§ Order for Second Reading read.
§ Motion made, and Question proposed, "That the Bill be now read a second time."—[Mr.>Burns.]
§ Dr. ADDISON
I do not wish to delay the Second Reading of this Bill, but I should like to receive an assurance and to raise two points in connection with it. The Prime Minister explained the other day in a question which I put to him, that this was a small Bill in connection with certain matters as to tuberculosis, but the Bill appears to effect a very profound change in the public health administration of the country, because the third Clause, while personally I heartily agree with it, says:—It shall be lawful for the council of any county or county borough to make such arrangements as may be sanctioned by the Local Government Board for the treatment of disease.As that stands it may mean anything. I believe the intention of the Local Government Board is that it shall be really an extension of the powers of the Infectious Diseases Act which I hope will be wisely interpreted. The other point is in connection with the recognition of the Metropolitan Asylunis Board with respect to the reception into their institutions of patients suffering from any disease. Of course, the object of this provision is no doubt to put into proper order the reception of tuberculous patients into the institutions under the Metropolitan Asylums Board. As far as I am concerned, I do not want to offer any objection to that. But I should like the President of the Local Government Board to state precisely what is meant by the words in Clause 4. "For this purpose the managers shall be deemed to be a sanitary authority." It would be a very bad principle, indeed—and I should offer my most strenuous opposition to it—to give the Metropolitan Asylums Board any sanitary powers outside their own institutions. I hope that, in clue time, we shall see the London County Council the public health authority for London, and I do not want 2178 to give the Asylums Board any additional powers with regard to public health outside their own institutions. I am not saying this in any depreciation of the Asylums Board's work. I believe that they administer their institutions in a thoroughly efficient and first-rate manner. It is only because we have such a medley of public health authorities in London that to add to the confusion by giving increased powers to one of them, which I believe should not ultimately be the public health authority, would only make confusion worse confounded. If the intention is purely to limit their authority to the institutions over which they have charge, and with respect to which they make arrangements with the London County Council or anybody else for the reception of patients, as far as I am concerned I have no objection.
§ Mr. BURNS
The object of this Bill is primarily to enable the Metropolitan Asylums Board to carry out more promptly the provision of sanatoria under the Insurance Act, and to do effectively, as they desire to do, the work which has been put upon them by the Act. Clause 4, which removes the disability under which the Metropolitan Asylums Board now labour, really answers my hon. Friend's question if he will read it closely, because it says:—It shall be lawful for the managers of the Metropolitan Asylums District with the sanction of the Local Government Board to enter into agreements for the reception into hospitals provided by the managers of patients suffering from any disease, and for this purpose the managers shall be deemed to be a sanitary authority.My hon. Friend asks for a definition of "sanitary authority." I can assure him that there is no intention under this Bill of devolving upon the Metropolitan Asylums Board any of the public health duties and functions now exercised either by the borough councils or by the county council. It is limited to the institutional treatment of disease—infectious disease, tuberculosis, and so forth—in regard to which the Board are anxious to have increased power. With regard to Clause 3:It shall be lawful for the council of any county or county borough to make any such arrangements as may be sanctioned by the Local Government Board for the treatment of disease—we propose not to retain the last two lines— 2179and for the provision of laboratory facilities for use in connection with the treatment or prevention of disease.The disease intended to be dealt with under Clause 3 is primarily tuberculosis; but in the event of a tubercular patient suffering at the same time from some other disease, it is intended that there shall not be a disability on the part of the Board to deal with that complaint other than the major disease for the treatment of which the patient was removed to the institution.
I trust with these two explanations that the House will allow this Bill to pass, and thereby give the Metropolitan Asylums Board that extra facility which it is entitled by the past excellent way in which it has met the emergency of the Insurance Act, both with courage and resource, and so enable it to continue that good work.
§ Mr. BOOTH
I do not propose to offer any opposition to this Second Reading, but I do ask that the Committee stage may be arranged so that London Members may be able to give their views fully. I am particularly sorry that the Chairman of the London Insurance Committee is not here, so that we might have here the advantage of his view.