be incorporated on cars. Most of them were suggested by research made available by us through research grants.

It is

This many years later people are making a great fuss, suddenly appearing on the horizon talking about the things that this committee made possible that long ago. I have the testimony with me. quite interesting to note that the fuss being made about safer cars is not at all new. These safety improvements were proposed by us in 1959 as a result of work that this committee made possible. So we are pleased about that. We would like to see credit go to this committee and share a small part of it. All the things that are mentioned, for example, in the GSA list of safety features to be incorporated in Government cars and others currently suggested, are listed in the 1959 testimony. So we feel good about that. We are accumulating many other things in addition to those suggestions but a tremendous amount more surely needs to be done. We are only scratching the surface.

There are many calculations, but about 20 times the amount of research money is being spent per death for cancer than is being spent for accident deaths, and many times more than that for heart disease deaths. That is fine, but I do not think the difference should be so great.

Mr. FOGARTY. I do not think it is enough.

Dr. JOLIET. It very likely is not. I was trying to draw a parallel. If funds are provided to answer questions, and if you look for answers, you will probably find them. We found those and we are finding others as we go along.

PERSONS KILLED DURING CHRISTMAS AND NEW YEAR'S HOLIDAYS

Mr. FOGARTY. How many people were killed during the Christmas and New Year's holidays?

Dr. JOLIET. I do not remember the figure, Mr. Fogarty. It is a depressing one.

Mr. FOGARTY. Will you supply it for the record?

Dr. JOLIET. Yes, sir.

Mr. FOGARTY. How many people were injured by automobile accidents?

Dr. JOLIET. We will also have to supply that. (The information follows:)

PERSONS KILLED AND INJURED BY AUTOMOBILE ACCIDENTS

The Public Health Service does not maintain statistics on deaths and injuries resulting from traffic accidents for time periods, such as holiday weekends. The following are estimates by the National Safety Council of deaths over the 1965 Christmas and New Year holiday:

The number of immediate deaths from motor vehicle accidents that occurred during the 3-day Christmas 1965 holiday was 720, while the total number of deaths for this period (which also includes persons who died after the holiday period as a result of an accident which occurred during the holiday period) was estimated to be 960. For the 3-day New Year's holiday, there were an estimated 562 immediate deaths from motor vehicle accidents and 750 total deaths. Both are records.

For the combined holiday period, the total estimated deaths were 1,710. Information on the number of injuries is not available for this particular holiday period.

The Division of Accident Prevention estimates that there were over 48,000 deaths from motor vehicle accidents during 1965. This is based on the first 10 months data from the Public Health Service 10 percent sample of deaths. Also, there were an estimated 3.4 million persons injured from motor vehicle accidents during 1965.

ROLE OF PHS IN PROVIDING EMERGENCY MEDICAL SERVICES

Mr. FLOOD. With reference to your emergency medical services, you say our emergency medical services program is directed toward getting people with an acute condition the best possible care in the shortest possible time. What do you have to do with it? How can you get anybody care of any kind and what length of time? What do you have to do with getting people care?

Dr. JOLIET. We do not do it ourselves, Mr. Flood.

Mr. FLOOD. I understand. What do you do?

Dr. JOLIET. We only are concerned that high quality emergency service is provided and not that we provide it ourselves. The responsibility lies with the States to provide it and the States want to do so. In those areas where we have been able to cooperate with local people in conducting surveys or where they conduct surveys without our assistance, there has been very serious-minded and high-level realization and appreciation that there are vast areas within State boundaries where the quality of emergency medical care is very poor.

Mr. FLOOD. Do you get down to the local level?

Dr. JOLIET. I visit every level as often as I can, yes.

Mr. FLOOD. By local, I mean municipal, small towns, or cities.

Dr. JOLIET. One of the worst accidents I saw recently was in New Castle, Pa.

Mr. FLOOD. What do you mean you saw? Did you just happen to be going by?

Dr. JOLIET. No, I was sitting on a porch. I used to avoid accidents as many doctors do. Over a period of time I decided I knew more even though in administrative medicine, than spectators do. When we heard this tremendous crash we went to the scene. My wife is a nurse and we both went. A small boy had fallen off a bicycle, was knocked off it, his right leg was partially severed, his right arm was partially severed, he was in the process of bleeding to death. We were able to temporarily stop the bleeding. An ambulance came up. I guess i was worth $15,000 and they did not have a tourniquet, splint, pressur bandage, or anything. They had a $15,000 air-conditioned ambulance though.

Mr. FLOOD. So

Dr. JOLIET. That could happen anywhere. My wife's home is i New Castle. It was a horrible experience and that is the only reaso I mentioned it.

Mr. FLOOD. How can you correct that?

Dr. JOLIET. One of the most effective ways we have, and it has bee quite effective, is to get local high-level groups together to say, "Let see what kind of services we have." The services are excellent in som places, you see. When we can persuade communities to take an inver tory and study their emergency medical services, in the process of doin the study, if they do it themselves they become interested in improvin areas that need improvement.

Mr. FLOOD. With their own funds?

Dr. JOLIET. Thus far, yes. We have no funds to give them.

SURVEILLANCE TEAM IN DENVER

Mr. FLOOD. Speaking of your surveillance teams which you have set up and are going to set up, how did you pick Denver, Colo.? What is there special about Denver? Out of what computing machine did Denver pop?

Dr. JOLIET. The purpose of the surveillance teams, we will call them epidemiological teams, is to provide information on injuries that result from accidents. One such team should be stationed in each one of the nine demographic areas of the country. Denver is in one of them. It did not make any difference with us where we started, but Denver knew of our plans.

Mr. FLOOD. Denver is in one of the demographic areas.

Dr. JOLIET. Yes.

Mr. FLOOD. Who has determined that?

Dr. JOLIET. Not I, sir, I can assure you that. They were already outlined.

Mr. FLOOD. They were outlined by what agency?

Dr. JOLIET. Not by us; it is common knowledge that you can divide the United States into Eastern, Southern, Central United States, and so forth.

Mr. FLOOD. You established your own demography? Dr. JOLIET. No, it falls within one accepted area. that Denver is a demographic area, but falls within one. Mr. FLOOD. Of course.

I did not mean

Dr. JOLIET. I beg your pardon, that is what I meant to say.
Mr. FLOOD. You picked Denver for what reason?

Dr. JOLIET. It happened that Denver knew what we wanted to do. They were tremendously interested, the medical school was interested, so were the local health officer and State health officer. They gave us free space and they got to us "fustest with the mostest."

METHOD FOR SELECTING ADDITIONAL SURVEILLANCE CENTER

Mr. FLOOD. In 1967 you are going to pick another one? Where? Dr. JOLIET. I truly do not know at this time.

Mr. FLOOD. How truly don't you know?

Dr. JOLIET. Absolutely truly, completely. I just don't know. Mr. FLOOD. What are the yardsticks that you will use to measure that one?

Dr. JOLIET. No. 2 should be in one of the other eight areas. There are nine of them. Whichever one is next should be in some other area. We would like to have it in a large population center if possible, for obvious reasons, and we would like to have it where there is a medical school, a university, the things that one usually needs to have to run an operation of this kind.

These teams are tremendously important. They may be the backbone of our program and they may be the thing that will provide a breakthrough on injuries, if we can get them started.

ELEMENTS OF AN EPIDEMIOLOGICAL INVESTIGATIVE TEAM

Mr. FLOOD. What are the elements of the team at Denver? Dr. JOLIET. The elements are five people who are reasonably well skilled in epidemiological investigations.

Mr. FLOOD. How many people?

Dr. JOLIET. We have five but we need more.

Mr. FLOOD. What are their skills?

Dr. JOLIET. One is a physical therapist, one is a statistician, one is a nurse, one is a trained investigator, one is a clerk and we need a statistician. We get our statistical service from the central office.

REGIONAL POISON CONTROL CENTER

Mr. FLOOD. You are concerned about poison control and in 1967 you are going to staff a regional poison control center.

Dr. JOLIET. Yes, sir.

Mr. FLOOD. Where will that be?

Dr. JOLIET. The same place.

Mr. FLOOD. What do you mean, "same place"?

Dr. JOLIET. Denver.

Mr. FLOOD. The path of least resistance.

Dr. JOLIET. It is refreshing, I think, rather than going to a place and fighting for space to have people come and offer space. In addition, Denver had a major poison control center. They have consulted with us hitherto on the development of the national clearinghouse and on the development of our operations.

Mr. FLOOD. They were in on the ground floor.

Dr. JOLIET. I guess you could say that as well as anything else. Mr. FLOOD. My curiosity never fails to be piqued by the legerdemain that establishes these regional offices and the various field centers. Also, my sense of humor sometime. This makes more sense as you are describing it. This is obviously based upon some merit for a change.

Dr. JOLIET. Thank you.

Mr. FLOOD. That is all, Mr. Chairman.

Mr. FOGARTY. Is there anything else you want to say, Doctor?

FUNCTION OF SURVEILLANCE SYSTEM

Dr. JOLIET. I would be pleased to say that we put great hope in the establishment of this surveillance system. I can say it very briefl and I think you will be interested. All groups, and there are man arguments between the many different groups, agree that we have t have information on injuries that result from accidents. We do no have it. There is no way now of getting it. Injuries are not repor able by law. We do not know what kinds of injuries are occurrin to what kinds of people in sufficient detail. It is utterly ridiculous t go beyond a certain point in programing without basic data. We b lieve we will be able to get basic data on injuries this way. We wi be able to put similar types of injuries together.

We will be able to work backward from that and find out what causing those injuries. I am completely hopeful that if this thing ca

be done we will not only supply ourselves information, but also others working in this field and then we can really get at injuries.

Mr. FOGARTY. I do not think the committee is going to cut your request. My only complaint is that you are not asking for enough.

LACK OF EFFORT BY AUTOMOBILE INDUSTRY

Mr. FLOOD. To what extent if any has the automobile industry, management, and labor, contacted your shop and volunteered carte blanche their services to help you execute your program and achieve your goals?

Dr. JOLIET. Three representatives visited us not very long ago. We then saw Dr. Stewart. We asked some questions during the course of that visit. I do not know about Dr. Stewart, but I was not too sure of the purpose of the visit when they had left.

Mr. FLOOD. The answer is to all intents and purposes they have volunteered no great effort and no indication that they changed that attitude.

Dr. JOLIET. Speaking only for ourselves, they have volunteered no great effort insofar as our operations are concerned.

Mr. FLOOD. I do not mean the after-dinner speeches made by the various attachés of the union and management. I read those daily. Dr. JOLIET. Yes, sir.

Mr. FLOOD. I get the impression it is little more than lipservice. But the fact is that with all of your enthusiasm and planning, with all of the stark naked facts as plain is the nose on your face, to everybody, it is difficult for the industry to ignore these very glaring things, yet it is obvious they prefer to ignore them.

Dr. JOLIET. They are making progress now, I think.

Mr. FLOOD. It is obvious they prefer to ignore them as far as cooperating with you is concerned.

Dr. JOLIET. As far as that is concerned; yes.

Mr. FLOOD. That is most unfortunate. This record should show a very pointed criticism of them for their pretense that you do not exist. They know you do. They know the work you are doing. You cannot possibly succeed without them.

It is most unfortunate that a great industry of this kind, which is without any question under certain circumstances responsible for contributing to this appalling condition prefers to ignore it.

STATEMENT ON TRAFFIC SAFETY BY RALPH NADER

Mr. Chairman, I would like to have placed in the record a statement that Ralph Nader made before another congressional committee earlier today on the subject of traffic safety.

Mr. FOGARTY. We will place it in the record at this point. (The statement referred to follows:)

STATEMENT BY RALPH NADER BEFORE THE SENATE SUBCOMMITTEE ON EXECUTIVE REORGANIZATION, SENATE COMMITTEE ON GOVERNMENT OPERATIONS, U.S. SENATE, FEBRUARY 10, 1966

The basic subject of inquiry before this subcommittee relates to the Federal role in motor vehicle safety. The public safety is one of the first and most fundamental functions of any government. Yet is it quite obvious that over the past five decades, there has been no more serious avoidance of governmental respon