Orders of the Day — Health Services and Public Health Bill

Part of the debate – in the House of Commons at 12:00 am on 7 December 1967.

Alert me about debates like this

Photo of Mr William Edwards Mr William Edwards , Merionethshire 12:00, 7 December 1967

I am very grateful for the opportunity to follow the hon. and learned Member for Solihull (Mr. Grieve). I was sitting here getting increasingly more depressed by reading the Bill and getting more and more depressed listening to the measure of agreement between hon. Members opposite and my own Minister upon the Bill, and I was delighted to see somebody who finds a sinister motive, a sinister aim to bring about the end of private practice which is operating in our public hospitals.

I do not welcome the Bill because of the indications in the first few Clauses of the way the Minister is thinking about the development of the Health Service. I should like to say this very briefly to the Minister. He is preparing a Green Paper and a White Paper to lay before this country his ideas about the way in which the Health Service should be developed, and I would like to tell him, before he prepares his plans and White Paper, not to fall into the same error as my right hon. Friend the Minister of Power did in the preparation of his White Paper and underestimate the feeling on this side of the House in relation to private practice.

I think that the first few Clauses of the Bill are indications that my right hon. Friend accepts that private practice should be allowed to continue in our public hospitals. I have no objection to private practice being continued outside the public hospitals. I have heard the name of Nye Bevan being called in aid of allowing private practice to continue within the public hospitals. I am sure that at the time when he was introducing the Health Service he thought there would be a mass exodus out of the Service, and the setting up of private hospitals all over the place, but I am sure that at this particular time this would not happen, because although some people would choose to go outside the Service if there were exclusion of private practice within the Service I do not think that it would be a very large section of the population and I am quite certain the Service would not suffer if that were to happen.

I would like to tell the Minister that if there should be exclusion of private practice from our Health Service there would not be an exodus of doctors out of the country. If I may declare an interest here, my wife works in the Health Service, in the hospital service; she does a number of sessions each week as an anaesthetist in the Service. What I hear from her is that the people who are leaving the country are the young doctors who are waiting for their promotion in the Health Service. They are young surgeons, young obstetricians and gynaecologists, young physicians, people who are well qualified, who are waiting for consultancy posts in this country and having to wait far too long.

These sorts of people would not be the ones who would leave if private practice were to be abolished. Their concern is to get promotion within the system; it is not their concern to acquire vast private practices. More and more doctors are, in fact, choosing to go on the 11–11 or full-time system, and are not asking for the 9–11 or part-time system. More doctors, as they reach the age of 55, chose to go on to the full-time consultancy system because they will thereby receive their full pension. It is a red herring to suggest that, if we do away with private medicine in public hospitals, there will be a mass exodus out of the hospital service.

One matter we should look at is the great disparity in pay and conditions between the junior hospital doctor and his consultant, and also, if I may add this, the disparity in pay between the well qualified junior hospital doctor and the general practitioner. If there is one field in medicine from which we are losing young doctors, it is from among the young doctors in hospitals who are underpaid, overworked and under-represented and who are dominated in hospitals by the senior consultants whose voice is so powerful in the B.M.A., as it was powerful when Nye Bevan was introducing the Health Service.

Is it not amazing that, at the time when the Health Service was being introduced, we were told by the B.M.A. that the system would not work? There were highly-paid Members advocating in this House that the system would not work. There were fundamental objections to it. Yet, suddenly, when the senior members of the B.M.A. were allowed to carry on their lucrative private practices, all those objections disappeared. That is what happened. That was the sort of thing which coerced our Minister at the time to accept this iniquitous system.

There is one particular aspect of private practice which should be dealt with, and I am disappointed that the Minister has not taken advantage of this miscellaneous provisions Bill to try to deal with it. I know, other hon. Members know, and I am sure that the Minister knows, that more and more people are jumping the queue into hospital by taking advantage of the private consultation with the part-time consultant. On a number of occasions, my wife is put in a difficult position in advising friends how to see an obstetrician or gynaecologist. The only way a woman can be sure of seeing a consultant is to consult one or other of these consultants privately, and then, by a miracle, she suddenly finds that she is admitted into the ante-natal clinic of a hospital.

Similarly in general surgery, and in medicine: one goes to see the consultant in Harley Street or, in Liverpool, in Rodney Street, and then, by a miracle, one finds one's way into the out-patients' department of a general hospital, jumping the queue and getting a bed in a public hospital. This is what is happening. If my right hon. Friend asks me for evidence, I cannot provide it, because the people who have taken advantage of the system will not admit to having done so. My right hon. Friend knows that that is so. He knows it is happening.

This Bill is a Bill produced by an administration, not by a Government—certainly not by a Socialist Government. If my right hon. Friend's thinking on private practice is the thinking which I find expressed in the first two Clauses, I assure him that I and many of my hon. Friends will do everything in our power to see that his intentions in those first two Clauses are not carried out. If he produces a White Paper on the lines of those Clauses, I shall do all I can to see that it is rejected by this party.