HC Deb 19 July 1859 vol 155 cc12-26

Order for Third Reading read.

MR. LOWE,

in rising to move the third reading of this Bill, said, that the manner in which this Bill came before the House was in this wise. When the Central Board of Health was abolished the compulsory powers possessed by that Board fell with it, and the care of the public health was committed to the local boards. He did not regret that, for he thought it would be wrong to involve measures that were in themselves just and reasonable, under a load of general unpopularity. The Central Board, however, possessed certain powers that could not be given to local boards, and the question was whether these powers should be extinguished or vested in the Privy Council. The latter alternative had been adopted, and the Act of Parliament, which had been passed for one year, would expire in a few days. The object of the present Bill was to make these powers perpetual; but he did not propose to vest in the Privy Council any compulsory powers of general or perpetual efficacy. By the Diseases Prevention Act of 1855 certain powers were given to the Central Board of Health, to be exercised at periods when epidemics of a violent nature were prevalent. So necessary were these powers that in 1831, when the cholera broke out, and before legislation had provided for similar occurrences, the Committee of Privy Council felt bound to put in exercise the prerogative powers of the Crown, whatever they might be, and took a great many steps of an arbitrary character which were acquiesced in by the public as tending to the preservation of the public health. The principal powers conferred by the Diseases Prevention Act were that a visitation from house to house might be ordered, that provision was made for the speedy interment of the dead, and for the distribution of medicine among the poor. It was impossible to vest these powers in a merely local authority, and it would be rendering a service to the local boards themseves to place these powers in some central body, which, from its position and knowledge, might be able to exercise them for the benefit of the public, and exercise them in moments of consternation and terror. The second power proposed to be conferred by this Bill was a power of making regulations with regard to the qualification of those persons with whom the Poor-Law Board were empowered to contract for vaccination. This power was desirable on behalf of those who were to be vaccinated, who had an interest in the competency of the vaccinators. This, however, was a clause of regulation, and not of compulsion. The third power given under the Bill would enable the Privy Council to inspect localities alleged to be unhealthy, and make a report through their Medical Officer of the state of the district, which should be laid upon the table of the House. If the local Boards were left without instruction and stimulus, there was too much reason to suppose that the experiment of local government would fail in this respect, as in many others. Of course, the function of reporting upon unhealthy localities could not be performed by a lay body like the Privy Council, but would be carried on by their Medical Officer, Mr. Simon, whose high qualifications and experience need not be dilated on. He might be permitted to mention, however, that that gentleman had given up an income at least as great as that he would receive from the country, and he had also given up prospects second to none that could be enjoyed in the profession. There was another clause to which many hon. Members felt great objection, and which enabled vaccinators and others to sue for penalties against those who had wilfully neglected or refused to comply with the Act regarding vaccination. The Bill enabled the persons so proceeding to pay for the expenses of prosecution out of the funds of the Poor-law union of the district. He (Mr. Lowe) was no friend to compulsory vaccination, but he hoped that the people would in time become willing to let their children be vaccinated. He thought the best means of bringing about so desirable a result, however, would be by providing plenty of wholesome lymph, and of skilful operators. He was willing to consent to the omission of this clause in the House of Lords if hon. Gentlemen so desired, and he trusted that they would accept it as a peace-offering and a concession. He had been recommended to continue this Bill for another year, but his sense of public duty did not permit him to make this further concession. He was quite satisfied that it was impossible for these powers to be fairly discharged by anybody who held them only upon sufferance. The powers he asked were not of a compulsory nature, and could the Privy Council act with any moral weight if they were told that Parliament would not intrust them with powers for more than a single year? It was not likely that an officer engaged in such duties as those which devolved upon the Medical Officer could discharge them with the same fearlessness as if he enjoyed a more permanent tenure. He did not ask for the Medical Officer of the Privy Council the immunity possessed by the Judges of the land, but he was an officer nevertheless who had to judge of questions affecting the lives of thousands, and it was not too much to ask that he should be surrounded with the same protection that other public officers possessed. He trusted that the House would consider how weighty this matter was. It was proved that not less than one quarter of the deaths occurred from diseases that were entirely preventable. If a single person met his death from a railway accident, Inspectors were sent down to inquire into the circumstances, and would they be less careful where the lives of thousands were concerned? While they were so jealous where mechanical agencies were concerned that they thought no trouble or expense too great, were they doing their duty to God or man if they did not take as much care to mitigate those subtle agencies that slew their thousands where mere mechanical agencies slew their units? He should not be doing his duty if he did not earnestly entreat them not to continue this year-by-year legislation, but to adopt a permanent measure, which by evincing the confidence of the House would obtain the confidence of the country.

Motion made and Question proposed, "That the Bill be now read the Third time."

MR. AYRTON

said the exceedingly temperate manner in which the right hon. Gentleman had moved the third reading had almost disarmed opposition; but he (Mr. Ayrton) was of opinion that any such measure as the present was quite unnecessary. He regretted, moreover, that the discussion on so important a measure was postponed to the third reading. His hon. Friend the Member for Finsbury, who had paid great attention to this subject, had assured him the perpetuation of the powers given by this Bill were unnecessary. The right hon. Gentleman had correctly stated the provisions of the Diseases Prevention Act; but that Act had, last year, been allowed to pass without deliberation, simply because it was a mere temporary measure which was to be seriously considered in the present Session. The powers given to the Privy Council with regard to epidemics, endemics, and contagious diseases, were of so large and extraordinary a character, that he could not conceive that Parliament would confer them permanently upon any body whatever. The Act provided that in the event of any "formidable" epidemic breaking out—that was a loose phrase— the Privy Council should have power to order, in the first place, the more speedy burial of the dead. That was inconvenient enough. In the next place, it might order house-to-house visitations. That was a very large power, and ought not to be exercised except under the direction of some body which had to pay for it. Again, it gave power to dispense medicines; but that was an object already sufficiently provided for by the Poor Law. Next came powers for guarding persons from contagion; a phrase under which anything in the world might be done. All these provisions, he it remembered, did not apply to epidemics only, but to endemics, which was a very different matter. Consumption was an endemic; for it was of the nature of an endemic that it should be a disease to which people were ordinarily liable. But the question arose who was to pay for all this? The Bill imposed the burden upon the local authorities, so that while it gave the Government power to interfere with all the regulations of life, it gave power likewise to throw the whole cost upon the local authorities. Would the House make such a state of things the ordinary rule? It was one thing to say that such powers should be given from year to year, and another thing to say that an Act giving such powers should be permanent. If the country were unfortunately threatened with another visitation of cholera, it would be quite enough if the Government and the House of Commons should deal with it when it came. With regard to vaccination, there were already very ample powers given to the Poor Law Board; and he did not see why, having already one expensive Board, they should give new powers to a department of the Privy Council to deal with the same subject. The Poor Law Board cost this country £200,000 a year, and he thought it would be much better to leave this subject entirely in the hands of that body. That part of the Act, therefore, appeared to him to be entirely unnecessary. With regard to the clause relating to investigations, he should not object to the Privy Council being invested with that power; but he should strongly object to having a new Department set up for that purpose. He should certainly have thought, after the precedent set in the Local Management Act, that it would have been better to confer the power in question upon the Secretary of State for the Home Department. He doubted very much whether there would really be work enough in making the proposed investigations to occupy one person's time; and it seemed to him, therefore, that this branch of the Act vanished with the two former, and that its existence was wholly unnecessary. Under these circumstances it would be better to let the existing Act expire by the efflux of time. As for the objection suggested by the right hon. Gentleman about the Privy Council exercising its sanitary powers, sub terrorem, he had only to say that he might just as well attempt to make the Mutiny Act permanent, and give up the system of maintaining the army from year to year. In truth, it was because the measure had hitherto been a temporary one that it had proved so innocuous. He therefore would beg leave to move that the vote for the third reading be discharged, in order that the Bill might be recommitted.

Amendment proposed,— To leave out from the word 'That,' to the end of the Question, in order to add the words, 'the Order for the Third Reading of the said Bill he discharged' instead thereof.

MR. W. WILLIAMS

said, that whatever might have been the justification for passing the Act in 1855, there was none for its renewal, as since the passing of the Metropolis Local Management Act, the most eminent members of the medical profession had been appointed to watch over the public health. Amongst them he might particularly instance Dr. Letheby, of the City of London. These gentlemen, he had been informed, had made arrangements for meeting in the event of an epidemic breaking out and suggesting precautionary measures, which would of course govern the whole country. The Bill, if passed, would involve an unnecessary expenditure of public money, and, instead of recommitting it, he thought it ought to be rejected at once. In Lambeth he was aware of one most eminent medical gentleman connected with the local Board who had only £400 a year, whereas this Bill proposed a permanent salary of £1,500 a year.

SIR GEORGE PECHELL

said, that for ten years hon. Members had been brought down to the House in the hottest part of the Session to discuss a Public Health Bill. He objected to this Bill, as he had done to previous Bills, as one which was satisfactory to no one. To perpetuate the existing Act without amending it would be absolute nonsense, because it depended entirely upon the working of the Local Management Act. It recited that Act in almost every page, and the whole question of penalties depended entirely upon the construction of the Local Management Act. In Worcester so strong was the objection to the introduction of the Act, that it was only after scouring the whole city and getting up all the old people, between 90 and 100 years of age, to vote for it, that at length they succeeded in introducing it. In other towns its provisions were considered so objectionable that it had not been introduced at all, and considering the monstrous power it placed in the hands of certain parties, he was decidedly of opinion that if it were necessary to enact it at all, they ought only to do so from year to year.

MR. HENLEY

said, he thought the Bill involved larger principles than the right hon. Gentleman who introduced it appeared to suppose. No one could demur to the objects of the Bill; namely, that in a time of epidemic, power should be conferred upon the Government to take all the means which science pointed out to mitigate the evil; but it was another matter when the House was asked to make perpetual an arrangement with new machinery and less safeguards than existed before. The system of house-to-house visitation was an invasion of the domestic privacy, but it could only be done heretofore under an order of the Privy Council, to which the Lord President or one of the Secretaries of State was a necessary party. That requirement gave the public confidence that the matter had been brought to the cognizance of the Cabinet, and that the vast machinery of the Act had not been improperly put in motion. But the fiat of the Vice President, which it was now proposed should be sufficient, would not give the same confidence, notwithstanding the great abilities of the right hon. Gentleman who now filled that office. Then, again, the House had not any experience of the working of the new system. The right hon. Gentleman had told them that the Privy Council had no special knowledge upon this subject, and could only be guided by the reports of their Medical Officer. That officer was undoubtedly a very competent gentleman, but he did not think it was satisfactory that the whole matter should rest with that gentleman. He would not have objected to the Act being continued for two or three years, in order that some idea of its working could be formed from actual experience; and he hoped the right hon. Gentleman would consent to limit the operation of this Bill to a certain time instead of making it perpetual.

MR. T. S. DUNCOMBE

observed, that if the right hon. Gentleman would consent to limit the Bill to one year, it would be unnecessary to continue the discussion. [Mr. LOWE made a gesture of refusal.] In that case he hoped the House would agree with the right hon. Gentleman who last spoke, and would support a limitation of time in respect to the Bill. As the matter stood now, it appeared to him that a grosser attempt at jobbery, or a grosser violation of good faith towards that House had never been attempted by any public department. It must not be thought, that because two or three metropolitan members had spoken, that the metropolis had any special interest in the matter. In 1848 a Public Health Act was passed for five years, which Mr. E. Chadwick administered at a salary of £1,000 a year. That Bill did a great deal of good, but after a time Lord Llanover thought fit to commence an attack upon it; and of course the Government was a good deal puzzled. They asked the noble Lord if he would undertake the thing himself, and he consented. Accordingly he was appointed to the head of a new department, with a salary of £2,000 per annum, and the Act was continued from year to year, until 1855. The President of the Board of Health appointed Mr. Simon Medical Officer, at a salary of £1,500 per annum. In 1858 the late Government brought in a Bill which was passed, and had acted well, permitting of local control in those matters; but now it was proposed to hand over the whole matter to the Privy Council. But then came the question, what was to be done with the Board of Health, Mr. Simon and the secretaries of the Board. Well, the Vice President of the Committee of Education had but little to do. His office was almost a sinecure, and so it was proposed to assist him by another sinecurist, a Medical Officer, and the whole thing would be comfortable. Such an arrangement would not be tolerated for a moment by the Members of any popular constituency; but the Member for Calne—a rotten nomination borough—saw no objection to it; and so he had undertaken to look after Mr. Simon, and to establish a nuisance all over the country. But the country had something to say upon the point. It was not only a question of expense but of constitutional principle. New powers were given, the Privy Council was to be transformed into an executive department. If these powers were to be given to the Privy Council, why should not others be transferred also? All the acts of that body were done in secret without any responsibility to that House. Then it was to cost £6,000 a year, and all that was to be got for it was the blue-book, containing Mr. Simon's reports, showing his visit to Windsor and two other places. The truth was, no permanent medical officer was necessary. When an epidemic came, there would be plenty of qualified gentlemen who would give their services, and at a much cheaper rate. When objections were urged against the Bill last year, the then Home Secretary (Mr. Walpole) admitted it was an experiment, and therefore consented to limit its operation to the 1st of August, 1859, in order that the matter might be fully discussed during the present Session. Circumstances, however, had prevented any discussion during the Session, and therefore he (Mr. Duncombe) thought he was only making a reasonable request when he asked that the Bill be simply a renewal for one year, in order that in the ensuing Session the attention of Parliament might be given to the matter. To make the thing permanent was such a proposal as a Whig Government alone dare to make. There were compulsory clauses in the Bill which the right hon. Gentleman had promised to strike out, but which still remained. He should certainly support the Amendment of the hon. Member for the Tower Hamlets.

MR. COWPER

said, he thought the hon. Member for Finsbury, from his monomania against public health legislation, could hardly have given his mind fairly to the consideration of this subject. Misled by the name, both the hon. Gentleman and the hon. and gallant Member for Brighton (Sir G. Pechell) appeared to think this was the renewall of the Bill that had been the subject of contest in Mr. Chadwick's time, In the old Bill there were two portions— one which was unobjectionable, and another to which much objection was made. The objectionable portion—the interference with local government—had been made permanent in the Local Government Act, while the unobjectionable part only was dealt with in the present Bill. The hon. Member for the Tower Hamlets (Mr. Ayrton) had asked why meddle with the matter till the cholera came? But you might just as well make no military preparations until the enemy was thundering at your gates. Everybody would remember that at the last visitation of cholera everybody was asking, and asking with justice, why the Government had not taken precautions, at a time when the public health was good? The same hon. Member had also spoken of the acts of the Privy Council as done in secret; but surely a proclamation by the Council, as provided for in the Bill, would give publicity to all their acts. The Diseases Prevention Act was a permanent Act, although its provisions were at first administered by a temporary body—the Board of Health. If this Bill were not passed, the result would be that there would be upon the Statute book an Act with no one to administer it. The real question was whether medical science was to have a voice in a department of the Executive. For to be of use the sanitary branch of the Council Office must be permanent. Take the case of public vaccination. That operation being left to the public practitioners uncontrolled, vaccination was often performed inefficiently by persons ignorant of the right way of doing it. As the Legislature had enacted that vaccination should be compulsory, they ought to take care, by responsible authority, that it should be properly performed. The hon. Member for Finsbury had accused the department of the Privy Council of being a sinecure; it was certainly not so at present, but he was trying to make it so by depriving it of its present functions and requiring new ones. Mr. Simon had rendered his office a laborious one, and the last report of that gentleman of visits to Windsor, Conway, and another town, where epidemics had broken out, showed the utility of such investigations in discovering the sources of disease. Those who complained of the salary earned by Mr. Simon should recollect that he had given up the emoluments of a lucrative profession in which he held a good position. He was selected as the great authority on sanitary subjects. He took the appointment as a public duty. Had he considered only his private advantage and ease he might have done better by refusing it. There were 100,000 lives annually lost from preventible causes. No measure had been proposed so useful as this, for preserving the life and health of the working classes. It would be the saving of many lives from fever, cholera, diphtheria, and other diseases that ravaged families and made widows and orphans, and yet this was a Bill which Gentlemen who professed to advocate the popular cause opposed. It was thought very reasonable when the newspapers sent their own correspondents to inquire into the diseases and mortality of the Crimea. Well, this Bill enabled the Privy Council to send their "own correspondent," a scientific medical officer, to report upon the causes of death and offer recommendations for the prevention of disease. For these reasons he should cordially support the third reading.

MR. SOTHERON ESTCOURT

said, that he was sorry his right hon. Friend the Member for Stamford, Sir Stafford North-cote, was not present to take part in this debate, but he believed if he had been in the House, he would have supported the Bill; nay, further, that had he remained in office he would no doubt have endeavoured to persuade the late Government to introduce it. For his own part he thought it would be better if the Bill were re-enacted from year to year. No one in that House proposed to repeal it; and all they asked was, that sufficient time should be given to enable the House to judge of its general effect. On the other hand to reject the Bill altogether would interfere with a great sanitary movement. But the House were asked to put upon the Statute-book, as a permanent Act, the measure of last year, and he doubted whether the time had come for such a proceeding. By that Act the power of the Privy Council to make the order depended upon the concurrence of the President of the Council or the Secretaries of State, whereas by the present Act any three members of the Council might put the powers of the Act into operation. As soon as the country understood that their legislation was for the public good opposition would cease, for it had never shown any reluctance to raise the money necessary to carry out sanitary enactments. At the same time he thought the whole law relating to the public health ought to undergo a thorough revision, with a view to prevent all clashing of authorities. If they made this Act permanent they ought to take out of it all the powers relating to vaccination, which ought not to be exercised by a central Board, but by local Boards of Guardians. All that the Privy Council should concern themselves with should be to take care that the lymph was sound and good. It was desirable that the country should know a little more of the working of the Act of last year, and if the right hon. Gentleman had proposed to continue that Act for two or three years no one would have objected. Mr. Simon the medical officer, under the present Act, had done his duty very well, and his reports were very interesting; but he did not see how the Privy Council or their medical officer would be in the slightest degree impeded in the exercise of their functions by continuing the Bill as a temporary measure. If at the end of a year or two the results that were anticipated should be shown, then, instead of carrying a permanent Bill by a narrow majority, the right hon. Gentleman might come before the House and pass a permanent statute amid the general concurrence of the House.

MR. EDWIN JAMES

said, he objected to the perpetration of the present Act from a fear that if Parliament permitted the Privy Council to supersede the local authorities the latter would become lethargic. He should be glad to know whether the failures as well as the successes of the Boards of Health were recorded in blue-books, because, in that case, the House might hear something of Croydon, Hitchin, Folkestone, and Chelmsford—in two or three of which towns indictments had been brought against the local Boards for fouling the streams, by emptying their drainage into them. He should not object to passing a Bill for two or three years, but he did most emphatically protest against the attempt to make this a permanent measure.

SIR WALTER FARQUHAR

observed, that though he did not wish to reject the measure, he thought it unadvisable to make the Bill perpetual. Time had not yet been given to see how it worked.

MR. CAYLEY

said, he saw no harm in making it a permanent measure.

MR. BASS

said, he saw no harm in passing a permanent Bill, as it would not prevent any future legislation that might seem desirable. The hon. and learned Member (Mr. Edwin James) had complained of the injury done by local Boards, but this only proved the necessity of some central body to supervise the proceedings of the local Boards.

MR. CONINGHAM

said, he must deny that there had been any sanitary failure at Croydon, though he could not but admit that there had been some mismanagement in carrying out the drainage. The pipes at first employed were too small. They had thus got clogged up, and that circumstance, joined to an unusually wet season, had led to an outbreak of fever. But subsequently the health of the town was im- proved, and the death-rate diminished, as had been the case in every instance where improved drainage had been carried out. A more efficient public officer than Mr. Simon could not be found. His earlier reports when Medical Officer of Health to the City of London were a text-book on sanitary legislation. He should also be sorry to see vaccination performed by improper persons.

MR. LOWE

replied, observing that when the Central Board of Health was destroyed with it fell the compulsory powers. There were some powers which could not be vested in the local Boards of Health, and, consequently, the Government of the Earl of Derby sought to vest them permanently in the Privy Council. The hon. Member for Finsbury used against that Bill the same arguments which he had used that day, and the Government made terms with him, and took the Act for one year rather than run the risk of losing the Bill altogether. Yet hon. Gentlemen opposite now joined in the opposition to the act of their own Government, and he was rather disappointed that he could not count upon their support. He must, however, take his stand upon right, justice, and the public interests. By them he must stand or fall, and not by the permutations or combinations of parties in that House. The right hon. Gentleman the Member for Oxford-shire (Mr. Henley), was wrong in supposing that the powers given by the former Act were by this Act given to an inferior authority. The powers transferred to the Privy Council by this Act were not the powers vested in the Privy Council of declaring that a formidable epidemic, endemic, or contagious disease had visited the kingdom. Those powers were possessed by the members of the Privy Council, of whom the Lord President of the Council or a Secretary of State must be one. It was only the subordinate power of the present Act that was given to the Privy Council, and which might be put in motion by the Vice-President of the Committee of Privy Council. With regard to vaccination, it might not be generally known that it was no part of the examination for a surgeon that he should be a vaccinator at all, and it was therefore necessary for the public to have some protection. He had been told the Privy Council might hire a medical adviser when they wanted one for any special duty. But what was wanted was a medical man who should devote his whole time to the consideration of disease in masses, and who was possessed of all the facts and deductions that the new science of health might supply, and which the most experienced physician and surgeon who was confined to private patients could not he expected to possess. The hon. Member for Finsbury (Mr. Duncombe) had talked of an outlay of £6,000 on this new Board. Mr. Simon's salary had not been raised beyond the sum proposed by the Government of the Earl of Derby and that which he received from the Board of Health. It stood at £1,500, and last year a sum of £1,500 had been taken to meet contingencies, of which £300 had been spent. So that the outlay for the past year had been not £6,000, but £1,800. [Mr. T. DUNCOMBE: Take the previous year.] If he were asked why the Bill should be perpetual, he replied because the local Boards, upon whose proceedings the medical officer might have to report, were permanent bodies. If this Bill were continued from year to year the proceedings of the Privy Council would be stamped with a mark of want of confidence. If the medical officer gave offence to any one in his reports he would be told he should hear of it when the Bill was renewed next Session. If the powers now asked for were improper, let them be withdrawn altogether. Let the House visit with its displeasure any excess or abuse. But let not the House paralyze the arm extended over the local bodies. The Privy Council would have to contend with many local elements of prejudice, ignorance, and self-interest, and unless they could bring evidence before the people that would rouse them, the question of sanitary science would not advance, but would retrograde. The victims of a want of good sanitary arrangements were to be counted, not by thousands, or even by tens of thousands, but by hundreds of thousands, and there was no parsimony more miserable, and no jealousy of power more misplaced, than to put an officer like Mr. Simon in a position which showed that the department he administered did not enjoy the confidence of Parliament. It was his duty to state that the powers proposed to be granted under the Bill might not long remain unused. The cholera had broken out at Hamburg, several fatal cases had occurred, and who knew how soon it might reach this country? They knew the temperature, the state of the river, and the predisposing causes that were now in existence. He hoped it would not be said that they were unwilling to hear this fearful visitation named, or that they refused to consider this important question.

MR. SPOONER

said, he rose to disclaim any such motives as those which the right hon. Gentleman opposite had chosen to impute to the Conservative party. They had not supported the Bill last year merely because it was introduced by the Earl of Derby's Government, nor did they now oppose it because it was brought in by the present Government. The only reason that he and other Conservative Members opposed the present Motion was because they considered that further trial was necessary, and if it had been a question of renewing the Act for one year, or rejecting it altogether, he should vote for its renewal.

Question put, "That the words proposed to be left out stand part of the Question."

The House divided: —Ayes 101; Noes 95: Majority 6.

Main Question put, and agreed to.

Bill read 3° and passed.