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I was hoping, with regard to the all-round demand that has been made in reference to housing, that we should receive from the Minister some assurance that in the near future a reversal of the existing housing policy was contemplated. I feel profound disappointment at the Minister's statement with regard to that, and I am inclined to believe that that disappointment is shared by most of us on this side of the Committee. I shall endeavour to meet one or two of the points which have been presented in connection with the housing policy, or the lack of it, but, before dealing with that, I desire briefly to refer to one or two other matters in connection with the Ministry of Health's administration. During the past few weeks the Minister has been assailed by a large number of questions from various angles with reference to the milk supply, and a few days ago I myself put forward a
question upon this matter, in reply to which very little satisfaction was given, and certainly not the satisfaction which I think the subject matter demands. There is no more important service in this country from a public health point of view at the present time than that of the milk supply, upon which the public have to depend. It can be touched upon from many points of view. There is the question of tuberculous milk and there is the point of view of the conditions under which the milk is produced. I desire, however, to draw the particular attention of the Department to the very extensive sale in this country at the present time of milk below the standard quality. It is a feature of the milk supply of this country to which sufficient notice has not been directed. I find, from the Board of Trade Returns for 1920 and 1921—the 1921 figures have been given to me by the President of the Board of Trade—that over 22,000 mechanical cream separators were imported into this country in those two years. These articles are not brought into the country for ornamental purposes. They are brought in for use, and these appliances are in general use all over the country. As soon as the milk is produced, the mechanical appliance is set to work, the cream is extracted, and the milk, before it, is a quarter-of-an hour old, has had all its nutritive properties extracted; and this commodity is being sold all over the country. The Milk and Dairies Act, 1915, contained a Section which, if it had been put into operation, was intended to make provision for this matter. This Section reads:
Every tin or other receptacle containing condensed separated or skimmed milk must bear a label, clearly visible to the purchaser, on which the words 'Machine-Skimmed Milk' or 'Skimmed Milk,' as the case may require, are printed in large and legible type, and if any person sells or exposes or offers for sale condensed separated or skimmed milk in contravention of this Section, he shall be liable on summary conviction to a fine not exceeding ten pounds.
That Section of the Act of 1915 has not been put into operation. Why was it incorporated in the Act? It was, I presume, because it was considered to be necessary. If it was necessary then, it is necessary now, having regard to the extensive use of these mechanical appliances for extracting the cream from the milk, and to the large quantities of this milk which are offered for sale to the
public. The Minister of Health suggested that the public had ample protection against anything in this direction under the Sale of Food and Drugs Act. I do not agree, and I do not think that the statistics of samples of milk taken and convictions recorded justify the statement of the Minister. While it is not necessary to assume that every milk vendor is a rogue, and that he is endeavouring to palm off this separated milk, which is worthless, as the genuine article, there is another aspect of the matter which is extremely important. We are living in very bad times, when the earning capacity of a large number of people has been lowered, and the financial means at their disposal are extremely limited. These poor people, having regard to the fact that they can buy this separated milk cheaply, are attracted to the commodity from that point of view, but they may just as well, from the point of view of its nutritive properties, be purchasing water from the ordinary domestic water tap. I know that this milk is being sold in large quantities, and I would urge upon the Minister and upon the Department that the matter merits more consideration than it has received. I would suggest that the Department look into this aspect of the matter and the way in which the public are being served in this direction.
The next matter to which I desire to refer in connection with the Ministry of Health service is that of maternity and infant welfare, which has not been referred to during the course of this discussion. A very doubtful change of policy is in prospect. As far as children and nursing mothers are concerned, the policy has fluctuated at different times. We were permitted, as local authorities, to distribute milk to children and nursing mothers as part of the administration of the Department, and 50 per cent. of the cost was received from the Exchequer. Subsequently something caused the Ministry of Health to modify that financial arrangement, and they sent out a Circular intimating that, so far as the milk was concerned, only 5 per cent. of financial help would be granted. Questions put to the Minister in the House of Commons got from him the concession that he would leave the old order intact until the 31st March, and the old practice of granting assistance to the extent of
50 per cent. is at the present moment in operation. A much more drastic change, however, is now contemplated. A further Circular has reached the local authorities of the country, which indicates that it is proposed to abandon the granting of milk to children and nursing mothers on the principle hitherto prevailing, and it suggests that an innovation shall at least be attempted which, in my judgment, is an exceedingly foolish one, and not likely to have any beneficial results. The local authorities are asked to estimate the expenditure that will be incurred during the year 1922–23 in supplying a midday meal to expectant and nursing mothers. Expectant and nursing mothers are not likely to go down to the town hall seeking a midday meal. It is not reasonable to expect them to do so. That they must go there is evidenced by the fact that the Circular contains this paragraph:
The local authority shall not incur any fresh expenditure in providing premises for dining centres, and, where they have no suitable buildings at which dinners could be served, they should endeavour to make a contract for the supply of the meals required. Further, the women to whom these dinners are supplied should be required to attend with reasonable regularity, and should pay a proportion of the cost where they can afford it. The meals should be consumed on the premises, except immediately before or after confinement. The cost of the meal to the local authority should not, as a rule, exceed 6d. per head per meal.
That is what I would term the lame alternative which is to be submitted to nursing mothers in lieu of the assistance which has been given to them under the old dispensation. I suggest that, if it is attempted by the local authorities—I do not expect it will be; it does not deserve to be—it will break down. If it is an attempt on the part of the Ministry to economise by offering this alternative, and thus disposing of the liability they have had—if the Minister tells us that that is the intention—we can quite understand that the object in view is likely to be achieved.
Some reference has been made to the question of tuberculosis, and I regret to find in the Estimate a reduction for the coming year of £359,000 under that head. I agree that on the other side there is a new item of £175,000 for the provision of sanatoria, and that reduces the sum I have named to just under £200,000. We cannot afford to cut this Department to that extent, and we ought not to attempt to do so. I have often said in the House of Commons, and I repeat it, that, for the expenditure which is at present being incurred in the treatment of tuberculosis, we are not getting value for the money and energy expended. I do not mean that from the point of view put forward by the hon. Member for Wood Green (Mr. G. Locker-Lampson). I am not at all criticising the nature of the treatment. I do not say that we are spending too much on institutional treatment, or that we are not getting the best advantages from it. My great point is, and in this matter I speak with some opportunity for close observation, that we do not get hold of the consumptive persons in this country early enough. The great trouble in this matter appears to be the difficulty of early diagnosis of this disease. The medical men of the country either fail to effect a sufficiently early diagnosis of the disease, or they neglect to disclose the fact when they have found it. Whichever it be, the people who are called upon to administer this side of our health services do not get the material into their hands soon enough to produce the best results.
The figures relating to this matter are very significant. In 1913, for every 12 cases of tuberculosis notified there were 5 deaths; but in 1920, for every 7 cases notified there were 4 deaths. The deaths were in the proportion of 5 to 12 in 1913, and of 4 to 7 in 1920, so that we were actually getting a greater proportion of deaths from tuberculosis, in proportion to the number notified, in 1920 than was the case in 1913. Anyone who has had experience of the administration of this side of our public health service must be absolutely appalled at the number of deaths from tuberculosis immediately following the date of notification. Within my own experience, I have come across cases in which the death of a person has occurred from tuberculosis which has never been notified at all. This is not a matter of new expenditure; it is a question of stiffening up the administrative side of the Ministry of Health medical service. I agree that this point deals exclusively with the ameliorative side of this problem. The ameliorative aspect of tuberculosis is only a minor factor. When we have done the best we can on the side to which we are referring, there still remains the necessity of a recognised
system of after-care treatment, and there still remains the greater aspect of the question, that of prevention, and we cannot dissociate the prevention of tuberculosis from the great housing problem. We have heard in this discussion some references to overcrowding. I believe the overcrowding of our industrial populations in the cities and towns is one of the chief factors which create tuberculosis and assist it to flourish. The recognised greatest authority upon tuberculosis, the gentleman who discovered in the first instance the tubercle bacilli, committed himself to this declaration, the great Dr. Koch himself:
It is the overcrowded dwellings of the poor that we have to regard as the real breeding places of tuberculosis. It is out of them where the disease always crops up anew, and it is to the abolition of these conditions that we must first and foremost direct our attention if we are to attack the evil at its roots.
Everyone who has looked into this aspect of the matter will agree with that pronouncement, and I was absolutely startled to hear some of the declarations by the Minister upon this matter. The old Local Government Board, before the inception of the Ministry of Health, or some Department acting for it, fixed the standard of overcrowding, and their standard was that a house was occupied on an average by more than two persons per room. The 1911 Census disclosed the fact that, taking the whole of England and Wales, something like 8 or 9 per cent. of the population were living in overcrowded conditions. Further investigation into this matter indicates that in some parts of the country a much larger percentage than that prevails. If you go to Devonport and Plymouth you have an average of 16 and 17 per cent. overcrowded. St. Helens, the highest I can find in Lancashire, was 17 per cent. If you get to the North East Coast, in Sunderland and Gateshead there are 32 and 33 per cent. of the population living in an overcrowded condition. In eight of the Metropolitan boroughs, you find 23 to 39 per cent. of the population living in these overcrowded conditions. If that was the census of 1911, what must be the conditions that prevail at the present time? I am positively astounded to hear the Minister of Health indicate that one of the methods of dealing with the housing problem was for the local authorities to
take over the Housing Acts and repair, as far as possible, existing houses. We had a good long spell at that before the outbreak of the War, and the local authorities patched up undesirable property on all sides, and what is more, they closed a large number of houses, and I can tell the Minister, and I guarantee that my colleagues can support what I am going to say, that in those days the houses were closed by the order of the local authority and remained closed for a considerable period. Some of them are now occupied, because there was no other accommodation to be found. The remedy for the present condition of housing is not to be found in that direction, because we have in all the industrial towns tremendous areas of cheaply-erected house property which has been standing 40, 50 or 60 years, the product of the early factory system. All those houses are going bad at the same time and at the same rate, and the wholesale policy of patching up will not touch the fringe of this problem. Those houses ought to be emptied of their population. They ought not to be patched up, because when you have made a back to back house the most desirable place possible, with repairs and ventilation and all the rest of it, it still remains an undesirable habitation. It still remains a place where the infantile death rate will be high and the prospect of tuberculosis will be very pronounced. We have to empty those places, and we can only empty them by erecting new houses for the people to leave them.
I was also very much surprised at the Minister of Health throwing some doubts upon the estimates which have been made of the number of houses that are required, in a statement by the ex-Minister of Health and a speech that he made to a deputation in 1916. I was a member of that deputation, and I remember well that it was represented to the President of the Local Government Board, as he then was, that 100,000 houses were required every year to meet the normal growth of the population, and an additional 50,000 houses were required every year to meet those that were dilapidated and worn out, and that figure of 150,000 houses has been accepted, not only by representatives of the Government but also by experts in this matter of housing requirements in many walks of life. [An HON. MEMBER: "NO."] It was accepted on that occasion as being a reasonable demand for the housing requirements of the country. The Prime Minister, in December, 1920, committed himself to the belief that 500,000 houses are required and now, seven years after the outbreak of the War, when we are told that 176,000 is the sum total of houses erected, houses started, and houses contemplated, we have the Minister of Health telling us that the margin of that 176,000 houses which is yet incomplete, is the great work in front of us to complete. We cannot accept that as a solution of the housing problem. They do not more than produce one year's requirements, and I suggest, with some little knowledge of our industrial population, that there is not an industrial town in this country with over 50,000 population which does not need several thousands of houses at this moment. If the right hon. Baronet is inclined to doubt that position let me make this enquiry. Is it a fact that applications from prospective tenants to the local authorities in the places I am going to name have been made to the extent I am going to quote—15,000 in Glasgow; 25,000 in London; 9,000 in Manchester, and 5,000 in Leeds? I invite the reply of the Minister to that question. Further, does he doubt the estimate which was made by the local authorities when that circular was sent out to them? I was a member of a local authority at the time and I know the method we adopted in endeavouring to arrive at an estimate of the houses that were required, and the sum total was 800,000 houses. I will put another question to the Minister. If any of those local authorities who made that, estimate can make good their claim and justify their estimate, will he agree to that number of houses being erected by that local authority? There are points of some substance in this matter, particularly having regard to the exceedingly lame position which has been presented by the Minister himself.
With reference to the aspect of the question which was referred to by the hon. Member for West Middlesbrough (Mr. T. Thomson) we all know the difficulties of the financial situation, but here again the indictment is against the Government who initiated that policy. There never was such a policy in public administration with as much muddle in it as the policy which has moved in the direction of building these houses. What does the Ministry of Health do when a local authority wants to borrow some money for a public service of any kind? The period of borrowing is based upon the life of the service that is going to be put into operation. If it is a road, it is 30 years; if it is a bridge, it is 60; if it is a house, it is 60. But the first principle of municipal borrowing sanctioned by the Ministry of Health is that, whatever service is provided, at any period of its life it will be worth as much as the outstanding debt that is against it. If we have paid for 20 years on a loan and there are 40 years still to run, the service that has been produced is worth the outstanding debt and will realise upon the market the outstanding debt that is against it. There is not a single house which has been erected under the Government scheme which will produce at the present time in the open market anything like the figure it has cost. That is obvious to everyone. I will go further. There never will be a time in the life of any of these houses which have been erected when they will yield as much money in the open market as the outstanding debt that there is against them at any period in the life of the house—I am making allowance for a possible reduction in the rate of interest—because we know what many of these houses have been. The Government ought to have seen that. They would have expected a local authority to see it. As a matter of fact local authorities did see it, but they were led to believe that after their responsibilities had been met the balance would come from some other quarter.
I regret that the right hon. Baronet the Member for the City of London (Sir F. Banbury) is not present. Some time ago he inquired with dismay where this balance was to come from. We heard a great deal about the economic rent, and everybody realised that the economic rent could not be charged, whereupon the right hon. Baronet looked across to this side of the House, and, with a note of alarm and dismay, inquired where the balance was to come from to pay for the houses. We answered, and quite rightly, that it would come from the same place where the balance came from to pay the railway companies their compensation. As soon as it was found that the railway companies could substantiate their claim to £60,000,000 from the Government—which we say was done very unfairly and very inequitably—there was no question as to where the money was to come from. As soon as it was established to the satisfaction of the Government, they dipped into the public exchequer and handed out £30,000,000 last year and £30,000,000 this year to the railway companies. We are entitled to say to the right hon. Baronet that where the railway companies have found their spoil at least some measure of assistance should be given from the same source to the housing needs of the country.
We are hearing great complaints from all parts of the country about housing schemes being held up. We are entitled to expect that some of the partially completed schemes should go ahead, having regard to the fact that labour is now available, and that materials can be found in abundance. I will give an instance to illustrate my point. At Ilford the local authority proposed to erect 2,000 houses. They got sanction for 638. They erected 220, and they have at the present time 418 houses incomplete, the sewers for which are laid, the roads made and the foundations put in, and they are only waiting for some assistance and some encouragement from the Ministry of Health to go ahead with the work. It is all very well, for the Minister of Health to say that the local authorities should proceed with the schemes that have been sanctioned, but who has put on the brake? The Ministry of Health has applied the brake to these schemes, and it does not convey an accurate representation of the case to complain, as the Minister of Health did, that the local authorities are not proceeding with their schemes, when at the same time they are not proceeding with them because of the pressure from the Ministry of Health at Whitehall. The works that have been executed in connection with the Ilford scheme are estimated to cost about £20,000, and the authority are anxious to proceed with the work.
With regard to the controversy which has arisen about the shortage of labour, the hon. Member for Central Edinburgh (Mr. W. Graham) has drawn the attention of the Minister of Health to the fact that an arrangement has been made between the plasterers and bricklayers in the Manchester area that if there is a shortage of plasterers, the bricklayer will do that work if there is one avail- able. It has been suggested from the Front Bench to-day that there are no plasterers out of employment. Since the Debate started I have had a statement put into my hands, from a reliable source, that on the 31st January, 1922, the official figure of people unemployed in the building trade was 176,119, including 740 plasterers. I have also a letter from the National Federation of Building Trades Operatives, who at least can be accepted as an authority, and they tell me that at the present time the total number of people unemployed in the building trades has reached 210,815, and that 30,000 people in the building trades have been discharged since October. That there is plenty of labour available cannot be denied, and that materials can be found in abundance must also be accepted, and when we have the Minister of Health's statement that the cost of housing has gone down by at least one-half, there is no reason why some stimulus should not be given by his Department to enable the schemes to proceed.
One very awkward fact emerges. Some months ago in this House very violent criticism, and a great deal of unreasonable criticism, was directed to this side of the House about what was called the dilution of the building trade with ex-service men. The Prime Minister and other responsible Ministers visualised the possibilities of work in the building trade, which was extensive and likely to be prolonged. Here we had a field where labour was required, and where there was a shortage of that labour. Why should not ex-service men be admitted into the building trade? Ex-service men were admitted into the building trade. Thousands of them have entered the various training establishments in connection with various phases of the building trade, and the Government have taken certain responsibilities by establishing centres. I believe there is one at Hull. Ex-service men were put in these establishments and trained in the various phases of the building trade, and then the building schemes have been stopped, and we have thousands of ex-service men partly trained to do work in connection with the building of houses out of work. We have scores of thousands of skilled men in the trade itself out of employment. What chance, therefore, is there of a half-trained ex-service man finding a job in the building trade at the present time? The policy of the Government has been absolutely cruel towards these men by leading them to hope that there would be abundance of opportunity for employment in the building trade, by spending money in the training of them, and then taking the lead in hanging up the housing scheme and throwing these men on the labour market, out of a job. Therefore, not only does the Government's action operate to the disadvantage of the people who could find regular employment in the building trade, but it also operates in a repressive sort of way on the ex-service men.
The declaration of the Minister of Health to-day will be looked upon throughout the country with profound disappointment. We were entitled to look for something better at this juncture. The urgent need of houses is admitted, however much the Minister may endeavour to side-track that belief. Everybody connected with an industrial area is made vitally alive to that fact. In these days when there is so much unemployment admittedly in occupations concerned with the building of houses, and at a time when schools are required by the hundred all over the country, if there is one Department of public activity which might be stimulated from the point of view of the benefit which it would bring to the community at large, quite regardless of the incidental advantage to the people in the trade, it is the building trade of this country. When we add to that the happiness and comfort it would bring to many people who now require decent houses, all the advantages taken together indicate an irresistible case for a definite step forward to be taken in this direction. The three essentials of life are food, clothing, and shelter. Shelter is the one thing which is deficient in this country at present, and from the point of view of the physical and moral development of our people it is not the least essential. Once more I must express profound disappointment, which is shared by my colleagues, at the very unsatisfactory defence of his policy put forward by the Minister of Health.