CONDITIONS OF ENTITLEMENT (Hansard, 15 February 1979)

§ Mr. Robert Boscawen(Wells)
I beg to move amendment no. 8, in page 2, line 30, after "Man", insert 'or any other territory which is still administered by Her Majesty's Government'.

The Chirman
With this we may take amendment no. 10, in page 3, line 25, after "forces", insert 'or others persons serving overseas in the employment of Her Majesty's Government'

§ Mr. Boscawen
These amendments are slight additions to the entitlements in this clause. I am not putting forward this amendment in order to complicate the Bill in any way. As my hon. Friend the 1395 Member for Reading, South (Dr. Vaughan) said, we wish to see it go through and not be held up by unnecessary complications. I believe that in Committee we should try to avoid, as far as possible, any marginally difficult cases. There may be a few, unless we hear an explanation as to exactly who is covered by clause 2.
The first amendment refers to a vaccination carried out in the United Kingdom or the Isle of Man. In addition, we feel that we should consider those areas where the United Kingdom is responsible for the administration.
Many people will ask where we are responsible for administration outside the United Kingdom. I do not know exactly our responsibilities in the Channel Islands, for example, but I feel that the Minister should tell us whether the Channel Islands would be included should the vaccination of a child take place there. Large numbers of children from this country go there on holiday and may need something like a tetanus vaccination. I would not feel that places such as Gibraltar were within the administration of the United Kingdom, but if this amendment were included they might be. Therefore, I should like an explanation as to where outside the United Kingdom and the Isle of Man this would apply.
For example, what about the sovereign base areas in Cyprus? Children of civilians serving on those bases might have to be included or might not. What about British ships at sea? This is an important point. It may well be covered in the orders that are to be brought forward, but we need an explanation about this. Surely this is a matter of importance, because large numbers of children come to this country and could be vaccinated en route. We feel that that ought to be cleared up at this stage.
We are glad that vaccinations on members of the families of serving members of Her Majesty's forces are included in the Bill. But we feel that it does not go quite far enough and that it should include others serving on Her Majesty's service overseas. For example, many civilians carry out jobs with BAOR. Of course, there are individuals working in our foreign and colonial service. All these people may have children who are vac- 1396 cinated within the meaning of the Bill—that is, in accordance with routine policy vaccination programmes in this country. We would like an explanation in this regard.
There is another category which is not strictly within the wording of the amendment. I should like the Minister to confirm whether vaccination for diseases carried out in this country, because they are the public policy of other territories overseas, are to be included. I take it that they are. If it is the public policy of this country it will be included. But what happens if a child is vaccinated in the United Kingdom and then goes abroad with his parents for the next 10 years or so? Would that situation also be covered? I think that we need an explanation in this regard. There may not be many cases, but I am sure that we want to avoid any hard cases at this stage.
Not on this list of diseases are those other diseases for which vaccinations may take place at airports for those travelling overseas under the aegis of the Ministry of Overseas Development. It could not necessarily be said that such people were vaccinated for any of those diseases because of public policy in this country. Nevertheless, they will be returning to this country after a few years. I want to be sure that these marginal cases are dealt with under the Bill, and I hope that we shall have a full explanation.

§ Mr. Alfred Morris
The right hon. Member for Crosby (Mr. Page) referred to the likelihood of a misprint in clause 1. However, amendment No. 8 appears to contain a misprint. Presumably it should open with the words "man or any other".
Amendment No. 8 is designed to extend eligibility for payment under the Bill to persons vaccinated outside the United Kingdom and Isle of Man in places administered by the Government. This amendment would unacceptably widen and complicate the scheme, which is, after all, designed to provide a measure of speedy relief to people severely disabled as a result of routine public policy vaccination programmes.
It is not clear to which territories this would apply. Dependent territories have their own health arrangements, and they are sometimes very different from ours. They might have routine vaccination programmes which differ appreciably from 1397 ours. In any case, it would be far more appropriate for them to make provision about such arrangements in their own legislation and to finance them out of their own funds. I have no doubt that there will be a great deal of international interest in the scheme for which we are legislating.
We have, by arrangement with the Manx authorities, included provision for any Isle of Man cases, as its national health service is very similar to ours. But, by administrative arrangement, the cost will fall on Isle of Man funds. The hon. Member for Wells (Mr. Boscawen) asked about the position in the Channel Islands. We have kept the authorities there in touch with our arrangements. It will be for them to decide whether to introduce a corresponding scheme and, of course, to finance it. I am advised that we have checked with the Jersey authorities and that they know of no cases there.
I turn now to amendment no. 10. Under this amendment, the provision in the clause for coverage for members of Her Majesty's forces and their children when overseas would extend to other Government employees overseas and their children.
The general intention of the Bill is to provide payments in respect of vaccinations which are part of the United Kingdom Government's routine public policy vaccination programmes. In general, vaccinations overseas do not form part of such programmes. Such vaccinations take place in accordance with the public vaccination programmes of the country in question. We have made an exception in the case of Her Majesty's forces and their families because, in some countries, substantial numbers of forces' families are provided with these services by the Ministry of Defence as, in effect, an extension overseas of the National Health Service.
The position with other Government employees is very different, and we do not think it would be appropriate in this Bill to make provision to cover vaccination of such employees or their children overseas. For one thing, I am not sure how one could defend the provision of cover for such cases without also doing so for other civilians from this country who happened to be abroad because of their employment.
1398 Again, in the case of vaccination of members of the forces overseas, there will be adequate records within Government control to consult. This would not be the case with children of civilian employees, and the extension to cover such cases would be a further complication of the scheme. I must again say that this Bill is intended to make provision for a simple scheme which can be used to bring help to a limited number of beneficiaries quite rapidly.
There will be no routine vaccinations of children on board ship. Members of the forces serving in the sovereign bases in Cyprus will be covered under clause 2(5) If a vaccination takes place in the United Kingdom, it is covered provided always that it is for one of the listed diseases. I hope that I have explained why we are proceeding in the way that has been suggested, and I hope that having heard my reply the hon. Gentleman will agree to withdraw the amendment.

§ Mr. Boscawen
There are still several points about which I am not clear. We are told that no routine vaccinations are taking place on British ships at sea. That may well be, but there could be. For example, if a ship enters a harbour where there is a measles epidemic it may be called upon to vaccinate the children. I believe that that is a matter which ought to be looked at again.
There is also the question of tetanus. A tetanus inoculation is something that might be given following an accident on board ship. That is not necessarily a routine inoculation. But if following an accident an anti-tetanus inoculation was given in this country it would presumably be covered, because one could not distinguish between that and a routine inoculation. I believe that it would be very difficult to discriminate between the two.
7.30 p.m.
I turn to the problem of civilian families in Government service overseas. I am not happy that they should be excluded, particularly those civilians serving with the forces. If the child of such a person suffered as a result of a vaccination, it would be regarded as a hard case and that person's Member of Parliament would be the first to come to the House and plead.

§ Mr. Ernest G. Perry (Battersea, South)
I am perturbed about what the Minister has said in this respect. There are a large number of Service men and many staff in Gibraltar who have families and children. Would they be covered by the Bill?

§ Mr. Boscawen
I did not fully understand the Minister when he said that there would be no records of such people. Surely they would have the same records as civilians in this country. I am mystified about that.
I do not wish to hold up the Bill or to complicate it. We are trying to avoid as far as possible the marginal, hard cases. There might be only one or two such cases. I hope that the Minister will consider my arguments. Perhaps at a later stage in the Bill he will consider whether the points that have been made should be put into effect. If the Minister were willing to do that, I should be willing to withdraw the amendment.

§ Dr. Vaughan
My hon. Friend the Member for Wells (Mr. Boscawen) has raised an important matter. Not only are the Services involved but so also are the diplomatic service, Ministry people and a host of professional people who have been sent abroad as consultants in the medical and engineering spheres. They often take their families with them. I urge the Minister to consider this matter because such families may not know how the Bill affects them.

§ Mr. Alfred Morris
I appreciate the solicitude of the hon. Member for Wells (Mr. Boscawen) in referring to the borderline cases. When I mentioned vaccinations for children aboard ship I emphasised the word "routine". The hon. Member will appreciate that I was not suggesting that there could never be a vaccination aboard ship. On the contrary, I was emphasising that there would be no "routine" vaccinations of children in such circumstances.
My hon. Friend the Member for Battersea, South (Mr. Perry) asked me about Gibraltar. Gibraltar has its own public health policies. In my reply to the hon. Member for Wells I spelt out that even dependent territories have their own health arrangements, which are sometimes different from ours.
I shall consider what has been said. The hon. Member for Wells takes a keen, 1400 genuine and sustained interest in all matters that affect disabled people. But I hope that he will agree that I have tried to answer as fully as possible the points that have been at issue in this short debate.

§ Mr. Boscawen
Because of the assurance by the Minister, I beg to ask leave to withdraw the amendment.

§ Mr. Ashley
I beg to move amendment no. 9, in page 2, leave out line 31.
I do not propose to detain the Committee for long. The amendment aims to pay children or families of children who were damaged before 1948. A small number will be involved because that is a long time ago and that was in the early days of vaccination.
I appreciate the difficulties facing the Secretary of State. The National Health Service began only at about that date. I presume that the Government recommended vaccination as a public policy as a routine procedure at about that date. I appreciate that it will be difficult after all this time to categorise cases of vaccine damage.
Nevertheless, I assume that Ministers and doctors were recommending vaccination at that time in the interests of the community as well as in the interests of the children. If that is so and if the basis of the Bill is that the families of vaccine-damaged children should receive a payment because they were damaged in the interests of the community, it is reasonable to include the group of people covered by the amendment.
I hope that the Government will recognise that the principle is exactly the same —that those damaged before that period in the interests of the community and by vaccination which was recommended by Ministers and doctors should receive the payment.
The hon. Member for Wells (Mr. Boscawen) rightly said that we should seek to avoid marginal cases and to lean over backwards to help them. That is the right spirit for this debate. My amendment fits that category. I hope the Government will deal sympathetically with this small group of people. If the Government are not able to accept the amendment now, I hope that they will bear in 1401 mind what has been said and consider including this group of people in the Bill.

§ Mr. Ennals
I am sorry that I shall have to turn down my hon. Friend once again. Not many people are likely to be affected by his amendment. It would make little difference to the number of payments under the Bill, but it would lead to substantial practical difficulties. It would be very difficult to investigate today the circumstances of disablement arising 30, 40 or 50 years ago. One might have regarded such problems as so daunting that the Bill would not have been introduced.
Producing a link between a disability and a vaccination is difficult when it involves a vaccination which was given 10 years ago, let alone 30 years ago. That is one of the difficulties involved in fulfilling the terms of the Bill. Medical records are usually destroyed after 20 or 25 years.
We take the view that equitable determination of claims on the balance of probability—that is what we are having to do—dating back before the National Health Service started would raise major problems and lead to delays that could possibly hold up payments. There has to be a dividing line somewhere, and the logical dividing line seemed to be when the NHS started. It is not right to say that there was no public policy before its formation. For example, the smallpox vaccination policy was in operation before the NHS started. I am certain that there are many other examples, but I am not an expert on those days.
Basically this is a scheme to provide help for families with disabled children. Any pre-1948 victims are now over 30 years of age. Although some of them are probably still with their families, they qualify for social security and social service provisions for disabled adults. Most of them will be receiving the attendance allowance, mobility allowance and the non-contributory invalidity pension. Some of them, if they do not have other resources, may be eligible for supplementary benefit. Their needs are not ignored. To bring them into the scheme under the Bill would cause a great deal of difficulty. It would be time-consuming and it would be for what I reckon to be a small number.

§ Mr. Ashley
I am grateful to my right hon. Friend for that reply. I beg to ask leave to withdraw the amendment.

§ Mr. Ashley
I beg to move amendment no. 13, in clause 2, page 2, line 42, leave out from 'he' to 'was'.
This is yet another attempt to extend the provisions of the Bill. If there is a case, as is recognised in the Bill, for paying the family of a child when the child has died, the date when the child died should not make any difference; it is utterly irrelevant.
The Bill is, rightly, a retrospective measure. I know that the House does not often like retrospective legislation. On the whole the House is right to avoid it. However, the Bill is retrospective in the sense that we are paying children who were damaged before the decision to pay was taken by the Government. I applaud the sentiment that is embraced in the Bill. I see no logic in excluding children who died earlier. The case for paying the families of those children is exactly the same as the case for paying the families of children who died after 9 May 1978.
The Bill specifically provides for the payment to families whose children died after 9 May 1978. A false distinction is being made. I assume that the Government will feel that it is necessary to retain the word that I am seeking to delete and to exclude the category that I am seeking to include because of the difficulty of dealing with the claims of those who died before the scheme was announced. However, the Government have a responsibility to outline the difficulties whatever they may be. I hope that my right hon. Friend will feel able to deal sympathetically with the sentiment.

§ Mr. Alfred Morris
The amendment would extend the provisions of the Bill to cover persons who died when over two years of age notwithstanding how long ago they died. In considering its effects, together with the intention of my hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley) in an earlier amendment to remove the condition of vaccination after 5 July 1948, let me say that it would authorise payments to the heirs of 1403 persons who died a long time ago. Unfortunately a dividing line must be set somewhere. The Government have set it at 9 May 1978. That was the date on which my right hon. Friend announced the scheme. To have to assess now whether someone who died some years ago was 80 per cent. or more disabled and, if so, to have to determine the cause would be extremely difficult in practice.
The other problem is that to provide for payment now to the legal personal representatives of such persons would be to introduce a compensation scheme. As my hon. Friend knows, we have said all along that the Bill is not to provide compensation but to introduce a measure of speedy relief for the severely disabled and their families.
Payment in respect of those who have died is included in the Bill only because the Government feel that the scheme should start straight away on 9 May. The Government feel that no one should lose because of delays in the system of dealing with claims. To provide for payment in respect of those who died before the scheme was formally announced would, in the Government's view, change its nature.
I much appreciate and understand my hon. Friend's feelings for parents who coped, for perhaps a long time, with a severely disabled child and who have suffered the loss of the child. Our central difficulty is that the Bill has not been introduced to provide compensation for such families. Its intention is to provide current help. Nothing gives me less pleasure—indeed, more pain—than being unable to go along with a suggestion from my hon. Friend. As my right hon. Friend has said, he has performed an immense service on behalf of vaccine-damaged children and others in campaigning for the Bill. Without his work, in association with that of Mrs. Fox, it would not have been posisble to make so much progress over the past years.
I hope that my hon. Friend will be able to accept the distinction that I have made and that the Bill makes and will agree to withdraw the amendment.

§ Mr. Ashley
I am grateful for my right hon. Friend's reply. I recognise that there would be some practical difficulties, but I do not think that they would be so 1404 great that they could not be overcome by the Goverenment. I do not believe that the provisions of the Bill would necessarily result in a compensation scheme by extending them further. That does not follow. The line being drawn at 1978 is unduly restrictive. However, I appreciate my right hon. Friend's argument. I also appreciate his generous words. I hope that the comments that I have made during the debate will be borne in mind in future.

§ Mr. Graham Page
I am puzzled by one small provision in subsection (5) that refers to serving members of Her Majesty's forces". Why does the subsection provide that the regulations may define those who are serving members of Her Majesty's forces"? Why should there be that simple reference to members of Her Majesty's forces? Is there some intention in the regulations to distinguish between officers and other ranks so that officers shall be serving members and not other ranks?
The wording is peculiar. It seems to give the Secretary of State power to select certain people from the Armed Forces, perhaps airmen but not soldiers, perhaps naval men but not airmen. I do not know why these strange words appear. Why cannot we use the words "regulations relating to serving members of Her Majesty's forces"?

§ Mr. Alfred Morris
The right hon. Gentleman may be assured that there is no evil intent. It is not our intention to discriminate in favour of officers and against other ranks.
The right hon. Gentleman said earlier that arrogance was displayed by those on the Treasury Bench. I hope that I have acquitted my right hon. Friend and other colleagues from that charge.
Certain people do not form part of the forces but are extra to them. I shall be in touch with the right hon. Gentleman. My best course is to give him a considered answer to his point. He is a great expert at looking for difficulties in the wording of Bills and other parliamentary 1405 papers. He may be assured that I shall be in touch with him on his point as soon as possible.

§ Mr. Graham Page
Mine was not just a niggling point. When we consider the regulations, we must take into account their validity and whether they give the Secretary of State the power he appears to be taking if he makes a regulation. If, in this case, he wishes to make a regulation making a selection between serving members of Her Majesty's forces, as I read the subsection he would have the right to do that. I am sure that the House would not wish to give the Secretary of State the power to distinguish between different members of the Armed Forces under these circumstances. I think that the Minister should look at the point in this way. Does he need to have those words included? Will not the words persons defined in the regulations as serving members cause confusion? Would it not be simpler to use the expression "serving members of Her Majesty's forces"?

§ Mr. Boscawen
Does my right hon. Friend have in mind the serving members of the Gurkha regiment? They may not necessarily be British subjects at birth or when vaccinated. Their children may not be British subjects. There are complications. Perhaps my right hon. Friend has those in mind.

§ Mr. Page
I am grateful to my hon. Friend for giving specific examples. We must clear up this matter so as to know what is the intention behind the wording dealing with the Secretary of State's power to make regulations.

§ Mr. Alfred Morris
I am advised that there is a need for these words and that parliamentary counsel gave careful attention to the drafting of this part of the Bill.
I said that I was prepared to be in touch with the right hon. Gentleman to set his mind at rest. I have the impression that he is not half as worried about the competence of parliamentary draftsmen as we perhaps feared. I shall be in touch with him at the earliest possible date.