Rehabilitation in Industry

– in the House of Commons on 22nd October 1942.

Alert me about debates like this

Motion made, and Question proposed, "That this House do now adjourn."—[Mr. A. Young.]

Photo of Mr Robert Taylor Mr Robert Taylor , Morpeth

I am glad to avail myself of the opportunity, on behalf of my party, to introduce a discussion on the subject of rehabilitation. This discussion will, I believe, give my hon. Friend the Parliamentary Secretary an opportunity of stating what has been, and is being, done on this very important question, and while I believe he will be able to say what progress has been made, I would want this Debate so to arouse the national conscience on this question that we shall be able to say to the Government that we want to be satisfied that adequate provision is made for the clinical treatment of our injured people and for the rehabilitation of every injured man or woman who is in need of it. I appreciate—and my party appreciates—the splendid example of the Minister of Labour and National Service and the statements which he has made. He has done an invaluable service to the working classes of this country in making and helping to make this subject a very live issue. In dealing with this question I will endeavour to avoid dealing solely with miners and to deal more particularly with the industrial side. I recognise that the subject of rehabilitation is one of the things which, of necessity, the war makes very urgent. The statement that we heard from the Minister of Labour and National Service to-day was another pointer to the need in the future for these services to be ready when they are wanted. But the statement also showed us the need for our being able to return to normality, if possible, the men in the Services who will be wounded.

Let me turn now to the industrial field. The other day some figures were issued by the road transport authorities, I believe, giving the numbers of deaths and accidents on the roads. That may not be an industrial matter, but the lives of those people are valuable to the nation. The figures were startling. I will give the House some other figures which I can quote approximately from memory. I will not give the number of fatal cases, because they are outside the scope of the subject I am raising, but between 1928 and 1938 accidents in mines and quarries numbered 1,600,000, and in all other industries 1,600,000, the difference being only in the odd figures. Every day something like 1,000 people are injured in industry in this country. If one takes the seating capacity of the place in which we are now sitting as being 500, the figure I have given would mean that this place could be filled twice a day with the people who are injured in doing the nation's work. I do not say that all those people would be cases for rehabilitation, but the probability is that from 10 to 15 per cent. of them would be. The formidable numbers to which I have referred warrant my saying how justifiable it is that this question is being raised on the Adjournment.

In what I say I am speaking for all industries, but I have in mind particularly the mining industry. It is true that there has been progress in regard to accidents in the mining industry. It is not so very long ago—and my hon. Friends from mining districts will bear me out in this—when, if an accident happened in a mine, there was not the slightest provision for the easement of pain or the prevention of more serious consequences arising from what might be a very trivial accident. I remember the time when there were no first-aid appliances available, when no box was kept in the pit to which one could go for dressing and bandages, and when, if a limb was fractured in any way, a temporary setting had to be made by splitting timber, in order that the man might be brought to the surface. But, thank goodness, we are past those days. As far as concerns the liability for the actual treatment of compensation cases, however, there has not been that progress. The only thing that has been done has been the giving of compensation for loss of earnings, and that takes us a very little way. We have done our best to let our people know that they have been wrong in thinking they were paid compensation for the accident, We know all too well that they are not paid compensation for the accident. The compensation, which is very inadequate, is for the loss of earnings arising out of the accident. The payment of compensation will not meet the cost of rehabilitating the man himself. While it may not be opportune to do so, I want to make a digression here. I want to give the Government fair warning that if they think that it is safe to wait until after the Report of the Beveridge Committee before dealing with the larger question of compensation, they had better take further thought, because on the question of compensation things are very uneasy.

Industry has continued to pay a premium to make insurance in respect of the payment of compensation. There is one thing, however, which industry has been unable to see. I shall not make the charge of callousness, for it may have been due to lack of knowledge, but whatever may have been the cause, industry has not been able to see what income could arise as a result of the quicker return of men to industry consequent upon shortening of the period during which they received compensation, and, more particularly—and this ought to be the concern of all of us—as a result of a man again becoming a fit economic unit in society. Industry has not been able to see how the budget could be balanced. Industry could measure the cost of fracture clinics and rehabilitation centres, but it could not see what income there would be to offset the expense of again making a man a fit economic unit as soon as possible. In the latest figures which I have been able to get concerning Workmen's Compensation there is an item as follows: "Cases brought from other years." The total number—not for the mining industry alone, but for industry generally—was 6,703. The amount of compensation paid was £3,710,527. That concerns disablement cases only. I have not as yet referred to industrial diseases, and if they were included, the figure would be much higher.

In the quotations which I shall make before I finish my speech, I hope to be able to show from the number of cases and the amount of money paid in compensation, and the experience in the treatment of these cases so far, that there could have been saved a very considerable amount of money which might well have been placed on the income side of the balance sheet, and that the treatment which we are now urging should be given to our people would, if considered from the point of view of self-interest alone, have paid employers and industry generally. On the men's side, we are going on year after year accepting the inexorable toll of the mines, that endless stream of injured men. Sympathy, yes, because there is no place where sympathy finds more ready expression than in min- ing villages, but as to the after effects of accidents, we seem to have been ignorant, and it is regrettable. We were the people must affected, because we were the sufferers. It was not the shareholders of the colliery companies who suffered but the men who were doing the actual work, and they seem to have been in ignorance of the after consequences of these accidents. If after local medical or hospital treatment men did not return to normality, we have looked upon it very largely as inevitable. If industry has not been responsible for the rehabilitation of the workers, who has responsibility, because it must rest somewhere? I am pleased, of course, that the Minister of Labour is taking some responsibility, self-imposed to a great extent, because he has had to do with industry all his life, and so has his Parliamentary Secretary. We say it is the nation's responsibility.

The Lord Privy Seal and others have said pretty much the same thing that I am going to say, though in different language, that men are not employed in industry unless profits can be made out of them. By and large, every man engaged in industry produces more than he can consume, therefore there is a surplus, and every man and woman doing the work of the nation is adding to that surplus, which we call the national wealth, and it is on that national wealth that the Chancellor of the Exchequer bases his Budget. It is out of that national wealth that we derive subsistence for those who are unable to work, and it is out of that national wealth that we provide luxuries for some who can work and do not. Further, having tested it on those grounds, in the last analysis the workman is in the service of the State. He may get his wages from his employer, and before the Essential Work Order the employer has been able to give him the sack, but by and large he is in the service of the State. Therefore, if the people of the country in the past, in their wisdom—perhaps I should say in their darkness—have decreed that those who meet with accidents are only entitled to what is due to them in respect of their loss of earnings, it is the obligation of the State to make good the part that represents the loss in their service to the State. That is my claim to-day.

I am glad that a new light has come on this question of rehabilitation. There are some men who stand out as beacon lights in their research, in their endeavour and in their self-sacrifice, in bringing to the industrial world and to the nation the possibilities of clinics. We have heard much of Mansfield. I remember some figures which were given by Dr. Nicoll when he came here. There is a doctor in my constituency who has some splendid work to his credit in this matter. It is limited, because the facilities are few, but he only needs the opportunity. I remember one figure of 400 cases that went to the rehabilitation centre. The cases that go there are not hand picked. The purpose is to restore men to normality if possible, and therefore only the worst cases are taken. Of those 400, 378 returned to the pre-accident employment, 21 went back to light work—light work in the pit; it would be heavy work elsewhere—and two did not recover. One died, and one was too seriously injured. If you take those figures against the background of 60,703 outstanding cases in 1938, it seems to me that there would have been a tremendous field for recovery and for the bringing back of these men to productive economic work.

I saw the fine old mansion in beautiful surroundings. The men were having games and doing exercises. That is the sort of thing I am pleading for. I want our men taken away from the hospital atmosphere altogether. I went to see a friend in a very fine infirmary in the North. I will not mention its name, in case anybody may think I am speaking disparingly about it, but I do not intend to do that, because it is doing splendid work under great disadvantages. When I went to see my friend, who had had a serious accident, I found that the place was full of injured men. I had not been talking long with my friend before he had told me about the cases all up the line, and it seemed as though each case was getting progressively worse. That has a psychological effect on the men and retards their recovery. I hope that we shall not have that atmosphere in the fracture clinics. Those who go to the fracture clinics do not necessarily go to a rehabilitation centre. While there are 1,000 new cases a year, 750 do not go to rehabilitation centres at all. I want the fracture clinics to be in surroundings which are not those of a hospital, because the man who goes to the rehabilitation centre sees a progressive stage of recovery. The atmosphere is one of hope and cheerfulness, which implants itself on his mind and tends towards his recovery.

At Mansfield there are spinal cases. We are all used to broken arms and legs, but there is nothing which touches my heart so much as a case of a fractured spine. A man with a fractured arm or leg can get about sooner or later, but in the old days, in the case of a man with a fractured spine, we used to subscribe for a chair for him or he got it from the medical charity fund of our association. Then he was wheeled round the village for a few years until he died. If there is one thing I am glad of, it is that the treatment at Mansfield is helping spinal cases to such an extent that men are able to get back to their own work. It is a glorious thing, and no cost should stand in the way, for no cost can be measured against putting a man with a spinal fracture on his feet again and making him fit and able to look his fellow men in the eye and to earn his own living and be independent. I would like to add a word about the splendid service that is being done at Hoylake for one of the Services. If we can do that for the young men during the war, how much more necessary it is that we should be able to do it in peace-time for those who are doing the work of the nation. I think that we are passing from the reign of darkness where ignorance has held sway. The light is now breaking through, and on behalf of our party I hope we shall now enter into the reign of light and that the treatment of injured workmen shall be on the consciences of the people of this country so that nothing shall be left undone that will bring men back to normality and useful work.

Photo of Mr Harry Taylor Mr Harry Taylor , Mansfield

I welcome the opportunity of saying a few words on this subject, because I come from a division which can be regarded as the home and the hub of this great work of rehabilitation. During the past few months Ministers of the Crown, Parliamentary Secretaries and Members of Parliament have visited the centre at Mansfield and have paid tribute to the fine work that is being carried on there under the able guidance of Mr. Nicoll, the surgeon in charge. The work at the Mansfield centre is being carried on fairly extensively and with outstanding success. It is confined to the treatment of injured miners, and it serves a population of at least 33,000 belonging to the mining community. I will give later a few statistics which I hope will indicate the value of the work that is being done there from a social, economic and humane point of view. I wish to address myself to the general question of rehabilitation, and I am glad to see the Joint Parliamentary Secretary to the Ministry of Labour in his place, for he is interested in this work and his Department desires that it shall go forward. In order to carry on the work of rehabilitation with the maximum amount of success, the first essential is that there shall be the utmost co-operation between the fracture clinic and the rehabilitation unit. At the fracture clinic the foundation is laid for recovery, and at the rehabilitation centre the finishing process of healing becomes an. art which expresses itself in broken men being made fit, not only to walk but able to re-enter industry. It should not be overlooked that the work of the fracture clinic and the rehabilitation unit are interwoven. They cannot be divorced from each other if the work is to find its full expression and we are to get the maximum value from both the fracture clinic and the rehabilitation centre.

Another point is that the psychological aspect of this work is as important as the physical. It is necessary in this work of recovering broken men to fit them not only to enjoy life but to re-enter industry, and one of the first things to do is to remove from their minds the feeling of insecurity which was characteristic of past days. To achieve this, there should be the closest co-operation between the industry, the fracture clinics and the rehabilitation centres. Let me quote the case of two colliery companies with fairly extensive undertakings in Nottinghamshire to interpret practically the point which I am trying to make. They have appointed safety and welfare officers, and the scheme is working with remarkable success, both in the interests of the injured men and, may I add, in the interests of the industry itself. There is the closest co-operation between the safety and welfare officers appointed by these two colliery companies and the surgeon in charge at the rehabilitation centre, and when a patient has reached the stage of recovery at which, in the opinion of the surgeon in charge, he is capable of performing some kind of work, communication is established with the safety and welfare officers; and the work is carried on even when a man, after recovery, re-enters the industry.

Let me say a word or two about the size of these rehabilitation centres, because there is a diversity of opinion on the point. I believe this work has come to stay and will be widely extended in the future, and I maintain that what we ought to avoid is the setting-up of mammoth, herculean centres. I am told, and the information is on the basis of experience, that the ideal is to provide accommodation for about 60 patients. That helps towards maintaining individual relationship and close personal contact between those in charge and the patients themselves. I hope that at these centres we shall not follow the practice adopted in our elementary education system, where we have big classes of 50 and 60. In such a class there is possibly a small minority of pupils who—for want of a better term—are mentally retarded and backward, and the problem facing the teacher is that if there is concentration upon the mentally retarded, the brighter pupils will suffer, because the pace of the class is set in the interest of the backward pupils. If there is concentration on the mentally retarded in a big class, the brighter children suffer. I hope that in connection with these rehabilitation centres we shall profit from that experience in education. If we avoid building mammoth centres, we shall retain what is most important, individual relationship and close co-operation between those in charge and the patients themselves.

Only a few weeks ago the British Orthopedic Association paid a visit to the Mansfield centre, and one of their speakers, commenting on the point I have made, said that a centre catering for 60 patients was the ideal to aim at. Another point is that these centres should be residential. I hope the Parliamentary Secretary will give some thought to that point, because at Mansfield it has been proved that it works exceedingly well. The men get regular habits and have regular mealtimes, and so on, and that adds considerably to the progress patients can make. Let me give very briefly some account of the work done at Mansfield. At the fracture clinic, which is at the hospital, no fewer than 1,000 cases are treated each year, and that figure represents only the worst types of fracture. Of those 1,000 cases, between 15 and 20 per cent.—again the worst type of cases—are selected for treatment at the rehabilitation centre. I do not want to repeat what the hon. Member for Morpeth (Mr. R. J. Taylor) has said, but I would like to point out that one-third of those cases are spinal fracture cases, that 50 per cent. of the cases treated at the rehabilitation centre return to their pre-accident employment, and that no less than 94 per cent. return to some kind of productive and economic work in the mining industry. In the light of those figures, I can only say that the days of miracles are not past.

My hon. Friend the Member for Morpeth gave some other figures upon which I do not wish to enlarge, but this he did not say, and I wish to refer to it because of its significance. In the area covered by this centre the Bolsover Colliery Company have large undertakings, and within a period of time that company had 400 consecutive fracture cases, and 389 of them returned to productive economic work and 378 of them returned to their pre-accident work. Those are very alarming, sensational and astounding figures. What about the 6 per cent.? I said that 94 per cent. of the cases treated went back to work. The 6 per cent. who do not recover and cannot go back to the arduous work in the mining industry are turned over to the Ministry of Labour. I pay a special tribute to the facilities that exist for training these unfortunate 6 per cent. The training centres should, however, be in the industrial districts where the accidents happened, because men do not like to leave home after having had their accidents and be buffeted about. They like to be able to stay at home. This aspect of our industrial life has been terribly neglected in the past. Men have been left to endure suffering and torture consequent upon serious accident, and their services have been lost to the community and to industry. Their own hopes have been frustrated, and they have lived for years in suffering and pain. The work now being done is sufficient evidence that no time should be lost, and no effort should be spared to provide facilities which will reduce the wastage of manpower, particularly in the mining industry, and will bring new hope to broken men.

Photo of Mr David Adams Mr David Adams , Consett

It is a felicitous circumstance that, in the midst of our greater preoccupations, we can spend time upon this new science, which will be as a heritage to industry. This rehabilitation is relatively unknown, and the mining industry primarily has become interested in it; but it is equally applicable to all industry as well, as we have heard, as to the Armed Forces of the Crown. There has been very limited opportuniies up to now for making the knowledge that we now possess of our capacity to rehabilitate the injured more widely known, but the increasing mechanisation of production may make it more necessary throughout the whole field of industry for rehabilitation to take its natural part in restoration, where that is necessary.

From rehabilitation there is not only physical recovery, but great psychological changes in those who have been successfully treated. Mental and moral changes take place, we have been told. Whether this is due to the environment or to the treatment, or to both, I must admit that men who have been to Mansfield have come back with their entire outlook changed upon life and society and the problems of life. In that case, we have in this rehabilitation a new form of giving, to those who have been unfortunate enough to suffer in this way, a new and beneficial outlook. One of the men to whom I spoke had been a local preacher and described himself as a modern Naaman, suffering from the leprosy of invalidity due to an accident, and ne said, "I was washed in the stream of rehabilitation, and I have come out clean, whole and free from stain." I thought it was an admirable parallel and piece of imagery of what actually occurred.

It has been stated that compensation for earnings has been looked upon as the liability of those concerned, but to-day, after this knowledge has become general throughout the country and is accepted by the Ministry of Labour, a sufferer will be entitled to ask for rehabilitation in addition to any other obligation arising from loss of earnings. We were fortunate in being able to see in a Committee Room of this House the amazing results of Mansfield treatment. There was a film, and a lecture delivered by the great doctor who is at the head of Mansfield. Even more amazing was the information given to us that, unless there is absolute severance of the vertibrae, it is possible to-day to restore fully to health those who have been wheeled about in bath chairs, as in the county of Durham, where accidents are very common.

So far, there is only one of these centres at Mansfield, for 50 or 60 patients, but when this treatment becomes the natural part of the treatment of accidents, and disease, maybe, due to industry, perhaps some of the old-standing cases may be taken. Men of my acquaintance and constituents of mine may be restored by the magic of this rehabilitation scheme. It is clear to us that the obligation of rehabilitation must be made statutory, either upon the employers concerned, or freely, fully and gladly accepted by the State.

Photo of Mr George Griffiths Mr George Griffiths , Hemsworth

As I have sat here to-day my mind has gone back to yesterday, when there was a discussion about wages of the workers and whether they were not too high, and the benches across the way were full. There was no chance for any of us to speak. Now, when we are speaking about the rehabilitation of the workers after accident, the benches across the way are empty. I hope a note of this will be made by the Press, so that we shall know where we are. I am naturally interested in this rehabilitation scheme. I have heard my hon. Friends speaking with knowledge of the matter, and they spoke as one having authority, and not as the scribes. It was not something out of a book but something that they actually know and have seen and handled. I know something about the necessity for rehabilitation. My eldest brother 53 years ago sustained a fractured back in the mines. He is 69 years of age to-day, and he has never been enabled to go back to normal work from that day to this. Thank God, we can see on the horizon to-day the possibility of this kind of thing being wiped out. My hon. Friend the Member for Morpeth (Mr. R. J. Taylor) spoke about having seen the picture in the Grand Committee Room. My hon. Friend the Member for Consett (Mr. Adams) said he had also seen it. I like to see something better than a picture; I like to see the real thing. Along with the Parliamentary Secretary to the Ministry of Pensions, I visited Mansfield to see these men. We spent five or six hours there and talked to the men. We saw the men undergoing training—gymnastics, etc., outside and in- side. The psychology both of the instructor and of the men struck both of us. Why? Because we could see in the very eyes of these men, who had had fractured backs, fractured legs, etc., hope, inspiration. They said to us, "We have a chance now to get back to the work we were doing before we had our accident."

If one goes into any mining village today, one can see men who have had fractured legs, fractured arms. Some of them are bow-legged, some of them are knock-kneed; they are twisted all shapes. The reason is that no attention was given to them when the accident occurred. The attitude in the past when a man has been hurt has been to say, "What are his wages; what is his average wage for the last six months? Did he average £3 a week?" If he did not, he did not receive 30s. a week compensation. I have seen some of our chaps, married men with five or six children, go home with 21s. 6d. per week, and all the owners cared was that the man from the mutual indemnity company, when the injured man had been off work for a few weeks, would come round and want to know, "Is it not about time you were shifting and getting back to work?" If it was a serious accident, a bag of silver would be dangled before the injured man's eyes, and it would be put to him, "Take a lump sum settlement. You can manage a fish shop in a back street." That has been the attitude. We want it wiped out entirely. The way to do it is to make the insurance national State insurance instead of profits for the insurance company, so that if any profit accrues at all, it shall accrue to the man and to his wife and children.

I know the Parliamentary Secretary is waiting to get up, but my soul is full of this thing. My home has been hit by it; I was hit by it myself for 26 weeks when I was in the mines. I know something about it as a married man, because I had only 23s. for my wife, three children and myself. I wish to give another little example of experience. I cite a case about a lad who has had his leg off, a young fellow at Edlington. For over 12 months he has been like that, and nobody seems to think it is his business to see that he is rehabilitated. If somebody had been quick about it, this lad could have been back at work, the same work as he was doing, because without a doubt great strides have been made to-day, strides at Mansfield, but not only at Mansfield. There have been great strides here at Roehampton. I like the idea of that light leg, the aluminium leg, instead of a cork leg or wooden leg, whereby the wearers can move about and practically get back to their own work.

I went to the Mansion House a week last Wednesday, and I saw miracles walk across the platform there, not a picture on the screen, but actual human beings who had been mangled in the blitz of this war. A little girl 11 years of age who had been blitzed and had had her leg off came on that platform and skipped across it just like a little bird. One could not perceive that she had had a leg off at all. I thought that was wonderful. Another young lady who was there who had had her leg off is doing her work and travelling 26 miles daily on her bicycle. I do not want to enlarge on this. I want to say that if these things can be done for our own people who are blitzed by the enemy, it must be done for our own people who are in industry and producing the wealth of the country. It could be done. I believe the Minister himself and the Minister of Pensions also are whole-hearted so far as this is concerned.

The other day I went to Newquay, where they are beginning the rehabilitation of the men there while they are on their backs. I saw a lady instructress who had charge of about a dozen men. They were men who had been injured, men who were casualties in the war. There they were on their backs. Almost immediately they came into the hospital this lady was beginning their treatment, telling them how to move their feet, how to move their necks, how to move their backs, etc. When she had done with them they went to another trainer, a man. What is required in these rehabilitation centres is not only a man who knows how to manipulate the limbs, but a psychologist. I saw at Newquay one of the finest men instructors, who could read a man inside as well as read his accident. This man had the confidence of the people who were under him. There are great possibilities, there is great hope, and I believe that, not when we come out of the war, but now, for the casualties in the war, in the blitz, and in industry, we should do all we possibly can to bring these people back so far into industry.

Photo of Mr George Tomlinson Mr George Tomlinson , Farnworth

I am glad to have the opportunity to-day of replying to the discussion on this important subject, and I am glad to be able to agree in the main with almost everything that has been said. Rehabilitation is a big subject, and is interesting from more than one point of view. Hon. Members have dealt with it to-day primarily from the industrial point of view, and it is from that side that we of the Ministry of Labour are most concerned with it. But there is a tendency to think sometimes that it is only concerned with one aspect of disability, that which arises from accidents in industry. One can understand that, because people who have been most connected with industries in which accidents have arisen have seen the effects of these accidents more clearly than any others. But all diseases which lead to disability—and they are many—must be brought under review if the picture is to be complete. So must the numerous accidents unconnected with industry. It may be a surprise to many, as it certainly was to me, to find that the majority of accidents were not connected with industry, apart from the war casualties, both among civilians and in the Services.

The object of rehabilitation, as has been very adequately said, is to restore the individual as far as possible to normal. Successful rehabilitation is not solely a medical problem. I hesitate to use definitions which might be misinterpreted, but I would say that in the strictly medical sense rehabilitation means the process of restoring lost muscle tone, restoring the full functions of the limbs, and maintaining the general health and strength. All those things are included in the term, used in its medical sense. This should begin as soon as possible after the injury or the operation, as soon as the patient's condition permits; and it should be a continuous process. When restoration, in the medical sense, has been achieved, the social and industrial experts are required. In consultation with the medical experts, they should determine whether the patient can return to his former occupation, and if not, what other kind of occupation would ensure his making the greatest contribution in the field of productive effort.

It may be true that we are appreciating the value of our man-power, in an economic sense, more clearly than we have done before, and that the progress made in rehabilitation is due to the enhanced value of man-power when it becomes scarce. The fact remains that not only from the standpoint of restoring the injured person to productive effort, in the interests of the community, but in his own interests, rehabilitation is essential. That which the hon. Member for Morpeth (Mr. R. J. Taylor) spoke of as the feeling of independence which comes to the individual who finds himself able after a serious accident or illness to earn his own living, is more important, I believe, even than his value to the community from a productive point of view. After restoration in a medical sense come training and resettlement. Both need careful consideration. The point made by the hon. Member for Mansfield (Mr. B. Taylor) with regard to that training being conducted, wherever possible, near the individual's home, is one which we have already discovered to be of importance. These principles, broadly speaking, are accepted by all. What steps have been taken to implement the desire of all sections of the House that they should be put into operation? With regard to the medical side of rehabilitation, much progress has been made, although much still remains to be done. In the Emergency Hospitals Scheme organised by the Ministry of Health and the Department of Health for Scotland, many orthopædic centres have been established, with a full range of facilities, including massage, physical training, occupational therapy, and workshops, as well as orthopædic surgery. Other hospitals have been earmarked for fracture cases; and some, if not all, of these facilities are available there. So there is at least a skeleton service available.

I ought also to mention the work of the Ministry of Pensions and that wonderful work, to which tribute has been paid, which has been going on at Roehampton. The people responsible for the development of that work have been pioneers in a cause which we all realise is vital. My visit to Roehampton some months ago and my talk with the surgeon in charge had such an effect upon me that whenever I have seen since then a man with a peg-leg I have felt a cold shudder down my back. We shall not have completed our task until everybody who has lost a limb has the advantage of what science has produced in the limb-fitting centres. It was because of the scarcity of man-power, among other things, and the need for bringing back into industry the people who were lost to the productive economic life of the community, that the Minister of Labour introduced the interim scheme in October, 1941, for the training and resettlement of disabled persons. The experience gained in the short-time—barely 12 months—which has since elapsed is indicative of the work that we believe can be done through this scheme, and it may be that a greater scheme will emerge out of it. The first thing about this scheme that I would like to emphasise—one which has been spoken of by, I think, all speakers to-day—is the manner in which we get in touch with the people who have suffered injury or who are disabled as a result of long illness. That is done, in the first instance, by interviews, which take place in the hospital.

Somebody said that the individual at the rehabilitation centre should be a psychologist, but it is just as essential that the psychologist should be at work before he reaches the rehabilitation centre. One of the striking things about this scheme which we have been putting into operation during the last 12 months has been the effect upon the individual concerned when, on being interviewed in hospital, there has been the prospect of returning to work of some kind. Therefore the psychological effect of bringing to the individual the possibility of training and restoration is something which cannot be over-emphasised. It has been said that "Hope springs eternal in the human breast." That may be true outside hospital service, but I have been in many a hospital in which hope seemed to have departed from all the breasts that were present. Therefore it is essential that the two things should be welded together right at the beginning. In the interviews which have taken place what has been impressed upon the individual concerned was not only that there was hope but that we were looking for him to be restored in order that he might return to industry and health.

The scheme in its original stage was confined to the training of people for the war effort. The training could be carried out if the individual, after training, could be placed in industry which would be helpful in the war. After the scheme had been running for some six months it was found that there are scarcely any industries to-day which are not wrapped up in the war effort and the scheme has now been extended to cover all types of industry. Up to the end of August the total number of people interviewed under the scheme was just over 41,000. The great majority of these were hospital interviews and related to war service or war injury cases, but included among the total a proportion of interviews at exchanges of persons with pre-war disablement. It is obvious that a great many disabled people in the country to-day have left the hospital a long time ago and given up hope, may be, but they have been brought back to the possibility not only of being usefully employed and earning their own living, but of once again taking up the thread of life and a place in society as a consequence of this new scheme. Of this total, about 29,000 have been placed or have found employment, but I would not like to say at this stage that they have all been placed in positions in which their injuries have been taken into consideration.

One of the difficulties about rehabilitation in war-time is that man-power is at a premium and economic circumstances are such that the individual can obtain a job, whether he is fit or not, and the consequence is that he will perhaps take on a job which is not suitable to him because of the economic conditions. It may be that at the end of the war when circumstances have changed the necessity for the re-training of these men will make itself felt because of the fact that they have only been trained for a war occupation. The fact that they have been brought along the road and have been brought from a state of disability back into the labour market and been employed is a long step in the direction of restoring them into full man-hood and full economic work. The total number of persons admitted for training under the scheme is just under 3,000, and when you subtract 3,000 from 29,000, it means that 26,000 have either gone back to their own jobs or been able to obtain jobs in industry similar to those which they were doing or which are most in demand today. Originally the training provided under the scheme, as I have said, was limited to war industry or war effort occupations, but it has now been extended.

There is rather a striking figure with respect to the blind, who are in a special category of disabled people. It is strange to find, after all that has taken place with regard to the care of the blind and their rehabilitation and training, that out of 600 persons who have been interviewed, 200 have been placed in employment of a kind other than that which was regarded previously as being the exclusive employment of the blind. To-day there are many blind persons whose sense of touch has been so developed, perhaps as a result of their blindness who, after training, have been able to take inspection jobs requiring great delicacy of touch, and they are doing jobs in our engineering shops not only with credit to themselves but with great advantage to the people for whom they are working.

There is ample evidence from the individuals we have seen and the work that has been and is being done in different places that this scheme is successful and that it can be made more successful as the days pass. It has been possible to take over two centres at least which previously were subject only to voluntary contributions, and in which very badly disabled people are being treated or trained at the moment. I refer to the centres at Exeter and Leatherhead. Here training is given, and the object and purpose of the training, even in these centres where only the very badly disabled are being trained, is to restore them to a position in which they can obtain full work at full rates of pay. There is no desire either on the part of the Ministry of Labour or of any of the other Minis-tries in conjunction with whom we are working on this business to make these people into something other than the best type of workers. We feel that we owe it to these men who are injured either in industry or in connection with the war effort or even as the result of accident at least to bring them back into the scheme of things exactly on the same footing as those with whom and for whom they are working.

The second development in this scheme is the development of grants to undertakings which are employing the most severely disabled who have little or no chance of getting ordinary employment. That scheme has only just come into operation but it is intended to assist at any rate in bringing back to employment those who otherwise at this stage would not be capable of employment.

I would like to say a word or two, in conclusion, about one or two of the things which the introduction of this scheme and a study of the whole subject of rehabilitation have brought to our attention.