POLIO EPIDEMIC (Incompetence of Ministry of Health)

3.24 p.m.

Mr A. J. Braga: I was saying, Sir, that the Committee of Experts was so convinced of the safety of the Sabin vaccine that it also made recommendations, which I am now reading from page 25:

"After careful consideration of the data at present available on the use of live attenuated polio viruses as immunising agents against poliomyelitis, the Committee strongly recommends that controlled field trials be carried out for the purpose of testing further the value" -

not the safety, which has already been established,

"of these agents. It recommends that these trials be done in special situations and under special circumstances which are listed in more detail below",

and the special situations which the Committee believe will lend themselves to this type of trial, are; in the face of an impending epidemic, or at the periphery of an already existing epidemic; where poliomyelitis of the infantile type is endemic, and in particular, within those areas where signs are indicative of an imminent shift to the epidemic form of the disease to reinforce the immunity previously produced by an inactivated virus vaccine. Now, Sir, the Committee has recommended that large scale field trials should now be carried out, basing its considerations on the knowledge available up to July 1957. This was, however, not the only evidence upon which I relied.

I would like to quote from the Annual Report of the National Poliomyelitis Foundation covering the period July 1957 to 30th June, 1958.

"Three tests were carried out, one by Professor J. D. Verlinde of the University of Leiden, Holland, on 170 children and adults in families of Faculty members of the University. Next by Dr M. Ramos-Alvarez of Mexico City on the detailed study of 3,000 children under 8 years of age, and also by Professor A. A. Smorodintsev of the Institute of Experimental Medicine in Leningrad."

These are cited in the Annual Report of the National Poliomyelitis Foundation, at page 8. In the last-mentioned field trials, the Russian professor carried out five or more serial passages. He cultured the virus excreted from the first batch of children and injected them into the spinal cord of monkeys. The monkeys showed no evidence of paralytic attack. Then he fed that culture to a further batch of children and repeated consecutively five times or more, and this experiment was carried out on 3,000 children. The efficacy and safety thus shown by Sabin vaccine have resulted now in the Russians feeding 200,000 children with the Sabin vaccine as a preliminary canter. Mexico is trying on 200,000 doses, and Czechoslovakia 200,000, and the reason why the 100,000 doses now being used in Singapore are still under expert control, is largely to comply with the request of Professor Sabin with whom Professor Hale has been in constant touch, and to demonstrate to those who have doubts that it is both safe and efficacious.

Singapore is not a country as large as many others. In such countries it is possible to test the vaccine out amongst restricted communities without fear of it, if it is proved to be dangerous, spreading to the rest of the community. Any disastrous experiment of this nature in a small place like ours may involve the entire nation. That is the main reason why prolonged studies had to be carried out in Singapore and await the results of studies elsewhere until we are satisfied that it is safe to use it. It is of interest to Members to note that the tests conducted by Professor Hale on 50 to 60 persons specifically for giving immunity and the assessment of safety showed that the virus excreted in all cases were no more virulent than the weak virus put in.

At or about the time that Professor Hale was conducting his tests, many other matters were engaging the attention of the Ministry, such as the prevention of the spread of diphtheria, the anti-tuberculosis campaign and, in particular, the cholera problem in Thailand, the prevention of entry of which engaged the full attention of the Ministry. Hon. Members are aware of the success of these concrete actions. Singapore had not been visited by an outbreak of poliomyelitis since January 1957. Outbreaks usually occur every 2½ to 3 years, but let me assure Members that when cases of poliomyelitis were being notified in September, the Ministry recognised the urgency of a decision regarding the safety of mass use of live vaccine in accordance with the recommendations of the Report. The Ministry consulted the Federation Health Authority and the Services to study the problem. An Expert Committee comprising the following studied the problem:

The Director of Medical Services, Singapore; the Deputy Director of Medical Services, Singapore; the Assistant Director of Medical Services (Health), Singapore; the Director of Medical Services, Federation of Malaya; the Virologist of the Institute for Medical Research, Kuala Lumpur; the Assistant Director of Medical Services, Singapore Base District; the Assistant Director of Pathology, F.A.R.E.L.F.; Professor J. H. Hale; Professor G. A. Ransome; the City Health Officer, Singapore; Dr A. W. S. Thevathasan; Dr B. R. Sreenivasan; Mr Yahya Cohen and Dr Foo Chee Guan, and after studying this matter very carefully and critically, gave its final recommendation on a division of votes applied to all but the Ministry's representatives at the final meeting on the night of the 11th of October, 1958, that the vaccine is safe to use and should be employed without further delay.

Mr Speaker: Order. I hate to interrupt the Minister especially when he is on a very important point, but I must remind him that we are in a debate and he ought not to demonstrate that he is reading too much.

Mr Braga: Very well, Sir. I immediately consulted Professor Hale who had been conducting satisfactory tests and the Director of Medical Services, Singapore, after which we authorised mass inoculation and in accordance with the specific directive of Professor Sabin given to Professor Hale that the campaign must be done under his, supervision. Further supplies were immediately asked for. This decision was in no way precipitated by articles appearing in the Press or, in fact, by any suggested pressure. I would like to repeat that, Sir.

I have given the history of the decision right up to the time of the decision of the release of the vaccine and I can assure you, Sir, and Members of this House that it was not precipitated by any articles that may have appeared in the Press or by any pressure. The situation was ideal to use Sabin vaccine and to prove to doubting Thomases the efficacy and safety as recommended by the World Health Organisation and the polio experts so that in future the Minister for Health can authorise mass inoculation as routine. Hon. Members know that 100,000 doses have been received and are being administered in various centres. The virus now affecting the people of Singapore - and I am now giving this as a matter of information to all those interested - is Type 1 virus. The virus used in Sabin vaccine is Type 2, but evidence has shown that infection by Type 2 virus blocks the gut not only from infection of Type 2 virus permanently, but against Types 1 and 3 for a considerable time, and, in fact, no Type 1 virus can affect anybody who is inoculated with Type 2 for a considerable time. Type 2 virus cannot at any time produce a Type 1 epidemic. Perhaps I should read some of the telegrams that passed between my Ministry, Professor Sabin and Professor Hale. A telegram had already been sent by Professor Hale, but my Ministry did not hear anything, and so sent a cable on 21st October to Professor Sabin of the Children's Hospital Research Foundation, Cincinnati:

"Further to Professor Hale's cable this Government would appreciate one hundred thousand doses of your attenuated vaccine stop Will meet costs".

Professor Sabin then cabled to Professor Hale in a telegram which I will now read:

"Pending receipt your letter can ship vaccine immediately after I know plans for use stop Responsible investigators stop Arrangements for clinical and laboratory surveillance stop Regarding administration during epidemic would agree only to use of Type two vaccine if prevalent viruses are Type one or three - Sabin".

Then, Sir, we sent this cable after having consulted Professor Hale on the 22nd October to Professor Sabin:

"Epidemic due entirely to Type one stop Investigation and administration of vaccine in hands of Professor Hale stop Children three months to ten years being given Type two oral vaccine stop Four thousand doses already administered stop Investigations stop Proportion of excreted virus tested pathogenicity stop Virus isolation and typing is carried out on all cases of poliomyelitis stop Please assist one hundred thousand doses air freight vaccine as soon as possible stop".

And we have got the final cable on the 23rd October:

"Shipping one hundred thousand doses Type two oral polio vaccine on PAA Flight eightthree one arriving Singapore October twenty-seventh - Sabin"

Questions may have been asked, Sir, why the vaccine originally had to be administered at the two clinics - at Lim Ah Pin Road Clinic and the Yio Chu Kang Road Clinic. The vaccine which Professor Hale received from Professor Sabin was specially for his personal use in field trials and naturally would be insufficient for the purposes of an immediate national immunisation programme. There was, therefore, very great need to limit the numbers. Also, apart from the city, most of the prevalence was in the areas served by these two clinics. Until large stocks became available, the city could not be handled and the logical areas would be those two districts. The Ministry is satisfied that with large quantities of the vaccine now available we are able to immunise a very substantial proportion of the non-immunised population.

As I have mentioned earlier, Sir, the first large-scale administration of Sabin vaccine should be, in accordance with Professor Sabin's directives, under the supervision of Professor Hale. We are negotiating to retain Professor Hale who is due to leave in December this year until this epidemic is over. Subsequent administration of the oral vaccine can then be a routine measure.

I do not know whether it was suggested that the Sabin vaccine is still in its experimental stage, but it must be remembered that any vaccine is, in fact, still in an experimental stage. The Salk vaccine is still in its experimental stage, and there is much dissatisfaction as to its efficacy, so much so that a fourth injection is now advocated, and I would now like to read from Medical News, which is a newspaper for physicians, dated 6th October, 1958. It is an American paper from Washington:

"A nation-wide increase in paralytic polio incidence with the upswing taking on epidemic proportions in the Detroit area is adding weight to the arguments of those who advocate a fourth Salk shot. Some 11 deaths in 162 paralytic polio cases have been reported so far this year among Americans who received three shots of Salk vaccine. Under the circumstances, the Public Health Service said here that physicians may want to recommend a fourth injection to give their patients the maximum possible protection."

Now the Public Health Service authorities added:

"Waning immunity could not be ruled out as one possible factor in the development of paralytic polio among triply inoculated persons since many cases developed more than a year after the third injection."

Confidence in the Sabin vaccine, Sir, can be seen in a personal letter from Professor Sabin to Professor Hale - I am reading from the original - dated 22nd October:

"Dear James,

I am in receipt of the telegrams from yourself and from the Ministry of Health that were sent to me on October 21st and the one from the Ministry of Health sent on October 22nd in reply to the one that I had sent the day before. I have not yet received your letter."

Then it goes on to describe the technical ways of using it, and it finally winds up:

"You may be interested to know that a trial with aliquots of this vaccine on 200,000 children has been started in the Soviet Union and that another one is soon scheduled to start on 200,000 children in Czechoslovakia. Drs. Ramos-Alvarez and Gomez have already completed a trial on 3,000 children who received all three types without any complications and plans are now under consideration for extending these tests to an the 200,000 children under five years of age in Mexico."

With regard to the criticisms of the apparent contradictory statements by members of my Ministry, it must be borne in mind that the information we give to the Press is often asked for by telephone, is edited and published. These statements were made at a time when we were in no position to make any definite statement as to the use or otherwise of the vaccine when its efficacy and safety was still under discussion and no decision had yet been made.

Now, with regard to the question of the cost of Salk vaccine which was referred to by the Member for Tanjong Pagar -

Mr Lee Kuan Yew rose -

Mr Speaker: Is it in elucidation?

Mr Lee Kuan Yew: Yes, elucidation.

Mr Speaker: If the Minister will give way.

Mr Braga resumed his seat.

Mr Lee Kuan Yew: I am not in the least bit interested in the cost of the Salk vaccine. In fact, what I wanted to impress on the Minister is that nobody in Singapore is interested whether it costs $1 million or $3 million. All that they are interested in is to see that their children get the best possible protection. I am not interested in arguing costs.

Mr Braga: I do not consider that elucidation, Sir, because the hon. Member did refer to the fact that I mentioned $10 in the Press as the cost of a Salk vaccine injection, thereby involving the Government to the extent of $3 million.

Mr Speaker: The Minister is not out of order.

Mr Braga: That appeared, Sir, in the Sarawak Tribune which was under discussion at the time of the Press conference. It said here:

"It will be recalled that in April this year the Director of Medical Services in Sarawak, Dr Glynn Evans, in order to encourage the use of poliomyelitis vaccine among the people here, announced that vaccinations would be given free of charge until the end of last May, when a charge of $10 per vaccination was imposed."

That was the cost of a Salk vaccine injection.

With regard to the question asked by the hon. Member whether the Sabin vaccine would be rapidly and efficiently distributed, my answer is yes. The question is now being studied as to the various centres in which it would be properly and efficiently administered. It must be remembered that Professor Hale has to keep this vaccine at a certain temperature and there are certain technical matters involved of which I am ignorant. The vaccine has to be made up, sent out every morning and returned to him. He personally supervised the administration of the first batch that was given to him for field trials; and as regards the other batch he has got technical men who are fully trained and we will try and distribute the vaccine in more centres. As to the necessity of an expert team coming to supervise this, there is no doubt whatsoever in my mind at all.

Sir, I am not in a position as the Member for Tanjong Pagar is to make political capital of other people's sufferings, but as a responsible Minister I am fully aware of my duty to the public and to the advancement of medicine.

3.45 p.m.

Mr Lim Cher Kheng: Mr Speaker, Sir, in fact, I was prepared to keep quiet in this debate because I did not wish to make political capital out of the situation and also because I am not a medical expert. But, I wish to say this, after listening to such a lengthy and interesting debate in which the Minister for Health suddenly became a polio expert overnight. Looking at the motion charging the Ministry of Health for the inept and incompetent manner in which the current polio epidemic is being handled, I think this may not be entirely due to the polio epidemic itself but to the way Public Relations officers have been releasing information to the public. I wonder whether it is time for me to advise Mr George Thomson to learn something from Mr Gary Wang of the City Council. Sir, if that lengthy analysis of the polio situation by the Minister for Health had been published about a month earlier, I do not think the mover of this motion would have taken the trouble to waste his lungs in trying to seek cheap publicity here.

Mr Speaker: Order. I did not quite catch the expression. Would the hon. Member just repeat that expression?

Mr Lim Cher Kheng: Sir, I am sorry. I will withdraw the expression "cheap publicity".

Sir, I think the Government should learn a great lesson from this motion. It is not for us now to debate the merits or demerits of using Sabin vaccine. What the Government should do is:

(1) Avoid the ugly situation on Monday when the polio treatment centres were besieged by angry parents;

(2) The Ministry should consider whether it is wise for an observation team to be sent out to observe and supervise that the use of this Sabin vaccine is really effective, because we have already heard that some authority has thrown some doubts on its efficacy. I am sure the Minister will say, no, we are short of hands to administer the Sabin vaccine and Professor Sabin has specified that only Professor Hale in Singapore is qualified to carry out this vaccination. So, if Government doctors are not sufficient, then let the Ministry appeal to private practitioners to volunteer and help in combating this epidemic;

(3) I wish the Minister for Health would think three times, not only twice, and postpone his annual holiday to Japan. That will show us that he and the Ministry of Health are concerned with our welfare;

(4) I am sorry I have to pass this remark on the mover of the motion. He is trying to seek cheap political publicity by making this - Sir, I beg to -

Mr Speaker: Order. The expression has been withdrawn, but apparently not with effect.

Mr Lim Cher Kheng: I am sorry, Sir. I will withdraw the expression. I mean I wish to remind the hon. Member for Ponggol-Tampenis that if the mover of this motion is a regular goer to the Royal Island Club, is it wrong for the Minister for Health to be a regular hunter or fisherman?

3.51 p.m.

Mr R. Jumabhoy: Mr Speaker, Sir, I am glad that the mover of the motion has stated his case in very modest terms. Personally, Sir, as a father and a grandfather of many children and grandchildren, the first thing when I take up the paper every morning is to find out what the position is about this polio epidemic. There are thousands of parents in Singapore who might be doing the same thing every morning and worry. Personally, I believe in fatalism, but after taking all the necessary precautions!

Sir, the public of Singapore should have protection from the Government. The Government owes that duty to the public. Has the Government done its duty in this case? I am not going to make political capital out of this motion at all. As I said, I am a worried man. We have had polio epidemics before - during the lifetime of this Government - if I am correct. If that is so, what has the Government done since that time to prevent a recurrence or take precautionary measures against it? The Minister for Health has read out reports, telegrams and letters which only date back to September or October this year, subject to correction. He has not said that precautions were taken by his Ministry or by himself much earlier -

Mr Braga rose -

Mr Speaker: Point of explanation?

Mr Braga: I think, Mr Speaker, I did say that experiments had been conducted since 1956 by Professor Hale.

Mr R. Jumabhoy: Thanks for the explanation, Sir. His Ministry was doing something but could not do much to prevent the epidemic from reaching this stage. It was the Government's duty to have taken all the precautions. Today the parents are living in the greatest fear - what will happen next? it is my fear and it is everybody's fear. If it comes to a vote on this motion, I will, of course, abstain, because I am not going to make political capital out of it. This motion is rather late in deploring, because this Government has been found incompetent in every Ministry except the Ministries held by the official Ministers, if I may say so. That is why I will abstain if it is forced to a division. Sir, I hope even now the Government will take every possible step to protect especially the children from falling victim to this disease.

One more thing I might touch upon, and that is the hon. Member for Tanjong Pagar quoting from the Straits Times. This paper is not run by a charitable organisation. It is a limited company formed on a commercial basis. It is out to make as much money as possible, get as large a circulation as possible, and it will publish stories that will sell well. I think many other papers are also run on the same basis. What can we get out of them? Nothing. So the Government and we ourselves should be very careful about what statements we should make.

3.56 p.m.

Mr Soh Ghee Soon: Mr Speaker, Sir, I came here this morning with every intention of criticising the Minister for Health and his Ministry for their slowness in creating centres for vaccination and registration. So far we have only two centres. Daily the Press reports the spreading of this disease. Thousands of parents every morning are attending these centres. It is clear that these two centres are insufficient to cope with the work that is involved. I do not know why the Government has not provided more centres and engaged more staff.

Despite this shortcoming, Sir, after hearing what the Minister for Health said just now, I am satisfied that the Government has not entirely neglected its duty. It has done its best in trying to prevent the spread of this disease and, on the whole, Sir, I am personally satisfied that the Ministry of Health has not done too badly.

3.57 p.m.

The Assistant Minister to the Chief Secretary (Mr M. P. D. Nair): Mr Speaker, Sir, I think the hon. Member for Tanjong Pagar has been very unfair when he based all his criticisms on the Straits Times reports. Sir, the Member has often said in this Assembly that he does not rely on the information in the Straits Times and that only a small percentage of the population do read this paper.

I envisaged the type of argument that the hon. Member would advance in this debate and I have brought with me several cuttings from both the Singapore Standard and the Straits Times. Sir, I believe that there is no confusion in the minds of the people of Singapore, because of the factual reports that have been appearing in the Singapore Standard, the Nanyang Siang Pau and the Sin Chew Jit Poh and various other newspapers. For example, Sir, I will read out a Press report which appeared in the Singapore Standard on 2nd October wherein they said:

"'Protect Your Children'

POLIO WARNING TO PARENTS IN THE COLONY

The Singapore Government last night warned parents to take precautions against their children contracting poliomyelitis in view of the increase in the incidence of the disease last month.

The Director of Medical Services. Dr M. Doraisingam, in a statement, revealed that last month 32 cases of "polio" were reported, 24 of whom were from the City area.

Twenty-seven of these cases were under five years of age, said Dr Doraisingam.

The Director advised all parents and guardians that:

any child who has a fever, however mild, should be put to bed immediately and a doctor called in."

Sir, all these advices were given by the Doctor through the Press and the Singapore Standard deemed it fit to publish this in a factual manner. I think, Sir, we should not believe anything written in a mad paper and I believe sane people should understand the facts quite clearly.

I am sure, Sir, hon. Members of the Assembly are quite aware that the Ministry of Health has no control over the newspapers; for that matter, even the Government has no control over them. We have allowed full freedom to the Press and I do not think for a moment that this is the sort of thing we should try to control. I do hope that those people who have read the Straits Times and all other newspapers would be fully aware of what the Straits Times has been telling the people. I do agree with the hon. Member in this respect, Sir, that the Straits Times has exaggerated many of its reports and distorted the facts in such a manner as it has found fit to publish; but I do not think for one moment that the Minister for Health or his Ministry officials should be made responsible for what has appeared in the Straits Times.

What I have to say in this debate is this, Sir. The people of Singapore are not in any way confused. They have understood the position quite clearly. They have observed the advice given by the Ministry officials in this respect. They have understood what they should do as a precautionary measure for their children.

Finally, Sir, I must say that this motion should not have been brought into this House for discussion. Whatever little confusion the people may have had is now increased because of this motion before the House. I hope, as a result of the publishing of today's debate in the newspapers tomorrow, the people will be able to understand the problem much more clearly and know that the Minister and the Ministry of Health have not been responsible for all the muddle which appeared in the Straits Times.

4.02 p.m.

The Minister for Communications and Works (Mr Francis Thomas): Mr Speaker, Sir, I would like to make the point that we can all, whether in the Government or in the Opposition, be happy that although the methods of controlling and treating polio are still in the early stage, yet some progress is being made. It is a matter on which I think we should fix our attention.

In 1945, I was myself a victim of polio in a Japanese prison camp and there was no treatment available. I well remember the feeling of despair with which I arrived under American care in a hospital in Manila and received the final diagnosis there from the doctors. However, now I am able to get along with my two legs quite happily and the only inconvenience I suffer is that I cannot run and, as I do not like running, I suffer no real inconvenience from this affliction. Since those days 13 years ago, considerable progress has been made but we must still recognise that the science of medicine is a science and not a form of magic. We cannot expect the doctors to pull out of the air a cure which will immediately and definitely be final and absolute. The progress of science is much more moderate than that.

Now, when we leave aside that aspect and the aspect of newspaper publicity which are almost irrelevant to the motion, we are left with, I think, really one demand from the supporters of the motion, and that is that there should have been more centres and more staff to deal with this outbreak. I think it is fair to say that the medical services have been expanding at an enormous rate during the last few years and that expansion has only been insufficient because the demand for medical services has expanded still more rapidly. Time was when most people in Singapore had not very much faith in Western medicine. Today, I myself receive frequent requests from people in the countryside to try and get medical services of one sort or another provided. The demand is growing everywhere for Western type of medicine and the result is that the staff at the medical services with all its expansion is appropriate, I am told, for a population of about 400,000 people by Western standards, whereas our population is about 1,500,000. Consequently, the staff is just not there for all the requirements and, if in any attempt to deal with polio, staff were transferred from other essential work, it is by no means certain that the situation would really be changed for the better.

Polio is a horrible disease with a high rate of suffering and death attached to it, but there are many other diseases in Singapore which do not get the same publicity; perhaps because they are continuous and do not appear in sporadic outbreaks, and perhaps they are of less news value. But you cannot forget the sufferers from other diseases in demanding that more centres and more staff should be provided for this particular disease. I should like to stress that point because the same sort of situation is going to face Singapore in almost all departments of the public service, as far as I can judge, during the next few years. The demand for services from the Government is always increasing, but the means of supplying those services is at the moment not increasing or, where it is increasing, it is not increasing at the rate in which the services are sought. That is perhaps inevitable at this stage because of the adjustments that are being made in the country.

There is one thing that does need to be borne in mind. Attacks should not be made which fall on the wrong people and which, in so far as the civil service is concerned, might lead to a loss of morale. I have no doubt that in detail many things can be found wrong - medical services or any other services - but that does not remove the much important fact that a very great many things are extremely right and are extremely well done.

4.08 p.m.

Mr Lim Choon Mong: Mr Speaker, Sir, after hearing the speeches in this debate, I find that there is something in the motion which merits the attention of the people. They want to know how the battle against polio is conducted, who is directing operations in this battle, what he is doing and what he will do. We have heard that the expert for polio would like to take his leave arid go to England, but that he would rather remain here in order to see the whole scheme through. Could the Minister also not stay back in Singapore and postpone his holiday in order to see the battle through? If people whose homes are not here attach some importance to this battle, then our own Ministers should take a cue from them.

Sir, I would say that the public are all confused. They just do not know what to do. I have been talking to many people and I have asked them, "Why do you want to take Sabin?" The answer is, "Oh, we want to immunise our children." But I have heard from the Ministry that the taking of this vaccine is not to immunise the population but that it is something that should be done continuously, and so on, and not during an epidemic. I read again in one of the Sunday papers - I think it was the Singapore Standard - which gave a detailed report of an interview with the Ministry of Health. There I read some other reports again saying that there are three types of virus: Type 1, Type 2 and Type 3, and that if you get yourself immunised against Type 2, then there is still a chance of your being attacked by Type 1 or Type 3.

Mr Lee Kuan Yew: No, it blocks Type 1 and Type 3.

Mr Lim Choon Mong: Yes. Then we have been told too that the Salk vaccine condemned by the Minister for Health is not effective but Salk is praised by private practitioners as something that has been tested. Now all these are confusions. The people are confused; they get worried; they queue up at 3 a.m. in the morning to get their children immunised. We must stop this scare. We must tell them the truth about what the Government is doing in order to help pacify them. My colleague has said that the Government has done very well or has done its best. I do not disagree with him. The Government has done its best but, just as a school teacher will write on the report card of a student we will say: "He can do better." I am afraid the picture that has been presented to us is not too good. I would say that we expect the Government to pacify the people by telling them exactly what is being done for them and what results to expect, and so on. Let the whole picture be cleared up and not left in this muddle with too many experts voicing too many opinions, all different from one another.

4.12 p.m.

Mr Lee Kuan Yew rose -

Mr Speaker: In reply?

Mr Lee Kuan Yew: In reply, Sir. I do not want to whip a beaten dog but I would like to suggest to the Minister that a few things could be done: one, to restore public confidence; two, to see that the job of distribution of the vaccine and the vaccination is done strictly and effectively.

The first is to get his Expert Committee, who sat and deliberated on that W.H.O. Report after the Geneva meeting of experts, to set out in clear and simple terms why they agreed, unanimously, it appears, to recommend to the Government the use of the vaccine. That will dispose of the fear once and for all created by all these anonymous private practitioners who get quoted in the Press. Set out plainly and simply why this group of people - the A.D.M.S. (FARELF), the A.D.M.S. (Army), the D.M.S. (Federation of Malaya) and the D.M.S. (Singapore) - having considered everything, recommend it.

The second is, what does the Government propose to do to make sure that 100,000 vaccine doses are speedily administered, when it hopes to get more, and when it hopes to get the whole process over? If the Government would do that, there would be a return of, at least - if not of confidence - some reassurance that even if the Minister does not know what is going on, there are people there who do know so that even if the Minister is away on his annual sojourn, there are other people there who will get on with the job and see that everybody is immunised.

Question put, and negatived.

Motion accordingly negatived.