§ Postponed Proceeding resumed on Question, "That the Bill be now read a Second time."
§ Question again proposed.
§ Mr. J. JONES
During my 26 years experience of work in connection with mental deficiency, I have come into contact with all sorts of cases, and the only cases not provided for in this Bill are 1051 those of the most unfortunate character. The poorest of the people do not go into asylums or mental homes voluntarily; they are taken there. One of my old friends who used to work in the building trade with me was taken to the asylum 11 times in two years. When he got there he saw a clock in the entrance hall, and he asked the relieving officer who was taking him, "Is that clock right?" The relieving officer said "Certainly, it is synchronised every day with Greenwich," and he said, "Well, it is the only thing which is right in this place." I have another case in mind of a young man 24 years of age who committed an offence because of his mental disability. He was sent away 100 miles from London. His only relatives are a brother and sister who live in Silvertown. Naturally the officials of the institution will not allow him to come out, because he is subject to certain mental aberrations, and his brother and sister cannot afford the railway fare to visit him at the institution. I have made applications on their behalf for him to be transferred to an institution nearer London where they might be able to go and visit him. As it is, he is practically isolated. That sort of case is not provided for in this Bill.
If we are going to deal with mental deficiency, let us deal with it all the way round. The Board of Control; who are they? It is impossible to approach them. Every time you write a letter you get the same stereotyped reply. I should like to see a real Board of Control composed of civilians, with medical experts; a Board of Control of men and women who have had some experience in dealing with the lives of these people. Many people are now in our mental institutions who ought never to be there at all. The majority are there because they are poor; starvation and privation and the conditions of life have driven them off their mental balance. Now we hear of people going voluntarily into asylums. Those who are rich may go voluntarily, but the poor people cannot. They are generally taken there without their consent. This Bill is going to do nothing in the direction of making it easier for people to keep out of these institutions. That can never be done except by a complete change in our 1052 present method of dealing with these cases. Men and women after the age of 70 may become a bit of a nuisance to some of their relations. They may be in lodgings and they are sent automatically to the workhouse, and are later transferred to the asylum on the ground of senile decay. They are called lunatics because they are no longer capable of looking after themselves, and because in many cases it is too expensive for the local authority to look after them.
We want a complete reclassification of mental hospitals. We want homes for the people when they become incapable of looking after themselves. Such people are not mad and not dangerous, but there they are all together like Brown's cows, because it is cheaper to keep them in herds. This Bill goes part of the way, but not the whole way. I could take any hon. Member to a hospital in West Ham and show him children who, if they had a decent chance, would be restored to something like mental balance. But they are condemned for life, practically, to be inmates of the institution. The same thing can be said about older people, who are neither mad nor dangerous and yet have to remain there because locally there is no power to alter the arrangement. I hope hat when the Bill gets in Committee we shall have a chance of considering the position of all the mentally disabled. We do not want too many experts. Boards of Control are not quite as clever as they think they are. We have tried often to deal with individual cases of the afflicted and have always found our proposals turned down. I hope that some new board will come out of this Bill, so that we shall be able to do something on behalf of those people who ought not to be in institutions at all.
§ Lieut.-Colonel FREMANTLE
We have been treated this evening to so many excellent speeches from different points of view that I would not wish to add much before the end of the Debate is due. We are dealing with the distressing cases, that number already some 135,000 of persons in mental institutions. Of these, it is estimated that about one-third are what are called in this Bill non-volitional cases. That is to say, from 40,000 to 50,000 are non-volitional cases. As has been said, the expense and necessity of providing for these people is already met. Therefore, the need of new accommodation 1053 does not arise in their case, although one would naturally hope that in time better accommodation may be provided for them, as for all others. I would suggest that when the Parliamentary Secretary responded to the criticism made in that respect she did not state the whole of the case. With regard to the non-volitional cases, one of the objects of the Bill is to lead those who at the present moment are frightened off from certification, who do not come within the possibilities of treatment now, to submit themselves to treatment or to be so submitted by those who are responsible for them. Therefore there will be need of further accommodation.
It is well for us to recognise that there has been some exaggerated enthusiasm about the Bill as opening a new era. It is well to glance over the course of events in the treatment of the insane. It has varied with our conception and know ledge of their condition. In older days and even among uncivilised races to the present day the idea of insanity was suggested in the phrase "possessed of a devil" and the old stories in the sacred Scripture of men possessed by the devil were simply a picturesque way of indicating insanity in one form or another. Although that way of representing in sanity has gone out of fashion, I am doubtful whether the modern jargon of psychology which has taken its place gives any more accurate and scientific picture than the old idea that an insane man was possessed by a personal and malign influence. The idea of a man "possessed of a devil" gave way to the idea that an insane person was divinely afflicted and had to be restrained as a danger to society and himself. The first organic stage in our system for dealing with lunacy may be said to have started with the Elizabethan Poor Law and the institutional arrangements which arose at that time. The process of dealing with the insane then was one of mechanical restraint and that idea continued until His Majesty King George III, who was himself a sufferer, was treated under humane conditions by Dr. Addington, a physician of that day, and father of the statesman Lord Sid- mouth. He introduced the idea of humane treatment which, applied in such an exalted sphere, naturally attracted attention.
1054 Still the idea of mechanical restraint held sway in the beginning of the last century until Charles Reade wrote "Hard Cash," and Cockton wrote "Valentine Vox" which we all remember reading in our childhood. The indignation aroused was such that finally the lunacy laws were amended. It is also interesting to remember that one statesman or politician who stood more than anyone else of his time for reform of the Lunacy Laws was the great Lord Shaftesbury who gained such fame in connection with social reform. He more than any other contributed to the reform of mental institutions. He was responsible more than anyone else for the passing of the 1845 Act known as the Magna Charta of the insane, and he became one of the first Commissioners in Lunacy. He himself was so much averse from the introduction of the justice into the business of certification of the insane that when, eventually, the Act was passed he resigned his Commissioner-ship in protest and stood for the principle which is being introduced in this Bill to-day. From that time onwards, we have had a conflict or clash, between what has been called the static mind of the lawyer on the one hand and the dynamic force of the biologist on the other—that clash which was described by Sir Clifford Allbutt and by Professor Kenny in their "Outlines of Criminal Law." It is no disparagement to my brothers or sisters of the legal profession to refer to the static mind of the lawyer, because the law must necessarily deal with concrete and defined facts and that really creates the difficulty in this case.
We of the medical profession have necessarily to look at it from the other side. I speak, not as one who has practised the profession of curative medicine, but from the administrative point of view, the view of the lay authority and of the interests of the community as a whole, and especially from the point of view of prevention as well as of cure. Therefore, I would like again to call attention to the position of the medical man in the case. It has been referred to already, so pathetically and intimately, by those of my professional colleagues who have spoken in this Debate, but I ask the House to consider the position they are in when called upon to deal with 1055 a case that is first of all recognised in a family as one of difficulty, one of violent temper, of a rather changeable and fickle state of mind, of a person difficult to deal with. Commonly that person is regarded as not only a nuisance, but as being voluntarily responsible for the trouble in the family and the household. The medical man comes in and realises that it is a case where the strain, in one form or another, has been so great as temporarily to derange the mind of the individual. It is a temporary, early ease, and it would be ridiculous to sign that as a case of certified insanity. It is obvious, from the mere facts of the case, that it arises from the normal incidents of health and of ill-health in a life, such cases as arise after childbirth, after fevers, confusional cases, and temporary alcoholic or toxic cases.
These are different cases that arise and which have to be treated by the medical man, who says, "It is absurd that this should be signed up as insane." These are the cases that up and down the land at present are not being certified and never will be certified; and, therefore, here is a way in which these people can get the expert care, comfort and treatment that will enable them to tide over the time until they can again resume their normal place in family and public life. I think it must invite the sympathy of everybody who understands the case. When the doctor is called in, the case may be in a violent temporary state of insanity. What is the doctor to do? He chafes at delay, and the relatives chafe at delay, but as the case is at present the only possibility for these violent cases is to search out a Justice of the Peace.
I speak as a Justice of the Peace as well as a medical man, and I know how difficult it is for individuals to find a Justice of the Peace when he is required in such a case, or to find one who is able to go into the case. As has been well said already, as a rule the Justice of the Peace defers to the medical man's opinion, and says, "The medical man says so, and obviously I must sign it up." It is true, as the Royal Commission found, that the safeguard of a Justice of the Peace having to certify a case is a very small one, as compared 1056 with the safeguards provided in this Bill. What are those safeguards? You have a man who, it seems to me, is more qualified to look after the safety of the individual and of those concerned than is a Justice of the Peace, because it is to be a medical man approved by the Board of Control. In fact, the actual criticism of this proposal made from my profession is that it may start a new speciality, a separate, distinct class of practitioners. Be that as it may, I think the Board of Control will obviously approve only men who will take the public point of view and who will realise their responsibilities in the matter.
I want the House to sympathise with the ordinary family doctor and help him to get through these delays and difficulties that are so troublesome and tiresome to the patients and to their families. The medical man realises equally well the necessity of protecting the personal liberty of the subject. I do not believe that anybody so much as the medical man would be so acute and keen to discover any kind of ill-treatment and mischief that was going on in a case. There will always until the end of time be cases where the law will be defeated; no law will be perfect, and we who are supporting this Measure so keenly only ask people to recognise that we have put in a safeguard of a medical man approved by the Board of Control in addition to the family doctor, as a more efficient person than the judicial authority who has hitherto been asked to record his opinion. In regard to the Board of Control, I agree with many of the criticisms. It has been suggested that there is a stigma attached to the Board of Control, and that a new body should be formed to deal with these persons. There is no need to have a fresh Board for every class of insane or mentally inflicted who are to be treated.
It was in order to get out of the stigma that the Mental Deficiency Bill of 1913 was passed, and that the Lunacy Commission was absorbed in a new body which was called, not a Lunacy Commission, but a Board of Control. Some stigma must attach to any body that undertakes these functions, because they are concerned with people who may eventually be certified as insane. We must trust the Board of Control, and it will be for us in Committee so to consider the Clauses which deal with the board that the public will 1057 have confidence in it as being an efficient and expert, and at the same time sensible body to deal with this subject. A good deal of the criticism of the future Commissioners of the board and of their efficiency and so on, will stand or be refuted by the attitude of the Treasury in the matter. The Debate on that subject will arise when we take the Money Resolution. Unless we give a salary and position greater than that already enjoyed by the class of experts from whom the Commissioners will be drawn, we shall not get the class of experts to give their services as Commissioners, and therefore we shall not have men of the status of Commissioners whom the superintendents of the institutions and so on will be able to look up to as being able to guide them and control them. If we are sufficiently generous in that matter, we shall be able to get a board which will start with Commissioners and Inspectors who will be able to carry out this work. That is a matter for Committee upstairs, but the criticisms on that point are no reason for refusing the Second Reading of this Bill.
I would like to quote from the Royal Commission the opinion of a man who is an expert critic of the Board of Control, whose opinion as given to the Royal Commission was perhaps stronger than that of anybody else. I refer to Sir Maurice Craig, who said in his evidence that he had seen on the Board of Control a considerable change and progress in their methods; his former criticism had passed away, and he believed that there was evidence that they were doing their work well and in a progressive manner. We must not forget the matters which are naturally left out of this Bill, and which appear in the Royal Commission's Report.
There are two germane matters which do appear in this Bill, and they are of immense importance to the treatment of the individual before and after treatment in institutions. Those are the system of after-care and medical hygiene generally. There are many associations that undertake this voluntary work, which is invaluable. Some power is given for aftercare, and, when we come to Committee, we shall want to extend the powers that are given to the after-care associations in various ways, because I think everybody will recognise that the real trouble of the temporarily insane person begins 1058 when he gets back to his own home, especially in the poorer homes. These people then meet all the weight of domestic responsibility and domestic trouble and inconvenience, and have to fend for themselves, and the whole of the good done by six months' or a year's rest in an institution may be dissipated in three months if there is not sufficient after-care. Above all, we must remember that we want to be able to treat cases as early as possible, with a view to preventing many of the 50,000 people who are now in mental institutions from having to undergo institutional treatment. With newer ideas and newer possibilities we hope to get them early and develop the prevention, rather than have to engage in the cure, of the hopelessly insane.
§ Sir F. BOYD MERRIMAN
This Debate has shown pretty plainly that on two main principles there is general agreement. There is agreement, on the one hand, as to the principle of substituting prevention for detention, and, incidentally, making that method of treatment available to all classes of the community; and, on the other hand, there is the principle that the liberty of the subject must be duly safeguarded. It seems to me that such disagreement as there is with regard to the Measure arises from the fear that in giving effect to the first principle the second may have been somewhat overlooked. In that connection I would like to say one or two words on Clause 5, because I think the rather unfortunate wording which has been chosen for it gives some ground for these fears. I am afraid I cannot agree with the hon. Member for Denbigh (Dr. Morris-Jones), in his very attractive maiden speech, that the words "incapable of volition" which have been chosen to define the cases in Class 5 are the best that can be selected. In one sense the mere form of words is a Committee point, but this Clause is at the heart of the Bill. I do not in the least want to destroy Clause 5; on the contrary, I want it to be read and worked so as to conform with what I understand is the real object of the Bill; but, as I say, the words chosen to describe that particular class of patient are unfortunate.
As I understand the scheme on which we are all bent, it is this. At one end of the classes of patients with whom we are trying to deal we have the voluntary 1059 boarder class, the people who, whatever their other mental defects may be, have nevertheless got sufficient mental capacity or sense to be able to co-operate in their own cure by voluntarily submitting themselves to treatment. At the other end of the scale, there are people who are admittedly certifiable as lunatics and can be dealt with only as such. It is important to observe that it is common ground that you have to put into that category people who actually refuse to co-operate in their own cure by submitting themselves to treatment. It is common ground that those who definitely refuse to submit themselves to treatment have to be dealt with as certifiable. You are trying in Clause 5 to deal with a half way class between the voluntary boarder and the certifiable class whose disorder is such as to disable them from co-operating in their own cure by submitting to treatment. I think I have correctly interpreted the scheme. It is important to note, with regard to this last Clause, that the only incapacity that matters is that their incapacity is such as to prevent them from co-operating in their own treatment, and it is immaterial whether they are or are not incapable in any other respect. [Interruption.] I understand that the Parliamentary Secretary has indicated that my view is correct. I submit that, unless you are dealing with these people as an intermediate class, you have no right whatever to do away with the judicial safeguard of certification and the rest. It is only because they constitute a half-way class that you get rid of the scheme for certifying.
If I have made that clear, I want to call attention to one point which, during the time I have been in the House listening to this Debate, has not been mentioned, and that is that the Royal Commission made it a definite recommendation that, on the one hand, it was desirable, in talking about lunacy without giving any rigid definition of lunacy, to adopt a nomenclature acceptable to modern medical thought; and, on the other hand, they said that they thought that a greater uniformity of language ought to be devised than was found in the present Lunacy Act. They also pointed out that there is already in the code a large variety of tests or functions of people's state of mind. For example, you have the main definition of a lunatic 1060 as an idiot, or person of unsound mind. You have in various sections differences as wide as this: You have a person of unsound mind who is incapable of managing himself and his affairs. Another case is that of a person of unsound mind who is incapable of managing his affairs, but is capable of managing himself, and is not dangerous to himself or others. In another section, you have a man of unsound mind admittedly a lunatic, whose lunacy is in its nature temporary, and will probably be soon removed. That looks like the class of case you are trying to deal with in Clause 5. Again, you have another type of person, who though not found to be a lunatic, and not detained as a lunatic, is described as being a person who, through mental infirmity arising from disease or age, is incapable of managing his affairs.
You have already all these various definitions of people who are to be dealt with as of unsound mind, and yet in this Bill no attempt whatever has been made to introduce more uniformity into the description of people suffering from unsoundness of mind. On the contrary, what has been done is to add the entirely new conception of what are called non-volitional cases—a new conception in the sense that, so far as I am aware, that particular definition of a class has never been used in connection with lunacy before. You have adopted the Royal Commission's recommendation, on the one hand, to introduce something which, no doubt, represents a current of modern thought, without, on the other hand, making any attempt to introduce any inherent uniformity into the description of persons of unsound mind throughout the code as a whole. My fear is that in the process you have suffered the fate which proverbially overtakes those who insist on putting a new piece of cloth on to an old garment. You have selected this phrase "incapable of volition," and, at the risk of appearing to have what my hon. and gallant Friend the Member for Thorn-bury (Captain Gunston) described as a "habeas corpus face." I am afraid I must say a word or two about this phrase.
I have already indicated that my objection to the phrase is that it really defeats what is admittedly the object of the Bill, because, in my opinion, it is impossible to describe people who are said to be incapable of volition as an intermediate 1061 class between voluntary boarders and certifiable lunatics. To me, as a lawyer, incapacity for volition without any qualification at all is indicative of the most complete unsoundness of mind that can be indicated. Absence of volition is the criterion in law for incapacity to contract, to make a will, even, if you like, to be guilty of a crime. I suggest that you cannot describe anybody as being more of unsound mind than to say that he or she is in every respect, and without any limitation whatever, incapable of volition. Even people who are admittedly lunatics are not necessarily incapable of volition in all respects—not by any means; but here you are describing this intermediate class, which is supposed to be short of lunacy, as people who are, without any qualification except in point of time, incapable of volition. There is no limit to it on the face of the words. I am going to deal in a moment with my suggestion for making the definition comformable to the spirit of the Bill, but to talk about removing the stigma of lunacy from people with whom you want to deal in this intermediate way, and then to describe them as people who are incapable of volition, and leave it at that, is really a contradiction in terms. You are dubbing them for the time being as completely mad in every respect. That, for what it is worth, is my opinion of what the words "incapable of volition" mean. I suggest that you have adopted a medical jargon without appreciating all its implications as a matter of law.
Bear in mind that we are really trying to deal with the case of people who are incapable of co-operating in their own cure by submitting to voluntary treatment. It is obvious, surely, that a person who may be quite apathetic and inert with regard to this matter, and may be definitely suffering from mental disorder on the subject of assistance in his or her own cure, may nevertheless be perfectly capable of being aroused if, for instance some emergency occurs in regard to his or her affairs. Mental incapacity to cooperate in a cure does not in the least involve mental incapacity in regard to other affairs. I agree that the actual form of words is a matter for Committee, but I suggest that this can be dealt with perfectly simply, for the purpose of Clause 5, without stigmatising people as being incapable of volition in all circumstances, whether for the time 1062 being or not, by reversing the wording which you are applying to temporary boarders in Clause 1.
If hon. Members will look at Clause 1, the people who are described as temporary boarders are persons described as those who are desirous of voluntarily submitting themselves to treatment for mental disorder. There is a provision worth noticing in Clause 2, Sub-section (3), with reference to the case of a person who has been received as a voluntary boarder and who becomes at any time incapable of volition. Obviously, by that you do not necessarily mean incapable of volition in every possible respect. What you do mean is, incapable of voluntarily submitting himself to treatment You may deal with that the other way. Supposing, instead of dubbing these intermediate people as being incapable of volition, without any qualification whatever, for the time being, you simply described them as being people who are incapable of voluntarily submitting themselves to treatment for mental disorder. You then avoid any question of using a phrase which makes them appear to be more mad than the lunatic himself. You avoid a phrase which definitely throws a reflection on the patient and upon his capacities in any other respect.
§ Sir F. BOYD MERRIMAN
The phrase I suggest, without asking anyone to commit himself to it, is:incapable of voluntarily submitting themselves to treatment for mental disorder.You then limit the necessary incapacity which has to be found to what you are professing to deal with.
§ Sir BASIL PETO
The words in Clause 1 imply to me, as a layman, that if a person is desirous of voluntarily submitting himself to treatment, he is willing, or possibly anxious to have treatment in the institution or hospital. If you merely reverse those words for your definition in Clause 2, does that really mean that he is anxious to get treatment?
§ Sir F. BOYD MERRIMAN
I do not think the meaning is quite so restricted as that. The point I am trying to make is this. We are, I think, agreed that the real test of this intermediate class is their lack of capacity to co-operate in volun- 1063 tarily submitting themselves for treatment. The way I am putting it does, of course, include those cases where there may be some other incapacity, but you do not make that necessary to the test. As long as he is incapable in that respect, it does not make a person any the less amenable under Clause 5 if there is some other incapacity, but it is not necessary, in order to get a person under Clause 5, that he or she should be totally incapable of volition in all other respects. You limit the incapacity in that respect and, therefore, avoid an unnecessary slur. I have thrown out that suggestion as to a form of words, and I suggest that there is substance behind this. The form of words that has been adopted, to my mind carries the matter very much too far and, as I suggest, over-states the class of people and makes them, if anything, more lunatic than those whom you would otherwise admittedly have to certify.
I am not advocating in this connection any necessity for the retention of the Justice of the Peace. But I would suggest for the hon. Lady's consideration that the fact that you are allowing the introduction of a new class of those mentally afflicted without the intervention of any judicial authority necessitates this additional precaution, that the recommendation, a specimen of which appears in the Schedule, ought to contain the reasons for the recommendation, as in the case of the ordinary procedure of certification, under the headings "Facts observed and facts communicated." In saying that, I am supported by the recommendations of the Royal Commission, who themselves took that view. Let it be remembered, on the one hand, that you are introducing this new class and, on the other, you are taking extra precautions for immunity, so far as you can give it, to the medical profession. Therefore, at least I suggest that you should insist that in your recommendation the facts observed and the facts communicated should appear.
I would only add that I hope it will be insured that in any rules that are permitted to be made under Clause 5 with regard, among other things, to the giving of papers to the patient on request, after recovery, it shall not be permitted, under rules that may 1064 be made dealing with Section 82, so to modify that procedure as to make it possible for the patient to retain the certificate upon which he or she was committed. I only mention that; by way of precaution, because power is given to modify that section under the rules which are to be made under Clause 5. I want to make quite sure that the precautions will not be modified out of existence.
One word with regard to the protection of medical men. Everybody is agreed that it is essential to make it as difficult as possible to attack medical men in connection with this procedure. As has been pointed out more than once, the known reluctance of medical men to certify because of the risks which attach to it, is a very serious matter in connection with lunacy proceedings. The House will realise that there is no halfway house between complete immunity for the medical profession on the one hand, which has not seriously been put forward, and their liability to be attacked in cases where there is bad faith or negligence. It is in connection with the provision of safeguards in the latter class of case that the difficulty arises, because, as has been pointed out, you do not give complete immunity if there is a cause of action either from bad faith or negligence. There is always the risk that a person may be able to get a case on its legs against the doctor.
I would suggest that, in addition to the safeguard provided—and I think it is a substantial and a real safeguard—of going before the Judge, who has to be satisfied not merely that there is an allegation of bad faith or of negligence, but that there is sufficient ground for that allegation, it would be possible to make an additional safeguard on the analogy of the safeguards which are provided with reference to poor persons' litigation. As the House knows, before a person is permitted to sue in the High Court as a poor person under the Poor Persons' Rule, there is an independent committee of investigation, of persons who cannot by any possibility take part professionally in any proceedings which are afterwards laid; a committee appointed, I think, either by the Lord Chancellor or the Law Society, or both. I suggest that it would be quite possible here, and it would be in the interests both of the public and 1065 of the medical profession, to have a voluntary panel of investigation set up, appointed if you like by the Lord Chancellor and the President of the British Medical Association, some independent body like that, to investigate any claim which a person who has been certified desires to bring against a doctor, and make a report to the Judge, for the assistance of the Judge, before he is called upon to make up his mind whether the proceedings should go on. That, I agree, in one sense is a matter of detail, but it is of very vital importance, and I am sure the hon. Lady the Parliamentary Secretary to the Ministry of Health will agree, in the interests of the efficient working of the Lunacy Acts, that, if the doctors cannot be given complete immunity, they should nevertheless be safeguarded as much as possible.
§ Miss LAWRENCE
My right hon. Friend has no reason to complain of the way in which the Bill has been received by the House. It has been met with enthusiasm, as far as its main proposals are concerned, by almost every hon. Member who has spoken. It is true that hon. Members suggested here and there various points in which they thought the Bill might be improved, and my right hon. Friend will consider sympathetically in Committee any Amendment that can be suggested. It is very seldom that a Bill is received with such general favour. One hon. Member was a little surprised. He said that it was too good to be true, that such a Bill could not possibly come from such a Government and that there must be a catch in it somehow. I want to console the hon. Member by saying that the Bill is taken almost verbatim from the unanimous report of the Royal Commission, and that it was subjected to certain improvements in another place. If the hon. Member likes, he may call it the Royal Commission Bill. That being the case, and the Bill having been received in such a way, I hope that we shall not only have a Second Reading to-night, but that when we get into Committee we shall mutually convince each other and that the Bill will pass through Committee as happily as it has passed through this House.
All the points of objections raised are, in essence, Committee points. I will review some of them now, although they are not Second Reading points at all. I 1066 will take first Clause 5. The hon. and learned Member for Rusholme (Sir F. Boyd Merriman) has dealt with the different classes of persons of unsound mind who would come within the scope of the Bill. There are those whom we may classify as being able to express their willingness of their own volition to be treated. There are those who cannot say "yes" or "no." They are so incompetent that they cannot give an intelligible answer and must be looked after by somebody, because they are incapable of managing their own affairs or of giving a simple answer to a simple question. On the other hand, there are those who have a good deal of will, although it may be a wrongly directed will, and are quite capable, however little sane they may be, of actively resisting any proposal of this kind that may be made to them. If there are any words that will better express the intentions contained in Clause 5, we shall be glad to consider them. With regard to the protection of the doctor, which is dealt with in Clause 16, several hon. Members have expressed their views. If we can deal with that matter more satisfactorily in Committee, well and good, but having regard to the way in which the matter has been discussed and re-discussed, I very much doubt whether the intelligence of the Committee will be able to deal with it any better. As to the money which it was stated the local authority ought to have for discharging their duty, I would point out that the main duty is already upon them. Every single person is under care at the moment in asylums, and it is necessary to put this in the Bill because if we do nothing we should be freeing—
§ Lieut.-Colonel FREMANTLE
Is it not true that in addition to those under care that there are many others driven underground by the present treatment who will require care?
§ Miss LAWRENCE
I do not suppose there is a single case where the person is utterly incompetent which is not taken care of by somebody. The person who cannot say yes or no are all under care in asylums now, and we calculate that about one-quarter to one-third of the cases now in asylums will come under the Clause. The new duties imposed on local authorities are not mandatory, but permissive. Some local authorities already exercise them and have already passed 1067 special Acts of Parliament. The Bill places other local authorities in exactly the same position as London. Those who have pressed the Government on this matter will observe the extreme care with which the right hon. Member for West Woolwich (Sir K. Wood) dealt with the question. He is an old and experienced politician. He knows what Clause 135 of the Local Government Act means as well, or better than any hon. Member, and I noticed with all the admiration one gives to a Parliamentary tactician, in the hope of improving one's own Parliamentary style, that he did not say the county councils should have this money. I appreciate the delicacy with which he handled the matter. Seeing that the right hon. Gentleman may again occupy the position which I so unworthily occupy, he was careful to prepare himself a little way of retreat. He never said, "I will give this money to the local authorities," but he was prepared to say that the local authorities thought it should be given.
Now let me deal with a matter which has disturbed a good many hon. Members. It is perfectly true that the Royal Commission said—and we have put it in the Bill—that the Board of Control have many imperfections. The hon. Member for East Islington (Dr. Bentham) said that she found the Board of Control very good but a highly mysterious body. I do not wonder; if you look at the defects which the Royal Commission found. I will give two. First, it was understaffed; second, its duties took it travelling continually all over the provinces. If anything is calculated to make a Government Department mysterious and inaccessible it is that it should be always in the provinces and never in London. We propose to remedy that. We propose to bring the Board of Control into much closer relationship with the Ministry of Health than ever it has been before. We propose to place the Board of Control more in the position of a department of the Ministry. The chairman to be appointed by the Minister of Health is to be an executive officer, that is to say, in the position of head of a department, and hon. Members need not be afraid that there is no Parliamentary control. They have precisely the same amount of Parliamentary control over the Board of Control as they have over any other department of the 1068 Minister of Health. We present their Estimates; we appoint them; with the Treasury we settle their salaries; we answer questions for them in the House. Any part of their action can be discussed. This Bill has been received with the utmost unanimity. Every point that has been raised is of a kind that can be dealt with in Committee. I ask the House now, at the end of this long and careful Debate, to give us the Second Reading and to postpone consideration of detailed points until we can get upstairs and discuss them together.
Dr. VERNON DAVIES
While anxious to oblige the Parliamentary Secretary after her very short speech upon the Bill and on the points raised, I feel that the Bill is of so much importance that the House is entitled to consider it further on one or two points which, so far, have not been mentioned. As the Parliamentary Secretary has said, the Bill has been received with a wonderful feeling of unanimity, although I must confess, having heard all the Debate, that there are many varieties of understanding as to what the Bill really means. It is not a lunacy Bill; it is not a mental defective Bill. It is a Bill to get at the unfortunate cases before lunacy and certification are reached. That brings forward a most important point which has not been sufficiently stressed, and that is the case of the voluntary boarder or voluntary patient. The House has heard of the stigma, the shame and the horror which attach to lunacy and certification, how people in all walks of life are terrified at the word "insanity." One of the most tragic events in any family is, first of all, the suspicion that one member of the family may be mentally unbalanced; then on top of that, the fear that this may lead to insanity; and after that, if the case unfortunately does become insane and the patient is certified, the horror and shame and the stigma which remain upon the whole family. In the case of adolescent children it may very well affect their future life. They may not be able even to get married because father or mother was a lunatic, because of the fear that lunacy may be hereditary or a visitation of God.
What has been the result? That families in all classes of life have done all they can to hide these cases. On the earliest suspicious sign of mental in- 1069 stability they have gone to their doctor. One of the most tragic things that can happen to any man in private practice, as has happened to me so often, is when a poor patient, perhaps a woman, worried to death, with little money, her husband out of work, with no peace and no rest, finds that she cannot sleep, and that her nerves give way, and then she asks, "Oh, doctor, am I going mad? That is one of the most horrible questions which can be put to a medical man. Then take the ex-service man who has been struggling against adversity and fighting against overwhelming odds until the time comes when he overbalances for lack of treatment. There is also the business man who, under the stress of modern life, worries and worries until he reaches the point where he breaks down, and then we have records of suicides and other troubles. Would it not be better, if it could be arranged, that these people should know that treatment, absolutely separate and distinct from any suggestion of insanity, was available for them? If a man has an illness of the lungs he goes to a doctor or to a hospital, has his ailment diagnosed and undergoes the appropriate treatment. If a man feels that he has any heart weakness he takes medical advice and, though he may be told that he is suffering from heart disease, he does not worry himself in the same degree as he would at the merest suggestion of insanity. But once the word "mental" is mentioned, immediately a patient becomes worried. What we want is a change in the attitude of the public towards the idea of mental illness. It should be regarded just as physical illness is regarded, and the public should get the idea that it can be treated, with the hope of effecting an improvement.
We in this House have a great opportunity. The Minister of Health has been even braver than the Royal Commission. Their report marked a distinct advance, and he has advanced a little beyond that report. I would like to see the House advancing a little beyond the Minister of Health. Let us take our courage in our hands and say that we are determined to recognise mental illness in the same way as physical illness and not as insanity. Does the Bill carry out that idea? I say that it does not. I say that it falls short. The first four Clauses deal with the voluntary boarder or patient. What is the idea of the Royal Commission and of 1070 the Minister and of this House It is that on the very first signs of mental trouble— irritability, instability, hopelessness, worrying—the patient should be able to say, "I can offer myself as a voluntary boarder, for the requisite treatment, and I can be treated for this illness, just as for a broken leg or for bronchitis or pneumonia, and if I do so at the proper time I have a great chance of recovery." But the Bill says that the patient may be received after he has given notice, or, in the case of an infant, after notice has been given on his behalf, and that the case is then to be notified to the Board of Control. That spoils the whole scheme. I have nothing against the Board of Control, and, if time permitted, I would like to say how highly I think of the Board of Control, but in the eyes of the public the Board of Control means that the case is one of lunacy. We cannot get away from that fact. If a patient knows that by going to a general hospital or a licensed private hospital he is liable to be inspected at any time by a Board of Control, the suspicion of insanity is immediately aroused. With working-people, with uneducated people, what is going to happen. There will be no voluntary patients at all on account of that stigma and that fear of lunacy. The Minister ought to be courageous and advise the House and the country to treat the voluntary boarders as patients suffering from a physical illness, pure and simple. In no circumstances should they be notified to the Board of Control unless special arrangements were found necessary in the case of infants, sent in by parents or guardians.
By doing that, once the public get to know that they can go, at this stage of early mental illness, to a hospital and be treated, without any control or notification to the Board of Control, I think you will make a great step forward, and will get the people to go. The result will be to help thousands of people who now, through worry and anxiety, and lack of early treatment, go over the border line and became insane, and often commit suicide. Those are the cases we want to get at. We want to stop them going over the line, and we can only do that by persuading them to come for early treatment. You will never persuade them once they get the idea that the Board of Control is in the 1071 picture. These Debates are reported in the Press, and to-morrow morning there will be thousands of worried people in this country reading the Debates to see what the people are going to do for these voluntary boarders. I hope the Minister will seriously consider that point, be courageous, and say, "Very well, I regard these cases as cases of mental illness, and being mental illness it is the same as physical illness, and being physical illness the Board of Control shall not come in."
When we come to the other cases, of which the ex-Solicitor-General spoke, the qualifying point there is the non-volitional cases which are likely to be improved. That Clause qualifies the whole class of case, but the great danger there is going to be this, that every case in the future that is not a voluntary boarder will be called a temporary case, because no doctor will commit himself to saying that a patient cannot get better in six or 12 months. Prognosis in mental disease is not easy, and no doctor, for his own sake, will say, "I will certify this case as a lunatic, and there is no chance of recovery." Every case will come under your temporary patients' Clause, because the doctors will hope that they will improve within the six months or perhaps the 12 months, and will put off the stigma of certification as long as they can. There is no reason why they should not do it, and there is no disadvantage in doing it. I think the ex-Solicitor-General was looking at it too much from the legal aspect.
Is the Board of Control necessary? My opinion is that the Board of Control is the only safeguard for patients, because they are an independent body of medical and legal men, with some others, with expert knowledge of administration and of lunacy or mental work, absolutely unrelated to any of the local authorities, all perfectly independent men, and having the interests of the patient at heart. They want to see, first of all, that the patient is in proper circumstances, in a proper building, and secondly, that he is properly treated; and they have the power of compelling the patient either to be released—I do not like that word, which is a wrong word, and I will say instead discharged as cured—or certified, if necessary. They are absolutely independent of all parties 1072 except the Minister of Health. It is practically an impossibility for any patient to-day to be improperly detained. The National Society of Lunacy Reform presented a number of cases to the Commission which they said were cases that had been improperly detained, but in every single case the Royal Commission did not agree with them. Members may take it for certain that at present it is almost impossible for a patient to be improperly detained. These temporary patients are visited by the Board of Control, who can order them to be released or, if necessary, certified.
They are visited by visiting committees or visiting justices or by their friends, and one may take it for granted that these cases which go into hospital are received with the sole idea of a cure, and that under no possible circumstances can they be better looked after than by that body of gentlemen who live in London, and who see that the best is done for them. So I would increase the powers of the Board of Control; I would make them responsible to this House, but I would not under any circumstances allow them to have anything to do with voluntary boarders.
One other great defect in the Clause is that voluntary boarders may go to mental hospitals—that is, to asylums. That is absolutely ridiculous and fatal. You would have a border line, nervy cases going into mental hospitals, and seeing real cases of insanity, and that would be just the sort of thing to topple such cases over the line. Under no circumstances ought voluntary boarders to be sent to a mental hospital; they should be sent as out-patients to other hospitals. There are three hospitals that have these patients, one at Cardiff, one at Oxford, and the Middlesex Hospital in London. The Bill gives power to extend that. I feel strongly about this Bill because we are at the parting of the ways. This is going to be an epoch-making Bill, and I want the Minister of Health to have the credit of it, because he has had the courage to go a little beyond the Report of the Royal Commission; I want the House to have the courage to go even beyond the Minister, and to insist that the voluntary boarders should be kept away from the Board of Control.
The question of safeguards for the medical profession has been raised. The 1073 safeguards in the Bill are absolutely valueless, because he would be a very poor lawyer who could not make out a primd faciâ case to satisfy any judge, and I do not think the remedy of the late Solicitor-General is very much better. I recognise that it is a difficult thing to deal with I would ask the House to bear in mind that the medical profession is an honourable profession. They really try to do the best they can for their patients, and they have no real desire to see that people are locked up and detained or certified as insane when they are not insane. The result is that doctors at the present time, owing to difficulties which have arisen, refuse to certify, and we shall find that they will refuse to recommend under this Bill. There is a simple way out of the difficulty. Hon. Members know that there is such a body as the General Medical Council, which consists of medical men and some laymen, and any medical man who does any action which is infamous in a professional respect is reported to the Council which examines the case. If that man be guilty, they cross him off the roll, and he cannot practice as a registered medical practitioner. Why should not the Board of Control, when they come across a case where a certification is wrong, or where it is alleged that a medical man has betrayed the trust reposed in him, and has kept under control a patient who ought not to have been kept under control, refer the facts to the General Medical Council? If the Council said "We believe the charge to be true" and struck the doctor's name off the roll, that action would ipso facto be evidence in support of any proceedings taken against him to recover damages. That is a simple way out of the difficulty. The essential thing is, first, to trust the Board of Control and, second, to trust the General Medical Council; by doing that you get out of all legal quibbling. Whatever the safeguards that may be introduced, it will be found that doctors will distrust them, and that distrust will make them hesitate to certify. The hon. Lady on the Treasury Bench spoke of being satisfied with the reception the Bill had had, but I hope the points I have outlined will be brought up in Committee. If I am a member of the Committee, I shall embody them in a series of Amendments and I hope the Minister will give them serious consideration and really make the Bill 1074 what it is intended that it should be—a hope and a Godsend to many people who to-day are very worried, weary and tired.
§ Mr. McSHANE
I am opposing this Bill for almost every reason for which the Minister claimed support for it. I find it difficult to deal with the speech of the hon. Member for Royton (Dr. V. Davies), because in the first part of it he was asking us to beware of the Board of Control and afterwards was urging us to give the Board further powers. I am opposed to the Bill entirely and could go through it Clause by Clause and give reasons for my objections, but I do not propose to do that, and will deal with the general principles. To Clause 1 I will make only one reference. That Clause actually invites a person voluntarily to submit himself to treatment, I should say without hesitation that if any person submitted himself to the control of the Board of Control, it would prove at once that he was quite insane; and I may further suggest that those who concocted that Clause, in thinking anyone would submit himself to the control of the Board of Control, are also more or less insane. One point which has struck me about the Debate is that there has not been a speaker who did not make some reference to the Board of Control which was not to its credit. In the hearts of most of us there is a fear that the Board of Control has too much power; it has statutory powers to prevent any local authority, or even Parliament itself, getting at it, and it is that aspect of the position with which I wish to deal to-night. Every reason which the Minister of Health put forward for the treatment of these cases was a reason for taking the whole of this business out of the hands of the Board of Control. That Board has been established since 1840, and its tradition affects every official of that body and, although those officials are well-intentioned, they cannot act as most of the Members of this House would like them to act, because of the tradition of that institution. Not a single hon. Member of this House—not even the Minister of Health—who tried to defend the Board of Control has done so without saying something against that body. The outstanding feature of the Debate has been the complete dissatisfaction of every side of the House with the Board of Control.
§ Mr. McSHANE
The exception generally proves the rule. I will give an example which occurred in my own town. One of the officers of the Board of Control certified that a certain young lady was mentally defective, and she had been placed in the workhouse which was administered by the board of guardians of which I happened to be the chairman. We had this young lady before the board of guardians. We examined her and talked to her for an hour, and at the end of that time we came to the conclusion that she was as sane and as normal as most of us. This officer who had not the skill of the specialist was allowed to exercise a power of that kind. I saw that officer on the following day, and I asked what was her reason for suggesting that this young lady should be put into a mental home, and I told her that the guardians were opposed to it. She replied: "Do you know the history of that girl; she is 17½ years of age, and she has never earned her living since she was 14." I replied that I thought that was proof that she was sane and was only aping the best society. It subsequently transpired that this young lady who had been certified by the officer of the Board of Control was suffering from venereal disease. I object to any officer of the Board of Control having power to send a person for all time into a mental home. The right hon. Gentleman the Member for West Woolwich (Sir K. Wood) said that unfortunately some of the local authorities had not sufficient time to deal with such cases. My complaint is that they take too short a time and have too much power. Most of the medical men who have taken part in this Debate have spoken in favour of the Bill, but they are all specialists and so are the members of the Board of Control. A specialist has been defined as a man who knows more and more about less and less.
I have risen to-night to voice my objection to this Bill. The whole point of the Bill is that the taint of insanity shall be totally removed from those who are undergoing mental treatment, probably for a transitory illness. That cannot be achieved as long as the Board of Control deals with the matter. The Board of Control still deals with lunacy, and that 1076 is the whole function of the Board of Control. Whatever patient comes in any way under the Board of Control, that patient is, ipso facto, affected with the whole taint of that for which the Board of Control exists, and it is for that reason that I object to this Bill. I should have preferred to see the whole matter taken out of the hands of the Board of Control, and put into the hands of the municipality as a social service linked up with the hospital—with bodily disease—as being, as in fact it often is, due purely to a bodily disease. As long as it is under the Board of Control, the very purpose for which the Bill has been drawn up is defeated and for that reason I object to the Bill.
§ Mr. WOMERSLEY
I do not apologise for intervening, because I have sat here for a good many hours listening to speeches on the Bill. I listened with great interest to the Minister of Health and to the medical Members of the House who have expressed their opinions on the Bill, but I want to approach the question from another aspect, which has been touched upon by the hon. Member for Walsall (Mr. McShane), that is to say, the aspect of the layman—of a man who has been engaged in local government work, and has therefore had to come in contact with these mental cases, and also of a man who has had a different kind of experience, the experience of a magistrate who has had to certify cases of lunacy. We must bear in mind that, after all, this Bill, as the Parliamentary Secretary said, is founded upon she Report of a Royal Commission; and when we look at the names of some of those who served on that Commission, we surely must feel some confidence in the Bill as a whole, although there may be, as has been said, some portions of it that will require amendment in Committee. I should like to remind the hon. Member for Walsall that there is not a Bill that comes before this House that does not require amendment in, at any rate, some particulars; but the mere fact that these alterations are necessary does not mean that the Bill itself is bad. In my opinion the present Bill, on the whole, is a very good Bill.
Let me refer to the names of the members of the Commission. The Chairman was that very eminent lawyer, Mr. H. P. Macmillan, K.C., and the Commission also included Sir Humphry 1077 Rolleston, Earl Russell, Sir Ernest Hiley, the present Attorney-General—in whose opinion on these matters, I am sure, the hon. Member for Walsall will have a little confidence—and the hon. Member for East Woolwich (Mr. Snell). Anyone who reads through the Commission's Report is bound to agree that the time has come for some reform in regard to this question. As has been pointed out already, this Bill is by no means a party or controversial Bill. The present Government are evidently in agreement with the last Government that something ought to be done on the lines recommended by the Royal Commission. I welcome whole-heartedly the Clause dealing with early treatment. I think that boys and girls ought to be dealt with in altogether different institutions from adults. I know that the local authorities have power to deal with them now, but, unfortunately, very few local authorities have set up these separate institutions, and I suggest to the Minister of Health that even now, before this Bill is passed, all possible pressure should be brought to bear upon local authorities throughout the country, who have not yet undertaken this work, to proceed with it as quickly as possible. Those of us who have to deal with educational matters know that the most pitiable thing that can be found among a lot of school children is the boy or girl who is a mental defective, but not bad enough to be taken to an asylum. That child very often becomes the butt of the other children in the school, and does not have a very comfortable time. On the other hand, the old system of sending the children to an ordinary asylum was far more harmful than leaving them at home. We have the power and we ought to see that the local authorities exercise it. As regards the question of magistrates being relieved of the duty of certification, I can assure the House from my own knowledge, that magistrates will welcome this more than anyone. It is a most distasteful duty, and, as a magistrate, I shall be very glad to feel that I cannot be called upon to perform it. In temporary cases a magstrate feels that he has a very difficult task, and a decision on such a question is really not one for a mere layman. The hon. Member for Reading (Dr. Hastings) mentioned one fact that 1078 has come to my notice time and time again.
People who are the worst mental cases are always convinced in their own minds that they are perfectly sane, and it very often happens that they are perfectly sane up to a point. When members of local authorities go to those asylums as visitors or, as I have gone, with cricket teams which play against a team of asylum attendants, you are constantly asked by persons who come from your own district why they are not allowed to go home. They assure you they are perfectly sane and talk as though they were until you begin to be convinced that they are. It is only when something happens to upset one of them and half-a-dozen attendants are needed to deal with him that you realise that such a person, although sane on many points, is not capable of carrying on his own affairs.
As regards Clause 11, which deals with the question of the reorganisation of the Board of Control, at the present time there are supposed to be 15 Commissioners, but I believe there are only 13. Under the new proposals, these are going to be reduced to five—a chairman, and not more than four others, all of whom, other than the chairman, are to be paid. One of the commissioners must be a lawyer, another a medical man, and another a woman, but we are not told exactly who the other one is to be, whether a professional man or just someone who is interested in this matter. I suggest that he should be a layman and possibly one who has had some experience either as a member of a visiting committee or as a certifying magistrate. I am satisfied that the general public has a sort of suspicion—I do not suggest there is any real foundation for it—of lawyers and medical men dealing with this question. I am not saying this in any way disparagingly of lawyers and medical men, but only what I know to be the facts. If it were given forth that at any rate one of the commissioners should be a layman who could judge without medical or legal knowledge and from the common-sense point of view, I think it would inspire a general confidence among the public. This criticism and suspicion on the part of the public is probably ill-founded, but it is there.
1079 It has been suggested by some of those who have served as commissioners that this new arrangement is not going to be altogether a success. As I understand it, some of the commissioners already serving will not, of course, be re-appointed, but will remain in a sort of semi-official capacity. They will rank somewhat with inspectors and assistant commissioners, but will have no authority. They will be able to attend the meetings and may offer certain comments, but they will have no voting powers. I wonder why these commissioners are going to be kept on at all? Is it to save them losing any emoluments now attaching to their offices, or is it thought that they may be of some use in offering advice? At any rate, they are to have no power. Many of them have had long experience in the treatment of mental cases and some of them are specialists in this particular branch of the medical profession.
It is a pity we cannot utilise their services to a fuller extent than the Bill provides for. None the less the Bill ought to receive a Second Reading. It may be said that the Clause that gives the Minister power to appoint is not altogether in the best interests of the country, because we are getting Bill after Bill in which power is given to
§ the Minister of Health to appoint officials. Leave the officials there and it places a great responsibility upon him. Still I have not found anyone yet who can suggest a better method of dealing with it. Under the present system the Commissioners are appointed by the King. I take it that means that they are appointed by some Member of the Government acting on behalf of the King. Now we are going to know definitely that it is to be the Minister of Health. The present system of dealing with the mentally afflicted is not by any means satisfactory. The Bill is a step in the right direction. It will give greater facilities for treatment to people with mental disorders, and if it is going to help them—and I am sure it is—it is worth all the time we are spending in discussing it and all the time we shall be trying to amend it in Committee.
§ Bill accordingly read a Second time.
§ Motion made, and Question put, "That the Bill be committed to a Committee of the Whole House."—[Lieut.-Colonel Fremantle.]
§ The House divided: Ayes, 60; Noes 172.1081
|Division No. 168.]||AYES.||[11.59 p.m.|
|Acland-Troyte, Lieut.-Colonel||Gunston, Captain D. W.||Richardson, Sir P. W. (Sur'y, Ch'ts'y)|
|Albery, Irving James||Hacking, Rt. Hon. Douglas H.||Rodd, Rt. Hon. Sir James Rennell|
|Beamish, Bear-Admiral T. p. H.||Henderson, Capt. R. R. (Oxt'd, Henley)||Sandeman, Sir N. Stewart|
|Beaumont, M. W.||Heneage, Lieut.-Colonel Arthur P.||Shepperson, Sir Ernest Whittome|
|Bird, Ernest Roy||Hennessy, Major Sir G. R. J.||Smith, R. W. (Aberd'n & Kinc'dine, C.)|
|Brown, Col. D. C. (N'th'I'd., Hexham)||Kedward, R. M. (Kent, Ashford)||Somerville, D. G (Willesden, East)|
|Cazalet, Captain Victor A.||Lamb, Sir J. Q.||Southby, Commander A. R. J.|
|Colville, Major D. J.||Leighton, Major B. E. P.||Stanley, Maj. Hon. O. (W'morland)|
|Courtauld, Major J. S.||Llewellin, Major J. J.||Steel-Maitland, Rt. Hon. Sir Arthur|
|Courthope, Colonel Sir G. L.||Long, Major Eric||Thomson, Sir F.|
|Crookshank, Capt. H. C.||Lymington, Viscount||Titchfield, Major the Marquess of|
|Culverwell, C. T. (Bristol, West)||Margesson, Captain H. D.||Todd, Capt. A. J.|
|Davidson, Rt. Hon. J. (Hertford)||Merriman, Sir F. Boyd||Vaughan-Morgan, Sir Kenyon|
|Davies, Maj. Geo. F. (Somerset, Yeovil)||Mond, Hon. Henry||Wallace, Capt. D. E. (Hornsey)|
|Duckworth, G. A. V.||Monsell, Eyres, Com. Rt. Hon. Sir B.||Warrender, Sir Victor|
|Ferguson, Sir John||Moore, Lieut.-Colonel T. C. R. (Ayr)||Windsor-Clive, Lieut.-Colonel George|
|Fison, F. G. Clavering||Morrison, W. S. (Glos., Cirencester)||Womersley, W. J.|
|Ford, Sir P. J.||Muirhead, A. J.||Wood, Rt. Hon. Sir Kingsley|
|Glyn, Major R. G. C.||Penny, Sir George|
|Gower, Sir Robert||Peto, Sir Basil E. (Devon, Barnstaple)||TELLERS FOR THE AYES.—|
|Greene, W. P. Crawford||Remer, John R.||Colonel Fremantle and Mr. Charles Williams.|
|Adamson, Rt. Hon. W. (Fife, West)||Batey, Joseph||Brown, Ernest (Leith)|
|Adamson, W. M. (Staff., Cannock)||Beckett, John (Camberwell, Peckham)||Brown, James (Ayr and Bute)|
|Aitchison, Rt. Hon. Craigle M.||Bennett, William (Battersea, South)||Burgess, F. G.|
|Alexander, Rt. Hon. A. V. (Hillsbro')||Benson, G.||Cameron, A. G.|
|Alpass, J. H.||Bentham, Dr. Ethel||Cape, Thomas|
|Arnott, John||Bevan, Aneurin (Ebbw Vale)||Carter, W. (St. Pancras, S. W.)|
|Aske, Sir Robert||Brockway, A. Fenner||Charleton, H. C.|
|Baldwin, Oliver (Dudley)||Brooke, W.||Chater, Daniel|
|Barnes, Alfred John||Brothers, M.||Compton, Joseph|
|Daggar, George||Lathan, G.||Richardson, R. (Houghton-le-Spring)|
|Dallas, George||Law, A. (Rosendale)||Riley, Ben (Dewsbury)|
|Dalton, Hugh||Lawrence, Susan||Ritson, J.|
|Denman, Hon. R. D.||Lawson, John James||Romerll, H. G.|
|Dickson, T.||Lawther, W. (Barnard castle)||Rosbotham, D. S. T.|
|Dukes, C.||Leach, W.||Rowson, Guy|
|Duncan, Charles||Lewis, T. (Southampton)||Salter, Dr. Alfred|
|Ede, James Chuter||Lloyd, C. Ellis||Sanders, W. S.|
|Edmunds, J. E||Logan, David Gilbert||Sandham, E.|
|Edwards, C. (Monmouth, Bedwellty)||Longbottom, A. W.||Sawyer, G. F.|
|Edwards, E. (Morpeth)||Longden, F.||Shepherd, Arthur Lewis|
|Egan, W. H.||Macdonald, Gordon (Ince)||Sherwood, G H.|
|Elmley, Viscount||MacDonald, Malcolm (Bassetlaw)||Shield, George William|
|Forgan, Dr. Robert||McElwee, A.||Shillaker, J. F.|
|Gardner, B. W. (West Ham, Upton)||McEntee, V. L.||Simmons, C. J.|
|George, Major G. Lloyd (Pembroke)||McKinlay, A.||Sinkinson, George|
|George, Megan Lloyd (Anglesea)||McShane, John James||Smith, Alfred (Sunderland)|
|Gibbins, Joseph||Malone, C. L'Estrange (N'thampton)||Smith, Ben (Bermondsey, Rotherhithe)|
|Gibson, H. M. (Lancs. Mossley)||Marcus, M.||Smith, Frank (Nuneaton)|
|Gill, T. H.||Markham, S. F.||Smith, Rennie (Penistone)|
|Glassey, A. E.||Marley, J.||Smith, Tom (Pontefract)|
|Gossling, A. G.||Marshall, Fred||Sorensen, R|
|Gould, F.||Mathers, George||Stamford, Thomas W.|
|Greenwood, Rt. Hon. A. (Coine)||Matters, L. W.||Strauss, G. R.|
|Grenfell, D. R. (Glamorgan)||Messer, Fred||Sullivan, J.|
|Griffith, F. Kingsley (Middlesbro' W.)||Mills, J. E.||Taylor, W. B. (Norfolk, S. W.)|
|Groves, Thomas E.||Milner, J.||Thomas, Rt. Hon. J. H. (Derby)|
|Hall, G. H. (Merthyr Tydvil)||Morgan, Dr. H. B.||Thurtle, Ernest|
|Hardie, George D.||Morley, Ralph||Tinker, John Joseph|
|Haycock, A. W.||Morris-Jones, Dr. J. H. (Denbigh)||Townend, A. E.|
|Hayday, Arthur||Mort, D. L.||Vaughan, D. J.|
|Henderson, Arthur, Junr. (Cardiff, S.)||Mosley, Sir Oswald (Smethwick)||Wallace, H. W.|
|Henderson, Thomas (Glasgow)||Nathan, Major H. L.||Watson, W. M. (Dunfermline)|
|Henderson, W. W. (Middx., Enfield)||Noel Baker, P. J.||Wellock, Wilfred|
|Herriotts, J.||Oldfield, J. R.||Welsh, James (Paisley)|
|Hoffman, P. C.||Oliver, P. M. (Man., Blackley)||Welsh, James C. (Coatbridge)|
|Hopkin, Daniel||Owen, Major G. (Carnarvon)||Westwood, Joseph|
|Horrabin, J. F.||Owen, H. F. (Hereford)||Whiteley, Wilfrid (Birm., Ladywood)|
|Hudson, James H. (Huddersfield)||Palin, John Henry.||Whiteley, William (Blaydon)|
|Isaacs, George||Parkinson, John Allen (Wigan)||Wilkinson, Ellen C.|
|Johnston, Thomas||Perry, S. F.||Williams, Dr. J. H. (Llanelly)|
|Jones, J. J. (West Ham, Silvertown)||Pethick-Lawrence, F. W.||Williams. T. (York, Don Valley)|
|Jones, Morgan (Caerphilly)||Potts, John S.||Wilson, R. J. (Jarrow)|
|Jones, T. I. Mardy (Pontypridd)||Price, M. P.||Winterton, G. E. (Leicester. Loughb'gh)|
|Jowitt, Rt. Hon. Sir W. A.||Pybus, Percy John||Wright, W. (Rutherglen)|
|Kelly, W. T.||Quibell, D. J. K.||Young, R. S, (Islington, North)|
|Kennedy, Thomas||Ramsay, T. B. Wilson|
|Kinley. J.||Raynes, W. R.||TELLERS FOR THE NOES|
|Lang, Gordon||Richards, R.||Mr. Hayes and Mr. Wilfrid Pailng.|
Question put, and agreed to.