§ LORD BUCKHURSTasked, If it is the intention of Her Majesty's Government to propose any additional precautionary or remedial measures to check the spreading of small-pox in the Metropolis? The Registrar General's Reports 702 showed the great ravages which smallpox had lately committed not only in the Metropolis, but in the large towns. The number of deaths in the metropolis last week was 1,582, or 47 above the average of the corresponding week during the last 10 years; the zymotic class, or cases of an infectious or contagious nature, being 447, of which 288 were cases of small-pox. The number of deaths therefrom during the previous three weeks were 265, 276, and 261, and the mortality from this cause during the present epidemic had been almost three times as great as had been known during the last 30 years. This time last year the cases were only three or nine a-week; whereas in the 12 weeks ending the 29th April there were in London 2,688 fatal cases, of which 1,212 were unvaccinated and 973 vaccinated, while there was no return as to the remainder. Out of 85 children admitted into Hampstead Hospital during a fortnight, only 46 had been vaccinated. It was evident that the Vaccination Act, in spite of the stringent orders of the Poor Law Board, was not properly enforced. Moreover, in St. Pancras, which was seven miles long by one and a-quarter broad, with a population of 200,000, the number of vaccination stations lately appointed was only five—so that some of the parishioners were three miles from the nearest of them, and it was not likely that children would voluntarily be taken such a distance. Persons frequently lived nearer a vaccinator in a neighbouring parish or Union, who, however, was not allowed to undertake their case. These stations had not succeeded in Scotland; but if they were to be used, surely they should be arranged with a view to general convenience rather than with reference to parishes or Unions. Fresh cases were occurring every day, and the metropolitan hospitals were overflowing, and he hoped to hear that additional accommodation was being provided, as also that steps were being taken to enforce vaccination. The noble Lord concluded by moving—
That there be laid before this House Returns of the number of births and of the number of children vaccinated in the Metropolitan districts during the year ending the 31st December, 1869."—(The Lord Buckhurst.)
LORD ORANMORE AND BROWNEtestified to the success of the Vaccination Act in Ireland, where small-pox had almost 703 disappeared. The Poor Law medical officer was usually registrar, and being thus acquainted with the births, he was able to summon parents who neglected to vaccinate their children. He knew of one such officer who had been dismissed for failing in this duty. The system of stations had proved very effective in Ireland. If the same powers existed in England, it was only necessary to enforce them to prevent the recurrence of such a disaster.
§ LORD LYTTELTON, as the author of the first compulsory Act on the subject, trusted that the Government would take steps to secure an improved administration of the law, which was all that was requisite. In some of the smaller European States, where the Executive were naturally more powerful, the vaccination laws had been enforced, and the disease had almost disappeared.
THE EARL OF KIMBERLEYsaid, he could quite confirm the statement of the noble Lord as to the success of the Vaccination Act in Ireland. The smallpox had almost entirely disappeared. He thought the want of similar success in England must be attributed to some extent to fanatical agitators, who had persuaded a certain number of blind and ignorant persons to resist the operation of the law. He thought in this respect we had reason to be ashamed of ourselves compared with the Irish people. The questions of detail respecting vaccination stations he would bring under the notice of the Vice President of the Council, who would doubtless consider them. It was difficult to meet the convenience of all; but he agreed that the stations should be so arranged as to encourage and facilitate a resort to them. Prior to the present outbreak the Poor Law Board urged on the Guardians a stricter enforcement of the Act, and the appointment of inspectors, who would examine the registrars' returns and ascertain whether the law had been complied with. Where such inspectors had been appointed, a great stimulus had been given to vaccination, at a moderate cost. This was one of the most efficient agencies; for, unless cases were hunted up, prejudice and ignorance would always, he feared, leave a considerable number unvaccinated. The attention of the Government had been drawn to the present serious epidemic; but he was not prepared to say that the present 704 law required alteration. The law, he thought, needed not amendment, but enforcement, and he was informed by the Poor Law Board that the Boards of Guardians were making strenuous exertions in this direction, assisted by the inspectors appointed by the Privy Council to see to the sanitary condition of the metropolis. A Committee of the House of Commons on Vaccination had sat several weeks, and would shortly, as he understood, report. Any suggestions they might offer would have the careful and immediate attention of the Government. A Bill was passing through this House for giving further facilities for the erection of asylums; and, owing to the difficulty of obtaining sites, the Admiralty were willing to lend one or more ships as temporary hospitals, especially for convalescents. These would be placed by the Bill within the category of asylums. A Report of the Poor Law Board already presented had given the Returns moved for by the noble Lord up to the 29th of September, 1869, and a Return extending 12 months later would be presented at once.
§ THE EARL OF MALMESBURYsaid, the small-pox epidemic was even more serious than the noble Lord had stated. It was spreading considerably in the provinces; his own county, including Southampton and other places, was now suffering severely. He agreed that the present law was sufficient, if properly enforced; but the authorities bound to enforce it had been exceedingly remiss. The Poor Law Board, moreover, only looked after the poor; whereas the strongest prejudice against vaccination existed not so much among them as among the middle classes. One set of fanatics spread an alarm as to the consequences of vaccination to children; while another set, with feelings like those entertained as to the Contagious Diseases Act, deemed it impious to interfere with the intentions of Providence, and regarded the disease as a just punishment for our sins. Now, people should not be allowed at the expense of the public to entertain such fancies and superstitions, and there should be inspectors to enforce the Act on the upper and middle classes as well as on the poor.
§ LORD PORTMANsaid, the law did extend to all classes. One of the difficulties of enforcing it arose from the defective 705 supply of good vaccine matter. In his own neighbourhood several families about to come to London desired to have their children vaccinated beforehand; but out of ten medical men in the neighbouring districts not one had a sufficient supply of good vaccine matter. They then sent to London for the matter, and obtained sufficient for the vaccination of one child, whose mother refused to allow matter to be taken from its arm. If it was true that the matter could only be properly used when taken from a child vaccinated for the first time, it was evident that a very large supply would be needed, as matter taken from an adult on re-vaccination was known not to be prophylactic. Probably in Ireland a large quantity of the lymph was obtained direct from cattle, or there might be local circumstances which tended to prevent a spread of the disease.
§ EARL STANHOPEsaid, the Returns proposed to be given would be most inadequate. They should be made up to a later date.
THE EARL OF KIMBERLEYpromised to produce a later Return if possible. The machinery for enforcing the Act, he added, was complete, the registrars being required to send a list of births to the guardians, who were empowered to require vaccination in all cases.
§ THE EARL OF MALMESBURYadmitted this, but remarked that the middle classes were allowed to escape through scruples which were not extended to the poor.
§ VISCOUNT HALIFAXsaid, the law subjected the rich to fines as well as the poor.
§ THE MARQUESS OF SALISBURYasked what was the use of fining the poor. Their children were not thereby vaccinated. In one point our law was behind that of other countries. A policeman should be sent with the doctor to see that the child was vaccinated.
§ Motion amended, and agreed to; Returns ordered. (No. 111.)