VACCINATION BILL. (Hansard, 2 August 1898)

LORD HARRIS

I have to ask your Lordships to give a Second Reading to this Bill, which makes a change—an experimental change—in the law relating to what has been called—erroneously called—compulsory vaccination; for, as your Lordships are perfectly well aware, what the Act secures is not that the children shall be vaccinated, but that those parents who do not have their children vaccinated are punished, either by a fine or by imprisonment. That is the present state of the law. With reference to the Bill now before your Lordships, it is important to remember that it is an experimental Bill for five years; therefore, if at the end of that time experience shows that its provisions have not been wise, it will be possible for Parliament to revert to the present system, or to adopt a modified form of it, as it may think necessary. The important changes in the Bill are three in number. It secures the use of a lymph called glycerinated vaccine lymph; it secures that the children shall be vaccinated at their own homes instead of at the public vaccination stations; and, in the third place—and it is upon this part of the Bill that dispute has mainly raged—it abolishes the infliction of a penalty upon a parent, where that parent has been able to convince the magistrates that his objection to vaccination is a conscientious objection. I shall have to deal with these three points in some little detail presently, but I think I am justified in detaining your Lordships for a short time while I venture to draw attention to the facts which have necessitated—which have compelled the Government to ask Parliament to assent to these changes. I do not think it will be contested that there has been and is a very grave apprehension in the minds of some persons as to the result of arm to arm vaccination, and the fact that diseases—human diseases—are communicable by this system of vaccination is admitted by the Report of the Vacci- 812 nation Commission; but, whether the cause be well established or not, I do not think it can be contested for one moment that there is a very serious apprehension in the minds of some people as to whether vaccination is safe, and these apprehensions have been built upon by the agitation of a certain number of persons—I honestly believe many of them to be well meaning—who have conducted a campaign against vaccination throughout the country. In consequence of that agitation it is very possible that the apprehensions have been somewhat exaggerated. At any rate, it is undoubted that that agitation has induced many people to entertain these apprehensions, and I venture to suggest to your Lordships that there is one factor in this difference of opinion, which is an essential and most important factor, and one which I have not seen mentioned in any of the speeches made in the House of Commons, and that factor is maternal apprehension. My personal belief is that a very large percentage of the motherhood of England has been seriously alarmed as to the safety of the health of the children, and, if that be so, I appeal to your Lordships whether it is not very natural that that apprehension should have received a wide circulation amongst those whose business it is to administer the law. Of course, this apprehension has regard to animal diseases as well as to human, but I think in the former case it is confined to a very small section; and I believe it is undisputed that the medical authorities admit that the use of glycerinated calf lymph absolutely disposes of this latter apprehension. As regards the latter, I must ask your Lordships to allow me to quote from the Report of the Royal Commission, and I shall have to refer to this Royal Commission once or twice, because it is upon it that every recommendation of the Government in this Bill is based. Tour Lordships will remember that this Commission was appointed in 1879, and I may remind your Lordships of some of the most important men who were upon that Commission. There were Sir James Paget, F.R.C.S., Sir William Guyer Hunter, F.R.C.P., Mr. William Scovell Savory, President of the Royal College of Surgeons, Mr. John Syes Bristowe, F.R.C.P., Mr. William Job Collins, 813 F.R.C.S., and Mr. Michael Foster, M.A., Professor of Physiology in the University of Cambridge. That Commission was appointed in 1879. It took some seven years to consider the mass of evidence brought before it, and when it reported it made this statement, which I think, as regards the point I am touching upon—the communication of human disease—is so important that I should bring it before your Lordships' attention. In paragraph 430 they say— The evidence offered to us would lead us to the belief that whilst with ordinary care the risk of the communication of syphilis, in the practice of arm to arm vaccination can for the most part be avoided, no degree of caution can confer an absolute security. My Lords, I imagine it is the opinion of Her Majesty's Government—I venture to say that I hope it is—but, at any rate, it is my honest private opinion that, the Motion which I see has been put down by the noble Marquess, whom I do not see in his place, that this Bill should be read a second time this day three months, which would mean a reversion to arm to arm vaccination, is absolutely impossible, if your Lordships bear in mind what the Royal Commission said, that such a danger is possible. I do not care how minute the danger is, I do not care however small the presumption may be, I would never dare, from this moment, to introduce, as a Government Measure, arm to arm vaccination, after such a statement by such a body as the Royal Commission. Then there is another cause which has led to objection, and it is a cause which, no doubt, exists in a great many cases—the strong objection of the mother to have the bother of vaccination with a puling child. That is believed by those who have gone into the matter closely to be largely responsible for some of these objections to vaccination. Finally, there is the question of these penalties and accumulative penalties—that is to say, repeated penalties in the case of the same child. As your Lordships know, in the law as it stands a parent may be proceeded against time after time, as regards the non-vaccination of one child, with the result—and these cases often happen—that the parents' means may be entirely exhausted, his goods may be distrained 814 upon, and finally he may be committed to prison. Up to a certain date, whilst this Commission was sitting, he was treated as a criminal; so I do not think it is to be wondered at that the agitation which was got up by the conscientious objectors, rolled up into larger dimensions, and met with a considerable amount of success. The persons who were so proceeded against, and who went to prison, were met at the prison doors on their release, in some cases with bands of music, and paraded through the streets. All that agitation was very objectionable, but it was quite likely to induce converts to join the ranks. I have pointed out to your Lordships that in consequence of this agitation the Commission was appointed, and I have read you some of the names of those who served on it. There was one Member of your Lordships' House upon it—the noble and learned Lord, Lord Herschell—who, I regret to say, has been called away upon Imperial duties to another part of the country, and whose absence I specially deplore tonight, as I could have looked to him to support me in what I lay before your Lordships to-night, as a Bill depending upon the recommendations of this Commission. There was another result of this Commission. It sat for seven years, and since it reported the Government have been considering how best to carry out its provisions for two years. During these nine years the law has, in many parts of the country, been practically in suspense—that is to say, that a large number of the boards of guardians have not been carrying out the law as Parliament intended they should, with this result: that I believe I am well within the mark when I say that one-sixth of the boards of guardians at this moment are not prosecuting for non-vaccination, and with this further result, as regards the children, that it is estimated that out of 900,000 children born in the year only some 600,000 are vaccinated. Out of the other 300,000 deductions have to be made for deaths, for migrants, and for other causes, but undoubtedly a very large percentage of children are not vaccinated on account of objection to the system of vaccination. Your Lordships will see at once that the change proposed by the Government is not between what 815 is proposed and a system of universal vaccination, but between what is proposed and a system of vaccination which was desired to be universal, but which the Government have never been able to make universal, and which, in consequence of agitation, and in consequence of inquiry resulting from agitation, has in many parts of the country broken down. What is the outcome of the Report? Because, as I have already twice told your Lordships, this Bill depends upon the Report. In the first place, it recommends the use of glycerinated calf lymph. That is provided for in the Bill—that is to say, that, whereas the practice up to now has been arm to arm vaccination, when this Bill is passed, it is secured that, unless the parent wishes for arm to arm vaccination, the child shall be vaccinated with this glycerinated calf lymph, the Government undertaking, of course, to provide a sufficient quantity. That is recommended in paragraph 437 of the Report of the Royal Commission, which I do not think I will read to your Lordships, because it is practically accepted that it is a wise measure. As regards any fear of tuberculosis, it is satisfactorily accepted that the glycerinated calf lymph destroys all these organisms, which might be communicated from an animal to a human being. There is another advantage in using glycerinated calf lymph. Whereas now a child has to attend a second time on the eighth day, in order that the lymph may be taken from the vesicle, that will henceforth be quite unnecessary, and will be practically done away with by the use of glycerinated calf lymph, unless the parent is willing or wishful that it should be taken away. At present the law makes it penal if a parent refuses to allow lymph to be taken from the child. That will be swept away, and no one can be penalised in future, if this Bill passes. There is also an advantage in this way: it has been though that erysipelas has been caused in consequence of the vesicles being broken that danger will be removed. Secondly, domiciliary visits are strongly recommended by the Commission, and your Lordships will see, without my detaining you, how very convenient it will b for many poor people, who have had to take their children, perhaps in inclement 816 weather, to a distant vaccination station, not only once, but twice, that that should no longer be necessary, but that the doctor will be obliged to visit the children in their own homes. That is strongly recommended by the Commission, from their experience of what they find was the practice in Scotland, which is mentioned in paragraph 443, and which I do not think I need weary your Lordships by reading. Finally, I come to the third important provision in the Bill, which is as regards the abolition of penalties in cases where the parent can obtain a certificate from two magistrates that his objection is a conscientious one. I must explain to your Lordships precisely what will occur. The parent must either have the child vaccinated, or obtain a certificate that it need not be vaccinated, because the parent has a conscientious objection. He must do one of these two things within four months of the birth of the child. If he fails to do that, the public vaccinator, who will have become aware of the fact through the channel of the registrar of births, will call at the house of the parent, and offer to vaccinate the child with glycerinated calf lymph. If the parent has not had the child vaccinated, or does not produce the magisterial certificate within six months from the birth of the child, then he is liable to be prosecuted for non-vaccination once up to the age of four years, and then again, under another clause upon public vaccination, once more before the child is 14 years of age. That is the effect of the change in the law—that is, that the parents may be punished twice only—and it is a curious thing, historically curious, that it might have been the law 27 years ago but for a Division in this House. In 1871 the House of Commons, upon the recommendation of the Select Committee, sent a Bill up to this House which provided that parents should not be punished more than twice. I do not remember the names of many Members of that House of Commons Committee, which was a strong Committee, but I remember one gentleman whom I have had the honour of serving under officially, and whom I always thought was one of the most practical men I ever met in my life—Mr. W. H. Smith. That Committee recommended that the penalty 817 should be limited to two convictions. The Bill was debated once, I should think, from the look of "Hansard," for about a quarter of an hour, in a very thin House—so thin that it could not now count for a Division. There were 15 Peers present, and they divided—eight in favour of the cumulative penalties, and seven in favour of the Bill as it came from the House of Commons. Lord Redesdale moved that the House of Commons Amendment be struck out, and it went back to the House of Commons in that form on the last day of the Session, and Mr. Forster preferred to accept the Bill as it came down to losing it altogether. I am speaking by the book when I say that 27 years ago it was within an ace of being the law that there should be only two penalties, on conviction, instead of, as has been the law for 27 years, that there should be repeated penalties upon repeated conviction for the same child. I know, my Lords, that there are some in this House who object to this conscientious objection clause, and I have pointed out to you what the effect of it will be when the parent has an opportunity of alleging it within the first four months of the birth of the child. I, in my subordinate position, am not responsible for policy, but if your Lordships have read the speeches of the Leader of the House of Commons and of the President of the Local Government Board, I think there will be found to be practical evidence to anyone that what has caused the change from the Bill as it was originally introduced, when it did not contain the conscientious objection clause, and as it came up to you Lordships, is a very remarkable change of opinion in that House during the progress of the Bill through that House. Mr. Chaplin carried his Bill on the Second Reading by a majority of 10 to one; and on the Report stage, after the Bill had come down from the Grand Committee, where the conscientious objection clause—not the one you find in the Bill now, but another—had been inserted, I gather from the speeches then delivered that the Government upon the whole concluded that it was wisest to accept the conscientious objection clause rather than lose the Bill. Now, whatever may have been the policy of the 818 Government originally, it can certainly be supported by the experience that the Government has had of what took place in consequence of this practical suspension of the law, pending the Report of the Royal Commission. At any rate, the Bill, as your Lordships have got it before you, is practically the recommendation of the Royal Commission, and I think I must ask your Lordships to allow me to detain you a few moments, while I read a few passages from the Royal Commission to substantiate my statement. In paragraph 524 the Commission state— After careful consideration and much study of the subject, we have arrived at the conclusion that it would conduce to increased vaccination if a scheme could be devised which would preclude the attempt (so often a vain one) to compel those who are honestly opposed to the practice to submit their children to vaccination, and, at the same time, leave the law to operate, as at present, to prevent children remaining unvaccinated owing to the neglect or indifference of the parent. When we speak of an honest opposition to the practice, we intend to confine our remarks to cases in which the objection is to the operation itself, and to exclude cases in which the objection arises merely from an indisposition to incur the trouble involved. We do not think such a scheme impossible. Again, in paragraph 525, we find— It must, of course, be a necessary condidition of a scheme of this description that it should be such as would prevent an objection to the practice being alleged merely as an excuse to save the trouble connected with the vaccination of the child. We may give the following as examples of the methods which might be adopted. It might be provided that if a parent attended before the local authority and satisfied them that he entertained such an objection, no proceedings should be taken against him. Or, again, a statutory declaration to that effect before anyone now authorised to take such declaration, or some other specified official or officials, might be made a bar to proceedings. We do not think it would be any real gain to parents who had no conviction that the vaccination of their children was calculated to do mischief, to take either of these steps rather than submit them to the operation. Paragraph 527 says— We are quite conscious that the proposal we have made will be regarded by some as a retrograde step in the cause of vaccination. We do not believe that it would prove to be so in practice. Too blind a confidence is sometimes reposed in the power of an Act of 819 Parliament. It is thought that if the law be only sufficiently stringent and inflexibly enforced the desired end is sure to be attained. There is, however, abundant experience to the contrary. When that which the law enjoins runs counter to the convictions or prejudices o many members of the community, it is not easy to secure obedience to it. And when it imposes a duty on parents the performance of which they, honestly, however erroneously, regard as seriously prejudicial to their children, the very attempt to compel obedience may defeat the object of the legislation. At the same time we think it would b well to make the change a temporary one in the first instance, say, for a period of five years, and that in the meantime its effect should be carefully watched. Those paragraphs appear in the main body of the Report, which was not agreed to unanimously. The minority Report, signed by Messrs. Guyer Hunter and Jonathan Hutchinson, says— The undersigned do not find themselves able to go so far in recommending relaxation of the law as is implied in paragraphs 524, 525, 526, and 527. We think that in all cases in which a parent or guardian refuses to allow vaccination, the person so refusing should be summoned before a magistrate, as at present, and that the only change made should be to permit the magistrate to accept a sworn deposition of conscientious objection, and to abstain from the infliction of a fine. We are also of opinion that, in spite of the difficulties as set forth in paragraph 533, a second vaccination at the age of twelve ought to be made compulsory. The last Minority Report, signed by Messrs. Whitbread, Bright, Collins, and Picton, says— We cordially concur with the recommendation that the conscientious objector should be respected. These are the Reports of the Royal Commission upon this point, and, as your Lordships will see, the recommendations of the Government, as embodied in the Bill, practically carry out the recommendations of the Royal Commission. Those are the grounds upon which I support this Bill and ask your Lordships to read it a second time, because it practically carries out the recommendations of a body of most distinguished men appointed specially to consider this very subject, and who gave an immense amount of time and consideration and care to it by examining an enormous amount of evidence. They did not report hurriedly, 820 but deliberately, and, after all these years of consideration, that is what they reported, and the Government has practically accepted their recommendations. I am aware that there is a Motion down upon the Paper that this Bill be read a second time this day three months, and I want your Lordships to realise what the effect of such a Motion, if carried, would be. You would lose the advantage of the use of glycerinated calf lymph, unless it were possible by Executive Order to secure its use; but you cannot make it illegal to take lymph from the arm, excepting by means of an Act such as this. It will still be legal to take lymph from the arm of a child, even if it were possible to have glycerinated calf lymph used by Executive Order, and you would distinctly lose the advantage of domiciliary visits, which, as your Lordships, from, very great experience, must know, would be of infinite advantage, especially to the poor. What will be the most serious effect of rejecting this Bill? The children would not be vaccinated. Your Lordships will not secure that, the children will still go unvaccinated, and you may depend upon it Parliament, would have to go into the subject again. Once more I venture to press upon your Lordships that I submit to you the present Bill because its provisions are supported by an authority so wide and so learned on this particular subject as the Members of the Royal Commission. I will add this, if it is of any use: it is only a personal matter, and I do not know that it carries very much weight. I came to the consideration of the subject a few months ago, when I became aware that it would be my duty to bring it before your Lordships, with a private conviction in favour if the advantages of compulsory vaccination as legalised here. To-day I can honestly say that my conviction is that the Measure that has been introduced by he Government, and which I move to-light, is, upon the whole, the safest and the wisest way of dealing with this most difficult question. I do not believe that by adhering to the system of penalties, more or less severe, as the case may be, and certainly severe when they fall upon the poorest shoulders, will make vaccination popular. The object of us all, whatever view we may take as to what legisla- 821 tion should be, is to secure the vaccination of the largest number of people, believing as we do, and as I stated in the resolution of the Royal College of Physicians, that vaccination is the only known means, and the best means, of securing immunity from small-pox. That is the interest of us all. I venture to submit to your Lordships that the wisest and the most statesmanlike course is to endeavour to enlist the sympathy of the people in this country in the legislation which deals with this matter and to endeavour to make it a popular question. These are the convictions which have, to my mind, justified me in using the arguments which I have used to-night, and I thank your Lordships for listening to me, and I now beg to move the Second Reading of the Bill.