House of Commons Hansard Debates for 3 Mar 1994

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There are about 30 miles along the Severn valley where a bypass could easily be constructed--I am sure that the hon. and learned Member for Montgomery (Mr. Carlile) will agree with me--at a reasonable cost, given the nature of the Severn valley. That would give us a connection between the powerhouse of north-east Wales and the powerhouse of industrial south Wales. We see enormous lorries carrying forestry, for example, to the shop and paper mill from mid-Wales and the Brecon Beacons area in south Wales.

Mr. Alex Carlile : I am interested in what the hon. Gentleman is saying. Does he agree that we need a policy which consists of putting freight back on the railways, and not running a dual carriageway through central Wales but having a road of the sort of standard which we have on the Welshpool and Llanidloes bypasses?

Mr. Morgan : I entirely agree. I defer to the views of local Members. Certainly, the last thing I want is despoliation of the countryside by roads ripping through. A bypass would make it possible to travel, say, the 60 miles from immediately south of Newtown to Wrexham in one hour without difficulty and the sort of hold-ups that one gets at present when one is between Newtown and the southern edge of the Oswestry bypass. A bit of continuity would enormously improve communications there.

There was a big gap where the Secretary of State should have talked about north-south communications. Surely, even on the railways and roads, and the connections to England, I thought that he might have mentioned the one thing on which he as the constituency Member for Wokingham and the Members of Parliament elected by the people of Wales might agree, which is the need to do something about connections to Heathrow from the west.

The Secretary of State mentioned the importance of Heathrow. Why will we have to go all the way to Paddington and then back out again when what we need, as do the Secretary of State and his constituents--6 million or 7 million people live west of London, as well as the people in industrial south Wales, Bristol and so on--is the same access through the Heathrow express link without having to go all the way to Paddington and back out again?

The Secretary of State should be pressing that matter, because it is something on which he and the people of Wales can agree. He should take advantage of and push for it, along with Members of Parliament from the western edge of the home counties. Obviously, that is the origin of his political status which enables him to have the platform to become the Secretary of State for Wales, for however brief a period that may be.

We have also mentioned the issue of morality and housing, on which the Secretary of State made his name. The chairman of the Select Committee on Welsh Affairs referred to that issue as well. I do not want to intrude further on the Secretary of State's difficulty in trying to recover his reputation for talking about single mothers in an unprepared and off-the- cuff manner, so I shall turn to a subject on which he has also done a bit of talking off the cuff--the health service and bureaucracy.

Today, the Secretary of State said that he will merge the national health service in Wales with the health policy division, thereby saving one top civil servant's job. That is his way of giving practical effect to his attack on

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bureaucracy in the national health service which has caused such trouble between him and the Secretary of State for Health. We have been told that the Secretary of State for Health knee- capped him on the issue. After all, it is not every Minister who can combine the good looks of Nancy Kerrigan with the brains of Tonya Harding. The Secretary of State for Wales has had to learn that the hard way. I think the right hon. Gentleman will agree that we want not a lot of pretence and populist drivel about needing to drive down the number of bureaucrats, but acceptance that, in an internal market-based national health service, there will undoubtedly be a large army of accountants to shuffle bits of paper from one health authority to another. That is what we are seeing in the health service at present.

It is no use the Secretary of State pretending that one can introduce an internal market--which undoubtedly he supported in the Lobby, although he was not in the Cabinet at the time--but not like the consequences of it in terms of the number of bureaucrats. He must realise that, in an accountancy -driven health service, not a needs-driven health service, we will get the sort of crisis at the end of the financial year that we are experiencing at the moment. In the Cardiff area, we are aware that Llandough hospital is not taking any more non-urgent patients from South Glamorgan health authority because the contract money has run out. I believe that there are problems in the Ceredigion health trust, which is not taking any non-urgent patients. I think that there are similar problems in Pembroke involving contracts.

Mr. Ainger : There have been redundancies.

Mr. Morgan : Those problems have knock-on effects on employment. There is the problem of boom and bust in the Prince of Wales orthopaedic hospital. Mid Glamorgan health authority has paid for so many orthopaedic operations, including knee and hip joint replacements, that the Prince of Wales hospital cannot do them in time. I have talked to members of staff of the health authority and Mid Glamorgan will ask for its money back on 1 April if the hospital cannot complete 47 outstanding hip and knee joint operations. The health authority has come up with a wizard scheme. As well as working late at night after doing a full day's work, the staff come in at the weekend. Eight hip operations are carried out on each day of the weekend for two successive weekends, as that is the only way of completing the Mid Glamorgan contract. Otherwise, the health authority must pay the money back to South Glamorgan.

The doctors are being offered £250 a day to come in on Saturday and Sunday, while nurses get double time. However, the doctors cannot get anaesthetic cover without breaching the Royal College of Anaesthetists' professional rules. As a result, the scheme seems to be falling apart and the money may be repaid from South Glamorgan to Mid Glamorgan on 1 April because it was unable to complete the contract. What a way to run the health service.

Mr. Redwood : Does the hon. Gentleman agree that the patients charter is pioneering work to raise the standards of quality in a way which the Opposition never envisaged when they ran the health service? Will he welcome the fact that we are close to delivering those targets for the first time and does he agree that the Opposition got nowhere near that kind of performance?

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Mr. Morgan : I reject that completely. The patients charter has produced an army of clerks who tick little boxes to say whether a patient has been treated one or two years after he got an appointment with a consultant. There is a delay in getting an outpatient appointment with a consultant until the consultant is confident that he can see the patient within the maximum time specified in the patients charter.

The Minister asked me for examples of that, and I have given them. Out- patient appointments are now impossible to get. Constituents have come to my surgeries and said that their GPs tried to get them a first outpatient appointment with a consultant. The consultant's secretary has rung the GP and said that the appointment cannot be made and the patient cannot get on the waiting list, because the consultant is still seeing his cases from 1992. The patient is not on the waiting list--he is on a waiting list to go on the waiting list. That is the problem.

Mr. Gwilym Jones : The hon. Gentleman asked me to investigate those cases. I have done so, and his constituents are on the waiting list, as are all the others who are in the same situation.

Mr. Morgan : The Minister will confirm that he did not tell me that. I supplied him with the information for which he asked, but obviously he has not supplied me with the information that I asked for. That is not an entirely good thing.

Mr. Richards : On a point or order, Mr. Deputy Speaker. The debate is about Welsh affairs. The hon. Member for Caerphilly (Mr. Davies) spoke solely about south Wales and the hon. Member for Cardiff, West is speaking solely about his constituency. Is that in order?

Mr. Deputy Speaker (Mr. Michael Morris) : The hon. Gentleman should be aware that the debate is on the Adjournment. The hon. Member for Cardiff, West is entirely in order.

Mr. Morgan : Conservative Members were complaining five minutes ago that I was talking about the constituency of the hon. and learned Member for Montgomery. I do not know where that remark comes from. The House has learnt the hard way with the hon. Member for Clwyd, North-West (Mr. Richards). I am a fairly plain man myself and I believe in calling a shovel a shovel. However, it is what is sticking to the shovel that worries me about the hon. Gentleman.

The hon. Member for Vale of Glamorgan (Mr. Sweeney) spoke about police and crime. It was a useful contribution, because he was a calming influence after the previous speech from the Government Benches. The hon. Gentleman was more PC Plod than Flying Squad, despite his name, but he gave a proper illustration of the way in which the shoe is pinching on the police and crime front. The hon. Gentleman said that he had been to see the Home Office Minister, Earl Ferrers, about the matter. We have taken a deputation to see Earl Ferrers because of the problems with the South Wales police authority, for which the situation appears to be "capped if you do, damned if you don't." The problem is that it has been told by the Home Office to spend 5.5 per cent. but by the Welsh Office to spend only 1.75 per cent. That is a classic example of

interdepartmental cross-sterilisation.

The hon. Member for Vale of Glamorgan thinks that the main part of the blame should lie with the South Wales

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police authority. We do not agree with that, simply on the basis of the extremely instructive letter that the hon. Member for Cardiff, North (Mr. Jones) sent to my hon. Friend the Member for Cardiff, South and Penarth (Mr. Michael) dated 27 January as part of a parliamentary reply.

He made it clear that the 1.75 per cent. restriction applied even to police expenditure. There was no ring fencing and no way out of the restriction. The authority is bound hand, foot and finger. He will see that if he reads the reply that he gave in Hansard. That is the problem. We have to solve it somehow. I wonder whether, in his reply, the Minister might make some reference to the approaches that Lord Ferrers has made to Welsh Office Ministers to try to solve the problem.

The other major topic that has been covered extensively today is the constitutional issues relating to Wales. That is natural on a day like this. We have referred to the quangos, the forums and the assemblies. We have seen the Secretary of State's press release today about his letter to the two local authority associations in Wales. His press release contradicts the letter that he has sent as regards the position of Members of Parliament on any future forum or council of local authorities.

The press release says that Members of Parliament will be invited to attend. Therefore, they will not be part of the body. Clearly, one does not need to be invited to attend if one is part of the body. The letter to the local authority associations, which may have been doctored later, says that Members of Parliament and Members of the European Parliament probably could be part of the body. There is some confusion here, which we hope the Minister of State will clear up. The Secretary of State said that we were running down Wales by referring to criticisms of the quangos, and that the criticisms were partisan. He seems to forget--he ought to know--that the Public Accounts Committee has taken on most of the burden of criticising the quangos in Wales. It is the most non-partisan Committee. It has a Tory majority, although it has a Labour Chairman. Criticisms of quangos have come from both sides of the Committee. It would be wrong of us to seek to limit the powers of the PAC to make such criticisms.

Our problem is that the Secretary of State is the Secretary of State not for Wales but for quangoland in Wales. He is anti-Welsh, as most Opposition Members who have spoken tonight have mentioned. People in Wales look at him as a rising Tory placeman who missed his turn-off on the M4 one night. They do not have confidence in him, simply because he has not earned it. We shall find out on 19 March, because there will be a clash between his constituents, who will expect him to cheer for England, and people in Wales, who will expect him to cheer for Wales.

We have also said tonight that this debate should have been held on Tuesday. I tried to get some inspiration before I came to the Commons today by looking up at the gilt relief statue of St. David. I tried to get some inspiration to apologise to St. David that the debate was being held two days late. I heard an other-worldly, ethereal voice saying, "Hammer them, Rhodri." Everyone has told the Secretary of State that, if we had a vote tonight, the result would be 32 6 to this side. We hope that the result on 19 March will be the same. We know that St. David would be pleased about that.

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9.48 pm

The Minister of State, Welsh Office (Sir Wyn Roberts) : Today's debate, as most of us expected, has wandered over the fair face of Wales. I am not so sure that the debate has been such a good advertisement for a Welsh assembly, if we ever get one. Be that as it may, the first thing that I want to do is reassert the prime importance and high priority that the Government, my right hon. Friend the Secretary of State, my hon. Friend the Under-Secretary and I attach to the successful development and strengthening of the Welsh economy. That matters more than anything else because the living conditions and quality of life of Welsh people depend on it. Achieving a greater measure of prosperity requires a

single-mindedness and a unity of purpose on the part of all involved, which is never easy to achieve in Wales.

We are making progress out of the recession and business optimism is high. But no one is more aware than the Conservative party of how far we must go to raise GDP per head and average full-time earnings in Wales. We are driving hard on the inward investment front and our success in attracting manufacturing industry shows the way forward. We are also actively promoting exports, particularly by our small and medium-sized companies. Joint ventures between them and similar companies abroad are also being promoted because we know that full order books are one of the keys to safeguarding existing jobs and creating new ones.

The hon. Member for Caerphilly (Mr. Davies) pressed us to get alongside the "four motors", but we have been doing precisely that since 1987. One of the developments as a result of our connection with the four motors was to establish, through the Welsh Development Agency, Eurolink at Stuttgart. That has now developed links between some 50 European and Welsh companies. What is the Opposition's policy in that vital area? They always give me the impression that they think that inward investment and expansion by existing Welsh companies will continue automatically. I assure them that it will not unless the conditions are right--low interest rates, low inflation and low corporate taxes.

Mr. Ainger : Will the Minister give way?

Sir Wyn Roberts : Alas, I was given less than my ration of time by the hon. Member for Cardiff, West (Mr. Morgan).

We have also adhered firmly to our policy of improving infrastructure, with record high investment in roads--both Welsh Office trunk roads and county road schemes--and, as my right hon. Friend the Secretary of State said, there is more to come in the years ahead. I am delighted that most of his road proposals announced today were welcomed by Opposition Members, including the hon. Member for Merthyr Tydfil and Rhymney (Mr. Rowlands), who realises that the A465 can be a lifeline to Merthyr, as can the A470, which he and I had the pleasure of opening not so long ago.

That investment is crucial to the future development of all aspects of the Welsh economy, as is our investment in education and training. We have heard nothing of the Opposition's policies in those areas. It is all very well to criticise us, but they are repeating many of the points that we made in last week's debate and claiming them as their policies. From what I hear of their education policies, they would appear to take us backwards rather than forwards.

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They would undo much of what has been done in schools and elsewhere. Indeed, the Opposition's policies are very sleazy in the true sense of that word, which is "thin and flimsy".

Nothing could have been sleazier, in those terms, than the speech of the hon. Member for Caerphilly, which consisted largely of personal imprecations against my right hon. Friend and an attack on Plaid Cymru.

The hon. Member for Gower (Mr. Wardell), who, alas, is no longer here, reacted strongly to our review of the homelessness legislation and referred to our consultation document, "Access to Local Authority and Housing Association Tenancies". The hon. Member for Meirionnydd Nant Conwy (Mr. Llwyd) also referred to that. May I emphasise that we must always ensure that the operation of the homelessness legislation is fair to all those in need of social housing. It is in the interests of people in genuine need for us to ensure that no one uses wholly unjustified fast tracks to a council or housing association home provided with public funds.

The hon. and learned Member for Montgomery (Mr. Carlile) referred to agriculture and to hill livestock compensatory allowances in particular. As my right hon. Friend said, I am sure that he will be aware that the average level of net farm income for hill livestock farms rose by some 35 per cent. in real terms in 1991-92 and 1992-93 and is forecast to rise further in the current year.

Total direct subsidies to hill sheep farmers in Wales have increased by 38 per cent. over the past two years to an average of more than £26,000 per farm. During the same period, the average level of HLCAs paid to these farmers fell, but the reductions in HLCAs were more than offset by the overall increase in subsidies. Some 16,000 farmers are expected to benefit. There has also been a 16 per cent. rise in sheep annual premium rates in 1993 and farmers will benefit from the substantial increases in suckler cow premium for last year. Total payment of direct subsidies to hill farmers in Wales will be at least £160 million in 1994. That surely shows the Government's commitment to the farmers in the hills and uplands. Only recently, my right hon. Friend announced the addition of the Clwyd and Preseli environmentally sensitive areas.

There have been numerous references to education. We all know that more children are staying on at school or going on to further and higher education. I must tell the hon. Member for Blaenau Gwent (Mr. Smith) that that is why we are encouraging children to achieve vocational qualifications as well as or instead of strictly academic qualifications. We are encouraging them to take GNVQs instead of A-levels.

The staying-on rate at school has meant a tremendous increase in student numbers in the past 10 to 12 years. Since 1980, student enrolments in higher education in Wales outside the university have more than doubled, while at the university of Wales numbers rose by more than 50 per cent.

The higher education sector in Wales has grown by 53 per cent. since 1987- 88 and we are increasing the total funding available for students by some 4 per cent. next year. Those students are very important because they will make a significant contribution to the trained work force which is essential for Wales to remain competitive.

There has been a remarkable development in further education. We have given high priority to the launch of the new further education sector, which is the key to producing

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many more people with technical and other skills so that Wales can compete more effectively in the world economy.

This year's funding is intended to support an increase of nearly 10 per cent. in student numbers to an overall total of 46,000 full-time equivalents. So resources for next year will rise from £144 million to £160 million and further increases in funding have been provisionally earmarked for the following years.

As my right hon. Friend reminded us earlier, over the weekend the hon. Member for Caerphilly lectured Labour councillors on their arrogance. The Western Mail called it a stinging attack. Today he lectured us on our indifference. So, in the hon. Gentleman's view, friend and foe alike are guilty of the besetting sin of pride. If I were on the Opposition Benches, I should be worried as to when he would start lecturing me.

Opposition Members must be as puzzled as I am about what really lies behind the castigations of the hon. Member for Caerphilly. Is it all part of a softening-up process before we see Comrade Ron's little kingdom, his very own little Moscow, his dream socialist-style estate in Wales? Or is the real explanation that the hon. Gentleman is at fault in that he lacks a proper degree of humility? That is a fatal flaw in a leader and a sure prelude to riding for a fall. The Labour party may be riding high in the polls at the moment, but it is very uncertain about its policies and has nothing new to offer the people of Wales but stale and unprofitable policies, such as devolution. It being Ten o'clock, the motion for the Adjournment of the House lapsed, without Question put.

CHIROPRACTORS BILL [MONEY]

Queen's recommendation having been signified--

Resolved,

That, for the purposes of any Act of the present Session resulting from the Chiropractors Bill, it is expedient to authorise the payment out of money provided by Parliament of any expenditure incurred by the Privy Council under the provisions of the Act relating to the default powers of the Privy Council.-- [Mr. Lightbown.]

PARLIAMENTARY COMMISSIONER FOR ADMINISTRATION Ordered,

That Mr. Anthony Coombs be discharged from the Select Committee on the Parliamentary Commissioner for Administration and Mr. Andrew Hargreaves be added to the Committee.-- [Mr. Lightbown.]

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Bronchitis and Emphysema (Mining Industry)

Motion made, and Question proposed, That this House do now adjourn.-- [Mr. Lightbown.]

10 pm

Mr. Michael Clapham (Barnsley, West and Penistone) : I am aware that you, Mr. Deputy Speaker, as the Back-Bench Member of Parliament for Pontefract and Castleford, played an enormous role in the fight to persuade the Government to accept chronic bronchitis and emphysema as an industrial disease. I pay tribute to that work.

I requested the debate tonight for three reasons--first, to look closely at the new regulation, which I shall call "Amendment No. 2 regulation" ; secondly, to draw the attention of the House to the restrictive nature of the regulation, which is causing much concern in mining communities ; and thirdly, to suggest how the regulations might be amended to provide a fairer test for diagnosing the disease.

I am aware that the "Amendment No. 2 regulation" is based on the recommendations of the Industrial Injuries Advisory Council, but the recommended prescription is clearly too harsh, particularly because the council reported that the prescription test should be rather tight. Although the council established for the first time a connection between the retention of coal dust in the lungs and the development of chronic bronchitis and emphysema, it nevertheless put forward a prescriptive test that we feel is much too restrictive. The concern in our mining communities is highlighted markedly by the failure rate of that test. I am informed by the Yorkshire National Union of Mineworkers and by the DSS office in Doncaster that the failure rate in south Yorkshire is as high as 90 per cent. However, the DSS pointed out that there are some regional differences and that the failure rate in Scotland is even higher. I understand that the failure rate in Wales is slightly lower.

Hon. Members who represent mining communities are all too aware of the terrible, debilitating effect of chronic bronchitis and emphysema. We all know men who can hardly walk 100 yards without having to stop several times to fight for their breath. We are all aware of men who, having spent a lifetime in the colliery, cannot venture outside their doors and, in summer time, must sit watching television with an oxygen mask on to help to ease their fight for breath.

The cautious welcome that we gave to the regulations when they first appeared has turned to despair. There are several reasons for that, but the main one is the prescriptive criteria that are used in the diagnostic test.

In some instances, miners with 40-odd years' service underground, who have been treated by their doctors for chronic bronchitis and emphysema for many years, are now told by the examining authorities when they apply for a disablement assessment under the regulations that they do not have the disease. Naturally, that is causing considerable concern.

I feel that the problem arises from the prescription test of the Industrial Injuries Advisory Council, which I know that the Minister adopted and which is implemented in the new regulation. The Minister ought to be aware that it is

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possible under the test for a man who suffers from the disease to be ruled out of benefit because he does not meet other criteria laid down in the regulations.

As the Minister knows, a miner must pass three tests to proceed to full medical examination and then--hopefully--a disablement assessment. First, he must have the qualification of 20 years' work underground ; secondly, there must be X-ray evidence of dust retention in his lungs ; and thirdly, there must be a reduction of 1 litre in the forced expiration volume.

At the examination stage, miners are screened to eliminate those who do not meet the criteria. If a miner has worked underground for fewer than 20 years, he is ruled out, and no further examination is conducted. If he is successful at that stage, he is then given an X-ray. If he succeeds then, he proceeds to the FEV test. Only if he passes all three tests will he be referred to a doctor who will give him a full examination.

There are means of appeal to a special medical board, and, finally, to a medical appeal tribunal but there are flaws in the appeal procedure. I have not enough time to describe those flaws, but I will write to the Minister about them.

The procedure is clearly onerous and the prescriptive test is too restrictive, debarring genuine cases. An additional problem is caused by the difference between the pneumoconiosis principle of diagnosis and the new regulation principle. Let us suppose that two miners, A and B, have worked together underground for 17 years. Both leave the pit at the same time. Miner A takes a job outside the colliery, in an office, while miner B continues to work on the surface, in the coal preparation plant. At the time of retirement, both men have a respiratory disorder and apply to the pneumoconiosis medical board. In the first instance, miner A is examined and found to have pneumoconiosis and attendant chronic bronchitis and emphysema. He is given an assessment for his pneumoconiosis and then an additional assessment, because his pneumoconiosis worsens his chronic bronchitis and emphysema. Let us say that he is given 20 per cent.--10 per cent. for his pneumoconiosis and 10 per cent. for his chronic bronchitis and emphysema.

Miner B, who has spent a lifetime working at the colliery, is examined and found to have dust retention with acute chronic bronchitis and emphysema. Because the dust retention does not meet the criteria for pneumoconiosis, he is referred for an examination for chronic bronchitis and emphysema, under the new regulation, but, because he does not meet the criterion of 20 years underground, he is ruled out. I am quite sure that that was not the intention of the Industrial Injuries Advisory Council.

There are other examples, one of which is a situation that confronts many miners. As the Minister is aware, tens of thousands of young miners have been made redundant over the past few years. Those miners worked, using new technology, in conditions that were more dusty than was the practice in the mines in a previous age. However, as a result of the implementation of the redundancy scheme, many of those miners will not be given the opportunity to work for 20 years in the industry, and will have worked for only 10 to 18 years. Yet, inevitably, many of those young men will develop chronic bronchitis and emphysema.

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Under the current regulation they will not be entitled to claim benefit. The Industrial Injuries Advisory Council could not have intended that.

I ask the Minister to consider three matters. First, I ask him to consider reducing the qualification condition to 10 years, to equal the pneumoconiosis qualification condition. Secondly, I ask him to consider reducing the threshold for disablement benefit under the regulation. The threshold is now 14 per cent. and it ought to be equal to the pneumoconiosis threshold, which is 10 per cent. There is no logical reason for the difference under the new regulation, compared with the threshold under the pneumoconiosis scheme. Finally, I ask the Minister to consider seriously replacing the FEV test with a much more sensitive test for detecting obstruction in the lungs. The FEV test is much too rigorous. It has proved so restrictive that very few cases pass it. I hope that the Minister will be able to tell us that he is prepared to take those three items on board and to review the situation regarding the prescription test.

I also ask the Minister to think about the compensation aspect. As he is proabably aware, in the mining industry we have a no-fault liability scheme for pneumoconiosis. We should like him to enter into discussions with his colleague, the Minister for Energy, to consider extending the scheme to cover chronic bronchitis and emphysema. There is no logical reason why chronic bronchitis and emphysema should be outside the no-fault liability scheme.

With your permission, Mr. Deputy Speaker, I shall invite my hon. Friend the Member for Midlothian (Mr. Clarke) to add to that. 10.11 pm

Mr. Eric Clarke (Midlothian) : I thank you, Mr. Deputy Speaker. I know the history of the matter and as an ex-National Union of Mineworkers activist, one of the reasons that I became a Member of Parliament was to try to alleviate the anomalies that cause pain to the sufferers of those two diseases. I was also delighted when the Government accepted the recommendation, because an academic medical argument was going on and many people who had a great deal of disability in the past were not covered by the pneumoconiotic or silicotic coverage.

I do not have much time to go into detail, but I support the arguments of my hon. Friend the Member for Barnsley, West and Pensitone (Mr. Clapham) because I am confronted in Scotland, as are many Members of Parliament in their constituencies, with ex-miners who are bitterly disappointed at having been turned down. At this stage, I must thank the people in the Department of Social Security, who have brought things forward very smoothly. Mr. John Strachan is in charge in my area and he and his team are doing the best that they can to alleviate the problem.

Many people feel disappointed because, even when they meet the 20 years requirement, the X-ray that is looked at could be an X-ray that was taken up to 18 months previously. The argument is that the X-ray does not show traces of retention of dust in the lungs and that fibrosis is not visible so people are being eliminated from the scheme. Many people were proved to have pneumonoconiosis only after a post-mortem had been carried out because nothing showed up on the X-ray.

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The National Union of Mineworkers asked five eminent chest consultants to produce a paper on the subject but two of them produced a minority report on the diseases and their elimination. I remember being part of a delegation that went to see Reg Prentice who was the Minister of State for Social Security. We were knocked back--because of the cost, he said.

I do not have time to read out the details, but I have reports of consultants and doctors from the hospitals attended by sufferers. They say that the people involved are chronically ill, some are in wheel-chairs. I have here a copy of a letter sent to a widow, which gives an example of the terminology being used. It states that the "customer" has not been suffering from the prescribed diseases known as chronic bronchitis and emphysema. However, many such people have "puffers" or other equipment to alleviate the hardship of merely drawing breath.

I must stop now in order to allow the Minister time to reply. I say only that the people to whom I have referred have given their lives and their health to make Britain "Great" Britain. They have created the wealth and energy that we needed to make our industries tick. We cannot replace their health but we can make their lives more tolerable. I shall not repeat all the arguments but the question of the time limit, the capacity of the lungs and the dust on them must be considered more compassionately. We cannot give people back their health but we can make their lives and those of their relatives more tolerable by providing the compensation that we seek. We are not seeking a fortune but it would help. The needs of these people are greater than those of healthy people.

I thank the Minister for allowing me to speak.

10.16 pm

The Minister for Social Security and Disabled People (Mr. Nicholas Scott) : I congratulate the hon. Member for Barnsley, West and Penistone (Mr. Clapham) on securing a debate on what I acknowledge is an important issue that deserves the attention of the House. I very much appreciate his concens and the way in which he expressed them. I am conscious of the distress experienced by those suffering from these unfortunate respiratory conditions. I also listened to the passion in the voice of the hon. Member for Midlothian (Mr. Clarke) as he expressed his concern on behalf of those with whom he has worked so closely and whose interests he holds close to his heart. I echo the remarks of both hon. Gentlemen and acknowledge the tireless campaign that you, Mr. Deputy Speaker, as the hon. Member for Pontefract and Castleford, have conducted on behalf of miners to have chronic bronchitis and emphysema added to the list of prescribed industrial diseases. You have spoken and corresponded about those matters for a long time, but unable, because of your distinguished position in the House, to campaign as others have been able to do. I know, however, that you met the Prime Minister to discuss the issue with him in March last year and I am well aware of your continuing close interest in the operation of the scheme and the fact that we have, after a long period--the history of which I shall deal with briefly in a moment--recognised that these conditions should rightly be prescribed as industrial diseases under the industrial injuries disablement benefit scheme.

Industrial injuries disablement benefit is payable only for prescribed diseases, as we all know. The legal basis for

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this prescription has remained unchanged since the industrial injuries scheme was introduced in 1946. The statutory provision, which is now in section 108 of the Social Security Contributions and Benefits Act 1992, states :

"A disease or injury may be prescribed in relation to any employed earners if the Secretary of State is satisfied that

(a) it ought to be treated, having regard to its causes and incidence and any other relevant considerations, as a risk of their occupations and not as a risk common to all persons ; and (

(b) it is such that, in the absence of special circumstances, the attribution of particular cases to the nature of the employment can be established or presumed with reasonable certainty."

There are therefore two aspects to prescription, both of which must be satisfied. The first criterion requires unequivocal evidence of a causal relationship between occupational exposure and disease. The second criterion--attribution to occupation in the individual case "with reasonable certainty"--has in practice been interpreted as meaning "on the balance of probabilities", that is, more likely than not. Evidence of an increased incidence of disease in relation to a particular occupation or occupational hazard does not, on its own, necessarily justify prescription. The association with occupation must be sufficiently strong to show that the disease in the individual case is more likely than not to have been caused by the person's work, and that implies a relatively high risk.

I should like to move from that general outline of the scheme to the specific instance that we are discussing this evening. The Industrial Injuries Advisory Council first considered the prescription of chronic bronchitis and emphysema in coal miners in 1973, when it decided that it had insufficient evidence to recommend prescription. In 1985, it undertook a further study which culminated in a report in 1988. The limited information then available to the council suggested that the effects of coal dust exposure on lung function were less than those of cigarette smoke, and it was generally agreed at the time that tobacco smoke inhalation was a major cause of lung function impairment in coal miners as well as in the general population, and the council, therefore, again felt unable to recommend prescription.

In the following three years, however, as I think both hon. Gentlemen will recognise, reports were published in this country, in Belgium and in the United States which demonstrated that the risk of developing disabling impairment of the lung function increased more than twofold in coal miners, whether or not they were smokers, who had accumulated significant coal dust exposure, and it was with that evidence that the council felt able to recommend prescription of chronic bronchitis and emphysema in relation to those coal miners and former coal miners whose disability could most confidently be attributed to coal dust rather than to some other cause, such as tobacco smoking.

The council recommended the criteria to be used for evidence of sufficient exposure to coal dust for that to be the probable cause of the disability. Those were, as the hon. Gentleman identified, a minimum of 20 years' underground exposure and definite evidence of coal dust retention on a chest X-ray of at least category 1 on the International Labour Organisation classification of pneumoconiosis. The council also recommended that prescriptions should be based on an objective measure of

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impairment associated with clincially important disablement. It recommended that that measure should be a loss of lung function of at least one litre on the expiratory test, commonly called the FEV1 test, against that predicted for a person of the same age, height and sex as the claimant. The Government accepted and implemented the council's recommendations in full from September last year. I do not set myself up as an expert on chronic bronchitis and emphysema. I have had conversations with you, Mr. Deputy Speaker, and with other colleagues who have had much more direct experience of, and contact with, people who suffer from these conditions than I have ever had, and I have listened to them. But in this matter the Secretary of State and Ministers in the Department have always been governed by the expert opinion of the Industrial Injuries Advisory Council. It is right that we should look to its members to read the literature and to accumulate for themselves such evidence as they can discover about each of the individual matters of concern that are raised, and offer advice to the Secretary of State.

For the reasons that I have outlined, it is on that advice that we invariably depend when we make our decisions.

The covering leter from Professor Malcolm Harrington, the chairman of the Industrial Injuries Advisory Council, concludes by saying : "the Council suggest that the qualifying conditions should be reviewed after a suitable period of operation of say five years." So the IIAC and its chairman recognise that the judgment made on the qualifying conditions already outlined in the debate was not like the laws of the Medes and the Persians, but was something that should properly be reviewed after some experience.

I cannot say whether the council was influenced in coming to that judgment by the knowledge that there had been a substantial take-on of case load in the initial stages of the introduction of the new scheme. However, at the end of the covering letter, the recommendation was clearly made that the conditions should be reviewed after a suitable period of operation. The period of five years was mentioned, but the council was not being especially prescriptive about that. The Government accepted and implemented, as we invariably do, the council's recommendations.

I understand the concern of Opposition Members, but in general my impression is that the addition of chronic bronchitis and emphysema to the list of prescribed diseases has been widely welcomed. Hon. Members on both sides of the House have appreciated it, as have the unions representing miners. I am glad to say that the new scheme has been successfully implemented, too. Indeed, the hon. Member for Barnsley, West and Penistone paid tribute to that fact.

The hon. Members for Barnsley, West and Penistone and for Midlothian came to see me before the scheme was launched, and impressed on me the importance of smooth

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