§ 4.46 p.m.
§ Debate resumed.
§ VISCOUNT WAVERLEY
My Lords, if the issue raised by the Motion submitted by the noble and learned Earl had to be decided on a balance of professional opinion, your Lordships would, I am sure, be confronted by a most difficult and, indeed, a most invidious decision. The issue presents itself to my mind in much simpler terms. May I say at once that, having been Home Secretary and, what is perhaps more significant, having been for ten years, as Permanent Head of the Home Office, responsible for advising the Home Secretary of the day on the administration of the Dangerous Drugs Acts, I profoundly disagree with the attitude of Her Majesty's Government in this flatter. It must be manifest to your Lordships that on this issue professional opinion is fundamentally divided. There are many professional men of the greatest eminence, whose judgment is entitled to respect, who regard the administration of heroin for therapeutic purposes as wholly unnecessary. There are also unquestionably many competent, able, experienced medical men who take a diametrically opposite view. I have always regarded medical practice as a highly individual activity, and I take the simple view that for a Government to deprive an able, responsible and conscientious medical man of the opportunity of prescribing what he genuinely believes is necessary in the best interests of his patient is indefensible in the absence (I make this qualification) of the most cogent and compelling reasons.
What is the position here? We are told that it is necessary to prohibit the manufacture of heroin in this country in order to make effective an International Agreement to which a large number of countries are party and which is designed to assist in putting an end to a most horrible abuse, the abuse of addiction which, in the case of heroin, we are credibly informed is worse than in the case of any other drug—cocaine, morphine or whatever it may be. I wonder what possible good the prohibition of the manufacture of heroin in this country is going to do to any other country. Every country has its own problem to deal with. I feel I may claim that we in this country have been very successful in handling, the problem 48 of addiction, and I was glad to hear the tribute paid by the noble Lord, Lord Mancroft, to the effectiveness of the organisation that has been built up under the Home Office in this country. Whatever may be said, heroin can be prepared from morphine with the greatest ease. Morphine circulates very freely and it can be converted into heroin without the use of any appliance or any material which is not most readily available to any man or woman.
I speak from my own personal knowledge in this matter, and I say that if it were desired to give encouragement to those in other countries who are confronted by a most difficult and painful situation by "showing willing" in this country, the proper course would be to prohibit the export of heroin, and not that alone, but to accompany the prohibition—and as it can be and is, I believe, being accompanied—by the most complete and effective control of manufacture. Prohibition of export with complete control of manufacutre, can, I believe, effectively ensure that no heroin produced in this country can possibly contribute to the aggravation of this grave problem by which other countries are confronted. Our experience has shown that to deal effectively with the problem of addiction requires, first, complete and effective control of manufacture; second, sound police administration; and, third (and this is most important), stringent penalties.
My Lords, if I may quote for one moment from my own experience, let me tell you this. Many years ago it was my painful duty to send for the head of one of the most important and highly reputable firms in this country, a firm well known as manufacturers of alkaloids and hypnotics, and to produce to him evidence showing that because of laxity in the organisation under the control of his firm drugs produced under licence were being allowed to pass into illicit channels. And I told him that in those circumstances it would be the duty of His Majesty's Government to withdraw the authority under which that firm—very well known and highly reputable—had been for many years carrying on the manufacture of these drugs and exporting them in large quantities all over the world. The decision was accepted without a murmur because the facts were indisputable. I mention that only as an illustration of the kind of action that has 49 to be taken if the control of these drugs of addiction is to be made effective. That is the sort of line on which, in my humble opinion, other countries have to act. If we wish to show our sympathy, let us by all means not prohibit the manufacture, but prohibit and effectively stop the export to other countries which are not so favourably placed as we are in regard to the control and use of drugs of addiction. That is all I have to say. It gives me no pleasure to express disagreement with the view of a successor of mine at the Home Office, which has been expressed by the noble Lord, Lord Mancroft. I have done so only because I felt that as a matter of duty I had to come here and give the House the result of my own experience.
§ 4.54 p.m.
My Lords, it falls to my lot to be the first layman to address your Lordships in this debate. I am not an eminent lawyer; I am not an eminent doctor, and I am not an eminent administrator, as are those who have spoken before me. But in the course of an ordinary life as a man in the street—neither a very long nor a very short life—I have come across, as all your Lordships must have come across, many people of responsible thought and intelligence who have considered this matter: not merely doctors, surgeons and physicians, nurses and welfare workers, but others, people who have had direct or indirect experience of the use of heroin in desperate cases. In the cupboard in a doctor's surgery there are things in bottles and in tins which can subject one to sudden death, slow death, torture, or to the effects of a drug of addiction. So far as I am concerned. I have chosen my own medical adviser in the full knowledge that he has these things, and in the full confidence that he is at liberty to use them on me as and when he thinks fit. And I am very glad to think that he can do so It has been said we have a great responsibility in the international, aspect of this matter. The noble Lord, Lord Mancroft, has touched on this. May I suggest that this international aspect is bilateral; and we should consider that if we are going into this particular obligation without the real support of the opinion of the people of this country—and it seems obvious that there is a great body of opinion against this ban—we may indeed damage that leading position 50 which we enjoy in the international sphere. I am not going to keep your Lordships long. I rose to speak merely because I felt it my duty to help to indicate that there is a strong division of opinion in this House and to show which side I take.
Answering the noble Viscount, Lord Elibank, about a fortnight ago, Lord Mancroft, as your Lordships may remember, gave a very courteous (as usual) but completely negative answer to the Question raised by my noble friend Lord Elibank, which was virtually the same question as is being raised to-day. It may have been the result of a verbal infelicity—something to which few noble Lords are less prone than Lord Mancroft—but the answer had upon me a somewhat disturbing effect. The last part of the noble Viscount's Question was in these words:Whether in all the circumstances"—that means all the things which we are discussing to-day—Her Majesty's Government will consider the advisability of appointing an ad hoc committee to inquire into the position and of postponing the operation of this ban pending tint committee's Report.That was a modest request: the Government were asked only whether they would "consider the advisability." The noble Lord, Lord Mancroft, I admit did not say: "No, Her Majesty's Government will never consider even the advisability of appointing a committee," but it is a little disturbing that that might be the impression given by the noble Lord's Answer. I appeal to the noble Viscount, Lord Woolton, to say that Her Majesty's Government will give some consideration, and I hope very sympathetic consideration, to the views which have been so forcefully expressed this afternoon.
§ 4.58 p.m.
§ LORD DENHAM
My Lords, we have to look at this matter from two points of view—the national and the international: we are faced with two conflicting loyalties. In making up our minds over this, there are only two questions that we should consider. The first is this: is there, in fact, no adequate substitute for heroin, and will hardship and pain be caused by its banning? The second is: does the manufacture of heroin for legitimate purposes in this country lead to its abuse, here or elsewhere? 51 Several noble Lords who have spoken today have been questioning whether Her Majesty's Government took the right advice in coming to the decision which they did. I would say that that question is not relevant here. It is important that Her Majesty's Government should consider whether they have, in fact, taken the right advice, and, if they find that they have not, that they should make the necessary alterations, so that, should another problem like heroin arise, the advice they get then will be right. What we have to consider now, however, is not whether the right people gave the advice but whether they gave the right answer, and whether Her Majesty's Government's decision on that answer was right.
Medical opinion is divided on this issue. The experts disagree, as your Lordships will have noted from the speeches of the eminent doctors who are Members of your Lordships' House. When two experts disagree, the layman who is accustomed to take their advice has three courses open to him. He can toss up a coin in order to decide between the two. He can consult a third expert—though when his opinion is obtained the position will be much the same. Or, thirdly, the layman can hear both points of view and make up his own mind. That is what we have to do this afternoon. That is why a question like this is a moral one, and not so much a technical one. Your Lordships must all consider it. It is the duty of all of us to make up our minds as to whether the Government's decision is right.
Medical opinion is divided. On December 3 there was an article in the Lancet, which is one of the chief supporters of the Government ban, entitled "Doing without Heroin." Under a sub-heading, "Alternatives," it gave a list of suitable alternatives for heroin which can be used under given conditions. Before coming to speak to your Lordships this afternoon I took the advice of several doctors, and I could have come here armed with a list of their answers to these alternatives, but your Lordships would have been left in exactly the same position as you were before: confronted with the opinion of one doctor against the opinion of another. It is enough to say that a considerable body of opinion disagrees with that article in the Lancet.
52 Giving one of the reasons why heroin is not a unique drug which we cannot do without, the article says:In his study of Good General Practice, Stephen Taylor lists the drugs carried in the bags of general practitioners: these included morphine, pethidine, compound tablets of codeine, papaveretum, and methadone, but heroin was not found in any of the bags examined.It has been said in the Press and elsewhere that about one in five people are intolerant of morphine. I am advised that that is a slight exaggeration and that 5 per cent. to 10 per cent. would be a more conservative estimate. That gives a doctor who stocks his bag for emergencies only one in fifteen chances that in any given emergency a given patient will be intolerant of morphine. But that does not mean to say that the same doctor will not have a supply of heroin at very short notice in case it should be necessary.
I asked a well-known London general practitioner about the number of cases he had treated with heroin in the last year or so and he gave me details which I think I should give to your Lordships this afternoon to serve as an illustration. Last year this doctor had not treated any patient with heroin, but before that he had four cases at short intervals. The first case was of a man dying from cancer of the stomach who took a very long time to die. He was treated with morphine, not being intolerant of that drug, but the doses went up until eventually he had to be switched on to heroin and kept on heroin until he died, which was about three weeks later. The second case was of a man who had gallstone colic, which I am told is very painful. He was intolerant of morphine, treated with heroin while he was in pain from the disease, and eventually got better. The third man suffered from angina pectoris and was also intolerant of morphine. He had an attack of coronary thrombosis, was treated with heroin and recovered. That man is still alive to-day, but is dreading the possibility of another attack after heroin has been banned.
Those who support the ban suggest that one of the chief reasons why doctors want to keep heroin is because of its euphoric effect. I looked up "euphoria" in an ordinary dictionary and in a medical dictionary. The ordinary dictionary said: "ability to bear pain well." In the 53 medical dictionary, the definition was: "a feeling of well being not always justified by the circumstances." I suggest that euphoria combines both those conditions. It is just the feeling of well-being that drug addicts "go for" that is of such use to doctors. When a man is dying in great pain, it is not only an advantage to relieve the pain, it is also a great advantage to have the euphoric effect that only heroin can give. It is a great advantage to give the patient this feeling of wellbeing not justified by the circumstances.
Some doctors use heroin, some do not. Many of those who do not would be the last to interfere. The doctors and medical bodies who are for and against the ban have been quoted in your Lordships' House this afternoon, and I will only summarise them. The British Medical Association are fighting the ban as a body. Your Lordships will have received a circular from them, giving their three reasons, which have already been quoted. Many letters have been written to The Times, notably from the Royal Marsden, formerly the Royal Cancer Hospital, and from the Brompton Chest Hospital. The noble and learned Earl, Lord Jowitt, gave a list of the teaching hospitals in London who are against the ban. I am informed that the chairmen of the medical committees of eleven out of twelve of the London teaching hospitals wrote to the Minister deploring the ban, after having taken the full advice of the medical staff.
I submit, and I think your Lordships will agree, that there is a large number—if not a majority, at least a big minority—of doctors who are against the ban. We are confronted with two different opinions and cannot call in medical opinion on which side to take because medical opinion is itself so divided. I think there is a reasonable doubt on both sides. There may be substitutes for heroin, but it is reasonable to assume that there may not be one. The noble Lord, Lord Man-croft, mentioned a reply given to a Question in another place. In a Question for written reply, an honourable member asked the Minister of Health what drug he would recommend to be used far heroin for those patients who cannot take morphia. The Minister replied [OFFICIAL REPORT, Commons, Vol. 547, No. 73, col. 126]: 54It is not for me to recommend the use of any particular drug. The drug or drugs to be used must be decided by the patient's doctor.That seems to me like going into a butcher's shop and taking away the butcher's meat axe. Then, when he asks what he is going to cut up the meat with, you turn to him and say, "You are the butcher. You ought to know; don't ask me." My second question is this. Does the manufacture of heroin for legal purposes in this country lead to the abuse of it, here or elsewhere? Drug addiction is a terrible thing. The noble Lord, Lord Mancroft, has given some details, and I should not wish to minimise the horror of it. There are fifty-four addicts in the United Kingdom and many more in the United States of America. A letter to The Times put the figure at 50,000, but I do not know how accurate that is. There are two ways in which the legal manufacture of heroin for legitimate purposes in this country could lead to addiction. The first is addiction as the result of the prescribing of heroin. I am advised that if the patient gets better, with care and moderation by the doctor it should not lead to addiction. If the patient dies, as has been said in your Lordships' House this afternoon and will no doubt be said again, what does it matter? Her Majesty's Government could perhaps tell us what percentage of the fifty-four addicts in this country became so after first having heroin prescribed by a doctor. The second way it could effect addiction is for supplies of legally made heroin to go astray and get into the wrong hands. The record in this country of the number of addicts shows that, if it is going astray in this country, it is not to a great extent. But if it is going astray at all, why cannot the precautions be tightened up?
The noble and learned Earl, Lord Jowitt, and the noble Viscount, Lord Waverley, said that they would concede the point that heroin exports might be banned. Why should they? The safe guards for exporting heroin legally made in this country are colossal. Your Lordships may not have seen the second circular of the British Medical Association, which I do not think went to all Members of both Houses. The noble and learned Earl, Lord Jowitt, has already quoted the Articles of the 1931 Convention and the control exercised by the Home Office as the result of that. I will 55 not bother your Lordships by reading all the safeguards to prevent exported heroin from getting into the wrong hands, but they are considerable, and the final one, which the noble and learned Earl has already quoted, is:That the Government of the country where the heroin is received is responsible for its distribution.It is possible to stop the open manufacture of heroin. What we need to stop is not the open, but the underground, manufacture of heroin. Will those who make it secretly and for nefarious purposes stop making heroin out of the goodness of their hearts, just because the open manufacture of heroin is banned? It is doubtful whether supplies made illegally in this country are exported, also illegally, to other countries where addiction is rife—but that is beside the point, because we are dealing only with the legal supplies. The Home Secretary, in a written reply in another place, reported that the proportion of heroin made in this country was 69 per cent. of the amount made in the world. This figure can only be a proportion of the heroin made openly; and surely a lot more is made that is not known and not accounted for. A noble Lord has already quoted the ships of Canada and America that have been stopped. There was an article in the Daily Telegraph of November 12 this year about that. The result of the ban in this country would mean that sufferers would not get heroin and the addicts would.
To sum up, there are one or two further points that could be considered. A large body, if not a majority, say that there is no substitute. From these people, who really earnestly believe that there is no substitute, we are taking one of their most potent weapons against disease and pain. Not only that, but another of the weapons of a doctor is variety: having put a patient on to one drug, after a while he takes him off that drug and puts him on another; it is the change that does a lot of good. For that reason, it is a pity to reduce the number of drugs even by one. It is the addict's own fault or stupidity that he gets into the fix he is in; a man gets cancer through no fault of his own. Legal manufacture does not seem to lead to abuse; clandestine manufacture would continue, and might even increase. We are asked to follow America. 56 Our record is so much better than that of America, that, as the noble Lord, Lord Webb-Johnson, has already said, rather let them study our methods.
We are asked to ban the drug because fifty countries have already done so and we, as supporters of the United Nations, must not lag behind or, as one correspondent of The Times put it, "pursue our proud and selfish way alone." Surely, this is no argument. If we are right to use heroin, then we are right, even though fifty countries say we are wrong. Let us get this quite straight. I suspect that the other countries are anxious for us to ban heroin not just for the good that our having the ban would do to ourselves. The name of this country in the world still carries a good deal of weight, and I suspect that the other countries hope that if we ban heroin still further, countries whose record of addiction and of drug traffic is not so good as ours will follow our example. If that is the case, it would be much better to say so openly. With only fifty-four addicts in this country, and with the safeguards that we already have, our own house is in order, unless it can be proved that heroin made legally in this country is getting into the wrong hands abroad. We are being asked to deprive those who really need heroin of its pain-relieving qualities, which there is good evidence to show may well be unequalled, merely in order to give moral support to America and other countries. That, if your Lordships will excuse the expression, is just not good enough.
§ 5.17 p.m.
§ LORD HADEN-GUEST
My Lords, my first duty on rising is to congratulate the noble Lord who has just spoken on his maiden speech, which is one of the best I have heard. I have to add, however, that I do not agree with a large number of his remarks, since I, being a doctor, am one of those who are particularly anxious that we should carry out this ban on heroin. Let me remind noble Lords that what we are really discussing to-day is whether we shall adhere to the decision of the Economic and Social Council of the United Nations at its Eighteenth Session, which urged all Governments to prohibit the manufacture, import and export of diacetylmorphine—that is the medical name for heroin. Heroin has been medically used for 57 about fifty years and is recognised as the most dangerous of all drugs of addiction.
I will quote from an article in the British Medical Journal in January, 1949. That article was written some time ago, when there was no crisis in this matter, and it gives the opinion of the B.M.A. It states:The dangers of Heroin are well known. Addiction is acquired more rapidly than with any other drug; once acquired, the disorder progresses with greater speed and is marked by a more profound and disastrous moral degeneration than in any other addiction … In the light of these facts it is clearly the duty of the medical profession to examine again the therapeutic value of this substance and to weigh it against its social danger.Further, the article goes on:Pharmacological opinion has long held that its social dangers overshadow its therapeutic importance. It must be granted there is justice in the Permanent Central Opium Board's claim—that of 'an a priori case for its total abolition'.That was in 1949, and the Standing Medical Advisory Committee, which has been mentioned several times during the course of this debate, has remarked on it. I do not want to bore your Lordships with more recitations of statistics, but rather to point out some of the matters which are more immediately necessary fart us to consider—for instance, the comparison between morphia and morphine and heroin. And to quote from Martindale's Extra Pharmacopœia, morphine or some related drug can always be used as effectively as heroin. Since 1931, the profession has been deprived of heroin in sonic twenty-six countries. Opinion has long been held that its social dangers overshadow its therapeutic importance. That, I think, is an important issue. I also want to quote the opinion of the British Medical Journal on this claim. The Journal stated:It must be granted there is justice in the Permanent Central Opium Board claim of art a priori case for its total abolition.that is, the total abolition of the use of heroin.
We are confronted with a complicated problem. We have had examples of it to-day. There is a conflict of opinion arid difficulty of administration. But the B.M.A., to which I belong, like, I suppose, almost all other doctors in the country, has changed its opinion on this matter a number of times. Since 1949 it has issued various communiqués to the 58 Press. I am not going to read them all, and I am not going even to read the last one; I will merely point out that they have all had their different opinions at different times and that they by no means coincide. For many years heroin addiction, fed by a widespread international illicit traffic, has been a grave social problem in a number of countries, though not in this country, because of good administration. We are not concerned now only with good administration for ourselves. The human race does not stop at the cliffs of Dover. We are dealing with an effort made by the United Nations to ban heroin for the benefit of the world as a whole; and that, I think, is a very important matter. We must no: take the narrow view and talk about whether it will influence this or that part of the country. We are fortunate in our administration, and for heaven's sake[...]let us be willing to join an organisation which will ensure that that kind of administration is spread more widely in the world than it is at the present time.
§ LORD HADEN-GUEST
Yes, certainly. I have been on the field of battle and not been afraid there, and I shall not be afraid if I die of cancer on a bed. I should not complain and ask for heroin—very definitely not.
There has been too much sobbing about death by cancer—I speak at the moment as a doctor. Let me say that I have never used heroin in my life. I have not been careless with my patients. I have had a large practice, and I have relieved pain—because a doctor does not always need drugs to relieve pain. It is possible, by sensible advice and by management of the patient, with a little assistance from some harmless drug which will not cause addiction or any adverse effects, to get him into such a state of mind that the pain goes from him. I think there is too much "sob-stuff," if I may say so, about this business of the relief of pain in the last stages of cancer. I know from personal experience that many people do complain. The large mass of people do not need to complain because their ordinary doctor, the panel doctor, the man who comes when they send a message round, is able to relieve them in some 59 other way than by using heroin or some similarly powerful drug. There are many other kinds of drug which relieve pain, but it is not always necessary to use them; you can sometimes do that better by other means.
I speak like this with some heat and vehemence—I am quite aware of that—because I feel that we have got into an artificial atmosphere about this heroin business, as though heroin were the only thing which could ease pain. It is perfectly ridiculous. Do you suppose we had heroin in the First World War when we were fighting in France? Do you suppose we had it in the Second World War? We might have had it then, but I never used it and never had it, although I was there as a doctor. Do you think the ordinary soldier requires these things? He does not: and he does not expect them. A member of your Lordships' House—he is not here now—and I met for the first time on a famous battlefield in Flanders in the First World War. He and I often exchange reminiscences of the things that went on there, the times we had and the tasks men were called upon to carry out. Some people always seem to be trying to find something which they can get by hypodermic syringe or by some bottle of medicine—something to relieve pain—when what they really want is what one might call a change of heart, to look at life more sensibly and to look at life without fearing and without cowardice. I think that would be a great thing. In fact, in my experience, that is the way in which most people do look at life.
I hope we are not going to be led away by any cries asking that we should upset the Government's arrangements for the banning of heroin on a world scale—we are not thinking of ourselves; we are thinking of the world as a whole—because some people regard it as absolutely necessary that a few people should have relief from pain. I honestly believe that in 99 per cent. of cases that relief can be obtained without the use of heroin. Heroin is a good thing for some people, but it is a very bad thing for others. In fact, by a fortnight's use of heroin a man can become an addict and go down to an abyss of degeneration, moral and physical. That is merely a medical fact; it will be found in the medical textbooks.
§ LORD HADEN-GUEST
Perhaps you will not find it here, but I am not talking about that: I am talking about the effect of this drug on people. I do not suppose anybody here is a heroin addict. If there is such a person I wish he would let me know about it. I should be very interested to meet him, because I have never yet met one.
I did not want to be led into that diversion. I wanted to say that I believe that for many years heroin addiction, fed by widespread international illicit traffic, has been a grave social problem in a number of countries, including the United States and Canada. It is the United States which is particularly asking us at the present time to join her in making this a universal ban in the world as a whole through the United Nations Organisation. There is a great deal of addiction in the U.S.A. and Canada. It is recognised by competent authorities (by this Conference for the Limitation of the Manufacture of Narcotic Drugs) that the proportion of heroin addiction in many parts of the world is appalling. I underlined that in my brief, because that is the way it is written in the document from which I took it. After the last world war, it was recognised that heroin addiction and illicit traffic in heroin were still a serious and world-wide problem, and the international bodies chiefly concerned—namely, the Permanent Central Opium Board, the Drug Supervisory Board and the World Health Organisation—were once again compelled to give special attention to it.
In 1950, the World Health Organisation, in common with the Permanent Central Opium Board and the Drug Supervisory Board, circularised its members asking Governments for their views and those of the medical profession. In this country the Minister of Health consulted the Standing Medical Advisory Committee, and one result of this consultation was that the British Pharmacopœia Commission agreed to delete the monograph on heroin from the British Pharmacopœia, so that it is no longer an official drug in the sense of its being included in the British Pharmacopœia. This was done in 1953. The results of the replies to the World Health Organisation circular from sixty-three of eighty-two countries to which it was sent—that is to say, the letter asking them to join in a world organisation in 61 which heroin should be banned—showed that fifty-four countries expressed the view that heroin could be given up. Nine countries expressed the opposite view. Of nineteen others who did not reply, it appeared that eleven (including the U.S.S.R., Poland and Bulgaria) had either prohibited heroin or ceased to use it in practice. From information reaching the Permanent Central Opium Board and the United Nations it appeared that illicit traffic in heroin was continuing on an appalling scale. In 1953, the World Health Organisation Assembly considered that heroin was not irreplaceable and recommended member States to abolish the production and importation of the drug—with which view, incidentally, an article in the British Medical Journal of July 25, 1953, agreed. It was admitted that an organisation for the retention of the heroin was not necessary.
In 1954, the Special Commission on Narcotic Drugs of the United States agreed by a large majority to submit a resolution to the Economic and Social Council of the United Nations urging Governments to prohibit the production and import of the drug. It is now recognised by practically all Governments in the world that the struggle against narcotic drugs is essentially an international problem—I recommend that to the notice of some noble Lords opposite—and cannot be solved at the purely national level. Unfortunately, the illicit traffic in heroin is particularly lucrative. An ounce of the pure drug, costing very little in the lawful trade, may bring in anything from 8,000 to 10,000 dollars in North. America—that is, Canada and the United States. When broken down into capsules and diluted or adulterated, which is the usual way in which it is sold, the drug can be sold at a still greater profit. The illicit traffic in the world seems to be continuing, and will continue. The United States want a world-wide banning of heroin, and Canada has recently agreed to this.
The heroin manufactured here is made under strict supervision to see that it is not directed into illicit channels, and is exported only under stringent safeguards. It is not enough, I feel, merely to impose a ban of that kind. Owing to the fact that this country manufactures over 70 per cent. of the total of heroin, it is an obvious target. Thefts of heroin occur, 62 and last year in this country there was a serious theft. The only solution is a world ban on heroin. I trust that this House will agree to take steps to ban it and that the matter will be dealt with as an urgent matter and not as one which can be put off.
I regret that I have spoken more vehemently than I intended, but from long and practical experience as a doctor I feel bitterly on this matter. I believe that the majority of doctors do not use heroin. I myself have never used it. I have rarely used morphia. Whenever I have, I have always been careful about the care of the patients afterwards to see that they did not become addicts. Most doctors behave in that kind of way. They are men who make reasonable incomes now in present circumstances, but they are not, as a rule, men who become very wealthy. They live in the middle group between those who are poor and those who are wealthy. They are ordinary workers trying to do a good job in the world. One of the things they are trying to do is to protect their patients against the debaucheries of heroin and the frightful indignities that can become the lot of anyone who gives way to drugs, in the taking of which heroin is perhaps the worst.
§ 5.38 p.m.
§ LORD TEVIOT
My Lords, I am afraid the noble Lord who has just sat down shocked me greatly, as I think he did some other noble Lords, when he referred to the First World War and the fact that we had not heroin then. All I can say is that he should have seen some of the things that I saw in the dressing stations and the forward hospitals in the First World War. I wish to Heaven that we had had heroin to help us then
§ LORD HADEN-GUEST
May I say that I was in charge of not only a dressing-station but also a whole series of hospitals in France in the First World War.
§ LORD TEVIOT
At any rate, the noble Lord cannot possibly have seen what I saw. Perhaps I was nearer the front line than lie was and therefore saw things that he did not see until after the patient had gone. Like many others of your lordships, I have been connected with hospitals and with the health of people for many years, and still am. I find that noble Lords, with one exception, who is 63 a little bit of a "wobbler," agree with the Motion that was so ably moved by the noble and learned Earl. I shall be brief because there are many others who wish to speak, but, before I begin to say what I wish to, I must congratulate the noble Lord behind me on his able and well constructed speech. Although he did not say so, I believe it was a maiden speech; it was on the List as such and I took it that it was. I hope we shall often hear him again.
I want to ask one or two pertinent questions that have not been touched upon to-day. I put this to the noble Lords who are in the medical profession. As a layman, I can conceive a patient to be inoperable. What I mean is that he cannot be operated on, and yet, with treatment and with a certain amount of heroin, life may be made bearable. I understand that that is so, and that, as at present known, no other drug will do that except heroin. The noble Lord opposite was talking about "sob stuff" about heroin and cancer. My view is, that there has been a great deal too much talk about addiction and not nearly enough about how we can help those who are suffering from cancer and other painful diseases by the careful use of heroin. This raises the most interesting question. We are told on the best authority, that together with other drugs, morphine can be used with the same effect as heroin. Does it not immediately occur to a logical mind that if I am an addict to heroin, and I hear that heroin is going to be unprocurable and that there is some other drug that does the same thing, I shall do everything I can to find out that combination of morphine and other drugs and try it?
§ LORD TEVIOT
That is a question which must be seriously looked into. We all know what prohibition means; we have seen evidence of it with regard to alcohol in the United States—it produced there more drunkenness than ever before. It appears that in the twenty years since this ban was placed on heroin in the United States, there has been an enormous increase in addiction. My Lords, these are facts; we cannot get away from them. They were explained most carefully by the noble and learned Earl in his able speech 64 on the Resolution. I do not know whether other noble Lords have heard this, but I am told that the United States are seriously considering withdrawing the ban, for the reason that it has not had the effect that was hoped. One of the drugs that I am told is going to be used —I cannot say whether it will be with morphine or without it—is a drug called codeine. I have had that drug. Never again will I have it! It is a most ghastly thing, and I warn your Lordships that if anyone comes along and wants to give you codeine, for goodness sake say "No, thank you; I will take anything but that." It had the most horrible effect upon me.
I hate making a speech in which I am going to repeat what other people have said, and I am nearly at the end of what I have to say. Judging from the experiences we have all had, the undoubted effect of the ban will be that a black market will immediately start. Just think of the shocking effect that that will have on the morale of the country generally. It means that we shall be encouraging people to break the law. These are matters which I should like the Minister to study. I cannot see how anybody who has ever sat at the bedside of one who is suffering appalling agony can take the responsibility of not using anything to alleviate that pain. I think the Minister has a terrific responsibility in this matter. So far as I am concerned, I am going to see to it that my physician gets some heroin to keep for me and my family in case of need in the future, because I do not want to find myself in the course of a year or so in such a parlous state as has been described by noble Lords to-day and not be able to get hold of the one thing that will help me in my distress.
The trouble is there has been a frightful abuse of heroin and everything connected with it by other nations of the world. If we do what is now suggested and come to definite arrangements with these other nations, are we quite sure that they will carry out those arrangements as we have in the past, with the excellent results that we have achieved? These are questions which require far more investigation than has, I think, been given up to date. I have already apologised to my noble friend who is to reply for the fact that I shall have to leave—if I do not go soon, I shall never get home tonight—but I hope that the few remarks 65 that I have made will be given further consideration, and that the House will accept the Resolution moved so ably by the noble and learned Earl.
§ THE CHANCELLOR OF THE DUCHY OF LANCASTER (VISCOUNT WOOLTON)
The noble Lord will not mind my replying to him in his absence?
§ LORD TEVIOT
No, not at all. I hope the noble Viscount will reply and say any hard things he likes about anything I have said.
§ 5.46 p.m.
My Lords, I am sure that those of us who are against this ban will be grateful to the noble Lord who has just sat clown for his practical speech, although we must deplore the fact that he is leaving the House and may not be with us should this Resolution be carried to the Division Lobby. As the noble Lord, Lord Mancroft, has reminded your Lordships, I launched the campaign against this ban in the month of April, and I am most grateful to the noble aid learned Earl, Lord Jowitt, for having advanced my campaign to the stage of putting clown this Resolution and moving it to-day, as we must all agree, in the most admirable, eloquent and concise terms.
Most of the speeches that have bean made for the ban have been answered in advance by the noble and learned Earl who moved this Resolution, so I do not propose to take up much of your Lordships' time this evening. But, in the first place, before I pass to the main points, I should say something with regard to the remarks that have fallen from the noble Lord, Lord Haden-Guest. The noble Lord, Lord Haden-Guest, asked a supplementary question following upon my first Question in this House on April 27. He said (OFFICIAL REPORT, Vol. 192, col. 596):May I ask whether it is not a fact that the whole medical profession, so far as it is possible to ascertain, is behind this Order?The noble Lord, Lord Mancroft, jumped in and said:The information available to me is the same as that available to the noble Lord—namely, that the vast weight of the evidence is in favour of this; move.I notice that, as time marched on, the enthusiasm of the noble Lord, Lord Mancroft, became somewhat tempered. When again, on December 1, I put a 66 Question in relation to this subject, the noble Lord, Lord Haden-Guest, once more rose in his place and asked whether it was not the case that the bulk of the best medical opinion in this country was in favour of a ban on heroin at the present time. The noble Lord, Lord Mancroft having, if I may say so, with great respect, learned a little caution in the intervening months, answered that question by saying that although the noble Lord, Lord Haden-Guest, commanded a certain respect, his view was controverted by others.
§ LORD MANCROFT
Will the noble Lord forgive me if I interrupt? It was not caution that I had learned in the intervening months, but merely that I had had the advantage of seeing evidence which had not been seen by myself or anybody else when I made my original statement.
My Lords. what evidence had the noble Lord, Lord Mancroft, when he made his original statement that the information available to him was the same as that available to the noble Lord: namely, that the vast weight of evidence was in favour of the ban?
§ LORD MANCROFT
My Lords, we had then had nothing like the volume of opposition to the ban that we have now had and of which we have learned in the intervening period. I am not going to make my speech again, but we were entitled to think that we were correct in what we then said.
My Lords, on what evidence? I do not want to raise any point on this matter, but the noble Lord has put it to me that I was not correct in my statement. The noble Lord, Lord Haden-Guest, asked if it was a fact that the whole medical profession, so far as it was possible to ascertain the facts, was behind the ban. I must ask the noble Lord, Lord Mancroft, why, instead of saying that he was not aware of the facts or was not able to say whether the whole of the profession was or was not in favour of or behind the ban, he said that the information available to him was the same as that available; to the noble Lord and that the vast weight of evidence was in favour of the move. We will leave it at that. I am 67 not going to give away my point, and apparently the noble Lord, Lord Man-croft, is not prepared to give away his.
I say to the noble Lord, Lord Haden-Guest, that in this matter Her Majesty's Government are very largely dependent on public opinion, and quite rightly so. All Governments are swayed by public opinion; it is the essence of our Parliamentary system that public opinion should govern the decisions, motives and actions of Parliament. It is all the more important, therefore, that public opinion should be well and wisely guided and should never receive, especially from your Lordships' House, any information that might help to blur the picture of the pros and cons of any controversy that might arise in Parliament. Since I have engaged in this controversy I have had numerous Press cuttings, as no doubt have other noble Lords, giving reports by many of the newspapers of this country of the proceedings in your Lordships' House. In those reports particular prominence has been given to the questions and answers given in this House and to other matters relating to this controversy. In every one of these reports that I have seen the question was put in a form suggesting that it was the opinion of the noble Lord, Lord Haden-Guest, that the bulk of the best medical opinion in this country is in favour of a ban on heroin at the present time.
That statement was made on December 1, as a supplementary question, following an Answer to a Question which I had put. By that time it was quite clear, and this debate to-day has demonstrated more clearly, that there was, as the noble Lord, Lord Mancroft, admitted to me on that day, a distinct cleavage of medical opinion on this subject. I suggest that it did not lie in the mouth of the noble Lord, Lord Haden-Guest, on December 1, to say that the bulk of the best medical opinion in this country is in favour of a ban on heroin at the present time; nor has he said today from that Bench that the majority of medical practitioners in this country are in favour of this ban. It is very regrettable that the noble Lord in his remarks on December 1 let a statement go out from your Lordships' House to a public which was necessarily ignorant on the pros and cons of this matter, that 68 the bulk of the best medical opinion in this country is in favour of the ban; that is, unless he was prepared to prove it.
That does not lessen the fact that I consider it was most regrettable that he should have made that statement.
As the noble Lord, Lord Mancroft, said on April 27. I launched this campaign and have had a pretty good run, as I think the noble Lord will now admit. I do not propose to-night to say more than a few words to bring out some of the more substantial points made by various noble Lords who are opposed to this ban. The ground was so adequately covered by the noble and learned Earl, Lord Jowitt, that there remains little more to be said, but a remark by the noble Viscount, Lord Waverley, deserves emphasis. He put it in the form of a question to Her Majesty's Government, but I propose to put that question again in the hope that Her Majesty's Government may be able to answer it. The noble Viscount asked: what possible good is the banning of the manufacture of heroin to any other country? That point has not been answered. It was not answered by the noble Lord, Lord Mancroft, yet it emphasises and irons out the whole case against Her Majesty's Government in relation to this ban.
A number of questions were put to the Home Secretary in another place, and in answering those questions he said that, whatever decision was taken, he was bound to say he could never see any unanimity on it. The Government had to impose the ban in order to help the international situation. The Home Secretary said he was simple enough to believe that if many countries thought that a ban on heroin was a good thing to help to abolish the scourge, a contribution by Britain would help in some way towards it. On the export figures given by the noble and learned Earl, Lord Jowitt, tonight, I suggest that such exports can do nothing to help the United States or the other countries named in any problems of addiction or other difficulties which they have in relation to this subject. Will the noble Viscount, Lord Woolton, 69 who is to answer for Her Majesty's Government give a specific answer to the question put to him by the noble Viscount, Lord Waverley? I ask again, what possible use is the banning of the manufacture of heroin in this country to any other country? I was very much interested to hear the noble Lord. Lord Mancroft, say that, if and when this ban is put into operation, supplies will not cease at once. I wonder what he had in mind in saying that. Is that a sop to those who oppose the ban. Is it not really an admission that the ban ought not to be put on?
Will the noble Lord, or the noble Viscount, Lord Woolton, who I understand is going to reply on behalf of Her Majesty's Government, say what was meant by that? I think it is a direct admission that in putting on this ban they are imposing it for some reason far from those which affect the patient and the doctor in this country, and which has no relation at all to the sufferings which many patients have been undergoing. I am not going to enter again, as I did the other day, into the relative merits of the substitutes which the noble Lord cited in answer to a question. Nor am I going to ask him who advised him when those substitutes were named. All I know is that, despite what the noble Lord, Lord Haden-Guest, has said—he has said that he has never used heroin and that a large number of other doctors have not used heroin, which may possibly be true—it is common knowledge that there is a large number of doctors who use heroin to-day. It was used on me over fifty times in a few weeks. According to Lord Haden-Guest, I ought to be a drug addict. He said so.
I have a quotation here from the Evening Dispatch, Edinburgh, dated December 3, containing something which I think must have come from a similar source. The writer says:One doctor who backs the Government's ban explained to me"—this means that the explanation was given to the correspondent of the Evening Dispatch—what he considers is the real menace of heroin. If a patient were treated with it even for as short a time as a fortnight, he said,"—70 your Lordships will note, a fortnight. That was what the noble Lord, Lord Haden-Guest, said, so I presume that this explanation comes from the same source—then the patient would almost certainly become a life-long heroin addict. Because of this he has never used heroin.For some four or five weeks I had some fifty injections of heroin. I do not feel an addict.
There may be noble Lords, for all I know, who may have had heroin and upon whom it reacted adversely. But that is not an answer. Nor, indeed, am I putting up my case as an argument one way or another against the introduction of this ban. My case is that, as the Government have admitted, there is a distinct cleavage of medical opinion on this subject, and that in imposing this ban they are, as I said in a supplementary question on December 1, ordering doctors to use drugs which, in their opinion, constitute no satisfactory substitute for heroin.
Yesterday, in another place, the Minister of Health—upon whom, of course, rests the principal responsibility in this matter in the advice he has given to the Government—in a written reply to the Member for Holborn and St. Pancras said [OFFICIAL REPORT, Commons, Vol. 547, No 73, col. 126]:If any particular drug is not available it must obviously be for each patient's doctor to decide what alternative method of treatment is best suited to any individual.What does that mean? Surely it means this: that, by order of the Government, when and if this ban comes into operation, those physicians who are satisfied with heroin as a means of relieving the terrible agony of their patients—sometimes in cases of lingering cancer, if that is a correct term—are to experiment on their patients. That must be so. They are satisfied now with the use of heroin, and they are told that it would obviously be for those doctors to decide what alternative method of treatment is best suited to any individual. That is what these physicians, when heroin eventually ceases to be available, will have to do, although Lord Mancroft has said that the supply will go on. When heroin ceases to be a drug which these physicians can obtain 71 they will then have to conduct experiments on their suffering patients in order to find out what particular one of these substitutes suits their patients best.
§ THE MARQUESS OF SALISBURY
I am sorry, but I really must interrupt the noble Viscount here. I have not taken any part in this debate hitherto, but I must say that I think it is a monstrous suggestion—the suggesion which the noble Viscount has made that doctors should be asked to experiment on their patients. If the noble Viscount listened to the speech of Lord Moran, who read from an important article in the Lancet, he would know that these new conjunctions of drugs have been known and experimented with already and approved of by the great body of medical opinion. I am not saying that they are better than heroin—I am not entering into that. But that it should go out from this House that the Government were asking doctors to experiment on their patients with hitherto unknown drugs is to my mind a monstrous suggestion.
With great respect to the noble Marquess, I said that that was going to be the effect of the Government's action in putting on this ban. If I said anything to suggest that the Government were going to experiment, I withdraw that at once.
§ THE MARQUESS OF SALISBURY
I must get this right. Suppose a doctor had never used aspirin before and he was suddenly given no alternative to using aspirin. Would it then be said that he was asked to experiment on his patients? He would not be doing so.
If the supply of aspirin suddenly dried up and a doctor was unable to obtain any, he would have to experiment with other substances in order to discover which was the best substitute. If anything I have said suggests that the Government is ordering doctors to experiment, I certainly withdraw it. I think it is a perfectly fair thing to say, though, that if a doctor, say, for example, my doctor in Edinburgh who treated me, is deprived of heroin (with which, as I know, to this day he is treating his patients. and he is hot against this ban), he must experiment on his patients to find out which of these alleged substitutes is effective. He says only that they are 72 "alleged" substitutes—that is the cleavance of opinion on this matter. There is a distinct cleavage of opinion about whether the substitutes are adequate and effective. The only thing that Doctor A. B. Flett can do is to experiment on the patient to see which of these alleged substitutes react in a favourable manner. That is what it amounts to and nothing more.
§ THE MARQUESS OF SALISBURY
My Lords, I do not want to misrepresent the noble Viscount, but actually the impression of his words on the public mind would be that it is a pure experiment not tried before. It is not true to say that it is a treatment never tried before. One only has to read the Lancet to find out what is the position. It is not an experiment, in the sense in which the public will understand that word.
If the noble Marquess will forgive me, as between a doctor and his patient, it is an experiment. A doctor does not prescribe a particular drug in a particular case, just as one might give someone a bottle of port at dinner to-night. He knows his own patient and he must discover what is best to prescribe. It is a matter of experiment, and I am not withdrawing that statement. There is a difference of opinion on this matter. Sonic noble Lords have got up here to-night and said one thing, and others have said another. There are a great many practitioners who say that heroin is what they use in order to relieve suffering. It may be that in some cases they use other things, but if they are deprived of heroin there is only one thing they can do, and that is to experiment. If the noble Marquess does not like the use of the word, I will accept any other that is suitable; but that is what they do.
That is all I want to say, except that I am going to join with the noble and learned Earl, Lord Jowitt, in asking the Government to delay this ban; in other words, I am going to ask them to change their minds. That would not be a very wonderful thing for them to do. Governments have changed their minds before. Once before the war I made my own Government change their minds overnight by reducing to 20 the normal Liberal majority of about 100; that was when my friend Mr. Charles Lyell was Parliamentary Private Secretary to Mr. Asquith and I was Parliamentary Private 73 Secretary to Sir Edward Grey. Parliamentary Private Secretaries were not mere "hangers-on" in those days. The present Government have recently changed their minds over the V.1,000 and over the brooms, brushes and mops excluded from purchase tax. In view of the great conflict of opinion on this matter among medical men, I am going to ask the Government, in all seriousness, whether they will change their minds and delay the operation of this ban.
§ 6.15 p.m.
§ LORD CONESFORD
My Lords, the one point which I think will be universally admitted in this debate is the great importance of the subject we are discussing. There is no doubt at all in the mind of anyone who has heard the debate of the strength and sincerity of feeling on both sides. For my own part I can be shorter than I should otherwise have been on account of the admirable speech by the noble and learned Earl, Lord Jowitt, with which he opened this debate. I think we had consulted independently some of the same documents, and he took, much more effectively than I could, many of the same points. I would say at the outset, as he said, that no-one who has studied this subject doubts for a moment the complete bona fides of all the Ministers who have concerned themselves with this matter. It seems to me that the questions we have to consider fall into two classes, questions of fact and questions of principle. On both there are acute differences of opinion and on the second the lay man is hound no less than the medical expert to reach his own conclusion. I admit that I am a complete layman, but what the doctors have said arid written I have studied with the greater sympathy, because for four of my years in the House of Commons I had the honour of representing more doctors than any other Member, with one exception.
The questions of fact on which there is a difference are the value of heroin as a drug and the utility of the proposed ban. On the value of heroin, there is, as is obvious, the most acute difference of opinion. The noble Lord, Lord Haden-Guest, has expressed his low opinion of the drug. As against that, we have the emphatic opinion of the late Lord Horder, which was quoted by the noble and learned Earl, a quotation that I need not repeat. Nor shall I cite the various letters which the noble and learned Earl 74 pleaded in aid. I would say that, of all the long correspondence in The Times, the letter which most completely expressed what I should wish to express was that from Sir Francis Walshe, which was also mentioned by the noble and learned Earl. I will not repeat any of the arguments put forward in this correspondence by those who are opposed to the ban. I must confess that my own objection to the ban was immensely strengthened by those who wrote to support it. Those who wrote to support the ban seemed to me to produce even more convincing arguments against it than the others.
I have here the letter, which has already been mentioned in this debate, by Dr. Walker, of Cambridge. The noble and learned Earl gave a quotation, including the final words, "whether we pursue our proud and selfish way alone." The noble and learned Earl said that it was a curious use of the word "selfish," but I say that it is also a remarkable admission, because it is only selfish if what we are trying to retain is a drug of great value. The word becomes quite meaningless if the drug is as bad as the writer urges through most of his letter. May I quote another passage from his letter, a passage in which he criticises the special correspondent of The Times newspaper? Dr. Walker says that he detected in his articles some traces of "emotional overlay." Then these are his words, which I ask your Lordships to observe:He"—that is, The Times correspondent—seems to imply that those hospitals who have laid in a supply of heroin have somehow thwarted the Government, whereas I have no doubt the Government will be very pleased with their foresight, provided that they keep their supplies under lock and key.Why on earth should the Government rejoice in the foresight of the hospitals in laying in a stock of a drug which is thought so undesirable that its manufacture ought to be stopped? With permission, I leave Dr. Walker.
Let me come to the other most remarkable letter from a distinguished surgeon which appeared in The Times. The letter I refer to is that from Sir Stanford Cade, which contains this phrase:… patients influenced by the euphoric effects of the drug, and hence their dislike of substitutes.In other words, it makes them happy, and the others do not, and therefore it ought to be denied to the dying. I confess that 75 the argument and its force escape me. I understand that "euphoria" is an abnormal or exaggerated sense of wellbeing; pain ceases to matter, because the patient becomes indifferent to it. I should have thought that that was extremely desirable to somebody dying of an agonising disease. Many noble Lords have mentioned, and quite rightly, the case of cancer, but I would say, in passing, that the appalling pain that can be caused by gangrene also merits mention in this connection. I suggest to noble Lords that this drug may be desirable not only to alleviate the appalling sufferings of the dying, but sometimes, through euphoria, to maintain the morale of the living during a painful disease long enough for the medical adviser to give treatment as a result of which the patient may survive.
I have spoken, as I thought it my duty to do, to a distinguished doctor in preparation for this debate. He says that he knows in his own experience of several cases where the survival of the patient has been due to drug-induced euphoria. Of course, in such cases the greatest care must be taken by the doctor not to cause addiction; but there is no evidence that the legitimate use of heroin for patients in extreme pain leads to addiction. Many of us have had experience of this among some of our closest relations and friends. The case I know best is that of a patient who, after an operation, had pain entirely relieved by this drug, who completely recovered and who has never wanted or suggested another dose.
Drug addicts are almost invariably recruited from persons of nervous instability. I suggest to the House that we should be more accurate in speaking of "persons of addiction" rather than of "drugs of addiction." What evidence is there that the prohibition of manufacture here will do the slightest good elsewhere? Here I had a series of questions that I had intended to put to Her Majesty's Government, and I refrain from doing so for one reason only: that the case on this point was put so devastatingly, and out of his experience, by my noble friend Lord Waverley. Have the Government any evidence at all that the legal manufacture here has been getting into the illicit trade? If so, will they produce that evidence? For the reasons I have given, on the two questions of fact, I cannot disregard the evidence, first, that, in the 76 opinion of many well qualified to judge, heroin is a valuable drug with legitimate uses; and, secondly, that no satisfactory evidence has yet been published to show that the proposed ban on manufacture here will diminish addiction anywhere.
I turn from the two disputed questions of fact to the question of principle: should the State prohibit the manufacture, and therefore eventually the use, of a drug which many highly qualified people think of the highest value? I agree with my noble friend Lord Waverley in thinking that the answer to that is "No"; but I am quite certain that it is "No" until at least the considered opinion of the profession on the medical aspect has been obtained. I cannot believe that it has been obtained by consulting the Standing Medical Advisory Committee, though I agree that that is a most distinguished body. We know from the published letters of the supporters of the ban that its members have been asked to speak and act as individuals, and do not even disclose (I think) to outside bodies the proceedings of the Committee; and also it appears that they did not conceive that they were being asked to pronounce on the medical question of the value of the drug, but on a choice of social values.
§ VISCOUNT WOOLTON
I am sorry, but I must interrupt. I am sure the noble Lord would not like to mislead the House. That is not a fact.
§ LORD CONESFORD
I am glad to be corrected, because I do want to get this matter right. The opinion of the learned Presidents of the Colleges that appeared in The Times did at any rate sum up what they regarded as their first question in these words:Is heroin indispensable?With all respect, I agree with the noble and learned Earl. Lord Jowitt, and my noble friend Lord Waverley, that that is not really the right question. The question is not: "is heroin indispensable?" but "Is heroin a drug of great value; and, if so, is the prohibition of its manufacture indispensable in order to secure some other great good?" On that mainly medical question I do not think the best medical advice has yet been obtained. On this matter I adopt as part of my argument, if I may, both the written and the spoken words of the noble Lord, Lord Webb-Johnson, in The Times and in this 77 House this afternoon. As Sir Francis Walshe has asked, why has the Royal College of Physicians sitting in its quarterly comitia never been invited to place its considered view at its President's disposal? Would not the President of the Royal College of Physicians like to know the considered view of that important body? I beg the Government to reconsider their decision, even at the eleventh hour, and, as the noble Lord, Lord Webb-Johnson, has pleaded, to consult at least the Royal Colleges and the British Medical Association before taking this unprecedented step.
§ 6.29 p.m.
§ LORD STRABOLGI
My Lords, at this late hour I shall not ask for your Lordships' indulgence for more than a few moments, but I feel impelled to support the Motion of the noble and learned Earl, Lord Jowitt, as I think the action of the Government in banning the manufacture of heroin raises two important questions of principle. The first is that of freedom. This is the first time in our history, I believe, that a Government have stopped a doctor from using an established drug. It seems to me that a dangerous precedent is being created here if the State is to he allowed to interfere in this way in the relationship between a doctor and his patient. Where will it end? One of our leading chest specialists said to me yesterday that, if this principle of interference is allowed, it may not be long before some future Government will be dictating to the doctors exactly what medicines they are, or are not, to use.
I have discussed this ban with several members of the medical profession. There is a definite cleavage of opinion, as has been evident from the speeches in this debate. But all the doctors with whom I discussed this matter were unanimous about one point; and that is that the decision to use a particular drug should be left to the discretion of the doctor. That was felt very strongly by one of our leading chest surgeons with whom I discussed this point yesterday, although he told me that he himself never used heroin. But he felt very strongly as a matter of principle on this question of interference.
The second principle is an ethical one. It seems to me that our modern State, with its high ideals and deep humanity, 78 sometimes allows its attempt at criminal reform to take place at the expense of the innocent. We appear at times to be more concerned with the one bad apple in the pile than with all the good ones. In this case, it seems that far more concern is being shown for the small number of potential drug addicts than for the, many honest, decent, innocent people struck down by fate, suffering intolerably from some incurable disease, who will now be deprived of this drug for which, in the opinion of many doctors, there is, no adequate substitute. Whether this is, right or wrong must he left to a higher Judge.
§ 6.32 p.m.
§ THE EARL OF HUNTINGDON
My Lords, I do not wish to detain the House long at this hour, but I want to rise in support of my noble and learned friend Lord Jowitt. I claim no pretence to any special knowledge of either drugs or medicine, but I think anyone who has been in contact with the suffering of the dying will be very reluctant to agree to the withholding of any relief to people who are so suffering. Certain points have emerged from this debate. There seems to be no doubt that heroin is a powerful and great reliever of pain. What is in doubt is whether there is any fitting substitute for it. That is really the point at issue, and I was surprised that there should be this big cleavage of medical opinion. I went to see some surgeons and practitioners who are actually operating on cancer cases and who come up against this problem very decidedly. I thought that was the best way of deciding the issue in my own mind. Practically unanimously they were of the opinion that there was no adequate substitute yet discovered which would fill the function which heroin can perform.
I think this is a fair solution of this problem of difference of opinion. They said to me "After all, medicine is a very wide subject." We all know to our cost the different illnesses to which the human body is prone. You may be a very eminent doctor; you may have a very wide practice and deal with all sides of medicine and yet never come up against particular cases which can be dealt with only by heroin. Hence, if you are of that type, you may well believe that heroin is unnecessary. But if you come up against the intractable cases, then the opinion 79 naturally is to demand and insist upon this drug.
There are two points we ought to remember. One is that although relief in extreme cases of the dying is one of the most important uses of this drug, there are many operations where it is essential, such as in chest operations if a cough or hemorrhage has to be stopped, and in certain abdominal operations, where heroin is the only drug so far known that will do. The great point against morphine, which is the second most used drug of that kind, is that a certain small percentage of cases—a percentage almost impossible to determine, but which has been estimated, I understand, at between 10 and 15 per cent. —cannot take morphia. It produces unpleasant symptoms, including violent vomiting, and the symptoms are worse than the actual pain which it sets out to alleviate. So it is possible for a doctor to treat many cases satisfactorily with morphia, never having come up against that minority, and yet it is that minority which I think we must consider in this very important question. I put to my doctors the alternatives suggested by the noble Lord, Lord Mancroft—methadine, levorphan, pethadine, and so forth. Their opinion was that they were nothing like as effective in those cases. Although it is true to say that many, if I may use the word, "experiments" have been made in combining drugs, such as using morphine with dromomine and some of the anti-seasick drugs, nothing has been discovered which is as efficient. I must say that this view is supported by apparently strong feeling in the British Medical Association.
The second point which surprised me was why the British Medical Association were not consulted. Sometime ago I had some connection with agriculture, and whenever we had some new development or we had to ban some fertiliser from abroad, the first thing we would do would be to go to the National Farmers' Union, who were the people who understood the land and who knew the effects the farmer would suffer if we did what we proposed. Surely, in this case the obvious thing was for the Government to consult the Royal College of Surgeons and the British Medical Association. I still do not understand why that was not done, unless—and I hesitate to suggest this—the 80 Government were really aware of the view of the British Medical Association and thought it would be more convenient not to consult them.
§ LORD MANCROFT
That is quite contrary to the facts. I thought I made it clear that the Science Committee of the British Medical Association was in favour.
§ THE EARL OF HUNTINGDON
The Science Committee may have been, but not the General Committee, the Council. I have a document which I dare say many noble Lords have, issued by the British Medical Association, in which it asserts—I presume this is true—that the British Medical Council passed a resolution in reply to an inquiry from the World Medical Association. This is the resolution which was passed:That the World Medical Organisation be informed that it is the duty of the Government to legislate against the misuse of heroin but the medical profession should not in any way be deprived of the use of this or any other drug which may assist in the treatment of patients.I imagine that the Government must have known of that resolution. It is surprising that the Minister of Health—
§ LORD MANCROFT
I explained this at great length to the noble Earl, and if he will do me the courtesy of reading my explanation again to-morrow, he will sec that all the questions he is asking were answered by me then.
§ THE EARL OF HUNTINGDON
If I have misunderstood the noble Lord, I apologise. I will certainly read his speech to-morrow, but it still does not affect the main question I was asking: why the B.M.A. were not consulted. However, this issue ought not to be in any way influenced by the question of whether or not the B.M.A. were consulted. The question at issue, is: is it, or is it not a good thing to continue this ban? That is the point with which we are all concerned, and on which I should like to make one or two comments. The first is this. Of course the only reason for imposing the ban is the danger of addiction, which is abroad and not in this country. The figure of fifty-four addicts of heroin here has been quoted, but no one has mentioned the fact that these addicts are not necessarily what are popularly known as "drug fiends." Many of them are people who need the heroin 81 and take it under medical supervision, and who carry on with their work while they are taking it. As has been admitted by the Government, the question of addiction is not of importance in this country. Here, generally speaking, drug addiction does not exist. The only point is that in other countries the addiction is great. Are we, then, to go out and help other countries to try to cure their addiction? That really is the issue.
It would be worth while noting the fact, which has been brought forward already, that in the United States, which I gather is really the influence behind all this, there are 50,000 or 60,000 addicts. They are obviously the nation most influenced by what we do here. But not only did addiction grow there when this ban was imposed: we have always noted that the United States, with great respect to it, is a nation which goes to extremes and on which a ban acts as a sort of spur. I was in the United States just before Prohibition and during Prohibition, and the increase of drunkenness immediately Prohibition came was appalling. The same applies to this ban. The increase in the number of addicts results from the ban. Nothing that has been said or done here will affect them in any way. No suggestion has been made, I understand, that any heroin is illegally going direct from this country to the United States. If I am wrong, I shall be delighted to be corrected.
§ THE EARL OF HUNTINGDON
I gather that what has been suggested, though not from responsible quarters, is that we export a small amount of heroin to the Colonies and that some of that heroin possibly leaks through to the black market and might get to other nations, including the United States. I do not know whether or not that is true, but in any case it is a minute proportion. If it is true, the solution surely is to tighten up control here or, if necessary, ban its export. That is the answer, because the amount of heroin going from this country otherwise is practically nil.
In other words, what it comes to is that we are making a gesture of good will, saying: "You cannot cope with your addiction. We wish you could. We will try to make some sort of gesture to show that we are on your side." It is nice to make a gesture like that, but not at 82 the expense of our invalids and sufferers and when it means depriving medicine and doctors of one of the most powerful drugs in their armoury. That gesture is ill-timed. As long as poppies are grown in the Lebanon and the various countries throughout the world where it is warm enough, so long will there be a black market in morphia, opium and heroin; and nothing we can do here will affect that situation one way or the other. I therefore join the noble and learned proposer of this Motion in begging the Government to reconsider what I think is an ill-advised step. Before they bring in this ban they should review the whole situation again and consider the great deal of suffering that they must cause if they go forward w hit their policy.
§ 6.45 p.m.
§ LORD AMULREE
My Lords, at this late stage in the debate I want to take up only a few moments of your Lordships' time. I rise to support the noble and learned Earl who has put down this Motion to-clay. No-one, I am sure, will disagree with the statement that heroin is a dangerous drug which should be controlled. That is what I should prefer to see, rather than a ban on it, because, so far as I can make out, there is no suggestion at all that the ban which we may put on the manufacture of heroin will in any way assist those countries where the addiction is large. Nor, I think I am right in saying, is there any evidence that the heroin which is made under control by ourselves is passing to the black market in other ways. One country where the drug has been banned since 1924 is the United States of America. The ban has not been very successful there because the figures are going up rapidly now compared with what they were before the war. That does not seem to me to say much for imposing a ban. I agree that we could assist by banning the export of the drug, although the amount involved is not very large, because it may get into trouble on its way round the world, even though there are careful rules made for its disposal.
There are two other important points that I should like to mention. The first is that the Minister, maybe properly or maybe not quite properly, obtained views from the Standing Medical Advisory Committee when contemplating this ban. But did he go back to that Committee after he had received the deputation from 83 the British Medical Association on July 11 of this year so that the Committee could consider the objections raised by the B.M.A.? I should be grateful if we could have a reply on that point. As noble Lords have said, it is the first time that a Government have ever stepped in between a doctor and his patient over the treatment he should give his patient. That is a principle on which we have to stand rather firmly. Heroin is a drug that I practically never use in my hospital work. I use it a lot on myself, when I get one of these nasty coughs that are uncontrollable. I have tried substitutes, but not many. I like my little drop of heroin: it works very well for me. I have not yet become an addict. I have been taking it for twenty-five to thirty years on rare occasions when I have needed to.
On the general aspect of patients suffering from pain, I may say that a great deal of pain can he coped with by substitutes and other drugs. Fortunately, however, human beings are not all the same: what is good for one is not good for another. At the present time there remain a certain number whose pain can he controlled satisfactorily only by the careful administration of a certain amount of heroin. It is for that reason alone that I join the noble and learned Earl in asking Her Majesty's Government whether they cannot possibly postpone the imposition of this ban until further inquiries have been made. I admit, as the noble Lord, Lord Moran, pointed out, that it is difficult to make these inquiries, but nothing is insuperable. If further investigation into the pain-killers could be made, it would be of great advantage.
§ 6.50 p.m.
§ VISCOUNT WOOLTON
My Lords, we have had, at any rate, one of the most interesting debates that I remember in this House, and I am sure that I am echoing the opinion of noble Lords on all sides of the House when I say to the noble and learned Earl opposite that we are indebted to him for having raised the issue, even though we may not be agreeing with him. At any rate, it was obviously an issue that it was proper for this House to discuss. Of course, he had a great advantage over us, because he spoke with all the eloquence of the great advocate that he is, and he had a case to argue. I am sure he will not mind my 84 saying that he was perhaps just a little selective in the evidence that he brought forward. I thought he spoke with great effect about the evidence that he got from France. France is one of the four countries that does not want to join in this world organisation against heroin. They are, as yet, outside it. He quoted as an authority Sir Cecil Wakeley, who is a friend of many of us in this House; but there were other authorities he could have quoted on the other side, or that I could quote if I were to occupy your Lordships' time (it would be for a great length of time) because surely the debate tonight has shown more than anything else how clearly opinion is divided on this subject —and not only medical opinion. I am sure your Lordships are grateful to the people who have professional capacity to speak on this subject and who have helped us in the course of the debate. But opinion is obviously divided also among the lay Members.
I will not disguise from your Lordships the fact that when we were discussing the Business of the week, those of us on this side of the House who have responsibility in the matter decided that we should not send out a Whip, because we wanted to get the free opinion of the House in order that the Government might be guided. I think your Lordships will agree that my noble friend, Lord Mancroft, gave a pretty fair and certainly a full and accurate statement of the facts that had been before the Ministers who were responsible. Before I forget it, and if the noble Lord, Lord Denham, is here, I am sure your Lordships will agree with me in congratulating him on the maiden speech that he made on this difficult subject. He showed considerable courage in making a maiden speech on such a subject, and the House looks forward to his help on many occasions in the future.
My Lords, let us be clear about one thing. This question did not arise because some "bright boy" in the Government suddenly said, "Let us have a go at heroin." It arose because the Government of the day were faced with the question, put to them by fifty-four nations, as to what we were going to do about the drug. The present Government were not concerned in this—I make no Party point of it—but Mr. Bevan was the Minister at the time. He was faced, as we are faced, with this position. We in this country are the largest manufacturers of 85 this drug, about which some of your Lordships who have not had it have been so eloquent in its praise this afternoon. I have had it, and I am not nearly so sure of its benefits as are some of your Lordships: in fact, I asked my doctor not to give it me any more. Perhaps I did not like feeling so euphoric. But here was the position. We are the largest manufacturers in the world of this drug, and fifty-four nations were saying to us. "Here is a drug that is dangerous to society. We are asking you to give up the manufacture of it." That is not a subject that can lightly be thrown away. We have heard many arguments this afternoon from your Lordships about whether that course would in fact be effective—whether prohibition is the way to tackle the issue. There are powerful arguments in this matter. The noble Viscount, Lord Waverley, who has apologised for his absence, not only spoke to us with the great authority that always surrounds his name on questions of administration, but propounded problems to us the answers to which were not at all clear to me—difficult problems for any Minister to have to face.
Obviously, we had to do something Let me say this in passing, because I am going to say things later on which some of my doctor friends will not like very much. What a tremendous debt we in this country owe to the medical profession for the fact that we do not have heroin addicts here! I am sure that is considerably due to the fact that they have used this powerful drug with so much care, skill and discretion. The first question that the Minister at the time had to face concerned the problem of the international demand. But he, and we, have had another problem to face—namely, what about our people at home? Inevitably, that is a question which must affect any Government most seriously. That is not really a problem for the layman. The question whether one drug is absolutely essential, or whether there should he a combination of drugs—I speak with profound hesitation in the presence of doctors—is largely a personal matter. Different people react differently to different drugs, and there really is not a simple answer to it.
What could the Minister do? He was bound to go to authority—to medical and scientific authority. As the noble Lord, Lord Moran, has pointed out, there 86 was a statutory body appointed to advise him, not only on this subject but on all the subjects which concern the National Health Service. This subject was the concern of the National Health Service: so he went to that body. I maintain that he was right in so doing. I understand that my noble friend, Lord Conesford, does not like the evidence when he gets it from that body, and says that it would have been better if the Minister had gone to somebody else. Many people have asked: why did the Minister not go here, or why did he not go there? It is easy after the event to ask such questions. But he went to a body of people of extraordinary diversity—the noble and learned Earl made that point to its disadvantage. Your Lordships will forgive me for saying that perhaps it was not quite fair, because he dealt with the side lines. He told us about them. But in that body there was this great central body of opinion of the Royal Colleges, of the General Medical Council, and of the British Medical Association—people who were practising medicine. The Minister went to them and received a very clear answer. A noble Lord asked me what was the question put to them. This is the note that I have:Mr. Bevan asked his Standing Medical Advisory Committee to advise him whether, if an international agreement prohibiting the use of heroin was proposed, there was sufficient medical reason why ale Government should not support this proposal.I hope I am carrying the House with me in my next remark, because, whatever has been said this afternoon, I am sure none of your Lordships would wish to cast any reflections on the integrity, impartiality or competence of that very distinguished body of people, who are rendering great service to the State, free of charge—and so characteristically of the medical profession. Noble Lords may say, "We wish he had gone somewhere else," but that surely is a matter in which one man's opinion is just as good as another's. We recognise that this was a body of people of very considerable experience. Their advice was definite and decisive. They said that it would be justifiable to prohibit the use of heroin in Britain if international agreement should be reached on prohibition of the sale of the drug.
The noble and learned Earl said that Her Majesty's Government should have taken more account of the "G.Ps." Many 87 of your Lordships have said the same, and I gather that many have been impressed, as I was, by the circular that was sent round by the B.M.A. Let us be a little analytical of this question of general practitioners. Is the point a valid one? Is there really any considerable gulf between the general practitioner and the consultant? I speak of general practitioners with the greatest respect and gratitude, but they are not the only people who see patients in extremis and at the bedside. Consultants, too, are often in that position. Let us make this a personal question. What do we do when we are in trouble? Do we say: "Ah, well, the general practitioner will know what are the best drugs to give"? Do we rely upon him exclusively, or even principally? We do not. Indeed, what does the general practitioner do himself? Always he says. "I should like a second opinion, or even a third opinion." I have a most painful recollection of coming to semi-consciousness, finding five people round my bed and wondering exactly what was going to happen to me next when so many people had had to be brought in. It was the general practitioner who brought in the specialists. If the body that gave this advice consisted more of men of great eminence in the medical world than of general practitioners, I do not think it was much the worse for that, because those people of eminence, such as my noble friends, Lord Webb-Johnson and Lord Moran, have, in their time, been general practitioners.
§ VISCOUNT WOOLTON
I could not be clearer on the fact that the noble Lord, having had one opinion, says he thinks we had better have another. It is not unusual in his profession. The noble Viscount, Lord Elibank, who must be getting a certain amount of satisfaction from the public service he has rendered by raising this Question in your Lordships' House, asked what are the possible alternatives. He said. "Tell us what they are; we want to know." Were your Lordships very much better after you had heard my noble friend the other day read out those very long words, on whose pronunciation we congratulated him? Those names did not mean a thing to me. I wonder whether they did to the noble Viscount.
My Lords, I asked the Question, not for my own benefit, but for the benefit of the medical profession. Those names meant nothing to me but were for the benefit of the profession, whose members had never heard what were the alleged substitutes for heroin.
§ VISCOUNT WOOLTON
My Lords, I am sorry, but the noble Viscount must not ask me to accept that statement, because many members of the medical profession read the Lancet, and there were all those names, on page 1184 in the issue of December 3. There the whole matter was dealt with.
§ VISCOUNT WOOLTON
Nor does the medical profession rely on Questions and Answers in this House to know what drugs are available to them. I do not think the noble Viscount made much of a point there.
I make my next submission particularly to those noble Lords who have peculiar competence to judge. Noble Lords have asked why we did not make more experiments of a clinical nature before taking the responsibility of saying that the public should not have this drug. They asked, "Why did you not test this out clinically? Would it not be a good thing if we now proceeded to do that"? I do not know whether I have sufficient authority to say that I very much doubt whether clinical experiments of that nature would be any use. It is very difficult to prove a negative. We should be trying to prove that we could do without heroin, and surely the real difficulty is that pain is not a measurable thing; it is subjective, and it is not an easy matter on which to get any measurable result of the effect, on the patient, of different drugs.
I want to give this point to the noble and learned Earl straight away, if he wants it: if your Lordships feel that it would be a good thing, then Her Majesty's Government are prepared to take early advice from the Medical Research Council as to whether it would be practicable and advantageous to arrange a special series of scientific trials in this field. But, my Lords, there surely is some clinical evidence on which you might well form some judgment. There are many doctors 89 in this country who do not use heroin—very many. I have not been able to go round asking for medical opinion, but I am sure that Sir Henry Cohen would not mind my saying what was his experience in the Liverpool Royal Infirmary, which I used to know when I lived there, and of which he is the Senior Medical Adviser. He told me that at that institution they had used heroin once in two years. They are not insensitive people there they are really deeply concerned about their patients. And there is a lot of such evidence, evidence of men like Sir Stanford Cade, whose opinions we all value very highly, who say that in fact they do not use heroin. I submit that, not as an alternative opinion, but merely to show that there is some clinical evidence to the effect that other combinations of drugs can be effective. I apologise for keeping your Lordships for so long, but I must deal with these issues which have been raised.
I wish that the noble Lord, Lord Teviot, had not gone home—I warned him before he went that I should have something to say to him. It is monstrous that the noble Lord should say that we have not given enough attention to this problem, that we have not studied it long enough. Gracious me! three Governments have been studying it since 1949. And why does the noble Lord assume that we come to conclusions and do not give them proper consideration when they are matters of such grave moment? And was he really wise in making that dangerous remark about seeing that his doctor laid in a stock of heroin in case anything happened to him? The very worst thing in the world would be for the people of this country to get it into their heads that this was a drug of which they had better have their private hoards in case anything happened to them. I wanted to say that.
§ VISCOUNT THURSO
Is it not a fact that hospitals in this country are laying in stores? I do not see anything improper in the noble Lord's saying that he is laying in a store of this drug if hospitals are announcing it.
§ VISCOUNT WOOLTON
Of course the noble Lord has just as much right to his opinion as I have to mine. But I think there is a world of difference between private people doing this and hospitals doing it.
90 The noble Lord, Lord Moran, said he thought the medical profession (I hope I have his words correctly) had got a little restless under the National Health system. I think that is true. I think it is true that there has grown up in medicine during the last few years a body of people who, in the interests of their profession, have thought it necessary to seek to protect themselves against incursion by the State into their affairs. On whether they are right or not I do not think is for us to form any judgment. But if, for one reason or another (and this, I think, is a really important social and political point), the State, on the advice of the most expert body of opinion that it can command, decides that some drug constitutes a social danger, and, on the same expert advice, comes to the conclusion that there are effective alternative drugs, then I ask this question: "Have not the Government the right to say: 'This drug shall not be made in this country except for experimental purposes'?" Or, alternatively, are we to say that, in spite of the weight of medical opinion, the individual doctor must be allowed to follow his own conscience and his own knowledge in these matters, even though his knowledge may admittedly be inferior to that of the leaders of his profession?
It is no secret to most of your Lordships that I have never been very partial to State interference with the liberty of any person or profession, but when an individual finds himself opposed to the scientific thought of The leaders of his profession then I really cannot admit that, because he has taken such examinations as are necessary to qualify for the practice of medicine, he should be left as a law unto himself. I am surprised to find—as I admit I do find—that there are eminent people who have taken that view. I have great respect for their professional qualities, but I doubt whether they are wise in allowing their fear lest the State should interfere to lead them to such a conclusion.
§ VISCOUNT WOOLTON
I cannot say that it would. What were the premises I gave? The premises were that authoritative opinion had come to the conclusion that this was dangerous.
§ VISCOUNT WOOLTON
I am not talking about heroin but about the general principle. I do not see that there is any reason for fearing that it will interfere with advance.
The point I am making is that prescription, obviously, is the duty of the doctor; but permission to trade in dangerous drugs is the duty of the Government. Those two factors have got to be balanced. I wanted to say that, on the general issues that had been before me until last night, and before I knew of the legal issue which the noble and learned Earl has raised to-day, I was going to suggest to your Lordships that perhaps you would be well advised to suspend judgment until you had read the Government's White Paper—which I am authorised to tell the House is in preparation and will be issued at the earliest possible moment. I am told that there is two years' supply of heroin in this country at the present rate of usage. I trust that these facts which have been brought before your Lordships by various speakers—I am afraid that there have been very few on the side for which I am acting as advocate—may help you to suspend judgment for a while.
However, the noble and learned Earl has raised a legal issue to-day, of which he has given notice and of which I heard only yesterday. It is a point of considerable complexity and of great importance, and he will not, I am sure, expect me to express a view on it now. I would not express a view on it now. Obviously there are divergent views on this subject, but I can say one or two things. First, the ban on heroin will not be imposed by this Government unless and until it is clearly established that such action can legally be taken. The time is short and the end of the year is very near, and in order to give ample time for full and careful consideration of this matter I announce to your Lordships that the Government will not impose the ban on December 31. Of course it will be for the Government to consider what the next step should be if the legal issue put forward by the noble and learned Earl proves to be well-founded. In these circumstances, I think that the 92 postponement for which the Resolution asks can be conceded, and I hope that the noble and learned Earl will not think it necessary to divide the House.
§ EARL JOWITT
My Lords, may I clear up this point, because I am very anxious not to divide the House if I can avoid it? Does it mean that licences to manufacture heroin will be issued to the proper people for the year 1956 as before—of course, without prejudice?
§ VISCOUNT WOOLTON
Then the answer is in the affirmative. The point is that the ban will not be imposed.
§ EARL JOWITT
Then licences will be granted as before for the next twelve months' period? Of course, we realise that the Government have the right to reintroduce the ban (I hope by Bill, if they should be so ill-advised as to want to reintroduce it) as they think proper, but so long as I have secured at any rate that licences will be issued for the next year, I shall be content, and will ask leave of the House to withdraw my Motion.
§ VISCOUNT WOOLTON
My Lords, I have received information which I had not before which enables me to give a precise answer to the noble and learned Earl. The licences will be issued for a period of time.
§ VISCOUNT WOOLTON
Until we have determined the legal issue which the noble and learned Earl has raised. I think that covers everything.
§ EARL JOWITT
That is not enough. You cannot issue a licence for an indeterminate time. You cannot issue a licence temporarily until you have determined some legal issue. That is an impossible situation. What I must have is a period of time. The licence is always issued of for one year, and I want to know whether the licences are to be issued for one year. If so, I will withdraw my Motion.
§ THE MARQUESS OF SALISBURY
My Lords, I think the position would be that the point which the noble and learned Earl has raised is clearly one of great legal importance and must be cleared up. When it has been cleared up, of course, the Government must make a statement to Parliament. When it is made to Parliament, that statement can be debated and the matter will have to be considered further. But there will be no refusal of licences. The licences will be granted until such time as Parliament has had time to consider the matter further. I do not think the noble and learned Earl can ask more than that. We are postponing the ban partly in deference to his wishes and partly, to Amy mind quite properly, because a new point has been raised. The noble and learned Earl knows that we have not admitted, and do not admit, that the advice we have received was improper advice; and I certainly should not be prepared to concede that point. Indeed, to my mind, the most important part of the decision which the Government took is that it was taken on what they regarded as the highest medical advice. At the same time, as I say, no step can be taken until this point has been cleared and in my view no step should be taken until Parliament has been properly consulted.
§ EARL JOWITT
Let me put this to the noble Marquess. We have listened to a long and tiring debate and I think the House is ready and would like to express its opinion. If I am going to ask the House not to express an opinion, I must ask for something definite. If the noble Marquess is going to introduce this ban again—I am not going into the medical merits or de-merits of the han—I believe that it has to be clone by Bill, and I do not for one moment believe the Government can possibly get the Bill through to become effective until January 1, 1957. 94 I would say, therefore, what do you lose by giving licences for 1956? For aught I know, manufacturers may be quite unwilling to go on with the manufacture of heroin unless they have some security in time.
§ THE MARQUESS OF SALISBURY
I think I can relieve be noble and learned Earl's mind on the question of time. When I spoke to your Lordships' House before, I was not in possession of all the facts about the position. I have had a message which enables me to say that the licences will be for a year.
§ EARL JOWITT
Very well. On the understanding—I repeat, on the plain understanding: let there be no misapprehension about that—that licences will be granted for next year, that is to say, for the year 1956, as they have been hitherto, I ask leave to withdraw my Motion.
§ Motion, by leave, withdrawn.