EX-R.A.F. OFFICER (PERSONAL CASE) (Hansard, 24 June 1969)

§ Mr. James Dickens (Lewisham, West)
I rise at this late hour to raise the case of Flight-Lieutenant Cockayne, a former constituent of mine who now resides in Polruan, Cornwall, in the constituency of the hon. Member for Bodmin (Mr. Bessell). Thus, I should, perhaps, begin by explaining that I have arranged with the hon. Gentleman that I shall complete this aspect of Flight-Lieutenant Cockayne's family problems, but I am content to leave his current problems in the hands of the hon. Gentleman, who, I understand, is unavoidably absent this evening.
I should also explain that from December, 1966, until June, 1968, I handled a wide variety of family problems concerning the Cockayne family, most of which were in some degree or other related to the social services. However, matters took a sudden and somewhat dramatic turn on 11th June, 1968, when Mrs. Cockayne, having watched a television programme concerning the work being undertaken at Porton Down, wrote to Mrs. Hilary Rose of the London School of Economics asserting that her husband, Flight-Lieutenant Cockayne, was suffering from the nervous and physical after-effects of nerve-gas poisoning.
Mrs. Rose forwarded the letter to my hon. Friend the Member for West Lothian (Mr. Dalyell), who in turn was kind enough to pass the letter on to me. That was the first occasion, despite my concern with this family since December, 1966, on which this allegation had been made.
On 21st June, 1968 I wrote to Mrs. Cockayne and asked her to meet me to discuss what seemed to me to be the extremely grave charges which her husband, and she in turn, had made. Having seen Mrs. Cockayne on 26th June, I wrote to the Minister of Defence asking three specific questions: first, whether Flight-Lieutenant Cockayne served at the Chemical Defence Experimental Establishment at Porton during his service 1412 with the Royal Air Force; second, whether he was engaged on research into nerve gases; and, third, whether or not he at any time had suffered any exposure to nerve gas poisoning.
On 31st July the Minister of Defence for Equipment replied to me confirming that Flight-Lieutenant Cockayne had indeed served at the Chemical Defence Experimental Establishment at Porton from 1952 to 1954. My hon. Friend went on to make the following reply in answer to the other questions I had raised. Because of the importance of his reply, Mr. Deputy Speaker, I hope you will allow me on this occasion to quote it at some length.
On the second question I posed, the reply I received was (ii) He (Flight-Lieutenant Cockayne) was not engaged on research into nerve gases. His duties involved him from time to time in field experiments to assess the vulnerability of our equipment to nerve gas weapons. (iii) While at Porton, he reported sick twice to the small hospital there. On the first occasion, on 5th August 1953, he was suffering from myopis or contraction of the pupils caused by a mild exposure to a nerve agent. He was treated for this with Codeine and there was no recurrence of the complaint. Almost certainly this mild exposure occurred as a result of a field experiment to assess the vulnerability of tanks, which records show took place on 5th August 1953. It was not unknown for members of the Porton staff at the time to suffer mild myopsis as a result of small accidental exposure to agents. Recovery was normally complete in a few hours without any treatment at all. Later in his reply, the Minister said there is no record that when he resigned from the Royal Air Force in 1954 he made any complaint about his health having suffered from nerve gas poisoning, nor is there any evidence that he suffered any lasting ill-effects from the mild dose of nerve gas he received in 1953. If you feel that an independent medical examination, involving as it would full access to Flight-Lieutenant Cockayne's medical and service history, would be worth while, I would certainly have no objection. I would understand if you would prefer this to be done by a doctor unconnected with the Ministry of Defence. If you would care to suggest to Flight-Lieutenant Cockayne that he should get in touch with the Ministry of Social Security, they would be prepared to have him examined"— I stress the word "examined"— by their doctors since in fact what he is claiming is that he is suffering from a disability which is attributable to his service with the Royal Air Force, and this is a question which the Ministry of Social Security have the responsibility for determining. 1413 On receipt of that letter, I wrote, on 6th August, 1968, to my right hon. Friend the then Secretary of State for Social Security asking for this independent medical examination to be arranged. I received interim replies from the Ministry on 29th August and 7th October, and later on 17th October, 1968, following a telephone call, I received an extended reply from the Parliamentary Secretary containing this reference: Our doctors have now considered the medical history and the Chief Medical Officer wishes to obtain the advice of one or possibly two eminent independent consultants. Whether we will need to go to a second consultant will depend on the nature of the report received from the first. I cannot say at this stage whether the consultants will wish to see Mr. Cockayne. Thereafter, it will be for the doctors to decide, possibly to have a Ministry medical board, whether or not Flight-Lieutenant Cockayne's condition is connected with his service and, if it is, what the assessment of his disability should be. On 12th December, 1968, following some delay, I wrote to the Department of Health and Social Security asking for a definitive reply. On 20th December I received a reply from the then Minister of State at the Department, the late Mr. Stephen Swingler, who, after explaining that the papers were in the hands of the consultants, went on: I am sorry that this is taking so long, but I am sure that you will appreciate that in a case of this sort and when substantial longer-term awards depend on decisions based on complex medical considerations, there can be no substitute for meticulous examination and weighing of the evidence. Later, on 30th January of this year, I received a further reply from the Minister of State, this time from his private secretary, containing this passage: We have now received the report of the first consultant whom Mr. Swingler mentioned in his letter of 20th December. The nature of that report is such that we are submitting the case to an independent medical expert. To make such a submission we must produce a statement of evidence and we are at present engaged on its preparation. Mr. Swingler sincerely regrets that because of the necessity of this further examination there is no prospect of any immediate decision on Flight-Lieutenant Cockayne's claim. On 10th February, at my request, I met Mr. Swingler and we discussed the matter. I see from notes I made at the time that Mr. Swingler informed me that a second opinion on the case would be required and that the case would be referred to a consultant to be appointed by the Royal College of Physicians. My notes record that the consultant would 1414 have access to all documents and papers relating to Flight-Lieutenant Cockayne's claim and would ensure that he was medically examined. I informed Flight-Lieutenant Cockayne of this on 13th February.
There was a further delay, and then I received a reply from the present Minister of State, Department of Health and Social Security, dated 7th May, 1969. In the course of that he said: That the consultants have now reported. The first, who is an expert on the effects of nerve gas on man, considers that it is not in the least probable that the chemical agent to which Flight-Lieutenant Cockayne was exposed had any delayed or permanent physical effect. The second consultant, who is an independent medical expert appointed by the Royal College of Physicians to advise the Secretary of State on questions of serious doubt, found it unnecessary to examine Flight-Lieutenant Cockayne as the case was so well documented. He endorses the first consultant's report. It was not clear from the text of that reply whether the first consultant had actually seen Flight-Lieutenant Cockayne or whether, in fact, anyone had seen him at an earlier stage. Consequently, I was surprised when Flight-Lieutenant Cockayne, in the course of a number of Press interviews, made the allegation that nobody had been to see him.
I raised this matter with my hon. Friend, and on 22nd May I was informed as follows: It is perfectly true that neither of the consultants to whom we referred the case examined Flt.-Lieut. Cockayne". It was then stated that when we go to independent consultants and ask them for their opinions, it is not for us to direct them in any way as to their methods of arriving at their conclusions. For us to do so would be to detract from their independence and this would be quite improper. It is, therefore, for the consultants to decide whether they wish to examine a claimant and, in this case, they found that ample documentation rendered this unnecessary. I regard this reply as unsatisfactory. It clearly raises serious questions of principle. I make no comment whatever about the claim which Flight-Lieutenant Cockayne makes about allegedly suffering from nerve gas poisoning but, in the absence of any personal medical examination of the man, doubt, however unjustifiable, must remain over the allegations which he has made.
Second, the undertakings given by the Ministry of Defence and by the Department of Health and Social Security, both 1415 in writing and orally, to examine Flight-Lieutenant Cockayne have not been kept.
Finally, in the light of the extremely grave statements which Flight-Lieutenant Cockayne has made, and in the circumstances that at present surround this matter, I ask that there should be some further explanation and that a further medical examination should be considered. I urge my hon. Friend to act accordingly.

§ The Minister of State, Department of Health and Social Security (Mr. David Ennals)
I think I should start by giving a short resumé of this case.
Flight-Lieutenant Cockayne served in the Royal Air Force from 1935 to 1954, when he resigned his commission voluntarily, and shortly afterwards went to Australia. He returned to the United Kingdom in 1961. For the next three years, he had a great deal of psychiatric treatment, and was a patient in several hospitals. He said in 1968 that his condition was due to exposure to nerve gas at Porton Down, where he served from 1952 to 1954.
Representations were made to the Ministry of Defence in the first instance, and as, in effect, Flight-Lieutenant Cockayne was saying that his disability was caused by an incident of his service in the Royal Air Force, the matter was referred to my Department because we administer war disablement pensions. This was referred to by my hon. Friend.
I am sure that my hon. Friend will not expect me to go into the merits of the case. Neither did he. It would be improper for me to do so because Flight-Lieutenant Cockayne has indicated that he intends to appeal to the independent Pensions Appeal Tribunal. It would be wrong for me to make any remarks which might prejudice the hearing of his appeal in any way. This will inevitably limit what I can say, particularly concerning the nature of his claim for a war disablement pension. Happily, my hon. Friend was dealing not with the nature of the claim, but with the way in which it was handled.
My hon. Friend has made some sharp criticism of the procedure adopted by the Department in determining the claim made by Flight-Lieutenant Cockayne, 1416 and, in particular, commented on the fact that he has not been examined by one of the Department's doctors. I must make it clear that very many claims are dealt with without its being necessary for the Department to arrange a special medical examination. For instance, when men are invalided from the Forces our doctors generally find that the service medical records and reports of invaliding medical boards, which are automatically referred to them, provide adequate medical evidence on which to accept or reject the claim. The same often applies where we are supplied with recent civilian hospital and medical records, which can provide a full picture of the claimant's history and condition since he left the Forces. In Flight-Lieutenant Cockayne's case, his claim was not made when he left the Forces and not until 14 years later. The circumstances were unusually difficult, and my medical advisers considered with great care how the medical questions involved should be determined. I think the late Mr. Swingler explained some of the difficulties when he saw my hon. Friend. Basically my advisers had to decide whether Flight-Lieutenant Cockayne's present medical condition was or was not in any way connected with his service in the Armed Forces.
My Chief Medical Adviser decided to submit the evidence to two independent consultants. The first consultant is an expert on the effects of nerve gas on man as I said in my letter to my hon. Friend. The second consultant is a leading psychiatrist. This consultant was specially chosen because he is nominated by the Royal College of Physicians to be an independent medical expert to advise the Secretary of State on questions of serious doubt or difficulty in his field. I will return to the significance of this point later.
Both consultants were provided with the very considerable amount of evidence that we had obtained, including the detailed hospital case notes for the period since Flight-Lieutenant Cockayne returned to England from Australia. They were free to examine him, but they both made it clear in their reports that the documentation was adequate for them to reach their conclusions without the necessity of any physical examination.
I think my hon. Friend should know that, in addition to the full service 1417 records, the consultants were provided with case notes and reports from five different hospitals where Flight-Lieutenant Cockayne had been treated between 1962 and 1965. There were in all about 20 significant medical reports as well as letters written by Flight-Lieutenant Cockayne himself. I have no power to require an independent medical expert to conduct a personal examination. When a matter is referred to an independent medical expert my Department is bound to accept the conclusions reached. The order by Her Majesty which regulates war pensions for the Air Force lays down that where the opinion of an independent medical expert is sought the issue in question shall be determined in accordance with his opinion. Flight-Lieutenant Cockayne's claim was therefore rejected, though I might add that if the independent consultants had advised in the opposite sense the claim would most certainly and necessarily have been accepted. Had this been the case, Flight-Lieutenant Cockayne would have been asked to attend a medical board in order that his degree of disablement could be assessed.
As I have said, the claimant has indicated that he wishes to exercise his right of appeal to the independent Pensions Appeal Tribunal, and we have explained to him the procedures that need to be followed in order that his case can properly be heard. I can tell my hon. Friend that if an appeal is received from Flight-Lieutenant Cockayne arrangements will be made for him to be examined by an eminent psychiatrist before the case is heard by the appeal tribunal. This will be a personal examination. I might add that if Flight-Lieutenant Cockayne or his representatives feel that medical evidence used by the Department in the preparation of the appeal is incomplete they are themselves perfectly at liberty to obtain any further evidence from consultants or anyone else, and this evidence would be put before the tribunal at the hearing.
Our anxiety in all cases like this is to ensure that all possible information is available for those who have to take a decision and, to assist those who wish to make their appeal, to ensure that all the evidence they can muster is available so that the tribunal can reach a fair conclusion.
The tribunal is entirely independent of the Department, and consists of a chairman 1418 and two members, one of whom is a doctor. Apart from the assurance I have given that there would be a physical examination prior to the tribunal's hearing, the tribunal itself will be perfectly entitled to arrange for any further examination which it thinks appropriate.
My hon. Friend has cast some aspersions concerning the time taken by the Department in deciding the claim. He made it clear that he had to get in touch with the Department—

§ Mr. Dickens
I fully recognise that this was a very complex medical matter which had inevitably to take some months to consider and to reach a decision upon. I make no complaint about the time taken, but I am disappointed that after all that time a medical examination did not take place.

§ Mr. Ennals
I am grateful to my hon. Friend for having said that he understands the circumstances. I was about to say that matters like this take a considerable amount of time. We had to obtain all the evidence. As I have said, a good deal of evidence had to be obtained from five hospitals. Not only did we have to assemble the evidence, but we decided to submit it for consideration by the independent medical expert. This took a good deal of time, and it was not until 9th May that Flight-Lieutenant Cockayne was notified of the decision.
I know that my hon. Friend will understand the reason why I have not dealt with a number of points relating specifically to Flight-Lieutenant Cockayne's case, since it would be most unfortunate if any words of mine were to influence the decision of the Pensions Appeal Tribunal.
I hope that I have succeeded in assuring my hon. Friend that the Department has very carefully considered the evidence. Now that it appears that Flight-Lieutenant Cockayne will wish to take his case to appeal, we shall do everything we can to ensure that all the evidence is available and before the appeal tribunal when it has to reach its decision. As I have said, that evidence will include a personal examination by a very eminent psychiatrist.