I read the right hon. Gentleman's speech and my hon. Friend's admirable speech, and I intend to refer to them.
As I said, my sympathy for hon. Members opposite evaporates when I consider the way in which the present proposals have been introduced. On 14th April, the Secretary of State said at Question Time:
If my hon. Friend is asking me whether I expect further charges to be imposed on the Health Service, the answer is 'No'."—[OFFICIAL REPORT, 14th April. 1969; Vol. 781, c. 771.]
The right hon. Gentleman says that he was answering a question about the principle of selectivity. Indeed he was. That is one of the most astonishing Answers to a question about selectivity that I have ever heard. To say the very least, that was a thoroughly disingenuous answer to give the House. The House at that time was very crowded, and I wonder whether one hon. Member who heard the right hon. Gentleman make that statement imagined that, within a few days, he would be coming before the House to announce that he would be introducing higher Health Service charges.
Twice, also on that same day, I and my hon. Friend the Member for Somerset, North (Mr. Dean) asked whether it was the right hon. Gentleman's intention to increase prescription charges. The Secretary of State replied, "The answer is 'No'." Carefully, with a most exquisite precision of words, by slithering through some absolutely straightforward questions, the right hon. Gentleman did not tell a lie. Unfortunately, he just created an impression that no further charges would be imposed.
I wonder whether it was worth it. Now, only the most gullible fool in the country will listen to the right hon. Gentleman without examining the small print under a microscope. On 5th May, he announced that the increased charges were to be made. From then onwards, there was a sheer blizzard of chaos.
My hon. Friend the Member for the Cities of London and Westminster (Mr. John Smith) is resigning in order to call attention to the lack of facilities in the House. I must say that I have a certain amount of sympathy with him. My own filing system is collapsing under the strain of statements made by the right hon. Gentleman. Government statement contradicts Government statement, the morning editions of the newspapers are contradicted by later editions, and, in the middle of it all, sits the Secretary of State—to use the words of the hon. Lady the Member for Halifax (Dr. Shirley Summerskill)—whose left hand does not know what his other left hand is doing.
First, it was hinted in c. 47 of HANSARD, 5th May, that the £3½ million which was to be raised would be used to finance the psychiatric and geriatric services. Then we had the blazing headlines that the Secretary of State had informed the Parliamentary Labour Party that the money was to be used to finance the comprehensive schools in the key areas. That was on 15th May. Then he said that any such suggestion would be folly—that was on 19th May, in column 10—and he told us not to believe the report. Then the chairman of the Parliamentary Labour Party said that he was astonished that the accuracy of his report was doubted. That was on 21st May.
Equal confusion surrounds the timing of the Regulations, when they will be laid and when they will come into force. The decision to increase these particular Health Service charges was taken last January. It was to be in the Budget. The Secretary of State, in his B.B.C. broadcast on "The World at One", on 6th May, said:
This was a statement which we have had for a long time and I had hoped to see it in the Budget.
I can quite understand why he hoped to see it in the Budget, but it was not there. But lots of things which should have been there were not included in the Budget. It is only gradually, in debate after debate, that we have been able to extract the information from the Government.
The Chancellor of the Exchequer, that now rather tarnished Sir Galahad of the Labour Panty, has treated the right hon. Gentleman very badly. He announced the increased benefits, but forgot to announce how they would be paid for. He announced that there was a substantial deficit on the National Insurance Fund, but forgot to tell us how he would correct it. And he completely forgot to include this announcement, which the Secretary of State had expected would be in the Budget, that the charges for dentures and spectacles would be increased.
But it is not only the Chancellor who has behaved badly in this. The Secretary of State's own sense of timing is also rather haphazard. On 14th April, as I said, he announced that there would be no further charges. On 5th May, he announced that regulations would be laid "shortly". But weeks passed. Then, on 24th June, the B.B.C. and The Times and other newspapers said that there were reports that the increased charges were to be deferred.
On the same day, the Department of Health and Social Security issued an official statement that the references by The Times and the B.B.C. were "purely speculation". But it went on:
The timing of the Order has not even been discussed.
Is there one hon. Member who believes that? Indeed, a week later, on 1st July, the Secretary of State said that the regulations would be laid "at an early date".
I suppose that there is some charm about amiable incompetence, but I am not sure that this is amiable. It is certainly incompetence. What I believe is happening is something quite different. The right hon. Gentleman is desperately thrashing around for an escape. He wants a formula of words which will fool his colleagues and get them into the Lobby. He wants a form of words. Normally, of course, the Labour Party will swallow absolutely anything. Of course, as always, on this occasion the payroll vote, the multitudinous place-men of the present Government, will go into the Lobby behind the Government. Normally, of course, the Left wing are content with a mere Motion on the Order Paper and then flake out before it comes to a vote, but on this occasion I think that it is rather different.
They have tasted blood. They have thrown out the Parliament (No. 2) Bill, the jewel of the Queen's Speech, the very centrepiece of the present parliamentary programme. They have caused a reversal on the Industrial Relations Bill, and this time the Secretary of State has seen their Motion opposing the Regulations, signed by 138 hon. Gentlemen opposite and, rather surprisingly, also by my right hon. Friend the Member for Brighton, Pavilion (Mr. Amery). I have no doubt that that is a misprint, but his name appears in the list.
This time they really will vote. This is the last of their sacred cows which still remains alive and they are determined not to see it butchered by the right hon. Gentleman. He is seeking an expedient. He is seeking a formula of words which will fool his hon. Friends and get them to vote for his Regulations. He says, "This is not a violation of a principle; it is an extension of a practice". I wonder whether he knows what General Burgoyne said when he surrendered his troops at Saratoga. He said that he was signing a convention and not a capitulation.
It is widely believed that the right hon. Gentleman will capitulate. It is widely believed that he is trying to smooth down his critics on the benches behind him by pretending that the charges are only temporary. He will remember that when they were introduced in 1951, they were only temporary. They were to last for only the period of rearmament and then be removed. It is widely believed that this is the tactic which he will employ. For instance, the headline of The Guardian on 2nd July was:
Increased health charges may be temporary.
What the right hon. Gentleman is trying to do is to encourage his hon. Friends to look forward to an election which they can once again fight with the words, "These charges will be abolished. Our aim is to restore as rapidly as possible a completely free Health Service". Such an attitude may be altruistic, but it is utterly unrealistic and the Government Front Bench, to its credit, knows this to be so.
We shall discuss the merits of the Regulations when they are published, but at this stage I should like to make two points. Probably the delay in publishing the Regulations has lost completely the saving which the right hon. Gentleman intended to obtain in the current financial year. His intention was to raise £3·5 million during a full year and £1·7 million during the current financial year. I am told that there has been a substantial increase in demand in recent weeks. It does not require much brilliance to see that it is wiser to buy now rather than await the increased charges which will come later in the year. I admit that I cannot substantiate this, but I suspect that, far from achieving a saving during the current financial year, the dawdling will have resulted in increased expenditure.
Secondly, I want to make a general comment about charges in the Health Service. So long as there are proper and effective exemptions for poor people, I accept that some charges are necessary. If I had been a Socialist Minister, I would have avoided these charges, because such deep issues of principle are felt by hon. Members opposite. Luckily, I am not a Socialist Minister and I recognise, as do many hon. Members opposite, that the Health Service simply cannot afford to discard a source of revenue which does not cause unreasonable hardship.
Today, 85½ per cent. of its finance comes from taxation; 9½ per cent. from contributions and 5 per cent. from charges. We know that even to sustain the parlous state of Health Service finances, let alone secure an improvement, let alone implement Lord Todd's report calling for an expansion in the training of doctors, let alone raising the proportion of the gross national product spent on health to the figure which applies in many other European countries, or in the United States, or in Canada, purely to maintain the existing services expenditure on the Health Service will be increased from £1,900 million now to £2,500 million by 1974–75. To place full responsibility for financing the Health Service on taxation would be to condemn the Service to an ever deepening financial crisis.
I would try to avoid placing over-much reliance on charges. It is a pity that the Government are just maintaining the old pattern of finances as it was in 1948 and are not attempting to diversify the sources of finance, are not attempting to encourage private insurance to relieve the strain on the Service, not attempting to encourage local fund raising for the use of local hospital projects, not, for instance, following through the thinking behind the suggestions made by my hon. Friend the Member for Farnham (Mr. Maurice Macmillan) in his extremely interesting speech last week.
When one walks around hospitals, around wards for the subnormal, or long-stay wards for senile, geriatric confused persons, when one sees the strain on the nurses and staff as a result of overcrowding and understaffing, I fail to understand how one can seriously argue that one should aim to destroy one of the financial props of the Health Service.
When he introduces these Regulations, the right hon. Gentleman will be doing something which is unpleasant, but not unreasonable. All we ask is that he should cast aside this confusion which he appears to be deliberately creating and stand up like a man and explain to the House what are his intentions.