Orders of the Day — National Health Service

Part of the debate – in the House of Commons at 12:00 am on 19th December 1963.

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Photo of Miss Jennie Lee Miss Jennie Lee , Cannock 12:00 am, 19th December 1963

During the course of this wide-ranging debate, more than enough has been said to justify the Motion of censure which we have put down.

Straightaway, I pay my compliment to the hon. Member for Manchester, Openshaw (Mr. C. Morris) who, in a most sensitive and distinguished maiden speech, emphasised a point which, I believe, all of us on this side of the House would regard as one of the central themes to which attention should be called. He told us, for instance, that, although the average infant mortality rate is two per 100 for the country as a whole, in Openshaw it is three per 100.

Later in the debate, my hon. Friend the Member for Lanark (Mrs. Hart) returned to the same point, the essence of it being that, after twelve years of Conservative Government, a Government who have had full powers and full opportunity, the maldistribution of wealth in this country is in some respect worse than it was before, and this maldistribution is reflected in the health of the people and their relative chances of health or even of survival in infancy. There have been moments when hon. Members opposite have been speaking that have led me to ask myself who has been governing this country in the last 12 years. I hope that when the Minister replies he will address himself to the record of his party in those 12 years—not tell us about the future, because he will not be there in the future.

I should like to compliment him personally, but I would be more inclined, at the moment, to sympathise with him, because I think that the Sunday Times, which is not one of our Socialist journals, was quite right when it headlined the fact that he had inherited an awful mess from his predecessor. He has inherited a crisis in a great number of different fields. As I say, I am inclined to ask who has been governing this country.

Hon. Members opposite have been talking about the plight of the family doctor, the bad food in hospitals, shortcomings of many kinds. Before we go on to deal with specific sins, either of omission or commission, it is well for us to understand, and for the people of this country to understand, how it comes about that hon. Members opposite can stand for such a mass of contradictory evidence and contradictory apologies.

My hon. Friend the Member for St. Pancras, North (Mr. K. Robinson), in opening the debate from this side of the House quoted from One Nation, produced in 1950, and I think that most of us know it almost by heart. We have also had quotations from the Social Services: Needs and Means, 1952, with which two right hon. Members opposite have been closely associated. It may be said that there has been a change of heart, that the Conservatives are now "with it" and that they have come up to date. In fact, the most recent writings of young Conservatives express the same basic attitude towards social questions in general and the Health Service in particular as was expressed 10, 11 or 12 years ago.

What is the essence of the Conservative position? The right hon. Member for Wolverhampton, South-West (Mr. Powell) in his book twelve years ago stated quite boldly that redistribution of income in this country had already gone too far; that the gap between rich and poor had been narrowed too much. Again and again we have heard the plea in those earlier books that a means test should be applied, that no one should receive any benefit from the Health Service unless he was not able from private resources to look after himself. I do not think that hon. Members opposite would contradict that this was the philosophy put forward. What have the young Conservatives got to say?

A fascinating book was published in 1961 called Principles in Practice, produced by the Conservative Bow Group. Mr. Geoffrey Howe was particularly responsible for it. They certainly have had time to put their principles in practice. Part of the advice given in this book is that the public should insure in private companies and opt out of the Health Service. In order to encourage them to do so, it is proposed in this book that those who opt out of the Health Service should have their tax liability reduced by an amount equivalent to the average cost per head of the service.

I am not saying that the Minister has reached that point yet and I should be delighted if he would repudiate both the theory and practice of his pre- decessors. We have had about as many different Ministers of Health as Ministers of Defence, but every Minister of Health, however good his personal intentions may have been to begin with, has had to carry out Conservative policy. It is clear, both from theory and practice, that hon. Members opposite do not understand the meaning of a comprehensive Health Service.

The Government have even failed to give us even an adequate medical service. There is a difference between the two concepts, that is a comprehensive health service and a mere medical service. We are, after twelve years of Conservative rule, asking hon. Members opposite whether they think that they have brought this country to that level of economic well being when we can exempt at least the sick from financial worries when they are sick. We shall have the answer when hon. Members opposite go into the Lobby tonight.

What is the verdict of those on the benches opposite on Tory rule? Will they say to us that this country had such faith in its people and such vision two or three years after the most destructive war in history that it could say that from our combined resources the strong would look after the weak and that, whatever we had to go without, we would try to provide complete medical care for everyone, beginning with the mother before her child was born? What have hon. Members opposite done to this proud record? They should be providing not just a medical service but health service. Today, we should have been discussing preventive medicine. We should have been discussing health, not disease.

Even the party opposite should know that some of the main causes of illness today are tension, strain, nervous exhaustion and worry. Can any of us think of anything more liable to maximise strain and nervous exhaustion than for a family, at the very moment that it has to cope with sickness and needs additional income in the home, to be told by the great Conservative Party, "We have had our ups and downs in the last ten or eleven years". It has been rather like the case of the Grand Old Duke of York: we have gone up and then come down again. There have been times when we have been able to come to the rescue of Surtax payers."

Every time that there has been an economic crisis, it has been seized upon by the Government as an opportunity to put taxes on the sick and to transfer the burden, so far as it lay in their power, from the Chancellor of the Exchequer to the employer and the employee. This is Conservative philosophy.

Hon. Members opposite are not fit to be in charge of this Service. They do not understand it. If, once again, they were entrusted with power, they would be no better in the future than they have been in the past. They would simply try to take one step further towards their ugly, vulgar philosophy of asking the rich to look after themselves and leaving the insured worker, whether industrial or professional, to pay for his services as much as possible from his insurance and his taxation. For those not rich enough to sign a cheque for their child's schooling, for illnesses or for hospital services, if they were not covered by insurance, back they would go to the spirit of the old poor law and then to National Assistance, with a rigid means test making them feel that it is a crime to be poor.

I could spend the limited time at my disposal in taking each of the health charges one by one—spectacles, teeth prescriptions and the rest—but I consider it more important that we should be completely clear about why hon. Members opposite behave as they do. They belong to what I can only describe as a social handicapped group. Therefore, they must not expect me to be indignant with them or shocked by them. I would rather try to understand them.

Our medical services are not quite adequate to deal with the physically handicapped and with the mentally handicapped, but I hope that one day we will be able to deal even with the socially handicapped. By "socially handicapped" I mean having many of our Conservative leaders conditioned by birth to segregation. It was not for them in their school years to make friends with the little lad who did not have the right kind of accent. They had to be careful about all their social contacts. I do not blame them. Hon. Members opposite belong to a socially handi- capped class who, from their earliest days, have been conditioned to think in terms of the masses and the classes, in terms of "them" and "us", because I do not for one moment believe that they would ever allow their own children or their parents, or anyone who was close to them or one of them, to be treated in the way in which they expose hundreds of thousands of other children and parents to be treated.

There is something extremely brash and vulgar about the philosophy of "I'm all right, Jack", but there is something utterly contemptible in the philosophy, "My child's all right, Jack". For the love of one child should come the love of all children. Therefore, I am serious in speaking about enabling hon. Members opposite to understand themselves better. I am talking in all seriousness when I say that there are ranges of knowledge and experience which they simply do not share.

Hon. Members opposite want the type of society in which the rich look after themselves. They have increased the insured workers poll tax. They have increased the tax on the insured worker three or four times since they came to office, so that the maximum amount should be added to the burden of the employer and the employee, which, incidentally, is a burden upon industry and upon the products that we sell. Thus we have the three categories. The rich look after themselves. The insured worker, industrial or professional, pays through insurance. The third category goes for National Assistance, and National Assistance is made as rigid as possible.

Do not hon. Members opposite realise what a close link there is between welfare and industrial production? Let them imagine a typical working-class family with the man working overtime so that he has a little extra to spend in addition to rent and food and can go out and be a man among men, standing treat to himself and his friend. Visiting his mother and father, he would enjoy saying to the old man, "Here is 10s. Go out and enjoy yourself". But if he finds when he stands treat to his parents that his father has to use the 10s. to pay for a prescription for cough mixture or his mother has to use it to buy tablets for her rheumatic pains. what do hon. Members opposite think the typical industrial worker feels?

In other words, it is very important to realise that our social services are part of the standard of living of the country. When one transfers charges to the industrial worker through his insurance payments and when his parents have to use their savings to pay for prescriptions, one is depressing his standard of life. If hon. Members opposite want that, the young man's reply will be, "Right. If I am not going to have my standard of life sustained by civilised social services, then I want more money." Hon. Members opposite have not the slightest chance of carrying forward the country's economy on a buoyant basis with peaceful co-operation in industry.

Among the many letters sent to me is one from a retired couple. The writer says: I have money invested in Defence Bonds and local government stock that give me an income of £52 10s. a year. Because of this I am barred from assistance and have to pay for four different medicines, milk and a diet out of a health benefit of £5 9s. for myself and wife. Perhaps I should not have said 'a diet', because if you subtract £2 6s. 96. rent you can see my situation. Because of his life's savings, this retired worker is placed just a little above the bare retirement pension.

What hon. Members are saying is "Let us all end up on National Aissistance". Why should anyone trouble to set aside Is., £1, or £100? It seems a lot of money to poor folk. It may be that a worker may save between £1,000 and £2,000, but the investment income from it may be such that he will find that he has to pay for the prescriptions which he gets from the doctor.

The Conservative Party was the party which was supposed to believe in saying, dignity and independence. But this is why I call hon. Members opposite a socially handicapped class. They think it is quite all right for poor people to come appealing for National Assistance. Consequently, whether we are dealing with the general situation of our hospitals or these disgraceful charges for prescriptions and services, hon. Members opposite are not fit to administer the scheme.

I go further and say that when the right hon. Gentleman's predecessors had to deal with sick people, old people and crippled people they were very brave indeed. They got their own way. But when they were dealing with some of the highway robbers exacting quite indefensible profits in the drug industry they were beaten They met more than their match.

No Conservative Minister will really deal with the profiteering at the expense of the sick and the National Health Service and the community because it is alien to his philosophy to do so. There is no point in attacking the pharmaceutical industry for these vast profits and still leaving it to do the research. Many of these firms are sulking. They say, "If you are going to encourage the family doctor not to use our products, we shall not do your research for you." Right hon. and hon. Members opposite cannot do it both ways. There is no answer to the problem unless we are prepared to have competitive public ownership in the drug industry.

The Government must do proper costing and their own research to know what is happening. The other day I looked again at the Cohen Report of 1951. It set out clearly what had already been begun by the Labour Government and what could have been done by the Conservatives. I remember the joy it gave to many of us on this side of the House when we started investigating the profiteering that was going on, not just in medicine but in all kinds of equipment needed for patients and hospitals. I recall the case of the hearing aids brought down in price to one-tenth of what they had cost before.

It is nonsense to expect right hon. and hon. Members opposite to do anything about profiteering in any sector of the National Health Service, but I can promise them that in the near future, when what have now become the caretaker Government have got the verdict of the country, we shall be concerned not only to spend money on the National Health Service but also to save money in it. The pharmaceutical industry cannot be tackled, its high profits cannot be tackled, unless we are willing to go into this ourselves, change the costs and do a great deal more of our own research than the Government are doing at present.

I come now to an aspect that right hon. and hon. Members opposite have not touched—preventive medicine. The other day I was talking to the distinguished head of a dental institute. He was listing the diseases that are the result of dental neglect. The Government have managed in twelve years to begin and complete four hospitals. They have managed to begin and complete one dental institute. I hope that the right hon. Gentleman will contradict me at once if I should be misleading the House in any way in saying that.

When the right hon. Gentleman comes to reply, I would like him to tell us what he has done about preventive medicine. But I can tell him now. He has made it more difficult for children to get their orange juice and cod liver oil. He has made it more difficult for expectant mothers to get their vitamin pills. By the charges on prescriptions he has added money worries to the anxieties of every home where there is sickness.

I can think of nothing that has been done by the Government that can be genuinely called preventive care. I listened carefully when the phrase was used by the Joint Parliamentary Secretary, but he had nothing to say. He talked about the importance of the local authorities and, of course, the Government have managed to transfer from hospital care to the local authority care many of the mentally sick. They have managed in that way to make a bad hospital situation seem a little better than would otherwise have been the case.

But I wish that the Minister would tell me what he thinks he is doing for preventive medicine when he has these charges on the most vital disease-resisting foods and when he takes them from mothers and children, the most vulnerable in the community, and when he is harassing the health as well as the physique of many old people who are just above the National Assistance level. Far from being preventive medicine, this is exactly the opposite, but I do not see any hope of hon. Members opposite doing anything else.

A short time ago, I asked a child what a gentleman was. He was a very young boy, but, quick as a flash, he said, "Gentle and a man". He did not say someone who was very rich; he did not say someone who had 1,000 acres or 100,000 acres; he did not say someone who talked with a special quaint accent; none of those categories; he said, "Gentle and a man".

It is only someone who is both gentle and strong who is fit to be Minister of Health in this country. Gentleness alone is not enough, not when dealing with some of the tougher hon. Members opposite; gentleness is not enough when dealing with some of the great vested interests outside the House. It will take someone who is really tough and who really believes in what he is doing.

But, at the same time, it needs someone who is prepared to regard all the people of this country as his friends, all the children, all the old and all the young. This National Health Service was hard won. We fought hard to have it. Hon. Members opposite fought hard to prevent us from having it. All that has happened in these succeeding twelve years has proved that it cannot be left to their narrow, unloving, insensitive prejudices.