§ Order for Second Reading read
§ 9.31 p.m.
The Minister of Health (Mr. Aneur, Bevan)
I beg to move, "That the Bill be now read a Second time."
I hope it will not he necessary to spend very much time on what is a small but nevertheless important Measure. As the House is aware, penicillin is a very important substance indeed which has had a most beneficent effect on the wellbeing and health of the population. Some time ago it was in short supply. While it was in short supply, it was necessary to try to control its purchase and distribution. For that purpose the Government used the Defence Regulations. The Government now take the view that it would be inappropriate to control the sale and distribution of this drug by making use of Defence Regulations and that it ought, to be controlled, if at all, by a Measure passed by the House. As soon as it became obvious that there was enough of this substance for general use, the Government had to make up their mind whether it should he controlled at all. We were not anxious to control a substance of this kind if it were not absolutely essential so to do.
We have consulted a number of eminent persons who have very special knowledge about this substance. They are: Sir Alexander Fleming himself, Professor of Bacteriology at St. Mary's Hospital Medical School, who discovered the substance in the first place; Professor R. V. Christie, Professor of Medicine at Bart's; Colonel L. W. Harrison, Adviser in Venereal Diseases to the Ministry of Health; and Sir Philip Panton, Consultant Adviser in Pathology to the Ministry of Health. Their view is unanimous that there would be very grave dangers to the public health if this substance were in unrestricted sale and consumption. They base their conclusions upon their knowledge that this substance, among others, can, if consumed over a long period of time in small quantities, establish in the organism a resistance to its beneficent effects. Consequently, if any person took this substance over a period of years, or even a shorter period, and established a degree of immunisation to its good effects, later on, if he needed it in an operation or in any other therapeutical form, it would be of no value at all.
822 Therefore, it seemed to us to be highly undesirable that this very valuable substance should be the plaything of quacks with all sorts of ways of advertising it and selling it—penicillin lipstick, penicillin rouge, penicillin powder, and even penicillin waistbands, as we had iodine waist bands years ago. That would be highly undesirable, because hon. Members who have studied the subject will agree that this is one of the most beneficent discoveries in the history of medicine. It would be an appalling thing if, as a consequence of its misuse, the population might, in a period of years, receive no advantage at all from it because it would have developed resistance in those who take it. Therefore, it was decided that we should have a short Bill which would empower the Ministry of Health to control its sale and distribution. However, we are concerned only about controlling the sale of the drug to the individual consumer. We are not concerned at all about influencing its wholesale distribution. We do not, for example, want to impose any controls whatever on the sale of penicillin in bulk or for export. We have sufficient of it. We are not afraid of any shortage of supply, so we are really concerned about restricting its use where it comes into touch with the individual consumer.
For that purpose the Bill lays it down that penicillin can be given only on the certificate of a qualified medical practitioner or veterinary surgeon, or, on his certificate, by a chemist. That, in our view, is all the restriction which is required. We also take power in the Bill to deal with other drugs that may, later on, be found necessary and to which the same definition will apply. There is one which has received a great deal of publicity and, I must say, has caused me considerable trouble, called streptomycin. Very many things have been claimed for it but they have not yet been established. I am afraid great expectations have been carelessly aroused, and we know that in some instances the giving of this drug has caused definite harm, whereas in other instances it is still claimed that it has a healing effect, but that has not yet been established. There are other investigations of an analogous kind going on which, if they prove successful, will transform the whole field, but we are anxious that when they come along we shall at the same time have in our possession power to enable us to prevent 823 their thoughtless consumption and their commercial exploitation in a manner injurious to the public. Therefore, the Bill takes power to control those by regulation after we have received the advice of the Medical Research Council about them. Clause 3 deals with offences and penalties, and the remaining Clauses cover interpretation.
The Bill has been discussed in another place and since then, a number of suggestions have been made about Amendments. When the Bill goes into Committee, I am prepared to move a number of Amendments dealing with some of the criticisms which have been made—many of them have points of substance I hope that with that short explanation the House will give me the Second Reading of the Bill which, I am quite sure, is to the general public advantage.
§ 9.39 p.m.
§ Sir John Mellor (Sutton Coldfield)
I agree with the right hon. Gentleman the Minister of Health that this is a very important Bill, and I hope it will not be hurried unduly in its passage through this House. In the few observations I shall offer upon the Second Reading, I should make it clear that I do not pretend to any medical or scientific knowledge. I recollect a soldier in my company who objected to being vaccinated, saying that he did not hold with it though he had always been a medical man. Knowing that by trade he was a tailor, I asked him what he meant by saying he was a medical man. He replied, "Sir, my brother is a dentist." Although I cannot even claim to be the third cousin of a chiropodist, none the less, from the Parliamentary angle, I have taken a great deal of interest in this Measure.
I would like to congratulate the Minister on the point that by this Bill he is doing his best to make an honest woman of the Minister of Supply, because he has in the past most scandalously misled that Minister. The Ministry of Supply, under Statutory Rule and Order No. 731 of 1946, controlled penicillin on the ground of scarcity. That was a perfectly legitimate use of the Order that was made under the Defence Regulations, but the scarcity passed away. When it did so the Minister of Health desired that control should be retained, and he persuaded the Minister of Supply, in my submission, quite impro- 824 perly, to retain the control for an entirely different reason. We had one Minister obtaining control for one reason at one time, and later the control was retained at the instance of another Minister for a purpose entirely different, and one which had never been approved by Parliament. That situation still continues. I notice that the Minister of Health did not announce that it was proposed to revoke the Order. I assume that it is the intention to revoke it when this Bill becomes an Act. The Minister of Health has persuaded his colleague to retain that most drastic Order, which is more drastic than the provisions of this Bill, and it is still in force.
§ Sir J. Mellor
It might be desirable in the public interest, but I still submit that from a Parliamentary point of view it is most improper. Be that as it may, this Measure is a pretty tall order. To proceed to control a therapeutic substance that cannot be described as a poison or a dangerous drug is a novel step. I think the Minister will agree with that.
§ Sir J. Mellor
I quite agree I do not say that it is a step which is unjustified, but in my humble submission, in the light of what knowledge we have while I would say that some measure of control should be retained, I think we should be particularly careful to see that the measure of control does not go beyond what is absolutely necessary, and that it is not retained longer than is necessary The Minister of Health stated that this Bill was approved by some very eminent authorities, whom he quoted. I do not dispute their eminence, but I note that under Clause 2 the Minister is given power, by regulation, to bring under control certain other similar substances, after consultation with the Medical Research Council. I should like to ask him whether the Medical Research Council was consulted, in addition to the eminent authorities he mentioned, in regard to the provisions of this Bill, because I certainly think that the Government, before introducing a Measure of this sort, should have taken the fullest possible and most authori- 825 tative and responsible medical opinion? But it would appear, as tar as a layman can gather, that medical opinion has not vet crystallised upon this matter.
I should think that those who know most about it would be probably the first to admit that knowledge in regard to penicillin and its effects is in its infancy. It is quite impossible at present to know how far it is necessary to control the use of penicillin. For that reason, I am proposing to move an Amendment in Committee to limit the operation of this Bill to five years so that Parliament, towards the end of that time, can have another look at it in the light of the medical knowledge which may have been obtained. This Bill proposes to control the use of penicillin in any form whatever. In Clause 1, it not only controls the use of penicillin but… any preparation of which any such substance is an ingredient.I have heard considerable difference of medical opinion in regard to whether the use of penicillin in certain forms ought to be controlled. I think it was my hon. and gallant Friend the Member for Pudsey and Otley (Colonel Stoddart-Scott), who is a qualified medical practitioner, who said, in a Debate we had on a Prayer, that in his view penicillin toothpaste, and in the form of ointment, and so on, ought to be free from control. I do not know who is right or wrong in this matter.
§ Mr. Baird (Wolverhampton, East)
Does the hon. Member realise that the whole of the dental profession says that that would be completely wrong and would cause disaster?
§ Sir J. Mellor
I was not expressing an opinion. There is difference of opinion whether penicillin need necessarily be controlled in all its forms. That is another reason I say that we should have a time-limit to the operation of this Bill so that, when medical knowledge is more extensive and we have had practical experience, Parliament can reconsider the matter and see how far it is necessary to continue control. I have one further criticism to offer in regard to the provision contained in Clause 3 (2). I submit that this Subsection goes too far. Under it, if an assistant at a branch of, say, a company like Boots or Timothy White's commits an offence by supplying penicillin without a doctor's prescription, any 826… director general manager secretary or other similar officer of the body corporate or was purporting to act in any such capacity, shall be deemed to be guilty of that offence unless he proves that the offence was committed without his consent or connivance and that he exercised all such diligence to prevent the commission of the offence …That seems to be much too drastic and, in Committee, I shall propose to, delete that Subsection. It is the duty of the House, while recognising that control may well be necessary, to see that in the course of the passing of this Bill no greater degree of control is imposed than is absolutely necessary, and that we should enable the public to enjoy the widest possible measure of freedom which can be allowed with safety.
§ 9.48 p.m.
§ Dr. Haden Guest (Islington, North)
I do not want to pose as a great scientific authority on this question. However, I can tell the House that in the opinion of all responsible chemists, doctors and dentists and other professional people who understand this subject, penicillin is not only a very valuable drug which can cure diseases otherwise very difficult to cure, and cure them quickly, when otherwise they might be extremely slow, but if it is used in the wrong way it becomes a very dangerous drug. The germ which can be cured by penicillin when it is properly used, can be made immune if the drug is used in the wrong way. What is called "penicillin resistance" can be built up. This situation has already arisen in Japan in regard to certain diseases. As the Minister has said, we might have a situation where people are treated so much with penicillin that, in a short time, the people concerned—in this case, Service men—are no longer able to be helped by the penicillin when they fall victims to disease.
It is because of the existence of this peculiar quality that penicillin must be safeguarded by this method of control in its administration to the individual. It is not sought to establish control of its sale. I myself was inclined to query, from the reverse point of view to that of the hon. Member for Sutton Coldfield (Sir J. Mellor), the question of its control. There is no control of wholesale dealing, and no control of its export, but it must be controlled by a registered medical practitioner to see that it is used in its curative way and not in its dangerous way. I can assure the hon. Member that, 827 if he will ask representatives of the medical profession in the Services, and anyone who has had practical experience of.it in the war, he will find that all responsible opinion agrees that control of penicillin must be very rigid; otherwise, it will lose its effect as a very valuable remedy, as it is now, and will cease to be a remedy at all.
§ 9.52 p.m.
§ Mr. Linstead (Putney)
I welcome this Bill, and I agree with my hon Friend the Member for Sutton Coldfield (Sir J. Mellor) that, with an innovation of this kind, there is a considerable onus on the Minister to prove his case. We have not much left that belongs to us nowadays except our own bodies, and the freedom with which we are able to doctor ourselves is something that ought not lightly to be given up. In an instance like this, I think the Minister has proved his case. Not only is it possible for an individual to build up a resistance to penicillin, but, as the experience of the treatment of venereal disease among our troops in Italy—
§ Mr. Linstead
—has shown, it is possible to build up a penicillin resistant organism, with the result that penicillin becomes of no use in treatment. I think the Minister has discharged that onus, but I was very glad that he indicated that he hopes, in Committee, to move a few amendments that will not only make the Bill more acceptable, but also more workable. One or two of these points have occurred to me in studying the Bill, and I will rapidly draw attention to them. A case having been made out for the close control of penicillin, it has occurred to a number of people who have studied the Bill that most of the control seems to be given away by the exceptions in Clause 1 (2), and in another place there was evidently considerable misapprehension as to the effect of these exceptions. It appears from Clause 1 (2, d) that anybody who is running an institution which he describes as a nursing home is free to purchase any quantity of penicillin which he desires, and t is not until one turns to the definition of "supply" in Clause 4, that one finds that use by such purchaser of the penicillin is, in fact, prohibited under the Bill. It is a very obscure interpretation from which to find out what is meant by the Bill. I hope the Minister will look 828 a[...] it and see whether he cannot make clear, to those who want to know what the law is, exactly the effect of the limitation upon these exceptions.
Then I would draw attention to Clause 2, where the Minister takes the power to control additional substances. As Clause 2 is now drafted, these substances must be produced by living organisms, and it is more than likely that research laboratories may find that this substance may be produced by chemical action. I think it would be desirable to look at that definition again, unless the scientist who produces them is to be regarded as a living organism, and, therefore, covered by the Clause as now drafted. The only other point to which I wish to draw attention is the lack of any specific power of enforcement. I would like the Minister to consider whether the inspectors appointed under the Pharmacy and Poisons Act might not be used for the purpose, in the course of their other duties, of securing that the provisions of this Act are, in fact, observed. They are there, they cover, more or less, the same territory, and it would be useful if they were used for this purpose. With these few observations. I commend the Bill to the House.
§ 9.56 p.m.
§ Mr. Derek Walker-Smith (Hertford)
We on this side of the House have made it clear that the case for some measure of control of this great and important substance has been made out. At the same time, we ask the House to recognise that we are very much in the early stages with regard to this drug, and, therefore, we consider there is a case for putting a term on the operation of this Bill. Those are the two main points we desire to make this evening. We would request the Minister to clarify, at some future time, Clause 1 (2, f) and (3). These are points for the Committee Stage. As I have said, it is our view that the Minister has made out his case.
§ 9.57 p.m.
§ Mr. Christopher Shawcross (Widnes)
I only want to welcome this Bill in a very few words, particularly as the pioneer and the main factory, if not now the only factory that makes penicillin in this country, is in my constituency. Unlike hon. Members opposite, I do not think there is any onus at all on the Minister. This Bill speaks for itself. The only defect 829 is that it does not go far enough. I hope that the definition of "other substances" may be enlarged so that when it comes to the Committee stage more restrictions will be inserted than are in it as at present drafted, on what is probably the biggest, the most harmful and certainly the most shameful racket ever organised by private enterprise, namely, the patent medicine industry. I am sorry that my right hon. Friend the Minister of Health has not taken an earlier opportunity of introducing legislation in that regard. I hope that, if the scope of this Bill cannot be enlarged sufficiently to cover that matter in Committee, he will take steps to do so at the earliest opportunity.
§ 9.58 p.m.
§ Mr. Sidney Marshall (Sutton and Cheam)
For many years I have had experience of medicaments which have been discovered and which have never received such cheap publicity as has penicillin. I remember the discovery of adrenolin and of insulin. In the case of these medicaments, which have been of great service to the community, has it ever been decided that they should be controlled by Act of Parliament? I cannot understand why penicillin, in some respects a perfectly harmless preparation, should be the subject of an Act of Parliament. Penicillin, which comes with a great deal of false approbation from the medical profession, suddenly receives great attention because it is supposed to achieve miracles. I am afraid that is because it is supposed to be a specific in regard to the treatment of venereal disease. At one time, arsenic preparations were supposed to be the only specifics in regard to the treatment of venereal disease. Now we are told that penicillin is the one great specific which can cure that disease. I think it is most inopportune that this particular medicament, which has had so many false claims made in regard to it, should receive the attention of Parliament in the way it has. It is not a very excellent specific; it has failed in many—
§ It being Ten o'Clock the Debate stood adjourned.
§ Debate to be resumed Tomorrow.