PUBLIC HEALTH (SCOTLAND) AMENDMENT BILL.

TUESDAY, 12th MAY, 1925.

1439

The Committee consisted of the following Members:

Major Barnett (Chairman)

Adamson, Mr. William (Fife, W.)

*Advocate, The Lord (Carlisle)

Alexander, Sir William (Glasgow, Central)

Atholl, Duchess of (Kinross and W. Perth)

Baird, Sir John (Ayr Burghs)

*Balniel, Lord (Lonsdale)

Barr, Mr. (Motherwell)

Benn, Captain Wedgwood (Leith)

Berry, Sir George (Scottish Universities)

*Bethel, Mr. (Eccles)

Boothby, Mr. (Aberdeen, E.)

Broun-Lindsay, Major (Partick)

Brown, Mr. James (Ayrshire, S.)

Buchanan, Mr. (Gorbals)

Chapman Sir Samuel (Edinburgh, South)

Charteris Brigadier-General (Dumfries)

Cochrane, Commander (Fife, East)

Collins Sir Godfrey (Greenock)

Couper, Mr. J. B. (Maryhill)

Cowan, Mr. (Scottish Universities)

*Cowan, Sir Henry (Islington, North)

Craik Sir Henry (Scottish Universities)

*Crawfurd, Mr. (Walthamstow, West)

Crookshank, Colonel (Berwick and Haddington)

Dalkeith, Earl of (Roxburgh and Selkirk)

Elliot, Captain (Kelvingrove)

Fanshawe, Commander (Clackmannan and Western)

Ford, Mr. (Edinburgh, North)

Gilmour, Sir John (Pollok)

Graham, Mr. Duncan (Hamilton)

Graham, Mr. William (Edinburgh, Central)

Hamilton, Sir Robert (Orkney and Shetland)

Hardie, Mr. (Springburn)

Harvey, Mr. Charles Barclay- (Kincardine, Western)

Henderson, Mr. Thomas (Tradeston)

Henniker Hughan, Vice-Admiral Sir A. (Galloway)

Hope, Sir Harry (Forfar)

Horne, Sir Robert (Hillhead)

Hunter-Weston, Lieut.-Gen. Sir A. (Bute and North Ayrshire)

Hutchison, Mr. Clark (Midlothian and Peebles, North)

Hutchison, Sir Robert (Montrose)

Johnston, Mr. (Dundee)

Kennedy, Mr. Thomas (Kirkcaldy)

Kidd, Mr. (Linlithgow)

Kirkwood, Mr. (Dumbarton Burghs)

Livingstone, Mr. MacKenzie (Western Isles)

*Lucas-Tooth, Sir Hugh (Isle of Ely)

MacAndrew, Mr. (Kilmarnock)

Macdonald, Sir Murdoch (Inverness)

MacDonald, Mr. Robert (Cathcart)

MacIntyre, Mr. (Edinburgh, West)

Maclean, Mr. Neil (Govan)

Macpherson, Mr. (Ross and Cromarty)

Macquisten, Mr. (Argyllshire)

MacRobert, Mr. (Renfrew, East)

Maxton, Mr. (Bridgeton)

Mitchell, Mr. Rosslyn (Paisley)

Mitchell, Mr. Stephen (Lanark)

*Morrison, Mr. Robert (Tottenham, North)

Murnin, Mr. (Stirling and Falkirk)

*Palin, Mr. John (Newcastle, West)

*Richardson, Mr. Robert (Houghton-le-Spring)

Robertson, Mr. John (Bothwell)

Rose, Mr. (Aberdeen, North)

*Russell, Mr. (Tynemouth)

Scrymgeour, Mr. (Dundee)

Shaw, Lieut.-Colonel A. D. (Renfrew, W.)

Shiels, Dr. (Edinburgh, E.)

*Simms, Mr. (Down)

Sinclair, Major Sir Archibald (Caithness and Sutherland)

*Sinclair, Colonel (Belfast University)

Skelton, Mr. (Perth)

Smith, Mr. R. W. (Aberdeen, Central)

Solicitor-General for Scotland, The (Dumbarton)

Sprot, Sir Alexander (Lanark, N.)

*Steel, Major (Ashford)

Stephen, Mr. (Camlachie)

Stewart, Mr. James (St. Rollox)

Stuart, Mr. (Moray and Nairn)

Templeton, Mr. (Banff)

Thomson, Mr. Frederick (Aberdeen, S.)

*Warrender, Sir Victor (Grantham)

Watson, Mr. Maclean (Dunfermline)

Weir, Mr. McNeill (Clackmannan and Eastern)

Welsh, Mr. (Coatbridge)

Westwood, Mr. (Peebles and Southern)

Wheatley, Mr. (Shettleston)

*Windsor, Mr. (Bethnal Green, N. E.)

Wright, Mr. (Rutherglen)

* Added in respect of the Public Health (Scotland) Amendment Bill—12th May, 1925.

MR. COLOMB Committee Clerks.

MR. DENT Committee Clerks.

1440
1441 STANDING COMMITTEE ON SCOTTISH BILLS. Tuesday, 12th May, 1925.

[Major BARNETT in the Chair.]

[OFFICIAL REPORT.]

PUBLIC HEALTH (SCOTLAND) AMENDMENT BILL.

Mr. BUCHANAN: Before we begin the business, I would like to raise a point of order which, I think, has been raised once or twice before. Hitherto in my two years' experience as a Member of Parliament, the Members of the Scottish Standing Committee have had enough capacity and enough brains—I say this without intending any insult to the present occupant of the Chair—to produce one Scotsman who was capable of taking the Chair. It seems to me that there has been a change since the new Government came into office. In the business which comes before this Committee it would be better if the Chairman had a knowledge of the problems that we have to face from day to day in Scotland. I do not want to raise any anti-English feeling, but I wish to bring forward the point that in the last two or three Committees we have been making a departure from the practice that one who understands the problems of Scotland should preside over the Scottish Standing Committee. I would ask those who are responsible for calling us here, whether there is any particular reason why a Member from Scotland should not be allowed to take the Chair. I protest that when we are dealing with purely local problems, a man who understands those local problems ought to be asked to take the Chair. I want to protest personally against a Scotsman not being in the Chair.

The CHAIRMAN: I think the hon. Member for Gorbals (Mr. Buchanan)) is labouring under a misapprehension. The nationality of the Chairman is not an issue here, nor can it be a matter for this 1442 Committee. I will deal with the point of Order—I suppose it has been put as a point of Order. I happen to be an Ulster man, born in Kent, who can trace his descent from King Robert the Bruce of Scotland. My nationality is not an issue before this Committee, either on a point of Order or in any other way. The House of Commons in its wisdom has delegated to the Committee of Selection all these matters. The Committee of Selection has set up the Chairmen's Panel, and it is for the Chairmen's Panel to decide who shall be Chairman of any particular Committee, and I am sure I shall have the support of the hon. Member for Gorbals and of every other Member of the Committee in trying to carry on the work of the Committee in accordance with the rules of Order.

Mr. WESTWOOD: If it is correct that the Chairman can trace his ancestry right back to King Robert the Bruce, if he could go five stages further back, we should discover that he then belonged to Norway.

CLAUSE 1.
—(Power of local authorities to provide medicines, etc., to persons suffering from diabetes.)

The powers of a local authority under the Public Health (Scotland) Act, 1897, shall include and be deemed, as from the first day of March, nineteen hundred and twenty-four, to have included power to make such arrangements as they may think fit and as may be sanctioned by the Scottish Board of Health (in this Act referred to as "the Board") for providing medicines and treatment to persons who are suffering from diabetes and who, in the opinion of the local authority, require assistance in obtaining such medicines and treatment.

The CHAIRMAN: The first Amendment we have to consider is a manuscript Amendment in the name of the right hon. Member for West Fife (Mr. Adamson)—after the word "diabetes," to insert the words "or other diseases by an order of the Scottish Board of Health." I am afraid that Amendment does not come within the scope of this Bill. This is a Bill to authorise local authorities to make arrangements to provide medicines and treatment for persons suffering from diabetes, and other purposes connected therewith. The right hon. Gentleman informs me that when we were dealing with a similar Bill last Session, he was allowed by the Chairman to move an Amendment of this character. I have 1443 had the Bill looked up. It was one to extend the powers of local authorities under the Public Health (Scotland) Act, 1897, and it must be very obvious that that is a wide title, which would give power to make such an Amendment as is proposed by the right hon. Gentleman to-day. I must rule this Amendment out of order, because it does not come within the scope of a Bill designed to provide medicines and treatment for persons suffering from diabetes. The next Amendment stands in the name of the hon. Member for East Edinburgh (Dr. Shiels), who wishes, I understand, to move an alternative form of Amendment to that which is on the Paper, which is to add, at the end of the Clause: "The Board shall require the local authority to arrange that any medicines used for the treatment of such persons shall be supplied, according to an approved tariff, by persons, firms, or bodies corporate entitled to carry on the business of a chemist and druggist under the provisions of the Pharmacy Act, 1868, as amended by the Poisons and Pharmacy Act, 1908, who undertake that all medicines supplied by them to such persons shall be dispensed either by or under the direct supervision of a registered pharmacist except in cases where, with the sanction of the Board, circumstances make it necessary that the supply may be obtained from a medical practitioner." If there be no objection on the part of the Committee, I propose to allow the hon. Member to withdraw the Amendment on the Paper, and move the other Amendment in substitution.

Dr. DRUMMOND SHIELS: I beg to move, at the end of the Clause, to add the words "The Board shall require the local authority to arrange that any medicines used for the treatment of such persons shall be supplied—

  • according to an approved tariff, by persons, firms, or bodies corporate entitled to carry on the business of a chemist and druggist under the provisions of the Pharmacy Act, 1868, as amended by the Poisons and Pharmacy Act, 1908, who undertake that all medicines supplied by them to such persons shall be dispensed either by or under the direct supervision of a registered pharmacist, or
  • through a registered pharmacist in the employment of the local authority;
  • except in cases where, with the sanction of the Board, circumstances make it necessary that the supply may be obtained from a medical practitioner." 1444 The wording of the Amendment which I am moving makes the object a little clearer than the Amendment which appears on the Paper, and it is designed to meet some objections which were urged against that Amendment. There has been some suspicion expressed that there is an element of self-protection for chemists in this Amendment. There may be some such element, but, if there is, I think it is quite justifiable, and it is a very small part of the purpose of the Amendment, which is essentially for the protection of the public. I would not have moved the Amendment had it been solely, or mainly, one in the interests of any particular trade or profession. It must be remembered that both the medical and pharmaceutical professions have received from the legislature very great powers, and have had put upon them very great responsibilities. In spite of criticisms which we hear from time to time, I think they have discharged those responsibilities to the satisfaction of the community. It will be admitted, I think, that the amassing of fortunes is not very common among members of those professions, and in both of them very hard, exacting, and highly skilled work is done for a very moderate return. Both these professions, in addition to some attention to their own interests, do also conscientiously try to discharge their responsibility to look after the interests of the public. It is one of the most important functions of the executive of the Pharmaceutical Society to scrutinise all legislation which deals with any poisonous or potent substances, and to give the benefit of their expert advice to the public, and it is in that spirit that this Amendment is put forward to-day. Insulin, although not specifically mentioned in this Bill provides, as is very well known, practically the only treatment for diabetes, except dietetic treatment, which is still of very great importance. Insulin is a dangerous drug. Evidence of that is that it is included amongst the limited number of substances mentioned in the Therapeutic Substances Bill at present before Parliament. There is a suggestion that because insulin is made up in a form which is already complete and standardised, and does not require compounding, that, therefore, it is not necessary for any skilled or specially qualified person to be concerned in its 1445 distribution. That strikes at the very root of the Pharmacy Acts, and it is against the whole principle of our legislation in these matters. If that principle were conceded, then a great many of the substances which chemists handle, and which it is recognised that they only should handle—substances, for example like chlorodyne preparations which are sealed up, and others of a similar kind—might well be put into the hands of unqualified persons to give out according to their discretion or lack of discretion. Insulin is a very potent and dangerous drug, and there is no guide in this Bill as to how it is to be distributed. That is a serious defect in this Measure. It makes a general statement that public authorities are authorised to give out this insulin to necessitous persons, but there is no arrangement for its distribution. This Bill deals only with a limited class of persons. Insulin is already supplied under the National Health Insurance Acts, and it is a condition under those Acts that it must be supplied under the supervision of a qualified pharmacist, exactly what this Amendment asks for the additional class of persons dealt with in this Bill. That is made perfectly clear under the National Health Insurance Acts, which make provision for the treatment of some cases of diabetes. Insulin is supplied also by Poor Law authorities, and here again its distribution is supervised by qualified people employed by the Poor Law authorities. The Bill we are considering is designed to deal specially with the class of people who are treated in an infirmary or public hospital, and where, after a prolonged treatment it has been found that they cannot go on without a periodic supply of insulin. Sometimes it is found that, after treatment, the supply of insulin can be stopped, but in a certain number of cases it must be continued even for life. It is very necessary, therefore, that some arrangement should be made for the people who are not covered by the National Health Insurance Acts, and who do not come under the Poor Law. That is the object of this Bill. How are these people to be supplied with insulin? One possible and likely method is through the public health committees of the local authorities. The public health committees of county and 1446 borough councils will probably have the distribution of insulin to supervise for these cases. In the case of large authorities, like Edinburgh and Glasgow, they already have in their employment properly qualified pharmacists, and one of the objects of my altered Amendment was to make it quite clear that, where there were such qualified pharmacists employed, no objection would be taken to the insulin being supplied through them. Then, again, there are other cases where the patients are treated by their own doctors, and where insulin would be obtained from them after being supplied or paid for by the local authorities. Here also we do not propose to interfere. But it must be remembered that in many cases it is not possible for the patient to afford to have the services of his or her doctor to give insulin. Insulin is injected hypodermically, and a practice has grown up out of necessity whereby patients are instructed in the hospitals before they leave as to the method of using insulin and injecting it for themselves. That is now quite a general practice, and it is one with which my Amendment seeks specially to deal. We want to secure that the insulin with which they are supplied will be supplied by a properly qualified person who can keep a proper check and record as to the amount supplied, and who can also be assured of the condition of the insulin. Cases have been known where supplies of insulin which have been supplied to chemists have been rejected by those chemists because of evidence, which they were qualified to interpret, that the insulin was in a bad condition. That is a point of some importance. What is sought to be safeguarded against by this Amendment is a lump supply of insulin secured by local authorities being handed out by unqualified persons in an indiscriminate and dangerous way. I think the Committee will agree that that is a reasonable position to take up, and one that is in the interests of patients and public. Then, again, this Bill does not entirely limit itself to the supply of insulin. Diabetic patients, in addition to being taught to administer insulin, are also taught to estimate the extent to which they are suffering at any particular time from their diabetic condition by testing 1447 their own urine in order to see the amount of sugar, if any, contained in it. This is done usually by the use of Fehling's solution, and by seeing certain reactions they are able to estimate if any sugar is present, and, roughly, the amount that is present, which is very important. It is extremely desirable that the patients should be able to have a proper idea of how they are getting along, and they are also taught that, within certain limits, they can modify the amount of insulin they take. Unless this Fehling's solution is properly made up it will not give those delicate chemical reactions, and so, again, there is a considerable argument in favour of the principle of my Amendment. Further, with regard to hypodermic syringes. Anyone who has had experience of them knows how difficult they are to use, and how important it is that they should be supplied in good condition, so that they may be properly and safely applied. Patients are also taught what to do in the event of bad symptoms following the administration of insulin. In certain cases this has been followed by shock and even death, and the remedy is to take a glucose or sugar solution, when the symptoms usually disappear very rapidly. That glucose solution may also have to be supplied. I think I have made it clear that it is a more important and complicated subject than might be thought from the terms of this Bill. Instead of putting an Amendment in the Bill, it has been suggested that the Department might circularise the local authorities, informing them of the desirability of carrying out the principles laid down in the Amendment, and asking them to see that those directions are fulfilled. I think it will be admitted that it is very undesirable that an Act of Parliament should go out in a slipshod and unsatisfactory manner without an important matter like this being quite specifically dealt with. It is clear that those promoting this Bill have taken it for granted that some method will be found of distributing his insulin, provision for which has, however, been left out. There is no medium arranged at present for the distribution of insulin according to this Bill, and as this Measure is only the beginning of a very much wider application of the principle contained in 1448 it, I think it is very desirable at the commencement that we should make it quite clear that any drugs of a dangerous character such as this ought not to be supplied to the public unless under proper supervision. I think the Committee will be generally agreed that the next Government will be a Labour Government—I think there will be unanimous support to that contention. It has been clearly indicated by the speeches made on the Second Reading, and from the form of this Bill last year, that the next Government will seek to make this Bill apply to any disease, and to make any new method available immediately to the very poorest part of the population. That being so, I think it is very desirable that we should make the position definite at the very beginning of such legislation, and I hope that I have made it quite clear that I am not moving this Amendment, and the executive of the British Pharmaceutical Society are not urging this Amendment, from any selfish considerations. After all, the financial side of it, from their point of view, is a very trifling one. They are putting forward this Amendment in the exercise of their high responsibility as a body standing between the public and the State, as the guardians of the public, from any indiscreet or dangerous use of such potent substances as insulin, and I ask the Committee to accept the Amendment.

    The SECRETARY for SCOTLAND (Sir John Gilmour): I would like, at the earliest moment, to try and make clear, as far as a layman may, my view of this, question. I am sure that the Committee has listened with interest and appreciation to the speech of the hon. Member for East Edinburgh (Dr. Shiels), who, speaking with a knowledge on this question as a medical man, deserves, of course, the very fullest consideration. What, I take it, we are concerned with, to-day in this Measure is, first of all, that it is a Bill to legalise the local authorities in the action which they have been voluntarily taking in the provision of insulin for those belonging to the poorest class of the country who cannot afford the cost themselves. I want to make it clear, in the second place, that this is a permissive Bill, and for that reason there are not included in it a large number of restrictions as to what these local authorities may do in their methods of dealing with this problem. I 1449 am sure, however, that what is in the minds of all the members of this Committee is, that whatever provision is made for the use of this drug for the attempted cure of a difficult disease, the steps which are taken should be safeguarded, and that those concerned should obtain the benefit of this treatment under circumstances as scientific as is possible, and also that they should obtain the benefits as cheaply as possible. I have considered this problem, and it seems to me that it would be a dangerous principle to admit that the issue of these drugs should be confined, at any rate in present circumstances, to chemists. I am, of course, prepared to agree that the actual composition of these drugs is a matter of scientific knowledge and ought to be conducted by those who are fully qualified to do it, but when you come to the question of the cost alone, as I understand it the Board of Health, working with the other great department of health in England, has been able to obtain this drug in bulk at much cheaper prices than the ordinary chemist has been to retail it to the ordinary individual. This is rather a fresh departure, and undoubtedly it is a matter of the greatest importance, and if, as I believe, the Department has been able, by arrangement, to obtain it at something like 2s., as against 2s. 8d., which was the possibility on the other hand, that is a consideration which is bound to weigh with all of us. Then, when one comes to the question of the care of the use of this drug by the public, I think it is clear that this treatment must originate, in the case practically of every patient, either in a hospital or at a clinic or under direct medical supervision. I listened with interest to the hon. Member, but there appeared to creep into his speech some kind of idea that the chemists were actually going to be the individuals who could be relied upon to advise and to supervise the use of this drug. I am bound to say I should enter conclusions at once with him on that point. I do not think it would be the province of the chemist. The province of the chemist, as I understand it, is to produce a drug and to sell it to the public in a proper form. An individual may often consult, as I have consulted, a chemist from time to time, but I have done it with my eyes open, and 1450 with the knowledge that he really did not take the full responsibility. But, really, what we come to in this matter is that the Government are very anxious to secure the greatest purity of this drug and all others, and there is a Bill before Parliament dealing with therapeutic substances, which will largely deal with that question. But I think it would be most regrettable that we should to-day, without greater experience than we have on this point, limit and hamper by such an Amendment as this dealing with these drugs. I am afraid, in these circumstances, the Government must resist the Amendment.

    Amendment negatived.

    Dr. SHIELS: I hope I shall be allowed a word of reply.

    The CHAIRMAN: The Amendment is lost. At the same time, by the courtesy of the Committee the hon. Member may be allowed to speak, if he restricts himself to two or three minutes.

    Dr. SHIELS: I would point out that I rose to reply before the Question was put. The right hon. Gentleman has not. I think, made any serious objection to the principles which I have laid down. His principal argument was in regard to the matter of cheapness. He said local authorities could buy insulin in bulk, and thereby distribute it very much more cheaply. As long as that insulin, once obtained by local authorities in bulk, is given out by a qualified pharmacist, even in the employ of local authorities, I have no objection, and the Amendment specifically provides for that. Large local authorities like Glasgow and Edinburgh have such qualified pharmacists, but if you come to look at local authorities of smaller dimensions—smaller boroughs and county areas where there are no such qualified persons—in our opinion it would be very undesirable for local authorities to hand that dangerous drug out by the hands of unqualified people. In such a case we believe that if they are not able to employ a qualified pharmacist, it should be supplied through the local chemists. It is not so much a matter of the chemist in his commercial sense. The right hon. Gentleman stressed the word "chemist." It is the chemist as pharmacist, in the technical, and not in the commercial sense. That is the whole point of the Amendment. I have no 1451 desire that chemists in the commercial sense should supervise the buying and distributing of insulin. I think I made that perfectly clear. The National Health Insurance Act, which deals with the large bulk of the distribution of insulin, already has provisions in it similar to what I am proposing and it seems a very peculiar thing that we should have three methods of distribution of insulin, the National Health Insurance method, exactly as my Amendment, the Poor Law method, by qualified employés, and the third method of no system and no method at all. It is most unsatisfactory and shows for the first time a great want of co-ordination in such legislation. For these reasons I hope hon. Members will support my Amendment.

    The CHAIRMAN: I must remind the hon. Member that the Amendment has been lost. He is only dealing, for the benefit of the Secretary for Scotland, with what would have been his reply if I had seen him rise, and, no doubt, his arguments will be present to the right hon. Gentleman's mind at a later stage.

    Dr. SHIELS: If you rule that the Amendment is lost in spite of my having risen before the Question was put, there is no use in prolonging the funeral oration. But there may be another occasion on which I shall be able to bring the matter before the notice of a larger body of hon. Members.

    Motion made, and Question proposed, "That the Clause stand part of the Bill."

    Mr. W. ADAMSON: I do not rise for the purpose of opposing the Bill, but rather for the purpose of entering my protest against its limited character compared with the Bill of last year, which gave wider scope for the treatment of disease than the present one. I believe the Secretary for Scotland has limited it in the way he has done at the instigation of certain Members, and, it may be, of more than one local authority. I am well aware that in limiting the Bill he is following the lines he followed last year. At the same time, I believe his action then was taken because of the same influences, just as the action he has taken in limiting the Bill in the way he has done to-day. I think when we are considering legislation of this character, we should take 1452 the opportunity to give local authorities power to deal fully with the health of the people. The Amendment which you, Sir, in your judgment saw fit to rule out, had for its object the purpose of giving the local authorities wider powers for dealing with the health of the people. Why should our local authorities not have the opportunity of dealing with other diseases than diabetes, We may at any moment have as effective a cure for cancer as that for which we are making provision in the case of diabetes. In dealing with diseases of that character, promptness is the very essence of success. Unless provision be made similar to that which has been made for dealing with diabetes, valuable time and lives may be lost. Already we have had some experience of this. The Bill I sought to introduce last year was held up because of the opposition of the right hon. Gentleman to the inclusion of other diseases than diabetes. Somebody else, if a cure be found for cancer, may see fit to oppose the making of a similar provision to this, and valuable time will be lost, and, as a consequence, valuable lives as well. When we are dealing with the health of the people we are dealing with a question where our local authorities, subject to proper safeguards—and the Amendment which I handed in had what I considered proper safeguards attached to it, namely, that it would be by order of the Scottish Board of Health—should have the fullest power to deal with the health of the people. I want at this stage to register my protest against the limiting character of the Bill introduced by the right hon. Gentleman. I am not so very sure that it was not done with intent to prevent us from being able to move an extension of this Bill to other diseases. If it were so done, my protest is all the more justified.

    Sir J. GILMOUR: Perhaps I may be allowed to say a few words in reply to what my right hon. Friend the Member for West Fife (Mr. W. Adamson) has just said. In the first place, I think I can claim that I have been completely consistent in my attitude on this matter. It is within the recollection of Members of the Scottish Committee that on a previous occasion I objected to the Bill introduced by the right hon. Gentleman 1453 and his party on the ground that I believed it was too wide. I objected to it then. I object to it now; not only because I have that opinion myself, but because I am fortified in that opinion by the support and opinion of the local authorities. After all, I think it is right to say that the local authorities are not averse to carrying out any scheme, if and when it has really been proved to be of benefit to the population over whom they have charge. When the right hon. Gentleman talks to us, either here or in the House, about the folly of shutting out the possibility of dealing with some yet-to-be-discovered remedy for cancer, let me say this to him: a remedy, which we all hope may be found some day for cancer, is going to be a thing of such gigantic proportions that it has got, first of all, to go through the experimental stage in which all well-informed medical opinion must be perfectly satisfied as to its efficacy before it is launched in any large measure upon the population. In the second place, if this remedy be found, it will be a matter of so great importance and such magnitude as to be a national as well as a local question. Just as in the question of tuberculosis, which it is impossible to 1454 believe would have reached the stage where it is, unless it had received from the State generally some measure of support, so it would be in the case of the relief of cancer. I do not for a single moment believe, if a remedy for cancer is ever found, and produced, that there will be the slightest difficulty or hesitation upon the part of whatever House of Commons is sitting at Westminster to give effect to the necessary legislation to carry it into being.

    Question, "That the Clause stand part of the Bill," put, and agreed to.

    Clauses 2 (Combination of local authorities) and 3 (Short title), ordered to stand part of the Bill.

    Bill, without Amendment, ordered to be reported to the House.

    Sir J. GILMOUR: I am sure that in expressing to the Chairman, on behalf of Scotland, our thanks for his presiding over this Committee, I am doing that on which all hon. Members will be agreed. [HON. MEMBERS: "Hear, hear!"]

    Committee rose at Ten Minutes before Twelve o'Clock.

    THE FOLLOWING MEMBERS ATTENDED THE COMMITTEE:—

    Barnett, Major (Chairman)

    Adamson, Mr. William

    Advocate, The Lord

    Berry, Sir George

    Broun-Lindsay, Major

    Buchanan, Mr.

    Charteris, Brigadier-General

    Cochrane, Commander

    Couper, Mr. J. B.

    Cowan, Mr.

    Cowan, Sir Henry

    Craik, Sir Henry

    Crookshank, Colonel

    Dalkeith, Earl of

    Elliot, Captain

    Fanshawe, Commander

    Gilmour, Sir John

    Hardie, Mr.

    Harvey, Mr. Charles Barclay-

    Henderson, Mr. Thomas

    Henniker-Hughan, Vice-Admiral Sir A.

    Kennedy, Mr. Thomas

    Kidd, Mr.

    Kirkwood, Mr.

    Lucas-Tooth, Sir Hugh

    MacAndrew, Mr.

    MacIntyre, Mr.

    MacRobert, Mr.

    Mitchell, Mr. Rosslyn

    Murnin, Mr.

    Palin, Mr. John

    Richardson, Mr. Robert

    Rose, Mr.

    Scrymgeour, Mr.

    Shaw, Lieut.-Colonel A. D.

    Shiels, Dr.

    Smith, Mr. R. W.

    Solicitor-General for Scotland, The

    Sprot, Sir Alexander

    Stephen, Mr.

    Stuart, Mr.

    Thomson, Mr. Frederick

    Westwood, Mr.