§ 10.30 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Mr. John Edwards)
I big to move, in page r, line 20, at the end, to insert:(2) No person shall administer by way of treatment any such substance or preparation unless he is such a practitioner or surgeon as aforesaid or is acting in accordance with the directions of such a practitioner or surgeon.Administration of substances and preparations covered by the Bill is not permissible except by a doctor, dentist or veterinary surgeon or by a person acting under his directions. That is as the Bill now stands, but it has not been clearly 2140 understood. We think there has been some misunderstanding. Clause r prohibits the supply of substances or preparations covered by the Bill, except by doctors or dentists or veterinary surgeons, or persons acting under their direction. Then, under Clause 4, "supply" is defined as including administration by way of treatment. I hope that this Amendment will, incidentally, help to meet the criticism that undesirable nursing homes not carried on under professional supervision, might administer the substances or preparations to which the Bill applies. The adoption of this Subsection will make it clear in the early part of the Bill that only administration by professional people, or under the direction of professional people is permitted.
§ Mr. R. S. Hudson (Southport)
I think that the explanation which the Parliamentary Secretary has given helps to clear things up. But I would like to ask what is the meaning of the word "direction"? Does it mean that the practitioner has to write out the whole of his directions, or can he give them by word of mouth? I am not thinking so much of the administration to human beings, but administration by veterinary surgeons. Has the practitioner, in such cases, to give a formal letter of instruction?
§ Mr. Edwards
I am not a lawyer, but I understand that "direction" means instructions which are usually given in writing but may be given by word of mouth.
§ Mr. Hudson
I think we ought to know about this. We have here an hon. gentleman learned in the law, and it is a matter of some importance. It is of particular importance to the farmer to know the answer.
§ Dr. Haden Guest (Islington, North)
May I, as a humble member of the medical profession, say that, ordinarily instructions given by a doctor to a nurse in the course of the work of a nursing home are given verbally.
§ Mr. Hudson
Neither the hon. Gentleman nor I is a lawyer. We have the advantage of the presence of a gentleman who is supposed to be eminent in the law. I would be glad to know what he thinks about this.
§ Amendment agreed to.2141
§ Further Amendment made: In page 1, line 21, leave out, "The last foregoing subsection," and insert, "Subsection (1) of this section."—[Mr. J. Edwards.]
§ Mr. Derek Walker-Smith (Hertford)
I beg to move, in page 2, line 5, to leave out paragraph (f).
This Amendment is really exploratory. In the Second Reading Debate I pointed out that some explanation would be required at this stage of the reason for the insertion of Subsection (2, f) of Clause 1. This Clause deals with the control of the sale and supply of these various substances. Subsection (2) describes the various cases which will be exempt from the restrictive operation of the Clause. Most of these provisions are perfectly clear on the face of them. That is to say on the face of it (2, b) is for the purpose of being exported, (c) is the sale to any such practitioner or surgeon as aforesaid, and (e) is the sale to any person carrying on an institution or business which has among its recognised activities the conduct of scientific education or research, for use by persons engaged in that education or research, and (f) is the sale to any Minister of the Crown or Government Department. In all these cases except the last it is quite obvious why they should be exempt from the restrictive provisions of the Clause.
Paragraph (f) provides that penicillin can be available to any Minister of the Crown or Government Department. We are not clear of the purpose behind the reason why a Minister or a Government Department should be exempted from the restrictive conditions of Clause 1. There is, if I am in Order in referring to it, a more detailed Amendment which would seek to exclude from the operation of these restrictions those Ministers who are not Ministers directly in charge of any specific Government Department, including the Attorney-General. Perhaps when the Parliamentary Secretary replies it might be helpful if he would address some observations to the position of Ministers who do preside over a specific Department and also to those Ministers who would be included in the terms of this Subsection as it stands, but who do not preside over any Government Department. We feel that there should be some elaboration of the reason for putting in this Clause these people.
§ Mr. J. Edwards
I must resist this proposal. It is necessary for us to provide in the Bill for the inclusion of Government Departments in order that they may obtain penicillin and any other substance with which the Bill may deal. It may be necessary to supply penicillin for the Armed Forces, and there are a number of cases where we might need penicillin. I would remind the Committee that the Bill applies not only to penicillin; it may be extended to other substances at present in an experimental stage and we cannot see all the circumstances in which it might be desirable for Government Departments to secure those substances covered by the Bill. The provision has been drafted in a form sufficiently wide to cover unforeseen developments.
§ Mr. R. S. Hudson
The Parliamentary Secretary made a perfectly valid defence of the need to make provision in this Bill for the supply of penicillin and similar drugs to a Government Department No sane person would take exception to that, but what we want to know is why it should be necessary to apply this paragraph to Ministers of the Crown. Why should the Attorney-General, or the Solicitor-General, or the Lord Privy Seal want penicillin? They do not have to supply the Armed Forces, and while it may be reasonable that the words "Government Department" should be included, we ask why there should also be included "Ministers of the Crown?"
§ Dr. Morgan (Rochdale)
Surely the right hon. Gentleman sees that somebody has to give an order for penicillin, even on behalf of a Government Department. Surely, for instance, the Minister of Labour could properly order penicillin for one of his officers to do some form of penicillin work?
§ Mr. Walker-Smith
Would the hon. Gentleman allow me? His interesting argument seems to take no account of the fact that there may be Ministers who do not preside over any Department, and it is with them we are principally concerned.
§ Dr. Morgan
I wish the hon. Gentleman would tell me any Department which does not at some time or another have something to do with medical work. Almost every Government Department which 2143 exists may have the need to order medical supplies, especially penicillin.
§ Sir John Mellor (Sutton Coldfield)
Is not the position this: either the expression "Minister of the Crown" or the expression "Government Department" must be redundant. I can appreciate the point made by the hon. Member opposite that perhaps it is necessary for a Minister of the Crown to give an order or for an order to be given in the name of the Minister by his Department. But we do not want all Government Departments in. If "Government Department" is in, we do not want "Minister of the Crown" in. We should have some elucidation on that point.
§ fled with the reply of the Parliamentary Secretary. He put forward that it might be necessary for the Armed Forces to procure penicillin for their use from time to time. If that is so, I cannot understand why it is necessary to give power to the Ministers in general, because every one of the Armed Forces have a great mass of medical officers who can sign the necessary requisitions under this Bill without having recourse to the Minister at all. It is carrying it much too far that every right hon. Gentleman who sits on the Front Bench can ask for penicillin and make for himself a privilege denied to the mass of citizens of this country.
§ Question put, "That the words proposed to be left out stand part of the Clause."
§ The Committee divided: Ayes, 146; Noes, 42.2145
§ Mr. J. Edwards
I beg to move in page 2, line 8, to leave out "unless it expressly so directs," and to insert "subject as hereinafter provided."
I should like to take this together with the following Amendment in page 2, line 10, as these Amendments really cover the same ground. Their object is to indicate more specifically in what circumstances the substances or preparations covered by the Bill may be dispensed more than once, or more than three months after the date on which the prescription was signed. As the Subsection now stands a prescription may be dispensed more than once, or more than three months after the date of signature if the prescription expressly so directs. This is a little indefinite. For example, what would be the position if the doctor simply wrote, "Repeat"? Presumably the pharmacist would be entitled to dispense the prescription an indefinite number of times, which is clearly undesirable medically, and is a potential cause of black marketing. Under the Amendment the prescription may be dispensed more than once, or more than three months after signature only if the prescription actually specifies the number of occasions on which it may be dispensed, or over the specified period at which it may be dispensed. In the example I have given, if the doctor simply wrote the word "Repeat", then the pharmacist would not be authorised to dispense the prescription more than once. These Amendments bring the provision for prescriptions and preparations and substances covered by the Bill into line with those for poisons under the Poisons Rules, and I think it will be generally agreed will improve the Measure.
§ Amendment agreed to.2146
§ Further Amendment made:
In page 2, line 10, at end, add:
Provided that, if the prescription expressly directs that it may be dispensed on a specified number of occasions or at specified intervals in a specified period, it may be dispensed in accordance with that direction."—[Mr. J. Edwards.]
§ Motion made, and Question proposed, "That the Clause, as amended, stand part of the Bill."
§ Viscount Hinchingbrooke (Dorset, Southern)
I should like to know if we can have a little further information in relation to words on page 2. It appears that while the sale of penicillin to the generality of the community is restricted, there are certain privileged persons left who can obtain it simply by going to the chemist and asking for it. Those persons, as one would expect in these days from Socialist legislation, include Ministers of the Crown. The Under-Secretary has offered an explanation why it is necessary for certain Government Departments to have this right. But there are Ministers who are not in charge of Government Departments and who are not responsible for seeing that this penicillin finds its way to those who are served by those Departments. These Ministers, who are mentioned in the Amendment which was not called, in Clause 1, page 2, line 5, include the Lord Chancellor, the Lord Privy Seal, the Chancellor of the Exchequer, the Minister without portfolio, the Attorney-General and the Solicitor General. We got no reply from the Under-Secretary when the earlier Amendment was moved. I think the Committee is entitled to some further statement from him as to why it is not possible to alter the words to remove the objection that there should be left in the Bill certain Ministers without responsibility for Gov- 2147 ernment Departments who have an absolute right to go to any chemist's shop and acquire penicillin. Why is the Attorney-General included in this? I understand that the Attorney-General has recently been making attacks upon the housewives. The housewives are denied the opportunity under the Bill—
§ Viscount Hinchingbrooke
I was about to say, Major Milner, that the housewives are denied the opportunity under this Bill of going to a chemist's shop and acquiring penicillin as a right. Yet the Minister of the Crown who attacks them week after week has the right. He has the right to go to what chemist's shop he likes day after day if he so requires, as a right, to get what penicillin he wants.
I do not rest this case on the personality of the Attorney-General. Of all Ministers of the Crown today he is, I think, about the most unpopular throughout the country with the possible exception of the Minister of Fuel and Power. But I do rest it upon the simple words contained in this Clause, which gives certain Ministers of the Crown, who are not specified, this absolute right to buy penicillin. I think the Parliamentary Secretary ought to favour us with an explanation of why it is not possible to introduce some simple regular words in this Clause which would give Government Departments the requirement we all admit they must have, but which do rule out the particular persons to whom we on this side of the Committee object.
§ Sir J. Mellor
This Clause causes to be controlledany substance to which this Act applies or any preparation of which any such substance is an ingredient.If we look at the substances to which the Bill applies we find they are—and this is in Clause 2—penicillin and such other anti-microbial organic substances produced by living organisms as may be prescribed by regulations.The point is that in any case under the Clause penicillin is controlled and, further, certain other substances can be controlled by regulations. As far as the other substances are concerned they cannot only 2148 be controlled but also decontrolled by regulation because, under the Interpretation Act, if a Minister is given power to do something by regulation he has an implied power to revoke the regulations. As far as penicillin is concerned the control stands and there can be no change. The words which I first read out mean not only that penicillin is permanently controlled under this Bill in all its forms, but also that any substance which is added by regulation must also be controlled in all its forms. In other words, it would be quite impossible for the Minister to distinguish between one preparation and another.
At the present time there is, I think, a certain difference of opinion as to whether it is necessary to control penicillin in all its forms and preparations. It may well be as we gain experience and as medical science progresses and practical experience is gained, that it will be decided by the majority of medical opinion that pencillin and some other substances could safely be used without control in certain forms. For instance, it may. be demonstrated that certain derivatives of penicillin are unobjectionable and can be left to the general public without any control at all. An hon. Member opposite shakes his head. All I am saying is that it may be—I do not think he would claim so much knowledge of penicillin, although he has the technical qualifications, to say what. may happen in the course of the next few years The suggestion I am putting to the Parliamentary Secretary is this. It may well prove, as a result of medical experience, that, say, penicillin cream may be safely left uncontrolled, to be used by the general public without let or hindrance.
§ Sir J. Mellor
That might appear in the light of experience. It would be quite impossible under this Clause for the Minister to distinguish between that form of penicillin and other forms of penicillin, which might be held to have serious and dangerous consequences and for which control might be considered really necessary. I want the Parliamentary Secretary to appreciate this point because it is a serious one and I think there is a serious defect in the Bill. If the Minister decides that control is necessary for any substance, 2149 penicillin or another, he must control that substance in all its forms and any kind of substance that may be made from it. I think that is altogether too rigid. The Minister would have to introduce an amending Bill to get himself out of that difficulty.
There is one other point that I want to raise. That is with regard to the consultation which the Minister took before deciding on imposing this control. I asked a question on Second Reading as to why the Minister did not consult the Medical Research Council with regard to the provisions of this Bill. I asked that question because it is provided in the next Clause that the Minister shall only make regulations after consultation with the Medical Research Council. If it was considered desirable that he should consult with that council before making regulations I should have thought he should have consulted with them before introducing the provisions contained in Clause one.
§ Sir J. Mellor
I am much obliged. On Second Reading although the Minister made a speech, he did not reply to any of the points raised in the Debate. I am sorry he is unable to be here tonight. There may be an excellent reason for his absence, but I think we might have had it from the Parliamentary Secretary. Perhaps he may be good enough to give It in his reply, and I hope he will now give a full and detailed answer to the points raised.
§ Mr. Somerville Hastings (Barking)
The hon. Member for Sutton Coldfield suggests that there may be a complete change of nature and that the principle immunity which is fundamental in all living things may change. I do not think that it is at all likely in our generation or any other, because the whole principle of this Bill depends on the fact that by repeated small doses of chemical substances almost any organism may attain immunity, and those unpleasant microbes which attack us may attain immunity to penicillin and transfer it to their descendants. We by vaccination, for example, 2150 attain immunity, and I do not see how it is at all likely that these organisms which now attain this immunity to penicillin will ever lose that power.
§ Mr. J. Edwards
The noble Lord who opened this discussion said that I had refused to reply on an earlier Amendment. I submit that it was no part.if my business at this hour of the night to repeat what I had already said. I gave as fair and as complete an answer as I could, and I should not have helped by going through the motions of saying again what I had already said. After all what I had already said again. After all what is the point of this Bill? The point is to safeguard the public from the dangers of misuse of penicillin, and it can hardly be seriously suggested that there is such a danger of misuse by Ministers of the Crown that we have to itemise them and put them down one by one. If we are to have legislation, primarily designed for one subject, going into minute detail as to which Minister will purchase penicillin then we are producing legislation which is absurd.
Turning to the speech of the hon. Baronet, the Member for Sutton Coldfield (Sir J. Mellor), I am advised that there is no reason to suppose that in five or 10 years' time the facts as we have them now will have been disproved. Therefore I cannot accept his major statement that in a few years' time we may find that what we are working on here is completely wrong and that our powers will not be needed. Because I do not accept his major argument I cannot accept what follows.
§ Sir J. Mellor
I have not said that the powers would not be needed. What I have said is that this full degree of power might not be needed, and the Minister might even desire to relax the control in some degree and find himself completely unable to do so under the terms of the Act. I was suggesting the Minister should have some discretion to relax control which at present he has not got.
§ Mr. Edwards
I do not want to misrepresent the hon. Baronet. As I understood him, he said we would not necessarily want to use powers over every type of penicillin. As at present advised, I think we are as likely to want to do that in 10 years' time as now. I do 2151 not accept his submission at all. If in the end he is proved right, although on the scientific facts as we have them now I do not think he will be, then amending legislation would be necessary. But I do not see that need—conceding the point he makes—on the basis of the evidence we have now, which he has not disproved. In regard to the Medical Research Council, the answer is that we did consult the Medical Research Council before this decision was taken. Finally, a question was asked about the presence of my right hon. Friend. All I can say is that he had expected to be here to night, and I had expected that he would be here, and it is a cause of some anxiety to me, knowing as I do that he is on a longish journey, that he is not here.
§ Mr. R. S. Hudson
I am sorry that the Parliamentary Secretary made the remarks he did at the beginning of the speech to which we have just listened. I feel it is largely due, if he will forgive me saying so, to his inexperience of Parliament. Believe me, Government business is not got through in this House, as he will learn with longer experience, by trying to ride roughshod over the Opposition. He said that he did not feel it was his duty to repeat on this occasion the arguments he had used in answer to an earlier Amendment—as he put it, to the best of his ability.
§ Mr. J. Edwards
May I interrupt the right hon. Gentleman? I did not say I would not repeat the arguments I had used on an earlier Amendment. I said that I did not wish to repeat on the same Amendment the answers I had already given.
§ Mr. Hudson
As I understood the hon. Gentleman he said that he did not want to repeat on this occasion the answers he had given on an earlier Amendment. The gravamen of our charge is that he made no attempt, on the occasion of discussing the earlier Amendment to this Clause, to answer the arguments put forward from this side. He directed the whole of his speech to the need for a Government Department to get penicillin—with which we all agree—and neither he nor anyone else on the Front Bench made any attempt to answer the question "Why is there any reason for a given Minister of the Crown to buy this?" Government Departments, 2152 yes; but why should an individual Minister of the Crown be entitled to go into a chemist's shop and say "I, a Minister of the Crown, am entitled to get this without any prescription"? That is the question we are asking. That is the question which has not yet been answered. None of us wants to sit up unduly late, but progress will not be made with the expedition it could well be if we ar.2 going to be treated like that. We have spent more than half an hour now, and have not had an answer from the Parliamentary Secretary or the Attorney-General. I still say that we are entitled to an answer from the Government bench. Why is a Minister of the Crown, in his personal capacity as a Minister of the Crown, entitled to go into a chemist's shop and ask for penicillin 'which no ordinary individual is allowed to buy. What is inherent in his capacity as a Minister of the Crown that he should have this right to go and buy it when he could order his department to obtain it.
§ 11.15 p.m.
§ The Attorney-General (Sir Hartley Shawcross)
It is very difficult and quite unusual to attempt to discriminate between different Government Departments and different Ministers of the Crown when one is embodying provisions of this kind in Bills of this sort. That is the difficulty with which we are faced. Hon. Members opposite have not, I think, fully appreciated that there are a number of departments—the Department of Scientific and Industrial Research is one, and the Medical Research Council, another—which are not presided over by particular Ministers. On the other hand there are very few Ministers who do not, in fact preside over Departments. I myself have the distinction of presiding over what I regard as one of the important departments of the Government, the Law Officers' Department. It would be wrong, to mention that as an example, to deal with the matter by confining the power to Departments if the object were to exclude particular Ministers, such as the Attorney-General, since he would come in with his Department.
When the phrase, "Minister of the Crown" is used in this Bill, what is contemplated is a Minister of the Crown acting qua Minister, acting not privately but for the Crown as head of his Department. 2153 It is unlikely, I agree, that the Law Officers of the Crown would require penicillin, though the duties attributed to me recently have been so varied that I would hesitate to exclude the possibility that for one reason or another I might require it to administer to myself, or possibly to administer to the noble Lord, the Member for South Dorset (Viscount Hinchingbrooke) who seems to have been so gravely affected by the virus of the Housewives League, or the Housewives' League Company Limited, as I understand they are now to be called. But hon. Members will realise that the purpose of this is to provide that a Minister, or the Department presided over by the Minister, may be able to make these purchases if required for the purposes of his Department.
§ Mr. Linstead (Putney)
I have followed the argument of the learned Attorney-General with care, but I wish he could help me to this extent: can he name one Minister whose need of penicillin for his Department's purposes would not be met by the words "Government Department" alone, which are in the Clause.
§ Wing-Commander Robinson
May I repeat that question, because I cannot understand the necessity for giving Ministers of the Crown this right. Every Government Department which may have need of using penicillin will have attached to it qualified medical men who can sign the necessary certificate. The learned Attorney-General has spoken about some particular need for penicillin. But surely whatever Government Department is responsible for carrying out scientific research will have qualified men who can provide the necessary certificate; so that to give this additional power to the whole of the Ministers of the Crown becomes unnecessary and redundant.
§ Mr. Challen (Hampstead)
So far as I can understand the speech of the Attorney-General, it seems to be a defence of his position as Attorney-General in being able to buy penicillin. But he is not in command of a Government Departrnent. I am not at all sure if he is a Minister of the Crown. He is a Law Officer, but I do not know if he comes into the former definition at all. But when he says that this particular paragraph is necessary on legal grounds, and when he says that a Minister of 2154 the Crown must have these powers, one finds it very difficult indeed to see why he should come into this matter at all. I can only make my protest, and I have interrupted the proceedings to say that the learned Attorney-General, as a Law Officer of the Crown, should not be included in this Bill at all. He has given no legal argument in favour of this Clause, and I invite him again to say why he should be so included.
§ Clause, as amended, ordered to stand part of the Bill.