HL Deb 30 May 1923 vol 54 cc277-89

Order of the Day for the House to be put into Committee read.

Moved, That the House do now resolve itself into Committee.—(The Earl of Onslow.)

On Question, Motion agreed to.

House in Committee accordingly:

[The EARL OF DONOUGHMORE in the Chair.]

Clause 1:

Constitution of visiting committees.

1.—(1) A local authority may appoint as members of a visiting committee under the Lunacy Acts, 1890 to 1911, persons who are not members of the council of the authority by which the committee is appointed, so, however, that the number of persons so appointed shall not exceed one-third of the total number of the committee.

THE PARLIAMENTARY SECRETARY OF THE BOARD OF EDUCATION (THE EARL OF ONSLOW) moved, in subsection (1), to leave out "under the Lunacy Acts, 1890 to 1911." The noble Earl said: This is a purely drafting Amendment.

Amendment moved— Page 1, lines 7 and 8, leave out ("under the Lunacy Acts, 1890 to 1911").—(The Earl of Onslow.)

On Question, Amendment agreed to.

Clause 1, as amended, agreed to.

Clause 2:

Extension of powers of visiting committees.

2. Subject to the approval of the Board of Control, a visiting committee shall, subject to the consent of the local authority by whom it is appointed, have power to do any of the following things:— (3) receive and lodge as a boarder and maintain and treat in any institution under the control of the committee on such terms and conditions as to payment or otherwise as the committee may determine, any person who is desirous of voluntarily submitting himself to treatment and who applies in writing to the medical Superintendent of the institution to be received therein as a boarder: (5) subject to and in accordance with a scheme to be approved for the purpose by the Board of Control, undertake research in relation to mental disorder and the treatment thereof, and make contributions towards the expenses of any body of persons engaged in such research.

EARL RUSSELL moved, in paragraph (3), after "payment," to insert "(including the payment of expenses incidental to securing a recommendation for treatment by two medical practitioners or incidental to admission for and removal after treatment)." The noble Earl said: I have been asked to move this Amendment on behalf of the London County Council. The object is to give power to visiting committees to pay, if necessary, for the medical certificates that are required for recommendation for treatment. It is not intended that the visiting committees should pay in all cases, but it is desired to give them power to pay if the persons themselves are unable to do so. I do not think there is any real objection to the Amendment, but I understand that the noble Earl in charge of the Bill wants a little time to consider the words. Perhaps it would be bettor if I formally move it now, and hear what he has to say.

Amendment moved— Page 2, line 14, after ("payment") insert the said words.—(Earl Russell.)

THE EARL OF ONSLOW

As a purely drafting point the Amendment of the noble Earl should come in a subsequent clause, Clause 7, in which I also have an Amendment which carries out the latter part of the noble Earl's proposal. With regard to the payment of expenses for securing a recommendation for treatment by two medical practitioners I should like to have an opportunity of considering it in conjunction with the noble Earl, and perhaps we might then devise an Amendment on Clause 7 which would cover both points. When we come to that clause I propose to withdraw my Amendment in order that we may consider both points at the same time and avoid double drafting.

EARL RUSSELL

As the noble Earl pleases. I recognise that there has been very short notice of this Amendment and that time is required to consider it. I will not press it now.

Amendment, by leave, withdrawn.

THE EARL OF ONSLOW moved to omit from paragraph (5) "subject to and in accordance with a scheme to be approved by the Board of Control." The noble Earl said: The London County Council has pointed out that this may be impracticable and that it is undesirable to submit an absolutely cut and dried scheme in regard to research work.

Amendment moved— Page 2, lines 32 to 34, leave out from the beginning of line 32 to ("undertake") in line 34.—(The Earl of Onslow.)

On Question, Amendment agreed to.

Clause 2, as amended, agreed to.

Clause 3 agreed to.

Clause 4:

Temporary treatment of mental disorder without certification.

4.—(1) Subject to the provisions of this section any person who is suffering from mental disorder and is considered likely to benefit from temporary treatment in an institution, may on a recommendation for treatment duly given in accordance with the provisions of this section and without a reception order under the Lunacy Acts, 1890 to 1911, be received as a patient into an approved institution (subject to the consent of the persons having control of the institution and on such terms and conditions as to payment or otherwise as may be agreed), and may be treated therein for a period not exceeding six months:

Provided that—

  1. (a) a recommendation for treatment shall not be given under this section except in respect of a person who either is willing to submit to treatment or is incapable of volition, or in whose case, if he is a minor, consent to his reception as a patient in an approved institution has been given by his parent or guardian, and every such recommendation shall state whether the person in respect of whom it is given is willing to submit to treatment or is incapable of volition, or is a minor in whose case the necessary consent has been given, as the case may be; and

(5) Where the person to be received as a patient is incapable of volition or is a minor, there must be annexed to the recommendation for treatment a statement signed by a justice of the peace or a minister of religion to the effect set out in Part II of the Schedule to this Act.

LORD PHILLIMORE moved, in proviso (a) of subsection (1), after "minor," where that word first occurs, to insert "under the age of 16 years." The noble and learned Lord said: This Bill is founded upon a voluntary submission on the part of the patient to the treatment proposed, and, so far, there can be no objection to it. But when it comes to deal with minors under the age of 21 it substitutes for the will of the patient the will of the father or guardian. That may be very necessary in the case of children of tender years, but it seems to me that in the case of people nearly grown up, boys and girls of 17 and 18 years of age, that it is very undesirable that this machinery should be used to enable a father or guardian to compel their admission into one of these institutions and keep them there until they come of age, or until the father or guardian is pleased to allow them to come out.

The law with regard to minors does not, in its general principle, authorise such constraint. I believe that no father can get a habeas corpus to enforce the attendance of the minor where he pleases after the minor is of the age of sixteen. No doubt if there is a dispute between husband and wife with regard to the care and education of a child up to the age of twenty-one the courts will decide as between husband and wife, and no doubt the father or guardian, if the child is being restrained of its liberty, can get a habeas corpus for him. But I have always understood that young persons of the age of sixteen and upwards can go where they like and take what form of work, profession or occupation they like, and therefore it is not easy to put them under this constraint.

I would further point out that marriage has always been considered as an emancipation, but under the Bill as it now stands a married woman of eighteen, or nineteen, or twenty might, notwithstanding that her husband did not wish it and she did not wish it, be placed by the father in one of these institutions and kept there until the age of twenty-one. I am sure this cannot have been the intention of the framers of the Bill, and it is for that reason that I have put down the three Amendments standing in my name, all of which relate to the same matter. Since I put them down I have had the advantage of some conversation with the noble Earl in charge of the Bill and I understand that he and those whom he represents are favourable to the view that there must be some restriction upon the power of parents to act for a minor, to put a minor son or daughter into one of these institutions against that son's or daughter's will. So far as I understand the position, the only difference between myself and the noble Earl is that he is rather doubtful whether sixteen is not, too young and whether it should not be seventeen or eighteen

I put it at sixteen because there is a principle regarding that age. The age of sixteen is, as I have said, the age at which compulsion for many purposes ceases, and also the age at which not a few young women or girls marry. But if the Government, on reflection, think that the age ought to be seventeen or eighteen, I shall be in your Lordships' and their hands with regard to that. It must be remembered, however, that if the age is put at anything above sixteen there ought to be a provision that a married woman shall be emancipated and shall not be regarded as a person whom a parent or guardian can put into one of these institutions against his or her will. I beg to move.

Amendment moved— Page 3, line 33, after ("minor") insert ("under the age of 16 years").—(Lord Phillimore.)

THE EARL OF ONSLOW

In moving this Amendment the noble Lord mentioned that he had had some conversation with me on the subject and that I had intimated to him that the Government would not be averse from accepting the principle of his Amendment. We do feel, however, that sixteen is a rather early age at which to give this power, especially in view of the possible state of health of the person who is to benefit by the provisions of the Bill. I would venture, therefore, with the noble Lord's permission, to suggest that for "sixteen" we should substitute "eighteen"; and in view of what the noble Lord has said about the question of married persons, and particularly married women, perhaps, with his permission, the Amendment now before the House might be withdrawn and the point might be considered again before the Report stage. As a matter of fact I do not think that this question of the status of a married woman has been considered, and I cannot at present give an answer on the point which the noble Lord raised. I think it may be for the convenience of your Lordships if he will consent to the course which I have suggested.

LORD PHILLIMORE

I shall be quite ready to have this matter dealt with on Report, as I gather that the noble Earl has suggested, instead of at the present stage. I hope the noble Earl and his advisers will consider that if the age is to be eighteen they will have to put in a proviso that a married person under the age of eighteen is to be treated for the purposes of this Act not as a minor, but as emancipated. If I am right in supposing that the noble Earl wishes to deal with the point on Report I am quite willing to withdraw these Amendments. I should add that these Amendments would involve a consequential Amendment to subsection (2) of Clause 5, which enables people who are in these institutions to leave them, and that there again it ought to be conditioned in the same way. I ask leave to withdraw my Amendment.

Amendment, by leave, withdrawn.

Clause 4 agreed to.

Clause 5:

Discharge of persons detained in institutions under Act.

5.—(1) Any person received under this Act into any institution as a boarder or as a patient— (a) may at any time leave the institution upon giving the medical superintendent or other person in charge of the institution forty-eight hours notice of his intention so to do; or

EARL RUSSELL moved, in paragraph (a) of subsection (1), to leave out "forty-eight hours" and insert "three days." The noble Earl said: This is an Amendment to the clause which gives power to a voluntary boarder or patient to require his discharge at any time on giving forty-eight hours' notice. I have been asked to move it by those who are interested in administration, and who feel that a notice of forty-eight hours is very much on the short side and that if such notice were given, say, on Saturday at about mid-day it might be impossible to communicate with the patient's friends so that they could be ready to receive him as he should be received when discharged from actual care. They might well be away for the week-end or something of the sort. I appreciate that the reason of the shortness of the period is to preserve the liberty of the subject, but I think the noble Earl will probably agree that the liberty of the subject is not seriously infringed by the change from two days to three days, and I am told that as a matter of administrative convenience it is really almost necessary. Without it, some person might be discharged on a Monday morning without there being anybody to receive him and, as one very experienced alienist wrote to me, might be found cut up on the railway line a few hours later, having wandered in front of a train.

I have also ventured to change the form of the words and to put "three days" instead of "seventy-two hours." I do not think it can be necessary to have any exact limit of hours. It is obvious that dispute on such a point is not likely to arise under this clause, and the right to take discharge on notice will not be affected. I do not think you want an exact number of hours, and I suggest that "three days" is a more elastic and more convenient form of words. Some extension of the time is needed, and it will be very difficult to administer this clause properly without it. Since the introduction of the Bill we have had a discussion at a meeting of a learned society at which I was present, and this subject was raised by many speakers and considerable attention was given to it. I think it will be found that most alienists with experience of the administration of asylums will agree that some longer time is necessary. I hope the Government will see their way to accept this Amendment.

Amendment moved— Page 5, line 17, leave out ("forty-eight hours") and insert ("three days").—(Earl Russell.)

THE EARL OF ONSLOW

When I saw this Amendment on the Paper in the name of the noble Earl I confess that I felt some reluctance about accepting it, not Because I do not admit the force of his point that there is very little difference between two days and three days, but that I did not wish it to be thought that it was desired through this Bill in any way to restrict the liberty of a patient entering into these institutions in so far as it can be preserved when proper regard is had to administrative convenience. I have been much impressed by what the noble Earl has said, especially with regard to week-ends, and I realise that it would be very inconvenient, and might possibly be dangerous, if a person gave notice to leave on a Saturday. It might be difficult to communicate with his relatives on Sunday, and they would not know he was leaving the institution, so that accident or inconvenience might result. Although the noble Earl did not mention the point, it might also lead to difficulties which would involve the necessity of restraint and certification.

Therefore, being impressed by the argument of the noble Earl, I should be prepared to accept the Amendment if he would alter the form of words. He has asked us to substitute "three days" for "forty-eight hours." I am told that for legal purposes it is necessary to put in the hours, and that is why "forty-eight hours" is mentioned in the original Bill. If the noble Earl is prepared to accept "seventy-two hours," I should be willing to accept the Amendment, of course on the understanding that it is not intended to impose additional restrictions but is merely for administrative convenience.

EARL BEAUCHAMP

I hope the noble Earl who represents the Ministry will allow me to congratulate him upon his acceptance of this Amendment. It is not of importance in itself, but it is important from the administrative point of view, and I welcome very much this readiness on the part of the noble Earl to meet a point of this kind. I hope the noble Earl behind me will accept the suggestion made by the Government. I really think it is a substantial improvement of the clause.

EARL RUSSELL

I am told that there are legal considerations which make it particularly advantageous to have a definite time, like seventy-two hours, instead of three days, which is subject to differing legal interpretations. I had not appreciated those legal considerations, and I am glad to move the Amendment in the form suggested.

Original Amendment, by leave, withdrawn.

Amendment moved— Page 5, line 17, leave out ("forty-eight hours") and insert ("seventy-two hours").—(Earl Russell.)

On Question, Amendment agreed to.

Clause 5, as amended, agreed to.

Clause 6 agreed to.

Clause 7:

Expenses of visiting committees.

7.—(1) Any expenses incurred by a visiting committee under this Act shall be defrayed by the local authority by which the committee is appointed out of the county fund or out of the borough fund or borough rate, as the case may be.

THE EARL OF ONSLOW

The Amendment in my name to subsection (1), to insert, after "Act" ("including expenses incurred in conveying patients to and from institutions"), is the one which I suggested should be withdrawn, because it is the same as the noble Earl's Amendment to Clause 2. I therefore do not move my Amendment.

EARL RUSSELL moved to add to sub-section (1) the words: "any expenses incurred by the London County Council under this Act shall be defrayed out of the county fund as expenses for general county purposes." The noble Earl said: This is another Amendment desired by the London County Council and raises one of those complicated questions about the funds on which certain expenses should be charged. The London County Council are anxious that these expenses should be charged to the general county account, and they point out that that is usual in similar cases. I understand that they are in negotiation with the Corporation of the City of London, who take a different view. The differences have not yet been quite reconciled, but if they are reconciled, as I hope they may be before this Bill leaves this House, I trust that some similar clause may be agreed to. If, however, this Amendment is objected to, I will not now press it.

Amendment moved— Page 6, line 21, at end insert the proposed words.—(Earl Russell.)

LORD MARSHALL OF CHIPSTEAD

The Amendment proposed by the noble Earl has for its object the placing of the expenses of the London County Council under the Bill upon the general county rate, to which the City of London contributes, instead of upon the special county rate, to which the City does not contribute, which is provided by the Bill as it now stands. I venture to express a little surprise and regret that this Amendment has been brought forward, because the resolution of the London County Council to seek this alteration in the Bill was based on the assumption that it was intended that the Council should be the sole authority for London, including the City, whereas I believe, in fact, the City's separate position as a lunacy authority was somewhat overlooked in the preparation of the Bill—a mistake which I understand the Government have recognised and propose to rectify. It would seem, therefore, to follow that the two authorities should bear their expenses out of the appropriate rates raised in their respective areas.

This Bill is based upon the Lunacy Acts, and Clause 9 of the Bill provides that it is to be construed as one of those Acts. Under those Acts the London County Council is the local authority for London, exclusive of the City, and the City Corporation is the local authority for the City. These expenses are borne by the special county rates of the county and of the City respectively, and I venture to suggest to your Lordships that it is but fair and equitable that these expenses should be borne in their respective areas. I venture, therefore, to hope that your Lordships will reject this Amendment.

THE EARL OF ONSLOW

With your Lordships' permission I would suggest that the course proposed by the noble Earl who moved the Amendment might be followed with advantage, and that this matter might be considered by those most interested, namely, the London County Council and the Corporation of the City of London, before the Report stage, by which time it is hoped that an agreement may be arrived at.

EARL RUSSELL

In view of the fact that I thought this course might be agreeable to the Government I did not trouble your Lordships with a long argument, and in the hope that some agreement may be reached I ask leave to withdraw my Amendment.

Amendment, by leave, withdrawn.

Clause 7 agreed to.

Clause 8:

Application to London.

8. The provisions of this Act relating to the constitution of visiting committees shall not apply to the administrative county of London, and the powers conferred by this Act on visiting committees shall, so far as relates to the said county, be vested in the London County Council, and Section thirty-five of the London County Council (General Powers) Act, 1915, shall have effect as though the said powers had been transferred to the London County Council by that Act.

THE EARL OF ONSLOW moved to leave-out "administrative." The noble Earl Said: This clause, as drafted, would place the operation of the Bill in the hands of the County Council, but the Corporation are a separate authority, and it is desired to preserve their jurisdiction. This can be effected by leaving out the word "administrative," which has found its way by inadvertence into the Bill. I think my Motion to omit the word will prove agreeable to the City.

Amendment moved— Page 6, line 32, leave out ("administrative").—(The Earl of Onslow.)

On Question, Amendment agreed to.

Clause 8, as amended, agreed to.

THE EARL OF ONSLOW moved, after Clause 8, to insert the following new clause:— .Asylums provided by any public authority in England or Wales for lunatics or other persons of unsound mind shall hereafter be called mental hospitals, and accordingly for references in any public or local Act or in any order, regulation or other document issued under any such Act to any such asylum there shall be substituted references to a mental hospital. The noble Earl said: This new clause is a small matter, but it introduces a new principle into this question of mental deficiency. Hitherto mental institutions have been described as asylums, and the word "asylum" has been associated with mental deficiency, and, perhaps, has contributed to the view that it is less a disease than an irremediable affliction.

I had an opportunity the other day of seeing the representatives of the nurses in mental institutions, and they were all very anxious that this new nomenclature should be introduced into the Statutes. I may also say that many other authorities, such as alienists, and the Board of Control, are anxious to adopt this title of "mental hospital" instead of "asylum." We want to emphasise the fact that mental deficiency is a disease, like other diseases, and that institutions in which mental disease is treated, and I hope cured, are hospitals in the same way as other hospitals for bodily disease are known as hospitals. Therefore I think that if we assimilate the title of these asylums with the title which is usually associated with the hospitals for the cure of bodily disease, we may do a certain amount towards impressing upon the public the fact that mental disease is like any other disease. I trust that the Amendment will prove acceptable to your Lordships.

Amendment moved— After Clause 8 insert the said new clause.—(The Earl of Onslow.)

On Question, Amendment agreed to.

Clause 9:

Short title, interpretation, and power to make, adaptations.

(2) In this Act, unless the context otherwise requires— The expression "local authority" includes the Lancashire Asylums Board, the West Riding of Yorkshire Asylums Board, and the Staffordshire Mental Hospitals Board and any other body constituted for the administration of the Lunacy Acts on behalf of any combination of local authorities, and in relation to a visiting committee which is appointed by two or more local authorities means those several authorities:

THE EARL OF ONSLOW moved, in subsection (2), after "In this Act, unless the context otherwise requires," to insert: "The expression 'visiting committee' means a visiting committee under the Lunacy Acts, 1890 to 1911." The noble Earl said: This is a drafting Amendment. It is the definition of a visiting committee which properly comes under this clause.

Amendment moved— Page 7, line 2, at end insert ("The expression 'visiting committee' means a visiting committee under the Lunacy Acts, 1890 to 1911").—(The Earl of Onslow.)

On Question, Amendment agreed to.

Clause 9, as amended, agreed to.

Schedule:

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