HC Deb 18 January 1944 vol 396 cc67-73
Mr. Rhys Davies (Westhoughton)

I beg to move, in page 1, line 7, after "disease," to insert "whether physical or mental."

I do not want to deliver a long speech on this Amendment because I am happy to note that the Ministry itself has, in effect, accepted much of what I am trying to achieve. I might, however, be allowed to say a word about the purposes of my Amendment. I find that the wording of this Clause does not tally with the wording of Acts of Parliament in relation to similar problems. On turning to the Royal Warrant governing pensions in respect of war service, I find there the words "mental and physical" specifically mentioned, to cover all manner of diseases. I have had a little experience in administering benefits in this type of case and that is why I am interested in the point. One of the most difficult cases to deal with in the matter of rehabilitation is that of neurosis. I am not so sure that the Ministry of Labour would be able to deal with cases of that kind under the Bill as it stands at present. The last report of the Ministry of Pensions shows that the largest single group of disabled persons still remaining on their books from the last war is that of persons suffering from neurosis, and I move this Amendment in order to bring that type of case inside the meaning of this Bill.

Even now when we have before us the Minister's proposed Amendment which, of course, I welcome very much, I believe I am right in saying that it will not cover all the ground. I speak with some knowledge of this problem because I happen to be the chairman of a Mental Welfare Association in Lancashire. In spite of the law, some mental deficients have actually entered the Forces, and the Amendment that the Ministry of Labour propose to insert in this Bill apparently debars that type of person altogether from the provisions of this Measure. I do not want to say very much more, except that I am very glad that the Ministry have found out that I was right in principle in tabling the Amendment I put on the Paper. I welcome this Bill for many reasons; and it may interest the House to know that my experience shows that neurosis cases, in particular, are cured very often by training the patient to do something useful, and not simply keeping him in an institution and giving him medicine to swallow.

Having said that, I trust that the Minister will be able to say, when he comes to his own Amendment that the Ministry do intend to take very serious note of what I think will be the largest group at the end of this war, namely, neurosis cases. When I say that, I mean also those cases that have suffered very badly in consequence of the bombing by the Germans in this country. I move this Amendment in the hope that later on I may be able to withdraw it in favour of the Minister's own Amendment.

Viscountess Astor (Plymouth, Sutton)

May I ask the hon. Member whether he thinks there have been many cases of neurosis due to the bombing?

Mr. Davies

Yes, indeed. If the Noble Lady will forgive me for saying so, she will be surprised at the number of cases, happily of short duration, of women in particular suffering from neurosis due to blitzes.

Viscountess Astor

May I say that in Plymouth we have very few such cases?

The Joint Parliamentary Secretary to the Ministry of Labour (Mr. Tomlinson)

There is no doubt that the definition does cover both physical and mental. The Amendment which we have put down, deals with an entirely different type of case from that about which the hon. Member was speaking. He is entirely wrong when he says that mental deficients will not come under the Bill.

Mr. R. J. Taylor (Morpeth)

Surely the hon. Gentleman knows there is a vast difference between lunacy and mental deficiency. For illustration, I would point out the wording of the Government's own Amendment which says: the expression 'disease' shall be construed as including a physical or mental condition arising from imperfect development of any organ. The mental deficient is deficient from birth, and cannot answer for his brains at all.

Captain Duncan (Kensington, North)

I am not quite clear where we are on this matter of Amendments. Of the two Amendments I would prefer the Amendment proposed by the hon. Gentleman, because the Minister's Amendment deals only, as far as I can understand it, with mental deficients, with the imperfect development of an organ. That is mental deficiency. It does not in any way cover cases in which I am particularly interested—the serious neurosis cases. If there is to be a Division on this matter I shall vote for the first Amendment which has now been discussed.

Dr. Haden Guest (Islington, North)

Could I make sure that the conditions of a man suffering from nystagmus will be covered by the wording in the Bill? What I have in mind is this: There is no question that such cases will be covered during the time that a man is certified by the medical referee. It has often happened in my experience in dealing with men suffering from nystagmus that their condition has been put down to a neurotic state not arising out of their employment at all. One cannot say that it is really a mental disease in the accepted sense; it is a neurotic condition preying on the mind of the sufferer. Will that man be covered by the wording here? It seems to me that the Amendment to be moved by the Government is a limiting one which might have the effect of excluding certain things instead of including them, whereas the Amendment moved by my hon. Friend is one which does seem to include what is wanted, and if the Government wish to proceed with their Amendment they ought, I think, first to accept the hon. Member's Amendment so that they will not exclude anything while attempting to include something.

Mr. Graham White (Birkenhead, East)

As we are considering the Government's Amendment, will my hon. Friend explain——

The Chairman

We are not discussing the Government's Amendment, though it has been referred to in passing. The hon. Member should address his remarks to the desirability of otherwise of adopting this first Amendment.

Mr. White

I will raise my point later.

The Attorney-General (Sir Donald Somervell)

The reason why we are resisting this Amendment is that the word "disease" includes neurosis, a mental disease, and therefore it would be a pity to insert a word which might throw doubt on the wide connotation of the word "disease." The hon. Member who alluded to the later Amendment is quite right in saying that it deals with a different subject. It does deal with cases where it might be said there was no disease because the condition was congenital. Our reason for resisting this Amendment is that the word "disease" in the Bill includes mental disease and therefore it is unnecessary to add these words.

Mr. Bowles (Nuneaton)

The right hon. and learned Gentleman says that the word "disease" includes mental disease. His eminence at the Bar makes that statement of great value, though not necessarily binding on the courts. Can he give us his authority for making that statement?

The Attorney-General

I do not think it has ever come before the courts, because the courts give to words their ordinary meaning. There is no doubt that mental disease is disease—I do not know that I can carry it further—and neurosis is a recognised form of disease. In the present state of medical science and the use of the word there is no shadow of doubt that the word "disease" includes both what are called physical diseases and what are called mental diseases.

Sir Douglas Thomson (Aberdeen, South)

In regard to the point raised by my hon. and gallant Friend the Member for North Kensington (Captain Duncan) do I understand the position to be that if this Amendment is refused the ex-Service man whose disease does not arise from imperfect development will be excluded?

The Attorney-General

No, he will be included, because he will be suffering from a mental disease. It is the intention of my right hon. Friend that he should be included. I must not trespass upon the later Amendment, but it is the intention to include people whose mental infirmities arise from mental disease as well as, under a later Amendment, people whose mental infirmity arises not from disease but from a congenital condition.

Mr. Rhys Davies

May I say, in withdrawing this Amendment, that I think the Ministry may find in actually administering this provision that they will be in a difficulty? I can assure them that the words I have copied here would not be in the Royal Warrant, which is under the control of my right hon. Friend the Minister of Pensions, were it not necessary to insert those words. When a person claims benefit from any State funds the mere fact that he is suffering from neurosis is not sufficient to substantiate the claim; he must be totally incapacitated from following any employment and he is not of necessity so disabled by neurosis and kindred troubles. Anyway, it is no use challenging the Government. I know that I should be defeated, but I am pleased that I have been able to bring this problem to the attention of the Government. I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Mr. Tomlinson

I beg to move, in page 1, line 13, at the end, to add: (2) For the purposes of the definitions contained in the preceding subsection the expression "disease" shall be construed as including a physical or mental condition arising from imperfect development of any organ. The reason for this Amendment has already been given. It is to bring in those who may have been excluded. It has been suggested that this Amendment may have the effect of an excluding Amendment, but the very purpose of it is to prevent anybody from being excluded. The imperfect development of the optic nerve may cause blindness. That might not be referred to as a disease and it might not be a deformity according to the definition, and to cover cases where the disability arises congenitally, this Amendment has been put down, so that they may be included and not excluded.

Dr. Guest

Has the Attorney-General considered the question of definition in regard to the word "organ"? Is the mind an organ? The brain is, of course, an organ. What is the relation between the mind and the brain? I am not attempting to raise fine or subtle points which do not exist; I am attempting to get a definition which will stand up when the question comes up in a court of law. Supposing an individual has a mental defect which, as is often the case, cannot be correlated with any observable physical defect of any organ, does that case come within the definition if the mental defect is something of a congenital character?

The Attorney-General

Certainly it would come in, because it would be in already. Those we are trying to bring in by this definition are those which can be seen or those which are known and can be defined. I do not think the hon. Member need worry about the question coming before the courts. I cannot see it coming before the courts. Nor will the question of mind or brain be one on which the Advisory Committee will be called upon to adjudicate. It is the action of the mind or brain, however constituted, that will be the determining factor.

Mr. Graham White

I come to the point which I attempted to raise when I was out of Order a moment ago. It seems that we are getting into a highly rarefied argument over the difference between organic and inorganic. When I first read the Amendment I thought it was definitely a limiting Amendment. Without going into the refinements which have been referred to, could my hon. Friend assure me that there is no limiting purpose in the Amendment and that it is the intention to have in the Bill a Clause which will embrace every reasonable case?

Mr. Tomlinson

I can give that assurance fully. That is our purpose and intention.

Mr. Rhys Davies

Will the hon. Gentleman tell us how it comes about that he is running away from one of the recommendations in his own Report? The Tomlinson Report specifically states that rehabilitation should cover mental and physical diseases, and I have always understood that when Bills came before Parliament they were related more or less to the recommendations of the Committee which went into the problem. Here, however, the Department runs away from the words used in its own Report.

Mr. Messer (Tottenham, South)

I cannot see where the confusion arises. If we read it as saying that the definition shall include—we are saying nothing about construing—it has got to include something, because the smaller part is a part of the whole. What we do is to lay it down definitely that we include in the ordinary recognised description a description that can be dealt with. I think the Amendment puts the matter very definitely as showing that we include something that might not have been included if these words were not there.

Viscountess Astor

Is it not true that a great many physicians say that most physical diseases are mental?

Amendment agreed to.

Clause, as amended, ordered to stand part of the Bill.