§ Mr. Roger Stott (Wigan)
I beg to move,That an humble Address be presented to Her Majesty, praying that the Merchant Shipping (Medical Examination) Regulations 1983 (S.I., 1983, No. 808), dated 1 June 1983, a copy of which was laid before this House on 15 June, be annulled.The hon. Member for Wallasey (Mrs. Chalker), the Under-Secretary of State, is a sparring partner of long standing. We welcome her Government taking the advice offered in the Labour party manifesto to incorporate aviation and shipping in the Transport Department. If the hon. Lady and the Secretary of State continue to follow the Labour party's advice on transport policy we shall have little to quarrel about.
The need for the regulations arises because the Government ratified international convention 147 in 1978. As a result, we have an obligation to ensure that seafarers are medically examined at approved intervals, that certificates of fitness are issued and that the facility for appeal to an independent referee is provided to seamen denied a certificate because of alleged ill-health.
In modern times United Kingdom seafarers have been subject to such examinations. I was subjected to them when I was at sea, as was my hon. Friend the Member for Kingston-upon-Hull, East (Mr. Prescott). As a consequence of the regulations the examinations will be of a statutory rather than industrial nature. One might say that there is no significance in that, but the regulations exclude seafarers serving on ships of less than 1,600 tonnes. That is in harmony with the general sphere of application required by convention 147. The National Union of Seamen, the principal union concerned, did not object at the time. However, because of the Union Star and other, similar, incidents, it has been persuaded that such exemptions should not be granted. All British ships and seafarers should be subject to the same regulations.
Seamen serving on ships of over 1,600 tonnes are subject to the regulations, but seamen serving with the same company on ships below that weight are not. Nothing prevents the United Kingdom from applying a lower limit. I am advised that the Danes have a 20 tonne gross weight figure. Why cannot the United Kingdom follow suit if we are both operating under the same International Labour Organisation convention? Ships of less than 1,600 tonnes figure most prominently in the casualty returns. The General Council of British Shipping consistently implies that seafarers in its sector are less at risk than they often wish to claim but that seafarers in the non-federated sector are at greater risk. We cannot endorse a set of regulations which exclude medical certification for seamen to operate and sail ships of less than 1,600 tonnes. If we are to have regulations on the health of seafarers they should be spread across the spectrum of employed personnel within British shipping. They should not stop at some arbitrary figure of 1,600 tonnes. That is a major omission in the regulations to which I draw the Minister's attention.
Secondly, of great concern to the National Union of Seamen and with which my hon. Friend the Member for Kingston upon Hull, East will deal better than I, if he catches your eye, Mr. Speaker, there is the sum of money that seamen have to pay for these medical examinations. Regulation 10 proposes to charge each seafarer who appeals to an independent referee the sum of £48, of which £15 is returnable if a medical examination is not 367 undertaken. Currently, within the GCBS sector the employers bear all the expenses, including those for travelling. To confront a medically redundant seafarer with such an expense is unheard of. I suspect that it is another example of the self-financing public service philosophy that is favoured by the Government. The Minister should give us a commitment that the Government will place that expense on the shoulders of the seafarer's employer if the seafarer has been employed by the shipping company for six months or more.
The regulations give exemption to persons employed on ships but who are not employed directly by the shipping companies. That includes people such as musicians, shopkeepers and mobile repair gangs. I am advised that the NUS has pointed out that anomoly to the Department of Trade, as it was, and to the Department of Transport. It argues that such people sail on ships and are an integral part of the ship's company, so why are they exempted from the regulations? That is the second exemption that is being proferred under the regulations.
The medical examination standards are an emotive matter. The NUS and those seamen who will be subjected to the regulations contend that the medical profession will exercise its opinions under the regulations in respect of people's employment. If seamen are found to be in some way medically unfit according to the regulations, they will lose their jobs. I believe that the Minister is sympathetic to the objections to the medical conditions in the regulations. This is a way of making people redundant and that is why the NUS and the Opposition feel strongly about it.
I hope that the Minister will understand the strength of feeling that there is within the NUS, particularly among those who are over the age of 35. The medicals will be compulsory and those people over 35 working in our merchant shipping fleet are probably more prone to illness and sickness than younger men. If they are subjected to stringent medical standards, it could lead to the termination of their employment. That is our serious criticism of the medical standards contained in the regulations and that is the problem worrying the National Union of Seamen.
I should like to put to the Minister five points, to which I hope she will be able to respond. First, the Minister should convey to the approved medical practitioners the concerns of the seafarers. The hon. Lady will know of these concerns because I assume that she has had several letters of complaint from seafarers about the way in which the present standards are applied. The medical practitioners need to be reminded that the high standards of medical fitness that they are being called upon to administer are not matched by the standards of ill-health prevention. Indeed, according to the National Union of Seamen, little preventive or educational work is being undertaken in the shipping industry.
Secondly, the Minister should convey to the approved medical practitioners her concern that special care and consideration should be extended to those over the age of 35. Those seafarers may soon be in the majority because of the declining work force, yet they are also the most vulnerable because they are the most prone to ill-health. Doctors should be asked to give seafarers in this age group every reasonable opportunity to remain at work for as long as possible, provided this is the lesser of the risks they have 368 to face. There is special concern about this group of seafarers and the Minister should monitor the regulations in respect of them.
Thirdly, the Minister should give a commitment to agree that the regulations and the standards will be reviewed at some time in the future. On behalf of her Department she should give a commitment that a broad-based representative group of occupational health medical practitioners will undertake this review.
§ Mr. Donald Stewart (Western Isles)
Has the National Union of Seamen given any thought of the flexibility of the rules in the Merchant Service? For example, one can understand that the rules would have to apply to an able seamen suffering from epilepsy, but would there be some discretion in allowing a man with this disability serving as a steward to go to sea?
§ Mr. Stott
The right hon. Gentleman has drawn attention to one of the anomalies of the regulations. I cannot answer his question. We shall have to await the Minister's response. A steward suffering from epilepsy could carry out his duties capably — provided that his captain was aware of the position—but he could not sail as an able seamen, as the right hon. Gentleman pointed out. This is where problems arise which hitherto have been overcome because the health regulations were not statutorily binding as they are now.
Fourthly, the Minister must ensure that her medical advisers maintain a close watch on all aspects of the regulations and on the way in which standards are applied, particularly with regard to those declared permanently unfit. It is highly desirable that the Department's own doctors assume full rather than titular responsibility for what is now a statutorily based set of medical standards. This can be done only on a week by week, day by day, surveillance of the regulations.
Fifthly, the Minister should ask the appointed medical referees and medical practitioners to draw the Department's attention to any unnecessary rigidity in the standards, whether in content or application. It cannot be stressed too strongly that the standards of required fitness are extremely high. Although the stresses and strains on seafarers serve to make this a contentious issue, it must be recognised that seafarers are vulnerable to being prematurely retired as a consequence of the regulations.
The Minister will be aware that I am sponsored by the Post Office Engineering Union. British Telecom has a fleet of cable-laying ships, on which POEU members serve, and have served, with distinction. They, too, are worried about the regulations. In many instances they have a dual role because, in addition to being seamen they are cable layers and cable jointers. All other members of the crew are involved during the cable-laying operations, working shift rotas to assist specific operations.
My union would prefer to see the continuation of a British Telecom in-house medical staff. Medical expertise within BT has been geared to the problems that occur on cable-laying ships. It is a special sort of work that gives rise to special medical needs.
I suggest that the regulations and a number of others could be brought within the remit of the Health and Safety at Sea Commission. It happens that the Department of Transport has the controlling interest under the regulations, but a supervising body, such as the commission, could have full responsibility for ensuring 369 that the regulations are implemented fairly and properly and not to the disadvantage of seafarers, which we believe could happen.
The Minister must recognise that the introduction of these regulations will be met with a lack of enthusiasm from those whom they are intended to help. They will be unpopular. The House has a right to demand of the Secretary of State, in the light of the clear unpopularity of the regulations, an assurance that he will monitor their operation and give a commitment that their application will be reviewed.
The Minister and the House know that the regulations are causing serious concern among seafarers, who do an extremely good job on behalf of the United Kingdom. They have done that in the past and they will continue to do so, but they want an assurance this evening that at a certain time of life they will not be made medically redundant because the medical profession wishes to adhere to regulations that are extremely onerous.
These are the questions that the Minister needs to answer. If she does not do so satisfactorily, the Opposition will divide the House.
§ Mr. Alfred Dubs (Battersea)
One of my constituents complained to me that, as a merchant seaman who suffers from epilepsy, he is unable to return to sea because he is debarred by the old medical provisions. I am not sure, having read these regulations and the appendix to the merchant shipping notice, whether they make any easier his task of returning to sea.
The regulations state:Central nervous system. Any type of Epilepsy—a single epileptic fit—provided that the past med cal history is clear and investigation has shown no abnormality; re-entry could be considered after one year without any treatment.I am also concerned that on an appeal against such a decision the applicant must pay £48 to be re-examined to establish his fitness to return to sea. This is another difficulty for a person such as my constituent who is unemployed. Will my constituent be able to return to sea or are these regulations insufficiently flexible to allow him to do so?
§ Mr. John Prescott (Kingston-upon-Hull, East)
I declare an interest as a sponsored member of the National Union of Seamen. As an ex-seaman, I wish to put forward some arguments as to why the regulations are unacceptable. The Opposition must vote against the proposal unless the Minister is prepared to say that the charge of £48 will not be imposed. Although I was a seaman for 10 years, I would be unable to return to sea if I lost my parliamentary seat. Only a superman could return to sea having conformed with this proposal.
To understand the feelings of seamen about these regulations, we must understand their suspicions which are born of experience in the industry in the past 20 years, in particular the attitude of shipowners towards safety and welfare. The seamen are extremely suspicious of whether anyone will be open-handed about the proposed medical standards.
So incensed are seamen by the regulations that a full conference of the union took place which convinced them not to comply with the regulations in their present form. A collision course seems inevitable. The medical 370 standards in the regulations and in the maritime notices arise from the ILO conventions of 1946 and 1976. The National Union of Seamen, as an international union, has always encouraged the improvement of conditions via conventions.
The 1976 convention was accepted by the Labour Government in a White Paper. It makes it clear that there is concern about the ending of decasualisation in the shipping industry and about the need to advance the broad welfare demands of seafarers. In the past few years the industry has been slaughtered. The number of ships has fallen from about 1,600 to about 900 and it is expected to be halved again in the next few years, so decasualisation is very much a concern at present. Meanwhile, the other advances referred to in the conventions are not coming forward with the speed that the medical examinations show they warrant. On manning standards, the Government are actually encouraging reductions to keep crew costs down. That, too, is very much in the minds of seamen.
The medical examinations provided for in the conventions must be seen in their true preventive role. Their purpose is to recognise the medical problems arising out of seamen's conditions of work and to take action to prevent them. Maritime paper No. 1061 which is to be taken with the regulations recognises that seafaring is a hazardous occupation. That is true of all merchant navies. Statistics for accidents, sickness and mortality for seafarers of all countries are far higher than those for industrial occupations ashore.
That has been so for a long time. I recall writing evidence for the Pearson inquiry into the 1960 strike, about which politically motivated charges were hurled around the House. We made it clear at the time of the strike that the conditions of work and the accident and sickness rates had very much influenced that strike. Lord Pearson concluded that the accident and death rates in the shipping industry were deplorable. Yet they have increased since then and they doubled between 1975 and 1981.
The work done by Jack Kinnahan for the National Union of Seamen showed the same deplorable situation. The Minister looks doubtful. I will let her have the tables so that she can make the comparisons and assure herself that my arguments are based on fact. The accidental death rate for seamen is 25 times greater than that in manufacturing industry and four times greater than in mining, which is recognised to be the most dangerous occupation ashore.
Equally alarming for the seamen is the fact that, since the Health and Safety Commission took over accident rates in mining and manufacturing have fallen, but in shipping they have risen. In this context, it is interesting to note that there is no Health and Safety Commission to cover the shipping industry. Now that the responsiblity has passed from the Department of Trade to the Department of Transport, perhaps we shall see some real changes instead of civil servants working directly or indirectly for the employers. There is evidence, indeed, that a considerable number went to work for the shipping industry on leaving the Department of Trade.
Not only is the accident and death rate appalling. The industry is not in the vanguard in demanding safe gangways, safe clothing, eye guards where necessary. and so on, and safe manning levels. The industry has done nothing but obstruct advances of that kind. That is why the accident rate is so high.
371 I prepared the first paper on sickness and mortality for the Department of Trade in 1969 before I became a Member of the House. All the figures showed that mortality rates were higher for seamen than for workers in any other industry. Fifty per cent. of deaths at sea are due to disease, so more people die from disease than from death. [Interrruption.] I seem to have got that wrong. I meant that 50 per cent. of deaths at sea are due to disease rather than accident. That is a serious medical problem. We look to the industry to introduce preventive measures to help seamen in those difficult conditions. In some cases, it may be necessary to consider also preventive measures in terms of diet.
The Dreadnought hospital, which was built especially to deal with this type of medicine, is now in danger of closing. In so many areas, the emphasis is not on preventive medicine to help the seamen but on introducing measures which will lead to their being expelled from their jobs. Jack Kinnahan, a member of my union, gave much evidence to support that.
Seamen are sceptical when the industry says that the proposed medical standards should be enforced. We wonder about the industry's motive. We are worried when the industry says that it is concerned about our interests because it asked for and received exclusion from the Redundancy Payments Acts of the 1960s. That meant that, while standards were better on paper, seamen who signed off the ship never did two years' service and were never able to claim redundancy pay. The industry then told seamen that they were no longer redundant but did not pass its medical standards, so they were removed from the industry. The industry saved millions of pounds in that way. Indeed, the industry is now lobbying for changes to the Redundancy Payments Acts because thousands of seafarers are being made redundant—which is expensive — so it wants to change the law again so that the Government will provide the money. Shipowners have never given anything for nothing. They will always exact their price, and seamen are well aware of it.
It is a hazardous industry in which there is little preventive medicine. I do not believe that medical examinations have changed much since I went to sea. The doctor told the prospective seaman to drop his trousers, and the examination was complete. Perhaps it is a little better now, but there is still little emphasis on preventive medicine. It is hardly surprising, therefore, that seamen are wary when the industry says that it wants to look after their interests.
As the Minister comes from Merseyside, she probably knows about seamen's complaints abut the way in which the industry has implemented standards in the past. There is apprehension about making such standards statutorily enforceable and for it to be a crime not to have a medical certificate. I should like to quote from document M1061 about why it is necessary to have these standards. It says:It would be unsafe practice to allow seafaring in any known medical condition where the possibility of serious exacerbation requiring expert treatment could occur as a calculated risk.I understand the problems of allowing people to go away to sea if it is not possible to give them medical attention. It is good sense to prevent ill-health. Medical provision varies. Some liners are equipped with surgeons, doctors and a mass of facilities, whereas others have no doctors but simply someone with a medical book.
372 While the shipping industry's doctors have one idea of the standards, the Department's doctors want more flexibility built into the system. Our being faced with the regulations now means that the Department must have lost. The industry is imposing the standards and the conditions whereby a seaman can be expelled. We have often contested the industry's medical advice after discussions with consultants, but our suggestions have been rejected.
A letter in The Seaman by Dr. Buckland of Grimsby makes it clear that some of the reasons for expulsion from the shipping industry under the M notice procedure are utterly unacceptable. He is another medical authority who gives considerable evidence, and questions the reasons for expulsion under the M notice procedure.
I noticed that loss of hearing has been given as a reason for a seaman being denied employment in the shipping industry. In 1969, I called for special preventive medicine for lads working in engine rooms who were losing their hearing because they were subjected to concentrated noise as a result of new technology in engines. We did not achieve testing to find out if the men were losing their hearing. It is possible to remove such men from the engine room and give them paid leave ashore and their hearing will return to normal. However, the industry did nothing about that. It simply said, "You have lost your hearing and now you can be expelled." If we continue to have the standards embodied in that document, we shall face similar problems in future.
The document also states that if a seaman is more than 20 per cent. overweight he can no longer go to sea. Goodness knows what would happen to Members of this House, including me. As for female seafarers, the document states:Employment at sea shall not be permitted during the term of pregnancy.That means that female seafarers cannot get the full-time work that would entitle them to get benefits, so not only are they kicked out of the industry but they are denied benefits.
Another example is standards of eyesight. The document states:Where different visual aids are used for distant and near vision, a spare pair of each must be carried.Presumably a seaman must carry four pairs of glasses before he can go to sea. That must cost about £100 to £200, and who pays for it? That penalises people in their chosen occupation. On reading the regulations, one begins to believe that they have been proposed simply to make it easier to expel people from the industry, not through redundancy but on medical grounds.
My hon. Friend mentioned exemptions. Maritime notice 1078 states that exemptions can be made for those who go away to sea but who are not directly concerned with the ship. That means that a hairdresser or a shop girl, who may be diabetic, or have epilepsy or heart trouble, need not have a medical examination, but that the assistant steward who looks after them must have one. If he does not, he can be expelled from the industry. He will be especially aggrieved about the fact that there appears to be one law for him and another for the hairdresser or shop girl. An exemption may also be given for foreign seamen. M1078 states that Liberia can give medical certificates. Liberia will sell manning certificates to anyone who wishes to buy them, so medical certificates will be no 373 problem. Liberia loses four times as many ships as does Britain because of the incompetence of her certificated seamen.
Maritime notice 1078 also states that when one applies for a medical certificate, it can be done individually but that normally the company will apply for it, and that the company will pay £14. Many companies will shove that expense directly on to the seaman, especially if he does not belong to a federated service. The company will say, "If you have £14 to pay for a medical certificate, we will employ you, but if you do not have it, we will take someone else because there are thousands of unemployed seamen." That will penalise the seaman looking for a job. Section 10 provides that men aged 18 must have a yearly examination, so the heaviest costs will be placed on the lads who have the lowest income to deal with it. That is a further injustice.
My hon. Friend mentioned the appeals system. One can appeal against a decision of the medical authorities that one is no longer fit to go to sea. The right of appeal is written into the convention, and is an international obligation to which the House has agreed. However, today rights must be paid for. They do not come simply because one is a seaman, so if someone wishes to appeal against the medical standards imposed upon him—with which some authorities disagree — he must appeal to the Department of Transport. We fully agree that there should be an independent appeal tribunal, and we recognise that the Department is independent of the industry. It means that the state has a say about medical standards and does not have a vested interest in the matter. Unfortunately, it has not faced up to that obligation and has allowed the industry to dictate the standards required.
That being so, a seaman now has to send £48 with his application for an appeal. The regulations do not state that the seaman should pay the money, but his appeal cannot be heard unless he sends £48. In effect, a seaman who wants to appeal against a medical decision will now have to pay £48. That would not be expected in the national insurance system. If someone is denied a benefit, he is entitled to a free medical appeal, and he does not have to pay for it. Why should the seaman have to pay £48? He is supposed to have a right to appeal, but that right is denied because a charge is made.
In the past few years 400 seaman have left the industry for medical reasons. Only 60 of them elected to appeal and not many of the appeals were successful. At the moment the appeal does not cost anything; the charge is a new one. From experience when there was no charge, we can assume that the seamen, when not deterred by having to pay a charge, appealed because they wanted to do so. If there were only 400, the total cost involved is £3,000. That is not a lot of money. The Government should make it plain that the obligation should fall either on them or on the industry, and that, in any event, it should not be placed on the seaman.
When the seamen sees the regulations, he wonders why he should be treated differently. We have been told that the charge is a deterrent. It is designed to deter a person with no legs or no arms from wasting the time of the appeal board. But, according to the convention , any seaman has a right to appeal. We are attaching a charge to that right and that obligation.
One point in particular that incenses the seamen. A few weeks ago the Health and Safety (Fees for Medical Examination) Regulations 1983 came before the House. In 374 that case, if the health and safety executive wants to examine a man to find out whether, for example, he has lead in his blood because the nature of his occupation, Parliament has stated that the employer shall pay a charge of £19. Parliament did not say that it was the worker who had the obligation to pay. We said that the employer should pay the charge, because conditions in the industry were involved. It is interesting, incidentally, that when the employee pays, the charge is £48, but when the employer pays, the charge is £19. That is an interesting example of discrimination. The seamen see Parliament passing that legislation one day, and charging the seamen £48 on the following day.
It is not clear from the regulations that the seaman has any right to see the referee who is to make the decision. Even if he pays the £48, he has no guarantee that he will see the doctor who is to pass judgment on him. That is the least that we should guarantee him, whether he is charged or not, but it is not made clear anywhere in the regulations.
The seamen feel that there are many more questions to be answered. The Government were asked to put off introducing the regulations until further consideration could be given to them by the Department. As there is a new Department, I should have thought that that could have been done. But the regulations were pushed through during the election. One of the more favourable results of the election was that Mr. Sproat, who represented Aberdeen, South, lost his seat. He had provided much of the impetus behind the regulations. I hope that the hon. Lady will remember the fate of two hon. Members involved in fights with the seamen. Mr. Sproat is no longer here and the hon. Member for Weston-super-Mare (Mr. Wiggin), who tried to sell off our ships to the Royal Navy, is no longer in the Government.
This is the third fight, and this fight is with the Department of Transport. I hope that the Department will give serious consideration to the fears of the seamen, who have a legitimate grievance. I hope that the hon. Lady will tell us that she will reconsider the regulations, even though they are in force. If she is not prepared to do that, the only thing that we can do is vote against them.
§ Dr. David Clark (South Shields)
I support strongly what my hon. Friend the Member for Kingston upon Hull, East (Mr. Prescott) has made clear to the House. I represent a constituency which includes many thousands of seamen, and I know very well the depth and extent of feeling among the seamen about the regulations.
I shall not deal with the medical appeal fees or the medical hearing. My hon. Friends the Members for Wigan (Mr. Stott) and for Kingston upon Hull, East have deal with them in detail.
Seafaring is hazardous. The other major occupation in my constituency is mining. I know at close hand the accident rate in both industries. We tend to forget how dangerous seafaring is. The men earn their livelihood in difficult conditions and they are the first to accept :hat they must be of a sufficient medical standard. A man who is not up to the mark places a risk on his companions.
The whole background of employment in shipping does not give the men confidence in the regulations. If I were asked who comprised the most unpatriotic group of people in Britain, I would say the ship owners. They have no respect for the British flag, and they have a reprehensible 375 record when it comes to ship building and repairing. If they can get work done for 0.5 per cent. less overseas, they will willingly take it abroad.
In the past four years there has been a drastic reduction in the size of the British merchant fleet and, therefore, in the number of seamen. Their great fear is that these regulations may be a way of creating further massive redundancies in the industry. As my hon. Friend the Member for Kingston upon Hull, East said, it would have been appropriate for the new Department to show good will by withdrawing the regulations. However, we accept that they are already in operation, so all we can do now is to vote against them.
The Minister could at least acknowledge that there is medical disagreement about the regulations. It would help if we could have certain assurances. For example, will the Minister make it clear that the Government will oppose any efforts by the employers to use the regulations as an excuse to make more men redundant? Will all unfitness cases be reviewed by the Department's doctors? Is the Minister prepared to devise a system by which cases which the union considers to have been dealt with particularly harshly can be reviewed?
Will the operation of the regulations be monitored so that, in two or three years, if the international convention has not been working properly, the necessary alterations can be made? Assurances along those lines would help to persuade the seamen that the Government are not providing just another method of creating more redundancies in the industry.
§ 11.4 pm
§ Dr. M. S. Miller (East Kilbride)
Considering that the Conservatives have been saying over the years that they do not like interfering in procedures that have been in operation for many years and are against too much legislation, I wonder why all of a sudden this mass of complicated procedure has been initiated. Perhaps it is because the Government want to provide more work for the medical profession, which is well enough paid already. Or could it be because the Minister kept saying during the election campaign that there were far too many British seamen and that a method had to be found to get rid of them?
I spent 20 years examining seamen in the port of Glasgow. I found all kinds of conditions. They were treated. They went to sea. They had no difficulty. I was on board ships every day during those 20 years. I see no reason why this complicated procedure should be institutionalised in the way that it is in the regulations.
When I studied some of the conditions detailed in merchant shipping notice No. M 1061 I wondered where the Department obtained its information. Where does it obtain the information about the gastro-intestinal system? It says:Cimetidine maintenance therapy. The duodenal ulceration relapse rate while on treatment is too high for safe seafaring.The relapse rate after one or two courses of cimetidine is low. The incidence of duodenal or gastric ulcer perforating on cimetidine therapy is also low. The number of stomach operations has been reduced dramatically by this form of treatment.
376 Similarly with pulmonary tuberculosis—I understand that one does not send a man to sea if he has TB. The document states that.
Most cases are unsuitable for further seafaring but if the examining doctor is satisfied that the lesion is firmly healed, the radiological appearance is acceptable and the patient has completed a full course of chemotherapy, re-entry might be considered.I bet that most of the older Members of Parliament sitting here this evening will have healed tuberculous lesions in their lungs. No one says that we are unfit to sit in Parliament — [Interruption.] Perhaps some people say that we are. However, no regulations apply to us and say that we might, perhaps, be reconsidered by our constituents for an election campaign. That is a ridiculous statement. I have come to the conclusion, in complete agreement with my hon. Friends, that there is a sinister motive here. Why is there all this palaver? Why should all this be necessary?
I do not pay the slightest attention to the stupid list contained in appendix 1 of countries whose certificates are acceptable for these regulations. I have never read anything so ridiculous in my life — Algeria, Greece, Guinea-Bissau, Costa Rica, Papua-New Guinea and Liberia. I am sure that for a small bowl of rice a certificate will be granted easily by witch doctors or some of the doctors in those areas.
I believe that an attempt is being made to reduce the number of seamen. As regards the price of the medical certificates, my hon. Friend the Member for Kingston upon Hull, East (Mr. Prescott) was right to tell the House that the seamen, whom he knows well from years of experience, are up in arms against this charge.
I support my hon. Friends strongly in opposing these regulations.
§ Mr. Deputy Speaker (Mr. Harold Walker)
I remind the House that Standing Orders require that the debate be concluded not later than 11.30 pm. I am sure that the House would wish the Minister to reply.
§ 11.9 pm
§ Mr. Terry Fields (Liverpool, Broadgreen)
As has already been said, the Opposition's aim is higher standards of medical monitoring. I have some experience as a fireman. In the 1960s, medical examinations for firemen over 40 years of age were accepted by the union. There was strict monitoring. With the involvement of the Department, the area health authority, underastanding the nature of the tasks carried out by the firemen, carefully monitored the examinations.
The same should apply to the seamen. They have more of an affinity with water than the fire services. The maritime industry and those who work in it need to be assured that the regulations are in the best interests of the industry. No financial barriers should be put in the way of maintaining the highest standards for seamen.
Time is against me. I associate myself with my hon. Friends' remarks. If the regulations are to be used as a device for making seamen redundant, in no way can the Opposition accept them in their present form.
§ The Under-Secretary of State for Transport (Mrs. Lynda Chalker)
I cannot turn the clock back. I thank the hon. Member for Wigan (Mr. Stott) for his welcome, but 377 he knows as well as I do that the regulations are an inheritance and not exactly in my plan of action. Although not able to turn the clock back, I want to consider some of the things that have been said in the debate. I want to look forward. There are many seafarers in my constituency. It will not surprise hon. Members on either side of the House to know that my hon. Friend the Member for Wirral, West (Mr. Hunt) and I have represented the interests of seafarers in just such cases as have been mentioned tonight. when they have become sick, have had to face medicals in the past and so on
Therefore, I approach the matter from a slightly unusual stance. However, these regulations are necessary. At the back of what was said by Opposition Members is an acceptance that we have to have medical standards because those serving on the deck and those in charge of the ship must be able to carry that ship safely through the waters on its mission. There are difficulties from time to time. There have been over many years. We are now making the regulations so that the United Kingdom can meet its international obligations. They arise from the ratification of the International Labour Organisation convention No. 147, "Minimum Standards in Merchant-Ships". It was composed at the 62nd maritime session of the ILO in 1976 following the return of the United Kingdom tripartite delegation. The Government of the day, supported by Opposition Members, announced their intention of ratifying the convention in Cmnd. 7163, when they were satisfied that all shipboard conditions of employment were in every case covered by laws and regulations or by collective agreements.
One facet of the employment of seafarers is the requirement that they should all be medically fit and issued with certificates to attest to that fact. The requirement was first enunciated by the ILO in the drafting of convention No. 73 covering the medical examination of seafarers in 1946. In this country, the Government, of either party, have never been able to ratify the convention because it was considered too restrictive in a number of respects, notably the frequency that examinations were required and the relatively small number of vessels to which it applied. Eventually, through much negotiation the ILO came to appreciate that, although the principles underlying the convention were widely accepted, in many countries, including the United Kingdom, there were practical problems in its implementation. Perhaps that is why it has taken so long to reach this stage with the Merchant Shipping (Medical Examinations) Regulations 1983 which apply to all seagoing vessels that are not small ships, of under 1,600 tonnes. I shall come back to the point made by the hon. Member for Battersea (Mr. Dubs).
The United Kingdom law is now substantially equivalent to the international convention. It meets the obligations as well as exercises the privileges conferred by the ratification of ILO No. 147. I do rot think that there is any difference of opinion between the two sides of the House about the fact that seafarers' health is most important. It is common ground that the convention is a significant weapon in retaining a viable British merchant fleet, not only because it sets minimum standards for the vessels from the states that have ratified it but because it gives those countries the right to inspect ships of other nations that visit its ports and to report any failure to meet the standards of the convention or in extreme cases—where there is an identifiable risk, for instance, to the 378 safety of the vessel or the health of those on board—even to detain a ship until the shortcomings have been rectified.
I am sure that the House will agree that it is likely to be the most effective way in which we can protect the British merchant fleet from the unfair competition posed by those nations whose ships are manned by inadequate crews or with non-existent standards of safety and hygiene. If we are to derive the benefits of the convention, we have to accept it. That is what brings us to this point tonight and to the regulations which were laid in May by my former colleague, Mr. lain Sproat who was then the hon. Member for Aberdeen, South.
It has been said tonight that there was no consultation about the regulations, so why proceed? I have to say—as the hon. Member for Kingston upon Hull, East (Mr. Prescott) knows — that there were consultations. In digging around to see what has been going on over the last three years or more, I find that originally there seemed to be quite wide acceptance of what was involved, and then gradually the doubts crept in. Those doubts vary but in the main there are doubts about the rigidity of the medical standard. That was the point made by the hon. Member for East Kilbride (Dr. Miller). The doubts come from six unions. Although some of those unions, including the Post Office Engineering Union, originally seemed to be satisfied, of late a change of heart on the part of all the unions has been noticed.
Let us consider what the medical standards mean. They are not part of the regulation but part of the Merchant Shipping Notice No. 1061. Standards are necessary because we cannot limit the number of doctors if we are to have examinations readily available to merchant seamen. Therefore, we must have standards to apply. and here I hope I may be able to help Labour Members.
There are doctors in companies with their own shipping fleets—for example, some of the large oil companies and others. There are doctors in the employ of the General Council of British Shipping. There are also doctors who work for non-federated shipping companies. They must be working to the same standards as nearly as they can. That is why a group of standards has been arrived at— originally, I understand, with the support of the medical representative of the National Union of Seamen and the Merchant Navy and Airline Officers' Association and others—that seem to be right for the industry. As I said, some of the unions have now changed their minds. Nevertheless, the standards in the associated document have been discussed quite thoroughly.
We are also publishing the names of the doctors who will be carrying out the examinations in the Merchant Shipping Notice No. 1078. Therefore, there is no doubt who will be there to conduct the first-stage examination.
I know that there is some monitoring taking place among company doctors, particularly of standards of seafaring medicals. I have been asked tonight for an undertaking that we will monitor what is going on in the conduct of seafarers' medical examinations. I assure the House that a very keen interest will be taken if the regulations are accepted and the prayer is declined by the House. We shall look at the standards and at what is going on. I shall return to that point in a few moments.
If there is a failure and a seaman decides to appeal, the doctor to whom he appeals will be independently appointed by my right hon. Friend the Secretary of State. We wish to restrict the number of doctors doing appeals 379 to those who are accredited specialists of the Society of Occupational Medicine, because we believe that their experience is the sort that should be available to any case going to appeal. It would be worthwhile if they have also been to sea, and we hope to incorporate that as well. There may not be enough people with the dual role to fulfil the numbers that we need, and we shall have to see about that over time.
Hon. Members have talked about preventive medicine, and as the House is aware, I have been involved peripherally, not as a non-medical practitioner, but as an interested party, for many years. We need improved statistics about medical ill health at sea, and I should want to examine the collection of statistics about sea accidents, and whether that is possible. We now have an opportunity, as the result of the regulations, which was not available before.
Hon. Members also spoke about the rigidity of these regulations, particularly the hon. Member for East Kilbride, who is a medical practitioner. I hinted that M 1061 is not part of the regulations, and the debate shows that there is unhappiness about it. As it is not part of the regulations, it can be amended, and I give a firm undertaking that the Department of Transport, which takes on this responsibility for the first time, will monitor whether the regulations are too rigid. The hon. Member for Kingston upon Hull, East was right to say that there had been advice in Government circles about more flexible regulations. Any medical practitioner looking at the regulations, as the hon. Member for East Kilbride did, will know that there are treatments — which were not previously available for certain illness — that might enable a man to pursue his career at sea for longer than was previously possible. That must be examined in the light of the working practice. The hon. Member for South Shields (Dr. Clark) asked for a two or three-year review, but I hope that we can have a good look at this at the end of one year —I would not put it as far away as the hon. Member for South Shields.
Cases that go to appeal may need laboratory investigations, and in reviewing the standards, it is important that we use laboratory investigations on borderline cases. Provision has been made for this in the regulations under the re-organisation that is being set up. The medical referees who are hearing the appeals have been authorised to commission outside clinical tests if these are considered necessary in the appeal cases. The hon. Member for Kingston upon Hull, East made a point about the health and safety regulation 174. This was news to me, and I shall ask the Department to investigate it. It is strange that in one set of fairly similar regulations, the charge is placed on the employers, and it has always been acceptable that the Government would not bear the cost of the appeal cases. However, in these regulations, it has never been formally decided who bore the cost.
Much has been made tonight of the cost of going to appeal in those cases. Having been a Minister in the Department of Health and Social Security, one understands about medical appeal cases and what goes with them. I cannot give the House any undertaking that I shall wave a magic wand and change things tonight, and Labour Members know that. There is a problem for a few people, but the iniquity of requiring a seafarer who has been refused a certificate of fitness to pay the cost is not 380 as bad as hon. Members have made out. I had anticipated that point being made in the debate tonight. I cannot believe that personal applications should always be paid for out of public funds, but if it proves to be a problem, there may need to be a re-think within the industry about the bearing of the cost of appeals. I ask Labour Members to leave this for further consideration, because it is not a matter than can be solved in debate, and not—
§ Mrs Chalker
I have six minutes left and many questions to answer. I shall try to get through them, and if there is a second left I shall give way to the hon. Gentleman.
In carrying out the initial medical examinations I should expect all medical practitioners listed to undertake their duties seriously. I hope that a larger proportion of them will take the further training in occupational medicine offered by the Royal College of Physicians. Then eventually we shall reduce the need for appeal. That is important.
Hon. Members asked about foreign ships and foreign crews on United Kingdom ships. The regulations require the crews of foreign ships to carry certificates attesting to medical fitness. That will be an important improvement. Hon. Members laughed when it was said that certificates could be bought. I hope that the international convention, which is binding on all the nations that sign it, will ensure that that will not happen in future. Until an international convention is ratified in a number of countries there is no hope of wiping out the wrongs that have occurred in some places. That is why we are keen to proceed.
Non-domiciled seafarers on United Kingdom ships are required by the regulations to be examined and passed as fit by an approved United Kingdom doctor, or to have a medical fitness certificate issued in another country which has ratified the convention or in a non-convention country which is known to have an acceptable and properly constituted medical examination system for seafarers. We have sought to provide for the circumstances about which hon. Members have asked.
I was asked about ships of less than 1,600 tonnes. As part of the international maritime convention, bearing in mind the standards of training certification and watchkeeping, in the next few years we shall examine the regulations which give rise to the need to extend medicals to some on board. The medicals are designed for deck hands and engine hands, who guard the safe passage of the ship. Discussions about exemption from medicals do not apply to people in charge of running the ship. In the next few years, some ships of less than 1,600 tonnes will be included. That is a matter for further discussion on which the Department welcomes representations.
The hon. Member for Wigan asked about medical standards. I hope that I have given him the assurances that he sought. We shall keep a close watch on standards. If a man is declared permanently unfit and the case goes to appeal, clear monitoring will take place. The reports by referees appointed by the Secretary of State will be considered carefully by the Department, particularly in the first crucial year.
We shall obviously monitor age, because that can be an important factor in relation to some of the specified illnesses. Now that severance pay is available on a par with redundancy pay to those who are medically unfit, no-one 381 can accuse the Government of introducing the regulations to aid the slimming down of the shipping industry. That is certainly not so.
The hon. Gentleman also asked about the seafarers' concern for the medical profession. I hope that what I have had to say about the involvement of the Royal College of Physicians and the Society of Occupational Medicine will reassure him that we are going down a positive path and looking at what is necessary for the future safety of those who sail our ships.
I commend the regulations to the House and ask hon. Members to reject the prayer. I should tell the hon. Member for Battersea (Mr. Dubs) that, because of the wording in paragraph 11 of merchant shipping notice M1061, his constituent would not benefit because his epilepsy was obviously controlled by drugs and the regulation specifies "without any treatment".
I hope that the House will approve the regulations with my assurance that they will be most carefully monitored and reviewed in a year.
§ Question put:
§ The House divided: Ayes 90, Noes 202.383
|Division No. 11]||[11.30 pm|
|Barron, Kevin||Haynes, Frank|
|Bell, Stuart||Hughes, Mark (Durham)|
|Bennett, A. (Dent'n & Red'sh)||Hughes, Robert (Aberdeen N)|
|Bermingham, Gerald||Hughes, Sean (Knowsley S)|
|Blair, Anthony||Litherland, Robert|
|Boyes, Roland||Lloyd, Anthony (Stretford)|
|Bray, Dr Jeremy||Lofthouse, Geoffrey|
|Brown, Gordon (D'f'mline E)||Loyden, Edward|
|Brown, N. (N'c'tle-u-Tyne E)||McCartney, Hugh|
|Brown, R. (N'c'tle-u-Tyne)||McDonald, Dr Oonagh|
|Brown, Ron (E'burgh, Leith)||McKelvey, William|
|Caborn, Richard||McWilliam, John|
|Callaghan, Rt. Hon. J.||Madden, Max|
|Callaghan, Jim (Heyw'd & M)||Michie, William|
|Campbell-Savours, Dale||Mikardo, Ian|
|Clark, Dr David (S Shields)||Miller, Dr M. S. (E. Kilbride)|
|Clay, Robert||Nellist, David|
|Cocks, Rt Hon M. (Bristol S.)||O'Brien, William|
|Cohen, Harry||O'Neill, Martin|
|Corbett, Robin||Parry Robert|
|Corbyn, Jeremy||Pike, Peter|
|Cowans, Harry||Powell, Raymond (Ogmore)|
|Crowther, Stan||Prescott, John|
|Cunliffe, Lawrence||Randall, Stuart|
|Dalyell, Tarn||Redmond M.|
|Davies, Rt. Hon. Denzil (L'lli)||Richardson, Jo|
|Davies, Ronald (Caerphilly)||Robinson, G. (Coventry NW)|
|Deakins, Eric||Ross, Ernest (Dundee W)|
|Dixon, Donald||Sedgemore, Brian|
|Dormand, Jack||Skinner, Dennis|
|Dubs, Alfred||Smith, C.(lsl'ton S & F'bury)|
|Duffy. A. E. P.||Smith, Rt Hon J. (M'KI'ds E)|
|Eastham, Ken||Spearing, Nigel|
|Evans, John (St. Helens N)||Stewart, Fit Hon D. (W Isles)|
|Ewing, Harry||Stott, Roger|
|Fatchett, Derek||Strang, Gavin|
|Fields, T. (L'pool Broad Gn)||Straw, Jack|
|Fisher, Mark||Thorne, Stan (Preston)|
|Flannery, Martin||Tinn, Jamas|
|Foster, Derek||Wardell, Gareth (Gower)|
|Freeman, Roger||Wareing, Robert|
|George, Bruce||Wilson, Gordon|
|Godman, Norman||Winnick, David|
|Gould, Bryan||Tellers for the Ayes:|
|Hardy, Peter||Mr. Allen McKay and|
|Harrison, Rt Hon Walter||Mr. James Hamilton.|
|Alexander, Richard||Harvey, Robert|
|Alton, David||Hawkins, C. (High Peak)|
|Amess, David||Hawkins, Sir Paul (N'folk.SW)|
|Arnold, Tom||Hawksley, Warren|
|Ashby, David||Heathcoat-Amory, David|
|Aspinwall, Jack||Heddle, John|
|Atkinson, David (B'm'th E)||Hickmet, Richard|
|Baker, Nicholas (Dorset N)||Hind, Kenneth|
|Batiste, Spencer||Holland, Sir Philip (Gedling)|
|Beith, A. J.||Holt, Richard|
|Bellingham, Henry||Howarth, Alan (Stratf'd-on-A)|
|Biggs-Davison, Sir John||Howell, Ralph (Norfolk N)|
|Blackburn, John||Howells, Geraint|
|Blaker, Rt Hon Peter||Hubbard-Miles, Peter|
|Boscawen, Hon Robert||Hughes, Simon (Southwark)|
|Bottomley, Peter||Hunt, David (Wirral)|
|Bowden, Gerald (Dulwich)||Hunter, Andrew|
|Boyson, Dr Rhodes||Johnson-Smith, Sir Geoffrey|
|Braine, Sir Bernard||Jones, Gwilym (Cardiff N)|
|Brandon-Bravo, Martin||Kershaw, Sir Anthony|
|Brinton, Tim||Key, Robert|
|Brooke, Hon Peter||King, Rt Hon Tom|
|Brown, M. (Brigg & Cl'thpes)||Kirkwood, Archibald|
|Browne, John||Knight, Gregory (Derby N)|
|Bruce, Malcolm||Knowles, Michael|
|Bruinvels, Peter||Knox, David|
|Bryan, Sir Paul||Lang, Ian|
|Buck, Sir Antony||Latham, Michael|
|Bulmer, Esmond||Lawler, Geoffrey|
|Burt, Alistair||Lee, John (Pendle)|
|Butterfill, John||Lester, Jim|
|Carlisle, John (Luton N)||Lilley, Peter|
|Carlisle, Kenneth (Lincoln)||Lord, Michael|
|Carttiss, Michael||Lyell, Nicholas|
|Chalker, Mrs. Lynda||McCurley, Mrs Anna|
|Channon, Rt Hon Paul||McNair-Wilson, M. (N'bury)|
|Chapman, Sydney||Major, John|
|Chope, Christopher||Malone, Gerald|
|Clark, Hon A. (Plym'th S'n)||Maples, John|
|Clarke Kenneth (Rushcliffe)||Mather, Carol|
|Cockeram, Eric||Maude, Francis|
|Conway, Derek||Meadowcroft, Michael|
|Coombs, Simon||Merchant, Piers|
|Cope, John||Meyer, Sir Anthony|
|Couchman, James||Miller, Hal (B'grove)|
|Currie, Mrs. Edwina||Mills, Iain (Meriden)|
|Dicks, T.||Moate, Roger|
|Dorrell, Stephen||Montgomery, Fergus|
|Douglas-Hamilton, Lord J.||Moynihan, Hon C.|
|Dover, Denshore||Murphy, Christopher|
|Dunn, Robert||Neale, Gerrard|
|Dykes, Hugh||Neubert, Michael|
|Evennett, David||Newton, Tony|
|Eyre, Reginald||Nicholls, Patrick|
|Fallon, Michael||Norris, Steven|
|Favell, Anthony||Onslow, Cranley|
|Fenner, Mrs. Peggy||Oppenheim, Philip|
|Forman, Nigel||Osborn, Sir John|
|Forsyth, Michael (Stirling)||Ottaway, Richard|
|Forth, Eric||Page, Richard (Herts, SW)|
|Fox, Marcus||Patten, John (Oxford)|
|Franks, Cecil||Penhaligon, David|
|Fraser, Peter (Angus East)||Pink, R. Bonner|
|Freeman, Roger||Powell, William (Corby)|
|Gale, Roger||Powley, John|
|Galley, Roy||Prentice, Rt Hon Reg|
|Gardiner, George (Reigate)||Price, Sir David|
|Garel-Jones, Tristan||Proctor, K. Harvey|
|Goodhart, Sir Philip||Raffan, Keith|
|Goodlad, Alastair||Rhodes James, Robert|
|Gow, Ian||Rhys Williams, Sir Brandon|
|Griffiths, Peter (Portsm'th N)||Ridsdale, Sir Julian|
|Ground, Patrick||Robinson, Mark (N'port W)|
|Gummer, John Selwyn||Rowe, Andrew|
|Hamilton, Hon A. (Epsom)||Ryder, Richard|
|Hamilton, Neil (Tatton)||Sayeed, Jonathan|
|Hampson, Dr Keith||Shaw, Sir Michael (Scarb')|
|Hanley, Jeremy||Shelton, William (Streatham)|
|Hargreaves, Kenneth||Shersby, Michael|
|Silvester, Fred||Twinn, Dr Ian|
|Skeet, T. H. H.||van Straubenzee, Sir W.|
|Smith, Tim (Beaconsfield)||Viggers, Peter|
|Soames, Hon Nicholas||Waddington, David|
|Speed, Keith||Wakeham, Rt Hon John|
|Speller, Tony||Walden, George|
|Spence, John||Wall, Sir Patrick|
|Spencer, D.||Waller, Gary|
|Spicer, Michael (Worcs, S)||Wardle, C. (Bexhill)|
|Stanbrook, Ivor||Warren, Kenneth|
|Steen, Anthony||Watson, John|
|Stern, Michael||Watts, John|
|Stevens, Lewis (Nuneaton)||Wells, Bowen (Hertford)|
|Stevens, Martin (Fulham)||Whitfield, John|
|Stewart, Andrew (Sherwood)||Whitney, Raymond|
|Stradling Thomas, J.||Wilkinson, John|
|Taylor, John (Solihull)||Wolfson, Mark|
|Temple-Morris, Peter||Wood, Timothy|
|Terlezki, Stefan||Woodcock, Michael|
|Thomas, Rt Hon Peter||Yeo, Tim|
|Thompson, Donald (Calder V)||Young, Sir George (Acton)|
|Thompson, Patrick (N'ich, N)|
|Thorne, Neil (Ilford, S)||Tellers for the Noes:|
|Thurnham, Peter||Mr. Douglas Hogg and|
|Tracey, Richard||Mr. Tim Sainsbury.|
§ Question accordingly negatived.