COMMITTEE MOVED FOR. (Hansard, 15 February 1859)

§ MR. TITE
stated, that the reasons for the notice he had given for the appointment of a Select Committee "to inquire into the operation of the laws relating to the care and treatment of lunatics, especially of those found to be lunatics by inquisition," were to be found in the fact, that late in the last Session of Parliament he had moved for a Committee to inquire into the state of the law regarding Chancery Lunatics. That Motion was received into considerable favour by the House and the Government, and he was told by the Solicitor General, who replied to him, that if he would enlarge the scope of his Motion and renew it this Session, it was most probable the Government would support him in it. The Government, however, though they admitted the necessity of a change in the law by bringing in two Bills to amend it, so far as the lunatics in public and private asylums were concerned, had apparently not concurred in his Motion, for up to last evening he presumed that it was to be opposed; but last night the Secretary of State postponed his Bills, and informed him he had resolved to support the appointment of a Committee, and to refer the Bills he had prepared to that Committee, if the House should grant it. In this state of things, therefore, it would not be necessary to do more than state very shortly 404 a few leading facts, and the House would be spared the longer statement he should otherwise have considered it his duty to trouble them with. It appeared, then, that the last Committee that sat on this important subject was in the year 1828; since that time there had been Commissions to inquire into the Scotch laws, and another into the Irish laws, within the last two or three years, but none what-ever in England. There were, however, many Returns, and the annual Reports for the Commissions in Lunacy now amounted to twelve. From these documents it appeared that there were at the least 23,000 registered lunatics in England alone, of all classes. There were the pauper lunatics, the number of whom was stated in the last year's Report of the Commissioners at 17,572, having in one year increased to that number from 16,637; and there were about 5,000 lunatics of other kinds. They were subject to three jurisdictions—firstly, the Commissioners of Lunacy had the charge of the pauper lunatics and of private asylums; secondly, the Chancery lunatics were under the charge of a board of visitors, with a distinct jurisdiction; and the third class was, that of the criminal lunatics. The laws relating to this subject were conflicting. In 1828 the first law of an extensive scope was passed; it was amended in 1832, again in 1835, and in 1838, 1841, 1842, and, lastly, in 1845 it was entirely remodelled. In 1853 the Act regulating the Chancery lunatics, or those found so by inquisition, was passed—an Act drawn up by Lord St. Leonards. Last Session he (Mr. Tite) drew attention to the operation of that Act, which he believed to be inconvenient and oppressive. The number of lunatics under the care of the Court of Chancery was 600, and the total amount of their property under the control of the Court was upwards of £200,000. The Act of Parliament drawn up by Lord St. Leonards did not repeal previous Acts, but unfortunately referred to them, and the provisions relating to lunatics under the care of the Court of Chancery were to be found in five or six separate Acts. With regard to criminal lunatics also, it appeared that some provision was necessary. There were now 600 or 700 of them. He thought, as a criminal lunatic was not regarded as morally responsible for the act he had committed, when he was restored to health he should be restored to society. At present there was no power to do this, except by the judgment of the 405 Home Secretary, and this was very seldom exercised in the matter. Another large class of lunatics consisted of those who were just above the condition of paupers. In Scotland, in every large town, there was an asylum for them; in London there were two great foundations—St. Luke's, which only took them for one year, and Bethlehem, which took them only under particular circumstances. He hoped the Committee would consider whether it was not possible to do something for that large class, who suffered extremely, as well as their families, whenever that distressing disorder overtook them. What was wanted was a more complete supervision; and the measure now required was one for the consolidation of the law, defining the functions of the several boards, which had now a distinct and divided action. The hon. Member concluded by moving—

§ MR. WALPOLE
Sir, when the hon. Gentleman brought this subject before the House last year, my hon. and learned, Friend the Solicitor General on behalf of the Government, said he thought it reasonable that some inquiry into it should take place. The hon. Gentleman, therefore, in renewing his Motion, had certainly obtained a kind of pledge from the Government that they will not on their part oppose such an inquiry, provided it is conducted in a manner so as to lead to some practical and beneficial result. Perhaps I may be pardoned if I make one or two remarks on a question of so much importance to a vast portion of the community, with a view of showing what may be done and how an inquiry may usefully take place. The House is aware that there are four classes of lunatics in this kingdom—namely, first, criminal lunatics; secondly, lunatics found to be such by an inquisition under the Court of Chancery; thirdly, lunatics in private asylums; and, lastly, lunatics confined in county and borough asylums. With regard to criminal lunatics, I do not think we need interfere with the existing arrangements. With regard to those found to be lunatics by inquisition, I do think that some Amendment may be made in the law, chiefly in two respects; one with reference to the manner in which inquisitions are held and inquiries conducted. constantly extending over long periods of 406 time, at great expense, and indeed, I may say, to the great affliction of many people who are concerned in them. I also think that great improvement may be made with reference to the inspection, superintendence, and treatment of these lunatics; and that by providing for that superintendence and treatment in a more careful and constant manner than at present a great benefit may be conferred upon them. I then go to the other two classes of lunatics,—those who are confined in county and borough asylums, and those in private houses. Since the notice of Motion was given in the course of the summer I have felt it my duty to make some inquiries into this subject, and I own I am startled at some of the results which are the fruits of those inquiries. From the returns of the Commissioners it appears that, in the year 1852, the number of lunatics, exclusive of those in the union workhouses, was 17,412, of whom there were in private asylums 4,430—namely, males 2,331, and females 2,099; and in county and borough asylums 12,982. In the year 1857 the total number had increased from 17,412 to 22,310. Of these there were in private asylums 4,738—namely, males 2,508, females 2,230. I pause here for a moment to notice the great increase in the course of these five years—an increase little short of 5,000—and I want the House to observe this striking feature, that whereas the increase in the number of those confined in county and borough asylums was from 12,982 to 17,572, the increase in the number confined in private asylums was hardly perceptible; it was only from 4,430 to 4,738. Such was the increase in those years, and I believe it has been owing partly to the operation of legislation upon this subject by which so much better provision has been made for the poorer class of lunatics in county and borough asylums, for greater care has been taken of them, and consequently their lives have been prolonged. Then I come to the question which is, after all, one of the most important in this matter—"Of these unfortunate persons thus put under restraint, or into necessary confinement, how many of them are in the class of curables, and how many incurable!" Now, I find from the report of the Commissioners in 1857—and there is no report for a subsequentyear—that out of 21,311 lunatics in that year only 3,327 were curable, and 17,984 were incurable. Analysing these curable patients, I find that in metropolitan and provincial 407 licensed houses there were 917, in borough and county asylums 2,070, and in hospitals 360; so that one quarter of those in private asylums were curable, while only one-tenth of those in county and borough asylums came under that denomination. That being the state of the case—and most painful it is to any one who considers that at the present moment one in 830 of the population are unsound in their minds, and that the number is increasing at a great rate—you have a double duty to perform, partly to see how those who are incurable can be best taken care of, and partly to see how those who are curable can have the benefit of a restoration to sanity conferred upon them. Before the hon. Gentleman opposite gave notice of his Motion—on the same evening at all events—I announced my intention to introduce two Bills upon this subject. These Bills I propose, if the House will give me leave, to read a first time to-night. One relates to improvements in county and borough asylums; the other to improvements in private houses. The improvements in county and borough asylums are chiefly of a practical nature, and relate to matters which have been reported to me in the Home Office during the past year. I have noted down the matters which have been complained of from time to time, and have endeavoured to find a remedy for them. I do not think I need at the present moment detain the House with those remedies, particularly considering the course which I propose to take with regard to this Motion. That course is, so far as the Government is concerned, to accede, with the alteration of a few words in the terms of the Motion, to the inquiry which is asked for, and to refer my two Bills to the Committee which is to be appointed, in order that it may have something tangible and practicable to deal with. I am particular anxious for this, because, during the autumn and in previous years there has been a good deal of controversy upon this most painful subject, and some persons have advocated the adoption of a course which would be a retrogressive and not a progressive step in legislation. It has been contended that you ought to have public asylums for all classes of patients, that you ought to register them, and that you ought to confine no one without a public inquiry. Now I wish the House and the public to consider what would be the consequence of such a course as that. If an inquiry is asked for, for the purpose of leading to its 408 adoption, it is one which, I think, ought not to be conceded, because, if you once attempt to have public asylums for all classes of patients, this would inevitably follow, that those who thought that this painful malady had better not always be brought before the public eye would seek some private reception house, where patients could be placed, and once there, they would not have the advantage of the superintendence, the supervision, the care, and the control which they now enjoy in private houses. But, above all, I must say that I think you could not inflict a greater evil upon these unfortunate people themselves than by granting, in all instances, a public inquiry into these cases. The House must bear in mind that this distressing malady is often the result of most accidental circumstances. It very frequently is not hereditary in its character, and does not recur when once it has been cured. Now, by one illustration I will show the House what would be the consequence of having a public inquiry in all cases. I will suppose that this malady comes upon a person in business from over exertion of the mind, from great anxiety, or it may even be from bodily or physical ailment. That person might, under existing circumstances, be cured within a few months, and it might be known to no one in the world that he had been afflicted with this malady; but if you once establish a public inquiry all will be known; the excitement of the patient will be very bad for him, and retard, if not prevent his recovery; and when he returns to his business he will go back with a suspicion of insanity upon him, and as a consequence, I am afraid, subject to the mistrust even of his neighbours and relations. I will not trespass any further on this point, because I believe that that illustration will show what would be the evil of such an inquiry—an evil which would be increased tenfold when you applied such a proceeding to another class of cases, especially to those of the other sex. That being so I have devoted a good deal of attention to the measures which ought to be adopted for the better supervision and care of these persons, and I think the House has four things for which to provide. It has to provide that there shall be a proper guarantee for the confinement of any person in the first instance; that the houses of reception for these unfortunate persons shall be suitable for the purpose; that they shall not be confined, I was going to say, a day or an hour, but 409 certainly not a week, beyond the time when their recovery is clear; and lastly, that their treatment, whether curable or incurable, shall be the best which the wisest and most benevolent legislation can secure. I point out these things because I wish the Committee, to which this matter is likely to be referred, not to embark in a mere rambling inquiry, and, consequently I propose to lay on the table of the House a Bill with reference to private asylums which will, I hope, secure all four of these objects. With reference to confinement, in the first instance, I think the law is to a certain extent defective, and what I propose by my Bill as a proper guard and precaution is, that no person shall be put in confinement at all without notice of the fact being sent to the Commissioners within twenty-four hours. In the second place I propose that the justices in different counties shall appoint medical examiners for particular districts, and that when the Commissioners receive a notice that any person is put under restraint or into confinement, then within a week, not the medical officer of the house, not any person sent down from London, but the medical examiner on the spot shall inquire into the case, shall report specially upon it, and shall place the whole matter before the Commissioners. I then propose that after that is done the Commissioners shall have power either to make their report upon that case to the justices of the county, or to call upon the superintendent or proprietor of the House in which the person is confined to give further explanations. So much with regard to the reception of the patients in the first instance, and I think these checks will be sufficient. Then with regard to the houses to which they are sent, I think the present mode of forwarding the plans and estimates to the Commissioners fourteen days before the licence is granted, and then no action taken, is not sufficient. There are two modes in which the houses are licensed. The Commissioners have no jurisdiction beyond the metropolis. I propose that the Commissioners should have the power to report upon the plans of licensed houses, and to send them to the magistrates in the country, so that the latter may have the advantage of the central knowledge and experience of the Commissioners, and may apply it to their own local wants. I am anxious to read an extract from the last Report of the Commissioners, which shows 410 that some improvement in the law in regard to single patients is required. They say:— The condition of single patients has engaged much of our attention during the past year. The lists have been carefully revised; regular returns from the persons having charge of patients have been strictly enforced; and the country has been divided into districts, so as to insure the regular annual visitation of all cases returned to our office. On the whole, the condition of the patients so visited cannot be described as satisfactory. As a general rule, the accommodation provided is quite incommensurate with the payments, which, in many instances, are very large. The necessity for our continued and regular supervision has been clearly established, and, in some instances, we have found cases of marked neglect. In two or three we have discovered that, besides the patient who has been regularly certified and returned to this office, the proprietors of houses have also had under their charge other persons of unsound mind, relative to whom no return whatever had been made. In these cases, although from the presence of circumstances of an extenuating character we have not deemed it proper to institute prosecutions for the legal penalties incurred, we have insisted, by way of warning to others against commission of the same or any similar offence, that the offenders should insert apologies in the daily and medical papers. In order to insure greater vigilance of inspection, I propose that, in addition to four inspections in the year by the visitors on the spot, the Commissioners should, by themselves, or by some person authorized by them, make three visits to each licensed house. I also propose that they should have the power, which they do not now possess, of calling upon the proprietors to show the accounts relative to patients, in order that they may see that their allowance is properly applied to their maintenance. The fourth provision of the Bill has been framed to watch over all cases of lunacy, with the object of ascertaining that the patients are not confined a single day when they ought to be discharged. I trust that the provisions of the Bill will effect that object. In the first place, finding, on the authority of all those best informed on the subject, that the cures which are effected are generally accomplished at the earlier stages of the disease. I propose that a Commissioner should go down within three months after the confinement of a patient and report specifically upon that case, independently of all other visits that he may be required to make. I propose also that in the course of the year subsequent to the admission of each patient the Commissioner shall be required, when making one of his usual visits, to make a specific report upon the progress of that case, so 411 that the Commissioners may know the state and progress of that patient's malady from the period of his restraint to the end of the first year. I think also you ought to require, in the third place, that the proprietors of these houses should not be allowed to certify any person to be of unsound mind who is to be confined in any other licensed house—in other words that you should take away from proprietors of licensed houses the power of favouring another licensed house, or of sending patients to each other. Another provision in the Bill is that the notice of recovery should not merely be sent to the friends of a patient, but that it should also be immediately sent to the Commissioners, so that they may, if necessary, take action upon it. I hope, by means of these and other provisions, that we shall throw around these unfortunate persons every check and guard that can insure the propriety of the original confinement; secondly, the suitableness of the licensed house in which they are confined; thirdly, a more careful and vigilant treatment of each particular case; and, fourthly, the dismissal of the patient as soon as his recovery has been effected. There is one other proposal, the most important of all, which I had nearly forgotten to mention. We propose that power should be vested in the Commissioners to allow the patient to be out on trial when the case admits of such a proceeding, in order that it may be seen whether the restoration to liberty, under proper precaution and restraint, has any effect in promoting his recovery. If it should have no such effect, he may then be again confined. This provision is in one of the Acts of Parliament relating to lunatics, but has not yet been extended to those confined in private houses. I should desire to confine the inquiry so that it may embrace every practical object without leading the Committee to embark upon a rambling investigation that can lead to no good result, and that must give pain to the friends of many of these unfortunate persons. I should, therefore, propose that the Resolution appointing the Committee should be in the following words, which would equally effect the object the hon. Gentleman has in view:— That a Select Committee be appointed to inquire into the operation of the Act of Parliament and the regulations for the care and treatment of lunatics. I propose, if the House will allow me to 412 introduce the Bills of which I have given notice, to refer them to the Select Committee. I believe that my hon. and learned Friend the Solicitor General also contemplates referring to the Committee another Bill in reference to persons who have been found of unsound mind by inquisition under the Court of Chancery. The Committee will then have practical points before them, and if the effect of the inquiry should be to increase the comforts of those unfortunate persons, if it should improve their treatment, and, still more, if it should effect their recovery and secure their return to their families, I shall feel gratified that I have supported such an inquiry for such a purpose and with such a hope.

§ MR. DRUMMOND
said, he had heard no allusion made to a part of the subject which he thought most important of all—namely, the case of lunatics who were under the jurisdiction of the Court of Chancery. He supposed that when the Bill of the Solicitor General appeared, it would be seen how he proposed to deal with this branch of the question, as no inquiry could be complete without it.

§ MR. TITE
said, that the last thing he wished for was a "rambling" inquiry. He hoped his inquiry would have been a reasonable one; but he certainly had the greatest possible pleasure in acceding with all sincerity to the proposal of the right hon. Gentleman. He therefore should gladly withdraw his Motion, with the hope that the inquiry would be at once set on foot and be proceeded with as quickly as possible.

§ MR. PACKE
said, that when they adverted to the fact that all sane persons convicted of crime were kept at the common expense of the country, it was only dealing out even justice that there should be some general scheme of maintaining all convicted lunatics. It would really be a very great assistance towards this end that there should be one general asylum for criminal lunatics.

§ SIR G. GREY
said, that Her Majesty's late Government had come to a determination that a general asylum for criminal lunatics should be erected, and a Vote for that purpose was actually inserted in the Estimates, but what progress was being made in the matter he did not know.