Ministry of Health.

Part of Civil Services and Revenue Departments Supplementary Estimate, 1921–22. – in the House of Commons at on 27 February 1922.

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Photo of Mr Godfrey Locker-Lampson Mr Godfrey Locker-Lampson , Wood Green

I am glad we have once more the privilege of the presence in the Committee of my right hon. Friend the Minister of Health. During his absence one or two very important questions were asked, of which I have no doubt the hon. Member for West Woolwich (Sir Kingsley Wood) has taken note. Nearly the whole of this discussion has been directed to the question of housing. With the exception of one or two sentences, nothing has been said about the treatment of tuberculosis. I agree with the Mover of the Amendment—if I am not misinterpreting him—when he says that he doubts whether for the vast sums of money which we are spending on the treatment of tuberculosis we are getting full value. I very much doubt myself whether we get anything like full value, and this is a matter which we should look into, because the increases now being asked for are very heavy. My right hon. Friend the Minister of Health is asking in this Supplementary Estimate for an increase equal to 42 per cent. of the whole original Estimate for the treatment of tuberculosis, and he is also asking as a Supplementary Estimate for no less than 12 per cent, of the original Estimate for maternity and child welfare administration in Wales alone. I expect the reply of the right hon. Gentleman will be that this is merely keeping a bargain with the local authorities. No doubt during recent years great pressure has-been brought to bear on local authorities to act, very often in a direction which they did not consider the best or most expedient for dealing with this particular question. But these increases are all the more curious in view of Circular No. 182 which was issued by the former Minister of Health now sitting on the Front Opposition Bench. In regard to the treatment of tuberculosis, in that Circular he said: Cases where schemes have been approved but work not commenced should generally be postponed. He also asks for a reconsideration of the present schemes of dealing with this grave scourge, and as regards maternity treatment and child welfare, he said: Every effort should be made to reduce the cost of maintaining the existing centres. In spite of that Circular, we have these very large increases, and although my hon. Friend the Member for West Middlesbrough (Mr. T. Thomson) welcomes them, we have to remember that not only are they large increases on last year, but that last year's Estimates were very large increases on those of the year before. In 1920–1, £754,000 was spent on the treatment of tuberculosis and £800,000 on the maternity side, which is to say that in the treatment of tuberculosis the cost in one year was doubled, or more than doubled. It is quite clear there has been a very great expansion in the expenditure on these particular services. I do not in the least grudge expenditure of this kind, nor, I am sure, does anybody here, but we have to make up our minds as to whether or not it is wise expenditure. In April last year, the Insurance Committees gave up their work in connection with sanatorium benefit, and a great many of the Committees issued reports of their experiences of the previous 8¾ years during which they had administered that benefit. Nearly all these, reports showed that the results of sanatorium treatment were extremely disappointing. Even in the case of the non-insured, the better class, this was so, and the death rate at Midhurst was enormously high. The Chief Medical Officer of the Ministry of Health said: The sanatorium, as it has often been worked, has not yielded its full value, and in some instances has, without doubt, in this and other countries, been a failure. I am merely speaking as a layman, from figures, but there are hon. Members present who are technical experts on this question, and who will be able to give their opinion. There is no doubt, however, that according to statistics, the death rate from tuberculosis fell most rapidly in the years before institutional treatment began. In 1912 sanatorium benefit began. In 1913 it was getting into full swing, and in 1914, when it was in complete working order, there was an increase in the death rate from tuberculosis, and from 1914 until 1919 the death rate went up steadily. If you take the period of the War, leaving out the male population altogether, you will find that during the War there was a continuous increase in the female death rate from tuberculosis until, in 1918, it was higher than it had been during any year since 1901. For women I find that the lowest death rate on record was in 1913 before any of this treatment commenced. Then we only spent £117,000 upon it.