§ (1.) £12,797, to complete the sum for the Land Commissioners for England.1776
(2.) Motion made, and Question proposed,
That a sum, not exceeding £244,241, be granted to Her Majesty, to complete the sum necessary to defray the Charge which will come in course of payment during the year ending on the 31st day of March 1888, for the Salaries and Expenses of the Local Government Board, including various Grants in Aid of Local Taxation.
§ MR. ARTHUR O'CONNOR (Donegal, E.)
In accordance with the Notice I have placed upon the Paper, I shall ask the Committee to omit from this Vote an item of £16,500, being the item asked for on Account of Public Vaccinators. By a Statute of Her Majesty—33 & 84 Vict. c. 84, s. 5—it is provided that, by means of an Order in Council, public vaccinators may be appointed, and exceptional allowances are authorized to be paid to them, in addition to the payment received by them from the guardians or overseers, amounting to a further payment of Is. per child for every child they shall have successfully vaccinated during the time to which the said Order in Council relates. I object to that item, first, on the ground that it is a special and exceptional allowance limited to England alone. No such allowance is granted to the public vaccinators in Scotland or Ireland, and as it is an exceptional allowance limited to England, I think, on that ground alone, I have, as an Irish Member, a reasonable objection to the charge; but I invite the attention of the Committee to the fact that the charge is ostensibly made an account of successful vaccination. Now, the operation in respect of which the allowance is paid must, in order to be successful in the eye of the Administrative Department, be first of all legal and lawful; and secondly, it must be successful, presumably according to some standard or gauge recognized by the Act of Parliament. I am not going into the question of what vaccination is, or what it does, because if I did enter into that matter, I have no doubt that I should be called to Order by the Chair. Nobody appreciates more thoroughly and painfully than I do the narrowness of the plank which I should have to walk upon in discussing this matter. I therefore confine myself to the charges as they appear in the Estimates, holding myself excused from the necessity of examining the puzzling assumptions on which those charges are based, or the 1777 bogus statistics by which they are bolstered up, or the pitiful subterfuges by which those who are interested in the system attempt to conceal their own failure. But when the Local Government Board claims to allow to one portion of the country a sum of money amounting to several thousand pounds, and to distribute it yearly for what is called "successful vaccination," we who vote the money are entitled, at any rate, to inquire what the Local Government Board mean by the words "successful vaccination," and what is the standard by which they can pretend to gauge the success or non-success of vaccination. That is a question which, as far as I have been able to ascertain, the Local Government Board have never answered. They appear to be unable to answer it, or, at any rate, to be unwilling to do so. They have not yet defined—indeed, they appear to shrink from attempting to define—what vaccination itself is, and they seem to be utterly unable to give any intelligible account of the idea they entertain with regard to successful vaccination. Without desiring to enter into any matter of controversy, I suppose I may take it as admitted, and what nobody will question, that vaccination is the artificial introduction into the system either of an adult or an innocent and helpless child of poisonous matter taken from diseased pustules, which in their turn have been artificially induced. This matter, or pus, is called in official language "lymph." we have heard a good deal about pure lympth, and it is alleged that in cases properly tested by the Local Government Board the lymph that is used is legal, lawful, and recognized to be good and pure. I will not go into the question of the different kind of lymphs—the humanized lymph, the virus lymph, or the pure calf lymph. At the very outset I am met by this difficulty it is necessary in the eyes of the Government that the lymph should be lawful; but the difficulty is that nobody knows exactly what vaccine lymph is. The view current among medical men generally is, that vaccine lymph is the virus of modified small-pox. Some time ago a Committee of this House investigated the question, and a Member of that Committee asked Mr. Masterton—an authority on vaccination, this question— 1778What is the source from which you derive vaccination lymph.The answer was this—I have two sources of lymph just now. One is obtained from a cow by inoculation with the lymph of human small-pox, and the other is taken from a cow which had the disease in a natural way in the neighbourhood of Brussels it short time ago.The question was then asked—Did you inoculate the cow with vaccine, or small-pox lymph?Answer—It was obtained by a friend of mine, and £ am unable to say.That being the evidence in regard to vaccine lymph recognized by the Local Government Board, I would ask the attention of the Committee to an announcement by the Government Department with regard to a similar proceeding. Some time ago one of the members of a Board of Guardians, in order to secure what is called pure lymph, volunteered to furnish a calf for the purpose, and I have here an official letter which was issued in regard to the case. The Local Government Board for Ireland acknowledged the receipt of the minutes of the proceedings of the Board of Guardians of the Galway Union, from which it appeared that a suggestion had been made by a Member of the Board that a healthy calf should be procured for inoculation, in order that the pure lymph might be secured. Another member of the Board intimated his willingness to give a calf for that purpose, and the Guardians passed a resolution accepting the offer. The Local Government Board, in their note, observed that it was irregular to pass a resolution accepting a proposal to inoculate a calf with small-pox virus, or with vaccine lymph obtained from a human subject, and in no case could the Local Government Board approve of the resolution which had been adopted by the Guardians. The Local Government Board pointed out that small-pox virus taken from a calf might communicate that disease to a human subject, and therefore be a fruitful source of promulgating disease. Moreover, it would render the operator liable to come under the 4th section of the 34th of Vict. The Board go on to say that it has been ascertained long since that animal lymph for vaccination purposes must be in the first instance obtained from a cow 1779 in which the disease has spontaneously arisen, and that the vaccination performed by lymph taken from a cow vaccinated with human lymph is not reliable. I presume that the English Local Government Board holding the same view will have no objection to ascertain what is the character of the lymph used in these successful operations. The letter of the Local Government Board goes on to express its disapproval of the action taken by the Local Authorities, and I should like the right hon. Gentleman who represents the Local Government Board here to say what, in the opinion of the Local Government Board of Ireland, is the law of the case? I venture to say that I am not exceeding the existing limits of medical knowledge in regard to this matter when I say that the purity of vaccination lymph cannot by any possibility be ascertained, even microscopically. Then, I presume, it is not on the purity of the lymph that the success of these operations in the official eye is made to depend. Then does it depend upon the number of successes which are secured? If it is, we know very well that medical men differ altogether among themselves as to the number which make it desirable or necessary. Some say that vaccination, if worth anything, and if it ever can be successful, then one cicatrice thoroughly recognizable with the pustule well raised is adequate for all purposes. Others say that there must be at least two cicatrices; some say three; while some enthusiasts insist upon four as the minimum, requiring the four to be repeated over and over again until an effective operation has been performed. Then it is assumed that it is not on the number of wounds produced in the infant that the success of these operations is made to depend. Then is it in the number of the operations actually carried out? If it is, then your standard is most unfair, for this reason, that medical men who are stationed in very densely populated districts, and who have a very large number of people to deal with, must, as a matter of course, have a large number of persons to operate upon, and will be in a position to qualify for these gratuities which are supposed to depend upon the way in which the vaccination is conducted, a very great deal better than other medical men, who, although their care and skill and 1780 anxiety may be quite as great, are unfortunately placed in districts where there is a sparse population. If it was not on one of these three points that the success of the operation is supposed to depend, then I am driven to conclude that the standard must be the number of deaths—that is to say, the success is measured in an inverse proportion to the number of infants who are killed by the operation. Many infants, soon after the operation has been performed, die. I believe myself that a large number of children are done to death, not immediately after the operation, but it may be years after the cicatrices have begun to tell. Under the present system the State takes a toll of healthy infant life, the children being sacrificed for the benefit of the community at large. Now, however successful the operation may be, I contest the moral right of any set of men, or any State, or Government to take such a course, as a matter of right, as is taken upon this question. I would beg to point out to the Committee that the supposed success of the operation is tested within eight days of the performance of the operation. The medical man in the great majority of cases sees a child at the end of those eight days, and makes his report according to the state in which he then finds it; but after that he frequently never sees the child again, and he makes his report according to the appearances which present themselves within that period of eight days. Upon that matter I should like to read to the Committee a letter I have received from a gentleman named Morgan. He says that having recently heard that the question of vaccination was to be brought before the House of Commons shortly, he was desirous of calling attention to a case which had occurred in his own family, in which the death of a child had resulted from vaccination. He had had a particularly strong and healthy child, a boy who had never had half-an-hour's illness in his life, and who was vaccinated with what was supposed to be pure calf lymph, by a qualified medical practitioner, who remarked at the time that he had never seen a more strong and healthy child. The child was three months old. About nine days after vaccination the child's arm became inflamed, and the inflammation slowly but gradually spread down 1781 to the hand. He lingered in the most awful agony while the poison was doing its work; everyone who saw him declared they had never witnessed such awful suffering, and no death could have been more dreadful. The child died on the 20th of June, and the father says that he could only look on the case as one of slow murder, although everything was done to restore him. He expresses a hope that steps will be taken to prevent anyone else from undergoing similar sufferings in consequence of compulsory vaccination. The letter is signed "J. Morgan, Rochdale." It will be seen that dangerous symptoms appeared more than eight days after the lapse of the regulation period. After an apparently successful operation had been performed, symptoms manifested themselves which throw a lurid light upon the character of these cases. In this instance it was nine days before the unfavourable symptoms appeared, but it might have been nine months or nine years after the operation had been performed. My general contention is, that there is no certain rule by which you can have substantial proof of success, or anything that can be dignified with the name of success, in any of these cases. The system of giving bonuses for the successful performance of vaccination has now been in existence for some years, and yet last year, according to a published report, the Metropolitan Hospitals admitted 36,000 cases of persons suffering from small-pox who had been vaccinated. It is perfectly clear that in these cases the operation was not successful. On the other hand, the Registrar General admits that within the last five years 290 deaths have taken place, which cannot be ascribed to any ascertainable cause except vaccination itself. With regard to the returns of the Registrar General, I must certainly demur to accept them as at all conclusive or satisfactory, because a large number are in the habit of giving certificates of death, where the death has been caused by vaccination, in such a form and couched in such phraseology that it is impossible to recognize what the actual cause was. Now, I think that this is a very important point, and, therefore, I ask the House to bear with me while I refer to a passage contained in a letter from a gentleman residing in Camberwell, which puts the matter in the 1782 clearest light. He says that he was presented with his first-born in August 12 months—a very fine boy, and a remarkably healthy child for the first two months. At eight weeks old it was taken to be vaccinated. The effects of two operations were thrown off by the child, so that the Committee will see there were two unsuccessful attempts at vaccination, because the child, being sound and healthy, was able to repel them. he was vaccinated a third time, and that was the beginning of the end. It was a successful vaccination, but from the time of the operation the little one was never well. Eruptions broke out under the injured arm, on the back and on the head, the top of which became an entire mass of corruption. It lingered for 12 months in misery, and died in October, 1886, a victim of the cruel and compulsory vaccination laws. Two doctors who saw the child acknowledged that he was suffering from the effects of vaccination, and one of them described it as "a hideous failure" of vaccination. The doctor who performed the operation at the bedside of the dying infant admitted that it was a case of invaccinated syphilis, and described it as a hideous case of vaccination. Yet this doctor filled up the burial certificate by ascribing the primary cause of death to something other than vaccination. The truth of the certificate was challenged by the father, who reminded him of his repeated statements as to the cause of death, and demanded that a certificate should be filled up with "invaccinated syphilis" as the primary cause. The doctor refused to do this, adding that the certificate he had given was sufficient for the Registrar. The father in his letter says—So that my child was not only killed by vaccination, but he was registered falsely, in order to prevent any cause for reproach.This is a case in which the facts are easily ascertainable. I have the name and address of the man, and I shall be glad to place them at the disposal of the Local Government Board. Perhaps the Committee will allow me to compare this case with another—namely, that of Henry Clark, of Crewe, Cheshire, who writes as follows:—'' Sir,—Accept ray thanks for your objection to the vaccination Estimate. I have four sons and four daughters, whose ages run from seven to 26. None have been vaccinated, and none 1783 have had the small-pox. For this I have suffered 14 days' imprisonment, and have been ruined in my business.That is how the Vaccination Act has worked in the case of a man who has conscientious objections to the system, and who does not believe in the vaccination for which you ask this House to vote £16,500 a-year for certain privileged individuals. As to successful vaccination, I believe it to be all moonshine and a delusion. An inquiry conducted by Dr. Macuna, the late superintendent of the Fulham Small-Pox Hospital, proves that certain diseases are inoculable with the small-pox virus. Since the introduction of vaccination itself, and especially since vaccination was made compulsory upon the whole population, the diseases which are said to be inoculable have been immensely increased. It is not at all easy to obtain detailed information from the Local Government Board in regard to this matter; but I have had prepared, in great detail, from a variety of sources, a statement of the deaths which have resulted from these causes, separated from small-pox—namely, bronchitis, pneumonia, pleurisy, cancer, and erysipelas; and I find that since the introduction of vaccination, although the total number of deaths from small-pox in proportion to the population has decreased, yet deaths from small-pox have not diminished to a greater extent than deaths from all other zymotic diseases. In other words, improved sanitation, which has limited and checked other zymotic diseases, has also limited and checked small-pox; but when you come to the record of these diseases, which, according to the contention of those who have inquired into the matter, are inoculable with small-pox virus, you will find that all of them have increased to an alarming and horrible extent—for instance, the number of deaths from bronchitis in the year 1838, which is the earliest date to which I am able to go back, was 2,067, and there has been in that disease a steady and alarming increase concurrently with the operation of compulsory vaccination. The number went on increasing from 1838 until 1854, when vaccination became compulsory, from 2,000 to 20,000. From 1854 to 1867, the date of the Act under which rewards are given to the medical practitioners for the successful performance 1784 of vaccination, and which makes vaccination obligatory under very stringent penalties, the number of deaths from bronchitis went up from 20,000 to nearly 40,000. Since the operation of your system of special rewards has been in force—that is to say, from the year 1868 to the year 1885, the deaths from bronchitis have gone up from 33,000 to 60,000. Therefore, they were 2,000 in 1838; 20,000 in 1854; 33,000 in 1868; and 60,000 in the last year for which the Returns are complete. Now, this is a horrible and terrible disease; and it is a disease which, to a great extent, I believe is due to the operation of what is called "successful vaccination." The cases of pneumonia have increased from 17,000 to 29,000. In pleurisy the number is smaller, but is equally in proportion. From 1855 the cases of pleurisy have gone up from 552 to 1,677. I come next to cancer, which figured at 2,448 in 1838, the year of the Vaccination Act. In the year 1854 it figured for more than double that number—namely, 5,826. The number went up in the year 1868, after you had had 14 years of compulsory vaccination, from 5,800 to 8,800. That was when your present Act first came into operation, and the result of that Act and of vaccination is seen in the fact that there has been no diminution but an increase from 8,800 to 15,560. Another disease which is generally spoken of with great horror and loathing figured for only 159 in 1838, for 964 in 1854, but went up rapidly in 1868—that is to say, after your obligatory vaccination had been in operation for some years, and now figures at 2,196. The facts are similar with, regard to erysipelas, although the number has not increased in the same proportion. There has, however, been a substantial increase. The last point I would offer to the consideration of the Committee is this—that if this system of rewards is fair in itself it ought to be fairly administered. There are many portions of the country in which there are medical men who are perfectly prepared bonâ fide to carry out the Act quite as sincerely and as well as any other medical practitioners, and who, as far as I can judge, merit the rewards which it is proposed to provide in this Vote as much as any other men. But what is the case; what is a medical man to do in a place like Dewsbury, 1785 where there are 20,000 young children and no small-pox? What is to be done in a place like Leicester, where the people will not be vaccinated at all; where they have established local option for themselves with a most singular result, because there is no small-pox there either? Medical practitioners there can earn nothing, and therefore your system of rewards is unfair and partial. Where is it that these rewards are earned? They are earned wherever there is an accumulated and dirty population in large and closely packed towns like Birmingham, where one medical officer gets £224 a-year; or in places like Liverpool, where a medical officer receives £175 a-year; or in places like Middlesborough, Salford, Sheffield, Swansea, West Derby, and London—that is to say, where the population is placed in circumstances which are most favourable for the dissemination of zymotic diseases, and where small-pox may be said to have been endemic for many generations. In London you have a population more thoroughly vaccinated, probably, than any other people in the world, yet they are never free from small-pox—as witness the Returns from Bethnal Green, Camber well, Mile End, Chelsea, St. Pancras, Wandsworth, and other places. I altogether object to this system of rewards for successful vaccination. It leads to medical practitioners earning the rewards by making a favourable and rosy-coloured Report to the Department in support of a system in which the Department and themselves alike are interested. The indirect effects of the system are worse than its direct effects, because the Government are induced to shut their eyes to the real facts of the situation. It blinds the Government to the mischief which is being done; to the misery which is being inflicted upon the health of the child and the adult alike, and it induces the Government to close its eyes to the cries for mercy and pity which are so often addressed to them by people who have a conscientious objection to vaccination, and who have proved the sincerity of their convictions by submitting over and over again to fine, distress, and imprisonment. The Government, influenced by the men who have this pecuniary interest, refuse to recognize the mischief which is being perpetrated, and refuse to relieve the misery which is being 1786 caused. There are many instances of men who have been imprisoned several times after they have lost child after child by vaccination. The Jews of old had a rite somewhat similar to vaccination; but if you will look into the Talmud you will find that if a Jew lost a child by that operation, and then lost another, not only was he not compellable to have the operation performed upon a third child, but he was forbidden by the Jewish law to submit a third child to the rite. In this country, however, a true born British subject may lose half-a-dozen children by vaccination, and if he objects to submit the seventh to the same danger he can be prosecuted over and over again as the unfortunate man Hayward was, his goods distrained, himself fined, and imprisoned and ruined in his business. That is the system at present in vogue. It is a system hated by a large portion of the people, a system which, to a great extent, is bolstered up by these rewards in regard to which medical practitioners are practically identified, although as to them in private conversations many of them admit that they entertain serious doubts as to the real efficacy of the operation. I beg to move the omission from the Vote of the item of £16,500.
Motion made, and Question proposed,
That the Item of £16,000, for Public Vaccination, be omitted from the proposed Vote."—(Mr. Arthur O'Connor.)
§ DR. FARQUHARSON (Aberdeenshire, W.)
I do not propose to follow the hon. Member for East Donegal (Mr. Arthur O'Connor) in the long and elaborate condemnation he has passed against the present system of vaccination. It will be in the recollection of the House that there was considerable discussion upon the same subject about two or three years ago in which the right hon. Gentleman the Member for South Leeds (Sir Lyon Playfair) proved conclusively, as was shown by the Vote which was subsequently taken, that the system of successful vaccination deserves to be sustained by the House, and is certainly to the advantage of the public at large. I feel bound to protest in the strongest manner against the way in which the hon. Member for East Donegal has bolstered up his arguments against vaccination by bringing forward a number of cases from the country upon 1787 purely ex parts statements without having made the slightest attempt to investigate those cases from a scientific standpoint. Under such circumstances, the cases themselves are not worth considering. I know that the Local Government Board is anxious to investigate every case of injury, or supposed injury, by vaccination. Whenever any case is reported to them they at once send down an experienced Inspector to inquire into it, and, I need scarcely say, that all of these cases, of which so much has been made by agitators and writers in the Press, have broken down upon investigation.
§ DR. FARQUHARSON
The hon. Member says "No, no;" but he has not investigated the very cases which he has himself referred to. I have seen the Reports of Inspectors who have been sent down to investigate 10 cases of this kind, and of the entire number, at least seven or eight were admitted by the parents themselves to have had nothing to do with vaccination. One case, in particular, of erysipelas turned out to have had nothing whatever to do with vaccination. The hon. Member made a great point of the increase in a certain number of diseases since vaccination has been made compulsory and has become more common throughout the country; but of the diseases he mentioned, a number of them, I hear for the first time, have any connection whatever with vaccination. Did anybody in his senses ever hear of bronchitis or cancer being attributable to vaccination? It might just as well be said that any persons who died from being run over by cabs in the streets of London last year died from the effects of vaccination. Erysipelas is a different case; but I have known epidemics of erysipelas, and it would be dangerous and certainly inconclusive to take the statistics of one year and compare them with those of another. With regard to one of the points of the hon. Member, I have a complete answer. Everybody knows perfectly well that within the last 10, 15, or 20 years medical science has made immense progress, and in no direction more remarkably than in the investigation of syphilitic diseases. In former years the doctors only knew of secondary effects, but now they know of tertiary 1788 effects arising from affections of the liver and from other causes. I do not propose, however, to go into the general question; but I maintain that there has been a great and steady improvement in vaccination since the principle of compulsion was introduced. I have no doubt that the vaccination is better done by the compulsory vaccinators than by private practitioners. My hon. Friend spoke of the necessity of having four marks on the arm. I never heard of any difference of opinion existing among those who are acquainted with the subject and are the best qualified to judge. The opinions of the best informed persons have been adopted by the Local Government Board, and it is that four cicatrices are absolutely necessary in order to carry out the vaccination successfully. No doubt it is said by some medical men that four cicatrices hurt a child very much, and that one is quite enough; but I believe that that is the cause why vaccination done by the public vaccinator is so much better than that done by the private practitioner. In the case of a public vaccinator he must have a distinct qualification; he must be approved by the Local Government Board, and his certificate must be renewed annually—the certificate itself only being given after the most careful inspection carried out by a duly qualified Inspector sent down by the Local Government Board. The vaccination itself is only done from lymph, procured from perfectly healthy children, and there are recommendations made that the cicatrice should only be of a certain shape and number. I think we have only to look at the statistics to see at once the immense value of vaccination. My hon. Friend attaches very little value to the statistics of the Local Government Board. I do not know why he should have more faith in those which he has collected himself. The Local Government Board pay large sums for the collection of statistics.
§ MR. ARTHUR O'CONNOR
The statistics which I quoted were prepared by a friend of mine; but they were all taken from official sources.
§ DR. FARQUHARSON
I quite accept that statement. I will only say that personally my faith in the figures given by the Local Government Board is greater than his as it is also in the skill and knowledge of the Medical 1789 Profession. My hon. Friend hag stated that medical practitioners are actuated by a desire to obtain the reward. I repel with warmth any insinuation of the kind. Let me favour my hon. Friend with statistics. In 1881 117 children under the age of 10 died of small-pox after vaccination, and of those 82 were vaccinated by private practitioners, and 35 by public vaccinators. If my hon. Friend will go through the statistics he will see the enormous advantages derived by the child who is vaccinated by a public vaccinator instead of by a private practitioner.
§ DR. FARQUHARSON
Yes; but in much less proportion than those vaccinated by private practitioners. I will not detain the Committee any longer; but in conclusion, I will simply say that there is one point on which I am glad to find myself in thorough agreement with my hon. Friend. I think the primary object of my hon. Friend in bringing forward his Amendment was to protest against the money which is given in England for vaccination purposes not being extended to Ireland and Scotland. I have been in communication with medical men in Scotland on the subject, and I know they feel keenly in regard to it. The work is very well done there; but the medical men who perform it get no remuneration whatever. I do not think they get the slightest reward or remuneration at all, not only for carrying out excellent vaccinations, but for teaching the subject extremely well. They have also succeeded in popularizing it, whereas in England there are perpetual discussions going on as to the value of the system of vaccination. I do not think it is possible to pick out of the whole of Scotland as many anti-vaccinators as would fill this room. It is highly creditable both to Ireland and Scotland that the medical practitioners do the work without any desire to obtain pecuniary reward. In their case virtue is its own reward; but I do not see why they should not have it, and I hope on some future occasion to bring the question before the House and submit it to my hon. and learned Friend the Lord Advocate.
§ MR. PICTON (Leicester)
It is often said that doctors differ, although my hon. Friend the Member for West Aber- 1790 deen (Dr. Farquharson) seems to think they are all one, especially upon matters of this kind. Now there was one doctor to whom the present generation is supposed to be under great obligations for the present system of vaccination—I refer to Dr. Jenner, the founder of the vaccination system. No doubt his opinion is regarded by my hon. Friend as antiquated, and, therefore, it must go for what it is worth; but Dr. Jenner certainly took the view that one single puncture was ample to prevent any attack of small-pox, and that the medical practitioner is not bound to make more. At page 21 of Dr. Jenner's "Inquiry into Causes and Effects," he says—That some medical men make three punctures; but personally he had always regarded one puncture as being quite sufficient.Again, at pages 109 and 110 he says that a single pustule is all that is necessary to render the variolœ vaccineœ effective.
§ MR. PICTON
At the beginning of the century. It is Dr. Jenner's own words. It may be said that the ideas of Dr. Jenner are old-fashioned. They are certainly opposed to the views of the hon. Member for West Aberdeen, who insists that four wounds are absolutely essential. Although I had this extract in my pocket when the discussion commenced, I certainly did not expect that it would be of any value; and if I had supposed that it was necessary to make a speech upon the general subject, I would have prepared one, which would have convinced even the right hon. Gentleman the President of the Local Government Board. I have not, however, ventured to presume so far upon the indulgence of the Committee; and I propose to confine myself, as nearly as I possibly can, to the question which I take to be before the Committee—namely, whether we should or should not grant this money for extra rewards or fees to the Public Vaccinator who is supposed to have done his work well. Now, my first objection is similar to the one which has been raised by the hon. Member for East Donegal (Mr. Arthur O'Connor), although I shall put it, probably, a little differently. He said that it was giving two rewards for the same thing. I say that it is giving a reward because a man has not failed to do his duty. 1791 We confer knighthoods and baronetcies upon gentlemen because they have not failed in their duty on the occasion of some great State ceremonial; but I think it is an unwise and an unsound policy to lead persons to expect a reward for not having failed to do their duty. Surely, if vaccination is not effectively performed; if the proper virus is not introduced into the system of the child, no payment ought to be made at all. Any local Body who had the management and control of the system would soon stop payment to any person who failed to do his duty. It is said that the reward is given for extra successful vaccination; but how can the extra success be known? It either prevents smallpox, or it does not. If it prevents it, well and good; but how are you to tell that it has prevented small-pox, unless you watch the child until he reaches 50 or 60 years of age? You cannot know the success of the operation unless you watch the career of the child throughout life. Then my hon. Friend says there is a special form of scar or cicatrice which shows successful vaccination; and he says there is absolutely no case in which injury from vaccination has been proved to the satisfaction of the officials of the Local Government Board. Now, I admit that you are pretty certain to secure the satisfaction of officials, especially when they are prejudiced in favour of any particular system of operation; but how does the matter stand when it is the other way? In that case it takes more trouble to convince the official mind than it is said to take in order to force a joke into the heads of our Scotch fellow-countrymen. There have, however, been cases in which even this miracle has been performed—as, for instance, in the City of Norwich, where four children died, and it was admitted, on inquiry, that they died from the effects of vaccination, and that a considerable number of other children had suffered injury from the same cause.
§ DR. FARQUHARSON
I did not deny utterly that any such cases had happened; but what I said was that most of the cases, when investigated by the Inspectors of the Local Government Board, turned out not to be cases of death from the effects of vaccination.
§ MR. PICTON
I understood my hon. Friend to say that there had absolutely 1792 been no proof of death from the effects of vaccination at all. In the Norwich case, the very doctor who vaccinated the children, and who received himself the reward for successful vaccination, was in utter despair of finding any sufficient cause of death than the injury produced by the vaccine influence itself; and the authorities came to the conclusion that this doctor must, for once, at least, have been careless. There was no proof of it; and he altogether denied it himself. He is a man of excellent reputation, and there was no one to say a word against him. There was no proof of carelessness or negligence whatever. He did the same work he had previously done so well as to entitle him to the reward; and could it be possible that he could have been so careless as to use dirty ivory points? In previous cases he had shown himself, in the eyes of the Inspector, to be deserving of the reward. Then there is only one of two things possible—either that the Inspectors fail to do their duty, or they find it impossible to determine whether the public vaccinator has done his duty or not. It is said that the Inspectors require several scars to be made, whereas I have shown that Dr. Jenner was of opinion that only one puncture was necessary. What course is now taken to prove that the vaccination has been successful? It is found to be trouble enough to bring the child up to be viewed eight days after it has been vaccinated; and it is not likely that the parent will be troubled to bring it up before the Inspector again. Does the Inspector go round among the children who have been vaccinated? He cannot possibly go round among them all; and, therefore, he only takes a few specimens of the cases which have been vaccinated by the public vaccinator. Surely that is not a fair basis upon which to rest the claim which is made by the public vaccinator for the reward. I say that it is impossible to show that the money has been justly and fairly earned, and on that ground alone I think there is sufficient reason for refusing the Vote this afternoon, and I earnestly hope the Committee will agree with the Amendment of my hon. Friend. I trust that they will extend their sympathy for once to my constituents whom they know to be deeply interested in this question. Hon. Members have received a good many letters on the sub- 1793 ject. An hon. Friend sitting beside me says that all the scientific evidence is on one side. Well, I am not enough of a scientific man to say whether this is so or not; but this I will say—that no lave like this ever was or ever can be maintained by scientific evidence alone. The common people do not understand scientific evidence. What they do understand is sickness on the one side and health on the other. If a thing works properly they soon become accustomed to it, and willingly obey the law; but if they find that a number of evils arise from the enforcement of the law, then all the scientific evidence you can produce will fail to give them confidence. My constituency has been referred to. Undoubtedly there is in Leicester a very strong feeling on the subject. That feeling has often been cited. Ever since 1872 vaccination has rapidly diminished in Leicester, and now the principle of Local Option or Home Rule has been practically established. There is no compulsory vaccination in the borough of Leicester, and I would advise my right hon. Friend the President of the Local Government Board not to bring in a Coercion Bill for my constituents. Vaccination has been abolished in Leicester; but it was immediately after an epidemic of small-pox. 650 deaths took place, and the people observed that small-pox paid very little respect to vaccination. They saw that a large number of their friends who had been carefully vaccinated and even re-vaccinated were badly attacked or carried off altogether by small-pox, and the result of the practical experience they gained was such that the people began to have less confidence in vaccination. The body of the people were convinced that vaccination is of no avail against small-pox, and that it often causes other diseases. Those who now object to vaccination are entitled to say that having tried the experiment for a sufficient number of years they have come to the conclusion that vaccination is unnecessary; and, therefore, it is not likely that they would wish their Members to vote for the employment of public money for this purpose. I am not an uncompromising enemy to vaccination under all circumstances. All I oppose is compulsion and prosecution, and I cannot help thinking that if this compulsory law were done away with there would 1794 probably be less difference of opinion on the subject. With reference to some of the arguments advanced by my hon. Friend the Member for Aberdeenshire, I wish to say that I am a more firm believer in the germ theory than he is. He seems unable to suppose that a disease like cancer can be conveyed by vaccine; but we know that germs are transferred from the living body; and who is to guarantee that there are not other germs of zymotic disease conveyed with the lymph? At any rate, the possibility of such a thing is farther more removed from absurdity than my hon. Friend seems to think. Bearing in mind the rapidly growing feeling on this matter, I hope the Committee will support us in this Amendment. The money is not given on any fair systematic principle. There is no means by which Inspectors can collect sufficient information on the subject to satisfy themselves, and the money may even be awarded where evils have arisen and may again arise. For these reasons I support the Amendment of the hon. Member for East Done-gal.
§ SIR JOSEPH PEASE (Durham, Barnard Castle)
Having for some years past taken an interest in this question, I venture to trespass on the Committee for a few moments. It seems to me that in discussing this question, while believing as many do that it is better to be vaccinated, we must look at the feelings of those who object to vaccination. It is an important factor in this question that many persons have suffered in their families through vaccination, and have, for that reason, an objection to it. There have been several cases of this in Northumberland; and the Blue Books are full of cases where men have been over and over again committed to prison; to suppose that the objections are not conscientious is a most illogical conclusion to arrive at, because after some parents have been committed many times to prison their children have remained un-vaccinated. The Poor Law Board and Local Government Board have in my recollection sent Circulars to the Boards of Guardians telling them to be careful how they carry out the law, and warning them not to create opposition to the law by exciting sympathy with persons who have refused to have their children vaccinated. This question was fully investigated by the Committee, and the 1795 Report was a very clear one, and pointed out that it was most important to secure the support of public opinion, and that where one full penalty had been imposed the magistrates should not impose another.
The hon. Member is travelling much beyond the Vote under discussion. I would point out that it is not competent to him to enter into the question of policy.
§ SIR JOSEPH PEASE
I, of course, submit to your ruling, Sir, although it is somewhat difficult to confine one's remarks within it. It is most inconvenient to have to discuss a question of this broad character upon a Vote in Committee; but I point out to my right hon. Friend that if be once goes back on the old Rules on which this House has decided the question of these officers doing their duty or otherwise, it would not come up every year as it does now. My position is that, while I disagree with compulsory vaccination as carried out, I shall decline to vote on this question, on the ground that it is against public feeling to permit such. Votes as these to pass without discussion.
§ DR. CLARK (Caithness)
I strongly support this Amendment, on the ground that the grant is only to be paid to medical men in England and Wales—not one penny of it going to medical men in Scotland; and even if I were as strong an advocate of vaccination as my hon. Friend the Member for Aberdeen-shire (Dr. Farquharson) I should equally oppose the Vote on that ground. You pay our prison surgeons only one-half what you pay the English surgeons; our medical men have not the same privileges as English medical men, and we shall continue to refuse this money until you reduce the English scale or level the Scotch scale up to it. With regard to the general question, I have one or two things to say in reply to the hon. Member for Aberdeenshire. He has quoted the hon. Member for South Leeds (Sir Lyon Playfair); but in doing so has fallen into the same errors which he did, and which in a re-publication of his speech he corrected. I am not an anti-vaccinationist in the sense in which some are. I believe that vaccination modifies small-pox, and I have had some experience in the matter. I am not only of a different opinion from that of my hon. Friend, but I am of opinion 1796 that deaths are caused by it under certain conditions. I do not think these children die directly, but indirectly from vaccination—that is to say, without vaccination they would not die; that by this process the seeds of disease are awakened and cause the death of children who would otherwise grow up. I agree that it is absurd to suppose that bronchitis may result from vaccination; but may it not be that it gives rise to strumous and tubercular disease? I think it does, and that the great increase in these diseases is due to vaccination. I protest against the assertion that general practitioners endeavour to persuade people not to go to a public vaccinator by representing that the latter would make four marks on the arm instead of one; but I say that there are two children vaccinated privately to every one vaccinated by the public vaccinator. I am bound to say, having had experience of public vaccination, that I would not advise a friend to have a child vaccinated at a public office. I am sorry to say that I have in some cases vaccinated from children suffering from syphilis. I knew nothing about the parents of the children from whom the lymph was taken; and that will happen because, although they may look healthy, the children may have syphilis latent in them. It is said that four marks are better than one; but I cannot understand why my hon. Friend should think so. The virus enters into the blood and creates there constitutional disease; and, that being so, I think that one mark is just as effective as 40 would be. I must say that my faith in vaccination has been decreasing year by year. I think the medical theory is carried too far, and it seems as unwise to compel children, whose parents object, to be vaccinated, as it would be to compel them, under similar circumstances, to be baptized.
§ MR. WHITBREAD (Bedford)
I desire to point out to the Government, by way of warning, how very rapidly the feeling against vaccination is spreading in the country. I have always advised those who have come to me on the subject that the best course they can pursue is to move for a Royal Commission of Inquiry, which would get a great deal of information, and throw new light upon the subject. I think the House ought to approach with great caution and 1797 consideration those who think their children ought not to be vaccinated by the public vaccinator. I believe that vaccination is, in a great measure, a pre-ventative against small-pox. I desire to see it maintained still at the public expense; but that has nothing to do with compulsory vaccination; the two questions are entirely distinct. In the case of our own children we take them to the best practitioner we can get; we take the greatest care that they are not exposed to cold, the arm is kept clean, and, in short, everything is done to make vaccination a success; but the case is very different with the children of the poorer class, who are taken to the vaccinator when, perhaps, they are not in the best state of health, and whose parents cannot provide for them the same protection, comfort, or cleanliness. If hon. Members will bear in mind these facts they will understand that vaccination is a greater risk with the children of the poor than it is with their own children. It is compulsion that places this Vote in jeopardy. I do not believe that the anti-vaccinators would have moved against the Vote but for this, and I ask the House to remember what an absurd position we now stand in with regard to this question. Every step you take in the direction of fining, imprisoning, and bullying the objectors; every man you line or imprison becomes an apostle and ready to make converts to the anti-vaccination theory, and after all, if the parent resists, you do not get at the child. It seems to me that those who do not get their children vaccinated belong to two classes—those who are careless and put it off from day to day, and those who have a rooted determination that nothing shall force them to have their children vaccinated. If you do not distinguish between these two classes and consider those who conscientiously object to vaccination, I think you will increase the numbers of those who oppose vaccination to such an extent as, perhaps, to jeopardize this Vote.
§ THE PRESIDENT OF THE LOCAL GOVERNMENT BOARD (Mr. RITCHIE) (Tower Hamlets, St. George's)
I am very much alive to the great importance of the question which is raised on this Vote, and I only wish the occasion was one more suitable for going into the whole question of the effects of vaccina- 1798 tion, and for stating to the House fully, from the information which we now possess, what effect vaccination has had in reducing the mortality from smallpox, and what result might be expected if the precautions now observed were relaxed. The hon. Gentleman the Member for Bedford (Mr. Whitbread) has given the Government a warning that the anti-vaccinators are increasing to such a degree that unless some steps are taken with the view of amending the existing law we may anticipate some trouble in the future. I admit with regret that the opposition to the vaccination law is not decreasing; but, at the same time, the information I possess does not lead me to think that the position is so gloomy as the right hon. Gentleman has supposed. I do not think that the anti-vaccinators are largely on the increase in number. No doubt, year after year they do draw attention to this question of compulsory vaccination, and, perhaps, now more than has hitherto been the case; but I doubt whether it can be said that, except in the case of certain towns, the opposition to the vaccination law is increasing. But, if it were increasing, I should not think it in the least surprising, because anyone who is familiar with the gross misrepresentations that are constantly placed before the people, and especially the working classes in our large towns, as to the effect of vaccination, can fully account for any growth there has been of opposition to the law. I have before me here one or two illustrations of the way in which public opinion is sought to be influenced by those who take an active part in the anti-vaccination propaganda. Hero is a small bill headed "Vaccination propagates small-pox; it never protects; it often kills; 2,500 slain by small-pox." There is another bill in which vaccination is referred to as "The Vaccination Vampire;" and in addition to the letterpress there is a wood-cut entitled "Death, the Vaccinator"—there is a policeman presenting a vaccination warrant to a woman, and a skeleton is vaccinating the child. There is a joke no doubt intended; but the effect of publications of this kind must be, of course, considerable amongst the more ignorant portion of the populations of our great towns, and where these means are resorted to I think no one can be surprised that the opposition 1799 to vaccination increases. My own fooling is one of astonishment that when such means are resorted to opposition does not increase to an alarming extent. I should have thought, however, that in the present day it would not have been necessary for anyone to stand up in the House of Commons and defend vaccination, although I can quite understand that amongst those outside who are imperfectly informed there should be a feeling against it. I am surprised to find so intelligent a Gentleman as the hon. Member for East Donegal (Mr. Arthur O'Connor) standing up in this House and giving expression to the well-worn platitudes of the Anti-Vaccination Society, not one of which has the slightest shadow of foundation. I do not intend to trouble the Committee with many figures; but I will give a few with reference to the mean annual death-rate amongst children under five years of age. From 1847 to 1853, when vaccination was optional, the death-rate per 1,000,000 yearly of children under five years of age from small-pox was 1,617; from 1854 to 1871, during which time it was obligatory, but inefficiently performed, it was 817 per 1,000,000; and from 1872 to 1880, when the machinery had improved, it was 323 per 1,000,000; be that it may be stated that a yearly saving of 4,529 lives takes place by the enforcement of vaccination among the 3,500,000 children under five living in England and Wales. Now, look back to the death-rate among the children under 10 who died in 1884–5 in London from small-pox. Out of 1,000 consecutive deaths in that year, 323 were of children under 10 years, of whom 16 had been vaccinated; 34 respecting whom it was not stated whether they had been vaccinated; and 273 of the deaths were of children who had not been vaccinated.
§ MR. RITCHIE
I presume that those who brought the children in knew whether they had been vaccinated; but clearly what they had to do was to ascertain as well as they could whether or not vaccination had been performed. Then, again, nurses of London smallpox hospitals never catch the disease; 1800 and there has never been a single death amongst them. But the efficiency of vaccination is strikingly shown in the case of the German ship Preussen, on board which small-pox broke out. In this case there were 312 passengers quarantined at Sydney; there were 69 cases of the disease, and 12 deaths. Among 55 passengers who had been vaccinated and re-vaccinated, there were four cases and no deaths; among 209 who were vaccinated, but not re-vaccinated, there were 45 cases and three deaths, but in these cases the vaccination scars were very slight; among 13 who had previously had the small-pox there were three cases and no deaths; among 16 who were stated to be vaccinated, but had no scars, there were two cases and no deaths; and among 19 who were unvaccinated there were 15 cases and nine deaths; and besides one child, who lost one, and another both eyes. Thus we see that 6 per cent of the passengers were unvaccinated, and among them occurred 75 per cent of the deaths. As to the Vote itself, I ask the Committee to understand that it is in accordance with the Act passed in 1867. In 1866, Dr. Simon reported that the performance of vaccination in England was extensively deficient in quantity, and that also very generally it was lamentably inferior in quality. Similar testimony was borne by the annual Reports of the Department. I point out that by the use of the term "quality" it was not intended to imply that the lymph was bad, or that bad results ensued from vaccination, but simply that there was not sufficient protection to the children from the number of scars. The hon. Member for Caithness (Dr. Clark) does not place much account on the number of scars, and I think other hon. Gentlemen have spoken in the same sense; but I believe the hon. Member for Leicester (Mr. Picton) referred to the opinion of Dr. Jenner at the beginning of the century, that one scar was quite sufficient. I should be sorry indeed to say one word against the great authority of Dr. Jenner; but the hon. Gentleman must admit that science has made a great advance since then, and the result of the experience of eminent men may be placed against the opinion of Dr. Jenner. It is acknowledged by the best authorities now that one scar is by no means a sufficient protection. In 1866, as I have stated. Dr. 1801 Simon reported that the quality of vaccination was very imperfect, and the Committee who considered the Bill of 1886 inserted a clause providing for the payment which we are now asking for. This was assented to by the Treasury, and there was, no doubt, an enormous increase in the number of satisfactory vaccinations. It will be a satisfaction to the Committee to know that since the regulations were provided by Act of Parliament the number of successful vaccinations has nearly doubled. The question, of additional awards has been treated by some hon. Gentlemen as in the nature of a gratuity over and above that which the public vaccinator had earned in the performance of his duty. In 1871 the whole question was referred again to the Treasury with the view of seeing whether the awards should be continued, the whole question was thoroughly examined and gone into, and the opinion arrived at was that the results had been eminently satisfactory. The hon. Member for Caithness says that if the grants are continued they ought to be paid from the local rates. That question was also considered, and it was found that, while there was a great deal to be said on the subject, there was no local organization which could adequately perform the duty which is now performed by the Local Government Board; but Lord Lingen considered that the time might arrive when this could be done. I also think there is a good deal to be said for that view of the case, and I am looking forward to no distant day when we may be able to deal with the whole question of these grants in a comprehensive way, and when we may be able to propose to Parliament some means by which this grant may be taken off the Imperial funds and placed on the local rates. But that time has not yet arrived, and we cannot yet safely arrange that this grant should be discontinued, because I do not think you have the requisite Local Authorities to be put in the place of the Local Government Board to continue the grant for vaccination. One other question which Lord Lingen had to consider was the assertion that the payment was something over and above that which the officers were entitled to for operations, and he said that he did not regard the matter from that point of view at all; that the 5th and 6th sections of the 1802 Act of 1867 ought to be read together; and that the awards should be considered the remuneration to which the medical men were entitled. I have explained to the Committee why we are unable to assent to the Motion made by the hon. Member for East Donegal to discontinue this Vote, although I trust that the day may arrive when Parliament may fairly consider whether the grant should be continued by the State, or placed on local funds. The hon. Member for Caithness asks very fairly why the grant is paid in England and not in Scotland? The Act strictly limits the payment to England; and the hon. Gentleman will also know that Scotland, with reference to operations performed by public vaccinators, stands in a position altogether different from that in which we are placed. The only persons vaccinated in Scotland at the cost of the ratepayers are paupers and defaulters.
§ MR. RITCHIE
Yes; but the only persons who are vaccinated at the cost of the rates in Scotland are paupers and defaulters. In 1881 the number of such persons vaccinated in Scotland was 1,920, so that, supposing the same grant were made to Scotland as to England, the amount paid would be £98 10s. I now come to the case of Ireland, for which country the hon. Member for East Donegal says that we do not take any grant. Now, in Ireland the public vaccinator is also the dispensary doctor, and half his salary is paid by the State out of the Imperial funds, where the Local Government Board approves of his appointment. Take the whole question of grants in aid in England and Ireland, it will be found that Ireland does not come out very badly. The grant in aid of salaries of medical officers in Ireland is £75,000, whilst the corresponding grant in England is £149,000; and if we add to that the payments to public vaccinators £16,500, we bring the total for England to £165,500. This is only a little more than double the sum paid in Ireland out of the Imperial funds, and yet the population of Ireland is only one-sixth of that of England. If England received the same proportion that Ireland does towards the cost of medical officers, the sum paid would be £420,000 instead of £165,000. Now, the hon. Gentleman 1803 the Member for East Donegal put several questions to me in addition to the one that referred to Scotland and Ireland, and he asked what is the standard or gauge of successful vaccination? Well, according to the instructions issued with reference to the award of the Parliamentary grant, no award must be made to any vaccinator unless the scar produced by the operation is thoroughly well marked, and is not less than half a square inch in total area. That is what is considered successful vaccination, entitling a public vaccinator to a first-class award. Then the hon. Member for East Donegal said something about lymph. He said, I think, that it was the virus of modified small-pox. I cannot agree with the hon. Member in his definition as to that point. I am informed that no lymph which is used for vaccination of any kind has ever, within the memory of man, passed through the human body. Dr. Jenner's first lymph was derived from an animal source; and the lymph which is now sent out is calf-lymph. None of the lymph, I say—at all events, in historic times—has passed through the human body; therefore, I cannot think the hon. Gentleman is in any way justified in calling the lymph modified small-pox.
§ MR. RITCHIE
I am afraid I am not qualified to give the hon. Gentleman a medical opinion of what lymph is. I have told him whence it is derived, and he will see, from what I have said, that there is no ground for calling it modified small-pox. I must leave the matter as it stands, pleading my utter ignorance to give anything like a medical definition of what lymph is.
An hon. MEMBER
Will the right hon. Gentleman repudiate the answer given by a well-known witness before a Select Committee of this House, to the effect that he had two sources of supply for vaccine matter, and that in one case he obtained it from the cow with lymph of small-pox?
§ MR. RITCHIE
I am not entitled to repudiate a statement that I have not seen. I am not responsible for this statement. I can only tell the hon. Gentleman what my information is at the present time. I cannot attempt to reconcile what the hon. Member refers 1804 to with the information I have received. As to the diseases contracted by vaccination, they are said to be syphilis, tubercle, and scrofula. Well, 750,000 are vaccinated annually, and not a single case has come before the Board of communication of either disease through vaccination. I am told, on good authority, that among the last 6,000,000 of English vaccinations no case of syphilis has come to light.
§ MR. RITCHIE
It is certain that if cases could be substantiated they would be produced and placed before the Local Government Board. We are constantly receiving reports of cases of injury, and we make it a practice to inquire into every case laid before us. There certainly has not been a single case in which any allegation as to communication of syphilis by vaccination which has been made has been substantiated after full inquiry. I do not for a moment deny that cases of injury, and of death, unhappily, do occur; but their number, looking at the number of children vaccinated, is exceedingly small. I think something like 290 cases have occurred in five years—from 1881 to 1885. Those are all the deaths that have been registered as being due to vaccination. The hon. Gentleman the Member for East Donegal knows quite well that one of the most fruitful sources of these deaths is erysipelas, after the operation has been performed; and he also knows this—that erysipelas may be, and very often is, contracted not as any result of vaccination itself, but from the fact of a wound existing in the arm and the patient who is operated upon passing through an atmosphere of erysipelas. We invariably make inquiries into cases of that kind when they arise, and in almost every case we are able to discover the cause of the attack of erysipelas, and to show that it has not been by any means caused by the operation itself. In these cases almost any scratch—certainly, any wound, however inflicted—would have led to the disease being communicated just as readily as the operation of vaccination.
§ MR. RITCHIE
Because, I presume, the operation cannot be performed without it. Do I understand the hon. Mem- 1805 ber to hold that vaccination should not take place because that is what it comes to?
§ MR. RITCHIE
It is not a question of compulsion at all. The hon. Gentleman says—"Why scratch the arm?" That is to say, why perform the operation at all? Well, is the hon. Member prepared to abolish vaccination? I do not suppose he is prepared to do anything of the kind.
§ MR. PICTON
The right hon. Gentleman was describing the cause of erysipelas. He said a mere scratch would cause it in delicate children. Then I said—"Why scratch them?"
§ MR. RITCHIE
I never said a word about delicate children. It does not at all follow that because a child contracts erysipelas that therefore it is an unhealthy child in any way. I am not alluding to unhealthy children. I thought the hon. Gentleman (Mr. Picton), when the result of his observation was put broadly before him, would at once get up and repudiate it. Just one word with reference to Leicester, the condition of which town he has quoted as an example of the satisfactory result of non-compulsory vaccination. The hon. Member knows quite well that, so far as the Local Government Board have any jurisdiction in the matter, they are always averse to the law being pushed to extremities. We have again and again drawn the attention of the Guardians to the fact that when their prosecutions degenerate into persecutions, so far from doing good they do a great deal of harm. But we cannot take away by action of the Local Government Board—we cannot see our way to taking away from the Guardians the responsibility of judging of cases which responsibility should rest on themselves. Something has been said of the case of Charles Hayward, who has been again and again fined for non-vaccination. Well, I regret that case should have arisen. I felt regret so much that I sent an Inspector down to the Guardians, in addition to all the letters we have written to them. The Evesham letter, as the hon. Gentleman knows, has been sown broadcast amongst all the Boards of Guardians, conveying the views of the Local Government Board. In addition to that, I sent down an Inspector to see the Guardians, and ask them whether the course which 1806 they thought it necessary to pursue with reference to Charles Hayward ought to be pursued. What was the representation that was made to us? Why, that this was a case which was flung at our head by the Anti-Vaccination Society. This Charles Hayward acknowledged that all the fines were paid by the Anti-Vaccination Society. He had set himself up to fight the Guardians, and to defy the law as represented by the Board of Guardians. Well, we, having the responsibility cast on our shoulders in this matter, must act on our own judgment, and do what we think best to see that the law is carried out. I felt that this Board of Guardians was most conscientious in the performance of the duty devolving on them, and I did not consider that my powers went beyond what I undertook to do, to show to them that in certain cases they ought to seriously consider whether the law is more likely to be respected by operations of that kind or the reverse. Having done that, I left the matter to them, and I am bound to say that, having heard the explanation they had to offer, I think there is an immense deal to say for the course they have taken. I was going to say one word about Leicester. The hon. Gentleman who preceded the Gentleman who now sits for Leicester in 1883 gave as an illustration of the feeling against vaccination the condition of the town of Montreal. Mr. Taylor said that only five years before the Town Hall at Montreal was razed to the ground, to show that people would not endure vaccination. No doubt, up to that time, Montreal had been singularly free from smallpox. But in 1885 an epidemic reached the town. It commenced in August, and during that year 3, 164 deaths took place in a population of 167,500, or at the rate of 18,880 per 1,000,000. In one ward of the city the deaths were at the rate of 33,850 per 1,000,000. As regards Leicester, the authorities there have a small-pox hospital outside the town, and though it is a fact that only one death has occurred in the town from the disease in 10 years, there have been during that period 10 deaths in the borough hospital.
§ MR. RITCHIE
No doubt, the authorities in Leicester do exercise an immense amount of precaution with reference to 1807 small-pox. Whenever there is the least reason to believe that small-pox has broken out, the patient is removed at once to the hospital, and not only the patient, but everyone in the house, and the authorities immediately proceed to vaccinate and re-vaccinate each person.
§ MR. PICTON
I contradict that. What they do is to clean up the house, sanitate it, and put it into proper order.
§ MR. RITCHIE
I am very sorry to have laid such a charge at the door of the Local Authorities. The hon. Member, no doubt, is most justly indignant; but that is my information. I have no doubt that they clean up the house as well; but I think, if the hon. Member makes inquiries, he will find out that they vaccinate and re-vaccinate everyone in the house in which the infection has broken out. The hon. Member will not deny this, that every person who has anything whatever to do with the hospital in Leicester—medical officers, inspectors, nurses, matron, doorkeepers—are all vaccinated and re-vaccinated.
§ MR. RITCHIE
No doubt; and a very wise precaution to take. My information is that the greatest precautions are taken in Leicester with reference to the isolation of cases of small-pox when they do occur, and that every precaution is taken to vaccinate and re-vaccinate everyone who comes within the area of the infection of those who have been suffering. I do not know that there is any other point that has been alluded to in the course of this debate to which I have not referred. There was, I think, only one thing the hon. Gentleman the Member for Bedford (Mr. Whitbread) suggested, and that was that there should be a Commission of Inquiry. Well, I have very grave doubts whether any Commission the House could appoint would have the least effect in getting rid of the prejudices of those who are now opposing vaccination. I do not believe you could bring forward a single medical man of any eminence whatever before a Royal Commission to give evidence in favour of abolishing vaccination. I do not know a single man amongst the Jenners, Listers, or Gulls who would be prepared to come forward and say one single word against vaccination. The Committee of 1871, presided over by Mr. Forster, has been alluded 1808 to. Well, that Committee went very searchingly into the whole question of vaccination, and I do not know that anything has occurred since which would seem to demand further inquiry. The medical officers of the Local Government Board are, perhaps, the most skilled in matters of this kind of any medical men throughout England; and though they are taunted with their official connection with the Government, and though it is said that what they say and what they do is said and done in their own interests and not in the interests of the public, I venture to think that Dr. Buchanan and those who give evidence in favour of the Local Government Board are altogether oblivious to their own interests. These gentlemen are altogether above reproach, and they, with 99 out of every 100 of the thinking men of the country, are unequivocally in favour of vaccination. I confess that I cannot see the slightest chance of such an inquiry as that proposed by the hon. Gentleman the Member for Bedford having the least effect on the minds of the anti-vaccinators. I do not believe it would deprive us of one single opponent whom we now have the misfortune to meet. I am afraid I have trespassed somewhat unduly and long on the attention of the Committee. I have only touched very lightly on the various points that have been raised. I should have been glad if I had had an opportunity of going more fully into the question; but I hope I have satisfied the Committee that they would not act wisely in refusing to give the Government the Vote we ask for.
§ MR. A. M'ARTHUR (Leicester)
I did not intend to intrude upon the time of the Committee; but I desire to reply to one observation which fell from the right hon. Gentleman the President of the Local Government Board. I understood him to say that all the cases of small-pox treated in the Leicester Hospital came from the town of Leicester; but that is not the fact. We have traced each case to its source, and we have found them to come from Birmingham and other outside places. The cases have been taken into the hospital; they have been subjected to the sanitary arrangements to which reference has been made, and the disease has not re-appeared. I am not aware of a single instance in Leicester in which a fresh case has arisen 1809 owing to infection left behind by a case sent to the hospital; and if that amount of success attends the stringent application of precautionary measures in Leicester, why should it not happen in other towns? I am not disposed to argue against vaccination. On the contrary, I believe it—as is stated by the right hon. Gentleman—to be of great value. I have had all my own family vaccinated and re-vaccinated, and I believe that where the operation is performed with pure lymph and upon healthy children the effect is generally good, and if I could be persuaded that vaccination is in all cases a certain preventative of small-pox I should feel it my duty to vote in favour of compulsory vaccination. But I have known many cases where, as the right hon. Gentleman has himself admitted, injury has been done and death has resulted from vaccination. That being so, although I am in favour of vaccination individually, I feel that I cannot conscientiously vote for it in a compulsory form. I hope I am not transgressing your ruling, Sir, in saying that I have read a great deal about this question, and have heard a great deal about it, and that whenever I have had an opportunity of consulting medical men I have asked their opinion with regard to it. I am bound to say that, in the vast majority of cases, that opinion has been in favour of vaccination: but I am bound to say, also, that I have known cases in which medical men of high standing have disagreed with that view and have been opposed to vaccination altogether. I recollect some time ago asking a gentleman who had been 30 years in the profession for his opinion upon this question, and his reply was—"If you ask me for my candid opinion, it is that nine-tenths of all the skin diseases that we have in this country arise, directly or indirectly, from vaccination." "Well, I quite endorse the statement made by the right hon. Gentleman and others, that the medical men of this country are of high standing and of high honour, and that no charge has been brought against them as a whole; but in the case I refer to, where a medical gentleman told me he believed nine-tenths of the skin diseases of the country were due to vaccination, I asked him what he did with his own children, and he said—" I do not vaccinate them." 1810 I pressed him why he did not discuss the matter in the papers, and why he did not speak out on the subject, and his reply was—"I do not feel disposed to take that extreme step. I am a public vaccinator, and the post is worth a good deal to me." Therefore, the opinions of medical men are to be qualified by the fact that they are paid for their services as vaccinators. I may say, with reference to Leicester and other towns as well, that I do not for a moment doubt the accuracy of the right hon. Gentleman's statement. He states what he has heard; but I do not know that his informants are altogether to be relied upon. There are many parents in Leicester who would not allow their children to be vaccinated on any terms, as they are conscientiously opposed to it. There are now in the town between 20,000 and 30,000 people unvaccinated. Ever since I have been in Leicester I have heard it said that the time will come when the town will suffer for this disregard of vaccination; but we have never relaxed our sanitary precautions, and the outbreak which has been threatened has never come, and, I trust, never will come. I, therefore, say that this Vote is one which cannot be defended on any right principle, and therefore I shall vote for the Motion.
SIR UGHTRED KAY-SHUTTLE-WORTH (Lancashire, Clitheroe)
I merely desire to say a few words in reply to the opening and concluding observations of the right hon. Gentleman the President of the Local Government Board (Mr. Ritchie). The right hon. Gentleman, in the opening part of his speech, admitted that the opposition to compulsory vaccination was not decreasing, and he said he should not be surprised, at its increasing, because of the gross misrepresentations disseminated amongst the public. I would ask what is the proper way of meeting this misrepresentation amongst the public, which has a tendency to cause agitation of this kind to increase? Is it not by the measure pointed out by the hon. Member for Bedford (Mr. Whitbread)—namely, by the institution of a public inquiry of a character calculated to command public confidence, whose conclusions would be received not as the conclusions of prejudiced persons, but as 1811 those of persons appointed because of their impartiality and fitness to conduct the inquiry, and because of their capability of ascertaining the truth. The right hon. Gentleman has alluded to the fact that the medical officers of the Local Government Board are entitled to the greatest confidence. I would not say a word against that view of the right hon. Gentleman; but what I wish to point out to him and to the Committee is this—that those who have strong opinions or, it may be, prejudices on this subject—and I do not propose to decide whether or not they are justified in those prejudices—naturally do not regard the utterances of an official of a Department like that presided over by the right hon. Gentleman in the same way as they would regard the decision of a Commission constituted in the manner recommended by my hon. Friend the Member for Bedford. The officers of the Board are held to be committed, to a great extent, to certain opinions. Early in his career Dr. Simon committed himself to opinions which cannot now be maintained by the right hon. Gentleman and the present officers of the Board. It is natural that the public, or that portion of the public who are suspicious on this subject, should regard any views put forward by such officials with suspicion. Then the right hon. Gentleman has stated that prosecutions have a tendency sometimes to degenerate into persecutions. Is it not possible that there may be an advantage in having an inquiry, inasmuch as it may show why prosecutions are apt to degenerate into persecution? The right hon. Gentleman has himself described to the Committee how circumstances have occurred which have rendered it desirable for him to send down Inspectors of the Local Government Board to remonstrate with the Local Authorities as to the manner in which they carry out the law for the enforcement of vaccination. All these statements of the right hon. Gentleman during the course of this debate seem to me to illustrate the existence of scepticism in the minds of many people, and doubts in the minds of many more, as to the value of the law of compulsory vaccination. They seem to me to show the wisdom, which I trust the right hon. Gentleman will himself admit, of instituting another of those inquiries which have 1812 been held from time to time, and of taking care that it is one appointed in such a way as to command public confidence. I am going to be very careful myself not to express any opinion of my own on the subject of the present law. I wish myself to reserve my opinion until some inquiry of this kind has been held. I will boldly say, agreeing with what the hon. Member for Bedford has said in the course of this debate, that, personally, I regard vaccination as being, to a large extent, a preventive of small-pox, and therefore of great value; for we all know what a frightful disease small-pox is. It has been described as the most hideous, loathsome, and fatal disease, save, perhaps, hydrophobia, which can possibly affect the human system. My contention is that the right hon. Gentleman has shown by his observations that there is a cause for such an inquiry as that asked for by the hon. Member for Bedford; and I will not say any more than press upon the Local Government Board and the Members of the Government the desirability of considering very carefully whether it would not be better, in the interests of the views they have themselves taken of this matter, that there should be a full and impartial inquiry. Let me point out this in conclusion. Suppose that such an impartial inquiry by a Commission so constituted as to command public confidence is held, and results in the complete justification and maintenance of the view of the Government, that the present law is a good law and ought to be continued. The right hon. Gentleman's hands would be strengthened enormously. He says that not a single fanatic anti-vaccinator would be converted. That may be true; but there are many people who hang upon the skirts of the fanatics who strengthen a movement such as this anti-vaccination agitation by their sober and sensible support, and these people, I take it, would be greatly influenced by the result of such an investigation.
DR. CAMEROM (Glasgow, College)
I have come to my own conclusion concerning the value of vaccination, and have come to it not, as most men, too blindly and on simple anthority, but after careful analysis of the most detailed statistics of 50 years' experience; and I am the more strengthened in the 1813 conclusion I have arrived at after that examination into the subject, because I find that the laws which, on examination of these statistics, appear to reveal vaccination as a remedy for the prevention of small-pox, tally with the general principles in the laws which have since been discovered with regard to the action of vaccinators in general. Now, Sir, these inquiries on the subject have left me no doubt whatever as to the protective nature of vaccination—no doubt as to the efficacy of vaccines in a number of diseases, and as to their protective influence in connection with small-pox in particular. But I have always thought that the question of compulsion and administration is not a medical question at all, and that it is a matter which should be left in the hands of laymen. At the same time, I have never had any practical doubt about compulsion. I am perfectly willing to admit that it is not a medical question, but is a question of administration to be looked into by laymen; but, at the same time, I say I have no grievance against it. But what I desire to point out, or, rather, what induced me to rise, was the remark made by the right hon. Gentleman the President of the Local Government Board as to the power of the Government to find some means of reconciling to the practice of vaccination persons who do not altogether approve of it, and even some of those who are vehemently opposed to it. I am certain that if the right hon. Gentleman would take the trouble to look into the matter himself, and would, instead of making the practice of vaccination a deterrent to persons who ought to be vaccinated, he would try to make it as easy as possible to go through the process—I am quite certain that he would sweep away the objection which exists to the practice. Not long ago I succeeded in inducing the Government to set up a calf-lymph establishment in Lamb's Conduit Street, where persons could be vaccinated straight from the calf. I did so because I was convinced that this kind of vaccination would remove a great many of the difficulties which exist in the case of vaccination from the arm. Not only was I convinced that the vaccine-lymph from the calf would be a more perfect preventative, but I urged upon the Government that a number of persons would be willing 1814 to have their children vaccinated in that way who would not, perhaps, be willing to subject their children to vaccination from other children who might be supposed to be infected with disease. Well, the scheme was pronounced to be absolutely impracticable, and all sorts of objections were raised to it. At least 100 objections were raised—it was unreliable, it was this and that and the other. It was not until the institution was established that every one of these objections was found to be dissipated into thin air, and that the nature of the advantage of the plan was recognized. What has been the result of that institution? Why, as a matter of fact, the number of persons who have been vaccinated there is enormously greater than the number vaccinated at any other station in London. The fact that people can have their children vaccinated with calf-lymph straight from the calf removes from the minds of large numbers of people their one objection to vaccination. Let the right hon. Gentleman consider this matter, and act upon the suggestion. Let him not, for Heaven's sake, attempt to strengthen his case by suppressing facts. I have no doubt that he was quoting from evidence supplied to him when he said that no case is known in which it has been conclusively proved that syphilis has been communicated by vaccination. In saying that the right hon. Gentleman committed himself to a statement which is altogether incapable of proof. That statement was made for many years, and had it not been for the fact that during the sitting of the Commissioners there was an outbreak of syphilis, where it was clear that it had been communicated by vaccination, the fallacy would never have been recanted.
During the sitting of the Commission. One hon. Member, in speaking upon this question, referred to a certain amount of the vaccine matter used in this country as being modified small-pox. The right hon. Gentleman the President of the Local Government Board indignantly denied that assertion, and there again his denial was incorrect. I am not going to deal with theories on this question. The right hon. Gentleman mentioned facts referred to by Seely. As a matter of 1815 fact, that lymph, was very widely disseminated, and one of the highest authorities upon this subject—a French physician who is very well-known in this country—declared that that lymph was neither more nor less than modified small-pox, and that, according to his experiments, it was by no means certain that it was not contributing to small-pox infection. Now, I do not endorse that statement, or contradict it; but I say that when such an authority as this—one of the greatest authorities on the science of vaccines in the world—does not hesitate to take such a view, I hold that it would not be very dreadful for the right hon. Gentleman to look into the facts, and if he sees that such things are the case, to take steps to clear out of the country all the questionable lymph. I maintain that that could be very easily done. There is this calf-lymph in Lamb's Conduit Street, from the windows of which the entire stock of lymph in the country could be replaced in a very short space of time. I will take the case of Leicester. Now, I know that the medical authorities on the Local Government Board are always trying to explain away the case of Leicester; but to my mind what is going on in that town is a most important experiment, and I am perfectly content to observe that experiment in connection with other experiments that are going on in other parts of the country. Some years ago, when there was an epidemic of small-pox in London, I called the attention of the right hon. Gentleman's Predecessor to the system of vaccination adopted in Scotland as contrasted with the system adopted in London. In Scotland there is general vaccination; but from time to time—in Glasgow, for instance—an epidemic breaks out, and when such a thing occurs every care is taken to withdraw the persons infected, and to allow the authorities to give re-vaccination to all who desire it. I have shown that in London nothing of the sort existed. I showed that there are no opportunities afforded for this re-vaccination, and where there are opportunities people cannot avail themselves of them. I would urge the right hon. Gentleman to trust rather to facilities offered for vaccination and re-vaccination than to compulsion. If he did this I am sure that the facilities he would offer would be largely availed of, as they are largely availed of in 1816 every town of Scotland where they are offered.
Yes; but we do not rely upon it; if we did we should put ourselves in as bad a state as you do. But I say that instead of compulsion we have persuasion, and this leads me to a particular point in the speech of the right hon. Gentleman. He was challenged for not affording in the case of the Scotch vaccinators the same inducements for bringing about an improved system of vaccination, and he told us that when the Local Government Board scheme was brought forward that should be done. I called the attention of the right hon. Gentleman's Predecessor to the anomaly, and it is not at all attempted to defend it. In fact, the right hon. Gentleman's Predecessor admitted the anomaly, and promised that it should be rectified; but from that day to this no step has been taken in the matter. I must say that the right hon. Gentleman's facts as to vaccination in Scotland were incorrect. As a matter of fact, only paupers are vaccinated by these officials; but the public officer of health at the expense of the town has a vaccination establishment or public institution—for instance, "The Faculties of Physicians and Surgeons" keeps a vaccination establishment and a number of vaccination stations that, not paid for out of the poor rates, are supported at the public expense. [Cries of "Divide !"] Well, I do not wish to help the right hon. Gentleman to talk out the Vote, and I will not occupy the time of the Committee many more moments. I desire to say that I do not approve of the system of Grants in Aid at all; but when you want to make them fair as regards different portions of the Kingdom you must make them equal with regard to those different operations, or else do away with them altogether. There would be no difficulty in making them equal. He says there is no authority like the Local Government Board to look after the matter in Scotland, but we should adopt the same course as to this Vote in Scotland which is adopted in regard to the medical grant in England. the right hon. Gentleman should compute the proportion which Scotland should receive, and should distribute it under the present method.
Yes; it should be done by Act of Parliament one way or the other. It is the duty of he House to see that grants are given on equitable principles, and if an Act of Parliament provides for these grants being made on equitable principles he should see that the law is amended. While the right hon. Gentleman has receded far from the position taken up by his Predecessor on that Bench seven or eight years ago, the then President of the Local Government Board thought the anomaly was indefensible, and I think he promised on the very next Session to have the matter sent up with a view of rectifying that anomaly. As it frequently happens when a promise is made by a Gentleman occupying a seat on the Treasury Bench no practical result followed. The right hon. Gentleman (Mr. Ritchie) appears to be absolutely impenetrable to the just demands made to him in this matter. He appears to have no idea that there is any injustice perpetrated, and in that respect I think he has shown signs of very great retrogression.
§ DR. R. MCDONALD (ROSS and Cromarty)
I shall not detain the Committee more than a few moments. I want to point out, in the first place, what I think is not sufficiently known to the House and to right hon. Gentlemen on the Treasury Bench, and that is that the position of many of the public medical officers in Scotland and public vaccinators in England is very much on a par. When I was a parish medical officer in Scotland I vaccinated 1,100 people in the course of a few months. The parish paid me for the work. I am opposed to public vaccination, and I will explain why. A public vaccinator is appointed for a district wherein he may not be a resident. Children are brought to him to vaccinate. He may see one child which is apparently healthy, and take matter from it with which to vaccinate others. He knows nothing about the child; he may never have seen it before it was brought to him to vaccinate; he knows nothing about the constitutional history of its family. Possibly, a month afterwards, when he sees the child again he will find it suffering from syphilis. The system of public vaccination is wrong, because every man is 1818 bound, or ought to be bound when he takes vaccine lymph from a child, to know the history of the child. I regard these Grants in Aid as entirely useless. I object to them, in the first place, because they are not given to Scotland or to Ireland; and I object to them, in the second place, because they are given to the same gentlemen year after year. If the right hon. Gentleman will look down the list of gentlemen who get these public grants he will see the same name recurs six, seven, and 10 times. I do not say that the inspectors are much at fault. Perhaps they are doing the work in the different districts better than others could; but, at any rate, one cannot help regarding it as somewhat suspicious that the same men should receive the grants year after year. I must vote with my hon. Friend the Member for East Donegal (Mr. Arthur O'Connor), because these grants are not given to Scotland. I think it would be wise of the Government to grant a Commission of Inquiry into the system of public vaccination. I have seen evils arise from the system. I have seen deaths follow vaccination, but they have not been really duo to vaccination. If after vaccination a child has a skin disease and dies, the mother and father consider it has died from syphilis produced by vaccination when it has died through the sins of its parents. We medical men know very well that syphilis can pass a generation—that you may have parents perfectly free from syphilis all their lives, and yet you may find syphilis in their children. All this talk about death from vaccination is, to my mind, perfect nonsense. I think that calf vaccination has been a great boon. The hon. Gentleman the senior Member for Leicester (Mr. A. M'Arthur) has said that no cases of small-pox have occurred in Leicester. Surely no case of smallpox can arise anywhere unless the disease is communicated. Small-pox must arise through the disease being communicated to the individual. There are no germs of disease in Leicester because there is no disease there; but I make the statement in perfect faith and perfect knowledge that it will come to pass that as sure as the sun rises tomorrow Leicester will pay for its anti-vaccination doctrines. Ninety-nine medical men out of every 100 are of the same opinion as myself. Whatever our hopes 1819 may be we shall find, I am sorry to say, Leicester paying some of these days a heavy penalty for its opposition to, and disregard of, the vaccination law.
§ DR. TANNER (Cork Co., Mid)
I rise for the purpose of explaining my vote on this occasion. I intend to support the Motion of my hon. Friend the Member for East Donegal (Mr. Arthur O'Connor); but I do so simply because the Vote we are now asked to pass is a bonus conferred upon officials for doing their duty. To give such a bonus is absurd, and therefore I intend to vote against it. No one—no sane man, and I presume we are all sane men here—will deny the good results which have attended vaccination. The present generation are practically secure from that terrible disease which ravaged the generation which went before it. Every man who can recollect what happened a generation or two ago can tell us of the wonderful changes which have been effected by vaccination; and, accordingly, I am very pleased to-day to hear that my hon. Friend the Member for East Donegal does not support the anti-vaccination craze. [Mr. ARTHUR O'CONNOR dissented.] Oh, I understood him to say so. Then I hope the time will soon come when he will withdraw his support from this phantom. I must take exception to what the right hon. Gentleman the President of the Local Government Board (Mr. Ritchie) said with regard to the grant made to the Irish Poor Law medical officers. He said the grant made to these officers was equal to half of their salary, and that it was made to them in connection with vaccination. The Irish Poor Law medical officers have to perform all the various medical services, and they are not paid specially for vaccination services. The reverse is the case in England. Public vaccinators here are paid simply for vaccination work. People talk a great deal about the advisability of direct vaccination from the calf. There is no necessity whatever for keeping up these vaccination institutions. Anyone who has any practical acquaintance with the subject will tell you that vaccination direct from the calf is attended with very much graver results than other vaccination—that patients are placed in greater jeopardy and danger by vaccination direct from the calf than by vaccination from the individual.
§ MR. JACOB BRIGHT (Manchester, S.W.)
May I ask you, Mr. Courtney, if the Question before the Committee is whether there should be vaccination from the calf or from the individual?
§ DR. TANNER
I assure my hon. Friend (Mr. Jacob Bright) I do not intend to deal with the matter in extense. I merely want to convince some hon. Gentlemen who apparently are labouring, under a false impression. Let me give one instance of the evil effect of calf-vaccination, and perhaps that will do more than if I were to give them statistics galore, as we say in Ireland. The case occurred during the past year in the County of Cork. A lady of high rank in that county would not allow her child to be vaccinated from the lymph which was taken from the veins of an ordinary child—a child of the people. What happened? She sent over here to one of the public vaccine establishments and got lymph direct from the calf. This child of the aristocracy was not, as is very often the case with aristocratic children, very healthy; it got erysipelas and died. I assure hon. Gentlemen that this was the one solitary case in the South of Ireland of a child being vaccinated directly from the calf, and yet it was attended with fatal results. We are to say whether this Vote shall pass or not. I say the Vote is unnecessary. Although, at the outset, vaccination may be necessary to protect the population, as time rolls on there is not that absolute necessity for re-vaccination which people appear to think is necessary. The case of the North American Indians has been frequently mentioned. These people were not protected in any case from the virulence of the disease, and, accordingly, when small-pox appeared amongst them, it swept them down wholesale. That is not the case in any European country, or in this country. Vaccination has been in force here for a very long time, and, where it has not prevented the disease, it has modified its severity when it has broken out. This being the case, we ought to see a reduction of this Vote, instead of being asked, year after year, to vote the same sum. I give this as my second reason for supporting my hon. Friend (Mr. Arthur O'Connor) if 1821 he goes to a Division on the present occasion. I have only a word to say with respect to the proposal that a Commission of Inquiry should be appointed. The present Conservative Government have appointed many Commissions; surely one Commission more or less will not do any harm. There is no smoke without fire, and although I am against the anti-vaccinators, I think that if you appoint a good Commission to inquire into the alleged grievances you will certainly dissipate all the fears and doubts, and restore confidence where, at the present time, we have nothing but doubtings and trepidations. I sincerely hope that a Commission of Inquiry will be appointed, and that the Vote will be diminished.
§ MR. CHANNING (Northampton, E.)
I do not wish to prolong this debate; but it is only right to draw attention to two points in the speech of the right hon. Gentleman the President of the Local Government Board (Mr. Ritchie), which, I think, as the Representative of a constituency interested in this matter, I am entitled to do. The right hon. Gentleman threw doubt upon the connection of syphilis with vaccination. But, if that were so, I should like to know how it is that in the instructions which have recently been issued to the public vaccinators, the public vaccinators are especially directed to give their closest attention to the state of the children from whom they take the lymph, to ascertain whether they are free from syphilis or not? These instructions amount to an official recognition of the risk, and it is because of the recognition in official, as well as other sources of the danger of other diseases being communicated by vaccination, that there is this objection to the system. My second point is this. The right hon. Gentleman was challenged to state exactly what was the standard and the gauge upon which these bonuses and rewards to public vaccinators were to be assessed; and what he said practically was that the size of the scar which the public vaccinators produced was the gauge. I should think the best plan would be to wait for six months or a year, and to give the reward to the public vaccinator who had then the smallest number of children who had become ill on his hands. A great objection felt to the system of which these 1822 bonuses are part is that you are compelling people to submit their children to definite risks—risks which are acknowledged to be risks officially, as well as by the people and those who represent them—and that you are doing that to obtain a protection which is acknowledged not to be absolutely complete against a danger which is exceedingly remote.
§ MR. LABOUCHERE (Northampton)
I merely wish to explain my vote. I intend to give my vote in favour of the Amendment of my hon. Friend the Member for East Donegal (Mr. Arthur O'Connor), not because I agree with him for a moment in thinking that vaccination produces more harm than good, but because I am opposed to compulsory vaccination. It seems to me there is not a sufficient consensus of opinion amongst the medical men of this country in favour of vaccination that we should force people to be vaccinated.
§ Question put.
§ The Committee divided:—Ayes 66; Noes 196: Majority 130.—(Div. List, No. 315.) [6.20 P.M.]
§ Original Question again proposed.
§ THE FIRST LORD OF THE TREASURY (Mr. W. H. SMITH) (Strand, Westminster)
I wish to make an appeal to hon. Members. There will be an opportunity of asking any questions on Report. We have now been engaged on this Vote for three hours and a-half. It is of great importance we should take the Vote to-day, and, therefore, I hope hon. Members will allow it to pass without further discussion.
§ MR. PICKERSGILL (Bethnal Green, S.W.)
I appreciate the appeal made by the right hon. Gentleman (Mr. W. H. Smith); but really I must point out to him that the Local Government Board covers a very broad field—that there are many questions besides that of vaccination which may be raised on the Vote. My object in rising is to make one or two observations upon the relations of the Local Government Board to the pauperism of the Metropolis. I regret, 1823 Sir, it has not been possible to legislate during the present year, with a view of redressing the gross inequalities which at present exist between the poor rate of the poor districts of London and the poor rate of the richer districts of London, and I shall never be content until the cost of pauperism in London, being a common interest of the Metropolis, is defrayed by an equal rate over the whole area. My chief intention is to call attention to one item of expenditure which is defrayed out of what is called the Metropolitan Common Poor Fund. I refer to the rations of the officers of workhouses. It is a question to which I called attention in Supply last year. I complain that the Local Government Board, having imposed upon it the statutory duty of fixing a scale in accordance with which the cost of rations is to be paid out of this Fund, has fixed a scale which is not a reasonable and a proper scale; they have fixed a scale whereby every principal officer is allowed 12s. a-week, and every subordinate officer 7s. a-week. Since I last addressed the Committee upon this subject, I am happy to say that the scale has been raised by the right hon. Gentleman the President of the Local Government Board (Mr. Ritchie). I think I am right in saying he has fixed the scale as regards the principal officers at the old rate—namely, 12s.—but he has raised the scale with reference to the subordinate officers from 7s. to 8s. 9d. I am very grateful to the right hon. Gentleman for what he has done. It has relieved my constituents in Bethnal Green of a good many hundreds of pounds per annum, as it has also relieved the constituents who are represented by the right hon. Gentleman (Mr. Ritchie) himself. But my contention is that the right hon. Gentleman has not carried his revision quite far enough. Last year I drew his attention to the actual cost of these rations in two East End constituencies. In my own constituency of Bethnal Green the actual cost of the rations of the principal officers and subordinate officers together is 12s. 8d. a-head, and in Shoreditch it is 13s. 9d. a-head. Now, even after the revision for which we are indebted to the right hon. Gentleman, the amount per head allowed out of the Metropolitan Common Poor Fund is only 9s. a-head, so that the ratepayers of Bethnal Green are paying out 1824 of the local rates 3s. 8d. a-head, and the ratepayers of Shoreditch are paying 4s. 9d. a-head. I want to ascertain from the right hon. Gentleman—and I have given him notice of the character of the questions which I propose to address to him—I want to ascertain how he has arrived at the present scale. I want to know whether he has taken the absolutely lowest cost of rations throughout the Metropolitan Unions, or whether he has taken the average of a certain number of the lowest cases: and if he has adopted the latter course, I want to know upon how many cases he has formed his average, and what are the names of the Unions he has taken to form the average? I should also like to know what is the highest actual cost throughout the Metropolitan Unions, what is the lowest cost, and what is the average cost? I am also a little curious to know what is the cost of the St. George's Union itself? I press the right hon. Gentleman with this question. Does he contend that the Metropolitan Board of Guardians, exercising fair and reasonable economy in this matter, need not exceed the scale which is laid down, or, upon the other hand, does he charge the Guardians of Bethnal Green and Shoreditch, who, respectively, expend 3s. 8d. and 4s. 9d. more than the scale, with extravagance? Sir, there are one or two other questions upon which I desire to get information from the right hon. Gentleman. My attention has been drawn to the great discrepancies in the cost per head of the children educated in different pauper schools in connection with the Metropolitan Unions. In the Report of 1882 I find an analysis of such expenditure, and I invite the right hon. Gentleman's attention to the extraordinary, as it seems to me, discrepancy between the cost of educating a pauper child in one school and the cost of educating a pauper child in another school. At the head of the list there is a training ship Exmouth. I should expect that, owing to causes which I need not explain, the cost of education on board the Exmouth would be very high, and therefore I do not rely very much upon that case. The actual cost per boy in the training ship Exmouth is £38 per annum. But, then, I come to a pauper school proper, the South Metropolitan School at Herne Bay. The total cost per head is stated to be something over £31. I 1825 will not weary the Committee by giving the intervening instances; but I will take the lowest in the scale, which is—
Order, order! Perhaps the hon. Gentleman will indicate how this question is connected with the Local Government Board?
§ MR. PICKERSGILL
My object is to draw the right hon. Gentleman's attention to the cost in order that in accordance with what I understand to he part of the function of the Board, he may communicate with the various authorities.
§ MR. PICKERSGILL
I was under the impression it was one of the functions of the Local Government Board to look very closely into cases where there is great discrepancy in the cost of performing the different services; but I will submit to your ruling, Sir, and leave the question. There is one other question which I think will come within the cognizance of the Local Government Board, and it is the question of outdoor relief. Now, the Local Government Board has very large powers of supervision with regard to outdoor relief. I quite admit that outdoor relief requires to be very closely watched, but I am also convinced that in the present circumstances outdoor relief cannot be altogether dispensed with. My object in referring to this question is to impress upon the right hon. Gentleman the importance of not breaking up a decent home, where it exists, by sending the family into the workhouse. Upon this point I will—
§ MR. RITCHIE
I am sorry to interrupt the hon. Gentleman, but he is now raising a question over which the Local Government Board have no jurisdiction. The Guardians of the Poor are responsible to their electors, and they administer relief, some in one way and some in another—some give no outdoor relief, and others do. We have no control in the matter.
§ MR. PICKERSGILL
The Local Government Board certainly issue statutory orders under which the Guardians act; and, therefore, subject to your ruling, Mr. Courtney, I should like to say a word or two more upon this question.
If, as I understand, the Local Goverment Board can- 1826 not override the discretion of the Guardians in the matter of outdoor relief, it would not be competent for the hon. Gentleman to discuss the question of outdoor relief upon this Vote.
§ MR. PICKERSGILL
I understand it is not disputed that the Local Government Board have power of regulating to a large extent outdoor relief. I do not wish to detain the Committee for more than a moment longer. I simply desire to refer the right hon. Gentleman to an authority upon this subject, to which I am sure he will be disposed to pay very great respect. With regard to the care which is exercised in one London Union not to break up decent homes, Mr. Brown, the clerk to the St. George's Union, says—Applications for relief are met in moat instances by an offer of indoor relief either to the whole family or, where there is a home worth preserving, to a part of the family. In the latter case the remaining part of the family is assisted by co-operation with the Charity Organization Society, and thus decent homes are not broken up.I thank the Committee for listening to the remarks I have made, and I thank the right hon. Gentleman also for what he has already done, and the great care he has devoted to the complaints which have been brought before him.
§ MR. RITCHIE
I am very much obliged to the hon. Gentleman (Mr. Pickersgill) for what he has said with reference to my action in connection with the question of rations to which he called the attention of the Committee last year. As he well knows, I should have been very glad, representing as I do a very poor union, if I had been able to do more than I feel myself at liberty to do. He asks me upon what principle I acted in faxing the scale. Well, I felt that looking to the fact that this charge was borne by the whole of the Metropolis, I was bound to look at what was the lowest cost at which the rations could be provided. I thought it would be quite out of my power to fix a scale which would leave a profit on the rations in any particular Union. I felt I was precluded from fixing any higher sum than the lowest sum which I saw, from a Return made, it was impossible to provide rations.
§ MR. PICKERSGILL
Do I understand the right hon. Gentleman to say he took the absolutely lowest cost?
§ MR. RITCHIE
In Hackney the average weekly cost in Class II. was 8s. 10½d. per head. I do not know whether the hon. Gentleman wants the average weekly cost in Class I.?
§ MR. RITCHIE
I find that 12s. is the cost in the Holborn Union, and that that is the lowest cost in that class. I felt bound to adhere to the lowest cost.
§ MR. RITCHIE
We were bound to take each class by itself, and see what was the lowest sum for which it was possible to provide the rations required. Of course, we had to consult the lowest Union in each class; which we did. With reference to the question of outdoor relief, the hon. Gentleman is quite right in saying that the Local Government Board have certain jurisdiction in the matter. Within certain limits the jurisdiction lies with the Guardians. The regulations of the Local Government Board provide that where outdoor relief is given it is not to be given to able-bodied men without the labour test. Short of that it is entirely within the option of the Guardians. As the hon. Gentleman is aware, in some of the poorest Unions there is absolutely no outdoor relief at all. In St. George's-in-the-East, one of the poorest Unions, outdoor relief is so small that it is hardly worth mentioning, and there a large amount of assistance is given by the Charity Organization Society. I understand a deserving person is never turned away from the workhouse without relief in some way or other being given. The hon. Gentleman is aware that we have had a Return presented to Parliament upon the question of outdoor relief. If he does not possess a copy of it, I shall be glad to supply him with one.
§ DR. TANNER
I desire to ask a question for my own information and the information of hon. Gentlemen generally. I should like to know how it comes to pass that when there is a decrease in the salaries there happens to be an increase in the travelling expenses connected with the Medical Department? I also want to ask a question in connection with Sub-head D—Poor Law medical officers. There appears to be some doubt as to whether the English and Welsh Poor Law medical officers are public vaccinators—whether they are enabled to act as public vaccinators in the same sense as Irish Poor Law medical officers act as public vaccinators? I also desire to ask the right hon. Gentleman a practical question connected with the diplomas granted by the various schools. Are the Poor Law medical officers who are under the Local Government Board able to grant certificates in vaccination? This is a question which has cropped up again and again. I cannot understand why these officers in England and Wales are not able to grant certificates in vaccination, while officers in Ireland who are paid in the same way are able to do so.
§ MR. RITCHIE
The Poor Law medical officer in England is capable of performing, in addition to his duties as Poor Law medical officer, the duties of vaccination officer; but not necessarily so, as is the case in Ireland. Certificates are given by officers of the Local Government Board, and not by any Local Authority at all.
§ DR. TANNER
The right hon. Gentleman fails to grasp my point. Certificates are required in connection with various diplomas granted by schools. In Ireland these certificates, if signed by a dispensary officer, are valid for any of the examinations that the student may go in for. That is not the case in England. Students have to go to the public vaccinators, and not to the dispensary officers, for certificates. I want to know why that is the case, because it seems extraordinary that one system should exist in England and another in Ireland? The reason why I call the attention of the right hon. Gentleman to this point is that a number of Irish students 1829 come over to England to obtain certain English diplomas; and, to their surprise, they have to go to the public vaccinators, instead of taking out a certificate in the usual way—namely, through a dispensary officer.
§ MR. RITCHIE
The ordinary dispensary officer in Ireland is also the vaccination officer. The Poor Law medical officer in England is not necessarily the vaccination officer. Therefore, you could not expect the Poor Law medical officer to give a certificate which it is necessary for the vaccination officer to give.
§ Original Question put, and agreed to.
§ Resolutions to be reported.
Motion made, and Question proposed,
That a sum, not exceeding £8,227, be granted to Her Majesty, to complete the sum necessary to defray the Charge which will come in course of payment during the year ending on the 31st day of March 1888, for the Salaries and Expenses of the Office of the Commissioners in Lunacy in England.
§ Motion made, and Question, "That the Chairman do report Progress, and ask leave to sit again,"—(Mr. William Corbet,)—put, and agreed to.
§ Resolutions to be reported upon Monday next.
§ Committee also report Progress; to sit again upon Monday next.
§ House adjourned at five minutes before Seven o'clock till Monday next.