HL Deb 19 April 1883 vol 278 cc586-603

House in Committee (according to Order).

Clauses 1 and 2 agreed to.

Clause 3 (Title to registry).

Viscount POWERSCOURT

moved, in page 1, line 16, after ("appointed day ") leave out to the end of the clause, and insert— ("1. The medical registrar shall not register a person in the medical register unless he or she has obtained the diploma of one or more of the medical authorities for one part of the United Kingdom after having obtained, through a medical hoard constituted under this Act, a certificate that such person has proved his or her competency, by examination, to he qualified under this Act to practice medicine, surgery, and midwifery. 2. Each person who has obtained a qualifying certificate under this Act shall, before registration, be attached to one at least of the medical authorities for that part of the United Kingdom in which he or she has obtained such certificate, by obtaining from such authority a medical diploma (whether degree, membership, associateship, or other), subject nevertheless to this qualification, that if, on application by any such person to any of the medical corporations for the said part of the United Kingdom, the corporation refuse to attach him or her to such corporation by granting him or her some medical diploma, or demand a fee for so attaching him or her, or otherwise fail so to attach him or her within one month after such application, the applicant shall be entitled to be registered in the medical register without being attached to any medical authority. 3. Nothing in this section shall oblige a medical corporation to attach a person to such corporation by granting him or her a diploma for the purpose; and a person shall not by reason only of being attached to a medical corporation for the purpose of registration be entitled, except so far as the corporation in their discretion otherwise provide, to any share in the govern- ment, management, or proceedings of that corporation, or to any rights or privileges in connexion with that corporation. 4. A medical authority, without prejudice to any other power vested in thorn, may from time to time, by a statute or byelaw made with the approval of the Privy Council, constitute a new medical diploma, to he granted by them for the purpose of attaching to such authority, with a view to registration, persons who have obtained qualifying certificates under this Act; hut if any such now medical diploma is constituted by a medical authority for the said purpose, that diploma shall be the only diploma granted by such authority for the purpose of attaching to such authority, with a view to registration, persons who have obtained qualifying certificates under this Act?")

LORD CARLINGFORD (Lord PRESIDENT of the COUNCIL)

said, he could not assent to the Amendment, believing that the object which the noble Viscount had in view would be sufficiently met by the Bill as he proposed to amend it. He understood and fully appreciated the object of his noble Friend—namely, that under the operation of the Bill the medical bodies should not suffer or lose their status and means; and he (Lord Carlingford) certainly did not desire that they should do so. The Bill, with his Amendments, would recognize all existing titles of medical bodies, and would not attempt to create any fresh title, as it was supposed to do in its former shape. He believed that the medical authorities of the country would fool that the Bill as altered would not endanger their position, and the plan of compulsory affiliation was even from their point of view no longer necessary. The Bill now avoided the difficulty in respect of women candidates. He could not accept the Amendment.

THE EARL OF MILLTOWN

said, both the Colleges of Surgeons and of Physicians in Ireland were particularly anxious as to the point covered by this Amendment.

THE EARL OF CAMPERDOWN

said, the Royal Commission had examined the subject of compulsory affiliation, and had come to the conclusion that it was unjust, and that it would be impossible to carry it out.

THE DUKE OF RICHMOND AND GORDON

asked the Lord President to indicate whether his Amendments would meet the case now under consideration?

LORD CARLINGFORD (LORD PRESIDENT of the COUNCIL)

said, he proposed to omit Clause 26, and substitute another clause for Clause 27. As it stood, the Bill by Clause 26 provided for a new title of "Licentiate of the Medical Council," and Clause 27 proposed the recognition and registration of higher medical titles. The Bill, as it would stand by his Amendment, would provide that all the licensing bodies should be entitled to register all their titles.

Amendment negatived.

Clause agreed to.

Clause 4 agreed to.

Clause 5 (Registered medical practitioner exempted from serving in certain offices).

On the Motion of Viscount POWERS-COURT, Amendment made, in page 2, line 20, after ("hundred") by inserting ("barony").

Clause, as amended, agreed to.

Clauses 6 to 8, inclusive, agreed to.

Clause 9 (Establishment of Medical Boards).

LORD CARLINGFORD (LORD PRESIDENT of the COUNCIL)

said, he thought it might be convenient to the Committee if he stated at this point the views of the Government with respect to this important matter. And first he would say, that the constitution of the Conjoint Boards, as they were commonly called, was a matter of extreme difficulty. In fact, it was one of the most perplexing questions of a subject that bristled with perplexities, and one which would require the most careful consideration. First of all, there was the question as to the amount of representation which the medical bodies in the country, taken one by one, should have on these Boards; but over and above that there was also the question of the comparative representation and influence of the Universities on the one hand, and of the combined Medical Corporations on the other, and it was no easy task tantas componere lites. As regards the Scotch Medical Board, the numbers would stand as they were. But with regard to England, it would be seen that although the Royal College of Physicians of London and the Royal College of Surgeons of England returned three members each, while the Universities returned some two members and some one member only, yet in combination the Universities returned a larger number of members than the great Medical Corporations. He had taken great pains to obtain all the information in his power on this question, and had come to the conclusion that this proportion did not represent the comparative importance in the system of medical examination and licensing, and that the Universities, taken as a whole, were somewhat over-represented, while the Medical Corporations were somewhat under-represented by this distribution. The great Corporations took so prominent a part in the granting of licences that the Bill was hardly just to them. It was quite impossible, of course, to fix on any numbers that would represent the exact relative importance of each body, for they had to consider, not only the comparative importance of each body, but also the comparative importance of the two classes of bodies. His proposal, therefore, was that the five English Universities should return one member each to the Medical Board. The result of that would be to give a small majority to the Medical Corporations, who did so much the largest share of the work in the way of medical licensing. With respect to Ireland the case was different, and so it was in Scotland. There could be no doubt whatever as to the superior claims of the Scotch Universities, but in Ireland the two sets of authorities were rather more equally balanced; but, on the whole, he thought a majority should be given to the Irish Universities. There was an Amendment on the Paper dealing with the vote in the Irish Board proposed to be given to the Apothecaries' Hall of Ireland, and upon consideration he had come to the conclusion that that vote should be withdrawn, for, even if the Government decided to leave the Bill as it then stood, the Medical Council, under the powers proposed to be conferred on them by the Bill, would almost certainly feel bound to take it away. That being so, he proposed that each of the Irish medical authorities, with one exception, should return two members to the Joint Board. The two authorities which would have returned three members—namely, the Royal College of Surgeons in Ireland and the King's and Queen's College of Physicians in Ireland—would return two members. The Royal University of Ireland would, according to his present proposal, have two members. Trinity College would have one more member than the Royal University, and the result would be that together they would return five members to the board, and the two Irish Medical Corporations four. That was the proposal he had to make to their Lordships.

THE MARQUESS OF SALISBURY

said, he thought the action of the noble Lord a little extraordinary. He could well understand that the adjustment of these claims was one of the most difficult duties which the noble Lord had had to perform; but, at the same time, he could not help thinking that he had taken a very odd method of performing it. The noble Lord had announced on the second reading the manner in which these different Corporations were to be represented on the Council, and, after careful consideration and deliberation on the part of those bodies, they had assented to the course proposed. Now, when these terms were published, on the faith of which the second reading had been taken, the noble Lord came down to the House, and, without any Notice, proposed to revolutionize the former scheme as regarded the entire constitution of the Council. The noble Lord had said it was no easy task tantas componere lites. What did he think would have been the consequence if Paris had said at the last moment to Venus that she must give up the apple to Juno? Or, to take a more modern example, what would be the feeling of the House of Commons if a Reform Bill was introduced with much pomp and circumstance to the country, and then a Minister came down suddenly and announced that he intended to take away half the representation of certain counties? That was very much like the proposal which the noble Lord made to the House. As to the representation of the English Universities, he thought that in striking down their influence, the Lord President had not increased the value or dignity of the Council to be constituted. Not only was a representation given to an English University, which in itself was an important matter, for the Universities were one of the greatest securities that medical practitioners would have a high standard of education, but the strangest possible proposal was made in regard to their relative importance. Oxford, Cambridge, I London, Durham, and Victoria seemed all of equal importance in the eyes of the Lord President.

LORD CARLINGFORD (LORD PRESIDENT of the COUNCIL)

disclaimed any such view. He had expressly said that it was impossible to devise a scheme that would recognize their exact relative importance, and at the same time their importance taken together as compared wish other bodies.

THE MARQUESS OF SALISBURY

said, he was aware of that; but the effect of the Bill was to recognize their equality. But, apart from this, why stop at Victoria? Why was not the nascent Welsh University included as well as another which he believed was in Yorkshire? The proposal of the noble Lord was most injurious to the constitution of the Council, most unfair to the English Universities, which had been taken by surprise, and based on an utter misconception of the relative values of the Universities towards each other.

LORD CARLINGFORD (LORD PRESIDENT of the COUNCIL)

said, that his present proposal was based on information which he had received from many quarters, including the Universities, since the Bill was printed.

LORD EMLY

said, he agreed with the noble Marquess as regarded England; but as to Ireland he thought the arrangement proposed was most extraordinary. The noble Lord proposed to give the Royal University and Trinity College, Dublin, two and three members respectively. Out of 880 medical students in Ireland, only 230 were at Trinity College, and the remainder at the Royal University. Why, then, the Royal University should be in a worse position than Trinity College he utterly failed to comprehend.

EARL GRANVILLE

said, the discussion proved almost conclusively the impossibility of arriving at any theory of representation which would exactly be justified in all its particulars. He admired the manner in which the distinguished Chancellor of the University of Oxford resented that University being put in the same position as Durham. But with the greatest respect for the University of Oxford, to which he himself belonged, he would say that as a Medical University it had not the slightest ground for standing in the same position as the London University, cither as regarded the distinction of its medical degrees or the number of its students. He merely mentioned that, in order that their Lordships might not be led away by considerations of that kind.

THE EARL OF GALLOWAY

said, the Lord President did Scotland the honour to say that there was no doubt as to the superior claims of the Universities there, as to the representation they should have as compared with the other Medical Corporations. He was not going to propose that these Universities should not have their due proportion; but he had to-day presented a Petition from the Faculty of Physicians and Surgeons of Glasgow, and from what were called extra-mural Faculties, and the feeling of those bodies was that the representation proposed by the Bill was exaggerated as regards Scotland. Under the Act of 1858 it was enacted that the Universities of Scotland were only to be represented by two, and the Medical Corporations by three members. Now it was proposed to give no less than eight for the Universities, and to retain three for the Medical Corporations. He thought that was giving the Universities too great a preponderance, considering that the Medical Corporations hitherto had a majority of one. This had only been brought to his notice so recently that he had not time to place an Amendment on the Paper; but he should propose an Amendment on Report, and he hoped the noble Lord would take the subject into consideration.

EARL CAIRNS

said, that on the second reading of the Bill no indication was given that there would be a change in the representation, and even now the Amendment proposed by the noble Lord had not been placed on the Paper. Their Lordships, as well as all who were concerned, were taken by surprise, and he would suggest to the Lord President that, as there were objections to the proposal, he should make it at another stage of the Bill. With reference to Ireland, he would rather see the Universities on an equality, and he thought there were obvious reasons why a difference should be made in respect to them, giving the College of Physicians three, and the College of Surgeons two. As the noble Lord had now left the English Council, it would be composed of an even number of members, and there might be a complete deadlock.

THE EARL OF MILLTOWN

said, he thought that the Royal University ought not to be put on the same footing as the University of Dublin. Properly speaking, the Royal University had no students. It was simply an Examining Board to which students from various Colleges merely came up for examination. The idea of the noble Lord opposite (Lord Emly) that that University was entitled to as many votes on the Council as the University of Dublin, was, therefore, erroneous and absurd.

THE EARL OF CAMPERDOWN

said, he was unable to concur in a great many proposals contained in the Bill as originally drafted. He agreed that the question of representation on the Board was the great question. The difficulties mentioned had occurred to the Royal Commission, and they thought the question was one to be decided by Parliament, giving a general indication in their Report that in Scotland the Universities had taken a very large share in the medical education and examination, and that in England the two Medical Corporations had also taken a very largo share. With regard to Ireland, the proportion appeared to them more nearly equal, and they made no specific recommendation. The question of representation must be worked out according to the same principles in the Three Kingdoms. These principles were—first, the amount of interest that had been taken in the past, and likely to be taken in the future, by the different Medical Corporations in both general and special education; and, in the next place, there was the actual amount which had been done, and the relative proportion taken by each of them in the actual work of licensing. The clause under discussion dealt with three Boards— English, Irish, and Scotch. He would suggest that the question of the English Board should be postponed for discussion on Report, and that their Lordships should now go on with the discussion on the Irish and Scotch Boards respectively.

THE DUKE OF RICHMOND AND GORDON

said, he preferred dealing with the clause as it stood. The question had not been discussed on the second reading, and those connected with England had no idea that any alteration would be made. Oxford and Cambridge had made of late years enormous strides in all matters connected with medical science, and it would be unseemly to place them upon an equal footing with other Universities which had not done so much for medical science. He suggested that the Medical Board for England should be allowed to remain as it was in the Bill. If his noble Friend behind him went to a division, he should feel obliged to vote against the proposition of the Lord President.

LORD O'HAGAN

said, that some 900 medical students were connected with the Royal University in Ireland, and it would be unjust to establish the proposed distinction between that University and Trinity College. The medical students of the three Queen's Colleges and the Catholic University, whose professional education had been committed to the new Institution, were a great and growing body, and entitled to much consideration in the arrangements contemplated by this Bill. Its Senate had been specially careful that the instruction given should have a high standard, and that the qualifications required for degrees, as well as general culture in medical and surgical acquirements, should be such as must command the confidence of the public.

THE EARL OF BELMORE

said, that he was able to state on good authority that the University of Dublin was not desirous of any distinction being made between it and the other University. With regard to the number of representatives to be assigned to the Universities and the Royal Colleges of Physicians and Surgeons respectively, he wished to point out that whilst the Universities granted degrees after examinations in each of the three subjects of medicine, midwifery, and surgery, the College of Physicians gave diplomas in medicine and midwifery only, and the College of Surgeons in surgery only. Thus the two latter bodies only did together what each University did separately; therefore, there would be no hardship in their having five members between them, whilst the Universities had three each.

LORD CARLINGFORD (LORD PRESIDENT of the COUNCIL)

said, he was most anxious to take any course that would bring the matter to a fair conclusion, and he would therefore accept the proposal of the noble and learned Earl (Earl Cairns). He would, consequently, strike out the provision that the Apothe- caries' Hall should have a representative on the Board, and would give to the University of Dublin and the Royal University of Ireland three members each instead of two. He also agreed that the College of Physicians should have three representatives, and the Royal College of Surgeons two. As to England, he was very unwilling to take anyone by surprise, and therefore he would not press any Amendment on the subject at present; but, at the same time, he reserved his right of placing any Amendments on the Paper at a future stage.

LORD EMLY

said, he thought that the College of Surgeons, as being the teaching body, ought to have three members instead of two; while the College of Physicians, which was not a teaching body, but only a body of trustees, should be content with two.

VISCOUNT POWERSCOURT

Would it be a bad plan if each of these Colleges had three representatives?

THE MARQUESS OF SALISBURY

There would be no majority.

EARL CAIRNS

said, he merely desired that these Colleges should have five representatives between them.

THE EARL OF MILLTOWN

proposed that the College of Surgeons should have three representatives and the College of Physicians two.

EARL CAIRNS

assented.

LORD CARLINGFORD (LORD PRESIDENT of the COUNCIL)

said, he would agree that, subject to amendment on Report, the Universities should have three representatives each, the College of Surgeons three, and the College of Physicians two.

Amendment moved, in page 4, line 12, leave out ("Two") and insert ("Three"); line 13, leave out ("Two") and insert ("Three"); line 14, leave out ("Three") and insert ("Two"); leave out line 16.—(The Lord President.)

THR MARQUESS OF SALISBURY

said, he thought that they had better accept the Amendment provisionally.

Amendment agreed to.

On the Motion of the LORD PRESIDENT, the following words were inserted in page 5, after line 29:— (16. Any report of the Privy Council purporting to be made in pursuance of this section shall be laid as soon as practicable before both Houses of Parliament, if Parliament be in session at the time of the making thereof, or if not, then as soon as practicable after the beginning of the then next session of Parliament. 17. If either House of Parliament present an address to Her Majesty within forty days next after any such report has been laid before such House that such report or any part thereof ought not to be carried into effect, no further proceedings shall be taken in respect of the report with regard to which such address has been presented, but if no such address is presented by either House of Parliament within such forty days as aforesaid, it shall be lawful for Her Majesty by Order in Council to give effect to any such report, and any Order in Council so made shall be of the same validity as if it had been enacted in this Act.")

Clause, as amended, agreed to

Clause 10 (Medical Board to regulate examinations subject to control of Medical Council and Privy Council).

LORD BALFOUR,

in proposing the insertion of a Proviso to tho effect that— ("Such final examinations in medicine, surgery, and midwifery may, for the purposes of this Act, be held at each university by the examiners of the medical board in conjunction with the examiners of the university, or in each division of the kingdom, in conjunction with the examiners of a board formed by the combination of two or more corporations,") said, the object of the Amendment was to insure, if possible, that it should not be necessary for each candidate to go through two final examinations; and he proposed, therefore, that the final examinations of the Divisional Board and that of the University for the degree should be held at one and the same time. The reason for the Amendment was that the examinations of the Universities for degrees were very long, tedious, and somewhat expensive affairs. At all events, the clinical part of the examination was, and it was to avoid the repetition of that long and tedious process that he proposed his Amendment. The Lord President would doubtless say that the Amendment went to the root of the Bill; but that was no argument against it, unless it was proved that it was in itself bad. The examiners of the Boards and the Universities would conduct the examination at the same time; but they would deliberate separately, and might come to a different conclusion as to whether a particular candidate had passed or not. If, however, he was assured that the position given in the Bill to the Scottish Universities would not be altered at a subse- quent stage, in response to the contemplated Amendment by the noble Earl (the Earl of Galloway), he would be much less inclined to press his Amendment than he was now.

Amendment moved, in page 6, line 5, after ("examinations") insert— ("4. Such final examinations in medicine surgery, and midwifery may, for the purposes of this Act, be held at each university by the examiners of the medical board in conjunction with the examiners of the university, or in each division of the kingdom, in conjunction with the examiners of a board formed by the combination of two or more corporations.")—(The Lord Balfour.)

THE DUKE OF RICHHOND and GORDON

said, he could not agree with the proposal of the noble Lord. The Amendment was designed in the interests of the Scotch Universities, and he advised the noble Lord to bring it up at a later stage if he was not then satisfied as to the position to be given to those Universities under the Bill. But, even then, he could not promise to support him.

LORD CARLINGFORD (LORD PRESIDENT of the COUNCIL)

said, he was quite unable to agree with the Scotch Universities which the noble Lord represented upon this point. He was bound to say, as the noble Lord anticipated, that the Amendment was absolutely vital to the Bill. The proposal was made solely in the interests of the Scotch Universities, which were most valuable bodies; but if he were to put the Scotch Universities in a special and exceptionally-favoured position, it would be absolutely impossible to carry out a joint scheme affecting the Three Kingdoms. He thought, however, that the Scotch Board and the Universities would have no difficulty in arranging matters so as to avoid the final examination being conducted twice. He was convinced the fears of the noble Lord and those whom he represented with regard to the effect of this part of the Bill on the Scotch Universities were quite unfounded. It would be impossible to accept the Amendment. As to any danger to the Bill in "another place," if the Government and the Scottish Members on both sides could not provide for its safety as it stood, with respect to Scotland, he did not know what earthly power could do it.

Amendment (by leave of the Committee) withdrawn.

THE EARL OF MILLTOWN

proposed, in line 17, after ("Kingdom") to insert— ("And the Medical Council shall, before approving of the schemes sent up to it by the divisional boards, arrange that the examinations, curriculum of study and fees to be paid by candidates, shall be uniform in each division of the Kingdom.")

LORD CARLINGFORD (LORD PRESIDENT of the COUNCIL)

said, he agreed that practical uniformity ought to be attained; but absolute identity of curriculum and everything else would be going too far. They might safely trust the Medical Council and the Privy Council to prevent anything like that undue competition or underbidding between different medical authorities which had been so great a great blot upon the present medical system.

Amendment (by leave of the Committee) withdrawn.

On the Motion of The LORD PRESIDENT, Amendment made in page 6, line 15, by leaving out from ("So far as") to ("kingdom") in line 17, both inclusive, and inserting— ("The rules with respect to final examinations shall be framed in such manner as to secure, so far as is practicable, in each part of the United Kingdom, an equality of standard in each final examination and an equal capacity for testing proficiency, also care shall be taken that the same comparative value shall be assigned to the importance of different branches of knowledge in the final examination held in each part of the United Kingdom, and that for that purpose the same maximum number of marks shall be assigned to the same branch of knowledge in such examination.")

Clauses, as amended, agreed to.

Clause 11 struck out.

Clauses 12 and 13 agreed to.

Clause 14 (Establishment of Medical Council).

On the Motion of the LORD PRESIDENT, Amendments made in page 7, line 11, after ("due") by inserting ("supervisionand"); in page 8, line 24, by leaving out (" fourth or"); in line 26, by leaving out ("fourth or").

Clause, as amended, agreed to.

Clause 15 (Duties of Medical Council).

On the Motion of The LORD PRESIDENT, Amendments made in page 8, line 37, by leaving out from ("in") to ("visit") in line 38, both inclusive, and inserting ("have power"); in line 38, after ("to time") by inserting ("by visitation or otherwise, to inquire into the sufficiency of"); in lines 39 and 40, by leaving out ("and inquire into the sufficiency thereof"); in line 40, by inserting as a separate paragraph— ("The Medical Council may also make inquiries of and call for any information from any of the medical hoards constituted by this Act, also from any medical authority or medical school, or other medical body taking any part in any medical examination or medical education in pursuance of this Act.")

Clause, as amended, agreed to.

Clauses 16 to 19, inclusive, agreed to.

Clause 20 (Medical Board to regulate course of medical education subject to control of Medical Council and Privy Council).

LORD BALFOUR

moved, in page 11, line 4, after ("elsewhere") to insert— ("Provided always that examinations passed at a university preceding the final examination required by this Act, if satisfactory to the Medical Council, shall be received by the Medical Board in lieu of like examinations conducted by the Board.")

LORD CARLINGFORD (LORD PRESIDENT of the COUNCIL)

said, he did not regard the provision as necessary, or he would accept it at once. If he did accept it, he would have to extend it to all the Corporations. He might, however, point out that a satisfactory provision was already made in an earlier portion of the Bill.

Amendment (by leave of the House) withdrawn.

Clause agreed to.

Clause 21 (Medical Board to visit schools and examinations).

On the Motion of The Earl of MILL-TOWN, Amendment made, in page 11, line 22, after ("authority") by inserting— ("The order of the Board on this behalf being subject to appeal on the part of such examining authority or medical school to the Medical Council, and afterwards to the Privy Council.")

Clause as amended, agreed to.

Clause 22 (Registration of colonial practitioner with recognized diploma).

LORD CARLINGFORD (LORD PRESIDENT of the COUNCIL)

said, he had several verbal Amendments to propose, with the object of taking care that foreign countries, or colonies, should not make use of the powers contained in the Bill for the purpose of obtaining the advantages therein without giving this country corresponding advantages.

Amendments moved, In page 11, line 25, leave out ("appointed") and insert ("prescribed"); in line 28, after ("possession") insert ("to which this Act applies"); in line 35, leave out ("appointed") and insert ("proscribed"); and in line 38, leave out ("appointed") and insert ("prescribed.")—(The Lord President.)

THR MARQUESS OF SALISBURY

said, he was much struck with the reference to the principle of reciprocity. He had no doubt they would get to fair trade in time. Ho also wished to point out a great grievance in the fact that some drugs were absolutely prohibited in foreign countries, not because they were bad, but because they were prepared out of the country, He thought it might be possible to remedy this defect.

LORD CARLINGFORD (LORD PRESIDENT of the COUNCIL)

said, he did not think they had anything to do with drugs in the Bill. If he had charge of a Pharmaceutical Bill in the course of the Session, he would bear the matter in mind.

Amendments agreed to.

Clause 23 (Registration of foreign practitioner with recognized diploma).

On the Motion of The LORD PRESIDENT, Amendments made in page 12, line 6, by leaving out ("appointed") and inserting ("prescribed"); in line 8, after ("country") by inserting ("to which this Act applies"); in line 23, by leaving out ("appointed") and inserting ("prescribed"); inline 25, by leaving out ("appointed") and inserting ("prescribed").

Clause, as amended, agreed to.

Clause 24 (Medical diploma of colonial and foreign practitioner when deemed to be recognized).

On the Motion of The LORD PRESIDENT, Amendments made, in page 12, line 28, after ("possession") by inserting ("to which this Act applies") and after ("country") by inserting ("to which this Act applies ").

Clause, as amended, agreed to.

Clause 25 (Privileges of colonial practitioner).

On the Motion of the LORD PRESIDENT, Amendments made, in page 13, line 13, by leaving out ("shall") and inserting— To which this Act applies shall, if he is qualified to hold such appointment by the law of such British possession; in page 13, after Clause 25, by inserting as a New Clause— (Power of Her Majesty in Council to define colonies and foreign countries to which this Act applies.) ("Her Majesty may from time to time by Order in Council declare that this part of this Act shall be deemed on and after a day to be named in such order to apply to any British possession or foreign country which in the opinion of Her Majesty affords to the resident medical practitioners of the United Kingdom such privileges of practising in such possession or foreign country as to Her Majesty may seem just; and from and after the date of such Order in Council such British possession or foreign country shall be deemed to be a British possession or foreign country to which this Act applies within the meaning of this part thereof; but until such Order in Council has been made in respect of any British possession or foreign country this part of this Act shall not be deemed to apply to any such possession or country; and 'the prescribed day' as used in this part of this Act means as respects any British possession or foreign country, the day on and after which this part of the Act is declared by Order in Council to apply to such British possession or foreign country;") in page 13, by leaving out Clause 26.

Clause 27 agreed to.

Clause 28 (Penalties on misuse of medical titles).

LORD CARLINGFORD (LORD PRESIDENT of the COUNCIL)

moved, in page 14, line 37, after ("not") insert— ("Who practises for gain, or professes to practise, or publishes his name as practising medicine or surgery, or receives any payment for practising medicine or surgery.")

LORD MOUNT-TEMPLE

said, the Amendment was too stringent.

LORD CARLINGFORD (LORD PRESIDENT of the COUNCIL)

said, the Amendment was really in the nature of a relaxation.

Amendment agreed to.

Clauses 29 to 32, inclusive, agreed to.

Clause 33 struck out.

Clauses 34 to 37, inclusive, agreed to.

Clause 38 (Expenses of Act, and fund to meet such expenses).

On the Motion of The LORD PRESIDENT, Amendment made, in page 21, line 10, by inserting, as a separate paragraph:— (4. The expenses of maintaining any such medical museums and medical libraries belonging to any medical authority for the time being authorised to return a member to the medical board, as may before the passing of this Act have been ordinarily maintained for general public purposes by such authority in their capacity of grantors of qualifications for registration under the Medical Act, 1858, and have been so maintained out of fees paid by applicants for such qualifications, and may be of such importance to the promotion of knowledge in medicine or surgery as to deserve to be maintained out of the funds of the Medical Board.")

LORD BALFOUR

moved, in page 22, line 24, after ("determine") to insert— ("The fee to be paid by University graduates, or persons holding University certificates of having passed the examinations at their University qualifying for admission to the final examination of the Medical Board in medicine, surgery, and midwifery, and shall not exceed their proportion of the sum sufficient to cover the cost of the final examination of the Medical Board.") His object was to carry out the recommendation of the Royal Commission to prevent students from being unduly taxed, for instance, for museums and libraries.

THE EARL OF CAMPERDOWN

said, that the noble Lord had only partly adopted one of the resommendations of the Royal Commission. He thought it ought to be taken in its entirety, and therefore moved to add to the Amendment the words "and other expenses aforesaid."

LORD CARLINGFORD (LORD PRESIDENT of the COUNCIL)

agreed with the principle that persons coming from a University to a final examination ought not to be expected to contribute by their fees to support the libraries and museums of institutions with which they had nothing to do.

EARL CAIRNS

thought that if the Amendment were amended as suggested by the noble Lord, "the other expenses" might be held to include those which admittedly University candidates ought not to pay.

LORD CARLINGFORD (LORD PRESIDENT of the COUNCIL)

said, he would give the question careful consideration before Report, and amend the clause if necessary, in accordance with the principle he had stated. If the noble Lord's Amend- ment were adopted simpliciter it would, he said, prevent University candidates being charged anything more than the bare expenses of the examination.

Amendment (by leave of the Committee) withdrawn.

Clause, as amended, agreed to.

Clauses 39 to 46, inclusive, agreed to.

Clause 47 struck out.

Remaining clauses agreed to.

The Report of the Amendments to be received on Thursday next, and Bill to be printed, as amended. (No. 36.)