HL Deb 04 August 1898 vol 64 cc27-39

On the Order for going into Committee on this Bill,

THE MARQUESS OF AILESBURY

My Lords, in pursuance of the Notice which I have placed upon the Paper, I rise to move— That this House do resolve itself into the said Committee this day three months; and in doing so I should like to apologise for not being in my place on the occasion of the Second Reading, but I can assure your Lordships that that was due to no fault of mine. With all diffidence I venture to urge that a contentious Measure of this description, which has been chopped and changed about at the eleventh hour, should not have been pushed through, as this has been, and brought up at the fag end of the Session. I consider that that is unfair to your Lordships' House, and makes us, in other words, a mere registration society, and leaves us no time whatever to discuss this Bill. The three reforms which are wanted, as regards vaccination, m my opinion, are: (1) lymph hospitals, as in Germany; (2) no impure lymph, but to use the best vaccine matter that is procurable; (3) more latitude as regards age. Under this Bill there is an attempt to deal with this matter, but at the same time the Bill is badly drafted. It does not compel the local authorities to use the best lymph, but leaves them to use any lymph they think fit. Re-vaccination is not touched upon nor alluded to, and it would certainly be a help to this House if we had the opinion of an expert like Lord Lister upon this subject. We, who have always been brought up in the school of compulsory vaccination, do not wish to see the good work which Dr. Jenner accomplished entirely flung away or certainly abrogated. It is not likely that the Imperial Parliament of Dr. Jenner's day would have granted him £10,000 one year and £20,000 five years afterwards if this vaccination were to be as useless and ineffective as its opponents aver. It is not only England, but all the nations of the world, have honoured his name in adopting vaccination, and the monument in Trafalgar Square is a proof of the homage, not of England only, but of the world at large, and it is not likely that we, whose countryman he was, are going to see his good work put on one side when all the other nations of the world have honoured him. Before the days of vaccination, from 10 to 14 per cent, of those attacked with small-pox died, and many the same age as myself will recollect some 20 or 30 years ago, how often we saw people marked on their faces with small-pox; but you do not see that nowadays, and why? Because we have made vaccination compulsory. It has been proved that out of 15,000 cases in the London small-pox hospital, while the un-vaccinated died at the rate of 37 per cent, the vaccinated died only at the rate of 6½ per cent. In 1887 it was estimated that out of 750,000 infants vaccinated, only 50 died of this disease. My Lords, you are well aware that we are still liable to epidemics in this country, as witness Sheffield, Middlesbrough and Gloucester city. The Report presented by the Government investigator as regards Sheffield, is— Taking the whole population of Sheffield, only 155 of every 10,000 vaccinated persons were attacked, and only seven died. Out of the same proportion of unvaccinated persons, 970 were attacked, and no less than 480 cases ended fatally. Taking the total of persons living in houses actually invaded by the smallpox, the number of vaccinated children under 10 who were attacked was 78, and only one died. The unvaccinated patients of the same class amounted to no less than 860, with a fatal issue in 381 cases. Those, my Lords, are striking figures. In 1894 the increase of small-pox in London was distinctly attributed to the anti-vaccinators. In Austria and the United States small-pox is nearly stamped out. Why is that? Because they go in for compulsory vaccination, and I think we might, in that respect, take a leaf out of Uncle Sam's book, and recognise how much they know of the good work accomplished by Dr. Jenner. Perhaps it would not be out of place if I were to inquire of the noble Marquess the Secretary of State for War why it is that our soldiers are re-vaccinated on going on foreign service? Why is that done? There is only one answer—because it is right. Furthermore, I believe that the schoolmasters in our National schools are obliged to be vaccinated, and if they were to state that they had conscientious scruples against it they would not be allowed to be schoolmasters. And why, my Lords, are Ireland and Scotland left out in the cold? This Bill is to remain in force for five years, and that seems to me to be a very strange thing; but it simply means that the Government will get over the next General Election, and you will not be troubled with faddists. There are other ways of killing a Kilkenny cat without drowning it, and I remember the answer given by a Member of the House of Commons to a deputation of anti-vaccinationists the day before the General Election. He said— Gentlemen, if you will only vote for me to-morrow, you can all get the small-pox the day after. That is the way to treat these people. If this conscience clause becomes law, I ask the Ministry what will become of Lord Beaconsfield's dictum, "Sanitas Sanitatis, omnia Sanitas" You are kicking down the ladder that led you to glory. Do you mean to tell me that Lord Beaconsfield would have proposed a five years' experiment involuntary vaccination? It is enough to turn his dead body in the grave. The slums of London, and of our great cities, would be too horrible to depict if you added to them the scourge of small-pox. It is the poorest of the poor in these congested districts who will suffer—some of those 50,000 families, each family with only one room, and who are rack-rented besides, who will suffer. Where will the conscientious scruples come in when the bread-winners perish? The rich may go abroad, and even if he dies the Chancellor of the Exchequer may point to the increased death duties derived on account of the increased deaths; but if the bread-winner dies nothing is left but the poor-house, or, at best, outdoor relief. If this clause passes there will in future be an "open door policy," as regards small-pox. There are no safeguards in this Bill; they are flung away to "martyrs"; but my contention is that the Government might have let sleeping dogs lie until they had made up their minds one way or the other. The idea of endeavouring to make vaccination popular is absolute rubbish. Sanitary laws will never be popular with a certain section of the community. The Education Act never will be popular; but you have no hesitation about taking money from the parents who will not send their children to school. You cannot tell me that because hanging has not done away with murder, that that is a reason for abolishing hanging. There is no reason whatever why these pains and penalties should be done away with. The day will come, my Lords, when you will regret that you have ever passed this Bill, because you may see a most fearful outbreak of small-pox, of which you will, have been unwittingly the cause.

LORD STANLEY OF ALDERLEY

Although there are many reasons why your Lordships should defer going into Committee, yet I think that the speech of the noble Lord who moved the Second Reading gave one very strong argument in favour of proceeding with the Bill, and that is, that without this Bill being passed, arm to arm vaccination would continue, and that is the chief cause of the discredit into which vaccination has fallen; but no doubt some blame is due to the Royal Commission on Vaccination for not having reported earlier, and the Department responsible for the subject should have brought it before Parliament earlier. No doubt an enormous-number of children have died through vaccination—arm to arm vaccination. According to evidence before the Royal Commission lymph had been taken from the child of a scrofulous mother. Some medical men who gave evidence before the Commission seemed to regard with great unconcern the fact that calf lymph produces sore arms, and that is because they will not take it till the expiration of eight days, when as a matter of fact it ought to be taken at the end of five days, because the calf is a stronger animal than a baby; notwithstanding that, they continue the old formula. The defect of the vaccination law has been that from being compulsory it has been cheap, and, being cheap, it has been nasty. I am forced to say that the noble Lord who promotes this Bill seems to have put too much faith in the calf lymph which has been treated with glycerine. It was only yesterday that I saw a child six months old which had been treated with this new glycerinated lymph, and in five weeks he had not recovered from the effects of that vaccination. Its shoulders were full of marks of a very large size. There were three, but three seemed to be unnecessary. The parent of that child is a commissioned officer in the Guards and able to afford it every medical attention procurable, and yet after rive weeks it has not entirely recovered. In the evidence given before the Commission one doctor stated that he had vaccinated all his children within 24 hours of their birth. The speech of the noble Lord who moved the Second Reading was impressive, but it failed in one point; he gave no explanation of why clause 2 must be retained, the electioneering clause, which led to the loss of the Reading election, to the great satisfaction of both parties.

LORD LISTER

Happily it is not necessary to advocate the cause of vaccination. The great majority of the Members of the House of Commons—and, I trust, every Member of your Lordships' House—are aware of the enormous benefits which vaccination confers. The only question is, what are the best means of promoting vaccination in the country? It is to be observed that if the Amendment to omit the clause is passed, the result will not be the passing of the Bill without the clause objected to. The Bill will inevitably be sent back to us from the Commons with that clause re-introduced, and the consequence will be that the Bill will be thrown out for the Session. Not only so, but I am given to understand that if this Bill, which is framed very much on the lines of the Report of the Royal Commission, is thrown out this year, it is not likely that the Government will introduce another Bill next Session dealing with the subject, and very probably not in the year after, nor perhaps for many years to come. Therefore what we have to consider is whether it is better for us to pass this Bill in the form in which it is sent to us from the Commons, or be content to let the subject of the administration of the vaccination laws remain in the position in which it is. After giving the subject the best consideration in my power, my impression is that it would be better to pass the Bill as it is sent to us than to have no Bill at all. If, after the long labours of the Commission, and the endeavours of the Government, nothing whatever were done by Parliament in regard to vaccination, I think the result would be to cast discredit upon the whole subject. It is not as if the present compulsory system were working well. The appalling fact is that at the present time about one-third of all the infants born in England and Wales are not vaccinated. It is also true that nearly one-quarter of all the guardians throughout the country fail to put the vaccination laws into operation. This is a highly unsatisfactory state of things, and it is undoubtedly the result of the anti-vaccination crusade. The anti-vaccinator has two weapons. One of these is the supposed possible dangers of vaccination, and the other is the martyrdom which it is thought is endured by persons who are subjected to fines and imprisonment for disobeying a law which, rightly or wrongly, they believe subjects their children to danger. Now, as regards the former of these weapons—the supposed dangers of vaccination—the glycerinated calf lymph will remove it. With arm to arm, vaccination the danger does exist, though a very, very remote one, of introducing into a child the terrible contamination of syphilis. Now, this danger is absolutely done away with by the use of calf lymph, since syphilis cannot occur in the calf. Then, the introduction of tubercle by vaccination is equally prevented by the use of the new lymph. Tubercle can, indeed, affect the cow, and, though very rarely, the calf; but it has been found that if tubercle-bacilli are actually mingled with the glycerinated lymph, in the course of a time far short of that at which the lymph would be issued for use the bacilli have lost their vitality. There remains the possible danger of communicating erysipelas. This cannot be done by the lymph as such, for the microbes which are the essence of erysipelas are as effectually disposed of by the glycerine as are the microbes of tubercle. But there is the possibility of the communication of erysipelas to the incisions made in vaccinating, just as there is the possibility of communicating it to any scratch or sore in a human being. That is a possibility, and it would undoubtedly be diminished by having the children vaccinated at home, as is proposed in this Bill, instead of having them crowded together at the vaccination stations. But I trust that before very long any possibility of the communication of erysipelas by subsequent contamination will be done away with. The medical officers of the Local Government Board have now under consideration what would be the best, simplest, and most effectual means of using antiseptic measures for the treatment of the scratches—measures which will be simple and efficacious from the antiseptic point of view, and, on the other hand, not interfering with the efficacy of the lymph. I feel certain that the thing can be done. In the medical journals papers have been published by gentlemen who show that they have used antiseptic measures with perfect success in regard to vaccination. When this is accomplished there will be absolutely no objection to the vaccination of children on the ground of possible danger. But the conviction of the absolute safety of the process will take a long time to establish itself in the country. At the present time there is a deep-rooted idea, derived from the propaganda of the anti-vaccinationists, that serious danger exists; and it will take a long time before that idea is dissipated. The second weapon of the anti-vaccinationist—namely, the martyrdom of the honest objector—would, of course, be struck out of his hand at one stroke by the present Bill. It has been said that this conscience clause introduces a new and dangerous principle into our legislation. It may be so; but when I see that such a conscience clause was unanimously recommended by the eminent men who constituted the Royal Commission, including so distinguished a lawyer as Lord Herschell, I feel that I am free to consider this proposal on its merits otherwise. What is likely to be the effect of the Bill if passed into law? On this point we find the utmost discordance of opinion among medical men themselves. Some feel sure that the result will be an enormous diminution of vaccination throughout the country, and a consequent increase of small-pox. Other men of high position and large experience in sanitary matters are equally confident that the Bill would greatly increase the amount of vaccination. As to which of these opinions is really correct, I confess that I am hardly prepared to give an opinion. Those who hope for good from the passing of the Bill think that when the conscientious objector has been so amply provided for, the guardians who now object to enforce the vaccination law will not hesitate to prosecute persons who, from mere idleness, and without any real objections, neglect to have their children vaccinated. That this hope is not altogether without foundation we have a good illustration in a letter which appeared in the Times the day before yesterday from Sir Walter Foster. I will read to the House an extract from this letter— In 1897 the Barton Regis Board of Guardians, in face of difficulties in enforcing the vaccination laws, adopted (of course, without legal sanction) the recommendation of the Royal Commission. They informed the parents who had not submitted their children for vaccination that they (the guardians) would not proceed against them for default if a declaration of conscientious objection was made before a magistrate. In the Barton Regis Union in the last half of 1897 there was a population of over 200,000, and the number of births was 2,944. The defaulting parents were 350, and the actual number of declarations 130. Major Rumsey, the ex-chairman of the board, writes me— 'The number of declarations, 130, bore about the same proportion to the defaulters as the prosecutions under the Vaccination Acts did prior to the form of statutory declaration being adopted. The Barton Regis Guardians (44) were nearly equally divided in opinion upon the vaccination question, but from the time of the adoption of the declaration the anti-vaccinationists offered no objection to the prosecution of those who did not furnish a declaration, and a most disturbing element to the harmonious working of the board was removed. I may add that, had not the statutory declaration been adopted, a resolution would have been passed refusing to order prosecutions, and so the whole 350 would have escaped vaccination in place of the 130 referred to, the remaining 220 having no objection to vaccination, but being simply negligent or careless, and requiring pressure.' In other words, the announcement of the remission of penalties for those who made a declaration of conscientious objection, together with the threat of their enforcement for others, induced nearly two-thirds of the whole number of defaulting parents to submit their children to vaccination. So far as one case can go, this seems to me most encouraging. It is to be observed that this Bill by no means entirely does away with compulsion, though it is commonly spoken of as if it did so. Those parents who refuse to make a declaration of conscientious objection before the magistrate may be fined or imprisoned as under the existing law for not having their children vaccinated; but, beyond that, the fact that the parent is obliged to appear before the justices is a mild form of compulsion. It gives the parent trouble, and it will be a question with him whether it is more trouble to go before the magistrates or to have his child vaccinated under the very much less troublesome form provided under this Bill—namely, having it done by the vaccinator at the man's own house. If it turns out that the results are not so satisfactory, as regards the behaviour of the guardians, as may be hoped, it would be easy by a simple Bill to arrange that the administration of the vaccination laws should be transferred from the guardians to the sanitary authorities, or, at any rate, to arrange that the vaccination officers shall have the expenses of prosecution, which are now refused by the guardians, paid to them either through compulsion of the guardians or by the State. Therefore I must confess that I am disposed to be hopeful as regards the effect the Bill in its present form is likely to have. But there is one serious omission from the Bill, and that is that it neglects to deal with revaccination. It is a matter of bitter disappointment to the medical profession of this country that revaccination is not dealt with by the Bill. The immense value of revaccination has been shown by the splendid results obtained from it in Germany, in the Army, and more recently throughout the population. The value of revaccination is also indicated by the figures quoted by the Commission, as to its effects in diminishing death from small-pox in our Army and Navy and Postal Service. The immunity of nurses in our small-pox hospitals, who are always revaccinated before admission as nurses, is another most striking proof of the efficacy of revaccination. The Royal College of Physicians have lately made the following declaration— The Royal College of Physicians, having learnt that certain changes are likely to be made in the laws relating to vaccination, think it their duty to reiterate their conviction that vaccination, properly performed and duly repeated, is the only known preventive of smallpox. In the Times this morning there is published a declaration of the Royal College of Surgeons, in which the following passage occurs— We are, moreover, firmly convinced that revaccination is an additional safeguard, and should be universally practised. It is true that several members of the Commission considered that compulsory revaccination was so surrounded with difficulties that they were not able to recommend it. But two of the most influential members of the Commission, Sir William. Guyer Hunter and Mr. Jonathan Hutchinson, thought that in spite of those difficulties revaccination ought to be made compulsory. And those Commissioners who were of the opposite opinion made this significant declaration:— Again, it is impossible to leave out of sight the effect that such an extension of the present compulsory law might have in intensifying hostility where it at present exists, and even in extending its area, though, if our recommendations, especially that which exempts from penalty those who honestly object to the practice, were adopted, this objection would be much diminished. In the present temper of the House of Commons and of the country, it would indeed be hopeless to attempt to introduce compulsory revaccination on the lines on which infant vaccination is now compulsory. But the conscience clause of the present Bill opens the door for very valuable legislation on this subject. It could be arranged, with a little assistance from the Education Department, that every master or mistress of a school where children of the age of 10 attend, should keep a list of the names and addresses of those who had reached that age. Then the vaccinator could look in from time to time, at whatever periods it might be thought desirable, to see from the mere inspection of the arms of the children, which of them had not been recently vaccinated, and the parents of these would be dealt with as this Bill proposes to deal with parents who have neglected to have their infants vaccinated, including the offer of doing the operation at home. This would ensure the revaccination of the vast bulk of the population, except the children of the so-called conscientious objectors, who, under the new system, would, I hope, be a rapidly diminishing quantity. Another effect of this arrangement would be that many children who had not been vaccinated in infancy would be dealt with at the age of 10. Personally, I should like if the Bill could be withdrawn this year and brought in again next year with this question of revaccination attended to, and also some other matters which the Commission recommended, but which are not dealt with in this Bill. But I fear that is a hopeless suggestion. However, as regards revaccination, the members of the Government who have been approached on the subject have given us good reason to hope that a Bill dealing with revaccination may be brought in next Session. Such a Bill would, I think, be sure to pass the House of Commons, the great majority of which, however they may differ on other questions, are at one as regards the importance of revaccination. The medical Members of Parliament are certainly at one on this point. The Bill would therefore readily pass, and by introducing it the Government would do untold benefit to the community. The confident hope that the Government will see their way to take this course next Session make me the more readily acquiesce in what I confess is a tremendous experiment.

THE EARL OF PORTSMOUTH

I only wish to appeal to my noble Friend who has brought forward a Motion this evening which I very much regret. He objected very strongly to the conscientious objector. The Bill contains, in my opinion, and in the opinion of many others, most valuable provisions, and I would suggest to him whether he could find it consistent with his own views to agree to allow the Bill to go into1 Committee, and then, in Committee, to direct his attention to those clauses which have introduced this totally novel procedure—the conscientious objector. That will expedite the course of the Debate. I do not entirely share the views of the noble Lord who has just spoken, for, rather than have a Bill of this sort with such a provision in it, I would vote against it altogether. If my noble Friend will agree to withdraw his opposition at this stage it will greatly simplify matters, for those of us who could not vote to delay the Bill going into Committee might, in Committee, find some common ground on which we could vote.

LORD HARRIS

I trust that your Lordships will allow the House to go into Committee on this Bill. I need hardly remind your Lordships that you passed the Second Reading unanimously the other day, and in the speech of Lora Lister, who spoke with so much authority on this subject, the noble Lord gave it as his opinion that the Bill was a very great change indeed, and that on that account he would prefer to have it as it was to having none at all. I think it is hardly necessary for me to repeat any of the arguments that I used the other day at considerable length to induce your Lordships to allow the House to go into Committee; but there are one or two points which the noble Lord dealt with as regards revaccination that perhaps I should just allude to. The noble Lord indicated that he had already approached members of the Government, and had been encouraged to hope that the Government would consider the possibility of introducing a Bill next year with the object of encouraging revaccination. If the noble Lord had not indicated that fact I had authority to say so myself. It is, of course, quite impossible to attempt to introduce the principle this year, but the Government are prepared to consider during the recess whether it would not be possible to bring in a Bill next year to encourage revaccination. Under all these circumstances I trust your Lordships will allow the House to go into Committee.

Question put.

Amendment negatived.

House resolved itself into Committee on the Bill.

THE CHAIRMAN OF COMMITTEES (The Earl of MORLEY) in the Chair.

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