§ Order for Second Reading read.
§ SIR JOHN PAKINGTON
moved the Second Reading of the Vaccination Extension Bill, and said that in addition to its claim to consideration derived from the passage of the Bill through the other House of Parliament, it was entitled to it also on the ground that it provided further security for protecting the people from the ravages of disease. The voluntary system had been found insufficient as a preventive of small-pox; and the principle of the Bill, therefore, was compulsory—and it was upon that principle that the Bill had been introduced into the House of Lords by a noble Friend of his (Lord Lyttelton); and, having been affirmed by that branch of the Legislature, it had now come down for the assent of the House of Commons. The report of the vaccination committee of the Epidemicological Society was the basis on which he founded his support of the measure. By this report it appeared that in periods of ten years previous, and ten years subsequent, to the discovery of vaccination, deaths in every thousand were as follows: namely, from 1760 to 1770, 108—from 1780 to 1790, 87; while from 1800 to 1810 they were 64, and from 1840 to 1850 they were only 16. These numbers related only to the bills of mortality. On the Continent of Europe, in twenty towns, the average previous to the introduction of compulsory vaccination was sixty-six and a fraction in a thousand, while subsequently the deaths fell to seven in a thousand. In almost all the countries of Europe vaccination was compulsory, with the exception of England and France. In some it was direct, by means of a fine; in others indirect, by subjecting the people to civil pressure by the deprival of some municipal and civil rights. The result of the system in England was, that from 1831 to 1841 the deaths averaged as follows:—
There were thirteen countries on the Con- 471 tinent of Europe where vaccination was compulsory, and the deaths in the same periods were only in this proportion:—
London 10 in 1000 Glasgow 37 in 1000 All Ireland 49 in 1000 Connaught 60 in 1000 All England and Wales 21 in 1000
In England there was a great difference also, the mortality being greater in some places and less in others, according as vaccination was more or less attended to. At a place near Cheltenham, in 1821, there were forty-eight deaths in 800 inhabitants, or 1–16th of the whole, the people being poor, and vaccination neglected; while it four adjoining villages, the inhabitants of which were better off, and among whom vaccination was attended to, though these villages numbered respectively 1,200, 230 190, and 170 people, who were in constant communication with the infected village, not a single case occurred. In a place near Wells there had been no small-pox since 1837, in consequence of attention to vaccination. In a district of North Wales, containing 11,000 inhabitants, there had been only one death from small-pox since 1847, in consequence of the prevalence a vaccination, while the births amounted to 2,957 on an average of nine years. Again, in India, it was shown that while the smallpox devastated the left bank of the Sutlej, where vaccination was not practised, destroying fifty or sixty per cent of the population, on the right bank, where it was practised, the mortality was only five or six per cent. He would next come to what had been done in this country to promote vaccination. An Act had been passed in 1841 by which the boards of guardians were authorised to defray the expenses of vaccination in their respective unions. The Poor Law Board had done all in their power to carry out the provisions of that Act; but still the grave facts remained that the system was voluntary; that the people were prejudiced in many places on the subject; that a large proportion of the population were not vaccinated, and that mortality from small-pox existed to a very great extent. In the year ending March, 1843, out of 527,325 born in England and Wales, only 183,000 had been vaccinated, or thirty-four per cent of the whole, while in the succeeding years the numbers were in the following ratio:—
Saxony 8 and a fraction in 1000 Lombardy and Bohemia 2 and a fraction in 1000
In the year 1846–7 the births were 552,000, 472 of which only 267,000 were vaccinated—or less than fifty per cent of the whole. In consequence, however, of the stimulus given by the Poor Law Board, there were in
1844–45 100 to 156 45–46 100 to 1341847–48 born 700,000, vaccinated 400,000or at the rate of two-thirds of the whole. Of these, however, a great proportion were vaccinated late, the effect of vaccination being much less than it would have been if the child had been inoculated at three or four months old. As late as 1851, in thirty-two unions in and about Birmingham, the births were 17,700, while the vaccinations were only 6,174—two-thirds of the whole being without vaccination. Having shown the small proportion vaccinated, he would call attention to the number of people attacked by the small-pox, and the numbers who had died of that disease. The number annually attacked in Great Britain and Ireland was, on the average, 100,000; of which from twelve to thirteen per cent perished of the disease. In London the average deaths for thirty-three years was 913. In Ireland, on an average of ten years, to 1841, there were 58,000 attacked, and 7,836 died. The mortality was far greater in these countries, therefore, than in any country in Europe; and he therefore hoped, as the voluntary principle was not sufficient, the compulsory principle in the Bill would be adopted. As regarded the Bill itself, he was of opinion that the mode of carrying out the compulsory principle should be altered; and he should object to the 5th clause, which placed the remuneration of the medical officers on the same footing as the existing Act—an average of 1s. 6d. per case. He was prepared to adopt any suggestion for the improvement of the Bill; and he hoped, therefore, its principle would be adopted, as some enactment of the kind was imperatively required for the public welfare. He moved the Second Reading of the Bill.
§ VISCOUNT PALMERSTON
said, that small-pox was undoubtedly one of the greatest scourges that afflicted the human race; but the success of the measures of precaution which had been taken against it, exhibited in a striking manner how foresight and prudence might mitigate such evils. He thought the right hon. Baronet had produced irrefragable proof that some measure such as was involved in the principle of this Bill was requisite for the 473 security of the public health—the more so on account of the circumstances connected with it. The object was prevention by means of timely foresight and precaution, and the class of society for whom that foresight and precaution were required was the poorest, and that which was the least likely to have recourse to such measures voluntarily. The right hon. Baronet had stated some striking instances of the difference in the rate of mortality from smallpox in countries where vaccination was compulsory, as compared with those in which it was voluntary; but it was, nevertheless, satisfactory to be able to say that the exertions of the Poor Law Board in this country had, during the last twelve months, been attended with greater success in staying the ravages of this disease than the results of former years had shown. He found that in 1852 of 601,000 children born, 411,000 had been vaccinated, or 68 per cent, and this was independent of the number which had been vaccinated privately. He was quite prepared to give his support to the principle involved in the Bill; but he agreed with the hon. Baronet that the machinery of the Bill required considerable alteration, and he was glad to hear that the right hon. Baronet had undertaken to propose such Amendments in Committee as he might on consideration think calculated more effectually to carry out the object of the Bill. He gladly, therefore, supported the Motion for the second reading, upon the understanding that the right hon. Baronet would, between this and the committal of the Bill, turn his mind to the subject, with a view to make such alterations in the details as would make the Bill less liable to the objections to which it was now open.
§ MR. BRADY
said, the disease was the occasion of frightful ravages among the population, and any well-considered measure, having for its object to mitigate that scourge, would be received with gratitude and favour by the public. But the present measure, however well intended, was inadequate to carry out its object—it was not a compulsory measure that was required, but one which should meet the sympathies of the people, and which the people would assist in carrying out. He thought that the practice of placing vaccination under contract was injudicious, inasmuch as it made the medical profession lukewarm on the subject. As long as the Poor Law Board had the making of these contracts, so long would mischief exist. 474 The Bill in one way provided for the due supply of proper vaccine matter. In the next place, the first clause provided that vaccination should be performed from the arm of the child, and in the presence of the parents. It was a moral impossibility that this clause could be carried out. It might be that a child could not be vaccinated safely on the arm; the mother would, perhaps, object to vaccination on another part, and would decline to have vaccination performed. There would thus be the danger of carrying out into society a virulent disease to be spread abroad. Then the measure went on to compel vaccination within three months, and that the vaccination should be performed by the Union officer, or some qualified medical man, who was to be compelled to vaccinate gratis. This clause might be so construed as that persons having children to vaccinate would call upon some of the most eminent men, Sir Charles Clarke or Sir Benjamin Brodie, to vaccinate their children. Having made these objections on the Bill, he would, if permitted by the House, detail a plain of his own. ["No!"] He would content himself, then, with the remarks he had ventured to make.
§ SIR GEORGE STRICKLAND
rose to object to the principle of the Bill. He thought the House went too far in compulsory legislation; and he was always a friend to the voluntary system whenever it was possible. The right hon. Baronet (Sir John Pakington) had himself given the strongest reason why this Bill ought not to pass. The right hon. Baronet had shown that vaccination, as at present carried out, had already worked well, because it had reduced the mortality from smallpox from 116 to 16 in every 1,000. But the right hon. Gentleman wished to disturb the present good arrangement because some mothers had an objection to the operation. With the advance of education the small-pox would almost be rooted out, if vaccination were left to the voluntary principle. But there was too much resort to compulsion. One little measure was taken from Saxony, another from Austria, another from Prussia. There could not be one law for the rich, and another for the poor. The mother must be compelled to vaccinate; but in a rich man's house that was impossible. The House was going to force every one to give up prejudices against vaccination. If they acted more on the old English principle, and left people to the voluntary principle and to their 475 own good sense, the object would be more rapidly and successfully attained.
§ MR. FREWEN
would also object to the second reading. One of the penalties was 5l.; but how was that penalty to be enforced from the poor man? Then how was vaccination to be "properly administered?" They might have a medical man to vaccinate; but what security had they that the operation would be properly performed?
§ Bill read 2°.