Paper to be Read on Thursday Morning, 25th April
Bill :Author: Brain S. Miller, Clerk of the County Council, Devon.
In this paper it is assumed that the Local Governmenlas it before Parliament will be passed in substantially t e sa left the House of Commons. . , ;11 . p rts The parts of the Bill which I shall deal chie y wi m ^ I and VI. Part I provides for the transfer to County Coun County Borough Councils of the functions and proper y nrfWi<Ung Boards of Guardians, and Part VI relates to a new system of provic g those Councils with funds from National sources.
It 15 it is not my intention to confine myself entire y o . o? ^ sideration of the future machinery for working out e p t ODPOr- mentally deficient. I would rather call attention to ^8, dangers tunities which the present moment offers to us, an which we must avoid if those opportunities are to e ma c cVstem It is feared by many that the abolition of our old Poor!Law system constitutes a huge and disastrous blunder; that a e p , ers ledge and experience and the deep personal sympat y o of the old Boards and of their officials, gathered so a mental swept away in a moment and that their protegees, w e uoci;es deficients or not, will be left to the inexperience an aPa Y i ea(jy whose members (almost entirely men) and whose o cia tages overworked and who live so far away. Yet others ave se ,. risks, in the proposed change which allowther ‘ CQS^ning bodies’, Now if we representatives of the great ^ tem whether members or officers, are to make the est ? , change; we ought to examine what the reasons were or & avoid what, if anything, was wrong in the ^e|^^?ntages j? the new, committing similar errors; and what are the & so that we may utilise them to the full. L nm svstem Incidentally, one should also con^er ^ ^ ‘ neCessary to avoid, may itself contain new dangers, which it is q y What a field for thought, to be sure!
It is possible that the new Rill has deliberately incurred a sub- stantial risk of sacrificing much that was tried and found excellent in order to secure certain administrative advantages not possible under the old system.
For example, in the old days the Parish was the Poor Law unit. Each parish was responsible for its own poor, whether living in it, or after leaving it for elsewhere. The difficulties and cost of tracing parochial settlements were immense, as well as of providing Institu- tional care. So the policy was carried of uniting two or more parishes together to form Unions. This greatly reduced these difficulties and cost. Even at that time we may assume that fears were entertained that detailed local knowledge and the personal touch so necessary in dealing with the poor would be lost.
And yet to-day no one would say that, at least in the majority of cases, Unions are too large to admit of these things. Indeed, the question has become urgent whether, with improved means of transport and other methods of communication, existing Unions are not in most cases too small. Too small because, from the administrative point of view, it is clear that the larger the Union the better, provided it is not too large. A larger compared with a smaller area of administration per- mits of cost being borne by broader shoulders, of the provision of better and cheaper Institutions, of more suitable grading of cases in Institutions, of less money being wasted in tracing settlements, and so on.
Moreover, most of the Union boundaries of to-day were fixed almost a hundred years ago and, owing to subsequent developments, have long since become entirely out of date.
So that I for one can see that, on these considerations alone, definite and appreciable advantages ought to ensue from the changes that, whatever our views, we must now all accept. Another reason?or shall I say justification?for the change is found in the attempt to avoid what everybody calls the overlapping which has existed and latterly greatly increased under the system now to be discarded. This overlapping was the result of the growth of various social services which has greatly developed in the hands of the local authorities, services which had for their object the assistance in various directions of large numbers of individuals, some of whom were doubtless better off than others, but all of whom were too poor to help themselves properly and many were indistinguishable from those who used to be classed as paupers. Thus overlapping was due to a duplica- tion of jurisdiction. Take, for example, the case of a mental deficient in residence in a Poor Law Institution. He could be continued under the care of the Guardians or he could be taken under tCounty Council. In the former case he could (t eore ica y take his discharge at any moment. In the latter, ie cou , be permanently segregated. t .
The procedure for obtaining his transfer was C^C^?VS’- _ Authorities had to apply to a Government Departmen . would sent. This, after due enquiry, having been obtained, t ic a?ter have to petition the judicial Authority in the ordinary w y ‘ an Order had been made, the patient, for want of other acc would frequently remain at the same Poor Law Institution, at the cost of the County Rate instead of the local poor ra e. Under the new system, all such cases will be ^ over_ cases from first to last. Of course, this is only one ll us ra 1 lapping. There are many others.
Then there is one other aspect of the Poor Law ‘ to my thinking, is of considerable importance. Itis t is . P . not for the future to be kept so much as they cj~n ?1 . n(4er kind of watertight compartment. Henceforward t e u o . , whose administration citizens have been permittee to sin poverty line will not be able to hand them over to someone , , after. The old Guardians used to take over a ready-made article and do their best with it. They had no responsibility or pr Antvlor_ ventive measures?no power to provide them. Now t e sa , ity will have to tackle the whole problem and to bear any , ?? may themselves be said to create. I sincerely hope t a e , be not only to permit of the better grading, treatment, ins /u 11 employment of all cases of poverty, whether among e deficient or otherwise, but of the early and clear recogni 10n r vital need for taking effective measures for preventing the creat poverty, whether of spirit, mind or body
If such measures are not taken, and taken early and wid will not be long before the burden of the unfit will e Y ^ the fit to bear. At any rate, the Local Authorise8 can , mentll first time, survey the whole field, study the causes leading to men defect, and provide (we will hope) the necessary anti o es. A great opportunity, indeed, and an equally great responsibi ity. But let me pass now from this general outline of the tion, so that I can go more closely into some o t e p scheme which will have to be dealt with in connection with the of organisation.
Dealing first with Part I of the Bill? Under this, on April Fool’s Day next year, the functions (which expression, according to the definition in Clause 123, includes powers and duties) of Poor Law Authorities are to be transferred to County and County Borough Councils. I shall, for the-sake of brevity, refer to these hereafter as County Councils. Existing Poor Law Authorities, as such, will be simply wiped off the slate.
There are a number of clauses dealing with incidental matters, such as the dealing with cases where Union areas straddle County boundaries, the transfer to County Councils of the functions of Poor Law Authorities relating to infant life protection under Part I of the Children Act, 1908, and their functions relating to vaccination, and so on. But the broad effect is to transfer Poor Law Administration from one authority to another.
Clauses 105 and 111 complete the transition by transferring to County Councils all the property (including of course Poor Law Insti- tutions) and all the liabilities and all the officers of Poor Law Author- ities with further incidental provision for dealing with Institutions of Poor Law Authorities whose areas are not wholly comprised in one County, and the Sixth Schedule deals further with adjustments and apportionments of property and liabilities.
Then Clause 4 requires each County Council to prepare and sub- mit to the Minister of Health a scheme of the administrative arrange- ments proposed to be made for discharging the transferred functions, and Clause 5 provides that any such scheme may declare that any assist- ance which could be provided either by way of poor relief or by virtue of any of the following Acts, viz.:?(i) The Public Health Act, 1875, (ii) The Local Government Act, 1888, (iii) The Mental Deficiency Act, 1913, (iv) The Maternity and Child Welfare Act, 1918, (v) The Blind Persons Act, 1920, (vi) The Public Health (Tuberculosis) Act, 1921, and (vii) The Education Act, 1921, or any Acts amending those Acts, shall be provided exclusively by virtue of the appropriate Act and not by way of Poor Relief.
“Assistance ” includes maintenance and treatment at Hospitals, etc., the education of children, and any other services which could be provided either by way of poor relief or by virtue of any of the above Acts, and County Councils may arrange with District Councils to operate locally on their behalf Maternity and Child Welfare services. Clause 6 requires County Councils, under the scheme, to set up a Public Assistance Committee (which may consist wholly or partially of an existing Committee), and they have the option of co-opting from outside their own body up to one-third of the members of this Com-
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are to stand referred to the Public Assistance Commi e , Qom. (except in cases of urgency) acting only after consi en g “’””TheCouncil, under the scheme, may also legate to the Com- mittee any of the transferred functions (except money po ^ further provide for the discharge, on behalf of an su je , trol of the Committee, of any of the functions of tie any of the other Committees of the Council. . ro. Clause 7 requires that County Councils shal in t C1 - of vide (a) for the division of the County into areas, ?.^n2 more urban (including borough) or rural districts an ( ) up a local Sub-Committee of the Public Assistance om”j11 rnncist of such area, to be known as Guardians’ Committees ant o district councillors, local County Councillors an o PvDer- women, preferably ex-Guardians, and others wit approp manY ience. Here again, I should strongly urge the inclusion of * I ex-Guardians and women as practicable, and (c) or sue mcnt Committees to deal with applications for relief and t e ma g if desired, of Poor Law Institutions. t ?n_ Clause 13 (5) permits a Mental Deficiency Act om point Sub-Committees consisting wholly or partly o mem *ccs Committee. This power also should be of help in securing pmmtv of women and ex-Guardians who are not mem ers o
Council This rough survey of the machinery to be set upJ. . will indicate the problem that County Councils are at e solv VC The question they must ask themselves immediately is: How can we best meet the needs of those mental deficients w ., a|s0 care, for the moment, of Poor Law Authorities, and presu J of those who, in the future, being in^sirwl.ar es i u^ Guardians had would most assuredly have come under the ca wnrfl “How such a Body been permitted to continue in ^xlSje^c^* naiiner n’ow and are we best to meet the needs of the mentally e cie P p Aether hereafter? Are we to regard and treat all men a t^ ^ difler- destitute or not, under the Mental Deficiency >
entiate and continue to treat the destitute by way of Poor Relief? ” Of course, the same question has to be asked and answered in connection with other types of citizens needing help.
It is perhaps regrettable that the Bill does not allow of more elas- ticity, but as it does not, this question must be squarely faced forthwith. Personally, I have no hesitation in the policy I should adopt. I should advise at once that every and all cases of mental defect should be dealt with under the Mental Deficiency Acts.
In saying this I am not influenced in the least by the fact that I am addressing a conference of people all deeply interested in aiding those who are mentally afflicted, and those good souls also who chiefly suffer through having to take charge of them. I think it is plain com- mon sense in the interests as well of those I have just mentioned as of the community at large.
To begin with, Poor Law Authorities, as such, had no power of detention. Then again, most defectives now dealt with under the Mental Deficiency Acts, as distinguished from the Poor Law, are in very low circumstances. In fact, they generally constitute examples of ” overlapping.” We have all known this all along. Why, then, con- tinue any attempt at a dividing line? All are under similar handicap. Let us do the best for them all. Those relatives who can contribute something, however little, will continue to do so. Will these bear a grudge against those who cannot ? I do not think so. Whether this is so or not, I think it is certain that more good work can be done for defectives for the same cost if larger, rather than smaller, numbers are permitted to benefit by the same arrangements for grading, teaching, etc.
Now if we decide to relieve all mental deficients (whether actual paupers or not) under the Mental Deficiency Acts (and if the same principle is applied in the case of other types of sufferers, we shall run the risk of finding that each Committee of the Council will be working too much in watertight compartments with a possible waste of effort and expense (whether by officials or by voluntary workers) in ascertain- ment of cases, or in ascertainment of means, or in visiting or in report- ing at various stages, or even in granting relief.
I am afraid this must to some extent be inevitable. It would not be possible to look to the County Council itself as a co-ordinating body except in matters of broad finance, after considering the recommenda- tions of the Finance Committee. And it would not be possible to look to the Public Assistance Committee to co-ordinate the efforts of all Committees rendering social services, even if all the cases dealt with were actual pauper cases.
The work would be too varied and too extensive to be superin- tended by any one body. That is why I think it will not be found practicable to utilise the power conferred by Clause 6 (3) of the Rill enabling various Committees of the Council to discharge, on behalf 0 an<^ subject to the general direction and control of the Public Assist- ance Committee, the functions of that Committee. But it would perhaps be possible for the Public Assistance Committee to help other ommittees to some extent by keeping (through their Relieving mcers and their Local Guardians’ Committees) a Register of all desti- tute or semi-destitute cases in the County, and by being ready with in- ormation and advice with regard to the circumstances of families or individuals, whether above, on, or below the border line of destitution, and possibly also with regard to friends or relatives who could under- ta e care or supervision in suitable cases.
1 . t^le Past in Devon we have had considerable difficulty in ending whether the County Council or the Guardians ought to take c arge of particular cases (whether or not in Institutions), and at one irnc actually decided to relieve only those cases which the Guardians AU?rte<k t?- US aS not quite poor enough to be relieved by them. such difficulties of overlapping ought in future to disappear if the Pp icy is adopted of treating all cases as ” ad hoc Committee ” cases as istmguished from ” Public Assistance Committee ” cases.
C ? yesult s^ou^ be to reduce the amount of what used to be uardians work, although retaining the Public Assistance Committee an its local Committees in an advisory capacity.
In suggesting this policy I am not overlooking the fact that the c?n ltions of counties must vary considerably, and what may be appro- Prif-one County cannot apply equally in another. Undoubtedly, eac County must ascertain its own numbers and types of individuals ee ing assistance, as well as consider how far existing Poor Law In- itutions can be made use of. But in Devon I am satisfied that such a P? lcy 1S the sound one, and also that none of our Poor Law Institutions is really suitable for adaptation and enlargement as a central Mental ^ehciency Institution or Colony.
It is perhaps possible that one or two of our Poor Law Institutions ay be cleared of other cases and so made available for the accommoda- th^riparticular types of mental patients. But a central institution on e Colony principle should, in my judgment, be the ideal arrangement o aim at and no effort should be spared to secure this for every County, onsequently, if any County should not have sufficient patients of their ?wn to support their own Colony, they should join with other Counties or County Boroughs in setting one up.
The Devon County Council have already provided a small In- stitution of their own, and apart from agreements with some private houses and Poor Law Institutions, that County is fortunate in having within its area an old established home at Starcross known as the Western Counties’ Institution. This home was built many years ago by private subscriptions from the four South Western Counties, and has been enlarged and improved from time to time. The staff are experienced and deeply interested in the good work they are doing. The home is certified to accommodate 500 cases, and the Manag- ing Body have recently acquired for further extensions about 100 acres of agricultural land (part of Langdon Farm, Dawlish) which lies some two miles from Starcross.
The Starcross Managers have, for a considerable time, been in negotiation with the Counties of Devon, Dorset and Somerset and the County Boroughs of Exeter and Plymouth, with a view to assisting them in the solution of that most difficult question, viz., the provision of suitable accommodation for the mental defectives of the area. At the moment, representatives of those five Authorities and the Managers of the Starcross Institution have agreed on a scheme whereby the authorities will build on Langdon Farm a Colony providing at first 500 beds. This Colony and the existing Institution at Starcross will be pooled and run as one Institution under a new joint Body of Man- agers, consisting of 21 members, of whom 10 will represent the existing Board and 11 will be appointed by the contributing Local Authorities. Thus the old voluntary Body will contribute its existing buildings, its experience and traditions, its staff, and its newly acquired land, .while the authorities will be joint managers with them of an Institu- tion of 1,000 beds at the cost of 500.
The scheme has not yet been formally approved by the contribut- ing Authorities or by the Board of Control, but, at least for the South West, the above are broadly the lines on which it is hoped that the bulk of patients in that area will be accommodated. Such a concentration of patients should facilitate a far more humane and successful system of grading and treatment than would be possible under any plan whereby small numbers arc packed away in a variety of small places.
Some Counties, of course, may already have in their area, or otherwise available, Poor Law Institutions or other buildings which could readily be brought up to date, enlarged, and otherwise fitted at a reasonable cost for the reception of most of the patients in the district, and, as I said above, every County will have to review its own con- ditions and formulate its own scheme.
But at the bottom of all these problems is the old biigbear of ^ It is always the question ” Where is the money to come ? . always was the question even when half the loan c arges t re met by the Board of Control. But henceforth percen ag g going to be swept away. Cost then becomes more t an eve p question, and it is perhaps unfortunate that the cost o? the Devon scheme and other similar schemes in contemplation e se ,, j?r already been included in the accounts of the stan ar y could the Local Government Bill. I may perhaps say that n<: Local to get the operation of the Bill postponed so as to give 1 uefTUn Authorities to put their houses in order by dropping sc^emes1^tT g> and by completing schemes nearing fruition, but t e irea(}v fallen and we must all stand hereafter at the point we had already reached this year. t>-u?
What, then, is the financial position under the 1 ? . Under Part VI (Section 78), existing grants for Mental Deft V and certain other health services will be discontinued as ro^ P. ‘ 1930, and Local Authorities will also lose rateable value y e provisions of the Bill and of the Rating and Valuation c , x9 5* Under Section 79, however, Parliament wi provi e^y qqv_ from that date, a substituted annual contribution towar s of this “General Exchequer Contribution^be fixed for three years, then revised and fixed for four year , after for each quinquennium. . 1
The losses in rates and grants for the standar year, 1. ?’ , ended 31st March, 1929, over the Country as a who c wi < y made good because they will always form a part o t e e chequer Contribution, and to the amount of this loss wi e each of the first three years an extra sum of five million poun s, for each of these first three years, the Country as a whole will rece five million pounds more than it had received in the stan ar y >_ For each of future grant periods Parliament will settj^XtUre of the ” extra ” sum, but, stated generally, the Bill general exchequer contributions shall rise in propor lon cnent on expenditure, even including in that expenditure t e ar^? P services other than health services, e.g., on roads, educationandpohc^ So that, for the Country as a whole, there ought to behttk^orno apprehension as to whether or not there will avai a meet ment sources in aid of the services in question a sum su the reasonable extension of those services. Ww anv The difficulty comes in when endeavouring to ascertain what any
one Authority can or cannot count upon.
This difficulty has naturally been pressed upon the Government and the Government have given it every possible consideration, consistent, of course, with their avowed policy of transferring some of the greater burden now carried by the poorer parts of the Country on to the shoulders of the richer parts.
Let us see, then, what the proposals in the Bill are for apportion- ing the general exchequer contribution among individual County and County Borough Councils, and so allocating to each what is to be known as its County or County Borough apportionment.
The proposals appear in Clause 79 (4) and are, during the first seventeen years, to allot to each Authority from the general exchequer contribution (which I shall call ” the pool “) a percentage of the loss on account of rates and grants, and to divide the balance of the pool among the Authorities according to their weighted population. After the first seventeen years, the pool is divided up among the Authorities according to their weighted populations.
The percentage (as laid down in Clause 126) is to be three-fourths during the first seven years, one-half during the next five years, and one-fourth during the next five years. ” Weighted population ” is calculated according to rules set out in Part III of the Fourth Schedule, and (as seen above) will, after the first seventeen years, be the sole factor in calculating the distribution of the pool.
Without setting out in detail the rules in Part III of the Fourth Schedule, I may say generally that they are devised with the intention of arriving at the comparative needs of the different authorities and have no reference to the amount of expenditure in any one area. So that, as time goes on and more and more of the pool (although this may increase in amount) becomes divisible according to weighted pop- ulation, the proportion of the pool allocable to those authorities who to-day are the more fortunate becomes less and less.
Authorities* know from experience that expenditure on social ser- vices inevitably increases. What wonder, then, that these proposals caused them great anxiety? To meet this point, the Bill provides by Clause 82 that each County Council shall receive yearly from Govern- ment funds a minimum grant of not less than the amount of its own loss on account of rates and grants plus one shilling per head of its present population, i.e., about ?22,000 in Devon.
In a few years’ time, this, I fear, will not go very far?not nearly far enough?but it is the best the Bill could offer, and it may be more than enough for the first few years. In any case where this is so, I strongly advise that any excess grant should be reserved?either in the shape of investment or increased balances in order to & strain on the ratepayers which sooner or later is oun o ? ^ If the financial provisions ceased here,romnels such County Councils would not be so serious. But the 1 , P, ^[\ Councils to set aside, out of the moneys they receive ^ These certain sums for the benefit of the district counci s in Fourth sums are calculated according to rules under Part Without claiming to be an expert on finance (or’r^rules^ will on anything else), I cannot help feeling that these par 1 soon have to be amended. They constitute to my mind the least scientific part of the Bill. Unless I am mistaken, t ey > nerhaps’ have been set down merely as a temporary expedient ow S? P , ? to shortness of time to allow of their consideration, or pos exhaustion of the Parliamentary draughtsman . p lint,r annnr- Under these rules you divide half the total o t e >o 7 ^us tionments by the total of the populations of the various > producing so many pence. Each Urban District is en o ^ its County Council that number of pence multiphe y i P P and each Rural District one-fifth of that number o P^n i entirelv by its population. Thus the shares of district counci s ep ^ on their populations, and have no reference either CXPe Bwwhether or not these rules can be justified, County Councils have to make payments to District Councils in accor anc their and it is only what they then have left that they can spe i _ve own services. Indeed, under Clauses 84 and 85, they may s make certain other payments before they have ascertaine “TttSssp-** ? <? *?
Councils that still causes additional anxiety to County c?r ‘ 1 withstanding that a minimum County apportionmen is But under these somewhat uncertain conditions, I ^ 1 ? interested in mental deficiency work will not lose lear , a hands until the financial clouds roll by. On the con great should be all the more determined not to fail to seize p ascertain- opportunity for want of money and all the more vigi a claims ing what money is available in their area and in pressi g a ^They^lrouid realise that under the new re:gime, t;heir9?””^? cil will presumably receive some sum which wi e 1 chequer grant.” This sum will be paid into the General County Pur- poses Account and will be applied to various County services according to the advice of the County Finance Committee. In this way that Committee will have to exercise a much more extensive discretion than it has so far ever had to exercise. Consequently, Mental Deficiency Committees and the Voluntary Associations that assist them should not allow themselves to be the last to knock at that Committee Room door, but should batter at it and besiege it and, on gaining admittance, should curry favour without hesitation and without shame with every member of that influential body.
Personally, I have every hope that in Devon it may be found practicable to obtain the sanction of the Finance Committee to the allocation out of the general exchequer grant of that County of a sum at least sufficient to pay half the loan charges of the proposed new Colony at Langdon Farm. Indeed, I shall go so far as to suggest, if it is found that the new grants are temporarily in excess of present requirements, that, instead of reserving them?an admittedly difficult policy, however sound?a portion of the excess shall be immediately applied towards the cost of building the Colony. I venture to commend this suggestion for the consideration of others who may find themselves in circumstances similar to my own.
There is one more point I should like to call attention to, viz., the provisions of Clauses 94 and 98 of the Bill. Clause 94 (2) provides that the Minister of Health shall period- ically make schemes providing for the payment by County and County Borough Councils of contributions to voluntary Associations which undertake the duty of assisting or supervising defectives whilst not in Institutions, and Clause 98 enables such contributions to be paid by the Minister directly to the Associations concerned.
Here again is another source of help which Voluntary Associa- tions can tap, and I can safely say that the present Minister of Health at least is certain to lend to earnest applicants a most sympathetic ear.
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