HL Deb 04 July 1902 vol 110 cc791-811

House in Committee (according to order).

Clause 1:—

THE DUKE OF NORTHUMBERLAND

said the first Amendment standing in his name to Clause 1 was a drafting Amendment. The second Amendment provided a penalty which was omitted from the Bill.

Amendment moved— In Clause 1, page 1, to leave out section (1), and to insert: (1.) 'From and after the 1st day of January, 1905, any woman who not being certified under this Act shall take or use the name or title of midwife (either alone or in combination with any other word or words), or any name, title, addition, or description implying that she is certified under this Act, or is a person specially qualified to practise midwifery, or is recognised by law as a midwife, shall be liable on summary conviction to a fine not exceeding £5.'"—(The Duke of Northumberland.)

On Question, Amendment agreed to.

Amendment moved— In Clause 1, page 1, line 14, to leave out section (2), and to insert: (2.) 'From and after the 1st day of January, 1910, no woman shall habitually and for gain attend women in childbirth unless she be certified under this Act; any woman so acting without being certified under this Act shall be liable on summary conviction to a fine not exceeding £10, provided this section shall not apply to legally qualified medical practitioners, or to any one called in to render assistance in a case of emergency.'"—(The Duke of Northumberland).

THE EARL OF PORTSMOUTH

took exception to the words, "No woman shall habitually and for gain attend women in childbirth unless she be certified under this Act." He confessed that he did not know much about the general merits of the Bill, but these words appeared to him to be very objectionable. He reminded their Lordships that in a great many country districts and parishes it would be impossible for poor people to have the assistance of a trained nurse. In his own parish he and others subscribed towards a trained nurse, but there were many parishes where there was no such assistance and where the working classes found it extremely convenient to have the help of women who were not trained, but who came in to assist from time to time, and who practically assumed the position of a maid-of-all-work. Were they going to prevent the working classes from getting assistance of that sort? For that, it seemed to him, would be the result of the words to which he took exception. It appeared to him that these words were proposed to be inserted, not for the benefit of the working classes, but for the benefit of country doctors, to whom this was a lucrative form of practice. He doubted very much whether country doctors were themselves always expert in these matters, but he knew that in a great number of cases poor people preferred to have the assistance of a woman of this kind to that of a doctor. Certainly it would be rather lard to compel them to go to the expense if calling in a doctor. It seemed a very reasonable proposal that only those who were certified or otherwise qualified should take the name of midwife, but it would be unreasonably extending the purpose of the Act to insert words which would prevent a very respectable and useful class of women, whose services were of great assistance, from being called in to assist the working classes in country districts at times of childbirth. Were the trained nurses to be charged on the rates? Of course that would be another' matter, but he hoped their Lordships would strike out these words, for they constituted a provision which was mischievous and excessively vexatious.

* LORD CLONBROCK

was unable to see why trained midwives should not be paid out of the rates. Trained midwives had been appointed by the Boards of Guardians in a great many unions in Ireland, and in his union there had been one in every dispensary district for a considerable number of years.

* THE EARL OF JERSEY

pointed out that the Clause would not come into effect for eight years. That would give plenty of time for mid wives to become certified under the Act.

THE LORD CHANCELLOR (The Earl of HALSBURY)

said that if the same system prevailed in England as Lord Clonbrock had stated obtained in Ireland, he would not have the least objection to the Bill. But it did not. It was a question whether in rural districts the Clause would not affect very much the poorer classes in a very harsh manner and clause a great deal of suffering. On the last occasion when he addressed their Lordships on this subject he stated that he had received considerable correspondence which led to the conclusion that that would be the effect of the Clause; but he had that day received a deputation of ladies very well qualified to speak on the subject who took an entirely opposite view. It seemed to him to be an objection to the Clause that this matter had not been investigated in order to ascertain what the effect of the proposal would be. The question had not been properly threshed out in the other House. The Bill as it was originally framed, and as it passed through the Standing Committee, provided that no one should assume the character of a midwife who had not a certificate. No one would object to that. At the last moment a compulsory Clause was inserted penalising a whole class of persons without the least inquiry. In this way the entire character of the Bill was changed. If this Bill was not to come into operation for eight years, there would, he thought, be no harm in the delay necessary for inquiry. Before committing themselves to the Bill, their Lordships ought to know what the facts were. It appeared to him that this matter was in a very great measure a question of fact.

THE DUKE OF NORTHUMBERLAND

said that over and over again the words "trained nurse" had been used, but it was not proposed to insist on midwives being trained nurses. A trained nurse required a much more complete education than a midwife. There was no question of any charge on the rates under the Bill. The more he looked at this Bill the more it appeared to him that the provision in question was an essential one to the proper working of the measure. The noble and learned Lord asked what information they had as to the necessity of such legislation as this. That, of course, was an argument against the whole Bill. It was stated by those who supported the Bill, which, by the way, had been before Parliament for a great number of years, that there was great necessity for it, and that great harm was done in the country by untrained midwives. He thought it would be very difficult to put a stop to that state of things unless a penalty of some sort were imposed. The penalty only affected women habitually and for gain doing that which they were not certified as being qualified to do. A woman might attend another' in childbirth several times if she did not do it for gain, and she might do it for gain if she did not habitually do it. The object was to prevent a woman from making midwifery her profession unless she was certified. The question whether any hardship would be inflicted on rural districts would depend, he supposed, upon the rules laid down by the Privy Council for the certification of women to act as midwives. He quite admitted that they were putting into the hands of the Privy Council very large responsibilities. Although he could not assure the Lord Chancellor that his experience in these matters was very profound, he thought those of their Lordships who had had experience of rural districts would not be of opinion that there was any cause to apprehend any serious difficulty in obtaining the services of a midwife who would be certified under the Act. But, of course, that might not always be possible, and it had been guarded against. There was nothing in the Bill to prevent a neighbour being called in, in a case of emergency, and rendering assistance in the way described. This provision did not come into operation for eight years, and all that existing midwives would have to do to obtain certificates would be to satisfy the Mid-wives Board that their characters were good.

THE EARL OF MAYO

inquired whether they would not have to" pass an examination.

THE DUKE OF NORTHUMBERLAND

replied in the negative, and said that Clause 2 provided that any woman, who, within two years from the date of the Act coming into operation, claimed to be certified under the Act, should be so certified, provided she held a certificate in midwifery from various institutions named, or such other certificate as might be approved by the Central Midwives Board, or produced evidence, satisfactory to the Board, that at the passing of the Act she had been for at least one year in bonâ fide practice as a midwife, and that she bore a good character. The latter provision was sufficient to meet the case of all existing midwives.

EARL SPENCER

said he did not understand whether Lord Portsmouth intended to move the omission of this Clause, or what action the noble and learned Lord the Lord Chancellor proposed to take. In his opinion this Clause contained the pith and essence of the Bill, and if it were omitted it would be better to leave the Bill alone altogether. He entirely differed from the noble and learned Lord in what he had said as to there not having been any inquiries into this matter. There was a full report of a Committee of the House of Commons on this subject, and the Bill itself was a hardy annual. He felt that, if the Bill prevented women in small country villages from calling in their neighbours, who might have great experience, it would be an extremely hard thing; but the Bill did nothing of the sort. What it did was to impose a penalty on women who called themselves midwives without being qualified to do so. He did not wish to make a Second Reading Speech, but he thought the necessity for the Bill had been shown over and over again. There were in England and Wales 4,500 women a year, who perished in childbirth, or one in every 200. In the hospitals, where there were skilled nurses, the number was only one in 600. This showed that with skilled attendance a saving of something like 3,000 lives a year could be effected. He thought it was absolutely necessary to deal with this matter. It was stated in evidence before the House of Commons Committee that in eleven nursing institutions trained nurses attended 13,712 cases, and the deaths numbered only 17, or a death rate of 1–23 per cent. The general death rate in maternity cases throughout the country was 46. That, again, proved what trained nursing could do in these cases. He felt that if the words in question were omitted no advantage would be gained by passing the Bill.

THE EARL OF HALSBURY

said he had never questioned the superiority of trained over untrained nurses. He had not the smallest doubt that it would be very much better if every poor woman could be attended by a trained surgeon. The point he had tried to enforce was that, in endeavouring to effect an improvement, their lordships should be careful not to do more harm than good. It was possible that by preventing the poor from having what they had now they might prevent them from having anything at all. The noble Earl had talked about this being a hardy annual, but he was mistaken if he supposed that this penal Clause had been in any Bill up to this moment. None of the previous Bills contained it, and this Bill did not contain it when it was first introduced. The Clause was added at the last moment, after the Bill had returned from the Standing Committee, and without, be, ventured to think, full consideration.

* THE EARL OF CORK

said he desired So approach this question from a practical point of view. Those who knew how children were brought into the world in (he poorer districts knew how dependent the poor were on such occasions on their neigh hours. He had not gone into the question, but he believed that on the whole these people did their work extremely well. The noble Duke in charge of the Bill had said that he did not wish in any way to interfere with the system which obtained in the country districts, but merely to prevent people practicing as midwives who were not properly trained and did not possess the necessary certificate. The woman who was confined needed that some one should take care of her household until she, was able to dose herself. He thought the Clause as it now stood would to a great extent deter those among the poor who had hitherto acted as nurses from rendering their customary assistance. In some parishes the Bill, though introduced with the best intentions, would operate very hardly.

* THE SECRETARY FOR SCOTLAND (Lord BALFOUR of BURLEIGH)

joined with the noble Earl who had just spoken in desiring to look at the Bill from a practical point of view. They had heard a good deal as to the history of this Clause, which he thought was rather beside the point. The question for the House to decide was whether this was a wise and satisfactory provision to insert in the Bill. With regard, however, to what had been said as to the history of the Clause, he would point out that the provision which it was suggested had only been put in at the last moment in the other House, was at first in the Bill of 1900, and was afterwards struck out. He thought he could therefore claim that the mature wisdom of the other House of Parliament led them to the conclusion that it would be wise to pass the Clause. The section in question laid down that no woman should habitually and for gain attend, women in childbirth unless she was certified under the Act, but the coming into effect of the section wan postponed for eight years. There could be no doubt that in legislation of this sort care should be taken not to interfere with anything which by any stretch of language could be called a vested interest. He thought it would be unfair arbitrarily to interfere with the practice by a woman of good character of her calling. But he believed it was admitted that many of those who called themselves midwives were utterly regardless of the lives of those they attended. That had been proved over and over again at Coroners inquests, and it was very necessary that some sort of check should be placed upon parsons who took up this profession without sufficiently regarding their responsibilities. By the present proposal the greater skill which was obviously desirable would be obtained, and, at the same time, by the postponement of the regulation for eight years any hardship would be avoided in the case of those who undertook the calling in future. Ho believed the Bill would still be very valuable if the section were omitted, but it would be less valuable than as it stood. He did rot think any real hardship would be caused by the provision, as it would still be possible for a woman to obtain the friendly assistance of a neighbour in such a case.

THE EARL OF PORTSMOUTH

submitted that the provision in question had nothing whatever to do with the rest of the Bill, and was inserted after the Bill had been road a second time in the House of Commons. The noble Earl the Leader of the Opposition had given the House some alarming statistics as to the number of women who died annually in childbirth. If they wore correct, why put off the operation of the provision for eight years? The contention of the noble Lord the Secretary for Scotland amounted to this, that there was a vested interest in the capacity, and that after these people had practised on the unfortunate poor for eight years that vested interest might be considered to have lapsed.

* LORD BALFOUK OF BURLEIGH

said he could not accept the noble Earl's version of what he said.

THE EARL OF PORTSMOUTH

said the view he took was that these people were not doing the great amount of harm imputated to them, and that in a large number of cases they were of great assistance. The provision was one of those which were apt to be inserted to suit certain professional interests. It savoured too much of grandmotherly interference with the working classes, and he should support a Motion for the omission of Section 2.

THE EARL OF CAMPERDOWN

inquired in what part of the Bill it was enacted that a woman should not attend her neighbour in a case of childbirth.

THE DUKE OF NORTHUMBERLAND

replied that there were no words in the Bill to that effect. On the contrary, the object of the promoters of the Bill was that a woman who could not get trained assistance should get the next best assistance possible, in many cases that of a neighbour. There was nothing in the Bill to prevent a neighbour coming in. All that the Bill did was to prevent an unqualified and uncertified person from habitually and for gain following the calling of a midwife. The noble Earl Lord Portsmouth has spoken of a vested interest for eight years. There was no such vested interest.

THE EARL OF PORTSMOUTH

said he was only referring to what fell from his noble friend the Secretary for Scotland.

THE DUKE OF NORTHUMBERLAND

pointed out that what Lord Balfour said was that those who had practised for years as a midwife had a vested interest which under this Bill,

CONTENTS.
Grafton, D. Lnidsey, E. Rosebery, L.(E. Rosebery.)
Northumberland, D. [Teller.] Manveis, E. Sandhurst, L.
Portland, D. Mayo, E.. Stewart of Garlies, L. (E. Galloway.)
Rutland, D. Morton, E.
Wellington, D, Mount Edgecumbe, E. Cross, V.
Bath, M. Rosse, E. Falkland, V.
Lansdowne, M. Russell, E. Knutsford, V.
Ripon, M. Saint Germans, E. Llandaff, V
Bathurst, E. Spencer, E. Portman, V.
Camperdown, E. Stamford, E. Hereford, L. Bp.
Cawdor, E. Vane, E. (M. Londonderry.) Newcastle, L. Bp.
Derby, E. Waldegrave, E. St. Albans, L. Bp.
Feversham, E. Reay, L. Winchester, L. Bp.
Jersey, E. Ribblesdale, L. Aldenham, L.
Lathom, E. Robertson, L, Balfour, L. [Teller,]

if they were respectable people, would be secured to them, not for eight years, but in perpetuity. The real argument put forward by Lord Portsmouth was that they were not gradually, in the easiest way, and with the least disturbance to the class affected, to remedy the present state of affairs because they could riot in a moment put an end to the whole of the evil which the Leader of the Opposition had pointed to as existing. He did not think that was a practical argument. It would no doubt be better if they could put a stop at once to all the evils which existed under the present system, but what the Bill aimed at was to diminish them as far as possible without injuring the people who at present carried on the calling of midwives.

LORD TWEEDMOUTH

called attention to the fact that without the Amendment the Bill would simply contain a declaration that a certain course was right and ought to be the law of the land without imposing any penalty upon those who failed to comply with it. That would be reducing legislation to a farce. In addition to the great loss of life referred to by Lord Spencer, a large amount of blindness among children was attributable to the income-petency of the persons attending the mothers at childbirth. He believed the Bill would have the effect of reducing many of the present dangers and ameliorating the conditions that obtained in these cases throughout the country.

On question, the House divided:—

Contents, 66; Not-contents, 19.

Barnard, L. Kinbaird, L. Poltimore, L.
Belliaven and Stenton, L. Lindley, L. Tredegar, L.
Chelmsford, L. Monckton, L.(V. Galway.) Trevor, L.
Clonbrock, L. Montagu of Beaulicu, L. Tweedmouth, L.
Dnnboyne, L. Newlands, L. Ventry, L.
Glenesk, L. Newton, L. Welby, L.
Inchiquin, L. Norton, L. Zouche of Haryngworth, L
James, L.
NOT-CONTENTS.
Halsbury, E.(L. Chancellor.) Boyle, L. (E. Corkand Orrery.) Lamington, L.
Devonshire, D. (L. President.) Colchester, L. Leigh, L.
Carrington. E. Hatherton, L. Monkswell, L. [Teller.]
Morley, E. Hawkesbury, L.. Mowbray, L.
Portsmonth, E. [Teller.] Heneage, L. Thring, L.
Sidmouth, V. Howard of Glossop, L. Wimborne, L.
Belper, L.
LORD THRING

moved the omission of words in Section 5 of Clause 1 which he said would penalise women undertaking cases of abnormality or disease in connection with parturition. Events which caused cases to be abnormal occurred very suddenly, and could not be foreseen. It would, therefore, be a gross injustice to penalise a woman attending such a case.

Amendment moved— In Clause 1, page 1, lines 20 and 30, to leave out 'or to undertake the charge cases of abnormality or disease in connection with parturition."—(Lord Thriny.)

THE LORD PRESIDENT OF THE COUNCIL (The Duke of DEVONSHIRE)

said that the General Medical Council wished for much more stringent regulations, and the words in question were inserted to meet their views as far as was considered reasonable. The section did no more than impose certain limitations on the rights conferred on those who possessed certificates under the Bill, and it was surely desirable that a certificate ought not to profess to give the person holding it powers or qualifications beyond those which she actually possessed. he hoped the words would be retained.

LORD THRING

said he had no doubt as to the origin of the clause. It was put in to satisfy certain professional interests. He submitted that the section as it stood would make the position of poor women undertaking this work untenable.

EARL RUSSELL

could not agree with Lord Thring as to the effect of the words in question, which did not provide for, any penalty against the midwife, but merely meant that in the event of anything going wrong she would have to stand the ordinary racket of a charge for manslaughter. If that was all that the words meant, he did not see that they would necessarily prevent a woman undertaking cases of this kind. The governing words of the section were that the certificate should riot confer upon any woman any right or title to undertake the charge of cases of abnormality.

LORD THRING

held that if an Act of Parliament declared that it was the duty of a woman not to do a certain thing, although no penalty was imposed it would deter her from doing it.

EARL RUSSELL

pointed out that the section did not say a midwife should not undertake the charge of these cases, but merely that the certificate granted under the Act should not confer upon her any right or title to do so.

On Question, Amendment negatived.

Clause 1. as amended, agreed to.

Clause 2 agreed to.

Clause 3:—

THE DUKE OF NORTHUMBERLAND

explained that the object of the Amendment standing in his name to this clause was to include the Queen Victoria Jubilee. Institute for Nurses as one of the bodies who were to have representation on the Central Midwives Board. As originally drawn, the Bill did not provide for the representation of any Nursing Association, but in the House of Commons the Royal British Nurses Association was added, and it was now thought that theQueen Victoria Jubilee Institute, the representatives of which had had a good deal of experience in midwifery, should also be added.

Amendment moved— In Clause 3, page 2 to omit Section 4 and to insert 'one parson to be appointed for a term of three years by the Queen Victoria Jubilee Institute for Nurses, and one person to be appointed for a term of three years by the Royal British Nurses Association.'"—(The Duke of Northumberland.)

LORD WELBY

said the object of his Amendment was to make the Central Midwives Board subject, on questions of expenditure, to the previous approval of the Privy Council. The Bill provided that the Board should publish at the close of each year a financial statement, which, after being audited, should be submitted to the Privy Council, and if the statement showed any balance against the Board, and such balance was approved by the Privy Council, the Board might recover such balance from the rates of the different counties concerned. In the first place, it was not at all clear what was to happen if the Privy Council did not approve of the balance; but, even assuming that the Privy Council would be able to disallow any expenditure of which they did not approve, he thought that was a wrong financial procedure. To criticise expenditure after it had once been incurred was very much like getting butter out of a dog's mouth. He submitted that the proper procedure would be that the Board should be subject on questions of expenditure to the previous approval of the Privy Council. In that way a control could be preserved over the expenditure of the Board.

Amendment moved— In Clause 3, page 3, line 21, after 'Act,' to insert 'subject on questions of expenditure to the previous approval of the Privy Council.'"—(Lord Welby.)

THE DUKE OF DEVONSHIRE

said the Amendment was unnecessary, and it would be objectionable because it would impose on the Privy Council a duty it could not efficiently undertake. It might be, and probably was, quite right to require the consent of the Privy Council to regulations or specific items of expenditure, but to make its consent incidental to the action of the Central Midwives Board, under a general provision, would place an obligation on both bodies which neither of them would, in his opinion, be able satisfactorily to discharge. He, therefore, hoped the noble Lord would not press his Amendment.

LORD WELBY

reminded the noble Duke that under the Bill as it at present stood the Privy Council would Le called upon to approve any balance of expenditure before a charge could be made on the county rates. If that was to be of any service in protecting the county rates, then, he presumed, the Privy Council would exercise a check upon the expenditure. If it was not going to exercise such a check, it would simply mean that this body of experts would have a complete command on the county rates—that was to say, they would have the power of incurring expenditure which others would have to pay. He submitted that if the Privy Council were going to exercise any check upon the accounts when presented, and refuse to consent to expenditure which ought not to have been incurred, it would be equally in their power to exercise that control before the expenditure was incurred.

On Question, Amendment negatived.

LORD THRING

said the effect of his Amendment would be to omit the provision that the Privy Council, before approving Rules framed under the section, should submit them to the General Medical Council, and should take into consideration any representations which that Council might make with respect thereto. Unless the Amendment were agreed to, the Privy Council would be made subservient to the General Medical Council. The Rules were to be approved first of all by the Central Midwives Board; they were then to be approved by the Privy Council; and then, forsooth, the Privy Council were to submit them, before approving of them, to the General Medical Council. He objected to the in mandatory character of the provision, which was contrary to all precedent and common sense.

Amendment moved— In Clause 3, page 3, line 23, to leave out from 'and the Privy Council' to the end of the clause."—(Lord Thring.)

* LORD BALFOUROFBUELEIGH

said there was surely no harm in allowing the Privy Council to take the opinion of the General Medical Council on a matter of this kind. The clause did not bind the Privy Council to follow the recommendations of the Medical Council, but only to submit the rules to it. He thought it would be admitted that the Medical Council was a body of sufficient importance to entitle it to know what was being done by a Government Department on a matter of this kind before the rules were made actually effective. The provision did not ask the Privy Council to do more than what it would do under ordinary circumstances, but it gave a guarantee to the General Medical Council that rules touching a branch of the medical profession would not receive the sanction of the Government before that Council had had an opportunity of making representations upon it.

EARL RUSSELL

expressed the hope that the noble Lord would not withdraw his Amendment. It was an extraordinary proceeding that the Privy Council should receive a mandatory order in an Act of Parliament to submit its rules, before approving of them, to the General Medical Council. He agreed that in all probability the Privy Council would do so in any case, but he thought it was very undesirable to insert words compelling them to do so.

LORD TURING

stated that after what the noble Lord had said he would not press his Amendment.

THE EARL OF CAMPERDOWN

could not help feeling that as they stood the words in the clause were very strong. He felt sure the Privy Council would never issue rules without taking every precaution that they were in conformity with what was right, and for that purpose they would undoubtedly consult the General Medical Council. If the words were retained as they stood, he thought they would tend to create in the country a feeling that the General Medical Council was being given too much power in this matter. It was not in the interest of the General Medical Council that the clause should remain as at present. There was no fear that they would not be consulted, and he, at all events, would oppose the retention of the words in the Bill.

LORD BALFOUR OF BURLEIGH

said the desire, not, only of the Government, but of the promoters of the Bill, was to be as conciliatory as possible. He suggested that it would meet the, objections if the words compelling the Privy Council to submit the rules to the Medical Council were omitted, the words to the effect that it should take into consideration the representations of the Council being retained.

THE EARL OF CAMPERDOWN

criticised the proposed concession as effecting really no change at all. The provision that the Privy Council should take into consideration any representations which the Medical Council might make surely implied that the rules must he submitted to the Medical Council. Otherwise, what was the use of the words? He contended that the May in which the General Medical Council ought to hear of the rules was by the Privy Council voluntarily sending them, with a request for the opinion of the Medical Council upon them. He objected to the General Medical Council being mentioned in the clause.

THE MARQUESS OF RIPON

expressed the opinion that the word "submit" was the objectionable word, and said that the suggestion of the noble Lord the Secretary for Scotland appeared to him to be a wise one.

Amendment moved— In Clause 3, page 3, line 24, to leave out the words 'submit them to the General Medical Council and.'"—(Lord Balfour of Burleigh.)

THE EARL OF CAMPERDOWN

took exception to words remaining in the clause which made it obligatory upon the Privy Council to take into consideration any representations that might be made by the General Medical Council.

LORD BALFOUR OF BURLEIGH suggested that his Amendment should be agreed to, and that it should be left to the Standing Committee to finally settle the form of the words.

THE EARL OF CAMPERDOWN

agreed to accept this suggestion.

THE EARL OF MAYO

moved an Amendment providing that any woman holding a certificate in midwifery from the Rotunda Hospital, Dublin, should, upon the production of such certificate, be admitted to the roll of midwives without any further examination. Ho said the Rotunda Hospital held an European reputation for this class of practice, and it would be ridiculous to require midwives holding certificates from that hospital, and such other hospitals as, for instance, the Queen Charlotte's Lying-in Hospital, to go before a Board and be examined. He understood that the Bill would disqualify all Irish midwives from practising in England and Wales unless they passed an examination under the Central Midwives Board.

Amendment moved— In Clause 3, page 3, line 26, at end to insert 'Provided always that any woman holding a certificate in midwifery from the Hospital for the Relief of Poor Lying-in Women in Dublin (commonly known as the Rotunda Hospital) shall, upon production of such certificate, be admitted to the roll of midwives without any further course of training or examination, and shall be entitled to be certified under this Act.'"—(The Earl of Mayo.)

THE DUKE OF NORTHUMBERLAND

said there was no question that a certificate from the Rotunda Hospital was a good guarantee of efficiency, and he would have thought it would be obvious that the Central Midwives Board would attach the very greatest importance to it. As the only object of the Midwives Board was to see that properly qualified women were employed, they would acknowledge any certificate which guaranteed it. He hoped the noble Earl would not press the Amendment, because it would be invidious to name any particular hospital in a Bill which gave such large powers both to the Privy Council and to the Midwives Board. Moreover, the Amendment instructed the Midwives Board to do that which they would obviously do in any case.

Amendment, by leave of the House, withdrawn.

Clause.3, as amended, agreed to.

Clause 4:—

THE MARQUESS OF RIPON

protested against the giving of power to the Board to recover certain sums from the County Councils. Already a very largo amount of county expenditure was outside the control of the County Council, and he thought it was wrong in principle to enable an independent body, which had no responsibility to the county, to levy-on the county rate any sum of money, however small, without the consent of the County Council. He did not intend to take the sense of the House upon this clause, but he entered his protest against what might become a dangerous precedent.

Clause 4 agreed to.

Clause 5:—

THE DUKE OF NORTHUMBERLAMD

explained that his Amendment to this clause was little more than a drafting Amendment. It omitted Sections 1 and 2, and inserted new sections providing that there should be a roll of mid wives, containing the names of those midwives who had been certified under Clause 2 of the Act, and the names of all other midwives who had been certified under the Act.

Amendment moved— In Clause 5, page 4, to leave out Sections 1 and 2 and to insert—(1.) The names of those midwives who have been certified under Clause 2 of this Act. (2.) The names of all other midwives who have been certified under this Act."—(The Duke of Northumberland.)

Clause 6:—

LORD WELBY

pointed out that this clause provided that the Midwives Board should appoint a secretary, but no provision whatever was made with regard to other officers. Therefore, the Board might appoint any other officers they chose without any check whatever. His Amendment was to the effect that the Central Midwives Board should, "with the assent of the Privy Council," appoint a secretary, who should he charged with the custody of the roll, "and other officers." That would secure the assent of the Privy Council, as an independent body, to the appointment of the officers, whose engagement would otherwise, with the exception of that of the secretary, be at the discretion of the Mid wives Board.

Amendment moved— In Clause 6, page 4, line 17, after 'shall,' to insert 'with the assent of the Privy Council,' and, in line 18, after 'roll,' to insert 'and other officers.'"—(Lord Welby.)

THE DUKE OF DEVONSHIRE

said he had no objection to the Amendment.

Clause 6, as amended, agreed to.

Clause 7 agreed to.

Clause 8:—

THE DUCK OF NORTHUMBERLAND

moved to amend Section 3 in order to provide that it should be the duty of the local supervising authority to suspend any midwife from practice, in accordance with the rules under this Act, if such suspension appeared necessary "in order to prevent the spread of infection." As the section at present stood, the County Council were given authority to suspend any midwife from practice if such suspension appeared necessary. It was never intended that County Councils should have this large power, but only that they should exercise the power of suspension in order to prevent the spread of infection.

Amendment moved — In Clause 8, page 5, line 16, after 'necessary,' to insert 'in order to prevent the spread of infection,'" —(The Duke of Northumberland.)

EARL RUSSELL

did not think it desirable to limit the discretion of County Councils to the extent proposed in the Amendment, and expressed the opinion that County Councils were sufficiently responsible bodies to be given full powers in the matter. It was quite possible that urgent reasons, other than that of preventing the spread of infection, might arise which would make suspension desirable.

THE DUCK OF NORTHUMBERLAND

said he was entirely in the hands of the House in the matter. He pointed out, however, that County Councils were not judicial bodies, and had no machinery to inquire into cases of misconduct. It was an entirely new departure to give them power to interfere with persons who were lawfully carrying on their employment. He confessed that he thought he was disarming opposition by proposing this Amendment.

THE MARQUESS OF RIPON

called attention to Section 7, which provided that it should be the duty of the local supervising authority to give due notice of the effect of the Act to persons at present using the title of midwife. How, he asked, were County Councils to find out the persons who were using that title, there being at present no registration of midwives? Again, how were they to give the necessary notice? To ask County Councils to give individual notice of the effect of the Act to every person who, before the passing of the Act, used the title of midwife seemed to him to throw upon those bodies a duty which was very difficult to fulfil, and exceedingly troublesome.

THE DUKE OF NORTHUMBERLAND

said he should have thought that public notice would be sufficient to comply with this section. He suggested that the medical officer of the county, or the clerk to the County Council, where there was no medical officer, should communicate with the medical officers of the various districts, and ascertain what midwives were practising in their districts.

Clause 8, as amended, agreed to.

Clauses 9 to 13 agreed to.

Clause 14:—

THE DUCKE OF NORTHUMBERLAND

said a strong opinion was held by many well able to judge on the question that there ought to be some appeal from the Central Midwives Board, and the Amendment standing in his name was drawn up for that purpose. He did not think the Amendment came in very well here and that it would be better as a separate Clause, but, if it was agreed to in its present form, that point could be considered in the Standing Committee.

Amendment moved— In Clause 14, page 7, line 14, after ('sessions') to insert ('any woman thinking herself aggrieved by any decision of the Midwives Board, removing her name from the roll of midwives, may appeal there from to the High Court of Justine within three calendar months after the notification of such decision to her, but no further appeal shall be allowed.'")—(The Duke of Northumberland.)

Clause 14, as amended, and remaining Clauses agreed to.

Bill recommitted to the Standing Committee and to be printed as amended. (No. 137.)