MENTAL DEFICIENCY BILL. (Hansard, 20 December 1927)

VISCOUNT GAGE
My Lords, I beg to move that the House do now resolve itself into Committee. In doing so perhaps it would be as well if I made a few observations in regard to this Bill. It is very similar to the one passed by your Lordships' House without any opposition last year, when it was lost in another place. On this occasion it has passed through all its stages in another place and my right hon. friend is very anxious that your Lordships should pass it before the Session ends. The whole subject of mental deficiency was investigated by a Royal Commission prior to the introduction of the Mental Deficiency Act in 1913. Since then, I understand, there has been no Commission dealing with this particular subject, but experience has shown that the definition of mental deficiency is not really sufficient. The present definition includes the words "from birth or from early age," in the description of a mental defective, and magistrates and doctors in all parts of the country have given quite different meanings to those words. Some have adopted a narrow interpretation and have not found themselves able to give the protection of the Act to defectives who clearly were in need of that protection; and some have considered that a mental defect due to disease or injuries is outside the scope of the Act altogether.
One of the principal causes why this amending Bill has been found necessary is the prevalence of a disease known as encephalitis lethargica or sleeping sickness. This disease, I understand, produces an effect in adolescent individuals which is very similar to that of mental deficiency as from birth, and the authorities have considered it necessary to apply institutional treatment in those cases, but have been prevented from 1154 doing so owing to this narrow definition. The real object of the Bill is to amend that definition and the amending Bill, in Clause 1, puts the age now at eighteen years. That has been arrived at after full consideration by lawyers, doctors and others, and it has the approval of the Minister of Health and the Board of Control. Clause 2 provides that the local authority may deal with the case on the representation of the parent or guardian that the defective is in need of care or training which cannot be provided in his home. The original Bill specified that the child must be neglected before such treatment could be given. It was considered very cruel in cases where a child had a good home, that this word should be used, because neglect in such cases would only be purely technical neglect. It is obvious that a disease such as mental deficiency cannot very often be properly treated in a child's own home. The use of the word neglect does imply general neglect. That is the generally accepted sense of the word and it is usually only interpreted as meaning general neglect in the home.
Clause 4 safeguards the position of the child if the parent or guardian is abroad, and I do not think I need say anything more about that. Clause 5 was inserted at the request of the local authorities. Section 8 (1) (a) of the principal Act provided that in certain circumstances a court may postpone passing sentence upon a person charged with a criminal offence, and direct that a petition be presented to a judicial authority with a view to obtaining an order that he be sent to an institution for mental defectives or be placed under guardianship. The court is empowered to order that the person be detained in an institution or place of safety "for such time as is required for the presentation of the petition and adjudication thereof." Cases have arisen in which the court has given such directions, but as the result of further examination and observation or by reason of a divergence in medical opinion it has been found impossible for the local authority to present a petition, and cases may arise where such petition is presented and dismissed. In such cases it is conceivable, I am informed, that the accused person may escape justice altogether. Clause 7 requires the local authority to provide suitable training or occupation 1155 for defectives who are under supervision or guardianship or have been sent to a certified institution. That is of special importance in the case of defectives who are under supervision but remain in their own homes. Clause 10 empowers a local authority to take cases under contract from other local authorities whose own institutional requirements may be small. Very small institutions do not admit of proper classification of defectives, and on grounds of economy as well as of efficiency multiplication of small institutions is very undesirable. I do not think it is necessary to say any more about the Bill at this moment, as it has been previously passed by your Lordships in very much the same form, but I shall endeavour to satisfy any noble Lords who may desire further information.

§ VISCOUNT HALDANE
My Lords, I do not rise to make any objection to this Bill, which I think is a useful one, but there are two points which I should like to put to the noble Viscount who has just sat down. This Bill relates to mental defectives. I understand from the noble Viscount that it is not intended to cover all the cases of people who are imbecile but only those who are mentally deficient within the meaning of this Bill. That means, I understand, people who become mentally defective, or incipiently so at least, before the age of eighteen. Others, I presume, are left to be dealt with by the ordinary law. That was the subject of investigation by the Macmillan Commission, and I presume it will be dealt with by separate legislation. At any rate, it has not yet been dealt with. This Bill, I understand, is confined to the limited class of mental defectives who are defined by Clause 1, subsection (2). I should like to ask the noble Viscount whether there is anything in this Bill which comes into conflict with the recommendations of the Macmillan Commission. Those are the two points on which I wanted to ask for information.

§ LORD CHARNWOOD
My Lords, I happen to be what members of my family persist in calling "the mentally defective chairman" of a great authority. I do not know whether any of your Lordships have a prior claim to that honour, but I should like on behalf of the Mental Deficiency Committee of a great 1156 county to thank the Government very warmly for this Bill. I do not think it is necessary to add anything to what has been said so clearly by the noble Viscount opposite, but from very considerable experience of practical dealings with cases that come, and others that should have come, under the existing Mental Deficiency Act, I can assure your Lordships that all the amendments made in the law by this measure have proved themselves in practice to be very seriously wanted. There is one question I should like to ask. As I understand the Bill, it enlarges the definition of mental defectives who are to be treated to the extent of allowing that the deficiency may have been set up at any time before the age of eighteen. Is the Government advised that this clause sufficiently covers cases of encephalitis lethargica, to which the noble Lord referred? That is the only question that I wish to ask, and I rose chiefly because I thought that perhaps somebody should express the extreme satisfaction with which this Bill has been received by a great many authorities throughout the country.

§ LORD JESSEL
My Lords, before the noble Viscount answers these questions, I should like to ask, as one who took part in Committee on the original Mental Deficiency Act, 1913, whether the Government can see their way to consolidate these Acts. I should like any noble Lord who has this Bill in his hands to look at it. It is nothing but amendments—very proper amendments, but they make it extremely difficult for those who have to interpret or to read the Bill to understand all its provisions. There is a very long substitution in the first clause, and all through there is a series of amendments. Clause 7 is particularly difficult. I am sure that there is no opposition to the Bill and that its proposals are most excellent, but the Government will be doing a great public service if next Session they bring in a Bill to consolidate these Acts. I hope that the noble Viscount will bear my request in mind.

EARL RUSSELL
My Lords, as my noble and learned Leader quite correctly stated, the subject of this Bill was not within the purview of the Macmillan Commission, on which I had the honour of serving, but of course it was impossible 1157 to deal with the question of insanity without becoming concerned with this branch of mental unfitness, and I have taken an interest in consequence in the fate of this Bill. I am bound to say that, like other speakers, I welcome this Bill and I only regret that it was not passed some years ago, owing, I understand, to difficulties in another place. I think that it will undoubtedly do a great deal to help these afflicted people when it becomes law.

VISCOUNT GAGE
My Lords, in reply to the noble and learned Viscount, the Leader of the Opposition, I understand, though I speak subject to correction, that this Bill does not affect the recommendations of the Macmillan Report. There is, of course, a difference between lunacy and mental deficiency which is well understood in specialist circles. I do not think any of the recommendations of that Report affecting lunacy really apply to this Bill, except indirectly. However, I will make particular investigation and, if there is any further information to be given, I will give it at a later stage of this Bill. I understand that the age limit of eighteen was arrived at after very careful consideration by the technical experts and is fully approved by the Board of Control and, as this question of encephalitis lethargica was one of the principal reasons for introducing the Bill, I feel convinced that this point has been specially considered. In reply to Lord Jessel, I am not in a position to say what steps my right hon. friend is prepared to take in the matter of consolidation, but I will certainly call his attention to the point and I have no doubt that something will come of it, though at this stage of the Session such consolidation would be impossible.