Vote 11. National Health Service, Scotland

Part of Orders of the Day — Supply – in the House of Commons at 12:00 am on 12th March 1959.

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Photo of Mr Niall Macpherson Mr Niall Macpherson , Dumfriesshire 12:00 am, 12th March 1959

I am sure that my right hon. Friend will take note of what the hon. Lady has said. I cannot tell her whether it is possible or not.

On infant mortality, I have not the latest figures for Glasgow, but I have stated what the hospital authorities are doing to increase the number of maternity and antenatal hospitals and so to provide the better service we all desire. In Scotland as a whole the Registrar-General's provisional figure for 1958 shows that infant mortality was the lowest yet recorded. For every 1,000 live births there were 28 deaths of infants under one year, compared with 29 in 1957 and 47·3 in 1946–50. My right hon. Friend is concerned to make sure that that figure should be lowered further as fast as possible. I can give that assurance to the hon. Lady.

My hon. Friend the Member for Fife, East (Sir J. Henderson-Stewart) asked about the recent Acton Society Trust Report, and whether it covered Scotland. While much of what is said in this Report, and in previous Acton Society Trust Reports, has been written primarily with reference to conditions in England and Wales, the Trust has, of course, covered Scotland in its inquiries. My right hon. Friend and his Department have taken careful note of the views of the Trust.

On the question of leadership, which is perhaps the Trusts' main criticism, I suggest it is necessary to strike a balance. The hospital service in 1948 was a series of disconnected units when it was taken over. It must be allowed to grow gradually into one coherent organisation. It relies very largely on voluntary effort in the hospital boards and has derived great benefit from the efforts of those individuals. All this would be lost by anything resembling regimentation. My right hon. Friend believes, as I think his predecessors have done, that in some respects it is possible from St. Andrew's House to guide and to lead, but that it would be quite wrong to command and direct, save in the last resort. The military parallel drawn by the Acton Society does not seem to me to be a good one.

Perhaps I might mention one or two examples of the ways in which we have tried to do some of the things which the Acton Society has in mind. We have just sent to the hospital authorities a memorandum on some of the major questions of policy and organisation to which my right hon. Friend thinks they may wish to give more attention than has been possible in the difficult conditions of the first years of the Service. We have begun a series of discussions round the table with each regional board in turn, about the direction in which it should seek to develop the Service over the next few years. I can assure the Committee that there is no question of not looking forward and planning ahead.

Within the Department we have set up special machinery to study the trends of medicine, morbidity, and so on, to try to assess their impact on the hospital service. We are also strengthening the technical staff to cope with the architectural and other problems arising from new hospital building. On the building programme itself, we have provisionally agreed with the hospital authorities a list of the major projects which we and they would like to put in hand up to 1965, subject, of course, to resources being available when the time comes and to later adjustment for changing conditions. We had also begun to study with them farther distant projects which will take us up to 1970.

Perhaps I may turn to more immediate problems. We arranged a highly successful conference last year to examine, with the hospital authorities, the application of work study to the hospital service. The Department is setting up a special branch to deal with this and allied subjects, and the officer who is to take immediate charge of it is at present on detached duty studying the subject further with I.C.I. These are examples of what we are doing. While we welcome consiructive criticism of the kind made by the Society, and, indeed, of the kind that has been made in the Committee tonight. I suggest that my right hon. Friend and the Department are not quite so lacking in leadership as the Society's Report would suggest.

Although I have not been able to deal with all the points raised, I shall take note of the points made by the hon. Lady the Member for Coatbridge and Airdrie, with all her usual rugged vigour, and the point made by my hon. Friend the Member for Central Ayrshire (Mr. Nairn). What I have said will, I hope, be sufficient to show that these Supplementary Estimates represent a step forward as well as covering the higher cost of salaries, and so forth; and, as my right hon. Friend said before, they are in no way an indication of extravagance.