HC Deb 25 July 1944 vol 402 cc730-8

Motion made, and Question proposed, "That this House do now adjourn."—[Mr. Pym.]

Mr. Lipson (Cheltenham)

The House, for the greater part of the day, has been considering what it should do with its surplus war material—that material for which it no longer has any use. I want the House, for the short time available, to consider what is happening at the moment to certain human material—exService men—for whom the Services have no longer any use, and, particularly, I want to draw attention to the refusal by the Minister of Pensions to grant pensions to men who have been discharged from the Services suffering from cancer.

I think I can best illustrate the hardship caused by this decision if I give two instances, with both of which, I think, my right hon. Friend is familiar. They are constituents of mine. One is a man of 36 who is still alive, and the other, a man in the 30s, died early this year, so that in the latter case I am pleading for a pension for his widow. The first man, Mr. Green, joined the Army at the outbreak of war. He was called up because he was a Territorial and had been in the Territorial Forces before war broke out for 12 years, and I think the House will realise from that fact that he was not the kind of man to wait for the outbreak of war before preparing himself for the defence of his country. He was graded A.1, was sent abroad, was at Dunkirk and served for four and three-quarter years. In May of this year he was discharged from the Army on medical grounds. The disease was then described as inflammation of the bronchus, but I was told by the Minister that means cancer. The man had been married eight years before he was called to the Forces, and his wife assured me that, during the whole of that time, he had never had a day's illness. In May, he was discharged and was sent to an emergency hospital, and, after he had been there a few days, he was discharged from the hospital, not cured or in any way better, but because the beds were required for war casualties.

During the time he was in hospital, his wife was given an allowance of 30s. a week to maintain herself and a small child. When the man came out of hospital, the allowance was stopped. Apparently, the Minister has power to grant 30s. a week to a man receiving medical treatment after discharge by the Army on medical grounds up to a period of six months. In this case the 30s. ceased when the man came out. I cannot see either logic or humanity in an action of this kind, in that when the man was in hospital, and there were only the wife and child to maintain, he was allowed 30s., and that when he came out, and the wife had to maintain the husband as well, and he was put on a special diet, which was more expensive than a normal diet, the 30s. was stopped. My attention was drawn to this and I raised the matter with my right hon. Friend, and I acknowledge that in view of the fact that the man was discharged not cured, but because his bed was required, the 30s. was restored. But I would point out that unless action had been taken by somebody in authority the 30s. would have been stopped, because the wife had received the official notice from the Ministry of Pensions to say that that was the case.

I want to show what further difficulties the wife has which illustrate what many other people experience. When I went to the house I said, "I assume you are getting national health benefit, as your husband is sick." She said, "No, when the agent came from the company he said that I was not entitled to health benefit because of this 30s." I took that up with the Minister of Health and found that that was again wrong, but here was this poor woman driven from pillar to post and not given anything extra; and it was only because action was taken that the matter was put right. When the man was in the Army, the wife was working at a munition factory and earning between £3 and £4 a week. I visited their home, and it was a very good home. When he was discharged she had to give up her work because her husband is a hopeless invalid and cannot walk and has to be taken out in a bath-chair, and cannot do anything for himself. He has been refused a pension. That is very hard for a man who has gone through so much, and given so much for his country.

When I raised the matter with my right hon. Friend he said that the consensus of opinion is that cancer is in no way caused or aggravated by military service, I find that in conflict with the concession made to this House, that the onus of proof should be with the Ministry when they refuse a pension. If the doctors say they do not know the cause of cancer, how can they say that cancer is in no way responsible? I would also draw the attention of the House to a question asked by a Member of this House—a distinguished member of the medical profession—the hon. Member for London University (Sir E. Graham-Little). He asked the Prime Minister if he would have an inquiry held into the number of cases of young men in the Services who were discharged, suffering from cancer, the number being much larger than in civil life. My medical friends tell me that it is very unusual for a man of 36 to suffer from cancer. I, therefore, say there is sufficient reason for assuming that in some way the man's military service had aggravated the cancer. I would like here to read an extract from a letter which I received from the Secretary of the British Legion of Scotland, whose attention had been drawn to a question which I asked my right hon. Friend and the answer which the Minister gave me. He said: I note the Minister gave his usual answer, that it is the laid-down medical opinion that cancer is not due to service. I also notice that he added that this case in question has been taken to a tribunal and the same decision has been arrived at there. This particular case has not yet gone to the tribunal, I may say, The British Legion of Scotland has been representing a great majority of the cases which have been before the Scottish pensions appeal tribunals, and in view of the attitude of the Minister in regard to diseases, in which it is quoted that the consensus of medical opinion was against a decision favourable to the claimant, we consulted four or five leading medical specialists, in Edinburgh, on certain of these diseases, including cancer. The opinion that we obtained was that, in spite of the fact that the consensus of medical opinion would in general be against an ad- mission that these diseases were likely to be attributable to war service, that there would always be exceptions, where the medical opinion in a particular case would be in opposition to this opinion on generalities, and it may interest you to know that among the cases of cancer which we have represented at the tribunals, we have been successful in getting the tribunal's decision in favour of entitlement in three instances. I submit, therefore, that the Minister should exercise in a case such as I have quoted his discretionary power. May I refer to the second case, of a Mr. Stanley? This man, also A.1, joined in November, 1940, the Royal Tank Regiment, which I think indicates that he was of good physique.

Mr. Bartle Bull (Enfield)

How old was he?

Mr. Lipson

In the early thirties. His health deteriorated in the Army and he was then transferred to the Royal Army Pay Corps. He was treated originally for nervous heart. He complained to the medical officer that he was feeling ill and the medical officer—a woman, I regret to say—accused him of malingering. The men in his unit were so incensed at this that they persuaded the sergeant-major to get the medical officer to reverse her decision. Then she agreed to let him go to Birmingham to see a specialist. The day after he came back, he collapsed; he was sent to hospital, and, some time after that, he died. According to the medical certificate, his death was due to tuberculosis. His wife questioned this, and insisted on a post mortem, and it was found that he was suffering from cancer. The wife definitely says that this man's health deteriorated, so far as cancer was concerned, in view of the fact that he never received proper treatment in the Army. I would point out, too, that if a man in the Army complains of not feeling well and he cannot satisfy the medical officer of health that he is right, he is compelled to obey orders and, therefore, his deterioration may be worse than it would be in civil life when, in similar circumstances, a man would naturally rest and recover. In this instance, too, the wife is left without any pension at all because pension has been refused.

I want to say in conclusion that I am quite ashamed when I go to homes of this kind. I have been to both these houses; I know the circumstances and I have seen the treatment which these men and their dependants have received from the Government after such service. I feel that this House, as well as the Minister, has a very great responsibility. The country does not want instances of that kind, it does not want men and their dependants to have to resort to public assistance. Whatever may be said, the poor—and I respect them for it—in very large numbers hate public assistance, and these people deserve better treatment. They have to be maintained somehow. I submit that the least we can do is to give them a pension for such of their life as remains, and for their dependants after them. My last word is this, that this causes a great deal of bitterness amongst women-folk. They say, "The country has had my man, they have had all they want, and then they throw him aside as of no further use." Do let us remove that reproach. If the Minister says he has not the powers, I say "Come and ask for the powers. The House will give them and the country will give them."

The Minister of Pensions (Sir Walter Womersley)

I am glad to have the opportunity of giving a real reply to my hon. Friend the Member for Cheltenham (Mr. Lipson), because he has raised a serious matter. The question is whether a pension should be granted because of a disability or a disease, attributable to, or aggravated by, war service, or whether I should grant a pension irrespective of those two tests. That is the point at issue.

Mr. Silverman (Nelson and Colne)

Not at all.

Sir W. Womersley

Perhaps the hon. Member will allow me to make my case. He can make his case afterwards, if there is time. A demand was made by this House some time ago, on behalf of those who had been disabled, that they should have a privilege. That was agreed to, and we cannot have it both ways. It is laid down definitely in the Royal Warrant which, of course, can be altered, that the disease must be due to, or aggravated by, service. We took away the words, "directly attributable," or, "materially aggravated," and made it as reasonable as possible to get dawn to practically almost every case except a few, and the few include these cases of cancer. I must take the consensus of medical opinion in arriving at a decision as to whether a certain disease is due to, or has been aggravated by, service. Consensus of medical opinion means the views of medical men recognised as speaking with authority on the disability in question with regard to the effect of war service on its development. Immediately after the last war the then Minister obtained the views of such authorities through the Disabilities Committee, comprising experts nominated by the Royal Colleges of Physicians and Surgeons and the Medical Research Council, and the entitlement practice of the Department was based on their advice. A similar practice was maintained throughout the years between the wars, and in particular by reference of questions of difficulty to the Medical Research Council and to independent medical experts appointed by the Presidents of the Royal Colleges. This procedure has been used to the fullest extent since the war, and extended by the holding of special conferences with eminent specialists on new problems as they arise. As an example of the obtaining of a consensus of medical opinion, I may refer to the question of the possible relationship of cancer to war service. Cancer is one of the commonest fatal diseases of man and occurs in all races. I am told its apparent increase in recent years is, probably, largely due to the improvement in methods of diagnosis. Its inci[...]ence in the Army, so far as it is possible to estimate it, is no more than that amongst a similar population of the same age in civilian life.

Although most forms of cancer are more common in the old, some forms are more common in the young. It is, therefore, inevitable that, from time to time, cancer may show itself during service, and my Department has to consider whether or not service has played any part in its onset or development. Although the actual cause of cancer is not known, there has for a long time been a general medical agreement as to certain conditions which may possibly be casually related to its onset, and as to other conditions which are certainly not so related. The Medical Research Council, at the request of my Department, convened a conference of experts which gave comprehensive advice on the conditions affecting different forms of cancer, and the sites in which they occur, and this advice can be taken as constituting a consensus of medical opinion. It is, in general, to the effect that it is only in exceptional cases that the development of cancer may possibly be attributed to, or influenced by, a previous injury or disease arising out of war service, and certain criteria are laid down as affording a basis for decision. Each case of cancer is considered by my Department in the light of this advice, and, although it has not been possible to accept the vast majority of cases, yet in an appreciable number, where a reasonable doubt could be said to exist, entitlement has been conceded. So it is not true to say we have not granted pensions even for cancer if circumstances warrant it.

The point at issue is whether the case of my hon. Friend's constituent comes under the conditions that I have stated or not, and I had to give it very serious consideration on that account. As regards the allowance where we cannot accepted the suggestion that the disability was due to war service, that was a concession made by the Government on ray recommendation, to do the very thing that my hon. Friend suggests, so that a man should be able to live for a time until other arrangements could be made. The position of a man discharged from the Forces for a disability, not attributable to or aggravated by service, therefore, has to come under the same social service conditions as the civilian population; those conditions are there and he can avail himself of them. If the amount received under those social services is not sufficient it is for the House to see that they are improved, and not to say that, because a man has actually served, whatever is the matter with him, when he comes out I should take the responsibility. This man received this weekly allowance which has been granted for six months after discharge to men suffering from some disability, not due to or aggravated by service, to help them along the way but, in addition to that, he should have been receiving National Health Insurance, which brought the family income up to 51s. a week. [An HON. MEMBER: "He was not."] That is not my fault. He should have made application for it. If the representative of the approved society said they were not entitled to it, he was not acting in accordance with instructions from his society, because that is the definite understanding.

This is a matter which has not been in vogue for a very long time We brought it into operation because we foresaw this difficulty and wanted to meet it if we could. This 25s. was allowed to Green and his wife and 5s. to the child. In addition there was 21s. which he should have received from National Health Insurance, and is now receiving, and he is getting an income of 51s. a week. I hope it will not go out that we were expecting him to live on 30s. That was the supplementation of his National Health Insurance. I gave the case the greatest consideration. On the Regulations as laid down, and taking into account all the points I have mentioned, on the concensus of medical opinion I had to refuse the case. I was sorry to do so but I must carry out the Regulations, because it has to be either one thing or the other. The only thing I can suggest is that, if hon. Members cared to take it to the appeal tribunal, they would have to deal with the matter in the same way as I have, and if they gave a different decision it would be final and binding on both parties. I have already explained to my hon. Friend that as soon as I knew this man had been discharged from hospital, and as soon as he informed me that that was not because he was cured but because they wanted the room for wounded men coming from Normandy, I said at once that it would not mean the stopping of his allowance. It was immediately resumed and the arrears were paid. That shows what a useful function a Member of Parliament can perform. When he brings a case like this to my notice, I immediately take action, and I will do so in other cases as far as I can under the Regulations. When it comes to a question of altering the Regulations, I want the House to consider both sides of the question.

As regards Mr. Stanley, my information is that he was not informed that he was a malingerer. I should be very dissatisfied with any medical officer who told a man he was a malingerer unless he had clear evidence to that effect. I have a full statement of the case, and it seems to me that there has been some misunderstanding. The statement shows clearly that Mr. Stanley received the medical attention that was necessary and that he had X-rays taken. In my view, he got far better attention from the medical authorities in the Army that he could have got in any hospital. They paid special attention to him. I would like my hon. Friend to see the record, and I think that he will withdraw his charge that the man was neglected. Mrs. Stanley should apply for the contributory widow's pension. She is entitled to it, and if she has children she can get supplementation. She will not be much worse off than if she had a pension from my Department. It is not true to say that a woman is deprived of any pension, because we ourselves urge people, when we cannot grant a pension, to make application for a contributory pension; and if they cannot get it, I may then get a pension from the Royal Patriotic Fund. I am glad that this matter has been raised because the question of those diseases—there is only a short list of them—that cannot be attributed to service is one that exercises the attention of many hon. Members. I thought that this was a good opportunity for them to understand how we handle the matter so that they can advise their constituents accordingly.

Colonel Clarke (East Grinstead)

Is not failure on the part of a medical officer to diagnose cancer, with the result that the man is treated wrongly and loses his life, considered an aggravating cause? I have heard of cases where men have been wrongly diagnosed, have been treated for something else, and have died.

Sir W. Womersley

If it were a case of wrong diagnosis, and that was shown to me clearly as the reason for a man's life being shortened, it would be a case for a pension.

Mr. Silverman

I am afraid that there is very little time left, and I wish only to say that nobody doubts the Minister's good intentions in this matter. It all turns on our old friend the onus of proof. The position is that the medical profession is unable to say what is the cause of cancer, and therefore, it becomes impossible to ask the claimant to satisfy the Minister that his cancer was due to war service. Nobody can satisfy the Minister on that point.

Sir W. Womersley

We do not ask him to do that.

It being half an hour after the conclusion of Business exempted from the provisions of the Standing Order (Sittings of the House), Mr. DEPUTY., SPEAKER adjourned the House, without Question put, pursuant to the Standing Order, as modified for this Session by the Order of the House of 25th November.