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Scottish Devolution

13. Mr. Dalyell: What consultation he has had with the Scottish Office since the referendum on the transfer of responsibilities which are currently his to the Scottish Parliament. [13821]

Mr. Dobson: Our proposals for devolution are set out in the White Paper "Scotland's Parliament". There are no plans to transfer any of my responsibilities to the Scottish Parliament.

Mr. Dalyell: May I assume that fertility treatment and abortion will remain reserved powers?

Mr. Dobson: That is correct.

NHS Staff (Attacks)

14. Mrs. Ellman: What guidance has been issued by his Department to protect NHS staff from attacks at work. [13822]

Mr. Dobson: As my hon. Friend knows, I think it is disgraceful that our society has descended so low that people who work in accident and emergency departments or who go out with ambulances or are district nurses or GPs cannot perform their duties without fear of assault and abuse. Since coming to my present office, I have made it a major priority that national service managers must do whatever they can to reduce the impact of violent assaults on national health service staff.

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We issued a circular on the effective management of security in accident and emergency departments--which was prepared in part by the previous Government--and, since then, we have issued further health and safety guidance on minimising the risk of violence to staff. I return to my initial point: it is, and must remain, a major target of national health service management to ensure that staff are not assaulted and abused. It is the duty of the whole criminal justice system to make sure that anyone who assaults a national health service staff member is punished severely.

Mrs. Ellman: I thank the Secretary of State for taking such decisive action in an important area that the previous Government neglected so badly. Can my right hon. Friend inform the House how we might improve the patients charter so that we can move from the empty rhetoric of the charter introduced by the Conservative Government and towards a charter with real rights and responsibilities for both patients and staff?

Mr. Dobson: National health service staff at all levels and in all disciplines tell me that certain aspects of the patients charter have led to an increase in the number of assaults on and abuses of staff, particularly in accident and emergency departments. That is one reason why we intend to change the patients charter and make it an NHS charter in which patients have responsibilities as well as rights.

Mrs. Virginia Bottomley: The right hon. Gentleman may be aware that many NHS non-executives fear that they are being attacked by the Secretary of State. There is a large number of outstanding appointments. The system was essentially endorsed after exhaustive examination by Lord Nolan. If the right hon. Gentleman discusses the matter with his noble Friends Baronesses Dean, Jay and Hayman--and many others in this place who served on trusts--he will discover that they are very worried that he will exceed the actions of one of his predecessors who vindictively dismissed 150 appointees when he came to power. Will the right hon. Gentleman state that he has no intention of attacking those NHS non-executives who have done so much for the health service?

Mr. Dobson: I do not propose to demean the House by answering that stupid question about the former Secretary of State's Tory friends losing their places on national health service trusts, when my hon. Friend the Member for Liverpool, Riverside (Mrs. Ellman) was referring to the physical assault and abuse of nurses, doctors and ambulance staff. If the right hon. Lady thinks that there are parallels between the two cases, no wonder she made such a mess of this job.

Tobacco Advertising

15. Mr. Lock: What action the Government are taking to reduce tobacco advertising. [13823]

Ms Jowell: The Government are fully committed to banning tobacco advertising and are currently taking an active part in discussions with European Union member states on the draft directive on tobacco advertising.

Mr. Lock: I thank my hon. Friend for that statement. Does she accept that about one in six of my constituents

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who die, die as a result of tobacco-related illnesses, and that the vast majority of them began smoking before they reached the age of 20? Does she further accept that the tobacco companies know that, and target their billboard and magazine advertising at young people? Will she join me in condemning the Conservatives, who for 18 years knew the statistics and failed to take any effective action to protect our young people?

Ms Jowell: As my hon. Friend makes clear, the record of the previous Government is shameful. As a result of their negligence, there has been an increase in the rate at which young people smoke. That is why we are committed to implementing a wide range of measures, which will be set out in our White Paper next year and which are designed particularly to tackle the increasing problem of young people taking up smoking. Most people start smoking before they are 20. That is why it is important to focus on efforts to stop young people taking up smoking in the first place.

Dr. Julian Lewis: Can the Minister come up with even one formula to explain away the Government's U-turn on their manifesto commitment to ban tobacco advertising?

Ms Jowell: There is no U-turn on any manifesto commitment: we will ban tobacco advertising, because we are determined to reduce the rate at which people die through smoking.

Fiona Mactaggart: My hon. Friend the Minister mentioned in earlier answers the increase in smoking among young people that occurred under the previous Government. Has she any particular plans to tackle the increase in smoking among young women, as smoking has increased more quickly among them than among young men? Can she give us a preview of the actions she plans to take to target that group, who are extremely vulnerable and at risk of dying in future from their smoking now?

Ms Jowell: My hon. Friend makes an important point. There is no single measure that will enable us to be successful in reducing the rate at which people die through smoking. The case of young women is a good example. We will have to work with women's magazines and women's organisations to tackle the glamorising of smoking, which persuades so many women, young and older, to take up smoking. For many poor women, the reason they smoke is that their lives feel hopeless. That is why a range of other Government policies--such as getting young lone mothers back to work and raising educational standards--will all help in our battle to reduce smoking.

Cosmetic Surgery

16. Ann Clwyd: If he will make a statement on the regulation of cosmetic surgery. [13824]

Mr. Milburn: Statutory control of clinics offering cosmetic surgery in the private sector is provided through a system of registration and inspection delegated to health authorities under the Registered Homes Act 1984.

Ann Clwyd: I am grateful to my hon. Friend for that answer. I know that the Government have already set up

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a review into silicone implants. Will he look again at regulations for private cosmetic clinics? I gave the previous Government a great deal of evidence about hundreds of women who have been scarred and injured as a result of treatment by cowboy operators in some private cosmetic clinics. Is my hon. Friend aware that a previous president of the Royal College of Surgeons said that animals are better protected in Britain than are people? Will he re-examine the matter?

Mr. Milburn: I commend my hon. Friend's work on behalf of patients who have suffered through cosmetic surgery in the private sector. All patients, regardless of whether they receive their treatment and operations in the private sector or the national health service, should expect the highest possible standards of medical care. My hon. Friend will be aware that there are certain safeguards for patients within the current regulatory framework. Ministers are considering how better to safeguard patients' interests when they use private sector medical treatment.

National Blood Transfusion Service

18. Dr. Harris: If he will publish performance indicators for all regions of the national blood transfusion service. [13827]

Mr. Dobson: A range of performance indicators for the national blood service's operations are being developed. Some of them should be published later this month. I want to ensure that any indicators of performance make sense and are acceptable to the clinicians who receive the services from the national blood transfusion service. I am not wildly impressed by the senior management of that outfit.

Dr. Harris: Given the recently announced £3.5 million cost of redundancies in the national blood transfusion service since 1 April 1995 and that the interim Cash report on the move of services from Liverpool to Manchester stated that the national blood authority's plans were not proven and that it was too late to reconsider them, may I ask why the Secretary of State announced the setting up of the review only in August, given that it was an issue that the Labour party had campaigned on hard and effectively while in opposition and given also that the Labour Government prided themselves on hitting the ground reviewing in May?

Mr. Dobson: On getting into office, I immediately asked for reports on the state of the proposals for the transfer from Liverpool to Manchester of bulk processing of blood. Had I been in a position to take the initial decision, I would never have agreed to the transfer. I asked Professor Cash, the president of the Royal College of Physicians of Edinburgh and the former head of the Scottish blood transfusion service, to advise me. His advice was, reluctantly, that the Liverpool service was so run down that, in the interests of the safety and security of blood supplies, it was, sadly, necessary to go ahead with the transfer.

I expect Professor Cash to report to me shortly on the future of blood services in the north-west as a whole. On the basis of the reports which he has submitted to me, I expect that his views will have an impact on the

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provision of blood services throughout the country. That is one of the reasons why I am not very happy with the way in which the blood service has been run over the past few years.

Mr. Bermingham: Does my right hon. Friend agree that the mistake having been made--we all know that it was made in the transfer--steps should now be taken to review the north-west and the supply within it so that there might be adequate services in that area? Will he give me an undertaking that such a review will take place? I know that this appalling mistake is not my right hon. Friend's but his predecessor's, but will steps be taken to rectify it in due course?

Mr. Dobson: I have asked Professor Cash to produce a report that contains proposals on how best to secure the interests of the people of Merseyside and the needs of clinicians working in the area who are trying to provide top-quality treatment and care, and then to put in place machinery to make that possible.

I return to the basic point: that the blood service must be adequate and safe for the people of Merseyside and for people in every other part of the country. People throughout the United Kingdom should have sufficient confidence in the service to ensure that they are willing to continue as blood donors. I urge people to do so, because blood is always desperately needed and good use is made of it.


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