§ Order for Second Reading read.
§ 11.6 a.m.
Mr. A. DU CKWORTH
I beg to move, "That the Bill be now a read a Second time."
Judging by the propaganda which has been carried on against this Bill by numerous bodies outside this House, and in view of the anxiety which has been expressed on behalf of numerous interests, it is, I think, evident that very considerable misapprehension exists as to the scope and intentions of the Bill. I should like to make it clear from the outset that the scope of the Bill is extremely limited. Its provisions have received the support and approval of a large number of bodies, including the representatives of the proprietary medicines trade, the Advertising Association, the County Councils' Association, the Pharmaceutical Society, and many other bodies. The Bill is not promoted by any vested interests. It is not the intention of the Bill to discriminate in any way between the qualified and the unqualified practitioner, nor do we believe that it can possibly damage the interests of any religious body or association, since such bodies are specifically excluded from the provisions of the Bill. The Bill seeks merely to remove some of the worst abuses that exist in connection with the advertisement and sale of patent medicines and secret remedies. That the Bill sets out to achieve in Clause 1. In Clause 2 it strikes at another method, which is only, I think, practised by the unscrupulous person, and that is the method of offering to diagnose and give treatment by correspondence. That is not a practice in which any reputable unqualified practitioner engages so far as I know, and I do not think that such practitioners have anything to fear from that Clause in the Bill.
The existence of the abuses against which the Bill is aimed is not, I think, disputed by any hon. Members of this House, and I do not think that any decent person inside the House or outside it would attempt to justify those abuses. 1564 The Bill is designed solely to give the public some protection against the worst of the forms of exploitation that are practised by fraudulent and unscrupulous persons for their own profit; and, even should the Bill become law, it would still leave open an enormous field for the activities of the swindler and the cheapjack. Indeed, it seems to me that, when we consider the state of the law in this country as compared with the protection in this respect that is given by the law of other countries, particularly in the British Dominions, it may be very justly argued against the Bill that it errs on the side of moderation, and does lot go half far enough in affording protection to the public. It is, I think, worth noting that in nearly every continental country the law gives a very considerable measure of control over the advertisement and sale of all patent medicines and secret remedies, and that also is the case in the British Dominions. In Australia and in Canada the protection given to the public is specially comprehensive, and there are the most stringent laws against all fraudulent forms of advertisement.
The extent and the widespread nature of these abuses were first made known to the public through the Report of the Select Committee of this House which sat from 1912 to 1914, and reported in August of the latter year. That Committee examined a very large number of witnesses, and the study of their Report can leave no possible doubt in the mind of anyone as to the volume and growth of the traffic in patent medicines and so on, and as to the inadequacy of the law to protect the public from fraud and deception. The Committee in their Report made some very startling revelations as to the fraudulent claims put forward in advertising many well-known patent medicines on the market, and as to the ingredients used in their composition. I would like to call the attention of the House to the case, which was quoted in the Report, of Beecham's Pills. Beecham's Pills to-day are, I believe, a very respectable remedy, to be found in almost every house, but the origin of the advertisement of Beecham's Pills was far from respectable. It was claimed for a long time that Beecham's Pills exercised a remarkable curative effect in cases of Bright's Disease, and it was further claimed that Beecham's Bills could give 1565 substantial assistance in the cure of syphilis. These statements have to-day been dropped, and the claims that are made for Beecham's Pills at the present time are very much less ambitious. I only quote that example to show the kind of abuse that existed in such a well-known case as that.
The Report laid very particular emphasis on the abuses and dangers to public health that were inherent in the advertising of claims to cure diabetes, cancer, consumption, and the other diseases that are listed in Clause 1 of the present Bill. The Report pointed out that these complaints, by the very fact of their intractable nature, offered to the swindler his greatest opportunity of exploiting the credulity of the public, and it gave most tragic and pitiful examples of the cruel deception that was practised, and the misery caused among poor people who took these advertisements at their face value, were induced to part with their money in return for the rubbish that was thrust upon them, and in consequence in many cases aggravated the condition from which they were suffering by failing to put themselves in time under proper medical supervision. The Report laid bare the fact that the traffic in that type of advertisement had grown to enormous proportions, and produced evidence to show that agencies had been established where the unscrupulous, for a sum of money, could purchase thousands of names of persons suffering from these complaints. The Select Committee recommended that all advertisements in connection with these diseases should be prohibited by law, and that is the intention of the first Clause of this Bill.
The Committee's recommendations went a very great deal further than anything we contemplate. They recommended, in particular, that a very much more stringent control should he exercised over all forms of advertising in connection with the sale of patent medicines, that the law should be strengthened with regard to false trade descriptions, that the Ministry of Health should be placed in control of the whole of the traffic in medicines of all kinds, that a register should be set up of every manufacturer, importer and proprietor and that certificates of registration should be required in connection with every remedy put upon the market. The Bill does not attempt anything as ambitious as that. Indeed, there are 1566 reasons for thinking it would not be necessary. It is true that the report of 1914 is, to some extent, out of date, and that the public have meanwhile received some additional measure of protection through the passing of the Dangerous Drugs Act and the Pharmacy Act, which require the labelling of all bottles that contain any quantity of poison. It is also true that reputable newspapers have now established a voluntary form of censorship which excludes the more unsatisfactory type of advertisement; but all newspapers and periodicals do not come within the scope of that censorship and I think there can be no question as to the extent and the gravity of the abuses that still exist. I do not think that anyone who investigates the class of advertisement that is still put out on a large scale can come to any other conclusion. One cannot fail to be convinced that enormous frauds are still practised upon the public and that the public is exposed to very considerable dangers. I think one could only come to the conclusion that there is an urgent necessity that the law should in some form or other give some additional protection to the public.
I have been able to acquire a very large number of examples of the type of advertisements which are still current and which no one could possibly defend—the class of advertisement against which this Bill is specifically aimed. Those of which I have been put in possession can, I understand, be matched by thousands in the files of the Advertising Association. I have one or two here which are typical. A company that calls itself the Par-rimac Co. claims to cure diabetes. They advertise that their full treatment costs £1. It is stated that no long-drawn-out treatment is necessary. Various instances of cures are mentioned, including the case of a man who is stated to have been cured by taking only one dose. Here is another example of an advertisement claiming to cure tuberculosis. It is a firm called F. W. Cassell & Co., and the advertisement takes the form of a declaration made before a Commissioner for Oaths by Mrs. Jenny Ball of Coventry in which she declares that, having been. certified to be suffering from tuberculosis, she has been cured by a treatment that is not mentioned by name and readers are invited to write to her for details, and those who do so receive a duplicated 1567 letter telling them to apply to F. W. Casselll & Co., Ltd. for particulars of treatment. There is a whole number of these advertisements claiming to cure tuberculosis. Here is one claiming to cure deafness. It concerns a gentleman named H. Clifton. It was discovered, when this case was investigated, that this gentleman, who describes himself as an aural specialist, has been advertising a cure for deafness for over 20 years, nearly always from accommodation addresses. I think the House cannot fail to agree that this class of advertisement is of a highly undesirable character.
§ Sir ALFRED BEIT
Has the hon. Member any advertisements in his possession claiming to cure baldness? They seem to me the most lying of the lot.
That does not come within the scope of the Bill. There is one other class of advertisement of a particularly widespread character which holds out, by implication, the procuring of miscarriage by women. That would certainly come within the scope of the Bill, because we believe it to be one of the most harmful and it is among the most fradulent that can be found, because I have been assured by medical opinion that, in the first place, there is no substance known which is, in fact, effective for this purpose and, in the second place, if it is effective, it cannot be so without proving harmful to the health of women. In fact, I understand that the high rate of maternal mortality may even be connected with the widespread traffic in these substances.
This is not the first attempt that has been made to deal with these abuses by legislation. In 1920 a very comprehensive Bill was introduced by the Government. I believe it passed through all its stages in another place, but finally came to grief owing to the comprehensive, complicated nature of its proposals. In 1931 Dr. Somerville Hastings made himself responsible for a Bill which, I believe, was approved by the Health Committee of the Labour party, but it was submerged in the flood which carried away so many Members above the Gangway. This Bill is of a very much more modest character. It represents the greatest measure of agreement that has ever been obtained on this problem, and I believe that it will afford 1568 the public the minimum amount of protection to which it is entitled.
There is, I regret to say, an Amendment on the Paper for the, rejection of the Bill, and I will address myself to some of the criticisms which, no doubt, will be advanced against the Bill. There are hon. Members of this House in whom usually, and I dare say often very rightly, any Private Member's Bill arouses the most destructive instinct s, and, as far as they are concerned, I can only ask them to consider the Bill without prejudice, and upon its merits. There are, in addition to these hon. Gentlemen, other hon. Members who regard the Bill simply as a piece of unnecessary and interfering legislation. They say that a fool and his money are soon parted, and that it is not the business of this House to allay that process. That is not the principle of a very large mass of legislation that we have enacted in this House. The law of this country protects the public from swindles of many kinds, and, if one considers, to take one example, the class of financial fraud, it is plain that the victim of fraud of that kind usually falls through the prospect of gain that is held out to him. The man who falls victim to fraud through the tragic misfortune of disease and ill-health is far more deserving of the care of this House, and far more in need of the protection of the law.
I come to those other hon. Members of the House who sincerely believe that the Bill should be opposed because it may in some way damage the interests of the reputable and unqualified practitioner, and further, that it will establish a still greater monopoly in favour of the orthodox medical profession. I should like to make it quite clear that the Bill, at any rate, has no intention of that kind. There is no intention whatever to discriminate between the unqualified and the qualified practitioner. The removal of these abuses to which I have drawn the attention of the House will be as much to the advantage of the unqualified practioner as to the orthodox medical profession. It would be a grave misfortune if this Debate were to develop into a scuffle between those who champion one side or the other. It is possible, no doubt, to take a very cynical view of the medical profession. I believe that it was Voltaire who described the physician as onewho pours drugs of which he knows little into a body of which he knows less.1569 Medical science has certainly advanced very far since the days of that eminent philosopher. It is said, and with some truth, that the very diseases which are listed in the first Clause of the Bill are those against which the orthodox medical profession has so far proved unsuccessful. My reply is that no doubt that is perfectly true, but there is nothing prohibited in this Bill which any reputable practitioner, qualified or otherwise, carries out in the normal course of his practice. Is it seriously suggested that if a discovery were made, for instance, for the cure of cancer it should only be made known through advertisements for the commercialisation of the discovery? I do not believe that for a minute.
§ Mr. MICHAEL BEAUMONT
The Bill does not deal only with that type of advertisement; it deals with publishing a claim to cure the diseases enumerated in the Bill.
I do not think the unorthodox medical profession is in the habit of putting out advertisements of that character or of the class against which the Bill is aimed.
I will deal with that point in a moment. I hold no brief for the British Medical Association. In fact, I have personal reasons for not wishing to do so. I place no unlimited confidence in orthodox medicine, nor have I found the unorthodox practitioner any more helpful. But this I will say, with all respect to those hon. Members of this House who are qualified doctors. I believe that it is true to say that a certain amount of justifiable prejudice exists in the minds of the public on account of a certain narrowness of mind and pedantry, and pettiness of etiquette often practised by the orthodox medical profession. It would be all to the good if that prejudice could be overcome, but, in fairness to the medical profession, it is only right to recognise the fact that the public should be extremely thankful for the enormous progress that orthodox medicine has made during the course of the last 100 years. I recognise the excellent work that is carried on outside the orthodox medical profession by osteopaths, herbalists and others. I 1570 have no intention in the Bill of placing difficulties in the path of those people. I am, indeed, aware that they have expressed certain doubts with regard to the drafting and interpretation of certain Clauses of the Bill. I believe that those fears are ungrounded, and we have gone some considerable distance in the negotiations that took place before the Bill was finally drafted, to meet the views that were put forward on their behalf.
§ Mr. LOFTUS
With which societies were the negotiations conducted? The hon. Member will recognise that that is an important point.
That really is not a point of importance. I wish, at any rate, to give the undertaking that if it can clearly be shown that the Bill does in any way threaten these legitimate interests, we shall be perfectly prepared to accept Amendments further to safeguard their position. I do not believe that any reasonable person in this House can possibly oppose the main principles of the Bill. These abuses cannot be defended from any point of view. It is a tragic thing that in this country there should be so little protection for those whom misfortune has singled out for ill-health and disease. The more malignant the malady, the more easily do they fall victims to the unscrupulous shark. I commend the Bill to the House, and ask it to give it a Second Reading.
§ Mr. GEORGE GRIFFITHS
I am a little at sea in regard to the effect of this Measure. Would it prevent anybody suffering from diabetes getting medicine?
§ 11.35 a.m.
§ Captain ELLISTON
I beg to second the Motion.
I should like at once to congratulate my hon. Friend on the very able way in which he has presented a Bill so sorely needed and so long overdue. He has said that the history of this Bill started in 1912, but it goes back further than that. For years the country was educated on the subject of this fraudulent traffic by the periodical "Truth," a paper which did splendid work in teaching the people how they were being defrauded by unscrupulous quacks. The editor himself told the Select Committee that 1571secret remedies are an enormous evil. The public is defrauded of millions in the course of a year, purely by false statements.The publication of these exposures in "Truth" was followed by the formation of a Committee of this House. On the initiative of Mr. Charles Bathurst, now Lord Bledisloe, and Dr. Christopher Addison, the House in 1912 appointed a Select Committee. I fear that there are many hon. Members to-day who are not familiar with the findings of that Committee or the evidence they heard. It must be very gratifying to my hon. Friend to have such a good House this morning for this grand national cause. I feel that those who have attended this morning are more likely to back a winner than some hon. Members who may be engaged in other important business in Lancashire, although there may be some hon. Members who represent agricultural constituencies, like the hon. Member for Aylesbury (Mr. M. Beaumont), who might be better employed looking after their interests of horse-breeding. Another factor in the education of the public on this matter was the publication by the British Medical Association of a volume called, "Secret Remedies," which exposed the worthless character of the so-called cures which are sold to the public, and showed the shameless exploitation of sufferers. The Select Committee sat during three sessions in 1912; they had 33 public sittings, 42 witnesses appeared before them, and they asked 14,000 questions. In that volume there is such a mass of evidence showing the necessity for a Bill like this that any reasonable person who has given it a. careful study cannot fail to be convinced. Lord Bledisloe himself said:Probably never has such a tissue of fraud and falsehood been disclosed to any Parliamentary Committee in either House as was disclosed to us on that Select Committee.Other Members of the Committee were Sir Henry Norman, who was the Chairman, Lord Eltisley, and the hon. Member for Merionethshire (Mr. H. Jones), who much regrets that he cannot be present to-day. He wrote to me regretting his absence, saying that it was a good Bill which he hoped would secure the support of the House and the blessing of His Majesty's Government. I should like to summarise the findings of 1572 the Select Committee for the benefit of those who have not read the Report. In the first place, they found that there was a large and increasing sale in this country of patent and proprietary remedies and appliances; that some of these were genuine, valuable and scientific products; that some were unobjectionable remedies for simple ailments; that many of them made grossly exaggerated claims of efficacy; and that many were sold for improper purposes. They also found that many professed to cure diseases which were incurable by medication; that many were essentially and deliberately fraudulent; and that their constant use constituted a grave and widespread public evil. They also pointed out that in British Dominions and foreign countries this traffic was controlled by severe regulations, that in Great Britain the existing law was chaotic and inoperative, and that any successful prosecution for fraud in the advertisement and sale of secret remedies was fraught with the greatest difficulty, and that consequently the traffic was practically uncontrolled. They pointed out that this was an intolerable state of things and that legislation to deal with it was urgently needed in the public interest.
My hon. Friend has summarised the recommendations of the Committee and I will not deal with them now, but there are a few remaining recommendations which I should like to mention, some of which are embodied in the Bill. They recommended that the advertisement and sale of medicines purporting to cure specified conditions should be regulated; that there should be a limit to the diagnosis and treatment of diseases by correspondence, and that there should be a verification of testimonials. After making these recommendations the Committee concluded that there was nothing in the recommendations which would inflict any injustice on any genuine patent or proprietary medicines or appliances, but that they would, by their operation and deterrent effect, afford the public efficiently and urgently-needed protection against injury and fraud.
That Report reached this House on the fateful day, 4th August, 1914, and it is not surprising that daring the War years it was allowed to lie dormant. But in 1920 the Government introduced a Bill in another place which practically embodied all the recommendations of the Select 1573 Committee, and it was sponsored by the then Parliamentary Secretary to the Ministry of Health Lord Astor. It was given a Second Reading and went to a Committee, but, most unfortunately, it was introduced so late in the Session that it had to be sacrificed. In 1920 Dr. Addison introduced another Bill, but it was withdrawn because it failed to satisfy the demands of the newspaper people. In 1931 a third Bill was introduced by Dr. Somerville Hastings, an excellent Bill, going much further than the present Measure, and that Bill had the blessing of the Labour party. I am glad to say that Dr. Somerville Hastings, who is a great authority on this matter, approves of the Bill we are submitting to-day, although he is disappointed that it does not go further.
Although there has been no legislation on the lines of the Committee's Report, it has already produced important results. The newspapers in particular have tried to put into effect some of the recommendations regarding advertising, and magnificent work has been done by the Advertising Association, with the support of the leading newspapers, which have excluded advertisements of the most objectionable type. In the same way, bodies representing the manufacturers and proprietors of reputable remedies have done a great deal to exclude undesirable persons from the trade, and there has been continuous help right through from the British Medical Association.
The time has come, however, when these people ask why should they, the newspapers and advertising agents, do work for the country which ought to be done by Parliament? It is for that reason that we ask the House to give a Second Reading to this Bill to-day in order that Parliament may shoulder the responsibilities definitely placed upon it by the report of the Select Committee. Since 1932 I and others have been engaged in a drafting committee. We have sat many times and have taken an enormous time to produce a Bill which will do injustice to no one, but which will afford real protection to the public.
We bring forward this Bill to-day not as the expression of a few irresponsible people, but with the definite approval of many organisations of unquestionable standing. I will give the House the names of the organisations associated in 1574 the improvement and adoption of the draft. They are the Advertising Association, the Association of Municipal Corporations, the British Medical Association, the County Councils Association, the Institute of Incorporated Practitioners in Advertising, the National Association of Insurance Committees, the National Pharmaceutical Union, the Newspaper Society—I have to make it clear that the Newspaper Society which has 1,000 members, was watching the Bill to protect its own responsibilities, but I am bound to say that the representatives of the Society were most helpful in the suggestions they made on the Bill—the Parliamentary Committee on Food and Health, the Parliamentary Medical Committee, the Pharmaceutical Society of Great Britain, the Periodical Trade Press and Weekly Newspaper Proprietors' Association, Ltd., the Proprietary Association of Great Britain, the Surgical Instrument Manufacturers' Association, the Wholesale Druggists' Sundries and Proprietaries Association, the Wholesale Drug Trade Association, and the Society of Medical Officers of Health. I ask whether any hon. Member proposing to introduce a Bill could have gone more directly to the responsible and interested parties and asked them to shoulder the responsibility for preparing a Bill?
In some respects we did not deal with certain matters mentioned in the Report of the Select Committee, and the Bill is therefore less elaborate than the one recommended by the Select Committee in 1914. Since that time some of the recommendations of the Committee have been satisfied. For example, opium, cocaine and drugs of addiction are now controlled by the Dangerous Drugs Act; the Pharmacy Acts now require that the name and proportion of poisons shall be declared on the labels of patent medicines; the profession of pharmacy has now statutory powers to discipline its members, and there are certain limitations in connection with the cure and treatment of venereal diseases. Consequently, the scope of the Bill was limited in those directions.
In my experience in this House I have never known any Bill to be so grossly misrepresented as the one now before the House. I do not think that misrepresentation has been intentional. The 1575 majority of the protests that have been received have been based on an early draft, and others on a misinterpretation of what the Bill contains. My hon. Friend has told the House that this Bill prohibits only certain types of advertising. It does not prohibit anyone from treating any ailment, or from supplying any medicine or appliance, with the one exception of correspondence. I hope hon. Members who have read the Bill hastily, or those who have been influenced by circulars and other documents sent to them, will accept my definite statement that the Bill does not prevent anyone from treating any ailment or from supplying any medicine or appliance. It prohibits the "holding out" of medicines, appliances and treatment as beneficial to certain specified conditions, but it does not affect any advice given by a practitioner, qualified or unqualified, to the patient in the consulting room.
§ Dr. PETERS
Is it not a fact that the "holding out" of a medicine, surgical appliance or treatment is prohibted only if it does not come through a qualified medical practitioner or a registered dentist?
§ Captain ELLISTON
The hon. Member is under a misapprehension, and that will be dealt with by others who follow me. I have too much ground to cover to be diverted from the course I have marked out. The Bill permits the Minister of Health from time to time to remove any of the specified conditions from the list controlled. It has been said that this Bill would hamper research and would kill any attempt to develop new lines of treatment. That is not true. Anybody would be able to bring to the Minister of Health a prima facie case for removing any of the ailments or conditions from the list. The Bill prohibits invitations to correspond with a view to diagnosis or treatment, but it does not affect correspondence between a practitioner and patient following a personal consultation. The object is to stop the quack sending out broadcast his questionnaires asking people to describe their symptoms, but once personal contact is established between the practitioner—not the medical practitioner, but any practitioner—and the patient, they may correspond as long as they wish.
1576 The Bill cuts out the common informer, and no prosecution can be undertaken except with the approval of the Attorney-General. It exempts newspapers and advertising agents from any breach which is caused in the ordinary rush and course of their business, and it exempts faith-healers, Christian Scientists, and spiritualists. As is claimed in the explanatory Memorandum, those people are following their religious convictions. We have seen in other countries how gladly people become martyrs in matters of conscience, and we have no intention of interfering with those religious bodies which go in for faith healing and so on.
My great difficulty arises from the fact that I have been told that in justifying the Bill I must be very careful not to mention the medical profession. It is extraordinary how many people there are who are suspicious of anything which they believe to be "painted," as they would put it, by the influence of the medical profession. One gathered that from the ironical cheers which we heard just now. In this Bill the President of the Royal College of Physicians is placed on exactly the same footing as the most humble unqualified practitioner. In the early days of the promotion of the Bill, it was proposed to give exemption to qualified medical and surgical practitioners but when we found that there was this feeling about what was called safeguarding the monopoly of the medical profession, we said to the British Medical Association "Are you anxious for this protection?" and to my surprise they said "Not a bit." They said "Place us on the same footing as unqualified practitioners. We ask for nothing more." That struck me as a very remarkable concession and I think some of the legal Members of the House will consider it an impressive thing that a great learned profession should be willing to surrender the protection aid recognition that we have been accustomed to accord it.
There was a time when we were proud of the great traditions of British medicine. To-day a reference to the medical profession elicits sound, which are almost derisive. But this is the country of Harvey and Hunter, of Sydenham and Jenner, of Bright and Addison, of Lister and Osler—great names of world fame. We used to be proud them but to-day the mention of those names in the House 1577 of Commons is, I am told, likely to injure the chances of this Bill. It is a shocking thing. Again, we used to say that even in the remote villages in this country there was a higher average of skill among general practitioners than was to be found in any other country in the world, but to-day we seem to pay more respect to any kind of practitioner who is free, as has been said, to follow the dictates of his science, than to the medical profession. I am surprised at the hon. Members who are leading the opposition to this Bill. The hon. and gallant Member for Hitchin (Sir A. Wilson) has been brought up in surroundings and in an atmosphere which have given him the opportunity of realising the scientific basis of medical education in our schools and universities. In another capacity he has seen the achievements of British medicine in making it possible for white men to live in countries where it was formerly impossible for them to live. Yet he is the man who has come in here to-day to move the rejection of the Bill and, apparently, to disparage the medical profession. Then, again, there is the right hon. Gentleman the Member for Bow and Bromley (Mr. Lansbury) who has lived all his life under the shadow of one of the great medical schools of London. I am surprised that he should have lent his name to an Amendment which is, undoubtedly, disparaging to the qualified medical men. That Amendment says, that the Billwould unjustly penalise unregistered practitioners of various forms of genuine natural healing and would virtually prohibit the employment of many well-tried methods for preventing disease and correcting functional disorders.In other words, it says that the unqualified practitioner is better fitted to deal with certain conditions than the man who has been trained for the medical profession.—[HON. MEMBERS: "No !".]—The Privy Council, through the General Medical Council, lay down what they consider to be the essential requirements of a medical education. They require the students to go through a curriculum the minimum period for which is five years, and it is an exceptional student to-day who qualifies in less than seven years. Those who qualify go out to the four corners of the kingdom to practise, but when they leave the medical school they leave behind there chemists, bio-chemists, biologists, physiologists, bacteriologists 1578 and pathologists carrying on ceaseless research to keep these men abreast of the latest progress in medicine and science. Is that nothing? My hon. Friend has quoted Voltaire's words about the physician being a person who pours drugs of which he knows little into bodies about which he knows less, [HON. MEMBERS: "Hear, hear."]—The hon. and gallant Member for Hitchin says "Hear, hear." What does he think of a man like Sir William Osler, who, in the course of practice in his native Canada and afterwards in the United States, where he was offered fabulous fees to cross the Continent for consultations, either did or assisted at 10,000 post-mortem examinations in order to gain knowledge of the body which he was treating? Is the opinion of such a man as that on medical matters to be rejected?
I am not saying a word against the unqualified practitioner, but he has no opportunities for research, no hospital base for the observation of patients and no staff of research workers behind him. Are medical men, such as those to whom I have referred, to be rejected as advisers of this House on these matters? There was another example here in London in the case of a man who died a few years ago, Sir Victor Horsley, whose work in connection with paralysis and epilepsy—which we are told certain irregular practitioners are prepared to treat to-day—is well known. Sir Victor Horsley would reject any call which robbed him of the hours dedicated by him to work in his laboratory. There was another man who had every opportunity of acquiring great wealth, but who set aside a large part of his time for research while he was in active practice.
§ Mr. MacLAREN
I knew Sir Victor Horsley intimately, and I assure my hon. and gallant Friend that he was the most heterodox of all the medical men I have ever known.
§ Captain ELLISTON
It all depends on what you mean by heterodox. Turning to the matters in the Bill on which I gather there will be criticism, I would refer, first, to the subject of treatment by correspondence. Any educated man knows that most diseases take many varying forms and that each case demands individual study and treatment. 1579 The patient who interprets his own condition by the terms of an advertisement, may often prevent the discovery of the real disease. We all know that it is a common trick of the quack to pick out certain perfectly normal physiological phenomena and to indicate in their advertisements that these are indications of incipient disease. They thus fraudulently trade on the fears of nervous people, and that is why we attach so much importance to personal consultation between practitioner and patient.
I should like to have said much about cancer. By world agreement—this is not a conspiracy of English doctors—by world, scientific opinion the only treatment to-day that is recognised as offering any real prospect of a cure for cancer is early operative treatment, and in suitable cases the use of radium, either alone or in combination with surgical measures. That is the considered scientific opinion of the world, and for that reason I think there is no need to apologise for the inclusion of cancer in this list of specified conditions. But the quack trades on the natural aversion of people to an operation, and he employs as often as not caustic preparations which aggravate the sufferings caused by the disease and which are wholly ineffective. There is not a hospital surgeon in this country but can testify to delayed inoperable cases in which the infected area has been treated with some secret remedy and in which life might have been prolonged or saved by early treatment.
I was going to refer to the fraudulent instruments and appliances which are sold for the treatment of the deaf. The time will not permit, but I should like to ask hon. Members who have any doubts on the matter to see the reports recently issued by the National Institute of the Deaf, which is not a medical body, though it has medical members, men of sound judgment who advise people afflicted in this manner. One could say a great deal about the dangers of the treatment of hernia by unqualified men and the disastrous results that follow. I have so far avoided referring by name to any unqualified practitioner or to any preparation, but I am bound to mention the Whip that has been circulated to hon. Members to come here to-day to defend the pretensions of the gentleman 1580 called Major C. H. Stevens, who has offered to the public for many years past an infallible remedy for tuberculosis known as "Umckoloabo."
§ Captain ELLISTON
I ask for no better example of the class of cure which I hope this Bill will regulate. The report of the Select Committee, which is in the Library for all to see, gives a considerable amount of information with regard to Major Stevens. He is described in the report asa well known consumption curer who has been denounced in 'Truth' for nearly 10 years.I mention him because it is this Major Stevens whom we au, being asked to assist to-day. In 19)6 Major Stevens assured the Royal Commission on Tuberculosis that he had discovered "a positive cure for tuberculosis" that he could prove successful in 95 per cent. of his cases. A little later he challenged the great Brompton Hospital for Diseases of the Chest. He challenged the staff there to inoculate him with tuberculosis, to allow him to contract the disease, to treat himself for the disease, and to cure himself, and afterwards to introduce his cure into the wards of the hospital as the method of treatment for patients. That challenge was reported to the Select Committee, and the Chairman said:This challenge on the face of it was written knowing that in no possible circumstances could it be accepted.Later on this gentleman challenged Spahlinger, and now the hon. Member for Chislehurst (Sir W. Smithers) is appealing to this House for a test. I have been very much concerned about this cure, because it has been brought to my notice many times. I remember that shortly before the death of Sir Walter Morley-Fletcher I asked him. "Why is not a trial made of this remedy? Why are people allowed to persist in unconfirmed claims?" Sir Walter told me then, and I have a letter from him which conveys much the same thing, that a very little inquiry was sufficient to reveal the absence of any prima facie case for a remedy, and he was convinced that research in connection with it would be a waste of public money. I think we can all see that to men of science some propositions are so hopeless on the face of 1581 them as not to be worth consideration. There are honest, good people to-day who still believe that the earth is flat, but we could not expect the President of the Royal Society and his Fellows to set up a Commission to examine that proposition, and that, I think, is the attitude of the man like the late Sir Walter Morley Fletcher, a distinguished scientist, to the pretensions of such a remedy as this "Umckoloabo."
When the first draft of this Bill appeared in the newspapers this gentleman wrote to selected cases and said to them, "Write to Captain Elliston appealing against this very outrageous Bill, which will rob you of your hope of life." I received within a few days, less than 18 months ago, 1,350 letters from strong supporters of this remedy. I am bound to say that I was considerably shaken, because they gave such assurances of salvation and rescue from death that I began to ask myself, "Why, if these people believe this is curing them, should one rob them of it?" Finally, I put those letters in a sack and sent them to Dr. Ernest Ward, the Secretary of the Joint Tuberculosis Council, and I said to him, "What is your answer to these? What reply can you make?" I may tell the House that Dr. Ward, who is known to me personally, wrote back and said, "I am glad of this opportunity." He is a doctor of medicine at Cambridge, a Fellow of the Royal College of Surgeons, and a man who would deal with such a matter in a scientific spirit. He distributed these letters North, South, East, and West, Yorkshire, Lancashire, Devon, Essex, Kent, Wales, etc., for a personal investigation. He has not been able yet to complete the work, but he has sent me an interim report, which I think will help the House to understand the position of this treatment to-day. He has so far secured the investigation of 604 cases, of which 31 could not be traced, and 137 had never been notified as tuberculosis. Anybody who knows anything about this disease will not be wholly surprised at that, because many people do delay notification, but it is all the same interesting that 137 of these people who had been treated had not been notified as suffering from tuberculosis.
§ Captain ELLISTON
I can only say that Dr. Ward is very anxious to give information to any party who is interested and who asks him for it.
§ Sir FRANCIS FREMANTLE
Is it not obvious that if they had been diagnosed they would have had to be notified?
§ Captain ELLISTON
There were 137 cases not notified as tubercular; 122 were in good condition or fair condition and working; 115 were ill and not working; 62 of them were desperately ill, some at the point of death; 77 of them were dead. I have here 30 or 40 typical letters written to me less than 15 months ago by unfortunate people who were "cured" and are now dead. These letters can be seen by the hon. Member for Chislehurst (Sir W. Smithers) and others who are interested. Let us remember the claim that has been made by the discoverer of this cure. He says: "I do not say in my advertisement that consumption can be cured or that consumption is curable, or any such evasive remarks, but I say that I guarantee to cure you if you are consumptive, or to return your money." I do not know whether those 77 dead got their money back, but if they did it must have been small consolation. To show the pitiful credulity of these unhappy people let me read a few extracts from these letters:
All those people are dead. [HON. MEMBERS: "Of what did they die?"]—These people, I know, might quite as well have died if they had been under medical care; that is true enough. But here we are dealing with a cure which claimed to be infallible in 95 per cent. of cases. Here you have 77 dead and 65 moribund out of 600.
- "I owe my life to this treatment."
- "In time a cure is almost certain."
- "Think of what it would mean to be deprived of that which you feel sure is saving your life."
- "I cannot speak too highly of its health-restoring property."
- "Deprived of this remedy it would seem like a death sentence."
- "I attribute my life to this medicine."
§ Captain ELLISTON
But it would have been a very curious coincidence if 77 people out of 600 who met that violent death in 12 months had written to me. I hope that my extracts have justified me in making a direct reply to those who are opposing this Bill, because they think it would do an injustice to such a remedy. Dr. Johnston defined a quack asa boastful pretender in arts which he does not understand.I leave the House to decide whether that description can fairly be applied to the discoverer of this cure for consumption. If this Bill interferes with the liberty of any subject, then all the public health legislation which has been passed from to time by this House comes under the same description.
§ 12.30 p.m.
Lieut.-Colonel Sir ARNOLD WILSON
I beg to move, to leave out the word "now" and, at the end of the Question, to add the words "upon this day six months."
My hon. and gallant Friend the Member for Blackburn (Captain Elliston), who seconded the Motion for the Second Reading, interposed in his speech a defence of orthodox medical practitioners which I venture to suggest that the House will feel was wholly uncalled-for. We are none of us without respect and admiration for the medical profession. As Homer sang 2,000 or 3,000 years agoThe wise physician, skilled our wounds to heal,Is more than armies for the public weal.The difference between us and some of those who are supporting the Bill is that some of us do not feel that the orthodox medical profession has a complete monopoly of wisdom. Rightly or wrongly, from a careful perusal of the Bill, we feel that it would tend unduly to restrict the activities of the unorthodox practitioner. I do not think it is necessary to put it higher than that. But I submit that the House should pause before it acts on the assumption envisaged in this Bill, that most remedies and alleviations not approved by the orthodox medical profession are fraudulent, and that because remedies and treatment are advertised and sold for profit they are therefore deceptive.
1584 I rather regret that my hon. and gallant Friend who seconded the Bill should have devoted so much time to denouncing the particular remedy for a particular disease. Pulmonary tuberculosis, as those who have any experience of it know, is marked by hope until the very last moment, and you will find those very same hopes entertained by patients of the greatest medical practitioners. It is not really a matter which we can profitably discuss on the Floor of the House. We are in the presence of a great human tragedy, and I shall refrain from comment, but it must not be assumed, because I do not comment, that I accept all that the hon. and gallant Member has said. With much that he said we must all be in agreement.
I agree entirely that the problem presented by the vast development of advertising in relation to remedies and treatments should be dealt with, and if the Minister of Health brought forward a Bill on the lines of that which was introduced last year he may rest assured that the House would give it a patient and respectful examination, and that in Committee it would not be opposed except on matters of detail. Enormous frauds are being perpetrated on the public but they arc not those dealt with by this Bill. The loathsome atmosphere of fear is being created by a thousand advertisements. I shall not take up the time of the House by mentioning them by name. We all know of them—the fear of some form of disease, the fear of some personal disability, the fear for one's children, the fear for one's family.
The perpetual appeal to fear is one of the worst forms of advertisement and is of quite recent growth; and I am sorry to see that the Postmaster-General himself has been guilty of appealing to it quite recently in connection with the telephone service, by pointing out how mothers may well be afraid of their children being run over in the street and how nice it would be to have a telephone so as to be able to make sure, by telephoning to the headmaster, that their children were in fact being detained at school. That is an unworthy form of advertisement and the less we hear of it the better.
The hon. Member who moved the Second Reading referred to his vast collection of press cuttings, I assume that.
1585 he collects only the bad press cuttings. But they do not represent one-tenth of one per cent. of all the advertising of remedies and medicines. The impressive list of trade societies which support this Bill does not convince me. They are backing this Bill because it will not affect their financial interests. If it did affect those interests they would oppose it. When my hon. Friend said that this Bill showed the greatest measure of agreement, I reply, that such a measure of agreement is not a sufficient basis for serious legislation. We must be prepared for something far more drastic than this Bill originating in the office of the Minister of Health. It is 22 years since such a Select Committee was set up, and no action was taken on its Report. The Report of 1914 went out of print within 12 months. It was eagerly purchased, perhaps by the rogues mentioned therein, who bought the whole stock and it was never reprinted. Those who wish to remind themselves of what the Report contained are now unable to buy it, and although hundreds of applications have been addressed to the Stationery Office in the past 20 years for copies, the Stationery Office, although they are a thoroughly businesslike Department, have never received authority to reprint it.
We cannot discuss in Standing Committee matters such as are dealt with in this Bill. We ought to be able to hear the evidence and to take a judicial decision on it. That is why I suggest that a Select Committee is the proper procedure. It is possible to argue, as my hon. Friend suggested, that we should take the view of Herbert Spencer, that to preserve fools from the consequences of their folly would be to fill the world with fools. That is not the view this House can take. We have taught the people of this country to read, but we have not yet taught them to think. Until men and women are able to take independent views and not be misled by propaganda, we must protect them as far as we can. I accept that point of view, but I seriously suggest to the House that this Bill will do nothing to prevent the credulity of fools. Not one-quarter of one per cent. of the money spent on quack remedies in this country is dealt with by the Bill. Does the House realise that more money is spent on drugs than is spent on alcohol, if allowance is made for taxation on either side? Will anyone 1586 seriously deny that drugs are probably doing as much harm as drink?
The health figures do not suggest that the fourfold increase since 1913 in the consumption of drugs has been followed by a corresponding improvement in health. Innumerable drugs have been foisted and pressed upon the public by an immense increase of advertising; yet the Inland Revenue Commissioners' Report that the revenue derived by means of Stamp Duties on the sale of medicines has been diminished by one-half in the last ten years—a very remarkable fact. These trade and proprietary associations have been studying the law and have found means, I do not suggest of evasion, but of avoidance, which has been so successful that they have contrived to reduce the sums payable to the Exchequer by something like £750,000 in the last decade. All these things should be looked at and dealt with comprehensively, and I should welcome action by the Minister of Health. He is far too much engaged in his former functions as President of the Local Government Board to pay as much attention as could be wished to the problems of positive health. This Bill does not touch the real problem.
My hon. and gallant Friend the Member for Blackburn mentioned a series of sad cases. It would not be difficult, however, by taking the notebooks and correspondence of any great hospital or clinic, to find a similar result. There is nothing to be gained by recrimination as between one side and another in this sorry controversy.
§ Sir F. FREMANTLE
My hon. and gallant Friend will admit that hospitals never hold out the possibility of a cure for tuberculosis?
§ Sir A. WILSON
And possibly live longer. I have complained that the Bill does not touch anything like the so-called cures that it should. It does not touch the cures for asthma, bronchitis, influenza and the common cold; or the cures for too much flesh and too little—a very common source of illness on the part of those who take drugs to meet those conditions, as few of us are aware 1587 from personal experience, but as many of us must know from second-hand. It does not touch rheumatism and arthritis. It does not touch the cures for too little hair in men and too much in women—by no means safe remedies, as we see from scores of cases where the courts have given damages against persons who have done irreparable damage to women. Then there is "that tired feeling" at night and in the mornings, shyness and stammering, pimples and skin diseases. Credulous mankind feeds on these cures to the financial advantage of a, great number of persons, none of whom are affected by the Bill.
I do not like the Bill for many reasons. It begins by prohibiting the holding out of any treatment or medicine or appliance directly or by implication as being effective in certain diseases which are mentioned. Incidentally, the terms given to the diseases are not those used by the Registrar-General. There might be a much more satisfactory classification. Let us look at them and see what they are. The first is Bright's disease or nephritis. According to the Registrar-General, in 1924 the deaths from that disease were 12,563; in 1934 they were 15,611. Then there is cancer, the deaths from which in 1924 were 52,800, and in 1934, 66,000; diabetes caused 4,254 deaths in 1924, and 6,471 in 1934, an increase of 50 per cent.; epilepsy, 2,200 deaths in 1924 and practically no improvement in 1934. These are for the most part maladies which medical science admits that it has wholly failed to cure. That being the case I doubt whether much good would be done by prohibiting any reference to them in any advertisement. It is in no cynical spirit that I quote Hilaire Belloc ofPhysicians of the utmost fame,Were called to see, and when they came,They murmured as they -took their fees'There is no cure for this disease' ".On the other hand, tuberculosis, in all its forms, called here consumption, has greatly decreased, the deaths falling from 41,000 in 1924 to 38,800 in 1934. That is a most heartening and inspiring thing, but it is the result of one thing only, and that is the housing activities of the Ministry of Health. The Registrar-General has shown beyond all question that that, and that alone, is the sole factor accounting for it. We have to 1588 thank successive Ministers of Health and their staffs over the past 15 years, and county councils and other local government authorities all over England, working with the good will of the people of England, for having reduced this scourge to a greater extent than is the case with any other disease h. England. With so wonderful an achievement before us, is it worth while to pass a Clause like this, preventing the offer of remedies which do give some sufferers some hope and confidence? Because hope and confidence are a, bigger factor in bringing about recovery than many of us realise. The bedside manner of the physician is his greatest asset. I was reproved by my hon. and gallant Friend the Member for Blackburn for applauding the observation made by Voltaire. I applauded only the last part of it, "A body of which he knew less," for have lived long enough abroad to know how infinitely various are the reactions of the human body to its surroundings, and how quickly the body responds to a change in surroundings and mental attitude, as every doctor of experience. and particularly my friend Sir Victor Horsley, would agree.
I was distressed to hear my hon. and gallant Friend the Member for Blackburn quote the names of great doctors and say they were no longer held in repute. He needed only to add the honoured name of Sir Ronald Ross, who was not too well treated by the medical profession, and the name of Sir Herbert Barker and of his martyred associate Dr. Axham, we should have been well content.
The Bill prohibits, in the case of four other diseases, amenorrhoea, hernia, blindness, and deafness, any claim to cure but not a claim to alleviate. Fraudulent claims to cure deafness will not be prevented by this Clause, because advertisers will merely say "We will alleviate deafness." Claims to cure hernia will be prohibited, and I am inclined to think that that is right, but I am bound to remind the House that in the last 10 years deaths from hernia have risen by something like 10 per cent. and are now more numerous than at any previous time in our history. I suspect that those who seek these remedies are not persons who have never gone to their local panel doctors—and the panel system is becoming more effective every year— 1589 but persons who have not gained relief by orthodox treatment and turn in despair to other remedies. The fact remains that there were 4,265 deaths from hernia in 1924 and 4,825 in 1934. These are not diseases which I have taken at random, they are those mentioned by the promoters of the Bill.
Paragraph (c) deals with remedies for procuring the miscarriage of women, but that is already an offence under the Offences of Person Act, 1861, Section 59, and I can see no reason why it should be included in this Bill. If any such advertisement as my hon. Friend mentioned is being published it is the duty of the medical officer of health of the district where it is printed, published or circulated to prosecute the newspaper, the proprietor or the vendor forthwith, for I think it is clearly contrary to the Offences of Person Act, 1861.
Mr. A. DUCKWORTH
That is true, but the fact remains that the majority of those advertisements are by implication, and that is the difficulty about taking proceedings under the present law.
§ Sir A. WILSON
I have taken competent advice on the point, and I am assured that any advertisement of means for procuring a miscarriage, even by implication, would certainly result in conviction in a court of law. I doubt whether it has ever been tried, but I am certain that no court would hesitate, if the implication were clear, to convict under Section 59 of the Act of 1861, read in conjunction with the Aiders and Abettors Act. Then there is paragraph (d), dealing with the cure of habits associated with sexual excess. What is the meaning of it? Does it refer to venereal disease, or debility? I dislike having to discuss these things in the House, but they are in the Bill, and it is our business to consider them on 'Second Reading.
§ Mr. KEELING
It does not mean venereal disease, because advertisements of treatment for the cure of venereal disease are already prohibited by an Act of 1917.
§ Sir A. WILSON
If it does not refer to that to what does it refer? Is it a reference to debility? In the same paragraph claims to promote sexual virility in men are also prohibited. Is that desirable? Is it not perfectly natural and 1590 desirable that young men who hope some day to marry should look to physical training and physical exercises to increase the natural and proper functions of the human body? It seems to me perfectly unnecessary to legislate against it. Any dangerous drugs that might be used for that purpose are already prohibited under the Dangerous Drugs Act, 1920, and the Regulations made there-under. I have no reason whatever to believe that there is danger to the youth of this country if they are, by implication, led to suppose that a healthy course of diet and a healthy course of physical training and exercises will increase sexual virility and activity, and help them to perform wisely and nobly all the duties of a man and a father, for that is what it comes to. Every one knows that the absence of those qualities is a fruitful cause of married misery and even of mental disorder. Let us think twice before passing a Bill to say that sexual virility is one of the things which may not be mentioned even by implication in an advertisement. It would ill serve the interests of national health and well-being.
Paragraph (b) in Subsection (2) exempts publications of a technical character intended for circulation mainly among orthodox medical practitioners. That would have the effect of putting an end to the pamphlets and periodicals of the unorthodox, the herbalists for example, who are a very large and important body. My hon. Friend the promoter of the Bill shakes his head. I am glad of his assurance that it will not be so, but it would exclude the advertisements of many groups of persons who have developed the use of natural remedies and have found them to be effective. It is not our business to decide by Act of Parliament whether they are right or wrong in their convictions that their methods are beneficent, but long before this was heard of I had had testimony from men and women whom I have known for many years that unorthodox remedies had, in fact, done them good. Doubtless there are cases in which unorthodox remedies have done harm, but I have read every annual report of the Ministry of Health for the past 10 years and read, too, something like 100 reports of medical officers of health for different counties and county boroughs, and I have yet to find a single reference therein 1591 to any of the evil consequences which the Bill seeks to cure.
The number of prosecutions likely under the Bill is small, but how is it proposed to prosecute? The fiat of the Attorney-General is required, and I gather from the promoters of the Bill that they would expect medical officers of health to initiate a prosecution if they have found an undesirable circular being issued or in circulation in their area. Such circulars would, however, not be printed within the district. They would be printed in Manchester, say, and circulated in Leeds, or printed in Leeds and circulated in Birmingham or in London. I doubt, moreover, whether many public health committees would be prepared to put down money for the prosecution of some small man, or perhaps some powerful body, not easily to be found and not within their borders, merely because an illegal circular had been found in their neighbourhood. If the Minister wishes to regard himself really as Minister of Health, let him assume responsibility for the Bill and undertake prosecutions, and let the Bill go through. I make no apology for quoting the words of St. Paul to the Romans:
I believe that to be the principle on which Parliament should work. We all know of cases like that of the woman mentioned in St. Luke:
- "For one believeth that he may eat all things: another, who is weak, eateth herbs.
- "Let not him that eateth despise him that eateth not; and let not him which eateth not judge him that eateth … Who art thou that judgest …?"who had spent all her living upon physicians, neither could be healed of any.Such cases constitute the tragedy of life. They have very seldom gone first to the unorthodox practitioner, but generally resort to him after they have tried current methods. We must be careful and considerate to them, even if they are misguided.
The terms of the Bill are too wide. They would cover the waters of any spa. I tremble for our spas, and still more for the table water advertisements upon our great railways.
§ Sir A. WILSON
Thu suggestion "Beer is best" seems to be contrary to the provisions of the Bill, and there are innumerable advertisements which would be in like case. I will not attempt to arouse the mirth of the House by quoting some that would unquestionably be illegal if the definitions in the Bill were maintained.
Clause 2 is drawn so as to include the proprietor, vendor or distributor, but not the printer, of an advertisement. How careful the newspapers have been before they gave their whole-hearted support to the Bill to see that it was made perfectly clear that it did not affect them, for they cannot be prosecuted.
What is the real remedy? I do not deny that there are evils, but I submit that the remedy is to deal with unorthodox practitioners on their own ground. The General Medical Council should accept, for the first time in their history—it would be a great decision—the principle that they or the Medical Research Council should accept responsibility for broadcasting on public health at every opportunity, without the grudging statement which, to my regret, every medical man who broadcasts at present receives from the British Broadcasting Corporation, that he does so at his own risk. The General Medical Council are so frightened of advertisement that they have made it most difficult for medical men to broadcast as they should. I should like to see the National Health Insurance Commissioners spend considerable sums of money on sending out leaflets inculcating positive good health instead of presiding over the permanent endowment of ill health.
Let us clear our minds of cant—no easy thing to do in matters like this—and decide to use the public interest which has been aroused by the Bill to take a far more active part in promoting good health. The campaign for physical education will be useless unless it is accompanied by a campaign in favour of good, positive habits of life. The General Medical Council should move with the times. It must not merely tell doctors that they may broadcast at their own risk, but must find out who will broadcast and who can do it best, and must encourage them to do so. Let us remember that there is such a body as the Medical Research Council, provided, I 1593 understand, with money from the National Health Insurance Fund. Is it making the best use of the money at its disposal? Could it usefully do more? And should not that great body, with which I was associated in a most humble capacity on the Industrial Health Research Board, take a far more active part in broadcasting. Let us have the antidote to quack remedies over the wireless. "Drugs alone will not cure you. You should go to your doctor early." Let us have good practical advice put across the ether day by day to those who are listening; let us have positive action, not negative prohibitions.
Syphilis and gonorrhea are mentioned here. They deserve far more serious attention than they get. It is a shameful fact that there has been no improvement in the death rate in this respect for the last 10 years. Let us consider whether, in a few districts, we could not induce the local authorities to apply the Notification of Diseases Act, and make, in limited areas, an attempt to stamp out the foul disease. Let the Minister tackle epilepsy seriously; there has been no diminution in deaths here. The Eugenic Society state that the proportion of mental deficiency in the United Kingdom is four times as great as over the northern parts of Europe. That statement should make us pause. The remedy is not the Bill, but a bold programme of practical remedial measures. Let us not waste our time burdening the Statute Book with whitewashing what is only one of the bricks in a great but dirty wall. If the Minister of Health will take action on these lines he will carry the whole public with him.
If the Bill became law it would provoke fruitless, barren, bitter and purely negative controversy, and would tend further to exacerbate public opinion, which is inclined to regard the medical profession with a suspicion which is unfair and unjust. I repel utterly the suggestion that was made that those who oppose the Bill are inclined to treat the medical profession with less than the courtesy and consideration which everyone who has any knowledge of these things knows to be its just due.
§ 12.55 p.m.
§ Mrs. TATE
I beg to second the Amendment.
1594 We have been asked to support the Bill to-day in order to safeguard the public from fraud, but the public will go on being defrauded whether or not we pass the Bill. I am very much afraid that the Bill is designed to safeguard the business of qualified doctors and chemists far more than it is designed to safeguard the health of the public. The hon. Member who moved the Second Reading of the Bill did so in an extraordinarily able and in an extraordinarily fair way, and he was the first to acknowledge that the danger of undesirable advertisements was very much less to-day than it has been in the past. The speeches that have been made by hon. Members have shown that a great many of the dangers designed to be dealt with in this Bill are in fact already dealt with. Many of the recommendations of the Committee which reported in 1914 have been carried out.
The Bill will not do that which it is supposed to do, because it is full of loopholes. If it were pased it would be a perfectly ineffective Measure. How, for instance, is it proposed to prevent the wireless broadcasting from a foreign station, in English, of patent medicines? Who is to be summoned and in what court will the proceedings be taken? Secondly, how is it proposed to deal with advertisements in American magazines and papers, which are very often far the worst offenders They would not, however, be touched by this Bill because the publishers are not in this country and the newsvendors—hon. Members know the very able way in which the Press have protected themselves under subsection (3)—could not be prosecuted, because they would merely have sold the magazine in the ordinary course of their business. How is it possible to decide upon the exemptions under Clause 3 (4) which provides that there shall be no contravention of the Act on the part of a personprofessing religious belief in the effectiveness of meansprovided by him for achieving the purpose referred to? How is it proposed to define that religious body? One of the proposed reasons for exemption is if the religious body or denomination comprises a substantial number of persons resident in the United Kingdom. I cannot help feeling that that provision will be very difficult to interpret in a court of law.
1595 I deeply sympathise with the object of Clause 1 (c) having regard to what the hon. Member opposite said about advertisements for procuring the miscarriage of women. I know how numerous those advertisements are and how very serious the matter is, but I do not altogether agree with the hon. and gallant Member for Hitchin (Sir A. Wilson) who said that the medical officer of the district would always have support if he prosecuted in a case where the advertisement was only by implication. I do not think that that would be so. Supposing this Bill did away with those advertisements altogether, are women going to be one whit safer? Of course they are not. It is a very unpleasant subject to discuss in this House but it is quite time that the House did realise what the position is. If we take away these drugs, which I realise are a danger, because I know full well the harm they do, what are the women going to do? Simply to go in increasing numbers to the little woman of the street who uses some sort of instrument, an unsterilised knitting needle or something of that kind? We all know that these things are done. We know, or hon. Members ought to know, that the people who are in most real danger to-day, in that respect, are the poor women who cannot afford to pay. It is perfectly possible for a woman in the West End of London, with sufficient knowledge and with sufficient money, to have a miscarriage brought about at any moment she wants, through doctors of the recognised medical profession. It is happening every day. I am not condemning those doctors. I think in many instances they are doing very useful work, but do not let us pretend that it is not done because it does not happen to be legal or that it is not done by men with every possible medical qualification. It is time that the awful hypocrisy that goes on should be recognised, that people should be honest and realise that in many cases there is need for this help for women. We are not going to do away with malpractice and we are not going to safeguard women from very dangerous methods of terminating pregnancy in the very least by prohibiting these undesirable advertisements. This Bill will do nothing to safeguard women but it may make their position very much more dangerous than it is to-day.
1596 The hon. and gallant Member for Blackburn (Captain Elliston) said that the Bill made no differentiation between the qualified and the unqualified practitioner. It was therefore difficult to understand the extraordinary heat with which he then stepped in to defend the medical profession. There is no one in this House who dogs not recognise the tremendous service to the public that is rendered by the medical profession, but there is also no honest person who would fail to admit that the medical profesion have often very seriously erred in their unwillingness to grant any value to the work of the unqualified practitioner. Unqualified practitioners have been persecuted. We have only to remember the case of Sir Herbert Barker, which has been mentioned, aid the case of Sir Ronald Ross, who was qualified, but his discoveries were not wholly welcomed by the medical profession at first.
§ Mrs. TATE
The hon. Member who brought in the Bill mentioned the enormous strides made in medicine and health in recent years. That is true. Enormous strides have been made in some respects. To what in the main is that progress due? First, to improved sanitary conditions. How much of our strides in medical knowledge are due to the work of the late Louis Pasteur? What sort of treatment did he get at the hands of the medical profession? Anyone who reads the life of Louis Pasteur will not attempt to deny that the medical profession have not always welcomed help and discovery from those who came outside the ring of that incredibly strong trade union. I believe that it is that strong trade union which is going to be strengthened by this Bill and not the safety of the public. Honest medical men will agree that, although great strides have been made in medical knowledge, their ignorance far outweighs their knowledge.
§ Mrs. TATE
We are all agreed on that. I believe that, in the main, the medical profession think that. If so, is it not well to leave the door open to discoveries that may be made by the unqualified practitioner, lest the medical trade union should keep out even a ray 1597 of hope from the public? What was regarded as a sovereign cure a few years ago would be regarded as dangerous today. What the medical profession in many cases are doing to-day may be regarded as very dangerous to-morrow. We need all the help that we can get, whether from outside or inside the medical profession. We know that in many cases a perfectly worthless drug has its value. That fact has been admitted by a doctor who wrote under the signature "A Doctor" in "The Listener" of 25th March, 1936. He said:The giving of quite a useless medicine may be justified to people who cannot believe that they will get well unless they swallow some drug or other.In such cases, is it not just as well that the persons concerned should be obliged only to pay for the medicine, and not to pay for the doctor as well? Let them take their harmless drugs if it helps them. In many cases, even if the drug is slightly harmful, it is probably no worse than some of the food or drink that they are taking in the course of their daily life. I am sure that many of us, if we looked back at the menus of some of our repasts, would have to admit that we have all of us consumed large quantities of comestibles which really, mixed as we have mixed them, are nothing but poison in some form or other.
If this Bill were passed, there would be a very grave danger that some men whose work might be of immense value to the health of the nation would in future years be debarred from giving such help. For instance, what would be the position under this Bill of a man who is well known to have done such valuable work as Mr. Spahlinger? We know that, after the tests which have been made in Northern Ireland, his anti-tuberculosis injections for cattle are going to be taken up in that country, and we also know that our own Ministry of Health are going at last to make extensive tests. We know, too, that, at very great expense to himself, Mr. Spahlinger succeeded, not only in Geneva but here in London, in curing some ghastly cases of consumption. I take it, however, that under this Bill, if, unprotected by the privilege of this House, I were to inform any person that in my opinion Mr. Spahlinger, although an unqualified doctor, does possess the means of curing consumption, I should render myself liable to imprison- 1598 ment for three months. I should be very glad to be told that that is not true, but under the Bill as I read it I believe it to be true.
Again, if that be the case, what would happen to a book which was recently published, entitled "Spahlinger contra Tuberculosis," which was supported by and contained contributions from a large number of very eminent men who testified to the value of Mr. Spahlinger's work and his genius and ability to cure consumption? Would that book ever be open to the public had a Measure like this been in existence? I do not believe it would. I beg the House to reject the Bill, because, as has been shown very clearly to-day, many of the recommendations of the Committee which reported in 1914 have already been carried out. No one who has had much experience, either of ill-health in themselves or of the ill-health of others, will fail to admit that the medical profession still have a very long way to go, and I believe they are going to be very greatly helped on that road in the future, as they have been in the past, by many whom we call unqualified men.
§ 1.10 p.m.
§ Mr. J. G. KERR
Perhaps it may be allowed that I have some little justification, at least, for forming an opinion on this very difficult subject. One of my qualifications is that, in the first place, I am not a member of the incredibly strong trade union referred to by the hon. Member for Frome (Mrs. Tate), and, therefore, presumably, I am free from the prejudice that might attach to such membership. On the other hand, for about a third of a century I have been a teacher of medical students; I have had to teach the basic subject of biology, which forms the foundation of the medical curriculum. I have been an active, and often, I am afraid, a critical member of the medical faculty of a great University. I have been an active member of the board of management of one of our great national hospitals—a hospital in which, incidentally, a few decades ago, there took place a great event in the world's history, an event of greater moment to the human race than the Treaty of Versailles or the Treaty of Locarno, about which we heard yesterday. I refer to the devising, by a young member of the staff of that great 1599 hospital, of the method of antiseptic surgery, which forms the basis of the whole of modern surgery and to which the lives of an incredible number of human beings and the saving of an immense amount of human suffering Are due.
In that long experience I have learned certain lessons. I have had a great deal to do with the medical profession; I have watched it in a critical spirit; and the net result is that I have developed an intense admiration for and a very great trust in that profession. Further. I have learned to understand the enormous importance of putting our students of medicine through that small-meshed sieve formed by those toilsome years—five, six, seven or more—of hard work before turning them loose as practitioners among the general public. On these grounds I desire to offer a few 1600 remarks on the Bill which is now before us, and, as I understand that on the occasion of a Second Beading it is appropriate not to discuss details, but to leave details rather to the Committee stage and discuss general principles, I will confine myself mainly to general principles. Before we approach this problem, it is rather necessary to remind ourselves of one or two precautions that we must take. One is to realise the immense amount of natural healing that goes on in the animal kingdom. We often talk about normal health, and individuals in normal health—
Notice taken that 40 Members were not present; House counted, and, 40 Members not being present—
The House was adjourned at Sixteen Minutes after One o'Clock, until Monday next, 30th March.