NOTIFICATION OF BIRTHS (EXTENSION) BILL. (Hansard, 15 July 1915)

§ LORD HYLTON
My Lords, the Bill to which I ask your Lordships now to give a Second Reading is one to extend the Notification of. Births Act, 1907, to areas in which it has not been adopted, and to 446 make further provision in connection therewith for the care of mothers and young children. Your Lordships will remember that up to the passing of the Act of 1907 it was not obligatory to register the births of children for a period of six weeks, and statistics proved that during the first six weeks of infant life the mortality in this country was terribly large. It is still regrettably large, but the Act of 1907, as I shall point out to your Lordships in a moment, has materially mitigated the percentage of infant mortality. Before the passing of that Act infant mortality under the age of six weeks amounted in some places to no less than 174 per 1,000. It was held by medical authorities and by other persons conversant with these matters that if an Act were passed making it obligatory on parents to register the births of infants at a much earlier period than six weeks, this infant death rate would be largely diminished. The principal reason for that hope was this, that as soon as the birth of an infant was notified to the public authorities it was possible for health visitors, either appointed by the health authority or voluntary assisters of the local authority, to visit the home where the birth had taken place, and by looking after the mother and the child in various ways, and by giving advice, and so on, in many casts to save the life of the child; and there is no doubt that since the Act of 1907 became law infant mortality, as I have said, under tile age of six weeks has very largely diminished.
It is, of course, open to critics to say that this is only post hoc and not propter hoc; but, on the other hand, doctors all over the country and people most conversant with the matter do attribute the great improvement that has taken place largely to the Act of 1907. At all events, the infant death rate has been reduced since the passing of the Act of 1907. The general rate all over the country was 130 per 1,000, but it was especially bad in instances like Burnley, where it was 174 per 1,000. Now the general rate is only about 108 per 1,000. The Act of 1907 was a permissive Act, but it has been adopted in a great number of places all over the country, and I believe I am right in saying that at the present moment it affects something like 75 per cent. of the population. But being a permissive Act it has not been universally adopted. The Bill now before your Lordships would make it obligatory all over the 447 country. I think I am entitled to say that your Lordships would at all times receive in a sympathetic way any measure that appeared to the House materially to benefit children and to reduce infant mortality, but I hope that you will view this Bill with an extra amount of sympathy, for it is most important, in consequence of the ravages of the present war, to do all that the Legislature can to protect infant life and, if possible, to reduce still further infant mortality.
The Bill has been passed through all its stages with practically no opposition in another place, and it is, as your Lordships will see, a comparatively short measure. The first clause enacts that the Notification of Births Act of 1907 shall extend to and take effect in every area where it has not been already adopted. The second clause reads as follows— 2.—(1) Any local authority within the meaning of the principal Act (whether a sanitary authority or not) may, for the purpose of the care of expectant mothers, nursing mothers, and young children, exercise any powers which a sanitary authority has under the Public Health Acts. 1875 to 1907, or the Public Health (London) Act, 1891, as the case requires. (2) Any expenses incurred in the exercise of these powers shall be defrayed in the same manner as expenses of the local authority are defrayed under the principal Act. Any such powers may be exercised in such manner as the authority direct by a committee or committees which shall include women and may comprise, if it is thought the, persons who are not members of the authority. Any such committee may be empowered by the authority by which it is appointed to incur expenses up to a limit for the time being fixed by the authority, and, if so empowered, shall report any expenditure by them to the authority in such manner and at such times as the authority may direct. A committee appointed for the purposes of this section shall hold office for such period not exceeding three years as the authority by which it is appointed may determine. The third clause applies the Bill to Scotland and Ireland. I beg to move the Second Reading.

THE LORD ARCHBISHOP OF CANTERBURY
My Lords, the Bill which the noble Lord has introduced deals with a matter in which I have perforce taken a great interest for a long time, and I do not think any words are necessary to endorse what he has said. I believe the fact to be that most people imagine what is already enacted to be in existence throughout the country, and many will be 448 surprised to learn in what a large part of England to-day arrangements which have been long possible have not been adopted, and that we have been in different parts of the country without the requirements that this Bill will make obligatory. The need, in my opinion, was never more real than it is at the present time; and in view of all that is being said of late with regard to problems raised by war conditions, the need that proper arrangements should be made, and the desire that all possible information on the subject should be at the earliest possible date in the hands of the authorities with a view to preventing evils of any kind, I earnestly hope that no sort of difficulty will arise and that this Bill will be placed at once on the Statute Book.

§ VISCOUNT HALDANE
My Lords, the importance of this Bill has certainly not been overstated by the most rev. Primate. On the contrary, I think the Government are to be congratulated on having brought forward a reform of far-reaching importance. This is no suddenly conceived measure. It has been thought out for the last two years by the experts of two great Departments of the State, the Local Government Board and the Board of Education. I think the noble Lord who moved the Second Reading of the Bill was too modest. He has introduced a more far-reaching Bill than he told the House. This Bill does two things. First, it makes the Notification of Births Act compulsory. But that is a small matter compared with the way in which it enables the local authorities to set up health committees. If your Lordsiiips read the Bill you will see that these committees, the duty of which is to look after the health of mothers, have their activity directed not only to actual mothers hut to expectant mothers. When the noble Lord mentioned the figures of infant mortality, he referred to the mortality of children who are actually born. He gave a very formidable case, an unusually formidable case in one of the localities. According to the last reports that have been published by the Government, the mortality works out in the case of children already born at something like 10 per cent.—108 in the 1,000, I think was the average—in the districts where the figures were taken for the period after birth. But there was a much worse set of figures—about 150 per 1,000, or 15 per cent.—in the case of children not born. That is to say, it was estimated that 15 per cent. more children night have come—or 449 a large proportion of them might have come —into the world if only there had been sufficient care directed to the attention of the mothers before birth.
This Bill does what to my mind is quite as important as anything connected with the notification of births. It sets up these health committees to look after expectant mothers as well as actual mothers. The Bill makes the Notification of Births Act compulsory. That is of great value, because it gives the information upon which you can bring to bear the real machinery of the Bill. For a long time past it has been realised that the care of children must not be confined to school years; it must begin at that early stage of which I have spoken, and must come into operation even in the period before birth. Our birth rate is falling. We shall, through the war, lose some of our most valuable young men, men who might have been fathers of families, and it is necessary that in every way we should set to work not only to raise as high as possible the number of children who are brought into the world, but to see to it that they come into the world in a healthy condition and that they continue until the period of school life to be taken care of and looked after.
These health committees which will be set up over most parts of the country—some of your Lordships know the voluntary committees that are in existence in London and elsewhere at the present time—will have this great duty. They will be composed of experts and presided over by the medical officer of health; they will consist of volunteer ladies and of others who have in many cases already devoted great attention to this subject, and who will continue the splendid work that is being done in the northern towns such as Bradford and Huddersfield, where the system already has been in operation. This is a first stage in a policy which I ventured to press on your Lordships the other afternoon—a policy of paying as much attention to what is going to be the position after the war as to what is going on during the war. We shall be faced with a situation in which we shall need all that the State can do for us to enable us to face what we shall have to encounter, and I am very glad to think that the President of the Local Government Board has taken up this Bill, which was already in draft—it is part of a very far-reaching scheme—and is determined to press it through.

§ LORD SYDENHAM
My Lords, the Royal Commission of which I am chairman has been engaged for more than one and a-half years investigating matters very closely connected with the purposes of this Bill. The evidence that we have taken—and it is very voluminous—confirms entirely what has been said by the noble Lord and by the noble and learned Viscount. A few weeks ago we decided unanimously to press on the strongest grounds that the adoptive Act of 1907 might be made obligatory as soon as possible. That Act has been in operation over, I think, about 74 per cent, only of the population of England and Wales, and has had little effect in Ireland and Scotland. The Act has had far-reaching results already, and it is beneficial in two distinct ways. In the first place, it has provided statistical details which were wanting and which could not be obtained in any other way, and it has brought out important facts connected very intimately with public health which would otherwise have remained for ever hidden. The other excellent effect of this Bill, to which the noble and learned Viscount has drawn attention, is that it will empower the health authorities to get into touch with the mother and child at the earliest possible moment, and so enable them to give advice to the mother and bring treatment and medical assistance to the child in what is really the most critical period of its life. The loss of lives unborn is as great very nearly as the lives that are lost shortly after birth and in that way this Bill will have a marked effect in still further reducing the unnecessary loss. All who are deeply interested in trying to check the appalling wastage of infant life, much of which is really preventable, will welcome this Bill as a great advance in a direction in which we must move, and in a direction in which I believe we shall have to move much further in the future.

§ LORD HYLTON
My Lords, I thank the House cordially for the reception this Bill has been given by the various speakers, and I apologise to the noble and learned Viscount that I did not go as fully as I ought, perhaps, to have done into Clause 2. But the reason was that Clause 2 is only adoptive, whereas Clause 1, of course, is obligatory.