MIDWIVES BILL. (Hansard, 12 April 1899)

§ MR. TATTON EGERTON (Cheshire, Knutsford)
In asking the House to refer this Bill to a Committee, I would remind the House that this Bill is the result of a Select Committee, which sat in 1894, and reported favourably on the subject. The subject is one of immense interest throughout the whole country, because it deals with that which will affect the youth and also the mothers of the country. The disclosures that 948 took place before the Select Committee of the serious results of having inefficient midwives at the present time were such that a very influential Committee was formed, and it has been working incessantly from then up till now in preparing the Bill now before the House. The Bill, I believe, has received the acceptation of the medical profession through its heads—both of the Royal College of Surgeons, and the Royal College of Physicians. It has also been favourably considered by the United County Councils Corporation. It is for that reason, and also for reasons of a philanthropic kind, that I ask the House to grant the Second Reading of the Bill, and to refer it at once to a Committee.

§ MR. T. P. O'CONNOR (Liverpool, Scotland Division)
I am sure the honourable Gentleman who introduced this Bill cannot have seriously expected that a Measure of so very great importance should be adequately discussed in the small space of 20 minutes left at the tag end of a Wednesday sitting. I quite agree with the honourable Gentleman as to the importance of the subject with which this Bill deals; and it is because of its importance that I ask the House to agree with me that it is a Measure which requires full and adequate discussion, and which, therefore, ought to be postponed until a more convenient time on another day of the Session. I am bound to say that, so far as I can learn, the opinion of the medical profession in regard to the Bill does not accord with that of the honourable Gentleman who introduced it. I have strong reason for believing that it is a Bill which meets with vehement opposition from a large portion of the medical profession. I know that in the General Medical Council the doctor who is the direct representative of the profession has strongly and openly declared himself against the provisions of the Bill. Now, as the right honourable Gentleman who introduced the Bill did not deal with its provisions, I find it necessary to say something on that point. The Bill would create a number of registered midwives, on whom it would confer very large privileges and titles. Now, Mr. Speaker, the medical profession, and especially the practitioners in the small country districts, are strongly of opinion that this would have the effect of substituting inexperienced, unpractical, and untrained attendants on women in their hour of need, instead of trained and practised attendants. Undoubtedly the first result would be to deprive the country practitioners of a large part of their practice, and to induce a large number of women not to employ regular medical men at all, but the midwives registered under the Bill. What would be the effect of that? There is no doubt that in many cases a registered midwife would be equal to the emergency, but in a large proportion of cases the attendance of a thoroughly practical and well trained physician is required. What guarantee is there in this Bill for the proper training of these registered mid- 950 wives? In order to be thoroughly acquainted with the subject of midwifery a training of at least three years is required by a medical man, and it is only after such training that a medical man is in a position to attend on easy cases free from complication. What would happen if the Bill became law? These registered midwives would be called in in almost every case, and with only three to six months of perfunctory training would undertake all the duties, face all the difficulties, and run all the risks that require the attention and training of a medical man who has undergone a regular medical course of teaching. The result would be that in place of the evils which I recognise at present result from the inexperienced attendance at confinements, there would be a very considerable increase of these dangers and difficulties. Besides, by this Bill you are creating a privileged class—a class which, at the same time, has not experience or education. I must say that I am unable to understand how the honourable Gentleman has been able to arrive at the opinion that the medical profession is in favour of this Bill. I had the pleasure and the honour of being a member of the Committee which received the deputation from the country practitioners, and if my memory serves me right the honourable Gentleman was present on that occasion. and I know that some medical men of intelligence and good faith and honour showed by their speeches and representations that they were strongly opposed to the Bill, and, to my mind, they presented an unanswerable case against the Bill. They pointed out the danger to which I have alluded, namely, that a large number of the wives of working men would naturally be induced by the smallness of the fees that would be asked by the registered mid-wives to send for one of them, not as an assistant to the trained and qualified medical man, but as a substitute. The registered midwife is a very good assistant, but to make her the substitute of a medical man is to expose a large number of the mothers of this country to very serious danger at the most critical moment of their lives. Well, Sir, the other objection is that in some small country districts women are attended by their neighbours. That kind of assistance, given, I am glad to say, 951 gratuitously, and with that generous consideration which is one of the best characteristics of our poor, would be rendered entirely impossible by this Bill.

AN HONOURABLE MEMBER
dissented.

§ MR. T. P. O'CONNOR
Yes, it would. My honourable Friend will have an opportunity presently of explaining his view of the Bill. I give my interpretation of the Bill. I hold that this Bill would have the effect of rendering it practically impossible for women to get this gratuitous and simple assistance from their sisters that they get in small villages at the present moment. Now, Sir, I think I have said enough to show that this is a serious and very important matter. I may be right or wrong in my view of the Bill, but nobody can deny that I am right in that particular respect. I submit that the Bill involves a very serious question, and requires further consideration, and, as time does not admit of proper discussion, I beg to move the adjournment of the Debate.

§ * MR. SPEAKER
Order, order ! I cannot accept the Motion, seeing that in a few minutes the Debate will be adjourned by rule.

§ MR. GALLOWAY (Manchester, S.W.)
My honourable Friend has dealt with one or two, but by no means all, of the objections which can be raised against this Bill. In the first place, my honourable Friend in charge of the Bill asked that it should be given a Second Reading, in order that it might go to a Committee. He did not, however, tell us which Committee he wanted to send it to.

§ MR. TATTON EGERTON
A Grand Committee.

§ MR. GALLOWAY
Surely, Sir, if the subject of this Bill has been inquired into by a Select Committee, and that Committee reported in favour of that Bill, there can be no possible reason why this Bill should be referred once more to -another Committee, if the Report of the Committee was favourable. If it is to be referred to a Committee it should be referred to a Committee of the whole House. In looking over the Bill, one of the most extraordinary clauses to my mind is the last clause. My honourable Friend bases his claim in support of the Bill on the ground that it will assist in the better preservation of the lives of 952 mothers, particularly among the poorer classes. If this be so, I do not understand why my honourable Friend should apply this Bill alone to England, and not to Scotland and Ireland; for it seems to me that if the Bill be good in substance it ought to be equally good for Scotland or Ireland as for England. My honourable Friend opposite who moved the rejection of the Bill said, and said very justly, that one of the effects of it would be that inexperienced mid-wives would become substitutes for medical men, and not merely assistants. I understand that there is a provision in the Bill which does not render it illegal for unregistered women to render assistance to a lying-in woman in cases of emergency. Surely, if you are going to allow unregistered women to render assistance in cases of emergency there can be no possible ground for this Bill, for the whole object of the Measure is, as I understand it, that people should be assisted by properly registered men and women only. Therefore it seems to me that this clause would entirely do away with the benefits which the Bill seeks to establish. But my main objection to the Bill is that it would largely do away with the services of properly qualified medical men, and that, surely, particularly in poor districts, is a very serious matter, because it cannot be denied that the poorer classes, if they see a midwife with a certificate of efficiency, in nine cases out of ten would take her services, and not those of a medical man. That surely cannot be desirable. I say that, not because I have any desire to patch up the practice of the country practitioners. I have no such desire, but I do desire that proper assistance shall be rendered by duly qualified and experienced persons. Then another clause provides that on the passing of this Act— The President of the General Medical Council shall take steps to secure the election of a Central Midwives Board, which shall consist of (1) four registered medical practitioners, one to be elected by the Royal College of Physicians of London, one by the Royal College of Surgeons, one by the Society of Apothecaries, and one by the Incorporated Midwives Institute; and (2) two persons to be appointed for terms of three years by the Lord President of the Council. Now, Sir, are the midwives of the whole country to be brought up to London in order to obtain these certificates? Is that the proposal? All I can say is, that one of two things must obviously hap- 953 pen; either the mid-wives must come to this Board, or this Board must go to the midwives.

AN HONOURABLE MEMBER
The examination takes place in various places.

§ MR. GALLOWAY
There are, I believe, a few places provided for under the Board, but that does not make the objection any the less. I ask, Sir, what kind of practical examination are the four gentlemen constituted under this Bill going to give, unless they are going to devote a considerable amount of time to the question? Probably, if this Bill became law, it would result in a good many midwives obtaining certificates who are not by experience thoroughly qualified for the post. It does seem to me that to pass a Bill of so serious a nature, after 20 minutes or half an hour's discussion, is altogether beyond the right of the House of Commons. It is prostituting the powers of the House, and if the Bill is allowed to pass the House will very seriously regret it.

§ * SIR W. PRIESTLEY (Edinburgh and St. Andrews Universities)
It is quite true, as my honourable Friend opposite has said, that there is a certain amount of opposition to this Bill on the part of a section of the medical profession, but I think the danger that is likely to arise to the interests of the medical practitioners has been very much exaggerated. The object of this Bill is really to do something in the interests of poor women who are attended in their confinements, both in town and country, and to see that they are provided with skilled midwives. I have said that I think the danger likely to arise to the interests of the medical profession has been greatly exaggerated. In the first place, there are. I believe, in every Christian country in Europe, midwives, and that has not in the least interfered, I understand, with the medical practice. That is, I think, a very important point, and I may further say in reference to this question that the Select Committee of 1893——
And, it being half-past Five of the clock, the Debate stood adjourned.