§ Motion made, and Question proposed, "That this House do now adjourn."—. [Mr. Snow.]
§ 4.1 p.m.
§ Dr. Morgan (Rochdale)
I rise this afternoon for the purpose of making a plea for the very least and most unfortunate of the children of the country, namely, those children who, after medical 1569 testing and examination, it has been decided are quite incapable of any education or training. It is unfortunate that, apparently because of the incapacity of these children to call attention to their condition, this is one of the problems concerned with child welfare which have been most neglected in this country.
We have recently had the Curtis Report dealing with child welfare in general terms, but for the rest we have these children who are practically brainless, or whose brains are not functioning, but the have good physical frames, and it is they who are left absolutely alone and neglected, as I hope to prove, by the country as a whole and by the local authorities which have duties placed upon them to give some attention to the subject.
It cannot be held that these children are incapable of education through any fault of their own, nor is it through any fault of their parents, though it is true that sometimes the incapacity may be due to heredity or to injury at birth; but the cases I specifically want to emphasise are those of children who are mentally disabled in this way after disease. In my own constituency of Rochdale, where the local authority have been very keen and pressing on this problem because of the activity of one or two Labour councillors and, I am glad to say, of the Director of Education, there are at least seven, and possibly eight or 10 children of this kind, and I understand that that is a good average for the whole of the rest of the country. But there are no institutions in the country to deal with this problem. It is true that, the moment it is decided, after medical examination and certification, that a child is incapable of education, the local education authority has nothing further to do with the matter. In those constituencies where local education authorities deal with children up to that stage, the local council, according to law, report the matter to the county council, and the mental deficiency committees of the county council, dealing with cases of mental abnormalities, then have a duty placed upon them to take action.
I am sorry to say that the Lancashire County Council, in this matter, for a long period have procrastinated and delayed, and have done nothing. I happen to have been trained in medicine, and it seems to me to be cruel that little helpless children of between 5 and 12 years of age, disabled mentally in this way, should be 1570 allowed to be left with their parents, who are martyrs to a condition for which they have no responsibility. The children are a bad example, and are a worry to the household and to the other children. Take the case, in Rochdale, of a child of 6 or 5 years old, who became disabled in this way after suffering from meningitis. The child is quite incapable of education, and lives in the middle of the family. He is badly behaved, throws things about hits the other children and his parents. He cannot always be subjected to physical punishment, because the parents cannot go on doing this every day. The mother is with the child in the house all day, and the father comes home tired from work to these conditions, knowing that it is not his fault, and yet nothing is done.
When a parent neglects a child, pro-vision is made under the law, whereby action can be taken, and this subject is very topical, because, quite recently, parents have been prosecuted for neglecting their children. But who is to prosecute a local authority when they neglect their duties, and who is to prosecute a Government Department when they neglect their duties? According to the Act, in page 24, paragraph 91, of the Curtis Report, which did not deal with this subject, as it was stated to be outside their terms of reference:Responsibility for the administration of the Lunacy and Mental Treatment Acts and Mental Deficiency Acts rests with the Board of Control, consisting of a Chairman and four senior commissioners appointed by the Crown, and responsible to the Lord Chancellor and the Minister of Health.The Lord Chancellor, who is head of the judicial and legal system of this country, puts this duty on the mental deficiency committees, through the boards of control of the larger county councils. Their duties are being neglected by the larger county councils, and nothing is done. I submit that this is an impossible position. If you go to a local authority, once a child has been certified, they say it is not a matter of education, and the Board of Education say that the matter does not now come within their province. If you go to the Home Office, they will say that it is not a problem for them, and it is only when the child becomes a delinquent that action is taken.
Then we fall back on the Ministry of Health, who tell us that the law is that the local council, once a child is ineducable should report the matter to the 1571 county council. That has been done in the case of Rochdale and the Lancashire County Council. The fact is that this problem has been greatly neglected, and cannot be dealt with locally. It would be unfair to ask a corporation like the Rochdale Corporation, to provide an institution or a home, with personnel and equipment to deal with seven or eight children in one place, when they are perfectly well aware that in other towns in Lancashire there are similar cases, and that all the other authorities would have to do the same. This is a matter which should be dealt with on regional lines by providing regional institutions, or national institutions. May I ask the Parliamentary Secretary whether any special circular has been issued to local authorities, calling attention to the fact that the provision of these institutions is within their province? Has there been a conference between local authorities on the subject, or has it been entirely forgotten?
I do not want to keep the House long, but I think that this is a subject of some importance. These children cannot be boarded out because foster parents will not take them. That is quite natural because these children are ineducable, they cannot be trained, and nothing can be done for them. They are absolutely brainless individuals, incapable of education, training or improvement in any way. It is unfair that they should be left in the hands of their parents to set a bad example at home. It is obvious to anyone who has studied this matter, that the only responsible way of dealing with it is to say that the local authorities, at great expense, must put up special institutions in their localities, or, as ought to be done, have regional or national homes to deal with these children. I feel strongly on this subject. One of the Labour councillors in Rochdale has to his credit been pressing for years for some action to be taken on this matter. He has interested the Director of Education there in it, but in spite of the fact that we have been pressing on the Lancashire county council the need for a suitable institution, and that other boroughs have been doing the same in respect of their county councils, the subject remains in the air, and parents are being punished for the incidence of certain diseases, like meningitis, which leaves their children helpless and untrainable.
1572 In Rochdale, there is a very excellent lady doctor, a child psychiatrist, who has done good work in this connection. She has gone into these cases most carefully to see if there is any possibility of these children being trained and educated. She has taken months, in some cases, before coming to a decision, and when she decides that there is no hope of a child reaching a state fit for education, then the matter is reported to the local education authority, in the way I have indicated, and, so far, we have been left absolutely in the air, perfectly helpless, waiting for something to be done.
I appeal to the Parliamentary Secretary to tell us that the present Government and their active Ministers in the Health Department will take this matter in hand as a matter of urgency, and insist that the county councils do their job. Have conferences, if you like, of all the appropriate authorities, but let us insist that institutions be established where these children can be properly cared for, which have a specialist staff, and a child psychiatrist in charge of them. Let us do something to ease the lives of these children, so that we may feel that the humanity of the country is not being lost and that these children axe getting some comfort in an institution or a home.
§ 4.15 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Mr. Key)
I have to admit that I have heard many distorted and exaggerated cases in this House, but I doubt if I have ever heard one quite as bad as that to which we have just listened. That is the sort of a statement which is likely to lead to a great deal of concern amongst parents in this country, and one which I think is unwarranted in the way in which it has been presented. An "ineducable child" is very difficult to define, and I speak now as a schoolteacher of some 40 years standing. It may be defined in two ways. It may refer to a child whose mental condition is such that he cannot be educated in the ordinary public elementary school, as it used to be called, or being carried still further, it may refer to one who cannot be educated in any kind of school at all.
§ Mrs. Leah Manning (Epping)
As an old teacher who has worked in the old public elementary schools the hon. Gentleman knows very well that those are not the children to whom the hon. 1573 Member for Rochdale (Dr. Morgan) was referring. The child who is ineducable under the ordinary meaning of the term, in the elementary school in the old days was called a mentally defective child and these are the children to whom the hon. Member was referring.
§ Mr. Key
If the hon. Lady will allow me to develop my answer in my own way, I shall try to deal with the point raised. As a matter of fact there are two classes dealt with under the provisions of existing laws. Provision is made partly by the Education Act, 1944, and partly by the Mental Deficiency Acts, 1913 to 1938. In the first place, it is the education authority under the Education Act which operates. It is the duty of the local education authority under Section 34 of the Act of 1944 to ascertain what children in their area require special educational treatment, and in the process of that ascertaining the authorities discover certain children who suffer from disability of the mind and have to be sent to special schools. Certain others suffering from similar disability, though probably less serious in extent, have to receive special educational treatment in the ordinary school.
Under Section 57 of the Education Act it is the duty of the education authority to report to the local authority under the Mental Deficiency Acts—and that is to the county council or the county borough council—children who are found to be incapable of receiving education at school. A child is deemed to be suffering from disability of mind rendering him incapable of receiving education at school not only if his mental incapacity makes it impossible so to educate him but also if he has other characteristics which render it inexpedient for him to be trained in the ordinary school. When the local education authority proposes to report a child to the mental deficiency authority, they have first to give notice to the parent of their intention and inform him that he has got a right of appeal to the Minister against his child being transferred to the mental deficiency authority. Where an appeal has been made the education authority is not allowed or empowered to report the child to the mental deficiency authority without a direction from the Minister of Education.
All appeals are given most careful consideration, and the parents are given the opportunity of submitting medical or other 1574 evidence in support of their case. Once the child has been reported to the mental deficiency authority, then the local education authority has no power or duty with respect to that child. Under Section 116 of the Education Act, 1944, the child passes outside the sphere of the local education authority, and it is entirely a matter then for the mental deficiency authority to consider whether the child ought or ought not to be dealt with under the Mental Deficiency Acts. I do not propose to go into detail about what has happened in recent times, except to say that, between 1st April, 1945, and 30th September this year, the Minister received some 407 appeals against the references in these cases.
§ Dr. Morgan
May I interrupt the hon. Gentleman for a moment? With all due respect to him—I do not know whether he has been properly briefed or not—he is not speaking of the sort of child referred to by me. I have been talking of the child who has been certified medically, and in whose case all the requirements of the Education Act have been thoroughly fulfilled. I was speaking of the ineducable child, and the responsibility of the Mental Deficiency Act Committee of the hon. Gentleman's Department to deal with such a child. What is the good of talking about the Education Act? It is sheer demogogic repetition.
§ Mr. Key
Again, I say that, if I am allowed to develop my case, I will answer the point. I think I should have the chance of stating my case. I was saying that there was not a great number of these cases reported between 1945 and 1946. Where they have been reported, they have been very carefully dealt with, the necessary investigations have been made and the necessary certificates, and so on, given for their transference. But when once the local education authority reports a child to the Mental Deficiency Acts Committee, then, of course, it becomes the duty of the mental deficiency authority to see that proper arrangements are made for that purpose.
In the normal way, the care of these children is, as I say, transferred to another department of the same authority, that is, where the educational authority is the county borough or the county council. That is the normal procedure, and the number of children who have been notified 1575 under this within the last few years is not very great. But, in the specific case to which the hon. Member refers, there is a little difference. In the case of Lancashire, special arrangements have been made, and, instead of the county boroughs themselves carrying out their function, there has been set up, for a long time now, what is known as the Lancashire Mental Hospitals Board. As a result of that, instead of the county boroughs carrying out their functions in the normal way, they have been combined for the purpose of providing the necessary' accommodation, the necessary treatment and the necessary care, so far as these children are concerned.
In all these institutions, in other parts of the country as well as in Lancashire, we have been faced with the very same difficulties with which we are faced in connection with many of the other health services that we are providing. We are faced with a lack of accommodation, because it was taken over for hospital purposes during the war, a lack of the necessary trained staff in the way of nurses to look after the children concerned and a lack of the necessary materials and labour for the purpose of providing the institutions that are required as the services develop. That is common in health services all over the country. It is particularly the case in these circumstances with which I am now dealing.
In the case of Lancashire, where, as I say, the Mental Hospitals Board exists, they have, so far as they operate through their Mental Deficiency Acts Committee, provided two institutions for the children of Lancashire at Calderstones and Brock-hall. But the mental deficiency authorities in Lancashire are hampered, just the same as other authorities are ham-pered, by the difficulty of staffing the services which they wish to provide. In fact, the Lancashire situation is even more difficult than in some of the other areas. While, for instance, in the Brock-hall Institution they have actually got accommodation available and beds that could be used, because of the impossibility of getting the necessary female staff they cannot accept the responsibility of receiving the cases in the institution. In such circumstances, of course, it becomes necessary to try to deal with them by 1576 leaving them with their parents, under active guardianship and supervision to see, as far as possible, that the best conditions and provisions are made for children in those difficult circumstances.
§ Mr. Key
I do not see how it can be said that an authority is neglecting its duty if it is doing everything it can to provide the service but finds that the staff it requires is not available for the purpose. We are doing everything we can at the Ministry of Health, in consultation with the Board of Control, to stimulate the necessary recruitment of nurses for this particular service. We are finding it very difficult indeed to staff the ordinary hospitals, and even more difficult to staff these places where special qualifications are necessary and where there may be special difficulties making the job less attractive than it would be in other cases. Until more nurses are forthcoming, and until more beds can be made available for mental defectives, it will be necessary for alternative arrangements to be made for the care of these particular children. As I see it, the only reasonable alternative, if you cannot provide institutional care, is to leave the children with their parents, with that amount of supervisory attendance and guardianship which it is possible to introduce to assist the parents until such time as these difficulties can be overcome. It is no use hon. Members trying to exaggerate on this subject. We know and recognise quite definitely the necessity for the extension of these services and the necessity for additional staff. We are doing everything we can, not merely to secure apportionments of labour and material for the development of the institutions we want—and a considerable amount of labour and material has been so apportioned in the last 12 months— but also to stimulate the recruitment of the necessary staff. We shall go on doing that, because we quite definitely recognise that a special arrangement must be made for a limited number of these children and that, so long as the conditions are such that they are not being adequately and properly cared for, not only they but the parents and families with whom they are living are very often suffering unnecessary hardships, grievances and pain as a result. I can assure the House that this problem is one of those 1577 which are foremost in our minds. In consultation with the local authorities we have done everything we can, not merely to get them to adapt and use whatever accommodation is available, but to provide the necessary staff for carrying on the work.
§ Mr. Beverley Baxter (Wood Green)
None of us wants to make any party capital out of these children, but the hon. Gentleman should realise that there is a growing feeling that the Government, and especially the Ministries concerned, are not keenly alert to the disgraceful question of the sufferings of children in this country. However exaggerated the hon. Gentleman opposite may have been in what he said—
§ Mr. Baxter
—I think he did a service to the House in raising this question, and, speaking for myself, I say that we are keenly concerned about this and hope that the hon. Gentleman will look into what has been said and see if there is not something in it.
§ Mr. Key
I have undertaken already to do that, and not only have I undertaken 1578 to do it but we have already been making the necessary inquiries in the case of the seven or nine children in Rochdale, and we shall go on taking these necessary steps in every particular case. It is, however, the general problem that has to be dealt with, and the provision of a general service is bound. up with the labour shortage.
§ Dr. Morgan
No, I do not want to return thanks, I want to say that I resent the implication of exaggeration, and to say that I am shocked by the feeble display the hon. Gentleman made.
§ Question put, and agreed to
§ Adjourned accordingly at Half past Four o'Clock.