§ Order for Second Reading read.
§ The Minister of Health (Mr. Ernest Brown)
I beg to move, "That the Bill be now read a Second time."
The main purpose of the Bill— involving, as the House knows, a very old and controversial story— is to repeal the Medicine Stamp Duty and the Licence Duty in accordance with the promise given by the Chancellor of the Exchequer in his Budget speech on 7th April last. The Stamp Duty at present yields about £800,000. The Licence Duty yields about £40,000. The facts are, as both the present Chancellor of the Exchequer and his predecessor have informed the House in successive Budget speeches, that the tax has become difficult to collect, if not quite unworkable. The present small yield, as compared with the past, is due in large part to the many and anomalous exceptions from Stamp Duty contained in the Medicines Stamp Acts. Of the present exemptions, the main ones are, first, that only medicines in which a proprietary right is claimed are dutiable, and a disclaimer of any such right, if made on the label, exempts them. The second exception is due' to the fact that only medicines referring to the cure of ailments are dutiable. "Cough mixture" pays duty, but a "chest mixture" does not pay. The anomalies, however, do not end there. Owing to the right conferred on chemists and some others to sell what the law calls "known, admitted and approved" remedies free of duty, precisely the same medicine may be sold in one shop without tax, and in another shop only after tax has been paid.
There is little doubt that a number of these exceptions are not justified by considerations of public health. They have grown up in the course of more than a century, and, in short, the whole basis on which the duties rest is defective. What-ever views may be held about the desirability of some kind of tax on medicines, no one, after the reports of the Select Committees of 1914 and 1937, and the discussions on the various Bills which have attempted— but always failed— to deal 64 with this problem, is likely to dissent from the repeal of the present Acts. These Acts, as will be seen from the Schedule, are 12 in number, the first being dated 1802 and the last 1937. The Act of 1802 is still in force and is still the chief Act governing this matter. These Acts are quite unsuitable in the light of modern conditions and modern business. The High Court has stigmatised them as "a mass of confused and obsolete verbiage," which is strong language from the High Court. The Act of 1812, with its reference to:surgeons, apothecaries, chemists and druggists who have served a regular apprenticeshipand its exemption from duty of all drugs named in:the book prescribed in the name of Sir Harbottle Grimstone, Baronet,scarcely bears any relation to modern conditions of medical practice or to the very large trade in medicines.
Attempts have been made over a period of years, with a certain amount of success, to apply the law equitably and to secure by administrative action some relation between the spirit of the Statutes and the conduct of modern business. I am sure hon. Members will agree, however, that it is not desirable or even defensible, to retain on the Statute Book legislation which it is impossible to interpret and enforce in a fair, reasonable, just or logical manner. The alternative to this repeal and the abolition of the medicine duties, would be to substitute other legislation framed in accordance with modern views, and to impose duties on a new basis. There was a very formidable report from the Select Committee of 1914, and the Select Committee of 1937 did recommend an alternative. The House will doubtless have the advantage of contributions to this Debate from some of the members of that Committee who are with us to-day. The alternative which they suggested was fully explored. Their report was in favour of repealing the present Statutes, which they agreed were full of anomalies and largely obsolete. They expressed the view, how-ever, that medicines in general— not merely proprietary medicines— held out as cures for human ailments should, properly, pay a tax on an ad valorem basis, and they suggested a percentage duty of 16⅔per cent.
65 The Committee's recommendations met with much opposition. Hon. Members who take an interest in the subject will remember the close examination and discussion of one or two Bills, which showed that many difficulties were involved both in framing and administering such legislation. Bearing all these facts in mind, the Government decided in favour of simple repeal, as the Chancellor of the Exchequer informed the House. The general proposition that medicines constitute a suitable subject for taxation and that a fair ad valorem duty would be one of 6⅔per cent. have, however, been carried into effect by applying the Purchase Tax to medicines, at the rate advocated by the Select Committee of 1937. The House will be glad to know that the yield of the Purchase Tax on medicine at that rate is estimated at about £3,000,000 per annum, or nearly four times the present annual yield of the Medicine Duty.
The moment we begin to touch this taxation we must begin to think of its effect on the chemists' profession, on the trade in medicines and on the public health. Those who have gone into the problem of the Medicine Duties and the consequences of their repeal have been impressed by one difficulty in particular to which repeal might lead, namely, the possibility of damaging the interests of those who have entered the chemists' profession. Under the present law chemists enjoy a financial advantage, in having the right to sell, free of duty, any medicine, otherwise subject to duty, where a formula in accordance with a standard book of reference is printed on the label and proprietary rights are disclaimed. That is what is generally known as the exemption for "known, admitted and approved remedies." The financial advantage derived from this privilege has in the past undoubtedly formed one of the incentives to the recruitment of the chemists' profession, the continuance and maintenance of which are essential to the health services of the community. To sweep away the profession's present rights, without putting in their place some countervailing advantage, might therefore lead to public as well as professional loss, and this problem has been borne in mind in framing the Bill.
As the Chancellor of the Exchequer announced in his Budget speech on 7th April, the trade interests concerned have 66 considered the problem and have reached an agreement, which is embodied in Clause 7 of the Bill. There may be one or two of whom it may be said they have acquiesced but, broadly speaking, that is true. This is not an agreement made by the chemists or manufacturers only. It is one which has the concurrence of the representatives of almost every trade group concerned in the manufacture or sale of medicines. It provides a solution in our judgment which, while not in any way contrary to the public interest, or the interests of non-chemists taking part in the trade, safeguards the interests of the chemists in the event of the repeal of the medicine duties. The agreement provides that from the date of repeal of the duties all medicines shall be sold retail only by chemists, together with doctors and dentists, with the exception of herbal remedies, of mineral waters, and of proprietary medicines not described in the British Pharmacopoeia or the British Pharmaceutical Codex. Further minor exceptions are for proprietary medicines which though described in the Pharmacopoeia or Codex, are not sold under a title which includes words from the heading of the relevant paragraph, and for a few proprietary medicines at present on sale which are both described in the Pharmacopoeia or in the Codex and are sold under such a title. The effect of the agreement is to substitute a trading privilege for the financial advantage enjoyed by chemists under the present law, and at the same time to enable the normal channels to continue to be used for the sale of proprietary medicines.
§ Mr. Silverman (Nelson and Colne)
Is the House to understand that this proposal in Clause 7 has the approval of those who are known as herbalists?
§ Mr. Brown
That is a different point. The hon. Member need not be uneasy about that. One or two little points have been raised by them, but there is no desire on anyone's part to interfere with the legitimate practice of the legitimate herbalists. We are now discussing with them the meaning of a particular word. I would rather not go further to-day, because it is really a different point. Let me take the third issue, which is, of course, a public health issue, namely, if you repeal the tax and if you come to an agreement, as this agreement has been 67 made, what is to be done to regulate the trade in medicines? It is important to consider, first, the effect of the repeal of the duties and, second, the meaning of the agreement reached, but it is much more important to consider the provisions of the Bill for regulating the medicine trade.
§ Mr. Lathan (Sheffield, Park)
Would it not contribute to a better understanding of the position if the right hon. Gentleman could tell us with whom the agreements have been reached— with which bodies or associations?
§ Mr. Brown
I prefer not to do that on the Second Reading. It is a long list. I am prepared to circulate it in the Official Report, but I am not anxious to burden what is a very important issue with a lot of extraneous matters. This issue is: What are the provisions of the Bill for regulating the medicine trade? We are dealing with two outstanding problems for which solutions have been sought on many occasions. There are other issues to which great importance is attached, and I have no doubt some hon. Members will wish that we had gone further. I would only refer them to the past and to the needs of the present, and in my judgment we have done what is necessary in dealing with the secret remedy on the one hand and. the dangerous advertisement on the other with regard to a certain number of diseases, and I think we have chosen the course which is most likely to further this first step in a quarter of a century. The brutally scandalous age of patent medicines is in the past rather than the present. Public-spirited action by manufacturers and the Press has done a great deal to remove the grave grounds for complaint which caused the Committee of 1914 so vigorously to attack the frauds flourishing at the time, but there is no doubt that, in the present state of the law, opportunities still exist for the unscrupulous to trade on the credulity and fears of the ill-informed by the production of useless, or even harmful, secret preparations and— to my mind this is a most serious point— thereby to delay the seeking of proper advice and early treatment for serious diseases by advertising quack remedies.
Both these practices will be stopped by the Bill. From 1st January, 1942, all 68 medicines will have to bear on their labels, or wrappers, a statement of their composition or active constituents. If the medicine is described in the Pharmacopoeia or the Pharmaceutical Codex, the disclosure of composition may take the form of a reference to the formula in that work. Any qualified person in future will be able to tell the value of any medicine, whether it is harmful in itself or useless as a method of treating the patient who is taking it, and to advise the patient accordingly. The only kinds of medicines in regard to which disclosure is not required are those supplied to an individual person prescribed according to his needs, for instance, a mixture made up in accordance with a doctor's prescription. The principle of the Clause is fully accepted by the Proprietary Association of Great Britain, which is representative of most of the manufacturers of proprietary medicines. Similarly the future advertisement of remedies for certain diseases, or of articles for procuring abortion, will be stopped. Legislation of this kind is already on the Statute Book prohibiting the advertising of articles recommended for the treatment of venereal disease on the one hand and cancer on the other. The present Measure extends the prohibition of advertisements of remedies for Bright's disease, cataract, diabetes, epilepsy or fits, glaucoma, locomotor ataxy, paralysis and tuberculosis. Those are the diseases contained the Bill to which these particular provisions apply. The basis of this list is the report of the Select Committee of 1914. The actual diseases named have been selected because, like venereal disease and cancer, they are all of a serious nature, because each of them is susceptible to alleviation, if not cure, by normal methods of treatment and because it is dangerous in each case to delay seeking early treatment by resorting to quack remedies. The prohibition of advertisements of articles for procuring abortion carries into effect a recommendation made by a powerful Committee presided over by Sir Norman Birkett in 1939 and strongly urged in its report.
In addition to these main provisions, there are one or two minor amendments of the law. We have taken the opportunity to make certain minor amendments to the Pharmacy and Poisons Act, 1933, which are found to be desirable in the light of experience. The most important 69 is that in Clause I, in regard to the sale of drugs, where a retailer selling drugs including poisons in one shop also sells drugs not including poisons in other shops. That has been a pledge by the Government since an administrative arrangement was arrived at in 1934 be Co-operative societies and other bodies, the chemists and' the Home Office. So there has been no haste about implementing that particular pledge. Other Amendments are made relating to the powers of the Statutory Committee of the Pharmaceutical Society to add or restore names to the register of pharmacists. That is the explanation of the appearance of the name of the Lord President of the Council on the back of the Bill, for he is concerned in his capacity on that side.
Let me take a quick look at the Clauses. Clauses 1 and 2 deal with the amendments to the Pharmacy and Poisons Act to which I have referred. Clause 1 provides that the retailer who sells drugs, including poisons on Part 1 of the Poisons List at a chemist's shop need not have a registered pharmacist in charge of other shops where he sells drugs not including such poisons, subject to these conditions— first, the sale of articles other than drugs and medical and surgical appliances must form the main part of the business; second, that only pre-packed drugs must be sold; third, than no dispensing must be done or prescriptions received on the premises; fourth, that no title, emblem or description must be used to suggest that the premises are a chemist's shop. Clause 2 enables the Statutory Committee of the Pharmaceutical Society, who have their powers under the original Act of 1858, when considering the addition or restoration of a name to the register of pharmacists, to take into account any offence which may have been committed by the applicant while not registered. The committee is also authorised to remove or withhold names from the register for a stated period.
Clauses 3 and 4 deal with the prohibition of advertisements of articles as remedies for the diseases I have named or as a means of procuring abortion. Clause 5 lays down the maximum penalties for offences against Clauses 3 and 4, as well as certain grounds for defence. It also provides that any person who appears from the terms of the advertisement to be concerned with the manufacture, import 70 or sale of the article shall be presumed to be concerned in the publication unless the contrary is proved. Clause 6 requires the disclosure of the composition or active constituents of medicines as from 1st January, 1942; and Clause 7 embodies the agreement made by those concerned with regard to the sale of medicines after the repeal of the duties. Clause 8 lays down certain grounds for defence to prosecutions for offences under Clauses 6 and 7. Clause 9, which is the heart of the Bill, repeals the Medicine Duties from 2nd September, 1941. Clause 10 is the interpretation Clause; Clause 11 applies the Bill to Scotland; Clause 12 contains the Title; and the Schedule contains the list of diseases to which the Bill applies.
When a friend of mine heard that I was to take responsibility for this Measure, he said, "I suppose you know that this subject arouses deep feelings, touches many interests and has had a Parliamentary hoodoo upon it for 25 years?" I said, "Yes, but surely after 25 years in one case and seven years in another— Clause 1— and since it has become vitally necessary to do away with the duties, it is time that we took practical steps." Although I am introducing this Bill to a quiet House, this has been one of the most controversial subjects discussed in the House in the last quarter of a century. It is controversial in other countries as well, as anyone who has read that American book, "One hundred million guinea-pigs" will agree. I am introducing it also because the time is ripe and because with infinite shrewdness and great good will, and after long discussions, all concerned have worked hard to prepare the way for this, the first legislative step for a generation on the road to reform. It is as the first step to reform that I ask the House to give the Bill a Second Reading.
§ Mr. James Griffiths (Llanelly)
The Minister said that the subject matter of this Bill has had a long and stormy career in the House and the country, and he expressed the hope that this time it will be possible to get the Bill through quietly. Looking round the House, I see that the experts are gathered together, and I doubt whether the Minister will have quite as quiet a time as he anticipates. It is, perhaps, presumptuous as a layman to venture into the realm of the experts, but sometimes a layman can bring to bear experience as valuable as that of the expert.
71 There is a point over which the right hon. Gentleman skated very lightly. It has been put to me by my colleagues that the question of the Medicine Duties falls to be considered urgently for two reasons— first, the fact that the Chancellor has been busy in this matter in the Purchase Tax; and second, we were told some time ago that a legal action was pending and that the Government were advised that if the matter went to court, possibly the people who proposed to bring the action would be found to be right and that the law was in such a muddled state that it had been operating for a long time without any force. Apart from that, questions will be put to the Minister as to the urgency of bringing up the other Clauses. I hope that the Bill will get a Second Reading, so that many of these problems can be discussed on the Committee stage.
Apart from the repeal of the Medicine Duties, there are certain provisions of the Bill which it is very desirable that we should place upon the Statute Book. I propose to comment upon one or two of those and to ask one or two questions. I strongly support the Clause laying down that advertisements of alleged cures for certain diseases shall be prohibited. There is nothing worse than the exploitation of the fears of hopes of poor people who are ill. I have read the report of the Select Committee of 1912–14. No one can read that report without being moved to indignation at the system which permits such callous exploitation of people who are suffering. We can now look back upon that report with the experience of a generation that has followed, and if we compare it with the present conditions, it holds a valuable lesson for us. At the time when the Select Committee were considering this aspect of the problem they had put before them examples of all kinds of alleged cures for what at that time was a disease that troubled this country much more gravely than it does to-day, though it is still a very grave disease, that is tuberculosis, which was more familiarly known under the old name of "the decline." The part of the country from which I come has been decimated by this disease more than any other part of the country, and we know that there are two psychological repercussions of the disease. The first is that it makes those suffering stick more tenaciously to life, and the second is 72 that hope increases as the disease gets worse. These two factors make the sufferers much more subject to being exploited by those who appeal to that desire to live and that hope.
In 1912 and 1914 most of those were advertisements of quack cures, and sometimes much worse than quack cures, for tuberculosis, but it would be true to say that more recently there has been an enormous decrease in the number of such alleged cures. The explanation of that holds a lesson for us, I submit. People are not now so ready to respond to the quack in tuberculosis cases because we have provided an alternative. We have built up a service for the early diagnosis and the best treatment of this disease. What has largely killed the T.B. quack are sanatoria and a good medical service. Everywhere we have built up sanatoria. In my own part of the country, through the King Edward VII National Memorial, we have built up a national service dealing with tuberculosis and have provided sanatoria. In these days that service is being handicapped by the exigencies of the war, and I hope the Minister will do all he can to see that it is not restricted. The place which used to be occupied by tuberculosis is now taken by cancer, and here I would urge that the lesson of the last generation is that the best way to meet this problem is not merely to prohibit quack remedies— although that is desirable, indeed essential, and I fully support the Clauses of the Bill which deal with them — but to provide an alternative to the quack remedies which lead to the fraudulent exploitation of poor people. In addition to a policy of prohibition the Government should follow a positive policy by furnishing treatment for the victims of cancer.
An effort is to be made to abolish one social evil by prohibiting the advertisements of substances by which it is said that it is possible to procure miscarriage. I have spoken to medical officers and to social workers on the subject, and we find that it is a very grave problem, but it is a social problem. This practice grows or declines according as poverty increases or diminishes. In the depressed areas it became a very serious problem indeed. I urge upon the Minister that we shall not solve the problem by saying that no one 73 shall advertise these preparations in newspapers. The problem is that we live under a social system, under a wage system, in which the coming of a child, which ought to be regarded as a blessing, becomes a curse in many homes. That is the problem which has to be faced. I do not think that any woman, unless she is completely distracted and depressed by the circumstances of her life would look to this way out of the situation. I say to the Minister that I do not think a policy of prohibition is enough. The Chancellor of the Exchequer is here and he has recently been brought into this problem in another direction. I do not think this House ought to take up any attitude of moral superiority and say, "We will stop advertisements in newspapers offering quack remedies." That will not deal with the problem which was so startlingly revealed in the Driscoll Survey, showing that when a family get beyond the second child its poverty deepens with each addition to the number of children. I urge upon my hon. Friends who are experts and who will speak later to remember that the real remedy lies in the advance of education among the people, in the provision of medical services and medical facilities, in the building-up of a real health service. If the Minister of Health could widen the scope of that other Bill dealing with that aspect of the matter which is in contemplation so as to bring more people, especially dependants, within its scope, he could do more than is possible under the Bill before us to do away with the evils which this Measure is designed to tackle.
I do not propose to say much about the other Clauses. Some of my hon. Friends take different views about them, but I should like to put one point. In this, as in many other matters, the Government do not hesitate to hit the little man but are rather afraid of the big man. It will be said, and I share the view, that the Government have been very tender to the big trusts, to the big vendors of proprietary articles, to those who engage in what may in one sense be termed "respectable quackery," quackery that is a big vested interest, run by big combines. Such people are being left rather outside the scope of this Bill, and the Minister ought to be pressed to reconsider their position. Instead, the Minister has gone to the market place, has gone to the little village; he has attacked the 74 smaller people, but he leaves the very big people alone. I do not want to mention any names, but the Minister and other hon. Members know of some of the claims that are made for so-and-so's wines and for so-and-so's other products, and they know also the prices that are charged for them. Those advertisements, too, call for his attention. Since this problem is being tackled I would ask why it is that these larger vested interests have been left outside this Measure. The Minister may say that it is all part of the agreement to which he has referred. I notice that he said that those people were satisfied with the provisions of this Bill. I have no doubt they are. I see no reason why they should not be. It does not touch them. But it will create a very bad impression in the country if the Government pick out the small man and leave the public with the idea that the big vested interests can "get away with it."
§ The Chancellor of the Exchequer (Sir Kingsley Wood)
Would the ho a. Member indicate the Clause he is referring to which is having this dreadful effect upon the small man?
§ Mr. Griffiths
I am going on to speak about the small man, if the Chancellor of the Exchequer will be patient. There is a man who has become a familiar figure indeed in the industrial areas of this country, and that is the herbalist. There are good and bad herbalists. I shall not say a word in defence of the bad herbalists, but I think we shall make a mistake if we can condemn all herbalists altogether.
§ Mr. E. Brown indicated assent.
§ Mr. Griffiths
If the Bill does not treat them all alike, then I hope that point will be made clear in the course of the Debate. I know that the Minister says that there is a saving Clause, but the Society of Herbalists still have very great doubts whether they will be in any way protected under this Bill. They have the fear that they may be driven completely out of business. I should like to quote a letter on that point from one of the herbalists.We fear that under the Clauses of this Bill we shall be driven completely out of our work. Speaking for myself and many of my colleagues, I can say that we work in perfect amity with a large number of doctors. Every person who consults us does so with his75doctor's permission as a pre-condition. This Bill would deprive thousands of people of the opportunity to try herbal remedies if they wish to do so. We have now been working for 14 years and we have a mass of evidence of the beneficial effects of the herbs that we sell. We can prove this. In fact, we are carrying on a most valuable educational work and doing what no other body is doing.The Chancellor of the Exchequer may laugh. I know that this matter is open to quackery and to abuses of various kinds, but many of these people have done very good work in their own way. Many of them are not only respected, but revered in the communities in which they work. I hope this matter will be cleared up in the course of the Debate. I am putting to the Minister the point of view of many of my hon. Friends. We should not like to see people who have rendered good service and have not done a great deal of harm treated unfairly and penalised, while very much bigger people got off scot free.
While we might give this Bill a Second Reading to-day, we ought to examine its Clauses very carefully in Committee. There may be a problem of urgency, and whether we can afford the Parliamentary time to give the Bill an adequate Committee stage is a problem for the solution of which the Minister must take responsibility. I hope that we shall not be asked to pass hurriedly the Committee stage of this Bill, but that we shall be able to discuss all its Clauses. I hope that, as one consequence of the passing of this Bill, the Ministry of Health will proceed to develop a national medical service in this country which will give the best attention and the fruits of the best medical knowledge to people, whatever their incomes may be. This kind of service is not available now. People are exploited; their poverty is exploited. This situation is another aspect of the poverty problem. One way to prevent "the poor from being exploited is to provide them with a national medical service. In my area a struggle has been taking place, but an agreement has now been reached to provide a medical service which is ample for all the people in that industrial town. The Ministry must not say that it cannot be done. It is their duty to provide such a service for everybody.
§ Mr. Beverley Baxter (Wood Green)
As a member of the 1937 Committee, I 76 should like to say one or two words. That Committee met morning after morning, and those who sat upon it remember the very hard work that was put in by our old friend Sir Arnold Wilson. He extracted the last word from everybody in the box. That Committee came to the conclusion that the patent medicine industry in this country could well afford to pay to the country a revenue of about £3,000,000 a year. At that time the industry was paying some like £700,000 or £800,000 a year. We submitted a recommendation. Mr. Chamberlain was then Chancellor of the Exchequer, but he was not prepared to do anything in this matter. A year went by. Sir John Simon became Chancellor of the Exchequer. We listened to his Budget, feeling that the hard work we had done was to have its reward and the nation its £3,000,000. To our amazement, the right hon. Gentleman removed the existing tax. Not only was there no increase in the tax, but the tax was done away with. We went to see him, and subsequently he put the tax back.
Then came the war. Now, four years after the meetings of that Committee, this. House is carrying what I firmly believe could have been carried out in one week. The Treasury has been deprived of £3,000,000 for four years. The Minister said this morning that exhaustive arrangements, conferences and everything else had been in progress; I believe it could all have been done in one week. When the Financial Secretary to the Treasury replies to the Debate. I hope he will explain why the Treasury was done out of this money. The people in the patent medicine industry were anxious and eager to pay, since they would have secured the monopoly which they so earnestly desired. The Bill reads like a very innocent and constructive Measure, but it seems to me that it contains a tendency to place monopoly powers in the hands of the British Medical Association, which is a very reactionary institution and —
§ Mr. Baxter
I cannot believe that even any doctor, loyal to his profession, could say that the British Medical Association is alert and up-to-date.
§ Sir F. Fremantle
Does my hon. Friend realise that the British Medical Association, of which I am only a humble member, started the whole business by its wonderful book, which was published some-where about 1910 and which exposed the whole thing?
§ Mr. Baxter
I should be the last to say that, over many years, the British Medical Association never did anything useful.
§ Mr. Baxter
It takes genius to do nothing useful at all over a period of years. In prohibiting the advertising of quack remedies, the Bill is wise, but is there not an implication in that prohibition which ought to be studied? In the last 24 hours I have been lobbied by herbalists. Up to that time I knew practically nothing about herbalists. Now I am aware that they are people of eminence, social charm and some position in the community.
§ Dr. Edith Summerskill (Fulham, West)
Can the hon. Member say whether, in addition to their charm and social standing, they have any scientific qualifications?
§ Mr. Baxter
When one is lobbied over a period of 24 hours there is not much chance to ascertain all people's qualifications, and I have no knowledge of the scientific side of this matter. The people concerned appear to be responsible citizens, and they claim that, in these herbal remedies, there is a tendency or move towards a cure for epilepsy. Suppose that is true; do we not, by putting a ban upon the advertising of such things, make it difficult for us to develop such a cure? Might it not be muffled? I know I am putting this point badly, but I think there is a tendency to ban things too much. I would much rather have a system of inquiry and judgment as to merits. We have not much time in this House to discuss the Bill thoroughly. It has been rushed, we are going to be asked to agree to it, and we simply have not time to study its implications. I think it should be confined to those Clauses which deal with the necessary revision of taxation, and outside all that I strongly recommend that: this Bill be not rushed through in its present form
§ Professor A. V. Hill (Cambridge University)
I am very grateful for the opportunity of saying how warmly I welcome this Bill as a step in the right direction, and only a step, for I feel that it is a temporary Measure which will need a far more extensive Bill some day after the war. A leading article in the "Times" this morning, which may have been seen by many hon. Members, rebukes the Government for bringing in this Bill now. It reminds me of a story of a Vice-Master of a college in Cambridge, who said once that when any change was brought before the College Council he always asked himself two questions. The first was, "Is it a good change?" which he said he almost always answered "No." The second question was, "Is it needed now?" "And to that," he said, "I invariably answer 'No'." I am sure that my scientific and medical colleagues will welcome this Bill, and in particular two of the Clauses to which special reference has been made, that prohibiting advertisements of drugs supposed to cure certain special diseases and that requiring the disclosure of the composition of substances sold as medicines.
I am not always on the side of the medical profession, particularly when it seems to me that their activities are directed more particularly to maintaining their privileges. I admit— and admire— their good nature in the way they receive my ironical remarks, and I agree very warmly indeed with the remarks, we have just heard from the other side about the necessity of a more extensive public health service. When, however, attacks are made on the medical and allied professions because of their objections to nostrums and charlatans and other improper activities, my spirit rises and I rush at once to their rescue.
There are people who scrupulously obey the law, the Ten Commandments and Mrs. Grundy, but who like to have their fling at medicine and are in favour of quack medicines, thinking perhaps that in this way they show their liberalism and openness of mind. Unfortunately, liberalism of this kind is apt to verge on stupidity, and such openness of mind really means emptiness. The stupidity in this case is to neglect the elementary fact 79 that very large vested interests are involved in this question of the sale, and particularly of the advertisement, of secret remedies, and I have little doubt that when my right hon. Friend the Minister of Health read his "Times" this morning he gave a loud and ironical laugh. As an illustration of these activities— many of them are known to Members of the House — there is the excellent little book which has already been referred to, "Secret Remedies," published by the British Medical Association, which provides perhaps the most striking evidence. In it the composition, the cost of the constituents, the claims for these medicines and their probable effects, if any, have been exposed now for a good many years. The advertising interests soon realised the damaging effect of these exposures, and succeeded practically in excluding it from the bookstalls. It became almost un-obtainable, which apart from anything else is a great pity, because the book is very readable, rather in the style of the hon. Member the Senior Burgess for Oxford (Mr. A. Herbert).
As an example, the best known of all these remedies— it is a harmless and unobjectionable one which must have brought its owner countless money— is the one which is said to be "worth a guinea a box," and which costs is. I½d.— or did some time ago; the value of its constituents is one half of one farthing, and all it contains is aloes, ginger and soap. What fraction of the difference between the "retail price and one-eighth of a penny goes to the advertisers and what to the proprietors is not known. Another example, not so harmless because of the danger of not treating the disease properly, was advertised many years ago, namely, the Brompton consumption specific, doubtless intended to produce an association in the mind with the Brompton Chest Hospital. The contents of a 2s. 9.d. bottle were, chiefly treacle, ipecacuanha, opium and water, costing ¾d. Such illustrations show how necessary it is to scrutinise very carefully the objections which may be raised to the principles underlying some of the Clauses in the Bill. The motives of those who object to them, like the secret remedies themselves, are not always what they seem.
We must not imagine that the advertisers are. idle now, and the most respect- 80 able papers contain these advertisements. For example, the "Observer" last Sunday had advertisements inviting us to wake up our liver bile with little liver pills in a way that would make us jump out of bed in the morning. The "Sunday Times," in spite of the paper shortage, has a one-fifth of a page advertisement for Phyllosan, which "revitalises the blood," whatever that means, "fortifies the heart"— which sounds like the Minister of Information trying to keep up our morale, "corrects our blood pressure"— unfortunately without any indication of how it does it, ''stimulates our metabolism"— regardless of the fact that it is much more easily done by going for a gentle walk; "strengthens our nerves," "increases our vital forces,"— quite meaningless phrases— but gives no indication whatever of the contents of the remedy which is said to have all these effects on the system. The "Spectator," complaining of the paper reduction, yet has half a page to give to an eye lotion which is specially recommended for Civil Defence workers when they return after an incident. I personally should have thought that a dilute solution of boric acid would have been just as good, but it. has the disadvantage, of costing much less. The '' News Chronicle '' has. an advertisement for Zam-Buk, an old friend, at the present moment specialising in relieving tired feet.
§ Mr. A. Bevan (Ebbw Vale)
Will the hon. Member assist the House by pointing out which Clause of the Bill would prohibit advertisements of that kind? I understand that prohibition is confined to diseases specifically mentioned in the Bill.
§ Professor Hill
I am pointing out the importance of the interests of the advertisers in these remedies.
§ Professor Hill
I am pointing out that the advertisement of these medicines will be seriously decreased if the constituents are disclosed. Zam-Buk is composed of paraffin wax, 60 per cent., resin, 26 per cent., and eucalyptus 14 per cent. It is said to be a "grand herbal remedy." I do not know where the herbs come in. It is sold at 50 times the cost of its constituents, and in its day it has been advertised to cure every conceivable skin ailment, including dog bites and centipede stings. Bile 81 Beans allow you to slim while you sleep. Germoline is for bad legs. Limestone Phosphate— which sounds very grand chemically, but which I do not recognise — causes all fat-forming foods to be eliminated from the system; since nearly all our foods can form fat, this would appear a highly dangerous substance. Yeast Vite returns your money if it does not cure you of a wide variety of unrelated diseases.
"Picture Post" gives us Beltona, which penetrates the skin, dispersing uric acid, somehow miraculously escaping the blood-vessels on its way. It gives instant relief to rheumatism, sciatica, lumbago and sprains. None of them would cause so much waste of money and hope if the constituents were honestly exposed. Moreover, we might avoid the danger of objectionable constituents, as, for instance of a children's teething powder, which it was stated "does not contain opium." Actually it contained morphine the active constituent of opium. Perhaps the most important Clause is that relating to the prohibition of advertisements for the alleged cures of certain diseases. I once had an argument with an editor of a rather highbrow weekly about an advertisement for a nostrum which was guaranteed as a cure for tuberculosis. The editor defended its publication on the grounds that it is desirable that everyone should have freedom to express his opinion, or advertise his wares. I think he was a little ashamed of himself, because later the advertisements ceased. The episode reminded me of the editor of an anti-vivisection journal who allowed a statement to appear that several millions of people had died in India as the result of inoculation. When challenged, she said she knew that the statement was not true but thought that everyone had the right to express their opinion.
In America there is no law against allowing advertisements to be published, but the Postmaster can prosecute anyone for using the public service of the post to spread falsehoods or make claims dangerous to the public. It is very desirable that the British Government should have analogous powers. Therefore this Clause, which prevents the advertisement of treatments of the special diseases men is a great step in the right direction. It might be desirable, in Com- 82 mittee, to add further diseases or, at least, to give the Minister power to add others as needed. If anyone is fool enough to be taken in by advertisements for the cure of grey hair, he deserves to lose his money. With many diseases however it is necessary to get decent, responsible advice, not to waste money, to waste precious days and precious hope on fraud. This Bill, through no fault of my right hon. Friend, is long overdue, and I congratulate' him on bringing it before us. It must have required a certain amount of courage and determination on his part; he must have been aware of the misrepresentation which would be applied to him. We have been too respectful and tolerant for too long of the exploitation of the sick and suffering. It is time we realised that laisser faire in this matter means cruel scandals, that laisser faire is not freedom but simply everyone for himself and the devil take the hindmost.
§ Mr. Woods (Finsbury)
One of the Clauses deals, quite rightly, with the anomaly which was created by the introduction of the Purchase Tax. When that was under discussion it was pointed out that it involved an additional tax on an article already taxed. But as we pro with the Bill it was discovered that a far greater anomaly was being perpetrated, and that the Purchase Tax actually included a tax upon a tax as it applied to a patent medicine. That, I understand, will be corrected completely by this Bill. Now, with the Purchase Tax applying to patent medicines, there is an overwhelming case for the complete abolition of the Patent Medicines Duty. We welcome the Bill on that account. I was rather perturbed by the Minister's speech in explaining the Bill, when he referred to the fact that in the case of patent medicines to be modified the qualified chemist had an advantage not shared by others who from time immemorial-have been concerned in the sale of household specifier; The chemist, by selling the commodity with the prescription printed on, could sell minus the tax, therefore minus Purchase Tax on the tax, but the ordinary man in the village store was having to charge his customers the extra money. That meant that a considerable section of the population of this country who live in rural districts found that it paid them to pay bus fares to go to a chemist, and achieve the 83 economy they would effect by so doing, in not paying a tax to the chemist which, if they had bought at their local village store, they would have had to pay. Why should the Minister suggest that, because through the incidence of legislation a privilege was conferred on a section he is to go altogether out of his way in this Bill to try and see that there is no harm done, that he is not to take away from those people a privilege to which they were not entitled? I hope that he will modify his attitude in this, because if we are going to be concerned at any hardship that is incurred by people because they have had a privilege which they have no right to have, which is not theirs by any legitimate winning or service to the community, that is an attitude we ought to get rid of, especially in war-time.
§ Mr. Wakefield (Swindon)
Is the hon. Gentleman aware that chemists undergo a long professional training to enable them to become qualified, to discharge certain statutory qualifications?
§ Mr. Woods
I do not wish to enter into debate on that score. I am as familiar as the hon. Gentleman with that matter. I have come to the conclusion that there is perhaps more balderdash talked on that subject than any other. There are people who have to take a job at the age of 14 and are handicapped throughout their lives because of that. Others of us have been privileged, instead of going to work — we may have had a short period of work— to go to college. Because we had the pleasure and joy of practically doing nothing except increasing our own capacity, is the argument that we are to go on for the rest of our lives not only enjoying higher standards than other people, but that we are to have additional privileges created by legislation? It is time we began to be rational and dealt with human beings as human beings and that we should end these privileges and not perpetuate them. I have spoken more feelingly on that question than I might have done but for the hon. Member's interjection. There is no justification for this privilege. No privilege should be given or conferred in this way.
There are one or two other points with regard to the Bill which I think ought to be made clear. I hope that it will be made clear that there will be no inter- 84 ference with the present procedure in the selling of quite simple proprietory articles, the use of which is quite reasonable, for example, aspirins, the various carbolic disinfectants, and so forth. They ought to be readily available in every community, whether there happens to be a chemist's shop, or a branch of a chemist's shop, there or not. With regard to the publication of advertisements, I do not know what the position will be, and I would like the Minister to enlighten the House. It does not seem of much use to prevent newspaper publicity when one can go into the streets of any big city, particularly in the North of England, and have free entertainment from gentlemen with innumerable bottles, who tell one something about the contents of those bottles and of the wonderful things they will do. Such people will be able to do all the things that this Bill prohibits established traders, with business addresses and reputations to maintain, from doing. When trying to mitigate an evil, we should not go too far in the other direction.
There is a strong case for Clause 3, which deals with remedies for specific diseases, but the medical profession will agree, I think, that insulin is helpful to victims of diabetes. I am not an expert, but I think that that is usually conceded. It seems that if any specialist in the proof insulin wished to make insulin available easily, by laying down an efficient plant, the Clause would prevent him from doing so. That is a point which ought to be cleared up. It is only in recent years that the properties of insulin have been discovered. I can imagine other remedies being discovered, not only through university research and by famous people, but by humble people. I am reminded that at a recent Chelsea Flower Show the whole world was startled by the achievements of an old jobbing gardener from York, called Fred Russell, who if one met him in the street might have been mistaken for a tramp. We know him in York as "Old Man Russell." He lived for his lupins, and gave to the world a range of colours which startled the visitors to the Chelsea Flower Show. Genius is widespread in this country. It is not limited to those who, like some of us, have had the privilege of a university career. A rigid application or an extension of this provision might not only cut out initiative, but might prevent any gain from cures which 85 might be discovered. I appeal to the House to support the main principle of the Bill, and to see that on the Committee stage the Bill is made wholly beneficial, and that it does not become numbered among the quack remedies for our social ailments.
§ Rear-Admiral Beamish (Lewes)
I rise to make a short speech in very strong support of this belated Bill. I have many times been asked why I, as a sailor, take an interest in this, in some respects, complicated subject. But to-day we have already had speeches from a scientist, a journalist, a coalminer, and other people who are concerned with the health of the nation and with the prevention and control of fraud. Anyone who has travelled even about this country, and certainly anyone who has travelled about the world, as I have done, and who has come into contact with African and Chinese practices— the ju-ju practice in Africa, and other practices such as the sale of the wild ginseng root for its weight in gold in China— must take an interest in the subject. The ju-ju people and the people in China who deal with the subjects I have mentioned have nothing to learn from the advertisers of the quack remedies with which we are surrounded. Those of us who have read "The Golden Bough" can clearly appreciate the background which it provides of the incredible and in eradicable credulity of civilised and un-civilised men and women. Those of us who have had the pleasure of reading O. Henry's "The Gentle Grafter" and his tale "Next to Reading Matter" must surely realise that that is a description of the methods of exploiting the credulity of which I have spoken. This Bill seems to me, at least to control and, in some measure, to expose the monstrous and Pagan fraud of the quacksalver.
As for the abolition of the Stamp Duties I might mention, in parenthesis, that I was for a time on one of the Committees which went into the question— and that is an added reason for my being interested in the subject. In the eyes of the public, the stamp has always been a sort of seal of value, of rectitude and of purity; but it is no such thing. It is merely a method by which this and other Governments exploited one of the minor, but very dangerous, vices of the people. The revenue that has been obtained in this way has been, in the past, minute. If in future, 86 when this Bill becomes law, it is possible to find a way by which large revenue can be obtained from this trade, I shall be the first to support it. What is wanted is exposure of the methods which have led to some of the provisions of this Bill; and above all, the protection of the public. The Clause which deals with the prohibition of advertisements is of very great importance. Even to-day the Government, in my view, are much to blame. One has only to look at the books of postage stamps which we buy from the Post Office to see advertisements of quack remedies which cannot be justified.
This advertising of what I call ju-ju is not new at all. I took the trouble last night to turn up Steele and Addison's "Spectator," which was published not very long after the invention of printing, and from the date of printing perhaps these advertisements spring. In looking at that publication of nearly 250 years ago, I find that there were advertisements of the very worst possible type. Again, I would say that the modern advertiser has nothing to learn from the indecent exaggerations and lying statements of the people who advertised in Steele and Addison's "Spectator." I do not think myself that it is wrong to make revenue out of what I would call public vices, of which I have many myself— all of us have them— but when the vice takes the form of these secret remedies that we are discussing, we have no right, the Government and the House of Commons have no right, to condone this thing to the extent that we have in the past.
I repeat, that it is the business of this House, first of all, to protect the public, and perhaps almost as important as protection is enlightenment. My hon. Friend who spoke from behind me and cleared up a number of points connected with the composition of these secret remedies is right in saying that enlightenment is of extreme importance. Actually, I went into a chemist's shop this morning and asked for two sorts of pills and two sorts of ointment. I did not buy them. I found that they were is. 5d. each, and that in the case of one of them the ointment is alleged to cure no fewer than 63 ailments, of which my hon. Friend mentioned only two. If fools and their money are very easily parted— and they certainly are— at least let this House pass a Bill which will 87 enable the foolish to know what they are buying. Again, I refer to what has been mentioned here about this vested interest. How can we look complacently upon the vast fortunes that have been made from these miserable, cruel, witch-doctor frauds on the public? It is all very well for people to say that, if a man buys a secret remedy and he feels that it does him good, he should be allowed to buy it, but enlightenment will help him very much indeed, and if he knows he is buying soap, ginger and aloes, he will say, "I will keep my is. 5d."
Speaking of this vested interest, many of us have met— certainly I have— individuals whose names are a public, I will not say byword, but almost a password. They have made vast fortunes, and I personally never can meet them without feeling that they or their ancestors have committed a fraud on the public. These secret remedies are in the nature of a social crime committed by the people who push them, by trading on the credulity of the ordinary individual, and no Act of Parliament should condone them. That is why, when the times comes, I hope that I may be allowed to move an Amendment, which is already on the Paper, to try and clear up some of the doubts, and prevent the poor unfortunate individual who has no knowledge and perhaps not even the money to enable him to go and see a doctor, asking a totally unqualified man for some remedy for his trouble. I welcome this social reform, and if perhaps the steps are tortuous and testudineous, they are nevertheless welcome.
§ Mr. Arthur Duckworth (Shrewsbury)
I think that, taking into account the heated controversy which these Debates have raised in the past, the Minister has every reason to be highly gratified with the reception which this House has given to this Bill. I wish briefly to support he Bill, which is very long overdue, and the Government are certainly to be congratulated on the attempt which this Bill at long last makes to deal with problems that have been considered by two Select Committees of this House, and which have been debated on numerous' occasions both here and in another place. Really there can be no justification for the plea which was made by my hon. Friend the Member for Wood Green (Mr. Baxter) that there 88 should be any further delay in dealing with this question.
I claim some very small part in the parentage of the present Bill, because some of its Clauses follow, broadly speaking, the provisions of a Private Member's Bill which I introduced in this House in 1936. That Bill met an untimely, and, as I thought, an undeserved fate, and I am confirmed in that view by the fact that the Government have decided to introduce the Measure which we are considering to-day. But the present Bill is, of course, very much wider in its scope, though many of us think that it should be a great deal wider still. The Minister has told us that this matter was first considered as long ago as 1914 by a Select Committee that examined the whole question of the commercial traffic in patent medicines and secret remedies. They reported at that time that the existing law was wholly inadequate to safeguard the public against widespread fraud and deception, and they produced quite remarkable evidence of the extent to which human credulity can be exploited and of the colossal swindles that were being perpetrated on the public at that time. It is true that the Report of 1914 is to some extent out of date to-day and the public have meanwhile received some additional measures of protection through the Dangerous Drugs Act, and other legislation which has been passed by this House, and it is also true that there is to-day some small check at any rate on the more undesirable and fraudulent type of advertisements which is carried cut by the voluntary censorship which has been established by the reputable newspapers. But all newspapers do not come within the scope of this censorship, and no one who has studied the present situation— and many examples have been given by several speakers already— can possibly come to any other conclusion than that enormous frauds are still being perpetrated upon the public every day which are really a serious danger to the public health.
This Bill has been largely founded upon the Report of the Select Committee which sat in 1937 to consider the Medicine Stamp Duty. This matter of advertisements was largely outside their terms of reference, but, nevertheless, so greatly were they impressed by the view that further control of the medicine trade was necessary that they emphatically recorded 89 that view in paragraph 16 of their Report. Therefore I particularly welcome Clauses 3, 4 and 6 of this Bill, and especially Clause 6, which requires a list of the ingredients to be printed and affixed to the outside of the container, wrapper or label. I think that constitutes a most desirable and most necessary reform, and it provides a powerful safeguard to any-one who cares to take the trouble to see that he is not purchasing absolute rubbish.
The only criticism I have to make of this Bill is that it does not go nearly far enough in the matter of controlling undesirable advertisements. Clause 3, very rightly, provides safeguards against the exploitation of certain incurable diseases, and it is true that that Clause is fairly widely drawn. But the Bill makes no attempt whatever to deal with the far more widespread evil— the type of advertisement that is wholly fraudulent and undesirable in itself, quite apart from the preparation or substance which it advertises. Many of these preparations are no doubt perfectly harmless and, in fact, may be useful in treating certain minor ailments, but the manner in which the substances are advertised is nothing short of a public scandal. There are advertisements which are calculated to do infinite harm, because they prey on, and exploit, the emotion of fear, and it is not going too far to say that the interests which are exploiting this emotion in this way are attempting to levy a huge form of black-mail on the public.
One can give innumerable examples of that type of advertisement. We have all seen pictures of acid burning an immense hole in a piece of carpet: Underneath the picture we are told that this is what happens inside you when you get stomach pains and that if you take the tablets which are advertised you will be able to eat anything. We are told that four out of live people suffer from pyorrhoea, but medical authorities say that this statement in itself is wholly untrue. We are told that if we use a certain tooth paste we shall be protected against what is called this widespread disease. Further than that the ailments and disorders which may prove destructive to romance are heavily exploited. The advertising artist has used all his ingenuity in supporting that type of advertisement. There is the picture of the girl who has lost her friends and her lover, and it says that no one 90 would tell her why. I contend that all these types of advertisement are wholly undesirable in themselves and should be controlled by the Ministry of Health.
There are endless examples of this kind of advertising, and it is not enough to make sure simply that the ingredients of the substances advertised are harmless. I am convinced that the actual advertisements themselves should be brought under control, and I suggest to the Minister that it is quite easy to set up, under this Bill, a statutory body, under the Ministry of Health, to exercise censorship over the whole range of advertisements for patent medicines. Many reputable firms never use these methods, but, unfortunately, there are exceptions, and when we consider the enormous profits being made by this trade, I say that it is intolerable that they should be permitted to push their products by these methods. It is no defence to say that the ingredients themselves are harmless, that these advertisements are in a minority and that people are not fools enough to believe the statements made. The fact is that there is really no limit to human credulity. We have taught people to read and write, but we have not taught them how to think, and certainly this war has taught us, as never before, the unlimited powers of propaganda and that if you say a thing loud enough and often enough people will believe it. I believe this exploitation of the emotion of fear and the suggestion that most people may be suffering from some particular ailment may in itself be a potent cause of disease, and I see no reason whatever why this evil should not be dealt with under this Bill. It is a proposal that could only be opposed by vested interests which would stand to lose.
I would like to say a word in regard to the abolition of the Stamp Duties. It is generally agreed that the duties in their old form were wholly unsatisfactory and that the legal position was very anomalous. The Select Committer of 1937 recommended their abolition and, further, that a new set of duties should replace them, on a far wider range, levied on the selling price of the article. That course has not been followed, and many of us cannot accept the case made by the Minister for not pursuing that course; Many find it difficult to understand why, at the 91 present time, when revenue is urgently needed, this trade, which is still making colossal profits, should be exempt from any special taxation. It is true that mean-while the Purchase Tax, amounting to 16⅔per cent., has been imposed on all these articles, but is there any reason why this trade, if it were a fit subject to attract special taxation before the war, should not attract special taxation now? This matter is certainly no reason for opposing the Bill, but it is to be hoped that in the very near future the Chancellor will reconsider this question and will implement the recommendations of the Select Committee. I believe that this Bill constitutes a very considerable measure of reform, but I think it could be improved and widened in the way I have indicated, especially with regard to the further control of advertisements. Every effort made in the past to grapple with these problems has always been frustrated, and legislation in this country has lagged far behind the legislation which exists in Continental countries, and particularly in the British Dominions. The Government are to be congratulated on finding time to deal with this question in the middle of the war, and I shall certainly support the Second Reading of the Bill.
§ Mr. A. Bevan (Ebbw Vale)
I need not apologise for speaking by giving a testimonial to myself as to my qualifications for doing so, because I should have thought that in this matter the only qualification necessary was that one was a victim, or might be a victim, of some of the things with which we are supposed to be dealing. I have another qualification, in that I was for very many years a member of the committee of a medical aid society about which Dr. Cronin wrote in his famous book, "The Citadel." I think that some hon. Members who have spoken, and who belong to the medical profession, might have remembered the latter portion of that book before indulging in their praise of the medical profession.
Almost every hon. Member who has spoken has commended the Minister for introducing the Bill, and particularly remarked on the fact that it has been received with such commendation, consider- 92 ing that a Bill of this sort usually leads to bitter opposition owing to the many vested interests that are involved. I think that some hon. Members are rather too naive. Surely, the reason the Bill has not aroused any opposition is that it is almost innocuous to those vested interests, who would have fought the Bill if it had been an effective one. I think that before the end of the Debate it will be shown that even what the Bill pretends to do will not be done, and in fact, the Bill only tries to go a very little distance. I could say now in what way it would be possible for all the interests which the Bill proposes to tackle to evade the Bill. I could at this moment frame an advertisement which would escape under the Bill. The suggestion that, by having the ingredients stated on the bottle, one will deter people from buying it is one that I cannot understand. No doubt other hon. Members better qualified to speak about this will intervene before the Debate closes, but I am bound to say that I do not think one can devise legislation which will adequately protect people from their own credulity, without dealing with it in other places, in the schools, and in our methods of teaching science. As long as there are educational institutions which teach people to be superstitious, their superstitions will be exploited by commercial interests at every opportunity. Again, I am bound to say that it does not seem to me that quacks cease to be quacks by reason of their be given a charter. The suggestion that because doctors have to pass examinations, quackery is eliminated from the medical profession is a suggestion that is entirely opposed to our experience. For instance, the medical profession has not got to prescribe the ingredients of the medicine bottle in such a way that people will understand them. Very few doctors can write legibly, and even when they do, they write in Latin. How many patients will understand what are the ingredients of the medicine bottle?
In order to show that the claim that the medical profession is free of quackery is unwarranted, let me recall an incident from my experience of the medical aid society to which I have referred. We had a very successful and popular doctor who was attracting patients from all the other doctors whom we employed— and we employed a great many— to the disadvantage, of course, of the salaries of the 93 others, as we had a system of competition inside the society so as to enable the patients to select their doctors. This doctor was so popular that his salary was going up to astronomical heights, and the salaries of the other doctors were falling; but at the same time as his salary was going up, so was our drugs bill going up, in the same proportion, and for the same reasons. He was exceedingly popular because he gave to his patients long and impressive prescriptions. We had to do something about the matter, because it was demoralising the whole of the society. It was no good writing to the British Medical Association about it, because they would have supported the doctor in any case. Therefore, we sent for a private report from an analyst, and he reported, in a preamble, that it was not possible to tell with any degree of scientific accuracy what would be the reaction to a compound containing more than four or five ingredients, and that when the number of ingredients was in the degree of prediction declined. The doctor to whom I have referred had been prescribing 13,14 or 15 ingredients. The analyst said, with regard to one medicine, that the effect of the particular ingredients was, as far as he could see, wholly innocuous, and with regard to another medicine, containing 13 or 14 ingredients, he could only describe the result as an act of God. We managed to get rid of the doctor.
I refer to this matter in order to show that it is complete nonsense to suggest that because doctors are in a chartered society, there is consequently no quackery in the medical profession, or that the patients are necessarily protected against quackery by that reason. Indeed, no reputable doctor would claim any high percentage of science for medicine; medicine is about 25 per cent. science and 75 per cent. art; and as long as there is a body of protected citizens who cannot claim any high degree of scientific accuracy for their practice, it is very dangerous to prevent anybody else from practising the same arts. That is why I want to find out from the Minister whether it is true, as I understood him to say, that the herbalists' profession is protected. The herbalists do not think so. They have lobbied us, and they suggest that if the Bill goes through in its present form, very heavy disabilities will be 94 placed upon them. I have no special plea to make for them; all I say is that, as long as a body of people is working on a vast deal of empirical research conducted by citizens who have no legal licence, and do not need one, it would be a very bad thing for the medical profession to prevent them from going on with their investigations and explorations, because a very great deal of what is to-day described as quackery becomes the accepted practice in medicine tomorrow, as is known by anyone who is familiar with the history of medicine. Therefore, I suggest that, in the interests of the medical profession, it is undesirable to put legal disabilities upon persons who do not sell poisonous drugs, but who are engaged in a field of research to which many doctors are too pedantic to pay attention.
It is no argument against a drug to say that it is innocuous and that the patient is deceived by it. To a very considerable degree our therapeutic system consists in this, that the patient is getting better when, in fact, no organic change is taking place, simply because the induced condition of optimism has a great curative value. Therefore, it is no argument against a drug to say that a person is deceived when he thinks that it is doing him good. If this form of therapeutics has anything to be said for it, then the patient is better because he is deceived. Very many doctors would lose their patients if they had not that charm of manner and personality which convinces the patient that he is in good hands.
§ Sir Patrick Hannon (Moseley)
Am I to understand that the Minister's statement about the Society of Herbalists and those engaged in research into herbal treatment is satisfactory to the hon. Member?
§ Mr. Bevan
No. I confess that I have read the provisions very carefully, and I can see that it is intended to give some form of protection to herbalists, but it is disputed as to whether they are protected. That is the point. If the Minister had explained in his opening speech precisely and particularly the forms of protection, a great deal of this discussion might have been curtailed, because, as I have already said, most of the rest of the Bill is entirely innocuous, and, however well-meaning, misses the target. I hope, when we come 95 to the Committee stage, that we shall not place any legal disability upon persons who are carrying out an investigation of forms of treatment, which have not become part of the general medical practice, but which nevertheless may prove themselves of great curative value.
§ Mr. Henry Strauss (Norwich)
I congratulate the Minister on introducing a Bill which has certainly some very valuable features, including, in particular, the compulsory disclosure enjoined by Clause 6. I think that it is unfair to attack the Minister of Health on the ground that this Measure is introduced in time of war, because the introduction of a Measure on these lines was rendered essential once the Chancellor of the Exchequer had decided to repeal the existing Medicine Stamp Duties. I know that a number of speakers wish to intervene in this Debate, and I shall therefore confine myself mainly to a single subject— the prohibition of advertisements which is contained in Clause 3. I agree with many of the remarks which were made by the hon. Member for Llanelly (Mr. J. Griffiths) in making the opening speech on the other side, and with many of the statements contained in the speech of the junior Member for Cambridge University (Professor Hill). They both welcomed the prohibition of certain advertisements under Clause 3, but went on to mention a vast number of advertisements which, as the hon. Member for Ebbw Vale (Mr. Bevan) has pointed out, will not be hit by Clause 3 at all. The only way these advertisements will be hit, if at all, is by the indirect method of the proprietor being compelled to disclose the composition, with the result that a certain number of people may be deterred from buying the product. The doubts of the hon. Member for Ebbw Vale, on the question whether people will in fact be so prevented, are fully justified. I will give the House a few examples of human credulity which render any suggestion that they will be deterred extremely optimistic.
I do not know whether the House realises the vast extent of vested interests in these patent medicines. My figures may not be up-to-date, but I find that the public has been spending something like £30,000,000 a year on these medicines, on which this is the considered view of 96 perhaps our most distinguished living doctor, Lord Horder—
§ Mr. Strauss
He states:We have this campaign of quack medicines and food, totally un combated so far by His Majesty's Government, but led by very subtle and skilled generals bent upon maintaining national ill-health, moral and physical, in order to have a read' market for then-goods.I agree with Lord Horder that the advertisements themselves often constitute a greater danger to health than the contents of the medicines which they are designed to sell. What Clause 3 of the Bill says is that there are eight subjects about which you must no longer tell lies in advertisements. There are also two prohibitions contained in earlier Statutes. On all other subjects advertisements can continue to lie as at present. I was very much astonished by the optimistic statement in the admirable speech of my hon. Friend the Member for Shrewsbury (Mr. A. Duckworth) when he talked about the voluntary censorship by certain news-papers. I remember that not very long ago one of the newspapers which boasted that it was maintaining a very high standard through this voluntary censorship contained an advertisement, which I hold in my hand, on the subject of rheumatism. It was an advertisement for an ointment, which stated:There is literally no need to continue to suffer from rheumatism or its allied complaints.That was the promise given if you bought this ointment. The fact is that the advertisements which will be stopped by Clause 3 of the Bill are those which have now become least important. Subjects upon which advertisements are at present lying include rheumatism, vitamins, indigestion and the question of food values, about which the public is taking an in interest. I have given an example concerning rheumatism, and my hon. Friend gave a really disgraceful example of an illustrated indigestion advertisement which stated that the acid in the stomach would burn such a hole; in the carpet. Another advertisement, known to be a blatant lie, is that four out of five people have pyorrhea. That is known to be untrue, except among the uninformed, but the product will still be allowed to be sold 97 in this way, because Clause 3 does not hit this type of advertisement.
Perhaps one of the most serious of the many misstatements in advertisements concerns meat extracts. This may greatly affect the nutrition of the poor. A poor mother, if her child is ill, will very likely be induced by one of these advertisements to scrape her savings together to buy some meat extract, which she believes to be of almost supreme value, when as a matter of fact the same amount expended on ordinary food would do much more good. Those advertisements are absolutely out-side the scope of Clause 3. Let me give one other example— again a lying one— that "everyone takes a laxative." The ordinary healthy person, who does nothing of the sort, immediately begins to wonder whether he is health. That is a type of advertisement designed and calculated to depress and produce a sense of ill-health.
It may be said, if these are the evils, how are they to be combated? I can quite understand my right hon. Friend, or the Parliamentary Secretary when she comes to reply, saying it will be quite impracticable to make a great extension of the list contained in Clause 3. I agree that it would be quite impracticable to do so. If, however, you are not going to extend Clause 3, it would be much better not to have it at all. As long as there is no control whatever of these advertisements of quack medicines, so long will it remain possible to sow distrust of advertisements in the mind of the ordinary member of the public. The right way to combat these advertisements is to have distinguished doctors and others broad-casting speeches through the B.B.C. and giving the true answer to the bogus claims that are put forward by these vested interests. That, at any rate, might be effective. What the Bill does is to prohibit eight particular lies and to permit all the rest. The only effect of that is that the public is given a false sense of security. It knows that Parliament has made some provision for preventing frauds through advertisements of patent medicines. It does not read the details. It does not know that there are eight particular frauds that are prevented. The only effect of preventing those eight and allowing all the rest is to give the public the impression that any advertisement that still continues after the Bill becomes law is much more likely to be true, because otherwise 98 it would have fallen within the ban of the Bill.
In considering the gullibility of the public, I invite the House to consider two facts. The first is that after some 70 years of compulsory education it is the opinion of those who are making money from these advertisements that there is nothing too idiotic for the British public to believe. I wonder if anything more fantastic has ever been put before the public than the idea of night starvation. From the beginning of history people have thought it quite a healthy thing to sleep at night. Suddenly, by a brilliant advertising campaign, the public, or a great part of it, is convinced that, since you cannot simultaneously sleep and eat, the only way to sleep without incurring the risk of starvation is to take Horlick's before you go to bed, and then promotion in whatever profession you adopt is almost certain. The most interesting thing about this fantastic notion is that the article sold is, I believe, good, but it is sold by the propagation of this fantastic idea. Let me give another example. In every, popular paper published on Sunday for some years it has been considered essential to have an article by an astrologer. After 70 years of compulsory education that is the state of mind of the people. If it is true as the newspaper proprietors and advertisers believe that there is no statement so fantastic that you cannot get away with it by advertisements, is it sufficient protection for the public to think that mere disclosure of the contents will stop the sale of. worthless articles? Unless the Government are prepared to go much further than they do in the prohibition of advertisements they would do much better to leave out Clause 3 altogether, and then those of us who have 'any power of persuasion at all may induce in the public a distrust of all advertisements instead of giving them a false sense of security through the illusion that the worst evils have been removed and that they can rely on the advertisements which are allowed to survive.
Various Members have mentioned the Society of Herbalists. I have no connection with that Society, but I want to put in this plea. I think the Society is mistaken in thinking that it is as badly hit by the Bill as the Memorandum circulated to Members of the House would indicate. Nevertheless, there are provisions in Clauses 6 and 7 on which it is 99 possible for them to entertain legitimate apprehension. All other bodies whose interests were undoubtedly affected by the Bill were, I believe, taken into consultation before it was drafted. Probably the Society of Herbalists was not so consulted. I suggest that between now and the Committee stage the Ministry should consider with an open mind any representations that may be made by the Society, which I think is recognised as being a reputable society, and carefully consider any Amendments that may be tabled to meet the apprehensions which they express. I believe, from an intervention that the Minister made earlier, that this plea will be met, and the only criticism therefore that I wish to make of the Bill is the criticism of Clause 3 which I have put before the House.
§ Sir Ernest Graham-Little (London University)
I propose to support the Bill but to deprecate what I consider is the disappointing character of its scope. After so long a period of waiting for a really constructive Measure, it is frankly disheartening to see how little has been effected. The Preamble to the Bill states that one of its purposes is to regulate the sale of medicines. Two years ago, when the repeal of the Stamp Duties was suggested, the Chancellor of the Exchequer of that day was obliged by the consensus of opinion in the House to make a promise that he would deal with the sale of medicines both in its health and financial aspects. There is another event which has an important bearing on this Bill. At the beginning of this year the Ministry of Health made an important and useful advance by appointing a committee to supervise the provision of drugs. The committee has not yet reported, but one of the measures which are proposed is that drugs should be divided into three categories— those which are essential and available, those which are not so essential, and those which are not essential at all. The obvious desire of that measure is to restrict the consumption of drugs as such. The effect of the absence of legislation has been enormously to encourage the consumption of drugs in this country. A larger quantity of medicine is taken in the British Isles than in any other country in the world. That is not checked but actually fomented by the enormous number of patent medicines. The extent of the financial gains in that 100 trade has been mentioned by the hon. Member for Norwich (Mr. H. Strauss). It has really reached scandalous dimensions. A sum of £30,000,000 a year is extracted from the public for patent medicines, which is a larger sum than is spent on all the hospital services.
I hope that the Minister of Health will keep in view what is obviously one of his tasks, that is, the supervision of the health of the people. It is not for the health of the public that they should dose themselves and be induced to dose themselves and that no check should be placed on the encouragement of the use of drugs. What is one of the real reasons for the immense development of this trade? I submit that it is largely the power of the Press. Let me give an illustration of the power of the Press in the opposite direction, that is to say, in condemnation. About 17 years ago a famous chemist wrote a report for one of the newspapers on the product known as Yadil. That product was advertised very largely and this report contained an analysis of it. It was so damaging that the sale of the product immediately stopped. Inversely, the sale of a product may be enormously extended by advertising, and it is a cruel form of exploitation. It is becoming increasingly prevalent, and, I think, scandalously prevalent in the exploitation of what might be called war weariness. You will find in every newspaper— I have seen three or four this morning— an advertisement to the effect that "If you cannot do your job and you find it difficult to go to sleep, take two of our tablets; carry them in your pocket and give them to your friends." That sort of thing is horrible, because it is not true that such medicines are useful. They do, on the other hand, unquestionably produce a measure of disease consciousness. That is an unfortunate thing for any human being to contract and it is very easy to contract under the conditions from which we are suffering at the present time.
§ Sir P. Hannon
Do I understand my hon. Friend to say that the advertisements in the newspapers induce a sort of consciousness of illness which does not exist at all?
§ Sir E. Graham-Little
Yes, I do say that, quite definitely. I want to deal with an important item which has not 101 been touched on in the Debate. In the report of the 1936 Committee a valuable recommendation was made that drugs of common usage and common knowledge should not be prescribed under fancy names which concealed their nature and origin and which led to the sale of quite common drugs under what were practically fraudulent pretences. There is a commonly used drug known as aspirin. It is a German patent which has now become known by that name, which is used in preference to the chemical name, which is a long one and difficult to assimilate. There is a number of preparations which are nothing but aspirin, but which are sold under fancy names and pretend to be something which aspirin is not. It is true that one of these advertisers declares that their product is "pure acetylsalicylic acid," which is the chemical name for aspirin, but they do not say that the product is nothing but aspirin and that aspirin can be bought for about one-fifth of the cost of what they are charging. Let me give my experience of a hospital. All large hospitals have a hospital pharmacopoeia. These are arranged largely to avoid expense in prescribing on the part of the younger doctors in the hospital. They are given directions to use The drugs which are in-expensive and of equal potency as compared with others. It is a fact that there is a large number of patent medicines which are nothing but perfectly simple and well-known chemical products. I will give one instance. There is a preparation which enjoys a fancy name and is sold for 13s. for 100 tablets. Under its correct chemical name the same thing can be bought for 6s. That surely is a case of fraud upon the public.
The British Medical Association wisely produced a formulary some time ago for National Health Insurance, and it was approved by the Minister of Health. If a medical practitioner goes outside the formulary he is liable to censure. A demand was made at the beginning of this year to have a war formulary and the chief medical officer to the Ministry of Health announced in February the formation of a committee to devise it. It is obviously the desire of scientific medical practitioners to simplify as far as possible the medicine which they give. It is not true, as one hon. Member suggested, that the medical man wants to have a multi- 102 plicity of drugs. It is quite the other way. The scientific doctor wants a simplification of medicines. There is a salutary tendency to encourage the restriction of drug consumption when so many drugs are non-essential. Many of the drugs in the long list of non-essential drugs which I read out are used by nobody more profusely than by the manufacturers of patent medicines, and it is rather galling for medical practitioners who do use less expensive' ingredients to find that the patented product manufacturer has no such scruples as to non-essential drugs. I agree with my hon. Friend opposite that the proposals for restricting advertisements do not go nearly far enough and I do not think they will have very much effect.
I am also puzzled by the requirement that a description in the British Pharmacopoeia must be reproduced on the container. Does the man who buys medicine in a shop know the British Pharmacopoeia? To put down the scientific names of the products is really quite illusory. One cannot expect the ordinary patient who buys patent medicines to derive any sort of knowledge of what he is buying from a perusal of the chemical constitution. The use of these preparations leads not only to a waste of money but to a waste of valuable time before the patient receives proper treatment. I will give an illustration of a case which came to my own notice. A patient who was suffering from an inoperable cancer consulted a notorious cancer quack, a gentleman who pretended that he could cure cancer by drugs. He was given two powders and charged 15 guineas. He died two days later, after taking only one of the powders. The coroner ordered an inquest and the powders were analysed, and the county analysed reported that they were 100 per cent. cane sugar. The practitioner was absolved of all responsibility for the fatal termination of the illness, but that case, which was fully reported in the Press, exploded his claim to possess a cure for cancer. I support the Bill in its general principles, but I rather hope that the Minister may find it possible to give effect to the recommendation that drugs should not be allowed to be sold under fancy names when they are perfectly simple preparation and quite accessible to the public in the ordinary way.
§ Captain Sir Ian Fraser (Lonsdale)
I happen to be the director of a small private company in South Africa which is a subsidiary of one of the larger manufacturers of medicines in this country. I feel that I ought to tell the House that before I speak upon this Measure. It is, of course, the reason why I am to some extent informed about the subject, and also the reason why I have, during the past month, at the request of the Chancellor of the Exchequer, taken. some part in trying to bring the trading interests together in order to find a solution of the difficulties which presented themselves to the House two or three years ago. In 1936 a strong Select Committee of this House examined this whole matter, and I would briefly summarise what seemed to me to be the important recommendations of that Committee. They recommended the repeal of the Medicine Stamp Duties, and that these should be replaced by other taxation which should be simpler, which should be lower on the lower priced goods but should cover a, wider range of goods, and include not only medicines but medicated articles and even cosmetics. I think I have fairly summarised what were the primary recommendations of that Committee. Clause 9 of this Bill repeals the Old Medicines Stamp Acts and a Section in the Finance Act of last year put on to the Statute Book a tax identical with that which was recommended by the Select Committee. Therefore, the Finance Act and Clause 9 of this Measure carry out between them precisely the recommendations of the Select Committee.
I would remind the House that that Committee sat in 1936, so that there has been plenty of time for this matter to be considered in all its aspects, and it can be hardly true to say that it has been rushed. It may be asked why, if the Chancellor came to the House last year with the Purchase Tax, which was part of the arrangement, he did not then repeal the old Stamp Duties Acts. There were two reasons. One of them is that the chemist has a long-established trade interest under the old Statutes. It should be observed that the Select Committee proposed that that interest of the chemist should be abolished but did not propose to give any concession in its place. This House showed very clearly, and the Chancellor also felt, that a privilege which had been enjoyed over 100 years could 104 not be lightly abandoned, and it was partly for that reason that he was un-willing to deal with the matter last year. He wanted to give time for the interest of the chemist to be reconciled, if that were possible. Clause 7 gives to the chemist a protection which has. satisfied him. In place of the fiscal advantage which he had because he could sell certain medicines without a tax when other persons had to sell them with a tax, it secured for him that under certain conditions he alone may sell certain important medicines, Therefore, the chemist has been given a statutory advantage to compensate him for the kiss of the fiscal advantage.
Let me say in passing that all the benefits of Clause 7 apply to the herbalist. Where a herbalist has been carrying out the law as it stands, he will not be prejudiced by this Bill in any way whatever. I am sure that the Minister and the experts will agree with me in that submission. An agreement was entered into. Earlier in the Debate, an hon. Member asked who were the parties to the agreement. Since, as I have told hon. Members, I am interested in this matter and had something to do with the agreement, I would like to tell the House who were the parties. There was the P.A.G.B., that is to say, the Proprietory Association of Great Britain. It is the Society to which all the reputable manufacurers of proprietary medicines belong. There was the P.S.G.B., the Pharmaceutical Society of Great Britain, a professional body of chemists. It is an examining body, and, like the B.M.A. it is an ethical body. It rules the chemists' lives and sees that a high standard is maintained in their work. Then there was the N.P.U., the National Pharmaceutical Union, the body to which chemists belong in their capacity as shop-keepers rather than as professional men. It looks after the chemists' business. Finally, there was the Wholesale Drug Association, whose name explains itself. Those bodies thrashed out the arrangement, to make it possible for the proposed reform to take place without hurting the long-standing vested interests of the chemists.
When the matter was thrashed out, it was submitted to the Parliamentary Committee of the Co-operative Congress and to the Grocers' Federation of Great Britain. The co-ops and the grocers are 105 interested because they sell these medicines in their shops. While not parties to the agreement, they expressed themselves in agreement with it. There was delay, because all this negotiation had to precede action. The House has clearly shown that it was not willing to trample upon chemists' rights. Another reason for delay was that the Chancellor of the Ex-chequer felt that there was a strong public health aspect to this matter. That is why lie asked his colleague the Minister of Health to take the matter under his charge, to examine the public health aspect of it, and to bring to the House a Rill which would deal with the fiscal side as well as with the health side.
Three Clauses with two objects have been added to the Bill as a result of the representation of those who cared for the public health aspect of this matter. They are Clauses 3 and 4, which limit advertising in certain conditions, and Clause 6, which declares that the composition of the medicines shall be published. Much has been said about the advertising Clauses and I would like to draw the attention of hon. Members to the contrast of view evidenced by the speeches of the hon. Member for Ebbw Vale (Mr. Bevan), the hon. Member for Norwich (Mr. H. Strauss) and the hon. Member for the London University (Sir E. Graham-Little). Those speeches were very interesting, but they showed how carefully one has to go with a highly controversial matter of this kind.
The hon Member for Ebbw Vale made a plea for the utmost freedom to individuals to experiment with cures and alleviatives and to take what they think best: for themselves. The hon. Member said there were many things that doctors had riot shown us how to cure, and that what was experimental quackery to-day might: become, and often had become, the regular professional method of to-morrow. That is profoundly true. On the other hand, the other two hon. Members indicated that they felt that doctors alone were to be trusted. The hon. Member for London University cited the case of the poor person who had cancer and who took medicine that turned out to be sugar. The poor person died; but that patient would have died just as surely if he had visited the practice of the hon. Gentleman, though perhaps he would not have been charged 15 guineas. There 106 is much to be said for reasonable freedom in this matter and for no extreme view. To say that people are not to experiment or to sell medicines lest they do harm is a safety-first policy which may limit progress. On the other hand, to say that advertising dealing with dread diseases should go unchecked is too extreme. Somewhere between the two lies the right course, towards which the practical unanimity in this House to-day upon the Minister's proposal is perhaps the first step.
There have been criticisms. It has been stated that, whatever the argument and the merits of the matter, it is not right for the Chancellor of the Exchequer to lose £800,000. I would put forward for consideration the point that the companies concerned are paying Excess Profits Tax and that, consequently, any reduction of taxation, which would mean their making increased profits, will go wholly to the Chancellor of the Exchequer. It will not be a financial loss to the Exchequer. Other Members have made the very important point to which I want to address myself and to draw the attention of the House.
It has been stated, not only in this House but to me privately and in one or two organs of the Press, that these are wealthy manufacturers, who, despite the fact that they are making great sums, are trying to evade legitimate taxation and have come to the House in war-time to seek relief from taxation when most other people are bearing taxation with a smile and with courage. That point of view is profoundly untrue, and is extremely un-fair. The initiative in this matter did not come from the manufacturers. May I remind hon. Members of the history of the matter? Before 1936, the revenue from the old Acts of Parliament— 130 years old — was beginning to fall away rapidly because modern practice had got out of touch with ancient legislation. In these circumstances, the Select Committee was set up to investigate the question of the fall by over 50 per cent. in the two years before 1935 of the proceeds of that taxation. The desire of the Customs House at that time to have this matter in and dealt with was strong, but it is even stronger now, because the conditions have become worse in the course of time. The Customs House has a 107 primary interest in collecting the money which Parliament tells them to collect. The Chancellor's duty is to come to the House, impose taxation and tell the House when taxes are no longer fruitful.
This tax has ceased to be fruitful; nevertheless it has involved increasing work on the part of Civil servants, both clerical and administrative, and such work can no longer be spared for that purpose. These people are wanted to deal with the administration of extremely complicated new Measures of war taxation, which require all the skill and ingenuity of the Revenue and Customs House Departments to carry out at the present time. The Bill is not a manufacturers' Bill, nor is it conceived in the interests of the manufacturers. It is a Customs House Bill, brought forward to simplify the method of getting the taxes and to avoid what is now a waste. I have already shown that there will not be a loss of revenue.
There may be hon. Members who welcome all taxation on medicines rather as they would welcome all taxation on whisky and who say, "Let it be as high as possible, because we do not believe in self-medication." They either say it is bad or that doctors alone should write prescriptions. There may be various reasons and motives for that belief, but there are Members who say, "Let the accident that these medicines have been doubly taxed continue; we are glad that they are subject to this penal taxation, because all medicines should be cut down; they are altogether harmful." If that be the view, may I submit to the House that that end can be obtained without involving the Customs House in the extremely difficult business of maintaining these old Acts which are now becoming unworkable? The view that medicines ought now to be more severely taxed can prevail if a certain number of Members wish it. They can ask the Chancellor to raise the 16⅔per cent. tax to 33⅓per cent., and put medicines in. the luxury class, but there are others who think that the medicines the poor use should not be put in the luxury class and should not be taxed as heavily as fur coats and diamonds. It should, however, be open to Members to put forward their view that medicines are so undesirable 108 that they should be taxed out of existence, or at least that they should be taxed efficiently, fairly, and without involving the Customs House in maintaining this old and difficult legislation.
I have been asked sometimes whether the effect of the passage of this Bill will be to increase the sales of medicines just now, at a time when jumpiness and nerviness are common in the community and when increased sales may perhaps not be wholly desirable. My hon. Friend who spoke last touched upon that. The immediate answer is this: There can be no increase in sales, because the commodities of which the big proprietary brands of medicines are made are already under strict control; there is already rationing throughout the trade, and the cartons and packages in which they are sold are even still more limited. Nor is it credible that new lines or new remedies should be brought out now, because the House will be familiar with the fact that in all these manufacturing trades the packing and other materials are distributed on a quota basis related to pre-war sales. The fear that war-time neurosis may lead to an increased sale of medicaments is without foundation.
Another point to which our attention has been drawn by a rote in a journal this morning is that this is hasty legislation of a kind to be deplored in war-time. May I submit that the leader-writer who allowed himself that view must have hastily read the documents? I have read them at length, as I am sure the Minister has. They go back in history to 1914 and far before that, and the present proposals are an identical carrying-out of the recommendations of the Select Committee of 1936. The matter has been fully discussed in this House three times, and sufficient time has elapsed for us to be sure that every view has been put forward. This Bill is supported with a fair degree of unanimity in this House and outside it, and ends a long controversy, and it will, I hope, enable us to get on with more urgent business.
To sum the matter up as I see it, the Chancellor will get his simplification of taxation, which will help him in his staffing and in his difficult job. The Minister of Health has brought about a situation in which those Members of the House who feel that a beginning should be made in 109 the control of advertisements and in compelling the disclosure of the secret formula will get half a loaf if not a whole one. Many hon. Members will feel, and some have already suggested, that the Bill does not go far enough to please them in the control of this industry, and here let me inform the hon. Member who spoke from the opposite bench that the Bill does not discriminate between large and small manufacturers. There is no discrimination, all the provisions for control apply to all, and not to any one section. Finally, the recommendations of that Select Committee are being carried out in a way which meets with the assent of the chemists, who, on a previous occasion in this House, had reasonable cause to say that their interests had been neglected. In these circumstances it seems to me that the House may well be asked to give this Bill a Second Reading, so that this controversy may rest and that we may get on with more urgent business in connection with the war.
§ Mr. Rhys Davies (Westhoughton)
I would like to add a few sentences to the Debate on this Bill, and in doing so I would join with others in saying that I regard it as a very necessary Measure. On the point made by the hon. and gallant Gentleman opposite, that a Select Committee had recommended the provisions of this Bill and that consequently Parliament must translate those recommendations into law, I am tempted to suggest that if the Government translated all recommendations of all Select Committees into law, we should be doing nothing else in this House except that.
§ Mr. Davies
Perhaps the hon. and gallant Gentleman's "ought" meant "must." The reason I intervene is because I have come in contact with this problem in several ways. The House will be aware, of course, that there are in this country 20,000,000 insured persons under the national health insurance scheme, and they are all entitled to free medicines. They need not therefore turn to proprietary articles at all. They are entitled to free medicines by way of a prescription from their panel doctor; and I would like to ask the right hon. Gentleman whether he can tell us in the course of this Debate if the amount of drugs purchased outside National Health Insurance prescriptions 110 has increased since that scheme came into operation. It would be very interesting information, and perhaps I had better repeat the question in this form: As 20,000,000 of our 44,000,000 population are entitled to free medicine under the National Health Insurance scheme, is the sale of proprietary articles still maintaining itself? If so, it is indeed a commentary on the gullibility of the public.
§ Sir I. Fraser
If my hon. Friend will allow me, I believe it is a fact that a very great many panel doctors prescribe proprietary brands.
§ Mr. Davies
Yes, I believe that is so-. In any case, it would be interesting to find out what effect prescriptions under the National Health Insurance scheme has had upon the sale of proprietary drugs. The next thing I want to mention is that I feel that this Bill falls very short of the requirements in one particular, in so far as the approved societies which deal with some of these problems are concerned. The hon. Member for St. Albans (Sir F. Fremantle) will, I am sure, agree with me at once when I say that the biggest problem of all in this connection is not proprietary medicines but surgical appliances. I am wondering whether the right hon. Gentleman or his Department ever turn their attention, while dealing with this particular problem, to the many advertisement for surgical appliances which in some cases cost enormous sums to people who are suffering and who desire to buy them. I think the hon. Member for Blaydon (Mr. Whiteley) will agree with me in connection with National Health Insurance when I say that the approved societies have had to be very strict, especially in regard to earphones, for their members. They could probably be sold at a profit for £3 or £4, but the charge is sometimes 10, 12 or even 15 guineas. Had it not been for the Regulations of the Ministry of Health and the approved societies, there would have been a first-class racket in some of these appliances. I wonder therefore if tin.: Minister has come into actual personal contact with that problem in connection with Health Insurance and whether he has thought of including something in this Bill to deal with the sale of such instruments.
The insured population— 20,000,000 of them— are in part safeguarded under the Regulations of the Ministry on this score 111 — and let me pay tribute to the Ministry for the good work they have done in preventing on occasions the exploitation of the insured population. But they have not prevented the exploitation of the people who are not health insured, from exactly the same thing. I thought that the Bill we are now discussing might prove to be the means whereby we could have dealt with that issue. Let me ask the Minister, or whoever will reply, to tell us whether "advertisement" means the printed word only or whether it covers speeches delivered by a quack in a market place. I am not sure whether more trade is done in quack medicines by speeches in this connection than by the printed word. I have heard some of them, and as for an hon. Member saying that people are gullible after 70 years of free elementary education, their gullibility does not relate entirely to these drugs. Gullibility is colossal in respect of party politics, too. I am wondering about the attitude of the Minister of Health to these advertisements after the very excellent speech of an hon. Member who thought that such advertisements created despondency among the people. If that is so, why not prosecute those responsible under the Regulation concerning the causing of alarm and despondency? There is the point as to whether these quacks can still, without printing an advertisement, speak in the open market, as is done in scores of places almost every night.
Let me turn to another problem. I would like to be assured of one thing. Will shops which sell proprietary articles be affected by the provisions of this Bill? A statement from the Parliamentary Secretary to the Ministry at the end of this Debate would clear the atmosphere, if she were able to say that small corner shops, selling proprietary articles, will not be affected at all by the provisions of the Measure. With regard to herbalists, so far as I understand this Bill, it may be true that the herbalist can go on as before, running his business; but I have the impression that this Bill somehow puts him on the defence. He has to prove he is innocent. After this Bill becomes law is it not a fact that the onus will be thrown upon the herbalist to prove he is innocent of any offence? As I read the Bill, I should imagine it will be his duty, in future, unless the wording 112 of these Clauses is changed, to prove that he is carrying on his business within the law. If we could have a word on that point too when the Parliamentary Secretary replies, I feel sure it would be welcomed by a great number of people.
Finally, the Lancashire people, I understand, know more about taking medicine than the people in any other county of England, Scotland or Wales. I think that National Health Insurance statistics prove that. I am not sure that there are not more herbalists in Lancashire than anywhere else per head of the population. Consequently, in that county they will be very interested in the provisions of this Bill. Some hon. Members, from what I have gathered from their speeches, appear to assume that an Act of Parliament can settle all problems. As a matter of fact, this is one of the most difficult problems of all to settle by an Act of Parliament. For instance, if a person suffering from neurosis has faith in a given medicine, that is more important for the cure of his complaint than the medicine itself. The visit of a particular doctor to a person suffering from a nervous complaint is sometimes very much more important than the prescription he gives him to take to the chemist. I should say, therefore, that although all that may be true, I for my part welcome this Bill, and I trust it will pass into law very soon.
§ Mr. Wakefield (Swindon)
I think it is unfortunate that legislation on a matter of this importance should have to be introduced in war-time, but it is obviously impossible for all domestic legislation to be suspended indefinitely. Admittedly the Bill is a patchwork, but it is amply justified by the special problems which it seeks to solve. The Chancellor, the Minister of Health and other Government Departments, with the various organisations who have got together to solve their problems on the lines of this Bill, are, I think, to be congratulated on having reached a very workmanlike compromise. I am sure that none of them regards this as ideal, but it does represent a fair recognition of those many interests involved and it does contain provisions which have been referred to by several Members in connection with the controlling of proprietary medicines. I agree that it does not go far enough in this direction, but I hope that this Bill is not the end of the road but just the beginning. I am sure
113 there are many who feel that the State should take greater responsibility for proprietary medicines offered for sale to the public. The goal we should aim at should be that if a medicine is valuable, and if the claims made for it are reasonable, the State should authorise its sale. On the other hand, if a medicine is bad, it should be the responsibility of the State to prohibit entirely the sale of that medicine. That means there must be introduced into this country what is in existence in most other countries, a State register of proprietary medicines. The provisions in this Bill are a step upon the right road, but it seems to me that further steps will have to be taken in more auspicious times.
An indirect result of the passage of this Bill will be to throw open to manufacturers of proprietary medicines a large number of channels of distribution which they have hitherto not used. It is to be hoped that, when packing materials and supplies become more abundantly available due restraint will be used in making use of the possibilities of the various new avenues of distribution. Already, proprietary medicines have found their way into the public houses, the fried fish shops and the sixpenny stores. If uncontrolled expansion takes place so that the patent medicine comes to be regarded by the public as a commodity to be purchased like a box of matches. Governmental action in the interests of the public will be called for. The hon. Member for Fins-bury (Mr. Woods), who is not now in his place, stated that lie did not see there was any need for chemists to be privileged because of their qualifications. His thesis seemed to be that it did not matter for how many years a man had prepared himself to become a doctor, an architect, or an engineer or had been apprenticed to any trade; whatever qualifications he might have gained, he should not be allowed any privileges in practising that occupation. I think that that will not commend itself to the public or to Members of this House.
It seems not out of place for me to draw attention to the effect of this Bill upon the chemist who has become qualified and is registered by the State to look after the distribution of medicines. He is the sole retailer able by his specialised knowledge to advise the public with regard to medicines, proprietary and otherwise. He is an essential 114 link in the health services of the community. There is, however, a substantial business now in the hands of men with no such qualifications. This seems to me a source of danger. Protection is necessary if enough men are to be persuaded to apply themselves to the long training which is necessary for a chemist. It is in the public interest that we should obtain a sufficient number of expert chemists, not only in peace-time but in war-time as well. The chemist, therefore, is entitled to ask the Government to decide whether they need someone with his qualifications, and if they do, to ask that they should secure him from unreasonable competition on the part of those with none of his responsibilities.
Hon. Members have referred to lobbying which is being carried on by the Society of Herbalists, Limited. Reference was made to this society by the hon. Member for Norwich (Mr. H. Strauss), who said that the society was not consulted. But this society is a commercial company. You cannot consult various commercial companies. This company, also, is not representative of the herbalists. And, if I understand aright, the Bill does not affect the interests of the herbalists, except in so far as they have interests in common with everybody else. The circular which was sent to me asked me to oppose the Second Reading of the Bill. I do not propose to do that, because, from what I understand of the position, the only reference to herbalists in the Bill is contained in Clause 7, and herbalists have to make no further disclosure than does anybody else. I hope that the Parliamentary Secretary, in replying, will clarify that matter.
I would ask the Minister is he satisfied that Clauses 3, 4 and 5 will not prevent persons from communicating with experts overseas about articles for treating diseases in respect of which advertisements are prohibited? Is he equally satisfied that the definition of advertisements in Clause 10 will not include a recommendation by a doctor in, say, the United States to a patient that he should follow a particular course of treatment for diabetes, for example? How does the' Minister propose to give or to withhold his sanction in the case of medical experts not resident in this country? How will he deal with newspapers, books and magazines imported into this country which 115 contain offending advertisements? There are certain American magazines imported into this country which contain such advertisements. Is he certain that this Bill will not prevent publication in the general or scientific Press of articles describing the progress made in the cure of diabetes by insulin or of tuberculosis by various experts overseas? Finally, I would like to ask how he would deal with journals imported into this country which might contain such articles? I realise that it will not be possible for an answer to be given to all these questions now, but perhaps he will consider commenting upon the points I have made when the various Clauses are considered on the Committee stage.
I want to say one word about the enforcement of the Bill. Clauses i and 2 fit into the Pharmacy and Poisons Act, 1933. Their administration, therefore, falls automatically into the hands of the Pharmaceutical Society. For the remaining Clauses, as I understand, there is no enforcing authority. Presumably a Government Department or a local authority or the Pharmaceutical Society or a common informer could take proceedings, but I understand that it is nobody's duty to do so. That seems unsatisfactory. In the absence of any other machinery, is the Minister considering using the Pharmaceutical Society, for example, for enforcing these provisions, in the same way as it is used for the enforcement of the Pharmacy and Poisons Act? This seems to be a weakness in the Bill. Whatever action the Government decide to take in order to strengthen the Bill will, I am sure, receive whole-hearted support. I would like to congratulate the Minister upon introducing the Bill, which, as other hon. Members have said, is long overdue, and to assure him that it will have my whole-hearted support.
§ Captain Elliston (Blackburn)
We have had such an excellent Debate and the House is so anxious to hear the Parliamentary Secretary's reply that I hesitate to occupy more than a few minutes, but there are points which I should like to make, not because I expect them to be considered to-day, but because I hope that they will be considered before the Committee stage. I should like to thank 116 the Minister and his advisers for producing a Bill of such importance at a time when their Department is beset by so many urgent problems. Those who are especially interested in public health matters appreciate this, because we feel that this matter of the education of the people in regard to extravagant claims by advertisers of remedies is very necessary, and that in this Bill a great step forward has been taken. In Clauses 3 and 4 we have gone further towards some general control of the advertisement of proprietary medicines than has hitherto been attempted. We have, of course, in recent years dealt with advertisements in relation to cancer and certain other diseases. Now we are doing something more, and approaching that general protection of the public which is found in the British Dominions overseas and in the United States, where the exploitation of the people by misleading and fraudulent claims is severely restricted. The Bill contains also that most important Clause requiring disclosure on the label of the active constituents of the remedy. That in itself is a notable achievement in the interests of public health, because now for the first time you prevent that ringing of the changes which used to be practised by unscrupulous manufacturers who would vary the contents of their remedy, according to the market price of drugs.
I was surprised this morning to see in the "Times" that there was no sufficient urgency for this Measure to justify its production by the Government at this time. But this matter has been before Parliament for the last 30 years, and legislation is long overdue. There were the monumental report of the Select Committee of 1914, and the Government Bill introduced in another place in 1920. Again, there was a Private Member's Bill introduced here in 1936, and the report of another Select Committee in 1937. How then can we be told that this matter has been sprung upon the country? How could the Government justify further postponement? One was astonished to hear the speech of the hon. Member for Wood Green(Mr. Baxter), who also developed the point about the Bill being untimely, and who suggested that it was of a wholly contentious character. I myself played some part in the work of my hon. Friend 117 the Member for Shrewsbury (Mr. A. Duckworth) when he introduced the Medical and Surgical (Appliances) Bill in 1936. At that time we reached what was practically an agreed Measure. We had with us the doctors, pharmacists, newspapers, manufacturers and advertising agents, and the representative bodies of all these interests accepted, after long negotiations, the terms which practically reappear in this Bill to-day as Clauses 3 and 4.
The newspapers were especially helpful. For the hon. Member for Wood Green, who knows something about newspapers, to suggest that this Bill is unnecessary betrays his ignorance of the fact that the newspapers themselves some years ago set up a voluntary censorship. The reputable newspapers in loyal co-operation have been steadily enforcing that censorship. In the same way rules of conduct are being enforced by the reputable manufacturers. The newspapers who have been doing the censorship have anticipated this proposed legislation, and the reputable manufacturers have also welcomed this Bill. How then can the "Times" criticise the Government for placing such a Measure upon the Statute Book? The reputable newspapers are not unduly anxious to see the less conscientious publications, over whom they have no control, brought into line. The same applies with regard to the reputable manufacturers. They know that there is a certain number of un-scrupulous manufacturers whom they would not admit to membership of their trade association. This Bill will bring such people under some sort of control.
I am not going to pretend to have wholehearted enthusiasm for this Measure. Many of us still consider that this is no time for the State to surrender the revenue from the Medicine Stamp Duties. We may have more to say on the subject in Committee. But perhaps the weakest point in the Bill, as was pointed out by my hon. Friend the member for Swindon (Mr. Wakefield), is the absence of any enforcement Clause. I and my hon. Friends will make suggestions, which, we hope, the Minister will consider in the Committee stage, for the creation of some sort of advisory or controlling body for the registration and supervision of proprietary medicines in the interests of the public.
118 The Minister might well be pleased with the reception accorded to the Bill. Those who still oppose the repeal of the Stamp Duties had no desire to "soak" the manufacturers, but they had genuine misgivings about the removal of a charge which to some extent had prevented the widespread offer of cheap packets which encourage the public to treat their own ailments, instead of securing the skilled medical diagnosis and treatment provided by the National Health Insurance and other services. Nevertheless the Bill represented a definite step towards the better control of secret remedies,, and there was a general desire to thank the Minister for a Measure that was long overdue.
§ Sir Dymoke White (Fareham)
I rise to put the view of a large body of retail pharmacists, including the National Pharmacists Union. I am hot prepared to go into a large amount of detail, as this Bill was published only last Wednesday and the pharmacists' interests have not had a lot of time in which to get up their case. I have seen it suggested that the Bill has been agreed with the trade, but I am to say that that is not so. They are genuinely alarmed at many of the proposals in the Bill, and points upon it will be raised at a later stage.
§ Sir Francis Fremantle (St. Albans)
I do not want to add much to what has already been said in very interesting speeches to the House, but various references have been made to certain points, to which I feel I must make some reply. I particularly applaud the speech of the hon. Member for Llanelly (Mr. J. Griffiths), with his wide view— I might almost say his philosophy— concerning the improvement which has been made since 1914. The position to-day is not the same as it was when the Select Committee reported. It is ridiculous to speak of this as being hasty legislation when one remembers that the Select Committee of 1914 went into the business and made a full report. That report was only pigeon because of the outbreak of the last war.
This is the most maturely considered Bill which I remember during 20 years as a Member of this House. The hon. Member referred to the improved conditions and their effect upon the situation, and particularly in regard to tuberculosis 119 and sanatorium treatment. I would remind the hon. Member and the House that there is much more in it than that. There has been great improvement in the general standard of living and in the nutrition of the people. Improvements in these two respects have probably done more that anything else, really to give us a better position. I entirely agree that what we want when we are considering restrictive legislation like this is to provide people with better medical services. Nobody is keener on that object than myself. There is nobody who benefits so much from this quackery as the medical profession. The results of quackery come to the medical profession eventually and could have been avoided by a visit or two to a doctor in the early stage. My hon. and gallant Friend the Member for Lonsdale (Sir I. Fraser), in his otherwise excellent speech, suggested that a cancer patient would not be any worse for taking a dose of medicine instead of consulting my hon. Friend the Member for the University of London (Sir E. Graham-Little). I can give instances where certain treatments have resulted in the death of a cancer patient who might otherwise have been cured by proper X-ray treatment and operation.
§ Sir F. Fremantle
Well, my hon. and gallant Friend has me there, but the real point is that the medical profession wants the truth and wants to educate the public to recognise the truth. We believe in disclosure of the medicine and that, more than anything else, makes us unanimous in supporting this Bill. I admit that the Bill does not go far enough, because it does not compel disclosure of the quantities of the component parts of the medicine. But it is a step in the right direction. If all the active ingredients are included in the disclosure, that goes a long way towards showing people what they are buying and then they can use their intelli— which is growing markedly, as regards scientific matters, throughout the whole population every day and every year. It seems always necessary to remind the House that the medical and pharmaceutical professions were given statutory recognition, duties and privileges, not for their own benefit, but as a 120 necessary guide to the public and a measure of public safety. There are tremendous gaps in any profession but do not let us deal with this as a question of privilege as against the herbalists. The question is the health and safety of the community and pharmacists and members of the medical profession are safeguards of the public. Those who do not come under the official headings will suffer, to a certain extent, in competition with the privileges which have to be given in support of professions set up by law to safeguard the public. You have to look into these professions and see to what extent they are carrying out their job and how they can be improved.
I think the gibes against the British Medical Association are most unfair and unjust. The Association has tried to protect the interests of the profession and has gone a long way to promote the increased practice of medical men and advance science in every kind of way. It has done its best to run down the gross frauds and quackery about which so much has been said to-day. It took the initiative in its exposure of the book "Secret Remedies" and that has redounded to its credit. In this way, we have the medical profession as a whole wishing to support the proper administration of medicines, as proposed in this Bill. That being so, I agree with the hon. Member for Ebbw Vale (Mr. Bevan) and others who want to give as much chance as possible to initiative and originality, outside conventions or rules. I do not believe this Bill does anything to stop them and I agree with those who have said that the history of medicine shows that there have been homoeopaths who were once considered outside the pale but who, it is proved, have contributed largely to medicine. Homoeopaths who were damned by medicine 100 years ago, have had a large number of their teachings adapted for the present day. Osteopaths are now in the profession called manipulative surgeons.
I wish herbalists would genuinely come forward with their drugs and remedies and put them on the table so that they could be properly submitted to professional and scientific investigation. But they do not do that; almost entirely they trade on the ignorance of the public and their love for flowers. When herbalists believe they have the best thing, they are 121 not in a position to have it examined scientifically. I believe in physiological healing by nature but there are obvious and large exceptions. I entirely agree that this Bill is insufficient and I am glad that the hon. Member for Westhoughton (Mr. Rhys Davies) brought forward the case of the exception to this Bill as regards advertisements dealing with surgical appliances. I have had a great deal to do with the National Institute for the Deaf. The deaf find the least sympathy in the world yet are much traded upon and defrauded by so-called "deaf aids." The amount of fraud by those who sell so-called invisible appliances is extraordinary. I could expose them and give names to the House but we do not want to go into details. It is unfortunate, too, that there is not included in the Bill anything regarding the sale of trusses for rupture and the electro-medical apparatus, which some people have in their houses, so that they can have the benefit of electric rays when there is no sunshine. Disaster often ensues on the use of these appliances. There is nothing in the Bill either to deal with "foot comforts."
Why are these matters not included? Although we have tried to get them included we could not find a definition clear enough to enable us to deal with them in a non-contentious Bill, such as we are supporting now. If it were peace-time and there were no limitation on our deliberations I would press most strongly for Amendments to include such fraudulent things in this Bill. We are holding our hand and I hope we shall not introduce Amendments which will hinder the war effort. This Bill is a beginning and will help on the spread of truth and its application to patent medicines. I hope that the experience gained by this Bill will be such that in a few years' time the Government can come forward with an even more useful Measure. I thank the Minister for introducing it in such an extremely reasonable way.
§ The Parliamentary Secretary to the Ministry of Health (Miss Horsbrugh)
I think my right hon. Friend has ever' reason to be satisfied with the reception of this Bill on Second Reading. If there is one thing that has been made amply clear, it is that hon. Members feel that, far from the Bill having been brought forward in a hurry, it ought to have been 122 introduced a long time ago; and it is not haste, but rather slowness, which is the chief thing they have against my right hon. Friend. I also have something to be grateful for. Many of the questions that have been asked by hon. Members have already been answered by other hon. Members, and indeed, in one case an hon. Member both asked a question and answered it himself. The hon. Member for Westhoughton (Mr. Rhys Davies) and the hon. Member for St. Albans (Sir F. Fremantle) asked why various surgical appliances and instruments are not included in the Bill. In this case, hon. Members who have studied the problem— and I would mention in this connection the hon. Member for Shrewsbury (Mr. A. Duckworth), who brought forward a previous Bill on the subject— know the difficulty. What we want to get, if possible, is reasonable freedom and protection. There are some things on which we want to see further experiments carried out. We have also found difficulty in some instances in getting an absolutely clear definition of some of the appliances. It is for these reasons that the Bill does not go further.
I do not intend to go into the history of the Bill, which has already been covered by my hon. and gallant Friend the Member for Lonsdale (Sir I. Fraser), in his excellent speech explaining the history behind the Bill and the difficulties due to taxation. There are one or two points with which I want to deal. In the first place, there is, to a large extent, agreement between the parties concerned. We have heard from the hon. Member for Fareham (Sir D. White) that there are certain associations which are not in agreement. I can only assure my hon. Friend that all the points brought forward, even at this late hour, will be looked into with a view to seeing what further agreement can be reached on the Committee stage. The main points that have been raised come under the headings: who sells medicines, where are they sold, and what is sold. It has been suggested that the Bill in some way prejudices the little man, but I can assure hon. Members that there is no difference whatever between the treatment of and the arrangements for the little man and the big man, the big bottle and the little bottle, the high-priced and the low-priced goods.
123 The question of herbalists has been referred to in almost every speech in the Debate. I cannot see how this Bill will put herbalists out of action. My hon. Friend the Member for Norwich (Mr. H. Strauss) said he was sorry that they had not been received or communicated with, but I can tell him that I received a deputation from them yesterday. As far as we can see, there is no foundation for their fears; if they are abiding by the law now, they will not have to close down. They will be able to display their drugs and bottles, but, like everybody else, they will have to put on the label a description of the ingredients. That is the difference. But again, as in the case of other people, they will not have to make that disclosure if they are serving a particular person with a particular remedy. From my discussions with them yesterday— naturally, we shall look into the matter further— I cannot see how the Bill will affect them in any way differently from anybody else. A question was also asked as to whether there will be any difficulty with regard to the sale of insulin. There will be no difficulty whatever. The Bill does not prevent things from being sold; what it does is to tell the public what is being sold. A question was put as to whether the street trader is to be dealt with. If hon. Members will look at the Bill, they will see that all this trading has to be done in shops. I come now to the question of advertisements, on which, I think, more time has been spent than on any other aspect in most of the speeches. The hon. Member for Westhoughton asked whether oral advertisements are included. A definition of advertisements is given in Clause 10, and it reads:An advertisement includes any notice, circular, label, wrapper or other document, and any announcement made orally or by any means of producing or transmitting light or sound.As far as we can see, we have covered everything, but if the hon. Member for Westhoughton can think of any further addition to that definition, no doubt we can deal with it on the Committee stage. The main points that have been made on the subject of advertisements are these. From one or two hon. Members we have heard that we are controlling the freedom of the people, that there should not be this control, and that we should leave people perfectly free. The hon. Member for Ebbw Vale (Mr. Bevan) said that as 124 long as the public is gullible in this way, the only thing to do is to have more and more education in order to ensure that the men and women, at any rate of tomorrow if not of to-day, will not be so gullible. I think we all agree with that, but what is to happen in the meantime? The hon. Member for Norwich asked why, if we do not put down all advertisements, we should have Clause 3 dealing with certain advertisements concerning certain diseases. My answer is the same as that given by my right hon. Friend in his speech. The hon. Member for Norwich will remember that in the Report of the Committee in 1914, it was urged that certain diseases should be dealt with as an urgent and serious matter. All those diseases are of a serious nature and, as was said by my right hon. Friend, all of them are susceptible to alleviation, if not cure, by normal methods of treatment, and it is dangerous in each case to delay seeking early treatment by resorting to quack remedies. The reason those diseases have been particularly chosen, and advertisements will not be allowed concerning them, is the urgency. The hon. Member for Norwich then asked, Why not go further? The hon. Member for London University (Sir E. Graham-Little) and other hon. Members have told us of various advertisements which, they said, were completely fraudulent, which simply gull the public and get people to spend money on worthess medicines, and which, as was pointed out by the hon. Member for Shrewsbury, perhaps increase people's fear of certain diseases or the results they may have.
I think the hon. Member for Norwich gave us an answer in this matter when he spoke of the difficulty. He dealt with different types of advertisements of medicines, and then he came to the question of foods. He mentioned "night starvation"— "take Horlick's to prevent night starvation." If one goes further, one gets to cures for baldness— rub something on your hair and it will grow within a few weeks. Where would one stop? This Bill is not a Bill to deal with advertisements as a whole; it is not a Bill to protect a gullible public from every form of advertisement. I agree with the hon. Member for Ebbw Vale that the more the public can be educated, the more people realise that it is no use looking at slogans, or titles, or large letters on hoardings, the better; but this Bill cannot deal with the 125 whole subject of advertisements. From medicines one would get to foods, and it would be very difficult to know where to draw the line. I recall one advertisement — I do not know whether hon. Members would call it fraudulent or not— which comes into the region of foods.
Some years ago I was shown an advertisement in a paper on how to get fat. There was a picture of a lean man, and it was stated that your money would be returned if you were not absolutely satisfied after following the course suggested. Someone I knew wrote, enclosing a small amount, and received a letter back in which she was told, "Go to the butcher and buy some." People do not always get such a clear answer, but I think if we began to deal with all advertisements we should be going beyond the range of medicine and pharmacy. That is the reason why these particular diseases are dealt with in Clause 3. But we do not leave it there. The very fact that disclosure is being insisted upon will go a long way in this direction. How long will the public continue to pay money for a particular cure, if they are informed on the bottle or on the packet what are the contents? If as a result of disclosure the public are not attracted to buy these things, we shall see a gradual disappearance of these advertisements. I do not think hon. Members realise the extent to which most of us believe disclosure will go towards stopping what, in a great many cases, may be a racket. We cannot say for certain, but it is my own opinion, and the opinion of those who advise us, that this step will go a long way towards attaining this object. Suppose the ingredients in one particular mixture were very ordinary, such as salt, bicarbonate of soda, dandelions or cloves, and a few things like that. Gullible as the public may be, how long would anyone go on buying such mixtures?
§ Colonel Arthur Evans (Cardiff, South)
There is a practice, about which I am sure my hon. Friend is aware, by which free samples are submitted for a 10-day trial. If the person is satisfied, an expensive 126 bottle of medicine is then sent. Under the Bill, will it be necessary for these people to state the ingredients on the free samples which are circulated in the first instance? If so, they will know exactly what they are getting.
§ Miss Horsbrugh
I think I may assure my hon. and gallant Friend that that will be necessary, so that people will know what are the ingredients if they are sent a free sample.
§ Miss Horsbrugh
I was coming to that point, and to the methods of sale. As my right hon. Friend pointed out, the registered pharmacist alone is given the right under this Bill to sell certain medicines, whereas a person who is not a registered pharmacist has a right to sell other goods if the ingredients are disclosed. The medicines sold by the registered pharmacist will be those included in the British Pharmacopoeia and the British Pharmaceutical Codex. I was asked if it would be possible for people to obtain this volume in order to see from the number what are the ingredients. Of course they can; they can go. to the free libraries, where they. will find these books, and look up the ingredients.
§ Mr. J. Griffiths
What is the objection to inserting a Clause in the Bill, providing that the contents shall be stated in English which everyone can understand?
§ Miss Horsbrugh
No doubt my hon. Friend will consider whether he wishes to bring forward such a provision during the Committee stage. I do not know that I can give him a satisfactory answer now.
§ Mr. Griffiths
The whole policy is to protect people so that they will know precisely what they are buying. But a person does not know what he is buying until he has bought the bottle. Why should the ingredients not be stated in language which everyone understands?
§ Miss Horsbrugh
We shall certainly consider that point during the Committee stage, because we wish to see how clearly we can attain that object. I do not think I need keep the House over any of the other points which have been raised. I should like to say to the hon. Member for Swindon (Mr. Wakefield) that in regard 127 to the question of enforcement we are looking into the various suggestions, and that during Committee we may be able to go into the matter further. I quite agree with the hon. Member for Lanelly (Mr. J. Griffiths) that what we want in this country is a constructive health policy. It is because we see certain things happening which come in the way of our constructive policy that we want to put them right. He gave an example of tuberculosis. Treatment is going on, and more sanatoria have been put up. We hope as things get easier in our hospital services to get a great advance in that line. It is these things, such as these advertisements, which are keeping us back. People will not go for treatment, but instead they take these cures which they are told are remedies for tuberculosis. We do not want a negative health service, but something which is constructive; but in order to build we have to demolish. We have found some things which ought to be demolished, and it is because of that that my right hon. Friend has brought forward this legislation which I believe has received unanimous support from all hon. Members in this House.
§ Question, "That the Bill be now read a Second time," put, and agreed to.
§ Bill read a Second time.
§ Bill committed to a Committee of the Whole House, for the next Sitting Day.— [Mr. Grimston.']