because they support the individual mission of the agencies-we are forced to work very hard to just try to bring the numbers in one place so we know what is going on.

As I said, we did this in the water research field. But then when we try to support a program, we find that pieces of it, because of the agency responsibility, come in different things, and it is very hard for us to give a coherent picture to the Congress of what we are trying to do and very hard for the individual congressional committees to understand what is going on.

In the field of water resources, the atmospheric sciences, and oceanography, we now submit to the Congress each year what we call our national programs, showing what it is that each agency is doing and how they fit together. It is an attempt to help you and an attempt to hold our program together, because sometimes we are not doing something in one agency because we are doing it in another, only to lose it,

you see.

The Navy, for example, has on several occasions withdrawn research proposals in the field of oceanography, which is very important to the Navy, in order to let Interior or Coast and Geodetic Survey or some other group do a piece of research. We then submit this in an integrated package.

Now, this might be for a sum of money which is insignificant in the Navy budget and which the Navy groups in the Congress readily have supported but in the commerce budget it may seem rather out of balance.

We find that, in spite of our best efforts, we have not been able to do a good enough job to make this all clear. I know it is a problem on your side but I think we have to work at it because if it is impossible to create national programs in the executive or to create them here in the Congress, we are going to have fragmented programs; we are going to have distortion, and we are going to have duplication.

Mr. ROGERS of Florida. Then, generally, you would be in favor of trying to coordinate where you can in legislation?

be

Dr. WIESNER. Yes.

Mr. ROGERS of Florida. I realize it may be difficult.

Dr. WIESNER. I don't know how you can do it with an independent responsibility, but this is a problem that I think the Congress should very much concerned about; that in rightly impressing us with the need to do more coordination you have to recognize that one of the serious limitations we have is the fact that we are trying to coordinate agencies that deal with quite different groups of the Congress.

Mr. ROGERS of Florida. Yes. I think it is a more difficult problem when it goes past one agency, but what I was thinking and the question I directed to you was within one agency and yet we have a number of different laws under which they are operating rather than one law which would apply to that one agency.

Dr. WIESNER. Even that sometimes is hard to change.

Mr. ROGERS of Florida. I am saying I am willing to change it now; I hope this committee will.

Thank you very much.

I appreciate your testimony.

Mr. ROBERTS. Mr. Brotzman.

Mr. BROTZMAN. I have no further questions.

Mr. ROBERTS. Thank you again, Doctor.

I appreciate very much the fine statement you have made before our committee. I am terribly sorry I was not able to be here for all the hearing.

The subcommittee will stand in recess until 10 o'clock tomorrow morning at which time I believe we will hear Dr. Terry, the Surgeon General of the Public Health Service.

(Whereupon, at 12:10 p.m., the hearing recessed until 10 a.m. Tuesday, June 11, 1963.)

ORGANIZATION OF PUBLIC HEALTH SERVICE

TUESDAY, JUNE 11, 1963

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE ON PUBLIC HEALTH AND SAFETY

OF THE COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE,

Washington, D.C. The subcommittee met at 10 a.m., pursuant to recess, in room 1334, Longworth Building, Hon. Kenneth A. Roberts (chairman of the subcommittee) presiding.

Mr. ROBERTS. The subcommittee will please be in order.

Our witness today is Dr. Luther L. Terry, Surgeon General, Public Health Service, Department of Health, Education, and Welfare, accompanied by Mr. David E. Price, Deputy Surgeon General, Mr. James M. Hundley, Assistant Surgeon General for Operations, and Mr. Robert J. Anderson, Chief, Bureau of State Services.

Dr. Terry, you may proceed with your statement.

STATEMENT OF DR. LUTHER L. TERRY, SURGEON GENERAL, PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE; ACCOMPANIED BY DAVID E. PRICE, DEPUTY SURGEON GENERAL; JAMES M. HUNDLEY, ASSISTANT SURGEON GENERAL FOR OPERATIONS; AND ROBERT J. ANDERSON, CHIEF, BUREAU OF STATE SERVICES-Resumed

Dr. TERRY. Thank you, Mr. Chairman.

Mr. Chairman and members of the committee, I welcome this opportunity to explain more fully the purposes and provisions of H.R. 2410, a bill designed to provide a more flexible statutory basis for organizing the Public Health Service.

Earlier in these hearings, we reviewed for your committee the functions and responsibilities of the Service, with particular attention to their expansion during the past 20 years. This review was supplemented and reinforced by a number of program summaries, charts, and tables, some of which were included in a special committee printed entitled "Background Material Concerning the Mission and Organization of the Public Health Service."

The statutory provisions that now govern the basic administrative structure of the Service were first enacted into law in 1943. The growth of the Service and the new responsibilities assigned to it during th past 20 years make it imperative, in our opinion, that these provisions be modified to permit appropriate changes in the basic organization of the Service.

Section 202 of the Public Health Service Act now specifies that:

The Service shall consist of (1) the Office of the Surgeon General, (2) the National Institutes of Health, (3) the Bureau of Medical Services, and (4) the Bureau of State Services.

The Surgeon General has very broad authority to assign the various functions of the Service among these four statutory units. With the approval of the Secretary, he may also establish, consolidate, or abolish subordinate divisions or other administrative units. But all such subordinate units, and all functions of the Service, must be embraced within the four major units prescribed in section 202.

Thus, we cannot, without further legislative action, establish any new bureau or abolish or rename any of the four constituent units now specified in section 202.

In 1956, the Public Health Service Act was amended to provide in part H of title III-for the establishment within the Service of a "National Library of Medicine." Although certain provisions of this legislation implied a special organizational status for the Library, no modification of section 202 was included to authorize the establishment of the Library outside of the statutory "bureau" structure. Therefore, the National Library of Medicine has been administratively located within the Office of the Surgeon General.

In addition to the organizational provisions of section 202, title IV of the act contains a series of provisions relating to the establishment of specific research institutes and advisory councils. These provisions limit to some extent the general authority of the Surgeon General and the Secretary to establish or abolish subordinate administrative units within the Service, but they do not modify the basic requirement in section 202 that all functions of the Service must be assigned to one of the four statutory units prescribed in that section.

The provisions of H.R. 2410 would in no way modify the provisions of title IV relating to specific research institutes and councils. They would, however, make four substantive changes in the present provisions of section 202:

(1) The statutory specification of a "Bureau of States Services" would be deleted;

(2) The National Library of Medicine would be added to the list of major constituent units of the Service;

(3) The Surgeon General would be authorized, with approval by the Secretary, to establish "such other bureaus or other constituent units" as he may find appropriate for the organization of the Service; and

(4) The Surgeon General would also be authorized, with approval by the Secretary, to redesignate any bureau or other constituent unit of the Service-including those specified in section 202-whenever he deems such action necessary in view of changes in the functions of the unit.

These four changes would, in effect, give the Surgeon General and the Secretary almost complete administrative authority with respect to the organization of the Service. A simpler means of effecting this result might have been to delete all statutory specifications regarding specific bureaus or other constituent units. This more direct approach has not been proposed for two reasons:

ORGANIZATION OF PUBLIC HEALTH SERVICE

First, it would have required a series of conforming amendments
to other statutory provisions referring specifically to the National
Institutes of Health and to the National Library of Medicine.

Second, there are no organization changes contemplated in the fore-
seeable future that would modify the designation of the Office of
Surgeon General, the National Institutes of Health, or the Bureau of
Medical Services.

The proposed revision of section 202 would also delete an obsolete
and no longer meaningful specification that the National Institutes
of Health "shall be administered as a part of the field service."

In addition to these amendments to section 202 of the Public Health Service Act, H.R. 2410 includes several minor or conforming amendments to the act:

(1) The present requirement that the Deputy Surgeon General shall be responsible for administering the Office of the Surgeon General would be deleted from section 205 (a) of the act. With the expansion of Service functions and responsibilities, the deputy has too many servicewide responsibilities to permit him to serve as administrative head of the Office of the Surgeon General.

(2) Section 205(b) of the act now requires the Surgeon General to assign three regular officers of the Commissioned Corps to serve, respectively, as Director of the National Institutes of Health, Chief of the Bureau of State Services, and Chief of the Bureau of Medical Services. It further provides that, while so serving, these officers shall be Assistant Surgeon General.

Since the proposed amendments to section 202 would leave the number, functions, and designations of bureaus of the Service to administrative determination, a parallel amendment to section 205 (b) would simply specify the grade of Assistant Surgeon General for any officer assigned to serve as Director of the National Institutes of Health or as chief of any bureau of the Service.

(3) A conforming amendment would also be made in section 205 (c) so as to omit the reference to a specific number of statutory positions and to delete the obsolete reference to the title of "Assistant Surgeon General."

Finally, H.R. 2410 would amend a provision in a 1960 appropriation act which established a Bureau of State Services management fund so as to permit its replacement with a fund or funds designed to parallel future revisions in the bureau structure of the Service.

The main objective of these proposed amendments, Mr. Chairman, is to enable us to adjust the administrative structure of the Service to fit the growth and change in our functions and responsibilities. We have already outgrown the four-unit structure now prescribed in law and, as I pointed out earlier in these hearings, there are two changes that we would make immediately upon the enactment of H.R. 2410: First, we plan to replace our present Bureau of State Services with two new bureaus: a "Bureau of Community Health" and a "Bureau of Environmental Health." Actually, these two bureaus would be "new" only in their designation and status. Within our existing statutory authority, we have already organized the functions of the present Bureau of State Services into these two main categories. The proposed change would simply follow this grouping to its logical conclusion of dual bureau structure.