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Damages (Asbestos-Related Conditions) (No.2) Bill

Volume 505: debated on Friday 5 February 2010

Second Reading

I beg to move, That the Bill be now read a Second time.

Today is Groundhog day for this Bill, because its terms are exactly the same as those of a Bill that passed through the House last year. Unfortunately, there was insufficient time for that Bill to go through the other place before Prorogation last November. It received full Committee and Report stages, however, with amendments moved, discussed and, ultimately, withdrawn, so later today I hope to be able to put the Bill before us through all its stages, not out of disrespect to the House, but to point out the fact that this legislation has already been meaningfully debated.

Most Members know that for 20 years before I entered Parliament I was a personal injury lawyer, and I suppose that I still am: once a lawyer, always a lawyer. As the Minister for Borders and Immigration, said earlier, “Once a Whip, always a Whip.” I have never been a Whip, but I have certainly been a lawyer, and I still have my practising certificate, although I do not currently practice.

This Bill is about pleural plaques, a thickening of the lining of the lung. They are usually visible on an X-ray or a CT scan, and they are caused by exposure to asbestos. It is hard to imagine someone’s fear if they are at risk of developing an evil, disabling illness such as mesothelioma, and there is a statistical connection between the two, although a medical causal connection is debatable. The fact remains, however, that the statistical connection indicates to people that they are at a much higher risk than the population at large of developing mesothelioma. It is a painful and always fatal illness, and during the course of my practice and, indeed, my time in the House, I have met many pleural plaques sufferers who have expressed their strong feelings about the issue and the problems that have recently arisen because of court decisions.

Until recently, pleural plaques were compensated under common law. Since 1984, there have been three cases against the Ministry of Defence, the leading one being Church v. MOD, involving a diagnosis of asbestos-related pleural plaques—or asymptomatic fibrosis on the pleural lining of the lungs, as it is described in the cases. In the Church case, it was decided that the condition constituted an injury, enabling damages to be claimed. The amount of compensation varied, but before the cases that stopped the claims being brought, it was in the region of £7,000 on a provisional damages basis.

In the 2006 case of Rothwell, the Court of Appeal found that pleural plaques were not compensatable, mainly on public policy grounds. The Court refused to aggregate the condition of pleural plaques with the anxiety and distress that they cause, deciding that each individual condition was not compensatable and that the courts could not look at the aggregate of both pleural plaques and the psychological conditions that they cause because the two were separate.

If the psychological condition involved was a recognised psychiatric illness, that would be different. However, the psychological conditions of pleural plaques sufferers do not get so severe as to be considered diagnosable psychiatric illnesses. In this day and age, unfortunately, the legal system still treats injuries to the mind rather more severely than injuries to the body. Compensation is not awarded on a fair basis, comparing one with the other.

I return to the relevant cases. In autumn 2007, the Rothwell case was upheld by the House of Lords in the case of Johnston. In fact, it was the same case; several cases were heard together. The House of Lords upheld the Court of Appeal decision that pleural plaques were not compensatable, and that has been a cause of concern in the wider community and the House ever since. That concern has been the subject of numerous parliamentary questions, early-day motions, amendments to Government Bills and attempts at private Members’ legislation, including my own Bill last year. It has also been raised in I do not know how many Adjournment debates. There is no perfect option for dealing with the issue; various proposals have been debated and suggested but unfortunately the Government have not announced a formal position. That is why this Bill is a good way forward.

Pleural plaques represent a serious condition that affects many people, and doing nothing is simply not an option. My Bill tries to build on what has happened in Scotland, which is ahead of the game. The Scottish Parliament passed its own legislation to restore the position in law to where it was before the cases in the Court of Appeal and House of Lords. That Bill has now achieved Royal Assent in Scotland. There were attempts to challenge its legality through judicial review, but they failed in the Scottish courts; the outer house made a strong judgment that made it clear that certain points, particularly those arising from aspects of the European convention on human rights, were not sustainable.

My Bill is modest; all it seeks to do is turn back the law to where we all thought it was prior to the decisions of the courts. Doing that, however, would mean that the insurers, who were on risk at the time, would meet the liability rather than getting the windfall of having collected the premiums without having to pay out on the risk. The Bill is tightly drawn; it is not the thin end of the wedge and it will not open the floodgates to any form of parallel litigation for other illnesses or injuries. It relates purely and simply to pleural plaques.

The Bill maintains the basic principles of negligence or breach of statutory duty as the test for liability. The burden of proof that the claim exists and should be upheld is still on the claimant. The Bill provides for a suspension of the limitation period from the date of the House of Lords decision until the coming into force of the Bill. That is only fair, but it would not affect any cases that were already settled or decided in the courts. There would be no question of trying to reopen cases that were finished. The Bill also leaves out Scotland, which, as I have said, has made its own arrangements already.

The Bill is an important measure. If pleural plaques were outside the body, there would be no argument about their being compensatable, yet because we cannot see them they do not count, according to the House of Lords. The psychological injury in such circumstances can be looked at by the courts only if there is a physical injury that they consider compensatable. The House of Lords has ruled that the internal scarring of pleural plaques is not compensatable as it would be if it were on the outside, so the psychological consequences cannot be compensated.

I commend the hon. Gentleman for his pursuit of this issue. There is a particularly extraordinary position in relation to psychological damage and it appears to contradict established practice in other areas. I hope that, at the very least, his return to the scene will address that issue.

I am grateful to the hon. Gentleman. Basically, the problem is that the test for a physical injury is subjective. It is sometimes referred to as the “thin skull test”—the victim is taken as found, and if they have a thin skull and have had a brick dropped on their head, that is hard luck for the tortfeasor and the victim is compensated according to the injuries sustained. When there is psychiatric injury, that is not the case; it is assessed on an objective basis, with the victim assessed not as found but according to a “reasonable man” test, as it were. That is unfair. Our legal system discriminates against psychiatric injury compared with physical injury.

My concern is that if my Bill does not go through, the campaign for reform of the rules on psychiatric injury in general will gather strength. The system is ripe for reform anyway, but the failure to compensate for pleural plaques, and for associated psychological injury that is less than a diagnosed psychiatric injury, needs to be dealt with now. If it is not, the momentum behind the campaign for widespread reform of psychiatric and psychological injury law will gather much greater momentum and ultimately become irresistible. The Bill is a good halfway house that will alleviate some of the pressure, so that we do not end up in that position.

The hon. Gentleman mentioned the legislation in the Scottish Parliament. I recall that when we last debated the issue last April, we noted that the Scottish Parliament had asked for the costs of the implementation of its legislation to be monitored. Does he have any information about the monitoring of costs in Scotland?

I think that legislation has only just come into force, so it would be difficult to monitor the costs so far, but they arise in two situations. One is when the Government are the de facto defendant, often standing in the shoes of a former nationalised industry, and the other is when the defendant is a private company. As I understand it, the Scottish Bill has either only just come into force or is about to, consequent upon the judicial review challenge having failed, so it is too early to discuss whether there are any costs, and if so, what they amount to. I understand the UK Government’s position to be that any costs should fall on the Scottish Government, as I think they now call themselves, rather than on the UK taxpayer. That remains to be seen, and it is a matter for them to negotiate between themselves.

The hon. Member for Truro and St. Austell (Matthew Taylor) made the point about the different treatment of psychiatric injury. I believe that the Bill will resolve that issue, because it provides for the illness and injury of pleural plaques to be designated actionable damage, which is the key to unlock compensation for psychological consequences that may be less than a diagnosable psychiatric illness. There could then be compensation both for the pleural plaques themselves and for the lesser psychological consequences, which was what everybody thought the law was before the House of Lords intervened.

I hope that my Bill will find favour with the House, as it did last time. It was extensively debated in the previous Session, so I hope that the House will not only give the Bill a Second Reading today but put it through all its stages, bearing in mind that it has passed them before.

I congratulate the hon. Member for Hendon (Mr. Dismore) on bringing the Bill back to the House and on his tenacity on this important subject. I mean this with no disrespect to him, but it is very much a lawyer’s Bill. As a layman, I listened to his explanation hoping to find out exactly how the Bill would work. I think I got the general drift, but some of the more intricate parts of it eluded me.

I have a constituency interest, because for many years we had an asbestos factory in the area in which I have always lived. It seems that many people in my constituency suffer from various asbestos-related problems, including mesothelioma. I know the problems that that causes them, both physically and mentally, so anything that we can do to try to alleviate them—not only through compensation, but by recognising that we now understand what can happen—is to be welcomed.

I have listened to the various arguments and looked into terms of the hon. Gentleman’s Bill, and there are some concerns. However, as he said, it has been scrutinised in this House already, so, if possible, we should allow it to go down to the other place. If the Lords have any further worries or questions, it is appropriate that they should raise them there. Saying that, I wish the hon. Gentleman good luck with his Bill.

I apologise to you and to the House, Mr. Deputy Speaker, for not being as audible as I usually am. I shall therefore be brief, in order to spare the House the horror of listening to my strained voice.

I congratulate the hon. Member for Hendon (Mr. Dismore) on his persistence in bringing forward this important Bill again. We had a long debate on the matter on 24 April last year. I understand that the Bill has been in Committee since then, and he is right to bring it back here. When we discussed the Bill last year, everyone who spoke, from all parts of the House, expressed their compassion—I certainly did—for those who have worked, sometimes for a lifetime, in conditions that they did not know, and which their then employers were not aware, were dangerous because of the presence of asbestos.

There are now generations of people suffering from asbestos-related illnesses—people who gave a lifetime’s service, not only in private companies, but in the service of our country, doing important jobs in the armed forces and nationalised industries. They are suffering now, but there are generations to come who do not yet know the extent to which they will suffer. I appreciate that that is the point of the hon. Gentleman’s Bill.

My hon. Friend the Member for Uxbridge (Mr. Randall) said that this was a lawyer’s Bill. I am with the hon. Member for Hendon on that: perhaps it is a lawyer’s Bill, but I confess to also having been a lawyer once. As I think I mentioned last year, when I was a young articled clerk, a long time ago, I dealt with difficult asbestosis cases.

I did not take the suggestion that the hon. Member for Uxbridge (Mr. Randall) made in a pejorative way. My Bill is a lawyer’s Bill in the sense that lawyers can understand it, because it deals with our concepts, but it is also a Bill meant for ordinary, common, working people and their families who have suffered from a debilitating problem.

Of course it is, and in no way was I being pejorative about lawyers. Indeed, I was about to say to the hon. Gentleman that because I have dealt with the matter in a previous professional life—not quite to the same extent as him, but to some extent—I understand only too well why he has brought his Bill forward. It would allow a causal link to be established between certain actions by employers and future illnesses that might arise. I also appreciate that that is where the difficulty lies. As he said, if pleural plaques were on the outside of the body, they would be a recognisable disease and the difficulty would not arise. I fully understand the difficulty of recognising pleural plaques for the unusual condition that it is, and I give him credit for bringing that difficulty before the House for consideration. Pleural plaques do not cause illness or pain—although some argue that they do—but the psychological effects of having them diagnosed affect people and their families, as he has previously explained. The last time we debated this, the hon. Member for Hendon said:

“The problem is that psychological injury in these circumstances can be looked at by the courts only if there is also a physical injury that they consider compensatable. My Bill simply tries to establish that pleural plaques are compensatable, so that a link could therefore be made to the psychological injury.”—[Official Report, 24 April 2009; Vol. 491, c. 534.]

I appreciate the hon. Gentleman’s point; I recall him giving that clarification of the causal link theory for the benefit of those normal people who are not steeped in personal injury law.

I also appreciate, however, that there are various views in the medical profession on the way in which pleural plaques can be interpreted as affecting a person’s health. I will reiterate the evidence of Dr. Robin Rudd, a recognised expert on this matter. He has said:

“Pleural plaques are not thought to lead directly to any of the other benign varieties of asbestosis-induced pleural disease”.

Dr. John Moore-Gillon of the British Lung Foundation has also said:

“Pleural plaques do not themselves ‘turn malignant’ and become a malignant mesothelioma. They do not in themselves cause asbestosis to develop, nor do pleural plaques increase the risk of lung cancer, and they are a different condition from diffuse pleural thickening.”

I know that the hon. Gentleman will accept that those are correct medical diagnoses.

Pleural plaques are evidence of exposure to asbestos. The question of a medical link between the one and the other may be arguable, but the statistical link is not. We know the number of people who suffer from pleural plaques, and the number of people who get mesothelioma, and the one is evidence of risk of the other. That is what causes the psychological symptoms. A person who has pleural plaques will know that they have been exposed to the risks posed by asbestos, and it therefore preys on their mind that they are at greater risk of contracting mesothelioma.

I entirely accept the hon. Gentleman’s explanation. He makes his case very well.

We are speaking today about the psychological effect on a person of knowing that they have been diagnosed with pleural plaques. The difficulty is with the principle of compensation. It is unfortunate that the Government have not introduced a similar Bill. They have shown some enthusiasm for this one, and for this issue over the years, but not enough to introduce a Government Bill with the full backing that such a Bill would have. I do not mean political backing; I mean the access to the full medical evidence and all the other kinds of backing that a Government Bill would have behind it. I congratulate the hon. Gentleman on his persistence in bringing his Bill forward again.

I am worried that the hon. Gentleman has suggested that all stages of the Bill should be dealt with today. It is a short, precise, well-constructed Bill, but none of us has had the time or the opportunity to look in any detail at the matters that will be considered in its Committee stage.

I am sure that the hon. Gentleman is going to say that his other Bill was considered in Committee, but I will allow him to say it.

I know that the hon. Lady was present at the previous Bill’s Committee stage last time, but because of a slight hiccup, which we need not go into, she was unable to participate in the Committee. This Bill is identical to the one that went through its Committee stage at that time. It was subject to amendments tabled and debated in Committee, as well as to amendments tabled and debated on Report, so it had had full consideration by the House before it received its Third Reading last October.

I thank the hon. Gentleman for that explanation; he said exactly what I expected him to say. He is right that a technical error prevented me from taking part in Committee, but I witnessed those proceedings and I cannot disagree that the Bill was scrutinised to some extent. I nevertheless hope that if the Bill passes through the House today, it will be properly scrutinised in the other place. Although I do not disagree with the hon. Gentleman about the importance of the matters in the Bill—indeed, I welcome the clarification of the law that it entails—it is also important that we observe the proper procedures of Parliament when passing legislation, not least because this legislation is important and has far-reaching consequences, affecting many people. It may cost a lot of money and it is Parliament’s duty to balance the needs and rights of the individual with those of the taxpayer and the public purse. I put it no more strongly than that, but I express my concern.

Ultimately, we are talking about being fair to people who, through no fault of their own, have contracted what might turn into a terrible disease. I approach the issue with compassion and understanding for the individuals concerned and their families. That said, it is important to leave sufficient time to hear what the Minister has to say, so I shall conclude to allow him to address us.

I congratulate my hon. Friend the Member for Hendon (Mr. Dismore) on securing a Second Reading for this Bill, which deals with an extremely important issue. Issues of principle are raised, as well as practical issues; above all, this subject involves great human suffering.

I pay tribute to all who have followed the debate over many years, particularly to Members who have pursued the campaign. As we have just heard, my hon. Friend the Member for Hendon has been extremely diligent; this is his second attempt to get this Bill through the House. He deserves all our thanks for his persistence and diligence in this matter. I also pay tribute to my hon. Friends the Members for Blaydon (Mr. Anderson), for Jarrow (Mr. Hepburn) and for Barnsley, West and Penistone (Mr. Clapham), who have been equally diligent and persistent on behalf of their constituents. Many other Members have been involved, as we have received representations from them, from trade unions and from others who are deeply concerned about this issue.

Those who have followed the debate over the years will know that this is my first time speaking from the Dispatch Box on this particular subject. It is not, however, the first time that I have had occasion to deal with the issues raised in today’s debate. As the Member of Parliament for North Swindon, I am acutely aware of these problems. As the House will know, Swindon is a great industrial town: it always has been; it was created by Brunel as a great railway town. It had great railway works, which sustained the town and helped it to grow over many decades.

Very large numbers of my constituents worked in the railway works, so they were exposed to asbestos. Mesothelioma, a particularly horrible disease, is, because of its prevalence, well known locally as “the Swindon cancer”. Many constituents have had to live with it for many years, so I am deeply familiar with the problem. I have had to deal with some heartbreaking cases. I will always remember the pensioner who came to see me. Our meeting took a long time because he could not speak for tears, as he tried to describe how his wife had died from mesothelioma. He had not been diagnosed with it, but his wife had. She had contracted the cancer because every day when he came home from work, he had taken off his work clothes, which she washed for him before making his tea. As a result of that act of spousal duty, she had contracted this awful illness. He was consumed with grief at the loss of his wife, but also with guilt because his work had resulted in her contracting such a terrible illness.

As I have said, this subject involves complex issues of legal principle, difficult practical issues and weighty financial issues, but above all it is about human suffering of an especially acute nature. I know that all the Members who have raised it, including my hon. Friend the Member for Hendon, are deeply conscious that none of us should ever forget that human suffering is at the root of it.

Mesothelioma is a particularly unpleasant cancer. We have seen great progress in treatment of a range of cancers, but unfortunately we have not yet found a way of dealing with diffuse mesothelioma. It is always fatal and involves a very poor life expectancy of, on average, between 12 and 18 months following diagnosis, which makes the diagnosis particularly hard to accept. That bears directly on the issues raised by my hon. Friend the Member for Hendon about the psychological damage that can be caused by pleural plaques, which, as he has said, indicate exposure to asbestos. Those who are diagnosed with them will inevitably start to wonder whether they will develop mesothelioma, which is a particularly horrible illness because, I understand, very little palliative care is available. It is painful, and, as I have said, the diagnosis is invariably fatal.

The Government take mesothelioma extremely seriously, but it is difficult to deal with because, as with pleural plaques, the legal background is very complex. The hon. Member for Epping Forest (Mrs. Laing) was mildly critical of the Government—although not up to her usual coruscating standards—for not acting more swiftly, and I appreciate the urgency of the matter, but, as I have said, the issues involved are complex.

For many years, the defining mesothelioma case was that of Fairchild in 2002. In that case, the House of Lords held that a person who contracted mesothelioma after wrongful exposure to asbestos at different times by more than one employer could sue any of those employers, even if the employee could not prove which exposure had caused the disease. That is particularly important, because exposure to just one strand of asbestos can be clinically responsible for the development of mesothelioma. It is not a question of sustained exposure over many years. All of us Members who have encountered mesothelioma in our constituencies know that our constituents have often been employed in several workplaces, and that the same workplace may have had different owners. It has been very hard to prove legally which exposure led to the disease, and the Fairchild case was therefore extremely important.

When another case was brought, that of Barker v. Corus, the House of Lords decided that in a case within the boundaries of the Fairchild exception in which someone had contracted mesothelioma after wrongful exposure to asbestos at different times by more than one responsible person, the damages were to be apportioned among those responsible for the wrongful exposure according to their relative degree of contribution to the chance of a person contracting the disease. That means, in practice, that a claimant must trace all relevant defendants as far as possible before liability can be apportioned and compensation paid, and that the risk of any of those defendants’ being insolvent and unable to pay the appropriate share falls on the claimant.

That decision was taken in May 2006, and I am sure that Members will understand the huge burden it placed on any potential claimants, as well as the deep distress it must have caused them. I make no criticism of the House of Lords in this case; it was applying legal principles in a way that it has complete discretion to do, and it is not for this House to criticise its decisions. However, the emotional and human consequences of that decision were profound, not least because when someone is diagnosed with mesothelioma, their life expectancy is typically 12 to 18 months. As I am sure my hon. Friend the Member for Hendon will understand from his previous life as a lawyer, the prospect of someone in such a situation having to go through such a tortuous legal process, and of having to try to identify all the possible employers in whose employ they might have been exposed to asbestos, would be enormously difficult and time consuming, and in practice would make it more or less impossible actually to get any compensation.

When this became clear, the Government moved with great speed. The House of Lords made its judgment in May 2006, and by July 2006 the Compensation Act 2006 had received Royal Assent. Through that Act, the Government took measures to rectify the Barker v. Corus judgment by enabling claimants to sue any of the negligent persons and then to recover 100 per cent. of the compensation on a joint and several basis. It would then be a matter for the defendants to apportion the damages they had paid between themselves.

That was clearly the right thing to do. It threw the burden of proof, and the responsibility for seeing through all the complex legal processes, on to the employer, not the mesothelioma sufferer at such a difficult and painful time for them and their families, when they and their loved ones are having to come to terms with this dread diagnosis. When we could see a way clear to take action, we took it, and we did so with great speed. In my time in the House, I cannot think of another occasion when any Government have moved with such speed to rectify a situation.

We will, therefore, move as quickly as we possibly can, but these are very complex and difficult issues, and I want to say a little about them. This Bill passed through a number of stages in the previous parliamentary Session and there have been several Adjournment debates on the subject it addresses. The issues have been raised with great force and cogency by a number of Members, therefore, and I am extremely grateful to them for everything that they have done to highlight the issue and to keep it in the public mind. The Government are sympathetic. I am going to respond very sympathetically to the Bill today, and I should also point out that an identical Bill is today receiving its Second Reading in another place.

The Bill provides for asymptomatic pleural plaques and the separate condition of asymptomatic asbestosis to constitute actionable damage under the law of tort for which damages may be awarded. The overwhelming balance of expert professional opinion is that about 99 per cent. of pleural plaques cases are asymptomatic and therefore difficult to diagnose, and only 1 per cent. are symptomatic. It is important to stress that in that relatively small number of cases where symptoms are exhibited so the condition is readily identifiable, it remains possible to bring a claim under civil law. This Bill therefore addresses asymptomatic pleural plaques. It also contains provisions on limitation and retrospectivity.

For the sake of clarity, do the Government intend that asymptomatic pleural plaques, as a disease, will not give rise to compensation but will merely be noted in order to establish the causal link between the employment and the possible future development of asbestosis or other serious diseases such as mesothelioma? Is the Minister talking about that causal link, rather than having actual compensation for pleural plaques?

If the hon. Lady will forgive me, I will go through the argument first before I reach the conclusion regarding our attitude to the Bill. On her point about causality—if I understand her correctly—my hon. Friend the Member for Hendon has already set out the position clearly. The existence of pleural plaques shows exposure to asbestos, but, as I think is acknowledged widely, it does not mean that anyone who has pleural plaques will inevitably get, or is likely to get, mesothelioma. There is no causal link in that way, but it does indicate exposure to asbestos, and for that reason it is completely understandable that people who have pleural plaques will begin to worry, often very intensely—to the extent that, as my hon. Friend has said, it becomes very disruptive of their lives. To that extent, pleural plaques fall into the category of illness, so it is understandable that the existence of pleural plaques should often cause intense and disruptive worry about the possibility of getting mesothelioma.

In passing, I point out that I agree with my hon. Friend about the distinction that we in this House, as well as the courts, have drawn in the past between mental and physical incapacity. I have already made it clear regarding another Bill—I will not dwell on this, Mr. Deputy Speaker—that in relation to representation in this House, we should not draw any distinction between mental and physical incapacity. It is not tenable, and I am optimistic that this House will make progress on that area. The point that my hon. Friend raised about that distinction was very well made.

The Bill also contains provisions on limitation and retrospectivity to enable claims to be brought in cases that were stayed pending the House of Lords decision on pleural plaques, and in those which have not been concluded subsequently. Again, my hon. Friend spoke about that. The issue of pleural plaques, not because of causality but because of the linkage with the dread disease mesothelioma, has excited considerable interest and attention in this House, the other place and outside. I therefore hope that it will help if I explain the current position before turning to my hon. Friend’s Bill in detail.

As hon. Members know, the Government carried out a consultation exercise on the question of whether pleural plaques should be made compensatable under the civil law. The consultation paper proposed action to improve understanding of pleural plaques, to try to deal with the intense mental anguish that can often be caused, and to make sure that people understand that if they are diagnosed with pleural plaques, it does not inevitably mean they will develop mesothelioma. In the consultation paper, we proposed action to improve understanding in this way, and to provide support and reassurance to those diagnosed with pleural plaques to help allay their concerns. This is an important step forward, and it shows the Government’s recognition of the importance of this issue. It is also a tribute to the work of my hon. Friend.

The consultation paper also considered the issues arising in relation to changing the law of negligence, and invited views on whether this would or would not be appropriate.

Clearly those issues stretch far wider than this issue, important though it is. The law of negligence permeates almost every area of public life in one way or another, so it is important that the consequences of any change we might make on this particular issue are thought through and discussed as fully as possible. That was a subject addressed by the consultation paper, which also sought views on the merits of offering no-fault financial support to people diagnosed with pleural plaques, and on two possible ways of doing that.

Although the consultation paper was an important step forward, I do understand all the concerns expressed by hon. Members about the time it has taken to reach conclusions in the light of the consultation. As I have said, where we have felt that we could act speedily to resolve the situation, we have done so. We have done so specifically in respect of the legal situation that developed in 2006 in relation to mesothelioma.

The House of Lords decision has raised extremely complex and difficult issues, which, inevitably, have required very careful consideration within government and more widely. It has also been very important to look beyond the issue of pleural plaques to consider how people who have been exposed to asbestos—irrespective of whether or not they have developed pleural plaques or mesothelioma—can be supported much more widely. I am sure the House will understand that anyone who knows they have been exposed to asbestos will worry, so we must consider what we can do to support them. We have made it clear throughout that in our view it is important to ensure that any decisions are reached on the basis of the best available medical and other professional evidence on the nature of pleural plaques. For that reason, we have commissioned and published reviews of the medical evidence carried out on behalf of the chief medical officer and by the Industrial Injuries Advisory Council to help to inform consideration of the issue. Very helpful further discussions have also taken place with key medical experts on the medical evidence.

As I have said, it has been important to explore how we can support everybody who has been exposed to asbestos. I hope that the House will agree that the Government have been consistent in their commitment to give people suffering from mesothelioma and other serious asbestos-related diseases the help and support that they deserve, and we want to build on the positive steps that we have taken.

With that in mind, my right hon. Friend the Justice Secretary has confirmed that the Government are actively considering measures to make the UK a global leader in research for the alleviation, prevention and cure of asbestos-related diseases, and to help to speed up compensation claims for those who develop serious asbestos-related diseases such as mesothelioma. That is a huge undertaking and the Government are making a serious commitment. The work will include examining the process for tracking and tracing employment and insurance records—the House will understand how important that is in this context—as well as looking into the psychological and other support given to individuals who are unable to trace such records. The Government will shortly be announcing further details of our plans on these extremely important issues. I hope that the House will recognise—I think it will—just how important this is in taking this debate forward.

It might help if I were to tell the House a little about the consultation and the responses to it. We will be publishing this shortly, but I know that my hon. Friend the Member for Hendon will want to know what has happened as a result of the consultation. Some 224 responses were received, of which 163 expressed the view that pleural plaques should be compensatable in some form. Slightly more than two thirds of those who responded directly to the question regarding overturning the House of Lords decision supported changing the law. Views were equally divided on whether the proposal to increase awareness of the nature of pleural plaques would be helpful. I must say that there was only limited support for a no-fault scheme and a number of those who did express support for such a scheme made it clear that it was very much a second preference for them if the Government decided that they would not overturn the House of Lords decision.

I have been listening with great interest to the Minister and the hon. Member for Hendon (Mr. Dismore). Have any of the responses that have been made to the Minister come from medical sources? Can he confirm—this is my main point—that the cause of pleural plaques is always exposure to asbestos or can there, in some cases, be other causes?

I am grateful to the hon. Gentleman for that question and for the interest he is taking in this case. I cannot give him an exact breakdown of those responding, but we will be publishing the results. On the origins of pleural plaques, I am afraid that I cannot give him a definitive medical answer. I am very happy to write to him on that point. I hope he will correct me if I am wrong, but I think he is driving at the question of responsibility, liability and causality. I am happy to give way to him so that he can make that clear.

I am grateful to the Minister for giving way a second time. I have no doubt that there is a strong argument for compensation per se for pleural plaques. He has already pointed out, quite rightly, that the source of the exposure to the asbestos has to be identified. I wanted to have it explained to the House that there can also be no doubt that the symptoms and the existence of pleural plaques would always be owing to exposure to asbestos and not to some other toxic substance.

I want to make two points. First, the Bill makes it clear that the only pleural plaques that would be compensatable under it would be those that are asbestos-related. Secondly, I am not aware of any other source of potential pleural plaques but, come what may, it is still for the claimant to prove that their pleural plaques are asbestos-related.

I am grateful to my hon. Friend. I was going to go on to make exactly that point, but I am very grateful to him for clarifying it.

The hon. Member for Lichfield (Michael Fabricant) made a very specific point. I do not want to mislead the House. I am not aware of any other possible source of pleural plaques other than exposure to asbestos, but I would not like to give the hon. Gentleman a definitive opinion. As he will know, medical opinion on these matters varies. Some doctors can always be found to take a contrary view. I would not like to mislead him by giving him a definitive answer, and all I can tell him at the moment is that I am not aware of other causes and, in any event, as my hon. Friend the Member for Hendon has pointed out, that has no bearing on this Bill.

Before I conclude, I want to make a point about another complexity of this issue that we have to deal with in making progress. The House will be aware that claims management companies have been involved in this field. This is a particularly difficult issue. As 99 per cent. of pleural plaques are asymptomatic, there has been quite a vigorous campaign by claims management companies and some solicitors to try to persuade people who might have been exposed to asbestos to undertake scans. This has given rise to considerable disquiet.

I know that concerns have been expressed about the possible exploitation of vulnerable people. People have asked whether claims management companies can be prevented from acting in this area. Suggestions have been made that only those who were diagnosed by a registered doctor should be able to bring claims. This is a difficult and complex point and it was not directly raised by my hon. Friend the Member for Hendon, but I want to address it because I know that it comes up a lot and that people can get very angry about the exploitation of vulnerable people.

Claims management companies are already regulated under the Compensation Act 2006: regulations control any business offering claims management services and should prevent any malpractice from developing. The introduction of an absolute bar on claims management companies providing services related to pleural plaques would require primary legislation. If we tried to prohibit claims being made when they were the result of a commercial CT scan or when medical evidence did not originate from a registered medical source, that would cause significant concern about compatibility with article 6 of the European convention on human rights, as it would bar access to a court for a claimant who may, in the end, have a genuine cause for action.

My right hon. Friend can square the circle in a relatively straightforward way. He does not have to use primary legislation. This is a question of what evidence is sufficient to satisfy the court, rather than one of debarring anyone from bringing their claim to court. The court may not be satisfied if the evidence is not strong enough—a matter that can be dealt with through the rules of court.

I understand my hon. Friend’s point, but it does not address the issue of vulnerable people being exploited for commercial gain. However, those considerable problems should not stand in the way of our trying to make progress on the substantive issue that he has raised.

I want to put it on the record again that the Government are firmly opposed to the use of scan vans, as they are called. The provision of X-rays and CT scans is governed by two sets of regulations, which make it clear that initiating an X-ray or a CT scan purely for the purpose of obtaining compensation is not justified, and in those circumstances the Healthcare Commission could be asked to investigate. We would try to deal with the problem on that basis.

I want to say a little about the views that medical experts have expressed about the anxiety that people experience when they are diagnosed with pleural plaques. There is, it is fair to say, general agreement that a diagnosis of pleural plaques is likely to cause anxiety. That is a common-sense view. However, there are different views—as is inevitable, as I said, where professional opinion is involved—about how that should be addressed clinically and how far the level of anxiety can be controlled. One perspective was that a rational, honest explanation of the risks from exposure to asbestos could help patients, but that it would be impossible to alleviate the anxiety, that concerns were understandable and that those involved should be compensated.

The other perspective was that if the condition and the risks were properly and clearly explained, most people would be reassured, and offering compensation would send a mixed message to patients and could increase anxiety. In addition, because there is no direct link between the existence of pleural plaques and the development of mesothelioma, sending people to have scans might be a riskier process for many because it would lead to them being exposed to radiation, which holds some risk, albeit not a huge one. However, given that many people with pleural plaques never develop mesothelioma, it would be an unnecessary risk.

The Minister may in his last few remarks have answered my question. Does he agree that where those scans are not necessary, it is vital that they do not take place? He and the hon. Member for Hendon have both argued very strongly—I do not disagree—that it is the psychological effect of knowing that one has pleural plaques that causes the injury, rather than the pleural plaques themselves, in cases where they do not develop into a more serious disease. Therefore, not knowing that one has pleural plaques is a better position to be in than knowing that one has them.

The hon. Lady puts the point pretty well, and she raises an important psychological, and, indeed, philosophical, question. I think that the whole House deplores the use of scan vans. We are talking about people who seek to exploit the potentially highly vulnerable, and who prey on their anxiety and worry for commercial gain. That is not acceptable and we deplore the practice. I have outlined some of the measures available to prevent it, and I hope that our message is going out loud and clear.

I want to talk briefly about some of the new evidence that may be coming forward from the United States and France, and about the meeting of medical experts to which I referred earlier. At that meeting, a UK case study was discussed and it was suggested that, in that individual case, pain could have been associated with pleural plaques rubbing against a person’s ribcage. If that were to be the case, it would change the nature of the issue. However, the experts noted that no direct causative link to the plaques had been established. In any event, it is already accepted that pleural plaques can involve symptoms in a small minority of cases. Recent French research focused on the relationship between cumulative exposure to asbestos and the development of pleural plaques, rather than the medical nature of the plaques themselves.

The Bill has to be considered in the context of all those developments. It represents one possible approach to the issue of pleural plaques. I have set out some of the other dimensions of the issue on which the Government want to make progress, but there are a number of other approaches, and there are wider issues surrounding asbestos-related diseases. We want to ensure that all of them are considered fully and that the best response is identified, and we are doing that as quickly as we can. As we are still assessing what the Government response should be on pleural plaques and the wider issues affecting those suffering from asbestos-related diseases, it is not possible today to give a firm indication of what the Government’s ultimate position on the Bill will be. However, on that basis I can confirm that I am content for the Bill to proceed today.

With the leave of the House, Mr. Deputy Speaker. I am grateful for comments from Members from across the House. We have aired the issue yet again; I have lost count of the number of times that we have debated pleural plaques in the House. I am not sure that I have added greatly to the knowledge of the House or the general public, but we emphasised some of the arguments, and I hope that the House will give the Bill a fair wind.

Question put and agreed to.

Bill accordingly read a Second time.

Ordered, That the Bill be committed to a Committee of the whole House.

Committee this day.

Occupants of the Chair have deprecated proceeding at once from Second Reading into Committee without notice, since it makes it difficult for Members to table amendments.