§ Order of the Day for the House to be put into Committee read.
§ Moved, That the House do now resolve itself into Committee.—(Viscount Gage.)
§ LORD CHARNWOOD
My Lords, may I be allowed to say a word? I am very reluctant to intervene at this particular stage at all. I will briefly explain why I do so. This Bill came first into our hands yesterday morning, if I am not mistaken, and during the last forty-eight hours a number of your Lordships, I am sure, have been receiving information and communications from various bodies of competent people who speak with some authority upon this subject. The trouble is, in my case at any rate, that the communications which I have received to-day after the Second Reading throw a very different light upon this measure from that in which I, I suppose like the rest of your Lordships, would have been disposed to see it yesterday evening. It is only really a few minutes ago that there was put into my hands, by a very capable and experienced lady, a statement that a number of bodies object to one of the provisions of the Bill—namely, Clause 9 (2), which is the provision dealing with delegation.
Those bodies are the Incorporated Midwives Institute, the College of Nursing, Queen Victoria's Jubilee Institute, and the Central Midwives Board. All of these strongly object to the provision in regard to delegation, which, I understand, we may regard as a vital part of the Bill, if it is to get through 1240 this Session. I understood yesterday, that any disturbance of this clause at this moment would upset the agreement arrived at between two other interested bodies—namely, the County Councils Association and the Municipal Corporations Association. I am not saying whether that is right or well founded, but obviously objections coming from the bodies whose names I have just read out must be objections which your Lordships would consider very gravely. The question may occur to your Lordships why, if these ladies have these strong views, did they not succeed in bringing the fact to your Lordships' notice yesterday instead of to-day? There is some explanation of that which I am not able to give your Lordships in detail, but which, I understand, is of this character, that there have been negotiations between these bodies and the Ministry of Health, in the course of which some misunderstanding has arisen, with the result that the measure, in the form in which it now comes before your Lordships, came quite as a surprise to these ladies, who obviously, being responsible for the training of the midwives in the country generally, have some right to a voice in the matter.
That being so, and if there are objections made to this Bill which plainly ought to be considered, and which equally plainly cannot be adequately considered now, I venture to ask the Government whether even at this stage they will not resolve upon the course of bringing this Bill afresh into your Lordships' House in the early part of next Session, when your Lordships will be actually thankful for a little work to do. I will refrain from the temptation to embark upon the general subject of business in this House and confine myself to this particular case, and it seems to me that the best course would be to reintroduce this Bill in this House early next Session. If this be not acceded to by the Government, I only hope that your Lordships will not be deterred from voting on any Amendment which may be proposed strictly upon its merits, without being unduly alarmed at the possibility that your vote may be fatal to the Bill this Session.
My Lords, perhaps I ought to apologise for what may have been an unfortunate phrase which I used 1241 yesterday, when I spoke of the pressure of time. If it be taken to reflect upon I he conduct of the noble Marquess the Leader of the House I wish to state that no such reflection was intended. I am sure that everyone will agree that the noble Marquess does what he can to alleviate the difficulties under which we labour, and to secure that every member of the House shall have an opportunity of speaking if he wishes. Apart, however, from that, one cannot help being oppressed by the question of time, because one has difficulty in consulting other people and in putting down Amendments. I shall myself have to move an Amendment which it, not upon the Paper, because I was not able to put it upon the Paper in time, and if the Government can adopt the suggestion of the noble Lord I cannot help thinking that it will be to the advantage of the Bill and of the House. The difficulty is this. Except in first class matters, where it is our duty as an Opposition to embarrass the Government in every possible way, no one is desirous of preventing them from reaping their harvest of legislation, even at such a late hour, but I do feel oppressed by the difficulty of time, and if the Government can see their way to postpone the Bill for a year I cannot help thinking that it will be of great advantage.
§ VISCOUNT HALDANE
My Lords, I am not quite at one with my noble friend who has just spoken. What has been said by my noble friend Lord Charnwood is tantamount to an invitation to your Lordships to reject the Bill. It is that or nothing. It is all very well to say: "Bring it in at the beginning of the Session, and then we should have time to consider it." That is quite true, and it would be better. But we do not live in Laputa here, and therefore we have no confidence that this Bill will again have time found for it in the other House. There is a very large programme, if all report is true, for the other House next Session, and when this Bill may be reached, or if it will be reached, is a very speculative question. I am all for a bird in the hand. There are questions here on which, no doubt, we might interchange opinions, and possibly devise improvements, but I am so anxious to get these nursing homes inspected, and as 1242 soon as possible, that I am not prepared to lay aside the Bill merely for minor considerations.
It is quite true, no doubt, that, as my noble friend Lord Charnwood said, there are ladies very skilled in medical questions, possibly skilled in scientific questions also, who do not like the system of inspection to be delegated to the borough councils, instead of being retained in the hands of the county councils, but that is not a question of medicine or a question of science. It is a question of local government, and it is a question that was thrashed out in the other House and an agreement was come to. I am not prepared to disturb that agreement. I have no certainty that it would be departed from if the Bill went there again and I have no desire to imperil the prospects of this Bill, which is to me a valuable one, merely because of what I call a minor point of that kind. It is a question of local government, it has been thrashed out and agreed upon, and if the ladies did not quite understand what they were doing when they talked local government with the Ministry of Health that is because their chief concern was with nursing and science, and not with local government. I therefore feel that we should do well to pass this Bill now when we can, and thereby reap an advantage which becomes highly speculative if we allow the matter to stand over to another Session.
§ THE MARQUESS OF SALISBURY
My Lords, I am quite sure that your Lordships—or, at least, I almost hope that your Lordships—will sympathise with me in the position in which I am placed, because it is quite true that the case for protest against this method of legislation is overwhelming. I do not hesitate to say that it gives me the greatest concern as year after year we see legislation necessarily scamped—for I do not use a less phrase—because of the difficulties with which your Lordships have to contend. At the same time we have this Bill before us, and we have the noble and learned Viscount, who has taken a great interest in these subjects all his life, urging us to go forward, and there is the noble Earl, Lord Russell, who is, I will not say urging us to go forward, but quite willing that we should go forward; further, there is the great body of opinion represented in another place which 1243 is very anxious indeed for the Bill, and there are my colleagues, especially my colleague the Minister of Health, who has shown himself so very eager for the reform of government in every direction, and who is very anxious for this Bill.
Well, then, am I to consent to code to the gentle pleading of the noble Lord and also to the gentle pleading of the noble Earl, Lord Russell, when I find that such great pundits who sit opposite me are anxious that the Bill should go forward? As I have said—and I am going to keep my word—if there is a real feeling in the House that the Bill should be postponed, I mean a very considerable feeling, I shall not resist it. I shall very much regret it, but I shall not resist it. Would it not be better for us to go into Committee on the Bill, and see what we can do? I do not mean to hint that I am going to ask the Government to make concessions, but we might argue the point at any rate.
§ On Question, Motion agreed to.
§ House in Committee accordingly:
§ [The EARL OF KINTORE in the Chair.]
§ Clauses 1 to 5 agreed to.
§ Clause 6 [Power to exempt certain institutions.]
§ THE EARL OF PLYMOUTH
I have received intimation from the noble Earl, Lord Clarendon, who has an Amendment on the Paper to leave out Clause 6, that he does not desire to move this Amendment.
§ Clause 6 agreed to.
§ Clause 7:
§ Power of Minister to exempt Christian Science nursing homes.
§ 7.—(1) The Minister of Health may grant exemption from the operation of this Act in respect of any nursing home, as respects which he is satisfied that it is being or will be carried on in accordance with the practice and principles of the body known as the Church of Christ Scientist.
§ (2) It shall be a condition of any exemption granted to a nursing home under this section that the nursing home shall adopt and use the name of Christian Science house.
§ (3) An exemption granted under this section in respect of a nursing home may at any time be withdrawn by the Minister if it appears to him that that home is no longer being carried on in accordance with the said practice and principles.1244
VISCOUNT FALMOUTH moved, at the end of the clause, to insert as a new subsection:—
(4) For the purposes of the powers of the Minister under the provisions of this section, the Minister may at all reasonable times inspect any nursing home to which this section applies, and may refuse exemption or withdraw an exemption on the ground that as regards the home the provisions of paragraphs (a), (b) or (e) of the proviso to subsection (3) of Section 1 of this Act are not complied with.
The noble Viscount said: The noble Earl, Lord Russell, has an Amendment on the Paper which, if passed, would remove the clause entirely from the Bill. The Amendment that I have put down will, I think, remove some of the objections which are felt to exist by many people to the inclusion of Clause 7. Under my Amendment the homes which are used by Christian Scientists will be liable to inspection under three headings—namely, for experience and reputation of the person in charge of the home, secondly, from the point of view of the general state of the home as regards sanitation and cleanliness, and also in regard to the question of midwives. I understand that in another place a somewhat similar Amendment was moved by interests in connection with the Christian Science movement. I sincerely trust that the Government will be able to accept this Amendment. I have had considerable experience on the London County Council in matters relating to this type of legislation, and we all realise that it is very important indeed to get this Bill through. Personally I should like to see Clause 7 omitted altogether, but I feel, from what was said in another place by the Minister when he introduced it, that if the clause were omitted the Bill would practically fall, and not be carried forward.
Page 6, line 3, at end insert the said new subsection.—(Viscount Falmouth.)
It is not perhaps strictly in order, but it might be for the convenience of your Lordships if I were to discuss my Amendment [for the omission of Clause 7] and the clause that I propose to substitute at the same time as this Amendment. I had only time last night to put down the Amendment, which appears on the Paper, to omit the clause, but since then I have drafted an alternative clause, to which I will refer 1245 in a minute. I would ask your Lordships first to look at Clause 7. It states:—The Minister of Health may grant exemption from the operation of this Act in respect of any nursing home, as respects which he is satisfied that it is being or will be carried on in accordance with the practice and principles of the body known as the Church of Christ Scientist.Then your Lordships will notice that at the end of the clause it says that the Minister may withdraw the exemption if it should appear to him that the home is no longer being carried on in accordance with the said practice and principles. I do not quite know what the qualifications of the Minister of Health are for judging whether Christian Science principles and practice are being strictly adhered to. It seems to me at least as difficult a question as any that arose on the Prayer Book, and I should be sorry to be in his position of holding, so to speak, an inquiry about heresy on this particular faith.
But I object to the clause altogether very strongly because of its reference to this particular body, as I said yesterday. I can quite see that there may be a case for granting exemption from the provisions of this Bill, and particularly from the medical provisions, to a body which does not believe, in medical treatment; but I cannot see why that should be limited to any one particular sect. This American sect founded By Mrs. Eddy—which, it is true, has grown to considerable proportions in this country—is not the only one which holds these particular opinions about medical attention. We had in this country long before Mrs. Eddy our own Peculiar People who from time to time appeared at coroner's inquests on people who had died from want of medical attention and even from, time to time appeared in the Criminal Courts on indictments for manslaughter, for which they were generally not convicted on account of the obvious honesty of their purpose and beliefs, however unfortunate the result.
I cannot help thinking that if we are to grant this exemption at all it would be very much better that it should be granted in general terms, and I suggest to your Lordships that we might substitute for this clause a new one which I will read to your Lordships as, unfortunately, it is not on the Paper:— 1246The Minister of Health may grant exemption from the operation of this Act in respect of any nursing home which he is satisfied is being carried on without medical or surgical treatment. Such exemption may be complete or partial and shall remain in force for one year. No order of the Minister shall exempt a nursing home from the requirements of any by-law made under Section 4 (1) (b)"—I pause there to remind your Lordships that this is the provision which requires a report to be made of any death that occurs in a nursing home. It seems to me that deaths in a nursing home in the absence of medical treatment are, above all deaths, those which ought properly to be reported, and that in any case the requirements of that provision ought not to be the subject of exemption because they may be and very likely would be proper cases for inquiry. The proposed clause concludes in this way:—An exemption granted under this section in respect of a nursing home may at any time be withdrawn by the Minister if it should appear to him that the conditions have changed.I have been informed that the objections of the Minister to these wider terms are that they might let in undesirable and not respectable bodies.
I was accused by the noble Marquess yesterday, I think, of using, perhaps, somewhat intolerant or unkind language in regard to Christian Science. I can assure the House that I did not say anything like what I thought and I do not propose to do so to-day. But other bodies would have to show the Minister, obviously just as this body would, that the home was a respectable nursing home, was respectably conducted and for proper purposes, whatever the bodies were, whether Peculiar People or Christian Scientists or any other class of people. I think I am right in saying, and I ask the noble Viscount who is in charge of the Bill whether that is so, that the distinction between these homes is that they have no medical attendants, that they do not admit of the attendance of a doctor there, neither medical nor surgical; and the principal objection is to the principal head being a qualified nurse and to the general introduction of medicine, and that is properly met by the clause which I have just read to your Lordships.
Certainly, I really must apologise to your Lordships, but the noble Marquess knows how difficult it is to do these things in time:—The Minister of Health may grant exemption from the operation of this Act in respect of any nursing home which he is satisfied is being carried on without medical or surgical treatment. Such exemption may be complete or partial and shall remain in force for one year. No order of the Minister shall exempt a nursing home from the requirements of any by-law made under Section 4 (1) (b). An exemption granted under this section in respect of a nursing home may at any time be withdrawn by the Minister if it should appear to him that the conditions have changed.Your Lordships will notice that with one exception of the reporting of the deaths occurring in a nursing home, the clause gives the Minister sufficient discretionary power to exempt from this or that provision or from all the provisions of the Act in any case in which he thinks proper to do so. If any exemption is to be granted at all it is much more fitting that it should be general. I do not like to see a clause going forward in an Act of Parliament for this particular body; indeed, I feel so strongly about it that if I could induce any of your Lordships to agree with me I should be prepared to divide the House upon it.
But the noble Marquess, I think, realises that I do not desire that this Bill should not pass. I do not differ from my noble Leader. I think it is time that these nursing homes were inspected and brought under control, and I do not think that the putting in of this clause would imperil its chances in another place. I have not had time to make myself aware of the exact circumstances under which this clause was introduced nor have I had time to make myself aware of the stage of the Bill at which it was introduced; but if we are allowed, as we are told that we shall be allowed, to take a free and unfettered view of this matter, I cannot help thinking that in this case a more general clause is more appropriate than this special clause which does not meet all the cases and which has undesirable features. When the time comes and the noble Viscount's Amendment is disposed of one way or the other (which, I may say, would not at all meet my point, as your Lordships see) I propose to move the clause in the form in which I have read it to your 1248 Lordships, and I should be very glad indeed if I could obtain the consent of His Majesty's Government to it. I would much rather do that than make any attempt to press it upon them because I have done all I can to be reasonable in the matter.
§ VISCOUNT ASTOR
I understand that we have before us actually the Amendment which stands in the name of the noble Viscount, Lord Falmouth, as well as that which the noble Earl has read out. With regard to the Amendment of the noble Viscount, I have been authorised to say, on behalf of the Christian Science movement, that they would be quite willing to accept it.
§ VISCOUNT ASTOR
Viscount Falmouth's Amendment. As the noble Viscount rightly said, it is substantially on the lines of an Amendment which was moved in another place. The only point they asked for there was exemption from the obligation of having in charge of all their homes or institutions a duly qualified doctor or a duly qualified medical nurse. I think it was felt in another place that it would be illogical and unfair to insist upon having a medical man or a medical woman in charge of a home or institution to which people went who did not believe in medical treatment. Neither the medical profession nor Christian Science would gain if we insisted that they should try to run an institution jointly. As the noble Marquess the Leader of the House said yesterday, unless some exemption is granted it will in fact be impossible for a Christian Science institution to be maintained. It was felt in another place that it would be illogical and also would savour of religious persecution. The Minister of Health said that it would be illogical to say it was legal for a person to have this form of healing in his own home and illegal if he was to try to have it in an institution. The only point I want to make is that as far as the Christian Science movement is concerned they would be quite ready to accept the Amendment. They have always tried to explain that they would welcome all forms of inspection.
§ VISCOUNT HALDANE
If, in this country, we were governed by logic and not by Parliament I should agree with 1249 the noble Viscount who has just sat down, and I should agree with my noble friend Earl Russell, and I should agree also with those of your Lordships who think that this is an illogical Amendment. But that is not the practical question before us. The question is whether we are to have this Bill or not and you may just as well press your logical views about this Amendment as move that the Bill be read a second time this day six months. It comes to exactly the same thing. I want to pass the Bill and I am prepared to sacrifice logic in order to do so. I am as far away from the Christian Scientist movement as my noble friend can be. I do not believe in it and I do not believe in any of these exemptions. I have never believed in exempting people who object to vaccination and I have always struggled against it. But I am here confronted with a practical situation: are we to reject this Bill or are we not to reject it? I am against rejecting it. Therefore I am against this Amendment, which means the very same thing as rejection. Therefore if my noble friend (Earl Russell) goes to a Division I am afraid I cannot follow him into the Lobby.
§ EARL BEAUCHAMP
As the noble Marquess who leads the House, knows we have agreed to the consideration of this Bill and as he also knows we are naturally very much influenced as time goes on when we hear various objections being made to it. I am quite free to say if I had understood that in no circumstances could any Amendment possibly be allowed in this Bill I should never have been ready so far as I have any influence to allow it to proceed as far as it has. I think we are free to introduce any Amendment that we think desirable. It is desirable even at this late hour that we should move the Amendments because it is possible for us, if we find they are objected to in another place, not to insist on them, supposing they are now agreed to by your Lordships' House. There really are three Amendments to this particular clause, one standing in the name of the noble Viscount, Lord Falmouth, another (which is not now moved) to withdraw the clause altogether and the last one in the name of Earl Russell which is not printed but of which he has been good enough to give me a typewritten copy. 1250 It seems very important that there should be an Amendment to the Bill as it stands at present and of those three alternatives I prefer the one just mentioned by the noble Earl, Lord Russell. I hope very much he will go to a Division on the subject and I shall have much pleasure in following him into the Lobby.
§ THE EARL OF DUNMORE
May I ask the noble and learned Viscount, Lord Haldane, to say which Amendment he was referring to?
§ VISCOUNT HALDANE
I was referring to all Amendments that can be put down that alter the compromise come to in the House of Commons. If that is, altered the Bill is lost.
§ THE EARL OF DUNMORE
I understand the Christian Scientists are prepared to accept Lord Falmouth's Amendment.
It might be convenient if I said something at this juncture. Several Amendments are placed before your Lordships. From the point of view of the Ministry of Health they all involve questions of principle which can be dealt with from their point of view together. I hope the House will excuse me if I go over some of the ground that was traversed yesterday. The main reasons why the clause was inserted are these. Christian Science is not merely an unorthodox way of treating the sick, but is, or professes to be, a religion. It is not the business of the Minister of Health to say when a belief can be, dignified by the name of a religion, but I would point out that there are various members of this House and of another place who are professing members of the Christian Science Church. In that respect I think it can be distinguished from other unorthodox methods of treatment. There are various systems of treating the sick otherwise than by means of medicine; but they do not have this peculiar feature which has been mentioned to your Lordships to-day of being concerned with the religious belief of a large section in this country. The case for exempting Christian Science was put before the Select Committee on those grounds and it was argued that the inclusion of Christian Science homes within the scope of the Bill was tantamount to preventing such homes being estab- 1251 liahed in this country. The reasons were, I think, fully developed by the noble Marquess the Leader of the House yesterday.
A further point is this. Comparing the claims of Christian Scientists with those of other sects, we observe that no other sect thought it worth while, whatever their beliefs, to submit them before the Select Committee. That deals, to some extent, with the argument of the noble Karl, Lord Russell. Clause 10 does, in the opinion of the Ministry, definitely include Christian Science homes and if they are not to come within the purview of this Bill there must necessarily be an exemption clause. The Minister felt that it was not in accordance with the principle of religious tolerance to refuse to insert this exemption clause and that was accordingly done. It has been carefully drafted in order to make it impossible for a person who merely wishes to use the cloak of Christian Science to carry on an irregular and unregistered nursing home to obtain exemption. The Minister of Health has to be satisfied that the home is a bona fide Christian Science home and he proposes in every case to consult the central authorities of the Christian Science Church. There, again, the question of the whole status of Christian Science as a religion appears to arise, but it must be clear to your Lordships that the size of that body and the fact that members of both Houses of Parliament belong to it do entitle it to quite special consideration. Further, it is to be a condition of exemption that the home shall bear a distinctive name—Christian Science house—which will prevent any possibility of persons entering the home under a misapprehension.
The position of the Minister is that he wishes to be entirely clear of any responsibility in regard to these homes. Having accepted the religious principle, he wishes publicly to announce that these homes are Christian Science homes, or houses, as the definition goes, and as such are not subject in any way to control or supervision by the State. If the principle of religious tolerance is accepted it is difficult to see how the Minister could do otherwise. Of course it can be argued that the mere listing of these Christian Science houses by the State does imply a certain responsibility, but the Minister is prepared, in the circular for the information of local authorities which will accompany this 1252 Bill if it is passed, to make it perfectly clear that the whole object of listing these houses is to take away any possibility of the public imagining that these houses have any State supervision at all, except for irregularities for information as to which the Minister is relying on the Christian Science movement. These observations are intended to deal with the Amendment of the noble Lord, Lord Falmouth.
It must be evident that if this clause is omitted Christian Science houses will be included. If it appears to your Lordships, as it appeared to the Minister of Health, that that course is not fair, there are two courses open. The first course would be to require the homes to be registered and inspected in the ordinary way but with some relaxation of the conditions as to qualified nurses and doctors. The Minister of Health took the view that this would give these homes the imprimatur of the supervising authority. It would imply that the State took responsibility up to a point for the treatment in these homes. They could claim to be registered and to receive what would be regarded in fact as a State guarantee. The other course, which is the course followed by the clause, is to provide that if the Minister is satisfied that the home is a Christian Science house, he should publicly exclude the house from the whole system of registration and inspection provided in the Bill and compel the home to adopt a title which makes it patent to all that the home is so excluded.
That was the line taken. Whether it will commend itself to your Lordships I cannot say. We have various other stages of the Bill to-night and it is possible that further views will be put forward. Therefore I do not wish to make an absolutely final statement at present on the Amendment proposed by Lord Falmouth, but that is the position which the Minister has taken up and I think it is a logical one. There has been some question as to the number of these houses and I believe the evidence on that point has been conflicting. The number of the houses is very small, however, and it can hardly be said that they will compete, or are likely to compete on any substantial scale with ordinary nursing homes. I think that is all that it is necessary for me to say at the 1253 present stage. The argument which led the Minister to accept the Amendment has been put before you. If in the course of further debate any suggestions are brought forward which commend themselves to your Lordships' House no doubt my noble Leader will give them careful consideration.
I should like to intervene for a moment on a point of order. The Amendment now before your Lordships is to add a new subsection at the end of the clause. If the Lord Chairman were to put my Amendment in the form in which I propose to move it. I take it that he would have to put first that two or three lines shall stand part of the clause and then put as a subsequent question that the subsequent words of the first subsection should stand part in order to allow us to delete them to carry my Amendment. If we have carried a new subsection it seems to me it would hardly be open to us to take it out later.
§ THE MARQUESS OF SALISBURY
I realise as much as anybody the difficulty of the present discussion having regard to the very abbreviated form of procedure which we have agreed to pursue. I am not clear as to what is the exact position of the noble Earl—no doubt it is my fault—and I should like to ask whether he opposes Lord Falmouth's Amendment. Is that his position? I rather gathered from the noble Earl, Lord Beauchamp, that though he preferred the noble Earl's Amendment yet he would not be dissatisfied provided Lord Falmouth's Amendment was inserted. I am not quite clear whether I am to look upon them as alternatives.
My personal view is that I really do not care very much one way or the other about Lord Falmouth's Amendment. It does not in any sense meet my point.
§ EARL BEAUCHAMP
I should certainly vote with the noble Earl beside me in favour of his Amendment. Like him I really do not mind what happens to Lord Falmouth's Amendment.
§ THE MARQUESS OF SALISBURY
I am afraid it would be impossible for the Government to accept an Amendment which so radically alters this clause. The result of adopting the view of the noble Earl would be that it would be necessary for the Minister of Health to authorise any home which fulfilled these conditions, which he is satisfied is being carried on without medical or surgical treatment. I feel sure if the noble Earl had had time to consider the matter he would see that that is impossible. The Bill would read that—The Minister of Health may grant exemption from the operation of this Act in respect of any nursing home which he is satisfied is being carried on without medical or surgical treatment.In point of fact the noble Earl would make it a condition that there should be no medical or surgical treatment. In that case apparently, and in that case alone, the Minister of Health might grant exemption. It is true that the Government are stretching a point and going a very long way in order to meet the very special conditions of the Christian Science sect, but to widen it in the way in which the noble Earl proposes would really be like a provision in "Alice in Wonderland."
The condition which the Minister would have to contemplate in granting exemptions from all the provisions of this Bill would be that there should be no medical or surgical treatment. Provided there is no medical or surgical treatment he may grant exemption. That is impossible. I am not merely arguing theoretically. We know there are homes where old people are taken in to die. There is no question about curing them. They just go in and die. That is a very grave matter, because those homes would fulfil the conditions of the noble Earl. The point is really not to be argued as he has drafted the Amendment. You cannot give a perfectly free hand to the Minister to exempt provided there is no medical or surgical treatment. That would mean that there might be every kind of neglect and yet apparently it would come within the terms of the noble Earl's clause. I do not find any fault with the noble Earl. I quite recognise that he has had to draft under very difficult 1255 circumstances, but I am afraid it would be quite impossible for the Government to accept an Amendment in that form.
As regards the Amendment of my noble friend Lord Falmouth, which is perhaps more germane to the question, for it is the Amendment before your Lordships, there is a great deal to be said for it. I am not prepared to pledge the Government to that Amendment but, if my noble friend presses it, I do not resist its being put into the Bill. It must be quite understood, however, that if the House of Commons disagrees with it there is no pledge on the part of the Government to press for it. When my right hon, friend the Minister of Health comes to look at it, if he sees that there is serious objection to it he will no doubt move in the House of Commons to strike it out, and I must not be understood to pledge the Government to it. I do not mind accepting my noble friend's Amendment on those terms, if he wishes me to do so, but I cannot possibly assent to the noble Earl's Amendment. Really, since "Alice in Wonderland" was written I do not think there has been anything to compare with it.
I propose to deal with the one point made by the noble Marquess, for, with all respect to the noble Viscount in charge of the Bill, this seems to be the only point so far made against my Amendment. Most of what has been said is irrelevant to what I proposed. I understood—I may be mistaken—that the whole point of the exemption of these homes was that there was neither medical nor surgical treatment.
§ THE MARQUESS OF SALISBURY
May I interrupt for a moment? There is, in the opinion of the Government, a guarantee of good faith in the fact of their belonging to the Christian Science connection. It is not an unknown matter. We all of us know what the Christian Scientists profess, even if we do not agree with it—and I am one of those who profoundly disagree with the Christian Science view—but the fact that these homes would be connected with the Christian Science society is a great guarantee of good faith. That eliminates all the objectionable homes of which I have spoken. If you refer it to that connection 1256 you have a guarantee. Under the noble Earl's Amendment you have no guarantee whatever.
I am not going to suggest for a moment that there is no guarantee of good faith in the fact that these homes are connected with the Christian Science movement, but, as I understood it, the reason which justified this exemption was that there was neither medical nor surgical treatment, the inspection of homes being required to apply to all nursing homes where there was medical or surgical treatment with the intention of seeing that it was properly carried on, and every provision of the Bill being directed to that end, such as the provsions as to medical inspection as to qualified nurses and so on. All these provisions are directed to seeing that the medical or surgical treatment is properly given. I understood that the whole reason for the exemption of that particular class of home was that it had neither medical nor surgical treatment. Yet now the noble Marquess says that to ask the Minister to discover whether there is either medical or surgical treatment is like something in "Alice in Wonderland," and that it would be a thing impossible to discover. Let me ask him one question. Does he really think it more desirable that the Minister of Health should have to discover whether this treatment is carried on in accordance with the practice and principles of Christian Science? That seems to me a much more difficult matter than to discover the simple fact of whether there is medical or surgical treatment or not. That is what the clause would provide. As for the homes where old people go to die, there may be no question of curing them, but surely they are under medical observation and treatment when they are there and are kept as well as they can be kept.
§ THE MARQUESS OF SALISBURY
The noble Earl has misunderstood me. They are not kept as well as they can be kept. This is a device under which unscrupulous relations manage to divest themselves of the responsibility of looking after their old relatives. That is a very grave matter. Surely such unscrupulous people and homes of this kind ought to be stopped; and, so far as I can make out, they would come under the noble Earl's Amendment.
I certainly did misunderstand the noble Marquess in one respect. I did not realise that he was referring to discreditable cases of that sort. I see now the point he makes, that the mere fact that these people were being neglected and not properly treated would give an opportunity for claiming exemption under this clause. But has not the noble Marquess overlooked the fact that the whole thing is in the discretion of the Minister, and that the Minister will grant this exemption only where he is satisfied that the home is properly carried on? This is not a clause which exempts them by the Statute itself, but it clearly says that, when the Minister is satisfied that the home is properly carried on, he may grant an exemption. It is hardly fair to put it upon me as if the Statute said that these homes shall be exempted, no matter how discreditably they are carried on, because that is not what the Bill says, nor is it what my proposed Amendment would say.
While I am addressing your Loidships, perhaps I may be allowed to say that there is, I hope, no suggestion of religious intolerance in my proposal. I am merely suggesting that all sects should be treated alike and that the provision should be general instead of special. The noble Viscount who represents that faith in this House—I do not see him here now—said that he did not object to Lord Falmouth's Amendment, but he did not, I think, say whether he objected or did not object to mine, or if he did he did not tell me why. I suppose the objection would be that they have not a monopoly. That is all that I was pressing for, and there is certainly no question of religious intolerance involved. I should like to ask, in deference to what was said by my noble Leader behind me, whether it is suggested on behalf of the Government that, if my Amendment were accepted, it would be likely to delay or destroy this Bill, because I do not conceal from the noble Marquess for a moment that this is a suggestion that would influence me. It was not made, however, by anybody on behalf of the Government, though it was made by my noble Leader. I should be glad to know if the noble Marquess has anything to say upon that point.
§ THE MARQUESS OF SALISBURY
I certainly am not prepared to resist all Amendments simply because they are 1258 Amendments. Do not let your Lordships think that for a moment. Let me call your Lordships' attention again to one point. The noble Earl says, quite rightly, that the Minister would not be compelled to grant exemptions. It is true that there is the word "may," and the noble Earl relies upon the word. No doubt "may?" does not exactly mean "shall," but it would be very difficult for the Minister to refuse, not perhaps in the very extreme cases which I put, but in cases less extreme which lie on the borderland, unless there were directory words to tell him what to take into account in coming to his decision. The noble Earl has provided nothing of that kind. All the Minister has to consider is whether there is medical or surgical attention in deciding whether it is possible to make an exemption. The Minister, after all, does not act purely on his own caprice in a matter of that kind. He has to act according to some principles laid down in the Act of Parliament. The noble Earl lays down no principle at all. He says simply that, provided there is no medical or surgical treatment, then the Minister is to have this discretion. I am quite sure that this is not reasonable legislation. Either you must give on the very face of the clause some directory words (which would be very difficult to frame) on which the Minister would act, or you must attach the clause to some well-known organisation—let me use the most general word—which is in itself a guarantee of good faith. You must do one or the other. These are the only possible alternatives. As the noble Earl's Amendment stands, I am sure that we could not accept it.
I do not, of course, wish to carry the dispute any further. I certainly admit that the word "may" is a word that I rely upon and, if the word is not sufficiently supported, then the noble Marquess will have ample opportunity at a later stage or in another place to put in other words. The principle is a different matter. The principle concerns the difference between a general exemption and a special one, and by that I do stand.
Do I understand from the noble Marquess that he 1259 will accept my Amendment and that, when it goes to another place, it will be considered by the Minister?
§ THE MARQUESS OF SALISBURY
It will be considered by the Minister, but there must be no suggestion of a pledge on my part that the Minister will accept it in another place.
§ On Question, Amendment agreed to
EARL RUSSELL moved to leave out Clause 7 in order to substitute the following new clause:—
The Minister of Health may grant exemption from the operation of this Act in respect of any nursing home which he is satisfied is being carried on without medical or surgical treatment. Such exemption may be complete or partial, and shall remain in force for one year. No order of the Minister shall exempt a nursing home from the requirements of any by-law made under Section 4 (1) (b). An exemption granted under this section in respect of a nursing home may at any time be withdrawn by the Minister if it should appear to him that the conditions have changed.
The noble Earl said: I think we have already had sufficient discussion on my Amendment and I do not wish to say much more about it, but I shall be very
§ Resolved in the affirmative, and Amendment disagreed to accordingly.
§ Clause 7, as amended, agreed to.
§ Clause 8 agreed to.1260
§ glad if any of your Lordships who feel as I do would support me, because I think that this clause in the Bill is most undesirable. The alternative form I have suggested may not be the best form but I think the exemption should be general and not particular, and if the Minister has a discretion I do not see why he should not exercise it in a way which would exclude all the undesirable cases to which the noble Marquess referred.
Leave out Clause 7 and insert the said new clause.—(Earl Russell.)
§ EARL BEAUCHAMP
I do not know whether the noble Marquess would be satisfied if the word "properly" were inserted, so that the new clause would read "being properly carried on." If that would make it easier for the noble Marquess to accept the Amendment, I suppose that the noble Earl would willingly make this alteration, and we might then arrive at a unanimous decision. Otherwise I shall certainly follow the noble Earl, Lord Russell, into the Division Lobby.
§ On Question, Whether Clause 7, as amended, shall stand part of the Bill?
§ Their Lordships divided; Contents, 28; Not-Contents, 14.1259
|Cave, V. (L. Chancellor.)||Stanhope, E.||Cushendun, L.|
|Salisbury, M. (L. Privy Seal.)||Danesford, L.|
|Astor, V.||Dynevor, L.|
|Bertie of Thame, V.||Dunmore, L. (E. Dunmore.)|
|Airlie, E.||Falmouth, V.||Gage, L. (V. Gage.)|
|Cranbrook, E.||Haldane, V.||Kilmaine, L.|
|Iddesleigh, E.||Ullswater, V.||Kintore, L. (E. Kintore.)|
|Lovelace, E.||Lovat, L.|
|Lucan, E. [Teller.]||Arnold, L.||Muir Mackenzie, L.|
|Onslow, E.||Clinton, L.||Thomson, L.|
|Plymouth, E. [Teller.]||Cottesloe, L.|
|Northumberland, D.||Russell, E. [Teller.]||Charnwood, L.|
|Fairlie, L. (E. Glasgow.)|
|Lincolnshire, M. (L. Great Chamberlain.)||Chaplin, V.||Olivier, L.|
|Cowdray, V.||Ormonde, L. (M. Ormonde.)|
|Devonport, V.||Parmoor, L.|
|Beauchamp, E.||FitzAlan of Derwent, V.||Stanmore, L. [Teller.]|
§ Clause 9:
§ Local supervising authority.
§ (2) The council of a county may, on the application of the council of any county district 1261 trict within the county, delegate to the district council, either with or without any restrictions or conditions as the county council thinks fit, any of the powers or duties of the county council under this Act.
§ (3) If any district council by which an application is made under subsection (2) of this section is aggrieved by the refusal of the county council to delegate any of its powers or duties under this Act or to delegate any such powers or duties otherwise than subject to conditions or restrictions the district council may make a representation to the Minister with respect to the matter, and the Minister, after consultation with the county council may direct the county council to delegate to the district council either with or without restrictions or conditions such of its powers and duties under this Act as the Minister thinks proper, and the county council shall comply with any direction so given.
This clause relates to the question of delegation. I understand that this is really in the nature of a compromise, and that it would be very undesirable to interfere with it at this stage. I do not like delegation. Of course delegation to borough councils is one thing, but to small rural district councils it is quite another thing, but in the circumstances I do not propose to move either my Amendment to omit subsections (2) and (3) of the clause or that to leave out paragraph (iii) in Clause 11 (Application to London).
§ LORD CHARNWOOD moved to leave out subsections (2) and (3). The noble Lord said: My Lords, I do not know whether I shall be in order in moving the Amendment which my noble friend has dropped—I do not say that I shall press it to a Division. I think, however, I ought to say a word more about the position taken up in regard to this matter by the various bodies connected with the nursing profession, and more particularly the midwifery branch of it. I would ask your Lordships for a moment to think of the position in which this Bill would place maternity homes. As I understand, if delegation takes place, inasmuch as they are nursing homes, they may be subject to inspection by one Department, and inasmuch as they are maternity homes, they would be subject to inspection by another Department. To that situation, I understand, the body to which I refer strongly objects, and I think some weight must be attached to their objection. It was rather airily waved aside by the noble Viscount, Lord 1262 Haldane, just now on the ground that the people making this representation were only women. After all, these persons, though they may be considered by the noble Viscount to be of inferior intellect, are necessarily the working people in the whole business of nursing, and particularly maternity nursing, and the fact that they object to the possibility of delegation, involving, as I say, their being placed under a dual system of inspection, one of which systems is very likely to be conducted by less qualified persons than the ether, is, I think, a point which I am justified in asking the Government to consider, and therefore, for the sake of form, I move the Amendment standing in the name of Lord Russell.
Page 6, lines 22 to 40, leave out subsections (2) and (3).—(Lord Charnwood.)
I am much obliged to the noble Earl, Lord Russell, for not moving his Amendment. He is perfectly right in assuming that this matter was the subject of a compromise arrived at after great difficulty, and after being studied by a large number of responsible authorities. The district councils from the first resisted the proposal to entrust the administration of the Act to county councils and county borough councils. The county councils were unwilling to give way, especially in view of the powers and duties of inspection in the case of midwives, which they already possess under the Midwives and Maternity Homes Act. These considerations were very carefully gone into, and the Minister, I am informed, succeeded in getting the parties to agree. I think that perhaps the noble Lord, Lord Charnwood, may have overlooked the point that the clause gives the county council power to delegate any of its duties, either with or without restrictions, as the county council thinks fit. I understand that they can retain powers in respect to certain homes to which certain qualifications attach, such as the maternity homes, which are subject, I understand, to inspection by specially qualified inspectors. They can make an exception in that case, although those maternity homes may be in the area which is delegated in all other respects to another authority. I do not know whether that gets over the difficulty of 1263 the noble Lord, but I understand that there is very little likelihood of this dual inspection, of which the noble Lord is afraid.
I should add that, if this clause is rejected, it should be remembered that it is one of the really important clauses on which there is practically no hope of reaching agreement in the House of Commons again, and the present agreement has been arrived at after very careful study. I hope that your Lordships will not reject the clause at this juncture.
§ LORD CHARNWOOD
Did I understand the noble Viscount to say that this unsatisfactory system of dual inspection is not likely to arise? Of course, I appreciate that the county council under this Bill might delegate all its powers under the Bill. But has it under this Bill any possibility of delegating therewith powers which it now exercises under the Midwives Act passed about a year ago? I understand that the difficulty to which I refer arises from the fact that, in a home subject to delegation, an inspection created by this Bill would be going on together with, and possibly conflicting with, an inspection which would be carried on under the Midwives Act. I am only pressing this point because, if I am wrong in that, I think it would remove some apprehension and misgiving on the part of the persons to whom I infer. I do not wish to give trouble to the Government at this stage of the progress of this measure, but I have a rather strong feeling that, where you are, by legislation of this kind, introducing new machinery to interfere with activities which people have been carrying on with considerable efficiency for a long time, though speed may be a consideration, it is still more important that the legislation should be thrashed out in all its details.
THE UNDER-SECRETARY OF STATE FOR WAR (THE EARL OF ONSLOW)
Perhaps I may be allowed to answer 1264 the question of the noble Lord. I have not got the book with me, but I think my recollection serves me more or less accurately. I only came into the House in the middle of the noble Lord's speech, but, as far as I understood him, he asked whether the general law was in any way affected by this Bill, or whether the inspection here referred to applied only to this Bill. As the noble Lord is aware, the authority in the case of midwives is the county council or county borough council. The only delegation which is permitted under this clause is for purposes under this Bill. The general law remains the same. I am speaking now because I happen to be Chairman of the Royal Commission which is investigating questions of local government. I understand from those who are interested in this matter that a letter has been addressed to me as Chairman of the Royal Commission, saying that this is an arrangement for this Bill, that it is recognised that the whole question is under the consideration of the Royal Commission, and that the Royal Commission would form its own opinion and report in accordance with the evidence, which has not yet been received. I think that is the answer to the noble Lord—that, as the inspection with which this Bill deals is only for the purposes of this Bill, the matter remains exactly as it was before.
§ Amendment, by leave, withdrawn.
§ Clause 9 agreed to.
§ Remaining clauses agreed to.
§ Schedule agreed to.
§ The (Standing Order No. XXXIX having been suspended) Amendment reported: Bill read 3a, and passed, and returned to the Commons.
§ House adjourned at a quarter before six o'clock till eleven o'clock to-morrow.