§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Kaberry.]
§ 10.1 p.m.
§ Mr. Leslie Hale (Oldham, West)
From the time that I came into this House I have always endeavoured to raise, on the Adjournment, pensions questions such as I shall raise this evening. I have tried as far as possible to raise every aspect of this question without taking a tiresome attitude about it. [Interruption.] If hon. Members who were interested in the previous debate will now retire peacefully and quietly we shall be able to carry on our own short debate without difficulty.
I apologise to the Minister. I understand there are two Ministers now in the combined Ministry, one who deals with pensions and the other who deals with insurance matters. I want to raise the 674 question of people who are suffering from chronic diseases. On 22nd June last year I raised a similar question. There are very few more serious problems to discuss today than the dreadful cases of men who are told that they have a sentence of death lingering over them, it may be for four or five years, or longer—but at any rate a terrible sentence.
Many of us will be aware that the most intractable pensions problems among our constituents are the cases of men who are told they have disseminated sclerosis, Parkinson's disease, various kinds of skin disease some of which are very acute, and industrial diseases like pneumoconiosis or byssinosis. These are some of the gravest cases with which we have to deal. I have suggested to the Minister that he has ample powers, under Sections 46, 47 and 48 of the Act, to make new Regulations. It was not the hon. Gentleman who will reply tonight to this debate, but his predecessor, who tried to frustrate the whole matter on the last occasion when I raised it by stating that he had made certain Regulations, and at the same time complained that I was out of order in raising the matter because Regulations could not be made.
Let me take the case of Albert Slack, a byssinosis case. Byssinosis is a disease which always menaces Oldham. All the evidence shows, I am happy to say, that the disease is not so acute as it was because modern methods of hygiene and control make it less and less a grave menace to the community. Nevertheless, it is still a very serious matter. It is a grave disease, which unhappily produces its own misery, depression and despondency. The man affected lives not merely a physical but a mental wreck. Unhappiness is one of the symptoms of the disease.
This was a man of great respectability and high character, an engine-driver, who drove his engine from Manchester to Sheffield and back day after day. He had to go through a long tunnel, and because of the dust in it he became in the end a victim of byssinosis. He could not at first claim compensation under the existing law. He was not even working in a cotton mill. Let me correct myself, I should say " pneumoconiosis " in this case, because it was caused by dust from coal instead of dust from cotton. 675 They are very similar diseases, dissimilar only in the nature of the dust.
He could not make a claim, because he worked in an industry in respect of which disability from pneumoconiosis could not be claimed. It is fair to say that the Regulations were altered. He suddenly found that he was no longer debarred by the nature of his work from applying, so he applied. My instructions are that, under the new Act, he was examined by a specialist in Manchester who took 14 or 15 X-ray photographs, who had no doubt that the man was suffering from the disease, and who so reported. I have the photostat copy of his report. He had no doubt at all.
Under the Act, however, there comes a day when a doctor knocks at the door and says: " I want to examine you on behalf of the Byssinosis Board." One X-ray photograph only is taken, and a week or two later comes notice of the irrevocable decision that the man is not eligible. That is a shocking state of affairs. I make no criticism of the doctors. I understand that they are grossly overworked, and that the Ministry —and I do not say this in a partisan spirit—and the Minister agree that it is difficult to get experts in this field.
§ Mr. Hale
There are far too few people available to do this work.
When I tried to raise this question on 22nd June last year, we spent 20 minutes on points of order, with the result that the case of Albert Slack was never fully discussed. He died a month or two ago, so his case, with all its implications, has gone to a much higher tribunal. The medical certificate of death said what the Minister said—bronchial pneumonia. I concede that. And, with that certificate, no doubt the case of Albert Slack was filed and pigeon-holed and might have been terminated for ever.
However, as I have said, Albert Slack had a son who is a personal friend of mine and a councillor in Lees, near Oldham. He was not satisfied, and demanded further investigation. It was not a question of money, but he said " My father suffered long and miserably, and miserably he died. I want to know if his 676 claim was just." A post-mortem was performed and an inquest was held. At the inquest there was no question but that Albert Slack had suffered from pneumoconiosis and acute pneumoconiosis. I concede the difficulty of diagnosis—I am not wishing to be unkind about this. I know there is a real difficulty of diagnosis, but at the post-mortem the lungs were found to be thick with dust.
I myself have been to post-mortems and have seen the lungs of miners who have died of silicosis and anthracosis. I have seen sections of their lungs. And what is left now of Albert Slack, who was a kindly man and whom I knew very well, is a section of his lung in the National Physical Laboratory so that anyone can see another example of a miscarriage of justice.
Those things happen. I want to turn to the question of pensions, about which I feel bitterly. I am not making a party attack; I said this five years ago when another Government was in power. There are diseases like disseminated sclerosis, Parkinson's disease and many others, dysidrotic eczema, and various other forms of skin disease.
What is the position about a claim for war service? The onus is said to be upon the applicant. In point of law it is not and never has been. There have been decisions in law that at a very early stage the onus can be shifted. If the applicant establishes his service, his condition, and his disease, a stage is then reached where the onus can be shifted. Men come to me doomed from these dreadful diseases, and all of us know what will happen. It happens in case after case.
I have mentioned dysidrotic eczema. I had such a case in July. I said to the War Office, " Let me have the file." I spent two months trying to get it. The War Office said that a man's medical file was private, as, of course, it should be against a stranger—I concede that—but surely not against the man himself. Yet against him and his Member of Parliament who is helping him the War Office stall and tell them to go to the tribunal, to appeal, and go through all the wretched business.
I took up this particular case and received expert help from my hon. Friend the Member for Stoke-on-Trent, Central (Dr. Stross), who always gives his services most generously on these occasions. 677 The answer that he gave us was he said that nobody knows the cause of dysidrotic eczema. Therefore, of course, no one can discharge the onus of proof because no one can see it. This happens in almost every case.
I have known of men who have gone nearly blind with sclerosis and I have known of them trying to get a cure, yet when we came to the question of diagnosis we were told, " Of course you have got to prove that this is due to war service." Nobody can prove that. I raised this point, probably for the first time, four or five years ago, and we have medical tribunals to determine various diseases. Some say they are due to food, to climate, some to temperature, some to occupation, but nobody knows. Yet we go on year after year defrauding these wretched people of their clear right to support from the State. These are men who have given their all to the State, and we go on with this wretched fraud, and we say, " Go to the pensions tribunal," when we know that no one can diagnose it because no one knows. So it goes on.
I had a case of byssinosis within the last few weeks with which the hon. and gallant Member for Rochdale (Lieut.-Colonel Schofield) had dealt very efficiently. It was in his division, but it was sent to me because it came from the Textile Officers' Union, with whom I am in close contact, and friendship. The hon. and gallant Member for Rochdale did all he could. I am making no possible complaint of that. But here was a case in which a letter comes from the Minister saying that he would not intervene because the matter had been dealt with through the usual channels, a decision had been given, and the local tribunal had established the facts, and there was no power to intervene.
What happened? Professor Lane, who is recognised as the greatest expert on byssinosis, and who is a man of superb technical ability, great experience, and profound skill, said that unless one was disabled 50 per cent. one is not entitled to a pension. The Minister himself, in his correspondence, has said that no one can diagnose a case unless there is 50 per cent. disability. At least, that was the view until recently, I understand that the matter has gone back to the tribunal for reconsideration, but up to recently, unless there was 50 per cent. 678 disability, it was not possible to distinguish byssinotic from bronchial pneumonia.
Professor Lane said clearly that this man was entitled to a pension. What happened? The man went on the insurance officer's statement to the first local hearing, and it refused him leave to appeal. It seems that his claim was refused, even though there was before the tribunal a certificate from the greatest expert in the country on byssinosis in favour of the man. How could an unbiased tribunal refuse leave to appeal in those circumstances? How can it be said that it has applied its mind to the justice of the matter with fairness, with decency, and with consideration? It is a monstrous case. These things happen, and I think hon. Members will agree that they happen rather more frequently than they should.
I want to put a question frankly to the Minister. I suggest to him that there are two main things which can be done in the field of chronic disease. I have said this before, and I say it again. The first is to study this topic in order to cure the disease, spend some money on it, do more in research on sclerosis. We could take over one of the abandoned aerodromes which used to accommodate thousands of people and we could make it a home, a village, a town for the sufferers. They could live in their wheel chairs during the day and could go into the large adapted aerodrome to feed in their wheel chairs. They could have the social services—the cinemas and the theatres. The decencies of life could be provided for them in that settlement.
People who are maimed or crippled or diseased, generally speaking, live more happily with people who are suffering similarly.
§ Sir William Darling (Edinburgh, South) indicated dissent.
§ Mr. Hale
Yes, indeed. I respect the views of the hon. Gentleman, but all our experience in the work of getting people together shows that people with a disability, with the frustrations of that disability, are much happier in the company of other disabled people, and have a sense of collectivity. If we did that, there could be a research centre on the aerodrome where scientists could apply their minds to the question of how to cure this 679 disease. They could apply their minds to the consideration of the symptoms and could watch the treatment. It might take 2d. from the atom bomb but it would be money better spent.
The second thing is something which the Minister has failed to do for four years—the obvious thing. It is to say that once a man has established that he is disabled from the disease, he should be entitled to payment. What does it matter whether he contracted it in the sands of the desert of North Africa or work in a coal mine in Leicestershire—through industry or through Army service, or from some other cause? Why should these people not have pensions? We should save money that is being wasted on tribunals. We should save on the anxiety and the difficulty. The time has come when any Government—I hope there will be a change of Government; I gather there is to be a change of Government in about six weeks—must face up to this serious problem with courage, and not in the sense of apologising for possible mistakes made in the past. I hope that we shall do this.
I take the view that if we are to deal with the problem of chronic disease, we should deal with it collectively. I have lived and worked with byssinosis orders, pneumoconiosis orders, anthracosis orders, and so on, for 20 years. Time after time I have seen wretched sufferers from these diseases applying for 15s. a week, and their cases being fought in the courts at a cost of £200.
§ Mr. Hale
Yes, indeed, I have seen more money spent in fighting a case than it would have cost to give the man his pension for life. This is nonsense.
Let us acknowledge the debt we owe. I plead with the House to do this. Let us take the view that the man who, in the course of his day's labours and his work finds himself afflicted with one of these major disabilities, is as much a casualty in the battle of life, as much entitled to our regard and our assistance, as those who fought on the battlefield or as those who gave their lives in industry or in an accident. We are their guardians, and they are entitled to our care and our love and our respect.
680 I ask the House to notice that, under severe temptation, within a month of a General Election, I have not said one really controversial word about this subject. In the 20 minutes that I have taken, I am sure I have not said a word which could not be accepted by a single hon. Member on either side of the House. I could have asked—I have been very tempted to do so—how many cases have been referred to the Minister and in how many he has intervened. I could have raised criticisms about them, but I preferred not to do it.
I prefer to say that I passionately believe that there are enough hon. Members on both sides of the House who are interested in the matter to press for, and to secure from any Government, better treatment for the chronically diseased and sick than they have had in the past. If my intervention tonight has served the purpose of bringing those hon. Members together and providing a possibility for such a programme, then the last few minutes have not been wasted.
§ 10.21 p.m.
§ The Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance (Mr. Ernest Marples)
The House has always been sympathetic to cases which involve human beings and their sufferings. All diseases evoke the sympathy of the entire House, and rightly so. We all recoil with horror, as was said by the hon. Member for Oldham, West (Mr. Hale), from the thought of the havoc that is caused not only to the body but to the mind by disease. I should have thought that the evil caused to the mind was almost as bad as that caused to the body by the various diseases like tuberculosis, cancer, pneumoconiosis, byssinosis and disseminated sclerosis. I have often hoped that none of them would ever affect me and my relatives and friends, and I am sure that most of us have that feeling.
I have read all the previous debates assiduously and carefully. I have read the debate in October, 1945, when the hon. Member for Oldham, West made his maiden speech, which was on the National Insurance Bill, then passing through the House. As he was a contemporary of mine, I thought that, with due respect, I should read that contribution.
§ Mr. Marples
It was a very good contribution, far better than my own maiden speech.
I asked the hon. Gentleman for details of what he proposed to raise tonight, and he was courteous enough to give me a general idea. He did not, however, give me the points with great precision, and as they were not very precise my reply will lack the precision which I should normally like it to have in a case of this sort. One can only give a precise reply after prolonged study of the points raised.
I turn now to the facts of the case of Mr. Slack. I cannot discuss the ruling that was given by the independent tribunal, because, as a result of a special decision of Parliament, the Minister is not responsible for the independent tribunal. Mr. Slack died on 11th December, 1954. During his life he applied twice for benefit. The first time he had been off duty as an engine driver since July, 1953. He was in receipt of sickness benefit under the National Insurance Acts. In October, 1953, he claimed disablement benefit for pneumoconiosis, not for byssinosis, as the hon. Gentleman rightly said.
The claim was disallowed; it was disallowed not by the Minister but by the independent authority appointed under the National Insurance (Industrial Injuries) Act. The reason for that was, of course, that since 5th July, 1948, Mr. Slack had not at any time been employed in an occupation scheduled for that purpose under the National Insurance (Industrial Injuries) Act. The Minister has no more power to interfere with that decision than he could interfere with the decision of one of Her Majesty's judges.
Then my right hon. Friend the Minister of Pensions and National Insurance, who has been very sympathetic in these matters, introduced regulations which altered the conditions under which disablement benefit for pneumoconiosis could be claimed, and they came into force on 11th January, 1954. Under those regulations, pneumoconiosis was prescribed for men who had never worked in a scheduled occupation, but were employed in an occupation involving exposure to dust. That was a very wide extension of the field. The regulations also laid down that before the independent statutory authority referred a claim for medical examination there should be reasonable cause to believe that the man was suffering or had 682 suffered from pneumoconiosis. The independent statutory authority held that there was reasonable cause to believe that Mr. Slack had experienced exposure to dust.
Mr. Slack was examined and that medical board decided, following a radiograph of his lungs, that he was not entitled to benefit. Pneumoconiosis diagnosis is difficult, as the hon. Member for Oldham, West said. It is very difficult in life and it is not certain even in death. I have just made a visit to a pneumoconiosis medical panel, at Cardiff, where for the first time in my life, I handled lungs from a post-mortem. I did not particularly enjoy it. I looked at various specimens of lungs taken from diseased persons and talked with the doctors. It is one of those things about which certainty and mathematical exactitude is not possible.
Everyone absorbs dust. Town dwellers absorb dust, but it is only significant when it reaches one point and that point is the diseased state. We have all got it in our bodies to some extent. Those who live in London must have a certain amount of dust in their bodies. The question is, at what point does it become a disease? It is a question of degree. On that particular case of Mr. Slack—again, I record facts and make no criticism—the postmortem said that it was " cardiac failure secondary to right and left ventricular hypertrophy slightly accelerated by pneumoconiosis "—not acute pneumoconiosis as the hon. Gentleman said.
§ Mr. Hale indicated dissent.
§ Mr. Marples
It was slightly accelerated by pneumoconiosis; it was not acute pneumoconiosis.
Knowing the interest which there would be in this case and the claim which had been made, Dr. K. F. W. Hinson, who has special experience in pathology and pneumoconiosis and who is Director of Pathology at the London Chest Hospital, examined the lungs of Mr. Slack after he died and confirmed that it was severe bronchiectasis. He said that there was some fibrosis not associated with 683 dust deposits and he concluded that the lungs showed the chronic disease bronchiectasis. The infection fibrosis and collapse associated with this, would lead to cardiac failure. The minimal degree of pneumoconiosis present would not be a contributory cause. All I say to the hon. Gentleman is that I am not qualified as a medical man to argue with him and I am not legally empowered to discuss the particular facts of the case. For the purpose of the OFFICIAL REPORT I put on record what was undoubtedly found by these eminent doctors.
The hon. Gentleman said that chronic diseases ought to be more sympathetically treated by the Government. I only have a few minutes in which to make my speech and I hope that the hon. Gentleman will excuse me if I proceed quickly. He said that the Industrial Injuries Scheme should cover diseases such as bronchitis which may sometimes be aggravated by employment, but which are not at present prescribed. Probably Mr. Slack's case has helped him to say that. It has never been claimed that the Industrial Injuries Scheme would cover every disability occasioned by a man's employment. The treatment of bronchitis is very much at the centre of the inquiry by the committee which is at present working on its report under the chairmanship of Mr. F. W. Beney, Q.C. It has the following terms of reference:To review the present provisions of the Industrial Injuries Act under which benefit is paid for diseases and for personal injuries not 684 caused by accident and to make recommendations.I think that that would cover the point raised by hon. Gentlemen. It is being considered very comprehensively.
§ The hon. Gentleman mentioned the case of Mr. Slack to prove his point that he thought that the regulations were inadequate, and he instanced the case of what we call the 50 per cent. rule; in other words, a man should be 50 per cent. disabled before he can get any benefit for byssinosis. That is true. I ought to say this about that particular rule. In the past, opinion has been that there must be 50 per cent. or more disablement before a man can get benefit. The Minister has asked the Industrial Injuries Advisory Council to review the provisions made for byssinosis under the National Insurance (Industrial Injuries) Act and report. The terms of reference are wide and advertisements have been issued for interested parties to give evidence and I will put the hon. Gentleman's contribution to the committee.
§ The Question having been proposed after Ten o'clock and the debate having continued for half an hour, Mr. DEPUTY-SPEAKER adjourned the House without Question put, pursuant to the Standing Order.
§ Adjourned at twenty-nine minutes to Eleven o'clock.