§ 11.6 a.m.
§ Mr. A. G. Bottomley (Middlesbrough, East)
I beg to move,That this House records its continued anxiety for the safety and welfare of all workers and its concern for those disabled through industrial injury or disease, and in particular calls the attention of Her Majesty's Government to existing anomalies under the Industrial Injuries Acts, the limitations of the Schedule of industrial diseases, and the discrepancies in the treatment of the pre-1948 cases.The Minister of Pensions and National Insurance has told me that he is unable to be present this morning, for reasons which I understand. I know that the Parliamentary Secretary is well able to deal with all the matters which will be raised in the debate and I am sure that he will convey the feelings of the House to his right hon. Friend.
When I first entered Parliament in 1945 there were a great number of political, economic and social matters that required urgent consideration. J chose to make my maiden speech on 1630 the subject of industrial injuries. At that time we were, quite rightly, worried and anxious about those who had been wounded or made sick as a result of the war. However, for a considerable time we had felt that it was necessary to do something for those who became disabled through injury or sickness caused by employment.
For many years I worked in a railway workshop. Colleagues of mine often sustained injuries for which they received only a mere pittance in compensation for being unable to follow their employment. At that time it was possible to make a claim under the Workmen's Compensation Act, but there were many shortcomings in that Act. I recall the case of a man who lost an eye. In due course he was able to resume his employment but, some time later—due to circumstances unconnected with his work—hie lost his other eye. This prevented him from working and he was left penniless and blind, unable to get any recompense to help him face the trials ahead.
Under that Act the amendment which could be claimed for an injury was fixed by definite principles requiring, in many cases, complicated mathematical calculations based on the injured man's average earnings. If the injury resulted in death a lump sum was payable. This was fixed according to the deceased person's responsibilities; namely, whether he had a family to support or dependants. If there was a family the maximum payable was £600. If there was no family but dependants the maximum was £300. If neither of those conditions applied a sum of £15 was payable to meet burial and medical expenses.
A great number of hon. Members, and people generally, were of the opinion that an adequate scheme to cover accidents at work and industrial disasters was long overdue. I had the opportunity and pleasure of taking part in the debate which ultimately led to the placing of the Industrial Injuries Act on the Statute Book. This was one of the great social reforms piloted through the House by my right hon. Friend the Member for Llanelly (Mr. J. Griffiths), whom I am glad to see in his place today. The Industrial Injuries Scheme was a more enlightened and human piece of legislation than the old Workmen's Compensation Act and the 1631 new Act tidied up earlier legislation. Whereas previously there had been piecemeal legislation and committees appointed to deal with particular cases, the Industrial Injuries Act was all embracing.
It was a great step forward to have an insurance scheme which replaced the system under which compensation was so frequently a matter of dispute between an injured person and an employer. As we all know, what was the new pension scheme was based on loss of faculty rather than on compensation related solely to loss of earnings, and it had regard to a person's loss of health, strength and power to enjoy life. I recall that in the old days, when a depression brought about low wages the compensation was likewise low but, if there was prosperity, a man had a better chance of getting higher compensation for his injury.
A large number of workers were, of course, excluded from the operation of the Workmen's Compensation Acts—as, for instance, non-manual workers earning over a certain sum—and, except in the coal-mining industry, there was no compulsion on an employer to ensure against his risk. Under the Industrial Injuries Scheme, employers have to pay their contribution and the money is paid out by the State. In such circumstances, there can be no question of an employer defaulting because of bankruptcy or liquidation.
However great the benefits under the Industrial Injuries Acts, it is now nearly 18 years since the original Act was passed, and there is much room for improvement. Indeed, some say that there is need for further major legislation. The present benefits under the Scheme certainly ought to be higher even than they will be as a result of adjustments now being made. Distinctions in disputes and diagnoses are too finely drawn, and much distress and agony are caused to those seeking a decision on whether or not they qualify for benefit.
The number of diseases scheduled as arising from employment in industry is too small. It is estimated that there are about 2,000 different diseases associated with industrial employment, yet there are only just over 40 such diseases scheduled. In some cases, a disease is related to a special class of worker—as, for instance, in relation to tuberculosis, nurses and others who may be in direct attend- 1632 ance upon tuberculous patients. I am connected with the National Union of Public Employees, and we know of welfare workers and home helps who are also in constant touch with cases of tuberculosis. We feel that there is a case for further classes of these employees being added to the list.
A common industrial disease is dermatitis. To secure benefit, it is usually necessary to show that contact with some primary irritant produced the damage to the skin, but dermatitis may be caused in many other ways. For instance, it may be caused by a man being worried because he has a bullying foreman or, indeed, worrying about whether or not he will keep his job. A doctor has told me that the rise in unemployment in the North-East has resulted in an increase in gastric ulcers and nervous disabilities.
Many other things have to be considered, particularly with developing industry. Many new processes brine new diseases and physical disability. It is known that there is probably a connection between employment in the atomic energy industry and leukaemia, and experts will probably tell us of many other diseases that can be associated with this industry and call for the most careful consideration.
In the electronics industry and industries allied to it, many other problems arise which affect the well-being of the worker. These have not yet been sufficiently examined. I am told that a certain powder used in connection with the manufacture of cathode tubes is known to be injurious to the worker, and can cause an industrial disease.
Bronchitis and emphysema have frequently been mentioned in the House, and where these are accompanied by pneumoconiosis it is quite clear that they should be treated as industrial diseases and not, as now, left out of the diseases scheduled under the Act. The chemicals used in a number of processes, including the manufacture of foams, synthetic rubber, adhesives and paints—those called isocyanates—are believed to be the cause of respiratory troubles. Now that I represent Middlesbrough, East, I certainly know that foundry workers and steel workers are particularly susceptible to respiratory troubles. Special attention should be given to their cause, and greater recognition made of them as a qualification for benefit.
1633 I am also concerned about industrial noises. In my constituency, there is a lot of heavy industry, and I believe that industrial noises cause not only occupational deafness but other nervous diseases. I understand that this matter has been receiving some attention, and I should be pleased if something could be said about it in this debate.
The question of injury by process is admittedly a difficult one. A man may receive thousands of tiny injuries caused through his using some kind of machinery over a period, and may consequently suffer disablement that could have resulted from constitutional factors. There ought to be much more flexibility in the Industrial Injuries Scheme, so that inquiries can be made into a man's industrial history when he seeks to establish a claim for benefit.
My hon. Friend the Member for Bedwellty (Mr. Finch) recently sought to introduce a new Clause to the National Insurance Bill. I am glad to notice that in answer to a Question, the Minister has gone some way to meeting our wish that there should be this pre-1948 settlement that my hon. Friend sought. I know that if he should get the opportunity, my hon. Friend will have a little to say on the subject today, so I will content myself with the comment that it is largely due to his efforts that this concession has been made.
Some things in the present legislation cause particular difficulty. First, there is the provision for special hardship. This, in fact, was the only major change made when the original Bill went through the House. I admit that the special hardship allowance must cause the Department many administrative headaches, but I think that the Regulations are too narrowly drawn, and could well be adjusted to cover a wider range.
Cases now arise where, after the injury benefit period, the injured man may take up employment equivalent to his pre-accident work and at the same rate of pay. He will not be entitled to the special hardship allowance if, subsequently, as a result of the effects of his injury, he is unable to continue in that work. That seems to me to be quite wrong.
If a man is forced to change his employment, he may suffer loss of earnings and thus qualify for the special hard- 1634 ship allowance, but many of those on piece work may suffer loss of earnings when they return to their old jobs. I do not believe that any man should suffer a loss of earnings as a result of industrial injury or disease, and the special hardship regulations should take note of that, and measure it. In other words, the criterion for paying the allowance should be loss of earnings, and the allowance should not be affected by whether or not a man returns to his previous job.
There is also the question of the operation of the regulations governing the payment of allowances. This causes hardship. There should be a relaxation to allow payment of the allowance where incapacity to follow a man's regular occupation is likely to continue for a long period. Consideration should be given to the question of loss of pay through a man failing to secure promotion which he might have expected if he had not had an accident.
The question of gratuities is being looked into, but it seems to me altogether wrong that a man awarded a 19 per cent. allowance for life should receive £380 by way of a lump sum settlement when he could have received £2,500 over a normal lifetime if he were on the equivalent weekly pension. The Ministry could consider at least giving a man where there has been an assessment of 5 per cent. or over the right to opt to receive either a weekly pension or a gratuity.
War pensioners have enjoyed for some years now a "comforts allowance". This is given in old age and takes account of injuries worsening because of degeneration. Surely there is a case for the industrially injured receiving a similar benefit. When assessments of injuries are made it is often contended that the loss of a faculty is made up by the use of an artificial limb or a truss or spectacles, but Nature never intended that a man should wear these appliances. I submit, therefore, that the offset on this account should be kept at the very minimum.
The Ministry should also provide cars for the industrially injured in the same way as they are provided for war pensioners. I believe that it is possible that this can be done under the Act. The Minister may find that this is possible 1635 under Section 75 if he wishes to do it. Those who are industrially disabled should have the facilities to which they are morally entitled. If this concession were made I do not think that it could be said to be a direct burden on public funds. I believe that the Fund could support the modest cost involved in supplying cars.
The Parliamentary Secretary will be aware of a case in the House of Lords recently when seven steel dressers and the widows of two others employed by E. Jopling and Sons of Sunderland had their claim dismissed because of statutory limitation. I have reason to believe that this matter is now receiving attention and I hope that very soon it will not be necessary for their Lordships to say that they were concerned only with the Statute of Limitation and that this was the only reason why these men and women did not receive their legitimate rights. I shall wait to hear what the Parliamentary Secretary has to say about an amendment to the Statute of Limitation.
In many cases a man who has suffered an industrial accident is involved in expense in instructing solicitors and sometimes counsel on appeals to the local medical appeals tribunals and to the Commissioner. In some cases this expenditure may be unnecessarily incurred as a result of a wrong decision by the insurance officers or even by the medical board. In such cases surely it can be argued that the successful claimant should at least be able to recover his costs, otherwise hardship is caused to the workman. I recognise that in other actions a successful litigant is able to recover money from the unsuccessful party, but in this case I think that the costs ought to be met.
During my absence from the House I had to appear before many medical appeals tribunals and I did not find them altogether satisfactory. The chairman was always a lawyer and he tended to dominate the proceedings. Legal matters are raised from time to time but they are certainly not the most important items in the majority of cases which go before the tribunal. It is usual to find that both the medical members of the tribunal are consultants, but they are not always specialists in the conditions 1636 from which the complainants are suffering.
This age of specialisation in medicine has reached such a pitch that, while the consultant may be absolutely first class in his own speciality, his opinion in another type of case might not be worth much. The two panel members on the tribunal are often inadequately informed on the subject with which they are dealing. The conditions in which the tribunals work are certainly not always conducive to the best results and the surroundings are often most distressing to the claimants.
The time for appeals ought to be extended. In certain cases only 10 days are allowed. This is often insufficient for evidence to be collected to present a fair case for the claimant. It is sometimes thought, and I believe with justification, that the panel acts under a directive from the Minister. In the case of dermatitis, for instance, when a claimant has made a reasonably good recovery but recurrence of the disease is always a possibility, experience seems to show that the settlement is fixed at 3 per cent. for life. If the Minister is giving a directive, this figure certainly ought to be much higher.
There is need to consider more fully the causes of industrial accidents and to pay benefits in a great number of cases. I have mentioned insecurity of employment, but there are other factors which influence a man's health and physical capacity. There are such factors as age and experience and the atmospheric conditions and temperature. There is need for a National Industrial Health Service. The nationalised industries and some of the larger private industries are continually looking into the working conditions, health and welfare of their employees. The Nuffield Foundation has made a grant to help research into industrial health.
All this, however, is not enough. There is a need to develop the positive side of preventing accidents and removing the causes of industrial illness. A man who is working on a circular saw may have had experience of seeing a workmate lose a finger. This serves as a warning to him, but there are many cases where the danger is not so apparent. A man working on a lathe or some other piece of machinery takes no steps to protect his hands by the use of 1637 gloves or a barrier cream against the suds, which look like milk, used for cooling the machine. His mate has worked on the machine for 20 years and has never taken any protective measures. His mate has not suffered and he asks himself why he should take precautions. But he may be a person allergic to this skin irritant and might become a long sufferer from dermatitis as a result of his neglect to take the proper precautions.
Those who work with a synthetic resin glue in the furniture trade should use a protection in the form of a barrier cream. Certainly at the end of the day these workmen should be provided with the time and facilities to wash their hands so that the glue is removed and disease does not arise. There is need for greater publicity about disease and need to avoid industrial accidents. This is a matter not only for the individual but for the nation, because it affects the country's economy.
As we know, over many years there have been debates on road safety. The radio, television and road safety organisations are continually drawing attention to the danger on the roads. Yet it is a sad reflection that there are more accidents in industry than there are on the roads. On a comparative basis more people were injured and broken in health through working in industry than became casualties as a result of enemy action in the last war. The money that we spend on maintaining health and keeping men fit and able to work is of greater strategic value to the nation than the money to be spent on the Polaris submarine.
The number of accidents reported under the Factories Acts in 1961 was 192,517, of which 669 were fatal. To these figures of fatal accidents must be added 624 fatal industrial accidents in industries covered by other Acts, such as mines and quarries, railways, seamen and commercial aviation.
Of the deaths and incapacity of men and women occurring every day in in-dustry, many are due to industrial disease, often after long and lingering illness. Too many accidents are due to inadequate safeguards and carelessness. Too little attention is given to this matter both by managements and trade unions.
1638 The Government themselves might also spend more money on drawing attention to the harm that is done to the nation and to the economy by these industrial accidents. The appropriate Ministries, such as the Ministry of Transport and others, could do something about this. The B.B.C. and Independent Television help considerably to stress the need for safety on the roads, quite rightly, but they might also refer to the need to take safety precautions at work. These appeals could logically be linked with National Productivity Year. Attention should be drawn to the amount of production loss, the loss of wages and the suffering and the tragedy which are caused by industrial accidents. If industry is to be efficient and a high standard of quality and quantity of production maintained, the question of accident prevention must receive the most careful attention. To secure this there must be wholehearted co-operation between management and workers, with the management giving the lead in organising safety precautions. There ought to be set up an organisation and it should have resources.
It is also of immense importance that any system for accident prevention should be known and understood by every worker in each department. The chief cause of accidents in industry is manual handling. This was responsible for 26.1 per cent. of the industrial accidents in 1961. Other causes are falls, being struck by a falling object, knocking against objects and using hand tools.
To meet all the hazards of daily work there are certain precautions which should be insisted upon. There should be adequate arrangements for guiding and supervising young workers when they enter industry. Effective steps should be taken to instruct them in the safe use of machines, and they should be properly supervised afterwards. The inculcation of safe working habits should not be confined to young people only. Attention should be paid to adults who are new to industry or who change their jobs. The high percentage of accidents caused by manual handling indicates how important it is that there should be instruction on correct methods of lifting and carrying. This is done in the Services, and if it is done there, it ought to be done in industry too.
1639 There should be rigorous insistence on tidiness and cleanliness. Falls occur because floor surfaces are wet, slippery or greasy. Careless stacking produces risks. Another important means of reducing accidents is the use of protective equipment. Both management and the trade unions have a responsibility for urging the wearing of safety footwear, gloves, goggles and helmets, where appropriate. The connection between personal safety and efficiency cannot be stressed too much, and men must be made to realise that the time taken to put on helmet or goggles is well spent in their own interests as well as in the interests of industrial efficiency and the country's economy.
Tribute should be paid to the factory inspectors who do such a good job. The regret is that we have not got enough of them. I should like the salaries and conditions of this service to be such that they attract the very best men for this important work.
What I have said seems to underline the need for a comprehensive national industrial health service. Enlightened employers in large concerns often do splendid work, but in the smaller firms little or nothing is done about industrial health. They provide a small first-aid box, and perhaps a member of the staff has a little first-aid training, but that is about all.
There is a strong case for everybody concerned to do more than they do about national industrial health, and I believe this could be done if the employers, trade unions, regional hospital boards, factory inspectors, general practitioners and so on were to join together, say under the direction of the Ministry of Pensions and National Insurance, the Ministry of Health and the Ministry of Labour. Let us have some co-ordination and let them all put their minds to this great and important subject.
There is a need for more research into occupational health, and the Government ought to make more financial provision for this. After all, health is our most precious possession, and measures taken for its preservation should have first priority in our national economy.
I have covered industrial injuries and I have stressed the need for prevention rather than cure. I conclude by saying that the last debate on the machinery of 1640 the Industrial Injuries Acts, as distinct from the level of benefits, took place as long ago as 1st August, 1961. The new National Insurance Bill, 1963, now before Parliament, has raised benefit levels in most cases, although there are still some rather important exceptions, as was shown during the Second Reading and Committee stages of the Bill. What I have done today has been to carry on the debate of August, 1961, and to concentrate argument on the machinery of the Act and the conditions attached to certain of the benefits where they give rise to dissatisfaction. I have also raised other matters connected with industrial injuries, disablement and safety measures which I consider are of the greatest importance. I shall look forward to hearing further contributions from my hon. Friends and hon. Members opposite, and the Minister's reply.
§ 11.38 a.m.
§ Mr. James Griffiths (Llanelly)
As an old colleague and as one who has a deep admiration for him, I should like to begin by saying how glad I am to see my right hon. Friend the Member for Middlesbrough, East (Mr. Bottomley) back in the House of Commons. The gain that we have had from his return to the House has been evidenced by his constructive speech in moving this Motion, upon which I congratulate him.
I hope that during the course of the debate we shall have a survey of the industrial Injuries Act and that constructive suggestions will be put forward. I shall do my best to add to the suggestions which have already been made by my right hon. Friend. I join my right hon. Friend in thanking the Minister not only for having listened to what my right hon. Friend said about the old cases, but also for the proposals which he has announced and for having listened to us and answering our plea.
The Minister, although he has been only a short time in his present office, will know from experience that when one remedies one anomaly one sometimes aggravates another. I am sure that some of my hon. Friends who hope to catch your eye today, Mr. Speaker, will point out to the Minister that, while praising him for what he has done, he has left some problems behind, and, indeed, may have aggravated a number of them.
1641 I thank the Parliamentary Secretary, too. During our recent debate on the National Insurance Bill, I asked him a question and he promised to write to me very fully about the state of the Industrial Injuries Fund. I am very grateful to him for his letter and I am grateful also for the fact that the fund is in such a flourishing condition. This means that we can make suggestions which will cost money without anyone having to go to the Treasury, which must be a boon to any Minister in these days.
We can, I feel, begin this survey of the Industrial Injuries Act by congratulating ourselves that, on the whole, after fourteen years of experience of the working of it, no one, apart from a lone voice now and again—we heard one in the House the other day—wants to return to the old system. On the whole, the scheme has worked far better than the old one. What we are concerned to do now is to improve it in every possible way.
We do not want to go back to the Workmen's Compensation Act system. We do not want, except on special issues, to go back to the courts. We believe that, on the whole, the present system gives a better service, and we wish to improve it as we go along. At the same time, we must recognise that whatever success has attended the acceptance and operation of the present scheme is due to the fact that it does not stand alone.
It was one of the advantages of that period to which my right hon. Friend referred, the period when we were piloting through Parliament many Measures dealing with the wide field of social insurance and health, that we were able to link the provisions and benefits of one scheme with those of another. The Parliamentary Secretary will agree, from his experience already at the Ministry, that the linking of the benefits under the Industrial Injuries Scheme with benefits under the National Insurance Scheme, particularly the sickness benefit, has been a great advantage. One of the disabilities under the old scheme was that a man on workmen's compensation was shut out from all the rest.
The second feature of advantage to the workman and to industry as well is that the scheme has worked all the better because a man need not now, as he 1642 had to do before, elect whether to take workmen's compensation or other benefits. Everyone who has had any experience of advising men about workmen's compensation knows that this was one of the most difficult problems. Happily, it has now gone, and the doctrine of common employment has gone.
Our present scheme has been much assisted by the linking with National Insurance and the application of benefits from one scheme to another, by the abolition of the doctrine of common employment and the need to make an election. I think that we can say that this is, in fact, a better scheme and that we do not want to go back. Nevertheless, this does not give us any room for complacency, and I take this opportunity now to raise with the Minister some problems which he should be considering.
The right hon. Gentleman has the advantage of the Industrial Injuries Advisory Council, upon which sit very competent and experienced men and women. I hope that he is making full use of it. I hope that he is not only submitting draft regulations to it for discussion, but is taking full advantage of the council for consultation purposes.
The latest available Report of the Ministry is the one for 1961, published in the middle of last year. From this Report certain questions arise. The first one I put relates to assessments. The assessment of loss of faculty is at the core of the scheme. My impression, for many years now, has been that, on the whole, assessments of loss of faculty are generally on the low side. The hon. and gallant Gentleman the Parliamentary Secretary has told me bow much money there is in the kitty. I have a view about this. One of the reasons for the large sum of money, about £288 million, in the reserve fund is that the cost of disablement pensions on the basis of the assessments has been lower than we budgeted for. I ask the hon. and gallant Gentleman, therefore, to consider reexamining, after fourteen years' experience, whether the assessments are adequate. In my view, they are too low, and I am convinced that the matter should be looked at.
As I have said on other occasions, our only experience in assessing loss of 1643 faculty has been in regard to war pensions. As the hon. and gallant Gentleman knows, in the matter of industrial injuries and diseases a far wider field is covered, the subject is more complicated, there is a greater variety of disablement arising from all kinds of accident and disease. I hope, therefore, that the Minister will closely examine whether the levels of assessment, which seem to have become stabilised, are sufficient. I emphasise again that, in my view, they are, on the whole, too low.
Now, a second point about assessments. I am disturbed at the number of gratuities being paid in lieu of pension. Anyone with experience of the matter will know that one of the curses of the old Workmen's Compensation Act was the lump sum settlement. We have been speaking about some of the old cases today. There are tragic cases of men totally disabled whose weekly compensation was commuted, to use the old expression, to a lump sum settlement of £300. £400, or something of that kind, and there the thing stopped.
§ Mr. Arthur Probert (Aberdare)
Does my right hon. Friend agree that in many cases it was not a matter of choice, but the lump sum settlement was accepted under duress?
§ Mr. Griffiths
Under duress, yes. I will give an example of a further problem. When I was president of the South Wales miners' branches, I had one of the most difficult cases of all to tackle. It had arisen, in the first place, some time before I became president, but I took it up again. A colliery company had gone bankrupt. It had not been insured. Its assets had to be realised and claims had to be assessed. We assessed the claims of men who had been injured and disabled while working for the company and presented them to the receiving officer. The total was some thousands of pounds. Not a penny was ever paid. After this, steps were taken by the Government to compel coal owners to be insured, but many cases still remain from those days. For this and many other reasons, I and those of my hon. Friends who have advised workmen used to be very careful about lump sum settlements.
1644 In a sense, the gratuity is a lump sum, settlement. Here are the figures. In 1961, 106,000 gratuities were paid, and 30,000 pensions were paid—three gratuities for one pension. This is far too big a proportion, and I want the Minister to look at this matter closely. As things are now, a worker disabled by accident or disease whose loss of faculty is assessed at 19 per cent, is paid a gratuity. I ask the Minister to remember always that the scheme was devised not for administrative convenience, but for the service of these men.
As one who has a deep regard for the Ministry, as one who helped to build it, I hope very much that the right hon. Gentleman will convey to all the members of his staff that they must not influence a man to accept a gratuity. To do so would be a grave disservice. The Parliamentary Secretary will know that many of these men have a disability for the rest of their lives, for which they get £300 or £400. In years to come, when they are 45, 50 or 55 years of age, they will feel the consequences of that disablement again. I hope that the Minister is considering this. That is the first problem. The assessments are too low and the number of gratuities too high.
I wish to say a few words about the hardship allowance. As my right hon. Friend said, this was the one major change which I made in the Bill which I inherited from my predecessor in the Coalition Government. How lucky it was for the scheme that I made it, because, if one looks at this Report, one will realise that the scheme would have broken down but for this change. There is no doubt about that. In 1961, 108,000 hardship allowances were awarded. My right hon. Friend has dealt with some of the difficulties and objections to the present regulations and some of the hardships which arise from the operation of those regulations. I am sure that the Parliamentary Secretary will have listened to what my right hon. Friend said about this and will consider it.
I wish to raise one general matter on the hardship allowance. The reason why it has helped to sustain the scheme and to make it acceptable is that, without it, the gap between the assessed loss of faculty and the injured workman's loss of earnings would have been too high.
1645 It fills that gap. The Minister will realise that we are, I hope, entering an era of high wages. There are many skilled colliers in the coal mining industry who are earning £20 a week, although they are working very hard for it. The gap is getting wider. I hope that the Minister will consider this very carefully. Even though improvements have been made recently, I still think that this matter needs consideration.
A relatively minor or not too serious accident can prevent skilled men on whom we depend so much in industry—technicians, artisans and craftsmen whose skill has taken years to develop—from returning to their jobs, with all that that entails through loss of earnings. My view is that the gap between assessment on the basis of loss of faculty and the actual loss of earnings, including the loss of promotion prospects, is not covered by the existing scales of hardship allowance. Again, I hope that this matter will be looked at.
I turn now to industrial diseases. May I say how very much I agree with what my right hon. Friend said about the need for a survey of the incidence of occupational ill-health and for a widening of the number of prescribed diseases. I am surprised to find—if I am wrong, I hope that the Parliamentary Secretary will correct me—that Raynaud's disease is not yet scheduled. Raynaud's disease affects the tips of a man's fingers through the use of vibrating machinery. I should have prescribed it were it not for the fact that a case was pending in court in which it was argued for the workman concerned that this was an accident and that each one of the tiny blows which he received by using vibrating machinery was an accident. The workman won. I should have thought that, having regard to the fact that the court in that case decided that this was an accident, the Ministry by now would have prescribed Raynaud's disease.
I wish, as an old coal miner, to say a few words about prescribed diseases as they affect coal miners. When I read the Ministry's Report, together with the wealth of statistics on industrial diseases with which we are provided, one thing gladdens my heart and one thing depresses me. The thing which gladdens me is the virtual disappearance of miners' nystagmus. This is one of the biggest changes that I have seen. I can 1646 remember the time when miners' nystagmus was a plague. It has not gone completely, but its incidence has been reduced enormously.
I pay my tribute to the engineers and all those who have contributed to the virtual removal of this miserable industrial disease, with its often very serious consequences and mental derangement which arises from the nervous strain which it causes. This emphasises the point made by my right hon. Friend about how important it is to devote time, attention and money to the prevention of disease. We are well on the way to the complete removal of miners' nystagmus. We must try to do the same with many other diseases.
The thing which depresses me is this. I shall not quote the figures, because they are in the Report. I had hoped that by now the incidence of pneumoconiosis would have been reduced to a much lower level. I pay full tribute to the work done by the National Coal Board, the National Union of Mineworkers and to everyone in the mining industry on prevention by water infusion and other methods. However, the incidence of pneumoconiosis is still very high. Some of my hon. Friends who worked in the modern collieries after I left the mines will know that one of the penalties that we pay for mining coal by machinery is the amount of industrial illness which it brings. It increases the amount of dust in the atmosphere.
I hope that the Ministry is in very close touch with the Ministry of Power, with the Mines Inspectorate and with the other bodies concerned on this problem, Very good efforts have been made in this matter, but they must be redoubled because the incidence of this disease is far too high.
I wish to say only two things aoout benefit. First, it is 27 years—I know this because I came into the House 27 years ago—since the Medical Research Council made the last investigation into pneumoconiosis for the purpose of arriving at a new criterion. The criterion which is being used by the medical boards in diagnosing and, presumably, in assessing pneumoconiosis is the one which was laid down by Dr. D'Arcy Hart and the other people with whom I was privileged to be associated as president of the union in the early stages of their 1647 inquiries. It is time that this matter was considered again. Continuous research has been made into it particularly by the pneumoconiosis unit at Llandough, Cardiff.
There is a growing feeling among medical men that pneumoconiosis, associated with emphysema and bronchitis, should be treated as one identical disease. In understand that, when a person's disability and loss of faculty arising from pneumoconiosis are diagnosed and assessed, doctors still seek to separate the loss of faculty which arises from pneumoconiosis from the amount of disability or loss of faculty which arises from emphysema, or bronchitis.
I am a layman, but I hope that the Parliamentary Secretary will heed what am saying. I am told that this is a matter of guesswork. I do not think that the amount of benefit and pension which men get in respect of this disease should depend on guesswork. I am told that no doctor will state categorically that when he examines a man, he is able to separate these three disabilities and say how much percentage disability each of them causes. It is time that this state of affairs ended.
My view is that we want a wider definition and that we should include emphysema. There is now a strong case for doing this. One of our greatest difficulties occurs when we meet miners and one has had his disability diagnosed as pneumoconiosis, which has been assessed and he receives benefit and hardship allowance, whilst another man, who looks very much the same, or often worse, with all the same symptoms, including shortness of breath, is not receiving benefit. This situation needs to be looked into.
There is a feature of the administration of the scheme which has for some time concerned me. Whilst I agree that the new scheme is better than the old one—and we do not want to return to the old one—I have a feeling that the administration and the judicial decisions are now more rigid than in the old days, especially when cases were dealt with by the House of Lords, in working what we call the rule of acceleration. This is particularly true concerning pneumoconiosis cases.
1648 When a person who has been disabled by, and assessed under the Act for, pneumoconiosis dies, a post mortem is held and it may be decided by the medical board that he has died from another cause. There is an old saying that it is not enough merely for justice to be done, but that it must be seen to be done. There is deep concern about this matter. Under the old Workmen's Compensation Act, cases were taken to the House of Lords, and if death was accelerated by the disease or by accident compensation was awarded. There is a feeling that the Ministry is not as generous in its interpretation of the scheme as were the courts, and particularly the House of Lords, under the old scheme. I hope that the Minister will consider this aspect.
I have two or three final points. I am sure that during the debate some of my hon. Friends will raise the urgent need to deal with the problem of providing cars for workers disabled in industry. Secondly, I hope that in Association with the Ministry of Labour, the Parliamentary Secretary and his right hon. Friend the Minister of Pensions and National Insurance are discussing the problem, which is already becoming acute and could become very acute, particularly in the mining industry, of finding suitable light employment for disabled workmen.
As the mining industry contracts, as manpower is redeployed and production is concentrated in fewer pits, the opportunities for light employment are constantly being reduced. This should give great concern and I hope that the Ministry is considering the matter with the Departments affected. There is also the Remploy factory problem.
If I were Minister, with the immense changes that have taken place in industry as compared with fourteen years ago, I would be giving consideration to the relationship between the mechanisation of industry and accidents and disease, the growth of machine work in pits, and, in particular, the problem of noise in modern industry. I am glad to find that the Ministry is already conducting an investigation into the problem of noise, particularly in relation to occupational deafness. I hope that the Ministry will prescribe occupational deafness as an industrial disease.
Beyond that, however, it seems that we are committed to the materially 1649 affluent society and that we must produce more and more, and more efficiently. To do that, we must have still more machines. I suppose that we have made up our minds that we must have them. At the same time, we should be fully aware of the price that has to be paid for them. It is a price which has to be paid by the workmen. The pace at which they have to work is determined not by them, but by the machines. They must follow all the time.
In addition to the pace at which they work, theirs is often repetitive work. This is one of the problems that I should Like to see examined in association with what has already been said about industrial health. One of the problems of repetitive work is that there is nothing to hold the attention of the workman. His attention is bound to stray. For example, how long should men or women—and many women do this kind of work, too—go on doing repetitive work with safety to themselves? This is one of the problems which, together with the effect of noise and its consequences, should be examined.
I end, therefore, by saying how glad am that my right hon. Friend has emphasised the enormous importance of the problem of prevention as well as the great need for an industrial health service. When moving the Second Reading of the Bill eighteen years ago, I said that I regarded the scheme not as substituting one kind of cash payment for another under the old Workmen's Compensation Act, but as one which would be part of a great constructive service, which we have now came to call the Welfare State.
Our first aim is to prevent accidents and disease. Where they cannot be prevented and men are injured or disabled by disease, they must be restored to their old jobs. If that cannot be done, they must be retrained for new jobs and we must make sure that new jobs are available for them and that they can be cared for.
That is the spirit in which, I hope, this great scheme will continue to be administered. I hope that today hon. Members will make constructive suggestions to the Parliamentary Secretary and that he will consider them, so that we make this scheme of ours—as it already is in some ways, and certainly can be when it is improved—the best in 1650 the world to deal with the problems of disablement, accident and disease. If we can do that, not only will the scheme continue to be a success but it will be a scheme of which all those of us who have had any part in it will be proud.
§ 12.8 p.m.
§ Mr. Thomas Swain (Derbyshire, North-East)
I join my right hon. Friend the Member for Middlesbrough, East (Mr. Bottomley), particularly on behalf of the mineworkers in Derbyshire who were injured prior to 1948, in thanking the Minister for the quick and humane response to our plea in the House last Wednesday. I also congratulate my right hon. Friend on bringing the Motion before the House today, because the anomalies in the Act need to be discussed at every possible opportunity and to be dealt with as quickly and efficiently as the matter which the Minister has so ably dealt with this week.
For the record, I should like to add a few words to what has been said about our so-called affluent State, in which some coal miners are getting £20 a week. I should like to state categorically that at least 33 per cent. of the mine workers are still getting less than £11 a week. I say that so that people reading the report of our debate will not assume that mine workers' wages are in the region of £20 a week.
When new legislation is put on the Statute Book inevitably there arise anomalies which are thrown up only by practice and experience of the legislation. There are, of course, anomalies under the Industrial Injuries Act, and there are omissions which, to my mind and to the minds of my right hon. and hon. Friends, are anomalies, and we trust that the omissions to which we draw the attention of the Minister today—glaring omissions—will be dealt with.
When the Industrial Injuries Act was conceived it was with great purpose. I know it was done with great thought by the people who had the job of steering it through the House of Commons. It was very ably done, and again I must congratulate the party which steered it through the House of Commons at that time, because it was a great, revolutionary step forward by comparison with the old Workmen's Compensation Acts, the purpose of the Act being, of course, to right a wrong which had prevailed up to 1948.
1651 Prior to 1949, compensation was paid for loss of earnings and in most cases did not compensate adequately for the loss of faculty arising from injury or disease. The Act was, in its way, and I must say that my right hon. Friends saw it in this way, a major step forward towards putting right evils and injustices which had prevailed right from the Industrial Revolution to the time when the Act was implemented.
As I have already said, there was a genuine loss of faculty as against loss of earnings. Let me illustrate. Under the old Act, if a man in a fairly high wage group had an accident he could get pant-difference compensation on resuming work after being off work because of the accident, but another man in a lower wage group who met with exactly the same accident and suffered the same type of injury was barred from drawing part-difference compensation because the man in the lower wage group suffered no loss of wages, although he suffered the same loss of faculty, and he drew no compensation at all for part-difference after he resumed work. I would say that in the old days, particularly in the coal mines, the accident rate broke fairly even between those in the higher and those in the lower wage groups. I am convinced that if my right hon. Friends had stayed in office the anomalies of the Act would have been corrected as soon as they were known.
Let us look at some of the anomalies and omissions as I have seen them during my experience as a trade union official in Derbyshire, responsible for a time, under the area compensation agent, Mr. Parkin, for representing injured workmen who appealed against final assessments for loss of faculty by accidents. I have some knowledge of the difficulties encountered by the victims of accidents, by trade union officials who represent them, and in some cases—in quite a lot of cases, I should say—by the legal profession, who, in turn, advise trade union officials who attend to these cases.
Let us look at the anomalies which have been thrown up. One of them—and there are lots of examples of this—is that if a man has an accident and receives an injury he can and does re- 1652 ceive all the benefits of the Act, but the difficulty starts when he begins work again. He may decide, or, most important, the doctor may decide, that he is fit to resume his old occupation. In our industry his occupation may be, and, in most cases is, at the coal face. He may work for a period of four to five months at the face and his old injury is aggravated by continuous bending or kneeling or using a shovel, pick or hammer, which, of course, are the tools of the trade, and as a consequence he has to leave the coal face and be sent on to a day wage job.
If he had resumed on the day wage job he could and would, on the advice of his trade union, have claimed hardship allowance and would have received hardship allowance benefit, but because he made a genuine attempt for a period to work at the coal face and received face wages he is prevented from drawing the hardship allowance when his condition does not allow him to carry on.
This is an anomaly which interferes very much with genuine men. I have known many people who, in their own interests primarily, but in the interests of the pit, the economy of the industry, decided to go back to the coal face the moment they restarted work, sometimes against the advice of their trade union official. Perhaps they worked in a very low seam, such as we have in Derbyshire, and, indeed, in most of the coalfields in the country. Perhaps the man's injury was a knee injury. Kneeling causes his condition to deteriorate, and he has to go to what in the industry we term a standing up job, with a consequent reduction in wages.
I have tried dozens of times to get appeal tribunals to accept the logic of our argument, that a man has made a genuine attempt to go back to his old job but his condition has deteriorated so that he has had to leave it. The tribunals, however sympathetic they may have been towards us, are debarred from giving him the hardship allowance because of the wording of the Act. I hope that this anomaly, which is a very common one in the mining industry, will be seriously considered by the Minister. I am sure that if he looks at it seriously, and at the number of people who are turned down and do not receive the benefits of hardship allowance, he will 1653 find that the case is as common as I have stated it to be.
I turn now to appeals against decisions of the pneumoconiosis medical boards on questions of diagnosis. There are appeal boards on all other questions of accidents or industrial disease, but not against the decision of the pneumoconiosis board. We have in the industry, as my right hon. Friend quite rightly said, far too many cases of pneumoconiosis being registered every year. Great steps are being taken to prevent the disease and its causes by certain methods underground, but, unfortunately, conditions there, particularly where there is a low steam and where there is a high velocity of air travelling towards the coal face, are such that it is almost impossible to tackle the dust at source because of the speed of production and the velocity of the air which makes the dust airborne. The consequence is that, whatever may be possible for tackling the dust by water infusion or distribution methods, people have to swallow consistently, for six and a half or seven hours a day, dust which the machines are making.
It is inevitable that we must have a certain amount of velocity to control the noxious gases that accumulate in a pit, but in consequence it is very difficult to control the dust at source. All the way from the coal face to the pit bottom—and in some cases this is as much as four miles—there are a series of transfer points between conveyors, again all making dust. The belts are made of synthetic rubber, and if too much water is used on them it is impossible for them to run.
My right hon. Friend referred to the guesswork involved in the diagnosis of pneumoconiosis, and perhaps I might tell the House of my experience in this connection. Six years ago I knew a man who went before the Sheffield pneumoconiosis panel on three occasions. He had a bad chest, suffered badly from shortness of breath, and considerable inconvenience when walking. Each time the panel certified that he was not suffering from pneumoconiosis, and it was not possible to appeal against the panel's decision. Six months after his retirement the man died, and the post mortem revealed that he had been suffering from 70 per cent. pneumoconiosis. If this case does not show that the system of guesswork is absolutely ridiculous. I do 1654 not know what does. On the other hand, there have been instances of men receiving benefits because they have been certified as suffering from pneumoconiosis, though eventually the post mortem examinations have shown them not to be suffering from that disease.
Those two examples show the importance of reviewing the present methods of diagnosing pneumoconiosis. If, in this scientific age, the assessment of an industrial disease has to be left entirely to guesswork, it shows that we have not made much progress. I hope that the Minister will look at this anomaly and will give us the right, on behalf of victims of this disease, to appeal to a higher authority against the assessment of appeal boards. If he agrees to do this, he will be doing a good job of work in the interests of humanity.
Another anomaly in this. The incidence of certain types of rheumatism is heaviest in the mining industry. This applies also to emphysema, which has been dealt with by my right hon. Friends. I have seen a man assessed as having a 60 per cent. Disability—20 per cent. pneumoconiosis and 40 per cent. emphysema. If anyone in the world can say that someone is suffering 20 per cent. of one disease and 40 per cent. of another, then I am a Dutchman. Although I am a layman in this matter, I know from my experience as a trade union official, and from being a victim of the disease, that it is impossible to assess a man as suffering from 60 per cent. disability, and then split that percentage as to 20 per cent. industrial disease, and 40 per cent. natural disease.
For many years we have been trying to get the Minister to schedule emphysema as an industrial disease, because there is no doubt that it is directly related to pneumoconiosis.
It is amazing in how many cases the pneumoconiosis panel is prepared to state categorically that the patient is suffering from emphysema, and yet when the individual dies, sometimes in distressing circumstances, the post mortem examination shows that he has been suffering from pneumoconiosis, and his widow has to put up with the consequences of a wrong diagnosis.
An amendment to the Act is necessary to allow personal injury by process to be included for benefit. My right hon. Friend dealt with this, but I make 1655 no apology for bringing to light the number of cases which arise in the mining industry, because this is the industry of which I have some experience. We see many instances of injury by process. If, for many years, a man has to handle a shovel while working in a cramped position, perhaps in a seam which is only 28 inches high at the highest point, his knees and legs may become deformed, or stiff. In our opinion this is an injury by process, and I hope that the Parliamentary Secretary will consider this point. In the mining areas during the summer one sees old men sitting on seats, playing dominoes, and notices their hands are gnarled, and that their knees, shoulders, and backs are bent, all as a result of injury by process for which they get no compensation.
I come now to special hardship allowance. The permanent or continuous conditions should be modified to allow all those unable to follow their pre-accident work and suffering a loss of wages as a result to be included. Special hardship benefit should be paid as a separate benefit and not restricted by the ceiling at present in operation, that is, the 100 per cent. disablement benefit. This is an anomaly which could and should be corrected as a result of our experience of the administration of the industrial injuries scheme.
The next anomaly is the imposition of a time limit of 21 days in which to appeal against the decision of a local appeal tribunal in respect of injury benefit and special hardship allowance. This period should be considerably increased. A period of three months is allowed for appeals against decisions by medical boards. I have never been able to understand why only 21 days are allowed in one case, while three months are allowed in another. There is no consistency between the two. We have had hundreds of appeals dealt with by our compensation department at Chesterfield, and experience shows that 21 days are insufficient.
The man concerned gets the final assessment, and he then has to seek advice from his local trade union secretary. He is the appropriate person to go to in the first place. Then he is interviewed by a compensation agency or, if he wishes, by a member of the 1656 legal profession, after which he appeals. All this could be corrected by a stroke of the pen without cost to the Government. It would not drain a penny from the Reserve Fund, which, as my right hon. Friend pointed out, is in a very healthy state at the moment, amounting to £288 million.
These are major anomalies. No doubt my hon. Friends will 'nave found others, and will deal with them adequately in their speeches. I hope that the Minister has taken cognisance of what has been said about diagnosis, appeals, scheduled diseases and the various other points concerning the Industrial Injuries Act. If he accepts the advice which has been given to him by my right hon. Friends, who have dealt with the matter so ably, I am sure that he will be able to improve what is already a great piece of legislation.
With those few words, I express the hope that the Minister will act with speed and in good faith.
§ 12.31 p.m.
§ Sir John Langford-Holt (Shrewsbury)
I want to follow up something that was referred to by the right hon. Member for Middlesbrough, East (Mr. Bottomley). I apologise to him for not being present to hear the beginning of his speech. I want to add to what he said about the prevention of accidents. First, I ought to declare an interest—although it is not a direct personal or financial one—to the extent that for many years I have been engaged in the industry that manufactures protective clothing and equipment.
The trend of accidents in industry over the last 10 years shows that, whereas fatal accidents have decreased, all other accidents have increased. The latest available Report of the Chief Inspector of Accidents—the 1961 Report—showed that of all accidents, those arising from the handling of goods accounted for 25 per cent.; falls accounted for 17 per cent.; falling objects striking persons accounted for 8 per cent; stepping on or striking objects accounted for another 8 per cent., and, lastly, the use of hand tools accounted for 7 per cent. Those groups account for 65 per cent. of all accidents.
1657 At this point it is worth noting that, referring to that 65 per cent., the Inspector says:This pattern is repeated year after year, and it is often assumed that accidents in these groups are inevitable. This is not so. They can be prevented. For example, the use of safety boots would without doubt have prevented a large number of the foot injuries caused by falling objects and by handling operations, and some 1,800 head injuries caused by falling objects might have been prevented by the use of suitable head protection.It is a matter for conjecture—and we are all entitled to our opinions—why safety equipment and clothing is not used. Fundamentally, this seems to be a personal matter. Many workers regard it as being cissy to wear such equipment.
The use of motor-cycle helmets is probably the most typical example. During the 1930s motor cyclists wore nothing on their heads, except, perhaps, a soft leather helmet. After the war it became the fashion to wear nothing at all on the head. Only within recent years—and it is certainly true today—has the feeling developed that nobody but a clot would go about in anything but a proper crash helmet, or "skid-lid", as it is called. Nobody but a clot would do what Mr. Mike Same calls a "ton-up", with his hair and scarf flying behind him in the wind. That used to be the fashionable thing to do, but during the last 15 years it has not only become unfashionable not to wear a protective helmet but positively fashionable to wear one. What has been done in the case of motor cyclists could be made compulsory in industry.
It would be wrong to minimise the great achievements of the Ministry, certain employers, and organisations like RoSPA, but what those organisations now have to do is to teach the ordinary chap that the use of this equipment is not only their business but his personal business. They must show him why this is so. This must be done individually and collectively. People must be taught that it is not cissy to wear this protective clothing, but that, instead, only a fool does not wear it.
Why should a person who does not wear it be a fool? Not only is he doing damage to the national economy if he is injured through some fault of his own, and also doing damage to his industry and his own firm—which might not bother him too much—but he is endan- 1658 gering his workmates and family, and, of cours, always himself.
§ Mr. Swain
Does the hon. Member agree that protective equipment and clothing in industry has to be paid for by the user? Does he further agree that the employer should be under an obligation to provide, free of charge, the enormous amount of protective clothing that has to be used by employees in some industries?
§ Sir J. Langford-Holt
I am not sure what the percentage is, but some protective clothing is provided by employers, in some industries. But much of this equipment carries Purchase Tax, which seems to me to be extraordinary. I am not trying to argue who should provide the equipment; my point is that even when it is provided it is not properly used. It might be said that I was making use of my own interest in the matter if I said that it should be the responsibility of the State or the employer to provide the equipment. It is certainly true that much would be done to prevent accidents if this equipment were available free of charge to those who are supposed to use it.
§ 12.38 p.m.
§ Mr. Harold Finch (Bedwellty)
I congratulate my right hon. Friend the Member for Middlesbrough, East (Mr. Bottom-ley) on his luck in the Ballot, and also on choosing such an important subject for our debate this morning. He and my right hon. Friend the Member for Llanelly (Mr. J. Griffiths) have dealt very ably with the problems and anomalies which are a feature of the operation of the Industrial injuries Acts today. Such a great deal of ground has already been covered that I hope hon. Members will forgive me if I refer to one or two matters which have already been mentioned.
First, I would remind the House of the extent of the problem. Every year there are about 800,000 claims for injury benefit, 300,000 of which come from the mining industry. This may not mean that there are 800,000 persons involved, because—and this applies especially in mining—two or three claims may be made in a year by the same person. Nevertheless, the figure gives one some idea of the size of the problem. Three hundred thousand of these cases come from the mining industry.
1659 But, of course, even that number of cases is far less than the number claiming sickness benefit. There are about 6 million claims for sickness benefit in the course of a year. Here again, not 6 million people are involved; the same people are sick intermittently and their names occur many times in the course of a year—what the Ministry of Pensions and National Insurance calls 6 million "spells" in a year.
Then there are the widows' pensions and the war pensions, and all the multifarious recipients of benefit. One is amazed at the administrative work that has to be undertaken by the Ministry. I take this opportunity to pay my tribute to the pensions officers throughout the country who deal with these problems. They deal with an amazing number of cases in the course of a year. I speak for South Wales, and I know that in an industrial area it is inevitable that complaints arise, but when I look at the millions of cases dealt with by this very fine Department of the Civil Service today I am bound to pay tribute to the very excellent work which its official are doing.
My right hon. Friend referred to the fact that we are really concerned with industrial accidents, and the figures which he quoted give us an idea of the number of accidents that occur in industry. It is of paramount importance to reduce the accident rate in industry and to reduce the incidence of sickness. This can be done only by improving safety in industry. I do not want to go into that matter now because it has been dealt with by those who preceded me. It is a matter of urgency to prevent the loss of production and the suffering which arise from accidents and disease. This is a matter to which greater attention should be given in the Health Service and in industry.
If, therefore, we on this side of the House are somewhat critical of some of the aspects of the Industrial Injuries Scheme it is not because of its day-to-day administration. It is due to the failure of the Government, I submit, to make the necessary adjustments in some of the provisions of the Act in the light of experience and the changes which have taken place in industry since the Bill was first published in 1945. There 1660 have been vast changes in industry since that time. There has been a great increase in automation and mechanisation. New machines have been introduced. All this has created new industrial hazards in the coal-mining industry. In that industry there is ever-increasing mechanisation—coal cutting and drilling machines. Compressed air machinery has also been introduced. This machinery is not peculiar to the mining industry; it is to be found in many other industries today.
Reference has been made to noise. The question of deafness caused through noise was a subject raised in Committee at one time and it is being raised again today. I know that the matter was referred to the Industrial Injuries Advisory Council and that research is taking place into the matter. Noise is incapacitating a number of people today. I hope that the Parliamentary Secretary can tell us what progress is being made in this very important matter. Many other factors give rise to disease in industry. I know that the Minister is covered by Section 55 (2) of the National Insurance (Industrial Injuries) Act, 1946, and it is this Section to which I wish to refer. That Section says:A disease or injury may be prescribed for the purposes of this Part of this Act in relation to any insured persons, if the Minister is satisfied—(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.With regard to the phrasenot as a risk common to all persons".can see the difficulty of the Minister because some diseases are due to industrial hazards but are also common to all persons. One has only to consider rheumatism. Unfortunately, rheumatism is common to many people, but there is a peculiar form of rheumatism caused by working underground or as a consequence of working in water.
The strange thing is that compensation can be paid in certain circumstances to those contracting rheumatism. It can be paid if, for instance, there is the sudden fall-in of a roof or a sudden inrush of water which were totally unforeseen and which, perhaps, result in a man standing in water for several hours. Such a man may contract pleurisy or pneumonia which leaves him with a 1661 form of rheumatism. In such circumstances, the courts have in the past decided in favour of a person so claiming and he has obtained compensation on the ground that the accident or disease arose out of and in the course of his employment. But if in the course of his employment a man works in water all day and every day, year in and year out, and as a result contracts rheumatism, he is not entitled to compensation under the provisions of the Act.
I have here a report made in 1961 which says:Among miners who co-operated with an industrial survey unit based on Edinburgh University investigating at the collieries, 10 per cent. were found to be absent because of rheumatism contracted during the preceding year and it was estimated that the men had lost an average of £70 in earnings.In the course of the report it is stated:The overall prevalence of rheumatic complaints at the collieries was no higher than in other groups studied by the unit.But the unit stated, on the other hand, that the type of rheumatism appeared to be materially affected by working conditions. Osteo-arthritis was more prevalent among the mining community than among other industrial communities.
It is important to note that while it is stated that rheumatism is prevalent in the community that does not in itself mean that a person could not contract the disease due to his employment. This is borne out in the case of bronchitis and emphysema. These diseases are very prevalent among miners after the age of 40 or 50 years. Statistics show that these are diseases which, unhappily, affect persons employed underground in the mining industry. This is quite understandable. After all, there is a lack of fresh air underground. Temperatures vary—a man goes from a hot atmosphere to a cold atmosphere. Very often he is working in a confined space underground, in cramped conditions. It is no wonder that in these circumstances men develop bronchitis and emphysema.
Another factor to which I must refer is that of aggravation. While I agree with all that has been said about the benefits of the Industrial Injuries Act, there is one factor to which I must refer. I feel that when some of these oases came before the county courts on the issue of aggravation, under the Workmen's Compensation Act, the county 1662 courts took a far more liberal view than the local tribunals are taking today.
Under the old Workmen's Compensation Act a case was taken to the House of Lords. It was that of a man suffering from heart trouble. It was admitted in medical evidence that the man could have collapsed any time. He was suffering from a heart complaint and not from an injury. It was admitted that he could have died walking upstairs. But he was found underground lying beside a tram, and the specialist, under cross-examination, had to admit that the fact that the man was filling the tram with coal at that moment was the final factor in causing his death.
This question of aggravation applies in a moderate way to men suffering from arthritis. They get a blow underground or break a limb and recover but suffer the after effects of arthritis. The tribunals do not take a very satisfactory view of many of these cases.
Many of the consultants and doctors who sit on these tribunals are not always conversant with the particular complaint of the man before them. They may be consultants but they may not be specialists in that particular complaint. I hope that the Ministry will take note that in a case, for instance, where the man is suffering from dermatitis a dermatologist should be on the tribunal, or, in the case of arthritis an orthopaedic surgeon should be a member. Whatever the complaint, there should be a specialist in it among the members of the tribunal. We are not at the moment having very satisfactory experience in many cases under the present system.
I do not want to dwell too much on the question of hardship allowances. I have raised this on many occasions and do not want to repeat what has been said except to say, as my right hon. Friend the Member for Llanelly reminded us, that this hardship allowance was put into the National Insurance (Industrial Injuries) Act for the purpose of compensating to some extent a person who had suffered loss of earning capacity as a result of injury. In other words, it was a sort of hang-over from the old Workmen's Compensation Act in that respect.
There are many cases where the men have minor injuries, such as the loss of an eye or a finger. But in such industries as printing the loss of a finger may 1663 rob a man of his trade. There will probably be a gratuity or a small pension, but he has lost his training and his years of experience. Thus, in addition to loss of faculty, he has lost so much by way of earning capacity in his own trade.
It was to cover this kind of case that my right hon. Friend put into the National Insurance (Industrial Injuries) Act the special hardship allowance. This has become of greater importance as wages have increased. There are men who have been earning £20 or £25 per week but now find themselves, as a result of injury or disease, in what is called the labouring class with a small pension, without a future in a skilled occupation, and with a very low income. It is most depressing to see these formerly well-paid skilled men labouring on low wages.
This was borne in mind by my right hon. Friend the Member for Llanelly in drawing up the Act, but unfortunately the provision is restrictive. It lays down two conditions. The first is that the claimant… is incapable and likely to remain permanently incapable of following his regular occupaton;The second is that he must be… incapable of following employment of art equivalent standard which is suitable in his caseor has been continuously incapable since the end of the injury benefit period. Except in certain circumstances, if the man tries to do his work again from the point of view of medical treatment or rehabilitation, his claim will not be prejudiced. But how does all this work in practice?
A man has an accident which is not regarded as permanent. One feature of the Act, of which I do not complain, is that he goes before a board for pension but the board is not in a position to say whether the injury is permanent. It concludes that it may be but there is a possibility that after treatment he will fully recover. The board therefore gives a certificate of provisional assessment stating that the injury may be permanent. The man then gets a provisional pension. But he cannot get any hardship allowance.
The man may not be able to claim that he has been continuously incapable of work if he takes his job on again and, after three or six months, fails to carry on with it. But if he fails, he cannot come under the second provision for the hardship allowance because of the restric- 1664 tive nature of this provision. I ask the Minister, when he reviews some of the provisions of the Act, to bear these restrictions in mind.
In this respect I would tell my right hon. Friend the Member for Llanelly that the courts were more generous in dealing with this under the old Workmen's Compensation Act than they are under the Industrial Injuries Act. He wilt remember, from his dealings with insurance companies and the mining companies, that they used to say that, although they would suspend compensation to a man if he tried to do his job again, if he failed they would restore it. But under the Industrial injuries Act a man who carries on as lone as he can prejudices his case. As my hon. Friend the Member for Derbyshire, North-East (Mr. Swain) has said, this penalises the trier. A man tries to do his best and has this penalty placed on him. This is causing serious dissatisfaction among many industrial workers.
It is not my intention to go into the many aspects which have already been referred to, but I am glad to follow up what has been said about pneumoconiosis. Indeed, one cannot take part in such a debate without referring to it. I call the Government's attention to the fact that there are so many contradictory reports on these cases that it is giving rise to disquiet, particularly in the mining villages of South Wales, where nine out of every 1,000 wage earners in the mines are being certified as suffering from this appalling disease. Fortunately, many cases are being discovered in the early stages and they are not at all serious.
We must look very closely at this problem in the light of experience. I agree with the call by my right hon. and hon. Friends for further inquiry into the disease to see what more can be done in order, perhaps, to widen the diagnosis and include bronchitis and emphysema.
For example, a man may be examined by the medical board but the board is unable to diagnose the incidence of pneumoconiosis when it is accompanied by emphysema and bronchitis. I know of some countries in which, if a man has pneumoconiosis accompanied by bronchitis or emphysema, it is immediately classed as pneumoconiosis for compensation purposes. This has been done for tuberculosis. If a man has pneumoconiosis with tuberculosis, the medical board 1665 says that it is pneumoconiosis accompanied by tuberculosis, and the man gets his compensation benefit. Surely that can be done for pneumoconiosis when it is accompanied by bronchitis and emphysema. The distinction cannot properly be made by X-ray and it is only, in some cases, after death that it is clear that a man has had pneumoconiosis.
Doctors are contradictory in the matter. A local doctor may say that a man has died from pneumoconiosis. He may even call in a pathologist and there may be a post mortem examination. Death is said to be due to pneumoconiosis, and the death certificate is granted accordingly. The certificate may even say that he died from bronchitis partly caused by pneumoconiosis. I have seen death certificates to that effect, or certificates referring to emphysema with pneumoconiosis.
The widow sees the death certificate and says, "In these circumstances surely I can claim widow's industrial benefit". The reply is that it is a matter for the medical board to decide, and the medical board may differ entirely from the doctor issuing the death certificate. Hon. Members will appreciate the difficulty for trade union representatives, solicitors and others who have to take up such claims for widow's benefits when there are these contradictory documents, the death certificate stating that the man died from pneumoconiosis and the medical board stating that he did not.
We know that the medical board is the statutory authority which decides these matters. We shall be told that the Government cannot interfere with a coroner, but this matter is handled very well in Monmouthshire; the coroner will not give a verdict until he knows the decision of the medical board. This practice is increasing, but in some of the mining communities these contradictory reports give rise to dissatisfaction. It upsets the widow when one doctor says that her husband died from pneumoconiosis and the medical board says that he did not.
Another feature of the problem is that men are being certified as suffering from the disease in a very early stage. I think that the figure is about I per cent. The medical board tells a man, "You have it very slightly. We cannot give you a certificate of disablement". The 1666 man goes away with the knowledge that he has the disease slightly. I submit that as there is a slight disability, an assessment should be granted, even if it is only 2 per cent. or 3 per cent, That is not done, and the man has no connection with the industrial injuries fund. I do not know whether these cases are followed up by the medical board to ensure that the working conditions of the men underground are not such as will make their condition worse. This is a matter in which there should be further consultation between the employees, the National Coal Board and the medical board when the board certifies these men in the very early stages of the disease. Many of them are young men who have entered the industry, have worked in it for a few years and have then found that they are suffering from this condition. If a man is in the early stages of the disease, it is all the more necessary that his condition should be watched and the nature of his work should be such as to ensure that it in no way aggravates his condition.
There are many other problems to which I could refer, but most of them have been dealt with by other hon. Members. May I take this opportunity of thanking the Minister of Pensions and the Parliamentary Secretary for so readily responding to the arguments which we advanced from this side of the House on behalf of those who sustained their accidents and industrial diseases before 5th July, 1948? I want to thank the Parliamentary Secretary and his Department for so readily carrying out his promise—and so quickly—to put these men on something like parity with those under the Industrial Injuries Act. The miners and other industrial workers are grateful for what the Government have done and for the prompt way in which they have done it.
At the same time, I am sure that the Parliamentary Secretary will bear in mind one aspect of the problem to which I have referred and which has not been covered on this occasion. I draw his attention to the fact that under the Workmen's Compensation Act partial compensation is paid on the basis of two-thirds of the difference between a man's pre-accident wages and his light work earnings. The situation is different under the Industrial Injuries Act. At one time under the Workmen's compensation Act 1667 it used to be half the difference but it was increased to two-thirds. There are thousands of partially disabled men in the mining industry—7,000 of them still out of work—who are governed by this formula of two-thirds of the difference between their pre- and their post-accident wages.
In addition, there is a ceiling. A man cannot exceed a figure, which used to be £2 10s. but which I think was later increased by 15s.—I am open to correction on the figures, but there was an increase to those who were below the maximum level. A man may have been getting £18 a week before his accident. Afterwards he was on light work getting £13 or £14 a week. This left him with loss of earnings of £4 or £5 a week, and under the Workmen's Compensation Act he was paid two-thirds of the difference between £13 and £18. But he was still far below his pre-accident wages. Although he was getting two-thirds of his loss of earnings as compensation, he was still worse off than before his accident.
When we were dealing with allowances under the National Insurance Act, in 1961, in Standing Committee, the Minister of Pensions agreed to increase this amount for those on the maximum who were already getting the two-thirds benefit but were not getting the ceiling figure provided in the Bill. The Parliamentary Secretary is again increasing the figure, this time by 20s., which is very satisfactory, but the other problem will remain and will give rise to some dissatisfaction—the problem of those who are receiving two-thirds compensation but are not on the maximum amount. An example is a man earning £12 a week before his accident and £11 a week afterwards. The difference is £1, and two-thirds of that is 13s. 4d. He is to remain on a figure of 13s. 4d.
There are plenty of men receiving 5s., 6s. or 7s. in partial compensation. They have been receiving these small rates of compensation over many years, but under the concessions granted by the Parliamentary Secretary these men will receive not one penny increase. Only the men on the maximum rate of partial compensation will get the benefit of the Amendment which the Parliamentary Secretary proposes to have introduced in another place.
1668 I beg the Government to look again at this two-thirds rule. I cannot understand why the Ministry hold on so tenaciously to this rule, as if it can never be departed from. There is a hardship allowance under the Industrial Injuries Act; a man can get an allowance which will even put him up to his pre-accident level. The hardship allowance will now be over £2 a week. There is a difference between his pre- and post-accident wages; he gets a disablement pension and, in addition, a hardship allowance. He is working and earning, say, £12 a week. He guts a disablement pension based on, say, 20 per cent. loss of faculty, and he claims hardship allowance up to the maximum. Some men in this category are put in the same position as they were before the accident.
What is sacred about adding a supplement under the Workmen's Compensation Act so that men's earnings can be made up to their pre-accident level or at least to seven-eighths of the difference? It should be done. I ask the Government to make some concession to these men who are on the limit of the two-thirds difference between their pre-and post-accident wages. If this is done, the Bill now going through Parliament will be a much better Measure.
I ask the Joint Parliamentary Secretary to look at this problem from another angle. Many of these men are not in a position to review their pre-accident wages so as to give them an increase in compensation. A man's pre-accident earnings some years ago might have been £12 a week, but since then the wages in the job have increased. He is thus in a position to argue, "Had it not been for my accident, I should be receiving, not merely £12 a week, but £15 a week. As my light work earnings are only £10 a week, I claim two-thirds of the difference." In practice, however, many men cannot claim that there has been an increase in their pre-accident rates on the ground of increase in the rates of remuneration, which is the relevant phrase in the Industrial Injuries Act.
So many changes have taken place in industry because of mechanisation, particularly in mining with conveyor belts, etc., that many men are not able to show that there has been an increase in the rate of remuneration. The piecework rate has not risen—or, if it has, 1669 it has risen by very little. Men are earning more money because the machines help them to do so. If men had never sustained accidents and were working underground today with the up-to-date power-loading machines, etc., they would be earning more.
In these circumstances, the relevant provision should be amended so that men would be able to argue that their pre-accident wages are not to be restricted to rates of remuneration but to the rates earned by other men in the same occupation today. It would not be a difficult matter for a man to argue, "If I were working on that seam or in that job today, these are the wages I should be earning, because men are earning these wages today. It can be proved. They are earning them on the job I was doing". However, these men are confined to a pre-accident wage which is now fictitious in the light of changes which have taken place. They are also confined to the two-thirds difference. The Joint Parliamentary Secretary would be doing a great social service if he would consider this matter before the Bill returns to this House.
Thousands of men will see the allowance for others on the maximum assessment raised by another 20s. We heartily accept this increase, but hope that the Government will reconsider the two-thirds rule and get round it as best they can. I hope that the points so well advanced by my right hon. Friend the Member for Middlesbrough, East and those hon. Members who have already taken part in the debate will be borne in mind. I am sure that they have said enough for the Joint Parliamentary Secretary to realise the importance of this problem and the anomalies which exist. I hope that he and his colleagues will carefully study what has been said and will in the near future tell us that we have justified our case and that the Government are in a position to make certain amendments to the Industrial Injuries Act.
§ 1.15 p.m.
§ Mr. J. J. Mendelson (Penistone)
Like my colleagues, I am very grateful to my right hon. Friend the Member for Middlesbrough, East (Mr. Bottomley) for having chosen this subject and for the way in which he introduced it. I have felt for some time that the time is over- 1670 due for a detailed debate on this subject. There is a great deal of dissatisfaction in the Yorkshire coalfield about some of the ways in which the Acts ate being administered and about the limitations of some of the Sections in the relevant legislation.
We in this House who represent coal-mining communities deal practically all the time with cases that come under this legislation. No good purpose would be served by going over again and again the same general ground that some of my colleagues have already traversed, but it is important for the Joint Parliamentary Secretary and his right hon. Friend to realise that these considerations and complaints are widespread throughout our industrial areas, and are not in any way confined to the areas whose representatives have spoken so far.
I want to mention one or two examples out of my own experience, concerning the South Yorkshire coalfield and other industries in our area. I do this merely to fill in the picture. Then I shall turn to an important amendment which the Minister should be considering. I want to refer to the tragic circumstances in which widows of miners often find themselves. I have not been in the House very long, but I have already had to deal with a considerable number of cases in which the widow of a miner has come to me and shown me the death certificate relating to her husband.
The death certificate, which has often been filled in by a doctor who had known the man concerned for many years, has said that, although the actual, final cause of death was pneumonia, a contributory cause, or associated with pneumonia, was pneumoconiosis. In some cases where the cause of death was bronchitis the same association with pneumoconiosis has been mentioned. Then these widows have sent me the reports of the medical board which has contained the simple statement that the cause of death was pneumonia. As the cause of death was pneumonia, no case of compensation could arise.
Like many of my colleagues, I have often followed up these cases. I have sometimes gone to see some of the permanent officers of these various boards. These officers are very restricted in what 1671 they can discuss, but they have always been very helpful in giving me the technical information I require. I am not exaggerating when I tell the Parliamentary Secretary that amongst the people who know a great deal about it in those circles—the administrators, as distinct from the medical members of the board—there is also great distress about the way in which some of these cases are decided and handled.
They have a great deal of experience in these matters and some of them feel that a solution would involve the amendment of existing legislation. They consider, therefore, that it is up to hon. Members to push this matter ahead because, from an administrative point of view, there is a limit to what can be done by them under the present law.
The wife of a miner may know that for many years her husband has been suffering from an industrial disease, but, upon his death, it comes to her as a terrible shock to discover that the death certificate simply says that death was due to pneumonia, whereby she is unable to make a claim. The main argument always advanced by the Ministry—and like other hon. Members I have tried in Committee on a number of Bills on this subject to improve the situation, but we have always received this argument—seems to be the stumbling block that if one opened the door too widely in adding new prescribed industrial injuries to the list, or even if one accepted the sort of suggestion advanced by my hon. Friend the Member for Bedwellty (Mr. Finch) for a new combination of diseases to be added to the list, one would be going too far and the door would be opened too wide.
This is a particularly difficult argument for the general public to understand. When they are told that bronchitis cannot be added to the list of industrial diseases because many people get bronchitis—and that the Government will not establish bronchitis in combination with other diseases to be prescribed—they cannot understand what prevents the Government from accepting such a combination. This argument is all too frequently advanced by the Minister, as it has been by his predecessor.
Although the debate has been conducted in a harmonious way I am very critical of the Government and the 1672 Minister for the way in which they have neglected for many years to advance beyond this argument. There is, after all, an answer to it. It has been considered in many countries and this suggestion has often been put to the Minister. Difficulties arise under Section 55 of the Act. There are two hurdles to be overcome and I urge the Parliamentary Secretary to ask his right hon. Friend to reconsider whether the time has not come to amend that Section.
It is essential to find a distinguishing mark between what would obviously be absurd—adding diseases which are not easily identifiable as related to industrial occupations—and the other diseases. We are asking for something quite specific; an amendment of Section 55 which would provide that where there is reasonable evidence, after inquiry, to show that a disease has been acquired due to industrial occupation and is found to be either the single or combined cause of the industrial disease or death, compensation shall be paid.
This is not the time to go into the precise legal wording of such an amendment. That is for the Minister and his advisers. But the time is overdue for this to be done, because although we are dissatisfied with some of the administration of the medical boards, unless this major change is introduced we are limited in what we can achieve under the Act.
The problem industries, particularly those in which dust is prevalent, will continue to create problems and they will probably grow in intensity. Accompanied by some of my hon. Friends, I recently visited the engineering establishment of the National Coal Board. We were deeply impressed with the work being done but we got no great encouragement from the people there about their attempts to deal with the dust problem. This is recognised as one of the most awkward problems and it is agreed that as production methods become more efficient and as more advanced technological changes take place in the mines the problem will grow. I am not saying that no progress is being made towards the solving of the dust problem, but, being scientists and engineers, I suppose that they did not want to give us a rose-coloured picture but rather that we should know the facts.
1673 It seems that it will be quite a long time before a satisfactory and effective method of dealing with the dust problem is discovered. Many older workers in the coalfields—and I often listen to the views of the miners on this subject—thought that by now the problem would have died away of itself, but that is not so and it makes the sort of amendment to the Act which I have suggested even more urgent.
Not enough research, particularly field research, has been done into these problems. A few small teams are at work, but, excellent though they may be, their efforts are not sufficient. The crux of the disagreement between the Minister and those who agree that an amendment of the Act is necessary has always turned on the availability of data. I hope that the Government do not intend to go on arguing till kingdom come about the difficulty of distinguishing between the various diseases. It is not good enough for them to go on saying that one cannot isolate, say, bronchitis from other illnesses simply because the incidence of bronchitis is high among the general public. Constantly to adduce that argument is rather like saying that matters cannot be improved. The only way to overcome the difficulty is to provide more data—more research—and I am totally dissatisfied with the amount of research now being done.
I do not intend to spend too much time now discussing this matter, because the Minister must by now be aware of what is going on and the feelings of hon. Members and those outside the House on this topic. I hope that he will announce today that more money will be spent on research and that additional research teams will be set up.
It is equally clear that as we advance in our application of technology and science in industry, other industries will be affected in different ways. The foundry industry has always been a black spot for dust diseases and it remains one. In that industry there is excellent co-operation with the inspectorate and it is not uncommon for influential members of the inspectorate to attend conferences of the Amalgamated Union of Foundry Workers. But anyone representing foundry workers recognises that the industry is such that more research into its disease problems is essential and must be undertaken if the incidence of dust and chest diseases is to be reduced.
1674 I would like to comment on a group of industries which has not been mentioned today. In this group the problem is that of noise and the main illness is partial deafness. A great many changes are taking place in the heavy engineering and steel industries, and with the introduction of some of the new heavy machinery there will be a considerable increase in the incidence of noise. I have recently been told that a new type of steel-making machinery that is to be installed in one establishment in the Sheffield area will cause increased noise. It is quite common to be told by doctors in the locality that, over a period of 15 or 20 years, a large number of people have their hearing gradually impaired.
There is a great difficulty in defining partial deafness, but this is now so widespread and so important an affliction that legislation to deal with it should be urgently considered. We know that an inquiry has been held into this subject, and we are looking forward to any announcement that the Minister may be able to make. Although in some parts of the steel and heavy engineering industries as good deal of important work is being done to abate noise—and considerable progress has been made in some factories in my own constituency—at the same time, new types of machinery which increase the total volume of noise are being installed. Therefore, we are running but we are really standing still. A new approach to this problem is required, and it would be only common justice to include people afflicted in this way amongst those to be compensated. I urge the Government to list partial deafness as a prescribed industrial disease.
My hon. Friends and I have to face one or two general problems of administration. First, it ought to be made easier for Members of Parliament to be given more detailed explanations by medical boards. Very often, in a difficult case where there is conflict of opinion between the man's own general practitioner and that of the medical board, I write to the Minister. The Minister, having first ascertained what particular course of studies, if any, I might have followed when I was young, replies, "As neither you nor I are medical men", etc.
That puts us on a nicely equal footing which is supposed to capture my benevolence at once. It does not capture 1675 my benevolence, and I hope that the Parliamentary Secretary will pass that on to his right hon. Friend. What he is then telling me in polite language is, "You do not know anything about it and, therefore, have no proper standing to argue the case "—adding, in parenthesis, that he does not know anything about it either, but that he is obviously surrounded by a great number of people who know a lot about it, so that his position is better than mine.
That is not satisfactory. We may not be medical practitioners, but we are entitled to receive more detailed information from the medical boards. Our democratic form of Government works on the principle that while the experts take the actual technical decisions, the non-experts are entitled to look again at the problem. One of the great advantages of the Parliamentary Secretary himself is that, although he was not born an expert on National Insurance, he can bring his ability and common sense to hear on the problems with which he now has to deal. It is, therefore, essential that when medical boards reply through the Minister they should give more information, particularly on the critical points that I have already indicated.
I do not, of course, ask that we should in any way have over-riding power over medical boards, but if the argument is to be continued significantly we need more information. It will then be up to us, not to argue with the medical board, but to bring the information to the notice of the House and of the Minister, discuss it and correspond with the men in the industries concerned, with their trade union leaders—and, in some cases with their employers—so that when all of those concerned make the case for new legislation they have the maximum amount of information at their disposal.
A widow often finds herself in a helpless position when faced with this problem. She gets the advice and help of the trade union representative who, in most cases, has in many ways dealt with the case long before it is brought to my attention. That advice is well-informed, and based on the man's experience in his own industry. The woman gets the advice of her late husband's doctor, and may get that of one or two friends and neighbours. Yet, when it comes to the 1676 clinch, and she is actually faced with the problem of producing arguments to overcome the medical boards' opinion, she often has the feeling of being up against amorphous forces, anonymous entities, that mean nothing to her.
That is by no means conducive to the good administration of our National Insurance and Industrial Injuries Schemes. It is bad that people in that position should feel that they are helpless. It is bad that they should not have full confidence in the boards and authorities with whom they have to deal. It is bad for the fabric of democracy—far beyond a particular claim or Department. It is our job to point out that more should be done to explain the work of the boards; and to see that they provide more information so that people may feel—as they now do with many of our institutions in the National Health Service, where similar problems have in some part been overcome—that here are bodies whose composition they know, and whose workings they understand a little better.
It is immensely important that in this age of more and more advanced specialisation, there should always be on the medical board a man who has particular knowledge of the kind of case under discussion. In passing, I would say that in a good many cases that is so. I know some of the members of such boards myself. What we must insist upon is that it is quite certain that it is always so.
This is a national problem, and affects all areas where there are heavy industries and mining. The hon. Gentleman should report to his right hon. Friend that those of us who have spoken have done so on behalf of many others who have had similar experience and could put forward similar cases; that the time has come to take a further look at the problem, to improve the administration, and to realise that without amendment of Section 55 the real crux of the problem cannot be tackled.
§ 1.40 p.m.
§ Mr. Arthur Probert (Aberdare)
I join my hon. Friends in congratulating my right hon. Friend the Member for Middlesbrough, East (Mr. Bottomley) on his luck in the Ballot, and, much more importantly, I should like to thank him for choosing this subject. It is not a glamorous subject, or one that hits the 1677 headlines, but it is one of the most important that we can bring before the House. There has been much discussion of aspects of it in the debates on the National Insurance Bill which is currently before us.
In the House we frequently reveal the plight and suffering of thousands of our innocent fellow-citizens which have been brought about by anomalies in existing legislation, or the lack of legislation to deal with certain of these cruelties. I shall continue to have the highest regard for the House as long as we are able to bring before it the grievances and the cruelties suffered by our fellow-citizens. Although, as I have said, we do not hit the headlines, it is a great tribute to the House that we can discuss these matters so frequently. This subject is almost a hardy annual, and, if I may say so with respect, some of my right hon. and hon. Friends have become hardy annuals in connection with it. I should Iike to pay my respects to my hon. Friend the Member for Bedwellty (Mr. Finch), who has become deservedly recognised as an expert on these matters.
Whilst I should have liked to have dealt with many matters which have already been referred to, and particularly to commuted claims under the Pensions Acts, the decisions made by medical panels, and death certificates, I shall devote my remarks to one problem only. Before I do so, it is necessary to tell the House that my constituency is highly industrialised and includes between 7,000 and 8,000 miners. I do not have to remind the House, therefore, that such a constituency is particularly interested in this subject. Although I know that industrial injuries and diseases are widespread, because of certain occupations certain areas are hit more cruelly by them than are others.
I was much impressed by the Parliamentary Secretary's predecessor who produced figures in 1961 to show the incidence of industrial injury in areas such as the one I represent. He said that, 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. One can almost say, therefore, that 50 per cent. of those who drew injury and disablement benefit came from the mining industry.
A much more tragic figure was that during the same period approximately 1678 30 per cent. of those drawing death benefits were widows of miners. I should like to congratulate the Parliamentary Secretary's predecessor on showing his concern for this problem by giving these figures to the House. Of the 4,000 new cases of pneumoconiosis diagnosed in 1960, 80 per cent. came from the mining industry. These figures illustrate how industrial injury is such an important subject in my constituency. It not only affects the victims, but also all who live in the community. They are either related to a victim or their own economic life is affected by the fact that wages in the area are depressed because there is such a high incidence of injury and disease.
The matter with which I want to deal and to which my right hon. Friend the Member for Llanelly (Mr. J. Griffiths) has already referred is one of particular unfairness. It is the disparity of treatment in the provision of appliances for paraplegics. I fail to understand why this anomaly has not been corrected long before now. Three groups of people are eligible for invalid carriages. The first are war pensioners who are entitled to them under Royal Warrant. The second are the industrially disabled who come under the National Insurance (Industrial Injuries) Act. The third are people who come under the National Health Service Act. The two latter groups are recommended for carriages by a hospital specialist, but the first group can apply to the Ministry of Pensions.
The machines available to the three groups are invalid tricycles and chairs or carriages, either motorised or hand-propelled, all of which are single-seat vehicles. Only war pensioners are being issued with small cars enabling them to carry a passenger. I place this on record so that we may have a picture of the situation before I elaborate. I submit that this reveals a senseless discrimination, whatever the reasons put forward for inequality of treatment—and I admit that I appreciate some of them.
I should like to give the House a number of quotations culled from a large number of letters from disabled persons which have an important bearing on this subject. They read as follows:It would be nice to go out with my wife and son.1679It would mean so much to my wife and myself if we could go out together.These quotations reveal a stark tragedy:For twenty years I have not been able to go about with my wife, I have always been alone, and it does become a bore with no one to talk to.It gives one a great sense of isolation.Participation in shopping and sports expeditions … would help a disabled man feel more independent, and look forward to going out.I would even be able to take my girl friend out.It would mean we could be more together, which is an important thing in a happy married couple's life.I often feel like taking a trip to the country, but going on my own is not very enjoyable.I hope, clear sir, that you will be able to end this dreaded loneliness.… most likely if I could give another person a lift, they wouldn't mind helping me so much.I've got to travel around on my own, and if anything goes wrong I have to depend on strangers.I have been out all day alone without a hot meal or a drink.Every quotation from these letters mentions the loneliness of travelling in a single-seater. Some refer to the inconvenience of going out alone, particularly with reference to shopping. There is also the impossibility of going to a toilet on a long journey. The vast majority of these people are totally unable to leave their vehicles without assistance.
There is fear of a breakdown and the helplessness of not being able to get out and do something. This has the unfortunate effect of making a disabled person afraid to go out alone. This is very important. I have a personal friend who is a severely disabled paraplegic. He has had a three-wheeled carriage for years, but it is impossible to persuade him to go out in it. He is afraid to take the plunge and consequently has to depend on friends to take him out in a car occasionally.
Some of the letters I have received refer to the effect on families and friends. Often when a husband or a son goes out in a vehicle of this kind his family wait anxiously for his return, especially if he is delayed, because they think that he may have had a breakdown or something worse. I need not describe these things much further, because we all imagine what can happen. I remember 1680 a case of a vehicle going on fire and it was only at the last minute that the man was rescued. He could not get out of the vehicle. It was not a question of the doors being jammed or some trouble of that kind. I also remember stopping by the roadside because a vehicle appeared to be on fire. It had become overheated. The person inside was helpless, almost frightened to death and was unable to do a single thing about it.
It seems incredible that the appropriate Minister cannot make a satisfactory provision for this sort of case. Section 75 of the National Insurance (Industrial Injuries) Act, 1946, reads as follows:The Minister may make arrangements to secure the provision and maintenance, free of charge or at a reduce charge, of equipment and appliances for any person who, by reason of the loss of a limb of otherwise, is in need of them as the result of any injury or disease against which he was insured under this Act, and in connection with the provision or maintenance of any equipment or appliances for any person under this section may pay to that person such expenses incurred by him as the Minister may determine.The next subsection says:Any expenses incurred by the Minister under any such arrangements or otherwise under this section shall be paid out of the Industrial Injuries Fund.I mention that because, as I understand it, this part of the Act has never been operated. I am informed that when approaches were made to the Ministry in July, 1959, under this Section of the Act, the reply was given that Section 75 had never been used for any purpose by the then Government or their predecessors, and, as far as I know, has not been used since. My short answer to that is that it is about time it was used.
It was further stated that this Section—and this strikes me as absolutely farcical—was put into the Act to meet a possible gap before the National Health Service Act, 1946, came into operation. That position did not arise because the two Acts came in at once. The Ministry officials further said that it was not put in as a matter of principle to provide that better facilities should be available to those industrially injured than those injured in other circumstances. In other words, what the Ministry says is, "We do not feel that we could apply a different principle to industrial injuries from the principle which we apply to the National Health Service Act. We do not want to 1681 discriminate." I would fully agree. I do not want to discriminate. But discrimination is taking place all along.
Under the Royal Warrant a war-disabled person can get a four-wheeled carriage, and, of course, I welcome that. All I want to do is to bring these other people up to that level. Therefore, for the Government to advance this reason for discrimination, while discriminating in one case and not doing so in the other, is farcical.
I am not going to deal with the question of costs, because I feel that they should not have any bearing upon a decision, but I have been informed by a very reliable source that the difference in costs, especially taking into account the greater facilities provided, is very small indeed. I tried to elicit these costs from the Minister of Health this week, and he informed me that it would not be in the public interest—though I have some doubt about it—to declare what a three-wheeled vehicle and a four-wheeled vehicle cost the Ministry. I understand that argument in normal commercial practice, but I think that it is in the public interest that we should know the difference between the costs of the two types of vehicle so that we can tell the public. "This one costs so much to the Industrial Injuries Fund."
According to figures which I was given some years ago, a Ford Popular car, adapted for use by a disabled person, would cost only £10 more than the Invacar, a three-wheeled vehicle. That is after eliminating the Purchase Tax in both cases, which is the normal practice. Lot us assume that there is a larger difference, and I can visualise that there might well be a larger difference. The extra cost to be borne would, in my opinion, be infinitesimal and would be lost in the credit balance of the Industrial Injuries Fund, which I understand from my right hon. Friend the Member for LIanelly (Mr. J. Griffiths) is £288 million.
I would have liked to deal with the question of Remploy, but perhaps we can choose another day for a debate on that subject. The Parliamentary Secretaries we have had in the Ministry in the last few years have been a very happy choice. I have sat here throughout the whole of this and other debates, and I have noticed that the Parlia- 1682 mentary Secretaries themselves have also sat through the debates and have listened attentively to what has been said. I say that because I feel that we have had the sympathy of the Parliamentary Secretaries when we have been putting forward our various points of view.
I ask the present Parliamentary Secretary to ensure that, apart from showing sympathy, he will put an end to this obstinate refusal to allow these disabled persons, whether disabled by industrial injuries or by other diseases, to have four-wheeled cars, and also put an end to many of the miseries from which they are suffering.
§ 1.55 p.m.
§ Mr. R. E. Prentice (East Ham, North)
We have had a most valuable debate, and I join with those who have thanked my right hon. Friend the Member for Middlesbrough, East (Mr. Bottomley) for having introduced the subject.
There is one feature of this debate on which I cannot help making a brief comment, and that is that the benches opposite have been virtually empty all the time. The hon. Member for Shrewsbury (Sir J. Langford-Holt) is the only hon. Member to have contributed to the debate from that side of the House. I feel that is something we ought to deplore, because this is a subject on which the whole House ought to show its concern and about which there ought to be a great deal more public concern than there is.
Yesterday in the debate on the Contracts of Employment Bill there was a great deal of concern about time lost in industry from industrial disputes. The fact is that we lose from industrial accidents every year at least seven times as much working time as we lose from industrial disputes. There is a great deal of concern, and rightly so, about the number of road accidents, but the number of industrial accidents every year is well in excess of the number of road accidents. We are talking about a problem of great human dimensions and great economic importance, and it is something on which hon. Members in all quarters of the House should have contributed, whereas this debate has been dominated virtually by hon. Members on this side of the House.
1683 The outstanding fact about industrial accidents is that there are too many of them and the deplorable fact is that they have been increasing in the last two or three years. One of the worst aspects is that they have been increasing among young workers. Young workers in the first year or two of their working lives appear to be very accident-prone. The proportional rise in accidents among young workers is bigger than the proportional rise in accidents as a whole, and, with the bulge in school leavers which has been spilling out on to the labour market in the last two years, the problem has become aggravated.
I want to talk about the Industrial Injuries Scheme itself. On the question of industrial accident prevention, this is something on which we are all entitled to demand more positive action from the Ministry of Labour and from the other Departments concerned. Of course, it is not a problem which the Government can solve. It is a problem to the solution of which everybody in industry has a contribution to make. But we feel very strongly—and I make no apology for returning to a matter which has often been mentioned on this side of the House—that the Factory Inspectorate is far too small and that it ought to be increased. A far bigger effort ought to be made by the Government towards the inspection of premises where people work, and the strict enforcement of the Factories Acts and other legislation applicable to safety.
For just over six years I was on the staff of the Transport and General Workers' Union dealing with matters connected with the Industrial Injuries Scheme and, therefore, I could talk about this for a very long time. I shall have to be highly selective in the few points that I want to address to the House.
May I say, first of all, a couple of sentences on something which has already been mentioned, and that is the decision of the Government to do something about the old cases—that is, people injured before July, 1948. My hon. Friend the Member for Bedwellty (Mr. Finch) is to be congratulated by all for the way in which he has campaigned on this subject for many years. I hope that the point that he made about the partially disabled cases still on the two-thirds rate of compensation will be con- 1684 sidered. If the House is being asked to increase the rates of benefit for people injured at work, and if nearly everyone else is to have an increase, it is unfair that this small group should be left out of what is a general increase.
I am sure that it is the general desire that people injured at work should all share in the increases. Although I realise that there are special complications in respect of the partially disabled who were injured before 1948 because of the nature of Workmen's Compensation, which was so different from the present scheme, I do not think that it is beyond the wit of the Department to find a formula which will give them some sort of rough and ready equality with others. This should be done.
I hope that the Government now accept as their permanent responsibility the need to keep the levels of benefit to those injured before 1948 approximately in parity with those injured since 1948. One of the difficulties in recent years to which we on this side have constantly drawn attention has been that the gap between those covered by the Industrial Injuries Act and the old cases has been growing with increases in Industrial Injuries benefit. There has been no reason in principle why the rates in the old cases should not have been brought up at the same time.
There have been references today, notably by my right hon. Friend the Member for Llanelly (Mr. J. Griffiths), to the assessments under the Act. When I was working on these problems, I used to handle war pension appeals also for members of my union. I formed the impression that, generally speaking, people were more generously assessed under the Royal Warrants than under the Industrial Injuries Act. I wish to be very careful in what I say, and I emphasise that I am giving only an impression. It is very difficult to prove, of course, because the injuries were usually very different. As a general rule, it is impossible to take two cases and say that they are precisely the same, except where there has been the loss of a leg or an arm, or something like that, when, of course, there is a standardised assessment, applying equally under both Measures.
However, during my experience over a number of years, I got the impression that a war disabled man whose disability 1685 was equal to that of an industrially disabled man was generally assessed more generously. I think that this is an experience which accords with what my right hon. Friend the Member for Llanelly told the House earlier and with what others have said. It is a difficult subject on which no kind of legislation can have a direct effect since these are medical decisions, but I feel that the comment should be made and I hope that, if it is made often enough, it will have some effect on assessments.
Now, a reference to a problem which has not been mentioned in the debate so far, a problem particularly affecting transport workers and those whose employment takes them out of doors. We referred to this subject in more detail when we were considering the Family Allowances and National Insurance Act, 1961. We attempted in Committee to have Section 7 of the Industrial Injuries Act amended so as to provide wider cover for this group of workers. Our attempt failed. I shall not weary the House by going over all the arguments again, but we have a new Minister and a new Parliamentary Secretary, and I invite the hon. and gallant Gentleman and his right hon. Friend to do some new thinking on this matter.
There is a discrepancy here. Section 7 provides that the Act shall apply to those injured by accident arising out of and in the course of their employment. The words "in the course of their employment" normally apply directly a man enters the premises at which he is employed. A man who works in a factory or an office normally enters the course of his employment when he crosses the boundary of his employer's premises. If he stays there all day, he remains within the scope of the Act all day. If he leaves his work bench or desk to go to the toilet or to the canteen and is injured on the stairway or in the corridor, he is covered by the Act.
The driver of a bus or lorry is normally outside the scope of the Act the moment he leaves the cab of his vehicle. I have frequently had the unhappy experience of representing men who were injured crossing the road or of representing the widows of men who were killed crossing the road, quite close to their vehicles. I remember particularly the case of a man killed while crossing from his bus to a London Transport canteen on the other side of the road. If he had been in 1686 the bus he would have been within the scope of the Act. If he had been injured in the canteen, he would have been within the scope of the Act. Because he was crossing the road from one to the other, he was, for the purposes of the Act, at that time considered to have taken himself out of the scope of his employment and he was in the same position as a member of the public.
It is not easy to find a precise formula to cover these cases. During the Committee stage of the Act to which I have referred, we suggested a form of words which we believed would cover the case. I urge the Parliamentary Secretary to consider the matter again and see whether something can be done. Many years ago, some words were used to describe what we have in mind. These are the words of Lord Loreburn giving judgment in the case of Moore v. The Manchester Liners, in 1910:I think an accident befalls a man in the course of his employment if it occurs while he is doing what a man so employed may reasonably do within the time when he is employed and at a place where he may reasonably be during that time.That appears to me to be a commonsense comment on the intentions of both the Workmen's Compensation Act and the Industrial Injuries Act. Unfortunately, in the application of the Act to those whose work takes them out of doors, the interpretation has been far narrower. We invite the Government to look at the matter again. It is a special problem.
Now, a few words about the special hardship allowance. All those who have had experience in advising workers on the Act and representing them in appeals came very quickly to the conclusion that Section 14 of the Industrial Injuries Act was the most tiresome Section from the employee's point of view. Although I say that, I agree completely with my right hon. Friend when he says that it is a most important part of the scheme and, indeed, that the scheme without a special hardship provision would have been a much poorer scheme. There is, of course, a special problem for those who have suffered a relatively small injury from the point of view of assessment but who have, nevertheless, lost considerably in terms of earning power. The special hardship allowance is very important indeed.
1687 It has been tiresome in the sense that the way in which Section 14 was drawn has led to a lot of complication and anomalies. There were good reasons for drawing it in that way originally, but I think that the lessons we have learned since suggest that it should and could be simplified in the interests of the people concerned. There is also a special case now for raising the special hardship allowance in proportion to the other benefits.
I have been struck by the fact that the great majority of the special hardship allowances which are in payment under the scheme are paid at the maximum rate. It is recorded in the last Annual Report of the Ministry that out of 108,000 allowances in payment the maximum allowance was being paid in 95,000 cases. Also, the average payment being made was 95 per cent. of the maximum allowance. These figures suggest a sort of pressure against the maximum; they suggest that the great majority of the workers concerned were losing far more than the maximum and, I believe, will continue to be losing more than the new maximum allowance which is to come into effect shortly.
At a time when wage rates are rising and are likely to go on rising in the future, we should pay special attention to this point and try to compensate, as far as possible, those casualties of industry who suffer considerably in this way, and, very often, suffer permanent loss of earning power.
As to the rules under which the special hardship allowance is given, I urge that special attention be given to two points. I take, first, allowances paid to those who are not able to go back to their regular occupation or one of equivalent standard. The expression "regular occupation" has been interpreted by the Commissioner over the years in what seems to me to be a very narrow way. The man who goes back to the same kind of work but is not able to earn so much money is disqualified from the allowance. A man may go back to the same kind of work, but, because of his disability, he is advised by his doctor that he should not work overtime. A man may previously have been paid on piece rates but his rate of work has been slowed down by his injury so that he can 1688 now work only on time rate. Suppose that he goes back on piece rate but cannot work so quickly and thereby his earnings are reduced.
All these people are suffering a loss which should be compensated in the same way as if they could not get back to their job but had to take a diffierent type of job. It has been said through the years of the operation of the Act that that person has gone back to his regular occupation and therefore does not qualify for the allowance. We should find a new form of words to ensure that the loss of earnings due to an injury under the Act will count for this allowance without these artificial distinctions being drawn.
The other point which I wish to raise was made by my hon. Friend the Member for Derby, North-East (Mr. Swain). It concerns the rather complex wording by which a man must either be likely to be permanently incapable of following his regular occupation or should have done so since the end of the industrial injuries period. The simple and fair thing would be to say that anyone who is unable to follow his regular occupation for, say, 13 weeks, or some such period, should qualify during the period that he is unable to do so for the special hardship allowance. The fact that that is not the case at the moment leads to much unfairness and a great sense of grievance. This is something which should be simplified and improved.
The only other matter to which I wish to refer is the prescribed diseases schedule. It seems to me that we have always had a basic dilemma in this legislation. On the one hand, people are awarded benefit if they have had an industrial accident. On the other, people are awarded benefit if they suffer from a disease which is in the schedule and if they have worked in the relevant occupation. We have always known that there is a certain group of industrial casualties which does not come in either category. This group is made up of people who have become disabled because of a process of work rather than because of an accident, but, because they have not a disease which is listed in the schedule, they do not receive compensation for their disability.
Some years ago, the Beney Committee examined this matter and considered which of two ways should be followed 1689 to deal with it. One alternative was to wipe out the words "by accident" in Section 7 of the Act so that anyone who became disabled because of his work would receive benefit. The Beney Committee felt—and the Labour Government accepted its advice—that this would be casting the net too wide. On reflection, I am not sure that that was a right decision. I should have thought that there was something to be said for giving this wider consideration. But, assuming that that course of action is rejected, the alternative which the Beney Committee urged was that there should be a constant research effort made with a view to widening the schedule whenever it was felt justified. This is something which, to my mind, has not been followed up energetically enough.
The number of diseases added to the schedule since 1948 is very small. The only one to be added which affects many people is tuberculosis in relation to nurses and others who come into contact with patients. The time has come for a much bigger effort in this direction. Things which should be considered include, of course, widening the definition of pneumoconiosis in relation to miners and other people who work in industries where there is a risk from dust. I need not add to what has been said today on that matter.
There is a number of disabilities, each perhaps affecting a small number of people but which, when they are added up, make a considerable group, arising from the operation of power-driven tools and other things which create pressure. My right hon. Friend the Member for Llanelly mentioned Raynaud's disease, which is a clear example. Dupuytren's contracture is something from which a number of workers suffer through their having to grip something for many hours day after day. All the trade unions have had numerous medical reports on their members which have been the subject of submissions to the Ministry time and time again suggesting that large numbers of people who suffer from disabilities of this sort do so because of their employment. Of course, it is true that other people suffer from these disabilities although they are not due to their employment. That is so of Dupuytren's contracture. It is equally true of tuberculosis, which was rightly added to the schedule despite the fact 1690 that it is a common risk which applies to many people.
What we urge is that Section 55 of the Act should not be interpreted so narrowly. My hon. Friend the Member for Penistone (Mr. Mendelson) suggested that the Section should be amended. Whether that is done or not, the fact is that, if the same attitude were taken on this matter as was taken on tuberculosis, many of these complaints should be added to the schedule.
The next thing which clearly comes to mind is occupational deafness. I hope that the Parliamentary Secretary will say something about this. An investigation into this, which I believe is being financed from the Industrial Injuries Fund, has been going on for some time. It is time that we were told what is being done and how soon a conclusion will be reached. Many countries have prescribed occupational deafness as an industrial disease for many years. A number of States in America have it prescribed in their schemes.
My hon. Friend the Member for Penistone said that this question is becoming more urgent as more and more new types of machinery are aggravating risk to people's health. Work in some industries so clearly leads to deafness that it has become part of medical terminology. Doctor's say that a man is suffering from "boilermaker's deafness", it being something so common among boilermakers that it can be identified in this way. Clearly, these people are casualties of industry, and, if the Industrial Injuries Scheme is to be as comprehensive as we wish, it should cover them.
I believe that there is also an investigation going on into byssinosis so far as it affects people employed in the flax and hemp industries. I have not given the Parliamentary Secretary notice that I would raise this matter—I told him that I would refer to deafness and the other complaints—and I do not know whether he can tell us at short notice anything about it. It largely affects Northern Ireland, which has its separate scheme, but it also affects people over here. There seems to be evidence that byssinosis can apply to workers in the flax and hemp industries just as it does to people who work in the cotton textile industry.
1691 The final example that I want to give is much wider. It seems to me that so many new techniques are being used in industry, particularly in the chemical and similar industries, that many new risks are potentially present for workers all the time. I was handed by some friends only yesterday some new pamphlets of the Ministry of Labour Factory Inspectorate. One of them refers to the risk arising from processes in which sulphur dioxide is used. It contains warnings to the workers concerned and gives them advice on precautions to be taken. Another refers to hydrogen cyanide vapour, the risks which it involves and the precautions to be taken. I could give many other examples of processes which involve risk. These two examples are not covered by the schedule.
I am simply making the general point to the Parliamentary Secretary that constant research should be made into these new processes and that his Department should be constantly in touch with the Factory Inspectorate and with other groups under the Ministry of Labour so that quick action can be taken to add to the prescribed schedule in the event of a new risk being discovered so that workers who may unfortunately suffer injury and disablement may be covered in time. Again, the fact that there have been so few additions to the Schedule in recent years suggests that a research effort is not being made.
There is a Ministerial form of words which we have heard used so often. The former Minister often used it in answering Questions which we asked him. He said, "Of course, the Industrial Injuries Advisory Council constantly keeps this matter under review". That is all very well. We have great respect for the Council, but it is, after all, a part-time body of very busy people. We want to know how far it is backed up by full-time research work and whether the Department is able to supply it with advice about recent developments.
My union has drawn my attention to a recent case concerning a man who died from cancer following his work as a grinding machine operator at an ochre works. He died from cancer caused by contact with ferric oxide dust. All the medical evidence pointed to this and to the fact that his death was due to his 1692 work. The medical adviser of the Ministry agreed with that medical evidence. However, he did not come within the scope of the Industrial Injuries Act. His widow was not able to draw an industrial widow's pension because cancer of a bronchus or lung is prescribed only in relation to working with nickel and not with the materials concerned in his case. I quote that as another example of the way in which the schedule is falling short of industrial experience.
Only recently I drew the attention of the Ministry of Labour to a possible health risk to workers in hairdressing establishments from the use of lacquer hair sprays. I believe that the Medical Research Council is investigating that at the moment. Is the Ministry of Pensions and National Insurance in touch with this research? Will it take steps to prescribe that disease in relation to those workers immediately if the medical evidence establishes a connection between the use of lacquer hair sprays and certain chest complaints which are believed to be connected with them?
I could continue to give further examples, but I have spoken for long enough. I simply make the point that so long as we confine benefit to the sectors of accidents, on the one hand, and of prescribed diseases, on the other hand, there is an important duty on the Ministry to try to narrow the gap so that workers who are genuinely disabled because of their work should, when the medical evidence is clear on the point, receive the benefits of the Act and not be deprived of them.
That is one illustration of many that this is a large and complicated scheme. It represents a duty owed by the nation to those who are the casualties of industry and who are paying a price for our industrial progress as a nation. We in turn owe them the debt of ensuring that they are properly cared for. Therefore, this is a matter of great importance. We hope to see a constant development and expansion of the scheme and a determination by the Government to deal with the anomalies and difficulties that still remain.
§ 2.22 p.m.
§ Mr. Douglas Houghton (Sowerby)
I should like to join in the congratulations to my right hon. Friend the Member for Middlesbrough, East (Mr. Bottomley) in 1693 his choice of topic for the debate today. As he said, it is a continuation of a most interesting debate that we had on 1st August, 1961. Some of us then said what a pity it was that debates on the general administration of the Industrial Injuries Scheme had been so infrequent and that we hoped to remedy that in the future. I am glad, therefore, that my right hon. Friend chose this subject when he was successful in the Ballot.
My hon. Friends who have spoken from this side of the House, and especially my right hon. Friend the Member for Llanelly (Mr. J. Griffiths), have brought a wealth of experience and wisdom to this complicated subject. In passing, I should like to say how appreciative we are of the recent contributions to our debates by my right hon. Friend the Member for Llanelly. We recall his great part in the construction of this new fabric of social security in Britain in 1948 and his thoughts today on the working of the several schemes are of great value.
I am sorry that we have not had much interest shown in the debate from the benches opposite. I am sure that we are all grateful to the hon. Member for Shrewsbury (Sir J. Langford-Holt) for having occupied such a lone position on the benches opposite for so long this afternoon. I understand that my right hon. Friend the Member for Middlesbrough, East purposely drafted the Motion in uncontroversial terms so that we could have a quiet debate, of maximum value, without arousing any of the passions of party strife or bickering and criticism which so often are a feature of our debates.
That seems, however, to have driven everybody away. Since there was not to be any excitement, any bricks thrown or bombs dropped, hon. Members opposite seem, presumably—and I hope—to have gone to their constituencies. All I can say is that we have got on quite well without them and probably the debate has not suffered through the lack of contributions from the benches opposite.
If one looks at the Industrial Injuries Scheme in proper perspective, we are really discussing the terms of an insurance policy. The scheme is much more genuinely an insurance scheme than the National Insurance scheme. We have a different kind of fund and we 1694 have not had the same problem as the National Insurance scheme of assimilating into the scheme large numbers of beneficiaries who did not have the necessary contribution record to entitle them to benefits on the new scale. It is an entirely different kind of scheme in that respect.
Incidentally, I am not sure that the accumulated funds of the Industrial Injuries Scheme have been as well invested as they might have been. From the last Report, we seem to have dropped £34 million on the purchase price of all our investments in the Industrial Injuries Fund. Probably, the rise in gilt-edged subsequently has brought about a rather more favourable position, but I do not think that a private insurance fund would regard its finances as being properly managed if it had lost 14 per cent. of the purchase price of all the investments in the last ten or fourteen years. It is one of the problems of the Government investing money with themselves. They never seem to do as well as if the investments were spread over a much broader field.
On the question of, if I may so describe them, the assimilants into the scheme—the pre-1948 cases—I said a moment ago that the problem is not a very big one. We are glad that the Minister has felt able to make some proposals within the last 24 hours to meet the representations that were made to him the other day.
From the accounts of the Fund, one sees that the total cost of supplementation to pre-1948 cases is less than £1½ million a year, which is a much smaller problem financially than, for example, retirement pensioners under the National Insurance Scheme; so that however generous the additional proposals are, the charge on the fund will be relatively small.
This might be a convenient moment at which to refer to the proposals which the Minister has made. My hon. Friend the Member for Bedwellty (Mr. Finch) and other hon. Members have referred to the little problem which remains, how to deal with the "partial" cases, as they are called. We are grateful to the Minister for having responded so fully and so speedily to the representations that were made. We commend him because his proposals are now quite comprehensive and, in most respects, 1695 satisfactory. We shall welcome them when they come back from another place to receive the final approval of this House. We hope, however, that the Minister will be able to do that little bit more for the partial cases who, otherwise, would get nothing out of the improvements which are proposed.
I wonder whether this suggestion is of any help. There is no particular sanctity about the two-thirds rule, as it is called. It used to be one-half. It has been suggested that it could be seven-eighths. It seems to me, however, that the remedy would be to cover the difference completely, subject to not exceeding the maximum special hardship allowance. There is no special merit about two-thirds of the difference between pre-accident earnings and current earnings. It was a limitation which used to be one-half of the difference, and then it was extended to two-thirds. Why that fraction was ever applied, I do not know.
Under the Industrial Injuries Scheme, we have not a similar condition. The special hardship allowance does not put any limitation upon the proportion of the difference between pre-accident earnings and current earnings. What it does do, of course, is impose a maximum on the amount which may be received, which is the maximum of the special hardship allowance. There is an additional condition, and that is that disablement pension and special hardship allowance taken together must not exceed the level of 100 per cent. disability, which also seems to be reasonable.
But is this not the solution, to give the partials full compensation for the difference between pre-accident earnings and current earnings subject to the maximum of the special hardship allowance? That would make a completely clean job of it and leave us all on this side of the House perfectly satisfied. The amount involved must be negligible. I sincerely hope that the Parliamentary Secretary will be able to convey that idea to the Minister.
Turning again to the scheme in general, it seems to me that we can insure for anything we like. We can write anything we like into the policy of the Industrial Injuries Scheme on two conditions, first, that both sides of industry are prepared to pay for it, and, secondly, that what 1696 we do write in is administratively practical. I think that the second is quite an important condition, otherwise we get a shambles: we do not know where we are; we have no clear line which guides us through this most complicated question; and it is complicated. If sickness and accident insurance were a simple matter private insurance would have been securely entrenched in this field long ago, but actually it is hardly in it at all.
Accident policies are usually on very simple lines. The disablement suffered is usually clear-cue—one eye, two eyes, one finger, the index finger, a thumb, an arm, a leg, and the rest. But these problems of disease, which are more difficult of assessment, are rarely included in the private accident insurance policy, and when it comes to sickness—well, private insurance hardly touches this field, because of the problem of deciding whether a person is incapable of work, whether a person is incapable of doing the same job he did previously, and so on.
We all know that in matters of insurance we want the benefits to be as clearly stated as possible so that the insured person knows what he is entitled to and knows in what circumstances he is entitled to it, so that we have not got the whole scheme bedevilled by a large number of disputed cases and an enormous apparatus for settling disagreements. So, in general, I agree with having conditions which are administratively practical.
Yet I think that there are some things which we can look at fairly broadly and which public opinion would say are right. Take, for example, this most anxious problem of chest conditions suffered by workers in certain industries. We have heard this morning and this afternoon about the difference between pneumoconiosis and bronchitis and this apparently fantastic situation in which the same condition—one condition it seemed to everybody—can be divided into two. Some part of this condition is pneumoconiosis and some part of it is bronchitis; 20 per cent. is pneumoconiosis, 40 per cent. is bronchitis.
So, therefore, compensation under the scheme must be related to the pneumoconiosis part because the rest of it is common to all. Most people would regard that as absurd. I wonder whether, since we are looking at the conditions 1697 of the policy, public opinion would not support the idea that in certain industries, especially coal mining, which I mention as an example, any chest condition should be regarded as attributable to work in that industry?
When we bear in mind that over 40 per cent. of all the disablement cases and over 40 per cent. of all the industrial diseases arise in the coal mining industry we can see what a special risk that is, and I am sure that public opinion would concede to the coal mining industry something very much more clear cut and comprehensive in the Schedule of Industrial Diseases than the fine distinction which we have at the present time.
I know that one wishes to keep separate the diseases which, it is recognised, give a very special risk to particular occupations and those diseases which are likely to afflict us all, but, I repeat, we can write anything we like into this policy so long as it seems fair and reasonable to people of commonsense and good will. If we like to say that any chest condition, bronchitic or tubercular, existing at present in a person who has been employed in a particular industry for more than a certain length of time, should be written into the policy, I am sure that public opinion would support us.
The problem of loss of faculty has been mentioned this afternoon, the question whether the level of assessment is low. Well, it is difficult to judge on that, except that this proportion is based largely on the tradition of assessment of war disablement pensions, and it may be that we are not fully alive to differences between those standards and those of civilian injuries. It is difficult to say wartime injuries were mostly of a particular kind—wounds—not arising in industrial processes. There is the psychological problem, there is dermatitis, and there is a vast range of maladies related to industrial experience rather than war service.
It may be that assessments are too low. The fact that the proportion of gratuities is rising indicates that the proportion of under 20 per cent. assessments is rising. That, I think, does need examination. Why is it that the proportion of under 20 per cent. assessments is rising so greatly? That may be an in- 1698 dication of too low a level of assessment of loss of faculty, but it certainly ought to be looked at.
My right hon. Friend the Member for Llanelly, in his most interesting speech, said that no one would want to return to the old system. No one, indeed, except one lone voice which we heard in the debate the other day, that of the hon. and learned Member for Surrey, East (Mr. Doughty), whose rose to say that there were some features in the old scheme which were better than the Industrial Injuries Scheme. I am sure that my right hon. Friend is right when he says that no one wants to return to the old system. No one wants to go back. On the other hand, I think we want to go forward, and there are some things about the existing scheme which, I am sure we will agree, require reconsideration.
Although loss of faculty is the basis of the Industrial Injuries Scheme, 60 per cent. of the disablement cases have to be supplemented by special hardship allowance to make it in any wise tolerable to the beneficiaries, and the fact that 60 per cent. of the disablement pensions have to be supplemented by special hardship allowance shows that loss of faculty by itself is not the answer. A combination of the two is growing up now, and I am not sure that it is growing up in entirely satisfactory conditions.
My hon. Friend the Member for East Ham, North (Mr. Prentice) said that the proportion of hardship allowances at or near the maximum is very high, which suggests that in far too many cases the special hardship allowance is not enough to meet the loss of earning capacity. I know that much attention has been given by both sides of industry, and no doubt by the Minister, to the possibility of combining the two principles—loss of faculty and loss of earnings. Certainly, the special hardship allowance, which, after all, is compensation for loss of earnings, is now much too important a feature of the scheme to be ignored, and I believe that it is becoming increasingly necessary to look at this aspect of the matter.
Although the Minister is in constant touch with the General Council of the T.U.C., and no doubt with the employers' organisations as well, and they make very valuable suggestions to him from their vast experience, I suggest to him that that is not where he goes for excitement and 1699 adventure and that the time has come for a much more exciting approach to the Industrial Injuries Scheme. The country is ready for radical change in many ways, and I am sure that this is one of them.
The cost of the Industrial Injuries Scheme to the 21 million policy holders is very low indeed. What we could do in this scheme for a very small increase in premium! We could cover all the grievances mentioned in the course of this debate today, probably for not more than another 1d. a week, if that. The level of benefits could be increased far above the present, although that would be more costly.
In the country today there is an appreciation of the increase in risk to health, life, and limb, under modern industrial conditions, despite all that we are doing to improve safety devices and precautions. We are realising, too, that with the rise in earnings and wages the financial penalty, the effect on domestic expenditure in the home of loss of earning power, is very much greater than it used to be. The gap between compensation for injury and earnings is widening all the time, and I believe that the time has come to consider probably a wage-related industrial scheme, something which will come nearer to full compensation for loss of earnings as well as compensation for loss of faculty.
One does not want to be dogmatic about this. I am suggesting that there are new fields of research and thought to be undertaken in this regard. I think that the Industrial Injuries Scheme offers much more favourable opportunities for this kind of thinking than does the National Insurance Scheme, because it is on such a neat and tidy basis, with no problems of the past, except those to which I have referred, which are very small. The whole scheme lies at our feet to do what we wish with it for very low additional premiums, if any at all, to those participating in it.
The problems of repetitive work have been referred to, and here again there is much room for research into the effects of new processes and of new types of work. We know very little about the effect on our temperament and on our health, mental as well as physical, of many of the new processes in industry. I have heard that in the acres of the general index of the Ministry of Pensions 1700 and National Insurance on occasion the clerical assistant dealing with 88,000 "John Smiths" suddenly goes berserk, picks up the index cards, throws them into the air and goes hysterical, and is then moved on to other work—she is put on to the "William Robinsons" for a change.
I know it is sometimes said that one of the joys of repetitive work is that the person concerned does not have to keep his mind on it. Girls can do it almost mechanically while thinking of the boys they are to meet in the evening, or perhaps remembering what a good time they had the night before, and that sort of thing. But I wonder. Does anybody really know? Is not a good deal of industrial unrest due to the pressures of industrial methods, the monotony of the conveyor belt, and so on? Are not we seeing "City Lights" come to life in present conditions?
I read the other day, "Why is it that the motor industry seems to provide such a fruitful source of discontent?". It may be the tyranny of the conveyor belt, the tyranny of the machine, the tyranny of working to a timetable, and so on. We do not know what effect these new methods are having on our well-being, and much that we regard as a nervous breakdown, much that we regard as debilitation, or "it is his nerves, you know", may be just as much an industrial disease as some of those already prescribed. I think that there is room for a radically new approach to the whole problem of the effect of industrial occupations and processes on health. I hope that the Joint Parliamentary Secretary, new to his job, and the Minister, new to his, will apply their minds to some of these aspects of the Industrial Injuries Scheme.
Reference has been made to the problem of noise. This, again, is a new aspect of our working conditions, and I think that enough has come out of this debate to provide the Minister and the Parliamentary Secretary with all the work they want in the time left to them at the Ministry, because we do not expect them to be there for very long. They will, however, have plenty to do while they are there.
The hon. and gallant Gentleman's predecessor had thirteen years in the Welsh Guards, and he himself had eighteen 1701 years in the Navy, most of it, I gather, in submarines, so he knows all about working in cramped places, though I think that his predecessor, just to see the conditions under which some industrial injuries were sustained, negotiated a 27-inch seam in a coal mine. When the hon. and gallant Gentleman rises, we shall see what difficulty he might have in negotiating a 27-inch coal seam. But he has probably negotiated far more difficult things than that, and in any case we wish him well in his new appointment.
We hope he will be able to report to his right hon. Friend the Minister that we had a most interesting debate, that on the whole we congratulate him on what he has done, that we put forward many new ideas for his consideration, and that out of it all may come a still better Industrial Injuries Scheme.
§ 2.49 p.m.
§ The Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance (Lieut.-Commander S. L. C. Maydon)
Perhaps I might start by assuring the hon. Member for Sowerby (Mr. Houghton) that in my constituency there is probably the smallest publicly-owned coal mine in Britain, and certainly the smallest coal mine in the Somerset coal field, and I have before now succeeded in negotiating some of its more difficult places. I therefore have some experience of the difficulties under which some men have to work.
I congratulate the right hon. Gentleman the Member for Middlesbrough, East (Mr. Bottomley) for choosing this most important, interesting and yet serious subject for his Motion. The Industrial Injuries Scheme, more than any other of the major items of post-war social legislation, represents a complete break with the past. The general principles of the old Workmen's Compensation Acts were laid down as long ago as 1897. Under those Acts, an injured workman's remedy lay only against his employer. If they could not agree, his only remedy was to fight it out in the courts. Compensation was related only to the loss of earning capacity, and if a man succeeded in getting back his old job he received no further compensation, even though he might have suffered grievous disablement which would continue for the rest of his life.
1702 The Industrial Injuries Act substituted for this an insurance scheme financed by contributions from employees, employers and the State, which was administered by a Government Department, with independent adjudicating tribunals. It provided benefits based primarily on loss of faculty—that is, benefits related to the degree of disablement. This principle had long operated in the case of war pensions. When the right hon. Member for Llanelly (Mr. J. Griffiths) introduced the Scheme it was welcomed on all sides as a most important advance, and now, after over 14 years' operation, it can fairly be said to have stood the test of time. Although there may be some disagreement about this or that aspect, very few people would wish to see a return to anything like the old system.
Naturally, in a scheme of such enormous scope it has been necessary from time to time to make modifications in the light of experience, and changes have been made when the need has been demonstrated and whenever legislative opportunity has offered. I would mention in particular the easements made barely a year ago by the Family Allowances and National Insurance Act, 1961, of which perhaps the most important were the widening of the definition of industrial accidents to cover common risks, accidents caused by another person's negligence, misconduct, and even skylarking. This has always appealed to me as being the first appearance on the Statute Book of a word with a good nautical tang to it.
Included in the 1961 Act was an amendment to the special hardship allowance provisions, permitting loss of prospects of promotion to be taken into account. Contrary to some of the views expressed today, we never regard the scheme as beyond all possibility of further improvement, and we welcome suggestions which have been made by hon. and right hon. Gentlemen with long experience in industrial matters.
The development of this scheme has been interesting in that the changes that have been found necessary have been those of detail. Nothing that we have so far experienced seems to show that the basic principles are wrong, or that the scheme is failing to do what it was intended to do. In considering the scope for further changes, we must be 1703 careful to keep in mind these basic principles. That does not prevent us, as the hon. Member for Sowerby suggested, being imaginative and looking far and wide for possible improvements. The scheme covers over 22 million insured people—virtually everybody employed under contract of service in Great Britain. In 1961, claims for injury benefit totalled 833,000, and for disablement benefit, 182,000, while awards for death benefit were made in over 2,000 cases.
Before I answer the individual points that have been raised I want to make one point relating to vehicles—an issue which has been raised by many hon. Members. For very proper reasons, that facet of welfare has been made the responsibility of my right hon. Friend, the Minister of Health. Hon. Members will understand if I say that representations concerning vehicles should be made to that Minister, and it would not be proper for me to comment today on what has been said.
The right hon. Member for Middles-brough, East said that the schedule of prescribed diseases was far too small, and referred to the possibility of augmenting it. He mentioned that tuberculosis had been added, but that bronchitis was ex-chided. Enormous difficulties are involved in adding to the list of scheduled diseases, but as we go along medical knowledge is increasing and research is proceeding, and there are always possibilities for changes. I cannot go further than that today.
The right hon. Gentleman and other hon. Members asked specifically what was happening about deafness. It is common ground that deafness is markedly more prevalent in certain occupations. It has been mentioned that it is well known as the boilermakers' complaint. It has therefore been argued that this condition should forthwith be prescribed on the basis of evidence, for the most part subjective, that deafness is notoriously associated with a particular occupation. Unfortunately, that is not good enough to meet the statutory conditions for prescription.
The chief difficulty is that in the great majority of cases there is as yet no satisfactory method of distinguishing deafness due to noise from other types of deafness; nor is there adequate knowledge of the real extent and location of the noise risk 1704 in industry. That is where we come to research, and following consultations which took place with other Government Departments, the Minister of Pensions and National Insurance announced on 29th January, 1962, just over a year ago now, that the Government had decided to finance a major scheme of research under Section 73 of the Act.
This research is being done jointly by the National Physical Laboratory, the Department of Scientific and Industrial Research, the Wernher Research Unit on Deafness and the Medical Research Council. The inquiry is expected to cost about £65,000. It will, unfortunately, take three or four years, so we cannot expect completion before January, 1965, at the earliest and. perhaps, even as late as January, 1966. But it is hoped that before the end of this period it will be possible to provide an interim report which will enable the Industrial Injuries Advisory Council to give further consideration to the question of adding deafness to the list.
§ Mr. Prentice
Can the hon. and gallant Gentleman say why it is going to take three or four years, and can he give us any idea when the interim report will be made? We have waited a long time for this and are anxious to make progress.
§ Lieut.-Commander Maydon
I think the short answer to the hon. Gentleman's first question is that this is a highly complicated and very technical matter, and that is why it will take that length of time. As to when we can expect the interim report, I cannot say, but I will make inquiries and if we have any fairly firm expectation I will let him know.
Connected with that, and also raised by the hon. Member for East Ham, North (Mr. Prentice), was the question of Raynaud's Phenomenon, commonly known as "dead fingers." This arises, apparently, from a disturbance of the mechanism of blood flow at the tips of one's fingers and results in the fingers becoming white and numb. It is particularly noticeable, of course, in cold weather. It occurs widely among tile population at large, but it is generally accepted that it can also be caused in some circumstances by the use of high frequency vibratory tools and some other types of work which expose the hands 1705 to vibration. It became apparent in the early days of the Industrial Injuries Scheme that benefit could not be paid for this condition under the accident provisions of the scheme.
In 1954 the question whether the disease should be prescribed was reviewed by the Industrial Injuries Advisory Council after special medical investigation had been undertaken. The Majority Report of the Industrial Injuries Advisory Council advised that it could not recommend prescription because it could see no practical way of ensuring that claims would be restricted to those which could be satisfactorily decided or which stood a reasonable chance of attracting benefit. That is the reason why Raynaud's Phenomenon remains off the list of prescribed diseases.
§ Mr. J. Griffiths
The hon. and gallant Gentleman said Raynaud's disease could not be treated as an accident. He knows, of course, that in a certain case it was. The court held that each of these tiny blows collectively produced the accident, and compensation was awarded. Therefore, it is not strictly accurate to say that it has never been held to be an accident.
§ Lieut.-Commander Maydon
I ant quite sure that when the matter was referred to the Industrial Injuries Advisory Council it must have known that ruling when it gave the advice which it did to the Minister.
§ Mr. Mendelson
Is the hon. and gallant Gentleman now arguing that the advice of the Council was given because of the limitations put upon its deliberations by Section 55 (2) of the Act? Would it not possibly have come to another decision had the Act been amended by then?
§ Lieut.-Commander Maydon
Until Parliament may in its wisdom decide otherwise, naturally these two tests in Section 55 (2) of the Act are the basis on which these decisions are taken. Another hon. Gentleman opposite has queried whether it is time yet to consider amending Section 55 (2). I will come to that point later on.
There has been some criticism of the composition of medical appeal tribunals. Right hon. and hon. Gentlemen have expressed the opinion that only specialists 1706 in the disease before them should be members of the tribunal. The whole basis of medical adjudication is that prominent medical people, who may be specialists in certain diseases but not necessarily in the disease under consideration, are chosen not because of their specialised knowledge but because of their very wide medical knowledge.
All specialists' and consultants' reports and opinions are laid before the tribunal. If it feels that it has not got the necessary information it can adjourn and ask for it to be provided. But the members are specifically chosen for their very wide knowledge and, although they may not be specialists for a particular complaint which is under consideration, their wide medical knowledge and the fact that they can draw upon the best advice lead us to the conclusion that this is the best system.
If one thinks of an alternative, it it very difficult to find people who have the time available to undertake this sort of work apart from their everyday work. Under the system proposed by right hon. and hon. Gentlemen, if there were an industrial injuries case which went to appeal, there might be a long delay before a specialist with particular knowledge of the complaint in question was available.
§ Mr. Finch
I cannot agree with the hon. and gallant Gentleman on that point. After all, a man's whole future depends on the thorough examination of his complaint. However wide the knowledge possessed by a specialist, if he is not thoroughly conversant with the particular complaint in question grave injustice can be done—is done in many cases.
We do not want to go back to the old workman's compensation system, but in court an applicant was able to bring forward specialists who could be cross-examined on highly technical matters. It would be wiser if the hon and gallant Gentleman would agree to take a closer look to see if something can be done. There are consultants available with knowledge of various disabilities. The decisions of these tribunals mean so much for a man's future.
§ Lieut.-Commander Maydon
I certainly take account of what has been said. Of course we shall have another look at this, but I do not hold out much hope of changing the existing system which, on 1707 the whole, and apart from minor criticisms now and again, seems to have stood the test of time exceedingly well.
Hon. Members will not wish me to say a great deal about accident prevention, the Factories Acts and safety in industry, but the Government have been by no means idle in this respect. Going back a few years, I might mention the Mines and Quarries Act, 1954, which, although largely consolidating, brought in further improved safety measures; the Agriculture (Safety, Health and Welfare Provisions), Act, 1956; and the Factories Act, 1961, again a consolidating Measure. Bringing the system further up to date, there is before the House the Offices, Shops and Railway Premises Bill, which contains safety provisions based on those which have been approved over the years in the Factories Acts.
The responsibility in the Ministry of Pensions and National Insurance is to deal with these unfortunate people when accidents have occurred. Naturally, we should like to see everything done to prevent them and would like to put ourselves out of business in that respect. My right hon. Friends the Ministers concerned will take due note of what has been said today, I am sure.
The right hon. Member for Llanelly said that there was a feeling that assessments were on the low side, and he added that he would like a reexamination of the scale of present assessments. The task of collecting and collating these cases and of comparing them would be enormous, but I do not say that it is altogether impossible. I will see whether there is anything in this criticism that assessments tend to be on the low side. If I can find any evidence of it, we shall have to look into it more closely.
The question of gratuities in lieu of pension was mentioned. The basis of a gratuity is that it does not prevent the man from having his case reviewed if subsequently his disablement gets worse. It therefore has no parallel with the lump sum settlements under the old Workmen's Compensation Act. Where there is a right to special hardship allowance, the man can choose whether to have a pension or to take a gratuity in lieu. There is certainly no question 1708 of the staff of the Ministry of Pensions trying to influence the claimant in his choice.
A number of hon. Members claimed that the diagnosis of pneumoconiosis was sheer guesswork.
§ Mr. J. Griffiths
I did not say that, and I do not think that any of my hon. Friends said it. We do not say that the diagnosis of pneumoconiosis is guesswork. I pointed out that where a miner goes for examination by the medical board and the diagnosis shows pneumoconiosis accompanied by emphysema or bronchitis, the medical board has to decide, first, what is the total disability—for example, 10 per cent. or 15 per cent.—and then, in practice, how much of that total disability is due to pneumoconiosis and how much to emphysema. It is that division between the two which I said was guesswork, not the diagnosis of the disease.
§ Lieut.-Commander Maydon
I apologise to the right hon. Gentleman. I obviously was not listening quite so attentively as I would have wished, but I noted the word "guesswork". There are difficulties in all these matters. As we know full well—I was about to acknowledge this to the right hon. Gentleman—doctors make mistakes, whatever we like to do in the House or elsewhere. I do not think that any honest doctor would ever claim that his profession was infallible.
§ Mr. Finch
We were not talking about mistakes in diagnosing pneumoconiosis. It is not a question of mistake. A man may have emphysema, pneumoconiosis and bronchitis. Doctors agree that there is no mistake. Our point is this: how can doctors accurately assess the percentage of disability relative to each disease? We say that it should be the same as with T.B. If a man has tuberculosis and pneumoconiosis, he is certified for compensation.
§ Lieut.-Commander Maydon
I think that the misunderstanding between me and the hon. Gentleman is that in my present remarks I am trying to cover what was said by a large number of hon. Members. Some hon. Members were dealing, not with a case where the claimant had two complaints, but purely with pneumoconiosis cases. It is true that in diagnosing this disease one must have a record of the claimant's work so as to 1709 show whether he has been exposed to risks which might give him pneumoconiosis. The only infallible way of telling in the last resort whether a man has suffered from that terrible disease is a lung section after death. Most specialists in pneumoconiosis would admit that the only infallible way is the final post mortem lung section.
§ Lieut.-Commander Maydon
I was going on to say that one hon. Gentleman had quoted a case where after death it was found that a claimant who had not been accepted as a pneumoconiotic was in fact suffering from this disease. There are on record quite a number of cases where people have been designated as pneumoconiotics and after death it has been found that they were not in fact suffering from the disease. Therefore, this cuts both ways.
§ Lieut.-Commander Maydon
I could not give an immediate answer to that question. If the hon. Gentleman would care to write to me, I will certainly look into the matter and see if we can give him any figures.
I call the attention of the hon. Member for Derbyshire, North-East (Mr. Swain) to the fact that the present regulations allow a man a trial of six months, and more if his doctors advise it, in his old occupation before he loses the right to special hardship allowance which arises when he has to go to a lower standard of occupation. So there is within the regulations at present that right which allows for a trial period of rehabilitation.
A number of hon. Members have referred to the incidence of dust, particularly in the collieries. Since the even greater mechanisation of work at the coal face in recent years this is an increasing problem. It is not within the sphere of the Ministry of Pensions but I 1710 will see that the attention of the Minister of Power is drawn to the anxiety felt by hon. Members and the suggestions they have made.
With the criticism of the medical appeal tribunals—that is, the lack of appropriate specialists to deal with a particular case before one tribunal—came also the criticism that some of them had to meet in unsuitable places. The accommodation we are able to find is not our own responsibility but, by and large, we have found it satisfactory. There are 12 medical appeal tribunals which sit in 18 different centres. The accommodation usually consists of the tribunal's room, a waiting room, an examination room for the medical members to examine the claimant and a retiring room for the members of the tribunal.
It has not always been easy to secure accommodation of the standard we should like and the standard we must take varies from place to place. However, there has been no case we know of where it has been considered inadequate. Members of the Council on Tribunals have visited most of the tribunal centres since 1959 and have made a few criticisms of particular places, all of which have or are being met as far as is practicable.
§ Mr. Bottomley
The hon. Member has answered two of the questions I asked by saying that they are things for which his Department is not entirely responsible. I asked him a further question—about Ministerial directions being given to the tribunals—for which his Department is responsible. I referred to the indication which has been given that in a case such as bronchitis the figure of 3 per cent. should be fixed.
§ Lieut.-Commander Maydon
The tribunal is an absolutely independent body and there is no direction from the Minister. It would not be proper to direct a tribunal and this is not done.
The hon. Member for Bedwellty (Mr. Finch) raised the difficult problem of the partials and the rule concerning two-thirds of the difference between the pre-accident and post-accident earnings. He used as an example the cases of two men; one where the difference in earnings was between £5 and £6 and the other where it was under £1. He amply demonstrated that in the case of real 1711 hardship, where a man lost a large proportion of his earnings, he was well compensated. He also demonstrated that where the loss of earnings was not great, the payment to the man whose case he quoted was limited to——
§ Mr. Finch
I do not think that the hon. and gallant Gentleman quite got the point. I spoke of two men and the gap of Li between the pre- and postwar accident wage. The man in the instance I quoted has not been able to get the ample review of his pre-accident wages. Although there is a right of review, that right of review is so restricted that he has not been able to say, "Had it not been for my accident"—and he is tied to the old pre-accident rate—"I should now be earning so much." He has to prove an increase in his rates of remuneration which, as things are, he just cannot show. Therefore, he is tied down in that way, and we think that the principle should be amended as, otherwise, he loses in two ways.
§ Lieut.-Commander Maydon
That was one point, but I think that it was submerged in the hon. Member's main point. However, I would point out that there is a double limitation in the special hardship allowance. It is subject to a maximum and in addition the total award cannot exceed 100 per cent.
I should now like to go a stage further, and take up what was said by the hon. Member for Sowerby. He suggested that we should abolish the two-thirds rule and cover the whole difference, subject, again, to not exceeding the maxima applied under the special hardship allowance rules. We will certainly look at that suggestion, and let him know our conclusions.
Though I have tried, by and large, to cover the ground as well as I can, I must have missed a great many points. If any hon. or right hon. Members feel that I have not specifically met their points. I hope they will let me know, when I will do my best to answer them in writing.
We have today had both criticism and praise of this scheme. We have had comments and suggestions for improvement in related fields such as safety in industry and research thereon, which are not the responsibility of my Ministry——
§ Mr. Mendelson
The Parliamentary Secretary has said that he will deal in writing later with any points he has missed, but I would remind him that a quarter of an hour ago he said that he would deal specifically with my suggestion for amending Section 55.
§ Lieut.-Commander Maydon
I crave the hon. Member's forgiveness for having overlooked that. Obviously, the provisions of the original Act are not static, although, as I said earlier, the scheme has worked exceedingly well and only minor alterations have been found necessary over the last 16 years. I cannot give any undertaking that the two tests written into Section 55 (2) are likely to be altered, but we will certainly look at the hon. Member's suggestion. We will look, too. at the form of words with which he would like to alter the sense of that Section. I will let him know our views.
I cannot accept criticisms of these things for which my right hon. Friend's Department is not responsible, although I acknowledge the friendly and very nonpartisan way in which the right hon. Member for Middlesbrough, East, and his right hon. and hon. Friends have spoken.
I acknowledge with thanks the praise for the scheme and for those many devoted people who make it work. In this sphere Her Majesty's Government have three primary responsibilities—the full employment of people, their safety and health while they are at work, and their care and compensation when injured or disabled at work. No scheme is perfect, nor should it be static. Changing industrial processes and conditions require new measures. Changes in standards and modes of living require a new approach to care and compensation. My right hon. Friend has recently decided to make a further move to bridge the gap between the workmen's compensation cases and the new Industrial Injuries Scheme. Details of the proposed changes are to be found in columns 231–2 of Written Answers in the OFFICIAL REPORT of yesterday. We feel concerned for these matters but we do not agree that there is cause for anxiety. We think that the measures proposed for the pre-1948 cases and announced yesterday will remove most of the discrepancies.
I have explained the reasons for limiting in the schedule of diseases and I have 1713 acknowledged that any scheme is likely to present anomalies, but none of those referred to are serious and their elimination would often be likely to create even greater anomalies for the future.
§ Question put and agreed to.
That this House records its continued anxiety for the safety and welfare of all workers and its concern for those disabled through industrial injury or disease, and in particular calls the attention of Her Majesty's Government to exsting anomalies under the Industrial Injuries Acts, the limitations of the Schedule of industral diseases, and the discrepancies in the treatment of the pre-1948 cases.