§ Order of the Day for the Second Reading read.
THE PAYMASTER-GENERAL (THE DUKE OF SUTHERLAND)My Lords, the Bill now before the House for Second Reading was in a private Member's hands in another place. It was in charge of the Member for Kincardine and West Aberdeen, Mr. Barclay Harvey, but His Majesty's Government have given it their full assent as it now stands and it has been agreed that in the House of Lords it should be treated as a Government Bill. In Scotland we justly take pride in our public health legislation which, from modest though effective beginnings, has developed into its present form, complete in many respects, but with faults and limitations that are recognised only in 625 course of time, and it is with certain of these so far as they affect maternity services in Scotland that the present Bill is concerned.
The principles of the Bill have the support of the Scottish Departmental Committee on Puerperal Morbidity and Mortality presided over by Lord Salvesen, and of the Central Midwives Board for Scotland and many of the local supervising authorities under the Midwives (Scotland) Act. During last year an Act was passed, applicable only to England and Wales, embodying similar principles. There are at present two Acts in operation in Scotland which are concerned with the service of midwifery. The Midwives (Scotland) Act of 1915 provides for the registration of midwives and their supervision by local authorities under the guidance of the Central Midwives Board for Scotland. It requires midwives to summon medical assistance in cases of emergency and provides that the expense shall be met by the local authority in necessitous cases. The Notification of Births (Extension) Act of 1915 provides for the notification of births in all areas and empowers local authorities to make arrangements for the care of expectant and nursing mothers, and of children under five years of age.
Schemes of maternity service and child welfare are now in operation in most populous areas in Scotland providing for 92 per cent. of the population. While the infant mortality rate is steadily decreasing there has been no similar decrease in maternal mortality. The maternal death rate for the year 1926 was 6.4 per 1,000 births, and the average rate for the previous 12 years has been 6.2 per 1,000 births. On the annual birth rate of about 100,000 this represents an aggregate of over 600 maternal deaths per annum. The maternal death rate in Scotland compares unfavourably with many other countries, and it is in the belief that it can be reduced that the Bill has been brought before your Lordships. The primary aim of the Bill is therefore the reduction of maternal morbidity and mortality in Scotland, and it is proposed to achieve this aim by tightening up and amending the Midwives (Scotland) Act, 1915, and by providing for the registration and regulation of maternity homes. The alterations in the Midwives Act consist in, firstly, an endeavour to remove 626 the possibility except in genuine emergency of midwifery being undertaken by an unqualified person; secondly, in enabling midwives more readily to call in medical assistance in a case of abnormality or complication; and thirdly, in providing that in any area in which a maternity service and child welfare scheme is not in operation the local authority shall at the patient's request make available the services of a midwife or medical practitioner. Any other points I can explain at the Committee stage. I beg to move.
§ Moved, That the Bill be now read 2a.—(The Duke of Sutherland.)
§ On Question, Bill read 2a, and committed to a Committee of the Whole House.