"That a sum, not exceeding £17,572,797, be granted to His Majesty, to complete the sum necessary to defray the Charge which will come in course of payment during the year ending on the 31st day of March, 1921, for the Salaries and Expenses of the Ministry of Health; including Grants and other Expenses in connection with Housing, Grants to Local Authorities, etc., sundry Contributions and Grants in respect of Benefits and Expenses of Administration under the National Insurance (Health) Acts, 1911 to 1919, certain Grants in Aid, and certain Special Services arising out of the War."—[Note.—£10,000,000 has been voted on account.]
As the Committee is aware, this is the first time that the Estimates of the Ministry of Health have been presented to it. It will also be in the recollection of Members that the Ministry of Health during the first year of its life collected to itself a number of other Departments, so that it could proceed to consolidate in one Department all those interests concerned with the preservation and promotion of the public health, and also, so far as we could, delete from the work and the consideration of this Department matters which are foreign to that purpose. It will, I am sure, be with the concurrence of Members of the Committee if at the outset I mention the serious loss which the Ministry has suffered in the first year of its work through the death of Sir Robert Morant, who was at all times a loyal and trusted friend, a great servant of the public, and, besides this, was an example to us all of self-denying, far-sighted, resolute patriotism. During the course of the year various services have been amalgamated, including those relating to the Health Insurance Department, the Registrar-General, the work of the Board of Education in regard to school medical services and prospective mothers, the work of the Home Office under the Children Act, and a very important branch of the public service which lately came under its purview, the Board of Control, which deals with the whole question of lunacy, and other minor services. At the same time, I am glad to say we have been able to pass over, in accordance with the provisions of the Act, to other Departments a number of services which are foreign to our interests, particularly matters in connection with railways, roads, bridges, and locomotives, to the Ministry of Transport, and various matters to the Board of Education, such as libraries and museums, and there have been numerous other transfers.
Notwithstanding the amalgamations which have taken place, I think we may congratulate ourselves that, so far as any permanent increase in the staffs is concerned—I mention this matter first—we have not incurred the charge, which is in these days so often preferred against us, to any considerable degree. There are four sections of our work which have required the employment of a large number of people on a temporary basis, but these all arise out of the War. The first is the postponed valuation of the approved societies which has required a temporary staff of over 500 persons, and I am glad to say that this valuation will be completed by the end of the year or thereabout, and also, when the time comes, it will reveal the soundness of the financial operations of this scheme. I am glad to say that I know that in many societies there will be a surplus to be disposed of in additional benefits. Then there is the staff connected with the Housing Department, numbering in all about 750, of which 650 are on a temporary basis. Here may I remind the Committee, by an illustration which will be fresh in its memory, how difficult it is to avoid increases of staff which we are tempted to employ and at the same time to be able to meet fully the criticisms directed against us because we employ them. The other day I was asked by the hon. and gallant Member for Leith (Captain W. Benn) if I could give him particulars of the valuation of different parcels of ground which have been purchased for housing, and to my regret I was not able to do so, not through lack of goodwill on my part, but because of the fact that these parcels of ground have been purchased from portions of other farms and estates and were not a separate value entity. There are over 7,000 of these sites embracing 51,000 acres of land, and I was advised that it would have meant the employment of thirty additional persons for several weeks, and it was solely on that ground that I was unable to give the hon. and gallant Gentleman the information. That is a useful illustration of the temptations to which we are exposed of employing additional staffs when on some further occasion we have to answer the charge of having employed them.
The remarks which I have made on the work of the Ministry is an index of what is required to be done in any intelligent health system throughout the country, and therefore a great part of the work of the Department, apart from administrative duties, has been absorbed in consideration of various aspects of the proposals which we shall have in due time to submit to Parliament with regard to health services outside the Ministry. I will mention two matters with regard to our present local Government system, one of which is to me a source of profound dissatisfaction and the other the reverse. At 8.15 to-night we shall have to interrupt our proceedings and consider a dispute between Leith and Edinburgh as to which shall absorb the other. The present position, both as regards the great expense which is often involved and the lack of policy which has hitherto guided us, in regard to the determination of local government areas is exceedingly unsatisfactory, and the evidence we shall have later to-night will illustrate that truth. I have taken a step to simplify and cheapen the procedure on the inquiry stage, and we have also, by arranging, as an experiment, a Joint Committee of these Houses in regard to the Parliamentary stage, endeavoured to secure some cheapness and expedition there, but the matter is at present in a very unsatisfactory condition. Of one matter of routine administration, I am glad to say that, for the first time in the records of local government, we are up-to-date. The audit is up-to-date for the first time.
This Ministry is, or ought to be, or ought to grow into a Ministry of Health, and that word has a very wide signification. It enters into every home and every life from the first day to the last, and it is clear that a sound health policy will require time and patience for its development, and that any rash expenditure may be misleading and wasteful. The first essential in any well-defined health policy is the spread of good, common information, for, after all, the foundations of many of our disabilities is in the home and in the house. Then, any sound system must be based upon the principle of prevention. So far as possible, all our schemes must be designed with that dominant intention, and it is in that respect that we have not hitherto made as much progress as we might have done, and it is with that idea running through my mind that I am going to put before the Committee a record of some of the branches of the work of the Ministry.
Any proper development of a preventive health service must depend upon an adequate supply of trained persons, and there is at present in many branches a serious deficiency. It will take time to remove that want. You cannot produce trained staffs—nurses, midwives, and so forth—in the course of a year. I am quite sure that we should often be spending our time and money in vain, unless we rest on a well-thought-out scheme administered by people who know what they are wanting to do. Then, any systematic preventive scheme of service must offer fairly full facilities for dealing with early disability, and, above all, it must have at its service at all time an active prosecution of scientific research. The preventive services we have developed in this country have up to the present, so far as they relate to the surroundings of individuals, reached a stage of development beyond that of any other. Our sanitary services, so called, are well developed, and it is, I think, largely owing to them that the health of our people, who in many cases dwell in most pestilential places, is as good as it is; and it is from this point of view, dealing with the surroundings of the people, that the housing work, which is only one branch of the many activities of the Ministry—although it bulks largely in the public eye—must be regarded. In that connection I would say this, in case in the future I or any other Minister may be charged with neglecting to point it out, that in so far as the Ministry of Health is really successful and as, in course of time, its services become more complete and yield a better result, the less obvious and the less striking they will be. Nobody, when he goes about his daily life, feels particularly grateful to the men who have swept out malaria. It does not occur to them. It is not objective, and that is an essential feature of all successful preventive services, and therefore as time goes on and the development of schemes become more successful they will become less objective and will bulk less in the public mind, and the less they bulk the more successful they will be.
One item in the objective activities of this Ministry is housing. This has been the subject of discussion a good many times in this House, and I do not propose to give many minutes to it, because I want to speak more strictly of health questions which have not received the attention they sometimes deserve. With regard, however, to the housing, the period of our early difficulties has been passed, I am glad to say, and I will only deal with the situation as it is. The possibilities are great. May I say with regard to the refrain which inspired us and brought back many pleasant recollections as we heard it in the Division Lobby last night that with regard to the acquisition of land, at all events, the Ministry of Health, who have sanctioned the acquisition of 51,000 acres of land by local authorities for housing, have the satisfaction that they can rest on achievement rather than song? Therefore I felt quite disposed to join in the chorus in the other Lobby, knowing that we had actually done it. [An HON. MEMBER: "Do it now!"] With regard to the official plans of houses, we are now past the final plans in over 200,000 houses, but the tenders have been approved and finally settled with regard to 126,000 houses, and there is nothing in respect to them to prevent the work going on except the two conditions of finance and labour. With regard to these 126,00 houses passed for tender, I find the contract has been signed and in many cases work has been started on the site in respect of 69,887—that is to say, there is a difference between those two figures of over 50,000 where the tender has been approved and all details settled, but where the contract has not been signed. In addition to this, there are an additional 12,000 on which the commencement of work has been authorised under the subsidy scheme. Here you will find that the details of actual constructive work lags behind the figure just given just as that figure lags behind the figure for con tracts approved. Of course, many of the contracts cover two years' work. A man will begin his work in sections of ten or eight, and at any one moment there will only be a certain number under construction. The total number of which we have details at various stages of construction, finished or otherwise, is 37,511.
Over 2,000 are inhabited and another 5,000 or 6,000 will be completed in the next month or two. I want to direct the attention of the Committee to two points about these figures. There is considerable disparity between the period when the tenders are approved and the contracts are signed for work to begin. The cause of that delay in the main has been the lack of financial provision, and in this respect I would like to say a word as to the bond campaign which I am glad to say is being successful beyond what we could have hoped. Since 1st April, by means of stock issues, housing bonds and mortgages, the various authorities have raised no less than £30,000,000 in respect of housing, and it has been raised and is now being raised at a rather greater rate than £10,000,000 a month, which, I think, is a very creditable performance, and it means that the delay between the approval of the tender and the signing of the contract is becoming shorter. May I give two illustrations which I think are significant as to the success of the bond campaign? In the city of Bradford, where they have raised over £700,000, there are very few subscriptions of more than £300 each. That means that the contributors have been people of small means. It is a welcome and encouraging sign, but if all reports are correct as to the wealth which has been made in that city during the War, we might well have looked for larger contributions from those who have made great moneys, although in many cases employers of labour have given most generous contributions towards this scheme, and in some places the great trade union organisations, the railwaymen and so on, have contributed very large sums. I have at the bottom of the list a small village where the initial contribution was £15,000, representing more than £3 to every man, woman and child in the village. That is a very encouraging sign of the real interest in the subject.
The name of the village is Trimdon, Durham. The other point to which I would direct attention is the disparity between the schemes for 80,000 houses on which work has been authorised and the 37,000 in which there has been material progress. The main cause of the delay there is the deficiency of labour. Of course, the methods of construction also are important, but with regard to the labour supply there were on 30th June 15,000 skilled workpeople employed on building houses, and a deficiency of labour in respect of these houses at that date of 12,206. That shows that it is quite useless for people to say that there are sufficient men to go round. There are not, and, therefore, the case which I have so often made with the trade unions concerned is being abundantly justified by the result. It is perfectly clear, if this work is to go on at a proper speed, a great many more workmen must be brought in. I would also like to say a word with regard to output. There has been an encouraging improvement, but in many places it is still very much less than I think it should be, and certainly than it was before the War, and it is much less in some places than in others. For all that, the average output has substantially improved during the last two months. But I am persuaded that we are confronted here with the necessity for a scheme which, whilst giving proper guarantees of security for work to the men employed, will secure agreement with the trade unionists for an additional amount of labour being brought in, and thereby insure the utmost possible output. Proposals are being formulated to that end. As an illustration, I may say that a man who is laying bricks at the rate of 400 a day will build four houses a year. If he is laying at the rate of a thousand a day he will build 8½ a year.
They ought to, and I should be glad if a system could be devised, and the trade unions would agree to it, whereby that could be done. It is cheap to pay if we get the output. May I say that the steadily increasing cost ought to be stated very frankly to the House, because although with regard to the 126,000 tenders finally approved the last word has been said, we are faced with this, that whereas in the month of January the average cost of house with a parlour and kitchen and three bedrooms was about £800, each month since then the average quotation has progressively increased, and the average price of tenders for the same house during the month of June was £906. That is to say, there has been an increase in the tender quotation for the same class of house during the last six months of £100 in respect of each house. it is perfectly evident that an increase like that, with all its disastrous consequences, cannot go on, and the only way it can be compensated is by getting a check to the rise in the cost of materials, by getting an understanding whereby we can get a greater output from labour and a proper national. understanding with regard to wages. We have commonly, and often quite justly, blamed the trade unionists for not helping as I think they might have helped in this matter. I think labour has lost the greatest opportunity of its political life up to the present, because there is nothing more unselfish in the world than this campaign. However, I would like to say this, that some of our chief difficulties have arisen in many districts by the unconscionable competition amongst employers for labour, and all manner of inducements have been offered to attract labour from one man to another, with the result that labour inevitably asks this question: If a man in the next village or the next parish is getting twopence or threepence an hour more than I am, why should not I get it? And we consequently get demands for increases in wages.
The other hope with regard to this increase of cost is to encourage alternative methods of production, and I am glad to say that with regard to some of them we are meeting with conspicuous success. Over fifty of these new methods have been tried, but one of the best we have met with—with which most people are familiar—is that employed outside Leeds. Two unskilled workmen began two houses at 10.30 a.m., and they were up to the first floor joists by 2.30 in the afternoon. This is the slab method of construction which I am proposing to encourage as much as possible. I understand there has been discontent and questions raised amongst the skilled labourers in the district as to whether they are to allow this to go on, but I am glad to say that none of the responsible officials of the unions have countenanced this. I am perfectly certain this is our main hope, and it is clear that there is nothing more in the interests of labour than that we should get the houses built as cheaply as we can in order to check the increase of rents. For my own part, I shall never be any party to trying to keep rents down and thereby subsidising wages by letting houses at rents which have no relation whatever to the cost of the houses. Unpopular as it may be, we are pursuing that course, and we propose to go on with it.
I will turn now to the first duty of the Ministry with regard to the prevention of disease. At the time of demobilisation of great numbers of troops, vast tracts of Europe were devastated by disease, and our first anxiety was to secure the country against invasion. Therefore, one of our first duties was to organise a sanitary cordon round this country, and I am glad to say that up to the present we have been remarkably successful. Portions of Poland were ravaged with typhus, and many other parts of Europe by other diseases, but up to the present there has been no spread of any of these diseases in this country. We have arranged with the Treasury, in order to help the port sanitary authorities, to pay 50 per cent. grants towards their expenses for improving their facilities. I will only give one illustration of many which I have had brought before me of the way in which these invasions have been prevented. It is a very interesting case, and one of many where plague might have been introduced into this country. This particular ship called at Plymouth, and certain cases on board were reported as influenza. Fifty people came on shore and were distributed all over the country. When the ship came round to London the medical officer of the port, I am glad to say, was suspicious that these cases were plague It started, as plague generally does start on a ship, amongst the men who had to do with the food, for the disease is often carried by infected rats. Special arrangements were made to get the cargo off without the workmen being infected, and the cargo was disinfected and isolated. We supplied inoculation for the whole of the crew, and I am glad to say they had no conscientious objections. The result of these efforts was that the whole thing was trapped. The whole of the 50 people who had got into the country were traced, and no spread of the disease occurred. That is only one instance of a great many that I could give.
We had another danger before us last year, and that was the fear that rested on the minds of our people that we should have another influenza epidemic of the kind which had had such devastating results the year before. In the first quarter of 1919 no fewer than 37,000 people mostly adults in the prime of life; died of the disease, and that was a visitation not comparable with any that we had had for some hundreds of years. We did everything we could, by arrangements with the Foreign Office, to be supplied with information from abroad. We organised a number of experts in other Departments, and we prepared documents giving such information as we could to encourage the people to protect themselves against the disease. We also provided a great number of doses of a protective vaccine which, I am glad to say, large numbers of people used freely, and, although no doubt I gave great offence to those who are not in sympathy with such methods, I think we were justified in spending money in that way. Thanks to the weather and our good fortune we escaped the epidemic last year. Similarly we took steps, under Sir David Semple, to deal with cases that arose in connection with a rabies epidemic.
On the preventive side of our work, there is another disease to which I must refer—tuberculosis. In no disease is it easier to spend money unwisely than in combating tubercle. We have encouraged the development of accommodation in our sanatoria and have added more than 2,000 beds in the last year. We have done something even more necessary. In connection with the sanatoria we are providing additional places for the training of 1,000 men at a time. There is no doubt a large number of people who go into our sanatoria are maintained there at great expense for a long time, go back to home surroundings where they become re-infected, and who then try to enter the competitive labour market and break down. The result is disappointment to them, loss of public money, and sorrow to all concerned.
Unless this system can be one which begins at the home and ends in recreating, as far as possible, a useful unit in the community under healthy conditions, it must in many respects be largely wasteful. We have now a dispensary system developed to a certain extent, but no dispensary system will be successful in pre-venting tubercle, and no sanatoria will wipe out the disease whilst people have to live crowded in unhealthy dwellings. Do not blame the sanatoria for something with which the sanatoria cannot deal. Inappropriate or unsufficient food and bad conditions of life and work are all a part of the tuberculosis problem. We have to bring the conditions in the homes within the scheme; otherwise it is quite useless to expect the eradication of the disease. At the end of their treatment large numbers of patients get tired of the routine of the sanatoria. When they get well enough there is nothing for them to do. They just hang about, and some- times they become troublesome to them-selves and to other people. They cannot go back to the work they had before they entered the sanatorium, for they cannot do a long day's work. It is essential, there-fore, that in our system we should have facilities, while the patient is undergoing treatment in the sanatorium, to encourage him to train and to develop self-help habits in some direction. We have pro vided training centres in connection with the sanatoria. We found at one or two places, however, that although you may have taught a man in a sanatorium to be, say, a joiner, it is quite useless to expect him to enter that occupation as a competitive joiner in the ordinary way. There has grown up in some places the village colony conception of what is necessary, and we have one or two standing illustrations, notably in Cambridgeshire, of the very successful application of that principle. I was there myself some time ago and saw a number of men. They all work at trade union rates of pay and very largely support themselves. They have started a co- operative system of selling and buying for the colony, which is on a self-supporting basis. The men live in cottages under healthy conditions. Many of them have been there for some years, and they show no tendency to relapse, but are becoming useful members of the community. We have had a survey made of places suitable for the village colony scheme, and I have some of the valuable reports before me. In no matter is it more important than in connection with tubercle that you should proceed hand-in-hand with research. Otherwise we may waste great sums of money. Above all things it is necessary, beginning at the home, that all this service should be under the supervision of one directing authority, if we are to have a properly co-ordinated preventive system.
There is another set of diseases, of an exceedingly lamentable character, with which we are dealing energetically. I refer to venereal disease. Here let me say that there is no branch of service in which it is more necessary than in this to have a trained personnel. It is not enough simply to have centres for the treatment of venereal disease. It was in order that we might keep abreast of progress in this matter that I asked Colonel Harrison, who did brilliant work during the War, to join my staff with others and to help in organising this service. There has been a substantial increase in the number of persons attending these centres. The total attendances has gone up from 460,000 to 843,000. It means that people are beginning to realise the necessity of going to the centres early. The scheme is so far only at the beginning.
843,000 attendances. There is a tendency amongst certain protagonists to fall upon one another in regard to the method of dealing with this disease. I would exhort them to fall upon the disease. There are some branches of social work where our best efforts are often thwarted by the quarrelling of different people who have the same objects in view. I hope that those willing to help in this campaign will not commit that cardinal error. In giving instructions to the centres as to what they are to do, you have to secure that you do not recommend something that cannot be applied; otherwise you get only disappointment as a result, and you stultify the whole enterprise. It is most essential that you should not imagine that what you can do with 1,000 men under strict military control you can do with the whole population under no control at all. The conditions are entirely different. We have to proceed carefully. In this matter it is obvious that you are touching some of the most private, personal, and intimate concerns of the people in anything you say or in any instructions you give, and that you are likely to arouse susceptibilities. I am glad to say that the centres have increased in number and, more encouraging still, the people who attend them have increased and are beginning more and more to appreciate them.
The War has shown that properly directed efforts can cut short a great number of cases that otherwise would develop into mental deficiency of a permanent kind, and we are working out plans to provide that in any future arrangements the authorities shall be able to deal with mental cases while they are at an early stage to avoid their being labelled lunatics. The War has shown conclusively that that can be done with conspicuous success, and it is our business, now that we are dealing with matters affecting lunacy, to try to secure the development of a system designed for the early treatment of mental disorders. If that could be established, many of our asylums would be unnecessary. To develop the work towards this end post graduate courses for medical men have been arranged under various authorities, and courses of training of nurses and others for this class of disease are being pushed forward.
But in no matter is it more important to have trained personnel than in questions affecting the charge of mothers, and hence the importance of maternity and infant welfare homes. Early in the year it was clear to me that the thing necessary for success was to have trained personnel at our command in the way of nurses, midwives, etc. Therefore it was arranged last year with the Board of Education to have additional grants for training for health visitors, midwives, etc. That has been taken up very extensively. At present there are 700 midwives under training under the scheme, and the number of centres where this supervisory work is carried on has increased from 1,400 to 1,600.
It is the Board of Education Vote. The proportion of the population in the country which is now reached by these services increased during the past year from 55 to 61 per cent. which is a substantial increase of the rural population. But we ought to cover the whole of the rural population by this training scheme development and we shall, but this is only one illustration of the time that must elapse before any one of these services can be established which must rest on a trained personnel. I will not weary the Committee with details except in one respect. I think that the figure that I am going to give is the most encouraging figure that the Minister of Health could give, because the whole of this scheme, of which I have cut out a lot of detail, of health in the homes under the care of the health visitors, midwives, special nurses, etc., which is an elaborate organisation that is adopted now, I am glad to say, by all the big authorities in the country, is designed to secure a better opportunity for the mother and the child, and especially in infancy, because that is where a preventive service must really begin if it is to be successful.
I want to give a few of what I consider very startling figures in this matter. The infant death rate is generally quoted as so many per thousand. Towards the end of the last century and the beginning of this it remained stationary at about 150. It was 154 in 1900 and 154 in 1901. It did not begin to fall until 1906, when it was 132 In the year 1918 it dropped to 97, and last year it dropped to 89, and that was in spite of the fact in the last quarter of last year we had the influenza. But the figure that I am now going to quote for the last completed year, the last three-quarters of last year and the first quarter of this year, is only 78, or only about half what it was 20 years ago. No doubt this is the result of the spreading of good commonsense information and knowledge as to how to deal with infants. The development of these services throughout the country in nursing, midwifery and other facilities, and the combination of the whole big effort, has been able to reduce the infant mortality in 20 years from 151 to 78. That is a striking performance. Even during the last 10 years the fall has been continued. If you had had that figure of 75 during the last 10 years it would have meant the saving of 250,000 lives in that period.
But this is only an index figure. It refers to the children who survive as the result of our efforts. It is to the good that you do not lose so many, but the point is that those who survive are better nourished and more likely to be useful members of the community hereafter. 1 have therefore taken out in full the child death rate for the five-year periods up to 1915—I have not got them for the last five years—and the fall has been from 57 to 37, and it is still falling in the same way. Then I look to see what was the result of the medical examination of school children notwithstanding this improvement, which of course has not made itself felt sufficiently as yet, in the children who go to school. But I have found that, although we are developing medical service as energetically as we can, of the first 750,000 children examined in our schools last year, 40 per cent. were still found to be physically defective. That will drop as the diminished infant mortality rate makes itself felt. But it is an appalling figure that nearly 50 per cent. of the children aged five were physically defective. We saw the expression of it in adult life in the War. It is all one continuous process, and this is where we have to begin.
I am glad to say that the facilities for treatment have improved, and that 69 per cent. of these have received treatment.
We have passed through the House measures affecting nurses registration, and we have now before us various other matters which have given the Department a lot of work, but are all part of the scheme to promote a system of preventive service which it is essential to get—well-paid nurses, for example—before we can expect to meet the needs of the masses of the people in this matter. That is why the Nurses Registration Bill and a Dentists Bill are essential ingredients in any health scheme. When you come to the medical service you are at the last stage of your health service, that which is objective, that which is in the end of the lesser importance. The House has had before it, in the National Health Insurance Act, proposals to which I will not further refer involving a great deal of work. We are now establishing the referee service, which in its essence is a preventive service, to try to prevent undue demands upon sick funds, undue duration of sickness.
As to the main purpose of that new service the House has had before it the Report of the Medical Consultative Council under Lord Dawson, setting out the proposals which the Council felt were necessary ingredients in any properly constructed health service. It is quite true that for those who are not within reach of a good hospital, or are not very well supplied with this world's goods, the services for early scientific complete treatment are largely not available, and anything like a properly designed system must seek to secure that these are made more available. It has been part of our duty to survey the public expenditure at present under various heads, under the Poor Law in respect of health, and all manner of other services, and we are spending millions and millions every year on all manner of health services which are co-ordinated in no common direction, and I am quite certain that the right line to pursue is to consolidate them and give them a common direction and a common purpose rather than simply blindly to increase them. Therefore a properly considered policy in this matter is the first essential for real progress.
There are four consultative councils under the Ministry, and a great part of the work mentioned has been devoted to these matters during the past twelve months. It was in connection with that that I was speaking, and that was purely arising out of the Report which the Department has issued.
I am not proposing to elaborate what was set out in the Council's Report which I have supplied to Parliament, and which, I hope, at all events, some Members have read.
One of the subjects which must be a source of great anxiety is the position of our voluntary hospitals. We have, under the Poor Law, hospitals numbering more than half the hospitals of the country, and I have arranged to have these surveyed from a medical point of view, because it is necessary, of course, that not only should we be fully aware on the financial side as to what we are doing, but we require a medical, scientific survey of the hospital services which are available now, and might be made more available. Therefore, a survey has been ordered. Then, the position of the voluntary hospitals has been brought to my attention on many occasions. I have been able to meet those responsible for their direction, and for the present the King Edward's Fund, after consultation with the Ministry, has set aside £250,000 to meet the necessities of the hospitals, and grants are now being made out of that Fund. Other proposals are being worked out, but I would like to say that those who, representing the voluntary hospitals, came to the Ministry of Health and discussed the matters with us, had, I think, at first in mind, that the Ministry of Health was greedy to take hold of these institutions for some purpose or other of its own. We have enough responsibility in the administration of our services to save us from any temptation of that sort. Many of these institutions are pioneers of efficient service, and it would be a mistake of the first order to seek to interfere with that efficiency, and I am quite sure that any scheme the Ministry has put forward, and such as it has discussed with them, will be designed to promote their public utility.
In one other matter the Ministry has taken services under it, and consolidated them in other services of a similar kind, by taking the Department of the Registrar-General, making it a part of the Ministry of Health, and securing that the work there is directed in common with our own work in preparing vital statistics, and the census work, upon which they are now engaged as a preliminary, is thereby linked up with the main health considerations which the Ministry ought to have in view.
In one other matter the Ministry has taken a step which, I think, the Committee will recognise is essential, and that is in doing what it can to secure further provision for scientific and medical research, and the Treasury has made a grant for the service of £125,000, as compared with a figure of less than £60,000 a few years before. Although there is a great call for economy, I venture to say in no direction is expenditure more justifiable than this, and the paltry amount of £70,000, or thereabouts, by which we have increased the expenditure on medical research is a trifle compared with the results which have already been achieved, and a trifle compared with expenditure in other directions which are far from being so fruitful. In justification of the increased expenditure on scientific and medical research, I will give one or two illustrations of its proved value, because I think, the British character being what it is, and I am quite sure the traditions of this House being what they are, when it is shown that an increased amount of money has been devoted to scientific research, it is a material point to show that, at all events, we have got a good return for the money we have spent, and that the increased expenditure is thereby justified. I have before me a long list, but I will only take two or three instances of the useful work which is being done by the grants given under this head. I remember a grant was made with regard to the prevention of T.N.T. poison, for which we were paying several thousand pounds a week compensation. We only gave a few hundreds out of this Research Fund for this purpose, but it practically abolished T.N.T. poison, and what it saved us was certainly more than the total expenditure under the whole grant in any one year. That is one illustration of its value turned into a cash equivalent.
I will give another illustration. We remember that, when we have heard stories of mummies being brought over to this country and examined, we have been told by those who examined them that the germs of various complaints were still there, and potential in their malignity if they got the chance. One of the age-long plagues of Egypt would have given us immense expenditure just now, had it not been for the work of research, which was assisted out of the Research Fund. Owing to that work, what has been a plague of Egypt for all time was practically prevented from invading our forces there. In view of the large forces which we had in these parts, what it would have meant if we had not prevented the spread of that plague may be illustrated by the fact that we are still paying £6,000 a year to men affected in the South African War. I will give two other illustrations. I find that, in connection with one of the grants, work was done in the Eastern Command in connection with heart cases, the result being that in that Command alone, owing directly to the recommendations arising from the small grant, there was a saving of 4s. per bed per day, which represented £57,000 saving in the Eastern Command in one year. That, I think, is a good justification for this class of public expenditure, and for increasing it, as I have done, owing to the increased cost of These services.
We should be justified in making it more, but what I am doing now is justifying my Estimate. There is another illustration which, I think, further justifies this increased expenditure, and that is our record in the War in one matter. Various grants under different headings were made at different times out of this Research Fund in connection with anti-typhoid work, and I would like to give the Committee some figures. I am not saying it is due solely to these researches, but it is mainly due to them, without a question. In the South African War the total strength of the British Army was-about 530,000 all told, all through the War. The average ration strength was 208,000. In the South African War there were 57,684 cases of typhoid, and 8,022 died. In the recent War the total strength of the British forces throughout the whole of the War would be under-estimated if I put them at 5,000,000, and the ration strength would be under-estimated at 1,200,000. If we had had the same death-rate from typhoid among the men, who were living under the worst possible conditions in the recent War, as the death-rate in the South African War, we should have had 400,000 cases and 56,000 deaths. Between the South African War and the recent War these researches have gone on, some of them aided, I am glad and proud to say, with grants out of this Fund. The result has been that, although we had 5,000,000 men passing through the miserable conditions which obtained, there were only throughout the whole War in the British forces 7,423 cases and 266 deaths. You could not have a greater justification for expenditure on intelligently-directed re-search than that fact alone. I have given a selection. I could give three times as many instances to prove the mere money value of this expenditure on research, and there is no recommendation which our Ministry has made which I can commend with more confidence to this Committee than that.
In all matters in which the Ministry of Health is concerned, as it must ever be concerned, if it is to be intelligently directed, there must be the spread of knowledge. The knowledge we want to have spread is the kind of knowledge that should come to every home. Therefore, good sense and tact in the Ministry of Health is probably more necessary than in any other Department of the State. For the Department is concerned in matters which affect the homes and the interests of our people in all their ways. Therefore, it behoves us, above all others, to endeavour to secure well-ascertained knowledge and energetically to seek to spread it, and to apply it. It is on these principles only that a scientific and a well-directed health service can gradually be built up. It is on these lines that I commend these Estimates.
The Committee has listened to a very interesting statement from the Minister of Health in regard to that portion of his Department with which his record of personal and public service has been more closely connected, and which, if I may say so, lies nearest to his heart. The instances he has given to us in support of his claim that the scientific research has been dully justified, not only in the War, but since the Armistice, were, I think, amply convinc- ing to members of the Committee. No one can over-estimate the value of a Ministry of Health in full and efficient working order in this country. At all times necessary, it was never so vital as at the present moment, when, owing to the losses of the War, direct and indirect, every citizen, and especially every younger citizen, is an asset which should be preserved with no niggardly ideas of expenditure, but with a forward looking to the use, certainly of the young, and the development of the assets of this nation in the very serious times which lie before us. The variety of subjects the right hon. Gentleman has touched upon will, I think, convince any fair-minded listener, or reader, that under his guidance this portion, at any rate, of the Ministry of Health, is in wise and very earnest hands. Anything the House of Commons can do to support the Minister or his Department in the way of the ever-increasing needful development of that Department on the lines of public health will never, I am sure, be wanting.
There are many hon. Members in the House much better qualified than I am to develop that portion of the statement of the Minister. I pass, therefore, to a much more difficult, and what I regard as a more controversial matter—that is the question of housing. It is a matter of real regret to me that to-day this question of housing is where it is.
I hope in what I have to say I shall not be actuated consciously certainly, and, I hope, not sub-consciously with any desire to make a score. The subject is far too serious for that. But in so far as I feel it my duty to point out the shortcomings, as I think, of the Government in this matter, and to draw attention once again to the most serious consequences of the shortage of houses, I should not be discharging my public duty if I do not do so. I myself do not share the cheerful view of the position taken by the Minister. I hope I am wrong. I hope he is right. But he did not seem to regard the situation as one of that very deep seriousness that a very large number of Members do. What is the position? What was the admitted need, stated over and over again? It was that there should be no less than 800,000 houses built to meet the necessities of the case. These were not marginal luxuries, but the hard necessities of housing in the country, in relation to reasonable, habitable houses. By way of illustration it was put to me by someone quite qualified to do so this way, and what it really means is this: Draw a line, or take a road running from Southampton to Edinburgh. Line it on both sides with houses, each with a 28 feet approximately frontage—which I think is the demand of the Department, and which represents the kind of house which is needed—visualise that—which is the need—and I think we are entitled really to ask the Minister what are the present results?
We remember that in November and December, 1918, and certainly in the early months of 1919, that in this House, on its first assembling, we were told that it was hoped to raise at no distant date thousands of houses. The Minister has told us very frankly what is the position to-day. Eighteen months or more since this House first met, and very nearly two years since the Government was put into power, there are 2,000 finished houses. The right hon. Gentleman hopes that in the course of a couple of months 5,000 or 6,000 houses more will be ready for occupation. He has told us that a couple of hundred thousand plans have been passed; that 126,000 tenders have been accepted, and that contracts have been signed and work started, in round figures, on 70,000 houses. We have heard these figures before—of 100,000 plans, tens of thousands of tenders, and of contracts signed! We go back again. What has been done? Two thousand houses put up. That is the lamentable position in which the country finds itself. I am not for one moment suggesting that this is entirely due to the Government. There are other causes over which they had no control at all. I am stating the fact, however, and there it is.
The country is entitled to say that this vital need has not been seriously met. I think I may, without bringing myself into the matter unduly, make a reference to a suggestion which was made in this House somewhere about this time last year. One of the charges we are entitled to make against the Government is this: that they have never really grasped the fact that you cannot deal with this problem solely through official channels. That was the trouble with which the thing began. I remember my right hon. Friend
the Paymaster-General sitting, I think, below the Gangway in those days. Everybody was hoping that in and through the Act now on the Statute, but which was then a Bill passing through the House, that the Departments which were going to be set working in and through the local authorities would, in some way or another, provide us with the housing we wanted. I may not be practical in some things. On the other hand, I wish I could indulge in more flights of imagination. Somehow or another, I always do not seem to get far on the wings of oratory. But I try to keep to the facts of the situation. Greatly daring, I said:
Go on with your official scheme by all means, but do not overload it, rather give every chance to private enterprise to go on with the job also.
I remember Viscount Astor, who was then, I think, Secretary to my right hon. Friend, from that Bench scoffing at me. He said, "What does the right hon. Gentleman want? Does he seriously suggest that there shall be a subsidy given to the private builders?"
That was not in my mind. I thought it an impracticable suggestion. I was cautious and I did not answer. The spokesman for the Government said, "An awful thing!" The official mind was shocked with the idea. It was impossible! But what did we find afterwards? First the subsidy of £100, then £150, then £250. I also find there are 12,000 houses already built!
I said they were in various stages, from having their foundations dug to completion. I said we have granted certificates in respect of these. What stages they are in I do not know.
And the others fully eighteen months. However, there is the position! If you want houses, clearly that obviously is one of the main factors by which you can get them. Notwithstanding the objections then raised, I very gladly welcome the new departure that has been taken. But consider the way in which building materials have been held up! There was the official grip on the whole thing! Far too many practical men have submitted to me evidence on this matter, and to my mind it is overwhelming. At every turn one meets it. I have had instances put to me by practical men of what has happened as regards the building scheme at Woolwich. This was commenced, as I understand it, in August last. The scheme started there, as I am informed, was with an energetic and sympathetic council mainly composed of Labour. [An HON. MEMBER: "It would not be a Labour Council!"] They started well, and there was sympathy and understanding with the council. In May of this year only fifty houses had been built. I say that there has been too much officialism.
Wait until I have finished my little tale. I am told that this is what happened. They had the general lay-out which was the first step, and then there were the usual references to the regional commissioner. Then he had to refer the matter to the chief architect to the Ministry, who made certain alterations. After that the architects again began and prepared their sketch plan for the various types of houses, and this again had to be approved by the borough council. Again it was submitted to the regional commissioner, who suggested further alterations. Then came forward the working drawings for the first fifty houses, after which there was some more professional discussion. The regional commissioner took the architects' plans before the right hon. Gentleman's Departments, and drastic reductions were suggested. By that time the hopes and aspirations contained in the manual were found to be quite incompatible with the amount of money which the public could raise.
After that much time was spent in conferences with all the authorities, and at last tenders were accepted for 1,000 houses. These houses had to be built upon the prices settled by the contractor and director of building materials, and he could not supply the bricks and cement, and his excuse was that trans- port was lacking, and after a long discussion, in which a good deal more time was spent, consent was obtained, and they went into the open market, got the necessary materials, and went ahead. I have had those figures given to me on what seemed very good authority, and I do not think in the record which I have given that there is anything unusual. That is the sort of thing which has been going on, and unless strong measures are taken it will go on and throttle the real driving power by which you can get houses swiftly built.
The charge I pressed against the Department is that you are driving through the narrow bottle-neck of the Ministry far too many details in connection with the development of the housing scheme, and until you get rid of a large amount of your officialism you will continue to clog the machine by which houses could be produced. I have had instance after instance brought to my personal notice, and wherever they are discussed the evidence seems to me to be overwhelming that you must give much greater freedom to the local authorities and trust them far more than you do. You should encourage by all the means you can private enterprise, and let the materials go free.
I have received my information from those who have practical knowledge, and to say now that materials have been free for anybody to use, as regards building materials during the past eighteen months, seems to me to be flying in the face of what I hear from men who are in the middle of the business. I know we have to make allowance for the enormous financing difficulty, which is no doubt very serious, but I do not think I am far out when I say that to provide 900,000 houses which are needed now you want very little short of £1,000,000,000.
There is an added factor of real seriousness that the arrears are increasing. We heard a statement to-day with regard to the proposed increase of railway fares. You have to consider in this matter the hundreds and thousands of people, employed in London, who pour in and out every day for distances of thirty or forty miles. You are going to double the cost of a third-class season ticket to Southend. A season ticket which cost £15 is going to cost £30, and this will cause hundreds and thousands of people, who now travel out of London, to enter into this awful competition for houses in London. The problem of the holidays, although serious, is trifling compared with these things. With the increase of population going on there is no emigration, as there used to be, to relieve congestion, because you cannot get ships to take the people, and all the while this housing problem is daily increasing in urgency and in arrears from all those evil causes to which I have referred. We can all sympathise with any Minister who is charged with this terrible responsibility, and I confess that I do not see a way out of it.
It is easy to criticise and say that during the past eighteen months this and that might have been done, and we are entitled to say it. The question is, What are you going to do now? Money is extraordinarily difficult to get. I happen to know, from my own personal experience in business, that this difficulty is increasing. I suggest that you should get rid of as much officialism as you can. I know it is very difficult to do it. Once you have got these things inside a public Department, the tendency is to hold on to everything. I think my right hon. Friend is as conscious of that as anybody, but you will never solve this problem by officialism. I hope my hon. Friends of the Labour party will not think that I am hitting at their views.
Officialism has broken down, and we must make a fresh start somewhere. I suggest that, while retaining all the necessary control over the plans and the houses, you should have less officialism. I know you cannot allow public money to be flung about in any way, and there must be some measure of public control; but since officialism has broken down, you should give a much freer hand to private enterprise, and see if you cannot do better in that way. At any rate, private enterprise cannot be worse. The seriousness of the problem increases every day. I have the gravest apprehension of what may happen in the social order of the people of this country in the immediate future if they imagine that we are really prosperous and that everything is all right because wages are high at the present moment and employment is fairly easy to get. We should not overlook the fact that we are thousands of millions poorer than we were five or six years ago.
Production is not going up, and all sorts of factors are working us into a most serious and difficult state of affairs. If I changed places with the Minister of Health to-day, I might not be able to do much, but, at any rate, I should make a determined attack upon officialism, because it is throttling the country in all sorts of vital directions. These great industries, with all their faults, operated in days gone by to supply the national need to a substantial extent, and you cannot get all these things done by a Government Department. We require something to be done, and not drift along as we are doing in the present state of affairs.
I make no apology in following the right hon. Member for Peebles (Sir D. Maclean) for confining my observations to the subject of housing which, as the right hon. Gentleman said, bulks large in the public mind and is one intimately associated with public health. I hope I shall not add to the difficulties of the right hon. Gentle-man the Minister of Health. Even were I disposed to do so, after listening to the rather barren speech of the right hon. Member for Peebles, I feel convinced that if I were dissatisfied with my right hon. Friend's administration it would be exceedingly bad policy to kill Charles in order to make James king on this occasion. Frankly I have not the least idea of what was the right hon. Gentleman's one constructive proposal. He said more than once—and he laid considerable emphasis on it—that what he would do would be to give private enterprise a chance. I have not the faintest idea what he means by that. I was rather reminded of the man who said his object was to compel people to volunteer. The right hon. Gentleman seemed to be in the same position. Private enterprise has got its chance. While it has all the difficulties which confront private enterprise it has also a subsidy on every house it builds, and if that is not giving private enterprise a chance then I have not the faintest idea what the right hon. Gentleman wants. He says he wants private enterprise to be put in a position to build houses with the very smallest amount of interference from the Department which grants it a subsidy. That subsidy has been quickly obtained and effectively used in my own constituency. I am afraid my right hon. Friend has added rather to his own difficulties in dealing with this problem by not taking the House into his full confidence in regard to the question of the reinforcement of labour in the building industry, and that has had the effect of creating critics where he might have gained allies.
There are two main problems with which he is confronted and which I think we are bound to consider on this Vote and to criticise as constructively as we can. The first is this—is his internal administration as effective as it should be? The second is: Is he going the right way to solve as quickly as possible the wider problems which arise outside and beyond the internal administration of his Department? I will only say, one word on the question of administration. The secret of successful administration of this kind is to decentralise. The right hon. Gentleman has done so on paper, I admit, but I am not sure he has done it in the sense of really decentralising power, and giving it to the people in the locality. If you do not thus decentralise, if you do not delegate sufficient power to local representatives, you had better not decentralise at all.
I have one specific instance in proof of that. I am not complaining in the least of any treatment which I have had from the right hon. Gentleman's Department, because the moment I have got to the principal man in his office, I find I have been able to get a settlement within 10 minutes. The case I am referring to is one in which the purchase had been approved locally, and prices had been agreed upon. It was urgent that the whole transaction should be settled promptly, because a very advantageous agreement had been arrived at by the purchasers, under which they could get the purchase money, and they knew that if the bargain were not completed at once, they would never get another such chance. As soon as I got to the principal people in the right hon. Gentleman's office, the matter was settled, and an order was sent down by telegram sanctioning the purchase, thereby enabling the local authority to complete the transaction, and to save a considerable amount of money, not only for themselves, but for the Department. What I want to urge is, that if adequate powers had been delegated to the local officers, there would never have been a delay, which might have endangered the transaction. I hope the right hon. Gentleman will look into the administration of his Department and make quite sure that power is adequately decentralised.
The only other point about administration which I wish to raise is in connection with the question of finance. I hope the right hon. Gentleman will let the local authorities know quite clearly where they stand in the matter of finance. I am not going to say a word which will absolve the local authorities from using every effort to raise money locally for housing schemes. I am glad the right hon. Gentleman has been able to give so satisfactory an account with regard, at any rate, to a certain number of localities. What the local authorities want to know is this—whether they be authorities with a rateable value of over £200,000, or whether their rateable value is under £200,000—once a tender has been accepted and a scheme has been approved, if they are unable to raise the necessary money to carry it through in their own locality and they send to the right hon. Gentleman, will the difference be found for them by borrowing from the Local Loans Commissioners? They want that to be made perfectly plain, and I think it can be made clear without, at the same time, causing them in any way to relax their efforts to raise money in their own localities. The two things which local authorities most need in order to stimulate them to further action are effective decentralisation and definite information on the financial situation.
The second point I have to raise—and I will do it very shortly—is a rather big question outside that of general administration. It has reference to the ever
increasing difficulty in connection with labour shortage and soaring prices. It is not too much to say that the need for houses in this country, and for their quick provision, is as great as was the need for munitions in the early days of the War, and the same drastic steps must be taken to provide these houses as were taken by the right hon. Gentleman and his predecessor to get munitions in the early days of the War. It is difficult enough in the present state of affairs, when the country is prosperous, to find that men are practically tied to employment in one locality, but has the right hon. Gentleman considered what the position is going to be when we get a slump of unemployment? That unemployment when it comes will come quickly and, possibly, section-ally. It will very likely strike particular trades or particular localities, and unless you have got this question well on the way to settlement by that time you will have destroyed the mobility of labour, and be perfectly incapable of meeting the particular cases of unemployment as and when they arise. I am still in doubt as to what the right hon. Gentleman is really doing. We get the "Weekly Bulletin," which shows us how many schemes and how many tenders have been approved. The right hon. Gentleman tells us, with an unconscious double entendre, the increasing number of houses in what he calls "the tender stage," but at the same time we do not know how the steadily growing demand for labour is being dealt with. Last February the right hon. Gentleman told us that even if he were to put every bricklayer in the country on to houses required this year there would still be a shortage of 15,000 men. That was four or five months ago. Last month he said he was trying to enter into arrangements with the Joint Industrial Council in the building trade. I asked him if he was satisfied that he had got the number of men necessary to meet his requirements for the houses even then in contemplation, and he replied that he was perfectly satisfied that he had not, and that there was a real shortage. He has repeated that statement to-day, but he has told us also that "a proposal is being formulated." That really is not enough. I know the difficulty in this matter. What we want to know is what it is that has been holding him up for the last six months in arriving at that arrangement.
If he will allow me to say so, this Committee is not going to be satisfied simply by having a proposal formulated and then submitted to the Joint Industrial Council for acceptance or rejection. The Joint Industrial Council in the building trade have got a very much wider responsibility in this matter than I think they are prepared at present to recognise. No one is more anxious than I am to see the Whitley Councils prosper. When the Whitley Committee made its report it laid it down that the spirit which should animate these Councils was not merely a spirit of settling their own domestic difficulties, but they had a much wider and more national outlook. There is a passage in the Whitley Report which is well known, and which, I think, is worth quoting. It runs:
It has been suggested that means must be devised to safeguard the interests of the community against possible action of an anti-social character on the part of the councils. We have, however, here assumed that the council in their work of promoting the interests of their own industries will have regard for the national interest. If they fulfil their functions they will be the best builders of national prosperity. The State never parts with its inherent overriding power, but such power may be least needed when least obtruded.. …. We venture to hope that representative men in each industry, with pride in their calling and care for its place as a contributor to the national well-being, will come together in the manner here suggested and apply themselves to promoting industrial harmony and efficiency, and removing the obstacles that have hitherto stood in the way.
The building trade itself, in a preamble in its own constitution, lays it down that its object is not merely the settlement of domestic difficulties, but that it has a bigger and more complete service to perform not only in the interests of the trade, but in the national interest. If that Council and that trade do not recognise their responsibility, it must be brought home to them. My complaint is that the right hon. Gentleman has not taken us with him step by step in his negotiations with the building trade. He may have difficulties if he negotiates by himself, but there is no trade or industry in the country, however powerful, which can stand against the united public opinion of this country. If he is in difficulties, if he is being held up on proposals which are right and necessary for getting this scheme of housing through, why does he not let us know those difficulties? He
will have the whole force of public opinion, not only in this House but in the country, at his back in any measures which it is necessary for him to take. Prompt reinforcement is the only possible way out. I shudder to think of the possibility, which has been suggested, of further restrictions on one class of building or another. It is always dangerous to impose such restrictions. You find one class of man engaged on one class of work, and it is not easy to take him off to another class of work. It causes dislocation and trouble, and the further you carry it the further you get away from the economic process. I want to see such a reinforcement in this industry that it will be able to play its part fully. The men are there, and the opportunity for the work is there. I should like to see no embargo upon any form of building at all in the near future. An embargo is only to be looked upon as a last resort, and can in no way be a substitute for the necessary reinforcement of labour in the building industry. If the right hon. Gentleman is seeking any particular thing upon which to lay an embargo, there is one which I think most hon. Members would agree is a proper one—the rather ponderous, and exotic War Memorial which is at present threatening us from the obscurity of the tea-room.
I do hope we shall get publicity, as we have been promised. The right hon. Gentleman is only making the whole thing more difficult for himself, as well as for us, if he fails to give us publicity. I do not, however, want one-sided publicity. We want to know step by step what are the particular difficulties, what are the reasons which are being advanced, for the opposition to the reinforcement of labour in the building trade; and we want publicity upon both sides. I have a strong feeling that there must be some thing behind this raising of prices. I cannot believe that prices have gone up at the rate they have owing to the sheer necessities of the situation. I cannot believe that there are not some restrictive arrangements in some of the industries producing building materials which are necessary for the due promotion of the trade. Charges on one side or the other are being bandied about, but the one party that knows nothing is the great third party—the mass of the people who want to get the houses built and to live in them as soon as they are built. If any of those charges are untrue, let us know it, and we can pass on and concentrate upon the relevant issues. If, on one side or the other, action is being taken by any section which is holding up the obtaining of these houses, the right hon. Gentleman may rest assured that no obstruction will be allowed to stand in the way of instructed public opinion, once public opinion knows what the real position is. If he is uncertain, as I dare say he is sometimes, as to what steps he ought to take, let him explain his difficulties frankly to this House and to the country. We do not want to know his difficulties in order to exploit them; the matter is far too serious for that. The country wants to help. With a few negligible exceptions, probably every hon. Member, to whatever party he may belong, has been down to his constituency and interviewed the local authorities and tried to help over the Housing Schemes and Housing Bonds. We have given the right hon. Gentleman proof that the House of Commons will stand behind him if he will give us the opportunity. Let him mobilise the forces in the House of Commons and in the country, and we will see him through.
I make no apology for addressing the Committee on this subject, because I am one of the very few people who have practical knowledge of the difficulties of housing the working classes at the present time. When the Housing Bill was before the House I did everything I could to support it, thinking, in my modesty, that a Minister of the Crown who proposed a great scheme of what is termed social reform would know something about what he was dealing with, and that, although on the face of it, it appeared a most pernicious and foolish policy, that was probably due to one's inexperience, and not to the mistakes of the Minister in question. When the Act was passed, I myself started to build houses without any regard to the Housing Act. I wanted to get a check experiment, thinking that we should be able to estimate the value of the right hon. Gentleman's policy, and of his arrangements for housing the working classes, more truthfully if we had also another scheme working on the basis of pure private enterprise without State assistance. That experiment was certainly on a small scale, but still, to my mind, it has proved the fundamental fallacies upon which the Government based its policy. The first is the fallacy that the building of houses is a function of the State. The State has certain functions, but I fail to find, in any of the works of the wise men of the past, any suggestion that the building of houses is a function of the State. The second fallacy is one for which, I suppose, the great Liberal party is responsible, namely, that it is possible, under any circumstances, and by any dodges and contrivances, to raise the standard of living or the standard of the people's housing by an Act of Parliament. The third fallacy, which brings us to more practical points, is that the people of this country cannot, or will not, pay an economic rent. I do not speak at all in relation to rural housing, of which I know nothing; but, speaking of urban housing, that fallacy, to my mind, is the biggest one of the lot. We have a condition of affairs now, and we have had ever since the Armistice was signed, in which a considerable portion of the people are anxious for better housing conditions, are at present very much overcrowded, and have the money to pay for those better conditions and are ready to pay it.
My experiment was this: In my constituency, on my own land, I started to build a class of houses very much superior to those recommended by the right hon. Gentleman—superior in design, with greater space, and of infinitely better material and workmanship. The houses I have been building would not be passed by the right hon. Gentleman's Ministry under one of his housing schemes. He would say that they were extravagant, that there were all sorts of unnecessary details, entailing unnecessary expenditure; but those houses are costing me to build, even now, very much less than inferior houses, having roughly the same accommodation, built by the neighbouring municipality. And yet hon. Members on the Benches opposite will get up and say that private enterprise has failed! The Government always seem to me to be composed of pessimists, that is to say, of people who think that the world is so badly designed, and the universe so unreasonably constructed, that an utterly foolish and unjust policy may end in success. I take that to be true pessimism I am not a pessimist; I think that the world was created on such reasonable lines that, when you base a policy on panic, lack of consideration and injustice, it usually ends in the chaos in which this policy has involved this unhappy country. The Government proceeds to build, or to intend to build, houses of a better quality than those usually inhabited by the working classes of this country, and it builds them at such enormous costs that the rents it will have to charge, to get a true return and relieve other people from the burden, will amount, in many cases, to between 40s. and 50s. a week. Certain lucky people are to be selected, and in every municipality one knows who those people will be. They will be the relatives and friends of the municipal council. Those lucky people are to get their houses at anything up to half their real value, and the miserable wretches who have not the opportunity of getting those houses have to pay the difference. In the large industrial towns in the North, the rents of those houses will have to be 14s. or 15s. The actual economic rent is between 40 and 50s., and the difference is going to be made up by the unfortunate slum dweller, who is obliged to live in a slum because he can only pay some 5s. or 6s. a week for his house. The poor man in the slum has no chance whatsoever of getting those new houses, because he cannot pay even this absurd conventional rent which is going to be charged for them: and yet, through his rates and taxes he is going to pay for his richer and more lucky neighbour. Any policy based upon an injustice of that sort is bound to fail, as this present policy has failed.
There are some things which the State can do, and do admirably. Many hon. Members present will probably have read what is commonly termed the Tudor-Walters' Report. To my mind, that report is one of immense value. After careful study and comparison with textbooks, it enables anyone to start building houses, and I have to admit my own very great indebtedness to it. I am no architect, and yet I have had to be the architect of my own houses; I am no builder, and yet I have had to be the builder of my own houses. I am very deeply indebted, indeed, to that Report, and I can thoroughly recommend it to any hon. Members who may not have read it. It seems to me that the dissemination of information is distinctly a function of the Government, and one of which no one can complain. There is another function, that is the function of experiment. During the War I got home on leave when I was able and experimented in new methods of building houses, and it may be of interest to the right hon. Gentleman, and possibly of use to the Government, if I tell them that those experiments were based upon concrete buildings. As far as they went, they gave great prospects of ultimate success and of economic building. But the whole thing was knocked on the head once for all about the time of the Armistice by the rise in the price of cement, and even now, with increased wages and the increased cost of bricks, I am convinced that it is very much cheaper to build in brick than in concrete, provided only you get bricklayers to lay the bricks.
The present method of building houses is undoubtedly primitive in many respects, and I look to the future, I hope assisted by a research department in the Ministry of Health, devoted to housing, to produce a new system of building which will economise immensely. For the present we must stick to bricks and mortar and possibly various forms of concrete blocks and similar materials. But a real step in building will be taken when houses are manufactured in manufactories, and then put up on the site. The difficulty of the present method is that you cannot build by artificial light and you cannot build in bad weather. If houses could be constructed in manufactories, under cover, and then be transported to the site and erected there, we should be able to have a vastly greater period during any given year in which houses could be built. Probably the ultimate end of housing, so far as our generation is concerned, will be the manufacture of houses from concrete or similar material, cast hollow and including in the casting perhaps the whole side of a house, or at any rate one storey, that such casting will be made, just as iron and steel castings are made, in a factory under cover. On withdrawal from the mould they will he stacked and weathered, and then the customer will come to the manufactory, look at the book of plans, and say, "I want a house like that," and in a day or two the house will be delivered and put down on the site. But that is for, the future. The connection with this Debate comes in in this way, that the experimental work will be extremely ex- pensive because it means the erection of very large works, with proper machinery and proper iron moulds. But I think that very large sums of money might very well be devoted to a research department in housing on a large scale. The question whether people can pay economic rents was not solved very easily. I built houses, and I am going on building them, and I told the tenants that I charge them rents equivalent to 6 per cent. on the outlay and expenses. Those rents amounted to 18s. a week without rates. I have a waiting list as long as my arm, without advertising or anything of the sort. If I got hundreds of houses built, hundreds of people would pay an economic rent on them. I stated some little time ago that the present policy was a failure, and I think the figures given by the right hon. Gentleman are sufficient proof of that failure. He said that some 70,000 houses had been actually started. He told us that through bonds, mortgages, and other devices some £30,000,000 had been raised. I should like to know where the balance is to be got from with which these houses are to be constructed. 70,000 houses, at the prices which obtain now, will cost just over £100,000,000. Towards that we have got £30,000,000. Where is the other £70,000,000 coming from? If the Government policy were to succeed by any chance, it means that this country would be involved in an expenditure of between £800,000,000 and £1,000,000,000 but does any Member of the Committee assume for a moment that there is the faintest prospect of raising anything like that sum at present?
To come back to a practical point, I am a member of a small local authority, and I want the Committee to understand how these things work out actually in the country with the people who have to carry out the policy which the right hon. Gentleman embodied in the Act of last year. In common with very many other small local authorities throughout the country the whole of our debt was held in small amounts at 5 per cent. by depositors in loans withdrawable at call. Every penny of these loans is now in the form of an overdraft on the bank inasmuch as every depositor called up his money, because he can get so much more than 5 per cent. for it elsewhere. We gave permission to our clerk to advertise short date loans or loans withdrawable at call at 6 per cent., but not a penny of money was obtained. A neighbouring city of very large size indeed, with 750,000 inhabitants, also advertised for loans at 6 per cent and got practically nothing out of it. The result is that our authority is paying 7½ per cent, in place of the 5 per cent. they formerly paid for deposits. On top of that, the right hon. Gentleman's Department said we had to build 250 houses at a cost of something like £300,000, in a district where a penny rate brings in about £150. Naturally when a demand was made on a small public authority of that sort, there was consternation. In order to help this little authority out of its difficulty I suggested that I would build 200 of these 250 houses. Then as a favour the right hon. Gentleman allowed my poor unfortunate district to get off with 50 houses instead of 250. The 50 houses will cost us between £65,000 and £70,000 at present rates. What is a local authority to do under these conditions? We were told by the Government that we should never be obliged to spend more than a penny rate. Does any intelligent local authority believe that the rates of the town will not in the long run have to bear practically the whole expense of the Government's housing policy? We have had complaints to-night on both sides of the House as to the delay of the Ministry in passing plans. By delaying and by insisting upon all these little points of detail and putting off housing schemes month after month, the Ministry has made itself extremely popular with local authorities. They have an excuse for putting off the ruin of their districts.
I come to the more practical question of the cost of building. Here again I have an indictment against the Government policy. We have got to the condition now that costs, both of labour and material, are mounting week by week. When I say the cost of labour is mounting, sometimes the actual money value of the wages does not mount, but we get perhaps a little less work done for the same money values, and it comes to the same thing. To my mind, and I am speaking from some little experience, the real trouble and the real fundamental reason of the increase in the cost of building is the policy of the Government. They created in the building trade a condition of affairs for which speculators all over the world have been praying ever since speculation was invented. They created a complete corner. In other words, in a market where supplies are already small—supplies both of labour and material—they have introduced a customer with apparently endless money to spend, and determined to spend it, whatever the price charged, and that is what speculators throughout the history of the world, in every nation, have been trying to bring about, and the right hon. Gentleman has done it at last. Last night we did more to solve the housing problem than the right hon. Gentleman will ever do, even if he averages three housing Bills a year, as he is doing at present. We have removed, first of all; the real cause of the trouble. To my mind there are other causes which have to be removed also. I will come really to the fundamental difficulty and the fundamental reason why we are not getting houses built, and that is the Housing Act of 1919, helped by the subsequent Act. The effect of giving that subsidy to private builders has simply been to raise the average cost of building by an equivalent amount. I went very carefully into the figures before this proposal came into force, and as near as we can judge, averaging the price of these houses with those built under the main Act, one finds almost exactly that the subsidy granted has come out in increased costs, and to my mind that is always the result of subsidies, that if you subsidise any particular commodity, you immediately send up the price. So that I have the honour also to be at variance with the right hon. Gentleman (Sir Tudor Walters).
There was a possibility at one time of the Government stepping in and trying to prevent delay to get over the immediate crisis in housing, but that opportunity has passed. A suggestion was brought before the Government by a very great authority, indeed, but for some reason best known to the Government it was rejected. It was a proposal that if a Government scheme for housing the people was to be brought forward, it must limit the number of houses proposed to be built under that scheme. The suggestion in question, I believe, was to build 100,000 houses or thereabouts. If the Government's scheme, based upon a certain definite and limited number of houses, had been brought into action last year, it is possible that we might have got the houses, because the Government scheme would have been a complete watertight compartment by itself, and it would not have been wrecked by the building trade. As to the difficulty of the dilution of labour, that is an artificial difficulty created by Government action and Government policy. In this difficulty the Ministry of Labour is also concerned as well as the Ministry of Health. The difficulties have been created by the supposition that it is possible to fix the wages of all trades in the country on a. purely artificial basis and not by bargain between the employer and the men employed. It was a system which was introduced into the manufacture of munitions during the War, and I do not think there is any hon. Member of this Committee who would honestly say, even if he was one of the officials connected with that Ministry, that it was a success. It has resulted in a very high money value for wages and in very high prices for commodities. We have heard in this particular case that the right hon. Gentleman is having conferences with the building trade unions and is offering them a quid pro quo. He has been arguing with them. In my part of the world, in Lancashire, they have a saying, "I am not arguing, I am telling you." The only way to deal with labour in a crisis of this sort is not to argue but to tell them. I have had no difficulty whatever with building trade labour. I am employing no trade union bricklayers, but only soldiers and sailors, and I shall shortly be employing soldiers and sailors in every building trade there is.
The right hon. Gentleman spends his time having conferences with the building trade unions, and that is at the bottom of the whole trouble. The labour troubles in these days are made in Downing Street. It is a matter very much of atmosphere. When one reads in the newspapers that there is great industrial unrest in my part of Lancashire, that strikes are threatened in this, that and the other direction, that looks very terrible in the atmosphere of 10, Downing Street, and as the later editions come in, I suppose the terror in Downing Street becomes worse and worse, but we who live in the midst of strife, in the storm centre, know what value to put upon that sort of newspaper talk. Strikes and threats of strikes are absolutely beneath contempt when you are among them. It is only when you are sitting in Downing Street that they look so dreadful. If the Minister wishes to get houses built for this unhappy country there is one policy and one policy only, and that is to throw away all his quack remedies, his dodges and devices for getting rid of economic laws, and to stand out of the way and let us do it.
I beg to move, that the Vote be reduced by £100.
My object in moving the reduction is to draw attention to one particular question, but before doing so I wish to make reference to the remark of the hon. Member (Mr. Hopkinson) that we on this side declared that private enterprise has failed. It never succeeded even in normal times and never will. To talk about private enterprise building all the houses that are needed to-day is to make it perfectly hopeless. My only hope is in the local authorities, aided to some extent by the building societies. I am glad to hear from the right hon. Gentleman that housing has been started in several places, but I find only 2,000 houses are inhabited, although the Armistice was signed nearly two years ago. Why are there not more houses?
State enterprise won the War, and if the same enterprise had been put into the building of houses that was put into the War we should have succeeded in this enterprise as we did in the War. The right hon. Member for Peebles (Sir D. Maclean) called it "officialism" and said that that was the cause. I would call it interference with the local authorities. Sometimes the room is too large, another time the ceiling is too high by six inches, sometimes the sites are wrong. In certain cases I know of they have changed the sites three or four times and they are building on much worse sites to-day than the first one which was rejected. I know of a corporation which built houses on a certain piece of land eight or ten years ago and they wanted to build a few more since the War on that same piece of land, but they were not permitted to build the name class of house. They had to build inferior houses ten years after the others had been built. That scheme was held up for months because of that objection. There was so much interference that the local authority were led to believe that the obstruction was being done purposely to delay housing. Interference has been the great thing that has injured housing. I am glad to hear that the Housing Bonds are succeeding to some extent. I was very doubtful about that, and I am still very sceptical as to their great success. If they do succeed, I shall be only too glad, because we need houses so badly.
I want to challenge the right of the Minister of Health to raise the subsidy on houses by £100 without asking the authority of this House. I do not want to raise the point as to whether £250 is too much. That is not my point. I am not going to say whether £150 was enough. The point is, whether the right hon. Gentleman had the right to increase the subsidy without getting the authority of the House. Originally there was a flat rate of £150, but that was changed to a system of payments varying from £160 to £140 and £130, and on the Second Reading Debate the right hon. Gentleman contended that that was better than a flat rate of £150, which would encourage one type of house. The Paymaster-General spoke subsequently, and he referred to the £115,000,000 which was set aside for this purpose, and said that we should get 100,000 houses for that £15,000,000. If this subsidy has been raised by £100 it means that we cannot get 100,000 houses; we can only get at the best 70,000 houses. If I take the Clause by itself I should have to agree that the Minister had a right to do what he has done, but I am raising the point as to whether, in all the circumstances, in view of the definite figures given in the White Paper, and having regard to the speeches that were made on Second Reading, we should be governed only by the mere reading of the Clause. If so, we shall have to make sure that there is greater detail put into Bills in future In the Debate on the Clouse the hon. Member for Middlesbrough (Mr. Trevelyan Thomson) made frequent reference to the £150 subsidy, and it was also referred to by the hon. Member for Newcastle (Major Barnes). Therefore there was a distinct understanding as to what was to be the subsidy, and now, without any reference to this House, that subsidy is raised by £100. If the right hon. Gentleman has the right to raise it by £100, he has the right to raise it by £1,000, so long as he keeps within the £15,000,000. A question was put to the Chancellor of the Exche- quer on this point a few weeks ago and he was asked whether he had been consulted when this subsidy was raised. He said that he had been consulted, but so long as it was kept within the £15,000,000 he had not much to do with it. That rather goes to prove what I say, that if the subsidy can be raised by £100 it can be raised by £1,000 so long as they keep within the £15,000,000. That is a serious matter for the House as a whole. Surely we have some rights and privileges, and if a Clause is passed on the strength of certain data and after a long debate we ought to have something to say when that Clause is interfered with in administration. I challenge the right of the right hon. Gentleman to increase the subsidy without first coming to the House for authority.
We all regret that the time is so limited, and therefore I think that the Minister must not complain if he gets more kicks than halfpence in the discussion. We have no time now to commend him, but only to raise those points on which we differ. I want to put two points to him which, though they may be trivial, are of importance. Time after time the local authorities have asked the Minister why he would not exercise the powers he has or else take further powers to deal with the occupation of houses when they become empty in any given area. When a house falls empty the landlord refuses to let in many cases because he wants to sell with vacant possession, and that has resulted in a large number of houses being kept unoccupied which otherwise might have been let. The Minister replied to various questions I put that the number was only small, but I know in my own district that there are over twenty houses of that kind now. That number may not be very many, but if you multiply it by the population throughout the length and breadth of the land you will see that there are between six and seven thousand empty houses which might be occupied at once. Since the Minister has told us that only 2,000 houses had been built so far under his schemes, I think that this number of six or seven thousand is very significant and worthy of his consideration as to whether he should not take powers at once to remove the gross injustice which men feel when they are walking about the streets and see these houses kept empty and cannot find a home. I had a case brought to my notice only yesterday of an ex-service man who had been round to hundreds of houses to try and get lodgings—he made seven hundred visits—and he could only get a cellar, for which he had to pay 14s. a week. I know of another case of a woman in lodgings with herself, her husband, and seven children. They are living in one room, and the landlord of a house in a neighbouring street, although it has been empty for some time, refuses to let it. That is a case of abominable overcrowding, while in a neighbouring street there is a house with two bedrooms and kitchen being kept empty. That house was sold two months ago for £275, but the purchaser did not desire to let it, and he will not sell it again unless he can get £80 or £100 premium. That house cost originally £120 only. That case is typical of hundreds in our towns and villages. This sort of thing is causing very great unrest and illfeeling—more than any other single action. Surely it would have been simple for the Minister to have taken steps to-include in the Rent Restrictions Act a Clause giving local authorities the power to take immediate possession, or else to cause houses to be occupied by those who are wanting them. I appeal to him to take steps before the House rises to deal with this question. The Minister and the Government can, when they so desire, rush ill-considered legislation through this House, and I think they should use some expedition in dealing with this matter. If they did so, it would at any rate double and treble the number of houses which the Minister's own schemes have so far produced.
Yet another point of difficulty in many towns is that of getting labour, and also dealing with the available labour to the best advantage. In my own town two or three large cinemas have been put up since the War. We find our own housing scheme—we have some hundreds of houses under weigh—are held up by a shortage of materials and labour, because the cinema buildings are taking up all the bricks and all the cement and all the labour required.
That may be so. I agree it is perfect nonsense, but there is no disputing the facts, and they are typical of what is happening in many towns. Firms say, "We shall have to stop our schemes under the municipalities unless we can get bricks." Another firm says, "In our neighbourhood a cinema is going to be built, and we have to put up with inferior bricks from a distance." These firms cannot get labourers simply because the builders of cinemas are paying much more than the market and trade rates in order to attract builders. What can the ex-service man think when he comes home and cannot find anywhere to go, and has to crowd his family seven or nine into one room, when he can walk about the streets and see thousands of pounds being spent in building these cinemas. I do appeal to the right hon. Gentleman to get more drastic powers to deal with all these things. Power was given to local authorities in the Bill passed last year to obtain builders and labourers, but often local authorities make these things personal matters. They feel that if they veto these buildings, which belong to somebody they know, they may be burdening their own shoulders. If a general Bill was passed and luxury building was prohibited in any area where there was a shortage of labour it would give great satisfaction. I appeal to the right hon. Gentleman to take this into consideration. He said he would consider it many months ago. This is causing considerable dissatisfaction in the land. I appeal to him also to extend the period in the original Act whereby the local authorities had to submit schemes for slum clearance areas. He has suggested an increase in the subsidy to private builders, and he has extended the period over which these subsidised houses can be built, and I ask him to extend the period in which the local authorities may submit their plans for the rebuilding of the slum areas. He referred to the improvement in the health of the people and the greater reduction of the death rate for children and adults, and he said that he expected further results to come from the better environment and improved housing conditions. Where the municipalities are willing to clear the slum areas and where their time has been taken up by building houses on the outskirts of the town, and they have had no time to produce the plans for dealing with these slum areas, I think the time ought to be extended. Notwithstanding the complaints that have been made, I think that in a very short time we shall find that the rebuilding of the towns of England will be on such modern, sanitary, and decent lines, thanks to the measures the Government have taken, and that the death rate will be further reduced. It has been reduced during the last few years, but I think it will be found in the later part of the century that there will be a tremendous reduction of the death rate, thanks to the more sound, healthy, and decent surroundings provided by the Act.
I wish to call attention to what the right hon. Gentleman said in the discussion this afternoon. Although there have been a small number of Members present during the Debate, a very large number of them have risen in order to catch the eye of the Chairman, and, although I understand that the Committee is going to adjourn at a quarter past eight, the right hon. Gentleman himself (Dr. Addison) took up no less than one and a half hours for his speech. I would like respectfully to call his attention and that of the other Members of the Government to the progressive increase of the curtailment of the time of private Members of this House. Although the right hon. Gentleman's speech was interesting and important, the Government should realise that a Committee of the House of Commons is a very important organisation, especially with the huge Estimates with which we have to deal at present, and the right of private Members to criticise these Estimates and to discuss the policy of the Government is almost as important a duty as that of the Government itself in expounding its policy. I want to refer, if I may, to the brave speech made by the hon. Member for Mossley (Mr. A. Hopkinson). The hon. Gentleman made one reference to something which has hardly been referred to at all this afternoon. He referred to the importance of economic facts in considering this question, and economic facts always, in the long run, beat political pretence. If houses cannot be built within a reasonable time and within some region of an economic basis, either there will never be any houses—which may result in disturbances and possibly revolution—or the State will eventually become bankrupt. The whole of the housing policy under the State scheme required properly to house the people of this country, if carried out at the present price of building houses, will mean that the State will become bankrupt. That contingency has hardly been referred to by the right hon. Gentleman, and only a few speakers this afternoon have mentioned it. It really is a fact which the Labour party have got to face. Either houses somehow have to be built more cheaply or else the houses will not be built, and that would mean tremendous hardships for their own class with possible revolutionay outbreaks on the part of some of them.
I am sure that every Labour Member of this House would dislike to see that. If again the houses were built on the present basis of building, every building expert in this country will agree with me when I say that the country must eventually become bankrupt. With that situation how is it possible for anyone to come down here and regard without grave apprehension the sort of speeches we have heard from the right hon. Gentleman this afternoon, saying that while we have not advanced far we are better off than we were last year and that eventually we are going to get well into the swing. We have not really dealt with the main problem, which is that houses cannot be built economically in this country and that the difference between an economic basis and the basis on which houses are being built at present is greater than when we discussed these estimates a year ago. The right hon. Gentleman mentioned one appalling dismal thing—that the cost of one class of house which could be built for £800 last January has now gone up to £900. I throw out this challenge not in controversy to hon. Gentlemen opposite. What are they going to do about it? One reason why this cost has gone up enormously is because every few months men in the building trade are asking higher wages, while they are lay- ing far fewer bricks and doing far less work.
I admit the difficulties of hon. Members opposite and the difficulties of the trade unions, but the Committee ought to face the fact that owing to various reasons it is becoming more and more difficult to build economically, and that in every period of six months in each year the cost of labour rises with the result that houses are farther than ever from being built on an economic basis. The right hon. Gentleman, speaking on the 13th of June last year, referred to the number of building schemes which have already been undertaken and referred to a list which he said he would issue that evening. Sheffield, he said, had a building scheme of 653 houses, Birmingham had started on 74, Bristol 71, and there was a large number of cases—20 or 30—where houses had been begun. Bath, Sheffield, Birmingham, Bristol, Yarmouth, Bolton and Middlesbrough, Ipswich and Norwich. This is a statement as to the number of places where they had begun work although it did not necessarily mean bricks in every case. Anybody reading that speech last year would have had the hope that in the case of these large towns, though it was eight months since the Armistice, yet as they had started on their schemes many houses would have been built before now. The White Paper issued this morning shows what has been done in every one of those towns. In Bath two houses have been built, in Ipswich nine houses, in Norwich not a single house, in Sheffield—the only one which shows any considerable increase—143, in Middlesbrough none, Birmingham 105, Bristol 6, Yarmouth none, Bolton none. That is typical of the progress that has been made with the houses. All these places were specifically mentioned by the right hon. Gentleman last year as places where schemes were under way.
Somehow or other the Government have got to deal with this question of the ever-increasing cost. A great many of us on this side are not satisfied that the right hon. Gentleman has taken sufficient steps to go into the question of the cost of materials. I make no accusation against sellers of building materials except to say that certain points seem to me to require investigation. I may give one very short example of what I mean. I had occasion to look into the figures the other day as to the cost of river sand. Three tons were bought from a builders' merchant in London at a cost of £3 7s. 6d. I purchased exactly similar sand in Surrey at 7s. per ton or a guinea for the three tons plus cartage which worked out at £1 5s., and the difference in the price of the three tons in the two cases worked out at the sum of one guinea. I should be prepared to allow a reasonable amount for the storage of that sand with the builders' merchant in London and a reasonable profit, but the difference still leaves a great deal to be accounted for in the way of undue profit. I believe that there are many other cases of the same kind which require investigation. The right hon. Gentleman has not referred to that. I understand that his Committee has not yet reported.
The right hon. Gentleman has the misfortune to belong to a Government in which there is no co-operation, so that one Department never knows what another Department is doing. This Committee has had time to conclude at least its preliminary investigations and produce a report. All parties are anxious to know what conclusion the Committee have come to on the subject of materials and whether they are being held up and there is undue profiteering. Until we have those facts it is very difficult to bring home to the representatives of the Labour party the folly of the members of the building trade unions in not being prepared in the existing situation to relax some of their regulations as regards dilution, number of bricks to be laid, and so on, but as long as the Government ignore the question how far this ever increasing cost of building is due to the increased cost of labour and the increased cost of material it is very difficult to deal with the matter.
We shall spare no efforts to bring home what we regard as the enormity of the action of the unions in refusing to allow discharged soldiers, who are perfectly competent, to work at building trades, and we are only waiting until we get a little more information on the subject. In conclusion, I support what was said by my hon. and gallant Friend the Member for Hendon (Mr. P. Lloyd- Greame) when he said that what was needed is publicity. The House and the country, and the Press and this Committee, need to be taken more and more into the confidence of the Government. We want to know exactly the reason of the ever-increasing cost and why the cost is going up We want to know all about negotiations with the trade unions, about restrictions, dilution, etc. When the country does know precisely what institutions are to blame, if they were the most powerful trade unions in the country, there would be such a burst of indignation from hundreds of thousands of people who care more for the interests of the country than for any trade union, the trade unions will be compelled to give way, and manufacturers and merchants who are keeping up the price of building material will also be compelled to give way. I appeal to the Government to let us have more and more publicity in this most critical and dangerous situation.
I congratulate the right hon. Gentleman on the satisfactory and encouraging statement which he made in introducing the Estimates to-day. I do not propose to discuss the all-important question of housing, though it has a very important bearing on the general question of public health, but to refer to one or two important points which have been raised by the right hon. Gentleman in his statement. There is no question that the general health of the country has undergone an extraordinary improvement during the last 25 years. That has been due to the excellent sanitary measures which have been in existence, and which have been carried into effect so well as to cause practically the disappearance of great scourges which we had in our midst before, such as typhoid, small-pox, and typhus. I am very glad to hear that the right hon. Gentleman is asking for greater provision, for larger sums of money. for medical research, because we feel, having very carefully to consider trying to do our best to eradicate such important diseases as influenza, scarlet fever, measles, and diphtheria, that we do not know sufficient about the causation of these important diseases which cause such an enormous death-rate every year, and I feel sure that the right hon. Gentleman's suggestion of applying more money to medical research will be the way to discover the causes of those illnesses. I would like to refer for a very few moments to the very important question of the hospitals of this country. We are all very proud of the voluntary hospitals in England. They have been the pride of England and the envy of other countries, but we have now come to a time when these hospitals are unable, through insufficient support financially, to carry on the magnificent work which they have done for the last 300 or 400 years. Up to the present practically the whole hospital treatment of the great mass of the people of this country has been left entirely to the Poor Law, and we find now that there is a great intermediate class of the nation who are entirely overlooked in hospital accommodation, but they do not propose to accept charity and they resent very much having to apply to the Poor Law. No doubt England up to the present time has not had an efficient hospital system. I hope sincerely that the right hon. Gentleman in framing a broad and wise policy for the treatment of diseases in hospitals—because a great many of them can be treated only in hospitals—will, by combining and retaining the great voluntary hospitals and in some way associating the great Poor Law infirmaries, many of which are quite empty and not required by Poor Law patients, be enabled to provide a national scheme of hospitals which will be acceptable and beneficial to the whole nation.
I was very glad to hear the right hon. Gentleman say that we should at all costs encourage the voluntary hospitals and in no way interfere with their efficiency, but I am quite certain that financial support will have to be given to voluntary hospitals by the State if they are to continue the excellent work they have done for so long. With regard to the transference of the Poor Law infirmaries we have had an instance already in Bradford. With the permission of the right hon. Gentleman that city has transferred or transformed the Poor Law infirmary into a municipal hospital. I hope that that experiment will be copied in all our large centres, so that hospitals may be provided on a national basis in which the patients will be able to pay for what they receive. Another very important question is that of the treatment of mental disorders. What is most required is that there should be facilities for the treatment of those persons afflicted with temporary mental disorder without their being certified as insane. I feel sure that if such a course were pursued, and it was made possible to treat these temporary patients, a very large number of people would be saved from drifting into hopeless insanity, and that in that way a very large amount of the accommodation in the asylums would not be required. In the treatment of mental disorders I hope there will be no association whatever with any lunacy authority, and that treatment will be obtainable in some hospitals totally unconnected with a lunatic asylum. If after six weeks, or three months, such treatment is found to be unavailing, they could be certified as insane persons. I was very glad to hear that the right hon. Gentleman is sympathetic towards what is a crying and urgent reform.
I would like very briefly to mention another and, perhaps, the most important disease with which we have to deal—tuberculosis. No fewer than 60,000 people in this country alone die annually from tuberculosis. We know that tuberculosis is a preventable disease, which ought not to exist in any civilised community. I am sure that the efforts which are being made by the Ministry will in a comparatively short time result in limiting the enormous amount of the disease in this country and in providing means for its cure. I sincerely hope the right hon. Gentleman will keep in close association with the Ministry of Agriculture in trying to stamp out tuberculosis amongst dairy cows. We have to remember that 10 per cent. of the samples of milk submitted for sale to the public contain the living germs of tuberculosis. Children and infants in drinking that milk are now affected to a great extent by various forms of tubercle. I hope that the two Ministers will combine to formulate some practical scheme by which the public, and especially the children, will be provided with milk that is perfectly pure. At present we have no sovereign remedy for this disease, but the methods outlined by the Minister of Health to-day will do far more than any millions we can spend in providing mere sanatorium treatment. Sanatorium treatment cannot possibly be expected to effect any marvellous or certain cures after a few weeks or months' residence. What we want to aim at is the provision of permanent centres, where those affected will receive sanatorium treatment and at the same time be taught some occupation and, it may be, have their wives and children living near them. I would like to draw attention to the fact that there are 35,000 soldiers and sailors affected with tuberculosis, and to impress upon my right hon. Friend and the Committee the extreme urgency and importance of giving these men treatment in sanatoria and settlements. I know the right hon. Gentleman referred to it, but the matter is of such great urgency that I hope he will not mind my reminding him of it. I think the speech of the right hon. Gentleman to-day, with its outline of far-reaching schemes, has fully justified the formation of the Ministry. I look forward to very great results in the future, and I certainly hope that all his good intentions will be realised as quickly as possible.
I want to call attention to a remark made by my hon. and gallant Friend the Member for Mossley (Mr. Hopkinson). Dealing with the increase of subsidies, he made a statement based upon his own knowledge and inquiries that each housing subsidy as it has been granted has gone into the increased cost of material, and that so far from helping to solve the housing problem, it has helped to fill the pocket of some exploiter. If that is true, the subsidy has become a menace and a danger as well as a great burden upon the general community. I would emphasise what was said by the Noble Lord (Earl Winterton), that we want every inquiry into this housing difficulty, whether in regard to the workers or in regard to those who deal in materials, and if the statements made by the hon. Member for Mossley are correct, those concerned ought to be pilloried on the floor of the House and throughout the country. Much has been said as to the ever-growing increases of wages. I am quite sure that many of the workers themselves, if they realised that these increases meant that many of their fellow-workers had to be housed worse than cattle, would come with a better frame of mind for dealing with this question. After all, in a great national requirement like this we want to develop what I might call community of interest and civic consciousness in every section, so that the seller of raw material and the seller of labour would recognise that they are co-partners in relieving a great menace to many thousands of people who are badly housed.
The hon. Member for Hendon (Sir P. Lloyd-Greame) raised another question of interest, and from a different point of view the hon. Member for Middles brough (Mr. T. Thomson) seemed to gloat over it. The hon. Member for Hendon was referring to Labour's responsibility regarding the housing problem. I think, at the moment, he was thinking about the large number of soldiers and sailors who are still unemployed and who, with goodwill on both sides, could be used to ease the housing difficulty. The hon. Member said the cast-iron rule of dealing with luxury buildings was creating a lop-sided laboursupply in this country. The hon. Member for Middlesbrough seemed to argue that all over the country brick setters or carpenters were being taken from the building of houses and were being put on the building of cinemas, and that because he had a single instance in one locality, every part of the country was in exactly the same condition, and that such people were building cinemas without rhyme or reason and without consideration for the housing of the people in those localities. I say that that statement is far from being correct. I happen to know much better than the hon. Member those engaged in that industry. Let him not forget that it provides the enjoyment of 20,000,000 of the population and that they are not merely men who are looking to their own main end. There may be one here and there who is doing so, but, broadly speaking, those who are responsible for this great agency of amusement for the working classes are not anxious to take away any section of those engaged in building. They are just as anxious to see the people housed as the hon. Member for Middlesbrough. The hon. Member forgets that in this class of building there is a great number of people who could not be employed or will not be employed on the building of houses. There are wood carvers. They are not going to do ordinary carpenters' work. There are cabinet makers. They will not go to ordinary cabinet work. There are carpet makers and a whole army of other people who find employment. I wish to make my protest against the libel that has been uttered with reference to these people time and time again in this House. I say that they are just as honourable as any Members of this House and just as anxious to see the housing problem settled. But if they can prevent lopsidedness of labour producing unemployment on the one side, they are doing a public service and are not deserving of the hon. Member's castigation. I hope that when the hon. Member gets back to his constituency he will dispute, if he can, my testimony to their good citizenship.
One or two hon. Members have complained about the Minister of Health taking up a very long time in connection with his speech. It may have been a long time, but it was not a moment too long. My complaint is that we have so short a time to debate the matters upon which he informed us. As one who has taken part in public health matters and municipal work for the last 20 years, and has been head of the Public Health Committee of his town for the last 12 years, I am interested in many of the statements made by the right hon. Gentleman. We have all cause for congratulation in the statement that he made with respect to the reduction of infantile mortality in this country. Taking a series of years, he gave a reduction from 155 down to about 80 or 90. In my own town, largely through some of the reforms that were brought about by the Minister of Health and previous gentlemen who held the position, infantile mortality has been reduced from 187 per 1,000 to 97 per 1,000 during the last few years. But in spite of that reduction I was pleased to hear that the right hon. Gentleman is not satisfied, and that he thinks that more can be done. How can you expect children to be healthy and strong and to become decent citizens when they are brought up under the conditions and in homes where a geranium could not live. The problem is acute.
I should like also to say a word of commendation for the way in which the right hon. Gentleman spoke about the centres that had been formed for dealing with venereal disease. The figures that he gave of the increased numbers attending show that the people have confidence in the privacy and secrecy of these centres. We can hope for very great results to the people suffering from that dread disease. One of the points that
struck me in his speech was in connection with sanatoria. The right hon. Gentleman mentioned that during last year accommodation had been built for 2,000 beds. I am sure he knows that there is a very grave deficiency now in the accommodation at the sanatoria, and I hope he will do everything in his power to expedite the matter. There were one or two matters at which I was surprised that he said nothing. If he has time to reply I should like him to give the House some indication of what he intends to do to carry out the recommendations of the International Conference held at Washington in October and November of last year dealing with working women before and after the birth of a child. I should like to draw the right hon. Gentleman's attention to Article 3 of the Recommendations of that Conference, and to ask him whether he intends to bring in legislation to deal with that matter. This is what the Conference recommended:
That working women shall not be permitted to work during six weeks following her confinement; she shall have the right to leave her work if she produces a medical certificate stating that her confinement will probably take place within six weeks, and that whilst she is absent from her work she shall be paid benefit sufficient for the full and healthy maintenance of herself and child, provided either out of public funds or by means of a system of insurance.
The Minister for Health, on 17th June, I think, was asked the following question by the hon. Member for Houghton-le-Spring:
When does he propose to introduce a Bill to give legislative sanction to the proposals regarding the employment of women before and after childbirth, which were adopted at the Washington International Labour Conference.
The answer of the Minister for Health was:
The British official representatives at the Washington Conference refrained from voting on this question. The extent to which the British Government shall adhere to the recommendations of the Conference is at present under consideration. The matters involved largely affect insurance questions, and they are now being carefully considered.
My point is that whether the British official representatives voted or not, the question was brought about by that International Conference for the purpose of uplifting the whole standard of life—lifting up the nations below us to our standard and generally raising the stan-
dard of life. I think we are in honour bound to that Conference to bring in legislation to give effect to those recommendations. I ask the Minister, if he replies, kindly to state what he proposes to do.
Another point I should like to mention is in regard to the child welfare centres. These have done a very great and beneficent work wherever they have been opened. In my own locality we dealt with hundreds of children; thousands of visits were paid, and because in the adjoining areas there were no child welfare centres open, we threw our centre open to the whole of the surrounding public. In my opinion, the Minister of Health is not putting sufficient force behind the public authorities to compel them to open child welfare centres, because in some of the localities that I have named women had to bring their children miles to this welfare centre. There has been some little quickening, especially in the county council area. There have been one or two opened within the last few months in altogether unsuitable premises. They may be temporary premises, but they are altogether unsuitable, and I am sure the Minister of Health knows well that the child welfare centres cannot gain that popularity to which they are entitled unless they are suitably adapted to the purpose. I was present at the opening of one about two months ago where the women had to walk up three flights of steps. I admit it was a temporary building, and probably it was a beginning that will tend to grow, but places like that are altogether unsuitable. With three flights of steps, with no accommodation for the perambulators, welfare centres can hardly gain the popularity and confidence of the mothers that we want to see. My own experience of our own welfare centre is that nothing pleases the mothers so much as finding the voluntary ladies' committees holding meetings amongst the mothers, giving them tea, and conversing with them before the birth of a child, and how to look after the child when it is born. When the mothers bring the children to the welfare centres, nothing pleases them so much as to watch the growth and development of the child. Yet at two centres that I have been present at the opening of within the last few weeks, no weighing machine was available, and they were short of other requisites. I ask the Minister of Health, whose sincerity is beyond question, not only to quicken the pace of the governing bodies that are slow, and to see that child welfare centres are established, but also to take some interest in the suitabilty of the premises, and to see that those already opened are provided with all that makes these places attractive.
In connection with maternity homes, in my own place again we have purchased a building that probably will provide some 15 beds. What I complain of is that the Minister of Health and his Department are not putting sufficient pressure on municipal authorities in these matters. I wish the amount put down for this work was more, because I know the good that it has done. Children are born in places under conditions that are a disgrace to civilisation, and in which the safety of the mother is imperilled and the child itself can hardly be expected to survive. I ask the right hon. Gentleman to expedite the building of these homes, knowing something of the good they have done, and the possible good they might do. I should like to refer to the number of children who are still in the workhouses of this country. Has the right hon. Gentleman no statement to make as to what steps he intends to take to fetch these children out of the workhouses? Has he no statement to make as to how long it will be before he co-ordinates this system with the municipal bodies? What is happening in respect of the treatment of tuberculosis in my own town? The Guardians have a sanatorium there, and just across the road the municipal body has a sanatorium, and the administration of both places has to be kept up. You still have your workhouse schools. You have your workhouse hospitals, and hospitals kept up by voluntary effort or by the State. I do think on these matters the right hon. Gentleman might make some statement, because I am sure the whole of this Committee on public health matters is in accord. Members may complain about the cost of housing, but they never complain about the cost of the health services. We know that health is cheaper than disease, that prevention is better than cure, and it is only by looking after the children of this country that we can expect to get out of the Class C, which the War brought to light. That is as far as my criticism goes, and its object is to try, if possible, to get the Minister of Health to expedite these matters which are of vital importance to the health of the people of this country.
I wish to raise one point, but before I come to it I should like to congratulate the hon. Gentleman who has just sat down upon having delivered a most interesting and eloquent speech, with most of which I cordially agree. In the course of his speech he made reference to the Washington Conference and quoted the convention drawn up there with regard to maternity. He also said, quite truly, that the Government delegates had refrained from voting, and he wanted to know the reason. The reason is perfectly plain. The Government delegates had no mandate, and therefore they refrained from voting, because they did not want to pledge the Government to carry out the convention. The hon. Gentleman considers that we are pledged, nevertheless, because we were represented at Washington. In a sense that may be so, but let me tell him and the Committee that the structure of the labour organisation, that part of the Peace Treaty having to do with labour, was very carefully considered, having that particular point in view. As a matter of fact, the Governments represented at a conference are under a moral obligation to consider the resolutions of that conference. They are properly free to reject them if they think proper, and therefore it is of the utmost importance, if these conferences are to be of assistance to labour throughout the world, that they should not be used for mere propaganda, but should be used all the time with the single object in view of getting practical results, to adopt resolutions and covenants, and only to adopt resolutions arid covenants as to which there may be a reasonable prospect—a pretty sure prospect—that all the Governments represented will pass into law, not in the dim and distant future, but in the year following such convention. These conferences are to be held every year, and therefore the object of the conference is not to pass pious resolutions in regard to things which may be practicable 50 years hence, but in regard to things which we hope and believe may be passed a very few months after the conference has been held. It was because we thought, rightly or wrongly, that the convention as framed was of this propaganda character that we declined to vote for it.
I rose, however, to make an appeal to the colleagues of the party, of which I was once a Member, and with which all my sympathies still lie. I want to appeal to them to use the influence they possess in regard to Labour matters, with special reference to housing. I believe with the hon. Gentleman who has just sat down, that good housing and good health go together, and that you cannot have good health without good housing. A few months ago I noticed in the papers that a resolution had been passed by a Labour Conference demanding that the Government should build a million houses, and, not only that, but the resolution demanded the building of that million houses at once. What does that involve? It seems to me it involves two things. It involves that you should have more labour in the construction of houses, and that you should have the labour in the construction of houses apply itself with zest to doing all it possibly can, consistent with its own health. Therefore. I think it involves upon hon. Gentlemen—I do not like, or want to lecture them; I am speaking as one man to another—who have more influence with the Labour classes in the country—and rightly so—than anybody else, that they should use their influence, first of all, to get, if possible, the building tradesmen to consider the question of how they can increase the number of competent builders of houses in a shorter time than ordinarily, under normal circumstances, is required for the purpose. Bricklayers, carpenters and other people of that sort generally serve five years' apprenticeship. I would ask them to make an appeal to the working men engaged in building houses, and to say to them, "We cannot afford to wait for five years for the ordinary normal apprenticeship, and that some means can be found, and should be found, to increase the number of builders, so that building can be got on more speedily and expeditiously than it is being done."
The second point is this, that each one engaged in the building of houses should do as much as an individual can towards the building of those houses in a given time. I am going to say something which may probably bring me into trouble, but I think somebody ought to say it. There is a disposition in the mind of the average workman not to do his best in the way of turning out products, and there is a very laudable feeling underlying that. He has an idea that if he does less work there will be more work for his mate to do. We all know that the average workman has that feeling. I want to say that to my mind the workman in adopting that attitude is simply paying homage to a stupid fetish—because it is nothing else. Instead of being good for himself, or his class, or to any human being it is to a large extent the cause of this slowness which we all regret in the maturing of the housing schemes. [An HON. MEMBER: "And the cost."]—and the cost as well.
So far as the wage cost is concerned, under modern conditions of industry, with machines being more and more a factor in the calculation, wages do not matter so very much if the men only turn out the stuff. I have no intimate knowledge of building, but I know the feeling in the mind of the average workman. He thinks, as I say, that the less work one man does, the more is left for another. I say that no man can practise that doctrine without being morally the worse for it. I say that no man can practise it without weakening himself and the community economically, and that, far from such men making work for other people, the contrary is the case. Provided only we have production in proper proportions, then the more production there is the more work there is all round. It would, therefore, be a fitting thing if those who have most influence with labour would induce labour, first of all, to agree as much as possible to an increase of their number, without waiting for that long apprenticeship necessary, perhaps, so far, having regard to the fact that there is any amount of building work to be done by every possible man for the next twenty or thirty years, and hence there need be no fear of unemployment. In the second place, men, in the interests of themselves, their fellows, and the community, should, in the trying time through which we are passing, "buck up" and do as much work as they possibly can.
The criticisms which have been urged from various quarters of the House in respect to the operation of the Trade Unions with regard to housing schemes, I think, are very considerably exaggerated. There may be, possibly can be, produced cases where something in the nature of objection to dilution in a particular trade can be found. But it is very difficult to persuade a skilled craftsman to admit cheerfully into the trade union to which he may belong unskilled workers to be trained to that occupation at a time when the members of that particular union are unemployed. Hon. Members who have criticised would probably take another point of view if they were in that same position. I agree with everything that has been said: that all labour available, from whatever point of view, should be roped in to the erection of houses. But it ought to be considered that in almost every society in the country which has within itself members who are engaged in the construction of houses, that many of their own members are unemployed, and even the members that are employed recognise, in many cases, that they are engaged in phases of the building industry which do not come within the range of the erection of houses. They wonder how it is that criticism should be urged against them, that they should open their doors to the unskilled labourer to be taught, with their own members unemployed, and those who are employed working in directions which do not come within the range of the erection of houses.