§ 5.49 p.m.
§ Order of the Day for the Second Reading read.
§ THE LORD PRIVY SEAL AND MINISTER FOR SCIENCE (VISCOUNT HAILSHAM)
My Lords, this Bill will, I hope, prove quite uncontroversial, and it certainly is, so far as I know, uncontroversial in any Party sense. Its object is simply to replace an anomalous arrangement for the maintenance of the Public Health Laboratory Service, which was never intended to be permanent, with a permanent machinery.
At present the Service is carried on, under the terms of Section 17 of the National Health Service Act, 1946, by my right honourable friend the Minister of Health. When this Bill passes, as I hope it will, it will still be carried on by him, but instead of, as now, being carried on by the Medical Research Council on his behalf, it will be carried on by a new Board to be appointed especially for the purpose by my right honourable friend; and the Medical Research Council will be represented on the Board by two members who will have been appointed after consultation with them.
In order to explain the purposes of the Bill it is perhaps necessary for me to go back a little into the past. The Public Health Laboratory Service had its origin in an emergency service created shortly before the last war. This Service was provided by the Medical 998 Research Council at the request of the Committee of Imperial Defence. The original object was not to provide part of the day-to-day business of administration, but to provide a defence against possible enemy use of bacteriological warfare and against any major outbreaks of epidemic diseases arising from wartime conditions, including the anticipated large movements of population and the disruption of normal sanitary services. In the event, the Service was not used to deal with any major emergency of this kind. On the other hand, having been called into being, it came to be used by medical officers of health as a very valuable aid to their ordinary work. Only in the areas of some of the larger local authorities had any such service previously been made available. Indeed, the main reason for creating the Service in the first place had been the inadequacy of the arrangements before the war for the bacteriological work required for public health purposes, particularly in the vulnerable southern part of England.
Thus, it came about that a Service which had been designed for an emergency became an indispensable part of the normal functioning of peace-time administration. It was therefore decided after the war to maintain the Service as part of the regular machinery for the diagnosis and control of infectious diseases. The Medical Research Council, in view of their early association with the project, agreed to continue to administer it. At first they agreed to do so during an initial period of five years; in point of fact, there being nothing quite so permanent as the provisional, they have continued to do so ever since as agents for the Minister of Health.
The primary function of the Service is to undertake bacteriological and virological examinations for the assistance of local public health authorities in the control of infectious diseases. The work consists in part of the examination of specimens from human subjects suffering from infectious diseases, or suspected of having been exposed to infection. For the rest, it consists of the examination of so-called sanitary specimens—namely, samples of water, milk, foodstuffs and other materials which may be the sources of infection. A major feature has been the availability of 999 bacteriologists to go into the field to assist medical officers of health in the investigation of outbreaks. Although the laboratory methods used are largely the same as those of hospital bacteriological laboratories, the aim of the work is quite different; it is concerned with the control of infection in the population at large and not with the treatment of the individual patient, so that its field is in the community, as it were, and not in the ward. Therefore, unlike the hospital laboratory services, the Public Health Laboratory Service is organised on a national and not on a regional or hospital basis, and it is organised for the whole of England and Wales, Scotland having its own service with which this Bill is not concerned.
It is, of course, trite to say that infectious diseases observe no administrative boundaries, and it is therefore the case that an outbreak has often to be traced from one area or region to another. There is also facility in a national service for reinforcing one laboratory with staff from another in times of local stress. In addition, it is important when epidemics occur to have a national intelligence network. But although organised on a national basis, the constituent units of the Public Health Laboratory Service work, of course, in close touch with the hospital laboratories in their areas.
The service at present consists of the Central Public Health Laboratory, eight regional laboratories and 51 area laboratories. There are several special reference libraries, some included in the Central Public Health Laboratory but some placed elsewhere, in other institutions. The Service is considered now to be fully developed, and no increase in the number of public health laboratories is envisaged. The staff of the Service numbers about 1,068 persons, of whom 126 are medically qualified. Scales of pay are equated to those of the hospital services. The cost of the Service provided in the Civil Estimates for 1959–60 is £1,212,000 to cover the salaries and running expenses of the Service, including the cost of the purchase, testing and issue on behalf of the Minister of Health of certain immunological preparations distributed through the laboratories. Another £50,000 is provided for capital expenditure on buildings.
1000 The Medical Research Council, who came to be responsible for this Service in the way I have described, have for some time been anxious to divest themselves of this responsibility, and to substitute for what was always an anomalous and temporary arrangement a permanent organisation responsible to the appropriate executive Department. I hope that their reasons will commend themselves to the House. In the first place, the work of the Service is really peripheral to the Council's interests, for they are mainly concerned with research and, although scientific, the work of the Service is largely routine. Although it does include some research, this research is included only as a secondary function. In the second place, there is here a conflict of ministerial responsibility. There is some inconvenience in the anomaly that the Council are in this matter responsible in respect of their normal functions, through myself, to the relevant Privy Council Committee, and for the Service to my right honourable friend.
It is also somewhat embarrassing for the Council as employers of labour. The staff of the Council in its normal function is related to the level of remuneration enjoyed by the staffs of universities. As I have indicated, however, the remuneration of the Public Health Laboratory Service staff is related to that of staffs of hospitals in the National Health Service. There is also a reason of efficiency. The executive work of the Service has remained in the Council's headquarters staff, but the ordinary work of the Council and of their headquarters staff has continued to grow so that it has become necessary for the Public Health Laboratory Service to be given its own administrative machinery as soon as possible in order to release the headquarters staff of the Medical Research Council for its normal functions.
Accordingly, it was decided to introduce this Bill. This will enable my right honourable friend to administer the Service through the new Public Health Laboratory Service Board which he will appoint. The Board will exist as a separate entity, with legal status—an advantage, incidentally, not at present possessed, and which cannot be obtained, by the present Board assisting the Council—and it will enable it to employ staff and hold property in its own name. This body will, in a general way, be 1001 analogous to a Regional Hospital Board—that is to say, it will administer the Service as the agent of the Minister of Health. It will be appointed by the Minister of Health, and its staff will not be civil servants. It will be subject to the directions of the Minister of Health, whose control of the Service will thus remain more or less as it is at present. I think that no significant additional expenditure is involved, as the cost of administration by a separate staff should be largely offset by saving the payment at present made to the Medical Research Council for the performance of this function by their own staff.
My Lords, I turn now to the actual provisions of the Bill. Clause 1 constitutes the Public Health Laboratory Service Board to administer the Service as the Minister of Health may determine and under his direction. The Board is empowered to appoint staff and to pay expenses to its own members. Clause 2 transfers the staff of the Public Health Laboratory Service (other than certain headquarters staff) from the employment of the Medical Research Council to that of the new Board. There is contingent provision for the payment of compensation for loss of employment or emolument, but it is in fact thought unlikely that this will be required.
Clause 3 transfers from the Medical Research Council to the Minister of Health property held for the purpose of the Public Health Laboratory Service. The Board itself, however, is empowered, in paragraph 2 of the Schedule of the Bill, to hold property and to accept gifts. Clause 4 provides that the cost of the Public Health Laboratory Service shall continue to be met by the Exchequer. Provision is made in respect of accounts and audit in the usual form and continuing the practice followed under the existing arrangements. The Schedule provides for the Board to be a body corporate and to be able to accept and hold property on trust for the purposes of the Public Health Laboratory Service or otherwise connected with bacteriological research.
All the members of the Board are appointed by the Minister of Health. The Board consists of a Chairman and one other member, both medically qualified, two members appointed after consultation with the Medical Research Council, two members with experience as bac 1002 teriologists, two members who are medical officers of health of local authorities and two members with administrative experience. In all, the Board consists of a Chairman and nine others and provision is made in respect of periods of office and procedure. With this explanation I trust that your Lordships will give the Bill a Second Reading. I beg to move that the Bill be now read a second time.
§ Moved, That the Bill be now read 2a.—(Viscount Hailsham.)
§ 6.3 p.m.
§ LORD TAYLOR
My Lords, the noble and learned Viscount the Lord Privy Seal has said he hopes that this will be an uncontroversial Bill, or at least uncontroversial in any Party sense; and I entirely agree. It is completely non-controversial in any Party sense, and I hope that it will prove to be largely non-controversial in any other sense. Nevertheless, there are a number of points about this Bill which we wish to raise and a number of criticisms of the Bill which we shall make, with a view to improving it; and I hope that the noble and learned Viscount will look at our suggestions in that light.
It is an extraordinary thing that this Service has been in existence for 21 years and has never been mentioned in Parliament except, so far as I have been able to ascertain, in one Written Question in another place. Yet as the noble and learned Viscount has said, it is spending about£1.3 million a year and is doing a magnificent job: perhaps because it has had no Parliamentary attention it has been able to get on with its job. As he said, it is one of the very good things that grew out of the war, out of the complete miscalculation we all made as to what total war was going to be like.
I well remember that I was working in a hospital just before the war and the first intimation of total war that we had was the arrival of an enormous number of papier mâché coffins. The anticipation was that there would be an enormous number of casualties, great epidemics, possibly bacteriological warfare and great dislocation of population. Things turned out quite differently but it was to meet these possibilities that the Emergency Public Health Laboratory Service was set up. When none of these things eventuated, the Service started to 1003 do quite different work and, as the noble and learned Viscount mentioned, it provided a service for Medical Officers of Health. As a matter of fact from the start the Service did more; it provided a service of value to the Army, to hospitals and general practitioners, in all aspects of epidemiology. In fact, it is a kind of national medical Scotland Yard. It differs from Scotland Yard only in that it has its peripheral units scattered all round the country and does not have to wait for a county police force to call it in. It does, however, have to be called in by somebody, and the people who call it in are medical officers of health, the hospitals or local doctors.
One great feature of the Service is that staff have always been available for personal consultation. They have come out to see cases, investigate problems on the spot and to help doctors concerned with any kind of epidemiological problem. Moreover, there has been great advantage in having it as a national Service, because it has meant that techniques throughout the Service have been standardised at a very high level; and there has been maintained at the centre a very interesting and famous group of central reference laboratories. I believe the noble and learned Viscount spoke of libraries, but in fact they are laboratories for special kinds of bacteria and viruses; they maintain the central stocks of sera with which it is possible to identify germs which may occur, very rarely in any one particular area.
It is fortunate that the Service developed under the Medical Research Council, because the Service has done an immense amount of research work, and I was a little sorry to hear the noble and learned Viscount say that the bulk of its work was routine and that it was not primarily a research organisation. It is true that it is not primarily concerned with the research; but every year, as one sees in reading the Annual Report of the Medical Research Council, the volume of papers which are turned out by the research bacteriologists in this Service is amazing. I hope that this transfer of functions will not mean any lessening of the research activities of the Service. We should like to have a firm assurance that 1004 that is so. I think it is so, and I believe that under the National Health Service Act there is adequate provision to cover that. We hope that this change does not indicate any change in emphasis in the Service in this respect.
The Service has really put Britain in the forefront of bacteriology and epidemiology and, as the noble and learned Viscount has said, it was so valuable that it was made permanent after the war under the National Health Service Act, Section 17. Then in 1948 it was given a Board of its own by the Medical Research Council, and it has had that Board since that time—the Public Health Laboratory Board—the precursor of the Board which we are discussing this evening, which will run the Service in future, and which the noble and learned Viscount said was very analogous to a Regional Hospital Board.
At the outset, the Service was largely concerned with problems arising out of the war. Almost the first job it did was to make a study of meningococcal meningitis or spotted fever, which occurs in barracks among young troops—typical of the kind of situation which all wars have produced. This spotted fever has always been a problem, but here, for the first time, were a team of bacteriologists to tackle it. Then they went on to tackle something with which we were all familiar in war time, the bacteriology of dried egg which was being imported; unfortunately it brought with it a lot of salmonella organisms. When it was used there were very soon outbreaks of food poisoning, and control was largely accomplished by this Service.
For its third job the Service turned its attention to a condition called infective hepatitis, a condition which, again, occurred among troops when they were inoculated against such diseases as typhoid. It was found that if one of the injected persons was suffering from perhaps a very mild attack of jaundice, or even some mild degree of infection without jaundice, the folk who followed him in the row also developed jaundice if the needles were improperly sterilised. This was a very important step in the history of the Service, because it was found that the cause of infective hepatitis was a virus. It was at that point that the Service ceased to be a purely bacteriological Service and became a 1005 virological service. Before long it was extending its activities in other directions. It started to study pathogenic fungi, such as that which causes"farmer's lung", a condition which occurs as a result of inhaling a very small quantity of the fungus carried on corn during threshing, and tinea infections of the skin, and went on to study protozoa and larger organisms than bacteria, particularly the condition called toxoplasmosis which is transmitted, I believe, by rabbits.
Once the Service got going on viruses there was no stopping it, and it has been dealing with measles, poliomyelitis, smallpox and influenza. Indeed, the World Health Organisation has recognised the central laboratories of the Service at Colindale as a World Influenza Centre. So it has placed us in some respects in the forefront of world influenza research. It has also a virus reference library at Colindale and a mycological reference laboratory—that is, a fungus reference laboratory; and an air hygiene unit, which is studying such things as the spread of infection in schoolrooms and other crowded places, and recently has been studying infection in offices. It has been helping in the design of operating theatres in the new hospitals which are beginning to go up. It has an epidemiological research unit at Cirencester run by a part-time general practitioner; and I should like to ask the Lord Privy Seal whether it is intended to carry on this excellent little unit which has been doing some interesting work.
On the purely bacteriological side the Service maintains centres which concern the whole of Europe and the Commonwealth for seriological typing, particularly for two groups of bacteria, the salmonella organisms and dysentery organisms. Research activities range from bacteriological structure and metabolism to such practical questions as bacteriology of public telephones and iced lollipops. I should like to say a special word about salmonella organisms. They were discovered by an American bacteriologist named Salmon in the 1890's in the hey-day of bacteriology, when everyone could find new bacteria with a microscope and because methods of staining bacteria had just been devised. Salmon discovered the organism which caused hog cholera, and 1006 it was a prototype of a great group of bacteria which includes the typhoid and paratyphoid bacteria. There are now over 400 of them. It is impossible for any one local laboratory to have the necessary sera to identify the lot, and these organisms have become increasingly important in the last few years, with the increase in eating out and the importation of cooked food from the Continent. If your Lordships study the annual reports of the medical officers of health, you will see that one of the few diseases which are going up, and continue to go up year by year, is the salmonella infecttion. So it is a really important thing.
Recently one of the people in the new town where I work, Harlow, developed one of these salmonella infections. The specimens were sent to the local laboratory. They went on to Colindale; they were typed, and it turned out that they were a very rare type of salmonella. The only other cases were occurring in Birmingham, where there were a few. They were all traced down to a certain kind of sausage which was being imported from Central Europe—a very pretty piece of detective work ! An even more remarkable one occurred when another salmonella cropped up in Harlow a little while ago. It was sent to Colindale and it was identified as something called salmonella Abory. These salmonella are usually called after places. There are salmonella Poonah, salmonella Montevideo, and so on.
It so happened that our local medical officer of health remembered having read that this organism occurred in the alimentary tract of tortoises. So he visited the patient's home, and there, sure enough, in the garden he found a tortoise. It was hibernating, and the family readily agreed to the admission of this tortoise to hospital, and it is now asleep in the hospital laboratory. They are waiting for it to wake up, and I suppose one may say,"be a good tortoise." Then a specimen will be available from which they expect to discover salmonella Abory. The alimentary tract of the tortoise is alive with a whole tribe of these things that have caused quite a lot of human infection. One pathologist in the Public Health Laboratory Service runs a tortoise farm to collect them. It is a strange episode in human disease, but it is a very important one. Moreover, it is exceedingly difficult to 1007 get rid of, because the alimentary tract of the tortoise is exceedingly sluggish. It is necessary to put a tortoise into a thing called a tortorium where it is kept for four or five years while it clears itself and frees itself from salmonella.
There is another of these organisms in bone meal, which is particularly important in connection with animal feeding-stuffs, because it could contaminate the poultry and cause salmonella infection of eggs. There are other animal feeding-stuffs which can be infected. So it is clear that this is a very important problem, although it has its funny side, too. But one must remember that in children and in old folk these infections can prove fatal and they are increasing.
The Lord Privy Seal mentioned that this Service is primarily linked with the medical officers of health. It is linked more closely, perhaps, than is generally realised with the hospital services. In some places the Public Health Laboratory functions as a general hospital bacteriological laboratory, doing the routine hospital bacteriology for that hospital and for the general practitioners in the neighbourhood, including the routine culture of swabs and so on, as well as its own specialised work on milk, water, shell fish, and ice cream. In other places it does specialised work only. It has been suggested that the right thing would be to pop the Public Health Laboratory Service in with the hospitals and make it part of the Regional Hospital Board service. But I am sure that the decision taken by the Government is the right one. It should be kept as an entity, for precisely the reasons which the Lord Privy Seal has given—namely, that bacteria know no regional boundaries. Moreover, there must be a central reference organisation, if these germs and viruses are to be identified in the increasingly difficult varieties in which they are occurring. In some areas, there are rather poor links with hospitals, and in those areas we feel that something might be done under this Bill to improve the linkage, particularly when we come to look at the Schedule setting up the Board which is to run it, where your Lordships will observe there is no hospital representation at all.
I was very pleased to hear the Lord Privy Seal say that the staff of this Service would not be civil servants. I 1008 think it is quite right that they should not be, and that this should be regarded as a separate Board, run by technical experts, without those inhibitions which would result if they had been civil servants. I was pleased, too, to hear that the salary scales are to march in step with those of the National Health Service as they have been doing recently, and some of the bacteriologists in this service now get merit wages.
I think it would be proper and right to pay a tribute to two people who have played a special part in building up this service. They are Sir Wilson Jameson, a great Chief Medical Office of the Ministry of Health at the outbreak of war, who has as much as anybody else envisaged this service and brought it into being. The second is Dr. G. S. Wilson, the Director of the Service. He is a very remarkable man. As a student I was brought up on his great text book on bacteriology, Topley and Wilson, which is the most famous textbook on bacteriology in the world. He is remarkable because he is not only a great scientist but a great administrator, and the success of this thing has been very largely due to his tremendous dynamic energy. Long may be continue to look after the service!
The Lord Privy Seal has described the structure of the Service and how, it has its regional laboratories, its area laboratories, and then its central specialised laboratories. It has grown to a position where it is one-third of the size of the Medical Research Council, and it is quite right to hive it off now. But there are three provisos. The first is that there should be no curtailment of the research work which the Service does; the second is that the terms of reference of the Service should be sufficiently wide; and the third is that the new administration will give the Service the breadth it needs to continue to develop—for it will not be static: it really will not. The Lord Privy Seal said he hoped it would not grow. It will grow, because more bacteria and more viruses will be discovered.
I said that we were very proud of our Service in Britain, and I think it is probably the best bacteriological service in the world: but ours is not the best virological service. The Americans are better than we are on virology—that is to say, the identification of very small organisms. The reason is that it is so 1009 expensive to do virology. It requires twice as many people for any given unit of work as compared with bacteriology, because all the viruses have to be grown in living tissue, in tissue culture. So the work will grow.
Now with regard to research work, so far as I am able to ascertain—and it is only a rough guess—about a quarter of the work done by the Service is research work, and three-quarters is routine; but it varies enormously from laboratory to laboratory, and a good deal of it is what might be called field research—that is to say, going out and making investigations and studies in hospitals, on epidemics involving new organisms, and so on. Again we would urge that there should be no diminution whatever in this research work, not only because of its value in itself, but also because it is the only way to keep the bacteriologists"on their toes"—to keep them enthusiastic and tackling these problems as they ought.
In regard to the terms of reference, Section 17 of the National Health Service Act empowers the Minister to set up a bacteriological service for the control of infectious diseases, and this is referred to again in the Long Title of the Bill: it is called a"bacteriological service". But it is not, in fact, purely a bacteriological service, and, as I showed earlier on, it ceased to be a purely bacteriological service right at the start, when it started looking at infective hepatitis. It then became a virological service as well. At the present time, its studies include the chemical structure of the influenza virus, fungal infections of swimming baths, preservation of tissue cells by freeze-drying and all sorts of non-bacteriological work: all of them highly desirable and most beneficial, but perhaps, in the strict sense of the word, illegal. I am going to suggest that we ought to put this right. It is really a"micro-biological" service, and we ought to define bacteriology in the last clause of the Bill, where there are definitions. I hope that the definition can be drawn very widely. We might perhaps use the words"noxious agents", rather than trying to get a strictly biological definition of what the service is doing, because it covers viruses, bacteria, protozoa, worms, funguses, and even, on occasion, chemical agents.
1010 May I say at once that we are hoping that the Service will develop in certain other ways? Those of us who are concerned with health in industry urgently need a national laboratory service to do for us what the Public Health Laboratory Service is already doing for doctors in the public health sphere, in hospitals and in general practice. We think that the Public Health Laboratory Service could do the job with a minimum of alteration and at a minimum cost to the nation, without having to set up any new organisation. It is perfectly true that it would need added to it a certain number of chemists and physicists, but that could occur gradually over time if the thing were allowed to grow.
I mentioned that the Service had started to study respiratory infections in office workers. It is already doing quite a lot of industrial studies. It is beginning to be an industrial bacteriological service as well. It is studying a condition called"beat disorder" in miners, a condition caused at pressure points in a miner who is working on his side in a colliery wherever the skin rubs. He may get an infection of the hand or knees, and this infection may go on for weeks and months. In the case of the hand it may ultimately produce complete disability. There has been a tenfold increase in this disease since the 1920's and it has not been halted by mechanisation, as was hoped would be the case. The Public Health Laboratory Service has done some very fine work on this disease and it has found out that it was due to a staphylococcal infection at the point of injury. It is already studying anthrax, another industrial disease occurring in gelatine factories handling large quantities of crushed bones. It is also studying another industrial disease called"shipyard eye", a form of conjunctivitis amongst shipyard workers, which turns out to be due to a virus which attacks the glands as well as the eye: it gets into the eye as a result of minute abrasions due to the very large quantity of very fine dust generated in the shipyard industry. Here is the Service already doing studies of the physical factors in disease.
Now, my Lords, I would suggest that it would be ridiculous to duplicate these services. I am pretty sure that the right honourable gentleman the Minister of Labour is very much alive to the need 1011 for the environmental hygiene laboratory service. I am pretty sure also that the right honourable gentleman the Minister of Health is equally alive to this, and that they could and would, indeed, be very happy to combine in some kind of solution, in getting an industrial hygiene service grafted on to this excellent service which already exists. I hope that this will be looked at most carefully by Her Majesty's Government. I do not for one moment expect the Lord Privy Seal to give us an answer this evening. All one would hope would be that he will leave the door open, and that when we come to look at the definition of bacteriology, which I think we ought to do, he will make it sufficiently wide, so that if a decision of this sort were taken in the future it would be possible to do it under the existing Bill.
Now just a word about the administration. The proposals for the Board are set out in the Schedule. It is always a difficult matter for any Government to decide whether to leave the selection of some new Board to the individual Minister or to specify a whole series of categories. In my experience, I must say that it is usually best to leave the selection of the Board to the Minister, while at the same time saying that he must consult with various people before he does it. That is, in fact, what happened under the National Health Service Act in respect of Regional Boards. The Minister consults, but then he appoints whom he thinks fit, regardless of whether they fit into a series of neat little categories. Unfortunately, here we have one of these category boards very carefully worked out—at least, I hope it is very carefully worked out, though I am not quite sure whether it has been.
The first thing we notice is thatThe chairman and one other member shall be fully registered medical practitioners.Now this is a most extraordinary position. It so happens that the Public Health Laboratory Service Board which has existed up till now, and which has run the Service since 1938, has consisted of nine members, eight of whom were medical practitioners and one of whom, the chairman, was not a registered medical practitioner. And they have done it very well. It was, in 1012 fact, Sir Lansborough Thomson, an official of the Medical Research Council. I think it would be a great mistake to tie the Minister down to saying that the Chairman and one other member must be fully registered medical practitioners, and I hope very much that the Government, on mature consideration, will agree with this view. In fact, I can see no reason for the stipulation; because we can be fairly sure that of the nine members, I think it is, probably seven or eight will certainly be registered medical practitioners. So why specify that two should be?
With regard to the Chairman, it is widely believed in the Public Health Laboratory Service that the intended Chairman might be the Chief Medical Officer of the Ministry of Health. If I may say so, this is a very bad idea, for two reasons. First, the Chief Medical Officer is an exceedingly busy person, with an immense amount of work to do. I should think that he is one of the busiest civil servants there is, and that he should be virtually ex officio Chairman of this Board would be a thoroughly bad plan. Secondly, we want the Board, and I am sure that the Government want the Board, to have an autonomy, a vigour and a life of its own, and it will only get these if it is not the absolute creature of the Ministry. It should be the servant of the Minister and subject to his general direction, but it should bat on its own wicket and not be tied to the Ministry of Health in this sort of way.
I hope very much that the provisions about fully registered medical practitioners applying to the Chairman and one other member will go and that it will sometimes be thought desirable to appoint a doctor and sometimes someone who is not. If I may take the example of the Medical Research Council, it has often, if not always, had a Chairman who is a Member of your Lordships' House, who is sometimes a doctor and sometimes not. It is a very good thing to swing this about. So I hope that we shall not have any automatic Chief Medical Officer Chairman, though, of course, there can be no objection whatsoever to the Chief Medical Officer's being a member of the Board, as indeed he already is. There is another reason why we want someone who will give a good deal of 1013 time to the job. This is an organisation of 40 or 50 laboratories scattered about the country. I envisage the Chairman going round and seeing every laboratory once a year, instead of letting it be run"on the noel" by his officers. I think that this is for the good of the staff. I certainly cannot see it happening if we have a civil servant, or an ex-civil servant, in that position.
Then we come to paragraph (b), which provides fortwo members … appointed after consultation with the Medical Research Council;That is very reasonable, and very right and proper, and can guarantee the continuance of research functions. Then we have two persons… with experience as bacteriologists … appointed after consultation with such organisations as the Minister thinks appropriate;Again, that is very sensible. Then we have two medical officers of health—again, very sensible. But there is to be nobody from the hospitals, although the Service is closely linked with the hospitals, and there is no general practitioner, although the general practitioners, particularly the College of General Practitioners, are exceedingly interested in the kind of research which this Service does. They would be excellent people to have represented on the Board, so I hope that we shall put that right. If we are going to have categories, let us make sure that we have adequate categories.
The final group istwo members … appointed from among persons having administrative experience.That is the most sloppy piece of"administration" I have come across for a long time. I should say that it could mean anybody who has ever done anything which involved one other person. We are afraid that it might mean two more civil servants, but sincerely hope that it does not. We think that this provision ought to go. It might be better to put in somebody with experience of industry or industrial administration, particularly if later we are able to get the Service extended.
Finally, there is no representation of the staff on the Board. If we look up the annual Report of the Medical Research Council, we find that there are two people called staff assessors who 1014 appear to be members of the Council. They are Dr. Cockburn, who runs the Epidemiological Research Laboratory at Colindale, and Dr. Fry, who runs the Public Health Laboratory at Tennis Court Road, Cambridge. They are the two staff representatives sent to the Council as assessors, whatever that means. I do not think it matters a great deal whether the representatives of the staff on the Board have a vote or not. I think it is perfectly reasonable that they should be assessors. But if they are going to be assessors, that ought to be included in the Schedule of the Bill. It is too much to leave to"pot luck" and to the vagaries of civil servants, and we feel strongly that it ought to be clearly specified in the Schedule, and I hope that it will be.
I do not ask the noble Viscount the Lord Privy Seal to make an immediate answer to the many detailed points I have made. I hope that, with his colleague the Minister of Health, he will look carefully and sympathetically at these points. Lately, there has been a lot of talk in the papers and elsewhere about the increasing influence of your Lordships' House. I have always thought that it would be a mistake for us to have much more in the way of power, but I think that our influence can do nothing but good. But influence is useless unless it produces effects on Government policy, assuming that the influence we can exercise is right. I am sure that the noble Viscount and Her Majesty's Government will approach the suggestions we have made with open and sympathetic minds. Indeed, we have had a great deal of evidence, in the short time I have been a Member of your Lordships' House, that the Government do approach proposals made from these Benches in a sympathetic and reasonable way, and I hope that it will be so in this case. Our only interest is exactly the same as that of Her Majesty's Government and of the whole House—that is, that we should have the best Public Health Laboratory Service, serving the people of this country in a very important field.
§ 6.38 p.m.
§ LORD AMULREE
My Lords, I should like to support what the noble Lord, Lord Taylor, has said. I do not want to be in the least controversial about the Bill. It is a Bill which all 1015 Parties will welcome, and I am sure that all of those who are interested in the subject will echo what the noble Lord said: that we wish this country to have the best bacteriological and other laboratory services in the world. We have gone a long way towards that now and I am sure that we shall succeed.
One thing on which I should like to comment is the constitution of the Board that will control this new Service. From what I can see in the Bill and from what the Minister has said, I think that the new Board will be in the same relationship to the Minister as the Regional Hospital Boards which control the Hospital Service. That being so, I was pleased when the noble Viscount said firmly that the members of that Board were not to be civil servants. I had rather feared that this might have been the case. I imagine that the Board will work closely with the Regional Hospital Boards, and it might not be a bad idea to have serving on the Board one of the senior medical officers who advise the Hospital Boards and who have a good deal of knowledge of negotiation at that level and also of the peculiarities and wishes of the hospital management committees and other such bodies. I hope that there will be some representation of the Hospital Service on the Board when it comes into existence. The other sphere which I think might possibly be represented is general practice. The noble Lord, Lord Taylor, suggested that, too, and we are agreed on it.
Another important point is that there should be one lay member of the Board. That worked well in the case of the Medical Research Council. One of the people of administrative experience might be a layman, and it is not a bad idea, with a technical Board, for that person to be the Chairman. One final point is that the present Director of the Service, Dr. G. S. Wilson—and I should like to join the noble Lord, Lord Taylor, in paying a generous tribute to him—will be retiring, I take it, very soon. At the present time the Board does not meet more than once in six months. I trust that when the new Board is constituted it will be encouraged to have more frequent meetings and keep a firm watch on the Service, as it is never likely to get so good an administrator as Dr. 1016 G. S. Wilson. With those few remarks, I welcome the Bill and trust that your Lordships will give it a Second Reading.
§ 6.42 p.m.
§ VISCOUNT HAILSHAM
My Lords, I should like to thank both noble Lords who have given me such admirable support in the Second Reading debate on this Bill. I think it is a remarkable fact, which I certainly had not noticed myself, that the Service has never before been mentioned in Parliament. On the whole, I think this justifies our talking rather more generally on what otherwise might have been a somewhat formal Bill concerned primarily with administrative structure, and I certainly welcome both speeches. I enjoyed every moment of the informed and interesting, and sometimes amusing, discussion by the noble Lord, Lord Taylor, of the Service's wide range of useful activities.
I agree with the noble Lord that the research aspect of its work is all-important, and I certainly did not wish to convey the contrary in my remarks in introducing the Bill, although it is fair to say that the Medical Research Council do regard the research aspects, to some extent, as subordinate to its other aspects. It was for that reason, among others, that they wished to divest themselves of responsibility. But, as the noble Lord, Lord Taylor, said, if you want to keep a Service like this alive it is necessary to include research in its activities, and its research activities are both important and creditable. It was, as a matter of fact, as I think the noble Lord divined, partly, and perhaps mainly, for that reason that when the composition of the Board came to be discussed it was decided that two of the members should be appointed after consultation with the Medical Research Council. I think I can give the noble Lord an assurance in the terms he asked about the future of the research activities. So far as the Medical Research Council is concerned—and I am afraid I have more knowledge of their mind than that of my right honourable friend in this matter—they would wish that to be so; and I think I can give such an assurance on his behalf, as well.
As regards the definition of"bacteriology", I have no doubt that the noble Lord, Lord Taylor, is right in 1017 saying that the scope of the activities of the Service is not adequately defined by any narrow or legalistic use of the word"bacteriological". But I am told that our lawyers are perfectly content about this; that they are well aware that we have extended into virology and other things, but that, perhaps because they have not really studied the difference between bacteria and viruses, or perhaps because they are not pedantic men, they do not think it matters very much.
§ LORD TAYLOR
May I ask whether we can perhaps have the opinion of the Lord Chancellor in due course on this very difficult issue as to whether helminth is a bacteria.
§ VISCOUNT HAILSHAM
I think they are small things which go bang in the night. I do not think we need take too narrow a view of this: de minimis non curat lex, as the Lord Chancellor would say.
§ VISCOUNT HAILSHAM
Yes; but not when they get into Acts of Parliament. I think we can leave the bacteria to grow in their tissues untroubled by the lawyers. But I will certainly consider this matter again, as the noble Lord has raised it. When he raised the point I took advice on it, and the criticism was greeted with somewhat cheery insouciance by the experts. Maybe I am treating a serious subject too lightly, but at the moment I am not worried by the definition involved in Clause 17.
I agree that the composition of the Board is probably all-important for consideration on the Committee stage. I should not wish to commit my right honourable friend before consulting him, and therefore I will not answer in detail the various criticisms made by the noble Lord, Lord Taylor. It is, of course, true that the Schedule does not contain a direct reference to a hospitals representative on the Board, but as the noble Lord rightly pointed out, there are a number of medically qualified people who will have to be appointed to the Board, including bacteriologists and others; and whether or not it is right to insert a hospital representation in the terms of the Schedule, I should myself have expected to find that the Board 1018 contained names which came from the hospital service.
One is in some danger, I think, in dealing with things of this kind, and the noble Lord, Lord Taylor, adverted to one danger in part of his speech. A great many people want to be represented, and if they are all to be represented separately it means a much too unwieldy body, whereas in practice, if you start looking for a number of names who conform to fairly wide general specifications, you often find a name which will represent more interests than one, as we have all found when we have looked at the composition of committees. I think it is important to keep this fairly wieldy, but I will certainly not shut out any of the suggestions which have been made, and if the noble Lord puts down suggestions on the Committee stage I assure him that they will be given consideration. I have, of course, to consult my right honourable friend as it will be his responsibility, as it is now, to carry on the Service after the formation of the new Board.
There is one thing I ought to say to the noble Lord, Lord Amulree, who I think was misled by one remark of mine in opening. I did not say that none of the Board would be civil servants: I said that the staff would not be civil servants. Indeed, the noble Lord, Lord Taylor, seemed to be apprehensive that too many of the Board would be civil servants. But I think some of them almost certainly would. Indeed, the actual administration of a Service like this by people who are not going to be paid as such—as the noble Lord will have seen from the terms of the Bill—almost inevitably involves the proposition that some of them will be whole-time civil servants who owe their position on the Board to the official and remunerated position they occupy.
§ LORD TAYLOR
My Lords, I should like to say that I do not think that one could really accept that. After all, the Regional Hospital Boards are in exactly the same position, and there are, I suppose, some 300 people on these Boards working very much harder than these people will have to work, all of whom are unremunerated, and none of whom, so far as I know, is a civil servant.
§ VISCOUNT HAILSHAM
My Lords, I am not in the least denying the valuable work done by the members of the hospital boards, and I would rather not embark upon either the further analogy or the amount of work they will have to do. I simply wanted to say, in reply to the noble Lord, Lord Amulree, that he evidently thought I had given an assurance that none of the members of the Board would be a civil servant. I wanted to make it plain that no such assurance could be given, and that the staff would not be civil servants. I was referring to the status of the staff, and not to the composition of the Board.
§ LORD AMULREE
My Lords, I am extremely grateful to the noble Viscount 1020 for making that clear. I understand that some of the Board probably will be civil servants.
§ VISCOUNT HAILSHAM
My Lords, I quite realise that on the composition of the Board the noble Lord, Lord Taylor, has made a number of valid and legitimate points which will require discussion on Committee. With that assurance, I should ask the House to give the Bill a Second Reading.
§ On Question, Bill read 2a, and committed to a Committee of the Whole House.
§ House adjourned at eight minutes before seven o'clock.