§ 18. Dr. Strossasked the Minister of Pensions and National Insurance whether it is now accepted that prolonged inhalation of noxious dusts can cause injury to lungs and bronchial tubes without any changes shown on X-ray; and whether he 11 will instruct the pneumoconiosis panels to examine every worker clinically as well as radiologically when a claim is made.
§ Mr. Boyd-CarpenterAs a general proposition, I have no reason to disagree with the first part of the hon. Member's Question, though its application is limited to certain classes of case. As regards the second part, I am satisfied that in the case of pneumoconiosis there is proper opportunity for clinical examination whenever it is needed.
§ Dr. StrossWhile thanking the Minister for the first part of his answer, may I take it that he agrees that every case about which there is any doubt at all should appeal if the person concerned is rejected only on X-ray examination?
§ Mr. Boyd-CarpenterIt is certainly not for me to advise appeals, whether on that basis or any other, but I think, perhaps, the hon. Gentleman is in any event anticipating his next Question.
§ 19. Dr. Strossasked the Minister of Pensions and National Insurance how many workers were examined for pneumoconiosis in England and Wales by the pneumoconiosis panels in the last year for which figures are available; of these, how many claims were rejected on X-ray examination alone without clinical assessment; and how many of these latter cases were assessed as suffering from pulmonary disability after they appealed and were clinically examined.
§ Mr. Boyd-CarpenterIn the year ending 30th June, 1957, 13,597 persons were examined by the Pneumoconiosis Medical Panels in England and Wales following claims for benefit under the Industrial Injuries Acts. Of these, 6,512 were rejected on X-ray examination. There were 372 appeals against disallowance on X-ray examination and, after clinical examination, 39 of these appellants were found to be suffering from pneumoconiosis.
§ Dr. StrossDoes not the right hon. Gentleman agree with me that his answer gives point to these two Questions, namely, that if it is at all possible, and as soon as possible, every case should be examined clinically and not only radiologically? Does he not further agree that, however valuable radiological examination may prove to be—and, of 12 course, it is valuable—it does not entirely replace clinical assessment?
§ Mr. Boyd-CarpenterI should not like to generalise on as complex an issue as this. As the hon. Gentleman no doubt knows, the advance in X-ray examination in these cases in recent years, particularly at the hospital at Llandough, has been quite remarkable. I really would not like to seek to lay down any general proposition. In reply to the hon. Gentleman's earlier question, it is the fact that in cases of appeal there is a clinical examination in addition to the X-ray examination.
§ Mr. Boyd-CarpenterI cannot say without notice. It would certainly be the large majority, but I will get the figure if the right hon. Gentleman wishes.
§ Mr. J. GriffithsIs the right hon. Gentleman aware that there is a growing feeling that the criterion used in assessing and judging these cases ought to be reviewed in the light of experience gained in past years and, in particular, in the light of experience gained in the hospital to which he has referred?
§ Mr. Boyd-CarpenterThere has been great progress in scientific examination not only into the diagnosis but, I am glad to say, in the treatment of this appalling complaint. I am not aware, although a number of questions have been raised, that the main principles of the Industrial Injuries Act have been shown to be inappropriate.
Miss LeeIs the Minister aware that a higher percentage of miners who are certified to be suffering from pneumoconiosis are also certified as fit for light work? Will he therefore look carefully at Questions Nos. 1 and 2 which I asked relating to this matter, because a problem in many of our mining areas is that although it would be good for men to have light jobs—indeed, they want light jobs—and although they are certified fit for such light work, there is no such work available?
§ Mr. Boyd-CarpenterI acknowledge that that is a problem and has been so for many years.
§ Dr. StrossAs the right hon. Gentleman's answers have been only partially satisfactory, I beg to give notice that I shall raise the matter on the Adjournment.