Orders of the Day — National Health Insurance, Contributory Pensions and Workmen's Compensation Bill.

Part of the debate – in the House of Commons on 15th July 1941.

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Photo of Mr Rhys Davies Mr Rhys Davies , Westhoughton

I am sure my right hon. Friend the Secretary of State for Scotland will be more than pleased with the way this Bill which he introduced to-day has been received by the House of Commons. Nearly everybody has said that he welcomes the Bill, but there was a big "but" in each of the speeches delivered. I have that big "but," too. I welcome the Bill, but regard it as just a makeshift; and the right hon. Gentleman admitted so much in introducing the Measure. There is no doubt at all that the Bill is necessary, although it is only a short and puny Measure. It is a Measure which provides that cash benefits may catch up with the increased cost of living; it is not much more than that. In the case of non-manual workers, however —and I should imagine that there will be tens if not hundreds of thousands of them—they will benefit very much by the passing of this Measure. The Bill will do a great deal of good to them apart altogether from an increase in the rates of benefits. In short, this Bill covers Health Insurance benefits and the raising of the income limit for non-manual workers in connection with workmen's compensation and National Health Insurance.

Perhaps the House will forgive me if I utter just one jarring note. Financially, the Bill would not have been necessary at all were it not for the fact that the present Prime Minister, when he was Chancellor of the Exchequer, reduced the State subsidy to the funds of the Health Insurance scheme by over £2,000,000 per annum. You could have given an increase of 3s., 6s., 9s., or even 12s. per week if all that money had been allowed to accumulate since 1926 up to the present. The right hon. Gentleman the Minister of Health must not look quite so furious at me when I say that, because I am sure it is true. He, like me, may not be a very good statistician. The National Health Insurance scheme has come, naturally and rightly, under a great deal of criticism to-day. But it has been very helpful. Criticisms have been levelled against it from time to time both inside and outside the House of Commons, but the one thing we have to remember is that it is still probably the largest, most important and soundest financially of all our schemes; and it is worth while, therefore, that it should be brought under review in the House of Commons by a Debate of this kind. I regard the small grant made by the State towards the National Health Insurance scheme as the most effective subsidy of all towards social amelioration. The subsidy is not very much, but it provides the Government with the right to audit the accounts of the approved societies.

I would like to project my mind into the future of these schemes. Like my hon. Friend, I have no illusions as to what may happen at the end of the war. I do not forget the time when in a financial crisis we were all asked to tighten our belts. I am afraid that at the end of this war there will be no belts to tighten for some people, but I will leave that point there. I understand that the Minister without Portfolio has appointed a committee of very eminent persons to prepare us for a great advance in the field of social security; naturally we are all delighted that that work is going on, and we wish the survey every success.

I have tried to calculate how many persons will be affected under this Bill by the addition of 3s. per week disablement benefit because they will be the most tragic cases of all. There are about 350,000 persons always on disablement benefit of from 10s. a week down to 7s. 6d., or, in the case of women, to 6s. Most of them are likely to be on their sick beds; and it is a very remarkable comment on our democracy that, if you have 350,000 persons completely unorganised and voiceless, nobody takes the slightest notice of them. If, however, you have 350,000 persons in good health, all of them organised, and they have a mentality for politics, they can often get something done, and good luck to them. It is to that 350,000 that I think that this Bill will be most welcome. The increase is only 3s., but that is a lot if you have not very much to live on. Strange enough, nobody has made any reference to the greatest omission of all from this Bill. The three cash benefits under National Health Insurance are sickness, disablement and maternity benefits. There is no word here about maternity benefit, and I would like to know why, because this is quite as important a service as either of the other two.

I would like now to say a word or two about health insurance in general. I hope the House of Commons will never forget this fact—that the main objective of health insurance is not the payment of cash benefits, but the prevention of illness. Quite frankly, since the scheme was established the mass of the people seem to have developed the mentality of believing that this scheme is primarily for the purpose of providing cash benefits. As some hon. Members know, there were provisions under the original Act whereby you could classify the records of certain employments over a given period and said to the employer, "You employ 1,000 persons, and the average rate of sickness among them is far too high. Is there not something wrong with the ventilation or sanitation of your factory? If so, you must remedy all that in order to reduce the sickness rate among your employees."Now all that has disappeared. What I would like to do is to switch the outlook of the people back to the original aim of the scheme—to prevent illness and not merely to pay cash benefits when illness comes along. Let us remember the old adage, "Prevention is better than cure."

My hon. Friend the Member for Rochdale (Dr. Morgan) knows better than most of us that the health of the people of this country has improved enormously during the last two decades. The infantile mortality rate has been halved in the last 30 years; and anybody who cares to study the vital statistics of this country and relate them to National Health Insurance will see the benefit in improved health that has been derived from this scheme. There are, however, two diseases that seem still to baffle the medical profession and the Ministry itself—cancer and rheumatism. Strange as it may seem, once you conquer one fell disease, another seems to emerge.

I welcome very much what is probably the greatest achievement of all in this Bill—the equalisation of the increase in the benefit. It does not equalise benefit; it simply equalises the increase on the original benefits. There is the natural complaint that because an insured contributor pays a given contribution he does not receive the same benefit for that contribution as others. I think the Government will have to face that complaint. I happen to be the secretary of a Society that is regarded by some as being very well-to-do, and I like to think that it is so because I am the secretary, although nobody else believes that. Let me say one thing, with due humility, to the Beveridge Committee on that score. We are told that if you nationalise National Health Insurance and equalise benefits you must automatically abolish the approved society system. But I should have thought that without abolishing approved societies you could' value the whole of the assets and liabilities of all the societies in one unit, instead of valuing 7,000 separate units once every five years, as is the case at present. Additional benefits do not matter for the argument I am now putting forward. This complaint about the differentiation of benefits will persist, and I doubt if there is any alternative except to lay it down that all benefits paid under this scheme shall be statutory. If you add other statutory benefits, as I think you must, to the three main benefits —sickness, disablement and maternity—there are one or two you can add without much difficulty. I think dental benefit ought to be made statutory; it is one of the most beneficial of all benefits.

I cannot speak for my society, but as a politician I am willing to advocate that all benefits under this scheme should be statutory and not dependent on the valuation and surpluses of individual societies. There is another benefit that might be made statutory too. The time has arrived when medical attention ought to be provided for the dependants of insured persons on exactly the same basis as that provided for insured persons. What is the position now? The population of this country is roughly about 44,000,000, of whom 20,000,000 are already within the National Health Insurance scheme. Strange as it may seem, that 20,000,000 of the population have about 20,000,000 dependants. That would cover 40,000,000 out of the 44,000,000 of our population, and so far as I can understand it, that is one of the most necessary steps that can be taken. I am firmly of the opinion that an extension of medical attention for the non-insured population can be more easily provided through the National Health Insurance scheme. The Minister shakes his head. That is exactly what these Scotsmen do. It is strange, by the way, that we have had a Scotsman to introduce the Bill, a Scotsman is to reply and that a Scots lady is sitting next to the Minister. [HON. MEMBERS: "Withdraw"]. Well, politically the Minister of Health is a Scotsman.