INDUSTRIAL DISEASES (BYSSINOSIS) (Hansard, 11 December 1962)

§ Mr. Leslie Hale (Oldham, West)

I beg to move, That leave be given to bring in a Bill to make further provision for the definition of byssinosis and for the hearing and determination of cases relating to industrial disease. I wish to dispel the rumour, which was widely circulated last week, that the incidence of smog in London was one of the new and juicy ideas invented by the Minister of Transport for the delectation of denizens of the Royal Parks. In saying that, I should like to call the attention of hon. Members on both sides of the House—because we all have some shame to bear in this matter—to the point that the London Press last week called very proper attention to the fact that the risk of respiratory disease to Londoners, because of fog, was something like I in 10,000 of the population, whilst in Oldham people are still exposed to the risk of respiratory disease in cotton card-rooms and blowing rooms which, to the older workers with a long record of employment, is now accepted as rising to 50 per cent. or 60 per cent. of the persons working in certain departments of certain mills.

After long employment, 50 or 60 per cent. of the workers in some cardrooms are almost certain to suffer a long and lingering agony, an incurable disease and ultimate death in respect of a disease which is almost wholly preventable by the installation of modern machinery and in which the whole ingenuity of Ministers of Pensions and National Insurance over many years has been used to deprive sufferers from the provision of any form of industrial benefit.

I put it to the House, and I say this quite frankly, that I have with some reluctance drafted a very simple Bill in the hope that it will commend itself to the House in these circumstances. There are many things which I should have liked to include in it, and there are many things which workers in Oldham would expect me to include when dealing with this subject. But I want to get the Bill through. I have produced a Bill of only two Clauses, for the second of which I believe to be merely declaratory of the law. It merely states that when an 218 application is turned down, a later application can be made when fresh or more recent evidence is obtained. The House gave me leave to use a Clause of that nature as recently as last week.

I believe in a declaration of the existing law, and if only I could see the Parliamentary Secretary nodding it would be the first piece of acquiescence I have received from him since he became Parliamentary Secretary. As far as I know, there is nothing to preclude this being done, but no one seems ever to have realised that that right previously existed.

The House may regard the first Clause as being stated in somewhat unusual form. It provides that if a man who has complied with all the other conditions—and I ask the House to remember that before he can establish a claim for industrial benefit for byssinosis he has to prove long employment in the appropriate industry or sections of the industry, to prove disablement by a severe respiratory pulmonary disease, and has to prove exposure to dust, and so on—and after all that first, added to that, he has to prove all these circumstances and that he is suffering from a pulmonary disease which is medically indistinguishable from byssinosis, then it shall be regarded as byssinosis. I emphasise this point.

This is a very modest demand. Hon. Members might say that if it is indistinguishable from byssinosis, then it must be byssinosis, but in a large number of cases it is labelled bronchitis. After all the employment, the exposure to dust and all the statistics of industrial health, it is still called bronchitis, and that is the end of it.

Is there any method of distinguishing bronchitis from byssinosis? The whole of informed medical opinion in this country agrees there is no physical test. The Nuffield Professor of Industrial Health at the University of Manchester, Dr. Schilling, conducted a whole series of experiments—as to the incidence and epidemiology rather than the pathogenesis of the disease—in industrial circumstances, its relevance and its diagnosis, and Professor Gough, of the Welsh School of Medicine, conducted a long series of investigations into the post-mortem indications of the disease. It is conceded that in a large percentage 219 of cases there is nothing physically and medically either on the radiological examination of a living person or on the pathological examination of a dead patient by which one can say definitely that this disease can be distinguished from bronchitis.

So we come to a very curious, very remarkable and very unhappy state of affairs. The man makes his claim for byssinosis and is examined by a medical board, in the case I have in mind, one of the board being a medical officer on the staff of the Ministry of Pensions and National Insurance. One has to approach the subject with some caution, and say, "Do you feel any special symptoms?" The applicant usually says, "There are times when I feel as if I had an iron bar round my chest" and he means it. He is then asked, "Do you feel this at any special time?" and he may reply, "When I am at work". He is then asked, "Do you feel it on any special day?"—and this is where we reach the nub of the question, because if he says "Monday", he is half-way through, if he has got all the other symptoms.

The next question will be "Always on Mondays?", and if he says "Yes" to that, he has got byssinosis, and if he says "Mostly", or "Often" or "Occasionally", then he has not. These are the early stages of the disease. This is what happens, and I have a judgment of the tribunal which studied this.

May I flow refer to one specific case; and I am trying very hard to keep within the allotted ten minutes. May I make one introductory remark? I asked the Parliamentary Secretay some Questions about byssinosis some time ago, and he thought I was making some criticism of this particular case, in which he knew I had been engaged. Nothing was further from my mind. The Industrial Commissioner heard this case with the utmost courtesy, patience and attention to detail, and I have no complaint to make about the Insurance Commissioners at Grosvenor Gardens, Westminster, or of their staff, who I am sure received everybody with the utmost desire to help and to master the facts. The case lasted for part of two days, and I do not make any suggestion about that.

220 Having said that, now let us look at the particular case. Fred Mills was employed in the cotton mills for 47 years, and for 37 years at least in the cardroom, which had none of the modern contrivances for the elimination of dust. He was exposed to it for 37 years in its maximum form. Quite by chance, at a radiological survey looking into tuberculosis he was told "You had better have your lungs looked at: you are in a bad way". That was in 1955. In 1960, he made application for industrial disease benefit for byssinosis. He was examined by a medical board of two doctors and in that examination he established all the employment conditions and questions qualifying him for benefit. But the Ministry doctors decided he had not got byssinosis. By that time, his disability was so serious that he died a few months later. He did all that, but he failed to qualify on the final question, in that in reply to the question, "Always on Mondays?" he said "No, occasionally". The Board then said "It is not byssinosis, but bronchitis". He died within 18 months, having never worked after that examination, and having spent some weeks in Oldham General Hospital under observation. When his body was examined by the brilliant and talented pathologist in Oldham General Hospital, Dr. Garrett, it was said, "This is byssiriasis". An inquest was held, and the coroner, who is experienced in these matters, recorded a verdict of "Death from byssinosis". An application was made for an industrial diseases pension, and it came before the local tribunal which said, by a majority, "Yes, a pension for byssinosis".

I have already conceded that the pathologists could not say that there was this or that symptom which made it quite clear for them to be able to say, "This is not bronchitis," because there are no such symptoms and there is no pathological definition. At that stage, on an examination by the Ministry of Pensions and National Insurance doctor, and on the determination in favour of the widow by a Ministry-appointed medical board, the insurance officials in Oldham decided to appeal on a question of fact. The case went before the Commissioner, and on the evidence he heard, and there was not much, and on the certificate given by 221 the Ministry of Pensions and National Insurance doctor—who did not turn up at the hearing, when another doctor came along to say, "I have read what he said and I think it is right"—the widow was deprived of a pension. [An HON. MEMBER: "Always on Monday"?] Certainly, "Always on Monday?".

I will explain that. I have not come to the important point. He said "Occasionally on Monday". I think that Dr. Schilling's views are accepted fairly generally, and it is rather interesting to refer to an interesting correspondence in the British Medical Journal and a letter from Dr. A. Bouhuys, of the Laboratory of Clinical Physiology of Leyden, and Dr. S. E. Lindell, of the Clinical Research Laboratories of the University of Gothenburg, in Sweden. They take a different view of this and say that experiments have shown that respiratory activity can be limited by other causes. That was last week.

I must conclude the case of Fred Mills, because I have not yet stated the decisive point. He said, "Occasionally on Mondays". When we investigated the matter, we found that during the last five years of his employment in the cotton mills he had been a member of the maintenance crew which rarely worked in the cardroom on Monday, so that for five years, on Mondays, he had only occasionally been exposed to the risk of displaying these symptoms.

Dealing with a difficult and complicated subject, I have already said as much as would exhaust the time normally allotted to me, and I cannot therefore deal with the matter to the extent to which I had hoped to do, but the evidence is there. I tried to put these cases to the Minister of Pensions and National Insurance. I have tried to suggest to the House that in the whole area of industrial disease if a man has a chronic disease it does not matter how it is caused. We should see that he gets the same benefit. In my maiden speech in the House in 1945 or 1946 I raised the question of industrial disease in relation to the form of tribunal which 222 was being allotted to that and the use of State doctors to decide State matters which would cost the State money.

In what is called a Welfare State we have been told to regard the Minister of Pensions and National Insurance as something like the Sacre Cœur, in Paris, gleaming pure white in the mists of the evening and a shining message of hope and benison to all the inhabitants of the city. Sacre Cœur is very near the Place Pigalle. The attitude of the Minister is set out in the opening words of Jean Genet's remarkable play, "The Balcony", in which the bishop, who has been equipped with the Athenian tragedian's cothurni to enlarge his size, and padded shoulders to improve his importance, says: In truth, the mark of the prelate is not mildness or unction. But rather the most rigorous intelligence. Our heart is our undoing. We think we are master of our kindness; we are the slave of a serene laxity. In fact it is something quite other than intelligence that may be involved. In fairness to the bench of bishops, I should add that later in the play we find that the person was not a bishop at all but, appropriately enough, a man from the local gas works who was dressed up as a bishop to gratify his fetishism in a maison de tolerance.

These are the grounds on which I ask for the leave of the House to bring in the Bill.