Industrial Diseases (Notification) Bill

HC Deb 30 January 1981 vol 997 cc1210-21

Order for Second Reading read.

1.2 pm

Mr. Nigel Spearing (Newham, South)

I beg to move, That the Bill be now read a Second time.

I have great pleasure in moving the Second Reading of the Bill, particularly as the opportunity was unexpected. One is told never to be surprised in politics. However, many people will be surprised that we have ample opportunity to discuss the Bill. I hope that it will not be a great inconvenience to the Minister. Although the Bill is short, it covers a wide range of issues. I have apprised the Minister of almost all the subjects that I shall cover.

It is a privilege for hon. Members to initiate legislation, particularly when it results from their experiences with their constituents. Although the Bill is officially entitled Industrial Diseases (Notification) Bill, I should prefer it to be called the "Archie Morton Memorial Bill". If the Bill is enacted it will be a fitting memorial to a gentleman who imagined that his mortal remains would be of great use to the cause that he had espoused. I have reason to believe that if the Bill becomes an Act his wish will be fulfilled in a way that was not expected by him or by me.

Archie Morton was one of a number of my constituents who have of late been suffering from asbestosis. Although the disease has been known for some time, its extent and the ways to prevent it have only recently become more widely known. Even now there is considerable doubt about rules for its diagnosis. My constituent was subject to some form of asbestosis, but was unfortunately turned down by the asbestosis panel on a number of occasions when he applied for benefit. There is considerable concern about how such industrial diseases are defined, particularly the relatively new ones. My colleagues whose constituents work in printing, dying and chemical industries and for many years mining know of similar problems.

The Bill does not concern definition, diagnosis or compensation, although they are difficult and important matters. Its ambit is far more limited. It relates to regulations for the notification and certification of death and for the recording of information relating to industrial disease and so on.

It is only a permissive Bill. It does not require the Secretary of State to do anything. It merely permits him to make regulations. Hon. Members may say that a Secretary of State already has widespread powers to require certain things to be done about such basic and fundamental statutes as certification of death. However, in all my research, and having contacted the medical profession, I find that, surprisingly, the regulations are not as wide or as comprehensive as one would think.

In spotting what has become a lacuna in the law, one has to consider the background of death and its certification. Unhappily, people can die for many reasons. The historic reason for having coroners was to investigate untoward deaths caused by accident, acts of their fellow men, and so on. The registrar of deaths referred such matters to coroners. The registrar still has to rely on the certificate provided by the medical practitioner.

The whole area between certification by the doctor, registration by the registrar and subsequent proceedings under the authority of the coroner, such as postmortems and autopsies, was examined by the Brodrick committee, which was set up in the 1968 Parliament. It did not report until 1971, when it produced a lengthy volume, Cmnd. 4810. It was a thorough investigation.

It was known as the Brodrick report and was made to the Home Secretary, who is responsible for these matters. Unfortunately, as is not unknown in that Department, not much was done about it, so far as I am aware. I shall return to some of the proposals of the Brodrick committee. Although my Bill does not fulfil precisely the regulations that Brodrick suggested might be made, it goes some way towards them.

It is perhaps natural that the Home Office should not wish to take legislative powers. Like so many things in life, this matter affects several different Departments. The Home Office is perhaps the least actively concerned. We are now dealing with preventive medicine and with health and social security, which are clearly Department of Health and Social Security responsibilities.

Registrars do not deal entirely with matters of health. They deal with matters of law. In this respect they still come indirectly under the DHSS, but they are administratively responsible to other Departments. Not only is this a gap in the law related to actual need, but it has perhaps uncovered an area of responsibility that is shared by several Government Departments from which one would not expect a co-operative effort on their part, particularly under the pressure of time, to bring forward new legislation.

Whatever the result of this debate, I hope that it will focus attention on the proposals in the Brodrick report. I believe that they deserve further public discussion. I have good reason to suppose that that view is held by people in the medical profession and by some coroners.

I turn now to the technical matters that lie behind the Bill. These start with the medical profession and with doctors. All the information that goes to the registrar, and which, ultimately, enters the statistics, depends almost entirely upon the details provided by a medical practitioner. This information is the basis for the tables of mortality and the analysis of causes of death upon which a great deal of work in preventive medicine proceeds.

Statistics are as good as the method by which they are collected. That is true of all statistics. Hon. Members too frequently forget that the statistics that we bandy about in economic or other arguments are only as good as the method of their collection. The method of collection depends on what is on, or not on the medical certificate of cause of death. The certificate is required to be completed in cases other than those sent direct to the coroner where the cause of death is unknown.

The rules relating to the completion of the medical certificate are based on the Births and Deaths Registration Act 1953. Section 22 says: In the case of the death of any person who has been attended during his last illness by a registered medical practitioner, that practitioner shall sign a certificate in the prescribed form stating to the best of his knowledge and belief the cause of death and shall forthwith deliver that certificate to the registrar". The form of the certificate—particularly on matters relating to the possible cause of death—is crucial. The powers that give the Registrar General, not the Secretary of State, the right to say what that form shall be, and how that form shall be handled, are contained in section 39 of the Act, which says: The Registrar General may, with the approval of the Minister, by statutory instrument make regulations— (a) prescribing anything which by this Act is required to be prescribed. The death certificate is one of the things "required to be prescribed", but it does not go further than that. It does not deal with the way in which it can be handled. It does not deal with the way in which the Registrar General sifts that information or, perhaps, wishes to make some form of supplementary comment. That is left at large.

Therefore, the power to make regulations in this sphere is a little circumscribed, to say the least. I gather—it is quite understandable—that the Registrar General does all this in conjunction with the Department of Health and Social Security, but the Registrar General and his department have much wider functions to fulfil. One can well understand, therefore, that the focus of the matter may not lie entirely with that department, because it relates particularly to health and medical practitioners.

That is the mechanism which has in some cases, I believe, been shown to be wanting. It is easy to require in an Act of Parliament that the cause of death be shown but we all know, especially in politics, that causes are not always easily pinpointed, and I understand from medical practitioners that that is true in this case.

On the form there is opportunity to give what are called "antecedent causes", "other significant conditions" and so on. There is a box which can be initialled by the medical practitioner to say: I may be in a position later to give, on application by the Registrar General, additional information as to the cause of death for the purpose of more precise statistical classification. I do not know many people who voluntarily give themselves more work, and I am not suggesting that we should ask medical practitioners to do a lot more work when they fill in a death certificate. That is an optional point on the form, but it brings out the question of statistical classification.

There is therefore, at least a question mark over this matter—Brodrick makes the point—and it seems to me that we might well have another look at the death certificate itself to see whether there is a way by which more information could be gathered from that certificate both for the purpose of research into causes of death and for the purpose of ascertaining cause of death in a particular case.

Brodrick makes specific recommendations. This is what is said in paragraph 6.18, under the heading "Violent or Unnatural Causes": we have found great difficulty in finding a generic term which would cover the extremely wide variety of different circumstances which may make it necessary for a death to be reported for further investigation. We have reluctantly been forced back to the expression 'violent or unnatural'. This is where we are back to industry diseases, since death by industrial disease is unnatural in that it does not arise directly from the effluxion of time or the risks that an individual has voluntarily undertaken. It is therefore clearly a category of death in which further investigation is required.

I referred earlier to my constituent who was subject to refusal of benefit but who later by legal means received a substantial sum of money. Unhappily, however, there was no further investigation postmortem on his remains, and it was this circumstance which pinpointed the chain of events which I have now presented to the House and which, unknown to me at the time, Brodrick had investigated over 10 years ago.

What did the Brodrick report recommend? It said that there ought to be a new type of classification of death which is a reportable death. It said in paragraph 6.19 that at the moment A Registrar of Deaths is obliged to report a death to the coroner in cases when he has reason to believe or when it appears to him that…the death has been caused by abortion, or … the death has occurred during an operation or before recovery from the effect of an anaesthetic, or…the death was due to industrial disease or industrial poisoning. But, as the Brodrick committee then points out, this obligation is only on the registrar, and the committee recommends that it should be applicable to doctors as well as registrars. The report then goes on to say that a doctor should be obliged to report any death which he has reasonable cause to believe falls within one of these categories. In the main, we envisage that the Secretary of State will prescribe categories of death in respect of which there is for the time being a particular public interest". Clearly one might have thought that if this were recommended a lot of people would think that is what already happens. But, for reasons which I have explained, unhappily it does not. That is where my Bill comes in, because in one clause all the Bill does is to give the Secretary of State or, with his approval, the Registrar General powers to make by statutory instruments regulations concerning the notification and certification of death and for the recording of information relating to industrial diseases and matters related thereto. Those powers at the moment, curiously enough, for reasons that I have outlined, do not exist. I do not suggest that the drawing up of such regulations is a simple matter. I do not believe that it is. It will require, no doubt, extensive consultation between those professionally concerned—indeed, with anybody concerned in this very important but very complex matter. But I believe, as the Brodrick committee believed—and as the general public would believe, if it knew about the matter—that there is an onus and an obligation on the Secretary of State so to do. At the moment, unfortunately, he has not the powers. I believe that the Bill would achieve what is required in that respect.

I am not asking for the total classification of reportable deaths; that might come later. All I am asking for is that in the particular category on industrial disease there be a coherent set of regulations which comprehends the investigation by the medical practitioner of a death, the manner in which it is certificated, some of the questions which may well be put to the medical practitioner on the form.

I hope—indeed, I would think—that such a form need not be markedly more complex than it is at the moment; that no extra time need be required of the medical profession on these matters; that the regulations would then specify the manner in which that information is registered; the obligation either on the medical practitioner or on the registrar to report to the coroner a matter where further investigation is required; the way in which that is carried out; and conceivably—this is perhaps going into the area of "optionals" in the regulations—what happens to the information that is thereby gained.

Unless we have something of this chain of events, which is agreed by all, I do not believe that preventive medicine and the prevention of death can properly be tackled. As everybody knows—and the Minister has particular interest in matters relating to the chest—this is a direction in which medicine has to move. We are all impressed by the vast technical achievement of medicine in regard to open-heart surgery, limb transfers, and so on, but for most of us it is a matter of living in a healthy way, preventing those diseases which are preventable, and ensuring that those who are disadvantaged by diseases which the community imposes upon itself are provided with the necessary support if they are disabled.

I believe that the Bill fulfils almost all the qualifications of private legislation. It is a brief and permissive measure that plugs a gap in existing legislation. It places prime responsibility on the appropriate Secretary of State in an area where several agencies of Government play complementary roles. Its manpower and financial implications are minimal. The Secretary of State—not the House—would be able to decide when and how it should be implemented. If the regulation after consultation proves to be inadequate or ineffective, the Secretary of State can amend it, or he can withdraw it and return to the status quo.

At the same time, the Bill meets a need that is tragically revealed by a constituency case that rightly tests the practicability of our laws and shows the need for change. I hope that I have shown the need for change, and I hope that the House will agree to the Second Reading of this modest but important Bill.

1.26 pm

Mr. Frank Haynes (Ashfield)

It is not often that I have the opportunity to speak in the House. Of course, if one attends on a Friday, there is a much greater opportunity to do so. I know that you, Mr. Deputy Speaker, are aware of my association with the mining industry, as is the Under-Secretary of State. I have experience of the industry as a member of the National Union of Mineworkers. I assure the House that the problem to which my hon. Friend the Member for Newham, South (Mr. Spearing) has referred is causing my colleagues and me a great deal of concern. That is why I support my hon. Friend's Bill.

My hon. Friend went into much technical detail, but I do not intend to do so. Before coming to this place I was a trade union officer with the NUM. I receive a fair amount of mail on pneumoconiosis from constituents who work within the mining industry. After working for 32 years in the industry, I am able to address the Minister in this place about the problems associated with pneumoconiosis and my reasons for supporting the Bill. The tragedy is that many thousands of miners are no longer with us because of pneumoconiosis. Adjustment to the regulation by way of the Bill, if it had been made at the time, would no doubt have helped thousands of my colleagues over the years.

I support my hon. Friends when he says that the Secretary of State for Social Services would find no great difficulty in doing what he is being asked to do. It is a simple matter. If the Bill is accepted and implemented, there will be the possibility of withdrawal at a later stage if the Secretary of State is not satisfied. The situation is enmeshed in a whole web of difficulties. In the main, I am referring to pneumoconiosis. It should be remembered that the National Coal Board, the National Union of Mineworkers and all the other unions involved in the mining industry work together on the problems relating to pneumoconiosis.

I quote from a report on the subject of "Liaison with coroners and pathologists", which says: In England and Wales any death known or suspected to have been caused by pneumoconiosis is reported to a coroner who then becomes responsible for investigating the death and, for the purposes of registration, determining its cause. The coroner will normally call for a post-mortem examination and report, and may hold an inquest, although he can dispense with the latter if he considers that the post-mortem report indicates that there is no need for an inquest. The pathologist carrying out the post-mortem examination makes the thoracic organs available to the local panel so that the panel doctors can make their own independent examination. It goes on to say: the coroner ascertains the cause of death for registration purposes, and the statutory adjudicating authorities determine whether pneumoconiosis caused, or accelerated, death in connection with claims for industrial death benefit. The medical cause of death certified by the coroner after taking into consideration the pathologist's post-mortem report does not bind the adjudicating authorities, who must have regard to all the evidence including the opinion of the panel doctors. Difficulties have sometimes arisen because of a conflict of opinion between coroners and their pathologists on the one hand and the panel doctors on the other, particularly where the coroner has concluded that pneumoconiosis contributed to the death but the panel doctors have formed the opinion that death was neither due to, nor materially accelerated by, pneumoconiosis. More rarely, differences may arise over factual findings in relation to the heart and lungs; where such differences arise, panel doctors usually discuss these with the pathologist. Such apparent conflicts, whether they be of fact or of opinion, are nevertheless unfortunate, especially where the deceased leaves a widow and the coroner's finding raises unfulfilled hopes in connection with the death benefit claim. In the mining industry we have many problems that we have to try to solve on behalf of the people who work in the industry. This particular problem has been a thorn in the side of the NCB and the union. It creates delay and many other problems for the widow. On behalf of the people we speak for, I hope that the Minister will accept the Bill. We speak not only for our own constituents, but for the nation as a whole. The problem affects every constituency. We therefore speak on behalf of all the people who are affected by it.

1.39 pm

The Under-Secretary of State for Health and Social Security (Sir George Young)

I congratulate the hon. Member for Newham, South (Mr. Spearing) on his good fortune in the ballot and commend him for resisting the temptation to go for a glamorous and controversial Bill, going instead for modest but useful legislation, which he hopes—and I am sure that he is right—will be a monument to his constituent. This is a good example of how a conscientious constituency Member who is disturbed by a particular case that has been brought to his attention can pursue it in the House through legislation and try to put it right. It is an excellent example of democracy in action.

As the hon. Gentleman made clear, the Bill is essentially enabling legislation, giving the Secretary of State the right to make regulations and lay them as necessary. I should like to say something later about the consultation that will be needed first.

The objects of the Bill embody part of the recommendations of the report of the Brodrick committee on Death Certification and Coroners, Cmnd 4810, to which the hon. Gentleman referred. I should like to quote briefly from the relevant part of paragraph 6.34: In future it will not always be sufficient for a doctor to give a certificate which is simply as accurate as he can make it; he will be required to consider whether that standard of accuracy is good enough. We have recommended that, in future, a report to an appropriate authority should be mandatory unless the doctor is confident on reasonable grounds that he can accurately certify the medical cause of death and the death is not one which he has a specific obligation to report. Our recommendations should lead to a significant increase in the number of deaths reported for further investigation and the performance of many more post-mortem examinations. Since we are completely satisfied that certification when clinical diagnosis has been supplemented by a post-mortem examination is, in general, a more accurate procedure than certification without such an examination, the fact that the implementation of our recommendations would probably result in more post-mortem examinations being performed is likely to provide one basis for the general improvement in the accuracy of medical certification which it is our aim to promote. The Bill is welcome as providing a means for moving towards the implementation of a small but useful part of the committee's report. The committee recommended that a duty should be placed on doctors to notify the coroner of deaths that fell within a category of reportable deaths to be specified by regulations made by the Secretary of State for Social Services. It also recommended that there should be a new medical certificate of cause of death, which should specify the circumstances in which the doctor should report to the registrar and to the coroner.

Under the existing law the doctor in attendance during the last illness of a deceased person is required to issue a certificate stating the cause of death to the best of his knowledge and belief and deliver it forthwith to the registrar of births and deaths. The cause certified by the doctor is entered in the register of deaths unless the coroner certifies the cause of death to the registrar after an inquest or upon the holding of a postmortem examination.

The registrar is then required, by regulations made by the Registrar General, with the approval of the Secretary of State for Social Services, to report certain deaths to the coroner and await his decision before registering the death. Among other cases, the registrar is required to report, if it has not already been reported, any death where no medical certificate is obtainable, or the cause is unknown, or which appears to him to have been unnatural or to have been caused by violence or neglect, any death which occured during an operation or under an anaesthetic, or one which is certified to have been due to industrial disease or industrial poisoning.

Therefore, under the machinery that already exists, if a doctor certifies that the death was due to, or contributed to by, an industrial disease, industrial poisoning or any other reportable cause, the registrar should report it to the coroner, with whom it rests to decide whether to hold a postmortem examination and or inquest. It is open to the doctor to notify the coroner of the death himself. If he does, he is asked to indicate on his certificate for the registrar that he had done so.

In practice, many deaths are reported direct to the coroner by doctors. This is very desirable, because it is helpful to the coroner to learn as early as possible of deaths that may require investigation by him. It also helps to reduce the delay that may be entailed by the coroner's inquiries before the family can set about making the funeral arrangements.

The Broderick committee suggested that doctors might welcome a specific provision in law requiring them to notify deaths to the coroner, since they might find themselves in a more comfortable relationship with relatives who may occasionally be resentful that a death had been reported for further investigation.

The committee therefore recommended that a doctor qualified by law to issue a medical certificate of cause of death should either complete and send to the registrar a certificate in a new form, which would require him to certify that he was confident that the cause of death was as stated and that he knew of no reason why the death should be reported to the coroner, or notify the coroner direct, stating his grounds for so doing. The Bill would enable some progress to be made in the direction of the recommendations made by the Brodrick committe on those points. The Government have no objections to the Bill and will not impede its progress.

The hon. Member seeks to give power to the Secretary of State to require deaths to be reported to the coroner for investigation, where the certifying practitioner has reasonable cause to believe that death arose from industrial disease or industrial poisoning. It is not clear whether the duty to report such cases will be placed on the doctor in attendance on the disease during the last illness of the patient. We shall clarify that point later on.

Under the Births and Deaths Registration Act 1953, the Registrar General, with the approval of the Secretary of State for Social Services, may make regulations prescribing documents required for the purposes of the Act. Existing regulations prescribe the form of the certificate of cause of death, which the doctor in attendance during the last illness is required to complete to the best of his knowledge and belief, and to deliver to the registrar of births and deaths. That cause of death must be entered into the deaths register, unless the coroner certifies the cause of death to the registrar after an inquest or upon the holding of a post mortem.

The regulations also prescribe the functions of registrars under the Act and inter alia. In certain cases, a registrar is required to report deaths to the coroner and to await his decision before registering the death. In general, the deaths that he is is required to report are those where the cause or the circumstances appear to be such that the coroner thinks it proper to make inquiries in order to determine whether he has a duty to conduct an inquest, on the grounds that the death was violent, unnatural, a sudden death, the cause of which was unknown, or a death that occurred in prison or in circumstances that require an inquest in pursuance of any Act. In particular, he must report deaths that appear to him, from the contents of the certificate, to be due to industrial disease or poisoning.

As the hon. Member said, section 22 of the Births and Deaths Registration Act places a duty on the doctor to certify the cause of death according to the best of his knowledge and belief. Therefore, if the registrar has reasonable cause to believe that the death arose from industrial disease, the certificate should already indicate that. If the certificate shows that, the registrar is required to report it to the coroner.

The Brodrick committee recommended that a duty should be placed upon doctors to certify the cause of death, and, where the death has been defined under the regulations by the Secretary of State as a reportable death, the doctor should report it to the coroner. That has broad implications for industrial injury benefit, as mentioned by the hon. Gentleman. If the doctor who signs the death certificate does not think that death may have been due to industrial disease and passes on the case to the coroner to consider, a post-mortem will not take place. The panels to which the hon. Gentleman referred will also not see the lungs. In those cases, it is difficult, if not impossible, for a dead person's family to prove their claim for death benefit.

Claims for industrial death benefit in respect of diseases prescribed under the industrial injuries scheme are determined by independent adjudicating authorities, initially the insurance officer, and on appeal the local tribunal and the social security commissioners.

In claims relating to pneumoconiosis, including asbestosis, byssinosis and other respiratory diseases, in England and Wales these lay authorities have before them a copy of the report by the coroner's pathologist, the coroner's death certificate and the report from the pneumoconiosis medical panel.

The latter reports are based primarily on the panel's examination of the thoracic organs at the post-mortem. They also take into account evidence from other sources for example, hospital case notes, the deceased's GP and, in many cases, the panel's report from X-rays conducted in life. There has been some criticism of that procedure, particularly of the role played by the panel, from the House and from pressure groups, in particular the National Union of Mineworkers. They have proposed, for example, that appeals in death benefit cases should go to medical appeal tribunals rather than to local tribunals, perhaps with the aim of ensuring that the PMPs' views do not carry as much weight. The hon. Member for Newham, South and others have asked questions about this process recently.

The Bill seems clearly directed at improving recognition of possible cases of industrial disease by the doctor who signs the death certificate, so that they can be referred to a coroner rather than with what happens after they have been so identified and are being considered for industrial death benefit.

The impact of this proposal on industrial death benefit has been mentioned. I should like to stress that the adjudicating authorities which deal with death benefit claims are independent, and neither I nor any other Minister can interfere with them. I have confidence in the professional integrity and independence and in the exercise of clinical judgment of those on the PMPs, whose experience is second to none and which do a lot of work in examining some 14,000 claimants each year.

The hon. Member also mentioned asbestosis. The Industrial Injuries Advisory Council is now considering whether pleural thickening caused by asbestosis but without asbestos should be prescribed and whether lung cancer in asbestos workers should also be prescribed.

On the actual diagnosis of asbestosis, I agree that the medical problems are complex, but the PMPs have a great deal of experience on this matter. They take into account medical evidence—for example, expert pathologists can put evidence before them—and they keep up to date with the latest research and medical opinion. The hon. Member for Ashfield (Mr. Haynes) related this in particular to pneumoconiosis and his experience in the mining industry.

Perhaps I could say something about the way in which pneumoconiosis bronchitis and emphysema are covered at present under the industrial injuries benfit scheme. I should like to begin by explaining what pneumonociosis is for benefit purposes.

Schedule 20 to the Social Security Act 1975 defines the disease as Fibrosis of the lungs due to silica dust, asbestos dust or other dust. The expression includes the condition of the lungs known as dust-reticulation. The industrial injuries scheme provides two main benefits—injury benefit and disablement benefit. Injury benefit is, broadly speaking, the benefit for short-lived conditions and disablement benefit is designed for long-lasting disabilities.

Because there is no known cure for pneumoconiosis, it attracts disablement benefit, That benefit can be paid under the provisions of the 1975 Act only where an accident or disease has resulted in the loss of faculty, which in turn has caused disablement. The diagnosis of the disease largely depends upon the interpretation of chest X-ray photographs. Those are compared by the independent medical authorities set up under the Act with an internationally agreed set of standard films which serve to define the severity of the disease. The standard films are constantly reviewed.

Category 1 is the earliest radiological sign of dust retention in the lungs. At that stage, only a few small opacities will show up on the X-ray and it is generally held in medical circles that that stage is not disabling in itself. In categories 2 and 3, there are numerous small opacities. Categories 1, 2 and 3 are referred to as simple pneumoconiosis.

Some men, fortunately only a small percentage, have the more advanced form of complicated pneumoconiosis. This is the so-called progressive massive fibrosis and involves the development in the lungs of larger fibrous masses, which may continue to grow even in the absence of further dust exposure, and can cause death. Simple pneumoconiosis in itself does not usually progress after removal from exposure to dust.

Perhaps I could put this in context by referring to the dramatic decline in the prevalence of the disease in the last 20 years. This is undoubtedly largely due to the considerable progress which has been made by the NCB in dust control and in medical surveillance and I am convinced that proper certification has a crucial role to play in this area.

The medical board's first task is to decide whether a claimant is suffering from the disease and, if he is, the board can go on to assess the resultant disablement. It comes to its decisions on the basis of a full clinical examination, and in the light of its interpretation of the available films, tests of lung functions and any relevant hospital casebooks. There is a right of appeal against an adverse diagnosis decision to the medical appeal tribunals, the highest medical authority under the Act, although there are some restrictions on the right of appeal.

The hon. Gentleman mentioned research. I agree that there is a need for more research in this very complex field of respiratory disease. Some important projects are under way and my Department maintains a very close interest in all of them. My right hon. Friend the Secretary of State is also empowered, under the Social Security Act, to give financial aid to research into occupational diseases and will, I am sure, be prepared to look carefully at any specific proposals.

As the promoter of the Bill made clear, consultation will be needed before any regulations can actually be laid. When the regulations relating to the registration of deaths are being revised, the Registrar General consults all the interests that are immediately concerned, which are mainly medical interests. But, in a general revision, all those with any interest in any part of it are consulted—other Government Departments, the Home Office, local authorities, medical and other associations. I envisage that there will be a need to consult fairly broadly on the particular legislation that is before us.

The hon. Gentleman rightly mentioned the impact of this measure on prevention, which is one of the themes of this Administration. My own view is that we are fast reaching the area of diminishing returns in terms of pumping more and more resources into acute medicine. While we can continue to do so, I believe that the actual improvement in mortality and morbidity will be relatively modest. As the hon. Gentleman said, if we are to achieve improved standards of health, we shall increasingly have to look towards prevention to achieve that. As I believe he knows as well as I, this raises important political issues upon which I shall not embark at this stage.

The hon. Gentleman's Bill will enable the bank of data that is available to be improved. It should mean that research is conducted on a sounder foundation. For that reason, I make it absolutely clear that the Government welcome the Bill and we shall not impede its progress in any way. I commend the conscientious and informed way in which the hon. Member moved the Second Reading.

1.52 pm

Mr. Spearing

I should like to thank the Minister first, for what he has said, and, secondly for the comprehensive way in which he and others who are concerned have given additional information about the matters surrounding the Bill. I further thank the Minister for his kind remarks about my constituency work. I have not represented only the constituency of Newham, South, which is in East London and in which, as in many port areas, this is an issue. I have also had the honour to represent a constituency in West London.

When I first began my advice service in the constituency of Acton, which was a little smaller than the present constituency of Ealing, Acton, which the Minister now represents, the first person who came to see me wished to consult me on the death of her husband from this disease. It is therefore most fitting that there can be cross-party harmony as well as some cross-party constituency experience on these matters.

The Minister's speech, through the many matters that he raised, showed that the Bill—thanks to what the Minister said, a future Act—will represent only a door into what I suspect is a very important, but very complex, labyrinth that will have to be explored. I am sure that in doing that there will be good will on all sides.

I also believe, and the Minister has given me good cause to confirm that belief, that because of the benefits that will flow from this, not just the narrow area of asbestosis or even that of industrial disease, but the whole area of research into preventive medicine, to which he gave proper emphasis, will be helped. While the regulations that derive from the Bill relate to industrial disease—they cannot go further, due to the Long Title—discussions on the regulations that emerge may well be the means of furthering the proposals of the Brodrick report in other directions. As we all know, a pilot project is very often a very prudent way of making progress. It shows up the snags, as well as the way to further success.

I thank the Minister and the Government for not blocking the Bill. It is one of those measures which I believe will be of considerable benefit, especially to people in East London and other port areas. I believe that it also shows the constructive role and the centrality of Parliament in making our laws and how, within a relatively short time, one can go from a citizen or his family, through a Member of Parliament, into law-making in a way that is far quicker and perhaps hitherto unsuspected in its efficacy than many people believe.

I thank the Minister for his words, and I leave the Bill in the hands of the House.

Question put and agreed to.

Bill accordingly read a Second time.

Bill committed to a Standing Committee pursuant to Standing Order No. 40 (Committal of Bills).