§ 3.55 p.m.
§ Mr. Harold Finch (Bedwellty)
It is a considerable time since the House discussed the administration of the National Insurance (Industrial Injuries) Act, and we on this side feel that the time has come to give closer attention to this very important subject. Its importance cannot be over-emphasised, particularly having regard to the number of persons who daily come within its provisions.
In the factories and workshops of this country, there are approximately, year in and year out, about 170,000 accidents a year. In 1959, there were over 174,000 such accidents, and in the mining industry there are approximately 200,000 persons who sustain injuries in the course of their employment. While it is true to say, fortunately, that the majority are not severely disabled, nevertheless, 200,000 workmen lose more than three days' work each a year as a result of accidents in their work. In addition, we must take into consideration the facts that every year approximately 3,000 miners are certified as suffering from pneumoconiosis and, further, that large numbers suffer from other forms of industrial disease.
This demonstrates the urgent need to improve safety regulations in industry, and to improve safety measures which will bring down this casualty list. The tragedies, the suffering, the loss of wages and the loss of production are such that both management and men should do all in their power to see that the necessary safety precautions are taken, so as to bring down to a great extent the figures which meet us year in and year out.
Apart from the accidents in industry, many men are killed. In 1959, 589 men 1158 were killed in the factories and workshops and in the mining industry there were about 300 to 400. The figures vary from year to year, but approximately that is the figure. In addition, there are about 800 persons who die as a result of pneumoconiosis. These are appalling figures, and though, in some industries, the death rate is declining, the fact remains that it is a very high rate. When there is a colliery explosion or an industrial calamity, there is always a wave of public sympathy for the bereaved. Funds are opened, to which generous donations are given to assist the dependents.
Indeed, we had an illustration last year arising out of the terrible accident which occurred at Six Bells Colliery, and I know that I am voicing the opinion of the miners and of the mining communities when I say that they were deeply appreciative of all that was done to help that small mining community. Thanks are due to the Western Mail and other section of the Press, to the B.B.C. and I.T.V. for all that was done to assist that community in Monmouthshire.
I would remind the House that every day men are being killed in industry. Every day, men are dying from industrial diseases, in very many cases, a long and lingering death. Their families invariably become impoverished as a result of years of illness and, ultimately, the death of a man suffering from an industrial disease. That brings me at once to the rates of benefit, though it is not my intention to dwell on this matter today. I would only say to the Minister that he had a golden opportunity a few months ago of giving more adequate benefits to the industrially disabled, especially having regard to the fact that he reduced the industrial injuries contribution.
Even if the Minister did not choose to increase the benefits to the industrially disabled, he had an excellent opportunity of exercising his powers under Section 75 of the National Insurance (Industrial Injuries) Act, whereby he could have provided cars for the lonely paraplegic disabled workmen but he did not do so. He could have increased the rates of benefit under the workmen's compensation legislation.
In any event, I hope that today we can get an assurance from the right hon.
1159 Gentleman that he will do at least something for the paraplegic disabled. Even a cost of £2 million would not break the Industrial Injuries Fund. These paraplegic men are lonely. They have to go out on their tricycles along country lanes and often the tricycle may break down. The time has arrived when the industrially injured should be treated in this respect the same as the war pensioner.
It is not, however, my intention to deal with that aspect, but rather to deal with the grounds of dissatisfaction among the disabled concerning the present situation. We know that the National Insurance (Industrial Injuries) Act cannot be regarded in isolation and that people who receive disablement benefit can receive other benefits under the National Insurance Act. This is one of the factors which has contributed to an improvement under the National Insurance (Industrial Injuries) Act as compared with the old workmen's compensation system. Nevertheless, thirteen years' administration of the Act has revealed many anomalies and injustices.
I wish to turn my attention to some of the anomalies. Quite apart from them, we know that in the last thirteen years, conditions in industry have changed. There have been increases in production and we have seen the advance of science and medical knowledge. All these factors make it necessary for us now to review the working of the National Insurance (Industrial Injuries) Act in the light of the information at our disposal, which was not available to us thirteen years ago.
In dealing with some of the principal causes of dissatisfaction with the existing industrial injuries scheme, foremost in my mind is the problem of pneumoconiosis. Up to 1959, over 43,000 men were certified to be suffering from this disease. In the pits of South Wales, approximately 15,000 men who work underground are suffering from it. We have to take note of the fact that many thousands of men who come before the medical boards suffering from lung disability have their cases rejected.
The medical boards who examine men suspected of suffering from pneumoconiosis have two functions to perform, first, to diagnose the disease, and secondly, to assess the degree of dis- 1160 ability. The medical profession has divided pneumoconiosis into two distinct categories. The first is called simple pneumoconiosis, which is a rather unfortunate term, and the second or more advanced stage of the disease is massive fibrosis of the lungs.
The so-called simple stage is subdivided into three categories, each of which is a recognised pattern on a radiograph. The majority of experts appear to accept the view that category one does not, in the majority of cases, mean disablement. Therefore, the medical boards not only do not make an award, but they go to the extent of telling a man that he does not have the disease.
The published figures of rejections do not distinguish between men whose lungs are completely clear and those with category one readings. Thus, two men may go before a medical board. The X-ray shows that the lungs of one of them are clear. In the other case it it shows some dust retention upon the lung. The man departs from the medical board, however, in the belief that he has no dust upon the lung. This is one of the trouble factors in the coalfields of South Wales, if not in other coalfields.
What happens is that men begin to suffer from shortage of breath. It is not severe, but there is some discomfort. Their medical attendant advises them to be X-rayed at the local hospital. As a result of the X-ray examination, a man is told that he has some dust upon the lung. He is then recommended to go for examination by the medical board under the pneumoconiosis scheme. If, however, the board's examination reveals that there is very little dust upon the lung, the man is not told this and in many cases he leaves the board under the impression that there is no lung disability whatever.
This gives rise to a great deal of irritation and discontent in the coalfields. The X-ray from the local hospital shows that a man has dust upon the lung, but the medical board, whose job it is to deal with these cases, says nothing about it. One can understand the feelings of the men. Naturally, they worry. A man wants to feel that he is clear in health, but he knows that the X-ray from the local hospital shows that he has some dust upon the lung.
1161 Quite apart from that, there is the question of prevention. The National Union of Mineworkers and the National Coal Board are doing all in their power to warn men in that condition against working underground. We are getting quite a large number of young men who are declared to be suffering in the early stages of pneumoconiosis. In the interests both of safety and of health, it is all the more necessary that men should be informed when they have even only a small dust retention upon the lung.
I hope that as a result of this debate we will have an assurance from the Minister that he will take measures, as he has power to do under the Act, to ensure that even though the medical board in some cases does not regard the condition as one of disablement, men who are in category one and in the very early stage of the disease will at least be informed that they have some dust retention upon the lung.
If the Minister had some dust upon his lung and I had none, I imagine that that would indicate at least some loss of faculty on his part. Provided that our ages corresponded, his lung condition would be slightly inferior to mine. The provisions of the Act are based upon loss of faculty, and I should have thought that in a case of that kind some loss of faculty would be inevitable. I repeat that when a man is in category one and the X-ray film shows him to have dust upon the lung, he should be informed accordingly, so that those concerned—the Coal Board and the workman himself—can take whatever precautionary measures are possible.
The Minister is not being quite fair to his officials in this matter. The Ministry of Pensions and National Insurance deals with millions of cases. I compliment the Ministry upon the efficient way in which it does its job. When one realises the millions of records and cases which have to be dealt with, although there may be difficulties or delays here and there, the Ministry does its job very efficiently. In the mining valleys, however, all the good features of this administration are nullified by the stupid policy of refusing to tell a man when he is in category one, thus creating a controversy which need not arise. No harm would be caused to the Ministry by 1162 telling a man that he was in category one.
That, however, is not the only reason for the trouble with the pneumoconiosis problem. A large number of men in the mining industry suffer from bronchitis and emphysema as well as pneumoconiosis, and I submit—and on this I am medically advised on very good authority by specialists, Dr. Howell and Dr. Meiklejohn, who have made a speciality of this problem—that it is utterly impossible to assess the degree of disablement from pneumoconiosis when a person is suffering from bronchitis and emphysema at the same time as pneumoconiosis. The degree of disability cannot be properly assessed, with the result that the boards adopt to a large measure a certain amount of guesswork, and this is giving rise to a good deal of trouble.
In some cases, the board may give the man the benefit of the doubt. He is complaining of bad chest trouble, some due, perhaps, to emphysema, some due to pneumoconiosis, some proportion due to bronchitis. Sometimes, it is fair to say, from experience of the working of medical boards, that they may be prone to give the workman the benefit of the doubt and he receives benefit in respect of pneumoconiosis. On his death, the board says, "He did not die from the disease."
One can understand the problem which arises here immediately. Here is a man who has been suffering from chest trouble for a period of years, who has been in bed, perhaps, for a long time, suffering from chest trouble, and he is given a certificate that he is suffering from pneumoconiosis. On his death, the board says, "He did not die from pneumoconiosis at all." I am not assuming for one moment that because a man has pneumoconiosis he is bound to die from it, but where a man has chest trouble as the result of bronchitis and pneumoconiosis as well as emphysema, surely in those circumstances, where pneumoconiosis is present, the board should declare that the man is suffering from pneumoconiosis.
It is done in Australia. If a man has bronchitis and pneumoconiosis he is declared to be suffering from pneumoconiosis. It is impossible to dissociate them, at least during lifetime, and, in many cases, on death it is impossible 1163 properly to assess the degree of those three diseases separately.
Further, of course, Dr. Gough, who is an expert, an international figure, on pneumoconiosis, says that many men develop bronchitis as an alternative to pneumoconiosis. They continually cough up dust which they inhale underground, and get rid of it to some extent, but they develop bronchitis. It is noteworthy that bronchitis is more prevalent among miners than it is among any other industrial workers, and it raises a problem in no uncertain way as to the need for an inquiry at least—we have been asking the right hon. Gentleman for an inquiry for some time now—where we have very many men suffering from bronchitis and emphysema as well as from pneumoconiosis.
I must point out, too, that when a person is suffering from tuberculosis as well as pneumoconiosis he is given a certificate accordingly. I put it to the Joint Parliamentary Secretary, who is to reply to the debate, why should there be a different procedure adopted in respect of tuberculosis from that in respect of bronchitis or emphysema? If a man is suffering from tuberculosis and pneumoconiosis a certificate is issued accordingly. I submit that the same practice should apply where a man is suffering from bronchitis as well as pneumoconiosis.
There is another feature of this problem which is very disquieting. In the South Wales coalfield, in many areas, when the doctors have, on examination, found pneumoconiosis, a death certificate is given, signed by a coroner, that the person died from pneumoconiosis or emphysema accompanied by pneumoconiosis, but when the case goes to the medical board it says, "He has not died from pneumoconiosis at all." I want to point out the confusion which arises in cases of this kind. In the County of Monmouth a different procedure entirely is adopted, it is fair to say, and it is one which can be commended. The coroner does not give a verdict till he has had the report from the medical board.
However, in many parts of the South Wales coalfield, and in other coalfields, this is what happens. A coroner gives a verdict at a local inquest, reports of which appear in the local Press. A 1164 report will say, "John Jones died from pneumoconiosis." There it is. A few weeks later the medical board says, "He has not died from pneumoconiosis." We can imagine the consternation caused to the dead man's widow and dependants, the anxiety which is aroused, the disquiet, in circumstances of this kind.
How very difficult it is for an official to explain to a widow, "Well, you must not take any notice of the inquest. You must not take any notice of reports given at the inquest. You must realise that the medical board, whose job it is to deal with these cases, has given a certificate that your husband has not died from pneumoconiosis."
There is one other feature about pneumoconiosis. There is no right of appeal on diagnosis issues in pneumoconiosis cases. In a dermatitis case, or a beat elbow, or a beat knee case, or some of the other industrial diseases cases, persons can appeal against the decision of a medical board on diagnosis. Not so in pneumoconiosis cases. I doubt whether the ordinary medical tribunal is a competent body to deal with issues of this kind. Nevertheless, I think it fair that it should be possible for appeals to be made in certain circumstances to experts in these diseases, and I hope that the hon. Gentleman will give us an answer on this matter.
I turn now to assessment under the Industrial Injuries Act. We are very concerned with these cases. When a man is declared to be suffering from osteo-arthritis, after, say, a fracture of the shoulder or a leg or an arm, he receives injury benefit for 26 weeks and sometime thereafter. A man has been regularly at his employment and has apparently, a good health record. He may, perhaps, have had a twinge of pain, but miners do not take notice of slight twinges of pain. He receives benefit for a fracture which he has received. The case goes to the medical board which says, "He is suffering from osteoarthritis." He has lost no time at work, until the accident. It is not fair to the Industrial Injuries Fund that the Fund should be saddled with what is, after all, a complaint with which a man has been suffering because of natural causes, but I submit that there are generally many cases where a man has had very little health trouble over the years and 1165 has been working underground and then, after a very bad fracture, receives injury benefit because it is considered that he was suffering from osteo-arthritis. I know of many cases of men who are disabled as a result of an accident and if they are regarded as disabled the rate of assessment is a very low one.
There are not only the osteo-arthritis cases, but heart cases and other cases. In this respect at least I say that under the Workmen's Compensation Act the county courts and Court of Appeal in many cases dealt more generously with men than have the medical appeals tribunals. I have had experience of dealing with cases of this kind. There was a well-known case which went to the House of Lords. It was the case of a man suffering from heart trouble of whom it was said that he could have died walking upstairs, such was the nature of his heart condition. Nevertheless, he died while filling a tram with coal.
It was held that in such circumstances there was aggravation, whatever the condition of his heart may have been, and death was brought about by the conditions of employment. The medical appeals tribunal and the commissioner, in some cases, do not take the same view, and time after time men suffering from aggravation of their original injury or heart trouble are declared to have been no longer suffering as the result of an accident.
Apart from that, there is the question of the amount of the assessment. It will be known that where assessments are less than 20 per cent.—except in pneumoconiosis cases—the persons concerned are paid a gratuity. That is a relic of the old Workmen's Compensation Act. They are given a lump sum in final discharge. I should not say "final discharge", because the workman can obtain a review in certain circumstances. It is not final, I admit; but it is still very difficult to get a case of this kind reopened.
The man is paid off with a gratuity estimated at 10 per cent. or 15 per cent. He receives £100 or £120 and that is the end of it. Later, he may be able to prove aggravation or change of circumstances but it is not easy to do that. It requires a great deal of medical evidence to have the case reopened. I admit that it can be done, but, as I have said, in 1166 most cases there is a gratuity and a final lump sum settlement. This is a point which the Minister might well consider.
Where men are given an assessment of under 20 per cent. it is far better that they should be paid a weekly rate of benefit. It can be said that a man can obtain a hardship allowance in certain circumstances, but when he receives an assessment first and there is delay in proving entitlement he may not receive a hardship allowance. The man is given £90, or £100, or £120 possibly, to cover the rest of his life and the money is whittled away. This method of payment is a relic of the old Workmen's Compensation Act which I hope will pass away.
The Ministry from time to time issues circulars giving guidance to its officers and officials. It is all to the good if, by this means, it is possible to bring about a measure of uniformity. I do not know whether that circular has now been changed, but the Ministry issued one which stated that if a man who suffered from hernia wore a truss, or if a man who suffered from an eye defect wore glasses, that should be taken into account in making an assessment. In other words, the assessment would be reduced in such cases. This is quite indefensible. It does not apply to artificial limbs, but I assume that it applies to hearing aids. I do not think that it was ever intended to operate the provision in that way under the Industrial Injuries Scheme.
The rates of assessment awarded to men suffering from dermatitis are shocking, at 5 per cent. and 10 per cent. If a man leaves the pits or some other industrial occupation he thinks he is cured and is given an assessment of 10 per cent., which means that he is paid off with a gratuity. Later, when he returns to work, the dermatitis flares up again and the end result is that the man cannot resume his occupation. He receives £80 or £100. I ask the Minister to look closely at this problem. Dermatitis is a disabling disease and often prevents men from returning to their employment. I hope that this will be borne in mind when the question of assessment is dealt with in the Government's reply to the debate.
The hardship allowance is possibly the most troublesome feature in the administration of the Act. The House will be aware that provision was made for these 1167 allowances to ensure some limited compensation where, as a result of an accident, a person is unable to resume his occupation and he suffers loss of wages. This, again, is a survival from the Workmen's Compensation Act. In dealing with compensation the Act dealing with industrial injuries combines two factors—the man's loss of faculty and, secondly, his loss of earnings. In certain circumstances, he can be paid a hardship allowance which, under the war compensation scheme, is called a "loss of occupation allowance." My right hon. Friend the Member for Llanelly (Mr. J. Griffiths) caused this Section to be inserted in the Act. If it had not been for the hardship allowance I am sure that the operation of the Act would have broken down.
We all know about the old cases which concerned a man who lost an eye and who, when it was thought that the other eye was quite normal, had light work and was given low assessment. But men of that kind who were engine drivers or skilled engineers lost their job as a result of loss of sight in one eye and it was felt that there should be some payment for loss of wages and earning capacity. We took the same view about the payment of compensation for partial incapacity under the old Workmen's Compensation Act and, therefore, this provision was inserted in the Industrial Injuries Scheme, but with certain limitations.
The scheme requires that the claimant must prove—and I ask the House to note its restrictive nature—that at all times since the end of the injury benefit period he has been incapable of following his regular occupation or employment of an equivalent standard or he is likely to remain permanently incapable.
There are many men who cannot be regarded as permanently incapacitated. The doctors may hold the view that a man may be partially incapacitated for months or even years. In some cases the man eventually returns to his regular occupation. His condition is not regarded as permanent and the Act, of course, requires that he must prove that "at all times" he has been unable to follow his regular employment. The fact that he goes back to work, even though he may subsequently fail to con- 1168 tinue in that employment, deprives him of the hardship allowance.
I know that this requirement has been relaxed and that it was provided in 1952–53 that where a man goes back to his employment for rehabilitation purposes or ion medical advice to try out his old job a hardship allowance can be paid, but in many cases men go back to their previous occupation, try the job and fail, and they cannot receive a hardship allowance.
There are many such hard cases. A skilled miner, for instance, may have earned from £15 to £20 a week and after being incapacitated he thinks that he has recovered and goes back to try his old job for a time. He fails and then does not receive a hardship allowance. There was a recent case in Blaenavon, or Abertillery, of a man who was injured and who later returned to his employment. He was told that his condition was not permanent. The medical board said, "We do not think that he will be fit again for twelve months or two years." He ultimately failed in his old job, but since the board would not regard his condition as permanent he failed to receive a hardship allowance.
There are other features about these hardship allowances. There is the question of promotion. There are many cases where young men are given certain jobs underground in the mines, with the prospect of "going on the coal", as it is said, that is, of becoming colliers. They meet with an accident and application is made for a hardship allowance. In many of these cases loss of promotion is not taken into consideration. These young men hoped to be skilled workers. Because of accidents they are unable to do so, and they suffer as a consequence in the hardship allowance paid to them.
There is also the case of the piece worker who, on return to work, cannot keep pace with able-bodied men and cannot earn as much as he earned previously. These are problems which should be considered with a view to remedying decisions which are causing a great deal of dissatisfaction with this method of assessing hardship allowance.
The maximum payment is 39s. I remind hon. Members that these are skilled men, such as engineers and miners, earning £15 or £20 a week. They have probably been apprenticed to their 1169 jobs. If they have an accident and are disabled they apply for hardship allowance. Their wages fall to £10 a week, whereas previously they were getting £20. The hardship allowance is 39s. They sink back into what may well be termed the light labouring class. All their prospects for the future disappear, and all they can get is 39s. a week plus a few shillings a week disablement pension. Does that meet the serious handicap which many of these men suffer?
I have mentioned only a few of what I regard as serious anomalies and injustices. There are a number of others. This is a short debate, otherwise I could refer to many other anomalies under the Act. I hope that as a result of the debate the Minister or the Parliamentary Secretary will give an assurance that he will look at the whole question of the hardship allowance and the methods of assessment in respect of pneumoconiosis. Will he also consider such cases as osteoarthritis, which are causing a great deal of discontent in the operation of the industrial injuries benefits?
§ Mr. Harold Davies (Leek)
I hope that my hon. Friend will mention cases, now growing rarer, of miners who, before 4th July, 1948, worked in prescribed occupations and years later contracted pneumoconiosis. They can do nothing about it except by taking common law action, because they do not come under the Industrial Injuries Scheme.
§ Mr. Finch
Those who were certified as suffering from pneumoconiosis before 1948 and were working in industry can receive benefit under the pneumonconiosis benefits scheme. The benefits are low, and the T.U.C. has asked the right hon. Gentleman to increase them, as we hope for increases under the Workmen's Compensation Act. Perhaps we may have some assurance from the Parliamentary Secretary that something will be done for these men.
In any event, I have covered sufficient ground to warrant the Minister giving a definite reply on some of the points which I have raised. It is a long time since we reviewed the operation of the Act, and we do not intend to be as long in future, because many issues arise. The whole Act needs reconsideration and many of its sections need remodelling. The framework of the Act is very sound—far better than the old Workmen's 1170 Compensation Act—but there are anomalies. If the right hon. Gentleman or his hon. Friend the Parliamentary Secretary can get together with this side of the House to remodel some aspects of the Industrial Injuries Scheme, it would make it worth while and give some assurance and confidence to many of the men who are not in a position to help themselves.
§ 4.34 p.m.
§ The Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance (Mr. Richard Sharples)
As I am speaking from this Box for the first time, I hope that the House will excuse any shortcomings which there may be in my speech purely from lack of practice. My right hon. Friend asks me to say that he will be here throughout the debate and, at the end, will deal with any points which I do not cover and any which may be raised after my speech.
As always, the House has listened with the greatest attention to the hon. Member for Bedwellty (Mr. Finch), who speaks from such a long association with the coal mining industry and with such great authority on this subject. There can be no doubt at all about the importance of the Industrial Injuries Scheme to the coal mining industry.
The hon. Member gave some figures and I should like to give some more. In 1959, 44 per cent. of those who drew injury benefit and 43 per cent. of those who drew disablement benefit were classified as miners. Looking at a much more tragic feature of our industrial life today, during the same period about 30 per cent. of those drawing death benefits were the widows of miners. Looking at the figures for pneumoconiosis, of the 4,000 new cases diagnosed in 1960 by the pneumoconiosis panel boards, about 80 per cent. came from the coal mining industry.
Many of these cases may have been the result of conditions which obtained in the past. One of the characteristics of the disease is that it often takes many years for the consequences of inhaling dust to show in the form of a disability. Since 1943, when the form of pneumoconiosis due to coal dust was recognised as a distinct industrial disease, there has been a concerted attack on it at three points.
1171 First, and here I stray slightly outside my field, there is the supression of the dust, which is the responsibility of the technicians and engineers of the National Coal Board and the Ministry of Power. A few days ago I went to a pit in the Durham area and saw something of what is being done by means of spraying water upon coal and injecting water into coal before it is cut. An enormous amount of work has been done, none the less, I know from my own experience of looking at a 2 ft. 3 in. seam that there is a lot of dust and dirt about. Anyone who has seen miners working in a 2 ft. 3 in. seam knows that it is a tough and dirty occupation.
Secondly, there is the medical research which is being carried out under the auspices of the Medical Research Council and the Ministry of Health. With my right hon. Friend a week or two ago, I was able to visit the pneumoconiosis research unit at Llandough to see at first hand same of the work which is being carried out by Dr. Gilson and his team of doctors and scientists. I was tremendously impressed by the keenness and spirit of those who are carrying out these researches.
The third relief for this disease is provided through the industry's own scheme and also through this Department, which has the responsibility of alleviating the consequences of the disease through the administration of the Industrial Injuries Act. Looking at those three together—and there is a close link between them—what has struck me particularly since I have been in the Department is the close association which exists between those who are concerned with each of the three elements of which I have spoken. The result, I think, is the development of an overall medical organisation comprised of doctors with special knowledge and experience of the disease.
There is no need for me to tell the House that the incidence of pneumoconiosis is by no means confined to those in the coal mining industry. Since 1954, workers in all dusty occupations have been brought under the benefit provisions for the disease, which means, in effect, that the benefit is available wherever the disease is discovered.
I would like now to turn to points raised by the hon. Member and, first, 1172 I shall deal with the definition of the disease itself, because that is relevant to what one includes in it. The definition, as the House will know, is contained in Section 57 (3) of the National Insurance (Industrial Injuries) Act, 1946. It is, of course, the only industrial disease which is actually defined in the Statute. The definition is:… fibrosis of the lungs due to silica dust, asbestos dust or other dust, and includes the condition of the lungs known as dust reticulation.As the hon. Gentleman said, this definition originated under the old Workmen's Compensation Acts, and following its introduction in the 1946 Act by the right hon. Member for Llanelly (Mr. J. Griffiths) it has been fully reconsidered by the Industrial Injuries Advisory Council. To change the definition an amending Act would be necessary. When the Advisory Council considered the matter, it found in favour of retaining the statutory definition and said, in its 1953 Report:In a field where there is scope for wide differences of opinion, we think that there are substantial advantages in having some statutory indication of the interpretation to be adopted.
§ Dr. Barnett Stross (Stoke-on-Trent, Central)
Is not it fair to say, however, that when the hon. Member discusses reticulation as a feature of pneumoconiosis, he is speaking of pneumoconiosis in coal mining and not necessarily among potters, or flint workers, or other industrial workers? Is not this definition concerned with coal mining?
§ Mr. Sharples
The hon. Gentleman has much more medical knowledge than I have, but, as I understand it, the definition applies to pneumoconiosis as a whole. If I am wrong, however, I certainly stand to be corrected by the hon. Gentleman, who has far greater medical knowledge than I have on these subjects.
§ Mr. S. O. Davies (Merthyr Tydvil)
Is the hon. Gentleman aware that considerable research has been done since 1953 on pneumoconiosis, not only by the bodies and organisations which he has referred to but also by private and semiprivate researchers? Previous Ministers have been fully informed—I had the pleasure of trying to contribute to that—about the opinions expressed by very competent physicians, who have done a 1173 great deal of research into what pneumoconiosis means and, in particular, into the probable causes of it in addition to coal dust.
§ Mr. Sharples
At the moment, I am talking of the definition which is contained the Act. I will come a little later, perhaps, to what has been done since and what opinions have been expressed about making changes in the definition. Expressing an opinion is, of course, a different matter from producing concrete medical facts which may lead to an alteration.
In arriving at its conclusion, the Advisory Council gave full consideration to whether the definition should be widened to bring under the heading of pneumoconiosis other respiratory conditions, such as bronchitis and emphysema which may be due to, or aggravated by, dust, but which also commonly occur through various other causes. But the Council said firmly in its Retort that it would be wrong to cover such conditions under the industrial injuries provisions unless they were shown individually—and this is the point—to satisfy the fundamental test in Section 55 (2) of the Act, which is very specific and is the operative provision under which industrial diseases can be prescribed.
It says:A disease or injury may be prescribed for the purposes of this Part of the Act in relation to any insured persons, if the Minister is satisfied that—The Advisory Council, referring to these points, said in its Report that
- (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
- (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."… it would be contrary to the spirit and intention of the Act if these other conditions were brought under its cover by being admitted, as it were, through a back door under the guide of pneumoconiosis.Since then, although I agree that a great deal of medical work has been done, and that a number of medical opinions have been expressed, it is fair to say that nothing concrete has emerged which would lead one to alter one's 1174 views upon the definition of pneumoconiosis as contained in the Act.
A point which is sometimes misunderstood is that when a claimant is found to be suffering from pneumoconiosis, and is also suffering from some other respiratory condition, such as bronchitis or emphysema, medical boards increase the assessment of disablement from pneumoconiosis if other conditions make the effects of the disease more disabling than it might otherwise be.
§ Mr. Sharples
Can I leave death for a moment, for it to be referred to later?
It has been suggested that bronchitis and emphysema, two diseases commonly associated with pneumoconiosis, could be defined as industrial diseases in themselves. The difficulty here is that both are common amongst the population as a whole. On the Continent of Europe, bronchitis is known as the "English disease." Bearing in mind the limitations imposed in Section 55 (2) of the Act, it is very difficult to define either of those diseases as an industrial disease, in the light of present medical knowledge.
§ Mr. Finch
When a man suffers from bronchitis and emphysema as well as pneumoconiosis, how can the medical board, from an X-ray examination, properly assess the degree of disability due to pneumoconiosis? Is it not true that a great deal of guesswork is done when the condition is due to one of those three disabilities?
§ Mr. Sharples
I know that it is always difficult to say where any science leaves off and guesswork begins. The hon. Member has mentioned a real difficulty, but what happens in practice is that where there is a serious case of pneumoconiosis the man suffering from the disability is given the benefit of any doubt. The difficulty arises when bronchitis is the main disability, but when there may be an element of pneumoconiosis. There is no difficulty, in practice, in the more serious cases of pneumoconiosis.
The hon. Member asked why we could not do what was done in Australia and he might have used the same argument about South Africa. In South Africa and Australia circumstances are different, in that bronchitis is not a 1175 common disease among the population as a whole. Perhaps because of our climate, bronchitis is one of the most common diseases in this country and is probably put as the cause of death in more cases than any other single disease, both inside and outside industry.
§ Mr. Sharples
Statistics are always dangerous. I admit that recent statistics show that it is more common in mining areas. I should not like to go any further than that at this stage. It is more common in industrial areas, particularly mining areas, but we do not have any figures to prove that it is necessarily more common among the miners themselves.
§ Dr. Stross
The Parliamentary Secretary is very kind about giving way, especially as he has not been accustomed to speaking at the Box, as he has said. We very much congratulate him on the way he is doing it.
Has he come across the fact that for a whole generation in mining areas, without statistics because we did not have them, we have spoken of what we have called "miners' emphysema ", differentiating it both in type and form from emphysema of the surrounding population?
§ Mr. Sharples
I am interested to hear that. Frankly, I have not heard it before and I did not know that it was medically possible to differentiate between the form of emphysema which the miner gets and that which the population as a whole gets. That is the sort of thing upon which this matter depends.
The hon. Member for Bedwellty also asked me how it was possible to differentiate between the tuberculosis among the population at large and the industrial disease of tuberculosis. Tuberculosis as an industrial disease has been limited to a small number of people who are liable to get it from their employment. That is to say, it has been limited to those who work in close contact with tuberculous infection, such as those who work in T.B. hospitals.
§ Mr. Finch
I thank the Parliamentary Secretary for allowing me to interrupt again. Under the pneumoconiosis 1176 scheme, when a man has tuberculosis and pneumoconiosis he is given a certificate to say that the disablement is due to pneumoconiosis accompanied by tuberculosis. If that can be done with T.B., which can be contracted in other industries and among nurses and doctors, and if the public is liable to get it, as the public is liable to get bronchitis, why cannot the same sort of thing be done for men suffering from bronchitis and emphysema?
§ Mr. Sharples
In that type of case the tuberculosis is associated with the pneumoconiosis, which is the industrial disease.
The hon. Member asked me to refer to the death benefits and to the differences of opinion which there are from time to time between the pathologists and the Pneumoconiosis Panel itself. A scrutiny was carried out fairly recently of the death benefit claims far the three years ended 31st December, 1960, in which there was an appeal to the Commissioner on this issue. There were 143 such cases. In 17 of the 75 cases in England and Wales there was no medical evidence suggesting that the pneumoconiosis could have played any part in causing death. In 51 of the cases the pathologist considered that the pneumoconiosis played some part in the cause of death and gave an opinion contrary to that of the Panel.
In nearly all of those cases, however, the primary cause of death was some serious "killing" condition such as carcinoma or coronary or cerebral thrombosis, and the opinion of the pathologist on the effects of pneumoconiosis in such conditions was at variance with the general consensus of informed medical opinion.
As my right hon. Friend announced a short time ago, we have instigated inquiries on the wider front of general health in industry to show the extent and causes of the incapacity for work recorded in sickness benefit claims in different occupations and in different areas. We are very grateful to the employers far the way in which they have co-operated with us in filling in the inquiry forms in which we have asked them for information about the occupations of a sample of their employees. We wanted details of about 700,000 employees and the figure this 1177 morning was that we had received back 87 per cent. of the forms. We hope that in the weeks ahead that proportion will rise to the 100 per cent. which we want. It is terribly important that we should get all this information and get it early if the inquiry which we are making is to be a success.
As the House knows, this is only the first stage in a study of a very complex subject, and it will be some time before the results are available. The study was started in June. The information will be collected over the next year, and it will take some time after that to analyse the results.
I turn now to deal with some more of the points raised by the hon. Gentleman and in passing, I would say that he was good enough to warn me of some of the points he proposed to raise about assessments under the Industrial Injuries Scheme. One of the points he made was about offsets, that is, where an assessment is reduced because the part of the body injured was not normal before the accident. The hon. Gentleman quoted the example of a person suffering from arthritis. One of the difficulties in this kind of case is that the man may often not know that he is suffering from that disease before the accident.
I do not think that there is general disagreement that conditions existing before an accident should be excluded from the assessment. The difficulty arises when an accident adds to the disablement of a man who is suffering from a condition which does not affect his capacity to work. These cases are most difficult, and sometimes lead to a difference of medical opinion.
The position is that, although the actual disablement resulting from conditions which existed beforehand has to be excluded from the assessment, the extra disablement caused by the interaction between the industrial injury and the earlier condition is included in the assessment. It is very difficult to generalise about these cases where each one has to be considered on its merits by the medical board, and it is for the board to arrive at a conclusion in each case.
Very much the same considerations apply to dermatitis. A person may be suffering from a constitutional form of dermatitis which is aggravated by contact 1178 at work with dust, liquid or vapour, and it is only the aggravation which can be accepted as the prescribed disease. Misunderstanding often arises when the effect of the aggravation wears off and the person is left only with the constitutional condition which he suffered from originally.
I want to refer now to special hardship allowance, and put one or two considerations before the House. Since I have been in the Department, I have visited National Insurance offices and talked to the people who work in them. I confirm what the hon. Gentleman said, that special hardship allowance is probably the most difficult of all the allowances to administer. It depends on so many different factors. It depends on the earnings which a man is getting. It also depends on the level of earnings in the industry he was in before he had the accident. I know that one sometimes gets letters about cases of this kind where, for instance, there has been short time working in the industry with which the man was formerly associated and the insurance officer is forced to reduce the special hardship allowance which is being paid to him. That is the extreme case which arises and leads to a certain amount of difficulty.
I am slightly at issue with the hon. Gentleman on the next point. To my mind, the whole concept of the Industrial Injuries Scheme is based on loss of faculty. Almost any extension of special hardship allowance gets us further away from this principle, which was the whole concept of the Bill introduced by the right hon. Member for Llanelly, and back in the direction of a loss of earnings. I do not believe that there is any general desire on the part of anyone concerned with these cases to revert to the principle of loss of earnings, which was the fundamental concept of the old Workmen's Compensation Acts.
The third consideration is that the Industrial Injuries Scheme is based on flat-rate contributions from employer and employee. Special hardship allowance introduces to a limited extent—and I agree that it is only to a limited extent—an element of graduated benefit related to loss of earnings.
When the Scheme was introduced, the idea was that the benefit would go only 1179 to those who suffered special hardship, in that a small injury gave rise to excessive loss of earnings. Since the introduction of the Salome, special hardship allowance has played a much bigger part than was envisaged by those who introduced the scheme. I would like to quote some figures that I think the House ought to note. About one-third of the whole cost of the disablement benefits is accounted for by special hardship allowance. In 1959–60 it is estimated that out of a total of £24,600,000 paid in disablement benefits, £8,800,000 was paid in the form of special hardship allowance.
I realise that there is always the case which falls just outside the scope of this rather complicated allowance, and that there is always pressure, as the hon. Gentleman said, to extend the allowance to bring in the category of persons who are just outside it. But we ought to think carefully about where we are going, because we are near the point where any considerable extension of the allowance would undermine the whole principle of the scheme, which, as I have said, depends on loss of faculty and on fixed rate contributions.
The Industrial Injuries Scheme launched in 1948 by the right hon. Member for Llanelly was a complete break with everything that had gone before. At the time there was general agreement that a system of insurance should replace the system under which compensation was so frequently a matter of dispute between the injured man and his employer.
It was also generally agreed that the central feature of such a scheme should be a pension based on loss of faculty—that is to say, on loss of health, strength and the power to enjoy life—rather than on compensation related solely to loss of earnings, which was the feature of the earlier scheme. I think that it is fair to say that the groundwork of that scheme was done by Lord Ingleby when he was Under-Secretary of State at the Home Office, but it was made a reality by the right hon. Member for Llanelly.
Although the scheme has now been in operation for some thirteen years, I believe that this is the first general debate we have had on it. It is quite clear that it has stood the test of time pretty well.
1180 Apart from increases in rates, there have been amending Acts in 1948, 1953 and 1959. The present rates of benefit are higher, in real terms, than they have ever been. Considering the wide scope of the scheme and its complete break with the past, the amendments to it have been very few.
I am sure that the House would wish me to pay tribute, as did the hon. Member for Bedwellty, to those who administer the scheme—the officials in the National Insurance offices, to those who have the great responsibility of assessing the claims submitted, and to those who adjudicate upon the claims. The House would wish me, too, to pay tribute to the work of the Industrial Injuries Advisory Council, which has given very good advice to the successive Ministers who have borne responsibility for administering the scheme.
I do not say that some further modification may not be necessary in the course of time, and in the light of increasing knowledge. That has been done before, and may again be necessary. What I do say is that the common objective of all of us who are concerned with these matters, on both sides of the House, must be the fairest treatment of the casualties of industry, and the efficient working of a scheme that is financed by every employed person and by every employer.
§ 5.14 p.m.
§ Mr. Bernard Taylor (Mansfield)
First, it is my very pleasant task, and I am sure that the whole House will be with me, to congratulate the Joint Parliamentary Secretary on his maiden speech from the Dispatch Box. Both his presentation and the way in which he has endeavoured to help hon. Members who have desired clarification and elucidation have been excellent. It struck me as the hon. Gentleman spoke that in this debate we are on a journey of discovery. We are all anxious to get the best out of this piece of legislation because it concerns the men and women who are injured in industry.
I represent a very important mining constituency in Nottinghamshire, but I had not realised that the injury incidence was so high among miners. From the statistics quoted by the Parliamentary Secretary, it would appear that of those involved in 1959 in reportable accidents, 1181 and receiving benefit under the Industrial Injuries Act, 44 per cent. were miners receiving industrial injury benefit, and that 43 per cent. of the total number receiving disablement benefit were also miners.
As the hon. Gentleman has said, although thirteen years have elapsed since the inception of this very important scheme which has replaced the old Workmen's Compensation Acts and is based on entirely new principles, this is the first time we have had a debate devoted directly and solely to it. It is a pity that we were not able to have a full day's debate, because I know that many hon. Members want to speak and there are very many important points to be raised. All our previous discussions have been wrapped up with the contributions and benefits implicit in the National Insurance Acts that the right hon. Gentleman and his predecessors have introduced. Today, however, for the first time, we can directly ventilate matters concerned with the operation of the Industrial Injuries Act.
I join with my hon. Friend the Member for Bedwellty (Mr. Finch) in drawing attention to the fact that since 1948—this may sound fantastic, but it is true—millions of people have been affected by, and many more millions of days of incapacity have resulted from, accidents and from prescribed diseases. Many of these accidents and diseases have proved fatal and many more have been of a serious nature, involving permanent disability, but we rejoice in knowing that a great number have been less serious and have not involved any prolonged disability at all.
I was interested to note in the Ministry's latest Report that for the year ending May, 1958, there were no fewer than 718,000 reportable accidents. If we take that as an average year, and if we allow for the fact that some of the men and women concerned were involved in more than one accident in the period, a very conservative estimate shows that since the inception of the Act about 7 million or 8 million people in industry have been affected, involving many more millions of days of incapacity.
These are astronomical figures, and they are significant both in terms of human suffering and—very important in 1182 these days—in terms of loss of production. With those two factors in mind, it will surely be agreed that no effort should be spared by managements and workers and everyone in industry to reduce to the lowest possible minimum the number of accidents—indeed, entirely to wipe out avoidable accidents—and the incidence of industrial disease.
Having said that, I wish to raise a minor point with the Minister. It is an administrative point. The criticism which I make is not a severe one, but I make it in the hope of being helpful and useful to the people who receive these documents. The right hon. Gentleman will know the document which is sent to a person who has decided to appeal to the Medical Appeal Tribunal against the decision of the medical board. The Minister himself may decide to refer such a decision to the Medical Appeal Tribunal. The legibility of what is written on Form B.1/91 really beggars description.
I am sure that the Department could devise something better than these photo-stat copies. I have seen many of them, and I must confess that, when people have spoken to me about the forms, I have had the utmost difficulty to give a reasonable explanation of what is written on them. This may appear to be of minor significance, but it is very important to those people concerned when so much is at stake. Therefore, I hope that the right hon. Gentleman will be prepared to look at the matter.
I wish now to make a few observations, as my hon. Friend the Member for Bedwellty has done, about the special hardship allowance. I am not unmindful of the remarks made by the Parliamentary Secretary. Those of us who come from mining areas know that this benefit affects, numerically, miners more than any other section of industrial workers. Therefore, I make no apologies for reiterating and, I hope, reinforcing some of the comments made by my hon. Friend the Member for Bedwellty.
This benefit is a very old friend of ours indeed. Its purpose has been outlined to us and I want to say without any equivocation at all that in the set-up of the Industrial Injuries Scheme the benefit has played a very important part. Let us take the man with a small assessment. Because of the nature of his pre-accident employment he is unable to return to 1183 work, though his loss of faculty may be only very slight. As a result of the peculiarities surrounding his pre-accident work he is unable to go back. As my hon. Friend said, in many cases that pre-accident work was highly remunerative compared with his post-accident earnings.
Let us put ourselves in the position of that individual. When the Parliamentary Secretary talks about this benefit getting out of proportion and possibly undermining the principles of the scheme, I hope that he will have another look at the matter and think again. I wish to put it on record that, in my view, this benefit has saved the Industrial Injuries Scheme. That is how I feel about it. However, in spite of proclaiming its virtues, I hope that when the right hon. Gentleman replies to the debate he will not place too great an emphasis upon trying to marry these two opposites. We have had that before. Here it is, and we have to make it as good as we can in the interests of the people to whom I have just referred.
As my hon. Friend said, there are certain aspects of this benefit where changes are most desirable. I hope that the right hon. Gentleman will not say, "Well, your Government were responsible for introducing it." It was a good thing. The scheme itself was a good scheme but it was not absolute. It was only the beginning, and if experience teaches us that there is need for change and modification, why should we be like the ostrich and bury our heads in the sand? Let us admit it and face the situation.
In my view, the Minister should consider improving the conditions which are necessary for the qualification of this benefit. I think that 39s., the present level of the benefit, is too low. To be prevented by disablement from maintaining one's pre-accident standards—and in some cases the difference amounts to pounds a week—is very frustrating and certainly very disappointing. In my view the gap should be narrowed.
I now wish to turn the attention of the House for a short while to what I regard as some of the anomalies of this benefit. My hon. Friend the Member for Bedwellty quoted the Act, which states:In order to claim the claimant must prove at all times since the end of injury benefit he 1184 has been incapable of following his regular occupation, or is likely to remain incapable.I believe that in recent times—no doubt the right hon. Gentleman will tell us—the Trades Union Congress has made representations on this point. Coming as I do from a mining area, I know that the unions representing the miners are frequently—indeed, it is almost an every day occurrence—coming up against cases of difficulty and hardship because of the operation of the words which I have just quoted.
I am not unmindful of the trial period which, I believe, was extended in 1952 and which was very welcome, but I have come to the conclusion that it does not give to these men the desired protection. It would be much simpler if this condition were modified. I hope that the right hon. Gentleman will see his way clear to do that. More important still, it would remove a lot of the discontent which exists as far as the operation of the special hardship allowance is concerned.
The Parliamentary Secretary referred to the cost of the disablement benefit as being one-third. Do not let us forget the people with whom we are dealing, from what they are suffering and how frustrated and disappointed they are. Even if it is a question of cost—that point was raised and was implicit in the Parliamentary Secretary's remarks—I should not think that the cost would be very large. The fund is in a very healthy condition and could easily stand the cost, and then a sense of injustice and discontent would certainly Abe removed.
I should like to have said a word or two about promotion prospects. I think that this matter has to be looked at too. It is very hard on a boy who at the very commencement of his industrial life becomes disabled and who sees his chances of promotion completely removed. It is not uncommon in mining areas for a boy, having just started in the pits, to lose an arm or a leg. His prospects of becoming a piece worker or a ripper on piece rate work are accordingly shattered. After all, that would be his ambition, as otherwise he would not have entered the industry at all. It is important that we should have the maximum recruitment because employment in the pits is becoming a problem. I hope that the Minister will look at the question of promotion prospects.
1185 My hon. Friend the Member for Bed-wellty talked about offsets and I wish to reinforce what he said. I am sure that this is a matter which merits consideration. It is true that Section 12 (2, b) of the Act makes provision for medical boards to make offsets. We know that there are cases where prior to sustaining an accident a person may have a disease but show no sign that he has it. Osteo-arthritis is often triggered off by an accident. There is dissatisfaction in union circles at what is considered the unreasonable interpretation of the rules of the scheme in this connection by medical boards.
The last point I wish to raise has not yet been mentioned in this debate. Some time ago I put down a Question on the matter because it is exercising the minds of many people. I refer to industrial diseases and to the problem created by Dupuytren's contracture. My information is, despite the truthful answer which the Minister gave to my Question relating to applications, that this condition is becoming more prevalent among workers in industry. Within recent weeks I have had information provided by the area branch of the National Union of Mineworkers giving details of at least twenty eases which have occurred during the past few years. If a person is medically certified as suffering from Dupuytren's contracture he has a sickness benefit only if he is totally incapacitated. Many men are unable to return to their pre-condition work, because of the deformity which is set up. I am not sure, but I think that this condition has a more lasting effect than beat end. If a man can return to his pre-condition employment he has no disablement benefit and no hardship allowance either.
§ Dr. Stross
Dupuytren's contracture is much more lasting than beat end. It is permanent, and the condition gets worse from time to time even though no more work is being done and there is, therefore, no further aggravation. Unless operative treatment is made available there can be no alleviation.
§ Mr. Taylor
My hon. Friend the Member for Stoke-on-Trent, Central (Dr. Stross) knows much more about diagnosis and prognosis in these matters than I do.
As the right hon. Gentleman is aware, beat end is in the schedule of prescribed 1186 diseases. We call it "beat end" but it has another fancy name in the schedule. There is a distinction between this condition and Dupuytren's contracture. My hon. Friend the Member for Stoke-on-Trent, Central says that the disabling effect is, to put it at its lowest, certainly no less than in the case of beat end.
I hope that the Minister will not argue that already this schedule is long enough. We should remember that in 1897 there were only six prescribed diseases in the schedule and that there have been so many additions since that now the number is thirty-nine. I wish to bring the question of Dupuytren's contracture to the notice of the Minister in the hope that he will submit the matter to the Industrial Injuries Advisory Council. I join with the Parliamentary Secretary in paying tribute to the work done by that body over the years. It is my hope that before very long Dupuytren's contracture will be added to the list of diseases.
I am open to correction, but, so far as I know, the question of prescribed diseases has not been dealt with in a substantial fashion since the setting up of the Beney Committee in 1953, and that Committee reported as long ago as 1955. It may be that the Minister will have something to say about this matter, but, if not, I hope that he will give his undivided attention and full consideration to the question of Dupuytren's contracture, which is growing more common.
§ 5.36 p.m.
§ Mr. Arthur Tiley (Bradford, West)
I am very glad to be able to follow the hon. Member for Mansfield (Mr. B. Taylor). I shall not be able to follow him in his discussion of the last disease which he mentioned, because I can neither pronounce it nor can I spell it. But tomorrow I will look at the hon. Member's speech as reported in HANSARD and get to know more about it. I am also glad to follow the hon. Member because I have known him for a good many years before becoming a Member of the House. I am aware that he has always cared for his fellow men—I am glad to say that of him—and I wish to pay tribute to the work that he has done in this matter.
I join with the hon. Member for Mansfield in congratulating my hon. Friend the Parliamentary Secretary on his speech. It is strange that we can 1187 have an interesting debate on such a technical subject. On Wednesday and Thursday of last week I sat in the Chamber hoping for the opportunity to make a speech on economic affairs. I am wondering whether I should make it this afternoon—it is a very good speech. Looking round the Chamber today I feel like a tadpole in a very large pond. All the "giants" have departed and we happy few remain to deal with the problems which have been referred to, and to endeavour to bring happiness to so many of those people who are affected by them.
I do not wish to make a long speech, because I know that hon. Members opposite have so much to contribute to the debate, but there are one or two points which I wish to mention. I was shocked at the figures given by the hon. Member for Mansfield of the increasing number of accidents, and also by the references by the hon. Member for Bedwellty (Mr. Finch), and the information given about the cost to production in this country, which is almost beyond calculation. One should bear that in mind as well as the amount of suffering which is involved.
I am glad that the hon. Members who have spoken about this matter fairly laid the blame on both management and men. There is so much more which needs to be done to eliminate thousands of accidents which are caused by carelessness. I wonder how many accidents in our factories are caused by the increasing use being made of slippery floor materials. Why is it that the very thing which is abolished in hospitals—where the hazards which may result from polished floors are appreciated—is allowed in factories, offices and shops to an increasing extent? Accident figures are available for study, and if they were studied I am sure that we should be able to find means to reduce the number of accidents.
So many accidents are due to absolute carelessness. As the House knows, I am engaged in the business of insurance and recently I came across a terrible accident which occurred simply because one rung of a ladder was broken. As a result a man fell only a few feet, but his skull was fractured and now that man and his family will suffer as a result. It was not the man's fault and it was not the fault 1188 of the management. Other ladders were available.
There must be much more education. I wish that the trade unions and managements, would do more. I think that the Minister could gain a good deal of information from the centre of our commercial life, where the facts of almost every single accident that happened are known—that is, from the world of insurance. Why is there not closer liaison with the Accident Offices Association, where since 1946, when the Fatal Accidents Act was passed, nearly every accident, and the cause and details of it, is recorded. If there could be closer liaison between the Ministry and the people who know the facts, surely we should be able to sift out the causes of the most prevalent accidents and, through the unions, and management educate people by means of lectures, and so on.
There are one or two questions which I should like to ask. I believe that I am right in saying that a totally disabled war pensioner can receive a car under the disablement scheme. I believe that I am also right in saying that a person totally disabled in industry can have a tricycle provided for his use through the Ministry. I wonder whether we can extend the scheme a little further. Where a man is entitled to a tricycle, could not he be helped financially to obtain a car if he can find the balance of the money required himself or through his family?
It is a very great hardship to a man of 30—the miner, for instance, to whom the hon. Member for Mansfield referred—who loses a leg, or perhaps both legs. He is unable to enjoy the fuller life which we are trying to provide for all our people. If we admit the responsibility, as we do, to provide a tricycle in certain cases, surely we could go a step further. If a man has friends, or a club, or a union, by means of which a sum of money is provided towards the cost of acquiring a car, why cannot we contribute the cost of the tricycle towards that cost and so give the man a fuller life? Then he can take his family out with him at weekends.
On the subject of pneumoconiosis, I well remember reading, some years ago, the evidence given by Sir Bernard Spilsbury in a murder trial. When discussing the examination he had made of the victim, he said, "The victim had the 1189 lungs of a town dweller." I have never felt as well since then, because I live in a town. We have had discussions about pneumoconiosis, and tuberculosis, and I am sure that the Minister will agree that there are not so many people suffering from bronchitis who live in the vicinity of the Sussex Downs as there are in the mining and industrial districts.
I want to see in the administration of this Act a wider benefit of doubt given to the people who are suffering. I hope that hon. Members opposite will realise that there are occasional disadvantages in moving away from the older Workmen's Compensation Acts. It is a mistaken impression to think that because insurance stamps are paid for by both sides in industry the employer has been released from all the employers' liability premiums which he used to pay before 1948. I can assure the House that in industry the employer is paying a good deal more now in premiums than he ever paid under the old Workmen's Compensation Acts.
The reason for that is not far to seek. We altered the law and the net result is that with the advantage of common law claims and greater damages the cost to industry is just as heavy as it was under the old Workmen's Compensation Acts. The benefit of those Acts was that there were often ex gratia payments. It is very difficult to deal with Government pensions on an ex gratia basis.
One thing which always infuriates me is the refusal to accept that the loss of a limb or two limbs materially affects a man's general health. I give one example. It is that of a man who, at Mons—donkeys' years ago now—lost an arm. He had 30 or 40 operations and eventually he died of heart failure. No pension was payable because he died of heart failure. It is nonsense to suggest that the man's health and physical fitness had not been affected by the loss of a limb and the fact that he had undergone all those operations.
Doctors, scientists and others are trying to examine these matters. It is difficult for us as laymen to follow the technical arguments, but it is not difficult to apply a little common sense. I am sure that we should be a great deal more broadminded in the way we deal with doubtful claims, especially with regard to pneumoconiosis and the other 1190 cases mentioned, and when considering the effects of serious injuries, such as the loss of a limb, on a person's general health. We should try to seek a way of dealing with doubtful cases so that a greater measure of mercy is shown to those who need it most.
§ 5.48 p.m.
§ Mr. Dan Jones (Burnley)
I am very pleased to be able to make a contribution to what I regard as a very important debate. Perhaps I shall be forgiven if I do not follow exactly the lines which the debate has followed so far. So far as I am able I wish to deal with the subject of industrial injuries in a more general way.
I feel that I can speak on this subject from personal experience, having been a branch secretary of the Amalgamated Engineering Union for fourteen years and having handled the cases of a number of injured workpeople. I have also made a close study of the excellent book "Accidents and Ill Health at Work" by John L. Williams. Those two facts combined enable me to make my contribution and to put four distinct points to the Government.
I believe the problem of industrial injuries is so serious that public opinion ought to be educated about it for, in terms of human suffering and the end cost to the nation, it is a matter of very great importance. I do not think that is being done now, but it ought to be done. Secondly, we should ask ourselves if enough is being done about methods of safeguards. Thirdly, we should ask if enough is being done about industrial diseases. That may be the most insidious part of the problem of industrial disability. Fourthly, we should ask if further research could benefit the nation, the citizen and the good employer.
On the first point, my statistics are drawn from the book to which I referred and I believe they are quite reliable. We are asked to believe that every year more than 800,000 people suffer industrial injury and 2,370 of those cases are fatal. That works out at about 37.7 per 1,000 of all employed people. Those are dry figures, but I can add my personal experiences to them.
My father died before I knew him and my mother married again. Before I was 8 years of age my stepfather was carried 1191 home from the mines, killed. Those memories will last with me so long as I am privileged to walk this earth. The impact of those experiences on one so young are with me now. Fortunately, we were not a large family. Unless we see this problem in this way we shall fail in our duty. One is entitled to ask forthrightly, if the accident ratio in this House of Commons affecting hon. Members were similar should we be quite so detached in the way we view the problem? We cannot consider the problem properly unless we see it in those terms.
For those who are not prepared to be guided by these purely human interests, I mention the financial cost factor, which I think is outrageously high. Professor Mathew, speaking at a Ministry of Labour conference in 1951, assessed the cost to the country of injured workpeople at more than £100 million per annum. I am afraid that figure has been amended, for Mr. Tuckwell, the chief personnel officer of Dunlop's, has argued that it should be £300 million. He has worked out the figures on a comparative basis with those from the United States of America. A man in his position should be listened to with respect. Three hundred million pounds is a very big sum. Even if we said that Mr. Tuckwell had exaggerated and we took as a mean average £200 million, that is a figure which Her Majesty's Government should examine very closely to see if that high indebtedness cannot be appreciably reduced in the interests of the nation.
On the second point, the question of application of existing safeguards, I say quite bluntly that I have tried in vain to get the figures of common law accidents in this country and have failed. That is because so many cases are settled out of court. My personal experience in dealing with such people leads me to believe that all too frequently the injuries of those in industry who have their cases treated at common law, successfully or otherwise, happen as a result of neglect by the employer.
A case happened in my constituency recently of an active young man who lost his hand. As a result of assistance which I secured from London solicitors, he had a settlement of £3,700 made out of court. One could say that he was reasonably satisfied and the employers were also 1192 satisfied, because they passed on the liability to an insurance company, but that is not the end of the problem. That man was left minus one hand and it was due to the negligence of the employer. I do not think we deal with that kind of problem in the way in which it is entitled to be dealt with, for this nation has now to accept the liability.
Much has been said about pneumoconiosis and silicosis, both of which I know very well, as I worked in the mines for twelve years. I strongly suspect that I am suffering from some form of pneumoconiosis or silicosis. It is hardly possible to work for twelve years in the pits without contracting some dust disease. However, I am more concerned about dermatitis. From my personal experiences I consider that this disease is being contracted in British industry as a direct result of neglect by some employers.
I have been into this question as a trade union official. I have seen forty young people eating sandwiches placed between pieces of newspaper. When I asked why they were eating their food in that disgusting manner, I was told that it was because there were no washing facilities of any kind. The Minister is laughing at me—
§ The Minister of Pensions and National Insurance (Mr. John Boyd-Carpenter)
I beg the pardon of the hon. Member if I gave him that impression. I am far from doing that. Although it happens that this particular part of his speech comes within the departmental responsibilities of my right hon. Friend the Minister of Labour and not mine, I assure the hon. Member that I was not showing any discourtesy to what I thought was a most interesting and effective part of his speech.
§ Mr. Jones
I accept that from the Minister.
These people who were eating their food in the manner I have described said they did so because there was no hot water with which to wash their hands. I inquired where the manager was and found that, apparently, he was in the nearby town having his lunch. I left a message that I would be back within a week at the same time with a factory inspector. That was a case which 1193 I detected, but how many cases go undetected? I know from experience that a great deal of vicious disease is contracted for no other reason than neglect—because there are no washing facilities for those who are having to use dirty solubles on machines. I have frequently known of a case of a skilled man contracting this complaint. Then we lose a skilled man from industry. I should like an analysis to be made of how many workers we are losing in this way.
§ Mr. Raymond Gower (Barry)
While not dissenting from what the hon. Member is saying, may I ask if he agrees that most of his criticisms are directed against what he considers deficiency under the Factories Acts rather than of provisions for industrial injury cases?
§ Mr. Jones
I made the point that existing safeguards are not being applied or are being disregarded. I have pointed out that where there are clean coolants and lubricants, hot water and facilities for washing we could reduce the incidence of disease.
One cannot speak about dermatitis merely as a skin complaint. I know for a fact that certain people who have suffered from the complaint have required psychiatric treatment after about two years of trying to grapple with the disease, for it plays havoc with people's senses and well-being. This is something that we do not face up to properly.
My fourth point is research. I have always been rather amazed at the situation which obtains in mines. I know from personal experience that where inspections are held, the inspections take place at all times with a representative of the workmen present. Why does not the same thing take place in factories? I was a works convenor and also a branch secretary, and I have known of many inspections taking place in the factory, but I was never asked to accompany those carrying out the inspection. Why? In the matter of accidents, what is the difference between factories and mines? Are we not prepared that trade union representatives should be vigilant in ensuring that all safeguards are applied If this were done, the number of accidents could be reduced appreciably.
1194 Although more than 7 million people are employed in our factories, very little research is carried out. Indeed, of our 240,000 factories only 3,250 have voluntary safety committees. When it is realised that 90 per cent. of our factories employ fewer than 250 people, it can easily be appreciated that in the small firms all kinds of anomalies can be hidden away.
In passing, I pay tribute to the bigger companies which have very good schemes, and I wish they were imitated by the smaller firms. But it must be remembered that, in spite of all the big names in British industry, 90 per cent. of our industrial life is based on firms employing fewer than 250 people, and in consequence the vigilance there leaves very much to be desired.
Research is vitally necessary. I wish here to refer to a very pertinent Question which was asked in the House of Lords. It is a Question to which we ought to address ourselves. Lord Taylor askedHer Majesty's Government what is the present balance of money in the Industrial Injuries Fund at the latest available date, how many grants from the fund have been made for research into industrial injuries, under Section 73 of the Industrial Injuries Act, and what is the total amount of money from the fund so far spent on research since the Act was passed in 1946.Lord Taylor received the following reply from the Minister without Portfolio:My Lords, the latest accounts of the Industrial Injuries Fund are those for the financial year ending March, 1960, when the balance held by the Fund was nearly £238 million. As the noble Lord will be aware, the Fund is at present being built up, on the advice of the Government Actuary, with a view to accumulating amounts sufficient to meet its ultimate liabilities. Payments have been made towards six projects under Section 73 of the Industrial Injuries Act, and the total amount of money from the Fund spent so far on research is £3,910.I conclude with Lord Taylor's reply, with which I heartily concur:My Lords, in view of the very large size of this Fund, and the very small amount of money which so far has been spent from it on research—£3,000 as against nearly £300 million—would the noble Lord consider, in time for the next Session—."—[OFFICIAL REPORT, House of Lords, 26th July, 1961; Vol. 233, c. 1000–1.]
§ Lord Balniel (Hertford)
On a point of order, Mr. Deputy-Speaker. I wish 1195 to refer to this specific matter during the course of my speech, and I should like to ask whether we can, in fact, quote textually from debates in another place. I ask this simply for my information.
It is possible for hon. Members to make passing references to statements in another place, but it is not possible to quote them in toto.
If the hon. Member is referring to a Ministerial statement on policy, that is in order.
§ Mr. Jones
In fairness to the objection raised, Mr. Deputy-Speaker, I will leave the matter in that setting. I merely say that I agree with the sentiments expressed by the noble Lord. I feel that they are sentiments which ought to be re-echoed in the House of Commons in the interests of human happiness and the nation's well-being. This is surely a very great problem, and all too frequently we try to dispose of it merely by dispensing figures and percentages. There are very deep human issues here which I have been privileged to bring to light.
§ 6.6 p.m.
§ Lord Balniel (Hertford)
I am very glad to follow the hon. Member for Burnley (Mr. D. Jones), because I wish to refer very closely to the remarks that he has made. I shall be as brief as I can, because I realise that there are a number of hon. Members who wish to speak, particularly those representing coal mining constituencies which are closely concerned with the subject-matter of the debate, perhaps more closely than my constituency.
We have the unusual, if not rare, and happy experience today of discussing a fund, the Industrial Injuries Fund, which not only is solvent but, so far as I can see, does not contain in itself the seeds of future insolvency. The fund has now been built up to about £238 millon. Hon. Members opposite have said that it is 1196 in a very sound position, but the hon. Member for Mansfield (Mr. B. Taylor) and the hon. Member for Burnley were, very naturally, tempted to show that we should improve the benefits being paid from it.
That is very reasonable, and I would support such a view. But we must bear in mind that a fund of this nature must be built up very rapidly to begin with, and that as a result of the passing of the National Insurance Act last year the rate of growth will be substantially reduced through our increasing the benefits and reducing the contributions. This was borne out very clearly by the report of the Government Actuary at the time of the publication of the National Insurance Bill. He pointed out that the value in perpetuity of assets exceeding the value in perpetuity of liabilities has been decreased by that Measure from £617 million to £70 million.
I do not deny that £70 million sounds a very substantial figure, but it is, in fact, only about 3 per cent. of the total value of liabilities which will fall on the fund. Nonetheless, the fund is "in the black" and there is every prospect that it will continue "in the black" and not slide into the "red". It is reasonable that in a debate such as this we should discuss the improvements that we should like to see in the payments from the fund.
The hon. Member for Bedwellty (Mr. Finch) advocated that the list of prescribed industrial diseases should be widened to include new diseases not on the prescribed list at the moment. He mentioned, in particular, bronchitis. In reply, it must be pointed out that this was considered very carefully by the Beney Committee, and it was turned down emphatically by the majority of the Committee. Also, there are certain dangers, which I think we can all see, in bringing into the Industrial Injuries Fund diseases which are not specifically related to industry, but are endemic to the entire population. None the less, it was a perfectly rational means by which we can argue that improved benefits can be provided to contributors.
I question whether a widening of the prescribed list of diseases should be given the highest priority. This is where I should like to follow so closely the hon. Member for Burnley. Expenditure 1197 out of the fund on research into the prevention of industrial illness is of the very highest priority. The hon. Member for Burnley quoted what happened in another place, when it was pointed out that the Minister has power, under Section 73 of the National Insurance (Industrial Injuries) Act, to finance research into industrial illness.
It was there stated that the fund now stands at about £238 million and that only £3,900 has been spent on industrial research, spread over six different projects. This is sad. This money covers research into industrial injuries and accidents which are covered by the Industrial Injuries Fund. Therefore, in so far as research of this nature is successful, it inevitably diminishes the outgoings from the fund. Expenditure in this field would bring in a rich harvest of dividends, not only in the health and happiness of workmen, but also in monetary terms. At least, some portion of the £64 million which we spend every year in compensation would be saved if we were able to accelerate work on research.
Many hon. Gentlemen who are interested in the National Health Service have been disappointed because the preventive side of the Service has not developed as many of us would have liked it to develop. There are three main facets of preventive work. There is, first, the preventive work undertaken for the elderly by local authorities. There is, secondly, particularly since the passing of the Mental Health Act, the preventive work which will be undertaken by local authorities for those who are mentally sick but not in need of hospital treatment. The third facet, which is directly relevant to the debate, is the need for an industrial health service.
The last facet is in its absolute infancy. It is no more than a pipe dream for any of us to imagine that an industrial health service will be established on the Health Service Estimates in anything like the next four or five years. We all know the immense priorities of hospital building and mental hostels and the need for higher pay for doctors and auxiliaries. All these things have a higher priority than the establishment of an industrial health service.
1198 However, the fact that it cannot be borne on the Health Service Estimates does not in any way lessen the need or urgency for such a service. It is worth recollecting that as long ago as 1951 the Dale Committee of Inquiry on Industrial Health Services said this:… there should eventually be some comprehensive provision for occupational health, covering not only industrial establishments of all kinds, both large and small, but also the non-industrial occupations referred to in the Report of the Gowers Committee.The urgency has been re-emphasised in the last few months by the publication of a Report by the British Medical Association entitled, "The Future of Occupational Health Services." The Association says:… the British Medical Association urges that an immediate beginning be made in setting up a comprehensive occupational health service.At the moment there is a yawning gap in industrial health services. The gap is filled in small measure by the nationalised industries and by some larger private enterprise companies. The gap in research is also filled in some measure by the generous support and far-ranging vision of the Nuffield Foundation, which, this year, has devoted £250,000 to research in this sphere. That is quite a contrast from the figure being allocated under the Act. I realise that the Industrial Injuries Fund is devoted almost solely to the immensely valuable, but none the less negative work of compensating those who have suffered from industrial illness and industrial accident.
If a surplus becomes available and it is possible to improve benefits to contributors, will my right hon. Friend very seriously consider the possibility of devoting a slightly larger sum out of the immense sums which back the Industrial Injuries Fund? There is an excess of assets in perpetuity over liabilities in perpetuity of £70 million.
The hon. Member for Burnley criticised smaller companies. There is room for criticism, but what smaller companies need is the grant of fairly limited capital, combined with recurrent finance for a very limited period. It is necessary for there to be group health services, because health services of which the hon. Gentleman spoke cannot be borne by very small companies. Once group 1199 health services are established and the member industries contribute to them, they become self-supporting.
§ Mr. D. Jones
Does not the noble Lord agree that small companies should respect the existing safeguards as well?
§ Lord Balniel
Certainly. I should not dream of questioning that companies, large or small, should respect the existing safeguards. I am not asking that the Industrial Injuries Fund should be used to establish an industrial health service. That is far outwith the remit of the fund. Would it not be possible for my right hon. Friend to finance research to a slightly greater degree than is being done at the moment so that when, at long last, we can establish an industrial health service on the Health Service Estimates much of the research which will be be necessary to put the service on a proper footing will be undertaken out of the Industrial Injuries Fund?
§ 6.18 p.m.
§ Mr. Walter Edwards (Stepney)
I do not intend to take up much time because I know that several of my hon. Friends desire to speak. I want to make a short contribution on a topic which has not yet been mentioned, namely, the way in which the Act affects the thousands of people, probably the hundreds of thousands of people, employed on public service vehicles. They are bus conductors, conductresses, drivers and other people who come into contact with the public in the course of their duties. Some months ago I tabled a Question to the Home Secretary about people employed in the bus services who were receiving physical injury at the hands of private individuals whilst carrying out their duties on buses but who had been denied industrial injury benefit.
In many cases industrial injury benefit had been allowed until, I believe, 1958. A case occurred during that year of a bus conductor being physically assaulted on his bus while carrying out his duty, and his claim was refused by the local officer. Eventually the Transport and General Workers' Union took the case to the Commissioner, and the Commissioner ruled that although a bus driver or conductor may meet with an accident while carrying out his duties on his bus, if the accident were caused by a private 1200 individual, under the terms of the Industrial Injuries Act no benefit payment could be made to him.
The question whether the accident arises out of and in the course of his employment seems to be left to the Commissioner, because it is not clearly defined in the Act. If a bus driver or conductor carrying out his duties as laid down by his employer receives an injury, whether it is caused by a passenger on the bus, or somebody from outside the bus throwing a bottle at the conductor when he is on the platform of the bus, or at the driver in his cabin, the driver or conductor is as much entitled as anybody else to industrial injury benefit. Ha has met with his accident while carrying out the duties that he is called upon to perform by his employers.
It has been said that we have not had a debate on this Act since 1948. It is obvious that during those thirteen years many flaws in the Act must have come to our attention. I suggest to the right hon. Gentleman that as and when these flaws are discovered it is the duty of the Government to see whether they can be remedied.
In the case of employees of bus services, I contend that the Act needs revising—
§ Mr. Speaker
I am sorry to interrupt the hon. Member, but I must do so now or I shall have to be keeping order on the point all night. Practically the only thing that we cannot discuss on this Question is legislation.
§ Mr. Edwards
I am sorry. At any rate, the Minister probably has my point. I am sure that it has been put to him before. He must appreciate as well as anybody that a certain amount of injustice is being imposed upon employees working on public service vehicles, as a result of the decision reached by the commissioner, and I ask him to look into the matter very fully and quickly, in order to take the necessary steps to see that the people concerned receive just treatment under the Act, in the same way as do other workpeople who come within its provisions.
§ 6.25 p.m.
§ Dr. Barnett Stross (Stoke-on-Trent, Central)
I shall be brief, because I want to hear what the Minister has to say, and because other hon. Members also 1201 wish to speak. When the Joint Parliamentary Secretary was answering my hon. Friend he defended the non-acceptance of emphysema and bronchitis associated with work in the coal mines or in dusty occupations by stating that whereas it was suitable and reasonable for those diseases to be accepted in South Africa and Australia it was not suitable or reasonable here, because in those countries there was very little bronchitis, whereas it is notorious that there is a great deal of bronchitis here.
The Minister referred to Section 55 (2) of the original Act, which makes the position clear. I was glad to hear somebody from the Ministerial Bench accept, in principle, for the first time, what we have been pleading for a long time. In effect, the Joint Parliamentary Secretary told us, "There is reason in what you are saying; of course there is such a thing as pulmonary disability, and if a man works for many years in a dusty occupation he may be expected to contract it, but we cannot accept it, because many people have bronchitis in this country any way."
Let us see what that means. In the first place, I suggest that the Parliamentary Secretary has admitted that injustice is being regularly perpetrated merely because there is more bronchitis here than in Australia or South Africa, and the Ministry is prepared to allow the position to continue because it is difficult to distinguish between people who have contracted the disease as a result of inhaling dust for many years and those who have contracted it through other causes. I suggest that that is not the way to consider the problem. I know that the Minister and the Parliamentary Secretary are sympathetic, but I hope that they will ask the Advisory Committee to consider the problem once more in view of modern opinion and also the indignation of workers throughout the country who are compelled to inhale dust at work throughout their lives.
There are many forms of emphysema. Miners' emphysema is not the only type. Furthermore, people other than miners contract a condition similar to miners' emphysema. But there is a type which is common to miners. We do not know why. It may be the result of a combination of a number of factors, such as working in a very hot atmosphere, work- 1202 ing very hard, and inhaling a great deal of dust. Miners tend to get a focal emphysema, not necessarily with large bullae attached to the lung. It seems fairly apparent that there are also other forms of emphysema.
One type is caused through the inhalation of cadmium. That was put on the Schedule only recently, by the right hon. Gentleman's predecessor, following representations made by my right hon. Friend the Member for Huyton (Mr. H. Wilson), to whom I was able to give some assistance by doing a little research work and encouraging him. A few weeks' inhalation of the fumes of cadmium can cause death from emphysema. It is a different form, but it is emphysema. In those circumstances, if we cannot allow benefit in respect of anybody who suffers from emphysema without there being radiological evidence on an X-ray plate of silicosis or pneumoconiosis, why should we recognise the type of emphysema which causes death in a few weeks or months through the inhalation of cadmium fumes?
The time has come to say that, just as the miners examine every new entrant, will not take them unless they are fit and X-ray them regularly during their working life, if a miner is disabled the onus of proof that he should not receive benefit should lie with the employer. That is morally proper and the only truthful way of achieving our purpose.
My hon. Friend the Member for Bedwellty (Mr. Finch) raised a number of matters, and I sometimes deplore the fact that we are not able to get medical men who examine people to give their views in the witness box, where they can be cross-examined. We used to be able to do this and at one time I virtually lived in the court. I was cross-examined hour after hour and day after day for many years. I used to enjoy sitting next to counsel telling him what to ask the chap on the other side.
It is so easy now for medical men to give an opinion in, as it were, an abstract fashion. They know that there can be an appeal and that it could, ultimately, go to the commissioners. But it used to be very much better when, sometimes, doctors knew that they would have to defend their opinions in front of a judge and when they could be cross-examined by learned counsel. I do not want to 1203 return to those days again. How wicked and horrible it was to sell pain and blood and barter it in the corridors outside a court-room and inside the court itself.
I appreciate that there is no such thing as perfection, and this Act is by no means perfect yet. There are still plenty of injustices attached to the Act, and many men suffer. I urge the Minister to take the whole question of pulmonary disability to his Advisory Council and to consider the matter afresh.
§ 6.28 p.m.
§ Mr. Raymond Gower (Barry)
I do not intend to delay the House long, for I wish merely to comment on one or two points that have been raised. The hon. Gentleman the Member for Stoke-on-Trent, Central (Dr. Stross) and the hon. Gentleman the Member for Bedwellty (Mr. Finch) both called attention, and rightly so, to the strange situation that arises in many cases in industrial areas.
My right hon. Friend will realise that one must live in an industrial constituency, or near to one, to appreciate fully the turmoil that goes on in the minds of some of the people who are affected. At different times I have seen cases of men about whom, during their working lives, it has been acknowledged that they have been suffering from industrial diseases of one category or another. I refer particularly to pneumoconiosis in South Wales. In some cases, when death has occurred, there has been one finding by a coroner—apparently after receiving the best medical advice—that the man had definitely died from a scheduled disease, but in spite of this—again, on the best medical advice available—the claim has been rejected.
It is very hard to explain to dependants—the widows or others who are concerned—how this state of affairs has occurred. The hon. Member for Bedwellty suggested that one way out of it would possibly be to schedule other diseases and he cited, as an example, that of bronchitis. Hon. Members who hold this view should realise that there are real dangers in doing this in the case of a disease of this nature, not only for the reason cited by the Parliamentary Secretary. It would be extremely difficult to do this with a disease which is 1204 suffered by so many members of the general population. It would be difficult to extend, for instance, bronchitis as widely as suggested because of this. However, I am open to arguments against my point of view.
I submit to my right hon. Friend that there is a case for a different interpretation. I have reluctantly come to the conclusion that in both this sphere and in some aspects of war pensions it is as though the medical advisers are working in a water-tight compartment, without considering the full history of the person involved. In some of these cases I often wonder how they arrive at their decision about a man who has sustained a serious wound, or who has suffered during his working life from substantial industrial injury and who dies from a disease such as, for example bronchitis.
I say that there should be a different interpretation because the benefit of doubt should, in those cases, be completely on the side of the applicant. I realise that my right hon. Friend would probably say that that is already so, but my experience leads me to believe that it is not. That is my impression. I pay tribute to the care that is taken by the medical officers to find a definite cause of disability due to a particular disease or war injury, but I have come to the conclusion that when there is any doubt they tend to say, "This is not proven". On the other hand, they should say, "We cannot prove that this has not affected the man's health." That should be the approach and I hope that my right hon. Friend will be in a position to say that that will be the approach in future.
Several hon. Members have dealt with the question of research and the figure which was mentioned in another place, which was commented upon by the hon. Gentleman the Member for Burnley (Mr. D. Jones) and my noble Friend the Member for Hertford (Lord Balniel). Expenditure out of the Industrial Injuries Fund on research is really frightening by reason of it being so small. Out of such a large fund—and we are discussing a fund that appears to be financially sound and has every prospect of remaining so—which embraces so many millions of pounds, only £3,900 has been devoted to special research of this nature. That is almost unbelievable.
1205 The contribution of the Nuffield Foundation is comparatively greater and I hope that the Minister will assure the House that, in future, there will be a dramatic increase in the sum from the fund devoted to research. After all, it is a most desirable form of expenditure. It is not likely to benefit only individuals, but will probably bring a long-term benefit to the fund itself. It is a specialised form of research and a specialised fund, and I submit that there is a strong case far a much larger appropriation for the specific purpose of research.
The hon. Member far Burnley referred to the inadequacy of industrial health systems, particularly in relation to small firms. This is something to which we should direct our attention. I think that the hon. Member will agree that many of his criticisms were about the administration of the Factories Acts, rather than about the inadequacy of the present Industrial Injuries Fund.
§ Mr. Gower
Disregard or non-enforcement.
I think that the hon. Gentleman will agree, on reflection, that there are not so many real inadequacies in the Factories Acts themselves, although it may be that the hon. Gentleman has made a point when he says that they are not always enforced. My impression is that the inspectors are not lacking in calling the attention of small firms to defects. Indeed, having some association with a small firm, I know that the inspectors came to our place regularly. Even the colour of a wall which has become dull or dingy has been commented on and has had to be remedied immediately. If the inspectors are so much "on the ball" in a minor matter like that, I feel that they are probably much more likely to spot something that is seriously wrong.
I take the point about the smaller firms. Sometimes they may not have the resources to provide what is needed on an adequate scale, and here we must look to the setting up of some form of assistance on a group basis. That may well be the only solution. I think that it can be said that this is an aspect of the Measure introduced in 1946 which 1206 has vindicated itself again and again. Defects which exist can be remedied. We are learning from experience, and we should be confident that, with the experience we have gained, those defects can be put right very soon.
§ 6.42 p.m.
§ Lady Megan Lloyd George (Carmarthen)
My hon. Friends the Members for Bedwellty (Mr. Finch) and for Stoke-on-Trent, Central (Dr. Stross) have spoken with intimate and expert knowledge on pneumoconiosis, the crippling disease which is the price that miners pay for coal, and it is a very heavy price indeed.
The Parliamentary Secretary in his admirable speech—and I congratulate him particularly on his Welsh accent—said that there had been a considerable improvement in recent years, which is perfectly true. But still the figures are grave enough in all conscience. There are 43,000 certified as suffering from pneumoconiosis, bringing tragedy to thousands of homes and families. Of those 43,000, 15,000 are in the South-Western Division which means, in the main, in the Welsh coalfields.
There is another significant feature. The Parliamentary Secretary said that the incidence of the disease falls most heavily on the older age groups, but we must not forget that the disability in some degree or other falls upon earlier age groups. I have looked up the ages of claimants before the medical boards, where the disease was first diagnosed, in 1959, the last year for which I could find figures. In the age group 35 to 39, 215 were diagnosed; in the age group 40 to 44, 260; in the age group 45 to 49, 437. There is a leap between those two near age groups. In the age group 50 to 54 the figure was 634. This disability afflicts men in their prime and in the fullness of life.
We all deplore the suffering that pneumoconiosis produces. How do we show our concern? Having listened to this debate, and having dealt with many cases in my own constituency, I cannot say in my heart that we meet their suffering in a generous or an openhearted spirit. It seems to me that we meet it in far too niggling and niggardly a way. We shelter behind restricted and narrow definitions. We have heard a great deal this afternoon about these definitions which lead to disagreements 1207 between specialists and doctors and which, quite contrary to what the hon. Member for Barry (Mr. Gower) said, do not give the benefit of the doubt to the claimant. Indeed, the onus of proof is weighted heavily against the claimant.
We have heard of many instances this afternoon, particularly in the case of emphysema which is not scheduled as an industrial disease. Those suffering from dust, emphysema and bronchitis receive no benefit because those diseases are not classified as pneumoconiosis.
The Parliamentary Secretary spoke of the difficulties and complications that have to be met if any change is to be made. One of my hon. Friends said that tuberculosis had already been scheduled. The Parliamentary Secretary agreed that that was so, and I understood him to say that tuberculosis was registered as an industrial disease in the case of nurses and hospital staff in contact with the infection. He said that this is a very specialised case, that it is easy of definition. Surely, it would be possible in the same way to have a restricted definition in the case of miners, so that when a miner suffers from bronchitis and emphysema and also has a proportion of dust in his lungs this can qualify as an industrial disease.
If this were done in this restricted category we should meet the arguments about bronchitis being almost a national disease, the comparisons with Australia and so on. We should include in the category the miner who has worked underground, who is suffering from bronchitis or emphysema and who also has a proportion of dust in his lungs.
The Parliamentary Secretary referred to conditions which aggravated and reacted upon each other. I should have thought, although I have no medical knowledge at all, that bronchitis and emphysema would have acted as an aggravating factor upon dust in the lung. I would urge the Government to see whether a better definition is possible.
I should also like to refer to the matter that was raised by the noble Lord the Member for Hertford (Lord Balniel) about research, and to say how much I agree with him about the ridiculously inadequate sums that are spent on research into the prevention of indus- 1208 trial disease. The National Coal Board figures are very interesting in this respect. The amount spent on the National Coal Board on research is £170,000 per annum. This excludes money spent on regular X-ray examinations, dust suppression, sampling and measurement. But even that sum of £170,000, which is a considerable advance on the sums which have been quoted this afternoon, is still inadequate when one considers the immense problem with which it has to cope. Of course, a comparison of that sum with what is spent on research in military matters in this country presents a sad commentary on the society which we are seeking to defend.
§ Dr. Stross
My hon. Friend is, perhaps, being a little unfair. There are other Government Departments and organisations which are spending quite substantial sums. I have in mind the D.S.I.R., for instance, the Ceramics Association of North Staffordshire, and, of course, the Ministry of Labour.
§ Lady Megan Lloyd George
That is true, but I am sure that my hon. Friend will agree that if one adds all those sums together the total is still quite inadequate for a great nation such as ours to devote out of its resources to medical research.
With all the hazards of the coal industry to life, limb and health I marvel not that there is a shortage of miners in certain parts of the country but that there are any men at all who are prepared to enter the industry. Having regard to all those hazards, having regard particularly to the disease of which we have been speaking, and in spite of all the improvements which are made—and let us not forget that mechanisation may in many instances increase the amount of dust in the mine—I beg the Minister to give us some hope that he will extend the definitions and the benefits which will bring new hope to the mining areas.
§ 6.52 p.m.
§ Mr. Harold Davies (Leek)
The House is grateful for this opportunity of discussing the working of the Industrial Injuries Act. This is the first time since 1948 that the House has had an opportunity to discuss it, and, since then, there have been tremendous developments in all types of industry. In the pottery industry, of which my hon. Friend the 1209 Member for Stoke-on-Trent, Central (Dr. Stross) speaks, there have, thank goodness, been new methods and processes for suppressing dust, but in the mining industry new methods and processes and the acceleration of production have often meant that dust hazards have been increased. In one of the industries of my own area of North Staffordshire, agriculture, greater hazards have been introduced as a result of the use of new insecticides, seed dusting, and so on.
We should be out of order in asking for legislation today, but I hope that, after this debate, the Minister will—I know that he will, because he takes his job to heart as much as any Minister in his office has ever done—look at the matter again, take advice and, if an opportunity comes to him in the near future, seek a means of removing some of the anomalies in our industrial injuries system.
I have in my hand a very valuable book written by Mr. John L. Williams on "Accidents and Ill-Health at Work". It was written this year, and I believe that it is the only analysis made of health in industry. Mr. Williams records a fact which is often forgotten. On page 5, he says:Work accident figures have so far been compared with road and home accidents; a comparison with war casualties will surprise many readers. The I.L.O. has reported that in the 1939–45 war the rate of casualties in the British armed forces, including deaths, was 10,667 per month. In the same period casualties in British factories were 22,109 per month. In America, the figures were 24,896 per month for the armed forces and 160,747 per month for industrial casualties".He then quotes a comment by the I.L.O., but I shall not detain the House by reading further from the book because right hon. and hon. Members are well informed on these matters.
I thought it well worth while to spotlight the fact that, during the war, the toll of casualties in industry was at that high rate. It is vital to ensure that our Industrial Injuries Act is as perfect as human ability can make it and that the onus of proof should not be on the weakest link in the chain of production, the worker, but should be on the employer or, in respect of soldiers, the Government.
I am greatly indebted to my hon. Friend the Member for Burnley (Mr. D. Jones) for spotlighting for the House and 1210 the country the astounding fact that, despite the £238 million in the "kitty" of the Industrial Injuries Fund, the paltry sum of only £3,900 is used from the Fund for research. The noble Lord the Member for Hertford (Lord Balniel) made the very valuable and constructive suggestion that research should be undertaken. It would not need legislation. Research should be undertaken, and we should dip into these large sums of money so as to prepare the way. I am sure that there are groups of sociologists, doctors and scientists who would be thrilled to have such a great opportunity which could pave the way for an occupational health service for this country.
At the initiative of my hon. Friend the Member for Stoke-on-Trent, Central and some of his colleagues in the City of Stoke-on-Trent, we recently had in Stoke a very valuable conference of trade unionists, employers and representatives of the medical profession to discuss bronchitis and pneumoconiosis in North Staffordshire. A constructive little piece of work was done and, if funds were made available, a pilot scheme of research could have been undertaken in the area.
The fact that the incidence of bronchitis is six times greater in some of our industrial towns than it is in seaside places and that bronchitis is sometimes called the Englishman's disease, does not excuse us from going deeply into the question whether or not bronchitis should be one of the prescribed diseases. As a matter of logic, it follows that, if a nation is liable to bronchitis, men working in dusty industries have a greater liability to contract the disease, and the disease can, in turn, lead to aggravated forms of industrial disability.
It would be very remiss of me to detain the House further, but I thought it well worth while to emphasise the fact that, when we speak of injury and ill-health in industry, we often forget that, when the nation was at war, the toll of casualties in industry was higher than it was among the fighting men. The money that we spend on maintaining good health at work, on keeping men fit, is of as much strategic value to the country as any weapon one could devise.
§ 6.58 p.m.
§ Mr. Douglas Houghton (Sowerby)
This afternoon, we have a lull between the high drama of yesterday and the controversies of the next few days, and it is characteristic of the House of Commons that we can turn from the great affairs of the nation to the sufferings and welfare of those who are injured at work or who contract diseases at their jobs.
I am astonished that this should be the first debate on industrial injuries that we have had these many years. I confess that I feel very blameworthy on that account. But I assure hon. Members that I shall contrive to see that there is another one before long. We are suffering from the short length of time we have chosen to take for this debate. It is obvious from the most useful speeches which have been made by hon. Members on both sides that we could have spent the whole day on this subject without wasting a single moment of it. I am sure that the Minister would have welcomed more time than he has asked for this afternoon to deal with many of the points raised in the debate.
I join the Parliamentary Secretary in congratulating my hon. Friend the Member for Bedwellty (Mr. Finch) on his speech. It was full of practical experience and wise suggestions. If anything ever takes my hon. Friend away from the House of Commons, he will be sadly missed on occasions like this.
One of the drawbacks of a debate on this subject is that one has to master medical terms and Welsh place names. I congratulate the Parliamentary Secretary on having mastered both. Earlier in the debate I sat between a Scot and a Welshman. When the Parliamentary Secretary sat down it was the Scot who said that I ought to congratulate him on his pronunciation of Welsh place names, which I do. I should apologise for the absence of my right hon. Friend the Member for Llanelly (Mr. J. Griffiths), who has sat through a good deal of the debate and who, I am sure, the House welcomed to our discussion.
I am very conscious of the fact that we are discussing the Consolidated Fund (Appropriation) Bill and that this is more an occasion for reviewing the work of Administration than for discussing 1212 social reform. However, we can scarcely fail to look back over the thirteen years of the Industrial Injuries Scheme in our review of its operation. It was very welcome that my right hon. Friend the Member for Llanelly, the architect of the 1948 scheme, was able to hear some of the comments on its administration over this long period. The Parliamentary Secretary said that the scheme had stood the test of time. I think that that depends on what the test is. If the test is the adequacy of the benefits, it fails. If the test is the removal of fine distinctions in definition and diagnosis and the distressing and even agonising decision on qualification for benefit, it fails. If the test is the comprehensiveness of the schedule of industrial diseases, it fails. I could list a number of other tests on which it would be difficult to say that the scheme has fully stood the test of time.
The fact is that nothing to which the House of Commons agreed in 1948 is necessarily adequate today. Our social thinking is different. If our economic position is not different, it ought to be. There are new social horizons which we wish to reach. I should like the Minister to decide on a thorough and full-scale review of the Industrial Injuries Scheme and to invite evidence from those who have interesting and constructive ideas on it to put forward.
There is much about the scheme which cannot be dealt with in one debate. Nor can it be dealt with in sporadic discussions between the trade unions and the Minister, useful though they are. We must recognise that much of the difficulty in the administration of the Industrial Injuries Scheme arises from the substantial differences in the scope and level of the benefits between industrial injuries and National Insurance. If there were not those substantial differences in scope and level of benefits, it would not be necessary to argue whether the injury or disease fell within the scope of industrial injuries or National Insurance sickness or disablement benefit. I have no doubt that there will be considerable discussion in the days to come about whether those differences should be maintained.
I am sure that if uniformity meant lowering the work and value of the Industrial Injuries scheme to bring it into line with National Insurance, there would be strong opposition to it. What 1213 workers might feel about the scheme when National Insurance benefits came abreast of industrial injury benefits, I do not pretend to know, but, while things are as they are, I think that we must pursue our aim to make the Industrial Injuries Scheme as satisfactory as we can. We may have to wait some time for the nation to adjust itself and its social thinking to better and more comprehensive social welfare, but in the field of compensation for the casualties of industry I am sure that there is a great deal of public sympathy and concern upon which we can draw in any reforms which we may put forward.
What are we in Britain spending on industrial injuries today?—£54 million a year, just £4 million more than we put into the football pools. That is a comparison between one form of spending and another. We on these benches shall not be satisfied until we have created in the minds of the British people new social wants which they can put alongside their consumer spending. None of us can feel that he is adequately providing for the casualties of industry with an expenditure as low as this. Here is a challenge to the affluent society.
Much has been said from both sides of the House about the need for research. Once more this has been pressed on the right hon. Gentleman very recently by the Trades Union Congress, whose useful work in this field we must not forget during its turmoils with other and more difficult problems. Here is the real and constructive work of the trade union movement in social welfare.
§ Mr. Houghton
The Minister gives it full weight because he never denies the T.U.C. access to him on matters of this kind.
I believe that there is some difficulty concerning the Minister's powers in the scope of research. As I understand, there is provision in Section 73 of the 1946 Act which enables the right hon. Gentleman to spend some money on research, but I understand that it must be related to the prescription of industrial diseases and not to general medical research. It is not the wider medical aspects of these matters into which the Minister has power to inquire under the Act, but, whether it lies within his power or comes within the scope of some other 1214 Department, there is no doubt that there is a great and urgent need for much more research into occupational health.
The problem with which we are concerned is illustrated to some extent by the fact that the list of prescribed diseases has altered little in the six years since the Beney Report. It almost looks as though, unless some more research is undertaken, we have come to the end of the road of industrial diseases within the traditional definition. When we hear the Parliamentary Secretary refer to the proportion of industrial injuries and disablement benefits paid to those working in the coal mining industry, when we hear about the toll of life, limb and health in that industry and then we have to heed the medical and other problems of distinguishing between what is bronchitis, pneumoconiosis and emphysema, we wonder whether, in an industry of this kind, we should not schedule the lot.
Any disability which could be regarded as attributable to work in this dangerous and dirty industry surely should qualify for the highest benefit that we can give under the Industrial Injuries Scheme. If that conflicts with the narrow concept of the Industrial Injuries Scheme, we must widen it, and this is what I mean when I say that we have new horizons in this field which the House, on another and more suitable occasion, may wish to discuss.
There are minor points—minor in volume, but not in their application to individuals—and one point not mentioned in the debate, but which has been referred to me, is the increasing danger of workers being sent abroad to work for their employers there and who sustain accidents at their work abroad. The postion about their qualifications for benefit is not, apparently, very clear. Unless there is a reciprocal agreement with the country in which they are working, there seems to be some doubt whether they are entitled to claim anything under our own industrial injuries scheme.
§ Mr. Houghton
The hon. Gentleman, ever alert, has anticipated me by 30 seconds. I was about to add that employers at their expense are covering, I hope—and it is up to the trade unions and the workers to see that they are—the risk of accident to workmen abroad, but this is an expense falling on the employer and is an economy to the Industrial Injuries Scheme. I do not think that it is right that they should pay twice over.
§ Mr. John Diamond (Gloucester)
My hon. Friend is dealing with a most important point. The difficulty arises because a large number of employers are not doing this, although it is part of their responsibility. They are completely failing to do it, so that a man finds himself being sent abroad by his firm, and being injured receives no compensation because of the lack of reciprocity with the country concerned.
§ Mr. Houghton
I am greatly obliged to my hon. Friend. I will not dwell further on this point, which, clearly, is one of which the House should take note and which the Minister will no doubt consider.
The hon. Member for Bradford, West (Mr. Tiley) mentioned the provisions of cars, or tricycles, for the industrially disabled. The Trades Union Congress has asked the Minister more than once to make available the same type of transport for the industrially disabled as is available for the war disabled, and that is not an unreasonable request. We believe that the Minister has power to do it under Section 75 of the Act.
There is another point, which has been put to the Minister more than once, on the expense of attendance at hospitals, and incidental expenses of that kind, which fall on the disabled person. My hon. Friend the Member for Bedwellty went into the whole question of pneumoconiosis and the problem of definition and diagnosis there, clearly a most difficult field, upon which the House might wish to see adequate provision made for those who suffer. This is a dreadful disease, which is contracted in the service and work of the nation, and anything less than liberal allowances to men who are to live with this suffering, probably for the rest of their lives, cannot be justified in this House at this time.
1216 I come now to this very difficult question of the special hardship allowance. We must recognise that when this allowance was first introduced it was expected to play a much smaller part in the scheme than it is playing today. It is like National Assistance, which was meant to be the net that caught those who suffered special hardship, so this kind of provision was made for them. Now, we find that the number of special hardship allowances being paid is about 100,000 at any time, and 30,000 or 34,000 more every year come on the books. Why? It is because of the widening gap between earnings and social payments.
I believe that I am right in saying that in 1946 the benefits were a higher proportion of wages than is the case today. I know that the change of basis for compensation from loss of earnings to loss of faculty was a revolutionary change, and that it was thought to be desirable at that time. I think that it is still regarded as the main concept which the scheme should fulfil, but it is no good overlooking the fact that the money loss to many injured people is grievous indeed, and that it is directly attributable to their injuries. They have suffered more than loss of faculty. They have suffered greatly in their capacity to earn their living, and, in reviewing the Industrial Injuries Scheme, we cannot disregard that important aspect of adequate compensation.
Suggestions have been made this afternoon about marrying loss of faculty with loss of earnings in some kind of combined scheme. That is one of the matters which probably requires much closer examination than we can give it either on this or on a future occasion, but one thing I am disappointed to report is that the Minister has been asked in vain by the T.U.C. at least to make an inquiry into the actual loss of earnings suffered by those who are receiving special hardship allowances. What is the duration of the special hardship allowance? What is the nature of the disability which, on the whole, seems to give rise to this claim for the special hardship allowance? What is the age of those who are claiming the allowance? Could we know the content of the 100,000 who are receiving the special hardship allowance? We may learn some lessons from inquiries into these matters.
1217 I am sure that the Minister will agree—although we all see how difficult it is, and at this moment we are not ready to suggest, even if it were in order to do so, what shape the reform should take—that we have not by any means heard the last of the special hardship allowance. I recognise, too, that a substantial problem arising from the special hardship allowance arises from the administration by the right hon. Gentleman's own Department. In the past, under workmen's compensation, it was the employers who had something to say about a worker's incapacity to earn his pre-accident wages. In present circumstances, it is the Ministry which has to decide the question of incapacity or inability to earn the pre-accident wages.
We all agree that the Minister's local officers, zealous and capable as they are, are not always in a very good position to judge the real merits of the case, and we must not overlook that problem. It may be, therefore, that it would be necessary to bring the employers into this rather more than the administration of the allowance requires. These are big and important matters, and I should be trespassing on the time of the House if I were to spend further time in discussing them.
I will conclude by saying that those of us who have staged this debate feel very well rewarded for the short time which we have been able to spend on it. We are grateful for the mass of useful information which the Parliamentary Secretary gave to us, and it is now my duty to make way for the Minister, who, no doubt, will give us some more.
§ 7.20 p.m.
§ The Minister of Pensions and National Insurance (Mr. John Boyd-Carpenter)
The hon. Member for Sowerby (Mr. Houghton) was unfair both to himself and to the House when he said that this was the first debate on industrial injuries since the passage of the 1946 Act. It is true that it is, in my recollection, the first general debate, but the House has discussed in considerable detail, in the course of, among other things, legislation, certain aspects of the scheme. Although I find a general debate of this sort even more valuable than that inevitably piecemeal discussion, I felt that in fairness to the House I should set the record right, since some at least of our 1218 fellow countrymen outside might regard it as a serious dereliction of parliamentary duty if we let this vitally important subject rest undisturbed for thirteen years.
Certainly, as the Minister responsible for the administration of the Scheme, I found this debate extremely helpful. Discussions in this House always seem to to be so in inverse ratio to the controversy which they generate. As the hon. Member for Sowerby said, this debate has been a refreshing and agreeable interlude in the course of our recent discussions.
It is my remaining duty, in the limited time which the hon. Gentleman's and my own self-denying ordinance imposes upon us, to answer to the best of my ability as many as possible of the points made in the course of this debate. It may well be the case that, for that reason, I shall fail to deal with all the important points that have been raised from both sides, but I will scrutinise HANSARD tomorrow and endeavour to write to the hon. Members whose arguments or points of view I have not been able fully enough to deal with this evening.
I should like quickly to take up one or two things which the hon. Member for Sowerby said. He understated, for understandable reasons, the amount we are expending this year on industrial injuries. The expected provision in the current year is just under £64 million. What might have misled the hon. Member was that the rates of benefit have been substantially raised from the beginning of the year; that puts up the expenditure. There is the secondary factor that the number of those drawing these benefits tends to rise.
Concerning the rates of benefit, it is only fair, not merely to the Government, but to the community as a whole, to point out how substantially these have been progressively increased over the years. The initial rate of benefit for injury, and for the 100 per cent. rate of disablement benefit, was 45s. Today, it stands at 97s. 6d. Taking the comparison with ten years ago, that shows an increase, not in cash terms, but in real terms, of 59 per cent. That, at least, is an indication that all those who have been concerned with this matter have taken the view that, as opportunity and occasion offered, advances should be made on this 1219 front. Again, it is only fair to put that on record.
What has emerged clearly from this debate is that the profound nature of the change which the 1946 Act brought about was perhaps not generally appreciated at the time. That is a particularly interesting reflection for me, because I am, I think, one of the few hon. Members present tonight who was a member of the Standing Committee that dealt with the 1946 Bill. If one is to get in focus some of the detailed points that have been made this evening, one must stress the profound nature of that change, because, as it has worked out, the various points where the shoe pinches have become evident.
First, there was the change from the workmen's compensation system of wage-related provision to a system based on loss of faculty, on the analogy of the war pension provision. That is an enormous change. Its effect have been in some measure obscured or mitigated by the expansion—and here I agree with the hon. Member for Sowerby—to a degree that would not have been expected in 1946 or 1948, of the scope of special hardship allowance. We must now be quite near the point at which further substantial expansions in that would alter the nature of a scheme based, not only upon loss of faculty, but on flat-rate contributions. It is important to realise that the difficulties and the hard cases that some of us see are due basically to that change from a wage-related to a loss-of-faculty basis.
The other profound change was the change that resulted from the introduction of a social service at a preferential or priority level of benefit. As the hon. Member for Sowerby said, most of the problems that we have discussed this afternoon derive directly from that state of affairs. To get this in proportion, it is equally important to record that in the sort of cases which we have been discussing in which industrial injury benefit has been refused, in the generality of cases that has not meant that the injured person or the widow has gone without help from the social services. It has meant—I do not underrate its importance—only that those people have not drawn social service benefits at the preferential industrial injury rate.
1220 For that reason, it is, in my view, extremely important to preserve the link between an industrial and an occupational cause and the payment of this type of benefit. If one widens the scope of the scheme to the points at which ordinary people cannot see a clear-cut connection between the industrial injury benefit and an occupational disease or injury, it becomes difficult to defend a state of affairs in which somebody injured at work gets a higher rate of benefit than somebody injured in the street on the way to work. Although, as the hon. Member for Sowerby said, it is an interesting speculation what would happen if the present social service benefits were raised to the industrial injury level, I cannot help hazarding the thought that the disappearance of the differential for the industrially injured might arouse an extremely critical reaction, not least in the ranks of organised labour.
Therefore, some of the difficulties with which we are faced in the administration of the scheme derive from the related facts of a preferential rate of benefit and of the necessity, if that preferential rate of benefit is to be maintained and justified, to maintain a causal connection between it and the injury or the accident or disease that has given rise to it.
I am grateful for the tributes which have been properly paid to my hon. Friend the Joint Parliamentary Secretary. One which I thought was unmerited was that concerning his Welsh pronunciation. As one who served in the Welsh Guards for thirteen years, if he could not pronounce properly in Welsh after that, it would be a serious reflection on his linguistic ability. The House will, however, agree that my hon. Friend's speech this afternoon showed what the House has lost over the years from the enforced silence which enwrapped him when he was a member of the Whips' Office. We had, too, a vivid indication of the insight that the Industrial Injuries Scheme gives us into our industrial system as a whole in the spectacle of my hon. Friend and his not inconsiderable height negotiating a 2 ft. 3 in. coal seam. I should like to have seen it.
Now, I come to the detailed points. My noble Friend the Member for Hertford (Lord Balniel), my hon. Friend the 1221 Member for Barry (Mr. Gower), and the hon. Gentleman the Member for Burnley (Mr. D. Jones) all touched on the question of my use of my powers under Section 73 of the Industrial Injuries Act in respect of research. I think there was a little misunderstanding underlying at any rate some of the comments which were then made. Fundamental research is not a business, of course, of my Department. It is only, as I understand the Section, research related to the prescription of industrial disease which brings me, if I may put it so crudely, into the picture at all.
Basic medical research lies, as I understand it, with my noble Friend the Lord President of the Council with his responsibility for the Medical Research Council, and related activities. In parenthesis I may say that the very interesting work at the Pneumoconiosis Research Unit at Llandough which has been referred to more than once this afternoon is, of course, conducted by and under the Medical Research Council. Then there is my right hon. Friend the Minister of Health, who has general responsibility in the health field, and my right hon. Friend the Minister of Labour with his responsibilities in respect of industrial health. Therefore the very small figures—and I concede them at once—which my noble Friend gave to the noble Lord, Lord Taylor, in another place the other day are not an indication of the total weight of research which is taking place on the all-important question of prevention of disease.
Section 73 gives me a subsidiary or auxiliary power, but I will say, as I did say on another occasion, that if any scheme really coming within the Section is put to me where I think research would serve a proper purpose, I have a very open mind, and I should be very willing to consider it. But I must make it clear that I cannot set up a rival medical research installation in competition with my noble or my right hon. Friends.
§ Mr. Harold Davies
Is the Minister aware that in North Staffordshire the hon. Member for Stoke-on-Trent, Central (Dr. Stross) and others have initiated a conference on industrial health? I wonder whether, if in North Staffordshire we put a constructive project to the Minister, he might assist it, or, at 1222 any rate, consider it now or in the near future.
§ Mr. Boyd-Carpenter
I very much doubt, judging from what the hon. Member says, whether a project for the promotion of industrial health would come within the Section. I very much doubt it. If the hon. Gentleman would like to write to me I will consider it, but I do not want to hold out false hopes because it was in fact the industrial health service which Lord Taylor was concerned about, and it was that kind of project which was clearly outside the Section. I do not want to give the hon. Member any unnecessary trouble in undertaking a fruitless enterprise.
The hon. Gentleman the Member for Stepney (Mr. W. Edwards) raised an interesting and important point. He knows, and the House knows, that individual cases are not decided by me. Parliament in its wisdom has placed the decision in individual cases with statutory authorities with a system of appeal, and my only chance of altering those decisions depends upon precisely that kind of action which, Mr. Speaker, in your wisdom you have indicated we are forbidden to discuss this afternoon. Therefore, I can only say that I appreciate the particular case which the hon. Gentleman has referred to although it may not necessarily be a case which the new Commissioner will feel bound to follow. I appreciate that it raises a certain amount of disquiet particularly among transport workers, and all I can say is that I have noted that disquiet.
My hon. Friend the Member for Bradford, West (Mr. Tiley) raised again the question of prevention of industrial disease and injury. I do not want for one moment to seem to depart from the sensible and practical view that prevention is in this matter so infinitely more valuable than compensation payments afterwards, but I must remind him, as I am sure he knows, that this, of course, takes me outside my scope, and into that of my right hon. Friend the Minister of Labour, who will, no doubt, note what my hon. Friend has said. Again I think my hon. Friend was attributing to me a function of my right hon. Friend the Minister of Health in connection with tricycles but, no doubt, my right hon. Friend will have noticed that.
1223 The hon. Gentleman the Member for Mansfield (Mr. B. Taylor) alarmed me a great deal when he raised the question of legibility. Any question of the legibility of anything emerging from my Department arouses in me a fear that it may have a personal connotation. I understand that the difficulty does in fact arise, because what are sent out are photostat copies of documents bearing the handwriting of members of the medical profession. I think I have said enough to indicate where the difficulty lies, and I can only say that I will look into it to see if there is anything within my power which can be done. I agree with the hon. Gentleman that few things can be more infuriating than to receive an official document which one is incapable of reading.
The hon. Gentleman the Member for Mansfield raised the question of special hardship allowance. I have already touched on that and I do not want to repeat myself, though I thought his comments, if he will allow me to say so, were extremely interesting and helpful. As regards Dupuytren's contracture, the present state of medical opinion seems to me to point against it having an occupational context, but it is still under study, and, needless to say, I shall keep that point in mind.
Coming last but certainly not least to the hon. Gentleman the Member for Bedwellty (Mr. Finch), whose speech, if he will allow me to say so, I found most interesting, my hon. Friend the Joint Parliamentary Secretary dealt with most of his points, but there were one or two which he was good enough to leave to me. First was the question of notification of a man examined by one of the pneumoconiosis medical panels and placed in radiological category one, that is to say, found not to have pneumoconiosis but to have some dust on the lung. Of course, some dust on the lung, as my hon. Friend the Member for Bradford, West reminded us, is a normal experience of city dwellers, but the hon. Gentleman posed a very important point to which I have in fact been giving some consideration—whether there would be any practical difficulty in sending each man examined a brief note to say, "You have been examined and are found to be free of pneumoconiosis"? But the problem arises—perhaps in one case out 1224 of a hundred—where the X-ray, when it does not reveal pneumoconiosis, reveals something else, perhaps something even more sinister.
It would be very wrong—and I am sure the hon. Member will be with me on this—to write to a man out of the blue and tell him he has got cancer of the lung. On the other hand, if we were to make a practice of writing a letter which says, "You are free of pneumoconiosis", and though in such a case the letter would be literally true, I think we might be subject to justifiable criticism if we wrote to a man excluding one complaint but ignoring the existence of a more serious one. It is a difficult problem and I am anxious to deal with it. I think it may be possible to evolve a formula which does relate specifically to pneumoconiosis and does not purport to give a medical opinion on the state of a man's lungs from other points of view. I hope to meet some of the difficulties about that, and it is indeed a matter about which, as the hon. Member may perhaps know, I have been in consultation with outside bodies.
The hon. Member raised the question of the right of appeal on diagnosis questions in pneumoconiosis cases to the medical appeal tribunals. As he knows, when I introduced that right of appeal in respect of other industrial diseases a year or two ago I made it clear in public, and direct to those concerned, that it would not be possible to introduce it in pneumoconiosis cases for the time being. The reason was, briefly, a shortage of qualified men to provide the medical consultants to sit on those tribunals. The members of pneumoconiosis medical panels are, as I think he will agree, some of the most qualified people in the world, and it would be just no use to provide for appeal to a higher body whose medical members consisted of people of lower medical qualifications in this particular respect than the panels appealed from. There is equally the fact, as he knows, that the National Coal Board's survey is likely to throw up a considerable volume of work for pneumoconiosis panels, and so that prevents me from transferring members of those panels to sit occasionally on medical appeal tribunals.
Therefore I made it clear at the beginning that in my judgment it would not be possible to provide this appeal 1225 until the National Coal Board survey had been completed, which I understand will be two or three years ahead. I can only say to the hon. Member, as I said earlier, that I am conscious that logically it seems anomalous that this extremely difficult complaint should be the only one in respect of Which appeals on questions of diagnosis are not possible. I should like to put that matter right as soon as possible.
We are taking considerable stops to recruit to pneumoconiosis panels highly qualified medical men. It is not rapid progress because, frankly, we only want the best for this work. We have succeeded in recruiting several in the last year or two and the completion of the National Coal Board's survey may help us on that point.
I have found this an interesting debate, the report of which I shall read not merely from the point of view of showing proper courtesy to hon. Members whose points I have not been able to deal with, but also from the point of view of study and reflection in connection with my duties.
It is no reflection whatsoever on the framers of the original scheme, or even on those who sat in Opposition in Standing Committee, that various difficulties have shown themselves. We have managed to put some of them right. Others can be varied only by that method of proceeding which we cannot discuss this afternoon. I should like to thank the House for the debate and say that I, and those who advise me, will undoubtedly find it valuable and helpful. I hope that the debate will also have communicated to those outside the House the feeling that on both sides of the House this is a scheme which we regard as one about which we can differ on methods and expedients but which we regard as a measure of social value and help, and which we have every intention not merely of keeping as an effective instrument but of improving as the years pass.