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first-aid training. Industries, community leaders, and local organizations have shown great initiative in sponsoring medical self-help training.

OTHER TRAINING ACTIVITIES

Training courses are being developed for instructing allied health workers in the additional functions that they will have to perform under disaster conditions. With the projected disparity between the number of surviving physicians and the number of casualties following a thermonuclear attack, allied health personnel will be required to perform many medical procedures that they would not perform under normal conditions. A manual entitled "Austere Medical Care" has been developed as a basic guide for conducting these training courses.

Courses in chemical and biological warfare continue to be conducted in cooperation with the Army Chemical School at Fort McCellan.

EMERGENCY HEALTH PLANS

The Public Health Service has submitted to the Office of Emergency Planning new health and water chapters for the new national plan for emergency preparedness. Assistance is being given to regions and States in updating and implementing their emergency health service plans.

BUDGET REQUEST FOR FISCAL YEAR 1965

The estimate of $9,507,000 provides $7,145,000 for the medical stockpile, and $2,362,000 for emergency health training and community preparedness.

MEDICAL STOCKPILE

The request of $7,145,000 for the medical stockpile represents a net decrease of $20,571,986 from the 1964 program level. Components of this decrease are a decrease of $20,458,986 for the acquisition of stocks, a decrease of $149,000 for inventory management, and a program increase of $36,000 for stockpile management.

An amount of $6,559,000 will permit the inventory management activity to continue the essential programs of providing on-site inspections of the civil defense emergency hospitals; inventorying and maintenance of existing supplies and equipment; accelerating quality control, sampling, and testing of items sensitive to deterioration; transportation of materials for rehabilitation and relocation, and for the consolidation of depot stocks to secure underground storage facilities; expansion of depot management activities that include the reconditioning of equipment, stock surveillance, and rehabilitation of hospitals; and for providing modern packaging techniques for the longer preservation of materials. The program increase of $36,000 to a level of $586,000 will provide for the expansion and strengthening of stockpile management activities that plan and direct the operational functions of the medical stockpile.

EMERGENCY HEALTH TRAINING AND COMMUNITY PREPAREDNESS

The request of $2.362,000 for emergency health training and community preparedness reflects an increase of $239,000 over the 1964 level. This increase will provide $36,000 to strengthen the activities of our regional and State assignments in providing guidance and assistance to States and local communities to assure their recovery in the event of a national emergency. An increase of $161,000 is requested for the further development of health mobilization training programs, materials, training aids, and for the continuation of the medical self-help training program. An increase of $29,000 will provide for increasing the capability of the program planning and technical services activity in providing program evaluation, planning, and policy guidance. An additional increase of $13.000 is requested to expand the number of participating medical schools in the medical education for national defense program which provides for the inclusion of disaster training in the schools' curriculums.

We believe that the Public Health Service program of emergency health activities represents a most effective means to achieve the goal of providing a readiness program for the civilian population in time of national disaster.

I shall be pleased to answer any questions you may have.

EXPIRATION OF AUTHORIZATION

Senator MAGNUSON. You told me. I think vou testified. Mr. Secretary, the status of this extension, that is the authorization expires on June 30?

Mr. VANCE. Yes.

Mr. DURKEE. I spoke to that.

Senator MAGNUSON. You spoke to that.

Mr. DURKEE. House Armed Services Committee No. 3 has had hearings on extension of the legislation and voted an extension of 4 years. They are reporting to the full House committee, I believe, on the 12th, tomorrow, and of course, a bill will be introduced in the Senate for similar purposes.

Senator MAGNUSON. So we do have a reasonable chance, let's put it. Mr. DURKEE. I would certainly say so.

Senator MAGNUSON. Of the Senate and the House considering these items?

Mr. DURKEE. Yes.

Mr. VANCE. I would think so, sir.

Senator MAGNUSON. The other one, I think is a little bit, I doubt very much if they would do that considering the time.

All right.

We will recess now with the understanding that if and when the House acts on this bill Congressman Thomas has hopes that he will get it done before the month is out, and then we will come back and we will be able to discuss more specific items depending on what the House does, and I think it would save a lot of time by doing this.

We will put your statement in the record, Mr. Secretary, and we will leave the record open for any changes you want to make and we will call you back almost immediately when the House passes the bill or when it is convenient.

Mr. DURKEE. Will you wait until the House passes the bill or call us back when the committee reports it out?

Senator MAGNUSON. We probably will have to wait until it passes because if there are some floor amendments, this item provokes, your item provokes a lot of floor amendments and you never know what happens to the bill.

Mr. DURKEE. So your plan is to wait until after the House passes it?

Senator MAGNUSON. Yes, I think we had better.

(Whereupon, at 10 a.m., Monday, May 11, 1964, the committee recessed, subject to call of the Chair.)

INDEPENDENT OFFICES APPROPRIATIONS FOR 1965

THURSDAY, JUNE 4, 1964

U.S. SENATE,

SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS,

Washington, D.C. The subcommittee met, pursuant to recess, at 8:35 a.m., in room S-128, U.S. Capitol, Hon. Gordon Allott temporarily presiding. Present: Senators Magnuson and Allott.

VETERANS' ADMINISTRATION

STATEMENT OF MIKE GORMAN, EXECUTIVE DIRECTOR, NATIONAL COMMITTEE AGAINST MENTAL ILLNESS

MEDICAL RESEARCH PROGRAM

Senator ALLOTT. The committee will come to order.

The first witness this morning will be Mr. Michael Gorman, National Committee Against Mental Illness.

Mr. Gorman, we welcome you back to the committee.

You have a statement which you provided me with yesterday. Mr. GORMAN. Yes, sir.

Senator ALLOTT. This statement will be either inserted in the record and you may comment on it, or proceed as you please.

Mr. GORDON. Thank you, Senator Allott.

(The statement referred to follows:)

MORE RESEARCH ON AGING MAJOR NEED IN VETERANS' ADMINISTRATION

Mr. Chairman and members of the committee, since this is the 10th consecutive year that I have testified on the medical research program of the Veterans' Administration, it is appropriate to take stock of developments during the past

decade.

Testifying before this very committee in 1955, I pointed out that a special National Governors' Conference on Mental Health in 1954 had passed a unanimous resolution expressing its conviction that 10 percent of the budget of any public hospital system should be devoted to medical research. The argument behind the resolution was a simple one-unless new knowledge was acquired, the States and the Federal Government would be forced to appropriate constantly increasing sums for hospital construction and for compensatory payments to the sick and the disabled.

I am not a prophet, nor am I the seventh son of a seventh son, but the figures in the President's budget for the Veterans' Administration for fiscal 1965 tell a very revealing and somewhat disheartening story.

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OPERATING COST OF VA HOSPITAL SYSTEM

In 1955, the operating cost of the VA hospital system was about $800 million; for the coming fiscal year, it is estimated that it will exceed $1,100 million.

In 1955, the Veterans' Administration spent approximately $3 billion in compensation and pension payments to disabled veterans: for the coming fiscal year, it is estimated that approximately $4 billion will be required for these same payments.

In 1960, the National Research Council of the National Academy of Sciences, an independent organization composed of some of the most distinguished scientists in the country, conducted an exhaustive survey of the entire VA medical care program. I quote one paragraph from its findings to indicate that this distinguished body of scientists felt very strongly that the VA hospital system was in danger of lapsing back into the stagnation which had engulfed it during the 25 years prior to the end of World War II :

"The medical care program of the Veterans' Administration faces a challenge today in no way less than that which was successfully met in the years immediately after World War II. This new challenge is in some ways more difficult to meet because the issue is not as clear. The task in 1946 was to cast out an old, inferior pattern of medical care and to develop a new and better one. The present goal is to defend and improve a well-respected medical care system which is besieged by constantly rising costs of medical care, increasing competition for professional personnel, progressive deterioration in the relative strength of its salary scales, and the general complacency characteristically associated with success."

RECOMMENDATIONS OF NATIONAL RESEARCH COUNCIL

In order to prevent this stagnation, the National Research Council study recommended a minimum annual increase of 20 percent in the medical research budget so that the VA could cut down on hospital costs and realize its true potential as a leading force in medical research in this country.

For the coming fiscal year, the administration recommends $36,987,000 for the medical and prosthetic research programs of the Veterans' Administration. This is theoretically 10 percent over the current year's spending level, but when mandatory salary increases and rising laboratory equipment costs are taken into consideration, it is an increase of less than 5 percent.

Less than a month ago the House of Representatives cut the administration figure by a million dollars, bringing it down below the amount voted by the Senate last year for the medical research activities of the Veterans' Administration.

This cut, combined with inadequate administration requests in previous years, compels the VA Central Office to turn down millions of dollars in approved medical research projects which have survived a vigorous double screening-by a hospital and medical school committee at the local level, and by the Medical Research Division in Washington.

During the last 4 fiscal years, the VA has not had sufficient funds to support more than $20 million in approved medical research projects from approximately 160 hospitals scattered throughout this country.

In the coming fiscal year, based upon approved medical research requests already received from its various hospitals, the VA will be forced to turn down an additional $6 million in medical research projects.

EXPRESSIONS FROM MEDICAL SCHOOLS

The deans of our medical schools and many of the Nation's most prominent physicians have publicly expressed, in recent months, their deep concern over the lack of forward momentum in VA medical research and medical care. These are the same deans who 17 years ago formed an alliance with the Veterans' Administration to lift its hospitals from the level of bitterly criticized rest homes to modern therapeutic hospitals designed to provide a level of medical care second to none in the world.

In February of this year Dr. George Aagaard, dean of the University of Washington School of Medicine and president of the Association of American Medical Colleges, wrote:

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