112 THE WORKMEN’S COMPENSATION ACT, 1906.

THE WORKMEN’S COMPENSATION ACT,1906.

THE Workmen’s Compensation Act is here translated intoordinary language; its various parts are brought into con-secutive order, references being given to the clauses, sub-sections, and pages, in order that medical men who have theleisure may refer to the printed Act without much trouble,and those who have not may be placed in possession of itsdetails, so that they may be able to deal with their ownaffairs under the Act, or when asked by patients, as many ofthem will be, to give them information which will be ofservice. A correspondent with intimate knowledge of theActs of 1897 and 1900 has added in brackets commentswhich we think may be of use, but we shall return to theconsideration of the Act in an early issue of THE LANCET.

SHORT TITLE.THE WORKMEN’S COMPENSATION ACT, 1906.

1. (1) (p. 1). A workman suffering personal injury by accidentarising out of and in the course of his employment shall be compen-sated in accordance with the First Schedule o the Act.

First Schedule. 1. (1) (p. 18). If at death the workman leaves de-pendants on his earnings, his employer shall pay a sum equal tothree years wages, or jE150, whichever is the larger, but not exceed-ing in any case ;;12300. If the workman has not been employedfor three years by the employer, then the amount shall becalculated at 156 times his average weekly earnings while he hasbeen employed.

(2) If the dependants are only partially dependent upon the earningsthe amount is to be assessed by agreement or arbitration.

(3) If he leaves no dependants, reasonable expenses of medical attend-ance and burial not exceeding JE10 shall be paid.

1. (1) (b). Where total or partial incapacity results from the injury aweekly payment not exceeding 50 per cent. of the average weekly earn-ings, not to exceed .81 per week, shall be paid.

1. (1) (b) (p. 19). If the workman is under 21 years of age and hisweekly earnings under 20s. he is to receive 100 per cent., instead of50 per cent., of his average weekly earnings, not, however, to exceed10s. per week.

[This latter clause will make an imnzense difference to the rates of,Irnsurance for the cheaper kind of laundry, factory, and domesticlabour.1

First Schedule. 2. (17) (p. 22). After a weekly payment has been con-tinued for not less than six months the employer may redeem thefurther payments by payment of a lump sum based on the cost of animmediate life annuity purchased from the National Debt Commis-sioners, equal to 75 per cent. of the annual value of the weekly pay-ments, but nothing in this section is to prevent mutual agreements tosettle.

[An annuity of 75 per cent. of .P5f! a year in a person of the age of 25would cost aboitt,4C700; this will bring home to el’eryone the importanceof being covered by inszzranee.]Second Schedule. (9) (a), (b), (c), (d), (e). Very stringent rules are

made requiring any settlement whether made by committee, arbitrator,or by agreement to be registered at the county court, and the registrarmay refuse to register, or the judge may within six months remove asettlement from the register, it it is thought that the settlement wasobtained by " fraud or undue influence or other improper means."

[This is most important as it will prevent the sharp and 1tnreasonablesettlements which have been made by tarl inspeetors and unqztalifiedmen, late medical students or ’nnqualified assistants who have beenfreely employed by certainins2tra-tice offices.]

1. (2) (a) (p. 1). The employer shall not be liable in respect of aninjury which does not disable for at least one week.

First Schedule. (a) (p. 19). If the incapacity lasts less than twoweeks no compensation shall be payable in respect of the first week.

[These two clauses are giving !1I’eat anxiety to employers and ’

insurance managers, for it foLLows that in any disability lasting over ’

<t fortnight the workman 1J)llt be able to claim compensation from thedate of the accident and therefore there will be great temptation to ,

magnify slight injuries. If medical men have this clearly before themthey will be chary of giving medical certificates before the expirationof the first fortnight after the accident, especially as this will not in anyway prejudice the workman. for, as ioitL be seen later, a medicalcertificate is not required to be sent with the notice of accident.]

1. (2) (c) (p. 2). A workman cannot claim compensation for injuryif it is attributable to his " serious and wilful misconduct," unless theinjury results in death or serious and permanent’disablement.

[The Act of 1807 made no exception for death or serious injury.](3) Any disputed matters are to be settled as provided in the Second

Schedule, p. 24-namely, by a committee, an arbitrator, or, in absence ofagreement as to these, by a county court judge.Second Schedule. (5) (p. 24). A judge may, it he thinks fit, summon

a medical referee to sit with him as assessor.

[This is an innovation, and if it is acted on will constitute anideal ’method of dealing with disputed claims, as the judge will beable to gi1’e his decision, after heariliq arz ttnbial!sed medical opinionand after being able to ask any questions on the medical points thathe may consider necessary.]

(4) If an action is brought against an employer independently of thisAct and it fails the Court may assess the compensation due underthis Act and deduct therefrom all or part of the cost caused bythe bringing of the abortive action.

2. (1) (p. 2). Notice of the accident must be given "as soon as prac-ticable and before the workman has voluntarily left the employment

in which he was injured and within six months of the accident or dateof death; (a) and (h) (p. 3). however, provide that any defect or in-accuracy in the notice shall not be a bar to the proceedings if theemployer is not thereby prejudiced in his defence, or if a failure tomake a claim was occasioned by mistake, absence from the UnitedKingdom, or other reasonable cause.

2. (2) (p. 3). Notice of accident shall give the name and address of theperson injured and state in ordinary language the cause of the injuryand date of the accident and must be served on the employer bydelivering it at his address or by registered letter.

[The qacestions of schemes of insurance of workmen, stlbcontraeting,and bankruptcy of employers on pages 3, 4, 5. 6, and 7, are omitted asordinary medical men would not be interested.]

7. (1) (p. 7). All members of the crew of any British ship are broughtunder the Act, and it was stated in the House of Commons that thisincludes lasears and other foreign seamen employed.

8. (1) (p. 9). Where a certifying factory surgeon certifies that a work-man is disabled from earning full wages, or is suspended from work orthat his death has been caused by either of the following diseases he orhis dependants shall be entitled to compensation as if the disease was apersonal injury by accident, under, however, certain special regula-tions set forth on pages 9, 10, 11.Third Schedule.-Section 8.

Disease. Description of process.Anthrax. Handling of wool, hair, bristles, hides,

and skins.Lead poisoning or its sequelae. Any process involving the use of lead or

its preparations or compounds.Mercury poisoning or its Any process involving the use of mer-

sequelae. cury or its preparations or compounds.Phosphorus poisoning or its Any process involving the use of phos-

sequelae. phorus or its preparations or com-

pounds.Arsenic poisoning or its Any process involving theuse of-arsenic

sequelae, or its preparations or compounds.Ankylostomiasis. Mining.

8. (6). The Secretary of State may make orders extending the pro-visions of this section to other diseases, or injuries due to the nature ofthe employment not being injuries by accident, with or withoutmodification.

8. (f). An employer or workman aggrieved by the action of a

certifying or other surgeon in giving or refusing a certificate of dis-ablement or in suspending or refusing to suspend a workman for thepurposes of the section, can. under the regulations of the Secretary ofState, have the matter referred to a medical referee whose decisionshall be final.

9. (1) (pp. 12 and 13). The Act is extended to all servants of theCrown, except the naval and military, and the head of any depart-ment is to be deemed the employer.

10. (1) (p. 13). Power to the Secretary of State to appoint legallyqualified practitioners as medical referees, their remuneration to bepaid out of moneys provided by Parliament.The following clause being important to the profession is quoted in

full: " Where a medical referee has been employed as a medical practi-tioner in connexion with any case by or on behalf of an employer orworkman or by insurers interested, he shall not act as medical refereein that case."

First Schedule. 1. (4) (p. 20). Any workman after giving notice ofaccident must submit himself for examination by a duly qualifiedmedical practitioner provided and paid by the employer, if required,but by

(15) (p 21), he shall not be required to submit himself for examina-tion under paragraph (4) or (14) otherwise than in accordance with theregulations of the Secretary of State, or at more frequent intervalsthan may be prescribed in those regulations. When a workman hassubmitted himself to examination by a medical practitioner paid bythe employer or himself, and either has within six days sent a copy ofthe medical report to the other, and in the event of no agreementbeing come to as to the wotkman’s condition " the registrar of a countycourt on the application of both parties may on payment by theapplicants of such fee not exceeding P-1 as may be prescribed, refer thematter to a medical referee." The medical referee’s certificate is to beconclusive evidence as to the matters so certified. If the workmanrefuses to submit himself to the examination of a medical referee, hisright to compensation will be suspended until such examination hastaken place.

(16) Any weekly payment may be reviewed at the request of employeror workman, and increased or diminished in default of agreement byarbitration.

(18) Any workman ceasing to reside in the United Kingdom will notbe entitled to any weekly payment unless a medical referee certifiesthat the incapacity resulting from an injury is likely to be of apermanent nature, in which case, however, he may have quarterlypayments subject to proof of identity and continuance of theincapacity.

(19) No weekly payment or sum paid in redemption can be assigned,charged, or attached.

[It will be seen that the duties of the medical referees are very largelyincreased and that their decisions will be conclusive and final; thesuccess of the Act will therefore depend, so far as regards the medicalarrangements, on (1) whether the medical referees who are appointedhave the confidence of the profession in their several districts; (2) onthe support given to them by the cozcnty-eourt judges; and (3) on theregulations for medical examinations which are to be made by theSecretary of State.]

13 (p. 14). "Workman" does not include any person employedotherwise than by way of manual labour whose remuneration exceeds.e250 a year, or a person whose employment is of a casual nature andwho is employed otherwise than for the purposes of the employer’strade or business, or a member of a police force, or an outworker, or amember of the employer’s family dwelling in his house, but, save asaforesaid, means any person who has entered into or works under acontract of service or apprenticeship with An employer, whether by

113LOOKING BACK.-MEDICINE AND THE LAW.-VITAL STATISTICS.

way of manual labour, clerical work, or otherwise, and whether thecontract is expressed or implied, is oral or in writing.[The Aot therefore includes ordinary workmen of all kinds regularly

employed, clerks, secretaries, medical assistants and dispensers, curates,lay readers, and nurses, and last, but not least, all domestic servants.3

16. (1). The Act will come into operation on the first day of July,1907, and will not apply to any case where the accident happenedbefore that date, except so far as it relates to references to medicalreferees, and proceedings consequential thereon.

Looking Back.FROM

THE LANCET, SATURDAY, Jan. 10th, 1829.

On Dancing and on its advantages to young Persons, when itis scientifically taught.1

THOSE who affect to think that the most indifferent of ouractions should always be described in a manner whichindicates the highest degree of morality, speak of dancingin terms that I shall not repeat: religious fanatics speak ofit in a way that is connected with their modes of thinking ;the dealers in gymnastic exercises, as they are called,mention dancing in terms which show that they think itvery inferior, in point of utility, as well as in the power ofexciting pleasurable sensations, to their own exercises.Those who attend to these discourses, will be in a conditionto judge how far those opinions are correct ; but as I differin opinion, upon this subject, from all those persons thathave been mentioned, I shall only consider dancing as some-thing that either has, or may have, peculiar effects upon thehealth, as well as upon the form of those who practise it.Dancing is one of the most healthy, as well as one of themost pleasing, amusements that has been, or that can bepractised, by females of the superior classes of society ; if itis learned from those who are well qualified to teach it, andpractised, as it ought to be, consistently with the instruc-tions by which it is taught, it will contribute more to im-prove the health, as well as the form, of those who practiseit, than any other exercise. I advance this decisively, becauseI have lately seen a book, from which I have extracted thefollowing passage ;"I have adverted to the over anxiety to educate girls in the

fascinating accomplishments of music, drawing, and dancing;in the prosecution of which, they are confined in hot rooms,and forced into strained attitudes for hours together ; andto the manner in which it has led, in different ways, to themost distressing circumstances. If long perseverance, in

any habit, be sufficient to produce distortion and deformityin the spinal arrangement of adult and athletic males, it willsurely be much more likely to induce them in the sickly andpampered children of the affluent. Though various causesmay be assigned for the increased prevalence of these com-plaints in our own time, I am convinced that the relaxingeffects of hot rooms, and a too ardent pursuit of feminineaccomplishments, are the principal ones. By admitting theelasticity of the fibrous structure, and its disposition tostretch under certain favourable circumstances, we are

enabled to understand many obscure actions which are

going on in the animal economy, and in particular, to fix thedoctrine of spinal distortion upon a simple and lastingfoundation." "

It would be an unwarrantable display of false tendernessto the writer, to use any of the terms that are commonlyemployed to describe the writings of medical men, to give acharacter to this passage; it will, however, be doing himjustice, to use a term that is well understood in a neighbour-ing country, when they say a thing is all botheration ; orif he should prefer an English explanation, I would say, thewhole is a tissue of vulgar impudence that has no founda-tion in truth, and has been used to confound those who onlywish to know the plain meaning of plain words. This beingthe case, as I shall have occasion to pay much attention tothe writings of this person, at a future period, I shall onlyendeavour, at present, to show what are the real effects ofdancing, that those who are interested in understanding it,may see how little this person knows about the matter.

1 Excerpt from "Lectures on Muscular Action, and on the Cure ofDeformities." By Mr. Sheldrake.

MEDICINE AND THE LAW.

Tha Food of the People.AMONG recent cases in which the purity of food offered ’

for sale has formed the subject of legal proceedings may benoted a seizure of unsound fruit in Battersea with regard towhich Mr. De Grey held that the defendant, a wholesaledealer, was protected by a notice in his yard that ’Packets-of fruit are sold on the express condition that the buyersshall sort the said contents and before offering any part tothe public destroy the unsound portion." It will be interestingto see if this rather ingenious notice is adopted as widely asits success in a particular instance would suggest that it maybe and whether other magistrates will follow Mr. De Grey’s’example should a similar case come before them. It seems

open to the objection that the vendor was imposing a con-dition which he would find extremely difficult, if not

impossible, to enforce. In another case at Greenwich police-court a butter merchant, trading at Sydenham, who had beenpreviously convicted, was fined &pound;40 with 12s. 6d. costs, orin the alternative two months’ imprisonment, for sellingbutter adulterated with 80 per cent. of foreign fat.At Enfield two defendants have been fined &pound;10 eachwith the alternative of one month’s imprisonment forselling beer not brewed by the firm whose labels wereaffixed to the jars. The defence was raised that the

printed slips of paper which the prosecution said were labelsto deceive the customer were the headings of invoices stuck.on as pieces of paper only, in order that the defendant mightwrite upon them, with the further suggestion that the ales ofthe eminent firm of brewers in question would thereby be-advertised. At an inquest held in Battersea by Mr. Troutbeckthe death of a woman who had died from eating fried fishwas inquired into with no very definite result, the coroner-dwelling upon the importance of the constant inspection of-the people’s food-supply. The fish in this instance had notbeen fried in oil but in dripping purchased from a restaurant,which increased the difficulty of tracing the source of what-ever caused the death of the deceased, and the jury broughtin a verdict of " Accidental death."

Confidenee withheld from a Medical Man.At a recent inquest at. Battersea held before Mr. Troutbeck

the evidence showed that the deceased, a married woman,died from a fatal dose of ammonia which she had taken bymistake for gin, and that her husband, who was aware of.what she had done, called in a medical man, but apparently,through a desire to conceal his wife’s drinking habits, did nottell him of it. Indeed, when Mr. Percy A. Palmer, whc’attended her, asked him whether she had taken poison hedenied it and did not admit it until it was too late. As Mr.Troutbeck observed, medical men are sometimes expected todivine what their patients are suffering from as if they weremagicians, and to cure them in spite of their, or theirfriends’, denials of material facts and their refusal tovolunteer information. To persist in the endeavour to elicitall necessary details would seem to be the only course openbut this cannot always be done effectually when the sym-ptoms are not marked enough to assist the cross-examina-tion. Apparently no liquid has a sufficiently powerful anddistinctive odour to prevent it from being mistaken for the

! spirits usually consumed by those who habitually drink to! excess.

_______________

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN 76 of the largest English towns 9714 births and 6879deaths were registered during the week ending Jan. 5th.The annual rate of mortality in these towns, which had beenequal to 19 - 1 and 19’ 7 per 1000 in the last two weeks ofDecember, further rose to 22-4 in the week under notice.During the 13 weeks of last quarter the death-rate in thesetowns averaged 16’ 2 per 1000; the rate during the sameperiod in London being 16’ 0. The lowest death-rates in the76 towns during last week were 6’ 4 in Hornsey, 12’ 2 inEast Ham, 13’ 1 in West Hartlepool, and 13’ 5 in Barrow-in- -Furness; the rates in the other towns ranged upwards to27 6 in Preston, 28’ 0 in Oldham, 32-4 in Sunderland, and36’ 4 in Middlesbrough. The 6879 deaths in the 76 townsshowed a further increase of 891 upon the numbers in recent