Created [?]. Bailey, ‘Minute Sheet’, 23rd March 1935.
23 Mar 1935
Description:

‘Malaria laboratory work was first undertaken by the Ministry in 1919. At the outset a mobile laboratory for the purpose of conducting local enquiries in connection with the prevention of malarial was obtained but the Treasury refused to continue sanction for this beyond 1921. From that date until early in 1925 such laboratory work as was done was undertaken at the Pathological laboratory with a special laboratory assistant.

Early in 1925 and arrangement was made, in conjunction with the Board of Control and the London County Council, for the cultivation of a pure strain of the benign malaria parasite in mosquitoes which would be made available for the inoculation of patients suffering from general paralysis of the insane by mosquito-bites instead of by the direct inoculation of blood from other patients and the testing of the results obtained. The London County Council placed at the disposal of the Ministry, and especially adapted for the purpose, premises at the Horton Mental Hospital...

...

In 1928 the whole matter was the subject of a full discussion between representatives of the Medical Staff, the Establishment Division, and the Accountant General’s Department of the Ministry, and of the Board of Control as a result of which a letter was written to the Treasury.

Generally, the line taken by that letter was that the work when originally underaken by the Department was entirely in the experimental stage and that it was then essential the supply of mosquitoes and control of the treatment should be in the hands of the Ministry. That while it now appeared that it would shortly emerge from that stage it was vital that until the technique was definitely settled the present control should not be diminished...

...

... a further letter was written to the Treasury in March 1931.

This pointed out that the position had somewhat changed and that the experimental nature of the treatment had become more marked than was anticipated, that the technique was far from perfected, that it must continually remain under revision and that to diminish the Minister’s control would to a large extent destroy the utility of the valuable results already obtained. Reference was made to the bearing of this work on the functions of the Department in relation to international health and to the fact that a large part of the cost was borne by the London County Council.

Sanction for continuance was therefore asked...

The position is now again due for review and the review now has to be undertaken with the knowledge that Col. James will, in the normal course, retire from the Public Service in September of this year.

...

It will be seen from the above that the laboratory at Horton performs three functions

(a) the maintenance of a sufficient supply of malaria infected mosquitoes for the inoculation of general paralysis of the insane patients at Horton and elsewhere.

(b) the study of the technique of the treatment and of the results of the treatment of such patients by inoculation.

(c) incidental general research into certain aspects of malariology (including its international aspect);

That though in 1928 we went very far with the Treasury in explaining that the work was temporary and could not involve us in permanent commitments we have retreated very rapidly and almost completely, from that position; that we have hitherto justified the continuance of this work on account of its experimental nature; and that there are indications that the Treasury will want tome further information as to the position it is desired ultimately to reach.

It therefore seems necessary now to determine

(a) How far has the Ministry the power to keep this work going once the experimental stage has been passed.

(b) When the experimental stage is likely to be over.

(c) If the Ministry has power to keep the work what is the best way of securing continuity.

(d) Whether the various functions are so indivisible that they must all be kept together.

It is suggested that these questions can be considered apart altogether from the personal issues relating to Colonel James. It seems obvious that whatever the ultimate future of this work his services must, if the work is to continue at all, be retained in one form or another whether the Ministry keeps it or it goes elsewhere.

In 1928 we definitely took the view that the only justfication for the work being kept by the Ministry was its experimental nature and that once the experimental stage was over we could not continue the responsibility. Dr. Carnwath’s minute of the 7th September 1934 seems to agree that the experimental stage at any rate so far as the supply of infected mosquitoes is concerned is over and also to agree that the time has come when it should pass from this Department.

The Chief Medical Officer would also seem to agree that the work might well be transferred to the London School of Hygiene and Tropical Medicine if it were not for the difficulty of retaining the services of Colonel James.

It seems, however, generally, to be agreed that the Ministry must retain some interest in the work and it is suggested that a solution might be found somewhat on the lines of the arrangement with regard to Medico-Statistical work. Would it not be possible for the London School of Hygiene to take this work and for us to pay a given sum each year in respect of the work done for us? Initially this sum might be paid on the understanding that Colonel James were retained part time to train a successor. If we keep it the real difficulty that I see, apart from the technical question of whether or no we have the power to keep it, is that we can never be certain of securing a continuity of medical officers with the requisite knowledge and experience. The London School of Hygiene, being so peculiarly interested in malaria, would not be likely to have the same difficulty.

[?]. Bailey, 23.3.1935.

[separate hand:

‘Secretary.

This is a somewhat difficult question, & perhaps I might discuss some time with you?

Ha. Leggett. 25/3.’]