February 12, 1934

CON

Murray MacLaren (Minister of Pensions and National Health)

Conservative (1867-1942)

Mr. MacLAREN:

No. The understanding at the outset was that the federal government would make a contribution, and it was a very substantial one, for a number of years, with the object of putting the matter in operation and supporting the organization.

In reference to child welfare, the department of health keeps in close touch with the child welfare association. One of its aims is to further the care of maternity cases, of mothers, infants and children, and this cooperation has advanced in the last year so that there is now a special connection between the Department of National Health and the child welfare organization. That is something which I believe will lead to increased efficiency, and hon. gentlemen will have the opportunity of hearing more about it when the estimates are under consideration.

Quarantine and immigration come under the jurisdiction of the federal department of health, in order that the government may protect the health of Canadians by preventing the admission of serious infectious dise'ases. The officers of that department, so far as immigration is concerned, are responsible for seeing to it that only those who are healthy and free from disease are admitted to this country. I trust I have given some examples of the really important work carried on by the department and affecting the whole of Canada.

I am afraid that the government will not be able to support the resolution, which is similar to the previous one asking that the matter be referred to a committee for report. The government is responsible for the efficient and satisfactory administration of the department of health. I do not know the views of the mover of the resolution, but it seems to me to be desirable in a matter of this land that the motion should not be pressed to a vote. I trust he will view the matter in that way. In any case, however, the government will not be able to accept the motion.

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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UFA

Henry Elvins Spencer

United Farmers of Alberta

Mr. SPENCER:

Before the minister takes his seat, if he cannot give me some more hope than be has so far as regards the principle of the resolution, I would rather press it to a vote. The minister has certainly thrown cold water upon the whole question of cooperation in the matter of health. If he will give me any hope at all, I shall not press the matter to a vote, -but I certainly cannot sit still under the fast statement of the minister.

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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CON

Murray MacLaren (Minister of Pensions and National Health)

Conservative (1867-1942)

Mr. MacLAREN:

I do not understand my hon. friend's suggestion that I am throwing cold water upon the question of cooperation

Federal Health-Mr. Willis

between the provinces and the dominion, as almost everything I have said has been supporting it. I have given him many examples of the dominion government and in particular the department of health doing all it can to promote cooperation among the provinces. There is, so far as we Can carry it out, a close connection between the provinces and the federal deaprtment of health. For example, there may come to the federal department information of an important character concerning, perhaps, some infectious disease, and that information is conveyed to the health officers of the different provinces. There is cooperation in that respect. There is an attitude of mutual helpfulness between the provinces and the federal department; there is a good understanding, and I wish to convey to the hon. member that I am not throwing cold water, as he says, on the question of cooperation. I am indicating that there is a cordial recognition of the importance of the whole question, and an attitude of increasing, so far as possible, active cooperation between the various provinces and the dominion.

Mr. ERRICK F. WILLIS (Souris): Mr. Speaker, I should like to say a few words in regard to the resolution now before the house, because I am deeply interested in any policy which would give better health to the general public. The resolution before us, in my opinion, would involve a strengthening of the duplication of services which now exists as between the federal and provincial governments, and for that reason I am opposed to it. In the province of Manitoba from which I come we have a department of public works, even as we have here; a department of labour even as wrn have a federal department of labour; a railway commissioner even as we have a minister of railways at Ottawa; a minister of health even as we have the Minister of Health (Mr. MacLaren) who has just spoken; a department and a minister of agriculture just as we have in the federal government here; an attorney general just as we have a solicitor general here; a provincial treasurer as compared with the minister of finance and also a minister of mines just as we have a minister of mines at Ottawa. In my opinion the whole question of the matters to be handled by the federal as opposed to the provincial government should first be redefined in. the light of present day circumstances, rather than that we should do anything to increase the duplication of such services. I do not agree with nor am I in favour of an amalgamation of the western provinces to bring this about. I hasten to make this remark due to the fact that the press in Mont-

real recently said that I had made such a statement. Rather do I think we should commence now to define those matters over which the federal government has sole jurisdiction and responsibility as against those over which the provincial government has sole jurisdiction and responsibility.

Let us consider for a moment the question of public works. Recently as a relief measure we constructed public works partly through the municipalities, partly through the provincial government and partly through the federal administration. If the poor voter, the forgotten man on the street, desired to malqe any complaint in. regard to public works he had nowhere to go. He might try, if he would, to complain to the municipal council; he was passed on from the municipal council to the provincial government, from the provincial government to the federal government, and then, no doubt, the federal government passed him back to the municipal council again. This is on account of the fact that the individual responsibility of these bodies in connection with public works and other matters is not sufficiently defined. This fact is more clearly revealed in the operations of the department of labour whereby we now administer relief. Again the poor forgotten man has nowhere to go; he does not know where the responsibility rests. Here also we require a redefinition of where that responsibility may lie, because if you do not say definitely where it lies, you put a premium upon lying and much of it is done.

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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UFA

William Irvine

United Farmers of Alberta

Mr. IRVINE:

May I ask what is going to become of this forgotten man while my hon. friend is finding out where the responsibility lies?

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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PC

Errick French Willis

Progressive Conservative

Mr. WILLIS:

Perhaps in view of the fact that the hon. member is creating a new party he will need some of these forgotten men in it.

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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UFA

William Irvine

United Farmers of Alberta

Mr. IRVINE:

If we have them all we will have the biggest party.

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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PC

Errick French Willis

Progressive Conservative

Mr. WILLIS:

Then we come to the question of railways. I am completely at a loss to know what the railway commissioner of the province of Manitoba does. We have such a commissioner and no doubt he has some work to do. We also have a minister of railways in Ottawa and a department of railways in Ottawa, and why we should have the two services I am at a loss to know.

A duplication which perhaps will come still more closely to the attention of hon. members is that in connection with agriculture. We have experimental farms and experimental stations and experimental plots, some carried

Federal Health-Mr. Mitchell

on by the provincial governments, some carried on by the federal government; and also so far as I am able to see from close observation of those within my own constituency there is complete lack of cooperation between the two administrations. It seems to me that the experimental farms of this country either should be run by the federal government, in order to coordinate these services, or else should be run solely by the provincial governments with a view to provincial requirements. At the present time we have scattered over the country experimental farms, experimental stations and other experiments which are costing the people a great deal of money and which if coordinated would be of some use to the public.

Again we have the attorneys general of the provinces and we have the Solicitor General and the Minister of Justice at Ottawa. The fact that companies can be organized within provincial jurisdictions gives opportunity for those who desire to set up companies to sell nothing to someone for something. By this lack of cooperation, this lack of definition, avenues are opened to the man who desires to sell what he should not be permitted to sell, and to those who are trying to undermine the better kind of business in this country.

Then, as to the departments of mines, we have a minister of mines at Ottawa. I am not very well versed in what the provincial minister of mines does in the province from which I come; no doubt in most provinces they place provincial restrictions on a national mining policy, rather than seek to cooperate with the federal department.

The main point which I desire to make is that the present resolution is an attempt to increase the duplication of services to pay for which the taxpayers of this country are carrying a heavy burden. Whether we need at this time a health policy or not, I say the first step for the hon. member to take is to redefine the jurisdiction of governments in this country as between the dominion and the provinces. Having done so he can then pursue his measure, placing responsibility where it belongs. Therefore I point out again the very vicious policy that prevails in this country in respect of duplication of services as between federal and provincial governments, and say that I am against the motion, not that I do not desire better health conditions in this country, but rather that I think the wrong course is being taken to that end. I think first we should redefine those matters which are provincial and those which are federal, in order to relieve the forgotten man, the taxpayer of this country.

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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LAB

Humphrey Mitchell

Labour

Mr. HUMPHREY MITCHELL (East Hamilton):

Mr. Speaker, I would like to put briefly before the house the point of view of the industrial worker in connection with health services. The statement was made this evening that the health conditions in the farming communities are much below those in industrial communities. No figures were quoted, and I am inclined to disagree with that conclusion. I think the health services in this dominion, particularly from the point of view of the medical men, stand in the same relationship to the nation as the schools did a century ago, a condition of, might I say, anarchy. A century ago the boys and girls of this country got a more or less indifferent education, owing to the lack of organization, the lack of interest on the part of the state in educational facilities for the average boy and girl of working class people of that time. So in the development of our modern civilization, and largely through the efforts of those of progressive viewpoint, the opinion was eventually crystallized into action that every boy and every girl in the country should, in the interests of the state and in the interests of industry and commerce, receive an education. The development of our educational institutions has been one of the driving forces of our civilization. I think it fair to say that to-day the medical profession stands in the same relation to the country and its services as education did many years ago. It is a tragedy that the state should spend the enormous sums it does on the education of our young physicians, and that on the completion of that education they should have to sit down and wait ten or fifteen years before they get anything that approximates a livelihood. Particularly is this true in view of the fact that it is not because of any lack of desire and need on the part of many people for expert medical advice and attention, but because of their lack of ability to meet the financial obligations that would confront them should they seek that advice. I am not unmindful of the enormous contribution that the medical profession has made to the people of this dominion, but frankly I believe that policy is absolutely unsound. We have long since passed the stage when physicians and surgeons should be expected to make that contribution to our hospitals and to the people in general without thought of reward. They are the only section of the professional classes who do so; no one ever heard of the lawyers doing it, or the teachers, or, might I say, even the preachers. Eventually we shall have to deal with the problem in conformity, of course, with the particular conditions existing in this dominion, as they did in Great R'-'t-ain when

Federal Health-Mr. Mitchell

they instituted their national health and insurance system. I believe that is one of the great social questions that will have to be met by this dominion. It is one of the predominant questions confronting our people- the provision of health services organized on a sound basis and administered by the state. You had in Great Britain at the inception of this form of legislation the same condition that you have in this dominion to-day, that is, active organized opposition of the medical fraternity within the country.

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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CON

Richard Bedford Bennett (Prime Minister; President of the Privy Council; Secretary of State for External Affairs)

Conservative (1867-1942)

Mr. BENNETT:

Would the hon. gentleman mind if I pointed out further that the provinces and the dominion each exercise jurisdiction? That is the difference between Great Britain and Canada.

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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LAB

Humphrey Mitchell

Labour

Mr. MITCHELL:

I am well aware of that fact, and many times in this house I have expressed the opinion that in the very near future amendments will have to be made to the British North America Act to permit the government of this country to meet the problems of this industrial age in conformity with the very necessary social measures that we think should be in operation here.

If I may digress for a moment, I might point out to the Prime Minister that I had some experience in Europe this summer with regard to developments in different countries. In some countries one sees the development of dictatorships while others, of course, have remained with democracy. I believe the greatest contribution made in Europe in the last generation has been made by the British people in their approach to the question of social insurances. In the last generation they have practically redistributed the wealth of Great Britain; they have had a revolution in regard to the distribution of wealth without the loss of a single life or the shedding of a drop of blood. Frankly I believe that is a far better way to approach these problems than the way in which they have been approached in other countries.

To get back to my point, however, I believe that in this dominion we will have to meet the points raised by the Prime Minister. Unquestionably the question of jurisdiction arises in regard to all these social services, including unemployment insurance and national health insurance, but if, in order to organize properly on a national basis, it is necessary to amend the British North America Act, I think that should be done as soon as possible. But we have a right to know whence the opposition

fMr. Mitchell.]

comes with regard to such an amendment to the British North America Act, whether from the federal government or from the provincial governments, in order that we can bring into being the forces of public opinion-those forces that make a democracy and which are the very basis of its life-that are necessary in order to crystallize opinion in the various provinces with regard to such an amendment. I believ e this would be in the interests of the medical profession as well, and I speak with some knowledge of their sacrifices. I believe it would be also in the interests of the grea,t mass of the people in this country; the institution of a sound national health insurance scheme would be a great advance over the present condition which exists within the medical profession and would go some distance towards solving the problems of the profession with regard to the treatment of ill health and sickness in this dominion.

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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UFA

Henry Elvins Spencer

United Farmers of Alberta

Mr. SPENCER:

I appreciate what the

Minister of Health (Mr. MacLaren) has had to say with regard to the dominion council of health. I knew this body existed, but however good its intentions may be it cannot do very much in the way of spending money without the sanction of this house. The House of Commons is supreme; that is why we biing up these resolutions. I am offering this resolution to-night in order to secure the opinion of the house, because if the house goes on record as supporting a resolution of this kind it makes it possible for the dominion council of health, in its wisdom, to recommend what might be done to improve conditions.

For the life of me I cannot see why the minister should still object to the resolution going to the committee as proposed. I understood that last year it was agreed among certain members in different quarters of the house who were interested in health matters that the proper committee to consider health questions would be the committee on industrial and international relations. The government of the day have a majority on all the committees, and they are far better places to discuss these questions than in the house. The government have their own chairmen and have majorities on all committees. We could do excellent work if we were allowed to discuss these health matters in committee and bring in a report.

After I said I really did not appreciate his stand in regard to the resolution in the first instance the minister did go a little further.

Federal Health-Mr. Spencer

I understand now that he is in sympathy with the principle of the resolution, and that it has his good wishes.

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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CON

Murray MacLaren (Minister of Pensions and National Health)

Conservative (1867-1942)

Mr. MacLAREN:

I did not indicate that I was in sympathy with it at all; in fact I said that I was opposed to it. I said I was in sympathy with the idea of cooperation.

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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UFA

Henry Elvins Spencer

United Farmers of Alberta

Mr. SPENCER:

With the principle of the resolution.

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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CON

Murray MacLaren (Minister of Pensions and National Health)

Conservative (1867-1942)

Mr. MacLAREN:

Not at all. This resolution proposes that a committee deal with the matter of policy. That was one reason why I objected to it; I do not think a committee should form a definite health policy for the government. Let me make it clear that I agree as to cooperation; that is our duty. I also agree that the work should be increased and that the work carried on throughout the country, whether by the provinces or by the federal government, should receive our approval. But I am opposing this resolution which seeks to establish a definite health policy.

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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UFA

Henry Elvins Spencer

United Farmers of Alberta

Mr. SPENCER:

I cannot see why the

minister objects, but I am not going to press my point. Surely any government should have a definite policy with regard to these matters; I had hoped that the minister had a definite policy, in cooperation with the provinces. If he has not such a policy ^ I hope he will soon get one; if he has a definite policy then I think it is up to the minister to declare it to this house. The minister mentioned in detail certain definite work done by the federal department. I should say that probably the federal department would not give up some of that work, that there are some angles of public health in which they claim a prior right, such as quarantine, immigration, and all that sort of thing. That indicates the difficult position in which we are placed with regard to this particular subject.

I was interested in the remarks of the hon. member for Souris (Mr. Willis), who criticized the overlapping as between the dominion and the provinces, but I think the hon. gentleman was wrong with regard to the question of health. I believe it might be much easier to put some of these other matters under the definite jurisdiction of either the federal government or the provinces, but the question of health is entirely different. There are certain matters which I am sure the federal government would not allow to get into the hands of the provinces at all. I would have no objection if the federal government wanted to take over the whole question, but they would not do that either. Therefore the provinces are forced to set up their health

departments, and that being so it is imperative that cooperation should be pushed for all it is worth as between the federal and provincial government.

That is why, Mr. Speaker, this resolution was introduced; I had hoped to get a definite expression of opinion from the house which would strengthen the hands of the minister in bringing forward some plan which would let us know where we were going. We do know where we are going with regard to education, a matter which was brought up this evening. We have a definite plan in respect to the question of education, but we have only to go through the country to see the extraordinary situation existing in these times of crisis so far as sickness is concerned. We learn that the doctors in Winnipeg have gone on strike because they cannot earn a living. I am sure they do not strike because they do not want to give people necessary medical attention, but simply because the people are poor and cannot afford to pay their fees. Something has to be done. I believe on two or three occasions one of the hon. members from Winnipeg has brought this very important matter to the attention of the house. What are the doctors in Winnipeg going to do? They say they will not accept a case, unless it be one of emergency. When does an emergency occur? Hon. members may be familiar with the old story about the man who said he could feed his horse on nothing. He did very well until he got down to one straw a day, and then the horse died. That is the position we are likely to be in. When we hear the doctors say they will not attend except in a case of emergency. When that emergency arises many of the patients will have reached a point where help will be of no use.

As the hon. member for East Hamilton (Mr. Mitchell) said, we are facing a problem which could be compared with the educational problem of a generation ago. I believe it is about time the public realized that it is much better to pay a small insurance fee, through taxation, so that in the case of sickness a demand for proper services could be made. When people are well they can afford to pay a small amount of money for such a purpose, but when they are sick they may not be able to pay heavy fees for medical attention.

I must say I was quite disappointed that the minister did not bring forward a more definite plan. Of those who volunteered for war services we must remember the large number who were found to be unfit for military service. Undoubtedly those men thought they were fit, but upon examination found it was

50S

Federal Health-Mr. Spencer

discovered that they had something the matter with them. From the national point of view alone it seems to me that this matter of health is one which we cannot afford to overlook. I know there has been an effort to cut down grants for health measures, such as those relating to venereal disease and so on. I believe that by such action we are simply making ourselves poorer. The time has come when we should put first things first; when all is said and done the human being should be our first consideration. We should definitely state whether or not we are going to try to make this nation healthy, and whether we want to Put it into category A, B, C or D. Then, having made our plans, we should find some way of financing them. Surely we have not yet tapped all the sources. The hon. member for East Hamilton has said that in Great Britain a tremendous amount has been done with regard to the care of health, certain social legislation has worked wonders in improving the health of the people.

It seems to me that too many people are saying: "Oh, matters relating to money, or the ways of collecting it, are far more important than the care of the health of our people." I believe the time has come when we should change that attitude, decide first of all that we are going to have a happy, contented and healthy people, and then set about to put them in that condition. There may be a good deal in the argument of the hon. member for Souris as to the overlapping of federal and provincial departments. No civil servant wants to give up his particular end of the work. At the same time I believe he was quite wrong in his criticism of the overlapping of health measures. We must realize that we cannot give the whole work to the provinces, because in so doing we should be interfering with the care of immigrants in quarantine, and like matters. At the same time the federal government will not take over the whole responsibility for the health of the people, and it may be that they should not. As some of the work has to be done at one point, such as at the coast, .and other work elsewhere, it becomes a matter of cooperation.

I repeat, I regret very much that the Minister of National Health did not take a more constructive attitude. We were handicapped during the regime of the last government with an attitude similar to that taken by the present minister. Had I not seen the minister speaking this evening, I would have said it was the one who held office five years ago.

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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CON

Murray MacLaren (Minister of Pensions and National Health)

Conservative (1867-1942)

Mr. MacLAREN:

What about great minds?

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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UFA

Henry Elvins Spencer

United Farmers of Alberta

Mr. SPENCER:

Yes, great minds think

alike. At the same time I feel that the public

are demanding something more in the matter of public health. As I said before-

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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CON

Pierre Édouard Blondin (Speaker of the Senate)

Conservative (1867-1942)

Mi. SPEAKER:

I must call the hon. mem-bei s attention to the fact that it is now eleven o'clock.

Topic:   FEDERAL HEALTH POLICY
Subtopic:   COOPERATION WITH PROVINCIAL GOVERNMENTS- PROPOSED REFERENCE TO INDUSTRIAL AND INTERNATIONAL RELATIONS COMMITTEE.
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At eleven o'clock the house adjourned without question put, pursuant to standing order. Tuesday, February 13, 1934


February 12, 1934