It might help if I were to tell the House a little about the consultation and the responses to it. We will be publishing this shortly, but I know that my hon. Friend the Member for Hendon will want to know what has happened as a result of the consultation. Some
224 responses were received, of which 163 expressed the view that pleural plaques should be compensatable in some form. Slightly more than two thirds of those who responded directly to the question regarding overturning the House of Lords decision supported changing the law. Views were equally divided on whether the proposal to increase awareness of the nature of pleural plaques would be helpful. I must say that there was only limited support for a no-fault scheme and a number of those who did express support for such a scheme made it clear that it was very much a second preference for them if the Government decided that they would not overturn the House of Lords decision.
Michael Fabricant (Lichfield) (Con): I have been listening with great interest to the Minister and the hon. Member for Hendon (Mr. Dismore). Have any of the responses that have been made to the Minister come from medical sources? Can he confirm-this is my main point-that the cause of pleural plaques is always exposure to asbestos or can there, in some cases, be other causes?
Mr. Wills: I am grateful to the hon. Gentleman for that question and for the interest he is taking in this case. I cannot give him an exact breakdown of those responding, but we will be publishing the results. On the origins of pleural plaques, I am afraid that I cannot give him a definitive medical answer. I am very happy to write to him on that point. I hope he will correct me if I am wrong, but I think he is driving at the question of responsibility, liability and causality. I am happy to give way to him so that he can make that clear.
Michael Fabricant: I am grateful to the Minister for giving way a second time. I have no doubt that there is a strong argument for compensation per se for pleural plaques. He has already pointed out, quite rightly, that the source of the exposure to the asbestos has to be identified. I wanted to have it explained to the House that there can also be no doubt that the symptoms and the existence of pleural plaques would always be owing to exposure to asbestos and not to some other toxic substance.
Mr. Dismore: I want to make two points. First, the Bill makes it clear that the only pleural plaques that would be compensatable under it would be those that are asbestos-related. Secondly, I am not aware of any other source of potential pleural plaques but, come what may, it is still for the claimant to prove that their pleural plaques are asbestos-related.
The hon. Member for Lichfield (Michael Fabricant) made a very specific point. I do not want to mislead the House. I am not aware of any other possible source of pleural plaques other than exposure to asbestos, but I
would not like to give the hon. Gentleman a definitive opinion. As he will know, medical opinion on these matters varies. Some doctors can always be found to take a contrary view. I would not like to mislead him by giving him a definitive answer, and all I can tell him at the moment is that I am not aware of other causes and, in any event, as my hon. Friend the Member for Hendon has pointed out, that has no bearing on this Bill.
Before I conclude, I want to make a point about another complexity of this issue that we have to deal with in making progress. The House will be aware that claims management companies have been involved in this field. This is a particularly difficult issue. As 99 per cent. of pleural plaques are asymptomatic, there has been quite a vigorous campaign by claims management companies and some solicitors to try to persuade people who might have been exposed to asbestos to undertake scans. This has given rise to considerable disquiet.
I know that concerns have been expressed about the possible exploitation of vulnerable people. People have asked whether claims management companies can be prevented from acting in this area. Suggestions have been made that only those who were diagnosed by a registered doctor should be able to bring claims. This is a difficult and complex point and it was not directly raised by my hon. Friend the Member for Hendon, but I want to address it because I know that it comes up a lot and that people can get very angry about the exploitation of vulnerable people.
Claims management companies are already regulated under the Compensation Act 2006: regulations control any business offering claims management services and should prevent any malpractice from developing. The introduction of an absolute bar on claims management companies providing services related to pleural plaques would require primary legislation. If we tried to prohibit claims being made when they were the result of a commercial CT scan or when medical evidence did not originate from a registered medical source, that would cause significant concern about compatibility with article 6 of the European convention on human rights, as it would bar access to a court for a claimant who may, in the end, have a genuine cause for action.
Mr. Dismore: My right hon. Friend can square the circle in a relatively straightforward way. He does not have to use primary legislation. This is a question of what evidence is sufficient to satisfy the court, rather than one of debarring anyone from bringing their claim to court. The court may not be satisfied if the evidence is not strong enough-a matter that can be dealt with through the rules of court.
Mr. Wills: I understand my hon. Friend's point, but it does not address the issue of vulnerable people being exploited for commercial gain. However, those considerable problems should not stand in the way of our trying to make progress on the substantive issue that he has raised.
I want to put it on the record again that the Government are firmly opposed to the use of scan vans, as they are called. The provision of X-rays and CT scans is governed by two sets of regulations, which make it clear that initiating an X-ray or a CT scan purely for the purpose
of obtaining compensation is not justified, and in those circumstances the Healthcare Commission could be asked to investigate. We would try to deal with the problem on that basis.
I want to say a little about the views that medical experts have expressed about the anxiety that people experience when they are diagnosed with pleural plaques. There is, it is fair to say, general agreement that a diagnosis of pleural plaques is likely to cause anxiety. That is a common-sense view. However, there are different views-as is inevitable, as I said, where professional opinion is involved-about how that should be addressed clinically and how far the level of anxiety can be controlled. One perspective was that a rational, honest explanation of the risks from exposure to asbestos could help patients, but that it would be impossible to alleviate the anxiety, that concerns were understandable and that those involved should be compensated.
The other perspective was that if the condition and the risks were properly and clearly explained, most people would be reassured, and offering compensation would send a mixed message to patients and could increase anxiety. In addition, because there is no direct link between the existence of pleural plaques and the development of mesothelioma, sending people to have scans might be a riskier process for many because it would lead to them being exposed to radiation, which holds some risk, albeit not a huge one. However, given that many people with pleural plaques never develop mesothelioma, it would be an unnecessary risk.
Mrs. Laing: The Minister may in his last few remarks have answered my question. Does he agree that where those scans are not necessary, it is vital that they do not take place? He and the hon. Member for Hendon have both argued very strongly-I do not disagree-that it is the psychological effect of knowing that one has pleural plaques that causes the injury, rather than the pleural plaques themselves, in cases where they do not develop into a more serious disease. Therefore, not knowing that one has pleural plaques is a better position to be in than knowing that one has them.
Mr. Wills: The hon. Lady puts the point pretty well, and she raises an important psychological, and, indeed, philosophical, question. I think that the whole House deplores the use of scan vans. We are talking about people who seek to exploit the potentially highly vulnerable, and who prey on their anxiety and worry for commercial gain. That is not acceptable and we deplore the practice. I have outlined some of the measures available to prevent it, and I hope that our message is going out loud and clear.
I want to talk briefly about some of the new evidence that may be coming forward from the United States and France, and about the meeting of medical experts to which I referred earlier. At that meeting, a UK case study was discussed and it was suggested that, in that individual case, pain could have been associated with pleural plaques rubbing against a person's ribcage. If that were to be the case, it would change the nature of the issue. However, the experts noted that no direct causative link to the plaques had been established. In any event, it is already accepted that pleural plaques can involve symptoms in a small minority of cases. Recent French research focused on the relationship between
cumulative exposure to asbestos and the development of pleural plaques, rather than the medical nature of the plaques themselves.
The Bill has to be considered in the context of all those developments. It represents one possible approach to the issue of pleural plaques. I have set out some of the other dimensions of the issue on which the Government want to make progress, but there are a number of other approaches, and there are wider issues surrounding asbestos-related diseases. We want to ensure that all of them are considered fully and that the best response is identified, and we are doing that as quickly as we can. As we are still assessing what the Government response should be on pleural plaques and the wider issues affecting those suffering from asbestos-related diseases, it is not possible today to give a firm indication of what the Government's ultimate position on the Bill will be. However, on that basis I can confirm that I am content for the Bill to proceed today.
Mr. Dismore: With the leave of the House, Mr. Deputy Speaker. I am grateful for comments from Members from across the House. We have aired the issue yet again; I have lost count of the number of times that we have debated pleural plaques in the House. I am not sure that I have added greatly to the knowledge of the House or the general public, but we emphasised some of the arguments, and I hope that the House will give the Bill a fair wind.
Mr. Deputy Speaker (Sir Michael Lord): Occupants of the Chair have deprecated proceeding at once from Second Reading into Committee without notice, since it makes it difficult for Members to table amendments.
The Minister of State, Ministry of Justice (Mr. Michael Wills): I shall not detain the House long, but I want to say a few words about the Government's position. I hope that my hon. Friend the Member for Hendon (Mr. Dismore) is pleased that we have made so much progress on the Bill-I know that he has been here before. The Government want to resolve the issue, and again I pay tribute to him, to my hon. Friends the Members for Blaydon (Mr. Anderson), for Jarrow (Mr. Hepburn) and for Barnsley, West and Penistone (Mr. Clapham) who are not here today, and to all the hon. Members who participated in the debate today and who have made representations to the Government over the past few months.
As we have heard, the issue is extremely important for many, many of our constituents, affecting every aspect of their lives. Because of that, there should be no doubt about the Government's determination to resolve the issue. The fact that we have not yet been able to do so is not an indication of any lack of will on our part. There has been huge activity. Many Members of the House will be aware how much work has been continuing on the part of officials throughout Whitehall to try and resolve the issue once and for all.
It is a feature of our system of government that from time to time the courts produce judgments that throw public policy into disarray, and the Government then have to react. We must react in a way that is sustainable and which sends the courts a clear framework and a clear message about the will of the House. We have to make sure that we have covered every dimension. I hope I have shown today just how complex this area is.
My hon. Friend the Member for Hendon has performed an invaluable public service, for which all my constituents will be extremely grateful to him. In saying that, I am sure I speak for most Members of the House. However, he is dealing with only one aspect. It is important that we try to achieve a comprehensive solution, and I think we are not far off that. Today has been another step forward. It is not the final resolution, but we are not far off that stage. It will almost certainly not be me who stands at the Dispatch Box to announce further progress, but I am sure that before too long, a Minister-
Mr. Wills: I hope I can take that as a compliment from the hon. Gentleman. It will not be me because, in practical terms, the matter does not fall to my ministerial responsibility. I was pleased to be able to be present today because, as I explained to the House earlier, I have a distinct constituency interest in the matter, which has been of great concern to me as the Member of Parliament for North Swindon, but normally another Minister would be at the Dispatch Box. The hon. Gentleman should read nothing untoward into that, other than an allocation of responsibilities within the Ministry of Justice. As I said, I was pleased to be here today for a debate on a matter of intense importance to my constituents in Swindon.
I hope my hon. Friend will feel that I have been positive and constructive in my comments in moving the Bill forward. At some point in the near future a Minister-it may be me, but probably not-will stand at the Dispatch Box with an indication of how we intend to resolve the issue.
Matthew Taylor (Truro and St. Austell) (LD): That is a huge concern, so I hope that the Minister will provide a time scale, because it has taken a great deal of time to resolve the issue. He may not make the announcement, but I hope that it will be made soon.
Mr. Wills: I am grateful to the hon. Gentleman, who was perhaps being tactful. The hon. Member for Uxbridge (Mr. Randall) may have been trying to tease from me the date of the general election, because as the House will know, I am not standing for re-election. He may have been trying delicately to discern whether the announcement would take place before the general election, and the hon. Member for Truro and St. Austell (Matthew Taylor) may have been after the same thing. I certainly hope that it takes place while I am still a Member, so that I can report to my constituents in North Swindon that this Government have taken decisive action on pleural plaques, just as we have done on that dread disease of mesothelioma, which has caused such anguish for so many people.