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From the accumulated knowledge and experience in family service, we have arrived at some strong convictions. We are convinced that any attainment of happier and more socially useful living for either individuals or families is dependent not upon one but upon a combination of many factors. These include a strong foundation of religion; an advancing and unfettered educational system; a stable community giving every individual opportunity to work; highly developed, preventive health resources available to citizens in all areas of the country; a well-rounded system of social insurance and carefully planned social services, public and private, to assist individuals in overcoming those handicaps, physical, economic, or psychological, which human beings inevitably encounter in everyday living.

From long years spent in working with many hundreds of thousands of individuals, leaders in the family-service field have reached a sure conclusion, that there must be the greatest possible coordination and integration in the planning and operation of preventive and remedial services. This is of paramount importance not only in the voluntary and governmental services, but also between the two.

Any family case worker in a family service agency could cite for you one instance after another where problems of poor adjustment in school are matched side by side with related social conditions, inadequate health care or insanitary and substandard housing; or where conflict and dissension in homes can be traced, at least in part, to lack of play space and supervision for children, or lack of other public resources. Such situations are often impossible of solution in view of the patchwork social structure frequently existing in most communities and within which the social agency has to work.

I cannot speak for all the national organizations in the field of social work, but I know that practically all of them agree on the need of closer integration of social services.

Consistent with this belief, the Family Service Association of America has long favored the integration to the fullest extent possible, of governmental services as a step in promoting the general welfare of all citizens. Some progress has been made thus far in bringing the Public Health Service, the Federal Office of Education, the United States Children's Bureau, the administration of the social insurances, and the Federal assistance services together under the Federal Security Administration. It needs to be carried further, and to have bestowed on it the recognition and status which would accrue if these and other human welfare services were combined in a Federal department under the direction of an executive of Cabinet rank.

In November 1946, at the biennial meeting of the Family Service Association of America, after thorough consideration of this subject by its delegate body, the general assembly, the following resolution was adopted:

Whereas public services essential to the general well-being of the people must be well planned, comprehensive, and coordinated in order to be effectively available to those who need them: Be it

Resolved, That the general assembly of the Family Service Association of America urgently recommends that a Federal Department of Health, Education, and Welfare, headed by a Secretary of Cabinet rank, be established, whereby close administrative relationships could be achieved, the variety and quality of needed services maintained, leadership given to the strengthening of present services and development of new ones, and the importance of these services be fully recognized; be it further

Resolved, That a copy of this resolution be sent to the President of the United States, Members of the Congress, the governors of States, directors of State departments of welfare, health, and education, and to the individual members and member agencies of the Family Service Association of America.

Since then there has been, if anything, increased conviction in the family service field that this move toward closer coordination of the Federal welfare services is of engaging importance and in the interest of every American family. With the steady growth of our population, the increase in the size and complexity of our industrial plant, the need for the maximum of efficiency and the minimum of organizational structure becomes increasingly evident.

The CHAIRMAN. Any questions, Senator Smith?
Senator SMITH. No questions.

The CHAIRMAN. Senator Schoeppel?
Senator SCHOEPPEL. No questions.

The CHAIRMAN. Thank you very much.

Mr. PARKER. Thank you, sir.

The CHAIRMAN. Dr. Frank F. Furstenberg?


The CHAIRMAN. You may proceed.

Dr. FURSTENBERG. Mr. Chairman and members of the committee, my name is Frank F. Furstenberg. I am a practicing physician in Baltimore, Md. I am here on behalf of Americans for Democratic Action. I am a member of the Baltimore chapter of ADA, but today I am representing the national organization of ADA. At this point, I want to thank the committee for this opportunity of presenting our views on Reorganization Plan No. 27.

Americans for Democratic Action strongly opposes Senate Resolution 302 and urges this committee's rejection of it. We support Reorganization Plan 27 as submitted to the Congress by the President on May 31. Our support of this plan stems from the resolution adopted by our national convention in April of this year. The convention adopted position on which we base our approval of plan 27 reads as follows:

We support measures designed to increase the efficiency of the Government. We favor a reorganization of existing departments and the consolidation of overlapping bureaus and functions, provided such reorganization does not curtail or interfere with essential public functions.

Mr. Chairman, it is the view of Americans for Democratic Action that plan 27 meets the specific requirements and limitations of this language; that is, it will increase the efficiency of government without curtailing or interfering with essential public functions.

I do not make any claim to expertness in the field of governmental administration or organization. I am now a private physician, a specialist in the field of allergy, but I was for almost 4 years with the United States Public Health Service. My war service was with that agency. I held the rank of surgeon and was variously assigned to work with the State health services, in rural medicine, on vocational rehabilitation, and in marine hospital work.

Mr. Chairman, my own personal concern and interest in the enactment of plan 27 to create a Department of Health, Education, and Security, grows out of my experience with the Public Health Service, as well as out of my frequent contact with the many operations now within the Federal Security Agency. I have had extensive experience with the inefficiency and wasteful limitations which the uncoordinated work of the several bureaus now in the FSA necessarily developed under their present set-up. The integration of these many activities as provided for in plan 27 automatically eliminates waste and inefficiency and will improve the morale of the Government workers.

It is amazing to me that the multiple functions of the Federal Government in the broad area of human welfare, including the fields of health, education, and economic security, have not yet been granted Cabinet status. There is ample evidence, I am sure, in the record of this committee of the widespread and long standing public support for a Department of Health, Education, and Security. It is an indisputable fact that the activities of the Federal Security Agency exceed in volume and in importance several of the existing Cabinet departments. Its activities are among those of the Federal Government which most closely and directly affect the lives of the greatest number of the American people. We regard the greatly expanded responsibilities and operation of the Federal Government in the vital areas of health, education, and economic security as a demonstration of a dynamic democracy. It is an indication of the increased interest on the part of their Government in the welfare of the people.

Americans for Democratic Action supported plan 1 as originally submitted to the Congress in 1949. We felt that the congressional opposition to that plan was essentially trivial as contrasted with the obvious need for integration in a Cabinet department of the combined constituent units of the Federal Security Agency. The present plan obviously has been drawn to meet the principal objections underlying congressional disapproval in 1949. In view of this, I cannot help but feel that opposition now to the creation of a Department for Health, Education, and Security as provided for in plan 27 can only be assumed to be based upon political or some rather narrow professional considerations inconsistent with the general public interest:

As a doctor, I am naturally most interested in the aspects of the plan which are concerned with the Public Health Service. In my opinion, plan 27 represents certain improvements over plan 1. It provides for the best kind of Government administration, in my view, by assuring that professional functions and responsibilities continue to be in the hands of professionals. Special provision is made so that the office of the Surgeon General of the Public Health Service is to be filled by Presidential appointment with the advice and consent of the Senate. It provides that this officer must meet the professional qualifications required by the post. This kind of assurance of professional competence and administrative efficiency is also given in the case of the Commissioners of Education and Security.

Thus, while the peculiar competence of the constituent units within the Federal Security Agency is protected and strengthened under plan 27, those common functions and administrative details frequently called "housekeeping operations" are consolidated, obviously making for greater efficiency and economy.

Americans for Democratic Action is an independent progressive political organization dedicated to the achievement of a "society in which each individual enjoys the greatest degree of liberty compatible with justice and economic security for his fellows.' We welcome the great advances made within our democratic form of government over the past several years toward achieving greater economic and intellectual emancipation. These advances, particularly in the areas of health and economic security, present an administrative challenge which must be met. The departments of Government charged with the responsibility of protecting the people's interests in these areas must be geared to the job they have to do. We believe that plan 27 provides a program within which it will be possible for the existing agencies to function at maximum efficiency and effectiveness. We respectfully urge that this committee reject Senate Resolution 302 and recommend to the Senate that plan 27 be permitted to become effective under the terms of the Reorganization Act of 1949.

Thank you, Mr. Chairman.

The CHAIRMAN. Doctor, I would like to ask you a question in view of some of the testimony we heard this morning with reference to what would meet the test of qualifications under the plan for the head of the Public Health Service. It does not say specifically that the head should be a doctor, medical doctor or dentist, so it was suggested here this morning that a sanitary engineer in the Public Health Service might qualify as the head of the Public Health Department. Do you agree with that?

Dr. FURSTENBERG. I not only agree with it but I know of no reason why we could not have one.

The CHAIRMAN. You see nothing to prevent it?

Dr. FURSTENBERG. As I read it, it would be within the framework of the legislation.

The CHAIRMAN. In other words, he could meet the test laid down? Dr. FURSTENBERG. There are sanitary engineers in the Public Health field whose understanding of medical work is such that they could qualify.

The CHAIRMAN. I asked you for your views because others testifying this morning used that as an illustration. In other words, it does not require necessarily a medical doctor or dentist or somebody who has actually a professional standing in that field. When I say professional standing, I mean as a physician, as a surgeon, or as a dentist?

Dr. FURSTENBERG. That is right.

The CHAIRMAN. I also asked the others this morning the question if they interpreted to mean that a career man coming up, we will say, in the Public Health Service-I do not know what their different titles are down there anyone who had come up say in the Public Health Service who is not a doctor would be eligible under this because he would meet the test of background of experience and training?

Dr. FURSTENBERG. It would seem to me that some time in the future someone will head the Public Health Service who is not an M. D.; it might be a dentist or sanitary engineer or a public-health educator.

The CHAIRMAN. I wanted to clarify that, everybody's views, as to whether they think it should be a doctor or dentist. I just wanted to clarify the interpretation of the plan from both sides.

Dr. FURSTENBERG. Yes, sir.

Senator HUMPHREY. Is it possible that there is a definition for the term "Surgeon General"? The Surgeon General is a specific title and I wondered whether under the public law establishing that title of Surgeon General there is any qualification which must be adhered to.

The CHAIRMAN. The test here as to the qualifications in the plan is that the Surgeon General, and I will omit the others, "shall have professional qualifications, experience and training appropriate to the duties of his office." It does not refer to any statutory qualifications and that is why it has been suggested that it is a kind of broad and loose provision with reference to qualification and some suggested this morning that even a sanitary engineer might qualify under that and a career man who has come up in the Federal service might qualify. I just asked him to get his point of view since he appears in favor of the plan. Other viewpoints came from those who opposed the plan.

Senator HUMPHREY. My question, Mr. Chairman, was not with reference to Dr. Furstenberg's testimony, but whether or not the public law which established this title, which law is not repealed by this reorganization plan, had any qualifications for the title which were not included in the language of the reorganization plan. I think we will have to check into that.

The CHAIRMAN. If there is any question on it we can do that. (The above information is as follows:)


Washington, July 7, 1950.

Professional Staff Member, Committee on Expenditures
in the Executive Departments, United States Senate,

Washington, D. C.

DEAR MR. SCULL: I am told that Senator Humphrey has requested advice concerning the professional qualifications presently required by law for the Surgeon General of the Public Health Service.

Section 204 of the Public Health Service Act (42 U. S. C. 205) requires that the Surgeon General be appointed from the Commissioned Regular Corps of the Public Health Service. Section 207 (a) (42 U. S. C. 209) requires, for original appointment to the Regular Corps, the passage of an examination "in one or more of the several branches of medicine, surgery, dentistry, hygiene, sanitary engineering, pharmacy, nursing, or related scientific specialties in the field of public health." Section 207 (b), however, permits in addition the appointment to the Corps of a limited number of persons at advanced grades, if they meet "standards established in accordance with regulations of the President." This clause has not been construed as enlarging the professional categories eligible for appointment, beyond those listed in subsection (a).

Sincerely yours,


General Counsel.

The CHAIRMAN. Any questions, Senator Smith?
Senator SMITH. No questions.

The CHAIRMAN. Senator Schoeppel?
Senator SCHOEPPEL. I would like to ask one or two questions.


I noticed, Doctor, that you say at the bottom of the first page your prepared statement: "I have had extensive experience with the inefficiency and wasteful limitations which the uncoordinated work of the several bureaus now in the FSA necessarily developed under their present set-up." Could you briefly elaborate on what you have in mind there, sir?

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