§ Motion made, and Question proposed, That this House do now adjourn.— [Mr. John Ellis.]
§ 1.5 a.m.
§ Mr. David Lane (Cambridge)
I am glad to have this chance of raising a general problem that is highlighted by the facts of a particular constituency case. I have told the Minister—I am glad to see him in his place on the Treasury Bench—that I wish to describe this case in anonymous terms. I believe that my constituent and his family have already suffered enough, without the added ordeal of publicity.
Whatever else the Minister says in his reply, I hope he will be able to assure me that he will carry through, with his officials, a fresh review of the problems of medical students and of post-graduate students generally, so far as the social 1338 security system in its present form affects them.
I shall try to summarise fairly the sequence of events. Dr. X, the son of one of my constituents, died in 1974 at the age of 28, when he was employed as a junior hospital doctor. In fact, he took his own life, having discovered that he was suffering from very advanced heart disease, but undoubtedly a contributory factor to this tragedy was the extreme stress and long hours of overwork during his two and a half years as a junior hospital doctor, when he often had to work as much as a 120-hour week. This is an aspect to which I shall revert in a moment.
Dr. X left a widow and a baby son. Until he qualified at the age of 25, he had trained as a medical student. His fees and expenses were met out of his father's taxed income, apart from a small contribution from his local authority. He had married in October 1971. He took his final MB examination in December 1971, and he started his first job in a hospital in February 1972.
For natonal insurance purposes he had entered into insurance in 1961. While a student he paid a few contributions, but he paid regularly weekly contributions during his final years while he was employed in hospital. When his widow applied for a widow's pension, she was told that her husband's total contributions amounted only to 152, that is, four short of the necessary minimum. Therefore she was informed that she could not qualify for a widow's pension.
At this point I should mention—I shall revert to this also later—that Dr. X's widow had paid contributions on her own account for five years before her marriage while she was at work, and subsequently, working as a nurse, she had also paid full national insurance contributions during a period of seven weeks between her husband's qualifying and his starting his first house job in hospital.
When my constituent came to me with these facts, I checked the position with the manager of the local office of the Department of Health and Social Security, and discovered that he had no discretion to alter the initial decision. My constituent and I met the then Under-Secretary, the Minister's immediate predecessor, to go over the ground 1339 of the case, with the same negative result. After that, my constituent set in train, on behalf of his daughter-in-law, an appeal to the Secretary of State for a formal decision whether the contribution conditions were in fact satisfied. In December last year, that decision was given judicially by one of the Minister's senior officers, and the decision was that the conditions were not satisfied and that the arrears of contributions could not be paid so as to count towards the satisfaction of those conditions.
Later, the present Minister confirmed to me—I am grateful for the personal care that he has taken over this case since succeeding to his present job—that there was no possibility of an ex gratia payment to the widow.
In putting a few questions to the Minister which arise out of this sequence of events, I acknowledge that new rules apply, since about a year ago, so that the minimum period of qualifying contributions has been reduced from three years to one year. But that is no help to the widow of Dr. X, and even if it were she would come up against the rule about averaging contributions over a 10-year period, so that the pension for which she might have qualified would be still at a fairly derisory level.
Looking back over this whole tragic story, my first question is whether the system could not be operated with greater flexibility. I realise that we have to have rules, but it seems over-rigid that in a borderline case of this kind it has proved impossible to find just four extra weeks' credit of contribution for the period of about eight years that my constituent's son spent as a student. Could not credit have been taken, for example, for those several years of contribution by the widow before she married, and especially for the seven weeks between his qualifying and his first house job? As I understand the position, it appears that the benefits from a man's contribution count for considerably more than those from a woman's, and I wonder how the Minister would justify that in terms of the Sex Discrimination Act.
I believe that there might be more flexibility left to the Secretary of State and to other Ministers in the Department in cases such as 1340 this and I recall the flexibility exercised by Home Office Ministers in the immigration rules, when they come up against a case in which the circumstances are unusual or particularly compassionate. There again, we have rules, but there is some margin for Ministers outside the rules to decide exceptional cases. I am left with the feeling that the system is, by this example, proving not only over-rigid but inequitable, and it is because of its apparent denial of social justice that the outcome of this case has so upset my constituent, Dr. X's father.
My second question, and the main question on which I look forward to hearing the Minister, is whether we are making enough allowance for the circumstances of medical students and others, such as PhD students, whose period of studentship is longer than the average. As many of us know—but it is not sufficiently recognised outside this House—medical students have a heavy work load and when they become junior hospital doctors they not only have a continuing work load but a weight of responsibility far greater than that of nearly all their contemporaries. Surely, then, it is all the more unjust that, if a medical student's life should be tragically cut short, his dependants should appear to be ungenerously treated.
While medical students are students, they are not required to pay national insurance contributions, but they are encouraged to do so. After they complete their period of studentship, they are allowed an extended period when any arrears can be made up. One asks where they are supposed to find a sum of perhaps several hundred pounds if there is a considerable accumulation of arrears.
It is a fact that between the ages of 16 and 18, students' contributions are formally credited, but this arrangement ceases after 18, and that seems an odd bit of logic. Would it not be more satisfactory if, as the Government have accepted responsibility for supporting students during training, it should be deemed that national insurance contributions had been paid by the Government, as, so to speak, the employer, just as the contributions of their contemporaries already at work are paid by their employers?
We must bear in mind considerations of equity and not ask for special treatment for students, but I am suspicious that 1341 there is a bias against students in some situations within our social security system. That is illustrated by one unhappy phrase in a letter from an official to my constituent:Those who were fortunate enough to continue their studies after reaching the age of 18 … ".Searching for a solution and leaving aside the generality of students, should not medical students be entitled to more nominal credits than most other students?
Summarising my main point, I ask: Is enough weight attached to the extraordinary burdens falling on these men and women when medical students and during their early jobs in hospital?
I have one or two subsidiary points. First, in the whole structure of student grants, I do not think that enough notice is taken of inflation in arrangements for the parental means test. I hope that the Minister will refer that point to his colleagues in the Department of Education and Science.
Secondly, in tragic circumstances such as these, the Department has not proved as quick as it should in responding to correspondence. The leaflets are not as clearly phrased as they might be, and the attitude of officials has not seemed to be as warm and sympathetic as the circumstances demanded. Could the Minister not try to get this kind of correspondence humanised and the Department's leaflets simplified?
The whole experience has left my constituent and me feeling that the situation of medical students in particular, and of their parents, is unsatisfactory. The impact of the current legislation and regulations on the widow—his daughter-in-law—struck my constituent as unjust and inhumane. I therefore ask the Minister, finally, whether he will undertake this fresh review of the way in which medical and other long-term students are affected by the present system, in the hope that the trauma of this experience should not happen to any others.
§ 1.19 a.m.
§ The Under-Secretary of State for Health and Social Security (Mr. Michael Meacher)
I have listened carefully to what the hon. Member for Cambridge (Mr. Lane) has said about the tragic circumstances in which the widowed 1342 daughter-in-law of one of his constituents was unable to receive widowed mother's allowance, and I should like to put on record the fact that the manner in which he has conducted this case on behalf of his constituent commends him greatly, because he has persevered at great length over a matter about which he and I have strong feelings.
I shall seek to answer each of the hon. Member's questions, but perhaps I should begin with what he said at the end, about correspondence. I am sorry that he feels there has been undue delay, but there has been much thoughtful examination of this issue within the Department. If the hon. Gentleman has had to wait longer than he would have wished, it was for that reason, not because the matter had been put on one side for long periods.
§ Mr. Meacher
I am sorry if that has been the case. Again, I should say that was because there has been considerable internal discussion about this matter. It is not simply the general question behind which I might seek to hide, namely, the weight of departmental correspondence; there were special reasons in this case.
If the hon. Gentleman feels that some of the language has not been as humanised as it might have been, again I can only regret that he should feel that way. However, it does not indicate that this matter has not received extremely careful and sincere examination by both officials and myself.
The simplification of leaflets is a matter that we are always seeking to improve, and no doubt we still have a long way to go.
I should like to begin by making it clear that throughout the long history of statutory provisions for contributory benefits under successive schemes of national insurance, it has always been a cardinal principle that cover for sickness, unemployment, maternity, retirement and widowhood should be given only where the contributor concerned 1343 has established full membership of the scheme by the actual payment of sufficient contributions. That is the simple contributory principle.
Because widow's benefit is designed to substitute in some measure for the loss of the husband's support, only his contributions can count for this purpose. That is the answer to the hon. Gentleman's question about the contributory record of the wife which, for that reason, is not directly relevant, though it is relevant in other respects to her benefit entitlement. I should add, on the question of the relationship between the social security provision and the Sex Discrimination Act, that under the Act—as in the case of other existing legislation—previous social security provisions are excluded specifically from its application.
For widowed mother's allowance, under the National Insurance Act 1965, which was in force at the time of the tragedy to which the hon. Gentleman has alluded, the requirement was for 156 weekly contributions of any class to have been paid, and it was a sad fact that the deceased had paid only 152 contributions. There were, indeed, seven years, corresponding to the time when he was a student, in which no contributions had been paid, except for five contributions at the very end of that period when the deceased started regular work, in which he continued for two and a half years until his untimely death.
It was a statutory requirement of the scheme that contributions could be taken into account if paid after the death, but only if they related to the last complete year or to the year in which the death occurred. That rule limited the opportunity of paying contributions after the event, which clearly conflicted with elementary principles of insurance. Unfortunately, the seven blank years in which the arrears had built up were already too remote to enable the widow to pay any of the missing contributions.
The National Insurance Act, as the hon. Gentleman rightly said—indeed, I again commend him for a very lucid account of the facts of the case, about which he has been entirely correct in every respect—did not give the Secretary of State, or the independent statutory authorities which decide claims for benefit, any discretion to waive the con- 1344 tribution conditions. I think that is right. However distressing it may be to be involved in a borderline case of this kind, I am sure that the hon. Gentleman would not for a moment tolerate that rights to benefit or the withholding of benefit should be a matter of discretion, however generously exercised in some cases.
The hon. Gentleman made an appeal for flexibility. If we were to exercise discretion in a multitude of cases that arise in a vastly complex system, as the social security system is, we would simply generate a new borderline, and again some persons would find themselves, through no fault of their own, on the wrong side of the line. That is why the basic contributory principles have to be adhered to. Flexibility exercised by discretion, or extra-statutory discretion, involves considerable difficulties, which in our view—I think it is a view that the hon. Gentleman will share—cannot be exercised.
There is no discretionary power to enable compassionate payments to be made under the National Health Service Superannuation Scheme, of which the young doctor had been a member for only two and a half years. It is not irrelevant to say that payments under that scheme amounted to a little short of £4,000, although the deceased had contributed only £337. I know that this does not affect the general principle which the hon. Gentleman has raised, but it does indicate something about the equity of general receipts.
This debate centres upon the gap of about seven years in a young person's national insurance contributions record when he was a student. Because he was a medical student, the gap was longer than usual, and because medical training leaves little time for employment in the vacations, he had not had the opportunity to earn and pay a few contributions each summer. Nevertheless, the basic problem created by a late start in settled employment is one that concerns all young people whose education or unpaid training goes on after the age of 18. It is a problem that the National Insurance Advisory Committee has considered on three separate occasions, and the present rules entirely embody its recommendations.
Broadly speaking, a student does not have to pay contributions while he is not 1345 earning, but he is allowed to pay sufficient Class 3 contributions to protect his, or his widow's, prospective rights to long-term benefits. He is helped to do this by a special time limit for paying the contributions. Under both the repealed National Insurance Act 1965 and the present Social Security Act 1975, these contributions can be accepted if paid before the end of the sixth year following that in which the course of education ceased. That is a considerable period. It was a lack of sufficient paid contributions which prevented the award of benefit under the 1965 Act in the young doctor's case. Credited contributions would not have counted towards the requirement that 156 contributions should actually have been paid.
The Social Security Act 1975 now gives much better cover for the young mother who is left a widow. Since the hon. Gentleman raised this matter in general terms, it may help if I spell out briefly the effects that the Act now has. The first contribution condition is now satisfied if the husband has paid 50 of the old weekly contributions at any time between July 1948 and April 1975. Where the death is after 5th April 1976, he must alternatively have paid contributions as an employee in any past tax year, on earnings of at least 50 times the lower earnings limit for the year. A junior hospital doctor who, in the tax year just ended, paid contributions on earnings exceeding £550, because £11 is the lower earnings limit, would have satisfied that test once and for all. It can also be satisfied by payment of 50 Class 2 contributions for self-employment or of 50 Class 3 contributions.
There is a further contribution condition. The standard rate of widowed mother's allowance can be paid only if the husband had attained the reckonable level of contributions paid or credited in approximately 90 per cent, of the tax years starting with the tax year in which he reached the age of 16 and ending with the last complete tax year before his death. All young people are helped to satisfy this condition by credits awarded, where needed, for the years containing their 16th, 17th and 18th birthdays. Thus, had the present conditions applied in the case that prompted this debate, the widow would have received a per- 1346 sonal widowed mother's allowance at about half the standard rate, together, of course, with a full increase for her child, despite the non-payment of contributions for practically seven years of studentship. That is the present position under the Act. Another welcome improvement is that, following the death of an ex-student, his widow has rather more than a further year to pay arrears of contributions which he himself was entitled to pay immediately before his death.
It is true that 50 Class 3 contributions for the year 1975–76 would cost £95. Few young people who undertake a long and rigorous study such as medicine and who in many cases have to rely heavily on parental support—I shall pass on what the hon. Member said about parental support to the Secretary of State for Education and Science—will have £95, a not inconsiderable sum, to spare. It is tempting to say that the contributions should be credited, but it would be unfair to expect other contributors to subsidise students in that way. For every student there are many other young people who are working and paying contributions in jobs with no prospect of the financial rewards that most graduates will eventually enjoy. That is why students are given the opportunity of paying the contributions when they are established in their professions. Most of those who do not take this opportunity will eventually obtain a standard-rate retirement pension, despite a gap of five whole years in their contributions, but of course by not paying for at least some of the years of studentship they will be depriving their widows of full cover for widow's benefits.
There are special arrangements to help ex-students who started their courses of further education before the age of 21 and who need to claim sickness, maternity or unemployment benefit shortly after finishing their courses. But this is much the same kind of help as is given to new contributors generally, and confers no special advantage on students as compared with other people.
The hon. Gentleman suggested that the National Health Service should assume responsibility for arrears of national insurance contributions for former medical students who enter the hospital service. Apart from the expense, which 1347 of itself rules out this idea, the questions that would arise are whether the payment should depend upon a minimum term of service and whether, for instance, doctors who enter general or private practice, or are aiming at working overseas, should get the same cover. There is, of course, no more reason for the National Health Service to foot this bill than there is for any other employer with a higher graduate intake to do the same for its employees.
It could also be suggested that student grants should be sufficient to cover the cost of contributions. Perhaps the hon. Gentleman was hinting at this in what he said about parental support. That suggestion is not for me, but it is open to the same objection as that which applies to crediting the contributions; 1348 that is, it would require the ordinary worker to subsidise a person who had already acquired an above-average earning capacity at public expense.
I recognise that the hon. Gentleman sees the medical student as being in a special category, but I hope that he will also accept that one has to weigh the question of public advantage in terms of who makes the contributions and who receives—
§ The Question having been proposed after Ten o'clock on Tuesday evening and the debate having continued for half an hour, Mr. DEPUTY SPEAKER adjourned the House without Question put, pursuant to the Standing Order.
§ Adjourned accordingly at twenty-five minutes to Two o'clock.