§ 10.0 p.m.
§ Dr. Barnett Stross (Stoke-on-Trent, Central)
I beg to move,That an humble Address be presented to Her Majesty, praying that the Poisons List Order 1962 (S.I., 1962, No. 2669), dated 3rd December, 1962, a copy of which was laid before this House on 11th December, be annulled.Would it be reasonable, Mr. Speaker, also to discuss the second Prayer—That an humble Address be presented to Her Majesty, praying that the Poisons Rules 1962 (S.I., 1962, No. 2670), dated 3rd December, 1962, a copy of which was laid before this House on 11th December, be annulled.
§ Dr. Stross
We are dealing with a subject of some complication. Both of these Measures stem from one piece of legislation—the Pharmacy and Poisons Act, 1933. I have looked at a good deal of the previous legislation, going back more than 100 years, but I think that to refer to that would be out of order, because these matters stem from the 1933 Act. In every case, however, and certainly in this, the purpose of legislation is twofold. It is, first, to control the sale of poisons to the public and, secondly, to reduce the danger to human and animal life which may result from their indiscriminate sale to the public by unqualified persons. In other words, as the Under-Secretary of State to the Home Department is fully aware, the purpose of these Measures is to say who shall be responsible for prescribing a particular drug or so-called poison, whether it shall be a doctor, dentist or veterinary surgeon, or whether certain substances shall be made available in certain designated places, or completely and freely available.
My first question is why the Under-Secretary is here to listen to the debate. In other words, why is the Home Secretary responsible? I have made a note of some of the reasons which have been given. The Departmental Committee on the Poisons and Pharmacy Acts, which was set up in 1930, considered this very question of why the Home Secretary 1076 should be responsible and it gave the reasons in three short paragraphs. I hope that I will be able to state arguments to the complete satisfaction of the Home Secretary to show that the Committee was wrong and perhaps we shall be told that the Home Secretary will gladly rid himself of this responsibility from now on.
The first paragraph said:the Home Secretary, as the Minister responsible, in England and Wales, for the prevention of crime and all qusetions of 'police', is directly concerned in the control of the sale or supply of poisons and should, therefore, have the decisive voice in the making of rules which he has to administer",The second paragraph said:the Home Secretary is directly responsible for the administration of the Dangerous Drugs Acts, which are closely connected with the administration of the Poisons and Pharmacy Acts and embrace substances included in the latter Acts; and he is brought by the duties of that administration into close contact with the Pharmaceutical Society of Great Britain on many points.The third paragraph said:the Home Secretary acts on behalf of the Privy Council in the House of Commons in regard to all questions relating to the administration or amendment of the Poisons and Pharmacy Acts.Those are the reasons given, and I want to argue that the whole matter should be reconsidered.
There is a great deal of confusion here, and there is certainly divided responsibility. For example, at present the Home Secretary is responsible for the control of dangerous drugs, but the Minister of Health is responsible for tine control of therapeutic substances, and everybody knows that what is a therapeutic substance today may tomorrow be considered to be a dangerous drug. Secondly, when we are dealing with food adulteration and food additives, the Minister of Health and the Minister of Agriculture, Fisheries and Food are jointly involved. This is another example of confusion. Thirdly, when we are dealing with the Agriculture (Poisonous Substances) Act, 1952, we find that the Minister of Agriculture, Fisheries and Food alone is responsible for the regulations.
Therapeutic substances, as they are in these Rules, are very often placed in the Poinson List Orders in Part I or Part II, and in the first of these Statutory Instruments we find 31 substances, either 1077 singly or in groups, brought in for the first time. They include a whole group of diuretics. I propose to mention only one. I shall not attempt to get my tongue round some of these names. Diuretics include chlorothiazide and its derivatives. What is fascinating is that in this case there is a declaration, although it is not directly in these Rules, that any future derivatives of this will be included as well.
Secondly, I notice a slimming preparation in the list. Thirdly, I see antiinflammatory agents and drugs used in the treatment of high blood pressure, hypertension, and also a drug which is used to alleviate mental depression. There is also a group of anti-histamine drugs. I do not see what these have to do with the Home Secretary. This is wrong, and the answer is that 1963 is not 1930. In 1930 Pandora's Box was not properly opened, and chemists and manufacturers were not giving us all these strange, new, remarkably valuable synthetic drugs, some or all of which tend to have side effects and have to be carefully watched. I am sure that if the Committee were sitting now it would come to a different conclusion, because in 1930 the practice of medicine was very much simpler than it is today, and we have undergone a revolution. We cannot under any circumstances associate the control of these drugs with the fact that the Home Secretary has control over the police and is associated with the suppression of crime.
If we are to leave the Home Secretary out of it, to whom should we give the duties? I think that the right thing to do is to say that they should be the responsibility of the Minister of Health, the Minister of Agriculture, Fisheries and Food, for he has a definite part to play in the application of these Rules, and all future ones, and the Secretary of State for Scotland.
I hope that the Joint Under-Secretary of State for the Home Department will be able to answer this point. This again is a complaint, because it seems that if the intention is to protect the public we are going about this in the wrong way, and that we ought to reverse our philosophy and technique if we are to give the public maximum protection against dangerous substances, whether they be drugs or rank poisons.
1078 The 31 substances which have been newly added in Part I of the Order have been added because, after trial and free use by the public, and easy and free sale, they have been found to have side effects, some of which may be unpleasant and dangerous. They are added so that they will not be obtainable except on the prescription of a doctor, veterinary surgeon or dentist. Surely it would be wise to provide that virtually all new drugs should first go into that list—unless we are quite sure they are safe—and then, after experience of two or three years, perhaps be taken off the list. The Rules contain provisions whereby these substances can become exempt by being placed in the Fourth Schedule, which refers to the exceptions which are made, such as syrup of wild cherry, and the use of sodium fluoride in mouth-washes or dental pastes. These can be used more freely if, in the first place, most preparations are put into Part I when they first come from the manufacturer, so that only a doctor, veterinary surgeon or dentist may prescribe them.
I have only three short questions to ask the Joint Under-Secretary. The first concerns criteria. What criteria are used, and what mechanism is employed, to put a drug or substance into Part I or Part II of the Order? Is it done on the advice of the Poisons Board? If so, why does it take so long before action is taken? Why must it be necessary for disturbances in the Press, for a campaign to be started, and for Members on both sides of the House to point out that an undesirable drug is being widely used without any control on it, and is doing great harm to our constituents, before any action is taken? It is not good for the Home Secretary or his Department that this should happen so regularly.
Lastly, will the Under-Secretary give us an explanation, however brief, of the reason for the change of procedure in the appointing of what is described asa person duly authorised by the Minister of Agriculture, Fisheries and Foodinstead of the former method, where the qualification is listed?
I have no specific criticism to make about the Poisons Rules, except the question of principle, as in the case of the Order. I am delighted to see that sodium arsenite and potassium arsenite are no 1079 longer to be used in sprays, because it is now accepted that these substances are dangerous to agricultural workers.
§ 10.14 p.m.
§ Sir Hugh Linstead (Putney)
I agree with the hon. Member for Stoke-on-Trent, Central (Dr. Stress) and his hon. Friends that it is a useful service to have a short discussion of these Statutory Instruments through the machinery of the Prayer. Although none of us would wish to delay the Order or the Rules, it is clear that they now provide an extremely clumsy machine to achieve the purpose behind them.
Basically, the intention is to protect the public against deliberate or accidental poisoning. Yet, if we survey the medical field today, we see that it is far more than protection against crude forms of poisoning that is required by the public. What the public requires today, in reference to medicines in particular, is protection against impure medicines; medicines inaccurately manufactured; medicines being freely sold which give rise to addiction; medicines which may give rise to acute or chronic toxicity; medicines with deleterious side effects; the making of unjustified claims of therapeutic working and medicines which are dangerous if administered without proper supervision. It is extremely difficult under the corpus of medicine legislation—at the moment a patchwork of historical accidents—to give the public that comprehensive protection to which it is entitled.
I am sure that the hon. Member was quite right when he referred to the fact that it is only history which can make sense—if indeed it is sense, that even history can make—of the present situation. In fact this House and the Government have never faced the problem of how best to control the supply of medicines to the public as one comprehensive problem. That has become more obvious to us recently because we are discovering that medicines can give rise to far more social problems than was realised 100 years ago, or 50, or even 30 years ago when the drugs of addiction were first recognised. The tranquillisers, the oral contraceptives and drugs of addiction of the simple kind—heroin, morphine, cocaine and so on—give rise to social problems which can no longer be neglected by the Government. One appreciates 1080 that people carry benzedrine to pep them up and aspirin to deflate them—if that is the term—and even barbiturates to give them a quiet night's sleep.
The attitude of mind in the public is. I am sure, at any rate partly due to the fact that in this country we have legislated only for medicine as poisons. We have never really taught the public to regard medicines as something in almost all circumstances to be taken with caution. A very distinguished physician said to me a little time ago, in relation to the thalidomide tragedies, "When I was a young medical student we were always taught that in no circumstances were we to give drugs of any kind to expectant mothers. That is now forgotten. Our professors no longer teach that to medical students and some of these troubles arise because of that attitude of mind".
What I wish to say generally with regard to these Statutory Instruments is that they are a valiant attempt with inadequate machinery to deal with a problem that is much wider than is represented by the work of the Poisons Board. I had the privilege of serving on the Poisons Board for over 20 years and I can pay tribute to the work done there voluntary by members and by civil servants. Nevertheless, it is not the right instrument for the task to be fulfilled.
There are no fewer than seven Acts of Parliament dealing either with poisons or medicines. I have here a list of eight authorities responsible in one way or another for prescribing standards for medicines or standards of purity on different subjects. There are certainly three groups of enforcement authorities, the Health Ministry, local authorities and the Pharmaceutical Society. With that jungle of confused legislation and confused responsibility, it is beginning to become extremely clear that we need a comprehensive review of the whole field and the replacement of these bits of historical legislation by one comprehensive statute.
One or two principles ought to be clearly recognised. The first is that, legislatively speaking, there must be a separation of legislation on medicines from legislation on poisons. In the second paragraph of the Poisons Rules, 1962, there are references in two succeeding lines, one to a medicine and the next 1081 to a sheep dip. I put it to the House that we cannot legislate for two things as far apart in daily use as a medicine and a sheep dip merely because of the accident that they both contain sodium arsenite, which is what the Rules seek to do.
The first thing is to separate legislation on medicines and poisons. That would help on the point made by the hon. Member that over a part of the field the Minister of Agriculture, Fisheries and Food should be the responsible authority and the second principle should be the responsibility of the Minister of Health rather than the Home Secretary. Anyone who looks at the Schedules to these Instruments will agree with what the hon. Member said, that the Home Secretary should be most willing and glad to shed the responsibility which goes with these mystic lists. Thirdly, we ought to look for one basic Statute to deal with the whole of the necessary legislation covering the control of medicines in the public interest.
Fourthly, this will require at the service of the Minister of Health some expert advisory body which can tell him which are the medicines which need which control. I am not sure that I go quite so far as the hon. Member did in saying that everything new should be put under the control of medical prescription to start with and freed only after three or four years' experience has shown that to be necessary.
§ Dr. Stross
I qualified that by saying, unless one is absolutely certain that that procedure is not needed.
§ Sir H. Linstead
I do not think that there is anything between us. The hon. Member will probably agree that the only way to discover what a new medicine will do to 50 million people is to give it to 50 million people and that there must be some element of risk and doubt. It boils down to this. What should be envisaged now is an inquiry into the whole field that we have been looking at rather superficially tonight, with a view to formulating a consistent policy and putting it before the Government in the hope that in due course a Government will put it before the House. If we are to carry on as we are doing now with this old, and in some cases 1082 Victorian, machinery we shall have unsatisfactory results in spite of the efforts of civil servants and experts to make the machine work.
§ 10.23 p.m.
§ Mr. Kenneth Robinson (St. Pancras, North)
I am tempted to follow the lead given by the hon. Member for Putney (Sir H. Linstead) and to try to widen this debate to include a discussion of the whole question of the control, testing, distribution and approval of all drugs, ethical and non-ethical. However, I shall resist that temptation if only because I should probably very soon be straying outside the rules of order.
I content myself with one or two general observations which, I readily admit, have already been underlined by my hon. Friend the Member for Stoke-on-Trent, Central (Dr. Stross) and the hon. Member for Putney. There is hardly anything which either of those hon. Members said with which I find myself in disagreement. We all recognise, to put it no higher, that it is an anomaly that the control of poisons today rests with the Home Office. As both hon. Members pointed out, this is an historical accident because that was the Department responsible for the Pharmacy and Poisons Act of 1933, but I do not think that a very good reason for continuing this practice into the 1960s. It must lead to considerable difficulties. It certainly leads to some difficulty for hon. Members.
We are all aware of the sort of process which is put in train when a drug comes under suspicion and the suspicions are ventilated in the Press. One turns instinctively to the Minister of Health for some guidance and then finds that this drug is on sale over the counter in chemists' shops because it is not on the Poisons List. One then has to switch one's attack to the Home Office to try to get the drug put on the Poisons List, if there is a case for that. This all takes time. The hon. Member for Putney said that from his experience he feels that the Poisons Board does excellent work, but it seems to me that it is not one of the most rapidly moving agents of Government.
The Minister of Health cannot divest himself of his responsibility in these matters. He has a duty if only to advise prescribers about drugs, and he has to institute a parallel investigation with his advisory committee, which may have 1083 different personnel, or some personnel common to the Poisons Board. I do not know about that.
§ Sir H. Linstead
One observation arises from what the hon. Member has said. It is worth putting on record that the Council of the Pharmaceutical Society has been very wise in this respect and has given advice to chemists well in advance of action taken by the Home Office. In the vast majority of cases that has stopped the sale of these questionable drugs across the counter. But the fact that this has to be done emphasises how slowly the machine works.
§ Mr. Robinson
I am glad that the Council gives that advice, but I think that the hon. Member would agree that occasionally drugs slip through even that net.
This must lead to some inter-Departmental confusion, as in all cases of divided responsibility, and it is a situation which we ought to try to bring to an end. I certainly support the view of the hon. Member for Putney that the time has come for a fresh look at the whole problem, and certainly to consider whether it is still appropriate that the Home Secretary should be the responsible Minister in this field.
May I ask one or two specific questions about the machinery? What is the process which takes place before Instruments such as these are drafted and laid before Parliament? From where does the initiative normally come to consider the addition of substances to the Poisons List? Looking through the list I notice that a well-known tranquillising drug, perhaps the most commonly used tranquilliser in mental hospitals, does not appear on the list. This is not conclusive; I am only a layman, and it may be there under another name. But it would be surprising if it were not there, because I am sure that it is not a drug which ought to be freely available to those who go into a chemist's shop.
Clearly this is not the only machinery which divides drugs into ethical and non-ethical drugs. If the Minister can answer this question I should like to know how it comes about that drugs which do not appear on the list and have no statutory ban upon them nevertheless are regarded 1084 as drugs which can be supplied only on prescription. Are substances ever removed from the list and in what circumstances does that come about? How often is consideration given to a new batch of drugs? Does the Poisons Board "meet only if there is a demand for some new substance to be added to the list, and from where does the demand come? Does it meet regularly? What decides how frequently Orders of this kind come before Parliament? It would be helpful if the House were given some answers to those questions.
I hope that the Under-Secretary of State will carry back to the Secretary of State, and indeed to the Minister of Health, who has considerable responsibility in the matter, that, at any rate in a small House, a unanimous view from the Opposition benches and the Government back benches was expressed critical of the present machinery and asking whether the time has not come to take a fresh look at the whole problem.
§ 10.30 p.m.
§ Dr. A. D. D. Broughton (Batley and Morley)
I do not wish to detain the House for long, but there is one item in these Rules to which I should like to refer. When the previous Poisons Rules were made in 1961—Statutory Instrument 1961 No. 1612—included for the first time among the substances which could be retailed only on medical prescription wasSuprarenal gland medulla, the active principles of; their salts; except when contained in preparations intended for external application only or in inhalants.When these Rules came into operation it was discovered that the exemptions to that rule did not include rectal preparations or preparations intended for use in the eye. I wrote to the then Home Secretary about this. I should like to express my appreciation for the courteous manner in which he received my representations and for the sympathetic consideration that he gave to them. I understand that he passed on my views to the Poisons Board, which was agreeable to this alteration being made. I am very glad that the suggestion which I ventured to put forward has been incorporated in this new Statutory Instrument.
§ 10.32 p.m.
§ The Joint Under-Secretary of State for the Home Department (Mr. C. M. Woodhouse)
I am very much obliged to the hon. Member for Batley and Morley (Dr. Broughton) for giving us at least one good word tonight. The hon. Member for Stoke-on-Trent, Central (Dr. Stross) raised a number of extremely interesting, highly important and in some cases very far-reaching questions, which were echoed both by my hon. Friend the Member for Putney (Sir H. Linstead) and the hon. Member for St. Pancras, North (Mr. K. Robinson).
I am sure that hon. Members who have spoken will appreciate that it is scarcely possible for me to give an impromptu answer to the extremely grave and far-reaching suggestions that have been made. I clearly could not do so without very careful consideration and consultation, and what I want to say to the House now is that that careful consideration and consultation is exactly what we shall give. I give that undertaking on behalf of my right hon. Friend and the other Ministers concerned.
I will, however, try to answer some of the particular questions which have been raised tonight, but before I do so I want to make two brief apologies. My first apology is for not possessing the same technical familiarity with many of the substances about which we are talking which has been shown on both sides of the House tonight. I am even more a layman than most. I wish I could say that all these names are Greek to me, but unfortunately they are not.
My second apology is for the fact that I am the Minister answering the debate. This point was raised by the hon. Member for Stoke-on-Trent, Central. I assure the hon. Gentleman—I am sure that no one in the House will doubt my assurance—that this is not in the least a case of any empire building on the part of the Home Office. The Home Office is much more accurately described as the residual Department and I would describe myself as the residual Minister. We take responsibilities for which there is no other, obvious, appropriate location but I do not in saying that want it to be thought that there are not good positive reasons why these responsibilities rest with us. Nevertheless, we would willingly give them up if any other better 1086 arrangements could be found within the present structure.
As the subject of poisons has not been debated for a long time in the House it might be helpful if I gave a brief explanation of the present structure. I will not go into the history of it, although it has a very interesting historical development, as several hon Members have already gone into this. I have made a list of 10 or 11 Acts of Parliament governing different aspects of the use and control of drugs and poisons, and there are, of course, four Ministers who share responsibility for different aspects, and such non-statutory bodies as the General Medical Council and the Pharmaceutical Society. The Departments are Health, Agriculture, Board of Trade and the Home Office.
Since these Acts cover many different aspects of what my hon. Friend the Member for Putney referred to as" one comprehensive problem, "they deal with the control of sale, control of quality, manufacture, importation, sampling, distribution, analysis and so on and this diversity was recognised in the first Report of the Poisons Board—of which the hon. Member for Putney was a member—in which it was stated that any changes would affect not only the practice of medicine and pharmacy, but also industry, horticulture and agriculture. It also stated that, inevitably, such changes would affect a large number of interests and would be bound to cause overlapping to a certain extent. I do not find it surprising, therefore, that the Statutes are numerous and that several Departments are involved.
Although we shall give very close consideration to the suggestions that have been made tonight, it is at first sight difficult to see how all these responsibilities could be brought under one roof. The relevant Act in relation to the Prayers is the Pharmacy and Poisons Act, 1933, for which my right hon. Friend is responsible. Before that Act the Privy Council was the central authority for both pharmacy and poisons, but the Departmental Committee which led to the 1933 Act, and which reported in March, 1930, recognised the distinction of the profession of pharmacy from the control of poisons and recommended that while the Privy Council should continue to be responsible for the former a Minister in Parliament should be 1087 responsible for the second. It recommended further that the Minister should be the Home Secretary, for the three reasons which the hon. Member for Stoke-on-Trent, Central read out from the Report of the Departmental Committee. Those three reasons were first, the Home Secretary's position in relation to the prevention of crime and questions of police, secondly, his responsibility for dangerous drugs and, thirdly, his responsibility for answering for the Privy Council in the House of Commons.
I would entirely agree that no very great difficulty would arise over the latter two responsibilities if it were decided to make a transfer. But, of course, the first reason is an important one which nothing can be done to change. The Home Secretary has this responsibility in relation to the prevention of crime and police questions which no other Department has and which, I am sure, it would not be suggested should be transferred to any other Department.
It is possible to exaggerate the danger of divided responsibility which arises from the present arrangements. I have already indicated how widely the responsibilities are distributed in this and related fields, but it is right to point out that, in any case, whatever arrangements one chooses to make, two things would remain inescapably the case. First, the Departments concerned would have to keep in close touch, as they do now, and there would be inevitably more than one Department concerned.
Secondly, whatever Minister were responsible, whether he were the Minister of Health or my right hon. Friend, as now, that Minister must act on expert advice, and the expert advice would come from very much the same quarter that it comes from today. In the case of poisons, as far as the relations between Departments are concerned, the Minister of Health has two representatives on the Poisons Board, the Minister of Agriculture and the Secretary of State for Scotland each has one representative, and whichever Department were responsible there would be more or less the same representation and the Minister would have to act on the advice of that Board which certainly, as everyone has agreed, has given admirable service during the 30 years it has existed.
1088 The present balance of the Board is this: it includes nine official members from the Departments which I have mentioned, five from the Pharmaceutical Society, and one each from the General Medical Council, the British Medical Society and the Royal Institute of Chemistry. Whatever Minister it were responsible to, its composition would hardly be very different and its responsibilities would have to be very much the same as they are now.
But what is more important is the answer to the questions which have been raised tonight—such questions as how the Board does its work, how long it takes to do it, and the criteria which it applies in making up its lists. As for the way it does its work, it is open to anybody to make representations to the Secretary of State to the effect that a particular substance should be subject to control as a poison. In practice, the great majority of such submissions come either from the manufacturers themselves or from the Pharmaceutical Society, or from one of the Departments represented on the Board.
When a representation is made, it is the duty of the Home Office to collate all the relevant information on the substance in question and to anticipate a question which might very well be asked, and which in a sense has been asked by implication tonight. It is not the responsibility of the Board to carry out any tests itself. It makes use of information already available. It has neither the means nor the responsibility for testing substances itself. The information is presented to the Board. It may say that the information is inadequate, in which case further research will have to be done. But it is not the responsibility of the Board to carry it out.
The Board normally meets once a year. But there is no fixed routine. For the information of the House, the last two meetings were in September, 1961, and May, 1962. They were considerably less than a year apart. The next meeting will take place in the middle of next month. The regularity of meetings depends upon the urgency and volume of the business that has to be dealt with.
The Board, having met, makes recommendations to the Secretary of State about the controls which ought to be applied to 1089 the substances referred to it, as set out in the Poisons Rules under the 1933 Act. If the Secretary of State accepts the Board's recommendations, which of course he normally does, he publishes notice in the trade and professional journals indicating his intention to make an Instrument to give effect to the recommendations put before him. When he does that, objections are sometimes received and they are considered and the Order is then either not made or made in the form in which it now lies before the House.
In parentheses I might say that I was very struck by the suggestion of the hon. Member for Stoke-on-Trent, Central that the procedure should be stood on its head, so to speak, and everything should be on the list until it is taken off, instead of the Board's responsibility being that of putting things on the list. This is one of the questions which I know the hon. Member will not expect me to answer impromptu but to which I will certainly see that very careful consideration is given.
On the question of timing, this depends to a considerable extent on the number and urgency of cases referred to the Board and on the number of objections, if any, which are lodged by manufacturers and others when notices are published. Of course, it also depends to some extent on when the last meeting took place, because if something arises just after a meeting, unless it is an extremely urgent case, it will inevitably have to wait for some time. If it is an extremely urgent case the Board can be summoned ad hoc to deal with it, but unless it was very urgent that would not normally be done, bearing in mind that the members of the Board are busy and eminent men.
§ Mr. K. Robinson
Has the Joint Under-Secretary by any chance got any information about the number of occasions on which the Board has been summoned ad hoc in recent years?
§ Mr. Deputy-Speaker (Sir W. Anstruther-Gray)
Order. Without wishing to interrupt the debate at all, perhaps I should express a doubt whether on this Question that we are now considering,That an humble Address be presented to Her Majesty ߪ1090 annulling this Order, we are right in going too far into the details, the composition and behaviour of the Board.
§ Mr. Woodhouse
I am very sorry to get out of order. I have no doubt that the hon. Gentleman and I will find a way of exchanging an answer on these questions on another occasion. But I shall not be out of order if I say a word in answer to the question put to me about the criteria by which it is determined which substances should or should not be put on the list, because I think that is highly relevant to the subject before us tonight.
The essential consideration is whether the unregulated sale or supply or storage or transport of a given substance would be a danger to the public. Something a little more precise than that is needed for the guidance of the Board in practice and it is handicapped by the fact that there has never been a fully satisfactory definition of a poison—a fact which the Board has itself recognised from the beginning, though it has found in practice a middle way between the Oxford Dictionary definition and the definition given in Taylor's Principles and Practice of Medical Jurisprudence, which seems to work pretty well. But it is possible to define what is meant by the dangers against which the Act is a safeguard, and these are defined—I need not read them out—in the first Report of the Board, in paragraph 12, a definition which has never had to be revised.
There is a further distinction of some importance between Part I and Part II of the list which we are considering. The distinction is broadly that Part I includes substances which are used in the treatment of human ailments, and Part II includes all other substances that are in common use and which it is not necessary and desirable should be used, such as animal and poultry medicines, household articles like caustic soda and pesticides. Most of the recent additions to Part II which are included in this Order, four in number, are phosphorous compounds used as pesticides.
As to the additions to Part I, I do not know if my arithmetic is as bad as my chemistry but I made the number 33 and not 31. They include a wide variety of drugs which will be much more familiar to other hon. Members than myself, some which act on the central nervous system, 1091 Anti-histamines and diuretics to which reference has been made, some of which were originally put on the market for the treatment of anxiety states or as what I have heard described as anti-obesity agents which I take to be the same thing as slimming pills. They were being abused as stimulants and that is why they have been put on the list.
It has been argued that they should not be treated as poisons at all. In the absence of a definition of a poison, this is for me a difficult matter on which to pass judgment, but the fact is that under present legislation there is no other way in which they can be treated.
This leads me to the point raised about the desirability of changing the present arrangements. The House will know that the Minister of Health appointed a working party on this subject, and it will also know of the work of the sub-committee of the Medical Advisory Committee on which my right hon. Friend answered a Question last November. It is not for me to enlarge on those matters, nor would the House wish to question me about them.
A point I want to clarify is that it is not the concern of the Poisons Board how these substances are put to legitimate uses. The Board is concerned only with dangers to the public from their unregulated sale or supply. There are many cases of drugs having been used by the medical profession before they were considered by the Poisons Board, and inclusion in the poisons lists does not mean that they are prevented from being used for legitimate purposes.
The tragic use of thalidomide is a case in point. That we put on the Poisons List in 1960 before general public awareness had come about of the disastrous effects of thalidomide on pregnant women. The date on which it was put on the Poisons List is neither here nor there as far as the tragedy of the use of thalidomide was concerned, because it could still be used under doctor's prescription, as indeed it was. So it is important that the Poisons List procedure should not be criticised for failing to serve purposes for which it was not designed.
Nevertheless, I repeat the undertaking which I gave at the beginning, that my right hon. Friend will pay the most 1092 careful attention, in consultation with his colleagues, to all the suggestions that have been made in the debate.
In conclusion, I should like briefly to answer on behalf of the Minister of Agriculture the point raised about the change of nomenclature in Order No. 2670. This arises as a matter of internal convenience in the Ministry of Agriculture. It has reorganised its field officer staff, as a consequence of which the term divisional pests officer has been eliminated, which would have the result that under the Poisons Rules, as they stand, only the divisional executive officer would have the power to sign strychnine permits, and this could be extremely inconvenient if he were absent for any length of time. The reference toa person duly authorised by the Ministry of Agriculturehas, therefore, been substituted, and I can give an assurance that this will be an official of the Ministry of Agriculture. He will be an official not lower than the rank of higher executive officer, which I am told is often the rank of the second-in-command at a divisional headquarters, and his appointment will be conferred on him by a formal document under an official seal.
I hope that, with those assurances and with the further assurance that all the points that I have not been able to deal with tonight will not pass unnoticed and forgotten, the hon. Gentleman may see fit to withdraw his Motion.
§ Dr. Stross
In view of the assurances which have been given, I gladly beg to ask leave to withdraw the Motion.
§ Motion, by leave, withdrawn.