§ The CHANCELLOR OF THE EXCHEQUERsaid, the first vote he should move would be a vote for the Poor Law establishment. It was impossible for him to put into the estimates any other vote than the vote of last year, for the Government could not answer for the Poor Law passing. He would now state that it was proposed that the salary of the new Chief Commissioner should be 2,000l.; being, therefore, a saving of 4,000l. a year in the salaries of the Commissioners. But it was proposed to have two Secretaries at a salary of l,500l. a year each. So that whilst the expense of the establishment under the old law was 7,000l., the expense of the establishment under the new system would be 5,000l. He moved that 182,200l. be granted for the administration of the Poor Law.
§ MR. FERRANDsaid, it had been his intention that evening to bring under the notice of the House the medical treatment of the poor throughout the country; but, having communicated that intention to the right hon. Gentleman, and that right hon. Gentleman having informed him that it was the anxious desire of the Government, as soon as the new Board was formed, that that Board should take into consideration the medical treatment of the poor throughout the country, for the purpose of increasing and improving it if necessary, he would not, if he had a pledge from the Government to that effect, occupy more of the time of the House upon the subject. He might, perhaps, be allowed to say that it was proved by the evidence stated in the report, that in an union exactly opposite to that House (the Lambeth union), the medical officer had received only 1s. 4d. a day for attending in each case.
§ SIR G. GREYobserved, that the subject of the expenses attending medical relief was one which deserved the most serious attention of Her Majesty's Government; and he undertook to say that it should, with as little delay as possible, receive that attention. It would, he hoped, be so considered as to enable them to propose to the House a sound measure of legislation upon that particular point. A right hon. Member called upon the House in the course of the last Session of Parliament to vote a large sum for that purpose, thereby expecting to increase the efficiency of medical relief to the poor. The sums for this purpose were only voted half yearly, so that frequent opportunities of revision were open to Parliament, Whoever, in the present or in any future Government, might be charged with the expenditure of that amount of the public money, would, of course, take care that the utmost degree of efficiency should be secured which that amount of remuneration could obtain.
§ MR. WAKLEYthought that any further inquiry would be quite superfluous. Inquiry had already been instituted—all the evidence that they wanted was in the book then on their Table, and the discovery had clearly been made that there were no men so ill paid as the medical gentlemen who visited and prescribed for the poor. But when the Bill that they had recently passed was before them, they had introduced nothing upon this subject; and he at that time did not think proper to make any proposition regarding it, as he could not fairly expect that the right hon. Baronet opposite would have agreed to the introduction or discussion of any subject not immediately connected with the powers of the Commissioners or the constitution of the commission. If he had brought forward anything on the subject of reward or remuneration to the medical attendants, he should at once have expected that the Government would oppose any proposition of the kind. The subject, however, was one which must engage the attention of Parliament in the course of the next Session. Upon the poor the present state of the law worked with indescribable inhumanity and cruelty; and, as to the medical practitioners themselves, it was downright robbery. It was nothing less than letting out the care of the health of the poor by contract. Was there any man of common feeling or common prudence who would let out the lower animals in possession by con- 122 tract? Would any Gentleman in that House, or in the country, put out his stable of horses, or his kennel of dogs, to have their health taken care of by contract at the lowest possible charge, and by the lowest bidders? But that was what was done with the medical treatment of the poor—they were handed over to the tender mercies of those who made the lowest offers. It had been said, and said very truly, that medicine was included in the charge for medical attendance: they were not paid for separately; and he regretted to learn that any medical practitioner should have made such a statement as the hon. Member for Knaresborough had quoted. If any medical man engaged by contract to provide medicine and advice for the poor, he was bound to perform that contract, cost what it might; he was bound—having made the contract—to supply his patients with any medicines which their cases might require. The practitioner, in the case to which he had been referring, said that, for the sum which he received, it would be impossible for him to supply his patients with all the expensive medicines that they might require: he said he could cure the patient if he went, in the particular case in question, to the necessary expense. But he should have remembered, when he entered into his contract, that cases requiring expensive medicines, did occasionally occur; that some cases might be cured by cheap medicines, but that costly medicines might be demanded by others; in honour and honesty that practitioner was bound to refuse such a contract, for the nonfulfilment of it might have involved the destruction of human life. But, if the medical practitioner deserved blame, how much more deserving of blame were those who forced him into that contract? Medical men in small country places had often great difficulty in supporting a family; and the struggling members of the medical profession knew that if they did not accept the offer made to them by the poor-law union officers, some of their rivals would take it. Influenced by this consideration, he some time ago made a suggestion which he thought might have been advantageously adopted; it was to this effect—that those paupers who stood in need of medical assistance should, by the proper authorities, be furnished with an order which they might present to any medical practitioner whom they thought proper to select, and from him receive the necessary advice and medicines. This would give the poor man 123 the power of selecting his own adviser, and would often save him from a great deal of unnecessary toil, delay, and disappointment. It was well known that medical practitioners employed to attend to the wants of the poor often lived six, seven, and eight miles from the workhouse; or, if not at that distance from the workhouse, at least as far away as that from the most populous part of the parish or union; thus the poor man who happened to require their assistance would be often obliged to travel sixteen or twenty miles a day before he could obtain the necessary relief, although in his progress to and fro he might have passed the houses of many medical men, from whom he could easily have obtained advice and medicine if he had been previously supplied with an order for that purpose. All considerations of this kind, he ventured to say, would come before Parliament in the course of the next Session: he had no doubt that half their time would be taken up in legislating for the poor; and he sincerely hoped that every effort would be made by the new Parliament to ameliorate the condition of those who were dependent upon parochial relief. Of one thing he was quite certain, that nothing could be worse, both for the medical practitioner and for the poor man, than the present state of the law. He greatly regretted that the Government had thought proper to ask for the present vote—it was a vote founded upon a mutilated Bill. There had been, in another place, two most valuable clauses expunged from that measure, and expunged without any opposition on the part of the Government in the other House. He wanted to know why they had not the Bill before them when they were called upon to agree to the present vote? To propose the vote without the Bill, was a plain violation of a solemn engagement. Then, again, the amount was objectionable: 2,000l. a year was more than the Commissioner was worth. He had an objection to the vote, not being informed of the precise constitution of the establishment, for the Bill was not before them. He would ask them, was it dignified for the House of Commons to agree to such a vote till they saw the Bill in its final shape? The Bill, as they all knew, had gone up to the Lords; but the Government made no effort there to retain the clauses—the valuable and important clauses—that had been added in the House of Commons. Both those clauses were based upon sound policy and upon justice: they had 124 been sustained by arguments which no one had answered; and yet the Government sanctioned the principle of those clauses in the one House, and violated that principle in the other. There was no opposition in the Lords to expunging those clauses, nor any division on the subject: he thought, then, that the House had not been treated fairly in the matter, and he therefore felt disposed to divide upon the vote. It was not fair that the Government should give up in the other House a Bill that had passed the House of Commons with so much approbation. He hoped, then, that the right hon. Gentlemen opposite would agree to postpone the resolution till they knew the fate of the Bill in the other House.
§ The CHANCELLOR OF THE EXCHEQUERsaid, when the Bill came again before them, it would be competent to them to deal with the whole subject as they thought proper.
§ MR. W. WILLIAMSwas very happy to concur in the proposed reduction of expense, and he hoped that the Government would take this case as an example for the regulation of their future conduct. He sincerely hoped that the New Poor Law would be a very material improvement upon its predecessor. As much as 70,000l. a year was paid for medical aid, and he hoped that that charge would in future be very greatly reduced.
§ Vote agreed to.