The CHAIRMAN. Thank you very kindly, Senator, for your contribution. Are there any questions? Mr. DOWNING. I would like to congratulate my colleague on giving us an excellent presentation, Mr. Chairman. I would like to press a little. Taking the Norfolk hospital as an example, the nearest VA hospital would be Kecoughtan? Senator SPONG. Yes. Mr. DOWNING. What is the caseload at Kecoughtan? Senator SPONG. They presently have an average daily patient load of 80.8 percent, Congressman Downing, which is rather high, I am told. We have talked not only with those operating the facility at Kecoughtan but the other administrators in Virginia. I am inclined to concur with the testimony given earlier to the House Veterans' Affairs Committee that these hospitals, and particularly the ones in Virginia, do not have the capacity at present to take care of this service. Mr. DOWNING. Was any renovation done, as suggested in the letter of May 1970 to the Norfolk hospital? Senator SPONG. No. I think that has been a matter of continuing study, Congressman Downing. I would like to make it clear that we think that a study was necessary. We think finally it would show the need for additional health facilities, but at this time or at any time. in the near foreseeable future, to close this facility would, in my judgment, impair the entire health services in the Hampton Roads area. Mr. DOWNING. I agree. Thank you very much. Mr. MURPHY. Senator, does the VA hospital at Kecoughtan have a rental unit--a kidney-care unit? Senator SPONG. I can't answer that. I yield to Congressman Downing, who represents that area. I am not sure whether they do or not. I do not believe they do. Mr. DOWNING. I do not believe they do. Mr. MURPHY. How about coronary care? Mr. MURPHY. Do you know how many patients that it can take at one time? Senator SPONG. No; I do not. I will be glad to supply that information to the committee. The CHAIRMAN. Thank you very much, Senator. Our next witness is Congressman Brooks, of Texas. STATEMENT OF HON. JACK BROOKS, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF TEXAS Mr. BROOKS. Mr. Chairman, first, I want to thank the committee for graciously allowing me to testify and speak briefly on this matter so vital to a great deal of Texas and this country. I appear today to strongly protest the rumored closing of certain Public Health hospital facilities, particularly the Galveston, Tex., hospital which is in my congressional district. We also have in Texas the Fort Worth Narcotics Hospital, the only such facility west of the Mississippi for the rehabilitation and treat ment of narcotics victims. I think this certainly should be continued. I don't know that they contemplate abolishing that, but I think they should abolish heroin first. We are all aware of the effort that this committee made; we all worked on it some years ago, to prevent the closing of these hospitals. I think that you will find the Texas delegation, Mr. Chairman, pretty solidly behind you in an effort to see that these facilities are maintained for the betterment of the American merchant marine and for the other people that it serves, who work for the Government. Certainly, none of us are opposed to efforts toward economy, so long as they represent a reasoned order of priority and true economy. But at times when there is crying need for medical facilities in an area such as ours, where there are great concentrations of merchant seamen and Federal employees having need for this facility, there is no way to justify the closing of this hospital. I would point out that the ports of Beaumont, Port Arthur, Galveston, Texas City, and Houston, together, are second in tonnage only to the New York City complex. If we are going to have a viable merchant marine, if we are going to have American ships running around this world, we will have to take care of these merchant seamen in some way. If we are going to expect people to work for the Federal Government in many capacities, we are going to have to provide some opportunity for them to get medical services they desperately need. Any attempt to indicate that these medical services might be provided by the Veterans' Administration hospital in Houston or elsewhere in this country, I believe, is utterly ridiculous. Anyone who has any contact with the hospital in Houston knows of the crowded conditions, the long waiting lists for admission, the great strain that is already on their personnel. Now the marine biomedical program, one of the leading edges of this facet of human knowledge, is having installed in Galveston now, a $50,000 to $60,000 decompression chamber in connection with and under the auspices of the University of Texas Medical Branch there in Galveston. The Public Health Service has assumed the responsibility for underwater casualties. We have considerably more underwater activity in the gulf than we do elsewhere on the other coasts of this country. This will be a facility that will lead the way in how to take care of underwater casualties. There are 25 beds already set aside for such care in the new hospital that is now proposed. They have a training program in conjunction with the university; trained doctors and personnel who work with the Public Health Service in an effort to save these people. That hospital was built about 35 years ago to house 79 patients. It now has in it 160 patients. It has a steady use and need and requirement for 200 beds at all times. I would say that, rather than closing Galveston, the hospital needs replacement. I would urge the Secretary-and I am delighted to see you here, Mr. Secretary-to expedite consideration of the study which has been going on for several years and the implementation of the much needed 210-bed hospital there in Galveston. That study was started in 1967. It was to take 1 year. Then they were going to appoint architects. We never got past the study stage, and it has been 3 years. The need for this new hospital has been demonstrated. The wisdom of this investment in health service to our area is plainly evident. The dividends that will be paid by its association with the University of Texas Medical Branch will be astronomical; and continued delay can only result in losses of medical training and services on the same order. I might add that the Sealey Smith Foundation in Galveston donated-which was accepted by the Government-an excellent site adjacent to the hospital, to the medical branch that is there now, for the new proposed 210-bed hospital. Simply put, the administration is faced with a decision of where medical care and the health and well-being of our citizens rate in their scheme of priorities. Mr. Chairman, it is obvious that you and the members of this committee recognize the paramount importance of this matter. I deeply appreciate your concern and interest in this problem which directly affects so many people in my district and throughout this country. Thank you very much. The CHAIRMAN. Thank you very much, Mr. Brooks, for your fine contribution. If you care to join us here and listen to the rest of the testimony this morning, you are most welcome. Mr. BROOKS. You are very gracious, Mr. Chairman. I will do that. The CHAIRMAN. Mr. Pelly, from the State of Washington, has asked to make a statement. I note that the State of Washington also has a delegation petition made up in letter form, along with the State of Virginia, the State of Massachusetts, and the State of Texas, notifying the Secretary of their feelings on this matter. Mr. Pelly. STATEMENT OF HON. THOMAS M. PELLY, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF WASHINGTON Mr. PELLY. Mr. Chairman, I want to welcome the Secretary here. I think this is his first appearance before our committee. I think it is something that is important to the responsibilities that we have. I certainly don't want to give any indication that I am not for a continuing study of consolidation of other facilities that might affect the economy and such things that were suggested by the Hoover Commission Report. So, I do not want to appear in the light of objecting to a study, but I do wish to point out that in the area that I represent in Seattle, we have a veterans' hospital and a public health hospital, and the idea that you could eliminate the public health facility seems out of the question, unless we build additional facilities. The average patient load at the Seattle Veterans' Hospital is 268, as against 317 beds. That means that on the average there would be 49 beds available. Yet in the Seattle Public Health Service hospital, the average number of beds occupied in 1969 was 198. How are you going to care for 198 average patients when there are only 49 beds that are available? So I don't think that is going to work out. Incidentally, I would say to the committee that the Seattle Public Health Service hospitals are operated at a $52.55 cost per day, as against a higher cost at the veterans' hopsital. The cost there is $56.23. So, all these things have to be studied. I can't believe there would be any economy in the move, but again, I do not want to appear as being in any way opposed to a continuing study as to the economies that might be effected in Government. Before I conclude, I do want to indicate that I have received a number of communications from those who are fearful and are protesting that the Public Health Service hospital in my area might be closed. I ask for permission to put these in the record. I don't want to take any more time away from our important witnesses that we have. Thank you, Mr. Chairman. The CHAIRMAN. There is no objection, Tom. (The telegrams follow :) SEATTLE, WASH., December 29, 1970. Congressman THOMAS M. PELLY, Rayburn House Office Building, Washington, D.C.: The nine hundred members of Seattle Branch 18, Fleet Reserve Association strongly protests the proposed closing of the Public Health hospitals and urge you to take the strongest possible action to prevent such closings. CORNELIUS C. VANPOLL, President, Seattle Branch 18, Fleet Reserve Association. Hon. THOMAS M. PELLY, SAN FRANCISCO, CALIF., December 29, 1970. We of the Marine Cooks and Steward Union officials and rank and file members alike and those seamen who have been hurt in the line of duty from World War II on, urge you not to close down the U.S. Public Health Service hospitals. To do so would certainly create a tragedy in the communities they are located. ED TURNER, Secretary-Treasurer Marine Cooks and Steward Union. Representative THOMAS M. PELLY, Washington, D.C. SEATTLE, WASH., December 29, 1970. DEAR SENATOR: On behalf of the thousands of military, retired, active duty and dependents in the Seattle area, I respectfully request that you do everything in your power to prevent the closing of the Public Health Hospital in Seattle. The closing poses a serious threat to the well-being and access to facilities of literally thousands of people plus the economic hardship on an already depressed area. Yours in loyalty, protection, and service. BENEDICT A. ROBBINS, Regional President, Northwest Fleet Reserve Association. The CHAIRMAN. Mr. Secretary, will you please step forward? I might say, while the Secretary is getting seated, we have a letter here from Senator Warren Magnuson, chairman of the Appropriations Subcommittee on the Departments of Labor, Health, Education, and Welfare, and related agencies, which is also signed by Senator 55-467-72- -4 Yarborough, chairman of the Labor and Public Welfare Committee, and by Senators Russell, Mondale, Williams, Cotton, Boggs, and Jackson. Without objection, I will put this in the record at this point. (The letter follows:) The PRESIDENT, Washington, D.C. U.S. SENATE, Washington, D.C., December 22, 1970. DEAR MR. PRESIDENT: We are deeply disturbed by the rumor that the Department of Health, Education and Welfare is considering closing some or all of the Public Health Service hospitals and outpatient clinics in the United States. Because of the integral part that these facilities now play in our national health network, and their great potential, we are writing to express our concern again, and to state that these facilities should be kept open. As you know, nearly a million Americans currently receive comprehensive medical care through these hospitals and clinics. These include nearly 500,000 American seamen, members of the armed forces, the Coast Guard, Public Health Service and National Oceanic and Atmospheric Agency employees and their respective dependents. Well over 100,000 Bureau of Employment Compensation patients are also treated in these facilities every year. In addition, these hospitals and clinics provide a training ground for hundreds of physicians and dentists who are serving in internship and residency programs, and for scores of paramedical personnel who are trained at these facilities. Research programs now underway at these facilities receive support in the amount of approximatelly $6,000,000 annually. These training programs have yielded enormous dividends in highly trained personnel who now staff these facilities, and who have gone on to provide health care to the country in many other roles, Federal and non-Federal. Considering the impending national health care crisis to which you and many Members of Congress have repeatedly called attention, this group of professionally excellent, although physically neglected, health facilities located in strategic urban and rural population centers are vital to our national health effort, and should be strengthened. We strongly recommend a new mission for these hospitals and for the Public Health Service that is in keeping with current and future national health needs. Not only should they be strengthened in order to perform better their traditional roles which cannot now be adequately performed on a nationwide basis by any other health organizations-but they should be modernized in order to undertake new missions to which they are uniquely suited. They can help, for example, in pioneering and developing model health care delivery systems, which will be of enormous significance not only to their immediate beneficiaries, but also to the public as a whole. We also believe that these facilities can be an integral part of solutions to the health problems of the communities in which they are located, if imaginative new roles are sought for them. If these facilities are modernized and adequately funded, they can serve as demonstration centers for experimental programs utilizing the expertise of the medical and para-medical Public Health Service personnel who wish to satisfy a deep social commitment to the health of the urban and rural poor, and to those who live in areas where adequate health care is not now available. We believe that closing these facilities at this time would be a tragic error. Such action would have the effect of transferring Federal statutory beneficiaries to other, already over-burdened Federal and non-Federal hospitals without significant prospect of reducing costs. It would deprive local communities of muchneeded health facilities. It would abort ongoing training and research programs. It would disperse highly-trained medical personnel, and finally, it would seal the "front door" of the Public Health Service for potential careerists whose access, until now, has been largely through these clinical facilities. Congress has repeatedly stressed the need to keep the Public Health Service alive and vital, and to adapt it to new roles. Only yesterday, Congress passed and sent to you an act that would expand the role of the Public Health Service in providing adequate medical care to this Nation. This act reflects the overwhelming, bi-partisan sentiment of Congress that the Public Health Service should not |