§ 4.28 p.m.
§ Second Reading debate resumed.
§ LORD DRUMALBYN
My Lords, whenever a noble Lord or a Private Member in another place introduces a Bill which can have the effect of reducing suffering or making suffering easier to bear, one is always pleased and one likes to congratulate the mover upon it. In this case, I readily congratulate the noble Lord on bringing forward this Bill. One feels a double sympathy with him, because it is plain from the way in which he introduced it that it is not the Bill he would have liked to have introduced, and indeed that it is not the Bill which was originally introduced in another place.
884 The Bill as originally introduced— this is the measure of it, although perhaps not the right measure— would have cost some £20 million a year. From what the Parliamentary Secretary said in another place, as I understand it, it is estimated that this Bill will cost about £300,000 a year, and that the cost will fall on the Industrial Injuries Fund. The disparity is due to the introduction of subsection (2) into Clause 1, which limits the circumstances in which emphysema and bronchitis are to be treated as if they were effects of pneumoconiosis to those where the effects of the pneumoconiosis by itself are assessed at 50 per cent. disablement or more. I think it is fair to say— I am sure the noble Lord, Lord Blyton, would not disagree with this— that his main argument in favour of the Bill is that it represents a "foot in the door". What we have to consider is whether it is a foot in the right door, and whether in the long run it will be of advantage to all who gain benefit under the Industrial Injuries Act through industrial diseases.
What is well known is that the reason why some people are given higher levels of benefit than others under national insurance, for example (although I take national insurance and industrial injuries together) is because there is a causal relationship between the occupation and the disease in the one case and not in the other. If I may quote Section 56 of the National Insurance (Industrial Injuries) Act 1965, it says:A disease or injury may be prescribed for the purposes of this Part of this Act in relation to any insured persons if the Minister is satisfied that—That at once brings one to the question: Why has the level of 50 per cent. been chosen? I wonder whether the noble Lord can say what 50 per cent. disablement involves in the way of incapacity for work in the case of pneumoconiosis and susceptibility to other complaints, because logically to justify this provision the medical profession should be able to assume is that it is when a person is 885 50 per cent. disabled by pneumoconiosis, and not at any lower level of disablement, that he becomes susceptible to consequential bronchitis or emphysema. Is this so, and is this what the evidence shows? The noble Lord, Lord Blyton, in introducing the Bill said— and I took down his words— that medical evidence very strongly supports the view that where pneumoconiosis is accompanied by emphysema and bronchitis disablement benefit ought to be paid. He justified that later on by saying that the high prevalence of pneumoconiosis tends to be associated with the high prevalence of bronchitis.
- (a) it ought to be treated, having regard to its causes and incidence and any other relevant considerations, as a risk of their occupations and not as a risk common to all persons; and
- (b) it is such that, in the absence of special circumstances, the attribution of particular cases to the nature of the employment can be established or presumed with reasonable certainty."
Where we are just now in this matter was indicated by the Parliamentary Secretary on the Second Reading of the Bill in another place, when he said:… doctors have always accepted in cases of severe pneumoconiosis under the Act that there was a much more intimate connection… between the pneumoconiosis and any accompanying respiratory diseases in that they make disablement due to pneumoconiosis much worse."— [OFFICIAL RITORT. Commons, 22/12/66.]
§ LORD DRUMALBYN
I quote from column 882. I have had the experience, which I know noble Lords opposite have had— certainly the noble Lords, Lord Blyton, and Lord Taylor of Mansfield, who have spent a lifetime either working with the miners or representing them in Parliament; and I must say they have done their task extremely well— of visiting the research establishment at Llandaff, and I have seen sections of a lung which was affected by pneumoconiosis. I am bound to say that having seen that one wonders how the respiratory tracts work at all. I should be surprised if there were not some causal relationship between subsequent— and I think one has to say "subsequent"— bronchitis and emphysema and the original pneumoconiosis.
The difficulty with which we are faced is that if there is such subsequent bronchitis or emphysema, if it is clearly attributable to the pneumoconiosis and resulting from that, then it seems that doctors give a higher assessment than they would give on the pneumoconiosis 886 alone. If my recollection is correct, this is what happens. The difficulty is that the Bill is deeming that a causal relationship exists where a causal relationship in the individual case does not necessarily exist. All I would say is that this may be a dangerous precedent so far as the Industrial Injuries Act is concerned.
The noble Lord said that the 50 per cent. level would have to be carefully watched. I think that it must be watched for the reason I have given. On balance I think it is reasonable— and I hope the noble Lord who is to reply will say this — to take the view that in the case of bronchitis and emphysema accompanying pneumoconiosis, where the pneumoconiosis disablement is assessed at 50 per cent. or more, the high probability is that it has been caused by the pneumoconiosis or is an indirect effect of the pneumoconiosis. Therefore, in general it is fair to say that with emphysema and bronchitis accompanying the pneumoconiosis, where there is a 50 per cent. disablement assessment of the pneumoconiosis, this should be taken into account in assessing the total amount of disablement. I hope the noble Lord will be able to give an answer on that point.
For the good of all who receive industrial injuries benefits, I attach importance to the maintenance of this causal relationship. If one does not maintain that causal relationship, there is no reason for maintaining a different kind of benefit for industrial diseases than for any other diseases, or for diseases which are incurred, or can be presumed with reasonable certainty to be incurred, in one's occupation but which can be incurred elsewhere, and for industrial injury benefit to be paid in that kind of circumstance. I think this is a very important point of principle. As I have said before, it is highly desirable that where possible the benefit of the doubt should always be given in a case of this kind, and in the past I believe it has been given; that is to say, that where there has been emphysema and bronchitis accompanying pneumoconiosis, and the pneumoconiosis was relatively severe, that assessment has been higher because of the accompanying bronchitis and emphysema. I think it is reasonable that this should be made a general rule. I come back to the "foot in the door".
§ LORD DRUMALBYN
May I just finish this passage? If the "foot in the door" means that, irrespective of whether there is any causation in this matter, the additional assessment should be given where diseases accompany a prescribed disease, then I think that would be a dangerous principle. It seems to me that it is only where that additional disease is attributable to the prescribed disease, or at any rate can be reasonably said to be consequent upon it, that I think it is right to give the benefit of the doubt in this way and to pay the higher disablement benefit.
§ LORD BOWLES
My Lords, what the noble Lord is saying is that if it can be proved that emphysema and/or bronchitis follow from the fact that the man had pneumoconiosis, that is to be taken into account in giving him not only the benefit of the doubt but also a higher benefit.
§ LORD DRUMALBYN
That is not quite right. What I said was that reasonable benefit of the doubt should be given. Noble Lords who belong to the medical profession may be in a position to give the benefit of their experience to the House to-day, but I myself should have thought it would be a very difficult matter — and in my experience it is a difficult matter— to be able to prove while the person is still living that the additional disease follows or is consequent upon the prescribed disease. What I am saying is that, in general, there must be a reasonable presumption that it is so, and that where there is a doubt then the benefit of the doubt could be given to the applicant. But what I am venturing to warn your Lordships about—
§ LORD TAYLOR OF MANSFIELD
My Lords, before the noble Lord finishes that point, and it is a most interesting argument, I should like to be clear in my own mind whether I understood him correctly. Did he say that where bronchitis or emphysema or both accompanied pneumoconiosis, the medical boards gave a higher assessment?
§ LORD DRUMALBYN
My Lords, this is what I understood from what the Parliamentary Secretary said in another 888 place, and it is my own recollection that this is what was done, unless, of course, it could be plainly established that the bronchitis or emphysema was not a consequence of the pneumoconiosis. I understand that this is what is normally done and this is my recollection, also.
§ LORD TAYLOR OF MANSFIELD
My Lords, may I pursue this point? My experience has been that when a person who is certified as suffering from pneumoconiosis is also suffering from chronic bronchitis and emphysema, there is an offset. Where it has been so found by the pneumoconiosis medical panels, they make an offset for the bronchitis and the emphysema and give a lesser assessment than the man would be entitled to for the degree of his disability.
§ LORD DRUMALBYN
My Lords, of course this is a point which the noble Lord should put to his noble friend, and I hope that his noble friend will deal with it. There may be circumstances when this would be the appropriate thing to do, but, if my recollection is correct, that is not what was generally done where the assessment for pneumoconiosis was relatively high and where there was, as the Parliamentary Secretary said in another place, a much more intimate connection between the two in that the other diseases make disablement due to pneumoconiosis so much worse. I have always understood that this was the way in which the Act was administered. I hope the noble Lord will deal with this in due course.
What I think is extremely important is that the research which is being carried out should be continued. As I said before, I find it difficult to conceive that emphysema and bronchitis are not connected and do not flow from even a small amount of pneumoconiosis. But this is purely a personal opinion from what one sees of a dissected lung and so forth. I think we should all be delighted if that causal connection were established, but there are two sides of this problem. First of all, if that causal connection is established and bronchitis and emphysema develop following upon the pneumoconiosis, then I think that certainly the whole House would wish that the emphysema and bronchitis should be taken into account. There is also the other side which is equally important, and that is the prophylactic side. One cannot help 889 feeling that anyone who has a predisposition to bronchitis would be very ill-advised to go down into the mines at all, as with a weakness of that description one would feel— and I speak entirely without medical knowledge— that pneumoconiosis might be more likely to develop than in other cases. These are the questions which arise in my mind on this Bill.
As I said at the outset, it is a Bill which will do some good, if we are to accept the sum of £300,000 as a reliable estimate of its cost, and I am sure it is the most reliable estimate which can be made in very difficult circumstances. But it goes a very small way indeed towards the objective of the Bill which was introduced in another House, which would have raised the cost of disablement benefit by 50 per cent. overall, by £20 million from the £42 million last year, and which would have been a very far-reaching measure. It is for this reason, and since we are concerned here with only one group of diseases, that I am bound to urge caution on the House in regard to this whole matter, in order that we may keep firmly in our minds that in order to justify special rates of benefit for industrial diseases there must be this direct causation between them.
§ 4.46 p.m.
§ LORD PLATT
My Lords, may I say something from the medical point of view about the questions which the noble Lord, Lord Drumalbyn, has been raising? I think there is no possibility at the present time of proving these causal relationships. The causes of bronchitis and emphysema are very complex. The one factor which correlates most strongly with the development of bronchitis and emphysema is, of course, the inhaling of cigarette smoke, which is the best possible example of atmospheric pollution. This is not to say that there are not other causes or that a man who is in a state of pulmonary disease due to pneumoconiosis and is constantly coughing will not develop emphysema and bronchitis on top of it, because it is extremely likely that he will. Moreover, if he is one of those unfortunate people who have a tendency, which we do not at the present time fully understand, to develop bronchitis and emphysema, whether aggravated or not by cigarette smoking, and he has pneumoconiosis, then his 890 symptoms and eventual demise from pneumoconiosis will unquestionably be hastened.
Therefore I would support this Bill, but I would try to divorce from it any idea that we have at present any likelihood of proving these causal relationships, because there is no medical way of distinguishing, either during life or after death, between chronic bronchitis and emphysema caused by one set of circumstances, from chronic bronchitis and emphysema caused by another set of circumstances. Therefore the only thing we can fairly do at this time in our present state of ignorance— and, of course, a lot of further research is quite properly being done— is to give the unfortunate sufferer the benefit of the doubt, especially if his pneumoconiosis is such that it is causing a real disability. I had nothing whatever to do with the drawing up of this Bill, and I do not know the exact reasons why the figure of 50 per cent. was decided upon, but in view of all the doubts and uncertainties it seems to me a not unreasonable choice to have made.
§ 4.50 p.m.
§ LORD TAYLOR OF MANSFIELD
My Lords, I never approach the question of pneumoconiosis without some emotion and for two very simple reasons. First, I have lived for the whole of my life among men who have suffered from it. Also, I recall the last winter when my own father, who had worked in the pits for many years, was alive. In his last few hours I remember him saying to me: "My boy, in view of the difficulty in breathing which I have had for so long, and in view of what I have suffered, I hope that this is the last winter I am going to live". When the medical certificate was produced, it gave the cause of death as pulmonary emphysema and cardiac failure. In the case of my own brother, after an autopsy just over twelve months ago (he had worked in the dust of the coalmines for more than fifty years) there was the same medical certification, naming pulmonary emphysema. As my noble friend Lord Blyton has said, the incidence of emphysema and bronchitis among miners is very high indeed.
I should like for a moment to return to a point which was raised by the noble Lord, Lord Drumalbyn, on the question of off-sets. The noble Lord 891 had a long and useful experience as Minister of Pensions and National Insurance. I was there for a short time, and it was my experience then, as it has been since— and this was also mentioned in another place by one of the honourable Members— that off-sets take place not only in the field of industrial disease but also in the field of industrial accident. Take, for instance, the case of a man who has had an accident to his knee or to his back. I know this is a short digression from the Bill which is before us, but I want to join issue with the noble Lord on this point.
I have known many men who have gone to medical boards (and finally, in some cases, to medical appeal tribunals) who have been told that, either from respiratory disease or from accident, they are disabled, say, 50 per cent., but that there is a condition of arthritis. Who knows but that the accident triggered off this complaint known as arthritis? And yet, irrespective of that, the medical board has said that although the degree of disability is, say, 50 or 60 per cent., there is to be an off-set of 10, 20 or possibly 30 per cent. for the condition of arthritis, either in the knee or in the back. The same thing applies so far as respiratory diseases are concerned. The degree of disability may be 80 per cent., but on the clinical findings of the panel the degree of disability from pneumoconiosis may be given as only 50 per cent. because, instead of giving the person the total 80 per cent. which his disability warrants, there is this 30 per cent. off-set and he is given benefit based only on the disability arising from pneumoconiosis.
The noble Lord also said that the Bill which is now before us, and which was introduced so ably by my noble friend Lord Blyton, is not the original Bill. Neither is it— and I may have a few words to say about how I feel respecting the prescription of bronchitis and emphysema. Like the noble Lord, I too have been to Llandaff, and have seen many of the things he has seen, and much of the good work that has gone on at that medical research centre by way of defining simple pneumoconiosis from complicated pneumoconiosis, from modulated pneumoconiosis, from pneumoconiosis accompanied by tuberculosis, and so on and so forth— and it is indeed a most interesting place to visit,
892 My Lords, like my noble friend who introduced the Bill I would give it a welcome and support. It was introduced in another place as a Private Member's Bill, and after suggested Amendments had been incorporated it now has the support of the Government. I am pleased to be able to say that, judging from the speeches from all sides of the other place, it has the support of members of all Parties. Whilst the Bill is not as comprehensive as I should like it to be, my verdict upon it is that it is a good little Bill. It recognises as qualifying for benefit respiratory diseases such as emphysema and chronic bronchitis, if— and this is a big "if", I know— accompanied by pneumoconiosis. I make no pretence as to where I stand so far as these two respiratory diseases are concerned, in spite of the observations made by the noble Lord who has just sat down. I should like to see both emphysema and bronchitis prescribed in the schedule of industrial diseases attached to the Industrial Injuries Act.
There are two main reasons, I think (and the noble Lord, Lord Drumalbyn, made reference to this matter), why, in this field, only this little step is being taken. The first is the cost. It was said during the debates in another place that if emphysema and bronchitis were prescribed the cost to the Industrial Injuries Fund would be in the region of —20 million per year. But I doubt whether that is the greatest obstacle to prescribing these two respiratory diseases. I think the real obstacle is medical opinion. I do not want to read all that was published in the British Medical Journal of January 8 of last year as a result of the setting up of a medical committee by the Minister for National Insurance because it is too long. But perhaps I may summarise the report.
The kernel of the Committee's conclusions was that there is still not enough medical evidence to indicate that emphysema and bronchitis are due to occupational hazards. It is said that the researches into these two dreadful respiratory diseases are to continue, and I hope that the time is not far distant when the medical experts on these respiratory conditions will be convinced that these two dreadful diseases are occupational hazards. Whilst, as I have said, this Bill, by bringing in emphysema and bronchitis, is only a small advance, it is to me a recognition that certain 893 respiratory diseases are occupational hazards. As my noble friend said, this has been a very long and hard road.
I was reading during the Easter holidays a history of the Derbyshire mines in which was described the conditions of work in the Derbyshire pits in the middle of the last century. I know this is going a long way back; but it has some relevance in a debate dealing with respiratory diseases. In the history it was stated:Working under such conditions" —and the conditions that were described were: long hours, from 13 to 15 hours a day; going down the pits at 6 o'clock in the morning and not coming up before 9 o'clock at night—the miners had a short expectation of life.It continued— and this is the operative sentence—Most of them, by the age of 40, if they had not a confirmed asthma suffered from difficult breathing and had a look of premature old age.It was not until thirty or forty years after that that the first Workmen's Compensation Act (for accidents at work) was placed on the Statute Book in this country; and it was not until sixty or seventy years after that that silicosis was prescribed as a respiratory disease and became part of the Schedule to the Act.
I was also interested to read in the Observer of last Sunday some comments on the loss of the "Torrey Canyon" and the effect that it might have on the tourist industry in Cornwall. The writer said:China clay mining flourishes, and there is £2,500 million worth of tin reckoned to be lying below Cornish soil. But if tin mining does spring to life again it won't be Cornish miners. South Crofty, one of the tiny handful of working mines, has to import its miners from Europe and the North of England.The writer goes on— and this is the important sentence—Too many Cornishmen remember the dreadful suffering pneumoconiosis caused.Yes, my Lords, in the field of respiratory diseases it has certainly been a long, hard road to get some monetary compensation for the suffering that has ensued. In 1928 the disease of silicosis was first prescribed; but, as my noble friend said in his admirable speech, not only had a man then to be suffering from silicosis but it had to be proved that there was at least 50 per cent. of silica 894 in the strata. This applied until 1938, when some modifications took place and the handicap of percentages was removed.
Then, in 1943— and this year produced a very important development in this field of respiratory diseases— I remember going along with a deputation to the then Secretary of State, Home Office, who later became a Member of your Lordships' House, the late Lord Ingleby, to whom I should like to take this opportunity of paying tribute. He was not only Secretary of State, Home Office, but was at one time Minister of Pensions and National Insurance. In my humble judgment, the humane way in which he approached the question of these respiratory diseases in 1943 deserves that a tribute should go on the record here to-day. It was arising out of those deputations that this horrible word "pneumoconiosis" was coined. It is not everybody who can pronounce it; I have difficulty myself in so doing; but its creation and use represented a big step forward, because from 1928 the prescribed disease had to be caused by silicone dust and up to 1938 a percentage of silica in the strata had to be proved. But in 1943, when the word "pneumoconiosis" was coined, it was held to refer to disease from any kind of dust; it was to apply to any person in any occupation who was suffering from dust in the lungs— call it "reticulation", call it "fibrosis", call it what you will. "Pneumoconiosis" included disease from any kind of dust affecting the lungs of a person in any occupation (not only a coal miner, not only a tin miner) and that person could be compensated under the Act. Not only coal dust or stone dust or asbestos dust, but any kind of dust that caused reticulation or fibrosis of the lungs brought the affected person within the ambit of the Workmen's Compensation Act. Then, in 1948, I believe, on the inception of the Industrial Injuries Act, if pneumoconiosis was accompanied by tuberculosis, that would also be taken into account in assessing the degree of disability.
But what has happened meanwhile? In the meantime, not only those who suffered from respiratory diseases from 1948 but even the old cases under the Workmen's Compensation Act (those who were totally and partially disabled) have been supplemented; and further, as my 895 noble friend also said, a very important section who had been left out in the cold for so long (those whom we refer to as the "time-barred pneumoconiotics") have been brought in. Under this Bill we move a step nearer— I am quite sure about that— to the prescription of bronchitis and emphysema as industrial diseases due to occupational hazards. The noble Lord made some reference to the 50 per cent.; I, myself, think it is too high a proportion. A man who gets an assessment of 50 per cent. from the medical panel is almost under sentence of death. I agree with the noble Lord that if we are going to draw a line in this initial stage of bringing in emphysema and bronchitis, it should be at much less than 50 per cent.
My Lords, I think we can describe this Bill as doing a very valuable piece of ambulance work for the 3,000 or 4,000 beneficiaries who will participate in the £300,000 from the Industrial Injuries Fund which was mentioned by the noble Lord. I had proposed to make some remarks about offsets, but having dealt with that, I will leave the point. I said that this Bill is to me a very valuable and important piece of ambulance work; but we cannot have effects without causes, and pneumoconiosis, emphysema and chronic bronchitis, to use the terms used in the Bill, result from something; there is some cause for these illnesses being inflicted on individuals in occupations where these hazards are found. It is the amount of dust particularly in those mines in Britain where there has been a high degree of mechanisation during the past few years. At one time we used to say, "If we can get coal cut by machines, we may have less dust". Experience has proved that we are getting more dust. I wish to pay tribute to the National Coal Board and the National Union of Mineworkers. Co-operating together they have taken a number of measures to allay the incidence of dust in underground workings. These include water infusions on the coal face; sprays on the conveyors and on the loader heads— all these things have played a part in minimising the incidence of dust in the coalmining industry. I hope that the causes will be dealt with more effectively in future than has been the case in the past.
When my noble friend reported on the accident off the Cornish coast in which 896 the oil tanker the "Torrey Canyon" was involved, I thought of the amount of money which has, rightly and justifiably, been spent on clearing the oil from the sandy beaches of Cornwall. For generations the lungs of many healthy and brave men, particularly those working in the mining industry, have been clogged with foreign material, and I thought that if only a tithe of the amount expended in Cornwall had been spent on more research into the causes of the diseases to which I have referred, we might not have as high an incidence of pneumoconiosis as we have to-day. I welcome the Bill, and join my noble friend in expressing my gratitude to the honourable member for Merthyr Tydfil, a very old friend of us both, and also to the Minister, for bringing this Bill forward. In my view it is a step in the right direction.
§ 5.14 p.m.
§ LORD BOWLES
My Lords, we have had a most interesting debate and I should like to congratulate my noble friend, Lord Taylor of Mansfield, on his eloquent contribution. As he said, this is a Private Member's Bill, introduced by the honourable Member for Merthyr Tydfil, Mr.S.O. Davies, who is also an old friend of mine. We heard a very important speech by the noble Lord, Lord Platt, who is one of the most highly respected medical men in the country. I understood him to say that it is not possible to prove that bronchitis and emphysema are caused by pneumoconiosis. The contribution made by the noble Lord has proved of great assistance to me in winding up the debate. I am sure that all noble Lords will read what the noble Lord, Lord Platt, had to say, as well as other speakers in this debate.
Like everyone else, my sympathies are with the men who go down in the pits, or work in some other industry where there is a lot of dust. We all feel that they must be inhaling something which will affect their lungs. I feel the effect even when I get near the diesel fumes which may emanate from a taxi or a bus or one of the new locomotives. But I understand— I say this with great regret— that the cause of these complaints has not yet been proved. My noble friend Lord Blyton referred to what happens in Australia and South Africa, where industrial injury payments for bronchitis and emphysema are paid. 897 Those diseases are not endemic in those countries. As I understand it, if you can find a doctor who can prove that a disease contracted while at work has resulted in your suffering from bronchitis and emphysema, the Government or the appropriate Department will pay a claim.
It is not the same in this country. Here everyone over middle age has bronchitis, or a great number of people have. I was rather shocked when I heard this. I understand that if any noble Lord coughs to-morrow morning, he has bronchitis. I did not know that I had it although I sometimes cough in the morning; but there you are! It does not prove that the disease arose from my occupation; and that is the real issue before the Ministry and before both Houses of Parliament. I should be as delighted as anyone if it could be proved that miners suffering from bronchitis or emphysema had contracted these diseases from working in the pits, or if workers in the cotton industry or the woollen industry or the slate quarries or the tin mines of Cornwall were suffering for the same reason. I am sure that the Minister of Social Security would be delighted to find that she could go to the Treasury and say that this had been established beyond any reasonable doubt. The men who had worked themselves almost to death and suffered illness in the service of the nation could then get benefit from the Industrial Injuries Fund to which they, as well as the employers and the State, had contributed. They would be entitled to draw increased compensation for suffering from one or more of these terrible respiratory diseases.
My Lords, I was asked why the figure of 50 per cent. was chosen. It seems that the level of 50 per cent. disability has been selected on the best medical advice available because it is associated with the transition from simple pneumoconiosis (which is less severe and not progressive) to the severe and complicated form of the disease. I will not say any more about that now, but I can assure my noble friend that my right honourable friend the Minister of Social Security and her Ministry will go on with their research and inquiries into whether it is necessary to keep the figure of 50 per cent., and will also go on with their researches to see whether it can ever he established that bronchitis and emphysema 898 are caused by a man's occupation. I cannot promise anything, but that is the wish. As my noble friend Lord Taylor of Mansfield pointed out, the Ministry of Power, which controls the National Coal Board, and the National Union of Mineworkers, are spending in the neighbourhood of £1 million a year on research, which shows that the Government as a whole are very sympathetic.
If the Bill receives the Royal Assent, a considerable amount of work will still have to be done. In the first place, amending regulations will be required to make changes in the prescribed diseases regulations for industrial injuries cases, the "supplementation" and "benefit" schemes for "old cases". The Ministry will have to identify the cases likely to benefit and call them up for examination where necessary. This will, of course, be in addition to the ordinary work of the pneumoconiosis medical panels, the administrative boards which deal with old cases and the local offices of the Ministry. The Ministry's staff have already been giving thought as to what will be required and are anxious to launch the scheme as quickly as possible. I am sure they will do this with the efficiency we have come to expect of them. It is difficult to forecast when the Ministry will have been able to deal with all the cases affected but they hope, all being well, to make substantial progress in clearing cases likely to benefit under the Bill by the end of the year.
Both Parliamentary Secretaries, first Mr. Harold Davies, and then Mr. Loughlin, changed the character of the Bill considerably by the inclusion of the old cases. The Bill as originally presented did not provide for them. It now embraces two particular groups: first, those entitled to weekly payments of compensation related to an existing loss of earnings for the disease under the former Workmen's Compensation legislation. Their compensation is supplemented by weekly allowances from the Industrial Injuries Fund under the Workmen's Compensation Supplementation Act 1951 as amended by the Workmen's Compensation and Benefit (Amendment) Act 1965. Secondly, there are those whose disease developed so slowly that, as my noble friend Lord Taylor of Mansfield said. they were time-barred for workmen's compensation purposes. They now receive weekly allowances from the 899 Industrial Injuries Fund under the provisions of the Pneumoconiosis and Byssinosis Benefit Act 1951.
For technical reasons, it is not possible to put these "old cases" on all fours with industrial injuries cases. For one thing, the assessment of their disability is differently carried out. But the Bill provides that if a man is classified in one of the particular groups I have just mentioned as an "old case" and is partially disabled by pneumoconiosis (of gravity comparable to an assessment of 50 per cent. under the Industrial Injuries Scheme), he shall have any chronic bronchitis and emphysema taken into account, if all his chest disabilities would bring him into the range of allowances payable to a man totally disabled by pneumoconiosis alone.
My noble friend Lord Taylor of Mansfield referred to the Bill as "a great little Bill". The Government have accepted it and changed it, and I am glad to see from my reading of the debates in another place that my honourable friends there and my noble friend here are satisfied that it is going some way towards dealing with this problem, though obviously they would have liked it to have gone further. I hope that I have given some encouragement to them. The Government are just as keen as they are to find out if these two diseases are caused by the occupation of the sufferers and to see whether they cannot do something to include these poor people in the scheme as a whole.
§ LORD BLYTON
My Lords, I will not detain the House much longer, but I should like to clear up two points. To the noble Lord on the Front Opposition Bench I would say this. If a man is before a Board for pneumoconiosis, his condition is determined by the X-ray plate. Any other disability he may have is not taken into consideration at all. That has been our experience for the last twenty years. To my noble friend on the Front Bench I would say this. Do not think that a man in Australia or South Africa who has a cough can go to his doctor and get a certificate to enable him to get compensation. He cannot. He has first to prove that he works in an industrial atmosphere. These two diseases are scheduled under the Pensions Acts of those countries as industrial diseases, particularly 900 in relation to the mines in South Africa and Australia.
§ LORD BOWLES
My Lords, I accept that. In fact, I would go further. If the man can give medical proof that bronchitis or emphysema arose through his occupation, he would get pension or benefit.
§ LORD DRUMALBYN
My Lords, the noble Lord, Lord Blyton, quoted an experience which is contrary to my own. I wonder whether I may ask the noble Lord who answers for the Government if he would be good enough to let us both know the Government's view on this matter before the next stage of the Bill.
§ On Question, Bill read 2a, and committed to a Committee of the Whole House.