§ Considered in Committee.
§ (In the Committee.)
§ Clause 1.
§ Motion made, and Question proposed, "That the Clause stand part of the Bill."
§ MR. SEXTONWe have been here through a most fatiguing week. We were here till nearly 3 o'clock this morning, and the present Sitting has lasted more than seven hours. Does the Government think that there is no limit to the physical endurance of Members? I, for my part, cannot consent to going on with this Bill. The important business of this Sitting has already been transacted.
§ THE PRESIDENT OF THE LOCAL GOVERNMENT BOARD (Mr. Ritchie,) Tower Hamlets, St. George'sI would point out that this Bill was read a second time with the universal assent of the House. It has a most important bearing on the public health, and it is extremely desirable that it should pass into law as soon as possible. The Amendments are practically limited to three points, and the great majority of them hang one upon another. The first point is whether or not the Bill should be made compulsory; the second is whether the medical men should make the notification, and the third is whether the measure should apply to Ireland. At the request of the right hon. Gentleman the Lord Mayor of Dublin (Mr. Sexton) the Government considered the question of applying it to Ireland, and, with the view of meeting his wishes, they have put an Amendment on the Paper. If he does not desire it, the Government have not the slightest desire to press that Amendment. We propose to accept an Amendment which will make the Bill generally compulsory, and the whole matter is therefore reduced practically to the question whether or not medical men should have the obligation cast on them to send in a certificate. In view of the fact that the Bill has met with the approval of Members in all quarters of the House, I trust we shall not lose another year but that we shall be permitted to go on with it.
§ MR. HALLEY STEWARTThere is not, I believe, a single medical man in the House now, and they are all most deeply interested in this question. The hon. Member for Caithness (Dr. Clark), the hon. Member for Hackney (Sir W. Guyer Hunter), and others were anxious to take part in the discussion, and none of them are present. I move to report Progress, in order that the measure may be discussed at a reasonable hour.
§ Motion made, and Question proposed, "That the Chairman do report Progress, and ask leave to sit again."—(Mr. Halley Stewart.)
440§ MR. W. H. SMITHI trust the Committee will allow the Bill to proceed.
§ MR. SEXTONIt will take too much time.
§ MR. W. H. SMITHIf it is approached in a reasonable manner it is not likely to take up much time. It is a matter of great importance to the health of the country, and there is already abundance of business for transaction on Monday. We cannot postpone the Bill till Monday without running great risk of losing the chance of passing it.
§ MR. MURPHYThe Irish Members are unanimously desirous that the Bill should be extended to Ireland as a permissive Bill; but I understand the Government are going to accept the proposal to make it compulsory. Personally I see no objection to that; but I know there is a difference of opinion on the subject on this side of the House.
§ MR. RITCHIEI understand that there are circumstances in connection with Ireland which would make a permissive Bill more acceptable there than in England or Scotland, and I would therefore suggest that Ireland should not be included in this Bill, but that a Bill on permissive lines should be brought forward with reference to Ireland next year.
§ MR. SEXTONIf we bring forward an optional Bill will the Government facilitate it?
§ MR. RITCHIEI am not able to say without having seen the Bill; but certainly any Bill which proposed to reenact the provisions of this Bill in regard to Ireland in a permissive form would, I have no doubt, receive the support of the Government.
§ MR. SEXTONWhat does the First Lord of the Treasury say?
§ MR. W. H. SMITHI am willing to meet the right hon. Gentleman in any way, but I must be very guarded about giving a positive pledge.
§ MR. A. J. BALFOURThe right hon. Gentleman opposite can hardly expect us to consent to his proposal without having time for consideration, but I will give it full consideration. A Bill in the form of that now before the Committee would certainly be considered.
§ MR. T. M. HEALYThe time has arrived when we certainly ought to drop business. There is a long list of Orders on the Paper. Are we going to sit here till past midnight? The Government, of course, will say they have been here as long as we have, but they are Cabinet Ministers, and they have all the honour and glory of it. It is only reasonable to ask that the Motion to report Progress should be agreed to.
§ MR. W. H. SMITHSurely the hon. and learned Gentleman can be reasonable. It is not the Government and English Members who have been occupying the time of the House today. A large body of English gentlemen who take a great interest in this Bill have been waiting here for seven hours in order to discuss it. Is it unreasonable, under these circumstances, that the Bill should be proceeded with? There is nothing on the Paper after this Order that will occupy any time.
§ MR. SEXTONThis Bill will not occupy any time, because Members of the House who take the deepest interest in it are absent, and will have been taken by surprise. Most of the Amendments on the Paper stand in the names of Mr. W. McLaren, Mr. Hastings, Mr. Llewellyn, and Sir W. Foster, and they are all absent.
§ MR. HALLEY STEWARTI have been requested to put all Mr. McLaren's Amendments down for the Report stage, as he is unable to be here.
§ MR. TOMLINSON (Preston)There are a great many Members who take an interest in this Bill, and who have not put down Amendments because they are content with it in its present form.
§ MR. M. HEALYThe reasons which have been given for proceeding with the Bill to-night are equally an argument in favour of postponing it till Monday. If it is merely a formality it can be dealt with on Monday just as well as now.
§ The Committee divided:—Ayes 18; Noes 54.—(Div. List, No. 341.)
442§ Question again proposed, "That Clause 1 stand part of the Bill."
§ Whereupon Mr. T. M. Healy moved, "That the Chairman do now leave the Chair;" but the Chairman, being of opinion that the Motion was an abuse of the Rules of the House, declined to propose the Question thereupon to the House.
§ Question put, "That Clause 1 stand part of the Bill."
§ The Committee divided:—Ayes 54 Noes 18.—(Div. List, No. 342.)
§ MR. M. HEALYI wish, Sir, to move the first Amendment standing in the name of Mr. Walter McLaren. The Bill proposes to make the most absurd distinction between London and the rest of England. It proposes that in London the measure shall be compulsory after two months from the date when it becomes law, whereas in the rest of the country it will only come into force upon its adoption by a Sanitary Authority.
§ Amendment proposed, Clause 2, page 1, lines 8 and 9, to leave out Sub-section, (a).—(Mr. M. Healy.)
§ Question proposed, "That Subsection (a) stand part of the Clause."
§ MR. RITCHIEThis Amendment is unnecessary, inasmuch as we propose later on to accept an Amendment which will make the measure uniformly compulsory.
§ MR. MURPHYI think it would be better to leave the Bill as it is than to make it compulsory throughout the country.
§ MR. HALLEY STEWARTWhen the Bill was read a second time it was not a compulsory but a permissive Bill, and that was the whole argument used in the House.
§ MR. RITCHIEThe real state of the case is that there has been an unanimous expression of opinion that the Bill ought not to be permissive in any part of the country. The difficulty of an optional Bill would arise in the case of overlapping areas, and the result might be that one Local Authority 443 might adopt compulsion, whereas the next Local Authority might not. It was in response to an almost unanimous expression of opinion that the Government have consented to accept the Amendment of the hon. Member for Somersetshire. But they do not wish to make the Bill compulsory against the desire of the House.
§ MR. SEXTONThe present situation is an illustration of the difficulty of proceeding with the Bill in the absence of the hon. Member who has placed Amendments on the Paper. In the absence of the hon. Member we are not able to say whether or not the proposal of the right hon. Gentleman will be satisfactory.
§ MR. RITCHIEI think that the hon. Gentleman who has moved the Amendment has misapprehended the scope of the Bill as it stands. It proposes to make the Act compulsory in London and partly so throughout the country. The reason why it is proposed to make it compulsory in London is obvious. There are 20 or 30 different Central Authorities, and if one Authority adopts the Act and another does not the Act itself would become absolutely useless in the district in which it was adopted. If the hon. Member who has moved the Amendment desires to strike out the compulsion in London and make it optional we must leave it to the House to decide what shall be done.
§ MR. SEXTONI should like to ask the First Lord of the Treasury if, in these circumstances, it is possible to go through the Amendment Paper at this time? The same difficulty will arise on every Amendment, and it will, therefore, become our duty to divide the Committee.
§ MR. M. HEALYThis clause as it stands draws a distinction between London and the rest of the country. It proposes that in London the Act shall be made compulsory, and that it shall come into operation within two months 444 from its passing, whereas in the rest of the country it is only to come into operation when it is adopted by the Local Sanitary Authority, at whatever date that may be. I think it is most unfortunate that we should take into consideration an Amendment of that kind under existing circumstances; and in the absence of hon. Members most interested, I do not see any reason why there should be one law for London and another for the rest of the country. I do not apprehend that any serious difficulty would arise from the conflict of jurisdiction, and if there is to be a reform in London why should there not be also a similar reform throughout the country? If necessary, why not entrust the London County Council with the power of enforcing the Act? I should not myself like to make such a proposal to the House, as I am not sufficiently acquainted with the needs of London. But I should like the President of the Local Government Board to explain to the House what Amendments are to be accepted, as I have not had time to master the Amendment Paper.
§ MR. RITCHIEThere are two points which have been raised: one is the attitude of the London Members as to the position which London occupied in regard to this Bill when it was being debated on the Motion for Second Reading. Now, with regard to that, I am aware that one or two hon. Gentlemen recommended at that time that London should be treated in the same manner as the rest of the country. But they have since withdrawn their opposition, and have informed me that they are prepared to assent to London being dealt with as proposed in this Bill. The Amendments in the name of the hon. Member for Somersetshire (Mr. Llewellyn) the Government, if so desired, will accept, and they will make the Bill apply equally throughout the country.
§ MR. MURPHYI do not think the Government are justified in making the Bill compulsory in face of the opposi- 445 tion of hon. Members present, and in view of the fact that none of those hon. Members who have Amendments on the Paper in that direction are not here to propose them. If the right hon. Gentleman will leave the Bill as it was originally introduced, leaving it optional to the Local Authority to adopt the Act, I do not think he will meet with any considerable objections.
§ MR. SEXTONThis clause obviously raises the whole question whether the Bill shall or shall not be compulsory. As the Government have expressed their willingness to act in accordance with the wishes of the Committee, I think the time has now arrived when hon. Gentlemen should give an indication of what their opinion is. So far as my Colleagues are concerned the Representatives from Ireland desire to have an optional Bill.
§ MR. RITCHIEThe Government look upon the Bill as of such importance that they desire it to become law without delay; and if the right hon. Gentleman who last spoke is prepared to say that he and his friends will accept the Bill as it stands, the Government are so impressed with the great importance of the measure that they will be willing to make terms with them, on the condition that the Bill is allowed to pass.
§ MR. SEXTONThen all I can say is that if the Local Authorities are given the option of enforcing the Bill, my hon. Friends will withdraw from further opposition.
ME. SUTHERLANDWith regard to the effect of the Bill in Scotland, I wish to point out that provisions of a similar nature are already in operation in that country.
MR. J. BRYN ROBERTS (Carnarvonshire, Eifion); After the declaration we have received, I think it is hardly right in the absence of hon. Members who are interested in the measure, and understood that it was to be compulsory, for the Government to turn round and make it optional.
§ MR. TOMLINSONThe feeling of hon. Members on this side of the House is that the Bill is so important that it ought to be passed, either as a compromise, or as a permanent measure. It ought to be passed in some form or other.
§ MR. MURPHYI have no objection to make to the passing of the Bill in the form in which it was introduced by the right hon. Gentleman, and I would suggest that the operation of the Act in this form might be tried for a short time as a tentative measure, and if it was found not to be working satisfactory, why then a short Act might be passed next year making the Bill compulsory, which I would then willingly support.
§ Amendment, by leave, withdrawn.
§ Clause 2 agreed to.
§ On Clause 3,
§ MR. HALLEY STEWARTI desire to propose an Amendment to this clause, providing that the notice shall be given by the nearest "adult" relative. If the word "adult" is not inserted, I think the responsibility may in some cases be thrown on persons on whom it should not fall.
§ Amendment proposed, Clause 3, Subsection 1, before "relative" insert "adult."
§ MR. RITCHIEI am afraid I cannot accept that Amendment. It must be perfectly obvious to the hon. Gentleman that there may be brothers or sisters under age in law, but still of a sufficient age to be capable of giving the notice, and I think it would be extremely disastrous to relieve persons of that age of the responsibility.
§ MR. HALLEY STEWARTBut surely you will not throw the responsibility on a person under age and impose a penalty of 40s. in such cases. I do suggest that the Amendment I have proposed would not materially interfere with the effectiveness of the Bill.
§ Amendment put, and negatived.
§ MR. HALLEY STEWARTI have another Amendment which I wish to 447 submit, and I think it will make the clause more clear.
§ Amendment proposed, Clause 3, line 24, after "becomes aware," to insert "as soon as he reasonably can."
§ MR. RITCHIEI can assure the hon. Gentleman that these words are quite unnecessary. Any person not giving notice until he becomes aware will, of course, be amply protected. The efficiency of the Act depends on the promptitude with which notice is given.
§ MR. MURPHYI agree with the right hon. Gentleman that the Amendment is quite unnecessary, and I hope it will not be pressed.
§ Amendment, by leave, withdrawn.
§ MR. J. KELLY (Camberwell, N.)There is an Amendment to this clause, in my name, which I wish to press, although I fear that it has not much chance of being accepted. I think it will be admitted that the Bill, if carried, will effect a great reform, and be of considerable advantage. It provides that certain notices shall be given to the authorities when disease breaks out, and I desire that in such cases notice shall also be given to the head master or mistress of any elementary or higher school which is attended by a child belonging to the family in which the disease has broken out.
§
Amendment moved, Clause 5, insert—
Also of the head master or mistress of any elementary or other school, whether or not in the receipt of a Government grant, at which such patient or any person residing in the same building may he in attendance."—(Mr. J. Kelly.)
§ Question proposed, "That those words be there inserted."
§ MR. RITCHIEI assure my hon. Friend that these words are not at all necessary. The details are provided for by other regulations which are not inserted in the Bill. The towns which adopt the provisions of the Act will have power to make rules and regulations which will cover all these cases.
§ MR. KELLYI think it is of the utmost importance that this provision 448 should be inserted in the Bill, and I should like to give the Committee one illustration of the importance of giving this notice. In a Grammar School with which I am acquainted a boy attended as usual after fever had broken out in his home, and in two days no less than 11 of the scholars were attacked, and death resulted in one case. Surely it would be the most simple thing in the world when a person is sending a notice to the Local Authorities to write and send a duplicate to the schools which his children are in the habit of attending. It would not do to leave it to the medical attendant, for he might not be aware of what schools the children attended.
§ Amendment put, and negatived.
§ MR. HALLEY STEWARTI beg to move, in Clause 3, page 2, to leave out from "applies" to end of line 10, and insert the words—
Give a certificate to the head of the family or other person who appears to him to be primarily liable to give notice under the Act, stating the name of the patient and the infectious disease from which, in the opinion of such medical practitioner, the patient is suffering.
§ Question proposed, "That the words proposed to be left out stand part of the Bill."
§ MR. RITCHIEThis Amendment raises the question of a dual notification. The question is, shall the notice be given by the medical attendant, or by the head of the family, or by both? If it be true that the head of the family will make the proper notification then surely there can be no difficulty in laying the duty also on the medical attendant; but if, on the other hand, the head of the family would not, then surely if the Bill is to be effective it would only be right to insist that the notice shall be given by the medical attendant.
§ Mr. HALLEY STEWARTI feel I am labouring at an enormous disadvantage to-night owing to the absence of my hon. Friend the Member 449 for Ilkestone, but I should like to point out that the casting of this duty on the medical attendant might create suspicion between him and the head of the household in cases where great commercial interests are at stake. The right hon. Gentleman has told us that he has opinions in favour of the duty falling on medical men from those engaged in he profession in all parts of the country; but may I suggest that those opinions come from Medical Officers of Health, and not from private practitioners, who, as a rule, are opposed to this proposal. The case which I put before the Committee is this: The disadvantage which attach to the dual system of notification is that you call in a medical man to advise in cases of illness, and immediately, instead of his being the private attendant in the domestic interests, he is called upon to notify formally to the public Authority the existence of infectious disease. Having studied the statistics which have been prepared by an eminent medical authority, I have come to the conclusion, although I am in favour of the Bill, that there is no distinct advantage gained by the dual system, so far as the diminution of disease is concerned, in those towns where the system has been tried. If the dual system be of the advantage the right hon. Gentleman contends it is, there would certainly appear in the towns where it has been tried, not only a corresponding improvement, but a special improvement. But it is distinctly otherwise; the diminution of disease in those towns is actually less than it is in towns where the single notification system exists, and actually less than in towns where no notification at all exists.
§ MR. RITCHIEI have seen the figures, and they seem to me to be for all practical purposes of comparison absolutely worthless. To have figures which are of value we must have parallel conditions, and there are no parallel conditions between the various towns.
MR. H. STEWAETI understand it is beyond dispute that the Government do not intend to make this Bill compulsory, and that being the case it will be open to any Local Authority to refuse to accept it. I will, therefore, not press the point further.
§ Amendment, by leave, withdrawn.
§ Other Amendments made.
§ Bill reported; as amended, to be considered upon Monday next.