Clause 7. — (Removal of Hardships.)

Part of Orders of the Day — National Health Service (Amendment) Bill – in the House of Commons at 12:00 am on 9th December 1949.

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Photo of Mr Somerville Hastings Mr Somerville Hastings , Barking 12:00 am, 9th December 1949

I should like to make a humble but very sincere protest against the principle involved in this new Clause. I have always looked upon the National Health Service Act as perhaps the best piece of legislation carried out by the present Government. It is based on that great Socialist principle—to each according to his need. When the scheme first came into operation, there were many old people who did not appreciate the profundity of that great principle. They inquired whether, if they had never paid insurance contributions, they had any right to take advantage of it. Are we going to replace that great Socialist principle "Each according to his need" by "Each according to his shilling "?

I have discussed the question of abuse with very many doctors, both before and after the proposal to charge for medicine was put forward. I found that perhaps a little more than half of the doctors with whom I have discussed the matter agreed that there was some abuse. With a new service, people like to try it out, and there may have been some abuse. But, when I have tried to analyse the replies of the doctors who said there was abuse and those who said there was none, I found that, without exception, the doctors who agreed that there was any considerable abuse were the doctors who were opposed to the scheme from the start, who did not want a universal Health Service but who wanted the well-to-do to be compelled to pay for it directly. Undoubtedly, there may have been some abuse in the past. There always will be neurotic people who go to the doctor more often than they need, but I would like to ask the Minister whether he supposes that these neurotic people will be deterred by a shilling, and be robbed of the enjoyment of bad health, and, perhaps, the chief interest in their lives? I suggest that one of the people who will be deterred will be the poor mother with young children, who is over-burdened in any case and who is perfectly ready, unfortunately too ready, with all her preoccupations, to take advantage of any excuse for not bringing her children to the doctor at the earliest possible moment.

I suggest to the Minister that, so far from these proposals reducing the "cascades of medicine" of which he has talked, they may even increase them. Doctors generally are very concerned about the interests of their patients. They are ready to do anything that is reasonable and possible to serve these interests, and I think a doctor may very reasonably say, "This is a poor patient, who may feel the shilling, and I should be wiser to give him medicine for a month rather than for a fortnight." May not this, in some cases, result in more medicine being ordered, rather than less?

I have felt, and many have felt, that a great advantage of a free and universal service was that the doctors should get hold of illness earlier than they otherwise would do, for it is true to say, in medicinal treatment perhaps more than anything else, that the stitch in time saves nine. This has always been true, but it is infinitely truer today since so many bacteriocidal new drugs have been introduced.

Let us take the case of a child with ear-ache. The doctor orders penicillin, sulphonamide or one of these drugs, and the trouble clears up rapidly. If the child is not taken to the doctor at once, he would probably get a perforated drum, and that perforation might become permanent for life, or mastoid disease might develop. We do want to get the cases early. The same thing applies to cancer. Where it can be recognised early, the results of treatment of cancer are astound-ingly good. What the profession wants to know are the early symptoms of the disease so that we can get the condition under treatment before it becomes so obvious that it can be a real inconvenience to the patient. I had hoped particularly that this great service would help the whole profession to recognise disease earlier, and I look upon this proposal to put any obstacle in the way of the earliest possible appeal to the doctor as entirely retrograde.

The Minister interrupted my hon. Friend and very rightly pointed out that not a few doctors are inclined to order proprietary medicines when perhaps a cheaper medicine, identical in character but with a different name, would do just as well. I am certain that this is true. The public do not understand how busy the drug houses are in sending round their travellers to doctors. They give liberal samples, and the doctors try these proprietary medicines on one or two of their patients; if they succeed, they go on ordering them, although there is an equivalent in the British Pharmacopoeia which can be prescribed at a quarter of the price. I suggest to the Minister that if he would get busy giving the doctors lists of equivalent drugs and asking them to supply them to their patients, he would save the necessary money and also the good name of this great scheme, as the author of which he will go down to history.