The Lunacy Commission, A Study of its Origin, Emergence and Character
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Introducing the Lunacy Commission

The Victorian Ministry of Mental Health

The Lunacy Commission was a government department established in 1845 to supervise the treatment of lunatics in England and Wales. The commission was re-named the Board of Control in 1913. Since the second world war most of its functions have been absorbed by the Ministry of Health. (See 1919 and 1946 and 1959).

This is a study of its origin, emergence and character.

The Lunacy Commission was a Victorian "Ministry of Mental Health" but without a "Minister of Mental Health". It was responsible both to the Lord Chancellor and Home Secretary and had a Chairman who sat in the House of Commons or Lords (*).

(*) Lord Ashley MP (7th Earl of Shaftesbury from 1851) was Chairman from 1845 to his death in 1885. From 1846 to 1847, when he was not an MP, another commissioner (Seymour) was acting chairman in the House of Commons. Thomas Salt MP succeeded Shaftesbury in 1885, and was succeeded by two members of the House of Lords: Hatherton (1892-1898) and Waldegrave (1898-1913). See Charts

In 1845 the Lord Chancellor and Home Secretary were the principle Ministers with responsibility for home affairs. There were few other central departments of domestic government because this was principally the responsibility of local Justices of the Peace (JPs). JPs were appointed by the Lord Chancellor and (in as far as they were responsible to central government) regulated by the Home Office.

The only department comparable to the Lunacy Commission was the Poor Law Commission (Board from 1849), the Victorian's version of a Department of Social Security. This was also responsible to the Home Office and the two commissions worked closely together. The Poor Law Commission provided central regulation of local poor law Guardians who consisted partly of JPs and partly of elected members. The Lunacy Commission regulated JPs in the provision of lunatic asylums and control of private madhouses.

The Lord Chancellor had responsibility for the property of lunatics and idiots delegated to him by the Crown (see chancery lunatics) and it was specifically in this capacity that he appointed the Lunacy Commissioners.

The Lunacy Commission was developed from the Metropolitan Lunacy Commission (1828 to 1845) which itself replaced the commission of the Royal College of Physicians (1774 to 1828)

[Unless otherwise stated the Royal College of Physicians (or RCP) refers to the London college. Statutory names for the commissions were not provided until 1832. From 1832 the commission was to be known as The Metropolitan Commissioners in Lunacy, and from 1845 as The Commissioners in Lunacy. I avoid this form, however, so as to distinguish between the commission and its commissioners.]

The sequence: Physicians Commission; Metropolitan Commission; Lunacy Commission; Board of Control is the conventional one, but is inadequate for my purposes. Until 1842 the commissions were basically elements of the structure of local government. They licensed and visited (i.e. inspected) madhouses in the London area. Those elsewhere in England and Wales were licensed and visited by the JPs. The central government department was developed from the local over a three year period. From August 1842 to 1845 the Metropolitan Commission carried out a national inquiry into the treatment of lunatics (especially paupers) in all types of institution. This was a period of transition for the commission. During the inquiry it acquired many of the features of what it was to become formally in 1845. It is more meaningful, therefore, if we give the commission a distinct title for those three years: the Inquiry Commission.

My amended sequence is therefore:

1774 Physician Commission A local government unit
1828 Metropolitan Commission A local government unit
1842 Inquiry Commission Transitional
1845 Lunacy Commission A central government department
1913 Board of Control A central government department

The Physician Commission was only one aspect of the work of the Royal College of Physicians. Its Commissioners for Madhouses, and other officers of the commission were an integral part of its general organisation. The Metropolitan Commission, however, was a distinct organisation established specifically to control madhouses. Commission is thus used in two distinct senses: for an organisation in Metropolitan and Lunacy Commissions, for a function or responsibility of an organisation in Physician Commission. The latter use of commission also occurred in 19th century sources: when, for example, "Oxfordshire Commissioners" was used as a name for Oxfordshire's JPs licensing and visiting madhouses in the county (*).

(*) I only use commission to refer to the London authority.

My thesis seeks to establish the scope and character of the Physician and Metropolitan Commissions on the one hand and the Lunacy Commission on the other; and examine the transition from one to the other. It is an organisational study of the emergence of one of our first social service departments and the elements of which it was composed. - See concluding summary

A chapter is devoted to each commission: chapter 2 to the Physician Commission, 3 to the Metropolitan Commission, 4 to the Inquiry Commission and 5 to the Lunacy Commission. Chapter 6 contains biographies of all the commissioners from 1828 to 1913 with a chart showing the period each served. Data on the personnel of the Physician Commission is at the end of chapter two.

This is not a history of the commissions from 1774 to 1913. The Physician and Metropolitan Commissions are examined only to establish their scope and character so that the scale of the 1840s transition can be clearly understood. Similarly I make no attempt at a history of the Lunacy Commission from 1845 to 1913. The object of chapter five is to establish the commission's character, show the range of its functions in contrast to those of previous commissions, examine the continuity of organisation and personnel from the Metropolitan to the Lunacy Commission and locate the Lunacy Commission within the structure of central government and in relation to local government.

With each commission I start with the Act/s that established and governed it, and related legislation. The principle Acts were:

Physician Commission 1774 Madhouse Act
Metropolitan Commission 1828 Madhouse Act until 1832
and then the 1832 Madhouse Act
Inquiry Commission 1842 Inquiry Act and 1832 Madhouse Act
Lunacy Commission 1845 Lunacy and County Asylums Acts

The first few pages of a chapter place the legislation in its context with respect to preceding and succeeding Acts, Bills, Parliamentary Committees etc. Each chapter contains an annotated summary of the Act/s relating to the commission it deals with. The text, as distinct from the summaries, interprets the Acts in the light of the other historical evidence about the commission. Generally I attempted to establish with respect to each commission:-

    a) Its functions
    b) Its structure (including its membership)
    c) How it related to other departments of government
    d) How it related to the commission preceding it and (or) succeeding it


The Summary of Commissions (1.2.3) outlines the features of each from the inception of the Physician Commission in 1774 to the dissolution of the Board of Control by the 1959 Mental Health Act. 1.2.1 outlines the functions common to all and explains the distinction between the London area and the rest of England and Wales, usually known as the "counties". The London area is defined in 1.2.2.


The principle function all the commissions shared was responsibility for licensing and visiting madhouses in the London area. This was the main function until 1842, but was afterwards subordinate to national activities.

The 1774 Madhouse Act made it an offence for anyone to keep a house for the reception of more than one lunatic without a licence and this remained the law until 1959 (*). In the counties licences were granted by JPs in Quarter Sessions, but in London. by the commission (see table below). The licensing authorities also had to visit the houses they licensed. In the counties this was done by "visitors" appointed by Quarter Sessions; in London by the commission. From 1842 county houses were visited by commissioners and county visitors; the commissioners as national inspectors, the county visitors as inspectors from the licensing authority. The commission remained licensing authority in the London area which, from 1845, was known as their "immediate jurisdiction" (1845 Lunacy Act, s.14).

(*) 1774 Madhouse Act s.1; 1828 Madhouse Act s.19; 1832 Madhouse Act s.22; 1845 Lunacy Act s.44; 1890 Lunacy Act s.315. Chancery Lunatics excepted from 1774 to 1828.

In addition to licensing and visiting, all the commissions:

    a) Kept central registers of patients in licensed houses in London and the counties,

    b) Authorized searches of the registers so that enquirers with a reasonable interest could find out if a particular person was detained and, if so, where.

    c) Kept central records of the visiting "minutes" (reports) on houses made by themselves and the county authorities,

    d) Were responsible for enforcing the Acts by which they were established.

1774 to 1946

Physician Commission
Metropolitan Commission
Lunacy Commission
Board of Control

1774 to 1959

County JPs
or (after the 1835 Municipal
(Reform) Act) Borough JPs

1946 to 1959

The Ministry of Health
(1946 NHS Act, s.49(1))

By the 1959 Mental Health Act, s.14, "Mental Nursing Homes" were required to be "registered" with the local county or county borough council.


The Physician Commission was to license houses: "within the cities of London and Westminster and within seven miles of the same, and within the county of Middlesex" (1774 M. Act, s.2)

London, Westminster and a seven mile radius was, I believe, the area in which the Royal College of Physicians already controlled physicians practising, and inspected apothecaries' shops. It included the most densely populated parts of Middlesex and most of its madhouses. The area in the 1774 Madhouse Act merely added the rural fringe.

In subsequent Acts the definition became longer and more precise, but it defined essentially the same area. (1828 M Act, s.2; 1829 M Am Act, s.10; 1832 M Act, s.3; 1845 L Act, s.14; 1890 L Act, s.208(1) and 3rd schedule; 1946 NHS Act, s.49(1) and 9th schedule).

No alterations were made in 1828, but in 1829 a list was added of the "precise places" in Surrey, Kent and Essex that were included. The "parishes and places" listed that were furthest from London were: Wimbledon and Dulwich in Surrey, Lewisham and Woolwich in Kent, and East Ham in Essex. As all are within seven miles of the boundary of London and Westminster, no alteration was made to the area unless some parish boundary/s went beyond the seven mile radius. From 1845 the seven miles was drawn from London, Westminster and Southwark, so (probably unintentionally) an area the size of Southwark was added to the rural border of the commission's immediate jurisdiction. This minor addition was the most substantial alteration made to the area at any time.


1774 - 1828 - 1832 - 1842 - 1845 - 1913 - 1930 - 1948 - 1960 - 1969 - 1983 -

1774 to 1842: Commissions principally for the London area.

1774 Madhouses Act established:

The Physician Commission:

This was part of the Royal College of Physicians which each September appointed five Fellows commissioners for the year, who met in October to grant licences they could neither refuse nor revoke, and at least once in the year visited each house licensed making a minute of its condition. Any keeper refusing admission forfeited his licence. A Secretary to the Commissioners was to be sent a notice of the admission of every lunatic not a pauper to any licensed house in England and Wales. He kept registers of these in which he also entered commissioners' visiting minutes and those sent to him by the clerks of the county visitors (County Clerks). The RCP President, in the name of the Treasurer was to prosecute anyone (in the London area) who kept an unlicensed house, admitted any patients without a medical certificate (see law) or failed to notify the Secretary of the admission of a non-pauper.

The commission could not release a patient improperly confined. This was the traditional role of the High Courts at Westminster, for whose benefit the registers were principally kept. The Westminster courts could also order special visits and reports, and examine those engaged in the execution of the Act. Private individuals could apply to the commission to find out if someone was registered as a patient and, if so, where he or she was detained. The commission was financed entirely from fees charged for licenses, from which the Treasurer paid every commissioner one guinea for each house visited (irrespective of the time taken) and the Secretary an annual salary.

The 1828 Madhouses Act established:

The Home Secretary's Metropolitan Commission:

Five physicians, including the Secretary and Treasurer of the Physician Commission; six Middlesex JPs and ten other honorary commissioners, were appointed by the Home Secretary in August 1828 to form a commission specifically to control London's madhouses. The medical commissioners were paid £1 an hour, the others were not paid.

Honorary and Professional Commissioners:
Honorary (unpaid) commissioners and medical commissioners continued to be part of the Metropolitan Commission and the Lunacy Commission. Legal commissioners were added in 1832. I refer to the medical and legal commissioners (as distinct from the honorary commissioners) as professional commissioners.

A lawyer was appointed the Commission's "Treasurer-Clerk" (London Clerk) to establish an office and keep (national) registers.

New commissioners were appointed as and when necessary. With a few exceptions, the honorary ones needed replacing relatively often, but all but one of medical commissioners served until 1845 (and some beyond). (See Charts)

The commission was funded, in excess of licence receipts, by the national Treasury. It only licensed houses if it "saw fit", and the Home Secretary could revoke a licence on its recommendation. Quarterly licensing meetings were held, to which applicants had to submit, in advance, written details of proposed houses. Commissioners (usually two medical and one honorary) visited each house at least four times a year and their reports were taken into account before the (annual) renewal of the licence.

The Westminster courts could no longer order visits and reports and did not have statutory access to registers. Instead the commission had power to release a patients on its own authority.

The 1832 Madhouses Act established:

The Lord Chancellor's Metropolitan Commission:

Appointment of the commissioners was transferred to the Lord Chancellor as custodian of the property of lunatics. The number of professionals was increased by the appointment of two barristers as legal commissioners, paid (under the 1833 Madhouses Continuation Act) at the same rate as the physicians. (See Charts) The honorary commissioners were reduced and, because legal commissioners could take their place, they were no longer essential for licensing and visiting. Although largely responsible to the Lord Chancellor, the commission retained some responsibility to the Home Secretary.

1842 to 1959: National Commissions with changing functions

The (first) 1842 Licensed Lunatic Asylums Bill proposed:

A Barristers' Commission:

As it was thought that county licensing and visiting was defective, it was proposed that the two legal commissioners should visit and report on county houses supplementary to the county visitors. The House of Commons rejected this proposal and an amended bill became the Inquiry Act.

The 1842 Inquiry Act established:

The Inquiry Commission:

Two medical and two legal commissioners were added to the commission, and the number of honorary commissioners further reduced. No new commissioners were appointed during the Inquiry. One of the new medical commissioners was a psychiatrist, the other a medical statistician. (See Charts)

The medical and legal commissioners jointly visited and reported on public asylums and licensed houses throughout England and Wales, and in 1844 the commission published a 300 page report with recommendations for changes in the law.

The 1845 Lunacy Act established:

The Lunacy Commission:

The Act named eleven Metropolitan Commissioners as Lunacy Commissioners. Six (three medical and three legal) were to be employed full time at salaries of £1,500 a year. The other five were honorary commissioners whose main function was to attend board meetings. The Permanent Chairman had to be an honorary commissioner, but otherwise they were not essential to the commission's operations. The only Metropolitan legal commissioner not appointed as a Lunacy Commissioner was named in the Act as Secretary. (See Charts)

The Lunacy Commission had national authority, under the Lord Chancellor and Home Secretary, over all asylums (except Bedlam until 1853). It shared responsibility with the poor Law Commission/Board etc for pauper lunatics outside asylums. Its principle functions were to monitor the erection of a network of publicly owned county asylums, required under the 1845 County Asylums Act, and the transfer of all pauper lunatics from workhouses and outdoor relief to a public or private asylum; to regulate their treatment in private asylums, and (with the Poor Law Commission) monitor the treatment of any remaining in workhouses or on outdoor relief.

The Lunacy Commission was also to monitor the regulation of county asylums and county licensed houses by JPs, and to regulate the conduct of hospitals for the insane. With the JPs it monitored the admission and discharge of patients from all types of asylum. It collected, collated and analyzed data on the treatment of lunacy and advised on the development of lunacy law and policy. It also continued to license London's madhouses.

The 1913 Mental Deficiency Act established:

The Board of Control:

Which had extended functions with respect to mental deficiency. The Act provided that the Board should consist of not more than fifteen Commissioners of whom not more than twelve should be paid. Of the paid commissioners, four should be medical and four legal. It also required that at least one of the paid and one of the unpaid commissioners should be a woman. The legal members were appointed by the Lord Chancellor and (from 1920) the Chairman and the other members by the Minister of Health. (Newsholme, A. 1925 p.106) (See Charts)

The 1930 Mental Treatment Act

Reduced the maximum size of the Board to five: A chairman and not more than four commissioners, of which two were to be medical commissioners. (See Charts). 1930 appointments included six doctors who were previously "Inspector, Board of Control" or (in one case) "Temporary Inspector".

The 1946 National Health Service Act:

Stripped the Board of Control of many functions: Section 48 transferred to the Minister of Health the functions of licensing and registering hospitals and homes for private patients, certification and approval of places for the reception of mental defectives, superintendence of local authorities with respect to mental deficiency, and other (unspecified) administrative matters.

what actually happened? Percy 1957 par.789 says "...the Board of Control handed on to the Ministry of Health its functions as the central department responsible for the general supervision of the mental health services as distinct from the procedures applied to individual patients. Continuity in administration was well preserved by the arrangements by which the people who had previously exercised these responsibilities as members of the staff of the board continued to carry them out as officers of the Ministry, and at the same time continued in their former capacities to carry out the functions still vested in the Board. So smooth was this transition that we doubt if it is fully realised even now by some of those working in the mental and mental deficiency hospitals how much of the day-to-day work of the people whom they know as senior commissioners of the Board has in fact been performed since 1947-1948 in their capacity as officers of the Ministry.

In 1949 the collation of statistics moved into the Ministry of Health, although continuity was sufficient for the Percy Report to distinguish between "Board of Control statistics", "General Register Office statistics" and "Ministry of Health statistics". Some of the Board of Control series of statistics went back to 1845

The Percy Report also analysed the functions that remained formally with the Board:

The Board of Control, as Board of Control:

  • Remained the management of institutions for "defectives of violent or dangerous character" (see Rampton, Moss Side and Broadmoor), although ownership passed to the Minister.
    See Percy par. 785

  • Continued as an inspectorate of mental hospitals
    See Percy par. 737

  • Retained its oversight of compulsory detention and power to discharge.
    See Percy par. 765

  • Retained responsibilities for investigating complaints and for visiting patients who requested to speak to a commissioner
    See Percy par. 743

  • Retained powers to control some abuses of treatment
    See Percy par. 744

  • Continued to scrutinise documents
    See Percy par. 745

    The 1959 Mental Health Act abolished

    The Board of Control, which was dissolved on Monday 31.10.1960. A list of commissioners and secretaries from 1845 to 1960 was compiled and dated May 1961. By section 98 of the Act, the management of Rampton, Moss Side and Broadmoor (to be known as Special Hospitals) was moved to the Minister of Health.

    When the law for Scotland was revised in 1960, it replaced the General Board of Control for Scotland with a commission called the Mental Welfare Commission for Scotland

    and then... When mental hospital scandals were news in the late 1960s, some people argued that the abolition of the Lunacy Commission was the cause. In particular, because an independent inspectorate of the hospitals was needed. The Percy Report had considered this inconsistent with the development of integrated public health and social services, unnecessary and unconstitutional. A decade later, the theory of government had changed and the Hospital Advisory Service was established in 1969. This can be seen as reviving the independent inspectorate of mental hospitals. A decade further on, after the development of the patients' movement and concern over abuses of medical treatment, government was willing to regulate what went on in psychiatric hospitals.

    Part of this process of reinstating the Commission, was the establishment of a Mental Health Act Commission in 1983 which can be seen as reviving some of the Board's functions with respect to patient's complaints and regulating civil liberties issues. The Percy Committee had been advised by the Board of Control and the Ministry of Health to maintain an independent commission for this, but had recommended instead that the powers should move to the Minister of Health. The Ministry rejected this idea, in case it "detract from the standing and authority" (Jones, K. 1960 p.187) of the Mental Health Act Tribunals, set up under the 1959 Mental Health Act. The one aspect of the Board of Control that Percy had recommended should continue (under the Minister), reemerged in 1983 in the more conservative form that the Board of Control recommended, but Percy rejected.

    I am making some notes about the way the idea of the commission survived and survives after 1960

  • © Andrew Roberts 1981-

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