§ Motion made, and Question proposed, "That this House do now adjourn."—[Mr. G. Wallace.]
§ 10.0 p.m.
§ Mr. Cooper-Key (Hastings)
I am glad to have the opportunity tonight of drawing the attention of the House to a case of unwarranted intrusion and abuse of power by public servants on two respectable ladies, Mrs. Salter and her daughter. I might say that I have warned both the Minister of Health and the Home Secretary that I would be raising this matter tonight, but I do not see either of them on the benches opposite.
§ Sir William Darling (Edinburgh South)
The Parliamentary Secretary to the Ministry of Health has arrived.
§ Mr. Cooper-Key
Mrs. Salter is a well educated and highly respectable elderly widow who lives in a basement flat at Hastings. I might say at this point that she is animated by two considerations. The first is that she has a strong spirit of independence, and, secondly, she has an overwhelming affection for her daughter who for 20 years has been mentally deficient and whom she has nursed during that time.
On 8th October in the morning Mrs. Salter left her flat to go shopping, and her daughter remained alone in the flat suffering from a gastric trouble. An hour later Mrs. Salter returned to find that in her absence two policemen and an official from the Ministry of Health had forced an entry into her flat. When she returned she got through the window of her basement flat; she protested vigourously and ordered these men to leave the premises. At the same time she asked what authority they had for entering her flat. She was told that the forcible entry had been authorised by a very high authority, and she was asked for her keys. She refused and again she said to the men, "Leave my flat." She was told that this daughter of hers was to be removed to a mental hospital. To that she replied that for the last 20 years she had nursed her daughter, that her daughter was very ill, that the removal to any institution would aggravate that illness, and again she ordered those individuals to leave her flat.
At this stage a police surgeon arrived on the scene, and after a private conversation with the police and the local medical authority representative there, left the flat, went to his car and returned with a roughly drawn out certificate to the effect that Mrs. Salter and Miss Salter were of unsound mind and should be removed to the local hospital. Miss Salter at that point was removed on a stretcher through the window, the door not being open, up the area steps and into an ambulance. Mrs. Salter was carried out of the window, up the steps of the area and into the ambulance. This humiliating scene included in the street an ambulance, a police car, a doctor's police car and eight men, and it was witnessed by a large crowd of neighbours. Mrs. Salter 639 had her bag removed from her, presumably in order to obtain the key to the flat.
On the journey to the hospital in the ambulance these two ladies were accompanied not as one might expect, by a lady nurse, but by two men smoking cigarettes. At the hospital Miss Salter was removed to a private room, a justice was summoned and the necessary procedure to pronounce the lady of unsound mind carried out. Mrs. Salter was later removed from the ambulance, taken to the hospital with her arms held behind her and handed into the care of two lady nurses. She was removed to a private ward where she was told to undress and get into bed. Mrs. Salter refused and asked to see her daughter. About an hour later, after several interviews with the nurses, she was allowed to see her daughter in a private room—locked in it.
Later, at about 6.30, a meal of sausages and potatoes was offered to these two, one of whom, I would remind the House, was suffering from gastric trouble. At 7.30 Mrs. Salter was released without any further investigation into the state of her mental health and put into the street at what I know was some considerable distance from her home. She was told that if she called at the hospital next morning she would be able to see her daughter. In point of fact an hour later her daughter was removed to Hellingly hospital.
When I took this matter up next day the local authorities sought to justify their action under Section 14 (1) of the Lunacy Act as amended by the National Health Service Act. This provides (a) that if a duly authorised officer has reasonable grounds for believing that a person is of unsound mind and (b) that he is satisfied she is not under proper care, he shall, not may, within three days give notice to a justice. I have no quarrel with the provisions contained in paragraph (a) in this case, but is it seriously suggested that a devoted mother's attention and nursing is not proper care? Further, is the flat which those two ladies are now inhabiting regarded as not being a proper place in which that patient should live? Further, if the notice required is three days, surely that is to ensure that proper inquiries may be made before such drastic steps are taken. It occurs to me that in this case nobody counted ten.
640 It so happens that any argument against the committal of this woman to an asylum against the wishes of her parent is not required. Under Section 72 of the Lunacy Act, as amended by the National Health Service Act, any patient resident in an asylum shall be discharged on application by the appropriate relative. Thus, on the following Tuesday Mrs. Salter took a taxi to the asylum and demanded the return of her daughter, who was at once discharged. There had been no question of course of this patient having either homicidal or suicidal tendencies. In other words, the whole of this distressing and humiliating incident could have been avoided and was entirely unnecessary. It should never have been allowed to occur.
As the law stands, local authorities have the power, in this case wrongly asserted, to remove an individual to an asylum against the wishes of her parent or guardian, but that asylum must release the individual immediately on application by the parent. I submit that this renders nonsensical the administration of the Act It follows that certain rather serious questions arise, and I should like to ask the Parliamentary Secretary, first, if inquiries were made about this family who had been in this flat several years before this sudden raid on the flat—and it was a sudden raid? Secondly, was a warrant required, and if so, was it issued, to force an entry into the premises? Thirdly, was the police surgeon acting legally in certifying both the mother and the daughter on the spot without a second opinion having been taken? Again, why was the mother not informed of her right under Section 72 (3) of the National Health Service Act? Finally, what steps are being taken to iron out the administrative contradictions of this Act, as they have been revealed in this case?
I hope that in the reply we shall have satisfactory answers to these questions, and I hope it will also be made clear to public servants, that in the interpretation of their powers, they should realise that it is the poorer and least influential of our citizens who need the most chivalrous, careful, and helpful treatment.
§ 10.10 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Mr. John Edwards)
I am sure that the hon. Member for Hastings (Mr. Cooper-Key) will appre- 641 ciate that I have not had very long in which to secure anything more than reports from the authorities at Hastings about this case. I would say, however, at the outset, that while in a certain sense his description of the various events coincides with my own, I would not draw the same conclusions; and I cannot, for one minute, accept his view that there was unwarranted intrusion and abuse of power.
I think it would be for the convenience of the House if I recapitulated the facts as they have been given to me, and I ask the House to remember that in this matter the responsible authority is the local health authority which, in this case, is the County Borough of Hastings. As a consequence of information received by the medical officer of health for Hastings, a duly authorised officer of the authority visited Mrs. Salter's basement flat at 11 o'clock in the morning on 8th October. He heard peculiar noises coming from a room, but got no response to knocks on the door. Finding slightly ajar a window to the room from which the noises came, he looked in, and saw Miss Salter standing in the room and behaving like an imbecile. After unsuccessful attempts to attract attention, he left to seek further information from the person who had spoken originally to the medical officer of health.
Immediately afterwards, in view of what he had seen personally, he arranged with the police surgeon, the police, and the St. John Ambulance Brigade for them to meet him at the house, and a policeman and the ambulance met him at 1.15—that is to say, two and quarter hours after he had paid the first visit. Again looking through the window he saw Miss Salter standing in the room in her nightdress. As he pulled the window down she threw herself on the floor grovelling like an animal, making peculiar noises. She eventually jumped into bed, making all sorts of grimaces, and gnashing her teeth. He entered the room, followed by the policeman; and, as the hon. Gentleman said, subsequently other police officers arrived.
While preparations were being made for Miss Salter's removal, Mrs. Salter returned home. She did not come in through the door in the ordinary way; 642 she also came through the window. She refused to open the door, and became violently hysterical. At a quarter to two the senior partner to the police surgeon arrived and gave the medical certificate, upon which the authorised officer acted, that both Mrs. Salter and her daughter were of unsound mind. Accordingly, the duly authorised officer decided to remove them both to St. Helen's Hospital, being a hospital designated by the Minister in respect of Section 20 of the Lunacy Act.
The hon. Member has quoted Section 14 of the Lunacy Act, 1890, as amended by the National Health Service Act, 1946. The original action taken by the authorised officer was under Section 20 of the 1890 Act, as amended by the 1946 Act, which provides that if a properly authorised officer is satisfied that it is necessary for the public safety or the welfare of a person alleged to be of unsound mind, with regard to whom it is his duty to take proceedings, that the person should be placed under care and control before these proceedings are taken, he may remove the patient to a hospital designated by the Minister for the purpose, and the person in charge of the hospital must receive the patient and detain him for not more than three days.
The first point I want to make clear is that the duly authorised officer acted under Section 20 of the Act, of which I have given an outline, and under which he is entitled to act without any warrant, if he is satisfied on the grounds that are given, and, of course, he then has to follow with the procedure laid down under Section 14 if he wants the person to be detained longer. At St. Helen's hospital, Miss Salter was found to be in a dirty condition. She lay "all crumpled up in bed," so the description runs, with her faced covered, muttering what appeared to be gibberish. She was thin almost to the point of emaciation. She was in a weak state and could hardly stand and she could only walk with a little support. She had to be assisted with her feeding and did not appear to have evidence of sensibility or intelligence and showed no interest in what was happening.
§ Mr. Edwards
That, of course, narrows the ground between us. The hon. Gentleman said that she was suffering from gastric trouble. I do not know how serious that trouble was, but if it was very serious, I should have expected that she would have been under some proper medical care and attention.
§ Mr. Edwards
Again, my information is that she was not under proper medical care and attention, and in fact her state, as reported on at the hospital, does not seem to suggest that there was adequate care and attention. Let me continue the story as given to me. Later in the evening, Mrs. Salter and her daughter were seen by a justice of the peace and the partner of the police surgeon. The justice and the doctor together did not then consider Mrs. Salter certifiable under Section 14, and she was thereupon allowed to leave the hospital, but the justice signed the order for the reception of Miss Salter into Hellingly Mental Hospital and she was removed there the same evening.
On 11th October, the medical superintendent of Hellingly Mental Hospital reported to the Board of Control on Miss Salter, and I think that, since it is agreed that she is an imbecile, all I need say is that the report said that she was suffering from chronic schizophrenic dementia. On the 12th October, Miss Salter was discharged "Not improved" in conformity with a direction given by Mrs. Salter under Section 72 (3) of the Lunacy Act, 1890, as amended by the National Health Service Act.
The medical superintendent had no alternative but to allow her to leave since, under the law as it stands, he was not able to certify in writing under Section 74 that she was both dangerous and unfit to be at large. It would be wrong of me tonight to begin to go into that broad point of law, because it would involve legislation if we wanted to change it. I merely point out that the superintendent was obliged, under the law as it now stands, to release the patient if he was unable to certify that she was both dangerous and unfit to be at large: not "dangerous or" but "dangerous and" unfit to be at large.
The hon. Gentleman has put to me certain specific questions which I want 644 to answer. First of all: were inquiries made? Miss Salter was well known to the local authority; she had on four previous occasions been certified as a person of unsound mind, and on each occasion her mental condition was much the same; each time in the past she was treated as a rate-aided patient, and under the law as it then was her mother was able to get her transferred to a private patient and then to secure her release. That was the law then; it has now been altered to some extent, and in fact now covers all patients instead of, as in the old days, merely covering private patients. The hon. Gentleman then asked: was a warrant required? The answer is, as I understand it, "No."
The hon. Gentleman also questioned the right of the duly authorised officer to effect forcible entry into the flat. I would put it to him that the duly authorised officer was in a very difficult position. He had been informed that a person who appeared to be insane was locked up in a flat; he called at the house, was unable to get a reply to repeated knocking, he saw through the window an obviously insane person in a dark room with no electric light bulb, and containing by way of furniture nothing but a bed and a chair; two hours later the patient was still there. Now, he had a statutory responsibility to discharge. Had he not taken any action, and had there been trouble, I am sure that the hon. Gentleman would have been among the first to have suggested that the officer had been negligent.
§ Mr. Cooper-Key
When I asked "Were inquiries made about this family?" I was thinking that, had inquiries been made about them, not through the books of the mental authorities but locally of the neighbours before taking this drastic step, it would have been found that this patient was much too weak to come to any harm. They would have learned a great deal more about the subject, and saved themselves a lot of trouble, by making local inquiries. The Parliamentary Secretary and I both know that this action was taken at about an hour's notice from the first time the information was laid.
§ Mr. Edwards
I am sorry to say that I think the hon. Gentleman is not putting it quite rightly. An authorised officer goes along on information received; he 645 cannot get in; he sees the circumstances that I have outlined; over two hours later the situation is the same; and here is an imbecile, an obviously insane person, alone, locked up in a house; he has responsibilities under Section 20, and it was those responsibilities that he was trying to exercise.
§ Mr. Beverley Baxter (Wood Green)
Surely, the investigation would have shown that over a long period that was a common condition in this family of these two unfortunate women? Why was this sudden decision made? He must have known that this poor imbecile was left alone like this. Why could not they make contact with the mother first? Why this raid? Was there the slightest necessity for the raid?
§ Mr. Edwards
The hon. Member for Wood Green (Mr. Baxter) suggests that this was a raid. Information is sent to the medical officer of health that there is an imbecile locked up in a room. In my submission, the authorised officer would have been negligent if he had not tried to do something about it. What happened after Mrs. Salter arrived, with her hysteria, is another matter.
The third question I was asked was whether the surgeon was within his powers in certifying. The answer to that question is that it was his business to put the authorised officer into a position of being able to take a sensible decision. It was the view of the doctor who was there at the time, acting not under Section 14, which is permanent, but under Section 20, which is temporary, that they both ought to be removed in their own interests at the time, and that he certified. The fourth question was why the mother was not informed of her rights. I put it to the hon. Member that the mother did not need to be informed of her rights because she had exercised them on four occasions in the past. The mother knew of that particular provision.
§ Mr. Cooper-Key
The Parliamentary Secretary has already said that the Act 646 has been changed from the point of view of a person being a private patient in a hospital to being just a patient. The mother thought that the old law existed and that it was necessary to get the patient into the category of a private patient, which within her knowledge took a fortnight.
§ Mr. Edwards
There is no doubt that the mother had on four occasions known that by using certain processes she could get complete rights to bring her daughter back home. Finally, I was asked about the legal changes which are necessary to get rid of these inconsistencies. It would be wrong for me to go into that matter, and should be ruled out of Order if I tried to do so. It may be that this is not a completely tidy picture, but under Sections 14 and 20 the authorised officer seems to me to have acted in good faith. I ask the House to remember that, in the course of a year, we have some 40,000 admissions of whom something like one-half are admissions that would be covered by this type of case, and that it is most unusual for a case to be the cause of complaint.
It is very difficult indeed to condemn the poor officer, who was in an extremely difficult position and had a public responsibility. He had the possibility of negligence in mind, and he had acquired all the information he could about the woman. He had taken every precaution he could. Not only the police surgeon, but the doctors at St. Helen's Hospital all confirmed the view that here was someone who really needed care and attention. I say that in all the circum stances the officer behaved commendably, and in any case I would not wish, and I am sure the House would not wish, to put such officers under any greater difficulties.
§ The Question having been proposed at Ten o'Clock and the Debate having continued for half an hour, Mr. DEPUTY-SPEAKER adjourned the House without Question put, pursuant to the Standing Order.
§ Adjourned at Half-past Ten. o'Clock