HC Deb 17 September 1948 vol 456 cc475-84

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

4.10 p.m.

Sir David Robertson (Streatham)

Ernest Gaylon was my constituent. In November, 1942, when he was 18 years of age and a member of the Air Training Corps, he volunteered for service with the R.A.F. Six months later he was posted and served at home stations and in Burma. He was desperately anxious to fly. He volunteered for air crew duties but unhappily he was turned down for a minor defect in one of his eyes. He was released in May, 1947, in his 23rd year, and he died of cancer on 8th February of this year. During his service in Burma a wart developed on his neck. He disregarded it because it gave no pain, but in October, 1946, he was admitted to the R.A.F. hospital in Northallerton and he stated that the wart had been injured two months previously and had bled. An examination was made and a minor operation was performed and the wart was removed. The skin over an area of about an inch around the wart revealed infection, what kind of infection I am not certain. Doubtless the Under-Secretary of State for Air will be able to tell us what infection was present at that time.

In February, 1947, Gaylon was admitted to the same hospital, where a major operation was performed. Glands on one side of his neck were cut out and on examination being made they were found to be malignant, that is, he had cancer in February, 1947. When he recovered from that severe operation he was transferred in March to Westminster Hospital for deep X-ray preventive treatment to suppress malignant cells which might be present in the area adjoining that part which was operated upon. He left Westminster Hospital in April and on 16th May was examined by the medical officer at his unit, that is two days after visiting Westminster Hospital, assessed as fit for further service and released to find and earn his own living in civil life.

At that time he did not know that he had cancer. I doubt if he knew before he died that he had it. He had high hopes of getting a job with an insurance company. He applied to them, and their doctor examined him. When he found the scars on Gaylon's neck he asked about them and told Gaylon, "Go back to Westminster Hospital and bring me back a report about the scars." Gaylon went to Westminster Hospital, where he was told "We will not give you the report but we will send it by post to the insurance company's doctor." I beg leave to read a copy of that report. It is dated 25th June. Gaylon was discharged as fit for further service on 16th May, some five or six weeks previously. The report begins: Dear Dr. Price— that was Gaylon's doctor— This patient has asked me to give you a report on his condition as treated at this hospital. The history is that in October 1946 a pigmented mole on the right side of neck was removed in the R.A.F. because of its increasing size and bleeding, but the biopsy on this gave a report of 'non-malignant.' There developed a swelling of the right upper deep cervical glands which were exised again in the R.A.F. in February of this year."— February, 1947— the histological report this time being' highly probably malignant melanoma he was sent to his hospital for deep X-ray therapy to scar areas, which he received at the end of March. We have seen him on three occasions since, when there was no evidence of recurrence locally or metastasos in the rest of the body, and he is returning to us at monthly intervals for check-up. I would state that the patient does not know the possible gravity of the condition and I am writing this report only because he has specifically requested it although I have informed him that it may prejudice his chances of an appointment with you. This was five weeks after he was discharged as fit for further service. He subsequently got a job as a tram driver, a nerve-racking job of driving a tram in the London area, the driver of a London Passenger Transport tram, with irregular hours and irregular meals. The poor soul stuck it for nine weeks. He was ill all the time. At the end of that time he collapsed and was taken back again to Westminster Hospital in September where another extensive operation was performed: more glands and the tissues surrounding them were cut out and they were found to be cancerous.

By December the cancer had spread to his chest and abdomen. The surgeons at Westminster realised that they could do nothing more for him and that he was dying. They discharged him to his home where there was no income whatsoever, and told his doctor about the case. His doctor, of course, could do nothing, if the eminent surgeons at Westminster Hospital could do nothing. They told his wife he had cancer. He lay there for two months in agony, dying on 8th February, 1948.

From his deathbed he applied for a pension. That was refused. He appealed, but the appeal had not been heard when he died. I learned of the case at the end of May of this year, when the widow wrote for assistance in securing a pension. I wrote to the Under-Secretary of State for Air, and I beg leave to read part of his reply: When an airman is released from the service he is given a medical examination but he is not given a medical category. What our medical authorities are concerned with is whether or not a man is fit for further service. If he is fit he is released in the ordinary way. If he is not fit he is either invalided on medical grounds or he is kept in the service under our special long-term treatment scheme and given treatment either until he is cured or for at least 2½ years whichever is the shorter period. When the late L.A.C. Gaylon was allowed to go forward for release in May, 1947, our authorities were aware to a certain extent of his trouble but the disease was of an ambiguous kind and had not developed to a stage when it had any disabling effect on Gaylon. We therefore allowed him to be released in the ordinary way rather than to be invalided. Our medical authorities suspected he had cancer— Suspected he had cancer— and they made special arrangements for this to be treated after he left the service, but they did not wish, in the airman's own interest, to throw his whole attention on the disease which would inevitably have happened had they decided to invalid him. They preferred that he should spend his whole attention on trying to earn a living while he was dying. I was so shocked when I got that letter that I immediately went round to see the right hon. George Buchanan, who was then Minister of Pensions. He was as shocked as I was at the revelations I was able to make, and he told me that he would investigate the case at once. He left the Ministry, however, and was succeeded by another Minister, from whom I received a letter, from which I will quote one section, which again confirms that, in February, 1947, this man was suffering from cancer: In February, 1947, he complained to his medical officer of a swelling of the glands of the neck which he stated had been gradually enlarging for about two months. He was admitted to hospital and the glands were removed. On sectional examination, these proved to be of a malignant nature. That was the third indication which I received in writing stating that this man had cancer, in February, 1947, four months or thereabouts before he was released.

I put down a Question on 7th July to the Air Minister as follows: Why the late L.A.C. Gaylon was discharged from the Royal Air Force instead of being invalided or treated in the Service, when the medical authorities suspected he was suffering from cancer the disease from which he has since died. The Minister replied: I have made a careful inquiry into this case and I find that there was no evidence, at the time of his release, that this airman was in fact suffering from cancer. I regret very much that the hon. Gentleman was incorrectly informed, owing to a misunderstanding in my Department, that the Air Ministry medical authorities suspected he had cancer. I then asked a supplementary question, and the answer from the Minister was: The information that has been given to me by my medical authorities is to the effect that this airman had apparently completely recovered from his operation and was in fact fit and well when he became due for release in May of last year. I am afraid that I can only act upon the evidence that has been supplied to me."—[OFFICIAL REPORT, 7th July, 1948; Vol. 453, c. 347–8.]

Sir Patrick Hannon (Birmingham, Moseley)

Shocking!

Sir D. Robertson

I have been in this House some years, but I have never known an answer such as this. I do not think the Minister had time to investigate this case; otherwise, I should have received a very different answer, because, of course, it contradicts the statement of the Under-Secretary sent to me previously that the medical authorities suspected that this man had cancer. How could they do otherwise, when, in February, 1947, they had the clearest evidence that this man was suffering from this malignant disease? I hope I shall be able to receive answers from the Under-Secretary to these questions, which demand an answer. Before he replies, I think I ought to tell the House that I met Lord Horder yesterday. He is regarded as the greatest authority on cancer in our country, and, possibly, in Europe or the world. I showed him all the papers in the case, and he studied them, and he authorised me to say—and I noted his words—that Gaylon was suffering from cancer when released from the Royal Air Force, and that that fact was known to the medical authorities beforehand.

I also want to know why Gaylon was released in the grossly improper and hasty fashion and how it was that he was graded fit for service. Under this scheme of the Royal Air Force, they had all the means at hand for treating this man; alternatively, they could have invalided him, but they turned him out on the streets. Gaylon served our country for five years of his young life, and he was not 23 when he died. He served overseas and he tried to serve in the highest capacity of all, in the air, and it was not his fault that he failed to do so. If an employer treated an ordinary civilian employee as this soldier was treated, such an employer would be condemned by all decent people, and by none more readily than hon. Gentlemen opposite.

I wonder what right hon. and hon. Members opposite feel about the treatment that Ernest Gaylon received. They always claim very loudly that they have done more for Service men than any other Government. Is this how they do it? Perhaps they feel satisfied by the showmanship indulged in a few days ago by the Secretary of State for War when he put his P.R.O.s to work and went down to Southampton to inspect the welfare conditions of some troops going to Malaya. That was good political propaganda for the gullible, but I am wondering whether hon. Members opposite, and particularly right hon. Members, are satisfied with that kind of showmanship. It never was the duty of a Secretary of State for War at a critical time like this to leave his desk and wander to Southampton to inspect the welfare conditions of troops aboard ship. There are highly paid competent officers in the Service to do that, both in the Admiralty, which is responble for the chartering of troopships, and in the Army. After all, the first duty of regimental officers is to look after the welfare of the men. But what a different situation in the Gaylon case compared with that type of showmanship.

I invite the Under-Secretary, his chief, and the Government to give the same kind of publicity to the Ernest Gaylon case. Let them tell the people of this country how they treated this man and his pensionless wife who is working 10 hours a day in a London factory to earn a livelihood. Let them tell how he lay for two months in agony without a penny coming in from the State. I can imagine the feeling of an outraged public and the kind of postbags hon. Members of this House would receive. I hope the Government will not require that kind of stimulus to ensure that similar treatment can never happen again to any man in the Air Force, the Navy or the Army. I hope they will take steps to see that this young widow is given a pension. The Government can do nothing for Gaylon, but they can and must do that for her. I hope they will hold a court of inquiry, or a court martial, on the medical men at this man's unit who turned him out fit for service when he was actually dying of cancer. If the facts as I have revealed them today are true—and I have every reason to believe they are; I have checked them very carefully—then those medical men should be dismissed with ignominy from the Service.

4.29 p.m.

Dr. Stephen Taylor (Barnet)

I wish to make one observation and to ask the Under-Secretary one question about this tragic case before he replies. These cases are, I am afraid, occasionally met with in civil life as well as in military life, and they are almost all, without exception, fatal. They are terrible tragedies for the individuals who suffer from them. The observation I wish to make is that in these cases there is always a very difficult medical decision to make. In the first place, this condition may simulate exactly an ordinary brown wart. There is no external difference, and, indeed, when the growth is removed there may be no microscopic difference between an ordinary brown wart and these invariably fatal and terrible growths.

The second point I wish to make is that if such a wart turns out to be malignant, it is very questionable whether one should inform the individual concerned that he or she is about to die in a very short time unless there is some overriding reason for doing so. It is a very difficult and terrible situation that these persons have to face, and it is by no means always the right thing to let them know that they are about to. face death in a short time. I myself do not always know what is the right answer to give to the patient in that kind of case. The question which I would like to ask the Under-Secretary is: What provision is made for liaison with the civil medical authorities in cases of this kind? What guarantee is there that a patient who leaves the Air Force, with a possible malignant growth removed, but with no guarantee of recovery, unfortunately, will continue to be observed by the civil medical authority and that such treatment as is possible will be applied?

4.31 p.m.

The Under-Secretary of State for Air (Mr. Geoffrey de Freitas)

We have heard the sad story of Mr. Gaylon, and it is clear that the hon. Member for Streatham (Sir D. Robertson) feels deeply for Mr. Gaylon and his widow. The death of this young man has been a great tragedy. I ask the House not to fall into the easy human error of confusing a real expression of sympathy for the Gaylons with the apportionment of blame on the R.A.F. medical service. I fear that that is exactly what the hon. Member who raised this matter has done.

It is right that I should outline—and here I will, in part, answer the last question put to me by the hon. Member for Barnet (Dr. Taylor)—the care that we take in cases in which a man leaves the Service when there is even a suspicion that he is in need or has in fact been found to be in need of medical treatment. When a man is due for release he is medically examined. First, he may be found completely unfit for service but not in need of further treatment. He may, for instance, have a strained heart. He is then released, and the question of pension is decided by the Ministry of Pensions. Secondly, he may, on the other hand, be found to be suffering from sickness which can be treated while he is at work—for instance, venereal disease. He is released, and the treatment is continued by the local medical officer of health or the appropriate hospital. The liaison is very close between the Service and these local authorities. They have his medical record passed to them. Thirdly, a man due for release may be sick with influenza or something like that. He is kept in until he is better and then re- leased. Now, fourthly—and this is a more difficult and important point—he may be found to be in need of prolonged in-patient treatment. If so, he gets it. If the illness is not attributable to service, such as some cases of rheumatism, he is kept for 12 months in an R.A.F. hospital, then invalided out and placed under the care of his local hospital. If it is attributable or has been aggravated by service he is kept in an R.A.F. hospital for it may be as long as two years and is then invalided out and placed in a Ministry of Pensions hospital. At every stage—and we should recognise it in this House —the greatest possible care is taken of these men.

What were the facts about L.A.C. Gaylon when he came to be medically examined for release? When he was examined on 16th May he was found to be fit for service and therefore for release. He had apparently completely recovered. Two days before he had been seen at the Westminster Hospital by the people who had treated him throughout. On 14th May, they sent this letter to the senior medical officer—

Sir D. Robertson

Not the people who had treated him throughout.

Mr. de Freitas

These are the people who treated him all the time at Westminster—the specialists in this awful disease. This is what the letter says: There is no evidence of recurrence of the disease. Dr. Allchin would like to see him again in two months' time, whether he is still in the Service or has by that time returned to civilian life. That was the specialist at Westminster. On that and on their examination our medical authorities came to the conclusion that Gaylon had recovered. He was fit for service and if he had not been due for release he would have been put into the ordinary pool for posting, and the Record Office would have sent him to a station for service where a vacancy had occurred for a man of his trade and rank.

The Royal Air Force has always taken a pride in its medical service and that medical service has never been too proud to turn to leading civilian specialists and ask their help. The great work done for the R.A.F. by certain civilian specialists—work such as plastic surgery—is well known. but I am satisfied that in this difficult field of cancer and its allied diseases we are as well qualified to deal with it as anybody, because in this field we have the assistance of Sir Stanford Cade and his team at the Westminster Hospital.

As soon as possible L.A.C. Gaylon was sent there and the treatment which he received has been described by the hon. Member for Streatham. I have read from a letter which was written after his examination on 14th May. I have said that on 16th May the R.A.F. medical officer examined him and found him fit for service and, therefore, fit for release. He did not fall into any of the categories of men who should have treatment until fit for release. The Westminster Hospital were so anxious to be certain that there would be no chance of overlooking anything that could develop that they arranged for Gaylon to return there regularly from time to time.

On 11th and 24th June he was examined and again no recurrence of the disease was found. How careful they were is shown from a letter I have here which they wrote to Mr. Gaylon in September. Mr. Gaylon had written asking to be excused from going to the Westminster Hospital for examination from time to time because it was very inconvenient owing to the fact that the hospital was some distance from where he lived.

Sir D. Robertson

He was a tram driver and could not go.

Mr. de Freitas

The point is he asked to be excused from going there. This is the letter and I should like to read it: Thank you for your letter of the 30th August. I quite appreciate that it is difficult for you to report each month at the hospital, but I do feel that it is important that you are seen here from time to time so that if there is the slightest suspicion of anything wrong it can be seen to at once. Our clinics are also held on Monday and Friday mornings, so perhaps you could attend on either of those days, if Wednesday is not suitable. If you find you are quite unable to come, please let us have the name and address of your panel doctor so that we can get in touch with him but it would be better if you can come here. I cannot imagine a more sympathetic letter nor one written in a more helpful spirit on behalf of the hospital.

To sum up: This is a sad case and my right hon. Friend and I have nothing but the deepest sympathy for Mrs. Gaylon. However, I am at this Box to answer the charge that our Department is to blame. It is not. I most decidedly deny that it is in any way to blame and I see no fault whatsoever in the conduct of our medical advisers.

On the last point—about a pension. That is a matter for my right hon. Friend the Minister of Pensions. However, I have made inquiries and I can say this—

The Question having been proposed after Four o'Clock, and the Debate having continued for half an hour, Mr. DEPUTY-SPEAKER adjourned the House, without Question put, pursuant to the Standing Order.

Adjourned at Twenty Minutes to Five o'Clock.