§ LORD HORDER rose to call attention to the enormous growth in the quack medicine trade, and to the incongruity of exercising no control over the deleterious effects of such trade upon health at a time when a serious effort is being made to improve national fitness; and to move for Papers. The noble Lord said: My Lords, I make no apology for asking your consideration of a subject which may seem to be of very much less importance than the one which has just engaged your Lordships' House. It may be thought that my topic is rather a hardy annual, but I assure your Lordships that the question of quack medicines in relation to the health of the public is not really so much a hardy annual as, in my judgment, a pernicious growth.
§ I would like at the outset to state that when I suggested dealing with this subject the first objection raised by my friends was that I should have vested interests heavily against me—the vested interests, that is to say, of newspapers and their proprietors, the large Press agencies, and those who own hoardings and posters, for it is becoming more and more obvious that the head and front of the offence in the matter of quack medicines is not the medicine but the advertisement, so often grossly misleading if not actually fraudulent. I want to deal with this question of opposition at once. I want to tell your Lordships that so far from their offering any signs of opposition I have received both help and encouragement from the reputable members of those groups that I have mentioned. For very decency's sake and a sense of duty these people are themselves taking steps to exercise a degree of control and censorship which in 1177 other countries responsible authorities impose. I have received assurances on this matter from the Proprietary Association of Great Britain, the Newspaper Society, the Advertising Association, the Periodical Proprietors' Association, and the Institute of Incorporated Practitioners in Advertising.
§ The second point I want to make at the outset is this. Seeking again for advice from all authorities in any way connected with this subject, of course I was warned that "They will say that if you as a doctor raise this subject you will be charged with trying to create a monopoly for your colleagues; you will be charged with depriving the poorer classes of cheap cures to the efficacy of which they constantly testify." Now as to this question cat creating a monopoly, may I state, what I believe to be true, that if there be a monopoly it lies with the trade, which at a cost of nearly as much as the total money spent on the whole of our hospital services, bleeds the public to the tune of between £25,000,000 and £30,000,000 a year? I am seeking to break this unscrupulous monopoly, a monopoly which successive Governments seem almost to have gone out of their way jealously to guard; witness the exclusion of patent and proprietary medicines and food from the otherwise excellent Food and Drugs Bill which is about to become law.
§ Now as to the position of the doctor. I feel sure that were my friend and colleague the noble Viscount here he would agree with me that if the doctor thought only in terms of hard cash in this matter he would actually benefit from this unprincipled trade. The doctor has eventually more patients because of this trade, and not fewer. Especially would the surgeon benefit, for cases become serious in proportion as diagnosis and treatment are delayed. Ultimately even the undertaker benefits sooner and oftener than he might. Well, in striving to cleanse this Augean stable I am not acting in the interests of doctors, I am acting in the interests of that section of the public which is least able to stand up against exploitation—poorer people, who can less afford to lose money on health than any other section of the nation, and the straitened middle classes. People who are better off, but not perhaps less foolish, can afford to pay for any damage which their adventures into quack medicines may incur.1178
§ The third objection with which I propose to deal is expressed by the folk who say: "It is all very well to be destructive, but if the citizen does not send his coupon for his lung cure, and if he does not get his diagnosis by post for his kidney trouble, and if he does not get his gastric ulcer healed with a patent powder, what is there for the poor citizen to do?" And that brings me to perhaps the most important point that I have to put before your Lordships. I submit that now—perhaps only now—we have something infinitely better to put in the place of these extremely dubious specifics. We have now available to the poorest everywhere one of the finest health services in the world, and the slogan "Use your health services" was one of the most intelligent slogans I have ever heard. Health services, constantly expanding health insurance services—these, I submit, are what the Government can and must now encourage people to put in the place of this mediaeval witch-doctoring.
§ There are clear and abundant reasons why the present chaotic state of the law in relation to quack medicines should come to an end. In your Lordships' House and in another place from time to time for the past twenty odd years unanswerable arguments have been advanced in this connection. My main reason for pressing the Motion for Papers at this time is my deep concern for the success of the concerted move that we are making towards national fitness. By "fitness" I do not mean muscular supremacy, I mean health as a basis for good citizenship and happiness. So men and women of all Parties are converging on this objective. They are all of them genuinely moved with the desire to help. On the platform where the campaign for national fitness was launched there sat men and women of all Parties. That was good. I suggest that anything directly bearing upon the basic health and happiness of the people is outside Party politics. I know from the support I have received during the past few days, when it was known that I was going to put this subject before your Lordships, that it is commonly felt that in the realm of Party politics there is no room for this question of how we should keep the nation fit.
§ The incongruity to which I refer in the wording of my Notice is apparent to everyone. On the one hand, His Majesty's 1179 Government have launched a campaign to improve the national physique, have recruited all of us whose business it is to know something about health, have set aside subsidies for the purpose of education and demonstration in regard to fitness, and have spent quite a lot of money in health propaganda. Then, on the other hand, we have this campaign of quack medicines and food, totally uncombated so far by His Majesty's Government, but led by very subtle and skilled generals, bent upon maintaining national ill-health, moral and physical, in order to have a ready market for their goods. For every hundred pounds that the Government spend on making people health-conscious quack medicine-mongers spend a thousand in making them disease-conscious. We are trying to teach people the meaning of nutrition, and the money they might spend on food they are spending on quack medicines, or on very poor substitutes for good food. These are the considerations which led me to bring this subject before your Lordships. We have recently witnessed what financial friends assure me was a most necessary and, they thought, creditably expeditious effort to limit the evil called share-pushing. Well, it seems to me that if the State so rightly protects its less wary citizens against financial sharks, protects their property, that is, it should not regard it as less important to take some steps to protect their health from wanton damage.
§ I spoke of the extent of the trade in quack medicines and of how our people spend nearly £30,000,000 annually on them, an amount which is almost the same as the sum required to maintain all the voluntary and municipal hospitals in the country. A famous group of patent and proprietary medicine vendors, catering chiefly for nervous and digestive disorders, has just budgeted for a sum of nearly £1,000,000 for Press advertisements alone during the current year. This particular group covers some sixteen preparations, if we exclude shampoos and dog and cat medicines. I see that it is about to buy the control of some six to ten more preparations. The profits on the deferred shares have risen from £40,000 to £280,000 in the past six years. In 1931 the price of the 5s. shares stood at 5s. 7d., and in each of the past three years these shares have risen to above £3. These 1180 figures give some indication of the lucrative nature of the concern and of the great expansion of the quack medicine trade. No wonder the board of this company thought it a wise thing to make a large donation to one of the London hospitals. I am unable to inform your Lordships if the donation was earmarked for the treatment of patients who had doctored themselves with the company's medicines!
§ If this were a clean trade, and if people merely spent their money on it foolishly, that would be no matter for criticism, certainly not in this connection. But what is it that is sold and bought? A few patented and proprietary things are good things, and the claims made for them, as claims go, are not unreasonable. A good many things that do little or no good and little or no harm are sold at fantastic prices. But now and again something is sold that does definite harm—not often, because, as your Lordships are aware, an inquest is a thing that puts some of these people out of business more quickly than anything else, and for that reason dangerous drugs are as a rule avoided. All the same, there is nothing in law to prevent a vendor in this country from trading in some new drug not as yet on the poison schedule and concerning which experience of its action is required to discover the danger. In other words, the public is made the guinea pig, as it were, of the unscrupulous vendor.
§ But there is an enormous number of preparations which are fraudulent in the degree of the advertisement—fraudulent in the claims they make and very fraudulent in the way in which these claims change without any change in the nature of the specific, so called. The public is becoming slowly aware that certain diseases like cancer and hernia—rupture—are not cured by drugs, and the advertiser is quick to realise this. So disease conditions which are, for any reason, in the public mind are made the means of selling the same old goods. For example, the subject of malnutrition is topical just now, and a number of preparations formerly advertised to cure quite different conditions are now advertised as a cure for malnutrition. A spate of new preparations arises claiming to do the samething. The subject of vitamins having become somewhat popular, you will find that quite a large proportion of the quack medicine advertisements to-day claim 1181 that they contain "all the vitamins necessary for health."
§ Food substitutes are advertised in large quantity. There is no substitute for good food, unless it be better food. Some of us have quite recently become rather anxious about the prevalence of rheumatic disease in this country, and straightway the quack medicine vendors orientate their advertisements in our direction. In short, the more these things change, the more they are the same thing. Advertising, as your Lordships know, has become a specialised profession. The maker of quack medicine need no longer rack his own brains as to how best to overcome any reluctance the public may have in spending. He hands the matter over to the advertising specialist, together with a large sum—the larger the better—which has been appropriated for this purpose, and the thing is "put across the public," as they say. There is a rake-off for the manufacturer, a rake-off for the advertising agent, and of course a rake-off for the newspaper in addition. When we remember the enormous increase in the media through which advertisement operates—newspapers, omnibuses, hoardings, wireless, and aeroplanes now—we begin to realise also the appalling results which this mass suggestion must eventually have upon the country's health and morale. These advertisements have become a much gniver danger than the medicines they sell. Fear is the chief emotion they rely upon, so that much of this trade is, in effect, a huge form of blackmail. It is all very well to "vet" the medicine and reject its advertisement if harmful, which is claimed by some responsible newspaper proprietors, but there is poison in the advertisement. Nobody seems to "vet" the advertisements except a few papers, and let us pay them all credit for that.
This picture that I am showing of the operating theatre, with the surgeon and nurses in their masks, says:
Buy our invaluable ointment and you will escape operation, and the result is guaranteed.
There is this other picture of a strong acid burning a hole in the carpet, which says:
This is what is happening inside your stomach when it pains you. Take our tablets and you can eat anything.
Then there is this diagram of a circle, a very considerable part of which is
coloured on the poster to represent the proportion of nourishment in a certain meat juice. The representation is a lie because the stuff is mainly, as we term it, extractives, which are not nourishing, salts, and colouring matter, and the actual food value is almost negligible. "Of course everyone takes a laxative," says one advertisement, "so why not ours?" And the wretched man who does not take a laxative begins to wonder if he can possibly be well without it. "Four out of five have pyorrhœa," which is not true, says another advertisement. But the chances are so heavily loaded against the reader that the goods sell. Then these questionnaires, how subtle they are! Imagine a sensitive woman reading these questions:
Do you cry too easily? Do you ever get fits of dizziness? Are you often in fear of illness or breakdown? Have you ever been told you are anæmic? Are you extra-sensitive about what others say? If 'Yes' is your answer to any of these questions, this is a sign of dangerous weakness. Take it in time. You should begin with our tablets right away.
So I might go on almost endlessly. It is perhaps because some of our Continental friends have been reading our advertisement pages that they think that Britain has become decadent.
§ This of course is, in the language of the street, a ramp. It is not only demanding money with menaces, it is coining money out of the fears of the people. And it is not only the sick that are swindled, the well are swindled—for by what other word can we rightly stigmatise the deliberate promotion of credulity for the purpose of gain? I do not think that your Lordships can look at the advertisement columns of even the newspapers which I feel certain some of you take in the morning and feel easy about the situation. In Continental countries this pernicious exploitation is forbidden. It is forbidden in the United States, in our own Dominions of Australia and Canada there are heavy penalties for making false and fraudulent claims, and even in South Africa last year a Bill was introduced whose terms were based on the recommendations of the Select Committee of this country of 1914. It is humiliating to think that Great Britain remains complacent in face of this menace to the health of her citizens.
§ I said just now that the manufacturer got a rake off, that the advertiser got a 1183 rake off, and the newspaper got a rake off. Well, the Government get a rake off, and it is sometimes thought that this fact prevents legislation. I cannot think that that is a very powerful preventive of legislation in this country, because, all said and done, the Chancellor only nets £1,000,000 per annum out of this sordid business. Of course, he could make much more, because he does not even take the trouble to see that these gentlemen—save the mark !—are evading the Medicine Tax Act in the grossest manner. The Medicine Tax Act of 1812 is still in operation, and a few years ago the High Court described this Act as a mass of confused and obsolete verbiage. To quote only one anomaly, taxes are levied only on drugs if they are advertised as a cure for ailments; and so cough medicines and pills for backache are taxed, but chest mixtures and kidney pills are exempt.
§ It is nearly fifty years since a Royal Commission stated that the India opium revenue was morally indefensible, and within a month of the presentation of its Report Parliament approved. Well, there is the Report of the Select Committee on Patent Medicines. There are at least two copies of this compendious document, because I see the noble Viscount has a copy. But, although so compendious and apparently unwieldy, it represents an enormous amount of very useful work. The Committee sat under the Chairmanship of Sir Henry Norman, but its Report was so ill-fated as to be printed on that tragic day, August 4, 1914. But that is twenty-four years ago, and the Committee's recommendations, simple though they were—registration, disclosure, censorship of advertisements, were all the recommendations asked—have never been implemented. Why were we so prompt to protect the Chinaman and why are we so dilatory in protecting our own citizens? Yet my analogy is fairly close, because, if I may paraphrase a famous saying, "Quack medicines are the opium of our people.'
§ What is the remedy? With the best intentions, for which I give the reputable newspapers every credit, no censorship of their own will ever effectually deal with this nuisance. This voluntary effort has been on trial for more than twenty years, and things are much worse than they were. If we except the case of a few select papers, then the breathless, cutthroat 1184 race for advertisers, the struggle for clients, will determine the issue against them. It cannot be otherwise. If only one paper outside the controlled area refuses to obey a code—and there are many outside the controlled area—then the difficulty in such a case becomes insuperable. It is like people who want to be good but starve if they are good. Central or Government control would tighten up the situation at once. Now it may surprise your Lordships, but I am able to say that the people who might be expected to know, that is the owners of large newspaper combines, support me in this contention. I have letters, quite a number, from noble Lords to this effect, and they agree with me that the evil must be attacked at its source. I take it that when noble Lords wish me luck having read the wording of the Notice, and when noble Lords say "I am entirely with you," then they mean what they say. Now these papers which are trying to-day, but trying unsuccessfully, to control the grosser forms of exploitation of their readers would by some central control be protected and not penalised, which at present they are.
§ The noble Lord, Lord Southwood, who is President of the British Advertising Association, tells me that an important department of this Association devotes its efforts to the elimination of advertisements of undesirable products. Yet as an example of how impossible it is to carry out this good intention in practice, here is an advertisement of Yadil in this week's John Bull and it is fourteen years ago that Yadil was so thoroughly exposed in three successive issues of the Daily Mail that its sale was entirely stopped. This was the stuff, some of your Lordships may remember, that did not contain the harmless ingredient which it was alleged to contain, but it contained one per cent. of formalin, an intense irritant, of which it made no mention. True, the figure "1935," in brackets, appears now after the name Yadil. This may mean something, or it may mean nothing.
The point is that this monster is hydra-headed, and it can only be destroyed by being strangled at its birth. Now it is only fair to admit that a few things have been done since 1914, and they are to the good. The Venereal Diseases Act made it an offence to advertise medicines for venereal disease, and the very success of this veto shows that measures of this
kind are both practicable and effective. Then there were the Pharmacy and Poisons Act, the Dangerous Drugs Act, and the Therapeutic Substances Act; but good though all these laws are, I submit that, taken together, they do not touch the real problem which I am presenting to your Lordships to-day. In the Food and Drugs Bill, to which your Lordships have recently given a good deal of thought and time, there was a great opportunity of dealing with this pest, instead of which quack medicines are specifically exempted from any penalties under that measure, an exemption which renews automatically the exemption that was made in the previous Food and Drugs Act of 1928. In Part I of the new Bill Clause 4 deals with defences available in proceedings taken under the Bill. Subsection (3) contains the words "where the food or drug in question is the subject of a patent in force," and subsection (5) reads:
that the article supplied was a proprietary medicine and was supplied in response to a demand for that medicine.
In short, no action could succeed under that measure if it were attempted.
When the noble Lord, Lord Mamhead, introduced a powerful deputation on this matter to the Minister of Health in July, 1935, Sir Kingsley Wood, in his reply, said:
I should like to see something in this direction. I have indicated that I have never understood why we have never come to such an agreement as has been arrived at in other countries. It was left to be considered in relation to the Government's general programme of legislation.
Now, when it is clear that the Government's general programme of legislation did make that possible, the whole subject is side tracked. A record of the Bills that have been introduced in your Lordships' House and in the House of Commons since 1920 makes very gloomy reading. I do not propose to take up the time of your Lordships' House by dealing with them. They have generally died of that common disease, lack of Parliamentary facilities, though in one or two cases I would suggest that a more accurate explanation of death would be felo de se. On the last occasion the failure of the Bill in the House of Commons was attributed to its having had the bad luck to be introduced on the day of the Grand National.
§ There does appear to be a hoodoo resting upon Private Bills dealing with this matter. I earnestly trust that your Lordships will support me in the efforts I am making to persuade His Majesty's Government to tackle it by a Government measure. The machinery would be easily forthcoming. My friend and colleague who now has charge of the Ministry of Health must by virtue of his training and experience have exceptional knowledge of the whole of this subject, and must be more fully alive perhaps than some of his predecessors in this responsible office to the importance of this matter. I cannot but hope that when in a letter to me recently he spoke of certain matters crying out for immediate attention, he had this one amongst them in his mind. I believe that he would have the opinion of the country behind him and I think I have good reasons also for believing that the Press as a whole would support him. A Bill dealing with this would be a most fitting corollary to the efforts that we are all making for national fitness. It would demonstrate clearly to the world that His Majesty's Government are really serious in regard to their health campaign. It would close a wide gap in our defences, a gap which is increasing month by month and through which at the moment the enemy is pouring and spreading havoc amongst our people. Once behind the lines there is no limit to the damage which this particular enemy can do. I beg to move for Papers in this matter.
My Lords, you will perhaps excuse me if I bring the lighter artillery of the lay voice to the support of the big guns of the medical profession which you have heard and I believe are going to hear on this subject. A few days ago I was entertained to see in an American newspaper a picture depicting the private office in a large advertising firm into which an employee of the firm comes holding a piece of paper, waving it with enthusiasm and saying "This will make these hypochondriacs sit up." That may have its humorous side, and the hypochondriac perhaps does not get much sympathy, but I think the trouble goes further than that. I think it comes fairly near home to all of us. I imagine that there are very few members of your Lordships' House who are unaware of what is meant by halitosis. I think your Lordships' fathers would have been ignorant of this unfortunate thing, 1187 which their dearest friends apparently would not have told them about. They would have criticised everything else, from the length of their noses to their intelligence, but apparently something was hidden from them. That, I think, was one of the earliest cases of which the noble Lord, Lord Horder, has spoken, but advertisers have gone to far greater lengths since then, and I think far more dangerous lengths.
I have seen recently a number of advertisements of the same type, but which appeal rather to the emotions of people. They have pretended, shall we say, that a young woman's failure in her love affair may be due to some defect which a preparation which is to be sold can cure. They suggest that a husband's failing interest in his wife may be due to something of the same sort. I suggest to your Lordships that to people in this unhappy condition it is a crime that additional sorrows should be added unto them and that their money should be extracted from their pockets for such a purpose and at such a time. In fact I suggest that these modern advertised products are the present-day equivalent of the old love philter. It is now, I believe, illegal to sell love philtres, though from the sale of these preparations one suspects that they would have the rich market which they used to have.
The noble Lord, Lord Horder, has dealt, as of course he can far better than I can, with the details of the damage done by these medicines and with the measures which can be and should be taken to prevent them. I would, however, like to suggest that the recommendations of the 1914 Committee in one respect at any rate did not go far enough. They suggested the registration of preparations and disclosure to a Government Department of their contents. I cannot think that there is any reason why this disclosure should not be absolutely public. I would suggest, in view of the experience which we have now of the extraordinarily abstruse and incomprehensible nature of disclosure of contents—which is made in many cases incidentally to avoid the Government tax—of secret remedies, that there should be a legal obligation to make them in a form which is generally accepted by the medical profession, so that there should not be any misunderstanding 1188 as to what is contained in any preparation that is sold. It will, of course, be said that that would not affect a great many of the public, who would be unable, even if they knew the nature of the actual drugs in a preparation, to judge for themselves of the efficacy of those drugs. That is true, but a purchaser would always be able to consult his medical practitioner or the chemist from whom he bought it as to the value of a particular drug.
The noble Lord rightly repelled the suggestion that members of the medical profession have any personal or financial interest in the repression of this trade. The medical profession has, I think, shown a really admirable attitude since the eighteenth century in forbidding to members of the profession the use of secret remedies and insisting on publication. Nevertheless I think that something might be clone by the medical profession itself in co-operation with the educational authorities. I suggest to the noble Lord who moved this Motion to-day that perhaps it would be possible to give more public instruction in the use of household remedies. In that way people who have headaches would not buy some kind of headache powder; they would know, for example, that an ordinary aspirin was in any case the active drug in any preparation which they were likely to buy, and that it could be obtained in a purer form at a very much cheaper price direct from the chemist. That is, naturally, only one of many possible examples. I suggest that the general public, in the interests of its health, should be educated to appreciate the use of common drugs. The only defence that is made, I believe, to these quack medicines is that, even though they are sold at a price—-and I have had some figures given to me—as high as a hundred times the price which they cost their makers, they are still cheaper than a medical consultation and a prescription. I believe that if the general public were further instructed in the use of simple drugs, that one defence, which is not in any case a defence for the purely secret remedy, would disappear. I hope that the Government will be pleased to-day to give us a favourable answer. If they are not, I trust that the noble Lord who has moved this Motion will press it, and I am convinced that he will receive support from all sides of the House.
§ LORD ADDISON
My Lords, I intervene for a few minutes to support my noble friend Lord Horder, who I am sure has rendered a conspicuous public service by bringing this subject before your Lordships. Although it is very late in the Session, as we all know, I hope that the representative of the Ministry of Health will give us encouragement in this matter. The noble Lord has studiously understated his case, and he has done it deliberately. In 1920 or 1921 I remember, as Minister of Health, being a party to the initiation of proceedings which led to the getting-together of a joint conference which represented all the various interests concerned. I have here, and I expect your Lordships have had, the various recommendations which came from a body on which medical men and newspaper proprietors were jointly represented. This step does not go very far; it is a very tentative and moderate approach to the matter. I am only mentioning it to emphasize the certainty that if the Government will remove what the noble Lord has described as the fear which besets Private Bills and take upon themselves the responsibility in this matter, they will be supported much more vigorously and widely than they suspect. I believe that the general public will be glad to be protected against this exploitation, which has been enormously increased during the last few years. We are supported to-day by the unanimous recommendations of conferences which occupied many years and which were representative of the views of trades, medical men, newspapers, advertisers and the rest. But, as Lord Horder said, it is impossible in existing circumstances for any newspaper which wishes to adopt a good tradition to sustain it, sometimes, in face of the competition which prevails to-day.
Particularly dangerous in these days, the love which the public has had in all ages for quackery has now become exploited by a most skilful development of the advertisement promoting suggestion. I understand that the modern advertiser has a sort of technique in which he promotes what he calls a suitable atmosphere, and that this technique during late years —I have no doubt at great expense—has been imported into the advertisement of these various nostrums. The technique, as we may see in any paper that we like to open, plays particularly upon the fear of people and drives them into that state 1190 of apprehension which the noble Lord has described to us as being so exceedingly dangerous to a vast multitude of sensitive and nervous people. The scandal is much worse than it was even in 1914, and it is different now in that it has been developed more subtly and much more powerfully. The Government of to-day are supported by the knowledge that they have behind them the recommendations of all the various interests which matter in the case. I therefore hope that the noble Lord representing the Ministry of Health will give some support to the noble Lord's Motion.
The noble Lord who introduced this Motion made a most interesting speech, and other noble Lords have also made interesting speeches. I am sure my right honourable friend the Minister would wish that those speeches should command a wide attention. So far as the medical evidence submitted to us is concerned, I have very few comments to make. It is perfectly true that every investigation that has been made has borne out that the improper use of drugs and of substances which are in themselves harmless is a distinct danger to health in this country; that it has handicapped the work of the medical profession; and that we are behind other countries. I should be quite ready to agree with the noble Lord that it may constitute an obstacle to the national fitness which we all wish to obtain. Before considering the Government's responsibility in the matter, however, we ought to consider what has actually been done. Most of the more powerful drugs are, I think it will be generally agreed, controlled to-day by the Dangerous Drugs Acts of 1920 and 1923, the Therapeutic Substances Act, 1925, the Pharmacy and Poisons Act, 1933, and the Food and Drugs Bill which has just passed through Parliament. Generally speaking, the effect of these Acts is that they guarantee that the drugs are pure, that they answer the description advertised, and that, so far as their toxic qualities are concerned, they shall not be issued to the public except on the prescription of a qualified doctor.
The problem of the dangerous drug has therefore largely been solved, except possibly for the case mentioned by the noble Lord, Lord Horder: that of the new drugs that are continually being put on 1191 the market by the enterprise of manufacturing chemists. I think Lord Horder had some criticism to make on these new medicines. He said that the public had been used as a guinea-pig by the unscrupulous manufacturers. I am informed that there is no real method of foretelling what the effect of some of the new compounds is going to be; that one may be a mild disinfectant and another a very powerful explosive. It is true that their effect on the human body can only be ascertained by experiment, and I believe there have been fatal cases abroad where these experiments have been incomplete. I agree that this constitutes a possible danger, but it is one which is very difficult to guard against without putting an absolutely undue restriction on these very valuable new inventions. I understand—the noble Lord will correct me if I am wrong—that the majority of these substances are made by firms of the highest possible repute, who, in their own interests, see that the precautions which are taken are very complete. I believe that the dangers arising from that possible source are really remote.
The real difficulty, as the noble Lord has pointed out, arises from drugs and substances which are not in themselves harmful and which cannot be scheduled as dangerous or poisonous. It is quite true that the improper use of these drugs does constitute a danger, and that danger, I think, arises in two ways. A noble Lord mentioned aspirin. If it is used properly, there is no doubt that aspirin does provide a remedy, or relief anyhow, for a number of illnesses. If used to excess, obviously it is not beneficial, and I believe there have actually been cases where people have tried to take their own lives—I do not know whether they succeeded—by taking large quantities of aspirin. But take the other point of view. If aspirin is not used to excess, but is used to cure some dangerous fever, then it does harm because it may prevent proper treatment being applied. I take this case of aspirin because I think it is a well known product, about which, so far as I know, no very extravagant claims are made, and it is frequently recommended by the medical profession. I take it because I do not think the noble Lord said very much about a large number of perfectly reputable compounds which are on the market and which are frequently 1192 recommended by his profession. It is true that if these unfortunate results can arise from the improper use of these reputable products, advertised in a respectable way, far worse results can obviously ensue from the improper use of other drugs presented to the public with far less regard to truth and with far less security of quality.
Surely the inherent difficulty in dealing with these substances is that the real fault lies with the individual who takes them. It is surely just as difficult to stop people indulging in the excessive use of drugs and medicines as it is to stop people from excessive indulgence in drink. If people do not use the immense State assisted medical scheme which the noble Lord mentioned, and which has been provided for at least 18,000,000 of the inhabitants, and if people prefer to diagnose and treat their own complaints, it is surely largely their own responsibility if they suffer in consequence. It is perfectly true that they may be encouraged to do so by carefully worded advertisements, and I agree in theory that there is a case for controlling these advertisements; but here again I think the resources of the legal profession can easily be turned to bad account, and it is very easy to find forms of words which evade the penalties that may be devised in Acts of Parliament, unless these Acts are so strict as to bring within the meshes of their nets a number of perfectly harmless and well-established compounds that can at present be cheaply and easily procured.
The Select Committee, which reported in 1914, to which the noble Lord made reference, proposed three essential reforms. Firstly, registration of all manufacturers, proprietors and importers of patent, secret and proprietary medicines; secondly, that the exact composition of every patent medicine should be disclosed to the Ministry of Health; thirdly, that advertisements should be controlled. In regard to this last recommendation it was suggested that a definition of "false trade description" should bea statement designed or devised regarding any article or preparation or the drugs or ingredients or substances contained therein, or the curative or therapeutic effect thereof which is false or misleading in any particular.I have mentioned that it is not always easy to devise forms of words which cannot be evaded. We know that the 1193 Chancellor of the Exchequer takes particular care to devise forms of words by which to extract money from the taxpayers, and it is to be observed that sometimes these words are evaded. It stands to reason that we can equally expect evasion even from this carefully drawn definition which I have read.
I was surprised to hear Lord Horder and Lord Faringdon say how easily they thought this control of advertisements could be effected. I think Lord Horder said that these things were controlled in America—that they were forbidden. Other things have been forbidden in the United States, but I do not know whether they all ceased immediately they were forbidden by law. After all, the quack remedy has been used as a political metaphor for some considerable time, and if we were to apply to politics or to political Parties a similar law. requiring that any statement which is false or misleading in any particular should be punishable, I fear that some of the noble Lords opposite would begin to regard it as the thin end of the wedge, or at all events would regard us rather askance, or at least begin to argue very hard as to what was false and misleading and what was not. I think that as in politics so it may be in medicine.
I am not attempting to exclude the possibility of some legislation on the lines suggested, but I do say that I think it would be very difficult to guarantee that such legislation would be effective. Of course it has been suggested that certain advertisements relating to certain specified diseases should be prohibited altogether. The Committee did recommend that, and it has been adopted so far as venereal disease is concerned. A Private Member's Bill was recently introduced in another place to extend this prohibition to other diseases, and I am not betraying any secrets when say that if that Bill had gone any way in another place it would have received the sympathetic consideration of the Government. What happened was that during the Second Reading the House was counted out, and the Government were unable to take any action, sympathetic or otherwise, because the Bill was automatically dropped.
Parliamentary apathy in these matters is frequently explained by the phrase "vested interests," to which Lord Horder has referred. I appreciate the tone in 1194 which Lord Horder referred to that pressure, but others of his colleagues have gone a long way further than he has gone. I noticed that in an article Professor Clark said that "the obvious reason why Parliament has refused for a quarter of a century to attempt to remedy any of the disgraceful abuses revealed by the Report of the Committee" is that "the Press controls the politicians and the secret remedies trade associations control the Press"—the argument being of course that vested interests represented by advertisers in the Press are so strong that the Government is powerless against them. We may be perfectly certain that no major reform has ever been, or is ever likely to be, effected in this country except in the face of vested interest of some sort. I think Professor Clark is rather severe on the Press, and I am glad that Lord Horder treated the matter in a different way, as also did the promoter of the Bill to which he made reference. They both quoted the magnificent work done by the Advertising Association, with the support of the leading newspapers, and I think that several newspapers have played a prominent part in exposing the more glaring cases of misrepresentation. Perhaps I did not hear correctly, but I rather gathered that the noble Lord, Lord Horder, seemed to think that the proprietors of these patent medicines exercised some pressure on the Government apart from the Press.
Well, I am mistaken there. I was wondering how it was done. Apart from the very real administrative and legal difficulties of legislating on these matters, knowing as I say the ingenuity and evasion that we must expect, one of the principal obstacles to new legislation is one to which not very much reference has been made, either in this debate or in many of the articles that have been written, and it is one which I would like, with great diffidence, to illustrate from your Lordships' own proceedings. I have no doubt that your Lordships will remember that some months ago a Private Bill was introduced, the effect of which would have been to extend some degree of official recognition to osteopaths, and I think I am right in saying that that Bill excited almost as much opposition in the medical profession as patent medicines are doing to-day. 1195 Possibly some lesson can be learned from the reception that that Bill had in this House. Your Lordships will probably remember that on the Second Reading some of the most distinguished ornaments of the medical profession—I do not know whether the noble Lord was one of them, but certainly Lord Moynihan and Lord Dawson of Penn were two—made strong appeals to your Lordships to have nothing to do with that Bill. They were supported in that by several distinguished representatives of the law, and also by the Government.
I do not suppose that even the severest critic of your Lordships' House could describe this as a very impetuous body, but nevertheless, after considerable debate, the House decided by a large majority to proceed with the Bill. I admit it was only to send it to an inquiry but nevertheless they did decide to proceed to that stage. I think that a question does arise as to why your Lordships decided to ignore that large body of responsible opinion, as I should have regarded it, and of course on this matter we may hold different theories. Perhaps Lord Horder thought it was owing to the weak case made out by the Government spokesman, but I believe that the real reason was that the majority of your Lordships felt that, in the present state of uncertainty regarding so many aspects of the human constitution, and where so many diseases are still unfortunately incurable, the orthodox school of medicine—although I think everybody accorded it a great measure of respect whether he agreed with the orthodox school or not—should not be allowed to establish too rigid a dictatorship over other schools of thought.
That is not an attitude with which I sympathise myself, nor is it an attitude with which my right honourable friend, who is himself a doctor, could be expected to sympathise. But it is a fact of considerable importance, and as a Minister of a democratic country my right honourable friend has to take that into account. I think in a recent article the noble Lord, Lord Horder, himself has laid down that a law which aims at being in advance of opinion and practice is rarely a good law. I must say that, judging from the reception of legislation since the War, it appears that public opinion is, in spite of what has been said, greatly divided.
1196 If I am asked to say why, in the face of all these reports, successive Governments have done so little, I should summarise it in this way. I should first explain it by the popular theory that people have the right to make fools of themselves in their own way, provided they do not do harm to other people. That may perhaps sound a rather crude argument, but I do put it to the noble Lord, who is a great authority on these matters, that surely the point is to be considered as to whether there is no danger in weakening the individual sense of responsibility in these matters. Secondly, I think it is a fact that we cannot legislate effectively without at least risking adding to the difficulty and expense of obtaining remedies which are in many cases harmless and beneficial. In saying this I am not trying to exclude the possibility of further repressive and restrictive legislation. All I do say most emphatically is that repression alone is one of the most dubious of all lines of progress. I am sure the noble Lord will agree that it is only education as to what health and fitness mean that will really induce people to refrain, as the well known phrase goes, from "pouring drugs of which they know little into bodies of which they know nothing." My right honourable friend will carefully examine what the noble Lord has said, and will see whether anything can be done to incorporate in the educational side of the national fitness movement something of a warning nature against the misuse of drugs generally.
I have tried to be frank in answering my noble friend. Perhaps he may still not be convinced, and, if that is so, perhaps he would like to have a try at legislation himself. I notice that, in spite of the fact that the noble Lord assured me that there is a great mass of public opinion behind him in this matter, the only explanation he gave as to why private legislation had failed was in the perhaps somewhat unscientific phrase that there was a hoodoo on Private Bills. But I can assure him that on legal matters we should be very pleased to place all our resources at his disposal, and on medical matters we have no higher sources of information than those which he himself can command. I repeat that our own attitude must be, to some extent at any rate, dictated by public opinion because in these matters the public must have the last word. My noble friend has moved 1197 for Papers. I am perfectly prepared to lay any Papers he likes, but I hope I have met the main arguments he advanced to his satisfaction.
§ LORD HORDER
My Lords, I understand that I have free access in a private capacity, and I would like to avail myself of that. I beg leave to withdraw the Motion.
§ Motion for Papers, by leave, withdrawn.