§ (1) Any local authority to which this Act applies may make such arrangements as may be sanctioned by the Local Government Board, for attending to the health of expectant mothers and nursing mothers, and of children who have not attained the age of five years and are not being educated in schools recognised by the Board of Education:
§ Provided that nothing in this Act shall authorise the establishment by any local authority of a general domiciliary service by medical practitioners.
§ (2) This Act applies to the following local authorities in England and Wales, that is to say, the council of any county or county borough, the common council of the City of London, the council of any Metropolitan borough, and the council of any borough or urban district having a population of ever twenty thousand:
§ Provided that if any case after consultation with the council of any county the Local Government Board are satisfied as respects any county district in the county that any such arrangements as aforesaid (whether actual or prospective) can more efficiently be made by any district council not being a local authority to which this Act applies, the Board may, subject to such conditions as they think fit, sanction the making of such arrangements by the district council, and the district council may make such arrangements accordingly.
§ Sir W. MIDDLEBROOK
I beg to move, in Sub-section (1), to leave out the words "to which this Act applies," and to insert instead thereof the words "within the meaning of the Notification of Births Act, 1907."
In moving this Amendment I am giving expression to the views of the Association of Municipal Corporations, who are anxious not to take up any position of antagonism to this Bill, with which both the association and myself are in full accord, but to make the measure as universally applicable as possible, and to put the enforcement of its provisions in the hands of those who are responsible for dealing with questions of public health. If the words at present standing in the Bill which I am moving to omit are allowed to remain it will mean that only certain of the authorities who are now responsible for health administration 188 will be entrusted with the powers conferred by this Bill, and there will be excluded from the exercise of those powers all non-county boroughs and urban councils which deal with a population of less than 20,000. The same applies to rural councils. This exclusion would lead to confusion, which it is desirable to avoid. We want to ensure that the authorities shall be identical in each case for carrying out powers which are similar in their purpose and similar in their object.
I should like to support this Amendment. Ever since I have been in the House I have done all I could on behalf of the smaller local authorities, acting as vice-president of the Urban District Councils Association. I am confident my right hon. Friend the President of the Local Government Board will grant this small concession for which we ask. As a matter of fact, he has definitely promised to do so. Some time ago he received a very influential deputation representing county, borough, and rural district councils on this subject, and he told them that, as far as they were concerned in asking that these powers should be conferred on all local authorities, whether they dealt with a population of 20,000 or not, they were pushing an open door. That was on the 18th of October last. On the 24th of last month, when this Bill was being read a second time, the right hon. Gentleman told us that the question of powers was a point for the Committee stage. I think we have the very strongest reasons for hoping that on this point a concession will be made to us. I should like for a few moments to put another aspect of the case to the right hon. Gentleman and to suggest another reason why local authorities, whatever the size of population they may deal with, should have these powers conferred upon them. I am not for a moment opposing this particular Bill. But for the fact that I am vice-president of the Urban District Councils Association I dare say I should not have taken any part in the discussion at this stage. But undoubtedly this Bill, be it a good Bill or a bad one, is one which will constitute another link in the chain that is being wound around the British citizen. We are putting him under still another bureaucratic Department, and, that being the case, I do suggest that we ought to give the British citizen the chance of dealing direct with the man who is to exercise these powers. We 189 ought to enable him, if he dislikes the way in which he is treated by the members of the body who will have the enforcement of the powers, to express his opinion by voting against them if he so desires. Therefore I urge that these powers should be conferred on the small local authorities. Take the case of a man in the county of Middlesex, where there is a great body like the Middlesex County Council, with big offices in London. Suppose the man in question lives in a small rural district with a population of less than 20,000 which has its own district council. What is going to happen if the powers under this Bill are not to be exercised by the district council but by the county council? The man in the rural council area, if he has a grievance against some particular official set up by this Bill, will have to come up to London and try and see some official—some bureaucrat—at the Middlesex Guildhall, and possibly he may have a slender chance of voting against him should he stand for election as a county councillor. But to all intents and purposes this particular aggrieved individual would have no actual redress whatsoever in case something is done under some Clause of this Bill which he thinks ought not to be done. You are thus proposing to impose upon the ordinary citizens further restrictions and to deprive them of the chance of saying "Yes" or "No" as to what is proposed to be done under the Bill. It is for that reason that I support my hon. Friend's Amendment.
§ Sir HENRY HARRIS
I think it right to point out that the effect of this Amendment is to leave the London County Council out of the Bill. I have been asked by that council, on the assumption, of course, that it is one of the authorities under the Bill, to move an Amendment which would raise the question of the desirability or otherwise of the Metropolitan borough councils having concurrent jurisdiction with the London County Council on this question. Should arrangements be made by which both of these authorities will be performing the same duty? I have no information from the London County Council as to whether or not it considers it desirable to be in the Bill. It seems to me that this must depend on what arrangements the Local Government Board have in view under the Bill and how long it is going to be before some permanent measure for dealing with health matters is going to be 190 introduced. I certainly think that the Metropolitan borough councils ought to continue to do the work they are doing as health visitors and in other ways, but I can conceive that the London County Council would play a part in some comprehensive scheme for dealing with health matters in London; for example, they might take action in connection with the provision of maternity hospitals. I cannot think that in such a matter they should be left out. I do not know whether my right hon. Friend is going to accept this Amendment as has been suggested, but if he does take that course I hope it will not be accepted as prejudicing the position of the London County Council when more permanent legislation comes along. I wish to enter this protest. There is great difficulty in dealing with these matters in piecemeal fashion, but for the moment I will content myself with pointing out that this Amendment leaves the London County Council out of the Bill altogether, and any such action deserves careful consideration.
§ Major HILLS
There is one further point on the Amendment which was not mentioned by the Mover, but which the Committee should have before it. I am not altogether out of sympathy with the Amendment, but I think the Committee ought to understand the exact meaning of it. It says that the authority for the purposes of the Maternity Bill is to be the authority under the Notification of Births Act. 1907. Clause 2, Sub-section (4), of that Act names these authorities as the county councils, the borough councils, and the urban and rural district councils, which were given a chance of adopting that Act. But in 1915 another Act was passed which said that all the authorities which had adopted the Act were to remain the authorities for the Act, and where authorities had not adopted it they were to adopt it with the proviso that where a district council did not adopt the Act, then the authority should be the county council. If the Amendment is accepted in the form in which it is drafted it will practically effect the repeal of Clause I of the Notification of Births (Extension) Act, 1915. It there says that the county council is to be the authority and not the district council. I do not think that is the wish of the Mover of the Amendment. I do not think he wishes to go back on the Act of 1915. There is a good deal to be said on the general principle for not 191 multiplying these committees. I myself have another suggestion to make that I like better, only I cannot refer to it now—at least, I can only refer to it. The proper authority in the case of the county is not the notification of births committee, but the health and housing committee, which all councils are now obliged to set up under the Housing and Town Planning Act, 1909. I am afraid this is rather wearisome to the Committee, and it is rather technical, but there is a real point behind it, for if we accept the Amendment in the form it has been moved by my hon. Friend, we repeal by implication Section I of the Notification of Births Act, 1915, and we also leave out a large number of districts and a great many councils which did not adopt the Act of 1907 until they were compelled to do so in 1915. So it is quite clear that the Amendment cannot go as it is. On the general question I am with my hon. and gallant Friend the Member for Enfield, that the multiplication of authorities is bad. I also feel great difficulty in dealing with the question piecemeal now. It puts us in a great difficulty. I think on the whole the better plan is to use the existing machinery, that is the committee under the Notification of Births Act, or, as I think, the health and housing committee, but as the Amendment is drawn it will not do.
§ Major ASTOR
May I ask the President of the Local Government Board whether, if this Amendment is accepted, Sub-section (2) would be ruled out? It also deals with the local authorities. Before we go further in discussing this Amendment, and certainly before we vote, we ought to know what effect the Amendment would have on that part of the Bill?
§ Mr. BOOTH
I feel quite sure that we are not dealing with an unsympathetic President of the Local Government Board in asking that these non-county boroughs and the large urban districts should have a chance of helping him. I take it this is largely an empowering proposal, because it only asks these various authorities to be in a position to make such arrangements as may be sanctioned by the Local Government Board. There, I think, is ample power against overlapping. If one authority is dealing with the matter satisfactorily I cannot conceive that the Local Government Board would sanction another 192 authority in spending money in duplicate. I should be sorry to think that. Where, on the other hand, for some reason or another, an authority is backward, I do not think a progressive non-county borough or a progressive urban district council should be refused the chance of co-operating in this scheme. I remember my right hon. Friend attending the annual conference of the urban district councils, and I think he will agree with me that, considering the difficulties under which many of them labour in the fact of rapidly growing districts, no more public-spirited bodies are in existence in the State than the urban district councils. The right hon. Gentleman will, I feel quite sure, admit that the rural councils, as well as the many larger councils, have given much time and a great deal of self-sacrificing labour to assist matters of local government. It would be, I think, an ill-recognition of their local patriotism if in a Bill like this these authorities were refused all recognition. The matter is not one which needs much speaking about. I merely rise to say that there will be keen disappointment on behalf of those engaged in these difficult public services, whose members are endeavouring to work in harmony with the Local Government Board, if they are not allowed to come into these matters. I made the same plea in connection with the Education Bill. The plea is even more permanent here. It carries me beyond the immediate subject. If you say to these authorities time after time, "You shall not help us, you are not big enough or good enough, you shall not come into this new idea, or have these new powers, we shall not give you this new confidence," then so much the worse. I remember well when business men refused to go upon boards of guardians because, they said, they were bound up with red tape from Whitehall. They said, though, they would become members of municipal corporations. If you do as is suggested in an enlightened measure of this kind, and pass by a number of distinguished authorities, the tendency is to dishearten workers in local government, and, as I say, to lead desirable people to look askance at the matter. If my right hon. Friend will encourage them on this occasion, will give them a chance under the Bill to play a little part, I am sure it will be appreciated.
§ Mr. SHERWELL
Like other Members, I am thoroughly prepared to endorse the 193 principle of this Amendment, but for the misgiving which already has been indicated as to how far it will actually limit the operations of the Bill. As one of those jointly responsible for the introduction of the Notification of Births Act, 1907, it was rather a misfortune to have its possible usefulness circumscribed by the unwillingness of the then President of the Local Government Board to accept it on a compulsory basis. It was in consideration of his support that the promoters of that Bill made the Bill optional. The very fact, however, that the Bill was made optional has determined the number of authorities prepared to accept the powers given in the Bill. I am not at all sure that the case of both parties might not be met, that the case of the promoters of this Amendment might not be met, by some slight subsequent alteration in the terms of the second paragraph of Sub-section (2) of this Bill, where the President of the Local Government Board takes power to sub-divide a county area, and the special case of certain districts by consultation with, and with the approval of, the county councils. If the right hon. Gentleman could hold out the possibility of redrafting that particular Sub-section so as to give himself power not dependent upon the sanction of the county councils, that might meet the case of the promoters of this particular Amendment.
§ The PRESIDENT of the LOCAL GOVERNMENT BOARD (Mr. Hayes Fisher)
The discussion has been as to what the area should be in which these powers should operate, as to what councils we shall entrust the carrying out of any of the powers, which either can be exercised now under Treasury Regulations, or will be able to be exercised under the new Treasury Regulations, which I hope to publish very shortly. There were three possibilities. The first was to follow the lines of the Act of 1907, amplified by the Act of 1915, that is to say, that all sanitary authorities, both large and small, all county councils, borough councils, urban district councils, and rural district councils—omitting the London County Council—that we should give to them, one and all, great or small, all the powers which were given by the Act of 1915, and which will be given by this Act, very much amplified and extended, in my opinion, by the new Treasury Regulations. That was one possibility. Another possibility was to follow the line that I certainly thought 194 from the statement made by my two hon. Friends (Majors Hills and Astor) was their view. Certainly, if I may judge from their Amendments, they seem to desire to limit the user of these powers to boroughs of more than 50,000 population.
§ Mr. FISHER
Under the supervision of the Local Government Board; so that the power, even after consultation with the London County Council, is not to be given to smaller bodies than those of 50,000 population. I certainly judged that from the Amendment put down. I did not gather, from their speeches, that the view they held, and which my hon. and gallant Friend the Member for the City of Durham——
§ Major HILLS
I think I must interrupt the right hon. Gentleman here. I appear to be misunderstood. I am afraid I did not make myself clear. I have an Amendment down which gives power to the authorities, under the Notification of Births Act, 1915, to subject to a numerical limit. In my speech I should have made that clear, that the only terms on which the Amendment ought to be accepted are the inclusion of a numerical limit.
§ Mr. FISHER
My hon. and gallant Friend certainly did not make himself clear to me. As I was saying, the third, alternative was to take the middle course, which is one we very often do take, and make a limit to the size of the borough and of the urban district council to whom you give these powers, a population of about 20,000; and to give the Local Government Board the option, the discretion, after consultation with the county council, to enable these smaller bodies—smaller than 20,000 population—to exercise either the whole of the powers or a portion of the powers for any particular district in which they may be the authority. These, then, were the three possible courses open to the Government. The Government, in framing the Bill, followed a middle course. After all, there is a good deal to be said, and has been said, for still leaving these powers in the hands of the smaller authority. There is a good deal to be said because, after all, even the very smallest authority, and any authority, great or small, can only make such arrangements as are sanctioned by the Local Government Board. Those who think, as I think, and as the Local Government 195 Board always has thought, that a great many of these schemes will undoubtedly be far more successful if they extended over the larger area, can remember that this would still give the same opportunity for the Local Government Board to say, "So far as the portion of the scheme which you submit to us in concerned, we think that it may be worked much better over a county area than it will be worked by half a dozen small district councils, each trying to work their own scheme in the county council area."
It seems to me that by giving power to the Local Government Board to sanction any arrangement, you leave it to their discretion to choose the larger area for some portions of the scheme, while they may choose a smaller area for some other portion of the scheme. If the House were to decide on that arrangement—that is, to give power to the Local Government Board to sanction any arrangement put forward, either by the larger or by the smaller authority—so far as I am concerned, I should offer no objection. My hon. and gallant Friend the Member for Enfield (Major Newman) is quite right when he says that a very powerful deputation, representing urban district councils, gave an explicit assurance that they would be most willing to carry out these powers, but I want to discriminate between these powers, because some of them are much better carried out over a large area. There are other powers, such as the treating of expectant and nursing mothers, the power of establishing creches and matters of that kind, the power to establish perhaps a lying-in-home for certain unfortunate mothers—all these might operate over a district not of the larger size, and this would necessarily have to be part of a whole scheme, whereas other portions of a really comprehensive maternity and child welfare scheme would be infinitely better spread over the whole county. I have tried to get the opinion of the House on this point and the Committee seems to me to be willing to leave these powers in the hands of all those sanitary authorities, both large and small, and to trust to the Local Government Board not to sanction any arrangement made by any of these smaller authorities in smaller areas, if it thinks those arrangements ought to be made over the larger areas. If that is the opinion of the Committee, I shall be ready to accept the Amendment.
§ Mr. GEORGE THORNE
I think what the right hon. Gentleman has just stated represents the prevalent feeling inside and outside this House, and after what he has said, I trust the Committee will be willing to accept the Amendment.
§ Major ASTOR
I am very much surprised that the right hon. Gentleman has not given the Committee a lead on this point.
§ Mr. FISHER
I have already expressed the opinion that if the Local Government Board had power to sanction the arrangement, then, if part of the scheme would operate better in a larger area, or part would operate better in a smaller area, the Local Government Board should have power to sanction such an arrangement.
§ Major ASTOR
Then I gather that my right hon. Friend thinks that the larger authorities should have the power to delegate their powers to the smaller or subsidiary authorities. [HON. MEMBERS: "No!"] Then I take it what is suggested is that the smaller authorities are to be able to exercise these powers if the Local Government Board approves, and that otherwise it should be the larger authorities.
§ Mr. FISHER
If the Amendment is carried, any local authority within the meaning of the Notification of Births Act, 1907, may make such arrangements as are sanctioned by the Local Government Board. The Board will have power to say, "We do not sanction or we do sanction the scheme, or we sanction it conditionally, or we may prescribe that it shall fall into line with the rest of the county."
§ Major ASTOR
Then I misunderstood my right hon. Friend. I sincerely trust that we shall stick to the larger authorities. This point was discussed a few days ago in another place on the Midwives Bill. Under the 1902 Midwives Act, the larger authorities have power to delegate their powers to the smaller authorities. When this point was dealt with the other day in another place and they were dealing with that particular power, that Clause was repealed, so that only the larger authorities now have the power of exercising those functions under the Midwives Act, 1902. I think it would be a great pity if at the same time, within ten days, this House should pass another Bill dealing also with maternity, giving powers very similar to a different local 197 authority. I think that would not tend towards efficient administration. The reason the House of Lords repealed this particular Clause in the Midwives Act of 1902 was that they found it operated detrimentally. There was a Departmental Committee appointed in 1909, and they inquired into the working and operation of the Midwives Act, and that Committee emphatically recommended the repeal of the power of the delegation of the powers of the larger authorities from the county councils to the smaller authorities within their areas. They found in certain cases—I believe there were ten cases—that county councils had delegated their powers to the smaller authorities, and this power had to be revoked because it worked unsatisfactorily, and as a result of the practical experience of the working of the Midwives Act they came to the conclusion that the power should be exercised by the larger authorities.
My right hon. Friend just now, in suggesting that the smaller sanitary authorities should exercise these powers, said that some of them would only probably exercise some of the powers given to them—that is to say, that within a county you might have adjacent authorities exercising a certain quantity of the powers available. You might have one authority exercising 40 per cent. of the total powers available, and this might be sanctioned, and later on, after this had been in operation some time, an adjacent authority might get powers to carry out 60 per cent. or even 70 per cent., of the powers available, so that in one county you would have different powers in operation. I think it simplifies administration to have equal powers exercised in large areas, and not to have different rules and regulations in adjacent smaller areas. The bigger the district over which you have powers, the better it is for administration. In my view, the tendency nowadays is to give powers to the larger local authorities and not to encourage the smaller authorities to come forward with comparatively small schemes. I admit that the local authorities have done excellent work, but the whole tendency has been to give new powers to the larger authorities, and I suggest to the Committee that, in view of these facts, and the fact that in another place a larger authority has been selected for dealing with the Midwives Act, it would be a great pity within ten days to give powers dealing with maternity to a 198 different local authority. Therefore, I hope the Committee will decide in favour of the larger authorities.
§ Mr. ROWLANDS
First of all, I desire to congratulate the President of the Local Government Board upon the attitude that he has taken up in regard to this Amendment. I think he has shown a very fair spirit in trying to meet the various differences that exist in the House. The right hon. Gentleman has clearly denned to the House that, in accepting this Amendment, he maintains, or rather retains for the Local Government Board, full power over all schemes that may come in, and at the same time he has not lost that entire faith in local life which some of our hon. Friends seem to have lost, and which many of us have studied for a long period, and have seen great and good work done under those local authorities. We have also seen the work done by these men and women locally earn the esteem and respect of all those with whom they have been associated. I should like to point out, in asking for the powers still to be given in some of the smaller authorities, that we are not asking for a power to be given that is not in many instances being worked out well at the present time. Last night week I was down in one of the urban council districts in my own Constituency in the Erith district, where we were celebrating baby week, and the great work done during 1909, and especially the work done in later years and the work of the institution which has been started. This organisation has in full swing nearly all the things that you require. They have trained nurses and doctors, institutions, maternity classes, and all that is considered to be necessary under this Bill.
If you go into the urban district council area of Dartford, you will find that they are doing the same kind of work, and you will find that they have at the present time no less than nine maternity centres and three visitors, and they are advertising for a fourth visitor. I am sure that where there is public life in a locality a great deal of this work is being done, and that is what I desire to see maintained. It has been of the greatest benefit to the people of this country, and gives work to those who are deeply interested in the locality. I could take you to one or two of those places and show you how ladies and gentlemen and working women, who, I am glad to say, 199 have plenty of public spirit, are devoting themselves to this work, and it is on their behalf and in their interests and that of the community as a whole that I am pleased to think that the right hon. Gentleman is not going to snuff out all these local bodies, but is prepared, under such safeguards as he thinks necessary, to keep them in existence.
§ Mr. THEODORE TAYLOR
There is one thing that has not been mentioned yet that I think reinforces very strongly the argument for enlisting the work of smaller local bodies, and that is the coming into public life of women. You are now for the first time to have an enlarged body of electors, much larger than formerly, and they take a great interest in these questions. That is an additional reason, it seems to me, why we should not extinguish these sparks of local patriotism. I think the hon. Member for Plymouth (Major Astor) is a little mistaken in the interpretation he puts on the attitude of the President of the Local Government Board towards this matter. I did not understand the President of the Local Government Board to say that all the small bodies are equal to doing the larger kind of work suitable to the larger bodies, but I did understand him to foreshadow, at all events, that the Local Government Board would endeavour to divert the work of the larger bodies to the larger issues. It seems to me that this elasticity of scheme which the hon. Member for Plymouth seems to deprecate is one of the merits of the measure, and that is one reason why I desire to support it. I know the feeling of the larger bodies throughout the country. They have been expressed in this House for many years past. I remember very well that other measures of local legislation have been brought forward where the smaller bodies have been quite indignant, for instance, that a local body of 20,000 population should not have the same rights as a small borough with 5,000 or 10,000 population. I think we have got past that. I think the tendency of the time is to allocate more and more work for the local bodies and cause them to feel that they have a real interest in these questions.
§ Colonel WEIGALL
May I humbly submit to the Committee that it is not a question of small bodies versus large bodies? We are all probably agreed 200 that there is a useful sphere both to large bodies and small bodies, but, as far as this particular measure is concerned, it is not a question of small bodies or large bodies. I would suggest to my hon. and gallant Friend the Member for Plymouth that if you are to have this Bill the arrangement suggested by the President of the Local Government Board is far and away the best. It gives an elasticity and business arrangement which no other system will give. I do not want to disguise from the Committee my general view, for expressing which, I hope, I shall not be called to order, that it appears to me that in all this legislation, so long as you cannot guarantee our immunity from the jealousy of one Department of another, and also from the local authority point of view, the question whether it is to be a 1d. rate or a ½d. rate, I do not think you will go really very far in social reform. At the same time, I know the immense amount of good work that has been done on local authorities, and I suggest to the Committee that now we have got the umbrella of the Local Government Board over all these authorities, the suggestion made by the President of the Local Government Board is far away the most workable.
§ Mr. MORRELL
I do not want to detain the Committee, as I am entirely in favour of this Amendment. I merely want to clear up my mind on one particular point. I presume that it is the policy and intention of the Local Government Board to extend these maternity classes in time to the whole country. What I want to know is, Is anything being done now to prejudice that extension? It seems to me that if these provisions are good for one locality, they are probably good for another. I do not know why we could not have a simple form of words that any council may make such arrangements as may be sanctioned by the Local Government Board. I do not know what is the virtue of the particular words of the Amendment.
§ Mr. MORRELL
I want to make it quite clear that the smaller boroughs will be admitted and that it is the policy of the Government that this shall be extended in time to all local authorities.
§ Major HILLS
I hope the Committee ill realise the revolution they are 201 making. It is simply a complete change from top to bottom of the Bill as it was presented. It included only the urban councils of 20,000 and over. We are now letting in, urban and rural councils of all sizes. The 20,000 limit is to go absolutely. I should like to ask my right hon. Friend this question. He says, and I agree to a very large extent, that there is a proper work for both the larger and the smaller bodies, but where does this Bill give him power to divide power between these two authorities? It is perfectly clear it does not. This Bill grants certain powers to certain authorities but does not give power to divide it. Unless the right to divide these powers be more clearly included it is perfectly clear that they cannot be divided. Before we give these very autocratic powers to the Local Government Board we ought to know on what principle they mean to distribute the duties between the larger and the smaller authorities. In the past, unfortunately—I speak entirely of the past—the reputation of the Local Government Board has been that they favoured the smaller against the larger authorities. I have to call attention to this also that all the Members who have spoken with the exception of my hon. and gallant Friend are all more interested in urban district councils. Assuming that there ought to be certain powers for a large area and certain for a small area, which is the best authority to delegate, the Local Government Board in London or the county council on the spot? Here I am quite sure I shall receive the assistance of my hon. and gallant Friend the Member for Enfield. I want to make a stroke for local rights on a bigger and wider scale. I believe if there is to be anybody who has got the power to delegate it ought to be the local authority. I am not a great friend of the Bill. It may do more good than harm, but that is a doubtful point, but if my right hon. Friend is anxious for his Bill to succeed I do ask him to pause before he sets up these small rural councils against the county councils. I do not think it is the way to get what we want. We all want a distribution of power, the larger powers of healing to the larger authority and the smaller powers of domiciliary treatment to the smaller authority. I believe that if we carry the Amendment in this form, including the rural district councils and leaving out the 20,000 limit, the Bill will be a failure.
§ Sir F. BANBURY
I am in a difficult position. I see my Socialistic Friends opposing this Amendment on the ground that the Bill will do more harm than good if the Amendment is carried. There I agree. I do not believe in all these sort of Bills. I really do not quite know where I am or what I want to do. Is it a reactionary Amendment or is it an Amendment which tends in the direction of Socialism? I am not quite certain. I think on the whole if we go to a Division I shall have to abstain.
§ 5.0 P.M.
§ Sir H. NIELD
I hope the right hon. Gentleman will be reassured when he sees me joining not the Socialist ranks but the ranks of those who are protesting against this Amendment. Not a little pressure has been put upon me to support the proposal to introduce the lower limit of population, but I have resisted. What has struck me as so remarkable is that those who have become responsible for putting down this Amendment are in the happy position of not being affected. All of them but one are so situated as not to have a direct interest at all in the reduction. As one who has worked for many years on a county council, I protest against the extravagance, particularly in these times, of allowing a smaller body with 20,000 population to set up its own machinery under this Bill. It is perfectly clear that persons would not be able to give profitably their whole time to this work. Therefore, the authorities would have to appoint an officer who is partly an officer under this Bill and partly under something else. That is not at all desirable. In my own county of Middlesex I do not suppose that we have more than three or four rural districts or areas which will profit by this redistribution. There are two municipal boroughs and there will be three or four Parliamentary boroughs presently. The rest of the areas are big urban districts, whose area is sufficiently large and whose population is sufficiently large to justify the appointment of a whole-time man. We have actually got schemes in existence. We have actually maternity schemes in force. Are those to be completely cut out in order to make way for the powers of these smaller bodies? I am quite sure that my right hon. Friend in charge of the Bill, although he may have an intimate knowledge of the working of the county of London—in that he is second to none—does 203 not know how these measures affect an ordinary county council with regard to its rural areas. With all respect to those persons who take part in public life in the rural areas, I say that you will not get in those districts the right type of man, even if you could justify their appointment from the point of view of the work that is being done, who would be able to carry out this work half as efficiently as the county council for the area. I do not know that anybody can indict the county councils, at any rate justly, because they have discharged their duty in matters of this sort uncommonly well. I would urge, in the interests of economy, which is so necessary at this time, in the interests of good administration, and in the interests of getting an area sufficiently large to get a competent person at a competent salary, that this Amendment should not be accepted, and that the size of the area should not be cut down.
§ Sir J. SPEAR
I heartily support the acceptance of the Amendment because I believe it will make for the success of the measure. We are all convinced of the great importance of taking steps in the direction of maternity and child welfare. The only difference at issue is how to bring it into operation. I support the Amendment because it will enable the people affected to express, through the local bodies, what they wish. The mothers will be able, through the local bodies, to give effect to their preferences and their wishes with regard to the administration of the measure. While they have practically no influence at all on the county council, they will have that influence on the local council. Acting on the principle of the Government of the people by the people, we must accept the Amendment with the knowledge that thereby the people whose interests will be affected by this Bill will have an opportunity of deciding who shall be the men and women who will administer it.
§ Colonel Sir HAMAR GREENWOOD
I rise to support the Amendment. With reference to the comment made by various speakers who have opposed it that those of us who support it are not in direct touch with the counties, I would point out that the three hon. Members who have led the attack upon the Amendment cannot claim to speak for the counties themselves. The only two hon. Members representing 204 county divisions who have spoken in the Debate are the hon. and gallant Member for Horncastle (Colonel Weigall) and the hon. Member for the Tavistock Division (Sir J. Spear), both of whom supported the Amendment.
§ Sir H. NIELD
Enfield is not a county, and the hon. Member for Dartford (Mr. Rowlands) also spoke against it.
§ Sir H. GREENWOOD
At any rate, three county Members have supported it. The fact that no county Members have seen fit to come into the Committee at this time when this important measure is being considered proves to me that the county people are not the people to be entrusted with these duties as against the central bodies now carrying them out and who are at present empowered to carry them out in Scotland and Ireland. The President of the Local Government Board says that he desires to meet the views of the House of Commons. It shows how far we have travelled from any spirit of democracy when a Cabinet Minister has to say that he is anxious to meet the views of the House of Commons. I am glad that at least there is one who is prepared to listen to the House of Commons in matters of this kind. The President of the Local Government Board will be able to look back on a long life with considerable pleasure in knowing that he has always been anxious to accept the views of the House of Commons. The acceptance of this Amendment is in accord with the views of those most concerned, namely, the smaller bodies. Several deputations from them waited upon the President of the Local Government Board in reference to this measure, and they have asked that there should be granted to them these powers which, through a miserable squabble between two English Departments of State, were denied them, but were granted to Scotland and Ireland under the Notification of Births Act, 1915. We are now desirous of giving to the predominant partner in this realm powers which were denied to it owing to what I may call a fluke in 1915. The point that appeals tome in regard to this Amendment, and in regard to the Clause, is the fact that anything that is done is subject to the approval of the Local Government Board. As the Government finds a large portion of the Grant that will go to these various bodies, we can be assured that the Local Government Board and the Treasury 205 between them will see that the schemes submitted to them are good schemes, and that the money which is to be administered by the local bodies will be well administered. The Local Government Board especially is under the eye and immediate control of the House of Commons. I am one of those who believe in strengthening the Ministerial Department involved which is under the direct control of the House rather than in strengthening or giving larger powers to a large number of local bodies, like the county councils in this case. I prefer to have the House of Commons as the immediate lever for good work rather than the county council:
§ The SECRETARY for SCOTLAND (Mr. Munro)
I have considerable hesitation in intervening in an English Debate, particularly after what was said by the right hon. Baronet (Sir F. Banbury), who seemed eager to deny me the right to sit on the Front Bench on occasions. While that is so, perhaps the Committee will allow me to say a word or two with regard to our experience of the Notification of Births Act in Scotland. After all, we have had some experience on the other side of the Border of the working of that Statute which it is now proposed England should secure for itself. In Scotland, as the Committee know, under the Notification of Births Act, 1915, there is no restriction laid upon the size of the authority which is to exercise the powers under that Act. The powers are exercised by burghs, whether large or small, by public health authorities of the counties, whether large or small, and I am glad to say that our experience of the working of the Statute has been entirely satisfactory. I am told that at the present time child-welfare and maternity schemes are in progress affecting two-thirds of the population of Scotland. That is a very creditable record, considering the short time the Act has been in operation. While I should be the last person to dictate, or even to suggest, to English Members what they should do in England, they might perhaps consider it relevant that I should state, as I do here, that I know that the Act in Scotland, without any restriction as to the size of the authorities, has worked exceedingly well. I do not see why a system which has worked well on the other side of the Border should fail to work well on this side of the Border.
§ Mr. ALDEN
May I make one suggestion? There is something to be said for 206 the position taken up by the hon. Member for Ealing (Sir H. Nield). There are certain small local authorities who fail to carry out their duties. Over and over again the Local Government Board has remonstrated with those smaller authorities because, legislation having been placed on the Statute Book, they have failed to carry out their duties and have been compelled to do it. That is a good point. But, on the other hand, as the hon. Member for Tavistock (Sir J. Spear) has said, if you can interest the people of the actual locality in a Bill of this nature, you have undoubtedly secured a great point. If we hand over too much to the larger authorities, we fail to excite that interest in the smaller localities which is so desirable. My object in rising is to suggest to the Committee and to the President of the Local Government Board that, in any case, supposing the Bill stands as it does without the Amendment, the right hon. Gentleman might leave himself free, as has been done under other Acts, to include smaller local authorities where necessary and when they have shown their desire to carry out this Bill on their own account. There are certain small local authorities that are rather cut off, and which are not in very close touch with the county councils. At the same time they have displayed over and over again their zeal in local government work. In such cases, supposing the Bill stands as it does without the Amendment, it might be possible for the right hon. Gentleman to say, "We reserve to ourselves the right to give to these smaller authorities of 20,000 population or under the power to administer this Bill on their own account." I should prefer the Amendment as it stands on the whole, but if we cannot have that, I would suggest that the President should meet us in that way.
§ Mr. FISHER
I think we might possibly bring our Debate on this Amendment to a conclusion. The voices I have gathered from the Committee, whether they come from the urban areas or from the county areas, have satisfied me that in accepting the Amendment I am following the wishes of a very strong body of opinion in the Committee. So far as I am concerned, I accept the Amendment without any sacrifice of my own judgment. Let me assure my hon. and gallant Friend the Member for Durham (Major Hills), that the Local Government Board, at all events since I have been its 207 President—and I think I may say for long before that—has followed the general practice of enforcing the larger areas rather than the smaller areas for large schemes. I have here a circular of the 23rd September, 1916——
§ Mr. FISHER
Perhaps it is a long past. Here is a paragraph of that circular, which says:The experience which the Board have hitherto gained confirms them in the opinion that as a general rule the smaller sanitary districts can be served more economically and efficiently by a county scheme than by separate schemes for each sanitary district, provided that proper co-operation with the sanitary authority is secured.We have not gone at too great a pace, at any rate for me. I know that the pace does not at all suit the right hon. Baronet opposite (Sir F. Banbury), but then he cannot get any horse to go his pace—it is too slow. We are constantly adding to what is called the comprehensive scheme of maternity and child welfare, and anybody who examined it will see that some of the items are better suited to a large area, and others are better suited to a smaller area. My hon. and learned Friend the Member for the Ealing Division of Middlesex (Sir H. Nield) should not lay too much stress on what the county councils do and what the smaller local authorities do not do, because sometimes the smaller local authorities set a good example to the larger authorities. There are laggers in maternity and child welfare schemes, sometimes among the larger authorities and sometimes among the smaller authorities. They are not always to be found in the smaller areas. There is no doubt, as my hon. and gallant Friend the Member for Sunderland (Sir Hamar Greenwood) says, that the Local Government Board have very great powers in being able to give or to withhold the Grant. It gives them a large power in the schemes and the area that they will sanction I believe the Committee have come to a wise conclusion. At all events, we shall now be able to try this measure and put it into the power of local authorities, both large and small, to carry out what has been done in Scotland, covering two-thirds, and, I hope, before long, the whole, of England and Wales with schemes of this kind.
Mr. HUGH EDWARDS
I only intervene to thank the right hon. Gentleman for having accepted the Amendment. We have heard a good deal about Scotland and England, but no one has spoken for the principality of Wales. The President of the Local Government Board will be glad to know that the smaller authorities there have been unanimous in their request for this compulsory power, and that the feeling there is exceedingly strong. I venture to say that the local authorities of Wales in this matter have shown even more wisdom and esprit de corps than either England or Scotland.
§ Major HILLS
I take it, if this Amendment is carried, that the whole of Subsection (2) of Clause I will come out?—[HON. MEMBERS: "Yes!"]—I am glad to hear it.
§ Question, "That the words to which this Act applies stand part of the Clause," put, and negatived.
§ Sir W. MIDDLEBROOK
On a point of Order. Do not the words "within the meaning of the Notification of Births Act, 1907," require inserting?
§ The DEPUTY-CHAIRMAN (Sir Donald Maclean)
I am very much obliged. There was some confusion between the "Ayes" and the "Noes," which for the moment distracted my attention from the remainder of my duty.
Question, "That the words 'within the meaning of the Notification of Births Act, 1907,' be there inserted," put, and agreed to.
§ Major HILLS
I beg to move, in Subsection (1), to leave out the word "may" ["to which this Act applies may"], and to insert instead thereof the word "shall."
I am not at all sure that it is worth while moving this Amendment now that the Committee in its wisdom has decided that the authority which is to exercise the powers under this Bill is to be the smallest authority that we have, namely, the rural district council. When I put this Amendment down, I thought that I was dealing with county councils, with the large boroughs, and with urban districts of 20,000 and over. You can compel them to carry out the provisions of the Bill. You can compel them to raise a rate for the 209 purpose, and it is quite fair that you should do so. Unless the Act is made compulsory, I do not see that any good will be done. Otherwise, all that you would do would be to cause the advanced local authority to adopt the Act. I suppose the less advanced would not do so, and you would really remain in very much the same position as now, for, as the President of the Local Government Board informed us on the Second Reading, the progressive authorities at present, by hook or by crook, are doing the work that they will be enabled to do under this Bill. It, therefore, seemed to me that the best plan was to make the Act compulsory, and I still strongly feel so; but how can you compel a little rural district council with a weak personnel, no financial powers at all, and no experience to set up all this vast machinery?
§ Major HILLS
Yes, I am moving it. I am trying to explain the difficulty in which the President of the Local Government Board has placed us by revolutionising the basis of the Bill without notice. I do not see how we can compel a small rural district council. We might just as well try to compel a parish council. The Committee, however, has chosen to make the authority under this Act the small local authority. It has given the go-by entirely to the county council, and it is perfectly clear that there is no power to divide the duty under the Bill. I noticed that the Secretary for Scotland was extremely reticent on that point. There is no power to divide the duty, and it is therefore all or none. I formally move the Amendment in order to ask the President of the Local Government Board how he means these powers to be exercised.
§ Mr. SHERWELL
The point is more important than the Mover of the Amendment in his speech suggested. The provisions of the Bill proceed upon the assumption that the powers provided in it are of great importance from the point of view of the health of the children and of the nation. If the importance is such as to require the introduction of provisions of this kind, I cannot understand why the recognition of the importance of the provisions should not be made compulsory. 210 May I remind my hon. and gallant Friend the Member for the City of Durham (Major Hills) that in the actual experience of the operation of the Notification of Births Act, it has happily been proved that some of the smaller authorities are very ready and alive to adopt the optional powers given them under that Act?
§ Mr. SHERWELL
I have already explained that although that Bill, as originally introduced by the present Minister of Blockade and myself, was compulsory, we adopted the suggestion of the then President of the Local Government Board in Committee upstairs and made it optional in order to win his assent, because as private Members we were quite aware that there was not the least chance of procuring a private Member's Bill unless we had his support. Even under the voluntary basis it has proved that a number of the smaller authorities have been prepared to adopt the powers. It does not seem to me that there is any radical objection to making these powers mandatory, especially in view of what the President of the Local Government Board said a little time ago that he retains discretionary power, in sanctioning a scheme, to say that certain powers may be operated by a smaller authority, and that other larger powers shall be operated by a larger authority. The Bill in this Section provides that the schemes proposed shall be subject to the sanction of the President of the Local Government Board, and it is perfectly easy to see that he may make his sanction conditional on some such arrangement as he has suggested. I attach so much importance to the value of these provisions that I sincerely hope that the hon. and gallant Member will press his Amendment in a rather more serious spirit than he exhibited in moving it.
§ Mr. FISHER
This, to my mind, is a very important Amendment which raises a large point of principle, and I hope it will be a long time before this House makes it mandatory upon local authorities to carry out schemes of this kind. I am a thorough believer in local government, and by local government I mean giving power to local authorities to decide whether or not they shall carry out schemes of this kind, and, indeed, 211 schemes of many kinds. There is no doubt a very strong disposition throughout local bodies, large and small, to advance very considerably with schemes for maternity and child welfare, and we have no case at present for any mandatory measure to coerce them. Let us try the policy of persuasion, plus the policy of Grants. We have not tried it sufficiently. I quite admit that many local authorities are not doing anything like as much as the Local Government Board would like them to do in the direction of maternity and child-welfare schemes, but there is a very strong body of opinion which is growing round this question, and which will be able to make itself felt at the next election, when, I believe, it will have a stimulating effect upon those local bodies. In Australia it has been found that the women have not supported either the one party or the other on the larger questions, but have concentrated on matters of domestic policy that concern the health of the mother and the children and the sanitary condition of the houses in which they live, and I believe that the enormous women's vote that we are going to have will give a very great stimulus to the local authorities to put into force the powers that are now being given them, and which have been backed up by the Treasury in a very generous way by Grants which are placed at the disposal of the Department over which I preside. I believe it is far better to trust to the stimulating effect of public opinion on the laggard local bodies. I am thoroughly in agreement with this policy, and I think local authorities will be wise if they spend a limited portion of the money which they can raise from the rates to join with the money which is given by Treasury Grants for purposes such as these, and they will immensely improve the health of their people at no very great expense. But I do not think the time has come to make these powers mandatory.
§ Sir H. HARRIS
I should like to say a few words on this important question as one who has long experience of municipal government. When Parliament has definitely made up its mind that it wants certain things done in the localities, the doing of those things ought to be made a duty and not an option. Governments in the past have been rather apt to give optional powers to local authorities, and to make the fact that they are 212 optional an excuse for not making any Grant-in-Aid. But while I hold that view, I think there are great difficulties in converting this into a compulsory Clause. I am a believer in local self-government, and I think there is a limit to the extent to which you can spoon-feed the local authorities. The right course to adopt in connection with matters of this kind is, in the first place, to throw the responsibility direct upon the local authorities, and leave it to them to exercise some originality and to use their knowledge of the needs of the locality. You want also power to put pressure upon local authorities, but I cannot help thinking the right way of dealing with the matter is what has been adopted in the present Education Bill, where it is laid down in Clause 2 that any local authority "shall make adequate and suitable provision" for doing certain things. It should be provided in this Bill that any local authority shall make adequate and suitable provision for attending to the health of expecting mothers, and so forth. At the end of the Clause in the Education Bill it is provided that "any such authority from time to time may and shall, when required by the Local Government Board, submit to the Board a scheme for the purposes aforesaid." In any permanent legislation the matter ought to be dealt with in that way. But I think there are great difficulties in turning this into a compulsory Clause, and therefore, on the whole, it would be best to leave the Bill as it now stands.
§ Mr. ALDEN
I wish to echo what the hon. Member has said. On the general principle I should be in favour of turning "may" into "shall," but on this occasion it would be as well to try the experiment of seeing what the President can do by bringing persuasion to bear on local authorities, with the addition, of course, of Grants-in-Aid. I would suggest that, instead of merely sending the ordinary circular to the local authorities informing them of their powers under this Act, he should send with it a statement as to how these maternity committees are to be formed, and an illustration of how they have been formed in many districts. It seems to me that many local authorities fail to carry out Acts of Parliament because they do not know at the time just how to carry them out. They want that little extra bit of persuasion and advice which the President can very 213 well give in this instance. On the whole I am inclined to think he is right, and perhaps it would be well to wait until the Ministry of Health is set up before making it mandatory.
§ Amendment negatived.
§ Major ASTOR
I beg to move, after the word "arrangements" ["may make such arrangements"], to insert the words "including the providing, maintaining, and aiding of maternity hospitals and hospital beds."
I am under the impression that these powers are already in the Bill, but I should like my right hon. Friend to tell us, and I think it would be some advantage if the Amendment were accepted so as to make it quite clear that the authorities have these powers.
§ Mr. FISHER
I can see no advantage in accepting the Amendment. These are already within the powers which the local authorities have, and they are within the Regulations which I shall shortly issue for Treasury Grants, and to include one set of powers within what is more or less a definition Clause is rather, by implication, to exclude other powers. I cannot accept the Amendment.
§ Amendment negatived.
§ Major ASTOR
I beg to move, after the word "Board" ["as may be sanctioned by the Local Government Board"], to insert the words, "after having obtained the concurrence of the Insurance Commissions for England and for Wales, the Board of Education, and the Central Midwives Board."
There is a precedent for this in the Milk and Dairies Act of 1914, which says, "Orders shall be made by the Local Government Board with the concurrence of the Board of Agriculture and Fisheries." In the Report of the Departmental Committee on Tuberculosis, where several Departments were concerned in the same way as several Departments are concerned with the administration of maternity under this Bill, there was a definite recommendation that, with a view to securing prompt and effective concerted action, schemes should be jointly considered by the representatives of the Departments. Also in another place the other day the representative of the Government, when moving an Amendment to the Midwives Bill, said the Local Government Board should consult the Central Midwives Board in dealing with 214 schemes under the Midwives Bill. My object in moving this Amendment is that there should be one policy dealing with maternity. There are several Departments—the Local Government Board, the Insurance Commissioners, the Board of Education, and the Central Midwives Board—all interested and all concerned with maternity; and I think it would be an advantage and in the long run would expedite the administration of powers concerning maternity if we were assured that there was only one central policy, and the best way of obtaining that would be by co-operation between the Departments concerned.
§ Mr. SHERWELL
I hope the right hon. Gentleman will not accept this Amendment. I do not quite understand the view with which it has been put forward. There are various public authorities already dealing with this, but it would be an extraordinary condition of things for this House to confer powers upon local authorities subject to the sanction of the Local Government Board, and yet making the sanction of the superior Board depend upon the concurrence of the Insurance Commissioners and other Government Departments. It would be a most extraordinary innovation in our Parliamentary and Governmental proceedings. The Board of Education is one of the Government Departments dealing with this question, but its work is not in any way impinged upon by the Bill. It only deals with children under the age of five years who are not within the control of the Board of Education, and I do not see for the life of me why we should not supplement the work of other Boards.
§ Mr. SHERWELL
This is an arrangement for the care of children who are not yet within the control of the Board of Education. It is true the Board of Education has certain powers by way of instruction now, then why should the hon. and gallant Gentleman wish to make them dependent upon the concurrence of the Insurance Commissioners? The Insurance Commissioners have a vital interest in the question of public health, but it would be a startling innovation to make Statutes of this kind subject to a body constituted as the Board of Insurance Commissioners is. I think we should not fetter the powers of the local authorities concerned 215 more than they are necessarily and properly fettered by being made subject to the approval of the President of the Local Government Board. I hope in the interests of the Bill the right hon. Gentleman will not accept the Amendment.
§ Sir H. GREENWOOD
I wish to support what has been said by the hon. Member (Mr. Sherwell). I am sure I do my hon. and gallant Friend (Major Astor) no injustice in saying that with commendable and admirable zeal he wishes to make this small Bill a much larger measure, in agreement possibly with the very noble ideal which he has, and which moat of us share. But the acceptance of the Amendment would limit the paramount power of the President of the Local Government Board, and I pin my faith to the strength of his approval and control in the successful working of this Bill. I hope, therefore, he will resist the Amendment with all his power.
§ Sir C. WARNER
I wish to say a word on behalf of local authorities. It is very difficult to serve more than one master. They may serve the Local Government Board, but if they have three masters it would make it very difficult for them to submit satisfactory schemes. They are always under the control of the Local Government Board to a great extent, and in this case they will be completely under its control, because they have to have their schemes approved or they will not get the Grants. But I think it would be unfair to put them under four different Departments. More than that, are the four different Departments also to have control of the Grants, because, if not, it will be only half control by three of the four Departments. I would urge the hon. and gallant Gentleman to withdraw the Amendment, as I think it would be quite unfair to the local authorities.
§ Mr. BOOTH
I wish to oppose this so far as regards the first sentence. I should like to ask the Mover what he means by "Insurance Commission"? No such thing is in existence. The hon. and gallant Gentleman himself had on the Notice Paper on the Second Beading the correct term, but when he drafted this Amendment he forgot his own phrasing. If he means the National Health Commissioners I wish to offer the strongest opposition from the point of view of the insurance committees. The insurance 216 committee is a county affair. The Amendment would have been applicable before the Amendment already carried, but it will not at all suit the Bill now. As I understand, the discretion of the Local Government Board is to be exercised on a matter on which it is specially qualified to speak. It is informed, and it knows all the authorities, but the Insurance Commissioners do not know anything about large or small authorities. They only know about the county insurance committees. How the Insurance Commissioners at Buckingham Gate can be able to decide which maternity affairs are better put into operation by several districts united, and which are better put into operation by each locality in its own way, I have not the slightest idea. Surely the only possible connection between the insurance scheme and this Bill is the fact that the Insurance Commissioners give a maternity grant of 30s. One hon. Member who supports this Amendment but has not spoken on it, indicated apparently that that is why they think the Insurance Commissioners should be brought in. All that the insurance scheme does is to simply pay 30s. maternity benefit. It is an easy benefit. There is no malingering and no deception. It is simply a payment for which the people insure week by week out of their wages to get this benefit. All that the approved societies have to do is to hand over the 30s. They have nothing to do with the way it is spent. They have nothing to do with maternity. If you bring the insurance people in it would only lead to obstruction. It would not be intentional obstruction, but it would be actual obstruction. They might have to communicate with the county council, which might have to refer the matter to some sub-committee which would have to make inquiries, and they would not know what it was all about. As this is the first Amendment of several which seem desirous of bringing insurance matters inside the purview of this scheme, I think I had better offer a word of warning. I do not see how the Insurance Commissioners at Buckingham Gate can help. They might want time to consider, and it might be an obstruction. The Mover of the Amendment never suggested that it would be a driving or a helping force. While I do think that insurance committees should be kept in touch with the matter in the way that is suggested later, I do warn the Committee not to give either insurance committees or Insurance Commissioners 217 power over this Bill. They are not qualified for it. I hope, therefore, that the Amendment will not be accepted.
§ Mr. ALDEN
What the Mover of the Amendment wants could be secured in the Bill. I imagine that what he wants is that those people who are on insurance committees, or on midwives associations, or on education committees, should be consulted. That is secured in Sub-section (2) of Clause 2, where it says:The council shall also appoint as members of the committee persons specially qualified by training or experience in subjects relating to health and maternity who are not members of the council.It seems to me that the President of the Local Government Board, when he is issuing his instructions, will point out that it is desirable to have one member of the education committee and a member of the insurance committee upon the committee. That would serve the purpose which the hon. Member has at heart.
§ Mr. FISHER
I cannot possibly accept this Amendment, unless I accept it with the desire of making the Bill practically inoperative I cannot think of anything more calculated to hinder matters than that the local committees should submit their schemes to four different Departments of State. I have listened to a good many speeches of the hon. and gallant Member for Plymouth on the subject of the Ministry of Health, and I understood that his main argument was to get rid of too many Departments dealing with health matters. He is anxious to get rid of these Departments, who now, he thinks, mess and muddle things, and to get matters under one control, but he now proposes that no local authority shall ever be able to obtain sanction for any scheme even of the most limited character relating to the health and well-being of a mother and child unless it gets the sanction of the Local Government Board, then the Board of Education, then the Central Midwives Board, and then the National Insurance Commissioners. What an awful thing to contemplate, that all these hundreds of local authorities should have to submit their schemes to four different Departments! I wonder whether any one of these Departments have invited my hon. Friend to be their spokesman. I have never heard that the Central Midwives Board desire to intervene. I have a good understanding with the President of the Board of Education, who has no 218 desire whatever to interfere with this Bill, or to intervene in the operations of the Bill. I have not yet heard that the Insurance Commissioners want to have these powers. I cannot imagine that any possible good can come from an Amendment of this kind. It would put an immense amount of grit into the machine and would probably prevent the machine from working at all. I think the hon. Member is alone in desiring this, and I think I shall be acting consistently with the views of the House in refusing to accept the Amendment.
§ Amendment negatived.
I beg to move to leave out the words "and are not being educated in schools recognised by the Beard of Education."
I put this Amendment down in order to find out what this provision really means. I suppose it is the result of a friendly collusion between the President of the Board of Education and the President of the Local Government Board. The President of the Board of Education knows that there are already doctors and inspectors going to the schools, and he does not want any more of these officials going in to disturb the course of instruction. Therefore, he has arranged with the President of the Local Government Board that the officials under the Maternity and Welfare Bill shall not go into these schools. It will be said that these schools have their kindergarten, and that everything is done for a child under five years that can be done there, and that it is not necessary for another inspector, male or female, to go in to disturb the admirable arrangements that are being carried out by the masters and mistresses. That may be so, but I do not quite understand how far the thing goes. Can an inspector, made or female, go into the child's home and inspect it there, and see whether it is properly cared for, and brought up, and that the parents are doing what they are required to do under this Bill; or is it a fact that if a child is being educated in a school recognised by the Board of Education that that child is immune for the first five years of its life from attending under this Bill?
§ Mr. FISHER
I have a working arrangement with the President of the Board of Education, by which the local authority shall attend to the health of children who have not attained the age of five years and are not being educated in schools recognised 219 by the Board of Education. It is unwise to have two authorities attending to or having the power to attend to the health of the same children. I think this is a very good practical provision, and I hope my hon. Friend will not press his Amendment.
§ Sir W. CHEYNE
I do not think it is a good arrangement. Under the Education Bill, Clause 19, it is provided that the local education authorities have power to attend to the health, nourishment, and physical welfare of children attending nursery schools. They are also empowered to aid the supply of nursery schools for children over two and under five years of age, whose attendance at such a school is necessary for their healthy, physical, and mental development. I cannot see, therefore, what children are left for the President of the Local Government Board. I think it is a monstrous arrangement. Of course it has been made and I suppose we cannot help it, but I think the President of the Local Government Board who is practically the trustee of the health of the community until the Ministry of Health is set up, has made a very bad arrangement. I should like to have children under five included in this Bill.
§ Mr. FISHER
We have to have some kind of working arrangement. There may come a day when this House, in its wisdom, may say that there must be a Ministry of Health and that the whole of the medical inspection and treatment of children and other health matters must pass under the purview of one Minister of Health. Until that time comes it is absolutely necessary for the Local Government Board and the local authorities to have some working arrangements with the Board of Education and the Education authorities. We have made this working arrangement, that where the children are at nursery schools recognised by the Board of Education, whether they have attained the age of five years or not—they may be only two or three years of age—the doctors employed by the Education authorities will inspect them and provide for them. The President of the Board of Education might not have been a willing participator in this Bill unless he had secured immunity from interference with the health of the children concerned by the authorities other than the local education authorities. It may not be the very best possible arrangement and 220 method of supervising the health of the children, but unless and until the Government come to the conclusion that all children, of whatever age, whether at school or not, should be put, so far as their health is concerned, under one authority, it is obviously necessary that we should have a working arrangement between two Departments who are given supervision over children.
§ 6.0 P.M.
§ Sir C. WARNER
Am I correct in thinking that the children who come under the Department of the right hon. Gentleman will be those who are not at school? The children under five who are at school are sent voluntarily by their parents, and there will not be so many of them. There is no compulsion about going to school for children under five years old, and therefore the vast majority of these children will not be under the education authority, but will be under the Local Government Board?
§ Mr. ALDEN
We are making a great fuss over a comparatively small thing, because the Board of Education has, through the local education authorities, only a small number of these nursery schools, and we can fairly leave them to take care of the children in those schools. Where there are no nursery schools the children will come under the Local Government Board. In either case, whether they are under the Board of Education or the Local Government Board, it is perfectly certain that the children will be safeguarded.
§ Sir H. HARRIS
The London County Council, which is largely interested in this matter, has expressed the opinion that any confusion between different authorities would be most undesirable, and suggests that the Government should consider whether the powers of the rival authorities should not be so arranged as to make such competition impossible. It has not made any definite suggestions as to how that should be done, but I may express the hope that my right hon. Friend will go into the matter before the Report stage, in order to see if there is any likelihood of undesirable competition.
§ Amendment negatived.
§ Major HILLS
I beg to move, at the end of Sub-section (1), to insert the words "or authorise the transfer of any of the powers or duties of the supervising authority under the Midwives Act, 1902."
221 By Section 8 of the Act of 1903 the county council, which is the authority for supervising midwives, has power to delegate its duties to rural or urban district councils. In the consolidating Bill, which is now before another place, on Tuesday last the Section giving this power was repealed. If the Bill in another place as amended becomes law there will be no need for my Amendment, but until it becomes law the point is of great importance. Inspection of midwives is now, generally speaking, in the county council area. It is extremely important that it should be a large area, otherwise you cannot employ and pay a skilled inspector. Again, unless there is a large area, the skilled inspectors cannot keep their hands in by constant inspection. Again, if you have a, small authority as the inspecting authority, there is a great temptation to employ a part-time inspector, and employ a lady part-time as an inspector of midwives and part-time at other duties. That is extremely undesirable. Again, it would be very undesirable to have a different standard in different parts of the country, and in one part of the county have a highly-trained inspector inspecting midwives on a high standard and in another part of the county have a less well-trained and a less well-paid inspector inspecting them on a totally different standard. All my arguments are met if the present Bill now before another place becomes law, but it can do no harm to insert my Amendment. It will meet a very obvious evil, and I hope that my right hon Friend will accept it.
§ Mr. FISHER
I think that the words suggested are entirely unnecessary. I do not think it a good thing to put into a Bill words which are unnecessary. My hon. Friend has referred to the danger of a county council desiring to transfer the powers of supervising midwives to some smaller authority in some smaller area. After all, if it did so, that must be part of a scheme which would have to come under the supervision and control of the Local Government Board. At all events, there is nothing in this Bill which authorises them to make any such transfer of powers or duties, and nothing to suggest that they should, or encourage them to, make use of such powers, if they have any. Therefore I cannot see that these words in any way add to the value of the Bill. 222 At the same time, I agree thoroughly with my hon. Friend that it would be most unwise to choose a small area.
§ Major HILLS
I desire to right a misapprehension. The power conferred on county councils by Clause 9 of the Act of 1902 is an absolute power, and they can delegate without the consent of the Local Government Board. When the amending consolidating Midwives Bill was introduced the other day into the House of Lords, Clause 12 provided that the power was not to be exercised except with the consent of the Local Government Board, showing clearly that up to that time such consent was not required. In the result the other House refused to accept the Government Clause 12, and refused to allow the power of delegation even guarded in that way to stand. They struck Clause 12 out of the Bill, and in express terms repealed Clause 9 of the Act of 1902. The matter is of extreme urgency and the chances of legislation of this kind, especially of a small Bill, are not very bright. The words suggested do no harm, and I hope that my right hon. Friend will accept them, because at the very worst they express what we both want and I do see a great danger, if this Bill passes, of a state of affairs arising which he will deprecate as much as I do.
§ Mr. FISHER
I will look into the matter between now and the Report stage, and if there is any such danger as my hon. Friend suggests, and that it can be safeguarded by some such words as these, I will consider whether or not we can insert them.
§ Amendment, by leave, withdrawn.
§ Sir W. MIDDLEBROOK
I beg to move to leave out Sub-section (2).
It is necessary to leave out this Subsection in consequence of the first Amendment.
§ Amendment agreed to.
§ Motion made, and Question proposed, "That the Clause, as amended, stand part of the Bill."
§ Mr. BOOTH
It may be well to reassure the fears expressed by the hon. Member for the City of Durham with regard to the Amendment that was accepted. Most of us who supported that Amendment thought that it would lead to more being done than in any other way. We do not all wish to exercise the powers of destruction which sometimes masquerade 223 under the name of co-ordination. You have not gained anything when you say to one authority, "Leave this question alone until a certain time when something else is done." I know that some people are obsessed with the idea of a Ministry of Health, and a long series of questions are withheld because they think that we must not do anything until this is granted. But where we have these local government authorities, small authorities, taking part in and dealing with matters relating to health, I think that that is a matter to be rejoiced at. All that my hon. Friends are threatening to accomplish is destruction. They may prevent Bills for doing good, and try to take existing powers away, but whether some new set of bureaucratic officials in some idealistic form will replace the multifarious agencies now at work throughout the country is a matter which I think requires some proof, and the fact that different authorities now under this amended Clause will take their part in looking after child life will probably lead to fruitful experiments. It cannot be a good idea that the whole country should have uniform administration. Some hon. Members of this House are perpetually urging that the same thing should be done everywhere, and that the bigger the authority and the more uniform and the more monotonous is its administration the more successful it will he. That has not been so. We have a great deal to learn in local government, particularly in these matters relating to child life, and various authorities of different sizes are about to join in this work. Some will probably do a larger amount of work at less expense——[HON. MEMBERS: "Agreed!"]—I do not know that it is agreed—and if some authorities are able to show better results with comparatively smaller demands on the public purse it will have a stimulating effect on other authorities. Sometimes they are apt to think that spending a lot of money means a great deal, but that does not always follow. I would not like it to go forth that an Amendment which has been pressed for by the smaller authorities is going to have anything else but a very beneficial effect on the Bill.
§ Major HILLS
The Clause as now amended delegates important duties connected with maternity and the care of 224 mother and child from the larger to the smaller authority. You wish provision made on the most modern and up-to-date lines for maternity cases, and the care of mother and child afterwards, and you propose to employ small rural district councils. When that is the case, I think it is an end of your Bill. When the country appreciates that fact, I think the measure will suffer from ridicule, and will do no good. I am, in a way, sorry, because I think perhaps the Bill might do more good than harm, but there are many flaws in it. I have not the least wish to speak of these authorities other than as being valuable, self-sacrificing, and patriotic in their work, but I do not think that small authorities are the proper bodies to have control of the important duties and matters dealt with by this measure.
§ Mr. FISHER
My hon. and gallant Friend the Member for Durham has shown bitter hostility to this Bill throughout its course, and I cannot allow what he has said to pass without some reply. The Bill has so far passed without a single Division in Committee, which is very well attended. My hon. Friend says this Bill is ridiculous, and can do no good, but I submit that with the new powers conferred, and the Grant to be given by the Treasury, will effect an infinite amount of good in the hands of the local authorities. When the hon. and gallant Gentleman describes the Bill as ridiculous he is covering Scotland with ridicule, for we have heard the Secretary for Scotland state that over two-thirds of Scotland there are large schemes in connection with maternity and with children's welfare, and very much useful work is being done for the good of the community. This has been called a shabby little Bill, but, as I said the other day, it will give to many a shabby little mother—shabby because she is too poor to clothe herself well—proper treatment both before and after confine-men which she will be uncommonly glad to have; and all this will be effected, under this measure, for the mothers of England, at a time when they are most in need of the assistance and attention which can be afforded under this Bill. I for my part believe that this measure, little as it is—it cannot be compared with a great Bill like that of the Ministry of Health—will do far more than most of the little Bills that are passed by this House, and will really touch the whole root of 225 social reform in this country, while the poor will get that benefit and attention of which they are so greatly in need.
§ Question put, and agreed to.