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10.52 amMr. Nicholas Brown (Newcastle upon Tyne, East): I count it a privilege to follow the right hon. Member for Old Bexley and Sidcup (Sir E. Heath), and, like the right hon. Gentleman, I congratulate the hon. Member for Chislehurst (Mr. Sims) on having secured it. It is an important debate. It is important to Mr. Murray's family and friends, to the clinicians who cared for Mr. Murray, and to other health service workers who tried to do their best for him. It is also important because it raises wider questions about the provision of intensive care beds in the capital and the capital's catchment area. When the incident occurred, the Under-Secretary of State for Health, who is to reply to the debate, wrote to the hon. Member for Orpington (Mr. Horam) about the case. In his letter, he did something which was, frankly, deplorable. He said:
"The junior doctor in charge of his case at St. Mary's failed to persuade any of the other local neuroscience centres he contacted to admit him."
In other words, the letter sent by the Minister pins the blame firmly on the junior doctor.
Like the right hon. Member for Old Bexley and Sidcup, I deplore that scapegoating of health-care professionals. It is not justified. In any event, it is the job of the bed managers of hospitals to find beds. I cannot see how a senior doctor could find a bed that a junior doctor could not. A bed was either available or it was not. That is the issue to which those who have responsibility for the health service should address themselves, rather than seeking to scapegoat health-care professionals. Like the right hon. Gentleman, I also deplore the appearance of the previous Secretary of State on television pontificating on who was guilty and who was not before the matter had been properly inquired into.
The Under-Secretary of State went on to say that he had already commissioned a study of intensive care provision. That will be an important study, and we look forward with interest to seeing the fruits of it. This is not the first time that the House has debated the provision and availability of intensive care beds in the NHS and, in particular, in the capital. There has been a spate of highly publicised incidents in which seriously ill or injured patients have been transported from one hospital to another in a desperate search for a bed in an intensive care unit. Mr. Murray's tragic case is one of the most dramatic, but it is not an isolated incident. I well remember the Prime Minister being asked about this at Question Time. He defended the 200-mile journey by saying: "I understand that Mr. Murray required a highly specialised form of treatment with which Leeds was particularly able to help".--[ Official Report , 9 March 1995; Vol. 256, c. 454.]
It is incumbent on the Minister when he responds to say what the highly specialised form of treatment was--a form of treatment which apparently was not available in the capital. It is also incumbent on him to say how it was that Leeds was "particularly"--the Prime Minister's word--able to help. I look forward to the Minister's explanation, and I hope that it is as plausible as he can manage. As my hon. Friend the Member for Woolwich (Mr. Austin-Walker) pointed out, incidents such as this have sparked a series of inquiries into the availability of intensive care in the NHS. It is right in a debate such as
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this that we should ask what is the size of the problem. The Department of Health has already conducted a study entitled "Study of Provision of Intensive Care in England", dated 1993. It provides us with some useful facts and findings to guide our debate.The Department of Health tells us, for example, that, in the United States in 1992, the proportion of moneys spent on intensive care was 10 per cent. of total health costs. In the United States, total health costs consume some 12.4 per cent. of GDP. In the United Kingdom, for the same year, we spent on intensive care 1 per cent. of health-care costs, and in this country health-care costs consume only 6 per cent. of GDP. That represents a twentyfold difference. The report goes on to state:
"We found that considerable numbers of patients were denied the possibility of intensive care because the intensive care units were full."
It does not go on to say that perhaps, if a junior doctor had tried harder, or if a more senior doctor had asked for a bed, one would have been found. The Department's own study says that the intensive care units were full.
It goes on:
"In our study we have shown that intensive care provision in England based on numbers of staffed beds is unequal between regional health authorities."
Our debates on provision in London have highlighted that. The hon. Member for Chislehurst referred to an exchange about whether there had been increased or decreased provision for the capital in recent times. I wrote to him after the exchange telling him where I obtained my figures. I obtained them from the Minister in answer to a parliamentary question. They relate to the two London regional health authorities, and show that, between 1992 and 1993, the number of beds fell by 12 to 724. In other words, the two London regional health authorities covering London and its immediate catchment area have lost provision.
A survey was carried out in January this year by consultants at St. George's hospital, which showed that, out of 35 hospitals within the M25, only eight to 10 intensive care unit beds were available. Between 30 and 40 of those beds were closed because of funding or staff shortages. That is a slice of life revealed by a survey conducted by consultants at St. George's.
A second survey was conducted in February 1995 of five cities--London, Birmingham, Manchester, Cardiff and Glasgow--which found that, of a theoretical total of 452 intensive care beds, only 376 were open. The figures that the Government like to use do not reveal the whole story.
The Government responded to the survey by admitting the existence of pressing problems in the provision of intensive care beds, especially in London; and, as the Minister's letter reveals, they have ordered an urgent review. Given all that Ministers have said about the Labour party's call for a review and a moratorium on closures, it is a bit rich for them to say now that they will conduct an urgent review of intensive care provision.
Despite the Government's commitment, only two months passed before the previous Secretary of State signed the warrant for the closure of Guy's hospital, and approved the ripping out of brand new and as yet unused intensive care equipment from a ward in Philip Harris house. The hon. Member for Chislehurst knows what an
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obscenity I consider that to be; we have debated these matters in the House before, and I do not suppose that his views differ much from mine.It is fair to say that the provision of intensive care is very expensive. One bed costs about £1,500 for 24 hours, and health authorities and trusts think carefully before purchasing and providing more than is absolutely necessary. That apparent drive for efficiency, however, can have terrible, tragic results, especially in the event of an unexpected increase in demand.
The case that we are discussing suggests that one accident occasioned an unforeseen increase in demand in the capital on the day in question. What if four people had been injured in a traffic accident, rather than one? The tragedy would have been multiplied by four. If one bed was not available, four certainly were not. It is clear to me--as it is to every observer, whether politically neutral or not--that there is a crisis in provision in the capital, and, indeed, in other urban areas. That crisis is money- driven, and driven by the Government's peculiar approach to the management of the national health service: savings are everything, and the provision of a front-line service must take second place.
The demand for intensive and emergency care cannot be entirely predictable, by its very nature. No one can predict when a serious traffic accident, for example, will occur--or, indeed, when a hospital operation will go wrong or something unexpected will be discovered. It is therefore essential to proper patient care to allow a reasonable margin of safety in the number of intensive care places that are funded and staffed.
As my hon. Friend the Member for Woolwich (Mr. Austin-Walker) pointed out, that margin of safety has not been in evidence in several instances. It is not good enough for Ministers to pass the responsibility on to local management, or, even more shamefully, to try to scapegoat individual clinicians.
As the right hon. Member for Wokingham (Mr. Redwood) has observed, it is the duty of Government to ensure that there are enough intensive care beds. If today's debate has highlighted that need as well as the tragic case of Mr. Murray, I hope that it will have done some good.
11.3 am
The Parliamentary Under-Secretary of State for Health (Mr. Tom Sackville): I congratulate my hon. Friend the Member for Chislehurs(Mr. Sims) on raising a matter that has caused considerable concern not only in his constituency but nationally as a result of the dramatic events on the night of 6-7 March. I welcome the presence of my right hon. Friend the Member for Old Bexley and Sidcup (Sir E. Heath), who has been involved through his discussions with the doctor concerned.
The Opposition Members who spoke have used the words "crisis" and "chaos" liberally, no doubt in an attempt to draw attention to what they were saying. There is no crisis, but an intelligent discussion is needed about the number of intensive care beds. For reasons that have already been given, a difficult balance must be struck between wasteful over-provision-- the provision of resources that are then not used for much of the time--and the need to minimise the risk of incidents of the kind that we are discussing.
Both Opposition speakers refrained from specific discussion of the number of intensive care beds, and attempted to widen the argument to the question of the
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number of acute beds generally in the London area. The two issues may be conncected to some degree, but it is inappropriate to suggest that "a bed is a bed is a bed". As we all know, there is a world of difference between the question of how many acute beds there should be in London hospitals, and the specific issue of how many intensive care units there should be and how many staffed beds should be available in them.Today's debate principally concerns the incidents that took place in March, and the lessons to be learned about the provision of neurosurgery and intensive care. Hon. Members discussed, in general terms, the sorry circumstances of the transfer from Sidcup to Leeds on the night of 6-7 March in a debate on 23 March. At that time, we were awaiting the report of an investigation of the case; I am now able to reveal the findings of that investigation, and the action that has been taken since. Before I do so, let me add my condolences to those that have already been extended to the Murray family in their bereavement.
Much has been made today of the treatment of Mr. Anthony Percy, the orthapaedic consultant at Queen Mary's hospital in Sidcup. I appreciate the reasons for which my right hon. Friend the Member for Old Bexley and Sidcup expressed concern, but the investigating panel felt that Mr. Percy--who was contacted at home at various times by the senior house officer in his attempts to find a bed for Mr. Murray--might have done more to help in what was a highly unusual and difficult situation for hospital staff.
It is a matter of record that the trust's chief executive wrote a private letter of censure to Mr. Percy, commenting on his contribution--although stressing that he had been responsible for no failure of clinical care, and that the question of disciplinary action did not arise.
My right hon. Friend the Member for Old Bexley and Sidcup suggested that that was inconsistent with another statement that the clinical outcome of the case would not have been affected, but it is not. No one has suggested that the clinical outcome was necessarily affected, however unsatisfactory it was that the patient had to be transported to Leeds. No one has suggested that that had a significant adverse effect on the patient-- although I should be the last to say that what happened should have happened in that way: it is unacceptable that the patient had to be taken to Leeds.
Mr. Nicholas Brown: Will the Minister give way?
I well understand Mr. Percy's wish now to do all he can to put right the damage that he feels has been done to his reputation, and I very much regret the way in which the whole matter was reported.
Mr. Brown: Will the Minister give way?
Mr. Sackville: No. The hon. Gentleman had his chance to give his views; I have quite a long speech to make.
Given the possibility of legal proceedings, hon. Members will appreciate, as my right hon. Friend has said, that I cannot comment further on this matter. What I can categorically state is that there is no question of Mr. Percy being used as a scapegoat to deflect criticism of bed shortages in London.
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Indeed, the investigation panel concluded that there was not a shortage of beds. Although the intensive care beds in neurosciences centres were certainly all very busy, the panel believed, on the evidence it had before it, that Mr. Murray could have been treated that night in London following his head injury. The key point is the management and use of beds and the co-ordination and communication between units, rather than the absolute number. That is the real issue, and I shall return to it.Mr. Sims: My hon. Friend says that there is no question of there being any scapegoats in this matter, but has he read all the correspondence, in the course of which the chief executive says that he fears that scapegoats were required, the implication being that Mr. Percy is the scapegoat? Can my hon. Friend say whether Mr. Percy was censured or not? If so, why was he censured, and if there were no grounds for him being censured, why cannot that censure be withdrawn?
Mr. Sackville: I have stated the facts as I know them: a letter of censure was written to Mr. Percy by the hospital, critical of his performance. That is a matter of record.
Mr. Nicholas Brown: The Minister told the House that it was a private letter. If so, why did Ministers go on television and talk about it?
Mr. Sackville: We did so because it was very germane to the whole account of what happened on that night that the hospital was critical of Mr. Percy. There was enormous press interest in the matter. As I said, however, I regret the way in which some newspapers and media carried the story. I can understand why Mr. Percy feels that he has been unfairly treated.
Sir Edward Heath: That letter was sent some time after all this began, and I have quoted from the report of the hospital panel and its chairman of chancellors. Their conclusion was obviously different. The letter was sent by the administrator of the hospital. By what authority did he send that letter, when it was not justified by the whole panel of the hospital, with the chairman presiding?
Mr. Sackville: I understand that the letter was sent with the full knowledge of the chairman of the hospital, and that clearly the hospital was critical. The fact that that was perhaps blown up to a considerable extent by the media is regrettable, but it remains a matter of fact that, with the full knowledge and permission of the chairman, the hospital was critical of Mr. Percy.
Mr. Nicholas Brown: Will the Minister give way?
Mr. Sackville: No. I will carry on, because I have a lot to say about the action that has been taken since on intensive care beds. On the situation during that night, the panel also concluded that the Royal Free hospital did have two intensive care beds available and could have taken the patient. I appreciate that that raises all sorts of queries, and I would like to make it clear that a call was made by Queen Mary's hospital, and the information was given to the doctor concerned that the Royal Free considered it clinically inappropriate to transport the patient across London. That was its opinion, and it was therefore asked to see whether some nearer facilities could be found.
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As far as can be ascertained, there was no further contact after that. The Royal Free was not contacted again. That is why I say that there was a failure of communication and co-ordination, but it remains clear that two intensive care beds were available at the Royal Free. That much we know, and it is a matter of great regret that that was not followed up. I am not blaming anyone. The situation was confused and difficult. Later, a decision was therefore taken to transport the patient to Leeds.The report makes it clear that, with the proper use of existing intensive care facilities and better co-ordination between hospitals, it should be possible to minimise the risk of inappropriate transfers of this sort occurring in the future.
Sir Edward Heath: Does it not seem to my hon. Friend to be quite extraordinary that, if those beds were available at the Royal Free, which it has since denied, and a doctor is on the other end of the telephone, the hospital should not say to him, "Yes, it would be much easier and more suitable for the patient if you could get him into the Brook, but if you can't get him into the Brook, then come back to us." It said nothing of the sort. It said to the doctors in Queen Mary's hospital, "Aren't the beds available? Try the Brook."
Mr. Sackville: That is not the information that I have, which is that the hospital said that beds were available, but advised that nearer facilities be sought. Unfortunately, that was not followed up. That is one of the factors that led to the inappropriate transfer of this patient to Leeds.
As the House already knows, the report calls--
Mr. Nicholas Brown: Will the Minister give way?
Mr. Sackville: No. I shall continue, and I have said what I understand to be the facts about what happened in relation to that telephone call.
The report calls for the establishment of stronger systems for the referral of patients to specialist neuroscience centres, better co-ordination of bed usage between neuroscience centres, and improved communication between specialist centres and their referring hospital. Those are important recommendations. All of them are being implemented, with some already in place and others being refined. A key recommendation was that the London emergency bed service, about which my hon. Friend the Member for Chislehurst asked me earlier, should extend its service to cover intensive care beds. The new service began on 17 April, and is already proving to be of considerable assistance to units in helping to match supply and demand for intensive care services.
Trusts in the region were asked immediately to review their on-call protocols to make much clearer the involvement expected of staff out of hours.
All acute hospitals are required to make formal relationships with one of the specialist neuroscience centres. That is the centre that they will contact initially if they need to refer a patient for neurosurgery. Many hospitals in South Thames have already confirmed that they have such procedures in place.
For their part, the specialist neuroscience centres have introduced procedures to inform hospitals that normally refer patients to them of any severe pressure on beds and the alternative arrangements available. The burden of
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finding a bed is thus co-ordinated by the specialist centres. If the specialist centre cannot identify a place, a referral is made to the emergency bed service, which maintains a comprehensive information service on bed availability for all London hospitals. The procedures that have been established should ensure that, when a patient needs access to a specialist centre, the referral can be organised efficiently and with optimal clinical effectiveness. I have gone into the matter at some length, and I want to make it clear to the House that, with good organisation, the things that occurred on that night should be avoided in future. I hope that some of those actions that have been taken will minimise the risk of such events recurring.Health authorities are actively considering intensive care provision, and are working with their local hospitals to ensure that the referral procedures are in place. The two Thames regions are also holding detailed discussions to ensure a fully co-ordinated approach to forward planning and bed usage between their specialist neuroscience centres.
Mr. Murray's injuries were severe, and he required both neurosurgery and intensive care. An intensive care unit is a specialised hospital ward where critically ill patients with organ failure can receive treatment and monitoring, using invasive techniques and high-technology equipment, and benefit from the high staffing ratio--at least one to one--necessary to maintain adequate care. The number of available intensive care beds in England has risen by over 100 since 1989 to more than 2,600, and the number of qualified intensive care nurses has risen by 1,000 to 7,650. The working group that has been set up will produce guidelines on admittance and the better use of those beds.
Despite those increases in facilities, there were allegations of shortages long before the Murray case. To clarify the matter, we commissioned a report from Professor Klim MacPherson of the health promotion sciences unit at the London School of Hygiene and Tropical Medicine on the provision of intensive care services in England. That thorough report showed that, overall, there was sufficient provision. However, it identified a number of problems and important issues. In particular, it showed that about one in six admissions to intensive care are considered by clinicians to be inappropriate, on the grounds that the patients are either too ill to have any reasonable chance of recovery, or not ill enough to require the level of specialist care that is provided in an intensive care unit. On 7 February, the report was formally sent to all health authorities and trusts asking them to examine local provision carefully in the light of the findings and recommendations. Following the publication of the report, Ministers met leaders of the relevant professional bodies and, in the light of those discussions, a working group of professionals, to which I have just referred, is considering guidelines for admission and discharge. It is also looking at the relationship between intensive care units and other less intensive forms of care, such as high dependency units.
Given the resources that are required for an intensive care bed, it is vital that we get the balance right between meeting the need for both emergency and planned treatment requiring intensive care, and avoiding those facilities being under-used. As we have heard in the
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debate, that is a difficult balance. Getting it right remains a challenging priority for all those involved, given the fluctuations in demand for this highly specialised and intensive treatment. The Government's policy, whether for London or for the rest of the country, is that it is for individual health authorities to plan the level of provision that is appropriate for their, areas, taking into account all factors of need, demand and the availability and desirability of other services.Of particular interest to the debate is information on London. Professor MacPherson's report found that each of the Thames regions had more general intensive care beds per head of population than the national average. The former South East Thames region had the highest ratio in the country, with three beds per 100,000 of the population. The Department's information returns show that, in inner and outer London, the average number of available intensive care beds rose from 480 to 501 in the year to 1994.
The Government do not hold central information on the number of intensive care beds within different specialties. According to the London emergency beds service, there are currently 247 general adult intensive care beds in 35 hospitals within the 16 London health authorities. There are also 29 neuroscience intensive care beds, 50 paediatric intensive care beds and 186 beds in cardiothoracic units. In addition, there are 512 intensive care beds in renal, liver and other specialist units that are not presently covered by the emergency beds service.
To help to ensure the best use of available resources and to improve communication and co-ordination, the emergency beds service has extended its coverage to intensive care services, including neurosurgical intensive care in the Thames regions and surrounding area. It is operational 24 hours a day, and it contacts every intensive care unit in the Thames regions twice a day--or three times a day for those with specialist neurosurgery or paediatric beds--so as to update its information on bed availability. It is thus able to respond immediately to units that are seeking to transfer a patient because they have no spare capacity.
Initial experience of the emergency beds service is that it is proving very helpful. In the first 45 days of the service, there were 173 inquiries from 53 hospitals. On average, that is four a day, and there were as many as 13 on one day in April. The work of the service led to 112 patients being transferred to 54 destinations. Some 78 per cent. of the inquiries were for general intensive care and 14 per cent. were for neurosurgical intensive care.
The service is of considerable assistance to units in helping to match supply and demand for intensive care services. Similar services are being established in other parts of the country, with considerable benefit.
In the light of Professor MacPherson's finding that many intensive care beds are inappropriately used, no discussion of intensive care would be complete without considering acute bed provision. That the NHS generally will have fewer acute beds in 10 or 20 years' time is common ground. However, neither the Tomlinson report nor "Making London Better" includes a planned or target reduction in beds, and it is not Government policy to set such targets.
We have said that, in London, as in the rest of the country and in the world, more patients will be treated with fewer beds. Developments in modern health care,
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such as non-invasive diagnosis and treatment, and new and improved drug therapies, mean that, overall, the demand for beds is steadily falling. That trend is clear in Britain and overseas.Mr. Nicholas Brown: Will the Minister give way?
Mr. Sackville: No. I should like to continue.
The common theme from many studies is the need for better management. That was the key message of a report on beds from the chief executives of the inner London health authorities. Considerable work is being done to develop neurosciences in the Thames regions and London. That is well in hand, and the transfer of neurosurgery from the Brook hospital is being phased to ensure the continuation of safe and effective services. My hon. Friend the Member for Chislehurst spoke about that transfer.
The new neurosurgery service, which was established at a cost of £7 million including magnetic resonance imaging facilities at the Ruskin wing of King's, will begin to take patients next month. It will be complemented in 1999 by the move of the neurology service from the Maudsley to King's, so that a comprehensive service will be available in one building. The Higher Education Funding Council is also investing in specialist research and teaching facilities. That will bring an academic dimension, and further complement the service at King's.
A clinically led review of neuroscience services in South Thames recently proposed that a new specialist neurosurgery unit should be located at St. George's hospital, Tooting. If health authorities agree to those proposals, the new centre will replace the outdated facilities at Atkinson Morley hospital and Hurstwood Park. Actions already taken and current considerations demonstrate the commitment to ensuring that London and South Thames in particular have the best possible pattern of neuroscience services.
The events of 6 and 7 March underline the urgency and the importance of the work that is already in hand to define and facilitate the best possible future pattern of neuroscience and intensive care facilities in the Thames regions. I hope that I have been able to demonstrate the Department's commitment to ensuring that everything possible is done to avoid any repetition of the unacceptable events of that night. I understand the concerns of my hon. Friend the Member for Chislehurst about what happened. I am grateful to my right hon. Friend the Member for Old Bexley and Sidcup (Sir E. Heath) for his comments about the good work of the NHS. I agree that the many new technologies, new medicines and new ways of treating patients mean that there will be a demand for ever greater resources for the NHS. I hope that my right hon. Friend was not entirely correct when he said that Ministers have failed to acknowledge that.
I take it as read, just looking at the history of resources in the NHS, that the same pattern will continue; that we will need to find more and more resources to provide for ever greater demand for health as new ways of treating patients emerge. I think that many problems will exist. The problem of balancing the need for intensive care beds with supply will always exist. I hope that, as my right hon. Friend the Member for Old Bexley and Sidcup suggested, we will take a quiet and sensible approach to the matter, and that some of what I have said will convince him that we are doing just that.
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Sir Edward Heath: Does my hon. Friend accept that, while we welcome the improvements that he has outlined and hope that they will be more effective than the present arrangements, I for one cannot accept the information that he has been given on Mr. Percy? As the matter is likely to come before the courts, he has heard far from the last of it.Column 884
Radioactive Waste
11.30 am
Mr. Clive Betts (Sheffield, Attercliffe): I want to raise today issues surrounding the disposal of radioactive waste from the nuclear industry and that which is generated by medical processes in local hospitals. I want to concentrate on low-level waste, which has been the subject of particular concern in my constituency during the past few months. I hope that the Government will reiterate some good news on that subject.
The Government published a consultation document on 14 August last year in which they reviewed nuclear waste and its disposal. Last week, a White Paper was issued in response to that consultation process. I want to place on record straight away that I welcome the Government's decision to abandon their initial intention, as expressed in the consultation document, to allow waste from the nuclear industry to be deposited on public refuse sites. This morning, I want to ask questions about how we have come to have this debate today and why it was necessary to consult on the issue in the first place. I also intend to discuss some issues raised by the White Paper appertaining to low-level waste and its disposal--I want to seek some clarification from the Minister on that point. Last, I want to raise some issues surrounding the transportation of waste from the nuclear industry. My hon. Friend the Member for Nottingham, South (Mr. Simpson) hopes to raise his own concerns on transportation. It goes without saying that the issue of radioactive waste is highly sensitive. It naturally worries the public. Even when the waste in question comes from local hospitals, and people can therefore see an obvious benefit from the processes that have produced it, local residents are worried about its disposal and treatment. Those public concerns are naturally heightened when the waste is from the nuclear industry. It does not take speeches from politicians at public meetings to produce that concern; it is natural. The issue has therefore to be handled with sensitivity and I shall today question whether the Government have not been guilty during the past few months of substantial insensitivity.
In my constituency, we have a large public refuse tip called Beighton tip. Only four or five years ago, planning permission was granted to extend it. Tipping will continue on the site for the next two to three years. It is surrounded by houses. A local school and a nature conservation area of reclaimed land are next door to it. Excellent work has been put in by volunteers from the local community who are committed to our natural environment.
The tip has naturally caused public disquiet. No one likes living next door to a refuse tip, but when proposals are made to dispose of radioactive waste from the nuclear industry at such a site, it is natural that residents become extremely alarmed. For many years, radioactive waste from local hospitals has been deposited on the site. Even that causes some concern. A local group of residents has formed the Hackenthorpe against the tip campaign and been vigilant in monitoring all matters in connection with the tip. They attend regular meetings with me, local councillors and council officers, at which they raise concerns about the depositing there of any radioactive waste whatever.
In Sheffield, we have considered the possibility of incinerating radioactive waste, but we were worried about emissions into the atmosphere. On balance, it was thought
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that depositing the waste in a controlled and authorised way at Beighton tip was probably the best way forward. However, there is a difference between dealing with radioactive waste from hospitals and dealing similarly with waste from the nuclear industry.The first difference is that there are no problems of definition with waste from hospitals. It is all low-level waste. It is not a matter of where one draws the line. It is all the lowest level radioactive waste that is in need of disposal. That is not the case with waste from the nuclear industry which, as the Government's consultation document illustrates, comes in various grades from low level right the way through to high level, for which specific plans are made. There is also a difference in type, which I shall deal with later.
There is a scientific difference between waste from hospitals and waste from the nuclear industry. The Government's consultation document published in August last year therefore made chilling reading. I shall quote from the key points in the document. It says:
"Some of the waste from nuclear sites which is currently disposed of to Drigg could in principle be safely disposed of to local landfills, while still providing full radiological protection of the public, although each case would need to be carefully considered. Yet even though the charges for disposal at Drigg are high compared with landfill burial, the majority of the nuclear industry has not switched to alternative disposal routes, nor does the ability to charge for radioactive waste disposals seem to have generated interest from private landfill operators."
It is probably not surprising that people are not queueing up to take the material, but the document expresses some surprise that, despite the willingness of the nuclear industry to pay, even private operators have not been willing to take the material on board and put it on private sites.
The document continues:
"This current practice creates needless pressure on the disposal capacity at Drigg. The Government therefore believes that there would be advantage in encouraging waste producers to make greater use of controlled burial. Views are invited on this, as well as on the methods by which it might be achieved."
That was the key part of the proposal in the consultation document last August. It was some time before there was public recognition that the proposal was around at all. Indeed, the public profile of the issue was raised only when Greenpeace issued a press release and there followed an article in the Observer .
It is worth asking questions at this stage about why the idea was put out to consultation. I accept that it was a suggestion for consultation, but still it was raised. Once the public read about a Government proposal, even though the Government keep on saying that it is merely a matter for consultation, they become worried that what is proposed will happen--that waste from the nuclear industry will appear on their doorsteps. They know that, for all the security measures that are taken on refuse tips, children go and play on them and that, although they should not, people have motorbike scrambles on them. People can put up all the warning signs and fences in the world, but they will not completely prevent public access to such sites. People therefore become extremely concerned.
It is even more worrying that the proposal seems to have been brought forward for two reasons. The words that I have just read out gave the game away. First, the
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Government were concerned about the cost of using Drigg and were considering burial at public refuse sites as a cheaper option--it was about saving money. Secondly, they were looking to save money by considering Drigg for the disposal of intermediate-level waste, which would be cheaper than the way in which it is currently disposed of. There is also the complication of reprocessing waste from nuclear industries in other countries. The Government decided not to return the totality of that waste to other countries but have chosen, for cheapness of transportation, to send back high-level waste in concentrated form and leave substantial volumes of low-level waste for disposal in this country. That presents the Government with the problem of how to dispose of the low- level waste. Given the capacity problems at Drigg, and the pressure it will be under if it is also to be used for intermediate waste, there will be a difficulty not merely on cost but on where else the waste can be disposed of.It is worrying that the Government brought forward the proposals because of their policy decisions on reprocessing waste from other countries and because of considerations to do with cheapness. Burial on refuse sites was thought to be an easy, cheap and convenient way out of their difficulties.
It was also unfortunate that the Government chose to raise such a sensitive matter without bringing it more forcibly to public attention. Until the Observer story, the proposal had gone largely unnoticed. It was hidden away in a few paragraphs towards the end of a very large document which mainly dealt with other grades of waste from the nuclear industry. The Government made no attempt to highlight their proposals. That shows that, while it was a consultation document in name, little effort was made to activate the consultation process and bring it to the attention of people who might want to have a say--not least ordinary members of the public such as my constituents who live around the Beighton tip. The Government also said that there was not a list of tips into which they were proposing to put waste from the nuclear industry. In one sense, that was technically correct, because paragraph 126 of the report mentioned that authorisations were necessary. It states: "Disposals are permitted only when the waste containment characteristics and performance of the site have been fully assessed".
I accept that, even if the Government had carried on with this proposal and had come to a different conclusion the day after the White Paper was announced, waste from the nuclear industry would not have been deposited on tips without careful consideration of their containment characteristics. However, the fact is that the document listed municipal refuse sites that would be considered for the disposal of nuclear waste--nuclear waste would not be disposed of at those sites but they would be considered for it.
The existence of a list heightens public concern. People know that, even if the tip they live near has not been designated as a disposal site, it is on the list for consideration to be so designated. The public naturally react. They believe that Government lists have some validity and that proposals that the Government make are likely to come to fruition.
It is not as though the Government could not have foreseen what would happen. Indeed, I find it staggering that the Government felt that they did not have to offer
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