Lords Sitting of 6 April 1965

Preamble
The House met at half past two of the clock, The LORD CHANCELLOR On the Woolsack.
Prayers—Read by the Lord Bishop of Chester

OIL POLLUTION OF ENGLISH CHANNEL
2.35 p.m.
LORD WAKEFIELD OF KENDAL: My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.
[The Question was as follows:
To ask Her Majesty's Government whether a statement can be made on the damage done to the sea bed and marine life off the Sussex coast by the recent sinking of 1,000 tons of oil by the use of the chemical Gamlin.]
THE MINISTER WITHOUT PORTFOLIO (LORD CHAMPION): My Lords, the chemical Gamlin is an oil solvent and an emulsifying agent. When spread on oil at sea it disperses he oil into the sea water. No material damage to marine life or to the sea bed is expected to result from its use on this occasion.
LORD WAKEFIELD OF KENDAL: My Lords, while thanking the noble Lord for that reply, may I ask whether he could have an investigation made to see whether what he has told us is actually
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the case? Could there be an examination of marine life and vegetation on the sea bed to see whether any damage has been caused? We know how on the surface of the land the use of chemicals, while bringing advantages, creates grave disadvantages, and it would be unfortunate if a similar sort of thing were to happen to the marine life and the vegetation of the sea bed.
LORD CHAMPION: My Lords, I am assured that this chemical does not cause oil or any part of it to sink to the sea bed. It does produce emulsion which is dispersed over a very wide area. Very careful tests have been made and, so far as it has been possible to ascertain, only the plankton within a limited distance would suffer from the use of this chemical. It is, of course, a wonderful way to prevent all this oil from eventually landing on the beaches.

COMMONWEALTH IMMIGRATION
LORD ELTON: My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.
[The Question was as follows:
To ask Her Majesty's Government whether the reported statement of the Economic Secretary, Mr. George Brown, that any talk of limiting Commonwealth immigration into Britain was "absolutely mad" represents the policy of Her Majesty's Government, and if so whether the topics to be discussed by Lord Mountbatten's mission to Commonwealth countries are not to include the possible limitation of immigration.]
THE LORD PRIVY SEAL (THE EARL OF LONGFORD): My Lords, in his speech at Sheffield on March 28, my right honourable friend the First Secretary of State emphasised the need for economic expansion and greater industrial activity and the consequent necessity to create social conditions in which workers could move freely to the areas where they were needed. My right honourable friend was not making a speech about immigration policy, but made the obvious point that problems in such fields as housing were not confined to areas in which immigrants from overseas settled but arose wherever economic development required an influx of new workers.
LORD ELTON: My Lords, I thank the noble Earl the Leader of the House for that somewhat Delphic utterance. We know, of course, that however, obscure some of his statements may necessarily be, he at any rate will always be "Frank". I hope I may deduce from that Answer (and it needs a good deal of deductive work) that the mission under Lord Mountbatten is not excluded from discussing the possible limitation of the inflow of legal immigrants, which, after all, according to a Public Opinion Poll as long ago as last July, was desired by a majority of the electorate.
THE EARL OF LONGFORD: My Lords, I am, of course, deeply grateful to the noble Lord for his personal references. I know that women like to be thought mysterious, and I suppose men must not object to it. The Mountbatten Mission will certainly discuss with Governments of the Commonwealth countries to be visited what measures may be taken to reduce the substantial numbers who are believed to be evading our controls, as well as possible new measures for regulating the flow of immigrants. The question of the actual number of immigrants who should be admitted is primarily for Her Majesty's Government.
LORD CARRINGTON: My Lords, I found the first Answer of the noble Earl the Leader of the House rather difficult to follow; I hope that he will forgive me. Is he telling us that the First Secretary of State was misreported?—because, as I read my newspapers rather carefully, the First Secretary said, in point of fact, that the limiting of Commonwealth immigration to Britain was absolutely mad.
THE EARL OF LONGFORD: My Lords, I am sorry the noble Lord found my remarks difficult to follow. I am sure it was my fault; perhaps, if I may put it in this way, they were not any more easy to follow than usual. I can quote something which the First Secretary of State was reported as saying soon after he made this speech. He said, as reported in the Daily Express:
"The remarks were reported accurately, but they were out of context."
That is what he himself said. I do not want to suggest that he was criticising the Press, or the reporter at any rate, whatever may have been thought of the selection. I think it is worth mentioning, without trying to quote the whole speech and in that way providing the context, that he was reported in the Daily Express and other newspapers—the Daily Express gave it in direct speech, and this was the remark to which the noble Lord referred—as saying:
"It is absolutely mad that, at a time when our labour force is allegedly over used and when our new force is going to rise but slightly, that we should be talking about limiting the number of people who can be used."
I know that the word "immigration" came in elsewhere, but what he actually said was that it was mad
"that we should be talking about limiting the number of people who can be used."
While he is not complaining of a misreport, I think I must point out that the words used were not quite those which the noble Lord had in mind.
LORD CARRINGTON: My Lords, I am grateful for that help. Does that mean that when the First Secretary of State talks about immigration in the context of employment he can say something quite different from when he talks about immigration in the context of immigration?
THE EARL OF LONGFORD: My Lords, it would be unwise to draw that conclusion. To be honest, if the noble Lord wants to know exactly what he said, he will perhaps allow me to give him a transcript from the Press. There was no form of transcript available. I rely on the Press reference, and I have given the most relevant passage, in which it is clear that when he used the expression "mad" he was talking about use in general and not immigration. It would be difficult to pursue it further.
BARONESS HORSBRUGH: My Lords, could the noble Earl say whether there are any other parts of Her Majesty's Government's policy which Mr. Brown thinks are "absolutely mad"?
THE EARL OF LONGFORD: My Lords, I think it would be a mistake to suppose—and it shows that I have been all too Delphic—that Mr. Brown said that any part of Her Majesty's Government's policy was ill-judged. I should have thought that whatever noble Lords may think about some of us in the Government, most of them have a great regard for the particular job that Mr. Brown is doing.
LORD BARNBY: My Lords, would the noble Earl feel himself in a position to say, when dealing with matters affecting immigration from the Commonwealth as a whole, that those remarks apply equally to the population of Hong Kong as to the other parts of the Commonwealth?
THE EARL OF LONGFORD: My Lords, Mr. Brown was not confining his remarks to immigration from abroad, and least of all from Hong Kong. He was making a general remark about the need to give the fullest opportunities to using manpower in a very flexible way in this country.
LORD BARNBY: That was not the point of my question. The real point was to ask whether the noble Earl was able to confirm that there is no distinction or discrimination between Hong Kong and other parts of the Commonwealth.
THE EARL OF LONGFORD: My Lords, I am afraid I am not following the noble Lord as closely as usual. I do not know why anybody should wish to distinguish between Hong Kong and other parts of the Commonwealth. I am not entirely "with" the noble Lord there. Certainly there is no attempt to distinguish. Let me repeat, if I have not made it quite clear, that the First Secretary's statement was in no way intended to modify existing Government policy in regard to immigration, as stated very recently in this House by my noble friend Lord Stonham and other Ministers.
LORD BARNBY: My Lords, the noble Earl asks me whether I would elucidate
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the point. I was asking whether he would confirm that there is no discrimination or distinction in his remarks between immigration from the Commonwealth as a whole, and immigration from Hong Kong.
THE EARL OF LONGFORD:My Lords, the noble Lord can set his mind completely at rest on that point.
LORD ALPORT: My Lords, may I ask the Leader of the House whether it is the view of the Government that it is the responsibility of Commonwealth Governments to prevent their nationals from evading the immigration regulations of the United Kingdom; or whether that is not essentially a problem for the United Kingdom which cannot be transferred to Commonwealth Governments?
THE EARL OF LONGFORD: My Lords, certainly we should not wish to place the sole responsibility on Commonwealth countries, but we hope for their co-operation in that task.
THE EARL OF SELKIRK: My Lords, would the noble Earl agree that there are many parts of this country where there is no shortage of labour, where some of these activities could well have been carried on that are being carried on to-day in heavily over-employed areas?
THE EARL OF LONGFORD: To be absolutely honest, the noble Earl has me beaten. Could he amplify his question?
THE EARL OF SELKIRK: There are many parts of this country where there is already no shortage of labour but ample labour to be employed. It does not require people from outside to fulfil the duties. There are places in this country where opportunities for labour arcs urgently required.
THE EARL OF LONGFORD: My Lords, to the best of my belief, immigrants are not creating employment problems in that sense at all.
LORD BLYTON: My Lords, does my noble friend not think that there should be mutual agreement between ourselves and the Commonwealth in arriving at a good solution to this problem, instead of our trying to make a multiracial issue of it in this country?
THE EARL OF LONGFORD: My Lords, I am grateful to the noble Lord, who has brought his usual common sense to bear on the difficulties.
LORD ELTON: My Lords, without wishing to prolong these exchanges, I have been waiting to put one supplementary question. Having had, for whatever reason—I am still not entirely clear what the reason was—madness and the policy of Her Majesty's Government in this respect associated widely in the public mind, I should like to ask the noble Earl whether he recalls that, according to a Government spokesman, and quite apart from, say, 20,000 voucher holders and an unknown quantity of illegal entries expected this year, there are up to 500,000 potential immigrants, now overseas but with an unehallengeable right to permanent settlement here as dependants? And does he consider that bringing in immigrants in such great numbers and, therefore, having in perpetuity to import the food and so forth necessary for them, is an economic method of obtaining more cheap labour—if more cheap labour is desirable, which is to say the least of it open to argument?
THE EARL OF LONGFORD: My Lords, the noble Lord has raised a very wide question, and I can only say what I said just now: that I have nothing to add to the Statement of policy made recently. I do not want anything that has been said by me this afternoon to give an impression that there is some new emphasis. As the noble Lord is aware, voucher holders are not coming in at present without jobs to come to, and I hope he will realise that efforts are being made to cope with the problem.

EXPORTS OF TANNED SHEEPSKINS
2.50 p.m.
VISCOUNT LONG: My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.
[The Question was as follows:
To ask Her Majesty's Government what policy they propose to take to encourage the sheepskin tanners, and especially those who are splitters, to increase their exports.]
THE PARLIAMENTARY SECRETARY, BOARD OF TRADE (LORD RHODES): My Lords, may I thank the noble Viscount for his courtesy in the matter of this Question and say that the sheepskin tanners will, I hope, benefit from the export rebate of 14 per cent. for these goods and from the other measures which the Government have announced to assist exporters generally.
VISCOUNT LONG: My Lords, I am grateful to the noble Lord for his reply. Am I to understand, with regard to the export of animals on the foot, and skins and pelts, that the tanners will now have a chance of getting an allocation of those skins instead of having to import foreign skins of an inferior quality?
LORD RHODES: My Lords, I am afraid we cannot agree to restrict the export like that. I can understand that a free market in that raw material creates a problem for the tanners, but as a nation we live very largely by processing raw materials which we import from others, and it would be against our wider interests to adopt measures which would encourage countries which produce good raw materials to withhold them from the world's markets.
VISCOUNT LONG: Then, my Lords, as I understand the noble Lord, the Government's policy cannot help these tanners in any way.
LORD RHODES: My Lords, we are helping in the export of the skins by the export rebate.
VISCOUNT ADDISON: My Lords, can the noble Lord enlighten me on the expression "splitter"?
LORD RHODESMy Lords, a "splitter", so I understand, is the person who separates the flesh side of a sheepskin from the outside, which is called the "grain".

ARMED FORCES' PENSIONS
LORD RUSSELL OF LIVERPOOL: My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.
[The Question was as follows:
To ask Her Majesty's Government when they intend to fulfil the pre-Election pledge of the Prime Minister that Armed Forces pensions will keep their full purchasing power, instead of being eroded by inflation; and whether they will now accept the principle of parity by bringing the basic rates of those longest retired more into line with the rates current to-day.]
LORD SHEPHERD: My Lords, the Government are considering the position of public service pensioners. The review will, of course, include Armed Forces pensioners, and will take account of the various suggestions made from time to time about pensions increase measures. I cannot unfortunately anticipate the outcome of the review.
LORD RUSSELL OF LIVERPOOL: My Lords, I thank the noble Lord for his reply but should like to ask him a further question. As the Prime Minister was well aware of the circumstances at the time he made this promise, how is it that, when they have raised their own and many other pensions, Her Majesty's Government, who have now been in the saddle for 170 days—although I do not think much of their horsemanship—have so far done nothing for these unfortunate and well-deserving pensioners of the Armed Forces?
LORD SHEPHERD: My Lords, this is, as I am sure the noble Lord will agree, a very complex matter. We are dealing with 615,000 pensioners, over the whole of the public service, and 112,000 Armed Forces pensioners. As I say, this is a very complex matter. It is being reviewed in the customary way, and I hope that we may have a statement in the not-toodistant future.

PRIVATE BILL STANDING ORDERS
2.53 p.m.
THE CHAIRMAN OF COMMITTEES (LORD MERTHYR)THE CHAIRMAN OF COMMITTEES (LORD MERTHYR) rose to move that the following Amendments to the Standing Orders relative to Private Bills, et cetera, consequent upon the coming into force on April 1, 1965, of certain provisions of the London Government Act, 1963, and the Water Resources Act, 1963, be approved:

Standing Order 1,

line 2, leave out ("or metropolitan")

Standing Order 1,

line 27, leave out ("or metropolitan")

Standing Order 4A,

line 40, leave out ("or metropolitan")

Standing Order 25,

in the last paragraph leave out ("the London County Council")

Standing Order 32,

line 11, after ("River") insert ("Authority or Catchment")

Standing Order 33,

line 4, leave out first ("Board") and insert ("Authority")

Standing Order 33,

lines 10 and 11, leave out ("Board, or each of those Boards") and insert ("Authority or Board, or each of them")

Standing Order 36,

line 10, leave out ("metropolitan")

Standing Order 40,

leave out subsection (2)

Standing Order 42,

line 4, leave out first ("Board") and insert ("Authority")

Standing Order 42,

line 8, after the second ("the") insert ("Authority or")

Standing Order 43,

line 7, after ("River") insert ("Authority or Catchment")

Standing Order 47,

subsection (2), leave out ("(other than metropolitan boroughs)")

The noble Lord said: My Lords, the Amendments which I am proposing to the Private Bill Standing Orders this afternoon, which are set out in a Marshalled List, are, with a few exceptions, made necessary by the passing of the London Government Act, 1963.
The Greater London Council and the new London boroughs came into being on July 31, 1963, the date of Royal Assent to the 1963 Act. Since then, they have existed side by side with the London County Council, the metropolitan boroughs and other local authorities in Greater London for the transitional

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period until April 1, 1965, which was the date appointed for the disappearance of the superseded authorities. Your Lordships will remember that last July I moved a series of Amendments to the Standing Orders in order to provide for the deposit of various documents required by the Standing Orders with both the old and new authorities during this transitional period. The old authorities having now disappeared, it is necessary again to amend Standing Orders so as to remove allusions to them.
The exceptions that I mentioned in my opening words are the Amendments Nos. 4, 5, 8 and 9, which are made necessary by the passing of the water Resources Act, 1963. By Statutory Instrument under this Act, April 1, 1965, was the appointed day for the transfer of functions of the old river boards to the new river authorities, and I am now proposing consequential Amendments in the relative Standing Orders to provide for the deposit of Bills and ancillary documents with the new authorities. With the permission of the House I should like to take these Amendments en bloc and, if your Lordships agree, I will now move that the Amendments set out in the Marshalled List be agreed to.
Moved, That the Amendments as set out in the Marshalled List be agreed to.—(Lord Merthyr.)
On Question, Motion agreed to.

SWEEPSTAKES ON HORSERACES (AUTHORISATION) BILL
LORD AILWYN: My Lords, on behalf of my noble friend Lord Jesse], who is ill, may I say that it is proposed, with your Lordships' concurrence, to postpone the Committee stage of this Bill until next Tuesday, April 13.

LICENSING (SCOTLAND) BILL [H.L.]
2.56 p.m.
Order of the Day for the House to be put into Committee read.
Moved, That the House do now resolve itself into Committee.—(The Earl of Cromartie.)
On Question, Motion agreed to.
House in Committee accordingly.
[The LORD MERTHYR in the Chair.]
Clause 1 [Repeal of Sections 82 and 85 of Licensing (Scotland) Act, 1959];
On Question, Whether Clause 1 shall stand part of the Bill?
LORD INGLEWOOD: With a view to considering a possible Amendment later I should like to ask the noble Earl how far, during the preparation of this Bill, he tried to link up his action with similar action on the South side of the Border. The subject of this Bill is not wholly a Scottish interest. I am concerned particularly with the southernmost of the two areas, the one based on the brewery in Carlisle. The Border cuts this small area into two, and it would seem, much more efficient if we could deal with both sides of the Border as one problem.
I live in the part of Cumberland affected, and I cannot agree that what was said during the Second Reading about our being disinterested in any change; in fact, I think it was misleading, although I am not suggesting that the noble Lord intentionally misled the House. In my view, some few would like to see no change; some would like to see far-reaching changes; but the majority would like to see a change on the lines of the noble Earl's Bill.
If I may say so, without disrespect, I did not think that the speech of the noble Lord, Lord Hughes, was very helpful, as he did not tell us very much about the merits of the Bill. There was very little argument for or against the changes. He suggested, at the end of his speech, that in this case no bread was better than half a loaf, but he missed the bigger implications. There is, in fact, a big issue here, and I hope that the noble Earl who has introduced this Bill and the noble Lord, Lord Hughes, who I am sorry is

13
not in his place, would agree with one general proposition that I now make.
While we shall all agree that, for good historical or other reasons, there are many differences between the laws and administration of England and Scotland, it is none the less in the interests of the people who live on either side of the Border, and who cross it frequently (and I do not think that the interests of these people are always very clear to legislators who dive in London, Edinburgh or Glasgow), that we should avoid introducing new small pettifogging differences, just for the sake of being different. A little give-and-take on both sides could get over much of this difficulty. This sort of thing might have been thought appropriate a long time ago, but nowadays it happens much too often and it is just inefficient government.
This is too big an issue to pursue to-day, but I hope that some noble Lord on the Front Bench opposite will rise to say that he is in agreement with this general proposition, which is entirely innocent and entirely reasonable—though I see that the noble Lord, Lord Craigton, appears to be getting excited. I fear, on the other hand, that the noble Earl who introduced the Bill will say that it is impossible to extend the Bill to include parts of Cumberland. If so, I shall be very disappointed, and others who live in the area will be disappointed; but, unlike the noble Lord, Lord Hughes, I wish him luck with his "half-loaf".
LORD CRAIGTON: Of course my noble friend is quite right in pointing out the difficulties and procedural conflicts that arise in the Border area where the two systems of government meet. Such difficulties are to a greater or lesser extent world-wide. They exist, as they do in Scotland, on the borders of even the most friendly nations.
There are only two solutions. The first is that the Border areas accept the differences and strive to work ever more closely together in spite of them. Such cross-border co-operation is going to be very necessary indeed when the Government really to try to solve the Border depopulation problem. Furthermore, the noble Lord asks that we iron out local procedural difficulties. This Border problem can be reflected in legislation, as we sought to reflect it in this House only a few weeks ago in our deliberations on
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the Registration of Births, Deaths and Marriages (Scotland) Bill. The noble Lord, Lord Hughes, was very co-operative on that occasion and we hope to succeed in another place on this Border point. That is one solution, for the Government and the local people to work together. The only other solution is for the two nations to adopt wholly identical laws and practices in all fields throughout the length and breadth of both countries; in other words, what the noble Lord is asking for is one domestic Government instead of two.
LORD INGLEWOOD: If I may intervene, I was not asking for anything of the kind. What I was asking for was a bit of common sense.
LORD CRAIGTON: The logical conclusion of what the noble Lord was suggesting is one domestic Government instead of two. In so far as this, or something like this, is what is in my noble friend's mind, I, after eleven years as Scottish Minister, wholly disagree. I draw his attention to the Report of the Royal Commission on Scottish Affairs which reported in 1954. In paragraph 109, in answering the argument that (I quote)
"There might appear to be logical grounds for suggesting that the office of Secretary of State for Scotland is an anomaly and should be abolished",
they say:
"This argument takes no account of the existence of a separate Scottish ethos, history, and tradition and of practical differences between the two countries".
And in paragraph 110 they add:
"Considered in broad terms. most of the work handled by the Scottish Departments lies in fields where Scottish conditions are clearly distinguishable from those in England and Wales."
In the event, the Royal Commission increased the separation between the two countries by recommending that responsibility for Scottish roads and two other minor functions should be transferred from the responsible English Ministry to the Secretary of State for Scotland.
In the case of abolition of State management—on Second Reading I was talking of abolition, not of the suggestion in this Bill—it is perfectly true there was a difference of local opinion North and South of the Border, which was reflected at Government level in a difference of

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opinion between successive Secretaries of State for Scotland and successive Home Secretaries. It was only in the last year or so that public opinion in Scotland became so strongly in favour of abolition that something had to be done. And not for the first time—and, I hope, not for the last time—since England would not join Scotland in this matter, we in Scotland, with England's approval, decided that Scotland should go it alone.
This may be thought to be a minor matter, but it is not. I am always deeply conscious of the world tendency, which is for small nations to seek to run their own affairs. It is not right to say this simply could not happen here. This State management issue is exactly the sort of pinprick that can lead to trouble and dissatisfaction out of all proportion to the importance of the issue involved. There has been growing harmony between our two countries since the crisis of confidence which led to the appointment of the Royal Commission in 1952 following six years of Labour rule. This has not happened by chance. In the last twelve years Scottish Ministers have deliberately, and on every issue, sought to give expression to the legitimate needs and aspirations of the Scottish people, and in this they have had the full and understanding support of successive Prime Ministers and Cabinets. I see that the noble Lord, Lord Hughes, is not even here to-day.
If the Labour Government stay in office long enough they will regret the day that, as seems clear from their attitude to this Bill, they started once again, as they did when in office before, to pay little more than lip-service to Scotland as a separate nation. England with her greater population must always be the predominant partner. But for England, and for the United Kingdom, prosperity and harmony lie riot in domination but in understanding and in co-operation.
THE JOINT PARLIAMENTARY SECRETARY, MINISTRY OF LAND AND NATURAL RESOURCES (LORD MITCHISON): Speaking as I do in the place of my noble friend Lord Hughes, and being a mere Englishman, I have listened with reverent attention to the two speeches we have just heard. On the merits of the matter and on the merits
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of the beer supplied, I have nothing to add to what was said by my noble friend Lord Hughes on the last occasion. I would merely point out that, if this Amendment were carried or this clause rejected, little would be left of the Bill, and therefore on that point I should like to take up what has just been said from the Front Bench opposite. I should have thought that the Scots themselves have given the best indication of their feelings about the present Government, and that the ample representation in the Labour Party of Scottish constituencies, and consequently their overwhelming numbers in another place, was a better answer to the unfounded suggestions that have just been made than any we could otherwise make.
THE DUKE OF ATHOLL: On a rather lower plane than the two previous speakers, I think there are three reasons why we should not agree to my noble friend's suggestion that Clause 1 should be omitted from the Bill, which I gather is what he wishes.
LORD INGLEWOOD: No, on the contrary.
THE DUKE OF ATHOLL: I gathered that was his original idea. First, the two largest hotels in Carlisle, I believe, are not State managed and State management has been administered in a very different way on the English side of the Border as compared to the Scottish side, and therefore there is not the same stultification for the tourist trade on the English side of the Border as on the Scottish side. Secondly, of the Royal Commissions which looked into this matter 35 years ago—I admit it was a long time ago—the Scottish one was unanimously in favour of abolition of State management in Scotland, whereas the English one was—I speak from memory—split about eight to five. Presumably there was some good reason why the minority were not in favour of the abolition of English State management, although I admit I have not read the Report so I do not know what it was. Then, I believe that all licensing law has been done for the individual country and never has there been a licensing Act applied to both. Therefore, I should have thought that if my noble friend wanted to do this he had better introduce his own Bill for this purpose.
THE EARL OF CROMARTIE: Much of what I was going to say has already been said, so I will not repeat it. I obviously have a great deal of sympathy with my noble friend in wanting to extend this measure of freedom and democracy south of the Border. But there are two reasons why, in my view, this could not have been done. When the licensing law of Scotland was consolidated it was done separately from the licensing law consolidation in England, which would, I think—and I was advised—have given considerable legal difficulties. Secondly, and perhaps even more important, I had absolutely no mandate whatsoever from anywhere in England, but I had a very definite mandate from the Cromarty Firth area and Dumfries-shire. I think noble Lords will appreciate that I came down here with this Bill with a very large mandate in my pocket from both those places. I would thank the noble Lord, Lord Craigton, very much for supporting me in this matter. I really have nothing more to say as what I would have said has all been adequately said already.
Clause 1 agreed to.
3.10 p.m.
LORD DRUMALBYN LORD DRUMALBYN moved, after Clause 1, to insert the following new clause:
Minor and consequential amendments of existing law
"The enactments described in the Schedule to this Act are hereby amended or repealed to the extent specified in column 2 thereof."
The noble Lord said: I beg to insert the new clause printed on the Marshalled List. As this is purely a paving Amendment, if it is for the convenience of your Lordships I suggest that we take the Amendment to the Schedule at the same time. May I, however, at this point draw attention to an error in the Schedule. When I come to move the Amendment to the Schedule—I am indebted to the noble Lord, Lord Mitchison, for having pointed this out to me—the reference to Section 85 in the third line from the end should be omitted.
I think it would be convenient if I dealt with the first three groups of the Amendment, which fall together, and then with the fourth. The first part of the Amendment,
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"In Section 81 the words 'for the purposes of state management of the liquor trade' shall be omitted",
is entirely consequential on Clause 1. The effect of this Amendment is to leave out a portion of Section 81. I had better read the section as it stands. It says:
"The provisions of this section shall have effect for declaring the powers exercisable by the Secretary of State for the purposes of State management of the liquor trade in the districts specified in Part I of the Eighth Schedule to this Act."
The fact that Clause 1 has now been accepted in Committee means that it dispenses with the need for anyone who has obtained a certificate from the licensing courts in the State management districts, or for any club which has been registered by the Sheriff for the State management districts, to obtain authority of the Secretary of State before selling liquor. That is the effect of it. In short, that means that the State management will no longer manage and control the liquor trade in the State management districts, but only those premises in the State management districts which are owned and managed by the State. So that the words
"for the purposes of State management of the liquor trade"
are not only unnecessary, but confusing and misleading, and therefore I move for them to be omitted.
The second part of the Amendment deals with amendments which, in my view, are also consequential. It would be at variance with the spirit of the Bill —indeed, it would make a nonsense of it—if the Secretary of State were allowed to retain his power to acquire premises compulsorily, because if that were done, as soon as the licensing courts granted a certificate it would be open to the Secretary of State compulsorily to acquire the premises in question. This power is both unnecessary and anachronistic in Scotland. My noble friend Lord Inglewood, I think it was, or another of my noble friends, drew attention to the fact that there are two large hotels in Carlisle which remain (if I can put it that way) to be compulsorily acquired. But there are no such premises in Scotland holding full licences which could be compulsorily acquired; all this power is entirely spent. So the power is unnecessary in so far as existing licenced premises are concerned, and it would, as I say, be at variance with the spirit of the Bill if it were to be

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made applicable to premises in respect of which a certificate was granted by the licensing courts.
That goes for the second group of amendments. I might be asked why I have not extended this to land as well. I have not done so because it seems to me that this is neither necessarily consequential nor necessarily minor, and I thought in a Bill of this character that it was much better to limit the Amendments to be made to those which were purely consequential. That is what I am doing. Section 84 would fall with the abolition of the power to acquire premises compulsorily.
The last part of the Amendment deals with a small point in paragraph 16 of the Second Schedule to the 1962 Act. That paragraph reads:
"In section eighty-two (which restricts the sale and supply of excisable liquor in State management districts), at the end of subsection (1) there shall be inserted the following words—
'(d) to anything done under the authority of a restaurant or a restricted hotel certificate'".
These were the new types of certificate that were made possible in the 1962 Act. The effect of that paragraph was to make it possible for the licensing courts to give these particular types of certificate—that is, a restaurant certificate and a restricted hotel certificate—without the necessity of the approval of the Secretary of State under Section 82. Now that Section 82 is being removed, that clause is no longer necessary, and I suggest that it ought to be omitted. I beg to move.
Amendment moved—
After Clause 1, insert the said new clause.—(Lord Drumalbyn.)
THE EARL OE CROMARTIE: All I have to say on this Amendment is that I agree with it, and should like to thank my noble friend for what he has done, which is in effect tidying up the Bill. Being somewhat inexperienced in these matters, I find this most helpful and I am most grateful.
LORD MITCHISON: Since we are told that these are consequential Amendments —though I must not be deemed to agree with that statement entirely—I should like to mention that the noble Earl might care to consider leaving out Section 2(6) of the 1962 Act, if and when the Bill goes any further.
On Question, Amendment agreed to.
Clause 2, agreed to.
3.19 p.m.
LORD DRUMALBYN: I beg to move that this Amendment, as printed, be agreed to, with the omission of the reference to Section 85, in the last line but two.
Amendment moved—
Insert the following Schedule—
"SCHEDULE

MINOR AND CONSEQUENTIAL AMENDMENTS

Enactments

Repeal or Amendment

Licensing (Scot-land) Act 1959. 7 & 8 Eliz. 2. c. 51.

In Section 81 the words "for the purposes of state management of the liquor trade" shall be omitted.

In Section 83 the words "any licensed premises in a state management district and any land in such a district" shall be omitted, and there shall be substituted therefor "any land in a state management district"; and subsections (2) and (3) are hereby repealed.

Section 84 is hereby repealed.

Licensing (Scot-land) Act 1962. 10 & 11 Eliz. 2. ch. 51.

Paragraph 16 of the Second Schedule is hereby repealed."

—(Lord Drumalbyn.)

On Question, Amendment agreed to.
House resumed: Bill reported, with Amendments.

GLASGOW CORPORATION ORDER CONFIRMATION BILL
Brought from the Commons; read la, and (pursuant to the Private Legislation Procedure (Scotland) Act, 1936), deemed to have been read 2', and reported from the Committee.

AIRPORTS AUTHORITY BILL
3.20 p.m.
Order of the Day for the Third Reading read.
THE LORD CHANCELLOR (LORD GARDINER): My Lords, I have it in command from Her Majesty the Queen to acquaint the House that Her Majesty, having been informed of the purport of the Airports Authority Bill, has consented to place her interest, so far as it is concerned on behalf of the Crown, at the disposal of Parliament for the purposes of the Bill.
LORD BESWICK: My Lords, I beg to move that the Bill be now read a third time.
Moved, That the Bill be now read 33. —(Lord Beswick.)
On Question Bill read 33, with the Amendments.
Clause 8:
Accounts and audit
8.—
(2) The accounts of the Authority shall be audited by auditors appointed by the Minister, and a person shall not be qualified to be so appointed unless he is a member of one or more of the following bodies—
LORD BESWICK LORD BESWICK moved, in subsection (2), after "Minister" Ito insert "after consultation with the Authority". The noble Lord said My Lords, this Amendment was discussed in principle on Second Reading and again at subsequent stages of the Bill. We are all quite well aware of what is involved. The question of the appointment of the auditor has been presented as one which concerns the status of the Authority and the degree of trust and independence granted to it. The matter was first raised by the noble Lord, Lord Reith, and subsequently by Lord Hurcomb, Lord Selkirk and Lord Beattie.
EARL JELLICOE: Lord Jellicoe.
LORD BESWICK: I beg the noble Earl's pardon—Lord Jellicoe. I hope no offence is taken; it was the wrong Admiral. They all pursued the same line of argument, and my noble friend Lord Brown, from his industrial experience, put another point of view. The Amendment which I now move will, I hope, satisfy
22
all concerned. Very properly, it leaves ultimate responsibility with the Minister, but at the same time it recognises the standing and rights of this Authority. In moving this Amendment I should like to thank again the noble Earl, Lord Selkirk, for the way in which he was good enough to accept my undertakings on the Report stage and for withdrawing his own Amendment. I hope that he is satisfied with the wording I now bring forward. I beg to move.
Amendment moved—
Page 7, line 21, after ("Minister") insert ("after consultation with the Authority").—(Lord Beswick.)
THE EARL OF SELKIRK: My Lords, I should like to thank the noble Lord, Lord Beswick, for this Amendment. He has been as good as his word, and I am most grateful to him. This provision for consultation has now become more or less standard practice in public authorities, and I believe that it is a good thing that it should be formally incorporated in statutory form. Therefore it is a good addition to the Bill.
LORD OGMORE: My Lords, I should like to support the Amendment, but I am only using it as a peg (because I have not had an opportunity to speak on this measure before) to welcome the noble Lord, Lord Beswick. Fifteen years ago, he and I were colleagues at the Ministry of Civil Aviation, and I should like to tell him and the House how pleased I am that the Prime Minister has appointed him to his present position and that he is speaking for civil aviation. He knows a great deal about the subject and his heart is in it. Throughout the discussions on the Bill the House has been able to see with what authority the noble Lord, Lord Beswick, has spoken. I wish the new Authority every success, and I wish the noble Lord, Lord Beswick, the same.
On Question, Amendment agreed to.
LORD BESWICK: My Lords, I beg to move that the Bill do now pass. I think that it would be inappropriate to let the Bill go from us back to another place without a few words of farewell and good wishes. It has been subjected to a most rigorous examination whilst it has been before your Lordships' House. The procedures of this House have been used to the utmost. I must say that, coming from another place, it has been quite an

23
experience for me to find no fewer than four stages at which a Bill could be amended. I think we should all agree that it is a much better Bill now than when it was first brought before your Lordships' House. If I may say so, the other day my right honourable friend the Prime Minister said something about noble Lords having the bit between their teeth when voting in this House. If he was thinking of the War Damage Bill, I must confess that I, too, thought I saw some tell-tale marks around certain noble mouths. But on this particular Bill it is not so much the bit between the teeth that I could picture, but more the pencil behind the ear, because I must say, if I may be allowed to do so, that many noble Lords seem to have spent a good deal of time through the watches of the night doing their homework on this Bill.
I was asked on Report stage by the noble Earl, Lord Jellicoe, whether or not it would introduce into the Bill an element of hybridity if the grant-attracting areas were specified in the Bill. In answer to an interjection by the noble Earl, when replying on the Amendment, I said that as then advised it almost certainly would introduce this hybridity, but that this was not the argument which we had in mind when we first introduced the clause as it now stands. I went on to say:
"The basic argument for this clause is that there should be flexibility, as the noble Earl requires, and that flexibility is best obtained by spelling out the details in a Statutory Instrument."—[0FiriciAL REPORT, Vol. 264 (No. 60), col. 1239; April 1, 1965]
The noble Earl will realise that his question about hybridity was hypothetical. For that reason, and because the question of hybridity is one to be decided by the House authorities and not by Her Majesty's Government, I could not then, and I cannot now, give a precise answer. It will depend very largely on the drafting. In view of the hypothetical nature of the question, I cannot properly go further than to say that if the grant-attracting areas had been spelt out in the Bill, the House authorities might have felt it necessary to refer the Bill to the Examiners.
Having said that, I should like, finally, again to wish well those who will be responsible for this new Authority which the Bill will establish. No amount of words in this House or in the other
24
place will count as decisively and as importantly as the work which all those concerned, in the boardroom and on the airports, will put into the service of this new Authority. I am sure that I speak on behalf of the whole House (and I know that my noble friend Lord Ogmore, whose kind words I appreciate, will agree with me in this) when I say that we wish every success to this new public Authority which we propose to establish.
Moved, That the Bill do now pass.—(Lord Beswick.)
EARL JELLICOE: My Lords, I need not detain your Lordships long. As your Lordships know, this Bill came to us as a broadly agreed measure, and it is perhaps surprising that we have taken so long in discussing it. But although we agree on the principles behind this Bill, my noble friends and I had three areas of doubt when the Bill came to us. We had some doubt whether the responsibilities of the new Authority were clearly enough defined; and these doubts my noble friend Lord Selkirk ably expressed. We had some doubts whether the financing—and, above all, the initial financing—which the new Authority was to receive was adequate; and we had some doubt whether the status being conferred on the new Authority was adequate for a body of the standing we all wished such an Authority to have. I cannot, in honesty, say that the discussions in this House have done a great deal to resolve our doubts on the first two points, though I think they have done something to resolve our doubts about the status of the new Authority. That applies not least to the last Amendment moved by the noble Lord, Lord Beswick, for which I, like my noble friends, are grateful.
We have also been detained, of course, upon the important new clause introduced by the Government to enable householders around Heathrow to soundproof their houses. I suspect that this new principle, which has been introduced into the Bill, might prove even more important as time goes on than we at present think. But, having expressed some doubts about some aspects of this new clause, I would certainly confirm that we accept its principle. I am a little disappointed that the noble Lord has not been able to give

25
me a more definitive ruling on the question of hybridity. But this is a point which another place may well wish to take up, if they wish to specify in the Bill the areas to which the clause should apply.
That said, my Lords, I should like to add only two points. The first is to echo what the noble Lord, Lord Beswick, has just said, and wish this new Authority the best of all possible good fortune. I would add that, in my view, its success will stem not so much from the adequacy of this particular Bill, but, even more so, from the adequacy of its membership. I very much hope that the Minister of Aviation will soon be able to announce that he has been able to recruit really first-class people to this important new Authority.
The second thing I would say is that, although there have been two Ministers in charge of this Bill, I think that most of the heat and burden of the day has fallen upon the noble Lord, Lord Beswick. This has been the first Bill which he has piloted through this House, and I should like to thank him for the invariable courtesy which he has extended to myself and my noble friends. He has always been courteous, not only in accepting our suggestions—on the rare occasions when he has done so but also when, more frequently, he has "stonewalled". I should like to say how much we appreciate his handling of this measure.
Qn Question, Bill passed, and returned to the Commons.

REPORT ON CARE OF EPILEPTICS
3.33 p.m.
LORD HASTINGS LORD HASTINGS rose to ask Her Majesty's Government whether they will now consider the Report of the Sub-Committee on the Medical Care of Epileptics with a view to implementing its major recommendations. The noble Lord said My Lords, before I go any further, I think I should declare what is my personal interest in this matter, or perhaps it would be more accurate to say what is my connection with this subject. Some four or five years ago I was invited to become the President of the Newcastle-upon-Tyne branch of the British Epilepsy Association. I agreed to do so, because I remembered that in my youth a boy of my own age, about 15 years old, with
26
whom I used to enjoy that most agreeable form of cricket, village cricket, regularly on Saturdays, suddenly became subject to epileptic fits.
He disappeared completely from our social life. Very little was or could be said about him, and so far as I know he never enjoyed a normal social life again. I remembered that episode, and that is why I took an interest when the opportunity was offered me, although I must admit that up till that time I had not even heard of the British Epilepsy Association. Since then, as recently as last autumn, the Association did me the honour of asking me to become the Deputy President of the national organisation.
So far as we know, there are something like 250,000 sufferers from epilepsy in Great Britain. I think they can be divided into four groups. There are those who have only infrequent attacks and are in every respect, apart from that, normal. It is doubtful whether most people realise that they suffer from epilepsy. Then we have those who have attacks, accompanied by some intellectual or physical disability. The third category is of those who also have behaviour disorders and, in general, are of a rather anti-social nature, although otherwise they are quite normal. Finally, there are those who suffer from the most frequent attacks which are difficult, and sometimes even impossible, to cure.
When we are talking about these groups of unfortunate people, we have to remember at the same time the families, because this particular misfortune known as epilepsy proves to be a great embarrassment and inconvenience and leads to many misunderstandings, not only between families and the community at large, but within families themselves when they are not instructed in the medical and social problems accompanying epilepsy. This means that we are concerned with about one million people, which is a very substantial number in terms of unhappiness and sometimes misery, and considered in terms of the loss of productive work which, if the situation were properly handled, could be expected from these people.
If there is any doubt about this, I think I should quote from the Report which is the subject of my Question,

27
the Report on the Medical Care of Epileptics, produced by a Committee with the noble Lord, Lord Cohen of Birkenhead, as Chairman. This is one of only two parts of the Report, which is heavily underlined and printed in italics:
"We are, however, prepared to express the opinion, without reserve, that epilepsy is a sufficiently major problem to demand that special medical provision be made for dealing with it."
If I may, I should like to turn to some of the major recommendations of this Report. First of all, the Committee said that it was absolutely necessary that Regional Hospital Boards should provide diagnostic clinics and also treatment clinics, with beds available in the latter, in which people could be stabilised—that is the phrase used I think—for as little as two to three weeks, in some cases, or, at the most, two to three months; and that, in addition, there should also be longer-stay treatment and rehabilitation centres. These diagnostic clinics and treatment centres, the Report says, should be under a neurological surgeon with a team—and this is the important point—of paediatricians, psychiatrists, child guidance experts, radiologists, almoners, psychologists and others.
THE PARLIAMENTARY UNDERSECRETARY OF STATE FOR COMMONWEALTH RELATIONS AND FOR THE COLONIES (LORD TAYLOR): My Lords, before the noble Lord leaves that point, does he not mean a neurological physician?
LORD HASTINGS: My Lords, I am subject to correction on that point, and I believe the noble Lord is right. Without these diagnostic clinics and treatment centres, it is virtually impossible to give a sufferer from epilepsy the proper chance that he should have to become assimilated in the community as a whole. Very often he gets no treatment, or he may even get the wrong treatment, and a team is required to put this matter right.
The Committee also suggested that there should also be investigatory clinics for epileptics with behaviour disorders—one of the most difficult groups, that is to say—with 30 to 50 beds; and that these would be most suitably placed at a hospital centre, where the necessary
28
services, such as I have just mentioned, would be available, and particularly at a hospital centre with an active out-patient clinic and follow-up system. Then, in addition, they suggested we should also have resettlement clinics working in cooperation with the general practitioner, the almoner, the disablement resettlement officer, the local health and welfare authority services and other agencies which may exist—the British Epilepsy Association being, of course, one of them.
Now, my Lords, may I for a moment say a special word about the children? About 80 per cent. of the children who suffer in one degree or another from epilepsy are being educated, and quite rightly so, in the ordinary schools of this country, and it is most important that that should continue to be so. In fact, the Report says that no child should be sent to a special school, thereby segregating it from normal children, until it has been to an assessment centre at a hospital, where they can diagnose the exact state and degree of the epilepsy. It is suggested, in addition, that there should be long-stay hospital units for children with bad behaviour disorders. Finally, among the major recommendations—because these are, of course, only the major recommendations; I cannot deal with all of them, for there are too many—there is one which refers to the epileptic colonies: that is to say, places to which people who suffer very badly go and become resident, more or less permanently, and perhaps, unfortunately, more rather than less.
The Report suggests that these colonies, of which I believe there are eleven throughout the country, would be able to fulfil their role rather better if they were in a unified national plan for the management of epileptics and formed part of the National Health Service, and that there should be more emphasis on rehabilitation. Not necessarily everybody who goes to one of these colonies should go there with the belief, or with the intention on the part of the people who run it, that he should stay there always. The main aim must always be to get him out again, through the various services, into ordinary life. But if this is impossible—because it would need legislation to make the colonies part of the National Health Service—there should at least be a much

29
closer association of the colonies with the hospital service. There might be some form of compromise which could be worked out.
I think I have covered the major recommendations. What it really amounts to is that there should, in this country, be a continuing patient service a service for the patient from the general practitioner, who first of all comes up against the case, right through the diagnostic and treatment clinics recommended in the Report and the rehabilitation centres, and finally to the resettlement clinics, where again he will come into contact with all these various people who are interested in the subject—not only the medical but the welfare officer, the local authority service, the voluntary services and so on. There should be a complete cycle to look after these sufferers from the beginning to the end. Because, really, what one has to realise about epilepsy is that it is not just a medical problem it is equally a socio-economic one.
At the moment, unfortunately, these services are virtually entirely lacking because, I regret to say, although this Report was made and issued in 1956, really very little, if anything, has been done about it. We know, through my Association, that there is a widespread ignorance among general practitioners about epilepsy; but, even for those practitioners who are fully aware of the problems and of what to do about them, there are not the necessary services such as those recommended in this Report, and which I have just outlined, to enable the general practitioner to give his patient the best chance in life in the future.
My Lords, may I be permitted to close with a few words about the British Epilepsy Association? Because I should not like the noble Lord opposite or his right honourable friend the Minister to imagine that we are asking for a lot of things and are pressing for them without good reason. Noble Lords may have seen the noble Lord, Lord Taylor, I know, has seen—quite a good little article or report in the Guardian to-day saying that the British Epilepsy Association wants to put on pressure. Of course we do, but I think we have to justify ourselves at the same time; so I should like to spend the next
30
minute or two saying something about the work of the Association. Now we do a good deal—I say "we"; I should say the Association do a good deal—of educational work. We have films; there are the obvious leaflets and posters; there is a very good quarterly journal full of most interesting material on this subject; and recently there was appointed a full-time educational secretary in the London area. This lady has, in six months, I believe, given no fewer than 75 lectures to interested people who, after being written to, have asked for a visit. As a result, there are now a great many more teachers, welfare officers, doctors and other interested people who know something about this problem.
Then there is a welfare service, with a full-time welfare officer who not only helps all the cases which come to her notice at headquarters in London but travels extensively through the country, trying to help in the other areas where we have representatives, and even where we have not. There are also area representatives or organisers already appointed in Newcastle-on-Tyne, Birmingham, Bristol and Cardiff, and it is the intention of the Association to appoint another four or five such representatives when funds permit. The Association aims also to attach to these areas fully-qualified social workers, because directly you get a social worker in the area you find the demand is much greater than you imagined before you started; and it is necessary to have social workers in these areas so that as many people as possible can be given the necessary advice as near to their home as it can be done. It cannot all be done, of course, from London.
Then there are 28 clubs throughout Great Britain which cater for the social needs of these sufferers from epilepsy, in which they can feel thoroughly at home and learn to live with their disability. Members of these clubs include the family as well, and other people who are interested and willing to help but who are not sufferers themselves. This fulfils a very great need. Holidays, too, are organised, both for adults and for children, every year. Another thing that the Association wants to start is a lodgings bureau. One of the great problems of this subject is the question

31
of employment, and it is particularly difficult in the case of a sufferer from epilepsy to find a lodging in order to enable him to take up his employment, or even to go to a Government training centre, which would be preliminary to his getting into ordinary commerce or industry. Therefore we have it in mind to start a lodgings bureau; to get a list of landladies who are willing to take these people, provided that they know they have the help of a social worker in the vicinity should any particular problem arise. We shall aim also to give guarantees to such landladies that they will not suffer from any accident which may occur. We believe that this also is a useful service.
My Lords, there is also research activity. We have started a research fund. Unfortunately, it is a very modest one, but we are able to give grants to certain individual projects that are going on. A good deal of research in the general field of neurology is being done which may be helpful to epileptics, though there is no specific research into epilepsy as such. One is led to believe that, if there were funds available for such research, solutions might be found —because we want to get at the cause of this misfortune. However, I should perhaps leave that particular aspect of the matter to my noble friend Lord Brain, who I am happy to see has arrived. And I may say that if I have been talking for longer than I otherwise should have done, it was to give him time to arrive, because this little discussion has come on sooner than we expected.
Finally, I would say that there is in existence an international Bureau which was started in 1961, and of which the British Epilepsy Association in London can be called the headquarters and the instigators. This Bureau arranges for a good many interesting and useful exchanges of information. For instance, a seminar on "Epilepsy and education" was held only last year in Marseilles at which there were 90 participants from ten different countries. All this must be very much to the benefit in the long run of the people who are suffering from this complaint. I think I have now spoken for as long as I should; I have set out the case for the noble Lord opposite, and I hope that his Ministry will take this
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matter very seriously. In the last nine years since this Report was published there has been a better understanding in public opinion of the social and economic disadvantages accruing to people with epilepsy. The sufferer from epilepsy has had the feeling that he has been left behind his fellow men; so that I think now, in 1965, we should come to the conclusion that it is time that he was given a fair deal and that the services so necessary for him are provided.
3.53 p.m.
BARONESS SUMMERSKILL: My Lords, as my noble friend Lord Segal has only just arrived he has asked me to say a few words while he is getting his breath. I had no intention to-day of intervening in this discussion. As has been said, it has come on a little earlier than was expected, but I am sure that we are all very grateful to the noble Lord for putting this Question. I was deeply moved when I heard why he was interested in this subject. I must confess that I gave it a little thought, and I wondered why he had switched from what we all know to be his prime political interest to a medical one. I am very happy to learn that his heart is so big that when he sees a boy having an epileptic fit—and there is no doubt that he did so at some time—he is moved to take an interest in the subject.
I am quite sure that all of us, on both sides of your Lordships' House, approve of the recommendations, made by the Sub-Committee referred to in the Question, and it seems curious that in 1965 we have still not provided for this tragic little quarter of a million in our community. As I have said on other occasions, it is unfortunate that the least well-off in the country have the smallest pressure groups; and, generally, it is a long time before Parliament comes round to looking after their affairs. In my opinion these people are doubly unfortunate, because they suffer from a complaint about which so little is understood by the general public and, consequently, the deep sympathy which flows from understanding is not always forthcoming. It was interesting to hear that in the noble Lord's case, far from being repelled and frightened, as many are, he was moved to come forward and to help. Occasionally, the symptoms of this disease are calculated to startle, indeed to frighten, the uninitiated. The result

33
is that often employers are reluctant to employ people suffering from epilepsy, not only because they believe the employee must be less efficient but because they are afraid that, in the event of a fit occurring, the commotion caused might disrupt work. For this reason I believe we should emphasise the need in this field for more social medicine aimed at educating the public and so helping the patient.
It seems to me that, as more than half the cases occur in childhood, every child should receive the most expert care, in order that it can readjust itself to life and recognise that it possesses only a minor physical handicap with which it can come to terms and learn to live. That, I think, is very important. Whatever complaint an individual has, the sooner that he or she, child or adult, sees it in terms of a minor physical handicap (as most are) and the sooner the patient is taught to think of it in relative terms, the better.
I was astonished to learn from a paper on the subject by Dr. Pond, the eminent specialist in this field, that in a survey of epilepsy in fourteen practices in 1960 one-half of the 282 people suffering from epilepsy had not been referred to hospitals either as out-patients or in-patients. No doubt many general practitioners have had excellent results simply by prescribing anti-convulsant drugs. In the post of every general practitioner during the week come advertisements for anticonvulsant drugs, and every pharmaceutical firm recommends this or that new anti-convulsant drug as being superior to the last one that was advertised a month ago.
In this situation, in view of the fact that the patient is better, that the convulsions disappear, that the fits are limited, it is understandable that the general practitioner should feel that the new drug is eminently satisfactory. But, my Lords, I think that immediately the symptoms manifest themselves every patient should be referred to a clinic, or, if we do not have clinics—and the recommendation is that more should be provided, so obviously we do not yet have enough—to a specialist. Of course it would be better to have the team described by the noble Lord, but unfortunately we have not arrived at the stage when that team is operating,
34
because in nearly every case there is a shortage of qualified people. But if the team is not there, then all patients should be referred to a specialist, so that they can be fully investigated and treated. I welcome this debate very much because it will focus attention on the need for giving these patients expert treatment immediately the condition is revealed.
LORD FERRIER: My Lords, the noble Lady pointed to me in connection with the pharmaceutical industry, and I think it is proper to say that I retired from the industry as over age some time ago. But on the problem of drugs for the control of epilepsy, I know that a great deal of money has been spent and effort is continually being directed towards this condition, and I hope that when the noble Lord who is to reply speaks on the subject he will give credit where credit is due—namely, to the enormous contribution which the pharmaceutical industry and pharmaceutical research have made towards the control of this sad condition in the past few years.
4.1 p.m.
LORD SEGAL: My Lords, I rise with some reluctance. If I may be allowed to make a confession, my name was entered upon the list of speakers when I happened to be away in Hungary. But I feel I cannot refrain from rising and adding my own few words to those already so eloquently spoken by the noble Lord, Lord Hastings, and by my esteemed colleague, and friend Lady Summerskill, in an earnest plea that a great deal more should be done on behalf of this unfortunate section of our community.
As my noble friend said, too often we are apt to regard the sufferer from epilepsy as someone in the nature of an outcast from the community. Nothing could be further from the truth. If only we had some means of educating the public, we could get an idea into the head of the average person of the more or less normal course that an epileptic fit invariably takes; instead of a feeling of revulsion, horror and fear, we might be able to create in the mind of the onlooker that calm, reasonable, informed approach, which can do an enormous amount to help the sufferer in the fit and also counteract the effect that this fit may have on onlookers who are present.

35
Particularly would I stress that, in these days, it is most essential that the sufferer from epilepsy should come to be regarded as an ordinary member of the community. They may develop fits either from early childhood or as a result of some illness during life. They come on without any warning as a result of some severe emotional strain, and in every case the treatment is simple and straightforward. It is now recognised in the whole profession that the treatment of an attack, both at its onset and during the course of the attack, is so simple, that no member of the community should be left in ignorance of how to deal with these cases.
Above all, I would stress that a duty should be laid upon all employers not to regard the sufferers from epilepsy as in any way victims of disability, because in many cases they are people who are highly gifted, highly qualified and highly intelligent, and the fact that they happen to suffer from epilepsy should in no way disqualify them from all the opportunities open to average individuals for pulling their weight in the community. I am very glad that the subject has been raised and that it has been raised by the noble Lord, Lord Hastings, in the way he has brought it forward. I hope that the reply of the Minister, when his turn comes, will be fully adequate to the needs of this unfortunate section of our community.
4.5 p.m.
LORD BRAIN: My Lords, as both a member of the Cohen Committee and a Vice-President of the British Epilepsy Association, I am grateful to my noble friend Lord Hastings for raising this matter to-day. Epilepsy is not in itself a disease, but a symptom, which may be due to many diseases which damage the brain. Many of these diseases occur very early in life, perhaps as the result of difficult labour or the illnesses of infancy, and they often leave no serious disability behind beyond the liability to epileptic attacks. So, while it is true from a scientific point of view to say that epilepsy is not a disease, but a symptom. we have also to look upon it as a disorder which creates quite peculiar personal and social problems. In this respect, it differs from all other disorders, and that is the reason why special pro
36
vision needs to be made for sufferers from epilepsy—a provision which has to be based on the Health Service.
So the Cohen Committee, as your Lordships will know, recommended in 1956 the establishment by hospital authorities on a regional basis of diagnostic and treatment clinics and long-stay treatment and rehabilitation centres. It further suggested that these centres should normally be under the direction of a neurological physician, who should be the leader of a team consisting of pediatricians, psychiatrists, child guidance experts, radiologists, psychologists, almoners and others. Only in this way, we were convinced, could adequate provision be made for the needs of epileptics. It may be said that there are many neurological and neurosurgical and other departments in hospitals, where a great deal is now being done for epileptics. This is perfectly true and I should be the last person to minimise the very valuable research which is going on in this country into many aspects of epilepsy.
But what we are doing now does not really take account of the magnitude of the problem. As your Lordships have already heard, it is estimated that there are something like 200,000 to 250,000 sufferers from epilepsy in Great Britain. Each of these is an individual, who cannot be adequately treated with out, in the first place, as complete a diagnosis of the cause of the epilepsy as is possible. Then he needs continuing medical supervision and attention to personal problems at home, at school, in his occupation and in many other spheres. The large majority of epileptics are not at present receiving this care to the extent that they ought to be.
The object of the proposed centres is to provide this care for as many as possible and to educate both doctors and the public in what can and ought to be done, and thereby to raise standards generally. As your Lordships have heard, nothing substantial has been done to this end in the nine years which have elapsed since the Report of the Cohen Committee. Why is this? It is one of the principles of the Health Service to delegate as much responsibility as possible to the Regional Hospital Boards, hoards of governors and hospital management committees. This has its

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advantages. but it also has its drawbacks, and I believe, that when a national need like this has been recognised, the Ministers concerned should take much more responsibility for seeing that something is done about it. And he who wills the end must will the means. It is of little use suggesting to Regional Hospital Boards, whose estimates are already being cut, that they should embark on expensive new projects, without making any specific allocation of money to those who are prepared to undertake it.
I pointed out earlier that the Cohen Committee recognised the key position of the neurological physician in relation to the development of these regional centres. But let me draw your Lordships' attention to the plight of some neurological physicians in this country. In Plymouth, where one neurological physician has to provide the service for an area with a population of over half a million people, he cannot get more than six hospital beds, as a result of which many acute neurological emergencies cannot be admitted under his care. In a population of half a million people, as we have seen, there are at least 2,000 epileptics. What sort of facilities for diagnosis and treatment are available to them, in competition with all the other patients suffering from neurological disorders, when the local hospital authorities consider six beds an adequate neurological service for half a million people? Unfortunately, this is not the only instance where neurologists working in the region have not proper in-patient facilities.
I should like to mention what seems to me to be a great opportunity that has hitherto been missed. The Burden Institute at Bristol has done pioneer work of a particularly high standard in the field of epilepsy. It is independent of the Health Service, but it treats Health Service patients, for whom it is paid on a per capita basis. I believe both the Burden Institute and the Health Service would be greatly strengthened if some closer form of collaboration between the two could be developed. The Institute has in fact all the potentialities for just the kind of regional centre which the Cohen Committee recommended.
It is not for me to anticipate what I hope my noble friend Lord Taylor is going to say, but I can myself close on
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a note of hope. I welcome what the Minister of Health said the other day in answer to a Question in another place, and I have myself been in close touch with the Ministry about this question. I know that in one provincial region things are moving, and we may hope to see a regional centre for Epilepsy established there; and things are moving, too, in the North-East Metropolitan Region, where I have been discussing matters with the senior administrative medical officer. He is preparing a memorandum for submission to the Regional Advisory Committee on Neurology and Neurosurgery, of which I am Chairman, which we hope will lead not only to the development of a regional centre but also to a review of the work now being done at the two long-stay hospitals—the only long-stay hospitals for epilepsy in the Health Service—St. David's and St. Faith's. Patients suffering from epilepsy, and doctors specially interested in the subject, owe a great deal to the British Epilepsy Association, and as the developments we hope for come to pass, the Association, I am sure, will have an even bigger part to play, in co-operation with the regional centres, in the welfare of epileptics.
4.13 p.m.
LORD BROWN: My Lords, I had not intended to take part in this debate, but it is quite clear that we have a little time this afternoon and I wish to make a comment which really could be made anent a number of the problems which we debate in this House. Before going on, I should like to associate myself sincerely, as others have done, with the comments made by the noble Lord, Lord Hastings, and to thank him for raising this important matter. As he has said (I think these were his words), it is necessary to get the idea into the head of the average person concerning this matter. In other words, part of the solution of this most serious problem lies in an increase in the insight of the general public.
This is true of so many of the problems which we debate in this House. In one debate after another the point is made that we must get people to understand the problem better. The point was made on countless occasions anent the problem of immigration. Indeed, in some areas public insight has increased. For instance, in relation to our whole

39
approach to neurosis and mental breakdown the degree of insight among the public has grown, and it has made the problem easier to deal with. The question of alcoholism is now recognised by the general public as being the disease that it is rather than a moral weakness. With regard to the matter we are debating this afternoon, it has been said—and I am sure it is right—that this is a question which affects at least one million people, including the unfortunate 250,000, plus their families, and it may affect far more.
The point I wish to make is that the means of educating the public is at hand. We have this wonderful modern invention of television. Every time we come to this problem what we have to face is that a political decision made some time ago handed this wonderful instrument of education to commercial usage; and had we not done this, we should be in a position to-day to pursue a part of the solution to problems like this, and others I have mentioned, with much greater ease than is in fact the case. I have talked on more than one occasion to senior officials in the B.B.C. and asked them why the B.B.C. do not undertake more instruction or, if you like, propaganda in this or that area. I think your Lordships know the answer they are there partially to give entertainment, but at the same time they have commercial competitors; the listening gures for the commercial programmes heavily outweigh their own; they are regarded as failures, and they have to do something about it.
I think we all recognise that the more serious programmes, particularly those concerned with social problems which affect a minority of the population, are not the best ways to get good listening figures. So we are constantly in a situation where we have biased the use of a most important instrument, and perhaps the most important instrument, of public education. I am one of those who unrepentantly still hold that this country one day will change its mind about commercial television, or in some way so arrange matters as to divorce it from these' huge profits it is making and the bias of the strong profit motive which inhibits the more educational type of
40
programme, so that when we come to an issue like this, and other issues which are debated in this House, it will be within the realm of Government policy to decide that in the interests of society a certain proportion of the time on both networks (or as many networks as there are) can forthwith be devoted to increasing public insight, and so getting round, partially at least, some of the serious problems which constantly come before us in this way.
4.17 p.m.
LORD AMULREE: My Lords, when I came to your Lordships' House this afternoon I did not intend to take part in this debate, because it deals with a subject about which I know very little, and my purpose in coming here was to try to learn something which I did not know before. I have succeeded in learning quite a lot. However, one point raised by the noble Lord, Lord Hastings, was the position of the epileptic colonies vis-a-vis the National Health Service. It has always seemed to me wrong that if one has a National Health Service it should not be a far more widely embracing service than it is now. Therefore, I should like to support what the noble Lord said on that matter.
I have mentioned in your Lordships' House on previous occasions that there are a number of little health services in the country which are independent health services, and it would be far better for all concerned if they all came under one control and became part of a general service. I should like to thank the noble Lord for bringing up this point, and I just want to say how much I support him in regard to it.
4.19 p.m.
LORD TAYLOR: My Lords, I am sure we are all grateful to the noble Lord, Lord Hastings, for raising this question this afternoon. He pointed out, quite rightly, that the Cohen Committee reported nine years ago. I am not going to be defensive I am going to be descriptive. But what I shall be describing will be mainly what has happened in the past when Her Majesty's present Government were not in office. As to the future, I welcomed the reminder of the noble Lord, Lord Brain, that in another place my right honourable friend the Minister had said

41
that although the diagnostic and therapeutic facilities for epileptics have been developed since the time of the Cohen Report, more needs to be done. And more does need to be done—I think there is no question about that.
But I also think that it is important to keep epilepsy in a proper perspective, and not to exaggerate it. There are now, fortunately, many voluntary societies who devote their energy to the study and encouragement of sufferers from particular diseases. This is a very welcome development. One might say that it has replaced the work that used to be done on behalf of the voluntary hospitals. Almost the first of these societies was, I think, the British Diabetic Association, and since then we have had the people suffering from poliomyelitis, the relatives of the mentally subnormal, the sufferers from multiple sclerosis, and many another group, getting together to forward the interests and press the case of these relatively small minorities of patients. This is entirely to the good, and I am delighted that the noble Lord, Lord Hastings, should have associated himself with work of this kind. I am delighted that he should have become Deputy President of the Association, and, like my noble friend Lady Summerskill, I was moved by his description of how he became interested in epilepsy.
Fortunately, most epileptic attacks do not end in the subject's disappearing from circulation. The noble Lord, Lord Brown, said that we must increase the insight of the general public. And of course he is right. The position of the epileptic in society must be regarded as virtually that of a normal human being who has a disability like, say, a weakness of one leg or something of that kind. Above all, people have to learn to treat and deal with those who have the misfortune to suffer from epileptic attacks with a minimum of fuss and without gathering round. The wonderful thing is that in fact most people deal very sensibly—in the street if need be—with a great many cases, in fact the great majority of cases of epilepsy.
Following the Report of the Cohen Committee on the Medical Care of Epileptics, the Ministry took certain actions —though I am inclined to think that the noble Lord, Lord Brain, is right
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when he says that part of the price we pay for giving autonomy to Regional Hospital Boards and other Health Service authorities is that actions do not necessarily follow precisely the pattern we expect them to follow, or would wish them to follow. A memorandum was issued to Hospital Boards almost immediately commending wholeheartedly most of the recommendations of the Committee. The only recommendation of which I know that it did not commend was recommendation 19, and that was the one about the epileptic colonies. It would have required legislation to bring the colonies within the National Health Service. The noble Lord, Lord Amulree, is quite right when he refers to these as little services, as it were, which exist outside the National Health Service. These colonies are either provided by voluntary association or by local authorities, and are regarded as providing care rather than medical treatment. The only two which can specifically be considered as institutions for medical treatment are the two to which the noble Lord, Lord Brain, referred in the North-East Metropolitan Board area.
The Report was also brought to the notice of local authorities, local executive councils and local medical committees. The Hospital Boards were asked to review their services for epilepsy, and report progress in improving them. They have reported from time to time, and steps have been taken. I think that the time is now probably ripe for us to have another look at the situation. The normal course which an epileptic patient follows is from the general practitioner to the specialist clinic in the local hospital. My noble friend Lady Summerskill spoke most humanely about the lack of sympathy which epileptics may have; about the need to educate the public, and about the importance of the attitude of employers. But she also said that in a certain survey it was found that half the epileptic patients had not been referred to specialised clinics. I think she may well be right. The proportion, indeed, may be higher than that. But this is something where the clinical judgment of the doctor arises, and it would be quite wrong for me, speaking from this Box, to give, as it were, clinical advice to my medical colleagues.

43
We know that in children, in particular, a fit, or an alleged fit (because very often it is only the mother's description of something happening to the child), can occur from relatively minor causes, and may require no further treatment. Whether all these cases should be referred to specialists is something that I think is open to question, but I should not like to go further than that because the number of children who have such incidents is very large. But usually reference is to the neurological clinic, though sometimes it may be to a general medical clinic or, in the case of children, to the pœdiatrician. Certainly it is very important that any person who has repeated epileptic attacks should be seen by expert neurologists to make sure that the attacks are not associated with other gross neurological disease.
But apart altogether from the neurological cases, there are a substantial number of epileptic patients who suffer from intellectual defect or disability, or physical defect—for example, cerebral palsy. As the noble Lord, Lord Hastings, said, there are a number who also have serious behaviour disorders. These, fortunately, are in the great minority; but when they occur they present a great problem. The first step, clearly, is to make a proper diagnosis, and to make sure that other diseases are not present as well; and to arrange for proper physical treatment, whether by surgery or by the use of, modern drugs, or through the psychiatric services, as appropriate.
Here, one would say how much the outlook has changed for the epileptic in the course of the past twenty years. Modern drugs have vastly improved the outlook for the epileptic, and psychiatric help is also of real value where there are psychological frictions arising, or psychological causes playing their part. The suggestion of the Cohen Committee that there should be special diagnostic and treatment centres has not been generally followed, but the wide spread of general physicians and the increase in neurological and psychiatric facilities have led to an increase in the hospital services available for, and used by, epileptics.
Here, one needs to pause and think for a moment how far it is wise to isolate the epileptics into special epileptic
44
clinics. I think it is an experiment which is well worth considering—and I should like to come on in a few moments to what the noble Lord, Lord Brain, was saying about special clinics—but we want to avoid labelling epileptics. One knows that even such a simple thing as attendance at a child guidance clinic may lead to a child's being labelled in some way as mentally abnormal. The specialised clinic may not always be the right answer.
LORD HASTINGSMy Lords, may I just ask the noble Lord this point? Is he not really recommending a rehabilitation centre followed by a resettlement centre? What is needed in the early stages is specialist diagnosis and treatment, and then to get the people out of the segregation area of which the noble Lord is speaking, through the rehabilitation and resettlement centres, so that they come out as normal people.
LORD TAYLOR: Provided that the rehabilitation and resettlement centres are, in fact, general rehabilitation and resettlement centres, and not specifically for epilepsy, I would agree with what the noble Lord is saying. I think it is very important that they should be in the general stream of patients and not separated into special epileptic rehabilitation groups.
LORD BRAIN: My Lords, might I make a point here? I suggest to the noble Lord that to have a special clinic for epileptics does not necessarily mean that it must be at a geographically separate place. It could be provided in an ordinary neurological department. Surely one advantage of a special rehabilitation centre would be that specialist experience would be available.
LORD TAYLOR: My Lords, I would not dissent from the view the noble Lord, Lord Brain has expressed about this. I think that that would be a very sensible way to do it.
Reference has been made to the survey of the College of General Practitioners. Actually the survey, in which I am particularly interested, was carried out in 1960 in 67 practices, and the findings suggest that about 4 persons per thousand suffer from chronic epilepsy and that 40 to 50 per thousand have had a fit some time during their lives.

45
The great majority of patients (1,165 out of 1,391) were treated at home without admission to an institution. I am not quite clear whether the noble Lord, Lord Brain, wishes to see every patient admitted for investigation, or whether he is happy to see them investigated in neurological out-patient departments. I should have thought that most of them do not require admission; that only a very small proportion requires admission—for example, cases where there are indications of some other serious disorder, or where it is impossible to stabilise the patient as an out-patient. I am glad to see that the noble Lord, Lord Brain, indicates assent.
Some three-quarters of the chronic epileptics recorded in the survey of the College of General Practitioners were fully employed—and it is worth bearing in mind that employers are ready to carry their share of epileptics. This is an encouraging fact. The figures showed that 12 per cent. were partially employed. and only 8 per cent. were unemployed on account of epilepsy. Admittedly, it is a pity that there should be that 8 per cent., and we must do all we can to encourage employers. But again I must say that. in my experience, employers are remarkably good in these mattars, though there is always more education to be done.
My Lords, we know from the Cohen Report that about 80 per cent. of children with epilepsy are educated at ordinary schools; and this again is precisely as it should be. They should not be pushed out into a stream by themselves if this can possibly be avoided. In ordinary schools it is important that the teachers themselves should know in advance if a child is liable to have an epileptic attack so that they can treat the whole thing with the minimum of fuss and not get agitated and upset. This calls for collaboration between the general practitioners, the school medical officers and the school authorities themselves.
There is no firm evidence that the amount of epilepsy in the community is increasing, but there is evidence that more patients are being admitted to hospital for investigat on, diagnosis and treatment, and that the great majority of these are discharged back to the ordinary community. The estimated number of in-patients suffering from epilepsy discharged from non-psychiatric
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hospitals rose from 9,300 in 1953 to about 13,170 in 1961. Just as there has been an increase in the number of neurologists, there has been an increase in the number of neurological beds. Although I am sure that we are always short of every kind of bed (and I am sure, also, that the noble Lord, Lord Brain, is not painting an untrue picture when he referred to Plymouth), and that there is no kind of urgently required bed of which we could not do with more, it is good that there is an increase in the number of neurological beds and an increase in the flow-through of epileptic patients who are being properly investigated and stabilised.
There are, however, a great many epileptics who are in general psychiatric hospitals, and I hope that the British Epilepsy Association will not forget the needs of all the epileptics who are not in the colonies but who are in this particular position. In 1961 it was mated that there were 7,500 epileptics in hospitals for the mentally ill (that is, of course, they had a mental illness as well as epilepsy) and 10,000 in hospitals for the mentally subnormal—equally they are not there because of their epilepsy, but because they are mentally subnormal.
Now I come to the point that the noble Lord, Lord Brain, was raising. Recently discussions have been started in one Regional Hospital Board area which it is hoped will lead to the establishment of a special unit for epilepsy. This may become a reference centre for severe and problem cases and the focus for epilepsy in the region, from which advice may he given on the management of and the services available for any individual epileptic. It is hoped that a second unit may develop in another part of the country, but these discussions are in their early stages, so it would be wrong for me to say anything more about them officially. But if these two centres in due course prove successful, then they will provide a pattern for similar centres to develop elsewhere.
A number of epileptic people of course do not need hospital care but are not able to maintain themselves in the community, even with help, and residential care must be provided for them. For the most part, this is still given in colonies for epileptics which have existed since the 1880s. I had expected much

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more to be said about these colonies. I know that the British Epilepsy Association takes a great deal of interest in them. I have here a report of the Nuffield Provincial Hospitals Trust on problems of medical care with which I am sure the noble Lord, Lord Hastings, is familiar. In it is a very interesting survey of the population of these epileptic colonies, carried out by Dr. Kathleen Jones and another colleague at the request of the British Epilepsy Association. These colonies are very much out of the public eye. Besides the three local authority colonies, there are six colonies provided by voluntary organisations ranging in size from 480 residents to 37 in the smallest. Then there are St. David's at Edmonton and St. Faith's at Brentwood, to which the noble Lord, Lord Brain, made reference. The colonies, whether voluntary or municipal, cover wide catchment areas.
Those who remember the colonies in the old days, before modern drugs became available, will never underestimate the work they have done and now do. It was a tragic situation. With the coming of the new drugs which control the vast majority of cases of epilepsy, and the tranquillisers to help in the personality problems, the problems of these colonies have been reduced. But epilepsy has its severer manifestations often associated with personality changes, which make the work of running the colony a difficult and arduous one.
Because they are voluntary bodies, it is not easy for the Ministry of Health necessarily to carry them with them all the way. There were a number of recommendations of the Cohen Committee Report about these colonies which we hope we shall see implemented in due course. In 1961 they set up their own Epileptic Colonies Joint Consultative Committee, and this Committee keeps in touch with the Ministry to discuss ways in which their work can be improved. I am sure this was in itself a big step forward. In particular, it is desirable that the colonies should increasingly adopt a policy of rehabilitation, though one has to confess that there are many residents who, because of their age or other reasons, are unlikely to respond to a more vigorous policy. Some of them,
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for example, are patients who have severe physical disabilities following burns because they have fallen over and burned themselves, or they have had a stroke as well, and many of them are very "hospitalised" indeed. Nevertheless, in the colonies they are making efforts to introduce productive work as opposed to pure occupational therapy—for example, the making of concrete blocks and the making of chain fences—and the residents do a great deal of the normal work of the colony.
One of the results of keeping in touch with the Joint Consultative Committee is a closer contact between the colonies and the hospital service, which is highly desirable. In the long run it may well be that with improved methods of hospital and domiciliary treatment there will be some decrease in the number of cases who need residential care of the kind the colonies provide. I must say I hope that that will in due course be the situation. As local authorities develop their residential services for the handicapped there may be an increasing tendency to assimilate epileptics in hospitals or homes with other physically handicapped adults, so that the chances of their keeping in touch with the community may be increased. I am sure this is the right approach.
Most epileptic children can live at home and receive schooling or training in the ordinary way. Severe epilepsy may, however, stand in the way of ordinary measures, and residential school education may be essential. One of the most hopeful developments in this connection is that of schools run for severe epileptic children; and there I understand the average stay is about two years, which is really an encouraging sign that they achieve what they set out to achieve.
After the school years, most epileptic patients will enter employment. The work of the Ministry of Labour through its D.R.O.s cannot be too highly praised, as evidenced by the fact that the great majority of epileptics are working satisfactorily. A small number are also admitted to industrial rehabilitation units; and here I was very impressed with what the noble Lord, Lord Hastings, said about the problem of finding lodgings. I wish his lodgings bureau the greatest success, and I think

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it will be a splendid thing if they succeed in helping in that way.
Some epileptic people who can live at home need support and help in developing their lives. The social clubs, of which the British Epilepsy Association run 28, are of real value. It may also be desirable to try to fit epileptics into clubs provided by local authorities or voluntary bodies for the physically or mentally handicapped as well, again not to isolate them from the main stream.
The Minister of Health has recently been reviewing the present state of services for epilepsy and their development since the Report of the Cohen Committee. Though something has been achieved there is clearly room for further improvement, and he is going to seek fresh advice from his advisory committees to see what further guidance he can give to both the hospital services and the local authorities. There will then be many points of view to consider, and the Minister will not reach a decision until he has reviewed them all. He will certainly take into account all that has been said in this debate. In this important field of work it is clear that there is much scope for the understanding and hardworking help of voluntary bodies. The colonies, indeed, provide one example of that, and I hope that we may see the leaven of the British Epilepsy Association working thoughout the whole field of epilepsy, and not only in the colonies.
LORD HASTINGS: My Lords, I thitA the noble Lord has misundersta the position. We do work maisity outside the colonies, and not inside the colonies.
LORD TAYLOR: I realise that. I was hoping that his Association would continue to take an interest in the colonies and the, Welfare of those most severely handicapped by epilepsy. I simply finish by saying that we are really grateful to the noble Lord for having raised this question, and we hope that we may see great progress in this difficult field.

EDUCATION OF HANDICAPPED CHILDREN
4.45 p.m.
LORD GRENFELL LORD GRENFELL rose to ask Her Majesty's Government what plans they have to assist the education of children suffering from the dual handicap of deafness and mental subnormality or spasticity. The noble Lord said My Lords, I have put down this Question in order to stress the vital importance of assisting children who suffer from the dual handicap of deafness and mental subnormality or spasticity. These children, in my opinion, will not reach the highest possible level of education within their ceiling of intelligence without the special deaf training, and hence will not have the best chance of living a normal life within the community.
I am including spastics in this Question, as the case of Muriel Rissen has been highlighted in the Sunday Express, and I sent a copy of the article to the noble Lord who is to answer this Question. Muriel Rissen is a spastic deaf mute whose mother and father have frequently moved house and jobs to try to find some school which will' take her as a pupil, so far as I know without success.
Some noble Lords may remember that on the Second Reading of the Mental Health Bill I spoke about my daughter, who is a deaf mongol of 15 years of age with very little speech, and she was making little progress at a special training school owing to her incapacity to hear what the teacher was saying. In spite of deaf aids, the noise set up by a class of mentally handicapped children causes a buzz in the ear-phone which inevitably cuts out the voice of the teacher, and the size of the class prevents individual attention to the deaf child and hence the lesson is lost.
About eighteen months ago, with the assistance of Dr. Wickley, the Medical Officer of Health of the then Middlesex County, and Dr. Scott of the then London County Council, my daughter was accepted into a deaf school at Brighton called the Hamilton Lodge School for the Deaf. There are very few deaf schools which will accept mentally handicapped children, as they consider that they will hold back the other children. Miss Taylor, the then headmistress, never

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refused any children until she had proved over a period of six months that either she could not help them or they were unhappy. She, unfortunately, died last year, but Mr. Jansen, the present headmaster, and his dedicated staff carry on her great work and have over 100 pupils in their care, two of whom are mongol children. During the period of my daughter's residence at this school her progress has been astonishing. Before entering the school she could not draw any consecutive lines on paper, but now she is writing out simple letters. Her speech has improved a little, her understanding has made spectacular strides and she is blissfully happy. She has integrated with the other pupils completely, and all are most kind to her.
There are a number of mentally subnormal deaf children in the country who are not getting the expert training which my daughter is getting, and by reason of their deafness are not able to assimulate fully the teaching at special training schools, which are not wired for sound, nor are the wachers trained in the expert art of teaching the deaf. These children will never rise to the full level of education within the ceiling of their intelligence, which they have a right to do. Hence, their chances in life are sadly curtailed.
I have not raised this Question before because I wished to be certain that children with a dual handicap could benefit from this training. I am now convinced that this is so, and I feel sure that all noble Lords will agree that every effort should be made to see that the best possible education is given to these children. I am also convinced that deafness is as great a handicap as, or an even greater handicap than, mental subnormality. In fact, there have been tragic cases of some children being diagnosed as mentally subnormal when actually they were only deaf. I fully realise that in the paying of fees adjustment has to be made owing to the so-called uneducable children being under the Ministry of Health while the deaf children are under the Ministry of Education. But this can be and is being dealt with.
I hope that Her Majesty's Government will inform local authorities and the schools for the deaf that it is the wish
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of the Government that these children should be placed in schools for the deaf, and that these schools should accept them for at least a trial period. In many cases it will mean the children becoming boarders owing to their living a long distance from the school. But many of the deaf though otherwise normal children are boarders, for the same reason, and there should be no difficulty here. I would stress that one day a week in a deaf clinic is of no value, as it is essential for these children to have continuous deaf teaching if the best results are to be obtained. My story is a success story, and I have put down this Question in the hope that other children in the same circumstances as my daughter may have an equal chance to enjoy the best possible education within the ceiling of their ability, and a chance to live happy and useful lives.
4.55 p.m.
THE EARL OF ARRAN: My Lords, the noble Lord, Lord Grenfell, has spoken wisely and movingly on that part of the Question which concerns deafness. May I say a special word on the subject of mentally subnormal spastics, which is also referred to, because of course, spasticity and mental subnormality often go together? I thought I might tell your Lordships what life is like in one of the places where they look after the children whom the noble Lord has in mind, and what their needs are, for it is a proud and, at the same time, an incomplete story. My experience is limited to Harperbury, in Hertfordshire—a special hospital which does special things and has a world-famous cerebral palsy unit. So far as I know, there is, no other such unit in the country.
Let us face it, these children, carrying a double burden of spasticity and mental subnormality, are very pitiful The behaviour of some of them its suck, as highly to tax one's faith in the Divine purpose. But there is comfort at Harperbury. It does not exist merely to accept them as painful facts. Things could not be worse, so they try to make them better. They start from nothing and they work upwards, and they are getting results. One doctor, a Czech, to whom the whole world in in debt, is taking on the worst cases of all—children whose brains have been damaged before, during or soon after birth. For such

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children there had seemed to be no hope; but he has shown that they can be vastly improved, mentally and physically—though of course never completely cured—especially if they are treated early, before the pattern of uncontrolled movements has been established. To take the simple indication referred to by the noble Lord, it has only recently been realised that many of these children are deaf and therefore remain dumb. A simple hearing aid often works wonders. But, of course, the rest is not quite so easy: it calls for endless patience and resolve, and the stuff of dedication.
That is all very fine. But what more do we need? Where do we go from here? First of all, this, as I say, almost unique cerebral palsyunit, now established at Harperbury over four years. needs to be repeated in other parts of the country. Harperbury caters for about 90 babies and children of this sort. An estimate of the total number in Britain is about 2,000. At present, so far as I know, the other babies are not getting the benefit of the new educational techniques and treatment. Have they not the right to this? Why should there not be similar units in the Provinces, within the framework of the Hospital Boards, or at any rate in some hospital setting? And if these things are too difficult, or too expensive, should there not at least be out-patient facilities for these children in every district enabling them to spend, say, a day at the hospital, learning—and this is for them education—such simple things as how to eat and how to keep themselves clean, if that can be done?
To return to Lord Grenfell's point, are there really adequate facilities outside London and the immediate regions for diagnosing deafness or inadequate hearing which is so often the cause of what is falsely regarded as mental defectiveness? I have thrown out these points shortly, and at short notice. Clearly, they are not entirely my points, though I go along with them wholeheartedly, for they seem to me to make sense. Perhaps Her Majesty's Government will have a look at them, and, to-day or later, will let the House know their intentions. There is a little job to be done here. It will be greatly to the Government's credit if they do it, and do it quickly.
5.0 p.m.
LORD BROCKWAY: My Lords, I am sure the whole House will want to thank the noble Lord, Lord Grenfell, for introducing this subject this afternoon. We were all deeply moved by his speech. If I may say so, it is characteristic of so many parents who are in his position that when they have a child who needs special care they make that child the inspiration for all children who suffer similarly. I should like also to express to the noble Earl, Lord Arran, our gratitude for what he has said. I am not sure if I am in order, but I would extend this appreciation to the noble Lord, Lord Hastings, who introduced the earlier debate, because these two debates seem to me to raise the deepest test as to whether a society is civilised and human, whether we all belong to the human family, and whether it is not our duty to help specially all those who are handicapped, whether physically and mentally, and those who are rejected.
I cannot help remembering to-day one of the most depressing experiences of my life when, a year after the defeat of Hitler in Germany, I went to a mental institution there. The greatest crime of Nazism was that it was not only racialist in rejecting the Jewish people and the coloured peoples from the human family, but that it rejected even those who physically or mentally were handicapped. As I entered the room where those patients were gathered, I could not remain there. They were just skeletons clothed with flesh, with feverish eyes; they had been starved for years. It was a form of genocide against those who were unfortunate. The great difference between that philosophy and the philosophy which expresses the Christian ethic—I say that, though I am a humanist rather than a Christian—is the greatest challenge as to whether a society can regard itself as civilised.
I have risen to-day because I have been associated with the National Society for Handicapped Children, and particularly with its branch in Slough, the constituency which I represented in another place. I want to endorse the appeal which has been made from the other side that much greater care should be taken to decide whether these children are educable or not. I know cases in my own experience where later it has been

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discovered that a child is not abnormal mentally but has given the appearance of it only by deafness. There ought to be a certainty in our society that there is sufficient provision to be able to diagnose the condition of every child who is like that. My colleague in the neighbouring constituency was Mr. Ronald Bell, with whom I differ on every issue on earth, except this issue. Together we once went to a group of children who had been rejected as uneducable. Mr. Bell pays special attention to this subject, and we took the view that three of those children were able to learn. It was Mr. Bell's efforts which secured that two were able to join ordinary schools and were able to become part of a child community in education.
I have often been to the parties of these children. In one way they are distressing occasions, but on the other hand they are occasions of great inspiration. One remembers the love of the parents for the children, the extraordinary sweetness of the children themselves at moments when they are touched and when they respond to what has been said or done, and also the inspiration of the voluntary workers who maintain these activities. I think again of Slough, where the Secretary of the Slough Society for Handicapped Children, Mrs. Barbara Mason, a member of the board of St. Bernard's Mental Institution, devotes her time to the children. They have done extraordinary things. By voluntary labour they have established one of the loveliest little halls, which is known, most appropriately, as "The Friendly Club". There, twice a week, they have classes for the children of nursery school age, with trained attendants, which provides a tremendous relief for the parents who otherwise are so tied down. In addition, they have parties for the elder children, teenagers, and even adults who do not seem to be much more than children.
This leads me to my first question to the Minister who is to reply. Tonight in that hall the club for the teenagers and the older sufferers will meet. I want to ask whether it is not possible to apply to youth clubs of that character the same grant which is given by the county educational authorities to other youth clubs. I urge that this should not just
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be left to the generosity of some county councils, but that the Ministry should use its influence to see that it is applied everywhere.
Secondly, I want to put this point of view. There is a danger that the special schools for these children will not be regarded as a first priority. I think of the school in Slough, where there is a trained, devoted teacher, but it is in one of the older buildings and is rather makeshift. If we are to develop the best for the children, they must have the brightest surroundings that can possibly be given to them. I am urging that in the programme of educational advance which the Ministry is now undertaking it shall give a special place to provision for these children.
The third point I want to ask him is this. In Slough we have the experimental centre for the National Society for Handicapped Children. We have there, in Ellerman Avenue, workshops which are for the teaching of the older children—and later as they become teenagers—in just normal, simple things, with a view to their advancing to a capacity which will enable them to take jobs in industry. It is a little pathetic how they begin—just learning to tell the difference between a penny coin and a halfpenny coin, going on learning for the first time to use a knife and fork, passing on from that to being able to use a telephone, and then to doing little, simple jobs which will even prepare them for engagement in industry. That experiment is coming to the end of its period of two years. I am asking the Minister whether his Department will have a very careful look at this experiment and, if necessary, take it over as a model and a pattern of what might be done for children of this kind.
Finally, my Lords, I want to press for much more research enabling earlier diagnosis of these cases. The instance of the deaf children who are misunderstood as being subnormal is an example of this problem. I would say, although I speak as a layman, that here is a great field for human discovery, which would not only make the children happier and give them greater opportunities, but would bring hope to their parents.
LORD GRENFELL: My Lords, before the noble Lord sits down, may I say that my understanding about the Slough

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project—and I think I am right—is that in time that will be handed over to the Buckinghamshire County Council. They will take it over and will run it for ever and keep it going.
LORD BROCKWAY: My Lords, I am very much hoping that that will be done. I was speaking to Slough this afternoon, and I am not sure that an absolute decision has yet been reached. But I hope that will be done, and that the Ministry will encourage it.
5.13 p.m.
LORD SEGAL: My Lords, I feel that I must express some apology for inflicting myself on the House twice in two successive discussions. But although I was partly suborned into taking part in the previous discussion on epileptics, I cannot refrain from adding my own few words in this discussion, because it concerns a subject about which I feel so much more deeply than on the question of epileptics.
Let us remember that epilepsy is a problem which can recur from time to time, and that long intervals—perhaps of months, or years—may elapse between an epileptic attack; but the problem of the mentally handicapped children is, like the poor, always with us. In fact, it is to-day with us very much more than the problem of the poor, because we like to pride ourselves on the fact that, thanks to our Welfare State, the whole problem of poverty has been largely eliminated. But our Welfare State has so far done very little indeed to tackle this vast and heartbreaking problem of the mentally handicapped child.
I am sure that we are all deeply grateful to the noble Lord, Lord Grenfell, for having initiated this discussion. He spoke very feelingly about his own daughter, and those of us who know of his work in the past, how he has given unsparingly of his time, both publicly and privately, on behalf of the cause of mentally handicapped children, are especially grateful to him to-day for having raised this subject. He has highlighted what is really one small aspect of a very much larger and most appalling problem. He himself, I think, is a shining example of the way so many parents, in the happiest of homes, who find themselves afflicted with this problem of having a mentally handicapped child,
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have not only shouldered the burden themselves through the long unceasing agony of the years of childhood, of adolescence, and even of adulthood, but have always, perhaps as a result of this, tried to help so many other parents who are similarly afflicted.
If I were to declare my own interest, it would be that I have a niece who was born a normal healthy child, but who at the age of about three-and-a-half years suffered from a very malignant type of meningitis. Her life was despaired of, and then, through the care and the constant attention which she received at the hands of surgeons and physicians in hospital, and after a succession of ventricular and cysternal punctures, her life was saved. But she was left with some mild degree of mental impairment, from which she will have to suffer for the rest of her life.
The problem is so extensive to-day that I believe there is scarcely a single home in this country which is not involved, either among its own relatives or among its friends and neighbours. Although we try to-day to draw a veil over this problem, it does exist; it exists to the knowledge of almost every citizen in the land. And I believe that it is high time not only that further publicity was given to this question, but that a deeper understanding was installed in the minds of all our citizens. I also believe that our Government should now be seen to take a far more active part in dealing with this problem, in helping the parents, in providing and assisting for the education of the children, and in seeing that the utmost is done to enable them to grow up to become useful citizens and members of our community.
My noble friend Lord Brockway has spoken about the problem as it existed in his constituency, and I am very proud of the fact that in Slough pioneer work has been done in the establishment of a hostel for the training of children, and for helping them to learn some useful and productive activity. He has spoken very feelingly of the love of these parents for their children, of the actual sweetness of the nature of these children themselves. It is so fundamentally a human problem that, as he rightly said, it is by our own attitude to this question that our present-day civilisation will be judged. This work that is carried on in Slough

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is pioneer work of its kind. The tragedy is that it remains an isolated instance. It should be multiplied in many other regions in the country.
There is also a vast problem where these children are so handicapped that they are admitted into hospitals; for, unfortunately, despite all the care and devotion that they receive in hospital, their stay there tends to be prolonged. So little is done in the way of helping them and treating them, and there, alas! in many instances they tend to remain. Perhaps what is more needed to-day is not the admission of so many of these children into hospitals, but the provision of hostels where they can spend the daytime under the care of trained, efficient and experienced workers, and perhaps be trained in some useful occupation and enabled to go to their homes in the evening. In that way, the burden of caring for them can be lifted from the shoulders of their parents, and the children can have an opportunity of creating some useful place for themselves in our society. Not only is the provision of hostels for these children needed. One would like to see a much greater extension of holiday homes, where these children can mix together as a community, taken away from their immediate surroundings and given the benefit of a healthy holiday period, if only for a few weeks of the year. I am sure the good will is there, but the amount of work ahead is enormous. It is enormous, not only in the scope that it affords for voluntary help; it is enormous also in the scope that it affords to the Government for taking an active interest in this work and helping effectively in so many directions in which only the Government can help.
The noble Lord, Lord Brockway, has spoken about the need for research. Earlier diagnosis and dealing with causation of mental illness are dependent upon research; and there, too, I feel this Government could do so much more through the hospitals, through our medical schools and through our universities in stimulating fundamental research into the causation of this mental illness, so that the problem in all its present-day dimensions can perhaps be prevented from becoming unduly large in the future.
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The tragedy of these mentally handicapped children is that the extent and scope of the problem is relatively little understood. One of the first cares of our Welfare State is for the welfare of the blind. We have our blind register and we have our register of partially sighted, but so little is known of the extent of the problem of our mentally-handicapped children. Figures are given variously as between 80,000 and 100,000 or 150,000; 'but, surely, there is scope, with the initiative taken by the Government, to institute a register of our mentally-handicapped children, so that some idea could be given to the community as a whole of the dimensions of this problem. Because I believe that, by our treatment of these problems of our mentally-handicapped children, our Welfare State will ultimately be judged, and that by this test will our Government be enabled to justify their record of service to the community.
5.24 p.m.
LORD ROWALLAN: My Lords, I had not intended to intervene in the debate this afternoon, but I should like to express my gratitude to the noble Lord, Lord Grenfell, for raising this matter. As I listened to the eloquent and moving stories which were told by those who followed him, my mind went back two or three years to a little school in Tasmania. There they claimed with pride, and I think with justice too, that in its equipment it was the most up-to-date school in the world. They had gone to endless trouble in collecting and adapting to their needs visual and acoustic aids for bringing these children back into the community. The result that we were able to see before we left, two and a half years after it was founded, fully justified the faith of those who started the school and the devotion of those who taught in it. We still receive letters from those children, and only the other day one of the girls, who seemed a very difficult case indeed and most unpromising, wrote a letter to my wife saying that she had just passed a national examination in typewriting—a tremendous achievement, not only for the girl herself and her parents but also for those who had made that possible.
My Lords, I feel quite sure that work that is done among these children is not only work for them but work for the

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whole community, in providing an inspiring example of what can be done with good will, determination and faith. My wife is very proud indeed that that school bears her name, and we shall always look back with pride on the very sketchy association that we had with it during those two and a half years and realise that, in however small a way, we were in at the beginning of something which was a big experiment for a very small country, and well justified by the results.
5.27 p.m.
THE MINISTER OF STATE FOR EDUCATION AND SCIENCE (LORD BOWDEN): My Lords, I am sure that I speak for everyone when I say that we greatly appreciate the opportunity that the noble Lord, Lord Grenfell, has given us to discuss this most distressing problem. The personal tragedies of these children have been brought before us very clearly by several speakers who have first-hand experience of what they mean; and particularly, of course, we have all been very moved by the account given by the noble Lord, Lord Grenfell, of his own daughter. I am sure that this debate will inspire us all to realise that much can be done for these people and that much more must be done in the future.
I should like, if I may, to describe briefly the present statutory position. Local education authorities have a duty to make sure that education is provided for all children who have any disability of mind or body, unless, in the case of the mentally handicapped, the disability is so great as to render the child unsuitable for education at school. This statutory requirement applies whether a mentally handicapped child has normal hearing or whether he is deaf, or has some other physical handicap.
The Department of Education and Science has for many years believed that no child should be excluded from the education system without a very careful assessment of his potentialities, if necessary over a long period, unless his mental impairment is so great as to leave the matter in no doubt. This is a view which Her Majesty's Government believe very strongly to be right; and we will take it fully into account in our plans for the further development of the various services.
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It is in fact remarkable that a generation ago children who were short-sighted were sometimes mistakenly diagnosed as mentally-handicapped because they were unable to read what was written on the blackboard. To-day one finds that people who are unable to hear are sometimes similarly diagnosed as having some mental defect. It is very tragic that these things should still happen; but, none the less, very much greater care is taken these days than used to be the case, and the work of such of the schools for the deaf as I myself have seen is obviously based on the belief that most of these defects can be identified and that appropriate treatment can be given. It is extremely important, both for the mentally handicapped and the other children, that a distinction should be made between those children who can obtain benefit from education and those for whom some other type of provision is much more suitable.
At present, there are two maintained boarding schools which cater specially for children with hearing defects who are also educationally subnormal. There are many other special schools for the deaf and partially deaf, which provide to a greater or lesser degree for children with severe learning difficulties. A new boarding school is being built by the Royal National Institute for the Deaf, with the aid of a grant from the Department of Education and Science. It is intended both for deaf and partially hearing pupils who are emotionally unstable and are psychologically disturbed. In addition there are several independent schools which are able to accept deaf children suffering from a disability of mind, and local education authorities send pupils to these. The Department of Education and Science is at present considering the adequacy of this range of provision. If further facilities are shown to be needed, discussions will be arranged with the local education authorities and special schools concerned with a view to making provision as soon as possible if they appear necessary.
In cases where it has been established beyond doubt that a deaf child is also mentally handicapped to the extent that he is unsuitable for education at school, responsibility for the child's training and any other facilities which it needs becomes the responsibility of the National Health Service, either through local

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health authorities or through hospitals. Hospital specialists can also help in the very difficult task of assessment before this important decision is taken.
The number of children who have this severe degree of mental subnormality and are also deaf or hard of hearing is small. We have no reason at present to think that it is much in excess of the general incidence of deafness in the population as a whole, which is about one per thousand or one per two thousand for profound deafness. But when the defects of deafness and mental subnormality are found together in one child, the problems are extremely severe, and the difficulties of training such a child arc very great. It has been suggested that special hospital units and residential training centres should be established to give such children, or other mentally subnormal children who do not use speech as a means of communication, the benefit of specialised treatment and training in methods of communication.
In order to assess the possible demand for such facilities, the Ministry of Health is at present collecting information from hospitals and local health authorities about the number of such children known to them, and about any further defects from which they are suffering, such as blindness, cerebral palsy or congenital malformations of any sort. When the results of this inquiry are available they will be carefully studied and, if it seems desirable and practicable, encouragement will be given to the provision of specialised units, which inevitably would have to be residential because of the small number of children in any one area.
In the meantime, mentally subnormal children who attend local health authority training centres and are capable of benefiting from a hearing aid are provided with one. If the mental subnormality is very severe, or if the deafness is very severe, the child may not be able to use a hearing aid to the best advantage; but those who can do so, use them. Children who cannot use hearing aids are not at such adisadvantage compared with the other children as a deaf child might be in an ordinary school, as much of the training of severely subnormal children is always done through visual communication and
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manual practice. Nevertheless, in such circumstances the children would not receive special training designed to help them to make the most of such hearing as they have or to develop their speech; and it is for this reason that the Ministry of Health are investigating the extent of the problem and the practicability of establishing special centres.
I have looked into the case of Muriel Rissen, who was referred to by the noble Lord, Lord Grenfell, and it seems that she has so many handicaps that it is very difficult to provide satisfactorily for her education because her parents move around the country. But I feel that the article in the Sunday Express to which the noble Lord referred was in some ways misleading. Muriel Rissen has been under careful medical supervision since her birth. At the age of 4½years she was admitted to the nursery class of the Tottenham School for the Deaf and was later transferred, when she was six years old, to a day school for physically handicapped pupils which contained a unit for deaf children. Her departure from this school after four years was prompted not so much by educational considerations as by a change in her home circumstances, which made it necessary for her mother to seek employment and to move out of reasonable daily travelling distance of the school.
This was at the end of 1963. From the time she left Middlesex the girl's mother has moved through the area of four different local education authorities, each of which has made every effort to find a suitable school, but, except in the case of the authority now responsible for the child, each has had to relinquish the case before a vacancy could he found. It is not the case that the mother and the girl's stepfather have moved from place to place in search of a suitable school. They appear to have done so in the course of their employment. The nature of their employment, which involves their moving about, suggests that a residential school place is clearly desirable, but unfortunately the accommodation, especially the residential accommodation of boarding schools for the deaf, is mostly unsuited to the needs of children with a severe physical handicap.
I am glad to say that the Headmaster of the Royal School for Deaf Children, Margate, has now accepted Muriel as a

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day pupil for mornings only, at first, and the Kent local education authority are providing transport for her to and from school. She started school again on 19th March, some two weeks ago. At present she is living at a private boarding house in Ramsgate under arrangementsmade on behalf of the parents by the Spastics Society. The local education authority are aware that if this arrangement could not continue for any reason, an alternative would be needed to enable her to continue to live within daily travelling distance of the school.
My Lords, Muriel Rissen's case has presented peculiar difficulty, not only because of the lack of suitable accommodation in schools for the deaf for a child with her physical disabilities, but also because of the severity of her hearing loss, which was caused by meningitis and is much greater than that normally associated with spasticity. There are about 2,500 spastics in day and boarding special schools, excluding hospital schools, approved by the Department. It is not known exactly how many of these are additionally handicapped by deafness, but the number is not more than 100 to 150. Very few of the children in these schools are so severely handicapped by deafness as Muriel Rissen.
Special provision is made in a number of day schools for physically handicapped children in London, Middlesex, Essex. Bristol, and other heavily populated areas, for spastics who are also partially hearing. Special units are also being provided within new schools for the physically handicapped being built in West Ham and Manchester. There are one or two partially hearing children in a number of the special schools for physically handicapped children throughout the country. With the use of hearing aids provided under the National Health Service they are usually able to cope adequately with the ordinary curriculum of the school.
In addition to the above children there are also some 300 spastics in the independent boarding schools run by the Spastics Society. Two of these schools have special units for partially hearing children, but not for deaf children: they are the Wilfred Pickles School, Rutland, and the Ingfield Manor School, Sussex.
A survey recently carried out of physically handicapped children awaiting
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places in residential schools confirmed the Department's view that there is no evidence of any real need for more school places for children with this dual handicap. If evidence were forthcoming, provision could be made available without great difficulty in the new schools which are due to be built over the next few years for physically handicapped children, as well as in existing non-maintained boarding schools for spastics where there are vacancies, or where there are likely to be difficulties in filling all the places in the next few years. I am most conscious, as we all must be, of the great burden which a severely handicapped child places on its parents. It is important to remember that this is a handicap for the family, and not merely for the individual child. This is true whether the handicap is physical or mental, and it is greater still when the poor child has multiple handicaps. As several noble Lords have said, it is in large measure a test of the attitude of society that some effort is made to help people to cope with what can be an intolerable burden.
It is true to say that facilities for helping children and their families are now much better than they have ever been in the past. There are now many more day and boarding schools for the physically handicapped, and many more training centres for the mentally subnormal, which not only succeed in training children, but also in relieving the parents of caring for them part of the time, at least during the day. This is of enormous importance, because otherwise the burden can become quite intolerable. Most parents are devoted to these children and wish to keep them at home, but they need relief to enable them, for example, to take a family holiday without the necessity of being burdened by the child. It is now a recognised function of the local health authorities to arrange for residential care for mentally subnormal children and for adults, both for holidays and at times of domestic stress—for example, when the mother is ill. Voluntary organisations do a great deal of this work, both for mentally and physically handicapped children.
All in all, though most difficult problems remain, the parents of mentally handicapped children have at their disposal to-day a much wider range of

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facilities and services than was the case even twenty years ago. I am sure that your Lordships will be glad to know that there are prospects of even further improvement. In the last five years, the Medical Research Council have doubled their expenditure on research into mental illness, and I hope that this will lead to further results, so that more and more can be done for successive generations of handicapped children.
My noble friend Lord Brockway asked me about the club in Slough. I am afraid that I cannot tell him the answer to his question, which is rather technical, but I undertake to look into it and write to him. The noble Earl, Lord Arran, referred to the most remarkable work which is being done at Harperbury Hospital, near St. Albans, by Dr. and Mrs. Bobath. This is a hospital for the subnormal, and many of the patients are both spastic and deaf. Dr. Bobath is a psychiatrist and Mrs. Bobath is a physiotherapist, and they are working together in a cerebral palsy unit within the hospital. The technique which they have developed can be used for children as well as for adults, and Dr. Bobath has offered to train other doctors to use the methods he has developed. I understand that the Regional Hospital Board are arranging for other doctors to join the unit in order to learn Dr. Bobath's techniques.
THE EARL OF ARRAN: My Lords, does that mean that there is a possibility of cerebral palsy units being set up in regions other than the London and North Western Region?
LORD BOWDEN: I hope so, my Lords, but it depends on the success which Dr. Bobath has in finding suitable disciples who can take his techniques elsewhere.
As many of your Lordships have said, we are discussing to-day some of the most tragic of all the problems which can beset human beings, both as individuals and as members of families. I am glad that we have had an opportunity of discussing these problems, and that I have been able to describe to your Lordships at least some of the provision which is being made for such children, both in schools and in hospitals. It is a part of our social services about which, often,
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little is known. People are distressed by these things and often try to pretend that they do not exist. The work involves doctors, teachers and many voluntary workers. It is remarkable how much of the work is being done by people who, like the noble Lord, Lord Grenfell, have for many years devoted themselves to the alleviation of some of the worst consequences of these tragedies, the nature of which is still obscure to us.
Once more I would thank the noble Lord for all he said, and other noble Lords for the way in which they have helped to make this debate so memorable. I can assure your Lordships that all that has been said to-day will be of great help to the Government in framing policy.

SAINT LAURENCE, CATFORD BILL [H.L.]
Committed to the Committee on Unopposed Bills.
ROCHDALE CANAL BILL [H.L.]
Committed to a Select Committee.
LIVERPOOL EXCHANGE BILL [H.L.]
Reported, without amendment.
SAINT MARY, ALVERSTOKE, BURIAL GROUND BILL [H.L.]
  DURHAM MARKETS COMPANY BILL [H.L.]
  Reported, with Amendments.