§ Order for Second Reading read.
§ Mr. LONG
I beg to move "That the Bill be now read a second time."
Perhaps I ought to give the House a short explanation of this Bill. It is not a War Emergency Bill, but is to amend ordinary legislation, which is just as necessary in the middle of a great War. There are certain powers under an Act of 1907 dealing with the notification of births. It is a permissive Act, and local authorities have adopted it to a great extent, so that something like 80 per cent. of the population of this country come under its powers. The present Bill proposes to extend those powers, to make the Act universal throughout the country, and to effect certain ether changes. This Bill proposes also to deal with the health of the children and mothers. The Notification Act necessitates the notification of births of children alive or still-born. We propose to pave the way by this Bill for doing something to improve the health of mothers and young children. All experience of the areas where this Act has been in force goes to show that where this notification is made, and is followed up by a wise action on the part of local authorities or voluntary agencies, the most satisfactory consequences follow in regard to the health both of mothers and children.
I think the House will feel we are justified in bringing forward a measure of this kind, although not a War measure, because probably at no time in our history was it ever more desirable that we should do everything we could to improve the health of the mothers of our infants, or to make it more and more probable that our infants will be able to resist disease, and be so fed and cared for that they will grow to be healthy men and women. If this House will give a Second Reading to this Bill to-day the effect will be one on which they will be able to congratulate themselves. Clause 2, which deals with one branch of the subject as it stands in the Bill, has not proved satisfactory to our education authorities either central or local, and I have already arranged with the President of the Board of Education for Amendments which I think will meet the point raised by the hon. Member for Somerset. These Amendments will appear on the Paper to-morrow, and I hope the result will be satisfactory.
§ Mr. J. A. PEASE
I am quite sure that in every quarter of the House hon. Members will welcome any Bill which has for its object the reduction of the rate of infantile mortality. It is well known that the statistics vary very much in this country in regard to infantile mortality, and as a student of those statistics I welcome this measure, because I agree that the proposal in regard to notification will draw the attention of authorities to this question, and will do something to save human life, and enable many children who might otherwise die to be reared into healthy human beings. The statistics show that there is an enormous variation between one district and another. Take, for example, Burnley, which has an infantile death rate of 174 per 1,000, and compare it with some rural district where the rate is 60 per 1,000. In the last few years the rate has decreased from an average of about 130 to 108, which is the last figure that has been supplied by the Local Government Board. That shows what can be done by paying attention to this particular subject. I am quite sure that in every quarter of the House, that this Bill, which is intended to diminish infantile mortality, will be heartily welcomed and most warmly supported.
One other point I wish to refer to is the way in which infant welfare should be attended to by the Departments of the State, There has been some controversy, which I do not think we need go into, between Government Departments in the past as to the way in which infant welfare could be best treated by the State. Speaking for myself, I am anxious to get an assurance by the Government upon this particular point. I wish to be assured that the work that has been undertaken by the Board of Education in connection with infant welfare should not be interfered with by any provisions which may be put into operation by this Bill. In other words, I wish that the excellent work which I believe has been going on under the Board of Education in connection with schools for mothers, nursery schools, crêches, and other arrangements for dealing with children under the age of five shall not be handed over to the sanitary authorities. I rose with a view to justifying to the House the reasons why I think this work should not be interfered with, and that there should be no suggestion in this Bill to the sanitary authorities that child welfare is a subject to be undertaken exclusively by them and not be developed in 619 connection with the work, which has been very progressive and undertaken by the Board of Education and by local education authorities in the country. I am anxious not to raise any point of controversy. I recognise that in the Act of 1907 Parliament did insist on certain new powers being handed over to the Board of Education in connection with health work, such as the inspection of children not merely when they came to school and appeared on the register, but immediately before they entered the school, which was insisted upon in that Act. Subsequently, in addition to the inspection of children, the Board of Education were entrusted with powers by Parliament to see that those children were treated in the schools, and provision has been made to enable Grants to be given not merely for inspection, but treatment through the local education authorities.
We have had great experience in the country in connection with the provision of meals. The right hon. Gentleman alluded to the importance of the feeding of young children. The experience we have had in connection with the feeding of infants between three, four, and five years of age in our schools is a very substantial experience, which has been gained by the Department which I formerly represented in this House. The result of that experience is that we have found out, that if you are to avoid waste of public money, it is essential that children should be properly cared for before they come to school, and not merely after they come into the school. It is essential that attention should be paid to the little illnesses of the children before their school life commences. I think we are all agreed that this work should be undertaken, and the only question is which Department of the Government should assist it. I do not suggest that the right hon. Gentleman who has introduced this Bill desires to commit any breach of the truce, but I do feel that on the one hand the Local Government Board work in connection with the subjects which the right hon. Gentleman referred to, such as maternity cases, pre-natal cases, and for children so long as they are being nursed, are matters obviously suited to the Local Government Board. On the other hand, the Board of Education is already inspecting over 150 schools for mothers in the country, over 80 day nurseries, 300 clinics, over 3,000 classes in which housecraft, 620 hygiene, and infant management are being taught to girls in the public schools. 1,200 school nurses have been appointed, there are 1,200 school medical officers, of whom 93 are women, and inspectors, nurses, and doctors visit the homes of the children, and it seems to me obvious that this work in connection with infant welfare and infant consultation ought to be undertaken by these experts rather than be handed over to sanitary authorities. The greatest expert in connection with child welfare more than a year ago wrote a letter to me as follows:—The education of the young child should be primarily physical and manual rather than intellectual. Education should take the form of physical, motor and sensory training rather than of any direct appeal to its intellect, which is undeveloped and immature. Education and hygiene are complementary and inseparable, identical in practice. The exercise of a child's functions is its education.It is not a question of when a child comes to school or is registered, but it is really a question how you are to treat children even at the age of ten, eleven, or twelve months old. The child's education is a matter which requires a good deal of thought even as to the selection of the best toys and the quality which ought to be used for the benefit of these young children. Their education is then beginning. The point I really want to make this evening is that in this connection we should have some assurance from the right hon. Gentleman that this work, as developed up to the present time, should not be interfered with by the powers which may be taken under the Clause of this Bill which we have not yet seen, and which the right hon. Gentleman says will be placed on the Paper to-morrow. I believe that if there was any attempt made to poach upon the province of the Board of Education, which has been well covered, and which is developing to the advantage of the community, overlapping and extravagance will occur which I am sure we should all deprecate at the present moment. It is with a view of asking the Government to give some assurance on that point that I rose this evening. At the same time I wish to give a cordial welcome to the Bill, which I believe will do a great deal to reduce infant mortality in this country.
§ Mr. GOLDSTONE
Practically I agree with all that has fallen from the right hon. Gentleman opposite (Mr. Pease). I think everyone will welcome the making of the notification of births compulsory. In the past legislation of this character has not been a marked success, and the making of 621 this Act obligatory on all authorities is something to be welcomed. It appears to me that the inclusion of county councils as sanitary authorities is all to the good, and with those portions of the Bill I think there will be practical unanimity and approval in the House. Clause 2 as it is in the Bill appears to me to raise matters more controversial. I know it is going to be altered, but as we have not had an indication of the scope of the alterations I am glad that the right hon. Gentleman has asked for some very definite assurance that the new Clause 2 which will be placed on the Paper will not do what he fears it might do.
§ Mr. GOLDSTONE
That removes some of the apprehensions which I felt. This is not emergency legislation, and it is much to be regretted that there should be any matter introduced which, from what we have heard, appears to raise controversy as between department and department. I cordially associate myself with the sentiments of the right hon. Gentleman as regards keeping the matters he mentioned entirely within the province of the Board of Education and the local education authorities. They have for this service a very fine set of officers who, in the matter of child welfare, have practically become a magnificent body of specialists, and now that the Board of Education, with the cordial co-operation of the local education authorities, has had its powers extended so as to take note of day nurses, crêches, school clinics, and the like, and the looking after children up to the age of five, it appears to me that there has been an accumulation of experience which ought not to be lightly thrown aside, and that the Board of Education would be the correct authority to deal with this matter. They take on the children at five, and it would appear to me to be the more natural thing to allow the powers of the Board of Education to develop downwards and to include children at an earlier age than to extend the scope of the powers of the Local Government Board over children with whom eventually at five they cease to have any connection. Therefore this Clause, which I am glad to know is to be subject to the approval of the President of the Board of Education, we may take it will not entrench upon the powers now enjoyed by the education authorities.
Mr. PERCY HARRIS
There is no doubt that the functions of the two Departments do touch here. The problem is partly an educational one, and partly one connected with public health, and it is very desirable that the provinces of the two Departments should be defined so that there shall be no overlapping or friction. I will not attempt to express an opinion as to what those provinces should be until I have an opportunity of seeing the Clause which the right hon. Gentleman is to put down, but I would like to take the opportunity of thanking the late President of the Board of Education (Mr. J. A. Pease) for what he has done in the way of assisting schools for mothers, because I am sure that a great service has been done by means of those Grants. I welcome this Bill, and I am glad that the right hon. Gentleman has extended the Notification of Births Act to districts where at present it does not apply, and has also gone further and given additional powers for the care of mothers and young children. We must realise the fact that the adoption of the Act in various districts has not always been followed by effective action, and without effective action the Notification of Births Act is really of very little use. There are two reasons why action has not always been taken: One, the doubt there has been as to the powers of the local authorities; and the other the failure to perceive the good results which flow from effective action. The Bill removes any doubt as to the powers, and what has been done by public and private agencies has made clear the extraordinary fruitful field which is really open.
Voluntary agencies under various names—schools for mothers, and health societies—have really been pioneers in this field, and I think the community is very much indebted to them for what they have done. I hope in any arrangements made under this Act by local authorities and sanctioned by the Local Government Board that care will be taken to utilise the experience of these voluntary societies, to encourage their work, and to co-operate sympathetically with them. Local authorities, I think, would be reluctant to embark upon any new items of expenditure at the present time, and it is therefore all the more important to utilise every ounce of energy that can be put into this work. I am afraid also that the voluntary agencies will not now find it easy to raise money for this purpose. I am sure, however, that 623 much can be done in this matter at comparatively small cost. I had an example in my own Constituency of what could be done in the way of saving infant life by a timely use of special milk preparations.
The powers in the Bill are of a somewhat general and vague character, but, as it is to be amended, I will reserve my observations. I was asked, however, by a large municipality to inquire whether there would be power under the terms of the Bill to erect crêches in or adjoining open spaces. It seems a little doubtful whether erecting buildings for crêches would come within the words. I raise the point now in order that it may be considered, because that municipality was anxious to do something of that kind, and was thinking of applying for powers by a private Bill. One might in ordinary times look a little askance at any proposal to give large powers to spend money without any specific definition of those powers, but I think the right hon. Gentleman is quite right here not to attempt to define these powers. It might give rise to controversy. All you want is to facilitate action by local authorities, and I think we may rely upon the Local Government Board to see that wise action is taken, and also to do their best to see that action is taken. They might do a good deal if they would instruct the local authorities who perhaps are not well informed on this subject. A great deal of progress might be made with general consent, but one has to face the fact that there are questions of policy which will raise controversy perhaps both inside and outside of Parliament before they are settled. We want enthusiasm more than sensationalism in this matter. It is not a new problem which we have got to face. It is a very old one. I do see a tendency towards the treatment of motherhood as a transcendental operation, and people accordingly lose their heads, but I think we may rely upon the good sense of the President of the Local Government Board to direct the action of local authorities in a wise direction.
§ Mr. DICKINSON
We all welcome this Bill, and I am certain that it will go through the House practically with unanimity. The real problem will be one of administration, and I hope that the Local Government Board and the Board of Education will exercise all the powers they have to see that the Act is enforced. I rose particularly to welcome Clause 2, 624 which I understand is going to be redrafted. I will not discuss the question raised as between the Board of Education and the Local Government Board, but in view of the importance of it may I ask the right hon. Gentleman that we should have some time to consider the amended Clause before we come to the Committee stage. It is very important that we should realise its full bearing, especially as our experience has been that this question has suffered in the past from dual jurisdiction. The grants to these schools for mothers have been held up this year, and they have suffered considerably from the delay. That delay has been due entirely, I believe, to a difference of opinion between the Board of Education and the Local Government Board, and I do hope that it will very soon be remedied.
I want to ask the President of the Local Government Board if he will give us before the Debate closes some idea how far the local authorities can depend upon the central funds to carry out the work which is suggested in Clause 2. As the Bill is drafted, the whole of the expenses undertaken by the local authority will fall on the local rates. I do not think that is intended. I believe that the Government will subsidise to a certain extent, and I hope to a considerable extent, this particular expenditure, and it would facilitate matters very much indeed if the right hon. Gentleman would state this evening whether or not the Grants which have been given, and which I hope may be enlarged, will be continued from the central Exchequer to the local authorities to carry out the work under Clause 2. I hope that he will be able to make some announcement to-night. I see no reason why he should not do so, and from a public point of view it would be an advantage.
§ Mr. CURRIE
I am glad that this very welcome Bill has been made to apply to Scotland. I do not think the right hon. Gentleman will find that there will be any trouble arising out of departmental difficulties, but I should like some explanation or assurance in quite general terms as to the provision of money in Scotland for the actual working of the Bill, because its usefulness will really depend upon the sinews of war.
§ Mr. C. E. PRICE
I am glad this matter has been brought up. I have had resolutions cordially welcoming this Bill in that it applies to Scotland, because unfortunately in some districts infantile morta- 625 lity is very high indeed in Scotland. I listened with considerable interest to the right hon. Gentleman when he explained what was done in England with regard to mothers, but unfortunately in Scotland a similar Grant was not made. I think there is a Grant of something like £175,000 towards that object in England and Wales, but unfortunately we have had no such Grant in Scotland, and we have suffered very materially from that fact. I am glad to see the Lord Advocate here. Perhaps he will be able to give us some assurance that we shall have a Grant on similar terms in Scotland, because unless we do we shall feel that we are suffering a grievance. There have been, as he knows, several of our Grants reduced, much more so than in England and Wales, and if he will give us an assurance that in this matter there will be an equivalent Grant in Scotland, it will give us very great satisfaction.
§ Sir W. BYLES
I have desired this Bill for a long time, and I heartily rejoice that it has been introduced. In the terrible War in which we are engaged, we are destroying human life, young and lusty life, at a fearful rate, and if the House will turn its attention to the saving of human life it cannot be better employed. The terrible statistics of infantile mortality have been a discredit to our nation for a long time. I believe that this Bill will conduce to reducing those statistics, and also to reducing the evil of pre-natal conditions which have actually prevented child-life from coming into being. We have had in this country for some time now a falling birth-rate, and some alarming prognostications have been made as to the ultimate effect of such a condition of things on the nation. Therefore, any step we can take to save young lives and to promote child welfare is the best social reform, and of the most appropriate kind, to which the House can address itself.
§ 8.0 P.M.
§ Mr. KING
I have a notice on the Paper directed against the second Clause of this Bill, but I am glad to think that my objection has already been taken note of, and I hope that it will be met by the Amendments to be put down. Of course, with everybody else, I am heartily in agreement with this attempt to do something for the coming and the rising generation at this time. There is no work we can do that is better worth doing and more full of promise for the future of our country than preserving and building up infant 626 life, but I must say I greatly regret that a Bill like this has been introduced without the name on the back of it of some representative of the Board of Education. The Board of Education has been doing magnificent work for years past, covering the whole field which is in view of Clause 2 of this Bill. No representative of the Board has his name on the back of the Bill. I think that is very unsatisfactory. It is unusual when a Bill like this is brought in for the Minister in charge to confess that friction has arisen between his Department and the Treasury.
§ Mr. KING
I apologise; and, of course, withdraw the statement. But if difficulties or misunderstandings, or whatever you like to call them, arise between two Departments, it is evident that those Departments have not come to a full and perfect agreement, as they should have done, before the Bill was introduced. I do not want, however, to press this point at a time like the present. But I do, without hesitation, call the attention of the House to this fact: if we want to be united, if we want to get through our work well, if we do not want to spend time upon Amendments and discussions, in Committee, on small detail points, then right hon. Gentlemen on the Front Bench had better consult with one another, perfectly and fully, before they bring a Bill in.
So far as I have heard, no one has called attention to the recent report of the Chief Medical Officer of the Board of Education for the last two years. The features of those reports had been education and children's welfare. The whole outlook for education, and the problem of the well-being of the people, has got a new meaning and a new hope of promise, through what Sir George Newman has written and done, and what he has told us. I should like to draw the attention of the House to this fact: that we have here in England an argument which, I think, is perfectly conclusive. It is proved by the facts he brings forward, by the experiments he has worked out. That argument is, that the problem of the child's education depends upon the 627 health of the child, and it depends more upon the state of health in which the child is when it enters school than at any other point. The health of the child when it enters school depends upon the upbringing and teaching of the mother, and therefore the problem of education in the first instance devolves on the teaching of the mother and the assistance given to her in the earliest years of the child's life—even in the earliest months and weeks of the child's life—in regard to the question of health and nutrition.
I will not pursue this at any length, but I would like to call the attention of those bon. Members, who may do Sir George Newman the honour and themselves the good service of reading his report, to the list on page thirty-two of the schools where instruction is now being given to mothers, where infant consultations are taking place, and where infants are received again and again. I am glad to see in the constituency (Fulham) represented by the Parliamentary Secretary to the Local Government Board (Mr. Hayes Fisher) that there are no fewer than 600 children—infants—whose mothers have received advice and whose cases have been the subject of consultation during the year. I might point also to the magnificent work which is being done in some of our great towns. In Leeds no fewer than 2,000 children, infants under five, have been the subject of consultations during the year, and their mothers have been helped and assisted. In Manchester the number is 1,600, and in Bristol, two wards of which I am proud to represent, there have been no less than 1,200 consultations as to children. It is perfectly evident that the Board of Education has been doing magnificent work.
I contend that this Bill ought not to have been introduced without Section 2 being in a satisfactory state. I am almost sorry we have the promise of Amendment. I would sooner see the Bill withdrawn and another Bill introduced. I am glad it is introduced so soon after the remarkable speech which Lord Haldane delivered the other day, in which he called special attention to the duty of our country to prepare for the state of things that must arise after the War, and to the fact that, however much we may economise, there are three directions in which it is dangerous to economise too far, namely, upon education, on the health of the people generally, and, lastly and most important, 628 on those measures which we take to deal with the constant menace and danger of infant mortality. I am extremely glad, and I am sure hon. Members on all sides are glad, as too must be social workers in all parts of the Kingdom, that an effort is being made by this Bill to deal with a question of such great, vital, and national importance.
§ Sir JOHN SPEAR
I only rise to support the Bill in a few words, and to support also the appeal of the right hon. Gentleman the Member for St. Pancras, that funds shall be provided from the Imperial Exchequer for carrying this Bill into effect. We are all agreed as to the importance of the problem of infant life. I venture to submit that important as that duty is, it is a national responsibility rather than a local one, and, therefore, funds ought to be forthcoming from the Imperial Exchequer wherewith the local authority can put into force this Act. I submit that at this time, more than at any other, it is important that this Grant should be forthcoming. We all know the heavy burden that rests upon the rates through the local authorities making demands to carry into effect Acts of Parliament passed by this House, and I am bound to say that, generally, those Acts have been handed over to local bodies to administer without a fair contribution being given towards the cost from the Imperial Exchequer. Especially in this case is it a national responsibility, and I do hope, therefore, the right hon. Gentleman will arrange that the expense of giving effect to this measure shall be borne by the Imperial Exchequer. We were reminded last year by the Chancellor of the Exchequer that the burden of local rates had become intolerable and must be speedily relieved. We know that what has occurred since has made that impossible. But surely the burden ought not to be increased in the face of that statement by the Chancellor of the Exchequer. I hope the right hon. Gentleman will get his Bill, and will provide that the expense for giving effect to it shall fall upon the Imperial Exchequer rather than on local rates.
§ Mr. LONG
I can only speak again by leave of the House, but I will dispose, as rapidly as may be, of the points as to which I have been asked. First, with regard to the Grants-in-Aid which are to be paid in respect of Scotland and Ireland. There is a rule which, so far as I know, 629 has never been departed from, that whenever Grants are made in respect of legislation originated in this country, but applied to Scotland and Ireland, the distribution of those Grants follows the invariable practice and is made in due proportion to the three countries. That will be done in this case.
§ Mr. LONG
I am quite aware of that, but this year the Treasury has made a special Grant—an increased Grant—to meet the expenses of the Act, and I understand that the Scottish Office is in communication with the Treasury. No answer has yet been received, but my right hon. Friend the Secretary for Scotland is giving close attention to the matter. The hon. Member for North Somerset (Mr. King) made a complaint which was quite a novelty. As one of the students of our Parliamentary system he is fond of discovering matters of complaint which have never been heard of before. I certainly never have heard before a complaint that a particular Minister's name was not on the back of a Bill. When, on the introduction of the Bill, I was asked for the names, I found four there, and it never occurred to me to add a fifth. Had it done so, I should have given the name of my right hon. Friend the President of the Board of Education. I can assure the hon. Member that the absence of that name does not mean any less interest on the part of my right hon. Friend, or that he will exercise any less vigilance over the different proposals of the Bill than if his name were on the back. I am sorry it should be regarded as an omission. As regards the suggestion made by the late President of the Board of Education, I do not hesitate to say, as a very old Parliamentary official, that I deprecate, in the strongest way, and discussion of interdepartmental differences, if any exist, in the House of Commons. The proper place for settling them is outside the House of Commons. I am to blame, and I take full blame, for the misapprehension which the right hon. Gentleman has fallen into. There is no difference between the Departments in that sense. There was a slight misunderstanding, but it was at once removed. My right hon. Friend and I discussed the matter and settled it in a very few minutes, and I can assure the right hon. Gentleman it will not prejudice the 630 interests either of education or of local government, which are entrusted to the care of my right hon. Friend and myself. We will not prejudice them by entering into any discussion here as to the relative rights or areas of the different Departments. This question was settled amicably between ourselves, and the only thing we shall consider, in our legislation and in our administration, is the general good of the community in regard both to education and public health and all other questions in which his Department and mine are associated. Therefore any idea of friction between us will, I hope, be dismissed from the mind of everybody.
With regard to the establishment of crêches, I do not think there is any power for that under this Bill. With regard to the Grant, as to which a question was asked by the right hon. Gentleman the Member for St. Pancras, I may say we have secured an additional Grant from, the Treasury. It is proposed to make Grants-in-Aid to local authorities to carry out expenditure which is approved by the Local Government Board. I was asked when we proposed to take this Bill. In view of the fact that there is an Amendment to Clause 2, which will be on the Paper to-morrow, the Bill, I understand, is put down provisionally for Tuesday, but the Government would not dream of taking it if hon. Gentlemen feel that they require more time for the consideration of the amended Clause. I am inclined to think, when they see that amended Clause, which will give the power suggested to the President of the Board of Education, that they will find it entirely satisfactory. But if, in any quarter, there is a desire for further time, it will certainly be granted, and we shall be glad to postpone the Committee stage till a later date.
§ Question put, and agreed to.
§ Bill read a second time, and committed to a Committee of the Whole House for Monday next, 12th July.631
§ The remaining Orders were read and postponed.
§ Whereupon Mr. SPEAKER, pursuant to the Order of the House of the 3rd February, proposed the Question, "That this House do now adjourn."
§ Question put, and agreed to.
§ Adjourned accordingly at Sixteen minutes after Eight o'clock till Monday next, 12th July, pursuant to the Order of the House of the 3rd February.