Public Health (Notification of Births) Bill

– in the House of Commons at 12:00 am on 18th June 1965.

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Not amended (in the Standing Committee), considered.

11.29 p.m.

Photo of Mr Ken Lomas Mr Ken Lomas , Huddersfield West

I beg to move, That the Bill be read the Third time.

Like the previous Bill this is an entirely non-controversial Measure. It had a formal Second Reading on 9th April and the Committee stage was dispensed with in less than ten minutes. I am sure that the House will appreciate, therefore, that I do not intend to detain it very long but it is right and proper to explain the purpose of the Bill. It seeks in a modest way to put right something which should have been done some time ago, because it is intended to effect two minor but most useful changes in the arrangements for the notification of births.

The intention of the Bill is to ensure that in future notification of births is made in the quickest possible way and the best possible manner for all concerned. The need for these amendments has been recognised for some time both by local health authorities and the Ministry of Health. I am most grateful, indeed honoured, to have the opportunity as a private Member of bringing forward this Bill and asking the House to give it a Third Reading in this, my first, Session of Parliament.

At present under Section 203 of the 1936 Public Health Act, a father or doctor or midwife is required to notify the birth of a child to the medical officer of health of the welfare authority for the area in which the birth takes place. In 1948, when the National Health Service came into being, it was agreed that the authority which should be notified of births should be either the county council or the county borough council. That system worked extremely well for 10 years until in 1958 the Local Government Act was passed. It then became possible for the functions of local health authorities to be delegated to certain county district councils, but arrangements for the notification of births were not changed. They still have to be sent to the medical officer of health of the county council or county borough council.

It therefore follows that there is today a certain amount of delay because, before the county district councils who have responsibility for health and welfare functions can act on the information of birth notification, they must wait for the medical officer of health of the county council or county borough concerned to pass on the information. This inevitably leads to all kinds of delay, sometimes as much as three or even four days. This is at a time when it is essential that prompt action in visiting the mother of the child is in many cases essential and at all times desirable. It therefore follows that it is of vital importance that the time factor between notification of the birth and passing of the information to the appropriate authority should be cut if that is at all possible. Therefore, Clause 1 (1) proposes that in future notification should be sent direct, cutting out the middle authority, to the county district council.

Subsection (2) changes the form in which the notifications are actually made. At present, under section 203 of the 1936 Act, authorities are empowered only to supply addressed and stamped postcards. The Bill provides that in future local health authorities will be required to supply to doctors and midwives in their areas prepaid addressed envelopes with the forms of notification. It may be considered a very minor and small Amendment to substitute an envelope for a postcard, but it is quite obvious that this should be done because personal information concerning a birth and all the facts of the birth should be sent under cover, not only in the interests of the mother and the child, but so that various health authorities may be in the fullest possession of all the facts.

Nowadays birth notifications are used to a great extent to collect information about such matters as malformation of limbs and congenital abnormalities. Because of the effects of radiation and drugs it is of supreme importance that the health authorities should receive the fullest possible information on which they can often act. It is quite possible that under the present set-up by which this information is asked for on a postcard, it will not be fully and freely given. By asking that it should be sent under cover, my Bill will encourage those re- sponsible for notification of births to give the fullest details. In some small measure this may help in dealing with many tragic cases such as those which have occurred in the past.

This is not in any sense a money Bill, but the extra expense involved in using envelopes instead of postcards may be set off by the advantage of the fact that the fuller information will be passed on to the authorities.

Clause 2(2) provides that the Bill shall come into effect one month after it becomes an Act. This is a very simple, useful and, I think, a very necessary Bill. I express sincere thanks to the Ministry of Health and the Parliamentary Secretary who have helped me with ideas for putting forward the principles of the Bill. I thank the members of the Committee who helped me to dispense with the details in such a short time on 5th May. I hope that the House will approve and will give a Third Reading to this small but important Measure.

11.35 a.m.

Photo of Mr Robin Maxwell-Hyslop Mr Robin Maxwell-Hyslop , Tiverton

I congratulate very sincerely the hon. Member for Huddersfield, West (Mr. Lomas) on introducing this Bill and bringing it to this stage with such expedition. It is so rare nowadays to have a Bill which actually simplifies the work of local authorities rather than making it more complex. This aspect must appeal to all of us.

I have just had a little trouble with a local authority because my vehicle licence has not yet arrived, despite a lapse of 14 days. I was, therefore, delighted when I came into the Chamber, after being on the telephone about that, to find a Bill in progress in the House actually simplifying local government processes, making them more expeditious, less expensive and less time consuming.

I also welcome the fact that notice has been taken of the desire of many people for privacy in matters of this kind. In census legislation there is provision for people to answer some of the more detailed questions in private if they wish to do so. I am quite sure, as the hon. Member so rightly said, that any infinitesimal increase in cost of postal charges due to the use of envelopes instead of postcards will be more than compensated for ethically from the point of view of the privacy given and greater accuracy of the statistics arising there from. I welcome the Third Reading of the Bill and congratulate the hon. Member on introducing it.

11.38 a.m.

Photo of Mr Charles Hale Mr Charles Hale , Oldham West

I wish to join in congratulations to my hon. Friend the Member for Huddersfield, West (Mr. Lomas) and to say one or two things which I think are relevant to this Bill and which I commenced to say in discussion of the previous Bill. My hon. and learned Friend who replied to the previous debate made an observation which is equally relevant to this Bill when he said that there are certain matters to be considered by the Select Committee on Procedure. We are moving in an age of law reform and considerable contributions have been already made to the Government's expanding programme of collective cogitation in this and other fields.

I speak as one who has been a member of the Select Committee on Procedure for some years and have had to consider these problems when we find everyone sees pros and cons. It is a great pleasure after the storms of this week to spend a modest period of time dealing quietly with a useful Bill but also noting the costly procedure of legislation which has had to be used to bring about this reform. What we are doing is to correct a minor oversight or lack in the Bill of 1958, for which, looking at the date, I find I have no particular responsibility.

In the case of this sort of thing one is tempted to express a little surprise, indignation and urgency but most of us who have considered this matter have found that the House itself is rightly very jealous of extending privilege by delegated legislation and apt to look askance at it. It is very apt to limit it. I should have thought that in a Measure of the kind in 1958 some provision permitting legislative delegation in a closely defined ambit, permitting a Minister to give effective redress in respect of some practical difficulty of this kind which manifests itself, should not be beyond the power of human draftsmanship. Every form of draftsmanship is subject to controversy and argument. I speak this morning as one who was once a lawyer.

It is well to remember that the legislative process involves tremendous expense in one way and another. In respect of the previous Bill something like 50 printed slips must be issued to those who try to keep themselves up to date to note the amendment of 50 different Statutes. Notes are being made of the contents of the Schedule, and so on. This is an Amendment of a 1958 Act which amended an Act of 1907, and it takes a Statute to do it. If this document were placed under the steps of a building to be erected now, and which it was hoped, subject to bombing activities, might survive for many centuries, it might cause some puzzlement to future generations when they come to observe it.

It might perhaps be out of order to express a detailed view on what its effect might be on international relations at this moment. I am sure that there are many ratiocinating countries where this document would be regarded with extreme suspicion. The suggestion that the Lords spiritual and Lords temporal, normally never greatly in agreement on subjects relating to birth, were being consulted and asked to cogitate on the question whether we could substitute a sensible envelope for a postcard and send the information to the right address, would give rise to some suspicion. If one of the comrades, after a night on the vodka somewhere between Omsk and Tomsk, were to drop this document into a dead-letter office provided for the purpose, one does not know what might happen. Obviously it would go to the Academy of Sciences.

Photo of Sir Harry Hylton-Foster Sir Harry Hylton-Foster , Cities of London and Westminster

Order. Omsk and Tomsk are a little remote from the notification of births in this country.

Photo of Mr Charles Hale Mr Charles Hale , Oldham West

I was not quoting them for their geographical proximity. However, I would not for a moment dissent from your ruling, Mr. Speaker. I have been away for a month. Whilst listening to the discussions on Third Reading of the Highlands and Islands Development (Scotland) Bill, which ranged from Drumnadrochit to Mulligatawney and back and sometimes even, I thought, approached Macgillicuddy's Reeks, which must be out of our area of Highland development, I wondered whether there had been one of these modest amendments during my long absence which enable us to do it. All I would say, withdrawing Omsk and Tomsk, is that whatever reasonable foreign body came to consider this it would come to the rapid conclusion about its incredibility. It would regard it with suspicion. There might be a series of fingerprint testing, lemon testing, acid testing, and a litmus paper test, and so on. It would be submitted to highly skilled photography and cryptography and to learned associations of various kinds. In the end, it would probably be popped into a giant computer which would turn it over day after day and ultimately burst into tears.

Perhaps the explanation I have given will help to avoid an international tragedy, although it in no way impairs the good work my hon. Friend the Member for Huddersfield, West has done by piloting through this very useful reform and calling attention, indeed, to a certain lacuna or hiatus in our Parliamentary rules which makes it impossible to secure this reform without the care my hon. Friend has taken in the drafting of a Bill, the presentation of a Bill, the printing of a Bill, the taking of it upstairs, the bringing of it downstairs, and the sending it to another place and then to Her Majesty for her assent. We will have to consider these things at some time. In the meantime, as I said, I rose only to express this brief appreciation and to present some brief unconfident aspirations for the future.

11.45 a.m.

Photo of Mr Charles Loughlin Mr Charles Loughlin , Gloucestershire West

In commencing the brief observations I have to make on the Bill, I am torn between congratulating my hon. Friend the Member for Huddersfield, West (Mr. Lomas) on introducing the Measure and trying to see how far it would be possible to make observation on the observations already made by my hon. Friend the Member for Oldham, West (Mr. Hale) whilst still keeping within order. I appreciate that it may well be true that the Government at some time could consider the question, after having had it considered by the Select Committee on Procedure, whether it is necessary so often to have an Amendment of this kind to this legislation. I do not think I could dare try to walk in the footsteps of Olga Polovski the spy, to whom my hon. Friend by implication made some reference. I congratulate my hon. Friend the Member for Oldham, West on the way he is able to go down these devious paths and still remain within the rules of order.

The Bill is welcomed by the Government. As my hon. Friend the Member for Huddersfield, West said, it removes two small but vexatious anomalies in the arrangements for notifications of births and should prove encouraging to the doctors and midwives who are responsible for making these notifications.

It provides, first, that, in the area of a county district council exercising delegated health and welfare functions, notifications of births should be made directly to the medical officer of health of that authority instead of, as at present, to the medical officer of health of the county council. This provision applies only to England and Wales. It is not needed in Scotland, because Scotland has no comparable delegation of functions.

The second purpose, as my hon. Friend so clearly showed in his speech, is that the authority which receives the birth notifications should supply to doctors and midwives in its area, forms of notice and pre-paid addressed envelopes instead of, as at present, addressed and stamped postcards containing the form of notice. This provision would apply in Scotland also.

I appreciate the observations made by the hon. Member for Tiverton (Mr. Maxwell-Hyslop). This is essential, particularly at present. It is an indication of the progress of society when we begin increasingly to respect the privacy of the individual. At present, one sometimes shudders at the invasion of the privacy of the individual, not only by Government Departments but by people who ought not to have the right to do it at all. I appreciate the observations of the hon Member for Tiverton because from the beginning this was a joint venture and there has been no controversy of any kind among hon. Members.

Local authority maternity and child welfare services have been severely strained by the increase in the birth rate in recent years, but all statistics of maternity and infant mortality rates show that while there has been this increase in births, there has been a steady fall in deaths among mothers and young infants. I think this is fairly obvious. The present day standards of environmental health, health education and the advances in surgery and immunisation against infectious diseases have all provided safeguards against many serious risks to the life and health of infants and young children.

Photo of Mr Charles Hale Mr Charles Hale , Oldham West

Do not let us get too complacent about this. Those admirable results which testify to an improvement in medicine are arrived at by taking an average for the country. One has to have close regard to the great variations in the figures in different areas, which means that some of the areas which are making the biggest contribution to our economic success are still having the least provision of the resources to which they are entitled.

Photo of Mr Charles Loughlin Mr Charles Loughlin , Gloucestershire West

I do not want to get involved in a wide-ranging discussion of the services and safeguards that are now being introduced for the health and welfare of women and children. I suppose it is germane to this discussion because it means that in certain areas there will be a need for this type of legislation to meet the problems arising out of the greater incidence of these diseases. But I do not think it would be in order for me on the narrow issue in this debate to discuss the lack of or the provision of maternity beds in certain areas, and I hope my hon. Friend will not try to press me on it because even assuming that it were in order, I certainly would not have the information available to satisfy him completely in the matter.

The scale on which health and welfare services are required for mothers and young children depends basically on the numbers of births and of children under five. The total numbers of births in England and Wales rose from 700,000 in 1953 to 801,000 in 1960, and, according to the Registrar-General's projection for 1972, will reach 901,000 in that year. At the beginning of the 20th century the infant mortality rate was about 150 per 1,000 live births. At about that time the first baby clinics were started by voluntary workers.

In 1918 the Maternity and Child Welfare Act gave local authorities powers to safeguard the health and welfare of mothers and young children. By 1925, to a large extent in consequence of those powers, the infant mortality rate had been cut by one-half to 75 per 1,000 live births. As hon. Members know, the National Health Service Act, 1946 introduced into this country a comprehensive National Health Service and made this local authority power not a simple power but a duty. The result is that the infant mortality rate for England and Wales as a whole is now—here I quote the last known figure—21·1 per 1,000 births, or just under one-seventh of what it was 60 years ago.

Lest my hon. Friend the Member for Oldham, West should rebuke me again and say that I should not be complacent about this, I can assure him that we at the Ministry are not complacent. We shall be even more delighted with the progress that we have made if we can reduce that figure of 21·1 per 1,000 substantially before the next figures are issued.

Photo of Mr Charles Hale Mr Charles Hale , Oldham West

It is a very good thing to give local authorities powers. I am in favour of it. But give them a bit of money as well.

Photo of Mr Charles Loughlin Mr Charles Loughlin , Gloucestershire West

We really want to give them money and we shall do whatever we possibly can, in the context of looking after mothers and children, to see that a reasonably high proportion of the nation's resources in the next few years will be devoted to this purpose.

There is a need not only to maintain and improve the health facilities for mothers and young children but to be sure that these facilities are known to the mothers and are used by them. The notification of births to medical officers, besides providing us with reliable statistical information about the numbers of births, also gives the opportunity for the local authority to arrange visits to watch the progress of the young child, to advise the mother and to see that illness or defect is diagnosed as early as possible.

In moving the Third Reading of the Bill my hon. Friend the Member for Huddersfield, West made some reference to the effect of certain modern drugs, and I do not think there is any need for me to go into any detail on the subject of modern drugs. The thalidomide incident brings forth the whole picture to one's mind. I think we can agree with my hon. Friend that one of the first things we have to do if we are to watch modern medicine in this field is to see that any side effects or illnesses are not only known but are diagnosed as early as possible so that action can be taken to look after mothers and children.

We believe that the younger the age at which a physical, mental or emotional handicap is detected in a young child, the better are the prospects of treatment. The notifications of congenital malformations observable at birth, which are being made at the same time as the notifications of birth, will, we feel sure, make a contribution to the solution of this problem of early diagnosis. Whereas 10 years ago a high proportion of mothers stayed in hospital for 10 days after the birth of their child, it is now common for the mother and child to go home earlier. This makes it all the more imperative that there should be no delay while the notification of birth reaches the right authority which can co-operate with the hospital and the general practitioner to see that everything necessary is done to ensure the child's health and welfare at home.

If we have to have notification of birth first to the county medical officer, who then has to notify the district county medical officer before the district medical officer can go to the mother, in certain instances there will be delay which would not be in the best interests of the mother or the child. At the weekend, for instance, there is a delay of four days anyway.

Although this Bill may seem to be small, it will make a substantial contribution to the mechanics of the diagnosis of some of the problems with which we are now faced. I thank the hon. Member for Tiverton (Mr. Maxwell-Hyslop) and reiterate the congratulations of my hon. Friend the Member for Oldham, West (Mr. Hale) to my hon. Friend the Member for Huddersfield, West (Mr. Lomas) who so far, up to Third Reading—the Bill obviously has to go to another place, so that my hon. Friend has not got his Bill yet—has achieved something in his first Session as a Member of Parliament which many of us have never achieved although we have been in the House much longer. I have been here only a short time in comparison with my hon. Friend the Member for Oldham, West and I do not want to provoke him into telling me that I am only a baby, but even in the short time that I have been here I would have liked to have had on the Statute Book a Bill in my own name. I can only say that I am a little envious that my hon. Friend has done it so early and I sincerely congratulate him.

Question put and agreed to.

Bill accordingly read the Third time and passed.