HC Deb 10 April 1818 vol 37 cc1285-9

Mr. Courtenay moved the second reading of the Surgery Regulation bill. He should refrain from entering into the minute examination of the clauses of the bill for the present, although some of them, he admitted, contained matter which had excited considerable apprehension on the part of the colleges in Ireland. It had been asserted by petitioners to that House, that the object of the bill was, to create a monopoly on the part of the college of surgeons of London. Nothing could be more unfounded, except it was contended they produced that effect by exercising a controlling power over the affairs of the profession, so far as prohibiting men from endangering the lives of his majesty's subjects, through incompetency in the pro- fession they presumed to tamper with. The bill proposed to subject the cadidates to an examination before the college, and on exhibiting a competent knowledge, to admit them to practice. The experience and superior improvements of later days had rendered this mode of examination indispensably necessary. Of the merits of the bill, the House could hardly be at present aware. He would suggest, that the best way would be to allow the bill to be read a second time, and afterwards to discuss its several provisions in a committee of the House.

Sir C. Monck

spoke against the principle and details of the measure. He said, he could not see any necessity for its adoption, and he protested against the doctrine, that no surgeon should be allowed to practice, who did not submit to an examination by, had not a testimonial from, and, did not pay a fee to, some corporation of surgeons. The adoption of such a measure would, in his view, be peculiarly inconsistent with justice and sound judgment, as well as with he conduct of that House, which had recently abolished the restrictions imposed by the laws of queen Elizabeth, upon the subject of trade. He was not among those who deprecated the policy of the laws which subjected to a pecuniary penalty such as set up particular trades, without servings an apprenticeship to those trades; for such laws were, in his opinion, necessary to secure to society persons of competent skill in the mechanical professions. But it had become the fashion to deprecate those laws, and therefore they were repealed about two years ago. Would it, then, become parliament, after acceding to that repeal, upon the ground of removing undue restrictions, to adopt a measure which proposed to invest certain corporations with the power of deciding, who should or should not practise surgery? Such restrictions could only be tolerated upon the ground that it was necessary to provide against unskilful practitioners; but no such necessity was shown to exist; and if it existed, how did this bill propose to remedy the evil? Why, merely by making it obligatory upon persons to submit to an examination before certain colleges. But what guarantee did such examination afford to the public for competent practitioners The usual examination before the college of surgeons was, he was assured, conducted in a very loose and slovenly manner. Then as to the college of surgeons in Edinburgh, the fee for a testimonial or diploma there was in the first stage about 30l., but in a subsequent stage the fees required were no less than 250l., and those fees were exacted by the mere bye law, or internal authority of the college. Was the House, under all these circumstances, prepared to compel every candidate for the practice of surgery, to appeal to these colleges, and to depend upon their will for the right to pursue his profession He had no objection to a law to regulate the practice of surgery, and to prevent the evil of improper practitioners; but he thought the hon. mover had begun at the wrong end, for instead of proposing a measure at the instance of the public, for whose benefit such a measure ought to be adopted, he brought it forward at the instance of the college of surgeons of London, whose benefit it was calculated to promote. The hon. baronet concluded with moving as an amendment, "That the bill be read a second time this day six months."

Mr. W. Dundas

stated, that the fee required by the college of surgeons of Edinburgh, from a person desiring to practise as a licenciate, was only 5l. but that any one requiring (and this was wholly voluntary) to be admitted as a member of that corporation, which admission would entitle him to certain advantages for himself, his widow, and his children, was called upon to pay 250l. for the benefit of the general fund.

Captain Waldegrave

stated a case which came to his knowledge, and which served, in his opinion, to show the necessity of making some provision that the people should not be exposed to the danger of incompetent medical practitioners. This case had occurred in his own neighbourhood, where, upon the regular surgeons refusing to inoculate for the small pox, conceiving vaccination much preferable, some people were, through prejudice and imposition, induced to apply to chemists, and other unqualified persons, who inoculated for the small pox, and the consequence was, that the contagion spread throughout the country—that, indeed, no less than 800 persons in one parish were infected by it.

Mr. Peel

reprobated the idea of legislating upon a single fact, however respectable the authority by whom authenticated. The bill professed to be one merely to regulate the practice of surgery; yet a line or two after it stated, without even its having been attempted to be proved, that "Whereas ignorant and incapable persons are not restrained by law from practising surgery; whereby the health of great numbers of persons is much injured, and the lives of many destroyed." Was this, then, merely a bill of regulation, or was it not rather one of imputation, and that of the most alarming and. prejudicial nature? The college of Dublin, as well as other bodies, was inimical to the bill, though not to its principle. He was inimical to the principle of the bill itself; for if it were sufficient for a party merely to appear before a certain board (not that he supposed such board would be directly influenced by interested motives), in order to procure a licence or diploma, on payment of a sum of money, it was to be feared that the practice would ultimately degenerate into one of considerable abuse. It was natural to suppose a competition would soon be entered into between the several bodies who had a power to grant licences, for the purpose of procuring the greatest quantity of fees. The more testimonials they granted, the greater would be their profit. It would be evidently to their advantage to grant as many as possible; and, therefore, it appeared to him, that unless they had some other test of ability, beyond a mere diploma, a great abuse would be generated. On this account he should oppose the bill being carried into a law. With respect to Ireland, where, he believed, the profession was most respectably carried on, he would not attempt to regulate it there, without farther evidence of the necessity of legislative interference. In 1784, alterations of a beneficial character were made in the college of surgeons of Dublin, without which their new charter would not have been granted to them. By those regulations, an apprenticeship was rendered necessary, before an individual entered on the profession, instead of a mere appearance before the board, and receiving a diploma. In the bill now before the House, there was a clause, which set forth, that surgical assistance was often necessary in practising midwifery; and, therefore, that every person practising that branch of the profession, should also have a licence for acting as a surgeon. By this means a double imposition would be levied from persons acting as accoucheurs, which appeared to be unjust and unnecessary. He was altogether an enemy to the principle of subjecting the surgical profession to any such restriction as this bill proposed: for if such a bill were adopted, he very much feared that the fees required for the diploma would alone be looked to, and that the examination would become a mere formality. After animadverting upon the fees required for a diploma by the college of surgeons of Edinburgh, which in 1717 amounted only to about 3l. while they were now equal to 250l., the right hon. gentleman concluded with observing, that the present bill was the child of the late attorney-general, who transferred it to the hon. and learned mover, by whom, with all his paternal care for the bantling, it had not, he was sorry to say, been much amended or improved.

Sir J. Newport

opposed the bill, on the ground of its destroying the only check that now existed against an improper system of professional practice. It would destroy all competition. The examination would be a mere formality. The only object would be the fee.

Mr. Courtenay

said he was not disposed to press its adoption against the sense of the House.

Mr. D. Gilbert,

though he considered the present measure objectionable, thought some plan should be devised to guard against those abuses which were admitted to be too general.

General Hart

declared it the most exceptionable measure ever submitted to parliament. Its framers might with equal propriety have demanded, that the surgeons of the united kingdom should all pass through a certain turnpike and pay toll, in order to qualify them for the exercise of their functions, as to regulate their efficiency by such a test as was now proposed.

The amendment was then carried, and the bill was ordered to be read a second time that day six months.