RHEUMATOID ARTHRITIS (Hansard, 11 July 1961)

§ LORD WILLIAMS OF BARNBURGH
My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.

§ THE LORD PRESIDENT OF THE COUNCIL AND MINISTER FOR SCIENCE (VISCOUNT HAILSHAM)
My Lords, estimates based on two careful surveys of small populations suggest that about 350,000 persons over the age of fifteen years may be suffering from rheumatoid arthritis or have residual disabilities from an earlier attack. Figures based upon such small samples must be used with caution. It is also estimated that a further one million persons may have less well defined signs and symptoms. The total estimated expenditure by the Medical Research Council in 1961 to 1962 for research into rheumatism and arthritis is expected to be about £84,000.

§ LORD WILLIAMS of BARNBURGH
My Lords, while thanking the noble Viscount for his reply, I am afraid that I cannot congratulate him upon it. For is the noble Viscount not aware that if only 10 per cent. of the 1½ million suffering slightly or more dangerously from this disease were unemployed due to physical disability, we should be losing more man-hours of work than are lost by all the unofficial or official strikes in this country?

§ VISCOUNT HAILSHAM
My Lords, that may be so and I think that underlines the importance of dealing with the disease. But I do not believe that it invalidates any part of my Answer.

§ LORD WILLIAMS OF BARNBURGH
My Lords, is the noble Viscount satisfied that the very small contribution for research into this series of dangerous diseases called arthritis is an adequate complementary approach on the part of the Government to get rid, partially or wholly, of this disease?

§ VISCOUNT HAILSHAM
My Lords, the noble Lord will be aware, and certainly I think we must emphasise the fact, that in contributing sums to medical research we take the advice of our scientific advisers, the Medical Research Council. I know that they have this matter very closely under consideration. But I do not think that in dealing with scientific projects and research one can necessarily measure it entirely in terms of money. When we are dealing with the advance of knowledge we must, I think, face the fact that projects of research depend upon the existence of men of suitable quality and ideas worth investigating. As to what those men are and what those ideas are, we must take the advice of the profession as to what is worth doing.
Perhaps I ought to add some further information to my original Answer, because although the Answer is a perfectly correct Answer to the Question asked I think there are certain other things which should be said about it. The Medical Research Council examined the position of research into rheumatic disorders earlier this year. They expressed satisfaction with the quality of the work which they are at present supporting, but considered that it was necessary to keep the general state of research in this field under review. There are not enough well-trained scientific workers engaged in research on rheumatism. But a particular difficulty appears to be the relative lack of interest in rheumatology in the United Kingdom which discourages recruits. It appears that the remedy depends very much on a change of mind on the part of the medical profession, which must be encouraged to recognise the importance of the subject.
73 I should also like to add, because otherwise the figures would be misleading, that a good deal of research on the rheumatic diseases is, of course, carried out in university and hospital teaching departments and in the course of treating patients under the National Health Service. I cannot make a reliable estimate of the expenditure involved in this research but I should have to add the cost to the figures of the Medical Research Council's grant. One would also have to take into the account the extent to which voluntary bodies, such as the Empire Rheumatism Council and the Nuffield Foundation, are active in encouraging research in this country. I do not think I have figures for the Nuffield Foundation, but in 1960 the Empire Rheumatism Council spent another £56,800 on research. Those facts, also, ought to be borne in mind.

§ BARONESS SUMMERSKILL
My Lords, in view of the noble Viscount's comment that men and women were not coming forward because they found this field not very interesting, would he not agree that he will not attract the best researchers in this country unless they are paid adequately? He has revealed this afternoon that the Medical Research Council are giving a miserable contribution in respect of this very widespread disease. Perhaps he might make the picture a little better if he could tell the House how much is being contributed by the voluntary research organisations.

§ VISCOUNT HAILSHAM
My Lords, I think that if the noble Lady looks at the latter part of my Answer she will see the best figures I can give with regard to the last part of her supplementary. Obviously, research workers must be paid properly; but, equally obviously, the Government must take the advice of the Medical Research Council as to what projects are worth pursuing and what people are worth supporting. I think it is wrong, when you are considering research, to look simply in terms of pounds spent. There are many other factors which have to be taken into account. If the noble Lady knows of any suitable researchers or projects which are not being at the moment considered, I will, of course, undertake to see that they are carefully examined by the Medical Research Council, whose constitutional function it is to settle the 74 scale of research and also to settle the particular projects which should receive support.

§ VISCOUNT ALEXANDER OF HILLSBOROUGH
My Lords, may I thank the noble Viscount for the very great detail into which he has gone? But does he not think that the very facts he has given must indicate the inadequate nature of the steps being taken to treat rheumatoid arthritis, because of the lack of adequate research? And is it not for the Government, as well as for the Medical Research Council, to try to grapple with this problem and, by giving sufficient research grants, to make it an inducement to young students to come in, so getting a wider research than is at present going on? The noble Lord, Lord Williams of Barnburgh, and myself are very interested because we are vice-presidents of the Empire Rheumatism Council. I feel that the noble Viscount has given a lot of information this afternoon, but it seems to impress on to my mind the inadequacy of the present arrangements.

§ VISCOUNT HAILSHAM
My Lords, I do not think that it would be fair to say that the treatment is inadequate; or, at any rate, if there is any inadequacy in the treatment, it would not be fair to assume this from the answers I have given. That would be a question for the Ministry of Health, and I do not think I should accept that. Even if the Answer I have given reveals an inadequate scale of research, I should not myself accept the view that the Government would be right to disregard the advice of the Medical Research Council on this matter. If the noble Viscount will look at the first part of the second answer I gave, in which I told him that the Medical Research Council, while expressing satisfaction at the quality of the work, were keeping the scale of the effort under review, I think he will understand that they are well aware of the nature of the problem and of the extent to which they would welcome an increase of activity on this front.

§ LORD WILLIAMS OF BARNBURGH
My Lords, would not the noble Viscount agree with me when I say, in view of all our experience, that the medical associations have never taken arthritis seriously; hence the failure over the 75 decades to find any approach to a solution?

§ VISCOUNT HAILSHAM
My Lords, if the noble Lord looks at my Answer, I think he will see that this is precisely, in suitably guarded terms, the view which the Medical Research Council have instructed me to put before the House.