As amended (by the Standing Committee) considered.
said he desired to ask the House to recommit this Bill for reasons which he would state shortly. He shared to the full the view of the noble Lord who was responsible for this Bill as to the desirability of doing all they could to limit the high infant mortality which obtained at the present time, but it was because he felt sure that the Bill would not effect that object that he took the extreme course of moving its recommittal. The reasons which lay at the root of the question of infant mortality were not touched by this measure. The first point which he wished to raise was as to the authority to whom notification was to be made of the birth of a child. The second point was whether, failing the father of the child, liability was to rest on any person in attendance on the mother. It was because he understood that the noble Lord had tabled an Amendment which the Government had accepted excluding medical men from the operation of the Bill that he moved the recommittal of the Bill. The Amendment to which he wished to invite the attention of the House dealt with the case of the midwife, for whom there was no substantial body of opinion in that House ready to speak. The House should bear in mind that no less than 70 per cent. of the births among the working classes were attended by midwives without the intervention of a medical man. Under the provisions of the Midwives Act of 1902 a body was constituted called the Local Supervising Authority, who were charged with very large, extensive, and minute powers in relation to midwives. This authority was doing a most valuable and important work. It was the only authority which the midwives knew, and it would surely be desirable to employ an authority to receive notification which was already known to them. There was a provision that the Act might be adopted in every county borough, and in every county borough at this moment the Local Supervising Authority under the Midwives Act and the district local authority coincided, but in a county like Hertfordshire, the medical officer of the Local Supervising, Authority was not the same person as the medical officer of the local authority, and the midwives knew the former as the person to whom to notify still-births. He desired to see the Bill made simple in its working so that midwives might be able to comply with its requirements. That, he thought, as an administrative point, was one of first-class importance. Then there was the question whether notification should be made by a person in attendance at the time of the birth.
I have been carefully listening to the hon. Member, and I have not heard any argument that goes precisely to the point that this Bill should be recommitted. All the suggestions he has made should have been made on the Report stage. Why is it necessary to recommit the Bill?
said he was only asking the House to recommit it on the ground that this point of the authority which ought to be notified was not the subject, so far as he could judge, of any prolonged discussion in the Standing Committee upstairs and no Amendments were suggested. A new clause had been brought down by the President of the Local Government Board, and, according to the Report of the Committee, it was read a second time and added to the Bill.
The hon. Member must show some reason for recommitting the Bill, and up to the present has not done so.
said he did not desire to waste the time of the House, but it was almost impossible to divorce these questions.
If it is impossible to make the changes which the hon. Member desires, what is the good of recommitting the Bill? It is open for the hon. Member to move Amendments on the Report stage.
said under the circumstances he would not move.
moved to leave out of line 11 on page 1 the word "and" in order to insert the word "or." His desire was that those in a humble sphere of life should not be unnecessarily hampered by undesirable and vexatious regulations. He thought all that was desired could be achieved by a slight alteration in the registration law. Personally he disliked the Bill from beginning to end, and he did not see why the clauses should be so drafted as to be unnecessarily vexatious and annoying. He could not see what advantage was going to be derived from this multiplicity of notification. He would have thought that one notification was sufficient, and that by the father. The President of the Local Government Board had already laid down in the debate on the Vaccination Bill that it was the duty of the father to carry out his parental duties when the child was very young. Surely when the child was only a few days old the father was the right and proper person to carry out this notification. He hoped the right hon. Gentleman would accept this Amendment. The Amendment was not seconded.
moved to amend Clause 1 (provisions for the earlier notification of births) by leaving out the words which would impose upon the midwife the duty of sending the notification of a birth to the medical officer of health of the district. He questioned the wisdom of laying this new obligation upon women, many of whom were illiterate, and all of whom had already sufficient duties to perform. There were over 22,000 midwives practising in England and Wales, and by far the larger number of them were untrained women who had been registered under the Act of 1902 because at the time there were no other women to take their place. An enormous number of these women were quite illiterate and unable to read or write. They performed a most difficult task and were making every endeavour to comply with the regulations to be clean and use antiseptics. The great difficulty in the administration of the Midwives Act was that 90 per cent. of the penal cases, in which there had been a failure to give proper notice to the medical officers and the local supervising authorities, were due simply and solely to the fact that these poor women could neither read nor write. Under this Bll they had to notify every birth in fifty-three out of the sixty-two counties in England and Wales to a strange authority. If they laid upon the midwives this new obligation they would find either that this Act would be inoperative or they would drive all these women off the roll. If they laid a burden on these women which they could not stand they would resign. They could not afford to risk that result with the midwives of this country. There was nobody at the present time to take the place of these women, because the examinations and training centres set up under the Mid wives Act of 1902 had only had three years existence, and they had not trained sufficient new women to take the place of these untrained midwives. They had been told that their duties would be rendered easy by providing them with postcards, but there was nothing new in that, because they had been supplied with similar aids ever since the Act of 1902 came into force. These women could not write and they had to get somebody to write for them. He asked the House and the Government to consider the enormous difficulty women in London would have under this Bill, where the county council was now the only authority to be notified. He had been to the offices of the London County Council and even their council's inspectors when they came to write out their reports were not always quite sure which particular borough council area the streets were in without consulting the map. Under this Bill notification must be given not to the County Council but to the borough council within which the birth took place. How was it possible for a midwife Visiting three or four patients to find out in which particular borough council area her patients resided? This was a great hardship to place on these women without fee or reward, and it was the duty of the father to make the notification.
seconded the Amendment. Amendment proposed—
—(Mr. Bertram.) Question proposed, "That the words 'and of any person' stand part of the Bill.'""In page 1, line 11, to leave out from the word 'occurrence' to the word 'to,' in line 13.'"
pointed out that the effect of the adoption of the Amendment would be that, if the father was not actually resident in the house at the time of the birth there would be no notification at all. He reminded his hon. friend the Member for the Hitchin Division that midwives already notified births under the Midwives Act, and, as they were to be supplied with prepaid letters or postcards for the purposes of the present Bill, he did not think they were imposing upon these women any very difficult new duty. All the midwife had to do was to write the name of the child on one of these postcards and drop it into a letter box, and there her obligation ended. He thought his hon. friend had somewhat magnified the hardship.
failed to see how they could possibly carry out this slight but valuable experiment in social reform if they limited the persons who were to give notice to the father. He agreed that if they were placing a new duty upon midwives it should be done in the most convenient way. The county councils were not only the authorities under the Midwives Act, but they were also doing extremely useful work in promoting the education of midwives and trying to get a superior class of women to undertake this work. He did not think the arrangements which the county councils had made should be interfered with by this Bill without a proper hearing being given to them. His vote on this question would turn upon the answer the President of the Local Government Board was able to give upon this question of machinery. In some large towns it might be more convenient for the midwives to report to the district officers of health, because in some towns machinery already existed for carrying out the benevolent objects of the Bill. He asked the right hon. Gentleman so to amend the Bill that every county council would have the opportunity of adopting the Act for the whole or part of their area. The County Councils Association desired that county councils should be able in any case to argue before the Local Government Board as to whether they or other councils of borough or district were the proper authority. If he was assured that thelocus standi of the county councils would be preserved then he would vote against this Amendment, because he thought the Bill ought to be tried, but it should be tried in the most convenient way possible. In some parts of the county the district authority was the best, whilst in other parts the county authority was the most convenient, and this kind of flexibility ought to be applied to the Bill. The Bill ought to be made to work with a minimum amount of trouble to the poor people who would come under its provisions, and it ought to be done without increasing to any unnecessary extent the complexity of local administration.
said that when they reached the appropriate place in the Bill he would be ready substantially to adopt the suggestion made by his hon. friend the Member for Middleton. The hon. Member for the Hitchin Division had made a very strong appeal to the House not to place any additional burden upon midwives which might tend to these women abandoning their profession. He thought the hon. Member had needlessly emphasised the illiterate character of midwives, because the picture he had drawn of them to-day was more like the Mrs. Gamp style of midwife of fifty or sixty years ago.
said he had merely related his experience of cases which had come within his own observation.
said his knowledge of the poor had been like Mr. Weller's, "extensive and peculiar," and he knew something of the midwives in the Metropolis. The hon. Member had drawn a moving picture of the hardship that would arise through the midwife having put upon her the responsibility of filling up a printed postcard, stamped and addressed, which she had only got to sign or get somebody to sign for her, notifying the birth she had attended of a child whether alive or stillborn. The hon. Member supported this delightful picture of illiteracy by saying that the midwife had sufficient duties already to perform, and that she had at present to do a similar thing in the way of notification. If she had to notify a medical officer now in the case of a stillborn child, why could she not do the same under this Bill, and fill up a small postcard for the birth of a child that was not stillborn. To him there was nothing more extraordinary than the manner in which the poor people were availing themselves of the facilities offered to them for education. In 1876 there were no less than 148 per thousand of the husbands of working class women who when they were married had to sign their marriage certificate with a cross, but in 1905 the proportion was only sixteen per thousand. With regard to wives in 1876, 199 per thousand attested their marriage certificates with a cross, but in 1905 the proportion was only twenty per thousand. When they remembered that as far as education went the average midwife was more intelligent than the average working-class wife, he did not think the hon. Member had much of a case to support his Amendment on the score of illiteracy. He hoped his hon. friends would not press their Amendment, which would destroy the usefulness of the Bill, but would join in giving the Government the opportunity of making this humanitarian experiment. Let them have a year or two of experience in endeavouring to stop this dreadful and shameful infantile mortality which had become the curse of our industrial centres. With regard to any representations made by local authorities to the Local Government Board the House could rely upon the line of least resistence being pursued in order to achieve the desirable object they had in view.
said they all wanted to diminish infantile mortality, but he doubted whether it could be done by compulsory enactments of a severe character. Compulsory enactments often defeated their own purpose, and under this Bill there was a danger of people being deterred from aiding a woman in the hour of her direst need, lest they should he subject to a fine. As the Bill stood, every person who attended upon the mother was under an obligation to send the notice—the sister, the daughter, the niece, the neighbour, the midwife, the doctor, the doctor's assistant—every one of them was ordered to send this notice, and every one of them was liable to be prosecuted and fined 20s. and costs if he or she failed to give this notice. It was quite true that the section went on to say that a person should not be convicted if he or she satisfied the Court that he or she had good reason to believe that the notice had been sent by someone else; but (with the exception of the medical man) how could one of these poor people satisfy the court? They did not know how to give evidence; probably none of them had ever been in a Court of justice before. The law did not permit them to get the services of a friend who could speak for them; they could only emply a lawyer, and that they could not afford. They would be summoned, convicted and fined, and probably they would nut know what it was all about. They would not know that they were being tried; all they would know was that they were pushed about by the police, and told they must pay so much money or go to prison. Even if they knew how to defend themselves, and had a good defence, that might not avail them, because the clause did not say that they should not be convicted if they proved that they had good reason to believe that someone else would send the notice; it said they must satisfy the Court, and they had abundant experience in another class of cases that the Court often refused to be satisfied with the plainest evidence. The effect of the fear of all these penalties would be to deprive a poor woman of aid in her direst need, because everybody who went near her would be liable to this penalty.
said he was entirely in favour of the principle of this measure. He believed that the President of the Local Government Board had been encouraged by what might be called the unexpected success of the Midwives Act. That measure had certainly been of great utility to the community. Before voting on this Amendment he would like to know from the right hon. Gentleman whether it was the intention of the Government to accept the Amendment which was to be moved by the noble Lord the Member for East Marylebone exempting the medical profession from the duty imposed by this section.
That is the next Amendment on the Paper which we shall reach in due course.
said the reference which had been made to the increase of education in this country was extremely interesting and encouraging. It would have been more relevant to the subject if the right hon. Gentleman had given some information as to the number of midwives employed as compared with medical practitioners. He was satisfied that ii the county of London the number of midwives employed to attend births was small as compared with the number of doctors. He did not think he was fa wrong when he said that 90 per cent. of the cases were attended by members of the medical profession. If medical practitioners were exempted from the duty of giving notification of births, only those cases attended by midwives amounting to 10 per cent. of the whole, would be notified, and the question was whether it would be worth while in posing this duty upon them. In La don there were twenty-nine borough councils, and difficulties would arise as to the authority to which the notification should be sent, because the different areas were not separated by natural frontiers. The areas ran into of another, the middle of a street often being the boundary line. It would not be at all easy for a midwife or anyone else to give notice to the proper authority. Amendment negatived.
moved an Amendment, which he said was intended to relieve medical practitioners from the obligation to notify under this Bill. He regretted that it was necessary to move the Amendment. The case which the medical profession made was that the Bill would impose a new professional duty upon them without payment. He was advised that it would risk the success of the measure if they inserted a provision for the payment of a fee to the medical practitioner. There was something to be said for the objection to the Amendment that it would set up a distinction as between the doctor and the midwife. It might be asked, if the doctor is to be free in this matter why not the Midwife? He thought the answer was that the midwife had recently received from Parliament very important privileges under the Midwives Act of 1902, and that she was already under an obligation to send a notification of this character to I the supervising authority. To require that she should also send a postcard on this matter would be of very great advantage to the State. A doctor after a birth went away for sonic little time, and as some doctors had a great press of practice the duty of giving notification would put additional work upon them. That was not the case with the midwife who was a longer time with the patient. Personally he could not say that he had any great liking for it, but under the circumstances he trusted the House would accept the Amendment.
seconded the Amendment. Amendment proposed—
—(Lord R. Cecil.) Question proposed, "That those words be there inserted.""In page 1, line 12, after the word 'person,' to insert the words 'other than a medical practitioner.'"
said the Government reluctantly acceptd the Amendment. It was a matter to him of extreme regret that a great, honourable, and charitable profession, which signalised itself with great earnestness at the commencement of this beneficent movement for the reduction of infantile mortality, should have almost at the last hour practically dissociated itself from it. Through its representatives in the House, the medical profession had asked to be dissociated from co-operation with other people in this measure. He regretted it. He believed the best of the doctors would deplore it, and that a large number of them, notwithstanding that they were formally struck out of the Bill, would refuse to dissociate themselves from the rest of mankind in making this experiment. He still believed that the doctors were greater than their trade union, and better in this case than the narrow view their profession imposed upon them. He trusted that when this Bill had been in operation a year they would be in a kindlier and better mood, worthier of the great profession to which they belonged, and that they would ask to come in under some amending Bill to co-operate with the midwife, the nurse, and the parents in bringing about a reduction of infantile mortality in the great cities and towns of this country.
said he had never heard a weaker argument used by the right hon. Gentleman than that which he had given for accepting the Amendment. He had always thought that the right hon. Gentleman had the courage of his opinions; but he had given no reason why this wealthy trade union should not be called upon to make a return. The right hon. Gentleman, of all persons—might he be forgiven! —ran away from the poor women. The President of the Local Government Board had expressed the hope that the public spirit of the medical men would induce them yet to come into line. He wished that the right hon. Gentleman could get them to do so. If he could get one other Member to go into the lobby against this proposal he would vote against it. The action of the Government was extremely disappointing.
said that he also regretted to hear the remarks of the right hon. Gentleman, and he would be very pleased if the House refused to allow him to accept the proposal of the noble Lord, reluctantly or not reluctantly. The right hon. Gentleman had not given any reason whatever why the Amendment should be accepted, while the noble Lord had moved it in such a way as showed the House that he was almost ashamed of his clients. Was the signing of a mere postcard too heavy a burden to impose on the medical profession?
said that the noble Lord had offered some extraordinary arguments in support of excluding medical practitioners from the provisions of the Bill, and of including midwives as some kind of return for thestatus which had been conferred upon them by the Act of 1902. He would remind the noble Lord that thatstatus such as it was was conferred upon the midwives without their being asked; and that the result had been that an enormous number of them had lost their means of livelihood, while those admitted to the roll were subjected to very necessary but exacting regulatiosn.
said he thought that the hon. Member was really going too far. Thoe midwives who were able to get on to the roll had obtained very considerable means of livelihood.
said that it had entailed upon them a considerable amount of expense, and had given them in return no particularstatus. He thought that the Government had not done any good by accepting the Amendment, and he hoped that the House would reject it by a large majority.
said that both the noble Lord who moved it and the President of the Board of Trade who accepted it were against the Amendment, which he hoped the House would not accept. The person most competent to give the notice was the medical attendant, and it would not take more than a minute to fill in the postcard. He had doubts whether this measure, being compulsory with penal clauses, would have the effect of diminishing the infantile death rate.
said he wished to assure the right hon. Gentleman and the noble Lord that the non-payment of a fee was not the ground of the opposition to the Bill by medical practitioners. Nobody knew better than the right hon. Gentleman that he had done his best to get midwives excluded with medical men from penalties under this Bill, and any blame because the former remained in the Bill must rest with the right hon. Gentleman and the noble Lord the Member for Marylebone. It was the penalty to which the medical profession had always strongly objected.
said that both those hon. Members received a deputation from the British Medical Association on the subject, and Sir Victor Horsley put it plainly and distinctly that it was the penalty clause to which they strongly objected. Sir Victor said that a new duty was being placed on the medical profession, which was a civil duty, under a penalty for non-performance. They did not think that it was any part of their duty to notify a birth. The avocation of medical practitioners and midwives made them acquainted with certain facts, and because they knew these facts the State now required them to make the notification. He repeated that it was the largely penalty which induced the medical practitioners to oppose the Bill.
The hon. Member must surely forget some conversations we have had.
said that the medical profession felt that the notification was the duty of the parent; that it was a civil duty pure and simple. He complained that this Bill had been rushed both through the House and the Committee without adequate discussion. [An HON. MEMBER: That was another Bill.] This Bill was based on the Notification of Infectious Diseases Act, under which if a child was suffering from a disease the medical man was bound to noify the fact under a penalty, but there was a fee attached. Well, he saw no reason why the medical man should not receive a fee, for doing the State's work. They could always be generous at the expense of a noble profession. The administration of the Infectious Disease, Notification Act showed that under this Act it was the medical man who would be summoned and not the parent. While the medical man would be summoned the parent would get off. It was a most offensive thing to ask the medical profession to notify under a penalty when it was the duty of the parent to do so. As the first chairman of the Midwives Committee of the London County Council he knew how badly midwives were paid, and the Amendments he had placed on the Paper showed that he had always, asked that both medical practitioner and midwife should not be required to notify, and as they received no fee for notifying he did not see why they should be exposed to penalties.
thought the House should hesitate to, divide against the Amendment. They were all agreed in desiring that the doctors should be included but, unhappily, the doctors themselves, through their representatives, had strongly opposed the proposal and in order to save the Bill, and to secure facilities from the Government, the promoters of the Bill had reluctantly agreed to exclude them. That being so, he and some of his friends were under an honourable obligation to support the Amendment. The House should remember, however, that the doctors would, in any case, be supplied with the notification forms and the provisions of the Act would be brought to their attention, and he had sufficient faith in the medical profession to believe that, even if no legal obligations were put upon them, many of them would willingly cooperate with the local health authorities in carrying out the provisions of the Bill. It had been objected that it was unfair to exclude the doctors, while including the midwives, but while he personally would have preferred to see both included, he must point out to the House that experience in Huddersfield had shown that it was more important to include the midwife than the doctor. In Huddersfield, where, under a special Act, compulsory notification hid been in force for nine months, he found that only 20, per cent. of the births were notified by doctors as against 34 per cent. notified by midwives. He preferred, therefore, to accept the Amendment rather than jeopardise the chances of the Bill by dividing against it. Experience had already shown the great value of early notification. During the nine months in which it had been in operation in, Huddersfield the rate of infantile mortality had averaged only 85 per 1,000 births as against an average rate of 118 per 1,000 during the previous ten years. No doubt the present year had been a very favourable one from a public health point of view, but the period of ten years which he had chosen for comparison also included favourable years, and, when all proper allowance was made, it must be admitted that a reduction of 33 per 1,000 was a powerful suggestion of the value of early notification.
thought the reasons advanced by the hon. Member were not sufficient for accepting the Amendment and did not think they could accept the figures which had been put forward. He regretted that the authors of the Bill had not the courage of their convictions. If the Bill was justified in regard to the reduction of infant mortality he thought the medical profession were wrong in asking that they should be left out of it. He objected to midwives being put under the penal clause, as well as the medical profession.
said they were told by both the mover and the seconder of the Amendment that they objected to the principle expressed in it, but rested on the unanimity of opinion in the medical profession against it. He would be the last to say a word against the medical profession as a whole, but it was safe to say that the medical profession had asked the House on more than one occasion to protect the profession against the action of some of its members. The hon. Member for Huddersfield said he was pledged to an honourable undertaking which had been given to the doctors of this country. He would like to know by whose authority such an undertaking was given. Under all the circumstances he hoped that the hon. Member who had just suggested that this should be carried to a division would insist upon it, in which case he would gladly vote with him.
said they were asked to put certain words into the clause by hon. Gentlemen who had not a word to say in their favour, and they were asked by the Minister in charge of the Bill to accept this Amendment which he had been ashamed to bring foward and for which he had made no kind of defence, expressing instead some high-flown senti- ments about the honour of medical men as a whole.
said he gave a more substantial reason for this Amendment than that. What he said was that if the Amendment was not accepted there would be no Bill. There was not very much sentiment about that.
said he saw no reason why the progress of the Bill should be jeopardised if these words were not inserted. It was not a Party question, and it was obvious that the House did not wish to insert the words. They desired to place medical men in the same position as midwives. He trusted the House would go to a division.
said before they went to a division he would like to know how the House stood. As he gathered from the statements that had been made many Members were in favour of these words not being inserted. That being so, if the House divided and this Amendment was lost was the House to understand that the right hon. Gentleman would drop the Bill? That seemed to be the question. A good many Members would prefer to have the Bill with this Amendment rather than not to have the Bill at all. That was the dilemma and that was why he asked whether the right hon. Gentleman intended to drop the Bill if the Amendment were lost.
asked whether the Government would consider the question of including the medical men, provided they were paid a fee, such as they were paid in Huddersfield. Would the right hon. Gentleman be prepared to consider that, because he knew in that case a great many doctors would immediately consent?
said the medical profession would hardly be grateful to their advocates, who had succeeded in making it appear that they declined to carry out a professional act because they were not to be paid a fee of one shilling. That was not the case. The medical profession objected to being subjected to a penalty in respect of what was a civil and not a professional obligation. But they put their objection on a higher ground than that. Their function in the birth chamber was a professional one, and it was not for them to scatter broadcast notifications of births. He thought they might have undertaken this duty and their refusal to do so had, he thought, cast an aspersion upon a great and noble profession besides putting the midwives in a higher position. The hon. Member for Norwood had asked whether the Government would drop the Bill if this Amendment was rejected. That was not the question, but he had been informed that if the doctors were included there would be such a powerful opposition to the Bill in another place as would endanger the progress of the Bill at this stage of the session. He thought the Bill would he worth a great deal even if the medical profession were excluded from its provisions. The question was whether it was worth saving. He thought it was, and therefore he made an earnest personal appeal to his hon. friend not to press for a division.
said that if the Bill was imperilled by the rejection of this Amendment it would be imperilled in another place. Let another place look after its own affairs. They were in danger in this matter of imperilling the justice of this House. It was most important that this House should be just. Here they had a number of poor women, many of them illiterate working for a small fee among the poorest of the poor. They were to be subjected to this penalty while the medical profession with all its ability was to be exempted from the provisions of the Bill simply because their trade union had threatened the Government with what they would do in the House of Lords if the Amendment were not accepted. The House of Commons was not likely to listen to such arguments as that. They should do what they thought was right, and let the other House take care of itself.
said that if any intimation regarding another place had reached the Government it had not come through him. He had no reason to suppose that the other House would take any particular view about this Amendment one way or the other. He was told that unless the medical opposition to the Bill was withdrawn the Government could not see their way to "star" the Bill. He there- fore approached the Government and asked them whether they would assent to any Amendment of this kind. He then went to the representatives of the medical profession in the House, and they agreed to withdraw their opposition if he moved such an Amendment as this and it was accepted by the Government. If, therefore, this Amendment was rejected, he would feel bound to do his best to prevent the Bill from going further. He thought the Government were also bound by that understanding. They could not have gone on with the Bill without the consent of the doctors, and if the Amendment were rejected they were honourably bound to abandon the Bill.
said the noble Lord had approached him, and not he the noble Lord, and he withdrew his opposition to the Bill on the understanding that the Government would agree to the insertion of these words.
said the noble Lord had accurately stated the arrangement made between himself and the medical profession. It was true, as the noble Lord had said, that there would have been little chance of this Bill's being passed this session but for some understanding on the noble Lord's part and on his own with the doctors as to the conditions under which it should be passed. But they could not by an understanding or bargain between themselves withdraw the Bill from the purview of the House when perhaps there might be a chance of getting the Bill through. Personally he declined to accept the attitude in which the hon. Member for Bermondsey wished to place him. It was all very well to say that the doctors now did not want the fee. Had his hon. friend told the noble Lord and himself that before the necessity for a bargain of the kind referred to would not have been necessary. It seemed to him that if he had to choose whether this Bill should be lost and a million children in the next year placed under the disability that was imposed upon them by the hon. Member for Bermondsey, who he did not believe represented the medical profession in this matter, or leave it to the House, he appealed to the noble Lord to exonerate him from any breach of agreement, and to leave the matter to the good sense of the House.
said that he was sorry that the right hon. Gentleman and himself did not take the same view of this obligation. So far as he was concerned he felt absolutely bound by the obligation he had come under. That was not the Government's view. and therefore he appealed again to the House of Commons to honour an obligation which he had entered into on their behalf, but which he quite admitted he had no authority to enter into.
said that until that day he had no idea whatever that there was any compact with the medical profession as a whole in this matter. He would have hesitated to enter into any such compact. He and others were supporting the Bill because the awful infant mortality which took place in this country would be called infanticide in any other. It was an evil which everything should be done to prevent.
said a good many of them were of opinion that the million children which had been spoken of would have an infinitely better chance of living if they were left to the care of their parents and friends with the intervention of the Government or the local authority.
asked whether if this Amendment were rejected the Government would give further time to the measure. If the Amendment having been rejected by this House was put into the Bill in another House would they still continue to give time? Everybody wanted the Bill, and unless he could be assured that time would still be given in the event of this Amendment being rejected, he, being one of the parties to the undertaking referred to, would be compelled to vote with his noble friend.
asked the noble Lord to give way on this point, and he for his part would raise no objection to the House's passing the Bill in its present form. When he withdrew his Amendments it was on the distinct understanding that the Government would adopt the noble Lord's Amendment and the Bill become a Government measure and "starred." If he had not withdrawn his Amendment the Bill would not have been "starred." Therefore the onus of the bargain rested entirely with the President of the Local Government Board.
thanked the hon. Member for releasing both the noble Lord and himself from any supposed understanding.
reminded the House that he had come under a similar obligation to other hon. Members besides the hon. Member for Bermondsey.
said he was placed in a difficult position, but if the hon. Member felt himself at liberty to release him from his obligation he would not place any obstacle in the way. Question put. The House divided:—Ayes, 19; Noes, 87. (Division List No. 458.)
|Balcarres, Lord||Forster, Henry William||Sherwell, Arthur James|
|Bowles, G. Stewart||Harris, Frederick Leverton||Stanley,Hn. A. Lyulph(Chesh.)|
|Bull, Sir William James||Horniman, Emslie John||Valentia, Viscount|
|Cave, George||Lamont, Norman|
|Cooper, G. J.||Napier, T. B.||TELLERS FOR THE AYES?Lord|
|Corbett,C.H(Sussex,E.Grinst'd||O'Brien, Patrick (Kilkenny)||Robert Cecil and Mr. Master-|
|Craik, Sir Henry||O'Connor, John (Kildare, N.)||man.|
|Fell, Arthur||Rainy, A. Rolland|
|Adkins, W. Ryland D.||Branch, James||Clarke, C. Goddard (Peckham)|
|Alden, Percy||Brigg, John||Cleland, J. W.|
|Baker,Joseph A.(Finsbury, E.)||Byles, William Pollard||Clynes, J. R.|
|Bertram, Julius||Causton,Rt.HnRichard Knight||Collins, Stephen (Lambeth)|
|Birrell, Rt. Hon. Augustine||Chance, Frederick William||Cremer, Sir William Randal|
|Bowerman, C. W.||Cherry, Bt. Hon. R. R||Crooks, William|
|Dickinson,W.H.(St.Pancras,N.||Lloyd-George, Rt. Hon. David||Rickett, J. Compton|
|Elibank, Master of||Lundon, W.||Robertson, J. M. (Tyneside)|
|Essex, R. W.||Lupton, Arnold||Robson, Sir William Snowdon|
|Esslemont, George Birnie||Macdonald,J.M.(FalkirkB'ghs)||Rowlands, J.|
|Ferens, T. R.||Mackarness, Frederic C.||Scott,A.H.(Ashton under Lyn-3|
|Fletcher, J. S.||Macnamara, Dr. Thomas J.||Seddon, J.|
|Fuller, John Michael F.||MacVeigh,Charles (Donegal,E.||Seely, Colonel|
|Gill, A. H.||M`Callum, John M.||Shaw, Rt. Hon. T.(Hawick B.)|
|Gooch, George Peabody||M`Crae, George||Shipman, Dr. John G.|
|Grant, Corrie||Maddison, Frederick||Silcock, Thomas Ball|
|Hazleton, Richard||Morrell, Philip||Sinclair, Rt. Hon. John|
|Henderson, Arthur (Durham)||Morton, Alpheus Cleophas||Snowden, P.|
|Henderson,J.M.(Aberdeen, W.)||Murray, James||Verney, F. W.|
|Higham, John Sharp||Nannetti, Joseph P.||Vivian, Henry|
|Hobart, Sir Robert||Nicholson,CharlesN.(Doncast'r||Walters, John Tudor|
|Howard, Hon. Geoffrey||Nolan, Joseph||Weir, James Galloway|
|Illingworth, Percy H.||Norton, Capt. Cecil William||White, J. D.(Dumbartonshire)|
|Jackson, R. S.||O'Connor, T. P. (Liverpool)||Whiteley, George(York,W.R.)|
|Jones,William (Carnarvonshire||O'Grady, J.||Wiles, Thomas|
|King, Alfred John (Knutsford)||Parker, James (Halifax)||Wilson, P. W. (St. Pancras, S.|
|Lambert, George||Pearce, Robert (Staffs. Leek)||Wilson, W. T. (Westhoughton)|
|Lardner, James Carrige Rushe||Pease, J. A. (Saffron Walden)|
|Lever,A. Levy (Essex,Harwich||Radford, G. H.||TELLERS FOR THE NOES—Mr.|
|Lewis, John Herbert||Rees, J. D.||Acland and Mr. Gulland.|
moved to leave out "thirty-six" and insert "forty-eight," which, he said, would give another twelve hours in which the person might send notice.
If the hon. Member will put in the words "if delivered" we accept.
said he had another Amendment for seventy-two hours for delivery. The Under-Secretary had said forty-eight hours if posted or delivered within that time to the medical officer. He thought thirty-six hours very much too short a time. He proposed forty-eight hours for posting and seventy-two hours for delivery at the residence of the medical officer of health. Often a person would have to find out the address, and it would Take him some time to do so. As this would affect a lot of very poor people he did not see why they should not have more time. It should be remembered that the Bill imposed a penalty, in cases where the notice was given too late, of 20s. The Amendment was not seconded.
then moved to insert, "and the local postmaster or mistress shall be supplied with a sufficient stock of such postcards by the local authority, and shall supply the same free of charge to the father and person in attendance named in Sub section 1." He pointed out that the local authority in country places might live miles away from the father's abode, or it might be that poor people, unfamiliar with these matters, might not know the address of the authority, whereas everybody knew where the village post office was, and they would have no difficulty in procuring a postcard on which to send the necessary notice as by law required. A great deal was said about protecting a million babies; let them not throw obstacles in the way of the people who had put upon them the duty of notification.
This Amendment imposes a charge on the rates, and that cannot be done on Report.
next moved an Amendment providing that the penalty of 20s. should include costs. The Amendment was not seconded.
said he had now to move an Amendment to facilitate the defence in cases where the person had reasonable ground for believing that notice had been sent or would be sent by someone else. To do that he proposed two Amendments which he would explain together in order to save time, and would move them.
The hon. Member can only move one Amendment at a time.
said his Amendment was to leave out the word "satisfy" and put in the words "prove to the Court." The Amendment was not seconded.
moved to insert a provision that the notice should be registered in a book by the medical officer of health. He thought that that would he a very useful instruction to the medical officers of health, who, many of them, were not business men. The Amendment was not seconded.
moved an Amendment the object of which was to permit other people to search the registers. Under the Bill as it stood only the medical officer would have access to the register. He thought that it should not be a hole-and-corner affair. He would be perfectly frank; he moved this as an anti-vaccinator. The medical officer and his allies the Imperial Vaccination League, would take care that the poor little child was poisoned with pus from a diseased calf called vaccine lymph, which would keep up the death rate. It was a terrible thing that in the last seventy years, despite all our sanitary improvements, the death rate of infants had not diminished. He attributed this to vaccination. The poison which was put into the child rendered it liable to all sorts of ailments, and, notwithstanding all the medical progress and scientific knowledge of these times, the only class in the community that had not benefited were the poor babies, who were subjected to this poisonous process. If he could get this Amendment into this bill, other people would be in a position to examine the register and to sign the notice paper that under the Act exemption could be obtained for vaccine poisoning.
The hon. Member must keep himself to the Amendment.
said he would not detain the House, but he hoped that the President of the Local Government Board would accept the Amendment, so that the register would not be a mere hole-and-corner affair, but should be accessible to other persons, and not merely to pro-vaccinators. He had worked in this cause for over thirty years—
Order, order! The hon. Member is converting the liberty I gave him into licence.
seconded. Amendment proposed—
—(Mr. Lupton.) Question proposed, "That those words be there inserted.""in page 2, line 13, after the word 'adopted,' to insert the words 'or other person, such other person paying sixpence for each search.'?
did not think it was advisable to allow the register to be open to a number of other people who might subject poor women to inconvenience from which they had a right to be protected.
thought it was far better that all these people should have access instead of allowing a hole-and-corner arrangement of this kind. He hoped the House would accept this Amendment. Question put, and negatived.
moved an Amendment to provide that a notification by a midwife to the medical officer of the local supervising authority under the Midwives Act, 1902, within thirty-six hours of birth should be deemed a compliance with this Bill. He felt convinced that many women would erroneously send notifications to the old authority, and if they gavebona fide notice to the old authority which they knew he thought that ought to be considered sufficient.
seconded. Amendment proposed—
—(Mr. Bertram.) Question proposed "That those words be there inserted.""In page 2, line 18, at the end, to insert the words 'but any notification of birth or stillbirth given by a midwife to the medical officer of health of the local supervising authority under the Midwives Act, 1902, in compliance with such last mentioned Act or any rules made thereunder shall be deemed to be a compliance with the requirements of this section, and, if so given within thirty-six hours of birth, shall be deemed to be a compliance with this Act, and particulars of such notification shall be forthwith transmitted by such medical officer to the medical officer of health of the district in which the birth or still-birth has occurred."
said he sympathised with the proposition because he could see that possibly a little confusion might arise. It should not be forgotten, however, that the vital essence of this Bill was that the notification should be made as soon as possible. He thought this Amendment would only make confusion worse confounded, and as the Government felt sure it would only cause delay they could not accept it.
said the midwife would have now to make two notifications, one to the county council under the Midwives Act, and the other to the new authority. It was rather hard that she should be compelled to make two notifications. He thought the President of the Local Government Board might approach the Midwives Board and ask them to relieve the midwife of the necessity of notifying that authority. Then there would only be one notification.
promised to approach the Midwives Board with that object in view. Question put, and negatived.
said that in the Amendment he desired to move they had adopted with a slight alteration the definition of the hon. Member for Bermondsey. Amendment proposed—
—(Mr. John Burns.) Amendment agreed to."In page 2, lines 19 and 20, to leave out the words 'still-born children as well as to children born alive,' and insert the words, 'any child which has issued forth from its mother after the expiration of the twenty-eighth week of pregnancy, whether alive or dead.'"
moved to omit Subsection 2 of Clause 2. This was a public Act dealing with the whole country for a beneficent purpose, and surely it ought not to be left optional for the Local Government Board to force the thing on or hold it back. This proposal should go forward with the authority of both Houses of Parliament and not be left to the discretion of the Local Government Board. The Amendment was not seconded.
moved to omit certain words and insert words providing against the danger which might arise if differences took place between the midwife, who was legally responsible for the patient for ten days, and the members of any voluntary association. The purpose behind this Bill was to establish, where-ever possible, voluntary associations of persons whose duty it would be, as soon after a birth as possible, to come upon the scene and endeavour to help the mother and the child, and to promote the extension of infantile life. He asked whether it was not a very dangerous experiment, to run any risk of conflict as would certainly be possible under the Bill seeing that the midwife might be acting under one medical authority and the members of the voluntary association under another, each prescribing a different mode of treatment for the patients. Amendment proposed—
—(Mr. Bertram.) Question proposed, "That the words 'council of a' stand part of the clause.""In page 2, line 38, to leave out from the first word 'the' to end of clause, and insert the words 'authority for the time being exercising or established for the exercise of the powers of the local supervising authority conferred by section eight of the Midwives Act, 1902.'"
said his hon friend had overlooked the fact that half of the counties had not any medical officer of health at all. How were they going to do what the hon. Member contemplated by the Amendment in places where there was no medical officer of health?
Every Local Supervising Authority under the Midwives Act has a medical officer.
said he was well aware that every county council had power to delegate certain duties under. the Midwives Act, but a great many of them did nothing of the kind, and the power would still remain with the county council. It was quite impossible to accept the Amendment.
appealed to his hon. friend not to press the Amendment. Amendment negatived.
moved an Amendment to provide for the powers conferred by the clause being given to the county council. Each borough council had the option of applying or not applying the provisions of the Bill in its area, and it seemed to him desirable that London should be administered as a whole. He was surprised that the President of the Local Government Board, who was a strenuous apostle of the unity of London, should introduce a measure which would have the effect of dividing London into twenty-nine areas where the measure might or might not be enforced. Amendment proposed—
—(Mr. Radford.) Question proposed, "That those words be there inserted.""In page 2, line 38, after the words 'council of a' to insert the words 'county and the council of a.'"
said that what was wanted was uniformity in the administration of London, and the only way of getting it in this matter was by giving to the central authority the power to adopt the Act for the whole of the twenty-nine boroughs. That was done in regard to the notification of infectious diseases, and he thought it should be done in this matter also.
said that his view of uniformity of administration might not altogether tally with that of the hon. Member for East Islington. He differed from the hon. Member in some respects on the point here raised. If any of the borough councils showed a disinclination to apply the Act to their areas, it would be for the Local Government Board to impose the duty on them. There would then be that uniformity which the hon. Member sought. He believed the borough councils would unanimously put the Bill in operation. Question put, and negatived.
moved an Amendment to include county councils as authorities under the Act. Amendment proposed—
—(Mr. Adkins.) Question proposed, "That those words be there added." Question put, and agreed to."At end of Sub-section 4 to add the words 'and the council of a county, other than the county of London, may adopt the Act either for the whole of the county or for a district therein.'"
said that he wished to move an Amendment standing in the name of the hon. Member for West St. Pancras providing that the medical officer of health in every metropolitan borough in London should send weekly to the London County Council a list of all notices of birth received by him during the week. Amendment proposed—
—(Dr. Cooper.) Question, "That those words be there inserted," put, and agreed to."In page 2, line 41,at the end, to add the words in London the medical officer of health of every metropolitan borough (including the City of London in which this Act is in force for the time being) shall send weekly to the London County Council, in a form prescribed by the Local Government Board, a list of all notices of birth received by him under this Act during the past week.'"
proposed the omission of Clause 3, but the Motion was not seconded. Question put, and agreed to. Bill re-committed to a Committee of the Whole House in respect of an Amendment to Clause 2.—(Mr. Adkins.) Bill considered in Committee. (In the Committee.) [Mr. CALDWELL (Lanarkshire, Mid.) in the Chair.]
—( Mr. Adkins.)"In page 2, line 41, at the end, to add the words, 'and the council of a county (other than the county of London) who may adopt the Act either for their whole county or for any county district therein. Provided that (a) where the Act is adopted by the council of a county, the county medical officer of health shall be substituted for the medical officer of health of the district, and the expenses of the execution of the Act shall be paid as general county expenses, or special county expenses as the case requires; and (b) if, where the Act has been adopted by the council of a county for any county district, the council of the district, or where the Act has been adopted by the council of a county district for their district, the council of the county, subsequently apply to the Local Government Board to be made the authority for the purposes of this Act, the Board may, if they think fit, make an order declaring that the Act shall take effect as if it had been adopted by the council of the county district instead of the council of the county, or by the council of the county, instead of the council of the county district as the case may be, and on any such order being made the Act shall take effect in accordance with the order.'"
"Question, "That those words be there inserted," put, and agreed to.
Bill reported, with an Amendment.
Bill, as amended, on recommittal, considered.
moved that the Bill be read a third time. In doing so he said he wished to make the announcement that upon the Order Paper for Monday there appeared only the Lords Amendments to the Merchant Shipping (Deduction for Tonnage) Bill. But the real business would be the Lords Amendments to the Small Holdings and Allotments Bill, and to the Evicted Tenants Bill, which had not yet been received from the other House. As these would not appear in the Order Paper on Monday he wished hon. Members to know that most important business would be taken that day. Motion made, and Question proposed, "That the Bill be now read a third time."
said that this Bill, when introduced by its promoters, had two valuable points, it was compulsory and it for the first time in English law required the notification of the still-born child. He regretted that the Local Government Board had deprived the Bill of its compulsory character. The President of the Local Government Board had declared that the infant mortality of the rural districts was less than that of the towns, and therefore the Bill was not required in the country. The report recently issued of the Registrar-General ought to disabuse the minds of the Local Government Board on that point. That report showed that the infant mortality for the first mouth after birth was higher in the rural districts than it was in London. In the rural districts it was 35.9 per thousand, while in the county of London it was 26.2 per thousand. It was not till the fourth month that the death rate in the rural districts and in London was equalised. He did not believe that this Bill would do much good to prevent infant mortality. It was absurd to generalise on insufficient data, or on statistics gathered from a favour ably situated town like Huddersfield where the conditions of life could not be like those of London, Glasgow, Liverpool and other large cities. Ignorance of the management of children by mothers was not the only cause of infant mortality. It arose from very complex conditions. He believed ignorance was one cause, but impure milk was a far greater cause, and the Local Government Board would have been wiser to have pushed forward their Bill for municipal milk depots. Drink was another cause; but the real cause was the great economic factor that more than 13,000,000 of people in England were living on the verge of poverty. [Cries of "No."] Well, he would put it that 60 per cent. of the unskilled labourers wore not in receipt of a living wage, and were not in a position to provide their children with proper food. Their wives were compelled to go out to earn a living, leaving their children at home. What was the good of a health visitor suggesting to a half-starved mother an elaborate list of regulations? Until these workmen secured a fairer and juster share of the profits of labour there would be no improvement in the rate of infant mortality. The promoters of this Bill stated it would enable philanthropic ladies to help the poor, and in Huddersfield they invoked the aid of the Charity Organisation Society. The workmen did not want charitable doles or charity organisations, and they strongly objected to visitations in their homes from charitable ladies. What was wanted was that the labouring classes should be paid a living wage, and thus be given an opportunity of bringing up their children in a healthy and proper way.
said he heartily agreed with the hon. Member for Bermondsey in his belief that this Bill was no, likely to reduce the infant mortality, being based upon compulsion. What they required was that people should be guided in the right way, and should not be led to believe that it was advantageous that they should not have children. Some people complained of the falling off of the birth-rate, but if provisions of Bills such as this were enforced people would say, "The fewer the children we have the better." Therefore the measure would not promote the welfare of the country. It had been said by one speaker that a large proportion, in fact, the majority, of the people of this country were on the verge of starvation. That might very well be, but happily they were on the right side of the verge. That made all the difference. There were very few people in this country who had not plenty to eat and drink. But the way to proceed to improve the people of this country was not by drastic measures of compulsion, enforced by ruinous fines. They would succeed much better if those who bad knowledge, money, and leisure, proceeded in the gentle way of benevolence and charity. And he believed in charity; it would be a bad day for the country when that ceased; he believed in the salvation of our race through charity. He opposed the Bill because it was based on compulsion.
thanked the Government for taking this Bill up, and quite agreed that it would be of the greatest value. He supported the Third Reading.
also supported the Third Reading. He thanked the President of the Local Government Board for his concessions, and he hoped that till Bill, though slight in extent, would be a beginning of needed social reform it the preservation of child life.
said that he disagreed with the view that poverty was the great, or chief, cause of infantile mortality. There were many causes of it—bad food, bad milk, dirt, drink, ignorance. It had been alleged that low wages was the chief cause; in his judgment irregular wages were worse. It often happened that in rural districts where wages were low, but work was regular, the mortality was much lower than in more highly paid districts This was proved by the fact that in the rural districts 5,000 out of every 100,000 children born died in the first three months; in mining districts, where the wages were twice as high, 8,000 out of 100,000 died; arid in the textile districts, where wages were higher still, 9,126 out of 100,000 died. Married women, in his judgment, ought not to work in factories; their province was at home. The sooner the working classes recognised that fact the better for the home comfort of the men, the better for the children, and the better for the State. He thought if they put this law upon the Statute-book they would all have builded better than they knew. Question put, and agreed to. Bill read the third time, and passed. Whereupon Mr. SPEAKER, pursuant to the Order of the House of the 26th day of July last, adjourned the House without Question put.
Adjourned at twenty-five minutes after seven o'clock till Monday next.