HC Deb 22 November 1927 vol 210 cc1607-10

I beg to move, That leave be given to bring in a Bill to provide that certain communications be- tween medical practitioners and their patients shall be privileged from disclosure in evidence. The Bill which I ask leave to introduce is intended to remove something like a deadlock which has resulted from the conflict between the Regulations issued by a Government Department in 1916 and the law as interpreted by certain recent legal decisions. In 1916 a Royal Commission upon Venereal Diseases issued its Report. Its personnel was admirably authoritative and representative. It included one Member of the present House, the right hon. Member for Colne Valley (Mr. Snowden), who has done me the honour of backing the Bill which I desire to introduce. The title "venereal diseases," unhappily, embodies a belief that there is a special order of diseases resulting from illicit indulgence in a normal function, and that these diseases deserve the punishment which their victim gets and, in some mysterious way, differ from other communicable diseases. That view has never been held by members of the medical profession, and I hope that it is out of date even in this country, where it has been held. In practice, the term "venereal diseases" means two dissimilar affections, syphilis and gonorrhœa. The Report revealed an unexpectedly high degree of prevalence of both diseases in this country. It was established by evidence given before the Royal Commission that syphilis, taken by itself ranked third as a killing disease, coming next after tubercle and cancer, and probably ought to come first, because it predisposes in very many cases to those two, diseases; besides being a very mortal disease. Its mortality is extremely high amongst young children. In addition to slaying their tens of thousands, these two diseases easily head the list of disabling diseases that we know. Syphilis, in particular, is primarily responsible for a large proportion of the cases of insanity, and for a string of diseases of the nervous system, which make life a prolonged agony.

Evidence is found in the Report of the Commission for the estimate that at least one in every 10 persons in the community is thus infected, and more than half the total number of cases of blindness in quite young children is due to this scourge. The medical position on these diseases may be summed up in this epigram: the man who knows all about venereal diseases knows all about medicine, for they affect every organ and tissue of the body. The state of affairs disclosed by the Report of the Commission was so appalling that immediate action was called for; and was very rapidly taken. In consequence and in pursuance of the recommendations of the Commission, the Ministry of Health, in the same year that the Report was published, inaugurated a system of clinics throughout the country for the treatment of these diseases, and issued Regulations for their conduct. The foremost and most important of these recommendations was the instruction to medical practitioners and other persons concerned that all information obtained with regards to any persons treated at these clinics should be regarded as absolutely confidential. The evidence given before the Commission abundantly demonstrated that it is essential for the success of any measures designed to deal with venereal diseases that the patients should be fully assured as to the secrecy of the arrangements. The reason for that is surely obvious. Modern methods of treatment have completely revolutionised the prognosis of these diseases, which has improved immeasurably in the last 20 years, provided, however, that early treatment is instituted. Irreparable mischief may result, and has resulted, from the disinclination of the victim of these diseases to consult his family doctor. The reason for that is quite obvious. It is almost impossible to have the disease treated at home and conceal its nature, but the same person will go to a clinic where he is identified only by a number and where he knows he will get the very best treatment which medical science of the time can furnish. Under present rules patients coming to the clinics receive explicit assurances that no information concerning their disease will be given, and that assurance is fortified by the issue of a leaflet where the same promise is given by the Ministry of Health, carrying with it, therefore, all the authority of Parliament.

The success of these clinics rests upon two factors, the enthusiastic co-operation of the medical practitioners in charge and the complete confidence of the patient. This co-operation and confidence have been completely won by the assurance of secrecy, and repose upon it. Doctor and patient alike have felt secured by the regulations of the Ministry of Health from any possibility of being compelled to make any disclosure of these confidential communications, but this security has been completely shattered by a decision given by Mr. Justice McCardie in Birmingham last July, when a doctor was ordered to disclose the character of the disease from which his patient was suffering, although he had acted under the explicit protection of the regulations framed by the Ministry of Health. Medical men bred in the tradition of the Oath of Hippocrates find themselves forced to betray the trust of their patients, and I submit that this betrayal is really an affront to Parliament, because Parliament must be responsible in some measure for the acts of one of the most important Ministries under the Government. It is this position which this Bill seeks to remove by giving legal sanction for regarding as privileged communications which have been erroneously supposed during the past 12 years to be privileged. It is clear either that the law must be amended or that these regulations must be scrapped. I am encouraged in my view by the opinion of eminent Members of this House that any legal difficulties can be readily overcome, but if the regulations are scrapped the fate of a highly successful and important ministerial and medical effort is sealed.

Question put, and agreed to.

Bill ordered to be brought in by Dr. Little, Dr. Vernon Davies, Sir Walter Greaves-Lord, Mr. Edward Grenfell, Mr. Arthur Henderson, Mr. Merriman, Mr. Morris, Sir Basil Peto, Mr. Goodman Roberts, Dr. Salter, Mr. Snowden, and Mr. Storry Deans.