HC Deb 07 April 1948 vol 449 cc315-24

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

11.28 p.m.

Mr. Granville Sharp (Spen Valley)

I wish to raise the question of the award of disability pensions to men who, after having served in the various Forces throughout the last war, have been discharged on medical ground with diabetes melitus. It is somewhat difficult for a layman to go into the details of this disease but there is no doubt it has caused considerable trouble to many men who have been discharged from the Forces. It would probably be best for me to give an example. On 6th March, in answer to a Question from me, my right hon. Friend the Minister of Pensions stated that whereas 3,600 men had been discharged from the Forces suffering from this disease, of the number who applied for a pension only 600 had been successful in their claim. It is really on behalf of the other three thousand that I am putting forward an appeal tonight.

May I give an example? It is of a man whom I will call Corporal X. He served throughout the Italian campaign. He was a corporal in the 1st Battalion of a famous Scottish regiment—the Scots Guards. He served on the West coast of Italy in a very arduous campaign. Prior to his enlistment he was a very fit man. There was no trace of diabetes in his family; heredity is one of the reasons sometimes given for diabetes. He went through the normal medical examination when he enlisted, and it included the usual tests to discover whether a man has diabetes. No trace of any such disease was found. He could do his 40 miles in full kit, and prior to his enlistment he was a first-class football player. Then suddenly, at the beginning of 1946 he got a feeling of lassitude. He was not the type of man who goes to the doctor and says, "I had better go to hospital." He thought there was something wrong with him, but he carried on for some time. Finally, he was taken to hospital in the North of Italy, and his case was diagnosed as diabetes. He was sent back to this country and discharged.

Here was a man fit for very active service. He went through a very arduous campaign, and was discharged on account of diabetes melitus. Was this disease due to his military service or not? My right hon. Friend and his Department say that it was not. Why not? They admit that the onus of proof that it was not due to military service, that the disease was not aggravated by military service, rests upon them; but, when a close examination is made of the type of argument which they put up, it is obvious that they are not recognising that the onus of proof is upon them. What they say is really this: no evidence has been put up to them of why military service could have caused, or aggravated, the disease. Therefore, they say that a pension cannot be awarded. I believe that if my right hon. Friend had his way, he would recognise that there is justice on the side of these men, and would say, "These men were fit for service; let us give them a pension." But unfortunately the Minister is not master in his own Department in that respect. He is compelled to listen to his medical advisers.

I suggest that these medical advisers, not merely at the Ministry of Pensions but throughout this country and the world, do not understand diabetes melitus. I have read extracts from a few works on this subject and I have come to the conclusion that there is a variety of opinion on it. I want to give a quotation which I am sure will appeal to some hon. Members. It is from the Regius Professor of Medicine at Glasgow University—Dr. McNeil. Writing in the British Encyclopaedia of Medical Practice, he said that it was far from the truth that the mechanism of diabetes melitus had been solved, and he went on to say: He would be bold indeed who could venture to affirm that he understood all the secrets of diabetes melitus.

Sir William Darling (Edinburgh, South)

What is the date of that?

Mr. Sharp

1940. I have read a further work since that time, the biography of Dr. Banting, that even in those days it was fully recognised that this disease was not thoroughly understood. That being so, I suggest that the medical advisers in my right hon. Friend's Department are no better able to say whether the disease which has been contracted by this soldier and three thousand others was, or was not, contracted during their service in the Forces, or whether the disease, which might have existed prior to their enlistment but was not detected, had been aggravated by military service. That being so, I suggest that they have not been able to—and cannot—prove conclusively that military service did not contribute to or aggravate the disease.

I would ask my right hon. Friend to say to his fellow Members in the Govern- ment that it is about time that the Royal Warrant, which guides his conduct to a certain extent, was altered. I cannot go into that on an Adjournment Debate, but it is necessary that he should have powers to provide that a man who has served his country well should not be denied the right to proper maintenance in civil life. There are some very serious cases which my hon. Friends behind can raise. I will only mention one man in my constituency who, at the age of 22, has to inoculate himself daily with insulin. He has to earn his own living, and when it comes to overtime or anything like that, he just cannot do it. He is tired out. He goes home dreadfully tired and probably has to take a day or two off work.

I suggest that men who are suffering in this way should have at least a 5o per cent. disability pension. They are certainly worse off, from the point of view of earning ability, than many of the men who are receiving such a pension. I ask my right hon. Friend to give further consideration to this matter and to tell us tonight that he is going to do something about it and that he is not going to accept the medical views of his own advisers as conclusive. They cannot be conclusive because there is no full knowledge at the present time of the causes of this disease.

11.38 p.m.

Mr. E. P. Smith (Ashford)

I have no wish to stand between the House and the array of medical talent, which, I am quite sure, will help to inform us in this matter, bat I do feel, and have always felt, very strongly indeed that any disease which affects a man on war service ought to be regarded as due to war service. In my own constituency I have had numberless cases of cancer which is a particularly difficult disease in regard to war pensions. I have encountered some of the most tragic cases in my whole career of that terrible disease. I would like to support what the hon. Member for Spen Valley (Mr. Sharp) has said about diabetes melitus. I do hope that the right hon. Gentleman will take whatever opportunity is available to him of trying to get the whole basis of pensions for illness contracted during war service widened and broadened.

11.40 p.m.

Mr. Chetwynd (Stockton-on-Tees)

I want to emphasise as much as I can the strong plea of my hon. Friend on behalf of the sufferers from this very dreadful disease. I speak particularly of one case brought to my notice and now under consideration by my right hon. Friend, of an Air Force man who was admitted in 1939 as Ai, who went through Italy, and was discharged in 1944 with this disease. Tragically enough, later on, the disease developed into tuberculosis. This poor fellow is now in a sanatorium with very little hope of permanent cure, and because this disease, over which there is so much doubt, cannot be proved to have arisen out of war service, he is without future or financial security. Medical evidence in this man's case is such that the benefit of the doubt must be given to him. He has his own doctor's support and that of the head of the sanatorium.

It is clearly proved that a nervous upset brought on this complaint. I defy the medical officers of the Ministry to say otherwise. Where they cannot prove quite clearly that disease was not attributable to war service, then obviously the benefit of the doubt must be given. I ask the Minister to get away from this niggardly attitude of his officers and do what his heart tells him to do—to behave as he has done in all other cases brought to him and to give way on this matter. It would bring great joy and comfort to many people.

11.42 p.m.

Dr. Morgan (Rochdale)

I must be brief, although this is a subject which really takes some time to discuss. I congratulate the Minister so far on his very humane administration of the Pensions Ministry since he took office, but he himself is under great difficulty, for like other Ministers, he has to take the advice of his experts. Unfortunately, the bulk of medical men who get into Government Departments seem to lose a great deal of that human feeling which they should always have towards applicants.

Mr. Thornton-Kemsley (Aberdeen and Kincardine, Western)

That is why doctors do not want to be State servants.

Dr. Morgan

There has never yet been produced in the last 3o years an international authority on this matter. I could go on talking about the Colonial Service and the Post Office, of which I have experience, but we have not time to discuss that. I ask the Minister to use his powers as a humane administrator and, after listening to advice, to say "No" in spite of medical advice, and then say "I have still a reasonable doubt about this disease, that it was not caused or aggravated by service." How can they say that this disease was not caused by service? How can they say that, except from their own prejudice? It is well known in psychotherapy that many people have diabetes after shock—and shock there is in these cases.

The opinions of one of my contemporaries at Glasgow University, a very brilliant man, have been challenged, even in these days. When a man gets into the Ministry of Pensions he knows very little of what he is talking about. That type of person expresses opinions as if they were laid down in the Bible and for reasons which really cannot stand up to cross-examination in any court of law. On that account alone, I ask the Minister to be quite frank with his medical advisers in cases like this, though I know it is difficult, as I have had experience of it myself. In spite of that, I do ask the Minister to act in a humane manner—as he has been doing in many cases—and to say "No, I am prepared to take responsibility for saying in certain cases that this is due to, or aggravated by certain circumstances." I ask the Minister to stand by his guns in this matter, and in spite of any professional advice he gets, to continue on the lines along which he has so far proceeded.

11.46 p.m.

The Minister of Pensions (Mr. Buchanan)

No one could complain of the form or manner in which this Debate has been raised and no one can deny its importance. The hon. Member who raised the question proceeded quite properly by talking about the things he was interested in and built up a case from what he knew. That is good politics and good business, and I certainly welcome the Debate. Only one thing really sticks in the speech of the hon. Member for Stockton-on-Tees (Mr. Chetwynd). I take exception to his remark about my being "niggardly." This Ministry and myself are not niggardly, and nothing I have done there could induce anyone to say that I was niggardly. I take some objection to the phrase and I only hope that if and when the time comes for the hon. Member to assume my mantle, he will be as generous to the people as I have been.

I only want to say this about this question, that I am not a decider. The hon. Member for Ashford (Mr. E. P. Smith) raised the question of cancer. The cancer cases are much the strongest, even stronger than diabetes and much more tragic. They are much the strongest individual cases. If I wished, I could make hon. Members shudder by telling them about the case of a man with 20 years' service, including six and a half years in the Army and two years as a prisoner of war. Other cases pale in comparison.

Let us stop this nonsense about the "niggardly Minister." Let us face the facts. The facts are that to justify a pension we have to prove our case, and we do it in accordance with the rulings given in the High Court. That applies also to the Court of Session in Scotland. Mr. justice Denning has laid it down firmly and strongly that the onus of proof is on us and we are required to satisfy the courts about that. Under the Royal Warrant I must for every person who is to secure a pension, whether for this disease or another, secure a medical certificate and if there is a doubt, the doctors must give it to the applicant. In these cases our medical opinion says there is no reasonable doubt that this disease did not arise out of war service. Those are the facts. Let us face them. I would ask hon. Members not to use general phrases, but to try to assist me in my work. In regard to the remarks of my hon. Friend the Member for Stockton-on-Tees, the first I knew about his case was tonight.

Mr. Chetwynd

I have here a letter from my right hon. Friend's Department stating that the case is still under consideration.

Mr. Buchanan

I was never told that the matter was going to be raised tonight. I get letters running in number into about a thousand, and it cannot be expected that I should be able to answer off hand one which the hon. Member for Stockton-on-Tees picks out.

Mr. Chetwynd

I rang up my right hon. Friend's private secretary and asked for these papers because I intended to raise this matter tonight. That was before the Easter Recess.

Mr. Buchanan

This is the first I have heard about it, but had I known about it I could have replied to it. The hon. Member for Spen Valley has told us about diabetes melitus, but he is not sure. If my hon. Friend can bring to me a real responsible medical opinion to say that we are wrong—and I want more than a general phrase—I will once again have the whole thing gone into thoroughly.

Mr. Sharp

Will my right hon. Friend agree that if the doctors themselves admit that they do not know what are the possible causes of diabetes melitus, in many cases the benefit of the doubt should be given to the ex-Service man?

Mr. Buchanan

In many cases it is. I was coming to that. In this war we have allowed 600 cases because we exercised the benefit of the doubt in their favour. In the previous war none of those applicants would have got in. Where there has been a doubt we have allowed it. It is because my medical advisers say that in 3,000 cases there can be no doubt thatI have had to refuse them. If there was a doubt about it, I would have given it to them, but my medical advisers Will not give me a certificate because they say there is no doubt.

Mr. Willis (Edinburgh, North)

Is net that because the onus is on the medical officers to prove that the disease was not contracted in war service, and supposing the onus was on them to prove that disease was due to the war could they produce opposite arguments?

Mr. Buchanan

On the shoulders of the Minister rests the responsibility for exercising the benefit of the doubt. There are other diseases worse than diabetes melitus. There is cancer, which is by far the biggest and by far the most tragic. There are other diseases like leukaemia, and in these groups medical opinion is behind me in the steps I have taken.

Dr. Segal (Preston) rose

Mr. Buchanan

I have given way about To times in 10 minutes, and I hope hon. Members are not trying to take advantage of my softness. This matter has been decided in law. Mr. justice Denning, who it must be admitted has been a great friend to the ex-Servicemen, has decided in every case that has come before him that our doctors are right. In the Court of Session in Scotland, where three judges are required, only one case has gone against us. In all other cases the judges have taken the same view on diabetes as Mr. Justice Denning. In Northern Ireland one case has been heard, and the court there also agreed with Mr. Justice Denning. So we have the courts in England, Scotland and Northern Ireland agreeing with the independent tribunals in each case. It may be that the medical opinion can be upset; I am not sure; but if hon. Members can give me the slightest reason, apart from vague phrases like, for example, "He was Ai when he went in, and was not A1 when he came out," I will consider it.

I have all the sympathy in the world with these cases. My problem is how to overcome the difficulties. If the hon. Member for Stockton-on-Tees and his generous treatment were to be substituted for myself and my treatment, he too would have to decide this. He ought to apply his mind to this question: can he get any sort of evidence at all to get me to look at this case again? If he can, I will look at it. I will say this to the hon. Member for Rochdale (Dr. Morgan), who is a distinguished ornament of the medical profession: would he not apply his mind to helping me, rather than to a lot of abuse? Let him apply his distinguished medical brain to bringing me some evidence to counteract the doctors. If he can bring me decent medical evidence to show that diabetes is a thing that can be caused by war, I promise generous and fair treatment.

Adjourned accordingly at Two Minutes to Twelve o'Clock.