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Thursday, 8 March 1928

Mr LAZZARINI (WERRIWA, NEW SOUTH WALES) - Is that not stretching the position?

Sir NEVILLE HOWSE - It is not. I have not all the statistics with me, but it is a fact that in Australia tubercular infection occurs at a later period in life than in many other countries. Those who contract the disease between 60 mid 70 years of age contribute 12 per cent., or one-eighth of the total deaths from tuberculosis, while those who contract it between 70 and 80 years contribute 3 per cent. Altogether one-third of the total deaths from tuberculosis take place after the age of 50 years. These figures aPPly to our male population. In such cases there has often been a period of 30, 40, or 50 years without a day of illness. I have observed it in my own experience while a medical practitioner in Orange. I have seen men develop tuberculosis at the age of 50, 60, or 70 years without there being any possible reason to explain it. These facts are interesting, because they bear a close relation to the subject we are discussing. I should say that a sea voyage and camp training would be of distinct benefit to the men, and tend to prevent them from developing tuberculosis at a later period. I can sympathize with the tubercular men. Honorable members opposite are not alone in sympathizing with these men, and they have no right to claim that they are. Everybody has the same sympathy, and our sympathy is not reserved for the tubercular men only. I protest very strongly against this differentiation between one particular class of disease and the others. Successive governments, in their wisdom, have shown very clearly that they have practical sympathy with tubercular men. Every ex-soldier suffering from tuberculosis, accepted as being due to war service, receives a special pension of £4 a a week, and something extra if he has a wife and children. If he is able to engage in suitable employment, he may be paid less, but the pension is never below £2 2s. In 1926 the Government decided, as evidence of its sympathy, that a pension of £2 2s. a week should be paid to all ex-soldiers proved to be suffering from tuberculosis, and it was made retrospective to July, 1925. This means that an ex-soldier with a wife and three children on the 1st July, 1925, who is suffering from tuberculosis, receives a pension of £4 5s. a week irrespective of his earning capacity, or of his subsequent improvement. A certain amount of trouble has arisen in regard to this pension, and honorable members have asked me, both verbally and by a letter, why claims have not been proved. There has been much difficulty, however, over some of the cases. Many were diagnosed as tubercular, or treated for tubercular symptoms when in the forces, or by the Repatriation Department subsequent to discharge, and they demand that they should now be granted the pension of £2 2s. a week. That was never the intention of the Government. I have a very clear recollection of this discussion of the matter in Cabinet, and drafted the minute on which the present practice is based, and I remember that it had to be proved that there was tuberculosis present subsequent to the date specified.

Mr Coleman - A man might have had it before, and have been cured.

Sir NEVILLE HOWSE - That is possible. This led to a great number of claims, and most of them have been met. I have been asked by honorable members whether I could do anything to hasten proof of tuberculosis, and I have promised to-day to make some effort to hasten, if possible, a decision as to whether claimants are suffering from tuberculosis. There is difficulty, however, in coming to a definite decision. While at Orange, which is a health resort to which many people come, I was, during my twenty years' practice, frequently made conscious of the difficulty of coming to such a decision. Sometimes it was not possible to say definitely for one, two or even five years whether or not a person was suffering from tuberculosis. It is quite easy to prove a definite, straightforward case, but even when you have clinical indications such as a slight flattening below the collar bone, a slight cough, or a small loss of weight, it is sometimes difficult to prove the presence of the disease within three or four years. These claimants are not suffering any disability during the time their cases are pending, because they receive a pension and treatment if their condition is accepted as due to war service. They are not proved tubercular cases, and therefore cannot be awarded a permanent pension. If they got their £2 2s. a week for life, they might consider themselves happy. I know that I should have been in my early life.

Mr Lazzarini - Is that not rather callous ?

Sir NEVILLE HOWSE - The honorable member may be quite sure that I shall not say anything unjust against . my comrades, and they are my comrades, and not his. There is not a man in this House who can say that I have not lived with them, defended them, and given them a . fair deal. Definite instructions have been given by the Repatriation Commission regarding the proving of tuberculosis. The document containing these instructions goes very fully into the position, and I ask leave of the House that this statement be incorported in Hansard. The Commission's instructions are as follow: -

1.   As advised in the AllStates memorandumG.25/4588, dated 4th September, 1925, it is necessary (in consequence of the Cabinet's decision) to amend ruling 23 in such a way as to provide for the payment of a permanent pension of £2 2s. per week to ex-soldiers proved to be suffering from pulmonary tuberculosis as a result of war service. The Commission has, therefore, decided that ruling 23 shall be amended by adding to paragraph 5 thereof the following provision which will operate as from the 1st July, 1925:-

Notwithstanding the foregoing provision in this paragraph a permanent pension of not less than £2 2s. per week will be paid to all ex-members of the Forces proved to be suffering from pulmonary tuberculosis on or subsequent to the 1st July, 1925, as a result of war service, or as a result of a pre-existing condition having been materially aggravated by war service. These pensioners are to be medically examined periodically in order that they may be advised as to their condition, and for re-assessment of pension where necessary, provided that the pensions in such cases must not be reduced below £2 2s. per week.

2.   It will be noted that this provision does not apply in cases of "non-material aggravation." This is in accord with the principle already followed in connexion with cases dealt with under the 1921 amendment to the act (vide ruling 29). As indicated above, this amendment to ruling 23 will apply only to cases which on or subsequent to 1st July, 1925, where definitely proved to be suffering from pulmonary tuberculosis. This permanent pension cannot be paid in cases in which the tuberculosis has been recorded through an error in diagnosis 'or in cases in which pulmonary tuberculosis has been " cured," and in which, therefore, the soldier cannot be proved to be suffering from it on or since the date mentioned.

The Commission considers that nearly all ex-soldier patients, who have completed sanatorium; treatment and are on Second Schedule pension for pulmonary tuberculosis, will be found to be suffering from proved pulmonary tuberculosis. In a small number of cases the Second Schedule pension may have been granted without the Medical Superintendent of the sanatorium and the Departmental Medical Officer or T.B. Consultant being satisfied that pulmonary tuberculosis actually existed, i.e., that the pulmonary tuberculosis cannot be considered proved. Those few cases should be reinvestigated according to the standard of investigation set out in this memorandum.

4.   Every case now under consideration, or yet to be decided, must be "proved" or otherwise on or subsequent to the 1st July, 1925,' in accordance with the tests laid down in this circular letter. (N.B. This circular letter, being an alteration of others issued many months ago, it is necessary to point out that, where proof as laid down has already been established on or subsequent to 1st July, 1925, there is no necessity to submit the member to the test again.) Evidence on the ex-soldier's file prior to the 1st July, 1925, cannot, in accordance with the strict interpretation of Cabinet decision, be accepted as showing that the soldier was suffering from " proved " pulmonary tuberculosis. It is necessary, therefore, to apply the same standard of proof to all tubercular cases, and a very thorough examination should be made as indicated above.

5.   In establishing proof of diagnosis, it is recognized that the presence of tubercle bacilli in the sputum of an individual is of radical significance; however, the presence of tubercle bacilli in the sputum is not essential to establish proof. In the absence of this conclusive bacteriological proof, the disease is to be recognized by an association of signs and symptoms.

6.   In order that these signs and symptoms may be clearly and completely ascertained, it is desired that each case be investigated on the following lines: -

(i)   Brief clinical history (including all post-war illnesses, mode of life, habits, occupation).

(ii)   Signs and symptoms -

(a)   Cough,

(   b )Expectoration,

(c)   Night sweats,.

(d)   Temperature variation - daily,

(e)   Temperature response to exercise,

(f)   Effort responsive to exercise,

(g)   Pulse variation,

(h)   Response to diagnostics tuberculin (to be used with great discrimination) and focal as well as constitutional re-action noted. This test is not of paramount importance,

(i)   Mental depression,

(j)   Appearance suggesting toxemia,

(k)   Sleep,

(l)   Weight (coat and vest off).

State recent variations, if any.

(iii)   Sputum tests. Nature and number of tests to be stated. Repeated bacteriological examination to be made, and concentration method is to be used where necessary. Animal injection (guinea pig) in cases of pleurisy with effusion.

(iv)   Inspection. Local evidence from physical examination.

(v)   X-ray report - routine procedure.

(   1 ) Screen examination - to investigate -

(a)   Movements of diaphragm,

(b)   Normal clearness or otherwise of bases, presence of pleuritic adhesions (coatophrenic symphysis ) , fluid, &c,

(c)   Presence and distribution of gross densities,

(d)   Appearance of heart aid aorta.

(2)   Transverse 10 x 12 film of upper half of thorax includes essential parts if pluoroscopy shows any basal abnormality an additional 10 x 12 film should be taken at upper border of clavicle on affected side.

The order of description and type of report that is desired is set out in. tabulated form and attached herewith,

(vi)   Summary and diagnosis: (Consultant opinion to be obtained if required). It is especially desired that ambiguity should be avoided in recording dates or periods as well as in stating causation of unemployment, absence from work, and of medical attendance.

7.   On completion of tests prescribed, results of same are to be endorsed by the Departmental Medical Officer with his opinion as to whether the case should now be admitted as one of proved T.B. or not.

8.   ' Files are then to be submitted to the Board for. their recommendation to the Commission where acceptance is indicated; if, however, the Board considers the case should be rejected as not being one of proved tuberculosis, the file will only be submitted to the Commission if an appeal is lodged.

9.   It should be noted that all such cases will be re-assessed on application by the pensioner; otherwise, as the case comes up in ordinary course for review, or earlier if the case comes under notice for some other reason.

10.   All new applications for pension on account of pulmonary tuberculosis,- where no pension is now being paid for that disability, are to be investigated in accordance with the foregoing and submitted to the Commission with full reports, &c. In these cases, the pensions (if granted) will, of course, be paid, not from the 1st July, 1925, but from date of application, with six months' arrears (at a rate to be assessed) where the Commission considers the circumstances justify such a course.

11.   Circular letters 535 and 539 are hereby cancelled, but cases already determined under those circular letters will not be affected.

I shall have no hesitation whatever in explaining to honorable members anything which they may wish to know regarding the administration of the Repatriation Department. Every man who applies for a tubercular pension goes through a certain and specific course, and the system followed ought, I think, to be placed on record. This is what happens to the applicant -

The ex-soldier's attestation paper, military record in detail and all medical reports and medical board papers are obtained, together with a statement from the man himself, giving his reasons for attributing his condition to war service, particulars of employment, medical and hospital treatment subsequent to discharge, also names and addresses of employees, friends, &c, who might be in a position to give information in support of his claim. The Repatriation Commission at its own expense obtains statements from friends, employees, &c, and clinical notes from medical men and hospitals. The ex-soldier himself is medically examined, and when considered necessary is admitted, to a Repatriation Hospital for investigation. All the evidence obtained is reviewed by medical officers, particular attention being given to the nature and extent of service, his illnesses, wounds, and the probability of gassing. The opinions of specialists are obtained where it is thought advisable. The case is then reviewed by the branch office concerned, and forwarded to the headquarters in Melbourne for determination. If considered necessary at repatriation headquarters, the case is placed before the medical advisory committee, consisting of four eminent independent specialists with wide experience both on active service and in civil practice.

Where a reasonable doubt exists, the benefit of it is always given to the claimant. The honorable member for Reid (Mr. Coleman) is perhaps waiting to ask why applicants are not personally examined. There could be no possible advantage in such an examination. I have perused hundreds of files in the Repatriation Department, and I accept without hesitatation the statements on them as to the presence of the disease. I could not do more, even if I examined the men personally. There can be no question about the case that the honorable member for Ballarat submitted to the House. The man is undoubtedly suffering from tuberculosis.

Mr Coleman - The trouble is that doctors differ. One doctor may find that an applicant is suffering as the result of his war service, while two others may decide differently.

Sir NEVILLE HOWSE - That is not the result of the examination, but of the disease. The investigation facilities available in the Repatriation Hospital are complete in every detail. They include X-ray apparatus which permits of both screening and skiagraphic examinations, observation by trained and experienced nurses and doctors, and also such laboratory tests as are likely to reveal the true pathological condition of the patients. The investigation is conducted on routine lines, and its thoroughness is unexcelled. The practice is to ascertain the condition of all tracts, digestive, urinary, &c, even though the patient may complain only of his respiratory system. Whilst this practice takes time, it ensures that every possible opportunity and assistance is given to the ex-soldier to further his claim. As soon as an application is lodged, every official of the department recognizes that it is 'his duty to endeavour to connect the ex-soldier's disability with war service. No expense is spared, and nothing is considered too great a trouble in searching for evidence to substantiate a claim. I assure honorable members that ever since 1 accepted control of the department, in 1§25, I have endeavoured in every possible way to connect every ex-soldier applicant's disability with his war service. I believe that I can honestly say that that is also true of every person on the staff. I am not able to answer for what occurred previously.

It is important that honorable members should realize that, while in Australia we accept gassing as being responsible in a degree for the physical condition of our ex-service men, that is not done in any other country in the world. The British Ministry of Pensions appointed its consulting physician as a commission to study the effect of gassing upon ex-service men, At the same time a scientific research was being conducted into the subject in Germany, France, and I think, Austria. But in not one of those countries is it considered to-day, in the light of the reports that were submitted, that gassing is an important factor in connexion with any post-war disease. The following statement was made on the matter by the consulting physician of the British Ministry of Pensions -

As regards the question of the relation of T.B. to gassing, my experience concurs closely with those published in France by Archard, and by other observers, such as Hunt and Price Jones in England, that there is only a slight connexion between the two conditions. In only about 1 to 5 per cent, of cases that have been gassed, has T.B. subsequently been noted.

This Government has shown the greatest sympathy with; and has tried ia every conceivable way to provide pension benefits for ex-service men. In Australia, cases of tuberculosis that are now coming under observation are accepted as having been caused by war service, if any illness or condition occurred during active service that could possibly be regarded as factors in its causation. For instance, in cases where men on service contractedpneumonia or pleurisy, and afterwards developed consumption, no question is raised as to whether the tubercular condition arose during war service. The concrete case mentioned illustrates the view that the department takes. For four years after his return to Australia a man has suffered from no illness. He then develops an attack of pleurisy and pneumonia. Two years afterwards he develops consumption. It can not be said that his tubercular condition was the effect of war service. Exservice men who contract pleurisy and pneumonia two, three or four years after their return from abroad, and later show indications of tuberculosis, are in the same position.

On the 30th June, 1927, the number of ex-soldiers in receipt of pensions on account of tuberculosis was 2,675. The honorable member for Ballarat said something about men receiving a pension of 7s. 6d., or 5s. per week. I gathered from the expressions of sympathy which his remark caused, that some honorable members are under the impression that such a pension was being paid because of some tubercular infection. That is not the case. Many men during their active service fractured an ankle or broke a small bone in their arm or leg, and were treated for the casualty. Quite often those injuries were not the result of gunshot wounds. At the time the men were injured they were granted the full pension. After a period, the amount paid to them was reduced. Other reductions followed, until the pension amounted to only 7s. 6d. or 5s. a week. Men in civil occupations frequently fracture an ankle or a small bone, but within a few months are back at Work. Such accidents are quite common on the football field, and the sufferers recover so quickly that sometimes they are able to resume football during the same season, and no practical . disability is felt by them. Of the 2,675 tubercular men who receive a pension, 1,047 are in receipt of £8 per fortnight, 322 £5 per fortnight, and 1,306 less than £5 per fortnight. That is their personal pension, and does not take into account any amount that may be paid to their dependants.

Mr McGrath - Do the men who receive less than £5 per fortnight do any work ?

Sir NEVILLE HOWSE - I sincerely hope so. I trust that many of them are generally recovering their health and strength. During the last twenty years the Australian, death rate from tuberculosis has improved by 55. I trust that many of my former comrades-in-arms are among the cases which have shown improvement. In the year ended 30th June, 1924, that is, six years subsequent to the cessation of hostilities, 281 cases of tuberculosis were accepted as due to war service. New cases are occurring every day. Whenever a new claim for a pension is submitted, every effort is made to investigate the cause of the applicant's condition in the hope that some evidence may be found to justify its connexion with his war service. I estimate that out of every five claims received, only one is rejected. That also is surely evidence of the sympathetic treatment which the Government is giving to all applicants.

It is generally recognized to-day that the claims being received from ex-soldiers present, almost without exception, purely medical problems. In the examination that

I have made of hundreds of departmental files I have tried without exception to find some evidence that the applicant's condition is due to a disability, which he suffered while on active service. I was glad to hear the honorable member for Ballarat (Mr. McGrath), and the honorable member for Adelaide (Mr. Yates) admit that an effort was being made to assist all applicants. During the last three years I have given up the bulk of my time as Minister of the Crown to a personal investigation of these cases. In this circumstance, what practical purpose could an appeal court serve? It could not possibly give to applicants the consideration that they receive under the present arrangement. It would have to keep strictly within the four corners of the legislation under which it was appointed, and I am quite convinced that it would not be able to bring to light a single fact which is not revealed by the present investigation. I have not the power to grant pensions. It is fortunate that I have not. ' I trust that no Minister in charge of Repatriation will ever have that power.

Mr McGrath - The Minister has considerable persuasive power.

Sir NEVILLE HOWSE - That may be so. I respectfully suggest to the honorable member for Adelaide that if he wishes to serve the best interests of our comrades, it would be advisable for him to seek leave to withdraw the motion. The payment of war pensions has never been, is not now, and never should, become a party question. It has been said that I was an onlooker at the war for four or five years, that I was never in any danger - I am thankful to say that I was not - and that I was happily safe while other men were going to their death every day-

Mr Yates - I did not suggest that.

Sir NEVILLE HOWSE - It has been suggested. I ask honorable members to keep this subject out of the hurly-burly of party politics. Every politician should do his utmost to this end.

Mr Yates - I hope that the Minister is not suggesting that I have introduced this motion to gain an advantage for my party. Nothing is further from my mind. I feel very strongly that many of the promises that were made to the men who enlisted and to their dependants are not being honored.

Sir NEVILLE HOWSE - Let us restate the promises that were made. We assured the men who enlisted' that they would be given fair treatment while they were on active service. That was surely done. We promised them that they would be provided with medical attendance at least the equal of that which they could receive in civil life. That promise "was undoubtedly fulfilled, for with very few exceptions the ablest medical practitioners in Australia volunteered for service abroad. No civilian who remained in Australia during the war years was able to obtain such expert medical attention as the soldiers who went overseas. Those who enlisted were also promised that if they suffered from any disability in consequence of their war service, or if any disability was aggravated by such service, they would receive compensation. I believe that that promise is being fulfilled. If I were not permitted to do my best to honour it I would not continue to administer this department for another day. I propose for the whole time that I remain in charge of the department to carry out the policy which is at present in operation. I shall personally examine, with the same meticulous care that I have exercised in the past, all claims submitted to me. I shall spare no effort to give every applicant a fair deal. It may fairly be said that there is a good deal of truth in the statement that was published a day or so ago th/it, at least, since 1925, all applicants for pensions have received scrupulously fair and even generous treatment. In making that statement I do not reflect in any way upon the administration of the Repatriation Commission. It was charged with the administration of a certain act of Parliament, and I believe that it administered it faithfully. It is probable that since I have been in charge of the department I have stretched the provisions of the law, but I have always been guided by the principle that every applicant must be able to show that his disability was either caused or aggravated by his war service. Let us look for a moment at the manner in which our pensions bill has grown. In 1925 it totalled £7,146,000. In 1926 it was £7,347,246, an increase of £200,382. The increase in 1927 was £211,313. It is estimated that in 1928 the minimum increase will be £135,441. The total increase during the period 1925 to 1928 will therefore be not less than £547,136. Notwithstanding the deaths of pensioners, of which there were 2,391 last year, the re-marriages of widows, and the adolescence of soldiers' children, the pension bill has increased since 1925 by £547,136. If the administration had not been sympathetic the payments would have decreased instead of increased. The number of pensions in force at the 30th June las; showed an increase of nearly 10,000 over the figures for 30th June, 1926.

Mr MCGRATH - How many were for women and children?

Sir NEVILLE HOWSE - A great many, of course. I hope for' the sake of the country that Jill the widows will marry and have children. The desire of the Government -is to continue to administer the Repatriation Act liberally, and I feel certain that the cost of pensions will increase each year until either 1930 or 1931, when I estimate that it will reach its peak.

While speaking on the subject of war pensions, I wish to acknowledge the great assistance given to me by the Repatriation Commissioners and their officers, who have loyally supported my efforts to give to the soldiers all that they were entitled to. I thank, also, honorable membei'3 on both sides of the House who have repeatedly brought to my knowledge information which I have been able to convey to the department, the Returned Soldiers' and Sailors' Imperial League, which has been able to afford me most valuable help, and many men and women all over Australia who have written to me and brought under my notice the circumstances of soldiers who, in their opinion, were not getting a fair deal. I have in mind a specific Queensland case which was recently dealt with. For years a man who was suffering from tuberculosis had been refused a pension. The league was able to supply to me much information which that claimant had not divulged, and which was a very important factor in ultimately getting for him a full pension.

It must be clear to every honorable member that if this motion is carried it will be necessary to enact that all claims shall receive similar consideration. That cannot be given under the Repatriation Act,, which is governed by the vital condition that disability must be due to war service. I suggest to the honorable members for Adelaide and Ballarat that they have tackled a most difficult problem without giving it full consideration. The proposal now before us is Utopian; first, because it could not be carried into effect without a grave injustice to those suffering from other malignant diseases, such as Bright's disease, cancel-, and rheumatoid arthritis, and, secondly, because it is impracticable. The " expenditure upon pensions in 1927 was £7,558,559, and the estimate for 1928 is £7,694,000. If this motion were agreed to, I estimate that the pensions bill would be increased by £5,000,000 in the first year, and the increase would be progressive until it reached between £10,000,000 and £15,000,000 a year.

Mr Lazzarini - That would not be the actual increase.

Sir NEVILLE HOWSE - That, is an estimate of the increase if this motion were adopted and pursued to its logical conclusion. I remind the House that the honorable member for Adelaide said on the 25th February, 1926-

I would be disposed, if I were dictator in this country, to rule that all chronic illhealth suffered by ex-soldiers should be set down as having been caused by their strenuous war service.

Obviously, it would be grossly unfair, and, indeed, dishonest, to single out tubercular cases for special treatment, and to leave sufferers from other malignant diseases subject to the limitations of the existing act. The logical consequence of carrying this motion would be that every one of us who has seen active service would be drawing a pension before, we died ; certainly, every .one of us who is within hail of the palsied seventies would become a pensioner.

Dr MALONEY (MELBOURNE, VICTORIA) - Persons are entitled to a pension before arriving at that age.

Sir NEVILLE HOWSE - Yes, but not under the Repatriation Act, which allows a pension only in respect of a disability due to war service. The intention of the Government is to faithfully carry out the desire of every honorable member, and, I believe, of every person in Australia, that full consideration should be given to each application, and every effort be made to connect the disability with war service. I can say truthfully that I have never approached this problem halfheartedly, but have at all times had a sense of my responsibility as Minister in charge of Repatriation, and a clear recognition of the duty of the Government.

Mr RODGERS (WANNON, VICTORIA) - What is the procedure in connexion with " arrested " cases - cases in which the disease has been arrested through the soldier receiving the full pension and he has been able to return to work which, in conjunction with his fear of the disease, has again undermined his health?

Sir NEVILLE HOWSE - -If his disability is proved, he receives a pension of £2 2s. a week for life. If he is able to earn anything in addition, so much the better. I have heard of very many pensioners who were drawing £2 2s. per week for life, and were in good light employment. There is no reason why such a pensioner should not earn a reasonable income at light work.

There are very many cases resembling closely the one mentioned by the honorable member for Ballarat. Only last week a very interesting one was brought to my notice by the Leader of the Opposition (Mr. Charlton), who was able to assure me of his personal knowledge, that the applicant had been a sufferer for some years without having made any complaint or application for assistance. I carefully investigated the case. This man enlisted in 1916 at the age of eighteen, and did good service until he was wounded on the 1st September, 1918. and evacuated to England. His wounds were not serious, and seven weeks later they had healed, and he was discharged from hospital. On the 6th December, 191S, he was examined by a Medical Board, and declared fit for general service. He returned to Australia, and was examined by a Medical Board in Sydney, which reported him to be in perfect health. He was accordingly discharged on the 4th April, 1919. Later, he developed a cough and other symptoms, and, in an application for a pension in September of last year, he stated that he was unable to work owing to war injuries' and the effects of gas.- He was admitted to hospital and found to be suffering from pulmonary tuberculosis, but in the absence of a continuous history of illhealth since his discharge, it was considered that there were no reasonable grounds for accepting his ailment as. due to war service. However, the Leader of the Opposition was able to help me by his personal knowledge of the applicant, and ultimately the disability was certified as due to war service, and the man is now receiving a full pension.

The case mentioned by the honorable member for Ballarat is a very unfortunate one. This man enlisted in the 7th Battalion in 1916, and went overseas late in the same year. He served in the field for about twelve months, and when route marching in Prance slipped and fractured a small bone in his leg. He wap 'ti hospital for some time, and drew a full pension, which, as a result of medical examination, was subsequently reduced to one-fifth. On the 23rd November, 1925, he was medically examined for pension purposes, and his heart and lungs were found to be clear. His incapacity in respect of the ankle injury was assessed at one-eighth, and to that rate the pension was reduced as from the 10th December, 1925. On the 28th June, 1926, he appealed for a higher rate, on the ground that he was suffering from chest trouble. That was the first occasion on which he had mentioned chest trouble, although he had been repeatedly examined.

Mr McGrath - Is the Minister certain that the doctors examined his chest when they were examining his ankle?

Sir NEVILLE HOWSE - I am not. and I do not say that they did; but an entry appears on the file that his heart and lungs were found to be clear. In June he was examined by the local medical officer at Clunes. In addition to the ankle injury, he complained of loss of weight, anorexia, insomnia, and night sweats. The local medical officer, after examination, recommended his admission to the Caulfield Repatriation Hospital for investigation of the chest condition. He was accordingly admitted to Caulfield on the 20th July, 1926, and was found to be suffering from pulmonary tuberculosis. The fullest inquiries were made to discover whether this disability was related in any way to war service. In view, however, of the replies received, and the medical opinion, the commission on the 8th September, 1926, refused to accept responsibility. As the chest condition could' not be accepted under the act- as due. to service, the pension could not be increased. In October, 1926, an appeal was lodged in which Collins claimed that he had been gassed, and that he had suffered from a cough since 1917. He alleged that the cough very slowly got worse, and that about October, 1925, the worst symptoms developed. The case was reviewed, and the principal medical officer minuted the files as follows : -

In view of his medical reviews since discharge, it seems to be unreasonable to attribute his present disability to service.

In view of that report, the appeal was disallowed on the 22nd December, 1926. In the following March, the honorable member for Ballarat (Mr. McGrath) made representations to the Treasurer, and the case was referred to the Medical Advisory Committee, whose finding was -

As there was evidence that general health was good until 1925, the medical advisory committee did not consider it reasonable to attribute proved pulmonary tuberculosis as being duo to war service^ and resolved to recommend rejection of the claim.

On the 18th July last, the honorable member wrote to me to ask if anything could be done for this man, and stated, "I feel so strongly on this case that I have instructed Mr. Lazarus to issue a writ on the department, and I think this has been done." The result of the honorable member's action was that on the 12th July the Crown Solicitor advised the department that a writ had been received. On the 2nd August, 1927, I advised Mr. McGrath of the whole position, and pointed out that as the matter was before the Crown Solicitor, I was unable to personally go through the relative files, but as soon as the legal position permitted I would again go into the matter. On 11th January, 1928, Mr. McGrath forwarded two letters from Collins' comrades in support of the statement that he had been gassed. In view of this, the files were obtained from the Crown Solicitor, and the case re-submitted to the medical advisory committee on the 14th January, 1928. The medical advisory committee did not dispute the statement that Collins was gassed, but did not consider that gas was the cause of his tuberculosis, which was considered to be an acute condition. The committee did not see any reason to alter its previous recommendation. On 17th January, 1927, Mr. McGrath was accordingly advised, and that the .commission was unable to vary the previous decision. Notwithstanding all this, the legal action was persisted in, and the case was heard in the Supreme Court at Ballarat before His Honour Mr.. Justice Wasley. Mr. Justice Wasley stated that, apart from any other consideration, he was not satisfied ou the evidence that the plaintiff had shown that his incapacity was due to war service, and he accordingly entered judgment for the defendants, with costs, including pendings. The commission, however, in view of all the circumstances, decided not to press for recovery of costs. That is a perfectly clear and concise account' of the circumstances of the case, and it demonstrates that the man concerned is not entitled to a pension under the Australian Soldiers' Repatriation Act. The law contains a definite and fixed principle, which must be embodied in every act inthe world relating to war pensions. There is no need for me to . consult my honoured and learned colleague respecting the provisions of an act. All that would be required to give effect to the motion now before the House would be proof of embarkation and disability. There is no difficulty about proof of disability. I do not suppose that there is one honorable member in this chamber who has not some disability, and if he has not, I am perfectly certain that he imagines he has. A disability in a tremendous source of comfort to mankind. Sir John Lubbock once said that if we take away all real or imaginary ailments from the human being, we deprive him of 95 per cent, of his pleasures, and I, as a member of the medical profession, should be the last to wish to do that. I appeal to honorable members to consider the motion with an unbiased view. I understand that the honorable member for Ballarat (Mr. McGrath) purposes taking drastic action.

Mr McGrath - The Leader of the Opposition (Mr. Charlton) in one case submitted the evidence of people who for some years had known the returned soldier concerned. Would the Minister reconsider the case of Collins if 1 obtain similar evidence?

Sir NEVILLE HOWSE - Why has not the honorable member obtained it before?

Mr McGrath - The Minister was away at the time.

Sir NEVILLE HOWSE - I have been back in Australia for some considerable time. Although the Leader of the Opposition was successful in his appeal in one case, he has not been so successful in others. He has brought innumerable cases under my notice, and in many instances has received a reply similar to that which .the honorable member for Ballarat said at one time was extremely courteous but did not supply any food. I regret very much that I have had to go into these details, but I trust that I have explained the position to the satisfaction, at all events, of our soldiers, my comrades, and the Government which I represent. In the interests of those whom we are anxious to serve I appeal to the honorable member for Adelaide to withdraw his motion.

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