HC Deb 26 April 1955 vol 540 cc898-906

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

10.22 p.m.

Mr. Arthur Moyle (Oldbury and Halesowen)

I propose on the Adjournment to raise the question of those ex-Service men who have fallen victims to the disease known as disseminated sclerosis. There are, I believe, about a thousand—perhaps a few more—of those ex-Service men who took part in the last war and who, subsequent to their demobilisation, fell victims to the disease.

I do not want to say too much about the disease. The Parliamentary Secretary knows much better than I do the nature of it, and I have no doubt that the report of the debate will be read by those who are affected by it, and one has to be extremely careful, in referring to it, not to cause undue distress amongst those on whose behalf I speak tonight.

Here we have a number of ex-Service men, most of whom have seen active service, who were called up and declared to be medically fit, who were placed in category A, who did active service and many of whom were wounded in battle. As a result, their wounds have been subject to investigation by the Parliamentary Secretary's Department for the purpose of assessing pension, and pensions have been awarded for the wounds at a rate of 20 per cent., 30 per cent. and so on.

I understand that most awards were about 30 per cent., but a few cases have been admitted by the appropriate tribunals as having been aggravated by war service and, as a result, in those cases the pensions have been increased accordingly, But half of them who were called up, took part actively in the war, were wounded, returned to civil life and resumed their civil occupations, and at some point thereafter fell victims to this disease.

The procedure has been that application has been made by the ex-Service man affected by the disease to be considered for an increase in pension. The Minister has replied that on the advice of his medical experts the disease is in no way caused or aggravated by the man's war service or his wounds, and, therefore, the claim has been disallowed. It has then been referred to the Ministry's tribunal, to which the Ministry's expert advice has been given, and the claim has been rejected. The claim has then been referred to the appeals tribunal, and turned down. The final arbitration has been that of the independent tribunal which has considered the matter and turned the claim down upon the expert medical evidence given that the disease was not caused or even aggravated by the appellant's war service.

This sort of procedure is common to most of those who are affected by the disease. This came to my notice through a constituent of mine who is suffering from the disease. After I had gone into the matter, I felt that the Minister ought to look at the rules and the present terms of the Royal Warrant to see whether there was not a case for giving this body of ex-Service men the possibility of being assessed at the 100 per cent. disability rate.

I will tell the Minister why. First, it is admitted by all the experts that they do not know the cause of the disease. If that is so, why should not the benefit of the doubt be given to the appellant? The constituent of mine, a young man in category A, a well-known athlete in his regiment, returned—

The Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance (Brigadier J. G. Smyth)

On a point of order. The hon. Member for Oldbury and Halesowen (Mr. Moyle) is now referring specifically to a case which has actually been before an appeal tribunal. Therefore, Mr. Speaker, the case is not within my jurisdiction.

Mr. Speaker

I understand that is so. I caused the hon. Member to be informed that once a case has been dealt with by the independent tribunal it is entirely outside the Minister's jurisdiction and the Minister has no responsibility for it. Therefore, the hon. Member should make his point without identifying the case so as to bring his remarks within the possible misconstruction that he is either criticising the tribunal or asking the Minister to take some action for which he is not responsible.

Mr. Moyle

I regret that departure, Mr. Speaker. I am aware of the difficulty and will confine myself to the generalities of the case.

As it is admitted by the medical experts that the cause of the disease is unknown, why should not the benefit of the doubt be given to ex-Service men stricken by the disease who have rendered active service, some of whom, if not most of whom, have been wounded in the course of battle, and then returned to civil life before being stricken down by the disease?

I want the Parliamentary Secretary to convey this to the Minister. Does he realise the inevitable distress that is caused, not by the Department or those in charge of it, but by the prolonged consideration of these appeals by one tribunal and another in order to ascertain whether the appellant has a case for a higher assessment than that fixed by the Minister? I should like to know what is the exact cost to the nation, including the administrative costs, the costs of the experts, medical, legal and of those who man the tribunals and who try to dispense justice. I do not know what the cost is, but in this modern age, with the development of the Welfare State and with our whole body of social insurance schemes, is not the time overdue to revise this machinery of justice in the light of post-war circumstances which have arisen from the operation of our Welfare State?

The British Legion and various other voluntary organisations are trying to assist these poor people by gifts to supplement what they receive from the National Assistance Board. I am certain that it does not express the wish of the nation that these people should be dealt with in that way.

It would be an act of humanity and of sensible administration if these people were lifted entirely from the ambit of controversy as to whether their illness is due to, or is aggravated by, their war service. They should be put on an entirely different basis so that they would receive the benefits that would accrue to them from the Minister if their assessment had been 100 per cent. It would reflect greater credit on the nation if that were done. I hope that the Parliamentary Secretary tonight will say something in reply to my plea on behalf of these men, who have served the nation well, and will say that there is hope that they will receive consideration when the Royal Warrant—as I hope it will be—is soon reviewed and revised.

10.33 p.m.

The Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance (Brigadier J. G. Smyth)

I am grateful to the hon. Member for Oldbury and Halesowen (Mr. Moyle) for raising this matter in such a moderate way, because I know how strongly he feels about it and what a great deal of thought he has given to it. I am also grateful to him for raising this very distressing disease of disseminated sclerosis, which has often been mentioned and discussed in the House but which, I feel, is not properly understood.

I should like to get the hon. Member's plea into proper perspective. Since the last war, we have had a comprehensive social security scheme, including the National Health Service, which covers everybody in the country. It is a scheme of which we are all very proud. We also have a war pensions scheme to compensate, in addition, for disabilities due to war service.

The Royal Warrant could not be clearer than it is on this point. Article 3 says: Under this Our Warrant awards may be made where the disablement or death of a member of the military forces is due to service. It also makes clear the rules with regard to entitlement to pension, and that the onus of proof is on the Minister, where the claim is made or the death takes place within seven years of the termination of service. However, in all these cases, whether they are within the seven years or whether they are not, disablement, to come under the war pension scheme, must be causally related to service. That is the qualification, and that has been the qualification ever since the First World War.

In the First World War two-thirds of the casualties were wounds, gunshot or shell wounds. In the Second World War, on the other hand, the causes of two-thirds of our pensionable cases were diseases. In order that a war pension can be given, those diseases must have been causally connected with service. That is absolutely clear in the Warrant, and has been understood ever since the Royal Warrant has existed.

The hon. Gentleman has made the old claim, "Fit for service, fit for pension." That claim used to be pressed years ago, but it has been abandoned by all the ex-Service organisations now. There is no pressure for that claim now, particularly since the introduction of the social security scheme.

Arguing this case logically and not sentimentally—and I know that the hon. Gentleman will understand that I must not do the latter—we come to this, that in every case of disease like disseminated sclerosis, the question is, was it caused or aggravated by service? That is the whole qualification, and the pension can be granted under the war pensions provisions only on a medical Certificate, by the Ministry's medical officers, or by a tribunal, to which the hon. Gentleman referred, that the disablement is causally related to service.

Let us now come to this terrible disease, disseminated sclerosis. I should like to assure the hon. Gentleman that since I have been in this job I have taken a tremendous amount of trouble about this very horrible disease. I have not merely taken the advice of my medical officers, which I am sure is based on very sound premises, but I have talked to sufferers from the disease all over Britain, in England and Scotland, too, in hospitals and in their own homes. I have done so with the idea of trying to see whether there was any common basis for this disease. I have even talked with their parents. As a Minister, one cannot see the parents of all pensioners. If one had to do that there would be no end to the inquiries. However, on occasion Members of Parliament have brought here the parents of boys who have this terrible disease and I have met them. They refused to believe that their sons could have got this disease had it not been caused by war service, as the hon. Gentleman maintains.

There has been a series of very important judgments by the Court of Session and the High Court in recent years on this disease. I would assure the hon. Gentleman that the whole outlook of my Ministry on these matters is, "Can we give the man a pension for this?" and not "Can we find any reason on which we can rule him out?" If we can award a pension within the terms of the Royal Warrant we seek to give one.

I should like to tell the hon. Gentleman one or two facts about the disease. It is one of the most common diseases of the central nervous system. It is a progressive disease of unknown origin, and its progress is usually intermittent. I have talked to boys who have had an attack and then been perfectly all right for about three years before having another attack. Women are more frequently affected than men, in the proportion of about three to two.

The disease is most prevalent in Northern and Western Europe and rare in tropical and sub-tropical countries. It is found in persons of widely differing occupations and in all strata of society. It was remarkable that in the First World War, when we had thousands of young men who changed their habitat and their mode of life and underwent all sorts of risks and stresses and strains, there was among them very little disseminated sclerosis.

Mr. Moyle

On the point about the difference between the First World War and the Second World War, I understand that a number of rare diseases were discovered among our Service men in the last war which were not known in the first.

Brigadier Smyth

I have had a good deal of experience, for instance of Far Eastern prisoners-of-war, in whom I have been specially interested and who underwent particular stresses and strains. It is remarkable that I have come across only a very few cases of disseminated sclerosis among them.

The thing that we do know—and this, I think, is the really important feature from the point of view of the argument that the hon. Gentleman advanced—is that it cannot be considered in any way to be a military disease. There is no sign that people are more prone to disseminated sclerosis in the Forces, whatever stresses and strains they underwent, than are people in civil life. That is absolutely proved and clear. It is not a military disease in any shape or form.

Nevertheless, we try in my Ministry to stretch the Regulations to help these boys in any way we can. In cases where a man is subjected to a sudden shock and then, within a short period of time, he shows signs of disseminated sclerosis, we say that perhaps the shock, although we know it has nothing to do with the disease, might have accelerated its progress. Therefore, we give pensions for aggravation. I have here the figures of the last war cases of pensions given for aggravation of disseminated sclerosis. We have made 1,538 awards and there have been 1,117 rejections.

Mr. William Ross (Kilmarnock)

When did the Ministry start making these awards?

Brigadier Smyth

Since the last war.

Mr. Ross

Yes, but when did the hon. and gallant Gentleman start making them?

Brigadier Smyth

Since the 1939–45 war. That is the number of awards made. I think that will show the position, considering that this is not a military disease and that if it were more people would get it in the Service than in civil life, which has absolutely proved not to be the case.

I occasionally get complaints from civilians who are lying in bed in hospital next to a war disability pensioner. They complain that with the same disease they are not getting the same concessions as the war disability pensioner. I make that point only to show the hon. Gentleman that there are two sides to the question in what is not a military disease. I do not think anyone lays claim to that, and I am convinced from my experience of the way in which these cases are dealt with in the Ministry—certainly since I have known them and, I am certain, in the reign of our predecessors who dealt with them in exactly the same way—that the terms of the Royal Warrant are interpreted as generously and humanely as possible.

Mr. Moyle

The only point about which I am really concerned is that the benefit of the doubt should be given to the appellant in these cases and that the terms of the Royal Warrant should be amended to cover that particular case.

Brigadier Smyth

I could not agree for a moment that the Royal Warrant should cover all those cases. It gives the benefit of the doubt, but the hon. Gentleman is trying to make out that because a soldier gets a civilian disease he should therefore get a military pension for it.

Mr. Moyle

Not quite that. My case is that, as the cause of the disease is not known by medical or any other experts, it is therefore very difficult to ascertain beyond any doubt that a man's active war service was not at any rate a factor in aggravating this disease, if not the cause of it.

Brigadier Smyth

As I told the hon. Gentleman, we have been very generous in our interpretation of "aggravation." The hon. Gentleman is trying to persuade me to admit that a disease that everyone knows is not a military disease should be pensioned under the war pension scheme. I do not think that any ex-Service organisation or anyone at all has agreed to that. The whole criterion of the war pension scheme is: was the disability, whatever it was—obviously a wound is easy to ascertain—causally connected with the war service? If it was, then the disease is pensionable. If it was not, the man is in exactly the same position as all the thousands of other people who get disseminated sclerosis in this country. Just as many people get the disease in this country in civil life as in military life and they are all covered by our social security scheme and our National Health Service. All we can do in the war pension scheme is to compensate the man for any disability he suffers as a result of war service.

The scheme was never intended to be a scheme which for the rest of the man's life, whatever sort of ailment he got, would compensate him with an increase of war pension. That has never been the intention of the Royal Warrant under any Government. I believe that the hon. Member has been a little confused about that. Most people who have seen the Warrant in operation and the way it has been handled in the Ministry, both in my time and before my time, would agree it is done in the most human way possible. I assure the hon. Member that that is so.

Question put and agreed to.

Adjourned accordingly at ten minutes to Eleven o'clock.