LUNATIC ASYLUMS AND PAUPER LUNATICS BILL. (Hansard, 29 July 1845)

The Lord Chancellor

said, he would take the opportunity, before the House went into Committee on this Bill, which was a Bill to regulate the care and treatment of Lunatics, of briefly stating the nature and objects of the measure. The subject was one of deep interest, as their Lordships would concur with him in thinking, when he told them that at this moment there were nearly 21,000 lunatics in England and Wales, a great proportion of whom were paupers, who would in a certain degree come within the range of the Bill now under consideration. Before the year 1774, before the 14th Geo. III., there was no adequate protection for persons in that unhappy condition: not only was scarcely any adequate protection afforded to them by law, but they were often made the instruments of fraud in order to obtain possession of property, and for other unjustifiable abuses. The Statute 14th Geo. III. did, to a certain degree, afford a remedy; but its provisions were in many instances neglected, and were in many other instances found wholly inadequate to meet the evils they were intended to remedy. The law remained in this state until 1830, when a friend of his, with whom he was on terms of intimacy, in the other House of Parliament, Mr. Robert Gordon, directed his attention to the subject; and, after a good deal of consideration, embodied his views in a Bill, which afterwards passed into a law, in the 2nd and 3rd year of the late King, by which Commissioners were appointed with powers to license houses for the reception of lunatics, within a certain district round the metropolis, and to visit establishments of this nature all over the kingdom. Other provisions were also adopted for the purpose of remedying the evils to which he had referred. That Bill was a mere temporary measure, to endure, he believed, for three years, or to the end of the next Session of Parliament. That was a considerable improvement. Former experiments having failed, Parliament had no confi- 1187 dence that any settlement of the matter could be effected by this Act. The measure, however, worked so satisfactorily during the period to which he had referred, that before it expired it was again renewed, with some alterations, by the unanimous consent of both Houses of Parliament. It continued in force for another period of three or nearly four years, and application was again made to Parliament to renew the provisions of the Act, with further alterations and additions which experience had suggested; so that the Act had been twice renewed. It was now on the point of expiring, after an experience of twelve years; and the satisfactory manner in which its provisions had worked, the w holesome discipline exercised through its means over this unhappy class of persons, in the opinion of the Government, rendered it advisable to embody its provisions in a permanent measure. A noble Lord (Lord Ashley), one of the Commissioners under the Act, who had attended most sedulously in the performance of his duty as an unpaid Commissioner, and who on all occasions had displayed the greatest activity, wherever motives of humanity called for his exertions, was the author of this Bill, and introduced it into the other House of Parliament. It would be necessary for him to state, now that the Act was intended to be made a permanent measure, what alterations, suggested by experience, it would be desirable to introduce into the Bill. During the last year, a Report of the Lunacy Commissioners had been laid on the Tables of both Houses of Parliament, pointing out the defects of the existing system, the manner in which they might be remedied, and suggesting various additions to the existing provisions. The first alteration, which was rendered necessary, indeed, by the measure becoming permanent, was the permanent appointment of the Commissioners. The present Commissioners were twenty in number, of whom eleven were paid, consisting of barristers and physicians, or medical practitioners; the remaing nine being gentlemen who performed their duties gratuitously from motives of benevolence. It was proposed by the present Bill to reduce the number of paid Commissioners to six, and of the unpaid Commissioners to five. The whole number of Commissioners, under the present Bill, would therefore be eleven. While the measure was temporary, it followed as a matter of course that the paid Commissioners were also temporary; they were 1188 renewed every year, and the same individuals were retained; the gentlemen originally appointed having shown themselves most efficient in the discharge of their duties. The consequence of having Commissioners appointed for such short periods was, that you could not abstract them entirely from the professions to which they belonged, and to which it would be impossible for them to return with advantage after an absence of four or five years. This, undoubtedly, led to considerable inconvenience; for that their professional occupations should occasionally clash with their attendance for the purposes of the Commission, was inevitable: it was, therefore, thought expedient, in making the Commission permanent, to secure the attention of its members exclusively to the duties required by it. They were not to be allowed to practise either in the professions of law or medicine, but they would be required to give their entire attention to the duties of their office as Commissioners. By deciding upon this, they were enabled to diminish the number of Commissioners in the proportion which he had just stated. Another change, which had been the subject of some comment, was the mode in which it was proposed to remunerate them for their services. Under the existing Act, they were paid by means of fees for their attendance at boards, and a certain allowance which they received for travelling expenses in visiting the various establishments of the country. The scale of remuneration was one guinea for every hour they attended at the board, and five guineas for every day's attendance in the country, besides, he believed, an additional guinea for sustenance during the journey. Instead of this, it was proposed to remunerate them by means of a fixed salary; for considerable inconvenience was found to result from the former mode; for if the whole eleven paid Commissioners happened to attend a board, and the proceedings lasted four or five hours, the expense of the board might amount to 50l.; and it sometimes happened that scrupulous members, fearing lest they might be suspected of consulting their own interests rather than the performance of their duty to the public, were often unwilling to hold boards. He was aware that the new mode was regarded by some as calculated to lead to increased expenditure; but that was a mistaken idea, for the result would be a saving, as he trusted he should be able to satisfy their Lordships in Committee. The salary pro- 1189 posed to be given to each paid Commissioner was 1,500l. a year, making a yearly expense of 9,000l. for the whole number; and it turned out on inquiry that the expenses of the Commission last year exceeded that sum; so that their Lordships would find a considerable diminution in expense effected from circumstances to which he would now refer. By the effect of this Bill, the duties of the Commissioners would be greatly increased and extended; so that if they were still paid by fees, they would necessarily receive much larger incomes than they obtained under the existing Act for the discharge of their additional duties. The Commissioners were named in the Bill; they were not named by him (the Lord Chancellor), but with his approbation. They were selected from the existing Commissioners, and were some of the most able and most efficient of that respectable and honourable body; and he felt assured that all those of their Lordships acquainted with the subject, and with the qualifications of the gentlemen so named, would be perfectly satisfied that the selection was a most judicious one. So much with regard to that part of the subject. He had stated that the duties of the Commissioners were to be extended. It was a very singular circumstance, that although the Commissioners had the power of visiting all private asylums, they had no power to visit hospitals; subscription hospitals, in fact, were out of the range of the existing Act; they were entirely out of the range of the regulations imposed by law. It was not necessary for a party to be received into a subscription hospital that he should have a certificate or an order; he was received as a matter of course, and these hospitals could not be visited by the Commissioners. A provision had, therefore, been introduced into the present Bill, empowering the Commissioners to visit establishments of this description; and he felt assured their Lordships would join with him in thinking that a due supervision and scrutiny by experienced and intelligent persons, was just as necessary in these establishments as in private asylums; would prove most advantageous for the public interest; and would conduce greatly to the comfort and happiness of those subject to such a calamity, and afford an additional hope of their ultimate restoration to reason. Another improvement in the Bill, to which he was anxious to direct their attention, was one of considerable importance. At present, 1190 paupers were confined, by order of the justices, on production of a medical certificate; but it was not necessary that the justice who sent him into confinement should see the pauper; and it frequently happened that paupers were sent into confinement without being seen by the justice signing the order. It was certainly necessary that the certificate should be recent; but everything was vague and indefinite on this point. The present Bill required that no pauper should be confined unless he should have been seen immediately before by the person signing the order, and that no medical certificate should be allowed except where the person signing it had seen the pauper within seven days of the period of his confinement. Their Lordships, he trusted, would see the great importance of establishing salutary guards in a system of this description. Another point which it was material to consider was, that these visitors would be empowered to examine and inspect any establishment where any pauper might be confined, or was supposed to be confined. They were not to interfere with Poor Law Guardians or with the Poor Law Commissioners; but if they saw anything requiring amendment, it would be their duty to report it to the Poor Law Commissioners, so that it might be rectified. Their Lordships would also find a power conferred in the Bill of visiting gaols. This was a material provision, introduced into the Bill for the purpose of extending the operation of the former Act. There was another most important point to which he wished to draw their attention. He did not know how it happened, but in the first Bill introduced, although every establishment of this description was liable to inspection, and was put under the jurisdiction of the Commissioners, when the Bill came up to their Lordships' House, a clause was introduced for the purpose of exempting what were called "single" houses—that is, houses where only one patient was confined. It was considered a matter of delicacy that such establishments should be screened. Now, it had always struck him that these, above all others, were the establishments which required to be examined and inspected with the greatest degree of vigilance, being more liable to be made the means of abuse, and of inflicting cruelty on patients. A power was certainly given to the Lord Chancellor, on sufficient information being adduced to warrant an inquiry, to direct an inspection; but when he informed their Lordships that, 1191 although he had held the Great Seal for several years, he did not remember a single application of this kind ever having been made, he apprehended they would be of opinion that this remedy was not of a very effectual kind. One provision with respect to these houses was this: they were not obliged to make a return until a year after the patient had been placed there. Now, it was notorious that there were a great number of such houses in which single patients were confined, yet the number of returns did not exceed thirty or forty a year; and he understood that it was by no means unusual to transfer patients from one asylum to another, in order to evade the return. If it were left to him, he confessed he should be for placing these establishments on precisely the same footing as the rest. Such a course, however, did not seem palatable to their Lordships; and, as a different course had been pursued by the other House of Parliament, he was willing to recommend that course for their Lordships' adoption. Certificates would be required, and returns must be made to the Commissioners, when any person was lodged in an establishment of this kind, and a year would not be allowed to elapse, as formerly. The visiting of these establishments was not to be open to all the Commissioners; but the Chancellor was to have the power of selecting two, for the purpose of private inspection. These provisions appeared to him a great improvement on the former law. Their Lordships were aware, that in a matter of lunacy, the Lord Chancellor did not put himself in motion; he could only act on an application being made to him, upon which he ordered an inquiry, if the case seemed to warrant it; after which he took possession of the property, and made an order for its proper application. But a party might possess a great deal of property, and might be confined in a lunatic asylum—perhaps in an asylum for the reception of one patient merely, on the certificate of a medical man, without any commission whatever issuing, unless a petition were made to the Lord Chancellor for that purpose. What became of the property? It was wholly unprotected; and, in many instances, those who had obtained possession of it, after paying the allowance for the lunatic in an asylum for a year or two, dissipated or lost the whole of it. Many such cases had come under his own notice. Under this Bill, the Lord Chancellor was empowered to appoint a receiver of the property, and a 1192 guardian of the person of the lunatic; and then, if there should appear no prospect of ultimate recovery, the Lord Chancellor might order a commission of lunacy. These were the principal alterations proposed. There was another subject to which he would briefly call their attention. At present, persons who kept private asylums were in the habit of receiving as boarders, persons suffering from a nervous temperament, or a weak understanding. These individuals were without any guard or protection, and were allowed sometimes to execute instruments binding their property. Now, these cases it was highly necessary to subject to some control; the present Bill prohibited private asylums from taking any inmates of this description. There was another abuse to which he would also advert. Notwithstanding the provisions of the Bill, and the activity and vigilance of the Commissioners, it was found impossible to detect all the windings by which due inspection was sometimes defeated. The Commissioners were allowed to inspect every part of these asylums; but it was necessary that they should exercise their utmost vigilance to see, that they discovered every part. In more than one instance, series of apartments had been discovered entirely concealed from view, and to which the Commissioners had never been allowed admission. In one instance, the Commissioners, by mere accident, discovered three sleeping cells of such a description that they would not have been allowed for a moment, if they had been open to inspection; and would, in all probability, have caused the keeper of the house to lose his license. It was, therefore, proposed in the present Bill, not only to empower the Commissioners to examine every part of a building, but to make it the duty of the keeper or superintendent to show every part of the house, making him liable, for neglect of this duty, to animadversion and punishment. The noble Lord then moved that the House should go into Committee on the Bill.