REGISTRATION OF STILL-BIRTHS (SCOTLAND) BILL. (Hansard, 5 July 1938)

LORD ALNESS

My Lords, the purpose of this modest measure, which was sponsored in another place by the honourable Member for Orkney and Shetland (Major B. H. H. Neven-Spence), is to secure that still-births in Scotland shall be registered. The Bill, I think, may be supported on three preliminary grounds. First, it enjoys the support and the blessing of the Scottish Office. Secondly, it passed through all its stages in another place without a Division in the House, and with indeed substantial agreement. In the third place, it is intended to effect, and effects, the harmonising of the law of Scotland with the law of England, as that law has subsisted for the last twelve years. I venture to think that these are considerable credentials in favour of the Second Reading of the Bill.

When one comes to consider the Bill upon its merits I think that its claims upon your Lordships' support are equally exigent. The Bill may be supported on its merits on three separate grounds—on statistical grounds, on medical grounds and on humanitarian grounds. So far as statistics are concerned it is not unimportant to remember that: still-births, to-day, are registered by law in every civilised country in the world, with the exception of Palestine, Ireland and Scotland. Scotland now desires to rid herself of that unenviable association. The desirability of having vital statistics properly collated, both with regard to number and variety, and also accurate and complete, requires no stressing at all. And among vital statistics, one of the most important factors is the birth-rate. It is an essential preliminary to investigation of the wastage of infant life that there should be reliable and comprehensive records, and those this Bill sets out to provide. Moreover, the result of passing this measure will be that a comparison between figures in England and figures in Scotland will be rendered more intelligent and indeed complete. So much for statistical grounds.

So far as the medical grounds are concerned, I think it is manifest that the Bill will be of advantage and assistance to the health services in Scotland. These services are concerned, inter alia, with investigation into the wastage of infant 514 life, and it is necessary, in order that they should be effective, to have the assistance of this measure. If its provisions be carried out a flood of light will be cast on all the problems connected with maternal and infantile mortality, and many other cognate problems as well. In these circumstances it would be a great mistake, if I may say so, to regard this measure as based upon statistical grounds alone, or on any abstract desire to round-off a registration system which is admittedly incomplete in Scotland to-day. On the contrary, the Bill, I venture to think, will make a definite and valuable contribution to research, and will therefore be, in the best sense of those words, a health measure.

I said that the Bill could also be supported on humanitarian grounds, and there I would remind your Lordships that behind these still-births there always lies a background of human suffering and sorrow. The poignant tragedy of a dead child, which may be a first child, is often accentuated by the knowledge, which the facts justify, that the tragedy was really preventable. The research contemplated by this measure, and the discoveries which one hopes will follow upon that research, will make for the averting, or at any rate the abating, of the tragedies to which I have referred. Accordingly on the three preliminary grounds which I have mentioned, and also on the three grounds on the merits, I venture to commend the Bill to your Lordships for Second Reading.

If your Lordships will allow me, I will now come for a moment to closer quarters with the Bill and rapidly run through its clauses. It is a short and a simple measure. Clause 1 provides for the registration of a still-birth and imposes certain requirements upon the applicant for registration with regard to the information which shall be given to the registrar. Clause 2 provides that the registrar shall communicate the information which is given to him to local authorities. Clause 3 is what may be called a sanction clause. It provides a penalty, and a modest penalty at that—namely, on conviction before a court of summary jurisdiction, a fine not exceeding twenty shillings for non-observance of the requirements of the Bill. Clause 4 is definitive in its character: it defines a number of terms which are used in the course of the measure. Clause 6 is of the 515 usual character; it deals with the citation of the Act, and also provides that it shall come into force on January 1 1939. Having made those observations, I feel that I should not be justified in making a greater inroad on your Lordships' time in commending the Bill for a Second Reading. I beg to move.

§ VISCOUNT DAWSON OF PENN

My Lords, the noble Lord, Lord Alness, has made it very clear that by the non-registration of infants there is an important gap in our knowledge, and it is for the good of the community that it should be filled. Still-births represent from the national point of view a considerable wastage, and from the personal point of view a good deal of suffering. In these days of smaller birth-rates we need to do all that is constructively possible to secure that the babies which are born are of the best. Every baby that dies at birth represents a failure, and we can only find out the cause by investigating the why and wherefore of the failure. This Bill will secure that purpose. This is a real problem, because in the year 1934 in England 43,670 infants died at or soon after birth, and in the year 1936 in Scotland it was estimated that no fewer than 4,000 infants died at or soon after birth. In the old days when the birth-rate was high and the infant death-rate was high there was less need for this care, because there was a large production of children, a big turnover, and nature brought the fit ones to the top.

Civilisation has brought down the infant death-rate, little perhaps realising the consequences. As the result of bringing down the death-rate of infants, it has subsequently brought down the birth-rate, with the result that the turnover is today much smaller than it was when nature had a freer hand, and you do not get fitness brought about by the turnover of numbers. We are, therefore, led to the only other alternative open to us, which is to set to work and plan for fitness by every measure possible, and this small Bill goes a certain way to secure that object. There must be a certain mortality, and no one wants hopeless infants to survive. On the other hand, there are a great number of potentially fit children who by want of knowledge and care are 516 now lost to the community, and this Bill will help to secure that more lives shall be saved. It must not be supposed in any facile way that the loss of infant life either at birth or within a few days after it, is necessarily connected with a particular state of life or society. It is not associated with poverty. It is known that you get this high and unnecessary mortality of infant life in all classes of the community, and it is therefore in all probability a lack of knowledge that leads to this mortality.

If I might, with respect, make a suggestion to the Health Department of Scotland, it is that in addition to mere statistical information that such-and-such children die, it would be an advantage to knowledge if that Department would institute a close study of selected groups of infants who die, asking the Research Department to inquire as to the facts; and in this connection I must point out that no investigation is worth much in connection with these deaths unless postmortem examinations are carried out. That is part of a bigger question, for I think it would be to the advantage of the community if there was a greater readiness to encourage post-mortem examinations of people who die in difficult and obscure conditions, and I know of no better way of contributing to the health of the people as a whole. I beg to support the Second Reading.