Clause 1. — (Appointment and functions of Minister of Social Insurance.)

Part of Orders of the Day — Ministry of Social Insurance Bill – in the House of Commons at 12:00 am on 14 November 1944.

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Photo of Sir William Jowitt Sir William Jowitt , Ashton-under-Lyne 12:00, 14 November 1944

I hope I can give some reassurance to the Scottish Members, and, incidentally, also to Welsh Members. The object of setting up this Ministry is to make one Minister solely responsible for the various schemes of social insurance, assistance, including supplementary pensions and workmen's compensation. If the Amendment were accepted, we should get a complete division of authority, and this would result. The new Minister would be responsible for health insurance payments in England and Wales, for unemployment insurance payments throughout Great Britain, contributory pensions in England and Wales, assistance other than by way of supplementary pensions in Great Britain, supplementary pensions in England and Wales, old age over 70 pensions in England and Wales and workmen's compensation in Great Britain. That would be a quite unworkable set-up. What I propose is this. In the first place, it seems to me that the main principle upon which the new Ministry must work is devolution. It must decentralise. It must leave, as far as possible, Scottish officers sitting in Scotland to deal with Scottish problems with the very minimum of interference and reference to England. As far as the 340 officers who feared that they may find themselves removed from Edinburgh to London are concerned, many of them may be married people and I can understand that it would be a serious matter for them, but I do not think there is the slightest reason to fear any such thing. My intention, as far as I have anything to do with it, is that Scottish problems shall be settled in Scotland. I think I can do something to improve upon the present lay-out very considerably.

It is so easy to say that these problems all come under the Secretary of State for Scotland to-day but I would ask the Committee to consider in what sense they do. Let us always distinguish between medical benefit and sickness benefit. They are terms of art and they are defined in the Act of 1936. Medical benefit means treatment and attendance, sickness benefit means, of course, periodical payments which, after a time, give rise to disablement benefit and so on. Both benefits are, in some sense, at present, under the Secretary of State for Scotland but observe in what sense. Medical benefit is, of course, run through insurance committees and the Secretary of State for Scotland has power to give directions and instructions to insurance committees about this, that and the other matter. Sickness benefit to-day is run through approved societies, and the Secretary of State for Scotland has the right to make rules and regulations concerning approved societies, but the link that ought to be provided by the Secretary of State having ultimate control of both these functions fails in its effect altogether by reason of the fact that he has not got control at the critical point of time.

For instance, the right hon. and gallant Gentleman the Member for Kelvingrove (Lieut.-Colonel Elliot) last week referred to the fact that there were shelves upon shelves of medical reports which were not used, and that is true, because these reports belong to 101 different approved societies and there is no system whereby they communicate either to the Ministry of Health in England or to the Secretary of State for Scotland the conclusions that they ought to draw from the vast mass of statistics which they accumulate. If, for instance, an epidemic is breaking out in one of our great cities in England or Scotland there is no means by which the approved societies can communicate with the Ministry of Health. If there is one area of a town which shows a greater incidence of disease, which may point to bad drains or bad housing conditions, there is no system whereby they communicate in any way with the Ministry of Health or the Secretary of State for Scotland. Those Ministers have to rely for their medical statistics on other methods altogether. They have their own clinics and hospitals. In so far as their own doctors are consulted, information filters through but this great source of potential information, which might be of such enormous value in enabling health visitors to carry out their job, is denied them. Under the new dispensation I hope that this will happen. If you are to have a co-ordinated system of paying these sickness benefits, which, of course, are paid on the faith of doctors' certificates, I hope we will have a department which will see to it that these statistics are analysed and gone through and checked so that useful information can be obtained, and the department will be run in collaboration between the Minister of National Insurance and the Secretary of State for Scotland, so that we shall be able to give him what he has never been able to have before, the mass of information which comes from the payment of sickness benefit, based, as it must be, on doctors' certificates. It may be found that a large number of people in a particular area, at a particular time, are getting benefits. That would be at once a pointer, and the medical officer would look into it to see what is the matter. That is something which you cannot do to-day.

2.45 p.m.

Therefore, without being able to give details—the details have not yet been worked out—arrangements will be made to enable Scottish business to be settled on the spot with the minimum of reference to the headquarters of the Ministry in London, and that the Ministry in Scotland will keep in the closest touch with the officers of the Secretary of State for Scotland, who is the Minister of Health for Scotland. By no means one of the least important results of paying out these monies will be to enable the Secretary of State to have all the possible information to enable him to perform his part of the concern, that is to say, the medical benefits of treatment and attendance. What I have said about devolution to Scotland of course applies to other areas of England and Wales. I am satisfied that it is only on these lines that this Ministry will be able to function properly and well. I need hardly say that I shall keep in the closest touch with the Secretary of State for Scotland in this matter, and I hope that, from what I have said, the Committee will realise that the Amendment would not enable us to carry out our idea of a unified service.