Mesothelioma Lump Sum Payments (Conditions and Amounts) (Amendment) Regulations 2020

Lord Jones Excerpts

Tuesday 3rd March 2020 Grand Committee

[Lord Alton of Liverpool (CB)]

My Lords, it is a great pleasure to follow the noble Baroness, Lady Thomas of Winchester, and I will echo some of her remarks about resources, research and automatic uprating. Along with many other noble Lords in Grand Committee today, I have been involved in the fight against mesothelioma for many years. I am pleased to see this important issue before us again because it is important that we keep it in the public eye and keep talking about the questions that the noble Baroness has just raised.

This is not an abstract, theoretical issue for many Members of your Lordships’ House. I have been surprised over the years by the numbers of colleagues from both Houses of Parliament who have told me about the loss of loved ones—people within their own families—who were affected by this killer disease. I fully support the uprating of the lump sum payments in line with inflation. We must do everything possible to support people who have been exposed to asbestos and other hazardous substances at work and who now face these terrible consequences.

In previous years, when these regulations have been discussed, as they have been annually since the introduction of the compensation scheme, noble Lords have asked whether future increases could be made automatically rather than being at the discretion of Parliament—a point that the noble Baroness touched on a few moments ago. It is important that the Government give careful consideration to this argument, and I look forward to hearing from the noble Baroness, Lady Stedman-Scott, when she comes to reply, about how the Government intend to take forward the question of automaticity. Doing so would send a powerful message that we are committed to supporting people and their families affected by these awful diseases.

Why do we need to keep raising our voices about mesothelioma and pneumoconiosis? There is a misconception that occupational lung disease is a historical problem that has been solved. However, there are still many occupations and high-risk work activities that present risks to lung health, from construction and cleaning to artisan baking and much more. The Health and Safety Executive estimates that occupational lung disease results in around 12,000 deaths a year.

Mesothelioma is an invasive type of cancer caused by prior exposure to asbestos. It grows in the pleural membrane that lines the outside of the lung and the inside of the chest. Less commonly, it can also affect a similar lining around the abdomen or the heart. There is currently no cure. Mesothelioma patients often have a short life expectancy and experience complex, debilitating symptoms. Around only 5% to 10% of people diagnosed with mesothelioma survive for five years or more.

As the noble Baroness reminded us, I made the point last year that, tragically, we have the highest rate of the disease anywhere in the world. Mortality rates have more than quadrupled over the past 30 years. It is estimated that around 2,500 people die of the disease every year, and that over the next 30 years around 60,000 people will die of mesothelioma in this country unless new treatments are found.

Mesothelioma is more common in certain parts of the country, such as Liverpool, where people are 18% more likely to die of this disease. Indeed, it was as the Liverpool Member of Parliament in another place that I first encountered the tragic and always fatal consequences of this disease. In Liverpool, mesothelioma has its roots in the historic industrial shipbuilding legacy, as asbestos was used extensively in shipbuilding. Later we will hear more about pneumoconiosis from my noble friend—and friend in every respect—Lord Wigley, but I can see that the noble Lord, Lord Jones, wants to intervene. I would not dream of holding back from allowing an intervention from him.

[Lord Jones (Lab)]

I am grateful to the noble Lord. I rise simply to say that I recollect the strong campaigns in another place made over the years by the noble Lord, Lord Alton, with sincerity and indeed to some effect.

[Lord Alton of Liverpool]

I am grateful to the noble Lord. For me, it has been a great pleasure to co-operate with him in both Houses of Parliament on issues of this kind. As he knows from his experiences in north Wales, many lung diseases are caused by inhaling dust. The common types include coal workers’ pneumoconiosis, which is caused by breathing in coal mine dust, and silicosis, which is caused by breathing in crystalline silica dust and typically affects workers in industries such as quarrying, foundries and potteries. Like mesothelioma, there is a long delay between exposure and onset of the disease. In 2012, 374 people in the UK died because of pneumoconiosis.

What about diagnosis, prevention and support for people with mesothelioma or pneumoconiosis? Here I pay tribute to the British Lung Foundation. This wonderful charity raises awareness of occupational lung disease and funds research into treatments and cures. It also provides the secretariat to the Taskforce for Lung Health. The task force is a coalition of more than 30 organisations from across the lung health sector, including royal colleges, patients, and the Health and Safety Executive, who came together to publish a five-year national plan to improve lung health in England. Included in the plan are recommendations to improve prevention and awareness of occupational lung diseases such as mesothelioma and pneumoconiosis. I should like the Minister to listen to two of the recommendations, which I will highlight, in order to ask her what more the Government could do to support their elevation in order to make sure that they are given real substance.

Under these recommendations, employers are responsible for ensuring that effective measures are in place to control exposure to hazardous substances in compliance with the Control of Substances Hazardous to Health Regulations 2002. They should also highlight risks at work to employees and encourage people to think about their own and others’ safety, including wearing the right protective clothing and masks. What are we doing to make sure that employers are honouring those recommendations?

Secondly, healthcare professionals should be trained to recognise and understand lung diseases which are caused at work. Asking questions about occupation when a patient presents with respiratory symptoms could improve early detection, allowing people to start treatment as soon as possible, as well as to access any compensation that they are owed. The number of occupations that present risks to lung health is surprisingly broad. Staff training should be included in undergraduate and postgraduate curricula and continuing professional development. Is that something that the noble Baroness would be prepared to take up with the relevant Ministers in other departments to ensure that it is acted upon? What will the Government do to take forward these recommendations?

What are the Government doing to increase funding for mesothelioma research? Research into lung disease is underfunded in comparison with the disease burden. Only 1.8% of the total UK health research spend went towards respiratory disease in 2018, despite it being one of the top three killers in the United Kingdom. As I have said, there is no cure for mesothelioma and it is poorly understood as a disease. That point was made earlier by the noble Baroness: the reasons people contract the disease are not sufficiently well understood.

In 2014, I tabled an amendment to the Mesothelioma Bill, and in 2015, I introduced a Private Member’s Bill in your Lordships’ House which would have put a small levy on participating insurance firms to help secure long-term research funding into mesothelioma. Unfortunately, the amendment and the Bill were defeated. At the time, it had the potential to raise about £1.5 million a year for research. That represents a small amount of money to each of the insurance companies but would have created a great number of research opportunities and given hope to people living with mesothelioma and, indeed, their families.

Since then, the Government have allocated £5 million for a national mesothelioma centre at Imperial College. I thank those Ministers who put in considerable effort to secure that and to look at voluntary funding from the insurance industry—I am thinking in particular of the noble Lord, Lord Freud, and the work that he did on that. I am pleased that the British Lung Foundation was also able to secure match funding for this £5 million and that two insurance companies, Aviva and Zurich, donated a combined £1 million to the British Lung Foundation’s mesothelioma research programme. Unfortunately, negotiations for a broader long-term funding commitment from the insurance industry came to a standstill. What are Ministers now doing to take that forward, building on the excellent work of the noble Lord, Lord Freud?

Overall, the British Lung Foundation has spent over £8.7 million on research into the disease. With this money, the BLF has been able to support further research and clinical trials, and has set up a mesothelioma research network. The network brings together researchers to share ideas and collaborate to help translate research more quickly into new diagnostics and treatments for people with mesothelioma. It now has 180 members worldwide and has led to 12 new or potential research collaborations. I pay special tribute to the efforts of the noble Lords, Lord Giddens and Lord Willis, and the noble Baroness, Lady Blackstone, who have worked, with me and others, to bring some of that about. Some of the research projects funded or co-funded by the British Lung Foundation have included exploring using the immune system to fight the disease and the development of a tissue and blood sample bank, MesobanK, which gives researchers quick access to samples and data to help accelerate research.

I would like to see more research into how we deal with asbestos in schools. This is a very real issue, about which far too little has been done. Again, I pay tribute to my noble friend Lady Finlay of Llandaff, who has taken a lead on this. It is also important to look at the effect of mesothelioma in the Armed Forces. We should recall the noble Lord, Lord West of Spithead, describing to us how young men played snowballs with asbestos at Dartmouth. The consequences of our past ignorance are still being lived out today.

While I fully support compensation for the victims of these diseases, it is surely in everyone’s interest—the victims, the Government and the insurers—to put investment into finding a cure. That would, long term, remove the need for lump sum payments or any insurance industry levies. Because this field is so underfunded, every pound of investment is likely to be worth while and to attract further funding. I am pleased that the British Lung Foundation continues its work to secure funding for vital mesothelioma research. It has recently secured £5 million over five years from Catalina Holdings, aimed at achieving early diagnosis and trials of high-potential drugs. But the Government must do more as well.

I come to my last point. The Merseyside Asbestos Victims Support Group—I pay tribute to John Flanagan and to Joanne Gordon, who chairs the Asbestos Victims Support Forum—has raised with me the particular case of equalising and upgrading posthumous payments. I hope that the Minister will reply to this point tonight—I know that it has been raised with the Government by the metro mayor of Merseyside and others. The payments are meant to provide some compensation for asbestos victims who cannot take legal cases. That is surely right. However, there is an inconsistency in the schemes. If applications are made after the patient has died, the payments, which can be claimed only by surviving partners or dependent children, are substantially lower. That cannot be right.

A victim aged 77 making a claim based on a 100% IIDB award will receive £14,334. The surviving partner of someone who passed away at the age of 77 will receive £7,949. In such a situation, many family members feel that the life of their loved one lost to this devastating disease is regarded as being of less value. This is surely morally wrong, especially as in a legal claim a surviving partner will suffer no such disadvantage. Furthermore, victims’ families could suffer a financial hardship, as people budget on the basis of two incomes and, through no fault of their own, are reduced to one income and are further disadvantaged by receiving a lower government compensation payment.

The victims who receive payments are not interested in the money for themselves. However, they are concerned about the financial security of their families. In this situation there is clearly a moral and financial case for raising the level of posthumous payments. I know that the noble Baroness will have been listening with care, and I hope she will be able to respond in a positive way.

There are also practical considerations. Of the 3,830 payments made in 2018, only 260 were posthumous claims. In 2010, the Government acknowledged that there was no justification for differential payments, further adding that such inequality in payments could put pressure on victims at a time when they are most vulnerable. The Government made a firm commitment to bridge the gap between in-life payments and posthumous payments. I hope the noble Baroness is able to say today that that commitment will be honoured.

Some 60,000 people will die over the next 30 years. We owe it to them not to merely go through an uprating ritual every year but to provide tangible support and world-class leadership in research.

[Lord Wigley (PC)]

My Lords, I am delighted to follow the noble Lord, Lord Alton, in this debate. We have campaigned together on many occasions, and I was glad to support his Bill in the past. I came to the mesothelioma question through the death of a very close friend, my school chum Peter Wolfe, who died four or five years ago, within a matter of four months of having been diagnosed as suffering from mesothelioma.

The figure quoted, of 60,000 possible deaths, may be more than the number of deaths in the UK arising from the present flu scare. That puts it into context and underlines the need for us to address it. I have spoken in several debates on this in the past and will not repeat the points I have made. I very much support what was said by the noble Baroness, Lady Thomas, and the noble Lord, Lord Alton, about the need for funding for research in order to minimise the extent of suffering due to mesothelioma and asbestosis. I reinforce the point made about schools. So many schools were built using asbestos, and in Wales, the National Assembly are facing this issue in a number of locations. This has to be tackled, otherwise there will be problems.

I will focus mainly on the pneumoconiosis order, although the two do of course blend into each other. From debates in earlier years on the uprating orders, noble Lords may recall the interest I have in these matters, arising from having represented for 27 years a slate quarrying area in the Caernarfon constituency. They may well also recall the significant involvement that my colleagues and I had in pressing for the Act to be completed in the dying days of the 1974-79 Labour Government—something that my noble friend Lord Jones will well recall.

[Lord Jones]

The noble Lord will recollect that I was a member of that Administration, which fell on a vote of no confidence.

[Lord Wigley]

Indeed. Our three votes were not enough to save that Government, but they were enough to help the pneumoconiosis Act find its way through, in two days flat, to the statute book. That that happened is a tribute to Michael Foot, among others. There had been delays all along in getting the Act on to the statute book, but Michael Foot made sure that it went through both Houses within 48 hours—quite a remarkable achievement.

It might interest noble Lords to know that considerable interest is now being taken in this legislation in the context of the bid for UNESCO to accord world heritage status to the slate industry in north-west Wales, in a similar manner to that given to the coal industry’s big pit at Blaenafon. One aspect of interest in the presentation of that case is the way in which the slate quarrying communities led the fight and campaign to secure compensation, not just for slate quarrymen, whose health was undermined by breathing in industrial dust, but for workers in so many other industries. That includes those working in cotton mills, pottery production, foundries and other metal industries, and even some working in the coal mining communities who were not covered by the coal mining scheme.

In recent years we have seen asbestosis and mesothelioma, both covered by the Act, become the predominant part of the payments made under the Act, which I will come on to now.

At the time of passing the 1979 Act, the Government estimated that it would cost £5 million in the first year and, thereafter, £75,000 per year—yes, £75,000 per year. In fact, more than £20 million was spent in the first five years and £30 million over the subsequent 10 years. In the five years from 1994 to 1999, the figure was £25 million. Since then, expenditure under the Act has mushroomed. From 1999 to 2009, £236 million was spent, and from 2010 to 2019, £415 million was spent. A large part of that was clearly associated with asbestos-related diseases, but I have tried by way of Written Questions to identify which payments were related to which industries that come under the purview of the Act—which is a reasonable question to ask—so that we might see how the issue relates to other industries.

I wanted also to establish that the total cost of asbestosis is not only the payments under the 2008 scheme but a large part of the payments being discussed here, which adds to the significance of the need to find a solution for those suffering from mesothelioma. We have a right to know. Certainly, it is not the slate quarrymen who have been the beneficiaries of the huge sums that I have referred to, but they will of course be glad that provision is there is to help others in need. The trigger is asbestosis. Can the Minister confirm that, if those figures are not available now, the Government will undertake to identify exactly what costs are attributable to what industries?

I do not deny for a moment the absolute right of those in any industry who have suffered loss of health and even life as a result of their work to be properly compensated, but questions need to be answered about whether the schemes still help those not affected by asbestosis and to what extent. Perhaps a focus can be put on that. It is also relevant to ask what the total for mesothelioma is between all the schemes and what research budget is needed. It is a large sum, but it needs to be even larger to help those most in need. I would be grateful for the Government’s response.

--- Later in debate ---

[Lord Jones]

I thank the Minister, the noble Baroness, Lady Stedman-Scott, for her caring introduction. The increase of 1.7% in respect of asbestosis must be welcome, but, whatever the lump sum paid and whatever the increase, none of us can quite comprehend the miserable impact on the sufferer or the dependant, but it is good that some recompense has now been made.

Is there a regional breakdown of where sufferers worked historically? Does the department have that information? Is there any indication of the number of survivors and the number of dependants in receipt of payments? Does the department have such a figure? What sum of money has been paid so far since enactment? Does the department have that information? If so, could it be given to the Minister?

There have been some recollections. The late Lord Harold Walker of this noble House described to me how in the late 1960s workers in a factory in Hebden Bridge played snowballs with the piles of asbestos. The real tragedy in this case is that the asbestos was blue, which is, in effect, a certain prescription for illness and death.

I recollect debating the subject of the second SI with the Minister on a previous occasion. I remember it well; it might have been her first appearance in this Committee—a very fine appearance, if I might say so. She was responsive, as she always is. Again, I thank her. I intervene on this SI on the matter of the slate quarrymen, particularly those in north Wales, on whom the noble Lord, Lord Wigley, gave us his own insights. How many claimants are there now? How many dependants are claiming? Is there a breakdown for that part of Wales? Is there a breakdown by county—or country—of claimants throughout England and Wales? Is such statistical information available to the department?

Should there be the time and inclination, I will briefly describe a quarry in Blaenau Ffestiniog called Llechwedd. It is underground, of course, cavernous, dark and damp. There were dangers and pitfalls. Of course, the quarrymen worked underground at the quarry face. There were no health and safety regulations whatever when that quarry was at work. In what we call the olden days the quarrymen had to pay for the candles that lit their place of work. That is the memory and heritage. That makes some humanity of the regulations that the Minister must necessarily bring to the Committee. I stress that the emphasis of regulations should be on their humanity—the consequence for the citizen.

Another quarry, Penrhyn, was arguably the biggest in the world. Ten miles away from that great quarry, which is not active now, is a great castle, Penrhyn Castle. It is now a National Trust property. Should Members ever visit it, there is a Rembrandt in the breakfast room. My point is that the castle is mighty; it was built in the 19th century on the profits from the slate quarries. The contrast between the humble quarryman, and the mighty potentate and the wealth and treasure he and his descendants had, is enormous. It puts our debate into further context.

In 1976 I sat alongside the late Michael Foot, when he was deputy leader of the British Labour Party, as a junior colleague throughout the passage of the legislation. He enacted the first Health and Safety at Work etc. Act. It is relevant to emphasise that historic legislation to place this important SI in context. The department would then be the keeper of that memory, and the memories which noble Lords have recalled and put forward for consideration today.