Clause 1. — (Charges for Certain Drugs, Medicines and Appliances.)

Part of Orders of the Day — National Health Service Bill – in the House of Commons at 12:00 am on 3rd April 1952.

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Photo of Dr Horace King Dr Horace King , Southampton, Test 12:00 am, 3rd April 1952

It must be very difficult to convey to hon. Members of the calibre of the hon. Member for Putney (Mr. Linstead)—of whose excellent and devoted work for the National Health Service every hon. Member knows—just how bitterly we on this side of the Committee are opposed to the proposals contained in this Bill. Listening to the hon. Member for Abingdon (Sir R. Glyn), who lamented that party politics should come into this, it seemed to me that the whole tenor of his appeal for a non-party approach to the Bill was really in support of this Amendment which asks, first, that if the shilling charge and the charge for appliances is a non-party charge, if this is a matter of scientific as opposed to party political opinion, we should try it as an experiment and see at the end of two years what the result has been.

The hon. Member for Putney might very well have ended his speech by pleading with his own Government to accept this Amendment. It is a party decision that we should impose charges on the Health Service as a means of solving some of the problems with which we are confronted. I want to preface my remarks about this Amendment by attempting to convey to Her Majesty's Government something of the spirit in which we are tackling not only this Amendment but every other Amendment to this Bill.

It is a matter of simple fact that 14 million voters are opposed to any tampering with the National Health Service. It is probably true that day by day that number is increasing among people who now realise, after voting for the present Government, that attacks are being made on the Health Service.

6.30 p.m.

We cannot hope in the House of Commons to prevent the Bill being passed, but we shall seek by Amendment after Amendment to limit the extent of the damage which the Bill will do to the National Health Service; and if by this Amendment we can limit it for two years, we shall have done something worth while.

It may be argued by some of my hon. Friends that this Amendment is not necessary. Not only Members on this side of the Committee, but people in the country, are saying that the Government will not last until 1954. Perhaps, even as we are speaking, the first nail has been driven into their coffin in the first instalment of local government elections. Thousands of Londoners are walking into the polling booths to declare their opposition to any tampering with the Health Service. And as the Government may not live until 1954, and as a Labour Government will certainly repeal the Bill if it is passed, it is academic to limit it to two years. I think that such an argument is unsound.

It is possible that the Government may last until after 1954. If we are to overthrow the Government, we depend during the next two years on Members like the hon. Member for Putney becoming alarmed at what happens to the Health Service and on their supporting us in our resistance to further attacks upon it. I am afraid that is not likely.

Defeats in by-elections can only come if by-elections take place in marginal constituencies. Whatever happens to public opinion outside the House of Commons—and it is the belief of many of us that the Government day by day are forfeiting the support of public opinion outside—it is quite possible, it is a grim possibility, that the Government may last beyond 1954.

I want to deal particularly with some of the remarks made on Second Reading by the hon. Member for Enfield, West (Mr. Iain MacLeod) in a speech which was a brilliant and able performance. I do not want to deal with the polemical part of his speech but with an argument which, coming from the hon. Member, must be given serious attention. The hon. Member said that the Bill had social, medical and economic justification. He argued that the making of charges would stop abuses. Then he went on to say—I hope he will stop me if I paraphrase him wrongly—that already the charges made on teeth and spectacles had had a deterrent effect far beyond those which had been anticipated by the last Government.

Let me remind the House that already 1,000 dental mechanics have been dismissed, that opticians are facing something like the slump they experienced in the worst period between the wars. The hon. Member for Enfield, West, suggested in his speech that the deterrent effect of the charges already imposed on the National Health Service had been somewhere about 50 per cent.

He went on to argue that we should watch the deterrent effect of the charges imposed in the Bill and that if, as he feared, the deterrent would be much greater than was imagined by the Government, we should seek at some stage to ease it and to deal with the cases of particular groups of poor people who had been deprived of medical aid. I suggest that the whole of that argument is an argument for putting a period to the Bill; and that at the end of 1954 we shall see, in the light of two years' experience, what many of us are convinced will happen: that the Bill, by imposing charges on medicines, drugs and appliances will deter some people from having medicine or appliances which they ought to have.

Moreover, the practical difficulties of administering the Bill will be very great. As the Bill makes its way through Committee, we shall be considering the difficulties that chemists are going to experience—and chemists have already said what difficulties they have to face. We shall have to examine the practical problem of whether doctors will have to collect the charge that is imposed by the Bill. Indeed, if the Bill gets through the Committee and finally takes its place on the Statute Book, we may find that, as the Labour Government anticipated, the administrative difficulties surrounding this little Bill will make its proposals either unworkable or too costly. Therefore, on that ground also we seek to limit the operation of the Bill to two years.

The Clause gives power to the Minister to make regulations far beyond any of the charges which the Minister has stated he proposes to make under the Bill. As long as the Bill remains part of the law, it will be in order for further Regulations beyond those which the Minister has promised to make to come before the House and to impose higher charges and affect appliances beyond the small list which the right hon. Gentleman has given. A Bill which confers such wide powers upon the Minister should be limited to two years.

In the days when we on this side of the Committee were sitting on the benches opposite, when some of us managed to secure a similar concession from the previous Government, it was argued by the right hon. and gallant Member for Kelvingrove (Lieut.-Colonel Elliot) that this was a concession not of very great moment, that it might just as well be added to the Bill as be left out. But in the last Parliament we took the view, and the then Government accepted our arguments, that it was right to limit the provisions of the Bill to a certain period, so that if the Government wished to continue to impose the charges they would have to come back to the House. It seems to me quite certain that if the Government last until 1954, they will command a much smaller majority in the House and may have to yield far more in the way of concessions to the Opposition.

It is also true that at the end of two years we shall have a mass of evidence, comparable to the evidence which the hon. Member for Enfield, West has produced about the effects of the dental and optical charges, of the deterrent effect of the charges on the use by people of medicine. At the same time, we are quite certain that by the end of another two years the pressure of public opinion, steadily growing against this Bill, will make the Government hesitate to re-impose the charges.

But most important of all of the reasons for this Amendment is that we want to ask the Government tonight about the way they react to this Amendment, and to say whether they believe in a free National Health Service or not. Is it the case of the Government, is it the case of the Minister, that they believe in a free medical service in principle, but not in a time of economic crisis? If so, we believe that the Minister should accept this Amendment.

The economic crisis, we hope, will not last for ever. We believe that the Minister should adopt the method of looking at the Health Service Act that his colleagues have adopted in looking at the 1944 Education Act. There, at least, the Government have said, "We believe in equal opportunity for everybody, even if we do not believe in it just now." The Conservative Party have advanced from 1931, when they opposed secondary education for all children, and when the then Minister of Education said that secondary education for all was providing "an intellectual soup kitchen." They have advanced, so far as education is concerned, in that the Government have given an assurance that they believe in equality of opportunity, and that they are going to advance education as soon as the economic situation permits.

We have the right to ask them tonight, Are they going on record as saying, "We believe in charges for medical services under the National Health Service Act, not for two years but for ever"? If the Government say that, the country has a right to know, that, according to the Minister and according to the Government, it is right to add £10 a week to the income of a doctor and charge an old age pensioner for a bottle of medicine; that it is right, under Tory principles, to charge a millionaire 1s. for expensive drugs and to charge poor children 1s. for a 1s. 1d. bottle of medicine; that it is right to single out the bald, the clubfooted, those with varicose veins, the tuberculous, the diabetics and the gastric, and say to them, "The prestige of this country demands that you should pay a fine for being guilty of the sin of illness in order to relieve the rich taxpayer of £1 a week Income Tax."

I believe—and I speak very sincerely about this, as one, incidentally, who owes his life to the National Health Service—that this is the meanest Bill this Government have brought forward. At least I would ask them to say on this Amendment, "We have put in operation something which may seem mean but is only an expedient. We do not want this to be taken as a principle for all time." If they do not accept this Amendment we have a right to say that the Government believe in the slogan, "A shilling a day keeps the doctor away." We have a right to say that the Government believe that charges under the Health Service are a part of permanent Tory policy.

I would urge the Government to take a very different line—to have some consideration for the thousands of members of their own party who have done invaluable service for the National Health Service up and down the country on hospital committees and health executives, and so on, and to say, "At any rate, if we impose these charges, we impose them for two years only, and at the end of two years we shall look at them again, go to the House of Commons, after two years' extra evidence, and either ask that the charges be re-imposed—when the whole matter can be discussed again—or drop them"—as we believe they ought to drop them.