§ Motion made, and Question proposed. That this House do now adjourn.—[Mr. Fitch.]
§ 1.5 a.m.
§ Sir Myer Galpern (Glasgow, Shettleston)
It is with feelings of deep concern that I raise one of the most tragic human problems that I have encountered in over 30 years of public life. It concerns the misery and suffering of men of tough physique who hitherto have always enjoyed perfect health but who, as a result of working in compressed air during the construction of the Clyde Tunnel, contracted what is known as caisson disease of the bone and are now permanently disabled.
Generally speaking, workers in compressed air know the common health danger associated with the work, namely, decompression sickness, referred to colloquially as the "bends", of which there are two types. The symptoms of type one are severe pains around the knees, elbows and wrists coming on within an hour or an hour and a half of decompression and invariably relieved by the sufferer entering a recompression chamber. Type two, unfortunately, shows more severe symptoms: for example, an onset of paralysis within an hour.
The gravamen of my case this morning is that whilst knowledge of the bends is available to the workers in compressed 898 air, they have no prior knowledge, nor do they receive prior warning, of an additional and more serious hazard to their health, namely, caisson disease of the bone.
A statutory obligation is placed upon employers under Regulation 16 of the Work in Compressed Air Special Regulations, 1958, to supply compressed air workers with a prescribed leaflet. I have a copy of the leaflet with me. It is Statutory Instrument 1958 No. 61, and I wish to read two short extracts from it. It is a leaflet prescribed by the Minister of Labour for issue to workers in compressed air for the purpose of Regulation 16, and it states:Read these rules carefully. Make sure you understand them for your own sake—follow them. Compressed air workers sometimes get pains in their joints soon after leaving the workings. These pains are called 'the bends', 'caisson sickness' or just 'pains'. They can"—this is in heavy type—be almost always avoided.Overleaf is stated:If you obey these rules you will safeguard your health. If you do not—you may become seriously ill.I pose the question whether it is regarded as adequate warning to ask workers, who in some cases may not be the least bit literate, to study a document of this kind, and why, if they have read it, if their employers ensure that they comply with it and they ultimately contract caisson disease, they have no legal claim for compensation. My hon. Friend the Joint Parliamentary Secretary will, I think, agree that this leaflet confirms my contention that the worker is not warned of this hazard of bone lesions.
I have discussed the problem of bone necrosis in detail with Dr. J. K. Davidson, consultant radiologist, Southern General Hospital, Glasgow, a leading authority on the disease, who has been a member of the Medical Research Council Decompression Panel for three years. He carried out a radiographic investigation on 241 men on the completion of the compressed air work on the Clyde Tunnel in December, 1962. This showed that 47 men had already developed one or more bone lesions of varying severity which could lead to total disability and incapacity for work. It has recently become obvious that bone necrosis is a major hazard in 899 compressed air work, since it can transform a perfectly healthy man into a permanent cripple.
The bends rate of 0.19 per cent. of all decompressions while at work on the Clyde Tunnel is the lowest on record, while bone lesions have been shown to be unusually high. Estimates of the prevalence of bone necrosis are not easy because there is a high turnover of the labour force due to the peripatetic tendencies of the men. The bone lesions become evident about one to three years after work in compressed air has ceased. It could well be that the incidence of bone lesions in the Clyde Tunnel is in fact higher than preliminary figures indicate.
The existing Regulations are obviously unsatisfactory and grossly inadequate in preventing the disease. I hope my hon. Friend will be able to tell us that he proposes to have them amended. I understand that all the relevant data regarding the development of this disease are now being collected at the central registry in Newcastle, but what is ti6 happen in the meantime to the poor unfortunate men who are now helpless cripples, whose lives have been shattered as a direct result of blasting their way under the Clyde? They have observed all the Regulations. I say in fairness to the contractors that they insisted on the Regulations laid down; they have been thoroughly observed. Yet no legal compensation is available to these unfortunate victims, though actions have been raised in the law courts.
I wish to give examples with abbreviated case histories of a few of the people who have suffered. I mention one man by name because he is the individual who raised an action in the Court of Session for £8,000, which he lost. His name is James Patterson, an ex-coalminer, aged 39. He has caisson disease in both hips. He has already had one operation on the right hip, and between July and September, 1963, he was in hospital. In March, 1964, he began light work in a bakery, but found it impossible to continue. He is now unemployed. He is married, with three children. While in hospital he had a 100 per cent. disablement pension, presently reduced to 30 per cent. His net loss of income taking into account disability pension, unemployment benefit 900 and hardship allowance, is somewhere about £14 below his earnings of £28 a week, after deduction of tax, when he was engaged in this work. Unfortunately it is unlikely he will ever work again. He raised an action for £8,000 in the Court of Session, which he lost on legal grounds because it was established that his employers had discharged all their statutory obligations, but I should like to quote from the judgment of Lord Hunter:The pursuer has suffered considerable pain and will probably continue to suffer further pain and discomfort. He has had one fairly serious operation and may have to undergo at least one other. He is now a man of only 39 and but for the disabilities caused by caisson disease of the bone he might have expected to continue in hard and well paid work for many years yet. If I had found for the pursuer the award of damages would have been a total of £8,000.But he gets nothing whatsoever. Then there is the case of J. D. aged 41 who is affected in both the shoulder and hip joints. His disability is extremely severe. He is married, with three children, and his disablement pension has varied between 40 per cent. and 70 per cent. H. R., aged 25, has spent a year in hospital undergoing two operations on his hip. He receives an 80 per cent. disablement pension. He is at present in Bridge of Earn Hospital. He received from his employers an ex-gratia payment of £500. D. McD., aged 44 has the disease in his hip. He has an 80 per cent. disablement pension. He has six children, and he received an ex-gratia payment of £750.
The question that I pose is this: had these tough, physically perfect specimens of manhood, known as Tunnel Tigers, examined by the site doctor and passed as fit for work in compressed air, been warned that there was a possibility of developing this crippling disease, would they have bartered their physique and health for a lifetime of pain, poverty and distress for the big money that they could earn for a relatively short period? My investigation shows that if these workers had been warned that they were liable to contract caissons disease of the bones, not a single tunnel would have been built, and I do not blame them. There is no doubt that everything possible will be done to minimise, and I hope ultimately to eliminate, this hazard. Surely we have a moral, if 901 not a legal, obligation to make adequate and just recompense to these men for their suffering and disabilities?
In America they seem to have an entirely different, but more just, yardstick, because during the construction of the third tube of the Lincoln Tunnel in New York, despite the use of a new method of split shift system working, they paid out no less than 2½ million dollars in compensation to the tunnel workers who developed similar bone lesions?
Is it unreasonable to ask that my hon. Friend should do something by way of providing compensation for these unfortunate victims? My plea for these unfortunate crippled men is that some means should be devised for the payment of adequate compensation, and that it should be made retrospective. If exgratia payments have been made to two workers, why not to the others? I hope that my hon. Friend will make some investigations among the contractors to ascertain why there has been this difference in the treatment of the men concerned. I have heard it rumoured that Paterson and one other worker were not considered for ex-gratia payments because they raised actions. If this allegation is correct, something ought to be done about it, because I regard that method of discrimination as grossly unfair.
Lord Hunter assessed the damages in Paterson's case at £8,000. We have a Criminal Injuries Compensation Board, and it should not be difficult to devise an Industrial Injuries Board, supplied with funds from the tunnel contractors themselves, and if necessary supplemented by the taxpayer, to whom such cases as I have mentioned can be referred. It must be remembered that many more cases are likely to occur, but the victims may not associate their complaints with the fact that for a few short months they worked in compressed air in the digging of some tunnel or other. Surely it would not be too much to set up such a Board to whom these cases could be referred?
We have a moral duty and responsibility to provide compensation for these men. That is the least that we can do for erstwhile fit men now condemned to a life of misery and pain. At present we do not know how to prevent the onset of this disease, and I ask my hon. 902 Friend to give this real human tragedy serious and more than ordinary attention to see how far we can go to alleviate the plight and some of the suffering, by providing compensation for these men, and, unfortunately, the plight in which many more will find themselves as a result of having worked in compressed air.
§ 1.20 a.m.
§ The Joint Parliamentary Secretary to the Ministry of Labour (Mr. Ernest Thornton)
I have listened with deep interest to my hon. Friend the Member for Glasgow, Shettleston (Sir M. Galpern), and I have been deeply moved by the humanity of his remarks on this most disturbing subject. I assure him that we will study very closely all that he has said tonight. I can assure him, further, that my right hon. Friend and I share his concern that everything practicable should be done to protect the health of workers in compressed air. There is not time for me to describe what the existing requirements are and what are the problems of work in compressed air, other than to say that this type of work is subject to special Regulations made in 1958 and amended in 1960 under the Factories Act.
I should also mention that compressed air disease has been notified under the Factories Act since 1939. The object of these Regulations is to protect workers from compressed air disease, caisson disease, or decompression sickness, as it is variously known. The best-known form of decompression sickness is what is commonly known as the "bends", to which my hon. Friend has referred. It must be admitted that the Work in Compressed Air Regulations, even when conscientiously complied with, do not entirely prevent the occurrence of decompression sickness. The experience of the Factory Inspectorate is that the Regulations are usually faithfully observed. I was interested to note my hon. Friend's remark that the Clyde Tunnel workers, as far as he was aware—and it is obvious that he has gone into this matter very closely—observed the Regulations faithfully. We know that even if the Regulations are observed it does not prevent decompression sickness.
As for the bends, expert medical opinion is that the implementation of the Regulations substantially reduces the 903 number of cases. In the case of bone necrosis there are theoretical—I emphasise the word "theoretical"—scientific grounds for presuming that the Regulations reduce the number of cases. Beyond that, nothing can be said with any certainty, since bone necrosis may occur in men who have never complained of an attack of the bends. I understand that, although the association of bone disease with work in compressed air has been known for many years, the precise details of this association and its causation are still in doubt.
As the cause of the disease is uncertain it can be appreciated how difficult it is to know what special preventive measures should be taken. Hon. Members may think that this is an unhappy situation, and that it indicates plainly the need to strengthen the Regulations, as my hon. Friend has requested of me tonight. In principle I would agree, but unfortunately we do not know what can best be done to strengthen the Regulations. We will certainly consider any suggestions made here tonight, or any advice that is offered to us. At present, however, we know of no definite evidence that precautionary measures other than those already laid down in the Regulations would 'reduce the incidence of bone necrosis. But I must add that the Government have not merely been content to wait for something to turn up. The Medical Research Council has set up an expert panel on decompression sickness, and because of its great interest to our Ministry, it is attended by a deputy senior inspector of factories.
This panel, among its other activities, has paid particular attention to workers on the Clyde Tunnel. It has carried out a survey there on bone necrosis. The report of this survey has not yet been published. Some parts of [...] are not yet final, but I can briefly state the main findings. About 1,400 persons worked in this tunnel at one time or another and were exposed to compressed air, and it was possible to X-ray 241 men still employed on the job at the end of this contract.
§ Sir M. Galpern
Whilst we accept all the medical evidence and the inadequacy of knowledge of the disease, what I am most concerned about is what we are 904 going to do. Are there any proposals to deal with the suffering and misery by financial compensation?
§ Mr. Thornton
I was coming to that. I am afraid that the question of financial recompense will not be for me to deal with, but I will make passing reference to it before I finish. I think it is important that I should put on record this evidence that has been revealed so far, because it is disturbing evidence.
Bone changes were found in 47, and that is 19 per cent. of those 241 men who were X-rayed. These include the cases to which the hon. Member referred. Twenty-three of the 47 were unfortunate in having lesions at the head of the femur or the humerus, and this means that they might suffer from pain or disability sooner or later. It is known that four of them had already had to undergo surgical treatment on that account, and these are probably the four to whom my hon. Friend referred.
§ Mr. Thornton
There is no evidence, for example, that limiting exposure to compressed air to shifts of four hours or less diminishes the risk of bone lesion. As regards pressures, the survey has shown that the decompression tables scheduled under the Regulations do not prevent the occurrence of bone necrosis. But at the same time there is no new evidence on the basis of which these tables could be revised.
The general conclusion which might be drawn from this work is that the evidence does not indicate any changes which might be introduced which could be expected to improve protection against bone necrosis. This is indeed disappointing. It does, however, show that much as my right hon. Friend and I would like to strengthen the Regulations, they afford as high a degree of protection as can be achieved on the basis of the existing state of knowledge.
Let me make it clear, though, that efforts to improve the position will go on. For instance there is to be an international meeting in London this autumn in a continuing attempt to establish the best schedule of decompression, and the Medical Research Council has recently 905 awarded a research grant to enable further surveys of this type to be carried out among compressed air workers.
The prescribed leaflet which the Regulations require, and which my hon. Friend quoted, is being revised so that it gives a more realistic warning—and I take my hon. Friend's point here—to those a bout to take up work in compressed air of the hazards to which they are subject. In this connection the points made by my hon. Friend will be taken into account, I assure him.
With regard to financial compensation, I am afraid that this does not come within the scope of my Ministry's responsibility. It will be a question for my right hon. Friend the Minister of Pensions and National Insurance. The Factories Inspectorate of the Ministry of Labour is concerned with protecting persons from damage and from injury to their health. That is the main purpose of the department. I am sure that my hon. Friend will not expect me to comment on the judgment given on a claim for damages by a man who had worked on the Clyde Tunnel, but I have taken a very careful note of what he had to say, and I have seen a copy of the judgment.
I assure my hon. Friend that we shall give the closest continuing attention to this disturbing problem. We shall not hesitate to take further action in the light of improved knowledge. I assure him that we will study very carefully all the 906 suggestions that he has put forward tonight.
§ Sir M. Galpern
While I recognise that these people are entitled to receive disability pension from the Ministry of Pensions and National Insurance, surely the proposal that I put forward is something that the Minister of Labour could look at. It is that contractors who employ physically fit men who ultimately contract the disease, causing them complete disability and misery, should contribute to a fund set up by themselves. Surely that is a matter that his Ministry could look into, and decide whether something along those lines could be done.
§ Mr. Thornton
When I assured the hon. Gentleman that my right hon. Friend and I would give careful consideration to his suggestion, I had in mind the point which he has made. I should also be interested if my hon. Friend has any information on the American experience of compensation to which he referred, because I should be very pleased to look at it. But I am sure that he will understand my not being able to go further than that tonight. I undertake to look very carefully at all that he has had to say and to consider all the suggestions that he has made that come within the range of my right hon. Friend's responsibility.
§ Question put and agreed to.
§ Adjourned accordingly at twenty-eight minutes to Two o'clock.