§ Motion made, and Question proposed,That this House do now adjourn.—[Mr. Noble.]
§ 10.16 p.m.
§ Mr. John Eden (Bournemouth, West)
I am very grateful for this opportunity to discuss in the House a misfortune which has befallen one of my constituents named Mr. Barringer. It will be for the convenience of the House if, first, I set out in chronological order some of the main facts of the case which I wish to deploy.
The story starts in November, 1959, when Mr. Barringer was employed by a glassworks. He was carrying a sheet of plate glass, which weighed about 1 cwt., when he accidentally twisted his right knee. At first, the accident did not appear to be too serious and he was treated under the National Health Service for a strained tendon. He was provided with special creams to rub in his knee and with crepe bandages, but, although he asked for it at the time, he was not given an X-ray.
The pain persisted and ultimately at the beginning of April, 1960, about six months after the accident, he was booked by a specialist for a non-urgent X-ray examination to take place in May of that year. Mr. Barringer, however, was not happy about this. The pain was more acute than seemed natural with just a strained tendon, and, as he was anxious to get the matter settled so that he could get back to work, he went, at his own expense, to another specialist who arranged for him to be X-rayed about a month earlier, on 14th April.
As a result of this examination, he underwent an operation on 20th April for the removal of a small piece of bone from his knee. Nine days later, he was again examined and then sent to a hospital in Southampton for deep-ray treatment of a cyst which had been found in his knee. This treatment continued until 10th June. On 1st July he was examined by a medical board which subsequently decided that a loss of faculty had resulted from the industrial accident on 3rd November, 1959, and the extent of the disablement was assessed at 40 per cent. from 3rd May until 2nd 1480 November, 1960. This, as Mr. Barringer well understands, was a provisional assessment. It resulted in his receiving a disablement pension of 34s. a week.
During June and July, he regularly attended clinics at Boscombe Hospital. On 26th July, he was told that as a result of the inspections which had taken place and with the pain continuing as it had been, his leg would have to be amputated. He asked for a second opinion, which was given to him. He went to Westminster Hospital and on 3rd August the original opinion was confirmed. As a result, on 4th September his right leg was amputated to the hip.
On 7th November, Mr. Barringer appeared before a medical appeal tribunal. The tribunal concluded that the extent of the disablement resulting from the loss of faculty brought on by the industrial accident should be assessed at 15 per cent. for the period 3rd May to 2nd August, 1960, this latter date being the day before he was given the second opinion which confirmed that his leg would have to be amputated.
That resulted in a reduction in assessment from 40 per cent. to 15 per cent. and came at a time of extreme distress to my constituent when he had just learned that his leg would have to be amputated. It meant that there had been an over-payment of about £37. Graciously, however, repayment was not requested and he was able to keep that money.
In commenting upon its findings, the tribunal said that there wasa constitutional condition present before the accident, symptomless till then, which was brought to light and accelerated by the accident.It is this finding which I wish to challenge.
I am quite certain that eminent people were serving on the tribunal and I do not for one moment cast any aspersions on their integrity or professional standing. Even so, how can they be sure that the constitutional condition—in other words, let us be frank about it, cancer—was present before the accident? In the tribunal's own words, it had remained symptomless until the accident occurred. The tribunal claimed that itwas brought to light and accelerated by the accident.1481 Could it not conceivably have been caused by the accident? Is our knowledge of cancer in this country, or, indeed, in the world, sufficiently far advanced to enable anyone to be categorically certain as to its origin in any one case?
There is a variety of opinions on this subject. I am told that the view of the Imperial Cancer Research is thatit is not possible to state the age of any cancer whether it be in the bone or elsewhere in the body at the time of an operation.These views, of a body directly concerned with the disease, are an important reflection. I underline them by repeating the view of Imperial Cancer Research thatit is not possible to state the age of any cancer … at the time of an operation.In this case, it was six months after the accident that the first X-ray examination was made. Had it not been for the pressing action of my constituent, it might have been even later had it been left to the medical authorities. Who, therefore, can be sure about what happened during those six months? An eminent surgeon has written to Mr. Barringer to say that, in his experience over the past ten years, sarcomas such as my constituent has suffered take anything from three to six months to develop from initiation. We must surely all recognise that in dealing with cases of this kind, there is room for considerable doubt and even amongst highly professional persons there can be a variety of opinions.
The story of my constituent does not, alas, end even there. Since the amputation, Mr. Barringer has continued to suffer severe pains. During the past few months an additional scourge has been added in the form of deep-seated arthritis affecting his neck, shoulder, arm, and his remaining leg. He is receiving special treatment for this and also for a pleurisy condition brought on when he fell from an ambulance when his artificial limb failed to lock.
In his present condition, as the House will clearly understand, Mr. Barringer is not able to work, and he has a wife and two young sons, aged 12 and 11, to support. This man, before his industrial accident, was well and fit. There was no visible cloud on his horizon. He was working actively, and keeping a happy and contented home together. Yet, fol- 1482 lowing the accident, apparently such a minor one, he has suffered severe physical pain and substantial loss of earnings.
So even if we assume, as the medical appeal tribunal did, that the constitutional condition was present before the accident, are we not justified to assume that had the accident not taken place there would have remained to Mr. Barringer many years of active hard work during which the problem of supporting his family would not have loomed nearly so large and formidable as it must do now to him in his present condition?
My hon. Friend's powers, I know, are very limited in a case of this kind. I am sure that all hon. Members have experienced similar cases in which they have tried to help constituents and found that there comes a point beyond which statutorily they have no powers to go. I am aware that my hon. Friend cannot give any direction to the tribunal. Mr. Barringer himself also clearly understands this. Let me say here that Mr. Barringer and I are both grateful to my hon. Friend and to his predecessors for the sympathetic attention they have already given to this case and for the care with which they have heeded the representations which have been made to them.
What we want now, if I may put it this way, is advice and guidance from my hon. Friend. I claim that, in view of the six months' delay, of the limited extent of our knowledge about the origins and causes of cancer, and of the subsequent serious aggravations undoubtedly brought on by the accident itself, there are more than sufficient grounds for a reassessment. Is it not perfectly clear that since the tribunal's decision there has been, to quote the words written to me in a letter by my hon. Friend,unforeseen aggravation of the effects of the accident"?In these circumstances, even though time limits may have expired, and even though it may not be in strict conformity with the regulations, cannot my hon. Friend, without raising any false hopes, indicate a way in which Mr. Barringer could pursue his claim to have his case heard once again?
My statement of this case has been brief. The facts are straightforward and 1483 the plea is easily understood. Mr. Barringer is not a malingerer or a scrounger. Over the years I have come to know him well. He is genuine, conscientious and sensible and a man who, in adversity such as few of us would wish to experience, has found an immense reserve of courage. I have the greatest respect for him and for his brave young wife, upon whom there falls a heavy burden of work and responsibility. I want to help Mr. Barringer, but I find that my powers as a Member of Parliament, as perhaps my hon. Friend finds his powers in his present office, are limited.
Can my hon. Friend indicate any course of action or direct us to any society or organisation which would bring help to this very deserving young family in their hour of need? I feel that a case like this deserves such assistance as the State can give. I hope that my hon. Friend, without raising false hopes, can point out some course which my constituent can pursue.
§ 10.31 p.m.
The Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance (Mr. Richard Sharpies)
My hon. Friend the Member for Bournemouth, West (Mr. Eden) presented his case with the force and clarity which one would expect from him. There is nothing between us in our sympathy for Mr. Barringer in the very distressing circumstances in which he finds himself. I am sure that my hon. Friend recognises that. There is no need for me to rehearse the events. My hon. Friend set them out clearly.
My hon. Friend referred to the Medical Appeal Tribunals and I think that it might be helpful were I to say a few words about the position of such tribunals, which are statutory authorities established under Section 38 of the Industrial Injuries Act. The function of the tribunal is to hear appeals from claimants who are dissatisfied with the decision of a medical board on medical questions involved in a claim to disablement benefit under the Act, and also to consider cases, such as the case of Mr. Barringer, where the Ministry is of opinion that the medical decision ought to be considered by a tribunal.
1484 My hon. Friend referred to the composition of the tribunal. As he knows, it must consist of a chairman and two medical practitioners. The appointment of the chairman, in England and Wales since the Tribunals and Inquiries Act, 1958, has been in the hands of the Lord Chancellor. The medical members are invariably of consultant status and are nominated either by the Royal College of Physicians or Surgeons or by the medical faculties of the universities. There is the right of appeal from the decision of a tribunal to the Industrial Injuries Commissioner only on the ground that a tribunal decision is erroneous on a point of law. But leave to appeal in such a case must be granted either by the tribunal or the Commissioner.
As my hon. Friend knows, it would now be considerably out of time for such an appeal to be made here—in fact, about 17 months. If Mr. Barringer wished to appeal to the Commissioner he would have to satisfy the Commissioner not only on the grounds on which he wished to appeal but also on the reason why he had left his appeal so late. I put that to my hon. Friend in all fairness so as not to raise any false hopes in that direction.
I must also in fairness warn my hon. Friend that the Commissioner cannot substitute a different decision for that of the medical appeal tribunal. All he can do, if he considers that there has been a decision which is erroneous on a point of law, is to send the case back to the tribunal for another hearing. As my hon. Friend recognised, my right hon. Friend the Minister of Pensions and National Insurance has no power to interfere with a decision of a medical appeal tribunal and he has no power to arrange for a hearing by another tribunal.
Apart from the reconsideration to which I have referred on the direction of the Industrial Injuries Commissioner, a review of the decision of the medical appeal tribunal can take place only in the following circumstances. First, if a medical board is satisfied by fresh evidence that the decision was given in consequence of a non-disclosure or misrepresentation of a material fact. Secondly, if a medical board is satisfied that since the decision was given there 1485 has been unforeseen aggravation of the results of the relevant injury. Prior leave by the medical appeal tribunal is required before a medical board can consider an application for such a review.
I have tried to set out the position as fairly and clearly as I can without wishing in any way to raise any false hopes either on the part of my hon. Friend or Mr. Barringer, but there are two points to which my hon. Friend referred and to Which I wish to give particular attention. First, there is the difference of opinion about the cause of this disability. My hon. Friend himself said that this was a matter of considerable doubt and that there were a variety of opinions in the medical profession. It is precisely because of the difficulties of deciding cases of this kind that they are referred to a medical appeal tribunal.
He also referred to the time which elapsed between the initial treatment by Mr. Barringer's own doctor for the strained tendon and the arranging of an X-ray examination. I think my hon. Friend said that might have contributed to the disability as the injury was left too long for a cure to be effected. That was a point which certainly would have been considered by the medical appeal tribunal although, as he knows, treatment is not the responsibility of the industrial injuries medical authorities. I realise only too well that cases will arise from time to time where a claimant like Mr. Barringer is disappointed with the decision of a medical appeal tribunal, but I think that the House will recognise that at some stage there has to be a body charged with the responsibility for making a decision binding both on the appellant and upon my right hon. Friend.
Parliament has put this responsibility upon the medical appeal tribunals which as I hope I have shown are very 1486 qualified to exercise it. Somewhere or other there has to be finality in a matter of this kind. Bearing in mind the qualifications and the status of those who have the responsibility of sitting on these tribunals, I think it would be impossible to arrange for appeals to some other body with even more highly qualified medical members since the tribunals already have the services of doctors who are among the most eminent in the medical profession.
I realise that what I have said may be disappointing to my hon. Friend and to Mr. Barringer, but I should be quite wrong if I were at this stage to raise false hopes. I hope that what I have said will at least go some way towards reassuring my hon. Friend and his constituent that, however disappointing may be the outcome of all the work which my hon. Friend has done in pressing this case, it has been considered at the very highest level and that in any case my right hon. Friend the Minister has no power to intervene in this decision.
§ Mr. Eden
I am extremely grateful to my hon. Friend for his sympathetic answer to the points which I made, even though he has not been able to give any promise to my constituent. May I ask whether the services of any of his local officials could be made available to Mr. Barringer in trying to prepare his case in the hope of getting a rehearing from the tribunal? Are there local people who could come forward to assist him in dealing with this matter?
§ Mr. Sharples
If I may reply, very briefly, with the permission of the House, the local National Insurance office will give all assistance possible and will be only too pleased to do so.
§ Question put and agreed to.
§ Adjourned accordingly at nineteen minutes to Eleven o'clock.