Iain MacLeod – 1950 Maiden Speech

Below is the text of the maiden speech made by Iain MacLeod in the House of Commons on March 14th 1950. MacLeod later became Chancellor of the Exchequer in June 1970 although died a month after whilst still in office.

I think the only thing that draws new Members of this House to their feet to take part in these Debates is the sure knowledge that they can rely, as I rely tonight, on the traditional courtesy and kindliness of Members of this House.

We are today considering an Amendment which has been put down arising out of Supplementary Estimates amounting to about £148 million. Of that vast sum something like two-thirds, or nearly £100 million, is attributable to the National Health Service. All hon. Members are very familiar with the growth of the cost of this scheme from its first presentation to this House in 1946, when the House discussed it on the basis of a scheme costing £152 million a year, or about £3 per head, until the proposed Estimate for next year, which is about £400 million, or some £8 per head.

The first point I should like to make is that, formidable though these figures are, they are net figures and they do not show the full cost of the Health Service scheme, partly because of the transfer payments from National Insurance and partly because of various recoveries, and also because of the superannuation scheme, which shows inevitably in its first few years a surplus which will have to be repaid later, but which at the moment disguises the true cost of the scheme. It is true to say that when an announcement is made, such as the Chancellor made this afternoon, that there is to be a ceiling put on this scheme, we must remember that, in the absence of drastic action, the cost of this scheme will inevitably increase, for, apart from the reasons I have given, we are an ageing population, and for the next generation, in the absence of dramatic scientific or medical discoveries, the demands of sickness will inevitably increase.

It follows that the Chancellor of the Exchequer and the Minister of Health have got themselves at the moment into the position of Alice and the Red Queen. The House will remember that the inhabitants of Looking-glass Country had to do all the running they could do to stay in the same place, and if they wanted to get somewhere else they had to run twice as fast. If our resources — and this has come from both sides of the House — are inadequate — and they are and they will be for a long time to come — then it follows that we must establish priorities as between the social services and also within the social services. On this theme of priority I am quite certain there is general agreement on both sides of the House. The Minister of Health last year at the Socialist Party conference said that priorities were the religion of Socialism, and last night, speaking in this Chamber in the housing Debate, he returned to the theme of priorities, about which we have heard both from the hon. Member for Stoke-on-Trent, Central (Dr. Stross) and from my hon. Friend the Member for Luton (Dr. Hill). We should look for a moment on this scheme to see if, in fact, the correct priorities are being observed.

I should first like to refer to a matter that has been touched on already, and that is the bill for the general dental services, which at the moment is exceeding the bill for the general medical services. If we include Scotland, that means that some 10,750 dentists are being paid more in terms of gross income than some 21,000 doctors. Even if one makes all the adjustments in favour of the heavier cost of practice expenses that dentists have to bear to the full 52 per cent., which is I believe the amount allowed, the dentist at the moment is paid by the State far more in terms also of net income than is the doctor. I have no hesitation in saying that that is an indefensible position.

I am myself both the son and the grandson of a doctor. I believe that relative to their training, their qualifications, their ability, the load of responsibility that they ceaselessly shoulder, and above all the hours during which doctors are at their patients’ service — in my father’s house as in every other general practitioners that was 24 hours of the day and seven days of the week — doctors are by far the worst remunerated profession in the service. I have not the slightest doubt that there is no question, and there never will be of a doctors’ strike, for it is unthinkable for doctors to have anything remotely resembling a strike, but I think we should be wise not to presume too far on the infinite and most statesmanlike patience which the medical profession has shown in these last two years.

The second point I wish to make has also been touched upon. In Section 22 of the parent Act and in the White Paper which preceded it, and in the speeches of the Minister of Health on Second Reading and in Committee, stress was laid over and over again on the need for priority dental treatment for certain classes. Quite obviously that is a sound principle, for if the teeth of expectant mothers and those of infants and young children be sound, then in a generation we will have dentally a sound nation. Hon. Members know that, in fact, these priority classes — I am not arguing about the responsibility; I am stating a fact — are being neglected today, and there are many areas in this country in which the school dental service has virtually broken down. Wherever the responsibility may lie—and I know it causes the Minister of Health, the Minister of Education and the Secretary of State for Scotland great concern — the fact is inescapable that almost the only thing that was made deliberately by the Government a priority in the Health Service has failed.

The third point and the last on priorities which I should like to make is — there is a small Supplementary Estimate put down under research, presumably referring to the Minister’s powers under Section 16.

Dr. Morgan (Warrington) : Too small.

Mr. MacLeod : Too small perhaps, but I remember reading last year that the Minister of Health stated that he was awaiting information from the Peckham Health Centre to enable him to determine whether he could make a grant under his powers under Section 16. I do not know whether that has been done or not, but I know that on the same day that I read about these Supplementary Health Estimates for nearly £100 million I also read that the Peckham Health Centre was closed because it could not collect £20,000, which is one five-thousandth part of the amount to be passed in this House tonight. I suggest there is something sick at heart in the service, something desperately wrong with the priorities in a service in which that sort of thing can happen.

If it has been agreed that these figures are formidable, all thinking people, whether they are inside or outside the House, and everyone concerned with the future of this service are also agreed that the priorities are clearly in many cases unsound. Is it possible for us to suggest what has gone wrong? Very diffidently in a sentence or two before I sit down I should like to give my view on what has happened. The traditional function of the social services, as I understand them, is to rescue the needy from destitution, the sick from ill-health, and the unfortunate from the consequences of their misfortunes. It is a principle that was expressed very clearly by my right hon. Friend the Leader of the Opposition at our Brighton conference two years ago when he said this: The scheme of society for which we stand is the establishment and maintenance of a basic minimum standard of life and labour below which a man or woman of good will, however old and weak, will not be allowed to fall. I should like to take with that something said by my right hon. Friend the Member for Warwick and Leamington (Mr. Eden) in this House on 26th October, which was very badly misrepresented in the course of the recent election. This is what he said: Has not the time arrived when we must, as a nation, recognise that the principle of the social services ought to be that the strong should help the weak, and not to try to aid everybody alike indiscriminately? That is the whole basis on which I want the examination of this problem.” — [OFFICIAL REPORT, 26th October. 1949; Vol. 468, c. 1366.] I agree that that is the basis on which we should examine this problem of the minimum standard, and, secondly, of the duty of the strong to help the weak.

Today — and this is what I think has gone wrong—the conception of a minimum standard which held the field of political thought for so long, and in my view should hold it still, is disappearing in favour of an average standard. To an average standard, the old-fashioned virtues of thrift, industry and ability become irrelevant. The social services today have become a weapon of financial and not of social policy. This may sound Irish, but it is both true and tragic that, in a scheme where everyone has priority, it follows that no one has priority. This principle goes deep in the difference between the two sides of the House.

Perhaps I may sum up my argument in one sentence. I would put it like this: I believe that the conception of the minimum standard and the duty, which ought to be a proud duty, of the strong to help the weak, not only forms a nobler and juster basis for our social services but is a basis that is infinitely better matched to the independence and the character of our countrymen.