HC Deb 13 February 1871 vol 204 cc221-30
MR. W. E. FORSTER

, in rising to move "That a Select Committee be appointed to inquire into the operation of the Vaccination Act (1867), and to report whether such Act should be amended," said, that he made this Motion in compliance with the statement made by the Home Secretary towards the end of last Session, when a Bill was brought in by the hon. Member for Sunderland (Mr. Candlish), to relax the stringent punishments inflicted by the refusal to permit vaccination. The feeling of the House on this subject was such that there was little chance that his hon. Friend would be able to carry his Bill; but it was also felt that it was desirable to remove, if possible, the objections which existed in the minds of some persons against vaccination. He did not imagine that the hon. Member for Sunderland (Mr. Candlish) more than any other Member of the House had the slightest doubt of the utility and necessity of vaccination, and that it was necessary not only to encourage it, but to make it compulsory. Opposition to such views were not heard in that House; but it was to be found, he was sorry to say, among certain persons in this country who had indeed carried their resistance to an extent that had been injurious to health and destructive to life. They must have forgotten the state of the country and the civilized community before vaccination was introduced. During thirty years before the introduction of vaccination there were on an average 3,000 deaths from small-pox per annum in every million of the population, while between 1854 and 1865 they were reduced to an average of 202 per million. In Berlin the statistics were still more conclusive—owing, probably, to the great care taken in Prussian administration—for in that city the decrease was from 3,422 to 176. Again, in the Smallpox Hospital, where all the nurses and the servants were invariably re-vaccinated on their appointment, the resident surgeon had not a single case on record during the last 34 years. He only mentioned these cases to show that the Government had not the slightest doubt not merely of the advantages and efficacy of vaccination, but of the necessity of having a law to enforce it. It would, no doubt, be pleasanter not to be compelled to have recourse to law to have it performed; but, unfortunately, they had to contend with opposition — the opposition of ignorance, and also, he was sorry to say, with the opposition arising from interested motives preying upon this ignorance; and, lastly, with the great neglect which arose purely from apathy. It was owing to those causes that a compulsory law was necessary, and statistics showed that the destructiveness of the disease increased or decreased accordingly as compulsion had or had not been enforced. In Scotland and Ireland, where they had been able to secure complete compulsion, the disease which at one time had been very prevalent, had been reduced to a minimum and was, indeed, hardly known; in those districts of England where, before vaccination was introduced, it had been fearfully destructive, it had now been greatly diminished; whilst, on the other hand, in those districts where the guardians had not enforced it, they were liable to frequent outbreaks. With these facts before them, it might be asked where was the necessity for a Committee? But he (Mr. Forster) was strongly of opinion that good results would follow from their labours. There were some persons in the country who entertained in their own minds a conscientious objection to vaccination, from a belief that it did their children harm; but he thought the evidence that would be brought before the Committee would tend to convince them of their error. At all events it was due to the feelings of those parents who objected to vaccination that further inquiry should be instituted, and he trusted the result would be that martyrs to the prejudice against vaccination would no longer be found. Another reason for the appointment of the Committee was that it was desirable to carry public opinion with the action of the law, and there were some cases in which the guardians wished to be strengthened in doing what appeared to many to be an arbitrary act. The Committee must take into consideration many suggestions which had been made in various parts of the country for rendering the Act more effectual than it was at present. The administration of the Act should likewise be inquired into; and he believed that when that was done it would be found that both the Privy Council and the Poor Law Board had done their utmost to prevent imperfect vaccination. It was their wish in no way to limit the scope of the inquiry, and he therefore proposed that the Committee should be empowered to take evidence with regard to the operation of the Act within Ireland and Scotland. He trusted that the inquiry would not only be full and complete, but that, in the interest of the public, they would feel it to be their duty to make their Report speedily, as it was desirable that there should be as little delay in the matter as possible.

SIR CHARLES ADDERLEY

observed that the arguments urged by the right hon. Gentleman (Mr. Forster) in proof of the efficacy of the existing law in regard to vaccination had cut the ground from under his feet in asking for inquiry, for there could be no use in inquiring into a matter which was so well ascertained. Inquiry was good where there was anything to inquire about, but not where there was sound ground for action, and action was urgent. In such a case an inquiry was not only useless, it was positively mischievous; for nothing could be more dangerous than to profess a doubtfulness concerning a matter about which there was no doubt and which demanded only decision. The right hon. Gentleman, with a view to induce the House to acquiesce in the inquiry, had told them that there was ample evidence to show that where the law had been carried out small-pox had disappeared, and that nothing was wanted in England but strictly enforcing the law to secure similar immunity. And yet at the moment when the right hon. Gentleman brought forward this Motion for idle inquiry about vaccination, as a speculative remedy, the smallpox was raging in London. Instead of proposing an inquiry, those who believed that the law was right ought rather to express, and in action evince, their confidence in the results which it effected. He objected to the appointment of this Committee, moreover, because the subject had come within the scope of the inquiry entrusted to the Royal Sanitary Commission. That Commission had just taken evidence on the subject, expressed their opinion on it, and their Report would in a few days be in the hands of Members. Their opinion was that the law was complete, and required nothing but enforcing. They proposed better registration to insure its enforcement. It had been very imperfectly carried out in England; but in Ireland and Scotland it had been properly enforced, and with such complete success as to have nearly stamped out the small-pox. What was now really required was to empower the authorities to stimulate the responsible officers to enforce the existing Vaccination Acts. He thought that the reference of the question to a Select Committee was a most mischievous mode of shirking the responsibility of enforcing the law as it stands, and especially mischievous when the public had professed confidence in the mode already provided for meeting the present danger. The fact was that the Bill of the hon. Member for Sunderland (Mr. Candlish) at the close of last Session became—as so many Bills were still pressing at that period of the year—an embarrassment, and the right hon. Gentleman opposite in an unguarded moment had promised the hon. Member that if he would withdraw the Bill, though, there was no chance of its passing, but only of its choking the way of others, there should be an inquiry. It was an innocent and perhaps defensible weakness at the moment; but he trusted that at the commencement of a Session so full of business the result of cooler and calmer reflection would be not to appoint such a Committee, If its appointment involved nothing more than the waste of the time of 15 hon. Gentlemen upstairs, he, for one, would offer no objection; but he believed that at a moment when an epidemic was raging in London, even the appearance of doubt, where confidence was what was chiefly necessary, would be so mischievous that, though he would not divide them on this question—the House having been taken by surprise, he should certainly do so on the nomination of the Committee.

MR. CANDLISH

said, that the right hon. Gentleman who had just sat down (Sir Charles Adderley) argued against the Motion of his right hon. Friend on the ground that the existing law was satisfactory if it were only carried out. But that was exactly the weak point of the matter. The law was not now practically compulsory, and could not be carried out, and — arguing, therefore, the question from the right hon. Gentleman's own point of view—the law imposed penalty after penalty if vaccination were not performed. If a parent did not get his child vaccinated he might be summoned before a magistrate and fined 20s.; but the right hon. Gentleman knew very well that did not secure compliance with the law. There were cases in which the penalty had been repeated at least half-a-dozen times, and the child remained unvaccinated to the present day. Surely, then, the right hon. Gentleman, if he believed in the efficacy of vaccination, must be dissatisfied with the law. [Sir CHARLES ADDERLEY: With its administrators.] Well, then, would the right hon. Gentleman say how the administrators had the means of carrying out the law? The administrators had not the power to take the child out of the arms of the mother, and carry it directly to the operator, and until that power was given them the penalty was merely the legal price paid for the disregard of vaccination. The law as it stood was ineffective, and, notwithstanding, it was harsh and cruel upon some parents: let them try if it could not be improved. He believed that it could be made more tolerant in its operation, and, at the same time, more efficiently and successfully applied. If this Committee were not granted an amount of discontent would be generated in the country the consequences of which could not at present be foreseen. There was not a constituency in England in which there were not to be found a small number of intelligent and conscientious men who would be deeply grieved if the House should not grant this inquiry. The Committee of 1867 had for its object not to inquire into the effects of vaccination, but to deal with the clauses of a specific Bill. The question on its merits had never been referred to a Committee, and hence the weakness of the law at the present moment. He hoped, therefore, the right hon. Gentleman would forego his promised opposition.

MR. W. H. SMITH

said, he joined in expressing the hope that his right hon. Friend (Sir Charles Adderley) would allow the Committee to be appointed. There was no matter that required more consideration than the operation of the vaccination laws in England. We had evidence that in Ireland they had been perfectly successful; but in various parts of London, which was now visited by a fearful scourge, the differences in the administration of the law were very great. In some parishes it had been carried out very successfully, while in others no vaccination inspectors had been appointed, and scarcely anything had been done to insure obedience to the law. He held in his hand a letter from the medical officer of the Hampstead Hospital stating that so far as he could judge in the metropolis there could be no doubt the disease was increasing both in extent and in the malignity of its effects. However that might be, there could be no doubt that a very large number of persons were suffering from small-pox who, if the law had been properly administered, ought not to be suffering from it at all. There was no doubt that small-pox was a disease which could be stamped out if proper means were used; but now, on account of the inefficiency of our laws and the inadequacy of their administration, we had to submit to a fearful scourge, and in a great panic make haste to found hospitals, spending thousands of pounds when hundreds would have sufficed in the first instance. It was in the hope that the appointment of the Committee would bring home responsibility to some one that he desired to see the Motion carried. In proof of the way in which vaccination was neglected, he would refer to a report by one of the Officers of Health in London. That report stated that, in a particular district, during 1869–70 there were 1,105 births registered, and that the successful vaccinations had been only 253. There was no officer appointed to carry out the Act in that district. During the ten years from 1856 to 1867 the births annually registered were, on an average, 1,287, and the successful vaccinations 962, or three-fourths of the whole births; but they fell in 1868 to 685, in 1869 to 445, and in 1870 to 253: so that the Act in a large part of London had been entirely neglected. The six months allowed to the registrar to prepare a list of persons whose births had been registered but whose certificates of vaccination had not been received by him was too long, considering the migratory habits of many of the people. He had been told on very high authority that a very large proportion of the population moved from parish to parish and district to district every three months, so that if the Act were attempted to be carried out by the proper authorities the people could not be found, and in this way it was calculated one-fourth of the children registered were removed with their parents before the registrar's list was completed, and so escaped the operation of the Act. In one parish he was aware that the officer appointed used to go to the registrar and obtain a list at an earlier date, in order that he might follow up the people, and the consequence was that he had succeeded in getting four-fifths of the children vaccinated without a single prosecution. It was said by those who took an interest in the matter that all that was wanted was direct responsibility and proper organization. But the tendency of legislation of late years had been to divide responsibility, so that no one could say, when mischief arose, to whom the blame ought to be brought home.

DR. BREWER

said, the question was whether a Committee ought to be appointed to inquire into the Vaccination Act. The reason why he thought such an inquiry as that which was now proposed would be useful was not because that House or the intelligent people of the country doubted the efficacy of vaccination when properly performed, but because in various classes, especially in large towns, not only was there doubt whether it was effectual as a preventitive, but there was an exceedingly great fear that diseases even more to be dreaded than small-pox itself were conveyed by vaccine matter. It would be quite unwise of the House to ignore that opinion. He found it to prevail among the classes lately admitted to the small-poxhospitals, nor were these always the most ignorant, idle, or indigent of the population. Domestic servants, barmaids, men in similar employment, cabmen, busmen, and coachmen, gained admission to these hospitals, and were found unprotected by vaccination; and there were of every grade those who believed that vaccination was not simply no sure protection against small-pox, but the means of introducing serious diseases among the people. He was convinced that, if proper evidence was forthcoming, this fear would be dissipated, and therefore he believed that the House would do wisely and kindly by consenting to the appointment of this Committee. All that was necessary to improve the administration of vaccination, and to carry it more completely into the houses of poorer classes, was to instruct the poorer classes by such literature as would demonstrate to them the folly of the opposition which had been raised up in the large centres of population in this country against vaccination. He hoped there would be no opposition to the nomination of this Committee.

LORD ROBERT MONTAGU

said, that as in 1867 the House had enabled him to pass the Compulsory Vaccination Bill, he might be allowed to say a few words on the subject. He thought the necessity of an inquiry had been proved by the debate. His right hon. Friend who opposed the Motion (Sir Charles Adderley) said that by granting a Committee of Inquiry the House would east doubt upon a matter on which there was no doubt, and that the law of 1867 was complete; but the hon. Member for Sunderland (Mr. Candlish) said the law was not complete, because it was not compulsory. He hoped that inquiry would remove this difference of opinion. He thought his right hon. Friend could hardly have read the Motion: — it was for the appointment of a Committee to consider the operation of the Act of 1867, and to inquire whether it required improvement. That was a fair subject for inquiry. He had brought in the Act himself, and he admitted that it was not perfect. He would presently show where the imperfection lay. The fact that this subject had been already considered by a Commission was not a good argument against further inquiry. As much opposition to vaccination existed out-of-doors, it was advisable to inquire whether the law was efficient, and if it was not, then they could consider how it might be improved. The opposition in this country to vaccination had been promoted by persons who inundated the country with writings in which they said that vaccination was the cause of various diseases, and that it was not efficient to prevent small-pox; therefore it was good for the country that a Committee should be appointed in order that there might be an opportunity of inquiring into the truth of the allegations that had been made. He admitted that there was a fault in the law—a fault which he could not avoid when he had charge of the Bill. In Scotland and Ireland the compulsory Acts had been perfectly successful. In Scotland, before 1863, the average number of deaths by small-pox was 2,000; in two years after the passing of the Act the number was reduced to 123. Why, then, was the English Act not so successful? Where was the defect? He believed the reason why it was not successful in England was because registration of births was not compulsory. In Scotland, the registration of births was compulsory; there was, therefore, one list of the children that were born, and another list of the children that had been vaccinated, and, by comparing the two lists, any case of omission to vaccinate could at once be seen. But in England there was not a compulsory registration of births; the law went so far as to impose a fine on the registration of a birth within a certain period, which fine was escaped if the birth was not registered at all. In the case of typhus fever or scarlatina, we could make an epidemic less virulent; but vaccination was a certain specific against small-pox. He believed that, in every case, vaccination prevented small- pox. It was therefore most necessary to take every means to make the law most efficient.

DR. LYON PLAYFAIR

said, the reason why he opposed inquiry last year was because he was afraid of doing anything to shake the confidence of the country in vaccination at a time when he knew a great epidemic was rolling over to this country from the Continent. In London, we were now in the midst of that wave, and it was there felt with the greatest severity; but it had not yet reached its summit, and he thought it had become very important to inquire why vaccination had not been so successful in England as in the two other parts of the United Kingdom. He hoped, the right hon. Gentleman (Sir Charles Adderley) would withdraw his opposition to the Motion.

MR. W. E. FORSTER

also appealed to the right hon. Gentleman to withdraw his opposition. As he had before said, the Government did not propose this Committee with the slightest doubt about the principle of vaccination, or the necessity of compulsory vaccination—and he need not say they had no intention of relaxing the operations of the law during the deliberations of the Committee. But they believed that with the present amount of information possessed by the public, suggestions might be made for amending the law; for making it more effective for removing, he trusted, some of the opposition to the law throughout the country, and, probably, for improving the administration of the law. For all these purposes he believed that a Committee at this time would be of great service.

Motion agreed to.

Select Committee appointed, "to inquire into the operation of the Vaccination Act (1867), and to report whether such Act should be amended."—(Mr. William Edward Forster.)

And, on February 16, Committee nominated as follows:—Mr. WILLIAM EDWARD FORSTER, Mr. STEPHEN CAVE, Mr. CANDLISH, Mr. WILLIAM HENRY SMITH, Mr. MUNTZ, Lord ROBERT MONTAGU, Mr. JACOB BRIGHT, Sir SMITH CHILD, Dr. LTON PLAYFAIR, Mr. HOLT, Mr. TAYLOR, Sir DOMINIC CORRIGAN, Dr. BREWER, Mr. Alderman CARTER, and Mr. HIBBERT:—Power to send for persons, papers, and records; Five to be the quorum.