I move—

seconded.

We have not the slightest notion what this motion intends doing and how it is going to affect individuals in the profession. It is only fair that we should have some details. According to what I read a day or two ago, I see this motion has been introduced in order to conciliate some of the opposition to the Bill. That may or may not be so but I think it is only fair in the interests of those who are concerned that they should have the opportunity of communicating with their representatives in this House. I think the matter should stand over for a week and I move accordingly.

I support that. Surely there should be some more time. This is a new departure so far as the medical profession is concerned. Are you going to deal with other professions in the same way? For instance, the lawyers.

Lawyers’ fees are taxed.

What about barristers?

The hon. member for Von Brandis (Mr. Nathan) has moved that this matter be postponed for a week. He can move the adjournment of the debate, but he cannot move in the form in which he has put it.

Then I move the debate be adjourned for one week. May I be allowed with leave of the House and with your leave, sir, to commend to the Minister in acceding to the adjournment that he should let the House know what his proposals contain so as to enable us to communicate with those concerned.

The hon. member can only move the adjournment of the debate. Then when the date for resumption is proposed he can go into the question of date.

I move—

seconded.

I cannot see what the great difficulty of members opposite is. If the motion is passed, it does not mean that any proposal in connection with it is being passed. The House can still reject or adopt the proposed provisions. By the passing of this motion, no one is committed. Let me draw the attention of hon. members, who think that the proposals are net on the Votes and Proceedings, to the fact that they are and have been for some days. As hon. members know, the hon. member for Heilbron (Mr. M. L. Malan), introduced a motion last session which was ruled out of order by the Chairman of Committees and by Mr. Speaker. I do not know whether the hon. member will move again, but it is only right that, as it was then ruled out of order, he should have an opportunity of bringing it before the House.

Motion put and negatived.

Original motion put and agreed to.

First Order read: House to resume in Committee on Medical, Dental and Pharmacy Bill.

House in Committee:

[Progress reported on 24th March, 1927, new clause to precede Clause 73 standing over, Clause 76 had been put, to which certain amendments had been moved.]

When the matter was last before the committee the hon. member for Langlaagte (Mr. Christie) moved an amendment which, as far as I have been able to ascertain, met with the approval of the large body of chemists concerned. He made provision for the managing director to be a chemist, and my enquiries have shown me that the bulk of the trade is in favour of the amendment of the hon. member, so with leave of the committee I beg leave to withdraw my amendment.

I withdraw my proposed new clause to precede Clause 73.

And I withdraw my amendment to that.

On Clause 76,

I move—

Would it not really be a good thing to allow this clause to stand over? You, Mr. Chairman, had a good many amendments, which are difficult to follow because they are not on the Votes and Proceedings. On the Votes and Proceedings the first amendment is to Clause 78. The committee should be in full possession of everything it is going to vote upon.

I would submit, for the information of the committee, that these amendments have been moved, and therefore cease to be on the Order Paper, but we have not arrived at a vote. It would be unfortunate to adjourn the debate at this stage. Everyone, I think, is in full possession of the facts, but if not, let us go on and put everyone in possession of the facts.

May I point out that the Order Paper to which he refers is that of March 27th of last year. We have not all the same memory as my hon. friend, and we do not all remember these things. It is a very difficult thing for the committee to deal with amendments which were on the Order Paper practically a year ago, but are not there now. I move—

We do not understand the position. We do not know what the proposals are. Accordingly we cannot decide, and we ask that the clause stand over.

I have no objection to letting this stand over until the others have been dealt with.

I appeal to the Minister not to let this stand over. The amendment of mine has the solid support of every chemist and every wholesale chemist, except one firm in Cape Town, which has never made a pill in this country. Any hon. members who have taken any interest in this at all know where they stand. I move the deletion of the words—

Are we debating this amendment or discussing a motion that it stand over?

There is no motion that it stand over.

I move—

If the Minister wants it held over, I must submit.

We shall have much less delay if we allow the clause to stand over till the end than if we discuss it now. When the clause was under discussion last year a number of amendments were moved, but the clause being a very complicated one, it was difficult for the House to come to a decision on the amendments without their appearing on the Order Paper. I was under the impression that all the amendments proposed last year had to be repeated this year, but to-day I find that certain amendments moved last year are not on the Order Paper, and that creates confusion.

The procedure has been that amendments moved on one day should appear on the following day’s Order Paper, and it would be very serious to depart from that principle. It would be most inconvenient for hon. members to be asked to discuss a clause to which several amendments were moved many months ago without the amendments being on the Order Paper for the information of hon. members.

As the hon. member for Fort. Beaufort (Sir Thomas Smartt) is father of the House he ought to know the procedure better than he appears to do. The reason my amendment is not on the paper is that in accordance with the rules of the House, once an amendment has been moved, it disappears from the Order Paper. With regard to the clause, every section of the House has been circularized by both parties. The different people concerned have thrashed the matter out, and if there is any further delay it is feared that interested parties will get round the matter in some other way. Every chemist in the country feels very dissatisfied in regard to Messrs. Welcome and Dr. Mitchell, and feels that it is pernicious.

The question is that the motion stand over.

I am labouring under a misunderstanding.

We cannot hear you.

The Minister gave way to me, and I wish to know from him if he really moved that the clause stand over. If he did so move, then I can only appeal to him to change his mind.

Before putting this will you give us the page on which the amendment appears.

There is no amendment now. The motion is that the clause stand over.

But I would like to know on what page the amendment appears.

On page 298 of the Votes.

This year?

No, last year.

But he has last year’s votes.

The House is under a misapprehension regarding procedure. When an amendment is moved it appears on the Order Paper, at the end of the Order Paper, and is incorporated afterwards in the body of the Votes and Proceedings, and as soon as that happens it disappears from the end of the paper. Hon. members will find that the amendment is actually moved, and the amendment would disappear once it has been moved and would form part of the Votes and Proceedings.

I do not think the Minister’s amendment that this clause stands over until the others have been dealt with meets the position. We want to see this amendment on the paper. There are other clauses on the paper which have not yet been touched, and I take it that the proper motion should be that this clause stands down until the amendment appears on the paper. I understand from the clerk that this amendment will be printed and will appear on the paper tomorrow.

Yes, that will automatically take place. It will be incorporated in the paper to-morrow.

Then if the Minister allows this to stand over until to=morrow it would put the position right. We may come on to all these amendments to-night and finish them and we shall never see this amendment.

Motion put and agreed to.

On Clause 77,

I move—

… [Inaudible]. The Minister has done this and it makes a great deal of difference not only from the point of view of the chemists themselves, but to the public. Whenever a member of the public goes into a chemist’s shop he will have the assurance that it is under the management of a qualified chemist and druggist and I congratulate the Minister on recognizing this.

Amendment put and agreed to.

Clause, as amended, put and agreed to.

On Clause 78,

I move—

Amendment put and agreed to.

Clause, as amended, put and agreed to.

New clause to follow Clause 79,

I move—

80.

1. (1) No person registered under this Act shall himself make or attempt to make or to recover, or shall enter into any agreement or associate himself in any way with any other person for the purpose of making or fixing excessive or extortionate charges for any service rendered or to be rendered or for any article supplied to or to be supplied by him by virtue of being so registered.
2. (2) Unless the circumstances are such as to render it impossible so to do, every person registered under this Act shall, before rendering any service by virtue of being so registered, inform the person to whom the service is to be rendered or the person in charge of such person of the fee which he intends to charge therefor—
   1. (a) when so requested by any person concerned, or
   2. (b) when such fee exceeds that usually charged for the service.
3. (3) Any registered person who contravenes or fails to comply with any provision of this section shall be guilty of improper or disgraceful conduct within the meaning of Chapter IV of this Act, and it shall be the duty of the council or board to take cognizance of and deal with such conduct under that Chapter.

I think this amendment requires explanation. It is the amendment which the House, at the commencement of business to-day authorized to be included in the Bill. In my opinion the object of this Bill is, in the first place, to protect the rights of the public. It is not its object merely to put registered persons in privileged positions over other persons, and to protect them against outside competition. The object of legislation of this kind is the protection of the public in general. It has repeatedly been argued during the debate on this Bill that the law would draw a ring fence round certain people, and that they would be in a privileged position, and be protected from outside competition. It was repeatedly asked how then the public could be protected. What guarantee the public would have that the people would make use of their position to advance their own interests by demanding fees which would be as high as possible. I have already accepted several amendments to this Bill, and I am glad that it is possible to make this proposal, because on a former occasion when the hon. member for Heilbron (Mr. M. L. Malan) proposed it, it was unfortunately ruled out of order. The hon. member for Krugersdorp (the Rev. Mr. Hattingh) proposed that when doctors, or registered persons, sent an account to a patient the latter should be entitled to demand a specified account. He must say how much is for treatment, and what for medicines and travelling expenses. If it is all lumped together it is hard for the patient to judge whether it is fair or not. That amendment has already been made in the Bill. The amendment of the hon. member for Heilbron amounts to this that there may be no combination between registered persons to demand excessive fees from the public. When that amendment was ruled out of order I felt that it was necessary for certain provisions to be included in the Bill to protect the interests of the public, and my proposals in that connection are embodied in the amendment which is now before us. It is in the first place proposed that no person registered under the law shall be entitled to charge excessive fees. Further he may not combine with other persons to demand such excessive charges. In the second place it is proposed that a patient of a doctor, or registered person shall be able to ask beforehand what the fee will be, what, i.e., will be charged for an operation. The registered person will be obliged to give the information. If then anybody is not able to pay the charge he will have the opportunity of telling the registered person so. He can try to get it done for less, or abandon the treatment or whatnot. In the third place it is laid down that when a registered person intends to charge a fee, which exceeds the ordinary fee, for a special class of work he shall be obliged to tell the patient beforehand. In that case it must be taken that a special contract has been entered into between the registered person, and the person seeking his services. Both sides must approve of the special agreement before the contract is binding. It must be regarded in that way. It is further provided that the charging of excessive fees will be a disciplinary matter, and it will fall under the usual duties and functions of the Medical Council. These proposals are jointly and severally only reasonable, and I think that it is our duty to protect the public in this way. A few hon. members have said that it affects a large number of people, and ask whether those persons were sufficiently consulted about the amendment. They do not want us possibly to pass legislation, which directly conflicts with their interests, and of which they know nothing. My reply is that advices have been received from the Transvaal Medical Association, amongst others, that they certainly approve of legislation of this kind, not only in the interests of the public, but also of the medical profession. I want to explain to the House how I got at that and how I obtained their statement. Last year an hon. member mentioned a case that occurred in the Transvaal of a father going with his child to one of the large centres for an urgent operation. He went to the doctor and explained that he was not a man of means, and would like to know beforehand what the operation would cost. He could in no way find out from the doctor. He therefore had the operation performed because it was necessary. When he got home he got an account from the doctor for £200 for the operation. The man wrote to me, and I thought fit to report it to the Transvaal Medical Association. That Association in the first place informed me that, in its view, the fee was absolutely excessive, and not only that, but I was also asked to introduce legislation of the kind I am now proposing. I therefore think that the House should pass the proposal. Just let me say that as regards combines to demand excessive fees there is actually no provision necessary, because the constitution of the Medical Association provides for it. I therefore think that, although it is superfluous, there can be no objection to the inclusion of the provision in the Bill.

I regret very much the Minister made this long speech explaining this extraordinary clause, in Dutch, because for some of us on this side it was difficult to understand.

Time you learned Dutch.

This new clause, as far as I can understand it, means we are going to prevent the surgeons from charging fees which may be considered extravagant or extortionate. Supposing a patient says the charge is too much, would the medical man be subject to the pains and penalties of this clause? It is an extraordinary clause, and I think the Minister should give us an explanation.

I had a shrewd suspicion when I read this, that this particular clause had been sent to the Minister by the doctors, and I think I am right in saying that the doctors are at the back of this particular clause. It is only a copy of a clause in their ordinary constitution. My hon. friends who sit behind the Minister, the Three Musketeers, if they think they are going to score by having this put into law, they are making a great mistake. This clause will be welcomed by the lawyers because they will have to interpret it later. It is absolutely futile. I am against anything of this kind, because the medical profession of this country does a great amount of work for nothing. It is a most honourable profession and a most noble profession. Under this clause you won’t stop a doctor, who wants to charge what he likes, from doing so, because the clause says “When such fee exceeds that usually charged for the service.” Well, what is the usual charge for a service? It is true there is an ordinary charge for visiting. What is going to happen to this unfortunate man if he is called by telephone to a man who has been knocked down by a motor car? The whole thing is futile. It is enough to make a cat laugh, enough to make a Minister laugh. The joke or sting of the thing lies in its tail. It a patient says a doctor has charged too much, whom does the doctor appear before? A judge or a jury or a magistrate? Oh no, he goes before the Medical Council, his own trade union that he votes for, and may be a member of. Is it likely that a council of doctors are going to say that another doctor has charged too much? There was a case in the Free State during the influenza epidemic, where a doctor charged £1,000 for doing no work at all, but there were dozens of doctors who did an enormous amount of work and charged nothing. The Medical Council can deal with it to-day under their own rules and regulations. It is a pure piece of bluff on the part of the Minister.

I should also like to say a few words about the amendment. I am merely giving my own view, and am not speaking on behalf of the Medical Council, or the profession. My objection to the amendment is that it is entirely born on suspicion of the medical profession. There are, indeed, instances where there has been abuse, but they are rare exceptions. If the cases were gone into I do not think that more than a dozen cases over a large number of years could be found of medical men abusing their position. Last year one of the members of this House eloquently expressed his indignation, and now we have this amendment. I am sorry that it arises from suspicion and distrust of medical men. I am not here to protect the medical profession, but I want to protest against irresponsible statements, and insults to the profession. Is there any other profession which has done so much as the medical profession in the way of gratuitous services for the service of the public? As for the amendment itself I want to say that, personally, I welcome the provision of sub-Clause 1. Even if it were not contained in the Bill, then it would still be misconduct and punishable for a doctor to join with others to bleed the public. It is punishable by the Medical Council which has made strict provisions about it. It is therefore actually superfluous, but yet I welcome it if it will satisfy people. As for sub-Clause 2 again I have no personal objection. I have done it in practice during the 18 years I have practised my profession. If I understand it, that sub-clause expects a doctor, when asked, to state what his fees will be, but what of the cases where he is not asked? We have here again apparently only to do with a single concurrence of circumstances where a doctor will be obliged to comply with the provisions. Every honourable man who has confidence in his patients, and whom the patients trust will tell them. He will tell them what he can do for them, and what it will cost. But suppose the patient is not able to pay the amount, what will be the relation then? He then has the right of going to another doctor, but what if there is no other doctor? What becomes then of the moral obligation of the doctor? The law will practically protect him here. If a man cannot pay he can say, “That is my fee, I may charge it according to law.” That then actually derogates from the moral obligation to come to the man’s aid. This does not mean that any doctors will make use of it, but that is the position. The position of the man who cannot pay the fee is weakened. He becomes still more dependent on the moral convictions of the doctor. I have no objection personally to the provisions, but I feel aggrieved that the matter has arisen from suspicion. It is a peculiar proposal, and, except for satisfying a few hon. members, the effect will not be beneficial in regard to what they have in view. And what will the “excessive” fees be? Every district has special fees; the fees are much higher in the Transvaal than in the Cape Province, and in the Cape Province itself they differ in towns and villages according to circumstances, and vary from time to time. These provisions are entirely superfluous. The effect will only be to make the moral sense of the medical profession unnecessary. The Supreme Court and the Medical Council have the power to-day of taking action in cases of excessive charges.

Before the Minister made his explanation I was under the impression, my mind going back to March, 1927, that this was a “Mostert clause,” because the hon. member for Namaqualand (Mr. Mostert) and the hon. member for Middelburg (Mr. Heyns) had a great deal to say about these medical charges last year. The Minister has introduced a clause, if it is parliamentary, which has rather a bamboozling characteristic. It makes the hon. member opposite think he is gaining something. The Minister informs the committee that it has been really introduced at the request of the Medical Association of the Transvaal Did the Minister approach the Association, or the Association approach the Minister?

They approached me.

Did the Minister consider that there was only one medical association, or did he consider it while he did not consult the others?

I wish to modify what I said—it is not the Transvaal Association alone, but the Medical Association of South Africa.

After all, is this the place for a clause of this sort? It casts a slur on the medical profession. If the Minister is going to deal with the fees of professional men, he ought to introduce a special Bill dealing with all the professions, because I am perfectly certain that as far as overcharging is concerned, the medical profession of the Union or any part of the British empire is the very last which can be charged with overcharging.

There are exceptions.

What I have said is a recognized fact by everybody. Putting a clause like this in the Bill is really a stigma on the medical profession generally, and this is not desirable. For the information of my hon. friend opposite, I would say that it does not give the patient any protection whatever, but is rather to the disadvantage of a patient who does not inquire, because if he does not inquire I should say that the court would be inclined to allow a larger fee than it would ordinarily have allowed; that is, if he consults a medical man or surgeon of note and does not make inquiries as to his fees, and if they are higher than the fees of an ordinary medical practitioner. If a patient is charged more than he should be charged, the courts of the country, I think, are generally ready to see that no exorbitant fees are charged. But this clause goes further, and says that if a medical practitioner happens to be guilty of contravening any of the principles laid down in this Act, he can be convicted of disgraceful conduct. This means that his name can be taken from the register. The Minister knows that it is generally considered in the medical profession that disgraceful conduct is conduct of such a character as to make it impossible in the public interest for a man’s name to remain on the medical register. Why in the case of a medical man refusing to say what his fee would be should he be liable to be accused of disgraceful conduct? I, for the life of me, cannot understand how the Minister put that into his Bill. Did his technical advisers offer him any opinion on this clause? The clause will not protect poor misguided people like the hon. member for Middelburg (Mr. Heyns).

It is no doubt true that the medical profession is one which in the past has always been rated very high, but when we are passing, and in the past have passed, legislation by which the medical profession is protected against quacks, and also against people who, in consequence of their experience, have done work out of which they have made their living, then we have surely, not only to do with the protection of the public, but also with that of the medical profession. The profession is protected against unqualified people of whom many have, nevertheless, done very good work. When the State is protecting the medical profession the public may also expect to be protected. The medical profession practically gets a monopoly, and we should see to it that they do not demand too heavy fees from the public. The medical profession is an honourable one, and in the past the protection of the public was possibly not so much needed. I knew of honourable doctors in my young days. Possibly the hon. member for Fort Beaufort (Sir Thomas Smartt) was one of them, I have never heard that he charged too much. I know of a case where a poor man was sent by me to a doctor. I gave him a note telling the doctor that he was not well off, and he only charged £5 for the whole operation, whereas the operation would have cost anyone else in ordinary circumstances possibly £50 or £100. The law is not necessary for those persons, but there are so many people coming into the profession in these days that it is overstocked. Whole groups come in, possibly not so much from love of the profession as to earn their living. The other professions are full and so they choose medicine, and because they want to make a living there is a tendency amongst certain men to charge tremendous and absolutely exaggerated fees. The public must be protected. It is protected with regard to the other professions. The attorneys have fixed fees, and the advocates and others have also special tariffs for certain work. They do not feel terribly insulted about it. But the provisions are not quite clear to me, they seem to be vague. What is an excessive fee? I think that the fees might possibly be mentioned in the schedule. The Medical Council can possibly assist in this, and lay down fees as those for attorneys and advocates have been.

I hope the Minister will not press the amendment, which is a slur on the medical profession, and nothing has been brought before the House to justify the casting of that slur. It is rather singular that the amendment has come before the House at such a late stage, seeing that the Bill in one form or another has been before the House for the last eleven years. One of my objections to the clause is its extraordinarily vague character. Who is going to say what is an extortionate or excessive charge? An ordinary practitioner may make one charge, but a very great expert would, owing to his special skill, be entitled to charge a special fee. A fee of five guineas might be fair for an ordinary practitioner, but fifty guineas might not be a sufficient fee in the case of a specialist. The new clause appears to be contradictory. Does it mean that if the parties agree to a fee the matter can be reopened under sub-section 1 on the ground that the charge is excessive or extortionate, for, if so, that may act very harshly against both the specialist and his patient. Then cases will arise when it will be impossible for a doctor to state the amount of his fee owing to the extent and nature of the work being so dubious that a doctor would be unable to state how much time would be involved in the carrying out of an operation or course of treatment. Very often a doctor cannot tell a patient the work he will have to do until the work has been done. The laying down of a hard and fast rule which the amendment contemplates would be applying a very absurd restriction. There are very many cases in which a patient, when he is sick, is willing to leave the matter of the fee to the doctor, but when he recovers, he takes a very different view of the matter and endeavours to escape from his legal and moral obligation. The clause is quite impracticable. Has it been submitted to the Medical Council? The Minister tells us the Medical Association of the Transvaal acting upon a particularly glaring case was prepared to take certain steps. I would like to know if the Transvaal or any other medical association or council has been consulted on this clause as it stands.

But the Minister says the Medical Association of the Transvaal recommended it.

Well, I should like to know that, and I should like the Minister to tell us what their comments were upon it. In view of the slur cast upon the profession by this clause, personally, I should be surprised if any medical body has had this particular clause before it, and has given its approval to it. If the medical council itself has the power to deal with it, then why put it in the Bill? I hope the Minister will not press it.

The more hon. members of this committee look into the clause, the more ridiculous it becomes. This clause deals with the fixing of excessive or extortionate fees, but personally, I cannot conceive that doctors or any other body of professional men would meet for the purpose of fixing extortionate charges. They meet for the purpose of fixing a tariff but to suggest that it is to fix an extortionate tariff is an absurdity. The offence is for meeting for a purpose for which nobody would ever think of meeting, and the Minister goes further when he says in 2 (b) that such fee shall not exceed the usual charge for the service. How can they decide what a fee shall be until they have met together to fix the ordinary tariff for the service. The hon. member for Witbank (Mr. A. I. E. de Villiers) and the hon. member for Middelburg (Mr. J. D. Heyns) battled hard with the Minister that the tariff shall be laid down, and this clause is the pretence for it. When they go back to the backveld the people will soon come to them and tell them they have been nicely bluffed over this. I am in agreement that doctors should be disturbed as little as possible. In Johannesburg I have known many poor people who have had to go for a serious operation, and who could not pay the full fee but were prepared to pay a quarter of the fee. The answer of the doctor has always been: “The fee is so much, and it will cost you that or nothing.” The doctors do the work in Johannesburg for nothing where the people cannot pay rather than accept quarter fees. All I want to do is to put on record that I am not deceived by this matter. At the same time I am going to vote for it to see that it goes through, but I do want to impress upon the Minister that they only meet for the purpose of setting up a tariff, and I am not in favour of that because I know it could never work. For example, if the hon. member for Middelburg was on the verge of life and death and the tariff, to save his life, had been fixed at thirty guineas, and the hon. member for Middelburg was worth £30,000, then, to get the only doctor who might be available to attend him, he would gladly pay £5,000. It is a ridiculous clause.

I am very thankful for the amendment. We three musketeers have fought very hard for these provisions. All sorts of accusations have been made against us, but we stood up for the interests of the countryside. The misfortune is that this House is composed so much of professional men, and when the farmers from the country speak up for the public, then they are ridiculed as we are now being ridiculed. We farmers have to sit perfectly quiet and say nothing. The hon. member for Hopetown (Dr. Stals) speaks of suspicion and distrust of the doctors. Now I ask the hon. member whether he trusts all the doctors? He does so just as little as I do, but when we want to protect the public he talks about suspicion and distrust. The doctors were the first who got up to speak. They are practically the only section in the country which has an unlimited monopoly. No one can prohibit doctors, and they can practically ask just what they like and when the country representative speaks on behalf of the public he is made fun of. Is the countryside then to have no say whatsoever? The public is the sufferer and the sick people have to pay the doctors and keep them alive. What will the hon. member say if we form a monopoly, and all practise physical culture? Then the doctors will starve. There is surely no harm in having the right to ask the doctors what they will charge for an operation. A doctor can say whether he wants £25 or what, so that the patient knows whether he can pay it; the poor man who cannot pay £50 or £100 will then know where he stands. Otherwise he must put himself unconditionally in the doctor’s hands, and the doctors will have everything in the world to say. I hope that they will abandon this point of view, and will also give the public an opportunity of living and of saying something when their interests are affected. We three musketeers are accused of being the cause of this offence against the doctors. The whole farming population sympathizes with us, and I am sorry that we did not at once get more support. We started it, and fought for it. The Minister knows this, and the whole Nationalist party knows it, and we are thankful to the Minister for introducing the amendment.

As a country representative I want to thank the Minister very heartily for this clause. We hope the House will agree to it. We have been opposed by various professions, such as the medical profession, and they said that it was a slur on them. Now various members have said, and I have also said, that if there is one profession which is highly respected by the public, then it is the medical profession, but some members, and even doctors who have spoken here, have admitted that there are exceptions. Let me tell those members that this clause is exceptional. Do you object to it? I do not think anyone will object to it. The man who has always charged proper fees will not feel himself affected, but the man who has charged unreasonable ones will consider it a reflection. It is in the interests of the poor man and the public. Many people have gone to their graves who could not pay the large fees. They were too frightened to call in a doctor. An opportunity is now being given of asking the doctor what he will charge, so that the poor man will know where he stands. I hope the House will be fair. The provision is in the interests of the poor man in the country. I hope the amendment will be supported.

During the course of the debate on the second reading of this Bill and since the committee stage, we have had very strong requests brought forward from a certain section in this House for the inclusion of a tariff in this Bill. The Minister, as far as my memory serves me, was obdurate and absolutely declined to entertain such an idea. I would not like to say that wiser counsels have prevailed now, because listening to the speech of the hon. member for Bloemfontein (North) (Mr. Barlow), I feel that to adopt the whole of this section would be to adopt something which is absolutely unworkable. We have been flooded with more circulars and requests in relation to this Bill, it is well known, than in connection with any other measure. I ask any hon. member of this House to get up and say whether he has received a letter from the medical profession in Johannesburg or any other part of South Africa, asking him to support a clause of this kind. We have been flooded, even to-day, with circulars as to whether the chairman of a public company of chemists should be a qualified man or not. The hon. gentleman who has just spoken in harrowing words described how certain people had found their way to the grave by reason of not having had an operation consequent upon the extortionate fee charged or threatened to be charged by the medical profession. That is a grave statement to make, a very grave reflection upon the medical profession. Personally. I come into touch with a large number of members of the medical profession, and I have always found them most reasonable and most accessible, especially in cases where a person is too poor to pay a fee. The profession, in many cases, are prepared to render their services without a fee. That is also the case in the profession to which I have the honour to belong. We as a profession, do a large amount of work for nothing, and so do members of the medical profession. I speak subject to correction, but is there not a big medical institution (Messrs. Meyer Bros.) in the United States which ascertains, or endeavours to ascertain, the wealth of the patient and requires him to pay accordingly, and in many cases does the work for nothing? Take the case of a man like Sir John Barker, who, in his time did work for nothing and who, I know, in the case of a patient, a late member of this House, for whom his work occupied him ten minutes, charged a fee of 75 to 100 guineas. There was the experience of a lifetime placed at the disposal of a patient. Let us take the motion of the Minister. He says: “Where such a fee exceeds that usually charged for the service.” Now what is the fee which “exceeds that usually charged for the service.” or what is the” fee usually charged for the service?” I ask him, has he not himself been to a specialist, thinking he was going to get off with ten guineas and having to pay twenty? We have all had that experience. I do not think this is a clause which can be carried into action. The Minister, I understood, said that he had been approached by the Medical Association and they approved of this clause. He has been asked to tell us whether this clause, as it appears on the paper, has been submitted to the Medical Council for its approval. If so, with what result? We can even conceive that they accepted this clause. Of course, they would accept it, because it is useless. Why do we legislate in a direction which is absolutely useless? We have been told also that attorneys’ and barristers’ fees are fixed. They are nothing of the kind, as far as barristers are concerned. They fix their own fees, which are as moderate as possible. It is impossible to tell in advance what is going to be the nature of work that has to be undertaken. The Minister has been prevailed upon to introduce this clause. It is our duty now, who see the futility of this clause, to try and prevail upon him to withdraw it. I hope he has heard sufficient argument to induce him to do so. It is unreasonable, insulting and absolutely futile.

I am glad that the Minister has made an earnest effort to regulate doctors’ fees. I raised the matter two years ago and was becoming afraid that nothing would be done. I was surprised to hear that the medical men were opposing the clause, two of them, at any rate. I say that they are not rendering service to their profession, nor to the public. They are afraid that the profession is being blamed. On the contrary, doctors will be protected against members of their profession who are not a credit to it. Those exceptions will be controlled. That abuses take place is without doubt. I could give the House myself a number of instances. Only recently I heard of two cases on the countryside, and my information was from a good source. A doctor had been to a farm to see a patient, and he passed another farm where an accident had just taken place. They called him in, and he bandaged the injuries. A week or so later he sent in an account of £120. The farmer said that he would only pay £100. Recently I heard of a doctor who operated upon the son of a Free State farmer, and knew that he was well-to-do. The operation was successful, and he sent in a bill for £500. The farmer was foolish enough to pay it, because he was so glad that his son was well. He would even have paid £1,000. Such people are a discredit to the profession, and if anything of this kind will assist in bringing these people to their senses it will be a good thing. The question has been asked whether the public will actually get any protection. We know it is a difficult matter. Government after Government has endeavoured to fix tariffs. There were certain tariffs in the Free State before the second war of independence, but it was a very troublesome business. I think, however, that the clause will help a little to stop the arbitrary charging of any amount. It is difficult to fix fees, but these provisions will assist in that direction more and more, so that conditions will be created whereby exaggerated fees will not be charged. The public will now learn that they can enquire what the fee will be. They will be able to demand specified accounts. I believe the poorer part of the population which has undoubtedly been very fairly treated by many doctors will not be injuriously affected by provisions of this kind. On the contrary they will be able to ask the doctor what the fee will be, more or less, and if they say they are poor, the doctors can agree to do it for half fees, or even less. The doctor will the more readily mention the fees without the man thinking that if the doctor asks less he is still asking too much. The medical profession and the public are being protected, and something of the kind is absolutely necessary. I hope the Minister will put the Bill through, and when more cases have come before the Medical Council the time will possibly come to further amend the law a little in another respect.

I regret that it is necessary to pass such a law, but the blame unfortunately lies chiefly with the doctors themselves. I know myself that at the time of the epidemic in the Free State tremendously high accounts were rendered. In many cases it is the doctors’ own fault that the public ask for protection. I am sorry to have to say that the medical profession is no longer what it used to be, but has become a business. When I, as a young man, entered the profession I looked up to it very much, but it has become more and more a business, especially, for example, in Johannesburg. Instances have been given of very high fees, but I do not believe that the effect of the law will be quite what the hon. members wish. When a man goes to a specialist who asks £100 for an operation, and the man says that he cannot afford it, then the doctor will say, “My fee is £100.” If the patient will not pay it, he will have to go away, and the specialist cannot be compelled to do it for, say £20. I fear that maximum fees which will be laid down will in most cases eventually be minimum fees. I do not believe that the Bill will assist much, but it is sad that it is necessary. Other countries will be surprised at it, but the people on the countryside need protection. I would rather not give the instances I am thinking of at present. They do not redound to the honour of the profession. The clause is necessary, but I fear the object will not be attained.

We heard a lot about the Bill last year, and again this. I am sorry the amendment has been proposed. The last speaker has made it clear that it will do no good.

But he says that it is necessary.

In some cases.

In many cases.

It seems to me that the Free State doctors are the worst offenders. I think the principle of the amendment is nothing but socialism. I do not think the profession deserves to have the fees fixed. This is the beginning of it. The great majority cannot help it if there are exceptions. I have seen just the opposite, where a doctor came on to a farm and took a poor man to hospital in the middle of the night. In another case a doctor took a poor fellow to a nursing home, and paid the fees as well. The law will not assist in exceptional cases. How many miles has not a doctor to go sometimes to visit a poor man? He has to operate, and to cure him, and to be content if he gets nothing.

He can refuse.

No. They have to qualify and there are at the moment many of them qualifying, and there is so much competition that if one charges too much the people will go to the other. I shall not vote for the amendment. A doctor who charges too much will injure himself.

We are getting quite away from the point. The hon. member speaks as if the doctors’ fees a.re being fixed. There is no such intention at all. We know that it is not feasible, and have abandoned it. The doctor will only have to say what an operation, etc., will cost.

Any good doctor will do that.

Why then cannot it be said in the law? If I want to buy an ox from the hon. member for Johannesburg (North) (Mr. Geldenhuys), he will surely not be terribly insulted if I ask him the price. Fees are also laid down for the legal profession. If anyone asks me what a bag of mealies costs I am not insulted. If a man cannot pay £100 he will possibly say that he would rather die than bring his wife and children into trouble, or he will make some other arrangement. We must have an opportunity of knowing how we stand.

A respectable doctor will voluntarily say what an operation will cost. I recently sent someone to the doctor, and told them to ask what it would cost. The doctor simply answered—“That is my price.” If that is the position the Bill is superfluous.

I shall vote for the clause, not because I think that it will help very much, but because it will give a little satisfaction, and because people will think that they are better off. It goes without saying that the medical profession is an honourable one. One could quote splendid examples of the actions of doctors. I remember Dr. T. W. Smartt at Britstown; he was particularly honest and generous, and I heard that in some cases he paid for the funerals of his patients. If a doctor goes as far as that it says much for him. This provision will not assist much. I am afraid that where doctors in some cases treated poor people gratuitously, they may now, perhaps, say: “That is my fee.” That will, undoubtedly, be the possible result. Nor will it assist much if one knows what it will cost. You will still not know whether it is excessive. You will only know whether you can afford it or not. We must not forget that doctors are qualified men, who have to sell their professional knowledge. If two persons go to a doctor, both living 10 miles away, and the doctor asks both £5, and the one says that it is too dear, and the doctor goes to the other, who agrees to the fee, it shows that the doctor is selling his services to those who are prepared to pay for them. Now in these circumstances the doctor will have to bargain about his fees, and I do not think the provision will amount to much. There are, indeed, undesirable cases where doctors are out to rob the people, but they are exceptions.

I cannot understand the objections to the amendment. The occupations of attorneys and advocates are just as high as those of doctors, and we know that their accounts are taxed. Why cannot the doctors also have a certain tariff? The Medical Council will be able to make regulations. It cannot be denied that some doctors demand excessive fees, and it must be stopped. Subsequently, the law will doubtless be amended, and fixed prices laid down. The hon. member for Johannesburg (North) (Mr. Geldenhuys) talks about socialism. Is it socialism for advocates, attorneys and land surveyors to have a fixed tariff? It is a good thing for Parliament to point out that the members of the medical profession must not go too far. There are cases where a doctor is called in, looks at the patient, and mutters something. If one asks what is the matter with the patient then he will not say. A second doctor can also say nothing and a third likewise. It should also be laid down in the law that when a doctor has examined anyone he should also be able to say what the person is suffering from. The one orders quite different medicine from the other. The profession must also be made less proud by the law. Our doctors in South Africa are in many cases as good as the best in the world, but there are also quite a lot with certificates who are nothing else but quacks. I shall vote for the amendment.

The hon. member for Rondebosch (Mr. Close) has asked me whether this clause has been submitted for the consideration of the Medical Council. My reply is no. I don’t think anyone in this House will contend that it is the duty of Government or Parliament to submit amendments to Bills to interested parties. If, of course, it is at all possible to consult them, I personally think the Government and members will gladly do so.

I never suggested that you should consult them, but you said they had approved of it.

The Medical Council is representative, but there are bodies much more representative than the Medical Council, which, after all, has been elected by the medical profession. Seeing that we have the opinion, not only of the Medical Council of the Transvaal, but of the Medical Association of South Africa throughout the Union, in favour of legislation in this direction, I do not see why I should consult the less representative body.

I never said you had to.

Although we have not consulted the Medical Council, we are going on the opinion of the medical profession as expressed by its associations. Much has been made by several speakers of the argument that legislation of this nature would be a slur on the medical profession. I certainly think if that were so, we would not have got this opinion from the Medical Association of South Africa, for I take it that an association representing the medical profession would protect the medical men of a country against any slur as far as legislation is concerned. The fact that we have this opinion from the Medical Association of South Africa disposes very effectively of the argument that this clause casts a slur on the profession. I am quite willing to admit that the reputation of the medical profession stands very high in this country, but legislation of this nature is made to meet the exception. There is nobody in this House who would doubt that there are exceptions, and for that reason we have the Medical Council which has to exercise discipline over the profession. There are exceptions. There are exceptions, and we must have a law to meet the case of the exceptions. Now we come to the question of fixing what charges are reasonable, and that is not such a difficult matter after all; to find what charges are reasonable and what charges are extortionate. Hon. members must not forget that, to a certain extent, although not sufficiently so, the public is protected already by the common law. Any person who complains that the charges in his particular case are extortionate can go to the law courts and claim protection in common law, and the grounds upon which the magistrate or the judge would base their verdict are the usual charges in such a case. How does he find it out? He gets the evidence of professional men of standing and, according to their evidence, he works out what is reasonable and, according to that, gives his verdict. Is it not much more reasonable, instead of taking such a course, to go to men of repute on the Medical Council because they represent the whole of the medical profession to find out what is the usual charge? That is exactly what is proposed through this amendment. It shall be the duty of the Medical Council to take cognizance of charges generally, and I take it that the Medical Council will, in regard to fees and charges, fix a general standard and inform medical men generally in the country that charges above those fixed are extortionate, and if they wish to charge more than the usual standard laid down for the profession it must be a case where a special contract is entered into between the patient and the particular doctor. That is surely reasonable, and the Medical Council is the body to deal with that matter. All the regulations made in connection with this matter by the Medical Council must be approved by the Minister, and in that way the Medical Council itself can be checked, and the responsible Minister, responsible to Parliament, will place the matter under the control of Parliament ultimately.

Proposed new clause put and the committee divided:

Ayes—58.

Alexander, M.

Badenhorst, A. L.

Basson, P. N.

Bergh, P. A.

Brits, G. P.

Christie, J.

Cilliers, A. A.

Conradie, D. G.

Conradie, J. H.

Conroy, E. A.

Creswell, F. H. P.

De Villiers, A. I. E.

De Villiers, P. C.

De Villiers, W. B.

De Wet, S. D.

Du Toit, F. J.

Fordham, A. C.

Gilson, L. D.

Grobler, P. G. W.

Hattingh, B. R.

Hertzog, J. B. M.

Heyns, J. D.

Hugo, D.

Kemp, J. C. G.

Keyter, J. G.

Krige, C. J.

Malan, D. F.

Malan, M. L.

McMenamin, J. J.

Moll, H. H.

Mostert, J. P.

Mullineux, J.

Munnik, J. H.

Naudé, A. S.

Naudé, J. F. T.

Oost, H

Pearce, C.

Pretorius, J. S. F.

Reyburn, G.

Rood, W. H.

Roux, J. W. J. W.

Snow, W. J.

Strachan, T. G.

Swart, C. R.

Terreblanche, P. J.

Te Water, C. T.

Van Broekhuizen, H. D.

Van der Merwe, N. J.

Van Heerden, I. P.

Van Niekerk, P. W. le R.

Vermooten, O. S.

Visser, T. C.

Vosloo, L. J.

Waterston, R. B.

Watt, T.

Wessels, J. B.

Tellers: Pienaar, B. J.; Sampson, H. W.

Noes—31.

Anderson, H. E. K.

Ballantine, R.

Bates, F. T.

Close, R. W.

Coulter, C. W. A.

Deane, W. A.

Geldenhuys, L.

Giovanetti, C. W.

Grobler, H. S.

Harris, D.

Heatlie, C. B.

Jagger, J. W.

Lennox, F. J.

Macintosh, W.

Moffat, L.

Nathan, E.

Nicholls, G. H.

Nieuwenhuize, J.

O’Brien, W. J.

Payn, A. O. B.

Pretorius, N. J.

Richards, G. R.

Rider, W. W.

Rockey, W.

Sephton, C. A. A.

Smartt, T. W.

Struben, R. H.

Van Heerden, G. C.

Van Zyl, G. B.

Tellers: Collins, W. R.; Robinson, C. P.

Proposed new clause accordingly agreed to.

On Clause 81,

I move—

Agreed to.

Clause, as amended, put and agreed to.

On Clause 82,

On the motion of the Minister of Public Health, amendments were made in the Dutch version which did not occur in the English.

Clause, as amended, put and agreed to.

New clause to follow Clause 84,

I move—

1. 85. (1) If a medical practitioner administers chloroform or anything of a similar nature to a patient and that patient dies the magistrate of the district where the dead body is shall hold an enquiry in order to ascertain whether negligence on the part of the medical practitioner was the cause of the death of the patient.
2. (2) The provisions of the Inquests Act, 1919, shall mutatis mutandis apply to such enquiry.

I think there is no objection to this amendment. I have submitted it to the legal advisers, and they think the wording can be improved. Now I just wish to ask whether the hon. member is prepared to accept it in the following form—

I accept that.

With leave of committee, new clause proposed by Mr. Heyns withdrawn.

Before the amendment is put, perhaps the Minister will kindly explain what it means. As I understand the law at the present time, if anybody dies under an anaesthetic there must be a proper inquest, whether the patient is under private treatment or in a hospital.

That is a matter of course.

Then why this clause? Has my hon. friend submitted this to the Medical Council or to his medical advisers?

It has been submitted to the legal adviser, and he thinks, though it may not be quite necessary, it would be advisable to have it in this Act.

The hon. member for Middelburg (Mr. Heyns) puts this amendment on the paper, but he gives no reason why it should be accepted by the committee. I think we should have some reasons why we are going to accept this, because what it means is that if anybody dies under chloroform or any other anaesthetic, there will have to be a post-mortem examination.

I asked in my amendment for an enquiry when anyone dies under chloroform. There are undoubtedly many cases—we are again speaking of exceptions—where too much chloroform is given negligently. It can happen very easily. I know of cases in my district. I want proper enquiry to be made in such cases, to investigate whether too much chloroform was the cause of the person’s death. As far as I know there is no proper investigation now. A magistrate or someone must make an enquiry in these cases. We shall not ascertain it from the doctors. The medical men stand together and do not leave each other in the lurch.

I am glad to see the hon. member for Hopetown (Dr. Stals) is back again. I missed him when the division took place. I listened with great interest to what he had to say, and I was largely guided in the action I took by what he so eloquently addressed to the committee. Then I missed him. I thought, perhaps, he was ill, but I see that he has sufficiently recovered from the shock and is back in his place to look after the interests of his constituents. What I think my hon. friend (Mr. Heyns) forgets is this. He talks about a man dying suddenly under chloroform. Whether he dies under the right administration of chloroform or the maladministration of it, there must be a public inquest, but if the amendment of my hon. friend goes through, no matter what the condition may be, whether it may be self-evident that it is not necessary to have a post mortem examination, under the amendment in every case there will have to be a post mortem examination. He knows that many people who think as he does are extremely anxious not to have a post mortem upon the bodies of those near and dear to them if it is not absolutely necessary in the interests of the State to show whether foul play has taken place.

I do realize that.

Then his contention is that in every case there must be a post mortem examination?

Yes.

Then I am not going to oppose it, but I say that under existing conditions an inquest is the proper place to decide, and does decide, whether a man has died under chloroform from natural causes, or whether his death has been due to maladministration of the drug.

Hy hon. friends may speak of suspicion, but an enquiry must take place by someone not a member of the medical profession. People disappear, and we no longer hear that they have died under chloroform, because there are doctors who will not make it known. I am speaking on behalf of the public.

I am really afraid to say anything because every word is regarded as protecting the profession, and not the public. I yield to no one in protecting the public, but I should like to know what the intention is. Is it an enquiry into the capacity of the anaesthetist, or an ordinary inquest after death? In the first case I can understand the object of the amendment, but in the second I regard it as superfluous. Most members of the medical profession have had such accidents. I have myself, although it only happened once. The magistrate made a proper enquiry then, and it was not done by doctors. I should like to know from the Minister what the amendment means. There is an inquest now. If the object is to enquire about the doctor, then I also do not object, but then I do not understand the motives of the hon. member.

Surely this is a case of overlapping. You have the inquest law of 1919 in which Clause 12 provides for such a case in Section 2. I think it is quite unnecessary and I suggest this is a matter which might be omitted from the Bill.

I think I can clear up the matter. Under existing conditions an inquest is held when it is reported that a person has died from non-natural causes. If a doctor, however, reports that the death occurred from natural causes while the patient was under chloroform, and the doctor reports heart failure, then the Court assumes that there was a natural cause, and no inquest takes place. It is therefore for quite special cases where the non-natural cause would not be mentioned. We have wanted for a long time to rectify that defect in the Registration of Deaths Act. It will, however, possibly take a long time before an amendment of that Act is made, and we therefore thought that it would be best to pass this amendment.

New clause put and agreed to.

New clause to follow Clause 85.

I move—

86. (1) No chemist and druggist shall be permitted to pay to a medical practitioner any commission in connection with a prescription which such medical practitioner has prescribed and no medical practitioner shall be permitted to receive such commission. (2) Any medical practitioner or chemist and druggist who contravenes the provisions of sub-section (1) shall be guilty of an offence and may also be dealt with by the council or board as provided in Chapter IV.

The new clause is necessary because the law on the point is somewhat vague. The law is clear in the Cape Province, but not in the Transvaal or the Free State, with the result that some druggists pay a commission to doctors to send patients with prescriptions to them. Druggists themselves have asked me to move the amendment. Doctors are only human, and if, at the end of the month, they can draw a nice sum, the temptation is very great. The druggists, and the doctors do not pay it, but the public. The public are exploited. I understand that it is unprofessional, but there are people who think nothing of it. The Minister is, I think, prepared to accept the amendment.

I am very glad to say that from my experience there is not a great deal of this done, and I do not think there are many cases. It may be that there are cases in the country districts and the hon. member for Wakkerstroom (Mr. A. S. Naudé) has been brought face to face with them, as shown by this amendment. I think the Minister can accept it. Every honourable chemist and druggist would be pleased to see it and it is no reflection on any hon. doctor or chemist. It is a most iniquitous practice if it does exist, and it is a wicked imposition on the patient, because after all he pays the extra charge for this commission.

My only objection is that the proposal is unnecessary. If there is any vagueness in the laws of the Transvaal and the Free State, then it will be removed because those statutes are being repealed, and this one substituted. Action of the kind mentioned in the amendment is undoubtedly unprofessional, and it will be borne in mind when the regulations are made under this Act. I am not opposed to the amendment, but it is superfluous.

The Bill is not clear on the point. The good druggists must be protected

Can this be dealt with by regulation under the Medical Council?

Yes.

But it need not necessarily be dealt with in this way. It is quite conceivable that a medical council might give permission, by accepting the amendment of the hon. member, by law it cannot be done.

Proposed new clause put and agreed to.

On Clause 91,

I move—

This is an amendment which is really necessary to make the status of sanitary inspectors sand other health officers better than it is at the present time, and has been asked for by the South African Health Officials Association for some time. The Medical Bill of the hon. member for Yeoville (Mr. Duncan) originally intended to deal with it in this way. The Select Committee thought that the Medical Council would not be able to deal with it, but it has now found that the Medical Council would be the best body to deal with the matter. It will be necessary to move some amendment in Clauses 32 and 40, which I propose to do at the report stage. The tendency of administration in modern countries is to link up together these people mentioned in my amendment.

I can only say I have no objection in accepting this amendment. In principle I have never any objection to the registration of what were generally called sanitary inspectors, and now called health officials, which is a much better name. But the difficulty was to make provision for that in the Public Health Act Amendment Act, and in that case we should have to create machinery to deal with registration and discipline, and it was inadvisable to do that in the Public Health Act. Therefore we thought it better to incorporate provisions to that end in this Bill.

Amendment put and agreed to.

Clause as amended, put and agreed to.

On Clause 92,

I move—

The second amendment of the Minister treats of members whom he has himself appointed as Government nominees on the Medical Council. It seems only fair that the Minister should agree that the fees for those Government members shall not be paid by the Medical Council. Why should the Council pay them? The Minister is appointing them as protectors of the interests of the public, and I think the fees ought to be paid by the Treasury. I therefore move—

Those persons are not there in the interests of the medical profession, but in those of the outside public.

I am not quite sure that the amendment is in order, because it entails financial obligation, for which the approval of the Governor-General is first required; but if it is in order I hope the hon. member will not insist on it. In my opinion his argument rests on a wrong premise. The members are not only there on behalf of the public, but also of the medical profession. They assist the Medical Council in fulfilling its duty to the public. The whole Council, not merely those two members, must look after the interests of the public. The whole object of the law is to give the Medical Council more power than before, and it will have to pay itself, but I thought it advisable to make the provision that if they are short of money, owing to the two members appointed by the Government, or to the representative from South-West, also to be so appointed, and which latter may possibly cause considerable travelling expenses, that the Minister shall have the discretion to contribute to the expenses of the Council in connection with those members.

It appears that the effect of this amendment is to increase expenditure for which the previous assent of the Governor-General is necessary. I can not therefore admit it.

Amendments proposed by the Minister of Public Health put and agreed to.

Clause, as amended, put and agreed to.

On Clause 93,

I move—

“proprietary medicine” means a medicine prepared, or purporting or professed to be prepared, by a secret process or formula the property or in the custody of the manufacturer;

I move—

I have been at a loss to know what reasons can be advanced for this amendment. I had thought the hon. member would explain them, but he has not done so. If we delete “as such” here in this definition, it would not be in line with some definitions in the same clause. Take, for instance, what is a dentist? It means a person registered “as such.” Why should not a chemist and druggist mean a person registered “as such”?

The proposed amended definition is in conformity with the wishes of the chemists and druggists. I quite see the Minister’s point that the omission of “as such” might alter the sense of it, but will you accept the retention of the words “as such” and insert “and who sell”? This profession provides an opening for young men to take up, and if they undertake chemists’ and druggists’ businesses let them be qualified men, and not men who, as at present, may have shops in which they sell chemists’ stores, but they are not qualified chemists or druggists. If a man is employed as a chemist or druggist, he should be properly qualified, and only such should only sell medicines and drugs used exclusively for medicinal purposes. The definition is too vague as it stands.

If that is the intention of the hon. member, this amendment goes very far. Is it the intention to prohibit chemists’ stores from selling anything beside medicine? I understood that was the intention, and, if so, it goes too far.

I think the point my hon. friend has raised is covered by Clause 37, which makes it clear that a man cannot do any act or carry on a business which comes within the province of that clause “without being registered.” That will give chemists and druggists all the protection they require, and I do not think the amendment is necessary.

Amendment proposed by Mr. Struben put and negatived.

Amendments proposed by the Minister of Public Health put and agreed to.

Clause as amended put and agreed to.

On Clause 95,

I move—

It is just to bring it into line with the Dutch version which is the more correct.

There is an important principle contained in my amendment—

I draw the attention of the House to this word “lawfully.” You should not make unlawful any lawful occupation carried on to-day, and to make this clear there should be a new subsection following Section 2. The Minister last year told us he was not going to interfere with any calling lawfully carried on.

Before we come to the end of this clause I would like to move the amendment standing in the name of my hon. friend the member for Klip River (Mr. Anderson)—

In urging this amendment upon the committee I would point out that we are going to do a grave injustice to many thousands of natives throughout the whole of the country. It is provided in the Natal Native Code, under native customs, that medicine men and women are allowed to practise for gain, and they are known either as those skilled in healing or herbalists. On being called in they are entitled to a fee which ranges from 2s. 6d. to 10s. Should a cure result, payment is claimable in respect of the cure, and if there is a failure to cure then payment is claimable only for the call. These herbalists have been practising in Natal for many years and others following in their footsteps have administered to the natives and fulfilled a great want. If you are going to destroy the calling of these people, what does the Minister propose to substitute? What medical aid of any kind are you going to give to the thousands of natives throughout the country who are far away from a medical practitioner and who are unable to afford the services of a European medical practitioner? May I point out that this is in conflict with the Native Administration Act which we passed last year. If it is necessary to do anything regarding the control of these people in native areas, the powers already exist under the Native Administration Act, and it should be done by the Native Affairs Department and not, I submit, by the Minister of the Interior. I do not know whether the Minister understands the difficulty in which he is going to place a large number of the population of this country if he gets rid of all these herbalists. I would ask him to remember what the position of ourselves would have been one hundred years ago if we had not been able to avail ourselves of the services of herbalists. The earning capacity of the natives of this country is not such that they can afford to pay doctors who attend upon them. These men are skilled, they understand simple herbal remedies, and they administer to the pressing needs of the native people.

As regards the amendment of the hon. member for Hanover Street (Mr. Alexander), I would point out to him that an amendment similar in substance has been negatived.

May I say that one of the reasons why it was negatived was because it was suggested that this was the proper place in which to move it? It was said in the course of the debate that this was the proper clause in which to move it.

In that case it should have been withdrawn. I think the Chairman would have pointed out that it was not the proper place. The amendment, which was moved by the hon. member for Yon Brandis (Mr. Nathan), was put, as a matter of fact, and it was negatived after a division. Under these circumstances, I am afraid I cannot allow this amendment.

I take it that it would be possible to move it at the report stage?

Yes. The hon. member, of course, would have to give notice.

I am afraid it is impossible to accept the amendment moved by the hon. member for Zululand (Mr. Nicholls). It would simply mean that the present position with regard to the registration and practice of these native herbalists would continue. I do not think that is altogether advisable. A very large number of these people have already been registered, and are being registered, in Zululand. I think the number at present is about 2,000. That is to say, we have got on the medical registers of this country more of these herbalists who have the right to practise than we have registered medical practitioners, Europeans. Let me further point out that that provision for the registration of such persons you have to-day only in Natal. You have not got it in the other territories; you have not got it in the Transkei and yet in the Transkei they carry on just as well as they do in Zululand as far as I can judge. The only consideration here is as to what provision is being made for proper medical attendance for natives in these parts.

Nothing at all.

There is nothing at all, I agree to that, but in any case, that is a matter that has the consideration of the Government As the hon. member will know, a Commission has been appointed by the Prime Minister as Minister of Native Affairs to go into the whole question of medical facilities for natives, and we hope something will come out of that. In any case the whole question of proper provision for the natives has the consideration of the Government and of the country, and we hope in future to make progress in that direction. There is an amendment on the Order paper by the hon. member for Newcastle (Mr. Nel) which has not been moved, but I hope somebody will move it, otherwise I will move it myself, an amendment which I am able to accept. That makes this clause more optional. It leaves the matter very largely to the discretion of the Minister. If the Minister does nothing, then no new names would come on to the register. Then in the course of years, and it will take quite a long time, that class of medical practitioner, if you can call him that, will disappear, but if the proposed amendment by the hon. member for Newcastle is accepted then it would leave it to the discretion of the Minister to make it possible for new ones to be registered and the Minister could use his discretion according to the circumstances at the time. That is about as far as I can go to meet the objections against this clause as it stands now.

May I submit to the Minister that it is utterly unnecessary to achieve his purpose to have this in the Bill. You have complete power under the Native Administration Act. Why provide for it in legislation like this and make it impossible in cases of extreme urgency or where you have not set up that medical relief for the natives of which you speak? I believe the commission has been sitting for two years and you have not had a report yet. It may sit for twenty-two years and in the meantime you are going to deprive a very large section of this country, the natives, of that very primitive aid which is most necessary to them. Where the Government has power to refuse to issue these licences you do not need to put it in a Bill to destroy them altogether. The power is permissible now, but the Minister proposes to make it absolute. I submit the interests of the natives would be much better served if this amendment were passed.

I formally move the amendment standing in the name of the hon. member for Newcastle Mr. Nel), which has not been moved yet. I move—

Let me say further, in reply to the hon. member for Zululand (Mr. Nicholls), that this clause has been introduced after consultation with the Native Affairs Department, so it is the wish of that department that it should be incorporated

I was not aware of that. With the leave of the committee I beg to withdraw my amendments.

Amendments proposed by the Minister of Public Health put and agreed to.

Clause, as amended, put and agreed to.

On Clause 96,

On the motion of the Minister of Public Health, an amendment was made in the Dutch version which did not occur in the English.

Clause, as amended, put and agreed to.

On Clause 97,

I move—

Agreed to.

Clause, as amended, put and agreed to.

On the First Schedule,

I move—

Agreed to.

First Schedule, as amended, put and agreed to.

On the Second Schedule,

I move—

It would save confusion if this were held over until we consider my amendment.

If the hon. member’s amendment is carried I will agree to delete this at the report stage.

Amendment put and agreed to.

Second Schedule, as amended, put and agreed to.

The Sixth Schedule having been agreed to, the Committee reverted to Clause 76, standing over.

On the motion of the Minister of Public Health it was agreed to report progress and ask leave to sit again.

House Resumed:

Progress reported; House to resume in Committee to-morrow.