HC Deb 24 June 1915 vol 72 cc1419-25

(1) The Visiting Committee of the Council may if they think fit receive and lodge as a boarder and maintain and treat at the asylum known as the Maudsley Hospital on such terms and conditions as to payment and otherwise as they may determine any person suffering from incipient insanity or mental infirmity who is desirous of voluntarily submitting himself to treatment therefor.

(2) The Council may if they think fit defray the whole or any part of the expenses of the maintenance and treatment in the said asylum of any such person as a voluntary boarder.

(3) Rules made under Sub-section (1) of Section 338 of the Lunacy Act 1890 may prescribe the books entries reports notices and other documents to be kept and made in respect of boarders in the said asylum.

Mr. HARRIS

I beg to move, in Subsection (1), to leave out the words "asylum known as the" ["asylum known as the Maudsley hospital"].

Mr. KING

The Amendments which the hon. Member for Paddington has given notice of in connection with this Clause raise a very important question, and I think that it is only right that some notice should be taken of the changes and the peculiar circumstances of this question here in Debate. They all refer to the hospital known as the Maudsley hospital. Some years ago Dr. Maudsley gave, during his lifetime, and he is still living, a sum of £30,000 for the establishment of a mental hospital, and his idea was, and it was a very great one, that insipient insanity might be treated in the hospital with great prospects of cure. There are very few cases where preventive treatment of this kind can be adopted, and it was a very great idea and a very generous public act that induced Dr. Maudsley to found this hospital. It ought to be clearly understood that his idea was that this hospital should not be an asylum. Unfortunately, the London County Council have already turned this hospital into an asylum. As a matter of fact, the Amendments of which the hon. Member has given notice are really brought forward in order that they may have the name of asylum attached to it in ordinary parlance. As a matter of fact, it will be an asylum under the Lunacy Acts, as may be clearly seen if anyone will turn to the Preamble of the Bill, where they will read— Whereas the council acting as the local authority under the Lunacy Acts have established in the administrative county of London an asylum known as the Maudsley hospital. It is perfectly obvious, therefore, that the main and first intention of Dr. Maudsley's generous action is being thrown to the winds. The place is no longer to be a hospital for mentally curable cases, but it is to be an asylum under the Lunacy Acts. I see a very distinguished Member of the Government and of the medical profession on the Treasury Bench (Dr. Addison), and I trust that he will give us the benefit of his views on this subject. The suggestion of treating insipient mental cases in places which are not asylums where people go who are not certified as lunatics is a very great thing, and to throw aside this opportunity and this unique chance of doing something for this class of mental disease is very unfortunate, and it is particularly unfortunate at the present time, because there are a great number of soldiers returning from the War who are exactly in that position. A number of questions have been put recently in the House to the Under-Secretary of State for War by the hon. Member for the Thornbury Division, who has interested himself very much in the subject. Unfortunately he has not been able to be here to-night. All these questions have been directed to this point, that it is undesirable to send soldiers who have had nerve shock and who are in an unbalanced and dangerous mental condition, not actually certifiable, to lunatic asylums. It is very painful to their friends and relatives, and it is very undesirable in every way. This hospital is now an asylum and only a hospital in name, and a very large number of our soldiers are being sent there. I very much regret that this step has been taken by the London County Council. I know it is extremely difficult for a private Member to get up and oppose the London County Council, because it is a very powerful body, the biggest municipal body we have got, and its proposals are well thought out and discussed beforehand; but I think in this case they have been led far more by the object of getting the benefit of this great gift, and saving the necessity of providing lunatic asylum accommodation elsewhere, than by the real interests of science, of the treatment of lunacy, and of the country at large. I very much regret that this whole part of the Bill, part three, has been brought forward at all. I am not going to oppose it, but I certainly think some justification ought to be put forward. I am very sorry that the hon. Member who moved this Amendment, which is very material and important, should have done so sub silentio. There should certainly be some justification of a policy which, though possibly in favour of the ratepayers of London, is certainly against public policy generally.

8.0 P.M.

There is one other point to which I desire to call attention. The Maudsley Hospital will now undoubtedly be an asylum under the Lunacy Acts. This private Bill is going, in two respects at any rate, to take it out of the provisions and regulations of the Lunacy Acts. First, with regard to having a resident superintendent, which I think is in the next Clause of the Bill, but also in this very important respect that in a lunatic asylum you are not allowed to have voluntary patients. Those persons who are taken in lunatic asylums must all be certified as actual lunatics, and it is absolutely against the Lunacy Acts to take into a lunatic asylum patients who are not certified. This hospital is going to take such patients, and it is really a way of dodging the public Acts to bring this Clause into a private Bill. I shall not take the formal objection which I believe might be taken to it, but call attention to it, because it does not seem fair or right that a Bill of this nature raising these very important questions should be allowed to slip through without being fully discussed and justified.

The CHAIRMAN of WAYS and MEANS

I am quite unable to make out whether the hon. Member is opposing the Amendment or the Clause or the Bill, or is suggesting something that was not in the Bill at all. The Amendment now before the House—in fact, the series of Amendments in the name of the hon. Member—represents a suggestion that I myself made to the county council in order to meet the views of certain hon. Members who came to see me on the matter. I agreed with them that it was desirable that the name "asylum" should not be attached to this institution which is going to be used for the treatment of incipient mental cases, the very thing for which I understood all medical people were most anxious. I may inform the hon. Member that I have information that Dr. Maudsley is perfectly agreeable to the proposals of the Bill, so that I think he need not exercise himself quite so much in the matter. The Amendments are, in fact, that the institution be known simply as the Maudsley Hospital. In order to save the House any further discussion I might refer to the fifth of the series of Amendments, and say that the hon. Member has agreed to move that Amendment without the words in brackets: (After the expiration of such period from the date of his reception as he shall have agreed in writing to remain therein, which period shall not exceed six weeks.) to which the Home Office took certain objection; but together all these Amendments were advanced in a direction to which I thought the hon. Member for North Somerset would not have been opposed.

Mr. HARRIS

I was chairman of the London County Council when Dr. Maudsley first made this very generous offer. I remember that it was explained to him that the county council had no power to build asylums except under the Lunacy Acts. He quite accepted that position. I may point out that, though technically this will be an asylum, it will not be run on the lines of a county asylum. In the first place, there will be a very small number of inmates; and in the second place, it will not have what Dr. Maudsley called, I think, the atmosphere of lunacy, which it is almost impossible to get rid of in a large asylum. There is going to be an outpatients' department to which people can come to get advice and treatment, which I think is a very valuable institution, because there are many people probably suffering from slight mental disturbance who would avail of its treatment. I hope that permission will be given to have voluntary boarders in this hospital. It is all an experiment, and I think a very interesting experiment, and one that deserves well. I am surprised that the hon. Member should think that the object of the county council was to get something in favour of the ratepayer. The fact is that this is going to be a very expensive thing for the London County Council, because, though Dr. Maudsley gave £30,000, the asylum is going to cost more than double that amount and is going to be a very expensive institution per patient. The question of soldiers does not arise. The Government may take the building and use it for soldiers, but that is all. I hope that the hon. Member may be satisfied to some extent with what I have said. The fact remains that technically this is an asylum, but that everything will be done to avoid treating it in the ordinary sense as an asylum.

Colonel YATE

As this building is to be used for soldiers I trust that the word "asylum" may be separated from it. If a soldier suffering from nerve shock, neurasthenia, or any such disease comes home from the War, and is put into an asylum, people may say afterwards, "So-and-so has been in an asylum." I want to prevent that if I possibly can. If the word "asylum" is taken out of this Clause, as the Amendment suggests, I would also ask, if it is possible, that the word "asylum" should be taken out of the Preamble as well.

Question put, and agreed to

Mr. P. HARRIS

I beg to move, "In Sub-section (2), to leave out the word 'asylum,' and insert instead thereof the word 'hospital.'"

Mr. KING

I desire to reply very briefly to the remarks of the Chairman of Committees. I thought that I made my position quite clear. I said that I could not oppose this Bill, or the Clause or the Amendment, but I said that I did feel that such a change and such a policy ought to be discussed and justified. That is just what I have succeeded in achieving, and a very judicious and a very effective defence has been put forward for the Clause as it stands. I am sure that all who take an interest in private Bills know what very great attention the Chairman of Committees give to all suggestions that are brought to him, and especially at this time when these Bills are practically unopposed, and we all feel that his way of looking at things, and considering them in all their lights, is a great safeguard and, if it does not afford satisfaction to every one, does on the whole secure that a fair solution is arrived at.

Question put, and agreed to

Further Amendment made: "In Subsection (3), leave out the word 'asylum,' and insert instead thereof the word 'hospital.'"

Mr. HARRIS

I beg to propose, at the end of the Clause, to add the following new Sub-section:— (4) A voluntary boarder in the said hospital shall be at liberty to leave the said hospital on giving twenty-four hours' notice of his intention to do so.

Mr. KING

No defence was attempted either by the Chairman of Committees or by the hon. Member for Paddington with regard to my point that an asylum is a place for patients certified under the Lunacy Acts. Voluntary patients are not admitted, and this is getting round the Lunacy Acts in a private Bill. There is not only a technical objection to it, but there is an essentially important point. If there are patients in the hospital who are certified as insane it would be much more difficult to get voluntary patients. If yon want persons to come and say that they will undergo treatment in a mental hospital of this kind for several weeks—and the great hope and the great value of this experiment lies in being able to give treatment of that kind to persons voluntarily-giving up their freedom for a certain limited time—you will not get those people if there are in that institution certified lunatics. It is that mixture of the two classes, the voluntary patient and the certified lunatic, which in my opinion is objectionable and is diametrically opposed to Dr. Maudsley's first intention. In the case of soldiers here again there is the strongest objection to sending them to this hospital, because somebody may come along and say, "So-and-so was certified as insane, and was in that place. It must be a lunatic asylum." This mixture of the two classes is a thing which ought to have been avoided, and it is the great objection to the policy underlying this part of the Bill.

Colonel YATE

May I ask whether it is possible, as the word "hospital" has been substituted for "asylum" in the latter part of the Bill, that it should be substituted also in the Preamble?

The CHAIRMAN of WAYS and MEANS

I am advised, for legal reasons, that we cannot do that. The Preamble is not part of the legislative effect of the Bill. It is merely a recital.

Mr. RAWLINSON

I agree that it is desirable to have an explanation, because so many people seem to have misunderstood this Bill, judging from the letters which I have received from persons opposing this Clause. Generally, I am thoroughly an accord with the hon. Member who brings on this matter. Many people misunderstood the effect. This will probably supply a long-felt want, namely, a place where voluntary borders can go, but under the safeguards which the Lunacy Act applies to such places. Attempts have been made to make private houses do this work, and that would be very objectionable, because none of the safeguards would apply. In this case this scheme will be carried out in accordance with the way which has been put before the House in an institution which can call itself a hospital, and which I hope shall be run on the lines of a hospital, but with the safeguards of a lunatic asylum. No one will have any pecuniary advantage in keeping patients longer than necessary. The danger of a private house is that there may be somebody who is interested in keeping a patient longer than necessary. In this case that will not occur. I can hardly believe that anybody would be sufficiently brutal to suggest that a person who has gone voluntarily to such an institution as this would make reference to the fact. I think that the provision, as it stands, will really meet all that the hon. Member requires.

Question, "That those words be there added," put, and agreed to.