I beg to move,
That this House deplores the savage cuts in the much needed expenditure on the Health Service and the social services; and demands that the proper priority be given to these services.
In the debate on 11th December 1973 on the reorganisation of the National Health Service, I said that I wished the Press would take more notice of the matters affecting the National Health Service. I was glad to see that in this month's report on the future of broadcasting the Social Morality Council criticised the lack of attention given to those matters both by the BBC and by the Independent Broadcasting Authority. I was also glad to see that the point was taken up by the Lancet in its issue of 26th January 1974.
In the previous debate I pointed out that the National Health Service was in a state of administrative chaos. The situation today is no better than it was last December. There are still large gaps in the appointment of area health authority officers. Many district community physicians will not have been appointed by 31st March 1974, which is, as the House knows, the deadline.
All the evidence in the service suggests decreasing morale and increasing discontent. I mention this not because it is the subject of today's debate but because, concurrently with the failure of the National Health Service reorganisation have come the cuts in capital expenditure amounting to no less than 20 per cent. and a further £42 million in supplies and services.
In passing, we shall have to see how public health generally is affected by the environmental cuts, such as those in refuse and clean air facilities, since these, too, affect the general health and welfare of the community.
I start with a description of the situation in our hospitals, which will face a large series of cuts by reason of the capital expenditure cuts which have been announced. I should like to quote something of what the situation is like now. An article in the Nursing Times for 24th January 1974, which the Secretary of State has probably seen, says
The hospital supply situation, which has been gradually deteriorating in the past few months, is now near crisis point. Surgical dressings, disposables, cotton and plastic items of all kinds are in increasingly short supply".
The article goes on to say that this situation has lasted for the past six months.
The same issue of the Nursing Times highlights the increase in agency nurses. It quotes, for example, Poplar Hospital, which now has 30 per cent. agency nursing staff. The article goes on:
The dilemma about maintaining standards is one which faces many hospitals throughout the country which have to close wards because of staffing problems".
In the light of this I made inquiries at one teaching hospital and found that this also was the case there. In the six months which ended in April 1973 there were 43 staff vacancies. Six months later that figure had risen to 101. I asked the reason, and it was given as low pay and the high rents staff had to pay outside the hospital and the fact that there was no possibility of residential accommodation within the hospital grounds.
Inevitably, I have visited a number of hospitals during the past 12 months and I find much the same situation over and over again—lack of staff, lack of accommodation for staff at rents or prices which they can afford, and lack of residential accommodation for them. It is in the light of all this that one has to judge the cuts that are being proposed. We have the evidence of the British Medical Journal as recently as 12th January of what this will mean. It takes the view that, whatever the Department believes, there will be no new hospital building this year. The Secretary of State might care to look at the British Medical Journal. It says also that there will be savage cuts in maintenance.
I know that the Secretary of State in the high summer of last year shocked the Daily Mail by describing himself as the biggest slum landlord in the country when he described hospitals. I know what he meant. Having seen them, we have exactly the same feelings. But what is the future of our hospital service going to be with these cuts in view and these staff difficulties and shortages in mind? We shall obviously have a delay in building and in obtaining staff and an increase in waiting lists. What I fear most of all is that we shall have what we have had in so many other aspects of Government policy—a two-nation service.
I should like to tell the House about an advertisement which appeared on 18th January this year in The Times. The advertisement called upon people to form a BUPA staff group. The words in the advertisement were
To provide key men with private medical care.
A week later, on 23rd January 1974, there was an advertisement in the Financial Times. This related to another private patients' plan. It was headlined:
Your little girl has to go into hospital. You've been told she has to wait. You're worried. This situation can be avoided. If you were a subscriber to Private Patients' Plan your little girl would go straight into a private room.
Nobody who read The Lancet in its edition of 19th January 1974 could have failed to be moved by the catalogue of frightening diseases to which miners are prone by virtue of their occupation. I doubt whether the miners or, indeed, the 800,000 people who work in the National Health Service are the key men referred to in the advertisement which I have quoted. Not for them or their little girls is there a possibility of queue jumping straight into a private room. There we have it—unparalleled growth of agency nursing, unparalleled growth of private schemes for queue jumping. The Secretary of State now has the distinction of bringing back, after 200 years, leeches into the medical service.
I have talked about the hospitals. I want to mention the community aspect. In yesterday's Sunday Express, which I hope the Secretary of State read with considerable pleasure, as I did, there was a suggestion that he was soon to become Chancellor of the Exchequer and to move into No. 11. Of course, if the Sunday Express is right, this debate might very well herald his swan song. The right hon. Gentleman laughs. I am bound to say that it would do the health service no harm, and, so far as the Exchequer is concerned, it could not do worse.
I thought the proper gift to make to the Secretary of State at this moment, if this is to be his swan song, would be to remind him of the wise words he uttered in his first speech to the House as Secretary of State for Social Services on 13th July 1970. This is what he said:
Many people are in hospital who should be treated at home or by the local authority
services."—[OFFICIAL REPORT, 13th July 1970; Vol. 803, c. 1175.]
I absolutely agree, and I trust that he believes that today.
I should like to refer to another speech, this time by one of his hon. Friends, the Member for the Wrekin (Dr. Trafford) on 11th December last, reported at c. 236 of the OFFICIAL REPORT. It was a very thought-provoking speech. The hon. Gentleman, since he criticised me quite a bit, will not expect me to agree with him on every point, but he made a point of extreme interest and I have thought a good deal about it. He mentioned coronary care. He mentioned the case of an ambulance crew which, I think, answered 1,000 calls, as a net result of which there were four cases of possible saving in terms of mortality.
These were very impressive figures and it was an impressive argument. The hon. Gentleman did not make a definite statement; he merely speculated on whether we were using our resources wisely. The possible saving in terms of mortality in these four cases has been achieved at enormous cost, compared with the provision for all the other interests which press upon us. He mentioned specifically homes for the elderly, treatment of the limbless and the care of arthritic sufferers. He is following and, indeed, intensifying the Mather study reported in the British Medical Journal in 1971. I do not know that it made a definite point, but it seemed to indicate that for many coronary patients proper home care was at least as effective as the best possible treatment. So treatment in the home or in the community is the front line in medical service, or ought to be, in our community.
That was the way in which the Secretary of State first considered the future when he took office in 1970. He started by telling us that he was impressed by and interested in the development of health centres. It is perhaps worth while dealing with the history of the health centres. During the 13 years of Conservative Government up to 1964 we built 14 health centres, and then when Mr. Kenneth Robinson became the Minister of Health he inaugurated a push which resulted in a further 318 built or building by the time we left office in 1970. The number today is 492. Therefore, about 150 have been built during the period of office of the Conservative Government. The Secretary of State will find that my figures are correct, because in the total figure are included a small number—10, I think—built under the first Labour Government; 150 have been built under this Government.
However, the planning of a health centre is not done overnight. It can take many years. Four or five years is the usual period from the first idea to the final construction. What is happening at this moment is a total full stop on the building of health centres. The British Medical Journal of 18th August 1973 said:
Organising a move to a health centre takes time, certainly many months and sometimes several years…Such a sudden policy reversal "—
it was referring to the present Government's change of policy—
is bound to make doctors more cautious about entering into negotiations for health centres in future.
Obviously, this must be so because if they are once disappointed their feelings about trying it again, particularly in view of the time involved, are bound to dictate their attitude. The article went on:
Furthermore this damage to the profession's confidence comes at a time when experience suggests that health centres are an asset to patients and doctors without so far compromising the latters' professional freedom.
These are very strong words, and they come from a very authoritative source. They cannot be disregarded. But we can all see in our own constituencies the effect of the Government cuts. Take, for example, my own borough of Lewisham. There are eight social service buildings, I am informed, which are in danger of being refused permission to continue. Of these, there are four health centres, two homes for the elderly and one day centre for the deaf. I suppose every hon. Member, if he cares to consult his own borough, will find that similar worries and difficulties are occurring in his own area.
What should we do about it? In our motion, we say that under this Government the priorities are wrong. How do we put priorities right? I began by saying that I thought that the Press, the BBC and the Independent Broadcasting Authority ought to keep a watch on our health and welfare services and on our debates in Parliament. I believe that they should, but I believe also that we may be equally guilty. Normally, I suppose, we have two or three debates in a year on this and allied subjects. What is needed is a continual watch upon the situation. I suggest, therefore, that a specialist committee should be set up for health and welfare matters, a committee which would keep an ongoing watch on the whole service. Embarrassing as it might be to Secretaries of State of either party, it would be an admirable move for the future of our health services.
More than that, we should use our resources in the best possible way. I cannot help feeling that a party which prefers building Maplin and the Channel Tunnel, especially in the middle of an energy crisis, has its priorities wrong.
I am delighted to hear it, and it is about time we devoted some of those resources where they are most needed. A party which cuts down on housing and house building, and a party which neglects community services has its priorities wrong. Such a party in government is ruining the health and welfare services, and, once ruined, those services are difficult to restore.
There is another essential lacking in the service at present. We need, above all, a health service in which the voice of the patient is pre-eminent. After all, the patient is our concern. For this reason, we on this side have constantly advocated that there should be a democratic health service. We have seen what the effect of the managerial approach has been.
Earlier in my speech I spoke of administrative chaos. I could have gone much further, but it did not seem to me that we were today debating the reorganisation of the health service. But we shall return to it. We shall have to. The administrative chaos to which I have referred has come from a managerial approach, whereas a democratic approach, whereby the patients themselves are the ones concerned, whose word and advice is taken, will give the sort of service that we need.
What does the right hon. Gentleman mean by a "democratic" service? Does he mean that patients will man the offices and decide policy? It is a silly emotive word to use in this debate. What does the right hon. Gentleman mean by it?
For a reasonable fee—a contribution to the funds of the Labour Party—I am willing to give the hon. Gentleman a small seminar when he and I have a little more time. The word "democratic" means rule of the people, and the rule of the people, in our view, is best expressed by dealing with the health services through our local government structure. Incidentally, if the hon. Gentleman had taken the trouble to be present at previous health service debates or had studied the Committee proceedings on the National Health Service Reorganisation Bill, he might have informed himself rather better.
The third need—I regard this as vital today—is for a service in which the staff really count for something. The National Health Service has 800,000 employees. I include the doctors, of course, because they need to be consulted and to have their advice taken and tested. But, apart from doctors, I mean nurses, and not only hospital nurses but district nurses and health visitors. I mean therapists, radiographers, dieticians, technicians, office staff, transport staff, porters, the people who prepare the food, and, in the community, the home helps.
Those are the people who maintain the fabric of essential services—in other words, all those whom a former editor of the Lancet happily described as the "greater medical profession". These are the people to whom an efficient and responsible Secretary of State could appeal, who could work with him to produce the sort of health service that we need and restore to it the priority which it deserves.
We deplore the state of our health and welfare services at this time, for the reasons which I have given, and we shall not rest until they have been given the priority and the resources which their importance demands.
I beg to
move, to leave out from "House" to the end of the Question and to add instead thereof
endorses the Government's decision for the reasons given in the statement by the Chancellor of the Exchequer on 17th December to reduce during 1974–75 the demands on resources for the health and personal social services programme, without altering the substance of that programme.
Although, in answer to the right hon. Member for Deptford (Mr. John Silkin), I shall be able to show figures substantially better, on any fair basis of comparison, during the 3½ years of Tory Government as compared with Labour, this debate brings me no joy. It is a disappointment to me to have to preside over a reduced rate of improvement in the health and personal social services. That it is a disappointment to me is relatively unimportant, but it is also a disappointment to the devoted staffs of the National Health Service—the "greater medical profession" to which the right hon. Gentleman referred. It is a disappointment to the devoted staffs working in the local authority and voluntary sectors of our personal social services. More important still, it is a disappointment to the patients and to those families which are often bearing the burden of care at home without enough support.
I do not need the right hon. Gentleman to spell out the reasons why this country needs a better, more modern, and more systematic National Health Service and personal social services. Reason not the need, say I to the right hon. Gentleman. He is perfectly right to focus the attention of the House on the reduced rate of improvement which is the result of the Government's decision. Of course, one of the few happy advantages of an Opposition is that whatever the Government had decided to do in the face of an energy crisis—they agree that something had to be done—they would perfectly legitimately have initiated a debate and criticised. That is their right. There is to be a debate tomorrow on the wider issues lying behind the decision of the Chancellor and the Government upon where the economies for the ensuing year should be made. In passing, however, I must remind the House, after the right hon. Gentleman's relatively light-hearted references to Maplin and the Channel Tunnel as affording possible ways for the Government to economise in the current year, that no large spending is planned on either of those projects during 1974, and economies on them would not have produced the sort of scale of savings which the Opposition in their statements seem to regard as necessary.
Also, before I come to the main subject of the debate, I must correct one other misapprehension on the part of the right hon. Gentleman, who is normally so precise in his facts, although not, in my view, in his judgments. The right hon. Gentleman said that the district community physicians under the reorganised health service would not all be appointed by the end of March. It is my information that the crucial interviews are going on now and that all the district community physician posts will be filled. There may be one or two which, for personal reasons, will not, but in general all will be filled by the due date.
I shall go through the capital and revenue prospects for the National Health Service and the local authority personal social services in the light of the Chancellor's announcement, and by that means I shall answer systematically the argument put by the right hon. Gentleman.
I take first, the capital position in the National Health Service. Even after the reduced provision for this coming financial year, we shall be spending on National Health Service capital account—that is, building, new building, upgrading and improvements—significantly more in real terms, in comparable figures, than was spent by Labour in Labour's last full year of office. That is not a great comfort in itself. So we should. Over the last three years we have spent, on average, in real terms, 30 per cent. more each year than the average of Labour's last three years, and from that high rate of increased expenditure we now come down to a disappointingly lower rate: one which is lower than we would wish but still higher than Labour's last spending figure
We are discussing with the regions how the impact of this reduced capital expenditure will be spread. The House will note that we put a lot of extra money in to raise the level of the neglected sectors—mental illness, mental handicap and the geriatric services. We still intend to protect these services so far as is practicable in the allocation of the money available.
We also intend to protect one or two other services which particularly need encouraging—the cancer services, the rehabilitation services and the services for the younger chronic sick. We do not anticipate having to interrupt the expenditure on any work now in progress. However, the result of the lower than hoped for level of capital available will mean that there will be fewer new starts in the next financial year.
Will the right hon. Gentleman say whether provision for safety against fire will be affected by the cuts? Many of the old hospitals lack fire safety provision and more money is essential for it and should be brought forward without cuts in the immediate future.
The hon. Lady is on to an excellent point. That is also one of the areas of expenditure that we shall be sheltering so far as we can.
I turn now to the question of health centres, on which I think the right hon. Member for Deptford was a little wrong. It is true that often a building the size of the health centre is several years in gestation for all sorts of understandable reasons. We inherited 213 when we came to office. During Labour's term of office 167 of them were opened.
I shall be perfectly fair about this. Labour had opened 167, some no doubt due to initiatives they had inherited. Now there are 524 in action of which 254 have been opened in the last three and a half years, admittedly many of them inherited from a Labour initiative. More than 181 re being built, and even with the lower amount of capital available we hope to start another 72 during the next financial year. Therefore, the momentum which both parties welcome is being solidly maintained. I turn to the National Health Service revenue position. Here the only abatement of spending is 10 per cent. on purchases other than food, drugs and related supplies. Of course, a number of shortages to which the right hon. Member for Deptford referred are due to the energy position and to short-time working in the firms concerned. In spite of the lower rate of money available there will be a £60 million increase in real terms during 1974–75 in National Health Service revenue over the current financial year. The revenue available for the NHS has risen sharply since we came to office. It is now running at 15 per cent. more in real terms than 1970–71 and the evidence of this enormous increase of £300 million more in real terms per annum as a base for next year is the startling increase in staff.
During Labour's term of office health service staff increased by 2½ per cent. on average a year. During our term of office the staff has increased on average by 4½ per cent. a year. Certainly there are problems. Agency nurses worry us all. We have taken an initiative which we hope will reduce the problem, but it is true, as the right hon. Gentleman said, that the difficulty with housing makes it very difficult to recruit nurses in some of the London hospitals.
We also need more staff. There are more in-patients, out-patients and day patients. Treatment is more intensive, but mercifully we are increasing the staff, though never fast enough. During our period in office the number of hospital medical staff has risen by over 15 per cent. There are 18 per cent. more consultants; 20 per cent. more senior registrars; 4 per cent. more registrars; 22 per cent. more senior house officers and house officers; 12½ per cent. more in hospital nursing and midwifery; 14 per cent. more professional and technical staff; 4 per cent. more ancillary staff; 4½ per cent. more GPs and 14 per cent. more local authority nurses and mid-wives. The intake of medical students has gone up by 23 per cent.
These figures still leave us short, but they are substantially more than when we came to office, and the figures have increased at a far faster rate than during Labour's term of office.
The right hon. Gentleman says that they should, but the Labour Party constantly seeks to pose as the only champion of the National Health Service. It is fair to remind the House and the country that, judged by performance, we have done much better than Labour. Of course, we should like to do better still.
Since, as we are no doubt agreed, rehabilitation and assessment centres are aimed at keeping people out of hospital in their own homes and giving them what they need, is the Secretary of State planning to spend more on them, or less? We should be spending a whole lot more.
I said that rehabilitation was one of the services that we were going to shelter, and that is true of comprehensive assessment centres.
I turn to local authority personal social service capital. These are areas—old people's homes, homes for the mentally handicapped, hostels for the mentally ill, day centres and training centres—that have been sorely neglected by all Governments in the past. We have an increase in the numbers of the elderly, a new awareness of the needs of the disabled and the mentally ill and mentally handicapped, and the impact of legislation such as the Seebohm legislation, the Chronically Sick and Disabled Persons Act and the Health Services and Public Health Act. In the light of this the Government have rejoiced to be able to allocate much more money for local authority personal social service capital than the figures we inherited. The 20 per cent. cut in personal social service capital will reduce our spending to a figure still far above that, in real terms, which we inherited, but will be a great blow to those who regarded our original allocation—much increased though it has been—as far too little.
The projects we shall have to defer were conceived under pressure from the local interests, from the families of the mentally ill and the mentally handicapped, under pressure from the local pressure groups—and good luck to them—under pressure from the local authorities, and under pressure from the Government. It is all the more disappointing that some of them will have to be deferred. Yet the fact remains that the capital allocations in real terms, the capital for the personal social services, will be 40 per cent. higher next year than in Labour's last year of office. That surely is welcome to both sides of the House. We shall be deciding the reduced allocation as soon as possible. But even after the reduced allocation, the number of places we expect to be provided in 1974–75 by the local authorities will be at a record level except for one year—last year.
We hope for the provision of no fewer than 10,000 places—5,000 residential and 5,000 day places—which will enable a significant improvement for the elderly, the mentally handicapped, the mentally ill and the disabled. In our three years 1970–73, there will have been an increase of 30 per cent. in places in hostels for the mentally ill; of 30 per cent. in places in homes for the mentally handicapped; and of about 20 per cent. in places in adult training centres for the mentally handicapped.
On the 1970 levels. I am trying to cover a lot of ground fast, and I turn penultimately to the local authority personal social services revenue, where we face a slower rate of growth for next year. Yet the figure allocated next year of £395 million will be more than 50 per cent. up in real terms on the figure so allocated by the Labour Government in their last year of office.
Here again, we can show a sharp increase in the number of crucial staff. For example, there has been an 8 per cent. a year increase in the number of home helps during the Tory period compared with 2 per cent., on average, during Labour's term of office. There has been a sharp increase in the number of health visitors and district nurses; the number of home meals served in the last three years has increased by 35 per cent. and the number of social workers has risen by 33 per cent.
I do not say that these are enough, but they are significant evidence of the sharp increase in real spending where it most matters. I do not have full figures for 1973, but I gather from the grass roots that last year the local authorities spent more than they fore- cast. I have to say that I rejoice that they did so. I must also tell the House that, with the lower rate of increase, 1974–75 spending will still produce a forecast expenditure level in the personal social services 15 per cent. above the level of 1972–73. How much of that is spent next year will depend upon how much was spent last year—because some local authorities spent far more than they had forecast.
The reduced level of rate support grant, compared with what local authorities forecast they would need, leaves it to local authorities to decide how to allocate the money available from the taxpayer. A suggested distribution of the money available was proposed by the Government, but my right hon. and learned Friend the Secretary of State for the Environment stressed that the decision on distribution was up to the local authorities. He and my right hon. Friend the Minister for Local Government and Development emphasised that personal social services may not be the sort of services on which local authorities will choose to economise during the coming year. It is up to the local authorities. Some may limit the growth in personal social services expenditure to the forecast rate; some may limit it even more than that, although I hope that there will be very few of the latter. Some, perhaps many, may decide to keep up the momentum.
It was I, as the Minister concerned, who invited the local authorities to prepare 10-year plans for the personal social services. In the last three years' expenditure, so far as we can judge, the financial assumptions underlying the invitation to submit 10-year plans have been fulfilled. The money has been available for the spending to be maintained at the level on which we advised the local authorities to base their 10-year plans. That includes even next year because of their over-forecast expenditure during the last two years.
We cannot tell what money will be available for the rest of the decade, but the plans which the local authorities have been to such pains to prepare will have been first-class exercises because they will have enabled them to sort out their own priorities, measure their own needs, and assess the implications of the priorities they have established.
The Government propose to publish shortly information derived from these 10-year plans as a feedback for the next time the local authorities are invited to revise their 10-year plans, but there is no disguising from the House that the reduced rate of acceleration to which the motion refers is a disappointment to the Government and will be a great disappointment to the local authorities and all interested in the personal social services. But I maintain that, as the amendment suggests, the substance of the services has not been touched. What is being affected is the rate of improvement. We all regret that, but let us all rejoice at the rate of improvement of the last three years and hope that we can recover that momentum. I hope, therefore, that the House will accept the amendment and reject the motion.
I want to be brief and, if possible, non-political. Therefore, I shall refer first to some quite acceptable statistics of the number of people who will now be put at risk or whose hopes will be held back as a result of the Government's policies.
We are all well aware of what can be done for the disabled. We are all well aware that if they are properly assessed and go to good rehabilitation centres a substantial number of the disabled can be helped. These people can be helped, on an expanding market, only if we expand rapidly. I must say to the right hon. Gentleman that, although he made a nice, pleasant speech and said that things are going reasonably well and that he was sorry about the cuts, it is my view that about 1 million people will be disappointed by his statement and that 1 million people will be placed at risk by the Government's policies.
I am not going to use Labour Party policy or Labour Party figures; I am going to quote from Amelia Harris, a Government survey. This has clearly shown that very severely handicapped people needing special care number 157,000; severely handicapped people needing considerable support number 356,000; and appreciably handicapped people needing some support number 616,000. Those figures total over 1 million people.
The right hon. Gentleman has a tremendous amount of compassion and understanding, and he knows that the cut-back taking place affects 1 million people who have had great expectations of relief. I shall give one other figure, again from Amelia Harris. There are 79,000 severely handicapped women living alone. The Secretary of State knows that these people can be helped if their needs are properly assessed and if there is a proper follow-up procedure.
The hon. Gentleman is talking thoroughly inaccurately. He is suggesting that, but for the abatement of the rate of acceleration next year, all those people would have been helped in one year. Most of them are receiving some help now, and many of them will receive more help next year. The hon. Gentleman is wrong in suggesting that but for the modest deceleration which we are discussing people would have been helped next year who otherwise would not have been helped.
I accept the Secretary of State's censure. What is wanted is not deceleration but rapid acceleration. Whether my party does it or the Conservative Party does it does not matter a damn to me. I am concerned about these people. In a civilised society we should be advancing and recognising need where it exists.
Having recognised the need, how does one tackle it? The intelligent use of assessment centres and their staff in rehabilitating people holds great promise. It can keep substantial numbers of people out of hospital. It can save substantial sums of money. In the last few months I have visited three units in particular. First, tremendous work is being done at Mary Marlborough Lodge, in Oxford, by Dr. Phillip Nicholls and his staff. He is a first-class man who treats all his staff as equals, and they assist severely handicapped people to return to their homes and lead full lives.
The problem is that the number of assessment centres is not being increased as rapidly as it should be. In the long-term the Secretary of State may save money as a result, but what we are talking about is morally right, economically sound and technically possible, and we should be proceeding along these lines
I discovered last week, out of the blue, that there is a development unit at the Royal Manchester Hospital where every year about 300 to 400 children under the age of 5 are seen. Their needs are assessed and a team looks after them in co-operation with the parents. Each year 300 young people who might otherwise become a burden on society are assisted to earn a living and take their place in the community. If we slow down the creation of such places, it is a terrible condemnation of our society. I am not making a political point. We should be convinced of the need to spend more money in this sector.
I have mentioned the Mary Marlborough Lodge for severely handicapped people and the child development centre in the Eccles and Swinton area. Across the river, in St. Thomas's Hospital, the really severely handicapped person—the respo-naut—can be assisted to live at home, and the hospital will send a social worker to bring him back to hospital when he is at risk. We must not cut back on such services. The Secretary of State was in a dilemma in this respect. There is a crisis of conscience. Heaven forbid the right hon. Gentleman ever becoming Chancellor of the Exchequer. I think that he is happier and probably more content in his present post.
The Secretary of State referred to the long gestation period in the development of health centres. If the time it takes to bring a health centre into being is as long in the rest of the United Kingdom as it is in my constituency, the midwife will probably shoot herself because she would be waiting a very long time after the delivery of the baby. Clifton, Pendlebury and Swinton have been expecting since 1971. The birth of their health centre was announced in a local newspaper in 1971, but they still do not know when the baby will arrive.
By every criterion laid down by the Ministry—and there are six of them— that area qualifies, except for one which does not apply to my constituency. Swinton, Pendlebury and Clifton qualify for a health centre by the definition laid down by the Department. The matter was agreed in 1971, and people are still making up their minds about it in 1974. I have heard of gestation periods, but this is ridiculous. It is high time the Minister made up his mind and said that there was a clear case for providing the people of Swinton, Clifton and Pendlebury with a health centre.
People talk from time to time about the need to make peace with the miners. I am, proudly, the son of a miner. I was brought up in a mining community. I live in a mining area in North Wales, and my constituency has a very large mine in it. An uncle of mine died in 1931 coughing up his lungs with silicosis. Friends in Wrexham cough up their lungs because they suffer from the miners' disease. My hon. Friend the Member for Rhondda, West (Mr. Alec Jones), who is sitting on the Opposition Front Bench, probably knows a large number of people who cough up their lungs.
I do not refer to this matter for emotional reasons. A long time ago I made representations to the Ministry about the need for it to review its policy relating to the victims of pneumoconiosis. This morning I had a report about a widow whose pneumoconiosis claim was turned down. The wording states:
On the balance of probabilities, he did not die from pneumoconiosis.
I know that he died from pneumoconiosis because I met him and I heard him and saw him cough up his lungs. The pathologist opened him up when he was dead and said that he had pneumoconiosis. Yet some bright spark of an insurance officer, although everyone agreed that the man had died of the disease and that his widow should benefit, said, "No. I will appeal". He then went to court, where the matter was argued statistically. This is a callous situation. How mean can one get, indeed how obscene can one get, when there is argument about whether 10, 15 or 20 per cent. of a man's lungs has been destroyed? The man himself knew what he had; he was dying of it. His widow knew that he died of it. His doctor and neighbours knew that he died of it. The pathologist knew that the man had died
of the disease, but some bright spark in London had doubts. In legalistic jargon, the bureaucrat said that on the balance of probability he did not die of the disease.
If the Under-Secretary of State wants to show the miners that he has their interests at heart he must review his policy and reconsider the way in which the Government handle the victims of miners' diseases.
The hon. Member for Eccles (Mr. Carter-Jones) will have the sympathy of most people on his last point. I agree that the phrase "balance of probability" is a typical example of a bureaucratic decision. I do not know whether we had the full facts of the case, but certainly in most of what he said the hon. Gentleman has the sympathy of the House. However, having put such an example of what happens under "bureaucracy", I do not know why most of the hon. Gentleman's favours are bestowed on a system that would have the effect of extending the bureaucracy to other aspects of our life. For this reason I like to see a greater measure of private enterprise in any decisions which are made. That perhaps is the difference between the hon. Gentleman and myself.
I congratulate the Opposition on choosing this subject on one of their Supply Days. In a situation in which the overall inflationary problems facing the country are reaching such dangerous proportions—when it was obvious to everybody that some economies would have to be made to defeat the overriding killing dangers of inflation—it was obvious that there would have to be some cuts or slowing up in expenditure. When these cuts affect the National Health Service and social security, it is right that the subject should be examined in detail by Parliament. This Opposition Supply Day debate follows the proper decision made by my right hon. Friend the Chancellor of the Exchequer and the Government to stop inflation whilst seeking to maintain the material standards of our people and to preserve our general services. This is what they had to do to avoid our nation going bankrupt. Having taken the steps they have, it is right that the House should examine the allocation of the restricted amount of money which may now be spent—restricted only in the sense of the sum being a reduced future budget rather than a cut. It is important that we should examine the right things to be done in this situation
Although 90 per cent. of the remarks made by the right hon. Member for Dept-ford (Mr. John Silkin) were useful and constructive—he made practical points which I hope my hon. Friend the Under-Secretary of State and the Department will keep in mind in coming to their view on reduced allocations—it was a pity that the right hon. Gentleman sought to drag in a bit of "party blarney". The right hon. Gentleman had a good case to put in this useful debate without having to go in for such obvious party politics. I suppose it must be said that the Labour Party is responsible since in tabling its motion it referred to "savage cuts" as though to imply that the Conservative Government were being deliberately savage and unfair. Hon. Members opposite know that that is not true, and there was nothing in the right hon. Gentleman's argument to substantiate the suggestion of "savag" cuts.
Nowadays everybody seems to find it necessary in a debate of any sort to refer to the miners. The right hon. Member for Deptford managed to bring the miners into his remarks and sought to tie up that argument with BUPA. The BUPA organisation has a very fine record. I do not know whether the right hon. Gentleman, for purely sectional reasons, wished to go out of his way to seek to undermine that great organisation which is doing good work. Whenever I go to Blackpool—and I go there quite often, though no doubt the right hon. Gentleman goes only when his party conference is held there—and when I enjoy the bracing breezes, I do not envy the convalescent home which has been set up for miners in the resort. I have always taken the view that it is a sensible thing that they have fixed up that arrangement for themselves. Why should BUPA be dragged up in the House when it is merely seeking to do the same sort of thing?
In the long term if we sought to cut out BUPA altogether the scheme would probably be set up elsewhere, in Ireland or on the Continent. What would happen would be that we should lose those contributions from the revenues of this country and it would undoubtedly be pursued as a scheme elsewhere. It would also rob this country of the skill of the doctors who stay in this country because of the finances and assistance provided by such bodies as BUPA. I am not prepared to let private patients rob other more deserving cases of their proper priority. I do not think that happens. The fact that those doctors remain in the country gives us a better service which in the long run helps everybody.
I take it that the hon. Member for Peterborough (Sir Harmar Nicholls) was here when I read the advertisement from the Financial Times. That advertisement instanced the example of a little girl going straight into a private room of a hospital. Did that not strike the hon. Gentleman in the present situation, where one wishes to have a united nation, as obscene?
I heard the reference by the right hon. Gentleman to that advertisement. That is what I had in mind when I said that he was seeking to bring in party politics and matters of class bitterness and class distinction. I heard the right hon. Gentleman quote the Financial Times. I know what his intentions were in doing so. He wanted to give the impression that once again the Tories wanted to look after the favoured few, while the lovely Labour Party would look after the masses of real deserving people. That is not true. Indeed, what he said was obscene since it was untrue. It is not good that the right hon. Gentleman should seek to divide the nation in that way, and it is a pity that he has sought to upset this debate. The right hon. Gentleman had many good practical points to make. I do not believe that BUPA was deserving of his censure. After all, as an ex-Minister he has a responsibility to point to the good BUPA does.
I wish to make one quick point before I get on to the Peterborough Hospital and certain matters which I want to press on the Under-Secretary of State. If a slowing down of Government expenditure is necessary, and if the situation calls for imposition of cuts, there are surely many services which my right hon. Friend the Secretary of State for Social Services could look at as well as those he mentioned in his speech. I should like to put one example to the Under-Secretary of State, and I shall be interested to hear the Government's answer. This matter relates to social security rather than to hospitals.
On Saturday, 12th January of this year, in what is known as the "Late Late Show", run by a Mr. Byrne in Southern Ireland, it was announced that the show had paid to bring over an Irish lady living in Liverpool to give some testimony to the viewers of Southern Ireland. What follows is the testimony that she gave, and I believe that it was part of an attempt to point out how unfair was the situation in Ireland where a father is not forced in law to maintain his wife and children when he is separated from them. I believe that an effort is being made to alter that state of affairs, and it is not for me to comment on what another country like Ireland does.
However, the lady said that, because she was separated from her husband and wanted to keep the four children of the marriage, she sought advice and was advised to come to England. She had never been to England before. With her four children, she took a boat and landed at Liverpool. Within 24 hours of her arrival she went to the social security office and, as a result, she and her four children were put in an hotel. The total cost to social security was £30 a week, £25 going to the hotel and the other £5 to her to spend on the children. After five weeks in the hotel, paid for by our social security arrangements, she was allocated a council house at Liverpool and given £120 to buy furniture, again by social security. She is now living in that council house, and she receives £20 a week from our social security. Of that sum, £4·10 is for rent and the remainder is to keep herself and her children.
I am as sympathetic as anyone to the desire to build up proper safeguards and safety nets for people in trouble. But is my hon. Friend satisfied that this is the right way to spend British taxpayers' money?
On a point of order, Mr. Deputy Speaker. We are debating the Government's cuts in health and personal social services. The hon. Member for Peterborough (Sir Harmar Nicholls) is raising a matter affecting our social security arrangements. There have been no cuts in social security. Is not the hon. Gentleman out of order, therefore?
I do not think that that is a point of order. Perhaps the hon. Member for Peterborough (Sir Harmar Nicholls) will be able to reply to the hon. Member for Willesden, West (Mr. Pavitt) and to finish what he has to say. Alternatively, it may be that he will allow the hon. Member for Willesden, West to intervene if he wishes.
My point is that the cuts which we all deplore on hospitals could be considerably less if cuts were made in the other area of the Secretary of State's responsibility, social security payments. If we saved money there, it could be spent in areas like those referred to by the hon. Member for Eccles.
I am delighted that the hon. Member for Eccles has asked that question. I pass it straight over to my hon. Friend the Under-Secretary. That is precisely what I want to know. How many people are doing it? If we find that a sufficient number are doing it to enable us to save money by stopping it, we can spend more on hospitals and on the home help service. I hope that my hon. Friend will be able to tell us, because people believe it to be a widespread practice and it is the kind of practice which is disturbing so many of our citizens. If it is widespread, it should be dealt with, and I hope that this Government will have the courage to deal with it.
The final matter to which I wish to refer has to do with Peterborough. It has been a good neighbour to London. At the request of the Government of which the right hon. Member for Dept-ford was a member, Peterborough agreed to accept the new towns procedure and take overspill from London. That has happened, and the procedure for dealing with the overspill is moving reasonably satisfactorily. However, I discovered that the hospital services which were set up to deal with the Peterborough district as it then existed are not being expanded to deal with the additional people coming as a result of the overspill and new town procedures being foisted upon Peterborough by the Government.
I believe that this and any future Government have to recognise that if an area like Peterborough is prepared to help solve what is a national problem the local people making that contribution ought not to suffer as a consequence. The Peterborough Memorial Hospital was just about adequate to meet the needs of the area before the expansion plans to bring in thousands of other people.
My hon. Friend the Under-Secretary has visited Peterborough, and I know that he is aware of the problem. I ask him whether he will see to it in his Department that, in addition to Government grants which are made to regional hospital boards to deal with the general hospital services in their region, there will be an extra direct grant to any area taking on special responsibility such as that which Peterborough is now doing. I want him to discover within the regulations how that can be done. I know that my hon. Friend has sympathy with my view. In his official capacity he has said that this direct grant, which I think is morally right and ought to be put into effect, cannot be given. He said that the Department must keep to the procedures laid down.
My hon. Friend made a good impression when he went to Peterborough. People there thought that he was the finest type of Conservative Minister. I endorse that view. I was delighted that he visited Peterborough, and he is welcome to come again at any time. However, on this issue, unless the Government face the facts and accept what is Peterborough's due, he and I will have to continue a battle. Both he and his right hon. Friend will not easily silence me on this matter. The needs of the area are justified. Peterborough has been asked to bear a burden that it should not have to bear alone. Therefore, I want to use the opportunity of this Supply Day provided by the Opposition to impress upon my right hon. and hon. Friends, who now have the power of government, that Peterborough should get its proper deserts and have its problems examined with sympathy.
The point that I wish to make refers mainly to the impact of the cuts on the mentally sick and handicapped. I listened with great attention to the Secretary of State when he explained the mathematics of the cuts and how they will affect various forms of Government and local authority expenditure. It was not at all clear from his figures exactly what effect these cuts will have on these services. The right hon. Gentleman gave us a series of figures designed to show, I concede instantly, that expenditure in almost all these spheres is substantially above the level of expenditure during the Labour Government's period in office. But that does not help us to understand the problem. The problem is what effect these cuts will have on the kinds of schemes about which the right hon. Gentleman was talking. How will this year's expenditure compare with last year's? I hope that the Under-Secretary of State will try to enlighten us on what we all want to know, which is not told us by partisan comparisons between now and 1970.
The one thing that I deduce from such figures as we have is that at best there will be a standstill in the increase of capital expenditure in 1974 compared with 1973. I hope that I shall be corrected if I am wrong on that point.
The fact is that in the spheres about which I am talking there was already a critical situation before the cuts were made. The Government's policy for handling the problem of the mentally sick and handicapped in our community is right. The Opposition have always supported the policy of running down the mental hospitals and making provision in the community for all those patients who ought not to be there. But hon. Members who are in touch with the problem in their constituencies know that the policy has not been working.
Even before the cuts, the provision of community services lagged far behind what was necessary. The result was that many patients were coming out of hospital improved in their situation and condition but without support in the community. In consequence, they were relapsing and going back into mental hospitals, finding themselves in reception centres, sleeping out, or in other difficulties.
Now we are faced with having to cut these absolutely vital services. I recall that before the cuts the MIND organisation, of which I am chairman, made a survey of what local authorities were doing to provide residential accommodation for the mentally sick and handicapped coming out of hospital who would otherwise have to stay in hospital. We compared the performances of all the local authorities in 1970 and 1973. Though these two surveys showed that there had been some improvement, we concluded—I do not think that it is disputed—that the provision of community care for these people was still grossly inadequate before the cuts were made.
The Secretary of State said that it is heartbreaking that so many of these projects, conceived under the pressure of the local authorities, the voluntary organisations and the Government, have now to be deferred or abandoned. I should like to convey the despair, almost, of those who have been trying to stimulate local authority construction of day centres, residential hostels, training centres, and so on, when they see the most adventurous and imaginative local authorities now being punished, in effect, and the lazy ones being given an excuse for continued indolence. That is the effect of the sudden switches and sudden cuts in future available finance.
In my constituency Greenwich Borough Council produced an imaginative and ambitious community plan for nursery schools, a home for the elderly and, in particular, a £160,000 combined day centre for the physically handicapped and mentally sick, providing 60 places. There is a parallel day centre already working admirably in the borough. The proposed day centre was scheduled for 1974–75, together with a £197,000 training centre for the mentally handicapped, with 80 places. These projects are now at risk, whereas previously they were certain. Tomorrow, representatives of the borough council will be meeting Government officials to decide whether the schemes can stay in the programme.
Councillors in my constituency are asking whether they have been wasting their time by following the Government's lead and encouragement and producing an ambitious plan for services for the mentally sick and handicapped. They are asking if they will be able to carry on with these admirable schemes. No doubt what they feel is also felt by the best local authorities all over the country.
Because of the lack of community facilities for the mentally sick and handicapped the situation is becoming chaotic. It has been aggravated by the aftermath of the Seebohm Report. There is an almost universal feeling that at the moment the changes recommended by the Seebohm Report have been greatly to the detriment of the care of the mentally sick and the handicapped.
A psychiatrist friend told me a few days ago that he was called to see an old lady who, it was thought, might have to be compulsorily admitted to a mental hospital. When he called to see the lady the psychiatrist met a welfare officer—a young man who had formerly been a child care officer. The welfare officer, though he had no doubt been an excellent child care officer, simply did not know the provisions of the Mental Health Act. He did not know the provisions for compulsory admission to mental hospitals. As the old lady was out, my psychiatrist friend used the time to inform the welfare officer—who should have been able to protect the old lady from the attempts of the psychiatrist to have her put into hospital—of the provisions of the Mental Health Act.
We all hope that the Seebohm reforms will settle into place and that generic training of social workers will bring about further specialised understanding of all fields, including mental sickness. However, in the meantime this thoroughly unsatisfactory situation is adding to the difficulties resulting from the lack of residential care.
I make one suggestion of a sensible cost-effective way of helping to ease this terrible lack of community services. It is much cheaper and in many ways better to back voluntary effort in this field at a time such as this. Voluntary organisations can make economical and successful provision for community care for the mentally sick and mentally handicapped. I do not know whether an honorary chairman should declare an interest, but the MIND organisation is applying to the Secretary of State for further financial assistance to carry out its programme to provide group homes for these patients. The organisation's local associations already have 70 such homes, and there are another 70 in the pipeline.
Many voluntary organisations, such as MIND, carry out their work very economically. It is by no means false economy to give financial assistance to voluntary organisations for the work they are doing and I hope that the Secretary of State will pay attention to this point.
The Secretary of State argued his case well and put a brave face on it. No one doubts his sincere regret at having to make the kind of statement that he made today. But, having paid public tribute to him on more than one occasion on his success on squeezing money out of the Exchequer for the mentally sick and the mentally handicapped, I am entitled to say that his failure to protect—as I see it—these people now detracts from the reputation that he has built up. If fairness in government means anything it means giving priority to those in most distress, to those in greatest need and least able to look after themselves, and they are without question the mentally sick and the mentally handicapped, those who look to the Secretary of State, and they are the people who feel seriously let down.
Any young and aspiring politician could do worse than read the opening speeches of the debate tonight, because in them there is a horrible warning and it is, "Never, never trust statistic". The right hon. Member for Dept-ford (Mr. John Silkin) made his usual powerful speech, based on statistics, and then my right hon. Friend, on the basis of another set of statistics, completely demolished the right hon. Gentleman's argument.
The right hon. Gentleman is a very pleasant man and I must tell him that I agreed with many things he said tonight. I agreed with what he said about the problems of the hospitals, and all of us are worried that so many nurses must come from the agencies. But the right hon. Gentleman is mixing up a staffing problem and a cut. He talked of a 20 per cent. cut. That sounded terrible, as the motion sounds terrible. Here are the so-called wicked Tories, cutting the health service, but the truth of the matter is that we are spending hundreds of millions of pounds more on the health service than did the Labour Government. The growth of expenditure goes on increasing year after year. As my right hon. Friend put it, in real terms 50 per cent. more is being spent today than in the last year of Labour's office.
It is the rate of expansion on which the cuts have fallen, and that is very different from the rate of expenditure. We should all like to see the planned improvements going ahead as planned, but it is they and they alone which have been cut, and expenditure has not been cut. How could it be said to have been cut when today twice as many home helps are operating as only three years ago and when the meals-on-wheels service has increased by one-third? Those are excellent figures.
Across the Floor of the House we share a care for those who are disadvantaged in this life. I am sure that Opposition Members go round their constituencies as assiduously as we go round ours. We all know that more has been spent on the ill, the mentally sick, the mentally handicapped, the physically disabled and the chronically sick than ever before—that we have had introduced the invalidity benefit and the constant attendance allowance. We can all give instances of increased expenditures on the health service that my right hon. Friend has initiated. My right hon. Friend is unsurpassed in helping the needy, certainly over the last 20 years. More have been granted State help by my right hon. Friend than ever received it previously.
The hon. Lady says that more is being spent by the Conservative Government in 1973—was it 1973–74?—than was spent by the Labour Gov- ernment. I do not dissent from that. But if she cares to look at the Labour Government's White Paper on Expenditure, published in 1970 and projected four years ahead, I think that she will find a rather different conclusion from that which she has reached.
I am not trying to make a party point. I am seriously trying to understand his matter. The Minister said that the Government were spending 50 per cent. more in real terms than were the Labour Government. That we accept. He also said—and we agree—that it is a pity that there have to be cuts or reductions, because he agrees that even more ought to be spent. But from where are all these additional sick people coming? If there is 50 per cent. more expenditure, from where are they all coming?
The point is that many people who have been sick have not been helped until now. We should all like more help still to be available. All of us have our special pet causes, upon which we should like more money to be spent, I want more to be done for deaf children, for disabled housewives, for special training for the blind and for the mentally handicapped. Much more should be spent on the mentally handicapped. But we must face the fact that our Exchequer is not a bottomless pocket. We are not exactly a church mouse country, but neither are we an Onassis country. There is a limit on what we can spend on even the most worthy causes.
I do not attack my right hon. Friend for not helping enough. There is an area in which I criticise him strongly for helping too much. My hon. Friend the Member for Peterborough (Sir Harmar Nicholls) cited a particular case. I shall cite another. I think that my right hon. Friend is quite wrong in helping strikers with social security benefits. These payments will enable them to strike. It is an outrage to the vast majority of taxpayers that they should be forced to support the wives and children of men whose declared aim is to bring down this country. It was reported in the Sunday Telegraph of yesterday that the National Union of Mineworkers has decided not to pay strike money in the event of a miners' strike, as the strikers will be able to claim social security benefits. With those benefits and the tax refunds which will be received, no striker will feel unbearable hardship until many weeks have passed, if at all, and the NUM's funds will remain intact.
I am not able to assess its assets, but I am grateful for my hon. Friend's intervention. That may well be so. Whatever the NUM's assets are, they are to remain intact because the money is to come from social security instead.
In view of the very great hardship striking miners will cause to the rest of the community, the number of people who will be thrown out of work in the event of a strike, the bankruptcies, sickness and suicides which will occur, it is the height of folly, and cruel folly at that, to give hand-outs to the strikers from the taxes paid by the very people whom the strikers will harm so much.
It is as if a man were expected to pay for the gun with which a highwayman will hold him up, or for the rope which will hang him or the knife which will cut his throat; the highwayman, the hangman, or the knifer cannot perpetrate the crime without the help of the victim. This is what is so ridiculous.
The miners must be made to face up to the consequences of the action they contemplate. They cannot expect the State and social security to pay them to cripple the State. It is utter madness. The unions have strike funds. If the unions are hell-bent on striking, let them at least have the morals to use those funds.
It is said that if the State withheld benefits pictures and television programmes would materialise within days showing hungry, perhaps even ragged, children, probably scavenging at the dustbins. But it is a man's responsibility— a woman's, too—to see that his children do not go hungry. When men are fit, able and capable of work and have jobs to do, it is not the State's responsibility to feed their children.
I sometimes think that the Welfare State has gone mad. I have here a newspaper cutting describing the case of a woman in Birmingham with a job to do at £15 per week. She was told by the Department of Health and Social Security to leave her job because she would be better off drawing social security. I have letters from constituents who are angry and upset about this. There are many people today who have tried to stand on their own feet, who have saved their money, and who have been prudent, but who, when they see how the money they pay in taxes is being used, become deeply upset. They would like that money to go to the obviously disadvantage, to the real needy—the mentally handicapped, the physically handicapped, and so on. They would not grumble then. That is what they want their money to be used for—not for this extraordinary charade of helping enemies of the State to cripple it.
I believe that the people of this country have had quite enough of this sort of thing. We are a compassionate country and we want help to go to the needy but not to people who use that help against us. I hope that when my right hon. Friend reads this debate he will recognise that we want real help for the National Health Service in every possible way, but it must be for those who need it and deserve it, not for those who do not.
The muddled emotionalism of the hon. Lady the Member for Birmingham, Edgbaston (Mrs. Knight) has taken us far from the debate. On her last point, when she referred to miners as enemies of the State, I would merely comment that she has clearly aligned herself with Lord Carrington, who is also able to equate the miners in the present situation with the Nazis before the war. It does not do the hon. Lady credit for the real feelings she has for the National Health Service that she should have been led astray into that kind of argument.
I agreed with much that the hon. Lady said about the various sectors of the National Health Service and the social services which need further support. I hope that during the course of my short speech I shall be able to deal with some of those points.
The Secretary of State qualified as Chancellor-designate by the way that he was able to juggle the figures that he presented. The point the right hon. Gentleman missed all the time in trying to justify himself is that the greatest pressing need of the National Health Service for the last 10 years has been for greater resources, not fewer. In the argument that has gone on across the Floor of the House about the amounts given by this administration or any other, the salient point is not what has happened in real terms to the cash but the percentage of the gross national product which has been given. My Government between 1964 and 1970 improved the direct share of gross national product from less than 4 per cent. to 5·3 per cent. We have still not reached 5·5 per cent., despite the excellent record of help by the present Secretary of State.
The present cuts of £69 million on capital expenditure and £42 million on procurement, in the light of the inflationary situation, have hit the health services in recent months. Although the right hon. Gentleman talks about "real terms", those cuts are real cuts, because of galloping inflation and even if we had not had them at all they were equivalent, in terms of present costs, to a cut-back. We have the Secretary of State imprisoned and confined by the Chancellor of the Exchequer—that seems to be the fate of most Ministers of Health—and this Chancellor insists on running the economy on Tory dogma which is outmoded, unscientific, irrational and a sure prescription for disaster.
What is the dogma? It seems to me to be this, that private expenditure is good and public expenditure is bad. The Chancellor of the Exchequer made this clear on 17th December when he brought in his mini-budget and said:
I am sure that it is right that the main weight of the action I am taking should he not on persons or private sector industry but on public expenditure."—[OFFICIAL REPORT, 17th December 1973, Vol. 866, c. 963.]
He makes quite clear what his intention is.
What are public and private expenditure? I have mentioned the £69 million and the £42 million cut of public expenditure, but is this a necessity? In the community services, on health, on the disabled, the lame and the halt we spent jointly, as members one of another, £2,617 million in 1972–73 for these purposes out of our national resources.
Look at private expenditure. Last year we spent on tobacco £1,808 million, on alcoholic drink £2,948 million, on betting and gaming £400 million, a total of £5,156 million—private expenditure, twice as much as we communally spent on the National Health Service and on those three items alone of private expenditure, which the Chancellor of the Exchequer seems to think is good expenditure.
We are now cutting what we spend on the sick and on the need for health care. We spend £1,567 million on cigarettes alone at the same time as the right hon. Gentleman seeks to cut down expenditure on communal health services.
I should not like the hon. Member to get away too far with what he is saying, because what he is saying is that there are cuts on what is spent on the sick. He listened to the speech of my right hon. Friend and it was very clear at the time that the figures my right hon. Friend gave, which were not challenged, were not cuts on past expenditure but cuts on expansion in the future. The hon. Member cannot deny that.
I am not attempting to deny it. What I am saying is that the amount of increased expenditure as between the resources available for last year and this year is now being cut back, and the amount of the increase—which is what the right hon. Gentleman claims it to be—is not an increase at all, because examination of the figures for the three sectors, health, local executive councils, and local health authorities, shows that the sums of £69 million affecting capital expenditure and £42 million affecting procurement mean that expenditure will be more or less the same as last year's, and that means that with rising costs there is a real cut and not just a cut only on the increase.
I will admit that the cut of £69 million is probably in the right place in many ways, but the point being made by my right hon. Friend the Member for Deptford (Mr. John Silkin) and other hon. Friends is that this is irreplaceable in one sector, and that is the building of health centres. It takes years to develop a health centre; there have to be discussions with general practitioners, and they have voluntarily to join. With hospitals there may be delay but not an eventual loss, but if a health centre is delayed it may be lost. I am particularly concerned about the one at Neasden in my constituency. We have been fighting for it for five years, and now it may be lost.
I would remind the Minister that there were very long discussions with the BMA's General Medical Services Committee and there was a deputation to him on 13th September, and I will quote what one doctor. Dr. J. R. Caldwell, said in reaction to what happened:
How daft can the Secretary of State be?
The whole of Government propaganda has been directed towards the construction of health centres. In the event, however, the Secretary of State has been saying ' You must improve general practice but in no case must you spend any money on it '. The politicians have shouted for health centres, hoping that the GMSC would hold doctors back and that we would be blamed for bad facilities …".
This is not a politician talking—it is a general practitioner in the NHS. Where will my area's share of the £42 million cuts be made? For the North-West Metropolitan Regional Hospital Board the cut will be £2·1 million, but the staff cannot suffer, because wage agreements have already been made. Will it be on food, medical supplies or diagnostic equipment?
The House will be pleased that under phase 3 nurses have made a settlement of their pay demand, but will the cut of £42 million increase the anomalies of the nursing service? It is the only profession where, when one advances to a position of greater responsibility, one loses pay for a period. A State-registered nurse who wishes to take midwifery immediately loses pay to go back to student rates. A senior sister in a psychiatric ward who takes a diploma in mental health immediately loses a large amount of her pay. A clinical teacher in a hospital can be appointed only from those who have had at least two years as ward sister. Thus, if such a woman is appointed she loses £400 a year immediately.
I want to suggest what the right hon. Gentleman can do in the cut-back about the anomalies—I am not talking about the increases—which have recently been accepted, but he must spend more money to remove the injustices I have just illustrated in the nursing service.
Consider the cut-back effect on the local health authority in Brent, with its population of 275,000. The first thing that will be affected is our plans for a day centre for the mentally ill and mentally handicapped which requires 120 places in the next two years. Will that be cut back? We need 60 places, which are in the process of being planned, for the chronically sick and physically handicapped. We need 100 places for elderly persons looked after by supporting services. Will those plans be cut back?
One reason why we suggest that the right hon. Gentleman's figures are nonsense is the increased expenditure in the last three months caused by the three-day week and fuel shortage and prices on the meals-on-wheels and other necessary transport. The arrangements that have had to be made to cope with the power cuts mean that next year's expenditure will be greatly increased for merely supplying the same service. Our new area health authority in Brent is already facing a situation in which there will be a 15 per cent. shortage of staff when the area health authority starts on 1st April because of the number of people who have moved over from the health department into local government. Will more money be available to recruit fresh staff? Will the cuts mean that plans for health education, including preventive medicine, will go by the board? Is that another scheme which will be aborted in its embryo state?
If the right hon. Gentleman wishes to make useful cuts I offer him two which would total £6½ million. Why not cut the £4½ million spent by the drug industry on sending 7,640,000 free journals to 20,000 GPs every year, paid for indirectly by the Department of Health and Social Security? The right hon. Gentleman could further save the £2 million spent by some drug companies on advertising brand names, a practice which the Minister exhorts prescribers to ignore and use the national formulary.
The NHS is facing a crisis. I congratulate the right hon. Gentleman because I know that he must have fought hard in the Cabinet to get away with the amounts that he has, in view of the £1,200 million being taken, but I feel sad, like my right hon. Friend the Member for Woolwich, East (Mr. Mayhew), that the Minister who has done perhaps more in a number of areas for the dispossessed has had to back-track on health progress through no fault of his own and through no fault of his departmental officials.
We should look honestly at a situation which is painful to us all. None of us likes a cut-back in the rate of expansion. None of us likes the fact that cherished projects in particular areas of the National Health Service or any other part of the social security services cannot now go ahead as quickly as we had hoped.
The right hon. Member for Deptford (Mr. John Silkin), who opened the debate, did the House a disservice in not pointing clearly to what was happening. He gave the unfair impression that there was an attempt to cut down on present provision or change the general way in which priorities have been established in the health service. If there is to be a cutback in expansion, the first thing to ask is whether the ways in which it will be administered are right. I was very pleased to hear my right hon. Friend the Secretary of State for Social Services say that in the areas of mental illness, geriatric care and concern for the young chronically sick the rate of growth would be protected.
I am particularly pleased that my right hon. Friend said that about mental health, because one of the problems of dealing with the mentally sick is that their pressure group is, by the very nature of their illness, much less effective than the pressure group for many other people. Although they may have their friends, families and well-wishers, they do not have themselves, in a sense. Therefore, T am pleased that my right hon. Friend has put mental health high on the list of those areas that he will protect.
I believe that the House would also say that help for the geriatric section of the service is very important. More and more in my constituency, and throughout the country, the very frail are coming into the homes and centres. People are living much longer. They often come in a condition that is particularly difficult to deal with because they can stay in their homes longer owing to the ancillary services, which we have expanded so much faster in recent years.
It is right that the cuts should not fall upon the expansion of the services I have mentioned, and I congratulate my right hon. Friend on those decisions.
In a debate such as this it is wrong to pretend that there are easy alternatives in the reduction of public expenditure. For example, it was easy for the right hon. Gentleman to refer to what he called the cuts in housing and house building, as a throw-away line. It is interesting that that is one area in which no cuts are arranged—one area in which there is no intention that the cuts shall fall.
If the hon. Gentleman—my close neighbour, though not politically—wishes to be fair, which he is doing his best to be, he will tell the House that I was not at that moment referring to cuts in money but to cuts in the number of houses built. That was the whole point of my reference to housing.
If I misled the House in my recollection of what the right hon. Gentleman said, I apologise. It may have been that that reference was slipped in in much the same way as the Maplin Channel Tunnel reference, which was to suggest that by not spending £800,000 this year on the one and not spending £1¼ million on the other we could somehow make up for £100 million in the health and social services. Misapplied figures of that kind draw the public's attention to a kind of politics which is not acceptable.
The same was true when we talked about private expenditure in the health service. If we lived in an ideal world in which every decision was made to enable everybody in a minute grade to receive the help and service his disease needed, at precisely the right moment and in precisely the place in which he lived, it would no doubt be wrong to have any kind of private provision. But when we have a service which desperately needs all kinds of extra resources and money I cannot believe that it would be sensible to remove from it such moneys as come from private provision. I agree with the right hon. Gentleman that if there are any cases in which such private provision means that others who need help do not receive it, we should have a system to prevent that happening. But if the right hon. Gentleman merely objects to the extra money which comes in, to the building of nursing homes and the extension of hospitals because of private provision, that is a great mistake.
I conclude by referring to a point which was raised by my hon. Friend the Member for Birmingham, Edgbaston (Mrs. Knight). I would not go as far as she did in the way in which she presented her views on social service benefits. Neither would I go so far as another hon. Member, who said that we ought not to be discussing this matter at all. I believe that at this moment, when we are concerned with the difficult matter of trying to decide how best to restrict public expenditure, we ought to ask ourselves, in addition to what we have already discussed, three simple questions; first, even if there were only one case of the kind to which my hon. Friend the Member for Peterborough (Sir Harmar Nicholls) referred, is it not true that such cases mean that many people in this country are unhappy about the way in which social security benefits are provided? Is it not important that they should be made happier by an investigation of these cases so that the public may know what is true, and the rules changed?
Secondly, is it not true that when we are dealing with a matter of this kind we ought to remind those who would disrupt our society of the very people whom the right hon. Gentleman mentioned—the greater medical profession, all those dedicated men and women, the doctors, nurses and the people who provide food and keep hospitals clean, those whose standard of living is attacked at this moment by those who do not think of them but think only of themselves and are determined to grab from society more than society can pay and more than they really deserve in comparison with these other people?
The third point—and this I aim directly at my hon. Friend the Under-Secretary—is that at the moment, much to the despair of some people, we are operating a National Health Service in which a great deal of money and public resource is being used for the procurement of abortions. I ask my hon. Friend whether that is the first priority in a place like Lewisham, where so many people who need operations through no fault of their own are kept on long waiting lists because of a certain priority which we have made.
I ask my hon. Friend to look very carefully at the general problem in London and to see whether, in the general discussion which he will no doubt be having with his right hon. Friends in seeing what can be done for London, a careful look can be taken at the difficulties of the health service and other services in London. We are most concerned to make sure that we do not lose from London's services many people who go elsewhere because of the particularly high cost of living in this capital city.
The hon. Member for Lewisham, West (Mr. Selwyn Gummer) said categorically that there were no cuts in housing. Statistically, that may be true, but the hon. Gentleman may or may not be aware that in Norfolk planning permission is being held back for a number of schemes, entirely because of the lack of schools through the Government's action in reducing expenditure. There is, therefore, some indirect cut in housing.
At a time when the serious economic situation is inflicting increasing hardship on the less well-off sections of the community, it should be a question not of cuts but of an expansion in the stream of social services and in the essential stream covering the welfare of the aged, the disabled and others. The nation is called upon to make sacrifices. Naturally, we may differ about the reasons, but one thing is clear—there is no equality of sacrifice implied by the Government's actions. There would be less bitterness and more co-operation if there were a greater measure of equality than is in evidence today.
If she only knew it, the hon. Member for Birmingham, Edgbaston (Mrs. Knight) sowed the seeds of revolution and disaster in this country by her very words, for there was an example of class hatred at its worst.
The hon. Lady does not know what she is saying. There are many of us who, through bitter experiences over the years—I am not a young man—have fought and made sacrifices in order to bring about the degree of social security which we have today.
Does not the hon. Gentleman remember the terms in which I spoke? I am all for social justice, but these are not deprived men. They have a job, they have health, and there is every reason why they should do that job and not expect the State to keep them.
Has the hon. Lady no thought for the women or children? Has she no thought for the fact that these men, their wives and others at work have paid contributions and have some rights? Does she not realise—do the Government not realise—that some of my constituents are suffering social injustice at the present time, when those who work on certain days a week receive only two days' unemployment benefit and others get three days plus time-and-a-half on Saturdays? I have written to the Prime Minister. There has been no answer. We should get down to concrete problems like that and sow some harmony in the country, instead of trying to set worker against worker and class against class. Unfortunately, however, there are many people in the hon. Lady's party who speak and think as she does.
I do not understand how, in their amendment, the Government can claim to have maintained the substance of their programme while imposing cuts. The experience of all local authorities, including Norfolk, is that they have had to fall back and cut many of their vital services.
This sort of thing has gone on over a period of years. Why is it that at a time of financial stringency hospital building always has to be cut and deferred? It has taken nearly 37 years to build one hospital in which I have been interested. Every time, the Government of the day never realise that in the end each postponement inevitably leads to greater costs. The same applies to deferred maintenance, whether of hospitals or schools. The longer maintenance is left, the greater is the neglect, and in the end the country has to pay far more as a result of that procrastination.
My right hon. Friend the Member for Deptford (Mr. John Silkin) spoke of the acutely difficult position in the National Health Service. I happen to be a member of the area authority covering his constituency. We are doing our best, but we are working under extreme difficulty. We have a minimum of senior staff, and we were lucky to get a headquarters only a few month ago. But Heaven knows what will happen. The organisation is nowhere near ready to put the scheme into effect.
I appeal to the Minister on one other matter which, though apparently of minor importance, is in fact quite serious. There has been a great deal of Press publicity about the shortage of drugs and dressings in the National Health Service. This is not a new story, but each time it is given prominence anxiety is caused to many people who depend on drugs for their life and will continue to do so throughout their lives. When scare stories of this kind appear, the Department ought to come in and give the facts. It should issue a proper denial and make clear that the situation as portrayed in the newspapers is not as bad as might seem.
I promised to be brief, and I shall leave matters there. I am sorry that I got a little heated, but there are times when some of us, quiet though we may wish to be, feel very strongly and deeply. I am extremely sorry that on this occasion the hon. Member for Edgbaston provoked me beyond the bounds which I normally keep.
I am glad to have the brief opportunity of following up a point raised by the hon. Member for Norwich, North (Mr. Wallace) about social security payments for strikers. I, too, have strong feelings on this matter, and I consider the hon. Member completely wrong to shift the ground from talking about payments to strikers' families on to the people who are on short time as a result of industrial action in the coal mines. To use terms like "savage cuts" in the social services in a parliamentary motion when it is the opposite of the truth brings the whole House into disrepute, and it is a pity that we have to have a debate along these lines.
I could spend a long time discussing many areas of the social services, but I will not. The right hon. Member for Deptford (Mr. John Silkin) said earlier that he was chairman of a voluntary organisation. I am president of a branch of the Royal British Legion and I could speak at length on the needs of ex-service men and so forth. However, I want to support what my hon. Friend the Member for Birmingham, Edgbaston (Mrs. Knight) said about social service payments for the families of people in industrial disputes.
I wish to refer to a letter which I received this morning from the managing director of a small company in my constituency about the current industrial relations situation. With a small firm the managing director is in close touch with the feeling of the people on the shop floor. He knows exactly what they are thinking, and it was about that that he wrote to me. It is a very forceful letter. He says that his employees—they are not employed in a highly paid industry—unanimously thought that there were too many scroungers on the social services today. "Scroungers" is his word, repeating what the employees said. [Interruption.] I can see that the hon. Member for Norwich, North is trying to misrepresent me but I am simply stating what was in the letter.
There is particular resentment on the shop floor that the Government are prepared to support families who should be supported by trade union funds. No doubt the Opposition will misrepresent what I have said, but I am merely conveying the feeling of a large number of people whom the Labour Party would try to claim are its supporters, particularly at a time such as this.
The week before last I attended a meeting of old-age pensioners in my constituency. If Labour Members are to be believed I should have had a somewhat rough passage at that meeting, but I had nothing of the sort. Of course pensioners are not satisfied, neither am I. I am not at all satisfied with what the Government have done in social services but I am proud of their achievements. But the main complaint at that meeting, which was attended by about 700 pensioners, was there is no incentive today to thrift. Several old ladies put the point to me, saying "I have worked hard all my life, saved and been thrifty so that I might enjoy my old age. Now I see those who have gambled and been profligate and wasted their money drawing social security which is not available to me."
Before I am misrepresented again, I shall explain that my answer to them was that a lot of these people had been unable to save. They had been through a very rough time in the great depression, and I defended payment to them. Nevertheless, that was the criticism put to me. Again, the old people were extremely angry that we as a Government should be paying to strikers money that they have subscribed through their taxation and insurance payments throughout their working lives, and particularly because they were not able to go on strike to increase their earnings. I well remember last summer and autumn when we were told by the TUC that there would be strikes and industrial disputes in favour of an increase in old-age pensions. We do not seem to hear much of that today.
Finally, I wish to support what my hon. Friend the Member for Edgbaston said. She did not make a vicious attack. I would not be a party to seeing the families of strikers starving or in trouble. It is right that many men are being forced to go on strike against their will, brought out by the heavy mob as we saw in the building strike in the autumn of 1972. Of course it is right that they should be helped, but they should be helped primarily by the unions, and only if the unions have no funds to give them should they be able to draw on the State.
This debate has degenerated during the last half hour with the speeches of hon. Members opposite, particularly with reference to so-called "scroungers" on social security. If any hon. Member is aware of any scrounger on social security, he has a moral obligation and duty to refer the case to the Department.
I shall not give way. The hon. Member for Birmingham, Edgbaston (Mrs. Knight) talked of trade unionists as enemies of the State. Many of her constituents will remember that the country owes a very heavy debt to the miners.
Listening to hon. Members opposite one would imagine that these cuts in expenditure have arisen by accident, as though the Government were not involved at all. The Secretary of State, with crocodile tears, said that he was sorry that he had to make the cuts, which, he said, were inevitable as a result of the energy crisis. But in December the Chancellor of the Exchequer was asked how much the cuts depended on the actions of the miners and other industries. He replied:
If…the industrial troubles are settled soon, certainly there would be no immediate change in the proposals that I have made "—[OFFICIAL REPORT,17th December 1972; Vol. 866. c. 976.]
In other words, the Chancellor was clearly indicating that the cuts in health and education expenditure were not a consequence of the miners' dispute; they were admissions of Government failure over the past three and a half years—failure with which the Government should now be seeking to deal. But the Government have failed the nation; they have failed to support their own concept of "one nation". The Prime Minister is a great one for talking about "one nation", but no other group has done more to divide the nation than the present Government, the Prime Minister in particular.
On 18th December, The Guardian, which is no friend of the Opposition—it has never asked anyone to vote Labour to my recollection, and is not doing it now—said that:
from the point of view of national unity, in what the Chancellor acknowledged as the gravest crisis since the war, they have got it wrong.
Of course the Government have got it wrong because in making these cuts, they did not choose fairly-shared sacrifices. They chose to inflict savage cuts in public expenditure on schools, hospitals and
social services—the services on which the standard of living of ordinary people depends more than on anything else. The ordinary people depend upon publicly provided schools, publicly financed health services and publicly provided social services. They cannot possibly be expected to rely on private services.
The Secretary of State for Wales is supposed to be responsible for the health services, education and local government in Wales, but no Minister for Wales has taken part in this or the education debate, or given any indication how these cuts in public expenditure will affect education and health services in Wales.
Even before the cuts were announced the new area health authorities in Wales were seriously concerned about how they were to find the money to finance the health services. The Government, having claimed that the cuts are essential, should now indicate where they think they should be made and should not shelter behind the area health authorities and the local authorities, leaving them to do the dirty work.
The Secretary of State for Social Services said that the local authorities would be able to exercise choice in deciding where the cuts should be made in the social services. In Rhondda, the total capital expenditure allotted during the coming year is totally committed to one project, which is already under construction and cannot be stopped. It means that next year in Rhondda, irrespective of any local authority choice in the matter, the two day centres for the elderly will be stopped. The major kitchen at Ynysyfeio for providing meals-on-wheels is not to proceed. Therefore, when the Secretary of State said that local authorities would have an element of choice in deciding where the cuts should be made he was speaking only half the truth.
Today is a tragic day for the health and education services in Wales. It is a tragic day for the ordinary people. But it has been made inevitable by the three and a half years in office of the present Government.
The House will be grateful to my hon. Friend the Member for Rhondda, West (Mr. Alec Jones) for putting the position so clearly. The cause of the difficulty is deliberate Government policy to impose cuts in two areas—in the education and health services. My hon. Friend made a salutary point about the miners. I was sorry that one of two otherwise quite good speeches by hon. Members were spoiled by their clear venom and antagonism towards the miners. I do not propose to deal with the speech of the hon. Member for Bolton, West (Mr. Redmond), who apparently thought that he had wandered into a debate on pensioners and social security payments whereas, in fact, it was a debate on cuts in the health service.
My hon. Friend the Member for Norwich, North (Mr. Wallace) showed that the Secretary of State is absolutely wrong in assuring us, as he did today, that the reorganisation of the health service is proceeding well and happily. The right hon. Gentleman made a curious statement. He said that I was usually factually right but that my judgments were wrong. He then said that I was factually wrong in my opinion that the health service was likely to break down because of the lack of district community physicians. It was an opinion and not a fact that I was stating. My hon. Friend the Member for Norwich, North made clear the terrible dangers and fears which are arising in the health service.
What has emerged clearly and universally from the debate—the hon. Member for Peterborough (Sir Harmar Nicholls) first voiced it—is that there is unanimity in the House that we deplore the cuts being made in the health service. It is no good anyone pretending, although one or two hon. Members did, that these are what are called cuts in expansion. The figures have been increasing over the years, but the demand has been increasing, too. We have a larger population. We have an ageing population. The demand is much greater than it was.
How we know and love the comparisons which the Secretary of State makes. We hear them in every debate. In the first debate in the House to which I listened in July 1963 I heard the technique for the first time. He adopted it then, and he adopts it now. The basis is a comparison between the statistical position as it is now and the position under the Labour Government. Mr. Andrew Alexander dealt with the point as well as anybody in Wednesday's Daily Mail when he said that the Secretary of State's use of statistics was "either sloppy or fraudulent". I would not say that. I merely say that what Mr. Uri Geller does to metal spoons the Secretary of State does to statistics: he bends them until they break.
I challenge the right hon. Gentleman to show that proposition to be true on any of the statistics used by me this afternoon. They were scrupulous and meticulous statistics.
It is not the statistics about which I am complaining. It is the right hon. Gentleman's use of them. What I have noticed is that when the right hon. Gentleman produces statistics or comparables they are always slightly different ones and one needs a little time to examine them. However, the right hon. Gentleman will get a clear answer. The right hon. Gentleman spoke, for example. of a 20 per cent. cut in capital expenditure not really being a cut at all. He said that it was a cut in expansion, a cut in improvement.
I am sorry if I misheard the right hon. Gentleman. Perhaps one of his hon. Friend's made that statement, and the right hon. Gentleman might wish to correct him. What we are facing is a damaging blow to one of the most important social services we have. I think that the Secretary of State agrees with me on this. I wonder why he did not stand up in Cabinet and do something about it. The business of asking Departments to cut equally when some Departments are more in need of funds than others should be resisted.
The Secretary of State for Social Services has always said that he will battle for the social services and for the health service.
The hon. and gallant Member says "No doubt he did", but I think that the right hon. Gentleman's attitude has something in common with the attitude of Tweedledum, who gave the following reason for not battling:
I'm very brave generally, only to-day i happen to have a headache.
We on this side of the House believe, and rightly believe, that the social services and the National Health Service have been betrayed—and have been betrayed by the Conservative Government. We shall press for their restitution and for their improvement, and we shall not be satisfied until they take the correct priority in our nation's expenses.
Perhaps it will not be so clear to the hon. Member for Feltham (Mr. Russell Kerr) when I put some probing questions. The hon. Gentleman, who bulks so large at the moment, was not to be seen in the Chamber earlier this evening.
The question I wish to put is whether the right hon. Member for Deptford (Mr. John Silkin) thinks that some cut-back in public expenditure is necessary to release resources for export, in the light of pressure on resources, and particularly the deficits in balance of payments. If the Opposition do not think there should be some cut in public expenditure, do they think that all the cut-backs necessary to release resources for the purpose of exports—a purpose on which everybody is agreed—are to be piled on to the private sector, thus increasing the risk of higher unemployment and other considerations?
I do not think that I or any other Labour Member should be called upon to account for the total incompetence and failure of the Government's economic programme in the last three and a half years.
The Opposition having tabled their motion in this way, the right hon. Member for Deptford has no right to say that he will not answer the question whether the Opposition would propose to cut public expenditure at the present time. If we may assume that they would expect to make some public cuts in expenditure, the other question on which the House should be given an answer is as follows: would the cuts which the Opposition might make in public expenditure fall on the services which we are discussing tonight? May we take it that, as a result of this motion critical of the Government's cuts in health and welfare expenditure, the right hon. Gentleman is fully committed, as soon as the Labour Party comes to power, to restoring all the cuts that we have detailed this evening?
I hope that my right hon. and hon. Friends have taken the point, that the Opposition have tabled a critical motion denouncing the Government for cuts in public expenditure on health and welfare and, on being challenged about whether they disapproved of them and would restore them as soon as they returned to power, the right hon. Member for Deptford, in a way which would rejoice the heart of Andrew Alexander, has muffed the argument entirely and refused to come clean. He will not say whether the cuts that he has criticised will be restored.
I must invite my right hon. and hon. Friends to agree that it is an insult to the intelligence of this House for the Opposition to table a critical party political motion deploring the cuts of a limited kind that we have decided to make in public expenditure on health and welfare and then to say that they will do nothing about them, and that it would be their intention to maintain the cuts which they inherited from us. It is an insult to the intelligence of the British public and of this House to say that the Government should not make the cuts but that the Labour Party would not restore them.
I apologise to the right hon. Gentleman. It is his inherent quality which automatically led me to assume that he was. I have no doubt that he will be. No personal insult was implied in what I said.
The right hon. Gentleman has refused to come clean about whether a Labour Government would restore the cuts that we are discussing because, he said, the Opposition did not know the situation that they would find when they came to office. However, the right hon. Member for Grimsby (Mr. Crosland) has not been so shy. It may be that right hon. and hon. Gentlemen opposite have not read the speech which he made on Friday. He was not afraid to come clean about what the Labour Party would cut and not cut. There was no reference in the priorities which he laid down for the expenditure that a Labour Government would make and the improvements that they would seek to bring about. He was quite unafraid to be specific, and they did not include any restoration of the cuts in public expenditure on health and welfare which we feel to be necessary.
I can assist the hon. Gentleman, because clearly he is playing for time. The fact is that my right hon. Friend the Member for Grimsby (Mr. Crosland) never said that he approved of any cuts. If the hon. Gentleman cares to read my right hon. Friend's speech he will see that he said that he thought that, in the first year or two while we were clearing up the worst mess that this country will ever have had, there would be nothing more to increase than old-age pensions and housing—one of which I have mentioned.
I have read the speech. I have it before me in its full splendour.
The right hon. Member for Deptford has moved a motion criticising the Government for making cuts in health and welfare expenditure which his party has no intention of restoring in the short term. It is to that extent an insult to the intelligence of this House and of the British public.
To add injury to insult, the right hon. Gentleman then insulted my right hon. Friend the Secretary of State by trying to undermine and invalidate the hard figures which my right hon. Friend properly brought out to demonstrate how immeasurably superior this Government's performance had been in this connection to that of their predecessors.
Since the right hon. Gentleman was at pains to try to denounce my right hon. Friend and pour doubt on the validity of the figures that he has given, I will remind the House, by reference to the published and clearly available statistics in this sphere—which cannot be muffled and which nobody has attempted to muffle—in the current Public Expenditure White Paper, of the realities about which we are talking in the comparative programmes to which my right hon. Friend referred.
I start with capital expenditure on the health side for hospitals and community services. The figure for 1974–75 with which we shall end up—I refer to Table 2.11—is £240 million after the cuts on capital expenditure. Compare that with the figure that the Labour Government achieved in their last full year in office—£185 million. It is 30 per cent. higher, in real terms, than the figure achieved by the Labour Government in their last full year in office, yet the Opposition are now criticising us for cuts that they will not restore.
I turn now to local authority health services. The figure with which we shall end up in 1974–75—
I must not give way, otherwise the right hon. Gentleman will accuse me of trying to play out time.
The figure with which we shall end up in 1974–75 on local authority health services' capital expenditure will be £19 million. That is 40 per cent. greater in real terms than the expenditure of £13·8 million that the Labour Government left us with in their last full year. So, after the cuts, the figure in real terms is 40 per cent. higher than they achieved in their last full year in office.
Let us now look at the overall health figures on the current side. The figure to which we shall have cut this expenditure for 1974–75 is the staggering sum of £2,500 million. This is an increase though smaller than we hoped, of £60 million on this year. What did the Labour Government manage to do in their last year? They increased expenditure in their last year by only £53 million. Therefore, after the cuts, we have increased expenditure on health, current local authority and central Government, by £60 million next year compared with £53 million by the Labour Government without cuts in their last year. What on earth are the Opposition griping and trying to criticise this Government about in this context?
I come now to the personal social services. I pay tribute to right hon. and hon. Gentlemen opposite for the—
No, because of the time.
I pay tribute to the deep concern that many right hon. and hon. Gentlemen opposite have for those who make use of the personal social services. The capital expenditure on personal social services by local authorities is a key figure. Capital expenditure by local authorities on personal social services next year will admittedly be cut back to £60 million. But consider the increase in the last year of the Labour Government. It was nothing like £60 million. They ended with a total of £38 million in their last full year in office. We have cut back the expenditure, but nearly doubled what they were showing in their last full year in office. Therefore, this is a ludicrous motion for the Opposition to table.
I now turn to current expenditure by local authorities. After the cuts—I stress after the cuts—current expenditure by local authorities in 1974–75 is 15 per cent. up on 1972–73, 32 per cent. up on 1971–72, and no less than 54 per cent. higher in real terms than in the last full year of the Labour Government. This is current expenditure by local authorities on the social services.
I stress again, against the background of these mammoth increases that my right hon. Friend has been able to secure— the figures are indisputable because they are in the White Paper—the effrontery of the Opposition in criticising us for making cuts when they openly declare that they are not prepared to state which cuts they would restore. Indeed, they would not restore them at all. The truth is that the Opposition are unaccustomed to this scale of expenditure on the social services.
I turn now to some important questions raised by hon. Members. The hon. Member for Woolwich, East (Mr. Mayhew) finished his speech, of which I heard part—I had a record of the latter part—by making a plea for protection of the mentally handicapped and for the Government to recognise the contribution which the voluntary sector can make by responding favourably to an application by the National Association for Mental Health, particularly the MIND campaign. The programme cannot be totally exempt in general terms. It cannot be given an absolute priority over all other aspects of the social services. Where cuts are applied, decisions must be left to local discretion, exercised in the light of local needs. However, there is no doubt as to my right hon. Friend's sympathy for this sector.
The hospital capital programme for the mentally handicapped will be one sector that we shall try to protect. In the local authority capital programme we shall do our best to take account of the priorities in the White Paper, Better Services for the Mentally Handicapped. I undertake to give sympathetic consideration—my right hon. Friend will support me—to this matter, without commitment, to the specific application from the organisation which the hon. Member for Woolwich, East mentioned.
My hon. Friend the Member for Peterborough (Sir Harmar Nicholls) asked me to consider a special grant direct from the Government to Peterborough. In considering capital allocations for regional hospital boards, or health authorities, as they will be in future, the Government take account of increases in regional population. If the regional population rises, the capital allocation follows it. If Peterborough's population is expanded, leading to an expansion in the population of the region as a whole, it will automatically entail a higher capital allocation, but it should be and will be left to the incoming regional health authority—which will know the local situation and which will be under direct pressure, as the chairman of the region will be, from my hon. Friend—to divide the cake.
My hon. Friend the Member for Lewisham, West (Mr. Selwyn Gummer), in a notable speech, asked us to consider sheltering mental illness from the exigencies of a modified rate of acceleration. My right hon. Friend said that he hoped to shelter this sector, and this consideration will be borne in mind.
After the cuts, the annual average growth rate for the whole health and personal social services programme for the four years from 1970–71 to 1974–75 substantially exceeds that of the Labour Government during their last four years
in office. Our growth rate is accelerating about 12 per cent. more than that of the Labour Government. We have nothing to be ashamed of in our record, of which we are proud. This pride is reflected in the enormous increase in the morale of staff and those who are served, for example, in long-stay hospitals. Our record is without precedent in terms of generosity, and the Opposition have insulted the House by criticising cuts which they would do nothing to restore and which they do not even pretend they would restore. I beg the House to reject the motion and accept the Government's amendment.
|Division No. 41.]||AYES||[10.0 p.m.|
|Adley, Robert||Cordle, John||Green, Alan|
|Alison, Michael (Barkston Ash)||Corfield, Rt. Hn. Sir Frederick||Grieve, Percy|
|Allason, James (Hemel Hemostead)||Cormack, Patrick||Griffiths, Eldon, Bury St. Edmunds)|
|Amery, Rt. Hn. Julian||Costain, A. P.||Grylls, Michael|
|Archer, Jeffrey (Louth)||Critchley, Julian||Gummer, J. Selwyn|
|Astor, John||Crouch, David||Gurden, Harold|
|Atkins, Humphrey||Crowder, F. P.||Hall, Miss Joan (Keighley)|
|Awdry, Daniel||Davies, Rt. Hn. John (Knutsford)||Hall, Sir John (Wycombe)|
|Baker, Kenneth (St. Marylebone)||d'Avigdor-Goldsmid, Sir Henry||Hall-Davis, A. G. F.|
|Baker, W. H. K. (Banff)||d'Avigdor-Goldsmid. Maj.-Gen. Jack||Hamilton, Michael (Salisbury)|
|Balniel, Rt. Hn. Lord||Dean, Paul||Hannam, John (Exeter)|
|Barber, Rt. Hn. Anthony||Deedes, Rt. Hn. W. F.||Harrison, Brian (Maldon)|
|Batsford, Brian||Digby, Simon Wingfield||Harrison, Col. Sir Harwood (Eye)|
|Beamish, Col. Sir Tufton||Dixon, Piers||Harvie Anderson, Miss|
|Bell, Ronald||Douglas-Home, Rt. Hn. Sir Alec||Haselhurst, Alan|
|Bennett, Dr. Reginald (Gosport)||Drayson, Burnaby||Hastings, Stephen|
|Benyon, W.||du Cann, Rt. Hn. Edward||Havers, Sir Michael|
|Berry, Hn. Anthony||Dykes, Hugh||Hay, John|
|Biffen, John||Eden, Rt. Hn. Sir John||Hayhoe, Barney|
|Biggs-Davison, John||Edwards, Nicholas (Pembroke)||Heath, Rt. Hn. Edward|
|Blaker, Peter||Elliot, Capt. Walter (Carshalton)||Hicks, Robert|
|Boardman, Tom (Leicester, S. W.)||Elliott, R. W. (N'c'tle-upon-Tyne, N.)||Higgins, Terence L.|
|Body, Richard||Emery, Peter||Hiley, Joseph|
|Boscawen, Hn. Robert||Eyre, Reginald||HIM, John E. B. (Norfolk, S.)|
|Bossom, Sir Clive||Farr, John||Hill, S. James A. (Southampton, Test)|
|Bowden, Andrew||Fell, Anthony||Holland, Philip|
|Bray. Ronald||Fenner, Mrs. Peggy||Holt, Miss Mary|
|Brewis, John||Fidler, Michael||Hordern, Peter|
|Brinton, Sir Tatton||Finsberg, Geoffrey (Hampstead)||Hornby, Richard|
|Brown, Sir Edward (Bath)||Fisher, Sir Nigel (Surbiton)||Horn8by-Smilh, RI. Hn. Dame Patricia|
|Bruce-Gardyne, J.||Fletcher, Alexander (Edinburgh, N.)||Howe, Rt. Hn. Sir Geoffrey (Reigate)|
|Bryan, Sir Paul||Fletcher-Cooke, Charles||Howell, David (Guildford)|
|Buchanan-Smith. Alick (Angus, N&M)||Fookes, Miss Janet||Howell, Ralph (Norfolk, N.)|
|Buck, Antony||Fortescue, Tim||Hunt, John|
|Bullus, Sir Eric||Foster, Sir John||Hutchison, Michael Clark|
|Burden, F. A.||Fowler, Norman||Iremonger, T. L.|
|Butler, Adam (Bosworth)||Irvine, Bryant Godman (Rye)|
|Campbell, Rt. Hn. G. (Moray & Nairn)||Fox, Marcus||James, David|
|Carlisle, Mark||Fraser, Rt. Hn. Hugh (St fford & stone)||Jenkin, Rt. Hn. Patrick (Woodford)|
|Carr, Rt. Hn. Robert||Fry, Peter||Jennings, J. C. (Burton)|
|Cary, Sir Robert||Galbraith, Hn. T. G. D.||Jessel, Toby|
|Channon, Paul||Gardner, Edward||Johnson Smith, G. (E. Grinstead)|
|Chapman, Sydney||Gibson-Watt, David||Jones, Arthur (Northants, S.)|
|Chataway, Rt. Hn. Christopher||Grimond, Rt. Hn. J.||Jopling, Michael|
|Chichester-Clark, R.||Gilmour, Sir John (Fife, E.)||Joseph, Rt. Hn. Sir Keith|
|Churchill, W. S.||Glyn, Dr. Alan||Kaberry, Sir Donald|
|Clark, William (Surrey, E.)||Goodhart, Philip||Kellett-Bowman, Mrs. Elaine|
|Clarke, Kenneth (Rushcliffe)||Goodhew, Victor||Kershaw, Anthony|
|Cockeram, Eric||Gorst, John||Kimball, Marcus|
|Cooke, Robert||Gower, Sir Raymond||King, Evelyn (Dorset, S.)|
|Coombs, Derek||Grant, Anthony (Harrow. C)||King, Tom (Bridgwater)|
|Cooper, A. E.||Gray, Hamish||Kinsey, J. R.|
|Kirk, Peter||Nott, John||Soref, Harold|
|Kitson, Timothy||Onslow, Cranley||Speed, Keith|
|Knight, Mrs. Jill||Oppenheim, Mrs. Sally||Spence, John|
|Knox, David||Orr, Capt. L. P. S.||Sproat, lain|
|Lamont, Norman||Osborn, John||Stainton, Keith|
|Lane, David||Owen, Idris (Stockport, N.)||Stanbrook, Ivor|
|Langford-Holt, Sir John||Page, Rt. Hn. Graham (Crosby)||Stewart-Smith, Geoffrey (Belper)|
|Le Marchant, Spencer||Page, John (Harrow, W.)||Stokes, John|
|Lewis, Kenneth (Rutland)||Parkinson, Cecil||Stuttaford, Dr. Tom|
|Lloyd. Rt. Hn. Geoffrey (Sut'nC'fleld)||Peel, Sir John||Sutcliffe, John|
|Lloyd, Ian (P'tsm'th, Langstone)||Percival, Ian||Tapsell, Peter|
|Longden, Sir Gilbert||Peyton, Rt. Hn. John||Taylor, Sir Charles (Eastbourne)|
|Loveridge, John||Pike, Miss Mervyn||Taylor, Frank (Moss Side)|
|Luce, R. N.||Pink, R- Bonner||Tebbit, Norman|
|McAdden, Sir Stephen||Pounder, Rafton||Temple, John M.|
|MacArthur, Ian||Powell, Rt. Hn. J. Enoch||Thatcher, Rt. Hn. Mrs. Margaret|
|McCrindle, R. A.||Price, David (Eastleigh)||Thomas, John Stradling (Monmouth)|
|McLaren, Martin||Prior, Rt. Hn. J. M. L.||Thomas, Rt. Hn. Peter (Hendon, S.|
|Maclean, Sir Fitzroy||Proudfoot, Wilfred||Thompson, Sir Richard (Croydon, S|
|Macmillan, Rt. Hn. Maurice (Farnham)||Quennell, Miss J. M.||Trafford, Dr. Anthony|
|McNair-Wilson, Michael||Raison, Timothy||Trew, Peter|
|McNair-Wilson, Patrick (New Forest)||Ramsden, Rt. Hn. James||Tugendhat, Christopher|
|Madel, David||Rawlinson, Rt. Hn. Sir Peter||Turton, Rt. Hn. Sir Robin|
|Maginnis, John E.||Redmond, Robert||van Straubenzee, W. R.|
|Marples, Rt. Hn. Ernest||Reed Laurence (Bolton E.)||Vaughan, Dr. Gerard|
|Marten, Neil||Rees, Peter (Dover)||Vickers, Dame Joan|
|Mather, Carol||Rees-Davies, W. R.||Waddington, David|
|Maude, Angus||Renton, Rt. Hn. Sir David||Walder, David (Clitheroe)|
|Maudling, Rt. Hn. Reginald||Rhys Williams Sir Brandon||Walker, Rt. Hn. Peter (Worcester)|
|Mawby, Ray||Ridley, Hn. Nicholas||Walker-Smith, Rt. Hn. Sir Derek|
|Maxwell-Hyslop, R. J.||Ridsdale Julian||Walters, Dennis|
|Meyer, Sir Anthony||Rippon, Rt. Hn. Geoffrey||Ward, Dame Irene|
|Mills, peter (Torrington)||Roborts Michael (Cardiff N)||warren Kennath|
|Mills, Stratton (Belfast, N.)||Roberts, Wyn (Conway)||Weatherill, Bernard|
|Miscampbell, Norman||Rodgers. Sir John (Sevenoaks)||Wells, John (Maidstone)|
|Michell. Lt.-Col. C.(Aberdeenshire, W)||Rossi, Hugh (Hornsey)||White, Roger (Gravesend)|
|Mitchell, David (Basingstoke)||Rost, Peter||Whitelaw, Rt. Hn. William|
|Moate, Roger,||Royle, Anthony||Wiggin, Jerry|
|Molyneaux, James||Russell, Sir Ronald||Wilkinson, John|
|Money, Ernle||St. John-Stevas, Norman||Winterton, Nicholas|
|Monks, Mrs. Connie||Sainsbury, Timothy||Wolrige-Gordon, Patrick|
|Monro, Hector||Sandys, Rt. Hn. D.||Wood, Rt. Hn. Richard|
|Montgomery, Fergus||Scott, Nicholas||Woodhouse, Hn. Christopher|
|More, Jasper||Scott-Hopkins, James||Woodnutt, Mark|
|Morgan, Geraint (Denbigh)||Shaw, Michael (Sc'b'gh & Whitby)||Worsley, Sir Marcus|
|Morgan-Giles, Rear-Adm.||Shelton, William (Clapham)||Wylie, Rt. Hn. N. R.|
|Morrison, Charles||Shersby, Michael||Younger, Hn. George|
|Mudd, David||Simeons, Charles|
|Neave, Airey||Sinclair, Sir George||TELLERS FOR THE AYES:|
|Skeet, T. H. H.||Mr. Walter Clegg and|
|Nicholls, Sir Harmar||Smith, Dudley (W'wlck & L'mington)||Mr. Paul Hawkins.|
|Noble, Rt. Hn. Michael|
|Abse, Leo||Buchanan, Richard (G'gow, Sp'burn)||de Freitas, Rt. Hn. Sir Geoffrey|
|Albu, Austen||Butler, Mrs. Joyce (Wood Green)||Delargy, Hugh|
|Allaun, Frank (Salford, E.)||Callaghan, Rt. Hn. James||Dell, Rt. Hn. Edmund|
|Archer, Peter (Rowley Regis)||Campbell, 1. (Dunbartonshire, W.)||Dempsey, James|
|Armstrong, Ernest||Cant, R. B.||Doig, Peter|
|Ashley, Jack||Carmichael, Neil||Dormand, J. D.|
|Ashton, Joe||Carter, Ray (Birminghn, Northfield)||Douglas, Dick (Stirlingshire, E.)|
|Atkinson, Norman||Carter-Jones, Lewis (Eccles)||Douglas-Mann, Bruce|
|Bagier, Gordon, A. T.||Castle, Rt. Hn. Barbara||Driberg, Tom|
|Barnes, Michael||Clark, David (Colne Valley)||Duffy, A. E. P.|
|Barnett, Guy (Greenwich)||Cocks, Michael (Bristol, S.)||Dunn, James A.|
|Barnett, Joel (Heywood and Royton)||Cohen, Stanley||Dunnett, Jack|
|Baxter, William||Coleman, Donald||Eadie, Alex|
|Beaney, Alan||Concannon, J. D.||Edelman, Maurice|
|Beith, A. J.||Conlan, Bernard||Edwards, Robert (Bilston)|
|Benn, Rt. Hn. Anthony Wedgwood||Corbet, Mrs. Freda||Edwards, William (Merioneth)|
|Bennett, James (Glasgow, Bridgeton)||Cox, Thomas (Wandsworth, C.)||Ellis, Tom|
|Bidwell, Sydney||Cronin, John||English, Michael|
|Bishop, E. S.||Crosland, Rt. Hn. Anthony||Evans, Fred|
|Blenkinsop, Arthur||Crossman, Rt. Hn. Richard||Faulds, Andrew|
|Boardman, H. (Leigh)||Cunningham, G. (Islington, S. W.)||Fernyhough, Rt. Hn. E.|
|Booth, Albert||Cunningham, Dr. J. A. (Whitehaven)||Fisher, Mrs. Doris (B'ham, Ladywood)|
|Boothroyd, Miss Betty||Dalyell, Tarn||Fitch, Alan (Wigan)|
|Bottomley. Rt. Hn. Arthur||Darling, Rt. Hn. George||Fletcher, Raymond (likeston)|
|Boyden, James (Bishop Auckland)||Davidson, Arthur||Fletcher, Ted (Darlington)|
|Bradley, Tom||Davles, Denzil (Llanelly)||Foot, Michael|
|Broughton, Sir Alfred||Davies, G. Elfed (Rhondda, E.)||Ford, Ben|
|Brown, Robert C. (N'c'tle-u-Tyne. W.)||Davies, Ifor (Gower)||Forrester, John|
|Brown, Hugh D. (G'gow, Provan)||Davis, Clinton (Hackney, C.)||Fraser, John (Norwood)|
|Brown, Ronald (Shorerfitch & F'bury)||Davis, Terry (Bromsgrove)||Freeson, Reginald|
|Buchan, Norman||Deakins, Eric||Freud, Clement|
|Galpern, Sir Myer||McBride, Neil||Robertson, John (Paisley)|
|Garrett, W. E.||McCartney, Hugh||Roderick, Caerwyn E.(Brc'n&R'dnor)|
|Gilbert, Dr. John||McElhone, Frank||Rodgers, William (Stockton-on-Tees)|
|Ginsburg, David (Dewsbury)||McGuire, Michael||Roper, John|
|Golding, John||Machin, George||Rose, Paul B.|
|Gordon Walker, Rt. Hn. P. C.||Mackenzie, Gregor||Ross, Rt. Hn. William (Kilmarnock)|
|Gourlay, Harry||Mackie, John||Rowlands, Ted|
|Grant, George (Morpeth)||Mackintosh, John P.||Sandelson, Neville|
|Grant, John D. (Islington, E.)||Maclennan, Robert||Sheldon, Robert (Ashton-under-Lyre)|
|Griffiths, Eddie (Brightside)||McMillan, Tom (Glasgow, C.)||Shore, Rt. Hn. Peter (Stepney)|
|Hamilton, William (Fife, W.)||McNamara, J, Kevin||Short, Rt. Hn. Edward (N'c'tle-u-Tyne)|
|Hamling, William||Mallalieu, J. P. W. (Huddersfield, E.)||Short, Mrs. Renée (W'hampton, N. E.)|
|Hannan, William (G'gow, Maryhill)||Marks, Kenneth||Silkin, Rt. Hn. John (Deptford)|
|Hardy, Peter||Marquand, David||Silkin, Hn. S. C. (Dulwich)|
|Harrison, Walter (Wakefield)||Marsden, F.||Sillars, James|
|Hart, Rt. Hn. Judith||Marshall, Dr. Edmund||Silverman, Julius|
|Hattersley, Roy||Mason, Rt. Hn. Roy||Skinner, Dennis|
|Hatton, F.||Mayhew, Christopher||Small, William|
|Healey, Rt. Hn. Denis||Meacher, Michael||Smith, John (Lanarkshire, N)|
|Heffer, Eric S.||Mellish, Rt. Hn. Robert||Spriggs, Leslie|
|Hilton, W. S.||Mendelson, John||Stallard, A. W.|
|Hooson, Emlyn||Mikardo, Ian||Stewart, Donald (Western Isles)|
|Horam, John||Millan, Bruce||Stewart, Rt. Hn. Michael (Fulham)|
|Houghton, Rt. Hn. Douglas||Miller, Dr. M. S.||Stoddart, David (Swindon)|
|Huckfield, Leslie||Milne, Edward||Stonehouse, Rt. Hn. John|
|Hughes, Rt. Hn. Cledwyn (Anglesey)||Mitchell, R. C. (S'hampton, Itchen)||Stott, Roger|
|Hughes, Mark (Durham)||Molloy, William||Strang, Gavin|
|Hughes, Robert (Aberdeen, N.)||Morgan, Elystan (Cardiganshire)||Strauss, Rt. Hn. G. R.|
|Hughes, Roy (Newport)||Morris, Alfred (Wythenshawe)||Summerskill, Hn. Dr. Shirley|
|Hunter, Adam||Morris, Charles R. (Openshaw)||Swain, Thomas|
|Irvine, Rt. Hn. Sir Arthur (Edge Hill)||Morris, Rt. Hn. John (Aberavon)||Taverne Dick|
|Janner, Greville||Mulley, Rt. Hn. Frederick||Thomas. Rt. Hn. George (Card'ff. W.)|
|Jeger, Mrs. Lena||Murray, Ronald King||Thomas, Jeffrey (Abertillery)|
|Jenkins, Hugh (Putney)||Oakes, Gordon||Tinn, James|
|Jenkins, Rt. Hn. Roy (Stechford)||Ogden, Eric||Tomney, Frank|
|John, Brynmor||O'Halloran, Michael||Tope, Graham|
|Johnson, Carol (Lewisham, S.)||O'Malley, Brian||Torney, Tom|
|Johnson, Walter (Derby, S.)||Oram, Bert||Tuck, Raphael|
|Jones, Barry (Flint, E.)||Orbach, Maurice||Urwin, T. W.|
|Jones, Dan (Burnley)||Orme, Stanley||Varley, Eric G.|
|Jones, Rt. Hn. Sir Elwyn (W. Ham, S.)||Oswald, Thomas||Wainwright, Edwin|
|Jones, Gwynoro (Carmarthen)||Owen, Dr. David (Plymouth, Sutton)||Walden, Brian (B'm'ham, All Saints)|
|Jones, T. Alec (Rhondda, W.)||Padley, Walter||Walker, Harold (Doncaster)|
|Kaufman, Gerald||Paget, R. T.||Wallace, George|
|Kelley, Richard||Palmer, Arthur||Watkins, David|
|Kerr, Russell||Pannell, Rt. Hn. Charles||Weitzman, David|
|Kinnock, Neil||Pardoe, John||Wellbeloved, James|
|Lambie, David||Parker, John (Dagenham)||Wells, William (Walsall, N.)|
|Lamborn, Harry||Pavitt, Laurie||White, James (Glasgow, Pollok)|
|Lamond, James||Peart, Rt. Hn. Fred||Whitehead, Phillip|
|Latham, Arthur||Pendry, Tom||Whitlock, William|
|Lawson, George||Perry, Ernest G.||Willey, Rt. Hn. Frederick|
|Leadbitter, Ted||Prentice, Rt. Hn. Reg.||Williams, Alan (Swansea, W.)|
|Lee, Rt, Hn. Frederick||Prescott, John||Williams, W. T. (Warrington)|
|Leonard, Dick||Price, William (Rugby)||Wilson, Alexander (Hamilton)|
|Lestor, Miss Joan||Probert, Arthur||Wilson, Rt. Hn. Harold (Huyton)|
|Lever, Rt. Hn. Harold||Radice, Giles||Wilson, William (Coventry, S.)|
|Lewis, Arthur (W. Ham, N.)||Reed, D. (Sedgefield)||Woof, Robert|
|Lewis, Ron (Carlisle)||Rees, Merlyn (Leeds, S.)|
|Lipton, Marcus||Rhodes, Geoffrey||TELLERS FOR THE NOES|
|Loughlin, Charles||Richard, Ivor||Mr. James Hamilton and|
|Lyon, Alexander W. (York)||Roberts, Albert (Normanton)||Mr. Joseph Harper.|
|Lyons, Edward (Bradford, E.)||Roberts, Rt. Hn. Goronwy (Caernarvon)|
|Division No. 42.]||AYES||[10.13 p.m.|
|Adley, Robert||Beamish, Col. Sir Tufton||Bray, Ronald|
|Alison, Michael (Barkston Ash)||Bell, Ronald||Brewis, John|
|Aliason, James (Hemel Hempstead)||Bennett, Dr. Reginald (Gosport)||Brinton, Sir Tatton|
|Amery, Rt. Hn. Julian||Benyon, W.||Brown, Sir Edward (Bath)|
|Archer, Jeffrey (Louth)||Berry, Hn. Anthony||Bruce-Gardyne, J.|
|Astor, John||Biffen, John||Bryan, Sir Paul|
|Atkins, Humphrey||Biggs-Davison, John||Buchanan-Smith, Alick (Angus, N&M)|
|Awdry, Daniel||Blaker, Peter||Buck, Antony|
|Baker, Kenneth (St. Marylebone)||Boardman, Tom (Leicester, S. W.)||Bulius, Sir Eric|
|Baker, W. H. K. (Banff)||Body, Richard||Burden, F. A.|
|Balniel, Rt. Hn. Lord||Boscawen, Hn. Robert||Butler, Adam (Bosworth)|
|Barber, Rt. Hn. Anthony||Bossom, Sir Clive||Campbell, Rt. Hn. G (Moray & Nairn)|
|Batsford, Brian||Bowden, Andrew||Carlisle, Mark|
|Carr, Rt. Hn. Robert||Higgins, Terence L.||Orr, Capt. L. P. S.|
|Cary, Sir Robert||Hiley, Joseph||Osborn, john|
|Channon, Paul||Hill, John E. B. (Norfolk, S.)||Owen, Idris (Stockport, N.)|
|Chapman, Sydney||Hill, S. James A. (Southampton, Test)||Page, Rt. Hn. Graham (Crosby)|
|Chataway, Rt. Hn. Christopher||Holland, Philip||Page, John (Harrow, W.)|
|Chichester-Clark, R.||Holt, Miss Mary||Parkinson, Cecil|
|Churchill, W. S.||Hordern, Peter||Peel, Sir John|
|Clark, William (Surrey, E.)||Hornby, Richard||Percival, Ian|
|Clarke, Kenneth (Rushcliffe)||Hornsby-Smith. Rt. Hn. Dame Patricia||Peyton, Rt. Hn. John|
|Cockeram, Eric||Howe, Rt. Hn. Sir Geoffrey (Reigate)||Pike, Miss Mervyn|
|Cooke, Robert||Howell, David (Guildford)||Pink, R. Bonner|
|Coombs, Derek||Howell, Ralph (Norfolk, N.)||Pounder, Rafton|
|Cooper, A. E.||Hunt, John||Powell, Rt. Hn. J. Enoch|
|Cordle, John||Hutchison, Michael Clark||Price, David (Eastleigh)|
|Corfield, Rt. Hn. Sir Frederick||Iremonger, T. L.||Prior, Rt. Hn. J. M. L.|
|Cormack, Patrick||Irvine, Bryant Godman (Rye)||Proudfoot, Wilfred|
|Costain, A. P.||James, David||Quennell. Miss J. M.|
|Critchley, Julian||Jenkin, Rt. Hn. Patrick (Woodford)||Raison, Timothy|
|Crouch, David||Jennings, J. C. (Burton)||Ramsden, Rt. Hn. James|
|Crowder, F. P.||Jessel, Toby||Rawlinson, Rt. Hn. Sir Peter|
|Davies, Rt. Hn. John (Knutsford)||Johnson Smith, G. (E. Grinstead)||Redmond, Robert|
|d'Avigdor-Goldsmid, Sir Henry||Jones, Arthur (Northants, S.)||Reed, Laurance (Bolton, E.)|
|d'Avigdor-Goldsmid. Maj.-Gen. Jack||Jopling, Michael||Rees, Peter (Dover)|
|Dean, Paul||Joseph, Rt. Hn. Sir Keith||Rees-Davies, W. R.|
|Deedes, Rt. Hn. W. F.||Kaberry, Sir Donald||Renton, Rt. Hn. Sir David|
|Digby, Simon Wingfield||Kellett-Bowman, Mrs. Elaine||Rhys Williams, Sir Brandon|
|Dixon, Piers||Kershaw, Anthony||Ridley, Hn. Nicholas|
|Douglas-Home, Rt. Hn. Sir Alec||Kimball, Marcus||Ridsdale, Julian|
|Drayson, G. B.||King, Evelyn (Dorset, S.)||Rippon, Rt. Hn. Geoffrey|
|du Cann, Rt. Hn. Edward||King, Tom (Bridgwater)||Roberts, Michael (Cardiff, N.)|
|Dykes, Hugh||Kinsey, J. R.||Roberts, Wyn (Conway)|
|Eden, Rt. Hn. Sir John||Kirk, Peter||Rodgers, Sir John (Sevenoaks)|
|Edwards, Nicholas (Pembroke)||Kitson, Timothy||Rossi, Hugh (Hornsey)|
|Elliot, Cap). Walter (Carshalton)||Knight, Mrs. Jill||Rost, Peter|
|Elliott, R. W. (N'c'tle-upon-Tyne, N.)||Knox, David||Royle, Anthony|
|Emery, Peter||Lamont, Norman||Russell, Sir Ronald|
|Eyre, Reginald||Lane, David||St. John-Stevas, Norman|
|Farr, John||Langford-Holt, Sir John||Sainsbury, Timothy|
|Fell, Anthony||Le Marchant, Spencer||Sandys, Rt. Hn. D.|
|Fenner, Mrs. Peggy||Lewis, Kenneth (Rutland)||Scott, Nicholas|
|Fidler, Michael||Lloyd, Rt. Hn. Geoffrey (Sut' nC' field)||Scott-Hopkins, James|
|Finsberg, Geoffrey (Hampstead)||Lloyd, Ian (P'tsm'th, Langstone)||Shelton William (Clapham)|
|Fisher Nigel (Surbiton)||Longden, Sir Gilbert||Shprsby Michael|
|Fletcher, Alexander (Edinburgh, N.)||Loveridge, John||Simeons, Charles|
|Fletcher-Cooke, Charles||Luce, R. N.||Sinclair, sir George|
|Fookes, Miss Janet||McAdden, Sir Stephen||Skeet, T. H. H.|
|Fortescue, Tim||MacArthur, Ian||Smith Dudley (W' wick & L'mington)|
|Foster, Sir John||McCrindle, R. A.||Soref, Harold|
|Fowler Norman||McLaren, Martin||Sport, lain|
|Fox, Marcus||Maclean, Sir Fitrozy||Speed, Keith|
|Fraser, Rt. Hn. Hugh (St'fford & Stone)||Macmillan, Rt Hn Maurice (farnham)||Spence, John|
|Macmillan, Rt. Hn. Maurice (Farnham)||Sproat, lain|
|Fry, Peter||McNair-Wilson, Michael||Stainton, Keith|
|Galbraith, Hn. T. G. D.||McNair-Wilson, Patrick (New Forest)||Stanbrook, Ivor|
|Gardner, Edward||Made!, David||Stewart-Smith, Geoffrey (Belper)|
|Gibson-Watt, David||Maginnis, John E.||Stokes, John|
|Gilmour, Ian (Norfolk, C.)||Marples, Rt. Hn. Ernest||Stuttaford, Dr. Tom|
|Gilmour, Sir John (Fife, E.)||Marten, Neil||Sutcliffe, John|
|Glyn, Dr. Alan||Mather, Carol||Tapsell, Peter|
|Goodhart, Philip||Maude, Angus||Taylor, Sir Charles (Eastbourne)|
|Goodhew, Victor||Maudling, Rt. Hn. Reginald||Taylor, Frank (Moss Side)|
|Gorst, John||Mawby, Ray||Tebbit, Norman|
|Gower, Sir Raymond||Maxwell-Hyslop, R. J.||Temple, John M.|
|Grant, Anthony (Harrow, C.)||Meyer, Sir Anthony||Thatcher, Rt. Hn. Mrs. Margaret|
|Gray, Hamish||Mills, Peter (Torrington)||Thomas, John Stradling (Monmouth)|
|Green, Alan||Mills, Stratton (Belfast, N.)||Thomas, Rt. Hn. Peter (Hendon, S.)|
|Grieve, Percy||Miscampbell, Norman||Thompson, Sir Richard (Croydon. S.|
|Griffiths, Eldon (Bury St. Edmunds)||Mitchell, Lt.-Col. C. (Aberdeenshire, W)||Trafford, Dr. Anthony|
|Grylls, Michael||Mitchell, David (Basingstoke)||Trew, Peter|
|Gummer, J. Selwyn||Moate, Roger||Tugendhat, Christopher|
|Gurden, Harold||Molyneaux, James||Turton, Rt. Hn. Sir Robin|
|Hall, Miss Joan (Keighley)||Money, Ernle||van Straubenzee, W. R.|
|Hall, Sir John (Wycombe)||Monks, Mrs. Connie||Vaughan, Dr. Gerard|
|Hall-Davis, A. G. F.||Monro, Hector||Vickers, Dame Joan|
|Hamilton, Michael (Salisbury)||Montgomery, Fergus||Waddington, David|
|Hannam, John (Exeter)||More, Jasper||Walder, David (Clitheroe)|
|Harrison, Brian (Maldon)||Morgan, Geraint (Denbigh)||Walker, Rt. Hn. Peter (Worcester)|
|Harrison, Col. Sir Harwood (Eye)||Morgan-Giles, Rear-Adm.||Walker-Smith, Rt. Hn. Sir Derek|
|Harvie Anderson, Miss||Morrison, Charles||Walters, Dennis|
|Haselhurst, Alan||Mudd, David||Ward, Dame Irene|
|Hastings, Stephen||Neave, Alrey||Warren, Kenneth|
|Havers, Sir Michael||Nicholls, Sir Harmar||Weatherill, Bernard|
|Hay, John||Noble, Rt. Hn. Michael||Wells, John (Maidstone)|
|Hayhoe, Barney||Nott, John||White, Roger (Gravesend)|
|Heath, Rt. Hn. Edward||Onslow, Cranley||Whitelaw, Rt. Hn. William|
|Hicks, Robert||Oppenheim, Mrs. Sally||Wiggin, Jerry|
|Wilkinson, John||Woodnutt, Mark|
|Winterton, Nicholas||Worsley, Marcus||TELLERS FOR THE AYES:|
|Wolrige-Gordon, Patrick||Wylie, Rt. Hn. N. R.||Mr. Walter Clegg and|
|Wood, Rt. Hn. Richard||Younger. Hn. George||Mr. Paul Hawkins.|
|Woodhouse. Hn. Christopher|
|Abse Leo||Ellis, Tom||Lyons, Edward (Bradford, E.)|
|Albu, Austen||English, Michael||McBride, Neil|
|Allaun, Frank (Salford, E.)||Evans, Fred||McCartney, Hugh|
|Archer, Peter (Rowley Regis)||Faulds, Andrew||McElhone, Frank|
|Armstrong, Ernest||Fernyhough, Rt. Hn. E.||McGuire, Michael|
|Ashley. Jack||Fisher, Mrs. Doris (B'ham, Ladywood)||Machin, George|
|Ashton. Joe||Fitch, Alan (Wigan)||Mackenzie, Gregor|
|Atkinson, Norman||Fletcher, Raymond (likeston)||Mackie, John|
|Bagier, Gordon, A. T.||Fletcher, Ted (Darlington)||Mackintosh, John P.|
|Barnes, Michael||Foot, Michael||Maclennan, Robert|
|Barnett, Guy (Greenwich)||Ford, Ben||McMillan, Tom (Glasgow, C.)|
|Barnett, Joel (Heywood and Royton)||Forrester, John||McNamara, J, Kevin|
|Baxter, William||Fraser, John (Norwood)||Mallalieu, J. P. W. (Huddersfield, E.)|
|Beaney, Alan||Freeson, Reginald||Marks, Kenneth|
|Beith, A. J.||Freud, Clement||Marquand, David|
|Benn, Rt. Hn. Anthony Wedgwood||Galpern, Sir Myer||Marsden, F.|
|Bennett, James (Glasgow, Bridgeton)||Garrett, W. E.||Marshall, Dr. Edmund|
|Bidwell, Sydney||Gilbert, Dr. John||Mason, Rt. Hn. Roy|
|Bishop, E. S.||Ginsburg, David (Dewsbury)||Mayhew, Christopher|
|Blenkinsop, Arthur||Golding, John||Meacher, Michael|
|Boardman, H. (Leigh)||Gordon Walker, Rt. Hn. P. C.||Mellish, Rt. Hn. Robert|
|Booth, Albert||Gourlay, Harry||Mendelson, John|
|Boothroyd, Miss Betty||Grant, George (Morpeth)||Mikardo, Ian|
|Bottomley, Rt. Hn. Arthur||Grant, John D. (Islington, E.)||Millan, Bruce|
|Boyden, James (Bishop Auckland)||Griffiths, Eddie (Brightside)||Miller, Dr. M. S.|
|Bradley, Tom||Hamilton William (Fife, W)||Milne, Edward|
|Broughton, Sir Alfred||Hamilng, William||Mitchell, R. C. (S'hampton, Itchen)|
|Brown, Robert C. (N'c'tle-u-Tyne, W.)||Hannan, William (G'gow, Maryhill)||Molloy, William|
|Brown, Hugh D. (G'gow, Provan)||Hardy, Peter||Morgan, Elystan (Cardiganshire)|
|Brown, Ronald (Shoredltch & F'bury)||Harrison, Walter (Wakefield)||Morris, Alfred (Wythenshawe)|
|Buchan Norman||Hart, Rt. Hn. Judith||Morris, Charles R. (Openshaw)|
|Buchanan, Richard (G'gow, Sp'burn)||Hattersley, Roy||Morris, Rt. Hn. John (Aberavon)|
|Butler, Mrs. Joyce (Wood Green)||Hatton, F.||Mulley, Rt. Hn. Frederick|
|Callaghan, Rt. Hn. James||Healey, Rt. Hn. Denis||Murray, Ronald King|
|Campbell, I. (Dunbartonshire, W.)||Heffer, Eric S.||Oakes, Gordon|
|Cant, R. B.||Hilton, W. S.||Ogden, Eric|
|Carmichael, Neil||Hooson, Emlyn||O'Halloran, Michael|
|Carier Ray (Birminghn, Northfield)||Horam, John||O'Malley, Brian|
|Carter-Jones, Lewis (Eccles)||Houghton, Rt. Hn. Douglas||Oram, Bert|
|Castle, Rt. Hn. Barbara||Huckfield, Leslie||Orbach, Maurice|
|Clark, David (Colne Valley)||Hughes, Rt. Hn. Cledwyn (Anglesey)||Orme, Stanley|
|Cocks, Michael (Bristol, S.)||Hughes, Mark (Durham)||Oswald, Thomas|
|Cohen, Stanley||Hughes, Robert (Aberdeen, N.)||Owen, Dr. David (Plymouth, Sutton)|
|Coleman, Donald||Hughes, Roy (Newport)||Padley, Walter|
|Concannon, J. D.||Hunter, Adam||Paget, R. T.|
|Conlan, Bernard||Irvine, Rt. Hn. Sir Arthur (Edge Hill)||Palmer, Arthur|
|Corbet, Mrs. Frada||Janner, Greville||Pannen, Rt. Hn. Charles|
|Cox, Thomas (Wandsworth, C.) Cronin, John||Jeger, Mrs. Lena||Pardoe, John|
|Crosland, Rt. Hn. Anthony||Jenkins, Hugh (Putney)||Parker, John (Dagenham)|
|Crossman, Rt. Hn. Richard||Jenkins, Rt. Hn. Roy (Stechford)||Peart, Rt. Hn. Fred|
|Cunningham, G. (Islington, S. W.)||John, Brynmor||Pendry, Tom|
|Cunningham, Dr. J A. (Whitehaven)||Johnson, Carol (Lewisham, S.)||Perry, Ernest G.|
|Dalyell, Tarn||Jonnson, walter (Derby, S.)||Prentice, Rt. Hn. Reg.|
|Darling, Rt. Hn. George||Jones, Barry (Flint, E)||Prescott, John|
|Davidson, Arthur||Jones, Dan (Burnley)||Price, William (Rugby)|
|Davies, Denzll (Llanelly)||Jones, Rt. Hn. Sir Elwyn (W. Ham, S.)||Probert, Arthur|
|Davies, G. Elfed (Rhondda, E.)||Jones, Gwynoro (Carmarthen)||Radice, Giles|
|Davies, Ifor (Gower)||Jones, T. Alec (Rhondda, W.)||Reed, D. (Sedgefield)|
|Davis, Clinton (Hackney, C.)||Kaufman, Gerald||Rees, Merlyn (Leeds, S.)|
|Davis, Terry (Bromsgrove)||Kelley, Richard||Rhodes, Geoffrey|
|Deakins, Eric||Kerr, Russell||Richard, Ivor|
|de Freitas, Rt. Hn. Sir Geoffrey||Kinnock, Neil||Roberts, Albert (Normanton)|
|Delargy, Hugh||Lambie, David||Roberts, Rt. Hn. Goronwy (Caernarvon)|
|Dell, Rt. Hn. Edmund||Lamborn, Harry||Robertson, John (Paisley)|
|Dempsey, James||Lamond, James||Roderick, Caerwyn E.(Brc'n&R'dnor)|
|Doig, Peter||Latham, Arthur||Rodgers, William (Stockton-on-Tees)|
|Dormand, J. D.||Lawson, George||Roper, John|
|Douglas, Dick (Stirlingshire, E.)||Leadbitter, Ted||Rose, Paul B.|
|Douglas-Mann, Bruce||Lee, Rt. Hn. Frederick||Ross, Rt. Hn. William (Kilmarnock)|
|Driberg, Tom||Leonard, Dick||Rowlands, Ted|
|Duffy, A. E. P.||Lestor, Miss Joan||Sandel8on, Neville|
|Dunn, James A.||Lever, Rt. Hn. Harold||Sheldon, Robert (Ashton-under-Lyne)|
|Dunnett, Jack||Lewis, Arthur (W. Ham, N.)||Shore, Rt. Hn. Peter (Stepney)|
|Eadie, Alex||Lewis, Ron (Carlisle)||Short. Rt. Hn. Edward (N'c'tle-u-Tyne)|
|Edelman, Maurice||Lipton, Marcus||Short, Mrs. Renée (W'hampton. N. E.)|
|Edwards, Robert (Bilston)||Loughlin, Charles||Silkin, Rt. Hn. John (Deptford)|
|Edwards, William (Merioneth)||Lyon, Alexander W. (York)||Silkin, Hn. S. C. (Dulwich)|
|Sillars, James||Thomas, Rt. Hn. George (Cardiff, W.)||Wellbeloved, James|
|Silverman, Julius||Thomas, Jeffrey (Abertillery)||Wells, William (Walsall, N.)|
|Skinner, Dennis||Thorpe, Rt. Hn. Jeremy||White, James (Glasgow, Pollok)|
|Small, William||Tinn, James||Whitehead, Phillip|
|Smith, John (Lanarkshire, N.)||Tomney, Frank||Whitlock, William|
|Spriggs, Leslie||Tope, Graham||Willey, Rt. Hn. Frederick|
|Stallard, A. W.||Torney, Tom||Williams, Alan (Swansea, W.)|
|Stewart, Donald (Western Isles)||Tuck, Raphael||Williams, W. T. (Warrington)|
|Stewart, Rt. Hn. Michael (Fulham)||Urwin, T. W.||Wilson, Alexander (Hamilton)|
|Stoddart, David (Swindon)||Varley, Eric G.||Wilson, Rt. Hn. Harold (Huyton)|
|Stonehouse, Rt. Hn. John||Wainwright, Edwin||Wilson, William (Coventry, S.)|
|Stott, Roger||Walden, Brian (B'm'ham, All Saints)||Woof, Robert|
|Strang, Gavin||Walker, Harold (Doncaster)|
|Strauss, Rt. Hn. G. R.||Wallace, George||TELLERS FOR THE NOES|
|Summerskill, Hn. Dr. Shirley||Watkins, David||Mr. Joseph Harper and|
|Swain, Thomas||Weitzman, David||Mr. James Hamilton|
That this House endorses the Government's decision for the reasons given in the statement by the Chancellor of the Exchequer on 17th December to reduce during 1974–75 the demands on resources for the health and personal social services programme, without altering the substance of that programme.