Venereal Disease (Compulsory Treatment)

Emergency Powers (Defence) – in the House of Commons on 15th December 1942.

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Photo of Dr Edith Summerskill Dr Edith Summerskill , Fulham West

I beg to move, That an humble Address be presented to His Majesty, praying that the Order in Council dated 5th November, 1942, made under the Emergency Powers (Defence) Acts, 1939 to 1940, amending Regulations 27A, 47AA and 91 of, and the Third Schedule to, and adding Regulations 33B and 47AAA to, the Defence (General) Regulations, 1939, a copy of which was presented to this House on 11th November, be annulled. In rising to move this Prayer, I would make it clear that I am against the proposed Regulation because I am convinced that it will be quite ineffective and that, by introducing it, the Minister of Health is toying with an important problem which we have in our midst and which is a menace to the public health of the country. This House should face the facts boldly. Many who are here may vote against the Prayer because they sincerely believe that, by supporting Regulation 33B, they are at least doing something in the right direction. Before hon. Members retire for a meal I want to ask them to bear in mind that if they support the Regulation as it stands and do not support the Prayer, they will simply be delaying real action. I want hon. Members to realise the importance of this matter. The Regulation which the Ministry of Health have tabled will fail. I prophesy that it will fail, but, during the time when we are waiting for the proof of the failure, what is to happen in this country? When I tell hop. Members the facts they may realise how serious it will be if we wait any longer to deal with this menace.

Here are the facts. During the last year, 70,000 new cases of venereal disease have applied to our civilian clinics for treatment. There must still be thousands who are not obtaining treatment or who have not been traced. Let us add to the 70,000 those who have not been traced—thousands. The number of new cases of venereal disease may be 150,000 in all. We must add to that figure members of the Forces, since the 70,000 include only those who are receiving treatment in civilian clinics. We have, in fact, gone back in our figures to 1932. In a year or two we might go back to 1928, when we traced 16,000 expectant mothers who were infected, which meant that those women would transmit their disease to their unborn children: Perhaps it is unfortunate that the symptoms of venereal disease are not more spectacular. The blind babies born in this country are mostly sent to institutions. The symptoms are generally known only to the sufferers, who do not evoke the same sympathy as people who, shall we say, have suffered from air raids in this war, yet the effect of venereal disease upon the community is more disastrous than the injury inflicted by thousands of Nazi aeroplanes.

If the Government came to the House and said, "In defending our country and our men in the Services against the Nazis we can give you only second-or third-rate measures" the House would be incensed. Hon. Members would say, "We must have first-rate measures to defend our men from the Nazis." If hon. Members accept the Regulation, they will not protect the men and the country from venereal disease, but will meekly accept a third-rate measure which will not give protection against those insidious enemies, syphilis and gonorrhœa, which are more devastating to the health and happiness of the country than Hitler's bombs. Therefore I ask hon. Members to face the question, to realise that the casualties during the last year from venereal disease were far greater than the casualties of the Blitz, and to say, "Let us have only measures which can be regarded as effective and efficient."

What are we to do about it? What is the miserable little measure that has been introduced? Regulation 33B will provide for the treatment of individuals who have infected two others. Nothing more. Let us suppose a patient goes to a doctor and informs upon an individual as a contact; nothing will be done. If a second patient goes to the doctor and informs against the same individual, action will be taken. How would that have affected the 16,000 expectant mothers in 1928? It would not have availed them in any way. No two men will inform upon a respectable woman who has been infected innocently. This Regulation will get only a few people, probably only prostitutes, and a few other unfortunate women. The vast number of victims who are infected are left—ignored. I suggest that the Minister of Health has approached this problem like a Victorian spinster reared in a country parsonage and sheltered from the facts of life.

Photo of Mr William Gallacher Mr William Gallacher , Fife Western

It is a very good description.

Photo of Dr Edith Summerskill Dr Edith Summerskill , Fulham West

The Regulation reflects his timid, fearful attitude to the question. He is a preacher, yet surely he does not believe that the sins of the fathers should be visited upon the children. If he does not believe that, why does he not put his precepts into practice and introduce a Regulation which will protect innocent children? This problem calls for a bold and courageous lead from the Minister of Health. Why are we getting Regulation 33B aimed at a few prostitutes? What else is there? Hon. Members are asked to help the Minister in their constituencies, but about a fortnight ago I asked the Minister whether he had made any public pro nouncement on the subject and found that he had not made one—which position he admitted. In the last fortnight he has, perhaps, made up for it, having decided it was necessary to preach preventive medicine.

I ask hon. Members to realise that this serious menace to our health is not being approached in a bold and frank manner. We shall probably be told that we need more propaganda. What propaganda have we had so far? What have our efforts been in the past? Let me tell hon. Members the results of the analysis made of the number attending the film shows organised by the British Social Hygiene Council between 1030 and 1940. It was proved that only six persons out of 1,000 could have attended one film show in 10 years. That is the result of intensive propaganda. Hon. Members must not go away thinking that this proposal, will solve the problem. I suggest that the time and money spent on propaganda could be more usefully directed if notification and treatment of these diseases were made? compulsory. It is going to be suggested that many eminent members of the medical profession are not in favour of compulsion. I would like to ask the Minister of Health whether he consulted Lord Horder, the President of the Society for the Prevention of Venereal Diseases. Lord Horder is 100 per cent. in favour of compulsion. I believe he was never consulted. As the Minister and some Members of the House know, a Commission was sent by the Government to the Scandinavian countries in 1937 to inquire into the operation of compulsory measures there. At that time it appeared that in this country the incidence of venereal disease was slackening, and it was decided not to take action. But the findings of that Commission have been challenged. I wish to draw the attention of the House to a speech which was made by Dr. Laird at a meeting of the Medical Society for the Study of Venereal Diseases this year. This Society is composed of men who specialise in this subject and others who are particularly interested in it. Dr. Laird said that as a result of compulsory notification in Sweden the defaulter rate in 1935 was only 2.5 per cent., but in this country, where we have not compulsory notification, 82.5 per cent. defaulted. Of course, the House will realise that there is no advantage in persuading people to have treatment if they are to default.

Photo of Dr Edith Summerskill Dr Edith Summerskill , Fulham West

We can only quote figures given by responsible persons. These figures were in the editorial of the "British Medical Journal" three weeks ago, and the case was put for compulsory notification. I think it will be agreed that the "British Medical Journal" is recognised as the official organ of the British Medical Association, which, I suppose, represents most of the organised doctors in this country. The editor would not allow figures of that kind to be published unless they were authentic, and I would not think of quoting any figures unless I was sure that they were authentic. [Interruption.] An hon. Member asks me to explain "defaulter." I hope it is clear that a defaulter is a person who does not continue treatment, and is a danger to the community, who goes away and can infect other people. This proves that those who try to tell us that the results of compulsory treatment and of voluntary treatment are the same have really no case, if the figures are carefully examined. The Medical Society for the Study of Venereal Diseases passed a resolution asking for further powers, legislative and administrative, in order to deal with the sources of infection, contacts and defaulters.

I hope I have proved to the House that there is a good deal of very responsible medical support for compulsory notification. What are the arguments against? First of all, the argument is advanced that compulsory notification would not be in accordance with the idea of the liberty of the subject. That argument amazes me, because for years we have notified a whole range of diseases. That being so, why, at this stage, do people object to notification on that curious ground? The second argument against is that if we had compulsory notification, the way might be opened to blackmail. I think it is possible to introduce safeguards. Thirdly, that it is not easy to apply in a densely populated country. I realise that it is possible to evade notification, but let us at least try in a densely populated country before we say that it will not be effective. A further reason given is that if we have compulsory notification it will drive venereal disease underground. Can it be more underground than it is now; can we drive it further underground? I, for one, think that if this matter is ventilated, if it is made notifiable and discussed in a healthy, frank way, that in itself will bring it to the surface. The sort of thing that drives, it underground is when we support little Regulations like 33B and when we have a Minister who refuses to be bold or to make any public pronouncement on the subject.

What are my recommendations? My recommendations are the same as those of many other people. First of all, let us deal with clinics. Let us have clinics which are accessible. Do not let people who are working in a munitions factory feel that they cannot go to a clinic because if they do they will lose time and money. Let us have a social service or clinic which will follow up the contacts. Let us have also a 100 per cent. grant from the Government. At the present time I think the Government are giving a 75 per cent. grant. Be generous—it is worth it—and give us a 100 per cent. grant.

Photo of Dr Leslie Haden-Guest Dr Leslie Haden-Guest , Islington North

How many clinics should we have?

Photo of Dr Edith Summerskill Dr Edith Summerskill , Fulham West

That is rather an absurd thing to ask in view of the fact that in Sweden they have one clinic to every 20,000 of the population. I think we might have the same here. Also, from what I have said it is apparent that there are thousands of respectable women suffering from this disease who have probably been infected by their husbands. To have a clinic labelled "Venereal Disease" or "Venereal Clinic" is quite sufficient to prevent people from going there. Do not let us label it.

Photo of Dr Edith Summerskill Dr Edith Summerskill , Fulham West

There is not a label on the door, but I can tell the hon. Member—I do not wish to give details in the. House—of a place I know very well in connection with which every housewife in the neighbourhood knows why women go there. What I would like to have is a clinic where all women's complaints are treated, so that when a woman goes there nobody will be able to say, "We know where you go." Another thing which I feel is essential as a war-time provision only is to have a blood test for all expectant mothers. I think that could easily be introduced. I think we can profit by the experience of Sweden. There, every person with venereal disease must submit to treatment. The treatment is continued until the patient is declared to be non-infectious. There is a clinic for every 20,000 of the population. Immediately a patient reports to the doctor and his disease is diagnosed, the doctor then reports to the medical officer of health. That is a very important point, I think. A patient who exposes another person to the risk of infection is liable to imprisonment or a fine. If infection occurs, there are even more severe penalties. Another Regulation is that each party to a marriage must present a written declaration that he or she is free from venereal disease. If the patient ceases attendance at a clinic—I wish the Minister would not shake his head; he has to try these things first to see whether they are effective.

Photo of Dr Edith Summerskill Dr Edith Summerskill , Fulham West

It is my suggestion that if the Minister keeps his head still, he will absorb these recommendations much better. If a patient ceases attendance at the clinic, an order will be served on him, and if this order is ignored, he must have compulsory examination and treatment at the hospital. I think the House will agree that this would be a comprehensive scheme. It would bring home to every patient suffering from venereal disease that it was essential that he should have treatment.

That is all I have to say on the curative aspect. I want to ask the Minister whether any action has been taken as a result of the recommendations of the last official inquiry on the subject of venereal disease, which was undertaken by a Parliamentary Committee, under the chairmanship of Lord Trevethin, late Lord Chief Justice, in 1923? These recommendations dealt with the prevention of the disease. They suggested that the law should be altered so as to permit properly qualified chemists to sell ad hoc disinfectants, provided that such disinfectants are sold in a form approved, and with instructions for use approved, by some competent medical authority. They suggested that the Medical Research Council should be invited to undertake this task. I should like to know whether since 1923 any action has been taken in this matter. I have, very briefly, dealt with certain recommendations for the cure and prevention of disease.

My final point concerns the women who are informed against. Probably most of them will be prostitutes. I want the House to think of the unfortunate, and probably stupid, girl who has become infected, who is informed against by a second man, who is anxious to protect the woman who has in fact infected him. It may be that a girl will be wrongfully informed against. The result will be that she is labelled as an immoral woman. Probaby we shall be told that she has safeguards. What safeguards has a girl of that kind? How can she put the law into operation, particularly as the information given against her is of a privileged character, given by doctors? If this Regulation is introduced, it will not only be ineffective, but it may cause hardship and injustice to some unfortunate woman. I ask the House to support this Prayer, because unless they support it there will be a delay, and during that time the incidence of this horrible disease will be even higher than it is now. I ask the House to be bold, to be frank, and to be courageous. By doing that, they will reduce the suffering and misery of many unhappy people in this country.

Photo of Mrs Agnes Hardie Mrs Agnes Hardie , Glasgow Springburn

I beg to second the Motion.

I do so from a very different standpoint than that of my hon. Friend the Member for West Fulham (Dr. Summerskill). I cannot conceive that either this or any other form of Regulation will do anything to lessen this terrible scourge. I would like also to dissociate myself from the attack which my hon. Friend made upon my two right hon. Friends the Minister of Health and the Secretary of State for Scotland. The Secretary of State for Scotland, whom I have known since he was a lad, has done a great deal to clean up society and to reduce such evils as this. Nor am I opposing the Regulation from any great idea of the freedom of individuals. In the middle of a war very few people have freedom. When we have conscription and young men can be prosecuted for sleeping in of a morning and girls because they want to stay at home and look after their mothers, people are not likely to be excited about the freedom of an individual to spread disease. If anyone could convince me that by any sort of Regulation you could wipe out this kind of disease, I would not oppose the Regulation. But Regulations have never lessened disease in this country, and I am very sceptical about the figures provided by my hon. Friend from other countries. Many countries on the Continent have very drastic regulations, particularly so far as women are concerned, and the figures for venereal disease are not very much lower than in this country.

I understand that before the war the number of people in this country suffering from the disease was decreasing. Street prostitution, as such, was largely dying out. One had only to go about the cities, knowing what conditions were like years ago, to appreciate that. Years ago I was engaged in shop work, and had very late hours, and I often had to go home when the streets were very bad indeed; there were districts through which one could hardly walk. But before the war the streets had been almost cleared up. That was due largely to the fact that women's wages had been improved, and that they had Unemployment and Health Insurance. In the old days many men who went to church and chapel regularly and were considered good Christians drove more women on to the streets because of the wages they paid, than the worst profligates. The war, however, has brought about a reaction. It is one instance of the demoralisation and disease that follow war. We have taken young people from their homes and herded them together, and immorality and disease have spread. We have all received a lot of literature on this subject. I could not help thinking that in my hon. Friend the Member for West Fulham the doctor has smothered the woman, for every women's organisation which has sent me literature has been against all forms of regulation.

I was very distressed to see that the biggest number of men known to be infected are young men between the ages of 19 and 23. Does it not suggest that there is something very wrong with our educational system, with our care for adolescents, that those young people should be practically destroyed in this way? We need to carry on more educational work. In spite of what the doctors say, you cannot regulate vice. I try not to be Victorian. As a matter of fact, I have always been very broadminded. I am not sitting in judgment and laying down the law about what is possible and and what is not. I do not know how men feel. No doubt they have their own problems. But you must teach young people how dangerous promiscuity is. I think, if they realised exactly the results of this particular aspect of immorality, it would have a deterrent effect. Doctors are inclined to think of curing disease; those of us who have been social reformers ate rather inclined to prevent it. What has been wrong is what has happened after a child has left school at 14, when public authorities and everybody else washed their hands of them. Parents are not perhaps the most intelligent people to deal with these subjects, although I am not belittling what we have all tried to do. More education and care of the young are required, and then they would, probably not get into this kind of trouble.

There is another point with which I want to deal. A good deal of the present promiscuous immorality is due very largely to the extension of drinking facilities. We all know, whether we are teetotallers or not, that the taking of liquor clouds one's ideas as to right and wrong. Women used to go out on the streets in Glasgow when the public houses closed, as that was when they got hold of their victims. I am sure that the extension of drinking facilities, particularly among young people, has a great deal to do with this problem. It is appalling that facilities are now being given to young people for drinking that never existed before. Young people, especially young women, ought not to be allowed to go into a public house. What are we doing in other directions? We are now providing canteens which are very necessary for providing food, and I am very glad of it, but why do we provide drink? It was never the custom for drink to be provided for people during working hours. It was recognised among employers that men and women could drink what they like but not during working time. We are now providing drink so that they cannot escape from it. Owing to the claim for equality of treatment, drink is now being provided in women's camps as well as in men's camps. I do not know why women should need to copy men's vices. I do not want to elaborate this point, because perhaps it is not quite in Order, but it has a great deal to do with this promiscuousness.

There is another matter which has arisen during the war, and it is very noticeable in the City of Glasgow, to which I belong, and that is the introduction of the foreigner. You have all kinds of people, a sort of League of Nations, as they joke about it. Everybody is there, foreign seamen, Poles and French. I am not condemning other nations, but some of these people have different ideas on morals compared with us, and I am sure that foreign seamen are a very great danger. I am worried about the number of young girls who run about with these men. I am not blaming the young girls particularly. Surely it should be the part of older men to have some little regard for the youth of these girls. I do not only blame men for leading women astray; women sometimes lead men astray. But when it comes to younger girls, older men ought not to have anything to do with them but should rather protect them. It is easy to blame these young girls. They themselves indulge in hero worship of the brave men who come from over the seas and those who are fighting. It is a very natural feeling, but these girls do not realise that a man may be very courageous and yet be a very objectionable character in many other directions. They get carried away, and so we have all these evils forming.

I agree with the hon. Lady the Member for West Fulham that, even if we have to have Regulations, the present Regulations are very objectionable and useless. They concern a small section of the community, as she said, and will not affect the question very much. These Regulations may be found to be useless, and more drastic Regulations will be asked for, and so we shall go on further and further. There is a real danger of blackmail, not only under these particular Regulations, but under any Regulations. It is all very well to say that, if a person is ordered to go for examination and it is proved that he or she is all right, no harm is done. A great deal of harm is done, and I am sure that such a woman would never feel clean again. This sort of thing might cut both ways. You might get two very unscrupulous women who could blackmail a man with the threat that they would expose him. Therefore, these Regulations and all Regulations must lead to a very great deal of harm and are opening the way to the blackmailer and to the poisoned pen. There are always people ready to take away somebody's character if they happen to be a little jealous. You might very often have people trying to avenge themselves on some woman in this particular way. I repeat that these Regulations are useless for the purposes intended, and Regulations generally would be dangerous.

What is required is an extension of confidential medical treatment for sufferers from this disease. I do not want to punish anyone more than they are punished. Women and men who contract venereal disease, innocently or otherwise, should be able to have confidential medical treatment, and everything should be done to restore them to health. There should be a great educational effort. It is no use asking people to come and see a film on the cinema. You want to have lectures to members of youth clubs and at camps among the military people, and in connection with works if need be. Doctors should be obtained to talk to them and explain the difficulties. Life is not easy, and it may not be easy for people to live up to the ideals of what they would wish their lives to be. Life is a continuous struggle. We have to struggle all the time against the original sin of the past. Proper education should be given. Everything should be done to help young people, and there should be more facilities provided for recreation, and, I would add, a greater restriction upon drinking facilities for younger people and a better example set by older men in their behaviour towards young women. That would do a great deal more than could be done by Regulation. I therefore ask the House to agree to annul the present Regulations.

Photo of Sir Francis Fremantle Sir Francis Fremantle , St Albans

On this subject, which rarely comes before this House, it will be found that the medical profession is, as usual, divided, and that is because they do not all approach it from the same point of view. The whole question to-day must be, What is going to be effective at the present time? I would express my words of congratulation to the hon. Lady who moved the Prayer for the statement she made of the whole case. If it were not for the difficulties of the present situation—if we were legislating for an Eldorado—I think the whole of the medical profession would agree. We are all agreed that this disease should be treated like all other diseases and in the same way. Contagious and infectious disease should be notified and properly, treated. The Minister of Health and his Chief Medical Officer have come out boldly with the announcement recently that we should treat these cases on medical grounds apart from moral considerations.

Photo of Mr Robert Boothby Mr Robert Boothby , Aberdeenshire and Kincardineshire Eastern

What is my hon. Friend's objection to compulsory notification?

Photo of Sir Francis Fremantle Sir Francis Fremantle , St Albans

I am coming to that later. The hon. Lady who moved the Prayer did not deal with that. Neither did the hon. Lady who seconded it; she said that no Regulation—presumably she was referring to all countries—had ever had any effect in lessening the disease. If that is so, no Regulation can do so. I think we should all be agreed as to moral and educational measures, but that is not what we are discussing to-day. I merely want to endorse what has been said, because it is a good thing to endorse the facts of this disease and its terrible nature. The facts have been revealed over and over again, yet they do not seem to have got down even to the Members of this House and, through them, to the people. I blame the Members of this House, because they will not look disgusting facts in the face. They are in exactly the same position as most of us were in before the war began. We were so bent on peace that we would not look the ugly prospects of international war in the face. In the same way we have been so bent on health and morality and all the rest of it that we would not look the disgusting facts of venereal disease in the face. They have been made plain over and over again.

Committees and associations have been formed and have been active, yet hon. Members have not passed on their work. How many hon. Members of those who have been interested enough to be here to-day can say that they have dealt with this subject in their public speeches to their constituents? If so, to what extent have they done it? It is likely that some have written letters of approval and have said, "You are doing very good work; I would like to support it," but to what extent have they recognised that this is a national and an immediate peril which must be dealt with at once? It is not a new disease. It goes back to the prehistoric days of Mexico and Peru. It was brought over by the crew of Christopher Columbus in 1493 from the New World to the old. It was spread through the whole of Europe like wildfire by the army of Charles VIII in France and came to Bristol in 1497. That was our first knowledge of it. We have been suffering from it for four and a half centuries, yet it seems necessary to argue the case for dealing with it. In the last war the Government and the House recognised that it would be necessary to deal with the matter. In 1916 they set up a Royal Commission, which reported that in the large cities of this country no less than 10 per cent. of the population was infected with syphilis.

Is the extent to which this disease is permeating the population of this country fully recognised? It accounted for 15 per cent. of the admissions to mental hospitals in London and 16 per cent. of the still-births. As regards gonorrhea, it was familiar 3,000 years ago, and it was known to Cleopatra. It is crippling rather than killing. It accounts for half the sterility in women and 70 per cent. of the ophthalmia cases in newly born children. Only those who have taken part in measures to deal with the pathetic cases of babies blinded for life by their parents' folly recognise to the full the appalling tragedy of this disease. The loss of manpower in this war and at home and overseas is preventable. Why has it not been prevented? This is an international problem.

We had experience in this country of the Contagious Diseases Acts of 1864 and 1866, and we must recognise that these were compulsory measures. The hon. Lady who moved the Prayer did not deal with that. Of course, she and I were not born then, but when I was a boy at school my chief friend was the son of a London surgeon who spent his time in the evenings, after a hard day's work, in going to Portsmouth and, possibly, to Plymouth to investigate the work being done there under the Contagious Diseases Acts. He was all for general compulsion in those days, and strong opinion was aroused in favour of it. Yet a storm arose. This Act was limited to 12 particular garrison towns and naval ports. It was limited to prostitutes who were licensed, examined and, if necessary, compulsorily isolated and treated in hospital. That drove the disease underground, and statistics for it in the Army went up, with the result that the Act was suspended in 1883 and repealed in 1886. Then the admission rate in the Army dropped by over one half from 275 persons per thousand in 1885 to 180 per 1,000 in 1894.

Photo of Viscountess Nancy Astor Viscountess Nancy Astor , Plymouth, Sutton

Is it not true that the whole medical profession were against Josephine Butler, and is it not true that she was right when she said that what was morally right would be medically right? Is it not true that this country was more right than any other country in dealing with this question yet has always had the organised, highly skilled medical profession against it?

Photo of Sir Francis Fremantle Sir Francis Fremantle , St Albans

The Noble Lady has raised several questions, and no doubt she will have the chance to develop them later. Josephine Butler was a lady of enormous proportions, physically and mentally—

Viscountess Aston:

I am sorry to interrupt, but Josephine Butler was one of the real heroines of the English-speaking people. She was not a woman of enormous proportions; she was a beautifully gifted and spiritually minded woman whose light shines in every country.

Photo of Mr William Gallacher Mr William Gallacher , Fife Western

Why does not the Noble Lady shine her light in some other country?

Photo of Sir Francis Fremantle Sir Francis Fremantle , St Albans

The Army Medical Advisory Board then advised voluntary treatment, the diffusion of knowledge and the generous provision of both. The result was that what may be called the clean body policy was developed, athletics were encouraged and recreational institutes were created. The venereal disease admission rate at Aldershot dropped before the last war to a figure which was one-ninth of what it had been in 1885. But there still remained the hard core. The figure to which I have referred applied to the Army, where there was supervision and instruction and proper facilities for dealing with venereal disease; these measures did not have much effect on the country at large. At the International Conferences at Brussels in 1899 and 1902 the representatives of those countries which were in favour of general compulsion and general notification were brought face to face with those who recommended the voluntary principle we were trying to develop in this country. An extraordinary change took place in the general medical and scientific opinion on this subject, strongly backed by those who dealt with it from the moral point of view; that change was that the regulation of prostitution was inefficient and should be abolished and that free and secret treatment should be provided. These were definite resolutions by that international conference.

The subject was dealt with by the Union International contre le Péril Vénérien in 1925 and by Royal Commissions in this country on the Poor Law, Divorce and Venereal Disease, and finally, there was the Trevethin Committee, to which the hon. Lady the Member for West Fulham (Dr. Summerskill) referred. I happen to be the only Member of the House who served on that Committee, and I endorse a good deal of what the hon. Lady said about it and about the neglect of one or two of the proposals of that Committee. It is true that the Committee proposed that the voluntary system should be continued; that the time was not ripe for compulsion, and that the work of existing bodies dealing with the subject should be encouraged, extended and improved; but that speaking generally the general medical practitioner was not yet adequately equipped with the most advanced knowledge of venereal disease and treatment to enable him to deal competently with all the cases coming before him and that an improvement in medical education with regard to venereal disease was necessary. That holds good to-day. There has been a considerable amount of improvement. The British Social Hygiene Council, among other bodies, has held courses, and the medical schools have done a good deal, but no one can say that there is a proper amount of understanding among medical men of modern methods of treatment. That is essential when one is considering the provision of treatment.

The Committee also strongly recommended that the sale of disinfectants by chemists should be allowed, but only on condition that a proper statement giving advice as regards the use and the dangers, including a statement that there was only one safe safeguard, which was continence, should be included in the sale of disinfectants. Such a statement would have had to face both ways. No one body was prepared to draw up such a statement. The Medical Research Council said they could not deal with it, the Society of Medical Officers of Health said that they could not do so, and the British Social Hygiene Council were not of sufficient standing, and I do not think they could have dealt with it either. The Ministry of Health did not feel they could deal with it, and therefore, it has never been done. I still maintain that it should be done, because the sales still go on, and there should be the safeguard of a proper statement to accompany them.

The Trevethin Committee urged further methods of treatment, including methods of dealing with seamen coming from abroad, which is one of the greatest difficulties at the present time. Above all, the Committee recommended the continuous education of the community and the elimination of those conditions which foster promiscuity and spread the disease. The hon. Lady the Member for West Fulham belittled the work of the British Social Hygiene Council and said that, after all these hard efforts over 25 years, they had reached only six per 1,000 of the population. She said that this meant that proposals for education would have only a limited effect. Without reciting to the House all that has been done by the British Social Hygiene Council, an enormous amount of work has been done by it, through different committees representing the Churches, the Services and education. People go to lecture in factories, at the ports and in the schools—wherever they can get invitations. What has to be done is to give wholesale education on this subject to the people. With regard to the schools, I look forward to the Bill that is to be brought forward by the President of the Board of Education; I hope that may help. I look to the National Union of Teachers, with their tremendous influence, to help in bringing about an extension in this direction. I look to the parents to give the education themselves and to demand that such education shall be given in the schools. It is from fear of the parents that this education is limited in the schools. Some parents say that it is disgusting and that they will not have their children tainted by such knowledge.

It should be remembered that this particular body, formerly the National Council for Combating Venereal Disease, was established by the Government in the last war because the Government did not feel able to take up the campaign themselves. Therefore, they assisted the establishment of the National Council, now the British Social Hygiene Council, with a very remarkable woman, Mrs. Neville Rolfe, as honorary secretary. Originally, the Government made a grant of £10,000 a year. In 1929, when the Local Government Act was passed, I protested to the Minister of Health, at that time Mr. Neville Chamberlain, against the abolition of the grant and its transference to the local authority. It was provided then that the matter should be treated by the local authorities and come within the block grant. The result is that the amount which has been coming in from that source has been considerably cut down, as it is difficult to get the local authorities always to make the necessary provisions for dealing with venereal disease. In a democracy we depend largely on the support that we get from the people. In 1928, the Edinburgh Corporation brought forward a Bill to deal with the cure of the disease. That Bill was rejected by the House. I remember making efforts, together with Mr. William Graham from the Front Bench opposite, to try to get the Measure considered by the House. It was rejected because of the fear that it would impair the voluntary system of treatment. It is very important that we should bear that in mind when we are considering this matter to-day.

I believe this will be a very useful measure. It is a first step, and it is all that we can do now. What is the good of notification if you are not going to deal with it? You do not want to have notifications pouring into medical officers if they cannot do anything with the cases that are notified. You can only have value for notification if treatment is available. What we want are increased treatment, increased clinics, increased medical education and increased nurses. All that would be extremely valuable. It is being done to some extent. A little extra, prodding is a good thing, but I do not think that more than that is possible.

On the Medical War Services Committee week after week we have the terrible difficulty of dragging men up from civil practice in order to serve with the Forces; and, when we read after each action that so many have been killed and so many prisoners taken, that includes so many doctors, and more have to be dug out from civil practice. We are at our wits' end to find these doctors. We can only find them at the expense of civil practice, which is extended to the utmost at present. What is the good of pretending to set up clinics when you have not the doctors to man them, and you cannot get them while the war is on? The same thing applies to nurses, almoners and health-visitors. Notification without treatment is a waste of time and a waste of labour, and it brings the whole scheme of notification to ridicule. The hon. Lady talked of this Regulation as a miserable, puny measure. So was the original notification of diphtheria and typhoid when brought forward as a voluntary measure; but that is the way that administration in medicine, as in other spheres of life, gets its way. It is brought in in a small way and tried out to see how far it is efficient. We have been able to get treatment afterwards. As to the jibe against "informers," perhaps it is not realised that it is the duty of each Member of the House, if he gets a case of scarlet fever or diphtheria, not to leave it to the medical man but himself to "inform" or notify it to the medical officer of health. The doctors do it, and as a rule it is left to them. The Press is constantly doing good work, and I hope will do more in this direction. Surely we want to teach self-control and the patriotism of healthy marriage, the instinct of race-preservation, which is the prime origin of morality; you have to get the teaching on the right kind of lines. Meanwhile let us start with this small measure. A certain number of cases will be brought to book. I oppose the Prayer and support the Regulation.

Photo of Admiral Percy Royds Admiral Percy Royds , Kingston upon Thames

I do not think you, Sir, or the House can complain of having been overburdened with my voice. I am not going to take part in the free fight between members of the medical profession or to waste time on morals, but I want to say a few words in the interest of the Service personnel in support of the Regulation, about which the hon. Lady opposite has said her prayers, because it is necessary to combat these most prevalent diseases among Service ratings in peace-time, which are largely increased under war conditions. I hope this Regulation is only the first start of other movements of compulsion with regard to this unsavoury matter. Apart from one's experience in the Service, one has only to read medical reports to discover the seriousness of the matter. The percentage of naval ratings affected has gone up by over 100 per cent., and this is not confined to home ports. Wherever a naval base has been formed, the diseases have been prevalent. If that is the case in the Navy, I am certain that the other Services, with their numerous units, must be similarly affected. Although a commanding officer could put a honse or a street out of bounds, it would not have the effect that it would have if there were not an absence of power to tackle this subject. That absence of power is of vital concern to all the Forces, both from the medical and executive sides.

The treatment of venereal disease in this country is now and always has been on the basis of voluntary attendance at clinics set up by local authorities and the education of the public to the importance of early and continuous treatment. This treatment has been conducted in civil life and to an extent in the Services under a sort of veil of secrecy. That method has proved ineffective in peace-time and a danger in war-time. If everyone affected were to follow the advice and the treatment that is required, the hon. Lady's Prayer would not be necessary. As under all voluntary systems, there is a small minority who consciously or unwittingly fail to respond and so consciously or unwittingly spread disease. Those are the people against whom this Regulation is directed. People who are favourable to the Prayer and oppose the Regulation say that it is unfair to women. As I read the Regulation, however, it treats both sexes alike and is as much a protection for women as it is for men.

Photo of Mrs Mavis Tate Mrs Mavis Tate , Frome

As one of those who has her name to the Prayer, may I say that the last reason in the world why I am opposing the Regulation is that is it unfair to women? Nor has one word been said by the Mover of the Prayer that the Regulation is not equal as between the sexes.

Photo of Viscountess Nancy Astor Viscountess Nancy Astor , Plymouth, Sutton

That is one of the reasons for bringing it in, though.

Photo of Admiral Percy Royds Admiral Percy Royds , Kingston upon Thames

I was not addressing myself to the hon. Lady; I did not know she was the whole Mover of the Prayer. It has been represented to me, however, that that is one of the causes of the Prayer, but as I read the Regulation it is as much a protection for women as it is for men. In the personnel of the Services, for whom I speak, there are thousands of women.

Others who oppose the Regulation complain that it interferes with the rights of privacy of the people. There are, however, hundreds of cases in this war where such rights of the many have been taken away for the sake of the man-power and woman-power needed for the effective prosecution of the war. Why should this small minority be permitted to go without attention and so cause such a serious and avoidable drain on man-power? This war started under a system of voluntary enlistment, but conscription was found to be necessary. The treatment of venereal disease has always been voluntary, and I contend that the time has come, and that the necessity for it has been proved, for treatment to be compulsory. I hope that the Minister of Health will follow this up and bring forward other measures for the compulsory treatment and exposure of such cases. Although I support the Regulation, there is one respect in which I take exception to it. As I read it, compulsion is only necessary for the source of infection. If that is correct, it is a mistake. Compulsion is not only desirable but necessary for the patient also. With that one exception, I support the Regulation, not only for the sake of the personnel of the Services, but because of the serious drain that diseases cause to the man-power of the nation.

Photo of Viscountess Nancy Astor Viscountess Nancy Astor , Plymouth, Sutton

I pray with the hon. Lady the Member for West Fulham (Dr. Summerskill) and some others that this Regulation will not be passed by the House, but I pray for different reasons, because I know that compulsion will not do what the House wants. This Regulation is panic legislation. It is not even war legislation. If it is, it is two years too late. I want to remind the House of what Sir Wilson Jameson said in a broadcast in October. The House has to think seriously why we have this legislation at this, moment and whether it will do what everybody in the country wants, and that is to decrease venereal disease. Sir Wilson said: The increase that has occurred is all the more tragic because of the steady fall in syphilis that has been taking place in the prewar years. Year by year, right up to the outbreak of war, the disease had been declining. Even now the war-time increase means no more than a setback to the position we had reached in 1932. It is nonsense to suggest that this country has had a bad record of venereal disease. We have good reason to believe, from all the information at our disposal, that we had before the war, and still have, far less than most other countries and also that the increase we are now experiencing is much lower than in the last war. But because we have had such a good record there is all the more reason why we should try to keep it. That is what the Chief Medical Officer of Health said less than two months ago. Therefore, I ask why the Government are bringing in this legislation. The reason, I think, is that the Government are afraid to have any war-time policy for dealing with what they knew would inevitably come about. The Ministry of Health Report upon anti-venereal measures in Scandinavian countries mentioned that certain things had to be done if war broke out, and the Government must have known at that time that war was coming. It would be well worth while for hon. Members to look up that Report. It stated: Of necessity a state of war increases considerably the strain upon anti-venereal organisations. Venereal disease has been described as the camp follower of war, and it may be readily understood how far war circumstances would favour the spread of venereal disease. The general state of heightened nervous tension and excitement in persons, especially persons lacking in self control, is bound to cause an increase in promiscuity and the shifting of large numbers of people into areas hitherto sparsely populated may lead to an outbreak of venereal disease in places unprovided with facilities for treatment. We know that in spite of that Report the Government have done very little. It is no good the hon. Member for St. Albans (Sir F. Fremantle) talking about how wonderful the Government have been and how they have tried their best. It is no good comparing this disease with mumps or measles. [An HON. MEMBER: "Why not? "] Because it is a moral disease, and moral people have got to deal with it. I was very amused to hear what a Noble Lord said in the other House. I have his words here.

Photo of Mr Douglas Clifton Brown Mr Douglas Clifton Brown , Hexham

The Noble Lady must not quote the words spoken in another place.

Photo of Viscountess Nancy Astor Viscountess Nancy Astor , Plymouth, Sutton

Well, I will say that I read that a speaker somewhere had said that he was tired of the "Grundyism" of the Church and the good people. The hypocrisy of it. It is the good people who have always been interested in this subject. May I also say that I was very much amused at hearing an ardent churchgoer talking of what the Church ought to do and saying that the Church said we ought to be good because it was patriotic. That does not sound to me like Christ's message; it sounds more like Hitler's. The fact that the Government have now brought in this Regulation shows what a failure the past attitude has been. The House of Commons knows very little about this subject, and that is the tragedy of it. I have had to know a great deal about it. I was put on a Committee to look into the question of brothels in Singapore and other countries, and we went into all these questions, and we came to the conclusion that we in this country were far in advance of other countries in these matters. The only other country which can be quoted as being more advanced is Sweden. Sweden is a small agricultural country, and it has had a very intensive propaganda and a highly-skilled medical service to deal with this evil for the last 20 years. Even there, apparently, the compulsory part of their policy has been the least successful. There have been compulsory powers both in Sweden and in Denmark, but in Holland they have no compulsory powers, although Holland is a more densely populated country than either Sweden or Denmark and has a large sea-going population. But this Committee looked only into the case of the Scandinavian countries, because the Latin countries have a different moral outlook.

Photo of Sir Francis Fremantle Sir Francis Fremantle , St Albans

The Committee looked into the question in both Scandinavia and Holland.

Photo of Viscountess Nancy Astor Viscountess Nancy Astor , Plymouth, Sutton

Yes, but we did not look into any of the Latin countries, because we have a completely different moral outlook. I remember meeting one of our soldiers coming back from abroad in the last war. He was a glorious Cockney. He said to me, "I hope you won't mind my saying it, Miss"—He called me "Miss" 25 years ago—"but I don't understand these foreigners. When we break the Seventh Commandment we know we have done wrong, but they're positively proud of it." That was really a psychological truth. When people brought up in this country do something wrong they are not proud of it but ashamed of it, and that is why we have this venereal disease. It is not like mumps or measles, because when people get it they are ashamed, and while we need propaganda about it, while we want it talked about, we want it talked about on the high moral basis which has always prevailed in this country. It is no good telling us that we ought to do what other countries do. According to the Medical Officer of Health, whom I have quoted, we are far before other countries.

With regard to this particular Regulation, the people who are interested in this matter—I am sorry to say that the vast majority of people are not—point out in the first place that it is based on the work of informers. In Sweden, where there were 175 cases in which information was laid, they could get only 68 of those cases dealt with. Everybody knows perfectly well that the hope under this Regulation is to clear out the notorious prostitutes, who no doubt give this disease to men, but is it really worth while to take the risk which we shall take by passing this Regulation in order to get at a few notorious prostitutes? That will not settle the question, and, I believe, will do far more harm than good. It will drive the disease under, the one thing which we want to avoid doing. We ought to have a propaganda campaign in order to teach people the dangers of this disease and tell them where they can go for treatment. We ought to do what we can to arouse the country to the horrors of the disease, but do it without pulling down the moral level of the country. After all, what is morally right is bound to be medically right. Josephine Butler found that out, and she defied the whole medical profession. The story of Josephine Butler is one of the most extraordinary stories, yet very few people know it. I always look on her as one of the bravest women who ever lived. She was one of the first women ever to get on a public platform in England and say that there must be a single standard of morals.

What are the Government doing? I have been watching them closely. In the first place, they ought to have carried out the policy to which they referred in 1938. They ought to have prepared for war-time conditions. If this were really a war-time measure, it should have been introduced as soon as the war started. They might possibly have waited a year, but here we are now entering on the fourth year of the war, and so far they have done very little. There has been no propaganda at all. Women police were born out of the last war, and their introduction had a terrific effect on the young people. We know that the whole moral position has changed. It is not now so much a question of the old, hardened prostitute. In war it is a question of dealing with young people who are excited by the war, are away from home and do not know how to behave. We had 150 women police in London in the last war, and some 500 girls a week would come up to them and ask where they could go to be helped. There has been no effort to increase the number of women police, and there has been no effort to raise the whole tone of the civilian population. Look at our E.N.S.A. concerts. It was the soldiers themselves who had to protest against the vulgarity of them. There was "Blighty," to which the Prime Minister gave his patronage. A more filthy photograph you never saw in your life. Everybody knows that instead of a tightening-up of morals and of the spiritual outlook, there has been a positive lowering of them—and the Government have not said a word.

It is not too late to have a moral campaign. It would have more effect than anything else, alongside an increase in women police and a better dissemination of information as to where sufferers can get quick treatment. As a matter of fact, there are very few places where they can go. If we had done here what they have done in Sweden, instead of having only 119, we should have 399 places. We have not followed the matter out, and there has been a complete lack of vision, courage and imagination.

This is a matter into which the House as a whole has to look very closely. I do not believe it is as bad in some places as in others, but for the first two years of the war the Government did not try to do anything about it. I know two able American women doctors who were here during that period, and they wondered why their services were not being used. One of them is an expert. Those women doctors were ready to go anywhere and do anything. We are told that there was difficulty about doctors, but if the Government had taken the trouble in the early days they would have found a way. There is always a way. We have even made the Churchill tank better, so there must be a way to get out of every mess we get into—and we are in a mess. We are in a real mess, and this Regulation will make it much worse. It will give a false sense of security to people, who will think that something is being done, whereas very little will be done. The Regulation is one of the most feeble things ever brought before the House of Commons.

If hon. Members ask me what I would do, I reply that there are many things to do. First of all, I would change the people who have not had vision enough to face this problem courageously. We have to use women doctors far more, and we have to induce women to go to the clinics, which should not be made too public. This is not a disease for people to be proud of, and I do not think you will ever get English women to be proud of it. They want secrecy, and it is right that they should, and they ought to have it. Then there should be continuity of treatment, which is essential in the view of trained experts. In one town they have three women doctors, but instead of letting them all attend the same clinic at the same time every week, the doctors are changed about. The local authorities have had very little lead from the central authorities to do anything about this problem.

Above all, we want to attack the causes of the disease. They are war causes. One cause is excitement at being away from home or being lonely. I am told that one of the reasons for bringing in the Regulation is that overseas people are demanding it. May I give a tip to the overseas people? It would be far better if they banked some of their young men's money for them instead of letting them have it to jingle in their pockets in foreign countries. We had to do that with our own soldiers who were in Cologne during the last war, when we had this same problem. Mrs. Corbett Ashby wrote a very able letter to "The Times" about it. I was in all that. We sent out women doctors, and they did magnificent and marvellous work, showing how the problem can be handled, if it is approached properly. We ought to tell the Powers that are pressing the Government not to give their men so much money. Do not be frightened about this.

Another thing is that the number of women police ought to be increased at once. I was in a venereal ward the other day, talking to men who had the disease. One of them said, "Now, all we want is a drink of whisky." I told them, "If you hadn't had the drink, I doubt whether many of you would be here to-day." Out of 42 men, 36 admitted that that was true. Have the Government done anything about it? If you talk about drink in this House of Commons you are looked upon as a crank and fanatic. I am not a fanatic. [Laughter.] Hon. Members may laugh, but do they not realise that most of the social evils of the world are moral evils and that nothing loosens morals more than drink? Have we done anything about it? Not a thing. There has been no lead from the Government—in fact, we have seen increased facilities provided for girls to drink, which they did not have last time.

Photo of Mr Robert Boothby Mr Robert Boothby , Aberdeenshire and Kincardineshire Eastern

They did something about it in the Noble Lady's country, and it was not a great success.

Photo of Viscountess Nancy Astor Viscountess Nancy Astor , Plymouth, Sutton

I am talking about war-time measures and not about peacetime measures, but I am not so certain that the hon. Member knows much about my country or any other. I beg the Government at once to call a conference, under the Ministry of Health, of all social organisations with knowledge of venereal disease and the problems surrounding it. Let them be asked to put their knowledge and service at the disposal of the Ministry. That is the first thing to do. Then there should be an increase of medical facilities—we have got that—more women police appointed, social clubs and education. There ought to be a campaign about these things. I used to go round in the last war, particularly among the overseas people who came here, and I know that this is a moral and spiritual question. I beg the Government to face the facts properly and not to bring in panic legislation. Do not think that by locking up a few prostitutes you will get rid of the problem. You will get rid of it only if the House of Commons makes up its mind to face this thing boldly, in what I might call a really visionary way. Have your clinics, but, above all, appeal to the young people and tell them the truth, which is that you cannot make immorality safe. Nobody in the world can. We can give the young people all the help possible, but until the Government make that appeal, I pray God that hon. Members, for the sake of the country, will vote against the Regulation, and will demand a policy based on the English way, which has, up to now, proved to be better than any other way in the world for dealing with this appalling scourge.

Photo of Dr Leslie Haden-Guest Dr Leslie Haden-Guest , Islington North

The Noble Lady has spoken with great sincerity, but I am sorry I shall not be able to follow her. I shall even hope to convince her to some extent by the arguments I shall adduce in favour of bringing this Regulation into operation. I am speaking partly as a result of my experience during the present war as one of the administrative medical officers of the headquarters staff of one of the largest—at one time the largest—commands in this country. I was there for 15 months. From the Service point of view, I know what the problem is. Some hon. Members who have spoken to-day have been so concerned with the admirable objectives which they wish to realise and with the excellent ideals which they wish to see put into practice that they have not addressed themselves sufficiently to the concrete and definite problem which lies before medical administrators and before the country.

We had a little time ago an admirable speech, if I may be permitted to say so, from the hon. Member for St. Albans (Sir F. Fremantle). His experience as a medical officer of health gives him great authority in this respect, and his reputation as one of the most distinguished of medical officers of health lends added weight to his words. He knows this problem. He has served on committees surveying this problem, and gives it as his considered judgment that this Regulation is one which will advantage the country at the present time. I agree with him, and I agree with the hon. and gallant Member for Kingston-on-Thames (Sir P. Royds), that it is a most important thing from the Services point of view that this Regulation shall be put into operation. With much of what the hon. Lady the Member for Springburn (Mrs. Hardie) said I very heartily agree. With her deep humanitarian sympathies, with her approach to this matter from the standpoint of education, and the improvement and lifting-up of the moral level I entirely agree. But there is, apart from that, this definite problem of the young men and the young women in the Services and those outside the Services, most of them, of course, shortly to be called up, and subjected to conditions which, under existing conditions, make it probable there will be a great spread of venereal disease.

May I say one other thing in connection with the matter of this Regulation? This is only part of an offensive which has been launched by the Minister of Health, and I have no hesitation in describing myself in this matter as one of his most cordial supporters. This is only a part of an offensive against venereal diseases of which publicity in the Press and publicity through the B.B.C. are important parts. I wonder whether Members realise what a lot of work has actually been done in order to get this publicity in the Press—and admirable work the Press has done in recent months—and whether hon. Members realise the consultations and the considerations and the weighing of this and the weighing of that which had to come before a perfectly frank and free public health discussion of this matter by the B.B.C.—a most important weapon of information to the public in this country—could be got? This whole subject has been too much wrapped up in fear and in mystery. It is a matter which primarily must be approached from the moral point of view. It is a question which will never be solved until the human race has been raised to a considerably higher level than it has reached at the present time.

But there is the public health aspect of the matter, and I think it is of benefit that we should consider the matter from the public health point of view. What is the case with regard to this? I am glad to see that my hon. Friend the Member for West Fulham (Dr. Summerskill) is now in her place. What is the case with regard to the increase of the venereal diseases, gonorrhea and syphilis, during this present war? There has been an increase, of course, among the civilian population. The hon. Lady gave the figures. There has also been a considerable increase among two groups; one, the Services—the Army, the Air Force and the Navy; another among the Mercantile Marine, who are, of course, civilians and who therefore come, or should come, into the civilian figures. I know what these Services figures are, but they cannot be given at the present time. But do let me impress on the House that all this talk about the value of notification and even the value of treatment, unless it is directed to the source of infection, is not in itself a complete cure. In the Services there are compulsory notification and compulsory treatment, and it is in the Services that there is this tremendous rise in venereal infection. Compulsory notification and treatment are by no means a complete cure.

It is perfectly true that a great increase in treatment facilities is required. I interpolated a question when the hon. Member for West Fulham was speaking and asked her what number of clinics we should require. She seemed to think that that interpolation was irrelevant. I am afraid that, if anything, it was a little malicious. I wanted to get her to say what she did say, that we would need to have clinics set up in this country at the rate of one for every 20,000 of the population, as in Sweden. If hon. Members will make a little elementary calculation, they will see that means we require to multiply the present number of clinics by something more than 10 when it is difficult to add to them 10, or 20, or 30 more clinics, because however urgently they are needed the medical man-power, the almoner woman-power and nursing power, are not available at the present time, for the reasons given by the hon. Member for St. Albans. I have been pleading myself in another matter for the appointment of numbers of pensions appeal tribunals of some 25 doctors. The Minister has stonewalled every time and said that he cannot provide these 25 people. I still do not agree with him, but when it comes to the question of whether we can provide 1,000 or even 100 more doctors to specialise on a particular subject at the present time, it is asking for something which I will not say is impossible, because I do not believe it impossible, and I do not believe that my profession, the medical profession, would fail to respond somehow to any call which the Government thought was essential, but there are limits to what any group of people can do.

There has been a very great increase in venereal disease among members of the Services, and I have heard in this House to-day—and I have only been absent from the discussion for a few moments, which I regret to say was when the Noble Lady the Member for Plymouth (Viscountess Astor) began her speech just now—no statement which, as it were, seems to put into words the conditions under which our men and our women are serving at the present time, the conditions of strain, the conditions of pressure—moral, spiritual and physical pressure—under which they are living. The only film and the only play I have seen within a long period have dealt with conditions in the Services. The play was "Flare Path"; the other was a film, which I saw only the other night, the Noel Coward film, "In Which we Serve." Those two, the play and the film, give a wonderful representation of the tremendous strain on our men and women in the Services. In statistical terms it is shown that venereal diseases are most prevalent in young people from 19 to 23. That is the age of our young people in the Services. That is the age of the men who any night get the order to take off and fly over Germany or over Italy. Every man of them is glad to go, glad to be of service to his country, full of enthusiasm for his job, but he knows well that he may not come back. Every man who goes out in the Navy and in the Mercantile Marine, that great service of which we can never say too much, knows he may never come back. Those are not normal circumstances. That is a strain, placed on men and on the women who are supporting those men in the Services, which is difficult for those living in civilian surroundings, however much blitzed they are, to realise. If this Regulation 33B will help, as I believe it will, to protect those men against the dangers of venereal infection, it is the duty of this House to put it into operation.

Photo of Viscount  Turnour Viscount Turnour , Horsham and Worthing

May I ask my hon. Friend a friendly question? He has made a rather serious statement. I suppose it is accurate, or he would not have made it; but the other day I was privileged to visit a general hospital, and I was told that they had very few cases of venereal disease, and that the incidence was less than in the last war. My hon. Friend has made rather a serious charge, and one would like to be sure that it is accurate.

Dr. Guest:

I am not making any charges. I am stating what I believe to be accurate, as a result of my experience as medical officer of the largest command in this country. I am not saying more than that.

Photo of Mr George Buchanan Mr George Buchanan , Glasgow Gorbals

I have only a secondhand knowledge of this matter, because my brother happens to be one of those dealing with it in Glasgow; but may I put it that the increase is not so great but that medical inspection, not only in the Forces but in civil life, is very much more frequent, and that because of that people are finding out that they have the disease, whereas in peace-time it was there but was not found out.

Dr. Guest:

The hon. Member has suggested that inspection is more frequent than it was. I do not know that that is the case, but at any rate it would not diminish but would strengthen my case, because I am arguing that we need special treatment for the cases from which these men in the Services get their infection. Reference has been made to-day to professional prostitutes. As a matter of fact, infection is very largely conveyed to members of the Forces and to other people not from professional prostitutes, but from other sources. Let me give a case which was brought to my notice by an hon. Member in this House, who asked my advice about what could be done. He introduced to me one day a pilot officer, who informed me that immediately adjacent to the aerodrome where he was serving there was a house which had been taken by two women of about 35, who had money of their own, who kept up a very good table, and who invited the pilot officers and others to come and be entertained in their house, and who became all too friendly with them and did actually infect four or five of them with syphilis. [Interruption.] My hon. Friend the Member for London University (Sir E. Graham Little) will permit me to say that it was he who conveyed the information to me. Those are not prostitutes. They are women who wish to lead that life. There are large numbers of those people. I have here one of the numerous documents which have been sent to me in connection with this Debate. It is a very excellent document from the British Social Hygiene Council. This organisation, the secretary of which is Mrs. Neville Rolfe, is of high standing, and does not make statements without being fully satisfied of their accuracy. It says: There is no reason to believe that there is any large number of professional prostitutes. The majority of infections in the Services appear to involve the young irresponsible girl, or the man's best girl for the time being. Financial transactions occur in only a small minority of "the present-day cases of promiscuity. They give this as a reason for providing treatment facilities, with which I entirely agree, but they also show that the idea of venereal disease as something conveyed by a prostitute of inferior social status to a man of superior social status is out-of-date. It is due to promiscuity, by which one sex conveys it to another, much too freely, at the present time. That is done under the terrific strain of war conditions. If we in this House, the responsible body of the nation, have not been wise or far-seeing enough to prevent this war arising, who are we to sit in judgment on these young people? We should provide for them the best possible protection we can. I agree with the British Social Hygiene Council that there should be an increase of treatment centres and ailments of women centres, instead of venereal disease centres. But it is most urgent that we should secure the limited objective which the Minister of Health has set before him, of getting the class of cases to which I have referred notified to the Ministry of Health. They can be notified, of course, only if the man infected goes to a specialist in venereal disease. Beyond this, there is very much to do. There is the welfare side of the Services, the organisation of recreation, the organisation of instruction, the extension of treatment, and possibly, although I am very doubtful of it indeed, compulsory notification. May I just remind the House that compulsory general notification of tuberculosis has not been successful? Compulsory notification of a disease like venereal disease would not deal with the larger number of cases. You have compulsory notification in the Services, as I have said, and it has not prevented the rise of the disease. You must get at the centres of infection, and the 33B Regulation is a way of doing that. The Minister has picked out the greatest danger for immediate and special treatment, and, in the interest of our men and women, and of the future generation, we, as Parliament, should give the Minister the power for which he asks.

Photo of Sir Ernest Graham-Little Sir Ernest Graham-Little , London University

I support the measure proposed by the Minister of Health as the first step, and I recognise in that measure that the Minister appears to be carrying out the promise he made to me eight months ago that he would do something of this kind. I brought to his notice an incident which has been partly described by the hon. Gentleman the Member for North Islington (Dr. Haden Guest). It was a series of cases of infection of syphilis at a certain air station where there were something like 3,000 men stationed, and the surgeon squadron-leader who was in chief medical charge of that unit came up on purpose to see me about it. He said, "Look here. This is the position at A. I am medical officer for this unit. All these cases, 13 in number, have been traced without any doubt whatever to one source. We know the source, but the commanding officer has no power to take any steps."

Photo of Sir Ernest Graham-Little Sir Ernest Graham-Little , London University

The legal position is by no means as clear as my right hon. Friend suggests. Evidently the opinion of the squadron-leader and his c.o. was that there was no method by which the commanding officer could rectify that position. I put down a Question which was on the Order Paper for 28th April, in which I asked the Minister whether in view of the rise in the incidence of venereal diseases and the danger of the dissemination of these diseases in the Armed Services from sources outside the control of commanding officers, a recent instance of which has been brought to his notice, he will grant powers to medical officers of health to have persons of both sexes who are suspected as being sources of infection examined and, if necessary, treated."—[OFFICIAL REPORT, 28th April, 1942; col. 818.] I do not think that the House recognises the real position. It is useless to talk about ordinary peace conditions. We are met with a position which is a very serious one. I have here a very interesting and important paper by a very great expert on this disease who was for 20 years the head of the special department dealing with these diseases at the London Hospital. He wrote a very interesting paper, in which he pointed out that in the way years 1914 to 1919 there was a condition of affairs very similar to what now exists in this country as the result of this war. He pointed out—from the medical point of view a very interesting circumstance—that the curve of incidence of venereal disease followed closely the curve of epidemics, and obeys the same law which governs the spread of epidemic diseases. It is consequently perfectly proper to regard this position of affairs as an epidemic.

I submit that that is the way in which science; should regard a position of that sort. It is an epidemic. It is useless to pretend that you could stop an epidemic by dilatory methods such as are proposed from time to time in the way of safeguards. It must be something which can be done here and now. The epidemicity of this trouble is one of its main features, and why is it that that applies? It is easy to explain, because, as my authority points out, you have in conditions of war a very large number of young people who are not immune to infections, and who are thrust into very large aggregations in which opportunities of transmission are enormously increased. It is these conditions which determine the character of epidemicity. I want the House to recognise that that is a feature of this position.

There was another very interesting paper in November, 1942, contributed by a medical officer who filled the office of venereal officer for a very great provincial centre, and who is an expert upon the subject. He says: I am of opinion that the existence of compulsory powers has contributed to the remarkable reduction of the incidence of syphilis in Sweden. I am equally convinced the methods hitherto employed in Britain have failed to control the spread of venereal disease and I am of opinion that the application in this country of a scheme modelled on the Swedish plan should be seriously considered. He goes on to point out that: to achieve success a vigorous campaign in educating the public must be undertaken. It is time the man-in-the-street was told the truth about venereal disease in this country. He cannot be expected to co-operate in solving the problem if he is ignorant of its existence. The medical profession also requires education, and particularly in the epidemiological aspects of these diseases. and the approximation I have quoted of this disease to the well-known epidemics makes that point of the greatest importance. We want to know a great deal more on the reason why epidemics occur and how they should be dealt with. He goes on to say: The politicians and the Press must also be brought into line, and expert legal advice must be sought in drafting the necessary measures. Ecclesiastical support is also essential. and he points out that that was forthcoming in Sweden, which is rather remarkable. He concludes with this very pregnant sentence: It would only require the inclusion of venereal disease under the present law relating to contagious diseases which has operated without hardship to the individual and with much benefit to the community. That is surely the right line of approach to this question with which the House has to deal. I believe there is widespread ignorance on the part of the general public, as to the origin and the methods of the spread of so-called venereal diseases. It is by no means true that they are always necessarily spread by venereal contacts. I have been in charge of a hospital department for 3a years which dealt largely with these diseases, and I know a great deal about the behaviour and incidence of syphilis and these other troubles. I am now, however, concentrating on syphilis, because we have the exact figures as to the prevalence of that disease at the present time. They were contributed in the Report issued by the Ministry of Health a few weeks ago. In that Report it is pointed out that there has been a 70 per cent. increase in syphilis in the war years in this country. That, I think, disposes of the question of my right hon. Friend the Member for Horsham (Earl Winterton) as to what evidence there is for that increase. The fact of increase is indisputable. Therefore, measures are required to meet that position.

Now let me from my memory give a few instances of what we call innocent infection. Cases of this nature are quite numerous. I remember that a very famous surgeon of my own hospital was operating on a case not recognised as being syphilitic, when he happened to cut one of his fingers. It became a little sore, and, unfortunately for him, it was not recognised as being syphilitic, and the disease developed without treatment for 10 or 12 months, until he showed symptoms of late syphilis when the diagnosis was made. This surgeon suffered from abscesses of the bones of the head, which are very diagnostic features of the disease. Something like 25 or 26 operations were performed on this unfortunate person, who had to retire from practice. That was a case of innocent acquisition of the disease. Then I came across a case at my own hospital where a young house surgeon was looking at a patient's tonsils. The patient coughed, and some material from his mouth entered the right eye of the house surgeon. It became extremely inflamed. He saw an ophthalmic surgeon, but nothing much was done in the way of improvement. Then he became conscious of an eruption and consulted me. When I said the disease was syphilitic he was very distressed and told me the history, and we found the syphilis germ in the discharge from the eye.

Let me cite another ease. A young officer was in one of the military hospitals of the last war to which I was attached as honorary dermatologist. He had been thrown from his horse and was suffering from a wound on the buttocks. He had been kept in hospital for two or three weeks, as the wound would not heal, and it was obvious that some other infection had supervened. He developed an eruption and came to see me. I diagnosed syphilis, and it was confirmed by the laboratory tests. I had a consultation with the principal medical officer of the hospital, the late Sir Alfred Pearce Gould, and we both agreed that the young officer had contracted syphilis from the open wound, in all probability from one of the lavatories. There were 2,000 patients in that hospital, and it was quite impossible to suppose that there were no syphilitic persons in that number using the lavatories. Again, one day I saw a little girl of 12 who showed a very definite syphilitic eruption. I saw that she had a bandage round her knee, and I asked her what had happened. She took the bandage off, and I saw she had what we call a hard chancre, the first lesion of syphilis. The child had slipped on the pavement and had been taken home to have the wound dressed. But it would not heal, and after three or four weeks the characteristic eruption demonstrated the infection. I could multiply these cases many times. They are all from my own personal experience, and I want the House to understand the danger of infection to innocent people resulting from crowded trains, factories, hospitals and training camps. It is quite wrong to stigmatise a patient who has syphilis as being necessarily immoral.

What is it this Regulation asks us to do? I do not think it will be possible to make a very much wider application than it proposes at the present time. What I would like to see is immediate succour brought to these unfortunate people. The compulsory treatment of infected people is a cardinal point of the value of this Regulation, because while a person is not cured by one or two injections of the arsenical preparation now used so extensively, he or she is rendered very rapidly non-infective. That is an exceedingly important result of that treatment. It makes the danger to other persons in the neighbourhood very much less, and surely we ought to grasp the opportunity of making an improvement if it is at all possible. I am not very fond of notification. I think it destroys to a large extent the privacy which ought to attend medical treatment and may possibly defeat the object one-has in view. But I am not quite sure that it may not become necessary for the Minister of Health to extend his powers to include notification—as I hope he can—under the Defence of the Realm Regulations.

If something is not done, if the House rejects this Regulation here and now, what will happen? I regret very much to have to say that eight months have passed since I drew the attention of the Minister to this evil and obtained his promise of action. I think it is unfortunate that that delay should have taken place, although I quite understand the difficulties of Government Departments. I ask again, what will happen if the House rejects this Regulation? Some have said that the Regulation does not go far enough and they would, therefore, reject it. But if it is rejected, there will be again a long lag of inaction. We shall not get anything done for months, and while we are arguing about it this evil will be going on all round us. I am told that the disease is making rapid strides in factories and industrial institutions and that it is holding up the war effort in a very serious manner. The call is urgent for something to be done now. Let us take this Regulation as an instalment and not reject any progress whatever to the end which we all desire.

Photo of Mr Henry White Mr Henry White , Birkenhead East

Nearly all the hon. Members who have addressed the House in this Debate have given long study and consideration to this difficult subject. I do not claim to have given such study, or to speak with such authority, as those hon. Members. It may be asked why in that case I should intervene in the Debate, when there are so many other hon. Members who wish to speak. I think it is time that something was said on behalf of the man-in-the-street. In the early part of this year, my attention was drawn to the formidable menace which is arising from this trouble in one of the principal port areas of this country. I was so impressed and appalled by what I heard that I proceeded to make inquiries at another port area and found to my dismay that precisely the same state of affairs was arising there. Friends of mine who had some responsibility for the manning of ships found great difficulty in getting the boats away. I was so disturbed that on the first occasion on which there was a general debate on transport I raised this matter. I felt it was my duty to do so, although I had not had an opportunity of going into the matter from the scientific point of view.

I have listened to what has been said in many parts of the House about the necessity for further steps, but as I understand the matter, there is nothing in the Regulation which precludes the possibility of our proceeding, as soon as practicable, to the development of further measures. I hope we shall do so. I am bound to say that, on reading some of the literature which has reached me, some of the steps which are proposed seem to be almost crying for the moon in the present state of our resources and the present state of mobilisation of manpower. I have been led to this conclusion. Having regard to the conditions which prevail at the present time, I think that any Government or any Ministers who refrained from taking the best action which they and their advisers could devise at the present time would be failing in their duty. That is clear beyond peradventure. Something has been done. I would like to put it on record that, in my opinion, when the war came upon us, provisions for social welfare and recreation at the ports for our seamen were a disgrace. I am glad to know that during the last two years very rapid and considerable steps have been taken to put that matter right. During the last few days, I have made inquiries as to whether, as one might have hoped, the improvement of the welfare and recreational facilities had had any effect in checking the growth of this disease. I am told that it has not, and that the conditions are still bad; and, therefore, it seems to me very important indeed that action should be taken forthwith.

In conclusion, I do not feel that this is any time for quibbling about informers, and so on. The situation is far too serious to be left as it is. I can assure the Minister that those who are resident in ports, those who have any responsibility for the transport of the country at the present time, and all those who are moved by those wider motives which have caused hon. Members to speak so eloquently in the Debate, hope that this Regulation will become effective. [Interruption.] I listened with the greatest attention to the speech that was made by the Noble Lady the Member for the Sutton Division of Plymouth (Viscountess Astor). She began by saying that she would never be satisfied until the House took bold action, and then prayed that we would not approve this Regulation.

Photo of Viscountess Nancy Astor Viscountess Nancy Astor , Plymouth, Sutton

It is not bold; it is just bad.

Photo of Mr Henry White Mr Henry White , Birkenhead East

Let us have all the boldness possible, for the situation needs it. Let us approve this Regulation, and let those who have other remedies to advocate continue their work.

Photo of Captain Sir George Elliston Captain Sir George Elliston , Blackburn

The appeal which we have just heard for support for Regulation 33B will, I think, have impressed many hon. Members who came to the House to-day without having finally decided what line they ought to take on this subject. The Noble Lady the Member for the Sutton Division of Plymouth (Viscountess Astor) asked what is the reason for this panicky legislation, and why we are rushed into taking measures for which there is no call or excuse. Unfortunately, the Noble Lady left the House; if she had remained she would have heard the very convincing reply from the hon. Member for North Islington (Dr. Haden Guest), who speaks with authority, having had experience not only of His Majesty's Forces but also based upon a close connection with various departments of medicine. The hon. Member for the University of London (Sir E. Graham-Little) has also brought the weight of his experience to the matter and advised us that the Regulation should be supported.

What does the man-in-the-street want to know? What excuse can we offer him for introducing this Regulation and showing the need for it? Surely, it is enough that the authorities of the Ministry of Health should have made the plain statement that during 1941 there were as many as 70,000 new venereal disease infections and that during that period there was a 70 per cent. increase in syphilis among civilians and members of the Armed Forces. Do we require any further excuse for making this an urgent matter? The mild opposition that has been shown in the House has come as a surprise. It is but a pale imitation of what we have been told day by day in the newspapers about the seething indignation caused by the provisions of the Regulation. We have been told, for instance, that notification is a dangerous precedent. Hon. Members have spoken as though we had not been accustomed to the notification of infectious diseases. Yet for many years past there has been compulsory notification of smallpox, diphtheria, whooping cough, typhoid, and other diseases. Nothing is proposed in the case of these desperately dangerous venereal diseases which has not been done in regard to other infections. Moreover, the conditions in regard to enforcement of this Regulation are more exacting than the conditions applying to other notifiable diseases. In the case of venereal disease alone evidence has to be produced that the infected person has already infected at least two other people and has refused to undergo voluntary examination and treatment. The procedure required by the Regulation is already the practice in very many clinics. It is quite customary to ask the patient how he contracted the disease, and it has also been customary to make very discreet inquiries and to persuade the other infected party to come and accept treatment, and to give him or her advice and help as far as possible. The point has been made that, whereas the patient has to accept treatment, there is no such obligation on the informer, but as a matter of fact those who inform under this Regulation have themselves to be persons who have already voluntarily accepted treatment.

Photo of Mrs Mavis Tate Mrs Mavis Tate , Frome

The informers have to be people who are undergoing treatment, but there is no compulsion upon them to continue the treatment, and 85 per cent. of them do not continue it.

Photo of Captain Sir George Elliston Captain Sir George Elliston , Blackburn

The fact remains that the informers are persons who are themselves voluntarily undergoing treatment. The hon. Member for West Fulham (Dr. Summerskill) said that Regulation 33B would be no good, but she would cheerfully support total notification. She appears to think that this partial system of notification may afford opportunities for blackmail, and also for discrimination against women. I cannot think that objection has any serious foundation. Information in the shape of total notification has to be taken in more stringent ways than in connection with this Regulation. Where total notification is enforced, the evidence may be obtained not only from patients but from anonymous sources.

Photo of Dr William Thomas Dr William Thomas , Southampton

A doctor notifying scarlet fever, if he does it wrongfully, is liable to an action for slander or libel. With this particular disease, if an informer informs wrongly and some man or woman is forcibly examined, no action lies under the Regulation.

Photo of Viscountess Nancy Astor Viscountess Nancy Astor , Plymouth, Sutton

In 1918 a similar Regulation brought in in March was got rid of in September.

Photo of Captain Sir George Elliston Captain Sir George Elliston , Blackburn

I do not wish to pursue the matter of wrongful notification as I have reason to know that others are going to deal with it. As several speakers have already said, a great deal can be done by moral teaching, but the position is so urgent and immediate that we dare not wait till we have a complete scheme for the education and protection of the people. One thing has disappointed me very much. More than two years ago I was supporting the British Social Hygiene Council and others who were extremely anxious that we should employ a large number of women police, experienced and kindly women, who would be able to save young girls from drifting into indiscretions. It is most unfortunate that a moral effort of that sort was rejected.

Early in 1940, the Minister of Health issued an admirable circular, No. 1956, to local authorities telling them exactly what they might expect in connection with war conditions—the dispersal of the population, the creation of munition works and camps in isolated areas—and advised them how that would necessitate the creation of more treatment centres and mobile clinics. The local authorities practically ignored the advice. Several of us warned the House that, unless some sort of Exchequer help was promised, they would not get local authorities to move. They argued, with some reason, that these conditions were a national matter arising out of the war and were not necessarily a responsibility of the local authorities. I think the number of clinics opened in consequence of the circular rose by less than 20. We opened munition works all round the home counties and put up notices saying that those wanting treatment should go to one of half-a-dozen metropolitan hospitals five or ten miles away from the munitions works. It was asking for trouble.

I hope that those who are trying to annul the Regulation will reconsider the matter and withdraw their objection. We have such conditions as we have never had before which are bound to give rise to an unfortunate state of affairs socially. Husbands and wives are separated, there is an absence of home life, and there is every possible temptation. The hon. Member for East Birkenhead (Mr. Graham White) has rightly said that no Government dare resist the responsibility of enforcing some Regulation of this kind. We were told by Sir Wilson Jameson in his broadcast a few weeks ago that in discussing this matter we have to remember that we are dealing with a public health problem and that we must dismiss the idea that we can do anything other than apply public health measures if we wish to secure treatment for the relatively small group of cases who play a big part in the spread of venereal infections, as provided by Regulation 33B.

Photo of Mrs Mavis Tate Mrs Mavis Tate , Frome

The hon. and gallant Gentleman the Member for Blackburn (Captain Elliston) has asked those of us who pray against the Regulation not to deny the public this measure of protection. If we believed that Regulation 33B was a measure of protection, we should have no right and certainly no wish to pray against it. It is because we feel that the measure is inadequate and in many respects undesirable that we oppose it. All of us who studied the question before we came to the House to-day had already appreciated that there was great need for something to be done, for venereal disease is not like any other disease. Its effects on future generations and upon perfectly innocent people are so appalling that we have no right to ignore it and to leave things as they are. I do not think that it can be confined purely to the medical aspect. One side of the problem which has been very little stressed in the Debate is the lack of facilities for recreation in so many parts of the country. That has a real bearing upon this question. We need a far larger number of recreational facilities all over the country, especially where young people are gathered together in large numbers.

Under the Regulation two people who have contracted venereal disease and who believe that they caught it from the same person give information. I would ask the Minister why, although the person informed against must have treatment until he has the disease in a non-communicable form, no such compulsion is placed on the two people who have informed against him? Am I right in believing that there is no compulsion on the two informers to complete their treatment? If so, that is a serious deficiency in the Regulation. In our prisons there are a large number of people, and for years it has been a source of grave concern to prison visitors and those in authority that they had people in prison suffering from venereal disease in an acute form and that they were obliged to discharge them from prison knowing that they still had the disease but they were able to bring no compulsion on them even to receive treatment. It is possible for a woman to go into prison with venereal disease and for the prison authorities to know it, but it is impossible for them to examine her unless she gives her consent. Before we pass a Regulation such as 33B surely we ought to do something to deal with the disease in prison, where there are doctors, hospitals and facilities for treatment and cure. I am aware that that comes under the Home Office, but when we are dealing with a matter as serious as this it would surely have been possible for the Home Office and the Ministry of Health to come together and provide adequate facilities for treatment in prison hospitals. It may be said that that would lengthen the term of imprisonment and involve many other difficulties. I can only say that if a woman were found to be suffering in prison from small-pox she would not be able to leave until the disease had been treated and cured. We must consider venereal disease as of infinitely greater social importance than small-pox.

I endorse everything other Members have said about the necessity for clinics. I appreciate, however, that it would be impossible to have a clinic in a small place where everyone would know what people went to the clinic for. It would mean that people would not go for treatment. That is very natural. We have, however, all over the country enormous munition factories with, in many cases, adequate clinics for treatment inside them. To these, people can go if they have a small accident or a sudden acute illness, to receive treatment and advice. These clinics exist in munition factories, and there is no shame or embarrassment in going to them. Would it not be possible to instal there also facilities for instruction and advice as to the treatment of venereal disease in its early stages? Before we pass this Regulation are we able to say that we have done everything possible about instructing the young and adolescent and even the adults? There has probably never been such an opportunity for mass instruction in the history of our country. The people are ready for it and the facilities are arranged. I know that it is common talk that the young know a great deal. One often hears it said that they know everything. I think they know very little, and often have it told them in a very undesirable way. A great deal needs to be done in that direction. A great deal more could be done by lectures to our troops telling them of the appalling effects of this disease upon future generations.

That instruction has not been effective I think all of us know, because the lamentable superstitions which surround the disease have not been dealt with effectively. It is an unpleasant thing to speak of, but hon. Members probably know that there is a superstition among men that they can cure syphilis if they have intercourse with a virgin. To say that may sound ludicrous, but the effects are not ludicrous for the unhappy little children who are raped because of that superstition. I can say as a magistrate that that is the definite reason in some cases for the raping of children. Surely we cannot satisfy ourselves that we have given adequate instruction when such a ridiculous superstition can still exist. I appreciate the difficulties with which the Minister is faced, and I know that in everything one has to take the first step, but I do not feel that we have taken the first steps that we might have taken with very great ease since the beginning of the war, and I feel that we are now bringing in a Regulation which makes possible blackmail. I am not opposing the Regulation from any consideration that it will have an incidence of unfairness on one sex or the other. This disease has so serious an effect upon the innocent unborn child that I would willingly back Regulations that would really deal with the difficulty even if I thought they would be unfair to men or unfair to women.

We must have vision in this matter. It is because I feel that the Regulations are inadequate, that they are lacking in vision and that they are designed to make people feel we are going something whereas in fact we are doing pitifully little, that I am against them. Why have we not had a larger number of women police? I do not agree with the hon. Lady the Member for West Fulham (Dr. Summerskill) in advocating compulsory notification, because I agree with the hon. Member for St. Albans (Sir F. Fremantle) that it is not practicable at the present time even if it is desirable. The few suggestions which I have put forward—better recreational facilities, far better instruction of the young, the adolescent and the adult, clinics in munition centres, treatment of prisoners—are all practicable, and I believe would do more than 33B, and I believe that unless we are prepared to advocate all those things we have no justification for bringing forward a Regulation which is based solely on the common informer.

Photo of Dr Hyacinth Morgan Dr Hyacinth Morgan , Rochdale

I rise, with an experience of medicine not in one direction only but in many directions, to oppose compulsion in any form, whether it is notification or whether it is treatment. Apparently it is not only the general public and the venereally infected who have certain delusions and superstitions about venereal disease. The idea of compulsion is rampant in medical bureaucracy. I warn the House that there is a great danger that a certain type of medical men are banding together in order to get people to do things which are really unnecessary and unjustifiable from the medical treatment point of view. I ask the Minister to look at the officials of certain of the bodies which are backing this Regulation. One has certain medical men on its council. One of those medical men is the medical officer of the Prudential society. You look at the investments of the Prudential society and see what I mean. Another one, a very good man, a Labour Member of Parliament, a very fine chap, is medical adviser to May and Baker, one of the firms which makes the drugs used in the treatment. I am casting no reflections on those medical men at all. Far be it from me to do that. I happen to be medical adviser to a certain influential organisation, and the first charge that is made against me even with regard to an expression of strictly impartial medical opinion is that I am biased in favour of the workmen, which I am not. The men who occupy these positions should be like Caesar's wife, beyond suspicion, and should not allow themselves to be appointed to such bodies.

The hon. Lady the Member for Frome (Mrs. Tate) referred to the delusion of certain men who have venereal disease that they can rid themselves of the poison by infecting innocent girls. It is quite true, but there is also a delusion among some medical men. It was mentioned in another place by a very fine medical lord, one of the finest I have ever known, generous-hearted, skilled, who would see patients for me for nothing or for 5s. or for 10s., while other medical men would charge 10, 20 or 40 guineas. He has always treated me very nicely and is a perfectly noble specimen of the other Chamber. But there is the delusion among medical men that venereal disease is always curable. Believe me, it is not. [Interruption.] It can be cured in some cases. Sometimes patients resist the most intense form of treatment. If any medical man on the other side or the Ministry of Health denies that, I am prepared to submit a case, and if they can cure a case of congenital syphilis, no one would be better pleased than the victim. There is the case of a clerk, who had been infected by his parents, who was taken into the Army, against medical advice of the strongest possible description. And where did the Army place him? He was put into the kitchen, to peel potatoes. This boy, knowing he was infected, knowing that he had had treatment, knowing that he had done his utmost to get clear of this poison, was so worried by fearing that if he got a cut in the kitchen he might be infecting the soldiers through the potatoes, that he attempted to commit suicide; and then the Army wanted to prosecute him for attempting suicide. He is still in the Army, and I very much doubt whether he is not still peeling potatoes. I say that informers or no informers, degradation or no degradation, there will be difficulty in curing patients, and it is far better to take a patient quietly aside and give him treatment which will clear him of this inherent poison.

I have warned the right hon. Gentleman before that he is acting on very bad advice—he, a democrat, a Liberal, open-minded, anxious to do well, worthy of congratulation on his efforts. [Interruption.]—Do not interrupt me with trivialities. He has to try to do his best, and it is a very difficult position. A Minister of Health who is a layman cannot possibly act against medical advice given strongly to him from official quarters. It is almost an impossible position. Does the Minister not realise the mental and psychological effects upon a woman or young girl, an innocent person, against whom an informer lays a charge? The informer may become infected when drunk or doped and may not be quite clear where the infection came from, and have no real means of knowing, but is prepared, because of looseness of mind, to mention a name. Does the Minister realise the degradation for a young female, being submitted for the first time to compulsory examination in a public clinic, having her private parts opened by instruments in order that the examiners may get a proper view, and take proper swabs? It has the same degrading effect upon that girl as on a boy when he is first degraded in an act of sodomy. The examiners have to put their fingers into the dirtiest part of the human anatomy to massage the organ called the prostate, in order to take swabs.

This is not a very pleasant subject, and we should not be debating it. It is a subject for debate by a special committee of the Ministry of Health. There are some subjects which one should discuss with decency and in confidence, instead of doing it in public, and I feel very disinclined to discuss the subject. Does the Minister realise what can happen to a girl, innocently accused of some infection which she has not got, if she should become infected at a clinic from instruments which had not been sterilised? That has happened before. Do not tell me that it has not, because I know of instances in which it happened, in Great Britain as well as on the Continent. I feel as deeply and as strongly as anybody can on the subject of the proper treatment of venereal disease. The very first practice I had in my profession, after leaving Glasgow University, was when I fell unwittingly and unprepared into this kind of practice in London. I felt that the world was a hell. It was something I had never seen before. I had never seen it in Glasgow; I had to come to, London to get my first view of this aspect of the degradation of humanity.

I ask the Minister in all sincerity to think this thing over again. Let shim provide adequate facilities for treatment and do all he can voluntarily. Let him beg people to go to get treatment. I have never yet known a venereal case, when the situation was properly explained in strict confidence, that would not accept treatment. I have never yet known the most hardened prostitute on the streets, who might infect nine, or perhaps 20, people a night, when approached properly and with the true proletarian touch, to resist the call to get proper treatment. Sometimes doctors—I have seen them in workmen's compensation cases—lack that human and proletarian touch. Many of my friends in the profession have been venereal specialists, and I have had many opportunities of conversation with them. I would ask the Minister of Health to provide a little more education on voluntary lines and facilities everywhere for treatment. It can be done, and it ought to be done.

Before the Minister tackles the question of venereal disease, I would ask him to provide facilities for treatment for leprosy carried by refugees from the Continent and by people from the Colonies. There was a case in which I made a diagnosis and was sneered at, but have since been found to be correct, connected with refugees coming in from Europe, who have led to a great deal of extension of this disease, even in a country like Great Britain, where conditions are high. I would make an appeal to the Minister. What has been said and written in the Press, and what the medical Press has considered, would move anybody who has a human heart and really wants to see efficient treatment, but we shall not get results by compulsion. You will get much better results by the voluntary method. If the Minister does not know how to work the voluntary method, let him ask psychologists. He will find that they are easy of access, know their job and can do it properly. Let him provide facilities, not only in London but elsewhere, quietly and in the way which will attract the ordinary respectable mother who finds herself innocently infected and who may become the talk of the village, her reputation damned for ever if the information leaks out because somebody has informed against her. Whether she is innocently or guiltily infected, some stigma will remain on her for years. She may have to leave the village. I ask the right hon. Gentleman to consider the matter again. Let him withdraw the Regulations and do the thing in a proper and decent way.

Photo of Sir Joseph Lamb Sir Joseph Lamb , Stone

No matter what our opinions are upon this very undesirable question or how we have decided to vote, this House and the country must be greatly indebted to the hon. Lady who introduced the subject, because it has given the country and ourselves an opportunity to give voice to the question. I am sorry, after saying that, that I cannot support her. If I supported her, I should be helping to deny the public something which they ought to have. It is not as much as they ought to have, but I could not support something which might drastically deprive the public of what it ought to have. I am sorry more drastic measures are not being proposed by the Minister. He ought to ask for more; I am sure he would get more. The hon. and gallant Member for Kingston-on-Thames (Sir P. Royds) made a most effective speech. We are not privileged to hear him very often. He referred to the Services, but this question is not confined to the Services by any means. It is much more widespread than that. The right to discuss it is not confined to the medical profession, and we have heard very great divergence of view among medical people, all of whom are of great ability. The general public take a great deal more interest in this subject than they have ever done before. Much can be done by voluntary effort, but unfortunately we have tried voluntary effort for so long, and the results have been so little that I am afraid we must have compulsion.

Legislation is necessary. Legislation is not for punishing people; that is the wrong idea. It is to protect individuals. We ought to do what we can to protect these people. There is more necessity for protection than ever. The war has destroyed many things, but one of the great disasters is the extent to which it is destroying family life. People are being turned from their homes and from the protection of their fathers and mothers and being sent into districts quite foreign to them, to associate with people whom they have never met before and know nothing of, and they are put in very great danger. Not only have we a responsibility to the younger people themselves, but most certainly to the parents of those young people. It is a very great wrench to them to part with the children they have reared and seen grow up as decent citizens and good children, and to know the risks to which they are being exposed. We should do everything we can not only to protect the individuals but also to assure the parents that we as a country are doing as much as we possibly can to compensate them for the loss they have sustained by parting with their children.

Some people are against compulsion, I know. They wave their arms and say we are a democracy. Most people who do that do not know what democracy means. They seem to think it means to give them liberty to the extent almost of licence. Democracy has its obligations as well as its rights. We have our obligations to these people. While protecting all the liberty we can, we must remember that liberty also has its obligations. There is the question of education. To-day we make it compulsory for a child to have its head examined. It is very objectionable for a child to be told that its head is dirty and that it must go home to be cleaned. If we can adopt compulsion for that, to see that the child is protected by having the heads of all the children examined, can we not have protection to see that a child is assured of a clean father and mother, as well as of a clean neighbour sitting on the benches in school? We must not be opposed to compulsion when it is for the benefit, and in the interests, of the general public as a whole. As for liberty, liberty for what? Liberty has its obligations, and we must give all the liberty we possibly can consonant with the proper provision of protection for the individual. I have had the honour of being associated with hospitals of various types, including mental hospitals. Other Members who have had that privilege will call to mind the cases they have seen in hospitals. I feel sure they will realise that this Regulation does not go far enough in giving the protection we ought to give, not only protection for the individual, but protection for the unborn child. We spend a tremendous amount of money on clinics at the present time. At the same time how many of these clinics find a great deal of their work due to the fact that those who brought a child into the world are responsible for the condition for which the child is being treated? These are points we need to consider seriously.

In the old days it was thought that this affected the large towns rather more. Perhaps it was so, that the towns were looked upon as being suspect. But it is not confined to large towns now. Since we have put up all these factories and hostels and public institutions in the outer areas, it will be found that this same disease is becoming rampant all over the country, and it is not confined to large towns. The trouble in this respect is that while in the large towns those affected are close to secret places where they can be treated, it is the case very largely in the rural areas that they are miles away from such clinics, and consequently the remedy is not as available as it ought to be. There is one case in which I think that the rural child has sometimes an advantage over the town child. It is more closely associated with animals and nature, and consequently knows more. That brings me to education. I believe we should have more education on this matter, but not voluntary education. That is where the trouble has been; it should be compulsory education. Education has been given, in some cases, by various associations which collaborate with the education authorities by dealing, not with human beings first, but with plants and animals. Then the child can be brought to the consideration of the human question. It must be compulsory; otherwise you will find that someone on an education committee who is squeamish will say, "It is not nice, and it must not be done." That will apply to some of the teachers too.

Another great difficulty is that to-day we have many people from other countries in this country. I am not referring to any particular country. We have to speak generally, and we have to acknowledge facts, and some residents of other countries have not quite the same standard in this matter as we have, or hope to have, and consequently they are a very grave danger here. Let us remember that when we have people from other countries and districts, when they are away from their homes and among people where they are not under supervision, there is a temptation to say, "The neighbours do not know me; I am not known here, and I can do what I like." There is a grave danger.

Photo of Mr Henry White Mr Henry White , Birkenhead East

The hon. Member has stated something which has been said before in this Debate about the presence in this country of large numbers of foreigners which may give rise to a false impression. It might be thought from what has been said that the presence of our Allies in the country had in some way increased the menace which we are discussing. I rise for the purpose of saying that that is not the case, and that there has been among the Allied Governments in this country very grave concern about the state of things they have found here. That is another reason why my right hon. Friend must act, and act quickly in this matter.

Photo of Sir Joseph Lamb Sir Joseph Lamb , Stone

I quite agree. I am glad that when they came here they realised the state we are in, because we have been too blind to realise it. But I think people who have travelled will agree that in general the standard of the treatment of this undesirable traffic has been more lax in other countries than perhaps it has been here. I am not talking about the results of it. I am casting no reflection. Other people may think as they do without my having the right to interfere with them, but I feel very strongly on that point. I feel we ought to realise the fact that, bad as we were in the old days, we did at least try to appear respectable. I wish to make it quite clear we are speaking about very large numbers of people who are in fact people with whom one may like to sympathise—these boys and girls who have had to leave home; it is they whom we ought to protect as well as those who are affected.

There has been a reference to the scarcity of doctors. We know it The only answer I can give—perhaps it is a poor one—is that first things come first, and I believe that so far as the health of the public goes this is one of the first things, and consequently all the doctors required should be made available for this, even if some other things are neglected at the same time. I believe that if the Minister is really bold in this matter, he will find that there is far more of the public behind him in the efforts he makes to eradicate this disease than he realises, but unfortunately the position is the same as at elections, in that these people who support one do not say very much. Let the Minister realise that there is this vast quantity of non-vocal support for him in the country. At any rate, he will have the satisfaction of knowing that he has done what is right.

Photo of Mr George Muff Mr George Muff , Kingston upon Hull East

I have listened to speeches by the hon. Member for London University (Sir E. Graham-Little) and my hon. Friend the Member for North Islington (Dr. Guest). Both are supporters of the Minister. My hon. Friend the Member for North Islington was confident that we could not find the doctors to deal with this evil. If so, why should he support the Order? The hon. Member for London University told us frankly that this was an epidemic. If it is an epidemic, it is the duty of the Minister to use every possible means of combating it. The promoters of the Prayer have performed a great public service. Orders-in-Council come, Orders-in-Council go, but the flow of life goes on with the same old rhythm. To-day we have had a show-down. I cannot remember in my 10 years' membership of this House a Debate in which we have had such forthright frankness. I am certain that every reputable newspaper will tell the nation to-morrow that we have had a discussion on this dreadful evil, and even the B.B.C. may mention the fact. When the noble Lady the Member for the Sutton Division of Plymouth (Viscountess Astor) mentions the evil of alcohol, this House should say straight out that too much alcohol is not good for you.

I have been an Army welfare officer in the Northern Command for nearly three years. It is my job to mix with the families of serving men, owing to the troubles which have come along with this war. Every officer connected with a unit in any regiment in this country or outside receives from the Army Council copies-of a talk—not a hypocritical, but a straight talk—which he is to give to his troops, on the dangers which face them now that they are in the Armed Forces. Some people think that the Army Council has no human sympathies, but I am glad that in those instructions which are to be communicated to the troops the men are told of the danger, they are told what they can do if they fall into the danger, but the fact that is emphasised most is that the best thing is to practise self-discipline and try to keep away from this evil. I am glad that the professional prostitute is largely ruled out. As a magistrate of many years standing, I have had a certain amount of sympathy with those women in the past. The danger to-day is from the amateur prostitute, who has either a cut price or no price at all. This brings us to our methods of teaching these girls and boys of the dangers in front of them. I hope that now we have torn the veil from those hypocritical attitudes of mind, now that we can mention such names as syphilis and gonorrhoea, we can moralise upon what has happened to Empires in the past and what has brought them down—moral degeneration. Therefore, I have intervened in the Debate to put away the old silly teaching which was supposed to come from the Army and the Armed Forces that a man was compelled, to do certain things. He is not. Everybody who goes across the water, say, to places like India, is told that it is the best and far more manly thing to be able to refuse to undermine his moral qualities either by drinking or mixing with this even greater evil. How are we to prevent it? I do not know which way to vote so far, but I am convinced of the evil. I know that the authorities in the Armed Forces are trying to tackle it.

I do not like to use personal references, but I must say that, sitting on a watch committee, I have regretted that I generally cast my vote against the appointment of women policemen, but now, having seen the powerful, unobtrusive and good work of the women police in the W.A.A.Fs., the A.T.S. and the W.R.N.S., I think it is high time the Home Office gave more permissive powers, and compulsory directions too, to watch committees and standing joint committees—as my hon Friend says, there is no boundary of immorality now between the country and the town—to see that women police of the right sort are appointed, in order that their advice shall be available, especially to these young girls. I do hot wish to be puritanical or censorious or even hard, but in the course of my duties in going to camps and seeing a collection of these irresponsible amateur prostitutes—they are nothing more or less—I have felt that I could take the law into my own hands and give them a jolly good slapping. But I have to leave it to the Home Office. I know that my right hon. Friend would be loth to administer corporal punishment, even to his worst enemy. The Home Office, especially that department of it for which my hon. Friend is responsible, should tear down the mid-Victorian curtain which has so far shut him out from the outside world, and should tender more vigorous advice to the watch committees and standing joint committees to follow in the train of the War Office, the Navy and the Air Force.

Mention has been made of the guests we have in our midst to-day, those gallant young fellows who have come across the seas in order to help us in our time of need. I hope that every hon. Member has read the instructions that they receive when they come among us as our honoured guests. They are told in language equally vigorous to that of our own War Office that the best way is to keep decent and clean, so I am waiting to hear what the Minister of Health has to say to us. I hope he will not be like the negro preacher and say to this House, which is giving a lead to the nation, "My dear brethren, having looked the difficulty in the face, I pass on to the next subject." I hope he will not do that but will endeavour to give a lead, in order that we may rescue the coming generation from the dreadful evil that threatens to overcome it.

Photo of Mr Tom Driberg Mr Tom Driberg , Maldon

This is a Debate on a medical subject in which I think it has been quite right that a number of laymen should take part, because except perhaps for tuberculosis there is probably no disease which can less properly be considered in isolation from its social context than venereal disease. It is now about six weeks, I think, since I asked the Minister of Health a question with regard to a propaganda and publicity campaign to spread enlightenment and education about this disease, in view of the very alarming increase in its incidence. He gave a glowing answer, full of what was being done and what would be done through local authorities and in all sorts of ways. I go about the country quite a lot, and I have been in London and various parts of the country since then, and I can only ask the right hon. Gentleman, Where is his campaign? I have seen no signs of it at all in the various parts of the country I have visited. Whether his Department or the local, authorities are responsible I do not know, but venereal disease is still largely underground as regards public discussion and enlightenment. There have been, it is true, a few isolated stories and references in the Press and a certain amount on the B.B.C., but a few isolated stories, I must remind the right hon. Gentleman, are not a campaign. In fact, those stories have mostly consisted merely of quoting some distinguished personage as saying that we must "lift the veil of secrecy." Very few have contained any practical advice, information, or instruction to the citizen.

I am rather sorry that one or two hon. Members saw fit to make the suggestion that part of the trouble was caused by the presence among us of our Allies from foreign countries, that they are people who have a lower moral standard than we English. I must put in a word on behalf of the good name of our Allies. I do not know whether the references were intended for trans-Atlantic or European people, but in any case I think they were a monumental example of that insular hyprocrisy of which foreigners so often accuse us. Some of them are exceedingly shocked when they come to London and see prostitutes on the streets and pavements, a sight which is unknown in their own countries, where they order these things differently. I am not saying which is worse or better, but I do not think we can cast the first stone.

Photo of Sir Joseph Lamb Sir Joseph Lamb , Stone

As I was one of those who referred to this matter, may I point out that I did not wish to cast any slur on any of our Allies? All I said was that they had a different mentality on this subject. We have not done anything here; in many cases they have regularised it.

Photo of Mr Tom Driberg Mr Tom Driberg , Maldon

I am very glad if the hon. Member meant to pay a compliment, but I think he phrased the compliment equivocally. I quite agree with him that some other countries have undoubtedly tackled the subject of venereal disease more effectively than we have done so far. Reference has been made to Sweden. Some figures from Sweden were quoted, and some hon. Members showed a disposition to cast doubt upon them, apparently on the principle that if statistics are unpalatable they must be inaccurate. I do not intend to refer further to Sweden, but I have one very brief set of figures from another country, the Soviet Union. Unfortunately, statistics are not obtainable from there during the present war period or for the immediate pre-war years, but I have two comparable years, one four years before the Revolution and the other 18 years after it—1913 and 1935. These are the figures for fresh cases of syphilis per 10,000 inhabitants. In towns the figure, in 1913, was 25.67, and in 1935 it was 1.8. In villages, in 1913, it was 2.66, and in 1935 it had fallen to.62. There was quite a remarkable and drastic decline in the incidence of venereal diseases in the years following the Revolution in Russia. How was this brought about? We can at least learn something by looking at what those Allies did. First—and I think the most important thing in a way, on a long term view—it was done by raising the cultural and economic level of the whole people. There is still much that can be done on those lines in this capital city of ours. I do not believe that London as it is at present is a worthy capital of so many free nations of the world. It is dingy by day and sometimes Hogarthian by night. I suppose that, apart from the seaport towns, there is no greater concentration of venereal infections than is to be found in the West End of London and particularly in the district known as Soho.

One or two hon. Members, the hon. lady who seconded the Prayer and the Noble Lady the Member for the Sut-ton Division of Plymouth (Viscountess Astor), referred to drink. I think that the Noble Lady, who I am sorry is not here at the moment, rather exaggerated this aspect of the problem as she does sometimes tend to. She said that most social evils are moral evils, and she went on to say that drink was at the root of them. I would cavil at both those statements. I think excessive drinking of bad liquor in sordid surroundings may be an aggravating feature of this problem, but I do not think that drink in itself is either good or bad—good rather than bad, in fact. But a great deal can be done to clean up constructively London, and in particular the West End of London, and to provide for the legitimate claims to entertainment and welfare of the hundreds of thousands of troops of all nationalities who are now pouring into London and through London on leave. Even in the middle of war, perhaps even more in the middle of a war like this, they are entitled to their recreation and entertainments, and, if they are not provided with decent recreation and entertainment, they will fall back on the more squalid sorts, which breed venereal diseases, among other things.

I am attracted by the suggestion made a few months ago by the magazine "Horizon" that there should, within the limits of war-time economy, be a large and gay United Nations exhibition in Regent's Park next spring and summer to divert some of the thousands of people who spend their time mooning about the dreary West End streets and, after dark, drift into these dens.

But propaganda and enlightenment and amenities of that kind are not in themselves enough. I am convinced that the right hon. Gentleman will have to deal far more drastically than he has so far shown signs of doing with this problem as an immediate and urgent issue. It was not only raising the cultural and economic level of the people that reduced venereal disease in Russia. It was also because they took very drastic measures—more drastic than anything we are suggesting, such as imprisonment for six months, which was the penalty for knowingly exposing anyone to the risk of venereal infection. We are not suggesting anything as drastic as that, but we are suggesting something a good deal more drastic than 33B, and I agree with the hon. Lady who moved the Prayer that notification should be made compulsory. I am not impressed by the argument advanced against that by the hon. Member for North Islington (Dr. Haden Guest). He said that notification is compulsory in the Services, and it has not been a success, because it is in the Services that we have venereal disease still flourishing. The answer to that one is easy. Notification is not compulsory among the civilians with whom the Service men associate and from whom mostly they get infection. That is not really a fair test of notification at all. You must have it over the whole community, otherwise I agree that it will not be effective.

The right hon. Gentleman will, of course, have observed that two main trends of opposition to his Regulation have developed in the course of the Debate. There is the trend of those who say that the Regulation does not go far enough, and the other trend of those who say it goes too far in the direction of compulsion, that we simply need more clinics and more education, and that it should be left entirely voluntary. I hope the Minister will not say that those two trends cancel each other out, because of course, they do not. They provide a two-pronged thrust, and they reinforce each other. I am attempting to make a kind of synthesis of the two. The right hon. Gentleman's position vis-à-vis these two powerful trends of opinion is really quite untenable. If you have two sets of people, A and B, and A advocates certain measures which will be offensive to B, it is no good taking a half measure which will still be offensive to B and will not satisfy A. It does not please anyone, and it does not seem to do very much good. I hope that he will allow this Regulation to be annulled and that he will think again, and think quickly, and act much more vigorously.

The second trend of opposition to the Regulation, although I welcome it, frankly, for the votes it may bring in, I rather deprecate because I think it is, although perhaps not always consciously, a survival of the old obscurantist kind of puritanism which in the last century held that it was immoral for women to have anaesthetics in child-birth. It is a survival of that type of attitude, and some hon. Members will probably recall that it was the great Queen Victoria herself who gave that particularly degrading superstition its quietus. During the week-end I discussed the subject and this Debate with several clergymen and a number of other Churchmen. They were unanimously in favour of compulsory notification and the education of young men, in the Services and out of them, in the use of simple techniques of preventive disinfection. Whether some of those clergymen would have the courage to say so publicly I do not know, but they said, after talking it over, "We know it is right. We cannot get away from it, and it is simply a medical issue because of the innocent people who can suffer." It is primarily a medical and not a moral issue, although it has important social implications. I beg the right hon. Gentleman to regard it simply as a medical issue and not to allow his mind to be swayed by any considerations of the retrograde (as I think) moral kind which may have been advanced by one or two hon. Members. It is not the right hop. Gentleman's business to make his Ministry a ministry of morals any more than it is Mr. Mullins's business to make his court a court of morals. He is a Minister of physical health, and I hope that he will take the most effective steps to implement that task in this respect.

My last point is this. Several hon. Members have shown a disposition to support the Regulation and vote against our Prayer because, they say, "We are all for compulsion, and this is a step in the right direction. It is better than nothing; it is an instalment." Those phrases have been used over and over again. I differ very strongly from that point of view. If, as one hon. Member who supported the Regulation said rather querulously, it has taken the Ministry eight months from the time it was first raised to take this first very cautious and timid step, how long will it take them to take a more drastic step? The war will probably be over by then. I do not agree that the Regulation is better than nothing. If anything, it is worse than nothing, because not only, as has been shown in several hon. Members' speeches, is the Regulation likely to be ineffective and dangerous, and in any case would apply only to a very small section of the infected population, whereas the problem is a large and growing one—not only that, but it is worse than nothing because it causes a delay in the introduction of the really necessary drastic measures. I cannot profess to speak with anything of the weight of medical authority that some hon. Members have displayed on both sides in this discussion, but I am comforted and sustained to know that we have the approval of that great man Lord Horder with us in moving this Prayer, and that he feels strongly that this Regulation will be ineffective and in many respects undesirable. I therefore urge hon. Members to vote with those who have moved this Prayer, in the hope that the right hon. Gentleman will see his way to take quick action of a far more drastic and effective kind in the cause of the healing of the nation.

Photo of Mr Arthur Molson Mr Arthur Molson , High Peak

I think my right hon. Friend the Minister of Health will have a comparatively easy task in replying to those of us who are supporting this Prayer. I very much regret that the general criticism which has been made of this Regulation comes from different angles and that, a great deal of it is completely inconsistent with what has come from other critics. I should like to ask the Minister to deal with one or two of the points of procedure in connection with the Regulation. It appears to me to be a quite illogical compromise between those who desire to see effective compulsory action taken and those who desire to rely completely upon persuasion. The argument has been used that to compel notification or treatment of venereal disease would be an interference with the liberty of the individual. I am not impressed by that argument. It has long been recognised that in the case of almost any other form of disease which is communicable, the individual can be compelled rightly in the general interests of the community to admit that he or she has that disease and to accept the necessary treatment. This arbitrary distinction between other complaints and these particular diseases, whose only difference is perhaps that they are even more anti-social, can only, I think, be accounted for by the old conspiracy of silence.

Photo of Dr Hyacinth Morgan Dr Hyacinth Morgan , Rochdale

The hon. Member says that anybody who has an infectious or a contagious disease should be compelled to disclose it for the public safety. Would he then advise any person who had leprosy, innocently contracted, but who had no signs of it externally, publicly to divulge to the public authorities the fact that he had leprosy, knowing that with the present views on leprosy he would be segregated and interned for life—even though he could not infect even his wife?

Photo of Mr Arthur Molson Mr Arthur Molson , High Peak

I can hardly think of a stronger argument—that it should be solemnly and seriously suggested that if some one were suffering from leprosy and knew he was suffering from leprosy, he should be allowed to conceal the fact, to the general detriment and danger of the whole of society. I never had a more helpful interruption in a speech.

Photo of Dr Hyacinth Morgan Dr Hyacinth Morgan , Rochdale

You may not think so but I said he was non-infective. You are running away.

Photo of Mr Arthur Molson Mr Arthur Molson , High Peak

It is true that one is reluctant to find legislation compelled to make use of the public informer and yet in this case it appears to me to be in principle justifiable. Here the public informer is only required to give information in order that a medical examination may be carried out, and that surely is not going much further than the ordinary obligation upon every subject to disclose to the police that a crime has been committed. I am most uneasy at the way in which this obligation—or right—to give information is limited. A policeman who knows that some individual in a village is spreading disease all round is not entitled, under the Regulation, to give the information, and no action can be taken until two separate individuals have actually caught disease from the source of the infection. Why it should be necessary to wait until this amount of harm has been done, and why anyone who knows of the source of danger should not be obliged, in a similar manner, to give the information I cannot understand. It is only when someone presumably has had sexual intercourse with this person and has contracted the disease, that he is allowed to give the information. It seems wholly unreasonable and quite illogical. I am also uneasy about the effect of the clearance certificate. This seems to be a half-hearted introduction of the Continental idea of giving a clean certificate to prostitutes. In this case there is no guarantee at all that after the certificate has been given, within the course of the next day or two, perhaps, that person will not again contract the disease.

I urge upon the Minister to be more courageous than he has shown himself so far, and to go very much further. I suggest that the Minister should apply to the civilian population the law already applied to the Armed Forces of the Crown, under which it is an offence for a man, knowing that he has contracted venereal disease, not to obtain treatment for it. I suggest that it should in any case be made an offence for anyone knowingly to communicate the disease to anyone else. I believe it should be quite possible to work a system of compulsory notification. I am deeply grateful to you, Mr. Deputy-Speaker, for having allowed me to intervene for a few moments. I feel bound to register my vote in favour of this Prayer and against the Regulation. If I had not been able to explain my reasons for doing so and if it had appeared to the public mind that I was associating with those who are not prepared to use compulsion in order to weed out this great scourge, I should have been obliged to abstain from voting altogether.

Photo of Mr Robert Boothby Mr Robert Boothby , Aberdeenshire and Kincardineshire Eastern

I shall not detain the House for more than three minutes. I want to put one main point to the right hon. Gentleman. The Debate has been very interesting, and, with the possible exception of the Noble Lady the Member for the Sutton Division of Plymouth (Viscountess Astor), everybody has taken very much the same broad, general view of this problem. The Noble Lady seemed, at one point in her speech, to regard venereal disease as a rather salutary form of punishment for those who have been doing wrong, as against, say, mumps, which is a really serious disaster. But I feel that nobody resists the view—to which the Noble Lady herself came round in her concluding remarks—that any step which can be taken should be taken to try to control this frightful scourge, and the only real difference underlying the Debate is on the extent to which hon. Members think compulsion should be used.

If I have one criticism to make of the speeches, and I have listened to practically every one, it is that not quite enough emphasis has been laid upon prevention, as against cure. Every great advance in medical science since time began has been concerned with the prevention rather than the cure of disease. Cure is only a palliative; it is prevention we want. I beg the Minister to concentrate on that aspect of the problem. On propaganda and education so much has been said that it is unnecessary to add a single word, except to suggest that the Minister would be the first to feel that propaganda and education are not as good as he, as Minister of Health, would like to see, and probably he has not got as much money as he would like to spend on this vital social service.

There is one other point I would like my right hon. Friend to answer. I think it is an important point, which has been skirted round. In time of war we are not going to eliminate promiscuity completely from all sections of the population. Human nature is human nature, and sometimes irresponsible. It is well known that prophylactics are in a very large measure effective in preventing the spread of this disease. I would like to put this point to the right hon. Gentleman. I believe the time has come when preventive packets, or whatever one might call them, should, under proper regulations and subject to proper safeguards, be available to the public at authorised chemists up and down the country. It is one method of stopping the spread of this disease, especially in sea-port towns and garrison towns. At present in some shops you can get them; in others you cannot. Some are bad, some are good. The position is therefore most unsatisfactory. I feel that the main reason is that many people have not quite managed to face this particular aspect of the problem. Everybody knows, and nobody can deny, that disinfection is effective if carried out quickly and efficiently.

I believe that sooner or later compulsory notification and compulsory treatment of this disease is absolutely inevitable. It is bound to come. At present there is compulsory treatment for smallpox, for scarlet fever. Who can compare the ravages of this disease with those of scarlet fever? Therefore the argument arises, should we wait until that time comes before bringing in any measure of compulsion, or should we do what the Minister is now about to do, bring in this Regulation 33B? Although I have signed the Prayer against the Regulation I want the Minister to try to reassure the House on one particular point. The common informer rather sticks in the minds of many Members. To what extent is that method likely to open the way to blackmail? And will it be very effective? This disease is most dangerous and infectious in the earlier stages. By the time the informer has come along and action has been taken it may be too late. This is one of the points on which the House would like to be reassured. It is the blackmail aspect that has caused me more anxiety than anything else. I am sure the House will be grateful to my hon. Friend who opened this Debate because it has brought into the daylight and drawn public attention to this vital question, and that can only do good.

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

I am sure everybody agrees that it has been a very good thing to have had this Debate. There is nobody better pleased about it than the Minister. We have been doing a good deal about this very terrible problem for many months past, and this Debate gives me the chance of telling the House some of the things that have been prepared and that are being done. Also it is one of the freshest Debates I have heard for a long time; although I could not agree with my hon. Friend the Member for Maldon (Mr. Driberg) in his ingenious attempt to reconcile the irreconcilable, for what he said was a two-pronged thrust the prongs of which go in different directions. But one thing is certain. The Debate has given the House a chance to show the country that no matter what the convictions of the House may be, there is a very deep feeling about the issue; and, quite rightly, a concern as to whether the first step in compulsion which the Government are making, through me and through my right hon. Friend the Secretary of State for Scotland, is the right first step, whether there is some other which would do more good, or whether, as my hon. Friend the Member for Springburn (Mrs. Hardie) would like, the Regulation should be scrapped and its place taken not by any stronger compulsory measure but by education and the rest—[Interruption.] I said, "and the rest." Whatever may be our differences of opinion about the merits of the Regulation, there are certain very important points upon which we all agree, and the Debate has made that abundantly clear.

We all agree that the effects are evil, and even terrible, both on health and, what is as important, on family life. Insanity, sudden death in the prime of life, sterility, have all been referred to to-day. They are only a few of the results of the disease. An hon. Member has pointed out that babies may be born blind, or may be still-born, as a result of the disease, A family may be reduced to poverty by the death of the breadwinner, when his or her help is most needed. The diseases are an evil which, I am sure, the House and the country agree must be stamped out, if possible. The second point upon which we agree, whatever our view, is that the spread of these diseases hinders the war effort. Let the House not forget that this is a wartime Regulation. Let me say here that it is useless merely talking about a Regulation for compulsory notification, as the experiences of all the countries that have had it show, unless you have behind it great legal powers, some of them of a very drastic character. Let me make that quite clear. My hon. Friend the Member for Maldon, when he talked about the Soviet Union, did not go very far in his analysis of the methods of compulsion in the Soviet Union. I do not know whether, if I had proposed to follow those methods in a Bill—for it would demand a Bill, not a Regulation—I should have found him standing up in this House as my supporter, or whether he would not have been supporting ah Amendment, "That the Bill be read a Second time upon this day six months." I will come back to that later. We all agree that these diseases hinder the spread of the war effort. Women in the home or factory are being incapacitated; men are being kept from their proper jobs in the Services or in the factories, or—and this is most important—on the sea. This applies to those who not only go untreated but to those who are under treatment and who, owing to the conditions necessary for their treatment, may be prevented temporarily from following their occupation.

We are all agreed upon another thing. There have been sneers at the Victorians. I was born in the Victorian age—not a spinster and not sheltered. I left the elementary school at 13, and I have had a very hard battle in life. So the hon. Lady's joke was not addressed to the right quarter. But there is a great deal to be said for the Victorian, a great deal more than has been said in recent years by some people who had not their roots there. All the same, I am not a Victorian, but I say that, despite the sneers at the Victorians and the Puritans, I believe that, whatever view we may hold in this House, we shall all agree that there are moral, ethical and spiritual issues behind this question. We know that promiscuity is wrong and it is dangerous, and my answer to my hon. Friend here is that it cannot be made safe. My answer to him and to the recommendation in the Trevethin Report about prophylactics is that the Medical Research Council refused the task of recommending what should be used by way of prophylactic. It is by no means as simple as that, and there is besides—and this is my only reference to this subject, because I do not want to be diverted from the main topic—the most profound issue that this country will have to debate before long—the issue of the future of the race. The fact is, self-control is the proper course, and, whether we are Victorian or Puritan, it is beneficial, both medically and morally; we know that a higher ethical standard and a fuller appreciation of spiritual values are the only complete and final solution of this problem. I would agree with the Victorians who hold the view that personal purity is the only complete prophylactic.

I come now to an area where there is much agreement. I would say that most of us agree—there are a few who still do not agree—that we ought to do everything possible to extend and improve the spread of accurate knowledge about these diseases and about the need for voluntary attendance and continued attendance for treatment. There is a field of agreement there. There is one issue which has not been raised in the Debate, and it is as to what has been the effect of our voluntary system up to the coming of the war. What would be the effect (a) if there had not been this Regulation, and (b) of any drastic compulsory powers so frequently advocated in this Debate? It is a very vital issue, let me say at once, before I come to details later. Apart from some of the States in America, it is interesting to note that there has been only one country quoted, apart from what was said by my hon. Friend the Member for Maldon, as superior in prewar days in their effective treatment of this disease than this country with its voluntary methods, and that country is Sweden. It is a very interesting story, and I advise all Members to seek information about it, and I will try to make some available as to how that effect was obtained and the legal power needed to attain that effect.

I was surprised to hear it said that some of those in this country who talk of complete compulsory notification will go as far as the hon. Lady who moved the Prayer. She did a service. She called attention to the fact that there are 32 States of America where one of the sanctions behind compulsory notification is that there shall be an examination of young people before they are married and that they shall have to produce a certificate that they are free from syphilis. I say these things not as a means of providing debating points at all. I do not want to make debating points in this matter. The thing is much too serious. We have begun publicly on the Floor of this House in extended fashion to discuss this issue, and I hope that the argument will always be on the highest possible plane and that we shall not really seek debating points. Unless something more is done in this country, this may become a tragic issue. We do not all agree, but most of us do, that we ought to keep our voluntary system if we can and make it more effective. That is why the Ministry of Health and its predecessor the Local Government Board for more than 25 years impressed on all responsible local, authorities the importance of education as an essential part of the treatment service. I am glad to be able to tell the House—and this is most important and is part of the answer to my hon. Friend the Member for Maldon—that for the first time during the last six months we have taken steps to co-ordinate education on this subject with all other health subjects in the hands of the Central Council for Health Education. I do not for one moment want to belittle the work done by that very able body the British Social Hygiene Council, but they dealt with this subject in a specialised and separate fashion. I think it was a mistake and that it was difficult for them. I must say a word of gratitude to the Press, although I have not observed anything about this issue in the particular newspaper with which my hon. Friend the Member for Maldon is concerned—

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

My hon. Friend need not rise. He can make a joke with me and I with him. We are not as sensitive as all that in this House. However, I was about to say that the Press has treated this subject most helpfully; and now we have begun to discuss it over the air through arrangements made by the B.B.C., for which I am most grateful, we shall be able to present our education in a way in which it has never before been presented. My hon. Friend asked me to give a bold educational lead. To all those concerned with the spiritual side of the question I would say that I am certain that a bold, constructive and sane discussion of this matter on a healthy plane should help the religious forces in this country to make their own case clear. Those like myself who have given a great part of their life to religious work know that the difficulty of religious teaching on sex is this: If one is a priest, a clergyman or a religious worker and one gives an undue proportion of time to talking about sex, people look sideways, as they say in Australia. They seem to think you are not quite wholesome. I am sure that by getting a really public and healthy discussion on this issue—which we cannot evade, because it is personal and intimate and raises moral issues—we shall make the work of those who lead the Churches and those responsible for teaching religious truths much easier than it has been in the past with its furtiveness.

Now we come to the area of disagreement, which always creeps in directly you suggest further action. Those who begin action know perfectly well that the first complaint made against them is that it is not bold enough and that the second complaint is that you ought not to take it at all. That is what I have been told by the varying voices in the course of to-day's Debate. There are two questions which sum up the whole Debate. Is special action needed now? There seems to be an overwhelming opinion, from what we have heard to-day, that it is. There is, however, a strong and active minority, and I am not quite sure that there is not a feeling outside in the country rather larger in bulk than has been shown in the House. I am referring to the hon. Member for Springburn and the Noble Lady the Member for the Sutton Division of Plymouth (Viscountess Astor). I am not sure whether they do not speak for a good many more people than have been represented by the balance of numbers in this Debate.

The House can be sure that no Minister of Health and no Secretary of State for Scotland would raise this issue unless there were grave cause for doing so, because it is an issue raising personal questions of the most intimate kind. The Secretary of State for Scotland, in Scotland, and the Minister of Health in England and Wales have the duty of keeping the nation fighting fit. That is part of our task. To keep the nation physically fighting fit is not all of our task, for we have more responsibilities than that at the Ministry of Health, but we have that duty. As I have told the House, there are two black spots on our war health record; first, tuberculosis, and secondly, venereal diseases. I have spoken before, and I shall speak again, about tuberculosis. The facts about the diseases with which we are concerned in this Debate are now beginning to be well known. As always in wartime, there is a rise in venereal diseases. It is a very ancient thing in war, and perhaps the finest expression of its connection with war is in that great play of Shakespeare's, "Measure for Measure," that play informed with the light of a pure Christian ethic, a great play, and yet full of sex satire in which Shakespeare continues the hate theme that makes Hamlet cry, about these dreadful things and others, that the universe is unclean, and says, with exaggerated emphasis, but still says, about this old problem: Lechery, lechery! Still, wars and lechery; nothing else holds fashion: A burning devil take them. That is an old feeling, and it goes back thousands of years, and it was, therefore, no surprise that when war came there was a sharp reversal of what had been in this country a very remarkable decline in these diseases. I want to make that clear. It is not true that the work of the Ministry of Health and the Department of Health for Scotland, the local authorities and the medical authorities was failing in the voluntary system in pre-war days, though I do not say that more might not have been done. The last thing I am going to say is that there is any necessary contradiction between this Regulation and further compulsory steps, if they are necessary. What I am pointing out to the House at the moment is that before the war there had been a steady decline, for the number of new infections of syphilis attending centres for treatment fell by nearly half between 1931 and 1939. It is a very good reason for a Minister of Health's being bold, if he thinks that he might strengthen that effort instead of breaking it.

Now if Service infections contracted in this country be included, the estimated rise is 70 per cent. since 1939, which takes us back to the incidence rates of 1932. The fact is that this is a war issue—that is why I am making a war-time Regulation. The clock has been put back 10 years. The latest information is that the rise is still going on and the clock is being put back still further.

I do not think anyone can be deaf to the fact that some regulation is needed. Those who are against any regulation at all admit that we ought to have a great deal more education. Regulation 33B is only a part of the answer to the problem, and I cannot emphasise that too strongly. There has been a tendency to talk as if it represented the sum total of the Government's measures to deal with the problem and as if it is a little, beggarly thing. Nothing could be further from the truth.

In order to get the Regulation into the proper perspective, let us look at the other measures already taken or planned. There are three main essentials in any attack on these diseases. The first is public education, the second is adequate free treatment, and the third is indirect action to discourage promiscuity. I put education first. This is a sphere in which everyone can help. We shall certainly most warmly welcome the support of the Churches for the spread of knowledge, and I hope they will play a very full part in educating the public on the religious and moral aspects of the question. It has been most heartening to me to see that Members show signs of wanting to do that and I shall be happy to supply anyone who desires to take his or her part in spreading knowledge and in the work of public education with any information which will help him or her to do so. As far as responsible local authorities and Ministers are concerned, we have done a great deal in this direction, and more is being done. Educational work has been an integral part of the treatment service since it was set up 25 years ago, and we all know that knowledge is much more widespread now than it was then.

One of the reasons for the change of opinion to-day as compared with 25 years ago is that very fact, that knowledge has begun to spread. Education has been doing its work. In order to integrate more closely all education on health questions the Central Council for Health Education took over early this year, with my assistance and approval, the educational functions hitherto discharged by the British Social Hygiene Council. My Chief Medical Officer has broken new ground recently with the B.B.C. and has been discussing it with representatives of the Press. The Central Council for Health Education has been actively engaged in revising the educational material available, and very soon I shall be able, I hope, to satisfy the hon. Member for Maldon with a whole range of new leaflets and pamphlets, some of which are already available, as well as with competent lecturers and certain films. We are also arranging for a complete new series of posters for free issue to local authorities. [An HON. MEMBER: "Will that apply to Scotland? "] Yes, certainly. In the Services educational work is very fully organised, and I have recently been in consultation with various civil departments, especially on the production side, on the possibility of extending educational work in relation to the activities for which they are responsible; and here also the House can look for expansion. I am sure that that will be welcome to those who raised the issue.

Free treatment under conditions of complete secrecy has been available in this country for the last quarter of a century. There are now 249 treatment centres in Great Britain, of which three-quarters are at hospitals. Eighteen new centres have been provided since the war began, and five more are on the point of opening. Let me be frank with the House. The Service demands for specialists and other medical staff make it progressively less easy to start new centres, and in order to meet the need, especially in those rural parts to which my hon. Friend the Member for Stone (Sir J. Lamb) referred, we have initiated a new war-time arrangement under which general practitioners with special experience provide free treatment in their own surgeries. This is intended particularly for rural areas and to meet the needs of the camps which have grown up there. My latest returns show that 109 practitioners are taking part, and they serve 74 areas in 11 different counties. Both the responsible local authorities and the responsible Ministers try to meet the need wherever it arises, and especially, of course, in those areas to which war workers have been transferred in large numbers. We are only too glad to receive from any source reliable evidence of a need which is not being met. To-day there has been general talk about it but no specific instances mentioned. I would suggest that if hon. Members who feel that there are inadequate treatment arrangements will let me or the Secretary of State for Scotland know, we will do our best to meet the need inside the possibilities of war-time medical needs.

Other hon. Members have referred to indirect action. That may be less easy and less precise, but I agree with all the hon. Members who have spoken—and at least seven have—about the need for meeting the special war conditions. It was most eloquently put by the hon. Member for North Islington (Dr. Haden Guest). War strain comes into this. Absence from home comes into it. Boredom comes into it. These are among the most dangerous conditions leading to contracting the disease. We want indirect help by the provision of more and more healthy facilities for recreation. These are among the most valuable preventives.

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

I agree with the Noble Lady—temperance certainly. Hospitality to the Allies who are our guests and amenities of all kinds for members of the Services gain added value from this point of view. Everybody can help here, and I should like to pay a tribute to the activities of the Ministry of War Transport, the British Council and the Ministry of Labour and National Service through its Seamen's Welfare Board, which are doing so much for seamen in British ports. Much remains to be done. Hostels are being improved, new hostels provided, good billets are found, entertainments and recreation of all kinds are being organised, and rest homes are being set up, Each amenity provided brings added strength to the campaign for preventing the diseases. I agree with the hon. Members who have said that help can be given, in controlling solicitation, by women police, although I think that some hon. Members have over-estimated the potentialities of this method. Over 300 women police are employed in this country, and a number have been appointed since the war began.

I have gone into all this in some detail, because I have discussed with scores of people the points about the Regulation, and I feel that public opinion was feeling the need for these things and would be glad to agree to them if it were aware of the need. Regulation 33B is not, as was said twice in the Debate, a piece of panic legislation hastily conceived. It is not an ill-judged attempt to solve this problem by a single measure, but a carefully framed item in a planned programme. It does not abolish the general basis on which the present system rests and which has proved to be solid ground; that is, it does not replace voluntary attendance by compulsory notification and treatment. What it does—and this is what the Government claim for it—is to stop a gap in the voluntary system which has existed for a long time and which assumes a new seriousness in war-time. [Interruption.] There was such a place as Number 9, Rouen, in the last war. [An HON. MEMBER: "I know!"] So do I, and the interjection was quite irrelevant. If any more reply is wanted, I would remind the House that a Minister did bring down something to this House in the last war. What this Regulation does is to enable those people to be brought under treatment who are promiscuous in their sexual relations, are known to be spreading infection and are unwilling to submit to treatment. As has been said, they are often not criminal or vicious, though sometimes they are; sometimes they are irresponsible, feckless or foolish. Whatever their mental makeup is, we cannot afford in war-time to allow them the liberty to infect others with these dangerous diseases.

What I claim for the Regulation is that it represents a new approach to the problem, namely, a public health approach. That is our claim. It does not attempt to control solicitation, as did Regulation 40D of the last war, and it does not discriminate between the sexes, as did Regulation 40D. It provides the power to deal with a health problem on health grounds in a manner which, in my judgment, provides safeguards against blackmail, for some of the "timidity" of which some hon. Members have complained is due to our desire to make as sure as we mortally can against the risk of blackmail. It was interesting to see the line taken in two leaders written on the appearance of the Regulation, one in "The Times" and the other in the "Manchester Guardian." Those leaders in their concluding sentences accurately reflected the Debate to-day. One thought the Regulation was good but ought to go further. The other thought that the Ministers concerned and their medical advisers had been wise to start by doing their best to get as good safeguards as possible for this first action.

Let me briefly answer those Members who have asked points about the procedure under the Regulation by reviewing it. It will work in this way. A special practitioner, that is, one who has special experience in the treatment of venereal diseases, will, on receiving information from a patient—not an "informer," much less a "common informer"; nothing of the common informer here—about the suspected source of the patient's infection, send on that information confidentially to the Medical Officer of Health. At this stage there are two safeguards. The first is that the patient is liable to heavy penalties for deliberately false statements, and I am proposing to issue a direction that he will know of those penalties before giving detailed information of any kind.

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

I have not yet issued any direction under the Regulation, although I was entitled to do so, because I wanted first to take advantage of any practical advice offered in the Debate to-day, and there are one or two points which have been raised of which I shall take notice before giving my direction.

Photo of Mr Tom Driberg Mr Tom Driberg , Maldon

The right hon. Gentleman spoke of "deliberately false statements." There is a great possibility of error, surely, of unintentionally false statements when there is promiscuity.

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

That may be, but that statement does not come very well from those who want much wider measures of compulsion and many more sources of information, because every country where there is compulsory notification has ramifications and other measures, all of which demand information from some person in some way, some of it anonymous. That will not do. [An HON. MEMBER: "That is a Nonconformist answer."] Well, I will not go into that. The second safeguard is that the practitioner, the Medical Officer, must be satisfied that the information given is prima facie reliable in the light of the medical evidence he has.

Mr. McNeil:

The Regulation speaks of "any special practitioner who receives information." Is the Minister going to ask special practitioners to extract information, or will he depend upon information volunteered by the patient?

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

The answer is that it has always been the practice of medical officers who are specialists in venereal diseases, in the very successful pre-war effort, to do their best to find out where the disease was contracted. It was their public duty.

Mr. McNeil:

You are talking about clinics.

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

I understand. I am talking about the special practitioner. He is defined in the Regulation. The hon. Member will see that there is a Sub-section there, which will answer his question, because we foresaw that point. That is why the next stage is that the Medical Officer of Health must receive two separate notices. We put that in as a safeguard. It is not the case in Sweden, where they take action on information received from one person. In order to safeguard the persons concerned against any reasonable risk regarding false statements, we give much more than a double safeguard by asking for information to the medical officer of health from two different sources.

Photo of Dr William Thomas Dr William Thomas , Southampton

May I put my point now? Suppose information has been given, and the man or woman is found to be innocent. What remedy has such a person against the informer? At Common Law, I believe the person would have remedies. A woman could take action for damages for slander without proof of special damage if allegations were made about her chastity; or if she is alleged to have an infectious disease—she has her two remedies. What remedy does she have under this Regulation?

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

I was coming to that very point, if my hon. Friend would only be a little less hasty.

Photo of Dr William Thomas Dr William Thomas , Southampton

I tried to put it before.

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

That may be, but I want to make the position as clear as I can. The next stage is this: The medical officer of health—

Photo of Mrs Agnes Hardie Mrs Agnes Hardie , Glasgow Springburn

If the accusation is malicious, how can you possibly prove it? If the person accused is found to be quite clear, it will be easy for the accuser to say, "I thought it was so and so," and you will not be able to prove it.

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

One might have very good reason to suspect.

Photo of Mrs Agnes Hardie Mrs Agnes Hardie , Glasgow Springburn

I am saying, suppose the accusation was malicious; how could you prove it was malicious?

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

The hon. Lady is asking me to deal with the whole moral outlook of people in a Regulation meant to do a particular thing. It is a good Regulation with safeguards in it to meet the very points that hon. Members have been raising.

Photo of Mr David Logan Mr David Logan , Liverpool Scotland

How does the Minister expect to get doctors to be common informers when they get confidential word from their patients? How is he going to carry that out? Is a doctor to violate the confidence of his patient?

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

The Regulation does that very thing. It gives him the power, or rather the duty, to pass the information on, but not to anybody in public. I cannot make it too clear that the whole of the proceedings are private. There is no publicity unless the person concerned makes the publicity. We shall make it clear that the whole of the proceedings will be that way. Moreover, in the third stage, to which I was coming, when the notification is made, every attempt will be made to get the person to come voluntarily. The person will have private notice, and there will be private conversations. Every attempt will be made to secure that there is no need for compulsion. If compulsion comes in—

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

Because of the failure of voluntary effort to meet this particular and very tough problem with which I have been dealing in my speech.

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

In outline, that is what the Regulation is. The House has made it clear that there are two points of view in opposition, and they are quite irreconcilable. There is only one other point of fact in the Debate with which I want to deal now. I want to say that the comparison between Sweden and this country as regards persons defaulting before completion of treatment—2 per cent. and 82 per cent.—is completely fallacious, for this reason. The Swedish figure of 2 per cent. is arrived at by comparing the number of persons who in 1935 ceased treatment early, and could not be found again, with the total number of cases notified. The English figure of 82 per cent. is obtained by subtracting from 100 the percentage of cases stated to have completed their tests of cure in 1935. It is clear that the figures have no comparable basis whatever and that the picture given in that English figure is quite misleading. The important percentage is the proportion of new infections with early syphilis which did not complete one course of treatment since completion of one course even without any further treatment renders the great majority of cases non-infectious.

We have considered this with very great care indeed. We agree we want a great diffusion of knowledge; we agree we want the provision of more treatment facilities; we agree we want healthy recreation; and we agree we want a great moral campaign. We are asking the House to disregard those who take the view that this Regulation will be ineffective. I will sit down after giving one little bit of evidence that has emerged already. The appearance of the Regulation has caused some persons who have not volunteered for treatment before to come forward already. Members who read the "New Statesman" will have seen a letter by the County Medical Officer for Holland stating that that is happening. I do not believe the Regulation will be ineffective. I will add, on behalf of my right hon. Friend and myself, that if any new powers are needed, we shall not be slow to come and ask the House for new powers in view of the urgency with which we regard the disease.

Photo of Dr William Thomas Dr William Thomas , Southampton

May I ask the Minister for a reply to the question I put

Division No. 4.AYES.
Adams, D. (Consett)Jenkins, A. (Pontypool)Shute, Col. Sir J. J.
Ammon, C. G.Kirkwood, D.Silverman, S. S.
Astar, Visc'tess (Plymouth, Sutton)McGovern, J.Sorensen, R. W.
Barr, J.Mack, J. D.Stokes, R. R.
Buchanan, G.Molson, A. H. E.Tate, Mavis C.
Davies, R. J. (Westhoughton)Morgan, Dr. H. B. W. (Rochdale)Taylor, H. B. (Mansfield)
Davies, S. O. (Merthyr)Mort, D. L.White, H. (Derby, N.E.)
Douglas, F. C. R.Muff, G.
Driberg, T. E. NParker, J.TELLERS FOR THE AYES.
Grenfell, D. R.Pethick-Lawrence, Rt. Hon. F. W.Dr. Summerskill and Mr. Cecill
Hardie, AgnesPritt, D. N.Wilson.
Harvey, T. E.Reakes, G. L. (Wallasey)
NOES.
Adamson, W. M. (Cannock)Brooke, H. (Lewisham)Davidson, Viscountess (H'm'l H'mst'd)
Albery, Sir IrvingBrooks, T. J. (Rothwell)De la Bère, R.
Alexander, Rt. Hon. A. V. (H'lsbr.)Brown, Rt. Hon. E. (Leith)Denman, Hon. R. D.
Allen, Lt.-Col. Sir W. J. (Armagh)Brown, W. J. (Rugby)Dobbie, W.
Anderson, Rt. Hn. Sir J. (Sc'h Univ.)Bull, B. B.Drewe, C.
Attlee, Rt. Hon. C. R.Burden, T. W.Duckworth, Arthur (Shrewsbury)
Barnes, A. J.Butcher, Lieut. H. W.Duckworth, W. R. (Moss Side)
Beamish, Rear-Admiral T. P.Campbell, Sir E. T.Dugdale, John (W. Bromwich)
Beattie, F.Carver, Colonel W. H.Dugdale, Major T. L. (Richmond)
Beauchamp, Sir B. C.Cary, R. A.Dunn, E.
Beaumont, Maj. Hn. R. E. B. (P'tsm'h)Chapman, A. (Rutherglen)Ede, J. C.
Beechman, N. A.Chapman, Sir S. (Edinburgh, S.)Eden, Rt. Hon. A.
Benson, G.Charleton, H. C.Edmondson, Major Sir J.
Bevin, Rt. Hon. E.Chater, D.Edwards, Waiter J. (Whitechapel)
Bird, Sir R. B.Cobb, Captain E. C.Elliot, Lt.-Col. Rt. Hon. W. E.
Blair, Sir R.Colman, N. C. D.Ellis, Sir G.
Boles, Lt.-Col. D. C.Cooke, J. D. (Hammersmith, S.)Emmott, C. E. G. C.
Bossom, A. C.Courthope, Col. Rt. Hon. Sir G. L.Entwistle, Sir C. F.
Bower, Comdr. R. T. (Cleveland)Critchley, A.Etherton, Ralph
Bowles, F. G.Crooks, Sir J. SmedleyEvans, Colonel A. (Cardiff, S.)
Boyce, H. LeslieCrookshank, Capt. Rt. Hon. H. F. C.Everard, Sir W. Lindsay
Brass, Capt, Sir W.Crowder, Capt. J. F. E.Foster, W.
Brocklebank, Sir C. E. R.Culverwell, C. T.Fox, Flight-Lieut. Sir G. W. G.

as to what remedy has an innocent party against whom information has been given? They have remedies and can claim damages under the law at present.

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

My hon. Friend has got it completely wrong. All that they are asked to do is to come for examination in complete secrecy. There is no public discussion. If the Medical Officer of Health, or the local authority which would carry out the provisions of the Regulation, has reason to believe there has been malice, very heavy penalties are provided under the Defence Regulations.

Photo of Dr William Thomas Dr William Thomas , Southampton

Suppose there is no malice but a mistake? Anyway, what about the actions for damages, malice or not?

Question put, That an humble Address be presented to His Majesty, praying that the Order-in-Council dated 5th November, 1942, made under the Emergency Powers (Defence) Acts, 1939 to 1940, amending Regulations 27A, 47AA and 91 of, and the Third Schedule to, and adding Regulations 33B and 47AAA to, the Defence (General) Regulations, 1939, a copy of which was presented to this House on 11th November, be annulled.

The House divided: Ayes, 31; Noes, 245.

Frankel, D.Little, Sir E. Graham- (London Univ.)Rothschild, J. A. de
Fremantle, Sir F. E.Locker-Lampson, Comdr. O. S.Royds, Admiral Sir P. M. R.
Fyfe, Major Sir D. P. M.Loftus, p. C.Russell, Sir A. (Tynemouth)
Gardner, B, W.Logan, D. G.Salt, E. W.
George, Megan Lloyd (Anglesey)Lucas, Major Sir J. M.Scott, Lord William (Ro'b'h & Selk'k)
Gibson, Sir C. G.Lyons, Major A. M.Selley, H. R.
Gledhill, G.MacAndrew, Colonel Sir C. G.Shaw, Capt. W. T. (Forfar)
Gower, Sir R. V.McCorquodale, Malcolm S.Shepperson, Sir E. W.
Greene, W. P. C. (Worcester)Macdonald, Sqdn.-Ldr. P. (I. of W.)Shinwell, E.
Griffiths, G. A. (Hemsworth)McEntee, V. La T.Smith, Ben (Rotherhithe)
Griffiths, J. (Llanelly)McEwen, Capt. J. H. F.Smith, Bracewell (Dulwich)
Grigg, Sir E. W. M. (Altrincham)McNeil, H.Smith, E. (Stoke)
Grimston, R. V.Makins, Brig.-Gen. Sir E.Smith, T. (Normanton)
Groves, T. E.Mander, G. le M.Snadden, W. McN.
Guest, Dr. L. Haden (Islington, N.)Markham, Major S. F.Southby, Comdr. Sir A. R. J.
Gunston, Major Sir D. W.Mathers, G.Spearman, A. C. M.
Guy, W. H.Mayhaw, Lt.-Col. J.Stewart, J. Henderson (Fife, E.)
Hacking, Rt. Hon. Sir D. H.Mellor, Sir J. S. P.Storey, S.
Hambro, Capt. A. V.Mills, Colonel J. D. (New Forest)Strauss, G. R. (Lambeth, N.)
Hannon, Sir P. J. H.Milner, Major J.Strauss, H. G. (Norwich)
Haslam, HenryMontague, F.Strickland, Capt. W. F.
Hely-Hutchinson, M. R.Morgan, R. H. (Stourbridge)Stuart, Lord C. Crichton-(Northwich)
Henderson, A. (Kingswinford)Morris-Jones, Sir HenryStuart, Rt. Hon. J. (Moray & Nairn)
Henderson, J. (Ardwick)Morrison, Major J. G. (Salisbury)Studholme, Captain H. G.
Henderson, J. J. Craik (Leeds, N.E.)Morrison, Rt. Hon. W. S. (Cirencester)Sueter, Rear-Admiral Sir M. F.
Hicks, E. G.Murray, J. D.Sutcliffe, H.
Hill, Prof. A. V.Nall, Sir J.Sykes, Maj. Gen. Rt. Hon. Sir F. H.
Hinchingbrooke, ViscountNaylor, T. E.Taylor, Major C. S. (Eastbourne)
Hogg, Hon. Q. McG.Neven-Spence, Major B. H. H.Taylor, R. J. (Morpeth)
Holdsworth, H.Nicholson, Captain G. (Farnham)Thomas, I. (Keighley)
Holmes, J. S.Nicolson, Hon. H. G. (Leicester, W.).Thorneycroft, H. (Clayton)
Hopkinson, A.Noel-Baker, P. J.Tinker, J. J.
Horsbrugh, FlorenceNunn, W.Touche, G. C.
Howitt, Dr. A. B.Oldfield, W. H.Walkden, A. G. (Bristol, S.)
Hudson, Sir A. (Hackney, N.)O'Neill, Rt. Hon. Sir H.Walkden, E. (Doncaster)
Hughes, R. M.Paling, W.Ward, Irene M. B. (Wallsend)
Hume, Sir G. H.Peake, O.Wardlaw-Milne, Sir J. S.
Hunter, T.Pearson, A.Watt, F. C. (Edinburgh, Cen.)
Hurd, Sir P. A.Perkins, W. R. D.Watt, Lt.-Col. G. S. H. (Richmond)
Isaacs, G. A.Petherick, Major M.Wayland, Sir W. A.
James, Wing-Commander A. W. H.Peto, Major B. A. J.Webbe, Sir W. Harold
Jeffreys, General Sir G. D.Pickthorn, K. W. M.Westwood, J.
Jewson, P. W.Ponsonby, Col. C. E.White, Sir Dymoke (Fareham)
Johnston, Rt. Hon. T. (St'l'g & C'km'n)Price, M. P.White, H. Graham (Birkenhead, E.)
Jowitt, Rt. Hon. Sir W. A.Procter, Major H. A.Whiteley, W. (Blaydon)
Joynson-Hicks, Lt.-Comdr. Hn. L. W.Pym, L. R.Wilkinson, Ellen
Keir, Mrs. CazaletQuibell, D. J. K.Williams, E. J. (Ogmore)
Kendall, W. D.Radford, E. A.Williams, Sir H. G. (Croydon, S.)
Kerr, H. W. (Oldham)Rankin, Sir R.Willink, H. U.
Kerr, Sir John Graham (Scottish U's.)Rathbone, EleanorWindsor-Clive, Lt.-Col. G.
Kimball, Major L.Reed, Sir H. S. (Aylesbury)Winterton, Rt. Hon. Earl
King-Hall, Commander W. S. R.Reid, Rt. Hon. J. S. C. (Hillhead)Womersley, Rt. Hon. Sir W.
Lamb, Sir J. Q.Reid, W. Allan (Derby)Woodburn, A.
Law, R. K.Rickards, G. W.Woods, G. S. (Finsbury)
Leach, W.Ridley, G.Young, A. S. L. (Partick)
Leighton, Major B. E. P.Ritson, J.Young, Sir R. (Newton)
Levy, T.Roberts, W.
Liddall, W. S.Robertson, D. (Streatham)TELLERS FOR THE NOES.
Linstead, H. N.Robinson, W. A. (St. Helens)Mr. Boulton and Mr. J. P. L.
Lipson, D. L.Ross Taylor, W.Thomas.