On 29th July last, in this House, in a Debate on Service disablement pensions, the Minister of Pensions used these words:
One thing that was done recently in the time of my immediate predecessor, and about which the House knows little or nothing so far, I would like to mention. I do not want to say a lot about it tonight, because it is still in the experimental stages, but I would like to allude to it to indicate how we are trying to approach these problems. We have appointed some 25 welfare officers, which is, again, a new departure and something that has never been done before; in every region, there are welfare officers, and, if the service proves successful, we shall add to their number.
A little later, he said:
I would indicate that the service has been introduced, but that, as yet, it is experimental, and it is therefore too early to say whether it is a success or a failure."—[OFFICIAL REPORT, 29th July, 1948; Vol. 454, c. 1657.]
That was some five months ago, and my object in raising the matter tonight is to try to get some indication from the Minister how this new experiment is working, and also to try to make a few suggestions myself as to ways in which this work may be still further extended. We have one slight indication as to how things are going, because, in the recently published 23rd Report of the Ministry, in paragraph 114, there is a reference to the appointment of these officers:
These officers are interviewing large numbers of pensioners every week, discussing their personal problems and helping them in any way possible. In just over three months, about 33,000 pensioners have taken advantage of these arrangements.
I think that when we heard the announcement we all welcomed it because stress
is again being laid on the constructive side of the Ministry's work. People sometimes think that the work of the Ministry of Pensions is largely a matter of handing out money to disabled persons. That, of course, is only one side of it, and there is a great deal of very valuable constructive work carried out by the Ministry. As I see it, it is the job of these welfare officers to make sure that every disabled pensioner knows what is available to him, not only in the way of allowances and payments in cash, but also in the way of services.
I was grateful to the Minister when recently he took up a suggestion of mine and decided to issue a letter to every disabled pensioner giving full details of all the allowances and services available at the Ministry, so as to try to make sure that they all knew just what was available to them. In this letter, the Minister drew special attention to the existence of these welfare officers, and recommended every disabled man to get in touch with the welfare officer at the regional office. There is one aspect of the Ministry's work about which, I believe, a number of disabled persons are still somewhat uncertain. It is the right of the disabled person to treatment in respect of his disability under the auspices of the Ministry. I hope that the welfare officers are giving special attention to making sure that disabled persons fully appreciate just what they can obtain in the way of treatment for ailments arising out of their disability.
Talking of treatment leads me to the question of rehabilitation generally. I should like to quote again from the 23rd Report. In paragraph 110, under the heading "Rehabilitation," we find these words:
A most important feature of the Ministry's work is the rehabilitation of the war disabled. The approach to this problem is threefold. First, the disablement as such must be reduced to the lowest level to which medical science can bring it. Secondly, the patient must be helped to achieve a state of mind in which he will return to every-day life prepared and willing to play a normal part, to keep a job, to cultivate other interests and to enjoy his leisure. Thirdly, he must be helped and prepared in a practical way towards a job if his disability will affect the resumption of his normal occupation. The third matter is the responsibility of the Ministry of Labour and National Service, whose Disablement Resettlement Officers are in close touch with all Ministry hospitals and who see all patients.
My point in referring to that is to ask the Minister to give some clear indication of the liaison between the Ministry of Labour's rehabilitation officers and his own welfare officers. I want to feel that there is a close understanding between them.
There is another job which I think these welfare officers might do. As the House knows, the Service Ministries pay out quite a number of disability pensions direct. The Ministry of Pensions deals with those of the recent war, and will, in future, deal with them all, whether in wartime or in peacetime. A large number of pensions are already being paid out, and I have been gradually getting the figures from the Service Ministries. For the Navy the number is small, but for the Army it is over 7,500. These cases are dealt with on exactly the same scale as those administered direct by the Ministry of Pensions. There is parallel treatment. I suggest that if it is found desirable for welfare officers to keep in touch with those pensioners whose affairs are administered direct by the Ministry of Pensions, it will probably also be a good idea to allow the welfare officers to take under their wing those pensioners whose affairs are administered direct by a Service Department.
The Minister's own welfare officers will obviously be in a much better position to advise a pensioner than would someone direct from the Service Department. It might be a very good thing if a pensioner who is receiving his pension from the War Office, the Admiralty, or the Royal Air Force could have access to, and get advice from, the Ministry of Pensions' welfare officer.
As one reason for that, I should like to quote a case which occurred quite recently in my own constituency. It concerns a former marine who suffered a disability from his peacetime service, and who has for some years been drawing a pension through the Admiralty. I understand that he has been virtually bedridden ever since 1945, but until the autumn of this year he was not aware, apparently, of the existence of the constant attendance allowance. As soon as an application was put in, this man was granted that allowance at the highest rate. One feels it is a pity that he should not have applied for that allowance much earlier. It may well be that he could have claimed it ever since 1945. It is that kind of case to which the welfare officer might give his attention, even though it is not a case directly administered by the Ministry of Pensions.
There is a further category of people to whom the welfare officer might give some attention. Between the wars, as we all know, pensions were refused to many men who, on the present basis of assessment, would have got them. Many of those men are now approaching the 60's, and in many cases are more and more feeling the effects of the disabilities in respect of which they were unsuccessful in applying for pensions. It may well be that some of these men may have to have recourse to the Assistance Board because their disabilities, although not recognised for pension purposes, may be such as to make it impossible for them to earn their living in the normal way. Some of these cases, in the inter-war years, may have gone to appeal, and it may be that, legally, it is impossible for them to be raised again. However, that is a legal point, and I would not like to express an opinion about it. But not all such cases may have got so far. There may have been an application; it may have been refused and the man may then have left it at that, in which case it might well be possible that such a case could be raised again now—I do not know, but I think it needs looking into.
Obviously, it would be quite impossible to ask welfare officers to get in touch with all those men who, in the interwar years, were refused pensions. Some of the men may not wish even to have their cases raised again, but I think that something might be done on these lines: if such a man as I have described—a man who fought in the first world war and is now getting into his late 50's or 60's—because of his disabilities, which were not recognised for pension, now finds himself having recourse to the Assistance Board, I suggest that the Assistance Board might be asked to invite such a man to make contact with the Ministry of Pensions welfare officer. If that were done as a matter of routine, it would ensure that at any rate those men of that earlier period, who are in most difficult circumstances, are brought into contact with the welfare officers service of the Ministry, and it might be possible to do something for them. I throw that out as a suggestion. I appreciate that one cannot raise all the cases which were rejected in the inter-war years, but I think that particular group could well be looked into.
I would like to say a final word, almost by way of a caution. I want the Minister to make it quite clear that there is no connection whatever between an interview between a welfare officer and a pensioner and any reduction of an assessment by a medical board. I raise this point because, again, there has come to my notice a case which rather disturbs me. A pensioner went before a medical board for the usual check-up. He was invited to see the welfare officer. He did so, and the welfare officer and he had quite a long chat and discussed all the ins and outs of his case. The medical board reduced that man's assessment. Not unnaturally perhaps, as this was the first time the assessment had been reduced, and as it was the first time that the man had had a detailed discussion of his affairs with the welfare officer, the man unfortunately got the impression that there was some connection between the two, that the reduction of his assessment was not entirely due to medical grounds but that the interview and the discussion of his personal affairs had had something to do with it.
I hope very much that the Minister will do all he can to make it quite clear that it is not the job of the welfare officer in any way to affect that issue. Reductions of assessment, if they are made are made purely on medical grounds. In the case to which I have referred, I found that, far from having had any influence towards getting a reduction in the pension, the welfare officer thought that, on the face of it, there might be a case for granting a special hardship allowance because the man was no longer doing the job which he had been able to do before. In this case I was able to assure the man that, far from having any connection with the reduction of his assessment, the welfare officer had, in fact, from his point of view recommended that the case should be considered with a view to the possibility of granting a special hardship allowance.
Those are one or two points which have cropped up during recent months since this welfare officer service has been operating. No doubt, other points have come to the notice of the Minister. I think that the institution of this particular form of service is excellent, and it holds out great possibilities for the future. We want to be quite sure that it develops on the right lines, so I hope that the Minister will give us as full a report as he can on progress to date. The scheme has now been operating for several months. It is five months since it was last mentioned in this House, and I expect my hon. Friend the Minister will be in a position to say just how matters are proceeding. I hope that he will take the opportunity of giving us a report on this service, which is yet one more of the innovations of this Government which will be of great benefit to the ex-Service men.
I am sure that all of us who are interested in this subject of the welfare officers service and of the welfare of disabled ex-Service men in general are grateful to the hon. Member for Cambridge (Mr. Symonds) for having raised this matter and given us a chance to have a discussion on this very important subject. All of us who are connected with various disabled ex-Service men's organisations have the very greatest hope that when these welfare officers get into their stride, they will bring a degree of humanity into the administration of disablement pensions which possibly has not always existed in the past.
As I see it, the Government have decided at the moment to do nothing about the basic rate of pension. In case anyone should think that I am trying to bring party bias into this Debate, may I say that I support the Government in the attitude which they have taken on the question of doubling the basic rate at this period of economic difficulties in this country. The Government have decided to help the hardest cases by bringing in a very complicated system of supplementary allowances and special assistance to meet special cases. The result has been that the ordinary pensioner and disabled man today has not the slightest idea what all these supplementary schemes amount to or what his full entitlements are.
I am fairly certain that in this country today there must be thousands of disabled men who are not drawing their full entitlements, largely through ignorance. I do not think we can blame them. I doubt if there is a single Member in this House, other than the Minister himself, who could quote what all these supplementary schemes are and what a man can draw under them, or who in fact comes under them. To my mind that is one of the root causes of the agitation which is going on among ex-Service men in the country today. I think it is also one of the causes of the agitation on their behalf which many misguided people who are not themselves disabled are making. There are many people who seriously believe that 45s. is all that a 100 per cent. disabled ex-Service man receives. That is not the case at all. I do not say that a lot of people get much more. but certainly they are entitled to a great deal more if they knew how to get it.
I claim, therefore—and I hope all hon. Members opposite will agree—that if the Government do not intend to give extra assistance by way of increasing the basic rate of pension, at least it is the bounden duty of the Parliamentary Secretary and the Minister to see that all pensioners receive their full entitlement. In order to achieve that we shall have to see a slightly changed outlook in the administration at the Ministry of Pensions of the whole scheme for disabled pensioners. In the past the Ministry undoubtedly have been on the side of the Treasury and the taxpayer. The attitude was, "If a man is not drawing his full entitlement it is not our job to point out to him what his entitlement is."
There was something to be said for that point of view when our Pensions Code was a much more simple affair than it is today. The ordinary local branches of the British Legion, the ordinary voluntary British Legion secretaries, the ordinary man, should have known more or less what he was entitled to. He really cannot know today. I do not think there is any justification for that kind of attitude today. From what I have seen, there has been a change of view in the hon. Gentleman's own Department in Sanctuary Buildings, Great Smith Street, but I am doubtful whether that change in attitude has been transmitted to all the branch offices of his Ministry up and down the country.
I have great hopes that these welfare officers who are now being appointed will bring that about. Instead of sitting back in their offices and waiting for the men to come to them, they will make it their job to get about and try to inform everyone, including the secretaries of the British Legion, what the entitlement is. The obligation should be on the officers. They will be failing in their duty if the man is not drawing his full entitlement.
There is another matter. I asked the Minister today a Question about what special steps were being taken by his Department to assist ageing pensioners. In his reply, the Parliamentary Secretary said that the Minister hoped to say something about this problem in the Debate on the Adjournment tonight. I cannot anticipate what the hon. Gentleman will say, but I do not think it will be an answer to my Question to say that he is appointing welfare officers. Personally I have always held the view that there is a case to be made out for automatic increases in pensions for disabled men as they grew older. There is no question but that it is as a person gets older that these weaknesses begin to make themselves felt. I could take one particular case, but I will not argue it out because I expect I should be out of Order if I did so. I believe there is a case to be made out for some kind of automatic increase in a man's pension, or some up-grading, when he gets beyond a certain age and, say, every five years.
The noble Lord the Member for Rutland and Stamford (Lord Willoughby de Eresby) has put his case with studied moderation and very great fairness, and I think we all listened to him with pleasure and almost entirely with agreement. We are very grateful to the hon. Member for Cambridge (Mr. Symonds) for raising this important matter tonight and giving us the opportunity of this discussion. I hope, Mr. Speaker, you will permit me to make one apology to the Minister, which may be necessary; I may not be able to hear the conclusion of this discussion. We expected to have this discussion at a much later hour and I arranged to come along and take part in it, but I am now taking part in it three or four hours earlier than I had anticipated.
I want, without impertinence, to support what was said by the hon. Member for Cambridge on one or two points, and in relation to a specific aspect of the matter to which I have previously referred. The administration of disabled persons' pensions has certainly become much more enlightened, much more generous, much more sympathetic, during the last few months.
While that has been going on, while that change has been taking place, the law in regard to pensions has also been altering. Mr. Justice Denning, when he was dealing with pensions cases, laid down a whole new series of propositions, one by one, in a series of cases, which substantially altered the law. I do not want in any way to leave anyone under a misapprehension if I try to state a series of rules quite briefly, but I do not believe I am misleading by asserting that in a wide class of cases the onus of proof has now shifted from the applicant to the Minister in cases where the entrant into the Forces was of good health when he went in and was of bad health when he came out—particularly classes of cases which cause the utmost suffering to the sufferer and are most difficult of treatment.
While that has been going on, medical opinion has also changed very substantially. If I may go on to something which does not really affect the disabled pensioners, I would refer to miners' nystagmus, which was thought to be due to idiopathic idiosyncrasy inherent in the individual and acquired at his birth. Now we have a body of opinion which shows that this may be due to environment, or to diet, or other causes. Miners' nystagmus is due to occupational and other reasons.
I have had to deal with a very great number of cases of variations of psychoneurosis, the type of tragic disease associated with the nervous system. Parkinson's disease is a classic example and the example which causes the most immediate problem. The position at the moment is that the sufferer from this dread disease, which usually means a progressive worsening of his condition, is unable to get adequate treatment and to find any institution available for him. He is unable usually to establish a case in the line of the old law, although I believe many of these cases which went down, could now be established if they could be taken to the Court of Appeal again. What I am asking the Minister to say is this: as the welfare service is established and developed, its facilities will be available to any person who claims to be a disabled person after serving in the Forces, and who is suffering from one of these diseases, whether he has been granted a pension or not. Such a man is, perhaps, the man among all in most need of it.
I want the Minister to tell the House in more detail than we have been told previously, what institutional treatment is available for this class of case, what medical resources are available and how these men may have the limited resources which are now available. So far as Parkinson's disease is concerned, there is now a Parkinson's Club for the sufferers from that disease. We have also been told that medical research abroad is in advance of medical research in this country and that there is hope in the near future for these tragic sufferers.
That is the first point. The second grave question which I feel is of importance in this matter, and to which I want the Minister to apply his mind most seriously, is that there should be machinery by which a man, even if his appeal has been lost in the past, may now come back and re-submit his claim in view of the alterations of the law and the alterations of medical opinion. If he likes, there should be organisations established, but the Ministry should take powers to see that any appropriate case may have a full re-hearing, and a rehearing on its merits, in the light of present-day procedure.
I remember that on a previous occasion I quoted to the House the case of a man suffering from acute psycho-neurosis, who had been disallowed pension on the medical opinion that, because in his early days he was a man who was exceedingly conscientious in his profession, his very conscientiousness showed a predisposition to psycho-neurosis, because it indicated a peculiar type of mind. It is right that I should say that the Parliamentary Secretary dealt with that case with very real speed, that the pension was granted and that justice was done. However, it is a sample of the type of medical opinion with which sufferers can be confronted, and it gives a reason for a real review of cases, properly submitted and considered, where a prima facie case for review is made. I hope the Minister will do that.
I congratulate him on what he has done since he has been in office, and on carrying on the traditions of his predecessor. I am not trying to make any party point here, but I think it is fair to say that we have seen many applications turned down in the past that are now being granted—rightly granted and properly granted. I hope my hon. Friend is going to continue that good work. I think the points that I have mentioned are of importance, and I hope he will do something about them.
I, too, am glad that this subject has been raised tonight. I think it right to say that, owing partly to the campaign waged up and down the country in the last few months on the subject of the increase of pensions, the country has now become Ministry of Pensions conscious. For many years that Ministry was the Cinderella of the Departments, but I think it is right to say that now it is assuming its proper place in the social service structure of the country. The fact that we have had a number of Debates and Questions on the subject of pensions since last July is an indication that we are giving now the right amount of consideration to all the problems affecting the disabled ex-Service men.
As to the topic of welfare officers, the Minister is aiming to bring the personal touch into operation in all his dealings with the disability pensioners. As he states in his Report, it is quite impossible to do the job properly by post. The amount of money that is given by way of pension is, of course, tremendously important, and we cannot over-rate it, but the welfare services and the positive hospital treatment, and so on, are equally important.
I should like to ask one or two questions about the appointment of welfare officers. For what qualifications does my hon. Friend look when making these appointments? Does he choose men of very wide experience, of very broad human sympathies and understanding, and men of great initiative? I rather gathered the impression that the welfare officers were waiting to be contacted by the disability pensioners. In fact, they are instructed, according to this very admirable leaflet, to contact the welfare officers. I hope, however, that the welfare officers will not sit back in their regional offices, but make it their duty to seek out individual pensioners, rather than wait to be approached by the pensioners.
There is another matter that has not so far been mentioned. There are women pensioners and widows, and people responsible for orphans. They may have some diffidence in unburdening themselves to male welfare officers. I ask my hon. Friend whether he has considered the appointment of a woman welfare officer. I do not ask for one in each region, because, obviously, that would be asking too much; but if we could have one on a wandering commission up and down the country I think that that would be very beneficial.
It is most important, in my view, that the welfare officers should concern themselves, not only with seeing that the individual pensioner gets his due measure of financial aid, but that they should also make the pensioners aware of all the other services the Ministry can offer. It is most important that there should be a close follow-up of all pensioners after they have had hospital treatment. After prolonged hospital treatment, a pensioner may not be quite capable of adapting himself to the kind of life he is expected to lead after the treatment. In the hurly-burly of getting a living in an industrial town, for instance, unless he is properly looked after he may have a serious relapse, so that all benefit of the treatment he has received may be lost. I hope that one of the primary jobs of the welfare officers will be to follow up all those patients who have been in hospital.
I hope they will pay particular attention to the pensioners with artificial limbs. It is very difficult for a person with an artificial limb to go upstairs—to get on a bus, and so on. If his limb is not fitting properly and is causing discomfort, it is very hard for the pensioner to bear the discomfort and inconvenience. I hope that the welfare officers will take particular care of those people. They might even go so far as to approach local housing authorities to help in housing this class of pensioner. For instance, if a disability pensioner is living in a house in which he has to go up and down many stairs to get to and from his room, and so on, it may be possible, and certainly worth while, by liaison with the housing authority, to arrange some kind of exchange of houses, so that the disability pensioner may have other accommodation more convenient to him.
Then I think that the welfare officers ought to look after with special care men who are suffering from some nervous complaint, who often are most chary of seeking help. They shut themselves up in a little world of their own and try to convince themselves that there is nothing wrong with them. Thus they often debar themselves from getting their just rewards and treatment. I think there is a case there for particular attention by the welfare officers. This work requires to be done by men of great tact and sympathy.
These welfare officers must be able to keep in close touch with the Ministry of Labour, so that all the benefits of the resettlement scheme and all the benefits of sheltered employment may be brought to the attention of those who are in need of those benefits. They must also keep in close touch with the Ministry of National Insurance, so that all the troubles that arise from overlapping benefits can be explained properly, and, where possible, smoothed out. They must keep in close touch with the Assistance Board, because there are many cases in which the Assistance Board can help, over and above what the men are getting by pension. Also, it is very important that they should keep in close and harmonious contact with all the voluntary bodies serving ex-Service men, whether the British Legion, B.L.E.S.M.A., S.S.A.F.A. or other similar organisations. All these duties will make the job of the welfare officers a full-time job, and we must be sure to have men and women of the highest calibre to do it.
Then there is the question of the war orphans. The orphans are the Minister's own special care. They have been left outside the scope of the Children's Act. There are about 5,000 of them, and I believe that most of them are boarded out with foster parents. It is most important that the care and training of these children should be properly looked after. That is a job for the welfare officers. Any information my hon. Friend can give to the House on this matter will be welcomed.
Although we may disagree on the question of the rise in the basic rate, or on the question whether the Minister's policy in looking after specially hard cases is the right one or not—and I believe it is—I do not think that any of us can disagree that this new departure in his Department, this establishment of welfare officers, is a very good one. In conclusion, I would say that this is another sign of the human touch that has pervaded the Ministry of Pensions since this Government took office, and that I hope my hon. Friend will be able to give us answers to all the points that have been raised in the Debate tonight.
I am sure that we all welcome the opportunity which this Adjournment Debate will give to hear a progress report on the work of the pension welfare officers. I can add nothing to the admirable account which the hon. Member for Stockton-on-Tees (Mr. Chetwynd) has given of the scope of the work of these officers, and the method which they must necessarily follow. They must, it is quite clear, view their job in a broad way and not allow themselves—as I am sure the Minister will not allow them—to be bound in any way by red tape or by a narrow conception of their functions. Anything which can be beneficial to the disabled pensioner must be within their province.
I believe that their work could be of particular value in the case of the ageing pensioners to whom the hon. Member for Rutland and Stamford (Lord Willoughby de Eresby referred. I agree with what he said about the desirability of a special supplementary allowance in the case of ageing pensioners. It seems to me, from the relatively little that I have seen of this matter, that it is indisputable that there is a case for such an allowance. As age advances, inevitably the disablement which a man has suffered weighs with him year by year more heavily. The overwhelming majority of the pensioners of the 1914–18 war are now upwards of 50 years of age. Anyone who has discussed their problems with anyone with an intimate knowledge of them cannot fail to realise that there are many among these 1914–18 pensioners who genuinely feel that the present provision does not fully meet their individual needs.
Many of them feel, for example, the necessity occasionally of taking a day off from work and to lay up because of their disabilities. Frequently they find it impossible to do this. A British Legion official of very considerable experience, with whom I have discussed this matter, has assured me that many times ageing pensioners have said to him how beneficial they would find it to be able to take a day's or two days' rest from work, but they feel, for one reason or another, they cannot do so. This is specially the case with the self-employed pensioner whose needs require a little more special consideration. It is in all these individual matters that the pension welfare officers can play a particularly useful part.
We must recognise, I am sure, that some of those, at any rate, who have been disabled have in the past suffered psychologically even more than physically. I do not wish in any sense to make a party point, but it appears to me that the Minister of Pensions today has to a large extent to try to rectify conditions which arise from the fact that provisions for the employment as well as for the pensions of disabled persons have not been adequate in the past. This has produced on the part of some pensioners an embitterment and a suspicion of almost any public authority.
One of the greatest ways in which the welfare officers can show their calibre is by their capacity to win the confidence of the most difficult cases with which they have to deal—the men who are reluctant to bring their difficulties to any public official. That is why I think that the hon. Member for Stockton-on-Tees was particularly right in putting emphasis upon the desirability of maintaining contact with voluntary organisations, because very frequently they are able by their past services to secure the confidence of the pensioners to a very great degree. Therefore, I am sure that we all look forward this evening to hearing a fuller account of this most important service, and I feel sure that the Minister, from what has been said this evening, will be aware that on this side of the House at any rate, there is great appreciation of this new development in the work of his Ministry, and great anxiety that it should not be in any way hampered by a shortage of men and women to do this important work.
I should like to follow my hon. Friend the hon. Member for Colchester (Mr. C. Smith) and the hon. Member for Stockton-on-Tees (Mr. Chetwynd) in what they have said about ageing pensioners—the point first raised by the hon. Member for Rutland and Stamford (Lord Willoughby de Eresby). I am glad to hear that the Minister is to make a statement about these ageing pensioners tonight. They are one of the categories who are very shy about bringing into the public eye their difficulties. Not only as they get older do they begin to suffer more than the normal person from the various disadvantages of age, but there is the further point that the normal man who is not disabled usually earns more as the years go on; but the basic rate of pension remains stable all the time. I feel that whatever view may be taken about the raising or otherwise of the basic rate, some rise would be reasonable as a man gets older.
Another category of persons who, I think, will be very greatly assisted by these welfare officers—another category incidentally who are very reluctant to parade their defects in the public eye—are the widows. We tend to forget sometimes that a very large number of the Ministry's beneficiaries at the moment are widows with young children. I have thought for a long time that there must be in the country large numbers of widows bringing up children, most of whom will now be of school age, who are trying to run a home, and who are doing their best for their children on a very small amount of money. A weekly sum in the region of £3 10s. for a woman with two children appears to be quite inadequate for the purpose. I myself have two children and I know, only too well, just what it means in bills for shoes and clothes alone at the present day.
I hope that these welfare officers will make it their business not only to look at cases of disabled men but to go also to the widows and find out how they are faring. Some of them may well be all right; I would not suggest for one moment that they are not certainly a lot better off than they were 10 years ago. Nevertheless, this is a matter the welfare officers could do with very great effect.
A further point which I think is sometimes overlooked is the constant attendance allowance. This again is a matter which cannot possibly be decided as a whole. We cannot reach a general conclusion because each individual case is different. I have received not complaints but suggestions from men so badly disabled that they cannot dress themselves and do the ordinary things which a normal man can do for himself. I have heard the suggestion that the allowance of 20s. a week, which is the normal allowance, should, at any rate, be increased to 30s. The increased allowance of 40s. is only used in very serious cases and is not normal.
At the present time, when the Ministry of Pensions is doing so much, it is tempting to feel that the ordinary citizen has no real responsibility. I believe that the scope for voluntary work by the ordinary citizen and by other members of the British Legion—many of whom are at present doing a remarkable job, quite unostentatiously, in visiting pensioners and doing jobs for them—should continue, and indeed increase. I am thinking particularly of the performance of simple services for war pensioners.
Only a few weeks ago in my constituency I came across a man who is seriously disabled but able to get about. I spoke to him about his circumstances, and one thing he said was: "Whenever I want a job done about the house, a job which I could do myself if I had the use of my limbs, I have to get somebody in to do it for me. It is those small expenses which add to my liabilities." Surely that sort of job is one which any of his friends could do for him, if they thought about it. It is not that they are really thoughtless; it just does not occur to most of us until the facts are brought to our notice. I should not like anything to be said tonight which would tend to encourage people to think that the job of performing these personal services is being done by the Ministry of Pensions. These are matters which can only he done by those of us who have our full faculties still left to us.
I join with my hon. Friends and the noble Lord the Member for Rutland and Stamford (Lord Willoughby de Eresby)—who has played the part of a lone wolf on the Opposition benches for the greater part of this Debate—in thanking my hon. Friend the Member for Cambridge (Mr. Symonds) for this opportunity to discuss the functions of these welfare officers.
First, I should like to ask one or two questions concerning this scheme; it has now been in operation for some five or six months, so I assume that the Minister can give some indication of how it is functioning. My first question is: how many welfare officers have been appointed in Scotland? Second: where are these welfare officers stationed in Scotland, and are any arrangements made whereby they can assist pensioners to meet expenses, which are sometimes apt to be rather heavy, when they call for an interview? In districts where the population is sparse and widely scattered the welfare officer can hardly be expected to visit the pensioner. At the same time, it is rather an expensive item for the pensioner to visit the welfare officer.
A good principle is always to act through the personal medium rather than through the medium of correspondence, because the results obtained from personal interviews are much better than those obtained from correspondence; one gets to understand the case in a much better way. Perhaps my hon. Friend would also tell us how the distribution of his special letter to pensioners, drawing their attention to the numerous benefits now available to them, is going. Does the number of applications for the various forms of supplementary assistance show any increase as a result of sending out this personal letter?
I should like to reinforce the plea made by two or three of my hon. Friends, that the welfare officers should co-operate not only with the various Government organisations, such as the Ministries of Labour and of National Insurance and the National Assistance Board, but also with ex-Service men's organisations. I have had some experience of acting as an almoner for an ex-Service men's organisation, and it is true to say that a number of these organisations are prepared to assist individuals to get on their feet by making very considerable grants—grants of a size which I think the Minister would not be able to make; I do not know, but I do not think he could do that. Certainly ex-Service men's benevolent organisations would much sooner give money for the purpose of establishing the future of an ex-Service man than merely dispersing it in the form of charitable assistance to helping the fellow over the next week or two, not knowing what the future might hold. Most organisations would be only too keen to do that.
The noble Lord the Member for Rutland and Stanford touched on a very important question in referring to the problem of the ageing disabled pensioner. Anyone who is associated with disabled persons knows that after a certain age—and it is a much younger age than in the case of those possessing all their faculties—a disabled person begins to feel the wear and tear of life. There are two ways in which the ageing disabled pensioner can be helped. First, he can he helped financially. At present, of course, he can have his final award reviewed and increased. I do not know to what extent that does help towards solving this problem, but I do think that the suggestions made tonight for some further consideration of how financial assistance could be given should be borne in mind. Whether or not it could be done by a different approach, such as through the medium of hardship allowances I am not certain, but I suggest that the Minister might consider basing the hardship allowance not merely on the degree to which a man is disabled, together with a comparison of the job he is doing with the job he did before disablement, but also in some way on age. An approach along those lines might assist in solving this problem.
The second way of helping the ageing disabled pensioner is to give him a lighter job. The crux of the solution is to know some time ahead that the disabled man is getting too old for the job he is performing. I do not know whether that could be done through the welfare officers. If the pensioner could say to a welfare officer: "Look here, I am getting on in years, and next year or the year after I shall have to chuck this job, and I shall want another," perhaps the welfare officer could look around to try to find a lighter job for that man. That would help towards solving the difficulty. I believe that the problem of the ageing disabled man must be tackled along those lines. We want the best possible for these men who have given of their best for us. I am confident that the Minister will try to do that, and anything that he can do in this direction will, I feel sure, be welcomed by hon. Members in all parts of the House.
I also wish to congratulate my hon. Friend the Member for Cambridge (Mr. Symonds) on having been fortunate enough to raise this matter at such an early hour so that many Members on this side of the House can take part in this Debate, thereby showing the interest on the Government side in this matter, as compared with the Opposition side, from which we have heard only one of the three Members present make a speech. The appointment of these welfare officers marks an entirely new development in the organisation of the Ministry. It is something that ought to have been done 20 years ago. We now have the Ministry of Pensions officially out to help those who are entitled to receive pensions. Previously, we have had certain ex-Service organisations—and I am not going to criticise any of them, or mention any by name, or throw any stones into the placid waters of this Debate—and certain other organisations that have made a corner, so to speak, in this information, creating the impression that if anyone wants a pension or an allowance it is necessary to go to them. It is time that this bubble was pricked.
By far the greater number of people could have got pensions and allowances by applying directly to the Ministry of Pensions. The strange thing is that 30 years after the first world war, and three years after the second war, so many pensioners do not know what they are entitled to.
Is not the hon. and gallant Member aware that very often when a pensioner has been refused a pension and has gone to an ex-Service men's organization—and I speak as a member of the British Legion in Scotland—he has had assistance in getting his claim pressed with the Ministry?
There is no question of correcting me, because I have said nothing that is incorrect. If the hon. and gallant Member will take his mind back to the period just after the first world war, he will agree that if the pensions then awarded had been at the rate and magnitude they are today, and if Members of Parliament had then done their job, there would have been no reason for these ex-Service men's organisations to take part in this work. That is my answer to the hon. and gallant Member.
There is, of course, work other than pensions work done by these organisations. There is a great deal done by way of distributing voluntary help to some of the worst cases. I think everyone agrees that the administration of pensions schemes cannot deal with the special cases which need help, and that there is still room for voluntary and charitable work.
I wish that the noble Lord had registered what I said. I said that I was not going to mention any organisations by name, nor did I wish to disturb the placid waters, although the placid waters have now been disturbed by interruptions.
The hon. and gallant Member was talking about what happened just after the first war, but I am concerned with what happened after—and during—the last war. Within my personal knowledge, on many occasions the British Legion in Scotland has assisted persons, whose pension claims have been turned down by the Ministry, to get their pensions. I ought to know, because I am on the National Executive Council of the Legion.
If the hon. and gallant Member can only show patience I shall deal with that point. The question is why these unofficial organisations should be doing an official job. I agree with the noble Lord that these organisations still do a lot of other things, but that is outside the scope of this Debate. These welfare officers will take away the work that these unofficial bodies ought not to have been doing and will develop that work. As far as the argument of the hon. and gallant Member for West Edinburgh (Lieut.-Commander Hutchison) is concerned, it does not follow that these organisations were the only ones to take up cases that had been turned down by the Ministry. Similar cases have been taken up and won by Members of Parliament and other organisations. It may be that the hon. and gallant Member, because of his youth, does not know what happened after the first world war. It may be that he does not appreciate that the trade unions, among other organisations, have won a lot of these cases. We have the position today of unofficial organisations appealing to the country for funds, and getting millions of pounds which they have been frittering away in organisation, staffing, salaries and so on, to do a job which the Ministry of Pensions and the welfare officers will do in the future. That is a definite advantage both to the pensioners and to the State.
Since 5th July, we have had National Insurance and National Health schemes, as well as other social security measures, and I hope that the Minister will discuss with his Cabinet colleagues responsible for these schemes the question of setting up official citizens advice bureaux in the town halls of every city and town where the Service pensioners and civil pensioners can go for information about official and unofficial schemes. These unofficial organisations that have grown up on the backs of the ex-Service men ought never to have been engaged on this work, and if these official advice bureaux are set up there will be co-ordination of all these schemes with everyone getting his entitlement. It will mean that there will be no reason for these mammoth unofficial organisations to do this work.
Today the ex-Service man and his wife and family are better off, actually and relatively to the cost of living, than they have ever been before, and the majority of them quite frankly admit it. The Government and the Ministry should consider improvements in allowances and other things, which have been mentioned by hon. Members on this side, other than the basic rates of pension, which is a satisfactory foundation on which to build. We welcome the development of this welfare organisation, and we hope that the Ministry will increase the number of the officers and the scope of their work so that the pensioners will get their full entitlement according to the regulations.
I had no intention of making a speech this evening, but after the deplorable observations of the hon. and gallant Member for East Hull (Commander Pursey) I must say something in defence of some of the great voluntary ex-Service men's organisations which exist in this country. I do not know what the position of the ex-Service men would have been had it not been for the vigilance of these public-spirited citizens who have done so much during the past few years. Heaven help the ex-Service man if he had to rely entirely on officialdom. This idea that help can only come to these men through a town council or a municipality is fundamentally wrong.
Many members of the present Government, including the Secretary of State for Scotland, have commended the enterprise and system of voluntary help given by one section of the community to the other, and it seems to a great many people that these ex-Service men's organisations are doing a most valuable service. It is simply deplorable to suggest that their functions should be removed and put into the hands of a soulless bureaucracy already over-burdened through trying to carry out too many ill-considered Acts of Parliament.
I should not like to follow the hon. and gallant Gentleman too far in his observations for I do not wish to see any truculence introduced into the Debate. I am intervening as a civilian. The interchange of views makes it look as if my Service colleagues were truculently disposed when we are supposed to be pacific in dealing with the question under review. The remark about "a soulless bureaucracy" casts an aspersion upon administrative organisations and the hon. and gallant Gentleman must take responsibility in that regard. There is ample scope and opportunity for voluntary organisations to exercise their functions in every possible way.
I intervene only to ask my right hon. Friend one or two questions. In regard to pensions generally, I have been privileged to be interviewed by ex-Service men's organisations in my constituency, and I must frankly say that I have not exchanged any bitter words with them in any shape or form. I have always given the assurance that we would seek to promote the interests of the ex-Service men and to advance them as far as possible under present-day circumstances to a much better position. I am delighted that my hon. Friend has stated that he is prepared to look at this matter objectively and to meet it as far as is possible.
With regard to supplementary grants, it is my view that these have not been broadcast enough for the information of the general public. Not only should my right hon. Friend express this information in various ways, some of which he has done, but there is nothing to prevent information about these supplementary grants being exhibited in post offices, where they will become common knowledge. The second point I wish to make is to ask the welfare officers to co-ordinate more closely the work of my hon. Friend's Department with the local authorities, the National Assistance Board, and the voluntary organisations. The hon. and gallant Member for West Edinburgh (Lieut.-Commander Hutchison) spoke about "a soulless bureaucracy" but I would remind him that there is "a soulful democracy" in this country and it is behind the administration of this Government. I am sure my hon. Friend will express it.
It may be that in some Departments of State one meets a soulless bureaucracy, but we can say that that is not so today with the Ministry of Pensions. In my constituency is situated the old town of Nantwich, and the President of the branch of the British Legion there is Colonel Cross, D.S.O., a distinguished soldier. At the annual meeting of his branch he said that since the advent of this Government the office at Manchester had completely changed. I want to add my tribute to that office. Colonel Cross said that he found helpfulness and humanity there and particularly the right kind of approach.
I rise to ask a question about the functions of the welfare officer. The welfare officer may conceive his functions to be the administration of the scheme and the benefits under it. I wonder if my right hon. Friend would encourage the welfare officers to go beyond that. In view of the experience that they have through interviewing pensioners and through intimate relationships with these cases, would he encourage them to report back to him upon the state of pensioners in cases of hardship or anything which may arise, so that we may see carried out the promise we have given to these people that, although we are not supporting their request for an increase in the basic pension, we shall do everything in our power to see that special allowances are met as quickly as possible. Would the Minister, in encouraging the welfare officers to pass on that kind of information to him, also suggest that they might discover what is the state of the pensioner, his home, his children and so form a link which will not only help the Minister but also Members of Parliament.
There are one or two points I should like to put about the functions of the welfare officers. It has already been suggested that they should co-operate with the local ex-Service associations. Might I ask the Minister to consider asking these men to go out of their way to meet if necessary these organisations, and at special meetings review the whole situation and explain the point of view of the Ministry.
I suggest that, because there is an abysmal ignorance on the subject of pensions. The British Limbless ex-Service Men's Association have made a number of concrete suggestions which ought to be dealt with very soon. There are questions of travelling allowances, the position of the man who has lost an arm but does not wear an artificial limb and so on. It is obvious when the matter is considered that he should be entitled to clothing allowances, though he does not get any now. Welfare officers are very appropriate channels for bringing firsthand information of individual cases. I should also like to suggest that they should have regular conferences together and they should pool their information so that they can make the best use of one another's experience. In my constituency of Preston we have some energetic and excellent ex-Service men's organisations, and this important link in the chain will be welcomed by all.
Like all the hon. Members who have spoken, I am very glad that this Debate has taken place tonight, and that we have had more time for it than we expected. In consequence of that the Debate has ranged rather widely, and I do not feel that I can deal in detail with all the points that have been made if I am to satisfy the desire of my hon. Friend the Member for Cambridge (Mr. Symonds), who referred to the welfare service and suggested that an account should be given of it. Therefore, I can say little if anything about the subject raised by the hon. Member for Oldham (Mr. Hale), who spoke about the cases which had been decided on appeal. With all respect, that speech would have been more appropriate to the Debate we had earlier today or on the Second Reading of the Pensions Appeal Tribunals Bill.
All I would say about that is that, fortunately, today we have a National Health Service, and that men whose disabilities have been found not to be attributable to or aggravated by war service but who nevertheless have severe disabilities, can take advantage of the National Health Service; and, further, that National Health Service patients are now admitted, wherever appropriate, to the hospitals of the Ministry of Pensions. It does not seem to me to matter terribly with which hand the Government are assisting these disabled men as long as the disabled men are assisted. We shall certainly do all in our power to look after National Health Service patients who may be appropriately admitted to our hospitals to take advantage of our specialised services.
Nor do I propose to say anything about the children's service which we operate for war orphans. That service was mentioned by my hon. Friend the Member for Stockton-on-Tees (Mr. Chetwynd). I said something about that last July, and I do not propose to repeat it tonight. Suffice it to say that so excellent has the service been throughout the years that the Curtis Committee could find no fault whatever with it. That service was excepted from the Children's Act for that very reason. We have been operating all these years an admirable children's service which is manned by specially selected children's officers of the very highest quality, and the fact that never by any chance whatsoever has one received a single complaint about the service is proof that it is going well. I take as much personal interest in it as I can, and I am very well satisfied with it. I should be glad to let any hon. Members who are interested to know more about it at any time they like.
Nor can I say anything, I am afraid, about the question of widows. Suffice it to say that both in the children's service and in dealing with widows, we appoint women officers. A widow who wishes to go to one of our officers to discuss her allowance or any other problem which she may have will be met by a sympathetic woman officer who will discuss the matter with her in complete privacy. That is not part of the welfare service which I shall describe but it is an existing fact that there are women officers in all our offices dealing with the widows' and the children's service.
I now come more particularly to the welfare service proper about which it was not possible to include much information in the 23rd Report of my Department which contains ample information about all the other points raised tonight, particularly the scale of allowances and how the allowances compare with before the war. The welfare service was established because my immediate predecessor and I thought that the contacts between the Department and the pensioner were too remote and too cold. For quite good administrative reasons, between the wars the Department had become very centralised and there was a danger in consequence that it might lose touch with the individual. We found from our own correspondence that far too many of the war disabled simply do not know of the ways in which we can help them—by treatment or by supplements to their pensions, by grants towards the education of their children, and by helping them, with the aid of the Ministry of Labour, to find suitable employment and to undergo rehabilitation.
Successive Ministers of Pensions have been very grateful to the voluntary members of the war pensions committees. These committees consist of men and women in all parts of the country who have willingly given their time to help the war disabled and their dependents. The value of their work has been praised many times and has from time to time received public recognition by awards of honours by His Majesty. The work is still going on, and I want to make it quite clear that I fully appreciate the value of that work, that there is still room for it, that it is still going on and that it is still valued. Perhaps I might also say in passing that I agree with my hon. Friend the Member for South Bradford (Mr. Titterington) in his remarks about the value of the voluntary organisations. There is still room for these organisations also. I assure the hon. Member for Preston (Mr. Shackle-ton) that my welfare officers are constantly in touch with the voluntary organisations. It is definitely part of their job to keep in touch with the voluntary organisations.
As far as the British Limbless Ex-Servicemen's Association is concerned, the noble Lord the Member for Rutland and Stamford (Lord Willoughby de Eresby), who is an active member of that organisation, knows that I have already dealt with some of the suggestions which have been put forward by it and that the 30s. constant attendance allowance, which the association suggested, has now been accepted and is already in payment, and that the point it raised about the clothing allowance for men who do not wear an artificial arm has also been dealt with to their satisfaction. We are in touch with these organisations all the time both centrally and in the districts.
I want to make it quite clear that the initiation of a welfare service is not a derogation from the work of volunteers but it was necessary to appoint a full-time officer who is himself a member of the staff of the Department because he can help in a variety of ways which are not open to the volunteer. He is also of particular value when it comes to helping the pensioner in his relation with other Government departments. A man who is himself an official of one department knows the ropes of the organisation as it were, and can lift the telephone and get into contact with the right man in another Department who can deal with the case when it falls outside the responsibilities of the Ministry of Pensions. I was asked what sort of people have been appointed to these posts. They are men who have volunteered from within the department because of their special interest in this type of work. They have been very carefully selected from a large number of volunteers. They have received training, and what I go on to say will, I hope, prove that they are doing splendid work.
There is a welfare officer at every one of our hospitals. Their job is to help the patient with any personal problems which may arise while he is there but especially, of course, to help him before he leaves the hospital in that very difficult period, which any of us who have ever suffered severe illnesses know about, when we feel uneasy and unsure in getting back into the normal world. The interviews which our welfare officer gives at the hospital are entirely voluntary, but the patients are very ready to make use of the service. For example, I found that in the four weeks between 24th September and 23rd October, 1,936 pensioners in hospitals sought interviews and had a total of 2,632 interviews. In about one-third of the cases arising in the hospitals, the welfare officer can help by dealing with matters which are entirely within the control of the Ministry. The biggest bulk of these involves treatment, and the welfare officer sees to it that the pensioner requiring treatment who leaves the hospital and goes back to his house is provided with that treatment and that appropriate arrangements are made.
Large numbers of other questions arise concerning allowances, clothing grants and so on. If they are outside our own responsibility, the welfare officers, even at the hospital stage, make contacts with the appropriate authority, whether it is the Ministry of National Insurance, the National Assistance Board, the Ministry of Food, the Board of Trade, local authorities or voluntary organisations. About four out of 10 of the interviews which are given, both in the hospitals and in the regions, are found to produce matters on which some action can be taken.
Could the hon. Gentleman explain to the House how a disabled man in a district realises that the officer is available? I took the opportunity of trying to explain what we know of the system to the disabled men in my constituency and then found that it was difficult for them to get into touch. Is the coming of the officer advertised in any way so that people know about it?
Having dealt with hospitals, I was going on to deal with the officers in the districts, and I will do so in a moment. For a long time we have had the welfare service in the hospitals, but six months ago it was extended to all pensioners, the vast majority of whom are not in hospital but living at home and mostly working. When I last spoke to the House on the matter there were 25 welfare officers, but there are now 50 altogether at our local offices in all parts of the country. The hon. Member for North Edinburgh (Mr. Willis) will be interested to know that there are six in Scotland. At most of the local offices there are two, at some there is only one, and to date they have interviewed approximately 54,000 pensioners living at home.
So far—with an exception which I will mention later—the interviews have arisen when pensioners have come to the office in the normal course. As the House knows, men are surveyed medically once every two years, and they have to visit the office for that purpose. We began the service by interviewing men when they came in that way, or when they came in on some other business such as the payment of allowance. Gradually we shall extend the service so that we can go out to men who do not have to come into the office. I should say, in passing, that men who come into the office, having been called in for a purpose, receive payment of their expenses. In time we shall develop the business of visiting towns in which we have no offices, and we shall be able to do that with the co-operation of the Ministry of Labour and National Service, who have kindly promised to place a room in their offices at our disposal for this purpose when we are able to extend the service.
Can my hon. Friend say whether these welfare officers can act in the capacity of pensioner's friend, and visit in their own homes pensioners who cannot go to a local office and who feel rather shut off and in need of a visit from a welfare officer?
And would not my hon. Friend consider that the Ministry of National Insurance offices now opened all over the country would perhaps be more appropriate places, or provide extra places?
That may be so. Visits are made by welfare officers to patients in their homes at the present time, but in view of the number of welfare officers and pensioners, visits of that kind, unless specially called for, are not frequent. I have already mentioned the work done by the war pensions committees, and one of the most effective aspects of that work is by way of visits made by members of the war pensions committees to bedridden pensioners and others who cannot leave their homes.
The aim of all these interviews is that we can afford the pensioner an opportunity of a chat with a wise, well-in-formed and entirely discreet friend who knows all the ropes of our modern, complicated society and can help the pensioner to find his way about among the numerous agencies and regulations and requirements that exist. I want to stress that the interviews are entirely voluntary. Nobody is obliged to see the welfare officer if he does not want to do so. I think the service is appreciated because I have received a large number of letters from pensioners about it. I had it in mind to quote some of those, but I do not want to take up too much time. However, it happened that this morning I received one which I am permitted to read. It said:
Recently I received a letter from you inviting me to have an interview with your Mr. —, Welfare Officer, with whom I had a very pleasant and helpful chat.
Sir. I beg to take this opportunity to express my very grateful thanks for everything that has been done on my behalf by you and members of your staff who I have had the pleasure to meet during my visit to your offices.
Everybody has been most kind and helpful and to me it is very comforting to know that as a disabled ex-Service man I am able to receive such kind attention and helpful advice at any time I may need such advice.
That letter is typical of a great many we receive.
As I said, about four out of 10 of the interviews discover matters in which help can be given. Whereas in the hospital interviews a third of the matters raised are within the province of my Department, two-thirds affect other Departments, local authorities and voluntary organisations. In the interviews in the districts, the reverse is the case; about two-thirds concern my own Department and one-third the others, proving what I have referred to already, as have other hon. Members, the fact that all we are able to do for pensioners in the way of treatment and allowances is not known. One great value of this service is that it is making those things known, and known rapidly.
The information given by the individual about himself is treated in the strictest confidence. If it is divulged, it is only with his consent so that help can be given to him. I must emphasise strongly, in view of what the hon. Member for Cambridge said, that the information gathered at the interview with the welfare officer is not used in any way whatever in assessing his rate of pension. It is, of course, used for the purpose of examining his elegibility for special allowances, like unemployability supplement or the special hardship allowance to make up for lessened earning capacity The assessment of pensioners is made always entirely on medical grounds.
The welfare officers, then, are able to help in this way. I will read some examples from the periodical reports I get:
Welfare officer made successful representations to Scottish Local Authority on behalf of pensioner who had received notice of eviction from house.
Pensioner had been given no priority on housing list, but on representations by Welfare Officer the Local Housing Authority granted four points out of a maximum of five.
A 1914 World War pensioner was advised on medical grounds by an examining doctor that he should change his occupation which pensioner was reluctant to do owing to his age. Welfare Officer and Disablement Resettlement Officer made persistent efforts for three months which resulted in a very satisfactory post for the man who visited the Regional Office specially to voice his gratitude.
I had better not quote all the examples I could produce of the intimate, personal, kindly acts which the welfare officers have been able to perform for pensioners.
I was glad that the hon. Member for Cambridge and the hon. Member for Stockton-on-Tees mentioned treatment and rehabilitation, because many of the problems presented by pensioners in their interviews involve rehabilitation. In order to improve our work in this field, I have just appointed a specialist medical rehabilitation officer.
That is a new appointment altogether. Such a post has not previously existed in the Department. I have been fortunate in securing the services of a young man fresh from valuable rehabilitation work with the Army. He will act as a link between the work of our hospitals and that of our regional offices. He will review all the occupational therapy work done in the hospitals; he will discuss with and advise welfare officers in the hospitals and in the regional offices on the most suitable forms of occupational therapy and employment; he will, of course, pay particular attention to cases of special difficulty such as men suffering from nervous trouble '
The dividing line between our responsibility and that of the Ministry of Labour occurs just at that point. Although we are responsible for a certain amount of preliminary rehabilitation, after that work is done the man passes to the care of the Ministry of Labour, who have their disablement resettlement officers and who send the pensioners to Government training centres or submit them to employment after finding jobs which are suitable for them
May I ask the Minister who has the final say about this? The hospital staff have the man under their care and attention and curative treatment for some time, then this special rehabilitation expert comes along and makes recommendations. It is rather important to know who makes the final recommendation. The medical people might have strong views about whether a recommendation from a rehabilitation officer was right or wrong. If he is entitled to override them there might be some difficulty.
I am not quite clear what the hon. Member means by "recommendation." If he means a recommendation of a job for the pensioner, that would be the responsibility of the Ministry of Labour D.R.O. If he means a recommendation, not for a particular job but of the general type and kind of work, then, obviously, the advice of my specialist officer would, I assume and hope, be the determining factor. He would give that advice to the D.R.O., to whom he would say, "In this particular man's circumstances I think you should look for such and such a type of work for him." The D.R.O. will be guided by the general and medical advice in finding a particular job. Of course, as the hon. Member for Weston-super-Mare (Mr. Orr-Ewing) knows very well, especially in the sort of district he represents, the matching of the two is not always easy; but we do our best and this work will develop.
After the welfare service had been operating for about three months I decided to make a special effort to get into touch through it with the ageing pensioners of the 1914–18 war.
I am sorry to interrupt the Minister. He has given us a glowing description of the work which the welfare officers are doing. They are undoubtedly doing an exceptional job, but there seems a danger that they may now become overloaded. It would be useful, for the sake of his own welfare officers, if the hon. Gentleman could give us some dividing line as to where their responsibility ends. If, for instance, a local branch of the British Legion or a Member of Parliament has a difficult case for investigation, should contact be made with the welfare officer, with the ordinary regional office, as before, or with the Department. There are many cases where welfare officers may deal with cases better than does the Department, but we do not want to overwork them.
I quite agree. I am very sensible of the danger that they may become overworked. We must see that they are provided with the necessary clerical and other assistance as the volume of their work and their records grows. I do not know that it is possible to give a definite dividing line—to lay down a set of rules, as it were—about what matters should be referred to them. In general, I should prefer that if hon. Members wish to refer constituents to my offices—I certainly would be very glad if they would, for, obviously, there are large numbers of cases where the whole matter could be settled successfully locally and where reference to myself would not really be necessary; I should prefer hon. Members to advise constituents to go to the local office without saying particularly whom they should see. Then, according to the nature of the case, it could be channelled safely and satisfactorily to the right person in the local office.
I was going on to say that once this service had been well established and had got into its stride, I thought it was a good thing to use it as a means of getting in touch with ageing pensioners. I and everyone in the Department was sensible of the fact that in this direction lay some of the most difficult problems. Therefore, even before sending out the letter which is now being dispatched to all pensioners, I had special letters sent out in each district to a selected number of 1914–18 war pensioners inviting them to come for interview.
The awards of pension to men who served and incurred their disability in that war were made final long ago. Their right of appeal against an assessment was long ago exhausted. Yet, in some instances, advancing age brings a worsening of the disability. Fortunately, despite the statutory finality of the award and the absence now of any right of appeal, I have power to re-assess their disability under special sanction, where it can be shown that it has materially worsened. Between 1945 and today, under these powers, the disabilities of 2,400 pensioners of the 1914–18 war have been re-assessed and increased. A much larger number than that, of course, has been looked at. At first sight that number may appear comparatively small, but when I tell the House that over 1,000 of these re-assessments and increases have been made since I took office last July, it will be appreciated that the rate of reviewing these cases is obviously increasing.
No. We have not kept a special record of the numbers of 1914–18 cases which have been looked at again during the years. We have, of course, the records of those where re-assessment has resulted in increase of pension. I want to make it quite clear that re-assessment can be made only where a medical board is satisfied that a disability has materially worsened. As I have said, the numbers are not great, but the rate of increase is fairly considerable. I do not want to overstate the position, but it is clear that it is in line with our general policy of increasing payments where need is proved rather than of making some wide general increase which would include large numbers where need does not exist. I was grateful for the suggestion made tonight that the Assistance Board might draw the attention of my welfare officers to instances of disabled men who have had to resort to them. It does not lie within my power to say that that will be put into operation, but I will draw it to the attention of the Minister of National Insurance, who I am sure will be interested in it and at once consider its practicability.
The interviews are voluntary and I am sending out a letter to all pensioners informing them of the supplements which are available and inviting them to see the welfare officer if they wish to do so. What will probably happen is that in consequence those most in need will come forward and ask for help and those who are happily situated will not feel it necessary to seek help. Therefore, any general conclusion we draw from the interviews will not provide a fair picture of all the pensioners. Any general conclusions we draw will be biased, in the strictly statistical sense of the word, in favour of pessimism. It cannot be a fair example, but a biased sample, biased in favour of pessimism. We have not yet covered a sufficiently large proportion of the total number of pensioners to be able to draw firm conclusions, but I can safely say that within a couple of months we shall know far more generally about the disabled than has ever been known before. Although the circumstances of the individual will not be disclosed, it will be possible to draw general conclusions about categories before very long.
I was asked if I would extend this welfare service to men who incurred disability between the wars and are a special responsibility of the Service Ministers. I ask hon. Members to bear in mind what I said earlier today and on the Second Reading of the Pensions Appeals Tribunals Bill, namely, that in these cases we cannot take responsibility for appeals against decisions on pension claims. Apart from that, if we can help we will do so. Again this is not a matter within my responsibility and I must refer the suggestion to my right hon. Friends responsible for the Service Departments. I will do that with a sympathetic indication of my willingness to help if I can—
I would rather say that I will consult my right hon. Friends. There may be some unsuspected snag of which I am not aware at the moment and I do not want to make any promise I cannot fulfil. I will draw the attention of my right hon. Friends to that suggestion to see whether it can be put into operation. I think I have said enough to explain to the House in greater detail than has been explained already exactly how the welfare service operates. When I said some time ago that the Government were proud of their record in the field of pensions I was accused by one newspaper of complacency. I am not complacent, although I am glad to proclaim the numerous improvements which the present Government have made in the system. I do not deny that there is room for further improvement and, with my welfare officers, I am seeking all possibilities of further improvement that lie within my power and I thank the House for giving me their courteous attention tonight.
I wish to draw attention to a gap which I think still exists. The hon. Gentleman has rightly paid great tribute to the voluntary organisations affected by these problems, which are very real, but I feel there was a gap in what he said as to the use which can be made of the voluntary organisations by the welfare officers and of the welfare officers by the voluntary organisations.
There must be an interchange of information and help. We know that most of the voluntary organisations keep themselves as fully aware of terms, conditions, problems and regulations as they can, but we also know that, with the extraordinary complications of modern life, it is very difficult for those acting for the voluntary organisations to keep informed of all the problems on which they are asked to give advice. It would be very helpful if, apart from any circular letters sent to individuals or welfare officers, a more direct approach were made by the Minister to the voluntary organisations urging them by district, area, or county, or any other means he cares to suggest, to organise meetings as soon as possible so that not only can individuals make themselves known to each other, but also that there should be a complete interchange of information.
I know that is what the Minister wants, but I am a little doubtful whether, with all his good intentions, he is going about it strongly enough. I have a feeling that unless we are careful, we shall overwork these welfare officers especially in the next few months. While the system is being built up, these officers might make valuable use of the intimate knowledge possessed by the welfare organisations and I should like to know how it is proposed that that should be achieved. It is certain that the Minister and I are aiming at the same thing, but I want him to take stronger steps to achieve that aim than those he has suggested.
There is a grave danger that where we have big voluntary organisations which have to absorb a great deal of official information, when that information is passed on to the individual it will be in a too final form. If welfare officers are overworked that is one of the grave dangers we shall face. However well-intentioned an individual may be, if he is pressed for time, he looks on a case merely as a case, instead of a problem for a human being. Once that occurs, the whole prestige and value of the service—which is a very fine one—will be undermined. I ask the Minister to take active steps to prevent any damage being done to this new service while it is growing and, in order to achieve that end, to see to it that there is the closest possible liaison and interchange of information between welfare officers and organisations.