announced that a vacancy had occurred in the representation in this House of the electoral division of Wonderboom owing to the resignation, with effect from 12 September 1974, of Mr. R. F. Botha.

Mr. Speaker, I move—

The principles of the Bill before the House are based on the same principles as those embodied in the present Act. The present Act also includes provisions for the control of chemists and druggists and for habit-forming and potentially harmful drugs. Although the principles of control measures over chemists and druggists are the same as those over medical practitioners and dentists, control over the medical, dental and supplementary health service professions on the one hand and control over chemists and druggists on the other hand is vested in two separate statutory bodies. For this reason and in an endeavour to enhance the image of the pharmacy profession, it has been decided to provide for the control of that profession in a separate Bill. Although habit-forming and potentially harmful drugs are connected with the professions concerned, it has been felt that differentiation should be made between the control over the professions and the control over these substances. For this reason the Medical, Dental and Pharmacy Act, 1928, has been divided into three separate measures so that we will have a consolidated measure for each subject separately. Mr. Speaker, the belief exists in certain quarters that it is the intention of the medical profession and the Department of Health to create a medical monopoly for the medical profession with this Bill. This is best illustrated in a letter in the Rand Daily Mail of 6 November 1973 under the heading “Some power-mad men in medical profession”. This is far from the truth.

In South Africa we have nearly 22 million people. The medical profession consists of about 12 000 people. The department and myself are not interested in only safeguarding the income of such a small group of persons to the detriment of the majority of the people of South Africa. We are only interested in safeguarding the interests of the patient. The only way that this ideal can be achieved, is to ensure that any person who practises a health profession possesses at least a minimum standard of training and practises such profession under the control of his peers. Should any Government neglect to provide these basic precautions, such Government would be guilty of almost criminal negligence, because the life of the patient depends on the services rendered by these professions.

In the circumstances it was necessary to amend the provisions of the present Act to stop the loopholes under which training can be presented and professions can be practised outside the control of the Act. To save time I shall only deal with the difference between the Bill and the present Act.

In line with modern practice, the definitions have been taken up in clause 1 of the Bill.

The objects of the council are set out in clause 3. I wish to point out that this will be the first time that the objects of the council will be clearly defined.

In clause 4 the powers of the council are consolidated which are as contained in sections 10, 11, 13A, 22, 23, 25 and 26 of the present Act.

Clause 5 deals with the constitution of the council and provides for 25 members, instead of 33, namely

1. (a) the Secretary for Health;
2. (b) eight persons nominated by the Minister of whom—

1. (i) four shall be medical practitioners;
2. (ii) one shall be a dentist;
3. (iii) one shall be attached to a faculty of medicine or dentistry;
4. (iv) two shall be persons who are not registered under the Act;

1. (c) one person who is a Director of Hospital Services designated by the Administrators;
2. (d) three medical practitioners instead of six representing medical faculties and one dentist instead of three representing dental faculties, designated by the universities;
3. (e) seven instead of ten medical practitioners and two instead of four dentists elected by medical practitioners and dentists respectively;
4. (f) one person instead of two registered under the Nursing Act and designated by the Nursing Council;
5. (g) one person registered under the Pharmacy Act and designated by the Pharmacy Board.

For the first time provision will be made for a representative on the council by the provinces as well as for a representative on the council by pharmacists.

Mr. Speaker, much controversy existed over the constitution of the council. Even my good friend, the member for Rosettenville, was reported in The Star of 3 December 1973 to have stated, on the clauses affecting the composition of the council inter alia, that the Bill appears “to interfere with the autonomy of the council”. May I invite the attention of the hon. member and all other persons who are thinking along the same lines, that the council is a statutory body, established by an Act of Parliament and that it can only possess such powers as Parliament may decide to delegate to it. The opinion that the council is a fully autonomous body is a flight of the imagination, because even under the present Act, the Council has no power to make either a rule or a regulation except with the approval of the State President. Evidently the Council is capable of performing its functions autonomously within the framework of the Act, rules and regulations, but even a Government department possesses such power. Should the Government or any other party interfere with the Council in the exercise of its functions within the framework of the Act, rules and regulations, then the criticism about the autonomy of the Council would have been relevant.

The severest criticism on the proposed decreased membership of the council was raised by the Medical and Dental Associations. Both associations recommended that the number of elected members of the council should be raised from ten and four to 15 and six medical practitioners and dentists respectively.

The council recommended with a majority and with a number of absentees that the number of elected members should also be raised to 15 medical practitioners and six dentists.

In the South African Medical Journal of 8 September 1973 the editor expressed himself inter alia as follows in an editorial:

The Dental Association was reported in the Rand Daily Mail of 7 December 1973 to have said—

Mr. Speaker, I want to reiterate: The Medical and Dental Council was not established to serve the purpose of the medical and dental profession only; the Medical, Dental and Pharmacy Act was not passed by Parliament to establish a monopoly for the medical and dental professions and to organize the professions into a close-knit trade union. The Medical, Dental and Pharmacy Act, 1928, was passed and the Medical and Dental Council was established to safeguard the interests of the inhabitants of South Africa against malpractices and exploitation. In other words, Parliament delegated powers to the council to perform functions which usually would have been performed by the State, to protect the nearly 22 million people of South Africa, and not to create a body only to promote the interests of a small number of persons.

The composition of a council may well suit the needs of a profession, but the only body which has been established to look after the interests of all the inhabitants of South Africa, is Parliament. A profession certainly possesses the right to advise and to try to influence Parliament, but it has no further rights in this direction.

As a matter of fact, should the proposals of the Medical and Dental Associations be accepted, the council could just as well be abolished and these associations could then just as well be vested with these powers of the council.

Provision is made for representation on the council of the provincial administrations. One of the functions of the council is the control over training of personnel. The provincial councils play a major role in the framework of training by providing facilities and the need for representation has been felt for a long time. As a matter of fact, all the provinces wanted representation on the council but in view of the fact that it has been decided to reduce the size of the council, it is unfortunately not possible to make provision for more than one member.

You will also notice that the membership of faculties of medicine and dentistry is limited to three and one respectively. But you will also notice that special provision is made in clause 11(1)(a) for the appointment of an education committee on which a member of every medical and dental faculty must serve. It is an established practice of our universities to nominate a person to represent all the universities when necessary and this practice will now also be embodied in the representation on the council. But apart from this an instrument will be created through which every university will be given the opportunity to raise its views.

In line with the policy of a smaller council, the membership of the Nursing Council will be reduced to one person.

Provision is also made for representation of the Pharmacy Board. This is a long-felt need. In this way the opportunity will be created for the pharmaceutical profession to raise its voice in matters pertaining to the relationship between the different professions.

I realize that criticism can be raised against the number of persons who can be appointed by the Minister. First of all, it is not expected from any person appointed by the Minister to promote the views of the Minister in the council and every person so appointed will testify that he has never received any instruction from any Minister to follow a certain policy or to vote in a certain way. Even the Secretary for Health, who is an ex officio member of the council, has never received such an instruction. Such persons are appointed solely on the grounds of their personal qualifications and their own abilities. The only reason for making this provision is to create an opportunity to supplement any shortcomings on the council after the election of members. For this very reason the method of constituting the council is changed, to the effect that the Minister must make his appointments after the election of members.

*Clause 6 deals with the formalities pertaining to vacation of office, and the most important addition is that a member of the council is relieved of his office if he ceases to be a South African citizen, or if the State President deems it to be in the public interest to terminate his membership.

In terms of clause 9(1), nine members will constitute a quorum of the council, instead of the seven members required by the present Act. The provision lays down that at least one of the members constituting the quorum must be a dentist and that at least one must be a layman, in order to ensure that these interests are represented during deliberations.

Clause 10, unlike the existing Act, lays down which members are to serve in the executive committee of the council.

Clause 11 (1)(a) provides for the establishment of an education committee which must include at least one representative of each medical and each dental faculty established at a university, and the chairman of this committee must be a member of the council. Clause 11(1)(b) provides for the establishment of a specialists committee of which the chairman must also be a member of the council. These two committees are specifically being established by law in order to entrench the position of universities, inter alia, in the training setup.

Furthermore the council may establish such other committee as it may deem necessary: Provided that the chairman of any such committee shall be a member of the council. The chairmanship of committees is being restricted to members of the council in order to ensure the closest possible collaboration between the committees and the council.

In the appointment of the registrar and staff of the council, proficiency in both official languages is essential; for the rest, the provisions of clause 12 are similar to those of the existing Act.

In clause 15, the council is being instructed to establish a professional council for psychologists, in order to make provision for the necessary control over the profession. In fact, the council has already established such a professional council of its own accord in terms of the present provisions of the Act. This provision ensures, however, that the professional council cannot for some reason be abolished. For the rest the provisions concerning professional councils are the same as in the present Act.

Subject to the provisions of the Nursing Act, 1957, clause 16 will prohibit any person or institution from offering or providing any training aimed at qualifying any person for the practising of any profession or for the carrying on of any activity directed to the mental or physical examining of any person or to the diagnosis, treatment or prevention of any mental or physical defect, illness or deficiency, unless such training has been approved by the council. So the council is being empowered to exercise control over the training of health personnel, with the exception of nurses. As hon. members know, the nurses have a separate Nursing Council. Mr. Speaker, these provisions are essential for putting a check upon the development of all kinds of quackery. The certificates of one of the institutions at which instant practitioners are trained have become very well-known in the Transkei in particular, and it has been brought to my attention that one of these practitioners has insisted on being supplied with dependence-producing substances at a pharmacy, since he was allegedly registered as a “medical practitioner”, which was not the case. Credulous people are told that they can undergo the instant training in order to become a medical practitioner if they do not qualify for being trained as a medical practitioner in the conventional way. Consequently the provision is essential for prohibiting this practice.

The provisions of the existing Act are being extended in clause 17(1) to provide that a person who wants to practise a health profession for gain must be registered. The extension of this provision is necessary in order to prevent quackery.

Clause 18 places an obligation on the council to register psychologists. This links up with the other provisions concerning psychologists. In terms of clause 19(2), if a person’s name has been removed from the register, the registrar must notify him of the removal by registered post.

If a judge declares a person registered under this legislation to be mentally ill, he must notify the registrar of this fact in terms of clause 19(4), and the registrar must then remove his name from the register. Subclause (5), on the other hand, provides for such a person’s name to be restored to the register upon submission of proof of his recovery and discharge in terms of the provisions of the Mental Health Act, 1973. This provision serves to lighten the duties of the council and its committees and has been introduced at the request of the council.

The principle embodied in clause 36 is exactly the same as the one contained in section 34 of the existing Act. However, experience has shown that persons presecuted under the existing section of the Act are usually acquitted on technical points. These are people who give themselves out to be doctors. This provision is now prohibiting unregistered persons from performing an act for gain if such act pertains to the profession of a registered person, and was drafted in the light of findings by our courts in the past, after consultation with a well-known lawyer who specializes in health legislation. As you will perceive, the provision deals specifically with the performance of an act for gain and with misrepresentations. So this will not prohibit a parent from treating his child, as has been alleged. Nor will the provision prohibit a person from praying for the recovery of a sick person, even if the person who prays is being paid to do so, for in such a case he is not a medical practitioner, after all.

All we are trying to do by means of this definition is to eliminate quackery, and I do trust that we shall succeed in doing so.

Clause 37 prohibits any person from practising the profession of a psychologist or performing a function pertaining to the profession of a psychologist unless he is registered as such.

The provisions relating to psychologists agree in principle with those relating to medical practitioners. Once again I want to emphasize that the prohibition on the performance of acts pertaining to a psychologist is restricted to acts performed for gain and misrepresentations with a view to gain.

Subclause (2) specifies the acts which will be deemed to be acts pertaining to the profession of a psychologist.

Since it is realized that there will be an overlapping of disciplines, provision is being made in subclause (3) for certain persons and institutions to be specifically excluded from the prohibition on the actions deemed to pertain to the profession of a psychologist. I should like to dwell for a moment on these provisions. The first provision relates to an educational or research institution. It would be attempting the impossible to mention all such institutions in the Bill. A few examples of such institutions are the Human Sciences Research Council, the C.S.I.R., child guidance clinics at educational faculties at our universities, private schools that may perhaps not be registered, and so forth. In all these cases either education or research or both are being conducted, which would be completely restricted if this exemption did not exist.

The second provision relates to lecturers and teachers, and in subsection (4)(a) a restriction is imposed to the effect that such persons are not allowed to treat a mental illness as defined in the Mental Health Act. This refers to pathological conditions suffered by persons who are certifiable in terms of the latter Act, which are reserved for treatment by specialists in this field. The same applies to social workers and persons holding office in a church. We realize that the persons concerned must be authorized to diagnose problems, to assist, inter alia, with rehabilitation relating to personality, emotional and behaviour problems, and to promote personality change, growth and development, or else they will not be able to perform their respective tasks. But certifiable pathological conditions on the grounds of which patients may legitimately be detained in institutions pertain to the sphere of psychiatry, and in this sphere such persons may only perform their functions within the scope of their professions under the guidance of the psychiatrist.

The third provision relates to medical practitioners. Medical practitioners are being excluded in order that they may perform their functions in terms of the Mental Health Act, and in order that psychiatry may be practised. The same argument applies to nurses in the fourth position.

The fifth provision relates to churches. The allegation has been made that in terms of the draft Bill which has been published, lay preachers, elders, deacons and Sunday school teachers would not be able to perform their functions. As far as I know, the only person in the church who receives remuneration for his services is a minister or priest, possibly a lay preacher, which would then be the only shortcoming, but since when have elders, deacons and Sunday school teachers been paid for their services? I do not believe that the people who expressed this criticism could have read the draft Bill very well. I do trust that they will do so, because, Mr. Speaker, the only persons who are to be excluded from the provisions are those persons who perform such functions for gain. For that reason it is in fact only necessary to exclude ministers and priests.

I should like to state clearly and unambiguously that as the Minister of Health I do not have the slightest wish, nor does my Department, to exercise any control over churches or religion, and any person or organization who makes an allegation to this effect is spreading a barefaced lie. That is why this aspect has been specifically excluded from the provisions, since we realize that these fields of activity overlap. However, no matter how much we would have liked to keep the mention of church or religion out of the Bill, we have been forced to refer to these aspects in order to prevent any interference in the field of religion and the church.

The sixth exception which is being made is in respect of a student, in order to provide for training.

The final exception is in respect of a person who acts under the supervision of a psychologist in order to provide, inter alia, for unqualified assistance under the supervision of a psychologist. The second provision is necessary, too, in order to provide for organizations such as the A.A., Life Line, and so forth, which perform an essential welfare service.

Finally, Mr. Speaker, as far as psychologists are concerned, it is being provided that the Minister may by regulation indicate which acts pertaining to a psychologist may be performed by unregistered persons and under which circumstances. The situation exists in practice that several employers, including the Chamber of Mines, the Post Office, etc., employ tests drawn up by the Human Sciences Research Council and the C.S.I.R., for selecting personnel. Selection takes place on a basis that is determined in advance by the organizations responsible for drawing up the tests. In addition there are trained staff managers who promote the interests of employees. From the nature of the case it is impossible to make provision for these cases in the Bill, and for this reason it is essential that the Minister should have this power in order to deal with problems that may arise in this regard.

Clause 38 deals with the dental profession. The only changes in this regard are the provision that a medical practitioner may under certain circumstances perform essential dental services, and the provision for dental auxiliary services. These changes have been made at the request of the council. Apart from the fact that the provisions of clause 39(1)(e) now also provide for the protection of a nurse as far as the overlapping of the professions is concerned, the rest of the provisions in this clause are the same in principle as those in the existing Act.

The existing provision that medical practitioners may with certain reservations dispense medicines for their patients is being extended to dentists in clause 52. In this regard i should like to point out that there are several medical practices in existence which offer extensive dispensing services in competition with pharmacists. But this is not all. Habit-forming substances and dangerous dependence-producing substances are being handled on such a loose basis in some of these practices that the public may be endangered. In the medical profession it is considered to be unethical for a medical practitioner to entice away patients from a colleague or actively to advertise his practice. Cases have come to our notice where medical practitioners have sent circulars to patients advertising the fact that their medicine was sold at a lower price in an area in which there were in fact pharmacists practising. I believe that such behaviour is completely unethical and the council should take cognisance of it.

As a matter of basic principle, medical practitioners should have the right to dispense, but we have such a shortage of medical practitioners that such a right should not be regarded as a right to dispense medicines on a large scale in competition with pharmacists.

In order to protect the public against all kinds of false claims, a new provision is being inserted by clause 55(g) to prohibit unregistered persons from selling, offering or supplying any instrument or appliance for the purpose of diagnosing, treating or preventing illnesses.

In clauses 62 and 63 it is being made obligatory for persons who must be registered in terms of the Act and whose names have been removed from the registers because of failure to pay the prescribed registration fee, to pay the outstanding registration fee before their names may be restored to the registers. The only further change as against the existing Act is embodied in clause 61, in terms of which the Minister, instead of the State President, is now being empowered to make regulations. The only reason for this change is to lighten the administrative burden of the council and the department. In addition, the Minister is being empowered to make or to amend a regulation or a rule if he deems it to be necessary in the public interest, without consulting the council, but after consulting the executive committee. This is a measure to be used in an emergency. As has been mentioned, the council will meet twice a year, and circumstances may arise in the light of which it may be essential to make amendments. The provision has been inserted to provide for circumstances of this nature.

Clause 64(3) provides for the present council to remain in operation until such date as the council is dissolved by the Minister by notice in the Gazette. The present council’s term of office commenced on 1 January 1974, and it would be futile to wait for five years before putting the changes into operation. It has been alleged in certain circles that this Bill is interfering with the rights of the individual to choose his own practitioner, amongst other things, and that we are going to close down shops selling health food—whatever that may mean. As far as the latter is concerned, we must take note of the fact that the sale of food is regulated by the Foodstuffs, Cosmetics and Disinfectants Act. If such persons wish to practise a profession, they must undergo the necessary training and register. As far as the former allegation is concerned, the right of the individual is not interfered with in any way. However, the practitioner’s position is in fact interfered with, to the effect that before he may sell his services to the public, he must possess a minimum standard of training with a view to the protection of the person to whom he is selling his services.

A draft Bill was published on 10 August 1973 for information and comment. Its provisions have been adapted as far as possible in the light of the comment that has been received. On behalf of the department I should like to express my thanks and appreciation to those who expressed constructive criticism.

Mr. Speaker, I have listened with great interest to what the hon. the Minister had to say when he introduced this Bill. To me it is a Bill of three parts, each part being interwoven with the others. The whole appears to me to be an earnest endeavour on the part of the Minister to introduce a Bill which, mainly, will protect the public, the whole population from untrained, unregistered and unscrupulous people; those people who try to pass as persons possessing some special knowledge, some special gift or ability. They go so far as to say that with these abilities they can cure the most obscure disease, and they attempt to bluff those people who are attended by them into believing that they cure these diseases. I refer particularly to the malignant diseases that some of these people have been attending to. I think it is a good thing that the people who do these things should be stopped. They should be stopped as soon as possible.

Let me go to another part of this Bill. I think it is the most important section of the Bill, namely what the Minister considers to be the streamlining of the already existing South African Medical Council. Now, in streamlining this council, the Minister feels that the easiest way to do it would be to decrease the number of members. If he does this, he must not be surprised that members of the S.A. Medical Association disagree with him. What happened in 1928, when the Medical Council was formed and brought into being, does not pertain to the present situation. The number of doctors practising in South Africa at that time do not compare with the number that are in practice today in the Republic. I think the Medical Association does have cause for asking for an increase in the number of elected members to the Council. Again the number of medical schools that were in existence at that time were far less than the number we have today. They also would like an increase in representation. Let me just halt here for one moment and say how opinions differ in these matters. I have here a publication Health Services in Britain. On page 55 of this booklet reference is made of the British Medical Council, which is really the mother of the one we have here. Now, look at how their council is composed. The General Medical Council consists of 47 members. So, obviously, they take into consideration the population growth as well. Eight of these 47 members are nominated by the Crown, three of whom are laymen. The interesting point that I want to make is that out of the great number of medical men in Great Britain, only 11 of the 47 are elected—eight from England and Wales, two from Scotland and one from Ireland. The hon. the Minister could have used that argument in reducing the number of elected medical practitioners on this council, but he did not. I am pleased that he did not, because I think it would have been wrong taking into consideration the circumstances in which we live in South Africa. I want to say to him that he is doing the wrong thing by reducing the number of elected members. I believe he should not do that. I would be satisfied to have the same number of elected men, medical men and dentists, on the council. Here we have an interesting point. In the General Medical Council in Britain 28 out of the 47 members are chosen by the universities. What have we got here? One or two. We ought to give this group greater consideration. In a way I agree with the Medical Association—I think that their representations are not selfish—when they consider that the number of members elected by the medical and dental professions should not be drastically reduced and also the number of members nominated by the universities with medical and dental faculties. I want to say that the hon. the Minister must give great consideration to having more representation on this council from universities. I want to stop here for a moment. Why do I want a greater number of people from the universities? The whole basis of our medical practice today rests on the standards of our universities that we enjoy in South Africa, these very high standards which are regarded by persons throughout the world as being outstanding. These standards have been reached by the endeavours of the present Medical Council who set the standards for the universities with the co-operation of the universities concerned. I should like to see that being carried on. I think when it comes to the council, we must consider very seriously giving the universities, who are the core of the education of the medical profession, more representation on it. We shall introduce amendments at a later stage to try to put our point of view. However, this is the type of Bill which requires a great deal of attention. Amendments will have to come in from time to time in order to cope with the various changes which take place in the profession and when I talk about the profession, I mean all the allied members in the profession. We can start off now by trying to improve this Bill and whatever amendments we on this side of the House wish to introduce during the Committee Stage of this Bill will be introduced with the object of improving and not hindering the intention of the hon. the Minister. I want him to understand this.

Let me say here and now that we are completely satisfied with the basic principles of this Bill. There are details that we want to see altered. I can give him the assurance that we on this side of the House will give him all the support both today and in future in seeing that this Bill is carried out in the best possible way.

The composition and the functions of the Medical and Dental Council ought to be looked at just briefly. The hon. the Minister has already dealt with one or two matters in regard to the question of the functions and objects of the council, but I want to make it clear both to members of this House and to the people outside that the Medical and Dental Council has not been established for the good of the doctors. The doctors fear and respect this council. It has great powers and uses them justly. Whether the hon. the Minister interprets those powers as being autonomous or not, is merely an opinion. As far as I am concerned, these powers are autonomous. The Medical and Dental Council set down the standard of a medical practitioner’s behaviour, both in his practice and outside of it. The council also sets the standards that must be complied with in respect of their training and their educational qualifications, as well as in respect of the subjects in which doctors wish to specialize. The council sets the standards that must be maintained. These are very important objects and duties, and it is because of this great responsibility that rests on the shoulders of the members of this council that the medical profession itself regards this council as being a director of how they feel the public ought to be treated and looked after. The members of the council guard their rights very jealously. They realize what a great responsibility rests on their shoulders and it has been fortunate for us in South Africa that we have had men of such great ability and outstanding character to serve us over the last 40 years. I, for one, would like to pay tribute here this afternoon to every single one of these persons. They have not only protected the public but in their own way they have protected the doctors as well.

The Medical and Dental Council is obliged to keep a register on which must appear the names of all people who have duly qualified in the profession of their choice, and this register is most important because it excludes entirely the improperly trained and the unregistered persons. I want to say to the hon. the Minister that in this Bill there seems to be a tendency, one not to take into account the question of reciprocity of degrees in other countries on the new scale of attainment. However, it appears to me—and I shall discuss this at a later stage again—that the hon. the Minister is willing to give a temporary home to the qualified professional men from other countries who have not yet reached the standards obtaining in our country. The freedom of choice of these people, however, disappears, and they are obliged to practise where the hon. the Minister wants them to practise. That is the principle that I am opposed to. I say that if a man practises in South Africa, he must be fully qualified and must have attained the required standards of efficiency. If he is not so qualified, provision must be made for him at a university to enable him to qualify and attain the requisite standard as soon as possible. It is completely wrong to my mind to say that one man who is not as higher qualified as another man cannot practise in a certain area but can in another area. Whether he practises there under the supervision of others or not is beside the point. The point is that we are going to lower the standards in some parts of our country. I can see an evil in this. I have stated here previously that I do not want to see second-rate doctors in this country or any second-rate persons in any of the allied professions. These people should not be classified as not being good enough to treat all sections of our population. I know what is behind this. We just do not have enough doctors nor do we have enough dentists. We allow a few to enter the country from abroad and to practise at places where there are too few or not any other members of their profession practising. I want to tell the hon. the Minister that he must improve the facilities for ensuring that more doctors are forthcoming from the universities. There must be better facilities for them there. I say that he must make the conditions of employment for doctors in those areas which are unattractive at the moment, so attractive that these professional men will want to go and practise at those places.

Order! There are a few hon. members who should turn down their volume now.

In regard to the discipline which the Medical Council enjoys, I should like to say here that this is an example which could have been taken by another hon. minister in this House. In terms of this Bill, a person, who is charged with committing an offence, if he is taken to a court and found guilty—and sometimes if he is not found guilty—is obliged to appear before the Medical Council. The Medical Council can then impose a further penalty upon that person. However, the person accused has the right to be represented by counsel and he has the right of appeal to the courts. I feel that that pattern should exist right through our Statutes —that when people are dissatisfied with certain findings, they should have access to the courts of law.

I want to spend just a minute or two dealing with the proposed new board. If I understood the Minister correctly, there will soon be an opportunity for other supplementary services as well as Psychologists to establish their own boards. We are starting off with a board for the psychologists. The work of the psychologists is spreading throughout the country; it is becoming more and more important in every field of our life. Psychologists are needed in the schools, at the universities, in the Army, the Navy and the Air Force, in industry and in commerce. Right throughout our society we are employing more and more psychologists.

In the United Party too.

I have been reminded that we have them in Parliament as well; I think we need them here. Sir, because of the great demand for these people, provision has got to be made for them, and I am pleased that they are going to come under legislation similar to this measure and that they will be controlled by the provisions of this Bill. Their work requires special training, and I think it would be quite disastrous if we allowed the pseudo-psychologists to perform work that should only be done by people who are properly trained. Together with this, Sir, I think there is a fear that these particular provisions of the Bill may encroach upon the work of the churches, and when I say “churches” I mean all religions. I have listened to what the hon. the Minister has said. We in South Africa have always enjoyed religious freedom. None of us has been denied religious freedom. That has been so in the past; that is still the position today and I know that that will be the position in the future. Of this we are sure, proud and happy. I have the utmost confidence that we will continue to have religious freedom. If there is any fear in the minds of people that it is the intention to interfere with the norms of religion, I say to those people that their fears are groundless. They have nothing to fear. Those of us who practise our religion normally have nothing to fear. The Minister has explained this and I accept his word. I am satisfied that there will be no interference with the normal religious work of our churches.

Sir, I see my time is getting short. I want to say to the hon. the Minister that there are several other matters that we want to deal with. We want to make sure that the work of the social welfare worker is not interfered with and that he will be adequately covered. We hope that those people who wish to form boards and who have already established themselves as associations will be given the opportunity to do so as soon as possible. We do not want to see a chaotic state of affairs arising in this country through the establishment of numerous types of organizations consisting of people without proper qualifications practising in the field of health. I say to the hon. the Minister that he must try to get these people together as quickly as possible and allow them to establish their own boards. Sir, the amendments that we will move later will deal with the constitution of the council; they will deal with the formation of a quorum for the council in its executive state. The Minister knows that the Medical Council does not meet frequently. I think they have two statutory meetings a year but the executive meets very often and I think the executive should have a quorum established for itself, especially in times of emergency. I want to say to him that the boards which are going to be established should have every right to elect their own chairmen. The Minister has not made it clear in the Bill. He may intend to allow these people to elect their own chairman but we will try to rectify the position by moving amendments. There are other things like removing a man’s name from the register. If I remember rightly the Minister has said that if he has been out of the country during the last three years his name can be removed from the register. I do not think that is the intention of the Minister. I think the Minister means that if he has been away continusly for three years without coming back his name can be removed from the register but it is not made clear in the Bill. After all, a man can go away for a holiday every year and then his name can be taken off the register because he has been away during the three years. I think the Minister must rectify that.

I should also like the hon. the Minister to look at the clause which deals with the posting and the receipt of registered letters to members of the medical profession. I know what the object is. It is to say: “I posted you a registered letter; do not come and tell me you did not receive it.” But I think the hon. the Minister should have at least a receipt from the professional man who received that letter before taking action against him.

I have already spoken to the hon. the Minister about the prescribed areas and I should like to see the deletion of that clause in the Bill.

Finally, I want to say that even in a time of emergency where the Minister has got to act and to act quickly, he should still find time—and it can be found—to consult with the Medical Council before he takes any action which will affect the work of the members of the Medical Council or the members of the medical profession.

That is what I want to say to the hon. the Minister this Afternoon in regard to this Bill. I want to tell him again that I think it is a sincere attempt to improve what is at present on the Statute Book and we will give him our support.

When discussing legislation such as this, we are grateful to be able to depend on the support of the Opposition. We are grateful to them because in my opinion it is necessary that the control of medical science in this country be maintained at a high standard and this is the only way in which this can be done. It is with sadness that one takes one’s leave this afternoon of the Medical, Dental and Pharmacy Act, No. 13 of 1928, since this Act was and still is today responsible for a medical practice of exceptionally high quality, a medical profession with high ethical norms and scientific achievements that compare with the best in the entire world. I say one does so with sadness, but in saying this, one accepts at the same time that modern problems make changes necessary in an Act of this kind, too. Before taking our leave of the old council, I trust that you will allow me, Sir, to pay tribute to the present chairman of the Medical and Dental Council. I do this because in my opinion he is pre-eminently the person who has established my language, the Afrikaans language, in the medical world. I say this with pride, and I want to repeat that I know few people who speak such perfect Afrikaans as Prof. Hennie Snyman, the dean of the medical faculty of the University of Pretoria. I say this with deep gratitude, too, because after years of toil he even managed to publish a medical dictionary in Afrikaans. We are grateful to him for that, and not only for that reason but for other reasons too. For example, I have in mind his scientific approach and the development of faculties which took place under him. I trust that he will also take over the leadership of the council to be appointed in the future.

It seems to me that the Bill before us now differs from the existing Act in five basic aspects. In the first instance there is now to be a separate Act for the pharmacists. I do not begrudge them this, Sir. I think they have earned it, and I think it is necessary for them for the development of their own profession. I am pleased, too, that the hon. the Minister said in his speech that it was necessary for the development of the status of this profession. I should very much like to see that profession being developed to (the utmost. In the second instance, there is the composition of the council. In the third instance there is now an obligation to establish a professional council for psychologists. This is something which is now being brought forcefully to the attention of the public and the council. Previously the council had a choice; now it has an obligation in this regard. A fourth salient point is that the Medical Council now has control over training too. Up to the present they have had no control over training. They have only done registrations. In other words, the Medical Council, in effect, only came into the picture when people reached the stage of wanting to have themselves registered. At that stage the Medical Council could act, but they had no control over the training itself. The fifth salient point is that now, as the Minister has announced, there is a particularly neat definition of the medical profession and the psychological profession. I shall come back to that shortly.

This Bill has been handled in an unusual way. It was published in August last year and the comment of everyone was invited. This testifies to the fact that the Minister and his Department have gone out of their way to draw up an effective piece of legislation, and to do so to the satisfaction and for the protection of all. Unfortunately we know that certain people took the opportunity to set agitation afoot. We all know that hon. members on both sides of the House were bombarded with pamphlets, telegrams, etc., to an extent that has probably never been experienced before. I want to add that it was with much gratitude thalt one took cognizance of the fact that both the Afrikaans-language and the English-language Press held back from this agitation. I am sorry to say that this agitation eventually developed into a personal attack on the Secretary for Health. I think one should reject this with the contempt it de serves. I think that this legislation has been properly handled; I think that everyone has had an opportunity to put their case and we can be happy with the Bill that has been drafted for us.

I do not want to say much about the composition of the council. This was the first point I mentioned. It is something about which there can be difference of opinion, but there could never be any difference of principle on this point. I think the Minister was correct in thinking that this council was concerned with delegated powers in the sense that performed a function on behalf of the State. It is the duty of the State to protect its citizens. The only way in which the council can protect the citizens in the medical world, is by ensuring that every practitioner in the medical profession, whether in the paramedical sphere or the medical sphere itself, is properly qualified. As far as I am concerned the task of the Medical Council is a delegated one only.

I therefore believe that the State has no choice but to ensure that it will have control over this board. I do not think my colleagues realize that if the medical profession, the practising doctors, were to have control over this council, they would perhaps lay themselves open to the accusation that they were creating a monopoly for themselves. I think that this is a dangerous premise. If one says that every university should have representation, then one could also say that every province should have representation too. So one could continue. We have really pursued the middle course by providing that this council will be obliged to function on the principle of the establishment of committees. An education committee would be one of the obligatory committees. I shall not say any more about this. Certain of my other colleagues will also elaborate on the composition of the Medical Council but I am convinced that it can work effectively.

In my opinion, one vital clause is clause 15. This deals with the control of psychology, particularly when read in conjunction with clause 32. There is one point we should dispose of forthwith. There has always been control; there is already a professional council under the existing Act, which was established by the Medical Council. Unfortunately that professional council could only function within certain prescribed areas. Beyond those prescribed areas, in other words, there was no control over the rest of South Africa. Here it is being provided that although prescribed limits may still be laid down, it will still be obligatory for the council to issue regulations to control psychologists in the rest of South Africa too. There is obviously no point in controlling part of the country with regard to the psychological or psychiatric professions and not the rest. I think it is important just to quote a short excerpt from Die Kerkbode here. You know, when people are angry, it is very often said that this or that church objects. Here is a short article by the Rev. P. W. Jordaan, chairman of the General Commission for Public Morals. I quote from Die Kerkbode of 21 August (translation)—

Then he mentions a section, which is unfortunately a reference to the Bill originally published in the Gazette of 10 August 1973. At the moment it is another section. I quote further (translation)—

There, Sir, you see the opinion of the Dutch Reformed Church on the matter. I cannot see how any other church can have any other difficulty, because there is no reference to any denomination in the Bill. My hon. friend, the member for Rosettenville, is therefore 100% correct when he says that this Bill has nothing at all to do with religious freedom.

The next vital clause, in my opinion, is clause 16, in terms of which control over training is exercised. As I said a moment ago, previously the council could not exercise any control over training, but only over registration. How it worked was that a curriculum was prescribed for the various medical faculties, and after that course had been completed, a doctor or a psychologist was registered. But apart from these prescribed courses, anyone could take any course, and the council had no control whatsoever over that. I can only show you a copy of an advertisement which appeared in The Natal Mercury as recently as 19 February 1973. I quote—

Yes, it is a large advertisement—

They go on as follows—

They will at least keep one informed about developments which may occur in the future—

One need only treat a sufficient number of people to obtain a specialist degree in “Affinitive Therapeutics”.

Are the dead ones not counted?

Unfortunately they do not say. The advertisement continues—

Hon. members can see how the public are being exploited and why it is necessary to obtain control over these things, as is done by means of clause 16. In this connection one can but refer to the way in which medicines are advertised. Sometimes one even gets a prescription for the medicine in the advertisement. The Afrikaans version of an advertisement of this kind is interesting too. Strangely enough, this one also comes from Natal. This time I refer to a pamphlet, issued in shocking Afrikaans on 19 October 1973 (translation)—

Then we find extremely interesting medicines in this pamphlet. The following is an example: “A good medicine for girls, happiness to boys.” Medicine No. 31 on the pamphlet, according to them is (translation)—

What does it cost?

Seven rand and I can let you have the address too. Then there is medicine No. 35, “Medicine that will make women follow you around” and this costs R8. Then too there is, “Medicine for people who are mad”. Here there is even medicine for the hon. member for Bezuidenhout: “Medicine for a man who wants to be highly thought of.” This medicine costs R17.

I think that hon. members are already convinced that it is really necessary to exercise control over such things, and I want to tell my friends behind me here that control is going to be exercised. If they are interested, therefore, they will have to hurry. This to me is the essence of this legislation.

Lastly, then, there is the control which is to be exercised over psychologists. I think that the hon. the Minister and the hon. member for Rosettenville have elaborated on this in detail. The essence of the whole matter, once again, is just that there has always been control. The sole premise of this legislation is to ensure that control is made effective. Such exceptions as there are apply to teachers, lecturers, doctors, nurses in the practice of their profession, social workers and persons holding office in the Church. This reference we have here is the only reference to the church. In clause 37(3)(e) we read the following—

There will be many denominations that will object to that broad definition; there have in fact been representations and some of the denominations asked, too, that a narrower definition of a church be provided. I associate myself wholeheartedly with this description, not because I think that it is theologically correct, but because I agree 100% with the hon. member for Rosettenville and with the hon. the Minister, that we must and shall always uphold religious freedom in this country. That is why I feel that way. I think that one should make a point of stating that the pastoral psychologists of the church have always been registered with the council. Therefore there is no change in this respect.

I want to conclude by referring briefly to the sole reproach which could be levelled by some members of the public, namely that they may now no longer go to the doctor or the “healer” of their choice. But they may still go to the person of their choice, whether at the medical or the paramedical level, on one single condition, namely that the person in whose hands they place themselves, must be a properly qualified person. In my opinion, if that condition had not been set, the State would have shamefully neglected its duty.

Mr. Speaker, it is a privilege for me, too, to support the Bill from this side of the House.

Mr. Speaker, the hon. member for Fauresmith is a medical practitioner. My colleague, the hon. member for Rosettenville who spoke previously, is also a medical practitioner, as is the hon. the Minister who introduced the Bill. I, as a member of the kindred profession of pharmacy, will obviously have a slightly different approach to certain aspects of this Bill. Let me say that in the main I concur with the opinion expressed by my hon. colleague, the member for Rosettenville. We do intend moving amendments which we trust will receive the careful consideration of the hon. the Minister because they are designed to improve the Bill where possible.

It is interesting to recall that the Medical, Dental and Pharmacy Act of 1928, which is now being substituted, has been in existence for 46 years and that during that time there have been 16 amending Acts. Over that period during which medicine and pharmacy have made great strides, it has been necessary to amend the original Act on 16 different occasions. We in these professions were aware that it was the intention of the Department of Health to separate the medical and dental section of the Act from the pharmaceutical one and to provide the pharmaceutical profession with its own Pharmacy Bill which we will be debating later this afternoon. As far as the public is concerned, I believe they were given adequate notice that this was the intention, because in the Government Gazette published in August last year the three Bills were published in draft from for general information. I do express my regret, while I appreciate the administrative difficulties involved, that the Bills were not published in both official languages. I believe that, particularly as far as the Medical Bill is concerned, it has led to some confusion which may have been avoided had people been able to study the Bill in the language of their choice. As far as we in this House are concerned, it presented no great difficulty. However, there are certain members of the public who did find this a problem and they might perforce have come to conclusions which they would not have come to had they studied the Bill in the language of their choice. The most contentious aspect in so far as public reaction was concerned was the question of the supplementary health services. I am perfectly certain that the Department of Health sought to protect the public in their own interests and also to ensure that there was adequate supervision and control; that the various supplementary health services conformed to certain standards and practices, that they maintained adequate standards of training and that the personnel of these supplementary health services were offered the opportunity to organize their own affairs under the umbrella of a newly constituted medical council. Public reaction was varied. Some individuals felt—and I think they were quite correct in feeling so —that they should have the right to seek health where it could be found, and that this right was being interfered with. Certain organizations were of the opinion that there was a restriction upon their activities. Certain people involved in the treatment of disease and deformities regarded the draft Bill as an intrusion upon hitherto unrestricted activities. There was ample opportunity for these people to voice their objections. As the hon. member for Fauresmith stated, he and all of us have been inundated with representations, memoranda, visitations, objections and, in certain cases, complimentary remarks. I believe that the Department of Health and its officials left no stone unturned in their efforts to co-ordinate the various divergent opinions in the interests of the health, both physical and mental, of the people of South Africa. I believe that this attitude applied particularly to the supplementary health services because Act No. 13 of 1928 covered the activities of medical practitioners, dentists and pharmacists.

The principle of the establishment of professional boards was accepted in legislation by Act No. 43 of 1971. In that sense, therefore, it is nothing new. At present, there are three exclusions from these professional boards. These are the chiropractors, the dental mechanicians, who have their own Act, and in due course the homeopaths, naturopaths, osteopaths and herbalists whose Bill we shall debate at a later stage. The present position is that boards have actually been established. I should like to quote some of the supplementary health services that have been functioning under this system. We have the chiropodists, health inspectors, occupational therapists, psychologists, who have also had recognition but not to the extent envisaged in this Bill, optometrists, physiotherapists and the medical technologists. A supervisory control has also been exercised over other supplementary health services. Rules have been promulgated in the Gazette which affect the activities of medical technologists, blood transfusion technicians, audiometricians, electro-encephalograph technicians and health assistants. As far as I am aware, there has by and large been no difficulty in so far as the regulations promulgated for these various supplementary health services are concerned. As I have indicated, it is the intention of this side of the House to move certain amendments at the Committee Stage. We have, however, noticed in our examination of the Bill that many of the clauses which appear in this Bill and in the subsequent Bill are identical or very similar to the original sections of Act No. 13 of 1928 or the amending Act of 1971. Reference has been made to the composition of the Medical Council. My hon. colleague indicated that the intention of the Bill was to reduce the number of elected medical practitioners and dentists. Sir, this is rather interesting reasoning on the part of the people who drafted the Bill because in the original Bill of 1928 provision was made, and has remained, for 10 elected medical practitioners; provision was made for three elected dentists—and the number was subsequently increased to four—and now 46 years later, we find that it is the intention to reduce the number of elected medical practitioners to seven and the number of dentists to two. A look at the registration figures at that time and now is rather interesting. I quote the 1929 figures because in 1928 when the Act came into force the various provinces had their own particular boards and it so happened that certain professional men were registered in two provinces, and the figures of 1928 were therefore not really a true reflection; but in 1929 there were approximately 2 360 medical practitioners and the figure in 1973 is given as almost 12 000. Then, Sir, let us look at the position of the dentists; there were 750 in 1929 and today 1 650, so the increase in the number of medical practitioners is five times and the increase in the number of dentists is two and a quarter times, but we find that the number of elected personnel from these two professions has been reduced.

Sir, one aspect which I wish to welcome particularly is that the Bill now makes provision for a pharmacist designated by the South African Pharmacy Board to serve on the South African Medical Council. There has always been a relationship between the Medical Council and the Pharmacy Board, because the medical practitioners were represented on the Pharmacy Board. I believe that this system of reciprocity can only react to the advantage of both professions. Sir, in the past we found that the council and the board were mainly controlled by portions of the Act on similar lines, and I have a problem here which I would like to put to the hon. the Minister for his consideration. It may be a possible omission in this Bill. I do not know the reason for its inclusion in the Pharmacy Bill, and if you will forgive me for referring to it for one moment, Mr. Speaker, I would like to quote from the Pharmacy bill, clause 6(4), which says—

That is the clause dealing with the election of the six members of the South African Pharmacy Board—

Sir, this particular clause was not in the original Medical, Dental and Pharmacy Act; it was not in the draft Medical Bill published in August, and it does not appear to be in this draft; if it is. I cannot find it and I ask the hon. the Minister whether it is the intention that this particular clause should be included in both Bills and, if not, whether there is any particular reason why pharmacy should have been singled out in this particular clause which provides for a fine not exceeding R1 000, so it is obviously an offence which is regarded as being reasonably serious.

Then, Mr. Speaker, I have a further problem and that is in regard to clause 52. The marginal note to clause 52 says, “Medical practitioners or dentists may dispense medicines”. Then the clause goes on to say—

Let me explain, so as not to take up the time of the House unnecessarily, that the idea is that the medical practitioner will be entitled to dispense medicine for himself, his partners or his locum tenens; but the operative words here, in my opinion, were, “in such circumstances as may be prescribed”. The original Act of 1928 stated “medical practitioners and dentists may dispense medicines on payment of a licence fee, if any, fixed by law”. I know that this particular provision with regard to the payment of a licence fee fixed by law has never been invoked. But I submit to the hon. the Minister that the new clause is too broad and too vague and I am aware of the amendment which appears under the hon. the Minister’s name on the Order Paper today, where he even intends to remove “in such circumstances as may be prescribed”. I say again that I believe it is too broad and too vague. But I want to make it quite clear that I do not contest the inherent right of a medical practitioner to dispense medicines. He has had that right in the past; I believe it is an entrenched right which he has had for 46 years, since the Act of 1928. But I contend that the provision in the 1928 Act, namely that a medical practitioner shall be entitled to dispense on payment of a licence fee, if any, at least provided the Medical Council with a means of determining how many and which members of the medical profession dispense their own prescriptions, i.e. who have in their possession stocks of drugs, be they scheduled or unscheduled drugs, which enable them to perform the function of dispensing.

Now I want to refer to the report of the committee of inquiry into the abuse of drugs which was released in 1971, known today as the Grobler report. I would like to draw the hon. the Minister’s attention to paragraph 486, which I want to quote—

Now. I am not aware under the present position that there is any legislation which has put into effect that recommendation of 1971, neither am I aware of any proposed legislation which is on the Order Paper at the moment which in my opinion is intended to implement that provision. I believe that in view of the new clause 52 and of the Minister’s announced intention to move his amendment, he should tell this House whether he intends to implement the recommendation of the Grobler Committee, which I believe to be a most important recommendation, and if so, in what manner.

What is the present position? It is difficult to obtain an accurate assessment of the number of medical practitioners who are dispensing quite legitimately, but it is estimated after careful survey that there are approximately 3 000 dispensing doctors, and if they are dispensing doctors they must have some form of dispensary. In 1974 the figure of actual pharmacies was 2 535, so in effect there appears to me to be an urgent need for a register of premises because there must be well-nigh 6 000 premises where scheduled drugs are being stored. I appeal to the hon. the Minister not to omit “in such circumstances as may be prescribed”, but rather to extend that provision to read “prescribed by the council after consultation with the Department of Health and the S.A. Pharmacy Board”. I believe that this is a removal of any visible form of control and I want to suggest to the hon. the Minister, too, that South Africa is not short of qualified pharmacists to dispense prescriptions issued by their medical confrères. I also want to suggest that the medical practitioners themselves could be more fruitfully occupied than doing their own dispensing in areas where pharmacies are established.

Sir, at great expense to the State it provides training for pharmacists at 10 training institutions. There are five colleges for advanced technical education, two universities for White students and three universities for non-White students, at Turfloop for the Africans, at the University of the Western Cape for the Coloureds and at the University of Durban-Westville for the Indians. The course which they undergo is a four-year course. It is a very stiff course, equivalent to an honours science course. In addition to that, there is one year’s practical experience. Last year 172 qualified. Of these, 14 were non-Whites. They have joined the growing band of non-Whites who are qualifying, at great expense, at great Government expense, at these institutions. And, Sir, their idea and their limitation is to serve their own people in their own areas in the townships, and they are unable to make a living and to maintain decent professional standards because of the competition of the dispensing doctors, situated sometimes right next door to their premises. I suggest to the hon. the Minister, who also happens to be the Minister of Coloured Relations, that if he has not already visited the areas where some Coloured pharmacists are trying to make a living, he should see for himself how these highly trained pharmacists are struggling and are having to resort to commercial means and to the subjugation of their own professional instincts.

I want to draw attention also to clause 36. This particular clause, in the words of the side-note, deals with penalties for practising as a medical practitioner or as an intern or for performing certain other acts, while unregistered. The whole clause, as far as I am concerned, deals with practising for gain and appears to intrude upon the pharmacists’ traditional right to sell medicines and advise upon their use when requested by a patient to provide such medicines. I want to appeal to the hon. the Minister to consider this clause and relate it to clause 29(2) of the Pharmacy Bill, which also appears not to provide a right which I believe has been inherent in the practice of pharmacy since 1928.

It has been said by previous speakers that a number of clauses deal with psychologists. In the opinion of the public this has proved to be a most contentious matter. But, Sir, in this Bill the psychologists’ scope will be defined and their activities will be controlled. I believe with the Minister and previous speakers, that the anxiety which has been expressed by church and welfare organizations will not prove to be founded, because some of them have overlooked the fact that the practices referred to in this clause are practices “for gain”. The Minister has explained that churches and many other bodies do not practise for gain.

In so far as the establishment and constitution of the professional boards under this Bill are concerned, there is ample opportunity for control, because various clauses lay down conditions in regard to registration, to registers, to prescribed qualifications, to exemptions from restrictions and to examinations. But then, Sir, public concern has also been expressed on the possible effect this Bill might have on social work practice and on the activities of social workers as defined by the Mental Health Act. But I believe, and the Minister has in my view confirmed, that adequately trained psychologists and adequately trained social workers who are paid for their services— that is practise for gain—have nothing to fear from this Bill. They have nothing to fear if they are adequately trained and are registered. I go further, Sir. I also say that churches and religious bodies, as well as organizations such as Lifeline and Marriage Guidance organizations, which do not operate for gain, will continue to serve the community. Where there is doubt, the Bill will provide the power to control the activities of those whose actions may be to the detriment and harm of the people of South Africa. Throughout the civilized world, for many years now, there have been laws to control the use and the abuse of drugs and medicines which could cause damage to body and mind, and I believe that it is logical that control be exercised over those, no matter how good their intentions, who seek to treat and cure both mental and physical conditions by unorthodox methods, the safety, efficiency and efficacy of which have not been proved and are still the subject of doubt.

So, Sir, I have no difficulty in accepting this Bill in the terms expressed by my hon. colleague from Rosettenville.

Mr. Speaker, just to deal with one point which the hon. member for Berea raised in connection with clause 32, I immediately want to say that I have the utmost praise for pharmacists and for the way in which they have rallied to the fold in the last few years. There was a time when we had a tremendous shortage of pharmacists. In the Cape Province, for instance, certain measures had to be adopted to make bursaries available. A faculty was started at the University of Rhodes. The Cape Technical College was subsidized so that it could grant bursaries to enable Whites and non-Whites to qualify as pharmacists to make up this shortage. But because the profession has progressed and implemented its own status, it has reached the stage where we now have many qualified pharmacists—I will not say enough pharmacists—who can take over the work in provincial hospitals and in private institutions. I rejoice with him that we have reached the stage where the pharmacists will have their own body and their own Act, and will very shortly be removed from under the old Act. I want to congratulate the hon. member who is a member of this profession which has fought its way up and has taken its place in South African society as a very honourable and well-trained group of people.

I can only say that I am not in agreement with him, or with Dr. Grobler for that matter, about the fact that there should be a register for premises. There are registers with medical practitioners for the control of drugs and I am quite sure that no medical practitioner dispenses because he likes dispensing. It is a too complicated procedure to carry on with ad infinitum. When one does this as an aid to one’s practice, I do not think one wants to be hindered by such aspects as the registration of one’s premises. I can assure the hon. member that no doctor will spend his time dispensing when he has work to do. He only does it because he has to, especially in smaller villages. There is the safeguard of all the registers pertaining to the habit-forming drugs and scheduled drugs.

*Today we are dealing with a Bill based on Act No. 13 of 1928. I think this Act is a particularly fine example of how a certain profession, such as the medical profession and its related professions, has developed over the period since 1928. If you will allow me to say so, Sir, the legislators of those days, the National Party in 1928, were very far-sighted when they passed this Act. I agree with the hon. member for Rosettenville when he says that the foundation of the medical profession is a very firm one. It was taken from among other professions and related professions were added to it. The fact is that amendments were effected in the course of time and the nurses, for example, have their own Act today. In addition we have the pharmacists and dental mechanicians and others mentioned by members—proof that this process of evolution has been a gradual one. Today there is particularly great interest in the Bill before us. I want to say at once, however, that the Bill does not deal with doctors to any large extent. This Bill deals more particularly with man, especially his brain and his nervous system.

†It is important that we look at a few definitions which may aid us in our confusion when we deal with the human brain and the human sensory system. In the Chambers Dictionary “psyche” is defined as “the soul, the spirit, the mind; the principle of mental and emotional life”. It says the word comes from Greek mythology, and personifies the soul, depicted as a young woman with butterfly wings, the beloved of Eros.

*The Afrikaans translation of “psyche” is “gees, siel, psige”. It is clear that a great deal of confusion exists, otherwise there would not have been as much interest in this Bill, as to what we are actually dealing with, that is whether we are dealing with the psyche, the spirit or the soul. I do think that a great distinction should be drawn.

†I would like to quote from a book by Sargant, The Battle for the Mind.

Sargant?

Not the Serjeant of this House, but an author who wrote in 1956. I quote a paragraph—

Now we have the important part—

*That was written as long ago as 1956, and it still holds good today that “the argument often arises as to who exactly is doing what”. I continue by quoting the following:

Sir, if we pause to consider this short sentence, we shall see that a major onslaught has been made on the psyche of man during the past number of years. I prefer using the word “psyche”, because when one speaks of “soul”, one is speaking of something which is not tangible, just as one cannot feel the psyche. However, when one speaks of the psyche, one is speaking of something which is more in the medical line, whereas one finds oneself more in the religious field when one speaks of the soul. Man’s psyche controls his whole personality. It is for this reason that we have this enormous onslaught on man’s psyche today. This involves not only the people in society in general, but even the psyche of peoples. There are certain ways in which it is possible to affect the psyche. The time is past when it was possible for us to speak of the heart as being the seat of the psyche. In our country, at Groote Schuur Hospital, it has been proved that when one removes the heart of one man and transplants it into another, it has no effect whatsoever on his psyche. He remains exactly the same person. Prof. Barnard said the heart was merely a pump. Therefore it sounded very interesting to me the other day when I heard Pres. Ford of America, in granting ex-President Nixon amnesty, saying, “I believe with my heart, my mind and my spirit”. He was very careful not to single out the one or the other. So he mentioned all three of them together.

Sir, man’s brain is divided into areas. I do not want to become technical, but I do want to tell you that it is a computer in which emotions, feelings, habits and reason are housed. If things go well and one’s lines do not cross, as the hon. member for Durban Point indicated the other day, things go well with one and one is a tranquil, calm, reasonable person capable of making a positive contribution to one’s society. If there are short-circuits, they have to be identified. That is why it is so important that this psyche of man, which controls all his reactions, be treated properly, and, if necessary, be protected by legislation, as well. Onslaughts are sometimes made on this poor psyche of man under the guise of churches, societies, schools and other innocent occupations. I need only refer hon. members to things that happened at Wilgespruit. I can also refer hon. members to a few other similar occurrences. However, I shall content myself with one or two quotations and tell this House that the whole question of man’s psyche which has arisen in the discussion of this legislation, is not concerned with trivialities. It is concerned with a special attack on the psyche of the youth in the world. In the communist world one sees the methods of brainwashing and the tremendous dangers of sensitivity training. All these things are being controlled properly by the provision of this legislation. If I may. I should like to take up the time of this House by reading just one quotation to this House. The article is dated 8 September 1969 and concerns “Sensitivity training and teenagers”. I quote:

Here we have one of the phenoma to which I want to draw the attention of this House. When one speaks of the principle contained in this legislation, and then I am not speaking of the Medical Association because other members have already dealt with it, then I want hon. members to realize the dangers of the problems in so far as man’s psyche is concerned. Practices affecting man’s psyche should be placed under proper control, as the hon. the Minister has done here. I want to read a further quotation from this publication and I want to refer particularly to the section entitled, “Sensitivity training in the churches”.

They go on to say that in 1966 there was a report on a body of which we have some knowledge. I quote:

When one looks at what could happen when one has uncontrolled practising in psychology, or when one lets loose in the field of education, in the field of mental health, psychologists or persons who practise psychology—they sometimes do have a place in these fields if they are properly trained and registered—one sees that this can be dangerous. It can, however, serve as an aid when it is used by a doctor in helping his patients. There is psycho-therapy, that is the treatment undergone by a person who has psychotic aberrations. This is done when a trained person has gained the confidence of that person and has seen to it that he shall then be able to mean something in society. Against that background one may look at Act No. 13 of 1928, the long title of which clearly reads:

Under the “other classes of persons” one found this group that had to deal with the psyche of man. In this new piece of legislation, however, we find a great difference. In the long title of the new legislation it is very clearly stated, inter alia—

The other groups of people have gradually disappeared since they have been given status through their own legislation. Here specific mention is made of psychologists. I prefer to call them “psigoloë” in Afrikaans. It is a requirement that these people be properly trained. Since we are discussing principles, and not details, at the moment, I want to say that we are creating in this Bill the machinery for registering psychologists. Previously one had a voluntary professional council with members serving on it, but now a professional council is being created which, from the nature of the case, will control the profession in terms of this Bill. The necessary qualifications and what psychologists may do and may not do, are being written into this Bill for the first time. It is also mentioned that medical practitioners and certain other people may give this treatment. I want to say here today, although I am a medical practitioner myself, that we shall possibly have to take a proper look at a later stage at the registration of people who may be included. I want to say at once that all medical practitioners are not adequately qualified for giving psychological treatment to people. Similarly—and I say this with all the responsibility at my disposal—every minister of religion is not qualified to give psychological treatment to his parishioners unless he has a reasonable standard of training specifically in psychology. Once this Bill has come into operation and considerations such as training and registration are taken into account, it can only redound to the good of South Africa in view of the onslaughts that will be made on the psyche of the youth and of all its people in the future. When people treat patients, it is extremely important for a large measure of confidence to exist between the patients and the person treating them. I want to say that it is alarming to see the tremendous onslaught that is being made particularly on psychiatrists today, psychiatrists being medical men who have exceptional additional qualifications for dealing with people who have a problem with their psyches. The breaking down of confidence in the psychiatrist forms part of the onslaught on people so as to draw them away from persons who can really help them. I do not want to contend for a moment that the psychiatrist is the only person able to help such a person, but I do want to say that a psychiatrist has a better chance than an untrained person of ensuring the recovery of a person. There are many deep-rooted problems, there are hereditary factors and environmental factors and there are problems that may extend back to the patient’s childhood—all of them may be of importance. It is impossible for a person who deals with this kind of thing only now and again, to give the necessary treatment. That is why I say that as far as training and registration are concerned, I fully support this Bill. In this Bill we have the exceptional phenomenon of the body and the psyche being covered by one Bill, because it is true that the body and psyche of a person cannot be separated. Therefore I feel that the registration of psychologists as well as doctors, should be covered by this Bill, even though the psychologist may not be a trained doctor. The psychologist is in fact, providing a related service.

Finally, I want to come to just one other point. I refer to clause 5(1)(b) in terms of which the hon. the Minister has the power to appoint persons to the Medical Council. When he considers these appointments, I want to ask him not to give an answer to this, but to keep in mind appointing, included in the people appointed by him, a psychologist who is a graduate and well educated and who enjoys the confidence of the profession as such. I want to ask that such a person fill an official position, possibly as chairman of the professional board proposed in this Bill. By doing so the Minister will strengthen the confidence in psychologists. Today we are of the opinion that we should not separate the body from the psyche. It is possible that this professional board may develop into a statutory body at a later stage, although much water should pass under the bridge before it will be able to stand on its own feet.

My appeal is for this Bill to be given a chance. The registration and training of psychologists is of primary interest to me. It is something which will lead to proper control of psychology and which will ensure that these things such as sensitivity training, the onslaught on our youth, the onslaught on people who are confused, who are mixed-up and who will run anywhere for help, will be rendered less powerful. Ideas such as brain-washing and the undermining of groups of our people will disappear altogether.

I ask for this Bill to be given a proper chance by us. It delights me that the Opposition has ranged itself on the side of this Bill. They might differ on a few points, but we could possibly rectify these at the Committee Stage. However, we should all agree as far as the principle is concerned. No law remains unchanged on the Statute Book for years. This is not the purpose with a Bill such as this either. Because health services develop and because the profession of the psychologist develops, amendments will have to be effected. Let us, therefore, accept the principle of this Bill and place it on the Statute Book. Then we shall be affording the hon. the Minister the opportunity of enabling the Medical Council to gain proper control once again over the psyche of man in South Africa.

Mr. Speaker, I have listened with great interest and care to the remarks made by the hon. the Minister himself and to successive speakers in dealing with this very important Bill which is before us. I say that it is important not only because it deals with significant professions but because by its very nature and character it touches the life of every person and will affect every one of us not only in this House but throughout the country. It is inevitable therefore that many people will have watched with great interest the changes proposed in this Bill before the House. It is regrettable that so many people reacted to this Bill without having read it. Because it affects one so closely, it is understandable that many people will be concerned that this be the very best Bill possible under the circumstances. Unfortunately, the reaction initially was quite hostile from many circles. Previous speakers have already referred to some of these reactions. I think it is even more regrettable that the hostility in some directions towards this Bill is present up to today. Instead of the acceptance of certain changes by the hon. the Minister giving reassurances, there are still some people who are agitating against this Bill in its totality and with more specific reference to certain clauses. We in these benches support this Bill in principle and, indeed, support it very strongly. We believe that it is very necessary that there should be …

Will you repeat that?

I should like to repeat what I have just said for the benefit of those members opposite me. I say that we support this Bill in principle and support it very strongly indeed. [Interjections.] If I could just make sure that hon. members have heard me correctly, then I can proceed. The kind of opposition that has been forthcoming in respect of this Bill has emanated from two sources. In the first instance, there have been those who from ignorance and because of rumours have reacted to its contents. Once having read the Bill and having talked with informed people, I think that they will gain reassurance. I have been particularly impressed with the remarks of the hon. the Minister today. However, there are those who are very disturbed by this Bill and they have every right to be disturbed because they will now have to comply with strong professional and ethical standards. We believe that this is absolutely correct and as it should be. Inevitably, however, as one can expect in the case of such an important Bill, there are some aspects of the Bill with which we disagree, not as far as the principles are concerned but the wording of some of the clauses, and therefore we will seek clarification and make certain proposals by way of amendments in the Committee Stage, proposals which we hope will make a contribution towards the possibility at least of making it an even better Bill than it is. We hope, therefore, that when we do move these amendments in the Committee Stage, they will be regarded as an attempt to build on to something which is essentially and fundamentally sound.

Mr. Speaker, I referred to the reaction to this Bill from a number of areas and circles. This reaction has been very strong indeed. Several of the previous speakers have referred to the letters, the memoranda, the telegrams, telephone calls and personal representations that they have received and which are still coming in even today. I was very disturbed, Sir, to receive only this morning a newspaper, if it can be described as that—I assume that it is registered, but I am not sure; I have never seen a copy of this before—which goes under the title of “Total Freedom”. I hope that the hon. the Minister and his staff will take a look at this sometime because I think the statements made there are very exaggerated and can be very harmful. For example, right at the top, in the left-hand corner, it is said of this Bill, “mental illness is banned”. Well, Sir, when I look around me I wish it were. Unfortunately this is not true, especially as it serves to discredit what the Bill is trying to do. The main headline states—

Then it quotes letters from the various churches, including the Nederduitse Gereformeerde Kerk. Sir, this is to be deplored and one would hope that members of the public, when they pronounce on this Bill, will do so in terms of the provisions of the Bill itself and not in terms of what they think it is trying to do. I believe that adequate safeguards have been provided to allow the kind of freedom which we enjoy at present. Sir, I would like to underline one phrase to which the hon. the Minister himself has again referred today, and that is the phrase “for gain”. This is the one phrase which seems to have eluded so many of the readers of this Bill. Where people are practising for gain, it seems perfectly right that professional and ethical standards most be maintained, and that is why we believe that this Bill is right. Where, however, people are attempting to give service of various kinds to other people, not with the motive of gain but as a service organization or as a church organization, it seems to us in these benches that there are adequate safeguards which make provision for such services.

Sir, when we turn to the Bill itself, we will suggest, as far as the definitions are concerned, since the Bill deals so directly with psychologists and psychology, that it might be more advisable to speak more specifically in terms of “clinical psychology” rather than simply using the word “psychologist” itself. Obviously there is a vast difference here and it may improve the Bill and make it easier to understand if this were defined even more narrowly and more carefully than the Bill does at the moment. Then, Sir, to try to give some reassurance to people who are still concerned in terms of church work, I wondered whether we could not find a better definition for “church” or for “religious organization”, but I appreciate that this is a very difficult thing to do. We have been trying to do it for thousands of years and I do not think anyone has really succeeded. It seems to me that clause 37, which refers to “the performance of any act by a person holding office in a church which exists for the purpose of the worship of the Almighty God, provided it is performed for that purpose and in accordance with the normal pastoral practice of that church”, does cover those people who are attempting to regard man, as the hon. member for Caledon was saying earlier, not as separate components but rather as a whole and therefore as not only body and psyche together, but also the body and the spirit. There has never been any attempt in any church, whether it be the Dutch Reformed Church, the Roman Catholic Church or even the mere Methodist Church, to divorce the spirit from the body. It does seem that if one can find some way of trying to make that a little clearer, it will give greater reassurance to some people who are still a little dismayed that it may affect the kind of work they are doing.

Then we come to clause 17, which I think is another very important clause. We deal here with registration as a prerequisite for training, which is absolutely right. Here again the right to practise for gain is made subject to registration in terms of the Act, with some exceptions, and the exceptions are stated clearly in subsection (1). These relate to nurses, chiropractors and pharmacists; and the homeopaths are dealt with in a separate Bill which will come before this House. There the saving clause is provided. But one asks the question, on a point of clarification and information, as to whether this Bill adequately covers the provision and the existence of other agencies which may well be of a very helpful character and nature to man in his need. I refer, for example—and I hope this will not be regarded as being facetious—to an organization like the Weight Watchers. Now, the hon. member for Krugersdorp, in his maiden speech, one I will never forget, reminded us of the very real dangers of obesity, and one only has to look around, and not necessarily in front of me to realize that this is a danger and that it is something we really have to be concerned about. Now, what about these people? Do they or do they not provide a useful service? And, if so, is adequate provision made for groups such as this? Obesity, having listened to my learned colleague on my left, is presumably an illness or defect and one which is quite common these days. I should like to have some clarification on that point as well.

Reference has already been made by several hon. members to clause 5, which obviously is a very, very important clause of this Bill. I would support the hon. member for Rosettenville in his opposition to the clause in its present form. I listened with real interest and attention to the hon. the Minister, but I am not yet persuaded that the reduction in size is the best alternative facing us at this time, particularly when the S.A. Medical and Dental Council itself, the Medical Association of South Africa and the Dental Association of South Africa have proposed, quite independently, from each other, the exact opposite, i.e. the extension of the membership rather than its reduction.

In regard to clause 37 there has been concern expressed by a number of social workers and I think that they have a case. I think that in subsection (3)(d) an attempt is made to enable registered social workers to continue to practise their profession. When we come to subsection (4)(b), however, it seems to qualify subsection (3)(d) of clause 37 by stating that subsection (3) (d) should not be construed as authorizing—

I am not going to go into the exact definition in terms of the Mental Health Act, but it does seem a very, very wide definition indeed. If the Bill does become law, there are some social workers and professors of social work at certain universities in our country who are under the impression that it will make virtually every social worker potentially liable to prosecution. They may be wrong in their understanding or in their perception, but I think we have to deal with the fact of it at least. The clientele of most social workers includes such persons as the alcoholic where there is very, very real mental illness, the drug addict, the ex-prisoner, the retarded child, the unmarried mother and so on. All these people have not only a physical need, but obviously a mental need as well and the people who are often closest to them are the social workers, the psychiatric social workers. I hope that when we come to these particular provisions, the hon. the Minister will give very careful consideration to the amendments which we shall move to try to alleviate the fear which is in the minds of some fairly highly professional and well-qualified social workers and teachers of social workers in our universities.

There is only one other point that I should like to make. The added powers which this Bill gives the Minister seem in our judgment to be excessive. I speak now not personally, of course, of the present hon. Minister, but to the Minister in terms of his office. We would hope that some consideration be given to and another look taken at this extension of power as well.

Many of the points, understandably, have already been made by other speakers and I should not like to take the time of this House in repeating what has already been said. I have sought merely to say two things, namely that we would support this Bill, but that we have certain questions, certain problems with some of the clauses. In the Committee Stage we shall try to meet them in some of the amendments which will be before the House at that time.

Mr. Speaker, shortly after the recent election I actually started looking forward to this session since we were approaching a session at which a whole number of representatives of the Progressive Party would be present. I find myself in the position that this is the second time this session that I am the next speaker after the hon. member for Pinelands and that this is the second time that I have to compliment him. I think the hon. member has made a very constructive contribution and I, too, want to confine myself to a large extent to certain aspects of the criticism that has been expressed on this Bill.

Hardly ever, or never, I think, in the history of medical science in South Africa or in the history of legislation in this House of Assembly has action been preceded by so many misconceptions or facts having been wrested out of context to the extent that has been done in respect of this legislation. Fortunately, this attack came mainly from a limited group of people who apparently have the financial means and the publicity media to wrest certain aspects of this Bill totally out of context.

Many of the attacks were seriously libellous, not only in respect of persons but also in respect of honourable professions which have proved themselves through the years. These are professions which, in my opinion, have upheld the highest ethical codes. In my view, these people did their own cause much harm through this action, for at this stage, as a result of this hysterical attack, I have very serious misgivings about their own motives. Most of the articles were absolutely larded with the biggest trash. Although I myself have a critical attitude to life, and am very often critical of my own profession, the medical profession, and although I am also an advocate of human rights within the bounds of responsibility and the maintenance of an orderly social system, I can find no grounds in this Bill which justify these objections that were raised. That is why I am going to test a few of the objections that were raised, against the provisions of this Bill itself. Before doing so, I should like to associate myself with what the hon. member for Fauresmith said when he broke a lance for the Press. I just want to add that in my opinion the Press acted extremely responsibly in spite of the agitation which was started here. Let us at least in this instance grant the necessary recognition.

The first objection is that the medical profession is allegedly obtaining a monopoly. I think the Minister has already replied to that, but I want to make a few more remarks in this regard. The other aspect they mention in regard to the monopoly relates to the treatment of illnesses, mental aberrations and health services. In a certain sense most professions in South Africa do have a monopoly in respect of the practising of their professions. I want to mention the example of architects who are registered with the Architects’ Association and have the exclusive right to practise that profession. But in the case of the medical profession it is, in fact, not the case. After all, numerous exceptions exist in various other Acts of this Parliament. I mention, for example, the Pharmacy Act, the Nursing Act, the Chiropractors’ Act and other legislation which has also been mentioned here. In addition there is the whole field of the so-called fringe medicines. I should also like to point out to you, that there are specific exceptions in the Bill in respect of the practices which people in the medical profession may carry on. I am referring here, in particular, to clause 17(b), to clause 37(3), (4) and (5), as well as other clauses in the legislation. It is also the policy of the Government that any well-ordered, self-disciplined professional group that is able to identify itself and to put a proper case in terms of existing legislation, may enjoy statutory recognition or at least a code of directives in respect of new legislation that can be introduced for them. Consequently I am of the opinion that the objections in this regard fall away altogether, particularly in the light of the fact that between 40% and 50% of all doctors are associated with either State institutions or provincial administrations where they practise their professions under an entirely different dispensation. What is more, because of the services created by the provincial administrations at institutions, the patients also have a free choice to go to the out-patients section of any hospital and receive the necessary medical treatment there. In most cases, when a person is indigent, he can obtain medical services entirely free of charge. That is why in this case any thought of a monopolistic system need not be taken into account at all.

That the medical profession is not capable of taking into account the influence of the psychological factors which influence the curing of diseases, i.e. the psychological factors falling outside the medical profession, is a statement made by these people. This statement is made in an article written by one Prof. William James, back in 1898, when he opposed legislation in the American Parliament which also related to the medical profession. I think that conditions in the world in respect of medicine have changed completely since 1898, and that this no longer is a valid argument On the contrary, if this is the case, it is all the more necessary for the profession of the psychologist to come under the wings of the Medical Council, so that one may have proper co-ordination. Cognizance should, however, be taken of the fact that modern medical science has, particularly during the past 20 years, progressed tremendously in respect of knowledge relating to so-called psycho-somatic medicine which relates particularly to the influence of the mind on the body. Today effective treatment in this regard is already being undertaken by medical science in a large variety of diseases; not only by means of psychotherapy, but also by means of substances which have a selective effect on certain areas and functions of the brain. We are dealing here with a totally different situation. In fact, this aspect of medicine has developed into a highly sophisticated science. The latest break-throughs in respect of research in connection with the brain, the thinking processes and the functioning of the brain are really breath-taking, in the light of discoveries made in respect of enzyme action, the chemical processes in the protoplasm of the cell nucleus, which is enriching our knowledge to an increasing extent on the function of the brain and psychology. I think one of the hon. members who spoke before me already gave much clarity on this aspect. Nowhere, however, is there any indication that this Bill is intended to give the medical profession a monopoly in respect of the control of the thoughts of man or to take over the normal ecclesiastical or religious function of man. On the contrary, I think it has already been clearly pointed out that this is not the case.

A further accusation that has been made is that the right of the individual to exercise his free choice is being restricted. To me the following counter-question immediately arises: Whom does the individual want to consult in connection with a particular illness or mental condition that he cannot already, in any event, consult in accordance with our practices in South Africa? He has the right to consult a doctor privately or at a provincial hospital. He has the right to consult a psychiatrist, or his clergyman or any other member of the clergy in the service of the Church. He has the right to consult a social worker, chiropractor, homeopath, osteopath or any other person who practises the so-called fringe professions in medicine, persons who may be consulted and who fall under an association bound by an ethical code. I think that this is the norm we should apply in the future in South Africa as well. We just want to tell the objectors that we as a Parliament and as the Government of this country have a responsibility not to allow the public to fall entirely into the hands of totally untrained persons, exploiters and persons who even have questionable motives. The State has a responsibility and the Government has a responsibility and that is why we shall proceed with this legislation. We should have regard to the fact that, with the development of psychology in modern times, it has become possible for man to undergo serious personality aberrations by means of sensitivity training, brain-whashing and other methods. In these ways the values and the norms of people can be changed artificially, with serious social and political implications. The State has a great responsibility indeed to ensure that the public are not exploited in respect of these practices. In my opinion this Bill still leaves the door too widely open. When we look at clause 37(3)(e), we see that there are certain exemptions which are being granted under this legislation.

The attacks of these people on the psychiatric profession were absolutely shocking and I should like to say something about that. I do not want to contend that there are no deficiencies in psychiatry; on the contrary, we have the serious situation in South Africa today of having to contend with a dire shortage of psychiatrists. These people are working under tremendous pressure. However, the conduct and actions of psychiatrists are controlled not only by the Medical Council, but they also act in terms of the provisions of the Mental Health Act. Consequently they are guided by that Act to a very large extent as regards their standards of professional conduct. The Mental Health Act lays down the procedure of certification most meticulously. At every institution for the mentally ill there is a statutory hospital board. Any patient or member of his family is at liberty to appear before this board and make out a case for his discharge. In that case people outside the psychiatric profession may question the patient and may then determine whether he does in fact have the right to leave such an institution. The psychiatrist in South Africa does not have an easy task and I do not think we should make their task more difficult by making such undesirable attacks on them. It speaks volumes for psychiatrists that the number of discharges from mental institutions or institutions for the mentally ill in South Africa is at least as large as that of any ordinary general hospital. I am referring here to patients who are discharged after they have made a complete recovery. We should definitely take cognizance of that. After 13 years’ experience of general practice, I can tell hon. members that in my dealings with psychiatrists I have received only the best service and that the people providing that service are people well equipped for their profession. A psychiatrist is presented as a creature who is mentally ill himself and who is intent on exploiting mental aberrations for financial gain. I think this is really disgraceful.

There are also certain objections in regard to the representation of the professions by the Medical Association on the Medical Council. I should like to say something on that aspect as well. If we express the number of members in terms of the existing Act as a percentage of the total number in the council, we shall see that approximately 42% of the total council were representatives of the Medical Association. In terms of this Bill it will be 36%. In other words, in order to keep the percentage the same, there will have to be only one extra person. I think it may perhaps be necessary for us to look at that aspect in the Committee Stage for I do not think it would really make any big difference in respect of the composition of that council if that percentage ratio were to be rectified by the addition of one single person. This Government is always prepared—and I am also saying this to the Medical Association —to listen to people’s problems. I do think, however, that we should first give this legislation a chance of proving itself. If there are problems we can always look at them again. We should just not disregard the fact that this Government is not prepared to evade its responsibilities in respect of the professions in South Africa and in respect of the protection of the public.

Mr. Speaker, all the members who have taken part in this debate so far have indicated their full approval of the proposed legislation. I think it is indicative of the situation in South Africa today that this House is able to come to a unanimous agreement in principle on an important issue which in its early stages, when the draft Bill was first published, caused a great deal of anxiety and concern amongst churches and religious bodies and other sections of the community. I think that the Bill as it now stands is certainly an improvement on the 1973 draft legislation. We on this side of the House intend moving certain amendments which we believe will further improve the Bill as it now stands. The question of attaining higher standards and of exercising a degree of control over medicine and supplementary health services is indeed an issue of great concern to all the inhabitants of this country. Consequently, it is our task as the official Opposition to be vigilant in respect of the practical applications of the various provisions of this legislation. I refer particularly to the special provision that is to be made for psychologists, to the definitions that are set out to determine the field of the psychologists, to the evaluation of persons and so forth. These are matters which should of course be in the hands of persons who are properly trained and qualified to undertake such tests. In several instances we see that reference is made to psychological tests and to the question of the treatment of mental illnesses. I think that the hon. the Minister in charge of this Bill could perhaps, when he replies to the debate, give a further indication of what is entailed in respect of the definition of psychological tests and the treatment of mental illnesses. I mention this point because it is obvious that the hon. the Minister does not wish to hinder the work in other spheres of other professions which might to a certain extent overlap with the work of a psychologist. I refer specifically to the position of the registered social workers who are trained persons in terms of their own Act. I am referring to the National Welfare Act of 1965, an Act which was passed unanimously by this House. This Act grants professional status to the social worker who has been trained in this particular type of work. They have a university degree and at one university where they had a post-graduate course, they were able to qualify as psychiatric social workers. These people are playing a very vital role in the overall treatment of mental illness. We know that last year we passed the Mental Health Act, 1973, which defined mental illness. It is evident that there are persons other than psychologists who are also trained to carry out this work. Some degree of control over the training of such persons, the carrying on of the profession of psychiatrist, and other supplementary health service professions, is one of the main objects of the legislation before us.

In order to indicate the effect that this might have on the training of these people, I should like first of all to refer to the report of the Commission of Inquiry into the Mental Disorders Act, known as the Van Wyk Commission. Its report was tabled in this House [R.P. 80—’72] and subsequently legislation was introduced which culminated in the passing of the Mental Health Act, 1973. Paragraph 2.15.1 on page 21 of this report has the following to say in relation to social workers—

The report goes on to indicate the importance particularly of the psychiatric social worker and other social workers in regard to the after-care of persons suffering from mental illness and the motivation of the patient to undergo treatment. The report also indicates the tremendous shortage that exists in South Africa of this type of worker. Paragraph 2.15.12 on page 23 of the report has this to say—

I think that this indicates the great importance that the Van Wyk Commission attached to this matter and particularly to the shortage of psychiatric social workers in South Africa. Paragraph 2.15.13 on the same page states—

I think that this will indicate to the House the importance of the role played by the psychiatric social worker. That is why we must endeavour to see written into the Bill certain provisions which will ensure the unhampered continuation of the training and education of these people and indeed the expansion of the facilities for the training of psychiatric social workers. During the course of his Second Reading speech, the hon. the Minister indicated that he did not wish to alter the situation in any way, the existing situation, as far as social workers were concerned. He has stated that in clause 37 of the Bill he has made specific provision for the exclusion of persons who are registered as social workers.

The hon. the Minister has also placed on the Order Paper amendments that he intends to move to clause 37. Obviously in the Committee Stage we will have a greater opportunity to discuss these amendments and the contents of this clause. Then, Sir, subclause (4)(b) provides—

1. (b) in the case of a social worker referred to in paragraph (d) of that subsection, the conduct of a psychological test or the treatment of a mental illness as defined in section 1 of the said Mental Health Act.

I think it is important that the hon. the Minister should give the House some indication as to the implications and the practical application of the provisions of this particular paragraph, in so far as the conduct of a psychological test or the treatment of a mental illness is concerned. I think it is important to ensure that these people will be able to continue with their work. I am sure that the hon. the Minister endorses this view. I believe that these people have a very important role to play in South Africa and that every effort must be made to make it quite clear in this legislation that they will be able to continue with their training and with their work. After all, these people are trained professional people whose work is complementary to the work undertaken by psychiatrists and the work undertaken on a psychological plane for persons suffering from mental illness.

Sir, there are other aspects of this Bill in regard to which some people have expressed concern and anxiety. I want to refer here to a group of people who feel that they may be affected and I hope that the hon. the Minister will give some indication as to whether their fears are groundless or not. I refer to physical culturists, many of whom have health studios, where they endeavour to give physical, remedial treatment to persons who have suffered physical disabilities, often as a result of road accidents and, in other cases, the aftereffects of poliomyelitis and other crippling diseases. As far as training is concerned, the Bill makes provision in Chapter II, clause 16, for certain acknowledged training. There is some doubt here as to whether people who are personally undertaking this work are in fact giving treatment to people who are suffering from some physical disability or defect. This question of the training and registration of these people is particularly important, because subclause (4) states that—

Subclause (3) provides that the council may grant or refuse any application made in terms of subsection (2). I believe, Sir, that many of these people are undertaking important work in the health field, work which is beneficial to the community as a whole, and I hope that this Bill will ensure that the supplementary health services rendered by these people to the public are of a high standard which will meet with the approval of the Minister and, of course, of the proposed council. This is particularly important because in terms of this clause any decision made by the council shall be final; evidently people affected by any decision made by the council will not be able to appeal directly to the Minister for his intervention if they should feel that the council has treated them unjustly.

Mr. Speaker, I believe that this Bill is a milestone in the health services which are being provided for the people of South Africa. It is indeed an important piece of legislation, and I believe that all racial groups will benefit by the higher standards which this legislation will ensure, particularly in the case of non-Whites who are qualifying in increasing numbers in the medical profession as well as in the supplementary professions. This Bill will ensure that a high standard is maintained in the interests of the community as a whole.

After listening to my hon. colleagues on both sides of the House, I honestly thought that we should call this legislation the stop-and-think legislation. It really made me wonder, in these times in which we are living, whether we have not been doing some running away. The original legislation was passed in 1928. At that time there was no such thing as a psychologist, nor was there any such thing as a psychiatrist, nor was there any such thing as a physiotherapist. There were hardly any of these things which are so essential in life at the present time. And the question which springs to mind now, is this:

In 1928 this body was no more than a council to tell just a few doctors they were permitted to do this or that—a few basic things to control them. But as a result of what has happened now, it is necessary for this council to be transformed into a completely different organ, for clause 3(a) now reads “to assist in the promotion of the health of the population of the Republic”. This council is no longer a professional council as it originally was. It now has a responsible task and, in the final analysis in (e) it has to communicate to the Minister information on matters of public importance acquired by the council in the course of its functions under this Act.

Therefore, before making any further observations, I personally should like to pay tribute to this council which has been in existence for 45 years. Sir, do you know that the National Party thinks it is the most stable party because it has had only four Prime Ministers from 1948 up to the present time. But the Medical and Dental Council has had, from 1928 up to the present time, only three chairmen. I feel very privileged to be able to say here that the son of the very first chairman, the late Dr. Bremer, was a teacher of mine; and I am privileged in being able to say that the second chairman, Professor Oosthuizen, was also a teacher of mine, and I am also privileged in being able to say that the present chairman was also a teacher of mine.

I have a little background as far as this is concerned, Sir. [Interjections.] That is why I want to state clearly that this no longer is a professional council. Its task is much wider; it has far more responsibilities. I find it a pity that there is criticism from the Medical Association to the effect that they are being regarded as a monopoly. As regards the composition of the council, I want to point out that there will be 25 members henceforth. According to the procedure which will be followed with the composition of the council in the future, 17 of the 25 members will be doctors. However, a member does not serve in the council purely by virtue of his being a doctor, but may serve in the council by virtue of his capacity as dean of a medical faculty or as director of hospital services. Basically, however, such members will remain doctors. I am sure the Medical Association need have no fear that its members will be pushed out of the council.

Many facets of the Bill have already been dealt with by my hon. colleagues. I want to make a few remarks about training. Arising out of what I said by way of introduction to my speech, it is important —the hon. member for Caledon also referred to it in passing—that while the council will be controlling training and giving direction to it, it will have to give attention to the demands of the times in which we are living. Training will have to be adapted in this sense that we as doctors will have to give much more attention to psychology in order to be able to fulfil our function properly. We shall have to give far more attention to sociology and human relations than was the case in the past. For that reason I want to plead that when the council constitutes a committee which will be charged with the planning of medicine, attention will be given to these aspects.

There are also a few other matters I want to raise. The South African Medical Council is also concerned in the application of disciplinary measures. I have already told the House what my connection was with three previous chairmen of the council and therefore I can give the assurance that since the council has the right to punish, reprimand or remove someone from the medical register, temporarily or permanently, I have heard on numerous occasions the fatherly attitude adopted by the chairman when a colleague is involved in a disciplinary investigation. I am now speaking of disciplinary steps in respect of infringements of the code of ethics of the profession. In such cases the chairman acts as a judge in pronouncing a judgment on a colleague. I have come across a number of cases in which, when the accused appeared before the disciplinary committee of the council, the chairman gave him another chance to explain why he had acted as he did. The chairman does this in order to make sure whether a good excuse might not be found for the accused’s action before judgment is passed.

As regards other committees which may be appointed, I want to point out that my colleagues in the medical profession and members of the Medical Association need not be concerned that their status will be diminished in any way. They need not be concerned that they will have no say in matters affecting them. They should rather share our concern for the health of our people in this country. Many more committees will have to be appointed and we cannot expect that all the members of the council should always serve in the various committees as well.

Another very important facet of the legislation is the concessions being made in respect of foreign doctors, i.e. doctors from abroad. In the past we had agreements with certain countries solely on the grounds of reciprocity. There first had to be bilateral agreements before doctors from other countries were allowed to practise here. The position is now being changed in such a way, however, that such doctors will be allowed to practise here irrespective of whether or not their countries of origin recognize our medical degress, for even if they did not recognize ours, we can recognize theirs provided certain conditions have been complied with. This is a very positive step.

I want to conclude by saying that we are very grateful for the support from the opposite side of this House. I am just saying that although we still have problems, I have not yet seen any completely effective legislation in this House of Assembly. There is one area in which one can never act completely effectively, and that is in respect of the human body. It makes no difference what measures one adopts, one aims for the ideal, but one can never get complete satisfaction. That is why I am asking that we should view this legislation in the light in which it has been introduced. We should also view this legislation against the background of the times in which we are living and those needs which we find essential.

Mr. Speaker, I am not going to speak for very long on this Bill. As my hon. colleague, the hon. member for Pinelands, has indicated to this House, we on these benches are supporting this Bill in principle. There have been several speakers before me and they have covered most of the important points. However, I do want to say one or two things in order to allay the dismay and anxiety that I thought I saw on the face of the hon. member for Rissik, and also on the face of the hon. member for Potchefstroom when he was here, while the hon. member for Pinelands was talking. There is no doubt that the announcement that we were supporting this Bill in principle created suspicions in the minds of those gentlemen that there would well be something seriously wrong with this Bill. I want to allay the fears of those hon. members and tell them that although we do support the Bill in principle, we do have reservations about the Bill as well. So that will probably make them feel a little better.

What interested me is that in introducing this Bill the hon. the Minister did not, at any stage, give any valid reasons for the reduction in the size of the Medical Council. He told us he was going to reduce it. He told us what the council consisted of now. He also told us what the council would consist of in the event of the Bill being passed unamended. At no stage, however, did he give us any real reason for reducing the size of the council. I was especially surprised because the hon. the Minister knows that this is a bone of contention between himself and the Medical Council. He has had representations from the Medical Association and the Dental Association and they have objected to the reduction in size of the Medical and Dental Council. I am also surprised at the tone of the hon. the Minister’s speech when he referred to the Association and to the Council. One would have thought that over the past years, since its formation, the Council had not served this country and the profession well, and perhaps more important from the hon. the Minister’s point of view, had not served the public at large well. He also seemed to think it was necessary for him to take new arbitrary powers in the control of the Council. For this, too, he gave us no really good reason. As far as these two particulars are concerned, we shall certainly be moving amendments in the Committee Stage, and we hope very much to be able to persuade the hon. the Minister that in this regard he ought to accept the advice given to him by the two associations that are most concerned with the management of medicine and dentistry in South Africa, i.e. the Medical Association and the Dental Association.

Why has the hon. the Minister reduced the number of members on the council by eight? I have drawn up a little balance sheet. I find that the overall reduction in the number of members of the council is eight. There was a new acquisition in the person of the Secretary for Health, although previously he was no doubt ex officio. The same number of members will be actually nominated by the Minister, but instead of five medical practitioners, he will now nominate only four medical practitioners and one member from a faculty of medicine or dentistry. The number remains the same but the composition is different. A Director of Hospital Services from one of the provinces, nominated by the Administration, is also a new acquisition. The universities’ medical and dental faculties’ representation is very considerably reduced from nine to four. In other words, five members have been removed. The Nursing Council loses one member. Pharmacy gains one member. The medical profession loses three of its elected members. There are now only seven. The dental profession’s elected members are halved. That is a very considerable change, and I do not think simply announcing what the new council is going to consist of should be sufficient to persuade the House, or the Committee as it will be, to accept these very material changes, more particularly as there have been definite protestations by the two associations most concerned. These bodies wanted an increase in the number of members of the council. They wanted an increase more particularly as far as the elected members are concerned. They certainly at no stage proposed to hand over the powers to the hon. the Minister which he is taking in this Bill in clause 61.

The full council only meets twice a year for three or four days. The executive meets more often. Most of its work is done by smaller committees, committees from the council itself, not committees which are now to be formed, under clause 11, from outside the council, under the chairmanship of a member of the council.

The work of the council, as has been pointed out by other members, has greatly increased over the last few years, owing to the increasing number of doctors and dentists, and also, I might say, owing to the increasing number of supplementary health services personnel, who are also registered by the council. The associations recommend that more members are needed on the council to cope with this increased work, to serve on committees, and to prevent the inevitable delays that are going to take place in the functioning of the committees if they have to rely on a smaller number of people to do the work. Also, of course, the more members you have, the broader the spectrum of expertise, experience and knowledge. The hon. the Minister’s explanation that he is setting up sub-committees outside of the council I do not think is a very good substitute for a larger council, then dividing into smaller councils of its own members. Under the Minister’s scheme, there is not going to be a direct line of communication between the actual members of a committee and the council. Everything is going to be done through the chairman. I have no doubt that he will attempt to convey the views of the subcommittees to the best of his ability; but it cannot be as good as direct communication between the council itself and members of the sub-committees, who ought to be on that council, so that they themselves can express their views. Sir, we are going to move amendments which we hope will offset the changes which the hon. the Minister is proposing in certain clauses in this regard.

I might also say that the council is financed—the hon. the Minister can tell me if I am wrong, but I think that it is pretty well self-supporting—from the registration fees which the members are charged, and from the examination fees of aspirant members, i.e. would-be doctors, writing examinations, or persons who are specializing and writing examinations. I believe it is entirely self-supporting from these fees. So it is not as if the additional members on the council will mean an additional amount to be voted by the Government in order to finance meetings of a larger council.

There are one or two features regarding the actual composition of the new council which I find rather peculiar. Why lay down maximum representation from each province as far as elected members are concerned? Surely the more democratic procedure would be to lay down minimum representation from each of the provinces concerned, as in fact the situation is under the present Act. I am not too sure why it is necessary to have a member of the Pharmacy Board serve as a full member on the council. This could be acceptable for liaison purposes, such a member to have a vote in the proceedings of the council when matters affecting pharmacists are at issue. However, up to now, the council appears to have managed fairly well without this additional member. The hon. the Minister, while increasing the membership by a pharmacist, is reducing the representation of the faculties of medicine and dentistry of the universities, which are intimately concerned with the training of doctors and dentists, and also the supplementary health services personnel. I think that this is one of the bad features of this legislation. Reducing the number of people from the faculties of the universities is going to reduce the influence of the profession and of the universities themselves. The profession’s representatives are reduced from 14 to 9 and the universities’ medical and dental faculty representatives are reduced from nine to four. To me this too is something which the hon. the Minister has not justified in any way in his Second Reading speech.

Then, perhaps as serious, is the granting of much greater power to the hon. the Minister in terms of clause 61(2)(a) and (b). There has been some alleviation by virtue of the amendment to clause 61(1) which the hon. the Minister has placed on the Order Paper, but clause 61(2) is materially unaltered since the hon. the Minister’s amendment simply says: “after consultation with the executive committee of the council”. He may go ahead and make any regulation he likes. We have had many experiences in this House of the use of the phrase “after consultation …” It does not mean a thing because the hon. the Minister does not have to take any notice whatsoever of the advice he is given. It is only if he is bound by the law to accede to the requests made to him by the council that such an amendment has any force whatsoever. I propose to move an amendment to that effect during the Committee Stage.

I just want to say one final thing and that is that I am surprised that nobody has mentioned that this Bill is really implementing the proposals, of, inter alia, the Kotzé Commission. I presume that I am right in that respect.

It is implementing the proposals of various commissions over many years.

Well, I said “inter alia’’ and that includes others. The phrase “inter alia” is a very valuable phrase which serves to cover a great deal of ignorance on my part. However, this is how I read it and I have been wondering when the Government was going to take steps to implement the recommendations of the Kotzé Commission. It seems to me that clauses 36 and 37, which control the practice of psychology by untrained persons, have now brought such practice under the purview of the council, and that means that stricter control will be exercised in future. I believe this is the right thing to do.

With those few words, I repeat that we support this Bill and I hope that the hon. member for Rissik feels a little bit better now that I have at least expressed some criticism on the contents of the Bill.

Mr. Speaker, it is not every day that so many speeches pledging support for a Bill are made during a Second Reading debate. I expected that we would receive support from the United Party because I know the hon. member for Rosettenville well, and have great respect for his judgment. The only pity is that he is not always able to display this good judgment of his in politics. The surprise for me, however, came from the Progressive Party. When the hon. member for Pinelands rose to pledge his support for this legislation, I saw that the members on the Opposition side of the House were almost falling out of their benches. Personally I found it very difficult to believe. I had a reservation. My reservation was that I should first like to hear what the hon. member for Houghton had to say before I could believe that that party was pledging its support for this legislation.

I hope you feel better.

This has now placed me in the difficult position that I have to believe the hon. member for Pinelands and shall have to be careful in future and consider very carefully when to believe him and when not.

Don’t spoil it.

I hope the hon. member did not misunderstand me. I think he ought to have understood me correctly: it was a compliment I was paying him. The support which was given to this Bill could, however, still lead to that side of the House perhaps not believing that this side of the House supports this legislation so unanimously. Because five medical practitioners on this side of the House had to pledge their support for this legislation, I, as the only layman have to confirm, from this side of the House, that we do in fact support this legislation. I think that it is a very great compliment to the hon. the Minister and that he and his department deserve our congratulations for having come forward with legislation of this nature which was able to enjoy such unanimous support in this House.

In the past years the world has experienced a scientific development which was almost beyond comprehension. In this development medical science did not lag behind. In the great development which took place in the field of medical science, South Africa played a very prominent role. In fact, the role which South Africa has played in medical research during the past few years has placed South Africa in the forefront of the scientists of the world in the medical field. If we look around us we see that it often happens—yes, very frequently —that some of our medical scientists go overseas, not only to attend congresses and symposiums there, but to play a leading role at those congresses and symposiums. Today almost no international medical congress is held in the world at which there are no medical scientists from South Africa delivering addresses and acting as chairmen of works committees there. It is greatly to the credit of South Africa’s medical scientists that we are able to boast of this.

The great task of medical research rests mainly on the shoulders of those who are in the service of the State. This evening I want to pay tribute to our medical practitioners who are medical researchers in the service of the State for being able to achieve these wonderful results for South Africa, particularly if cognizance is taken of the fact that these people cannot compete economically with their colleagues in private practice. It is a great honour which those people, despite the disadvantage which they have in comparison with those in the private sector, are nevertheless conferring on South Africa. That is why I should like to avail myself of this opportunity to pay tribute particularly to our medical practitioners who are in the service of our State, and who are giving their lives to this.

It goes without saying that since we are experiencing this scientific development, any country must seize the benefits this entails and apply these in the best interests of the population. That is why it has become necessary for us to have new legislation which can adapt to these new times which we are experiencing in regard to what medical science offers. Now it so happens, in medical science, that all developments which take place, all new developments, can be applied to the benefit of mankind. That is why it is not, as in the case of other sciences, where what emerges from that development may be applied for the destruction of mankind. Medical science, however, is aimed at serving mankind. Because this is the case, any Government must seize this opportunity to utilize what this scientific development offers to best effect. That is why we have this Bill before us.

To my mind there are two very important principles in this Bill. In the first place it provides that everything which science offers can be applied on behalf of and to the benefit of mankind. It may be applied by way of this council which is being established here—through the constitution of the board and the persons who will serve on this board. In the second place, it goes without saying that since we are experiencing this development in medical science and are being offered new developments every day which could be applied to the benefit of mankind, protective action will be taken on behalf of the people of the country, and against those who exploit the sufferings of people for their own benefit. We also find this in the Bill. There is, for example, protection of people against charlatanry. To adapt to modern circumstances and to these modern times in which we are living, therefore, it is a good thing that these clauses in respect of psychologists have been inserted in this Bill. In these modern times in which we are living mankind is placed under tremendous pressure. This pressure under which mankind is placed, results in tensions and these tensions with which people have to cope every day, result in psychological problems, problems which find an outlet in the abuse of liquor, suicide etc. To us who are responsible for all developments, and all sectors of the political economy, it is very important, however, to note that as these tensions have a psychological effect on our people, so they have a detrimental effect on the manpower of a country. Because it is the case that our people are being subjected to ever-increasing tensions and psychological problems, it is obvious that the charlatan will come forward to exploit this situation to his own benefit. I am therefore very pleased that this step is being taken in the Bill to prevent, at such an early stage already, the psyche of a person from being exploited and abused to the advantage of charlatans.

There is one aspect in regard to the constitution of the council to which I should like to draw the attention of the hon. the Minister. I am very pleased that provision is being made in the constitution of this council for a representative of the provinces to serve on this council. The provinces have for many years now been making representations to have representation on the Medical Council. Now this has happened for the first time, and it goes without saying that this is the obvious person, viz the Director of Hospital Services, who will occupy this position on behalf of the province. But, Sir, I think the intention was that this person shall be a medical practitioner. I want to draw the attention of the hon. the Minister to the fact that the ordinances of the provinces do not provide that it should in fact be a medical practitioner who shall be Director of Hospital Services. Therefore it could happen that the intention which the hon. the Minister and his department had with this Bill, could perhaps be thwarted in respect of this matter. I therefore want to suggest that a change could perhaps be effected and that it could be made a condition that this person shall be a medical practitioner. Mr. Speaker, on behalf of this side of the House I should like to confirm that the medical practitioners who have spoken here do in fact support this Bill.

Sir, we have now reached a late hour and this legislation has been debated with great seriousness by hon. members on both sides of the House and perhaps, Sir, you will permit me at this late stage of the evening to strike a somewhat lighter note. Before I turn to the legislation, I do want to say that we have had a strange phenomenon here today, and that is the extent to which the Progressive Party is now supporting the Government. You will remember, Sir, that we were told in the newspapers that they were coming here as the new dynamic Opposition. Apparently they were going to do all sorts of things to the Government; we were told that they were the new stars. Why, Sir, the hon. member for Parktown looks so dynamic, he is bursting from his skin. We were told that they were coming here as the new stars. I must admit that many of us felt then, and even now, that perhaps they are not stars but comets; that they will flash brightly for a while and then become dissipated and go into orbit and that we will never see them again. But be that as it may. Sir, here we had the strange situation today where they were supporting the Government. The hon. member for Pinelands made as effective a “Thank you, the Minister” speech as those that we get from the very experienced campaigners on that side of the House. Well, Sir, strange things happen. Perhaps there is some need for psychologists to deal with this situation.

Mr. Speaker, this legislation has been dealt with, naturally, by the medical practitioners, by a pharmacist, by a theologian and by the patients, or potential patients, and I believe that perhaps it is appropriate that the psychologists should also say something about this Bill because it deals also with psychology. Sir, it was suggested earlier on that it would be a good idea if in fact there were psychologists in the House, but perhaps the problem is precisely that we do have psychologists in the House.

They are only great politicians.

Sir, I am told by statisticians that the average life of a parliamentarian is seven years, and as I have just passed that median point, I suppose I could begin to consider myself as an older member. On the Government side we have the hon. Chief Whip of the Government who has also specialized in this field. He would be a much older member of the House than I am and I think it would be appropriate perhaps for the hon. Chief Whip on the Government side and myself to deal briefly with the role of the psychologist, because what is happening in this legislation is that the training and the registration of psychologists is regularized for the first time; in a legal sense it means that the psychological profession, has come of age, and I think that is perhaps why some views and thoughts on the role of the psychologist would not be inappropriate. Now the first difficulty we have with psychology is its definition. Indeed the first difficulty that most people have with the term “psychologist” is that they find it a difficult word to spell. But if it is difficult to spell, I can assure you, Sir, that it is even more difficult to define. Because of what is involved in psychology, psychologists have become the butt of much sarcasm and humour, and that is why it is said that one could describe a psychologist in the following way. They say that when ordinary people meet, individual A will say to individual B: I am quite well today, thank you; how are you? But if two psychologists were to meet, A would say to B: You are well, but how am I? [Laughter.] In America psychologists and psychiatrists are known as “head-shrinkers”. This has become a very lucrative profession because no actress or starlet who really aspires to fame can ever be without an analyst or “shrinker”, and as many of these young ladies have much more money than common sense, the psychiatrists are doing very well and find it a most lucrative profession. But I think there is a need for psychologists all over the world in this modern time. I happened to pick up the Argus of this afternoon, and all one sees there is “moord en doodslag”. It is a terrible world that is portrayed here. Look at the headlines; ’’people fleeing from Lourenço Marques. Exodus by land and sea.” “Troops operating in Lourenço Marques.” The main picture: “Victim of flight from terror.” “Haille Selassie deposed by army”. “Mutiny on luxury liner.” “Soldier dies in Walvis blast”. “69 killed in jet crashes.” The only little note to liven up the scene is right at the bottom of the page, where the headline is: “Marlene Dietrich says: ‘I have nothing to wear’.” [Laughter.] If we have this kind of world, a sample of which I have just given to you, you will see, Sir, why we do need psychologists.

The general definition of “psychology” is that it is the science which deals with mental and emotional processes, or to put it more colloquially, it is the science of mind and behaviour. But because people often have difficulty in distinguishing between a psychologist and a psychiatrist, you will perhaps permit me to say a few words on that issue. The psychiatrist, is concerned with the medical application of psychology. The psychiatrist is basically a medical man; he qualifies as a doctor and he then specializes in behavioural problems. The psychologist is not a medical man, he specializes entirely in behavioural and mental disturbances. The psychologist works with both the normal and with those who deviate from the normal. The psychiatrist tends to concentrate only on those who show mental or emotional aberrations of one kind or another. I think in Afrikaans we have the distinction made probably clearer, because the psychologist is normally “doktor”, but the medical man on the other hand in Afrikaans is called a “dokter”. They usually operate in conjunction with one another. Let us take a simple example such as stuttering. Assume that a child happens to stutter. If this child went to a psychologist, he would initially be in some difficulty because stuttering can be either psychological or organic, which means that it is entirely physical or it can be psychosomatic, which means that it is a physical symptom caused by mental strain. Now the very first thing that is necessary is obviously to ascertain whether there is an organic basis for the stuttering. This a psychiatrist could do, but a psychologist could not because he has not had that medical training. So if a child who happens to stutter comes to a psychologist he would have to refer the case either to a medical practitioner or to a psychiatrist for the initial medical examination before he would be in a position to undertake any treatment. I think it is important, particularly to people outside, that this distinction between the psychologist and the psychiatrist be clearly understood.

The field of psychology is fortunately or unfortunately not defined in this legislation, but it deals, generally speaking, with behaviour and with man’s adaptation to his environment. There is of necessity a whole set of different fields in which the psychologist could specialize. You have, for example, genetic psychology which is the developmental part dealing with children— the way they grow, the way they mature, the way they try to adapt themselves to the environment in which they find themselves. One has industrial psychology which deals with man in his work environment. This includes psychometric testing, vocational guidance and a host of issues of this kind. You have learning psychology which deals with the didactic considerations—why people learn and how they learn. You have psychopathology which deals with abnormal psychology. In this you have the three important fields: feeble-mindedness, the neuroses and the psychoses. In these fields you have specific terms. To the psychologist the word “idiot” has a very specific meaning. It means somebody who has such a low mental I.Q. that he is not capable of protecting himself against common physical dangers. In common parlance one frequently finds that someone may call somebody else “an idiot”. In this House, whatever my feelings might be on the subject, you, Sir, would prevent me from calling an hon. member an idiot. Strictly speaking that appellation would not be true because technically there are no idiots in this House.

I want to make just one other point too in this connection which I think may apply here. In the same way as you can get mental and emotional disturbances in the individual, so, you can also get them in a group or in a nation. That is why you very often find that groups or nations are associated with unusual forms of behaviour. There are very many people in South Africa who are knowledgeable who claim that we, as a society, run the grave risk of beginning to exhibit strong schizophrenic tendencies. “Schizophrenia” means “split-mind”. Perhaps you will permit me to indicate what I have in mind here. [Interjections.] I think an important factor here in South Africa is that much of our behaviour and the behaviour on that side of the House particularly is conditioned by the fear reaction. We realize that we are vastly outnumbered by other races of other colour combinations, and so one of the most important factors in our society is fear. Under conditions of fear the characteristic psychological response is what we call “the flight reaction”. If you are afraid of something, you get away from it. If you see a snake over there, you do not go to it and stroke it; the instinctive thing is to get away from it. This is precisely what the concept “apartheid” indicates. Apartheid is a flight reaction—you remove yourself from the object of your fear.

The etiology of this flight reaction is interesting, because the moment you have removed yourself from the object of your fear and stand away from it, it tends to look bigger. It becomes more gruesome, it becomes more fearful. This is, precisely what has happened in S.A. The next step in this etiology is what is called “the whistle in the dark” approach. You see, if you really are afraid, like a small boy, when you walk around at night, you whistle; you pretend that you are in fact not afraid. We get this kind of behaviour and we see this evidenced very often in S.A. The next step in the growth of the fear process is what is called the “Van der Merwe syndrome”. We must remember that Van der Merwe was the fellow on the parade ground who, when everybody was in step and he was out of step, claimed that everybody was out of step and that he, in fact, was in step. This is what is happening here too. How often have we not heard from that side that the whole world is wrong, but that we are right? That is what is called the Van der Merwe syndrome. Finally one comes to the last stage in this etiology of fear, and that is when one begins to develop strong masochistic tendencies. One then wants to become a martyr; one then says that one must fight for White civilization on the southern outpost of Africa. That kind of behaviour we also see manifested very often. So I think that one has a situation here in which fear on the part of a group has got to the stage where, if this were applied to an individual, one would call him deeply psychotic and lock him up. I would not know what you do to a whole political party.

I want to refer to one other aspect. An important purpose this legislation is to bring the psychologists together. Strange as it may seem, psychologists are also divided. I think we have this other divisive principle in South Africa. There are probably about a thousand psychologists in this country and they grouped themselves into a professional association called the South African Psychological Association. This worked well up to a certain point. Then some of the members of this association realized that some of the members of the Psychological Association were in fact Black. In the kind of society I have dealt with here, how could a good psychologist sit on a board or be in any kind of situation with another psychologist who happens to be Black? It was therefore decided that the Psychological Association ought to split. In this way SIRSA was formed, and SIRSA means “Die Sielkundige Instituut van die Republiek van Suid-Afrika”. I might just say that it is a very great pity that Dr. Verwoerd lent his support at the time to this break-away association. It is always a surprise to me that a man, who in so many ways was such a great man, should have had so many blind spots. This association nevertheless broke away so that even the psychologists in this country today form themselves into two groups. One has the Psychological Association which is multi-racial, or if it would help hon. members over there “multi-national”. And of course one has SIRSA which is all White. The difficulty which then arose was that it was all very well to be in splendid isolation as a psychological association, but you at least want external recognition. Outside bodies, however, particularly the International Union of Psychological Science, which is the outside body, recognizes the multi-racial body in South Africa but does not recognize SIRSA. So SIRSA continues to stand entirely on its own. In framing this legislation, however, these bodies had to get together to some extent in order to get the recognition that is granted to them in this legislation, and I hope that now that we have reached this “verligte” stage in South African politics where we can box together, swim together and do everything else together, psychologists will also be able to meet together. It is because I see some promise that what ought to be together can be brought together, that I as a psychologist support this legislation and I hope that all right-minded psychologists will similarly support it.

Mr. Speaker, it seems that expressions of thanks are being received from all quarters today. These were not necessarily addressed to me, but to the people who have made it possible for the Bill to serve before us today.

†I have been thanked by all the members opposite and I sincerely appreciate that. I do not want to speak at length because I do not think I have much time left. I still want to see whether we cannot manage the Second Reading of the Pharmacy Bill.

Not a chance.

Well, at this particular moment it is for me to decide. I have the floor.

I wish to thank the hon. member for Rosettenville for his very constructive speech and for his very able and balanced approach to this whole matter. This Bill has not had a very even course, all along. There has been a lot of misunderstanding and opposition. It has been mentioned by many of the members opposite and members on this side. I have listened very carefully to all the matters raised by the member for Rosettenville. I have made a note of everything he has said, and made a note particularly of the amendments which he intimated he was going to introduce. However, I think we shall have ample time for that in the Committee Stage.

I come now to the hon. member for Fauresmith.

*The hon. member for Fauresmith paid tribute to the present chairman of the Medical Council. We have now come to the end of a period—perhaps I should come back to this in the Third Reading debate—in which we have begun to realize, particularly in recent times, that we are dealing with anachronistic, archaic medical laws. It has been a monumental task to put all these matters in order within the space of one year. For that reason hon. members must understand that there will be certain shortcomings in this Bill. We may find a shortcoming here and there, but it is time for us to start somewhere and to lay a foundation for a new dispensation which is suited to 1974, and not to 1928.

I want to associate myself fully with the tribute that has been paid to the chairman of the Medical Council. In addition, I want to associate myself with the tribute which the hon. member for Brentwood has paid to the previous chairmen of the Medical Council. These people have set a very high standard in our country over the years, which has been respected throughout the world. People inspired by the highest standards have unselfishly, laboured for medical training and for standards of medical practice that are unequalled in the world. During recent years, we have seen the results of this labour.

†The hon. member for Berea has mentioned a few matters. He has referred to the fact that this Bill was initially published on 10 August last year. If I remember correctly, three Bills were published, as a service to the public. It was not expected of us and is not laid down in the Constitution. Because we did not realize at the time that there was an election in the offing, there was not enough time for the translation of all these Bills.

I appreciate that.

So we published three Bills, two in English and one in Afrikaans. I do not want to bring a sour note into these discussions, but we did not have a single complaint because we published two of these Bills in English. We have had some complaints, however, because we published this Bill in Afrikaans. This was done only incidentally and was not because we intended to lead people astray. The hon. member must please accept my word as far as that is concerned.

I accept that.

The hon. member for Caledon expressed some very interesting thoughts on the human psyche which were well worth attending to. I do want to express my appreciation for the exceptionally high standard of the debate we have had here this afternoon. In order to stimulate our own mental powers, we might come and listen more often to debates on matters which really require some thought, which demand more than mere talk and demagoguery. This afternoon has been one of those occasions. The hon. member for Caledon made a fine contribution in this respect.

†I come now to the hon. member for Pinelands. I find myself in the position of congratulating also him on his contribution this afternoon. [Interjections.] It is not a question of strange bedmates; it is a question of congratulating somebody who can debate a matter like this on a high plane. In this legislation we are only concerned with the welfare and the health of each and everyone of the people of South Africa. The hon. member for Pinelands did mention that he had some doubts about the provisions regarding the social workers, religion, etc., although he also mentioned that we had done our best to allay these fears. We did that. However, he had a very well-balanced approach to the whole matter and I thank him for that. I can assure him that as far as Weightwatchers is concerned he need not worry at all. In the Committee Stage I shall refer to many of these people who are to a very large extent doing a good service to the public and we are not going to hamper these people in the good work they are doing at the moment.

He also referred to subsection (2) or one of the subsections in clause 52 in terms of which the Minister may by regulations prescribe how a medical man can prepare his medicines, etc. For the edification of the hon. member for Rosettenville, I also have a few amendments which I wish to move. I have even more amendments than the amendments which appear on the present Order Paper. As I have said at the start, many things still have to be considered in this new Bill. It is a new Bill and there are a few smaller things which can still be improved.

*We can look at the finer points of this Bill in greater detail in the Committee Stage.

The hon. member for Newcastle had a word of praise for the Press, and I want to say that I agree with him in that respect. The Press has conducted itself in a very responsible manner. It has not refused to publish the opinions of those who thought differently on the matter. It has not abused the desire for sensation, and thus it has not produced an over-reaction which would have made it impossible for us to succeed in our very good undertaking. As far as that is concerned I want to agree with the hon. member.

†As far as the hon. member for Umbilo is concerned, I can only tell him that physical culturists, health studios and social workers are not affected by this Bill. I shall come back to that aspect later. We have done our best to meet the demands and the complaints of social workers, but I think he will find that we really did our best and that we have solved many of the problems which confronted us there.

The hon. member for Houghton was much concerned about the reduction of the number of members of the council and about the power which the Minister has taken on to himself. As I have said, this is 1974. In 1928 we were very much concerned about the interests of the various groups concerned. We did not think that such a lot of work could be done with a few more than 20 representatives for more than 2 000 people in the professions. Nevertheless, in 1974 efficiency is actually the watchword and I think that by drawing in other medical practitioners, not specifically members of the council, we can get them to do their bit. On a council where all these interests are represented we can at least be assured that there will be much more efficiency than we have had in the past.

*In that respect I have no wish to offend the present council in any way, for I think that it has done a wonderful job. Still, we are moving in a direction where we can work with committees and where the council can function much more efficiently. Hon. members all know commissions and committees and they know that there is always a small percentage of members who actually do the work. In this case the cost to us, in terms of manpower as well as money, will be much more efficiently utilized.

†Although, the Medical Council as such may perhaps not be considered specifically as an interested party, the Medical Association as such proposed 21 members in a council of 39. Can you see where the catch is, Sir? They want control of this council. In other words, we could just as well have made the council a committee of the Medical Association.

*The hon. member for Bloemfontein East has mentioned the question of provincial representation. I just want to say that I think it is a matter to which we may give consideration. We really did intend from the start that the representative of the province should be a medical practitioner. If there is a deficiency here, it is a deficiency we can remove. We can set the matter right in the Committee Stage or in another way.

†The hon. member for Hillbrow was a little bit highbrow for me today. In any case, I listened to him with interest.

I think I have now said enough. There is not really anything else to be said because everyone supports this Bill. I just want to thank all the members on the other side once more for supporting this Bill. The minor matters we can debate in the Committee Stage.

*I should like to express my heartfelt thanks to the hon. members on this side as well for their fine contributions. And I want to thank the hon. members of the House of Assembly in general, in the light of the fact that a great deal of money has been spent in an attempt to cause this legislation to miscarry by having it referred to a Select Committee, which would have delayed the matter for another year or two or three, and in the meantime we would have had to plod along as we have been plodding along for many years now. So let us make a start with this, even if there are still shortcomings. Let us rather remove those shortcomings by coming back to Parliament from year to year. By approving the principles of this Bill as they have done, hon. members have not only done me a great favour, but the medical profession and the public of South Africa as well.

Motion agreed to.

Bill read a Second Time.

Mr. Speaker, I move—

The Medical, Dental and Pharmacy Act, 1928, came into operation on 1 January 1929. At the time it had taken approximately ten years before the Act was piloted through the House of Assembly.

The first amendments to the Act were effected in 1935, and since that time the Act has been amended approximately 20 times, which makes it essential that the Act be revised and consolidated now. Mr. Speaker, in view of the limited time I am, for the most part, going to confine myself to the changes which have been effected to the existing Act, and I shall not deal again with the provisions which have in principle been left unchanged.

Clause 3 contains a new provision in comparison with the existing Act in that the functions and objects of the Pharmacy Board—which was previously referred to in the Afrikaans version of the existing Act as the “Aptekerskommissie”—are being summarized in one provision. The objects of the board include assisting in the promotion of the health of the population, promoting and controlling pharmaceutical education and the maintenance of acceptable standards, controlling the pharmacy profession and investigating any complaints which may arise in this regard, and advising the Minister on any matter relating to pharmacy.

Clause 4 is also a new provision in so far as it summarizes what the powers of the board shall be. It provides inter alia, that the board shall have the power to issue registers and that fees for this purpose may be levied, that annual fees may be levied from registered persons, and that the names of such persons may, in specific circumstances, be removed from or restored to the prescribed register. The board shall exercise control over examinations relating to the pharmacy profession and approve, on such conditions as it may deem fit, the training of pharmacists. Furthermore, the board is also being empowered to acquire or dispose of properties, to administer funds and to appoint staff. To protect the board if the proposed changed board were to be constituted upon the commencement of the Act, it has been decided that the present serving members shall remain until the end of the period of service of the present board, except in the case of the medical practitioner who is in the employ of the State.

In clause 6 provision is being made for the procedure according to which the board shall be constituted. As you will observe a change has been effected in this regard as well, to the extent that the Minister shall make his appointments after the election of the elected members has taken place, i.e. precisely the reverse of the present position. The members whom the Minister appoints to the board, are not mouthpieces of the Government or the Minister. On the contrary, if this were the object of such appointments, the board might just as well be abolished. The object of such appointments is to obtain the services of the most competent persons on the board.

Clause 7 makes provision for the introduction of two new aspects in respect of which a member of the board will be deprived of his membership if such provisions should become applicable to him. Over and above the existing provisions a member shall vacate his office if he loses his South African citizenship or if the State President, in the public interest, relieves him of his post.

The Pharmacy Board is a statutory body and as such it has to carry out functions entrusted to it by law on behalf of or in the name of the State. Bearing this capacity in mind it would be unacceptable if persons who are not South African citizens were vested with the power to control a specific profession in South Africa on behalf of the State.

The power of the State President to terminate membership is being inserted because circumstances may arise in which it is necessary to relieve a member of his membership in the public interest, and which are not covered by the existing provisions.

This board is a statutory board which is able to function independently within the provisions of the Act and the regulations. As has already been said, the Minister has no power over the board. Circumstances may arise in which the State desires the board to give urgent consideration to a matter. The Minister may in such a case request the president to submit the matter to a meeting for urgent consideration, and since the board usually meets only four times a year, it could happen that such a matter would have to wait until an opportunity presented itself. In order to create an instrument through which such a meeting could in fact be convened, it is, inter alia, being provided in clause 9(2) that if the Minister should make such written request to the president, the president shall convene such a meeting within 30 days.

The present Act provides that a person who has obtained a South African qualification, shall undergo practical training for a continuous period of one year in an approved pharmacy in the Republic. The opinion is held that it is an unfair requirement that this period shall be a continuous period of one year, since illness or compulsory military service may prevent a person from complying with such a requirement. Consequently it is now being provided in clause 20(1) that the year of training may take place over a non-continuous period, so that provision may be made for such contingencies.

In addition to the provision for the above-mentioned contingencies, another aspect is also involved here. Rhodesia, for example, has until now provided no training for pharmaceutical students, and such students have been trained in South Africa. It is being provided that the practical training of pharmaceutical students may also take place in countries indicated by way of regulation. I may just mention that this amendment was effected at the request of the board. This makes it possible for neighbouring countries, that do not have training facilities for pharmaceutical students, to provide students who have been trained in South Africa with practical training.

†Clause 22 deals with the conditions under which a body corporate may do business as a pharmacist. Representations were received that ownership of retail pharmacies be limited to registered pharmacists and that all shareholders and/or directors and/or partners of retail pharmacies be limited to registered pharmacists.

Taking into account that this matter has as yet never been available for consideration by all the interested parties, the Department of Health published the relevant provisions for information of the parties concerned in order to give them an opportunity to comment thereupon.

*Mr. Speaker, we are very sympathetically disposed towards the pharmacy profession. The hon. member for Berea will be pleased to hear this. However, the problem is that there are vested interests which have to be protected. In view of this we have provided in clauses 14 and 22 that the body corporate which is registered as such with the board upon the commencement of the Bill, may continue to carry on business as a pharmacist, but that no new body corporate will be thus registered and allowed to carry on business as a pharmacist. This will have the effect of protecting the vested interests, while the profession will at the same time be closed to professional persons only.

It is also being provided that—

1. (a) all directors of a body corporate shall be registered with the board; and
2. (b) if any director contravenes any provision of the Act, the board has the power to cancel the registration of such body corporate.

The advantage of the above-mentioned provisions is that the board may now take action against the body corporate and may cancel its registration if a layman member of such a body corporate were to contravene the provisions, without any need for the board to take action against the managing director if he is innocent. In this way the possibility of a stigma attaching to the professional image of such a managing director is being prevented.

Read in conjunction with clause 49(1)(a) in which power is being granted to control the practise of pharmacy and the conduct of the business of a pharmacist by regulation, wide powers are being granted to the board to prevent and eliminate undesirable practices. In this regard recent announcements in the Press to the effect that a commercial undertaking intends establishing pharmacies everywhere and reducing the prices of medicines drastically, may be indicated as an example. All of us in South Africa would be particularly pleased if the prices of commodities were reduced, but such advertisements relate to the conduct of a profession and are ethically unacceptable. In terms of the said provisions, regulations may be made to eliminate acts of this type. It was not possible to do this under the present Act.

There is another aspect which also deserves consideration, viz. the practices which pharmacists are applying in their personal capacities today. Mr. Speaker, when one walks into most pharmacies in the Republic today, one could be walking into a department store. Medicines are, inter alia, displayed on shelves, and the client may simply walk through, make his selection, and pay for it at the counter. But apart from this, one finds a display of toys, rifles and revolvers, and refrigerators, freezers and even motor cars being sold in phamacies. Are these the acts of a profession, or are these the acts of a general dealer? In many of our pharmacies a prescription is taken by the counter assistant, and a little while latter the medicine is handed over to the purchaser, frequently with a mere indication of the price. The purchaser does not even see the pharmacist. What role does the pharmacist play in such cases as a professional person in the health set-up of our country?

As a counter-argument, the pharmacists state that they are being forced into acts of this kind to survive economically. But there are, nevertheless, pharmacies that sell only pharmaceutical products, and in what way are these pharmacists then making a good economic livelihood? But apart from that, where is the pride of the individual pharmacist in his profession? No one prevents him, or a medical practitioner or a dentist or an attorney or an advocate from carrying on a business or having a share in a business undertaking, but no medical practitioner or dentist or attorney or advocate carries on such a business in their professional chambers.

Another aspect is the price of medicines. The necessary attention will be given to this aspect at the earliest opportunity. But what is the pharmacy profession going to do about it? Mr. Speaker, approximately six years ago the board held a referendum among registered pharmacists on the question of whether a pharmacist would be willing to sell only medicines if they enjoyed more protection, and whether they would, under such circumstances, abandon those activities which were not related to the profession. Aproximately 80% of the then registered pharmacists confirmed at the time that they would be prepared to do so. The above-mentioned provisions furnish the profession with an instrument to bring about this situation itself and to place the profession on a sound professional basis. This is going to depend mainly on the profession and how it is going to utilize this instrument, and the extent to which it is in earnest about developing its status as a profession and effecting changes. To my way of thinking, however, there is an even greater problem, and that is the utilization of manpower. At present there are more than 4 000 pharmacists in the Republic, and approximately 1 600 students. Pharmacists are being trained at our universities in a four year course. The question which occurs to me is: What is happening to pharmacy as a profession? Has a pharmacist become a mere dispenser of pills? Should he, as a trained professional person, not be more directly involved in our health services? As an example, I should like to mention advice to medical practitioners. Medical practitioners do not always obtain all the facts concerning the tablets which they prescribe. The pharmacist is the authority on medicines; should he not be involved to a greater extent than is at present the case in the prescribing of remedies? The pharmacist is one of the few professional people who takes a course in hospital administration. Seen in the light of our shortage of medical practitioners, should he not be involved to a greater extent in hospital administration? The pharmacist is an integral part of the community; should he not be utilized to greater effect with regard to health counselling?

I now want to say, in all earnest, to the pharmacy profession: We have, on our part, done what we could, and we shall in future give whatever assistance we are able to give. If the Bill should be passed we would to a large extent be giving you what you wanted. But what is done by the profession, the practices which are going to be applied in future, and the changes which are expected to be brought about, are going to be observed closely. An Act remains on the Statute Book as long as it pleases Parliament, and if matters continue on the same basis as before, I, as Minister, will not hesitate for a moment to repeal these provisions relating to the body corporate and to arrange the handling of medicines in a different manner. This sounds like the sword of Damocles hanging over your heads, and I should like to make it very clear and say this quite plainly, so that you can take proper cognizance of this: It is the sword of Damocles hanging over your heads!

A further important amendment is being effected in clause 33(1) where control over training is being vested in the board. The present Act merely provides that the board shall determine acceptable standards of training. As far as pharmacists are concerned, the latter provision has not up to now given rise to many problems, but the indications are already there that, as in the case of medicine, private individuals also want to establish institutions to train so-called pharmacists. This compels us rather to take timeous precautions and to vest control over training clearly in the board, so that there can be no further misconceptions in this regard. As far as our recognized educational institutions are concerned, we see no problems in this regard, because only the closest co-operation exists between the board and these institutions.

In terms of clause 41 the board may, with the approval of the Minister, make rules relating to the acts or omissions of which is able to take cognizance.

A further amendment is contained in clause 49. In terms of this provision the Minister is empowered to make regulations after consideration of a recommendation of the board. In the existing Act this power is vested in the State President. The only reason for making this change is to make the administrative process a less protected one and to eliminate additional administrative burdens.

In addition the schedules to the existing Act have been abolished, and it is being provided that the matters which are being arranged by means of the schedules may be arranged by means of regulations. These matters dealt principally with the election of members and the payment of registration fees. This method of arranging matters in schedules to an Act is obsolete, and is no longer being used in modern practice.

You will observe that subsection 49(2) provides that the Minister be empowered, if he deems it to be in the public interest, to make or amend a regulation or a rule without consulting with the board, but in consultation with the executive committee. The board usually sits four times a year and may be specially convened in urgent cases. But all this takes time and circumstances may arise in which it is not possible to convene the board quickly and which necessitate that amendments be effected. This provision is being inserted to provide for such contingencies.

This is one of several Bills that have been brought to the House by this Minister during this short session. This is a time when I feel that we on this side of the House, at any rate, must thank the Secretary for Health and his law advisers and the other people associated with these Bills that have been put on to the Order Paper. I know the difficult circumstances under which they worked. I know of the difficulties that they have had both inside their working hours and outside, and I would say to them that we on this side of the House appreciate their work and efforts very much indeed. At the same time I also want to say that those of us who found difficulty in interpreting some of the clauses of the various Bills which we have in front of us, received great help from the department. For that our thanks.

As far as this Bill itself is concerned, the objects remain virtually the same because the board will have more or less the same constitution as it has in terms of the present Act. This board is an autonomous body. I know that the hon. the Minister does not like the word “autonomous” so I should rather say “statutory”. The powers and objects of the board will remain virtually unchanged. The main object of the board is to ensure that the high standards of the pharmaceutical profession are maintained. These standards have up to now been remarkably high, if one bears in mind the number of prescriptions that are dispensed every day. Every day of the week every one of at least 10 000 to 12 000 doctors in private and hospital practice probably prescribes a minimum of 60 prescriptions, and some times far more than that. With this situation in mind, one can readily appreciate what a high standard the pharmaceutical profession has reached here, because we know how very rarely an accident in dispensing occurs. When such an accident does occur, it reaches the headlines in the newspapers. I think that those of us who know the difficulties with which the pharmacists have had to cope during the past few years particularly, know how much we owe to that profession. I myself can testify that many times during the day doctors phone pharmacists for some advice on dispensing, it is always given readily and courteously.

I want to say that in view of the work that these people have been doing, in view of the high standard that they maintain, the pharmacist deserves some form of protection for his profession. I want to appeal to my colleagues in the medical profession not to harp on dispensing. I want to say to them that where pharmacists are available, they should rather direct a patient to the pharmacist than do what so many of my colleagues are doing, namely to diagnose, prescribe and supply. In some cases it becomes essential, but where there is a sufficiency of pharmacies in the area in which the doctors are practising, I say that it is the duty of the doctor to allow the prescription to be dispensed by a registered pharmacist. He should indicate that he himself does not do dispensing.

There is something else that I would like to say about the pharmacy profession. Those of us who are perturbed about drug addiction can say to the pharmacists that they have done their duty to the best of their ability by ensuring that the security measures they employ are sufficiently effective to prevent the unscrupulous from getting these drugs. We appreciate their efforts in this regard. In hospitals it is a simple matter for a locker to be provided for dangerous drugs and medicines. A chemist takes the same precautions and perhaps even more.

There are a lot of things a pharmacist has to do when he has a dangerous drug in his possession. He has to keep a register and every grain of the drug has to be accounted for in that register. I wonder how often the inspectors of medicine visit the dispensing doctors. I wonder if they ever take a look at the security measures which the dispensing doctors employ and whether they think those measures are adequate. We know that in one instance alone thousands of amphetamine tablets were taken from a doctor’s dispensary. If they are going to do dispensing, I want to appeal to them to take proper care of the medicines in their possession.

There is one aspect of education that I want to deal with. This course is a long course and a difficult course. It is a course which, strangely enough, is divided in South Africa. We have those individuals who go to university and those who go to colleges. In my view the time has come for us to get together and see whether it is not a good thing to have a college of pharmacy with various branches so that all may obtain the set standard of training and have opportunities of getting higher degrees if they so wish. This is the sort of thing that happens in the training of nurses. They all go to provincial hospitals and to nursing colleges. After that, however, they are given an opportunity to go to university and obtain higher degrees. I think we may be able to do that as far as the pharmacists are concerned.

The hon. the Minister mentioned the role the pharmacist could play over and above his duties as a pharmacist. He mentioned briefly how the pharmacist could be involved in the health set-up of our country at the moment. I think the Army is now trying to do something along those lines. Up to now it has virtually been something unheard of for a trainee pharmacist or a qualified pharmacist to be taken around the wards when the head of the ward is doing his ward rounds with his students. It is an unheard of thing to have a pharmacist accompanying the chief when he goes round the wards. It simply is not done. The pharmacist dispenses and supplies, and that is the end of the story as far as he is concerned. He does not see the patient. I think that we should now consider allowing the pharmacist entrée into the wards of the various hospitals. That is why I say to the Minister that he should consider establishing colleges for pharmacists from where they can go and do ward work as well as the ordinary dispensing work. If we have that as a basis, can the Minister not imagine how quickly the pharmacist would want to qualify as a doctor He has the basic grounding. If arrangements could be made to allow him sufficient time to take the basic subjects he could very easily join in with his colleagues and qualify as a practitioner. We have an abundance of pharmacists today. I think the supply is bigger than the demand. I heard yesterday that in the course of a couple of years more than 300 pharmacists have gone out of business. They have had to close their shops because they could not make a living. They have been absorbed elsewhere, but it is a tragic state of affairs that after a man has gone through these years of training—he has been unable to earn a living during those years and has had to depend on financial support—and when ready to open up his pharmacy, he finds that he cannot keep the pharmacy going through lack of support. It is no wonder that the pharmacists takes out a general dealer’s licence and starts to sell postcards, dolls and trains and such things. That becomes his livelihood. I have heard of cases in some areas of Johannesburg where some pharmacists do not dispense more than seven prescriptions a day. That is the total number they are dispensing. These happen to be pharmacists who are practising in areas where there are many doctors who are doing their own dispensing. Well, something has to be done about that. I do not want to deprive any of my colleagues of making a good living, but I think that where it is not necessary for them to dispense, they should not do so. I will leave it at that.

I now want to say a few words about the composition of the board. I think the Minister is giving fair representation. Whether he wants a representative board or not, I do not know, but to me it is a fair one. He has in fact even increased the size of the board in this case. I am pleased that there is a close connection between the board and the Medical Council. These people will work in co-operation with each other. I know that; I know what their feelings are. I think the register which requires so much detail, is necessary. I have heard criticism to the effect that the register is too detailed, wants to know too much. But I think that, in dealing with the pharmacists, they themselves would want a register of this type.

Again I want to say to the hon. the Minister that I cannot agree that those people who are not properly trained as pharmacists should be allowed to practise pharmacy in areas which are short of trained pharmacists. We cannot have that. Sir, it is wrong. If a man is not properly trained, he should not get that job. That is the way I should like to see the position. Only trained people must be employed. If we are going to have an influx of people who are trained overseas whose qualifications do not meet our requirements—I wish to repeat what I said during the previous debate today—let us make provision for them at either a college or a university. Let us give them every help to pass the examination as quickly as possible, so that they can go out as properly trained people. We cannot have discrimination here. The standard that is required in one part of the country must apply also in the other parts of the country. I do not agree with the idea that because a place is denuded of a particular profession, a person who is not properly qualified should be entitled to do such work in that area. Mr. Speaker, I notice that the time for this evening is just about drawing to a close. I would like to suggest at this stage …

That I should interrupt proceedings now?

Yes.