lord is, perhaps, getting out of date on this matter. There is a very definite movement in hand at this moment to persuade people that if they are suffering from some pain which they do not quite understand they should take early advice. An eminent surgeon who is occupied almost entirely with this subject, and who I am glad to call my very dear friend, tells me that he is quite sure 8,000 people die unnecessarily every year through cancer. That is to say that, if 840 we could persuade them to take early advice on this matter, 8,000 people could be saved every year. When I remember the interests, the very powerful interests, that were aroused some years ago in relation to the fact that some 2,000 or 3,000 women were dying unnecessarily in childbirth every year, I wonder if the public knew that there were these 8,000 people who could be saved, what kind of agitation could be worked up in this country in connection with that matter. This is such a dreadful subject, the suffering of these people is so heartrending, that no one can think of it without being disturbed. I did hope that the Committee would approach the matter from the point of view of a Council of State rather than as two Parties.
§ LORD KERSHAW
It is all very well to say, "Hear, hear!" The only thing that matters in this connection is action. What are you going to do? The noble Lord, Lord Llewellin, says that it is quite right to exclude people suffering from venereal disease, because it is so desirable that they should take early treatment. God bless my soul! the very thing we want in connection with cancer sufferers is that they shall take early advice and treatment.
§ LORD LLEWELLIN
If the noble Lord would kindly give way to me for a moment, I should just like to say that I was not approaching this grave and important matter in any Party spirit. I hope that the noble Lord will acquit me of doing that in a serious case like this. I believe it would be wrong to tell these people by an indirect way: "You are suffering from cancer" I really believe that, and I hope that the noble Lord will give me credit for it.
§ LORD KERSHAW
I think I made it perfectly clear, in moving this Amendment, that that was the difficulty—that if you exclude people on account of their having a malignant disease, then it might be that they would discover that fact through not having to pay for their certificate. But in my time I have had a good deal to do with our wonderful Civil Service, and I am satisfied, in my own mind, that even if cancer sufferers alone were to be excluded—and as the Committee knows, there are later Amendments which would exclude other sufferers, and the more 841 other classes of sufferers are excluded, the more the danger that Lord Llewellin referred to will be diminished—our Civil Service could devise a system of prescribing which would not entail a payment every week or month by people suffering from this and similar diseases. All I ask the noble Lord, Lord Woolton, to do is to take this matter back and think about it.
I am not approaching it at all from a Party spirit. I know of many noble Lords on the other side of the House who are as keen as I am on this subject and spend as much time as I do on it, and I claim no Party advantage for this Amendment or anything connected with it. But I say, with all the knowledge I have of this subject, that it is worthy of further consideration by the noble Lord. I am satisfied that ways and means could be devised that would avoid the disclosure of this disease to the patient, and I hope that the noble Lord will find himself able to respond in this matter. I appreciate that where a Minister in charge of the Bill is not in charge of the Department from which the Bill emanates, it is difficult to give a reply, but if the noble Lord will undertake to discuss the matter with his Minister, I shall be most grateful to him, and I think he himself will feel that he had done something good for these people.
§ EARL JOWITT
Before the noble Lord replies, may I make this suggestion? I appreciate the difficulty which the noble Lord, Lord Llewellin, mentioned about having to disclose to a patient that he has this sort of disease and that that is what influenced the mind of the noble Lord. The last Amendment on the first page, No. 7, reads,or is certified by a medical practitioner to be one of the chronic sick.Might that not be a way out, if the noble Lord, Lord Woolton, saw his way to accept this Amendment? Then, if a man suffering from cancer, who needs all kinds of sedatives and other medicines, is treated as one of the "chronic sick," he will not be labelled to his own knowledge to be suffering from a malignant disease. It seems to me a very unpleasant task for any Minister to have to impose a charge on these unfortunate people. If the noble Lord wants to help them, as he said he did—arid I am sure he does, as we all do—is there not a possibility that 842 by accepting Amendment No. 7, he may get out of this difficulty and meet Lord Llewellin's point?
§ LORD CHORLEY
Before the noble Lord replies, may I ask a question? The noble Lord has indicated that the Government would be prepared to accept this Amendment if it were not for the fact that it would involve disclosing to sufferers from this terrible disease that they are suffering from it. In many of these cases it is perfectly well known to the patient and there is no question of secrecy at all, but in those cases where the patient does not know he is suffering from this disease, it is the doctor handling the case who is in the best position to judge. If the doctor thinks he should not know, then the doctor need not give him the prescription. If this Amendment were accepted as it stands, would it not leave the matter in the hands of the medical practitioner in charge of the case?
§ THE MARQUESS OF SALISBURY
This is one of those cases where any House of Parliament would find itself in great difficulty, and I frankly confess that we on the Government's side find ourselves as much moved by the issue as anybody else in this House. It is a difficult question. The noble Lord, Lord Kershaw, said that if only we could accept this Amendment, that at any rate would give ease and comfort to a number of people. He seemed to indicate that if we accepted this Amendment, he would not press for any others. There are other similar Amendments on the Order Paper. For instance, there is one dealing with those suffering from tuberculosis. It has been my sad misfortune to know people in the last stages of tuberculosis, and I cannot believe that the suffering from cancer is very much greater than that. There are other Amendments dealing with other serious diseases, and there are other diseases which are not included in the Amendments and which might well be included. For example, there are no references to any disease of the heart, and some of those are just as painful and just as unhappy as this terrible disease we are discussing now. I do not think it would he possible to accept this Amendment without considering the acceptance of a great many others. I do not know where this would stop. With the best will in the world, it puts us in a difficult position.
What I would suggest for the consideration of the House is this. I hope the 843 noble Lord will not press this Amendment or any others, and when we come to the omnibus Amendment dealing with those suffering from chronic diseases—although I do not know exactly what a "chronic disease" is—that is a matter which might be considered before the Report stage, although I should not like to give any great encouragement. I should be dishonest with the House if I were to do so. I do not think it would be possible for us to accept this Amendment without accepting a large number of others, about which the noble Lord, Lord Kershaw, does not care so much, but to which other noble Lords attach equal importance. Therefore, I am sure my noble friend feels that we must stand firm on this Amendment because it does not seem to us that in this case we could make a differentiation. I am sure that others of us would be willing to consider some sort of wider Amendment, but I could not give very great encouragement about accepting it, because it seems to me to drive a cleft in the Bill and cause such injury to it that it would be hardly worth while putting it in.
§ VISCOUNT STANSGATE
No one who has heard this painful debate can be unaware of the fact that the question has entered a third phase. First, nobody says it is to save money. Secondly, nobody says that a man is humbugging, that he is shamming cancer to create an abuse. The new argument is that we must charge a man a shilling in case he should find out that he has cancer. That is the argument. The effort of the noble Marquess to get out of that is to say that we are moving an Amendment which is not anything so direct. If he can reject this Amendment, then it is clear that
§ when he comes to the chronic sick Amendment, all the arguments advanced on this Amendment can be fortified ten times and that chronic sick Amendment can be rejected. The fact of the matter is that this Bill is a thoroughly wicked Bill. It is a wicked Bill because it is charging money to people who are poor and people who are sick. That is the basis of our objection to the Bill, and it is focused on that particular point. Of course, we all sympathise; but what is the good of sympathy? Here is a person who is poor and suffering from cancer, and you pinpoint him for a charge: and you say that you should charge him because he has cancer. That goes also for the man who is a diabetic, and for the man who is tubercular. It means that the person to be charged is the person in the direst danger. Therefore, I think the Amendment is a good one, and that the mover should insist on it.
§ THE MARQUESS OF SALISBURY
I feel that the noble Viscount's speech is a most ungenerous one. I should have thought that it was clear to all noble Lords that we are very sincere in our attitude to this matter. For the noble Viscount to suggest that this is a pure Party manœuvre—
§ THE MARQUESS OF SALISBURY
That was the implication. I thought it an ungenerous and an almost indecent speech to make.
§ On Question, Whether the said new words be there inserted?
§ Their Lordships divided: Contents, 31; Not-Contents, 70.845
|Baldwin of Bewdley, E.||Chorley, L.||Macpherson of Drumochter, L|
|Douglas of Barloch, L.||Milner of Leeds, L.|
|Jowitt, E.||Douglas of Kirtleside, L.||Morrison, L.|
|Greenhill, L.||Ogmore, L.|
|Hall, V.||Hare, L. (E. Listowel.)||Pakenham, L.|
|Stansgate, V.||Henderson, L.||Pethick-Lawrence, L.|
|Kenswood, L.||Quibell, L.|
|Ammon, L.||Kershaw, L.||Rochester, L.|
|Archibald, L.||Lawson, L.||Shepherd, L.|
|Bingham, L, (E, Lucan.)[Teller.]||Layton, L.||Silkin, L.|
|Lucas of Chilworth, L.||Wise, L.|
|Burden, L. [Teller.]||Macdonald of Gwaenysgor, L.|
|Simonds, L. (L. Chancellor.)||Davidson, V.||Foxford, L. (E. Limerick.)|
|Furness, V.||Gage, L. (V. Gage.)|
|Woolton, L. (L. President.)||Harcourt, V.||Gifford, L.|
|Hudson, V.||Greville, L.|
|Margesson, V.||Hampton, L.|
|Wellington, D.||Maugham, V.||Hindlip, L.|
|Monsell, V.||Leathers, L.|
|Cholmondeley, M.||Rothermere, V.||Llewellin, L.|
|Reading, M.||Swinton, V.||Lloyd, L.|
|Salisbury, M.||Mancroft, L.|
|Willingdon, M.||Aberdare, L.||Milverton, L.|
|Ailwyn, L.||Parmoor, L.|
|Alexander of Tunis.||Aldenham, L.||Remnant, L.|
|De La Warr, E.||Amherst of Hackney, L.||Ritchie of Dundee, L.|
|Dundonald, E.||Audley, L.||Rochdale, L.|
|Fortescue, E. [Teller.]||Bethell, L.||Rockley, L.|
|Howe, E.||Blackford, L.||Saltoun, L.|
|Onslow, E. [Teller.]||Brassey of Apethorpe, L.||Sandford, L.|
|Rothes, E.||Cherwell, L.||Sandhurst, L.|
|Scarbrough, E.||Clanwilliam, L. (E. Clanwlliam.)||Schuster, L.|
|Selborne, E.||Cranvvorth, L.||Selsdon, L.|
|Selkirk, E.||De L'Isle and Dudley, L.||Teviot, L.|
|Shaftesbury, E.||Dorchester, L.||Teynham, L.|
|Ellenborough, L.||Webb-Johnson, L.|
|Bledisloe, V.||Ennisdale, L.||Wolverton, L.|
|Buckmaster, V.||Fairfax of Cameron, L.|
Resolved in the negative, and Amendment disagreed to accordingly.