§ Motion made, and Question proposed, "That this House do now adjourn"— [Major Dugdale.]
§ Mr. James Griffiths (Llanelly)
I gave notice that I would take the first opportunity of raising an individual case with the Minister of Pensions, not only because the case itself is one which deserves ventilation, but because it is one of a number which several of my hon. Friends have which deserve to be ventilated in order to impress upon the Minister of Pensions the very great need that he should go very closely into the matter. In these days it is very important, not only that we should do justice to men discharged from the Army who obtain pensions, but that we shall seem to be doing justice and that they shall be perfectly satisfied that, if they have a case and eventually it is turned down, it has been turned down after the closest investigation and after an impartial hearing and an impartial decision. When men go to the Army and are discharged and have a grievance, they judge the way in which the grievance is dealt with, with a considerable background of industrial experience, and it is inevitable that, when men who are engaged in industry enter the Armed Forces and have a grievance, the Ministry of Pensions shall judge the matter with the background of the Workmen's Compensation Act. If I was working in a coal mine or a factory and was disabled, and a dispute arose whether the injury was attributable to my work and whether I had a claim for compensation, I should have the satisfaction of knowing that I could argue my case before an independent tribunal and get a decision upon it. I urge upon the Ministry the real importance of reconsidering urgently whether it is not desirable that there shall be some independent tribunal which will have the last word in matters of this kind, and not the Minister himself.
As far as this case is concerned, I think the best thing I can do is to read a statement on it made by the man's own doctor, who has known him all his life and who sets out the position very lucidly. The case concerns S. B. Thomas, 2, Welsh Terrace, Dafen, near Llanelly, and this is the letter:In 1930 Mr. Thomas had a mild attack of rheumatic fever, from which he made a good 120 recovery. At the age of 14½years or thereabouts he became employed at the Welsh Tinplate Metal Stamping Works at Llanelly, where he was employed from November nth, 1932, to January 13th, 1940. During this time he only lost 12 days through illness. This was from 5th to 16th January, 1937, and the illness was an attack of influenza. During this period he was doing laborious work but did not complain that it was too hard for him. On December 4th, 1939, he was examined by a medical board consisting of five doctors and a chairman. He was graded A1. Thomas himself was rather surprised that he had been passed in this category as he had had rheumatic fever in his youth. He asked me to examine him again. I did on Sunday, December 24th, 1939. I paid particular notice to the cardiac organ, but I could only corroborate the findings of the medical board. I could find nothing wrong with him and told him so. He entered the Army on January 15th, 1940. He was examined and found fit for general service by the medical officer of the unit to which he was sent. If he was able to do laborious work for years before entering the Army and i£ five doctors at the medical board as well as his own doctor were unable to find anything wrong with his heart and on January 15th a military doctor confirmed him fit for general service, if he was suffering from mitral sterotis at all at the time, it must have been of such an extremely mild variety that it could not be detectedHe was passed fit for general service. That means any kind of service. That again is passing A1. He was in the Army for only three days when he broke down and eventually he was discharged as unfit. He has worked for nearly eight years doing a laborious job. I will describe what he was doing in his own words, which have been corroborated to the Ministry of Pensions by his employer:I was working at this Tinplate and Metal Company's Works as a grease burner. It was hard and strenuous work in front of the furnace, charging and discharging. I also had to look after fire and and keep the heat up, also bring the coal in. It meant a lot of sweating but I never once felt any ill effects after it. I was working alternate shifts, from 7 a.m. till 4.30 p.m., and from 7 p.m. till 6 a.m., five and six shifts respectively a weekHe is doing that kind of work for eight years, as proved by his employers, and during that time he was ill for only a week and a half, and that was from influenza. Then he goes into the Army, and in three days breaks down because of the strain placed upon him during that time. They were three difficult days, and the weather was very bad. I realise, of course, that there is some amount of emotional tension and mental disturbance in such a change of life.
121 The position now is that this young man of 23 is discharged, and he will never do his own job again. Some special job will have to be found for him, because his value in the labour market is so low that no one will employ him except as a concession on compassionate grounds. The first thing I put to the Minister is that we cannot take men into the Army and then throw them out and wash our hands of responsibility for them. These young men go back to their own homes, where they are seen and known by everybody. There are nearly 1,000 men employed in the: factory where this young man was working, and they say, "Before you took him into the Army he worked eight years at this job, earning decent wages and keeping regular work. Now he comes back to be a burden upon his widowed mother and upon the community. Surely you have the responsibility of seeing after this young man. You cannot wash your hands of him." I put it strongly to the Minister that nothing will contribute so much towards destroying the good feeling and morale in the country than the feeling that we treat the young people who go into the Forces badly. I have discussed this case with the Minister, and we have had some correspondence. The Minister says that he gave his decision after getting the advice of his medical advisers that: this young man's disability was not caused by his service in the Army or materially aggravated by it.
If this case had happened in industry, the young man would have gone before a judge and would have got compensation. He would have got it on the ground that his disability had been, if not caused— and I am not arguing that it was caused by his service—but aggravated and brought out by his service. We have had many cases of men with some trouble with their hearts who have been put on jobs which involved some strain, as a result of which they have broken down. The employers have gone to the judge and argued that they were healthy men, but the judge has held that the employers accepted the responsibility when they employed the men and that they could not get out of it if the men broke down. There are many cases which clearly lay down the principle that if a man was all right and doing his job, and if the work has put some special strain on him as a result of which he has broken down and become disabled for employment, the employer has to accept 122 responsibility. I put it to the Government that they cannot treat a man who serves the nation worse than a man in private employment is treated.
When the Minister rejected this case on the advice of his advisers, I raised another point with him. As I still contested his decision, he took the action which he is entitled to take under the Royal Warrant of submitting if to a specialist appointed by one of the Royal Colleges, He told me that the specialist would examine the case and that his ruling would be binding upon the Minister. When that stage was reached I asked whether the specialist would see the young man. The Minister said that that would be left to the specialist. I do not think that any man can fairly decide cases of this kind upon written statements, and I urged that the young man ought to have an opportunity of seeing the specialist. That, however, was left to the specialist to decide, and he never called the young man. All he had before him were the papers in the case. I also raised the question whether, when the case was being submitted to the specialist, the man or his representatives would be entitled to submit a statement of their own. The Minister replied that further medical evidence could be produced if it was asked for, but the specialist did not ask for it.
I submit that this method of finally deciding cases of this kind will not do. It is not how we decide cases in workmen's compensation. Cases of entitlement to a pension go before a referee. He decides whether he can dispose of a case on the evidence in writing or whether an oral hearing is necessary. If he decides that no oral hearing is necessary, a full précis of the evidence is submitted, and there is an opportunity of submitting further evidence. In Ministry of Pensions cases there is nothing of that kind. I beg the Minister to reconsider this case. For eight years this man was doing a difficult job. I would like the specialist who has reported to the Minister and the medical advisers who have decided that his disability was neither caused by nor aggravated by his service in the Army to go and see the place where he worked. This young man did that job for eight years without breaking down, and people say that if he had not been taken for the Army he would still have been doing that job and earning that wage and maintaining his widowed mother. But he was 123 taken for the Army and he broke down, and now he is back in the condition I have described. That is something we cannot explain away. I therefore urge upon the Minister to reconsider this individual case, and, arising out of this and other cases which I and my hon. Friends have submitted to him, I urge him to consider the advisability of setting up a Board.
There is one further point. Before these young men are accepted for the Army they go before a medical board composed of five civilian doctors with a chairman. If that medical board think that there is something unusual about a case, they are entitled to say that they will not decide upon it at once but will send the man to see, say, an ophthalmic surgeon if there is anything wrong with his eyes, or to see a tuberculosis specialist. When a board of civilian doctors, after having submitted a young man to such a thorough examination, decree that he is A.1, surely that means that he is in an A.1 condition. If after that we find him turned adrift from the Army, I say frankly that we get a situation to which I cannot make any reply. Something has got to be done for these young men. Once we have accepted them, we have to accept responsibility for them. My final word is to impress upon the Minister to reconsider this individual case and to reconsider his decision to refuse to set up an independent tribunal. I hope he will take this kindly from me, but I must tell him that until the young men of this country know that they can take their cases to an independent tribunal they will never feel that any decision which is given is satisfactory
§ Mr. George Griffiths (Hemsworth)
I want to support the appeal made by the hon. Member for Llanelly (Mr. J. Griffiths). He has brought forward an individual case, but I want to say that there are scores of similar cases in the country, and the Minister and the Parliamentary Secretary cannot be complacent about the situation. Case after case is sent to us. I have had two cases this week, and they are two very hard cases. One is the case of a young man from my division who was taken into the Army as A.1 in 1939. He went on with his training, he carried out the regulations, and then he fell sick. He could not stand the pace with the others, and he had to 124 lie up. An Army doctor examined him and told him he was idle and that he must get out of bed. He was told that he must do the same as the others, and he kept going for a time. Then he came home, having got seven days' leave, and his own doctor examined him and told him that he was suffering from T.B. and must not go back to the Army. He did not go back, and he is now in a sanatorium belonging to the West Riding County Council. His father is on the railway, with wages of £218s. 9d. a week before stoppages are deducted. After allowing for the stoppages, he has about £2 15s. a week. The lad is in a sanatorium and does not get a cent. If his parents desire to visit him, they have to take so much out of the old man's wages—the father's wages. The mother wrote me a pitiful letter last week. She said, "We have to take the lad a few things when we go to visit him, and we can hardly make ends meet as it is"
I ask the Minister and the Department not to delay dealing with these cases. The delays at present are dangerous. We are asking for all the fit young men we can get to fall in, to get into the fighting line, and when lads who have had the experience which I have detailed come home and our young men hear about them it leaves a nasty taste in the mouth. The people in the district turn to us and say, "What are you doing about it?" As the Member for Llanelly has said, they say to us now, "You are part and parcel of the Government now and what are you doing about it? Are you going to treat them like this?" Further, it must be remembered that not as many are coming back now as will come back later on. If there is delay in dealing with these cases now, what will the position be when crowds are coming back? I ask the Department, I ask the Minister, to deal with the matter. The Minister is boss of the Department. I hope he will rule the Department and not let the Department rule him.
I hope the Minister and the Parliamentary Secretary will see to these cases. We know the present Parliamentary Secretary quite well. When he was made Parliamentary Secretary I said in my innermost soul, "Well, there have been delays, but Will has got plenty of ginger in him and will help to ginger things up." Of course, he has only just got there, but I hope he will help the Minister to prevent these 125 delays. Again, I hope there will not be so many rejections on the verdict of medical officers belonging to the Depart meat. Here was a young chap practically dying on his feet in the Army, and a medical officer in the Army tells him he is idle and that he must get out of bed and undergo the same training as the others. When he gets home his own doctor, who has known him from birth, is sent for by his mother, and he is in a sanatorium within a month. There is something serious about such a state of affairs. Surely to heaven the Army doctor ought to have realised what the lad was suffering from.
I ask the Minister to give stricter attention to this matter and not to have so much complacency. Do not deal with them as numbers and figures, but, for the sake of the Government, treat them as human beings. Do not let the consideration of their cases be delayed and do not let their appeals be rejected. I have been away ill from the House two months myself, but I have had these cases coming in to me, and I have replied to them. "Ah," someone said to one of them the other day, "go to St. Annes" —and then they want to know where St. Annes is. I ask the Minister and the Parliamentary Secretary—I know he is looking at me with a frown—to put their soul into this business and not deal with it as complacently as has been the case in the past.
§ The Minister of Pensions(Sir Walter Womersley)
May I say first how pleased we all are to see the hon. Member for Hemsworth (Mr. G. Griffiths) back in his place? When I heard that he was not very well I, like many other Members, felt very sorry, because we miss him from our assemblies.
§ Sir W. Womersley
I am glad to know that the hon. Member is still making earnest appeals for those who are in difficulties. I can tell him that my Parliamentary Secretary and I will not have any delays if we can possibly help it, but at the present time, as I am sure that he and the House will appreciate, we have almost an over plus of work. We do not complain of that fact, but it is a pity, because it means that many people are 126 suffering. We are using every endeavour to expedite cases, but there are cases which require a good deal of inquiry, even in the interests of the persons concerned. It is just as well not to reject a thing outright or to agree to it outright without investigating the evidence. It is better that a full investigation should be made before a decision is arrived at.
In regard to the particular case which has been raised, it is a pity that the Secretary of State for War was not here this afternoon, because the case should have been addressed to him. If the conduct of a member of the Army Medical Corps appeared to be called into question, and if it is a case that ought to be investigated, I suggest that the hon. Member take it up with my right hon. Friend, on the point whether it is correct that a statement was made that the boy was lazy and would not get out of bed, when really he was ill I think the matter ought to be inquired into as early as possible. I ask the hon. Member for Hems-worth to believe me when I say that my Parliamentary Secretary and myself have a great responsibility. We realise that if injustice is done it will react adversely upon our war effort. Further than that, as ordinary common men, we wish to do the right thing as far as we are able, under the Regulations that Parliament laid down for this work. I can assure him that' it will not be for the want of consideration that a case is turned down or for want of effort if there is delay in dealing with a case. It will simply be because there are many aspects of the matter that have to be inquired into before we can come to a decision.
I would apologise to the hon. Member for Llanelly (Mr. J. Griffiths) for not being in my place during the earlier part of his speech. I think he understands my position at the moment, and he is renderingvery great assistance to me in my Department. I have to make the best use of every minute of the day, or otherwise I should be in receipt of more complaints from hon. Members. We cannot judge at what moment an important Debate such as that which we have had to-day may finish, but my Parliamentary Secretary made some notes of the hon. Member's opening statement, and I should like to refer to them. The hon. Member said that we should not only do, but should seem to do, justice. Let me tell him that 127 it is our keenest desire that justice shall be done and that it shall be apparent that it has been done. We are guided by what happens under workmen's compensation, with the reservation that we must work, in Service cases, as nearly as possible to what is done in peace-time conditions of the Army. Many things occur from time to time about which I have to consult other Departments, respecting matters of policy, before I can come to any decision. I agree with the hon. Member that we must take as a guide what would happen in similar cases under workmen's compensation.
He made mention once again of that rather contentious matter, the tribunal. I have said in this House on more than one occasion—I have said it in the presence of representatives of the British Legion and at public meetings—that I would personally welcome the setting-up of tribunals, from the selfish point of view that they would help me in cases of doubt. I could simply hand a case of doubt over to a tribunal and ask it to decide. Whatever decision was arrived at would be binding on myself and on the Treasury on the one hand, and upon the claimant on the other. It is not easy, but, as soon as possible, tribunals will be set up, I assure hon. Members. Apart from the fact that they will relieve me from great responsibility, there is the point that a Britisher gets some satisfaction from knowing that, even though a tribunal is not a competent one, he has had a hearing for his case.
Why cannot we set up those tribunals at the present moment? I think hon. Members will agree that tribunals, if they are to deal properly with cases, must have medical representatives upon them. Very many cases have practically to be decided upon medical evidence. It is not possible to get doctors at the present time. I cannot get enough doctors for my Ministry to deal with cases, especially hospital cases. The Ministry of Health, who have emergency hospitals, have secured all the doctors they can lay their hands upon. The Army want doctors, and so do the Navy and the Air Force. At the moment it would be impossible to get the right men to serve on the tribunal, I think hon. Members will agree also that it would not be wise to set up a single tribunal in London, because, if cases had 128 to come from all over the country to be dealt with by that one tribunal, there would be much delay, and some cases would have to wait many months before they could get even a hearing.
It will therefore be necessary to set up tribunals in all parts of the country as was done in 1919. We shall have to do it again when possible. It will mean that some of the most competent men on my staff will have to deal with the tribunals, in which case we shall not have their services for the very important business of dealing expeditiously with cases that come along. Out of the very large number of cases with which we deal, very few would have to go to a tribunal. Tribunals would have to be sitting even if there were only one case to be heard. The members would have to be called together to hear that case, which would mean their travelling in from the districts round the towns in which the tribunal sat. I have been able to deal myself with an enormous number of cases that were rejected in the first place. Hon. Members will have had letters from me, on cases where I have been able to reverse the decisions previously given. I regard this work as a tremendous responsibility. It is such a big responsibility that I never let a case go unless I am absolutely satisfied about it, in a way that would not be the case if it were taken before the tribunal. That may seem a rather strong statement to make, but I would like to show hon. Members papers that would prove up to the hilt what I say. Time and time again I have sent papers back, and in some cases it has meant that we have had to alter our Regulations. When we have made our alterations in the Royal Warrant I have seen to it that the grievances were put right. I would emphasise to hon. Members that I am keenly desirous that justice shall be done. I repeat that I shall set up tribunals as soon as practically possible, and then cases can go there, and the decisions will be final and binding on both sides.
Let me come now to the particular case, but before I get to the details of it I will say a word on the general question which it raises of men who are taken into the Army and, after short service, are discharged when they are no longer fit for military life. It does not mean that men are so ill that they cannot work and are finished for ever, just because it has been stated that they are not fit for military 129 service. Very often a discharge is made in the interest of the man himself, because the doctors have realised that with strenuous training he would probably break down, and they think it far better that the man should be discharged rather than that he should take the risk of a breakdown. Cases of discharge are not always of men who are thrown on the scrap heap. I could quote many cases of which I personally know where men have been discharged from the Army, and it is always the same: "No longer fit for service in His Majesty's Forces" It sounds terrible. But these men have been able to go back into civilian life and to take up their former occupation or a similar occupation, and they have been able to carry on. As a matter of fact, the discharge board had conferred a benefit on such men by preventing them from continuing in a Service which would possibly entail their ultimate breakdown.
It is a fact that in the early days of this war many men who ought never to have been enlisted were taken into the Forces. I say that frankly, and openly. When I discovered, as I did early on, that we were going to have a pile of these cases of men discharged and who would be making claims for pensions, I took the matter up strongly with the War Office. I pointed out that there was something radically wrong somewhere, with the result that there has been an enormous improvement.
§ Mr. G. Griffiths
May I interrupt the right hon. Gentleman? He has made an interesting statement about the War Office. Can he say whether the doctors are paid according to numbers or the time they work? If they are paid for numbers, I can understand that they soon pass the men out.
§ Sir W. Womersley
I received all sorts of explanations from the people concerned. I have heard remarkable explanations. In some cases there is no question that the medical man was not in a position to judge at the time. There are certain forms of disease which cannot ' be traced by an ordinary examination. They require X-ray examinations and all kinds of things. It may be that owing to the fact that there is this shortage of doctors, men who were not quite competent were being employed. At any rate, the fact remains that in those early days a large number of men who ought never 130 to have been taken in found their way into the Forces.
§ Mr. G. Griffiths
I am sorry to interrupt again, but the Minister has not answered my question. I asked whether the doctors were paid by the hour or by the numbers of men they passed through.
§ Sir W. Womersley
I am sorry, but I cannot answer that question. In the first place, the examination is undertaken under the jurisdiction of my right hon. Friend the Minister of Labour, and afterwards by the appropriate authorities when the men are in the Forces. But I do not suppose that they are paid by numbers, because the examination is made by members of the Royal Army Medical Corps. On this general question it is a fact that there is now a much stricter examination; I am getting fewer of these cases, and they are beginning to get down to what I call reasonable proportions. We must also remember that when the Territorial Army were mobilised they did not have an examination straight away. They had some sort of examination when they joined the Territorials, perhaps some two or three years before, but they were embodied with the Regular Forces on the outbreak of war, and it was afterwards, on representations made by myself, and I have no doubt by other hon. Members, that the War Office undertook a re-examination, with the result that many men were discharged. Some of them claimed pensions and some have not.
I wanted to make it quite clear that the matter now is not in the same stage as it was in the early days of the war. I am still pressing for even stricter examination, because apart from the man's aspect—and that is a very important one—one must also look at it from the point of view of the nation and consider the money that has been wasted in trying to train a man who will not give service. It is a sheer waste of public money to take into the Services a man who is not likely to make an efficient soldier, sailor or airman, and from that point of view I hope that we shall be able to give a stricter examination than we are giving now, and, as I have said, that is much stricter than we had at the beginning of the war. I hope hon. Members will realise something of the difficulties I have to face. When I have a case such as this one sent to me, I 131 give it most serious consideration. I realise what it means to the man, and I also realise what the rejection, in a really bad case, would mean to the national morale. This is how I view the present case—my hon. Friend will correct me if I am wrong. The claim for pension on the part of this man was that his service was responsible for his present condition. I have gone through all the papers—the letters sent on behalf of the man and so on—and it is claimed that owing to the cold conditions under which he was first treated in the barracks hospital his health was adversely affected. The Army documents which I have here say that Mr. Thomas served from 15th January to 16th August, 1940—that seems a long period of service—being discharged under the same rule which is applied to everybody as "permanently unfit for any form of military service." That sounds very bad, and when it gets into the Press it seems that such a man must be in a desperate condition. But that does not always follow. What actually happened, as my hon. Friend has said himself, is that this man performed three days' effective service in the Army. He joined up and reported sick after three days, being taken into hospital.
In some cases I have found, when dealing with men who have been taken in and afterwards discharged as permanently unfit for service, that there has been good excuse for the doctor inasmuch as the man has not disclosed that he has had any previous illness. That applies mostly in cases of older men trying to get into the Pioneer Corps or the Royal Defence Corps because they are keen soldiers and really want to get into the Army. It should not apply in the case of a young fellow like this, called up as a Militiaman. He ought to disclose anything that has previously happened to him, and then the doctor, knowing that, could form a better judgment. So I have had to agree with the War Office that in cases where men have failed to disclose previous illnesses, having been asked six leading questions and having replied "No" to all, that there was some excuse for the doctor passing them in Grade A when they turned out afterwards to be nothing like Grade A. In this case the man himself on enlistment gave a history of rheumatic fever 132 in childhood, and having told them that, was medically examined and was placed in Grade I. That does seem to be one up against the doctor, but it is a matter for which I am not entirely responsible. When he was taken into the barracks hospital on 18th January, three days after joining up, he told the doctor that he had felt unwell for some days, with severe pains in the joints. He was removed to Wrexham Hospital on 24th January and discharged from that hospital on 26th July, 1940, not being finally discharged from the Army until a later date. That is a point I wish to mention as having some bearing on the general question: once a man is in the Army it takes a long time to get him out, even if he is a sick man; he has to go before boards and be put back for further examination and so on. Also, when a man is taken into the Army, there has to be considered not only the expense entailed in fitting him out and keeping him for the few days before he goes into hospital, but all the expense of treating him in hospital—all coming from the national Exchequer—for months before boarding him out. I would like to see a better method of boarding out.
§ Mr. J. Griffiths
I am making no complaint about the man not being discharged for all this time; as a matter of fact he was not fit to be. His mother was wired for because he was dangerously ill, and he was in hospital because he was dangerously ill.
§ Sir W. Womersley
I know my hon. Friend is not complaining about the delay. This man was invalided out in August, 1940, and it was stated that he was suffering from mitral stenosis, which is a later development from the childhood rheumatic fever and not from the rheumatism he was suffering from at the time. The Ministry considered that this was unrelated to the man's very short period of military service, and the case was rejected. Then my hon. friend brought this to my notice, and we went into the matter further. He made strong representations to me, and he has given correct details. I found that there was a difference of opinion between the man's own doctor, on the one side, and not only the Ministry's doctors, but the Medical Board, who found that the man's condition was not aggravated by his service, on the other side. When a medical man joins 133 the Ministry of Pensions it does not follow that he loses all his humanity or that he will act differently from an ordinary medical man. I have found these doctors extremely sympathetic in most cases, and certainly very desirous of getting at the truth.
I have had provision included in the Royal Warrant purposely to enable these cases to be dealt with. If it is a case of a difference of opinion between the man's own doctor, on the one hand, and the Ministry's doctor, on the other hand, the only course is to call in a third medical man, a specialist in the particular disease or wound, in order to get an independent opinion from someone who must have greater knowledge than the doctor attending the man or than my own doctors at the Ministry. Therefore, to make quite sure of getting an independent medical specialist, I did not appoint anyone, but I requested the President of the Royal College of Surgeons and the President of the Royal College of Physicians to nominate men to deal with special diseases and wounds. I asked the medical specialist nominated by the President of the Royal College of Physicians to deal with this case. It is true that I had to leave it to him to decide whether he should examine the man or not. In this case, he did not examine the man, because he said that there was no dispute between my doctors and the man's own doctor as to what the man was suffering from, and that, therefore, it was not necessary for him to take the trouble of coming up to London. The point at issue was whether the condition now manifest had anything to do with the three days' effective service that the man had had in the Army.
This is what he reported. He gave a general description of mitral stenosis, and then he stated that this disease is caused by rheumatic fever in early life. He said that, provided that the heart is little affected, it may be present with little symptoms of heart disease, and the patient may be able for years to live an ordinary life, even one involving manual labour. Further, he said that it not infrequently happens that, on medical examination, the signs of this form of valvular disease at times may easily be overlooked, as they may be very slight. When the characteristic murmur and thrill are well marked, as in the present case, it might 134 be regarded as an indication that the valvular defect was of considerable standing. The specialist men advised that the illness made the heart condition worse, but that it was a case of worsening irrespective of the service the man had performed. As I said, he could have examined the man if he had desired to do so, but evidently he did not desire to do so in this case.
§ Mr. J. Griffiths
With all due respect to this specialist, whom I do not know, how does he know that the man's service in the Army had nothing to do with the condition? In view of the fact that this man worked eight years after his illness at a very heavy job—which I would have liked the doctor to have seen—how does the doctor reach his decision?
§ Sir W. Womersley
In his report the doctor said that this is a disease caused by rheumatic fever in childhood, and that, therefore, it could not have been caused by the three days' service.
§ It being the hour appointed for the interruption of Business, the Motion for the Adjournment of the House lapsed without Question put.
§ Question again proposed, "That this House do now adjourn"—[Major Dugdale.]
§ Sir W. Womersley
On the question of whether the medical specialist should have examined the men or not, I believe that it is much better to leave the decision to the medical specialist. If you appoint an independent medical specialist and begin to interfere with him and tell him what to do, he does not continue to be an independent medical specialist. That is what I feel about it. If this case could have gone to a Tribunal the specialist would have given this evidence before the tribunal.
§ Sir W. Womersley
There would have been the evidence of his own doctor, which was also submitted to the medical specialist. It is true that, in the case of a Ministry of Health contributory pension claim, where there is an appeal a 135 full precis is sent to the appellant and observations can be made rebutting the statement. When the case comes before an independent medical specialist a full statement of the man's own doctor is placed before him for examination; he does not merely receive the papers presented by the Ministry's doctor. He has to get a picture from both sides and then decide which side has been right. The complaint made in one of the letters —it has not been the complaint to-day, but I think we had better deal with the whole thing—was that the man was put into hospital when the conditions were cold and not very agreeable. That is a matter of which I took great heed. I had to decide many of these cases of men who have been for a short time in the Army and have then been discharged. I have had to take into account the conditions under which men lived in the winter of 1939–40. I had to deal with many cases where the conditions in which the men were living brought about or aggravated their trouble, and in all these cases the decision was given in favour of the men. On the other hand, where you get cases of men with constitutional disease who because of slight examination or because it was impossible, as in this case, to detect the trouble, you can not make liability lie at the door of those responsible for billeting.
I myself made very careful inquiries regarding this case. I asked the officer commanding for a full report, and I take it that he has given me a true report. If he has not, then it is a matter to be inquired into. The hospital has been examined also, and we are informed that the conditions to-day are the same as they were on that occasion. They say that the temperature conditions were satisfactory in all wards, and that it is a sound and good hospital. I have the papers here and I would like the hon. Member to go through them with me. I would ask him, if he were in my position, what decision he would arrive at in the light of the evidence presented and of the specialist's report? On the other hand, I am told— at any rate it is in the correspondence— that his own doctor stated that the man was not fitted for the job at which he worked before, but that he was fit for light employment. I know that hon. Members will not think I am making this 136 an excuse, but I would like to do something to help this man to get a job that he can do and if the hon. Member will consult me about it I will see what can be done, either through the help of my right hon. Friend the Minister of Labour or in some other way. I have been able to do this in other cases and may be able to do something for this man. Although this is quite apart from the merits of the case, I hate to think of a man who has served even three days in the Army being left in a position where he cannot get employment.
§ Mr. J. Griffiths
I am much obliged to the right hon. Gentleman for the fulness and detail of his reply, but he has not touched the major point which I am putting to him and to the Government. Here is a man who has been accepted in the Army as A1. Once you decide that, then you have no right to decide on what may have happened before. If this were a workman's compensation case the judge would not hesitate for ten seconds. He would refuse to accept evidence on what had happened before. The Government ought not to accept less responsibility than they have laid upon employers in this country. The Government doctor said the man was A1 and, having decided that, you must accept full responsibility. The Government cannot get out of that.
§ Mr. J. Griffiths
I am not putting forward propaganda. I am speaking as one who has had 20 years' experience. A workmen's compensation judgment would decide such a matter on grounds of equity.
§ Sir W. Womersley
I am not saying that the hon. Gentleman was using the point in that way. I am saying that that is how it has been used. In my early days, in connection with pensions matters, long before I came to Parliament, it was an attractive thing for me. I said it about men who came out of the Army at the end of the last war and until I got into pensions administration, as a member of a local war pensions committee connected with the British Legion, I believed it. In spite of all that, after my long experience in dealing with these cases, I say that if we accepted the fact of a man being taken into the Army, Navy or Air 137 Force as making us fully responsible for what happened to him before, the whole pensions system would break down. That is what I am afraid of more than anything else. We are dealing to-day with a problem far different from that of the last war. We are dealing with many millions of people—civilians, civil defence volunteers, Mercantile Marine men, fishermen and the Army, Navy and Air Force, and if a man has been inadvertently taken into one of the three Services and graded A.1 and in a short time it is proved that there was a mistaken diagnosis, I do not think that we ought to be responsible.
§ Mr. J. Griffiths
Surely, the people who made the mistake ought to accept the responsibility and in this case the Government made the mistake.
§ Sir W. Womersley
I do not think there is any question that such a man would be accepted in the Army to-day. I have to deal with these cases on the facts, and I have tried to do that with this case. If the hon. Member will go through the papers with me, I am sure he will form quite a different opinion on the whole thing.
§ Mr. Mathers (Linlithgow)
The Minister has given a characteristic answer to the Debate. We believe in his sympathy for the men on whose behalf he is administering his great Department, but he ought to be told that there is widespread dissatisfaction in what is happening in many cases. I am sure that many hon. Members could cite cases, although perhaps not in such great detail as my hon. Friend the Member for Llanelly (Mr. J. Griffiths), because of the exhaustive inquiries that have been made and the evidence that has been put forward in that case. My own position is that I have to warn my constituents who put forward cases of this sort that they must have the strongest possible medical evidence, because in my experience the Ministry of Pensions medical people are very difficult nuts to crack.
The discussion of this matter has caused me to recollect some details about a man who was taken into the Army with a very slight curvature of the spine. He was passed A1 for the Army, and because of the vigorous exercises which he had to undergo in his training, the defect from which he suffered developed so much that 138 he had to be discharged, and, as in the case referred to by my hon. Friend, he was unfit to do the job he had previously done. That is the position with which we are concerned. A man goes into the Army after having been able to do a job, involving it may be, as in the case which has been quoted, heavy manual work. One would say that he would be able to stand up to any reasonable exertions called from him. He is passed into the Army by medical opinion, and thereby is looked upon as a man who will stand the form of training required to fit him for being a soldier.
In my judgment, those who examine the man for the Army take the responsibility of saying that he is fit to stand the training to which he will be subjected. If they are proved wrong in their estimate of the man's strength, if they are proved wrong in regard to the category in which they have placed him, then I think that anyone who looks at the matter fairly will agree that the Army authorities and the Ministry of Pensions must take the responsibility for what may be argued to have been a wrong diagnosis on their part. But after all, they have made the diagnosis, they have taken the responsibility, and the man is placed in the position, because of his having been in the Army, of being a less useful citizen, less able to carry the responsibilities of manhood, and unable to do the work he was able to do previously. There is very great perturbation in many minds regarding men so treated. The Minister made a plea which undermined any case he might have had in this connection. He indicated to us that he himself objected to the way in which the medical examinations of Army recruits were being carried out, and that he urged the absolute necessity of strengthening and improving the examinations.
For what reason is that? Because he was taking the responsibility for drafting men from industry into the Army, and they were becoming casualties, proving that the medical examination was unsatisfactory. If the Minister has strengthened that examination, all the more reason why claims should be made for that examination to be looked upon as a responsible method of putting a man in a particular category. If afterwards he shows that he is not fitted to be a soldier, the Government must accept the responsibility for 139 the impairment of that man's usefulness. That is the position, and this particular case puts it in a nutshell. If it is extra powers the Minister requires, I am certain that this House will give them to him. The Minister makes the point that he wishes cases of this kind to march very closely with those which come under workmen's compensation. In that case, is there any indication of this to the independent medical referee? There is not, and there is nothing like it.
§ Sir W. Womersley
If I began to give instructions to any independent medical referee, he would cease to be independent.
§ Mr. Mathers
I do not want a medical referee to cease to be independent, but I think we are entitled to ask the Minister to indicate how he wishes cases of this kind to be dealt with, and to show what sort of treatment and what kinds of evidence he wishes to have in determining cases of this kind. When he does call in medical evidence, let him note that in asking one medical man to disagree with another and give a contrary verdict, he is expecting a very great deal, because the medical profession is a very close corporation, and one medical man is very chary indeed of giving a verdict contrary to one previously made by a member of his own profession. Doctors will say in conversation, when one approaches them about a constituent who is placed in a position of this kind, that they believe there is a good case for the man. But it is a very different thing to get evidence on paper which will be convincing to the Minister of Pensions, and have sufficient weight to cause other medical men to change their opinion. I should not have intervened but for the fact that the Minister ought to know that this is not an isolated case, and that there is a very widespread opinion on matters of this kind in the country. I hope that whatever is necessary will be done by the Minister, not only to do justice in these cases, but to make it abundantly evident to everyone that fair dealing is the case and that actual justice is being done.
§ Sir W. Womersley
Of course, I only intervene by permission of the House, but I should like to reply to two points raised by the hon. Member for Linlithgow (Mr. Mathers). The first is in regard to the independent medical specialist, and the 140 other in relation to the medical profession being a kind of close freemasonry or trade union. The hon. Member misunderstood the whole position. This man is called in to decide between two doctors' opinions. If he agrees with one, he disagrees with the other. It cannot be said that he is afraid to disagree with a member of his own profession, because he is bound to do that, whatever decision he arrives at. From what I know of these independent specialists, they do not worry about disagreeing with my doctor or the man's doctor. They give their opinion and give definite reasons for it. What he has to decide upon are the medical facts of the case, and I do not think we need worry about his being so soft-hearted that he does not want to disagree with one of his own profession. We can cut that right out. When it comes to the question that I gave the hon. Member credit for nearly finding a flaw in my armour when I was admitting that these men were taken in, I did ask them to tighten it up, and I am glad to say they have done so, because they were taking it on a wrong diagnosis in many cases. Where it was shown that, whatever service a man performed, it was detrimental to his health and aggravated the disease, I have given the pension in every case.
§ Sir W. Womersley
This is not on all fours. We have to come down to the facts. I have to deal with these questions on the facts. If it could have been shown that this man suffered any hardship during these three days or was under any adverse conditions, or that there was any thing likely to bring about a recurrence of rheumatic fever —
§ Mr. J. Griffiths
Here is the simple fact. He had worked day in day out for eight years and lost only two weeks through influenza. He collapsed at the end of the three days and not before. Whatever it was, was in the Army. It is not suggested that there was any misconduct on the man's part. Whatever happened happened in the service of the War Office.
§ Mr. J. Griffiths
It does not matter, but his illness was materially aggravated by service. He collapsed and was eventually taken to hospital. On the facts I think there is a 100 per cent. case.
§ Sir W. Womersley
I can assure the hon. Member that if a verdict could be given, I should have given it, because he put up the case with all earnestness and he honestly believed in it, but there is no evidence of any kind that the man suffered from anything likely to bring about a recurrence of rheumatic fever. His own statement was that he had had these pains for days. In dealing with something like 2,000,000 men you are bound to get a case here and there where a man is likely at any time to have a breakdown, and it just happens that he is in the Service. What I have to find out is whether there has been any negligence on the part of those in authority. Has anything happened in the Service likely to cause this disability to arise or to aggravate it, and, if so, the verdict goes to the man every time. In this case I cannot find anything which disagrees with the decision arrived at not only by my doctor and the Army doctors but by 142 the independent medical specialist. As to the hon. Member who spoke last, I do not believe there is this widespread trouble over these cases, because the cases are not widespread. They are very few. It is astounding to me how few there are considering the rather slack examination in the early days. Many have come to me when pensions have been awarded because I felt that certain circumstances during the man's service might have brought about an aggravation of the disability. It is only in those cases where I am absolutely convinced that there has been nothing in the man's service likely to cause any aggravation that I have had to turn it down. Those cases are not so widespread as my hon. Friend seems to imagine, and I have not had any evidence of the storm of indignation that has been indicated.
§ Question, "That this House do now adjourn," put, and agreed to.