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Pneumoconiosis And Byssinosis Benefit Scheme

Volume 496: debated on Wednesday 20 February 1952

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10.1 p.m.

The Parliamentary Secretary to the Ministry of National Insurance
(Mr. R. H. Turton)

I beg to move,

That the Draft Pneumoconiosis and Byssinosis Benefit Scheme, 1952, a copy of which was laid before this House on 29th January, be approved.
I ask the House to give their approval to the draft scheme under the Pneumoconiosis and Byssinosis Benefit Act, 1951. The Act itself set out in considerable detail the provisions of this scheme. The scheme embodies those provisions. Briefly, the scheme puts uncompensated men and their dependants in the same position as if they were entitled to workmen's compensation for total disablement or death from either disease. It provides for a basic weekly allowance of 40s. for total disablement. This allowance will be a life pension additional to any payments, such as sickness benefit or retirement pension, under the National Insurance scheme to which a beneficiary may be entitled.

The scheme also provides for a capital sum of £300 for the benefit of members of the family of the deceased who were wholly dependent on the deceased. The scheme also provides, in view of the request made by hon. Members of all parties, that where there is no person who was wholly dependent on the deceased there will be a death benefit for those who were partially dependent, the amount to be made available by variable sums, not exceeding £300, to be determined by the administrative board. Following the practice under the Workmen's Compensation Act, the benefit in either case will be paid into a county court and administered by the court for the benefit of the dependants.

The scheme will be administered by an administrative board, as in the 1951 Act, which the right hon. Member for Fulham, West (Dr. Summerskill) introduced, and their decision will in all cases be final, but they will refer certain questions to other statutory authorities for decision. In particular, the question of whether a man is totally disabled or not or of whether death resulted from the disease will he referred to a medical board for their decision. I would remind the House that where the medical board's decision is that a man is totally disabled, that decision is final, and even if the man obtains work of any nature that decision still stands and cannot be rescinded.

I think that the House would like me to mention two points. First, the timing of this scheme. Directly this draft scheme has been approved by both Houses, it will be signed, and 14 days from the signature of the scheme it will come into operation. On the Thursday following the 14th day, payments will be made, and, in the case of the 800 men who are covered at present by the 1943 pneumoconiosis scheme or the National Coal Board scheme or the 1941 byssinosis scheme that payment will come on that Thursday.

In a certain number of cases, further inquiries will have to be made into such matters as unemployability supplements. In other cases, where men are outside the 1941 byssinosis scheme and the 1943 scheme, we shall have to try, and we are now trying, to discover those men.

I want to say a word or two about publicity. During the passage of the Act the hon. Member for Ince (Mr. T. Brown), my hon. and gallant Friend the Member for East Grinstead (Colonel Clarke) and my hon. Friend the Member for Handsworth (Sir E. Boyle) requested us to try to make the scheme easily understandable to everybody and to undertake publicity to see that everybody understood it. Frankly, I cannot say that the scheme is light literature for the ordinary working man, but I claim that the scheme as drafted will be readily understood by every union official.

We are taking steps to see that every man affected has the scheme brought to his notice. We shall arrange through the B.B.C. that due publicity shall be given to the scheme so that everybody can hear it over the air. We are arranging for a full advertisement of the scheme in the national and local Press. We have also prepared a leaflet, now in draft, which will be available directly the scheme comes into operation. I have gone through the draft carefully and I can assure hon. Gentlemen that the draft can be classed as light literature as no legislation can be.

Therefore, we hope that the scheme will be brought to the attention of everybody who is likely to be concerned with it, in particular to those dependents of men who died after 31st December, 1949. We are relying on the unions for the details of men who died after 31st December, 1949. We have enjoyed great cooperation on the part of the unions in this matter. All the unions concerned will receive a copy of the draft leaflet immediately it is printed.

I ask all hon. Members to help us in securing that the scheme is brought at the earliest possible date to the notice of all their constituents who are affected. We mean to make this a success, and, with the help of hon. Members on both sides of the House, it can be made a success. I hope the House will give the scheme its approval tonight.

10.8 p.m.

As the scheme derives from the Pneumoconiosis and Byssinosis Benefit Act, for which, as the Parliamentary Secretary agreed, the Labour Government were responsible, I can only give it a very warm welcome. I have no intention of being critical, but I should like to make a few general comments.

The Parliamentary Secretary and his right hon. Friend have during the last few months had an opportunity of examining the whole question and of considering in some detail the needs of totally disabled men suffering from pneumoconiosis and byssinosis. The scheme provides only for the totally disabled and the families of those who have died from these diseases.

I should like to know whether the hon. Gentleman has also considered the partially disabled. He knows as well as I do that the Department have endeavoured to devise a scheme which would help the partially disabled. Not for one moment am I trying to minimise the difficulties. In the comparatively short time that I served in the Department, we tried to devise a scheme to cover both the totally disabled and the partially disabled. I recognised full well that it would be a mistake to wait until we had arrived at some comprehensive scheme and by so doing allow the totally disabled to suffer. Therefore, the Bill was introduced last July, and I am pleased to see this scheme today.

However, it deals only with the totally disabled. I know that the difficulties in regard to the partially disabled are very great. It is argued that it is very difficult to assess the needs of the partially disabled because there are so many degrees of partial disablement, but I feel that now that this scheme has been presented and the administrative machinery has been built up, this might offer an incentive to further investigation.

Another thing I want to say is that this scheme could be used for other diseases and I should like to ask the Parliamentary Secretary to consider such diseases as epithelioma, which is skin cancer. Many of my hon. Friends, who have worked in those industries where skin irritants are used which are responsible for skin cancer, know that there are totally disabled men who will come within the scope of this scheme. I do not ask the Parliamentary Secretary to find out now. What I am trying to do is a little probing.

I ask the Parliamentary Secretary to read the speeches tomorrow and consult with his officials who know all about it—he is well served—to see whether skin cancer could be included. I cannot think that there can be any question of not being able to diagnose skin cancer. Therefore, the Parliamentary Secretary has a first-class piece of work in front of him. I might add that the reason I mention skin cancer is that it is one of the time-barred diseases. As the Parliamentary Secretary knows, this scheme is particularly concerned with time-barred cases.

The Parliamentary Secretary mentioned publicity. I see in Part IV that it is said that the patient must apply in writing. The Parliamentary Secretary said that the B.B.C. will be asked to broadcast the news that at last a scheme is in being. I must remind him that we are dealing with men who are totally disabled, and have been totally disabled for many years and have been living at subsistence level. Many of those men cannot afford a radio, and many of them cannot for economic reasons have a daily paper; they have one only at the weekend; and I am conscious of the fact that the very words "pneumoconiosis" and "byssinosis" are not words which friends or relatives could pronounce easily or indeed remember.

There is a chance that this news might not reach the men who are in the very greatest need. It has occurred to me that the Parliamentary Secretary might ask the excellent officials of the National Assistance Board to co-operate in spreading the news. If one could try not only the conventional publicity media but also those people who may be in touch with totally disabled men, bearing in mind that the totally disabled will have only a very few years in which to enjoy this benefit, I am quite sure that the House will be very satisfied.

May I again thank the Parliamentary Secretary for introducing this scheme tonight, which I am quite sure the House will approve.

10.13 p.m.

When the Bill was going through this House during the Committee stage several hon. Members, including the hon. Member for Ince (Mr. T. Brown) and myself, drew attention to the importance of having this scheme drafted in such a way that the ordinary person could understand it. Having this evening read through the draft scheme, I think the Ministry have made a very good job of it, and I was very pleased to hear that they have drawn up a short leaflet which will be issued. As this is a point which I raised, I should like to take this opportunity of adding this word of tribute.

I should be out of order if I pursued too far questions about the application of this scheme to other diseases, but perhaps I should not infringe the Rules of Order if I just said that it seems to me that this scheme might form a good precedent for other schemes. I very much agree with what has been said by the right hon. Lady the Member for Fulham, West (Dr. Summerskill) about seeking the assistance of the officials of the National Assistance Board all over the country to help in this scheme.

I am sure that many more people will benefit from this scheme, even in a constituency like mine which is a residential constituency though there is a pit not far away. I very much hope indeed, now that the scheme has seen the light of day, that it will help those in the greatest need.

10.15 p.m.

I have no desire to disturb the placid atmosphere, but I have a grouse to make. I want to ask the Parliamentary Secretary why it has taken so long since the passing of the Act to present these Regulations.

Publicity is of paramount importance to the unfortunate victims of the dreaded disease pneumoconiosis. I speak from day-to-day experience in my constituency in saying that many of those affected have drifted away from the minefields to other parts of the country. I do not know what methods we can adopt to get into touch with them, but the suggestion made by my right hon. Friend the Member for Fulham, West (Dr. Summerskill), of using the National Assistance Board as a medium to draw their attention to the very important Regulations may be useful, and I hope that that will be done.

It does not mean putting extra administrative duties on the Assistance Board, as they probably are in touch with many men who have been denied the right of compensation to which they have been entitled since the day of certification. They will have many men coming to them for assistance, driven there because this country—I am not blaming the Government—has failed to meet its obligations to men overtaken by this disease in days gone by.

One of the pleasing features, as I said on my Second Reading speech on 16th November, 1951, is that I was appointed a member of the committee which started the battle for fair play and fair do's for victims of silicosis and pneumoconiosis. That was in 1922. It has taken us 30 years to secure justice for the totally disabled.

There is still the other point, again of paramount importance, that a large number of men in the minefields are partially incapacitated as a result of the disease which they have contracted. I plead with the Parliamentary Secretary and his Ministry to hasten the day when the just demands and rights of the partially incapacitated will be met. I hope that every available means will be used to convey information to the victims of these diseases, including the Post Office, which might be a suitable medium for getting information to them.

In conclusion, despite the fact that we are only now dealing with these unfortunate men, I am happy to have lived to see the day when the agitation which we started in 1922 has at last borne fruit in the year 1952.

10.20 p.m.

I want to join in the congratulations to my hon. Friend the Parliamentary Secretary to the Ministry of National Insurance on the introduction of this draft scheme. Hon. Members on all sides of the House are delighted to see it and we have all played our part in assisting it through the House.

I do not want to enter into rivalry, but it should be said that my hon. Friend the Member for Somerset, North (Mr. Leather) played a very prominent part by introducing a Private Bill with this object in view. In bringing his Bill to the attention of the House my hon. Friend made several speeches, not only then but since, emphasising the importance of the position of the partially disabled.

On the Second Reading of the Pneumoconiosis and Byssinosis Benefit Bill we were told that if we were to press the claim of the partially disabled too much, there might be a danger of wrecking the entire Bill. Now there is no such danger. We now have the Bill and also this scheme, so that the time has come when we can try to see what can be done for the partially disabled without any danger of making more difficult the position of those who are totally disabled.

There are two points in the scheme to which I wish to draw the attention of my hon. Friend the Parliamentary Secretary and to ask for a little clarification. During the Second Reading of the Bill my hon. Friend drew a definite distinction between the Workmen's Compensation Act and the Industrial Injuries Act. He said:
"…it struck me from the speeches of one or two hon. Members that they were not fully aware of what we are trying to do by using these words 'total disability' from the Workmen's Compensation Acts.
That is not the same thing as total disability under the Industrial Injuries Act. This condition under the Workmen's Compensation Act was defined by Lord Loreburn as: 'The man who has a physical defect which makes his labour unsaleable in any market reasonably accessible to him.'"—[OFFICIAL REPORT, 16th November, 1951; Vol. 493, c. 1384.]
As I understand it, the point my hon. Friend was making was that he was proceeding under the Workmen's Compensation Act rather than under the Industrial Injuries Act. Therefore, I see with some concern in Article 6 of the scheme the statement referring to Section 13 of the Industrial Injuries Act—
"Where a person entitled to an allowance could, for the purposes of section 13 of the Industrial Injuries Act (which relates to unemployability supplement), be treated as being incapable of work and likely to remain permanently so incapable as the result of pneumoconiosis or byssinosis.…"
I hope that does not mean that my hon. Friend is giving up the definition in the Workmen's Compensation Act in favour of that in the Industrial Injuries Act.

If my hon. Friend will allow me to interrupt, if he reads Article 6 carefully he will see it says that the unemployability supplement granted under the Industrial Injuries Act shall apply in like nature to this scheme. It does not for one moment say that the definition of total disability is anything like the definition of total disability under the Industrial Injuries Act. Here we are accepting a wider definition, as I hoped I had made clear in my opening speech.

I am grateful for my hon. Friend for clarifying that point.

The second point about which I am slightly disturbed is that the Board seems to be the final arbiter in its own case. I am wondering whether there is not some way in which there could be another arbiter—application to a judicial court, for example—in cases of this kind.

10.25 p.m.

I was unavoidably absent when the Bill was before the House, and I should like to take the opportunity now of congratulating the Parliamentary Secretary on his appointment as my successor. This is the first public opportunity I have had, and I do it with pleasure.

With my right hon. Friend who was Minister of National Insurance in the late Administration, and with many others, I join in welcoming the Act and the scheme. I express not only by own personal pleasure at the passing of the Act and the bringing of this scheme before the House, but also the pleasure of the organised miners, who for so long have suffered from the time limits—

And pottery workers. Being an ex-coalminer, I speak particularly for the miners, and I am sure that if my hon. Friend is fortunate in catching your eye, Mr. Speaker, he will express the same pleasure on behalf of the pottery workers. Although in my own coalfield, happily and fortunately, we have not had a great incidence of either silicosis or pneumoconiosis, to miners, and particularly to those in the Welsh coalfield, the Act and the scheme will be a great boon and blessing.

The point I want to make is very brief. The scheme is to be administered by a Board. Can the Parliamentary Secretary state tonight what will be the composition of the Board and give the names of the chairman and vice-chairman and the other members who will be responsible for the administration of the scheme?

I was glad to hear the hon. Gentleman say that the Ministry are taking every possible step to give the widest publicity to what will be the rights of the men who will be affected by the scheme. I was particularly pleased when he said that in addition to using the B.B.C. and the national Press, the local Press is to be utilised for this purpose. That is a far more important medium than the national Press. I compliment the Parliamentary Secretary upon the initiative which the Ministry propose to take in this matter of publicity.

There is another point, getting to know which men are suffering from this dreaded disease. When we were discussing the Act in relation to the pre-1924 cases, the Minister drew our attention to the fact that he knew of a man nearly 90 years of age who had had an accident long before 1906, let alone 1924, and he wanted to know how that individual would be acquainted with the scheme.

The local officers of the Ministry of National Insurance are widely diverse throughout the land—there are nearly 1,000 of them—and if, in connection with publicity, there is close co-operation between them and the secretaries of the local branches, I am not sure that that would not be more important than contacting either the headquarters of the N.U.M. in London or the headquarters of the various areas.

The best possible point of contact for getting the utmost out of the publicity which is the aim of the Department is that there should be keen, close co-opera- tion between the Minister's staff on the spot in the colliery areas, and the local branch secretaries. I welcome this Measure and hope that the Parliamentary Secretary is in a position to give the constitution of the Board, with particular reference to whom the chairman and vice chairman will be.

10.31 p.m.

May I offer my heartiest congratulations to the Parliamentary Secretary, to his predecessor, and to their advisers upon having produced a scheme which will be of such benefit to the men suffering and to those who have died as a consequence of pneumoconiosis? I rise at this stage in the debate not to deal with the various relevant points which seem to be applicable to detailed consideration on so important a matter. I feel that the arguments put at some length—and rightly so—on the Second Reading of the Bill, were sound. But it is quite clear that this scheme closely coincides with the provisions of the Bill and carries the intentions of the Bill fully into effect.

One point on which I should like a reply is this. I am sure that the Parliamentary Secretary would agree that it is the intention of everyone concerned with the scheme that those who die as a result of pneumoconiosis shall be covered and provided for. One should, therefore, look most carefully at the scheme and, as is so often the need, judge the words liberally and then look at them with a restricted mind to see if these cases are really fully covered.

I would confine myself to one point which is, I think, by far the most important so far as the fatal cases are concerned. In Article 2, there are the words "as a result of pneumoconiosis" and, on the face of it, nothing could be more simple. But, in the fatal cases, it is not always so simple a matter. One cannot always resolve the question by asking, "Did the man die as a result of pneumoconiosis?"

There may be other causes of death, but among them is pneumoconiosis. There might be argument as to whether the person, prior to his death, was suffering from that disease and other conditions as well, and it could be that there would be great difficulty in showing that death was the result of pneumoconiosis because of the other contributory factors.

It is quite obvious that a man who dies while suffering from pneumoconiosis may not die because of it. To take an extreme case, a man might be knocked down in the street and killed while suffering with pneumoconiosis. Because the man has pneumoconiosis, and yet dies from some other cause, is he covered by this scheme? I would press the Minister on the type of case where, in the chain of causation, pneumoconiosis is present. In that case, if we apply a liberal interpretation to these words, the man would be within the scheme, whereas, if we apply a restrictive interpretation we will find that the men's dependants will not be provided for.

I am not satisfied—but I hope I will be after I have heard the Parliamentary Secretary—but I have a strong impression that he and his advisers are most anxious that the most liberal interpretation shall be given to the construction of these words by the Board. I put it to the hon. Gentleman that it would be most helpful to the success of the scheme, and to the dependants of those persons concerned, if a clear pronouncement were made by the Parliamentary Secretary tonight to the effect—if I may say so without appearing presumptious—that it is the intention of all concerned that there shall be this liberal interpretation of these words.

10.36 p.m.

There is one point that I should be pleased if the Parliamentary Secretary would clear up. In putting forward these Regulations the hon. Gentleman said that payment would start on the first Thursday after the expiry of the 14 days after they had been accepted by this House and another place. I have on my files at the present time about six cases of old miners who are awaiting these Regulations becoming law. In every one of these cases the men have been told by the pneumoconiosis medical board when they made application that as there was no legislation they could not be examined. I know that when these Regulations do become law these men, and many others will be making application for examination, and I would like the Minister to say whether payment will be made retrospective to the time when they first made application if it is found that they are 100 per cent. disabled. If it is not these men will have been waiting weeks or perhaps months for payment.

The Minister suggested that the medical board would give its decision to the administrative board in certain cases, and that the decision of the administrative board would be final. That is not unlike what happens now. The pneumoconiosis medical board decide on the percentage of disability from which a man is suffering, and a suggestion has been made that it is a bad thing that there should be no appeal from the decision of the administrative board. I have felt ever since I became interested in this subject that there is a great deal of dissatisfaction among miners on this point. I, and other members who represent mining constituencies, continually have miners attending interviews and telling us that their own board has diagnosed pneumoconiosis.

In many cases they are sent to Edinburgh Royal Infirmary, where a specialist, after an X-ray examination, decided that a man has pneumoconiosis, and he is thereafter sent to the medical board, which, in a number of cases, decides that a particular man is not suffering from the disease. It might be that the general practitioner could make a mistake, but where a specialist in an infirmary like that of Edinburgh has given a decision and the medical board gives a different one it is impossible to make a miner believe that he has had a square deal.

We want to let these men know that everything possible is being done to decide what is fair in their interest. I do not know if a law court would be the right place—it is one medical opinion against another. I have given much thought to this: in my early days in this House I interviewed the Minister, but I cannot say who should be the final deciding factor in this matter. It is very difficult, but I do think the Ministry should give some serious thought to it to make many of these people who have been turned down by the pneumoconiosis board feel that everything possible has been done to make it as clear a Bill as is possible.

My final point is this. I suggested in Committee that many people would be rushing to be examined by pneumoconiosis boards. Is there going to be one administrative board for the whole of Britain. If there is I have no objection at all. I take it that the medical boards—we have one in Edinburgh, we used to have to wait on doctors from Manchester—now we have one in Edinburgh will deal with the medical examinations and it will be one administrative board for the whole of the United Kingdom.

These are the only three points I want to raise and add my plea with those of my friends that the Ministry as quickly as possible will bring in a scheme covering the partially disabled.

10.43 p.m.

All people who have a knowledge of mining areas, pottery areas or other industries affected by this scheme, will welcome this mitigation of the hardships which many casualties have sustained in the industrial processes of this country. One has seen over the years an improvement in the arrangements to deal with what I have described as industrial casualties and my own view, for what it is worth, is that men who are incapacitated in industry ought to be cared for by the state or the industry itself.

This scheme does not go the whole way—it provides for total incapacity. I share the right hon. Lady's view on the Front Bench and hope that without the lapse of a great deal of time some process will have been arrived at by which it will be possible to carry this a stage further and deal with the thousands of people who have a sense of grievance. They are not provided for in this scheme because they are not, in fact, totally disabled under the description of this Bill but I think a scheme such as I have adduced should be considered.

There is a great deal of dissatisfaction because the men feel that while they have courtesy and an excellent service from the medical boards there is very often a conflict amongst medical men themselves in the diagnosis. In North Staffordshire men sent to tuberculosis hospitals and the medical men have formed the view they were suffering from an industrial disease—pneumoconiosis—and when a man has been referred to the medical tribunal they have said he was suffering from something congenital or something which might have been given to him in any case whatever his industry was.

It is very easy to pose these difficulties, but is very difficult to suggest a remedy. We and the men must be assured that whoever has the responsibility of making the final decision in these matters are men of the highest medical reputation and men whose word is beyond question as far as that can be made possible. But modern science is revealing increasingly new conditions and in my own area we find men, who have been out of the industry a great many years and who, when they were in the industry or about to retire from it, had a medical examination which showed they were not suffering from the disease, now many years afterwards, under examination of highly-qualified men, are told they have pneumoconiosis or silicosis.

But they could get no redress under the present set-up, and no compensation. For that purpose, I hope our whole research and the appointment of the men responsible for this humanitarian work are of the highest quality and that with increasing patience and efficiency we shall see the best is done for the men.

I was glad to hear the Parliamentary Secretary say that such trouble had been taken to make this scheme widely-known over the country. I am sure the unions will co-operate as they are agencies for this good work and they will not refuse to give advice because a man has left the industry. However, in an industry like the pottery industry, we have married women, who have been out of it many years, but who are now suffering from what they suspect to be pneumoconiosis. They are people sometimes with a family and who are no longer members of a union so that they have not access to the professional and legal advice which is normally forthcoming.

These simple, good people want to know, and have already expressed some anxiety about it, what is the procedure by which they can get the benefit under this scheme. I support the view, which is almost universally expressed, that we should use the Ministry of National Insurance offices for this matter and not refer people to an administrative board, which may be a remote body of men unknown to the ordinary citizen. If possible, details should be given of the regions applicable to a citizen and there should be definite information from which an ordinary person can see what he has to do to qualify for benefit.

The Ministry of National Insurance is one of the best Ministries we have introduced in this country, and its offices are very helpful. But, so far, they have no information on this matter and are unable to answer queries. There has been some delay, of which my hon. Friend the Member for Ince (Mr. T. Brown), has complained, but in building up a scheme like this and in the compilation of a fine document, inevitably some time is required.

This is taking the rough corners off the hard circumstances of many men, who have usefully contributed to the industry but who have felt discouraged and disheartened very often because they have had no consideration after being not totally incapacitated, but often so incapacitated as to have to leave the industry and not able to earn money. Whereas they had been able to earn from £10–£12 a week before being incapacitated, they are now to get only 40s., plus an inability allowance, if it is available. But I welcome this step, even if it does come from a Conservative Government.

10.50 p.m.

I am very happy to follow my colleague who represents the mother of the Five Towns and who can speak with real knowledge on this subject as one who, like me, has lived and worked in the atmosphere of the area. We know something of pneumoconiosis which we used to call "potter's rot." I would like to reveal my hesitations and fears on one or two aspects of this problem which have been touched upon, in part by the hon. Gentleman the Member for Wigan (Mr. R. W. Williams) who has great experience in advising the Miners' Federation.

The Parliamentary Secretary said that total disablement and death claims would be referred to a medical board whose decision would be final. He realises, of course, that at present if a man or woman believes he or she is suffering from pneumoconiosis the machinery is available so that the sufferer can be examined by the pneumoconiosis panel, and, if the case is rejected, a further appeal can be made a few months later. We know of cases in which, because the disease is progressive, refusal in one year meets with acceptance the next. May we take it this technique will be continued for these people?

I am happy to know that.

When a man or woman dies of pneumoconiosis the death normally is reported to the coroner by the general practitioner in charge of the case, and if there be any question of compensation there is always a post mortem. The post mortem examination, as a rule, is attended by a representative of the pneumoconiosis panel, and the evidence is given to the coroner who records on the certificate that death was due to pneumoconiosis. It must be understood that the medical officers of the pneumoconiosis panel never perform the post mortem examination but are present and examine the appropriate organs. When the certificate is given, pneumoconiosis could be present as a primary or secondary cause, or, as has been mentioned by the hon. Member for Wigan, as an unconnected cause—for instance, a man being run over and killed who was suffering from the disease.

I want to augment the hon. Gentleman's plea to the Parliamentary Secretary on how these death claims will be construed, and ask that they will be treated in as liberal a manner as possible. I remember most vividly the case of a man suffering from an advanced stage of silicosis whose life was a misery and burden to him. He could not lay down on a bed, but spent his last days, day and night, in a chair. No longer wishing to live he committed suicide, dying of gas poisoning. The death certificate showed that the primary cause of death was carbon monoxide poisoning.

In that case the medical referee certified that death was due to silicosis. It would then in those years not have been possible for the widow to have had any redress. Everyone who knew the case realised that the man killed himself because of the burden of the disease, and it was, therefore, technically wrong, though morally correct, to say that he died of the primary disease.

Today, we might be in great difficulty. I have mentioned this case because it is such a rare possibility, but there are others. Recently, I was approached by a widow; her husband had received compensation for some time before he died, and she asked me why she could not receive any benefit. What had happened was that his death was due not only to pneumoconiosis but to cancer of the thyroid, and it was considered that death was primarily due to the cancer and that pneumoconiosis had not hastened it. Whether that be true or not, the widow felt aggrieved.

When one signs a death certificate there is a primary cause, a secondary cause, and unconnected or apparently unconnected causes. If a man dies of pneumonia and also had pneumoconiosis there will be no difficulty with any medical board; but supposing a man had heart disease, coronary insufficiency or coronary thrombosis, there are some medical men who might say that there was no connection between pneumoconiosis and coronary disease. They would be quite wrong. A man whose vital capacity for breathing is permanently embarrassed cannot possibly escape aggravation of the organ which lies between the two lungs.

I am urging, almost praying, that the Parliamentary Secretary and his right hon. Friend should be most careful that a really liberal interpretation of this should be understood by the medical boards, whose decision is final. The same must be applied to the question of total disablement. In the old days, however difficult they were for workmen, many county court judges had no difficulty in interpreting liberally what was the meaning of an "odd lot," a man who though it could be argued he was not totally incapacitated for work could not find it. I hope that now, in 1952, we are going to get as much benefit as in the days of 30 years ago in the interpretation of what is and what is not total disablement. That is the type of question I am putting. I do not necessarily expect the Parliamentary Secretary to give me an answer tonight. All I say is that this is what all of us, on all sides, are thinking about, and how we expect him to interpret the Regulations.

10.59 p.m.

In the previous debate I drew attention to the effect of this on the quarrymen in my native county of Caernarvonshire, and the Minister was good enough, in subsequent correspondence, to reassure me on one or two points. I am glad to know the measure of publicity that is proposed, and that the Government are going to such trouble to ensure that nobody is going to be left out of consideration. I want to ask him whether his Department intends to issue an explanatory statement in Welsh, because it is important that it should do so. It would be no precedent because excellent documents have already been translated into Welsh by the Ministry of National Insurance.

Yes. Is it intended to issue an explanatory statement in the Welsh language because, as I said in the previous debate, possibly no part of the country has suffered more from the effects of these diseases than has Wales. I want to make quite sure that any Welshman has the same opportunity of knowing what are his rights under the scheme as anyone else.

In view of the time, I leave that one request with the Minister and hope that he will grant it.

11.1 p.m.

I am most grateful to the House for the reception given to this scheme and I will try, as a token of my gratitude, to answer the points that have been made.

I am in a little difficulty on some of the points made by the right hon. Lady the Member for Fulham, West (Dr. Summerskill), and by some of her friends, because this scheme is made under the Act which excludes the partially disabled. I am too junior and unaccustomed to this Box to wish to be called out of order by you, Mr. Deputy-Speaker, but perhaps I could say that we explained at an earlier stage the difficulties that made us exclude the partially disabled from the Bill. We have not minimised those difficulties. We are considering how to get over them, but it will take time. We are seeking the cooperation of the unions in this matter but the outcome will not be reached soon.

The right hon. Lady the Member for Fulham, West, also asked me about skin cancer. This draft scheme is entitled "The Pneumoconiosis and Byssinosis Benefit Scheme"—

The hon. Gentleman ought to know—although I know he is new to this kind of thing—that Speakers and Deputy-Speakers often allow a great deal of latitude in the House when we are discussing a subject of this kind which has a humane aspect. So I do ask the hon. Gentleman not to be quite so rigid in his interpretation of what is done.

The right hon. Lady has considerable experience—I have been in this House a mere 23 years—

I know, but the Opposition are much more at the mercy of the Speaker than the Government side. I have not found Speakers so lax, Mr. Deputy-Speaker, and I would not like to suggest that you would be lax.

This is a pneumoconiosis and byssinosis Act and scheme. If we were to deal with skin cancer a new Bill would have to be introduced and then a new scheme. So I shall leave that problem and come to a very good point which the right hon. Lady then made.

The hon. Gentleman should speak from the heart and not from the head. That is a good piece of advice from a woman.

On the question of publicity she asked that we should give details of this scheme in the National Assistance offices. It is certainly our intention that every Ministry of National Insurance office shall have plenty of these leaflets, on the reverse side of which will be an application form. Therefore, anybody who has a leaflet will have the application form ready for completion and submission. We shall certainly take into consideration the suggestion of the right hon. Lady with regard to the National Assistance offices as well as the post offices, which were suggested by the hon. Member for Ince (Mr. T. Brown). We shall endeavour to see that everybody knows about this scheme, and that is why I sought the co-operation of hon. Members on all sides of the House in this matter.

The hon. Member for Ince took me up on the question of delay. May I try to plead my case on this? The Bill received the Royal Assent on 7th December, the day Parliament went into Recess. We laid this Scheme on 24th January, which was before Parliament reassembled. We took every opportunity to get this earlier and, if it had not been for the sad event over which we all grieve, this scheme would have been in operation before now. That is the explanation and I do not think my Department can be charged with any delay in this matter.

I was asked by my predecessor, to whom I was grateful for his kind words to me, what will be the composition of the Board. We shall be using the same administrative board as is used under the Workmen's Compensation Act, 1951, which was set up by the right hon. Lady the Member for Fulham, West. That is a Board composed of: Chairman, Mr. Paul Sandlands, Q.C.; Deputy-Chairman, Mr. J. A. Crawford, Q.C.; representing the T.U.C., from the N.U.M. is a friend of all sides of the House, Sir Will Lawther; and there is Mr. A. McAndrews; representing the National Coal Board is Mr. Pilkington, and Mr. Stansfield is representing the Employers' Confederation. That Board are well acquainted with these problems, and they will be employed for this purpose.

In reply to the points made by a number of hon. Members about the interpretation of the problem of total disability and the question of whether deaths arise from pneumoconiosis, it will be the medical boards who at present determine these questions who will determine them in the future. These medical boards, as the right hon. Lady well knows, are composed of the greatest experts on whether the cause was silicosis or pneumoconiosis.

It will be the pneumoconiosis medical boards, and not the ordinary medical boards under the Industrial Injuries Act?

I think I am correct in saying it will be the silicosis medical boards under the Workmen's Compensation Act; those for pneumoconiosis came later. They are the experts in this matter.

I must not say anything that will limit them in their determination, but I can say this: I do not recognise the subdivision of the hon. Member for Stoke-on-Trent, Central (Dr. Stross) of causes into three categories. When I used to practice at the Bar we had not so sublimated causes to that extent. It is a causa causans, and not a causa sine quanon, that we are seeking. In other words, where a material factor of death is pneumoconiosis, the medical board can say that it is the cause of death. It would be unwise for me to go further than that at present.

The hon. Lady the Member for Lanarkshire, North (Miss Herbison) asked me—I nodded at the time—whether there will be one administrative board for the whole country. But for Scotland we shall be using the Scottish medical board. That is the answer to the hon. Lady's question.

The hon. Member for Droylsden (Mr. W. R. Williams) made an appeal that the leaflet should be written in the Welsh language. I have not considered that before, but now that he has made such an impassionate plea I can see that there is considerable advantage in doing that, and we will consider whether it is practicable.

I regard the scheme as a bold operation. We have had great help from Members on all sides of the House, and I hope that it will be the success that we all, on all sides, wish it to be.

Can the Parliamentary Secretary answer the other point, which affects a great many people: Will those who have still to be examined by the pneumoconiosis medical board have their payment made retrospective if the case is finally decided in their favour?

I am grateful to the hon. Lady, and am sorry I omitted that. She will see from paragraph 3 of the Order that the weekly payment

"shall be payable as from the date this Scheme comes into operation.…
That means that those who are at present receiving benefit under the 1943 scheme or the National Coal Board scheme for pneumoconiosis, or the 1941 scheme for byssinosis, will receive it at once, because they are already earmarked and examined.

Those who are not in the scheme will require a medical examination, but if the application is made in due time the payment will be retrospective to the time when the scheme comes into operation, which, as I have said, is the 14th day after the signature of the scheme; and the first payments will be made on the first Thursday thereafter.

I should say that there is a precedent for disseminating the leaflets in the Welsh language as well as in the English. The family guides and many of the leaflets explaining the National Insurance Act, 1943, were printed in Welsh.

Question put, and agreed to.

That the Draft Pneumoconiosis and Byssinosis Benefit Scheme, 1952, a copy of which was laid before this House on 29th January, be approved.