PUBLIC HEALTH (PREVENTION AND TREATMENT OF DISEASE) BILL. (Hansard, 11 August 1913)

§ LORD STRACHIE
My Lords, this Bill is an amendment of the Public Health Act, 1875, Section 281, under which joint boards can be created. It was not thought at the time what the effect of the creation of these joint boards would be. When a joint board has been created which joins up one or more sanitary authorities for some such purpose as, for instance, an infectious hospital to serve one or two authorities, the effect is that those particular areas under the joint board are themselves unable to deal with any of the matters dealt with by that joint board. For example, where there is a joint area for the purpose of an infectious hospital, one of the areas under the joint board might think it desirable to set up a dispensary for the treatment of tuberculosis. Under the Act at the present moment they would be debarred from doing so, and the object of this Bill is to make it possible for that particular area if they think fit, notwithstanding that they are under the joint board for hospital purposes, to set up a hospital or dispensary in their own area which would not be used in common by the rest of the other areas. There is also a provision for regulations being made under the Act of 1875 as regards the treatment of cholera or any other epidemic, and these regulations are to be sent out to the local authorities. That Act was, of course, in force before the passing of the Local Government Act of 1888. County councils did not exist then, and there is no power for the Local Government Board to enforce their regulations upon county councils to deal with this question. But county councils are protected under this Bill, and are not required except in cases of great emergency to act in this matter. There is also power given to county councils for the treatment of tuberculosis, or any sanitary authority may provide for it if they are sanctioned to do so by the Local Government Board. I beg to move the Second Reading.

§ THE EARL OF SELBORNE
The noble Lord has given an interesting account of a Bill on a subject which is of the utmost concern to us all. But I think there is something almost as important as the subject-matter of the Bill—I refer to the form of Clause 3. I am surprised that the noble Lord did not dwell at rather greater length on Clause 3, which says— It shall be lawful for the council of any county or for any sanitary authority to make any such arrangements as may be sanctioned by the Local Government Board for the treatment of tuberculosis. That is quite a new method of legislation. It is only an example of how the real control of these matters is passing from Parliament to Government Departments. I think this Bill might be correctly described as a Bill for making Mr. John Burns a national dictator in respect to the treatment of tuberculosis. I am not at all sure that that is not a wise thing to do, but it is a new departure, and I ask your Lordships to mark how these things are put before us at the end of the session without any explanation of the reason -for this action or where it may lead to. I am not sure that Mr. John Burns is not one of the few people I should be rather pleased to live under as a dictator, still I should like to know a little beforehand what is involved in the dictatorship. What effect does this clause have on the existing powers of county councils and all the other county authorities, and to what extent does it supersede the health authorities as existing at present? There is another very important question, How does it affect the rates? All we are told is that the council of any county or any sanitary authority may do anything it likes with respect to the treatment of tuberculosis providing that it gets the approval of Mr. John Burns. I submit to your Lordships that that is a new method of legislation, and that it deserves rather more explanation than we have received from the noble Lord. As I said at first, it is only one further stage in the process through which we are going of transferring to the Public Departments, through the means of by-laws and regulations, the control of legislation winch has been hitherto reserved by Parliament to itself.

LORD MONK BRETTON
My Lords, the noble Lord who introduced this Bill stated what was its scope, but he did not state what its scope was as it was introduced in another place. Its scope in another place 1756 was far wider. Instead of the word "tuberculosis" in Clause 3, the word was "disease." The County Councils Association considered the clause as it stood with the word "disease" and heartily approved of that word and of the clause as it then stood. They thought that it was desirable that county councils should have that power. When it came up in another place Mr. Hayes Fisher raised a very important matter. He said, "Supposing the London County Council got tins power as regards disease, and got the power, therefore, of creating hospitals in London on the rates, it might eventually lead to a revolution in the London hospitals which are supported on voluntary terms." On that, Mr. John Burns accepted an Amendment and put in "tuberculosis" instead of "disease." I am instructed to say, on behalf of the County Councils Association, that they are very sorry that the word "disease" could not stand. Of course, every one will concede that it is impossible to do anything which will affect the administration of the voluntary hospitals of London.
The object of my remarks is to ask His Majesty's Government whether before this Bill gets to the Committee stage it would not be possible for the noble Lord, who is himself in sympathy with the County-Councils Association, to bring forward an Amendment which would safeguard hospitals in the great cities and enable rural county councils to have these powers as regards disease in rural districts. It would be a very valuable power in certain counties. There are places in out of the way parts of England where it would be a great advantage if the local authorities could create a hospital other than for tuberculosis only, and put it upon the rates. It is a purely enabling thing, and it is also a thing which is under the control of the Local Government Board. As the County Councils Association are very much disappointed at the change which was made in another place I hope His Majesty's Government will consider as to whether they cannot again broaden the scope of the Bill while safeguarding hospitals in towns like London.

§ LORD STRACHIE
I am sorry that the noble Earl, Lord Selborne, did not think that I went at sufficient length into this Bill. My reason for not going more into detail was that there are so many Bills before your Lordships at the present moment that I wanted to be as brief as I 1757 possibly could. With regard to the point raised by the noble Earl on Clause 3, I would point out that it is not the President of the Local Government Board who initiates the request for these powers. He merely has the right to sanction or not to sanction the application for these powers by the various local authorities. If the local authorities like to spend their own money they have a perfect right to do so. They are elected by the ratepayers, and the ratepayers are the proper persons to direct them if they do not approve of the expenditure.
As regards the question raised by Lord Monk Bretton, the vice-chairman of the Parliamentary Committee of the County Councils Association, of which it is true I am also a member, I would point out the difficulty, which he himself must be aware of. This Amendment was moved by Mr. Hayes Fisher, as the noble Lord very truly told us, but I would remind him that Mr. Hayes Fisher sits on the Front Opposition Bench in another place as an ex-Minister, and when an Amendment is so moved it naturally looks as if it came from the Opposition. The President of the Local Government Board thought that if he could accept the Amendment it might mean a safe passage for the Bill, and that if he had not accepted it the Bill would not have gone through the House as practically an unopposed Bill I will certainly take an opportunity of consulting the Local Government Board as regards this matter, and see if anything can be done to meet the wishes of the noble Lord and the County Councils Association.