§ Motion made, and Question proposed, "That this House do now adjourn."—[Mr. Redmayne.]
§ 10.1 p.m.
§ Mr. W. J. Taylor (Bradford, North)
After the long and controversial debate which has just concluded, I wish to draw the attention of the House to a matter which is giving very serious concern to my constituents, to public bodies and to medical authorities in the City of Bradford. I refer to the high incidence of tuberculosis among European volunteer workers in and about the city.
This matter has been given considerable publicity in the last few months, many resolutions have been passed and much Press comment has been made. The Bradford Trades Council, at their meeting on 24th May, 1951, passed a resolution expressing their deep concern at the increase in tuberculosis in the city and district, and in particular made reference to the very high rate at which tuberculosis was making itself apparent among the European volunteer workers in the area.
The Trades Council passed a resolution at that meeting calling upon the Yorkshire Federation of Trades Councils to initiate a campaign to combat the disease. The medical authorities in the area whose duty it is to look into these matters reported that their difficulties were increased by the fact that tuberculosis was being virtually imported into the district.
It is right that I should say what these European volunteer workers consist of. 2064 It is estimated that there are 8,000 of them in the city and suburbs. They come from a great variety of European countries. There are among them Latvians, Esthonians, Lithuanians, Poles and Czechs, also Ukranians, Yugoslavs, White Russians, Italians and Austrians. I am anxious that my action in raising this matter on the Adjournment should not be taken as in any way an attack upon aliens. They came to this country when there was a great shortage of labour, or they found themselves here at the end of the war. They have helped to fill and man our industries which were very short of labour.
All the reports which I have had about their work and their conduct indicate that they have proved themselves to be good workers and good citizens. In short, they have done a good job in this country and have helped us along the way to recovery. They now feel secure in their new employment, in their new surroundings, and in their new life after the bitter memories of poverty and suffering which they brought with them.
These people arrived in this country in one or two different ways. Some found themselves here at the end of the war as a result of having served in the Polish Army. Others came under the Ministry of Labour European Volunteer Workers' Scheme. Others came by private arrangement with prospective employers. The fourth class came as refugees. Perhaps there was only a small number of the last named.
In raising this matter, I am concerned with the medical standard required of immigrants entering this country. Under the Ministry of Labour scheme all workers are examined before being accepted for employment here. Under the private arrangements made with employers, however, the onus for the fitness of the immigrant seeking to enter this country rests with the employer. Over and above all this, all foreigners coming here, whether European volunteer workers or not, are liable under the, Aliens Act, 1920, to medical examination by the immigration authorities at the ports.
It is this medical examination of immigrants at the ports that I want to see tightened up. All the evidence appears to point to the fact that many persons have been admitted to this country suffering from active tuberculosis. This fact 2065 came to light in Bradford in quite a regular way through the normal inquiries which the chest physicians make from time to time in that city. In February, 1951, an investigation was undertaken by the senior chest physician for the city. As a result of the report which he made following that investigation, the Medical Officer of Health was asked by the Tuberculosis Sub-Committee of the Bradford "A" Group of Hospitals to press the Ministry of Health for stricter medical screening of European volunteer workers entering the country.
During the investigations the chest physicians at the Bradford Chest Clinic found a high incidence of active tubercular disease among foreign workers sent to the clinic by general practitioners and hospitals. The Medical Officer of Health reported in these words:It is regrettable to have to record that there are many infectious cases in their own homes in most unsatisfactory conditions, sometimes occupying the same room and even the same bed as susceptible children.It is a fact that the bad housing conditions in Bradford have been a contributory factor to this unfortunate state of affairs. It is also a fact that the introduction of the National Health Service divorced the preventive from the curative service. The management of the hospitals had been transferred to the Leeds Regional Hospital Board, and a large waiting list was in existence for admission to sanatoria.
I ought to mention that the City of Bradford has a very unfortunate record in post-war housing. For some years after the war, Bradford did not compare favourably so far as housebuilding was concerned with any city of comparable size. I am glad to be able to record that as the result of the policy of my right hon. Friend the Minister of Local Government and Housing, the situation is now improving. There is no doubt, however, that the introduction of a large number of aliens into the district has aggravated the housing problem. After all, 8,000 aliens in one area is a very large number to bring in.
The figures produced by the medical authorities showed that there was a higher incidence of pulmonary tuberculosis out of all proportion to that in the normal population. A member of the Hospitals Committee said: 2066We are doing everything we can to deal with our own patients. Our sanatoria are full, and yet we are importing patients from abroad.Following those remarks in public, the Ministry of Health instituted a local inquiry and the Ministry's inspectors visited the city.
§ Mr. Jack Jones (Rotherham)
The hon. Member has already said that the Ministry of Labour examined the mass of those who came in under the two particular schemes. It would be interesting to know who was responsible for the bringing in without adequate supervision of these people, particularly domestic servants, and so on.
§ Mr. Taylor
I have indicated how and under what arrangements these people came in, either under the official scheme or under the private scheme, or found themselves here at the end of the war. It is not possible to break down the figures to show the number of active cases in each class, but if the hon. Member will be patient I think I shall be able to indicate where, I feel, the trouble lies and how it should be put right.
In reply to Questions in the House on 19th April, 1951, the Minister of Health gave figures for pulmonary tuberculosis among foreign workers in the City of Bradford as having risen from nil in 1947 to 10.4 per cent. of all notifications in the city in 1950. The Minister further stated that he was examining with other Ministers concerned how he could avoid any immigrants entering the country with the active disease. He indicated that it was virtually impossible by way of answering a Member across the Floor at Question time, to give the full information which it might be felt was necessary. The whole object of my raising the matter on the Adjournment is to inquire of the hon. Lady the Parliamentary Secretary to the Ministry of Health, who is to reply, whether anything towards a solution of the problem has been done since I put my Questions in the House.
The figures are very interesting. Early last year, of 225 cases sent to the Tuberculosis Officer of the Corporation, 52 were found to be positive and 21 were suspect: and in the latter part of last year, 29 other active cases were added to the list. These figures were a very great shock to the city, to the public and to me.
This may interest the hon. Member for Rotherham (Mr. Jack Jones). Half the 2067 positive cases to which I have referred were European volunteer workers who had come in either under the official scheme or under private arrangements, and the others were ex-prisoners of war or ex-members of the Polish Army.
What is more alarming than the local figures is the thought that perhaps what is happening in Bradford may be happening elsewhere. The mass radiography survey of 1946 revealed that there was an incidence of 0.4 per 1,000 patients examined who had the active disease. In 1950 that figure had risen to 1 per 1,000 examined; that is more than double the rate of incidence in a period of four years.
The history of the 57 cases I have mentioned is very interesting. All their movements have been traced and there is medical evidence in my file to show that at least 11 cases had the active disease on entering this country, that one reported to the chest clinic for an artificial pneumothorax refill within 14 days of arrival and that this was induced in Germany six months before that person's arrival in this country.
Four other cases gave history of previous treatment in a sanatorium. In one case the doctors were informed that there had been recent injections treatment for tuberculosis and in two other cases there was evidence of recent pleural effusion and in one case evidence of dry pleurisy.
The facts and figures and all the circumstances of this very complete survey were submitted to the Ministry investigator by the senior chest physician of the City of Bradford in the presence of the medical officer of health and a medical representative of the Leeds Regional Hospitals Board. It was stated when these facts were pointed out to the Ministry that all European volunteer workers here under the official scheme—this again applies to the question raised by the hon. Member for Rotherham—were X-rayed before admission.
I have several suggestions to make for the alterations in the procedure for medical examination of emigrants at the ports and in doing so I would like to press for the implementation of the resolution of November, 1950, of the General Tuberculosis Council, which read as follows:That a letter be sent to the Secretaries of the Ministry of Health and the Ministry of 2068 Labour asking that the procedure for the medical examination of immigrants be altered to provide (1) that X-ray photographs taken in the country of origin should be read by doctors of consultant rank in this country and (2) that a large X-ray photograph should accompany each emigrant and (3) that unless these regulations be complied with the person be not allowed to land.I believe that in other countries the standard of these medical examinations of immigrants is very strict indeed. In Canada the examination is by Canadian doctors, or approved doctors, prior to sailing. The Aliens Order, 1920, says that entry of a prospective immigrant suffering from tuberculosis to this country is forbidden, but I am not satisfied that the examination is sufficiently strict and the evidence I have produced sustains this.
In conclusion, I seek an assurance from the hon. Lady that steps are being taken to tighten the regulations governing medical inspection of immigrants. In doing so I wish to reiterate that my only anxiety in raising this matter is to protect the health of our own people; particularly those constituents of mine who have to work in the closely confined atmosphere of the textile mills, and who run the risk, not only of contracting infection themselves, but of carrying it to their families. I feel that if as a result of this short debate we can establish medical examination conditions which will preclude any risk whatever so far as medical science can provide, our time will not have been wasted.
§ 10.20 p.m.
§ Mr. George Craddock (Bradford, South)
I wish to thank the hon. Member for Bradford, North (Mr. W. J. Taylor) for having introduced this matter. I understand that, arising out of war conditions, we agreed to take into this country so many Poles and other people who were without homes. Last year I put a Question to the Minister and was amazed to receive the reply that only the particular person coming to work and not his family were examined before entering the country.
It seems astonishing to me that of a whole family only the person who comes here to work is examined before they enter the country. If only for that reason I am delighted that the hon. Member has raised this matter, and I wish him every success in his efforts.
§ 10.22 p.m.
§ Mr. Jack Jones (Rotherham)
I rise to congratulate the Member for Bradford, North (Mr. W. J. Taylor) for raising this very important issue and also to congratulate the Parliamentary Secretary to the Ministry of Health, who is to reply, as I understand that it is her birthday today. In the midst of all our political acrimony we would wish her all that she would wish herself on such an auspicious occasion.
The hon. Member for Bradford, North, has raised a very vital question and I hope the hon. Lady will be able to assure the House that some effort is made to ensure that conditions are similar for those who come into the country under official schemes, and who are examined at the point of departure and arrival, and those who come in under private domestic service schemes.
It would appear that there are a number of loop-holes which are utilised by people in Bradford to obtain domestic servants. Some of these people who come into the country under such schemes have married the sons or daughters of Britons, and have created something of a menace in many parts of this country, including places like Bolton.
§ 10.23 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Miss Patricia Hornsby-Smith)
I wish to thank the hon. Members who have raised very interesting points on this important subject and also, if I may, I would thank the hon. Member for Rotherham (Mr. J. Jones) for his felicitations on another matter.
Hon. Members will be aware of the Government policy of strengthening the labour force and bringing in foreign workers under officially sponsored schemes. I think it is true that in the early years there was no check on the health of those coming into the country and, having regard to the conditions during the war and the privations which many of those workers suffered, there was a higher than average incidence of T.B. among them.
As a result of the findings when those workers arrived here, action was taken in association with the Ministry of Labour and National Service in June, 1948, whereby all newcomers arriving under official arrangements would be 2070 X-rayed and examined at the transit camp on the Continent before coming to this country. I think it fair to say that the incidence of T.B. has been remarkably lower since this check was instituted.
Looking at the figures for Bradford, which we have obtained from the records of the medical officers of health, of 50 E.V.W.s found to be suffering from T.B. in Bradford, 41 of them came to this country before 1948 and before the check was instituted. It is also not certain that all of them had it before that time. Indeed, there may have been some who contracted it since they came here.
It may do much to dispel some of the alarm which may unwittingly have been engendered by some of the remarks made this evening if I give an analysis of all foreign workers who have come over to Bradford and who have been found to be suffering from tuberculosis. In the four years, 1948, 1949, 1950 and 1951, there have been 73 foreign workers certified as suffering from pulmonary tuberculosis. They fall into four categories—ex-prisoners of war and former members of the Polish Armed Forces, 13; persons on a Ministry of Labour permit coming in for specific jobs, three; cases which cannot now be traced and classified, seven; and E.V.W.s sponsored by the M.O.L. schemes, 50, of whom 41 came in before the checks were made.
Of the first category of 13—the ex-prisoners of war and members of the Polish Armed Forces—I think it will be accepted that in providing post-war resettlement for them it was not feasible to make asylum conditional on medical examination. That is an instance which is not likely to be repeated. The number of those cases will not grow. Of the E.V.W.s, 41 came before the institution of the check and only nine afterwards. All workers are now checked in camps in Europe before being allowed to come here.
The main part of the debate has centred around those who came in on individual Ministry of Labour permits without being checked. I think it is fair to point out that the total in four years in Bradford is only three. I should not like to be exaggerated so that it spread alarm in the bon. Member's constituency. The matter was fully considered by our predecessors at the Ministry and, following 2071 the Question by the hon. Member for Bradford, North (Mr. W. J. Taylor), we have had further consultations with the aliens department of the Home Office and with the Ministry of Labour on the points raised by the hon. Gentleman in his supplementaries to that Question.
We were anxious to decide whether it would be possible to take special steps about every individual foreigner who comes into this country to take up employment of any kind. Under both the present Government and under our predecessors at the Ministry the closest consultations have taken place. We have come to the conclusion that it is impossible to carry out such a medical inspection at the port because the facilities there are inadequate for the purpose of ascertaining whether or not the immigrant is suffering from tuberculosis. They cannot there make a full diagnosis of tuberculosis which in some cases may be symptomless and which calls for specialist clinical investigation. It is, therefore, outside the scope of port medical inspection.
The other point suggested by the hon. Member was that we should make incoming aliens produce evidence at the port of entry that they are free from any form of tuberculosis. After consultation, we have come to the conclusion that such a measure is not practical. It would involve medical and administrative organisation out of all proportion to the extent of the risk which it is intended to prevent.
It is a very easy matter when all these people are in a central transit camp with an X-ray unit on the spot—when there are large numbers of people being moved as the E.V.W.s were—to make the full investigations. But we have not found it practicable to provide for each new person coming in to be treated in this fashion.
2072 There is further the deterrent effect on the foreign workers voluntarily seeking employment in this country—employment which the Ministry of Labour and National Service has decided they shall be allowed to take up—if we did insist on a medical examination prior to their coming here.
I should like to reiterate that in four years the number has been only three. In Bradford, in particular, this matter was a legacy of a post-war period, when they gave not only asylum to members of the Polish Resettlement Corps, ex-prisoners of war but also took in many European volunteer workers. If one ignores the 13 prisoners of war and members of the Polish Armed Forces and the 41 who came before 1948 without a check, then in four years there have been 19 cases amongst foreign workers coming into Bradford.
The hon. Member also raised the question of housing, which he will appreciate is a matter for another Department. Viewed against the marked improvement in the general situation regarding tuberculosis, the substantial fall in mortality reflected in Bradford's figures, the progress in early diagnosis and treatment and the reduction in the waiting lists, I can assure hon. Members that we are alive to this problem and are doing our utmost.
In conclusion, I would say that in Bradford deaths from respiratory tuberculosis have fallen from 47 per thousand in 1946 to 35 per thousand in 1950. That city's record compares very favourably with that for the rest of the country.
§ The Question having been proposed after Ten o'Clock, and the debate having continued for half an hour, Mr. SPEAKER adjourned the House without Question put, pursuant to the Standing Order.
§ Adjourned at Twenty-nine Minutes to Eleven o'Clock.