Mesothelioma Bill [HL]

Lord Walton of Detchant Excerpts

Wednesday 5th June 2013 Grand Committee

[Lord Wills]

My Lords, I support my noble friend’s amendments on this issue. I first became aware of this terrible disease shortly after I was elected as the Member of Parliament for Swindon North. A man came to my surgery in the exact circumstances that my noble friend has described. He was absolutely distraught because his wife had just died from this terrible disease, which she had contracted from washing his clothes. Every day, he came back from the railway works in Swindon and gave his work clothes to his wife. She washed them and, as a result, she died from this disease. It seems completely wrong, as a matter of natural justice, that people in these circumstances should be denied any access to justice under the terms of this Bill.

Like my noble friend, I hope that the Minister will surprise us pleasantly by accepting these amendments, although I fear that we may be disappointed. If we are disappointed and the Minister relies—as I understand he may well be advised to do—on the dangers of creating a precedent by accepting these amendments, I hope that he will be able to say in exactly what circumstances he thinks such a precedent will be created. Given the very particular nature of this disease, its particular virulence and the very particular way in which it is contracted, can he say precisely what precedents he thinks will be created by accepting my noble friend’s amendments?

In the mean time, I hope that the Minister will at least agree to look again at these amendments, which seem to be absolutely consistent with the basic principles of natural justice, and I very much hope that they will find their way into this Bill in one way or another.

[Lord Walton of Detchant]

My Lords, I rise to support Amendment 8. I spent the greater part of my professional life practising medicine in the north-east of England. Even though I practised largely as a neurologist, I saw many patients with mesothelioma, many of whom had worked in the shipyards on the Tyne and the Wear, and who had been exposed to asbestos. However, I also saw, not under my direct care but under the care of colleagues, some women who developed mesothelioma because they had been involved in washing the clothes of their husbands, who had been exposed to asbestos—clothes which were deeply impregnated with asbestos fibre. For that reason, I would say that this issue does not rest just on the balance of probabilities; in my view, it is beyond all reasonable doubt that they developed mesothelioma because of that activity.

[Lord Alton of Liverpool]

My Lords, like my noble friend Lord Walton of Detchant, in my time as a Liverpool Member of Parliament I also came across shipyard workers from the River Mersey who, sadly, had contracted mesothelioma. I also saw tunnellers, masons and others who had come to surgeries to talk about what compensation schemes might be available.

I vividly recall meeting a man and his wife, and she came back to see me just weeks later when she was a widow, he having died. The rapidity with which people can die after prognosis is alarming, and of course it is a fatal disease. It is suspected that another 56,000 people will die of mesothelioma before this terrible curse is ended.

--- Later in debate ---

Given that there is a valid precedent in law in the form of the Gambling Act, a solution to any human rights objection—that is, a proportionate levy—and a clear power for government departments to raise money outwith their remits, what exactly are the outstanding objections to the proposal? Surely it is the principle contained in this amendment, with which I know the noble Lord will have some sympathy. Surely, if he does have sympathy with that principle, he should now help us all to overcome any of these objections, rather than raising objections. Accepting this amendment or something like it—the principle of it—would finally remove mesothelioma’s Cinderella status and offer hope to some of those 56,000 British citizens who will die of this disease if no cure is found. I beg to move.

[Lord Walton of Detchant]

My Lords, it is a pleasure to follow the noble Lord, Lord Alton, particularly in the light of the lucid and forceful way in which he has proposed this amendment. I have added my name to the amendment because I believe very strongly that, as he has pointed out, the amount of funding in this country that has been devoted to research into mesothelioma, its causation, its development and its treatment has been miniscule. I join him in paying tribute to the contribution over the years made by the voluntary organisation, the British Lung Foundation, in examining ways in which research into this wretched disease can be conducted. However, the Government’s contribution to this research—for instance, through the Medical Research Council, of which I was once a member—has been minimal. Therefore, I am very much in favour of the principle underlying this amendment.

I used to teach my medical students that while there are plenty of incurable diseases in medicine, there are none that may not have their effects modified by pharmacological, physical or psychological means. Mesothelioma is almost an exception to that rule, although it is clear that in the early stages of the disease certain physical mechanisms can alleviate some of its worst effects. The tragedy of mesothelioma is that the deposits of this cancerous process are laid down in the pleural cavity, between the surface of the lung and the internal surface of the chest wall. Gradually, as those deposits increase, the actual flexibility of the movement of the chest wall—in the muscular contractions which are responsible for our involuntary taking in and expiring of air—is slowly but progressively lessened, so that in the end the patient is almost subject to the feeling of having a straitjacket around their chest that prevents them from respiring. Eventually, it is fatal. Happily, there are mechanisms with drugs, sedatives and many other things that can help to ease the terminal phases. Nevertheless, the end result is tragic and appalling for anyone who has witnessed it.

A colleague of mine who was a consultant neurologist developed mesothelioma—the result, it appears, of being as a youth a keen club cricketer in villages in County Durham. It turned out that the changing room in which he regularly changed before appearing on the cricket field was lined with asbestos. That was eventually thought to have been the source from which he acquired this disease. It is a tragic condition and it deserves close and careful attention.

I also used to teach my medical students that today’s discovery in basic medical science brings tomorrow’s practical development in patient care. As yet, there has been no such basic discovery in the science underlying the causation and development of mesothelioma and, as yet, no drug has been discovered that is capable of reducing that progressive, cancerous deposit and the progressive process of strangulation. That is not to say that there have not been some limited discoveries that have benefited individual patients, but much more is needed.

I know what the Minister will say: that an amendment such as this has no place in a Bill or a statutory instrument because it is, in a sense, permissive. I can understand fully the view that he is going to take in that regard. However, I do not believe that it is beyond the wit of man, and certainly not beyond the wit of the Minister, to achieve some kind of Machiavellian political intervention or manipulation enabling the principles underlying this amendment to be fulfilled in law.

Although I have given my name to Amendment 31, I must say that I disagree with its last phrase. It says that,

“the funds raised through this charge shall be remitted to a competent research institution to fund research to find new treatments for mesothelioma”.

It should say “a competent research-granting organisation”. What could be better than the Government’s own research arm, the National Institute for Health Research, which is chaired by the Government’s Chief Medical Officer, Sally Davies? It could be the perfect example. I hope very much that the Government will find the means to fulfil the principle underlying this crucial amendment in managing to persuade these insurance companies— perhaps “persuasion” is not exactly the right word; it might need something a bit firmer to get the money out of those bodies—to enable the National Institute for Health Research to fund crucial research on this devastating disease. It deserves everything that we can put into it and a great more than we are already doing.

[Baroness Butler-Sloss]

My Lords, I, too, have put my name to Amendment 31. It is with some hesitation that I rise to speak after the two formidable speeches that we have just heard. Having put my name to the amendment, though, I want to say something to support it. It is indeed a modest amendment but it has enormous potential advantages for important research seeking new treatment and a possible cure. We have already heard from the noble Lord, Lord Walton of Detchant, what he thinks could be done and why it needs to be done. Of course, I defer to him.

As one of three judges in the Court of Appeal, I heard a number of these cases, and each story was tragic. Although I was a judge for 35 years, these stories have remained with me. We know that currently there is no cure. We know that currently the treatment is poor compared with that for other forms of cancer. It is crucial and urgent that we have proper research. As the noble Lord, Lord Alton of Liverpool, has said, it is a scandal that this is so poorly supported, when it is a killer but other forms of cancer can be treated and people can live for a long time. Sufferers die two years after the diagnosis—it is like motor neurone disease, and even that, as I understand it, gets more research funding than this does. It is extraordinary that the people who suffer from it are not properly regarded by the state or indeed by insurers. It is high time that the lack of financial support should be remedied with this Bill, at least to some extent.

I very much support the principle of the amendment. Like the noble Lord, Lord Walton of Detchant, I do not entirely support the wording. I do not think that matters because we are not going to vote on it today, and if the Government can come up with better wording and be supportive, that is exactly as it should be. The amount of money that would be raised under the present scheme is a modest £1.5 million. It would be much better if the Government felt able to match it; that would be valuable.

I was entertained by the reference by the noble Lord, Lord Alton of Liverpool, to the Gambling Act, which shows a very useful precedent. It is just possible that if some law were passed in this Bill, we could then to go the insurers on a voluntary basis and say, “If you don’t, it will be backed up by primary legislation”. So we want it there as a spur. If that can be done in gambling, I really do not see why it cannot be done in mesothelioma.