§ LORD BUCKMASTER had given Notice to move to resolve. That His Majesty's Government be requested to withdraw all instructions given to, or conditions imposed on welfare committees for the purpose of causing such committees to withhold from married women in their district information when sought by such women as to the best means of limiting their families.
§ The noble and learned Lord said: My Lords, the question that forms the subject of the Motion standing in my name possesses an importance that few will deny. It is one of the large group of new grave questions that are pressing upon us with increasing insistence and demand that rational, restrained and intelligent discussion which can be obtained nowhere better than within the walls of your Lordships' House. One of the strangest ironies of life lies in this, that man everywhere is seeking for rest and everywhere he encounters change. One position is no sooner occupied than it becomes necessary to seek a new one, and in the continual adaptation to the ever-changing conditions of environment and life you find the only means for development and growth. This question 997 illustrates what I mean. Some fifty years ago it was new. Its advocacy was attempted to be punished by the Criminal Law, it startled and it shocked people, but to-day the only thing that is left is this: Will you take steps to withhold from the poor the knowledge that is possessed and practised by the rich?
§ I believe that no one who has the least familiarity with the facts will deny the truth of what I say. You cannot read any book that deals with this question—and I have read many—without finding that they treat it as an accepted axiom that birth control is being extensively practised by the people who are well-to-do and that it is only among the poorest and the most ignorant, the most destitute, the most shiftless, helpless, hopeless stratum of society that that knowledge has not permeated and is not used. Statistics themselves are eloquent upon the point. If you take a thousand married people under the age of 50 the birthrate for schoolmasters is 93; for clergymen of the Church of England it is 100, for clergy of all denominations it is about 102; for doctors and professional men, from 103 to 105; for skilled labour, 153; and for unskilled labour, 247. If you take the standard of intelligence, measured in the same way by examination of the children in the schools, you will find that there is a descending scale of intelligence which is in the exact inverse ratio to this standard of birth rate. The truth is that in spite of what people may say about the nation being divided into classes, there is continually going on the winnowing process of nature and in the great solution of life every organism takes its proper place according to its specific gravity. These people for whom I speak represent the lowest sedimentary stratum of them all. I want to ask in these circumstances: Why is it that this knowledge should be withheld from them?
§ The position at the present moment is this: The Ministry of Health will provide money for the purpose of assisting welfare centres that are set up by local authorities, to enable those welfare centres to give help and advice to women who are expecting children and to women who have young children under their care. But there is an expressed prohibition that prevents these people, though they are qualified medical men and women, from being able to give 998 information to any person who asks them as to the means by which further birth might be prevented. The question, the only question before your Lordships this afternoon, is whether or not that state of things ought, not merely in the interests of justice but in the interests of our race, to be allowed to continue. There are, I know, many people who deplore the fact to which I have referred, that birth control is in fact exercised by people who are well-to-do and by the intelligent among all classes. It is no use weeping over lost battlefields. That struggle has been fought and it has been lost and won, and you can never recapture the position.
§ The reason is not, as some people say, that women are selfish and men are worthless and the world is addicted to nothing but pleasure. It is nothing of the kind. It is due to a much higher and much more permanent cause than that. It is due to an increased respect for the sanctity of life. It is due to the desire of people to secure that their children are not pressed out by the illimitable competition of unrestricted numbers of their brothers and sisters, and it is inspired by the hope that people will be able to make for their children an easier and a better place in the world than they themselves once filled. Some people, of course, talk about the ennobling effect of a struggle with poverty. The people who talk like that have never known the struggle. It is the most degrading, the most demoralising struggle to which a human being can be put. To suggest that poverty is a good thing is an astonishing suggestion when you remember that every man, from the time he first begins to work until the time when he can work no more, spends the whole of his energies trying to escape from it. I say that these people are prevented from knowing the facts that will enable them to prevent the illimitable repetition of their children.
§ What are the cases which I desire that these people should be at liberty to remove? I beg your Lordships carefully to note that my Motion lays no burden, imposes no duty upon any medical officer of health at all. It does not even contain directions that it should, or say that in the opinion of the Ministry of Health it ought to be done. It is to let these qualified medical people, if they 999 in their judgment think lit, exercise their medical knowledge for the relief of the women that come before them. What are the classes of the women who come for help? I do not propose to read to you a very large number of instances and, of course, the instances that I take will probably be liable to the criticism that they are selected. They are selected from a most tiny handful of the population and you could reproduce and multiply the cases that I give you in any single parish within the City of London and in any one of the wards of our great cities throughout Great Britain. Please do not think that these cases, terrible as they are, are simply selected and extracted from the wards of hospitals. They are typical cases of a condition of misery that is to be found throughout the poorer areas of our great cities.
§ Let me read to you one or two of these cases. Here is a woman who was married at the age of seventeen. At the age of thirty-four she had had eighteen pregnancies with eleven live children. Her husband, a hawker, was often away from home and does not attempt to support the family. The mother does this by hawking. The three youngest children are backward and unable to walk and have to be taken out with the mother on her rounds in a perambulator. The housing accommodation is one living room and two bedrooms. The mother shares a flock mattress, without sheet or blankets, with these youngest children, and her last confinement was conducted under these conditions. The mother and all the children are clean and well-cared for, so please do not think that you are dealing with a woman who does not care what happens. She refuses to have relation with her husband until he overpowers her, and of course, by the merciful law of this country, a man cannot rape his wife. She has asked him to take other women. During the last pregnancies she has done everything she knew to procure abortion. She cannot go away from home.
§ That is one case and, believe me, that case is by no means unusual. You can reproduce it again and again, and such cases will continue if you do not enable these women to obtain knowledge by which they can prevent themselves having children. There is one thing which they will all admit—namely, that 1000 they have made repeated and frequently successful efforts to procure abortion. I cannot help thinking that we live in a world of sham or in a Cloud-Cuckoo-Land. Every now and then cases come before the Courts and some person is sent to gaol for a long period of years for performing an illegal operation. This is the commonest thing you can think of in these places. These women will all confess it to you and will tell you that at the imminent risk of life and health they are driven to resort to this as the only means of escape from a state that they find intolerable.
Let me give some further cases. Mrs. M. has had thirteen pregnancies, and has three living children. Mrs. N. has had three children, two of whom are not walking. Housing accommodation may be sufficient, but the children are underfed and the mother cannot cope with the position. Mrs. P., aged thirty, has eighteen children, is tuberculous and has a uterine disease: each child is worse than the last and it is difficult to help except from the point of view of birth control. Then listen to this:
She does her best to secure abortions, and she does not observe the deficiencies in the children when they once arrive.
I wonder if your Lordships realise what this means. This woman comes and tries to relieve her situation with the help of the medical officer of health. She tells him that she is sorry that she is in this condition, that she has clone her best to produce miscarriages and failed. "Cannot you possibly tell me," she asks, "how to prevent my getting into this condition again?" The medical officer of health says: "No, if I venture to tell you anything of the kind the Ministry of Health would stop the grant for this centre and we shall not be allowed to continue."
§ I will give your Lordships other cases. Mrs. S. has six children, three of whom are mentally deficient and quite hopeless. The next case is of a mother who is tubercular, with seven children, two of whom already have advanced tuberculosis. The mother has done everything possible to secure abortion during the present pregnancy. Then there is a mother aged thirty-one, with eight children, and another who has been married seventeen years, has eight children and has been in an asylum for four and a half months since the birth of the last child. Then 1001 there is a woman, married twenty-two years, with twelve children and five intentional miscarriages. I could read your Lordships innumerable cases of this kind. They go on and on. In North Kensington, a place not supposed to be one of our slum areas—I suppose the inhabitants would be distinctly hurt if it were so described—I have a case described in a letter written by a very eminent woman. Mrs. A. has had thirteen pregnancies and has eleven children living. The husband is earning £1 a week. Mrs. B. has had twelve pregnancies and has seven children living and they are desperately poor. Then we come to C., D., E. and F., all similar cases with three, four or five pregnancies, with children either insufficiently fed or insufficiently clothed or both and every one of them, I beg your Lordships to note, going to be a burden upon the better-to-do artisans and the other people in that place.
Probably the saddest story of all is one that is not drawn directly from hero. But listen to this:
When we first knew this family they had four children all of whom had been born without eyes. The two oldest had died when quite small and two little girls, aged two and four, had managed to survive. The mother was suffering from dementia prœcox, and spent eighteen months in hospital. She was incapable of training the children, who, sightless and speechless, sat all day long in their little beds manifesting not a single normal reaction to the tests that were given. The father was devoted to the mother and refused to send her to institutions but, realising that she ought not to have any more children, begged the information by which he could prevent such a result.
The answer is, of course, that if this information is given the grants are stopped. These women are told: "We are not permitted to give this information. If you want it you will find a shop not far away, with unclean pictures in the window, and every suggestion of prurient and filthy literature inside. Go there and they will probably be able to tell you, and it is perfectly certain that they will give you information which may be most deleterious to your health, and you certainly will not be under trained medical supervision. But it is not for us to help you, and we are not going to help you."
§ I want to know why these people are not to be helped. It seems to me that it 1002 is preposterous for us to sit still and accept the facts of the story as they stand now in the knowledge that all the better and more thoughtful people are carefully limiting their children—the people who, beyond all others, we need—while people such as those, sickly, mad, diseased, underfed, are reproducing at a rate that is nearly double that of anybody else, and there is no one to tell them that they ought not to do it, there is nobody to say that they ought not to bring into this world a child that is cursed from its birth with disease, that they have no reasonable opportunity of supporting and intend to throw upon the rest of the community for support. But, instead of saying that this is an immoral action, this Department says that it is a highly moral one, that they must go on doing it, and that nobody is to tell them how it can be stopped.
§ I really am anxious to know what is the answer to the case that I have put. I ask that duly qualified medical men and women should not have their discretion fettered as to the way in which they give advice to people who seek their help, when those people are living within the district which it is their duty to serve. I am really anxious to know what the answer can possibly be. Of course, you may raise the old economic answer that economically, in any circumstances, your population ought to be reproduced. That I cannot help thinking is an echo of arguments that are long since dead and had better not be resurrected. They come from the time when it was thought that every added unit to a labourer's family meant more material out of which the factory owner could extract work. Anybody who has read the history of the early part of the last century, and seen the way in which big fortunes in our manufacturing districts were built up at the expense of the lives of the children and women who worked in the factories, will have a sense of shame which it will be difficult to eradicate. Those conditions have, thank God, gone by, and can never come back. Children can no longer be made instruments for the production of profits in a balance sheet. It is no use asking that they shall be reproduced in order that you may have a bigger profit-earning unit in a workman's family.
§ It is said that directly you limit the birth rate you begin to descend in the 1003 scale of the world. Do I understand that the measure of nations is to be tested by their fecundity, as you test the value of o rabbits? It is not a question of numbers, but a question of quality. It is not numbers that will win the next war. It is brains; and the future of the world is going to lie with the nation which can best see under the sights of a microscope, and not with that which can best see over the sights of a gun. At the moment you have got just upon a million people unemployed in this country. Is there any person who really thinks that in the conditions in which we stand you are going to absorb those people within your industries within a measurable period of time, and if so, are you going to absorb that ever-flowing increase from the populations I have quoted?
§ People do not seem to know, when they talk about the diminution of the birthrate, what the facts are. In fact, last year the population increased by 247,000 people, and before that the increase was larger still. If you have a larger population, of course the rate must necessarily fall, although the numbers added are greater. I think that within the first twenty years of the century we added more to the population than during the whole of the eighteenth century. If it is said that it is for the public good that the population to which I have alluded should be reproduced, then those who take that view must accept responsibility for the consequences which must inevitably occur.
§ I think that the answer probably is to be found in the deep-rooted religious objection to any such principle as this. I speak of a religious objection with the respect that all deep religious feeling involves, but I find myself quite unable oven to understand what is the ground upon which religious objection to this application is based. I notice that all attempts artificially to prevent the necessary natural consequences of relations between man and woman have been condemned by a group of eminent ecclesiastical authorities at Lambeth. They do not, so far as I can see, say that such children as those to which I have referred—blind, syphilitic, tubercular, mad—have got to be reproduced. No! But they say that the right course to follow is for a man or woman to exercise self-restraint, 1004 and that abstention is his or her real duty, and that that will really solve the question.
§ What a strange doctrine to teach to people who live in the conditions of the people from whom those examples I have given have been taken. Have they pictured for a single moment what the life of such people is? You take a young man under thirty, and a woman under thirty, and you put them together night after night, unceasingly, in the closest possible physical contact you can imagine, and then you say: "Oh! you must remember you must abstain, because if you do not your children will be cursed with sickness." We all remember the story in Gibbon of the young Christian who quelled a rising temptation caused by a wanton woman, and he succeeded, but he only had one temptation to meet. If he had been tempted night after night he would have had no members left on his body to destroy. Human nature being what it is, this doctrine of abstention is impossible, and what else is it you propose?
§ I cannot help thinking that this idea is fundamental in the conception that there is something in itself that is evil in the relations between man and woman. I am bound to say that there are occasions when I feel that if I stood alone in the world I would protest against such a doctrine as that. Why, if it be true, then evil is to be found in the very centre of all beauty, of the blossom of life, and it is demonstrated by every living creature that seeks its kind and by every flower that blows. So far from it being evil within the strict limits of monogamy, and within the restraint that every man is bound to put upon all his appetites, I assert that it is not evil but that it is good, and that this doctrine that people should abstain from it is wrong and mischievous and is certain to lead to the shattering of more homes than any of the causes that we have heard denounced in this House.
I do not believe myself that the most rev. Primate, with his great sagacity, will assent to any such proposition as that, because I see that he has written a foreword to a book, written by a lady who objects to birth control
and at the end of which these conclusions are stated:—
There are certain women who, for medical reasons, should be prevented from bearing children.
There are couples with undesirable inheritance who rightly decline to bear children and who should follow medical advice as to the means of prevention.
There are many women of the poorer classes in whom child-bearing is sometimes the last straw in the circumstances all of which tend to destroy health and vitality. Such conditions will only be truly remedied by social reforms, but, where the health of the mother is impaired by too frequent pregnancies it is the duty of her medical adviser, whether in private or at hospital to safeguard her health.
And though I have not the least desire to pin anybody to a phrase that may not have been thought out, I find that the most rev. Primate of all England said this:
I desire on moral and religious as well as on social and national grounds to support your general conclusions.
That is all I ask. I ask for nothing more than that the conclusion of that woman should be carried into effect through the only medical channel which is accessible.
§ There remains only the position put forward by the Roman Catholic Church. I find myself in the unfortunate position of always being in acute conflict with the Roman Catholic Church. I am sorry, because I say sincerely I believe that there is no one outside its own communion who has ever felt the power of its appeal more really than I have myself. But, none the less, though I speak of them with all respect, I say that that Church must remember that it is no longer living in the days when it could compel Galileo to come upon his knees and say that the sun went round the earth, and that the earth did not go round the sun They have no power to impose their views upon us, and, deeply as I respect them and their faith, I am entitled to ask precisely the same respect for the opinions which I just as earnestly hold.
§ It is perfectly fantastic to suggest that because there are Roman Catholics who will have to bear the burden of taxation therefore those taxes ought not to be used for purposes to which they object. Why, there are thousands of people today who, though you may think them weak-minded—and I do not share their 1006 views—earnestly and sincerely and with the deepest religious faith believe that all warfare is a sin against Almighty God. Do you therefore refuse to collect taxes from them for the purposes of supporting your Army and your Navy? The Roman Catholic Church believe just as strongly that all divorce is sinful. Do you therefore exempt them from paying the salaries of the Judges who sit in the Divorce Courts? There are people who believe that all forms of vaccination and inoculation are a sin against nature and against God. Do you therefore say that they shall be relieved of anything that has to do with that? It is not the case, it is not possible. You have to deal with your body as a whole, and you cannot possibly, in administering public affairs, consider the feelings of a few of the people who are concerned with what you do.
§ But, of course, the real truth is that we cannot meet the Roman Catholic Church because reason and faith have been in age-long conflict, and, though they may respect each other, they can never be reconciled. The view that the Catholics take of this world is different from that which I hold. What, to them, is all the trouble and the pain, the sickness and the disease and sorrow of this world? It is nothing but a mere trouble and transient ripple upon the surface of the great ocean of eternity. Cardinal Newman, one of their greatest Cardinals, proclaimed their faith in these words: He said that the Catholic Church held that it were better that the sun and the moon should fall from their places, that the earth should fail, and that all the many millions upon it should die of hunger in extremest agony rather than—I will not say one soul should be lost, but should commit one venial offence, should tell one simple falsehood or steal one poor farthing without excuse. I cannot reach to the sublimity of that transcendant faith.
§ I have another and a different vision of the mystery of life. To me the main purpose of man's existence is to fight these very evils of pain and sickness and unhappiness, to engage in endless and constant struggle with the forces of nature until he makes them the servants of his will and the ministers of his delight. And I believe that every step forward in that triumphal march is accompanied by a fuller development of 1007 all the highest moral qualities, by an increasing love, not merely of his fellow men but of all living fellow creatures, by unflinching self-sacrifice and un-deviating devotion to the truth. You may not share my creed, but there must be many among you who think that if that is not the chief purpose of life it is at least one of the purposes of our existence, and to them I would appeal.
§ I would appeal on behalf of the men who struggle in the grip of forces that they can neither stem nor understand, upon whom the pressure of our civilisation falls with such a burden that beneath its weight there is blotted out all the beauty and some of the simpler happiness of life that should be the heritage of us all; on behalf of the women—the women upon whose bare backs falls the untempered lash of the primeval curse declaring that "in sorrow thou shalt bring forth children," the women with the pride and glory of their lives broken and destroyed, and the flower of motherhood turned into nothing but decaying weeds; and on behalf of the children—the children who are thrust into this world unwanted, unwelcomed, uncherished, unsustained, the children who do not bring "trailing behind them clouds of glory" but the taint of inherited disease, and over whose heads there stands for ever the haunting horror of inherited madness: on behalf of them I also would appeal and for all who believe in the great future of our race, and I would beg of you, I would earnestly entreat you, to support the Motion that I beg to move.
§ Move to resolve, That His Majesty's Government be requested to withdraw all instructions given to, or conditions imposed on welfare committees for the purpose of causing such committees to withhold from married women in their district information when sought by such women as to the best means of limiting their families.—(Lord Buckmaster.)
§ THE LORD PRIVY SEAL (THE MARQUESS OF SALISBURY)
My Lords, I was quite certain when I came down to your Lordships' House this afternoon that we should listen to a very eloquent speech from the noble and learned Lord, and I am sure that I and your Lordships have in that expectation not been disappointed. Although I shall have occasion to controvert to some extent at 1008 any rate what the noble and learned Lord has said, I desire upon my own behalf, and I believe I may also say on behalf of your Lordships, to thank the noble and learned Lord for the eloquence of his speech and the wonderful conviction with which his eloquence was sustained.
I approach this subject with very great diffidence because I know the deep passions which these subjects always excite, and rightly excite. But I should be very sorry if a mistake were made by your Lordships this afternoon because what is really concerned is the success of the great policy of hygiene which has been the characteristic of the last half-century in this country, and which has met with such success. Of course, everyone who listened to the noble and learned Lord must have sympathised most deeply with the feelings which he expressed in respect of the wretched cases of misery and sorrow the details of which he gave to your Lordships. Of course we sympathise with him, and of course we will do our utmost to prevent them. But we must be very careful indeed that in finding a remedy for the evils he detailed we do not strike a fatal blow at a great service which is doing infinite good at this moment to the very class for which the noble and learned Lord pleads.
I do not for the moment go into the big question of how far population should or should not be increased; I may have a word to say about it before I sit down. But I want to deal with the plea of the noble and learned Lord that we should do something to prevent the sorrows of the poor, especially of the poor women who are engaged in bearing children. There is a system in operation to which the noble and learned Lord refers in his Motion but about which he said nothing in his speech—the maternity and child welfare system of this country. The care which is given under that system has grown enormously and with immense success. I dwell upon this matter because it is vital to the reason why I am resisting the Motion of the noble and learned Lord. I dwell upon it also because I want the noble and learned Lord and your Lordships to realise how very anxious we and all those who care about this subject are to help the very class of people for which the noble and learned Lord pleads.
1009 The maternity and child welfare system has been in existence for a certain number of years and has grown enormously. May I remind your Lordships, though I expect most of you know it very well, that there are over 400 maternity and child welfare committees, which are committees sometimes of the county council and sometimes of the lesser local authority. Under these committees there are a large number of centres—over 2,000—scattered all over the kingdom and engaged in this work of helping expectant mothers and mothers who have just had children. These centres are composed, in the first instance of course, of representatives and members of the local authorities. But that is a very small part, or only a part, of the personnel which looks after these things. They are assisted by a large number of voluntary workers co-opted upon the county council or local authority committees. There are voluntary workers in the centres in every part of England, and their support is absolutely vital to the success of the system.
The centres are very successful. They are manned, as I have said, by independent persons, by compassionate ladies, by those whose calling leads them naturally to look after all the compassionate and charitable services of the country. They belong to this system and it could not be carried on without them. As I have said, they have great success; their ministrations are usually overcrowded. I believe I am right in saying that there are, roughly speaking, 700,000 mothers who bear children each year. Of those upwards of one-third probably—the figure is very large—take advantage of these maternity centres, and the success not only of the movement but of that of which it is a symptom has been very great. The mortality among children under one year of age has gone down by fifty per cent. since 1900. I want your Lordships to reflect upon the fact that this movement, which is spread in all parts of the country, is availed of by a very large proportion of all expectant mothers and those whose children are just born, with such success that the mortality among children of under one year has gone down by fifty per cent. since the beginning of the century.
I dwell upon this because I am most anxious to induce your Lordships not 1010 to take any step which will prejudice the success of that movement. If, as I believe, most of your Lordships share the compassionate feeling of the noble and learned Lord, you ought to be doubly anxious to do nothing to injure the success of this great system. Unless the noble and learned Lord is very careful he will strike a fatal blow at if, because he is proposing to bring within its purview a subject which is alien and in the highest degree controversial. It is alien because this system is concerned with the object of producing children, while the movement to which the noble and learned Lord directs our attention is concerned with the object of not producing children. The psychology is entirely different. It may be useful, it may be necessary; but the kind of people who are interested in the one are not necessarily interested in the other. Indeed, we find that is the case. I have made some little inquiry and I find that to bring this other subject within their purview would profoundly shock a very large number of those who are engaged in this voluntary work.
I hope the noble and learned Lord will understand that I am not saying for a moment whether they are right or whether they are wrong. I am merely recording the fact that it is so. He mentioned the Churches and spoke, in one of his most eloquent passages, of his difference with the great Roman Catholic Church. The feeling on this subject is not confined to the Roman Catholic Church. A large number of religious bodies share the views, I will not say in their intensity but to a large degree, of the Roman Catholic Church. And it is not only religious bodies who share those views. I have received a resolution from the Mothers' Union, which represents a very large number of women. I do not know what view the noble and learned Lord may have of that organisation and I do not want to put it too high, but I know it represents a very large number of women of the lower class. My noble friend tells me it is 700,000; I had not the figures. That is a very large number. I have received a very strong resolution, drafted, I think, in terms which go beyond that to which I would subscribe, against the noble and learned Lords Motion and urging your Lordships not to pass it.
1011 Supposing a large number of those voluntary workers who agree with the Roman Catholic Church, or who agree with the other Churches—I believe I am right in saying many of the Nonconformist bodies take the same view—and supposing a number of ladies interested in the Mother's Union, or men similarly interested, were to resign and throw up all connection with the maternity and child welfare centres because of the introduction of this subject which is really alien to the original purpose and practice of the maternity and child welfare centres, what would become of this great and successful movement? What right have we to interfere with its prosperity and with the popularity which it enjoys? Why should we offend a number of people whose support is really essential? If we did anything that would interfere with the success which has hitherto characterised these centres, I submit to your Lordships that we would be extremely rash. It is for that reason in the main that His Majesty's Government cannot support the noble and learned Lord's Motion. We think it would be a thousand pities, however strongly we sympathise with the noble and learned Lord's feelings, to spoil what is essential to the welfare of the very working classes for whom the noble and learned Lord pleads, by introducing this alien and highly controversial subject into what is not controversial and what is so eminently successful.
I would like to go a step further. Let us consider for a moment how this would work in these welfare centres. Are we quite sure that these Indies and gentle men who would withdraw their support in consequence are entirely wrong? If you issued an order that the medical officers attached to these centres were to give this information and take this course—
§ LORD BUCKMASTER
I do not ask that they should be ordered to give the information. I ask that they should be allowed to give it.
§ THE MARQUESS OF SALISBURY
The noble and learned Lord is fully justified in that correction; it was a slip of mine. If the local authorities give the directions—the noble and learned Lord would leave it to the local authorities to give 1012 such an order—it would be for the county council or district council to arrive at a decision—
§ LORD BUCKMASTER
It is not that at all. I am asking that it should be left to the unfettered discretion of the medical officer who has charge of the cases. That is the real point.
§ THE MARQUESS OF SALISBURY
Even so, if the officer did it he would do it as an official and in his official position. The noble and learned Lord cannot escape from the fact that the medical man would be an official, and would do this in his official position.
§ THE MARQUESS OF SALISBURY
A man in an official position may mend a broken leg. I suppose he would be the doctor attached to the centre. Could he discriminate? The noble and learned Lord said that he wants him to deal with those unfortunate women whose health is deeply prejudiced by the number of children they have had and by the conditions in which they have had them. Most of us deeply sympathise with the noble and learned Lord's account of those people, but the applicants in these cases will not be confined to those women. The noble and learned Lord must look as a man of the world at the other side of the case. It is not only the sick women, or the miserable women, or the women whoso health has been undermined, who will apply. There are indolent people and vicious people. We must face that.
The movement for birth control is not confined to people whose health dictates that they ought not to have any more children. Everybody knows that the movement for birth control is largely supported by women who could have children but who prefer not to have them—married women, women who do not do their duty, women who prefer their own ease to the obligations that they have undertaken, women whose duty, not only to their husbands, but to their country, is to bear children and who will not do so. Birth control is far more common even than the number of cases to which the noble and learned Lord has drawn our attention would lead one to suppose. We may be deeply sorry for the unfortunate, the 1013 unhappy, the wretched and the miserable women, but we have no pity whatever for the lazy woman. And it is not only the lazy woman; it is the vicious woman.
Supposing a woman wants to have a relation and not to have the consequences of it. She goes to the doctor at one of these centres, and he has received official sanction that he may deal with these cases. He may be a very nice man—or she a very nice woman, for it is more often a woman than a man—how can he or she discriminate? How can he say: "I gave Mrs. Brown information because she was a woman whose health dictated that I should give her such information, but you, Mrs. Jones, ought to have children, and I cannot give it to you." How can he refuse to give Mrs. Jones the information he has given to Mrs. Brown?
§ THE MARQUESS OF SALISBURY
Yes; but this is not a private doctor. It is an official doctor. The noble and learned Lord knows perfectly well that you cannot make those distinctions. How can the doctor sit in judgment and say: "I consent to tell Mrs. Brown but I refuse to tell Mrs. Jones." Of course he cannot. He would have to accept each one as she came to him. I do not want to push any argument too far, but, broadly speaking, I say that is what he would have to do. It does not matter very much what I think or what the noble and learned Lord thinks. What matters is what will be thought in the country, What is the impression which will be given to the public throughout the country? It will be said: "The House of Lords or His Majesty's Government have agreed that henceforward, so far as their official sanction is concerned, a woman may choose for herself. It does not matter even what her husband thinks."
I would like to ask this: Does the noble and learned Lord not think, in these cases of which I have spoken, that the husband ought to be considered? I am not speaking of the sad, miserable cases of which he spoke; I am speaking of the indolent women. Is the husband not to be considered? Are they all to be allowed to go to the official doctor and get advice on how they are to avoid 1014 bearing children whether the husband likes it or whether he does not? Is that to be the decree which is to go out from your Lordships' House? Is that to be the sanction which is to be given by His Majesty's Government? We must look at that side of the case. I hope your Lord ships will distinguish between the deserving cases and the undeserving, and that you will not, because you are impressed with the deserving case, commit yourself to a policy that will do infinite harm.
Let me say one word about the deserving cases. I do not want to diminish unduly any of the effect of the noble and learned Lord's plea, but surely he rather over-stated the matter in respect even of the hard cases with which he dealt because a good deal applied to the increase in the population of degenerate or defective children. These women would not go to these organisations.
§ LORD BUCKMASTER
These cases I have quoted are the cases of women who have come for this very help which you say they will not come for.
§ THE MARQUESS OF SALISBURY
They may have come in certain cases, but the women whose mental condition makes the results so deplorable are not the people who come for assistance to anybody, because their minds are not qualified to form a rational conclusion at all. Therefore these cases must be eliminated. I do not want to press this point unduly. Take the hard cases themselves. It is not true that they are absolutely unable to get relief. I would like the noble and learned Lord to realise that they can go to the doctors just as richer people can. It is a great mistake to think that they are utterly ignorant in these matters. Of course poor women are ignorant in matters of science, but in these human matters they know just as much as richer women. They are able to go, for a small fee relatively, to the doctors whom they generally consult. However that may be, 1015 I would ask your Lordships not to allow these hard cases to influence you over much.
I would like to revert for a moment to what I said just now of the effect of giving the impression that Parliament or His Majesty's Government have an open mind upon the abuse of birth control. I am more impressed every year with what I may call the influence of legislative suggestion. The reason we pass Bills in favour of thrift is not merely that it makes people thrifty by direct enactment but because the sanction of Parliament has an immense influence on the habits of the people. The same reason applies to all drink legislation. The action of Parliament has immense influence on the habits of the people. It is a sort of official endorsement which they accept, and if that can be done for a good purpose it can also be done for an evil purpose. It may have a good effect, it may also have an evil effect. If it has an evil effect, how deep will that evil be?
I have spoken of the moral effect, but I ought to say also a word on the material effect. I should have thought that the noble and learned Lord would not have spoken with such indifference of the fall of the birth rate in this country. He seemed to think it was rather a good thing. I think it a very serious thing. He seemed to suggest that he would like to see the increase of the population checked. I am not speaking of hard eases. These hard cases, though deplorable, represent a very small proportion of the whole. He seemed to think it was a good thing that the vast mass of the healthy population should be diminished. I venture to say that the more health English men and English women are produced the better. They have not merely to populate our own country but to populate our Empire. There are vast unfilled parts of the world to which they ought to go and the population is going there. Just consider for a moment what the figures are. In the decade 1871 to 1880 the births were 35 per 1,000. In 1924—the last year for which I have figures—they were only 18 per 1,000. They have fallen by one half in those very few years. The noble and learned Lord said that the population is increasing. It is true it is increasing, but it is because of the shrinking death rate and not because of the increasing birth rate. It is because 1016 of the success of these maternity and child welfare organisations of which I have spoken. That is the reason which has disguised the other and kept it out of sight.
Let me refer to what is happening in other countries. Look at France. The processes to which the noble and learned Lord referred are most popular in France. Birth control is the commonest thing there, but far more than that is prevalent in France and the population is actually going down. It is less every year than it was the year before. That is the real catastrophe in front of European civilisation, not the catastrophe to which the noble and learned Lord has referred. The real catastrophe is that the white races will begin to diminish. It is not true, of course, of the Slavs yet, but the Germans are going back, not positively yet but the ratio of increase is going back. It is going back in our own country. It has got to such a point in France that actual diminution has taken place. We must do nothing to give countenance to that process. That is vital. In that direction national death lies. We must not be afraid of hardship, though misery we must do our best to remedy. For these reasons I hope your Lordships will not pass this Motion. I will only reiterate that it is not from want of any sympathy with the kind of case to which the noble and learned Lord has referred, but because we feel that in the great movement of maternity and child welfare organisations immense hope lies in the direction of maintaining and increasing the population. That does really succour the miserable and help the unfortunate. Do not strike this controversial note and spoil it. Leave it to do its work. Follow the example set you in another place and do not lend any countenance to the official sanction of birth control with all its dreadful suspicion.
THE LORD ARCHBISHOP OF CANTERBURY
My Lords, the House has listened to-night to a speech of characteristic eloquence and pathos and persuasiveness. The eloquence of the noble and learned Lord has always, to me at least, the power of evoking sympathy or the desire to feel the fullest sympathy for all that he contends. If I thought that the case as he presented it to-night corresponded in fact with what he said 1017 I should reach his conclusion and agree with him. It seems terribly prosaic after such an appeal as he set before us to come down to the actual facts on the particular point that his speech raised—that is to say, the attitude of the Ministry of Health to the maternity and child welfare centres throughout England. That, and nothing beyond it, was what was covered by the Resolution which the noble and learned Lord moved. That Resolution is technical in its character and is limited in its application. The words are perfectly plain. The noble and learned Lord moves—and I ask your Lordships to note carefully the terms of his Motion—That His Majesty's Government be requested to withdraw all instructions given to, or conditions imposed on welfare committees for the purpose of causing such committees to withhold from married women in their district information when sought by such women as to the best means of limiting their families.I believe the noble Lord's Motion to be based on a misapprehension. There are no such instructions, at least none that correspond to the description that he has given—or at any rate, if there are, I should like to see them, for I have failed to find them either at the Ministry of Health or elsewhere.
§ LORD BUCKMASTER
The most rev. Primate is under a profound misapprehension. Is it not a fact that they impose conditions upon these centres and tell them that if this information is given the grant will be withheld?
THE LORD ARCHBISHOP OF CANTERBURY
I have so far failed to get them. If the noble and learned Lord could give me that letter—
THE LORD ARCHBISHOP OF CANTERBURY
Thank you. To understand what is happening I think we ought to consider for a few moments what are the places to which the noble and learned Lord refers and what is their object. The noble Lord speaks of welfare committees, 1018 but that is not the technical phrase. There are maternity and infant welfare centres, and it is to these, I gather, that the noble Lord refers when he speaks of welfare committees. These centres include two classes which may be independent or may work together in combination; one is the maternity and ante-natal centre and the other is the infant welfare centre. The two may be, and constantly are, worked together, though they are not necessarily dependent on one another.
These centres may be established—I am saying what to many of your Lordships is only too familiar, but I should like to put it again—either by a local authority or by a voluntary body, or by both, and they can receive aid from public funds towards their expenses. They are founded for a specific purpose—namely, to secure healthy birth both in the interests of the mother and child, the birth of children who shall start their lives in a healthy manner. Again and again that has been reiterated as the object and purpose of these infant welfare centres. This is secured by the observance being taught to the mothers of well-ascertained and well-established laws as to the pre-natal treatment of the mother and post-natal treatment both of mother and child, and tend to bring about, as we hope and believe, the upbringing of a healthy race. Of these centres there are 2,122 in England to-day and at 641 of them—nearly one-third—pre-natal work is carried out.
Evidence of their value has already been given by the noble Marquess, but I might reiterate that it is easily shown by figures. Prior to the formation of any such centres the death-rate of children under one year old was very high. In 1905 the death-rate was 128 per thousand, in 1910 it had fallen to 110, after many of these centres had been established, and it is now seventy-five per thousand. That fall, of course, goes far to conceal or disguise the effect of a rapidly falling birth rate. The noble Marquess has already referred to the falling birth-rate in England and told your Lordships that in 1924 it had fallen to eighteen per thousand as compared with twenty seven per thousand in the previous decade—I think in 1910. The gravity of that falling birth-rate is counteracted by the corresponding fall in infant mortality. The 1019 manner in which these centres produce that result is, when one observes it on the spot and goes into it with the workers, more marvellous than one could have expected beforehand to be in the least possible. The way in which the expectant mother and the mother with the young child flock round and cling to these centres to receive the instruction which they need and the friendships that they have formed with the workers, male and female—especially female—are such as almost to change the character—I was going to say of the whole neighbourhood, but certainly of the upbringing of little children in the poorer regions.
In addition—and this is important to remember—to these subsidised maternity and welfare centres, there are now in England a good many of what are called birth control clinics, established wholly by voluntary agency, and supported either by voluntary subscription or by the fees of the patients, or by both. These are primarily, and even avowedly, for giving advice to married women who desire to limit their families or not to have another child. They profess to give that advice only to married women. Whether that is so I do not know. In the maternity centres with which we are concerned and have most to do no distinction is drawn as regards giving advice and help between married and unmarried expectant mothers. We are equally careful with regard to the expectant mother whether she be married or unmarried, our object being to produce a healthy confinement and a healthy child, and that both mother and child shall have the advantage of the wisest advice to this end.
Is it realised that those who desire to obtain the advice that the noble Lord is anxious should be given at our maternity centres officially can obtain it in that other way, although I quite admit that it is a very different thing from obtaining it in the way that he is now suggesting? We make no kind of suggestion that there should be any restriction or interference with these birth control centres, which have been established for those who desire to use them and are supported by some exceedingly thoughtful people in this country. The noble and learned Lord asks, if I understand him aright, why the advice there given cannot be given in all the welfare centres and why it 1020 should be necessary to go to these voluntary bodies in order to obtain advice which might have been given by maternity and infant welfare centres. He goes on to say that the officers in these centres are prohibited from giving that advice on pain of losing their grants. I think the noble and learned Lord said that he had a letter to that effect. I should like to see it, for I have hitherto failed to obtain such a letter.
§ LORD BUCKMASTER
My noble friend Lord Balfour of Burleigh, I think, has the letter and will read it in a moment. I omitted to bring mine down.
THE LORD ARCHBISHOP OF CANTERBURY
I should be very much interested to hear what my noble friend Lord Balfour of Burleigh says.
§ LORD BUCKMASTER
Of course, if they do not give those instructions there is an end of the matter. If the Government will get up and say that they do not place any such conditions on these people, then the whole thing is at an end.
THE LORD ARCHBISHOP OF CANTERBURY
I hope before I have done the noble and learned Lord will sec that it comes very near it.
THE LORD ARCHBISHOP OF CANTERBURY
Is it the fact that these instructions are being given in that definite way? The correspondence which has taken place with the various clinics has been placed in my hands. They sought advice from what we may call official quarters, and the answers which were given do not go nearly as far as the noble Lord has stated to-night, and the only letter which spoke of the possibility of a withdrawal of the grant was a conjecture based upon the fact that it had not obtained a satisfactory answer.
I know, of course, very well, medical men and health visitors who are at work in some of these large centres, and the noble Lord's Resolution having been postponed I have had an opportunity, during the last few weeks, to make in- 1021 quiries and to put myself in close touch with the workers in these various centres. I find a perfect assurance everywhere, firstly, that the number of applications for advice of that particular kind is rare—not unknown, but rare—and secondly, that no restraint whatever is put upon the doctor if, upon medical grounds, he thinks it necessary to give advice respecting child-bearing, but he is under no obligation to give such advice. He is not there as a public officer who is bound to give an answer to an inquirer upon that particular subject.
Surely that is rightly so. Very many of these people object on principle to giving such advice in anything but the most rare and exceptional way, and if they were bound to do it on every inquiry they would feel themselves in an impossible position. Moreover, many of the other patients object to the centre being used for such a purpose, and the public outside, whose aid supports our health and maternity and welfare centres, object, many of them, very much indeed to such advice being given. It may be said that if patients do not like it they need not ask for it. I wonder how many of your Lordships have studied the manner in which these maternity centres are worked. It is not merely by individual advice, but by advice to mothers in a group. It is given to married and unmarried. If the advice and guidance to be given is to cover questions as to how in future years they are to regulate themselves with regard to the number of their children, and if such advice is given to unmarried as well as married women, we can see what a condition we launch into with regard to the moral obligations that are being placed upon doctors and centres.
If you look at the Rules which the Ministry of Health issues you will find thatcollective teaching may be given either on the consultation day, when most of the mothers will be present, or on other days for women who wish to learn about some special subject. On consultation days the teaching will usually be limited to short, simple 'health talks' by the Super-tendent on subjects of general interest, and accompanied, when possible, by practical demonstration.I want your Lordships to realise that we are not speaking simply of the power of the doctor, which is not restrained, to give individual advice. If you pass a Resolution like this on the Paper you lay 1022 upon these men, who are public officers, a moral obligation to give that advice to groups who ask for it.
But that is not all. We have not had them quoted to-night, but the two Regulations which do exist, and upon which the noble Lords Resolution rests, are as follows:—(1) That the maternity and infant welfare centre should deal only with the expectant or nursing mother (and infant) and not with the married or unmarried woman contemplating the application of contraceptive methods.(2) It is not the function of an antenatal centre to give advice in regard to birth control, and exceptional eases where the avoidance of pregnancy seems desirable on medical grounds, should be referred for particular advice to a private practitioner or hospital.I am prepared to say that I do not think that the second of these two Rules is worded in the best way. I do not think it is exactly what the Ministry of Health meant, but the medical man or woman wants, in my judgment, to be protected against having that moral obligation laid upon him or her to give advice upon this subject of contraceptives, which advice he or she may not wish to give and which those who are supporting and guiding them do not wish should be given.
In order to satisfy myself further I made inquiry from some of the highest authorities in the Ministry of Health and I ask your Lordships' attention to this memorandum, which I have had drawn up from the conversations which I had with the highest authorities as to what happens now:—In all cases attending the clinics where this information is necessary on medical grounds advice is always given by the doctor irrespective of any request on the part of the mother. Neither by the wish of the mother nor by statistical evidence have we been led to believe there is any great demand for this kind of advice. In suitable eases recommendations have been strongly made that the use of contraceptives should be discontinued and we have reason to know that the advice has been acted upon with satisfactory results.The extreme medical cases in which another birth would be likely to prove disastrous to the mother are few and far between. Such cases would not ordinarily attend a maternity and infant welfare centre; but if and when they did, it may be safely assumed that the mother would be advised as to the right course to adopt in order not to have any more children.The purpose of the maternity and infant welfare centre is to deal only with 1023 the expectant or nursing mother (and her infant), and not with cases of disease on the one hand, or, on the other hand, with married or unmarried women contemplating the application of contraceptive methods. The object of these centres is—(1) to advise the expectant and nursing mother; (2) to provide ante-natal supervision; and (3), to care for the infant. In order to conserve the purpose of these maternity and infant welfare centres, it is necessary to exclude any systematic or organised work in the direction of contraception.It was made perfectly clear that no sort of restriction was placed upon medical men.
I asked further whether if the medical man or woman did give this advice it would mean either the withdrawal of the grant or discredit to the individual. The idea was laughed at and I was told: "Nothing of the kind." There is no sort of interference between the patient and the doctor desired or thought of. If that is so, what becomes of this Resolution? We really are asking for something to be withdrawn which, so far as I can sec, does not exist. I admit that the second of the Regulations which I read is unfortunately worded and I cannot; help hoping that as the result of this discussion to-night, the Ministry of Health will think it advisable to revise the wording of that Regulation. But if it is revised in the direction of what I have just read—which emanates from the Ministry of Health—it will be seen that, in vulgar phrase, that practically knocks the bottom out of the grievance which is supposed to exist.
In these circumstances I cannot help thinking that the Resolution is really based upon a misunderstanding. There is no sort of wish, as I have been told again and again, both in the centres and at headquarters, to intervene between doctor and patient, but the officer does not wish to be morally forced to give such information against his or her will. And surely that restriction is wise at the present time. Not only is there the widest possible difference of opinion on the ethical side of the question, but what about medical knowledge? This is, again, another point which, I think, is of high import when dealing with this subject. What is the medical knowledge which is supposed to be used by those who, if the noble and learned Lord had his way, would be invited, or pressed, at all events encouraged—and by this 1024 Resolution of the House very much encouraged—definitely to give that advice now? Let me quote the opinion of one whose opinion on this subject will carry great weight, Lord Dawson of Penn, who, to my regret, is not present to-day.
I have had talks with Lord Dawson of Penn about it, and I have read the evidence which he has given on the subject. Let me quote what he says:Up to now there has been no systematic investigation of contraceptive methods by the medical profession in this country, though such an investigation is now proceeding in the United States.Are we to come in at the moment when there has been no systematic investigation of this subject, and lay upon the men and women who are at these centres the moral obligation—I will not put it higher than that—of giving information about something upon which medical opinion is still so uncertain and so undivided and to so large an extent uninformed? I am not prepared, as I have said, to stand for the words of the Regulation which I have quoted, such as it is, but it does seem to me, with what I have also read before, and with such testimony as Lord Dawson of Penn has given with regard to the present uncertainty of our knowledge on the subject, that it would be intolerable to lay upon the medical authorities the duty of giving such advice.
I have said nothing about the great ethical and religious question which lies behind all this discussion. I should be perfectly ready to take part in the discussion of that subject, and to bear my part in it if it were necessary, but the noble and learned Lord's speech in eloquent terms dwelt on that subject and he quoted a letter of my own prefixed to a book by Lady Barrett. To every word I have said there I entirely adhere. I have never been able to take the stern and uncompromising view of some people on this subject, who think that the thing per se is wrong and evil, although I discourage it by every means in my power. The question now divides us. The words I would rather choose to adopt would be such as these. They come from the Report of a very strong Committee of clergy of the Church of England and Nonconformists which recently sat on this subject. They say: 1025The use of contraceptives is a symptom of the artificial character of our civilisation where by, for large numbers of people, the simple, healthy, normal married life is difficult, and in some cases all but impossible. There are numerous cases in which control of conception, considered in itself and apart from the question of the methods employed, is medically necessary and economically advisable, but in every such case all the circumstances should be weighed in the light of the best available scientific and ethical counsel.That is not a direct negative to the doing of what is asked for to-night, but I do believe that by a Resolution such as this House is asked to pass we should be doing very real harm by encouraging what I believe requires discouragement and not encouragement.
Of course, the conditions of life are artificial, and the problems for many parents are extremely acute. The sympathy of every one of us is elicited by such stories as the noble and learned Lord brought forward to-night. But Lord Buckmaster will pardon me for saying that we have had these cases again and again, which causes a little wonder whether they are quite as numerous as some people suppose. I think the case that Lord Buckmaster quoted to-night has been before me from seven or eight different quarters during the last couple of years. I have heard it again and again. I have spoken of it to the men and women at the health centres—
THE LORD ARCHBISHOP OF CANTERBURY
The case of the woman who was confined of six children in the bedroom. The story which the noble and learned Lord told is one I know almost by heart I share to the full, so does every one of your Lordships, the very deepest sympathy with those cases. There are such cases, they are horrible cases, and there are also cases not nearly so bad as that which still are entitled to our fullest possible sympathy, and I feel extreme perplexity in knowing how we ought properly to deal with them. But I do feel that now and then the repetition of a few tragic cases is apt a little to make people suppose that they are more normal than they really are. We have not tried in the Church of England to lay down absolute rules upon this subject which will meet the needs of every abnormal case, and we have definitely 1026 said so in the gatherings of Bishops which have been held on the subject. We regard with grave concern any increase of the habit of contraception, but we decline to lay down rules which will meet the needs of every abnormal case. At any rate, I, for one, do not dare to face the mischief we should do were we to pass a Resolution which would disquiet and divide our best workers in the very cause for which we all care, and I dare not seem to urge or assent to as a normal thing a mode of procedure which may easily, if it became the rule, create or augment some of the very greatest evils which confront us in the social life of to-day.
LORD BALFOUR OF BURLEIGH
My Lords, the course of the debate so far clearly shows that there is a good deal of misapprehension on this subject, and I am bound to say, with very great respect to the most rev. Primate, that I believe the misapprehension to be on his part, rather than on the part of my noble and learned friend who moved the Resolution. The attitude of the Minister of Health, it is perfectly true, has not been laid down by definite Regulations. It is perfectly true that there is no written Regulation forbidding this information to be given in the circumstances in question. But the position is nevertheless perfectly definite. In every infant welfare centre which I have visited the condition is perfectly well known, and is rigidly observed. The most definite information that I have upon it is derived from a letter addressed to the Edmonton Urban District Council by one of the officials of the Ministry of Health. The most rev. Primate read part of this letter. It reads as follows:—I am directed by the Minister of Health to refer to your letter of the 4th inst. with regard to the subject of birth control, and to state that the Minister has adopted the policy laid down by his predecessors with regard to this matter which is set out in the following principles:—(1) That the maternity and child welfare centres should deal only with the expectant and nursing mother (and infant) and not with the married or unmarried woman contemplating the application of contraceptive methods.(2) That it is not the function of an ante-natal centre to give advice in regard to birth control, and that exceptional oases in which the avoidance of pregnancy seems desirable on medical grounds should be referred for particular advice to a private practitioner or hospital.1027 It is perfectly clear to me that the misapprehension has arisen owing to those words "exceptional cases in which avoidance of pregnancy seems desirable on medical grounds."
It seems desirable that the representative of the Government should tell us exactly what is meant by those, words. My information is that they refer definitely and rigidly to cases in which a further pregnancy will mean danger to the life of the mother. I am sorry to trouble your Lordships with medical details, but the cases are very few and are easily expressed. I am told that it means one of two things—either a particular form of disease of the kidneys or else a physical condition which is known as restricted pelvis. I am given to understand that the phrase in the Minister's letter refers to those two cases and to no other cases of any sort or kind. Even in those cases I believe that the exception made by the Minister of Health—that they can be told where to go for the information—is illusory because a case has been brought to my notice in which a woman to whom that description applied went to a hospital and asked for the information. She was told that it was perfectly true that pregnancy would involve great danger to her life, but they refused to give her the information. I do not insist upon that because I believe it is the intention of the Minister of Health that those cases should be dealt with in the way required.
But that exception does not touch such cases as my noble friend referred to in moving his Motion. The most rev. Primate threw some scorn upon these cases as having been brought to his notice half-a-dozen times in the last two years. I venture to say that is not quite fair. Expressed in a more general way, the cases in which the noble and learned Lord wants information given are cases where there is disease, say, tuberculosis or venereal disease, and where children would be been diseased. I was given the case of a woman who has had three children in two and a-half years; the eldest is blind, the second is blind and the third is going blind. Surely it would have been better for the woman, the children and the State had those, children never been born, and there are hundreds and hundreds of cases of that kind. I want to make the point that it 1028 would be very desirable if the Minister of Health would extend his definition of medical cases a little to cover those cases, but it would not meet the case my noble friend wants to meet by moving this Motion, because it is illusory to instruct the doctor that he may tell the woman where to go.
It is suggested that she may go to a hospital or a private practitioner. In the out-patients' departments of big hospitals they will not or cannot give this information. To begin with, the out-patients' department is not a very suitable place for the purpose. The woman would have to apply and be examined and instructed in the presence of a crowd of students of both sexes. You cannot expect any woman to do that. An even stronger argument is that if a woman goes to a hospital and asks for this information in other than the very extreme cases I have described she is simply told to go about her business. They do not regard it as their business. With regard to the private practitioner the most rev. Primate said that it was easy for a woman to go to the practitioner she was accustomed to consult. A woman of this class has not a private doctor in the way that your Lordships have. If she is ill she goes to a hospital.
LORD BALFOUR OF BURLEIGH
I beg the most rev. Primate's pardon if I misrepresented him; it may have been said by the noble Marquess. These women do not have private doctors to whom they can go, and if they go to a doctor they will be told probably to go about their business.
The point I want to make is that we-are not discussing the general question of birth control; that is agreed. We are all agreed that the refusal of the duties of parenthood by married people for selfish reasons is reprehensible and we do not want to see a broadcasting of this information to young people who will be hurt by it.
But what work is done by the centres? Primarily, the centres have the object of educating the mothers. They are to give advice and teaching on the care and maintenance of the health of small children. The people who go to them are 1029 Mothers, and they only go because they are mothers. The people who want this information are mothers who feel that if they have any more children they cannot do justice to those they have already. The centres know all about the women who go to them. Each one has a qualified medical officer in charge and health visitors who visit the women in their homes and follow up the cases. It is obvious that that is better machinery for disseminating this information in cases where it must be disseminated than a birth control clinic or some other organisation which cannot follow it up or cannot really judge to whom the information is being given. It is perfectly true that collective as well as individual teaching is given at the centres, but it is obvious, surely, that the medical officer of a centre will not choose one of his classes of married and perhaps unmarried women, if they attend, in order to disseminate the information. He would do it in a private way.
The noble Marquess referred to the question of the voluntary workers, and made the point, which I think is one of the most important he urged upon your Lordships, that the support of the voluntary workers was vital to this movement. It is perfectly true that it is most important to retain the support of the voluntary workers, but I have a resolution passed by some of the voluntary workers which indicates that: as a body they are in favour of this step. It kills two birds with one stone. It is good evidence that the embargo of the Minister of Health is a very real thing. The resolution was passed in February last by a meeting of the London workers' section of the Association of Infant Welfare and Maternity Centres, a body which is particularly devoted to the voluntary principle as opposed to the municipal. By thirty-two votes to seven they adopted the following resolution—The London Workers' Section beseeches the Ministry of Health to remove the embargo on the giving of information on birth control at infant welfare centres by the medical officer in charge to cases when he or she considers it necessary, and draws the Ministry's attention to the danger of the indiscriminate sale of birth control literature and the display of contraceptives.The noble Marquess seemed doubtful as to whether the medical officers in charge of centres could discriminate or not. I 1030 have sufficient confidence in the medical profession to be prepared to leave that duty to the medical officer in charge. The noble Marquess made the point that women might go who were not entitled to the information. Women in the well-to-do classes who want that information and are refusing the duties of motherhood have no need to go anywhere near these centres. They are perfectly well able to afford to pay for the information and have only to go to a private doctor to get it.
In addition to the individual argument, we have, I think, to look at the question from the point of view of the race. The noble Marquess made a point of the declining birth rate in France. The declining birth rate in France is important, because the death rate is still so high. The declining birth rate in this country is not the important thing. The important thing is the survival rate of healthy children and in that connection the analogy of Holland is worth looking at. In Holland information about contraceptive methods has been placed at the disposal of the poorest people for the last thirty or forty years. It is true that the birth rate has fallen, but it has not fallen by anything like so much in the educated classes as it hap in this country. The birth rate of unskilled labourers compared with professional people in this country is two to one, or more. In Holland, where this information has been provided, it is something like five to four. Another observation I should like to make from the point of view of the welfare of our race and of our country. What could be a greater recruiting agency for Bolshevism than the irresponsible and ignorant propagation of the unfit as it is going on to-day in the slums of our industrial cities?
The opposition to this Motion has nothing whatever to do with the ethics of birth control, as the most rev. Primate pointed out. It is a question of giving this information to women who are entitled to it on medical grounds, in a broad sense, in the welfare centres, by medical officers who will do it in a proper way. The opposition—we are bound to face the fact—is largely on religious grounds. Your Lordships no doubt have had letters written to you. I have received one from the Mother's Union. I desire to speak with the greatest possible respect of the Mother's Union, but in this connection I think it 1031 is fair comment to say that its opposition is based rather upon its being a body of religious people. It is the religious aspect that is their chief concern. It is the same with doctors. One sometimes hears doctors arguing against this proposal, but one always finds that in addition to the fact that they are doctors they share in the religious point of view. Religious people who take this view may be right or they may be wrong, but it is quite certain that religious people are not all on one side.
The real objection which I take to the religious standpoint is this. I cannot see that religious people have the right to impose their point of view on women who are helpless simply because of their poverty. They have not the right to prevent these women having access to information which their richer sisters can get. These women have just as good a right to know and to choose for them selves. For that reason I think people who are opposed to birth control but who do realise the necessities of the particular case and do attach some importance to the principle of the liberty of the individual, will support this Resolution. Do not forget that it is permissive. After all, there is no interference with conscience. It is absolutely permissive. The centres that do not like it will go on just as they have done hitherto. It seems to me that the coercion is much more on the side of the people who are preventing the information from being obtained than on the side of the people who propose to give it.
I heard with very deep regret the noble Marquess the Leader of the House say that he was unable to accept this Resolution. Surely it is not right that this question should be made a Party question. It has nothing to do with Party polities. It has got nothing to do with loyalty to the Conservative Government. I do hope that the Leader of the House, if he is not able to say anything further and if it goes to a Division, will not think it necessary to make it a test of loyalty to the Government. Apart from the merits of the question, it seems to me rather absurd to do that. The, Minister of Health in another place only last year gave this answer to a question on the subject:—I am in agreement with the views of my predecessors that institutions provided 1032 at the cost of the public funds should not be used for so controversial a purpose without express directions from Parliament.Here is public opinion attempting to manifest itself through your Lordships' House and we are threatened with the Government Whip. The position really is absolutely illogical and I venture to say that it is absolutely wrong. For that reason, unless some more favourable answer is given by the Government, if my noble and learned friend opposite thinks fit to go to a Division, unwilling though I should be to vote against the Government, I shall feel it my duty to support him with my vote.
§ VISCOUNT FITZALAN OF DERWENT
My Lords, I should like to say a few words in opposition to this Resolution, and in doing so I wish most emphatically to state that I fully believe that the noble and learned Lord, in moving it, is actuated solely by the highest motives for the amelioration of human suffering. But that does not alter the fact that if this Resolution is passed by your Lordships' House your Lordships, in the view of many people, will be acting absolutely contrary to the moral and natural law. The noble and learned Lord, judging from what he said, seemed to think that my co-religionists were the only real opponents of this proposal. If that is so I am very proud to hear it. He will forgive me if I say that I do not think materialistic measures will improve the happiness or the comfort of the people of the world. If it is the fact that my co-religionists are the most extreme opponents of measures of this kind I personally am proud of it, and I can assure the noble and learned Lord that so far as we are concerned those extreme views will continue to be maintained until the end of time.
But I am not so sure that I can truthfully claim that on purely religious grounds we are the only extreme opponents of this. At any rate, if we are the most extreme opponents we certainly are not the only opponents of measures of this description. Far from it. I think that your Lordships will find great opposition from all denominations and not only from all Christian denominations but also from the Jews and the Mahomedans. If the Government were to advocate such a proposal as that of the noble and learned Lord there would be 1033 a sensation of pained surprise not unmingled with contempt throughout the Empire. Of course, I understand that the noble Lord's proposal on this occasion is very limited. If I may be allowed to say so without offence, the noble Lord's baby is a very small one, but at the same time if the Government take it up it can only be construed as a decision in favour of these practices, and to that extent my belief is it would cause a rude shock in many a family and many a home, not at nil limited to the well-to-do, but amongst the very poor. It is by no means clear that public opinion is as much in favour of this proposal as some of the speeches to which we have listened, especially that of the noble and learned Lord, would lead us to believe. Mention has already been made, of the Mothers' Union and my noble friend who spoke last implied that that was a religious body. It may be: I know nothing whatever about it.
§ VISCOUNT FITZALAN OF DERWENT
The noble Marquess says it is not a religious body. Anyhow, it is a very big one and it seems unanimously against a proposal of this kind. I would like to call your Lordships' attention to the fact that in February last a Bill to exactly the same effect as this Resolution was introduced in the House of Commons. It was brought in by a Labour member, Mr. Thurtle, under the Ten Minutes Rule. It was opposed by another Labour member, the Rev. Mr. Barr, a Minister of the Free Church and a member for a Scottish constituency in Lanarkshire, I believe. That Bill was defeated in the House of Commons only in February last by a majority of over two to one. It is a curious and interesting fact that in that Division—I have not analysed the figures myself, but I am told that in that Division about two-thirds of the members of each political Party represented in the House voted against that Bill and only about one-third of each political Party in favour of it. If the House of Commons is representative of the opinion in this country I do submit that the Government would not be, justified in going against the opinion expressed so lately on the very same point as is raised by this Resolution.
§ LORD BUCKMASTER
Surely the noble Viscount is in error. The Bill is quite different from this Resolution. It was in general terms.
§ VISCOUNT FITZALAN OF DERWENT
I will read the title of the Bill. Noble Lords will bear in mind the Motion of the noble and learned Lord. Mr. Thurtle said:—I beg to move that leave be given to bring in a Bill to authorise local authorities to incur expenditure when deemed expedient in conveying knowledge of birth control methods to married women who desire it.
§ VISCOUNT FITZALAN OF DERWENT
I do not myself see very much difference between that and the noble Lord's Motion. Very little has been said in this debate with reference to medical opinion on this subject. I submit that no Government would be justified in acting on a Resolution of this kind unless they were satisfied that there was at any rate more or less unanimity in the medical profession with regard to it. I have a list of names of eminent physicians who are all against these proposals connected with birth control. They are: Dr. H. R. Andrews, senior obstetric physician, London Hospital; Dr. Hector Cameron, physician to Guy's Hospital; Mr. Bellingham Smith, senior obstetric surgeon to Guy's Hospital; Dr. Ernest Ware, senior surgeon, Hospital of St. John and Elisabeth; Dr. A. E. Giles, senior surgeon, Chelsea Hospital for Women; Dr. R. A. Gibbons, physician to the Grosvenor Hospital for Women; Dr. T. J. McCann, surgeon to the Samaritan Free Hospital for Women, and Lady Barrett, who has been quoted by the noble Lord quite fairly. As he mentioned himself, she is not in favour of birth control, though with qualifications. Then there is Dr. Mary Scharlieb, and Dr. Louise McIlroy.
I should like, in support of what fell from the noble Marquess and from the most rev. Primate with regard to child welfare centres, to call your Lordships' attention to the fact that in July last the welfare group of the Society of Medical Officers of Health at its annual meeting debated this subject. Dr. Letitia Fair-field urged that the removal of the ban of the Ministry of Health would inevitably split the child welfare movement from top 1035 to bottom. I think it is significant that though the whole of this question was debated at that meeting, and though of course there was undoubtedly considerable medical support, no resolution in favour of birth control was passed. I will quote from the Lancet of May 14, 1921. Dr. Giles, senior surgeon to the Chelsea Hospital for Women, is reported as saying that he wished the opinion to go forth from the obstetric section of the Royal Society of Medicine that the use of contraceptives is a bad thing.
I would like also to quote Dr. Robertson, medical officer of health for Birmingham, a man I imagine in a very considerable position as holding an important office like that. He says in his annual report for 1924 on the question of artificial birth restrictions:—Its public health importance largely centres round the fact that already in a certain number of cases most mischievous results have come to light in Birmingham, due to the fact that methods of birth control are becoming widely known to many young people, who, as a result, indulge in promiscuous intercourse with the knowledge that no inconvenient result will follow.Then I have one more quotation from Dr. McCann, surgeon to the Samaritan Free Hospital for Women and consulting surgeon to the West End Hospital for Nervous Diseases. He is reported in the Pall Mall Gazette of January 31, 1923, is saying:—Besides being the wrong method of dealing with the question of birth control, contraceptives are dangerous and harmful to any woman who would use them. There is in my view not one of these appliances that is not either injurious or unhealthy. It is a truism to say that one should not interfere with nature, but it is one which many people have forgotten. The extensive use of these things invariably produces some form of ill-health, together with a general distress of mind.I submit that, in view of this divergence of medical opinion, no Government would be justified in taking the course demanded of them by the noble and learned Lord this afternoon.
In conclusion, I should like to emphasise one point which I cannot help feeling is the most important of all as regards our own country. The noble Marquess and the noble Lord who preceded him alluded to France. They did not say that the French Government, only five or six years ago, found it necessary to forbid by law the use of contraceptives. I will read a literal translation of the 1036 French Law of July 31, 1920, whereby it is a criminal offence, punishable by fine and imprisonment—to disclose or to offer to disclose by public speech or by any writing or imprint, whether the same be publicly or privately distributed, and with the object of propaganda for the prevention of conception, any method suitable for the prevention of pregnancy or to facilitate the use of such method.No modern French Government would have passed a law like that unless they had felt compelled to do so for the safety of their own country. Speaking for myself, I cannot see how any British Government with the smallest germ of patriotic feeling could possibly, after the example of France, take the smallest step to advertise methods of this kind. At any rate, as an Englishman, I protest against this proposal, which I am firmly convinced would in time let my country down.
§ EARL DE LA WARR
My Lords, I feel that I should ask the indulgence of the House in rising to speak for a few minutes on an occasion when so many of the senior and most eminent members of your Lordships' House have addressed you. I will, however, be very brief, if only because, in my view and, I think, in the view of every single fair-minded and disinterested member of your Lordships' House, not a single argument that was put forward in that magnificent speech by the noble and learned Lord, Lord Buckmaster, has been touched or answered. The answer of the most rev. Primate was merely, in effect: "It does not exist." I think the strongest argument of the noble Viscount, Lord FitzAlan, was that in another place they had refused to pass a Bill on very similar lines and he then proceeded to read out a large number of medical names which, if time permitted, I could counter with an even longer list upon the other side.
But what is the case of the Government? Why is the Government refusing to accept the Motion that stands in the noble and learned Lord's name? We are told that it is for fear of destroying the maternity welfare work. How would it destroy that? Do you really imagine that you are going to destroy a piece of work like that by giving the authorities who are responsible for that work increased powers for dealing with the problem that confronts them? What a folly to think that it is possible to deal with the problem of maternity and child welfare and to 1037 give ante-natal and post-natal treatment if you are going to neglect to deal with what is probably the most important problem of all—namely, the fitness or the unfitness of the mother! We are told that the birth rate will go down. We have heard cases to-day, perhaps old, familiar eases, but none the less true, and including the extreme case of a woman who had eighteen pregnancies and only eleven children alive. Surely it is very much better that a woman should produce a small number of children who will be healthy than that she should produce an enormous number that have no chance of surviving.
Next we are told that this will split the movement. But will it? We have heard from the noble Lord, Lord Balfour of Burleigh, that some of the voluntary workers have passed a resolution in favour of the equivalent of the Motion that is before us to-day. Then the noble Marquess the Leader of the House ended by expressing the deepest sympathy with the well-meaning mother who, because of ill-health or for some other reason, was unfitted to have children. But, he added, what about the indolent, what about those who are not willing to do their duty, those who care more for their own pleasures than for producing families I What about the vicious I What shall we do about them? Does the noble Marquess honestly contend that it is essential for the prosperity of this country that the indolent, the pleasure-seekers and the vicious should be asked to populate us? I really think that very little weight is to be attached to that argument. The noble Marquess said that he pitied the well-meaning woman. I am very glad to hear that he does so, but he has made no suggestion whatever for helping the well-meaning woman. What about the State? What about the community? Are we not to pity the community that is going to have these children, diseased and poverty-ridden as they are, thrown upon it to be supported out of public funds?
Then the noble Marquess spoke of the point of view of the husband. He asked what was to be the position of the husband if the wife went off to one of these centres and got this advice against his wish. Surely we in these days do not continue to regard women merely as the property of men for their enjoyment. 1038 But if the noble Marquess or this House is of that opinion then it is perfectly possible, in the Regulations that would be issued if this Motion were passed, to say that the husband's consent must be given. It is not a limitation that would necessarily be supported by very many of us who are supporting this Motion, but it is by no means ruled out. We are told that there are grave dangers ahead of us if we commit ourselves to the spreading of this doctrine. That may be true, but if it is true how infinitely more important it becomes to place the guiding hand of a community upon it. It is a movement that is coming upon us whether we like it or not. The noble and learned Lord who moved the Motion said that the question of birth control was already a decided question. To realise that it was with us, it was only necessary earlier in the debate to look at the Benches in your Lordships' House, and to look at the galleries, which were full in a way they have not been full during many other debates on seemingly more important political issues.
Just as men in the industrial world are no longer content to be mere wage slaves, so I believe women are no longer content to be mere machines for the production of unwanted children. I was told a story the other day. It was told me as being a humorous story, and it made me laugh at the time it was told, but it seems to me to contain the germs of a very great tragedy. It was of a man who was engaged in discussing the general question of children, their upbringing avid education, and he was asked: "How many children have you got?' He said: "As a matter of fact I have only got three, but I have had more than a dozen frights." The noble Lord who moved this Motion said that he did not believe that it was just the selfishness of women that was making them want to limit their families. It is because they realise the enormous responsibility of having children, and they are fighting not merely for themselves but for their children, and they are realising that they have no right to bring children into the world when they know themselves to be physically or economically unfit. I believe that realisation is one that may well have very great social effects if properly fostered and assisted.
1039 Finally, it is for us in this House, quite irrespective of what the House of Commons did, to recognise, and to show that we can recognise, a good, wholesome social tendency when it appears, and instead of turning our backs on the forces of science, which make the realisation of that new spirit possible, to show that we are prepared to meet and to utilise them for the good of society. Left to themselves those forces may very well become grave dangers to society, but with direction and co-ordination they will prove both a boon and a mercy to hundreds of thousands of our fellow men, in this and future generations.
§ LORD RATHCREEDAN
My Lords, I desire to support the Motion of my noble friend, and I do so because I think I am in a position to place before your Lordships certain information which may enable you to come to a decision as regards this matter. For some thirty years I was closely associated with South London, and during that period I had ample opportunity of realising what this question meant in the homes of the poorest of the poor. Let me give your Lordships one special case. A young constituent of mine married the daughter of another constituent whom I had seen as a girl at school. I did not see her again until ten years had elapsed, and when I did see her her state of health was such that I scarcely recognised her; but during that interval she had produced no fewer than eight children. She was married under most favourable circumstances. Her husband was in good and constant employ in the City of London, and was, moreover, a very good husband, and assisted her in the bringing up of the children and with her domestic duties before going to business in the morning and on his return every night.
I know, however, of many other cases of girls whom I had seen in the board schools and who had married within the area. These young women, not being endowed with such good constitutions, and having husbands not in such good and constant employ, were in a much more sorry state. There were even worse eases than those—unfortunate young women who, having to confront poverty on the one hand, and rapidly increasing families on the other, and living in one, two or three rooms, had in their distress and poverty had recourse to drink, and thus 1040 had brought themselves and their families to the verge of destitution, if not to complete destitution.
But my experiences were more than substantiated by the experiences of my wife. For seven years she was a manageress of schools in South London, and took part in Happy Evenings for Children and also in the Holiday Fund, and it was part of her duty, before sanctioning a grant for a child to go into the country, to inquire most narrowly into all the circumstances of the homes she visited. In those pre-War days there were many men in London, one-horse carmen, earning 22s., 23s. and 24s. per week, out of which they had to pay 5s., 6s. or 7s. per week rent for very inadequate accommodation. These unfortunate women brought to her notice the fact that they were in such dire distress that they had to have resort to all sorts of illegitimate and undesirable practices, otherwise they could not live and carry on.
Let me give your Lordships an opposite case. Some two or three months ago I was at the house of a painter and decorator to whom I wished to give instructions. The door was answered by the wife—a fine, strong, handsome young woman with a beautiful baby in her arms. Noticing the baby, I said: "Your baby is a boy?" "Yes," she replied, "I have only boys. My eldest is now nearly fifteen, and has begun his apprenticeship; my second boy, seven years old, is at school, and I am very glad of this little fellow to keep me company." Now, I had taken this woman to be a young married woman of 25 with her first child, whereas she must have been at least 35, and she had borne three children, but at intervals of about seven years.
If we follow the advice given by some, that we should leave things to nature, what will be the result? It is said that other countries do not do this, with the exception, perhaps, of France, and why should we interfere with the course of nature? Take Russia, they say—what a fine people the Russian peasants are! I know nothing about the Russian peasantry of to-day, but some thirty years ago I travelled throughout the Russian Empire, and what did I see I Fine men, yes, but who were these men? They were the survival of the fittest— 1041 two or three out of enormous families, because at that time the death rate m that country was three times as great as it was in this country, and the infantile mortality was simply appalling. Those who oppose this Motion will say: "What a very unfair comparison—between Russia and England—Russia with its rigorous climate lasting at its worst for nearly six months." Then I will go to the opposite extreme and take North Africa. Shortly after France had succeeded in subduing the Kabyle tribes I visited that country, and saw there very fine men, but I rarely saw a woman over thirty years of age who was much better than a broken down slave. But all these women had produced families of ten or twelve or more. Does anybody seriously suggest that we should revert to the survival of the fittest? It is not possible. We cannot stay the march of civilisation.
We know that medical science will continue to advance, that those who are in a position to do so will take advantage of that science, and are you going to deny it to the poorest of the poor? We are confronted with, I do not say excessive population, but with difficulties in housing and with want of employment. Is it not better for the race that our women should produce two, three, or four sound, healthy children, at intervals of from five to seven years, rather than eight, nine, ten, or eleven under conditions which you know must necessitate the bringing up of those children in far less comfort, safety, and good health than would be the case if the families were limited to three or four? All these questions can be dealt with by sound common sense. The great Duke of Wellington, who was not only the greatest soldier of his day and a great statesman, but a man of great wisdom and judgment, was looked upon as omniscient by most people of his day, mid all sorts and conditions of people came to him asking for his advice. The advice he invariably gave was this: "Take a sheet of foolscap, put the advantages on one side and the disadvantages on the other. Balance them, and decide in favour of that which appears to you to be the best." If you will do that with reference to this question I think there is not a shadow of doubt that, in the interests of the poor 1042 especially and in the interests of the country at large, you will decide to support this Motion.
My Lords, it is a pleasure to follow the noble Lord who has just sat down, because I was associated with him rather closely thirty years ago in the portion of South London to which he referred. Your Lordships might well think that after the eloquent, the unanswerable—and the unanswered—speech of Lord Buckmastcr it was not necessary, to say much more, but there are just one or two considerations that I would like to submit to your Lordships. In the first place, I do not know whether any one else is going to speak on behalf of the Government, but, if so, I hope we may have some reconciliation between the speeches of the noble Marquess opposite and the most rev. Primate. They differed completely on a fundamental issue. The noble Marquess gave us many reasons why this embargo should be maintained: the most rev. Primate devoted a great portion of his speech to saying that there, was no embargo to maintain. Those two positions are clearly inconsistent. If the noble Marquess were to endorse what the most rev. Primate said, that is to say, that a doctor at a welfare centre was entitled to give whatever advice his professional conscience dictated—and I think that is all that the noble and learned Lord has asked for—without interference with the grant by the Ministry of Health, I think we should have won our case. I should also like to ask the most rev. Primate, in view of his speech, which way he is going to vote. If he thinks this embargo does not exist, is he going to vote for retaining or removing it?
The noble Marquess spoke about the advice that would be given to women who required it for various reasons other than the legitimate medical one. It has already been pointed out that the so-called medical one is generally some very serious, almost operative reason, which is by no means the only reason which is regarded as legitimate. Does the noble Marquess, or does the most rev. Primate regard it as a legitimate or a proper thing that a woman has a fresh child every ten months? Is not the prevention of that sort of thing a natural and a reasonable part of ante-natal care, 1043 and can it not properly be included in the definition of ante-natal care? Really, why we should have been frightened by the bogey that the most rev. Primate raised, of addresses being given to classes of young girls and young women on this matter, I cannot conceive. Surely those classes refer to things which are common to every woman, such things as the proper care of her own health in the interval, the proper feeding of the baby, and things of that sort, but all intimate personal matters are not dealt with in a class of that kind, nor is there any reason why they should be.
The most rev. Primate said—what is perfectly true—that there do exist a few, very few, birth control clinics in this country and he did not know whether advice was given to young married women or not. I am only acquainted with one, the first that was founded by Dr. Stopes. I can tell him what the rule is there, and it will meet with his approval. No birth control advice is given to newly-married women, but only to married women who have already had one child. I think he will agree that that is a very reasonable limitation of the advice that is given, in that same connection, in these cases which he says he has seen again and again and which he rather regards as a stage army. I would commend to his notice, I do not know whether he has seen it, a little pamphlet which has been published called "The First Five Thousand." It deals with the first 5,000 cases that were dealt with at this clinic and gives the facts as regards the whole of them. I can tell him that these facts bear out entirely the kind of case that Lord Buckmaster gave us at the beginning of this discussion. Again and again in the course of his speech the most rev. Primate, whom I confess I had hoped to find supporting the Motion, said that he sympathised very deeply with these cases. I am reminded of the story of a very poor pieman who was selling pies in the streets, to whom a passer-by stopped and spoke and with whom he continued to express his sympathy, until at last the impatient pieman said: "Hang your sympathy: buy a pie!" I think it is possible that some observation of that 1044 kind might be made by the women who read the observations of the moat rev. Primate.
With one observation made, I think, by the noble Marquess I most profoundly disagree, and I could not resist registering my disagreement in this debate. He spoke about the duty of women to bear children because their husbands desired it, or because it was for the good of the country. That point has already been dealt with, but I wish to say perfectly clearly that the time surely has passed when woman is to be regarded as a serf either of her husband or of the State.
It is perfectly true that the noble Marquess was quite careful not to use the word, but he said that it should depend to some extent upon the husband's wishes.
§ THE MARQUESS OF SALISBURY
I said that she ought to do her duty to her husband and to the country, and so she ought.
I do not think it ought to depend upon her husband's wishes. It is for the woman who bears the child to settle, not with her husband or with the State, but entirely with her own conscience, whether she will bear a child or not. That is the liberty to which every woman is entitled, and I think now that women have the vote the noble Marquess will find that view will be rather more insisted upon than perhaps it has been.
We also heard in the course of this debate what I rather hoped we might be spared—some discussion of the medical advantages or disadvantages of certain proposed methods. I do not think that the most ardent advocates of birth control have ever contended that any perfect methods have ever yet been devised and that there are any methods which are entirely free from all objection. It is true of so many other branches of medicine, indeed, it is true of most of them, that we have not devised the perfect treatment. It is perfectly true, for example, of cancer that we know very little about it. But that is no reason for not using the best medical knowledge that is possible, or for not doing what you can with the knowledge you have.
1045 Then, again, we had an argument advanced of which really one is rather tired, about the course of nature and not interfering with the course of nature. The clothes in which we are sitting here tonight, the electric light under which we are sitting are interferences with the course of nature. Does "not interfering with the course of nature" mean that everything is to run on unchecked? The plumbing and the sanitary conveniences in our houses are an interference with the course of nature. It is really impossible in a civilised community to suggest that nature is to be allowed to run wild and unchecked and that the knowledge and civilisation and skill of man are not to be applied to control the operations of nature in the interests of mankind.
When your Lordships divide I hope you will consider what is really at the root of this question. The noble Marquess said it would split the welfare centres. I hope it would not and I think if there are any women so indifferent to the sufferings of their fellow-women that they would object to necessary cases being taught contraceptive methods they had better not be connected with welfare centres. They do not seem to me to be the right kind of women. The point is that not only the rich but all the reasonably well-to-do have knowledge of and practise these methods, and that the poor and the poor alone are deprived of the possibility of being informed of them, and they ought, at a centre which professes to give information in the interests of children, to be given information which will enable them to bear a smaller number of healthy children rather than a large number of diseased children—any of whom die—who bring suffering and sorrow upon the mother and very often discomfort into the home because of their constant illness.
The noble Marquess had the courage to talk about the vast number of healthy and strong Englishmen. The records in the War did not show that we had such a remarkably good population in the way of health. Indeed, I think it was a courageous observation to make. I wish to recall to mind, if possible, before your Lordships divide that the real question we are deciding is whether these centres which are established for this very purpose should be allowed, at the discretion of the medical officer and to married women, to give information which 1046 is obtainable by all other women who are not so poor as to have to go to a public place for it.
§ LORD WRENBURY
My Lords, it is very seldom in these days that I address your Lordships' House, and after the length to which this debate has run I certainly should not have risen to address you new but for the fact that this question is, to my mind, of such great importance that I should not be doing my duty if I did not lay before the House the reasons which induce me to follow the noble and learned Lord, Lord Buckmaster, into the Division Lobby. The question of birth control is one of very large and first-rate importance. The particular form in which it presents itself to-day is but one part of it. It includes, if you take the whole of it, the question whether there should be in some circumstances compulsory restriction of children; whether, for instance, there should be legislation which should compel the lunatic, the epileptic, the criminally vicious person from ever assuming such a position that he could beget children; whether the same thing is true of persons who are not under any such disabilities as those I have mentioned but who suffer from hereditary diseases, the tuberculous or those who are disposed towards that terrible disease cancer: and whether there should be any birth control as regards them. With all that part of the case your Lordships have nothing to do this afternoon. The whole question of compulsory restriction is out of the way, but the question is whether persons should be put in possession of knowledge which will enable them voluntarily to control the conception of children.
In talking about this matter to others, and I have talked with many, I have always detected, as it seemed to me, at the back of the mind of the person whom I was addressing an idea that there lurked two motives of which they are, perhaps, only half-conscious. The first of them is that they think that any interference with birth, any birth control, is acting contrary to the laws of nature and is endeavouring to interfere with the laws of nature. No doubt it is. But why in the world is that a wrong? I cannot understand why that should be a wrong. If it be wrong to take steps to control nature, we must dismiss at once the 1047 whole physical and surgical skill of the country. The whole of the medical profession are engaged in trying to control the operations of nature. You are taken with a complaint, or you suffer a severe wound, and the physician or the surgeon comes. Nature would have killed you; the physician or the surgeon heals you. Those who go to that length are reduced ultimately to this it seems to me—that they bring themselves down to the level of the Christian Scientist and in fact go so far as to say that they cannot even condescend to take a dose of aperient medicine.
The other lurking doubt which seems to me to lie in their minds is that they think that, somehow or other, this whole subject of birth control is indecent, is a matter which so far as possible should be set on one side, and is not a matter which decent people in decent company should speak about: the less said about it the better. I do not know whether any of your Lordships could for a moment think that. The fact is that this mysterious thing called birth is one of the subject matters which are of the greatest importance to every human being who lives. The more he knows about it the better. There is no reason to conceal it from him. It is a thing which is of the essence of his existence. To live his life properly it is necessary that he should understand it. It should be open to him to know all about it. There is nothing indecent or indelicate about it. Indecency consists in doing something improper in an improper way. Those who want to spread knowledge of this sort of thing are desirous, on a proper occasion and in a proper manner, to communicate knowledge on a state of things which is of vast importance to us all.
With these considerations in view I want very briefly—for I am anxious to be as brief as I can—not to speak in general words but to put a couple of illustrations and to ask your Lordships to say how you would think it proper to deal with them. Let me suppose a case of a young married woman who has borne her husband two children. On each occasion her confinement was excessively difficult and dangerous. It was necessary to resort to mechanical means, to use artificial means of delivering the child. On both occasions that succeeded. After she has recovered from her confinement her 1048 doctor sees her and congratulates her on the state of things. He adds: "My dear madam, you must never have a child again. Your life is forfeit if you do so." She says: "Very well, doctor. It is all very well to say that but how is it to be done?" "There are two ways of preventing it," he says. "Tell me what they are?" she asks. "The first is that you should cease to have sexual relations with your husband." That she immediately discards. It is contrary to her affection, to her love, to every duty in the position in which she stands. She will have none of it. "Tell me what is the other?" she says. "I will not tell you," the doctor replies. I pause upon that, because I am going to submit to your Lordships that every one of you who is going to vote upon this Resolution must answer this question for himself: "Was that doctor right or was he wrong in saying, 'I will not tell you.'?" I will give my reasons presently for saying why it seems to me you must decide that.
You may take another instance, different in substance but not, I think, in its material result. A young married couple have had three children. They have an income sufficient to enable them to look forward to bringing those three children up properly, to meeting the vast expense of education and so on, but they feel that they cannot do more. They want to do their duty to themselves, to their children and to the State, and they determine that they will have no more children if that can be done. They call in medical advice. You will notice that it is not now a question of danger to health but a purely voluntary act to avoid having further children for a perfectly proper object. They call in a doctor and they ask him the question. He gives them the same answers as he gave to the other lady whose health was in danger. When the lady refuses the first alternative and asks for the second, the doctor again says: "I will not tell you." Again, I say, in voting upon this Resolution your Lordships must make up your mind whether that doctor was right or wrong.
Let me say why I think that is so. These clinics have been established all over the country for the purpose of giving assistance to married women who go to them to get information regarding their approaching confinements, or the health 1049 of their children, or advice on the question of cleanliness and various other matters. We will suppose that they put to the medical attendant the first case that I have instanced. I do not care which of the two cases that I have mentioned is taken. They present that case to the person who is in charge of the clinic. As the Regulations at present stand, if I rightly understand them, the doctor in attendance must answer: "I will not tell you," because; he or she knows that if they do not take that course the clinic will lose the assistance of the State. All these clinics are dependent upon voluntary subscriptions. It is difficult to get money and they have perpetually to have recourse to bazaars or concerts or balls to get the money together, and it is only with the assistance of the State that they are able to carry on. If the medical man makes that answer, in point of fact he is saying: "I cannot do this because my society cannot afford to let me do it. We shall lose money if we do it, and, therefore, I cannot tell you." That, it appears to me, must be wrong. It is wrong to put the person who is in attendance there in a position in which he cannot do that which his professional knowledge shows him to be desirable and right because, for pecuniary reasons, it would land his society in difficulty.
I pause again to ask your Lordships to put this question to yourselves. There is an attendant at the clinic. There appears a person with a baby who asks for information of some kind such as Mint I have indicated from the medical officer. Ought he or ought he not to be placed in such a position that he must answer: "I will not give you the knowledge which I know would be of use to you"? I say: "No." I say every person who is going to vote upon this Resolution must make up his mind upon this: Would the doctor be entitled or not to refuse to answer? If ho says: "Yes, he would be entitled to refuse to answer," then he will vote against this Resolution, but if he would answer that a man ought to be free to answer, then, if he give a vote according to his conscience and not according to any rules such as prevail in this House, he must vote in favour of the Resolution.
I do not wish to dwell further upon the matter. I only hope that I have made it plain as I see it. One word more. I 1050 was very sorry to hear from the noble Marquess the Leader of the House some observations directed, as it seemed to me, to deprecate the communication of knowledge to some persons because it might be abused by others. I entirely reject any such principle of the communication of knowledge. It appears to me that it is the duty of all of us, if we have knowledge which is useful, to promulgate that knowledge to the best of our power and to run the risk of somebody abusing it. We should endeavour to obviate that risk, but there is no right, if you have knowledge which you can communicate and which will be useful, to say: "I will not tell you that which I know."
§ THE LORD CHANCELLOR
My Lords, I think your Lordships will very shortly come to a decision on this question. Before you do so I think it is desirable that a few more words should be said on behalf of the Government. I will not keep you long, for I mean to confine myself to the Resolution upon the Paper. Let us examine that. Your Lordships are not asked to-day to express any opinion upon what is called "birth control," either for or against it; nor are you asked to say whether advice in favour of birth control or propaganda in favour of birth control shall or shall not be allowed. There, is no law to restrain it so long as it is properly done. Doctors may, and do, advise it. In some cases, I suppose in many cases, it is their duty, speaking for myself, to advise it—that is to say, in cases where further conception will endanger the life or the permanent health of the woman who seeks advice, and in all those cases which the noble and learned Lord, Lord Buckmaster, referred to in his moving speech, I do not doubt that a doctor, if consulted, would give that advice. Again, the clinics to which reference has been made advise, and in many cases indulge in wide propaganda in favour of, the practice, although their methods are not always wise.
We have not got to pronounce on any of these things. Your Lordships are asked to express the view that what is really a statement of policy as circulated by the Ministry of Health among the welfare centres should be withdrawn. Now, will your Lordships consider for a few moments what these welfare centres are. They are formed to deal with cases of 1051 child birth; that is to say, to give advice and help to expectant or to nursing mothers, and for no other purpose. They are composed of the medical officer of health, who is a member of the centre and gives general advice, but who, of course, cannot and does not, I take it, always attend, and of other members, especially women, who give their time and help to this admirable work but who, of course, have little or no medical knowledge or experience. Now, remembering the character of these bodies, what does the Resolution of the noble and learned Lord propose? It is that the centre should no longer, as he calls it, withhold from married women this information as to "the best means of limiting their families." The Resolution is not confined to women who seek advice on the ground of health. It extends to all married women who ask a question about this matter, and it might be construed—and it would, I believe, be so construed in some cases—as entitling these committees to give general advice to married women on the subject of birth control.
Secondly, the Resolution would not only empower the medical officer of health or a doctor who is a member of one of these committees to give this advice. It would be in the power of any member of the committee, without any medical knowledge and without any examination of the person seeking advice, to give her the advice which is now under discussion. Of course, the doctor is not always there—he cannot be always there—and much of the work is done by these other members of the committee who, much to their credit, attend day after day. Are we to allow those persons, however excellent they are and however helpful they are in many ways, to take the grave responsibility of giving women this advice? After all, the practice which is being discussed is still in the region of experiment. There is much discussion among doctors whether any of the methods recommended are free from danger. There is evidence to the effect that some of them are fraught with very great danger to the health of those who use them, and to allow unskilled persons to advise any of these methods is to take a very grave responsibility indeed.
I pass over the possibility of other members of the Committee who take a different view, so greatly objecting to the 1052 practice of giving this advice as to impair the harmony and me efficiency of the Committee. Let me pass from that and see what is the statement of policy to which reference has been made, and I will ask your Lordships to say whether you do not think it wiser to adhere to that policy than to allow the indiscriminate giving of the advice recommended by the noble and learned Lord. Your Lordships must remember that this statement is made to a mixed body of the kind I have described. I leave out the first clause, which I do not think is material to-day. The second clause is the one with which I want to deal:—That it is not the function of an antenatal centre to give advice with regard to birth control, and that exceptional cases in which the avoidance of pregnancy seems desirable on medical grounds should be referred for particular advice to a private practitioner or hospital.Lord Balfour of Burleigh has suggested that the exceptional cases there referred to were confined to two classes of disease, diseases of the kidneys or pelvis. That is not so. The expression—I am speaking with authority—is, and was intended to be, perfectly general.
In any case where it appeared to the committee or to a member of the committee that a further conception might be dangerous to the life of the person seeking advice or might destroy her health such a person might and would properly be referred to the medical attendant who would be responsible for her. The direction is to refer such cases to a private practitioner or hospital. That, I understand, only means that the advice must be medical advice. The person who asks this question should and can in proper cases be referred to a doctor. It may be a private practitioner and it may be a panel doctor, for everyone at least has a panel doctor. The medical officer himself may take the responsibility of advising the woman as to her health. He may give the advice himself. If you told a medical officer not to do so I think he would very rightly protest. But the essence of it is this: that advice so responsible, so fraught with danger and harm to the person in question and to others, should not be given by a mixed committee of this kind formed for a totally different purpose, but should be given by a medical man with proper knowledge and proper experience. That 1053 is the essence of what my noble friend the Leader of the House has said and that is the view I would maintain. After all, the Government, and especially the Ministry of Health, are responsible for the protection and encouragement of these admirable welfare committees. If in any suggestion which is made they see a danger that the work of the committees may be wrecked or injured, or that harm may be clone to individuals, it is their duty at least to give their advice.
I will make only one observation on the speech of my noble friend Lord Wrenbury. In the case which he put of a person having asked a question of a member of the committee, the answer would not be: "I will not tell you." He or she would say: "This is a serious case. Go to your doctor and ask his advice." That is a very different thing from not giving any answer at all. I feel sure that if you consider the question carefully and without regard to sonic of the general observations that have been made, yon will see that the only course consistent with wisdom and with the sympathy for these people that we all feel, although we have not the same power of expressing it as my noble and learned friend, the course most consistent with a real desire for the welfare of the poorer classes is not to pass this Resolution but to adhere—I do not say strictly, for everything may be reconsidered and modified—but in general to adhere to the policy laid down by the Ministry of Health.
§ LORD BUCKMASTER
My Lords, I certainly do not propose to occupy you for long, but it is plain that there is grave misapprehension about the terms of this Resolution, and they, at least, should be made quite clear. It never was my intention, however ambiguous my language may have been, that the information that I desire to be given should be disseminated broadcast by wholly unqualified people, and I am sure that everybody who listened to my speech must have noticed that I emphasised all the way through the point that it was the medical officer by whom the information should be given. If, therefore, the speech of the noble and learned Viscount upon the Woolsack means that the Government would not object to my Motion if I introduced some such words as" through their medical officer", I should have been glad to introduce them
1054 at the first and I am quite willing to introduce them now. But in truth your Lordships know well that, even with those words introduced, the trend of the debate on the other side has been to oppose this Motion, not on the question as to whether or not information was to be given through any of the members of the committee—and up to the time when the noble and learned Viscount on the Woolsack spoke no human being would have supposed that any such proceeding was intended—but on the ground that the information ought not to be distributed at all.
It is perfectly clear that the position at the present moment is that there are conditions and restrictions imposed upon these medical officers that do in fact hinder and prevent them in cases where, according to their best medical judgment, information should be given. They are to withhold that information from the poor women who conic and ask for it. We are told that they should send these poor women to their doctor. They have come to their doctor already; they have come and asked their doctor what it is they are to do and the doctor has said: "The real trouble is this. Your pregnancy is going to be difficult. You are going to suffer, and one of the reasons is that you have had children far too quickly and too often and you ought to stop it." The women say: "How am I to stop it?" "I cannot tell you that," the doctor is to reply, "that is just one of the things that I am not at liberty to tell you." Medical officers know that for these children there is waiting the curse of inherited weak-mindedness. But they are to say: "Go on; this world wants people, and it makes no difference what the quality is. Let them be mad, syphilitic, tuberculous, only for heaven's sake do not stop them coming, because it is a terrible thing to check the birth-rate."
§ THE MARQUESS OF SALISBURY
The noble and learned Lord knows very well that none of us have said any such thing.
§ LORD BUCKMASTER
But it is the inevitable result of what you do. It is not a question of what you say. The point is that if a woman comes to these centres to-day with a syphilitic history and says: "I do not know what to do; I cannot bear bringing these children into the world; tell me how to stop it," the
1055 doctor is not at liberty to give the information. This very notice tells you that, except on medical grounds, he is not to give it, and that it is not his business to give it but to send them round the corner to somebody else. Do let us know what we are doing. Do not let us vote with our minds obscured by a misunderstanding of the facts, the reality of which is not denied. If it were denied, all that the Government had to do was to accept this Motion. I am perfectly willing that there should be medical control and that this matter should be in the discretion and power of the doctor. What I am not willing to consent to is that you should put a medical officer in charge of one of the most delicate and important medical subjects in the world and then fetter his discretion and say that he is not at liberty to do as he thinks right but must send the enquirer to another doctor round the corner.
It is said that these women whom you seek to benefit are so indolent, so
§ ignorant so foolish that they will not come for the information. It is not merely that, they do come, but the people who make that statement do that which men so often do—they overlook the woman's side of this question. What to a man may be a mere triviality, an act between a sleep and a sleep and forgotten in a few moments, may bring to the woman the terror of consequences that we cannot measure, of months of sickness, misery and ill-health ending with hours of agony that are not veiled under the merciful cloak of chloroformed sleep. These are the people that we want to help; but in spite of the willingness that, I am certain, has been genuinely expressed to help them, I say that the people who oppose this Motion are not helping but are hindering the cause of these unhappy women.
§ On Question, Whether the Motion shall be agreed to?
§ Their Lordships divided: Contents, 57; Not-Contents, 44.1057
|Bedford, D.||Ashton of Hyde, L.||Kilmarnock, L.(E. Erroll.)|
|Marlborough, D.||Askwith, L.||Knaresborough, L.|
|Rutland, D.||Balfour of Burleigh, L. [Teller.]||Lawrence, L.|
|Lawrence of Kingsgate, L.|
|Lansdowne, M.||Banbury of Southam, L.||Leigh, L.|
|Belper, L.||Marshall of Chipstead, L.|
|Cromer, E. (L. Chamberlain.)||Biddulph, L.||Montagu of Beaulieu, L.|
|Buckmaster, L. [Teller.]||Muir Mackenzie, L.|
|Ancaster, E.||Cawley, L.||Newton, L.|
|Chesterfield, E.||Clanwilliam, L.(E. Clanwilliam.)||O'Hagan, L.|
|De La Warr, E.||Raglan, L.|
|Eldon, E.||Clwyd, L.||Rathecreedan, L.|
|Graham, E. (D. Montrose.)||Cozens-Hardy, L.||Rayleigh, L.|
|Lindsey, E.||Denman, L.||Redesdale, L.|
|Oxford and Asquith, E.||Desart, L. (E. Desart.)||Stanley of Alderley, L.|
|Russell, E.||Gainford, L.||Stanmore, L.|
|Glenarthur, L.||Swaythling, L.|
|Bertie of Thame, V.||Gorell, L.||Thomson, L.|
|Churchill, V.||Hanworth, L.||Wharton, L.|
|Hood, V.||Harris, L.||Wrenbury, L.|
|Annaly, L.||Hunsdon of Hunsdon, L.|
|Canterbury, L. Abp.||Midleton, E.||London, L. Bp.|
|Cave, V. (L. Chancellor.)||Stanhope, E.||Arundell of Wardour, L.|
|Vane, E. (M. Londonderry.)||Braye, L.|
|Salisbury, M. (L. Privy Seal.)||Carson, L.|
|Cecil of Chelwood, V.||Clifford of Chudleigh, L.|
|Northumberland, D.||Falmouth, V.||Crawshaw, L.|
|Sutherland, D.||FitzAlan of Derwent, V.||Danesfort, L.|
|Haldane, V.||Daryngton, L.|
|Airlie, E.||Hambleden, V.||Erskine, L.|
|Clarendon, E.||Hutchinson, V. (E. Donoughmore.)||Faringdon, L.|
|Harewood, E.||Gage, L. (V. Gage.) [Teller.]|
|Leven and Melville, E.||Leverhulme, V.||Hampton, L.|
|Luean, E. [Teller.]||Peel, V.||Howard of Glossop, L.|
|Jessel, L.||Parmoor, L.||Shandon, L.|
|Kenmare, L. (E. Kenmare.)||Phillimore, L.||Somers, L.|
|Lamington, L.||Saltoun, L.||Walsingham, L.|
§ Resolved in the affirmative and Motion agreed to accordingly.