(c) crown copyright
Catalogue Reference:CAB/24/58
Image Reference:0028
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75
OF HEALTH BILL:
Memorandum by t h e P r e s i d e n t of t h e Local Government Board.
' 1,
Whatever B i l l t h e Government e l e o t to i n t r o d u c e must
be t h e B i l l of t h e Government and t h e y commit t h e m s e l v e s t o t h e
c l a u s e s and t o t h e p o l i c y embodied i n t h e c l a u s e s .
It is
t h e r e f o r s i m p o r t a n t t h a t t h e p r o v i s i o n s of t h e B i l l s h o u l d be w e l l
considered before they are brought i n .
I t ia p a r t i c u l a r l y
n e c e s s a r y t h a t t h e p r e s e n t B i l l should be a g r e e d upon by a l l t h e
D e p a r t m e n t s whose f u n c t i o n s i t may t o u c h .
I t ia n o t enough f o r
t h e M i n i s t e r of R e c o n s t r u c t i o n t o say t h a t such and suoh a c l a u s e
i s p u t i n t o c o n c i l i a t e suoh an such an i n t e r e s t o r i a t h e
p r i c e a t ^ h i c h such an such an o p p o s i t i o n can be w i t h d r a w n .
U n t i l t h e B i l l i s b e f o r e t h e House i t i s s p e c u l a t i v e t o say what
l a t h e s t r e n g t h of a p a r t i c u l a r i n t e r e s t oar f a c t i o n , and i t la
t h e r e f o r e u n w i s e t o admit c l a u s e s m e r e l y t o a p p e a s e a s e c t i o n o f
p u b l i c o p i n i o n u n l e s s t h e Government e i t h e r a c c e p t t h e i r views
o r f e e l t h a t t h e i r o p p o s i t i o n cannot be w i t h s t o o d .
3.
I t ia a l s o n e c e s s a r y f o r t h e Government t o have cone to
some d e c i s i o n on t h e scope and purpose o f t h e B i l l .
The o b j e o t
of t h e measure a s d e s c r i b e d i n the Report of t h e S u b c o m m i t t e e of
which Dr. Addison w a 3 t h e Chairman, was t o s e c u r e t h e more
e f f i c i e n t working of e x i s t i n g p u b l i c h e a l t h s e r v i c e s .
By oomaon
c o n s e n t i t i s a g r e e d t h a t i t s h a l l o n l y e x t e n d t o t h e powers of
t h e C e n t r a l Government r e l a t i n g t o H e a l t h .
The s e v e r a l D e p a r t ­
m e n t s enumerated i n t h e R e p o r t a s c o n c e r n e d w i t h t h e p u b l i c h e a l t h
a r e t h e Local Government Board, t h e E n g l i s h and Welsh I n s u r a n c e
Commissions, t h e Board of E d u c a t i o n , t h e M i n i s t r y of P e n s i o n s ,
t h e Home O f f i c e , t h e Board of T r a d e , t h e Board of A g r i c u l t u r e ,
t h e P r i v y C o u n c i l , t h e A d m i r a l t y and t h e War O f f i c e .
All the
arguments c u r r e n t l y u s e d i n s u p p o r t ' o f a M i n i s t r y e f H e a l t h aye
b a s e d on t h e i d e a of c o - o r d i n a t i o n .
Though I am i n favour of a
M i n i s t r y of H e a l t h , I do n o t b e l i e v e t h a t c o m p l e t e c o - o r d i n a t i o n
of t h e h e a l t h f u n c t i o n s of t h e C e n t r a l Government I n one w a t e r ­
t i g h t compartment would e v e r be p o s s i b l e .
But w h a t e v e r we a r t
t o do we must know what we a r e doing and w i t h what f u n c t i o n s
u n d e r what Departmenta we a r e p r o p o s i n g t o d e a l .
3.
The comments on t h e B i l l t h a t f o l l o w a r e made mainly
w i t h two o b j e c t s , one t o a n t i c i p a t e p o i n t s which I f e e l s u r e
w i l l be r a i s e d and w i l l have t o be answered i f t h e B i l l i 3 i n t r o ­
dueed a s i t s t a n d s , and t h e o t h e r t o a v o i d t h e i n c l u s i o n of
unnecessary matter.
Clause 1 . - I t i a not p o s s i b l e t o d i v o r c e Health from
l o c a l Government of which i t forms so l a r g e a part and with which
i t i s inextricably intertwined.
P r a c t i c a l l y a l l the Local
A u t h o r i t i e s whether Councils o f C o u n t i e s , Boroughs, D i s t r i c t s or
P a r i s h e s or Boards o f Guardians are concerned i n g r e a t e r or l e s s
decree with health.
And they a l l are a l s o engaged with
q u e s t i o n s not r e l a t e d t o h e a l t h .
S i m i l a r l y the Local Government
Board, though l a r g e l y occupied with h e a l t h Q u e s t i o n s , d e a l s with
a v a r i e t y of t o p i c s not s p e c i a l l y r e l a t i n g to h e a l t h .
Thus i t
s a n c t i o n s l o a n s f o r a l l purposes, approves byelawe on a v a r i e t y
o f s u b j e c t s , a u t h o r i s e s a l i e n a t i o n of l a n d s , d e a l s w i t h highways,
r a t i n g , a u d i t , o l d age p e n s i o n s , l o c a l s t a t i s t i c s , l o c a l Aots &e*
&e.
I t h e r e f o r e t h i n k i t would be more appropriate to c a l l the
M i n i s t e r the "Minister o f Local Government and Health".
Clause 3 . -
I think t h i s c l a u s e should d e f i n e with
SUFFICIENT ELAARIIEAS FCFCE FTAOTIOIW WHIOO a*f TE PASS F I D ETHER
DOPERTAENTE TO THO NEW MINISTRY EITHER AT ONCE OR SUBSEQUENTLY.
I T my
BE A QUESTION WHETHER A TIME LIMIT SHOULD BE IMPOSED FOR
THE TRANSFER OF THE SERVIOES WHIOH ARE NOT TO PASS AT ONCE.
PARLIAMENT AND THE DEPARTMENTS AFFECTED WILL I THINK CLAIM TO
KNOW WHAT ARE THE INTENTIONS OF THE GOVERNMENT.
REMEMBERING
THAT THE WHOLE OF THE EASE FOR a CENTRALISED MINISTRY OF HEALTH
I E ARGUED ON THE VITAL NECESSITY OF IMMEDIATELY CO-ORDINATING
ONE DEPARTMENT THE HEALTH FUNCTIONS OF SOME DOGEN DEPARTWENTE,
I CAN HARDLY SUPPOSE THAT QUESTIONS WILL NOT BE ASKED AN TO THE
POSSIBLE IMMEDIATE TRANSFER TO THE NEW MINISTRY OF THE FOLLOWITTC
POWERS?­
(A)
THE POWERS OF THE BOARD OF EDUCATION WITH REFERENCE TO THE
INSPECTION AND TREATMENT OF THE AILMENTS OF SCHOOL CHILDREN:
(b)
Tha POWERS OF THE HOME OFFICE I N RALATION TO THA B $ A M
OF CONTROL AND I N RELATION TO INFANT LIFE PROTECTION:
It))
Tha POWERS OF THA PRIVY COUNCIL UNDER THO HEDIOAL ACTS
; AND THA TLIDWIVEE ACTS:
(D)
THA POWAXS OF THA BOARD OF AGRICULTURE I N REGARD TO MILK
AND OTHER FOO&SJ ,
AND AA TO THE PROBABLE TRANSFER WITHIN A ABORT PERIOD O F T ­
(A)
THA POWERA OF THA MINIOTAR OF PENSIONS I N RA^ARD TO THA
TREATMENT OF S I OK AND DISABLED MAN;
("p)
THA POWERS OF THA BOARD OF TRADE I S REGARD TO THA
i HEALTH OF THE HSROANTILE MARINE:
( O ) Tha POWERS OF.THA-HobA OFFICE RELATING TO TNOAT WHO
/
WORK I N FACTORIAA AND M I N E S . '
I T la NET POSSIBLE TO BASE THE B I L L ON THA NEED FOR
CO-ORDINATION AND TO LEAVE ALL THAAE POWERS UNCOORDINATED AND
THA P O S S I B I L I T Y OR PROBABILITY OF-THEIR CO-ORDINATION A NEFCILOUE
BLANK.
Tha PROPER OOUREA AS I T SEEMS TO MI IO TO INDICATE ( A )
THE- POWARS WHIOH ARE TO BA TRANSFERRED AT ONCE AND LB) THA POWERE
WHIOH ARE TO BE TRANSFERRED WITHIN A FIXED TIME, SITTING AACH
. CATEGORY OF POWARA OUT I N THA B I L L .
I m NOT I N FAVOUR OF ANY TRANSFER FROM THA MINISTRY
OF LOCAL GOVERNMENT AND HEALTH OF POWERS NOT STRICTLY CONCERNED
' WITH HEALTH.
MAJOR ASTER EU/R$EETED FOR. EXAMPLE TBAT AUDIT MIGHT
^ BE TRANSFERRED.
THIS WOULD BA A MOAT RETROGRADE ATOP. THA M A L T
OF THE aooounto OF LOCAL AUTHORITIES WHO. ARE THA PUBLIC HEALTH
AUTHORITIES SHOULD OBVIOUSLY BE UNDER THA CONTROL OF"THA MINISTER
^ WHO I S I N CHARGE OF THE CONCERNS OF THOSE AUTHORITIES. .
THE COURSE WHIOH I AM DISPOSED TO SUGGEST I S THAT,
BEFORE ANY B I L L I S CIRCULATED, THA HOME AFFAIRE COMMITTEE SHOULD .
A COMMUNICATE WITH ALL THE MINISTERS OONOEMED AND SHOULD INVITE
THAM TO CONFER ON THE QUESTION OF THE EXTENT OF POWERS TO BE
TRANSFERRED,
WHEN THIS I S DONE THERE WOULD BA NO DIFFICULTY I N
- DRAFTING THE NECESSARY OLAUSOS.
UNLESS THIS I S CLOW AMENDMENTS
MAY BA SPRUNG ON U S FOR THA TRANSFER OF POWARS OF VARIOUS DEPARTMEATS, TO WHIOH I T WILL BE DIFFICULT TO REPLY.
CLAUSE G .R
I ASSUME THAT THIS I S REGARDED AS
n e c e s s a r y i f a l l the powers of the Insurance Commissioners art
tranaferred.
I should myself have p r e f e r r e d a l e s s ambitious
aoheme which would have rendered t h i e o l a u e e u n n e c e s s a r y .
Clause 4 , - I have already urged my o b j e c t i o n s t o
t h i s c l a u s e on c o n s t i t u t i o n a l grounds.
I think the o l a u e e
should be o m i t t e d .
I f i t be r e t a i n e d , i t should be i n the
following terms:It
s h a l l be l a w f u l f o r the M i n i s t e r t o
" e s t a b l i s h an Advisory Oounoil f o r a d v i s i n g him on any matter
*wbioh he may t h i n k f i t t o r e f e r t o them".
An Order i n Council
i s unneoossary.
The i n i t i a t i v e must l i e w i t h the M i n i s t e r and
with no one e l s e , and he must have the r i g h t of determining the
appointment o f any member o f the Advisory C o u n c i l ,
To s u g g e s t , a s
appears t o be i n t e n d e d , t h a t members of the Council s h a l l be
nominated by the Crown for f i x e d p e r i o d s independently of the
M i n i s t e r i s t o put him i n t o an almost untenable p o s i t i o n ,
c o u l d d i s m i s s h i e permanent o f f i c i a l s but could not g e t r i d of
members of h i s C o n s u l t a t i v e Committse.
tt
Clause 5 . *
This c l a u s e i s not I oonoeive n e c e s s a r y t o
the B i l l .
Subject t o the consent of the Treasury, and of t o t
House o f Commons i n c o n n e c t i o n w i t h h i s V o t e , the M i n i s t e r can
m a i n t a i n a bajanch o f f i c e a^ay from London i f i t i s n e c e s s a r y .
The c l a u s e a s d r a f t e d reads r a t h e r a s though i t was Intended t o
e s t a b l i s h a new o f f i c e .
I presume a l l t h a t i s r e a l l y contemplated
i s the continuance of a N a t i o n a l Health Ineruraaoe Offioe at Cardiff.
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I have a l r e a d y e x p r e s s e d my ooj
paragraph 1 o f t h i s
y^including
g i v e d f f e o t , and i t s mere presence w i l l b r i n g i n t o being a l l t h e
Ouardiana whom i t i s proposed t e \ b o l i s h
8
b r i n g i n g t o the a i d o f the G o v e r m e n f the
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W. HAYES FISHER.
al Government Board,
Whitehall, 8.W.I.,
16th J u l y , 1918.
WAR CABINET,
Tho a t t a c h e d Paper has "been
r e f e r r e d t * . t h e Committee of Hame
Affairs.
2
t
W h i t e h a l l Gardens,S.W.