MIDWIVES BILL. (Hansard, 15 October 1918)

§ The PRESIDENT of the LOCAL GOVERNMENT BOARD (Mr. Hayes Fisher)
I beg to move "That the Bill be now read a second time."
I can perform this duty in a very few sentences. The Bill was introduced in the House of Lords, on behalf of the Privy Council, early in the Session, and passed that House with only one important Amendment. When it came to the House of Commons someone with a lynx-eye detected in some of its Clauses an infringement of the privileges of the House of Commons. These Clauses were held to contain a public charge. That being so, according to our usages, the Bill should have been introduced into the House of Commons 31 instead of in the House of Lords. Therefore it had to be laid by. Three courses were open to the Government. One was to introduce the Bill into the House of Commons in the terms in which the former Bill left the House of Lords; the second to introduce the Bill into the House of Lords in an amended form; whilst the third was to drop the Bill. The discovery of the tiny though damaging flaw in this otherwise spotless Bill was made very late in the Session, some time in July, and about the time of the "slaughter of the innocents." Those who were responsible for the conduct of business in the House felt themselves unable to find a place in their time-table for this Bill before the House rose for the summer holidays. The Bill was accordingly dropped, and I gave notice to introduce it into this House on the reassembling of Parliament. I consequently introduce it precisely in the form in winch it passed the House of Lords.
The basis of all legislation relating to midwives is the Midwives Act of 1902, which set up a Central Midwives Board, and required that after a certain interval women should not act as midwives unless they were duly certified by the Central Midwives Board. This Act applied to England and Wales only. After some years', experience of its operation a Departmental Committee was appointed, in 1909, to consider its working. This Committee made certain valuable recommendations as to Amendments which might very fittingly be brought into the Act by some subsequent legislation. Subsequently, when Scotland, and later Ireland, obtained the benefits of a Mid-wives Act, the principal recommendations of the Departmental Committee were incorporated in those Acts; and so it came about that England and Wales became, as it were, the Cinderella of midwifery legislation. The whole object of the present Bill is to assimilate the law relating to the midwives of England and Wales to that which obtains in Scotland and Ireland—to make the whole of the legislation relating to midwives in the United Kingdom in harmony in every possible respect. I would like to make one or two observations in view of the importance of the Clauses.
Clause 1 provides simple and convenient machinery by which the constitution of the Central Midwives Bill can be altered at times, with proper safeguards, by an 32 Order in Council. Clause 2 endeavours to make an equitable apportionment of any deficit that may be shown in the case of the local supervision authorities against the Central Board—apportionment on the basis of population, and not on the basis of the number of midwives who have taken out certificates. The present system is more cumbersome and less equitable and appears, to a certain extent, to penalise the more active authorities as against the negligent ones. Clause 6 amplifies the provisions relating to suspension; in this Clause Sub-section (2) introduces, for the first time, the principle of compensation. Clause 7 allows the Central Midwives Board, if they think fit, to pay the expenses of any midwife who may be required to appear before them to defend herself; whilst Clause 8 empowers the Central Board in removing from the roll the name of any midwife, also to prohibit her from attending maternity cases in any other capacity.
Clause 10 introduces provision for the reciprocal recognition of certificates granted by the Central Midwives Board in this country and of midwives certified granted by similar bodies in other parts of His Majesty's Dominions. There is a condition that the training must be equivalent in each case. It this Bill is passed there will be reciprocal arrangements between all parts of the United Kingdom and His Majesty's Dominions. Clause 11 empowers the local supervising authorities to contribute to the training of midwives in conformity with the resolution passed by the County Councils Association. Clause 12 repeals Section 9 of the principal Act. This proposal gave rise to a division of opinion in another place, and I think it is probable that in the Committee stage some objection may be taken. I do not propose to argue the case now, but if there be a division of opinion in the House during the Committee stage, I shall be only too glad to listen to all those who are capable of advising me as to the best form this proposal ought to take. Clause 14 provides a simple machinery for the payment of medical assistance summoned by midwives in cases of emergency, and it makes it obligatory to summon a doctor in typical cases of emergency. Although it is obligatory on the local authority to pay the fee of the doctor, half that fee will be paid back under certain regulations issued by the Treasury. Therefore any payments the local authorities may make for this act of 33 welfare and mercy will be recouped to the extent of 50 per cent. by Grants made under the advice of the Treasury and administered by the Local Government Board.
It only remains to be said that the Bill embodies the principal recommendations of the Departmental Committee, and that it brings the whole of our legislation connected with midwives in England, Wales, Scotland, and Ireland all on the same footing. We are all most anxious to do everything we can to promote maternity and anything Chat relates to child welfare. If we can pass such a Bill as this, which improves the status of midwives and removes some of the difficulties under which they suffer, I feel that we shall have done something to diminish the suffering of motherhood and we shall have done something to attract more women and possibly a better class of women to that ancient and honourable profession. By this Bill we shall take an important step forward in one branch of the public health which endeavours to see that everything is done for the strengthening of the health and the general improvement of the vitality of both mother and child.

§ Mr. GEORGE THORNE
With the concluding remarks of the right hon. Gentleman I entirely agree. I rise to refer to one point relating to Clause 12, to which reference has already been made. I understand that the right hon. Gentleman does not desire any discussion on that point, as he wishes to reserve it for the Committee stage, but if he were able to make any statement at this stage it might very considerably reduce the time required for the Committee stage. The memorandum of the Bill distinctly indicates that this measure is proposed in such a way that all contentious matter is avoided. As the right hon. Gentleman no doubt recognises, the question raised in Clause 12 is a distinctly contentious matter. The county councils very strongly object to Clause 12, which robs them of the power they at present possess of delegating their powers to district councils, and I hope the right hon. Gentleman will be able to indicate that he does not intend to proceed with that Clause, and so avoid discussion on the Committee stage.

§ Sir JOHN HARMOOD-BANNER
I wish to endorse what the last speaker has said. The Memorandum says that all contentious matter is avoided, and yet Clause 12 is contrary to the very strongly 34 expressed opinion of the municipal and county council associations of the kingdom. It is rather curious to call this measure non-contentious when that is the position. These associations have already written to the right hon. Gentleman and have had no reply, and they have had no opportunity of discussing the matter. They feel very strongly that it is proposed that populations of 170,000, 150,000, and 140,000 are being deprived of their right to deal through their medical officer of health with this very important subject. It is perfectly true, as the President of the Local Government Board says, Clause 12 appears in the Bill because the House of Lords has put it in, but that is a very poor reason. The representatives of the county councils and municipal associations have a strong view upon this question, and they do not like to have the opinion of the House of Lords foisted upon them by stating that this is a non-contentious question when, as a matter of fact, these associations all disapprove of it.

§ Sir F. BANBURY
I had hoped that I should have been able to congratulate my right hon. Friend upon bringing in a Bill which was non-contentious and to suggest that this example might very well be followed by other right hon. Gentlemen; but, to my great sorrow, I gather from the speeches which I have just heard that there are contentious matters in this particular Bill. I hope that that is not really the case, and that this new procedure of bringing in Bills which are not contentious will prove to be a reality.

§ Mr. BOOTH
On behalf of the local authorities I wish to give my support to the view expressed by the two hon. Members who have spoken in this Debate. I desire to draw attention to Clause 1 and to have it clearly understood that the word "person" in Clause 1 includes women. It may be a technical point, but the Law Courts have held that the word "person" does not in certain circumstances include a woman. If this Clause includes the appointment of women, it will enable the Government to increase the number of women upon the Central Midwives Board. As things are developing now, there is, I think, a general recognition that women must more and more be called into the counsels of the nation, and this is peculiarly a province in which it is natural that women should be asked to assist. If we could have an assurance from the Government that they contemplate under 35 Clause 1 having the freedom to appoint more women—I suggest, possibly, a midwife, providing a suitable candidate came forward—on to the Central Midwives' Board, I think the House would regard it as a distinct step in advance.

§ Major HILLS
I do not wish now to argue the rather thorny question of Clause 12, but there is another side of the case, and the House must not assume that all the arguments are on the side of my hon. Friends who have spoken. There is a very strong case the other way, which I and other Members of the House are prepared to make at the proper time. Since the Memorandum has been referred to and since stress has been laid upon the fact that it states that the contentious matter has been withdrawn from the Bill, may I direct the attention of the House to the fact that the Memorandum also says that this Bill brings the law of England and Wales into line with the law at present in force in Scotland and Ireland and that that uniformity cannot be effected unless Clause 12 remains in its present form?

§ Mr. FISHER
My hon. Friend the Member for Pontefract (Mr. Booth) asked whether it would be possible under Clause 1 to increase the number of women now on the Central Midwives' Board. Yes, that will be possible, and I entirely share his view that in all this maternity and child welfare legislation we shall need more and more the services and the special knowledge of women. It will be possible, if it is thought desirable, to give the midwives themselves direct representation upon that board. The questions have all ranged round Clause 12. We thought it better, upon the whole, to bring in the Bill as it left the House of Lords, but, as I have said, when we come to Clause 12, which will probably be the only Clause which will require any debate or Division, I shall certainly listen with a very open mind to the arguments that will be brought forward as to whether or not there should be any power on the part of the county councils to delegate to the district councils. I will only indicate a certain preference in my own mind not upon this subject only, but upon many other subjects. I think generally it is wise to give a discretionary power subject to the sanction of the Local Government Board. I do not think it is wise to close the door altogether upon the power of delegation by these local bodies. It is 36 best to leave them with that power subject to the sanction of the Local Government Board. That is the only indication of opinion that I will give. I can assure the House that I have a very open mind upon this question, and that I have purposely kept it open until we debate the whole matter in Committee.