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1.13 pm
The Parliamentary Under-Secretary of State for Transport (Mr. Steve Norris): I am grateful to my hon. Friend the Member for Faversham (Sir R. Moate) for introducing what might at first glance appear to be a rarefied subject--trenchless technology--but one that is extremely important.
My hon. Friend rightly suggested that we cannot afford to ignore this issue. Trenchless technology is a generic term for techniques that essentially allow equipment to be installed or replaced under the street without breaking the surface--the no-dig concept. One example of this technology is a mole that can bore a tunnel between shafts that may be some distance from the street.
There is no doubt that such technology can be useful in reducing traffic disruption from street works. My hon. Friend rightly said that, even now, a number of industry experts believe that the full benefits or potential benefits of trenchless technology are not as well understood as they might be. That is a matter not just for the Department and local authorities but for those who sell the technology and develop it commercially.
The Department is clear that, as an alternative to open-cut trenching, trenchless methods have considerable advantages, the principal of which is that it generally costs less. For example, there is no doubt that they will be significantly less expensive for running a cable under a road--a classic application. Disruption on the surface is minimised: my hon. Friend gave a valid example from his area that could be replicated throughout the country.
Trenchless tunnelling is safer for operators and for the general public, and it improves relations between the utilities and the general public, because nothing more irritates the general public and upsets their relations with, for example, the gas or electricity boards than endless disruption of local streets.
Reduced environmental and social costs are associated with the technology. My hon. Friend gave some specific and graphic examples, and the effects of fully or partially closing a road, thereby severely restricting traffic flows, are quite serious.
There are, however, some disadvantages to trenchless technology--it is not necessarily a panacea in each case. I am advised that there are limitations on the use of the technology in certain ground conditions, and there is still the prospect of failure during operations, which can be extremely disruptive. The accuracy range of the technology is limited, and operators must be highly skilled.
The Department does not formally promote the use of the technology for street works, but disruption of the highway has become an increasingly important issue in recent years, not least because of the advent of the cable companies and the tremendous explosion in information technology that has resulted in countless new cables being laid, along with the expansion and upgrading of the sewerage system, and the supply of electricity and other services to new industrial areas.
In response, the New Roads and Street Works Act was deliberately designed to improve the co-ordination of works by local authorities, because it was felt, quite
rightly, that they should be in the driving seat, if hon. Members will excuse the pun, of such development. They have an incentive to encourage undertakers to consider trenchless technology wherever possible. Specific statements to that effect appear in the 1991 Act's code of practice, in the context of traffic-sensitive streets where the avoidance of disruption is particularly relevant.
In 1989, the Transport Research Laboratory was commissioned to undertake a project on the use of trenchless technology, to indicate the extent to which it could be used to avoid road opening. The resultant report, "Trenchless Construction of Pipelines", was completed in 1993, but has not been published. It suggested that new technologies could considerably reduce the social cost of traffic delays.
My hon. Friend cited some spectacular figures, but I have no reason to disagree with his conclusions. The report's findings may supply key evidence for the use of the reserve powers in the 1991 Act or for an extension of that legislation, if that proves necessary, whereby undertakers can be charged for unduly prolonged occupation of road space.
My hon. Friend would be the first to accept that it would be difficult to require the use of a particular technology as the only one available, given the myriad number of applications under the 1991 Act. We must take account of the fact that it may be necessary on occasions to allow a different methodology. However, if the utilities are provided with a real incentive to complete work in a timely fashion and with minimum disruption--using the obvious technique of charging for unduly prolonged road occupation--that might provide a spur.
We have not yet gone that far, because there has been a considerable improvement in street works co-ordination since the introduction of the 1991 Act. When a new computerised system is implemented that will enable utilities to notify local authorities more quickly and accurately than at present--allowing them to exercise their co-ordinating role to the full--further benefits will derive from the 1991 Act.
Further support for the use of trenchless technology came from the Street Works Advisory Committee report that was submitted in July 1995. It contained the specific recommendations that highway authorities should encourage the use of trenchless technology where appropriate, and that the codes of practice published under the 1991 Act should adopt a more positive approach to technology progress. Those recommendations were accepted by the Government, so we will consider amending the codes to reinforce the value of trenchless technologies.
Sitting suspended.
Driving Licences (Medical Conditions)
Mr. George Howarth (Knowsley, North):
I should first like to express my gratitude for the opportunity to have this debate today. The Minister will be aware that, on 12 July 1994, I introduced the Unfitness to Drive on Medical Grounds Bill under the ten-minute rule. The purpose of the Bill was to place a statutory obligation on medical practitioners to report cases to the Driver and Vehicle Licensing Agency when they considered a patient to be medically unfit to drive. As is usually the case with ten-minute Bills, mine did not receive a Second Reading.
My reasons for introducing the Bill arose from the tragic death of a young constituent, Paul Scarisbrick, in a road traffic accident on the M62 in Liverpool. The circumstances of Paul's death illustrate my argument. The accident occurred because a 73-year-old man, Mr. Abrams, who was suffering from Alzheimer's disease, took the wrong turn and ended up driving the wrong way along the M62. The outcome was that his vehicle collided with Paul's vehicle, and Paul was killed.
It emerged at the coroner's inquest that Mr. Abrams and members of his family had previously been advised by a consultant at Mossley Hill hospital that, given his condition, it was unsafe for him to continue driving. Unfortunately, that advice was ignored. Equally unfortunate was the fact that the medical practitioners concerned took the decision--the consequences of which were appallingly visited on Paul and his family--not to inform the Driver and Vehicle Licensing Agency of their concern.
It was the practitioners' view--it is a view held by many medical practitioners--that their greater responsibility was to preserve the doctor-patient confidentiality aspect of their relationship. It logically followed that public safety considerations were of subsidiary importance.
I received a letter from the corner who conducted the inquest--Mr. S. R. Barter MBE, a respected Liverpool district coroner--who said:
There have been further developments since I first raised the issue in the House two years ago. I have received a great deal of encouragement from members of the public and from a wide variety of organisations to continue pressing this issue, and I have been encouraged greatly by Mr. and Mrs. Scarisbrick, Paul's mother and father, to continue the campaign.
I received a letter from a person in Crewe. I do not have her permission to use her name, and so she shall remain anonymous. She said that she had heard about my Bill on BBC news, and went on to say:
On 29 July 1994 I received a letter from a solicitor, Mr. Bernie Rowe, of Lyons Davidson solicitors, in Bristol. He said:
That is some of the evidence. I have files full of evidence, but selected only those two examples because I think that they make useful and significant points.
Some 12 months ago, with Mr. and Mrs. Scarisbrick, I met the Minister, who was kind enough to arrange a meeting in his office. We all felt that it was a constructive and useful meeting. I thank the Minister for the helpful and sympathetic approach he has taken to this case and to the issues that it raises.
The Minister's position then was that, while he sympathises with the aims of my Bill, he has been advised by the lawyers concerned that it would be difficult to introduce an acceptable procedure for policing statutory obligations on medical practitioners. I think that that is still his position.
In a letter to Mrs. and Mrs. Scarisbrick, dated 13 May 1996, the Minister said:
So far, so good, but I remain unconvinced that those new arrangements, although very much an improvement over the previous system, provide any sanctions against medical practitioners who choose to ignore them, whether from misguided ethical considerations or from sheer negligence. Ideally, I should still like the arrangements to be put on a statutory basis. However, I realise that that is not a likely probability, at least in the short term.
I propose that the Minister enters into a consultation exercise with the General Medical Council, and with other interested parties, to discover whether it would be possible to develop a voluntary scheme that will be policed professionally rather than statutorily.
If the idea is to succeed, it must have three vital components. The first and most important criterion is that there must be a clear commitment to the reporting of such cases to the DVLA as a matter of routine, not as an exception. If a medical practitioner feels that somebody is unfit to drive, he must immediately report that fact to the DVLA. A separate set of procedures, which are extremely fair and do not make any prejudgments, is then pursued. The decision is subject to an independent medical examination.
Secondly, a clear sanction should be applied to medical practitioners who neglect to carry out that responsibility. If it could be made to work, I should have no objection if that were to be a professional sanction rather than a legal sanction under the criminal or civil law. If, when the Minister consults the General Medical Council, it can come up with such a way of dealing with the problem, I would be happy to see that go ahead, and to see whether it could be worked out without the need for statutory regulation.
Thirdly, Mr. Scarisbrick is keen, especially with progressive diseases such as Alzheimer's disease, that we should take into account the need for clear thought about how to determine at what point, in a general sense, a patient is liable to become unfit to drive for medical reasons. I know that that is a difficult concept to pinpoint, and that doctors are wary of applying generalised arguments to specific cases.
However, Mr. Scarisbrick has a point, because it is predictable that someone suffering from a degenerative disease is likely to become unfit to drive at some point. If the prospects cannot be easily determined, cases must be monitored and patients re-examined on a regular basis, to establish when they have reached the point at which they should no longer be driving.
Mr. Scarisbrick also asked me to raise four points, and I shall do so briefly. If the Minister wants to take more time to consider them, that is fine by me. I am sure that he will write either to me or to Mr. Scarisbrick about them. First, Mr. Scarisbrick feels that some progress has already been made, and he is grateful for that. Secondly, his main aim is to ensure that, once a person has been discovered to be suffering from an illness such as Alzheimer's disease, that person should not be allowed to drive. I covered that point in a slightly different way earlier.
Thirdly, Mr. Scarisbrick has noted that there are more and more reports of accidents involving older people, especially in cases involving motorway driving, in which the risks are often far greater--I believe that the Minister mentioned another such case in his letter of 13 May. Fourthly, Mr. Scarisbrick feels that, perhaps for a limited number of cases, there should be some process of medical certification when people apply for the renewal of insurance policies.
1.30 pm
"I am in no doubt in my own mind that the existing law should be changed by statute. Once a doctor has made a clinical judgment, following full investigation, that a patient is suffering from a disease which makes him a danger to himself and the public if he continues to drive, then he should be under a statutory obligation to inform the DVLA of his opinion."
That point of view should be taken heavily into account.
"My father suffered a stroke four years ago and lost the use of his left hand, and movement in his left leg was severely restricted. He applied to have to his licence renewed stating that he had been ill. A new licence was sent to him and no further checks were made. My father was 74 at that time and extremely anxious to drive. As he is a widower and I am the only child I felt responsible and
19 Jun 1996 : Column 848consequently wrote to DVLA to explain his condition, they then cancelled his licence that they had just issued. This action by me made the relationship between my father and I very awkward as he still thinks he would be all right to drive."
That letter is an example of the dilemma faced by family members who feel that an elderly parent who is in some way infirm should not be driving, and who take action. The decision clearly creates difficulties for their relationship with their parents or elderly relations.
"My firm deals with several thousand road traffic accident claims each year, and each year produces its 'crop' of cases, nearly always involving relatively serious road accidents, where serious injury or death has resulted from drivers who have continued to drive despite health problems which would suggest they should not be behind the wheel.
He went on to mention my Bill, which he supported.
As an immediate past chairman of the Motor Accident Solicitors Society, I know of many other solicitors throughout the country who will have a similar experience to my own. I had not been aware of your initiative on this matter until today, but as a result of reading the article in The Post, I have asked the Motor Accident Solicitors Society administrator to add to the next management committee's agenda details of your initiative."
"I would be sorry if you had the impression that progress had not been made in responding to the problem. When I wrote to George Howarth on 8 June, I included a copy of extracts from the document which the General Medical Council had recently agreed, advising doctors that they should be prepared to notify DVLA of cases of this sort, in certain specified conditions. This guidance has since been officially promulgated, publicised in national press and circulated to every doctor in the United Kingdom. Our Chief Medical Adviser has recently discussed the matter again with the GMC, and they will be undertaking some fresh publicity."
I am grateful for the action that has been taken.
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