HL Deb 20 November 1918 vol 32 cc295-304

LORD SYDENHAM rose to ask His Majesty's Government what steps are being taken to prevent the spread of venereal disease during and after demobilisation.

The noble Lord said: My Lords, always after a war there has been a great spread of venereal disease. That happened after the Boer War, and we have accurate statistics as to what happened in the case of men belonging to the Navy and the Army. But no statistics can be obtained as to the effect upon the civil population, and it must be that some of these effects arising from the years of that war are lasting even to this day. At the present time there are conditions among the population far more favourable to a spread of venereal disease than in those days. I have had some special opportunities of studying these conditions, and I want earnestly to warn the Government that, if strong measures of precaution are not taken, and taken quickly, there will be most serious results upon the whole of our population extending over many years to come. There has been much necessary legislation which has not been taken, or which has been too long delayed. Practically I think it may be said that we have done nothing except to pass the Bill dealing with quacks and quack remedies. That Bill has done good; but as it is nobody's business to prosecute the quack, I do not think that the good has been as much as one had a right to expect. It is certain that in some places quacks and quack medicines are still prevailing.

The Local Government Board have taken some wise and excellent steps in establishing free treatment centres in various parts of the country, but many more of these clinics will be needed when demobilisation takes place—and the time is running very short. The Criminal Law (Amendment) Bill has been held up, and I assume that the Joint Select Committee will be discharged. I hope that the work which this Committee has already accomplished will not be wholly thrown away. That Bill passed through Grand Committee in the other House, and I have never been able to understand why the Government did not proceed with it. One of its provisions is most urgently needed, and I pressed that it should be taken in a separate short Bill by itself and passed quickly. Clause 5, which is the one to which I refer, make it a crime knowingly to communicate venereal disease. I think it would be a disgrace to our humanity if that crime is not recognised within a short time. The offence may be, and often is, much worse than murder; because it may wreck not only one life but many young lives of the unborn generations. If that shocking crime is made penal, then I am certain that a strong moral revulsion would be created against it, and I believe that public opinion is pre- pared to support the passing of that clause. Regulation 40D, I believe, will be shortly abolished. It was open to a great many objections, and I do not think it has done real good of any kind; but the withdrawal of that Regulation leaves us without any protection against wilful and knowing spreading of disease. Another important clause in the Criminal Law Amendment Bill seeks to save young girls who may be infected from the degradation of prison, and to give them the means of being kindly treated and cured, and so to make a fresh start in life instead of remaining a danger to themselves and to others.

My Council has prepared a set of recommendations which it is going to send to all the Departments concerned, and I hope that these recommendations, which have been carefully considered, will be also carefully considered by the Departments and that something may come out of them. One of the most important of the recommendations is that no soldiers or sailors shall be discharged while they are in an infective state. The percentage of infection in the enormous Forces of to-day is very small; but I am sorry to say that the total number of infected and infective men is very formidable, and the danger when they are spread about the country is therefore obvious if this precaution is not taken. Another recommendation is to strengthen considerably the medical profession for dealing with the civil population. There are several others with which I will not trouble the House at the present time. I will only say this, that our present line of defence against the spread of venereal disease is not sufficient, and that it ought to be very quickly and very materially strengthened. The other day the Prime Minister laid great stress upon the vital necessity of raising the standard of health in this country. I hope he realises that the conditions which he deplores are largely due to the ravages of venereal disease; because that is the most insidious enemy to national vigour, and also a cause of immense economic loss. We now have a very large amount of medical knowledge which is constantly increasing. If that knowledge is wisely and quickly applied then it may save us from what might easily become a national disaster; and that is my excuse for bringing forward this Question in the last hours of this Parliament.

Much can be done by administrative Order before Parliament reassembles; but when the new Parliament is assembled it imperative that certain legislation should be taken without the least delay, and I am convinced that the working classes generally are now alive to the danger and will support such legislation as I think is required. I do not press the noble Viscount for any detailed answer to my Question, but I press him to give an undertaking, which the country will understand, that the Government intend to grapple with the peril which will arise on demobilisation, and that they are determined to act promptly and fearlessly to safeguard unborn generations. If such action is not taken, then without a doubt harm will be done which cannot be remedied for many long years, and a deadly blow may be struck to the national health and to the vigour of our people which will tell in the years when both will be the supreme need. I beg to ask the Question standing in my name.


My Lords, I do not think there was anything in the speech of my noble friend to cause any reflection on the Joint Committee, of which I happened to be chairman, which dealt with the two Bills that were brought forward in the spring in this House. The Joint Committee was not actually constituted until the very last day of the sitting in the summer. They commenced their sittings on the very first day that Parliament resumed, and sat until the day before yesterday, two days a week all day, so that I think there is no doubt that the Joint Committee did their best to get through the task which was set before them.

A great deal of most valuable evidence was brought before the Committee, and I do not think there was any difference of tone amongst the witnesses, varied as their views were. There was no difference of opinion upon one point, and that was that this was a very grave and serious matter, and ought to be dealt with soon and with a definite hand. The witnesses were in very sharp conflict over the remedies which they recommended, and probably the danger of the case is rather that of a deadlock. I think it might be open to a cynic who was always a champion of the doctrine of the equality of the sexes to say, after hearing the evidence before that Committee, that the two sexes were in irreconcilable divergence. My own opinion, if I may mention it, is that strong and prompt measures are required. It is no use talking to people as to how dangerous it is to play with fire when the house is actually burning.

It is very unfortunate, I think, that Parliament, by dissolution, has extinguished the Joint Committee. It is impossible not to refer to the disastrously long interval that was allowed to elapse between the time when your Lordships resolved to send the two Bills to a Joint Committee and the time when the House of Commons were asked to concur in that proposal. Ten weeks were lost at that time, and I think there was a strong feeling on the Joint Committee that had the Committee been appointed at the beginning of those ten weeks instead of at the end of them, they would have been able to finish their labours, and that there would still have been time for some Bill to be brought in fouuded upon such recommendations as they might make. I do hope that the Government will not let these labours be thrown away, and that the next Parliament will take up the subject in the light of the consideration which has already been expended upon it. I do not think I should be disowned by any of my late colleagues if I were to say that they would be ready to give their services again if called upon. What is required urgently is to get rid of a thing which is both a scourge and a disgrace.


My Lords, my noble friend Lord Sydenham, who has raised this question speaks upon it with great authority and experience, and he has already brought it on more than one occasion before your Lordships' House. My noble friend referred to the fate of the Criminal Law Amendment Bill, and regretted that it did not take its place upon the Statute Book. I understand that this was mainly due to those Parliamentary difficulties which arise in a crowded session. There were a great many Amendments on the Paper, and in the circumstances it was not possible to press the Bill at that time. My noble friend is aware—in fact, he spoke of it with some sympathy and approval; approval, I think, not always shown in this House to the work of the Local Government Board—of the action of that particular Department. And I think he is aware that in judging of the action of that Department in the future on demobilisation it is only fair to judge what it may do by the serious attention which it has paid to this matter in the past.

I do not know whether my noble friend is aware, though he probably is, that an arrangement was made so long ago as April last between the medical officers of the Local Government Board and the Army Council that soldiers who were about to be discharged on account of venereal disease, or for any other reason, should be examined to ascertain whether they were at the time of discharge suffering from active disease, and that the cases found to be suffering from venereal disease should be retained in military hospitals until all signs of active disease had ceased. My noble friend well knows that an arrangement in that form was only possible during the continuance of the war, and that a fresh situation may arise on demobilisation. But I should like to express to him very strongly that the Local Government Board is fully aware of those dangers which may arise from the release of infected men on the population, and at the present moment I understand that discussions, which I hope will eventuate early in a definite arangement, are taking place with the War Office, and that everything will be done that can be done. The noble Lord knows that there are certain difficulties under the Military Service Acts to see that these men are not let loose on the civilian population.

There is one other point on which my noble friend may be interested if I refer to it. It is the arrangement made in this country with reference to dealing with disease. I need not, I think, go into the methods of notification and so on, with which my noble friend is quite familiar. He spoke also with approval of the clinic system which had been set up under the auspices of the Local Government Board, and deplored the fact, I think, that this system had not been sufficiently widely established. He may be interested to learn that as regards the treatment of venereal disease after demobilisation, some 130 treatment centres for these diseases have already been established in England and Wales. My noble friend suggests, I think, that this number is not enough. but I am sure he will make allowance, with his wide knowledge of the situation, for the fact that the shortage of medical staff and other difficulties created by the war have really made it impossible to develop the work of these centres to the extent which is ultimately desirable. The same difficulties have made it impossible to set up any of these clinics and treatment centres in the areas of the smaller authorities.

The Local Government Board have made an arrangement, and are at present carrying it out—it is being carried out with the Ministry of National Service—for the early release of naval surgeons and Army doctors who have specialised in the treatment of venereal disease, and it is intended to press upon the local authorities and the hospitals the necessity for establishing further treatment centres and for arranging further clinics, especially in the evenings, at the existing centres. It is also intended to urge provision for facilities for irrigation for gonorrhea, either at the treatment centre itself or in special auxiliary centres, at intervals between the regular clinics whether at the treatment centre itself or in special auxiliary centres, so that I think it is true to say that the Local Government Board have done all they could in this matter, subject to the very severe limitation put upon their activities by the shortage of doctors and so on. With demobilisation and the gradual return of doctors and surgeons more clinics will be set up, and the system of treatment largely extended. I hope my noble friend will forgive me for not giving a more fully detailed answer to the Question at this moment, but I think I can give him, anyhow, a general assurance that the whole matter is being not only examined into but dealt with. The very grave situation that may arise from the demobilisation of these men to whom he has referred, has very seriously engaged the attention of the Local Government Board, and the dangers and difficulties are fully realised by that Board.


My Lords, I cannot help feeling that I should have liked something a little more definitely assured in the reply of the Government to the Question asked and to the action taken by my noble friend Lord Sydenham. The whole of this subject has been, from a variety of reasons, bandied backwards and forwards between different authorities, civil and military, medical and lay, in a way that, has really resulted in confusing the public mind, and inflaming the alarmist feelings which, not without foundation, were current; and the very fact that the matter is obviously a disagreeable one for public discussion has added to the difficulties which already surrounded it and which could, I think, only have been met if the matter had been quietly but quite firmly taken in hand by His Majesty's Government with the military and civil authorities acting together, and if definite proposals had been made and persevered with.

There have been several proposals made that have been successively tinkered with and dropped, and as the matter now stands it is in a condition of confusion. The noble Viscount Lord Peel says that the delay in dealing with it and in bringing forward a Bill was due to Parliamentary difficulties. I am inclined to think it was due to other things than Parliamentary difficulties—to the lack of a determined dealing with the effusive utterances, quite wholesome on either side but widely differing, which men and women were putting forward, followed by responsible action, on the part of the Government. What Lord Muir Mackensie has called a "disastrously long time" was allowed to elapse between the original discussions on the subject and the introduction of a Bill and the appointment of a Joint Committee. It is absolutely certain that strong and prompt measures are required for dealing with the difficulty which is going to grow far graver than we have yet known it to be in the period of demobilisation which is coming.

After a discussion which took place in this House upon my initiative a good many months ago, it was promised that there should be conferences held at the War Office between those who were responsible as Military authorities, those who were responsible as medical authorities, and those who were dealing with the matter on its social side philanthropically, religiously and in other ways, which would bring to a point the various proposals which had been made and which we were led to hope would eventuate in specific proposals for action through the Home Office or the Local Government Board. Two such conferences were held. I attended both of them. It was done with the best intentions, but nothing less effective than these conferences proved to be, either in performance or result, can I remember in my experience. Now we are at this moment in the position of further indefinite delay. The Joint Committee over which Lord Muir Mackenzie presided has, he tells us, taken a great deal of evidence, and I greatly hope that the evidence may be published because I think it would be of very real use to those on either side who have been apt to exaggerate the matter from their own point of view and who would be steadied by the publication of such evidence. Whether that is going to be done or not I do not know.

Equally strongly should I urge that, at the earliest possible moment, that Committee should be re-appointed to resume the work at the stage which they had reached, for if this is allowed to drift on while the early months of next, year see England covered with men returning from the front in circumstances which are certainly not likely to be conducive to the strictest manner of life and the sternest self-restraint, I should feel that we may fear even worse things than we have yet had to experience. There is a constant danger, when people hear statistics quoted in this matter, that those who quote them or read them forget what an enormous number of people we are dealing with, and that a number which looks very large is not large at all if you take it as a percentage.

I have seen references made to figures about the extent of disease in the Army or Navy or civil life at the present time, which are entirely misleading unless they be turned into percentages and are not taken as positive statements alone. They look appalling until compared with the enormous numbers of the men to whom these statistics apply. All that kind of difficulty, of fallacious or misleading argument, is fostered at present by the confusion in which the whole matter is allowed to rest. The noble Lord referred to that strange Regulation 40D about which so much was heard. I entirely agree with what he said about it—that it has not worked well. Presumably—from what he tells us I gather—it is going to perish with other temporary Regulations which come to an end with the return of peace. I do not regret that it should perish, provided it is superseded by or gathered into something firmer, larger, and more definite and far-reaching, which would be obtained in the kind of Bill which I hope will be the result of the discussions of the Joint Committee.

But it will be a disaster indeed if the Joint Committee is not quickly re-appointed when Parliament meets again, if it does not conclude its business shortly, and if that does not eventuate very quickly indeed in definite legislation. We do want this matter to be firmly dealt with, and I do not believe that firm dealing with it is the least impossible. I do not think it is the least impracticable to bring into line even those who seem at present widely divergent, provided a somewhat different course is followed from the vacillating and drifting way in which, as it seems to me, it has been handled hitherto. I am very grateful to Lord Sydenham for having brought the matter before the House, and I am quite certain we must, all of us who are interested in the morals and in the health of the community, see to it that, the matter is pressed forward at the earliest possible moment when Parliament reassembles.


My Lords, I beg to thank the noble Viscount for his reply. I accept his assurance that the Government is in earnest and will do everything that is possible for this important object. I know, and he knows, that it is difficult to deal with the discharged men, and that it is quite different during the war when men are merely discharged from hospital. That difficulty must be got over, or we shall have centres of infection established all over the country. He said, perfectly truly, that it has been difficult to establish clinics for the want of doctors, but doctors are now being released, and more could be relieved, from the Front. I hope, therefore, these fresh clinics will be able to find staffs to work them, but the most important thing of all is that there should be the fullest co-operation between the Local Government Board and the Naval and Military authorities.