HC Deb 25 May 1881 vol 261 cc1278-91

(Mr. Dillwyn, Sir George Balfour, Mr. Benjamin T. Williams.)

[BILL 56.] SECOND READING.

Order for Second Reading read.

MR. DILLWYN ,

in moving that the Bill be now read a second time, said, there was no class in the community which demanded more urgently the attention of the Legislature than those unfortunate persons afflicted with insanity. Yet the law seemed to him to treat them in a very cavalier manner. He had hoped that the Government would take this matter up; but, failing that, he had brought in a small Bill to meet pressing abuses. The whole law in this matter, however, required amendment. Our present system had gone upon wrong lines, inasmuch as it treated lunatics as a criminal class rather than as an imbecile class. It treated them with reference to their care rather than their cure, and it was to the cure that the law should be directed. The number of lunatics was rapidly increasing. By the Report of the Commissioners, the number in 1859 was 36,762, in 1865 it was 53,177, and in 1880 it was 71,191. This showed the seriousness of the question. He was strongly impressed with the propriety of entirely separating curable from incurable lunatics, because many patients afflicted with curable lunacy were often rendered incurable by forced association with hopeless idiots and raving maniacs. But this involved a greater change than he felt able to attempt to deal with at present, and in order to remedy the present defects of the law he proposed that a better system of supervision should be instituted over all asylums for the accommodation of lunatics, that better security should be provided for the liberty of the subject than the law at present afforded, and that better accommodation should be provided for the class of lunatics who could afford to pay for it, instead of being required, as at present, to go into ordinary asylums with pauper lunatics, or to private asylums, where the interest of the proprietors to cure patients was not so great as to keep them. With respect to supervision of asylums, the Bill provided for the appointment of a paid Chairman for the Board of Commissioners. This he did on the recommendation of the Earl of Shaftesbury. It was desirable that a person should have his whole time and energy devoted to the subject, and he should be responsible for the performance of his duties by receiving a proper salary for his work. He believed that would give a great additional weight to the Commissioners, and would secure for their proceedings rather more responsibility than now existed for the direct control of the business, which was now practically in the hands of the Secretary. With regard to personal liberty, he ad- mitted there were better securities in pauper asylums than in regard to other classes. In these asylums the inmates must be sent there by some public official, and in this respect they were in a better position than those able to pay. If a person wished to remove a relative, all he had to do was to arrange with some unprincipled keeper of an asylum—give him a sum of money—to ask him to secure a certificate of insanity from two medical men, and then the liberty of that relative was gone. Once inside the asylum, the inmate would find it almost impossible to get out. In the last Parliament he had to appeal to the Speaker with regard to the case of a Member of that House who was Confined, and who, according to Dr. L. Robertson, would become permanently insane if confined and subjected to the treatment he was undergoing. He was talking of facts within the knowledge of the Speaker and others. After some trouble and appeals to the then Home Secretary, this Gentleman was released, and he was put under treatment entirely different from that to which he was subjected in the asylum. He was cured, and for two Sessions afterwards he sat and voted in the House as any other Member would. He had the curiosity to inquire, and he found that this Gentleman, who lived in Scotland, properly exercised all the duties of his position. Well, if these things were done "in the green tree, what would be done in the dry?" If a gentleman of wealth and position was restored to his position and properly treated only at the instance of high officials, such as the Speaker of the House of Commons, what happened when persons who had none to take up their case for them were improperly incarcerated in these private asylums? Surely it was the ditty of the Government at once to intervene to amend the law with respect to such cases as this. He had no doubt such cases were of frequent occurrence—painfully and sadly frequent. He knew he should be pooh-poohed; but the question was one of the highest importance. He proposed by his Bill that, without exception, no one should be detained as a lunatic except upon an order of a justice of the peace. That was the first alteration he would make, and it was a most important one. No person ought to be detained except by order of some public authority. He did not care very much what that authority was; if it were only a police constable it would be better than the present system. Then he would also provide that no person should be incarcerated except at the instance of a near relation or of some solicitor of repute. The case of wandering lunatics was also provided for. There was also provision that due notice should be given before the justice made the order, and that the order must be authorized by two medical officers, one of whom should be the medical officer of the district. Then there was the class of violent lunatics, for whom he would legislate in the same way as was done by the Scotch law, which had a system of emergency certificate which enabled persons who had paroxysms of lunacy to be detained for 24 hours, but for no longer period, except on the order of some competent authority. The discharge of lunatics was also by his Bill placed on a better footing. He proposed they should be discharged on the order of a Judge in Chambers, a stipendiary magistrate, or a County Court Judge, who should order two medical men to visit the lunatic and report on the case; and such Judge, after communicating with the Lunacy Commissioners, might order the lunatic to be liberated within ten days. The third and last point to which he would refer was the question of patients who were able to pay. Many persons were able to pay a moderate sum, and could not afford the private asylums. He knew he should be met by the argument of vested interests on the part of the keepers of private asylums; but he did not think such interests ought to be exceptionally respected. He did not wish to introduce compulsion in the matter; but he proposed that the justices should be enabled to raise money by way of Terminable Annuities for the reception in public asylums of those who could pay. There need be no difficulty, and such a scheme would, in the end, prove remunerative. Certainly the keepers of private asylums made handsome profits. He had nothing to say against those establishments, which, on the whole, were very well conducted. But, unfortunately, it was often no one's interest to procure the discharge of patients, and certainly it was the interest of the proprietor to keep them as long as possible. As things were in the public asylums, there was no distinction between paupers and those who paid, either in class, food, or treatment. He had received many letters on the subject, to one of which he would refer. The letter was written by a gentleman whose wife had become a lunatic, and who could not afford to pay the charges made in the private asylums. The lady had first to go to a workhouse, and was thence transferred to the asylum. The husband paid 9s. 8d. a week for her maintenance. But the lady was treated in all respects as a pauper, and the writer expressed his opinion that the fact of wearing a pauper's dress was alone sufficient to prevent her recovery. With every word of that letter he agreed, and he had made provision in his Bill for cases of that kind. He would refer also to the evidence of the Earl of Shaftesbury in 1859, which fully sustained the views which he had been advocating, especially as regarded the discharge of lunatics. The same noble Earl was examined before the Select Committee which sat in 1877, and stated that, though he should not now in all respects give the evidence he did then, he had seen no reason to change any of the opinions which he had expressed in 1859 as regards the objectionable principle of persons having an interest in the retention of lunatics being intrusted with the care of them. He thought the present system of inspection was also very unsatisfactory and inadequate, and he proposed to deal with that part of the question. He would give an illustration of the unsatisfactory state of things with respect to private asylums. He had been told by a gentleman of the highest position and character, who was well known to most Members of the House, that his wife having become partially insane he had sent her to a private establishment. This gentleman, having heard that his wife was better, and that she would probably improve still more if she returned home, determined to remove her. But he found that all sort of difficulties were placed in his way, and he was much startled to think what facilities he would have had for the wrongful detention of his wife if it had been his interest or his wish to get rid of her in that manner. He had indicated as briefly as he could the evils of the present system, which he thought were effectually dealt with by his Bill. The hon. Member con- cluded by moving the second reading of the Bill.

Motion made, and Question proposed, "That the Bill be now read a second time."—(Mr. Dillwyn.)

MR. FLOYER

said, he approved of some of the provisions of the Bill, which could be advantageously amended in Committee. The subject of providing asylums for all classes of lunatics was one of great importance, and it was quite distinct from the question of the management of pauper patients. To provide accommodation for all lunatics above the pauper class would require a large extension of accommodation. The hon. Member for Swansea said that from the profit now made in these private asylums, those who provided those establishments would be recouped for their outlay; but he (Mr. Floyer) feared that, in the first instance, resort would be had to the county rates, and that proposal would hardly find favour with the ratepayers in these depressed times. In the great majority of cases the managers of private asylums were men of high character and position, and were not capable of being influenced by the inducement of high-paying patients to keep them longer than was necessary. Such cases might occur here and there. It was with regard to the admission into asylums of the class just above the pauper class that some changes might produce good results. In his own county, for instance, a step had been taken which had proved advantageous. Between £2,000 and £3,000 had been devoted to the erection in the asylum of 20 or 30 additional cells, which were appropriated to the reception of members of the class referred to, who were admitted at a charge of 10s. a-week. They were kept upon much the same footing, with regard to clothes and food, as the pauper lunatics, it being undesirable to make distinctions between the two sets of inmates. Another point which he thought should not be lost sight of was the importance of treating lunatics at as early a period as possible—that was to say, as soon as symptoms of insanity manifested themselves. He should be sorry to see any impediment placed in the way of the speedy admission of patients into county asylums; but the provision in the Bill of the hon. Member requiring that the certificate for the admission of a patient should come from the district medical officer would most probably, in many counties, cause such an impediment. The medical officer might live at a great distance from the residence of the patient, and be totally ignorant of the circumstances of his case—nay, he was not required even to see the man whom his certificate would relegate to a madhouse. He also objected to the proposal of the hon. Member with regard to the discharge of patients, for he held that it would be dangerous to give the power of discharging patients to two medical men from London, whose decision would not be subject to appeal. The proposal was defective in this, that it did not meet the difficulty of what was known as lucid intervals. Owing to this imperfection, there might be a great many persons let loose who ought to be under stringent regimen. For his part, he would strongly advocate the construction of asylums in which patients, not paupers, but coming from the class immediately above the pauper class, might be taken care of at a small weekly charge. The wealthy had the private asylums to which to send their insane relatives, and the paupers had the workhouse infirmary, where they were cared for out of the rates; but a man of this class, too poor to pay for the accommodation afforded to the rich, and too wealthy to come upon the rates, was without any such accommodation whatever. He thought they were indebted to the hon. Member for Swansea for bringing forward this Bill, and if it went into Committee he would endeavour to make it a more perfect measure.

DR. CAMERON

said, he wished to point out that the principles which had been advocated by the hon. Member for Swansea (Mr. Dillwyn) were the principles which had worked thoroughly well under the Scotch law. In Scotland there were a number of Royal Charter asylums, carried on by directors for philanthropic purposes, and they were under the control of medical men of high standing, who were paid salary, and who had no interest but in the cure of the patients. Patients were not admitted without an order from a sheriff. He must say he had a distinct preference for the order of a sheriff over that of a justice. The sheriff was a trained lawyer, whose whole training was against any abuse of the power com- mitted to him, and in favour of a judicial and careful exercise of that power. The machinery in the Bill for the committal and discharge of patients was very much that which existed in Scotland at the present time. It was open to anyone to apply to the sheriff where they thought a patient was wrongfully detained, and the sheriff issued a warrant to make an inspection. If asylums could be got up in the same way in England as in Scotland that would get rid of the financial difficulty. All the suggestions in the Bill of his hon. Friend had been found perfectly compatible with the safe custody and proper treatment of lunatics, and that was a fact which he thought would recommend them to a practical Assembly like the House of Commons.

SIR HENRY HOLLAND

assured the hon. Member for Swansea that many who sat on the Opposition side of the House wished the Bill every success. No one could read the Report of the Committee which had considered the subject of lunatic asylums without seeing that some alteration was wanted in the law. The principles of this Bill were such as would commend themselves to those who had studied the question, and the details could be settled in Committee. There were three points of special interest and importance in the Bill. The first object was to do away, as far as possible, with that part of the present system which gave a proprietor of an asylum an interest in keeping the patients under his care. It was undoubtedly the interest of proprietors of asylums to keep patients longer than was necessary; and, although he did not say that this interest had been greatly abused, he thought the temptation ought to be removed. No doubt, if private asylums were bought up by the justices under this Bill, liberal compensation should be secured to the proprietors of such asylums; and, upon the whole, the provisions of the 2nd section would, with some alterations, meet the case. The second object aimed at by the Bill was to secure a proper check upon the admission of a patient. The hon. Member for Dorsetshire commented upon this point, and raised a question as to the inconvenience that would be likely to arise if the relieving officer of the union or parish had to petition. Any practical difficulty, however, on this point could be considered and removed in Committee. The third object was to secure a simple mode of liberation from an asylum. The hon. Member for Dorsetshire, when criticizing this part of the Bill, appeared to think that the liberation order would be granted upon insufficient grounds, and without sufficient examination of the patient. But he had clearly overlooked the provisions of the 13th section, which provided for two separate examinations by two medical men at intervals of seven days, and made it necessary for the Judge or magistrate to communicate with the Commissioners in Lunacy, who must be acquainted with each case, and further provided for the expiration of 10 days from the production of the order before the liberation. As he believed the Bill was calculated to benefit not only the wealthy classes by protecting them against improper admission to, and detention in, asylums, but also the middle classes, who most required protection, he should heartily support it.

MR. COURTNEY

said, that no one who had listened to the speech of the hon. Member for Swansea (Mr. Dillwyn) could help feeling great sympathy with much that he had uttered; and whatever might be the immediate result of the proposals, he was quite sure the labours of the hon. Gentleman would not be without fruit. At the same time they could not lose sight of the fact that investigations into cases of lunacy must always be subject to the hazard of mischance. The Select Committee on this subject had, however, reported that no case of miscarriage of justice in the committal of alleged lunatic persons had occurred for many years past. The hon. Member for Glasgow (Dr. Cameron) and the hon. and learned Member for Midhurst (Sir Henry Holland) had expressed their approval of the Bill; but they could, he thought, have scarcely examined the proposals which it contained with sufficient attention. If they had done so they would hardly have accepted those proposals as a basis of legislation without some qualification. Many of them appeared to him to be impracticable, and were hardly capable of being transformed into a practical shape in Committee. Hishon. Friend who moved the second reading laid great stress on the proposal requiring the certificate of a magistrate; but under the scheme of the Bill the magistrate would have nothing whatsoever to do except to sign the certificate, and the Proviso requiring the signature of a magistrate made no mention of the apparently necessary condition that the magistrate should see the patient. [Mr. DILLWYN: It would be a record.] Yes; but it would be only the appearance of a public guarantee without the reality, and it might lead to much mischief. At present, a person fraudulently confined in a lunatic asylum had a right of action against the relatives or friends who put him there. Was it intended to remove that liability and responsibility from the shoulders of the relatives or friends and to transfer it to the magistrate? On the whole, he thought the machinery for regulating the admission of patients would rather weaken than strengthen existing guarantees, whilst the machinery for regulating discharge was uncertain in its action and difficult to understand. For instance, it was doubtful whether the author of the Bill meant to give the Commissioners in Lunacy a veto or not over the discharge of a patient. The gradual suppression of private asylums and the enlargement of the public asylums for the admission of paying patients was a subject of the highest interest. He entirely sympathized with his hon. Friend in seeking these two objects; but the propositions contained in the Bill were quite insufficient to bring them about. In the first place, how was this suppression of private asylums to be effected? Was there to be compulsory expropriation? [Mr. DILLWYN: No.] Then the liberty of bargain between the justices and the proprietors of private asylums given by the 1st clause was affected by the extraordinary regulation as to price contained in the 2nd clause; and he was persuaded that the justices would never exercise the power proposed to be given to them under those circumstances. He hoped that the private asylums would, in the course of time, die out. There was no vested interest in them, and the reception of paying patients at county asylums was even now established in some counties—Cornwall, for instance. As to the private lunatic asylums, which it was sought to suppress, they existed, for the most part, in the Metropolis or its vicinity; and if the Bill were to pass—one of the great objects of his hon. Friend being to establish public lunatic asylums throughout the country—a burden would be imposed on the rates of the Metropolitan counties, in order to carry out the great reform suggested in non-Metropolitan counties. He would also point out that there was nothing in the law to prevent lunatic asylums from being enlarged by the addition of private wings in those cases in which the authorities in a county were not unwilling that that should be done. In all the circumstances of the case, he hoped his hon. Friend would be satisfied with the discussion which had taken place, and that he would consent to withdraw his Bill, leaving the matter in the hands of the Government, who would be prepared, when there was time at their disposal for the purpose, to lay upon the Table of the House a measure not merely for the amendment of the law but for its consolidation—a Bill which would produce smile of the Amendments aimed at by the hon. Gentleman, but which he would fail to realize under the provisions of his Bill. No doubt the hon. Member thought the Government had been slack in dealing with this matter; but the House knew the difficulty the Government had in dealing with any subject at present. He did not for a moment deny that the law was capable of amendment, and if the hon. Gentleman would only leave it in the hands of the Government, they would draw up a Bill and submit it to an early Session of Parliament. He could not recommend the House to receive the Bill as it stood, and he hoped the hon. Gentleman would withdraw it.

SIR R. ASSHETON CROSS

said, he was glad to find it was admitted on the part of the Government that the Lunacy Law was capable of considerable amendment. For his own part, he had no doubt that in connection with several of the points which had been raised by the hon. Member for Swansea (Mr. Dillwyn), amendment was not only desirable, but absolutely necessary. Having had considerable experience of the operation of the law in one of the largest lunatic asylums in the country, of which he had been visitor for many years, he was enabled to confirm many of the grievances which the hon. Member had pointed out. In the first place, he did not think there were sufficient safeguards with regard to the admission of lunatics. In the asylum with which he was connected, he was perfectly satisfied that many cases had been admitted which ought not to have been admitted at all. He also thought that the law with regard to the release of lunatics was not satisfactory. He had himself, on many occasions, interfered, and had caused many patients to be discharged who, he was persuaded, ought not to have been detained. The question was a most difficult one, especially as regarded the admission of lunatics, because if a case of lunacy was only treated early enough there was almost a certainty of cure; and it was, therefore, sometimes a charity to put a person in an asylum, although, to an ordinary individual, it might appear very doubtful whether he was a lunatic or not. He concurred, to a great extent, in the views of the hon. Member as to the desirableness of gradually suppressing private asylums. He did not think it desirable that it should be even supposed that persons could be kept in confinement for purposes of private gain. On the other hand, it must be borne in mind that many recoveries were accomplished in these private asylums by reason of careful personal superintendence. As regarded the enlargement of asylums, his opinion was that many asylums were far too large. Medical men of eminence in connection with the treatment of lunacy had come to the conclusion that the massing together of people suffering from the disease was a positive evil. If they had 1,000 or 1,200 patients in one asylum, he believed that adequate personal supervision became impossible. He held that the number of patients in one asylum should not exceed 500 or 600. The subject under discussion was one with which he and the late Government had been most anxious to deal. When the Under Secretary of State for the Home Department, speaking for the Government, said he approved of all the principles contained in the Bill, he thought one of two courses would have been adopted—either to allow the Bill to be read a second time, and then to refer it to a Select Committee; or to bring in a short Bill dealing with the points upon which there was mutual agreement. He quite agreed with the Under Secretary of State that to consolidate the whole law on the subject would be an admirable thing to do. In fact, it was so admirable he was afraid it would not be done, because such an un- dertaking, while not of the first importance, would be one of magnitude, as they would find that any measure with this object would eventually be thrust out and indefinitely postponed in the pressure of other legislation. He therefore ventured to suggest to the Government that they should adopt one of the two courses he had indicated.

MR. DILLWYN

said, he could not comprehend how any fault could be found with the draft of the Bill, seeing that in drafting it he had had the assistance of his hon. and learned Friend the Solicitor General.

MR. SPEAKER

pointed out that the hon. Member was not entitled to make a second speech.

MR. DILLWYN

said, he only wished to state that he could not accept the suggestion of the Under Secretary of State (Mr. Courtney) to withdraw the measure, and he must divide the House.

SIR WILLIAM HARCOURT

said, the subject was one with regard to which, especially after the observations of the right hon. Gentleman (Sir R. Assheton Cross), who had just sat down, the House seemed agreed that something should be done; and the only question was how it was to be done. As to the proposal that the Government should introduce a short Bill on the subject, he was sorry to say the Home Office was full of short Bills; and it was absolutely impossible to find five minutes to introduce one. He hoped he might have some success by trying the experiment of sending them to the House of Lords, which was not very much occupied with Business. But he found that when they got there they were strangled. There was such a Bill in the House of Lords on the previous night (Charitable Trusts Acts Amendment Bill). It came to a bad end; aid, therefore, there was no encouragement for the endeavour to get Business transacted there. He was afraid, therefore, that if the Government were to promise to pass a Bill dealing with the Lunacy Laws in the present Session, the promise would be a delusive one. But although the Government might not be able to bring in a Bill on the subject, they had no wish to prevent anyone else from doing so. That the Bill of the hon. Member for Swansea had a good object he did not mean to deny, though it might require a good deal of amendment. As to sending the Bill to a Select Committee, he would point out that the House was already overburdened with Committees; but if his hon. Friend wished to take the second reading of his Bill, with whatever chance of amending and putting it in proper shape he might be able to command, the Government would not object.

Motion agreed to.

Bill read a second time, and committed for To-morrow.