§ Order for Second Reading read.
Mr. CROMPTON WOOD
I beg to move, "That the Bill be now read a Second time."
I know that the House is always very sympathetic to maiden speakers, and in this case I want an extra amount of sympathy, because this Bill deals with a problem so vital to the happiness of that tragic part of the community, the mental deficients. I would remind the House that in the eyes of the law there are two classes of people who are afflicted mentally. First there are those who suffer from a mental illness or disease which in its very nature can or may be cured, and which is dealt with in the Lunacy Acts. Secondly, there are those who come under the Mental Deficiency Act of 1913, with which this Bill deals, and who are considered to suffer from arrested or incomplete mental development, and who, while likely to recover, require care, supervision and, control. The 1913 Act—I think that Act is one of the most valuable social Acts ever passed—had one defect, namely, that only those who were mentally deficient from birth or from an early age came within its scope. Those words "from birth" and "from an early age," as generally defined by the magistrates and medical practitioners, whether rightly or wrongly exclude from the benefits of the Act several important classes of people who, I am sure, were never intended to be excluded when the Act was brought in in 1913.
I shall try to give the House a few instances of the class of people who are excluded. There are those who suffer from the disease of encephalitis lethargica, or sleepy sickness, meningitis, and frequent epileptic fits. All those three classes of disease may attack a person, not at an early age only, but right through life, and unless the attack takes place at an early age those suffering from these diseases cannot come within the benefits of the Act. Yet under these diseases they are often rendered mentally deficient. Then there is another class, the class that suffers accidents which cause damage to the 2320 brain. I had an instance the other day where a boy of 12 had a brick dropped on his head, and was rendered mentally deficient, yet could not come within the scope of the Act. Then there are frequent cases where the early history of a man is lost. I think I can best illustrate that point by reading particulars of a case that came before the Board of Control. It is the case of a man 36 years of age. Summary of Police Court convictions between 21 and 34 years of age: 40 convictions, 20 of them for indecent assaults, and the rest for sleeping out, begging, stealing, etc. He was certified by the local authorities and medical officer as a "moral imbecile" within the meaning of the Mental Deficiency Act. There was no previous history known till he was 14 years of age, when he came to the city. A police constable gave evidence that he knew him at 14 years of age, and said that he was regarded in the district as "soft." When out of prison he would indecently expose himself to women and girls, and no female was safe when he was at large. The magistrates would not make an order for his detention under Section 8 of the Mental Deficiency Act, as they held that it was not proved that the defect had existed from an early age. He was committed to the Sessions and sentenced to prison for 12 months. The various periods of imprisonment between 21 and 34 years of age amounted to five years. The costs in Police Court procedure and prison detention have amounted to fully 21,000, apart from the moral injury and the outrage on women and girls caused by a perverted and diseased mind. That is the report.
The House will notice that this man could not be certified as a mental deficient because we knew nothing of his history before 14 years of age. Had the provisions of this Bill been part of the Act he would have been certified and put into an institution, where he could no longer commit such terrible outrages on the community at large. The Bill of last Session was intended to remedy this defect, but it was crowded out at the end of the Session, and there was a good deal of criticism raised that it might interfere with the liberty of the subject. That well known defender of the liberty of the subject, the right hon. and gallant Member for Newcastle-under-Lyme (Colonel Wedgwood), I think, headed the opposition. The present Bill has 2321 been drawn to obviate any such charge and to do away with the possibility of its being said to interfere with the liberty of the subject, and I really think that the right hon. Member for Newcastle-under-Lyme is safe under the Bill. The Bill was drawn up under the advice of the experts at the Ministry of Health and the experts of the Board of Control, with the invaluable assistance of their president, Sir Frederick Willis, and also with the great help and attention that were given to it by the Association of Mental Welfare, whose president, the right hon. Member for the Exchange Division of Liverpool (Sir Leslie Scott), has given a great deal of attention to this subject, and whose committee of mental experts are more able to speak, I suppose, than any other committee in the country. I have a letter from the right hon. Member for the Exchange Division asking me to apologise to the House for his absence, as he is detained in Court.
May I now turn to the Bill itself? Paragraphs (a), (b), (c) and (d) of Clause I remain the same as in the Act, with the exception that the words "from birth" and "from an early age" are deleted. It is rather interesting that in the recent report of the Departmental Mental Committee on Sexual Offences against Young Persons the deletion of those words was specifically recommended. At the end of Clause I there is added Sub-section (2). This Sub-section, defining mental deficiency, was not in the Act of 1913, but in the Bill of last Session it read rather differently from the version in this Bill. I will read what was in the Bill of last Session:For the purposes of this Section mental 'defectiveness' means a condition of arrested or incomplete development of mind innate or induced after birth by disease, injury or other cause.Last Session's Bill limited the period within which mental deficiency must have made its appearance to the ages at which mental development was going on. But it was felt that this was rather dangerous. The doctors say that mental development can only go on to, at the most, 25 years of age; but doctors may vary, and I think it was quite rightly contended that this might interfere with the liberty of the subject. In the present Bill we have, therefore, put an age limit of 18 years. The House may ask, why 18 years of age? It was debated among 2322 the scientists, and in the end, although many people wished the age to be higher, it was decided that to avoid opposition to the Bill we had better put the age as low as possible. The Clause in last Session's Bill contained the words:induced after birth by disease, injury or other cause.The House will note the words "or other cause." These words are not included in this Session's Bill, because again it was felt that its inclusion might provoke similar opposition. Therefore the Sub-section will now read:(2) For the purposes of this Section mental defectiveness' means a condition of arrested or incomplete development of mind existing before the age of eighteen years, whether arising from inherent causes or induced by disease or injury.That is the main Clause of the Bill, Clause 2 deals with the Amendment of Section 2 of the principal Act. The principal Act provides that a defective may be placed in an institution or under guardianshipwho is found neglected, abandoned, or without visible means of support, or cruelly treated.It is felt that this provision is not fair to the good mother. In order to get a child into an institution she must plead that the child is cruelly treated, neglected or abandoned. It was felt that other words should be added so that the good mother could go to the magistrates and say— "I want the child to get the benefit of the Act. Will you certify him, because at my home I cannot give him the care and training which ought to be provided." I am sure the House will sympathise with this proposal. Sub-section (2) of Clause 2 provides that children incapable of receiving benefit in special schools or likely to be detrimental to the interests of others, shall be allowed to be placed under supervision or guardianship or sent to an institution. It simply adds the power of sending them to an institution. Sub-section (3) of Clause 2 provides that education authorities shall have the power to recommend for supervision children who have been in special schools as well as the power of recommending that they should be placed under guardianship or sent to an institution. I want the House to realise the meaning of this provision. Education Committees have to certify, when a child leaves a special school, whether they think that child ought to go to an insti- 2323 tution, ought to be placed under guardianship, or ought to be allowed to go altogether. That is their power at present. It is a rather steep decision for them to make. They have no other alternative. They must either shut up the child in an institution and label him mentally defective, or let him go into the world, where he is lost sight of until he turns up in prison or comes back again to a mental defectives' home. It has been thought advisable to put in this provision which allows them a half-way house. They may let the child go from these schools and recommend that he be placed under supervision. I wish to explain to the House how valuable this supervision is, and why it is that I look upon supervision over mental defectives in their own homes as one of the great hopes for future dealing with this problem. To illustrate its value I cannot do better than read a short extract from a letter from one of the authorities in the London County Council dealing with girls under supervision:In the first ten years after the introduction of the Mental Deficiency Act we found that out of 360 girls of reproductive age, only 18 had married and 17 had had illegitimate children.That means that under 10 per cent. of the girls who were allowed out under supervision in their own homes had children, and I am sure the House will sympathise with the view that the one thing we want to do by every means in our power is to prevent mental defectives from giving birth to children. They may hand on the mental deficiency, and in any case, they are quite unfit to bring up children. There is another point of value in the system of supervision. It gives to those who are under supervision more freedom of the subject and it works for greater economy. Children who are under supervision in their own homes cost the country a great deal less than they would if they were in institutions. Even if they go to an occupation centre for training, which I think they certainly ought to do, their cost to the country is only about £10 per bead; whereas in an institution their cost to the country is something like £60 per head.
Clause 3 defines the power of dealing with defectives otherwise than at the instance of the parent or guardian, and is only a drafting Amendment of Sec- 2324 tion 4 of the principal Act. Clause 4 deals with the case of a parent or guardian being abroad. Great hardship may be caused by the absence abroad of a parent whose consent has to be obtained before a child can be certified as mentally defective. The delay in getting the necessary consent from a father who is, perhaps, working in Canada or Australia may be of such detriment to the child that it is considered better to give the magistrate the power to waive this consent where he thinks delay would cause undue harm to the mental defective. Clause 5 deals with defectives who axe out under licence in connection with the continuation of orders. The object is to prevent the defective having to leave his work and return to his centre in order to be recertified. The House should know that patients may be sent out to work who are kept under certification, and at stated periods they have to get continuation orders. To bring patients back to the centre on each occasion for such orders from the place where they are working, might prove a great detriment to them. This provision will empower a doctor at the place where the boy is working to give the certificate necessary for the continuation order. I do not want the House to think for one moment that the boy is recertified for a continuation order by one medical practitioner alone. After the medical practitioner sends in his report, the case has to be investigated by visitors. These consist of three Justices of the Peace, with one or more women added, and also a medical practitioner; and when they make their report it goes up to the Board of Control. Even then, the Board of Control can only recertify the case when it is satisfied that the continuation order is in the interests of the patient himself.
Clause 6 makes it the duty of the local authorities to provide suitable training and occupation for defectives who are at their own homes under supervision. I am sure the Labour party will agree that this is a most valuable condition. It enables the children of the poor to get that training and occupation which the children of the rich get in their own homes, and it is vital that children who are in their own homes under supervision should be watched, and cared for and should get some training. It is the idleness into which they may fall which 2325 is likely to lead them into trouble. We cannot emphasise too much the need of giving them suitable training and occupation. I have seen it in practice, and I feel sure it is of great value. The proviso at the end of the Clause was added because the County Councils Association and the London County Council agreed that with this addition it was a fan: Clause. Clause 7 empowers a local authority to take cases under contract from other local authorities whose institutional requirements may be small. Small institutions do not admit of proper classification of defectives, and on grounds of economy as well as efficiency the multiplication of small institutions is very undesirable. It is also the case that there are better opportunities in large colonies for village life and the amenities which induce such happiness among the patients. Sub-section (2) of the Clause allows of a combination between a mental deficiency, committee and the education committee for the provision of residential schools. It enables the two authorities to combine in providing for these children.
Earlier I spoke of what I considered to be the benefits of the principal Act and if the House will forgive me I propose to give an instance of what I mean. At Epsom there are two very large modern institutions run by the London County Council. One, the Manor Institution, is for mental deficients, and the other, the West Park Mental Hospital, is controlled under the Lunacy Act, and I mention these two because they are the two most modern of their kind in England. I went there the other day to see what was going on, and I found at the Manor Institution, that is, the one for mental deficients, a large mass of young people all as busy as bees. There were workshops all over the place, and they were working at different trades. Everybody was employed, and they were making brushes, shoes, baskets, and clothing, and learning carpentry, sewing, and cooking, and all these things they were doing to supply the Institution with what it needed, and what they made more than it needed they sent to other institutions.
Mostly what I call young people—from about eight up to 25. Of course, there were a few more elderly, but you would have said it was rather like an ordinary public school. Outside there were playgrounds, cricket grounds, football grounds, where I was told they were all turned out at 12 o'clock, and left to do what they liked, to play any game they liked, as long as they kept within certain bounds. In fact, it really took one back to one's old school days. They were teaching these children trades which would enable them very often to go out and use this teaching in the world, to earn their own living, and the authorities told me they hoped that about 10 per cent, of the young people learning trades there would get out into the world and find employment.
I went after that to the West Park Mental Hospital, which is under the Lunacy Act, and again the most improved of its kind, and there everything was being done for those lunatics, but among them were a lot of cases of encephalitis lethargica, which could not be included ender the Mental Deficiency Act, 1913. These young sufferers from encephalitis were among the elderly people, and they had no great provision made for their training. There were not enough of them to be classified. Their were just a few of them dotted about among all these middle-aged and elderly people, and I am sure the House will agree that it is not good for young people to he put among middle-aged people in a mental hospital, who probably would teach all sorts of perverted moral teaching to them. I am certain that, if any hon. Member had been there and seen his own child there, and had also seen what could be done across the road at the Mental Deficiency Institution, he would have said: "For goodness' sake, remove my child from here and put it over there." It is that power to put such children suffering from encephalitis into mental deficiency homes that this Bill is really directed at securing. I will ask hon. Members, before refusing to give a Second Reading to this Bill, if they will go down to Epsom and see what they would do if their own children were there. Would they be content that they should remain in a mental hospital? For the last few weeks I have been continually meeting men and women who have most devotedly given 2327 the whole of their lives to the care of these poor deficients, and with one accord these workers beg for the assistance embodied in this Bill. Can we refuse to give it them?
§ Sir DOUGLAS NEWTON
I beg to second the Motion.
It is not often that a Member is able to make a Maiden speech, and at the same time introduce an important Measure. The House will perhaps allow me, as the first following speaker, to tender hearty congratulations to the hon. Member for Bridgwater (Mr. Crompton Wood), who has moved the Second Reading of this Bill, not only on the importance of the subject which he has chosen to submit for the consideration of the House, but also on the lucid, and, I might almost be permitted to say, admirable manner in which he has presented the case to the House.
Although the Bill at first sight may appear to be a somewhat ambitious Measure for introduction on a Friday afternoon, with so many Clauses and so many pages, yet the actual legislative powers which the Bill seeks to provide can be summarised in a very few words. The Bill desires to extend the definition of a defective so that provision may be made to deal, not only with congenital defectives, but also with those in whom defects arise as the results of disease or injury during years of adolescence. There are many cases where the need for further powers has not made itself apparent until the relatively simple demands, which may be made as life proceeds, render patent the defects of the deficient person. I think it is generally admitted on all sides that the Act of 1913 has proved a sound and wise Measure. It has proved not only to be in the interests of the defectives for whom it was designed, but of value to the community as a whole. The Medical Committee of the Central Association for Mental Welfare, an organisation which, I think it is true to say, represents all the chief workers associated with this branch of medical science, is anxious that the definition of a defective should be extended in the way suggested in this Bill, and that it should be amended in 2328 the light of the experience which we have now gained as a result of the working of the 1913 Act.
Experience of that Act has shown that defectives have frequently been unable to receive the treatment which they ought to receive and from getting the help which they ought to have, for there is no doubt that, when available, the care and training provided under the 1913 Act have proved of the greatest help to defectives and given them a great deal of happiness and assistance. I would urge this further provision on the grounds of humanity, because it ill behaves us to allow any section of our community to go unprotected, uncared for, and untaught. This Bill does not touch later ages. It is not intended to deal with lunatics as such, or with cases of mental disorder which supervene after maturity has been reached. The Bill deals only with defectives, that is to say, persons who are actually deficient in brain cells at birth, or those whose brains do not develop along normal lines as they grow up into manhood and womanhood. No doubt there will be some defectives, even under this extended provision, who will not be covered by the Bill, but we think there will not be a sufficient number of such cases to justify a further extension than that suggested in the Bill, and if there are any further cases, we think it would be wiser, at any rate in the first plac0e, to proceed somewhat slowly and leave such cases to be dealt with under the Lunacy Act. The existing position is unsatisfactory, because, as I have pointed out, it is only those who are defective at birth or at a very early age, who can now be taken care of adequately under the 1913 Act.
I would like to point out that the position of members of the medical profession is by no means satisfactory. That is one of the principal reasons why the Bill has been brought forward. In many cases they have found themselves unable to take the responsibility of certifying cases which were not congenital. It has been difficult for them to assess the right weight and the right meaning to the words. "or early age." and that fact has precluded them in many cases from dealing with defectives urgently in need of treatment. My hon. Friend has given the case of a boy who was hit by a brick, and for whom provision could not be made- 2329 I am sorry to think there are many cases of that kind where you have a happy, upright, clean, high-spirited lad, and he may meet with some injury or accident as the result of which he becomes a defective. He may then steal, grow ill-tempered, and become uncontrollable in all his ways, yet there is no possible means of dealing with him at the present time under existing legislation.
The medical profession, in the administration of the Act of 1913, have shown, I think it will be agreed, a great deal of courage in dealing with what is, admittedly, a difficult situation, for they are inadequately protected under the existing law. By raising the age to 18, much will be done to safeguard their position, and to bring about a better state of affairs. I suggest that we have, indeed, a duty in this matter to discharge to those unfortunate persons, for a State which does not make provision for its defectives is neither a humane State nor a modern State. Nor if we fail to make this provision can we shirk responsibility for the degradation, disease and crime which follow neglect of the mentally defective. From the financial point of view, in this case virtue brings its own reward, because the better the provision we make, the more surely in the long run will a saving ensue to the community as a whole, and further inroads upon our national resources be avoided. Time does not loiter in matters of this kind, and this question, I venture to think, is one which urgently calls for the attention of this House.
Perhaps I may be allowed to refer to the position of local authorities. In the Annual Report of the Board of Control—an excellent, though, if I may be permitted to say so, a somewhat too bulky volume—reference is made to the position of local authorities under the Act. Under the Act of 1913, 124 local authorities, that is to say, County Councils and County Borough Councils, were charged with the duty of administration, and that duty entails reporting upon the incidence of mental deficiency in their respective areas, and in notifying cases in need of guardianship and control. Under the existing provision, the local authority, as my hon. Friend has already pointed out, has no power of notifying the Board of Control of a defective who may be needing the care of the local authority, unless that defective is in need of guardian- 2330 ship or control. If that defective be merely in need of supervision —and there are many such cases—yet the local authority has no power, as things now stand, of notifying the case. Under Clause 2, Sub-section (3) of this Bill, we are giving an enabling power to local authorities to notify cases which may need supervision, and I would point out that cases needing supervision may well be important cases and stand in need of that independent inquiry and that independent visiting which are necessary to ensure in some cases proper and fair treatment being meted out to the unfortunate defective. We think this is an important and a valuable extension of power in the Bill.
I would like to say a word or two on the question of ascertainment. It is interesting to note from the Report of the Board of Control what has been done in this connection. In 1924—if the House will permit me to give a few figures—it was ascertained that there were 48,778 mental deficients in the country, or 1.29 per thousand of the population. In 1925, there were 55,480, or 1.40 per thousand of the population. Ascertainment, unfortunately, tends to increase the figures, but there are great variations in the figures in different areas. For instance, I find that Oxford heads the list with 440 per 1,000. I find that in Swansea the ascertainment only admits at the moment to 0.12 mental defectives in that area. I cannot help venturing to comment on that matter, and to say that it seems not unreasonable to suggest that Swansea should take note of her responsibility under the 1913 Act.
With regard to the question of expense, this problem is a far-reaching and comprehensive problem, and it does, and will, necessarily result in further expense. The necessary funds are at present raised on a basis of 50–50, that is to say, 50 per cent. of the money has to be found by the taxpayer and 50 per cent. by the ratepayer, and I cannot help pointing out that I think this allocation as between taxpayer and ratepayer will in future have to be reconsidered, and that more help will have to be given by the State to local authorities. While local authorities have expressed their general approval of the aims and the objects which we have in view, at the same time they cannot, from the very nature 2331 of their resources, be expected to countenance too great a burden being placed upon ratepayers. When a Bill on very similar lines to this was introduced in the House last year, it was felt that the safeguards proposed were hardly adequate, and that the words defining a mental defective, by which a mental defective could be put under guardianship and control, were rather too wide. In criticising the Bill now being submitted, I hope the hon. Members will appreciate the very considerable alteration that has been made in phraseology of the Bill, and will realise that any peril there might have been under any previous Bill has been removed under these proposals. Now, only persons who are defective before the age of 18 can be dealt with, and they cannot be put under guardianship or control unless in addition to being defective they are unable to guard themselves against common physical dangers, or unless they are incapable of managing their own affairs or themselves, or unless they require care, supervision or control for their own protection or for the protection of others.
§ Sir D. NEWTON
Or if they are moral defectives with vicious and criminal propensities who require supervision and care for their own protection and the protection of others. Further, I would like to point out that no case can be placed under guardianship or control unless it has been examined by two independent members of the medical profession, and unless a member of the bench is satisfied, and certifies, that it is to the interest of the patient himself that he should be placed under guardianship and control. No person can be placed under this guardianship merely because he happens to be a defective; he must also come under one or other of the heads which I have just read out to the House. If there was a peril of a miscarriage of justice in the previous Bill, I do not think there is any peril under the present proposals. We owe too, a thought to the guardians and to the parents of these afflicted persons, for their homes may very well be rendered not only unhappy, but actually unsafe, and at any rate undesirable, to all who live in them.
2332 I would like to say a word on another question which will probably be raised, that is sterilisation. It has been suggested that with a view to preventing the growth of future generations of mental defectives, preventive measures might be taken, and that sterilisation would prove a cheap alternative to segregation. I do not think that argument is a sound one. Mental defectives nearly always require care and protection, and sterilisation would not get over that difficulty. Also, they nearly always lead useless and probably harmful lives, and, what is more, they would be in a position to spread disease. Moreover, little expense would be saved to the community. My hon. Friend has pointed out that in institutions every endeavour is made to find some useful employment for them, and their limited capabilities are used to the fullest possible extent. Again, sterilisation could not be resorted to without compulsion, and with compulsion I think it would be very seriously objected to, and rightly so. When we examine the proposal for sterilisation I think we shall realise that as it would not diminish the need for institutional treatment to any extent—and I have been given figures showing that if it were resorted to it would only result in from 3 per cent. to 5 per cent. of the people now in institutions being allowed a greater measure of freedom—it is not a practical solution or one which this House, at arty rate at the present time, need seriously consider.
It has been estimated that there are 160,000 mental defectives, and criticism has been advanced that if we ascertain that there are more defectives the existing accommodation will prove to be inadequate, and that we shall not be able to provide for them. I do not see why, however, any class of persons should be left out as being ineligible for treatment. In this connection I would like to urge the need for local education authorities taking action. It is very important that local education authorities, who at present are charged with ascertaining the mental status of children under their care, should deal effectively with that branch of their work, and that all cases which ought to be notified should be notified before they reach the pro-creative age. It is only if they are notified that they can be effectively dealt 2333 with, and that the neglected and the abandoned can be properly provided for. I have pleasure in seconding the Bill, both on the grounds of humanity and of public interest, and I venture to think that on both those grounds, as well as in the interests of defectives themselves, it is worthy of the consideration of this House.
§ Colonel WEDGWOOD
I beg to move, to leave out the word "now," and, at the end of the Question, to add the words "upon this day six months."
The hon. Gentleman who moved the second Reading referred to me as an expert in the defence of individual liberty. I am afraid I can lay no claim to expertness in that direction, if we are to judge from the fact that I make no converts, but at least I can claim to be an expert in judging of the introduction of Bills such as this on a Friday afternoon, and I would like to congratulate the Mover on one of the best introductory speeches to which I have ever listened on a Friday afternoon. I will not say he nearly converted me, but at any rate he left me feeling that if he, and not these experts, were looking after the mental defectives of this country, it would be less necessary for criticism of such a Bill as this to be brought forward. He had been down to see a home for the mentally defective—an admirable preliminary to introducing a Bill on the subject.
I have been thinking how I should put before the House to-day my rigid objections to this sort of legislation. It seemed to me that the best way would be to remind the House of two oases which have been before the Courts recently. About a year ago I saw that a man in Birmingham had been sent to prison because he would not force his daughter back into a mental deficients' home. She had been allowed out on leave, they had sent for her to return, the father had protected her, and, therefore, at last, she was torn off back to the home and the father was sent to gaol. If you can divorce your mental defective legislation from this detestable coercion, from forcing the parent and the child to be separated against their wish, nearly all my objections would go; but you will insist, not on taking those defectives whose parents want them to go to homes, but on taking those whose parents do 2334 not want them to go. As everybody knows, it happens over and over again that the one member of the family who is slightly deficient is, in the eyes of the mother or the father, by far the best loved member of the family; and that you should give to these experts the right to break up that family and take that child away against the wishes of the father is, as I maintain, utterly unnecessary—because you have by no means got in your homes at present all those defectives whose parents would willingly allow them to go. To do that under the guise of charity and benevolence seems to me to be utterly damnable. Even philanthropists might consider for one moment the liberty of the individual.
Let me give another case which illustrates another side. I noticed the other day that in the North London Police Court a man, a common labourer, was sentenced to nine months' hard labour for cutting off a tress of hair of a girl on the top of an omnibus. He had been sentenced many times before for similar offences. We all know that that is a form of moral or sexual pervision. The, man, instead of being sent to gaol, should have visited a doctor; but he was a poor man. This man got nine months' imprisonment, and when he comes out he will probably go on another omnibus, cut off another lock of hair, and probably undergo another sentence of imprisonment. Under this Bill that man, instead of being sent to gaol, would be sent to a home for mental defectives or to a lunatic asylum. Let hon. Members put themselves in that man's position. Supposing that through some divine wrath you had been placed under that form of insanity would you rather go to prison for nine months or to a lunatic asylum. I am sure there is not a Member of this House who would not rather go to prison under those circumstances when it means a sentence of nine months imprisonment or a life sentence in one of these institutions for mental defectives. It is cases like the one I have mentioned that provide me with my opening in trying to persuade hon. Members that everything will not be so beautiful when we pass this Bill. We know that at present the only alternative for a man like that is the lunatic asylum. It is true that if one had to choose between a lunatic asylum and an institution for mental de- 2335 fectives the former would be chosen because the treatment is more humane, but in the case I have given the man would never have been sent to an institution for mental defectives because at the present time there is not sufficient accommodation. By this Measure you are putting the cart before the horse. It is no use making laws of this kind unless you have homes in which to put your patients.
We have heard a good deal in this debate about sterilisation. I do not think the Eugenic Society is represented in this House, but I should be very interested to see one of those Eugenists urging that we should supervise the breeding of the working classes as we do in the farm yard. I believe the school comes from Cambridge as did the Seconder of the Bill. It is true he could not approve of sterilisation, but his argument appears to be that if we cannot compulsorily sterilise these peoples we can at any rate lock them up. There are other ways of preventing undesirables from breeding besides surgical operations. You can lock them up. I think that is just as bad, but it is rather more hypo critical. In this Bill you have three definitions of mental defectives. They are not very different from the old definitions, and these defectives in any case have to be judged by experts whose reading of an Act of Parliament almost inevitably varies with the public opinion of the day. Let hon. Members consider for a moment the words of the Bill: Paragraph (b) of Clause I, Sub-section (1) provides for personsin whose case there exists mental defectiveness, which, though not amounting to idiocy, is yet so pronounced that they are incapable of managing themselves or their affairs.It is claimed that these inbeciles require supervision and control for their own protection. There are very few girls under 21 who do not require care and control for their own protection. [An HON. MEMBER: "And over 21!"] I would not like to say that, in view of the new Franchise Bill. Now I come to the New 2336 Clause for moral defectives, that is to say,Persons in whose case there exists mental defectiveness coupled with vicious propensities and who require care, supervision and control for their own protection.I think we all require protection against moral deficiency. Some of us rely upon the police while others rely upon the Church. Nevertheless we all require some form of protection in that direction. I think the liberty of the subject requires protecting under these circumstances, especially as it is argued that it would be more economical to prevent them breeding. Many good citizens of both sexes in this country think that girls of light character should be prevented from going about because they are morally defective, and that it would be in the interests of mankind if all girls of this tendency were prevented from breeding. All their arguments are based upon the idea that persons whom they call morally defective are sure to have mentally or morally defective children. The statistics prove nothing of the sort. You never had any statistics to prove that, and all of us know that great brains and mental deficiency often run together in the same family. The border line of eccentricity may go either towards genius or towards insanity. If you take into your hands presumptuously the business of nature, the business of Providence, and say who shall breed and who shall not, you take a responsibility which is impertinent even in the twentieth century, and which is likely to lead this world in directions other than those intended by eugenist societies. The hon. Member who moved the Bill said that he had been to one of these homes. I have been over one, and I cannot forget it. He said they were all young people up to 25 years of age or thereabouts. I will wager that the vast majority were women and not boys.
Mr. CROMPTON WOOD
I think I should say, had I to give an answer, that most of them were boys and not women.
§ Colonel WEDGWOOD
Were they? I am glad to hear it. The danger is that this Measure will be used, not for charity, but for curing the "social evil" as they call it, by preventing girls being on the streets. There are, I know, and every 2337 hon. Member knows, hundreds of cases where a girl goes to the workhouse to have her baby; as soon as the baby is born she is back on the street, and then once more into the workhouse to have another baby. You can make an irresistible case in favour of putting these women into an institution on the ground of economy, or charity, but, on the whole, I think it would be better that that sort of thing should still go on. Believe me, it is less prevalent now than it was in old days. The illegitimate birth-rate is less now than it was a generation ago, and infinitely less than it was 100 years ago. It is better that that should go on than to hold over girls on the border-line of vice and immorality the fate of being enclosed in one of these institutions for life. That is the alternative before us.
I have nothing to say against or for this Bill. It is merely continuing and accentuating proposals of previous Measures. I fought the 1913 Bill through every stage in this House for three years, but they passed it at last. They have got the. Bill, but they have not got the mental deficiency homes. Now we get the usual amending Bill, giving a little more power to the State and to the experts, hemming in a little more closely those who approach the border-line—the eccentrics and mentally defectives. I will say this for the hon. Member who moved the Bill; that he did hold out one line of advance in which I believe he can have the support of eccentrics like myself. He did hold out the hope that under this Bill there might be a little more supervision in the home, the real home, and a little less incarceration in the home which is compulsory. I think along that line it is possible that there may be a few other eccentrics who would like this treatment of the mental defectives to move. Inspection in the home does not break up the home life. It gives the mentally defective child a certain amount of protection from ignorant, stupid parents or brothers or sisters, and if this system of treating the mental defectives develops, it may be possible to achieve a real reform in this matter which I hope to see, namely, the turning of the mental deficiency home into a free home. I do not mean free in the way of expense, but where the lock shall be taken off the door, so that there shall be for the parent at any rate the free alternative home 2338 treatment, inspected properly, or institution treatment with a free interflow between the one and the other system.
However excellent your institution may be, however carefully you may select the matrons and managers in charge, so long as you have a lock on the door you can never prevent suspicion of those minor cruelties, injustices, and acts of arbitrary authority which may embitter the life of the inmates of these institutions. Once you have got rid of the lock, why then your institutions, even without so much inspection, will improve, because freedom—publicity—is the cure for any inhumanity and injustice. I have nothing to say against any of these institutions. I believe so far as I have heard that they are carried on on thoroughly humane lines. But what do we know while the door is locked, while publicity is practically impossible? Do we not, on the other hand, know that everywhere that you have people in absolute authority you cannot avoid minor injustices which spread and develop as institutions such as these get older and more established.
There is only one final word I want to say, and it is about the experts. The definitions in the old and new Bills are not of much importance. They are to be read by the experts. As soon as the expert has made his decision, in regard to a mass of our population, which may amount to 50,000 more or less—I attach no importance whatever to the statistics which have produced that figure, because it is not that Oxford is more mentally defective than Cambridge; it is that they happen to classify on a different system what constitutes mental deficiency—the expert has his own way with the Act of Parliament. The expert has his own way with the institution. He may lock the door or open the door. He can sentence a person to imprisonment not for nine months, but for life. The experts, after all, are so very often expert merely in the imagination of others. I suppose I have inherited from countless ancestors an anti-priest complex. My every reading of history fills me with horror at the thought of priestly authority. From Egyptian times down to the days of the Reformation, and even later, the whole population of the world trembled before the priestly experts, who could not only guide you to Paradise or to Hell, but could condemn your body for word or 2339 thought. That danger, that awful nightmare over humanity, has gradually vanished; let us take care lest in this generation we build up by this worship, by this prostration before the experts, a new terror as horrible as the old.
§ Mr. RHYS DAVIES
When this Bill in its original form came before the House, I ventured to offer some criticisms of its proposals. I am glad to see that the Bill has now been altered considerably, and, in consequence, I propose to say a few brief sentences giving the reasons why I support the Measure in its present form. I agree fundamentally with the political philosophy of my right hon. and gallant Friend the Member for Newcastle-under-Lyme (Colonel Wedgwood). I belong to a race that has fought for personal freedom for centuries, and, strangely enough, our fight for freedom has been against the nation to which my right hon. and gallant Friend belongs. That is by the way. I do not think, however, that the question of liberty is the only issue before the House to-day. Those of us who try to study what is happening in the Courts of law of this land are getting a little apprehensive as to the way in which they are compelled to deal with some offenders who come before them. Let us take the example which my right hon. and gallant Friend gave, of the man who seems to have a fetish about cutting girls' hair. My right hon. and gallant Friend says that he would prefer to see that man imprisoned for nine months, so that he could get his freedom afterwards, rather than that he should be sent to an asylum for a longer period. I venture to say that the logic of that case is this, that, unless that man is placed in a mental institution soon, he will find himself ultimately in a place of detention under the control of the Prison Commissioners, where he will probably spend the greater part of his life. Of the two I would prefer, as my right hon. and gallant Friend does, that that man should be placed in prison rather than that he should spend a long period in an asylum; but those are not the only two alternatives possible. It is proposed here to set up institutions to deal with mental deficients—we are not dealing with lunatics at all to-day—and I should prefer to see these three alternatives compared to-day, that is to say, the asylum for 2340 cases that are definite enough to be sent there, on the one hand, prison on the other hand, and, in between them, homes for mental deficients. It is the last class with which we are dealing particularly to-day.
I approach this subject from an entirely different angle from those who have spoken already. I am convinced, from my experience, that there are young people—and I refer to them in particular —now in prison, who ought never to be there. They are not cases at all for punishment; they are cases for sympathetic medical treatment. I am convinced, too, that in our Borstal institutions there are several young people who ought never to be regarded as subjects either for that kind of training or for punishment because they have committed offences; they ought to be dealt with medically and psychologically, and to be trained in mental homes on such lines as have been suggested to-day. There is, however, one very strong argument against this Measure which I must utter here and now. The Report of the Board of Control for 1925, on page 57, gives a warning to this House in dealing with a Measure of this kind, and here I agree entirely with my right hon. and gallant Friend. I will read the paragraph which I think ought to be borne in mind by the House. I feel sure that the Minister of Health is quite conversant with and appreciates the position. The Board of Control say, in their last Report:The responsibility for the degradation, crime, pauperism and disease which follow the neglect of the mental defective, rests now on the local authorities.They go on to say—and this is the significant part—Out of the 124 local authorities under the Mental Deficiency Act, only 17 have at present provided any accommodation, and in no case is the provision adequate to the needs of the particular district.Those are very weighty words indeed, and I do not fail to appreciate to the full this problem of accommodation. The reply, however, is this, and I feel sure that the argument in favour of this Bill is stronger than the objections that are made on account of lack of accommodation. This country, like any other country, I suppose, has its progressive and its reactionary local authorities. The progressive authorities have done all that they are called upon to do under the powers they now possess, and the 2341 argument, therefore, that we should prevent progressive authorities from proceeding a step further because reactionary bodies have not used the powers they now possess, is, in my view, a very poor case indeed. I happen to live in one of the most progressive cities of this country, namely, Manchester. [Interruption.] Most people think it rains more in Manchester than elsewhere, but it does not; the rain takes longer to come down—that is all.
This question of accommodation is, as I have already said, the strongest argument against this Measure; and, to those who are critical of it on that score, I would say that, if and when this Bill goes to a Committee, I am prepared, as one who is supporting the Measure, to see that two things are done. In the first place, if the principles of this Measure are embodied in an Act of Parliament, I shall urge that greater powers be given to the Ministry of Health to see that local authoties perform their tasks properly in this connection. The second point that I think ought to be mentioned, and in respect of which I think a case has been made out, is this. I do not like compulsory powers myself, I prefer emphasising the case that my right hon. and gallant Friend made, of supervision in the home; and, as other Members have given cases to prove their arguments, I will give two cases in favour of what I say. The first case that has come under my notice is one which, in my view, is in favour of the passing of this Measure. A member of my society, a man about 35 years of age, has suffered from sleepy sickness. He is a mental wreck, but is quite inoffensive, and knows very little of what is happening around him. As Secretary of the Society I have been appealed to, and I have communicated with the right hon. Gentleman on the case. I do not complain of his reply, because, as he says, he has no power. I have endeavoured to find an institution to which this man can be sent for medical treatment and training and I find that there is not a place in the country to which an adult suffering from sleepy sickness can be so sent. I should be very glad if the Minister can tell us anything to-day as to whether any progress 2342 is being made in providing institutions where that type of case can be dealt with.
The other case is this. I know a workman and his wife who have had 15 children, nine of them are now dead. Of the six who are living, five are mentally deficient and absolutely incapable of doing anything for themselves. I do not know that they could even be trained to do work of any kind. I want the local authority to supervise this kind of case and help them financially too. At the moment they can do nothing, except turn round and say, "We will help them if they come into an institution." I think, on the other hand, that they ought to be under guardianship in their own home. The reply of the local authority is that "They will ultimately come to us, consequently, why should they not come now?" There is a very strong argument there in favour of the local authority, because, if so, they wit: ultimately land in an institution. As stated, I prefer emphasising the point of supervision and guardianship in the home, and on that point I am entirely with the right hon. and gallant Gentleman.
The Seconder of the Motion threw a slight slur on Swansea. I have looked up the records, and I find that the hon. Member who moved the Second Reading of the Bill hails from Swansea, so I think they should now settle that problem between themselves.
Everyone who has studied this question closely, especially since sleepy sickness has come upon our people, has been compelled to come to a conclusion on the lines of the proposals in this Bill. The Lunacy Commission never touched this problem at all, because mental deficiency was outside their ken; but there was a Departmental Committee set up by the Home Office some time ago to inquire into sexual offences against, young persons, and one of the strongest recommendations they made is in favour of something being done on the lines of this Bill. I feel sure that another Departmental Committee which is about to issue its Report will have come to the same conclusion.
All who are interested closely in mental deficiency and listen to evidence and inquire into the facts, are compelled, whatever their views may have been 2343 beforehand, to come to the conclusion that the time has arrived when something on these lines ought to be done by Parliament. I do not agree with every word in the Measure. I hope when it goes to Committee we shall be able to amend it.
I have no doubt at all in my mind that we ought to be vigilant of the expert; but it seems to me that, whatever number of people are inside asylums, prisons and mental homes, there will always 'be some cases of injustice; and Parliament ought to see to it that those cases shall be brought to light. But when that is done we should not carry the argument to the, absurd point of saying that, because there is one injustice inside, you are going to allow a hundred injustices to remain outside these institutions. I feel satisfied that there are people in our prisons to-day who are suffering from mental deficiency. They ought never to, be there; and I am confident that medical science, though not as advanced as I should like to see it, is sufficiently capable of helping us in dealing with this complicated problem, and I have no hesitation at all in supporting this Bill.
§ The MINISTER of HEALTH (Mr. Chamberlain)
There is a very well-known picture—I think it is in the Tate Gallery to-day—which represents a young lady sitting at a piano and singing, while in a chair in another corner of the room is her father, who shows evident signs of emotion and appears to be lost in recollections of a by-gone past. I think the picture is called "Her Mother's Voice." If hon. Members see any particular signs of emotion about me to-day, it is because in the features of this Bill I seem to recognise the portrait of another dearly loved Measure of my own, which perished untimely last autumn, I am afraid owing largely to the activities of the right hon. Gentleman the Member for Newcastle-under-Lyme (Colonel Wedgwood). The loss of that Bill created something like consternation in the minds of a very large number of people—I do not know whether the right hon. Gentleman would call them experts—who have been taking a great deal of interest in the efforts that are made from time to time to improve the conditions of mental defectives and to give the public such protection as is due 2344 to them, for these mental defectives may be a public danger. I received a great number of letters from Mental Deficiency Committees and various organisations interested in mental welfare, all expressing their deepest regret that the Bill had to be dropped and urging the Government to take the very earliest opportunity of reintroducing it in its existing or in a slightly modified form. My hon. Friend the Member for Bridgwater (Mr. Crompton Wood) has undertaken tie task of reintroducing a Bill on the same lines but with certain modifications. I should like to add to the compliments which have been paid him by other speakers my own congratulations upon the manner in which he has set himself to this task, because his speech showed us that not only had he approached the subject with a real fund of human sympathy but that he had taken no end of trouble to make himself acquainted with all the facts that were relevant to the case and had evidently devoted a great many weeks to an intensive study of the whole question.
One of the points in the Bill of last year to which most criticism was directed was the new definition of mental deficiency. Other speakers have already explained to the House the defect in the original Act in regard to the problem of dealing with mental deficiency. Mental deficiency was there so defined that it could only be established where proof could be given that the mental deficiency was either present at birth or in the early years. Since the passing of that Act we have, unfortunately, been brought over and over again face to face with the fact that mental deficiency may exist from causes which were not present at birth but which have supervened at an age later than the earliest years, and which have produced similarly unfortunate defects.
The disease which we know as sleepy sickness, or encephalitis lethargica, although I do not think it is a new disease, has attracted sufficient attention in recent years because of its unhappy results upon the mental and sometimes the moral condition of the unfortunate children who suffer from it. The complete change in the character and the complete degradation of the character of some of the children who started off with every advantage in life, but who have been attacked by this terrible disease, is 2345 one of the most painful circumstances that anyone can name. It means the complete wreck of a life which promised every happiness and brightness to the home. There has been, as an hon. Member opposite said, a good deal of distress in the public mind over the idea that children might be exposed to the shame of the unsuitable conditions of a prison for offences which really were beyond their control, and which have arisen out of these circumstances of physical diseases.
The new definition which was in the Bill of last year sought to bring such cases as these within the definition of mental deficiency. I am inclined to think that the definition in the present Bill is too narrow. It confines the cases to cases which can be shown to have originated before the age of 18, but development is not always complete by the age of 18. It may come on at a somewhat later age, certainly beyond the age of 20. The very dreadful and horrible case quoted by the hon. Member for Bridgwater would have depended, if this Bill had been an Act, upon the possibility of establishing that the defect from which the man suffered, and which made him a terror to society in general, had originated before the age of 18. In that particular case it was possible to show, and it was shown, that the defect existed at the age of 12. That was all right, hut it is quite conceivable that there might not have been such evidence, and there would have been difficulty and trouble in the case. Therefore, I prefer the original definition. I would not press for the extreme view if there were opposition, and if there were any danger of losing what I consider to be an extremely valuable provision of the Bill as a whole.
With regard to the speech of the right hon. and gallant Member for Newcastle-under-Lyme, one must make allowances for the fact that he is, as he said, an eccentric on this question. I think I should call him a fanatic. He says that he has a rooted objection to all legislation of this character, and to show his open-mindedness he told us that he had not been into one of these institutions for 20 years. How can he tell what is the effect upon the people who are put into these institutions if he has not been to see them? I have been to them.
§ Mr. CHAMBERLAIN
I think it is the right hon. and gallant Member's business. If he is going to come down to criticise legislation of this kind, he should make himself acquainted with the facts, painful as they are. I agree with him that there is nothing more painful than the sight of these children, who differ from the insane because an insane person is curable, but these children can never be cured. Nevertheless, I do think that people, before they criticise, should see what they are criticising. I do not think that anyone who has visited one of these institutions can doubt that, in the first place, the children who are there are happy, and certainly far happier than they would be in their own homes. The care and the strong motherly feeling which the matrons and the superintendents of these institutions show is to me a marvellous thing. I frankly confess that I cannot understand it, but I bear witness to it, and I have the greatest possible admiration for it, that the feeling which these people who are in charge of these children show towards them is almost like that of a mother. The children have the additional advantage that in these homes there is every possibility of giving them such attention as is not possible even to the best mother in the world in many of the homes from which these children come. In the first place, they have the society of other children. That in itself is an enormous advantage. All their amusements are organised, and they have not to try to amuse themselves.
§ Mr. CHAMBERLAIN
Perhaps the right hon. and gallant Member will permit me to say what I have seen. He has not seen these things. There are opportunities for giving these children pleasures which I do not think would be open to them in their own homes, however attentive, however careful or however anxious their own parents were to do all they possibly could for them. We have to remember that we must not think merely of the individual child. We have to think of the rest of the community, and that is why it seems to me that the right 2347 hon. and gallant Member took a one-sided view. He spoke of a man who spent his time in cutting off girls' hair as having a justifiable grievance because he was sent to prison.
§ Colonel WEDGWOOD
The right hon. Gentleman has mistaken the point. I said that he would prefer prison to going to an institution for mental defectives.
§ Mr. CHAMBERLAIN
That makes it even worse. The right hon. and gallant Member only thinks what the man's preference would be He might like to go to prison for a short time instead of being put into an institution, where he would be permanently looked after, but the right hon. Gentleman suggests that it is a very great outrage that he should be put inside an institution. What about the girls whose hair he is going to cut off if he is left outside? Are they to have no rights and no protection? Whilst that is an extreme case, I would ask my right hon. Friend to bear in mind that the defective child is not altogether a suitable companion for his non-defective brothers and sisters. The right hon. Gentleman drew a picture which attracted my attention, because he said it was a man in Birmingham whose child had been sent to an institution. She went home and then had to be returned to the institution. I wonder if the right hon. and gallant Member realised what the procedure was under which such action could be taken, because under the Mental Deficiency Act a person cannot merely be taken to an institution because he is defective—
§ Mr. CHAMBERLAIN
They cannot be taken back to an institution unless they are found, in addition to being defective, to be neglected, abandoned, or without visible means of support or cruelly treated.
§ Colonel WEDGWOOD
This was not a case of taking the child in the first instance. If I remember rightly, it was the case of a girl who went home for a weekend, as she was able to do occasionally, and her father decided that she was so 2348 much better that he would keep her out of the institution. But the institution, took her back.
§ Mr. CHAMBERLAIN
If she was taken to the institution in the first instance, it was with the consent of the father. The right hon. and gallant Member does not know whether the father gave his consent or not. If he will look at Section 6 of the Act of 1913 he will see that where the petition is not presented by the parent or guardian, the order shall not be made without the consent in writing of the parent or guardian. The parent in this case must have given his consent in the first instance. If by caprice he changed his mind at the last moment, what right have we to suppose that the conditions had so changed that he is to be the sole judge as to whether the child should remain outside the institution or not.
§ Colonel WEDGWOOD
It is quite conceivable that the girl told him something about the institution which she did not like.
§ Mr. CHAMBERLAIN
The right hon. and gallant Gentleman has no evidence to indicate that the girl did not want to go back.
§ Mr. CHAMBERLAIN
No, I have not, and the right hon. and gallant Gentleman does not understand the facts of the case. I am merely suggesting to him that he is assuming facts for which he has no evidence whatsoever. I will not spend any more time on this ease, which will always remain more or less hypothetical, but I want to protest against the suggestion of the right hon. and gallant Member that life in these institutions is embittered by acts of minor cruelty and injustice. I do not think that is a phrase which should be used by the right hon. and gallant Gentleman who admits that he has not been inside one of these institutions for 20 years. All the evidence shows that so far from their lives being embittered by acts of cruelty, they are treated with the most unvarying kindness, and that, taken all round their lives are happier in these circumstances than they could have been in any others. The hon. Member for Westhoughton (Mr. Rhys Davies) has said that on the whole he 2349 desires to support the Bill. He indicated that he would like to see Amendments moved, but I think it was only a general desire to move Amendments, and that there were no particular Amendments which occurred to him that he was prepared to put into words. He did suggest that the strongest criticism against the Bill was that it would create more certified cases, and that there is not sufficient accommodation for the cases that are already certified. I must say that, while I admit the accommodation is unsufficient, I do not quite follow the reasoning which says that certain cases which ought to be certified are not to be certified because there is no room in institutions.
While there is a general shortage all over the country there may be no shortage in any particular locality, and why should we choose particular cases and say that they shall not have the benefit of institutions, which it is admitted they ought to have, because in sonic part of the country there is not sufficient room at the time. The Board of Control are always pressing local authorities to provide more accommodation for these unhappy cases, and on the whole it is not backwardness of opinion on the part of local authorities that prevents them from providing this accommodation. It is financial stringency, which is very acute at the present time, and seeing that the building of one of these large institutions on the scale which is the ideal one may cost anything from a quarter of a million pounds to something nearer half a million pounds, it will be seen that this is an undertaking which cannot be rashly or hastily faced, and it is not to be wondered at that even quite large authorities hesitate before embarking on such an addition to their already severe financial burdens.
I have from time to time indicated my own view that, if certain other institutions now administered by boards of guardians could be handed over to the councils of counties, or county boroughs, there might be found in some of these institutions some temporary alleviation of the situation which would perhaps make it unnecessary, either to embark on these huge schemes, or spend anything; and perhaps before very long it may be possible to consider doing something of that kind from the point of view of practical politics. Meanwhile, I say let us at any rate have certified all those who ought to 2350 be certified in order that, even if there is no room for all of them, we may be able to judge which of them are in the greatest need. It is quite possible that room is now being taken in institutions by persons who are not in such great need as those who will be brought in under this Bill, and that would be a sufficient justification for the Bill. As for the provision for adult cases of encephalitis lethalgica, about which the hon. Member for Westhoughton spoke, I really do not quite know what the hon. Member had in his mind. If the suggestion was that there should be institutions specially devoted to this purpose, I do not think there are enough cases to make that necessary. It should be quite possible to deal with these adult cases in existing institutions.
I hope this Bill will be more successful than its predecessor, and not only be read a Second time but that it will get a Second Reading without a Division. If it reaches the Committee stage, as no doubt it will, I am sure my hon. Friend will be ready to consider any Amendment which may be suggested with the desire to improve its provisions. I do not think myself it will be found possible to improve it very much. It has already been through a Committee stage last Autumn and such alterations as have been made by my hon. Friend have been directed to meeting the criticisms made at that time. I hope before this Session is over he may have the satisfaction of seeing the Bill which he commended to the House in a maiden speech, achieve what very few Private Members' Bills do—reach the Statute Book, in which case he will have carried through a Measure which will be a very important and valuable addition to our legislation this Session.
§ Mr. SNELL
As the only Member of this House who was privileged to serve on the Royal Commission on Lunacy, it may not be inappropriate that I should say a few words upon this subject. As the hon. Member for Westhoughton (Mr. R. Davies) pointed out, the question of mental deficiency was not in itself referred to the Royal Commission for examination, but in that the process of 'two years' work, it very necessarily touched upon this question at many points. I would like to suggest there may be a certain danger in dealing with this aspect of the matter 2351 apart from the general question of which, in my judgment, it is a part. In any case, I think that the lessons which were derived from the examination by the Royal Commission of the larger problem should be very clearly kept in mind when dealing with this more limited aspect, and I would like to suggest that it is extremely difficult to be dogmatic as to precisely what should be done in regard to a section of this problem.
There is no really clear line of demarcation between deficiency and efficiency. Thus we may be in very considerable danger of trespassing on that border land case which, not being hopeless, might, if treated properly, offer aspects of real hope or improvement. Nothing in my judgment could be worse or more dangerous than labelling a child or young person as a deficient until everything has been done to give it the best chance of improvement. As in the case of lunacy itself, I very strongly feel that certification should not be the first but the last thing, that should be done when everything else bas been tried and everything appears to be hopeless. Such condition as we are this day calling mental deficiency may be caused by many things. It may mean merely arrested physical growth and that the mentality of the young person is influenced by its physical condition. The first thing to do would appear to be, before such a person is certified as mentally deficient, to make sure that his physical health has been attended to, which might result in the improvement of his mind. In any case, the world has happily arrived at a new conception of what mental disease means. We no longer regard it in the old superstitious way of thinking that a person who is mentally afflicted is thereby possessed of devils and things of that kind. We rather look upon mental disease and mental sickness as being akin to any other sickness and that disease of the brain is as natural, or unnatural, as disease of any other part of the body. We are also approaching the stage when we can assume that in an increasing degree modern science can "minister to a mind diseased." Therefore, while I intend to give my support to this Bill—as I am sure, in general, hon. Members on this side will—I feel we need to be 2352 extremely cautious before we put a certificate of incurability on young persons and insist that, before that is done, everything else should be tried.
In the Report which the Royal Commission on Lunacy presented some time ago, I think the main thought was that the keynote of the past had been detention and that the keynote of the future should be prevention and treatment. We are, therefore, compelled, under our obligations to these sick persons, to search for every means of development as well as for the best way of controlling. This Bill, if this principle be kept in mind, will be very helpful; if it is not, it may be in the highest degree a dangerous Bill. What is the present condition in relation to these mentally deficient persons? It is that they must have been afflicted from birth or from an early age. But defects have a habit of revealing themselves in all ages of life and it may not be possible to detect real mental deficiency in infancy. This fault very often shows itself just before, or during, adolescence, which is a time of great physical and emotional change, a time when things that were obscure and passive reveal themselves in an active way. It cannot always be diagnosed in infancy, and I feel that whatever good there may be in medical treatment for afflicted persons, should be available for the adolescent as well as for the child or people in any other stage of life.
I am not quite satisfied about the precautions taken in this Bill to distinguish between an affliction which may be temporary as against the affliction which is to be regarded as permanent. We have in a certain way to rely on the advice, and skill of medical people for a decision on this point. If it is a case of real biological degeneration and if there is a debasement of the brain structure and cells, then, of course, the case is clear and there is nothing more to be done. But there is another class of sufferers who require very anxious attention. The fault may be due to some error in the functioning of the brain. It may be caused through mal-nutrition and be one of those borderland cases which might offer some hope if treatment, rather than a controlling view of the situation, were adopted. In any case we may be assured 2353 that this question of deficiency is related in a very real manner to the physical condition of the human being, just as in the case of lunacy. A child who is merely backward ought not to have the stigma put upon it as being classed as inherently defective until everything else has been tried.
Some cases, as the Minister has pointed out, develop very slowly. Some people find their mental development slow, and thus you should not be in a hurry to put a special label upon a child or young person. I have said that in these matters the House is compelled in great measure to rely on the skill and wisdom of the medical authorities, and yet. I think we ought to have a very wholesome distrust of those medical onmiscients who will sign away the liberty of humans. That is a distrust which has persisted for many centuries, and it must be based upon the fact that these medical gentlemen, charming as they always are and wise as they always look when they draw their fees, have shown themselves not really thoroughly able to master their own subjects. In any case they are merely empiricists and have to guess as to what should be done. I find that this view which I am presenting is a very old-established view. I find, for instance, the Gospel of St. Mark treating it in this way. It speaks of the woman who had been ill for 12 yearsand had suffered many things of many physicians, and had spent all that she had and was nothing bettered, but rather grew worse.
§ Mr. SNELL
Such as they were, they were the physicians of that time. I am seeking to apply the idea to the physicians of our own time. Take a little older comment from the same Book on the same problem. We are told in the Old Testament that.Asa was diseased in his feet, until his disease was exceeding great; yet in his disease he sought not to the Lord, but to the physicians.Then follows that biting sarcasm:And Asa slept with his fathers.We need perhaps to be a little cautious before we try to put complete power into the hands of those charming gentlemen who do so much for us. All that I 2354 desire to say is that the suggestions which the Royal Commission ventured to make as dealing with the bigger problem, should he considered in relation to this secondary problem that is now before the House. I think, for instance, that these mental defectives should be classified. I cannot conceive anything much worse for any child for whom there is any hope at all than to be placed in daily and immediate contact with the worst cases of mental deficiency. Whatever is right to be done in regard to those who are subject to perhaps temporary afflictions of the kind, should be done in regard to these. The strictest attention should be given to any possible scheme of classification in the matter. Then the cases should be subject to periodical review. Directly a person gets this label on him, there may be a tendency to shut the door on him for the rest of his life. The very greatest care should be taken to see that these cases are periodically reviewed in the medical and in every other way. I know that in theory that is done, but we ought to see that it is done thoroughly and that there is no question about it. I am not criticising for a moment what is done. Wherever it is possible for any child to leave an institution of this kind some attention should be given to its after care. We want to get people out of the control after they are in, if it is at all possible. It is the easiest thing in the world, apparently, to get inside one of these institutions, and the hardest thing in the world to get out, and precautions of that kind should be taken into account.
I hope that if this Bill goes to a Standing Committee, as I suppose it will, this matter will be thoroughly considered in all its aspects. I desire to say a further word upon the question of liberty. It all depends what we want. It is a horrible thing for any person to contemplate, that they may have to be controlled in one or other of these institutions. I know that those who are in charge of them do their best. I am sure that, granted the affliction, a man is perhaps more fortunate to be under their charge than not to be under their charge, but, when all that is said, life in these institutions cannot be happy, and we ought to use every possible influence we have to make the institutions as good as we can, and to give everyone 2355 who is inside the chance to get out without very much difficulty. But on the subject of liberty, I want, in regard to these afflicted persons, these young people, to give them that higher liberty, if I can, that will enable them to enter into their rightful heritage of the kingdom of the mind. While I have criticised in some way the medical profession, I feel that medical science in an increasing degree will be able to grapple with these points of mental trouble and that we should regard no case as hopeless.
§ Rear-Admiral BEAMISH
I wish to say a few words on this essentially humane and eugenically sound Bill, which in my opinion has been delayed a great deal too long. We have not heard very much in opposition to the Bill, but fears have been expressed on the Benches opposite in regard to what is called the liberty of the subject. It is a very curious thing that the Labour party, who in certain respects are tyrannical in their endeavours to control people, the very instant there is a suggestion of anything in the nature of vaccination or purification of the race or its improvement, are inclined at once to get up and express the most extreme fears that the liberty of the subject is being interfered with. I have allowed myself the pleasure of reading the arguments which the right hon. and gallant Member for Newcastle-under-Lyme (Colonel Wedgwood) put forward in this House in similar circumstances 13 years ago. They ran to something like 20 or more columns of the OFFICIAL REPORT. But there was in them, as far as I discovered, nothing that differed in the slightest degree from what the right hon. Gentleman has expressed to-day. In listening to him to-day, I found that his objections to the Bill were put forward very clearly, but that there was nothing constructive or suggestive as to what should be done to improve the Bill or to produce something that would have the same effects in protecting the public against mental deficients.
One suggestion which he made seemed to me the most fantastic I have heard expressed for a long time. He suggested that because at the present moment the country does not possess sufficient homes for housing mental defectives, we have therefore no right to proceed with legislation for improvement in that respect. 2356 He suggests that we should postpone all such legislation until we have the country dotted from end to end with homes sufficient to house perhaps 100,000 mental defectives. He suggests that the taxpayers' and ratepayers' money should be spent in this way before any legislation is brought in, but, obviously, the right thing to do is first to pass a Bill of this kind and then, if there be a strong expression of public opinion to the effect that there are not sufficient homes, that will be the time to take the necessary steps to house the mental defectives comfortably, happily and properly. The right hon. and gallant Gentleman also spoke of interference with the liberty of the subject. If it is considered an interference with the liberty of the subject to control and look after mental defectives and make them happier and safer, one might just as well extend that argument, let us say, to the matter of education. I can imagine the right hon. and gallant Gentleman's disgust if it were suggested from these benches that people should be allowed to have their children educated or not educated as they pleased. On the subject of vaccination, I am not so sure what he might say but I am inclined to think his comments would be illuminating. One might as well extend this argument to such matters as the notification of disease and the collection of refuse or any of the other social services.
The right hon. and gallant Gentleman, when this matter was under discussion 13 years ago, remarked that he would sooner in these respects trust to Providence than to the Home Secretary who, presumably, was in charge of the Measure introduced at that time. No doubt, the right hon. and gallant Gentleman would extend that expression of opinion to the present Minister of Health and to the hon. Member who moved the Second Reading of the Bill in such an admirable speech, but I feel sure that hon. Members on this side will not be prepared merely to trust to Providence to put this matter to rights. The public have a right to be protected, and it is a public duty to safeguard and help mental defectives. There can be no shadow of doubt that, they are increasing in number and, that being so, legislation is overdue. We have had certain remarks on the subject of experts and particularly medical experts. I have been an expert myself in connection with certain professional 2357 duties of my own, and I admit that experts have one failing in that they become too expert and are inclined to be rather "groovy." But I feel confident that you cannot get on without experts, and it is the general practitioners and the people with wide horizons and reasonable views on whom we must rely to ensure that the difficulties suggested in connection with this Bill by its opponents do not arise. It is a dreadful thought, I agree—if it should be true—that it is too easy to get into one of these institutions and almost impossible to get out. That is a very tragic thought. At the same time this Bill enables reasonable and proper precautions to be taken, and it should not be beyond the wit of Parliament to make sure that if anything should go wrong in that matter it can be put right.
The Eugenic Society has been mentioned this morning. One need not expect a member of that society to agree to everything that is said on its behalf. It is not expected that membership of a society involves attachment to all the opinions expressed by the society. The right hon. and gallant Gentleman the Member for Newcastle-under-Lyme, however, rather jeered at the science of eugenics and compared it with the science of poultry breeding and so forth One cannot study any great subject ouch as the human race without going closely into detail, and I submit that a good deal of the backing for a Bill of this kind comes from people who have taken an immensity of trouble in studying the tremendous problem of the purification and improvement of the human race. I advise anybody who has not had an opportunity of making any reasearch in the library of the Eugenic Scoiety to reconsider their position forthwith and get into touch with that body, which has carried out immensely wide research. This Bill is going to do a great deal of good, but it is a very small and tentative step on the road towards the purification and improvement of our race. For that reason—and it is the very strongest reason one can adduce—I have nothing but pleasure in supporting this Bill now and in its future stages and doing everything possible to bring it to the Statute Book.
Mr. C HARLETON
I rise to express the point of view of a working-class parent with regard to this Bill. I am in 2358 the unfortunate position of being such a parent and I know a little of the working-class view on this matter. The hon. Member who moved the Second Reading in his very excellent speech spoke of giving the mother an opportunity of sending her child to one of these institutions if she so desired. I wish to speak without giving any offence or without incurring any charge of class bias when I say that the position of the working-class mother towards her children in the matter of separation is a little different from that of the well-to-do mother. I do not claim that the well-to-do mother does not love her children as dearly as the working-class mother. That is the last thing I should suggest, but it is the custom in well-to-do families that boys and girls should leave home to go to school. Among the professional classes it is quite a common thing for the boys on their return from the University to leave England and go to remote parts of the world to follow a career. The love of the parents for the children is none the less, but separation from the children is not viewed by the well-to-do mother from the same angle as the working-class mother who does everything for her child. Therefore members of committees and doctors and others who talk lightly of taking the children away should consider the point of view of the mother.
I accept without reservation everything said by the Minister about the excellence of the institutions and the way in which children are treated in homes for the mentally defective. I have however visited with my wife a number of mental hospitals and homes and my wife has drawn my attention to the fact that in some cases the children in those homes cringe when certain attendants pass them. The history of mental hospitals shows that medical superintendents have had to bring increasing pressure to bear and have had to introduce ail sorts of regulations in order to prevent assistants and attendants from ill-treating patients. One is compelled, I think, to come to the conclusion that attendants are far more eager to prevent the appearance of bruises on their patients than they might be to treat them kindly in many cases, because if the doctor found a bruise, he would immediately want to 2359 know what it was there for, which shows that there is still, if unrestrained, a type of person who becomes engaged as an assistant who is not all that the Minister would have indicated. So far as these children are concerned, it seems to me—and this is the only criticism I have to offer against the Bill, to which I shall give my most hearty support—that the Bill does not provide that intermediate school or training home that I think might be provided. The Minister might say it was a question of funds, but I believe that in London, say, there are children enough to form a home where they might go every week. They might be fetched Monday morning and brought home Friday, and in that way, it seems to me, they would get all the training they require in the school and the loving care of the mother at the week-end, and the satisfaction that the child was being looked after.
Some 15 years ago we were looking around for a school for my boy. We saw many of the experts of that day, and the question my wife put to them was: "Will you teach my boy anything that will make him useful, anything that he can do when he grows up?" They held out no hope, and then she said: "If it merely means that you are going to take care of him, I will do that, and give him a mother's love." I was only a fireman on the railway when we discovered that my boy, 27 years ago, when he was just over two, was mentally defective, and it was a struggle to keep him tidy and that sort of thing, but the mother's love overcame all that, and whatever the Minister may have said about these homes, they cannot give anything in exchange for a mother's love, which is the greatest thing in the world. Therefore, it seems to me that something ought to be done for these children, who are perfectly harmless to walk about and know everybody. All that they want is special training, it seems to me, and a mother's love, and I think mothers are entitled to this, because, after all, we have the happiness and welfare of everyone to consider, and unfortunately in going about from place to place, with all the ramifications of our friendships, we have got to know so many people in the same position as ourselves. Every working-class mother will re-echo 2360 what I am saying, that there is nowhere between the ordinary day school where the backward children go and what they term an asylum. You may call them what you like, but to a mother they are asylums, and it is viewed from an altogether different point of view from that tram which well-to-do people would look at this question.
I take this opportunity to put this before the House, knowing that it cannot be often expressed. With regard to experts, I must say that I am a little bit sceptical. Some four years ago I was interested in a man who was in one of our mental hospitals. He was an old school-fellow of mine, and his wife had been trying to get him out for some time. The medical superintendent said he must not go out and that if he did he would be back in six months' time. Well, that man has been out for four years, and he got a job in his own trade directly he got out, and he is a happy, healthy citizen to-day. He still has hallucinations, but he is absolutely harmless and a model husband, one of the most tender-hearted, loving men I have ever met in my life, so that when the experts have got to decide, one is a little bit sceptical. That is the only other point I have to make against the Bill, though, of course, I must admit that I have not a plan to substitute for it. The main points that I wanted to make were that the working-class mother does look at the question of taking her children away from a different angle from that of well-to-do people who are used to their children going away to school or to the uttermost ends of the earth for a career, and I think we ought to have an intermediate division between the elementary school and the mental home, where the children could go right away. One might have a school, especially in large centres, where these cases who are fit to receive training might spend their week, say, from Monday to Friday, and then have the week-end at home in the mother's care.
§ Lieut.-Colonel JAMES
The hon. Member for South Leeds (Mr. Charleton), who has just sat down, made a series of insinuations which, I think, cannot be passed over without some reply being made to them. I cannot claim an intimate experience of these mental homes, but I think it is very hard—in fact, it is 2361 worse than hard, it is grossly unjust—on the part of the hon. Member to say that he and his wife and his friends visit mental homes, and that they are, sure that something is wrong there, on account of a look, a shrinking, or this, that, and the other, on behalf of one of the inmates. You cannot accuse people by insinuation. If you have definite cases, for heaven's sake, bring them forward, but it is most cruel to come to this House and insinuate—
§ Mr. CHARLETON
I was not making a charge, I was trying to point to the effect on the mind of the working-class mother who saw it. I am making no charge.
§ Lieut.-Colonel JAMES
The hon. Member did not make a charge, and that is exactly my point. My point was that the hon. Member insinuated that he and his wife had been in some home or other and had seen the children flinching and cringing. His speech, I presume, will be reported, and working-class mothers, will read it and lay more emphasis, and, perhaps, more credence, on the words spoken by him than I do, and I think it is most unfair, when one realises that the nurses in hospitals, irrespective of whether they be mental or other hospitals, spend devoted lives and services, and they have no opportunity or means of answering, not a charge, but a suggestion that their treatment of their patients is not all that it should be. An insinuation of that kind calls for some note of protest in this House, and I venture to offer it. In the second place, all of us know that there is an urgent need for institutional treatment for these defective cases. In our own private capacities, in our homes, in our neighbourhood, we always come across these tragic and sad cases. The hon. Member for South Leeds spoke with great truth and emphasis of the power of a mother's love, but how often in these cases of mental deficiency—to treat a very delicate subject in as delicate a way as I can—are not these mental deficients unwanted children? The one thing that they do not get in their lives is a mother's love. The child, perhaps one of many, and defective mentally in contrast with its brothers and sisters, gets a cuff on the head rather than the love which in nine eases oat of 10 children do get. But there 2362 are many of these cases where these children are not wanted, and it is very often the case, I believe, of mental deficiency where, so far from getting love, it is the very last thing they get in their homes. This morning I was reading a paper, and I jotted down this epigram:Science finds out ingenious ways to kill Strong men, and keep alive the weak and ill,That these a sickly progeny may breedToo poor to tax, too numerous to feed.Only the other day, close to my home, there was a case of a mental defective. His father and mother had both spent periods of their lives at varying intervals in mental homes. They came out, and used to go back with unfailing regularity. They had a large family, nearly all of them mentally deficient, not sufficiently insane to be interned, and not sufficiently sane to be able to do any useful work. One of these sons having reached man's estate, went to his daily work as a woodman. Coming back from work in the middle of the day, he went to a public house, called for a glass of beer and then, having got his glass of beer, proceeded to chop open the head of the publican who served him. Then, too late, they discovered that this unfortunate creature was raving mad, and he has had to be confined at Broadmoor during His Majesty's pleasure.
There are many borderline cases, and these suddenly, in colloquial language, "go off the deep end." It is to meet cases of that kind that this Measure is so urgent and necessary. I get appeals from my own constituents, and I sympathise with every word they say. For Heaven's sake, let us try to bring these people back to health and some measure of normal sanity. I do not think that one of the speakers who preceded me was altogether just or fair when he said how easy it was to get into the asylum, and how difficult it was to get out. I have had two sad cases—employes of my own. Both, unfortunately, had to go into the asylum. One stayed nearly six months, at the end of which she was returned to her home sane and well. Another one—a very violent case—was four months in the asylum. She was able to return at the end of that time, I hope cured. Both went back to the land. Let us try to make this Bill as good as we can. Let us try to see it is not obstructed, as 2363 was a Bill not so long ago in Committee, and let us place it on the Statute Book as a monument of serious political forethought.
§ Mr. SMITHERS
I want to address myself, not so much to the mentally defective person as to the effect of the mentally defective person upon the community as a whole. I, too, have had lately one or two cases brought to my notice, which I have taken up, and about which I have had a large correspondence. As other cases have been given, I think it would add to the interest of this Debate if I might be also allowed to give one. This was a case where I had most pathetic appeals from o boy's family, who wrote to me as their Member of Parliament asking me to do my utmost to get this boy out of the asylum. I took considerable trouble, had a long correspondence with the medical superintendent of the asylum, and went very carefully into the case. He explained to me that for months on end this boy was to all intents and purposes perfectly normal, but every six months or so completely broke down, had suicidal tendencies, and also tried to murder people. The hon. Member for South Leeds (Mr. Charleton) mentioned a case where he rather suggested a man after some difficulty was got out of an institution and came back to be, as he said, a useful citizen, but still labouring under hallucinations. I do not know the particular case, but in similar cases is it altogether a good thing from the point of view of the community to let out these borderline cases, so that they may come back to normal life, and beget children who may or may not be able to bear the responsibilities of citizenship of this country?
The hon. Member for East Woolwich (Mr. Snell) was rather inclined to attack —perhaps "attack" is too strong a word—was rather inclined to criticise the doctor. I happen to have a son who is a medical student, and he, in a long conversation I had with him a few days ago, impressed on me that they were taught all the time that as students they were, as it were, to be on the look-out, that there was no such thing as finality in medical science. They were taught not to pretend to be omniscient, or that they had got to the end of their studies, that they were constantly to make leaps 2364 in the dark to try to make some fresh discovery, to try to add to what they were being taught their own initiative, their own powers of penetration into the future, so that the rising medical profession should be, so to speak, a band of adventurers, knowing full well that there were great discoveries almost within touch of the medical profession. That was the attitude with which they were, asked to approach their medical studentship. I think one of the things of which we can be proudest in our country to-day is the very high standard that our medical profession upholds. It is a wonderful thing how in the case of death or accident, or in a coroner's court, everyone seems to accept the doctor's decision as given in truth and in justice. Of course doctors, being human, occasionally fail, but there is no reason why any general criticism should be passed upon the profession as a whole.
I began by saying I wanted to approach this subject rather from the point of view of the community, and I would like to remind the House of the growth of government in this country. Writing of the time of William the Conqueror, Kipling says:England's on the anvil.She was being hammered into shape by William the Conqueror, a monarch who had almost despotic power in this country. England was then being governed by one man, and the happiness of the people depended upon the character of that one man. Coming down through the ages, we find the Government being spread over more people. First there were the barons, and then from autocracy we passed to an oligarchy; the responsibilities of the Government being spread over more people, and the happiness of those people depending upon the character of a few people. If those few people were good, then the people were happy. What is the form of our Government to-day? It is for the people, of the people, by the people. Upon whose character does the happiness of our country depend to-day? It depends upon the character of every man and woman who has a vote, and that is why it is so important to lead public opinion to tighten-up the possibility of people who are not fit for it bearing the responsibilities of citizenship through their votes, and, by Measures such as this, restricting 2365 the possibility of mentally-deficient people being produced by mentally-deficient parents. It was pointed out by the hon. and gallant Member for Lewes (Rear-Admiral Beamish) that mentally deficients are increasing, and it is of the utmost importance for the future of civilisation to do all we can to purify and improve the race and improve the character and the intelligence of our future citizens.
Many people think that civilisation today is being attacked on many sides by subversive influences all over the world, though I do not want to raise any discussion on that point. Civilisation has been called the flowering of the human race. Civilisation has been built up by human agencies, it is composed of human organisation, and is sustained by human individuals, and the future of civilisation depends upon the power of individuals to carry it on and improve it. Civilisaton depends upon human products, and we ought to do all we can to see that the products of civilisation are sound, strong and healthy. It is for these reasons, not only for the sake of the mentally-defective himself but for the sake of the community as a whole, that I welcome any attempt to build up men and women of better character to sustain and hand on the civilisation under which we live, for civilisation, while it is a benefit, also has its obligations.
§ Mr. MARCH
I wish to say a word or two in support of the Bill. Last year, when a similar Bill had to be dropped, I received representations from several parents in my Division who would have blessed the passing of such a Measure, and I am sure they would bless the operation of this Bill if it becomes an Act. I would pay a tribute to the London County Council for what they have done in grading children in the various schools. If they find a child slightly defective and unable to take advantage of the education given in the ordinary schools, they send it to a special school. Anyone who has visited those special schools, as I have, knows the great care devoted to those children by their teachers, and very often those children grow up useful and able citizens. But there are others who are graded as non-educable children, and these seem to be left almost derelict. In my district there is a school of about 2366 20 of these non-educable children. It is in a large hall, very bare and very uncomfortable, and to my mind very unsatisfactory. If these children, who, I understand, are mainly being supported by voluntary contributions, could be taken away to a proper school during the week they could be trained there, and their parents could be allowed to have them for the week-end, returning them to the school on Monday, great good would be accomplished, and I believe there would be a great possibility of many of them becoming useful citizens. There ought to be the fullest opportunity for the parents to visit them when they are away any time they would like to see them. I do not say every day, but facilities should be given to the parents to see these people at least once a month, and then they would be more satisfied that their children were being looked after. It has been said that these cases should be certified before the institutions are prepared for them, and they recognise that there is not sufficient accommodation to take in the number of cases mentioned by the Mover of this Bill. I understand that there are between 40,000 and 50,000 of these kind of defective children in the country and yet we have only two or three schools to accommodate them. I think there is a sufficient number of eases of this kind to warrant the local authorities setting about building institutions for these people.
I am rather concerned to know to what local authorities representations must be made. Is it to the education authority, the board of guardians, or the local borough council? I think some provision dealing with this point ought to be inserted in the Bill so that we shall know exactly where representations have to be made. I am also glad to learn from the Minister of Health that this Measure will be included in the Principal Act of 1913 and that the parents will have the last voice or the last word in saying whether they are agreeable to their children going into these institutions. I think it is only proper and right that the parents should have the last word. I know from experience I have had in connection with boys and girls over the age of 18, where they have been in an institution under observation for a period that then the medical expert has considered that they ought to go away for 2367 mental treatment to an asylum. I should like to see the word "asylum" abolished and the word "institution" substituted.
As a justice of the peace, whenever I have had parents before me in such cases, I have always used the word "institution" and they prefer to hear that their boy or their girl is being sent to an institution or hospital rather than an asylum. In this country we appear to have selected the most unhealthy names for these institutions. Whether this was done as a kind of deterrent I do not know, but people certainly have acquired a dislike for names like Bedlam. Claybury and Colney Hatch. I believe this Bill will be beneficial to a large number of these children in the future who will be sent away and will get proper treatment. I have sometimes seen men and women who are what is sometimes called "a little bit wanting in the upper story" made fun of by their colleagues, and this only makes them worse. Therefore, I hope that when this Bill gets into Committee, some of the words now appearing in the Bill will be obliterated and more appropriate words chosen, because I am sure that would have a better effect.
§ Sir GEORGE HUME
I always listen with the greatest interest and sympathy to the criticisms made by the right hon. and gallant Member for Newcastle-under-Lyme (Colonel Wedgwood), more especially when he stands up in favour of individual liberty, because there is an undoubted tendency nowadays to travel too much in the opposite direction. We are considering to-day a Mental Deficiency Bill, and I am sure the right hon. Gentleman's arguments would carry him very far indeed if they could be adopted. The hon. Member for South Poplar (Mr. March) has dealt with the term "asylum," a word which is very generally used in connection with hospitals and institutions where mental people are accommodated. I would like to point out however, that the London County Council have abolished that word and their instituitions, are now known as mental hospitals, and we have what is known as the Mental Hospitals Committee. Consequently that point, as far as London is concerned, has already been dealt with. In view of the references which have been made to London County Council institu- 2368 tions, perhaps I may be allowed to give to the House a few details as to what is actually being done in London in our schools and our institutions for mental defectives. Take the cases dealt with by the London County Council last year. In the Council's four institutions, including some absent on leave, there were 665 males and 637 females. In 29 institutions under contract there were 562 males and 605 females. There were also under personal gaurdianship 22 males and 19 females and in places of safety awaiting other action, 4 males and 20 females. That makes a total of 1,253 males and 1,281 females. There were also under supervision in their own homes, 854 males and 1,002 females. The advantage of this supervision in their own homes is that it enables the public authority, where supervision of the homes is suitable, to give assistance to the parents in the homes where the children are being supervised. The figures I have given show a grand total of 4,390 cases in London. At the Manor, Epsom, there are children of all grades and both sexes. There is a training department for children, and industrial training, as I have already stated, is given to the elder cases and adults.
§ Sir G. HUME
1,053. At Farnfield, criminal and intractable, there are 85 men. At South Side Home, Streatham, improvable, there is it home for women and girls, and there are 80 of them. At Brunswick House, Mistley, improvable, lads, there are 50. There are, altogether, 1,268. At the present moment the council are considering the steps that will have to be taken for meeting the needs of further accommodation, chiefly for criminal, intractable, and very immoral women. We have been able to do it for the men, but, so far, segregation has not been possible so far as the women are concerned. There is no doubt that more accommodation will have to be found, but, as regards the present Bill, it is not introducing any new principle whatsoever. It is enabling us to deal with a class of case which we cannot touch to-day. The hon. Member for Bridgwater (Mr. C. Wood) has pointed out very clearly that it is of vital importance that children, who are now in homes, who are now put into our mental 2369 hospitals, should not have to mix with the adults there. Anybody who knows anything of these hospitals—I have had the opportunity of visiting them—knows how very undesirable it must be for children to be confined in an atmosphere of that sort. Although the control is extremely good, still the contact' is unhealthy.
Like other Members of the House, I also have come across most distressing cases. I think every Member from time to time has cases brought to him by parents who are bitterly troubled by having to separate from their children. The question, after all, is this: How far can we really encroach on the liberty of the parent for the good of the child? I have found, in settlement cases, that where the authority has decided that the child should be taken away from the home, although, as the right hon. and gallant Gentleman has said, the weakest member of the family is often the one most loved, the conditions are such that they do not give the child a chance. It is really a balance of advantage which has to be carefully considered, and I cannot help feeling, if compulsion were not exercised as it is exercised to-day, with very great restraint and moderation and, an anxiety to be as just and fair as possible, then we should be driven to that other alternative which we all detest, where the child would have to be dealt with so as to make it impossible that future generations could be damaged by the liberty granted to the parents. It is under those conditions that I, for one and, I may say, the county council itself, strongly support the Bill which was so ably introduced by the hon. Member for Bridgwater, and we earnestly hope that it may be passed into law.
§ Major CRAWFURD
The first remark that I would make arises directly from what was said in his concluding sentence by the hon. Member for Greenwich (Sir G. Hume) who has just sat down. A certain experience which I have had of what are called schools for defective children leads me to believe that in a great many of these schools, after a number of years, you can determine the amount of mental deficiency which a particular child may possibly reach, and, having decided that it cannot go beyond 2370 a certain point and having come to the decision that that boy or girl is not to be allowed to enjoy the fullest human life, it is your duty to give it the nearest approach to that human life that you possibly can. That is my first point.
My only other point is this. The existing practice of certification of people, whether under the definitions of this Bill or as they exist at present, does not seem to me on the face of it to be entirely satisfactory. I feel very much with the right hon. and gallant Member for Newcastle-under-Lyme (Colonel Wedgwood) that in connection with the whole of this business of the mentally deficient more than in any other matter, almost more than in criminal cases, you have to be perfectly certain that you are not doing an injustice to the person who is really more normal than abnormal. You have to take every care in that matter, and, as I understand one or two medical men are going to follow in the Debate, I would direct their attention to Clause 5 of the Bill, where it says thatwhere a defective who…has been sent to an institution or has been placed in an institution by a parent or guardian is absent therefrom …may make arrangement for his examination by a duly qualified medical practitioner residing in the locality.I am not attacking the profession in any kind of way, but I would like to hear from medical Members of the House whether the ordinary medical practitioner who is entitled to be called a, duly qualified medical practitioner is, as a matter of fact, duly qualified to give an opinion on these cases. I know that my own medical adviser, a man who is extraordinarily careful in diagnosing any complaint that you may have, freely admits that with regard to all sorts of diseases he is not qualified to give a final opinion, and I imagine, from what I know as an ordinary layman hearing of these matters, that there is no side of medical practice or knowledge which is more uncertain than that dealing with mental deficiency, and I would like to have some assurance that it is the present practice, or that it is contemplated under this Bill to make provision, for people who have specialised training to give decisions in these matters.
Before actually dealing with the Bill, I would like to draw attention to a very important fact in connection with private Members and private Member's business. It is often assumed that Friday afternoons are private Members' days, and it is a privilege for which we private Members on the back benches have always fought and carefully guarded. A very remarkable fact has occurred to-day, and I only mention it as an illustration of the growing tendency in the House to push the back bencher away from the forefront and out of the picture altogether. We had this Bill proposed in an extraordinarily able speech, and seconded by another speech. Then we had two Members speaking from the Front Benches, and one who has been a Front Bencher. We had the Government position given very early in the day. The Government position was given on a Bill which we know is really for practical purposes a copy of a Bill which they themselves had last year, and their opinion was given before any back bench Member of any party, apart from the proposer and supporter of the Bill—I naturally exclude the right hon. and gallant Member for Newcastle-under-Lyme (Colonel Wedgwood) who has formed part of the Government—had had a chance of giving his opinion on the Measure. That is taking Fridays right away from what we have always understood to be their position, namely, an opportunity for the House of Commons to express, through its back benchers, their position as individuals in regard to a particular Bill, and is, in the case of this Bill, coming very close—much too close, in my humble judgment—to using Fridays merely for the purpose, through the luck of the ballot, or in whatever way it may be put, of passing a Government Bill.
The right hon. Gentleman who moved this Bill last year has supported it again to-day, and I do not see how we can hope, in the course of this Debate, for a reply in any ordinary way to the view of back benchers, which has been voiced by others and which I hope to be allowed to voice in the course of the next few minutes. I noticed that the right lion and gallant Gentleman who moved the rejection of the Bill told the House that he considered himself to be a bit of an eccentric. I do not know whether he 2372 is going to a Division or not, but I, certainly, have never regarded him as an eccentric; I have always regarded him as a visionary, and as one whose visions are sometimes backwards and sometimes forwards, so that it is never very clear in which direction he is really going. He made a very excellent and interesting speech to-day, but, when he talked about what he had inherited from his ancestors, I was not quite certain where be was standing. I sympathise with him, and many others sympathise with him, in regard to the tendency of modern legislation, which, as I understand it, is to take the individual and, if there is anything wrong with him, not to give him a reasonable chance of getting better in his home—I want to see such individuals get better in their homes if possible, but I will deal with that later —but to take him and shove him into home institution.
With regard to the Bill itself, I should like to draw the attention of those who are to follow me—and I gather that a number of medical opinions are going to be put before the House later in the day —to Sub-section (2) of Clause 1, in which the age is raised to 13 from the 12 or 14 which is the limit now. I listened with very great attention to a large number of experts in the Standing Committee last year, and I think also in the House telling us at what age the limit of development of the mind is reached. It is a very curious thing, and I think the House will do well, if I may say so very humbly, to bear it in mind, that what expert medical opinion thinks to-day is a direct contradiction of what it thought 20, 30 or 40 years ago, and in all probability that will be again contradicted in the next generation. I believe that the fixing, of the limit of age at 18 is absolutely and utterly wrong. I do not want to see a definite limit of age fixed, because I do not think that any human being can decide at what definite age the mind ceases to develop. It is possible to decide at what age the skull ceases to develop, but no one can decide at what age the mind ceases to develop. That is far beyond any person, and I should like to see the House, instead of concentrating on a definite age such as is laid down in this Clause, concentrate on getting the worst cases of all into homes or other institutions, whatever 2373 they may be. It is the very bad cases that I want to see dealt with, and not so much cases that are on the borderline.
In Clause 4 power is provided for dealing with the children of parents who are abroad. I happen to come from the West country, where a very considerable number of our people are engaged in mining operations abroad. They are, in many cases, far away from civilisation, and they obviously cannot deal with a case of emergency. I believe that there ought to be power to deal with cases of that kind, but I do think that power ought to be reserved to the parent, who must ultimately be responsible in a moral sense for the child, so that, when there has been time for communication, he can go into the whole matter fully, and, if he can provide other means, or if he objects very strongly and can put the child in a satisfactory position, he may be able to do so. I know it is a Committee point, but I think it would not have done any harm if it had been discussed more fully than it has been to-day.
I now want to deal with the position of the Bill as compared with the position of last year. On the 22nd January, or thereabouts, there appeared in a certain newspaper, which is fairly well known, a very interesting letter signed by a large number of very worthy people, who said that when we were dealing with this matter last year the Opposition, whatever it was, was based on a misunderstanding In the first place, I want to make it very clear that, as far as I am concerned, there was no opposition to this Bill last year, and I doubt if there will be any real opposition to its guiding principles this year. I believe I am right in saying that there was no Division on this Bill last year, but what there was last year was a great deal of doubt in the minds of the Committee and in the minds of certain Members of this House—a doubt which grew as the discussion on the Bill proceeded—as to what was the real extent of the Bill in regard to two principal, cardinal factors. The first of these was the subject of the freedom of the individual, and the second was the matter of finance.
As far as freedom of the individual is concerned, we have had a certain amount of discussion to-day, and I do not think that any of us wish unnecessarily to re- 2374 strict the freedom of the individual. I myself differ from the right hon. and gallant Gentleman who moved the rejection of the Bill. I would do nothing to restrict the freedom of the individual unnecessarily; but, if the individual in his freedom is a danger to the community, I say that the interests of the community as a whole are infinitely greater than the freedom of the individual, and I think that that is a point which we might well consider. The matter of finance, as to which some of us asked questions last year, is a very important one from the point of view of this Bill, and that is why I regret that there is no Minister here at the present moment, and why I regret that this point should not have been brought forward before the Minister spoke. I should like to hear clear answers to three or four questions on the financial position of the Bill. In the first place, if I understand it rightly, we, as a House of Commons, are essentially a Chamber dealing with finance, and I want to know from the representative of the Ministry, if they give any reply, as I hope they will, before this Debate is ended, whether the present institutions are full. It is essential that, before we so widen the scope as to enable us to take in more people, we should know absolutely clearly if the present institutions are capable of dealing with a wider definition of lunacy, or whatever it may be called.
I gathered from the Minister of Health that in many cases these institutions are full, and I also gathered from his speech that there are other institutions which he thought—I believe rightly, if I may be allowed to say so—would be useful in dealing with this matter. He also brought up the point very clearly that to have really modern up to date institutions would mean that they are very costly concerns. A second point that I should like to have clear information on before we pass the Bill is a matter of the staffs of these institutions. It is no good having new buildings, and widening the scope of the Bill, unless you are perfectly certain in your own mind that you have the means of training and equipping a staff that is competent to deal with the inmates of these institutions when you have them. It will take you a long time to get the institutions, but it takes far longer to train fully competent doctors and supervisors for these people 2375 than to build and to equip the institutions. You can only extend your institutions themselves gradually, but it is a still more difficult undertaking, as I understand it, to expand the staffs of thoroughly efficient people to deal with these people if you deal with them.
The next point I should like to raise, which certainly was not made clear in the first part of the Debate, is what is going to be the actual cost of this if you enlarge the scope, as you do under this Bill, to the ratepayers and the taxpayers. I believe rates are no more and no less injurious than taxation. I have never held the view that rates bear more heavily on industry than taxation. I think it is economically unsound. Both are equally bad, and I gather from the Minister that roughly he puts it on a 50–50 basis. I want to know quite clearly if you expand the Bill to its fullest capacity, if you build and equip institutions to the numbers which you may expect under the Bill, what is going to be the cost, first of all, in capital outlay. He told us a new modern institution would cost from £250,000 to £500,000. I want to know how many you need, and I think we have a just right, as representing the taxpayers as well as the ratepayers, to ask how many are likely to be needed. He only can tell us that, because after all it is easy to visualise from the figures he gives that you can very easily get an increased cost not of a few millions but of £20,000,000 or £30,000,000.
Again, there is, in dealing with this matter as it stands to-day, a natural desire in the minds and the hearts of every one of us to try to do what is best for these unfortunate people. We all want to do that, but in wishing to do it, if we are to deal with our duty as I think we should do, we cannot only think of them but we must think of the whole of the rest of the community as well. We have a habit of coming here on a Friday afternoon and putting out legislation and concentrating our minds on the immediate effect of it, as we are doing to-day, and neglecting the whole of the other things that are going on round us. We all want to do our best for these people but what is going to be the effect and the cost of what we are doing today on the whole of the rest of the community? I do not say it in any hard way but we really ought to look at it not 2376 merely from the point of view of the actual Bill you are dealing with but from the point of view of the whole community. I think on this occasion, when we are contemplating a Measure which must inevitably in the long run bring very heavy burdens on many sections of the community, we ought to know quite clearly from a responsible financial authority on the Front Bench what is going to be the cost to the community either in rates or taxes. It is rather a pity if this Debate is allowed to go through without having a really responsible answer to that question.
As far as the people we are dealing with themselves are concerned, I think we ought first of all to try to frame a Measure which will deal in the first place with the very worst cases of all. I do not think we want necessarily an age limit at all. I do not think we want to keep in our minds whether a man has come to it from this or that cause, but we want to get the worst people, the people who are most afflicted, in these institutions in the first place and, in the second place—a point which I consider of vital importance—if you have a family of children in which one individual is mentally afflicted, knowing the habits of children in copying each other, knowing how these things are apt to occur from the process of imitation, from the process of example or what ever it may be, we ought to be very clear in our own minds that where a child is liable to be a bad influence—by which I mean an influence to deteriorate the characters of the others —we ought to consider very firmly and clearly the interests of the other children in the family. I should like to see the first dealt with in the first place as being more important than anything else—first of all the very worst cases, and in the second place individuals who may have a bad effect on the growing children of the present day. I hope the Bill will pass and will go through Committee and have the sympathy, as I believe it has, of almost every person in the House, but I hope it will be dealt with very thoroughly from the financial point of view and all other ways. I believe if we can pass it on a sound basis it will be in the interest of the community as a whole and for that reason, although I doubt whether it is anything like a perfect Measure, I shall give it my support.
§ Mr. HARDIE
Although this Bill does not apply to Scotland, there has been a nasty habit recently that, when they try a Bill on England, they push it over into Scotland. I want to anticipate any idea of that being brought about. The Mover of this Bill made what seemed to me a sensible remark. That was his reference to the increase in the number of cases dealt with under the Bill. I should have thought anyone having made such a statement would try to give the House some of the conditions which have changed to bring about that increase, The last speaker has pointed out that we do not know what this is going to cost. Would it not be much more logican and much more sane to deal, if we can, with the causes? In that way we should permanently reduce the expense and also reduce these unfortunate conditions. I speak with five years' experience of au education authority where we had schools for mental defectives under our own control. The point which has been raised in regard to the relation between the parents or the guardians of the child were met with there in our own practice. I am surprised that none of the speakers seem to have had any practice or any experience in that direction; at any rate, if they had, they did not mention it.
Those of us who have sat on public bodies know of the tremendous force of public opinion in deterring what might be done for mental cases. A man or a woman does not shrink to speak of any member of their family who suffer from tubercular disease or any disease other than mental disease. When it comes to mental disease, they have been compelled because of public opinion, wrongly and cruelly developed, to feel that it is something to hide. That feeling is one of the greatest facts which has to be overcome as far as this question is concerned. We must get public opinion with us, because it does not matter whether the parents are freed from responsibility or not, we find in our practice that when you take any form of plebiscite, as we did, you always have the major vote against you.
The discussion this morning has been concerned with the names of institutions. We had that prejudice against us when we started, and we changed the names. We called the school by the name of the district in which it was located. We 2378 had one building in a beautiful glen, and we called the building by the name of the glen. We did not feel in, actual working that there was anything at any time in that opposition which came from what would be called the ordinary daft school, The thing is to get the children to understand that they must not tease children because they are mentally defective, and they will not do so if they are properly trained. All these feelings on the part of parents axe the real basis of the contention against this Bill. We have to contend with public prejudice.
The right hon. and gallant Member for Newcastle-under-Lyme (Colonel Wedgwood) spoke great truth to-day, but the House misunderstood what he was driving at. I agree with him that where a person is dangerous he aught to be locked up as a danger to the community; but what the right hon. Member was fighting for was the freedom of the individual who is not a danger to the community and who should not be locked up. There is a great deal to be said for that contention. When we come to the question of the schools—and I am glad to see that the Under-Secretary of State for Scotland is present, because he has visited many of our schools—you can make the schools so attractive that even in its own expression of homeliness, comfort, care and kindness, you have gone a great way towards reaching the innermost part of the child's mind, and it is there that you must begin if you are to have any effect at all.
The medical men of whom I have had experience are not bigoted in any way. They have never said: "Here is an entirely hopeless case." They have said: "Here is a case. Let us make what experiments we can. Let us apply the experience which we have already got, and see what we can do." We have had cases of children, and they are all on record, who in the ordinary sense would have been looked upon as hopeless, who have been taken into these schools, and benefited wonderfully. I know of the case of a boy who when he was admitted could not speak and could not do a simple addition of two and two. To-day, that young man is a first-rate designer in a carpet factory. He is one of the most skilled draughtsmen, and when it 2379 comes to the question of the association of colours when applied to other materials, there is not his equal anywhere. That is only a simple illustration, but I could multiply it by hundreds. It is in view of these facts that we have to fight for the favourable point of view of the parent. I will always fight for that, having gone through my experience.
We have to remember that the development of the mind is quite a different matter from the development of the body. There was the weakly body of Shelley, but what a mind! I would have liked to-day to have heard more as to the reasons for these mental conditions, especially in the state of adolescence. I know from watchful experience of 10 years in connection with schools, that I have seen boys and girls who have been looked upon as not being altogether correct mentally, but sometimes in a year, sometimes in two years and sometimes in three years, certain changes have taken place. Although I am not a medical man it seems to me that something had been out of bounds, due perhaps to uneven growth, and it had come back into bounds, and you have what was called a defect remedied through the development of the body. If a child is to he designated as defective, in the absence of more correct information as to its condition, we are doing injury to the child, because just as we inflict an impression upon any human mind that it is something out of the ordinary, whether we do it by an Act of Parliament or by placing them in an institution, the impression becomes a factor not in their regeneration but in their further deterioration mentally.
Reference has been made to the borderline. The backward child is referred to as being on the borderline, and vet the backward child, as proved by those who take an interest in the development of children, is not necessarily mentally defective. Take the children in Glasgow, London or Manchester. A backward child is not necessarily a mentally defective child. A boy who was considered a very backward child in Glasgow, is to-day a highly skilled engineer, and in last month's trade returns this young man is the author of a very ingenious production in connection with the motor car business. He has been offered £4,000 for the 2380 idea. Originally he was looked upon as a backward child. He was not a backward child. He was just that type of individual whose mental qualities did not unfold until a later period than is the ease in the average child. This is what I am fighting for, and I shall fight against this stamping of an individual before you really know whether you will not do a greater injury to the child than you can ever repair. In the ease of adolescence and, puberty, no doubt the medical men will tell us exactly what takes place; how that lack of balance can develop in a day or two, and a year or two before the balance goes back. I want an assurance that none of these eases will be looked upon as something that has necessarily to be dealt with by this stamping of an individual.
The question was raised about defectives being at large, and I thought of all the laws which have been passed by this House, and the great amount of taxes we pay, in order to employ an army of highly skilled analytical chemists to see that we are not poisoned in our foodstuffs. These people are not considered to be mentally defective; that is, these people who would poison our food and give short weight and short measure. We are not passing a Bill to deprive these people of their freedom, they are left to roam at large. To me they are mentally defectives. We have had the moral question brought in, but there are no morals about these people and, if we are going to talk freely about locking people up, I shall introduce into this House a Bill to keep this type of person locked up because a man who is poisoning the food of the people for the sake of a halfpenny profit—
§ Mr. DEPUTY-SPEAKER (Mr. James Hope)
These are provided for by institutions not covered by this Bill.
§ Mr. DEPUTY-SPEAKER
The complaint against these persons is that they are only too mentally efficient.
§ Mr. HARDIE
The lack of moral sense makes them mentally defectives. A man who has a moral sense would never think of poisoning another man's food for a halfpenny profit. That is a form of insanity which ought to be dealt with. The proposals of this Bill seem to me to 2381 deprive the individual of his liberty. Take the Clause which deals with a decision in the absence of the parent or guardian. I will allow nobody in my absence to settle for me a question like that; a question as to whether someone is going to be stamped for life. That is why I give every opposition to every form of legislation of this kind.
§ Dr. VERNON DAVIES
I congratulate heartily the hon. Member who moved the Second Reading on the efficient manner in which he introduced the Bill. It is an exceedingly complicated and technical subject, and the hon. Member who gave us such a lucid explanation of its provisions is entitled to all the credit. He may also feel a certain amount of pride and pleasure in the course the Debate has taken, because there has not been developed any real and marked opposition to it as it stands; and that is a tribute to the skill and care with which the Bill has been drafted. We have the opposition, which to a certain extent was expected, from the right hon. and gallant Gentleman the Member for Newcastle-under-Lyme (Colonel Wedgwood). It is a matter of principle in his defence of personal and individual liberty that he should oppose all Measures such as this, but he gave the impression that his heart was not in his work this afternoon and that he opposed the Measure because he felt he had to and not because he really wanted to. It was weak as compared with the opposition we experienced to this Measure last session. This is a very difficult subject and I imagine that there are certain hon. Members who have not even yet quite appreciated what a mentally defective is. I do not speak as an authority on the subject but I may speak perhaps as a medical man, and there is a definite distinction between a mentally defective and mental disorder or lunacy. In the case of mentally defectives, they suffer from what may be scientifically called amentia, while mental disorder may be called dementia. The two classes are absolutely distinct one from the other. The unfortunate thing is that in the case of amentia, or mentally defective, you cannot expect a cure. It is impossible. In the case of mental disorder, or lunacy, of course we do get a complete cure sometimes.
2382 Certain hon. Members do not seem to appreciate this difficulty, that you cannot cure mentally defectives but you can improve them. May I use a homely illustration? It occasionally happens that a child is born with a deformed hand, perhaps only a thumb and no fingers, or only the stump, which may involve a condition of amentia, but that child by education and training can develop a certain amount of power in that stump or thumb and become really proficient in certain movements. The same thing can happen in mentally defectives, if they are under proper care and treatment. You cannot cure them. There may be certain cells which have not developed, but you can train other cells to take on a little extra work and improve the condition of that child. You never can make that child normal. That is the essential point and certain Members have not quite understood it. This Bill allows children to be put under supervision in their own homes, if necessary, or under guardianship, or in institutions.
Many hon. Members have stressed the point that nearly all these cases must, of necessity, go to institutions. It does not necessarily follow that that must be the case at all, but, if these cases have to go to institutions, the process is so complicated that it ought to satisfy those hon. Members, who desire the liberty of the subject, that that liberty is guarded very efficiently by the procedure which has to be gone through. In the first place, you must get evidence that the child is a defective within the meaning of the Act. After that, you have got to get two doctors who will certify that the case is a mental defective. Then you have to prove that the conditions set out in the Act of 1913 exist, namely, that the case is neglected, abandoned or cruelly treated. In addition to that, the parent has to give his written consent, but that consent cannot be unreasonably withheld. Finally, the magistrate must be satisfied that it is in the interests of the defective that he shall be placed in an institution. So you find that the interest of the defective is safeguarded at very point. It is not easy to get them in. The whole idea of the Act of 1913 and of this Bill which is an amending Bill, is the benefit of the child. We want to put them under such conditions and circumstances as will enable those children to live as nearly as 2383 possible a human and intelligent life. I ask the House to bear constantly in mind that there is no possibility of curing these cases or of making them normal.
As to the cases of encephalitis, in which you get arrested or incomplete development—this unfortunate disease occurring perhaps in a brilliant child— something possibly happens there to certain cells of the brain which prevents their future development. It is accepted now by most people who are competent to judge, that these cases only occur in adolescence, that is before the brain is completely developed. There has been a certain amount of puzzling about that. People say, "Our brain never stops developing; we keep on learning until the day we die." You must divide the brain into two. There is, first of all the structure of the brain, which is completely developed by the age of 25. Then there is what I will describe as the furniture of the brain which, like the furniture of a house, can be improved, added to and strengthened during the whole period of mental and physical life. They are two very distinct things and what is called the furniture of the brain is not concerned in this Bill. This Bill is only concerned with the structure. The Bill does not deal with adults over 18, who are suffering from encephalitis lethargica with its accompanying defects, unless you can prove that that person was a mental defective before the age of 18. There was one unfortunate case mentioned by an hon. Member, that of a boy of 14, who could be dealt with under this Bill but cannot be dealt with under the existing Act. The Bill is a marked improvement, a definite step in advance. It will allow certain other cases to come in that otherwise would not have done so and it will be for their benefit. The hon. Gentleman thought the liberty of the individual must take precedence over the comfort of the surrounding people. That may be so within limits, but we have to remember that the community also has certain rights. There is no reason why members of the community should have to suffer inconvenience or harm or danger or offence due to the action of some poor 2384 person or child who is mentally deficient. The community have a legal, a natural and a moral right to protect themselves.
§ Dr. DAVIES
To a certain extent. At least I think so. The right hon. Gentleman was, as many other Members were, rather down on what were called "experts." I have to make again a protest, which I have frequently made in this House, that the medical men of the country are sometimes criticised by the party above the Gangway in perhaps not too kindly a manner. We know that all experts in all departments of life are unduly criticised, but one has to bear in mind that experts have a certain amount of knowledge and, presumably, a greater amount of knowledge than their critics. However wrong they may be, we ought to give them the credit of doing the best to the extent of their knowledge. If their knowledge is more than yours you should be inclined to accept their verdict. For instance, I would not presume to judge a horse because I am not a veterinary surgeon. I would be prepared to take the value of the horse or an opinion as to what was wrong with it from the veterinary surgeon, the man who was trained to that job. The same thing applies to furniture. I should not be prepared to value or say what should be done with a certain article because I am not expert in that department. I should refer to an expert and take his opinion.
Medical men, who have been trained for a certain number of years, have a certain amount of knowledge, and their knowledge is superior to that of a layman. It is only fair that a certain amount of attention should be paid to them. Whether you believe them or not, the essential thing to understand is that the medical men are doing the best for the patient to the best of their ability. It is not their wish or desire to incarcerate anybody who has queer ideas or queer whims, otherwise there might be a lot of us in danger. The point is that these men have a certain kind of knowledge, and as they go through the whole process, which I have described and which makes it so difficult to get these cases in, the House may well come to the decision that this is for the benefit of the patient. That is the essential point in every case.
2385 As has been mentioned by the hon. Member, this Bill is not only supported by the Board of Control, the Ministry of Health, and the medical men as a whole, it has got the support of every organisation which is concerned with looking after these cases. There are kind and motherly women who see the good these Committees are doing, who have a definite and human interest in these children and in their development, and they unanimously support this Bill, as they supported the last one, because they say that they are certain that what is being done is for the benefit of the child. These Committees are practically composed of lay people who are not medical men. That must weigh very considerably with the House.
The hon. Member for Westhoughton (Mr. Rhys Davies), while he did not oppose the Bill, complained of the action of backward local authorities. That is a point which I have no doubt the Minister of Health will look into, because I know that the right hon. Gentleman is extremely anxious that this or a similar Bill should be passed and one can rest assured that he will do his best to see that it is worked efficiently and without undue extravagance. The hon. Member for East Woolwich (Mr. Snell) said that there was no definite line between the deficient and the efficient. I think that that view is quite wrong. There is an essential difference between mental deficiency and lunacy. I think the hon. Member did not quite grasp that essential difference. He said that it was horrible to be controlled, and several hon. Members have objected to putting children into an institution, and pictured one of them as saying, "Here I am, under lock and key. I am not allowed freedom like any other child." But it does not take them in that way. It may happen in the case of a mental hospital, where you have a lunatic suffering from mental disorder, with sound intervals. Such people may recognise that they are incarcerated and may wish to get away. But it is not the same with these children. They cannot compare as sane children can. They are all together, one happy family, and it is rather an excess of feeling to imagine that such children feel that they are under restraint and are unhappy. I have found that such children, when allowed to go home for a week or a 2386 fortnight, have always been delighted to get back to the institution, to their school and games and playmates.
I was sorry that one hon. Member tried to draw a distinction between the treatment accorded to the children of the rich and that accorded to the children of the poor. He stated that he did not wish to bring in class differences or class thought, but his point was that the rich people could afford to have their people looked after at home or in private institutions, while poor people have had to look after them at home. Poor people can apply to have their children sent to an institution, if necessary, and they know that everything that can be done will be done for the best, and that a child will be perfectly happy, and that we, recognising our responsibility to the State, are determined to do all in our power to uplift and benefit these poor children who, through no fault of their own, are in this very unnatural position. The hon. Member asked a specific question which I would like to answer. It was, Are the medical men who are called in duly qualified to give an opinion on these cases? The special case was this—that a child, a mentally defective, may be sent from a home or institution to some part of the country under supervision. At the end of 12 months, or whatever the period may be, this patient has to be re-examined by a medical man and the question has been asked, "Is that medical man competent to do so?" I say, "Yes, certainly." This medical man has not to decide whether or not the patient is mentally defective, or is to come under the Act. The patient is already under the Act and the sole intention is to avoid the necessity for taking the patient perhaps from some place in the country back to the home to be examined.
§ Major CRAWFURD
My point is that when the child was originally certified, it was probably at the instigation of a doctor who had known the child as a patient. In the new circumstances, a doctor who has never known the child may be called in to give an opinion. My question is whether the ordinary medical practitioner, meeting a new patient of that kind, is qualified to give a decision?
§ Dr. DAVIES
I think the hon. and gallant Member is confusing the original medical examination for certification and the repeat examination which 2387 takes place after 12 months. The first examination is a complicated affair which is conducted by two medical men who have been approved by the Board. In regard to the second examination a local medical man is perfectly competent to decide whether the child should continue under control or should be allowed to go free. In addition to that you have the visitors under the Board of Control to ensure that everything is properly carried out.
§ Lieut.-Colonel FREMANTLE
The House will permit me to make two points which still require to be made, although I do not wish to delay any further the passage of a Measure which is so much needed. I am strongly in sympathy with those who have spoken on the question of the liberty of the individual. The right hon. and gallant Gentleman the Member for Newcastle-under-Lyme (Colonel Wedgwood) touched on what is one of the most difficult points which medical men have to decide and that is the question of where it becomes essential to, interfere with the liberty of the child, either for the sake of that child or the sake of the community. Medical men are the last to say at any moment that they are right in any decision, or that they can lay down a hard and fast law. It is true, as said by the hon. Member for South Leeds (Mr. Charleton), that we medical men are empirics. In the last resort we must be. We have information which is a little wider and deeper than the information of other people but at the last moment we have to decide upon experience as to whether in a particular case it is necessary or right or justifiable to introduce restrictions. I suggest to the right hon. and gallant Gentleman the Member for Newcastle-under-Lyme that he has carried his argument quite far enough. There is, in the first place, the fact that mental defectives can be shielded and at the same time can enjoy great liberty. Very often these restrictions result in greater individual liberty than they would otherwise have. Those who have expressed the fear that individuals are retained in these homes against their will should be glad to know that experience in those places frequently shows the reverse to be the ease. The individual very often wants to stay when the officers of the institu- 2388 tion suggest that he is in a position to go home. Frequently the individual has become so used to a protective institution that he desires to remain.
A definite and constructive suggestion was made by the hon. Member for South Leeds to the effect that we should have an intermediate institution where a patient could be kept for five days of the week and allowed home at weekends. That system already exists in a number of institutions. The heads of those institutions can give a patient an exeat for 48 hours in a case which is suitable, and, in all cases, parents may visit their children every Sunday and if suitable take them for little outings. There is one other point which I should like to make. It is clear that where there are 55,000 mentally defectives, r number which may be much enlarged with a higher standard, or, as some people would say, a lower standard, of definition, there is accommodation for only 5,000 in mental institutions. On the other hand, we see that a very large number of institutions under the guardians are being set free by the legislative Measures of recent times, like the Widows' and Orphans' Pensions Act, and so on.
I would only say this, in conclusion, that this Bill gives adequate importance to the need of putting under one local authority or one local system of authorities, the Poor Law institutions and the other institutions, in order that there may be free play for the local authorities, whether institutions which would be suitable in the past for Poor Law patients or in the future for mental patients, that they shall have one authority which may be able to make the most use of the existing accommodation. These are points which, I think, will eventually have other values, and as regards the question of age and other points which have been raised, they are Committee points, which we shall have to consider very seriously upstairs. In the interests of the mentally defectives themselves, of their families, of the public, and of the future generation, I hope this Measure may be passed into law.
§ Mr. R. MORRISON
I do not think it would be right if this Bill left the House, even after the authoritative declarations of two medical Members, without a mere layman saying a word It seems to 2389 me that this Debate has tended to get out of proportion, that the Bill has been magnified altogether out of proportion. It is not so much a matter for experts laying down their opinions, as it is a matter for the exercise of common sense in regard to the ordinary people of the community. I think the Bill, which I support, is only a very small matter, and, at the same time, I think that its success or failure will depend almost entirely upon its administration rather than upon the additional powers that it gives. If the administration of the Measure is bad, it may mean what is commonly called locking up people, which I think is a wretched expression to use in regard to the abnormal people of the community, but that is only a question of the method of administration. Some hon. Members, and certainly the President of the Board of Education, know that I have been worrying him recently to get the figures of the numbers of mentally defective children who are in special schools, who are in ordinary schools, and who are not being educated at all. I will not worry the House with the figures which the right hon. Gentleman has given me—they are on record—but, broadly, there are thousands of mentally defective children in this country who are attending ordinary schools but who ought not to be attending ordinary schools.
If the present law, without any new legislation, were administered properly and efficiently, these children would not be in the ordinary schools, but the local authorities would be compelled to carry out their duties, and provide some special education for them. The probability is that this Bill, when it goes through this House, may be largely winked at by the local authorities. I do not think they will administer it as they ought to do, any more than other legislation dealing with mentally defectives in this country has been properly administered. I might add that if this Bill, when it becomes law, is administered as I think it ought to be, it will mean, not locking up, but education, and training, and care for these children. There is a horrible word, the word "institutions," which is frequently used in this connection, and I think the sooner we get this idea out of our heads, that the only way to deal with the abnormal people in the community is to lock them up in institutions, the 2390 better it will be. I prefer to look forward to the time when a Measure like this will be administered by the local authorities and by the other people responsible, in a much more sympathetic spirit, not in the spirit of locking people up to protect the community from them, but from the point of view of putting them into colonies, where they can become very largely self-supporting, as has been proved over and over again, and where they can be happy and live much more satisfactory lives than they could do outside.
An hon. Member opposite raised the question of the cost. It is one of the curses of this sort of legislation that there are always some petty-minded people who want to know exactly how much it will cost in pounds, shillings and pence, and do not pay the slightest attention to the appalling cost to which the community is being put to-day by allowing people to roam about at large when they are not fit to be at large. There are to-day a number of children who, if some legislation be not passed by which they can be cared for—not locked up, but put into colonies and helped to earn their own living—will be in and out of prison and the workhouse, and on parish relief, all their lives, at an appalling cost to the community, far out of proportion to any cost this Measure might entail, even if it were administered in a form in which, I am afraid, it will not be administered. The hon. and gallant Member opposite put up the extraordinary proposition that the best way to make sure of not spending a penny more than was necessary was to begin with the worst cases and never mind the others. Even from his own narrow point of view, from the point of view of getting value for money, you cannot neglect the less bad cases, the cases which are educable, the cases which are likely to produce results.
An hon. Friend behind me referred to the fact that, unfortunately, in a Debate like this, people made speeches who had no experience of this sort of subject. I am not a medical man, nor do I pretend to have any great knowledge, but before coming to this House I spent a good many years in teaching mentally defective children, and I have seen the wonderful results achieved in the special schools of this country. I have seen children 2391 come in who could not, as one hon. Member said, tell how many two and two were, boys of fourteen who could not tell the time, and I have seen the wonderful results from the different methods applied to their education. In the same way that a blind person's hearing is usually much more acute than that of a person who is not blind, so there are nearly always in the case of these mentally defective people some senses much more acute than those of ordinary people, and the business of the special school teacher who has been trained to deal with these children is to find out the particular bent of these children so that they can be developed and be useful to the community.
As I have said, I have no intention of delaying the passage of this Measure, but I want to emphasise the only point I really rose to make, that it is not so much a question of fresh legislation, as a ease of administration. There are today thousands of mentally defective children, who come under the legislation we have on the Statute Book, and yet are not being provided for. No one is taking any notice of them. Not only children, but grown-up mental defectives roam at large. The right hon. and learned Gentleman who, I think, is going to follow me, could tell the House if he liked of the struggle that has been going on on the part of one of the most important county councils during the last five or six years to get the Board of Control to give permission to the Middlesex County Council to provide accommodation for the mentally defective children in the county, but up to now without success. The result is that in a county like Middlesex the mental defectives are scattered in 60 or 70 institutions all over the country, hundreds of miles away from their home and friends, and putting their friends to tremendous inconvenience.
I hope one result of this Debate will be to arouse public attention to the pathetic and unhappy plight of these mentally defective people, and that, it may also result in a tightening-up of the administration of the legislation already on the Statute Book. I hope we may have that sympathetic administration under which the mentally-defective will not be looked upon as confounded 2392 nuisances who ought to be locked up in institutions, but as pitiful products of our present generation who need care and sympathy and who, under proper treatment, can, in a very large percentage of cases, be made able to earn their own living and live quite happily. They may have to put up with deprivation of their freedom, in the interests of the rest of the community, but that is no reason why we should not concentrate on enabling them to earn their own living in colonies, not institutions, thus helping to make their lives a little more happy.
§ Sir HERBERT NIELD
I am going to resist the temptation which the last speaker put upon me to enlarge upon my own experiences in connection with administration of the existing legislation in the County of Middlesex. As a magistrate, I wish to speak on one aspect of the legislation which will recommend itself to the right hon. and gallant Gentleman the Member for Newcastle-under-Lyme (Colonel Wedgwood). We who have to administer the criminal law at Sessions very often find ourselves up against the case of a person who is on the border line, and we come across these difficult words, which it is proposed to repeal by Section 1 of this Billfrom birth or from early age.I, myself, in the last six weeks, had a man before me who was found guilty of an offence in circumstances which made it appear as though he must necessarily have been out of his mind to have committed it. I made a special recommendation that in the interval before sentence was passed the prison doctor should examine him as to his mental condition, and the report was that the man was upon the border line, but that as the law stood he could not be certified. Had it been possible to certify that man he would have been dealt with in a totally different way. He would have bad modified treatment—been treated more as a defective than as a prisoner. This Bill would help in a case like that to ensure a prisoner receiving proper care instead of the ordinary punishment. As it was, I was able to deal with him, but in the ordinary case such a prisoner would have had to go for hard labour or to imprisonment without hard labour, under circumstances which would tend to aggravate rather than mend his condition. I wish to say this in order to show that the Bill 2393 can really cure a difficulty which exists at the present time, and I hope it may go through.
§ Question, "That the word 'now' stand part of the Question," put, and agreed to.
§ Bill read a Second time, and committed to a Standing Committee.