PROPRIETARY MEDICINES (PRICES) (Hansard, 12 July 1948)

§ Mr. Skeffington (Lewisham, West)
I have no doubt that the Parliamentary Secretary to the Ministry of Health will realise that I am raising this subject tonight mainly to see whether it is possible to obtain the reaction of the Minister of Health to the proprietary medicine industry now that the new National Health Act is in operation. Frankly, I do not expect to get very far, because despite the number of far more distinguished Members than myself who in the past have raised this issue, very little has been done with regard to this industry, whose capital probably is more than £100 million, and which makes some of its profits, at any rate, out of human credulity and a good deal of human suffering. Yet it is almost uncontrolled even in this year of grace 1948.
Although we have not gone very far in the past, I think it is necessary that those of us who are interested in the subject should keep it in front of the House, especially at a time like the present when we are just beginning to operate the new National Health scheme. On the face of it, it seems a little ludicrous and a little illogical that we should be spending possibly £160 a million a year on the provision of services to look after the health of our people while our 'buses, newspapers and hoardings all over the country carry certain inducements which may lead people not to take full advantage of the scheme. They may, in fact, be discouraged from taking full advantage of the scheme. Before the war, the advertisement costs of this industry were put some 972 where in the region of just under £3 million, and I have no reason to suppose that they are any less today.
In raising the subject, I would like to make three points clear. I am in no way dealing tonight with those proprietary preparations which are advertised in medical and scientific journals. Even here, of course, not every so-called ethical preparation is above suspicion, but, nevertheless, professional men ought to be sufficiently qualified to use their own discretion, and that is not the subject which which I want to concern myself. I am interested only in those proprietary remedies which are or have been advertised directly to the public. Even in this group there are, of course, some preparations which are sold at not too unreasonable a cost, and which may do the consumer some little good or at any rate no positive harm. Like most things in life, there are very few studies which are completely in black, and I am perfectly willing to recognise that there must be some well-known remedies that can be used without causing any great harm to the individual.
Nevertheless, having said that I think the Ministry of Health ought to realise, as I have no doubt it does, that proprietary medicines today are responsible, first, for extracting many millions each year from the pockets of credulous persons, and, secondly, by encouraging in some degree self-medication, they may prevent the best use being made of the Health Service. I like to be reasonable in this matter and I realise that not every complaint means that it is necessary to consult qualified opinion. If one's liver is slightly upset, then no doubt the remedy can be very easily and effectively be applied to one's self without bothering a doctor.
The dangers of self-medication are, however, very obvious. I had a case recently brought to my notice of a man suffering from digestive trouble; he invested in one of these well-known stomach powders—I will be kind and even in this privileged Chamber I will not reveal the name—and he obtained relief for some period. After six months all his symptoms returned, and when he finally 973 went to his doctor after one complete year's delay it was diagnosed that he had an acute duodenal ulcer which necessitated an operation. Had he taken medical opinion 12 months earlier, it is quite likely that that operation would have been unnecessary and he would have been saved a great deal of unnecessary suffering, trouble and expense.
I think it is intolerable that misery and suffering of that kind should be permitted without the Ministry making some attempt to educate public opinion in the dangers which they may run. If I may turn to the subject of the exploitation of the public I should like to quote a few instances. One Sunday newspaper yesterday said that, despite the National Health Act, the public was still willing to buy patent medicine. One can hardly expect a revolution in five days, but it is because I think now is the time for the Ministry to act that I have raised the subject. Of the cases which I want to raise tonight, I would point out that it is extremely difficult for an individual outside this House to do very much about them. A gentleman of my acquaintance has just produced a study of 120 well-advertised proprietary medicines, but such are the curious intricacies of our law of libel that he could not find a publisher, and when he did finally find one man prepared to take the risk of publishing the book, he could not find a solitary printer prepared to take the risk of printing it.

§ Dr. Haden Guest (Islington, North)
Ask the B.M.A. They have done it once.

§ Sir William Darling (Edinburgh, South)
Shortage of paper.

§ Mr. Skeffington
If the hon. Member for South Edinburgh (Sir W. Darling) is suggesting that the publisher, realising he has a very good seller, is turning it down because of shortage of paper, he is not showing the acumen with which I usually credit him.

§ Sir W. Darling
rose—

§ Mr. Skeffington
I would rather get on, because we have not very much time and there may be others who would like to speak. Let me start with the remedy called "Mrs. Johnson's American Soothing Syrup." Why the unfortunate Americans should be blamed for this remedy I do not know, particularly as it 974 is made not very many miles from this House. The formula is 6.6 per cent. of sodium chloride, which is a very much better way of describing common salt, and 2.5 per cent. tincture of tolu. A three-ounce bottle sells for 1s. 6d. and, even if one allows for 33½ per cent. Purchase Tax, the difference between the cost of the ingredients and the retail price needs a good deal of explanation. Common salt is still 1d. a lb. and water costs very little indeed.
I should like to mention one or two remedies which may be rather better known. I turn first to Birleys Antacid Powder. This is composed of magnesium carbonide, an ounce of which can be bought at about 3d. Even if it is dispensed and the cost of the bottle be added, the total expenditure would not be more than a shilling. It actually sells for 3s. 7d., for which, allowing for Purchase Tax, there is a good deal that needs accounting. Then there is Dinneford's Magnesia which, I believe, is manufactured by a member of the Beecham group. It is obtainable in tablet or liquid form. The liquid form is made from magnesium bicarbonide, and the tablets from magnesium hydroxide, though I believe the tablets and liquid are advertised in similar terms. The cost of the ingredients is about a penny. The tablets are sold at 1s. 7d. Again there is a discrepancy. Then there is Fynnon's Salt, made by the Maclean group. This is sodium sulphate, 96 per cent. of it. The cost price is 4½d. It is sold at 2s. per 6 oz. tin.

§ Mr. Deputy-Speaker (Mr. Hubert Beaumont)
I must draw the attention of the hon. Member to the fact that, so far as I can see, he has no possible remedy in this matter that does not involve legislation. We cannot discuss legislation on the Motion for the Adjournment of the House.

§ Mr. Skeffington
I think that there is no fear that I am suggesting legislation, Mr. Deputy-Speaker. What I am suggesting is that, in the public interest, attention should be drawn to the wide discrepancy between the basic costs of these ingredients and the price at which they are sold. I am suggesting that this is something about which the public should be made aware. As far as I am aware, there is no other way of doing that than in this Chamber.

§ Mr. Deputy-Speaker
Even so, this may not be the appropriate time, in a Debate on the Motion for the Adjournment. The Minister cannot reply if legislation is involved.

§ Mr. Skeffington
I fully understand that, but I have not asked for legislation. What I am suggesting to the Minister is that, perhaps, steps should be taken to make these facts as widely known as possible. I have previously stated that it is almost impossible for an individual outside the House to do that. I should have thought it would be possible for these facts to be made known without legislation.

§ Mr. Deputy-Speaker
That does not alter the position. The Minister cannot reply, inasmuch as legislation would be involved.

§ Mr. Skeffington
With due respect, Mr. Deputy-Speaker, surely we ought to wait to hear what the Minister's reply is, before we can know whether it involves legislation?

§ Mr. Deputy-Speaker
The hon. Member cannot hear the Minister's reply because he cannot reply.

§ Mr. Skeffington
I am in something of a difficulty, because I have a list of a considerable number of preparations to which I should like to call the attention of the House. I can only hope that what I have said so far about those which I have mentioned will arouse some interest, and that some publicity may be given to it. I think it is very important at the present time that we should secure the fullest use of the new National Health Service, and I shall wait with interest to learn what is the Minister's attitude to the problem.
It seems to me that one very good point that can be made is that when members of the working public are being asked to contribute 4s. or 6s a week to the National Insurance scheme, one way in which they could make a considerable saving would be to cut out all expenditure on these unnecessarily expensive and possibly harmful proprietary medical remedies. In view of the fact that I cannot say more about them, I shall leave the matter now to hear the Minister and in the hope that hon. Friends of mine may be able to pursue the subject.

§ Sir W. Darling
rose—

§ Mr. Benn Levy (Eton and Slough)
On a point of Order. I should like to be clear about your Ruling on the matter, Mr. Deputy-Speaker. If an hon. Member wants to raise certain points, would he not be in Order in doing so, in so far as he is asking, as in the present case, whether or not he is prepared to take legislative action, whether the Minister would undertake certain salutary publicity? Is that not possible in an Adjournment Debate?

§ Mr. Deputy-Speaker
So far as I can see, the only thing that the Minister can say is that this would involve legislation and that being so, he cannot deal with it.

§ Mr. Levy
Cannot the Minister say that he is prepared to give public warning or public advice, or salutary publicity?

§ Mr. Deputy-Speaker
The Minister is in the position that he cannot in this Debate recommend that the public should do this, that or the other. All he could do would be to say that this would involve legislation and that as it involves legislation, it is not desirable on the Adjournment.

§ Mr. Somerville Hastings (Barking)
Further to that point of Order; does not the Minister give advice to the public in the form of posters and by the publication of leaflets, one of which I hold in my hand? Is it not in Order for the Minister to do that, and if so, is it not in Order for us to discuss it and make suggestions?

§ Mr. Deputy-Speaker
It is not for me to say what the Minister can say or cannot say. All I desire to point out to the hon. Member who raised this matter is that to rectify this, would involve legislation. What the Minister will have to say we shall have to wait and hear.

§ Sir W. Darling
Would the hon. Member for West Lewisham (Mr. Skeffington) say whether he is personally responsible for the analysis which he gave to us? Can I take it from him that it is an authoritative statement which I can rely on, and is he conversant with the things he described and does he know that they contain what he said they did contain?

§ Mr. Skeffington
Oh, yes. One of the great advantages of the Medicine and Pharmacy Act, 1941, is that the contents have now to be stated on the label on 977 the bottle. The difficulty from the point of view of the public about the Act is that the contents are described in extremely small print, which most people cannot read, and often in Latin, which many people do not understand. Nevertheless, for those who have knowledge of the subject, it is possible to read what the contents are. I am not quite certain whether I can continue with what I was going to say.

§ Mr. Deputy-Speaker
I cannot stop the hon. Member going on, but I can prevent him from going on the lines on which he started.

§ Sir W. Darling
Would the hon. Gentleman tell us more about fluid magnesia in the contents of tablets? That interested me very much.

§ Sir Ian Fraser (Lonsdale)
I must disclose an interest in this matter being a director of one of the companies concerned in making proprietary medicines. The hon. Gentleman's main argument is that the cost of these medicines is too high. He has not suggested that they are bad in themselves. Indeed, he cannot, because many of them are identical with preparations recommended by doctors which appear in the British Pharmacopoea. The main burden of his case is that they cost too much. I would point out that they are subject to 33⅓ per cent. tax which naturally raises the cost. Secondly, they are extremely well packed, marketed and advertised. That in itself adds substantially to the cost. When we come to advertising, there is an element of service in these advertisements. Not all people can see a doctor; there is a shortage of doctors. Not all people could afford a doctor in times gone by, and it is by no means certain that the free service will for some time to come—

§ Mr. Deputy-Speaker
I am sorry to interrupt the hon. Gentleman. Again, I see a difficulty. The Minister cannot give instructions of this kind without having legislative power to do so.

Dr. Guest
Is the Minister to have an opportunity of replying?

§ Mr. Deputy-Speaker
I am not stopping him. I am waiting for him to rise.

§ Mr. Skinnard (Harrow, East)
Would it be in Order to ask the Minister how 978 these particular proprietary medicines stand with regard to present legislation? We have had one Act mentioned, and I would like him to make clear whether this matter is subject to the provision of the Food and Drugs Act.

§ Mr. Deputy-Speaker
If that question is asked, it is for the Minister to decide how he will answer it, and not for me.

§ The Parliamentary Secretary to the Ministry of Health (Mr. John Edwards)
We seem to have got a little involved, and one is, of course, in very considerable difficulty in dealing with a matter like this and keeping within the rules of Order. I think, however, that it is permissible—indeed, I hope that it is—for me to take up the first point raised by the hon. Member for West Lewisham (Mr. Skeffington) when he talked about proprietary medicines being almost uncontrolled. There is, as a matter of fact, a large number of statutes governing, in one way or another, articles which frequently are proprietary medicines. While in the main the statutes are concerned with the safety of persons, and with saving people from their own credulity, they are considerable in scope. It might be worth while my running over what the actual statutes are at present so that the House may see the scale of control which exists.
First of all there is the Venereal Diseases Act, 1917, which makes it illegal to advertise the sale of medicine for the prevention, cure and relief of these diseases. Secondly, there is the Dangerous Drugs Acts, 1920 to 1932, which severely control the sale of preparations like opium, cocaine and the like. Thirdly, there is the Therapeutic Substances Act, 1925, and the regulations made under that Act, which cover the preparation and manufacture and sale of such things as vaccines and serums. Then there is the Pharmacy and Poisons Act of 1933, which deals with the whole range of poisons. The Food and Drugs Act, 1938, makes it illegal to sell a drug which has a label which falsely describes it or is otherwise calculated to mislead as to the nature of the substance or the quality, or to publish similar advertisements. That clearly is a very important measure. Then there is the Cancer Act, 1939, which prohibits advertisement of cures for cancer, and the Pharmacy and Medicines Act, 1941, which prohibits advertisements altogether for 979 the cure of diseases like Bright's disease, cataract, diabetes and epilepsy, loco-motor ataxy, paralysis, tuberculosis and the like. This same Act requires the full disclosure on the label of the active ingredients of all the medicines, and also prohibits advertisements relating to abortion. Finally, there is the Penicillin Act, 1947, which deals with the whole range of penicillin products.
So it would be wrong to say that there is no control so far as the safety of persons is concerned. But, of course, this control is not concerned with the prices at which any of these things are sold, and as far as I am aware, there is no way under present legislation by which they could, in fact, be controlled. However, we have had a fair amount of voluntary action which has, I think, improved the position. Voluntary efforts have been made—and one ought to say this in all fairness—by some of those most directly concerned to keep extravagant advertising in check.
I am here dealing solely with descriptions, and not with price. Bodies like the Proprietary Association of Great Britain, and the Advertising Association, have drawn up fairly recently a much tightened code governing what should be put on to the bottles or into advertisements. Although this code unfortunately does not bind those who are not in these associations, those in the associations have shown willingness to tighten up very considerably the standards of advertising.

§ Sir I. Fraser
Before the hon. Gentleman leaves that point, may I ask him one question? On the point of keeping down the price, is it not also true that competition helps to keep down prices and that the Co-operative Movement not only manufactures but sells a very large amount of these popular medicines, so there is a competitive element which also helps to keep down prices?

§ Mr. Edwards
Yes, that may be so, but it is, after all, fairly limited, and the whole point of proprietary articles is to maintain a pretty firm, continuous and traditional market. The final point that I wanted to make was this: from last Monday we have a situation where everyone 980 in the country is entitled to a comprehensive health service, and I believe that by providing for everyone, and this for the first time, the medicines which the doctor considers necessary, there will be less inducement to buy medicines which make misleading claims. I do not imagine that doctors, at any rate for the most part, will prescribe medicines of the kind that we have had mentioned this evening in the ordinary way, and certainly if doctors were to do so, their own colleagues on the local medical committee would, I think, very soon put them right.
So I think we shall in a certain sense be helping to educate the public to take a more critical attitude towards claims which are made. Certainly, in so far as these medicines are costly in relation to the cost of the ingredients, then it is for the public to be educated, to weigh carefully the advantages of what they get against the cost, and in these particular instances to weigh the service that is freely and comprehensively available under the National Health Service against the doubtful virtues of self-medication—not that for one moment do I want to suggest that there is no place for simple household remedies, for clearly most of us have our pet remedies and I think none of us is the worse for having used them.
Disregarding that, we must expect to find improvements with the mere introduction of the new service. It would, as you, Mr. Deputy-Speaker, have pointed out, be impossible for me to go further in this discussion this evening, certainly on the matter of price where we have no powers of any kind. I hope very much that the efforts which some of the trade themselves are making, combined with the fact of introducing the new service and the public education associated with it, will go at any rate some way towards meeting the situation. It is true that debates of this kind have a most useful purpose because they do bring these matters to the attention of the public. Limited as I am by the rules of Order in this case, all I can do is to say that I am grateful to my hon. Friend for having raised the matter.