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Voluntary Sterilisation

Volume 322: debated on Tuesday 13 April 1937

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4.13 p.m.

I beg to move, to leave out from the word "That" to the end of the Question, and to add instead thereof:

"in the opinion of this House, the Government should give further consideration to the potentialities of voluntary sterilisation for hereditary defectives in accordance with the unanimous recommendations of the Departmental Committee that reported to the Minister of Health on 8th January, 1934."
I think it will be generally agreed that there is a growing anxiety in this country about the problems connected with the population in general and the health of the individual in particular. We had in this House last week a full day's Debate on physical training. There was also recently a Debate on the general problem of nutrition. I, therefore, make no apology for inviting the House to consider one particular aspect of possible benefit to the health of the nation as a whole. I would like to start by quoting, from the report of the Committee on Scottish Health Services, a paragraph which puts the whole matter in a nutshell. I give the quotation because this was a very strong committee and the most recent Health Committee to report. It says:
"In considering what measures should be taken to improve the health of the people, we have to take into account at the outset the question of heredity. Physical and mental capacity has a basis in inheritance, and some people, therefore, because of their hereditary constitution, will be less fit, physically and mentally, than others, no matter what is done by way of medical care and improvement of environmental and other conditions."
There is a slight disparity between the Amendment in my name which is on the Order Paper and the recommendations contained in the report of the Departmental Committee commonly referred to as the Brock Report. That is due to the fact that it would be out of order for me this afternoon to propose legislation designed to implement the recommendations in the report. Therefore, all that I can, and that I intend to do is to invite the Minister to give his attention to the need for further research into the problem of genetics. The fact that my Amendment is not completely in agreement with the recommendations is not because I disagree with any of them, or would in any respect depart from them but is merely a matter of technical form.

I believe that in this matter in which no party issues are involved, for the problem of sterilisation cuts across all parties. Nor is there any controversy between what I may broadly call nature and nurture.

The first point I will endeavour to make is that mental deficiency, which covers the largest number of people concerned, has generally, in varying degrees, a basis in heredity. There is a great deal of published evidence on this matter, some of it reliable and much of it unreliable, but I will refer to a specific piece of accurate research which is quoted in the report of the Departmental Committee. In the case of the Colchester inquiry it was shown, in a considerable number of cases examined, that heredity played the greater part or the lesser part in the predisposition to mental deficiency in approximately 91 per cent. of the cases. In addition to mental deficiency, there are other forms of hereditary disability, notably some forms of blindness, which are much more directly hereditary even than the average form of mental deficiency.

I do not intend to weary the House by going into great detail, because a very comprehensive survey of this most interesting and important subject was made and published in the report of the Departmental Committee, commonly known as the Brock Committee. That report is perhaps the most interesting Blue Book that has ever been published. It is full of original research and is very readable, and I hope that all hon. Members who are interested in social problems will read it. One finds that most of the opposition to the idea of sterilisation comes from people who have not read that report. There are two points in the report to which I will refer as a basis for my arguments, the first being the extent of the problem. The Brock Committee agreed with the findings of a previous committee—the Wood Committee, which published a report in 1929—that there were in England and Wales about 300,000 defectives, and they gave it as their opinion that of that number approximately 200,000, that is to say, two-thirds, were fit for community life, their degree of deficiency or defect not being high enough to justify their being retained in any form of institution. At the present time, of course, a very much smaller proportion than one-third is in fact in institutions or under care.

I will give one other instance of the extent of the problem of deficiency. On 1st January, 1936, the London County Council published a report containing the statement that the London County Council Hospitals Committee was responsible for the care of 27,730 persons of both sexes. In an earlier report they stated that 30,000 beds were occupied by deficiency cases. They stated further, in the 1936 report, that since 1920 there had been an average annual increase of 603, and that during the next few years they anticipated a net annual average increase of 560 in the number of persons for whom accommodation would have to be provided.

Is the hon. and gallant Member referring to those certified under the Lunacy Act as well as those certified under the Mental Deficiency Act?

I am referring to the report of 1st January, 1936. I do not wish to mislead hon. Members in any way. It should be remembered that the increase recently is partly due to the growth of population of the London County Council area, which should be taken into account in comparing it with less rapid increases previously. I am not arguing as to the increase that is taking place, but am stating the problem that has to be faced. The expenditure on such cases by the London County Council during the last financial year was ¤1,698,633. As to the cost of deficiency, I have frequently tried during the last few years to obtain figures showing what is the burden of mental deficiency and certain forms of physical deficiency, but it is impossible to arrive at even an approximately accurate figure, because the expenditure comes under so many votes and under so many departments. It comes under national expenditure and local expenditure, under the Ministry of Health and the Board of Education, in the expenses of voluntary hospitals, in charities and in relief. All one can say is that there is an enormous total expenditure in connection with this problem.

I do not suggest for one moment that if sterilisation were legalised it would be an economy. In the long run there might be an economy, but it is not from the point of view of economy that the Brock Committee recommended sterilisation, or that anyone else should consider the problem. If sterilisation were legalised, the immediate effect would be small. All I am suggesting is that there is an enormous expenditure which, if any part of it could be diverted to other channels and other social services, would benefit the community as a whole. Any hon. Member who is interested in this subject and who has not been over a mental hospital ought to do so. He would then get an extraordinarily vivid picture of the great misery which afflicts so many people. The hospitals are extraordinarily well and very sympathetically run, and the treatment given to these unfortunate people is splendid; but in going over one of these hospitals one sees the number of unfortunate people who are condemned, largely through hereditary causes, not only to lead miserable lives themselves, but to be a source of great misery to their families.

I would like now to refer briefly to the first three recommendations of the Brock Committee. They recommended that, subject to certain safeguards which they proposed, voluntary sterilisation should be legalised in certain cases. In the body of the report there are most powerful arguments as to why sterilisation must be voluntary. The cases in which it is recommended are as follow:
"Firstly, a person who is mentally defective or who has suffered from mental disorder;
Secondly, a person who suffers from, or is believed to be a carrier of, a grave physical disability which has been shown to be transmissible; and
Thirdly, a person who is believed to he likely to transmit mental disorder or defects."
They recommended that before sterilisation is sanctioned in the case of a mental defective, care should be taken to test his or her fitness for community life, and that such a person should receive adequate supervision. There is a statutory body, supported by a great many devoted and voluntary workers, which does an immense amount of valuable work, and which does not receive half enough credit for what it does. It is the Central Association for Mental Welfare. It is a body, mainly on a voluntary basis, which looks after persons who have been in institutions and have gone back to their homes, or persons who need assistance and help. That body has vast experience and it actively supports the suggestion that sterilisation should be legalised. Its members know more about the condition of defectives, probably, than any other body of persons in this country, and they have pointed out that if the fear of parenthood could be removed, it would greatly ease the mental condition of many defectives. They have pointed out that there are persons in the community who are mentally unstable but in many respects perfectly normal, and who know that their unfortunate condition is due to their unhappy inheritance. Those persons often marry, and are capable of conducting a home, but if and when a child arrives, the extra strain imposed by the burden of parenthood may throw them off their balance again.

Another point in opposition to this proposal which has been raised before, and will I am sure be raised this afternoon by the hon. Gentleman opposite—I think it is one of the arguments which he and his friends always use when there is any attempt to make an advance in these matters—is that the existence in the community of persons who have been sterilised would lead to a lowering of the standard of morality. That point was examined, and answered by the Brock Committee. It has been examined and reported upon elsewhere, and if the hon. Member opposite or any of his hon. Friends raise that point this afternoon, I hope they will produce some evidence in support of it. So far, I have not heard any evidence adduced in support of that general statement.

There are one or two other considerations which I wish to advance. There is still a great deal of misunderstanding about the nature of the sterilising operation. If there are any doctors among hon. Members who are here I think they will confirm the statement that the operation is very simple, and in the case of a male trivial. In the case of a male it is wholly unattended by risk and in the case of a female it is virtually unattended by risk. It has no effect whatever upon the normal ordinary life and health and capacity of the individual. It has nothing in common with any of the operations used for the removal of any gland. It in no way affects sex life or sexual secretions. The only effect is that the sexual act when performed does not result in fertilisation. It has no other effect.

Another argument frequently used against the recommendation of the committee that sterilisation should be legalised is that a mentally defective person cannot have full volition. That argument, again, was dealt with extensively in the report, but as some people have not read the report I may be allowed to refer to it. I have always been reminded in this controversy of the comparison with a Ministry of Defence. Most people who interest themselves in the co-ordination of the Services, at first glance become protagonists of the idea of a Ministry of Defence, but when they go into the matter they become firm opponents of a Ministry of Defence and see that co-ordination can be achieved better in other ways. So sometimes people when they first consider sterilisation get the idea that sterilisation of the unfit should be compulsory, but when they examine the facts and figures and go into the recommendations of the committee, they are left in no doubt about the fact that sterilisation can only be, and must only be, voluntary.

It should be remembered that sexual sterilisation is legal to-day in cases of operations for the health of the individual, that is to say that sterilisation for health reasons as opposed to eugenic sterilisation is perfectly legal. Let it not be forgotten that every year hundreds of people in this country have such operations performed either by private practitioners or in general hospitals for reasons of their own health. Most frequently this occurs with women who are likely to be endangered by child-bearing and are voluntarily sterilised, and that operation is legal. Thus we have the curious anomaly that whereas it is legal for a man or a woman to be sterilised, even in a public general hospital if his or her own life is in danger, it is illegal for such a person to be sterilised in the interests of posterity—or it is probably illegal, because it is not settled as a matter of case law or statute law. That is a curious and accidental anomaly of the law.

As I said earlier, of the 300,000 defectives estimated to be in England and Wales, 200,000 at least conduct their lives in the ordinary way as members of the community and for all other purposes save this are held to have volition. Their volition, however, is sometimes denied in the arguments which are put forward on this particular score. Persons who have suffered from, and recovered from, some mental disorder are held to have complete volition, and I would make just this distinction between mental disorder and mental defect. Mental disorder implies that a person is in possession of full mental capacity, but suffers from a disturbance of the brain, whereas mental deficiency indicates that the person is actually short in some degree of capacity. One class of person can in case of recovery exercise full mental powers, whereas the other can never rise above a certain level. But as I say those who have recovered from mental disorder are held to have complete volition in other respects save this, and research tends to show that theirs is the most hereditary type of mental trouble. Then you have people who have disabilities, such as certain forms of blindness which are hereditary. Is it to be said that they have not complete volition? There are also carriers, persons who being themselves sound, come from stocks so tainted that it can be said with varying degrees of assurance, from moral certainty down to possibility, that their progeny will suffer from some congenital trouble. It is right to remind the House that, in the last few years, since the medical profession and a large section of the public learned how simple, safe and effective the operation was, many people are to-day upon eugenic grounds having themselves sterilised. There are no figures available, but it is well known that many people are having themselves sterilised on eugenic grounds. [An HON. MEMBER: "Where?"] If the hon. Member makes inquiries from his doctor, he will find that it is being done.

There is little doubt that there is a general tendency for mental and physical defects to spread among the population. That is only to be expected when it is remembered that our social services, of which we are rightly so proud, have had the effect among others of preserving the life of a great many of the weaker stocks which in earlier and less happy times would have been killed off by the ruthless pruning of nature. Before 1875 there was a birth-rate of between 31 per cent. and 38 per cent., but this high birth-rate was accompanied by a very high death-rate. Then, came the development of medical science, and improvements in sanitation, housing and nutrition. The social services were expanded. All these alleviating and ameliorating factors operated discrimination, and to-day many children are born and grow up who, in the lifetime of many of us, and certainly in the lifetime of our parents, would have been killed off by nature's hard hand. There is one point by which the Brock Committee was very much impressed, and by which anybody who has encountered it must be impressed, and that is the position of the unfortunate normal child of a defective parent. It is perhaps one of the most telling arguments in favour of sterilisation. Just think of the position of such a child. I think I see a light brightening in the eyes of my hon. Friend opposite, and I hasten to add that there is no inconsistency in my remarks at this stage, for the reason that some proportion of mental deficiency is due to environmental causes usually pre-natal infection. At present such persons, who may be described as borderline cases, may marry and have children. I ask hon. Members to consider the life of a child who is being brought up by a defective parent, though defectives may be and often are extremely good and affectionate parents. This point has been emphasised by the Royal Society for the Prevention of Cruelty to Children.

One of the obstacles to what many of us believe would be a desirable reform arises from the opposition of the Roman Catholic Church, and I wish to say a few words on that head. I yield to nobody in this House in my respect and admiration for the most powerful, and best organised and perhaps greatest of the Christian churches. I would not willingly say anything which would give offence to any Roman Catholic. But their attitude in this matter is one which is not always easy to appreciate. I have studied it for many years. I have tried to inform myself of their position, and to appreciate what it is. I have discussed this matter with many Roman Catholic priests during the last 15 or more years. I have read their literature on the subject very carefully, and tried to see their point of view. In a study of this matter, one thing has impressed itself upon me, and that is the extent to which the attitude of the spokesmen of the Church of Rome has been modified. Fifteen years ago the whole question of sterilisation was brushed aside as so improper, so unthinkable and so impracticable as to be unworthy of argument. Public opinion has moved a long way since then, and with it that great Church, which for generations has moulded and directed so much of human thought but which, I believe, has never in the long run stood across the path of progress, has also modified its position.

Four or five years ago I was very kindly put in touch with the leading Papal authority in this country. I went to see him in the country, where he gave me a most excellent luncheon and put certain points to me. My first and most important impression was that the objection of the Roman Catholic Church to sterilisation is a matter of discipline and not of dogma. There is no reason why, if the Papal authorities decided to do so, they should not with perfect consistency change their attitude on the subject. As I say, it is a matter of discipline only and not of dogma. I think it is really rather a queer turn of the wheel of fortune that the main opposition to the idea of sterilisation should come from that great Church one of whose most distinguished sons, the Abbe Mendel was, jointly with Darwin, the founder of the modern science of genetics, and the main inspiration of modern thought upon heredity. The short answer to that objection—I think I see my hon. Friend opposite taking notes; perhaps he is going to speak and perhaps he will address himself to this particular point—is that since no responsible authority in this country has ever advocated sterilisation being anything but voluntary, and since, therefore, there is no possible suggestion that it could be inflicted on anyone, why should they, so Far as we who are not Roman Catholics are concerned, deny to us a form of relief which we desire?

One other point which I should like to raise is the political aspect of this subject. Members of Parliament are of necessity timid creatures. If they sit for seats with a very small majority, like I do, they tend to become more timid still; but this is a subject on which no hon. Member need be in the least afraid. It so happens that the very last speech I made in my constituency before the last Election—it was most widely reported,. I have never been so widely reported before and never shall again—was a speech advocating voluntary sterilisation. That was on the eve of the General Election. I did not know the Election was coming, but it came. Not one word of complaint of any sort or kind did I have on that score. I have spoken on this subject in a good many parts of this country, in Scotland, and England, and in the East End of London among the very poor and in the West End among the supposedly richer classes. There is not only much less opposition to the idea in the country than is supposed, but particularly among the poorer classes, who are the people who suffer most from the proximity of defectives and comprise the class which cannot afford the use of nursing homes, there is a fervent demand for the legislation of sterilisation.

The present position is class legislation. Those who are well off can get themselves sterilised if they want to, and those who are not well off cannot do so. There comes in again the question of volition. I have had people come to me and ask how they can possibly get themselves sterilised. They have produced a history and a story which, to my mind, abundantly justified their demand. One woman had five children, three were defective and one was too young to yet know. She herself was a high-grade defective and a most worthy person up to a point, but she had a bad family heredity. She was the wife of an agricultural labourer, and I had taken the matter up with the county council. But no, they could do nothing, because it was not possible for the local practitioner to say that the woman's life would be in danger by child labour; so she could not be sterilised. If the local practitioner had been able to say that her life would be endangered, she could have been sterilised, That is the present position of the law. Hon. Members should not be deceived by a certain taboo which still operates in this matter. Ten or 15 years years ago it was impossible to get the Press to refer to sterilisation at all. Now that taboo is dying down, but it still occasionaly persists, I observe, in "The Times." Only yesterday "The Times," referring to the business in the House this week, said that, "Tomorrow (this day) will be devoted to a discussion of matters arising from the Estimates for the Civil and Revenue Departments." That taboo is breaking down, and Members must not be deceived by the fact that for various reasons the demand for sterilisation is relatively unexpressed.

I will inflict on the House a brief note of some of the more important bodies which have recently signified their support of the principle of voluntary sterilisation. They include the Royal College of Physicians, the Royal College of Surgeons, the Society of Medical Officers of Health, whose journal has been very good in this matter, the Mental Hospitals Association, the Women's Public Health Officer's Association, the County Councils Association, the Association of Municipal Corporations, and many others. As I say, there are many more, and especially among societies for the welfare of the blind there has been a large number of resolutions on this subject. Among other outside bodies I would refer to the National Conference of Women at Edinburgh, in October, 1934, which passed a resolution by a very large majority. Last, but by no means least, the National Conference of Labour Women at Swansea, in May, 1936, emphatically passed a resolution in favour of voluntary sterilisation. That I who sit on this side of the House, should find myself cordially agreeing with the resolution of a National Labour Conference is a remarkable thing.

I very much hope that the Minister of Health will be able to give us some statement as to what is being done about the research that was recommended by the Brock Committee, and incidentally by other bodies, such as by the Departmental Committee on Scottish Health Services of 1936. I should like to remind the right hon. Gentleman that there are now many countries abroad which have on their Statute Books and in practice sterilisation laws. Those countries include not only Germany but the Scandinavian countries and some British Dominions. I hope that the Ministry of Health is keeping itself informed as to the progress of sterilisation in those countries. Those of us who advocate this do not for a moment suggest that it is going to be a universal panacea or a substitute for other efforts. All we say and believe is that voluntary sterilisation for those who want it, administered under adequate safeguards—such safeguards as are recommended by the Brock Committee—would be a more important and very necessary weapon in the armoury of preventive medicine.

4.54 p.m.

I beg to second the Amendment.

The hon. and gallant Member has made so good a case in his extremely interesting speech that I do not want to take away from the impression he has made by labouring the case at any length. All I would say is that though I have come into the field very much later than he has done, the more I have studied the question the more convinced I have become that something ought to be done without too long a delay. As to what, it is not for us this afternoon to suggest. It was quite natural, I think, within the first year or two after the publication of the Brock Report, that anyone approaching the Minister of Health on the matter should be told to go outside to make converts, to provide their appeal, to have it well explained to the working classes who were concerned, and to see what action they might provide. That was done. But when the matter was raised only last year, when almost everything of that kind that could be done had been done, it was just a bit disappointing to be told again that we must still work away at public opinion and get Resolutions passed. Whatever we may hear to-day, and there are things to be said, of course, on both sides of the question, I rather hope that we shall not be told that now, having got every possible organisation and society which we can have and which looks at these matters as matters of public health, in favour of this scheme, we are expected to do further missionary work. That would be only boring to the working classes, who have already considered this matter and made up their minds, and it would be rather vexatious to those who have worked very hard in bringing these questions properly before responsible bodies.

I do not want to read the long list of bodies which I have here, and which I can give to any hon. Member who is interested. I want to draw attention only to this in connection with the bodies in favour of this reform, that they are not only technical bodies connected with health or with mental deficiency, who are really strongly in favour of some action being taken, but ordinary common-sense bodies like the County Councils Association and—taking a very different type—the Women's Co-operative Guild, a body for which I have had a great deal of respect ever since my brother founded it, and the Church of England Temperance Society. Of those bodies the only one with which I am personally connected is the County Councils Association, and I should like to dispel a suspicion which I have heard mentioned by those who argue against the case I am trying to make, namely, that the minds of the representatives of local government bodies are influenced by the belief that if this change were to be brought about they would be saved from doing a considerable part of what is now their duty under the Mental Deficiency Acts, and so the ratepayers' money would be saved. I agree with my hon. and gallant Friend that that is not the attitude from which the matter is being regarded.

As I see it the position is quite different. There are many people falling under the custody of local authorities, suffering from various degrees of mental incapacity, who must always be kept under restraint, and I fear that the way in which some of those persons are treated by some local authorities leaves a good deal to be desired. I saw some terrible quotations from a recent report with regard to the treatment of the insane which were horrible to read. Although that is not the matter which we are discussing to-day, it needs a good deal of attention. But the development in the work of the local authorities which has been most striking in recent years, under the influence largely of the Board of Control, has been on its remedial and education and training side. Of course that training cannot be given to persons who are wholly irresponsible. These institutions very largely specialize on this remedial treatment. Such persons are fitted to take, not a full place but some place in ordinary human society, and they are taught suitable occupations, which give them an interest in life.

There are now many in those institutions who have been benefited in that way, and who might be allowed to go back and take such place as they can in civil society but for the danger that they will become mothers or fathers of defective children. They have been taught all they are capable of learning, and they have parents or other relations who have that splendid thing, keen family affection for them, in spite of their defects, and who want them back at home and could make something of a home for them; and they are in many cases of the class who know thoroughly well, although their minds are to some extent defective, what it would entail if they were to ask for voluntary sterilisation, and are therefore capable of asking for it. If they could go back, as they could, under those conditions, the effect on the local authorities would be this. There would be nothing in the nature of closing down institutions in which they now have to be kept, but the work of those institutions in training those who are trainable could be extended because, so far as my information goes—and I have made a considerable number of inquiries—there are always people on the waiting list who would be willing to go into institutions for training, who now cannot be accommodated, but for whom training and remedial work is really extremely desirable so that the more modern methods of remedial treatment may really be applied to them. The point I make is that the desire of local authorities, as shown by careful consideration and approval of this reform by organisations like the County Councils Association, is not a desire for economy, but a desire for greater efficiency in the work that they do.

Now I intend to confine myself almost entirely to one other subject. I wish to make a point which is implicit in the whole campaign for voluntary sterilisation on the lines of the Brock Report, namely, that this campaign is not only, as it has been represented to be, the thin end of the wedge towards compulsory sterilisation; it is in fact the very reverse and antithesis of the whole idea of anything compulsory. In the first place I have never come across—and I do not suppose my hon. and gallant Friend, with his longer experience has ever come across—anyone who would not agree with us that to introduce compulsory sterilisation would be utterly alien to all our traditions and inclinations, and would lead, in the hands of certain executives and in certain countries, to most pernicious abuse. I feel that it would be a terrible wrong to the conscientious religious convictions of a definite section of the community. But may I at the same time say in rather different words what has already been said by my hon. and gallant Friend, that, while I take that view very strongly, I may be allowed to quote this sentence from the Brock Report:
"The law has long recognised that a man should not be compelled to submit to something which he conscientiously believes to he wrong, but the law has never recognised the right of an individual to impose his scruples on others who do not share his views."
So, while we fully respect and intend to safeguard the views of those to whom I have referred, we ask them to respect ours. That view, I think, is universal among those who advocate this reform. But, besides that, there is this, which in practice is still more important. The proposal is not that anyone can go and get himself or herself sterilised, but there must be very careful inquiry and certification by the two doctors, who are both specially approved for the purpose, with an expert Ministry of Health committee in the background in case the Minister's advisers are not satisfied with the medical reports and certificates. Well, that has this importance, that in three out of four classes who would be entitled to apply for voluntary sterilisation under the Brock Report, the certificates could only be given if the practitioner were satisfied that the person applying was suffering, or had suffered, from disability or disorder deemed to be inheritable, or was a person deemed to be likely to transmit defectiveness or disorder or great disability to a subsequent generation. I am not using the precise words, but I think I give the precise sense.

But the point is that no really honest opinion with regard to that can be formed—and it is intended that these opinions shall be honest and careful opinions—unless the practitioners concerned have had access to the family histories of both, of the past generations and of the collaterals of the persons concerned. Now no one will give information with regard to people of a superior generation, or of his own generation, or of a subsequent generation, if there is any possibility that, as a result of that opinion, that person may be sought out and compulsorily sterilised. Therefore, the whole machinery on which voluntary sterilisation rests, which depends on the care and conscientiousness and thoroughness of these reports, would be brought to naught immediately any system of compulsory sterilisation were to be introduced.

There are two other small points I would like to mention, pointing in the same direction. First of all, people will not enter institutions, which it is very desirable that they should do, if they feel that there is any liability that they will have to be sterilised as a condition of leaving those institutions. That is just what one does not want, because one wants them to go into a remedial institution in many cases. Further, once you allow compulsory sterilisation, a person known to have been sterilised would surely be believed to have been sterilised by some compulsory legal process. He is, therefore, under some stigma, and the chances therefore of voluntary sterilisation being resorted to, for good and sufficient causes, practically disappear, because nobody wants to put himself under what may be regarded as a stigma. I therefore conclude on this matter that if ever there was a case where the thin-end-of-the-wedge argument, which has been used so much, is inapplicable it is this case, when it is suggested that voluntary sterilisation would lead to compulsory sterilisation. The two things are built up on entirely differing conceptions, and one is the direct opposite of the other.

The only further point I desire to make, is to give a slight elaboration of the legal position. As my hon. and gallant Friend said, therapeutic sterilisation, that is, sterilisation for the benefit of the health of the individual sterilised—of those who are at the time insane or mentally defective—is probably illegal. The law as to sterilisation of persons who are in their right mind at the time that they apply for the operation is uncertain, and they would, I believe, be a considerable majority of those who might come under the Bill. It is believed to be legal if there are good eugenic reasons for it, and if the proper consents have been obtained. That means, of course, as my hon. and gallant Friend said, that it is frequently performed now, probably with adequate inquiries and safeguards, but of course without the full safeguards that would have to be applied to similar cases in future if anything were done on the lines of the Brock Report. But the doubt means in practice this, as my hon. and gallant Friend said, that persons who have the means to consult a private physician and to employ a private surgeon can get the operation done, but those whose means are limited, so that they would be compelled to go to a hospital, cannot, and they of course are just the class who, because of the narrow compass of their homes and housing and sleeping accommodation, find lifelong and invariable self-control in the married state particularly difficult and almost impossible.

As the writer of a letter said—the victim of a hereditary, and actually inherited, physical deformity, who had succeeded in getting himself sterilised, though only after a special fund had been raised on his behalf—the promoters of this Bill, in trying to get sterilisation legalised, are only trying to get made available for the poor what is now the privilege of the rich. After the reasons I have ventured to give, in addition to the far fuller and masterly sketch of the matter given by my hon. and gallant Friend opposite, I very much hope that the Government will now be able to give a favourable reply to the Amendment which I have the honour to second.

5.15 p.m.

I wish to thank my hon. and gallant Friend opposite for the manner in which he approached this subject. I may perhaps be isolated in this House in answering one or two of the queries of my hon. and gallant Friend, but in the first place he postulated that the individual has the right to be able to say that he or she shall carry on in a certain fashion. I am one of those who believe that, as far as the law of the land is concerned, that is a falsehood. You are subject to the law and you must obey it. It is one thing to talk of legal ordinances; it is another thing to talk of the law of the Church, which often differs from it because one deals with material and the other with spiritual things. I believe that there is not only a teaching but a moral force in a particular Church, and therefore, in regard to faith and morals, those who belong to that Church and are not slaves to the law, but are within the law, are bound by the law of that Church. I am bound to analyse the reasons that are put forward for this Amendment.

The popular front point of view does not appeal to me because, if we look at the wonderful popular front point of view which we have in this House, we find it is neither in consonance with good management or organisation of government, nor with what is beneficial to the State. It is illogical politically, opportunist in its action, and injudicious in its representatives. Therefore, the criterion that a popular movement or popular opinion may be in favour of some faddist point of view does not appeal to me. One would imagine that every new-fangled notion that comes along must be carefully examined. There are in the country sane men and women, but the majority of mankind, as I know them, appear to be insane. I often see as much insanity on this side of the House as I see exhibited on the other side, and on this particular point I am wondering who will come into this category. Who is to decide about mental defectives? Two men may have a conversation. We are told that if two people in company have a conversation for any length of time there must be equality from the point of view of association. If two people, one sane and one insane, talk together, it is a bad thing for the sane man because of the company he has been keeping. If two insane people get together talking about other people they form an opinion. I am asked to accept the authority of certain individuals who have expressed an opinion.

I am told that there is a popular front, an association in this country, that has met with a view to making everything all right in the world. He have had our fanatics in the House who have wanted to do that. Are they to be classified as insane? Is that to be one of the hereditary defects that ought to be got rid of? Where are we going to stop? This Amendment speaks of voluntary sterilisation for hereditary defectives. That is incorrect. The English has no meaning. It is nonsense. It implies that if you are going to volunteer you have to be compos mentis because my right hon. Friend the Member for North Cornwall (Sir F. Acland) said there is to be no compulsion. A person who is in a state of mind to know exactly what he is doing will be able to consent to voluntary sterilisation. If a person is unfit and he knows he is unfit, it implies a very high state of sanity. People are going about who do not recognise that they are insane, and we are going to impose the choice of sterilisation only on people who are defective. It is an imposition because anything that takes away from the faculties of a man or woman is an imposition. It prevents them from carrying out the functions for which they were made. Many people want to get rid of Christian teaching because it lays down laws and rules that they have to obey, and they want to have an easy state of society which enables them to be rid of the ordinary functions of life without having the terrible indictment which may be raised against them of not doing the right and proper thing.

The hon. Member will be able to say what he wants to say in regard to the Vatican. I know that he is an advocate of the Vatican and that he will bow to anything that comes ex cathedra from it. As I believe that the hon. Member has a right to express his view, I believe that I have a right to express mine on this matter. If I can incite hon. Members who take a rationalistic point of view to some intelligence on the subject, I shall be pleased, for I shall know that they at least do not come within the category of mental defectives. We are told that a person can make a statement to a medical man that he is willing to undergo this operation, but surely it is wrong to say that anybody who has that power of will is defective. I find great difficulty in this House at times to understand many of the speeches that are made. I am at a loss to understand why men should vote without hearing the discussion. They take second-hand information. In regard to something which is important to the individual, however, I take a different view. I maintain that my life and all that I am is mine, and that I have the right to protect that which is mine against all others.

I believe that all men and women are equal, but there are gradations in life, and who is going to set the standard in regard to mentality? Some of the greatest men of England were considered to be defective, and the whole of their lives shows, from the point of view of rationalisation, that they did not lead a rational life. We have the progeny of those people with us to-day, and I should like to know, in regard to extermination by sterilisation from the point of view of the propagation of the species, where we are going to end. I want to know, if people are compos mentis, to what they are going to consent. They can only consent to the prevention of the only thing for which men and women were created, namely, the propagation of the species. It may be a fallacy to pronounce it to-day, and it may he one of those doctrines of the Church which appear to the modern mind to be out of touch, but the teaching of the Church is that man was made to multiply, and there is no getting away from that special ordinance.

It has been stated that people in possession of their faculties would not apply for sterilisation. I maintain, therefore, that this Amendment cannot work, because people in the possession of their faculties, if they would not apply, are the very people who would not be considered mentally defective. If they have not got their senses, it cannot be voluntary, for they would not know what they are applying for. Therefore, this measure cannot be applied until it is made compulsory. We are told that many people in possession of their faculties do apply. That is a very specious argument. The hon. and gallant Member said that many people ask for sterilisation on eugenic grounds, and he went on to amplify that by mentioning people who do not want to have more children. If my hon. Friend is going to qualify that with the word "defective" it will mean that a defective parent is able to consider what is the right and proper thing to do in regard to a family, and we credit him with faculties which he does not possess. It means that the defective parent is regarded as able to take a whole survey of life and, even after three or four children have been born, to decide for voluntary sterilisation.

With the falling birth rate and the demand of the nation for men and for women, there are other points of view to be considered rather than the point of view of the mental defective and his attitude towards sterilisation. I want to see remedial measures taken by this House which will avoid the difficulties with which the right hon. Gentleman has to deal. We are taking up the wrong end of the stick in dealing with the problem under this proposal. If we want to deal with mental deficiency cases, we have a Mental Deficiency Act for that purpose, and remedial measures can be applied in institutions. What right has anyone to come along and suggest to the individual that his standard of life is such that we consider him to be defective, effete and an incubus on society? It is a very bad thing for medical men in Council to advocate sterilisation, in view of the great advances in science, and I suggest to the Minister that we should be doing better to give attention to the question of raising the standard of life for the worker.

There is a particular hereditary disease which has brought terrible trouble into homes and yet no one who brought in a proposal to make that disease notifiable would get a majority in this House, although in walking through our hospitals and asylums we see the effects of the ravages of that disease. Through malnutrition, poverty and a thousand and one other effects of the general depression many of the poor are brought to terrible straits, and we ought to undertake measures which will assist in building up their lives, thus giving men and women the opportunity to live the normal life which is ordained for them. The advocacy of sterilisation is pernicious. It is working in conformity with the easy code of the year 1937, with its week-ends and the promiscuity of male and female—making all that a much easier proposition. When the voluntary system can be brought into operation by those who fear to have children, you make disregard of the conventions of life much easier. From the moral point of view the adoption of sterilisation would bring many difficulties, and I feel that the protection of the morals of our people is absolutely essential. In a world of disorder I find no discipline except through the influence of the Church. I cannot see that the State, with all due respect to its legislators, exercises the moral influence which it ought to exercise among the people of this land, but I do believe that a Church can exercise a moral influence. In view of the abuses that would be likely to arise under this pernicious system, I think the Minister would be well advised not to countenance it.

5.35 p.m.

We all appreciate the sincerity of the hon. Member for the Scotland Division (Mr. Logan) and his references to his Church. I had the honour to serve with an Irish Regiment, and though I am not a member of his religious faith, I very much admire the leaders and the laity in that religion. In listening to him I felt that if we had been talking about the causes of mental deficiency and any remedy had been suggested other than sterilisation, he would have been with us. He suggested that one of the causes was a certain disease, but if he looks at the report of the Brock Committee he will not find that idea borne out. Environment is undoubtedly a contributory cause where there is the hereditary element existing, but the Minister of Health, who has been so energetic in clearing the slums, will tell us that slum clearance and improved housing conditions have not resulted in diminishing the number of cases of mental deficiency. The Brock Committee, while admitting that there were many other contributory causes, came to the conclusion that heredity was one of the chief factors. On page 21 of their report they say:

"The children of parents one or both of whom are mentally defective are, on the average, below the normal, and our inquiry shows that nearly one-third of such children as survived are likely to be defective, and more than two-fifths must be expected to exhibit some degree of abnormality."
In the face of evidence like that can we really say that we ought not to take measures to reduce the number of mental defectives born into the world? We are not proposing to take any function away from any subject in this country, but we do say that where a man or woman suffers from mental deficiency and fear that they may convey it to their children it is a Christian act that they should be allowed voluntarily to undergo sterilisation, so that there shall be no children to suffer as they themselves have suffered.

A mental disease is probably the worst illness to which the body can be subject, and surely we ought to do all we can to reduce mental diseases. It is some years since the Brock Committee reported, and I hope that when the Minister of Health replies he will be able to give us some indication that the Ministry of Health have not been inactive in the interval, and that they propose to take more active measures in the future. In the Brock Report we are informed that it is difficult to trace the antecedents of mental deficients. Of course it would be. People are not proud to say that their grandparents were mentally deficient. But a good deal more research on the matter could be undertaken. The Brock Committee came to the conclusion that though it might be difficult to trace antecedents, valuable information might be obtained by finding out the proportion of mental deficients and subnormal children coming from mentally-deficient parents and they wrote to the local authorities to ask if they would help in an investigation. On pages 16 and 17 of the report they print the result of that inquiry, which I regard as really startling.

I do not think that the hon. Member for the Scotland Division can have read that report; I doubt it after hearing his speech. They found, out of 8,800 cases investigated, that 2,000 children died at a very early age, which does indicate some direct connection betweeen infant mortality and mental deficiency on the part of the parents. They divided the remainder into age groups of those between 7 and 13 and those over 13, and found that no less than 40 per cent. of the children still living were subnormal. When it is remembered that 22 per cent. of the children had already died, it will be seen that the proportion of subnormal children was high, so high that this House cannot regard the situation with complacency. When we realise all that normal or abnormal children born of abnormal parents must go through, surely we are not asking very much in advocating that sterilisation should be permissible. A fellow Member said this afternoon that he did not agree with my attitude, that he thought the matter should be left to the individual, but the matter cannot be left to the individual, contrary to the belief of many people. No doubt many families in this country have some hereditary taint, but they do not want to be prevented from marrying. If people are in an institution they do not want to think that they may never return to live with their families.

All that we ask is that, by their own voluntary action, and with the advice and consent of their medical advisers, they may have sterilisation, so that they can lead a normal life without feeling that they run the risk of bringing into the world children who will suffer as defective children do now. I hope that the Minister of Health, who is well aware of the terrible sufferings caused by mental disease, and who has been renowned for his forward action in dealing with health problems, will not be frightened at the opposition which he may get from people with points of view like that of the hon. Member for the Scotland Division of Liverpool. I hope also that he will give us a lead this afternoon and that the coping-stone of his great work at the Ministry of Health may be action which will make it possible for mentally deficient people, and those suffering from mental diseases, to have a small operation done to them voluntarily, with the advice of doctors. It is not very much to ask, and I hope that we shall have a favourable answer from the Minister.

5.47 p.m.

I did not intend to intervene in this Debate, and I propose to speak only for a short time. The speech of my hon. Friend the Member for the Scotland Division of Liverpool (Mr. Logan) made me feel it necessary to say a few words. So excellent a case was made out by the Mover and Seconder of this proposal, and by my hon. Friend who supported it, that very little more needs to be said about its merits, but the speech of the hon. Member for the Scotland Division, coming from the Labour Benches, might give a false impression. It might give the impression tha the Labour movement as a whole supports the obscurantist and reactionary attitude taken up by him, whereas, in point of fact, the Labour movement as a whole is strongly in favour of the proposal. The very representative conference of Labour women which has gone into this matter thoroughly, passed a resolution in favour of this project by an overwhelming majority. That opinion of Labour women accurately reflects, I think, the opinion of Labour men.

Let us be under no misapprehension on that point, but the point that I wish to deal with in particular is the claim of my hon. Friend to impose the authority of the Roman Catholic Church upon the British people. In tearing a passion to tatters in the way that he did, he was taking up an altogether mistaken attitude. We are not asking members of the Roman Catholic Church to obey any other law than that of their church. If they feel that sterilisation, divorce and birth control are contrary to faith and morals, by all means let them leave the accursed things alone, but let them have the decency and the toleration to allow other people who want to make use of those things have the freedom which they claim for themselves. This is an entirely voluntary proposal, and we do not want any one to be subjected to it who is not freely willing to have the operation performed. My hon. Friend made the suggestion that people who did not know what they were undergoing would be subjected to the operation, but I can give him a very long and impressive list of representative associations, technical and other, which support the proposal. That ought to be sufficient safeguard against the suggestion that people will have the operation who ought not to do so.

In the list to which I referred are the Royal College of Surgeons, the Royal College of Physicians, the Association of County Medical Officers of Health, the Society of Medical Officers of Health and the Central Association for Mental Welfare. There is a long list of extremely representative and very well-qualified persons, who are fully in support of the proposal. I back up the appeal made to the Minister by the hon. and gallant Gentlemen opposite not to be timid in approaching the question. I remember the unnecessary timidity exhibited years ago by the Ministry of Health on the question of birth control, when Government action in the matter was proposed. It has been proved by experience that public opinion was behind that movement. To-day, in a modified form, the Ministry of Health supports the policy of giving birth control information to women who want it.

Although I am a Labour Member, I hope there is no misconception or wrong statement. There is no truth, as I understand the position, in the statement just made by my hon. Friend, that there is any countenance from the Ministry of Health. I should like to know whether that is not the case.

All I can say is that all over the country—I do not know the number, but I should think there are hundreds—are clinics which have been established by municipal authorities and which are giving, among other things, information with regard to birth control, and they are doing so with the approval of the Ministry of Health. If that is not a justification for my statement I should like to know what is. The hon. Member who moved the Amendment said that the Roman Catholic Church had never stood in the way of progress. I shall not differentiate between churches, but I join issue with him on that statement. The record of history will show that churches have been standing in the way of progress all along the line. If we consider our laws, what I would call ecclesiastical domination has left an evil mark upon many of them. There are the marriage laws, which are known to be archaic and mediaeval in their conception, but every attempt to change them is opposed steadily and with the utmost bitterness and virulence by the churches to-day. There is the question of birth control; that also has been opposed with the same unscrupulous bitterness by the churches. I might give other instances. About a century ago, thanks to the discoveries of scientific men, it was found that the sufferings and agony of women in childbirth might be mitigated by the use of anaesthetics but we find, even on that proposal, we have the churches in bitter opposition against it. Time went on, and they gave way. They have largely given way on birth control and are giving way, to some extent, on divorce. With a little courage on the part of the Minister of Health they will give way on this matter of sterilisation.

I would emphasise what has been said about the class nature of this issue. If people with money, men or women, feel that they want to be sterilised because they are going to bring unwanted children into the world, they can go to private practitioners and get it done without let or hindrance, but poor people, who may have an overwhelming case for having the thing done, may go to hospital after hospital, and panel doctor after panel doctor, but there is never a chance of their getting the operation performed. That is an entirely unjustifiable class distinction. I hope that the Minister will therefore see the necessity of taking action in this matter.

We are discussing to-day the standard of health and fitness of the nation—very desirable objects. We want to see this nation a body of fit men and women, as far as is humanly possible, and we are talking of measures for bringing that about. Whether they will be adequate I do not propose to say at the moment, but that is our ideal. We want to get a fit nation, and an overwhelming argument can be produced by medical men for dealing with a situation which is lowering the physical and mental health of the nation. It is incumbent upon the Ministry of Health to use the power which it undoubtedly possesses to take action which will enable us to improve the national health and to get rid of this particular evil.

5.53 p.m.

I support the Amendment which has been so admirably moved by my hon. and gallant Friend. The hon. Member for the Scotland Division (Mr. Logan) posed the dilemma that if people were in possession of their faculties they would not be sterilised, and if they were not in possession of their faculties they would not understand the meaning of sterilisation. I would point out to him that that has not been proved to be the case in California, where a great advance has been made in the matter.

May I remind the hon. and gallant Gentleman that the Mover, when he put forward his proposal, itemised those two points about those that would and those that would not apply? In any case it was a question of abuse which was likely to arise.

Perhaps the hon. Gentleman does not appreciate all that my hon. and gallant Friend said. The point is that the dilemma is not a correct one, as we are able to prove from the example of California, where they have gone a long way in this direction. There, where there are defectives in an institution, the doctors in charge of the institution are often asked by the defectives how soon they can have their operation so that they can he sent out. They are not in possession of their faculties, they are apparently non compos mentis, and yet they apply for the operation. Again, even if it is not certain that every child of a mentally defective parent would be defective, yet such a parent is totally unfitted to bring up a child, whether that child be normal or defective. If the child were normal and were brought up by a defective parent, I agree that it is a heartbreaking situation. Such a parent is quite unfit to bring up any child, normal or otherwise, whether from a moral, material or physical point of view, and it is most undesirable that they should have to do so.

Again, where one or both of the parents are mentally defective, if they live in a block of flats or in any small community it is possible for them to become a sort of plague spot. However sorry we may be for the individuals, such a family must have a demoralising effect on the children of other families. In my own county of Hampshire, in 1935, there were just over 2,500 mental defectives under supervision of some sort. Of these, only just over 900 were actually in institutions; the rest were living quite free of all restraint. They included a large number of men and women of an age to have children, even after making allowance for those who were too old or too young, and actually three men and TO women who were known to be mental defectives got married in that year. It is not good for man to dwell alone, and I do not wish to deprive this unfortunate class of any of the happiness that they may be able to get in this way, but I do not wish to see their numbers increased if it can be avoided, and I think the State should do everything it can to help and enable them to think for the good both of themselves and of the State.

With a potentially falling population and a low birth-rate, it is a matter of great importance to the State to keep the proportion of low-grade minds among its citizens as small as possible, but, almost from the very nature of their disease, it follows that these people will not, in matters sexual, exercise any self-restraint any self-denial, any moderation of any sort. Therefore, they are likely to have large families, and these are the only large families which the coming years are likely to see. There is a chance that some at any rate of these unfortunate people might be persuaded of the great wrong they are doing by risking the passing on of their own defects, and might consent to voluntary sterilisation, and, therefore, I support the Amendment with all my heart.

It is sometimes said that legislation on this matter must await the de- velopment of public knowledge and demand, and I think that this Debate will do good in that way, but I venture to suggest that an announcement by the Government that they are giving further consideration to the report of the Committee on Voluntary Sterilisation would arouse interest and stimulate knowledge, and that eventually the legalisation of the operation on a voluntary basis would be the best possible way of bringing the benefits to be obtained by it to the knowledge of the country.

6.5 p.m.

We heard, from the hon. and gallant Member who opened the Debate, with that skill and learning which we recognise whenever he gets up, the observation that there was still need for further research, and, while that was not the general burden of his speech, it is in a sense the burden of the somewhat unworthy speech with which I will not detain the House very long. Attractive, and almost overwhelming in some ways, as the arguments for the Amendment appear, as arguments nearly always do when they are in favour of a proposition for a purely voluntary reform, I and some others feel that this is a very fundamental step to propose, and that further research is really the proper course. We are not, even now, any too sure how far mental defects are hereditary or transmissible. There are informed and scientific observers who say that 50 per cent. of the defects commonly attributed to heredity are not so due, and we do not know how far environment can really either create, on the one hand, or cure, or at any rate alleviate mental defects, on the other. One thing of which we can be quite sure is that it is no use simply getting rid of a certain number of potential mental defectives in the next generation if at the same time we leave virtually untouched all the evils of environment that are bound to create further mental defectives.

The hon. and gallant Member for Thornbury (Captain Gunston) suggested that progress with slum clearance had not diminished the statistics of mental defectives, and that, therefore, one could not look for very much help in that direction; but I think that perhaps he was speaking a little too quickly, because no one would suggest that slum clearance has yet proceeded far enough to produce any substantial effect on people most of whom, at any rate, are still young. And, of course, it is not only slum clearance that we want, but nutrition and many other things as well as better housing. Not very much has been said on either side of the discussion about the experience in the United States. Certainly it provides some argument, but I understand that on the whole the results so far from those of the United States that have seriously applied voluntary sterilisation have been a little disappointing from a statistical point of view. The results in Germany, I hope it is fair to say, really ought to be ruled out entirely, because in the first place they have not been going very long, and, secondly, they are obviously administered with such bad motives and such reckless disregard of decency that it would not be fair even to use them as an illustration of the abuses that might result in a civilised country.

A good deal has been said about the difficulty of talking about voluntary sterilisation when what is the matter with the defectives is that they have not much voluntas, or volition, or whatever one might call it. I respectfully agree with the hon. and gallant Member for the New Forest and Christchurch (Major Mills) that that is nothing like a complete dilemma, but I do think there is something in it. As I understand it there is a large number of people coming within the classes recommended in the Brock Report who have, at any rate frequently, if not always, sufficient mentality to make up their minds with at any rate sufficient intelligence to form a real resolution, and those people, at any rate, can arrive at a true voluntary decision. I remember an interesting case, some 20 or 25 years ago, of a Noble Lord whose mentality on close inquiry was found to be sufficiently good to allow him to go to another place, but not sufficiently good to enable him to look after his property, and he might perhaps have had some difficulty in arriving at a proper consent to his own sterilisation. But, after all, one Noble Lord does not make a summer.

One difficulty which I regard as possible in connection with the proper exercise of a voluntary will in the matter is of a type that is familiar to a number of us in cases where people make voluntary confessions, or do other voluntary things, under strong pressure. There will be hundreds of people in this situation who can really arrive at a decision by the use of their own will, but who will be much more easily brought to a decision by the not wholly unreasonable urgings and persuasions that may be brought to bear upon them. I do not suggest that it covers the whole field, but it is a matter for some little anxiety. Of course, when a man or woman is told that they can be given their discharge from a mental home of one kind or another—which, if it is good, is still a prison, and if it is bad is something too dreadful to think about—if they voluntarily submit to sterilisation, it may sometimes be a good thing to put before them, but it is an abuse of language to say that the decision arrived at in circumstances of that kind is really a voluntary decision in any full sense of the term. In all the circumstances I suggest that, attractive as the arguments are, and cogent as the point is, all that is being asked for is that people shall be at liberty to make a voluntary decision about some part of their own destiny, and that the matter should be very carefully looked into.

6.13 p.m.

In the brief observations that I desire to make, I would first like to congratulate the Mover of this Amendment, my hon. and gallant Friend the Member for Wellingborough (Wing-Commander James) on his statement of his case. I think that anyone who reads it to-morrow will agree with me that it is one of the best presentments of the case that we have heard; and it has been ably seconded by the right hon. Gentleman the Member for North Cornwall (Sir F. Acland). I think that very likely the object of my hon. and gallant Friend in moving the Amendment is to call the attention of the House and the country to this matter, and that all that he is asking—I do not think our procedure permits anything further—is that the Government should give further consideration to this question. It may well be that he and his friends may at some later date do what I do not think has yet been done, and that is to test the opinion of the House on a matter of this kind, which, I may say, raises other questions besides that of health, including, perhaps, matters of conscience and religious conviction.

I would like to make one or two observations on what has been said this afternoon from the point of view of my Department and my own official position. An allegation has been made that there has been an increase in the number of defectives in this country. Of course it should be borne in mind by the House that the number of defectives under care increases as the general population increases, and as the local authorities become more efficient in ascertaining the existence of defectives, but I think it can be said with authority that there is no proof that the incidence of mental deficiency in this country is rising. Reference has also been made to what has been done by other countries with regard to sterilization, and I would like to assure my hon. and gallant Friend and the House that of course my Department and the Board of Control keep themselves, as the House would expect them to do, fully informed of the progress made under foreign statutes; but I would remind the House that this legislation in many other countries is comparatively new, and I think it can be said with accuracy and truth that, at any rate up to the present time, no results of significance can yet be assessed. For instance, a system of voluntary sterilisation was approved in Norway, and also in Sweden, in 1935. Germany brought in a compulsory system of sterilisation in 1933. Although Denmark began a system, as regards a limited class, in 1929, again no useful lessons can in fact be learned from it. The hon. Member will appreciate the importance, apart from the merits of the case of taking public opinion wholly with you. Sterilisation laws are in operation in several of the United States but, in some, little use has been made of them. In certain cases the laws appears to have been enacted without any money being provided to work them, but the real explanation of failure in other cases is probably that the enthusiasm of small groups secured the passage of legislation for which there was no general demand and no sufficient backing of public opinion.

One or two hon. Members, perhaps unconsciously have let fall observations which would lead one to think that perhaps in certain cases the treatment of people who unhappily suffer from this terrible disease is—I think one expression used was "very horrible." I should very much like anyone who comes across a case of that kind to give me information at once. I share the view of a good many people of what a terrible tragedy it is and what it must mean to people who have to be dealt with in this way. But I must testify to the increasing provision, care, forethought and kindness that are displayed in these institutions. I should not like it to go out that there was anything else but the utmost consideration shown and large sums of money spent in order to see that reasonable care and treatment are given. I was asked whether the Government, and my Department, and the Board of Control, were taking further steps, which I still think are necessary in the matter and which may help those who support this campaign, in connection with research. Undoubtedly a great deal has been done, as I think the House would desire. For instance, only in 1934, in consultation with the Board of Control, the Medical Research Council appointed a new committee to advise and assist them in promoting research into mental disorders. Another committee of equal importance has also been appointed by the Medical Research Council, a committee on human genetics, because in spite of the advances made in the biological study of heredity and the application of the results it was felt that the study of human genetics had been relatively neglected. Under the aegis of this latter committee some very interesting researches are now taking place at the Royal Eastern Counties Institution at Colchester by Dr. Penrose and his colleagues, and an important examination of the hereditary characteristics in the blood of mental defectives and their families is now being made by Professor Fisher and Dr. Taylor of the Galion Laboratory, University College, London. This work is being assisted by grants from the Rockefeller Foundation. Dr. Slater at the Maudsley Hospital, London, is also working on a large-scale field of inquiry into certain different types of mental disorder amongst twins. Other work is also being carried on, so that my hon. Friend will see that this aspect of the question is not being neglected by the Government.

Can my right hon. Friend give an assurance that any funds needed for research would also be forthcoming from the Government?

That would be a very bold undertaking to give without consultation with the Chancellor of the Exchequer, but, if a question of money arose which I thought was important, I should not hesitate to take it to the Chancellor of the Exchequer. I can say from my knowledge of many years now in connection with health work that there is no doubt that opinion is growing in favour of sterilisation. When I came back to the Ministry after an absence of some time I saw the record of a deputation from the County Councils Association and the Association of Municipal Corporations in 1935. They represent a large body of people discharging responsible duties in a wide field of public and social work. It would have astonished a great many people if such a deputation had taken place only two or three years before. But we cannot disguise from ourselves the fact that opposition still remains and there is much conflict of opinion, particularly on religious grounds. The medical profession are by no means unanimous on the matter. If you ask even the medical men that one knows in one's private circle, there is not a great deal of unanimity of opinion. Resolutions of certain learned Colleges have been quoted but I very much question whether you would get anything like unanimity from the British Medical Association.

Is it not a fact that on most matters you cannot get unanimity in the medical profession?

There are always small minorities, and one deals with them as best one can, but there will be found, I think, in the British Medical Association a pretty steady and strong view on most medical matters of the day. I am endeavouring to put fairly the other side of the matter and I doubt very much whether you would get such a strong vote as would justify a Bill being promoted at this moment. I think it is desirable that ample time should be given for consideration and to get public opinion developed as I believe it is developing, so that whatever action may be taken may follow generally the desires of the country and the dictates of the public conscience. We should be wise if we could gain their support. However, these investigations are taking place and, no doubt, as my hon. and gallant Friend pursues his advocacy the time will come when he will be able to test the opinion of the House and see whether the representatives of the constituencies are so strongly in favour of the matter. I hope my observations will be satisfactory to him as far as this afternoon is concerned, and I think a very useful purpose has been served by the Motion, and everyone will desire to congratulate and thank my hon. and gallant Friend for bringing this very important subject forward.

6.29 p.m.

Probably if a suggestion of this character were carried into effect I should be one of those who would be sterilised, because within recent months I have been mentally and physically afflicted. Therefore, on the terms of this proposition I should not be able to propagate my species—not that that would matter much to the general interests of the Empire. But I want to ask who are the people who are to be experimented upon voluntarily? I have been a member of a mental hospital committee for 33 years, and we have had experience of the kind of people who enter into those institutions and are supposed to be mentally unfit and physically incapable in many cases. I could take hon. Members to my institution and show them men of great ability, men who can do all sorts of things of an artistic character, yet they are mentally unfit, according to the doctors.

I do not know much about these psychological problems. You require to be a psychologist to understand them. I have heard our doctors explain how certain people have come into a certain condition. All sorts of troubles come into their lives. A man may have a row with his wife which may drive him off his head, and a woman may have a quarrel with her husband and become mentally defective, and, according to the proposition that has been made, as far as I understand—and I do not understand a very great deal—that man and that woman, in certain circumstances, could be voluntarily sterilised. Are you going to ask that man and that woman voluntarily to agree to become incapable of enjoying the ordinary conditions of life? I do not know what is meant by voluntary sterilisation. I think it means that you begin on a so-called voluntary scale, and you end up with compulsion. That is the way you will end—with compulsory sterilisation. Fancy Members of the Tory party wanting to sterilise us‡ If the Labour party come into power, as at sometime they will, we might want to sterilise them, because they will be mentally deficient.

This proposition may be coming from gentlemen who represent the Services. Do they imagine that the ordinary workers have no rights? How are you to decide who is to volunteer to be sterilised? Who is to settle it? What kind of board is to be established to settle whether a man or woman is to be sterilised and made incapable? Frankly, I would not trust any board to decide that matter. In view of my experience of 33 years as a member of a mental hospitals committee, I would not even trust the doctors, much as I respect them. They make mistakes, and if they did not make mistakes their lives would not be worth living. As to the attitude of the Government towards the Amendment, the Minister of Health is a very kind gentleman. He is like Caesar's wife, "All things to all men." He tries to oblige everybody, and he ends up by obliging nobody, generally speaking. Some of us are opposed to this proposition. We have got on very well without voluntary or other sterilisation. They have tried it in Germany, and what is the result? They have sterilised the whole population. They can say nothing but "Heil Hitler." A hundred Members of this House are to accept an invitation to go to Germany and "Heil Hitler." They are going round Germany. What for? To become part and parcel of the machine. [An HON. MEMBER: "What about the right hon. Member for Bow and Bromley (Mr. Lansbury)?"] I do not care what the right hon. Member might say; it does not interest me. If he can convert Hitler I shall be glad, but I am afraid that it is he who will be converted.

There is no such thing as voluntary sterilisation. If you are to have sterilisation it must be compulsory, because the only people who will suffer as a result of voluntary sterilisation are those who cannot help themselves. They will be put away by other people. I know that voluntary inmates of a mental hospital with which I am connected are not always there by their own volition, but because their relations have put them there. They have not the sense to be able to say whether they should or should not go. What is it proposed to do with voluntary sterilisation? Are persons who are mentally and physically unfit to be asked to go into an institution to be treated or not? If they are, you will not get the answer that you want. It means that compulsion will be enforced upon people who are not capable of resisting, and, speaking for myself, and for other hon. Members, we are opposed to the system of so-called voluntary sterilisation.

Owing to the nature of the reply of the Minister of Health, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Question again proposed, "That Mr. Speaker do now leave the Chair."