369

might suppose. Bacteriology is a necessary part of

medicine; in that respect it arranges for its own

teaching.It is much the same with new subjects. If they are

good and live and genuine they edge their way in willy-nilly. Students listen avidly, teachers find it profitableto display their erudition on something outside theirusual sphere. The best registrars suddenly start side-stepping into the novelty, and in self-defence the schoolhas to appoint someone to its staff to take care of it.It is being taught as much as it deserves usually longbefore the curriculum has even noticed it exists.

Good luck to your discussion, James ; I’m sure the

grand debate will be the better of your contribution.But don’t waste too much time on it. Remember only,as the Inquisitor nearly said, that bacteriology comesfirst.

Yours,PETER DAVEY.

Parliament

Capital PunishmentON Feb. 1 the debate on the first private member’s

Bill of the day-a measure for the control of hire-purchase advertisements-lasted for five hours. As aresult of this exhaustive discussion the private member’sBill to abolish hanging lost its slender chance of survival.On Feb. 6 the third reading of the Government’s HomicideBill, which restricts but retains the use of capital punish-ment, was carried by 217 votes to 131, and sent to theHouse of Lords.In introducing the third reading Mr. R. A. BUTLER,

in his first speech as Home Secretary, said that the newdefence provided in clause 2 would enable the courts totake account of the great strides that had been made inthe understanding of the human mind, and to avoidtreating as murder killings for which the accused oughtnot to be held wholly responsible. This was part of thenew approach to the problems of the mind which hethought would exercise both the Home Office and theHouse in the coming months and years. He believedthat the unexplored territory of the mind would beperhaps one of the most exciting of the adventuresbefore the human intellect in the years to come, and asimportant in our relationships in the human sphere asnuclear development in the scientific. He hoped thathe might have the support of the House in any furthermoves in this direction in the humanising and under-standing of relationships, whether in crime or in theother spheres for which he was responsible.In the course of the debate Dr. REGINALD BENNETT

returned to this clause about which he confessed he feltuneasy. The new code on diminished responsibilityseemed to him in conflict with the McNaughten rules yetthe rules had not been abolished. He feared that thecourts in future would be baffled which of these mecha-nisms was to be invoked in murder trials. If there was aprima-facie abnormality of mind did a charge of murderstill stand ? Or, if it was evident from unopposed medicalevidence before a trial came to pass that the prisoner’smental condition was in other ways deranged, did theindictment drop to that of manslaughter ? If there wasa charge of murder, must the outcome of the charge beeither that the prisoner was unfit to plead on arraignment-that he was guilty or not guilty or that he was guiltybut insane-or was there the further alternative, whenthe charge was murder that he was guilty of man-slaughter ? Or did he really go for trial on a chargeof manslaughter to which he could be guilty or notguilty ?An even greater difficulty, Dr. Bennett suggested, was

to decide on what basis and to what degree there wasirresponsibility. The provision in clause 2, was whetherthe accused

"... was suffering from such abnormality of mind (whetherarising from a condition of arrested or retarded development

of mind or any inherent causes or induced by disease or

injury) as substantially impaired his mental responsibility forhis acts and omissions ..."

Against that we had the McNaughten rules, whichasked whether the accused was suffering at the timefrom such a defect of mind as to be unable to appreciatethe nature of his act or the fact that it was wrong.Which of these two standards came first ? Did onesupersede the other ? Might it be assumed that infuture in cases of homicide there would be no con-

sideration of the McNaughten rules ? The point wasimportant because if the McNaughten rules applied, aman found to be suffering from a defect of reason wouldgo to Broadmoor which was automatically an indefinitesentence. If, however, his defect of mind was found tobe one which justified a sentence for manslaughter,there would be no consideration of any treatment for hismental state except such as is incidental to an ordinaryterm of imprisonment.

In winding up the debate Mr. J. E. S. SiMON, the jointunder-secretary of State for the Home Office, said thatthe Bill provided a criterion which took cognisance ofthe fact that there were, humanly speaking, manydegrees of mental responsibility for crime. Till now theonly legal criterion of mental responsibility for crime wasprovided by the McNaughten rules, and unless thatrigorous test was satisfied, the death sentence was passed.The Home Secretary, in deciding whether to recommendthat the sentence should stand, applied a different testand one not prescribed by the law. The Bill went far toreconcile that divergence.

Turning to Dr. Bennett’s question as to the relationshipbetween the two defences, Mr. Simon said that theaccused man might, on the face of it, be unfit to plead.That was generally a matter which was initially deter-mined by the prosecution, though it might be raised bythe defence, and a jury was then empanelled to decidewhether the man was fit or unfit to plead. It was onlyif the man was fit to plead that any question of thesedefences arose, and then it was a matter for the man.The prosecution could not raise any question at thatstage as to his mental responsibility for the crime. Itwas for him to say whether he would raise a defencewhich would lead to a verdict of " Guilty but insane "or whether he would raise the sort of defence which wouldlead to a verdict of manslaughter by raising a questionof diminished responsibility. The one was under theMcNaughten rules. It was a complete defence and theverdict was guilty but insane, which was equivalent tonot guilty. The diminished responsibility defence wouldlead to a verdict of guilty but guilty of manslaughter.For this the sentence was not necessarily a fixed term.It was a matter for the judge’s discretion, on the evidencethat was then given to him after the verdict, as to whetherhe passed a sentence for life if he could not determine thetime necessary successfully to treat the prisoner. Hecould sentence the convicted man to a term of years.Equally he could, if he wished, put him on probation forthe crime of manslaughter, and he could make a conditionof the probation in a proper case that the man shouldsubmit himself to psychiatric treatment, or, indeed, anyother medical treatment for a suitable time.

Domiciliary Services for Old PeopleOn Feb. 6, under the ten-minute rule, Mr. FRANK

McLEAvy introduced a Bill to amend section 31 of theNational Assistance Act, 1948, so as to empower localauthorities to provide meals and domiciliary and otherfacilities for old people.

QUESTION TIME

Supplementary EstimateMr. ARTHUR BLENKINSOP asked the Minister of Health

how much of the Supplementary Estimate for the NationalHealth Service was due to an increase in the number ofmedical and other staff of our hospitals.-Mr. DFNNis VospERreplied : None. Provision for staff increases was made in theoriginal estimate. With insignificant exceptions, the extraexpenditure on hospital-running costs provided for in theSupplementary Estimate is in respect of increases in pay,prices, and rates.

370

Number of PrescriptionsMrs. L. JEGER asked the Minister the number of prescriptions

dispensed during the first month of the new charges, and thenumber for the corresponding period last year.-Mr. VOSPERreplied : An accurate figure is not yet available. From a

representative sample it is estimated that the number

dispensed in England and Wales during December, 1956,was of the order of 15.5 million. The total number inDecember, 1955, ,was 19,349,115.

Dental HygienistsMr. BARNETT JANNER asked the Minister, as representing

the Lord President of the Council, whether he would makea statement on the availability of dental hygienists for thegeneral public in accordance with the provisions of theDentists Act, 1956.

Mr. V OSPER replied : Some dental hygienists are alreadyemployed in the local-authority and hospital dental services,but they cannot work with dentists in private practice untilpermitted by regulations made under the Dentists Act,1956, by the General Dental Council. The General DentalCouncil has asked the Privy Council to approve draft regula-tions which provide that dental hygienists shall not beallowed to work in private practice until such time as therequirements of the local-authority and hospital dentalservices are, in the opinion of the General Dental Council,satisfied. This limitation would not appear to accord with theintentions of Parliament as expressed during the passage ofthe Bill and the proposals have therefore been referred backto the General Dental Council for further consideration.

Fees for Poliomyelitis VaccinationMr. Moss TURNER-SAMUELS asked the Minister of Health

whether, in view of the fact that the remuneration of generalpractitioners for the carrying out of the responsible duties andcomplicated arrangements required to collect, store, andadminister the vaccine and keep the necessary records inconnection with inoculation against poliomyelitis was unreason-ably low, he would increase the present inclusive fee of 5s. forthe two inoculations required in each case to a more reasonablefigure.-Mr. VOSPER replied : The vaccination will be per-formed as part of the general practitioner’s comprehensivemedical care of his patients for which he receives remunerationfrom his local executive council; the additional 5s. fee is to bepaid by the local health authority for the record of vaccination.This is the present fee for records of other forms of immunisa-tion and was agreed between representatives of local authoritiesand of the medical profession.

Overseas Dental Students

Mrs. HILL asked the Minister of Health how many studentsat present in British dental schools are from the Commonwealthand how many from foreign countries ; and how many heestimates will practise in this country after qualifying.-Mr. VOSPER replied : The numbers from Commonwealth and

foreign countries in English dental schools are 109 and 113,respectively. I cannot estimate how many will practise inthis country after qualifying.

Senior Medical Inspector of FactoriesSir LESLIE PLUMMER asked the Minister of Labour if he

would now improve the grading of the post of H.M. SeniorMedical Inspector of Factories, to reflect more accurately theimportance attached to industrial health organisations andequated with the grading of the chief medical officer of theMinistry of Pensions and National Insurance and of theColonial Office as well as with the Treasury medical adviser.-Mr. pain MACLEOD replied : No. The present grading of thepost of H.M. Senior Medical Inspector of Factories is basedupon the recommendations of the Howitt Committee whichreported in 1951. The salary has been adjusted in accordancewith the recommendations of the Royal Commission on theCivil Service.

Occupation Centres for Mentally HandicappedAt the end of 1955, 12,372 mentally handicapped people

were attending occupation centres and 7877 others, mostlyadult, were reported by local authorities to be suitable toattend when places could be provided. At the end of 1956there were 301 centres in full-time and 69 in part-time use.Schemes for 41 full-time centres have been approved, and thesemay be expected to be working in the course of the next twoyears. Proposals for 33 others are being considered.

‘

In England Now

A Running Commentary by Peripatetic Correspondents

You might think that transplanting a couple of goose-berry bushes a simple operation ? Not in our garden.I was poised with my fork when the dustmen arrived andamongst them my old patient Tom Hoggart.

" Are t’ movin’ goosegogs, doctor ? "

"

Yes, into the orchard, Tom."" Thou’lt send ’em to their grave."" Eh ? "" Th’ acid in t’ground. They might show first year, small

an’ ’ard. Followin’ year they’ll wither down. Th’ acid’lldraw ’em down to t’root ends."

At that moment my wife came rushing out of the house,her hands and arms white with flour.

" You’re not moving the gooseberry bushes are you ?" "

" Why not ? "

" Every time anything looks as though it’s going to take ahold in this garden you decide to move it. Even weeds can’tgrow here, they haven’t time."

" Relax, honey-child. In three years these two bushes haveproduced five hard, hairy goosegogs. They need a new start.And that’s what I’m giving them !

"

" It will be the children next," she said. " You’ll be sendingthem to boarding-school."As our eldest child is only 31/2 I considered this a

remark of quite tangential irrelevance and was about tosay so when Mr. l2cGillivary, the smith, walked by. Iwas in need of an ally.

"

Moving the gooseberry bushes, doctor ? "

" He’s always moving everything," said my wife. " Everytime I come out into the garden the plan is changed. I neverknow where to look for things."

" And isn’t that what the ladies do in the house ? " saidMr. McGillivary. " When a man wants his pipe or his slippersor a piece of string or his screwdriver where are they ?Moved ! "

I smiled on Mr. McGillivary. Not for nothing had wethrown together the companionable dart at the GoldenBall. I looked towards the orchard.

" Where would you put them, Mr. McGillivary ? "

" In the orchard. The ground is sweet under the appletrees, and when summer comes their skins will be burstingwith sugar."

* * *

The Church, the Army, the Law, and Medicine are allin their way connected with death. The cloth discussesit, the warrior arranges it, the solicitor is ready for it,the doctor delays it (or tries to do so). These lugubriousconclusions arose from my recent visits to the third ofthese fell sergeants. The man of law’s touch was so light.His remarks were far removed from the forebodings ofthe post-Victorian revivalist. He spoke of some far-offdivine event. When the. event happened, you, me, theclient would be obviously performing a gracious act

(gracefully), and he was armed at all points cap-a-pieto carry on the good work with all propriety. Howcomforting a speculation. Everything prepared for.Nothing, or only very little, to go wrong.

Part of the solicitor’s finesse comes from good training,from those articles, not the thirty-nine, for which as apenurious father I have just paid so much, but part surelyfrom the fact that the lawyer acts after life, and theparson, the colonel, the doctor during life. When theLaw is in action during life its mills grind as slowly asthose of God, its results may be as uncertain or as foggyas the case of Jarndyce v. Jarndyce.

If our profession could be as futuristic as the familysolicitor is, how different it would be. Luckily I suspectfor ourselves, we are continually being held up to theransom of necessary decision, and some of us can shutour eyes like the fighting man guided by some highercommand, or like the cleric call upon some vision whichnot all mortals can share with him. The sword ofDamocles hangs by its thread ; in Lincoln’s Inn it has