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The discussion so far has been mainly in connection with housing. I wish to divert it from that for some moments, and to call the attention of the Minister of Health to a circular which was issued by his Department in November last. I feel sure that when he hears about it he will be disposed to withdraw the paragraph of which I complain. In the circular which is numbered 257, the Minister says that he considers that local authorities should require a contribution towards the cost of residential treatment of persons suffering from tuberculosis. I am proud to think that very few local authorities have adopted the right hon. Gentleman's suggestion, but I know of one case in which a local authority has required a consumptive to pay a certain sum as a condition of entering a sanatorium. This is a violation of pledges which have been given by the Minister of Health. We have heard a great deal in this House of pledges to ex-service men, bondholders, and others, which have been broken, but I wish now to draw attention to a pledge which has been broken which was given to persons suffering from consumption in this country.
The issue of the circular is without precedent. When the Insurance Act came into operation insured persons who came under that scheme were entitled by law to receive sanatorium treatment because they paid for it in their contributions. Then the Minister of Health suddenly found out that overlapping was occurring as between local authorities and insurance committees, and in May, 1920, he secured the passage of a Bill transferring from the insurance committees to the local authorities the duty of providing sanatorium treatment. The statement was made from that bench then that the transfer of duties was made definitely in favour of the consumptive, and yet we find this circular issued with the consequences which I have mentioned. If persons suffer from any other disease, contagious or infectious, typhoid or scarlet fever, no local authority would, and the Minister of Health would not ask them to, require persons suffering from those diseases to pay any sum whatever for entering into an institution. Why is there this difference in the case of a consumptive?
Consumption is a dread disease, a disease of poverty, poverty of food, of clothing and decent housing conditions. The right hon. Gentleman has created a very bad feeling among insured people by the circular to which I have referred. To require, as the circular does, that an insured person who is a consumptive should pay as a condition of entering a sanatorium will act as a deterrent against the individual entering the sanatorium at all. I can give a case in which it has been put to a man suffering from consumption that he must hand over his State insurance benefit as a condition of treatment in the sanatorium, and, rather than leave his wife and children without any income by paying the money to the sanatorium authorities, the man has remained at home. He is now consumptive and is probably transferring the disease to his own family. I hope that we shall have a pledge from the Minister that he will withdraw the paragraph complained of and keep the promise made from that Bench to all people suffering from consumption, which promise was made when the Bill I have referred to was passing into law.
On the question of the treatment of tuberculous people I wish to draw attention to the valuable work that has been done in this country. In 1915 the number of primary notifications was 90,592, and the amount spent on the service was £245,000. The amount increased year by year until 1920, when the sum spent on the work was £754,000, but there was a decrease approximately of 20,000 in the primary notifications of tuberculous people in this country, and the number of deaths decreased by 13,000 in that period. Those figures will show that the more we spend and spend wisely in this direction on the cure of consumptives, the more good work we do in this matter.
I would like also to say something on the question of housing. Manchester, the city in which I live, is afflicted very much with overcrowding. I hope that some of the speeches delivered to-day will help the Minister in connection with this very important matter. A census of overcrowding has been taken in our city. I do not want to weary the Committee with figures, but I quote one case in order that the Minister may be moved to do something more than he is doing at the moment. Strangely enough, the case which I am quoting has occurred within a few yards of where the Prime Minister was born, and the Prime Minister once talked of houses fit for heroes to live in. There are at present, for the heroes of whom he spoke, few houses in Ardwick, Manchester. I give as an illustration of what is actually happening, a case in which there are two rooms up and two down where the man, his wife, and 10 children, 12 persons in all, are living in four rooms. That is not the worst case. I have it on very good authority that the number of cases of incest brought before the police court in our city is on the increase, and that those cases are attributed in the main to overcrowding. I trust that this point will be borne in mind by the right hon. Gentleman when he replies.
Between 1905 and 1910 there were 11,983 houses built in our city, which was an average of 2,396 per annum. In the next five years the average had fallen to 961; within the last five years the average was only 67 for a population of 750,000. On account of the shortage of houses there is a great deal of farming of houses going on in Manchester. There are people in our city who own houses, and they farm them by putting a family in each of the five or six rooms in that house at an extortionate charge. This exemplifies what is happening in our city. There are 1,686 rooms farmed by these people, and the number of persons in these rooms is 4,221. An hon. Member referred to the immorality that comes from overcrowding. I agree with him, but I could never understand any man saying that sedition comes from over crowding. I thought that it required a clean heart, mind and intellect to know anything about sedition. You cannot get those from overcrowding. On the question of approved societies I wish to say a few words. It is assumed in this country that the State Health Insurance scheme is a national scheme. It is nothing of the kind. There are in this country several thousand approved societies, and each approved society has its own method of handling its business. I would ask the Minister to take into consideration the nationalisation of the whole of the schemes, and—