Heroin

HC Deb 05 December 1955 vol 547 cc25-9

45. Dr. Broughton

asked the Minister of Health whether, in view of the opinion having been expressed by a number of practising doctors to the effect that he has been ill-advised on the therapeutic value of heroin, he will alter the composition of the Medical Advisory Committee by including among its members a pharmacologist.

Mr. Iain Macleod

The Standing Medical Advisory Committee already includes a distinguished member with both pharmaceutical and clinical experience.

Dr. Broughton

is the right hon. Gentleman aware that his decision to ban the manufacture of heroin has shocked many members of the medical profession and has caused serious concern among the public, and will he not consider altering the constitution of the Medical Advisory Committee by adding other distinguished pharmacologists to it, so that the Committee will have among its members a body of individuals understanding the value of drugs?

Mr. Macleod

The hon. Gentleman is switching his ground. He asked me whether I would include among its members a pharmacologist, and I have said that there is already one of great distinction on the Committee, namely, Sir David Campbell, who is President of the General Medical Council, and who has recently reaffirmed his views. Perhaps I may add to that a quotation from the British Medical Journal, of 1949, which stated on this subject that pharmacological opinion has long held that the social dangers of heroin overshadow its therapeutic importance. Therefore, it may well be that if we increased the membership of the Committee in the way suggested we would get an even more definite expression of opinion.

Sir R. Boothby

Is it the opinion of the right hon. Gentleman that the Medical Advisory Committee was set up under the Act for the purpose of giving advice on this kind of subject, namely, the therapeutic value of a specific drug? Because that is not the reading of the Act which a great many of us take.

Mr. Macleod

If hon. Members read the first Section of the Act, which lays on the Minister the comprehensive duty of providing health services for all the people of this country, they will see that this clearly comes within the matters which would normally be referred to the Committee.

Mr. Hastings

Is the right hon. Gentleman not aware that whilst the work of consultants, who are so well represented on the Medical Advisory Committee, is to confirm or make a diagnosis and indicate a line of treatment, the carrying out of that line of treatment, and the relief of symptoms such as pain and cough, is often the responsibility of the general practitioner, and ought he not to have consulted the general practitioners before taking this step?

Mr. Macleod

General practitioners are extremely well represented on this Committee, which includes amongst its membership three members of the Council of the British Medical Association. All those matters were carefully taken into account by that Committee, which included no fewer than 19 members with active clinical experience at the time of the recommendation to me.

Dr. Summerskill

Is it not a fact that the members of this Committee, representing as they do pharmacologists, general practitioners, surgeons and physicians, were unanimous in their recommendations to the Minister, and that similar committees in 54 other countries have recommended their Governments in a similar fashion and that their decision has been accepted?

Mr. Macleod

Yes, it is true that this distinguished Committee was unanimous in the opinion that it gave. It is equally true that in the majority of countries similar advice has been tendered in similar circumstances. All the same, I do not want to pretend anything other than that this decision is a desperately difficult one for a Government to take, and I recognise that there are sincere differences of opinion on the matter.

Sir J. Crowder

May I ask the Minister if he has read the leading article in The Times today, which says clearly that the Medical Advisory Committee is not the proper and efficient body to give its opinion on whether heroin should be banned or not? In view of what most hon. Members in this House have said, would the right hon. Gentleman reconsider the question and submit it to an altogether different body of practical doctors?

Mr. Macleod

This subject has been referred by four Ministers of Health of different parties to the same Advisory Committee over a period of five years. Until the last few days, it has never been suggested that this body was other than the correct one to which to refer it.

46. Air Commodore Harvey

asked the Minister of Health why he adheres to his original decision, despite the opposition presented by the majority of London teaching hospitals and the British Medical Association, in respect of the ban on the manufacture of heroin.

50. Dr. Broughton

asked the Minister of Health whether, having regard to the volume of protest against the proposed ban on the manufacture of heroin for clinical use in the United Kingdom, he will request the Medical Advisory Committee to reconsider the matter.

59. Mr. Hastings

asked the Minister of Health whether in view of recent representations from authoritative sources as to the value of the drug heroin, he will request the Medical Advisory Committee of the Central Health Services Council to re-examine the question.

Mr. Iain Macleod

I would refer the hon. Members to the statements of the Government's decision which were made in this House and in another place on Thursday last.

Air Commodore Harvey

Whilst recognising the tremendous responsibility of my right hon. Friend in this matter, may I ask whether he will take into account the serious views of certain sections of the medical profession and the public which have been shown in the Press and in speeches in the last few days, and will my right hon. Friend say why it is that in America, where heroin is prohibited, there are about 100,000 drug addicts against the very small number of 53 in this country? Will he look at this matter again in view of public opinion?

Mr. Macleod

The responsibility in this matter rests fairly on the Government, and we would not wish to put it on to any other shoulders. We have most carefully and with great sympathy considered all these matters in taking what I said earlier was a desperately difficult decision. As regards experience in America, I have been in communication with the Surgeon-General of that country and I have heard his opinion today by letter, namely, that there are adequate alternatives to heroin available for use by clinicians.

Mr. Bellenger

Whilst it is difficult for non-medical Members to follow these arguments and counter-arguments, can the right hon. Gentleman say specifically that in relation to the stopping or alleviating of pain there is any suitable substitute for this drug?

Mr. Macleod

All one can say on this matter, which is to some extent in dispute, is that we have taken the best medical advice we could find, and that this is the general opinion. I would recommend hon. Members who are interested in this matter to read an article on the alternatives to heroin in this week's edition of the Lancet. If I may add one more point, which I am not sure everybody realises who thinks that this matter is perhaps of small importance here—which it is in relation to the number of addicts we have—it is that in this country we produce not a small quantity but about 70 per cent. of the world's heroin.

Dame Florence Horsbrugh

Might I ask my right hon. Friend whether in the article in the Lancet to which he has alluded it is made clear what alternatives are being used and found successful in, say, Canada and the United States? I think that a great many people in this country would like to know if there are successful alternatives which have been tried out in other countries.

Mr. Macleod

Yes, that matter is specifically covered by quotations from American textbooks and, as I have indicated, I, or rather my Chief Medical Officer, has been in touch with the Surgeon-General of the United States on their experience of this matter.

Mr. H. Morrison

Like other hon. Members, I do not pretend to have adequate knowledge of this matter but, having listened to the questions one way or the other, would not the Minister agree that there is something to be said for considering the production of a White Paper on the matter in which the various issues could be canvassed, the arguments set out and the conclusions of the Government stated?

Mr. Macleod

I am very ready to consider that suggestion. This is not a question of pure black and white in which one can say finally that one opinion is right or another is not. In the last resort, it is a matter for judgment and, therefore, decision by the Government. I am anxious, if I can, to carry public and medical opinion with me on this matter, and I will be glad to consider any steps I can take to make people better informed.