§ 11.15 a.m.
§ Lord SEGALMy Lords, I beg leave to ask the Question which stands in my name on the Order Paper.
§ The Question was as follows:
§ To ask Her Majesty's Government whether they have evidence of patients continuing to receive certificates of incapacity over long periods for border-line conditions such as nervous debility.
§ Lord WELLS-PESTELLMy Lords, I can confirm both that certificates do on occasions run on for longer than the diagnosis on the certificate would have suggested was likely, and that the Department of Health and Social Security control procedures will operate in these circumstances to provide further evidence in relation to the patient's claim to benefit. If the noble Lord has any particular difficulty in mind, I hope that he will give me further details so that I can look into the matter more closely.
§ Lord SEGALYes, my Lords; but is it not a fact that an aggrieved patient who is certified by a doctor as fit for work can 1466 retaliate by taking his name off that doctor's list, taking with him the whole of his family, with a consequent fall in that doctor's income? Is not the regional medical officer who certifies the patient as fit for work starting a whole train of investigations which involve him and others in troublesome and time-consuming procedures? Is not the whole machinery of medical certification creaking with anomalies, and badly in need of a complete overhaul?
§ Lord WELLS-PESTELLMy Lords, I have no evidence, and I have gone into this matter very carefully, which would support the statement that the procedures are not serving a useful purpose, or that they are in any way out of date. If the patient has a certificate and the incapacity goes on for longer than is normally considered to be right, I think there is an obligation to investigate the matter. At the risk of incurring your Lordships' displeasure by being longer in my reply than I might have been—and I know that my noble friend Lord Shinwell complained to the House quite recently about the length of my replies—there are about 650,000 references to the Regional Medical Service each year for a second opinion on incapacity. In about 60 per cent, of the references incapacity is confirmed, but in about 10 per cent. of the 650,000, the claimant is found to be capable of work. In the remaining 30 per cent. the claimants themselves, when they are called before the Regional Medical Service, cease to make any claim. I think that alone rather suggests that the procedures are highly desirable.
§ Lord SEGALMy Lords, would it not be much fairer to invite the doctors to submit confidential reports direct to the Department of Health, under safeguards which would not involve them in loss of income? Also, should not civilian medical boards be conducted by more than one medical officer, as is done in the Services, and preferably with an experienced lay official from the Department present, to give advice in borderline cases where an element of doubt exists?
§ Lord WELLS-PESTELLMy Lords, the whole purpose of the procedure is that if there is a borderline case, the Regional Medical Service provide facilities for a second opinion. With regard to the other 1467 suggestions made by my noble friend, I am sure that my Department and the Government would want to examine them.
§ Lord SHINWELLMy Lords, is my noble friend aware that although I heard him mention my name, I did not hear the reference? Would he tell me what crime I have now committed?
§ Lord WELLS-PESTELLMy Lords, when your Lordships were discussing procedures in this House, I seem to have read in Hansard that when the length of answers was raised, the noble Lord asked the noble Lord the Leader of the House whether my attention had been drawn to that particular point.