Page 28, line 8, at end, insert—
Provided that where, it shall appear to the satisfaction of the Lord Lieutenant that the guardians of a union wholly or partly within a county have allocated and fully equipped a department of their workhouse for the reception of chronic lunatics, certified as aforesaid by the medical officer of the workhouse, and that such department of the workhouse is suitable for the purpose, the Lord Lieutenant may direct that such department of the workhouse shall be utilised as an auxiliary lunatic asylum within the meaning of this section."—(Sir J. Haslett.)
§ SIR J. HASLETT (Belfast, N.)
The Amendment which stands in my name I may explain in a word or two. Already some of the workhouses have provided ample accommodation for carrying out the Act relating to chronic lunatics. In Belfast the guardians have expended a sum of something like £14,000 in building a completely separate wing with a separate entrance. I think the section, although it is very excellent in its way, does not go sufficiently far. It would 237 necessitate the council taking possession of this wing and administering it, whereas my Amendment would enable the guardians to retain possession of it and to carry it on, receiving the capitation grant provided by this Act.
§ MR. GERALD BALFOUR
The question is whether part of a workhouse should be taken away from the control of the guardians and handed over to the control of the committee of the county council entrusted with the management of lunatic asylums. I think it is very doubtful indeed whether the Local Government Board ought to give their consent to that. I observe that the Amendment proposes to place the power of deciding whether it should be done in the hands of the Lord Lieutenant. I think it is clear that the Local Government Board is the proper Department to exercise that power. I am afraid I cannot accept the Amendment.
§ SIR J. HASLETT
All I want to ensure is that the city of Belfast shall not be obliged to spend another £14,000 in providing another building for exactly the purposes already satisfactorily fulfilled by the present asylum. Every Report sent in by the inspectors to the Government will show that that asylum will compare favourably with any asylum in the north of Ireland; the imbeciles are better treated there than in any other asylum, and I earnestly ask the Chief Secretary whether he is going to place on the citizens of Belfast the necessity of spending another £14,000 while there is abundant room already for carrying on the work that is required.
§ MR. GERALD BALFOUR
If the guardians are carrying on this work in a satisfactory manner, there is nothing in the clause which will prevent things going on as heretofore.
§ MR. WOLFF (Belfast, E.)
Would it not meet the case pointed out by the honourable Gentleman if, in line 51, after the word "workhouse" were inserted the words "or portion of a workhouse"?
§ MR. GERALD BALFOUR
I am not prepared to accept that, but if it is put down I will consider it before the Report stage.
MR. J. H. M. CAMPBELL
I do not think the Chief Secretary has exactly met the difficulty pointed out by the honourable Member for North Belfast. The fact is that in the case of one of these workhouses—namely, at Belfast—a distinct portion of the existing workhouse has been earmarked for pauper lunatics, and an expenditure of £14,000 has been incurred by the ratepayers of Belfast for the purpose of fully equipping a portion of the workhouse for these harmless pauper lunatics. It has been most favourably reported on by the inspectors, and it in every respect fulfils the requirements of the case. But the difficulty is this—and I do not think the right honourable Gentleman has met it—that, notwithstanding this provision, in Belfast power is given to the new county council to entirely ignore that provision, and, notwithstanding the existence of it, to establish at the expense of the ratepayers all over again an independent new building for the purpose of maintaining these new lunatics. Now, I venture to suggest (and I think there can be no conflict on this question) that in the interests of the ratepayers themselves, who have put their hands into their pockets to the tune of £14,000, there ought to be some provision that where accommodation is already provided which has fulfilled every want up to the present day, that accommodation should be maintained in the future. It is not maintained if this clause is passed in its present form, because it gives power to the new county councils, wholly independent of any action of the board of guardians, to ignore the existing accommodation altogether. The only object of the Amendment of my honourable Friend, as I understand it, is to prevent this expenditure being made over again for the same purpose, and I submit there ought to be some provision of that kind. The right honourable Gentleman, I think, has not met the difficulty by saving that you can go on as heretofore, because under the clause 239 at present the county council of Belfast may ignore the existing provision if they like, and erect a new asylum for themselves at the expense of the ratepayers.
§ SIR J. HASLETT
The Amendment I shall put down on the Report stage will be that the control and management may still be left with the guardians so long as these imbeciles are retained there, and that the capitation grant shall be given to the guardians.
§ Amendment negatived.
That clause 51 stand part of the Bill.
Page 28, line 12, leave out 'two' and insert 'four.'"—(Mr. Dillon.)
§ * MR. DILLON
I would suggest that some additional expense may be thrown on the ratepayers by this clause as it stands at present. I confess I am not very clear about it, but I think we should have a statement from the Government as to the exact effect of the clause. At present, as I understand by the Act of 1875, it is possible to transfer a harmless lunatic from the district asylum to a workhouse, and those lunatics have to be kept on the books of the lunatic asylum. I do not know what amount of grant they draw when transferred to the workhouse, whether it is the; whole capitation grant of 4s. a head. A great body of the lunatics in workhouses at present have not been transferred, and I suppose no capitation grant is drawn. Now, I assume, or at least I hope, that one of the objects of this clause is to provide for the improved treatment of the 4,000 lunatics who are now in workhouses in Ireland. It appears to me, as far as I understand lunacy administration, that the only proper thing to do is to put all lunatics in asylums. I do not think it is possible properly to treat lunatics in wards or portions of workhouses set aside for their treatment. The 240 law, as I understand, at present provides that you may keep in workhouses harmless lunatics who are certified to be harmless, and I presume that this clause provides for this same class of lunatics being transferred to what are described as auxiliary asylums. Now, I think that lunatics who are harmless lose their chance of proper treatment by being transferred from lunatic asylums into workhouses. The clause provides—That the sum payable out of the Local Taxation (Ireland) Account in respect of the net charge for any lunatic therein may be paid when the net charge equals or exceeds three shillings and sixpence a week, but that, sum shall not exceed two shillings a week.That appears to contemplate that the fair average of the charge for a harmless lunatic may be taken at 2s. a week. I think that is preposterous. The average cost of maintaining a lunatic at present is nearly 9s. a week, and from all I can gather from the reports of the inspectors the charge will before long be increased to 10s. a week. I think it ought to be. I think probably 10s. is the very lowest on which you can treat these people with humanity. I want to know on what principle are we to set aside a large body of these lunatics, and because they are harmless they are to cost 3s. a week, while dangerous lunatics are to cost 9s. I say that that is a most drastic and monstrous provision. I cannot understand why a harmless lunatic should cost much less than an ordinary lunatic in the district asylums. I can quite understand why there should be a slight additional charge, say perhaps 1s. a week, in a large asylum—conceivably 2s.—for the extra warders who are required to take charge of dangerous lunatics. There may be a slight increase in the proportion of warders necessary to look after these people, but I hold that the only rational and humane system would be that all lunatics should be dealt with by the same administration, and practically in the same asylums; those who are easily managed, and comparatively harmless, to be looked after by their relatives at a reasonable sum. But for any lunatics who are in such a condition as to require constant and laborious attention I say that to provide 3s. 6d. per week as the normal cost of their maintenance is a 241 perfect absurdity and an outrage on our lunacy administration.
§ MR. GERALD BALFOUR
I may point out that the part of the clause to which the honourable Member objects fixes 2s. a week as the minimum.
§ MR. GERALD BALFOUR
The honourable Member is correct, but I would point out that the lunatics in Ireland for whom this grant of 2s. per head is to be given are at present entirely supported out of the local rates throughout the kingdom. This grant is only to be given after the committee of the county council establishes institutions of this kind, and therefore it will actually benefit the ratepayers generally. This grant will come out of the local taxation account; that is to say, out of the proceeds of local licences; and as those moneys are devoted to the benefit of the ratepayers in any case, it will be obvious that it is not so much a question of gain to the ratepayers, though it might possibly be a gain to a particular section of the ratepayers. Now, I will just mention to the House that I have had investigations made into this matter, and I find that out of some 4,000 lunatics in Irish workhouses somewhere between 1,500 and 1,600 might properly be treated in those institutions, while the remainder are lunatics who with great advantage might be transferred to the asylums which I hope will be constituted under this clause. I should hope that a certain number—a number difficult to arrive at, but still not inconsiderable—of lunatics who are now in the asylums might be transferred to the auxiliary asylums, and that would also be a gain to the ratepayers. The clause, I think, will not do any harm to the ratepayers, and, on the other hand, it was not my idea that the ratepayers should derive any pecuniary gain from the new arrangement.
§ MR. M. HEALY
I put a question some weeks ago to the right honourable Gentleman as to whether he had made any inquiries which justified him in the supposition that lunatics in these proposed auxiliary asylums would not cost more than 3s. 6d. per week. He informed me then that he had based his opinion as regards that figure on a report of Mr. O'Brien and other experts in lunacy, made as far back as 1879. It would occur to me that it would be a prudent thing before fixing this figure if the right honourable Gentleman had taken counsel with the managers and superintendents of lunatic asylums. I have recently been in communication with one of those gentlemen, and he tells me that the notion that a lunatic can be maintained in auxiliary asylums at 4s. a week is absolutely absurd. His view is that a person can be so maintained at something under the ordinary figure, but that 4s. is absurd.
§ MR. M. HEALY
But the subvention was based on the supposition that the total cost of maintenance was 4s. If you go back to the report of Mr. O'Brien and others in 1879, you will find that at that date the Government subsidy in some cases—I think even in the majority of cases—considerably exceeded the amount levied under the county cess.
§ MR. M. HEALY
I am aware that, if you compare the figures of 1879 with the present figures, that is so. The position at present is that, in addition to expense of maintenance, nearly all the counties of Ireland now have to contribute annually large sums to pay for the maintenance of lunatics—I mean maintenance apart from lodgings as we may call it, and perhaps apart from the cost of superintendence. The maintenance of a lunatic in that sense is about 9s. 9½d., but that does not affect my argument. In 1879, in nearly half the counties of 243 Ireland, the amount contributed by the State in the form of the 4s. grant exceeded the amount spent on the lunatics.
§ MR. GERALD BALFOUR
That cannot possibly be so, because the amount of the grant is regulated by the amount of the expenditure.
§ MR. M. HEALY
So far as my knowledge of the matter goes this is the first time it has been proposed that the amount granted by the State should have any relation to the amount expended, and, as a matter of fact, it was made a matter of complaint in 1880 that the amount contributed by the State was more than the amount expended upon the lunatics. Even when the present lunatic inspectors came into office in 1880 they made it a matter of complaint, and I think in some lunatic asylums even in their day—that is to say, in 1880—the amount contributed by the State was in excess of the amount actually spent. However, that is somewhat apart from the point on which I am now addressing the House. I was only pointing out that the Report upon which the right honourable Gentleman fixed his figure of 2s. a week is a very old Report, and for that purpose I think he would have done well before he fixed that figure to have consulted with the medical superintendents and managers with the object of ascertaining what, in their opinion, would be the expense of maintaining these lunatics when they were transferred from the workhouses. If he will look to the exhaustive Report made in 1880 by the present Commissioners of Lunacy, he will see those gentlemen enter into elaborate calculations, and that in no case did they calculate that the cost would be any less than the present cost in lunatic asylums. In fact, they rather throw discredit on the proposals to adapt workhouses for the purpose of lunatic asylums at all, on the ground that, in the long run, it would be cheaper to build a special building than to adapt an old workhouse for the purpose. I do not pretend to have mastered the Report of 1879, because it was a very long document, but my impression of it is this, that even the calculation of 2s. a week does not relate 244 to the cost of maintaining a lunatic in a lunatic asylum. In the Report of 1879 there were three categories of lunatics dealt with; one the lunatics maintained in lunatic asylums, then the lunatics maintained in the auxiliary asylums, and then, thirdly, lunatics maintained in some inferior asylum, and it is in relation to the third class that this figure is given. The right honourable Gentleman speaks of auxiliary asylums, but certainly the suggestion of 2s. a week had no relation to the cost of maintenance in an auxiliary asylum as it was recommended by that Report. Of course, the right honourable Gentleman was justified in saying that this grant will come out of the ratepayers' money, and that we should not get any more money if they increased that 2s. a week; but it does occur to me that the suggestion of 2s. a week, which would be generally construed to mean a total expenditure of 4s. a week, greatly minimises the cost which will have to be incurred when these lunatics are ultimately transferred. It is for that reason that I take such a strong view of this clause, because my view is that, if not 8s. a week, certainly not much less than 6s. is required. For that reason the grant which this clause proposes will, in a few years' time, mean a large deficit for the Irish counties, and they will not be getting even 4s. a week.
§ MR. GERALD BALFOUR
I am far from dogmatising as to what the result would be, but I am rather inclined to think that the superintendents of asylums judge from the asylums of which they have had experience, and I cannot help thinking that it is necessary to bear that in mind in reading their reports. The honourable Gentleman complains of the amount of the grant, but I should remind him that the lunatics that he will find in lunatic asylums, and who will be transferred to the workhouses under this clause, are really lunatics who ought to be transferred. I am convinced that the effect of the clause must be a saving to the ratepayers.
§ * MR. DILLON
The right honourable Gentleman has entirely failed to answer my question, which has a very important bearing on the subject. He has stated 245 that with regard to the lunatics now in question there never was under the law in England, Scotland, or Ireland, any grant from the Imperial Exchequer. That is not my impression, and I think the right honourable Gentleman is wrong. Section 9 of the Lunatic Asylums (Ireland) Act, 1875, is this—The guardians of any poor law union in Ireland may, with the consent of the Local Government Board and the inspectors of lunatics, and subject to such regulations as they shall respectively prescribe, receive into the workhouse of such union any chronic lunatic, not being dangerous, who may have been received into a district lunatic asylum and selected by the resident medical superintendent thereof, and certified by him to be fit and proper so to be removed upon such terms as may be agreed upon between the said guardians and the board of governors of any such asylum; and thereupon every such lunatic, so long as he shall remain in such workhouse, shall continue a patient on the books of the asylum for, and in respect of, all the provisions of an Act passed in the Session of Parliament held in the first and second years of the reign of his late Majesty King George the Fourth, intituled 'An Act to make more effectual provision for the establishment of asylums for the lunatic poor, and for the custody of insane persons charged with, offences in Ireland,' and the Acts amending the same, so far as they relate to lunatics and insane persons received into district lunatic asylums; and any expenses incurred by the board of governors in respect of such lunatic in such workhouse shall be deemed part of the expenses of such district lunatic asylum, and shall be paid by the governors out of the moneys applicable to the payment of such expenses.The right honourable Gentleman said that there was no grant under the law of Ireland in respect of pauper lunatics. My impression is that a certain number—I do not know how many—are, practically speaking, boarded out by the guardians on terms agreed upon by the governors of asylums, and are still kept on the books of the asylums, and draw a certain amount of the Government grant; but whether they are allowed to continue to draw the whole of the Government grant or not is a point about which I am in some uncertainty, and the Government themselves appeal to be in a similar state of uncertainty. However, the right honourable Gentleman, in meeting my point, which is undoubtedly a very strong point, said he was not bound to make this provision for Irish ratepayers, because it was not the law in England or Scotland. I should like to read a report which appears in the Times of yesterday 246 of a meeting of the County Councils Association. I find this passage—On the motion of Mr. E. J. Halsey, seconded by Mr. T. Parry, it was resolved, 'That it is desirable to again urge upon Her Majesty's Government the pressing necessity for legislation in regard to the extension of the 4s. grant in respect of pauper lunatics, and idiots maintained in accordance with the scheme approved by the executive council at their meeting on November 24, 1897.'I cannot be quite certain, but if I am not mistaken that means a demand from the County Councils Association of England, which is declared to be of pressing and urgent importance in the very direction which I am now urging for the ratepayers of Ireland. My contention is greatly strengthened by the fact that in this Bill we are now discussing there are stringent and extreme powers given to the Lord Lieutenant to insist on the local bodies making proper provision for pauper lunatics. If those powers be properly imposed, I contend that you put an immense additional charge on the ratepayers, because it is idle to talk to us of decently maintaining lunatics at 3s. 6d. a week. I say that 8s. a head is the very lowest figure. The whole system of treatment ought to be, and must be, I contend, on a totally different principle to the treatment of the ordinary paupers in workhouses. Whether for good or for evil, a system has been devised in regard to ordinary inmates of workhouses which keeps their expenses of maintenance down to the very lowest point. I think in some places it varies from 2s. 6d. to 3s. 6d.
§ * MR. DILLON
It used to be lower. It may be true, and I believe it to be true after some little experience, that it is slightly more expensive to deal with dangerous lunatics than to deal with harmless lunatics, but the way you deal with harmless pauper lunatics at present is nothing short of a blot on humanity. These degraded creatures require careful nursing, and many of them, by careful nursing and scientific treatment, can be in a great measure cured, or, at any rate, their condition can be vastly improved. They require very careful treatment, and their condition can be greatly improved by care; but if they are treated as they 247 are at the present moment in the poor-houses of Ireland—or in many of them—as if they were able-bodied men, and capable of looking after themselves, their condition becomes very disgusting and scandalous. I do seriously impress on the right honourable Gentleman that in dealing with these 4,000 unfortunate creatures who are in the workhouses of Ireland, who ought not to be left there a day longer, any scheme for their better or more humane treatment based on the idea that they can be maintained on 3s. 6d. a week is nothing short of a public scandal.
§ MR. GERALD BALFOUR
There is no statement in the clause that 3s. 6d. is to be the limit. Of course, I anticipate that it will be more than that; how much more I cannot say.
§ SIR J. HASLETT
The reports as to the condition of the lunatics maintained in the Belfast Workhouse show that everything possible to be done for the humane treatment of the unfortunate lunatics there is done. You cannot hope for any permanent improvement of these unhappy people. All you can do for them is to see that they get reasonably good food and careful treatment. In the Belfast Workhouse the lunatics get the same food which in ordinary asylums costs 6s. 6d. or 6s. 4d. a week.
§ * MR. DILLON
Does the honourable Gentleman, mean to say that in the Belfast Workhouse the lunatics have the same food as in lunatic asylums would cost 6s. 4d.?
§ SIR J. HASLETT
The conditions are different. The means even of giving these people food is different. In asylum you cannot even give them a knife or fork. I would earnestly put this question before the Government. We only want to do what is just and right for all parties, and I am not so sure that, unless we have a very considerable alteration in this Act, lunatics can be detained at all in these asylums. With regard to the other side of the question—namely, the 248 lunatic who becomes to some extent harmless in an ordinary asylum, and is then transferred to the workhouse—I think it is only done where there is a necessity for room, such as in the case of the Belfast Asylum, where they are overcrowded. In Belfast, unfortunately, our accommodation is not sufficient, and wherever a doctor can reasonably transfer harmless lunatic to the workhouse it is done in order to provide room for others.
§ * MR. SERJEANT HEMPHILL
I should like to mention one lunatic asylum near Dublin, which is one of the most important and the largest of all lunatic asylums in Ireland. The governors of that asylum have had this Bill before them since it was printed, and I am quite sure that they must have made some communication to the Chief Secretary as to this clause. The medical superintendent of that asylum, who is one of the most scientific and able medical men in Ireland, especially with reference to the treatment of lunatics, assures me that the expense of maintaining lunatics is increasing instead, of diminishing, because, as civilisation advances, a better standard, both in lunatic asylums and also in workhouses, is expected, and, whether rightly or wrongly, the governors of that asylum are strongly of opinion that this figure of 2s. a week—seeing that the cost of food exceeds, as it always must exceed, 3s. a week—is certainly inadequate. It will certainly be a great pity that a Measure of this sort should impose a limit like this, when it ought above all things, as it appears to me, to keep in view these unhappy lunatics, who are an increasing body, I am afraid, in Ireland; and, notwithstanding the arguments to the contrary, I do not think there is any hope of the number diminishing; on the contrary, I am afraid it is increasing from day to day. I would urge on the Government to raise the amount to be paid for the support of pauper lunatics under this section. If the maintenance of lunatics in workhouses does not amount to the figure inserted in the clause, of course, the grant will not be given to that extent, but if you keep the grant down to 2s. a week, it means that 5s. a week is all you can possibly allow under any circumstances for the maintenance of these wretched 249 lunatics in the auxiliary asylums. The regulation of these asylums has for years been a source of great trouble and anxiety to the authorities, no matter to what party they belong, in consequence of the overcrowding and the enormous expense of maintaining the institutions. We know that the frightful disease of beriberi has broken out, and we all know that that is a kind of disease that is almost certain to spread.
§ MR. P. A. M'HUGH
The honourable Member for Belfast spoke about the manner in which the lunatics in the workhouse in Belfast were treated, and he said that nothing could be better than the treatment that was given to these harmless lunatics. Now, I hold in my hand the last Report of the Inspectors of Lunacy in Ireland. After saying that in Belfast only 112 pauper lunatics were kept in the workhouse, the inspectors say—As we have stated in our previous Reports, we cannot report favourably on the condition of the insane inmates transferred under this section.I accept the statement of the inspectors in preference to the statement made by the honourable Member who represents, I understand, one of the divisions of Belfast. The inspectors on page 36 of this Report say this, and I would ask the attention of the Chief Secretary to this statement. In the course of his observations, in reply to the honourable Member for East Mayo, he said that the expense of keeping lunatics in workhouses would be very much less than the expense of keeping them in properly equipped asylums. The statement in this Report is as follows—Our Reports on the lunatic wards of the workhouses visited by us will be found in appendix F. Unfortunately we have not hitherto been able to report favourably on the care bestowed on the inmates of these workhouses, some of whom almost need the care and treatment of a fully equipped asylum.Now, do those inspectors know what they are talking about? If they do the Chief Secretary is grievously mistaken when he imagines that pauper lunatics can be kept on the wretched pittance of 3s. 6d. or even 5s. 6d. per week. The Act 38th and 39th Victoria, chapter 67, has been a total and absolute failure. I certainly think the Chief Secretary ought to see his way in the interests of these wretched 250 people to accede to the Amendment proposed by the honourable Member.
§ MR. POWER (Waterford, E.)
My experience is that you find in these unions a number of these poor people who ought to be transferred to lunatic asylums, and I think instead of transferring lunatics from lunatic asylums to the workhouse we ought rather to make provision for transferring a number of the present inmates of workhouses to lunatic asylums. There can be no doubt that the present state of things is a blot on our poor-law administration. My own idea is that there is a number of these lunatics confined in the poor-law unions in Ireland who, if they are sent to lunatic asylums, and properly attended to, would probably be cured. As to the idea that 3s. or 4s. a head will support these people, I think it is preposterous. To do justice to them little short of 7s. would suffice.
§ MR. CREAN,
speaking as one who has had some experience in the management of lunatic asylums, said that the limitation of the grant to 2s. a week per head was altogether preposterous. He had inquired of doctors and inspectors as to the actual amount it cost to maintain these people in workhouses, and he found that in order to give them proper care and proper medical attendance it would cost practically the same as if they were kept in properly equipped lunatic asylums. It was a disgrace to any civilised country that these unfortunate people who were not able to take care of themselves should be housed in places where they could not be properly attended to. All that was asked from the Government was that the State should pay sufficient to keep these unhappy creatures under proper charge. These poor, harmless imbeciles could not be treated in such a manner as to lead to any improvement in their condition if this limit of 2a. a week were maintained.
§ * MR. DILLON
There does not appear to me to be much chance of getting anything out of the Government, and therefore I do not desire now to prolong the discussion, but I cannot help saying that I think it is deplorable that the Chief Secretary should take the stand he is taking. The right honourable Gentleman spoke of this sum of 3s. 6d. as being a minimum. Now, I find here in the Report, to which I have already referred, 251 that at that time—that is in 1891—the average cost of maintaining a pauper lunaitic in poorhouses in Ireland was slightly over 4s., and while it was slightly over 4s.—and I suppose it has been slightly over 4s. from that day to this—we have the testimony of all inspectors that the condition of these pauper lunatics was a scandal and disgrace. In the face of those reports and the experience of these years the right honourable Gentleman deliberately proposes to limit the Government grant to 2s. a week, and sets up 6s. a week as the minimum, which is put on the face of the Bill as a reasonable minimum for the support of these lunatic poor. On the faith of the Report of these skilled experts appointed by the Government seven years ago the Chief Secretary deliberately ignores all that the Report says, and proposes to stereotype the present bad system. Sir, I think it is a most unfortunate proposal, and I would venture to suggest that it would be better to leave the whole question of the administration of lunacy to be dealt with under another Act. I think the Irish lunacy system is one that involves an immense deal of inhumanity and suffering. However, all our protests seem to be unavailable; it would be useless, I suppose, to press the matter to a Division, and I have nothing to do but withdraw my Amendment.
§ Amendment, by leave, withdrawn.
§ Clause 50, as amended, added to the Bill.
§ Clause 51 added to the Bill.