HC Deb 15 March 1898 vol 54 cc1675-80
The PRESIDENT of the LOCAL GOVERNMENT BOARD (Mr. H. CHAPLIN,) Lincolnshire, Sleaford

I hope that within the time permitted by the standing order I shall be able to explain the Government proposals—to explain the changes which are made in the laws relating to vaccination by the Bill which, according to promise, I ask leave to introduce to-night. There are various reasons for these changes which, in my humble judgment, make them eminently desirable. Prominent among them is the fact that the Royal Commission, appointed so long ago as 1889, after many years, has presented a Report which was published towards the end of 1896. Another and not less cogent reason is to be found in the de-deplorable outbreaks of smallpox which have recently occurred in Gloucester and Middlesbrough, and which must be fresh in the recollection of the House. Now, I do not stop even for a moment to dwell upon the views pronounced upon the necessity for vaccination, and its efficacy in either preventing or greatly diminishing the evils of smallpox, they appear to me to be conclusive and unanswerable; but I do desire, with the permission of the House, very briefly indeed to refer to one or two of the recommendations made by the Commissioners. Some of them relate to administrative changes in the methods and procedure under which the practice of vaccination is conducted at present. Others refer to modifications of the existing law under which children are required to be vaccinated whether their custodians desire it or not. In the first category, there are some which seem to me to be of primary and cardinal importance. One of these relates to the kind of lymph which the Commission recommend should be used in future, and on this point I may remind the House that there have been some very remarkable scientific discoveries in recent years, and if we take advantage of them, as I hope and believe we shall, they will go far to revolutionise the whole system of public vaccination. I am referring now to the results which, it is proved, are obtained by the preservation of calf lymph in glycerine. The views of the Royal Commission have been greatly strengthened and confirmed by further investigations made upon their recommendation and since their Report was published. These investigations were conducted by Sir Richard Thorne and Dr. Copeman on behalf of the Local Government Board. Since the report of the Commission upon the systems in practice abroad—in Paris, in Berlin, Dresden, Cologne, and Geneva—was published it appears that calf lymph preserved in this way possesses remarkable properties and advantages. In the first place all extraneous organisms, when the lymph is mixed with glycerine in this way, are destroyed. We are told that such organisms as the microbes of tubercle, erysipelas, and diphtheria, and other diseases, and this is very remarkable (even when they have been added for the purpose of experiment), very rapidly disappear although at the same time the lymph retains its full activity for vaccination purposes. In the second place, I am advised that it can be made in great quantities, and retains its faculties for a considerable period of time. Thirdly, and, perhaps, this is the most important of all, the necessity for arm to arm vaccination, and, consequently, all risk and possibility of inoculation with syphilis, whatever it may have been heretofore, wholly disappears. On this point the Commission make two recommendations—that the lymph shall be placed within the reach of all, and secondly, that no parents shall be required to submit their children for vaccination by means of anything but calf lymph. We accept their recommendations. By arrangement with the Medical Institute of Preventive Medicine the Local Government Board have acquired the necessary accommodation, and preparations for the supply of lymph are now in progress; and while the Bill provides that vaccination will continue, as at present, to be obligatory, vaccination by anything but calf lymph will cease to be compulsory. This change in the law carries with it another change perhaps even more important to the comfort of parents and children, and is a distinct advance on the present method. At present the statute for vaccination in England and Wales provides that the child shall be vaccinated with humanised lymph from arm to arm. This necessitates the attendance of parents with their children at the various vaccination stations throughout the country on two occasions—on the first occasion for vaccination, on the second, a week afterwards, for inspection when the attendance of the child is also required for another purpose, which is, that the lymph may be taken from the arm of the one child, if necessary, to be used upon another. Under this Bill vaccination from arm to arm will cease to be obligatory, and with lymph supplied from other sources there will be no necessity for the attendance of children at the stations to provide the required lymph for others. This point we adopt. The next recommendation of the Commission is that vaccination should be domiciliary, and that instead of requiring the attendance of children at the stations, the vaccinator will be required to attend at the house of the child. In other words, instead of sending the child to the doctor, the doctor in future will go to the child, and in that way we shall assimilate, as nearly as possible, the law of practice in England to the law of Scotland where vaccination has never been the difficulty that it is sometimes with us. There is one more point that I might mention. Children must at present be vaccinated within three months after birth. We extend that period to 12, on the ground that all authorities agree that there is greater immunity from any risk of undesirable consequence from vaccination at 12 months than at three. There is only one other subject upon which I may detain the House for not more than a moment, and that is with regard to the existing penalties for non-compliance with the law; and here I am unable to accept the recommendation of the Committee that anyone who conscientiously objects to vaccination may escape the obligation by simply making a statutory declaration to that effect. The effect of this, it seems to me, would be to make the law a dead letter wherever people wish and chose to do so. Nothing could be more unfortunate or injurious to the community in my opinion than the discontinuance, on any considerable scale, of the practice of vaccination, and I observe that the Commission themselves were not united upon that point. Where they are agreed, and where we are disposed to meet them, is in another recommendation which they make, that where a person conscientiously objects to vaccination, he or she may be relieved from the imposition of repeated penalties. This recommendation was unanimously made in an interim report, published six years ago, and it is also the unanimous recommendation of the Select Committee of 1871. I am the more disposed to agree with it for the reason that, so far as I can learn, this provision of the law does not appear to have attained it object. Repeated penalties have often been enforced without securing the vaccination of the child on the one hand, and, on the other, they have a tendency to bring the vaccination law into bad odour, and to rouse opposition to it which could not otherwise exist. Now, there are many provisions in this Bill which I shall ask leave to introduce to-night by which we have sought, to the best of our ability, to remove any reasonable objections that we can to the existing Act, and at the same time to give greater facilities for its operation in future, and, on the other hand, to modify the law where its operation appears to be uselessly harsh. These changes will be, as we believe, especially in the interests of the poorer classes of the community who have not always the same facilities for the vaccination of their children as their richer neighbours. It would be manifestly impossible to allow vaccination to fall into disuse, and we have good reasons, I think, to hope that full advantage will be taken of the changes we propose to make which may be instrumental, if not in preventing, at least in lessening the prevalence and minimising the effects of smallpox which is one of the most loathsome and terrible diseases which afflict the human race.

*SIR W. FOSTER (Derbyshire, Ilkeston)

I congratulate the right hon. Gentleman upon the practical Measure he has sketched out to the House. After the statement which we have heard tonight, one cannot criticise the Bill at any length. It appears to me that the salient points of the Report of the Royal Commission have been adopted in the Bill which it is proposed to introduce to-night, and which will be a very useful Measure for aiding the public health. I understood the right hon. Gentleman to say that he hoped to make progress in some quarters by using the new form of lymph to which he refers, and which, I believe, both from his statement and from the experiments which have been made, is free from many of the objections which are raised to the present vaccine matter. If we can only impress on the public mind that we have the means of vaccinating children without communicating any disease, we conquer one of the greatest obstacles to the use of the benficent preventive which we believe we have got. I am glad also to see that he proposes to do away with the attendance of the poor at the vaccination station, and make domiciliary vaccination the practice throughout the land. That will be done gratuitously. Then I also understand the Bill will do away with cumulative penalties. I am not quite clear whether the right hon. Gentleman meant us to understand that if under this Bill anyone made a statutory declaration that he had a real conscientious objection to having a child vaccinated he would be able to avoid the penalty for non-vaccination.

THE PRESIDENT OF THE LOCAL GOVERNMENT BOARD

No, that was a recommendation I said I could not accept. Repeated penalties will be abolished. He will still be liable to two prosecutions, as under the existing Act, but no more.

*SIR W. FOSTER

Then, in that respect, I do not sympathise with this section. I do not think it will do away with the opposition to vaccination. We shall still have difficulty in obtaining that full effect which we might obtain, if we do not rely upon these penalties. I do hold this, that while it is necessary for the benefit of the public and for the safety of the general health that we should vaccinate everybody, perhaps the worst method by which we can bring about universal vaccination is by injudicious compulsion. There exists in the minds of many people a very strong objection to this method of enforcing the law, and I am afraid—I do not say that it will be so—that there will exist in the minds of some, on this ground, opposition to the measure, and, that, moreover, it will be the means of keeping up what is a most mischievous and hurtful agitation against a beneficent method of avoiding disease. On the whole, I congratulate the right hon. Gentleman on the method he has sketched to the House, and I think it will be a great improvement on the law, matter. If we can only impress the as it has hitherto existed.

Bill brought in and read a first time.