MEDICAL RELIEF IN IRELAND. (Hansard, 26 February 1847)

The EARL of CLANCARTY

My Lords, in rising to put to the noble Marquess opposite, the question of which I yesterday gave notice, respecting the intentions of Her Majesty's Government, in reference to Irish medical charities, I shall only preface it by such observations as I think may show your Lordships the great importance of the subject; for, I cannot, like the noble Earl, whose Motion has just been disposed of, say of Ireland as he did of Scotland, that it has occupied but little of your Lordships' attention; I feel on the contrary, that when so much consideration is given to Irish questions, it would be unpardonable, without very strong grounds, to introduce any new question relating to Ireland. But important as is the consideration of those measures which have for their immediate object the relief of the destitute in that country, not less important is the duty of taking such steps, by means of legislation, as may ward off destitution from the industrious poor. Such, I conceive, was the object of Parliament, in the several Acts that have been passed, for the establishment of hospitals and dispensaries over the country for the relief of the sick; and such certainly, to a great degree, is the effect of such institutions wherever they are in beneficial operation. They are designed to afford relief, not to the destitute, for whom the law has otherwise provided, but for the industrious poor; a class which should be kept as much as possible distinct from the destitute; because, instead of being a burden to the community, it may be truly said of them, that they constitute its strength, wealth, and very dependence; but who, though under ordinary circumstances capable of maintaining themselves and their families in independence, are often, in sickness, unable out of their scanty earnings to provide the medicines and professional advice which, promptly administered, might hasten recovery, and ward off the ruin and destitution in such cases commonly resulting from a prolonged suspension of employment. That such legalized assistance to the poorer classes—not fraught with any of those demoralising consequences to be apprehended through the system of out-door relief contemplated, as I understand, in an amended poor law for Ireland, but on the contrary, affording a direct encouragement and protection to industry, and tending to unite the upper and lower classes of society in Ireland, by the kindest sympathies—was intended to be 525 fully efficient and impartial in its operation, may, I think, be inferred from the several Acts which Parliament has from time to time passed for the extension of medical charities. In these respects, however, the law has failed. For want of central superintendence, abuses have crept into the administration of many of the medical charities; in others there is mismanagement and irregularity; and of those which depend in any degree upon voluntary contributions, the benefit can only be fully realized in such localities as are so fortunate as to have residing in them, persons able and willing to give their money and their personal labour to the superintendence of the charity. That such localities should be rather the exception than the rule, your Lordships cannot be surprised, after all you have of late heard of the destitute state of large tracts in the west and south of Ireland. One thing alone is uniform, and that is the taxation: in each county all are alike assessed to uphold the medical charities belonging to it; and even the poorest occupier of the soil, himself perhaps suffering from sickness, or with a sickly family, although beyond the reach of hospital or dispensary, is taxed in proportion to the land he holds for the maintenance of these institutions, just as much as if he derived the fullest benefit from them. This is a fact well known to such of your Lordships as are acquainted with the operation of the grand jury laws in Ireland. Further, I would observe, as a consequence of the unsatisfactory operation of the present law, that it appeared in evidence before the Select Committee appointed to inquire into it last Session—and while acting as chairman of a board of guardians in the west of Ireland, I have since had personal knowledge of the fact—that of the present inmates of the workhouses, many have been brought to destitution by neglected sickness, or by having become permanently disabled for the want of timely surgical care; and the vast numbers that enter the workhouse for the infirmary only, attested by the overcrowded state of all those infirmaries, shows undeniably, that the poor have not, without the walls of the workhouse, the appliances of medical relief which Parliament designed that they should have. And it may be observed of the industrious poor, who are in consequence compelled to seek infirmary relief among the destitute, that they most commonly resort to this last resource, when they are in an almost hopeless or a dying state. Every year that the 526 amendment of the laws so often prayed for has been delayed, it may truly be said that a great injustice is done to a most deserving class; that there has been a neglect of the interests of the industrious poor; and I have no hesitation in saying that while this is the case an injury is likewise done to the whole community; for it is undeniably for the interest of all classes that the sanatory state of the poor should be duly cared for. The subject has been abundantly inquired into; the frequency of the inquiries that have been instituted without leading hitherto to any practical result, have at length caused them to be looked upon as mere pretexts for delay; they have, however, established the fact that the law requires to be amended; and a reference to the several reports that have been made, down to the latest which I had the honour of presenting to your Lordships, from the Select Committee appointed in the last Session of Parliament, would show the concurrence of opinion, both as to the defects of the existing law, and the principles which should be kept in view in any measure for its amendment. The present state of Ireland, so far from justifying delay, is an argument for the earliest consideration being given to the subject. It can hardly be expected that when the diminished resources of landed proprietors are required to meet so much increased taxation, together with the urgent claims of a famishing population, there should be the same facility of upholding institutions dependent upon the voluntary contributions of the charitable; although I am quite sure that the utmost would be done to prevent their falling to the ground. What is wanted, and what is recommended in the report to which I have referred, is a complete organization of the country for the purpose of administering medical relief, by an increased number of infirmaries for the in-door treatment of difficult medical and surgical cases, whereby professional science may be at the same time advanced; by the establishment of fever hospitals in sufficient number, whereby the spread of fever in any locality may be at once checked; and by the proper distribution of dispensaries, whereby advice and medicine are brought home to the dwellings of all who need them. It is not a question of imposing a new burden upon the imperial treasury, or an increased tax upon any part of the community; it is simply one of economy and regulation—of economy in the distribution of relief, and of economy in the 527 distribution of the burden. There is much in the report to which I would pray the attention of Her Majesty's Government; and I trust that if the recommendations of the Committee have not received attention, they will be taken into their earliest consideration. The question to which I request an answer is, "Whether it is the intention of Her Majesty's Government to propose in the present Session any measure with respect to the medical relief of the sick poor of Ireland, founded on the recommendations in the report of the Select Committee appointed last Session to inquire into the subject; and if not, whether it is intended to propose any other measure for the improvement of Irish medical charities?"