I beg to move, in page 2, line 22, after "totally," to insert "or partially."
I take it that we can discuss at the same time all the subsequent Amendments which cover the same point. I do not propose to take up much time, but I want, if I may, to take the opportunity that presents itself in moving this Amendment to pay my tribute to the people, who I think have not yet been mentioned by anyone, who deserve our gratitude, the Committee of the Medical Research Council, without whose report we should not be considering this Measure to-day. It began its work in the village from which I come, and it began it in the pit where I started work as a boy. I went to the original meeting where the men were invited to join in finding out what this terrible disease was. I saw them in the whole of that work, and I want to pay my tribute to scientific work for human welfare at its very best.
The point I wish to raise is already in a sense implied by what has been raised by my hon. Friend. We have a disease scheduled as silicosis, and a man claiming benefit has to be certified by a medical board as totally or partially disabled. We discover in our area that men go before a medical board, and the board say, "We are very sorry; you are disabled. It is obvious you cannot work in the pits. You have some lung disease, but we are restricted. We have to decide, not whether you are suffering from lung disease which has disabled you, but whether you are disabled by silicosis according to the definition made by someone 10 years ago."
I go back to 1932–33. Of the cases submitted for certificates, 80 per cent. were certificated. This fell to 70 per cent., then to 60 per cent., and in later years more than 50 per cent. of the cases, submitted for examination have been rejected because they did not come within the purview of the narrow definitions of silicosis. I give these figures for South Wales, not because this is a disease limited to South Wales, but it is a fact that the coalfield to which I belong, which produces 5 per cent. of the nation's coal has 85 per cent. of the silicosis cases. In South Wales in the years from 1937 to 1941 applications for disablement certificates numbered 3,502, of which 1,801 were granted and 1,701 rejected. I am positive that the last people to deny what I say would be the Medical Research Council.
Here are 1,701 rejections of men who are suffering from disablement through lung disease caused by their occupation in the coalmine. They are turned down. As a result of that, we press upon the Government that they ought to change the definition, that this term "silicosis" is a misnomer altogether. We urge that, and the Government say, "Very well, we cannot go outside the definition. We will have this investigation." The investigation lasted several years, and in the end the Medical Research Council brought in a finding in favour of what the laymen in the area said 10 years ago. Ten years ago we said it to the Home Office. We said, "There is a disease. We call it all kinds of names." What do we do now? Let me say that I welcome this benefits scheme. I know the position. The difficulty is that every time we have brought in a Regulation to schedule a disease, apparently there is a rule of the House, or a constitutional rule of some kind, that the provisions of a Regulation cannot be made retrospective. The result is that when a Regulation is brought in to alter the conditions under which compensation is paid for an industrial disease, it only covers persons from the date of the Regulation. The people whose suffering has led to it are denied the benefits.
These people for whom we provide a benefit scheme—I welcome it very much indeed, and I pay tribute to those, including the Parliamentary Secretary and the former Secretary for Mines, the hon. Member for Gower (Mr. Grenfell) for having worked for it—get only 15s. a week plus the right to retain their National Health Insurance, without that being taken into account or taken out of their compensation or vice versa. We only provide that for the people totally disabled. I ask the Parliamentary Secretary to accept this Amendment: I ask him to consider it. I want, in addition to having the right to consider claims and make benefit payments to those people disabled by this disease, that those partially disabled should come within the purview of these benefits. I want first of all to urge consideration of the fact that partial disablement from this industrial disease is in a category of its own. It is not the same as being partially disabled from an accident. When a man meets with an accident, he may lose a finger or fracture a bone. That physical injury may leave him partially disabled, and the amount of partial disablement can be measured. But you cannot measure the amount of partial disablement from an industrial disease like this. This is a progressive disease. There are various stages. When a medical board have a man before them they have to decide, first, whether he is suffering from the disease, and, secondly, whether the disease disables him totally or partially.
I will quote from the actual certificates of men who have been certified as partially disabled. One certificate says, "Disease well established." You know what that means: it means that that disease will take the man's life; it is so established that it cannot be cured. Another certificate says, "Disease moderately advanced." If the disease is well established and moderately advanced—and these are the terms generally used in certificates of partial disablement from silicosis—think what it means. We have hundreds of those people. Once a man is declared to be partially disabled by silicosis or pneumoconiosis, it means that he cannot go back to the pits not only to work underground, but even to work on the surface. The medical board says, "This man is fit for light work"—sometimes they say, "for the lightest work"—"in the open, free from dust." If a man is certified as partially disabled and told that he must not go back to the pits—which means that they will stop him going back—but that he must get light work, what work is there? It is just as though the man were totally disabled. I know something about the cost of this disease. I know the incidence of this disease upon the anthracite industry. The Under-Secretary to the Home Office, in moving the Second Reading yesterday, said that he knew the cost. Even if the cost in pounds, shillings, and pence is heavy, the cost in human suffering cannot be described in words. The cost of this benefit scheme is one penny per ton of coal—not a continuous levy, but one levy of a penny per ton. Who will miss that? Add another penny, and I am sure you will get enough to include the partially-disabled men. This benefit scheme is to be administered, under Subsection (3) of Clause 2—
But it has reference to what I am saying now. An administrative board will be set up. Will the Undersecretary to the Home Office and the Parliamentary Secretary to the Ministry of Fuel and Power consider the possibility of allowing this administrative board to consider claims by partially-disabled men, who, in real fact, are totally disabled? If you do not allow that, you will do a great injustice to men who are disabled and who cannot get compensation because up to now we have refused to schedule this disease. This affects hundreds of men in the constituency I represent. I have made representations to my hon. Friend the Parliamentary Secretary to the Ministry of Fuel and Power. I ask him, at this late stage, to reconsider the matter. It would be unfair and unjust if such men were deprived of these limited benefits.
I shall endeavour not to repeat what my hon. Friend has said, except to express my appreciation of the Medical Council's work, without which we should not have had this Bill to-day. I trust that the Committee will not repeat the many blunders of the past. For more than 20 years I have been concerned about this special disease—not to the same extent, of course, as my hon. Friends the Members for Gower (Mr. Grenfell) and Llanelly (Mr. J. Griffiths), largely because so many pits which came under my purview have closed. In South Wales a very large number of cases are coming before our committees. Quite 50 per cent. of the persons affected are not certified definitely by the Medical Board, but there can be no doubt that with the broadening of this definition to include pneumoconiosis all those persons will be brought in. But it is important to realise—and this was, I think, the main word that was emphasised by my hon. Friend—that this is a progressive disease. It is no use talking about schemes for rehabilitation unless we get cases very early, because the disease is progressive. If we wait for what might be called totality in this disease, it is too late. Once a man is certified as totally disabled, that is a death sentence. We ought, from humanitarian grounds alone, to realise that once a man is found to be suffering, even slightly, from that disease, we should pay him compensation, take him out of the pit, and fit him for a new job. That is the only remedy. If we are faced, as we shall be shortly, with the necessity for conserving manpower, we shall not only by this means be able to repair a damage done, but we shall be able to win a man back to industry. If we do not pay these people compensation, they will continue to work until they are totally disabled.
I realise that, but quite a number of persons have been partially incapacitated, and they ought to be brought in. I hope my hon. Friend will endeavour to meet the Committee on this point.
One would have been glad to have a talk about the compensation laws in general, but one is tied down by the Amendment. The Joint Parliamentary Secretary yesterday made reference to a disease in South Yorkshire known as Lowe's Disease. It took my mind back to the time when I was a very young man and worked in the pit. One saw strong, virile men from 30 to 40 years of age working among ganister, and also men making silica bricks who in a few years began to fade away as a result of the terrible cough it induced. Their lungs were torn after a few years and they eventually lost their lives. It was a terrible thing, and one is glad to know that the description has been broadened so as to bring in men who have hitherto been kept outside. I have been in touch with a colliery for many years and I have taken scores of men before medical boards, and in all my experience of over 30 years I have, never been able to get one case through. I am confident that with the new description of "pneumoconiosis" the whole aspect has been broadened and more of these men may now be brought into the scheme.
I hope that the Department will agree to deal with the partially disabled. The matter is very serious. On the point of rehabilitation, I hope that it will be possible to get hold of these men earlier. It is terrible to realise that while we are sitting here men are being affected by this terrible disease. We have not been able to take them early enough. I believe in preventive medicine. It is said that the Government do not want to alter the terms of the compensation Act. It was said yesterday by one or two speakers that it is absolutely obsolete. It is 50 years old and it is time that the construction of the whole Measure was altered. I hope that the proposed Amendments will be agreed to. One of the outstanding questions upon which I have had talks with solicitors interested in these cases is that men who were injured before they were 21 years of age have had to go back to their previous average wages. This may be outside the question to-day, but I hope that at some time we shall have an opportunity of going into the whole question of workmen's compensation.
I listened carefully to everything that was said by the hon. Member for Llanelly (Mr. J. Griffiths) and other hon. Members who have supported this Amendment. That is a matter to which we have given the most careful and earnest consideration, but we find that the practical difficulties involved are very great. I should like to remind hon. Members exactly what we are doing under this Clause. It is something which is quite unprecedented in workmen's compensation law. There have been dozens of Workmen's Compensation Bills and many Workmen's Compensation Acts which have passed through or been in- troduced into this House, but none, until a little Bill two years ago, had a retrospective effect or made any attempt to provide for old cases. That was the byssinosis scheme for workers in the great looms of the Lancashire cotton industry. The scheme was agreed by employers and the workpeople and was an excellent one. It provided for a benefit, in cases of total incapacity only, of only 10s. a week, but it was very acceptable to the disabled workpeople.
The cases of pulmonary disease among coal miners, as the hon. Member knows perhaps better that I do, are very sad. They develop very slowly over a number of years, and medical science can at present do very little by way of alleviation. Therefore, we felt it very important to do something for the old cases, and in this Clause we have done a good deal. We go back to 1934, which was the time when the silicosis scheme for underground workers in coalmines came into operation. That scheme at the time did not permit of attempting to deal with old cases. That was the mentality of the time, and I am glad to say that we have made some progress since then. It goes back to 1934, and under the scheme for which we provide in the Bill, five years from the date to be prescribed under the scheme will be available in the future for men to make out their ease in respect of the benefit scheme. There will be a total period of 13 years which will be open to persons who become totally disabled.
Is it possible, in order to meet some of the cases which may not now be regarded as partially disabled but which are on the verge of complete breakdown, to postpone this prescribed date for another period so as to enable people who up to the present have not been certified as disabled to be covered?
I am anxious personally because of the very great numbers of cases which are known to me and to my hon. Friends. Suppose there are two or three hundred people unable to work, and that 100 of them are declared to be totally disabled and the remainder are only declared to be incapable of working underground, they may not be working but left in the air, so to speak. Can the hon. Gentleman hold out any hope or prospect of these men being looked at again to see whether they can be found to be partially disabled, before the door is closed?
I should not like at this stage to make any promises on that point. We have felt that we are providing for cases of total incapacity going back to 1934. As regards the future, we are satisfied that the period of five years from the commencement of the scheme during which men may make out their claim to be totally disabled will cover the cases of some men partially disabled at the present time who will become totally disabled in the course of the next five years.
The hon. Member knows of the position at present where a man is partially disabled and fails to secure light employment himself, and the employer does not find full employment for him. Is he in those circumstances entitled to be regarded as totally disabled; and does that apply under the benefit scheme?
I am afraid the hon. Member has asked a question to which I cannot give an answer, but I will certainly look at it and see how that would operate. As regards the bigger question of applying the benefit scheme dealing with old cases to cases of partial incapacity as well as cases of total incapacity, there are one or two very considerable practical obstacles. In the first place, a totally incapacitated man is off work. There is no question of his working, but in the case of partially incapacitated men many of them—I should have thought the majority—could be employed on war work at war wages. It is fairly easy now for a partially incapacitated man to obtain employment of some kind. In the second place, some of these partially incapacitated men, if they are unemployed, will be in receipt of unemployment insurance benefit which will be a higher figure than the benefit provided under this scheme. If we were to start to deal with partially incapacitated cases, we should have to make some provision that a man could not draw both his benefit under this scheme and unemployment benefit.
It is true that those who are in the early stages of the disease and are declared to be partially disabled may be in work or may be getting unemployment benefit, but there are people who are technically partially disabled who have no work and no hope of getting any work. Is it not possible for this matter to be reconsidered, because to all intents and purposes they are totally disabled men?
It is difficult to say whether a partially incapacitated man is incapable of finding work or that work is never likely to be available for him. Once a man is totally incapacitated there is, alas, no chance of him being fit for work again. It is true that this disease is progressive, and the result of that would be that if you tried to apply the benefit scheme, there would have to be a constant re-assessment of the man's degree of incapacity, because incapacity gets greater as time goes on. To do that would be placing on the Silicosis Medical Board, the authority under this scheme, a very heavy task. They would have to assess in each case not only whether partial incapacity existed, but its degree, and they would have to re-assess its degree from time to time. You would then have to allocate by a rule-of-thumb method the proportion of the 15s. which a man would receive.
I regard this Clause as the most important in the whole Bill. Has not the Department power to establish organised medical treatment and examination of these cases? Would not these cases come periodically under review in order to see whether the person certified as having the disease had it in a well-established or moderately advanced form?
It is not possible, under a benefit scheme of this kind, for workers in one industry, to deal with the question of rehabilitation. That is a far wider question and is one which my right hon. Friend the Minister of Labour has very much in mind at the moment. Careful inquiries have been made about rehabilitation, and measures on that are intended, but it would not be possible in a financial scheme, to provide financial benefit for a limited class of persons in one industry, to establish machinery for rehabilitation and treatment. Therefore, I suggest to the Committee that we cannot go further and embark upon something which would lead to great practical difficulties if we tried to extend it to cases of partial incapacity. As it is, I do not think the scheme is ungenerous. Indeed, it is unprecedented. It sets a precedent for other industries in the future, and I hope the Committee will accept the Clause as it stands.
The answer which the Under-Secretary gave a few moments ago disappointed me immensely. I concede with considerable pleasure the fact that there is something unprecedented in this scheme, but I should not like this Clause to go by having as its only virtue that of being unprecedented. I see in this Clause an opportunity of doing something really substantial, not merely to establish a benefit scheme for those who are suffering from this disease, but to provide some organised, constructive, medical treatment for these people. We are still left with these old cases; they will not come under this medical scheme at all. They are the persons who have been before the Silicosis Medical Board and who have been certified as having this disease in a "well-established" or "moderately advanced" form. They are supposed to be partially capable of work. This disease is progressively eating up their lives, as it were, yet they will not be covered by this benefit scheme. I do not want to enlarge too much on this, as we have a great deal to do in connection with this Bill to-day, but I must point out that it should have been possible to have increased this 15s. by a very substantial amount. I appreciate the fact that those in receipt of national insurance benefit will have the amount they receive from this source disregarded, but that men suffering from pneumoconiosis or silicosis and on public assistance benefit will not have the amount they receive from this source disregarded. Why this unfair discrimination? Detailed conditions upon which the scheme will be established have not yet been laid down, so I ask that the conditions which will determine benefit shall be more generous.
I think the speech of my hon. Friend the Member for Merthyr (Mr. S. O. Davies) deserves a reply, but I do not want the Committee to confuse the issue on this Clause. I ask hon. Members to believe me when I say that it has not been an easy thing to get this Clause into the Bill. The fact that it does something which has not been done before is no reason why it should not be done now. We have tried to do two things in this Clause. First of all, in the case of the workmen coming under it, we suggest a payment of 15s. a week, whether they are totally or partially incapacitated, and secondly, where the man dies as a result of the disease, we suggest that £250 shall be paid to the widow. We have had quite a lot of difficulty in drawing up this very intricate provision. My hon. Friend mentioned the question of medical attention, and so on. He knows that under the White Paper the Ministry of Fuel and Power have very definite instructions both in regard to medical services and in regard to rehabilitation. Although that is not contained in this Clause, I think my hon. Friend can take it that much headway has been made in that direction. There has been a great deal of drive up till now, and I think my hon. Friend can take it that these cases will be, and are, constantly under review.