HOSPITAL TREATMENT (PERSONAL CASE) (Hansard, 18 December 1953)

§ Mr. Arthur Moyle (Oldbury and Halesowen)
I am grateful to the hon. Member for Harrow. East (Mr. Ian Harvey) and the Parliamentary Secretary to the Ministry of Defence for shortening their speeches to enable us to get back to schedule for the last Adjournment debate.
The case to which I shall address myself refers to a constituent of mine. 800 Daniel Edwin Hulse, who has since boy hood been a resident in Oldbury. He has had five years' active service in the British Army—

§ Mr. Moyle
Mr. Hulse and his family enjoy the highest esteem of the community in which they live. He is an active member of the British Legion and also of the Association of ex-Servicemen's Families. I mention these facts because of what follows in stating the case on his behalf.
Hulse is 36 years of age, and was 31 at the time when he fell ill. As a result of disquieting symptoms, he presented himself to the General Hospital, Birmingham, and reported to the Steel-house Lane Clinic, Birmingham, on the advice of his own doctor. This case has been the subject of representations by me to the Minister of Health, on behalf of Mr. Hulse for the purpose of securing for him an ex gratia payment for he was the subject of wrong diagnosis and for what he suffered as a result of that wrong diagnosis.
This case was the subject of an action in the High Court of Birmingham in October this year, when a claim for damages was made on the ground of negligence on the part of two doctors, a Dr. Wilson and a Mr. Kirkham, both of whom were attached to the West Bromwich General Hospital. These two doctors were listed with the Birmingham Regional Hospital Board as defendants. The case received widespread publicity, and there was a five days' hearing before judgment was reached by Mr. Justice Finnemore. The action for damages failed.
I do not propose to question that judgment in any way. I am merely concerned that consideration shall be given to Hulse in the light of some of the comments made in that judgment by Mr. Justice Finnemore. Hulse, as I have pointed out, reported on the advice of his doctor to the Steelhouse Lane Clinic, whose sole purpose is the treatment of venereal diseases. Hulse was examined by doctors at the clinic and became an out-patient. 801 There was a period of seven months between the time of his first examination by the doctors at the clinic and his admission to the West Bromwich General Hospital on 1st January, 1949. On 3rd January, 1949, he there underwent a minor operation, and it is clear both from the history of the case and the whole process of treatment that he was suspected of venereal disease throughout the whole period prior to and at the time of this operation.
I am advised that he was subjected to the strictest ostracism while in the hospital. All his linen was specially named, all the crockery which he used was specially marked, a screen placed around his bed throughout his stay—all based on the assumption that he had this particular disease. That assumption was bound to go beyond the hospital, and it caused social ostracism in his own community. For some three years he had been keeping company with a young lady, but by mutual arrangement that friendship was broken off.
It was not until March, 1949, that, as a result of an examination by Dr. Brooks at the Birmingham General Hospital, it was first discovered that he was not suffering at all in the slightest degree from venereal disease of any kind, but from what was described as a perfect ulcer and what is generally known as cancer.
While Mr. Justice Finnemore, in his judgment, discounted the charge of negligence against the two doctors and the hospital board, he did make specific reference to that seven months period. He said that he could not accept the charge of negligence but, expressing sympathy with the plaintiff said specifically that had there been a correct diagnosis in the first place the man would have been saved much pain and suffering. Further, there was strong evidence given, although not accepted by the judge, that had the diagnosis been correct in the first place there might not have been the necessity to undergo a grave major operation in July, 1949. In July, 1949, at Queen Elizabeth Hospital Mr. Hulse underwent an operation which caused a grave amputation as a result of which he is no longer able to return to a normal life, nor is he, and never will be, capable of becoming a father.
This case has aroused a great deal of criticism in my own constituency, and 802 Mr. Hulse has been the subject of much ostracism until it was subsequently discovered and made known that he was affected by cancer and that there was not the slightest case for suggesting that he had venereal disease. He has been unemployed and unable to work for five years, and I am advised that it is not likely that he will be able to resume employment for some time to come.
I pointed out these facts to the Minister and I made my claim for some ex gratia payment without prejudice to the judgment and without prejudice to the interests of the Ministry and of the Treasury, because I realise how difficult it is to establish such a claim against a judgment reached in the courts, but it is a practice which is resorted to in local government service in certain special circumstances and. of course, in the commercial world.
I repeat to the Parliamentary Secretary what I stated to the Minister, that the social ostracism that this man had to sustain in the light of the treatment that he received over a period of many months was even worse than the disease itself, and I also wish to emphasise the delay which was experienced from the time that my constituent was first treated in May, 1948, until his admission to hospital in January, 1949.
I was somewhat surprised when I received the Minister's decision couched in terms which, I thought, was Ministerial officialese at its worst. There was not a note of sympathy, but just a bare reply dismissing the application and referring to the judgment of the High Court and the right of my constituent to appeal, if he so desired, against that judgment.
I should have thought that the Minister would at least have expressed some sympathy with my constituent when he sent that letter to me, and I hope that the Parliamentary Secretary will find it possible to express, at any rate, a note of sympathy with my constituent. I think that can be done without in any way imperilling the legal position of the Ministry, most certainly in the light of the fact that the judge went out of his way to express the sympathy of the whole court with my constituent because of what he had endured.
That is my case. I repeat that my constituent is a good citizen, one of the 803 highest repute, with a first-class record in the Army in the last war. Not only he, but two of his brothers and his sister were engaged in active service. Therefore, notwithstanding the decision conveyed to me in the Minister's letter yesterday, I hope that further consideration will be given to the representations which I have made, and that some way will be found by which an ex gratia payment can be given to my constituent, in the light of the grounds which I have advanced in support of his case this afternoon.

§ The Parliamentary Secretary to the Ministry of Health (Miss Patricia Hornsby-Smith)
I must say straight away that my right hon. Friend and I have the greatest sympathy with this unfortunate young man, who has been the victim of a very rare condition of a disease which is found most infrequently in a man of his years. I can assure the hon. Member for Oldbury and Halesowen (Mr. Moyle) that my right hon. Friend was certainly not lacking in sympathy for this case. In his reply to the hon. Member it is probable that, in his opinion, he was replying only on the facts of the case.
It is true that Mr. Hulse was initially referred to the Steel House Lane Clinic, and it was established by independent medical witnesses, and the best advice that could be obtained—and these matters are ones of medical decision—that there was nothing to suggest, in the early stages of examination, that this unfortunate young man was suffering from cancer. It is true that, initially, it was suspected that he had venereal disease, and he was therefore referred for tests and treatment. Later, he had a minor operation, when the ulcer was disclosed which, ultimately, was diagnosed as that of cancer.
But it was possible from his symptoms that his condition might have been caused by three different types of complaint, and in the opinion of the medical advice at the time cancer was the least likely cause. Subsequently, in July, 1949, as the hon. Member said, he had a total amputation and later had several further operations, mainly of a plastic nature.
The patient claims that if his condition had been diagnosed in time total 804 amputation would have been avoided, or he might have needed only a partial amputation. He brought his action for negligence against Dr. Wilson and Mr. Kirkham and a decision and judgment was given by Mr. Justice Finnemore. In that decision, which the hon. Member very fairly says he does not challenge, it was not established that an earlier diagnosis of this acute and rare condition would have affected the result or made less necessary a total amputation.
With regard to the question of ostracism, of which the hon. Member has made a particular point, I am sure that on thinking over the matter he will realise that the decision he requires would have very wide implications. I am sure he will realise further that, however much we sympathise with this young man, medical diagnosis of a condition like this cannot be an exact science. Often it does take time to get down to the exact cause of some severe and rare type of ailment, such as this young man had.
So far as the question of ostracism is concerned, I should not like to accept in any way the condemnation of the hospital that the hon. Gentleman made in suggesting that this young man was treated harshly, that he was unduly ostracised, beyond the normal medical precautions of the staff, taken with the best interests of the patients at heart, and in the light of their then diagnosis that he was suffering from a venereal complaint.

§ Mr. Moyle
I did not speak of harsh treatment. I speak with some experience of general hospitals before I came to the House, and what I did say was that it is most unusual for a screen to be put around the bed, for the linen to be marked with the patient's name, and the cups and saucers used, for the period that he was in the hospital, from 1st January until his discharge on 4th January.

§ Miss Hornsby-Smith
If those were the medical precautions deemed necessary I do not think it is fair to challenge them. The young man has been fully cleared of any such stigma, if that is what the hon. Gentleman feels it was, and that is very apparent from the wide publicity given to this case and to the establishment of the fact that his complaint was a form of cancer. In a young man of his age it is very rare indeed, as was established 805 by the court's investigations. There was nothing in the early stages to put Mr. Wilson on his guard against the grave condition that was ultimately discovered after the lesser operation.
The suggestion that an ex gratia payment should be made is asking the Minister, if he had the power, technically to override a decision of the High Court. If the patient is dissatisfied with the decision of the High Court he has the right of appeal, and he is entitled to take his case to appeal. He did not so decide. To pay an ex gratia payment to a patient who has suffered from a severe ailment through no medical negligence of the staff, and in a difficult and complicated case, has lost a claim in court on the grounds of negligence, would technically override the decision of the court.
I am sure that the hon. Gentleman will, on mature reflection, realise that it would open the floodgates to endless cases of claims from people who have suffered severely from particular diseases, though there had been no negligence, and who have suffered severely, as we all acknowledge this young man has done. It would negative the decision of the courts and would certainly lead to claims following cases taken, rightly or wrongly, against hospital authorities or doctors and lost in the courts.
To my knowledge, there is certainly no precedent for making a payment of this kind. This case has been fully heard over a long session in court, and the court has decided that there was no negligence. No one will deny that the patient has 806 had a most unfortunate and unhappy experience of a rare illness for one of his young age, with very grave consequences to himself, but, as no negligence can be imputed to the hospital authorities or to the doctors concerned my right hon. Friend feels that it would be quite wrong to treat this as a special case and, in effect, reopen the judgment of the court. As I have said, if the plaintiff had wished to reopen the case he could have done so under the ordinary processes of appeal.
I realise the hon. Gentleman's real sympathy—indeed, I share it—with this unhappy and unfortunate young man, but it is obvious that if a case of this kind has been taken through our courts, outside the Ministry or this House, and decided, then it is not for the Ministry or the Treasury to override that decision and, by making a payment, impute to the doctors a negligence which the courts do not admit, thus opening the floodgates to any and every appeal on sympathy grounds.
I am sorry that we cannot meet the hon. Gentleman in any way which we believe fair to the general conduct of the National Health Service but I should again like to assure him of our very great sympathy with this young man in the very unhappy time he has had.