HC Deb 29 October 1958 vol 594 cc289-312

10.0 p.m.

Mr. R,. E. Prentice (East Ham, North)

I beg to move, That an humble Address be presented to Her Majesty, praying that the National Insurance (Industrial Injuries) (Prescribed Diseases) Amendment Regulations, 1958 (S.I., 1958, No. 1068), dated 26th June, 1958, a copy of which was laid before this House on 2nd July, be annulled. On the last occasion that I moved a Motion of this kind, affecting the Ministry of Pensions and National Insurance, one right hon. Gentleman opposite suggested that he had never heard an hon. Member who moved a Prayer less anxious that his Prayer should be answered, and I must admit that, to a certain extent I am very much in the same frame of mind this evening. In moving this Motion, I do not hope that the House will reject the Regulations, because there is a great deal in them which I think both sides of the House should welcome. At the same time, we wish to comment on some points in the Regulations, to make one or two reservations and on one point in particular to express some rather grave doubts.

These Regulations replace Part I of the Schedule under the National Insurance (Industrial Injuries) Act by a new Schedule. In doing so, they make alterations in the prescription of no fewer than 22 of the 42 diseases listed there. In most cases they provide some widening of the cover; in other words, they will possibly provide the benefits of the Act to workers who were previously excluded, In almost all of those cases I think that the Regulations will affect only very small numbers of people, but in so far as they provide an extension of the cover under the National Insurance (Industrial Injuries) Act, we should welcome them.

I say that against the background that I have always been rather worried by the fact that there are a great number of casualties of industry who fall between two stools. They are people who have not suffered an injury by accident and have not suffered from a disease which comes within the Schedule, but who, nevertheless, have suffered because of a process of work or a disease not in the Schedule and not covered by the Act. That is one of the imperfections of an otherwise very good piece of legislation. Because of that, we should welcome anything which will narrow down the number of people who will fall between two stools.

These Regulations are based upon a Report by the Industrial Injuries Advisory Council entitled "Review of the Prescribed Diseases Schedule" and first published in April of this year. Going carefully through its recommendations, I believe I am right in saying that all the changes which it recommends have been followed exactly and that the Regulations do not depart at all from the changes which the council suggests.

In studying the Report I came across a great deal of technical discussion and jargon and a great many long words, and I am glad to say that my comments will not involve any of the long words, although, as it is one of the functions of the Opposition to cause trouble to the Government, I should like to challenge the "top brass" of the Ministry who are on the Government Front Bench to pronounce disease No. 21. I do not think that I could do so and I should like to hear the Parliamentary Secretary have a go at it.

In discussing these problems the Advisory Council stated in its Report that its terms of reference were only to consider the terms of prescription of the diseases and it was not asked at that time to consider whether any new diseases ought to be prescribed, but in the course of its discussions it makes certain suggestions. It mentions, for example, that there appears to be a case for prescribing bursitis of the shoulder.

The Council mentioned that there appeared to be a toxic effect from a substance called BHC—there is a longer name, but I am glad to call it BHC—and suggested that it might be asked to prescribe this disease. I should like to ask if and when that will be done and if and when this Report will be followed by another to carry that into effect.

I want to refer to dermatitis, because the new Regulations in some ways alter the way in which dermatitis is prescribed. It was covered in the old Schedule under diseases 24 (a) and 24 (b) and it appears in the new Schedule as prescribed diseases No. 41 and No. 42. There has been a rather wider definition of the complaint than before. There is one point upon which I have some doubts. Because of the way this has been reshuffled, there are two types of dermatitis, one is chrome ulceration and the other is dermatitis due to radiant heat, which no longer enjoy a presumption.

Perhaps I should explain that dermatitis is the one disease in the old Schedule which was not presumed to be due to a man's employment. The onus was on the claimant to prove that it was due to his employment, and that is still the position. Because of the way in which the provision has been rephrased, these two types are included in the heading of those diseases which no longer have a presumption. I hope that the position will be watched and I should appreciate an assurance that it will be watched.

I am conscious of the fact that there is a great deal of dissatisfaction among claimants for industrial injury benefit who suffer from this disease because the onus is on the claimant and claims necessarily become rather complex. Sometimes a man may have dermatitis due partly to work and partly to other factors, and a medical board has to try to sort it out. I have found that some medical boards do not take a sufficiently sympathetic view of cases of that kind. That arises because the onus of proof is on the man, whereas for other industrial diseases the man has the presumption in his favour. Since the new Regulations will slightly reduce the number of men who have the presumption in their favour, I ask that the position should be carefully watched.

I want briefly to refer to prescribed disease No. 25 which deals with a number of complaints which may be caused by radioactive substances, X-rays or other radioactivity. Here again, we appear to be making an improvement. For example, certain blood disorders have been prescribed. Previously only leukaemia and aplostic anaemia have been prescribed. There is now a wider definition to include a greater range. It is recognised that radiation may cause cataracts.

I hope that the Minister will give an assurance that all this matter will be kept under review, because this is a type of illness about which public opinion is, naturally, very sensitive. Because nuclear energy is being used in so many new ways, and since there are new nuclear power stations, and so on, the number of workers who may be involved is growing. While completely approving what is suggested in the amendment, I should like an assurance that high-level research is taking place and that the Ministry of Pensions and National Insurance is in close touch with the Atomic Energy Authority and that everything is being done to see that amendments can be and will be quickly brought forward if any new discoveries are made.

I want briefly to refer to a group of complaints with which the Schedule deals, Nos. 28, 31, 32, 33 and 34, various complaints which may be suffered by manual workers. These are not diseases in the sense in which we usually understand the word "disease". There are such things as bursitis of the elbow and bursitis of the hand, and also other complaints which are due to friction or pressure in the course of manual operations and which, quite properly, are dealt with in the Schedule.

Here again, there has been some amendment. A man who suffers from chronic bursitis is now covered, whereas previously the prescription was simply for acute bursitis. But all these complaints are ones which were there in the days of the old Workmen's Compensation Acts. There has not been any addition in this field since the Acts came into force, and there is still no addition, although the Advisory Council's Report suggests that there may be a case for looking at bursitis of the shoulder, and tennis elbow, which is not confined to tennis players but affects many manual workers. In this field there is much scope for research. Many complaints are probably due to repetitive movements at work and they should be covered equally with those that have been covered for so many years.

The two that I have mentioned are obvious examples. Then there is Ray-naud's phenomenon, or the "dead hand", which I know the Council has looked at. I feel that that should be included. There is a need for a field survey of manual workers and the kind of troubles they get from doing repetitive work, and work which involves pressure on various parts of their bodies. There should be a widening of that part of the Schedule.

I now come to the section of the Regulations which causes me the greatest doubt. I refer to disease No. 38, tuberculosis. This disease was prescribed for the first time in 1951. At that time its prescription as an industrial disease was a new departure. For the first time we were prescribing a disease which was common to all sections of the population and not merely to people who suffered an occupational risk, although those who had an occupational risk obviously had a bigger chance of getting it than did the general public. That is why is was prescribed.

The view was expressed at the time that this might be the first of many diseases to be prescribed, because a nurse, doctor, or medical attendant who is dealing with people who suffer from any communicable disease has a greater risk of getting that disease than has the general public, and one would have hoped that the prescription of tuberculosis in the case of nurses and others might have led to other diseases being dealt with in the same way. Unfortunately, the Government have been too cautious in this matter. It may have been something to do with the fact that there was a change of Government in 1951, but caution descended upon them, and no further diseases of this kind have been scheduled.

The change made here narrows the definition of people who are covered for tuberculosis. Four groups of people were covered in the original Regulations, and the fourth group were those whose occupation involved work with material which was the source of tuberculous infection, such as laboratory workers, pathologists and post-mortem workers. The Advisory Council recognised that that might well be interpreted to include people dealing not only with human remains, but with animal remains, and it decided by a majority—it was not a unanimous decision—that that was casting the net too wide, and that people dealing with animal remains ought not to have the disease prescribed for them. These Regulations therefore amend the Schedule to make it clear that only those who deal with human remains are covered.

I want to ask the Parliamentary Secretary to what extent the Regulations as they used to be phrased led to claims succeeding on behalf of people who had been in contact with animal remains. If there were no such claims, or only very few, the change would appear to be unnecessary, but I am more worried at the thought that if there were many such claims we should be excluding a whole class of people. The matter needs very serious examination. Speaking as a layman, I should have thought that a man whose work brings him into contact with diseased animal remains would have a substantially greater risk of contacting tuberculosis than would the general public.

Therefore, he ought to he entitled to the benefit of the Industrial Injuries Act, particularly as the way in which this matter is dealt with in the Regulations makes it clear that for all the occupations—nurses' or anyone else's—there must be "close and frequent contact with the source of the infection". If it were laid down that the people who dealt with animal remains were covered, it would still have to be only the people who were in close and frequent contact with the source of infection. One would have thought that to be sufficient safeguard for the Ministry.

When the Advisory Council considered this matter, it had representations brought to it that certain other groups of workers should he included who are not included at the moment. I have had the benefit of seeing the evidence put before the Council by the Civil Service Clerical Association on behalf of National Assistance Board officers, and I think it was very impressive. At the moment, for some extraordinary reasons which I cannot understand, home helps and even welfare officers employed by the Ministry of Pensions and National Insurance come within the Schedule if they visit people, but officers of the National Assistance Board do not. I should have thought that an unreasonable position.

In making its recommendations the Advisory Council was not unanimous on this point. When the sub-committee's Report was originally brought forward, Mr. C. R. Dale added reservations. I will quote a short extract from them. He said: I am unable to agree with the recommendation in paragraph 52 for removing existing cover from certain workers (e.g. slaughterhouse workers) whose employment involves close and frequent contact with infected animal remains. Furthermore, I am satisfied from the medical and other evidence which we have received that some of those for whom claims for prescription have been made in the course of the present inquiry are at equal risk of contracting the disease as some of those already covered. When the sub-committee's report was considered by the whole Advisory Council, three other members of the Advisory Council supported Mr. Dale's reservations.

The Joint Parliamentary Secretary ought to tell us tonight why his right hon. Friend preferred the majority recommendations of the Advisory Council to the minority recommendations. If we as a House are asked to approve a reduction in the cover for industrial diseases, the onus is upon the Minister to tell us in detail why we should do so. I am not being dogmatic, but am expressing grave doubts and asking that the case should be fully made out and deployed by the Government.

I would like to put one other question to the Joint Parliamentary Secretary. In arriving at this revised Schedule of industrial diseases, how far did the Ministry carry out the advice that it received from the Beney Committee, a Departmental Committee which reported more than three years ago on the whole question of industrial diseases? The Beney Committee examined the matter to which I referred earlier, that there are people who fall between two stools because they do not get the benefit of the Act after having had an industrial accident and their cases do not come within the Schedule of diseases. The Beney Committee concluded that the Schedule was the correct method of covering these industrial diseases.

The Committee also said that because that was so, and because other people were left out of the Schedule, a great deal more research ought to be done by the Ministry into the whole question of industrial diseases, both as to the way in which they are prescribed and whether further diseases ought not to be added to the Schedule.

They asked that there should be a specialist staff always at the disposal of the Industrial Injuries Advisory Council. Is there such a staff, and what advice did it give on the new Schedule? It was suggested that there should be close liaison between the Medical Research Council, the Factory Inspectorate, the Mines Inspectorate, the universities, and other organisations which could give advice. How far has that been carried out?

I feel that the record of the Government has been far too cautious. There are forty-two diseases in the Schedule and only five of them have been added since the 1948 Act came into force, the others dating from the days of the Workmen's Compensation Acts. Also, of the five new diseases tuberculosis is the only one which affects a large number of people. The four others are important but do not affect many people. Our approach to the question has been far too cautious. We are leaving far too many people out of the benefit of the Industrial Injuries Act, and the Government ought to be doing as much as they can by careful research and sympathetic reconsideration to ascertain whether there can be a further extension.

The Schedule is a modest improvement on what went before, and for that reason we welcome it, but I hope it is an instalment towards better things and not the last word.

10.22 p.m.

Dr. J. Dickson Mabon (Greenock)

I beg to second the Motion.

I had never heard of disease No. 18, poisoning by "gonioma kamassi (African boxwood)," and I doubt whether there are many medical men in the country who have yet heard of it. An interesting thing in this regard is that the Council say under this heading: We were informed that no claims had been received in respect of this disease for many years and we considered whether we should recommend its deletion from the Schedule. The Minister of Labour and National Service have advised us however that small quantities of this African boxwood are still being imported into this country. In view of this we have decided to make no recommendation regarding this disease. That is eminently sensible and a very sound argument. The Council is saying "Even though we have no proof from the past that claims arise because of this rare condition, nevertheless because we are still having the material used in this country we will still keep it as a prescribed disease."

That is essentially a good argument, but it is not consistently maintained throughout the rest of the Advisory Council's Report, and that is lamentable. The argument in respect of the rare disease was admitted even when there were no cases, yet when it comes to the argument about veterinary surgeons, the Committee change the terminology. Veterinary surgeons engaged in dissecting the dead bodies of animals are open to infection. This is a claim that can reasonably be made. Yet the Committee says: Animals are infected by both the bovine and human types of tuberculosis, but the evidence before us was to the effect that the risk of veterinary surgeons contracting the disease because of work in general practice is not significant. It is a most peculiar argument to say it is not significant. Does it mean that there is none, or does it mean that there is some? If there is some, it must he of a minimal kind, and I admit that there may not be many. If there is none, surely we can apply the argument of paragraph 15 in respect of poisoning by gonioma kamassi and say that we would admit the logic that the argument applying to that disease might apply to the veterinary surgeons if the Minister could tell us there were none. I hope we shall be told whether there have been any claims, but I am protecting myself in case I get an adverse answer by insisting that the logic of it is to say that there is a possibility.

There is another curious argument in the same paragraph. It says in relation to the argument about veterinary surgeons or anybody else engaged in dissecting the bodies of dead animals", which includes slaughterhouse attendants, butchers and other people. It also says: Moreover, we were told that bovine tuberculosis is declining in this country and is expected to disappear almost entirely in the course of the next seven years or so. That is a most curious argument. It is said that the disease will last for seven years but that we should not worry about it because in seven years' time it will have disappeared and no action is therefore necessary. What happens to those who contract it in the meantime? I should like to know what infallible scientist has been willing to maintain that it will disappear in seven years or so. It is a most curious figure. Why not ten years or a dozen years? Why seven? I should like to know what precise medical evidence is able to maintain this as an argument.

Even if it were sound, even if we knew that by some process such as the Labour Government's Act of 1950 dealing with milk, or by some other process which we established to try to stamp out bovine tuberculosis, it would disappear in seven years, it seems eminently unreasonable to suggest that we should take no action about those affected in the meantime.

Another argument used about the position of veterinary surgeons is that in paragraph 47 where an additional reason is given for their exclusion. It says that in a particular occupational group there must be positive evidence of a special risk for that occupation. The risk has to be such as to warrant the application in day-to-day administration of a presumption that in the ordinary case the disease is due to the nature of the employment. Those who are involved in these matters know how difficult it is to substantiate a matter like that with precise scientific evidence. It is stated in Section 55 (2, b) of the Act, …it is such that, in the absence at special circumstances, the attribution of particular cases to the nature of the employment can be established or presumed with reasonable certainty. Those words were not inserted by Parliament as a mere peroration. They were inserted because it was admitted, as all reasonable men must admit, that one cannot have absolute proof in all these cases. I suggest that the arguments about veterinary surgeons contained in that paragraph of the Report are not fair.

There are two arguments here, and I am trying to demonstrate the invalidity of both. I suggest that we ought to give to the veterinary surgeon the same protection as is open to any other person engaged in health work. After all, he is engaged in health work. Those employed in slaughter houses, too, may be open to this infection and are also entitled to protection. In the last Session we passed the Slaughterhouses Act designed to raise the standards of the methods by which we slaughter animals for human consumption. Surely we should be willing to extend that application of the regulations to those engaged in that work.

The argument advanced before the Committee does not, however, primarily concern these people. As my hon. Friend mentioned, it concerns those who were actively engaged, like the National Assistance officers, in attending people who suffer from tuberculosis. In other words, I am departing from criticising paragraph 38 (d) of the revised suggestions which we are discussing and which affect veterinary surgeons and slaughterhouse workers and turning to paragraph 38 (b), which says in attendance upon a person or persons suffering from tuberculosis, where the need for such attendance arises by reason of physical or mental infirmity; It seems wrong to withhold this from people simply because they are not, in the medical or nursing sense, in attendance on these infected people. Many social workers are obliged to attend them. Indeed, they regard it as their duty to attend these people and to try to help them through all their social difficulties.

I wonder what would be the position of an almoner from a hospital who was infected. As we all know, an almoner is not often medically qualified. She may not even be trained in nursing. She may be simply a social worker. What else is a National Assistance officer than a social worker? I would argue that an almoner might be in a position to claim benefit under this part of the Industrial Injuries legislation while, on the other hand, a National Assistance officer doing precisely the same work as the almoner would be denied it. As my hon. Friend has suggested, the National Assistance officers argued the substance of this matter reasonably well through their appropriate association.

The other matter which is worthy of comment is the Minority Report, at least the submission by Mr. Dale, who put three very fair points which are unanswerable. [An HON. MEMBER: "Is he Mrs. Dale's Husband?"] If he were Mrs. Dale's husband, the Minority Report would have been full of medical jargon, in which case equally it might have blinded the other members with science and run away with much more than the Council did.

In my view, the argument put by Mr. Dale at the end is well worthy of attention by Members of the House. It was that the Committee that was set up had very narrow terms of reference. I should like to read his last two sentences, which states: Action to deal with this anomaly would, however, involve discussion of the basic conditions for prescription laid down by Section 55 (2). Since this would be outside the present enquiry's terms of reference, I am strongly of the opinion that an enquiry into these basic conditions should be undertaken and claims for extending cover for tuberculosis reexamined in the light of its conclusions. In other words, although, as my hon. Friend has said, we welcome a great deal in this proposal, nevertheless we are objecting to the fact that there is here a constriction; that people who are open to equal risk of contracting diseases are being discriminated against, and that the Government are taking, in this regard at least, a retrogressive step.

We should like to see the Minister tonight, first, try to answer all the questions put to him by my hon. Friend and to try to justify this action. At the same time, we should like him to admit that an inquiry on wider terms of reference should be instituted now.

10.33 p.m.

Mr. F. H. Hayman (Falmouth and Camborne)

I should like to make one point arising from what my hon. Friend the Member for Greenock (Dr. Dickson Mabon) has just said. Although there has been a decline in deaths from tuberculosis and although there has been a great decline in the number of occupied beds in chest hospitals and sanatoria, I believe that there has not been a decline in pulmonary tuberculosis itself, partly because many of the active cases are receiving domiciliary treatment. This, it seems to me, would put into danger the National Assistance officers and welfare officers who have to go to the homes of these victims of tuberculosis. If there is to be an inquiry, I hope that this point can be taken into account.

10.34 p.m.

The Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance (Mr. W. M. F. Vane)

I appreciate very much the early remarks of the hon. Member for East Ham, North (Mr. Prentice) in saying that he raised this debate tonight as much as anything because he wanted information, which he thought would be of general interest, rather than that he wanted to oppose the Regulations tooth and nail.

I will endeavour to do what I can to answer the large number of questions which have been asked me by representatives both of laymen and of the medical profession. It is true, as the hon. Member said, that many of the diseases referred to tonight have extremely long and unpronounceable names and that many of the questions are highly technical by nature. I cannot claim to have had the advantage, or the disadvantage, of the hon. Member for Greenock (Dr. Dickson Mabon), who, I believe, is a qualified medical practitioner. All the same, I will do my best.

First and foremost, the need for this review is to bring the Schedule in line with the latest advance in knowledge, because medical knowledge advances continuously, and it is right and proper that we should bring this Schedule up to date.

It is also true, as has been said by both hon. Gentlemen opposite, that these definitions are generally wider than those in the Schedule which they supersede. Certain reference has already been made to Section 55 of the National Insurance (Industrial Injuries) Act, 1946. I do not think that I ought to go very deeply into that which is something really beyond the scope of this Prayer. All the same, I should like to refer to Section 55, because these Regulations must be drafted within the powers which that Section gives to my right hon. Friend, and they cannot, in fact, go beyond.

The hon. Member for Greenock quoted from Section 55, and, if I may, I should like to read the following three sentences: A disease or injury may be prescribed for the purposes of this Part of this Act in relation to any insured persons, if the Minister is satisfied that—

  1. (a) it ought to be treated, having regard to its causes and incidence and any other relevant considerations, as a risk of their occupations and not as a risk common to all persons; and
  2. (b) it is such that, in the absence of special circumstances, the attribution of particular cases to the nature of the employment can be established or presumed with reasonable certainty."
That shows how difficult is this problem and how difficult it is to draw the right boundary lines. That really lies at the root of many of the problems which the hon. Member for Greenock put to me.

In the very nature of the scheme, we have here to draw a line somewhere, and in this sort of world wherever one draws the line difficulties are bound to arise, and it is going to be easy to compare those on one side of the line with those who are just on the other side of the line. It is quite impossible for us to depart, as the House knows only too well, from some such definition. Otherwise, there is no justification for an Industrial Injuries Scheme at all. There must be a definite cause and it must be associated with the man's occupation. That, of course, must apply to the individual case and cannot be treated just as a generalisation. That rules out cover without limit for diseases which are common to the population at large.

As I say, I should fall outside the terms of this Prayer if I were to go much further on this general point.

I will now do what I can to answer the very large number of questions put to me by both hon. Gentlemen opposite. May I say, first, "Thank you" to the hon. Member for East Ham, North for giving me advance notice of some of the points which he proposed to raise.

First, I should like to take tuberculosis. It is probably the most difficult point raised and perhaps the one which deserves the most comprehensive explanation. Tuberculosis is a communicable disease and is, therefore, different from nearly everything else in this Schedule.

The criticism has been levelled that the definition of the new Schedule has been narrowed, and the feeling perhaps is that it should at least have been left as it was even if it had not been thought possible to widen it. In fact, the effect of the change in the definition is much more apparent than real.

How was this decision arrived at? It was certainly not reached without a great deal of eminent advice. The early inclusion of tuberculosis in the Schedule has been referred to. Reference has been made to the Industrial Diseases Sub-Committee of the Industrial Injuries Advisory Council, 1949. There was a limited recommendation as a result of that inquiry and the sub-committee was very careful to point out the repercussions which would result from implementing its limited recommendation. Without any doubt the committee had in mind only tuberculosis from human contact. It stressed, too, the very special condition that one would have to maintain that the contact would have to be close and frequent, that cover could be given to no other group without this condition without making it extremely doubtful whether the infection had, in fact, come from their occupation or whether they had come into contact just as members of the population at large. I say that because I want the House to realise that this is not an easy problem.

Then, in 1955, the Beney Committee made an exhaustive general review of the diseases provisions of the Industrial Injuries Scheme, and it rejected the idea of a general cover; but there was a minority dissent, and there has always been a minority view, which we have heard expressed tonight, to the effect that the cover for tuberculosis and perhaps for other diseases should be made a great deal wider.

The hon. Gentleman asked about the incidence of tuberculosis in this country. I am glad to give him the figure which I asked for, in case somebody should ask that question, because I thought it would help. The number of claims against the Industrial Injuries Scheme since 1952 has dropped year by year. There were 920 new claims in 1952; they have dropped annually, and in 1957 there were only 458. These figures are very satisfactory, and I think that they bear out the general contention that tuberculosis is, for a whole number of reasons, much less severe a scourge than it was only a short time ago.

In 1956 the same sub-committee was asked to review the list, and in its Report it commented at some length about tuberculosis. In the light of that recent Report, and in the light of the Beney Committee's review which took place only three years ago, there hardly seems reason to go over the whole field again, because it does not seem likely that any new factors would be brought into consideration. That 1956 sub-committee offered a more precise definition to be included in the Schedule, and it drew attention to a very few cases—a very few cases: they may equal the number of fingers on one hand, for that is the sort of number; I cannot give the exact number, but it is that sort of number—of men who had been working with animal carcases whose claims had been accepted as a result of the Commissioner's decisions.

The Commissioner has given more than one ruling, and his final ruling narrowed the field considerably.

Mr. Harold Finch (Bedwellty)

There are some cases.

Mr. Vane

There have been cases, a very few cases; but since those earlier cases were accepted the Commissioner has defined the words in the Regulation more narrowly, and it is most unlikely that more than, we will say, an odd case would be accepted in future under the definition as it was left.

Dr. Dickson Mabon

Do I take it that if the present Regulations had been operative at the time when these cases were being discussed the medical supporters would have lost on the ground that the Regulations did not include them? In other words, if there is any case of a comparable kind to come out when we pass these Regulations, and if there is only one case, I suggest that these are bad Regulations.

Mr. Vane

That is the point to which I was trying to address myself, and I was trying to explain why this happened.

There have been the odd cases. There may in future be another. They would not be frequent in future because one can assume from the Commissioner's narrowing of the ruling on this subject that it is extremely difficult for any such to be accepted. But they were accepted for a reason which was quite outside the mind of the sub-committee when it considered the original definition. There is no doubt whatever that when it was considering the case of persons working in the postmortem field it had in mind the human and not animal remains. There is no evidence of any sort that it had animal remains in mind.

It is because of the rather imprecise drafting of those original Regulations that it has been held that working with animal remains was not necessarily to be excluded in every circumstance.

The next point which hon. Members may make is that since this is a very small instance, even if it has come in by infiltration and certainly was not part of the general plan, and since the numbers are very small, why should we not leave the matter as it is, since there may be one person who will be affected in future. The answer is that when we have to face an anomaly, when one is shown to have appeared, as one has in this case, we have to try to be fair as between workers. And it certainly would not be fair to persons working in the animal field if a rare one was included by infiltration and not because the merits of the occupation were considered to have justified it by the experts who have gone into this question.

This change in the Regulations that is opposed by the Prayer was not made lightly. I have been asked about the advice that was taken. The advice referred to in the Report was given to the Industrial Diseases Sub-Committee by a Cambridge professor.

Mr. Prentice

Do we take it that the advice was that a man handling diseased animal remains did not suffer the same risk as the man who might handle diseased human remains?

Mr. Vane

The advice was to the effect that there was no justification for extending this very limited provision to workers in the field of human contacts, and the professor added the opinion already quoted that not only was there no comparable risk but, also, that tuberculosis was a disease whose incidence was contracting rapidly in this country; and he mentioned, perhaps rashly, the figure which has been quoted tonight.

The Minister accepted this recommendation, but did not accept the more general tightening of regulations for the prescription of tuberculosis which the sub-committee offered. Nor, to be fair, did the Industrial Injuries Advisory Council accept the whole of the views expressed by the sub-committee. My right hon. Friend has accepted the advice tendered to him by the Industrial Injuries Advisory Council and I think that the House will agree that what he has done is just, particularly when I say that the rights of those few men whose cases have already been accepted by the Commissioner are safeguarded.

The next disease to which I should like to refer is dermatitis, which is always a difficult one. The presumption of dermatitis due to radiant heat and chrome ulceration has been changed. What does this mean? The question is answered at some length in paragraph 23 of the subcommittee's Report, but the short answer is that the change is immaterial and that there is no intention at all of reducing the existing cover.

On the question of poisoning by BHC, a form of benzene whose name is so long that it defies pronunciation, the sub-committee's Report includes a suggestion that the Ministry should comment on this with a view to inclusion in a future schedule. As yet there are no authenticated cases of poisoning by this substance in this country, but the Ministry is looking into this recommendation and if any cases should arise I am advised that it should be possible for it to be accepted as an "injury by accident."

I shall now deal with the question of manual workers' disabilities—beat knee, beat elbow, beat shoulder and other comparable disabilities, but something more than the common sprain or common knock. The addition of the word "external", which appears in the Schedule as an adjective, is included to remove ambiguity and it defines what, in fact, has always been accepted and it is not intended that there should be any change in practice. It in no way restricts the rights of anyone genuinely suffering from industrial injury.

The Report invites the Minister to put in hand an inquiry into the elbow complaint known as tennis elbow, which, I understand it is suggested, can arise, for example, through bricklaying. My right hon. Friend is seeking preliminary information and is in contact with the T.U.C. about this matter.

Radioactivity is a more general subject and one which is of very great concern to the public. It has a topical interest, as I know living in Cumberland which is not so far from the scene of the accident in the generator. The new Schedule provides wider cover and in their inquiries the Industrial Injuries Advisory Council was in touch and, I believe, still is with the Atomic Energy Authority.

Research of a more general and fundamental kind is not mainly the responsibility of my right hon. Friend. There are the Medical Research Council, the universities and the hospitals and other bodies, all of whom are contributing and working in this matter. We are not indifferent. We want to avoid overlapping which is not efficient, but, nevertheless, my right hon. Friend keeps in touch. One of the senior doctors in the Department is on the Occupational Health Committee of the Medical Research Council and my right hon. Friend has power to initiate research himself.

On appropriate occasions he has done that, but it was never intended that it should be a major research operation. However, he has these powers and the House may be interested to know, since Raynaud's phenomenon was mentioned as a possible industrial disease, that my right hon. Friend instituted some research into Raynaud's phenomenon, which the Industrial Injuries Advisory Council could not recommend for prescription, and into certain aspects of bysinossis which are continuing at present.

I hope that hon. Members will feel that the information I have been able to give meets any anxiety they have about the amended Schedule and especially about tuberculosis, since it is an exaggeration to suggest that the amendment, which was suggested first by the sub-committee of the Industrial Injuries Advisory Council and then by the whole Council to my right hon. Friend, makes any big change. The change is very small, indeed.

This, of course, is not the last word for all time. It is not something to be compared with the law of the Medes and the Persians, because changing circumstances and advances in medical knowledge will doubtless indicate changes in future. However, I hope that hon. Members will accept that in present circumstances the Regulations are fair and in keeping with the spirit as well as the letter of the Industrial Injuries Acts.

10.55 p.m.

Mr. H. A. Marquand (Middlesbrough, East)

Hon. Members are frequently asked, as I have been many times, to talk to various bodies about the work and duties of a Member of Parliament. No doubt, every one of us on such an occasion draws attention to our duty to supervise delegated legislation and our duty to exercise vigilance about it.

Nobody was a more prominent champion of this cause than the right hon. Gentleman the Minister of Pensions and National Insurance when he was in opposition. He frequently moved Prayers and talked about the evils of delegated legislation. Tonight we have had a remarkable proof of the importance of Members of Parliament exercising vigilance in this matter.

Incidentally, we have about five or six times as many Government supporters to listen to this debate as we had three or four hours ago, when we were talking about unemployment, education, house purchase, pensions and many other very important matters. I wish I could feel that their presence here was entirely due to their belief in the importance of supervising delegated legislation. However that may be, I think that all who have listened to what has been said must have been impressed by the care and skill with which my two hon. Friends who moved and seconded the Prayer deployed their case. The House is fortunate that it should have on this side such careful and thorough students of this very complicated and difficult matter, who have brought to bear on it their experience—one as an adviser to a trade union and the other as a medical man.

I possess neither of these expertises and cannot, therefore, attempt to cover the field in the way they, or the Joint Parliamentary Secretary, with the advice available to him, have done. I would. however, like to make a few general remarks before coming to one particular point. The Joint Parliamentary Secretary has, as part of his responsibility, the oversight of the Minister's powers in regard to war pensioners. He specialises in that field, and he must be aware of the great importance of what is called "the compelling presumption," which was enunciated by Mr. Justice Denning, to the great benefit of war pensioners, many years ago. It is well-established that in that field the onus of proof that, within a reasonable period, a person is not suffering from a war injury must lie not upon the claimant, but upon the Minister. I hope that the Joint Parliamentary Secretary will agree that in the case of industrial injuries also the onus of proof should not, so far as possible within the law, be changed to the disadvantage of the claimant without very special reason.

There has been some alteration in one particular in the matter of the onus of proof. I will not say any more, except that I am glad to think that the Joint Parliamentary Secretary and the Minister will carefully watch the working of that section of the new Regulations.

Brigadier Terence Clarke (Portsmouth, West)

Has the right hon. Gentleman noticed the very thin ranks behind him while he is referring to war pensioners?

Mr. Marquand

What I have noted is the remarkably expert speeches of those who introduced the Prayer. If the hon. and gallant Member wants to stay a little longer and hear some more from similarly expert Members I am sure we can oblige him, and I am also sure that he will be very grateful.

I was specially interested in what my hon. Friends and the Joint Parliamentary Secretary had to say about radiation. It is very important and valuable, and a good thing, that these radiation hazards have been brought within the scope of the Industrial Injuries Act, and that wider cover has been given. It is equally important that the hon. Gentleman should have been able to assure us that careful watch is being kept upon those hazards, so that, if necessary, the Regulations can be further extended to cover other aspects, if it becomes clear that radiation hazards affect human beings in some other way than is now known. All this research is valuable, and so are all steps taken towards preventing this exposure to radiation from causing serious injury and damage.

I would only express the hope that since it has now been found desirable and necessary that workers in Civil Defence and in the establishments of the Atomic Energy Authority, and nurses using X-ray apparatus in hospitals, should carry with them regularly what are called dosimeters, which are scientific instruments for measuring the degree of radioactivity an individual has suffered in a given period. the Government are giving serious consideration to the desirability that all workers in industries where radioactive materials are used should carry them.

We had a serious case not long ago, where a factory which had been making luminous dials for watches had to be closed completely, because it was found that the degree of radiation was greater than anyone had anticipated it could be. That could have been detected earlier if instruments of that kind had been carried.

But the most important issue tonight is the issue raised by the new Regulations concerning tuberculosis in respect of workers engaged in post mortems, particularly veterinary surgeons, slaughterhouse workers and others, who may come in contact with infected animals. There again, I would remind the Parliamentary Secretary of the war pensions code, where we have always said that where there is reasonable doubt the claimant should hay-the benefit of the doubt.

The Parliamentary Secretary said that his right hon. Friend and he had sought to ensure that the relation of an infection of this kind to the occupation concerned must be established with "reasonable certainty". He then went a long way to accept the doctrine that claims should not be rejected where there was reasonable doubt, and I began to have hope that he might undertake to give my hon. Friends the assurance that this would be reviewed, and that, possibly, a further amending Regulation might be introduced.

But the hon. Gentleman, unfortunately, did not go on to say that kind of thing at all. He said that even under the previous Regulations only one or two claimants could possibly have benefited, because of the narrowness of the Commission's rulings. Then he added that there might have been, under the previous Regulations, another case which would qualify. He did not deny the possibility that there might be, under the previous Regulations, someone who might be entitled to industrial injuries benefit as a result of tubercular infection, which might have been contracted in the course of his occupation. Yet, in spite of the fact that there might be another case, he said that he was going to alter the Regulations so that that case could not qualify.

That strikes me as a very curious doctrine, and a very unhappy conclusion to come to—one which I cannot conceive of the House accepting. He said, if I understand him rightly, that it would not be fair to other workers in the animal field if one of these cases got in by infiltration. I cannot understand the doctrine that one should deny to an individual a right to compensation for something which he has suffered, which one believes could have been caused by this, because some other people would not benefit. This is an illogical and wrong argument.

The hon. Gentleman fortified the decision of the Minister to make this new Regulation about tuberculosis in respect of workers coming in contact with dead animals which had tuberculosis by saying that advice had been received from a Cambridge professor. I should be the last to deny the value of advice from a professor, since I used to be a professor myself once. But I tried my best to follow the advice that the Cambridge professor gave, and it seems to have been based on his belief also that there could be very few cases in future, and that bovine tuberculosis in any case was declining and one could, therefore, take the risk that there would be no more. Suppose it is true that bovine tuberculosis is declining; I do not doubt that it is. Why not wait until it has declined altogether? That is how it strikes a layman.

Normally, on these occasions when Prayers have been moved by some of my hon. Friends I listen to the Minister's explanation and feel that in the circumstances, with all the expertise that is brought to bear on these things within the Department and by the Advisory Council, I can advise my hon. Friends to withdraw the Prayer; but I do not feel that I can do so tonight.

Mr. John Mackie (Galloway)

There are not sufficient hon. Members opposite for a Division.

Mr. Marquand

The number makes not the slightest difference. If only I were here and I thought it right to do so. I should divide the House.

A substantial number of those appointed to the Committee to review the Schedule were dissatisfied on the point, and there was a minority Report by Mr. Dale, who has great knowledge of the subject. He is the Trades Union Congress adviser on the subject. Several other members of the Committee agreed with his dissent. With the best will in the world, and having come here with the intention of advising my hon. Friends to withdraw the Prayer, I feel that the explanation that we have had is not as satisfactory as it ought to be, no matter whether it involves the refusal of a pension to only one person. If we knowingly accept new Regulations which we think might deny a pension to one person who might otherwise have got it, we should be doing wrong. For that reason, I am disposed to uphold the Prayer and not ask my hon. Friends to withdraw the Motion.

Question put and negatived.

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