289

THE LANCET.

LONDON: SATURDAY, AUGUST 16, 1919.

The Reorganisation of Pensions.

THE REORGANISATION OF PENSIONS.

THE speech Of Sir LAMING WORTHINGTONEvANS, the Minister of Pensions, in asking theHouse of Commons, sitting as Committee of

Supply,l to agree to the supplementary voteof JE45,855,000 for the Ministry of Pensions, hashelped the nation to realise the responsibilityimposed by the care of its injured sailors andsoldiers. A nation yet unborn will gather theaftermath of the world-war and see the last maimedpensioner carried to the grave from which the

surgery of this generation saved him. It is withthe sailor or soldier disabled by his service that ourprofession is chiefly concerned; it is here our assist-ance is indispensable to the carrying out of thework of the Ministry. The granting of pensions tothe widows and dependents of the dead is anotherbranch of pensions work, for which medical adviceis essential, being invoked chiefly when there isdoubt whether death by disease should be attributedto war service. The figures relating to pensionsare instructive, and may do something towardsexplaining the occurrence of delays and mistakesin a department newly organised in the midst ofwar, of whose duties the granting of pensionsto’ the injured and to dependents forms only onepart. Pensions, gratuities, and final allowancesduring the past 12 months have been consideredin respect of more than two and a quarter millionpersons, including officers, nurses, and men, withtheir widows, their children, and their other

dependents. The annual payment at presentcomes to near JE100,000,000, though this sum issubject to reduction in the future, not only by thedeaths of pensioners, but by the cessation of

gratuities that will not have to be repeated.Moreover, no pensioner, wounded or invalided atany date in the war, will leave the protection of thePensions Ministry save under proper medical certi-fication that he is fit to undertake the trainingproposed for him by the Ministry of Labour.The part to be played by medical men in

future pension administration was considerablyinsisted upon by the Minister of Pensions, whodescribed the procedure in detail. The medicalboards for men applying for pensions, or for therenewal of them, passed on April lst out of thehands of the Ministry of National Service into thoseof the Ministry of Pensions, which departmenttook over on August 4th from the War Officeresponsibility for the Re-survey Boarding ofOfficers. This is a task which demobilisation hasrendered very heavy, and during the six monthsending with last June medical boards were heldupon 229,697 men. At the same time, and owing tothe process of demobilisation, there has come underthe jurisdiction of the Ministry the care of thedisabled, including their treatment in hospitals,clinics, and convalescent centres. Colonel WEBBwill be the chief medical officer, under whom amedical, surgical, and nursing staff will carry outthe duties assigned to them by the Ministry, amongwhich will be the provision of artificial limbs andtheir repair. These increases in the sphere of the

1 THE LANCET, August 9th, p. 267.

activities of the Ministry of Pensions will, however,be of less interest to the public than the stepswhich are promised for reorganisation of thework of the department. There has been publicexpression of dissatisfaction, which may havebeen exaggerated but has not been altogetherbaseless, and the existence of which cannot be denied.A system by which medical officers at the head-quarters of the Ministry were empowered to reviewthe decision of a medical board, and by which amedical officer was authorised to alter the amountof a man’s assessment, though made by a board,without himself re-examining the case, was onewhich, in popular phraseology, " asked for trouble."There are now to be Medical Appeal Boards to whichthe medical assessor of the Ministry may refer acase, if not satisfied, on the perusal of the papers init, that substantial justice has been done to thepensioner or to the taxpayer. For the taxpayermust be protected. To these boards the pensionerhimself will have a right to appeal, if not satisfiedwith the amount awarded him, and such re-

examination should do much to justify the finalityassigned to the decision which will then follow.In a question of incapacity the body of the manconcerned supplies an essential part of the materialrequired for the consideration of his case, and asummary or statement of the observations and con-clusions of others, whether medical men or not,cannot satisfactorily be substituted for it.In addition to the Medical Appeal Boards

there will be, we understand, other new tribunalsset up as the result -of the report of the SelectCommittee recently published, and these will beindependent of the Ministry of Pensions, and

appointed by the Lord Chancellor when a Billfor that purpose has been duly passed. Theirfunctions will be to consider appeals by a claimantof a pension in cases of its refusal either on theground that the disability was not attributableto, or not aggravated by, military service, or

on the ground that the disability was due to,serious negligence or misconduct of the claimant.They will also review refusals of pension to a

widow or dependents on the ground that the sailoror soldier’s death has not been due to militaryservice. These tribunals will be composed of abarrister or solicitor as chairman, a medical prac-titioner, and a disabled officer or disabled man,according to whether the case to be considered isthat of an officer or of one not holding a

commission. Thus a statutory .right will be

granted, as distinct from one arising out of a

Royal Warrant, to claim a pension before an

independent statutory court, whose decision willbe final. This court will have to decide, we mayadd, one of the most difficult of the many complexquestions that arise in the granting of war pensions.A man may have entered the Army an apparentlyhealthy man, or with an admitted unsoundness.He may have faced the rigours of one or

more winters in the trenches and returned to

develop disease, ending in death or disability, inthe healthy surroundings of his home or of a well-ordered camp in the United Kingdom. Naturally,to him or to his surviving relatives it is clearbeyond demonstration that his war service is theresponsible cause of a result which otherwisewould never have supervened, and yet it maynot be so. We urge in such a case a liberalconsideration of the facts, medical and otherwise,with the benefit for the claimant of such doubt asscience may not be able to clear up. We are not,however, altogether in accord with the observations

290 ERNST HAECKEL.

of Dr. D. MURRAY in the House of Commonswhen he said that this question of the attributionof disease to war service should not be put to amedical board at all. We agree with him that it isa cruel duty, and one the perfect fulfilmentof which is wellnigh impossible. We regardthe matter, however, as one essentially formedical decision, and we are inclined to ask our-selves whether an appeal tribunal with a majorityof laymen upon it can really do more than relievea medical board of a painful responsibility.Whether it supports or overrules a medicalboard’s decision, it can hardly add weight to it.It is our fervent hope that the changes intro-duced by the present Minister of Pensions mayresult in his department combining justice withgenerosity, and giving that degree of public satis-faction which is essential to the smooth working ofthe affairs of the State. It has to create its ownstandards and to live up to them. The standards ofpension administration created by previous warsare not merely obsolete ; they were never altogetherworthy of the occasions which called them intobeing.

Ernst Haeckel.THE death is announced at the age of 85 of

Professor ERNST HAECKEL, who attained world.wide reputation as a biologist, a zoologist, andan apostle of Darwinism in Germany; later hesecured notoriety as an expounder of a theoryof the universe by which he settled, according tohis own satisfaction, such problems as the exist-ence of GOD, the freedom of the will, and theimmortality of the soul. In addition to theselabours he travelled widely in the East, and duringthe war was an embittered opponent of GreatBritain and an ardent upholder of the Germancause. He was a skilled artist both with the brushand the lead, and his books of travel were illustrated.with his own hand, while many of his biological andzoological works were also embellished by him withmagnificent drawings, both coloured and uncoloured.HAECKEL’S chief claim to fame is that when quitea young man at the very beginning of hisscientific career, apart from medicine, he readand at once accepted DARWIN’S thesis as laiddown in "The Origin of Species." He was the firstGerman biologist to do so, and he maintained hisposition in opposition to many of the foremostthinkers in Germany, among whom the most

prominent was VIRCHOw. Before very long, as

every one knows, DARWIN’s doctrine of evolutionwas accepted in scientific circles in Germany aswell as elsewhere. HAECKEL’S mind, however,worked on different lines from that of DARWIN,who was eminently cautious and who worked byamassing particulars and from them formulatinga general rule. HAECKEL considered that thedoctrine of evolution could be applied to thesolution of all problems wherein men or animalsare concerned with almost the certainty ofmathematical laws, and in upholding this thesis hewas as bitter and dogmatic as any of the clericalsagainst whom he so often tilted. Thus, we findhim saying in " The Riddle of the Universe" (wequote from the shilling edition of 1913), on p. 12 :-"In the famous speech which Emil du Bois-Reymond

delivered in 1880 in the Leibnitz session of the BerlinAcademy of Sciences he distinguished seven world enigmas,which he enumerated as follows : (1) The nature of matterand force ; (2) the origin of motion ; (3) the origin of life ;(4) the (apparently pre-ordained) orderly arrangement of

nature ; (5) the origin of simple sensation and consciousness;(6) rational thought and the origin of the cognate faculty,speech ; ’(7) the question of the freedom of the will."

HAECKEL goes on to say that DU Bois-REYMONDconsidered three of these problems entirely trans-cendental and insoluble-namely, problems 1, 2,and 5 ; three others, problems 3, 4, 6, capable ofsolution though difficult ; while as to problem 7 heremained undecided. HAECKEL sweeps all doubtsaway as follows :-"In my opinion the three transcendental problems (1, 2,

and 5) are settled by our conception of substance ; thethree which he considers difficult though soluble (3, 4, and 6)are decisively answered by our modern theory of evolution;the seventh and last, the freedom of the will, is not an

object for critical, scientific inquiry at all, for it is a puredogma, based on an illusion, and has no real existence."

HAECKEL’S "law of substance" is the combina-tion of the fundamental chemical law of the con.stancy of matter with the fundamental physicallaw of the conservation of energy, and accordingto him it definitely rules out the three centraldogmas of metaphysics-GoD, freedom, and immor-tality. We can expand this doctrine in the wordsof Mr. JOSEPH MCCABE, who is HAECKEL’S warmestsupporter in this country, by the following quota-tion from his " Haeckel’s Critics Answered," wherehe says that HAECKEL concludes-

’’ That the thinking and willing force in man-what wecall his mind or spirit-is identical with the force thatreveals itself in light and heat. In other words, he is forcedto think that spirit and energy are one and the same thing,and so he uses the names indiscriminately. But he is furtherconvinced ...... that matter and spirit (or force) are not twodistinct entities or natures, but two forms or two aspects ofone single reality, which he calls the fundamental substance.This one entity with the two attributes-this matter-forcesubstance-is the sole reality that exists."

Belief in GOD is not the exploded idea thatHAECKEL seemed to consider it, nor can we seehow belief in the two cardinal doctrines of theconservation of matter and energy necessarilyrules out belief in GOD. But here HAECKEL showedthe typical psychology of the Prussian. Just asthe pan-German-i.e., Prussian-ideal was that thewhole world should be ruled and governed byPrussian kultur, that phase of psychology being .

the one and only mental attitude which possessedany real good, so HAECKEL held that belief in thelaw of substance explained all the problems whichhave exercised the mind of man for centuries,whence it followed for him that anyone who didnot hold with his ideas was a gross obscurantist.We turn with relief from HAECKEL the Monist

philosopher to HAECKEL the biologist. In that fieldhe undoubtedly did excellent work ; his champion-ship of DARWIN at a time when that great observer’sviews were generally looked upon with disfavouris greatly to his credit, and the biological .museumwhich he gradually formed at Jena is comparableto the immortal HUNTER’S museum in London. His" General Morphology " was highly praised byHUXLEY, while DARWIN gave similar praise to his"History of Creation." As to his views on thewar, which, when they were published in October,1914, rightly aroused indignation, we can, now thattheir author is dead, feel nothing but pity that oneof such intellectual gifts should have associatedhimself with 92 other professors in glorifying theatrocities in Belgium and the German doctrine ofkultur and militarism. His work as a biologistwill stand as a whole, although it was undoubtedlydefective in part; his philosophical and politicalviews will be buried in oblivion.