PATENT MEDICINES AND THE LAW IV
By LORD HORDER
[In the last article in this series the stringent measures taken in countries like the United States and Nor-way, Sweden and Denmark to regulate the sale and advertisement of patent medicines were outlined. Lord Horder here indicates the legislation desirable in his view in this country] IN the three articles which have just appeared in successive issues of The Spectator your Special Correspondent has underlined and supplemented my presentation of this matter in the House of Lords on July 26th last. I asked for some control of the present unsatisfactory position, a reasonable request bearing in mind that the twenty-four-years'-old recommendations of the Select Committee dealing with the question have never been implemented, and the fact that Great Britain is the only country of note in which any such control is lacking.
With every desire to be fair, I think it may be said indubitably that since I drew attention afresh to the anomaly at present existing in regard to quack medicines, the articles, speeches and comments that have appeared show a consensus of opinion in favour of some action being taken in the public interest. The Government apologist made it clear that, though legislation would be difficult, there would be sympathy with reasonable suggestions for action provided we made good our case and convinced the Minister that public opinion was with us.
Lord Gage reminded us that this is a free country. I would add that there are so few free countries left that I am always very careful to do anything to prevent ours from remaining any longer one of them. Lord Gage's contention (though he did not press this point) that in a free country a man can be a fool if he chooses seems to me somewhat evasive. There is all the difference between deliberation and victimisation. Even in democratic countries the citizen is protected : we have our Merchandise Marks Act, under certain conditions share-pushing is illegal and— what is more pertinent—milk must be milk if it is an article of commerce and meat must be free from contamination. A man may not drink alcoholic beverages where and when he likes—unless, by the way, it be in the form of a fairly potent draught miscalled a " food " or a " tonic wine." I hold that it is the duty of any protective and educational Ministry, such as the Ministry of Health, at least to render it difficult for the citizen to make a fool of himself where his health is concerned. He is a member of a community, and if Lord Gage's argument be sound, then why a Fitness Campaign ? Lord Gage reminds us that education is the better part. True, but whilst this process is going on, do we not -protect the child ?
But I must resist the temptation to deal with this and some other important aspects of the matter in this article. The Editor desires me to make concrete suggestions on the lines of that control for which, as I say, a large body of the intelligent public is asking.
We need control of two things : (0 of the remedy and (2) of the advertisement. In regard to (r) control should not be difficult. We require (a) a register of all persons offering remedies for sale, to each and all of whom a licence may be granted. We also require (b) disclosure of the ingredients of the remedy, not necessarily to the public but necessarily to the controlling body (presumably the Minister of Health). The disclosed formula must be a correct description of the ingredients, nothing must be added to, cr subtracted from, the remedy without notification, inactive ingredients must be omitted, and no new name may be given to an old ingredient without notification and authorisation.
In regard to (2) control would not be so easy, yet it is even more important in the public interest, as I tried to make clear in my speech in the House of Lords. The evil of the misleading advertisements grows apace; the evil of harmful or inactive ingredients grows less and less.
The propaganda becomes rapidly more dangerous than the armament, so much so that no form of control which does not include the modern type of advertisement in its ambit can be really effective in checking the evil. Today, disclosure of the remedy is often made in the hope that this will condone all faults. The expert advertisement-writer need not concern himself with the nature of the remedy, he need only concern himself with the psychology of the potential purchaser. Fear and credulity are his great allies. Less often than formerly does he offer the remedy for incurable diseases ; it is latent disease of which he warns the citizen, so that no one, even the healthiest, be he or she at all sensitive or apprehensive, is likely to escape. There is, too, the topical appeal, either to recent advances in medical science (vitamins, radium, rays, &c.), or to events (the Prime Minister's catarrh, nerve strain during the crisis, &c.).
There are two alternatives here, (a) censorship of all adver- tisements, or (b) calling advertisers to book in respect of their form of " holding out " the remedy, if this is a gross abuse, requiring the withdrawal or modification of the advertisement and, if this be not done, withdrawing the licence. " Diagnosis " and " treatment " through the post would be prohibited.
What of the necessary machinery for effecting this control ? This requires a committee, to advise the Minister of Health, consisting of members with technical knowledge who will concern themselves with chemical, physical and therapeutic matters; and members who are representative of the manu- facturers, the pharmacists, the advertising agents, the news- papers, and the medical profession, who will consider the "holding out." Indeed, the persons who were represented in the deputation which presented the last Bill dealing with this subject to the Minister in July, 5935, are those required for this purpose. Through the Minister, who should have the final veto, this advisory committee would warn, would inflict fines, and would, if necessary, remove names from the register. Any such action would carry the leave to appeal to the High Court.
By control such as is here envisaged legitimate proprietary medicines, reasonably presented to the public, would gain and not lose. The public would not be prevented from getting access to simple remedies, even without medical advice, if they chose so to do. I mention this because it is frequently said that doctors have a " down " on patent medicines for the reason that, by purchasing them, the public short-circuit the visit to the doctor and his prescription. Such control as is intended would not " insulate knowledge," it would tend to disseminate accurate knowledge, and thus educate as well as protect the citizen.
What, then, should be the next step ? Should it be taken from within or from without ? Should the Ministry of Health initiate action which the gathering momentum of public opinion surely demands ? Or should a private member's Bill in one or the other House mobilise the opinion of -Parliament and give the mandate to the Ministry ? There is an influential group in both Houses bent upon dealing with this growing menace to individual and national health. But the general tenor of the Government reply to the motion in the House of Lords leads them to believe that the Minister might act if a little more pressure were brought to bear upon him. And from several points of view a Government measure would have great advantages.
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