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Commons Chamber

Volume 43: debated on Wednesday 27 June 1838

House of Commons

Wednesday, June 27, 1838

Minutes

Petitions presented. By Mr. F. FRENCH, from Medical Practitioners in Galway, and by Mr. YOUNG, from those of Cavan, and of Belturbet, in favour of the Medical Charities (Ireland) Bill.—By Mr. SHAW, from the Apothecaries of Dublin, and from the Surgeons of the Lying-in-Hospital, Dublin, against the Qualification Clauses of the same Bill.—By Mr. HAWES, from Coach and Omnibus Proprietors, against that Clause of the Hackney Carriages Bill which required the Drivers to wear a Badge.—By Colonel LOWTHER, from a place in Westmoreland, against any further Grant to the College of Maynooth.—By Mr. GROTE, from Proprietors and Managers of Steam Vessels in London, against various Clauses of the Bill for the regulation of the Delivery of Coals in the Metropolis.

Messrs. Praed and Bulwer

said, it is my duty to acquaint the hon. and learned Member for Aylesbury (Mr. Praed), that he was required to attend in his place to-day in consequence of the statement which was made last night by several Members of the House, that they were under apprehensions that the hon. and learned Member had left the House last night with the intention of taking hostile proceedings for expressions used in the course of debate by the hon. Member for Lincoln. How far those apprehensions are correct it is for the hon. and learned Member for Aylesbury now to state.

said, that he was not responsible for the introduction of irrelevant matter into the discussion of last night, neither would he to-day be responsible for continuing the discussion to which he alluded. He had said nothing which could in the slightest degree offend the nicest sense of honour in any individual Member of the House, and he would go further, and say, that he had meant nothing offensive. He had, therefore, nothing to retract as to any thing be had said; neither had he used one word which could be impugned by any of the orders of the House, and therefore he had no apology to make to the House; but he knew perfectly well that the House was entitled to call upon him, not for an apology or excuse for any offence of which others had been guilty, but for an explicit statement of his intentions as to his future conduct in reference to this matter. Without going, therefore, into the cause which led to the course of conduct he had pursued, he would frankly avow to the House, that on leaving it last night, he had felt it due to that regard for his character for honour and veracity, without which he should be ashamed to sit in that House, to place his honour and his character in the hands of a friend. That friend sought au immediate interview with the hon. Member for Lincoln, but was unable to obtain it until midnight, and then his friend, before any message was delivered on his (Mr. Praed's) part, learned from the hon. Member for Lincoln the steps which the House had taken. On hearing them, his friend had stated on his behalf, that in that case be had no message to deliver and no duty to perform. He would only further state to the House, that his own views were perfectly in accordance with those of the friend in whose hands he had placed his honour, that he had no disposition to struggle with the powers possessed by the House. Under these circumstances, believing that he had done what he could, and was bound to do in vindication of his character and his honour, he now pledged himself to the House, without any reservation, that he should take no further steps in the matter.

said, that as the hon. and learned Gentleman opposite stated that he had not intended to say anything calculated to wound the feelings of any individual possessing the nicest sense of honour, so he was bound to say, that in the observations he had last night made, there was nothing intended to excite the indignant feelings of the hon. and learned Gentleman. Since he had sat in the House he had never before been even suspected of wounding the feelings of any hon. Member, and it would give him pain to fancy he had wounded the feelings of the hon. and learned Gentleman. He knew of no retractation he could make beyond the general expression of regret and pain that he had innocently been the cause of wounding, the feelings of the hon. and learned Gentleman, and of occupying the time of the House by the discussion which had followed.

said, that having called the attention of the House to this matter with a view of preventing the consequences that might ensue, he felt bound to say, that he hoped the House would consider that the declarations made by the two hon. Gentlemen were satisfactory, and that there was no reason for either of those gentlemen supposing that his honour was wounded by what had taken place. He was of opinion that neither the House nor the hon. Gentlemen themselves had a right now to consider this matter as otherwise than as satisfactorily settled.

Subject dropped.

Steam Navigation

wished to impress on her Majesty's Government the importance of its attention being directed to the accidents which were now constantly taking place in steam-vessels, and which went to create in the public mind a strong prejudice against those modes of conveyance. He thought it would be well if the Government was to appoint some person connected with the Ordnance Department to inquire and report upon the causes of the accidents by the explosion of steam-boats, and at the same time to establish friendly communications both with the authorities in the United States and in Paris, with a view to ascertain the causes of similar accidents in those countries. It did appear to him that the result of those communications and inquiries might possibly lead to a great saving of human life, and to effectual precautions against the occurrence of similar accidents. On looking at the American papers, he found that these accidents were now much more frequent than they were four or five years ago, and he feared that in this country the same was the case, and he repeated, that he thought by an interchange of information as to the cause of these accidents between this and other countries much useful matter might be acquired, and the interests of humanity thereby greatly served. He did not mean to advise the Government to take upon itself the responsibility of appointing a board of officers to examine into the con- struction of steam-ships, and to prevent the use of any engines except of a particular construction and under certain regulations, but when accidents had occurred, he thought there ought to be a careful examination into the cause, and a detail furnished as a warning for the future.

concurred with the right hon. Baronet, the Member for Tamworth, as to the impolicy of a board merely to give opinions upon the construction of steam-boats. Such a course would be neither wise nor prudent.

denied, that accidents by steam-vessels had increased of late years; on the contrary, he believed the security of the steam navigation had been greatly increased.

Subject dropped.

The order of the day read for the further consideration of the report upon the Medical Charities (Ireland) Bill.

Medical Charities (Ireland)

said, the medical charities in Ireland were in number between 600 and 700; that 175,000l. a year was annually levied for their maintenance, and upwards of 1,500,000 persons were yearly relieved by them; that after deducting those relieved by the infirmaries, fever hospitals, and lunatic asylums—institutions to the efficient management of which he bore testimony, upwards of 1,000,000 of sick persons were found depending exclusively on the dispensaries; that the funds of these institutions were mismanaged, and that there was no professional education required by law for the person or persons who were to discharge the medical duties of these charities; that there were numerous instances of their offices being filled by persons who had not any licence to practise in medicine, in surgery, or in pharmacy. It was needless to tell the House, that in the poorer districts it was impossible to obtain these subscriptions, and the consequence was, that many most populous districts of ten and twelve miles square were without any medical establishment whatsoever, nowhere was there a power to enlarge them according to the necessary wants of the people, nor for supplying any deficiency of funds which might arise from casual circumstances. In the parts of Ireland where dispensaries were most numerous, they were still not proportionate to the necessities of the population. The county of Down, with a population of 352,571 persons, had but one medical institution for every 35,000 souls; Galway, with a population of near 400,000, had one to 28,000; Monaghan, with a population of 195,532, one to 24,000; Leitrim, with a population of 144,303, one to 28,000; Longford, one to 27,000; Antrim, Fermanagh, and Carlow, about one to 21,000; and at the time the medical reports were published, Mayo, with a population of 400,000, had but one medical establishment in the county. He alluded to these facts for his own justification, as the reasons which induced him to propose vesting in the Lord-lieutenant the power of ordering the establishment of new hospitals and dispensaries. A considerable number of the dispensaries were attended by non-resident men, many of whom lived at such distances from their districts as to make the proper discharge of their duties a matter of physical impossibility—certainly, to render them of no earthly service in cases where prompt attendance was essential. There were numerous instances where the administration of three or four dispensaries was confided to the same person. He considered the medical officers ought to be prohibited from belonging to more than one of these institutions at the same time; for if they visited the poor at their own dwellings, their duties, properly discharged, would be extremely onerous. Lest it should appear to the House he was overstating the case, he would refer the House to the report of Sir David Barry and Dr. Currey, to show how fully borne out he was in everything he had said. The hon. Member quoted the 26th and 27th pages of their report. They state, the qualificacations requisite to entitle a person to be elected medical attendant to a dispensary are not defined by law; the acts for establishing these charities contain no clauses relative to this important point; consequently, persons who have no diploma whatever, or are at best but students, are found in charge of dispensaries, and have confided to them a large number of poor, who are unable to apply for advice to any other quarter; they give instances where the medical officer is well paid, has a large district, and yet lives in a town several miles distant, where he keeps his dispensary drugs, often placed promiscuously with his own; sees what poor he likes, and pursues his private practice, the nearest point of his district being five or six miles, and the furthest fifteen or twenty miles. Both Sir D. Barry and Dr. Currey came to the conclusion, that without regular superintendence, no plan can succeed, and to the want of it they attribute entirely the deficiency of the present system. They report the rooms in which the medicines are kept to be generally the sole department belonging to the dispensary, in some cases sufficiently large and well aired, but too frequently presenting the most slovenly appearance; medicines were found spoiling in damp paper, or evaporating from unstopped bottles; drugs of a powerful kind were seen in bottles not labelled, or, what was worse, with wrong labels. In more than one instance no measure, weight, or scale, could be found on the premises; instruments for the more important surgical operations were seldom to be met with at dispensaries, and still less frequently were the property of the charity. The hon. Member also quoted the 16th page of the general report to confirm these statements. He would put it to the House, did not both justice and humanity call for an alteration in this system? At all times and in every country a number of persons would be found who were unable to furnish themselves with professional assistance during illness. In this rich country it was the case; a vast number of persons in England depended on the hospitals and dispensaries for medicine and advice. In London alone upwards of 250,000 persons were annually relieved by them. In Ireland, suffering under periodical disease and famine, where contagious fever constantly existed, where the habits of the people were such as to favour the origin and extension of contagion amongst the poor, the indispensable necessity of these institutions and their proper management must be apparent, and the fact is well authenticated, that wherever fever hospitals had been established, their beneficial effects were immediately perceptible, not only in checking disease, but in rendering it of a much milder nature. To show how liable to fever the peasantry of Ireland were, from the pernicious influence of their wretched habitations, scanty clothing, and miserable diet, he should refer to a pamphlet published by authority by Drs. Barker and Cheyne, which showed that in the short space of two years and a half, while typhus fever was raging in that country, 1,500,000 persons, nearly one-fourth of the population, were attacked by it, of whom 65,000 died; he found on an average of the years when no particular disorder was prevalent in Dublin, 135,000 persons, more than half the population of that city, were relieved by the hospitals and dispensaries. With all her necessities, he would beg of them to mark the contrast between Ireland and England in point of hospital accommodation. England had hospital accommodation for 1 in 1,911 of her population, Ireland but for 1 in 4,000. In her provisional infirmities England had one bed for every 2,543, all of which were usually occupied, Ireland but for one in every 5,827. More than two-thirds of the population of that country was at such distances from the infirmaries, that the most serious medical and surgical cases could not bear removal, or if removed, could not be admitted for want of room; even in the infirmaries, institutions he admitted to be well managed, he found in the returns, things he could not understand the reason of. Some infirmaries admitted in the year cases in the proportion of fourteen and a fraction to each bed, others from ten to twelve, and some not more than two and a fraction; the average cost for provisions for each internal patient, was in Londonderry 3l. 0s. 7d.; in Donegal 2l. 12s. 2d.; in Meath 11s. 11½d.; in Cork, at Mallow, 10s. 3½ and in Louth but 9s. 4½d. For the total cost in one hospital, the average was as high as 5l. 6s. 10d., in another as low as 1l. 10s. 4d. This extraordinary disparity could only be understood and explained by medical men, without whose assistance, as inspectors, it was vain to hope the medical institutions of the country could be rendered efficient, or that the public could understand why one particular hospital, or one particular system, was more effective than another. The hon. Member concluded by describing the provisions of the bill, and by saying, it was not the cause of the College of Surgeons, it was the cause of the most helpless class of the community—the destitute sick poor in Ireland, and as such he left the bill with confidence in the hands of the House.

objected to the qualification clauses of the bill, which he considered as offering only a nominal, and not a real, security for better medical education, and they were opposed by various departments of the medical profession in Ireland. The objection, as he collected, to the qualification clauses and schedule was, that it vested in the College of Surgeons a power of acting also as a College of Physicians, accoucheurs, and apothecaries, recognizing by statute an examination in medicine, phar- macy, and midwifery by the College of Surgeons, as of equal value with that of the various distinct departments, and, no doubt, it would then be easier and cheaper to get one diploma in medicine, surgery, pharmacy, and midwifery jointly, than separate diplomas from the bodies which now qualified distinctly in those various branches. No one held the College of Surgeons at Dublin in higher estimation than he; still he could not on that account consent to favouring them by statute to the prejudice of the other medical bodies. He did not think a bill for regulating medical charities merely, was the proper mode to legislate upon the important and very difficult subject of medical education, and that it was better not to attempt legislation at all on such a subject, than to do it imperfectly. He did not pretend to a full personal knowledge of this difficult and intricate question; but when the heads of the four great medical bodies objected to the bill in its present form, it was absurd to suppose it could become a law in the present session: but let those clauses relating to medical education be omitted, and he would not object to the remainder of the bill, which would be then a bill, in pursuance of the avowed object of the present, for the better regulation of medical charities in Ireland.

was extremely concerned to think, that the same unanimity should not prevail amongst the members of the medical profession in Ireland as, he was happy to say, existed in Scotland. He should deeply regret that, because some medical bodies were dissatisfied with the bill, it should therefore be lost. But the principle which was laid down in the bill both with regard to medical education and medical practice would, he trusted, be adopted, if not in the present, at least in some future session, as the foundation of some general measure for the United Kingdom.

opposed the bill, against which every chartered medical body in Dublin was arrayed in opposition, with the single exception of the College of Surgeons. He had also in his hand a statement hostile to the bill, which was signed by all the most eminent medical practitioners of Dublin.

observed, that the bill contained so many objectionable clauses that he apprehended it would be useless to attempt to alter it in Committee so as to render it acceptable. He objected, for instance to the power given to the Lord-lieutenant of appointing additional governors to the medical charities of Ireland, if the number should fall short of that required by the bill. At this period of the session he did not think, that this bill ought to be proceeded with, there being so many objections to it; and he would suggest to his hon. Friend, the propriety of withdraw-it for the present, and bringing it forward in a different shape next session.

also hoped the hon. Gentleman would not press the bill this session. There were two considerations which ought to weigh with him in postponing it. First, instead of being in the hands of any individual, however respectable, it was a portion of the duty of the Government to take such a measure into their own hands. Secondly, they were at the beginning of a new experiment—that of the poor-law, a question which had been hitherto unknown in Ireland. Those charities, which for the greater part were voluntary, were instituted by gentlemen in Ireland, because there was no poor-law. They were now about to have a poor-law. They would consequently know next year what they could not know now; in all probability the whole question would be then essentially different, and he would therefore urge upon his hon. Friend, to whom the House was greatly indebted, the necessity of withdrawing it for the present.

said, that he could not agree to the bill in its present shape, and thought his hon. Friend could withdraw it, without at all compromising its principle. He was sure until a system of superintendence of the medical charities was established, there would continue to be the same waste of the public funds.

Bill withdrawn.