§ Order of the Day for the Second Reading read.
My Lords, the Bill to which I am going to ask you to give a Second Reading has been introduced twice into the House of Commons in the course of the present Parliament by Mr. Boothby, the Member for East Aberdeen, but although, as I am aware, there is a large body of opinion in that House in favour of the principle of this Bill, it could not be proceeded with there owing to pressure of other business. With less pressure in your Lordships' House, I will, with your Lordships' permission, endeavour to pilot the Bill through this House so as to facilitate its passage at a later date, as I hope, through the House of Commons. The purpose of this, Bill is a very simple one. It has a twofold object. Its main purpose is to establish by Act of Parliament a Board armed with the necessary powers and authority to compile a register of osteopaths, and to regulate the practice of this new system of therapeutics in this country. The other main object aimed at in the Bill is to impose upon the practitioners of this system a prescribed standard of professional training and technical competence, which will debar unqualified and incompetent persons from setting themselves up, as they now do, as osteopaths, claiming to be able to practise a system of manipulative therapeutics out, side the ambit of the Medical Acts.
187 May I briefly explain what osteopathy is, and why its practitioners ask Parliament to legislate on the lines of this Bill In non-technical terms osteopathy is a system of healing which dispenses largely with the use of drugs or the surgical knife, and lays emphasis mainly upon a standardised manipulative technique in dealing with bodily ailments. The system is differentiated, osteopaths claim, from ordinary medicine and surgery. Osteopathy claims to he a system of drugless medicine and bloodless surgery, in the sense that it relies mainly in the treatment of disease upon the principle that most diseases, if not all, have their origin in some maladjustment or misplacement of the body framework. Fundamentally, I suppose, the difference is that the osteopath does not rely, as the regular medical practitioner does, upon the use of drugs in the treatment of disease. He relies mainly upon a manipulative technique, the purpose of which is to restore the body mechanism to its proper work. The osteopath, generally speaking, does not believe that drugs effect a cure. He thinks the body itself, when it functions properly, will produce its own remedy for disease, which originates, in his view, in some kind of structural impairment in the first place. Unlike the ordinary medical man, who relies in the treatment of disease upon something called medicine which he puts into the body, or by cutting something out of the body, the osteopath relies upon the curative action of the body's own resources to produce, under the skilled touch of the manipulative surgeon, the medicinal agencies which will cure a disease.
Obviously, the difference between these two schools is fundamental. I may have simplified unduly the nature of the differences between them, but the point I wish to emphasise is that there is a difference in the view as to how disease originates and a difference in the method of treatment when a disease appears. I respectfully submit that, although your Lordships are not called upon to adjudicate in this conflict of theory, the House is entitled to say, and indeed should as a matter of public policy say, that the existing laws regulating medical practice shall not allow any unnecessary or unreasonable obstacles to lie in the way of each school of thought developing its system for what it is worth. Parliament, I am sure, did 188 not intend to confer upon any school of medical theory powers which would interfere with the development of an alternative theory regarding the causation and cure of disease. The Medical Acts were, I believe, primarily intended to ensure that the practitioners of the healing art should be fully qualified, and that unqualified persons should not be allowed to exploit the public by claiming to possess the qualifications in respect of medical education and professional training which the medical men have to prove they possess before they are registered. Registration under the Medical Acts was, I submit, intended to be a method of distinguishing between the qualified and unqualified practitioners for the protection of the public. It was not intended to be an obstacle in the way of developing medical science or preventing the discovery and use of new methods or new principles in the treatment of disease.
Undoubtedly the medical law, as it now stands, does impede the development of an independent system of treatment of disease such as osteopathy claims to be. According to the existing medical laws, unregistered practitioners, whether they are qualified as practitioners of osteopathy, or whether they have merely an empirical knowledge of manipulative surgery, or whether they are merely ignorant and incompetent, are all classed in the same category and stigmatised as quacks and charlatans. A registered medical man is not permitted by the competent authority controlling his profession to act even as an anaesthetist to an osteopath. It is within the recollection of your Lordships' House that one medical man of high and unblemished reputation was penalised for so acting. That was Dr. Axham. Other cases could be cited. My object, however, is not to prolong that controversy or to revive unhappy memories, but rather to plead that the time has come to frame a plan for avoiding in the future such causes of controversy and quarrel among those who are, I am sure, all anxious to do their best, according to their own lights, to develop the art and science of healing for the good, of humanity. This Bill will, I believe, attain this desirable aim.
Its prime object is to remove, under a separate and self-contained Act of Parliament, the disabilities that now attend the work of genuine osteopaths. I 189 venture to appeal to my noble friend Lord Moynihan and to my noble friend Lord Dawson—it may be there are others—who are concerned, and rightly concerned, to maintain the high standard of medical education attained in this country, who are jealous, and rightly jealous, of the high responsibilities imposed upon their profession by law, who realise, and properly realise, the necessity of preventing impostors and humbugs practising as doctors—I venture to appeal to those members of the House to examine this Bill entirely from the ethical point of view of bringing the osteopath's profession in this country into conformity with the standards laid down for the medical profession. What does this Bill propose to do? It is proposed in the first place to set up a. Statutory Board whose duty it will be to keep a register of qualified osteopaths. That Board is to be given the power of supervising the admission to that register of persons who have followed a prescribed course of study to qualify them to practise as osteopaths. The intention is to provide machinery for registering and controlling osteopathic practitioners similar to the machinery operating under the Medical Acts for the registration and control of medical practitioners.
In this Bill there is nothing which will enable an osteopath to obtain admission to the medical register. The osteopaths are not asking for admission to the medical profession. They are asking that they shall be admitted to an osteopaths' register; that only qualified osteopaths shall be registered; that the qualifications for registration shall in their own particular way be as strict, as definite and as onerous as those which admit to the medical register; that no osteopath shall be allowed to practise unless he is on the register of osteopaths; and that those who are admitted to the register as properly qualified osteopaths shall be allowed to claim the qualifications which in fact they do possess, and to use such titles and descriptions as will identify them as osteopathic practitioners and as nothing else. In this connection some objection may be taken by the noble Lord who is to move the rejection of this Bill, to Clause 6, under which graduates of foreign Universities may be registered by the Board when the Board is satisfied 190 with their diplomas. Let me say at once that should your Lordships believe that this clause is too loosely worded, I should have no objection to its being tightened up. I regard this not as a matter affecting the fundamental principles of this Bill, but merely as a point to be dealt with in Committee.
In asking the House to give a Second Reading to the Bill I may point out that it is designed and calculated to do what is already done in other countries. In the United States of America, where osteopathy originated more than half a century ago, practically all the States of the Union have legislated on these lines. Since 1930 in all the forty-eight States and Territories, and in most of the Provinces of Canada, the osteopathic profession is regulated and controlled by Boards similar to the Board which this Bill proposes to set up here. Under the protection of these laws osteopathic colleges and schools, sanatoria, hospitals and clinics have developed, and now that the profession of the osteopaths is organised their science is being furthered and their technique is being perfected in a very impressive manner. New forms of specialised treatment are being evolved by the osteopaths, and their claim to be able successfully to diagnose and treat disease is not now seriously contested in the United States of America. That is also the case in Canada.
As I have indicated, the purpose of this Bill is to prevent the practice of osteopathy by those who are not qualified, to distinguish between registered and unregistered osteopaths, and to prohibit the practice of osteopathy under any name by unqualified, which means non-registered, persons, and incidentally thereby to protect the public. This Bill ensures that; nothing more and nothing less. It will establish a register similar to the register maintained under the authority of the General Medical Council for ordinary doctors, and it will establish a Board which will include amongst its members independent persons with scientific and technical qualifications, selected by the Ministry of Health. One of these independent persons will be appointed by the Privy Council and will he Chairman of the Board. The others selected by the Ministry and not being persons of the ordinary medical profession, are to be persons of recognized 191 scientific status who will, along with the representatives of organisations of osteopaths in this country, lay down the subjects of study and the length of training which will qualify for registration. The Bill, as your Lordships will see, follows in its general outline the Acts which have established for the ordinary medical profession similar machinery of regulation and control.
There is very little left for me to say, but before I sit down I should like to ask the noble Lord who is moving the rejection of the Bill what he proposes to do if the Bill is rejected. How does he propose to protect the public from the obvious danger connected with treatment by unqualified persons describing themselves as osteopaths? Why does he object to osteopaths—whose profession, after all, is a recognised profession to-day—registering themselves? Did the noble Lord object to the registration of dentists, or of veterinary surgeons, or of midwives, or of masseurs? If all these are registered, why should not osteopaths, who, whatever the noble Lord may believe, are as definitely members of a profession, and a profession which is recognised by the public in this country, also register themselves?
There are very few, if any, noble Lords in this Assembly who cannot point to some case or another where osteopathic treatment has been of the greatest value either to themselves or to some friend. Even the medical profession is not agreed on this point, and there are broadminded medical practitioners who to-day send their patients on for osteopathic treatment. Since I introduced this Bill I have received letters from all over the country congratulating me on having introduced it and giving me instances of advantageous treatment which has been given to the writers by osteopaths. I feel so certain that I am upon the right lines in the Bill which I am asking your Lordships to pass, that I sincerely hope that your Lordships will not be carried away by the weighty words which I am sure will fall from the lips of my noble and distinguished friend Lord Moynihan, and from the lips of my noble and distinguished friend Lord Dawson of Penn. I am sure that your Lordships will feel that in this instance they should represent the public feeling in this country in this matter.
192 It is very difficult for me as a layman to argue with two noble Lords who have all the technicalities at their disposal, and so, in the event of your Lordships giving this Bill a Second Reading—as I am going to ask your Lordships to do in spite of the fact that, as I understand, the representative of the Ministry of Health is not altogether in favour of the Bill—I will thereafter ask your Lordships to agree to the appointment of a Select Committee to examine this subject carefully and to advise your Lordships upon it. Obviously it is a matter of a highly technical character, and it would he very difficult to examine this Bill across the floor of the House in the way in which it should be investigated and examined. Therefore, if your Lordships in your wisdom allow this Bill to have a Second Reading, I will subsequently move and ask your Lordships to agree to a Motion setting up a Select Committee, with full powers to call witnesses, with the object of examining this Bill and reporting to your Lordships' House upon it. I beg to move.
§ Moved, That the Bill be now read 2a.—(Viscount Elibank.)
§ LORD MOYNIHAN, who had given Notice that on the Motion for the Second Reading he would move that the Bill be read 2a this day six months, said: My Lords, it is to me a matter of no little regret that I feel compelled to oppose a Bill introduced by my noble friend Lord Elibank, for I cannot forget that when, a shrinking and timorous novice, I had the audacity to introduce a Bill to your Lordships' House, the fact that that Bill received a Third Reading was due in no small measure to the wise counsel and the invaluable help which were given to me in Select Committee by my noble friend. But I feel that the noble Viscount has not fully perceived the implications of this Bill, nor has he foreseen what I think would be the irreparable calamity that would follow if your Lordships gave assent to it.
My objections to this Bill are chiefly on two grounds. The Bill involves the negation of all those principles which are already embodied in the Medical Act of 1858, and before this Bill could become effective the Medical Act of 1858 would require to be repealed. This Bill would defeat the intention and the effect of that Act. Through the Medical 193 Register, the Medical Act enables every one to make discrimination between those who have and those who have not passed through the ordinary curriculum. The public are therefore enabled to distinguish quite easily between the qualified and the unqualified practitioner. The Medical Act of 1855 received its inspiration and its relevant purpose in the desire for the protection of the public, the protection of the public against those ignorant and really very dangerous people who have undergone no adequate medical training of any kind in those fundamental sciences upon which medicine is for ever based, and in the elements of that clinical work which is the task of both physicians and surgeons. This Bill sets aside all the defences which have been erected for the protection of the public, which time and circumstance and opportunity have shown to be se necessary. If, by mine miracle of perversity, your Lordships were to give your assent to this Bill the plea made to-day would not end with osteopaths. If one particular "theory" of medicine were guaranteed recognition, contrary to the Medical Act of 1858, especially Sections 23 and 28 of that Act, it would not be long before other cults which relied in some measure upon a smattering of medical training made their plea to your Lordships.
Many of your Lordships are far more competent than I could ever be to express an opinion upon the first point that I raise, and that is, that this Bill would involve the repeal of the Medical Act under which we at present conduct our work. But my second objection, and in fact, the one objection I am most competent to make, is that the acceptance of this Bill would involve a denial of, and would hold up to obloquy, the whole of the scientific basis of medicine to-day. If there is one country in the world which should regard itself as the custodian and the guardian and the protector of the fabric of scientific medicine it is this country. Medicine may quite truthfully be regarded as the parent and nurse of all sciences. It is by the methods first introduced and perfected by practitioners of medicine that all sciences are capable of advance. The method of inductive logic was introduced not by Aristotle, nor by Plato, nor by Socrates, it was introduced by Hippocrates, of whose ancient and serious diligence Lord Bacon 194 speaks at length. Hippocrates introduced the method of inductive logic, the method of inductive inquiry, comparison and generalisation, and the formation of conclusions. It was by Galen, who lived centuries after Hippocrates, that the method of experiment in medicine and in other sciences was, not first introduced, but certainly perfected and adapted for general use by other sciences. After Hippocrates and Galen there was a long and dark sterile period lasting for a thousand years, when the work of those two great pioneers was submerged by the reign of authority. To deny the teaching during that period of Hippocrates and Galen was not merely foolish, it was heretical and dangerous, as Servetus, the discoverer of the pulmonary circulation of the blood, found to his cost when be was burnt at the stake at the guilty hands of Calvin in 1553.
After this long and dark period, light was first seen in Italy in the oldest of her Universities, Salerno, in the wealthiest of her Universities, Bologna, and in Padua, famous for its teachers. It was at Padua that Fabricius, the great anatomist and surgeon was at work, and Fabric ins was the lodestone and magnet attracting Harvey to Padua, and it was Harvey who, after working there, first brought the Hipprocratic and Galenic methods together once again, and, by his discovery of the circulation of the blood, changed the whole aspect of medicine from being empirical to being scientific. The first foundation-stone of scientific medicine was laid by Harvey in his discovery of the circulation of the blood. But comparatively little could be done, even after Harvey's days until John Hunter, our patron Saint of the Royal College of Surgeons of England, with the help of Morgagni in Italy, established the science of pathological anatomy, the science by which the morbid changes in organs were for the first time correlated with the symptoms produced by disease.
But, in surgery at any rate, comparatively little benefit to the individual sufferer came until immortal Lister—in my quite deliberate judgment the greatest man that ever lived, and a member of your Lordships' House—came and, basing his work upon the investigations of Pasteur—not a quack and an outsider, but already a medallist of our own Royal Society—Lister, basing his work upon that of Pasteur, showed 195 that infection in wounds was similar to the process of fermentation which Pasteur had shown to be due, not to chemical changes in the atmosphere, but to the propagation of living particles in the air. Lister, by that very simple and almost childlike discovery, changed the whole face of the medical world. Lister has been the means of saving more lives than all the wars of all the ages have thrown away. It is the work of Lister that has been responsible, I am sure, for saving some of your Lordships, and for saving what you would regard as more important, the lives of many of those you love. Three great Englishmen have therefore been responsible for the modern developments of medicine, and there is surely a special responsibility resting upon our nation to see that nothing contrary to the great teaching of our leaders is undertaken, either here or elsewhere.
Osteopathy has no connection whatever with the main stream of scientific medicine. If there is any truth in the fanciful and imaginative basis of osteopathy, there is no truth whatever in scientific medicine. Medicine and osteopathy do not run on parallel lines: they are not complementary one of the other, but they are in direct and hostile opposition the one to the other. If the teaching of osteopathy is true, the foundations of scientific medicine have not been well and truly laid. The work of Harvey and of Hunter and of Lister must go. In place of all the knowledge which has been gained in the wards, in the laboratories, and in the operation theatres throughout the civilised world, we are seriously asked to accept an alien cult founded on no research, discovered by a process of serendipity in the mind of a layman in the United States of America. It is hardly credible that such a proposition could be put before a body of intelligent men anywhere, still less before your Lordships' House.
I do not deny that this problem may present some elements of obscurity to some of your Lordships who either in your own persons or in the persons of those with whom you are acquainted, have perhaps received some benefit from the practice of osteopathy. I do not deny—in fact I may claim, as my noble friend Lord Dawson will agree—that I have some personal reason for believing 196 that medicine is slow to accept new truths. Both Lord Dawson and myself in first announcing truths have found orthodox medicine just a little reluctant and dilatory in their acceptance. It is true that only well-proven truths find a place in orthodox medicine, to-day, but I would really ask your Lordships seriously, do you wish it otherwise? Do you wish any new-fangled, ill-founded creed, however firmly believed in by incompetent minds, to find a place in orthodox scientific medicine? Manipulative methods, which it is the great claim of the osteopath to practise, find a place, to-day, in the curriculum of orthodox medicine. I admit it was slow to introduce into its teaching manipulative methods, but that introduction is due to my late friend Robert Jones, the greatest orthopœdic surgeon the world has known. Robert Jones was apprenticed to his uncle, Hugh Owen Thomas, of Liverpool, the inventor of the Thomas splint, which rendered such Wonderful service during the War, and has done so since, as few people realise. Owen Thomas was himself the son of a bone-setter who left Wales to settle in Liverpool. Owen Thomas was in partnership with his father, an unqualified hone-setter, until a year after he qualified, when the Medical Act of 1858 rendered it illegal. Thomas, in his own person, had learnt all that was to be known of the craft of bonesetting, and it was through the teaching of Robert Jones that the craft of bonesetting, after trial and great improvement, at last found a place and an accepted part in orthodox medicine.
I do not venture to waste your Lordships' time in detailed criticism of this Bill. If opportunity ever came, here or elsewhere, I think I could make it clear to you all, to the point of conviction, that osteopathy receives no definition in this Bill. To say that what an osteopath practises is osteopathy is a perfectly futile and meaningless definition. This Bill grants to foreign osteopaths the right to practise in this country, although the standards of other countries, as I know from personal observation, are really grotesque, and reciprocity with other countries would almost certainly be denied. The suggested training in medical subjects also is too short to give a competence in any degree comparable with that of the general medical practitioner in medicine to-day. If in future 197 there is a medical training it must be that which is required for the practice of medicine. There is no room for special sanctions for any branch of medicine. All must receive an equal training. A shorter training than that which we have under the Medical Acts, and the curriculum licensed by the General Medical Council, would surely attract an inferior type of practitioner. This Bill would create two standards of entry into the medical profession.
§ LORD MOYNIHAN
Four years instead of five. That only refers to time. Of quality, it is almost idle to speak. Does the noble Lord admit that four years is shorter than five?
I agree that four years is shorter than five, but I am not quite satisfied on the point.
§ LORD MOYNIHAN
This Bill would debase medical training at a time when the best minds within the profession are seeking to exalt it. I venture to suggest that the right to sign death certificates, and to perform operations, should on no account, in the public interest, be granted to those who have not, after passing through the recognised medical curriculum, been licensed by the General Medical Council, whose authority is conferred through the Medical Act by Parliament; that Clause 8, subsection (1) of this Bill, if strictly interpreted, would prevent the ordinary medical practitioner from carrying out his own methods, which are in danger of being annexed by the osteopath, and that this clause would confer upon osteopathy a monopoly now even denied to medicine itself.
Finally I may point out that if osteopaths are at last realising that a formal medical training is essential, there is nothing to prevent them from passing through the present medical curriculum, and supplementing it by training in manipulative methods. This is the method followed by those who specialise in certain medical work. I do not desire to deal in any but the most cursory manner with details of this Bill. It is to its principles that I offer most serious and, most confident objection. It embodies an endeavour to destroy the Hippocratic unity of medicine, to foist upon the public, unaware of the danger, a spurious 198 science, which sets aside all the accumulated wisdom and expert practice of centuries, and seeks to put in its place, with legislative authority, a theory of medicine that has in no country proved its validity, and is the derision of all competent and experenced minds. I beg to move that this Bill be read a second time this day six months.
Leave out ("now") and at the end of the Motion insert ("this day six months").—(Lord Moynihan.)
§ LORD GAINFORD
My Lords, I had not come here for the purpose of making a speech, but I am absolutely convinced in my own mind that osteopathy, as practised in this country, is of enormous benefit to a great number of people. I, myself, have known many accidents to many parts of the body, at polo, cricket, football and other pursuits, and I have seen a great number of other accidents, and I have come to the conclusion that osteopathy is the best cure for nearly all these troubles. Convinced as I am that it is in many cases the only way in which parts of the body earn be restored to a proper condition, I believe it is advisable that a Bill of this kind should go before a Select Committee and be thoroughly thrashed out there by witnesses and evidence.
I do not believe myself that an individual should necessarily have a lot of medical training in order to understand the simple matter in connection with the circulation of the blood through an injured part of the human frame. I will just give one illustration. I was playing a game of lawn tennis at Cannes with Lord Lovat, and I sprained my ankle. I had sprained it three times before, and was treated by the medical profession. On each occasion it took about six weeks before my ankle was restored to full strength. I asked at Cannes whether there was a Swedish masseur. I was told that there was. I went to him and within a week he bad cured my ankle by manipulation. He had been trained in the Stockholm School and was a properly certificated masseur who had received his training there.
He told me that on one occasion an Austrian came to him when he was a medical student at Stockholm. As this man was getting out of the train he had sprained his ankle and he had come in 199 order to compete in the world championship in long-distance skating. The accident occurred on the Sunday morning, and this man and another osteopath treated him for the best part of twenty four hours. That man won the long-distance skating championship of the world, thanks to the way in which these medical students—medical because they had only learned osteopathy—had treated this particular ankle. The man showed me pearl ring which he had received as a reward for the way in which he had enabled the man to compete in this competition. I could give many other cases. It does seem to me that osteopathy has a good work to do in this country without interfering with medical practitioners at all, and that there is a very good case for the Bill being read a second time.
§ LORD ERNLE
My Lords, I should like to support the Motion in favour of this Bill being read the second time. We have all listened to a most impressive speech from Lord Moynihan, coming as it does from a man who is not only a most distinguished surgeon but is at the moment the spokesman of the profession of doctors. I felt when he sat down that I could hardly venture to put before him my own point of view, but I would remind him that though as a mere layman I cannot argue with him on scientific questions, yet, however easy and however great the victory that science may win in argument, it would find the great mass of laymen in this country entrenched behind what they think impregnable lines—that is to say, the lines of their own experience in their own cases or in those of their friends.
If I might illustrate my meaning and suggest to him a test of what I mean, let him go down to Melton or any resort of the men and women who follow hounds. Let him summon a meeting of these hunting people and put before them his proposition that osteopathy ought never to be practised in this country except under the advice, direction, and supervision of a doctor or a surgeon. I am convinced that he would be overwhelmingly defeated on the vote. And why? It is, after all, only the opinion of ignorant laymen: granted; but the vote is given from the experience of these men and women who know what benefits they have received from osteopathy, which they have failed in like measure, 200 or with the same rapidity, to obtain from either doctor or surgeon.
I am quite aware that in some respects the principles of osteopathy are fundamentally different from those of medical practice. Their theory, for instance, of the human laboratory and of the natural medicines which it supplies is quite contrary to the almost indiscriminate administration of drugs which is followed in ordinary medicine. So also is their method of approach, which is a new and independent angle, and if that be so—and I think Lord Moynihan said they were fundamentally opposed to British medicine—is it not desirable that these avenues should be explored to the utmost limit, that these latent possibilities should be fully developed both as a matter of public policy and in the public interest? At the present moment their development is completely stopped, and it is stopped, if the noble Lord will forgive me for saying so, by the attitude of the General Medical Council. Quite rightly, he would say; but the point is that they are stopped.
What I want to see is that they should be liberated to develop to the full their own theories of the medical art, and that they should for that purpose be enabled, which they are not now, to guard themselves against the unqualified and unregistered practitioners who exploit the credulity of the public. We must remember that at the present moment any qualified medical practitioner who associates himself with an osteopath in a case is under the ban; he does so at his peril; he may be struck off the register. The General Medical Council, therefore, stamps the osteopath as a quack or a charlatan almost indiscriminately, and they have no means of helping themselves. Lord Moynihan, I think, said something about schools and colleges. Let me answer that with another question. What standing would a University have, what class of student would it. attract, if the osteopaths who were asked to join it were quacks and charlatans and so stamped by the medical profession What chance would it have of attracting any benefactions if the benefaction is to go to a system which is still stamped as that of a charlatan? There is no way out of it except, as I see it, in what this Bill proposes to do.
201 I am entirely with the noble Lord on the facts to which he called attention. I noticed myself that the period of training was shortened, which I think is a great pity, and I have no doubt that every osteopath in the world would welcome an extra year to be spent on anatomy and similar subjects. But what the Bill does do is to give the osteopath an opportunity of putting his own house in order and keeping it in order, preventing the intrusion of unqualified persons and at the same time enabling him to start with some prospect of success the proper educational facilities with which he must be equipped. I realise with Lord Moynihan that the essential question is not so much the clauses to which he called attention as the underlying purpose of the Bill—that is, to recognise as an independent branch of the science and art of healing this new science of osteopathy. I quite agree that that is the issue. At the same time I do not shrink from it, and I shall vote for the Bill. Let me say this. I do not believe that a vested interest or true dignity was ever impaired by a generous concession, and I can assure Lord Moynihan that in the vote I shall give I am actuated by what I think is the best mode of maintaining the true dignity and, if possible, of increasing the utility of the noble profession which he represents.
§ LORD DAWSON OF PENN
My Lords, I would also like to express my gratitude to the noble Viscount for having raised this question, for in doing so he raises an important matter of principle. There are certain callings so necessary to the well-being of the public that, either by long custom or by Statute, there is for those callings a prescribed training, and authorised tests are laid down for all those who wish to pursue them. I could give many examples. I will take three. I will take the law, the profession of the master mariner and medicine. In each of those professions there is a prescribed course of study, followed by recognised tests. That prescribed course of study is mistakenly understood by many to be entirely vocational. The first part of the prescribed course of study is preparatory and preliminary, established for the purpose of securing that people who enter those callings shall have adequately trained minds before they are vocationally educated. Supposing, for example, that a body of people were to come along 202 and say: "We want to train people for the Bar; we want to do it in our own way, we want to do it without reference to the existing colleges of law or the Inns of Court. "Or again, supposing a body of people came along and said: "We have a splendid way of training captains of Atlantic liners; we have a very good training; we ask for the same status as is given by the Board of Trade certificate. "I ask what would the answer be to either of those questions? I venture to think an emphatic negative; and, why should there be any difference in medicine, which has grave responsibilities towards human life?
No doubt lawyers and mariners, like doctors, have a variety of views and opinions. They are all perfectly free to indulge in them when once they have passed their tests and gained their qualification. And so areosteopaths. Osteopaths, after qualification as medical men, are free to pursue any branch of treatment they like. There is complete liberty of thought within the medical profession. If a man wishes to be an electro-therapeutist, he can become one. If he wishes to become a psycho-analyst, he can become one. There is no reason for making any exception for osteopathy. There is no case made out at all. The whole road is clear. As a matter of fact a great many doctors, and a great many men who have been trained, do practice osteopathy, and very successfully, and we are perfectly willing, that they should do so. What we ask is that they shall show a medical training; they must go through the mill of education, then they are free to do what they like. There must be this background of the trained mind in any profession.
I would like to point out that in the early part of medical training, that training is non-vocational. It has little or nothing do at first with the actual handling of disease. Our first business is to see that the students committed to our care have trained minds, and they are put through a training in physics and chemistry and anatomy which, to a large extent, they hold in common with other callings cognate to them, and it is only as they proceed in their course, and when we are satisfied with their basic training, when we have put them through university tests in science and other 203 subjects—it is only when we are satisfied in those respects that we permit them to turn to the vocational part of their training. We have found by experience, if a man wishes to get an adequately trained mind to take up the responsible side of the healing art, that we cannot do it under five years, and during those five years the medical student has to live laborious days. More than that, the large majority of students require further training after that. But, by law, the moment they have passed their qualification, just as the lawyer or the master mariner, when he has passed his qualification, they are free to take up osteopathy or any other opathy they choose. As the student comes along he studies diseases, both pathologically and in the wards. We do not pretend that in five years we can take that student over every form of disease. Even then our main purpose is to train his mind so that he may go on being a student after he has qualified, and so at last he reaches, at the end of his training, the apex of his training, and that is the apex of diagnosis.
Diagnosis is the means whereby you can discern the nature of disease, the means whereby you can differentiate one disease from another, and through all our years of training for the medical man that is the point to which we seek to reach, and there can be no giving away of that essential point, that a knowledge of diagnosis must precede power to direct and guide treatment. Do let us sweep away pretence. This Bill really aims to give a short cut to a body of people who want to get and acquire by this Bill the status of a doctor. I ask, in the public interest, what would be the result? If you allow this kind of training to displace that scientific training which after years of experience has been built up, not built up to fight any particular creed but in order to train the mind of the student, if you once allow any kind of short cut, any sort of back-door entrance, what will happen? You will bring down the whole fabric of the efficiency of the healing art from the level which it has taken years to build up. There was never a period in history when it was more important to keep up the standard of learning within the medical profession. If you pass a Bill like this you will debase that whole standard.
204 If your Lordships look at the Memorandum to the Bill you will see that it says:"Bona-fide graduates of schools and colleges of osteopathy recognised and approved by the Board will be given the status, responsibilities, and immunities attaching to the practice of the art and science of healing as defined under this Bill.What is that but a claim to a status equal to that of a medical man? If osteopathy, why not psycho-analysis, and if psycho-analysis, why not other things? What you give to one you will have to give to another. There really is no substantial difference. I am not here to deride osteopathy. Far from it. We are quite prepared and have always been prepared to give it its proper status. The osteopath has two careers open to him, and both of them equally honourable, He can, if he chooses, go through the arduous training of a medical student. Then he will have all the powers and the privileges of a doctor. He will only be doing what the homeopaths have done for generations without complaint. There is just as much difference in opinion in regard to homeopaths as with regard to osteopaths. Homeopaths do not ask to be let off training. Why should osteopaths?
But if a man does not wish to become a doctor, does not wish to have power to decide whether a case is suitable for osteopathy or not, if he does not wish to earn the right to diagnose, which he can only get with proper training, there is an optional career open to him. He is perfectly free to carry on treatment and he will receive the same recognition as the X-ray expert who carries on his work, as the electro-therapist who carries on his work, as the physical therapist who carries on his work and as the dietician—the most modern of all—who carries on his work. All these crafts have a free field for their skill provided diagnosis and direction have been given first. If they wish to have the power of diagnosis and direction they must become doctors. If they do not wish to do that, they are perfectly free to carry on their craft without any let or hindrance. For myself I should never hesitate to ask the osteopath to help me in any case if I thought his craft suitable to that case. In fact, it may be said that with regard to these crafts we are 205 prepared to treat, and do treat, them all as co-workers. But we are not going to give them an equality of status in the science of medicine for which they have not had a proper training. Nor will this Bill give them a proper training.
The fact is, my Lords, osteopathy is not a science. It has the support of no scientific man of any eminence in the whole world as a science. It is not a science, it is a craft—a very valuable craft, a highly skilled craft, which in its proper place can do good in its day. Those who practise it have that wonderful thing, the gift of hands—a gift which can by training and education be brought to great dexterity and skill. It belongs, in short, to that large department of physical therapy which includes such things as remedial exercises, which were originally founded by Ling in Sweden, vibration therapy, and various other things which come under the category of physical therapy. What we say to osteopathy as a profession is "Welcome!" but for an osteopath to have the status of a medical man without the basic training, without training in pathology, would be a public danger.
Is not history repeating itself? This osteopathy is nothing but one particular chapter in a rather interesting past. At no epoch in civilisation has there not been some craft, some particular fashion, that by the public opinion of the day, by the laity of the day, has been extolled as osteopathy has been extolled in this House to-day simply on the ground of individual cures. To give a few examples, I ask your Lordships to carry your minds back to the middle of the eighteenth century. There was a gentleman known as Elisha Perkins, who claimed that rheumatic aches, and pains of a similar sort, could be cured by means of certain electrical rods. They were known as metallic tractors and they had great vogue in their day. There were two rods of metal and those rods were applied as treatment to patients, and patients were cured by hundreds. That went on for a considerable time until it occurred to a doctor in Bath—one Dr. Haycraft—to use a number of rods made of wood painted to look exactly like metallic rods. He got more cures than anybody.
To give a more notable instance, I am sure your Lordships will remember 206 mesmerism. Mesmerism owes its existence to a certain doctor of medicine, by the name of Mesmer, who took his M.D. degree at Vienna in the year 1776. He said that the whole of disease could be cured by magnetism. He did not believe in the knife for surgery. He believed in drugless medicine, as the osteopaths do to-day. His plan was this. He used to have wine bottles—why wine bottles it is difficult to think—full of magnetic fluid. They were to give off a mild magnetic current. The bottles were placed in a most beautiful receptacle covered with the most lovely lid and the people who came for cure used to sit for hours round this wonderful structure. Cures were legion. Pains of every kind were cured. Diseases which had been hopelessly mismanaged by the medical profession were cured. The support of osteopathy is as a mere drop in the bucket compared with that which mesmerism received in that day. So great was it that the Government of the day supported Mesmer; they offered him a pension of 20,000 francs and a decoration if he would communicate his discovery to physicians nominated by the then King of France. When it got to that point our friend Mesmer evaded it, and three or four years after that he was discredited. But mesmerism has comedown to these times, and it has always had its successes.
I ask your Lordships, briefly, to remember that in the spacious clays before the War there was a gentleman in this country—and a very clever man too—by the name of Kelvin. Kelvin was an extremely skilful Swede and a great adept at all forms of physical therapy, and in his own line of work supreme, but he was made such a fool of by the British public—and that is always what happens—that he began to think that he could do any thing, and finally some of his devotees said that they could cure appendicitis by his method. That is the danger of all uncontrolled and unguarded crafts. They begin well and in their own spheres they do admirably, but when they are uncontrolled by proper and scientific methods, they grow like a snowball, and they assert that they can do more and more; but you do not hear of the infinite damage which they do to the poor creatures who are their victims.
207 Good as osteopathy is applied under proper diagnosis and direction, it can be a perfect terror and a tragedy, as I myself know. I will give just this one example. A poor woman who had a hopelessly injured spine, the result of old age—an entirely wrong case for an osteopath—went to an osteopath, with the result that she had six months of constant agony and pain, and had to be relieved by morphia, one of those drugs which would not be allowed in osteopathy. Manipulative treatment, whether it be by osteopathy or by the treatment of a man like Kelvin, or some other form of treatment, has a place and a most valuable place in the treatment of illness, and it is in its proper place admirable, but if osteopathy once assumes, as it would do under this Bill, a status equivalent to that of a highly trained doctor, all I can say is that it would be very much against public interest. For these reasons, my Lords, I oppose this Bill.
THE EARL OF KINNOULL
My Lords, knowing the very conservative character of the British Medical Association, I was not in the least surprised to see a Motion for the rejection of this Bill standing in the name of my noble friend Lord Moynihan, but having heard the speech of my noble friend Lord Moynihan and the speech of the noble Lord, Lord Dawson of Penn, I am rather at a loss to know what their real objections to this Bill are. My noble friend Lord Moynihan has talked about the "irreparable calamity" which will happen in this country if your Lordships give this Bill a Second Reading this afternoon. I think he said it was the negation of the principle of the Medical Act of 1858. 1858 was a long time ago. Osteopathy was introduced into this country, I believe, thirty-one years ago, and I think the noble Viscount who brought in the Bill said that it had been practised in America for some sixty years.
For the best part of ten years this subject has been intermittently before Parliament. The noble Viscount who introduced the Bill said that the question was first raised in 1925 at a time when Dr. Axham was removed from the Medical Register for acting as an anaesthetist to one of the leading bone-setters. Then again in 1925 the right honourable Member for Wakefield put a Question to the 208 Prime Minister asking whether his attention had been called to the warning notice issued to registered medical practitioners by the General Medical Council; whether he was aware that this notice had the effect of deterring such practitioners from assisting, by administration of anaesthetics or otherwise, qualified but not registered practitioners of osteopathy and other new forms of treating ailments; and whether the Government would set up a Commission or Departmental Committee of Inquiry to investigate the working of the various Medical Acts and the way in which the General Medical Council exercised its powers and functions. The reply given on behalf of the Prime Minister was to the effect that the notice of the General Medical Council had been in force, except for verbal changes, since 1897, and that the Government did not see the necessity for appointing any Commission or Committee as suggested.
One of the main points made by my noble friend Lord Moynihan was the protection of the public, but as I read this Bill the whole point of it is to protect the public against people calling themselves osteopaths who really have no knowledge at all of osteopathy. I know the case of a gentleman very much like that, whom I came across some years ago, and who was by trade, I believe, a steeplejack or something of that description. He made quite a good living out of osteopathy, bonesetting, and massage generally. I do not say that he was bad—I do not know about that—but he had had no previous training in it at all. The whole object of this Bill is to make it compulsory for people who practise osteopathy to have some training such as the noble Lord, Lord Dawson of Penn, was talking about a few moments ago.
I was exceedingly interested in the remainder of the speech of my noble friend Lord Moynihan—it was an extremely interesting survey of medical history—but I really could not see the relevance of it; and that applies also to a certain extent to the speech of my noble friend Lord Dawson of Penn. He went into very interesting facts of medical history; and as so much has been said about medical history, I should like, with great respect, to remind my noble friends in the medical profession that it was not such a very long time ago 209 when doctors believed that the only way of curing anything was by blood-letting, or by the administration of crushed oyster shells, or by taking moss from around the skull of a dead man and all that kind of thing. The medical profession have always systematically gone against anything which has been the slightest bit in advance of the ordinary. There is no good reason as far as I can see for the opposition to this Bill, because both noble Lords have this afternoon praised osteopathy, both of them admitted quite freely that there was a tremendous amount in osteopathy, and the noble Lord, Lord Dawson of Penn, said that he himself would not hesitate to call in an osteopath if he were satisfied in certain circumstances that it was necessary. Yet, in spite of that, they say that it would be "an irreparable calamity" if this Bill obtained a Second Reading!
The noble Lord, Lord Dawson of Penn, made great play with the argument that persons should go through a prescribed course of study before acting as osteopaths. This Bill as I read it does prescribe that. It was said by one of the noble Lords—I do not recall which—that this was a back-door way into the medical profession. As I read this Bill, it has nothing to do with it. It would seem to me that dentists, veterinary surgeons and midwives are in exactly the same position as osteopaths, but I have not heard from anybody that because dentists, veterinary surgeons and midwives are registered, they have been trying to get through a back-door into the medical profession. I have not noticed it at all. I have heard no real argument this afternoon against this Bill. The only argument that I have heard, which was used by one noble Lord, is that doctors are frightened that under Clause 8 osteopaths will take their living away from them.
THE EARL OF KINNOULL
Well, I understood that to be said. I will withdraw it if that was not the intention. But there is no other argument I can see against the Bill, and I hope your Lordships will give it a Second Reading.
§ LORD AMPTHILL
My Lords, I had no intention whatever of speaking when I came here, but after hearing the two 210 noble Lords who are so eminent in the medical profession, I feel I must really say a word or two in support of this Bill for a personal reason. In the first place, I owe very much to osteopaths, and so do my family and many of my friends. Whatever the General Medical Council may do, osteopathy is here and has come to stay, and the time is not far distant when every sensible medical practitioner will send his patients to an osteopath, if his is the appropriate treatment. Indeed, I was glad to hear Lord Dawson say, if I understood him rightly, that he himself had done that. My two noble friends, if they will forgive me for saying so, spoke entirely beside the point. Very little that they said had anything whatever to do with the Bill, and the noble Lord who moved the rejection used language of exaggeration such as I have never heard in this House before, language entirely inappropriate to a case of this kind. Just fancy talking about an irreparable calamity if this Bill were given a Second Beading. We have registered midwives and dentists and nurses, and no irreparable calamity has resulted. If you register osteopaths, it is not going to do the slightest harm to the medical profession, or affect them in any way whatever.
§ LORD AMPTHILL
What is your objection to the Bill, then? I thought that was the whole thing. The object of the Bill, as I understand it, is to have registration of osteopaths so that the public may be protected against quacks. But at the present time people go to osteopaths when it is appropriate. A young fellow who has put out his knee at football—and it happens again and again—never thinks of going to a doctor: if he did, he would be told to lie up for three months, and probably get a permanently stiff leg. He goes to an osteopath and in a week he is playing again. If young people get tennis elbow, they do not go to a doctor: if they did they would not be allowed to play tennis again that season. They go to an osteopath and they are playing tennis 211 the next day. I could give hundreds of cases within my own knowledge, among my friends and in my own family, where the osteopath has done much good.
Lord Moynihan said grudgingly that perhaps people received some benefit from what he called "an alien cult" founded on no research. He was not entirely in agreement with his colleague, Lord Dawson, who said he was not here to deride osteopathy. But after their remarks I am obliged, with some reluctance, to remind your Lordships that the medical profession is the closest and the most jealous trade union in the world, and that the General Medical Council has obstructed and resisted and crabbed and derided a very great many advances in medical science. Notably the great discovery of Jenner was resisted and ridiculed in exactly the same way as osteopathy is to-day. But the noble Lord, Lord Moynihan, would have you believe that medical science of to-clay depends upon some immutable principles which were laid down for ever with the force of divine law by the Medical Act of 1858, and he tells you that if you pass this Bill for the registration and regulation of osteopaths, it will impair those principles and set aside all the defences which have been raised for the protection of the public. He went even further, and said that the registration of osteopaths would hold up to obloquy the whole of the science of medicine. Do your Lordships really believe that the science of medicine is founded on such a slender basis that if you, for the protection of the public, give some sort of qualification and standard of training to osteopaths the whole of medical science will be held up to obloquy? Medical science was not laid down on immutable principles in 1858. It has been steadily advancing, thank goodness, every year. Every year we hear of new discoveries, new processes and practices, which are at first objected to by some medical men, but afterwards adopted. Listening to the last words of the noble Lord, Lord Dawson, your Lordships would think that no doctor ever gave a wrong diagnosis or prescribed a wrong treatment. Unfortunately, that has happened very often, and therefore the fact that some osteopaths may have treated a case wrongly is no reason for refusing them this measure of justice.
212 I could easily give many instances in which doctors have diagnosed cases wrongly and treated them wrongly. I myself might say with some justice that I have suffered much at the hands of many physicians, and spent my substance and been no better, but rather worse and that is quite a common thing. I really cannot understand anybody going out of his way to refuse a Second Reading to a measure of this kind, talking about it as inflicting an irreparable calamity upon the very basis on which medical science rests. All that is most arrant nonsense, and I hope that your Lordships will not put yourselves in the false positions of refusing to a profession which now exists for good, and is very widely extending in this country, the necessary measure of protection. If you refer this Bill to a Select Committee, as has been suggested, you will be on perfectly safe lines, as the Committee can call witnesses, and there you can get the whole of the reasons, for and against, set down and recorded so that there may be no false judgment.
§ LORD HEWART
My Lords, I certainly did not come here this afternoon for the purpose of speaking about osteopathy. But I have not merely listened to the speeches, I have taken the unusual course of reading the Bill, and while, as I gather, nobody in the least objects to the protection of osteopathy within its own sphere, there is grave objection to osteopaths' entering upon a sphere for which they have never been trained. May I give your Lordships one example which is typical? Clause 7 (2) provides (I leave out the immaterial words) that:An osteopath … shall have the power to sign certificates of birth and certify the cause of death….Speaking as a mere lawyer I am staggered at that provision. Has anybody ever heard of a dentist or a midwife signing a certificate of death? As for registration, nobody, I gather, objects to the registration of osteopaths. It is quite a desirable thing to have persons put upon a register, if only that, in an appropriate case, they may be struck off. But this Bill, I venture to think, goes far beyond what any reasonable osteopath could properly desire, and, I sincerely hope it may not be read a second time.
My Lords, it is almost time we got back to where we were. I admit that my brain is very 213 nearly in a complete fog. I heard my noble friend Lord Moynihan get up and move the rejection of the Bill. The first word of the Bill is "registration," but he says he does not object to registration in the least. To my mind that is the most important part of the Bill—the elimination of the quack—the power to make a register or people to whom the patient can go and know that he is not going to an ignorant person, with no training of any sort or description whatsoever. I listened to the noble Lord, Lord Dawson of Penn, with great care. He led me up by-paths and side lanes, and finally I knew not where I sat, and was very hazy as to where he was himself. It struck me as a first-class attempt to get us all in such a maze that when it came to the question of voting we should DA know what we were voting about at all. The real question is this: Is osteopathy in such a state to-day that a Select Committee of this House should be appointed to enquire into the whole question, or is it something so beneath our contempt that all the millions of people in this country who have benefited by osteopathy were silly idiots to go to them? I am going to support Lord Elibank to the best of my ability.
My Lords, we have heard the case put by the protagonist of this Bill, and also the case put by Lord Moynihan on behalf of the medical profession. I should like to say a word or two on behalf of the Ministry of Health, who are obviously wry much concerned. It is obvious that the Minister of Health has the duty of maintaining justice between various branches of the healing profession, but his primary duty is to the public, and. what I would suggest to your Lordships, for the moment, is that we should compare the position of the ordinary member of the public as it is now, with what it would be under this Bill. If I have anything wrong with me to-day I may decide to go to an osteopath. There is nothing to prevent an osteopath from treating me, and from receiving from me a fee for so doing. He may be perfectly successful. In fact, it may be I have some common complaint in dealing with which he has some special aptitude or experience. He might have what I think Lord Dawson of Penn described as "the gift of hands." Supposing, however, what is wrong with me is not a 214 simple complaint. Supposing it is something much more deep-seated and complicated. The osteopath may possess no qualifications for diagnosing that complaint. He may have good qualifications, or he may have none at all. That is a risk which I run, and which, to-day, I know that I run.
If this Bill becomes law I should, it is true, be protected from the absolutely ignorant practitioner, but my complaint would still be diagnosed by somebody who possessed a good deal less than the qualifications which have hitherto been accepted as the minimum qualifications of a medical man, and that would be done under the official blessing of the Ministry of Health. Surely if things went wrong I should then have some grievance against the Ministry. Surely I could complain that I had been confused and misled. Lord Sandhurst complains of being in a fog. I think that the public generally, if this Bill became law, would be in an equal fog, for the Ministry would have put them in the position of having to decide for themselves whether their complaints could be more properly dealt with by a doctor or by an osteopath. That we claim would be an unreasonable thing to do.
Osteopathy is not a function which deals with one part of the human body, like dentistry. Most of us have little difficulty in deciding whether we will go to a dentist or to a doctor. There may be border-line cases, but it is generally a simple matter for the public to judge. We have heard from Lord Elibank that it is not a specialised type of subject. He said it is a new and complete "system of drugless medicine and bloodless surgery," which I gather is to deal with all, or practically all, pathological conditions of the human body. Lord Ampthill gave us illustrations, such as having your knee put out, or tennis elbow, but this system, as explained by Lord Elibank, goes a great deal further than that. This Bill would be inviting the public, to all intents and purposes, to decide between two rival schools of medicine. What justification would we have for putting the public into that dilemma? It is perfectly true that there may be among the osteopaths, today, exceptionally gifted men. There are, no doubt, very remarkable cures which can be attributed to them, but we cannot 215 legislate for exceptions. We cannot get away from the fact that if we agreed to this Bill, or anything like it, we should be countenancing diagnosis and treatment by persons who were more or less imperfectly qualified.
That is our fundamental objection to the Bill. There are, however, other practical difficulties. There is the difficulty that in this country there is no osteopathic equivalent of the medical school-cum-hospital, which trains the aspirant for ordinary medical registration. There is still no school of osteopathy in this country, capable of giving instruction in the basic sciences set out in the Second Schedule, which is at all comparable with the existing medical schools. The register would, it seems, in so far as it did not consist of existing osteopathic practitioners admitted without examination or proof of training or qualifications, other than three years bona-fide practice, be composed to an overwhelming extent, at the outset, of graduates of American colleges, over whose curriculum no one in this country has any control, and the value of whose diplomas it is practically impossible to assess. I think somebody said that that is a Committee point, but it is one which must be borne in mind.
Something has been said about the injustices which at present are being experienced by osteopaths, and I would like to say one or two words about that. Osteopathy or manipulative surgery is to-day practised by persons on the Medical Register. That has been brought out. There are doctors who use what is called mechano-therapeutic methods to-day. Some practitioners hold American diplomas in osteopathy in addition to British registrable qualifications. Manipulative surgery and mechano-therapeutics are included in the ordinary medical curriculum which is modified from time to time according to needs and the advance of knowledge. There is nothing in the law to-day to prevent any person, whether he is or is not a registered medical practitioner, from practising osteopathy or any other system of healing he chooses. There is nothing in the law to-day to prevent the union of the more skilled of the osteopaths in a single body which can speak for them with authority. There is nothing to prevent such a body from com- 216 piling a voluntary register, and in this and other ways endeavouring to gain the confidence of the public in their theory of the causation and cure of disease, and in such practitioners of their art as in the opinion of such a body are worthy of that confidence.
The noble Viscount, Lord Elibank, concluded his speech with a very moderate appeal that the Bill should be sent to a Select Committee. I do not want to appear unreasonable, but is there any point in our agreeing to this course in connection with a Bill with the fundamental principles of which we are in disagreement? It seems to me that we must take up some intelligible line of policy. Osteopathy, as has been brought out, is not the only rival to orthodox medical science. I am sure that various noble Lords would get up and testify to the extraordinary efficacy of mind healing. Would that justify us in setting up yet a third school in contradistinction to the orthodox school of medicine?
If we are to give advice to the public, then I think that advice should be given definitely and not be really a mass of contradictions. The proper course open to osteopaths is either to convince the General Medical Council as to any changes which osteopaths think are necessary in the curriculum and then seek admission to the Medical Register through the normal procedure, or to remain unregistered and convince the General Medical Council, if possible, that registered practitioners can properly be allowed to give anaesthetics and such things for them. This would involve proof of a proper minimum standard of medical education and probably the compilation of a list of osteopaths recognised for the purpose by the General Medical Council. Or, thirdly, they might adopt the position that the registered medical practitioner is the principal who is fully responsible for diagnosis and treatment and the osteopath is a technician possessed of special manipulative skill whose responsibility is confined to carrying out manipulative work under the direction of his principal. That is as far as we can go. We cannot support the Bill in any shape or form; or rather I would say we cannot support sending this Bill to a Select Committee because its principles are fundamentally opposed to our ideas.
May I ask the noble Viscount whether the Ministry of Health or the Government can support a Commission of Inquiry into the whole matter?
That is quite a different question. I cannot give any answer to that without consultation with the Minister.
§ LORD MELCHETT
My Lords, I had not intended to intervene in this debate until I heard the speech made by the noble Viscount representing the Government. I am most distressed to find the line the Government are taking. It seems to me that the very least they could do would be to appoint a Commission of Inquiry; the very least would be to accept the noble Viscount's Bill and to send it to a select Committee. If they do not approve of the Bill they can change it. As to the very grave doubts and difficulties there are in this matter, I have my own personal experience. I have seen a member of my family operated upon by an osteopath through a member of the medical profession, one of the very few in this country, and two doctors of high standing came down from the operating theatre saying, "We have seen the impossible done. We never believed this operation could be performed." That operation was perfectly successful. With so much controversy and doubt on a subject of this kind, and the deep gratitude I have to this very skilled man, I could not remain silent. I beg the Government not to oppose this Bill, but to agree to the noble Viscount's proposal to refer it to a Committee, and I hope the House will support the noble Viscount.
§ LORD MERRIVALE
My Lords, that this Bill should be accepted as a preliminary to an inquiry seems to be putting the cart before the horse. It would be the proper thing to have the inquiry before the Bill. There seems to be a great body of facts and a great body of opinion which call for inquiry. Inquiry is one thing, but that the inquiry should be preceded by the sanction of the House to this Bill, to which most grave objections have been pointed out, does seem a very extraordinary proposal.
LORD BALFOUR OF BURLEIGH
The formal Second Reading of this 218 Bill would be merely a method of securing an inquiry. Very many noble Lords are anxious for an inquiry, but we know very well that the hope of getting an inquiry, unless your Lordships pass the Bill to-day, is very remote indeed. It is only because we want an inquiry that we want to see this Bill passed. Many of us are aware of the defects of the Bill, but we feel that a case has been made out for inquiry, and unless the noble Viscount representing the Government can give us some hope of an inquiry I shall certainly support my noble friend.
My Lords, the noble Lord really assumes that no steps will be taken under any circumstances to examine the question or do anything further about it unless this Bill is read a second time. I have already said that this matter of a Royal Commission of Inquiry is something that has been mentioned during the course of this debate, and obviously I cannot without authority, not being an official representative of the Department, give any undertaking on the subject.
LORD BALFOUR OF BURLEIGH
I did not expect my noble friend to say here and now; but we know that we shall have an inquiry if we read this Bill a second time with the instruction that it should be referred to a Select Committee.
I do not wish to detain the House by going over the points which have been discussed this afternoon, because actually a great many of the matters raised by Lord Moynihan and Lord Dawson in objection to the Bill have been dealt with by my noble friends who have already spoken. We have actually got to this stage, that the House generally believes that the subject warrants an inquiry into it. How is that inquiry to take place? The noble Viscount, Lord Gage, has told us that the Ministry of Health is not in favour of the Second Reading or in favour of a Select Committee. He has made certain suggestions under which the osteopaths may come together and form themselves into their own union, but he has given no hope whatsoever, either in his remarks on the debate or in the few observations he has just made, that the Government will take any 219 action in order to have this inquiry. Therefore, I have no option, in order to show, I hope, the strength of feeling that there is in this House and in the country in favour of a measure of this kind, but to go to a Division. I claim no perfection for the measure. There may be details in it which will have to be altered, but that there is a demand for such a Bill is evident from the speeches that have been made this afternoon and from the interest it has aroused in the country. Therefore, I propose, if your Lordships are good enough to give a Second Reading
§ Resolved in the affirmative, and Bill read 2a accordingly.
My Lords, I now beg to move that this Bill be referred to a Select Committee with full power to call witnesses.
§ Moved, That the Bill be referred to a Select Committee.—(Viscount Elibank.)
§ On Question, Motion agreed to, and ordered accordingly.