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that cut across agency lines. The functions of the Assistant Secretary for Environmental Health, as you know, are still under consideration. The role of the Assistant Secretary for Health and Scientific Affairs, Dr. Lee, is like that of Mr. Keppel. Dr. Lee will concern himself with health activities as they exist throughout the Department. When Bob Ball wants to work out some problem with the Public Health Service on medical matters, Philip Lee will be present. When Ellen Winston wants to make comparable arrangements, he will be concerned with it. The same is true of the Assistant Secretary for Individual and Family Services, Lisle Carter. He will concern himself with a range of things, some of which are comprised in the term "welfare,” some in social security, some involving the Administration on Aging, and in general he will be concerned with this kind of social service.
Of the special assistants, the only one of particular interest is the Special Assistant on Civil Rights. I think I have gotten the best fellow in the country to join me and to pull together the civil rights activities of the whole Department. We are doing two things at once. We are putting the responsibility for civil rights activities on the operating agencies themselves. We are saying, in effect, that nobody in this Department can really get out of the civil rights business. We have a law to administer, one that is integrally involved with what is being done out in the field, and we cannot delegate responsibility for civil rights only to a small group in the Office of the Secretary. At the same time, we are building up our capacity in the Office of the Secretary to monitor all our civil rights efforts, to see whether they are effective, to relate our activities with those of the Department of Justice, and to do all the kinds of things in which we must act as a department. For example, we have asked the Public Health Service to concern itself with all civil rights problems relating to hospitals to avoid having both the Social Security Administration and the Public Health Service coming in at different times to work with the same hospital. We have asked the Office of Education to concern itself with all civil rights matters involving educational institutions, so that hereto we won't have several different agencies seeking compliance from the same institution.
I'd like to add one additional word. As you know, we have nine regional directors. It has always been a task to keep them in close touch with what we are doing. In my opinion, they play an extremely important role. They are the one part of our organization that not only sees the Department and its operations whole, but gets an immediate feedback from the operations of these programs. You cannot talk to a regional director without getting a sense of the actual impact of these programs as they hit the grassroots. So I am establishing improved communication with the regional directors. I have appointed Ed Baxter who is our Charlottesville regional director to head this office and he will work directly with me in trying to bring the regional directors closer to us.
I think that is all I want to say.
Mr. FOGARTY. Thank you, Mr. Secretary, that is a very good statement. I would like to commend you for what I think are fine appointments you have made.
Many of them I have known for some years.
ASSISTANT SECRETARY HUITT
Mr. LAIRD. There is another new Assistant Secretary that has not appeared before this committee in his official capacity. Perhaps he could be introduced.
Mr. FOGARTY. We would be glad to listen to your background, too. I imagine one of the most important things is that you came out of Wisconsin.
Mr. Huitt. Yes; I think that probably is. I grew up in Texas, was educated in the public schools and at Southwestern University and did graduate work at the University of Texas. I served in the Navy for 3 years. I went to the great State of Wisconsin in 1949 and spent 16 years there as a professor of political science. I am on indefinite leave from there now and I am delighted to be with the Department.
Nr. FOGARTY. Thank you.
VIEWS OF SECRETARY ON DEPARTMENT'S ROLE IN PROVISION OF HEALTH
SERVICES Mr. Secretary, I have been very much impressed with your deep interest, from what I read, in education and your refreshing views on educational problems. You have written and spoken a great deal on this subject before you became Secretary, with the result that your views are fairly well known to those who read. You have had less occasion to address yourself to our national health problems. It would, I think, be helpful to this committee to have an expression of your views--your own personal views on the role which the Federal Government and more specifically the health components of your Department could play in improving the Nation's health and insuring that the best of medical service is available, widely and readily, throughout the country. Some of the programs for which funds are included in the budget are becoming more deeply concerned with the provision of medical services.
I think the committee would like to hear your views on this aspect of the Federal Government's health activities.
Secretary GARDNER. Yes, sir. I will be glad to give you a very general statement, because this is something that interests me very deeply. I believe, briefly, that we are at a historic moment in the development of health activities in Government. In fact, in the development of health activities in this Nation, this is a moment that we may all remember for quite a long time to come. We have come to our present position because of the spectacular advances in the health seiences, because of the really remarkable legislative record of the 88th and 89th Congresses, and because of the very impressive backing which your committee has provided to these fields. Because of these gains we now have an unprecedented opportunity to take a step in health services in this country that will lay down a pattern for a generation to come. In my belief, we are now in a position to do a remarkable job of building on the base that you people have provided. There has been a lot of discussion about where the emphasis should be from now on, whether it should be on research or whether it should be on the delivery of services. I am not inclined to argue the question. I beleve very, very strongly that we must maintain and strengthen the emphasis on research at the same time that we are building a very strong emphasis on delivery of services. It is my belief that we have in the NIH possibly the most distinguished unit within our Department, perhaps the most distinguished unit in Government, and we want to keep it that way and do everything possible to strengthen it.
As for the totality of the Public Health Service's activities, I have not yet run into anyone who doubts that some kind of reorganization is needed if we are to move on and take these great next steps. Nor have I run into anyone who doubts that reorganization will very much involve the NIH as a central factor. In my view the integrity of the NIH should be maintained. It should come much closer than it has in the past to the totality of the Public Health Service's concerns, and together they are going to have to work out with the universities, with the university hospitals, and with community hospitals, a new pattern of health activities involving both public and private resources and both public and private institutions, in order to more adequately serve the people of this country. I think the regional medical complexes provide an example of some of the kinds of problems you face in developing this new pattern. We are going to have to make health care more widely available. We are going to have to make it as available to people in the outlying areas as it is now avail. able to people who are nearby and can afford care in the great medical centers.
SUBCOMMITTEE CHAIRMAN'S GENERAL ASSESSMENT OF THE BUDGET
Mr. FOGARTY. That is a pretty general statement.
I, personally, am not at all satisfied with the health part of the budget that is now before us. The funds requested for a number of these important programs will only provide for a level of activity that is substantially lower than it has been during the past year. În a few cases, the amount requested is substantially below the amount specifically authorized by the Congress. During the course of these hearings I shall ask those responsible for operating these programs to explain in detail to the committee exactly how these inadequate budget requests were arrived at. I would like to have your comments, Mr. Secretary, on the way in which this budget was developed and to hear your explanation of the philosophy underlying all of these budget cuts. I notice in your prepared text this morning you talk about progress in the field of health and education. But I would not term this a budget of progress. I think we are going backward. I would think the President is interested in going ahead, knowing all the legislation that was passed in the last session of Congress, much of which he recommended.
PRESIDENT'S INTEREST IN HEALTH BUDGET This report just came to my attention this morning, a report to the people on health—“Foundation for All Our Aspirations." The foreword by the President reads like this:
It is imperative that we give first attention to our opportunities—and our obligations—for advancing the Nation's health. For the health of our people is, inescapably, the foundation for the fulfillment of all our aspirations *
Our first concern must be to assure that the advance of medical knowledge leaves none behind. We can—and we must-strive now to assure the availability of and accessibility to the best health care for all Americans, regardless of age or geography or economic status.
With this as our goal, we must strengthen our Nation's health facilities and services, assure the adequacy and quality of our health manpower, continue to assist our States and communities in meeting their health responsibilities, and respond alertly to the new hazards of our new and complex environmentLyndon B. Johnson.
That is what the President said in the foreword of this pamphlet I am reading from, but this budget does not go along with that statement. I can think of many instances where this budget does not fit in with this statement at all. We are not doing enough to train more nurses. We are not doing enough to train more physicians. In health research facilities you practically cut the program entirely. We thought during the Korean situation that President Truman was wrong in cutting back construction at that time because we have been told that cutting back construction on some of these programs like this will set the programs back 10 years. So after your general statement on health, and your prepared statement about progress, and the President's interest in all these fields, then you come up with a budget that is one of the most conservative I have seen since I have been on this committee. Talking about progress--I do not see any progress in this budget at all. I think you are going backward with the budget you are up here to defend. Now you go ahead. I made my speech.
Secretary GARDNER. I would like to have you view this budget against the backdrop of our total national situation this year. I have been drawn in the last 2 or 3 weeks into a good deal of attention to what is going on in Vietnam, so I am even more aware of it now than I was before. This is inescapably the background against which we carried on our discussions and examinations of what we could do this year. Now if you look at how HEW fared in this very difficult year compared with other departments, and if you look at how the health activities of this Department fared compared with other activities, I think you will very clearly discern that the President's strong personal interest in this program is still very much alive and has left its mark on the budget.
EXECUTIVE REDUCTIONS MADE IN BUDGET REQUESTS Mr. Fogarty. I do not think that is a very good answer as far as I am concerned. I still think it is a very poor budget. I think it is one of the poorest that has been sent up here. When I look at some of the requests that were made by your agencies and how they were cut back I am just amazed. We will put this table that shows these cuts in the record.