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Clause 85—(Medical Examinations)

Volume 529: debated on Thursday 1 July 1954

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I beg to move, in page 55, line 27, to leave out "or seeking employment."

Perhaps it would be convenient to take the next two Amendments also in line 29, leave out "either absolutely or."

In line 38 at end, insert:

(2) A true copy of the report of such medical examination shall be furnished to the person concerned or to his representative.
(3) The regulations shall provide that art, person examined pursuant to the foregoing provision of this section shall have the right of appeal against the contents of the medical report and against any prohibition made pursuant thereto.
(4) Provision may be made by regulations for requiring any persons seeking employment at mines for the first time to submit themselves for medical examination.

Certainly, Mr. Speaker.

The Clause gives power for the making of regulations by which those employed in the industry will be medically examined. I do not know in how many other industries regulations of this kind apply, but that is what the Clause provides for miners. Not only that, but having been examined, the miners can be given notice of dismissal as a result of the words "either absolutely or" in the Clause. In any case, if the medical examiner employed by the National Coal Board is of opinion that a miner is fit only for light employment he can certify that he is incapacitated and the miner may be given other suitable employment or he may not.

Our proposal that the words "either absolutely or," should be deleted, that if there are to be medical examinations there shall be a right of appeal for the workman, that the medical report shall be sent to the workman's representative or medical adviser, and that if there is disagreement the matter can be forthwith referred to an independent authority or medical board selected for the purpose.

We have to be very careful, on the question of medical examinations. We are very concerned about output. Coal production is going down to some extent through loss of manpower. If there are to be rigid medical examinations of men who have worked in the industry for 20 or 25 years and if from time to time doctors say that a man is not fit, unless there is a right of appeal to an independent tribunal or authority to decide these matters there is likely to be further depletion in manpower, with all its evil consequences to the production of coal. We are justified, therefore, in pressing the Amendment.

If there is to be medical examination, it should be subject to appeal if the workman's medical adviser or anybody on his behalf feels that there is injustice. We all know that medical men are apt to differ about a man's condition. Is the National Coal Board doctor to be the final arbiter in cases of this kind? We feel that a true copy of the medical examination report should be furnished to the man's personal representative. Surely, a man who has given his life to the industry is entitled to ask that his own doctor should look into the case to ascertain whether the certification by the Coal Board doctor is justified.

It is true that in South Wales, if not in the industry generally, there are men working in the industry who are suffering from the early stages of pneumoconiosis. After medical examination they are returning to the industry to specified conditions of employment. That is all very well, and perhaps it is necessary to have medical examination in certain circumstances, but we suggest that the workman should have the right of appeal.

I beg to second the Amendment.

The House is making very good progress and I hope that the Minister will meet us handsomely on this Clause so that the harmony may continue. We are not against the medical examination of new entrants into the pits. The industry is entitled to examine new entrants so that the mines can get the best available labour. We are not against the 12 months' probationary period.

What we object to in the Clause is that if, say, a man has worked at the pit for 20 years and the pit closes and he goes to another pit for work, within the meaning of the Clause he is seeking employment and could be medically examined. The Coal Board doctor at the second pit may certify that he is not fit for any employment, with the result that he is thrown out of the industry. We are not prepared to accept such a position. We believe that if a man has spent a lifetime in the industry, and he is changed from one colliery to another, he is not leaving his employment but must be regarded as a man who is still within the industry.

The second point to which I wish to refer is that we cannot give to the National Coal Board doctors the absolute power to determine whether a man shall go to work in a pit or not. We do not question the medical qualifications of those making these examinations, but surely if a man is certified by an N.C.B. doctor as being no longer fit for underground employment and the man thinks he is, he should have a right of appeal to some independent doctor to determine whether or not the N.C.B. doctor is right.

We ask the Minister, even at this late stage in the Bill's progress, to redraft this Clause so as to protect the man who has worked for years in the industry and give him the right of appeal against an adverse decision by an N.C.B. doctor. We urge him not to allow one man to determine whether a miner shall lose his livelihood at the pit. If we can get those two points accepted, then we shall be satisfied. We are not concerned here with entrants into the industry, who should be medically examined, but with those who have spent their lives in coal-mining.

I think I ought to say a word at this stage. I accept the two principles put forward in these Amendments. I agree that the medical examination which might result in somebody leaving the industry should be confined substantially to new entrants. There is the point about a probationary period which we all understand, but that is highly technical. It is one of the reasons we have not succeeded in bringing forward suitable Amendments at this stage.

Secondly, there is the question of appeal. Considering the importance of the issues involved, it seems to me that, when a man may be made to change his job, there must be an appeal. One man cannot decide the fate of another without some kind of appeal, and, therefore, I can say quite briefly that I can accept the principles laid down in these Amendments.

I can also tell the House that I would have done this already if it were not for the existing regulations and the desirability not to invalidate them. That was one of the difficult drafting problems which we had to face. Now that we have done so much of the rest of it and the House has approved of so many of the other proposals, we shall have more time to devote to this and we shall succeed in finding a solution to it.

I am delighted to know that the Minister has gone another length of rails as we say in the pits. We had a very long discussion in Standing Committee on 4th May on this point, and we were sustained extensively by the remarks of my right hon. Friend the Member for Morpeth (Mr. R. J. Taylor) on the desirability of appeals and on the men having to submit themselves to medical examination. At that time I gave an example of a concrete case of how these medical examinations, in fact, affect men who are seeking employment in another pit. We all accept the fact that in the days that lie ahead many of the men now working will be redundant and the working of old collieries will come to an end. Developments that are taking place will absorb at least those who are 100 per cent. capable of working underground, but the difficulty will arise when we come to the employment of men who have sustained accidents while working in the pits. We want to safeguard the interests of those men.

7.45 p.m.

The case that I have in mind came to my own doorstep when I was in charge of men in the pits. On 3rd February, 1937, the four pits of which I was lodge secretary closed down completely. Those who were 100 per cent. physically and mentally capable could get work, but those men who had sustained accidents at the pits where they had worked all their life could not find employment. There were 127 men. Had those pits continued in commission producing coal they would have continued to work there, but because of the medical examination, to which they had to submit themselves and which revealed their partial but slight incapacity, they could not get work at all.

We have come a long way on the question of medical examinations. We say that the new entrants into the pits must be medically examined and, if need be, we shall have to have periodical examinations. What we are seeking is that when a man is medically examined and the decision goes against him, he should have the right of appeal to some one higher up. That is what happened from 1935 when the industry was still in private hands. A man who was turned down by the company's doctor went to another doctor by way of appeal and invariably we got those men through. I am glad that the Minister is prepared to consider the principles embodied in these Amendments.

I should like to say a word or two here, because I feel rather strongly about this matter. Unfortunately, I have had as much experience as anybody in the House of pits closing. When men have been working in a coal mine from the age of 13 or 14 until they are 50, and then because their pit closes they have to be medically examined, it is but natural that they should not be perfectly fit men. It is a remarkable thing, however, that had the pit not closed those men would have continued working there for many years.

They are prevented from working only because of the medical examination. I do not want to say anything derogatory of doctors. Sometimes I feel very strongly about them and I have seen some very naughty things that they have done. However, on the whole, I believe that they would be prepared to give a fair examination, but I submit that they are not in a position entirely to give such a fair examination to a man whose pit is closing under circumstances over which he has no control. If he is 45 or 50, there are few avenues in life left open to him.

The Minister has been treating us very well, but I notice that when he said he would meet us on this matter he remarked that he would do it in a substantial way. What is "substantial"? Is that 50 per cent. of what we want, 51 per cent., or 100 per cent.? What we want to ensure is that men who are in pits that are closing should be able to work in other pits. Many of these pits are closing today. Some of them should have been closed a long time ago, because they are nothing but junk pits. What is more, we paid considerable sums of money in compensation for them when nationalisation came long. Further, there are hon. Members opposite who thought that we did not pay enough for them. But that is by way of digression.

These men come under a word new to the coal industry—it is "redundancy." The N.U.M. has done its best and the Coal Board has done its best in paying men, as far as possible, during redundancy. But it is not easy to find work for men aged 65 or 70. I am thinking of men who are actually producing coal, who are some of the best workmen in the pit from the point of view of production because of the regularity of their employment. It is not right that they should have to be medically examined, although I am all for the new entrant being examined. If, however, this should be necessary, they should have the right of appeal. Will the right hon. Gentleman tell me what he means by "substantially"?

This is a most difficult medical problem which is not easy to explain to the layman. The Miners' Federation has no medical officer attached to it, and while some miners' lodges have medical officers attached to them, they are only doing general practitioner work in the main; so that there is no one to whom the general practitioner can appeal unless he sends these men to some other place away from the mining industry.

I ask hon. Members who belong to the medical profession to be careful in accepting medical machinery for reexamination in cases of this kind. Some of these claimants for work at a certain age may be suffering from various degrees of scattered pneumoconiosis, that is to say, it is not concentrated in one part of the lung but is in patches all over it. It is difficult to diagnose such a case even with a decent X-ray. These intermittent examinations may cause great hardship to many old or middle-aged men who have given their lives to the industry and who have given their physical constitution to the industry—

I do not think that this Amendment has anything to do with the nature of the medical examination.

If the hon. Member will look at the Amendment, he will see that it deals with men having to submit to medical examination.

You are drawing it rather tine, Mr. Deputy-Speaker, though I am perfectly prepared to submit to your Ruling on the matter. You are giving a Ruling by which subsequent medical examination or intermittent medical examination can scarcely be discussed. I can only say, God have mercy on the miners who will undergo future medical examination and periodical medical examination whenever something happens in a pit, and either it closes completely or is partially closed.

Unless this Amendment is accepted, great injustice will be dealt out to men who have done all they can for the industry and who have great experience of various kinds of mines. So I beg Labour Members to be very careful in watching this scheme. Although I am getting old, as a medical man I speak from experience, and I beg my hon. Friends on these benches to try to see that these men are protected in every possible way from being thrown on to the labour market simply because a medical officer in a certain area decides that they are not fit for mining work.

I want first to say how much we appreciate the Minister accepting the principle of this Amendment. If he had not done so, something insidious would have been left in the Clause which would have worked against those who are qualified only for light work. Throughout the mining world there are vast numbers of men who are only able to do that kind of work, and if this test of a medical examination applied to those of them who were to be transferred to another colliery, in all probability those people would not be employed there. So it is in that sense That we appreciate what the Minister has done.

This also works against the person who is not 100 per cent. physically fit, who may not be able to obtain a lighter type of work at his own colliery, and yet might have an opportunity of going elsewhere because, if he had first to submit to a medical examination, it would go against him. There is also the question of redundancy, mentioned by my right hon. Friend the Member for Morpeth (Mr. R. J. Taylor). In the case of a number of pits closing down, a large number of men might have to be re-examined in order to remain employed in an industry in which they had worked all their lives.

So I end by saying, as I began, how much we appreciate the Minister agreeing to the principle of this Amendment.

May I reply briefly and particularly to the right hon. Gentleman the Member for Morpeth (Mr. Taylor) about the meaning of "substantially"? I used that phrase only at the end of my remarks after I had accepted two importtant principles. One is that medical examination of anybody already in the industry could in no circumstances lead to his exclusion from the industry. The second is that medical examination for the purpose of a man continuing in the industry would only apply to new entrants, which I understood was generally accepted, with the exception of the probationary period.

I think that those two principles meet substantially what hon. Gentlemen and right hon. Gentlemen opposite have in their minds; and, of course, we could not allow any sharp practice, which it would undoubtedly be, of trying to treat as new entrants men in pits which were closing down because of redundancy. That would be disgraceful.

In view of the assurance given by the right hon. Gentleman, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.