DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, Hon. OREN HARRIS, DEAR MR. CHAIRMAN: This is in response to your request for a report on H.R. 8398, a bill to amend the Public Health Service Act to provide for the establishment of an Institute of Child Health and Human Development, and for other purposes. This bill embodies a proposal transmitted by President Kennedy to the Speaker of the House of Representatives on July 18, 1961. We are enclosing a copy of the President's transmittal to the House of Representatives and of our letter to him describing the proposal. For the reason stated in the President's transmittal, and in our letter to him, we urge favorable consideration of the bill by your committee and its enactment by the Congress. Sincerely, WILBUR J. COHEN, Assistant Secretary. [For release at 12 noon July 18, 1961] A LETTER FROM THE PRESIDENT TO THE PRESIDENT OF THE SENATE AND THE OFFICE OF THE WHITE HOUSE PRESS SECRETARY, July 18, 1961. DEAR MR. SPEAKER (DEAR MR. PRESIDENT): I am enclosing for consideration by the Congress a draft bill to authorize the Surgeon General to establish within the Public Health Service a National Institute of Child Health and Human Development and a National Institute of General Medical Sciences. At present, there are seven separate Institutes within the Public Health Service. Each Institute focuses its attention on a major disease problem. Each Institute organizes, arranges for financing, and stimulates a wide range of studies in its field. They have all made important contributions to our knowledge of the dangers in crippling diseases and advanced the frontiers of medicine. It is now both appropriate and timely to elevate two additional areas of medical research activity to the level of Institutes. In this way, the kind of research effort that is needed to improve the health of children and to stimulate basic studies in the biological sciences will be assured. One of these two Institutes will deal with child health and human development. It will include a Center for Research in Child Health, as well as other activities not now covered by the existing Institutes. It is my belief that this concentration of attention in this field will help us discover some of the secrets of the aging process. In time, it will help us live happier and more useful lives. The other proposal will convert the Division of General Medical Sciences in the Public Health Service into an Institute, thus recognizing the importance of its program. This new Institute will be an important center for research in the general medical sciences. The purposes and functions of both of the new Institutes are outlined in detail in the attached letter from the Secretary of Health, Education, and Welfare. I urge the favorable consideration of the proposal. Sincerely, JOHN F. KENNEDY. THE PRESIDENT, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, The White House, Washington, D.C. DEAR MR. PRESIDENT: I am enclosing for your consideration a draft bill to authorize the Surgeon General to establish within the Public Health Service a National Institute of Child Health and Human Development and a National Institute of General Medical Sciences. The proposed institutes would be similar in organizational character and function to the seven Institutes which are presently contained within the National Institutes of Health. The establishment of these two new Institutes would provide a sharper focus for research and training activities in two vital areas-first, the broad fields of research relating to child health and human development and, secondly, research in the general and basic medical sciences which underlie all fields of medical research. However, only the first area will require the establishment of a new program. At the present time the National Institutes of Health, through its Division of General Medical Sciences, is carrying out an extensive program of grants for research and research training in the general and basic medical sciences, and the draft bill would merely elevate an important ongoing program to Institute status. The legislative proposal for the establishment of a National Institute of Child Health and Human Development will implement the recommendation, in your health message to the Congress on February 9, "*** that there be established in the National Institutes of Health a new National Institute of Child Health and Human Development, which will include a Center for Research in Child Health as well as other broad-ranging health research activities not now covered by the specialized work of the existing Institutes.” This new Institute will provide a central focus and coordinating point in the fields of research relating to child health and human development similar to the focus which the existing Institutes provide for their respective disease areas. In spite of the extensive research already supported by the National Institutes of Health which relates to the problems of children and youth and the process of human maturation, we believe that the importance of these problems deserves the emphasis of a special organizational unit and the attention of special research and training programs. This Institute could provide the basis for a stepped-up program of research into such specific problems as congenital malformations, infant mortality, mental retardation, and maternal factors which relate to the health and development of the child. There is an equally great need for more research into the developmental and adaptive processes (both normal and abnormal), beginning with the reproductive system and then continuing logically through the perinatal period, infancy, and childhood, and including the processes of maturation (physiological, physical, intellectual, social and psychological development) through adolescence and into adulthood. This type of fundamental research is needed to provide the basis for specific advances in the health and well-being of our children, youth, and other age groups in the years to come. The research program of this Institute will also form a particularly suitable setting for an effective research effort in the aging process. The study of aging is a logical extension of a program which is concerned with the processes of human development. We do not propose that this new Institute take over from other Institutes the study of those childhood diseases which can best be undertaken in the context of a total disease category. For example, the study of leukemia in children would remain in the National Cancer Institute, and the National Institute of Mental Health would continue to be responsible for research into schizophrenia in children. We believe that there are great research opportunities in the areas described above which will occupy the total attentions of the proposed Institute and which can be undertaken without any harmful disruption of the current research programs of other Institutes. Nor would this legislation impinge upon the authority of other agencies which have responsibilities in the sphere of child health and human development. The draft bill contains a specific provision which recognizes the existing authority of the Secretary to conduct related studies and investigations through the Children's Bureau, and we are submitting for your approval companion legislation to clarify and expand this authority of the Secretary. It is our intention to have a representative of the Children's Bureau serve as an ex officio member of the advisory council which would be established to advise the Surgeon General on the activities of this new Institute. In carrying out its functions the proposed Institute of Child Health and Human Development could utilize all of the mechanisms provided in section 301 of the Public Health Service Act, including grants for research projects and direct conduct of research. In addition, the Institute could support training activities related to child health and human development, including training grants, fellowships, and traineeships. Provision is also made in the draft bill for an advisory council, similar to the national advisory councils associated with the present Institutes. As indicated above, the proposal for the conversion of the Division of General Medical Sciences into a National Institute of General Medical Sciences is made in recognition of the importance of the general and basic medical sciences to the progress of medical research. The conversion of this Division into an Institute was recommended by the group of expert consultants appointed by the Senate Appropriations Committee for the purpose of considering all aspects of the Federal support of research. The program of research and research training supported by the Division of General Medical Sciences has increased both in size and importance. The elevation of the Division to Institute status is a logical step in the evolution of this vital program. The functions of the Institute of General Medical Sciences would be similar to those of the other Institutes at the National Institutes of Health and to the authorities of the Institute of Child Health and Human Development described above. The Surgeon General would also be authorized to establish an advisory council to advise on this program. An amendment to section 301(d) of the Public Health Service Act is proposed in this draft bill in order to clarify the general authority of the Surgeon General to make grants for research training projects. Additional provisions included in the draft bill would authorize the Surgeon General to appoint advisory committees to provide advice and consultation concerning any programs of the Public Health Service. Also included is an amendment exempting members of Councils and other advisory groups, existing or prospective, from certain conflict-of-interest laws, except for the prohibition against participation in the prosecution of any claim against the United States on any matter with respect to which he was directly connected as a member and except for a prohibition against receipt of salary from other than the member's employer at the time of his appointment. We believe that the enactment of this legislation will provide the Public Health Service with new tools to be used in the expanding fight against human disease and disability. These proposed new institutes would constitute a needed complement to the present significant efforts in this fight. Faithfully yours, ABRAHAM RIBICOFF, Secretary. EXECUTIVE OFFICE OF THE PRESIDENT, BUREAU OF THE BUDGET, Washington, D.C., February 19, 1962. Hon. OREN HARRIS, Chairman, Committee on Interstate and Foreign Commerce, DEAR MR. CHAIRMAN: This is in response to your request for the views of the Bureau of the Budget on H.R. 8398, a bill to amend the Public Health Service Act to provide for the establishment of an Institute of Child Health and Human Development, and for other purposes. The President's letter of July 18, 1961, to the Speaker of the House, and the letter of July 12, 1961, to the President from the Secretary of Health, Education, and Welfare, have set forth the reasons for enactment of this legislation. For these reasons, you are advised that enactment of H.R. 8398 would be in accord with the President's program. Sincerely yours, Hon. OREN HARRIS, Chairman, Committee on Interstate and Foreign Commerce, DEAR CONGRESSMAN HARRIS: This is in further reply to your request for our comments on H.R. 8398, a bill to amend the Public Health Service Act to provide for the establishment of an Institute of Child Health and Human Development, and for other purposes. We support the enactment of the proposed legislation, which is designed to carry out certain recommendations made by the President in his health message of February 9, 1961. As pointed out by the President, we must meet the health 81475-62- -2 needs of the young as well as of older groups in our population. With respect to the functions of this Department, we believe that research into the special health problems and requirements of children and aged persons, as provided for in the bill, would be helpful to us in planning programs affecting the employment of our young and our older workers. The Bureau of the Budget advises that there is no objection to the presentation of this report from the standpoint of the administration's program. Yours sincerely, ARTHUR J. GOLDBERG, Secretary of Labor. The CHAIRMAN. We have scheduled only two days of hearings. on these bills, and we have a substantial number of witnesses to accommodate, many of whom have come from out of town. Therefore, it is urgent for us to conserve time. It is my understanding that arrangements have been made by several of the witnesses to cover different aspects of this legislation in order to avoid duplication of effort. I welcome this arrangement because it is my hope that it will preclude our spending an hour or more with the first witness and giving the remaining witnesses only a few minutes of time to summarize their statements. Without anything further, I believe our first witness this morning will be Mr. Ivan A. Nestingen, Under Secretary of the Department of Health, Education, and Welfare, Washington, D.C. STATEMENT OF IVAN A. NESTINGEN, UNDER SECRETARY, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE; ACCOMPANIED BY RUFUS E. MILES, JR., ADMINISTRATIVE ASSISTANT SECRETARY, HEW, AND DR. JAMES A. SHANNON, ASSISTANT SURGEON GENERAL, NIH Mr. NESTINGEN. Thank you. Mr. Chairman and members of the committee, in the absence of Secretary Ribicoff from the city, I am pleased to have this opportunity to testify before you in support of S. 2073, a bill "to authorize two additional Assistant Secretaries in the Department of Health, Education, and Welfare, and for other purposes." S. 2073 has already passed the Senate, and is now pending before your committee. At the outset, Mr. Chairman, I should emphasize that while the title of the bill indicates that the two additional Assistant Secretaries would be authorized, in fact only one entirely new position would be established. Although enactment of the bill would provide two new assistant secretaryships in the Department, one of these would primarily be a change in title for an existing position. The present statutory position of special assistant to the Secretary (health and medical affairs) would be abolished, and, in lieu thereof, an Assistant Secretary would be created. With respect to this latter position, I want to emphasize that the official charged with coordinating related health and medical programs within the Department, and with advising the Secretary on all major health and medical policy matters, is carrying out responsibilities of major significance. The position fully warrants Assistant Secretary status, in our judgment. Indeed, the method of appointment, the salary, and the scope of responsibilities are at that level. During the time that I have served as Under Secretary, I have come to realize that the role played by the Special Assistant is of particu larly high importance. He is, in fact, the principal staff adviser to the Secretary on all policy matters in the health and medical affairs field. In our Department, this is an extremely complicated matter because each operating agency has programs or responsibilities in the health fields. Additionally, the Special Assistant serves as the principal Department staff officer in dealing with major organizations throughout the country concerned with health matters. From our standpoint, the work of the individual in this position would be clearly facilitated were he to carry the title and designation of Assistant Secretary. Furthermore, as the need may arise from time to time, duties outside the health field may have to be assigned to this position, and he would not be precluded from assuming such additional responsibilities. For these several reasons, we strongly support this proposal. With respect to the other position, Mr. Chairman, it is the Secretary's intention to have the individual who would be appointed to it assume primary responsibility in the field of international affairs, although he might from time to time be assigned additional functions, and he would not be precluded from assuming additional duties. The Department urgently needs an Assistant Secretary who can devote substantial attention to the international activities of this Department, which have been steadily increasing in number and importance. We strongly support the provision for this additional Assistant Secretary position. In this connection it should be noted that the President's policy is that the Department of State is the focal point for the formulation and implementation of foreign policy. The functions of the proposed new Assistant Secretary in the Department of Health, Education, and Welfare will be in complete accord with this basic premise. The involvement of our Department in international affairs always has been and will continue to be consistent with U.S. foreign policy objectives and subject to policy direction and coordination by the Department of State. Within this framework, however, our participation in international activities is substantially increasing. For this reason, the President and Secretary Ribicoff have recommended that this Assistant Secretary position be authorized. This would help to give effect to the policy of the administration of placing more emphasis on the development of human resources in overseas programs. It also recognizes the growing significance of developments abroad, including research, to the health and welfare of the American people. Direct responsibilities of the Department of Health, Education, and Welfare, related to the well-being of the American people, include supporting research overseas, or study of developments abroad, in many of our spheres of interest in health, education, welfare, and rehabilitation. We also administer provisions of the National Defense Education Act relating to foreign language and area study centers, service a large number of influential visitors from abroad who come directly to our Department, and undertake a growing number of programs under Public Law 480, using U.S.-owned foreign currencies. In addition, we are making a significant contribution in backstopping the Department of State and other agencies by making available full use of our professional and technical skills and resources, and we are in a position to increase this contribution in the months and years ahead. |