§ DR. TANNER (Cork Co., Mid)
, in rising to call attention to the entirely insufficient medical requirements and supervision on board Transatlantic liners for emigrants and steerage passengers; also to invite inquiry into the great risks incurred by master mariners and seamen on board vessels making long voyages, in consequence of the former being obliged to act as physician and surgeon to the crew, in addition to his 1740 other duties, said, the Irish people were leaving our shores in vast numbers, and, as an Irishman, he felt bound to try in the best way he could to safeguard those people when undergoingthehorrors—because it was a fact that horrors did exist on board those steamers—on their passage across the Atlantic, notably in the inclement season of the early spring and in the winter. The medical men who were on board those steamers might practically be divided into separate classes. First, there were men who went on board those vessels, such as the White Star steamers and the American liners, for a certain period. During that period they hoped to enjoy themselves, and did not look for any pecuniary advantage. At the same time, they always tried, as most men did, to endeavour to make their responsibility as small as they possibly could. Then there were men who went on board those steamers, and who undertook the care of the passengers in course of transport across the Atlantic, as a means of livelihood. Unfortunately, the major portion of those medical men were men who could not always get other employment—they were men who possessed minor qualifications; and he maintained that if the hon. Gentleman the Secretary to the Board of Trade (Baron Henry De Worms) inquired into the qualifications of the medical officers on board most of those Transatlantic liners, he would find that, with the exception, of course, of some of the great Companies, and some of the excellent and super-excellent steamers, the major portion of the men so employed possessed qualifications which he would term totally inadequate to the responsibility entrusted to them. The position of the doctor was also very unsatisfactory. He was not treated as a gentleman, and had no authority. He wished to call the hon. Gentleman's attention to the fact that the doctors on those emigrant steamers, though appointed by the Board of Trade, practically speaking, were not allowed to report to the Board of Trade. The doctor on one of these ships ought, no doubt, to be subject to the authority of the captain; but he ought to have in his own department sufficient authority, and to be responsible to the Board of Trade. Only three years ago the Board of Trade issued a form, which required that all ships' 1741 surgeons should report any complaints made by passengers on the voyage. That Order had never been complied with; and why? Simply because, like many other Orders which had been formulated in that House, which had received the sanction of that House and of the responsible Government, the Government, and possibly the House, were not strong enough for the shipmasters. The owners of the vessels were practically too strong for them, and although the Order was given it had not been carried out. The Shipping Companies, in defiance of that Order, stated that the doctors who complied with the Order would be instantly dismissed the Companies' service. Now, he maintained that that in itself would certainly warrant him in calling attention to this subject. The letter of Dr. Irwin, which appeared in The British medical Journal in February, 1884, first drew attention publicly to the matter under discussion. He stated that the average shipowners took a person whose qualifications complied with the minimum requirements of the law, and who could be judiciously silent when it might be inconvenient to speak and judiciously blind when not intended to see, but who would act as a buffer between negligence on the one hand and public indignation on the other when the health and interest of passengers came into opposition with the money interests of his employer. Dr. Irwin at the present time occupied a distinguished position in America, and it was stated in the medical journals of America that if the Government of this country did not pay attention to these facts it would become the duty of the American Government to fill up the gap. Dr. Irwin went on to state that practically the public did not see the danger; and what he (Dr. Tanner) maintained was, that in due course of time, if they did not safeguard the position, they would have a calamity which might be a very grave one on some of these ocean-going steamers, and a calamity which might be easily guarded against if they only paid attention to these facts which he brought under their attention. Dr. Irwin stated that his statistics were disregarded by the right hon. Gentleman the Member for West Birmingham (Mr. Joseph Chamberlain) when he was President of the Board of Trade. He (Dr. Tanner) sin- 1742 cerely hoped that the present occupant of that position would practically go in and win. Cargo ships were often sent to sea as emigrant vessels, and emigrants wore condemned to wretched quarters which could be patched up on an emergency. A great number of vessels were sent from Liverpool to America with goods. They brought back cattle, and then, without being sufficiently cleansed, they received large numbers of emigrants. Ought not that to be seen to? Then, there were no interpreters on board these vessels. He also wished to draw the attention of the House to the fact that there was insufficient hospital accommodation on board those oceangoing steamers. If he were to take any hon. Member of that House into same of these little dens which were dignified by the name of hospitals, they would be surprised at the miserable inadequacy of the accommodation. The hospital was generally a small apartment not the size of the Table in that House, miserably fitted up, and totally inadequate to meet any emergency which might arise. Practically speaking, there was only one line of steamers—the White Star Line —which carried such a thing as a surgery. There ought to be ample accommodation on board every ocean-going steamer for treating cases of sickness, and a proper place where medicine and medicinal appliances could be made out and put at the disposition of the medical men. There should also be some isolated place set apart for the treatment of infectious cases. On one ship capable of carrying 1,500 steerage passengers there was only one water tank. the House could appreciate the danger of such a state of things. In many cases the accommodation for steerage passengers was wretched in the extreme, and passengers were huddled together in a manner which it would be horrible to describe in detail. He hoped the Government would give their earnest attention to this question, and take steps to bring about a better state of things.
§ THE SECRETARY TO THE BOARD OF TRADE (Baron HENRY DE WORMS) (Liverpool, East Toxteth)
I have listened with attention to the remarks of the hon. Member for Mid Cork (Dr. Tanner),who has brought his professional knowledge to bear upon the subject; but the question was narrowed to much smaller limits than the speech of the hon. Mem- 1743 ber by the Notice which he placed upon the Paper, and which is—To call attention to the entirely insufficient medical requirements and supervision on board Transatlantic liners for emigrants and steerage passengers; also to invite inquiry into the great risks incurred by master mariners and seamen on board vessels making long voyages, in consequence of the former being obliged to act as physician and surgeon to the crew in addition to his other duties.It is scarcely necessary for me to point out to the hon. Member that the regulations of the Board of Trade are simply the embodiment of the Act of Parliament which relates to the carriage of passengers on ships, and the sections which bear specially on the question are Nos. 41, 42, 43, and 44. These sections of the Passengers Act clearly lay down that every passenger ship must carry a duly qualified medical practitioner. I quite admit that the words "duly qualified" are somewhat elastic, and may be construed in one way by some persons, and in a different way by others. I would only point out that those particular cases in which practitioners have not proved themselves fit for the situation they occupied are not, as a rule, reported to the Board of Trade. In nine cases out of ten the Board of Trade are utterly-unaware of the condition of things as stated by the hon. Gentleman. When a passenger ship leaves Liverpool with emigrants on board, it is accompanied by a doctor, and it is inspected, before it leaves, by an official from the Board of Trade, who inspects the ship in the first instance, goes down below and sees that the berths for the emigrants are in accordance with the rules laid down by the Passengers Act—for instance, that every passenger has so many cubic feet of air, and that there are proper divisions between the different sexes. The officer in charge of the emigrants has all the emigrants paraded before him for inspection, and if there is the slightest symptom or suspicion of infectious disease the emigrant is sent on shore. So far as the Board of Trade is concerned, every possible precaution is taken to prevent the spread of infectious disease on board ship, and to see that the regulations founded on the Act of Parliament are rigidly carried out. As to the qualifications of the medical officers, the Board of Trade have very little authority. A "duly qualified medical practitioner" is deemed to mean 1744 one who has taken a diploma as a doctor, or surgeon, or, in some cases, as an apothecary. I am bound to say that I do not think that an apothecary ought to be considered a duly qualified medical practitioner; and I hope that this view may be adopted generally on board passenger and other ships. With regard to doctors or surgeons, it is impossible for the Board of Trade to ascertain whether the officer is duly qualified or not. If a medical officer turns out to be incompetent, and his incompetence is brought to the notice of the Board of Trade, the Board would have a right to exercise the power of causing such person to be dismissed. I believe that in the large lines of Transatlantic steamers the proprietors do their utmost to procure the services of competent medical officers, but the difficulty is that there are a great many young medical men who are anxious to take a passage on board these steamers in the summer months, as a matter of pleasure, who go away when the more inclement season arrives. No doubt that circumstance does give rise to difficulty; but in dealing with that difficulty the Board of Trade are in no way called upon to assist the Steamship Company. We have nothing to do with the selection of medical officers, although we might interfere in a flagrant case of incompetency. It is in no way my province to provide medical officers for ships. As to the hospital accommodation, it is such as the proprietors of the steam ships deem adequate; but I am not prepared to say that it always is adequate. I am informed that in cases of infectious disease they are invariably isolated. No doubt the accommodation for such cases is occasionally inadequate, and certainly, so far as the Board of Trade is concerned, it is our endeavour to do all that is possible to improve the accommodation for emigrants, and to see that the rules as to cleanliness and hygiene are properly observed. The hon. Gentleman says that the accommodation for emigrants is insufficient in certain very important particulars. I believe that the hon. Member is right in that statement, although I know that in all new ships of the White Star, Inman, Cunard, and other great lines, those arrangements are being perfected and great improvements are being introduced. In every ship a list of drugs in store is required to be kept.
§ DR. TANNER
I said nothing about that. I merely spoke of the inadequate provision for the storing of drugs.
§ BARON HENRY DE WORMS
The Board of Trade is extremely particular, not only with regard to the storing of drugs, but to the general surgical accommodation.
§ BARON HENRY DE WORMS
I do not think the hon. Member is correct in his objection to the arrangements in that respect.
§ DR. TANNER
In many cases there is not only inadequate surgical accommodation, but no proper place allotted for the storing of drugs.
§ BARON HENRY DE WORMS
There is a special cabin fitted up for surgery. In some of the largest steamers provision is made for every surgical appliance. The hon. Member will find, if he chooses to inquire, that every possible precaution is taken in the large oceangoing ships, and that they do fulfil, as far as possible, the requirements of the law. The Board of Trade have no further responsibility in the matter than to see that the requirements of the Passengers Act are thoroughly carried out, and I can assure him that so long as I have had the honour to be at the Board of Trade no charge of negligence or gross violation of the provisions of the Passengers Act on the part of a medical officer has been received. I can only say that if the hon. Member will bring forward any definite case that requires investigation it shall receive the fullest inquiry. It is our desire to see that the regulations are fully carried out, and that the rules which concern the comfort and well-being of the passengers and emigrants are fully carried out.
§ DR. TANNER
May I be permitted, by the indulgence of the House, to say one word? I am afraid that I did not sufficiently explain myself in regard to the difficulty in which ship doctors are placed. It unfortunately happens that their grievances cannot be brought forward properly on account of the paramount influence of the shipowners. If the ship doctors were to parade their grievances and the consequent grievances to which the emigrants are subjected, they would inevitably lose their place and their means of livelihood.