WAR PENSIONS AND REHABILITATION.

HL Deb 20 January 1943 vol 125 cc671-89

LORD NATHAN rose to call attention to the present position regarding war pensions and rehabilitation; and to move for Papers. The noble Lord said: My Lords, I bring to your Lordships' notice to-day the question of war pensions and rehabilitation. It is a matter that must in its nature be very close to your Lordships' minds and hearts. The year 1943 is the year of decision; it may or may not be the year of victory. It must be the year of battles, and that means the year of casualties. That is, we do not know when all the Private Snookses will come home again, but we do know that before that a great many Private Snookses will come home wounded. When Private Snooks comes back wounded there are certain things he necessarily needs. He wants maintenance for himself and his family; he wants treatment for his disability; he needs rehabilitation so that he may be fit to work for himself and his family; he wants a job, and, above all, he wants independence. The problem of war casualties is in essence similar to the problem of industrial casualties. There are the same problems of maintenance, of rehabilitation, of re-employment. But the problem of war casualties is also very different from that of industrial casualties. Industrial casualties are actuarially calculable, they can be insured against and guarded against, but the scope of accident prevention for those in the Forces is very limited indeed.

War casualties are a special case for a number of reasons. There is the abnormal side of the problem. I do not know whether your Lordships fully realize that the number of war pensioners carried over from the last war is still 400,000. So far in this war the fighting has not attained the bitterness which we must expect, and while so far casualties have been relatively light we must anticipate the time when they are heavy and are measurable in scale with those of the last war. That is an indication of the size of the problem. And then Private Tom Snooks, wounded, has special claims for treatment, and there will be much widespread discontent if the right treatment is not given.

I wish to say quite frankly that actually the position with regard to pensions and rehabilitation is good. The Ministry of Pensions gives the impression of being run in a really businesslike way, and, unlike some Ministers and Ministries, Sir Walter Womersley and the staff under him, as I can testify from personal experience, far from putting themselves on the defensive against inquiries, show a real forthcoming-ness, a readiness to respond and a genuine spirit of co-operation. To say less would be ungracious and unjust, but I have special reasons for saying this. Important as it is, in my judgment, as I think your Lordships will agree, to those already disabled, it is of even greater importance for the morale of those whom the harsh necessities of war make the potential clients of the Ministry, that the vast numbers of men and women in the Fighting Services should have confidence in the Ministry of Pensions. I believe they can feel that confidence. But that is not to say that there is no room for improvement. I have a few observations to make to your Lordships in that regard this afternoon.

I do not propose to spend much time on the question of the rate of pensions, but I think it might be interesting if I were to draw your Lordships' attention to the fact that with 100 per cent. disability the soldier with a wife and three children is entitled at present rates to the sum of £3 4s. 7d. per week. This £3 4s. 7d. a week, is, except for the odd 7d., precisely the same amount as Sir William Beveridge proposes as benefit for the unemployed man with a wife and three children. But note that Sir William Beveridge's standard is a mere subsistence standard; and I think the question which your Lordships might perhaps like to ask is whether a subsistence standard is adequate for a man with 100 per cent. disability. Should the nation be satisfied to provide no more than a mere subsistence standard for those who are so grievously wounded as to have been assessed at 100 per cent. disability? Then, by a curious anomaly, the pensioner of this war at present receives somewhat less than the pensioner of the last war for the same degree of disability. A private soldier of the last war with 100 per cent. disability is entitled to 40s. per week; the private soldier of this war with 100 per cent. disability gets only 37s. 6d. per week. The reasons are based on history. The Great War pensions were subject to a sliding scale according to the cost of living, and though pensions went up as the cost of living went up, so that a 100 per cent. disability man got 40s. a week, the pension has remained at the peak notwithstanding some reduction in the cost of living index from the peak. The pensions of this war are based upon the current cost of living. Is it not an anomaly that these different rates should exist side by side? Might it not be proper to bring the pensioners of this war to the same rates of pensions as the pensioners of the last war?

Another rather curious anomaly arises in this way in die case of widows. The widow of a man in the Fighting Services dying in the Service may be ineligible for a war pension under the Royal Warrant. She may, however, be entitled to a widow's pension under the Contributory Pensions Act. As your Lordships are aware, a condition of a pension under that Act is that her husband should have paid two years' contributions under the Act. If he has not paid two years' contributions then there is no widow's pension. You may therefore get, and you do get, the anomaly of two widows whose husbands had died in the Fighting Services side by side under precisely similar conditions, and the one becomes entitled to a pension while the other is not so entitled. The soldier comes under the Contributory Pensions Act from the imminent when he joins the Army whether he was tinder the Act before the war or not. If he had already paid two years' contribution before joining the Forces his widow is eligible for a widow's pension under the Act even if he dies immediately after joining the Service. If, for instance, he has paid eighteen months' contribution before joining the Army, when he has been in the Army for six months his widow would be entitled to a pension.

But take the man who, before the war, did not come under the Act. Take for instance the small shopkeeper. His qualification begins only when he joins the Forces. If he dies six months or even eighteen months after joining there is no pension for his widow, though if he dies after two years there is. Your Lordships may perhaps think that it is a situation which requires amendment. I find it myself impossible to explain to the satisfaction of the ordinary man in the street why death in the Service should, in the one case, qualify, and in the other case not qualify, his widow for a widow's pension. The solution would appear to be simple. It would appear to be that every man on joining the Forces should be deemed to have paid his two years' qualifying contributions whether in fact he has paid or not; that he should receive a credit for two years' contributions is probably the technical means of effecting this. I hope the Minister of Pensions may feel that this is a case upon which negotiations might usefully be undertaken by him with the Service Departments, and also with the Ministry of Health and, I suppose, the Treasury, with a view to dissipating this anomaly. I am sure that your Lordships will agree that it is one which should be remedied. Death cannot be appraised on a time basis.

The class of case that gives rise to the greatest difficulty for the soldier and the greatest dissatisfaction among the public, is the treatment of claims in doubtful and border-line cases. I agree, and I think we must all admit, that the border line between the eligible claim and other claims is hard to trace. Where is it that the Army is responsible and where is it that the claimant is responsible? The test of eligibility under the Royal Warrant is, in non-technical terms, whether or not the wound, injury or disease was caused by, or aggravated by, war service. If a man is actually wounded—if he gets, for instance, a bullet through the head—there is of course no difficulty about deciding eligibility. He is entitled to a pension. The hole in his head is there for all to see and it has come from an enemy bullet. But if he sustains an accident, is he pensionable or not? The present position is by no means clear. If a man suffers an accident on his way to or from leave, on the railway journey for instance, he is, as I understand, entitled to a pension, though he is not entitled to a pension if he suffers the accident between the time of arrival at home and the time of his departure from home, for during the time he is actually at home he is deemed to be subject to no more than ordinary civilian risks of life. That seems to me an understandable and not unreason- able theory, but there are cases which are by no means so simple. If for instance a man is visiting a canteen within the precincts of his camp and is run over by a lorry on his way back to his quarters, apparently he is entitled to a pension. If, however, there is no canteen within the precincts of his camp and he visits a canteen just outside the camp, and is run over by the same lorry while returning to the same quarters, he is not entitled to a pension. It is very difficult to understand the basis of this discrimination. I would suggest that cases such as those to which I have referred need review with a view to their assimilation.

But what gives rise to the greatest difficulty, and is the least satisfactory feature of the pensions administration, is in regard to the treatment of those disabled by disease. One would think that if a man is once passed into the Forces with a medical grading A1 and he contracts some disease which involves his discharge, a right to pension would almost automatically arise. But that, in fact, is not necessarily the case and undoubtedly little nests of discontent have been created all over the country because of the situation which has arisen by reason of this way of treating matters. On medical examination a man is asked to state from what illnesses he has suffered during his life; he is asked to give a medical history, and his statement is, of course, taken into account by the examining medical officers. If he has said, and said truthfully, that his health has been good and he is passed A1, it would, in my submission, seem logical that the State should accept responsibility for any deterioration in his health involving his discharge from the Army. Similarly, if he discloses some ailment, and is then accepted for the Army on a proper grading but is afterwards discharged for ill-health, the deterioration would seem to give rise to a good claim for pension.

Take the case of a man who three months after he joins the Army develops, let us say, duodenal ulcer, and is subsequently discharged on that account. Pension or no pension? I believe the practice at present is that in such cases no pension is awarded. But if the man developed duodenal ulcer after eighteen months in the Army there would be an entitlement. Or take cancer. On medical examination a man has declared in perfect good faith that he has suffered from no disease and he is passed A1. A little time after he joins the Army it is discovered that he is suffering from cancer. Admittedly this would not have been discoverable even if it had existed when he was medically examined. Pension or no pension? I understand the practice is that if, for instance, cancer of the leg is disclosed within three or four months of a man joining the Army he is regarded as pensionable because, according to my understanding, cancer of the leg will disclose itself before it is three months old. But if, on the other hand, he develops cancer of the lung he is not entitled to pension because that may have been latent, even though unknown, at the time he joined the Army.

It is obvious, in dealing with the ordinary man in the street and his relations, that it is extraordinarily difficult to explain to the man and woman in the Forces and their families upon what basis pensions are awarded in cases of disease when such apparent disparity in entitlement so often arises. Surely, there is a case for erring on the side of generosity and lenience, and this would have the tremendous psychological advantage of giving to those in the Forces and to their relations. But does not it in fact all lead up to the suggestion that it is imperative that appeal tribunals should be set up at the earliest possible moment? I know the difficulties of finding personnel to man these tribunals. If the analogy of the last war be followed, I believe that it will come within the province of the noble and learned Viscount who sits on the Woolsack to select the president and perhaps—I know not—the whole of the personnel for these tribunals. It is suggested, no doubt with a good deal of substance, that it would be difficult, at this time, to find lawyers and doctors to act as chairmen or members of such tribunals. But is it necessary that they should be lawyers or doctors? The problems with which the tribunals would be confronted would be simply problems of eligibility. They would not be matters of assessing degrees of disability—these are matters for the medical boards. The tribunal would be concerned merely with the question of right to pension or no right. In other words, it is a question of evidence.

I should be the last to dissent from the view that lawyers are those who are best qualified to adjudicate on matters of evidence. But if there be a shortage of lawyers for this purpose, as there may be, surely there are many senior officers—each of us knows some—who, on grounds of age, Lave been retired from the Services who could be called in. These officers have, while on the Active List, been entrusted with the greatest responsibilities in regard to matters of evidence. They have sat upon courts martial, presided at courts martial, reviewed the decisions at courts martial, and have adjudicated upon serious offences involving periods of imprisonment. Surely, men with that kind of experience have some qualification for adjudicating on questions of eligibility ender the Pensions Warrant. I know, and I am glad of it, that the Minister has recently set up a small Committee to look into the possibility of now establishing these appeal tribunals and I throw out this suggestion of using retired senior officers as one which I hope will be considered by that Committee. Even if it were not possible to man sufficient tribunals to cover the country as it should be covered, surely it would be good to make a beginning, even if, at the start, the country can only be covered thinly. The problem is cumulative, and unless a start is made now the job will become overwhelming if we have to wait until the end of the war to get these tribunals started.

Now what I have said here by way of comment and suggestion in no way derogates from the remarks I have made earlier on the good work being done by the Ministry of Pensions, and I am sure that, at all events as long as Sir Walter Womersley is at the head of the Ministry, men and women in the Services may rely upon their cases being treated with sympathy and goodwill, and that in the Minister they have a man who is, so to speak, on their side.

I leave Pensions now and come to the question of rehabilitation. Only a few days ago the very important Tomlinson Report was issued. Its formidable title is the "Report of Inter-Departmental Committee on the Rehabilitation and Resettlement of Disabled Persons," Command 6415. No doubt your Lordships have taken the opportunity of reading this valuable Report. To me it seems very good. It is penetrating in analysis and positive and constructive in solution. I am concerned with it to-day not in its general aspect so much as with its application to those in the Fighting Services. It would be a pity, however, if it were thought that little or nothing has been done hitherto by the Ministry of Pensions in the way of rehabilitation. In fact a great deal has been done, and done admirably, and I only wish that more publicity could have been given to it. I have recently had the advantage of paying a visit to St. Mary's Hospital at Roehampton. I wish the Minister could see his way to invite members of your Lordships' House to go to Roehampton to see what is being done there, for I am sure that you would be impressed. There you may see men with shattered faces having new faces made for them by the miracles of plastic surgery. You can see these extraordinary and almost miraculous artificial legs being provided for those who are legless. So good are they that, when I was asked to give an opinion as to which of the two legs of one of the men there was an artificial one, I could not make up my mind. As I had to say something, I said that it was the right leg, and then I asked whether this was correct. The answer was that it was correct, but that the other leg was an artificial limb too.

I saw a man walking on two artificial legs who was indistinguishable in the way in which he was walking from the normal man with ordinary legs. That seemed to me very striking, because the fact that he has these two legs upon which he can walk, and that he is to all outward appearance normal, has an enormous psychological effect on the man himself: he does not feel that he is a man to whom anyone can point, or that he has any obvious inferiority of a physical character which would mark him out from amongst his fellows. The work which is being done in this way seems to me quite extraordinary. Men with these artificial limbs have even climbed Snowdon, and have been known to walk all the way to Brighton—not a bad effort for those without the usual complement of normal legs.

It is not strictly relevant to my argument, but it is a striking fact and may be of interest to observe that the ratio of arm amputations to leg amputations in this war is almost precisely the same as in the last war, notwithstanding the differ- ence in the risks taken and the differences in tactics and in the weapons and projectiles employed. It may also interest your Lordships to know that, of the arm amputees, women show a far greater facility than men in using the various gadgets that are supplied to arm amputees to bring them back into normal life and work. I saw one girl there who had been a telephone operator in the North. Both her arms had been taken off above the wrist. She was very jolly and cheerful, and was being re-trained. I understand from an inquiry which I made the other day that she is now back again at her job as a telephone operator, although she has only artificial hands. I think that there is scope for those who are experts in these matters to devise something more satisfactory in the way of artificial hands. Nothing really satisfactory has yet come out of all the inventive work which has been done, although arms and legs are so admirable as to make the damaged person able to perform even the most unlikely tasks.

What I thought was perhaps the most interesting thing that is done for these patients is this. When a man or woman comes to one of these hospitals, fairly badly smashed up, it is always found that he or she is extraordinarily worried about the future. That is particularly true of the married man with a family; he is very worried about what will happen to him so far as his job is concerned. As soon as the first difficulties of his actual disability have been overcome, and whilst he is still in hospital and, it may be, still in bed, a psychiatrist comes to the hospital and talks to him, discussing his past and his possible future, and inspiring him with the idea that he really has a future before him, if not in his old trade then in some new occupation. Later, when he is a little further on the road to recovery or improvement, but whilst he is still in hospital, a representative of the Ministry of Labour attends at the hospital with a view to indicating to him precisely what he can do and where he should go.

I have dwelt at perhaps undue length on what happens at this hospital at Roehampton, because I was most profoundly impressed by it. My only regret was, and is, that the public have so little knowledge of what is being done in that regard, so that too little appreciation of it is shown. I could wish that the Minister's publicity department or Public Relations Officer might be instructed to make all these remarkable facts with regard to the work that is being done known to the public at large. I believe that I shall have your Lordships' concurrence when I say that no time or energy or effort is wasted which inspires confidence in those in the Forces and their relations that things will really be done for, them if they are wounded, and which makes them realize that the utmost care and trouble will be taken to bring them back into a wage-earning life.

I have digressed to say a few words with regard to Roehampton, but I must, before I sit down, say something with regard to the rehabilitation suggestions made in the Tomlinson Report. The outstanding point about the rehabilitation service, taken as a whole, is that it is quite inadequate to fulfil its normal tasks, let alone the tasks which will fail upon it when the flow of Service casualties comes to be dealt with. I cannot emphasize too strongly that success in rehabilitation depends not on good intentions or even upon the right policy in themselves, but on the existence of sufficient personnel and apparatus in the form of doctors, nurses, instruments, institutions, hospitals and clinics. At present there is no doubt that the apparatus is inadequate, although the right policy is known and accepted. There are hospitals at which a special treatment in physio-therapy and occupational therapy is given to reduce the effect of fractures; but that is not enough. There are 21 orthopedic centres and 60 hospitals ear-marked under the Emergency Medical Services to deal with fractures in a specialized way, but most hospitals do not provide more than ordinary surgical treatment, and the number of specialized institutions is quite insufficient.

Moreover, in what has been done so far attention has been paid too exclusively to fractures, and to the rehabilitation of persons with mended fractures. It is one of the virtues of the Tomlinson Report that it recognizes the importance of rehabilitation outside the main field of fractures. It deals with the rehabilitation and post-hospital treatment of persons disabled by tuberculosis, blindness, deafness, damage to the cardiac muscles, neuroses, psychoses and so on. All these aspects of rehabilitation are of the greatest importance in considering the problems of Service casualties, and any scheme will stand or fall by the extent to which the necessary apparatus and personnel can be found to deal with the scale of the problem. Where I think that perhaps the Tomlinson Report is weakest is in the assumption that the means for carrying out its proposals will be available. This is not only a question of finance, though of course finance has its importance, but it is also a question of administrative and technical apparatus and personnel. It is no good deciding to carry out this policy or that policy unless at the same time steps are taken to see that the necessary apparatus for carrying it out will be forthcoming at the right place and the right time. The great danger is that, unless this practical point is fully realized and foreseen, nothing effective will be done, whatever policy is accepted; that is to say that by shooting too high you may hit nowhere. The urgent need is not only to see what is to be done, but also to work out how it is to be done arid to decide what in practical terms is possible.

The Tomlinson Report deals with rehabilitation in general, but all its recommendations and all its assumptions concern very specially ex-Service rehabilitation, because of the scale of the ex-Service casualties which we must expect, and because of the claims of ex-Service men and women. The Tomlinson Committee lay stress, and welcome stress, not only on restoring disabled persons to health and fitness, but also on the restoration of the utmost possible degree of working capacity by special treatment and, more important than anything, on re-employment. It cannot be too strongly emphasized that rehabilitation only starts when hospital treatment ends. Re-education and re-training, with all the necessary apparatus and skill, are crucial. Re-employment, either in the old field of occupation or in a new one for which special training facilities are provided, is the crucial test of a rehabilitation policy. Here the Tomlinson Report is most highly to be commended, for it stresses the fact that the rehabilitated person can be made fit for full work, and it has produced, as your Lordships will have seen in the Report itself, ingenious suggestions for ways and means of securing re-employment in ordinary occupations and especially in scheduled occupations set apart and reserved for those unable to follow their normal pursuits. I will not weary your Lordships with the details, for your Lordships will have read them in the Report.

Finally, I would say this. The real problem, as I have said, begins when hospitals have done their work, and the real problem is how to re-employ the rehabilitated. This question of re-employment is, of course, an essential part of the large post-war economic problem. If there is work for all who are willing to work then the disabled and rehabilitated Snooks will have a better chance of finding his niche, but if there is mass un-employment, or anything approaching mass unemployment, Snooks will be left by the wayside. He must not be left by the wayside. I beg to move for Papers.

LORD FARINGDON

My Lords, after the eloquent and exhaustive speech on pensions and rehabilitation which we have heard, I feel your Lordships will agree with me that there is very little that can be usefully added. I should like to thank the noble Lord for an extremely interesting exposition of the whole subject. I rise only for a very brief moment to outline to your Lordships a line of investigation into the last problem which the noble Lord mentioned, that of reemployment, which was being followed in certain industries in this country before the war. It had been noted that a man who was injured or had fallen sick was frequently on the sick list for a very considerably longer time than was necessary because he was unfit to take up his old employment, which required 100 per cent. fitness, though in fact he could have engaged in some lighter employment. This was very unfortunate, both because it impaired the man's earning capacity at a time when it was most essential that there should be adequate money coming into his home to pay for perhaps special feeding or treatment, and also because of the bad moral effect of being out of work and dependent upon some form of pension.

To this end labour in a number of industries was subdivided into three classes. There was first of all the A class, where a man was 100 per cent. fit; then there was the B class which did not entail the lifting of any load greater than 56 lb.—which is I believe medically considered the maximum load that should be lifted by a woman; and then there was the C class where no load of more than 10 lb. need be lifted. An analysis of the man-hours employed in a number of industries of these three classes of work over a number of industries so examined—and obviously your Lordships will realize that these figures can only be tentative—tended to show that 25 per cent. of the man-hours in the examined industries came under the C class, 60 per cent. under the B class and only 15 per cent. under the A class. Quite clearly it would be impossible to put only Grade C men to do C class work, and only Grade B men to do B class work, leaving A men to do A class work only, because the strain on the A class men would be too great. But it has been computed by competent medical opinion that every industry could possibly, without putting an excessive strain on its A class men, carry as much as 25 per cent. of the men of the B and C classes to do that work. This line of inquiry seems to me to be worthy of the attention of the Ministry of Pensions, and to link up usefully with this problem of re-employment, and that is why I have ventured to bring it to your Lordships' attention.

LORD SNELL

My Lords, it is altogether appropriate, even in the midst of a desperate war, that sympathetic consideration should be given to the needs and the claims of those who have been disabled in its service, and the fact that this problem is not being neglected will give assurance and bring some comfort to the men and women of every rank in the three great Services. The noble Lord, Lord Nathan, has a long-standing and commendable and useful interest in the matter which he has brought before your Lordships' House, and the Government welcome the discussion which his Motion has stimulated. The problem is in fact everybody's responsibility. Everybody has a responsibility to see that all that can be done in this matter shall be done in a generous way. We should be accused and we should be shamed if men who have suffered for our safety and our freedom were left uncared for. Therefore I am sure your Lordships will welcome the Motion that the noble Lord has introduced. As far as I understand the argument which Lord Nathan has put forward with force, it is that the anxieties of the men who are serving are greatly increased by the fear that they may be dismissed wounded and incapacitated and that insufficient help will be provided for them. Lord Nathan has summarized his criticisms on this matter by saying that the men demand maintenance for self and family, treatment for their disabilities, rehabilitation until they become self-supporting, and, above all and most important of all, they demand a job when they are able to resume their work. The noble Lord has laid proper and particular emphasis on the needs of the individual man whose life has been spared but whose health has been lost and whose industrial efficiency has been impaired.

It may be worth while to remind your Lordships that the problem as it exists to-day is not immense nor is it unmanageable, and also that the vast majority of those already discharged have been discharged on medical grounds and not on account of wounds. It may also be useful if, in a few brief phrases, I greatly abbreviate a description of what the actual provision is for these men. So far as pensions are concerned, disability pensions are available to men whose disability is accepted by the Ministry as being due to, or aggravated by, service in the present war. The rate of pension depends on the degree of disability and on the man's rank, and it may also be affected by the length of his service. The degree of disability is measured in comparison with a normal healthy person of the same age and sex, and the pension, it is to be noticed, is not disturbed by the amount of wages that the man receives. Then there are some family allowances. These include allowances in respect of wife and children. The rate varies according to the degree of disability, and the allowances for children are ordinarily terminated when the children reach the age of sixteen. There are certain conditions required as to eligibility. In regard to education, there are allowances available not exceeding £40 towards the cost of education, if the Ministry is satisfied that family circumstances justify it. Then there are certain allowances for cases where constant attendance is required upon 100 per cent. disability. These do not exceed 18s. per week in the case of the men and are not over £90 Year in the case of officers. Finally, there are certain allowances for limbs and appliances. The Ministry arranges these if no other source is available. Those afflicted may, during treatment, receive allowances based on pensions, together with any additional allowance for which they may be qualified in respect of their families.

That is a highly summarized account of the present provisions, and I thought it might be useful to your Lordships to be reminded of them so as to form a basis upon which to think of the future. Lord Nathan has made certain criticisms in regard to the rates and so on which are paid. His general position is that the situation in regard to pensions is on the whole satisfactory, but there are certain points of criticism he has to make. One of these refers to injuries received when a man is on leave. This difficulty is commonly described as the "on and off duty" question. Under the Royal Warrant a disability must be attributable to, or aggravated by, war service. This is generously interpreted, but there must be a limit. Accidents on duty are always accepted, as are accidents occurring directly between stations and billets. Accidents when going on or returning from long leave are accepted. Accidents in an immediate battle area and accidents due to unfamiliarity with foreign conditions, or with some unsuspected danger peculiar to a locality at home, are accepted. Accidents while a man is on pass or while he is actually on leave are not accepted. What a man does when on pass or whilst actually on leave is not subject to any Service compulsion, and any accident with which he meets might equally befall a member of the civilian population. Accidents of the most common kind are those arising from traffic and black-out conditions which are general to all of us, unfortunately, in these times.

Lord Nathan made certain criticisms in regard to tribunals, and I promise him that both his criticisms and his suggestions will receive the consideration of the Minister. His desire is that these tribunals should work with the utmost publicity, because this will allay dissatisfaction with decisions in border-line cases. The Government have announced their intention to set up independent appeal tribunals at the earliest opportunity. Their immediate institution would require a considerable medical staff and some hundreds of lay staff. Qualified personnel are not at present available, and to the extent to which some could be made available it would be at the expense of activities more immediately vital to the war effort. The whole problem is being further explored by a sub-committee of the Ministry of Pensions Central Advisory Committee. I repeat that the suggestions made by the noble Lord, Lord Nathan, will be transmitted to the Minister and will, I am sure, receive his consideration.

LORD NATHAN

Is my noble friend in a position to say anything upon the anomaly regarding widows to which I referred? If he is not in a position to say anything now I understand.

LORD SNELL

I regret that I am not informed on that special point, but it will receive consideration. The question of the rehabilitation of afflicted men and reemployment for them is one of the most important that your Lordships have to consider. Let us always remember, however, that merely to find work for a man is not a satisfactory solution of the problem. It must be suitable work. Merely to throw a man into some sort of job for which in any case he would be unfitted, is not to deal with the problem effectively. In regard to rehabilitation there is, I think, very little basis for Lord Nathan's criticism that rehabilitation only starts when hospital treatment has ended. It is recognized in the general treatment of these men that rehabilitation should begin as soon as possible after the injury or operation and continue throughout the whole period of convalescence. For instance, if a man has a fractured limb it is important that he should begin to use it at the very earliest moment and that is looked after by the authorities.

The criticism that the Tomlinson Report is rather weak on that point would, I think, not be accepted by the members of that Committee. If I may I will refer your Lordships to page 42 of that Report where you will see that rehabilitation is dealt with under five points. I will not trouble your Lordships to listen to my reading of them, but the Report does deal with this matter, and I think on the whole fairly efficiently. Much has already been done in the matter of rehabilitation in the Ministry's hospital. Their object is to bring the man back to the stage when he is either able to resume his old occupation or be trained by the Ministry of Labour for a new one. The interim scheme for the training of disabled men is working well. Officials of the Ministry of Labour and National Service dealing with this particular matter visit the man while still in hospital and discuss his position with him and his doctors. Training is available for all who need it, and with the present demand for labour there is no difficulty in placing in employment those who have been trained.

In regard to re-employment, this, as Lord Nathan rightly said, is a major anxiety of the men. No one who remembers the grim tragedy of unemployed men after the last war can possibly seek to minimize the importance of that anxiety, and I will see that the attention of the Minister is brought to the suggestions which Lord Faringdon made in his interesting speech. So far as the re-employment of disabled men is concerned the problem is undoubtedly a difficult one, but it is one to which the Government are giving full and serious attention. A strong Committee under the Chairmanship of the Parliamentary Secretary of the Ministry of Labour and National Service has just produced a comprehensive Report on the whole problem of the rehabilitation and re-settlement of the disabled. The proposals in this Report are not limited to the war disabled, and they will be discussed with the British Employers' Federation, the Trades Union Congress and the Royal National Council. They cover the whole field, but at the moment the position is that they have been accepted as a basis of discussion. The House will forgive me if I have not dealt adequately with particular points mentioned by Lord Nathan in his interesting speech. I was entrusted with this duty at very short notice, and I have tried to indicate as far as possible what the general attitude of the Ministry is in this matter. There is the fullest sympathy with what has been said to-day, and a desire to see that the needs of those to whom the nation is so greatly indebted shall be adequately provided for.

LORD NATHAN

My Lords, I thank my noble friend for his full, careful and sympathetic reply. I shall not in these final words indulge in any controversy, but I should like to protect myself against possible misapprehension arising from what the noble Lord has said and in regard to which I have perhaps in my opening observations not made myself sufficiently clear. My noble friend seems to think that I was speaking in a critical spirit when I said that rehabilitation starts when hospital treatment ends. I was not speaking in a critical sense, I was speaking in a chronological sense, although I agree that rehabilitation and hospital treatment may to an extent overlap.

Again—and this is perhaps a little more serious—I should not like there to be any misunderstanding in regard to another point. My noble friend seems to have thought that I attributed to the Tomlinson Report a weakness in that it had not dealt with rehabilitation, and then my noble friend pointed out how rehabilitation is dealt with in that Report. Far from attributing this as a weakness I pointed out in my observations that it was a special virtue. Where I referred to a weakness was in a different context. I said that where the Report was weakest was in the assumption that the means for carrying out the proposals would be available. That is rather different from what was attributed to me by my noble friend, but I do not pursue that matter any further except to point out that it would be a misapprehension if it were suggested that I had blamed where in fact I had praised. Finally, I hope my noble friend may possibly think it advantageous to suggest to the Minister of Pensions that the proposal I made as to members of your Lordships' House being given an opportunity under his guidance of visiting the Roehampton Hospital is worth while pursuing. With that closing remark I beg leave to withdraw my Motion.

LORD ADDISON

My Lords, before the Motion is withdrawn may I put a question to the noble Lord, Lord Snell, with respect to one point mentioned by my noble friend Lord Nathan? We do not expect him to reply to it to-day. The point is that concerning the case of widows of men killed side by side mentioned by Lord Nathan. May not both be eligible for a pension? Will the noble Lord assure us that he will ask the Minister to look into that matter and perhaps give the House some information and some hope for the removal of this manifest hardship in the near future?

LORD SNELL

The noble Lord will realize that I cannot give an authoritative answer now, but I will see that the point is put to the Minister and perhaps some other opportunity of explanation will be available.

Motion for Papers, by leave, withdrawn.