§ Order of the Day for the Second Reading read.
THE LORD PRIVY SEAL (THE EARL OF CRAWFORD)
My Lords, I beg to submit this Bill to your Lordships for Second Reading, and I will briefly indicate its main provisions. The Bill is an amendment of the English Act. The general Act has already been amended as regards Scotland, and, this spring, as regards Ireland. This proposal practically makes the law in England identical with that now prevailing in Scotland and in Ireland, subject to one or two small exceptions to which I will draw your Lordships' attention. Broadly speaking, one may say that this measure is founded upon the Report of the Committee of Inquiry which sat some years ago under the chairmanship and direction of Sir Almeric FitzRoy; but certain further amendments are proposed which are the fruits of experience gained since that Inquiry took place. If this Bill passes into law, the practice with regard to the registration and control of midwives will be identical in Scotland, Ireland, and England.
The first clause is taken from the Scottish and Irish Acts. It follows the model of the Medical Acts, and provides machinery 216 by which further changes in the constitution of the Board may be made by Order in Council. This proposal is obviously convenient, because as time goes on it is quite possible that small alterations in the constitution or powers may be proved necessary, and it seems hardly worth while to have to come to Parliament for an amending Statute upon each occasion. Your Lordships will observe that subsections (2) and (3) make it certain that no alteration can take place in the constitution without Parliament having a thoroughly adequate opportunity of expressing its views upon the subject.
Clause 2 is a financial clause. It amends Section 5 of the principal Act and deals with the apportionment of deficit balances. It is advocated by the Central Midwives Board. It is not in any way a serious charge on the local finances, but it is a good administrative improvement, as it removes from the most active authorities the penalties under which they have suffered up to now of being most heavily mulcted to meet the outlay of the Central Board. Clause 3 is purely technical. It absolves the secretary from personal attendance when any question arises before local tribunals. Clause 4, again, allows reasonable expenses—travelling expenses, I presume—to be paid for those who attend the meetings of the Board. With regard to Clause 5, I should point out that at the present moment the Privy Council receives the annual Report from the Central Board. It is a voluntary proceeding on their part, but it is considered right that it should be a statutory obligation to Parliament, and Clause 5 imposes upon the Board the duty of sending in their Report every year.
Clause 6 is an important clause. It amends and amplifies the existing provision about the suspension of midwives. The power to frame rules governing the conditions of suspension is vested in the Central Midwives Board, which is a representative body and on which full powers have been conferred to deal with these cases. Subsection (2) of this clause introduces for the first time a very desirable principle—namely, that compensation shall be payable to a woman who has been suspended from practice owing to no fault of her own. This provision already appears in the Scottish and Irish Acts, and it seems to be a fair and equitable arrangement. Clause 7 relates to the reimbursement of costs (for which no provision exists at the 217 present moment) to a woman who has been summoned to give evidence. It authorises the Board to reimburse or pay part of the expenses of a woman who has been summoned to appear before them in her own defence.
Clause 8 is a very valuable clause. At the present moment a woman who has been struck off the roll for carelessness, or incompetence, or bad conduct is not obliged to surrender her certificate, and there is nothing to prevent her from becoming a monthly nurse next day if she is minded to do so. Clause 8 provides that a woman who has been struck off the roll is obliged to surrender her certificate to the Board; and if the Board consider that the continued attendance by this woman upon other women would be fraught with public danger, they are empowered to prohibit her from taking any further professional part in maternity practice. I understand that importance is attached to this clause for the protection of public health. Clause 9 merely requires midwives to notify a change of address.
The next clause—Clause 10—is of some interest, and brings the English practice on a parity with the practice prevailing in Scotland and Ireland. At the present moment the authority in Scotland and Ireland (the county council) is empowered to employ a midwife who is qualified by an English certificate, but in England it is impossible to employ a midwife who is qualified by a Scottish certificate. This clause provides for reciprocal treatment in that respect; and, following precedents which already exist in the medical service, in time dental service, and, I think, also in the veterinary service, it is applicable to any other part of His Majesty's Dominions. Provision is taken in the latter part of subsection (1) of this clause to ensure that the standard of training and examination required in such other part of His Majesty's Dominions is equivalent to the standard adopted by the Board. The Privy Council determine any question of doubt which arises under this clause. Clause 11 provides that the local supervising authorities shall be free to make grants for the training, within or without their areas, of midwives.
Clause 12 is an amendment of substance. The Scottish and Irish Acts confer upon the local authority—that is, the county council—no power of delegation to smaller or subordinate authorities. In England that power exists, and the county council 218 is authorised to delegate to district councils its duties under the main Act. This clause provides that in future no such delegation of authority shall be permitted except by the consent of the Local Government Board. The fact is that delegation in this respect has not been as great a success as had been hoped. It is, in point of fact, a very narrow delegation, applying only in a very few cases. The results of this delegation have certainly not been encouraging, and it has therefore been decided that no further delegation shall take place except after inquiry by, and with the sanction of, the Local Government Board. I think I am correct in saying that the Local Government Board is entitled, under this clause, to revoke ally delegation of authority where it thinks the authority has not been adequately exercised.
Clause 13 is purely administrative, and is intended to ensure that the local supervising authority shall receive due notice when a woman's name is taken off the roll. Clause 14 entitles the local supervising authority to pay a medical practitioner a sufficient fee when called upon in cases of emergency. I understand that there are certain cases where the local medical practitioners cannot be called in, as they should be, because there is some doubt, often very well founded, as to whether they can receive their fee or not. This clause provides a simple machinery by which the medical man who is summoned in cases of emergency can be properly paid. Clause 15 is inserted with the concurrence of the General Medical Council. The Executive Committee meets more frequently than the English branch of the Council, and it is desirable for purposes of expedition that this should be done so as to prevent delay. This exhausts the outline of the clauses of the measure, and I commend it to the consideration of the House. Subject to your Lordships' convenience, I suggest that the Committee stage should be deferred until next week.
§ Moved, That the Bill be now read 2a.—(The Earl of Crawford.)
LORD BALFOUR OF BURLEIGH
My Lords, I am glad that there is to be a little interval for the consideration of this Bill before the Committee stage is taken. We are indebted to the noble Earl for the clear and extremely full exposition he has given of its contents, and any points that may 219 arise will, I am confident, be Committee points. I do not think, however, it would be right to pass over the way in which this Bill has been dealt with without some comment. The noble Earl said it was founded on the Report of a Committee of Inquiry held by the Local Government Board some years ago. The Bill was read a first time on Thursday; it was circulated on Saturday, and we are now asked to give it a Second Reading on Tuesday. I do not want to be unduly troublesome in war time, but I would point out that neither of the representatives of the Departments which are concerned with the measure are present in the House to move the Second Reading of the Bill. It stands in the name of the Leader of the House, the Lord President of the Council, in whose Department all these cases are chiefly managed; but, of course, the Local Government Board has a great deal to do with it, and I thought that the noble Viscount, Lord Peel, who represents the Local Government Board, might have had something to say about it, or even taken charge of the Bill. I understand, privately, that there is some special reason for his not being here to-day.
I submit that it is extraordinary treatment of this House that a Bill, founded on the Report of a Committee which sat some years ago, introduced on Thursday and not circulated until Saturday, should be read a second time to-day (Tuesday) without it having been possible for any of us who are interested to consult people in the country as to its exact tenor and effect. This does not matter so much if there is going to be an interval before the Committee stage is taken, but I cannot understand why the Second Reading should have been taken to-day. There can he no possible hurry, and having regard to the congestion of business in another place I shall be extremely surprised if the Bill is taken there before next October. I do not believe there will be much controversy on it except in regard to Committee matters; but I have nothing more to say on that point, on the understanding that a proper period will be given for us to consider the large number of amendments which are being made in the existing law.
So far as I can gather from the statement of the noble Earl, I believe the amendments made by the Bill are in effect improvements and a move in the right direction. Personally I am doubtful whether the prohibition of delegation goes far enough, but 220 that, of course, is a purely English matter. It does not exist in Scotland, and those who are interested in this matter in England must take the lead on that question. I am glad that the Bill has been introduced, and I hope that at least ten days or a fortnight will be given to us before the Committee stage is taken.
THE MARQUESS OF CREWE
My Lords, I cannot pretend to be altogether surprised at the protest which my noble friend above the gangway made with reference to a certain unreality in cur proceedings of which he considers, and I think that perhaps your Lordships may consider, that the conduct of this Bill is a tolerably vivid instance. It has so often been my fate, sitting where my noble friend the Lord Privy Seal is now, to be taunted with having reduced the proceedings of your Lordships' House to an unreality by our legislation, that perhaps I may be forgiven if I express the quite serious opinion that there never has been a time—Parliament Act or anything else—when the proceedings of your Lordships' House have been so unreal and so little considered. I do not know whether by His Majesty's Government, but I am afraid by another place, as they are at this moment. No doubt that circumstance is mitigated by the fact that our proceedings uniformly remain absolutely unreported, and therefore unless people will take the trouble to study the debates in Hansard—and I beg leave to say that there have been in the course of the last session or two some exceedingly weighty, important, and interesting debates in your Lordships' House—and read there the report of what takes place, our proceedings here might almost as well not occur.
As to this particular Bill, the matter is of interest to me because I was twice Lord President. This particular subject of midwives falls, as my noble friend stated, within the department of the Privy Council, and I have had in the past many dealings with it. I congratulate His Majesty's Government and the noble Earl in charge of the Bill on the introduction of the measure, which I am sure, in its main lines, will prove to be extremely useful in consolidating and elucidating the law on this subject. The only point on which I have received, as an outsider, a number of strongly-worded protests is one which was mentioned by my noble friend, but, as he says, it does not apply to Scotland and 221 therefore did not specially interest him—namely, Clause 12, subsection (1), on the subject of delegation. Apparently the bodies who are specially concerned with this subject—the Central Midwives Board, and certainly the Institute of Midwives—take a strong view that His Majesty's Government, having tackled this subject, ought to have gone further and forbidden delegation altogether. As the noble Earl said, the experiment of delegating powers to district councils has not been in the main successful. The point is no doubt worthy of close inquiry, because the opinion of all of us in a matter of this kind is on general grounds rather in favour of decentralisation than of excessive centralisation; but if it really is the case that the attempt to work through the small local authorities has not in this particular matter been successful—and not being successful in a matter of this kind means, it must be remembered, being positively disastrous—I think it is a serious question whether it would not have been better to take the bull by the horns and stop delegation altogether. However, the matter will no doubt be carefully considered before the Committee stage, and we shall have the opportunity of further inquiry and discussion either with the Department or with the different bodies interested in the subject. It will then be seen whether any noble Lord desires to put down an Amendment on this matter, or, indeed, on other matters in the Bill. In the meantime I have no doubt that the House will desire to give a Second Reading to the Bill.
§ THE MARQUESS OF SALISBURY
My Lords, I rise, not to repeat what two of my noble friends have just said, but to suggest to the Government that after what has been stated to your Lordships they should give us ample time between the Second Reading and the Committee stage. The same sort of representations had reached me as have reached my noble friends Lord Balfour of Burleigh and the Leader of the Opposition. The request which was made to me was that there should be ample time between the Second Reading and the Committee stage, and the reason this request was put forward was that the Bill had come upon those interested in the subject as an absolute surprise, which does not mean that the Bill is in any way objectionable. On the contrary, it appears on the whole a very good Bill. It is not only that the Bill has come suddenly upon 222 your Lordships, but also upon the Central Midwives Board, who were not even told that such a Bill was intended. No doubt there is nothing sinister in that omission, but it is an additional reason why there should be ample time between the Second. Reading and the Committee stage. I hope that my noble friend will be able to give us a fortnight.
THE EARL OF CRAWFORD
My Lords, I am sorry if any of your Lordships should think that we are trying to get this Bill through with indecent haste, but the fact that it has been long in coming to maturity was, I think, sufficient justification for not wasting any more time. As for my noble friend Lord Balfour of Burleigh telling the House that he does not understand the Bill, the very idea of that is preposterous. He, I believe, is the father of legislation on all these matters. He dealt with the subject five-and-twenty years ago; in fact, he dealt with the very first Bill that was ever introduced on this subject, and he knows the contents of this Bill by intuition. He of all Peers has no grievance whatever in the matter being brought before your Lordships' House at short notice. But there is no wish whatever to press it unduly. It is desired to get a Second Reading this week in order that we might prepare for the Committee stage, and I would suggest, if it meets with your Lordships' convenience, to put it down for Committee on Thursday of next week. If during the early part of next week it becomes obvious that Thursday is too soon to take it, then I suggest that it should be again postponed. That would bring it, perhaps, to this day fortnight.
§ THE MARQUESS OF SALISBURY
should wish the Committee stage put down for this day fortnight, if the noble Fad will agree.
§ On Question, Bill read 2a, and committed to a Committee of the Whole House.