§ Order for Second Reading read.
§ THE PRESIDENT OF THE LOCAL GOVERNMENT BOARD (Mr. RITCHIE,) Tower Hamlets, St. George's
This Bill, the Second Reading of which I now move, has been for some time printed, and I think it speaks for itself. The design of the Bill is to extend what 1818 is practically the law in many of our large towns to the whole country. I may say the provisions of the Bill are practically enforced by local Acts in 52 towns throughout the country, comprising a population of no less than 3½ millions. If any other town desires to adopt the same provisions, the present process is for the Authorities to introduce a Bill, a process which, as hon. Gentlemen know, is attended with considerable expenditure of money and trouble. That the provisions are good in themselves I think is proved by the fact of 52 large towns having availed themselves of the opportunity of applying them. The extension of the provisions contained in this Bill has been recommended strongly by the Police and Sanitary Regulations Committee, by the Royal Commission of 1882, by many Local Authorities throughout the country, and a large number of Medical Officers of Health, who have represented to the Local Government Board that their difficulties in connection with the preservation of health in their districts are very great owing to the absence of notification of the outbreak of infectious disease. It is clear that the Sanitary Authorities are thus placed at a great disadvantage in taking timely measures to prevent the spread of diseases such as are referred to in the Bill. With a view to legislation on the subject, the Local Government Board in 1887 addressed communications to the Authorities of all the towns where notification is carried out, and received absolutely unanimous testimony in reply in favour of the system, which is represented to work smoothly and efficiently. If the Bill is assented to, if these powers are conferred, the procedure will be that notification will set the Medical Officer of Health and the Inspector of Nuisances in motion at once. They will visit the house from which notification has been received to insure that due care is taken to prevent the spread of disease, by means of isolation, or, if that is impossible, by means of removal of the patient to hospital. That removal is not compulsory. We do not give powers of forcible removal, but it will be the duty of the Health Authorities to use such influence as they can in order to obtain the removal of a patient to a hospital where all precautions will be taken to prevent the spread of dis- 1819 ease. Proper disinfection will then be applied to the house from which the patient is removed. Where it is necessary, the Local Authorities will communicate with school managers, with the managers of public institutions, such as free libraries, &c., giving such information as will conduce to prevention of the spread of disease. We found that it was extremely useful also in enabling the Local Authorities to trace the source of disease, and to attack it without delay. For instance, there was one borough in which there were no less than 30 cases of typhoid fever notified to the Local Authority, and the Medical Officer of Health not only took precautions with reference to the cases, but set to work at once to find out how it was that the disease had attacked so many persons. The whole of the cases were traced to one particular source, and the Authorities were able to prevent the outbreak assuming greater dimensions. In another case where scarlatina was notified, all the cases were traced to a particular school, where a child suffering from scarlatina in the peeling state was mixing with the scholars. But for this notification the outbreak would, in all probability, have assumed very large and startling dimensions. The Government propose that the notification shall be compulsory in London, but that outside London it shall be optional for the Local Authorities to adopt the Act by Resolution. To make the Act compulsory at once on Urban and Rural Authorities all over the Kingdom might create some amount of friction; but if it be found that Local Authorities are slow to adopt the Act, it may be necessary for Parliament to consider whether it should not be made compulsory. With reference to London, it is perfectly obvious that the same course cannot be adopted, because London is controlled by a very large number of Local Authorities, and it could not be contemplated with satisfaction for a moment that the Local Authority in one part of London might adopt the Act, while a Local Authority in another part of London might not adopt it. There are other considerations in connection with a town of the enormous dimensions of London which render it desirable that in the Metropolis the provisions of the Act should be obligatory on the 1820 Local Authorities. The diseases which it is proposed to include in the Bill are smallpox, cholera, diphtheria, erysipelas, scarlatina, typhoid, and relapsing fever; but the Bill also contains a provision that a Local Authority may, in an emergency, by Resolution approved by the Local Government Board, include some diseases other than the diseases mentioned. I refrain from dwelling, as I might at length, on the obvious advantages which will unquestionably result from placing the authority charged with the health of the inhabitants in possession of the information necessary to enable it properly to carry out its duties. I can quite understand that there may be objections to one or other details in the Bill. But I cannot believe that objections from any quarter will be urged against the principle of the Bill.
§ Motion made, and Question proposed, "That the Bill be now read a second time."
§ MR. RITCHIE
No, Sir, it does not; but I have not the least objection to take measures, if hon. Gentlemen desire, to insure its extension to Ireland.
§ * SIR W. FOSTER (Derby, Ilkeston)
This is a most important Bill from the point of view both of the Local Authorities and the public; but I think it right to point out that there are many people among the industrial classes who view with great jealousy interference of this kind, which they believe would soon lead to the removal of all persons suffering from infectious diseases into hospitals. There is certainly no provision of that kind in the Bill, but that is thought likely by many to be the result of such legislation. On this account there is a good deal of objection to the Bill in certain quarters. I mention this in order that Members of the House generally may know the views of people outside with reference to the Bill. But, looking at it from another point of view, I must confess that I have a good deal of sympathy with the object of the Bill. I think it necessary that we should endeavour as far as we can to stamp out the diseases which this Bill contemplates stamping out by means of notification. It is, of course, necessary that all citizens should 1821 endeavour as far as possible to check the prevalence of disease, and I think this may be done to a considerable extent by the Notification Clause which the Bill contains; but I have no complete sympathy with the method proposed. The Bill calls upon medical men to perform something more than the ordinary duties of citizenship by requiring them to become informers of the occurrence of diseases. The relation of a medical man to his patient ought to be one of complete confidence, and anything that comes to the knowledge of a medical man in the practice of his profession is practically an inviolable secret; and I do not like any Bill to interfere with that relationship. I know myself that one of the results of this Bill, if passed into law, will be that in scores of cases medical men will not be called in to attend people suffering from infectious diseases. I have known cases of this kind occur in a populous district. The child of a man keeping a small general shop has an infectious disease, the medical attendant notifies it and the Medical Officer of Health sends down his Inspector in the uniform of his class. The result has been that the neighbours are alarmed, and the whole of the poor man's business has fallen off and he has been practically ruined. What is the consequence? Six months or twelve months afterwards the doctor is called in to a case of much graver infectious disease, and the shopkeeper pleads earnestly with the doctor not to notify it or he must go on without any doctor. I think that all the advantages of notification will be obtained if you insist upon the householder or guardian of the patient making the notification. You can also insist upon the medical men giving a certificate to the householder as to the nature of the disease. I admit the difficulty of the position, but I am anxious that no measure should pass into law which will induce the public to keep these diseases more secret than they have been in the past with the risk of adding to the spreading of them. We must be very cautious not to do anything which will prevent the public from placing full and implicit confidence in their medical man. I can quite conceive it to be possible that, if an outbreak of infectious disease occurs in a populous part of London, the people may, in order to prevent exposure, 1822 refuse to allow a medical man to come in, and in such a case we shall have tenfold more difficulty than at present. Therefore, while I am anxious to promote the notification of disease, I do not want the Government to adopt any rough and ready method which will be likely to promote rebellion on the part of the public.
§ * MR. LLEWELLYN (Somerset, N.)
I wish to inform the right hon. Gentleman how thankfully this Bill will be received by those who have the duties relating to the public health thrown on them. The hon. Member who last spoke has given an instance of a small shopkeeper, and has said how hard it would fall upon him to have the doctor compelled to notify the outbreak of infectious diseases on his premises. But I would point out that those are just the cases which this Bill is designed to meet—cases in which an infectious disease breaks out amongst the children of a village shopkeeper, and is spread from family to family in consequence of the reluctance of the householder to make known the fact that the disease is in his house. Sometimes a whole village school may become infected through the absence of proper notification, and this is particularly the case with measles. I am sorry that the right hon. Gentleman the President of the Local Government Board does not propose to include measles in the Bill, for nothing is worse than to have an outbreak of that malady in a village school. I am prepared for the opposition of medical gentlemen to this Bill. The hon. Member who last spoke would throw on the householder the duty of reporting the outbreak of infectious disease; but we know that the householder does not report in such cases. We know that he is too often apt to allow his children to run about the streets, in spite of the fact that there is an infectious disease on his premises, especially if the disease is of a mild type, though we know that a person having an infectious disease of a mild type may communicate it to another person, who may have it in such a severe form as to cause death. Very often, when measles and scarlet fever occur, if the cases are mild, the parents of the sick children refuse to call in a doctor, preferring to treat the maladies themselves and to take their chance; and 1823 those are the cases we want to deal with. In a local sanitary district with which I am connected, I caused a circular to he sent to all the doctors, asking for information in regard to the outbreak of infectious diseases, and they all refused to give it, and I was told that it was only natural that they should refuse to give such information voluntarily. I would, therefore, make it compulsory. To make the Bill really useful throughout the country I would make it obligatory to put the measure in force in rural districts as well as in towns.
§ MR. SEXTON
I agree that the subject dealt with in this Bill is one of great importance; and, after the statement made by the right hon. Gentleman in reply to my inquiry just now, I will consult with my Colleagues in the interval between now and the Committee stage, to take their opinion as to whether or not it would be desirable that the Bill should apply to Ireland. I understand, both from the text of the Bill and the right hon. Gentleman's speech, that this is to be an enabling measure. But with regard to the diseases not named in the Bill there is a peculiar qualification of the enabling principle. The Bill says that, before proceeding to put these powers in force in regard to diseases not in the measure, the permission of the Local Government Board must be obtained. Well, I must say I fail to understand the reason for that distinction, and I think the Local Authority should have the same power in the one case as in the other. Also, it seems to me peculiar that if the Local Authorities, who are empowered to put the Act in operation, desire to discontinue the exercise of these powers, they should be obliged to come to the Local Government Board for permission to do so. I think the provisions of the Bill indefensible in those two particulars, and I would ask the right hon. Gentleman in charge of the measure to consider them very carefully before the Committee stage.
§ MR. J. ROWLANDS (Finsbury, East)
The speech of the Lord Mayor of Dublin would have been a very effective one if the Bill applied to Ireland. I wish to urge on the President of the Local Government Board the desirability of treating the Authorities in London as having the interests of the community at heart quite as much as the 1824 Local Authorities in urban districts round London and all over the country. I can see no earthly reason why London should be treated differently to the country districts, and I would ask the right hon. Gentleman to remember that the Metropolitan Members sitting on this side of the House have constantly urged upon the Government the wisdom of creating one central health authority for the whole of London. The right hon. Gentleman seems to me afraid to take the people of London into his confidence as he does those outside. He says that if he gives London the discretion which under the Bill he allows to urban authorities, it will cause friction; but does he think he will save himself from that friction by making the adoption of the Bill compulsory in London, whilst refraining to render it compulsory over the whole of the country? I could have understood the logical position of the right hon. Gentleman if he had comedown and said, "We have this principle in force in some of our large towns, and we think it necessary to apply it to the whole of the country," but when he tells us—and I do not think he sufficiently demonstrated his reason—that he is afraid of applying this compulsion to the outside districts because it may cause friction, and at the same time that he intends to apply it to London, I think his position is altogether illogical and unsound. I am not sure that the measure will not meet with serious opposition in London, if it is sought to enforce it in its present shape. It may be thought—as the hon. Member for the Ilkeston Division has pointed out—that this is the thin end of the wedge, and that eventually it will be sought to compel persons attacked with infectious diseases to be removed from their homes to public hospitals, and, certainly, if that is so, a Bill which would have the effect of leading up to such a state of things is one which requires serious consideration. I cannot help thinking that we have been unfortunate to-day in making such rapid progress with the other business on the Paper, because the result has been that this Bill has come on unexpectedly, and none of the hon. Members who have notices of Amendment down are in their places. At any rate, I would urge the right hon. Gentleman in charge of the measure to carefully consider such points as 1825 have been raised. Let him have confidence in London—let him rest assured that the people of London will be as ready as the people of any other part of the country to enforce the powers of the Bill if they are for the good of the community; and let him also be satisfied that the way to prevent friction in a matter of this kind is to trust the representatives of the people, locally elected, and to treat all parts of the country alike. If the case of London is made an exception to the general policy of the Bill, the people of London will consider that the right hon. Gentleman does not regard them as having sufficient intelligence to put in force the powers of this measure.
§ * MR. GAINSFORD BRUCE (Finsbury, Holborn)
I hope this Bill will receive general support, and I believe the people of London very generally appreciate its provisions. The hon. Gentleman who has just spoken said the Sanitary Authorities of London would hardly approve of the provisions of ths Bill. But they have petitioned this House in favour of it. I believe more than half of the Sanitary Authorities of London have petitioned the House in favour of this Bill, and I am satisfied that there is a strong desire for it on the part of the people of London. There is one matter I should like to mention. Most persons are of opinion that the relatives, or the persons in attendance on the patient, and, failing them, the occupier of the house, should be bound to give notification to the Local Authorities, but there is great difficulty in framing a satisfactory definition of the word "occupier." I am informed by those who have had experience in these matters that the Act will fail to reach many of the worst cases, unless the definition of the word occupier is somewhat extended. I only mention the point that the right hon. Gentleman may, before the Bill reaches the Committee stage, consider how far he can meet the views of the Local Authorities.
§ * MR. W. P. SINCLAIR (Falkirk)
I think the difficulties felt may be very easily overcome if the duty is first placed on the householder of informing the Health Authority of the outbreak of disease of an infectious character, and secondly, and only secondly, on the medical practitioner in attendance on the 1826 case. I think it would be wrong in the first instance to place that duty on the medical attendant. It is quite right that the duty should be performed by some one, but it seems to me that it ought first to be performed by the householder or some one responsible in the household, and that is so provided in this Bill; but where the difficulty arises is that the duty is also at once thrown upon the medical attendant. That might be overcome by requiring the medical practitioner to go to the head of the household and giving him a certificate stating the nature of the disease, and drawing attention to the sub-section in which the duty to notify is first cast upon the householder. If he neglects his duty, then the duty would be thrown upon the medical officer. I think medical men would have a just grievance if the duty were thrown upon them in the way proposed by the Bill. But they could have no grievance if they were only required to give the householder a certificate that the disease was infectious and required him to give notice; or, if the householder neglected to do his duty, that the medical practitioner himself should give notice to the Local Authority. If an Amendment to that effect were introduced in Committee, the Bill, which is a very valuable one in other respects, might fairly be accepted.
§ * MR. HALLEY STEWART (Lincolnshire, Spalding)
I am anxious to state that those who object to the 5th section of the 32nd clause of the Bill do so in the interest of the public health. They believe that the proposal would add to the danger which at present exists. If the right hon. Gentleman would promise to consider the position of the medical profession, I think the Bill might go through without opposition. The case of the village shopkeeper, to which the hon. Gentleman (Mr. Llewellyn) referred, is just a case in point where the medical man should not have thrown upon him the responsibility of being a private informer. A breach would be made in the relations of the medical practitioner and the family he attends, and constant distrust would be created which would lead to medical aid being dispensed with, and so result in a very serious growth of infectious diseases. I hope the right hon. 1827 Gentleman will consider the inclusion of a disease of which I do not know the medical name, but which is known as German measles, and which I am informed is a serious kind of disease not infrequently fatal. One other observation. Those of us who are opposed to compulsory vaccination feel that the true alternative is to fall back upon a safeguard like this. I do not, however, regard the question of compulsory vaccination from a medical but from a political point of view. I am opposed to interference between the parent and a healthy child. But the moment that child becomes a centre of infectious disease, I do not know where I would stop, even if it should result in the compulsory conveyance of members of a household to the hospital and separating them from all the comforts which are supposed to be associated with home. I cordially support the Motion for the Second Reading.
§ * MR. WINTERBOTHAM (Cirencester)
I think this a most valuable Bill, but I think the objection which has been raised as to the medical profession, and which is felt very strongly in the country, is worthy the consideration of Her Majesty's Government. The Bill will be doubly valuable if it enlists the co-operation of the medical profession throughout the country, but if the duty is first cast upon the medical attendant to give notice, it may lead to distrust among patients. Should it not be left to the medical attendant to give a certificate to the person in charge of the patient requiring him to give notice to the authorities?
§ * SIR J. LUBBOCK (London University)
I concur with what has been said by the hon. Member behind me with regard to London. I quite believe that if this Bill were left optional to the authorities in London it would be applied as much in the Metropolis as in the country. I am afraid if it is made compulsory upon London it will prejudice the consideration of the matter in the eyes of the Metropolis. Londoners have a great objection to being too much interfered with, and I cannot help thinking, anxious as I am that the Bill should be applied to London, that my right hon. Friend would do well to consider the suggestion that London should be treated in the same way as the rest of the country. He did 1828 not object to the Bill being compulsory, but in that case the compulsion should be general.
MR. HUNTER (Aberdeen)
This is a Bill of very great importance, and as a number of hon. Members who are interested in it are not present, it would be a more convenient course to adjourn the Debate. I beg to move the adjournment of the Debate.
§ Motion made, and Question proposed, "That the Debate be now adjourned."
§ MR. RITCHIE
Hon. Members who were interested in a matter such as this might be fairly expected to be down by half-past three o'clock on a Wednesday afternoon when the Bill is on the Paper. Yesterday I communicated with the Gentlemen who have given notice of their intention to move the rejection of the Bill, intimating my desire to know what their objections to it might be. One of them very frankly replied that he had no views upon the subject at all. Looking to the fact that the opinion of those who have spoken in the House have been altogether unanimous in favour of the general principle of the Bill, I hope the hon. Member will withdraw his Motion for the adjournment.
MR. BEADLAUGH (Northampton)
Considerable pressure has been put upon me in regard to another investigation which is now going on, and which is considered to have a bearing upon the present Bill. I thought it was one of the matters which the right hon. Gentleman might well consider, because no doubt that investigation relates to a class of infectious diseases which this Bill does not touch. Having been considering another class of infectious diseases only a few minutes ago, I find myself in considerable difficulty in entering upon a discussion which I had not anticipated.
§ MR. RITCHIE
I would point out to the hon. Member in reference to the other investigation to which he alludes, that those who were opposed to vaccination are the strongest supporters of this Bill.
§ * SIR W. FOSTER
I would like to ask the right hon. Gentleman whether he will consider the suggestion I have thrown out?
§ * SIR W. FOSTER
I wished to explain that I do not care to vote for the adjournment of the Debate, and if an opportunity of indicating the nature of his reply were afforded to the right hon. Gentleman, it might guide others in voting.
§ The House divided:—Ayes 48; Noes 187.—(Div. List, No. 266.)
§ Original Question again proposed.
§ * THE SECRETARY TO THE LOCAL GOVERNMENT BOARD (Mr. LONG, Wilts,) Devizes
Mr. Speaker, I must first express the gratification of Her Majesty's Government at the tone of the Debate in all quarters of the House. What objections there are are directed more to points of detail than to the general principle of the Bill. At the same time, I am instructed by the President of the Local Government Board to give hon. Gentlemen some information on the points they have raised. In the remarks of the hon. Gentleman the Member for the Ilkestone Division of Derbyshire, he urges, in the first place, that there may be jealousy on the part of the industrial classes as to interference with their domestic freedom. I think it is essential, in the interests of the working classes, that a Bill of this nature should be carried; and even if it did, in some degree, hurt their feelings, the good which would be derived by the prevention of the spread of infectious disease would overwhelm any annoyance or objections of that description. Then the hon. Gentleman referred to the fact that the medical man's position will be a very difficult one, and he contended that nothing should be done by Parliament to interfere with the confidential relations between the medical man and his patient. I think the House and the country ought to hesitate a long time before they allow any consideration of that kind, deserving of attention though it be, to interfere with necessary precautions in defence of the public health. I would appeal to the hon. Gentleman whether, under the present system, it is not his practice, when he knows of an infectious disease in the house of a patient, to make the fact more or less known. The main objection is that we are placing the medical profession in a peculiarly unfair position, and the hon. Member asks that the duty should be 1830 thrown on the householder, and not on the medical man. He says his experience leads him to believe that if this unpleasant duty, as he calls it, is thrown on the medical man, the medical man will not be sent for. That is a matter which can only be tested by practice. We have, at all events, this on our side—that in the 52 towns where similar precautions to those contained in that Bill have hitherto been in force, householders have not only not been deterred from calling in medical assistance, but the origin of disease has been traced and its spread arrested. It has also been said by the hon. Member that a medical man ought not to be called upon to proclaim to the world that a small tradesman has disease in his house, because when the fact becomes known the tradesman may suffer loss in his business. But the fear of such a loss would surely operate on the mind of the small tradesman himself if it were thrown upon him alone to notify the outbreak of disease in his house, and he might be induced to hide the fact. Therefore, my right hon. Friend cannot hold out any hope that it will be possible to relinquish that part of the Bill which imposes the double duty on the householder and also on the medical man, because if the householder alone has to make the notification, and there is default on his part, the provisions of the Bill will be weakened and its successful working seriously imperilled. It has been suggested that the measure should be extended to other diseases, and that German measles in particular should be included within its scope. The Government will not object to consider in Committee any legitimate addition to the list of diseases to which the Bill applies. The hon. Member for Finsbury (Mr. J. Rowlands) has urged that London should be placed on exactly the same footing as the rest of the country in this matter; but the position of London is absolutely distinct from that of any other part of the country. In large towns the Corporation is the Sanitary Authority for the entire area of the town, and the regulations, if adopted at all, will at once be enforced over the whole of it. But in the Metropolis the case is different. There we have a large number of Sanitary Authorities, and if the provisions of the Bill are adopted by only one-half or two-thirds of them, and 1831 not by them all, the good effect of the measure will obviously be defeated or greatly impaired. Therefore, the Government cannot consider any proposal not to make the Bill compulsory for London. We should be much more inclined to adopt a suggestion for making it compulsory over the whole country. Any suggestion of the kind will be a fitting subject for discussion when we reach the stage of Committee. With regard to the remarks of the Lord Mayor of Dublin (Mr. Sexton), it should be borne in mind that the diseases specified in the Act of Parliament stand on a different footing from those to which Local Authorities may wish to apply the regulations without any reference to superior authority. I may say I think the hon. Member for Finsbury has hardly realised that Petitions in favour of some such measure as this have been presented by half the Vestries and District Boards in London. That hardly looks as if the measure is regarded with any feeling of hostility by the people of London generally. I have only once again to say how grateful we are for the considerate and practical way in which this measure has been discussed, and how earnestly I hope it may be passed in the interests of the public health.
§ MR. STOREY (Sunderland)
I represent a town which a few years ago adopted such a law as is now proposed by this Bill. At the time we adopted it all these old-fashioned objections which have been expressed in the House this afternoon were brought up against the proposal. We have now had experience, which is the best teacher in these matters. In Sunderland there is not, and never has been, since the first three or four months, any jealousy at all on the part of the householders against it. Our population is much in favour of individual liberty. We object to law, and have as little to do with it as possible. If we could live under the old dispensation, when every man did what was right in his own eyes, we should be the first to do it, and if there is any town in the country that would resent any interference with public liberty, it would be ours. The Bill has recognised that this notification of diseases is a good thing. We have had bitter experience in our town of the spread of contagious diseases through our not having 1832 had the means of laying our hands upon it in the early days. The town once lost 2,000 lives from an attack of small pox introduced by a ship that entered the port; and the Municipal Authorities afterwards came to Parliament for a private Act which gave powers analogous to those contained in this Bill. Those powers have worked admirably. There is no jealousy whatever on the part of the householders in regard to them, the people recognising the advantage arising from them. One of the doctors at first thought it unfair to call upon him to reveal the existence of disease in the households of his patients. We settled that doctor. We arranged that every doctor who made a notification should receive a fee. Although I admit, as a rule, doctors care more about doing good than about fees, still, like other people, they like fees. They represented that the fee we offered was not quite enough. We gave them a little more. Their objection to reporting has entirely disappeared, and they work most willingly with the medical officers- The Act has worked admirably in Sunderland, and has been a great blessing to us, and as far as our experience has yet gone, we have diminished the quantity of infectious disease in our midst by the judicious carrying out of the Act. I shall be willing to support an Amendment to extend the compulsory operation of this Bill to the whole of the country.
§ MR. BUCHANAN (Edinburgh, W.)
In Edinburgh we obtained an Act of this kind some 10 years ago, and the duty of notification is placed on the medical officer alone. When the measure was first proposed for adoption by Edinburgh, a certain jealousy was expressed by the medical men, but as soon as it came into operation that jealousy disappeared, and it has now been in operation for 10 years, with the full and cordial approbation of the whole of the medical profession of Edinburgh. The operation of the measure imposes upon the rates of the City something like £1,000 to £2,000 a year, and no complaint whatever has been made against the expenditure of that sum of money, whilst the inhabitants in the poorer parts of the City give every assistance to the medical officer in the carrying out of the Act. As to the benefits we in Edinburgh have de- 1833 rived from it, I can confirm most absolutely the expressions used by the hon. Member for Sunderland. Medical officers have stated to me that at least two outbreaks of small-pox were stamped out in consequence of the observance of these provisions. We have enormously diminished the death rate of the City, but the enumeration of diseases in Edinburgh is somewhat wider than that provided for in the Bill; measles, for instance, is included in our list. I am convinced that if an Act of this sort is once put into operation in large communities it will not fail to receive the support and co-operation of the people. I sincerely hope the Bill may pass, and be given full application.
§ MR. H. H. FOWLER (Wolverhampton, East)
I would not have interposed in this Debate but for the fact that I was one of the Members of the House who sat upon the Committee to whom this question was referred seven years ago. I am very glad to find that even now, after this long interval, the recommendation of that Committee is at least being brought before the House so far as general legislation is concerned. We had a large number of private Bills referring to the notification of diseases before us, and we reported that we had little difficulty in forming an opinion that the time had arrived when provisions of law on this subject might be sanctioned, at least in the most important urban districts. We had before us the experience of Sunderland and Edinburgh, and, I think, of some 23 or 24 other places which had adopted these provisions. We submitted to the House clauses which were drawn by very competent authority, and, indeed, the question received our most anxious consideration. We heard the evidence from the medical officers' point of view, and we came to the conclusion that it should be the duty of the occupier of the house to give notice, and that it should also be the duty of the medical man to give notice, and we recommended a uniform fee—a very moderate one. I am bound to say, in justice to my hon. Friend the Member for the Ilkeston Division (Sir W. Foster), that in Nottingham there was very strong objection on the part of the medical men to this clause, and Parliament was induced to modify the clause so as to compel the medical men only to 1834 give notice to the head of the family. Certainly, if I were called upon to vote again, I should vote as I did in 1882. I should vote for the proposal of the Government—namely, to make the notification compulsory upon the medical men; because, although I quite appreciate the natural jealousy of a medical man in the matter of being compelled to disclose that which comes to him in a confidential and professional capacity, I think the enormous preponderance of evidence is in favour of notification by medical men. I hope the Bill will pass. We are all agreed that if this is a good thing for Manchester, Nottingham, Huddersfield, and Sunderland, it is a good thing for the rest of the kingdom. I strongly urge that the Bill should be read a second time, because in Committee we shall have full opportunity of discussing the clauses and arriving at a satisfactory conclusion.
§ * MR. J. E. ELLIS (Nottingham, Rushcliffe)
As I put down a notice of opposition to this Bill, I desire to say that I only did so in order to secure a proper discussion of the measure. We have seen that the President of the Local Government Board has tried to rush the Bill through after half past 5 o'clock on a Wednesday evening, and more than once after midnight. I venture to think that is hardly the course for the Government to pursue in regard to a Bill of this character. I think the President will allow the discussion this afternoon has been a most useful one, and it is due to our having secured a proper interval for discussion. Having said this, I do not for a moment wish to delay the passing of the Bill.
§ COLONEL GUNTER (Yorkshire, W.R. Barkstone Ash)
I should like to give my experience as Chairman of a Board of Guardians and a Sanitary Board. It is that although people who are suffering from infectious diseases may not go into the streets, other people may go into the houses where the disease is, and in consequence spread it all around. We had in our district an outbreak of scarlet fever. As the Sanitary Board we did all we could to prevent it spreading, but we found great difficulty in doing so. The fever broke out in a village where there was a large number of Irish people who would insist upon waking the children and others who died. It was with the 1835 utmost difficulty we stamped out the disease.
§ * MR. ESSLEMONT (Aberdeen, E.)
I think this Bill will be very valuable when it is made compulsory all through. Having had many years' experience of the working of the Public Health Act, I can testify to the fact that thousands of lives have been saved, and are being saved, every year by a careful observance of the Public Health Acts as regards infectious diseases. I want upon this occasion to make the application of the Act universal. In Aberdeen we have really two burghs in one Parliamentary burgh. Each burgh has its own way of carrying out the law, a fact which does not tend to a satisfactory end. The more uniform the administration of the law can be made, so much more effective will it become. I trust the President of the Local Government Board will introduce a clause which will make the administration of the law uniform.
§ MR. JAMES STUART (Shoreditch, Hoxton)
I should like to know whether it is intended that under Clause 7 the existence of syphilis will have to be notified.
§ Question put, and agreed to.
§ Bill read a second time, and committed for Monday next.