The Battle Against Asbestos Related Diseases Such As Mesothelioma – which will kill another 60,000 British people Unless We Find A Cure – Raised In Parliament Thursday February 14th 2019.
Lord Alton of Liverpool (CB)
My Lords, if the noble Baroness, Lady Donaghy, does not mind, I would rather change the metaphor and say that I am very pleased to be part of the infantry; on this issue she is a very good general.
The noble Baroness, Lady Thomas of Winchester, made her case admirably, too and I am grateful to the Minister for the way in which she introduced the orders.
I return to an issue that I have raised often in your Lordships House: the harrowing and lethal effects of mesothelioma, something which unites all of us in all parts of the House.
Many of us in the Chamber today have been involved in the fight against mesothelioma for many years and I am pleased to see this important issue again being debated in your Lordships’ House.
I wholeheartedly support the uprating of the lump sum payments in line with inflation. It is a matter of compassion, of justice—I will return to that issue—and of equalisation.
In that last respect, I was disappointed by one thing that the Minister said, although I rather anticipated that she would say it—I shall return to that matter, too.
As the Minister told us, mesothelioma is an invasive type of cancer caused by prior exposure to asbestos.
It grows in the pleural membrane, which 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 heart. There is currently no cure and mesothelioma patients often have a short life expectancy and experience complex, debilitating symptoms.
I vividly remember when I was a Member of House of Commons, representing an inner-city area of Liverpool, constituents coming to see me once there had been a diagnosis and then meeting the widow only weeks later, their loved one having died.
The UK has the highest rate of the disease in the world. Mortality rates have more than quadrupled over the past 30 years. It is estimated that around 2,400 people die of the disease every year and that, over the next 30 years, around 60,000 people will die of mesothelioma in the United Kingdom unless new treatments are found.
When these regulations were discussed in the other place, a number of Members of the House of Commons asked whether future increases could be made automatic rather than be made at the discretion of Parliament.
The Minister there agreed to consider this.
It is important that the Government carefully consider the argument. Has any consideration been given since the Commons stages about making the payments automatic? It is vital that we continue to support people and their families affected by these awful diseases.
Back in 2014 I tabled an amendment to the Mesothelioma Bill, and in 2015 I introduced a Private Member’s Bill which would have set up a small levy on participating insurance firms to help secure long-term funding for research into mesothelioma, an issue on which the noble Lords, Lord Wills and Lord Giddens, played an important part.
At the time, it was estimated that 150 insurance firms were active in the employers’ liability insurance market, and this had the potential to raise around £1.5 million a year for research.
This represented a very small amount of money to each of the insurance companies, but would have resulted in a great number of research opportunities. It would also have given great hope to people living with mesothelioma and to their families.
Unfortunately, the amendment and the Bill were defeated.
Since then, the Government have allocated £5 million for a National Centre for Mesothelioma Research at Imperial College, and I thank Ministers who put in considerable effort to secure that and to look at voluntary funding from the insurance industry.
I am very pleased that the British Lung Foundation, referred to by the noble Baroness, Lady Buscombe, was also able to secure match funding for this £5 million from a philanthropist who has seen the devastation wreaked by this disease.
Unfortunately, although several individual insurance companies, including Aviva, Zurich, RSA and Allianz, had also, to their credit, previously contributed towards research into mesothelioma, negotiations for a broader, long-term funding commitment from the insurance industry came to a standstill.
More recently, there have been some impressive results in mesothelioma research, which demonstrates why it is important for us to find more funding.
Through the match funding, the BLF set up the Mesothelioma Research Network to bring researchers together to share ideas and support each other’s research. Our understanding of the genetics of mesothelioma has increased at the same time as a breakthrough in harnessing the immune system against cancer, and a clinical trial, the first of its type, has just opened in Leicester.
Another BLF-funded project is currently looking at ways to treat mesothelioma with immunotherapy.
The creation of the MesobanK project now allows researchers across the world to access tissue and blood samples and other clinical data. The first MesobanK-British Lung Foundation fellowship is helping to develop gold nanotubes as potential new mesothelioma therapies. The British Lung Foundation continues to raise awareness of occupational lung disease, most recently through the creation of the Taskforce for Lung Health.
The task force is a coalition of 30 organisations from across the lung health sector, including royal colleges, patients and the Health and Safety Executive, who came together to develop a five-year national plan to improve lung health in England. It makes recommendations to improve awareness of and compliance with the Control of Substances Hazardous to Health Regulations 2002 and to embed understanding of occupational lung disease in healthcare professional training.
Because this field is so underfunded, every pound of investment is likely to be worth while and to attract further funding.
I pay particular tribute to Penny Woods and the British Lung Foundation, which continues its work to secure that funding for vital mesothelioma research. It has recently been able to leverage further research through the success of previous projects, helping to secure a £10 million grant from the Engineering and Physical Sciences Research Council.
While I fully support compensation for the victims of these diseases, it is surely in everyone’s interest—the victims, the Government and insurers—to invest in finding a cure. This would, in the long term, remove the need for lump sum payments or any insurance industry levies. Investment in research is crucial.
On the subject of lump sum payments, as the noble Baroness told us, two statutory schemes make payments to mesothelioma sufferers, both of which make payments according to the age of the sufferer and their level of disablement.
Both make payments either to mesothelioma sufferers who claim a payment in life—so-called in-life claims—or to their dependants where a claim is made after death. These are so-called dependency claims.
However, there is significant inequality between dependency and in-life payments.
From April 2019, the maximum in-life payment for a sufferer aged 77 is £14,334 and for a sufferer aged 37 is £92,259. From the same date, the maximum dependency payment for a sufferer aged 77 is £7,949 and £48,013 for a sufferer aged 37. Dependency payments are 45% less for a sufferer aged 77 and 48% less for a sufferer aged 37.
The disparity between payments is partly the result of the difference in assessment of disablement and age of the sufferer. In-life payments under the 1979 Act are assessed at a maximum of 100% disablement. Dependency payments are assessed at 50% or over. In-life payments under the 1979 Act are paid on a rising scale up to the age of 77 and over. Dependency payments are paid on a rising scale up to the age of 67 and over.
Most dependency payments are made to women—widows of mesothelioma sufferers who are doubly disadvantaged by low dependency payments. As the average age of sufferers is approximately 77, many widows, who traditionally may not have a full record of employment, may have very poor pensions, a point alluded to in our discussions on the earlier orders.
Personal injury compensation payments to dependants are higher than compensation payments to sufferers paid in life.
The law recognises the financial loss incurred by widows of mesothelioma sufferers. The number of dependency claims compared to in-life claims is very small. In 2017 under the 2008 Act, there were 20 dependency payments and 370 in-life payments. In that year, under the 1979 Act, there were 240 dependency payments and 2,770 in-life payments. As a percentage of total payments, dependency payments make up 8.2%. In 2017, the Asbestos Victims Support Groups Forum estimated that the percentage was approximately 10%.
One reason for the decline in dependency payments is the success of the Employers’ Liability Tracing Office in identifying employers’ liability insurance. This has resulted in an increase in the amount of benefit and lump sum payments recovered by the Government. In 2017, the Asbestos Victims Support Groups Forum estimated that the cost of equalising payments would be approximately £1.5 million.
In the same year, the Government estimated the cost at £2 million. Yet in 2018, the Government estimated the cost of equalising payments to be £5 million.
Can the Minister explain why this estimate has more than doubled and how that figure of £5 million was reached?
It was in 2010 that the noble Lord, Lord McKenzie, the then Minister, to whom I pay particular tribute, committed the Government to equalising payments and went on to do so.
In that year, he increased dependency payments to commence a gradual process of equalising payments. Nothing has been done since the noble Lord did that back in 2010.
Manifestly, there is an unjustifiable disparity between dependency and in-life payments. The number of dependency payments is a fraction of total payments, just 8.2%. The cost of equalising payments is modest: between £1.5 million and £2 million.
Meanwhile, it is worth noting that the Government have benefited from increased benefits and lump sum recoveries as a result of the stimulus to the Employers’ Liability Tracing Office in finding employment liability insurers once the Diffuse Mesothelioma Payment Scheme made employers’ liability insurers responsible for untraced insurance. Furthermore, the Government have recovered millions in benefits and lump sum recoveries as a result of the Diffuse Mesothelioma Payment Scheme payments which incur such recoveries.
The millions of pounds in recoveries dwarf the modest cost of equalising the payments.
So I welcome the Government’s decision to accept their duty to honour the previous Government’s commitment to equalise payments. However, successive Ministers have excused themselves in the manner of the noble Lord, Lord Henley, who said:
“However, we do not intend to equalise payments this year. Instead, we will continue to keep this matter under review and consider equalisation, once resources allow”.—[Official Report, 28/2/17; col. GC 193.]
Can the Minister, when she comes to reply, tell us when that elusive date might finally be reached?
I have two other brief questions for the Minister, of which I have given her notice.
I sent her an email last night; I hope it arrived.
During the passage of the Mesothelioma Bill, the noble Lord, Lord Freud, gave a commitment to increase DMPS payments in line with CPI. Despite his commitment, this has not been done. Would the Minister explain why the commitment of the noble Lord, Lord Freud, to implement annual CPI increases, at a time when it was already known that the scheme would not make 100% awards, has not been honoured since the establishment of the DMPS?
My final point, alluded to a moment ago by the noble Baroness, Lady Donaghy, is on the position of people in the Armed Forces and those affected at a step’s remove, such as those who might have been washing overalls.
I recall, in some of the debates I referred to earlier, that the noble Lord, Lord McNally, movingly described how his own sister had died through washing her husband’s overalls after he came home from the factory.
The MoD mesothelioma scheme—to which the noble Lord, Lord West of Spithead, also referred in previous debates—pays lump sum compensation in lieu of a war disablement pension to veterans exposed to asbestos while serving in the Armed Forces.
As the noble Baroness, Lady Thomas, said, there has been little research on why these things occur in the Armed Forces.
Why have we not increased payments since the scheme’s inception in 2016?
Do the Government have any plans to increase the level of payments made under the MoD scheme? If not, why not?
Full debate at: