§ Motion made, and Question proposed, "That this House do now adjourn."—[Mr. Heath.]
§ 10.1 p.m.
§ Mrs. Barbara Castle (Blackburn, East)
In bringing before the House today the case of Mr. Aaron Barnes, of Blackburn, I am not merely raising a case in which injustice has been done to an individual, although I hope that this House will always be a place in which hon. Members can fight even for individuals. I am raising this case because it also involves an important point of principle. As the Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance knows, the British Limbless Ex-Servicemen's Association has been righting this case as representing an important principle for nearly 12 months and it was only when it had been unsuccessful in persuading the Ministry to change its mind that it 1774 approached the right hon. Member for Blackburn, West (Mr. Assheton) and myself and asked us to take the matter up as Members of Parliament.
We did; we received the routine replies, but I, personally, was not satisfied with those replies. Ever since I have been trying to persuade the Ministry to change its mind and I am now making a last desperate effort in the hope that my persuasion may bear fruit. I want to pay tribute to the never-failing courtesy of the hon. and gallant Gentleman the Joint Parliamentary Secretary who has patiently answered many thousands of letters on this case and given freely of his time when I have interviewed him upon it. I pay tribute to his courtesy, but, I regret, not to his reasoning because he and his Ministry, despite his attentiveness, has failed to do justice to my constituent and to give him the benefit of reasonable doubt. My point tonight is that Mr. Barnes is being sacrificed as an individual because a wider medical principle is involved and just because the Ministry is afraid of creating a medical precedent which might have far-reaching effects and consequences.
I want to curtail my remarks because I believe that other hon. Members want to address the House on the principle of this matter. I hope that my hon. Friend the Member for Barking (Mr. Hastings) will have a chance of giving the House his medical view on this matter. I will briefly recount the history of Mr. Barnes. In December, 1916, he lost his left leg in the First World War. Earlier, he had sustained a gunshot wound in his right leg, which was considered to be a rather trivial wound. He lost his left leg and, for nearly 36 years, he wore an artificial leg. In September, 1952, he developed gangrene in his right toe, which was amputated in an attempt to save his other leg, but the attempt failed and, in February, 1953, Mr. Barnes's right leg was also amputated.
The case of the Ministry, as I understand it, is that the cause of the loss of the right leg was arterio sclerotic gangrene. The Ministry maintains that this is a degenerative condition of the blood vessels which cannot under any circumstances whatever be said to be associated with the extra strain caused to Mr. Barnes's right leg by the fact that 1775 for 36 years he had lived, walked and worked on an artificial left leg. My case is that there is not enough medical certainty about the cause of this degeneration of the blood vessels for the Ministry to be able to say beyond any reasonable doubt whatsoever, that there could not be a causal connection between the condition of Mr. Barnes's right leg and the fact that, for 36 years, he wore an artificial leg.
I maintain that the medical authorities do not know. The Parliamentary Secretary has told me that a consensus of medical opinion has stated that there cannot be any connection. But I have sent to the Parliamentary Secretary a letter from the consultant surgeon of the Blackburn group of hospitals, Mr. Pearce, who examined Mr. Barnes and who, I understand, advised the amputation of his right leg. I will read one paragraph from that letter:The term 'senile obliterative arteritis' is used to cover all classes of degenerative arterial changes associated with increasing age, and included under the general term 'arteriosclerosis.'The cause is largely speculative and is not known. This being so it is very difficult to say whether or not the wearing of an artificial limb on one side would accelerate the degenerative changes in the blood vessels on the other side.That is the opinion of the consultative surgeon for the Blackburn group of hospitals. He also said that the Ministry had some argument on their side, but that there is still doubt and that Mr. Barnes should get another medical opinion.
The British Limbless Ex-Service Men's Association went to the trouble and expense of sending Mr. Barnes to another independent consultant, Mr. Eastwood Sykes, whose letter I have sent to the Parliamentary Secretary. I quote briefly from his report:As I see the matter, it depends upon the interpretation which one puts on the course of events. It seems reasonable to me to say that the extra strain resulting from the absence of one natural limb has tended to aggravate the tendency, which may well have been present anyway, for the blood vessels of the normal limb to become diseased, and so eventually for gangrene to occur. In other words, it seems to me fair to say that the state of the remaining leg has been aggravated by the previous amputation.There are two reputable independent medical opinions conflicting with the opinion advanced by the Ministry. I say 1776 that under the terms of the Royal Warrant, in the light of that medical evidence, my constituent is entitled to the benefit of the reasonable doubt expressed by these reputable opinions. If it is a medical toss-up as to what caused this degeneration of the blood vessels my constituent has a right to have the coin come down his way up.
I suggest to the House that perhaps the Parliamentary Secretary may attempt to draw a red herring over the trail. We had Questions in the House earlier today about what level of pension should be payable where a man loses a limb because of the war and later loses another limb, apparently because of civilian causes. It was announced earlier today that the Ministry has decided to increase the pension in those cases. I understand that Mr. Barnes, who has been receiving a 60 per cent. pension, will now probably get an 80 per cent. pension.
I am not satisfied with that ruling for two reasons. First, because of the principle involved. I claim that the principle of reasonable doubt is on the side of my constituent and he should be entitled, therefore, to another disability pension. Secondly, I am not satisfied on financial grounds. When Mr. Barnes receives his 80 per cent. pension he will be exactly 3s. a week better off because his present pension, with sickness benefit and National Assistance, amounts to £4 17s. a week. With the increased pension he will, I understand from the Parliamentary Secretary's Department, receive a magnificent increase to the sum of £5.
If he had received a 100 per cent. disability pension he would be entitled to such complementary allowances as the constant attendance allowance, which is only payable to the recipients of 100 per cent. pensions, and perhaps he might get a small grant in the form of a comforts allowance which, I understand, is paid only when a constant attendance allowance is paid. In other words, the Ministry's ruling is depriving my constituent, now a man without legs who in his later years has become a helpless individual, of the additional financial resources which would enable him to meet his later years in reasonable comfort.
I therefore beg the Parliamentary Secretary to reconsider the case for the sake 1777 of the prestige of his own Ministry. Ever since the war the Ministry has had a high reputation, a reputation of giving the benefit of the doubt to many an applicant. In this case that reputation is being smeared. I plead tonight for Mr. Aaron Barnes. He is entitled to 100 per cent. disability pension and to the additional comforts that go with it.
§ 10.11 p.m.
§ Mr. Alan McKibbin (Belfast, East)
I do not wish to speak for long, but I wish to say that I was pleased with the reply given by the Minister of Pensions and National Insurance to several Questions this afternoon. Like the hon. Lady the Member for Blackburn, East (Mrs. Castle), whom I congratulate on raising this matter, I should have liked to see the Minister go all out and give 100 per cent., but neither the hon. Lady nor I have to find the money. However, this is a valuable concession which will be much appreciated by those to whom it may become applicable. It will give to disabled men a right to a higher rate of pension without their having to go before the National Assistance Board.
None of the Questions this afternoon mentioned the deaf. I was glad to receive the Minister's assurance that they would benefit because, in my view, the unfortunate deaf seldom receive the sympathy which is accorded to those who are blinded or those who have lost limbs. The disability of those who are deaf is not so obvious. It is a natural feeling of being cut off from the world that tends to make them irritable, and the difficulties of conversation with other people make them irritate the other people, also.
On several occasions the Parliamentary Secretary has said that the door to war pensions was never closed. This afternoon his right hon. Friend opened it and what I hope was a forerunner slipped out. I trust that, as soon as the national situation improves, it will be possible for the Minister to throw the door wide open and to satisfy the just claims of the war disabled and the war widows. When that time comes, and I am sure that it will come during the period of the present Government, I am certain that no one will be more pleased than the Parliamentary Secretary and his right hon. Friend, who have done so much for disabled men.
§ 10.14 p.m.
§ Mr. Somerville Hastings (Barking)
We must all be grateful to the hon. Lady the Member for Blackburn, East (Mrs. Castle) for bringing this matter before the House, as it brings to our notice some most important principles. I do not set myself up as an authority on arterio-sclerosis, but it seems to me quite definitely that, given a tendency for this disease to develop, it would choose the part, the organ or the limb which had double the amount of work to do owing to the absence of its fellow.
Several Questions were inspired today by that case. The Minister in reply, set out a new principle which, in his own words, we may describe as:…a more equitable result would be achieved in these cases by adding one-half of the difference between the existing assessment and the assessment appropriate to 100 per cent.…Then he gave two examples which, in my opinion, prove conclusively the injustice of the very scheme that he puts up.
Let me give them to the House. To take the case of a man who lost both eyes, one through military service and the other through subsequent accident or disease, he indicated in that case that there would be 70 per cent. disability. Then, to take the case of a man who had lost one leg below the knee as the result of military service and the other leg from some other extraneous cause, he then said the disability would be 80 per cent. I ask the Minister whether he would rather hobble about on a straight leg and a crutch or be completely blind? Yet the man who has lost a leg and has to hobble about with a crutch is better off than the man who is completely blind.
I want to suggest that this is quite wrong, and to mention another case, which I wish I had greater time to develop. A man received a gunshot wound in the head, and became stone deaf, and I have seen many such cases in both wars. Being young, he had the intelligence to lip-read, and, except for the disability of slight change of voice, which is always present with persons who are stone deaf, he got on very well. He then became totally blind. What is to happen to that man? When he became blind, even though he was totally deaf before, to all intents and purposes all his communication with the outside 1779 world ceased. I should like the Minister to consider such cases, because I suggest to him that these cases cannot be dealt with by rule of thumb, but that he must deal with each one on its merits.
§ The Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance (Brigadier J. G. Smyth)
I should like to thank the hon. Lady the Member for Blackburn, East (Mrs. Castle) for the kind remarks she made about me, and, in return, I wish to make one or two about her. She brings a great many cases to me, both in correspondence and by interview, and she takes very great trouble about each one of them. Actually, this is the first one which we have been unable, so to speak, to settle out of court, and which she has raised on the Motion for the Adjournment.
I think that the House as a whole has considerable confidence in the Ministry dealing fairly and sympathetically with nearly all the many personal cases which come to us under the war pensions scheme, and I think that that fact is borne out when I say that this is only the second personal case in two and a half years which has been brought up on the Motion for the Adjournment. However, I am grateful to the hon. Lady for bringing up this particular case, for it is a difficult one to answer by means of Question and answer.
Any case of severe disability excites the sympathy of this House, and it would be very sad if that ceased to be the case, but I, as Joint Parliamentary Secretary to the Ministry, have to deal with the matter as objectively as I can. The history of this case has been given by the hon. Lady. It is perfectly clear that, 37 years ago, Mr. Barnes lost his left leg in action, and that for 34 years he has been wearing an artificial leg. He was in work until 1952 and his pension was at the 60 per cent. rate.
Then, at the age of 61, he showed symptoms of senile arteritis, or arteriosclerosis in the right leg. Gangrene began, and, eventually, an amputation became necessary and was carried out in November last year. The hon. Lady submits that the cause of this arteriosclerosis was the amputation of the other leg and the wearing of an artificial limb. 1780 I want to make the point that the war pensions scheme is one for war disabilities. All ex-Service men are jealous of that fact and wish to keep the priority that exists as between the true war disability and the disability which is perhaps a half-war and half-peace one.
§ Dr. H. Morgan (Warrington) rose—
§ Brigadier Smyth
I have very little time and cannot give way. This case falls into two distinct categories. The first is the purely medical category under which the hon. Lady brought this case, and the second is that of paired organs. The hon. Lady did not bring this case up as a paired organ case, and it would have been a waste of time for her to do so, because under the paired organ scheme which existed until today Mr. Barnes could have obtained only a 50 per cent. pension and he is already in receipt of a 60 per cent. pension. The hon. Lady was quite right in not attempting to bring the case up under that scheme.
I do not want to go at all deeply into the paired organ scheme, because that is not really the matter that we are considering, but if anyone wishes to study it—it is nothing new—it is set out in the Hancock Report of 1947. Considerable mention of it was made at Question time today, and in his announcement my right hon. Friend gave a considerably increased assessment for paired organ cases. In this case the increase in the pension amounts to 20 per cent., which is considerable. The hon. Lady was correct in her general assessment of what that will amount to, but, as she knows, the one wish of nearly all war pensioners is that their war pension should be increased rather than that they should be dependent upon National Assistance.
I should be giving great distress to all amputees in this country if I were to admit that because a man had lost one leg and had worn an artificial limb he was thereby more likely to have arteriosclerosis than anyone else. I also wish to say, most emphatically, that a great consensus of medical opinion is to the opposite effect. Naturally, on this point we have a tremendous wealth of experience in the old Ministry of Pensions and the new Ministry of Pensions and National Insurance. Our hospital at 1781 Roehampton is world-famed, people coming to it from all over the world to obtain opinions about amputation and limb fitting and the various accompanying ailments.
In addition to that consensus of medical opinion, a test case exactly similar to that of Mr. Barnes—I have studied it very carefully—was submitted to two independent medical experts in 1948. They were quite emphatic in their opinion, which entirely agreed with that of the consensus of medical opinion which I have mentioned. There are two points that I should like to mention. The average age at which the disease appears is 50.
Despite the fact that he had been wearing an artificial limb, in considerable discomfort, as we admit, Mr. Barnes was 61 when the disease first appeared and is now 64. The disease attacks un-wounded civilians in exactly the same way as it does people with a war disability. In fact, at the moment, we have attending Roehampton Hospital 20 to 30 civilians who have had limbs amputated because of the disease. My doctors in the Ministry consider that if Mr. Barnes's left leg had not already been amputated the chances are that it would have had to be amputated from arterio-schlerosis, with the other leg.
I know that the hon. Lady has taken the greatest trouble to get what she considers highly reputable medical opinion to support her point of view. Medical opinion is always highly reputable when it agrees with our own opinion. The hon. Lady has quoted from the medical opinion the little bits which I perhaps 1782 should not have quoted, but not the principal bits, one or two of which I should certainly like to quote. The first is:It is very difficult to say if the condition which caused him to have an amputation was the result of the stress and strain of wearing artificial equipment, but I think that it would be worth while to make a claim on that basis.The other is:There are no physical signs to which I can point in support of the claim that the latest episode of gangrene is related to his original amputation.In essence, both those local doctors say to-the hon. Lady: "Have a shot at it," and. I think she was quite right to do so.
There is no reasonable doubt in this case. There is a great consensus of medical opinion, and the Minister, as he is bound to do—or rather his predecessor did in an exactly similar case—referred the case to two independent medical experts. It is possible that the Rock-Carling Committee which is sitting at the moment may throw some light on these cases that we do not yet have. I assure the hon. Lady that if that proves to be so, we shall re-examine and reassess Mr. Barnes with a whole lot of other cases. As things stand at the moment, I cannot alter the decision I gave to the hon. Lady when I answered her Question on the Floor of the House. I am very grateful to her for giving me this opportunity to make this explanation.
§ Question put, and agreed to.
§ Adjourned accordingly at Twenty-eight Minutes past Ten o'clock.