CLAUSE 124.—(Appointment and duties of examining surgeons.) (Hansard, 17 June 1937)

§ Mr. Rhys Davies
I beg to move, in page 99, line 40, at the end, to insert: and subject to the consent of the employed person concerned the examining surgeon shall have the right to inspect the medical records 715 of the medical practitioner employed by the occupier of the factory. This Clause relates to the medical officer who is at: present commonly called a "certifying factory surgeon" but whose title is now to be changed to "examining surgeon" and Subsection (4) provides that the examining surgeon is to have power, at all reasonable times, to inspect general registers of the factory. A new scheme of things has come into existence in industry: large industrialists have recently adopted the practice of appointing their own medical officers. Those medical officers are employed exclusively by firms to look after the health and well-being of the workpeople. That is all to the good, but a point of etiquette may arise as to that inspection by the examining surgeon of the register in a factory where a medical practitioner is employed by the firm. We propose that the examining surgeon, for this purpose, should be paramount over the medical officer employed by the firm.

§ Mr. Lloyd
While we are indebted to the hon. Gentleman for his suggestion, I would put to him and to the House certain objections to it which have occurred to us. It depends entirely on the doctor employed by the firm having kept his records at the factory and in a form in which they could he read by people other than himself, whereas he might have kept them in his own house. In that case the proposal would not be practicable. Another and more serious objection is to the suggestion that the examining surgeon should have the right to conduct a sort of roving inquiry into records of another practitioner, irrespective of the precise scope of his duties under the Act. With his experience of Home Office administration the hon. Gentleman will appreciate the undesirability of giving an undefined power of that kind. We think it would be more practicable to leave the matter to be settled beween the two doctors.

§ Mr. Rhys Davies
Can I have an assurance from the hon. Gentleman that, in relation to Sub-section (5), under which the Home Secretary may regulate the duties of the examining surgeon, this point will be home in mind?

§ Mr. Lloyd
Most certainly.

§ Mr. Davies
In that case, I beg to ask leave to withdraw the Amendment.

§ Mr. E. Smith
I beg to move, in page 100, line 5, at the end, to insert: (7) Where any person is liable to contract an industrial disease from any process carried on in a factory the examining surgeon shall examine such person at least once in every month during working hours and keep a record of such examinations for inspection by the inspector. During the last half-hour we have been inclined to skip over some very important matters in the consideration of the Bill, and I hope the House will be tolerant and generous enough to devote some time to this question. I represent an area which has suffered more from industrial diseases in the last 150 years than any other area in the country and the object of my Amendment is to secure that further steps shall be taken by the Home Office to deal with silicosis, asbestosis, dermatitis and other industrial diseases. I admit that the Bill is an improvement on existing arrangements. If the Home Office officers administer it in a generous way, it will deal with some of the troubles which bring about these diseases but it is not enough to deal only with the individuals. The question is important, having regard to the changing chemical processes which are now being introduced into industry. I know of no better way of bringing the serious effects of these diseases before the attention of the House than to quote briefly from a newspaper correspondent in our area who had an interview with a woman whose husband was suffering in this way. When she was being interviewed this woman burst into tears and said: I have watched his father and his brother as they choked alive with this cursed thing—fine men, both of them. Now I have to watch him dying. Perhaps when he is almost at the end they will give him a pension. Perhaps they will look after me when he goes, but what do I care about that? It's his life that I want. If it is a crime to work a sick horse, why isn't it a crime to make a man work when his own death sentence has been brought up as a result of contracting an industrial disease? That is typical of the homes of thousands of people who have been subjected to silicosis and other industrial diseases, and what we are mostly concerned about in this matter is to take steps to prevent 717 people contracting these diseases. We know that people have to obtain their livelihood and that these industries must continue, but what we say is that, just as progress has been made in the past and other industrial diseases have been dealt with, so the Home Office should also deal with these diseases on the lines that we are indicating, with a view to preventing the contracting of the diseases.
Why are we concerned about this matter? Primarily I am concerned about it because for 25 years I was engaged in industry, and every minute that I lost from my work meant loss of earnings and of income to our house. That is the plight of all who contract industrial diseases. When they have to begin to lose time it means that they automatically suffer a reduction in wages, and gradually it may mean that they are suspended from their employment. Then there is the difficulty of securing compensation, and there are all the legal quibbles that take place in dealing with compensation. Therefore, in addition to the fact that it takes people away from their employment, it means increased insurance premiums for the employers when these industrial diseases are contracted, so that those who are concerned about the employers and we who are concerned about the employés ought to be on common ground in taking steps to deal with these diseases. Our idea is to save these lives, to prolong them, to save the earnings, to save the payment of compensation. As I have already said, in the area that I represent they have suffered more from these dreadful diseases than in any other area. It is plainly to be seen on the skins of people as they walk about, and the local newspapers reflect the effects of these diseases, day after day and week after week, as the Home Office records would show if their files were turned up. At inquest after inquest, after the post mordem examination, the coroner brings in the verdict that the person has died as a result of contracting an industrial disease, and generally speaking it has been silicosis.
I ask that the Home Office should take steps, based upon their own records and reports, to deal with this question. I have recently read the report submitted to the Lord Privy Seal by the Medical Research Council, and I am convinced 718 that if the Home Office would instruct their officials who have specialised on these problems to concentrate on the numerous reports which have been published in the past two years, great steps forward, based upon this Amendment and the means already introduced in the Bill, could be taken in the elimination of the effects of these industrial diseases.
I have this last day or two gone purposely to the Industrial Museum quietly in order that I could again examine the effects of silicosis. Every Member of this House should visit that Museum. There you see the effect of silicosis on the human frame. No one could possibly believe it unless he had medical knowledge or had seen the specimens in this museum that the effects on the lungs of people who have contracted silicosis. I am not exaggerating the effects. I am sorry the time is so late and that one cannot deal adequately on this matter, but the House has already been generous enough to listen in the way it has done. Therefore, I want to conclude by drawing the attention of the House to the latest report of the Factory Inspector.
He says, on page 7, The number of cases of silicosis remains at present static. Then he goes on to deal with the matter fully. I had intended to give the House information from the Workmen's Compensation Act returns and the Factory Inspectors' returns, showing the great need for doing something adequate. But, as the House has been sitting for so long and has been generous enough to listen in the way it has done, I will conclude by moving the Amendment in the hope that the Home Secretary will be prepared to accept it.

§ Mr. Tinker
I beg to second the Amendment.
Perhaps I ought to say one or two words in reference to it to explain to some of my hon. Friends exactly what it means, because all industrial workers resent the idea of being examined, and if this had been mentioned to me 20 years ago I should have been as keenly against it as anyone. We have to ask ourselves: Is it wise to let disease make ravages into a person and let him become derelict because, if he is examined 719 and found to be prone to a certain disease, the employer may have him discharged? I claim that our trade unions are now strong enough, if any attempt of that kind should be made, to insist that a job be found for the man or compensation be paid to him. I, too, have been to this museum and have seen cases which have horrified me, where disease has got hold of a man and resulted in a sight which it was almost impossible to believe. If I can do anything to prevent any human being driven to that kind of end I am going to do it. There are thousands of mine workers who, once they have contracted silicosis, are fit only for the undertaker. They are no use after they have got this terrible disease. Very few get through. It means a living death. If we can prevent that taking place by examining a man regularly and by saying, "You are unfitted for this kind of work, for in 12 months or two years death is bound to follow," I am prepared to take the risk of the man having to fight the employer for either employment or compensation. Dermatitis also is a very insidious form of disease. There are many such diseases, and the time has come when we ought to take steps to arrest them. The Amendment is designed to protect workmen against getting these diseases and making them useless to themselves and their families. I have given careful consideration to this question, and I believe I am doing right in asking the House to take some such steps as these in order to give men good health, for without good health life holds little for them.

§ Mr. Lloyd
We all want to do what we can to prevent these terrible industrial diseases, and the hon. Gentleman who moved the Amendment knows how much the Home Office does under its various powers. The question is whether this proposal is a good one from that point of view. I will point out some considerations which, I think, has escaped the hon. Gentlemen's notice. The term "industrial disease" in the Amendment is very vague, and much vaguer than the Home Office advisors on drafting would allow. It might mean a large variety of diseases from serious ones to trivial ones, and ones which occur with great rapidity. It would mean that a vast number of examinations would have to take place. A more serious objection to the Amend- 720 ment is, it is too rigid a requirement to lay down a month as the period for examinations. For some diseases it would be appropriate, but for others it would be quite inappropriate. The period ought to depend upon circumstances, and consideration must be given to the disease and the process which causes it. In the lead poisoning regulations, for example, the period between the periodical examinations varies according to the process for practical reasons. Silicosis develops very slowly, and and monthly examinations would not be appropriate. Actually we have periodical examinations under the silicosis provisions of the Workmen's Compensation Act, but the periods vary according to the process and the concentration of silica dust in a particular process.
The hon. Gentleman's proposal from the point of view of silicosis would not be very practicable, especially bearing in mind that a highly technical and skilled diagnosis is required which the ordinary doctor is not capable of carrying out. Perhaps I might suggest that a more practical direction for his efforts to take would be for him to consider whether, in the case of the industry with which he is particularly connected, there is a stronger case for requiring periodical inspections in connection with additional processes. If he has further information and thinks there is a strong case in that matter we will look into it carefully. We think that would be a more practical step in the case of silicosis than laying it down that there shall be a monthly examination.
With regard to dermatitis, the position is exactly the reverse. In place of a slowly developing disease we have one which develops, I am informed, very quickly indeed, and a monthly examination, instead of being too frequent, would not be frequent enough. I will not go into all the details concerning dermatitis with which I have been furnished, but the really important thing is not that there should be a periodical medical examination but that particular care should be taken to secure the cleanliness of the hands. The workman should have his hands examined daily, perhaps, as he goes into the works I suggest to the hon. Member that the most practical method of dealing with this question would be for the Home Secretary to make regulations under Clause 59, the dangerous trades 721 Clause and, as a matter of fact, we have already made orders in industries in which dermatitis is particularly prevalent requiring that there shall be an examination of the hands of the workers as they go into the factory. I appreciate the desire of the hon. Member to improve conditions wherever possible, and I would, in conclusion, remind him of the powers under Clause 11, those important powers which the Home Secretary has, for the first time, to require the medical supervision of workers in all factories in certain circumstances. That is an important new power and if it is used, as I am sure it will be, it may easily prove to be a very important provision from the point of view of preventing industrial disease. Perhaps with this explanation the hon. Member will be prepared to withdraw the Amendment.

§ Mr. E. Smith
If I may be pardoned for speaking again after the explanation which we have had, I would say there are various opinions among ourselves as to the best way of dealing with the matter. After the generous way the Under-Secretary has dealt with it and the undertaking he has given, I beg to ask leave to withdraw the Amendment.