Social Security Regulations (Chronic Bronchitis and Emphysema) Amendment (Hansard, 16 March 1994)

§ Mr. Michael Clapham (Barnsley, West and Penistone)

I beg to move, That leave be given to bring in a Bill to amend the Social Security (Industrial Injuries) (Prescribed Diseases) Regulations to reduce to ten years the aggregate period of underground work required to qualify for benefits in cases of chronic bronchitis and emphysema; to amend the rules relating to medical assessment of percentage levels of disablement in people suffering from these conditions; and for connected purposes. I should like to declare an interest. I am sponsored by the National Union of Mineworkers.

My Bill would change in four main ways the prescription test that was introduced in the Social Security (Industrial Injuries) (Prescribed Diseases) (Amendment No. 2) Regulations 1993. First, it would reduce the qualifying period from 20 years to 10 years. Secondly, it would reduce the disablement threshold from 14 per cent. to multiples of 10 per cent. Thirdly, it would specify that soft exposure X-rays should be used for diagnosing dust retention. Finally, it would replace the FEV1 test with a thorough and sensitive medical examination.

I want to consider the background to the original regulations and to explain the rationale on which my amendments are based. The original regulations were based on the recommendations of the Industrial Injuries Advisory Council. After more than 20 years, the council has finally accepted that there is a causal connection between the exposure to coal dust and the development of chronic bronchitis and emphysema. As a result, it has recognised that the disease should be prescribed in relation to deep coal mining and recommended the application of a prescription test. That test has already proved to be too harsh.

The failure rate in South Yorkshire, according to the Department of Social Security office in Doncaster, is estimated to be 90 per cent. of applicants. I am advised that the overall failure rate nationally is the same. That means that, of the 23,477 applications received in the first wave, about 21,000 will be turned down. That cannot be what the Industrial Injuries Advisory Council intended.

Let me give the House an example of the sort of case that is being rejected. Last Saturday week, I received a telephone call from Mr. G. Scott, a former miner. He told me that he is so enfeebled by breathlessness that he has to use a nebuliser to assist his breathing. He has been treated for chronic bronchitis and emphysema for years, but when he was recently subjected to the prescription test he was told by the examining authorities that he did not have a sufficient degree of the disease for a disablement assessment. Mr. Scott is not unique. I have received letters from former miners who are similarly disabled and have had the same experience at the hands of the medical authorities.

I shall explain the rationale that underpins the amendments in my Bill. Pneumoconiosis, chronic bronchitis and emphysema have the same causation: coal dust in the lungs. It is an established fact that pneumoconiosis, which is defined as fibrosis of the lungs, is a more complicated stage than dust retention and can be contracted by an exposure of 10 years or less. That fact is recognised in the regulations on pneumoconiosis that 886 specify a qualifying period of 10 years. It is, therefore, illogical that the less complicated stage of dust retention should require a longer exposure period.

The second and related difficulty that my Bill seeks to amend involves the level of disablement threshold. Under the original regulation, that level is 14 per cent., but my Bill proposes to reduce it to multiples of 10 per cent. For my reasoning, I again turn to the example of the pneumoconiosis regulations. In cases where that disease is accompanied by chronic bronchitis and emphysema, and where the examining authorities consider that the former disease worsens the latter, additional assessments are given in multiples of 10 per cent. It is, therefore, unreasonable to move away from the already established principle of assessing chest diseases, particularly chronic bronchitis and emphysema in relation to coal miners, in multiples of 10. On those two matters, one cannot avoid the conclusion that the Industrial Injuries Advisory Council saw itself as the controller of the Government's purse.

I have referred to the case of Mr. Scott. Let me now give the House two hypothetical, but extremely realistic, examples of miners who were suffering from the disease but could be ruled out of benefit because they did not meet one or other of the criteria. Two miners who work together underground for 17 or 18 years both leave underground work together. One continues working in the colliery on the surface in dusty conditions, and the other takes a job as a school caretaker. When they reach retirement age, both have respiratory conditions and both apply to the pneumoconiosis medical board.

The former miner who left the pit is found to have pneumoconiosis with attendant chronic bronchitis and emphysema. He would receive 10 per cent. for the pneumoconiosis, plus 10 per cent. because the pneumoconiosis worsens the chronic bronchitis and emphysema, and would finish with an assessment of 20 per cent. The miner who had spent all his life at the colliery is examined and is found to have dust retention with very acute chronic bronchitis and emphysema. However, as he is not a pneumoconiotic, he cannot be afforded an assessment under that regulation. He is referred to the chronic bronchitis and emphysema regulation, but immediately is ruled out of benefit because he does not meet the 20-year criterion. Again, I contend that that cannot be a fair procedure.

My second example relates to redundant miners. Tens of thousands of former miners have now been made redundant and have not been able to work for 20 years underground. Sadly, but inevitably, some of those young men will develop chronic bronchitis and emphysema due to coal dust retention in the lungs. However, under the qualifying period of 20 years, they will be ruled out of benefit.

In preparing the Bill, I sought medical advice from an eminent chest physician who sits on the regional medical appear tribunal, and that advice was of particular value for the third and fourth amendments of my Bill. Diagnosing dust retention in the lungs from X-rays is an extremely precise art. I am advised that it is made difficult because the normal type of hospital X-ray may not show the condition. A surer way of making an accurate diagnosis—it is called for in my Bill—is to use specific soft exposure X-rays.

Finally, my Bill calls for the replacement of the FEV1 test by a more sensitive medical examination. I am advised that, medically, although the test measures the overall lung function, it is possible for a man to be more breathless due 887 to coal dust induced chronic bronchitis and emphysema and, because of that, to suffer greater disability than a man who has a one litre reduction in the lung function test. Clearly there needs to be an examination to eliminate other causes of breathlessness, and there needs to be a more sensitive examination under the pneumoconiosis regulations. The disease is diagnosed from X-ray evidence and medical examination.

Even when it is accompanied by chronic bronchitis and emphysema, the degree of disability is determined by a medical examination. The amendments in my proposed Bill would make the prescription test for diagnosing chronic bronchitis and emphysema in coal miners and former coal miners a fairer and more just procedure. I urge the House to accept the motion.