§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Pym.]
§ 11.1 p.m.
§ Mr. H. Boardman (Leigh)
I wish to raise a matter concerning Mr. Charles Abbott, a medical herbalist, and the treatment he received from a coroner presiding at the inquest on one of Mr. Abbott's patients, a patient who had been under his care for about 20 years.
Mr. Abbott was requested by the coroner to submit a written statement concerning this lady's death and was summoned to attend the inquest, at the end of which he was offered 25s. by the coroner as an ordinary witness's fee, which—I believe quite properly—was refused by Mr. Abbott.
I wish to point out that neither Mr. Abbott nor I are primarily concerned with the monetary aspect of this matter, particularly as the difference between the 25s. offered and the sum which I think should have been offered has been spent many times over by Mr. Abbott in pursuance of this case. I think that he should have been paid considerably more than he was offered.
Since I believe that the ordinary witness's fee of 25s. was offered by the coroner simply to show his disdain—and I am sure of this—and I regard it as a studied insult, I must inevitably base my case on the fee, for, according to the rules for coroner's fees and allowances, such fees mark the status of the individuals giving evidence.
The rules set down various fees and allowances for various categories of witnesses. There are fees for professional witnesses; there is provision for the expert witness, and presumably the coroner uses his discretion as to the fees payable to these; there are fees for lawyers, for dentists and—rather surprisingly—for veterinary surgeons. There are fees also for ordinary witnesses, for whom the figure is 25s. for the half day. I received a letter from the Joint Under-Secretary of State on 1st November last and I will quote one extract: 1938These rules draw a distinction between the expert witness and others, and provide for different allowances. The distinction does not turn simply on the qualifications of the witness but rather on the nature of the evidence he gives.But the answers Mr. Abbott gave to the coroner were strictly related to the questions which the coroner asked, and I wonder whether it is now suggested that Mr. Abbott in his replies ought to have gone completely outside those questions? I think that he would quickly have been ruled out of order.
The witness might have been myself or the Joint Under-Secretary of State, who might have witnessed a road accident which had fatal results. In that case we would have been paid 25s. for our attendance for a half-day, or 50s. for a full day's attendance at an inquest. But by what stretch of the imagination could either the hon. Gentleman or myself in these circumstances be put into the same category as Mr. Abbott, who had had had the medical care of this woman for upwards of 20 years?
What in fact happened at this inquest was that a coroner, who the hon. Gentleman has stressed time and time again is a judicial officer, put Mr. Abbot into the same category of witness as myself or the hon. Gentleman if we had witnessed a fatal road accident. That a coroner should be capable of such distortion seems to me to be disastrous, and something which can only bring disrepute upon the office he holds.
I wish to say a word about Mr. Abbott, and I want to make it clear that it is this case alone which I am discussing. My plea tonight is not for every marketplace quack. I am seeking justice for a man who has devoted the whole of a very long life to the service of healing.
There are thousands of people throughout this country who can bear testimony to that. In the First World War Mr. Abbott's patients petitioned the late Sir Auckland Geddes, Director of Recruiting, 1916–1917, and Director of National Service, 1917–1919, with a view to getting complete exemption from military service for Mr. Abbott. Sir Auckland Geddes took the very exceptional step of receiving a deputation from Mr. Abbott's patients in order to discuss their petition. As a consequence, Mr. Abbott was given complete exemption during 1939 the 1914–1918 war in order to carry on his practice as a medical herbalist.
I want to stress to the hon. Gentleman that this decision by Sir Auckland Geddes was not the emotional decision of a misguided Minister, as one can see from Sir Auckland's background. Indeed his background adds significance to the decision. I should like the hon. Gentleman to pay attention to this particular point, because I do not know whether he is aware of this.
Sir Auckland was formerly Demonstrator and Assistant Professor of Anatomy at Edinburgh University, Professor of Anatomy at the Royal College of Surgeons, Dublin, and Professor of Anatomy at the McGill Unversity in Montreal. In view of that, I think that he was better qualified than many other people to judge whether Mr. Abbott would be doing more useful work in the Services, or by attending to his patients. During the Second World War Mr. Abbott was to all intents and purposes treated like a registered practitioner. He was supplied with all the petrol that he needed to go the rounds of his patients.
I am reminded of the case of Sir Herbert Barker who had to meet every form of opposition, scorn, and derision, and yet of whom The Times obituary notice of 22nd July, 1950, said:He placed the medical profession of this country in his debt in two ways. In the first place he challenged professional complacency by a long series of successful treatments of cases which the doctors had failed to cure.His second service had the effect of challenging professional skill and so, in the end, of increasing it.Almost from the beginning Barker had found himself in conflict with the medical profession.… The doctors were not animated by hatred of Barker; they were merely doubtful about his knowledge and distrustful of his skill.I think that those words could be applied to Mr. Abbott.
The coroner in his summing-up said that Mr. Abbott may be able to treat certain ailments and certain people may have faith, but there is no doctor of my acquaintance who would claim more. Hence the reason why this House is anxious to expand the medical specialist services.
Last week the British Medical Association held its annual meeting in Manchester, 1940 and it attracted quite a lot of publicity. I think that that is generally what conferences are for. Dr. J. E. Struthers, a senior medical officer at the Ministry of Health, addressed the conference. He had headed an investigation into prescribing by some registered practitioners.
The Evening Standard of 22nd July reported:Dr. Struthers revealed that drugs of no proven value, dummy pills, and harmless fluids given simply to keep the patient's faith going were costing the taxpayer £3 million a year.The Evening News headed its leader on that night, "Medical Madhouse".
The morning papers also commented on the conference. On 23rd July most of them gave a catalogue of the irresponsible prescribing quoted by Dr. Struthers. These were some of the headlines: The Daily Telegraph said:A family had 800 purple hearts each day. Lunatic prescriptions.The Times said:Family got 800 pills a day. Lunatic fringe prescriptions.The Guardian said:800 pep pills a day on the National Health Service.The Observer of Sunday 26th July said:Doctors at the British Medical Association Conference were told that £3 million a year were spent on drugs that were of little or no value to the patient, and at least £100,000 on drugs that were positively dangerous or detrimental.One might well ask at this point: where do we look for the quacks? We need not confine ourselves to the market places any longer, yet had any one of the doctors who so wildly, so dangerously, prescribed for his patients been called on to attend this inquest, he would have been treated with respect and without any shadow of doubt would have been paid the professional fee. Fortunately—and I think that one must say thank heaven—it can be said that such doctors represent only a very small minority. The people who go to Mr. Abbott go to him because they choose to go to him. Every person who goes to him pays for his treatment, yet everyone could get free medical attention almost literally at the corner of his own street. But they all prefer to be treated by Mr. Abbott.
In a world of diminishing freedoms, let us pray that one that shall for ever 1941 remain shall be the freedom of the individual to choose how and by whom his body shall be treated. Coroners are independent judicial officers. But if a coroner allows his personal prejudice to override his sober judgment to the detriment of his decisions and to the detriment of those who appear before him, something must be done about it. I believe that something can be done about it without violating the coroner's Independence. Tonight I have been privileged to say more on Mr. Abbott's behalf than ever he could have said for himself. What I have said I have said only in the cause of justice. I therefore ask the hon. Member to acquaint the coroner of tonight's discussion—after all, it concerns him—and if, in the light of what has been said, the coroner comes to feel that his decision was harsh or even wrong, it lies within his discretion as a judical officer and a gentleman to remedy it.
§ 11.17 p.m.
§ The Joint Under-Secretary of State for the Home Department (Mr. C. M. Woodhouse)
The debate on the Adjournment at the end of the day's business traditionally provides an occasion for discussing the grievances of individual constituents, and on this last night of the present Session I suppose one could have no more proper subject for debate than a coroner's inquest. This is a particularly appropriate opportunity for discussing the case which has been raised by the hon. Member for Leigh (Mr. Boardman), because his constituent, in whose case I have taken a considerable personal interest, falls into a very rare category of individual, and his grievance arises from the difficulty of applying to him regulations which do not precisely take into account his unusual qualifications.
I should like to say as clearly as I can to the hon. Member that I do not for a moment dispute his constituent's qualifications or ability, of which he has spoken; nor do I question the eminence of those who have expressed confidence in him. Nor would I challenge his strictures of some of the far more doubtful medical practices of those whom I am glad agree with him are a very small minority of the medical profession.
The hon. Member has carefully and thoroughly explained the circumstances 1942 from which his constituent's complaint arises. I know that he will forgive me if I go over some of the same ground again from a slightly different point of view in order to explain why, so far as the Home Secretary is concerned—and I emphasise that qualifying phrase "so far as the Home Secretary is concerned"—it was not possible for the case to have any other outcome.
The circumstances are that early last year a woman died whom the hon. Member's constituent, Mr. Abbott, had treated for many years. He tells me it was for 20 years, and I am sure that that is correct. A post-mortem examination was held and an inquest was ordered. The pathologist who conducted the postmortem asked Mr. Abbott for information on the treatment he had given, and Mr. Abbott readily provided that information. Mr. Abbott further prepared a written statement for the coroner, and also indicated that his attendance at the inquest would involve him in a loss of 10 guineas, and he asked for reimbursement. The inquest took place on the morning of 9th August, 1963, and lasted for 1¼ hours. Mr. Abbott attended the inquest, travelling in all about 20 miles in order to do so. He gave his evidence, as the hon. Member has said, in response to the coroner's questions and, at the end of the inquest, he claimed for his expenses. It is over this claim that the dispute has arisen.
I must now explain that allowances for witnesses at a coroner's inquest are governed by statutory regulations made in 1955. They are precisely the same as those payable for attendance in connection with proceedings at magistrates' courts, and the same considerations apply. The regulations make provision for the payment, where it is appropriate, of subsistence allowances and travelling expenses, and these provisions apply to all witnesses alike. No dispute arises over that part of the regulations.
There is also provision for a payment in respect of attending an inquest, and to calculate the amount of the payment that shall be made the regulations make separate provision for three categories; professional witnesses, expert witnesses, and ordinary witnesses. The professional witnesses are medical practitioners, dentists, or veterinary surgeons and one group which the hon. Gentleman did not mention, members of the legal profession. 1943 They are entitled, for attending to give professional evidence, to eight guineas for a whole day, or four guineas for half a day.
An expert witness who attends to give evidence and for work in connection with its preparation, may be paid an expert witness allowance of such amount as the coroner may consider reasonable, having regard to the nature and difficulty of the case, and the amount of work necessarily involved. Any other witness—that is, an ordinary witness such as the hon. Gentleman or myself—is entitled to 50s. for a whole day, and 25s. for half a day.
When Mr. Abbott made his claim it was clear that he was not a medical practitioner, a member of the legal profession, a dentist or a veterinary surgeon, and he could not, therefore, be paid as a professional witness. The coroner also concluded that he could not be treated as an expert witness, and that he was, therefore, entitled only to the sum of 25s.
Before I say more, and discuss the wider issues which have been raised tonight. I should like to make two points. The first is that the ordinary witness's allowance is not intended to provide full compensation for loss of earnings. If a person has knowledge which is relevant to court proceedings, whether they are related to a criminal charge, or to proceedings in a coroner's court, it is that person's public duty, if summoned, to attend and give evidence. The allowance which may be paid to him for performing that duty is intended to ensure that he should not suffer hardship by so doing. It is payable only if he loses remuneration by having to attend the inquest, and it is not measured by the extent of the loss.
The second point is that the expert witness is not specifically defined in the regulations, and to find out what is an expert witness, we must go to the general law. The law of evidence as a rule allows witnesses to give evidence only about matters of fact within their knowledge, and expressions of opinion are not admissible. However, as an exception, the expert witness may be called upon to give an opinion based on the facts or other matters which he has investigated. Typical examples of expert witnesses are the handwriting expert and the ballistics expert.
1944 The important point to bear in mind is that the expert witness qualifies as such, not only by virtue of his own qualifications, but by virtue of the nature of the evidence which he gives. Accordingly, for a witness to be entitled to an expert witness allowance, two points must be determined. The first is that he must have given evidence of a certain kind. That is a question of fact. The second is that evidence must have been expert evidence. That is a question of law.
Accordingly, this dispute is, in essence, a dispute about the coroner's interpretation of a point of law. I must now emphasise that coroners are independent judicial officers. They are appointed by local authorities but, subject to the requirements of the law, they are autonomous.
§ Mr. Boardman
I agree with that, but according to the hon. Gentleman's own letter, they have their own discretion in the matter of the expert fee.
§ Mr. Woodhouse
That is so. They have this discretion, and in this case the coroner concerned exercised the discretion in a way unfavourable to the hon. Member's constituent.
What I have to point out is that nobody can compel the coroner to alter that decision. He cannot be given directions about the way in which he carries out his duties either by the authority appointing him or by the Home Secretary. Like any other judicial officer, he is subject to judicial control but to no other control. If Mr. Abbott considers that he has a real grievance as regards the payment made to him, or offered to him, by the coroner, there are legal remedies open to him to pursue. I do not think that this would be a suitable occasion—and time is very short—for me to attempt to outline his legal remedies, but if he wishes to take that course I have no doubt that the best step for him to start with would be to take legal advice from a solicitor on the correct procedure. But this is not, in any case, a matter in which the Home Secretary can intervene.
The Home Secretary's responsibility in this case—which I have very carefully examined in the light of my correspondence and discussions with the hon. 1945 Gentleman—is determined by two factors. The first is the coroner's judicial independence, which prevents the Home Secretary from issuing any directions about his conduct of his duties, and the second is that a question of the interpretation of the law is involved. Supposing that the Home Secretary's power was not fettered by the coroner's judicial independence, before he could act he would have to make a full investigation of the facts and, having done so, determine the application of the law to those facts. But these are not functions that the Home Secretary can properly exercise. They are the functions of a court.
I am sorry that I can, therefore, offer no help to the hon. Member, who has argued his constituent's case so persuasively. I realise that, as the hon. Member has said, for Mr. Abbott the sum involved is unimportant and that he is concerned with the question of principle and the establishment of his status. The context in which this issue of principle has arisen, however, makes it impossible for the Home Secretary to assist or to intervene in any way.
1946 This does not involve any challenge of Mr. Abbott's status, but is a statement of the law governing the Home Secretary's position and actions. The issue is one that might be determined in the courts, and that would be a matter for Mr. Abbott to take legal advice about, but for the Home Secretary to attempt to determine this question would be a gross violation of the fundamental constitutional principle that the Executive do not intervene in matters that are properly for the judiciary.
With every sympathy, I am afraid that it is impossible for the hon. Member in this case to invoke the Home Secretary's aid for the benefit of his constituent.
§ Mr. Boardman
I apologise for the omission, but I had intended to express on behalf of Mr. Abbott and myself our appreciation of the way in which the hon. Gentleman has dealt with the case, with very great sympathy from the beginning. I thank him.
§ Question put and agreed to.
§ Adjourned accordingly at twenty-eight minutes past Eleven o'clock.