Mr. DINGELL. Would you say it is a necessary part of the teaching institution?

Dr. NEAL. A very essential part. Unfortunately, it is located so near Pennsylvania that most likely the clinical material that will be furnished there will have to come from Pennsylvania rather than West Virginia, because it is located in a section of the State that doesn't produce the clinical material. It is a very fine institution. They have done a good job, and I must insist again, as I did the other day, they have done it without Federal aid.

Mr. DINGELL. That is a very interesting point. That is the point I was going to work around to.

Now, what about this medical school constructed in Mississippi? I assume it is going to have a teaching hospital, am I right? Dr. MCGUINNESS. I presume it is.

Mr. DINGELL. Nurses' homes and so forth?

Mr. WILLIAMS. We have the teaching hospital already built, with our own money.

Mr. DINGELL. And nurses' homes, and animal houses, and research facilities there, too, won't I be fair in that, too?

Dr. McGUINNESS. I would assume so.

Mr. DINGELL. I assume if it is a first-class medical school

Dr. MCGUINNESS. It should have all those things, and I am sure it does.

Mr. DINGELL. Now, I took the trouble to go through a document here, Committee Print, Staff Report, Committee on Interstate and Foreign Commerce, House of Representatives, 85th Congress, 1st Session, Containing Background Information Relating to Schools of Medicine, Dentistry, Osteopathy, and Public Health, and in that I discovered a few interesting things. I found, as our chairman, and my good friend, has said, people don't run around stopping up the chimney on Christmas Eve.

I looked under the State of Mississippi and I found that the State of Mississippi had gotten a university teaching hospital at Jackson, estimated cost $5 million; $3 million of which were Federal funds under Hill-Burton. I have got no objection to the State of Mississippi getting its hands into the taxpayer's pocketbook. I happen to think it is a good thing, and I think Mississippi should have that hospital, and I think there ought to be some Federal funds in it if the State of Mississippi thinks there should be. I was interested to note this is defined as

This is a new 350-bed general teaching hospital with outpatient and clinic facilities.

Then I went on down, on the subject of the same State here-well, let me go to West Virginia.

Mr. WILLIAMS. I must say even in the State of Mississippi we don't stop the chimney up on Christmas Eve. [Laughter.]

Mr. DINGELL. I went down here to West Virginia, and I looked here and I saw West Virginia University Medical Center, at Morgantown-I assume that is the school that Dr. Neal has been talking about here they talk about a medical center. I assume this is the teaching hospital that we have been discussing. Estimated total cost,,

$1,857,564 Federal share, $314,996. This facility will provide: 143chronic-disease beds for long-term patients.

Now, underneath that same facility they are going to have in addition to that another facility for the West Virginia University Medical Center, total cost $999,920, of which $114,996 is going to be Federal funds, and this committee print says this:

This project offers rehabilitation services to inpatients and outpatients with multiple disabilities.

Then I went on down here and there is another item here for the same school, $1,813,640; $200,000 Federal share. This is an outpatient facility with over 60 examining rooms. It includes facilities for general medical clinics and for various medical specialties.

Now, then, there is another item here under the same, West Virginia University Medical Center, $9,528,876, of which $370,487 is Federal contribution. And it says:

This is a 328-bed addition to a 520-bed hospital which is a teaching hospital to the University Medical School and will provide diagnostic and treatment rehabilitation and chronic disease services.

Now, we don't know how much else they might have gotten under Hill-Burton for the construction of the original facilities, because that is not included in here.

And I was very interested to go into some other parts of this committee print here. And I looked up here and I found that the State of Mississippi had constructed a sanitarium, tuberculosis infirmary for Negroes, $1,753,115, of which $584,372 was Federal contribution. Then they constructed Mercy Hospital, that was a new construction, $3,177,155. They got $1,046,670 of Federal funds.

Then coming down here to West Virginia again, I found that West Virginia had also gotten some Federal contributions here that they had not exactly rejected for hospital construction. I was interested to find that Charleston Memorial Hospital, at Charleston, new construction, $3,976,603, $1,325,534 Federal contribution.

Dr. NEAL. All Hill-Burton funds. And the first series that you read there were contributions that were made to the 2-year training medical school down there, before the institution was finally created as a 4-year medical school.

Mr. DINGELL. I might say, Dr. Neal, I am delighted that you were able to do that in West Virginia.

Mr. WILLIAMS. Permit me to say that if this legislation should pass, Mississippi intends to come in for its share if possible. As far as I can tell, Mississippi is not asking for any Federal handouts.

Mr. DINGELL. Then I came down here and under the same city in West Virginia, Charleston Nurses' Home and Training School, addition, $418,567, total cost, $255,326 Federal contribution. Parkersburg, St. Joseph's Hospital, an addition to the existing structure, $1,262,707, $770,075 Federal contribution. Camden Clark Memorial Hospital in Parkersburg, addition and replacement, $1,013,336, of which $405,517 was Federal contribution.

Then there are two other items under West Virginia in which Federal contributions ran $960,332, and $1,261,972. Dr. NEAL. What items are they, may I ask you?

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Mr. DINGELL. The last 2 items, 1 was Philippi and the other was Wheeling, Ohio Valley General, and the cost of each was $1,574,315 for the first, $5,033,726 for the second.

Now, I come over here and I see the University of Mississippi got Federal contributions of $1 million-no, it was a loan-$1,300,000 for dormitories to house 100 men and 100 women respectively, and apartments for 100 married students.

Now, along these lines, the reason I have been reading these things is because I wanted to ask you to give the committee for the record here a list of Federal grants for research, for hospital construction, for facilities for teaching and other things of that sort, so that we could understand who has gotten what and the general nature of the Federal program.

Dr. BURNEY. For all States, you mean, sir?

Mr. DINGELL. Yes, sir, if you could, for schools, teaching, hospitals.

Dr. BURNEY. For construction purposes?

Mr. DINGELL. For construction, for research grants. Could you get that together for us, Doctor, without its being a monumental task?

Dr. BURNEY. I believe so; yes, sir. The only difficulty I would have would be in the research grants, but I suppose we could get that. Dr. VAN SLYKE. It would be very helpful if we could give it to you in items, and not list each grant, which would be a monumental task.

Mr. DINGELL. All right. I don't want a monumental task, Dr. Van Slyke, for the National Institute. But I assume you can give it to us for construction?

Dr. BURNEY. Very easily on that.

Mr. DINGELL. And I would be willing to take it whatever way you could give it to us.

Dr. VAN SLYKE. And for a single year, Mr. Dingell, say for the last year.

Mr. DINGELL. For a single year. But I think, Dr. Burney, you could give it to us differently, couldn't you?

Dr. BURNEY. We could give it to you for the last 5 years or any period you want.

Mr. DINGELL. I would be willing to leave it to your good judg ment, in the way you think it would be most helpful to the committee. (The information was later submitted by Dr. Burney and appears in appendix B.)

Mr. WILLIAMS. I don't know what the significance of all these figures might be. The Hill-Burton program, as the gentleman knows, is not an educational program but is for hospital facilities.

I might say even if they were for educational institutions and we had been provided such funds in the past, that would not necessarily justify or permit the same sin in the future.

Mr. DINGELL. Well, I merely offer the bulk of these as I was going to remind my distinguished chairman and good friend, I was reading these things into the record only to show that the medical centers at the University of West Virginia and Mississippi have received substantial Federal funds, as integral parts of the two State medical schools, of which we have heard so much.

And I am sure that Dr. McGuinness and Dr. Burney will correct me if I am in error. They did receive substantial funds for that purpose, did they not, sir?

Dr. BURNEY. I would have to look that up, Mr. Dingell. I don't know the details of it.

Mr. DINGELL. I assume from what I read it would be fair to infer they had received fairly substantial Federal contributions.

Dr. BURNEY. I don't recall the specific instances. I don't know whether they were simply projections or whether actual construction was done, and whether $1 of Federal funds to $2 of State, I am not

sure.

Mr. NEAL. Practically all of those have been completed. And St. Mary's Hospital, in Huntington, has recently received something less than a million dollars.

I think it was about $850,000 as contribution, Federal contribution, to a $212 million extension they are making there on the basis that the new addition would furnish approximately 60 beds for chronic patients.

Mr. DINGELL. I hope that both you, Doctor, and our distinguished chairman and my good friend will not get me wrong. I am not against this, I am for it.

Was there any construction, Doctor, of educational facilities and medical schools and so forth under the PWA and WPA?

Dr. BURNEY. Not to my knowledge, but I would have to check that for the record, sir.

Mr. DINGELL. Was there any construction of universities and university campuses and things of that sort under a similar program? Dr. BURNEY. I cannot answer that question, sir. I would be glad to get it for you, if you would like.

Mr. DINGELL. I want to go to just one more point that I have been belaboring thoroughly during this hearing, and that is the business of incentive to new construction and incentive to schools to expand their teaching staffs and their graduating classes.

I just want to start out briefly by saying I assume that I would be fair in inferring that both the AMA and the Association of American Medical Schools have a responsibility in accrediting and in policing and supervising the schools; is that correct, sir?

Dr. BURNEY. That is correct, and a similar council in the American Dental Association does it for accreditation of dental schools.

Mr. DINGELL. I recall that you were present when I went into this with other witnesses, and none of those witnesses brought out any information that was false, incorrect, or misleading, did they, when they told us how the AMA and the Association of American Medical Schools both accredit and then continue to maintain a supervisory capacity and function over the way these schools conduct their curricula and teach their students; is that correct?

Dr. BURNEY. That is correct.

Mr. DINGELL. And you are familiar, I am sure now, both you and Dr. McGuinness, with the Fogarty bill, H. R. 7841, which provides for substantial increases in the amount of grants for new construction that is for construction of new medical schools and dental schools, and also for schools which will expand their capacity to produce graduates by about 5 percent.

Am I correct? And I would also be fair in inferring that you, as Surgeon General, and I think probably Dr. McGuinness, as special assistant to the Secretary, will have a substantial say and an opportunity to supervise the quality and the standards of instruction and the quality of graduates that will be produced by these schools. Would that be a fair statement?

Dr. BURNEY. No, sir; we would not.

Mr. DINGELL. I mean in determining whether or not they shall qualify for these new grants.

Dr. BURNEY. They would have to be an accredited school of medicine to qualify for the grant.

But as for any concern with the teaching part of that university, past, present or future, we have stayed religiously away from that in all of our trainee programs, our research programs.

Mr. DINGELL. And the AMA will be able to get in there, though, and see to it that the standard of graduates and the standard of instruction is maintained under this bill through their accredited practices as presently used; am I right?

Dr. BURNEY. Yes. But let me add this. I think the greatest incentive for meeting minimum standards established by the Dental Council and by the AMA Council, is the pride of the people in that school to meet not just minimum standards, but to have the best possible medical school and the highest possible standards.

So when we are talking about the standards of the AAMC, and the AMA, and the Dental Council, we are talking about minimum standards. And I would say that the greatest incentive for not only meeting those standards, but improving them continuously, rests with the faculty and the dean and the other members of the profession. Mr. DINGELL. Would I be fair in assuming that that would mean there would be two factors working for high quality consistent with quality presently available?

Dr. BURNEY. Yes, sir.

Mr. DINGELL. If we do offer some kind of an incentive feature for construction of new medical schools and for expansion of existing facilities. Would that be a fair statement, Doctor? I am not trying to trap you.

Dr. BURNEY. No, I understand. May I sum up this way, sir, relative to the incentive.

No. 1, and this goes back to the basic philosophy of our chairmanI think it is undesirable for the Federal Government, except in those areas where there is a demonstrated disparity of great need—for the Federal Government to do more than match dollar for dollar. Now, that is No. 1.

No. 2 is that I think these schools that can, will expand without any incentive. In other words, they will add 5 students or 7 students. They have been doing it all along. At the same time their expansion, whether it is 1 student or 10 students, will be determined not so much by the standards of the AMA which they will want to meet or the American Dental Association, but by their own evaluation or assessment of their ability to train these additional students, plus the multitudinous pressures upon all medical schools to expand.

Mr. DINGELL. I am delighted to hear that. And I am certainly not debating that at this particular point, Doctor. But the thing I want