WAR DISABLED PENSIONERS (Hansard, 10 May 1956)

§ Mr. Raymond Gower (Barry)
For the short time at our disposal tonight, I wish to focus the attention of the House upon that part of the Ministry of Pensions and National Insurance which deals with the pensions paid to those who were wounded in two world wars.
When I gave notice of my intention to raise this subject, I gave the names of two persons, Mr. Martin Harraher and Mr. Chaffey. These are the names of quite dissimilar cases affecting two of my constituents, but I stress that if I refer to these two cases as my chief examples, they are also illustrations of many others which exist up and down the country, of which, I am sure, hon. Members on both sides of the House have had experience. 1547 For some time I have been a little uneasy about the appreciation of some of these cases by the Department and its medical advisers. I am, of course, cognisant of the excellent work which has been, and is being, done. I realise the generous help and assistance which is given by the Ministry in many cases. I know perfectly well how anxious my hon. Friend the Joint Parliamentary Secretary is to do all in his power to help those who suffer for their service to their country and to us all.
However, occasionally cases have come to my knowledge which have made me uneasy. Is there not, perhaps, sometimes a disposition in the Department and on the part of its advisers to take too restrictive a view of the possible effects and consequences upon men in later life of the wounds they received in war time? Let me, therefore, cite the facts of my first example.
My constituent, Mr. Martin Harraher, of 15, Forest Ride, East Barry Island, is an ex-Service man of the First World War. Demobilised in 1919, he was granted a 30 per cent. war disablement pension, attributable, so I am advised, to chronic bronchitis, malaria, and gunshot wounds. In 1923 the worsening of his chest condition led to an increased assessment of 40 per cent. In 1924 another disability, rheumatism, was accepted by the Ministry as due to war service, and that led to a 50 per cent. grant. In subsequent years my constituent was on several occasions re-examined, and ultimately, in 1932, a 100 per cent. pension was granted to him.
After a long period of fifteen years, it was stated, in 1947, on behalf of the Department that the chest condition had improved, and the pension was accordingly reduced to one at the rate of 60 per cent. My constituent's health has since been poor, but this is attributed by the Ministry as due partially to high blood pressure, and is stated to be quite unconnected with Mr. Harraher's war service. I am assured locally by his friends and by his local medical adviser that he is in a poor state of health.
In the past, malaria, bronchitis and rheumatism were all accepted as due to war service, as, of course, were gunshot wounds. Is it now submitted that his general debility, his blood pressure, etc., 1548 are quite unconnected with these other troubles? Is it really possible to apportion consequences with such mathematical exactitude? His condition, I am assured by people who know him, his general state of health, is indeed worse today than at the time when he was receiving a pension at the rate of 100 per cent. I ask my hon. Friend whether, in cases of this kind, his Department takes too narrow a view of the natural consequences which may follow war service and disablement many years ago?
Again by way of illustration I would briefly refer to the facts in another case. This is the case of my constituent, Mr. L. C. Chaffey, who lives at 5, George's Row, Eastbrook, Dinas Powis, near Cardiff. He is an ex-Service man of the last war. He served from 1939 to 1945.

§ The Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance (Mr. Richard Wood)
On a point of order, Mr. Deputy-Speaker. I am a little embarrassed when my hon. Friend mentions the specific example of this constituent of his because the case. as he knows, has been subject to a pensions appeal tribunal, and I believe it is not in order to discuss it in personal detail.

§ Mr. Deputy-Speaker (Sir Charles MacAndrew)
If it is sub judicewe cannot deal with it.

§ Mr. Wood
It is not sub judice. It has been adjudged some time ago. But Mr. Speaker said on one occasion that it would not be in order to discuss such a matter.

§ Mr. Deputy-Speaker
If there is no Ministerial responsibility, there is no point in discussing it.

§ Mr. Gower
On that occasion it was ruled that the Minister was not obliged to reply in detail on the facts, but nevertheless, after a submission similar to this, the hon. Member was permitted to cite the facts by way of illustration of the case which he was seeking to put.

§ Mr. Deputy-Speaker
I do not see how an hon. Member can as an example something about which nothing can be done.

§ Mr. Granville West (Pontypool)
Is it not in order for an hon. Member to raise on the Floor of the House a matter which perhaps might call for action by 1549 the Minister? Is he not entitled to bring to the attention of the House a matter of great importance?

§ Mr. Deputy-Speaker
That may well be so, but that would have to be dealt with by legislation, which would be out of order on the Adjournment.

§ Mr. Gower
I am not asking for legislation. I am asking for a different approach to these cases by the Ministry and its advisers. I submit that too restricted a view is taken of the possible consequence of wounds sustained during two world wars. I have cited, first, a case of the consequence of a variation of pension. I am not asking for legislation; there is nothing in the case which requires legislation. The second case, too—

§ Mr. Deputy-Speaker
The second case which the hon. Member has mentioned is one over which the Minister has no power, and there is no point in talking about it.

§ Mr. Gower
The Ministry has power to take a different attitude in the future if it is felt that there is substance in what I say. That is all. I will not develop that case at any great length. This man is in a terribly poor state of health. He has to go round in an invalid car or hobble along with the aid of sticks.

§ Mr. Deputy-Speaker
Is this the case which has been decided?

§ Mr. Gower
Yes.

§ Mr. Deputy-Speaker
Then it cannot be discussed.

§ Mr. Gower
I will leave that case, and say to my hon. Friend that it is my respectful view that, in arriving at a decision on the facts in such cases, the Ministry and its advisers are governed by too restricted a view. They are governed purely by whether it can be shown clearly that the actual state of health is directly and obviously attributable to some war service. In my opinion, it is impossible to do that. The balance of the human physique is far too delicate to arrive at so accurate a mathematical calculation. I hope that in such cases of 100 per cent. disability as I have illustrated and other cases which have been turned down and about which hon. Members are disturbed, the approach will be somewhat different in future.

§ The Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance (Mr. Richard Wood)
I appreciate the persistence of my hon. Friend in continuing to try to raise this matter on the Adjournment after he had failed under somewhat unfortunate circumstances about a couple of months ago, when the Parliamentary day was rather prematurely cut short. I also appreciate his concern about the two cases which he has in mind, one of which I submit he was quite in order in discussing. As to the other case, I should like to reply to my hon. Friend in general terms, and I am sure he will understand why.
My hon. Friend complained that the Ministry of Pensions and National Insurance tended to take too restrictive, or restricted, a view of the nature and extent of war disablement and as his first example the case of his constituent, Mr. Harraher, whose disablement history he broadly described. Mr. Harraher is now 67. My hon. Friend told us accurately the extent and changes of his disablement and in his pensionable disabilities after the First World War. It was in March, 1924, a date which my hon. Friend mentioned, when his pensionable disabilities—which by that time included rheumatism—reached 50 per cent., that my Department considered whether or not to give this man a final award. It decided that it should not give a final award in this case because Mr. Harraher's diagnosis at that time was a little uncertain.
I think my hon Friend will agree that subsequent events of the next seven or eight years bore out the wisdom of that decision. As my hon. Friend has said, from 1932 Mr. Harraher's disablement was assessed at 100 per cent. for fifteen years until 1947 when, as my hon. Friend said in his speech, his chest condition was found to have improved. One thing which was not said just now was that the reason for the re-boarding of Mr. Harraher in 1947 was the fact that in that year he applied for an unemployability supplement. In 1947, as at the present day, there are many war pensioners receiving a disability pension of 100 per cent. who are in full-time employment. Therefore, it was natural—indeed my Department would have been 1551 acting quite wrongly if it had not done so—to call Mr. Harraher before a medical board when he applied for unemployability supplement. It had to do that in order to determine his eligibility.
In 1947 he was examined by a medical board. He was X-rayed and a report was received from a tuberculosis officer. As a result, his disability on all the counts was found to have considerably improved and was reassessed, as my hon. Friend said, at 60 per cent. I am well aware that Mr. Harraher also suffers from very high blood pressure, but I am quite certain my hon. Friend will agree that some distinction must be made between disabilities which are and can be shown to be a result of a man's war service and disabilities which arise in the normal course of events, and would have arisen whether or not he had ever served in the Army.

§ Mr. Gower
What my hon. Friend is really saying is that a man who has suffered from malaria and from bronchitis and rheumatism in the Army is no more likely to get high blood pressure than a man who has not suffered from those complaints?

§ Mr. Wood
I am not enough of a medical expert to know whether or not it is more likely, but certainly in Mr. Harraher's case it was considered that his high blood pressure was not in fact the result of war disability or the effect of war disability over the period of about thirty years which elapsed since his war service.
In fact, when the disability was reassessed in 1947 at 60 per cent., I can well appreciate that, after all those years, he was bitterly disappointed about the reduction in his assessment, but we are bound by two facts: first, the disability was found to be only 60 per cent. instead of 100 per cent.; and secondly, in a case where we find the disability to be only 60 per cent., we are unable to pay a greater pension than the pension at that scale.
I can reassure my hon. Friend that if at any time there is any evidence of deterioration in Mr. Harraher's case or any other case, it can very readily be reviewed; and his assessment will be reconsidered at any time that he thinks himself to be worse.
1552 The second problem which my hon. Friend raised was the general problem which is connected with diseases of unknown origin. If I am not out of order in saying so, I think that the case which my hon. Friend was a case of that most unfortunate disease, disseminated sclerosis. These cases are profoundly regrettable to all of us, and I am bound to admit that it must be extremely difficult for any man who is seriously disabled when a Government Department says to him, "We do not know the cause of your disease, but the one thing which we cannot accept is that anything which happened in your war service caused it or made it any worse." It has naturally been harder still to accept it since 1943, when the onus of proof was fairly and squarely placed on my Department.
There are two different sets of circumstances in which these difficult problems arise. One is the circumstance in which the man was fit on discharge from the Services and developed the disease later, and the second is the circumstance in which he was fit when he enlisted in the Services and was later discharged with the disease. It is clear that in the second circumstance—when he is fit on enlistment and is discharged with the disease—there is a much stronger presumption in favour of the claimant than in the first circumstance, and for the purpose of these general remarks I will therefore use that illustration.
The question which we ask ourselves is, "Is there any possibility that Service factors caused this distressing disease of disseminated sclerosis?" I think that my hon. Friend will agree, if one considers the question of cause and effect in all its manifestations, that there are always, in any train of causation of which we can think, very strong grounds indeed for presuming that certain causes have certain effects, but there is always a remote possibility that certain effects are not in fact caused by the causes which we think caused them. I hope I make myself clear to my hon. Friend. There remains the remote possibility that we are wrong about disseminated sclerosis and that disseminated sclerosis might be caused by Service factors.
Having said that, however, I should like to quote the judgment which was given nine years ago in a case of this kind 1553 —a case of cancer, another disease of which we do not know the cause—by the then Mr. Justice Denning. He said that evidence …need not reach certainty but must carry a high degree of probability … If the evidence is so strong against a man as to leave only a remote possibility in his favour which can be dismissed with the sentence, ' Of course it is possible but not in the least probable ', the case is proved beyond reasonable doubt. I am convinced that the evidence in this case and in cases of disseminated sclerosis as a whole is so strong as to leave only the remotest possibility that Service factors may have led to its inception.
I am impressed in this respect by the immense weight of evidence in support of that opinion, which seems to show that the disease is no more likely to originate in Service than in civilian life. A fact which has always weighed very heavily with me is the millions of men in the last two wars who served in all theatres of war—and and men, let me say, of an age at which they are likely to be most prone to this disease—and the mere handful, as compared with those millions, of disseminated sclerosis cases which came out of the war. In fact, there was no sign of any upward movement in the incidence of this disease either in the First World War or in the Second World War compared with other years that one might take as a comparison either between those wars or afterwards.
I should like to assure my hon. Friend that I and the Department are immensely sympathetic in cases of this kind, and immensely sympathetic in cases such as he first mentioned—cases where there is a possibility that the disability was caused either by service or by the consequent disability after the war, but we cannot, as I am sure he will appreciate pay pensions where disablement was not due to service.
Our opinion on this disease of disseminated sclerosis is not fixed for all time. I am glad to say that there is an encouraging amount of research going on to try to discover the causes of the disease, but at present—and this is the present position—there does not seem to be any shred of evidence to show that service in the Armed Forces is more 1554 likely to cause the disease than is civilian life. Therefore, we must reluctantly refuse any claims at the moment that disseminated sclerosis is attributable to service in the Armed Forces.

§ Mr. Granville West (Pontypool)
I should not have intervened in this debate, Mr. Speaker, had it not been for the successful attempt of the Joint Parliamentary Secretary to prevent his hon. Friend from dealing with the details of the case of his constituent who was aggrieved by the recent decision of the pensions appeal tribunal. The Joint Parliamentary Secretary took exception to his hon. Friend dealing with the facts of the case, on the ground that it had already been decided by the pensions appeal tribunal. That view was supported by Mr. Deputy-Speaker, who was then in the Chair.
I submit to you, Mr. Speaker, that it is a matter of considerable importance to hon. Members that, on grounds put forward by the Joint Parliamentary Secretary, they should be prevented from raising on the Floor of the House details of matters affecting their constituents when they are seriously aggrieved. I should be glad if you would give your Ruling upon this, in the interests of hon. Members who may wish to deal with matters affecting their constituents.

§ Mr. Speaker
This is a debate upon the Motion for the Adjournment of the House, and it is a cardinal rule about any discussion on that Motion that there must be Ministerial responsibility. It seems to me that the position of the independent appeals tribunal is such that once it has given its judgment the Minister has no further responsibility, and therefore a debate on the Adjournment would become out of order, because there remains no Ministerial responsibility.

§ Mr. West
With great respect I should have thought that the Parliamentary Secretary could guide the House on this, because the members of the pensions appeal tribunal are, in fact, appointed by the Minister and under his control.

§ Mr. Speaker
They are not under his control, they are an independent tribunal, and I think the position as to the finality of their ruling in a disputed case is 1555 statutory. Therefore, once the matter has gone to the independent tribunal, the Minister is, as lawyers say, functus officio.

§ Mr. Gower
You have not had an opportunity of seeing and reading the facts of this debate, Mr. Speaker, but when you have that opportunity you will observe that I was trying to state a general case, and I was using the facts of a particular case affecting a particular constituent by way of illustration. I hope that you will be able to rule that in future it may be permissible to do that in similar circumstances.

§ Mr. Speaker
I should not like to give a Ruling, not having heard the whole of the debate. But what I said about the lack of responsibility of the Minister merely extends to the facts of the case which was decided actually by the independent tribunal. It goes no further than that. General questions about pensions administration still remain a fit subject for discussion on the Adjournment.