NATIONAL INSURANCE (INDUSTRIAL INJURIES) (AMENDMENT) BILL (Hansard, 4 April 1967)

§ LORD BLYTON

My Lords, I beg to move that this Bill be now read a second time. May I say, as one who, with my noble friend Lord Taylor of Mansfield, has been connected with the mining industry for many years how much we lament the death of Lord Williams of Barnburgh who was a miner and was in our union over many years. I think his life work will stand by itself, and particularly the work he did as Minister of Agriculture.

This is a Bill: to amend the enactments providing for benefits out of the National Injuries Fund in respect of industrial diseases; and for connected purposes. It is a Private Member's Bill from another place, where it was introduced by the Honourable Member for Merthyr Tydfil; and it went through all its stages there with Government support. The Bill deals with the connected diseases of bronchitis and emphysema with pneumoconiosis. While the Bill does not go all the way I should like, at least it represents a landmark in the history of our fight over the years on occupational diseases. For the 12 years preceding 1965 (these are the latest figures I have) there were 37,203 men certified as suffering from pneumoconiosis. This does not take into consideration the many reexaminations made by the medical boards on men previously certified as suffering from the disease, where the finding is that the condition has deteriorated. And there are many hundreds more in industries other than coal mining who suffer from byssinosis. I am pleased to say that to-day the numbers of these cases are showing a decline, but there are still over 1,000 a year, and it must be remembered that there are thousands fewer men now employed in the mining industry. There is nothing like this in any other industry. The figures are appalling. The disability, suffering and deaths from chest affections have given us a great deal of cause for thought over many years.

869 This is not the whole of the sombre picture, however. Many hundreds of men are suffering from emphysema and bronchitis, which we consider—and we nave a great deal of medical support behind us—are associated with employment in a dust-laden atmosphere. It is generally agreed that there are different kinds of emphysema. Focal emphysema already qualifies for disablement benefit, but in its diagnosis there is a requirement of X-ray abnormalities. The fact remains that emphysema may be present without any X-ray change, and it is now well held that emphysema in the presence of pneumoconiosis should be accepted as an industrial disease.

Bronchitis is increased considerably by pneumoconiosis. The bronchial tubes are damaged. It will be appreciated by your Lordships that constant inhalation of dust results in men constantly coughing, and that in turn must affect the bronchial tubes. Sir Barnet Stross, who was for many years the Member of Parliament for Stoke, did great work in the field of research on these diseases. He said on February 3, 1961, as recorded in Hansard: Every time men cough as a result of breathing noxious dust they are damaging their bronchial tubes and lungs. The cough is given to us in the first place as a possible means of protecting ourselves, but prolonged coughing over many years damages more than the bronchial tubes. We do not need doctors to tell us this. It destroys the elasticity of the lungs and ultimately prevents the interchange of oxygen and carbon-dioxide in the tissues. That is why men cannot breathe, and why they cannot work."—[OFFICIAL REPORT, Commons, col. 1398.] My Lords, those of us who have spent a life in the coal-mining industry have seen healthy men coming into the pits and falling victim to pneumoconiosis, emphysema and bronchitis, and have seen their terrible plight. It is most distressing to see men gasping for breath, coughing incessantly, and awaiting the end of their lives, for in most cases, of course, these diseases are progressive.

What is the cause of this disease of bronchitis? We know that whenever the incidence of pneumoconiosis is high, so is the incidence of bronchitis. Statistics show that in many of our mining areas where pneumoconiosis runs at a high rate, so does associated bronchitis. Therefore it seems, on probability alone, that pneumoconiosis and bronchitis should be 870 scheduled as industrial diseases. The case is far stronger when we look at the evidence of the cases of emphysema and bronchitis existing with pneumoconiosis. Here it is not a matter of the law of probability, and medical evidence very strongly supports the view that where pneumoconiosis is accompanied by bronchitis and emphysema, disablement benefit ought to be paid. Even medical specialists who have serious doubts about this condition as the cause of bronchitis say that, even though they cannot decide in favour of bronchitis and emphysema being due to mining, industrial conditions at least accelerate and aggravate it.

I could quote many medical experts to support my contention, but two will suffice. Dr. Howells was appointed some time ago by the Miners' Union to investigate pneumoconiosis in mining. His conclusions were that many difficulties could be resolved by changing the legislation so that general emphysema and bronchitis occuring in the presence of pneumoconiosis should be recognised as industrial hazards and total disablement benefit paid to those applicants in whom the two conditions were present in combination. Then, again, Dr. Rogan, the Chief Medical Officer of the National Coal Board, though cautious in his approach, said in his paper on pneumoconiosis: Bronchitis diagnosis by questionnaire also varies widely in prevalence, ranging from 9 per cent. to 43 per cent. Though relationships between bronchitis and pneumoconiosis may still be unsure, we have concluded that the high prevalence of pneumoconiosis tends to be associated with a high prevalence of bronchitis. We have also noted, when we correct our data to allow for the effects of age, that symptoms of bronchitis tend to increase as the pneumoconiotic conditions advance. We have had many cases of men who received entitlement to benefit for pneumoconiosis in life and who, on death, after a post-mortem, were certified as having died from bronchitis and emphysema. In cases like this the widow has no entitlement at all. Another feature of our agitation over the years has been the criteria of diagnosis. We have seen some men examined and certified, while others are not, though they show the symptom of gasping for breath in the same way as those who are certified; and people cannot understand why one man should be certified while others working 871 in the same conditions are not. This Bill at least will eradicate some of the discontent and dissatisfaction which we have experienced over the years.

In Australia and South Africa emphysema and bronchitis are accepted as industrial hazards and their victims are compensated; and several countries, Socialist and non-Socialist, are well in advance of us in this respect. The problem of pneumoconiosis is still large and serious. The long-term problem is being tackled by the Coal Board and the Miners' Union through research into the application of improved methods of dust suppression, yet the figures are still high. Many men in the later years of their life are declared to be totally incapacitated. In a survey taken in 93 collieries all over the country it was found that 12.4 per cent. of those X-rayed had the disease. In the ageing group, 30.2 per cent. of those aged 55 years or over were declared suffering from pneumoconiosis, compared with 2.7 among the younger men. Many others show the same symptoms and are incapacitated but are certified as suffering from bronchitis and emphysema.

This Bill provides that those declared to be 50 per cent. disabled, or over, with pneumoconiosis with the presence of these two diseases will be declared to be totally incapacitated, and this is a great step forward. While the Bill does not go all the way to meet our claims, it does for the first time establish the principle of associating emphysema and bronchitis with pneumoconiosis; and I should like to thank the Minister for giving this to these suffering men.

Many of us have had considerable experience under the old Workmen's Compensation Acts. We experienced many hundreds of men declared to be suffering from pneumoconiosis who, when examined, were assessed to be only 10 per cent. or 15 per cent. disabled. These men had the choice only between total and partial disability. Many of them may not be actually disabled from pneumoconiosis, but now when they appear before the Board under this Bill may well be found to be fit for very little work. If now they are 50 per cent. incapacitated by emphysema or bronchitis they can come within the terms of this Bill, and this is of great importance.

872 Under the old Compensation Acts men were not paid compensation on their injury but were paid for their loss in earning capacity. Under this Bill men will qualify if they are certified as seriously disabled. Under the old benefits scheme there was no declaration of assessment, but that will now be brought into the Bill and many men will come within its provisions. The old cases and the supplemental cases, that is, all those who contracted pneumoconiosis before July 5, 1948, and all the time-barred cases, will come within this Bill. They will get a little more compensation, because the old cases were not compensated under the old Workmen's Compensation Acts. But I would urge upon the Minister who is to reply to this debate to continue the research to determine on the medical evidence available the connection of bronchitis and emphysema with pneumoconiosis. Our experience over many years shows this connection even in those with an assessment of less than 50 per cent. I hope that the Government will keep the 50 per cent. limit under constant review.

My Lords, while I have dealt specifically with these diseases as they affect miners, because I know the mining industry best, the Bill affects also those with byssinosis and silicosis in industries other than mining. Potteries, quarries and textile industries are involved in this Bill. The Bill makes it clear that only those under the National Insurance (Industrial Injuries) Act and the old Workmen's Compensation Act who have a 50 per cent. pneumoconiosis assessment and a condition of bronchitis or emphysema will have these diseases taken into account in the total assessment of their disability. For this I am grateful, and I live in the hope that, having established for the first time the connection between these diseases, medical research will prove beyond doubt that the 50 per cent. limit is too high.

In days gone by we had a long struggle to get silicosis established as an industrial disease. In those days the doctors said that silicosis was not due to work in the mines. After years of argument and agitation they agreed that there was such a thing, but they said it was connected with silica and a man had to prove that the stone he worked with had a 50 per cent. silica content. Then men were certified as suffering from silicosis though they I had not been handling silica. Doctors 873 found by examination that such men died from silicosis. Then the medical people came to the conclusion that any dust was injurious to the lungs, and they extended the diagnosis to one of pneumoconiosis. For years now we have agitated that bronchitis and emphysema were connected with pneumoconiosis, and at last in this Bill there is a limited recognition that this is so.

The National Insurance (Industrial Injuries) Act 1965, Section 58(1)(a) says: Where any person is found to be suffering from pneumoconiosis accompanied by tuberculosis the effects of tuberculosis shall be treated for the purpose of this part of the Act as if they were the effects of the pneumoconiosis. This Bill extends that section to include emphysema and bronchitis as if they were the effects of pneumoconiosis, if the assessment is 50 per cent. or over. This will give to over 4,000 people some benefit from the National Injuries Fund. The establishment in this limited way in the Statute of the connection of emphysema and bronchitis with pneumoconiosis is, I believe, a start on the march ahead, and some day these two diseases will be scheduled as industrial diseases, proved to arise from a man's employment when working in a dust-laden atmosphere.

Meanwhile, I think the thanks of us all go to the honourable Member for Merthyr Tydfil and to the Minister who, in the face of great difficulties, have established in a Bill that there is a connection between these diseases and pneumoconiosis. All of us who have lived with these problems and have seen the suffering entailed by those who misfortune it was to contract pneumoconiosis, byssinosis and silicosis welcome the Bill and regard it as an historic occasion. Whatever disappointments there may be for those whose disability is less than 50 per cent., let it be said here that this should not detract from the many virtues embodied in this Bill. It must be regarded as a significant step forward, and a step in the right direction. With thanks to the Minister and all those in the other place who have sent this Bill here, it is with great pleasure that I beg to move its Second Reading.