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26 Feb 2003 : Column 261—continued

Point of Order

12.30 pm

Mr. Eric Forth (Bromley and Chislehurst): On a point of order, Mr. Speaker. The House is in an absurd position today, as a long-awaited, oversubscribed and vital debate appears to have to finish at 7 o'clock. Is there any proper reason for that, Mr. Speaker? Is there any reason why, in another place, debate will continue for as long is necessary to hear all the speakers, whereas here we are apparently subject to an arbitrary and unnecessary 7 o'clock time limit? Is there anything that can be done even at this late stage, with your help, Mr. Speaker, and that of the Government, to extend the debate to allow more people to speak on a matter of the greatest importance to hon. Members and everybody in the country?

Mr. Speaker: I am in the hands of the House, and the House has decided that 7 o'clock will be the moment of interruption. There is nothing that I can do about that. However, the right hon. Gentleman gives me the opportunity to say that he is right—many hon. Members have applied to speak in the debate. Before we go onto the main business, we have the ten-minute rule Bill. It would not be appreciated if hon. Members approached the Chair to ask whether there will be an opportunity for them to be called. That would be out of order on a day like this.

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Needle Stick Injury

12.32 pm

Laura Moffatt (Crawley): I beg to move,

I should like to start—[Interruption.]

Mr. Speaker: Order. It is bad manners for hon. Members to hold a conversation, as the hon. Lady is addressing the House. Hon. Members should leave the Chamber quietly and should not walk in front of her, as that is also bad manners.

Laura Moffatt: A needle stick injury is a puncture wound in which the needle is either whole or broken. Astonishingly, 100,000 such injuries are reported to occur in the NHS alone every year. All workers in a health care setting are at risk—nurses, doctors, midwives, phlebotomists, cleaning staff, portering staff, domestic staff, ambulance staff, community nurses and therapists. However, the problem is much bigger because public sector workers, including refuse collectors, park wardens, road sweepers, police and their support staff, gardeners, builders and teachers—in fact anyone who may come into contact with a hypodermic needle—are at risk.

The injuries themselves are comparatively superficial—it is only a pin-prick, after all—and rarely serious, but that only increases the likelihood of under-reporting and failure to obtain necessary testing and treatment. I shall come back to that later. The real danger is the infections that may be transmitted, including blood-borne viruses such as HIV, hepatitis C, hepatitis B and 20 other serious blood-borne viruses. The first ever transmission of HIV to a care worker from a patient happened in the UK. So far, five staff are known to have contracted HIV in that way and, sadly, four of them are dead. The Department of Health study in 2001 found the risk of transmission following a needle stick injury to be one in three for hepatitis B, one in 30 for hepatitis C, and one in 300 for HIV.

It is astonishing to learn that needle stick injury is second only to violence and aggression as a cause of occupational injury in the NHS, but it is not only NHS staff who are affected. Between July 1997 and June 2002, the Public Health Laboratory Service received reports of more than 1,500 exposures to blood-borne viruses, of which 734 cases—140 a year—were caused by hollow bore needles, which are the riskiest. Nurses and doctors account for an astonishing 77 per cent. of those reports.

The Royal College of Nursing is involved in an excellent monitoring study called Epinet, and is working to improve our understanding of the size of the problem and its causes. As I said, the figures show that at least 100,000 needle stick injuries occur every year. Between January and June 2002 across 19 sites, the Epinet study found that 925 incidents were reported. Figures for the six months covered show that on average per 100 beds,

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12.74 needle stick injuries will occur each year. With under-reporting estimated at about 60 to 80 per cent., the actual figure is probably much higher than 100,000.

The highest cost of all is the distress caused by such an injury. As a nurse with 25 years' experience, I know only too well how much anxiety is caused as a result of needle stick injury. For some, it can take a year of routine testing before they know whether or not they have contracted a life-threatening infection. For most, thankfully, the test results finally come back clear, but for others the news is devastating, life-altering and sometimes life-threatening.

There are financial implications. The Safer Needles Network, which has spearheaded the campaign, has done a huge amount of work around the financial impact on the NHS of such injuries. We already know that people outside the NHS can be at risk, and they may have no idea of the level of risk that the needle with which they have been stuck could cause them.

What happens when someone suffers such an injury, whether it be high or low risk? Some of the implications are time off work, blood tests, occupational health time, vaccination, treatment, counselling, administration time on the part of managerial staff, and of course compensation. The cost to the NHS of a low-risk accident is £310. The cost of a high-risk accident could be as high as £35,000. Taken as a whole throughout the NHS, the cost of needle stick injuries is £300 million. The estimated cost of introducing safer needles into the NHS is £49 million. The figures speak for themselves.

Much of our current legislation and Department of Health guidance is about protecting patients from infected health care workers, and rightly so, but we must ensure that any public sector or health care worker who may be at risk is protected. Safer needles cannot do the job alone. Good education and training for groups at risk is a must. I commend the work of the Federation of Master Builders, which last October issued excellent guidance to its 13,000 members. In 2002, the World Medical Association called on all national medical

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associations to work with their Governments to develop effective policies on the safe and appropriate use of injections. That is why I am pressing for change today.

Many people are involved in the Safer Needle Network. It is made up of the trade union Unison, the Royal College of Nursing, the British Medical Association, clinicians, professional organisations and, of course, the manufacturers of the devices themselves, all of whom have been working extremely closely with the Department of Health, the Medical Defence Association and Her Majesty's Prison Service. I particularly want to thank Bob Wade for all the help that he has given. I should also like to thank the Minister of State, Department of Health, my right hon. Friend the Member for Barrow and Furness (Mr. Hutton) for the personal interest that he has taken in this matter, and for receiving a delegation led by my hon. Friend the Member for Barnsley, West and Penistone (Mr. Clapham).

The Bill deals with an important issue that needs to be taken on board by the Government. It is time to protect all workers who are at risk from used needles by improving existing health and safety legislation. For that reason, I commend the Bill to the House.

Question put and agreed to.

Bill ordered to be brought in by Laura Moffatt, Mr. Michael Clapham, Mr. Ben Chapman, Mr. Neil Gerrard, Ann Keen, Anne Picking, Helen Jones, Jonathan Shaw, Mr. Kelvin Hopkins, Judy Mallaber and Ms Julia Drown.

Needle Stick Injury

Laura Moffatt accordingly presented a Bill to make provision about the protection from needle stick injury and resulting infections of persons employed in the health care sector and of other persons engaged in activities at work which carry a significant risk of such injuries and infections; to establish requirements relating to the recording and publication of information about such injuries and infections; to establish standards relating to the supply and use of certain equipment for work which carries a significant risk of such injury and infections; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 4 April, and to be printed [Bill 61].

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Mr. Speaker: I inform the House that I have selected the amendment tabled in the name of the right hon. Member for Islington, South and Finsbury (Mr. Smith).

12.42 pm

The Secretary of State for Foreign and Commonwealth Affairs (Mr. Jack Straw): I beg to move,

This motion means what it says. It is not an endorsement of military action by United Kingdom forces. No decision to deploy British forces in action has yet been taken. As my right hon. Friend the Prime Minister spelled out a few moments ago, we will put any decision on military action to the House, and the timing will be subject only to the usual caveats about the safety of our forces. It is as much in the Government's interest as it is in the paramount interest of the House that we should do that before the start of any hostilities. In addition, there will be oral statements to the House on the business of the Security Council, and a full opportunity to debate and vote on the outcome of proceedings on any second resolution.

Let me commend to the House the Command Paper "Iraq", which I presented yesterday. For the convenience of the House, this contains in one document the reports of Dr. Blix and Dr. el-Baradei, statements on the Iraq crisis by the European Union and by NATO, my statements at three recent Security Council meetings, and, above all, the full texts of 13 of the principal Security Council resolutions on Iraq passed since August 1990.

The situation that we face is plainly grave. It is a matter that, across a range of beliefs, arouses great concern and anxiety. So in this debate I want to answer what I think are the central and continuing questions in people's minds. Why Iraq? Why now? Why not more time, more inspectors? Why a second resolution? Why not persist with the policy of containment, rather than contemplate military action? And finally, is not the west guilty of double standards, especially in relation to Israel/Palestine?

Let me deal with those questions in turn. First, why Iraq? The best answer to that question is to be found in the 42 pages of text of the 13 Security Council resolutions that form the first section of the Command Paper. There we see, paragraph by paragraph, the exceptional danger posed by Iraq, and its continued defiance of the United Nations. On 2 August 1990, resolution 660 tells Iraq to withdraw from Kuwait. On 29 November 1990, resolution 678 offers Iraq a "final opportunity"—interesting words—to comply, which it fails to take. On 3 April 1991, resolution 687 gives Iraq until 18 April 1991 to make a full declaration of the "locations, amount and types" of all chemical and biological weapons and of all medium and long-range ballistic missiles. That resolution bars Iraq from ever developing biological, chemical or nuclear weapons.

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On and on the resolutions go. Resolution 688 is "gravely concerned" about the repression of the civilian population in many parts of Iraq. In 1994, resolution 949

three years after the original invasion. In 1999, nine years after the invasion of Kuwait, resolution 1284 establishes a further inspection regime

Iraq flatly and completely refuses to comply.

Last November, resolution 1441 recognised

and gave Iraq its "final opportunity to comply".

So, for the United Nations, the answer to the "Why Iraq?" question is very clear. Iraq is the only country in such serious and multiple breach of mandatory UN obligations. It is the only country in the world to have fired missiles at five of its neighbours, the only country in history to have used chemical weapons against its own people, and the only country in the region that has invaded two of its neighbours in recent years.

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