NATIONAL ASSISTANCE (AMENDMENT) BILL (Hansard, 23 July 1951)

§ LORD AMMON
My Lords, I rise to ask your Lordships to give a Second Reading to this small but important Bill. As its Title indicates, the Bill seeks to amend the provisions of Section 47 of the National Assistance Act, 1948, for dealing expeditiously with urgent cases in need of immediate care and attention. Section 47 of the Act lays down that seven clear days' notice must be given to the person concerned before an application can be made for his removal to a hospital or other institution. To illustrate the necessity for bringing in this Bill, I cannot do better than quote a case which was brought before another place by the honourable Member who introduced the Bill there. The case is so extraordinary that one wonders whether there is not some exaggeration, but the honourable Member spoke from his own knowledge as a medical man.
A spinster aged fifty-eight fell and broke her thigh. She was assisted back to her house by some neighbours, but refused assistance from doctors, nurses or home help, in spite of every effort made to persuade her. The medical officer of health was called in, and when he suggested at once that she should be removed to hospital, she refused to go. He had no power to move her. All he could do, under the Act, was to give notice for her removal, and that required seven days—nine effective days. This woman lay on the floor of her house for nine days, refusing all help, with the result that sores formed on her body and tetanus germs entered. After the notice had become effective, she was removed to 1136 hospital, where she died a few days afterwards. Had this been an infectious case, or if she had been certified as mentally defective, it would have been possible to give instructions for her to be removed to hospital at once. Or had this happened before July 5, 1948, when the National Assistance Act came into operation, it would have been possible for the relieving officer to take immediate action, on the ground of her being neglected. On inquiry, it was found that this was not the only case of its kind. Therefore, it was decided that the law required amendment.
This Bill makes no fundamental change in the law. What it provides is a shortening of the waiting period. I think there are few Bills which have come before your Lordships' House more strongly recommended. It is a Private Member's Bill, and was backed in another place by members of all Parties. It impressed the Government so much that facilities were provided for its rapid passage through the other place. It now comes to your Lordships without amendment. It shows the almost utter impossibility of legislating to meet all the vagaries of human nature. We have to do this in order that people like the person I have mentioned should be saved from themselves in such circumstances. It will be necessary on Committee stage to move a small drafting Amendment to meet the particular case with regard to justices in Scotland. I beg to move that the Bill be now read a second time.

§ LORD LLEWELLIN
My Lords, I rise to support this measure. It is evident that, not for all cases but for some, when we passed the National Assistance Act, 1948, we made the qualifications for getting a person into hospital by order of justices too rigid. After all, as the noble Lord has said, a person suffering from an infectious disease can immediately be taken into what used to be called a fever hospital—I do not know whether they are still called fever hospitals—on the order of the medical officer of health; and a person who is of unsound mind, when certified by a doctor and a Justice of the Peace, can 1137 be taken into a mental home. All this measure seeks to do is, where the medical officer of health is supported by another doctor, and obtains the assent of a bench of magistrates, or of one magistrate having jurisdiction in the area, to make it possible to move a person suffering from a grave chronic disease to a place where he or she can receive proper care and attention.
Some of these people are, quite naturally, reluctant to be moved from their own homes. They are reluctant if they have an infectious disease, and there is even greater reluctance when a person has to be moved to a mental hospital. Even people who fall down and break a limb, who have perhaps never been in hospital in their life, hate the thought of leaving home and going into hospital. But it is for their own good that they should go there, and not lie unattended for days, until eventually, as in the case which the ruble Lord cited, death intervenes. Ample safeguards for the liberty of the subject are provided, in that this action must be commenced by a responsible official either the local authority itself or the medical officer of health, if he is designated by them. His opinion has to be backed up by another doctor, and the whole thing approved either by the local bench or by a justice having jurisdiction for that area. We can eliminate all the difficulty with regard to the time factor that exists with the main Act without in any way departing from the principle of preserving the liberty of the subject. It is for those reasons that I hope that this Bill will be speedily passed into law.

§ LORD HADEN-GUEST
My Lords, this is a Private Member's Bill which was brought forward in another place and to which the Government have no objection. Both the noble Lords, Lord Ammon and Lord Llewellin, have indicated to your Lordships the provisions of the Bill. All I desire to emphasise is that it makes no fundamental change in the law but does increase the safeguards against any infringement of liberty, in that under the provisions of this Bill the signatures of two doctors, and not one as before, are now necessary prior to a person in need of assistance being removed to the place where that assistance can be obtained. Further, as tile procedure laid down in 1138 the Bill does not allow for an appeal, it is provided that the period for which the patient may be detained in hospital, or such other place where treatment can be obtained, shall be limited to three weeks, instead of, as previously, three months. During that period of three weeks it will be possible to initiate procedure under Section 47 of the main Act which will enable the individual concerned to be detained for further treatment if necessary. The Bill makes no fundamental change in the law, but it does make a great and desirable improvement in the method of administration, and I hope that your Lordships will pass it speedily.