HL Deb 07 May 1930 vol 77 cc375-94

Order of the Day for the House to be put into Committee read.

Moved, That the House do now resolve itself into Committee.—(Earl Russell.)

On Question, Motion agreed to.

House in Committee accordingly:

[The LORD STANMORE in the Chair.]

Clause 1:

Extension, of 15 & 16 Geo. 5. c. 84, s. 47, to industries involving exposure to asbestos dust.

1. Section forty-seven of the Workmen's Compensation Act, 1925 (which provides for the application of that Act to workmen suffering from silicosis), shall extend to industries and processes involving exposure to asbestos dust; and accordingly the amendments specified in the second column of the Schedule to this Act shall be made in the provisions of the said section specified in the first column of that Schedule.

VISCOUNT BRENTFORD moved to leave out Clause 1. The noble Viscount said: I am very sorry to trouble the Committee in this matter, but your Lordships will remember that on the Second Reading there was another important debate coming on, and I said I would reserve one or two points which were of importance until the Committee stage. This is a Bill to enable the Home Secretary to make a new arrangement in regard to the examination of all persons who are or may be affected with silicosis. That, I believe, is Clause 2 of the Bill. That will affect 70,000 workmen, and will involve considerable expense, in regard to which I hope to get an explanation from the noble Earl opposite. But in addition to that the Home Secretary has included in this Bill a clause altering the Workmen's Compensation Act, to make the conditions which already apply to silicosis applicable to a new disease called asbestosis. Silicosis is a fibrous disease of the lungs occasioned by the inhalation of silica dust. It has apparently been discovered during the last few years that there are a certain number of workers engaged in asbestos factories who may inhale asbestos dust, and that that sets up a somewhat similar form of disease—what doctors call asbestosis. I asked several doctors what they would do in such cases, and they all admitted that they had never heard of the disease—it is as new as that. I am now moving to omit Clause 1 of the Bill so as to strike asbestosis out of the Bill.

There has been a very important Home Office Report by Dr. Merewether, an eminent doctor and inspector of factories, and an engineering inspector of factories, on this subject, and quite early in their Report, on page 3, these words occur:— An early survey of the industry in 1910–11 by the Department did not disclose any evidence of the existence of a serious health hazard in the industry. So far as is known at present there are, as a matter of fact, only 2,200 workmen who could by any possibility be exposed to the infection of this dust. That is also part of the Report that these gentlemen make. In addition to that, there were until recently only three known deaths—one in 1900, I think, one in 1904, and another one recently. But last year 363 workmen employed in the industry were examined in order to find out whether the disease was very serious or not, and, quite rightly, they took these 363 men who had been longest employed in the industry, so that if there were cases of asbestosis or fibroid disease of the lungs from the inhalation of this dust, they would be able to find it out. They did come to the conclusion that 105 out of that number were affected by this form of fibrosis.

I may add that silicosis gave me a great deal of trouble when I was Home Secretary, and I was responsible for making several Orders for the prevention, as far as we could, of silicosis in various trades, notably the grinding trade of Sheffield, and some of the sandstone quarrying work. But before we did anything with regard to the important question of com- pulsory medical examination in all these trades we tried all we could to diminish the disease by various Orders insisting upon various schemes for limiting or preventing the effects of the disease. In regard to asbestosis these doctors, on page 10 of their Report, say that the increasing application of methods for the suppression of dust will have a cumulative effect in reducing the fibrosis incidence rate in future years. I think it very possible—more than possible, very probable—that by the making of Orders by the Home Secretary dealing with the prevention of disease it will not be necessary to insist upon this very troublesome and, to the employers and I think to the workmen also, unpleasant necessity of having the whole of the men examined every year.

The doctor and his colleague go on to suggest certain preventive measures. I do not think it is necessary to weary your Lordship with them because there Are Many forms of manufacture in which asbestos dust is used and they suggest various forms of prevention for each of those manufactures. I do not think the noble Earl opposite would desire me to weary the House with all these suggestions, but he will admit, I think, that the doctors in their very careful Report have made suggestions for the prevention of the disease by the application of various items of machinery, very largely the extraction of dust by ventilation shafts and so forth, which I think and which they think—what they think is more important than what I think—would have the effect of minimising the disease.

It comes to this. Here is a disease which so far as is known has caused only four deaths and which at present is not within the provisions of the Workmen's Compensation Acts. The House of Commons at my request in 1925 put silicosis in and I think the result has fully justified that. I give the noble Earl anything he can make out of the fact that I put this disease in and that the inclusion of the disease, in view of the very great burden an the employer, has been justified by the compensation which has been paid to the workpeople. But on the whole I think the time has hardly come to put in this new disease. There is not sufficient certainty as to the number of deaths and as to the incidence of the disease itself, and no real effort has yet been made to prevent it. The noble Earl is a man of the world as well as a Minister, and I am sure he will agree with me that when once a disease is included in the list of diseases it becomes more prevalent. I do not wish to say more than that. Possibly the noble Earl will remember that when miner's nystagmus was included in the workmen's compensation diseases the House was told that there would not be more than 200 or 250 cases. There are now 8,000 cases claiming compensation for that disease. Naturally, diseases have a tendency to become more prevalent when there is compensation.

I am sure it is for the advantage of the men themselves, and I think your Lordships will agree with me that it is possible, that prevention should be tried rather than that compensation should be given. If we can prevent these men having what is a very uncertain and after a number of years—because it takes many years to produce asbestosis or silicosis in an extreme degree—an unpleasant disease, it is far better to ask the Home Secretary, or to leave it to him, to make the necessary Order and to insist upon the necessary efforts for the prevention of disease, before giving him power to include it for compensation and medical examination within the terms of the provisions of the remainder of the Bill. In those circumstances, I thought it my duty, as the Bill is supposed to emanate, and does emanate, from the Report of a Committee which I appointed myself when I was at the Home Office—

EARL RUSSELL

Hear, hear.

VISCOUNT BRENTFORD

The noble Earl will remember that it was appointed on silicosis and not on asbestosis. I was questioned on this matter of asbestosis in the House of Commons in 1928. I had two questions put to me, and on both occasions the answer was prepared for me by the very able officials of the Home Office who, I take it, are those who are in support of this Bill at the present moment. On both those occasions I was advised to say to another place that the matter had been carefully investigated by the medical inspectors, and should their inquiry show that any special precautions were required the necessary steps for the purpose would be taken. Again, in reply to another question in the month of February of last year, I said that the effects of this dust were already the subject of a comprehensive inquiry by the medical inspectors to determine the precautions necessary for the prevention of a disease. That was the view of the Home Office in 1928 and 1929.

These medical inspectors have gone very fully into it and, in accordance really with the answer I was authorised by my Department to give in the House of Commons, they have made various suggestions for the prevention of the disease. Had I remained there I should have been bound by the answer I gave in the House of Commons, and I should have made the necessary Orders for the prevention of the disease in accordance with the view of the factory medical men who had reported. In the circumstances, I think it would be better for the present Home Secretary to make those Orders rather than to ask now for the inclusion of this very new disease under the provisions of the Workmen's Compensation Acts and its inclusion in this very elaborate scheme of medical investigation proposed in the remaining clauses of this Bill. I beg to move.

Amendment moved— Page 1, line 6, leave out Clause 1.—(Viscount Brentford.)

EARL RUSSELL

I am rather surprised at the speech made by the noble Viscount opposite. I was a little surprised altogether at his attitude towards this Bill; but he has now developed his argument and, as I understand it, I think it is this. The disease has only recently been discovered. The extent of the disease is not large. Preventive measures would at present be sufficient as apart from compensation measures, and the Home Secretary would be wise to take those preventive measures and not to put it under a scheme similar to silicosis. That, I understand, to be the outline of the argument he has offered to your Lordships. I think I shall be able to show your Lordships that that is really rather a mistaken argument. Among other things, the noble Viscount said that there had been only three deaths reported. As a matter of fact, many Orders have been made where there has been no mortality from the disease preceding the Order. The noble Viscount has himself made Orders and included in the scheme for silicosis many processes in which there is undoubtedly a very definite risk, but which could not show any mortality figure approaching that for the asbestos industry.

If the argument is that the mortality rate is so small that you need not take any account of it, I think it is clearly contradicted by the facts and by what was the policy of the Home Office under the noble Viscount. Eleven fatal cases were referred to on page 15 of the Report and those have now risen to fourteen. At the bottom of page 18 of the Report there is a paragraph which says that up to the end of 1929 there were ten cases in which an advanced degree of asbestos fibrosis without tuberculosis was the primary cause of death. Then there was an eleventh case which was asbestos fibrosis complicated with pneumonia. Those deaths, with one exception, were in the years 1927 to 1929, and those 11 cases have now risen to 14, which is, after all, very considerable. There were in addition three deaths from asbestosis associated with tuberculosis. The figure is not 3 but 14, and in 8 of the 17 fatal cases the period of total disablement before death varied from six months to several years, and in four cases from a few days to a few weeks. With regard to the general incidence rates of this disease, they are given on page 10 of the Report and, although they are 1 in 8 among those actually employed and at work, if you exclude those employed less than five years—and it is stated quite clearly this disease does not begin to show itself in less than something between five and ten years, and rather nearer the upper limit than the lower—and take all those who have been employed more than five years, you get an incidence rate of 1 in 3, which is very considerable.

Your Lordships should remember that these figures are really very conservative figures, because they exclude people who have been disabled and have left the industry because of that disablement. If you were able to collect the statistics of those who passed through the industry and had been disabled, the figures would probably be worse. Of the 95 cases which were investigated, there were 31 slight, 55 that were moderate and 9 that were advanced, and 3 of those 95 have died since they were examined. The statement in the Report that exposure to asbestos gives a more diffuse fibrosis than that due to exposure to free silica does not mean that the effects are less serious. As a matter of fact, the contrary is the case because, while the silicotic fibrosis is laid down in more or less isolated nodules, the asbestos fibrosis is laid down as a fine cobweb permeating ultimately the greater portion of the lungs and leaving very little sound tissue. The Home Office regard the evidence furnished by this Report as evidence of a very serious risk indeed, the sort of risk which, I am bound to say, I think would probably have led the noble Viscount himself to take action if he had still been at the Home Office and had those figures before him. Prevention is by no means done away with by the fact that you are going to make a scheme providing for compensation, but prevention can run side by side with it, and one very material matter in the prevention is the periodic medical examination. I am advised that the Home Secretary would have no power to require these examinations unless a scheme of this sort was made.

It would be possible to schedule this disease, if necessary, as an industrial disease. That could be done under the existing legislation, but that would have consequences which really in the end would be undesirable, even from the employers' point of view. First of all, the examination would have to be made by the certifying surgeon instead of by a specialist in this disease, and he might wrongly diagnose some ordinary tubercular affection as a fibrosis when it was not, thereby charging the employer with what he was not due to pay. Moreover, a matter of that sort does not involve a scheme, and, therefore, the whole cost of compensation would fall upon the individual employer, even supposing that the workman had acquired a degree of infection for some years before he came to the employer. To that extent also it would damage him, and, moreover, it would hurt the employer most of all in this way, that not having the periodic examinations you would not remove from the industry people who were particularly susceptible to this disease, and who would, in due course, become a charge upon it. For all those reasons it really would not be in the employers' interest to deal with it under the ordinary work men's compensation provisions instead of in the manner proposed by this Bill, under which, as your Lordships know, by Clause 2, a special general medical body is to be set up under a general scheme of medical inspection by people who will be experts, and will be certain as to whether the disease has occurred or not.

I did not quite understand what the noble Viscount meant when he said a disease tends to become more prevalent. What he means surely is simply this, that you tend to give the right name to what has before been diagnosed wrongly. It might be said that appendicitis had tended to become more prevalent, but vast numbers of people in past years have died from appendicitis under another name, and that is all that would probably happen in this case. Whereas previously the case would probably have been certified as tuberculosis or pneumonia or an affection of the lungs, it would now be certified as due to asbestos fibrosis. It is a question of it becoming more rightly identified and discovered.

On Second Reading your Lordships may remember that Lord Askwith, speaking on behalf of the tin miners of Cornwall, was inclined to oppose the Bill. Since then a meeting has been held at which the tin owners were present, and at which the Bill was discussed. Lord Askwith has not only withdrawn his opposition on behalf of those owners, but they now support the Bill, and, I think, I ought to read to your Lordships the letter which he has written to me.

VISCOUNT BRENTFORD

That relates to silicosis.

EARL RUSSELL

Yes, but I think the argument is the same, as the noble Viscount will see. This is the letter:— Since the Second Reading I have been able to interview representatives of some of the chief Cornish tin mines, and am authorised to state, as far as these representatives were concerned, they would support the Bill. They thought that it was in the interest of the whole industry that a special scheme should ultimately be effected as in other industries, to consolidate the tin industry, and not leave it under the difficulty of the 'various industries' (silicosis) scheme. With this view they will endeavour to obtain the consent of the owners of the Cornish tin mines as well as the miners. The next sentence is the one I want to call special attention to because it applies equally to asbestos:— It cannot he denied that the scheme will be a serious liability"— I should not admit it will be serious in the case of asbestos industries which are on the whole more flourishing industries than the Cornish tin mines— upon an industry which it is hoped may revive from its present condition, particularly as so many miners have worked in South Africa, and may have the seeds of this difficult and obscure disease, but they recognise its importance to their work-people and will cordially co-operate with them in endeavouring to give the best effect to a suitable scheme which will promote the interests of all classes engaged in the Cornish tin industry. Those words apply absolutely to asbestos. The disease is a definite disease, capable of definite ascertainment. It takes a definite toll of human life and of human misery, and the people who suffer from it are as much entitled to compensation as any other workmen under the Workmen's Compensation Act. I can hardly believe that your Lordships will be willing when that plea is put forward on behalf of the Home Office and supported by the facts and figures I have given—I can hardly think your Lordships will be willing to have it said you turned down flatly the proposal in this Bill to insure and to protect workmen who suffer from that particular disease, which, after all, except that it applies to a small number, is on exactly the same footing as silicosis in regard to which, as the noble Viscount said himself, he had made several Orders. I hope your Lordships will not pass this Amendment and I hope that the noble Viscount, on reflection, will see his way to withdraw it.

VISCOUNT BRENTFORD

I thought it necessary that I should move this Amendment in order to get a statement from the noble Earl in regard to it. I do not want to press one way or the other this Amendment. I have evidence in regard to the matter from the employers, who feel considerable anxiety about it. I wonder whether the noble Earl could agree to a variation in the clause. Under the clause as it now stands any person who does anything with asbestos—for instance, the plumber who at my request comes to my house to attend to a hot-water pipe to prevent it becoming too heated, by means of asbestos—would be liable to have all his men who were engaged in that work, even if they did it only once every three or six months, examined. Equally the carpenter who puts a piece of asbestos sheeting up and cuts it with a knife, which would necessarily create a certain amount of asbestos dust, would also have to be examined. The suggestion of the employers, which I should like to put before the noble, Earl is this, that in Clause 1 instead of "shall extend to industries and processes involving exposure to asbestos dust" the words should be "shall extend to those processes in the fabrication of asbestos which involve exposure."

The whole of the Report of the Home Office officials relates to the manufacture of asbestos and not to the use of it in such forms as I have suggested. It would involve the possibility of a tremendous series of examinations all through ancillary trades which use asbestos for these purposes merely, and though they may technically or actually create a little dust by filing or cutting a piece of asbestos, that cannot be said to come within the gravamen of the charge. I wonder whether the noble Earl would be willing to consider an Amendment on these lines between now and the later stages of the Bill? If the Home Office is conducted now on the same lines as it was under the last Government I am sure there would be no desire to pass a clause in the Bill which might create considerable trouble and difficulty in a part of the industry which really does not seriously come under the complaint.

EARL RUSSELL

I think if there were any such danger as that which the noble Viscount suggests under the Bill an Amendment would be perfectly reasonable, but I think I must give him an analogy. He was responsible for the silicosis scheme and it might just as well be suggested that you can bring under that scheme the carter who shovels sea-sand into a cart from the shore. There might be some silica dust from that. The noble Viscount knows that the Home Office has always been perfectly reasonable about matters of this sort and that no industry would be subject to this except where there had been a case of asbestosis and where the incidence of asbestosis was a real thing. As a matter of fact under the scheme for silicosis only those cases in which definite risk occurs have been included. The same course would be followed in the case of asbestosis. Why does the noble Viscount think it likely that a different course would be taken by the present Home Secretary than by him? I think he may well leave the Bill as it is, but if he wishes to press the point and puts down an Amendment at a later stage I will certainly consider it.

LORD BANBURY OF SOUTHAM

The noble Earl says we had better leave this Bill alone because, as I understand him, the Home Office is perfectly reasonable. My experience is that Government Departments are by no manner of means reasonable, and I certainly would not wish the Bill to be left entirely to the discretion, reasonable or otherwise, of a Government Department.

THE MARQUESS OF SALISBURY

I was a little bit alarmed at the tone of the noble Earl's remarks until he got to the very end and then he said that if my noble friend puts down an Amendment at a later stage he will consider it. I do not think that he can be asked to do more than that; but I hope he will consider it with a fairly open mind. We do not want to have interfering legislation except where it is necessary. I do not go quite so far as my noble friend behind me, but I must say that I think the confidence which the noble Earl now reposes in Government Departments was not always characteristic of him. Perhaps he will remember former occasions when he has criticised Government Departments. All I desire to say is that I hope he will consider my noble friend's Amendment, if it is put on the Paper, with an open mind.

EARL RUSSELL

Such an Amendment will of course be considered by those who advise me—it is not really a matter for me—with an entirely open mind, but I would remind your Lordships that these schemes have to be laid before Parliament, so that if they were unreasonable they could be dealt with then.

LORD HANWORTH

May I say, as I have some experience in dealing with these matters in respect of industries and processes brought within Section 47 of the. Workmen's Compensation Act, that I have never found a case which has not been a proper case to be brought before the Courts. I think some misapprehension may arise from the structure of the Bill. All that it does is to say that Section 47 of the Workmen's Compensation Act is widened for the purpose of bringing within its ambit the processes involving exposure to asbestos dust.

EARL RUSSELL

Hear, hear!

LORD HANWORTH

I am perhaps more familiar with Section 47 of that Act than some noble Lords. That section gives power to the right and proper authorities to bring within the ambit of the Workmen's Compensation Act a particular disease. In other words it makes the inception of that industrial disease the happening of an accident. Unless and until there has been an Order made under Section 47 the Workmen's Compensation Act does not apply at all. All that this Bill does is that it gives a wider power to enable a further industrial disease, if and when necessary, to be brought within the character of those accidents for which compensation is given. I do not believe—although the noble Viscount has great knowledge and experience—that he could put clown an Amendment that would be useful. Equally I do not share any fear at all on this subject, because I am quite satisfied that a very important branch of compensation is introduced into the Workmen's Compensation Act by the method of Section 47, which allows industrial disease to be treated as the happening of an accident.

If the evidence—of which of course I have no knowledge—which is before the Home Office is sufficient to say that asbestos dust ought to give rise to similar rights and compensations as in many other cases, then it is quite right that it should be brought in as this Bill proposes. Then the right and proper authority, subject to its being brought before Parliament, will have power to include it under Section 47 so that the powers under Section 47 may be used in a proper case and the disease arising from asbestos dust may be treated as the happening of an accident and compensation paid. I have only ventured to intervene for a moment because it so happens that a great number of cases come before the Court over which I preside direct from the County Court. I do not think it would be fair either to employers or workmen to say that it would not be right to allow this power contemplated under Clause 1 to be exercised in the case of what may be a very painful and serious disease.

Amendment, by leave, withdrawn.

Clause 1 agreed to.

Clause 2:

Amendments of 15 & 16 Geo. 5. c. 84, s. 47.

2.—(1) The powers of the Secretary of State under Section forty-seven of the Workmen's Compensation Act, 1925, as extended by this Act, shall include power to make a general scheme applicable to all industries and processes and groups of industries and processes to which compensation schemes apply, for the purposes of coordinating the medical arrangements in connection with those compensation schemes; and provision may he made by such a general scheme—

  1. (a) for the establishment of a medical expenses fund to be administered by trustees appointed by the Secretary of State or otherwise as may be provided by the scheme:
  2. (b) for requiring such fees in respect of any examinations made or certificates given under the scheme, as may be prescribed by regulations made by the Secretary of State with the approval of the Treasury, to be paid into the said fund by or on behalf of employers and workmen, and for the recovery of such payments; and for the payment and recovery out of the said fund of any expenses arising in connection with the medical arrangements provided for by the scheme, or with the administration of the medical expenses fund, which are directed by the scheme to be so paid, subject to such exceptions in special cases as may be made by the scheme:
  3. (c) for any of the matters mentioned in paragraphs (d) and (e) of subsection (3) of the said Section forty-seven.
  4. (d) for securing that employers—
    1. (i) shall not employ in any industry or process involving exposure to silica dust or asbestos dust any workman who has been suspended in pursuance of the scheme or has refused or wilfully neglected to submit himself to any examination required in pursuance of the scheme;
    2. (ii) shall make such arrangements in connection with examinations as may be prescribed by the scheme;
    3. (iii) shall give to such medical officer or medical board as may be prescribed by the scheme such notice as may be thereby required of the commencement of any industry or process involving exposure to silica dust or asbestos dust:
  5. (e) for the recovery on summary conviction of monetary penalties in respect of any contravention or failure to comply with the provisions contained in the scheme for securing the matters mentioned in the last foregoing paragraph of this section, so, however, that such penalties shall not exceed five pounds for every day on which the contravention or failure occurs or continues.

(2) The general scheme and any regulations made for the purposes thereof may contain different provisions as respects different industries or processes or groups of industries or processes affected by the scheme or regulations, and subsections (4) and (5) of the said Section forty-seven (which relate to the laying of schemes before Parliament and to the notification thereof) shall apply to any such regulations as well as to any scheme.

(3) Any compensation scheme shall, in so far as it provides for any of the matters mentioned in paragraphs (d) and (e) of subsection (3) of the said Section forty-seven, have effect subject to the provisions of the general scheme.

(4) In this section the expression compensation scheme "means a scheme made under the said Section forty-seven providing for the payment of compensation by the employers of workmen in the industry or process or group of industries or processes specified therein.

VISCOUNT BRENTFORD moved to leave out Clause 2. The noble Viscount said: I move the omission of Clause 2 formally in order to put myself in order, but really I rise to ask the noble Earl whether he is able to give some information on a point I mentioned on Second Reading, that is as to the method of examination which is proposed. Under Clause 1 of this Bill there is brought in a new disease by an alteration of the Act of 1925, and Clause 2 will enable the Home Secretary to make a new form of order involving the examination of all people who may be engaged in the particular manufactures which may give rise to silicosis—or now, as we have agreed to Clause 1, to asbestosis. That involves the examination, presumably at least once a year, of something like 75,000 workmen. I found when I was at the Home Office that two doctors in a particular branch of industry were able to examine 1,600 workmen in one year. Each doctor may be assumed to examine 800 cases a year and I think that the House will agree that that is as much as any doctor can be expected to do.

Now there will have to be an examination of workpeople extending from the Orkneys to the Scilly Isles and from Anglesey to Kent. There is a large aggregation of workpeople in Sheffield, but of course there are small works all over the country. There will have to be a very elaborate system of medical inspection, involving, I think, something like 100 full-time doctors. I should like to know from the noble Earl something of the proposals of the Home Secretary, something of what he has in mind, because a great portion of the expense of this will, of course, fall on the employers who already contribute to the national health insurance system. If this Bill passes I take it the panel doctors under that scheme will be no longer called in in these cases, and the health insurance scheme will benefit to the extent that this new scheme involves the employment of other doctors and taking these cases out of the hands of panel doctors.

I think that, before we pass this, we ought to have information of the kind of scheme that the Home Secretary has in mind, and further—and this is very important—what proposals the Treasury will make in regard to the suggestion that some grant should be made from the Treasury towards the very great expense that will be involved. If the noble Earl can give me some ideas on that subject I think it will go far to minimise the anxiety of some employers regarding the effects of this new proposal. I do not know if it will be convenient if I mention now the further Amendment I have put down, in order to avoid making another speech. That course is sometimes adopted in another place. The procedure that is going to be adopted by the Home Secretary is important, since it involves the setting up of a new system of medical examination—

EARL RUSSELL

I think that is quite a different point, which it would probably be more convenient to consider later.

VISCOUNT BRENTFORD

Certainly. I only wished to avoid speaking again, but I will accept the suggestion of the noble Earl and will merely ask him if he will make a statement on the main lines of the proposal.

Amendment moved— Page 1, line 14, leave out Clause 2.—(Viscount Brent ford.)

EARL RUSSELL

The noble Viscount was courteous enough to give me full notice of the questions to which he wanted an answer. That course was not only courteous but also very convenient, for it enables me to give full answers which I think and hope he will find satisfactory. His first observation was to the effect that it is assumed that the general scheme contemplated in the Bill will be confined to medical arrangements and will not deal in any way with the question of compensation. My reply is that the assumption is correct. The general scheme cannot, and will not, deal with any question respecting the liability to compensation, the amount of compensation to be paid or the method by which it is to be provided. All such questions will continue to be dealt with, so far as necessary and in consultation with the industries concerned, by special schemes under the existing powers in Section 47 of the Act.

Then the noble Viscount put it to me that it is assumed that, whatever method is adopted for the payment of fees into the proposed Medical Expenses Fund, the amounts which any particular industry will have to bear will be dependent on the incidence of silicosis in that industry and not on the number of workers engaged in that industry. I can inform him that this also is correct. It is intended that the medical expenses should be met by fees based on the number of examinations made. The National Confederation of Employers' Organisations and other employers' associations, who made inquiry on this point and were informed of the method proposed to be adopted, have raised no objection subject to the cost being fairly apportioned between the different industries, and to their being adequately represented on an Advisory Committee which the Secretary of State has agreed to set up to advise as to the fees to be fixed and the method of collection, and generally on any financial questions arising in connection with the medical arrangements.

The third assumption put to me by the noble Viscount was to the effect that there is no intention of placing upon every industry under the different silicosis schemes the burden of having the whole of its workers periodically examined irrespective of the incidence of silicosis in the industry. This, too, is correct. In deciding whether the requirement as to periodic medical examinations should be applied to any industry or process, one of the governing factors will be the extent to which silicosis is prevalent in the industry. There is no intention to apply this requirement indiscriminately. It way be mentioned that there are indications that more than one industry not at present subject to this requirement is coming to realise how valuable these examinations are in the interests both of employers and workers. As I explained to your Lordships, this disease hardly becomes definite until after five years' work in the industry, and if its onset can be detected and the man removed from the industry the employer escapes liability to pay compensation.

The noble Viscount's fourth assumption was that, in view of the burden which the setting up of a Medical Expenses Fund will impose on industry, it is the intention of the Treasury to make some contribution to the cost. My reply to that is that, under the existing medical arrangements under the Various Industries Scheme, which it is proposed should be superseded by the General Medical Scheme, The Exchequer pays the remuneration and expenses of medical referees in cases of appeal from the certifying surgeon's certificate to a medical referee, and the cost of any radiographic or any other expert assistance obtained by the medical referee. In view of the saving to the Exchequer which will be effected by the new arrangements, the Treasury have agreed to make an annual contribution to the Medical Expenses Fund.

The noble Viscount's fifth question was this: If the proposal is to finance the Medical Fund by means of fees to be paid by the employer for each examination, how is it proposed to protect the employer against the cost of unnecessary periodic examinations or unnecessary examinations arising from unfounded claims? As regards periodic examinations the noble Viscount need have no apprehension that unnecessary examinations will be made. Periodic medical examinations will be made only as and when prescribed under the scheme, and the greatest care will be taken to see that they are made only in cases where they are really necessary and only to the extent to which they are really required.

In the case of the refractory and sandstone industries, the examinations in the highest risk occupations are required to be made annually; in others they are required biennially. The noble Viscount is familiar with these schemes and the procedure adopted. It is unlikely that the examinations prescribed for any industry or process will be more frequent than once a year, but it may be that in the light of experience an even longer period than two years might be allowed in certain occupations. As regards examinations arising from unfounded claims, it is agreed that some check on applications to the medical board will be necessary, such as requiring the workman or his dependants to support the application by medical evidence at his own expense, or to pay or deposit a fee in respect of the examination. It will be noted that, under Clause 2 (1) (b), fees in respect of examinations made or certificates given under a scheme may be required to be paid by or on behalf of employers and workmen.

Finally the noble Viscount asked me, in view of the scattered geographical distribution of the various industries affected by the different silicosis schemes, how it is contemplated that the examination of workers in the remoter districts will be dealt with. On that point, I think, he felt considerable uneasiness. My reply is that the existing medical hoard, under the existing schemes, which is divided up into three panels with centres at Sheffield, Newcastle and Bristol, already covers a very wide area, including works in districts as remote as Devonshire in the South and Caithness and the Orkneys in the North, with quarries in various parts of Scotland and Wales. This arrangement has so far proved adequate and worked quite satisfactorily. The new industries which will be brought under the General Medical Scheme will not very greatly extend the geographical area already covered, and it is confidently anticipated that the medical board, with the addition of one or possibly two new panels and centres, should be able easily to cover the whole field.

It must be borne in mind that, although there are various works in the industries concerned in outlying districts, the principal silica industries are to a large extent localised—e.g. the potteries in Staffordshire, cutlery and edge tools in Sheffield, and the refractories industries in the neighbourhood of Sheffield and in South Wales and Durham. It is possible, of course, that isolated claims will arise in remote districts which cannot be conveniently dealt with by the medical board on the spot, but in such cases it should usually be possible to arrange for the worker to attend the board at a con- venient centre. As regards fatal cases, it is the increasing practice of coroners to hold inquiries into deaths alleged to be due to silicosis in co-operation with the medical board, and this should help to prevent any trouble in dealing with death claims in remote districts.

I think I ought now to give the noble Viscount some figures as to costs. The additional cost is expected to be between £4,000 and £6,000 a year. The higher figure will he the amount if it is necessary to set up two new panels. That does not relate to asbestos fibrosis only but to both asbestos fibrosis and silicosis, and the total cost will rise from the present figure to something between £13,000 and £15,000 a year, meaning an addition of either £4,000 or £6,000. That covers the point raised by the noble Viscount and I hope satisfactorily covers it.

VISCOUNT BRENTFORD

I am very much indebted to the noble Earl for his full answer to the questions which I put to him. Those are questions submitted to me after consultation with the Employers' Federation, and I am sure that his reply will give very general satisfaction. His reply was very fully and clearly made. I think I heard from him in one of his earlier answers that the Government were going to appoint a Committee to prepare a scheme. I think he said an Advisory Committee.

EARL RUSSELL

Yes.

VISCOUNT BRENTFORD

In that ease I do not intend to press my Amendment, and I do not think it will be necessary to press my other Amendment of a proposed new clause. I think if a scheme is prepared in consultation with the Employers' Federation or the employers' representative on the Advisory Committee, that will meet all their objections or anxieties, and I am very much obliged to the noble Earl

EARL RUSSELL

I will repeat my answer in order to make it quite clear. The employers raise no objection to the method if the costs are fairly apportioned and if they are adequately represented on the Advisory Committee which the Secretary of State has agreed to set up.

VISCOUNT BRENTFORD

That would he before the Order was made?

EARL RUSSELL

I assume it would.

Amendment, by leave, withdrawn.

Clause 2 agreed to.

Remaining clause agreed to,

Schedule agreed to.

Bill reported without amendment.