HC Deb 07 May 1951 vol 487 cc1716-26

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

10.2 p.m.

Mr. Leather (Somerset, North)

I am extremely pleased to have the opportunity of raising the subject tonight, because it is one which has not received recognition in the House for a very long time. My principal ally on this subject—I have always been glad to acknowledge it—was the Parliamentary Secretary's predecessor, the present right hon. Gentleman the Minister of Labour. I should like to begin by saying that if I can work and co-operate on this subject with the hon. Gentleman as happily as I did with his predecessor, I shall be pleased, and I hope very much that he will be too.

The matter of the annual X-ray examination for coalminers has been raised very periodically in the House. I raised it first in a speech in March, 1950, and again three weeks ago in a Question to the hon. Gentleman's right hon. Friend when I was pleased to have the assurance that the Minister would give this matter top priority in his Ministry. The background of the problem is something which has cursed the mining industry probably more than anything. Above all the vicissitudes and tribulations of that industry is the curse of dust.

Dust disease with miners everywhere, especially in the soft coalfields and particularly in South Wales and my own constituency, is one of the biggest problems, psychological fears and curses which the miner has to face. It is responsible for not only a colossal and frightful wastage in the finest manpower we have in the pits but also for a dreadful psychological fear, a curse which causes great moral harm to many of our miners. Being a disease which is cumulative, it gets worse year after year and takes its heaviest toll of the oldest and most experienced and skilled craftsmen.

Five days ago I had down a Question on the subject of compensation in connection with this matter, and the Minister of National Insurance said that the problem had been well known to medical science for many years. That came as a complete surprise to my humble self, as it did to the hon. Member for Luton (Dr. Hill) who is reputed to have certain knowledge of these matters. If the right hon. Lady the Minister of National Insurance meant that for many years the doctors have known about such dust diseases as pneumoconiosis and all their causes she is right. If the right hon. Lady can be taken to mean that the doctors knew how to control and cure this disease, she is dangerously wrong and very misleading.

The tragedy is that to this day, despite all the progress made in the last five years, the doctors have no cure or treatment for this disease, which causes distress, agony, incapacity and fatality among miners. In the last four or five years Dr. Fletcher of the Pneumoconiosis Board and his colleagues have made great strides. This report of the Medical Research Council in Memorandum 25 to Which I referred in my question to the right hon. Lady, puts forward clearly, decisively and definitely statements of fact which, so far as I know, have never appeared in any Government publication until that date.

The point of this annual X-ray scheme is that we must find some way of capitalising on the work of Dr. Fletcher and his colleagues. They have gone much farther in the last five years than has been accomplished in medical history, but they have still found no cure and no treatment. I do not care who is responsible for what Dr. Fletcher has done. I give them full credit for a magnificent and worthy job. The important thing is to capitalise on their work and to make use of the knowledge which they have acquired and the scientific researches that they have carried out.

This can only be done if the work is used as a preventative, and the only way in which it can be used is in the compulsory annual X-ray scheme which I have been urging in this House ever since I was fortunate enough to come here some 12 months ago. The disease is progressive. If it is caught in its initial stages when a man is only 5 per cent. or 10 per cent. affected, he can be removed to the surface and given a surface job, when he will be sound and fit like any other man.

If, as has often happened in the past the man's condition was not discovered until be was 40 per cent., 50 per cent. or 60 per cent. affected, then one day that man will drop down in his tracks and will be thrown on the scrap heap. The tragedy is that that happens to the older men. A man may be aged 40 or 50 and have been in the industry for 20 years. He is suddenly unable to do anything but light work, but what can he do? We cannot teach a man of that age to become a clerk or to learn a skilled trade. He is only capable of doing heavy work, but if he does it he will kill himself, as many honest and decent men have done.

The psychological case is one of fear and terror. I do not know which is worse—the disease itself, or the terror which men can have from seeing what happens to other men. At the first sign of difficulty with breathing, of bronchitis or any other respiratory disease, they have become haunted by this fear. If we took these men and forced them once a year to go before a unit and have their chests X-rayed as a matter of form and routine, we would catch all these cases very quickly. After the first year or two we would have weeded out all the unfit and then we should catch cases at the 5 per cent. or 10 per cent. stage. We should eliminate not only the psychological curse but a tremendous amount of human and economic waste.

There are the two sides. If we are going to be human and philanthropic we will eliminate human suffering. If we are going to be purely material and statistical we will eliminate a dreadful wastage of manpower. There is this awful problem of recruiting men for our pits, but this dust disease is constantly taking away some of the best and most experienced manpower from the pits. Therefore, I suggest that for a minute amount of money, with which I will deal in a moment, a compulsory X-ray scheme for miners would be an investment which, in human suffering and £ s. d., would yield colossal dividends in a short time to the National Coal Board and to the nation.

If I may I should like very briefly to give one or two figures which I have been able to get. No doubt the Parliamentary Secretary with all the information and statistics at his disposal will have more accurate figures than mine, but these are the best figures I could get to give a measure of this problem. I am informed that the finest X-ray equipment, a mobile vehicle, with all the most modern scientific equipment would not cost more than £15,000. That equipment has been tried in other countries and is dealing with 100,000 men per year. If we take an industry of 700,000 men, that gives us seven units, but let us be on the safe side and allow nine units to cover such things as replacements and break-downs.

For nine units the capital investment would be £135,000 in an industry, which has a capital investment of several hundred million pounds. The figure is proportionately so small as to be almost negligible. If I may say so, it would not be noticed in the National Coal Board budget if it were not pointed out to the people dealing with these matters. A staff of 36 people, who would be fully trained, would be necessary to take the initial pictures and weed out all the suspicious cases, which would be sent to Dr. Fletcher and his expert staff, who would then deal with those cases and decide on questions of compensation, treatment and so on.

It is the initial diagnosis which is the vitally important thing, and it could be done at a capital cost of a mere £135,000, and there would be a staff of 36 trained technicians. There is no need for skilled doctors at this point. Skilled technicians, of whom we had hundreds and thousands in the Armed Forces during the war, would do the job, and it is right to say that if this were done the problem of dust disease could be eliminated in our mines in from five to six years. It is a curse which has haunted the mining villages in South Wales, throughout the country and in my constituency for 50 to 100 years and it could be eliminated. It has been done elsewhere and I am prepared to give the Parliamentary Secretary, as I gave to his predecessor, details of that or even to bring people here who have experience of these matters.

It could be done; it can be done. The Minister of Fuel and Power assured me that he would give it top priority, and I hope that, in raising this topic tonight, I am giving every possible encouragement to Dr. Fletcher, and his colleagues in the vital work that they have done, and that we will be able in this House to make some small contribution to bringing about this reform. I hope the hon. Gentleman will be able to tell us that some progress has been made since I last raised this subject and that a pilot scheme will be started soon. In conclusion, I only plead with him that in starting this scheme he will not forget the small corner of North Somerset.

10.15 p.m.

The Parliamentary Secretary to the Ministry of Fuel and Power (Mr. Neal)

May I first thank the hon. Member for Somerset, North (Mr. Leather), for the kind things he has been led to say about my appointment? I am sure he would agree that in following my right hon. Friend in this office, I have a high tradition to maintain, and that in saying now that I hope to follow his record of service, I am setting myself no easy task.

I thank the hon. Gentleman also for the interest he has taken in this subject and the courteous manner in which he has presented his case. I hope to answer some of the points he has raised and to assure him that not only are the Government deeply concerned with all aspects of the problem of pneumoconiosis, but that we are dealing with the question of X-rays as quickly and as expeditiously as possible.

Pneumoconiosis represents by far the greatest hazard to health to which coal miners are subject in the course of their employment. And amongst those concerned with the many-sided attack now in progress on this problem there is no conflict of opinion about the potential usefulness of periodic X-ray examinations. The main object of such examinations on a routine basis is to detect the disease in its earliest, and usually symptomless stages, so that special measures may be taken to protect those affected from working in an atmosphere containing dangerous quantities of air-borne dust.

The National Joint Pneumoconiosis Committee has for some time had the matter of a scheme of periodic X-ray examinations under consideration. As the hon. Member was advised in the reply made to him in the House on 19th March, that committee has now decided that an experimental scheme is required before any general plan can be drawn up to cope with the formidable objective of the periodic X-ray examination of more than half a million mine workers. This decision had the full agreement of the National Union of Mine Workers' representative who is on that committee. I am sure the hon. Member will agree that it is essential, in order to get a scheme on a right basis, to learn from the pilot scheme, which could easily be expanded if the original scheme were successful. Indeed, I wish profoundly that it was as easy to undertake this scheme as the hon. Gentleman pretends——

Mr. Leather

Thinks, not pretends.

Mr. Neal

Thinks. It is, of course, fundamental to the success of any scheme that the X-ray used shall be able to detect the disease in an early enough stage to protect the man concerned from any progression of the disease. If the labour saving, and more easily operated, mass miniature radiography is found to be sufficiently reliable to detect early pneumoconiosis, the introduction of the experimental scheme will be much easier, compared with the situation with which we shall be faced if large X-ray films have to be taken with the more complicated equipment required for large X-ray pictures.

This important question has therefore been remitted to a committee of experts presided over by the Deputy Chief Medical Officer of the Ministry of Health. The completion of arrangements for the experimental scheme must await the conclusions of this expert committee, the first meeting of which is to be called shortly.

Mr. Leather

Will the hon. Gentleman ask that Committee to study the experience of the Aluminum Corporation of America who have had great success with these miniature X-ray schemes?

Mr. Neal

I am afraid I cannot be led into that diversion because time is always the enemy on these occasions and there is much more I want to say. At present it is impossible to say how soon this Committee will be able to report on this highly technical question, but every endeavour will be made for the Committee to reach decisions as quickly as possible.

It is clearly impossible to form a precise scheme until the basic question of what X-rays must be used has been decided. It is anticipated, however, that the National Coal Board medical service, together with the Ministry of Health, will exercise a general responsibility. The Ministry of Health have, of course, gained considerable experience of such surveys through the operation of the mass-radiography units of the regional hospital boards. The experience of the Ministry of National Insurance medical boards will also be available.

The National Joint Pneumoconiosis Committee have advised that the experimental scheme is more likely to succeed if it is not linked directly with the various X-ray and dust environmental surveys which are being carried out by, or under the auspices of, the Pneumoconiosis Research Unit of the Medical Research Council. Instead, it is aimed to confine the experimental scheme to the routine detection of pneumoconiosis by X-rays and to build up a technique of safeguarding men found with the disease by confirming that they work in, or are given every opportunity to work in, approved dust conditions underground. The scheme will, naturally, not undertake the assessment of disability on account of the disease. That is the function of the Pneumoconiosis Medical Boards set up by my right hon. Friend the Minister of National Insurance under the National Insurance (Industrial Injuries) Act, 1946, and any miner may apply to appear before them at any time.

To attempt at the outset to relate the comparatively simple objectives of the scheme to research such as that already referred to, would introduce complications from which it is best kept free. Both the experimental scheme and the research surveys are, however, expected to provide useful information for each other, and ample opportunity for the exchange of information and ideas exists in the National Joint Pneumoconiosis Committee and its sub-committees.

I now turn to the subject of previous experience in this field. I have said that in the first experimental scheme our aim must be to secure the main objective of detecting the disease in its early stages. This does not mean that the scheme will operate without reference to previous experience in this field. Full account will be taken of the invaluable work done by the Pneumoconiosis Research Unit and also of similar schemes abroad. In regard to other countries, which the hon. Member has mentioned, such schemes as are in operation in any case cover a comparatively small number of men compared with the many hundreds of thousands eventually to be dealt with here. Moreover, our scheme will be operating on a basis of a standard of early radiological diagnosis of coalminers' pneumoconiosis, which is at least equal to, and probably in advance of, any standards elsewhere.

I have discussed, first, the Government's proposals to introduce a scheme of periodic X-ray examinations, but, as hon. Members are aware, extensive facilities for X-ray examinations are already available in the industry. Under the Industrial Injuries Act and its provisions for pneumoconiosis, every miner who feels that he may be suffering from the disease can make a claim for benefit. If he makes a claim, he is automatically X-rayed. Full-size films of his chest are taken as a preliminary to clinical examination by the Pneumoconiosis Medical Board. If, after scrutiny of the film by the doctors of the Pneumoconiosis Panels, it is decided that the claimant is not suffering from the disease, the clinical examination is not proceeded with. A man is quite free to make another claim to benefit should he feel doubtful about his condition; he is X-rayed on every subsequent application.

In the two-and-a-half years ended 31st December, 1950, about 31,000 X-ray films have been taken under this procedure. During the same period 10,000 miners were diagnosed as having pneumoconiosis. All of these, whether or not they have decided to remain in the coalmining industry, are required to report periodically for re-examination by a Pneumoconiosis Medical Board. Each re-examination involves a new X-ray film of the man's chest. The interval between examinations may be up to three years. The average interval is well under two years, but the boards frequently recall men for re-examination at much shorter intervals. Many of the men in whom the disease has been diagnosed are found to be only slightly disabled. For example in South Wales which in recent years has accounted for the bulk of all diagnosed cases, about two-thirds are now found to have 10 per cent. or less disability from the disease.

Mr. George Thomas (Cardiff, West)

At what age?

Mr. Neal

I could not tell my hon. Friend that. The increased confidence of the men in the arrangements for advice from these boards and in the advancing dust suppression technique is shown by the fact that at the end of 1950 about 5,500 of the 10,000 cases diagnosed had remained at work in the industry. The current annual number of X-ray examinations taken by the Pneumoconiosis Medical Boards is approximately 12,500 in respect of first applications under the regulations and 11,000 in respect of cases already diagnosed and recalled periodically for further X-ray. In South Wales, every new entrant to coalmining employment has to undergo X-ray examination. This is a special requirement in view of the particularly high incidence of pneumoconiosis in that coalfield. The average annual number of men X-rayed is approximately 3,500.

As the hon. Member was advised on 19th March, some 50,000 miners, an average of about 12,000 per annum, have in addition been examined in recent years by miniature radiography under the National Health Service. At present nearly 40,000 X-rays of coalminers are taken annually in this country under one procedure or another. This of course is not enough and does not remove the need for a systematic scheme of periodic X-ray examinations, but it does enable the experimental scheme to be fully considered from all aspects before it is put into operation.

I do not think it would be right to leave this subject of X-ray examination without referring to the general campaign against pneumoconiosis. The most effective measure against this disease is, of course, to prevent and suppress the dust which causes it. I am glad to say that His Majesty's inspectors of Mines and the National Coal Board are taking all steps towards this end. It can truly be said that at no time have greater efforts been made to combat this disease. The hon. Member can be assured that not only shall we introduce a scheme of X-ray examination as quickly as possible, but that we shall continue to take all possible measures to remove pneumoconiosis from the industry.

10.29 p.m.

Mr. Geoffrey Lloyd (Birmingham, King's Norton)

I only intervene for a moment after the hon. Gentleman's interesting remarks because I was Under-Secretary of State at the Home Office before the war and later Secretary for Mines. Curiously a Question on the subject of the Safety in Mines Measure, came up this afternoon. When I was working to prepare that Bill the right hon. Member who is now Colonial Secretary and the father of the present hon. Member for Stechford (Mr. Jenkins) very kindly took me to South Wales. I was shown cases of silicosis as it was called in those days, as the hon. Member for Gower (Mr. Grenfell) will remember. I had never seen a case of silicosis. It is undoubtedly an extremely tragic disease, At that time it appeared to be largely localised in South Wales and was not very well known, but now it is prevalent not only in the hard coal and anthracite districts, but is spreading into other coalfields, because machine mining is becoming more widespread.

I think it is valuable that my hon. Friend brought up this subject tonight. I have only one thing to say. I remember the difficulties of obtaining sufficient medical knowledge of the disease in those days to make a sound diagnosis on which compensation and other important matters could be based. The Departments were somewhat slow in advancing from one step to another. I think hon. Members who study this Report will find that progress has been slower perhaps than technical knowledge would justify. I have only one plea to make tonight. Let us not wait too long in this matter, but let us press on as hard as we can. There is a real job to be done.

Question put, and agreed to.

Adjourned accordingly at Twenty-Nine Minutes to Eleven o'Clock.