SECOND READING (Hansard, 16 May 1899)

* THE EARL OF LICHFIELD

My Lords, the Hill which I am now asking your Lordships to read a second time has been introduced with the object of amending certain recently-discovered flaws in the Isolation Hospitals Act of 1893. That Act applies to England and Wales, but not to Scotland, Ireland, the County of London or County Boroughs. It empowers County Councils to provide or cause to be provided within their respective administrative areas isolation hospitals to serve the district, and it also empowers the County Councils to contribute out of the county rate towards the maintenance of these hospitals. Though the Public Health Act of 1875 has been in operation for 24 years, it has not succeeded in covering the country with isolation hospitals to anything like the extent which is now thought necessary. That is no doubt owing to the fact that the Act is entirely permissive. In Staffordshire we have only one-sixth of the necessary hospital accommodation, provided under the Act of 1875, and to remedy this state of affairs our County Council has lately promulgated a scheme whereby, under certain conditions, they agree to contribute towards the annual expenses of hospitals established under the Act of 1893, and they have also prepared a tentative plan under which the county is divided into suitable hospital districts. We have in our county something like 57 authorities, urban and rural, but under the scheme now proposed we hope to divide the county into only 16 suitable hospital areas. These hospitals are intended to serve a very large population, but in almost every case, except where there are scattered rural districts, they will not be more than five miles from any part of the population they are intended to serve. It seems obvious that a scheme of grouping, such as I have mentioned must he conducive lour to economy and efficiency. It will be conducive to economy, because where you have a large hospital the expense per bed for construction is less than it would he in a small hospital; and where you have a large hospital serving a large district, the number of beds pro rata of the popu- 694 lation necessary, is less than the number of beds required in a small hospital serving a small district. This grouping also contributes to efficiency, because in a large hospital the staff would be more likely to be up to the times and efficient, than the staff of a small hospital where cases may only be admitted perhaps at intervals of weeks or months. What is occurring in my own county is also taking place throughout the whole of England and Wales. County Councils are desirous of taking advantage of the Act of 1893, and in some cases, indeed, they have already taken partial advantage of that Act, but unfortunately a serious flaw has recently been discovered in it. It had been assumed that where efficient Hospitals were in existence, built under the Act of 1875, with the assent of the local authority and the Local Government Board, they might be transferred to the new Hospital Committees, and that the County Councils might contribute to such hospitals if they so pleased. Unfortunately, the Local Government Board have decided that in neither of these cases is it legal so to act, and thus the operations of the Act of 1893 are seriously imperilled. In fact, at the present time there is a deadlock existing in many counties. It will be obvious that, where a comprehensive scheme is initiated by the County Council, in all fairness the Council should he able to give assistance to all parts of the county throughout the administrative area; but the effect of the decision of the Local Government Board will be that where the local authorities have done their duty and have established efficient hospitals, they will he doubly penalised. In the first place, they will be unable either to sell their hospital or obtain a contribution from the County Council. In the second place, they will have to pay their proportion of the county rate to maintain hospitals in other districts in their county which have not been so forward as they have been in providing proper hospital accommodation. Under these circumstances it is cry essential that there should be some alteration in the law. I should not have brought this matter forward on my own responsibility or for the benefit only of my county. But this is a matter of great importance to the whole of England and Wales, and I am bringing in this Bill with the assent and the 695 full support of the County Councils Association of England and Wales, who are most anxious that a change should be made in the law as speedily its possible. I will very briefly refer to the provisions of this Bill. Clause 2 provides that any district council and any joint board constituted under the Public Health Act, 1875, which has provided or acquired under the Public Health Act, 1875, or under any local Act of Parliament, a hospital for the reception of the sick may, with the sanction of the Local Government Board, agree to and carry into effect a transfer and conveyance to the council of the county within which their district is situate, of such hospital and its appurtenances upon such terms and conditions as may be sanctioned by the Local Government Board. Under Clause 4 power is also given to county councils, where they deem it expedient so to do for the benefit of the county, to contribute out of the county rate, on such conditions as they may prescribe, a capital or annual sum towards the structural and the establishment expenses of an isolation hospital or hospitals provided either before or after the passing of this Act by a District Council or a joint board under the Public Health Act, 1875, or under any local Act of Parliament, or to either class of such expenses. Clause 5 gives power to County Councils to borrow money, which they have not the power to do under the Act of 1893. Many County Councils prefer to contribute to the building of these hospitals rather than to give an annual grant, and it is very much desired that they should have the power to borrow money. I am afraid I have troubled your Lordships at some length, but I was anxious to explain the position as best I could. I hope my noble friend who represents the Local Government Board will be able to advise the House to allow the Bill to be read a second time. If there are any points on which we may not be quite agreed, they may be left over for discussion, and, I hope, settlement, in committee If the Bill is read a second time I do not propose to put down the Committee stage until after the Whitsuntide recess. I beg to move that the Bill be read a second time.