MIDWIVES (SCOTLAND) BILL. [H.L.] (Hansard, 1 April 1914)

LORD BALFOUR OF BURLEIGH

My Lords, I rise, in pursuance of notice, to present a Bill to secure the better training of midwives in Scotland and to regulate their practice. In doing so, I propose to make a short explanation of the circumstances which have led to my introducing this Bill and of the contents of the Bill, which I shall ask your Lordships to read a first time. Your Lordships are all aware that some years ago an Act for a similar purpose was passed for England. As a matter of fact, I was in charge of that Bill in this House, and I became aware that opinion was not sufficiently ripe in Scotland to make it expedient at that time to extend similar proposals to the country north of the Tweed. I need not go into the reasons for it. There are certain differences of practice, and opinion was not in favour of the change at that time. As a result of further discussion, partly, I think, owing to the experience of the working of the Act south of the Tweed, opinion has largely changed, and I believe I am not going too far when I say that in Scotland opinion is now practically unanimous that it is necessary 878 to have a measure of this kind and also to a large extent unanimous as to the lines upon which it should be drawn.

There have been more than one attempt to legislate in this direction during the last year or two for Scotland, and I have to a large extent taken as the foundation of the Bill which I am presenting to-night to your Lordships a measure which was introduced into the House of Commons both in the year 1912 and last year. But I have made some changes. I have been in consultation with the Privy Council Office and with the Office of the Secretary for Scotland, taking that Bill as a foundation, and almost all the changes which have been made from the Bill to which I have referred have been made to meet the views expressed either by the Scottish Office or the Privy Council. I am far from saying that I am entitled to speak for either of those Offices, but in a matter of this kind, which naturally ought to be presented to Parliament in as little controversial a form as possible, I am sure your Lordships will think it expedient that one should ask for advice from Government Offices of that kind before introducing a Bill.

The main objects of this Bill are to provide that after the year 1916 no woman not certified as competent shall take or use the title of midwife, and that after a further limit of years—namely, after 1921—further limitations are put upon the attendance at child-birth of those who are not so certificated. But all this is subject to reasonable provision to protect the interests of those who are now practising in that way. The Bill further provides for the constitution of a Central Board for Scotland to carry out the Act under the Privy Council, and it sets forth at some length the powers and duties of the Board. All these, as I have said, are largely modelled on the English Act, but with alterations which are necessary to make them suitable to the circumstances as they exist in Scotland. There are provisions in the Bill for discipline, for expenses, and for dealing with offences, all of them much in the same phraseology as in the English Act, but modified to some extent by the experience which we have gained in the operation of the English Act during the last five or six years. The local authority for carrying into effect the provisions of this Bill and for the local supervision of those who are certified will be the local authority of every district— 879 that is, the county and town councils, with their district committees when the counties are divided into districts—and it is distinctly provided that the term "local authority" shall have the same meanings as in the Public Health Act 1897, the reason for that being that we are anxious in this matter to avoid the prejudice which is created, both in the minds of the medical profession and in those of the midwives, if they are to be to any extent put under the Poor Law.

In addition to the Government Offices which I have mentioned, I have been in communication with the Committee of the British Medical Association for Scotland, and have accepted one or two suggestions which that body has put forward. I am able to say that the Local Government Board for Scotland are in favour of legislation on the lines of this Bill. The Medical Service Committee for the Highlands and Islands of Scotland have passed a resolution strongly advocating a Bill of this kind. The medical officers of health of all the large towns that I know of who have taken it up at all, certainly those of Edinburgh, Glasgow, Leith, and other places, have passed resolutions in its favour. The Scottish Maternity Hospital for the four great centres of medical education—Edinburgh, Glasgow, Aberdeen, and Dundee—are also in favour of it. And at an important nursing conference held at Glasgow last month the following resolution was unanimously passed— That this meeting of nurses and others interested in nursing and the welfare of mothers and infants unanimously and earnestly urge upon the Secretary for Scotland the great need for an Act for the protection of women in child-birth and for the training and supervision of women practising as midwives in Scotland. One of the matters which have ripened opinion in Scotland in favour of this Bill has been certain provisions in the National Insurance Act. I believe the National Insurance Commissioners are also in favour of legislation, and that legislation of the kind is absolutely necessary in the interests of the poorest women in the community, who are most helpless and most in need of assistance at this time. I have thought it right to make these remarks. I now present the Bill and ask your Lordships to read it a first time, and I shall as a matter of course allow a long interval to take place, far on into next month at any rate if your Lordships give it a First Reading, before I ask the House to proceed with its further stages.