PROHIBITION OF MEDICAL PRACTICE BY COMPANIES BILL [H.L.] (Hansard, 29 April 1907)

§ LORD HYLTON
My Lords, in asking your Lordships to give a Second Reading to this Bill I hope to be able in a few sentences to convince you of the necessity for legislation of this character. The Medical Acts of 1858 to 1886 provide, in effect, that persons who are legally qualified, by having passed prescribed qualifying examinations, and by being registered in the Medical Register, can lawfully practice medicine, surgery, and midwifery throughout the United Kingdom and His Majesty's dominions elsewhere; and the Acts impose disabilities on persons who carry on medical practice without being duly qualified, and penalties on any unqualified person who falsely assumes the designation of a legally qualified medical practitioner.
But it has, unfortunately, been proved that what it is illegal for a man to do 465 individually he can do by joining unto himself five, six, or seven other unqualified persons. It seems scandalous that such a state of things should be possible, but the General Medical Council, the body whose duty it is, under the Privy Council, to administer these Acts, find that this practice has not only taken root, but is spreading widely. From a document furnished to me by the General Medical Council it appears that the incorporation of these bogus medical and dental companies goes on steadily. A considerable number have been registered since the date of the Council's last memorial to the noble Earl the Lord President of the Council; two, at least, have been quite recently incorporated, and a circular has been actually widely distributed by a firm of company registration agents in which it is urged that unqualified doctors and dentists should avail themselves of incorporation as a means whereby the prohibitions of the Acts may be entirely avoided, these prohibitions being elsewhere described as onerous.
I have had furnished to me by the General Medical Council a long list of these bogus companies. Many of them were included in the Return procured in the House of Commons by Sir John Batty Tuke, but there are others which, for certain technical reasons, were not included in that Return. I will not weary your Lordships by reading out the list of these companies. I might, however, quote one—the British Viavi Company. This company was incorporated in June, 1899, and there was no qualified person among the original signatories. The company had its head office in Regent Street, and many local branches; and the local agents gave applicants who applied to them printed instructions with the various preparations they sold. The treatment by this company has resulted in more than one coroner's inquest. There was an inquest at Eastbourne in the year 1900, where the jury found, in effect, that this company was a fraudulent body. The company brought an action for libel against one of the daily news-papers which reported this verdict, but the jury stopped the case and found at once for the defendants. This company offers one of the most flagrant examples of the way in which fraudulent medical advice is offered to the poorer classes of the community, and the great object of this 466 Bill is to protect the poorer classes, who are more liable to be deceived by these sham doctors and dentists.
Then there is the Macdonald Dental and Medical Company. This company was established in the north of England, and was registered at first as a dental company, but it found its operations so successful that it extended its work, and is now, I believe, established in many of our large towns. There is another company to which the attention of the General Medical Company has been specialty called—the World's Dispensary Medical Association. Then there is Izod's Eye and Ear Dispensary in Leeds. The principal partner, a man of the name of Izod, was prosecuted and fined, at the instance of theGeneral Medical Council as a private individual for not being qualified. Immediately he had been fined he formed himself into a company, and has gone on practising ever since, and the General Medical Council find that he cannot be touched. But, even if these companies could be prosecuted and fined, they would at once go into liquidation and no practical result would accrue. There is also Sequah, Limited, and Warner's Safe Cure Company. At an inquest it was stated in evidence that this Safe Cure Company had given pernicious advice to unfortunate patients.
Investigation at Somerset House shows that there are very few shareholders of these companies, and there is no money as a rule behind them. Only sufficient shares are subscribed to enable them to be formed. Your Lordships will naturally wonder why legislation has not already been initiated in order, on the one hand, to protect an honourable profession, and on the other, to prevent poor people's health and lives being sacrificed. The General Medical Council are not to blame. They have endeavoured for several years past to induce successive Governments to take up this matter and to initiate legislation. They were so far successful that in the year 1900 the noble and learned Earl Lord Halsbury, then Lord Chancellor, inserted two clauses into his Companies Bill of that session which would have effectually put a stop to these evils. Those clauses were accepted by your Lordships' House and the Bill containing them went down to the House of Commons. There, unfortunately, the clauses were struck out 467 for the reason that they were not germane to the Bill. Whether or not those clauses were germane to the Companies Bill of that year, the representatives of the medical profession, without exception, in the House of Commons, including Sir Walter Foster and Sir John Batty Tuke, and other Members such as Mr. Bryce, begged the Government of the day not to strike the clauses out. The month, however, was August. Both Houses of the Legislature were anxious, as they usually are at that period of the year, to get the business through, and in order to prevent any opposition the clauses were struck out and the Bill returned in that form to your Lordships, and it was impossible at that late period of the session to re-insert the clauses.
To show the general view of the medical profession at this moment about the absolute necessity of something being done to stop this growing evil I will quote a very few words from The Hospital of 13th April. This medical journal says— It is high time for the Legislature to interfere on behalf of honest citizens and for the protection, more especially, of the poorer members of the community. We are glad that a Bill has been introduced into the House of Lords on the subject. In short, the object is to prevent any person doing under the Companies Acts what it is at present illegal for him to do as an individual. Since Lord Halsbury's Act of 1900 became law the GeneralMedical Council have not been idle in this matter, but, owing to a variety of causes, they have been unable to induce Government to take it up. They approached His Majesty's present Government, and it was suggested that a private Member should bring in a Bill dealing with the matter. I confessthat I wish the Bill had been in the hands of some Member more likely to be successful in passing legislation than myself, but I am convinced that if your Lordships will look into this subject you will see that a very serious evil at present exists which it is desirable should be ended as speedily as possible.

§ THE EARL OF HALSBURY
My Lords, I must say that, like the noble 468 Lord who has just sat down, I greatly lamented the fact that the House of Commons struck out the two clauses referred to from the Companies Bill of 1900. But when that Bill came back to this House it was impossible, owing to the late period of the session, to insist upon the clauses being restored without running the risk of losing the Bill altogether. I can assure your Lordships that at the time these clauses were introduced I received an enormous amount of literature pointing out that the provision made by the Legislature to secure the proper qualification of different classes of medical men had been completely evaded by people turning themselves into companies. In these circumstances I am surprised that so long a time has elapsed without that remedy being applied which I attempted to apply in the clauses which I added to the Companies Bill in 1900. I do not concur that it was quite proper to reject those clauses on the ground that they were not germane to the Bill. I thought at the time, and still think, that they were germane, because they constituted an attempt to prevent the machinery of the company law being used for such a purpose. The objection, however, prevailed, and I regret that so long a period has elapsed before another attempt has been made to remedy the defect.

§ * THE LORD PRESIDENT OF THE COUNCIL (The Earl of CREWE)
My Lords, the noble and learned Earl who has just sat down and the noble Lord who introduced this Bill have given the past history of this by no means unimportant matter. I think what happened in the year 1899 was that the noble Earl began by introducing a Bill dealing with this subject only, called the Companies (Medical Profession) Bill, and then it was thought better to attempt to incorporate the substance of that Bill in a general Companies' Bill, but when the Companies Bill went to the House of Commons those clauses met with the fate which has been described. I believe, as a matter of fact, that when the Bill was before the Standing Committee in the House of Commons the clauses were left in by a large majority, principally consisting of those of our way of thinking, and that it was the noble Lord's friends in the other House who got them struck out afterwards. But, 469 however that may be, it is satisfactory, I think, that the noble Lord has brought the question forward again on the present occasion.
This Bill, in our opinion, meets something which really approaches a public scandal—namely, the possibility of evasion by unqualified people of the law relating to medical practice. It is important to point out, however, that this Bill is in one respect exceedingly drastic. Not only does it interfere with the proceedings of unqualified persons, but it also prevents the formation of a company which should employ fully qualified doctors to act for it. That is, no doubt, rather a strong provision, but I think it is quite possible to defend it on the ground that the relations between a doctor and his patient are of so personal and intimate a character that it is not right that he should divide the responsibility; that it ought to rest altogether on him individually, and that he ought not to be able to shelter himself behind the name of a company; and I think it would be generally agreed that the kind of doctor who would allow himself to be employed in that way by a company, probably at a fixed salary, would be one of the derelicts of the profession, and that it would be just as well not to encourage the kind of practice which would exist if such companies were allowed to be formed.
The noble Lord, as I understand, is quite willing, and, indeed, desirous, that this Bill having been read a second time should be referred to a Select Committee. With that course we should fully concur. It is no doubt important to hear what is to be said on the other side, if there is very much to be said on the other side. We desire to avoid all hardship to individuals and any suspicion that we are dealing hardly with the kind of practice that obtains among the very poor. I think it is desirable, therefore, that the matter should be thoroughly thrashed out before a Select Committee, and I hope your Lordships will agree to the Second Reading of the Bill with that purpose.