§ Order of the Day for the Second Reading read.
§ THE PARLIAMENTRY SECRETARY OF THE MINISTRY OF TRANSPORT (LORD PONSONBY OF SHULBREDE)
My Lords, this Bill is a Home Office measure, and was put down in the name of my noble friend the late Lord Russell. Perhaps I may be allowed to say that Lord Russell's sudden and unexpected death has removed from the House a very popular figure. His persuasive eloquence and skill in debate, combined with a very genial disposition, made him appreciated, I think, in all quarters of the House. We on the Government Bench, already small in numbers, are deprived of a very valuable public servant, and there are many in your Lordships' House who feel the loss of a very charming friend.
This Bill is the outcome of a Report of a Departmental Committee, which was set up by the last Government to examine the law in regard to poisons. The general effect of the existing law is contained in the various Pharmacy Acts dating back to 1852, and I think, perhaps it would be as well if I just summarised the position as to how the present law stands. The substances and preparations which are treated as poisons for the purposes of the 302 Acts are scheduled as such by Order of the Privy Council upon the resolution of the Council of the Pharmaceutical Society. The retail sale of all poisons and preparations containing a poison is reserved to registered pharmacists, except in the case of poisons required for certain purposes in agriculture and horticulture, which may be sold by persons licensed for the purpose by the local authority. Before granting any such licence the local authority is required to take into consideration whether in the neighbourhood the reasonable requirements of the public in respect to the purchase of the poisons in question are satisfied. That expression "reasonable requirements" has led to a good deal of dispute. The selling of poisons by retail is required to be in accordance with certain statutory provisions in regard to records and labelling. The enforcement of the law lies with the Pharmaceutical Society, and the penalty is obtained by an action, civil in form, and is paid to the society. There is practically no regulation of the wholesale sale of poisons or the manufacture of medicinal preparations containing poison.
That having been the case, it was decided to hold an inquiry, and the Departmental Committee reported. They found that the existing law in which the practice of pharmacy and the sale of poisons are mixed up, was extremely complicated, very largely obsolete, and not adapted to modern requirements. The progress made in the application of science to industry and social and domestic life has rendered some of the provisions relating to the sale of preparations containing poison unnecessarily restrictive. On the other hand, in certain respects the present control over the sale of poison and poisonous substances is far from adequate. As a result of these facts, and partly as a result of the fact that the administration and enforcement of the existing Acts lie with an unofficial society, with insufficient resources, the control provided for by the law, such as it is, is not being enforced at the present time. The existing machinery for determining what substances are to be treated as poisons was felt to be unsuitable and not in harmony with modern practice. It was felt that a non-official association whose members have a direct finan- 303 cial interest, and which does not represent all the interests affected, while it can properly deal, like other professional associations, with the discipline of its own members, is not the right body to regulate matters affecting large sections of the public, and it was felt that the best scientific, medical, and administrative knowledge and experience should be made available in regard to matters immediately bound up with the health and safety of the public.
The law should require that these matters should be administered by a Minister responsible to Parliament. The administration of the Dangerous Drugs Act and the long succession of cases of murder by poison and accidental death from poison has shown the necessity of precision in defining the legal requirements with regard to poison, and of greater care in enforcing them; and there was a strong demand from the agricultural and horticultural community that the law should be altered so as to allow firms and co-operative societies which supplied their general needs also to supply them with such substances as sheep dips and insecticides. The Departmental Committee which was set up by the last Government was a very strong one. Apart from the representatives of the Government Departments which were concerned in the administration of, or whose work was affected by, the existing law, the Committee included the President of the General Medical Council, Sir Donald MacAlister; a prominent toxicologist, Sir William Willcox; the Chief Parliamentary Counsel, the Assistant Government Chemist and three leading representatives of pharmacy. The Committee thoroughly examined the situation, took evidence from the interests affected and presented a Report, which was practically unanimous. There was a Minority Report by one member and also a reservation.
The Bill, if I may roughly summarise what it does with regard to poisons, transfers, in Clauses 13 to 18, the duty of determining what are to be treated as poisons and of administering the law, including the making of regulations, from the Pharmaceutical Society to a Minister responsible to Parliament, the Home Secretary. The Home Secretary will be assisted and guided by a Poisons Board 304 composed of technical experts, representatives of medicine and pharmacy, and representatives of Government Departments. The Bill provides for the establishment of a new poisons list which will consist of two parts—the poisons which may only be sold retail by registered pharmacists; and those poisons which may be sold retail not only by registered pharmacists but also by other persons or firms. These latter firms will have to be registered with the local authority for the purpose. The local authority will not have the power to refuse to register except on the ground that the applicant himself is unfit or that his premises are unsuitable. That enlarges the field in which these particular agricultural necessities can be sold, and there is a certain widening of the former regulations in this connection in the interests of agriculture. It is felt that this provision will meet the demands of the agricultural and horticultural community, will remove the hindrances which have existed hitherto to the efficient supply of disinfectants, and will remedy the inconveniences which attend the present restrictions by facilitating the sale of commodities in common use which are in no real sense dangerous and can properly be sold by other retail businesses.
I should explain that the sale of poisons under Part II of the Bill, in the second part of the list will be controlled by regulations which will be drawn up by the Poisons Board, and that the control will in fact be more effective than it is at the present time. It may be added that it is contemplated that the poisons in Part II will in the main be poisonous preparations sold in sealed containers and bearing appropriate warnings, which are or should be in general use for sanitary, industrial, domestic, horticultural or agricultural purposes, or as vermin killers. There is an important new power given by regulation or by rule to prohibit the sale, except on the prescription of a registered medical practitioner, of certain medicinal substances of a specially dangerous character. This is a very important provision of the Bill. Leading examples of such substances are veronal and other drugs in the same group which 305 are much in vogue for inducing sleep. Numerous deaths and suicides have been due to the use of these drugs. The need for this reform was strongly urged before the Committee and has been frequently recommended by coroners.
The Bill also provides that rules may be made by the Secretary of State after consultation with the Poisons Board. As I make reference to the Poisons Board, may I say that its constitution is set out in the First Schedule. There will be a representative of the Homo Office, a representative of the Scottish Office, two representatives from the Ministry of Health, one from the Ministry of Agriculture and Fisheries, one Government chemist, five representatives of the Pharmaceutical Society, one representative of the Royal College of Physicians, one representative of the Royal College of Physicians of Edinburgh, and one representative of the General Medical Council. There may be a few additional members. The Secretary of State, after consultation with this body, may draw up rules as to the containers in which these substances are sold, and as to the labelling of them to prevent mistakes and accidents; rules as to transport and storage; rules requiring the addition of some ingredient to make the poisons readily distinguishable (as is done at present with methylated spirit for example); and rules relating to the wholesale sale of poisons. These are matters which cannot be satisfactorily dealt with by provisions in the Statute itself.
In case it should be felt chat the Secretary of State is here assuming bureaucratic powers, I think I should explain that this is not a new power, that the Act of 1868 gives power to the Pharmaceutical Society to make regulations as to the keeping, dispensing and selling of poisons, subject to the consent of the Privy Council. In that case it is the Privy Council giving its consent, and the Society issuing the regulation. The Act of 1908 gives power to His Majesty by Order in Council to make regulations on a number of points connected with the sale of poisons required for agricultural or horticultural purposes. I think I could quote quite a number of other Acts of Parliament where the Secretary of State or head of the Department in question is 306 given power to make regulations under a Bill. For instance, under the London Traffic Act, the Minister of Transport is empowered to issue regulations after consultation with the London Advisory Traffic Committee. Therefore, this particular power which is given to the Secretary of State in this Bill is nothing new, and is only giving a high authority behind whatever regulation is issued.
The Secretary of State cannot be said in this or in any other connection in this Bill, to have an absolutely unfettered discretion, because he has to consult the Committee and to be consulted by the Committee, and he would necessarily, in the case of such an expert Committee, take their advice. But it is conceivable that in emergencies the interests of the State, or even the considerations of the Government of the day as to policy, might make it necessary for him to issue some special regulation, or to mitigate one upon which he had been given advice; but one can imagine that very rarely would the Secretary of State act without the full concurrence of this large expert Committee. There is no doubt that as time goes on these matters will require modification or addition as new discoveries are made and new substances are put on the market. Rules will be laid before Parliament, and will be subject to annulment by Parliament. I should emphasise this fact too. Not only has the Secretary of State the Consultative Committee behind him, but the regulation itself has to be submitted to Parliament and can be annulled by Parliament. I think that is a sufficient safeguard against the exercise of any so-called arbitrary bureaucratic control.
At present there is no legislative control whatever over the manufacture of pharmaceutical preparations containing poisons, although it is becoming increasingly the practice for the compounding of medicinal preparations to be done by the wholesaler and not in the chemist's shop. There is a case on record in which two children were poisoned by "Calomel" pills found later to contain strychnine. It was discovered that the pills were made by two labourers under no qualified supervision in a shed in which preparations containing strychnine were also compounded. The Bill accordingly enables rules to be made for requiring the manufacture of such pre- 307 parations to be under the control of a registered pharmacist or other qualified chemist. One of the objects of the Bill and of the rules to be made under it will be to make it more difficult for persons to obtain poisons for criminal purposes without much fear of detection. Dealers by wholesale as well as by retail will be required to keep proper records, and will be subject to supervision. Clause 3 also provides for the registration of the actual premises, and the Bill (in Clause 20) simplifies the procedure for the recovery of penalties.
As regards pharmacy, the Bill makes important alterations in the existing law relating to the practice of pharmacy. The Departmental Committee was not charged to review the whole field of pharmacy, but in its inquiry into the control of poisons it was led to the conclusion that certain changes in the provisions of the existing Acts relating to pharmacy were important, and ought to be carried out in the public interest, which requires that pharmacy, to which the monopoly of the retail sale of medicines containing poisons is given, should be kept in a high state of efficiency. When it is suggested that the Bill should be extended in order to deal with what no doubt still is the rather chaotic condition of the law with regard to pharmacy outside the realm of poisons, I fear we could not extend the scope of the Bill to go beyond the perhaps narrow limits which have been laid down. The Select Committee recommended, and provision is accordingly made in the Bill, the strengthening of the representative character and the disciplinary powers of the Pharmaceutical Society. It makes every registered pharmacist a member of the Society, whilst leaving the Privy Council as the central authority for the pharmaceutical profession, as it is already for the professions of medicine and dentistry. The Bill strengthens the Privy Council's relationship with the Society by giving it power to nominate three members of the Council of the Society. This is very necessary in view of the wider powers to be given by Statute to the Council of the Society in regard both to the control and protection of the profession.
The whole status of the Society is raised, while its powers are extended and its power of supervision increased. 308 At present there is practically no disciplinary power over the profession of pharmacy. A pharmacist cannot be removed from the register for misconduct, except in the case of his conviction for an offence against the Pharmacy Act. The Bill provides for the Statutory Committee to be appointed by the Council of the Society, with a Chairman of legal experience to be appointed by the Privy Council, before which the case of any pharmacist guilty of a criminal offence or of any conduct which renders him unfit to be on the register, can be brought, and which will have the power, subject to an appeal to the High Court, to remove him from the register.
The Bill also goes far to meet the pharmacists' desire for increased protection in regard to titles, but at the same time it recognises the right, which is denied by the existing Acts, of a scientific chemist, such as a member of the Institute of Chemistry, to use the title of chemist for purposes other than those of retail business. The Bill definitely places upon the Society the duty of enforcing that part of it which deals with pharmacy and affects the pharmacists, and increases the powers of the Society in this respect and also their revenue. The aim of the part of the Bill relating to pharmacy is, in short, to increase the status of the profession, and to maintain a high standard in the profession, and it is manifestly in the public interest that this should be done. The Government have been in close touch with the Society. There are still points of detail outstanding which, we hope, may be adjusted, and we are ready to put down Amendments on the Committee stage. There have also been consultations with the county councils.
Since the Bill was put down for Second Reading the noble Lord, Lord Dawson, has put down a Motion for its rejection. I sincerely hope that it is not on account of any main principle on which the Bill is founded that he objects to it. If it is on any details we shall, of course, be prepared to listen very attentively to such an authority as the noble Lord if he has any suggestion he wishes to make. I trust that he will see that on that sort of point adjustments may be made at the Committee stage. May I urge, therefore, 309 that he should not persist in opposing the Second Reading of this measure? I beg to move.
§ Moved, That the Bill be now read 2a.—(Lord Ponsonby of Shulbrede.)
§ LORD DAWSON OF PENN, who had given Notice that on the Motion for the Second Heading, he would move, That the Bill be read 2a this day six months, said: My Lords, this Bill aims at making many important changes affecting both the practice of medicine and the practice of pharmacy, both of which I may venture to say have close relationship with the public weal. The provisions of this Bill have been drawn up without anything approaching a consultation with the medical profession who as a natural consequence are affected by the Bill. Those people who are responsible for having drafted this Bill are people who are experts in their own callings in life, but they have ventured to put together this Bill without finding out from the people who really know. The noble Lord did say just now that the Pharmaceutical Society had been consulted. Perhaps I may point out that medicines are prescribed by, and the handling of poisons mainly rests with, the members of the medical profession.
§ As a matter of history this subject started with a Departmental Committee which was instructed to consider and report whether any modifications were necessary or desirable in the Poisons and Pharmacy Acts. Of the distinguished members of that Departmental Committee there was only one practising physician. When I remind your Lordships that practising physicians comprise roughly three quarters of all the doctors of the country, I think you will realise that that was not a very adequate representation. That would not have mattered if wise steps had been taken later. It is true that the Departmental Committee did listen to witnesses and did hear two Fellows of the Royal College of Physicians and take their evidence. But when it had completed its Report it proposed very considerable changes—changes which involved the dispensing of drugs and the question of poisons.
§ At that stage, before the Department concerned sought to put these provisions 310 into a Bill and present them to your Lordships' House, one would have thought that it would have occurred to them to have taken conference with representatives of the medical profession, with the Royal Colleges, with the British Medical Association, with those recognised authorities that have to do with the care of the sick and the health of the nation. I could not bring myself to believe that this had taken place, although it was very unlikely that I should not have known, and therefore I took special steps to find out whether any such conference was held, and I find there was none. This Bill is presented to your Lordships' House without the approval of the medical profession at all. They are not in a position to approve or disapprove because the Bill has not been submitted to them.
§ The Department responsible for this Bill, which concerns these large matters of health, is the Home Office. If the Ministry of Health had had charge of this Bill there would have been a little more justification, because on the staff of the Ministry of Health there are gentlemen—apart, I need hardly say, from their intrinsic abilities—who have some knowledge of the day-to-day practice of medicine. But on the staff of the Home Office there are few medical men, and, although we all know they are men of high standing in their own domain, of the practice of medicine they know nothing. Yet these are the people who are to have the last word in advising the Secretary of State as to what is right or wrong in handling the difficult questions of drugs and poisons. The point of view of the Home Office on the matter of drugs is the point of view of criminal intent and drug addiction, and extremely well they do it. But I do suggest to your Lordships that the most important question in the matter of drugs does not concern that small fraction of the population who are given to addiction or who have criminal intent. Drugs and poisons in their day-to-day use are-matters which concern the general health of the nation and therefore should be considered by those who give up their lives to the study of these very intricate subjects.311
§ My next point is that you cannot separate drugs from poisons. With the modern development of medicine the number of medicines that are prescribed by medical men get fewer in total, but the medicines they prescribe are prescribed with a much more precise knowledge of their composition. That is due to the very satisfactory progress of pharmacological science. The result is that a large proportion of the drugs used are potential poisons and the same substance which is wholesome if it is given in the proper dose becomes a poison if given in excess. There are examples which are familiar to all your Lordships. Take, for instance, strychnine, morphia, heroin and a large number of new sleeping draughts so necessary in our modern life, such as veronal, aspirin, medinal. All those drugs have come into use owing to the high pressure of civilised life. But these very drugs given in excess become poisons. Therefore I want to emphasise the point that no distinction can be made between a substance which is a drug and a substance which is a poison in the large majority of instances.
§ It therefore comes to this, that in deciding very intricate questions as to whether particular drugs should be put into the scheduled list you have a highly technical and difficult question which can only be decided by those who are intimately associated with the specialised knowledge of clinical medicine, with the specialised knowledge of pharmacy and with the specialised knowledge of chemistry. How has that been met up to now? Not at all badly, for the constituted authority under the present law is the Pharmaceutical Society. There you have a body of expert pharmacists, who are best fitted to decide whether a given substance should go into the schedule of poisons and be protected as such. On the whole, they do their work very well because they are a skilled body. I am not denying that you could make that body even better than it is by adding to those skilled pharmacists one or two skilled chemists and a representation of skilled hospital physicians.
§ But what does this Bill propose to do? It proposes to take the administration of poisons—and this is one of the central pillars of the Bill—from this expert body, which has, as is proper, a very con- 312 siderable discretion as to how it should act, and transfer it to the Secretary of State, who is to be advised by a so-called Advisory Committee. I will show your Lordships that the Advisory Committee is a sham. The Secretary of State has power to do almost anything. First he appoints the Chairman, then he can appoint four additional members, and he has power under another clause in the Bill to override advice and to act on his own terms. The real authority in regard to poisons will be transferred to permanent officials at the Home Office, for no Home Secretary can know anything about the technicality of poisons, and he will be subject to the advice of the officials of the Home Office, who know nothing about clinical medicine and whose point of view is really confined, and very ably confined, to people who are drug addicts or who have criminal intent.
§ If I may digress for a moment, let me consider the Board. It can consist of eighteen members and, to deal with this highly technical matter, there are to be two physicians, one appointed by the Royal College of Physicians in London and the other by the Royal College of Physicians of Edinburgh, and then, scattered about, there are to be people from this Ministry and people from that Ministry. In other words, it will be an out-and-out bureaucratic body. Most of the members will have very little knowledge of the subject, and the people really concerned with the care of the sick, the medical profession, will have little or no power. It will be in the power of the Secretary of State to overrule them and to act entirely as he pleases. I put it to your Lordships that here is a body, on the one hand, which has been working for years most satisfactorily, under the control of the Privy Council, composed of expert pharmacists (and strengthened, I hope, in due course by expert doctors), people who spend their lives in association with the scientific aspects of drugs and the medicines that are mostly concerned with the use of poisons; and they are to be replaced by this extraordinary body, which aims at centralising all power inside the Home Office. I submit to your Lordships that it is a downright bad provision and I venture to say that, if the Home Office had thought it necessary, if they had 313 condescended even to have consulted the members of the medical profession before they issued this Bill, there might have been no difficulty in convincing them that the right people to manage technical affairs are people with technical knowledge.
§ LORD PONSONBY OF SHULBREDE
May I remind the noble Lord that this Report of the Committee, with the Bill attached, has been out for a year and two months, and no comment has been made, until the noble Lord speaks to-day, by the medical profession?
§ LORD DAWSON OF PENN
That does not in the least alter the fact that the Bill has been issued without consulting the people most concerned, the people who possess the knowledge. Let me remind your Lordships that this is not the first occasion on which this has happened. There has been a great deal too much of this. Time after time measures are brought forward without proper consultation with the medical profession. I would remind your Lordships once more that the people in official positions in the Government Departments, excellent as they are, are entirely unacquainted with practice, and represent only about one-quarter of the medical men in the country. Although it is quite true that the Bill has been out for some time, the Bill should not, I think, have been brought out at all without such a conference as I have suggested having first taken place. I have little doubt that, if such a conference had taken place, these objectionable provisions might not have been there.
This Bill includes two parts, dealing with pharmacy and with poisons. We all wish to see an improvement in our pharmacy. If there had been consultation with the people who know something about pharmacy, the provisions would have been far better than they are. I will supply one instance. It is part of the law that insured persons shall have their medicines prescribed by doctors and dispensed by registered pharmacists. That is a very proper provision but, by some curious anomaly, if you are a non-insured person no such protection is given, and if I write a prescription today I have no power to demand that it shall be dispensed by a registered phar- 314 macist. Among all the clauses in this Bill this has not been put right, which shows how completely foreign the subject is to the people who have ventured to try to put the Bill together. Any medical man would have told them that this part of the law needs to be put right. From that example you can judge many others. If you look at medical history, you will find that in the fourteenth century, in the time of Siena, it was laid down that no medicines were to be dispensed except by a registered apothecary. We are behind in those matters. No medicines should be dispensed except by registered pharmacists or under the supervision of a doctor.
I pass to the question of poisons, and there again I say that this is the wrong body to put in. Looking at the matter more from a general point of view, is it not true that the burdens of government are becoming increasingly heavy on the shoulders of responsible Ministers? That is partly due, no doubt, to the much greater needs of modern life, but it is also because, with the progress of life, specialised knowledge becomes more and more essential to successful government. It is impossible for any Government Department, able as the civil servants are, to be intellectual Whiteleys. Accordingly I think the concentration of functions, as proposed in this Bill, is unsuitable, for people are invited to carry on the work without training or knowledge, transferring it from those who do know about it. You are going to have this concentration, and it is going to lead to inefficiency.
Is not the proper principle of government, with an increase of knowledge, to delegate rather than to concentrate, to unburden some of the difficult technical questions on semi-autonomous bodies? Has that not been recognised by various Governments? Was it not recognised in the case of broadcasting that that highly technical question required to have a specialised autonomous body, in order that it might be conducted well and scientifically? The same thing has been applied in regard to radium. A short while ago there was a Radium Commission, with a Government representative on it, it is true, and I would welcome representatives of special knowledge and practical 315 education if the Pharmaceutical Society and medical societies were left to look after, as they should be, this difficult question of poisons. I put it to your Lordships that the right policy of the Government should be not concentration and centralisation—that simply means mechanical government—but rather delegation of these difficult problems to some autonomous bodies, as is done with broadcasting and as I believe the present Government had in mind to do with transport.
I submit that that is the right course to take with this difficult question of drugs and poisons. This Bill traverses the sound principle of government. It has been put before the House without having been approved by the people who really know about it, so far as medicine is concerned, and I would point out the unwisdom of taking away from a profession, whose life is spent in dealing with these intimate problems, the authority which they have very well carried out in the past, and giving it to a small centralised authority, with an Advisory Committee, which has no real power and which can be completely over-ridden by a Secretary of State and by people with a very imperfect knowledge of the subject with which they are called upon to deal. It is for these reasons that I ask your Lordships to reject this Bill. I may say that I am not against the improvement of the profession of pharmacy. It is part of the policy of the medical profession to bring together these ancillary callings and to raise their status; but how can that be done except by people acquainted with what is needed on the educational side and on the administrative side? If, by agreement, a suitable measure could be produced, as I have little doubt it could, I am not against change as such—far from that—but it must be change which is an improvement and not something like this Bill, which is nothing but a studied reaction.
Leave out ("now") and at end of the Motion insert ("this day six months").—(Lord Dawson of Penn.)
§ LORD ASKWITH
My Lords, I rise to endorse the words of my noble friend Lord Dawson of Penn with regard to the rejection of this Bill, unless the Government can show that it is possible to ex- 316 tend it in such a way as to give that wider scope for what is desired or aimed at by both the medical profession and the body with whom I have been in consultation—namely, the Pharmaceutical Society. Before mentioning my points I would wish to endorse from the Back Benches the remarks which the noble Lord who introduced this Bill made with reference to the late Earl Russell, who was to have taken charge of this measure. So many comments have been made to me by noble Lords on the Back Benches, as to their admiration of Lord Russell's ability and growing popularity, especially since the most admirable manner in which he conducted the Committee stage of the Road Transport Bill, that I feel, without any derogation from the abilities of the noble Lord who has introduced the Bill, that Lord Russell's knowledge and skill would have been of great value in dealing with this difficult measure.
I associate myself, as I have said, with the remarks that my noble friend Lord Dawson of Penn has made with regard to the administration of this Bill. The Advisory Committee is drawn, as many Advisory Committees are, from all sorts of people, many of whom could scarcely dispense a milk and soda, much less a gin and seltzer, from their knowledge of medicine. As Lord Dawson has pointed out, it would be much better if this difficult subject could be dealt with by those who have some knowledge of medicine, and the effects of those poisons which are included, as well as the effects of other inventions which may be produced and may come within the poison area. The Pharmaceutical Society was established by Royal Charter in the year 1843, and, I think, since 1862 they have had the control of the question of poisons. By this Bill there is taken away from them a large portion of their power, without the alteration in their constitution which they much desire, or any widening of the sphere which comes within their purview. This power is given to a Poisons Board—a very unsuitable name—composed of persons who can scarcely deal adequately with such a wide subject as this.
Apart from that, if it is confined to poisons alone, this Bill, I am informed, would be absolutely worse than useless. It has many points which the Society would welcome, but the Committee upon whose report it is based was appointed 317 under its terms of reference to deal with poisons, and the whole Bill has to do with poisons. It is no fault of the Government at all—it is not a matter to be disputed among parties—but if it is confined to poisons only it is quite worthless. If, however, it can be extended, so that the question of dispensing medicines and of extending the advantages given to those who come under the national health insurance scheme to other people, may be dealt with, then it might be a very valuable measure; but in addition to poisons usually considered to be within the term poisons there should also be power to extend its provisions. Without that extension the Society say the Bill would be worthless. It would not deal with such subjects as vaccine, thyroid glands, sera, etc., which, unless looked after, grow old and stale and may become poisonous. Also there should be elasticity, by which new substances which may be invented or become poisonous in the estimation of science in the future can be included in the poisons list, and be dealt with by the Board or by any Board which may be established.
One of the great objections to this Bill is that there is not sufficient control—that there can be shops set up by anybody for the sale of substances which may be very deleterious. In one city in the north that has been particularly rife and yet this Bill takes away some of the control which existed beforehand as to who should be permitted to dispense medicines or to sell poisons. A licence had, before this Bill, to be taken out under the auspices of the county council, who were to take into account the requirements of the district. Under the Bill as drafted any person can apply, and apparently, unless there is objection to his personality or to his premises, a licence has to be granted to him. That is considered to be much too wide; but it is, I think, a Committee point.
The other matter of importance for a Committee would be the widening of the Pharmaceutical Society so that there could be by Statute two different grades, as in the legal profession, of those who passed different examinations and became very learned in the matter, or who, at any rate, were sufficiently good, under the supervision of a doctor or by their own knowledge, to dispense medicine. From that control a very difficult ques- 318 tion would arise as to the exceptions which were to be made. There are questions connected with the great chemical houses, the methods by which people should sell their products, the sending of packages, the keeping of stocks of arsenic or what not, of which the labels come off and where the person knows nothing whatever about the contents and the dangers of the contents—how, within the four corners of the Bill, such delicate matters could be promoted. Therefore at present, unless my noble friend, on the reply of the Government, feels that he can safely withdraw his Amendment for reading the Bill a second time six months hence, I shall most certainly, if he divides, go into the Lobby with him.
THE EARL OF ONSLOW
My Lords, I should like, before saying anything else, to associate my colleagues behind me and myself with the words which have fallen from the noble Lord opposite and from my noble friend behind me in regard to the late noble Earl, Lord Russell. Your Lordships will, I am sure, regard the untimely death of the noble Earl as a great loss not only to your Lordships' House but to the country. I remember when he conducted those two Bills to which my noble friend referred that, on the Third Reading of, I think it was the Mental Treatment Bill, the noble Marquess, Lord Salisbury, the Leader of the Opposition, congratulated him on having carried through those two Bills in a manner which was a model for any noble Lord in charge of a Bill, and I think that all your Lordships endorsed that remark. Although the large majority of your Lordships' House were not in agreement with the views held by Lord Russell, I think he was universally liked and esteemed in every quarter of the House, and we all deeply mourn his loss.
I come now to the Bill which we have before us. I wash my noble friend Lord Brentford were here to-day, because I understand that the Bill was drafted upon a Report of a Departmental Committee appointed by him when he was Home Secretary. I was rather surprised to hear from the noble Lord, Lord Dawson of Penn, that he took exception to the findings of this Committee, because of the fact that it did not consult sufficiently with the medical profession. 319 But the noble Lord told us that distinguished members of the medical profession were members of the Committee. I think the President of the General Medical Council was one, Sir William Willcox was another, and distinguished medical men were examined before the Committee as witnesses. So that I think it is only fair to the Committee and to the noble Viscount, Lord Brentford, to say that every reasonable step was taken to permit of consultation with, and obtaining the advice of, those who are most competent to give it from the medical point of view.
The next point that was taken was that these powers which the Home Secretary assumes under the Bill are wide powers and unsuitable to be exercised by a Secretary of State. I have had a certain amount of experience of these questions of administration, and it is the usual practice—and I should be almost inclined to think that it was really the universal practice—that the Secretary of State, the representative of the Government, the servant of Parliament, is the individual who has the last word in all these matters. Somebody has to be responsible, somebody you can get at, and not an advisory board, or anything of that kind, but a member of the Government which is responsible to Parliament. I think that is the constitutional and usual practice. I know the matter has often been argued before from other points of view in regard to other matters, for example the question of borough extensions, but when I had the honour of being Chairman of the Royal Commission on Local Government we had many witnesses complaining that the last word was with the Minister, and that it should really rest with an independent body. But that is really not a workable proposition. Ministers take the advice of experts, hold inquiries and have Committees, on whose views they act. The last responsible person must, I think, be always a person who is responsible to Parliament, otherwise the system does not work.
The noble Lord took exception to the fact that it was the Secretary of State for the Home Department who was the Minister responsible. As a matter of fact, it is the business of the Home Office to look after these matters, but that is really a minor matter. It is a matter of convenience. It does not matter whether 320 it is the Minister of Health or the Home Secretary, because I think that if the noble Lord had behind him as much experience as I and many of your Lordships have had of the inside working of Government Departments, and had served there, he would know that in a Government Department consultation with other Departments, on any point, even the most minor point, is always going on. I think it will be agreed that there is very often delay by consulting the Home Office, the Foreign Office and other offices; and not only offices but public bodies. Personally I am inclined to the view that it is just as well to consult everybody, and I think that that objection which the noble Lord has raised is hardly one which, if examined, can be entirely sustained.
The next matter was the question of the Advisory Board. I think that the noble Lord, Lord Dawson of Penn, was inclined to think, from the constitution of the Board in the First Schedule, that it might consist of persons who were not competent to deal with this question of poisons. Well, why? Surely the Secretary of State for the Home Department, the Secretary for Scotland, and the other Ministers are not going to appoint anybody who does not know the business? They will get the very best people they possibly can and appoint them to the Board. There are many advisory boards of this kind, and I think your Lordships will agree with me that they always consist of competent persons, and persons on whose judgment the public can rely with confidence—because, of course, as the noble Lord rightly says, the Secretary of State for the Home Department personally knows nothing about the matter. I therefore see no reason to share the fear of the noble Lord that this body will not be the best body which can be obtained for the purpose. I have sometimes thought that possibly the powers of adding additional members are a little wide. Perhaps it might be desirable to limit the numbers to a certain balance of those appointed by the Government and those appointed by the Royal College of Physicians, the Pharmaceutical Society, and so forth, so as to obtain a rigid balance, and that perhaps might meet the point which was raised by the noble Lord behind me. But, generally speaking, I should be quite ready to 321 have every confidence in a Board appointed on the principle laid down in this Bill.
Both noble Lords who have addressed your Lordships against the Bill were, I think, only dealing with points which may be met in Committee. I do not say that the Bill is perfect by any means. I do not say that there may not be very many valuable additions which, on the advice of the noble Lord, Lord Dawson of Penn, your Lordships may be able to snake to it. Bills laid before Parliament are by no means the last word. That is why they are laid before Parliament. That is done in order to secure the advantage of expert criticism and advice from members of your Lordships' House and of another place. I would be inclined, therefore, to recommend that your Lordships should give this Bill a Second Reading and that noble Lords who are so well qualified should address themselves to the various points in Committee by way of improving it. Indeed, the speech of the noble Lord, Lord Askwith, led me to think that there was very little against the Bill in principle. The whole of his criticisms were in respect of points which might be met in Committee. I dare say they were excellent points and that he will be able to frame Amendments which will widen the Bill as he suggested, improve it and altogether make it more workable. I dare say it can be changed a great deal for the better, but I venture to hope that your Lordships will give it a Second Reading because I think the principle that lies at the bottom of the Bill is one which has your Lordships' sympathy. To give it a Second Reading and endeavour to improve it as widely as you like in Committee is, possibly, the course which is most in the public interest.
§ LORD STRACHIE
My Lords, while I am in sympathy with the noble Lord, Lord Dawson, regarding the pharmacy part of the Bill, I am rather doubtful about the poisons part of it, and I should like to know from the noble Lord in charge of the Bill to what extent it will interfere with the present local control exercised by county councils. It may be necessary to move Amendments to see that this control is not unduly interfered 322 with, and that there is not too much control by the Home Office and nobody else.
Under the part of the Bill dealing with poisons for agricultural purposes, the Poisons and Pharmacy Act of 1908 is repealed. When that Act was passed particular care was taken that the requirements of agriculturists should not be interfered with. A provision was inserted in subsection (2) of Section 2 of that Act that the local authority before granting any licence should take into consideration the requirements of the district concerned. The county councils were limited to the consideration of the reasonable requirements of a particular area. They had not to consider whether there ought to be any proper control of the people to whom they issued their licences. Although I am most anxious that every facility should be given to agriculturists and horticulturists in respect of the poisons used in their trade, I see that it may be necessary to have some control, and I think that the county councils should have the right of saying not only whether the requirement is reasonable or not, but also whether the person applying for the licence is or is not a suitable person to hold it. Then it seems to me that it would not do to say that only chemists or licensed pharmacists should sell these particular poisons. That would mean a monopoly in the area. Agriculturists ought to be able to buy their goods in the cheapest market and the only way of securing that is to have competition in the sale of such goods.
Would the noble Lord in charge of the Bill kindly inform your Lordships of the extent to which veterinary surgeons are interfered with, if at all, by the Bill? Does it alter the law very much in regard to their position? No doubt I ought to be able to find that out from the Bill itself, but I think the noble Lord will agree with me that it is a rather complicated measure and that there are a great many cross references in it. On the whole, I agree with the noble Earl on the Front. Opposition Bench in his suggestion that your Lordships should give the Bill a Second Reading. Indeed, I rather think it would not be a good thing if it were not read a second time.
§ THE EARL OF HALSBURY
My Lords, the first criticism I have to make has 323 reference to the speech of the noble Earl, Lord Onslow. He rather called in aid the fact that he had more experience of Parliamentary work than the noble Lord, Lord Dawson of Penn. That may be perfectly true, but I think my recollection is equal to his. I remember the noble Earl absolutely advocating and voting in your Lordships' House for a completely arbitrary board known as the Electricity Commission; a body without any responsibility to any member of the Government or to any sort of person at all. That Commission was to be put absolutely and completely on the top for five years. That was an Act which I think I recollect that the noble Earl was in favour of.
§ THE EARL OF HALSBURY
He thinks it is now hopeless to suggest that there should be a proper Board to deal with a question that has to be dealt with quickly and firmly, instead of a Board which he says he is content to allow to consider the matter from time to time and eventually to come to a decision.
Another point I should like to bring forward is that the noble Lord who introduced the Bill said that the Secretary of State has to have an Advisory Committee and has to have a general veto, and if these things are put up in the wrong sort of tins with the wrong label, naturally he ought to be able to stop it. But that is not this Bill at all. If your Lordships will look at subsection (4) of Clause 15 you will find that:The Secretary of State may from time to time, after consultation with or on the recommendaton of the Poison Board, by order amend or vary the said list as he thinks proper.That is the list of poisons. That has nothing to do with wrong labels or putting things up in tins or cans or baskets. It is the list of poisons, and the Secretary of State has an absolute right to say on his own account: "Oh, yes, I have their recommendation, but I do not agree with it. I am going to alter the list of poisons."
May I also point this out to the noble Lord opposite? He referred to the year 1868, and said that the Secretary of State has always had these powers since that date. If he would enquire I think he would find (and I think my noble friend 324 Lord Dawson of Penn would agree with me in this) that the whole of pharmaceutical chemistry has altered since then. You are getting new drugs not every ten years but every week, and you must have a Board which can deal with these things absolutely from a definite technical point of view, and say there and then: "This is dangerous. We are going to put it on the danger list. We can do it without consulting any Whitehall Board, and can do it before any of the public get hurt by it." If they put something on which possibly is harmless they could take the ban off again and not much harm would have been done. But if you are to hold this thing up week after week till a Whitehall Committee considers it, you may get a certain number of the public badly hurt by it. Let us have a Board that can deal with the thing quickly.
The argument, however, goes a little further than that even. I have some technical experience of this matter. At the present time you will find in the Poison Schedule a very dangerous word, and it is the word derivatives. You will find such a thing as veronal and its derivatives. That is a very, very dangerous word, because it assumes that because two things are derivatives of the same thing they are also derivatives of each other, and they are not. It is very difficult to say that medinal is a derivative of veronal, and yet both are derivatives of the same original substance. It is a bad word. You want a technical board who can say definitely at once that this thing ought or ought not to be on the danger list.
Your Lordships may disagree about what I have said, but I shall end on two propositions as to which I am sure members on both sides of the House will agree with me. My first proposition is that this Bill does deal with very serious matters, and the second proposition is that in no circumstances whatsoever can this Bill ever be fought on any Party lines. It is purely a question as to whether in your Lordships' House we cannot find the best means to bring in what we all want—namely, an amelioration of the present law. I should welcome any suggestion from noble Lords on the other side of the House that they would consider with a certain amount of 325 favour some Amendments between now and the Committee stage. If they would give us that assurance I certainly would hope there would be no Division. But if they can give us no assurance of that kind then I should certainly divide with my noble friend Lord Dawson.
§ VISCOUNT LEVERHULME
My Lords, after the very interesting and authoritative speeches to which your Lordships have listened it is not my intention to trespass upon your time for more than a very few moments; in fact I would not attempt to trespass at all were it not that I think it is important the Government should realise that the need for amending and enlarging the scope of this Bill is widely supported inside your Lordships' House, as it certainly is in circles interested outside this House. What I have in mind more particularly is the need, as pointed out by my noble friend Lord Dawson, and also by Lord Askwith, of taking this opportunity, which an enlargement of the Bill would offer, of ensuring to the whole community that protection regarding the dispensing of their medicines which is enjoyed only by, I think it is, 15,000,000 odd people who happen to be insured under the National Health Insurance Acts.
It is surely one of the attributes of wise and sound legislation that it should, as far as possible, draw no distinction between the various sections of the community. Very frequently legislation has, rightly and properly, to be directed toward extending to the less fortunate members of the community the advantages enjoyed by the more fortunate. It happens in this ease that a reversal of that procedure is necessary. I hope His Majesty's Government will be as anxious in one case as in the other to see that all His Majesty's subjects are placed on the same level of security. It may be argued that none of them are affected, and that practically all non-insured persons do take their prescriptions to a qualified pharmacist. I have no doubt that applies to all members of your Lordships' House. But however safe we may feel ourselves to be, the fact does remain that it is possible, and it frequently happens, that people do, without being aware of it, take their prescriptions to shops which are not, strictly speaking, qualified to deal with them, 326 although superficially they may appear to be what are popularly called chemists' shops. In any case legislation that deals with a matter of this kind should be complete and comprehensive. Where gaps exist they should be filled up, and where anomalies are found they should be removed.
If it is urged that a measure of this kind would be endowing the Pharmaceutical Society with monopolistic powers, I would reply that it does not give them privileges very different in character from those already enjoyed by the medical profession, the legal profession, the chartered accountants' profession, and others which I could mention. It is not, however, the prestige of a profession which is at stake so much as the health of the community. Therefore I hope the noble Lord who introduced this Bill will see his way to give favourable consideration to this aspect of the matter. The noble Lord, Lord Dawson, referred to the fact that the medical profession had not been sufficiently consulted regarding this Bill. I would like to support what he said in that connection. In all matters of health the first person you turn to in a crisis is your own doctor, and in matters of public health the first authority we should consult is the medical profession. If any proof is needed of the advantages of having the benefit of medical advice in these matters surely we want no better proof than the speech to which we have listened from the noble Lord, Lord Dawson himself.
My Lords, I do not propose to detain your Lordships for more than a few moments, but I rise to support the views which have been so forcibly put by the noble Lord, Lord Dawson, and particularly on the ground of general policy. To my mind this Bill is one of the worst examples of Departmental usurpation. Though Parliament certainly has not time in these days to legislate on details, and must necessarily leave much to be worked out by regulations, it is not by any means always necessary or desirable to make the assumption, which Government Departments are so apt to make, that the only authority to whom the power of filling in details can be delegated is a Secretary of State. If it is held that the ultimate reponsibility must lie with 327 the Secretary of State, why should not the usual procedure be more or less reversed? Why should not the Secretary of State be given power to move an Address to revoke some order made by the Board to which the matter has been delegated?
In the present Bill the provisions in regard to the Statutory Committee and to the Poisons Board are really reduced to a farce. The packing of the Committee by the Secretary of State and the over-riding of the decisions of the Board seem to me to be quite indefensible. Arbitrary powers of that kind are always objectionable, and they are doubly so in cases like the present which must, by their very nature, be decided on technical grounds by expert advice. Delegation is certainly necessary, but in matters of expert opinion it is surely unwise to give to the Minister the power, on the advice of his own particular experts, who may perhaps belong to one school of thought, to over-ride the considered opinion of a Board set up by Parliament to determine those very points, and a Board so constituted by Parliament as to focus the different views of all the schools of thought. For these reasons I strongly support the stand which the noble Lord, Lord Dawson, has taken. I hope the noble Lord in charge of the Bill, realising the force of the arguments which have been advanced, will see his way to agree to modifying the Bill to meet the objections. If that is done I will gladly vote for the Second Reading, leaving to a later stage other points of not inconsiderable importance on which, I think, the Bill needs amendment.
§ LORD PONSONBY OF SHULBREDE
My Lords, the speeches on the Second Reading of this Bill have, I am very glad to say, shown really an approval of the fundamental principle and the necessity for some Bill of this sort. I am glad to find that the criticisms, although very forcibly expressed in some cases, really amount to criticisms of detail. I can assure noble Lords opposite who have expressed opposition that the Government intend to take into account all bodies of opinion which are closely concerned with this question of the sale and control of poisons. I think that the noble Lord who proposed the Motion for the 328 rejection of the Bill was perhaps a little unfair in saying that no attempt had been made to consult the medical profession because after all Sir Donald MacAlister must be regarded as a very high medical authority and he was on the Committee. The Committee's Report, with the Bill, has been published now for over a year, and the Government and the authorities at the Home Office would have been only too glad to have had close consultation with high medical authorities in the same way as they have had consultation with the Pharmaceutical Society. The noble Lord's fear that the Home Secretary's power of over-riding the opinion and advice of the Committee, the constitution of which he strongly disapproves of, is, I think, hardly justified. The noble Earl, Lord Onslow, who supported the Second Reading, very rightly said that the Home Secretary was some one you could "get at." If you have a Secretary of State and Parliamentary sanction as well it does make any regulation open to public attack and debate, and it seems to me that in that case control is far greater than when it is delegated to some private body who can act without the public being aware of its decision.
The noble Lord, Lord Askwith, and, I think, one or two other noble Lords in their speeches, raised the question of extending the Bill to such things as vaccines, sera and thyroid extracts. I admitted in my opening remarks that the Pharmacy Acts are in need of revision and amendment, but no inquiry has been instituted into this branch of the subject and the Government felt that it was not advisable to go beyond the actual question of poisons. I think that is the only point upon which I should have to say that we could not accept any extension or amendment of the Bill. With regard to all the other points raised—the constitution of the Poisons Board, the exact power of the Secretary of State to override decisions or to use an unfettered discretion—on all those subjects we should be open to consider on the Committee stage and give due weight to the expert opinion which in your Lordships' House has been shown this afternoon to be present. But I go further than this, because we are very anxious to carry everybody with us in a measure of this sort, and naturally the opinion of such a high 329 authority as the noble Lord, Lord Dawson, carries so much weight that we should not dream of going forward feeling that he was in opposition even though we had a Division and the Government succeeded in getting a majority. It would be unsatisfactory on a technical Bill of this sort to have any division of Opinion at all.
If the noble Lord would entertain the idea, I would suggest that between now and the Committee stage a full consultation should be held with representatives of the medical profession. It might be possible, for instance, for the Registrar of the Royal College of Physicians to get together a representative body who could consult with the officials in the Home Office and with those of us who will be responsible for the further stages of the Bill. I only make this reservation with regard to date. We had intended to put down the Committee stage for Thursday in next week. We would postpone the Committee stage to Thursday, March 26. Beyond that I am afraid I could not consent to go, because unless the Bill can be sent to the House of Commons before Easter its prospects of passing into law before the end of the Session would be very remote. If, therefore, the noble Lord who has moved the rejection of this Bill could see his way to withdraw that Motion on the understanding that a consultation is held with the medical profession, and that all these points of difference are gone into carefully so that when we get to the Committee stage we might find that by amendment we could make this into an agreed measure, the Government would be very glad to fall in with that.
§ LORD PHILLIMORE My Lords, I only want, to ask a question on one point to clear up a matter to which considerable attention has been paid in the debate. Am I right in understanding the noble Lord to say that the Government was opposed to the extension of the Poisons List, to any extension whatever? I did not quite catch what he said.
§ LORD PONSONBY OF SHULBREDE
No, I did not intend to convey that. I thought that in some of the speeches on behalf of the Pharmaceutical Society there was a desire to extend this Bill still further in the matter of dispensing—to medicines that did not contain poisons.
§ LORD PONSONBY OF SHULBREDE
Although there may be need for a review of the Pharmacy Acts in this connection, this Bill is exclusively intended to deal with poisons.
§ THE EARL OF HALSBURY
May I ask the noble Lord whether it is quite impossible to put off the Committee stage until after Easter? My reason is that I know that several others who are very interested in this matter would find it very difficult to be in this country on that date.
§ LORD PONSONBY OF SHULBREDE
I should be very sorry to inconvenience any noble Lord who is interested in this Bill, but I am afraid that Government business makes it necessary for us to get the Committee stage on March 26.
§ LORD ASKWITH
May I ask the noble Lord one question? If he is going to have a learned deputation from the medical profession, the Pharmaceutical Society and others, could be not, without a long inquiry or a long Commission—I believe that the last Commission took three years—enquire from the experts of the country whether it would not be an advantage to have vaccines, thyroid matters and sera introduced within the power of the Poisons Board set up by the Bill?
§ LORD PONSONBY OF SHULBREDE
Whether we should embark on that subject without a rather special inquiry is, I think, very doubtful.
§ LORD ASKWITH
I am told that this Bill is a very difficult Bill, and very worthless, unless such matters are allowed. Can the noble Lord give an indication that a speedy inquiry will be set up to see whether an amending Bill might be brought in to include those substances?
§ LORD DAWSON OF PENN
May I express my appreciation of the concession that the noble Lord has made? My only difficulty is that the subject is a complex one and we have been waiting for weeks for this Bill to consider it. It is difficult, a short time before Easter, for me to make a promise that such a conference could be implemented with any chance of success in dealing with so complex a question within the limits of a fortnight. Many of us are rather busy people, and it is impossible to put off certain engagements, as a noble Lord said. It is very difficult to get people of that kind together. That is my only doubt. Otherwise I should accept that which the noble Lord offered. I will do my best to see if it can be done in a fortnight, but I must express grave doubt whether I shall succeed in doing it. I will do my best.
§ VISCOUNT BERTIE OF THAME
Supposing this conference does not come to anything between now and March 26, does the noble Lord still intend to have the Committee stage on that date?
§ Amendment, by leave, withdrawn.
§ On Question, Bill read 2a, and committed to a Committee of the Whole House.