specific diseases on the ground that it tends to departmentalize research and investigation, whereas broad discussion and knowledge are essential for sound investigation. Since the Veterans' Administration would not be charged with any duties or responsibilities under the proposed legislation other than in representation on the proposed National Health Council, no comment other than the above is offered. It is assumed that your committee will desire the views of the Surgeon General of the Public Health Service and the Federal Security Administrator relative to this proposed legislation, since these officials will, in case of enactment, have primary responsibility for its administration. Due to the urgent request of the committee for a report on this measure, there has not been sufficient time in which to ascertain from the Bureau of the Budget the relationship of the proposed legislation to the program of the President. Sincerely yours, CARL R. GRAY, Jr., Administrator. Hon. CHARLES H. WOLVERTON, WAR DEPARTMENT, Washington, August 5, 1947. Chairman, Committee on Interstate and Foreign Commerce, House of Representatives. DEAR MR. WOLVERTON: The War Department is opposed to the enactment of H. R. 3464, Eightieth Congress, a bill to provide for the mobilization of the scientific resources and knowledge of the United States for the purpose of seeking the causes and cure of cancer, heart disease, infantile paralysis, and other diseases of mankind. H. R. 3464 would create a Medical Research Agency which apparently would act independently of other Government agencies established to promote research in the fields of medicine and allied subjects. The War Department feels that the agency proposed in this bill would be in conflict with the ideals and purposes of a National Science Foundation, which the War Department has strongly supported. We feel that the Foundation should encompass all the physical sciences, including those of medicine. As medical research depends on support from allied fields of science as well as specific fields within medicine proper, it is felt that the over-all supervision and coordination of medical research can best be handled by the National Science Foundation, as approved by the Senate. Except for the specified salaries of the Director and his two deputies totaling $42,000, and an initial appropriation of $5,000,000, the War Department is not able to estimate the fiscal effects of this bill. For the reason set forth above, the War Department recommends that H. R. 3464 be not favorably considered. The Bureau of the Budget advises that there is no objection to the submission of this unfavorable report, as the enactment of the proposed legislation would not be in accord with the program of the President. DEAR MR. WOLVERTON: Further reference is made to your letter of May 21, 1947, requesting a report of the Commission's views on H. R. 3464, a bill to provide for the mobilization of the scientific resources and knowledge of the United States for the purpose of seeking the causes and cure of cancer, heart disease, infantile paralysis, and other diseases of mankind. H. R. 3464 authorizes the establishment of a Medical Research Agency to conduct scientific research into the causes and cure of certain diseases. The only provision of the bill regarding which the Commission desires to make any comment is section 5 (a), which reads as follows: "SEC. 5. The Agency is empowered to do all things necessary to carry out the provisions of this act, and without being limited hereby, the Agency is specifically authorized "(a) to prescribe such rules and regulations as it deems necessary governing the manner of its operations and its organization and personnel ;". The language quoted above may give rise to some question whether employments in the Agency are subject to the Civil Service Act, the Veterans' Preference Act, and the Classification Act of 1923. Ordinarily, such language would not be construed to authorize an exception from these statutes as several opinions of Attorneys General have held that all Government employments are subject to the general laws relating to appointment and compensation unless the pertinent statute contains language to the contrary which is so clear and unequivocal as to admit of no doubt. Furthermore, the Civil Service Act itself gives the President full authority to make any necessary exceptions whether on a full-time or parttime basis. The Commission believes that employments in the Medical Research Agency should not be excepted from the general laws relating to appointment and compensation of Government employees. In order to avoid any doubt in the matter, it is suggested that the following language be added at the end of section 5 (a): "subject to the civil-service laws and regulations and the Classification Act of 1923, as amended." The Commission, in accordance with established procedure, has been informed by the Bureau of the Budget that there would be no objection to the submission of the proposed report to your committee. By direction of the Commission. HARRY B. MITCHELL, President. Hon. CHARLES A. WOLVERTON, UNITED STATES CIVIL SERVICE COMMISSION, Chairman, Committee in Interstate and Foreign Commerce, House of Representatives, DEAR MR. WOLVERTON: This has reference to your communication of January 22, 1948, transmitting a copy of H. R. 5087, and requesting that the commission irnish a report in triplicate covering its reaction to this proposed legislation. Initial acknowledgment by the Commission of your letter was dated January 27. The legislation referred to provides for setting up within the Public Health Service (presumably the United States Public Health Service of the Federal Security Agency, although this is not made clear in the present wording of the bill) an organization to be known as the National Heart Institute. The Institute is to be empowered to gather from appropriate sources all available information relating to the cause, prevention, and treatment of diseases of the heart. Such is to include the actual conduct of experiments as well as cooperation with and fostering of similar activies being carried out by other instrumentalities. The various devices by which this is to be accomplished are recited in detail in the bill and will not be referred to individually in our comments. Information disseminated by the press, radio, current serious literature, and technical publications all bear out the unforunate prominence which cardiac and circulatory disturbances occupy as cripplers and killers of our population. As a corroboration of such statements, I know your committee will be interested in knowing that heart disease (and associated conditions) is by far the largest single cause for retirement under the disability provisions of the Civil Service Retirement Act which is administered by this Commission. The loss to the Government of the services of employees who retire prematurely for this reason together with the resultant drain on the retirement fund (a sizable portion of which is a direct contribution by the Government) is certainly a cause for concern, In view of these facts, it is considered most fitting that the Congress take cognizance of the seriousness of the problem and enact legislation which will enable it to be dealt with on a concerted national scale. It is believed that the United States Public Health Service is preeminently fitted, both with respect to its professional components and the purposes for which it was established and has been expanded, to be entrusted with the responsibility of inaugurating this program and then making certain that it is effectively continued to the extent permitted by modern skills and available resourecs. It is true that many universities, hospitals, and foundations of various types have been conducting laudable and productive activities along parallel lines; however, it is believed that the material assistance and integra tion which this bill will furnish would not serve as a justifiable basis for a charge of excessive paternalism in government. That this proposed legislation would result in a rise in the general health level of the Nation would seem to be a logical prediction. Likewise, it is felt fully warranted to assume that the benefit to that segment of our population which carries on the Government's work would be reflected in a material increase in the total efficiency of government, The Commission is in hearty accord with the intent and general format of the bill and recommends its enactment. Although wishing to detract in no way from the above comments, it is felt advisable to transmit one observation for whatever value it may be to your committee. The Commission has been advised by the Federal Personnel Council that the personnel legislation committee of that organization is of the opinion that the language used in section 7 (b) of the bill with respect to provisions for personal services by contract is not sufficiently restrictive. It was stated that the committee has gone on record as not objecting to contract provisions for scientific and professional personnel, but they have, however, consistently objected to any extensive securing of secretarial, stenographic, and related services by means other than the recognized appointment procedures. The Commission does not desire at this time to recommend any specific changes in this connection. However, should your committee desire to give consideration to the point raised, we shall be glad to furnish additional specific comments along any lines requested. The Commission has not been advised as to the relationship of the proposed legislation to the program of the President. By direction of the Commission. Very sincerely, HARRY B. MITCHELL, President. UNITED STATES CIVIL SERVICE COMMISSION, Hon. CHARLES A. WOLVERTON, House of Representatives. DEAR MR. WOLVERTON: We refer again to your letters of January 22 and 28, 1948, requesting that the Commission furnish reports in triplicate on H. R. 5087 and H. R. 5159 which are presently before your committee. The Commission transmitted its comments on both bills in letters of March 12. However, we were at that time unable to comment as to their relationship to the program of the President. We have now been advised by the Bureau of the Budget, in its letter of April 7, 1948 (copy enclosed), that the above legislation is not in accord with the program of the President for the reasons stated in the letter reporting on similar provisions in S. 2215, to Hon. Robert Taft, chairman of the Committee on Labor and Public Welfare, United States Senate. A copy of the latter letter is also enclosed. It will be noted that in letter of April 7, 1948, from the Bureau of the Budget special attention is invited to the last paragraph of the Bureau's letter of April 7 to Senator Taft in connection with S. 2215. The Commission concurs in the specific comments from an administrative standpoint contained in the Bureau of the Budget's report to Senator Taft. By direction of the Commission, MY DEAR MR. MITCHELL: Receipt is acknowledged of your letters of February 16, 1948, transmitting a proposed report on H. R. 5087, a bill to provide for research and control relating to diseases of the heart and circulation, and February 27, 1948, enclosing a report on H. R. 5159, a bill to provide for research relating to diseases of the heart and ĉirculation, including high blood pressure, in a supreme endeavor to develop speedily more effective methods of prevention, diagnosis, and treatment of such diseases, and for other purposes, which you propose to submit to the chairman of the House Committee on Interstate and Foreign Commerce. For reasons indicated in the Director's letter on S. 2215 which contains similar provisions to H. R. 5087 and H. R. 5159, the legislation would not appear to be in accord with the program of the President. I am attaching a copy of this letter. Your attention is called to the last sentence in this letter which has reference to increasing the limitation contained in the present law with respect to grants to States for State and local control activities. You may wish to give consideration to the submission of an amendment which would carry out the objective outlined in this paragraph. Very truly yours, ELMER B. STAATS, Assistant Director, Legislative Reference. EXECUTIVE OFFICE OF THE PRESIDENT, BUREAU OF THE BUDGET, Washington 25, D. C., April 7, 1948. Hon. ROBERT TAFT, Chairman, Committee on Labor and Public Welfare, MY DEAR SENATOR TAFT: In response to your request of March 1, 1948, for the views of the Bureau of the Budget regarding the provisions of S. 2215, a bill to provide for research and control relating to diseases of the heart and circulation, the following comment is offered. Much of the basic authority which would be provided in this bill already exists in the Public Health Service Act. Section 301 of that act already gives broad authority, including unlimited appropriation authorization, for financing both intramural and extramural 66* * * research, investigation, experiments, demonstrations, and studies relating to the causes, diagnosis, treatment, control, and prevention of physical and mental diseases and impairments of man * This section also authorizes the establishment and maintenance of research fellowships. Section 314 (c) of the act gives broad authority (within a $30,000,000 annual appropriation limitation) for making grants to States for maintaining adequate public health services, including grants for the training of personnel for State and local public health work. To aid in planning and administering the Public Health Service research program, consultative and advisory services are provided to the Surgeon General by the National Advisory Health Council and he has authority to secure such experts as may be desired for this purpose. There already has been established by the National Institute of Health of the Service a Cardiovascular Study Section, composed of specialists in heart disease, which is regularly available for consultation and advice with regard to research activities and proposals relating to that field. Action has already been taken by the Congress upon the President's budget recommendations, making available funds to construct a large clinical research laboratory building at the National Institute of Health, which will stress research in cardiovascular diseases. Section 2 (d) of the bill would authorize grants-in-aid for education, including grants for construction of educational facilities. While there is little doubt that improvement and expansion of medical and related education is needed to provide adequate trained personnel to improve the Nation's health, the advisability of providing for such aid on the basis of each disease category is questioned. It would seem that Federal aid to education, at least in the health field and probably in the total field of higher education, should be approached on an integrated basis. The bill would establish within the Public Health Service a National Heart Institute and would change the name of the National Institute of Health to the National Institutes of Health. In the medical research field the premium is upon the closest possible interchange of information and ideas, and upon flexibility in the assignment and use of personnel and equipment. To achieve this close working relationship the Congress has authorized the construction of a great new medical research center at Bethesda which is to house in one building scientists and doctors working on a wide variety of medical research problems. Cancer, cardiovascular diseases, and mental health will be three of the principal points of emphasis, but a great many other types of research will be extensively pursued. When the building is complete it will house three institutes: The National Institute of Health, the National Cancer Institute, and the National Institute of Mental Health. What seems to us to be already needed is not the building of additional organizational walls within this great new institution by the creation of a new institute for each disease, creating greater rigidity and more overhead cost for each institute. Rather, what seems important is the exercise of every effort toward the closest possible organizational relationship of the men and women who are being brought together in the new research center. Section 7 (f) of the bill would authorize the payment of salaries up to $15,000 for the services of specially qualified scientific and professional personnel concerned with research activities in the National Institute of Health, one bureau in the Public Health Service. While the National Institute of Health is the main research bureau of the Service, much valuable research is carried on by other bureaus of the Service. This provision should not be extended to the one bureau, but should be Service-wide. The emphasis placed upon and expenditures made by the Public Health Service for research in and control of cardiovascular diseases is progressively increasing. The rate by which these activities can be expanded is limited by the number of qualified persons in the cardiovascular field. Most of the basic authority which enactment of S. 2215 would provide already exists in the Public Health Service Act. Provision for graduated expansion of adequately planned programs under existing law would appear to make for a more integrated and effective attack on cardiovascular diseases. At some early date it would be necessary to increase the $30,000,000 limitation in section 314 (c) of the existing law to provide additional grants to States for State and local control activities. DEAR Mr. WOLVERTON: This has reference to your communication of January 28, 1948, transmitting a copy of H. R. 5159, and requesting that the Commission furnish a report in triplicate covering its reaction to this proposed legislation. Initial acknowledgment by the Commission of your letter was dated February 6. The Commission has previously considered H. R. 5087 which in all major respects conforms to the provisions of H. R. 5159. The differences will not be recited in detail and the following remarks are parallel to those furnished in connection with H. R. 5087. The legislation referred to provides for setting up within the Public Health Service (presumably the United States Public Health Service of the Federal Security Agency, although this is not made clear in the present wording of the bill) an organization to be known as the National Heart Institute. The institute is to be empowered to gather from appropriate sources all available information relating to the cause, prevention, and treatment of diseases of the heart. Such is to include the actual conduct of experiments as well as cooperation with and fostering of similar activities being carried out by other instrumentalities. The various devices by which this is to be accomplished are recited in detail in the bill and will not be referred to individually in our comments. Information disseminated by the press, radio, current serious literature, and technical publications all bear out the unfortunate prominence which cardiac and circulatory disturbances occupy as cripplers and killers of our population. As a corroboration of such statements, I know your committee will be interested in knowing that heart disease (and associated conditions) is by far the largest single cause for retirement under the disability provisions of the Civil Service Retirement Act which is administered by this Commission. The loss to the Government of the services of employees who retire prematurely for this reason together with the resultant drain on the retirement fund (a sizable portion of which is a direct contribution by the Government) is certainly a cause for concern. In view of these facts, it is considered most fitting that the Congress take cognizance of the seriousness of the problem and enact legislation which will enable it to be dealt with on a concerted national scale. |