Mental Deficiency under the Local Government Bill, 1928
- Author:
Wormald,
Executive Officer, Leeds Mental Deficiency Acts Committee. No legislation considered by Parliament since the passing of the Education Act, 1902, when the functions of School Boards were transferred to County and County Borough Councils, has created more widespread interest than t e oca Government Bill, 1928. In fact, for a generation there has been no Measure belore Parliament which has raised so many fundamental issues in the system and pro- cedure of local government. A Bill which contains proposals for the relief ot industry and agriculture under a scheme of de-ratmg, abolishes Poor Law Guardians, transfers their powers and duties to County and County Borough Councils, and re-casts the financial relations between national and local taxation, may be well described as omnibus legislation, and is a challenge to the tradition, custom, and vested interest of local government. It is the application of the principles of the Bill to sound and progressive methods of local government, and to the financial burdens being equitably arranged between the State and the County and County Borough Authorities, which will enable it to pass the judg- ment bar of public opinion. The Bill is complicated and weighted by ^financial and statistical tables and formulse which supply only the roughest estimates of the incidence of State contributions to local expenditure. Local Authorities have naturally been tempted to view it with suspicion, and as a device to relieve the Treasury at their expense, especially with regard to the proposed method of paying grants for health services.
If passed into Law, the Bill will have an important effect on the administra- tion of mental deficiency in England and Wales. The Mental Deficiency Act, 1913, while creating a new authority for mental deficiency left existing Authorities in statu quo. The proposed repeal of Section 30 proviso (ii.) of the 1913 Act, removes the embargo on Local Authorities dealing with defectives who for the time being are under the Poor Law, and is consequential on the passing of Clause 1 of the Bill transferring on the appointed day?namely, 1st April, 1930?the functions of Poor Law Authorities to County and County Borough Councils. Clause 3 also provides that the Councils shall within six months after the com- mencement of the Act submit to the Minister a scheme of the administrative arrangements proposed to be made for discharging the functions of the defunct Poor Law Authorities, and Clause 4 further enacts that such administrative Scheme may declare that any assistance which could be provided, may be provided either by way of poor relief, or exclusively by virtue of appropriate Acts (specify- ing the Mental Deficiency Act, 1913, and other Acts.) The Councils will thus have alternative powers to provide assistance for mentally deficient persons, either by way of poor relief, or by virtue of the Mental Deficiency Acts, except that the Bill does not diminish or affect the duty of a Council under the Poor Law Act, 1897, to provide relief for the poor.
Within recent years Parliament has imposed upon County and County Borough Councils duties in connection with the care of the mentally deficient, the blind, maternity and child welfare, tuberculosis, the guardianship of children, which have been carried on side by side with similar work under the Poor Law. Dual authority has resulted in overlapping of service, duplication of duties, and avoidable and unnecessary expenditure. The opportunity is now presented to unify them under one control. With respect to mental deficiency, it makes a direct approach to the principle laid down in the Report of the Royal Commission on the Care and Control of the Feebleminded that the Council of each County and County Borough should be the Local Authority to make suitable and sufficient provision for the care and control of the mentally defective, and that their mental condition, and neither their poverty nor their crime, is the real ground of their claim for help from the State. County and County Borough Councils will no doubt be impressed with the principle of unit control, especially seeing that the new Public Assistance Committees to be created, will be in the same position as Poor Law Guardians, who are without statutory authority to provide care and control for the mentally deficient except by way of poor relief. The insufficient powers of Poor Law Guardians accounts for the practice of mentally defective persons using the Workhouses for shelter and treatment and taking their dis- charge at their will. On the other hand, Poor Law Guardians have had to resort to certification of feebleminded persons and imbeciles under the Lunacy Acts, to prevent them taking their discharge; or in the case of children, to adopt them until the age of 18 years, and place them in Certified Institutions for defectives as private cases under Section 3 of the Mental Deficiency Act, 1913. The validity of the Reception Orders in respect of adopted children, especially on attaining the age of 18 years, is a matter of concern to the Managers of Institutions.
The whole question of detention of mental defectives under the Poor Law and the provision of suitable training and classification can now be clarified and placed on a satisfactory basis by County and County Borough Councils including in their Schemes a recommendation to the Minister of Health that all mental deficients in need of Institution treatment, or Guardianship, 01 Sivpei vi become subject to be dealt with under the Mental Deficiency c s, ‘
The financial Clauses of the Local Government Bill
duced opposition by the Local Authorities. The Bill abolishes percentage grants and substitutes therefor one consolidated grant payable o e , , , rant to cover all grants which are now allocated by the Tieasury. financial is to be estimated on the Local Authority’s expendituie 01 e It is to be year ending 31st March, 1929, designated the ” Standard Year It. is tobe known as the “General Exchequer Contribution and is compos totalling forty-five million pounds, namely :
1. An amount equal to total losses on account of rates of all Count} and ?16,000,000 ?5,000,000 An amount equal to total losses on account of rates ot an county uuu County Boroughs fcz4,uuu,uuu 2. An amount equal to the losses on account of all discontinued grants An additional amount which for each year of the first quinquennial period is fixed at
Grants 1 and 2 are permanent and fixed for all time, but the additional grant under 3 will, for quinquennial periods after the first quinquennium, be detei- mined by Parliament. The purpose of the additional grant is to make good any loss which may arise on account of rates and grant-borne expendituie a^ec 01J the standard year so as to raise the General Exchequer Contribution to a eas 25% of the whole.
The Minister of Health has expressed his willingness to make final con- cessions to objections taken by various Associations of Local Authorities by fixing for the first two quinquennial periods, three years and four years respectively, for determining the percentage of grants payable to Lc>cai Autnoi- ities, which extends the period from 15 to 17 years befoie the full ormu a operates, and with a guarantee of 75 per cent, of the estimated loss on account oi rates and grants for the standard year and their share under the formula of the balance of the Exchequer Contribution. After 1931 a census is to be taken at quinquennial intervals, so that the distribution of grants would be based on census figures of weighted population instead of on estimates.
It is submitted that the change in the system of grants proposed under this Bill will be detrimental to the mental deficiency service of the country. The care and control of the mentally deficient is more a national than a local duty and to merge the exchequer grants for mental deficiency into one con- solidated grant to be paid to the Local Authority based on a general formula tor the area, will destroy the national character of the service and subordinate it to a greater degree to the exigencies of local politics and finance. I he piogiess anc development of the work will be impeded. The grants for the first quinquennium are to be based on the expenditure of the present financial year, which is a mos disadvantageous period, as many Local Authorities are committed in the couise of the next year or two to large schemes of Colony extensions which w ill not be allowed to qualify as grant-borne expenditure. I he abolition ot peicentage grants will remove incentive to other Authorities to pioceed with new schemes. Mental Deficiency is even now with a pound-for-pound local and national ex- penditure an unattractive and unpopular form of municipal work, and Local Authorities have substantial ground for complaint at a change which will opeiate before they have had time to stabilize their financial position. Mi. Mclvenna, in introducing the Mental Deficiency Bill in the House of Commons, gave Local Authorities the following undertaking : ?
” So far as a duty is imposed on a Local Authority under this Bill, it is limited to the ” extent to which the cost of carrying out the duty is borne by the State as to one ” half of that amount. The Local Authority will have no duty imposed upon it except ” that in which the State bears one half the cost.” (vide Hansard, Vol. 53, No. 45, p. 215).
The Local Government Bill is a violation of that pledge. Mental Deficiency- expenditure falls into an exceptional category and is incomparable with any other form of public assistance. It is a recurring and increasing liability in the pro- vision of lifelong care and maintenance, which, ipso facto, prolongs the lives of its subjects, and its incidence varies in districts without regard to class or creed. To standardise it either with the ordinary expenditure in its own area or with the expenditure of another area is uneconomical and inequitable. The principle to be followed is that recommended by the Royal Commission that the liability of the State and the Local Authority should be borne equally. If a block grant is to be substituted for the percentage grant, it should at least be supplemented by a main- tenance or deficiency grant per head of the number of defectives provided with Institution treatment or Guardianship or Supervision.
It is hoped that the Bill in its financial Clauses will be amended to exclude the Mental Deficiency Acts from the operation of the consolidated grants, and to ensure that the Local Authority receives in Exchequer Contributions at least 50 per cent, of the cost of maintenance.
The Local Government Bill repeals Section 48 of the Mental Deficiency Act, 1913, which is the authority for the payment of grants to Voluntary Associa- tions assisting defectives. The existence of Local Voluntary Associations is, however, safeguarded, as under Clause 84 (2) the Minister of Health is required, before the beginning of each quinquennium, to make a Scheme providing for the payment of contributions by Councils of County and County Boroughs to Volun- tary Associations undertaking the duty of assisting or supervising defectives whilst not in Institutions. No such provision appears in the Bill for financial assistance to a Central body such as the Central Association for Mental Welfare. It is essential to the success of the administration that both the Central and the Local Voluntary Associations should receive substantial moral and financial support to enable them to continue their excellent work on behalf of statutory defectives under supervision in their own homes, and of voluntary and ” border- line ” cases of defect who but for their existence would not be dealt with by any other organized means.
If this Bill passes in its present form, on the most favourable prognosis there will be a considerable reduction in State grants in support of the mental deficiency service. The Minister of Health, whose interest in this fateful national problem is unquestionable, should be seriously urged to keep this developing branch of humanitarian work off the block.
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