§ VISCOUNT KNUTSFORD rose to ask His Majesty's Government why it is proposed to close the Home of Recovery for Neurasthenic Pensioners at Golder's Green, seeing that the monthly reports show that a very large proportion of the patients treated there are discharged fit for work, and considering the large amount of money which has been expended to fit it for its present purpose; and to move for Papers.
§ The noble Viscount said: My Lords, I hesitate to trouble any member of His Majesty's Government with a question in these times, but the decision of the Minister of Pensions to close the Golder's Green Hospital for the Recovery of Neurasthenic Pensioners has come as such a bombshell to the medical profession and to all of us who are interested in the cure of these neurasthenics, that I cannot help asking whether there is an adequate reason for this decision. The Golder's Green Hospital for the Recovery of Neurasthenics is one of the most successful hospitals—if not the most successful—in the whole of our country. The sum of £11,000 has been spent upon it by the Red Cross, who had no notice whatever from the Minister of Pensions of his intention to close it, except what they had seen in the public Press. It is absolutely and perfectly equipped for its work. It has a large gymnasium, perfect electrical apparatus, and workshops of every sort, and has every facility for training men to return to civil life again after having learned a trade. The Minister of Pensions himself admits that the hospital's work is satisfactory. I should think that it was satisfactory. In the last seven months—these figures are almost unbelievable, but they are true—of 189 patients 183 have been returned fit to work, and are in work to-day. One would have thought that the record of such a hospital as that would have resulted in its being encouraged and commended for its work. On the contrary, it is to be scrapped.
§ When two of the best-known neurologists in the world, who are on the Committee appointed by the War. Office to deal with neurasthenic cases, went to the Minister of Pensions and asked why this hospital was to be scrapped, the answer was that it was in the raid area, and that it was to be closed for that reason and was to be 1060 used for paraplegics! For those who do not meet as many medical men as I do, perhaps I may explain that a paraplegic is a man who is paralysed in consequence of injury during the war. I speak with experience—I happen to be connected with four hospitals for officers who are suffering from shell shock and who are neurasthenic —when I say that they are not distressed by air raids. A very small minority of them are disturbed by the noise of the guns, and I think that it is rather a helpful thing that we are able to sit up with these men and explain to them that there is no reason for fear, and help them to regain their courage and calm in such a time. It is really quite surprising how few of them are in any way adversely affected by an air raid. But if there is one class of patient who ought not to be in what is called an air raid area, surely it is the paraplegic. The man who is suffering from neurasthenia can at any rate get out of bed and go to a place of safety, but the poor paraplegic is a man who cannot move. In one of our important hospitals the neurasthenic patients are making a dug-out so that they can shelter on the occasion of the next air raid, and they are very much amused with the job and are looking forward to the next raid. What can the paraplegic do? Of all people these persons are those who should be removed as far as possible from the influence and disturbance of air raids. So that that reason, at any rate—and it is the only one that we have had—is quite as silly as it is insufficient for the closing of this successful hospital.
§ To-day in the newspapers we are given other reasons for closing this hospital, and I will deal with them all. The Minister of Pensions says that 50 per cent. of the pensioners to whom Golder's Green Hospital is offered decline to go there. He says that there are a large number of beds available there and not in use, and he says he is going to start another institution in the country where these cases can be sent at some distance from London. Those reasons are perfectly astounding.
§ I will deal with the last one first—namely, that the patients are going to be sent to a hospital at some distance from London. There is a very limited number of men in the country who have studied neurasthenic conditions. You can almost count them on the fingers of your two hands. It is quite impossible for these men to attend to patients if they are sent to hospitals at 1061 some distance from London. In dealing with them these doctors have to sit by the patients sometimes for half an hour, sometimes for an hour, before they can have any effect upon them, and it is impossible for a doctor to go all the way down to Maidenhead, or some other place to which this hospital is going to be removed, and give the time to deal properly with the patients. Therefore that reason—the removal to some distance from London—is one which will really result in these patients not getting the best medical attendance that is available for them in the country. It is quite impossible for an ordinary doctor to attend a neurasthenic patient. He has not had the experience. He has never made the subject a special study, and it is only those men who have who can properly deal with these cases.
§ The next reason is that 50 per cent. of the pensioners who are offered Golder's Green have refused to go there. But it depends very much on how a man is asked. If you say to a poor fellow whose nerves are wrecked, "Would you like to go where there is likely to be an air raid, or would you like to live by the beautiful river Thames?" of course you get the answer you want. And that is exactly the sort of way—I am exaggerating for picturesque reasons—in which these men may be asked.
§ We cannot be surprised that these poor men dislike the idea of going to any other hospital. They have been handed about from Army hospital to Army hospital; they have been treated and misunderstood by doctors who have never studied these diseases; they have been thought to be malingerers; they have been laughed at by fellow patients—I am speaking from actual experience—and it is quite likely that, if you ask a neurasthenic patient whether he would like to go to his home and live upon a pension, or go to yet another hospital, he would say that he very much preferred to go home and enjoy his pension there. But are you going to frame your policy upon the decisions of men who are admittedly, I will not say weak-minded, but not quite normal; or ought you to frame your policy upon the admitted success of the hospital treatment?
§ Then the Minister says that he has a large number of beds available and not in use. I do not like to use a strong word, but that is absolutely untrue. At Golder's Green there are 100 beds, and 92 of those beds have been in constant and actual use 1062 every day for the last seven months. When the Minister says that he has a lot of beds there available and not in use, can he mean really that they are adding forty beds to the 100, and that these are not equipped yet, and that these are the beds that are not in use? Can such a quibble as that be thought to be a sufficient answer? And yet that is the answer given in the newspapers to-day—that a lot of beds available are not in use. It is untrue. The decision has been come to, we are told, upon the advice of the medical adviser of the Ministry of Pensions, Sir John Collie. But I would ask the Government, before this drastic step is taken, to find out whether the board of which Sir John Collie is the head are unanimous, because I am informed that they are not at all unanimous.
§ I do not want to say anything offensive, so I had better sit down. I can only add this, that if the Lord Privy Seal, whose courtesy and fairness everybody knows, would appoint an expert Committee to look into this matter we should all be content. More than that, if he would constitute himself the judge whether this hospital should be closed or not, he could in one day hear the reasons on both sides, and we should not have the slightest fear as to the decision.
THE EARL OF CRAWFORDMy Lords, I confess I feel some embarrassment in replying to my noble friend, because during his speech I have looked through the answer which I am about to give, and I observe that every statement I propose to make has been contradicted in anticipation by himself. I can only inform him of the view taken of this matter by the Pensions Department. The Minister of Pensions has decided, upon the recommendation of his medical officers, that the presence of a hospital for the treatment of shell shock and neurasthenia within the zone of antiaircraft gun fire is undesirable. Whether the medical advisers or the board of this hospital were unanimous or not I do not know, but I think it would be, perhaps, imprudent to decide off-hand that no change may be made unless there is unanimity; otherwise, it is quite possible, as your Lordships will all admit, that one single medical man night exercise his veto upon the policy advocated by a great majority.
Accommodation in a rural district admirably suited for the treatment of this 1063 class of case has been procured at some distance from London, near Maidenhead. In making these arrangement the Minister has followed the practice of the War Office, which, upon the advice of its Committee of experts, has recommended a similar course. The president of the special medical board which alone decides the suitability of patients for these institutions has reported that a large number of these men refuse to enter Golder's Green because of the not unnatural anxiety to escape from conditions which too often vividly bring before them the memory of the circumstances under which their trouble originated. Lord Knutsford advocated a decidedly homeopathic policy with regard to these patients. I would remind him that all these men are discharged soldiers, and therefore completely free to enter or refuse to enter any hospital to which they are invited by the Minister of Pensions. If they were soldiers, no doubt discipline could insist upon their going to this hospital or that, hut, as they are all civilians again, the matter is entirely within the discretion of the neurasthenic patient himself.
The total number of this class of case for which the Ministry of Pensions has now to provide has greatly diminished owing to the more efficient method of treatment adopted by the military authorities in France. The number it is anticipated will in the near future be still further diminished by the recent action of the War Office in establishing, as it is now doing, from six to eight similar institutions in the country with provision for some 3,000 to 4,000. The Minister of Pensions is making provision for between 500 and 600 beds throughout the country apart from the Home at Golder's Green. At present there are 216 beds occupied in the institutions already established, which is less than 40 per cent. of the bed accommodation which will be available in the country for this class of case before the patients at Golder's Green are transferred to the country. The Home of Recovery at Golder's Green has, or will have in a few days time, accommodation for 140 beds. Owing partly to the fact that pensioned soldiers refused to enter the institution on account of air raids, only 50 per cent. of those considered suitable for treatment availed themselves of it when offered. The result is that a large number of the beds available are not in use. An institution has been provided in the country in favourable surroundings which will amply accom 1064 modate a number of cases for which provision has hitherto been made at Golder's Green.
VISCOUNT KNUTSFORDMy Lords, I have only to say, in reply, that if the number of patients is diminishing so fast, is it not almost incredible that the Minister of Pensions should think it necessary to open more homes for neurasthenics all over the country? Why, if they are diminishing so quickly, should he not leave this successful Golder's Green institution alone and not open another at Maidenhead? I am sorry that I did not catch the argument which was put forward with a sweet smile about the beds not being available, but the Minister of Pensions cannot say that there are beds at Golder's Green which he cannot use when he is using ninety-two out of 100. It is true that very soon there will be another forty, but on the day of his saying that he has a large number of beds there not in use he is actually occupying ninety-two beds out of 100.