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31/9/49 (8am)

THIS DOCUMENT IS THE PROPERTY OF HIS BRITANNIC MAJESTY'S GOVERNMENT

SECRET

Page 56&ife@6for the Cabinet. September 1949 Page 568 of 662.

279

Copy No. 31

C.P. (49) 190

14th September, 1949

CABINET

NATIONAL HEALTH SERVICE

USE OF THE SERVICE BY ALIENS IN THIS COUNTRY AND POSSIBILITIES OF RECIPROCAL ARRANGEMENTS IN OTHER COUNTRIES

MEMORANDUM BY THE MINISTER OF HEALTH

The Cabinet, at a meeting on 30th June, 1949 (C.M. (49) 43rd Conclusions, Minute 8 (2)) invited the Foreign Secretary and the Minister of Health to consider what might be done to improve reciprocal health service facilities with the Brussels Powers. I prepared a draft paper for prior discussion with the Foreign Secretary, but he has been unable-under present pressure to consider it. I therefore submit this paper alone, and I must emphasise that it has not been agreed with the Foreign Secretary.

Application of the Health Service to Aliens

2.

The National Health Service Act, 1946, extends all its provisions to any alien, while in this country, without charge. There has been some criticism of this, in two forms-

(a) does it do so lawfully, and

(b) ought it to do so?

3. As to (a), there seems to be no real doubt. It is true that Section 1 speaks of the Minister promoting a service designed to improve the health of the people of England and Wales." But it goes on to require the effective provision of all the services to be later explained in the Act. Then the Act sets out every service hospitals, local authorities, doctors, &c.-and for each creates a duty that it is not limited to our own people at all. Most opinion agrees that the aliens are covered, and that any doubt of legality can be discounted. People coming to this country are told this, in a leaflet handed to them on arrival. The only exception is that we do not extend the facilities of the service to anyone whom we know to have come over merely to obtain them. There cannot be a complete check but my officials have an arrangement with the immigration officials of the Home Office, which is designed to identify cases, for example, where the purpose. of visit is a surgical operation or similar purpose.

4. As to (b), has it been right to extend the Act to aliens? First, it would have been difficult not to. In a universal free service, not dependent on insurance or other qualification, it would have involved a mammoth organisation to check the nationality of every patient arriving in hospitals, or at the doctor or dentists' surgeries, the optician, or elsewhere. Second, and more positively, it is surely a very worth-while gesture, and an inexpensive piece of practical propaganda at a time of the furthering of good relations with the Western European countries. It is a unique service, which interests other countries, and which it pays us to

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