HC Deb 15 August 1913 vol 56 cc3401-9

"Where any person satisfies the Insurance Committee that on conscientious grounds he does not desire treatment by a duly-qualified medical practitioner, his right to medical benefit shall be suspended and the Insurance Committee shall pay to him in each year the sum equal to the sums payable to the Committee in respect of his medical benefit."

Clause brought up, and read the first time.

Mr. ALDEN

I beg to move, "That the Clause be read a second time."

This Clause is intended to meet the case of a few people who have conscientious scruples against medical practitioners. Personally, I think people ought to consult doctors as often as possible, but there are cases known to hon. Members here of people who, for some reason or other, whether rightly or wrongly, conscientiously object to treatment by doctors. I do not say that this Clause is satisfactory, and I do not say that there are not other safeguarding words wanted in the Clause, but I do say that some provision should be made to meet the case of a very few people who desire to stand out. Personally, I do not even know whether these people are members of approved societies, but, if they are, then I think perhaps the sanction of the approved societies should be obtained. Otherwise I can see no reason for refusing to allow them to stand out and take the money which they would be entitled to receive in respect of medical benefit. I am thinking of two special cases. One is the case of the man who has all his life been in the habit of going to a herbalist. I think that he is very stupid, but there it is. The other is the case of a man or woman who goes to a Christian Scientist for treatment. I think that in both those cases they are misguided, but there are such people, we have to take them into account, and I do not quite see why they should altogether lose the money which, under this Bill, is set aside for their medical treatment.

Dr. ESMONDE

I am very much astonished that the right hon. Gentleman should have put his name to this Clause. I understand we had a sort of tacit arrangement that on neither side, whether for or against medical benefit, would we have any controversial Clause here to-day. This, however, is a Clause which, if adopted, will break up medical benefit altogether. The healthy man in a society who never wants a doctor, and who never thinks of having a doctor, will say "I am a conscientious objector," and the consequence will be that you will have the societies giving medical benefit to people who really require it, and those who do not require it and at present help to pay for those who are sick will not pay at all. I venture to say that if this Clause is carried we shall have considerable trouble not only with the friendly societies, but also with the medical profession, who have come to an arrangement with the Government which I think it would be a great mistake to break through.

Mr. MASTERMAN

The Clause is not quite so ridiculous as the hon. Gentleman suggests, nor is there any fear of our coming into any dispute with the medical profession in the matter. They object to what some Insurance Committees have done—giving leave, as some of them have done, to persons to have authorised treat- ment of various kinds, and at the same time asserting that treatment is under the regulations equal in value to that given by the medical profession. This Clause meets a real case just as much as the anti-vaccination conscientious objector meets a real case, and I can assure hon. Gentlemen, if they are ignorant of the facts, that they would not be if they were in my position. There are a very considerable number of insured persons and employers, especially in the North of England, who say that they will not pay the money which is going towards ordinary medical treatment, unless the employés are not able to contribute towards that medical benefit. We are only giving a permissive power to the Insurance Committees, and that permissive power was promised in the original Act. If the Insurance Committee assures itself that one of these persons has a conscientious objection, then it will let him contract out. It is never any good the State entering into a fight with conscientious objection, Again and again, as in the vaccination laws, we have found that it does not work. Conscientious objectors are quite prepared to go to prison, and it is very foolish for us to enter into any such struggle.

Mr. MacCALLUM SCOTT

Is the right hon. Gentleman advised by his legal advisers that the Insurance Committees at present have not got power to do this?

Mr. MASTERMAN

They have power to do it under the condition that it is assumed the herbalist's treatment is as good as the doctor's treatment, and it is to that the doctors object. I have talked to some of the best men in the medical profession, and whilst they object to that, they do not object to the conscientious objector going out altogether, because they quite rightly realise that directly you raise the question of conscientious objection to medical practice, you raise a very unpleasant controversy in various parts of the country, and a general onslaught on compulsory medical service may result. I have seen deputations of these people on the subject. They were promised in Parliament that they should be allowed to contract out, and I do therefore ask the Committee to support the Government on this Clause.

Mr. BATHURST

I admire the ingenuity of the right hon. Gentleman's North country employer.

Lord H. CAVENDISH-BENTINCK

There are a lot of them in the Midlands.

Mr. BATHURST

The employer who has discovered a means of getting out of his payments by means of calling himself a conscientious herbalist or Christian Scientist! For my part, if this Clause is carried, I shall seek to get over the unfairness of the flat rate in the rural districts by advising all my rural labourers to be conscientious herbalists. Some of us know something about these herbalists. I do not know that I am disclosing any secret when I say that it has already become apparent to a certain committee which has been sitting lately to consider this and similar questions that herbalism is founded largely, if not entirely, upon the ignorance of the poorer and less instructed people among whom they practice.

Mr. ALDEN

Have the poor no ignorance with regard to the doctors?

Mr. BATHURST

I do not want to raise that difficult point, but I think that hon. Members will be prepared to admit that those who carry on the profession of a medical practitioner, and are recognised as such, have some education, and have to pass certain degrees in order to practice. Who are these people who go about professing to be herbalists? They are, almost without exception, cranks. They are people generally of no education or very little education, of curiously little scientific knowedge of botany, upon the basis of which they carry on their profession, and they are peculiarly well suited to impose upon the poorer and less instructed class of the community. There will be nothing whatever, if this Clause is passed, to prevent two-thirds of the population of the villages, under the influence of a so-called herbalist, coming forward as conscientious herbalists, and thereby getting a cash payment instead of receiving medical treatment under the Act.

Mr. J. SAMUEL

I hope that the right hon. Gentleman will not really press this Clause, because I am afraid if he does that he will open the door to a very wide question. For instance, in the county I have the honour to represent, there are something like 65,000 living in the non-county boroughs, and there are no less than two or three thousand workmen who conscientiously object to going to the panel doctors.

Mr. MASTERMAN

Conscientiously object?

Mr. J. SAMUEL

Yes, they conscientiously object. They will not go to the panel doctor on any consideration.

Mr. ALDEN

Will they go to any doctor?

Mr. J. SAMUEL

Yes.

Mr. ALDEN

Then they cannot be conscientious objectors.

Mr. J. SAMUEL

They have a conscientious objection to going to the panel doctor. If you are going to give this right to persons who have a religious objection to consulting doctors or to herbalists, then you certainly must carry out the intention of Section 15, Sub-section (3), and give it to those in my Constituency who have made representations to the Commissioners over and over again that they want a medical man of their own choice. They certainly have a conscientious objection. I know that from my own personal experience, because they have made appeals to me. They will not go, and you cannot make them go. If the right hon. Gentleman presses this Clause upon the Committee, I am quite certain that he will give great dissatisfaction.

Mr. HAMILTON

I wonder whether the right hon. Gentleman has considered what the effect will be on the approved societies if we have these Christian Scientists attended by a considerable amount of prayer, because they are likely to receive medical benefit for some considerable length of time!

Mr. GLYN-JONES

There is a real difficulty, but obviously this Clause does not meet it. The right hon. Gentleman constantly used the words "they ought to be allowed to contract out," but that is not what this Clause does. I quite agree that you have no right to enforce an insured person who believes in herbalism or some other form of medicine to take his medical treatment in a way in which he conscientiously disbelieves, but that is no reason for throwing 9s. at him. Surely, what the Committee have got to do is to see that he does not get the money which the approved societies are paying to the Insurance Committees for medical treatment of some kind or other without he gets it! I should have thought that the best way would have been to have provided that where an insured person requires treatment under a system of medicine not practised by any medical practitioner who has entered into arrangements with the committee, the Insurance Committee may, subject to regulations, subscribe to the cost of the treatment he desires to receive. When a person goes to the Insurance Committee, and wants to contract out with a qualified medical man, we say, "No, we cannot give the Government Grant unless you comply with the conditions of treatment," and yet, under this Clause, a man has only to say, "I do not want any of your doctors," and we then say, "Very well; there is the money, do what you like." It is perfectly obvious that this Clause does not meet the difficulty, but it is no use running away from the difficulty. The hon. Gentleman opposite may say herbalists are foolish, and we may have our own view about Christian Scientists, but, however foolish they may be, we cannot compel them to take treatment in any other way. Therefore, I would suggest that either now or on Report we should make the Clause read: "The Insurance Committee shall pay towards the cost of treatment by people who are not registered practitioners where they are satisfied that there is conscientious objection to receiving treatment from a qualified practitioner." Speaking for an Insurance Committee, I know the work that will involve, but I am perfectly certain that we would infinitely prefer that extra work to giving 9s. to everybody who chooses to accept the opportunity of coming to us for it.

Mr. LYNCH

I rise to oppose this Clause, and I cannot but express my astonishment that the right hon. Gentleman in charge of the Bill should have allowed his name to be associated with it. It shakes not merely my faith in this Amending Bill, but also my faith in the right hon. Gentleman. Whilst I am astonished that he should put his name to it, I am still more astonished at the argument which he adduced in support of it. That shattered the last vestige of faith I had in him. I suggest that as certain influences have been brought to bear upon him to put his name to the Clause, he should use his influence with those hon. Gentlemen to induce them to withdraw the Clause. He brings forward in support of his position the case of the conscientious anti-vaccinator, but there is no parallel at all between those two cases. Vaccination is something applied to a healthy person. It is quite possible that a person may on medical or other grounds object to having a child vaccinated, but when that child is free from the obligation of being vaccinated— [Interruption]. The right hon. Gentleman has been open to some arguments, and I hope he will be open to this one.

The CHAIRMAN

I have really not heard what the hon. Gentleman has been saying, but I infer that it is not to the point of the Amendment, otherwise I should have heard him.

Mr. LYNCH

The argument about anti-vaccination has no force in this regard, because vaccination is something which may be applied to a healthy person, but people may have medical grounds for objecting to that procedure. In this instance, when the State proposes to compel persons to do something, it does not pay them 9s. Another point I must take is that allowing his name to be applied to this Clause is a great violation of the agreement by which he induced Gentlemen opposite—the hon. Member for Salisbury for one, and the hon. Member for the London University for another—to withdraw various Amendments much more important than this and having much more weight and authority behind them. Then, again, I am astonished to find what has been said about the medical profession. The medical profession is very badly used, and by means of this Amending Bill it has now been brought to a state of degradation, so much so that we actually have to defend it, as the hon. Gentleman has done, by placing it higher than herbalists and Christian Scientists. On this very point, I should like to ask you in what regard I have been out of order? I have been traversing arguments to which you yourself have listened.

The CHAIRMAN

I called the hon. Member to order because it seemed to me that he was wasting time. Half of his remarks appeared to be addressed to hon. Gentlemen around him, and I thought he had really finished.

Mr. MASTERMAN

Will the hon. Member allow me to say here that I do not want to move any controversial Clause, and the Committee apparently has made up its mind that it does not want this Clause? I was under a pledge to press it, but I will not press the Committee to a Division upon it. I do not believe there is any reason why this Clause should have excited such an hysterical expression as the hon. Member for West Clare has given.

Mr. LYNCH

Is that in order?

The CHAIRMAN

I have not heard half of what the hon. Member for West Clare was saying. His remarks appeared to be addressed to those beside him rather than to the Committee.

Mr. LYNCH

The point of Order to which I rose, Mr. Chairman, was that the right hon. Gentleman in reply, and in default of arguments, addressed what was intended to be an offensive expression. I ask you to take notice of that.

The CHAIRMAN

I am sure the right hon. Gentleman did not mean anything—

Mr. LYNCH

On a point of Order. I am glad to have that expression from you, but I should like to have it from the right hon. Gentleman.

Mr. MASTERMAN

I am sorry that when I attempt in any degree to chaff the hon. Member he takes it in a very serious way. I am quite content to withdraw anything that has offended him, and, in view of the expressed wish of the Committee, also to withdraw the Amendment.

Mr. GWYNNE

I should like to ask the tight hon. Gentleman a question. He has just told the Committee that he has made a promise that this Clause should be passed.

The CHAIRMAN

No.

Mr. GWYNNE

He told us that he had met a deputation and made a promise on the subject. I do not think that the right hon. Gentleman should break this promise; and if he has made the promise, why does he withdraw the Clause because sonic hon. Members press him to do so? It is very undesirable to make promises beforehand, but, if a promise was made, why did not the right hon. Gentleman put the Clause down in the original Bill; or, if he did not do that, why did he not put the Clause down in his own name, instead of waiting for another hon. Gentleman to do it? I certainly disagree with this Clause, which requires some explanation.

Mr. MASTERMAN

I am quite able to look after my own promises. I have made no more promise than to attempt to get this result. As to the general question, I promised not to try and run controversial Clauses.

Question, "That the proposed Clause be withdrawn," put, and negatived.

Question, "That the Clause be read a second time," put, and negatived.

The CHAIRMAN

I would appeal to hon. Members, as we are having a long sitting, and it is a hot afternoon, to address the Chair as much as they can, and that those who are not speaking should refrain from using expressions. I only appeal on behalf of those conducting the Bill. Moreover, it is very hard for me to follow everything that is being said, and this difficulty caused me, perhaps in an abrupt manner, to call the hon. Member to order. This is a personal appeal.