I thought that we might have had some observations from the Joint Parliamentary Secretary on this very important Scheme. Perhaps the hon. Lady is waiting until speeches have been made from this side of the House.
The Scheme provides three main changes, on which we, on this side, have not any criticism to make. The first is an increase in the dependant's allowance for those who are participants under the pneumoconiosis and byssinosis schemes. The second change is the modification in the period of time for those who are working in a prescribed industry and who are certified as suffering from byssinosis. The third change is the reference to the medical authorities. These changes are very welcome to us.
We had criticisms to make on the National Insurance (No. 2) Bill this year this Scheme arises out of that legislation. The changes proposed are necessary and desirable, and improve the Scheme. It was laid down in the Act of 1951 that the pneumoconiotic and the person suffering from byssinosis shall receive a weekly payment of 40s. Am I right in believing that the wife will receive 30s. per week as a dependant's allowance, that the only or eldest child will receive 15s. and every other child after the first 7s.? If that is so, the benefit will be equivalent to those paid under the Industrial Injuries Act. Perhaps the hon. Lady would confirm that point.
From what was said during the Second Reading and Committee stage of the National Insurance (No. 2) Bill, I regret that a step has not been taken to increase the 40s. benefit for the participant himself. There is a very wide gap between the participants in the pneumoconiosis and byssinosis schemes and those who are receiving benefits under the Industrial Injuries Act. Perhaps the hon. Lady will tell us whether consideration is to be given to that point.
The improvement concerning the time factor for those in a prescribed industry suffering from byssinosis is a very welcome change. The reduction from twenty years to ten is a step forward and brings the Scheme into line with what is laid down for those receiving benefit under the Industrial Injuries Act for this disability. The Industrial Injuries Advisory Committee gave a lot of time and thought to this matter and, in view of the change in medical opinion on this chest condition, that Committee recommended this very substantial reduction. I note that there is no possibility of any retrospection in this connection and that the ten years will apply only to cases of death from the passing of the National Insurance (No. 2) Act, on 28th November, and, in cases of disablement, from the operation of this Scheme.
I ask the Parliamentary Secretary what that means. Two conditions had to be fulfilled: one, that of suffering from byssinosis, and, two, having worked in a prescribed industry for not less than twenty years. Can those who have been refused on a certificate, not on the grounds that they are not suffering from byssinosis, but because their period of employment in the prescribed industry was less than twenty years, apply again? If they worked for less than twenty but not less than ten years in that industry, would they become participants in the benefit laid down in the 1951 Act? I should like the hon. Lady to enlighten us on that very important question.
In my view it is a very good thing that the pre-1954 position is to be restored in the reference to medical authority. In the trade unions and among hon. Members on this side of the House there was some fear that when these cases were examined medical boards were likely to be cluttered up and to be unable to cope with the situation. By general consent a decision was arrived at that, instead of two medical men, one medical authority should be sufficient to say whether the person was disabled as a result of pneumoconiosis or byssinosis.
The Parliamentary Secretary will agree that the position since 1954 has been established as an emergency measure. I expressed my own pleasure and, I know, that of my right hon. and hon. Friends when I say that we are very happy to know that the position is to be restored to that before 1954 and that two medical authorities will now be responsible for these suspected cases of both pneumoconiosis and byssinosis. That would restore the position to that under the Industrial Injuries Act. The medical boards under that Act must consist of at least two medical authorities.
With those few observations, I welcome, on behalf of the Opposition, the three changes envisaged in this Scheme. We think that they are necessary and that they will be in the wider interest of the unfortunate people who suffer from these two dread diseases; pneumoconiosis and byssinosis.
I should like to add a few words to those of my hon. Friend the Member for Mansfield (Mr. B. Taylor), who welcomed the Scheme. The diseases with which it is concerned are terrible and afflict very many people. I am interested particularly in pneumoconiosis as it affects foundry workers, and I believe that they will benefit considerably from the Scheme.
I have one question to ask, because it has been disturbing foundry workers. They are concerned about the people who contracted the disease before 1948. I think that these people are covered by the Scheme, but I should like an assurance from the Parliamentary Secretary that that is so. It is causing great distress at the moment among workers who wish to be certain that those who contracted the disease before 1948 will be adequately covered.
In particular, I welcome the Schedule, which deals with radiological reports, and I should like to ask the hon. Lady whether those reports are to be made as a result of X-rays with large instruments instead of with only small miniature instruments. The hon. Lady may reply. "Of course," but it is not a matter of course, because the initial radiological surveys are made with small instruments which many foundry workers, and, I think, many miners, contend are not adequate. I hope that they, as well as the final surveys which are mentioned, will in future be made with instruments which are sufficiently large to give an adequate survey instead of with a very small miniature X-ray instrument which many people consider does not give an adequate result.
The most important thing of all is to make certain that with the Scheme goes the spirit not only of the need to compensate, but the need to prevent this disease. I know that much has been done to prevent the disease, but much more can be done. I hope that when she is considering this Scheme and the question of pneumoconiosis generally, the hon. Lady will look upon it as a disease which must be attacked by a great campaign and that she will set a D-day after which no foundry may have the kind of instruments in it or the lack of organisation in it which permits the dust which produces this terrible disease.
If that can be done it will not be necessary to pay out so much in compensation. Important though it is, this Scheme deals with the payment of compensation, but we want to be certain that people will not contract the disease; if they do not contract it, it will not be necessary to pay compensation. That is our aim, and I hope that it can be achieved either by this Government or by the next, for on this, I think, we are both united.
This Scheme is necessary and I am sure that the House will pass it, but I do not want the Joint Parliamentary Secretary to imagine that because we are accepting paragraph 5 (4), which says that
In paragraph (8) of the said Article, after the words 'shall be' there shall be inserted
the words 'signed by not less than two members of the Medical Board on behalf of the said Board and…'
we are fully satisfied with the position. We are not.
Unfortunately, there is, particularly in our coalfields, a lack of uniformity in dealing with cases of men suspected of dying from pneumoconiosis. In many parts of the coalfield, pathologists are called in who the medical board can consult. Those men attend examinations, and report to the medical board, which, therefore, has the advantage of their reports before coming to its conclusions. That is not the case in other parts of the country, where reliance is placed only on the local medical attendant. There is no uniformity.
Although the Joint Parliamentary Secretary may argue that this is not, perhaps, the responsibility of the Ministry of Pensions and National Insurance, I can only hope that as a result of what I say this evening, steps may be taken to ensure that coroners—or whoever is dealing with the case—will be advised that in all cases a pathologist will be called in to consult with the local medical board. In the coalfields alone, we have hundreds of men dying each year from pneumoconiosis, and the medical board has a big task in continually dealing with them only on a post-mortem examination basis.
The great problem arises when a man dies who has been certified for many years as totally disabled by pneumoconiosis. I can think of men who have been totally disabled by this disease for as many as ten or fifteen years. Then death occurs, and the medical board declares that death is not in any way related to the pneumoconiosis. One can imagine the anxiety felt by the widow and by her friends.
It is in such cases that the value of the pathologist to the medical board is apparent. The pathologist has an advantage, because in many of these cases men die from certain forms of heart disease which may not be directly related to pneumoconiosis. I would be the last to say, of course, that because a man has, say, a 40 per cent. disability, he is bound to die from this complaint. One cannot accept that, but there are many cases where a man has died from a certain form of heart disease which medical men say has been aggravated or accelerated by the continued suffering from pneumoconiosis.
That is the problem I want to put to the Parliamentary Secretary—acceleration or aggravation. Under the old Workmen's Compensation Acts, even in cases of accident, medical men have argued in the county court, or in the Court of Appeal, that, because of the condition of his heart, the man could have died when walking upstairs, but because he was found underground, lying by a tub which he had had to fill, the medical men have said that that one act, in itself, accelerated or aggravated a pre-existing heart condition.
The same problem arises with pneumoconiosis. A man may have died from a heart disease, but we want to know to what extent pneumoconisis accelerated that condition, particularly where men have been 100 per cent. disabled by it for years and have then suddenly died from a heart complaint. A pathologist may be called in. The advantage is when the pathologist and the medical board agree. In many of these cases there is agreement between the pathologist and the medical board. That gives greater satisfaction to the widow and all associated with the case.
Where the pathologist disagrees with the medical board, different circumstances arise. I hope that the Parliamentary Secretary will note this, because I feel that we should have regulations in the near future to deal with cases where the pathologist, with all his knowledge and experience in these heart cases, disagrees with the final findings of the medical board. In those cases there should be a right of appeal.
If that course were adopted it would give greater satisfaction to all people who have the unfortunate task of dealing with so many cases of men whose death is suspected of being caused by pneumoconiosis.
The hon. Member for Mansfield (Mr. B. Taylor) welcomed these changes, as have succeeding speakers, and we are agreed that this is a modest measure of improvement for, in the main, people suffering from byssinosis. This Scheme refers generally to the extension of benefit to those suffering from byssinosis, where the period in the prescribed occupation is reduced from twenty to ten years. There are small additions which the hon. Gentleman stated. He asked me a series of questions. First, would dependants' allowance for wife and children be the same as in Industrial Injuries cases? The answer is, "Yes". The dependants' allowance for the wife will be 30s. and for the first child 15s., and so on.
The hon. Member asked me also whether I would comment on the rates of benefit for the old cases and suggested that I might be able to enlighten the House. I think he was rather taking advantage of the situation, because he knows as well as I do that we are discussing regulations concerned only with the conditions for benefit and not rates of benefit, which would be dealt with under the main Act. Therefore, I think that his point is out of order, although he has successfully put it on record.
The hon. Member welcomed the proposed change which has been made possible because we have gathered further medical opinion on byssinosis. He asked me a question about the operative dates, although I think he had understood the regulations very effectively and had arrived at the answer himself. The payments for the disablement allowance will be made from the date of the beginning of the amendment Scheme which we hope will be before the end of the year. When this Scheme has been passed by both Houses, we hope to be able to operate it before the end of the year; and the death benefit will be paid for any death occurring after the 28th November of this year, when the National Insurance (No. 2) Act, 1957, came into operation.
The hon. Member asked me another specific question about the men who had been unable to qualify for benefit because they had not been twenty years in the prescribed occupation. He asked me whether they would now be able to claim. The short answer is, "Yes", but I think that the hon. Gentleman would wish me to add that we have records of those who have failed in their claim because they had not been twenty years in the prescribed occupation. It is our intention to get in touch with them so that they will be picked up and, we hope, will qualify for benefit.
The hon. Member's comments on the restoration of the position of two doctors to be on the examining board are entirely favourable. I do not think that he would wish me to add anything to that except to say that we in the Ministry are now happy to be able to go back to the pre-1954 position, having overcome the volume of work which came in when the scheme of benefit for the partially disabled was introduced.
The right hon. Member for West Bromwich (Mr. Dugdale) asked whether those who had contracted the disease before 1948—he had in mind foundry workers, in particular—would be covered. The answer is that they will be covered if they satisfy the conditions. The right hon. Member then asked whether X-rays in connection with this work are taken on the small miniature films, because he would prefer them always to be taken on the large films. I am happy to reassure the right hon. Gentleman. All the work in connection with the Ministry is done with the large films. The right hon. Member is perhaps a little confused with the miniature radiography which is the province of the Ministry of Health and is used generally in connection with the ascertainment of tuberculosis.
The right hon. Member expressed the feeling that it was urgently necessary for all of us to embark on a campaign against pneumoconiosis and he hoped that the day would not be far distant when a foundry would not be allowed to operate machinery which created dust which gave rise to pneumoconiosis. That is a hope which I share, but it is not a matter for the Ministry. I would say that it is almost essentially an engineering problem and that in this House my right hon. Friend the Minister of Labour would be the most directly concerned with it. If it were possible to find such a solution, all of us who are concerned about this dreadful disease would be very happy to see it.
Although it concerns a number of Ministries, obviously the Government could give great encouragement and, if necessary, financial encouragement to those firms which are willing to introduce such machinery. Will the hon. Lady see whether it is possible to discuss with her colleagues the possibilities at least of providing such financial assistance?
I appreciate the point, but I must make it clear that it is not a matter for my Ministry.
The hon. Member for Bedwellty (Mr. Finch) advanced an argument which he and I have discussed privately before. He feels strongly that there should be the report of a pathologist in ail cases of death and that, where the pathologist disagrees with the medical board, there should be what, in effect, would be a further court of appeal. That, again, would be rather out of order in this debate, because it is a matter for the machinery of the main Industrial Injuries Act and certainly much more affects that Act than this diminishing number of cases which we are dealing with and which arose from pre-1948 days. The hon. Member has, however, made his point. I, in turn, will undertake to convey it to my right hon. Friend.
I hope that as these small recommendations of the Scheme are all beneficial, we may now agree to pass them.