My Lords, this Bill seeks to empower local authorities in Scotland to provide treatment for persons suffering from diabetes. This power is already possessed by local authorities in England under the Public Health Act of 1873, which gives local authorities general powers of the kind; but in Scotland the powers of the local authorities are limited to epidemic, endemic, or infectious diseases, a definition which does not include diabetes. As your Lordships are aware, insulin has proved most efficacious in the treatment of this disease. Insulin undoubtedly has kept alive many persons who would otherwise have died, and has restored to working capacity many people who otherwise, without it, would have been permanently incapacitated.

I understand that in the majority of cases the treatment of diabetes is by means of dieting. It is only in more serious cases that the necessity for insulin treatment arises. But where cases require insulin treatment it is generally for a long period and possibly for the whole life of the patient, and in these circumstances the cost of the drug becomes a serious factor. The cost of insulin is much less than it was when the drug was first introduced, but still in an average case I understand the cost may be as much as 5s. a week, which is sufficient to place the treatment beyond the reach of considerable classes of the community. There are, of course, a large number of people who are able to obtain insulin under existing legislation. Persons insured under the National Health Insurance Acts are able to obtain it as part of medical benefit, persons on the Poor Roll are entitled to treatment by insulin by way of medical relief, and, finally, expectant and nursing mothers and young children under five years of age may also receive it through the medium of maternity and child welfare schemes. The persons who will benefit by this Bill will mainly be such persons as the small man working on his own account and also the wives and children of insured persons who are not entitled to medical benefit under the Insurance Acts.

I have only to add that the Bill is an enabling Bill; it is not made obligatory on local authorities to provide insulin free except in cases where the recipients can not afford to pay anything. The local authorities will make such charge as the recipient can reasonably pay and the Bill will be worked under a scheme approved by the Scottish Board of Health. As your Lordships have on many occasions expressed a dislike of retrospective legislation, it is right to point out that this Bill is to a small extent retrospective, dating back to March 1, 1924. The reason for this is that certain local authorities have, in fact, been providing the drug to a small extent and this Bill is intended to regularise the position.

My Lords, I am entirely in favour of this Bill. The small cost which it imposes ought to be much more than compensated by the saving in health and life which the system should bring about. But I want to ask the noble Lord a question: Who is to provide and administer these drugs, and particularly insulin? It is a dangerous drug for people to handle by themselves and one would like to know that under the vague terms, arrangements to be made with the Scottish Board of Health, the administration of the drug, the quantities and the conditions, are to be under the supervision of somebody less abstract than the Scottish Board of Health. Is it meant that the patient is not to have it by merely asking for it, that the panel doctor or somebody of the sort is to superintend the administration? Perhaps the noble Lord can tell us that.

The answer to the question is, I think, that this drug will be provided in capsules. It is quite true that it is a dangerous drug, but the quantities in the capsules will be quite definite. When this question was raised in another place the Secretary for Scotland was able to give an assurance that the drug would be manufactured directly under the supervision of the Medical Advisory Council and that, so far as the handling and manufacture of it are concerned, they will be done by properly qualified people. The suggestion was made in another place that provision should be made for the drug to be issued only by qualified people—which I think is the point that the noble and learned Viscount has in mind—and this objection was met by the fact that it is provided in capsules and the danger of any mishaps such as the noble and learned Viscount has in mind is not likely to arise.

I can only speak again by the leave of the House, but it seems to me that to put capsules into the hands of somebody in the country who does not know anything about them would be rather dangerous. He might use half a dozen capsules and as he has to inject the drug subcutaneously he might, so far as I know, inject a great deal too much. However, we have raised the point and no doubt the Scottish Board of Health will see to it.

rose to ask His Majesty's Government whether it has been found necessary to prohibit fox hunting in those areas which are under restrictions on account of foot-and-mouth disease. The noble Marquess said: My Lords, the Government has thought it necessary in the public interest to issue an agricultural edict which, though no doubt they consider it to be necessary, will, I think, be generally acknowledged to be somewhat drastic. I am speaking under correction, but I understand that this Order is temporary and experimental. There is a very general desire among all classes to act in obedience to the Order, but there are some things which are not, as yet, quite understood. It is for this reason that I have put this Question on the Paper.

My Lords, in reply to the Question of the noble Marquess, in support of which his preliminary observations, if I may say so with respect, were not wholly relevant, I should like to point out that there are now two restriction Orders, or two kinds of restrictions on areas which will affect hunting. As the noble Marquess realises, foot-and-mouth disease restrictions necessarily involve some interference with hunting, not merely with fox hunting, but with all forms of hunting. On the occurrence of an outbreak the normal procedure is simply to restrict all movements of livestock within a radius of 15 miles from any premises on which the disease has been confirmed. Of course, incidentally this will involve, inter alia, the prohibition of all hunting and all coursing. If there are no further outbreaks within that area, the radius will be reduced to five miles within fourteen days. If no further outbreaks occur, after twenty-eight days all restrictions on movement will be removed.

I may also take this opportunity of mentioning, in case noble Lords are not aware of it, that where restrictions are likely to be prolonged, if Masters of Hounds satisfy the Ministry that there are too many foxes in the neighbourhood, and that poultry are likely to be destroyed in consequence, a licence is granted to enable the foxes to be killed in cover—only in cover—but if they break cover they must not be followed, and, if they are, the licence will be withdrawn. In any case, no cover must be drawn by hounds within three miles of an outbreak. By way of illustration I may say that only last week it was pointed out that in the Duke of Beaufort's country there were too many foxes and farmers were beginning to complain of the destruction of poultry, with the result that a licence was issued to enable hounds to draw Badminton Lower Woods, where there was supposed to be an excess of foxes.

Now I come to the particular point about which I think the noble Marquess is anxious. Last Monday the Ministry of Agriculture issued what we call a partial Standstill Order which applies to the whole of the Midlands, using the expression "the Midlands" in a very large sense, and the South of England not already included within infected areas. A cordon has been drawn on the map round all the existing groups of outbreaks and the spaces between them. I may mention that it really means comprising a very large area of the whole of England. This Order prohibits the movement of animals outwards to any free district—any district that is at present free of the disease—and regulates all movements within the area by licence. We describe this large area as a regulated area. Markets of all store stock are prohibited within it, but fat stock markets may be held by licence subject to veterinary inspection. Hunting is not prohibited within this regulated area. I may also mention that within this regulated area farmers will not be prosecuted if their animals stray. Obviously it would not be fair to them, with the danger of gates being loft open if hunting continued, if they were prosecuted should, as a result, their animals stray.

The noble Marquess has asked whether this Order is temporary and experimental. I think it may be so described. Such an Order has been issued on at least one previous occasion when there seemed to be a danger of extensive outbreaks spreading to other parts of the country. But, as your Lordships are aware, this practice has not been observed in the case of outbreaks in recent years. We want to try to avoid the flare-up of disease which took place two or three years ago, resulting in the destruction of an enormous quantity of cattle and other livestock and, of course, in large sums having to be paid out of the Exchequer by way of compensation. The Ministry has reason to believe that the regulations it is making as regards hunting are satisfactory from the point of view of the prevention of the spread of disease, and I may mention that this Order has been received apparently with much satisfaction by the National Farmers' Union and the farming community generally. It is hoped that hunting people will do all they can to make this Order effective and I feel sure they will do all in their power not to rebel in any sense against the present policy of the Ministry in view of the grave position in which we stand in relation to foot-and-mouth disease. Fox hunters have always shown themselves patriotic and unselfish in this matter in the past, and I think they can be confidently relied upon to study the interests of the farming community, even though it involves some considerable sacrifice on their part.

I do not know whether your Lordships would desire that I should say anything as to the exact position in which we stand in relation to the present outbreak. From the beginning of the year until September 25 we were, fortunately, remarkably free from this disease and we thought at the beginning of September that it had, in fact, been stamped out. Unfortunately, there was what I may call a flare-up towards the end of the month and since September 25 there have been no fewer than 164 outbreaks in sixteen different counties and in fifteen separate centres. These include an outbreak, which was confirmed to-day, at Winter-borne Monkton in Wiltshire, where it occurred amongst sheep, and no fewer than 204 sheep have already been slaughtered in connection with this outbreak. There have been slaughtered all told up to date in connection with these recent outbreaks, 5,267 cattle, 6,204 sheep, 1,893 pigs and 26 goats, and the amount of compensation so far payable in respect of these outbreaks is estimated at £197,000.

Many questions have recently been asked as to why there has been this sudden recurrence of this scourge. We do not know what the actual mode of the transmission of the disease is, but we are convinced that its serious prevalence at present is traceable, and must be traceable, to the far more serious prevalence of the disease upon the Continent, particularly in those countries which are nearest geographically to this country. In Denmark, for instance, it is estimated that since the beginning of the year outbreaks have occurred on no fewer than 50,000 holdings in that small country, while the disease is very prevalent at present in France and Holland. Unfortunately, the disease is very serious in both those countries and it appears to be still spreading there.

In reference to the actual spread from initial outbreaks in this country, it is significant that two for certain and possibly others have spread from markets. For instance, many of the 59 cases in Lancashire are undoubtedly traceable to diseased animals actually appearing in Blackburn market on October 13, 14, and 19. Infected animals were, undoubtedly, in that market on those dates, but the disease was not discovered until the first resulting outbreak was reported on October 20 from a place called Haslingden. Twenty-six outbreaks were directly traced to infection picked up in Blackburn market and thirty other outbreaks in Lancashire may be indirectly traceable with some confidence to that market, and six further outbreaks resulted from Gisburn market, where animals from Blackburn had gone. A similar story can be told in respect to the outbreak in Gloucestershire and also, I believe, in the case of the outbreak in Wiltshire.

Some suspicion has been thrown upon Irish animals, as is generally the case when this disease is largely prevalent. We have no reason to suppose that the disease has come from Ireland; but we have reason to think that some of these animals of Irish origin have developed the disease after their arrival in this country. Undoubtedly some of the animals that were found diseased in Blackburn market were Irish cattle. I do not propose to say anything more unless your Lordships desire further information, except to state that we are taking every opportunity to point out that the two main sources of danger in connection with the spread of the disease are lack of prompt reporting of outbreaks on the part of the farmer and lack of effective veterinary inspection at markets where the disease may break out and from there become spread over large areas of the country. We are asking the local authorities to do all in their power to see that their markets are regularly and efficiently inspected by a competent veterinary surgeon, and also that farmers shall make every effort to report promptly any suspected cases that may arise on their premises.

My Lords, I should like to ask the noble Lord whether he can tell us if his Veterinary Surgeons' Department has made any real progress in the matter of discovering the origin of foot-and-mouth disease, and also whether he is in communication with veterinary surgeons in other countries where foot-and-mouth disease exists, as he says it does, such as Denmark and elsewhere.

My Lords, in reply to the noble Marquess I may say that research is being conducted into this question, but without at present any certainly hopeful results. It was thought about a year ago that a distinguished veterinary research worker in Germany had discovered the particular germ, an ultra microscopic filtrable germ, which is responsible for the disease, but unfortunately his supposed discoveries have not been substantiated, and I am afraid that we cannot look for any help in that direction. The Research Committee which was appointed a few years ago to investigate this matter is, of course, still sitting, and has made an Interim Report which, I think, has already been published, and is, therefore, available for your Lordships' inspection, but I am afraid it does not contain anything so far which has any finality about it for the solution of the mysteries of this disease, which remain as deep as ever. Perhaps I ought to add that we are in close touch with veterinary authorities in other countries, and that everything that can be done to compare notes amongst research workers in this country is being done. It is hoped that, as the result, something further may before long be discovered.

My Lords, I beg to move that this House do now adjourn until to-morrow at the usual time. I do that in order to give the opportunity, if we are lucky, of reading the Tithe Bill a first time formally to-morrow. There will be no Orders of the Day printed, or Notices of Motion, but there may possibly be a Message from the Commons, in which case there will be a House ready to receive it.