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Motion made, and Question put forthwith, pursuant to Standing Order No. 108 (Welsh Grand Committee (sittings)),

Question agreed to.

30 Nov 1999 : Column 277


Motion made, and Question proposed, That this House do now adjourn.--[Mr. Jamieson.]

11.55 pm

Mr. Adrian Sanders (Torbay): Thank you Mr. Deputy Speaker, for allowing me to raise--[Interruption.]

Mr. Deputy Speaker (Mr. Michael J. Martin): Order. An hon. Member is addressing the House, so other hon. Members should leave the Chamber quietly.

Mr. Sanders: Thank you, Mr. Deputy Speaker.

I am grateful for the opportunity to raise an important issue in the House. I have declared a relevant interest. It has been pointed out that some might take offence at a Member of Parliament addressing the House in a dinner jacket, but that is unavoidable: I came here straight from an event to which I hope to return at the end of business.

Currently, 140 million people throughout the world are known to have diabetes. That figure--

Rev. Ian Paisley (North Antrim): On a point of order, Mr. Deputy Speaker. In the previous debate, you made a ruling in respect of something I said. May I draw your attention to column 605 of the Hansard of 24 November? At that time, the Secretary of State for Northern Ireland made certain comments which could be taken to refer to only one person, my hon. Friend the Member for Belfast, East (Mr. Robinson). I should like you to read the Hansard and give a ruling on the matter.

Mr. Deputy Speaker: The matter will be looked into. Let us return to the Adjournment debate.

Mr. Sanders: Currently, more than 140 million people around the world are known to have diabetes. That figure is projected to rise to 300 million by 2025. In the UK, the figure is currently 1.4 million, and it rises every week.

Diabetes is the biggest single cause of blindness among adults of working age in the UK. The risk of hospital admission owing to heart disease is increased fourfold among those with diabetes. Diabetes is one of the most common causes of kidney failure. Half of all lower limb amputations other than those carried out following trauma are a consequence of the disease. Diabetes consumes more than 5 per cent. of health care spending in this country, which is £2.5 billion each year or £70 a second.

The Government's response has been to launch the national service framework on diabetes. It is imperative--[Interruption.]

Mr. Deputy Speaker: Order. The best thing would be for the owner of that device to leave the Chamber.

Mr. Sanders: It is imperative that people with diabetes have access to top-quality diabetes care. I hope that the national service framework will achieve that, when it is published in 2001. The Government recently announced the co-chairs of the NSF expert reference group, and are currently assembling the core members of the group. I hope that people with diabetes are properly represented on the core group and topic sub-groups, because they are

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the end-users; they, like me, live with the condition every day. People with diabetes are the real experts and the Government should make full use of their input.

The scope of the NSF has yet to be announced, but I believe it to be imminent. Vital to the success of a comprehensive NSF is that it covers the entire diabetes life cycle, from cradle to grave. That means from diagnosis to treatment, and from childhood to old age.

At the beginning of this month, the British Diabetic Association launched its report on diabetes care in nursing and care homes. Research reveals numerous deficiencies in the care elderly people receive in care homes: lack of care planning, inadequate nutritional guidance, lack of specialist health expertise input, and inadequate and unstructured medical follow-up. With about one in 10 people in care homes having diabetes, that issue must be examined. I should like all to receive equal, high-quality care, and the BDA report makes a number of suggestions, based on the active involvement of individual residents, to rectify the shortcomings I have described. The Secretary of State has been sent a copy of the report, and I hope that he will respond positively and take action.

The Government announced in the Queen's Speech their proposals for a care standards Bill to improve care across social services in private and voluntary health care and in child care. I hope that such a Bill will have the desired effect. Meanwhile, the on-going "Fit For the Future?" consultation document on improving standards of residential care for older people is a further opportunity for progress.

It is important that better standards of care are introduced, and we need to end discrimination against people with diabetes. The recent implementation of the second European Community directive on driving licences effectively bans insulin-dependent diabetics from driving large vans and minibuses.

Mr. Desmond Browne (Kilmarnock and Loudoun): I first became aware of the absurd state of the law in relation to insulin-dependent drivers in the United Kingdom when one of my constituents, James Murray, who was a light goods vehicle driver, became insulin dependent and found himself almost overnight not entitled to an LGV licence or to retain the licence that he had previously held, which allowed him to drive vehicles between 3.5 and 7.5 tonnes and some minibuses.

The hon. Gentleman will be aware that the roots of the legislation lie in the directive to which he referred, but it is one that allows some flexibility to the member countries of the European Union. Does he agree that the James Murrays of this world will find it inexplicable that while our Government have applied the directive stringently, other European countries have protected existing drivers who have occupational licences by using the exceptional circumstances provisions of the directive?

Mr. Sanders: The hon. Gentleman is absolutely correct. There are different interpretations and it is bizarre that a Dutch diabetic can come to the UK and drive a vehicle on our roads while a UK driving licence holder cannot drive the same vehicle if they are both insulin-dependent diabetics.

Since 1991, diabetics have been banned from driving heavy goods vehicles under the first EC directive on those matters. I would argue that the Department of the

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Environment, Transport and the Regions has interpreted the second directive in an unnecessarily harsh way. I would reiterate the points that the hon. Member for Kilmarnock and Loudoun (Mr. Browne) made.

Since 1998, more than 1,000 people with diabetes who applied to renew their C1 licence, which allows them to drive a van or vehicle weighing between 3.5 and 7.5 tonnes, have had their application refused. My attention was recently drawn to the case of a man who ran a haulage firm in Kent for 26 years. Running the company meant moving lorries around in the depot. He lost his licence as a result of changing on to insulin. He was a diabetic before that happened. As he could not afford to hire an extra employee, he was forced out of business.

I have examples of people in my constituency who have had their earnings reduced--at worst they have lost their jobs--as a result of the restrictions. There are hundreds more cases of that sort, yet the Department's suspicion that people with a medical condition, such as diabetes, are less fit to drive than others is not substantiated by any medical or scientific evidence. Instead of a blanket ban, I believe that a system of individual assessment should be adopted by the Driver and Vehicle Licensing Agency.

The EC directive under which the regulations were adopted allows for a certain amount of flexibility, and as I have mentioned, other EU member states take a more lenient approach. I am not advocating a lapse in road safety--far from it. Stringent annual health checks by a diabetes specialist should be used as a basis for individual risk assessment. Only those who show good blood glucose control and have no further complications would be allowed to drive larger vehicles or passenger carrying vehicles.

Blanket bans are always unfair and I am sure that many hon. Members will be aware from their postbags and surgeries that this discriminatory policy is causing distress to many people throughout the country. With the possibility of a third EC directive on driving in the pipeline, it is time that the Government reviewed their approach. Meanwhile, the Select Committee on Science and Technology is investigating the issue, and I hope that the Government take note of evidence to the Committee calling for a fresh look at the regulations.

Health care should be accessible, and that includes accessibility in terms of cost. Yet in many parts of the country people who use pen needles to inject insulin currently have to pay for their needles. I and a number of hon. Members on both sides of the House have been engaged in a long battle to make those needles available on prescription. I pay tribute to the hon. Member for West Lancashire (Mr. Pickthall) for the work that he has done on the issue over the years.

When the current Secretary of State for Health was first at the Department, before his spell at the Treasury, he initiated a consultation process, but the matter has still not been resolved almost a year on. I see no justifiable reason why the decision should be delayed further. The Government have given an assurance that they agree with the principle that pen needles should be free on prescription. They say that they are still consulting, but surely the situation should not be allowed to drag on any longer.

Meanwhile, the Department of Health has yet to rule out the blacklisting of disposables as a cost-saving measure. Disposable pen needles are essential for people

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who have visual impairment or lack manual dexterity and find it difficult to fill reusable pens. These simple devices are a vital part of many people's diabetes control. I ask the Government not to delay any further, as the current situation discriminates against poorer people with diabetes.

Good health care should be a right in this day and age, and should not be based on ability to pay. I urge the Government to consider seriously the various points that I have raised tonight, and to ensure that people with diabetes are treated with equity, fairness and dignity.

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