Department of Health for Scotland.

Orders of the Day — Supply. – in the House of Commons am ar 28 Mehefin 1935.

Danfonwch hysbysiad imi am ddadleuon fel hyn

Motion made, and Question proposed, That a sum, not exceeding £2,062,724, be granted to His Majesty, to complete the sum necessary to defray the charge which will come in course of payment during the year ending on the 31st day of March 1936, for the Salaries and Expenses of the Department of Health for Scotland; including Grants and other Expenses in connection with Housing, certain Grants to Local Authorities, &c., Grant in Aid of the Highlands and Islands Medical Service, Grants in Aid of Benefits and Expenses of Administration under the Nation Health Insurance Acts; certain Expenses in connection with the Widows', 'Orphans' and Old Age Contributory Pensions Acts, and other Services.[NOTE.—£1,100,000 has been Voted on account.]

11.12 a.m.

Photo of Sir James Macpherson Sir James Macpherson , Ross and Cromarty

On a point of Order. We are discussing to-day the two most important Votes, as far as Scotland is concerned, and I should like to ask you, Captain Bourne, in view of the fact that this is a very short day, whether you will guide the Committee as to how long the first Vote will be likely to take. Next week we have a long discussion in front of us, for two or three days anyhow, on housing, and in my submission the really important discussion to-day should take place on the Vote for the Department of Agriculture. The issues there are tremendously important, and, in view of the fact that we have a very long discussion on housing next week and of the fact that we had many days' discussion on housing in Committee upstairs, we ought to be assured to-day that a large proportion of the time in any case will be allowed for the discussion of this very important question of agriculture.

11.13 a.m.

Photo of Mr Robert Bourne Mr Robert Bourne , Oxford

The right hon. and learned Gentleman will, of course, realise that I have no control over the action of Members of the Committee in this matter. It is a matter for Members who represent Scotland themselves. If they desire to limit the discussion on the first Vote so as to have more time for the second discussion, the matter is in their own hands by making only short speeches on this Vote. All that I can say is that it is entirely 'in the hands of the Members of the Committee.

11.14 a.m.

Photo of Sir Robert Hamilton Sir Robert Hamilton , Orkney and Shetland

On the point of Order. There is a general understanding, I think, on all sides of the Committee that what you have suggested should be done, that the two portions of the day should be divided and that as soon as the health part is dealt with, which I hope will not take very long, in view of what the right hon. and learned Gentleman has said, we shall then get on to the Department of Agriculture.

11.15 a.m.

Photo of Mr Archibald Skelton Mr Archibald Skelton , Combined Scottish Universities

I am glad that the point of Order has been raised, because it enables me to say that I do not propose to introduce this Estimate in a long speech. I will deal with only two topics, namely, health and housing, the latter only on its administration side. If other questions are raised, I shall deal with them in a brief reply. I do not think I need say anything about the amount of the Estimate further than that there is an increase of £160,000, but that needs no justification. It is almost exclusively due to housing expenditure, and I think that the Committee will on that account, if on no other, agree to it. Wherever the health of the nation is tested, there is an improvement. The death-rate is the lowest on record since death-rates were recorded, being 12.9 per thousand. The infant mortality rate is also the lowest ever recorded, being 78 per thousand. Infant, mortality in the 35 years which have elapsed since the beginning of the century has decreased by 30 per cent.—a remarkable example of what can be done by public health services.

The health of school children shows a, similar improvement. The result of the examination by medical officers shows that children who are subnormal in health have declined from 7.5 in 1923–4 to 5.5. That is a matter of great importance, and it is borne out by the detailed reports, which I will not quote, further than to say that the Medical Officer of Health for Glasgow says that the health of school children has never been better during the last 15 years. We may, I think, expect consistent improvement in this matter, because we have now got in working operation the scheme for the giving of milk to school children. It is, from the point of view of health, important for the Committee to know that out of a school population which might enjoy the benefits of the milk scheme of 760,000, 437,000 are getting supplies. That figure would be larger if in one area, namely, Aberdeen, the Milk Board had found it possible to come into the scheme for supplying milk to school children. It would give opportunities to some of the 60,000 children there to have milk, and I am sorry to say that, according to my latest information, the Aberdeen and District Milk Board has not yet found it possible to adopt the scheme.

The only direction in which the situation has not improved is in maternal mortality, in which there has been a slight rise as against last year, although it is about the same as the average of the last five years. The deaths as the result of child-birth in 1934 were 6.2 per thousand in place of 5.9 in the preceding year. In that connection, I would like to draw the attention of the Committee to what is probably the most important announcement that I have to make on this Estimate, namely, that the report on maternal mortality, which has long been subject to anxious examination by experts, is to be published in the course of a few days. I should like to take this opportunity of directing the attention of the Committee to the importance of this document. I will not go into it in detail, but will only say that the report is based upon an examination as intensive as, if not more intensive and exhaustive, than any previous examination into this question that has taken place in either England or Scotland. The report proceeds upon records of approximately the whole of the maternal mortality cases over a period of many months ending in 1932. The records of these cases, numbering 2,400, have been examined by experts in the subject with the most meticulous care, and I believe that the conclusions which they have drawn and the recommendations which they have made will be of immense importance.

I am not going to draw attention to any of the recommendations, but two conclusions are of such importance that I think I should mention them. They are these: First, the general level of antenatal care is unsatisfactory and the number of ante-natal beds in Scotland is inadequate; second, and this is perhaps the most important, there is no doubt that one of the most disquieting features of present day obstetrical practice is hurried, unnecessary, meddlesome midwifery, and the evidence in this connection shows beyond doubt that the resort to artificial interference with the normal processes of delivery is excessive. I will not say more on the report, but I commend a study of it both to the House and to the country. I need hardly say that my right hon. Friend, myself and our advisers are giving, and will give, the closest consideration to its conclusions and recommendations. I believe that it is as important a document as has been issued on a subject which is increasingly attracting public attention in England and Scotland.

There is nothing else I need say on the subject of the health of the nation. The record is satisfactory. It is not a case of getting weary of well-doing, because it is only by constant attention to, and the improvement and development of, the health services that progress can be made. In that connection, I would recall that the Public Health Services Committee, which was appointed last year by my right hon. Friend, is carrying on its work with great energy and vigour, although I regret to say that the Chairman, Sir John Dove-Wilson, unfortunately, died quite recently. He has been succeeded by one who will, I think, command respect and approval in every section of the community, namely, Professor Cathcart of Glasgow.

The other topic on which I wish to say a word is the progress of housing under the existing Acts, leaving to another occasion the next stage of the matter arising from legislation which is still before Parliament. First let me compare the number of houses completed in 1933 and last year. In 1933 they numbered 20,915, but then, of course, subsidies to private enterprise were still going strong, and there was not that concentration on slum clearance which was produced by the Act of 1933. Of that 20,915, 15,000 were local authority houses and the balance private enterprise houses. Last year the total was 18,417, 14,700 being local authority houses and 3,600 private enterprise houses. This drop had been expected, as was frequently pointed out in the discussions on the Act of 1933 and on the Estimates, but I am glad to be able to say that the most recent figures of completions show that we are again increasing the numbers. Take the first five months of this year and compare them with the first five months of last year. In neither case was there any assistance to private enterprise and the figures are for local authority houses. In the first five months of 1934 6,056 houses were completed and in the first five months of this year 6,500, an increase of practically 500. Although it is only an estimate, and a very rough estimate, I hope and believe that the local authorities' completions, which were 14,719 for last year, may be in the neighbourhood of 17,000 for next year. So much for houses completed.

As to houses under construction, we have this year the highest number of local authority houses that there has ever been. The actual peak month up to date is not last month but an earlier month in the year. At the end of May this year there were 18,119 houses under construction, whereas in May last year there were only 14,488—these are local authority houses—and in the year before 17,033. The position of houses under construction is, I think, satisfactory. Most striking of all is the progress of slum clearance under the present five year plan. The new period of five years began on 1st January, 1934. The local authorities estimated their needs over the period to be 61,316 houses. The actual further building programmes submitted provide for 47,900 houses, or 78 per cent. of the total. As I told the Committee last year, many of the local authorities, whilst feeling that the figures they submitted were the highest they could safely submit, have undertaken that if it is any way possible they will increase their programmes to such an extent that 92 per cent. of the needs will be undertaken in the five years.

What progress has actually been made with the programme of 47,900? At the middle of June, 17½ months after the beginning of the five years' plan, tenders had actually been approved for 30,681 houses out of the 47,900, a very large proportion. But we must not be satisfied with tenders approved. These figures of tenders approved include 8,732 houses completed under the new programme and 15,931 under construction, so that of the 30,000 odd tenders approved by the middle of June only 6,000 represent houses which have not been either begun or completed. I think that is a remarkable record, and shows the zeal and energy with which the Scottish local authorities as a whole have undertaken the work of dealing with slums in the course of this new period. The momentum with which slum clearance is being tackled shows no signs of slackening. I pointed out last year that in 18 months we had done almost as much as had been done in the previous nine years, and the momentum is still increasing. The slum clearance houses completed in 1933 numbered 7,199, and in 1934, 8,598, or 15 per cent. more. To bring the Committe right up to date, the first five months of 1935 show completions numbering 5,240 whereas in the first five months of the previous year the completions were only 3,420, showing an increase of 1,820, or 53 per cent.

Photo of Mr James Maxton Mr James Maxton , Glasgow Bridgeton

Can the hon. Gentleman tell me whether this increase is spread over the whole country, or does it mean that one or two places only have been, making a special effort?

Photo of Mr Archibald Skelton Mr Archibald Skelton , Combined Scottish Universities

Broadly speaking, I think it is spread over the whole country; but I will look into that point and say a word on it in my reply. There is, in short, a steadily increasing momentum in the work of slum clearance. It would be highly improper for me to deal with legislation which is before the House, but the Committee are familiar with the fact that one of the provisions of the Bill now before us is that the subsidy will be directed to all houses in connection with the removal of overcrowding begun after the 1st February this year. They will be interested to know that under that provision tenders have already been approved for 854 houses, showing that the local authorities are not letting the grass grow under their feet in this respect. We are taking every step to ensure that any tenders approved under that provision will deal first with the worst cases of overcrowding. I take this opportunity of saying that no tenders are being approved for two-room houses, nor will they be, and that a very considerable proportion of the 854 tenders are for four-room houses and some for five-room houses. Overcrowding does not always arise where there is a large family, but that is often the case, and therefore it is of importance to have an adequate number of the larger size houses.

The only other matter is rural housing. Under the provision in the Rural Workers Act the reconditioning of farm cottages goes steadily on. I will not weary the Committee with particulars now, because any hon. Member who requires them can obtain them. We propose to put before local authorities who are administering the Act the importance, where they give grants for reconditioning, of seeing that the improvement of the cottages includes, if necessary, an increase in the rooms available. That is one way in which the administrative question of rural overcrowding can be dealt with. We can only bring the matter before the local authorities, because the Department has no power in the matter, but I have no doubt that once their attention is directed to it they will respond.

I do not think there is anything else with which I can deal under this Estimate, but I would add one general observation. Great sums of money are spent upon health and housing. It is most important and reassuring to know the response that is made by those who get the advantage of the expenditure. In the vast majority of the cases of people who are removed from slums there is immediate and strong response to the improved conditions. It is also true that in the sphere of health the population of Scotland is increasingly responsive to the efforts that are made by public health authorities. Maternity and child welfare centres are constantly increasing in popularity, and one could give, from various angles and in various connections, evidence of the fact that where efforts are made by public health authorities to help individuals towards a higher standard of health, the population of Scotland are more and more alive to the importance and to the advantage of making use of the facilities afforded. That is a matter of supreme importance. You might have the most perfect public health service, but if there were not a response on the part of the public, that service and the efforts and expenditure it involved, would not be effective. We may take this as an example of the fact which one sees upon every side, that there is an immense improvement in the morale, the outlook and general wisdom, as a result of the varying forms of effort and education which are now being made. Without further ado, I will ask the Committee to accept this Estimate.

11.39 a.m.

Photo of Sir Archibald Sinclair Sir Archibald Sinclair , Caithness and Sutherland

We have in the Under-Secretary of State who has addressed the Committee a Minister of Health who has himself just been healed. We rejoice to welcome him back to the Committee, and to listen to a vigorous speech from him, which shows that his strength and vigour are unabated and that his firm grasp of Scottish health administration is unweakened. We listened with great interest to his survey of the problems of his Department, and it is a pity that the limitations of the Debate caused him to curtail his speech. When the Estimate was first asked for, we were aware that a very important document affecting Scottish agricultural problems was likely to come before us, but unfortunately we did not know on what day, and we put down the Health Estimate before the Agricultural Estimate. When the document was presented, we tried to get the arrangement altered, but the announcement had been made, and it was considered to be for the convenience of the Committee generally that the arrangement should stand. I join with the right hon. and learned Gentleman the Member for Ross and Cromarty (Sir Ian Macpherson) and with the Under-Secretary in hoping that we shall be able to have a discussion of agricultural problems, particularly with reference to the smallholders and the crofters who were the subject of the petition to which my hon. Friend referred, and that we shall have a better opportunity of discussing at length that very urgent question.

I do not intend either to follow the Under-Secretary in all the remarks which he has just mach or to discuss at length this interesting report of the Department of Health which is in the hands of Members of the Committee. I would like, in passing, to congratulate the Secretary of State and the Under-Secretary on the early appearance of this and other departmental reports. They came in good time for all of us to consider, and the Secretary of State has given valuable assistance to his Scottish colleagues in ensuring that the reports should be ready early. I hope that that will be a precedent for future years.

There are only three points arising on it with which I wish to deal. I welcomed, as I am sure did every other Member of the Committee, the picture which the Under-Secretary drew of the improved health of the people of Scotland. I welcomed particularly his announcement of the early report of the maternal mortality committee. We shall all study that report with great interest. We are glad to know that, broadly speaking, the health of the people of Scotland is good and is improving, but it still remains true, as is pointed out in the annual report of the Department of Health, that the public demand for hospital treatment increases. That demand is not peculiar to any type of case nor confined to any particular social class, and not only is the demand increasing but, unfortunately, it is not being met. The Under-Secretary of State said that the health services were improving and meeting all demands; this is one vital demand which, at present, as the annual report shows, is not being met.

Photo of Sir Archibald Sinclair Sir Archibald Sinclair , Caithness and Sutherland

No, but increasingly meeting demands. Perhaps the hon. Gentleman did not say all demands. In regard to hospital services, this is what the report says: Recently a study was made of the records of a large number of consecutive patients admitted to the medical wards of one of the best of our general hospitals. It was found that many of them had been ill for months or years prior to admission. Pressure on bed accommodation was so great that the duration of in-patient treatment had to be kept as short as possible. Only 26 per cent. of the patients reviewed remained in hospital for more than one Month, and only two per cent. for more than three months. It is not surprising, therefore, that on discharge from the hospital more patients were classified as 'relieved' than as 'cured'. The report adds, It is impossible to regard such results with equanimity. I would ask the Under-Secretary to say a word about that, because it is very serious. It is impossible to regard the condition of our hospitals with equanimity, and I would ask what the Government are doing to remedy that state of affairs. I was recently talking to a doctor who had returned, after a number of years spent in the Malay States, to take up an appointment in Scotland, and he told me that our hospital services in Scotland were inferior to those in the Malay States. I was incredulous, but I must say that his opinion is not inconsistent with the stern and sombre warnings addressed to the local authorities in the Report of the Department, which speaks in the language almost of despair—or, I will withdraw the word "despair" if the Under-Secretary dislikes it, and use the word "discouragement"—in calling upon the local authorities to takes steps "if ever," as they say, Scotland "is to have an efficient hospital service."

Duchess of ATHOLL:

Would the right hon. Gentleman mind saying whether that statement about hospitals in the Malay States refers to the quality of the hospitals, or to their extent I Are we to understand that a larger proportion of the inhabitants of the Malay States seek hospital treatment than in Scotland?

Photo of Sir Archibald Sinclair Sir Archibald Sinclair , Caithness and Sutherland

I cannot answer the Noble Lady's question precisely; I can only say that that was the statement which the doctor made to me, that the hospital service—I would rather not be drawn into a definite statement as to equipment—available for the people of the Malay States was better than the hospital service available to our people in Scotland. I commend to Members of this Committee the warnings about the condition of the hospitals which the Report gives, for they are couched in very serious language. But warnings are not enough, and I think we are entitled, and, indeed, in duty bound, to ask the Government what steps they are taking "to build up"—which again is the phrase used in the Report—an efficient hospital service in Scotland. I am far from suggesting this as a score against the present Government, or suggesting that the present Secretary of State and Under-Secretary are less anxious about the situation than their predecessors, and I desire to acknowledge the help which we, at any rate, in Sutherland and Caithness, have received from them in dealing with our hospital problems. In particular, the appointment of a resident surgeon to the hospitals in Caithness has been of immense value and a, real practical boon to our people there. It would also be a great boon if we could have also—I understand the proposal has been considered and mooted among the local authorities in discussion with the Department of Health—a consulting physician. I understand that certain proposals are being made for extending the infirmary in Inverness, and I would suggest that a consulting physician there, ranging over a wide area of territory in the Northern Highlands, could render very valuable help to his medical colleagues in the area.

The next question that I want to raise is one which is germane to the subject of housing, with which the Under-Secretary has dealt, but it is really fundamental. That is the question of town and country planning. As the Under-Secretary has pointed out, vast numbers of houses are being erected all over Scotland, and we want to be certain that, in the erection of those houses, valuable public amenities will not be permanently destroyed and lost for ever, and that ground which is necessary for public open spaces and playing fields is not going to be absorbed. In the Report, progress is reported to be slight—those are the words of the Department; and, indeed, apart from Aberdeen and Glasgow, I would say that it is negligible. There is an urgent need for some active and unifying body to co-ordinate the activities of local authorities; otherwise, we or our children will have to pay a heavy penalty in the loss of open spaces and playing fields and public amenities. The Departmental Committee on Garden Cities and Satellite Towns issued its Report about two months ago. The Committee recommended the appointment of a planning board to act with the local authorities as a stimulating and unifying agency. If the Secretary of State is going to reply, I should like him to tell us whether that Report has yet been considered by the Government, and what action the Government propose to take on it.

For the rest, as regards housing in Scotland, I would only say that the shadow of the Act of 1933 lies across the housing record of 1934, over which the Under-Secretary skated so lightly just now. It is true that the construction of slum clearance houses was increased by one-sixth last year, but the construction of other local authority houses was reduced by a quarter, and the total reduction in the number of houses constructed, including those constructed by private enterprise, was no less than 12 per cent. It only shows the usefulness of the debate which took place last year on these Estimates, in which they were discussed without party bias, with as little party bias as could be brought in, and in the course of which, in all parts of the Committee, grave dissatisfaction was expressed with the working of the Act of 1933. That was a very useful debate. The Ministers seem to have thrown new energy into their task, and they have introduced new legislation. As it would be out of Order to disuss that legislation to-day, and as it has occupied many weeks of the time of the Scottish Grand Committee and is to occupy the time of the House for a further three days next week, I will only take this opportunity of reminding the Government of the problem upon which the Under-Secretary touched in his speech—the problem of rural housing, the housing of crofters, smallholders and farm servants.

The Under-Secretary said that the rehousing of farm servants was going on steadily, but it is not going on nearly fast enough, and the pace at which it is going is placing an increasing and very nearly intolerable burden of rates upon the local authorities. While the Under-Secretary was unfortunately incapacitated, the Secretary of State received a deputation from the Highland authorities, who made it clear that they were reaching the limit, and definitely demanded that there should be a maximum beyond which they should not be expected to undertake any further burden under the Housing (Rural Workers) Act, but rather that the Government grant should be increased to the amount necessary to enable the work to be continued without throwing additional burdens upon the local authorities. The Government have undertaken that this matter shall be considered by the new advisory committee which is to be set up, and I hope it will receive their urgent attention.

I come now to my last point, which is, indeed, the main burden of my speech, and that is the question, which is of real and fundamental importance at the moment, in the Highlands of Scotland at any rate, of the water supply. In the evolution of our social services, it happens that public opinion concentrates first upon one aspect of social reform—it may be housing—and then upon another aspect, perhaps transport or roads; and not only do other aspects not receive a proportionate amount of attention, but the improvements which are made in these particular departments of public activity throw an increasing burden upon the neglected parts of our system of social services. For example, housing and the general raising of the standard of living which has come with the improved housing in country districts has increased the demand for water, and it so happens that, with a series of drought years, the available supplies have got worse, and, therefore, there is at the present moment no more serious need under the heading of public health in the Highlands of Scotland than an increase in the water supply. Let me ask the Committee to consider the importance of this question of water supply as brought out in the report of the Department of Health itself. They begin their report naturally and properly in chapter 1 with "The Health of the People", and they go on to say: It is satisfactory to observe, however, a growing appreciation of the fact that the improvement of housing, water and food supplies and the prevention of atmospheric pollution must remain cardinal points in any health programme. Atmospheric pollution does not trouble us in the Highlands of Scotland, our food supplies are admirable, and our housing is certainly improving, but where we are not making progress comparable to the progress in those other cardinal points is in water supply, and I impress upon the Government and upon the Committee the vital importance of that cardinal requirement. The Department say that in January of last year they called for reports from local authorities on the adequacy of their water supplies during 1933, and of 787 supplies reported on, 300 were found to be inadequate. The report of the Committee on Scottish Health Services was rendered during the year, and they reported that: The evidence leaves no doubt that the areas of deficiency, which are mostly though not exclusively rural, are sufficiently numerous and important to constitute a serious problem. There is no part of the country where this need is greater than in the northern Highlands. The Rural Water Supplies Act last year provided grants, but I warned the Under-Secretary at the time that large grants would be necessary in the Highlands because of the great poverty of the people and the low rateable value. Every district in the country, however prosperous, can get grants of 75 per cent. for the reconstruction of their roads, but the most impoverished districts of the Highlands where the water supplies are in some cases dangerous, where a district rate of 1d. will raise perhaps only 20s. and even the yield of the penny rate in the County is only £150—people living in such districts cannot get a grant of more than 20 per cent. or at most 25 per cent. for what the Government, in their report, describe as a cardinal necessity of public health. There is no justice and no sense in that situation. To dangle these little grants of 20 and 25 per cent. before these impoverished communities is to add the tortures of Tantalus to the hardships and dangers to which they are now exposed in obtaining water, at great distances from contaminated supplies, because that is what they are bound to do in a number of cases which I shall quote to the Committee.

I have pitched the case high, deliberately high, because it is serious, and I will give examples which prove it. In Caithness there are some six schemes which have been put before the Government by the county council for a supply of water to Reay, Dunnet, Keiss, Knockally and adjacent townships, Lybster and Latheronwheel. These are all populous districts and places where water is badly needed. Some places suffered from fever last year. The scheme of the Government, of a maximum grant of 25 per cent.—over and above the cost to the county council, and therefore the county ratepayers as a whole, whose rates are 11s. in the pound—would throw an additional burden on the ratepayers in each district, in one case of 8s. 5½d. in the pound; in another 6s.; 8½d.; and in the very urgent case of Ramscraigs and surrounding district of £1 16s. 2½d. in the pound. So urgent was that case recognised to be that the Department devised a special and cheaper scheme for the extension of water from the neighbouring district of Dunbeath, but that scheme would have added 5s. 2d. to the rates of that district, an addition of nearly 50 per cent. to their present high rates, and would have further necessitated raising the rates to the people from whose district the water was being brought from 3s. 6d. to 5s. 1d. without any advantage whatever to them, and, let me add, would have raised their rates to just under 18s. in the pound. Naturally that scheme cannot be proceeded with in spite of the really desperate need of the people for water, with which the Under-Secretary of State, let me acknowledge quite frankly, has shown personal sympathy. So that here, as elsewhere throughout the Highlands, that 25 per cent. grant makes the scheme of the Government a grim and ludicrous joke at the expense of these townships. They are told that the Government are giving them, a 25 per cent. grant, but with that grant it is impossible to make progress.

Take the position in Sutherland. At Elphin and Knockan the sanitary inspector reports that the people have to rely upon shallow wells which are showing signs even now of drying up, and he adds: In my opinion it is imperative that a proper water supply should be introduced. Imperative, yet the assessable rental on all the poor little crofts in that district is only £33, and more than a 25 per cent. grant would be necessary. Take Scourie, where the supply of one half of the district has been to some extent improved. We have an area where the schoolmaster has to go at three o'clock in the morning to the only available well to get water for cooking purposes. I take this from the report of the sanitary inspector. This is not my report after a personal talk with a particular schoolmaster, but the official report of the sanitary inspector. To quote from another local authority's official report, the school medical officer speaks of the desperate need of the people in Scourie of water, but here the yield of 1d. rate is only 19s. 5d., so that with a 25 per cent. grant no progress can be made.

Take Rogart and Pittentrail, where the sanitary inspector says that the water shortage is so bad that the village baker has sometimes to restrict his output of bread. Take the case of Lairg, where visitors have had to leave the hotel owing to water shortage, and where the sanitary inspector says that unless matters are remedied the livelihood of the inhabitants will be seriously jeopardised. The hon. Member for Govan (Mr. N. Maclean) was good enough to support me by raising this matter in the House the other day, but the answer he received carried matters no further than my correspondence with the Under-Secretary of State a few weeks ago. In the opinion of the sanitary inspector, the only satisfactory solution is to tap a certain lake, but the proprietor objects on the ground that it would interfere with the trout fishing. Meanwhile, at the suggestion of the Department of Health, certain improvements have been carried out which it is expected will result in a satisfactory improvement in the position. If this expectation is disappointed I have some reason to hope that the Department will declare firmly, promptly and unequivocally that the public health requirements of the 300 inhabitants of this village will be preferred to the interests of the trout fishing in the loch.

Lastly, let me take the case of the Doll, a large township near Brora. Here the school has no water laid on. There is only one well there from which the children are allowed to take water, and it is the best well for the whole of this large township. But the children are not allowed to drink the water unless it has been boiled. That is the best water supply for the township. It is not surprising that there were cases of fever in the village last year. The Under-Secretary of State knows well the conditions in the village. He has written to me in very sympathetic terms. I would ask him in the discharge of his dual responsibility as Minister of Health for Scotland and also Minister for the Education Department, and therefore responsible for the children attending the schools, to devise a scheme so that the people can get a pure supply of water.

It is not enough to say that the county council has power under the Act of 1929 to give larger grants. The rates are piling up in these Highland counties. I am glad to see that the Lord President of the Council has come into the Committee. The other day he was paying his rates in Lossiemouth, and he wrote a letter to the town council—[Interruption]—but I have a quotation from the "Daily Express," which states: The Prime Minister has just paid his rates at Lossiemouth, through his Secretary, Miss Rosenburg, and says that the increases in the rates during the last three years are giving him 'cause for consideration.' The Lossiemouth rates have risen to 11s. 10d. In Caithness the county rate is 11s. The rate rises to over 16s. in some districts where they have water schemes. Other Highland counties have similar rates. I think those facts should give the Government cause for consideration, because it is obvious that when rates of that amount are in operation it is no good telling the county councils, as the Under-Secretary and the Secretary of State are doing, that all they have to do is to give higher grants under the 1929 Act. The authorities are told that they have powers under that Act to give higher grants, but the rates are causing concern to the county councils, and they cannot afford to bear these increases of rates. It means that in districts where the ratepayers are paying 16s. in the £, the rate includes the cost of their own water supply and their ordinary normal county rate, and they will not pay an additional rate to help some other district to get its water supply. In moderation they will do that, but we cannot expect them to go beyond what the county councils are now contributing, which averages something from 20 to 25 per cent.

I am criticising the use that has been made in the past of the grant of money by Parliament. It was used for little grants which were useless for the purpose of improving water supplies to the houses in the Highlands. Nothing less than a 75 per cent. grant, the grant which is normally given for road construction to prosperous counties, is any good if you are really going to tackle the question of improving what is recognised in the Report of the Department of Health as a cardinal necessity for the health of the people. I am not attacking the Under-Secretary. It is not that he is unsympathetic. He and the Secretary of State have in the Melvich-Strathy scheme, Where the Department of Agriculture was able to help, provided, or are providing, a satisfactory solution, but in that case there were special circumstances.

I am pleading for the ordinary villages which are deprived of what is rightly described in the report of the Department as a cardinal necessity of public health. Let the Government come to Parliament if there is not enough money. There is no restriction in the Act of the amount of grant that they can give. They can grant 75 or 100 per cent. under the Act. If more money is wanted, let them come to the House of Commons and ask for it, and I am sure that Parliament would support them in meeting any demand that may be necessary to provide for the cardinal necessity in the Highlands of Scotland, where the people are deprived of it, namely, a pure water supply. Money is idle in the banks and men are employed. Why not utilise these resources for improving the water supplies?

Photo of Mr Archibald Skelton Mr Archibald Skelton , Combined Scottish Universities

What my right hon. Friend is advocating would involve fresh legislation.

Photo of Major Murdoch Wood Major Murdoch Wood , Banffshire

I hope that the right hon. Gentleman will not pursue that point further, as it would mean legislation.

Photo of Sir Archibald Sinclair Sir Archibald Sinclair , Caithness and Sutherland

With great respect I submit not. I have looked at the Act which was passed last year and there is no restriction in it of the amount of grant which the Government can give. They can give a grant of 100 per cent.

Photo of Mr Archibald Skelton Mr Archibald Skelton , Combined Scottish Universities

That is not quite accurate. The grant given by Parliament was limited in the ease of Scotland to £137,000, and all that has been earmarked already.

Photo of Sir Archibald Sinclair Sir Archibald Sinclair , Caithness and Sutherland

That may be so, but I am perfectly entitled to criticise the Government on the ground that the grants for the Highland counties were inadequate. If the Under-Secretary says that the funds are not adequate, let him come to the House of Commons, and, with the support of all parties, we will give him the money. If the Department will act in this matter I have not the slightest doubt that, as they would be acting really as a National Government, they would get the support of Members in every part of this House and another place.

12.14. p.m.

Photo of Sir James Macpherson Sir James Macpherson , Ross and Cromarty

A great many of my colleagues are very anxious to speak on an important subject which is down for debate later, and consequently I shall only detain the Committee for a minute or two. I should like to preface my remarks by congratulating my hon. Friend the Under-Secretary of State on his reappearance in the House in his pristine vigour. We are delighted to see him and to know that he is once again back at his post. I should also like to congratulate the Department of Health on its Report. Not only did it appear quickly but at the right time and, us usual, it is a first class document, full of interest and very well written, and I would recommend that every Department of State should take it as an example of a Government document.

I am not going to deal with all the points which my right hon. Friend has raised, but I agree entirely with what he has said about water supplies. Two things of great importance in the Highlands are the question of rural housing, including the housing of the farm servants, coupled with such a supply of water that those houses and the townships all over the place may have a good and pure supply. I have been looking at the latest grant—£137,000, I think it is. It is totally inadequate. You have in the Highlands a very small rateable area, and you are giving only a quarter of the amount from the State, instead of giving three-quarters. I do not think out of that £137,000 there was any more than £20,000 spent in the Highlands altogether. I think that is a very poor proportion, and I strongly support what my right hon. Friend has said. I know he was speaking for the Highlands as a whole, particularly the more rural parts and the smaller burghs.

Let me deal with one or two points which struck me as I was reading the Report. I will refer to the Highlands and Islands Medical Service. As we all agree, there has never been a more useful service introduced into any country than the Highlands and Islands Medical Service. I see my hon. Friend the member for Orkney and Shetland (Sir R. Hamilton). I have no doubt he knows all about it personally. It is now a common thing to take patients from remote islands to a central hospital by aeroplane. When some of us advocated the establishment of this Highlands and Islands Medical Service a quarter of a century ago, we never dreamt that any such thing could possibly happen, but not only has that happened, but, as my right hon. and gallant Friend has just said, we are establishing a very fine hospital service in the Highlands. We have a good many hospitals well equipped, and I am inclined to disagree with my right hon. and gallant Friend when he says that the hospitals in Malay are, as far as service is concerned, better than the hospitals in the North of Scotland. I have been to a good many of these hospitals one way or the other, and I would decline to compare any hospital in Malay with, say, the Royal Infirmary in Inverness.

Photo of Sir Archibald Sinclair Sir Archibald Sinclair , Caithness and Sutherland

I did not compare hospital with hospital, but what I intended to convey, though, of course I do not accept responsibility for the opinion—I was only quoting it—was that the hospital services available to the people are not as good in the Highlands as in Malay.

Photo of Sir James Macpherson Sir James Macpherson , Ross and Cromarty

I quite agree with my right hon. and gallant Friend when he says the statements were not his, but he gave them to the Committee as the statements of a doctor, a Scotsman, who had been in Malay. Not only do I say that the equipment in the Highland hospitals is better—I refer particularly to the Royal Infirmary in Inverness—but I say that the services are better. You have types of doctors in the Highlands just now, and in Inverness, who are, in many respects, beyond compare. They are first-class surgeons. The only point that remains is, are there more hospitals in Malay than there are in the Highlands? During the last 10 years we have seen the establishment of first-class hospitals. My right hon. and gallant Friend himself paid a tribute to the hospitals in his own constituency. I agree that there is a tendency to utilise these hospitals mostly for surgical cases. But I think the time has come when the State might well consider—and the State is always backed up in the Highlands by voluntary grants from the people themselves—the extension of these hospitals for an increase of medical services. I think the advance made in hospitals and medical service in the Highlands is a most remarkable achievement, and during these last years the Government have been supported in every effort in order to make that achievement still more remarkable.

Let me take one other point. I have always advocated in this House that the doctors and the nurses in the Highlands ought to be well supplied with houses and telephones. I notice with great pleasure that there has been an advance in that particular direction, and I only wish to say to-day that I am encouraged by it, and am hopeful that the Government will go on with its good work. Picture for yourselves a little township 25 miles away from a doctor or a nurse. What earthly chance have the people there for what is called first-aid, unless there is communication by telephone to the nearest doctor? I could take Members to heaps of places in the Highlands where but for the telephone, and the skilled first-aid of the nurses, and really the chivalry of the local doctor, who is prepared to go out in storm and sunshine miles over moors, regardless whether he is paid or not, the people would have fared badly. The Highland Medical Service has been of great benefit, and I should like to pay my tribute to the Department of Health for what it is doing in that respect. I will not say anything more, because I know a great many of my colleagues wish to speak and consequently with these words, and in the hope that we may be encouraged to expect more of this laudable work and enterprise, I sit down.

12.21 p.m.

Lieut.-Colonel Sir CHARLES MacANDREW:

I should, first of all, like to say how very glad I am to see the Under-Secretary back in his place restored to health. With regard to the Report of the Department of Health, there are one or two matters I would like to raise, and, following previous speakers, I shall be extremely brief. The birth-rate in Scotland to-day is about half what it was 60 years ago. That seems rather alarming, but if we look at the figures, we see that the population is keeping up and not decreasing, and if we compare it with the English birth rate in the last 20 years, we find that the English Birth rate has decreased by about 38 per cent. whereas the Scottish birthrate has only decreased by about 31 per cent. Therefore, it is not such a serious problem, although at first sight it seems a considerable drop in the last 60 years. What, however, is a very serious problem is that of maternal mortality. I think that is a matter which calls for the greatest possible attention. We read in the Report that the death-rate of women in child-birth, which was slightly higher then in 1933, has resisted the intensive and widespread effort to bring it down. This problem, which apparently baffles the medical authorities, must really be attacked, and I am glad to see that the report says: The Department and this Scientific Advisory Committee share the common anxiety that new knowledge should be made publicly available at the earliest possible moment, and on the special problem of maternal mortality they hope to publish the results of recent inquiries at an early date. I hope the Under-Secretary will bear this in mind, and publish the results at the earliest possible date.

Photo of Sir Charles MacAndrew Sir Charles MacAndrew , Glasgow Partick

That is very gratifying. On the question of maternal mortality, the report says: The total number of midwives enrolled by the Central Midwives Board for Scotland since the roll was established in 1915 up to the 31st March, 1934, was 11,002 of whom 7,440 were enrolled after passing the Board's examination. That perhaps may account for this maternal mortality. It seems extraordinary that over 3,500 midwives who cannot pass the examination should be on the roll. I hope the Under-Secretary of State will give us some explanation of this, because it is a matter which requires attention. Midwives who are not able to pass the examination but who nevertheless are on the roll might do enormous damage to health in Scotland. Then there is the question of venereal diseases, on which the report says: In the absence of any system of notification the incidence of venereal diseases in the country is unknown. It may be that legislation is required to make it notifiable. I think it should be made notifiable. The report says: Infected mothers often show great anxiety for the health of their children and bring them willingly to the centres for observation, and for treatment if necessary. In one or two areas, also, infected parents have been persuaded to allow their children to be admitted to hospital for intensive observation. Is it not possible to make it compulsory for doctors to notify these cases when they find that the mother is suffering from this disease in order that the children may be properly cared for. It is a dreadful thing to allow women affected in this way to go on attending their children because it may have the most dreadful results to the children in after life. I think that there should be notification in these cases. Then there is the question of the teeth of the children. The dental staffs consist of 48 whole time and 35 part-time dentists, and the report says: It is very doubtful whether the existing dental staffs can adequately supervise the condition of the teeth of the children, especially since much of their time is occupied in attending to casual cases, that is, children suffering from tooth-ache whose teeth may be beyond saving. I remember that every holiday I was taken under protest to the dentist, with the result that I have now no bother with my teeth, and if a little of the money which might be saved on other things could be devoted to this service it would be of great benefit to the children. It is most regrettable to learn that at this age the teeth of many children are beyond saving. I hope the Under-Secretary will give this point his consideration. The last matter upon which I desire to speak it not so important, although it is worthy of attention—it is the question of holiday camps. In the report I read: Complaints of insanitary conditions at such camps have frequently been made to the Department. Investigation, however, has generally failed to disclose any measurable departure from the standard of public health laid down in the by-laws. Anyone who has had an opportunity of seeing any of these camps must be aware that the sanitary conditions are anything but satisfactory. It may be that my standard of sanitary conditions is unduly high because I have had the honour of commanding a territorial unit, but, if the camps which we occupied for only a fortnight were in anything like the condition of these holiday camps, which are occupied throughout the whole summer, the medical officer who inspects the camp would have had something to say. The medical officer attached to my own unit was a soldier of some distinction and is now in the service of the Department, and it might be a desirable thing if such men by agreement were allowed to inspect these holiday camps, because they have much more experience of camps than the officials of the Department of Health.

12.33 p.m.

Photo of Mr James Maxton Mr James Maxton , Glasgow Bridgeton

I rise to offer a few observations on the Estimates. I should like to have congratulated the Under-Secretary of State on his return to duty, but I do not do so because I think he stayed on duty too long before he was laid up and that he has come back too soon. I can assure him that so far as we are concerned we are quite prepared to give him a more extended holiday than he has had, and that we will not unduly harass his colleagues in his absence. Out of the mass of figures in the report of the Department of Health he has presented to us a very cheery selection. Every figure he quoted showed improvement and progress. It was a wise and judicious selection on his part. I should like him, if he can, to give me some assurance on the lines of the interruption I made, that the progress in housing development is general all over the country and not confined to the areas of a minority of active and progressive local authorities.

I want to make some reference to other figures which are not quite so encouraging. Among the statistics which are given is a table which goes back into the 1860's and shows the number of persons per thousand of the population who have had to apply for poor relief. I was interested to know that the number of persons who had to apply for poor relief per thousand of the population in Scotland in 1934 was precisely the same proportion as had to apply in 1867. That is a rather distressing figure. It shows that over a period of 70 years there has been no substantial change made in the ratio of very poor people to the total population. It may be claimed, however, that those who go to public funds for their maintenance are more generously treated now than they were in 1867. That does not alter the basic fact that there is that very large proportion of people in Scotland for whom society is not able to find the ordinary method of maintenance.

I turn now to another figure, namely, the cost of maintaining the poor in Poor Law institutions—the sick poor, the able-bodied poor and the insane poor. Tabulated figures show the cost in various districts. I find that in some cases the figure falls as low as 5s. a week for maintaining a poor person in an institution. That is an appalling figure. It occurs in only one area, but I ask the Under-Secretary whether he would make some inquiry with reference to that particular district and find out how it is possible to maintain poor people inside an institution, in house accommodation, clothing, food and presumably some supervision, for the sum of 5s. a week. Above that figure of 5s. there are all sorts of variations.

Within the last two years we have passed the Scottish Poor Law Act, and I was assured at the time by the Under-Secretary that all my talk about Bumbledom and institutionalism and so on was so much nonsense. The hon. Gentleman did not use language so crude, but that was the general suggestion. He said that that Act was a new charter for the poor of Scotland. The hon. Gentleman, more than anyone else, was responsible for carrying that Act through its somewhat extended Committee proceedings and through the House. His assurance, which I ultimately came almost to believe, was that it was a great charter which was going to raise the whole treatment of the Scottish poor in institutions to a higher level than ever before. I want the hon. Gentleman to examine the figures of costs. I am sure that on the money that it has cost to keep poor people in Poor Law institutions in Scotland, in general there cannot be inside these institutions the amenities of life that were certainly made possible by the Poor Law Act that we recently passed. I would like the hon. Gentleman, who was responsible for the legislation to a large extent, to turn his administrative attention to the work of the local authorities, and to see whether they are in fact operating the new Poor Law Act in the way that he believed and hoped it would be operated.

I wish to say a few words in reference to the water supplies problem. I only came across this local government problem last week-end. The township in which I live when I am in Scotland is faced with the necessity of making very considerable extensions to its sewage disposal works. It is a comparatively small community and is called on for a large capital expenditure in this direction at a time when it has incurred very large responsibility in the matter of housing development and other developments. It is a community that is trying to do its duty well, a community that was a pioneer in the matter of an up-to-date sewage disposal scheme. Now it finds that the scheme is not adequate to cope with the necessities, and it is faced with a very big capital outlay, just as remote Highland constituencies and Northern constituencies are faced, if they are to have an adequate water supply, with a heavy capital expenditure which they cannot bear.

I want the Secretary of State and the Under-Secretary to consider that matter, apart from the water supply grants which we are told are already exhausted. I would like to have particulars about these grants, for I do not think they are mentioned in the Report. Recently I was told that only £600 had been spent up to date on the rural water supplies grants of Scotland, but the figure given to us to-day seemed to indicate that the whole of the money available had either been spent or earmarked.

Photo of Mr James Maxton Mr James Maxton , Glasgow Bridgeton

I would like the Secretary of State and the Under-Secretary to see whether they cannot make the capital financing of these schemes easier for local authorities if additional grants cannot be found. The community to which I have referred is faced with this new development for sewage disposal capital expenditure before it has paid off the original loan for the original scheme. It seems to place an intolerable burden on the community. It is a shocking thing that our local authorities should be continually living on the hire-purchase system as it were, that townships should be like housewives with their sewing machines or young fellows with bicycles; they keep on paying so much per week, and by the time the last instalment is paid the bicycle has burst or the sewing machine is out of action. That seems to be the position of a large number of local authorities in Scotland under the existing method of financing their larger capital expenditure.

It was a well-established practice in this House that there should always be two days in the year for Scottish Estimates. I hope that this is not being considered as one day, because a Friday is not a day in terms of hours. For Scottish Members it is particularly inconvenient. A very large proportion of Scottish Members make week-end engagements in Scotland for Fridays or Mondays, and the intimation of this day being allocated to Scottish Estimates came late, after most people had made their engagements. I know that a very large proportion of Scottish Members who desired to be present to-day are unable to be here. I hope, therefore, that this will not be regarded as one full day and that we still have one and a half days to come. I recognise that this is not a point for the Under Secretary to deal with but it is a point for the Committee and therefore I voice it here.

12.45 p.m.

Photo of Lieut-Colonel Sir Thomas Moore Lieut-Colonel Sir Thomas Moore , Ayr District of Burghs

As congratulations are in the air this morning, may I add my voice to the welcome which has been given to the Under-Secretary this morning and express my satisfaction at seeing him again with us? Good people are, no doubt, plentiful in Scotland but they can ill be spared from this House. We have missed the Under-Secretary in our discussions both here and upstairs and we are by contrast very happy to have him back. We only ask him now to take care of his health aid not to over-exert himself. I wish, in the first place, to thank the Scottish Office for the report of the Department of Health. It is one of the most interesting, lucid and readable reports which has been issued from the Scottish Office for many years past. One feature of it which must have impressed all who read it is the tragic increase in maternal mortality. It seems a strange commentary on our scientific, medical and surgical progress that, year by year, not only in Scotland but all over the country, there should be cut off all these apparently strong and healthy young women as the result of child-birth. On reading the report, I made inquiries about the maternity homes in my constituency and I found professional and lay opinion united in saying how well-managed and how satisfactorily conducted these institutions were and how capable were the medical staffs, the matrons and the nurses. Obviously, therefore, it is not the homes that are to blame and we must look elsewhere for the cause. It may be to some extent due to the fact that the midwifery attention which some of these women have to receive at their own homes is not of the highest standard that can be procured. But I know that the Under-Secretary, who mentioned the matter specifically, is keenly anxious about this increase in the mortality. I feel sure that we Scottish Members can leave it to him to do whatever can be done during the forthcoming year to check the tragic increase in the number of deaths from this cause.

I pass from that subject to the question of housing. I recently analysed the letters which I received from my constituency and I find that 65 per cent. of them deal in some form or other with questions of housing and the difficulties of procuring accommodation. The Under-Secretary said that no tenders had been approved or would be approved for two-roomed houses. I do not understand this dislike of two-roomed houses. Those houses meet the need of young newly-married people and they also meet the need of older people whose children have grown up and left them. I find among the people themselves a very common demand for two-roomed houses. While the increase in the number of houses has been remarkable in the past year and while I add my tribute to those already paid to the Secretary of State and his colleague in that connection there is still a flaw somewhere in the provision of accommodation.

I submit to my hon. Friend the case of an ex-service man with a wife and five children who occupied a house in my constituency. The house was condemned by the medical officer of health and he was evicted. After trying in vain to find alternative accommodation he was eventually forced to seek refuge in a disused byre, which, for some time, was the only shelter he and his family had against the somewhat inclement weather which we experience in the West of Scotland during the winter. Then the sanitary officer came along and naturally compelled the man to leave that shelter. It was obviously wrong that a man with a wife and five children should be living in such surroundings. The man made every effort to find other accommodation and I assisted him to the best of my ability but without result. Finally he and his wife and five children had to shelter under a tarpaulin against a hedgerow. I wrote letters to town clerks, and county clerks, and I consulted every housing authority but I could find no means of securing a house for that man. He was on the dole and on account of the size of his family received a large amount of financial relief. He was able to pay rent and yet, he could not get a house. There must be something ethically wrong in the position, when such a condition of affairs can exist in a great country like ours. I ask my hon. Friend to give me some indication of what steps can be taken or what arrangements can be made to provide men like that with a roof for themselves and their family. Those are the only points which I desire to raise.

12.51 p.m.

Photo of Mr George Morrison Mr George Morrison , Combined Scottish Universities

I wish to join with those hon. Members who have already spoken in congratulating the Under-Secretary on his return to us after his illness, and in wishing him a speedy and complete restoration to health. There are two points which I wish to raise in connection with the Health Report. The first relates to the reports of the medical officers of schools with reference to the large number of children who on coming to school are found to be suffering from what would have been easily remediable defects. That matter would perhaps be more appropriate in a debate on the Education Estimates but I take this opportunity of pointing out that the inspectors of the English Board of Education use it as one of the strongest arguments for the institution of more nursery schools, especially in the large cities. The other matter to which I wish to draw attention was mentioned to me by my wife in connection with her experience in a girls' club in Aberdeen. She was struck by the number of girls of 17 and 18 years who had very bad teeth and in some cases almost no teeth at all. These girls presumably, received skilled dental attention during the period of their school life but there was a gap between the time when they received that attention and the time when they were due to receive dental benefit from some approved society. I have been told that some of the friendly societies to which these girls belong do not provide any dental benefit. This gap would be to some extent closed if there was an extension of the provision of dental attention to the junior instruction centres. The matter is important and I make no apology for drawing the Under-Secretary's attention to it.

12.54 p.m.

Photo of Mr Archibald Skelton Mr Archibald Skelton , Combined Scottish Universities

Let my first words be words of personal thanks to hon. Members for the very kind references they have made to me this morning. It is a very great pleasure to be back at work and to know that my fellow Members have kindly feelings towards me. That kindness has certainly been reflected in the tone of this Debate. I shall now do my best to deal with some of the questions that have been raised. The hon. Member for Bridgeton (Mr. Maxton) raised the question of the allocation of days for the discussion of the Scottish Estimates. I need hardly point out that the selection of subjects for discussion in Committee of Supply is a matter for the Opposition. My right hon. Friend and I will be only too pleased to deal with any question on any Estimate that any branch of the Opposition may think it necessary to raise at any time.

The right hon. Baronet the Member for Caithness and Sutherland (Sir A. Sinclair) drew attention to the observations in the report dealing with the provision of hospitals and asked what the Government were going to do about it. I think his own administrative experience must have satisfied him that the question is one on which the Government cannot interfere with local authorities. It is a matter for them. The 1929 Act increased facilities for proper hospital accommodation by making it easier for local authorities to combine for the purpose of hospital building and maintenance. I regret to say that it has not always been taken advantage of and, while I agree that progress has been slow, I certainly do not propose to relax pressure upon local authorities to get on with the work of hospital accommodation wherever it is insufficient I entirely agree with the observations in the report that much still requires to be done before the matter can be regarded as satisfactory and that will be borne out, I think, by the maternal mortality report, but under existing legislation, which is the only situation that I can deal with now, apart from exerting pressure on local authorities there are no substantive steps which my right hon. Friend or I can take on this topic of the supply of hospitals. I will not enter into the thorny question whether the hospitals of Malay or of Sutherland are the better, nor will I say anything with regard to town planning. The right hon. Baronet referred to the suggestion made at the recent conference that a co-ordinating board should be set up.

Photo of Sir Archibald Sinclair Sir Archibald Sinclair , Caithness and Sutherland

That was the report of the Departmental Committee on Garden Cities and Satellite Towns, which was presented to the Secretary of State and to the Ministry of Health two months ago.

Photo of Mr Archibald Skelton Mr Archibald Skelton , Combined Scottish Universities

That is so. It was a joint report. That in itself will mean legislation. We have, I think, no powers under the existing Town Planning Act to set up such a board. As to its utility, I am not at present satisfied. I think it is the case that the progress of town planning has not been very rapid either under the new Act or its predecessor, but one has to recollect that local authorities have a very large number of important topics to deal with, and it is very difficult to keep the whole team of topics abreast at one moment. It is a matter for gratification that both Glasgow and Aberdeen now have town planning schemes. I do not, nor does my right hon. Friend, intend to lose any opportunity of pressing the claims of town planning upon local authorities, but it is a difficult subject. Somehow or other planning for the future must proceed as fast as we can have it done, because otherwise the dangers and difficulties to which the right hon. Baronet referred may very well occur. With regard to the question of water supply, Parliament some time ago gave us £137,000 to extend assistance to rural wafer supplies. There were a variety of methods open as to the use of the money, but it was felt, I think rightly, that grants should be limited to 25 per cent. The money is all earmarked and has now begun to be spent. Local authorities in the Highlands will find a grant of 25 per cent. very useful. There was a halcyon period, when the last Government but one was in power, when grants up to 60 per cent. were available for a short time.

Photo of Mr Archibald Skelton Mr Archibald Skelton , Combined Scottish Universities

That is entirely due, as the right hon. Gentleman says, to the fact that there were men of action. That halcyon period was not made use of by the Highland counties referred to, and many an admirable opportunity has been let slip. I can make no promise when the next halcyon period may arrive. I sympathise with and appreciate the difficulties involved in the Highlands and, although I can say nothing more than that at the moment, the right hon. Baronet may be satisfied that we will not forget the question of Highland water supply. I entirely sympathise with him in the view that the provision of a water supply is absolutely essential.

An hon. Member raised the question of midwives' examinations by the Board. That refers to those who were midwives when the last Act came into operation. It was not possible to apply the provisions of the Act to existing midwives. With regard to the question of teeth, that again is primarily a matter for local authorities. I should like to see more dental provision for school children, but I have not any ready-made solution for the particular point raised by my colleague in the representation of the Scottish Universities, namely, what happens in the interval between school years and coming into insurance. Speaking on the spur of the moment, I do not think there is any legislative provision which would enable me to deal with that, but one sees the importance of the point. With regard to camps and their sanitation, that is an important matter, of course. Local authorities have considerable powers at present in the making of by-laws for the control of such camps. It may well be that there may at some time be legislation giving them greater control, but my hon. Friend must not think they are entirely without powers at the moment, if they like to make use of their by-law making powers, on that point. I would like to thank my right hon. and learned Friend the Member for Ross and Cromarty (Sir I. Macpherson) for the, I think, fair but encouraging view he took of the effect upon the Highlands of the Highlands and Islands Medical Service. I do not think my right hon. Friend opposite will seriously disagree with that view, although he was emphasising the difficulties in the hospital situation. My hon. and gallant Friend the Member for Ayr Burghs (Lieut.-Colonel Moore) raised a particular case with regard to housing accommodation. On the facts as he stated them, I should have thought the local authority was bound to have given priority to that case, but facts put forward in debate cannot be very carefully analysed, and if my hon. and gallant Friend cares to send me full particulars, I shall be glad to have the facts examined and to give him an answer.

Photo of Sir Charles MacAndrew Sir Charles MacAndrew , Glasgow Partick

Can my hon. Friend say anything on the question which I raised about mothers and their children?

Photo of Mr Archibald Skelton Mr Archibald Skelton , Combined Scottish Universities

I was reserving that matter for correspondence with my hon. and gallant Friend. I will look, as is my invariable custom, over the Debate, and if there are any points in it with which I have not already dealt, I will deal with them by way of correspondence, and that is what I propose to do with that particular question.

Motion, by leave, withdrawn.