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Madam Deputy Speaker: As I understand it, the two-week period ended last night.
22 Feb 2005 : Column 186


Prevention of Terrorism

Mr. Secretary Clarke, supported by The Prime Minister, Mr. Secretary Prescott, Mr. Chancellor of the Exchequer, Mr. Secretary Straw, Mr. Secretary Darling, Mr. Secretary Murphy, Mr. Peter Hain and Ms Hazel Blears, presented a Bill to provide for the making against individuals involved in terrorism-related activity of orders imposing obligations on them for purposes connected with preventing or restricting their further involvement in such activity; to make provision about appeals and other proceedings relating to such orders; and for connected purposes: And the same was read the First time; and ordered to be read a Second time tomorrow, and to be printed. Explanatory notes to be printed [Bill 61].


Mr. Secretary Darling, supported by The Prime Minister, Mr. Secretary Prescott, Mr. Chancellor of the Exchequer, Secretary Margaret Beckett, Ms Secretary Hewitt, Secretary Tessa Jowell, Mr. Peter Hain and Mr. Tony McNulty, presented a Bill to make provision for a railway transport system running from Maidenhead, in the County of Berkshire, and Heathrow Airport, in the London Borough of Hillingdon, through central London to Shenfield, in the County of Essex, and Abbey Wood, in the London Borough of Greenwich; and for connected purposes: And the same was read the First time; and ordered to be read a Second time tomorrow, and to be printed. Explanatory notes to be printed [Bill 62].

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Regulation of Laser Eye Surgery

2.27 pm

Mrs. Gwyneth Dunwoody (Crewe and Nantwich) (Lab): I beg to move,

Last year, in the United Kingdom, more than 100,000 laser eye procedures were carried out. It is important to understand that laser eye surgery, in the hands of those who are properly trained and who have proper after-care and pre-care services, is a safe procedure; indeed, it is an entirely safe procedure. It is also important to realise that the United Kingdom is ahead in such procedures and is rapidly building a reputation for high-quality surgery of this kind.

Some time ago, however, the House of Commons Tea Room, which has been the venue for many important meetings, was the establishment in which my hon. Friends the Members for Stockton, North (Mr. Cook) and for Norwich, North (Dr. Gibson) decided at a breakfast meeting that there were some real worries in this type of surgery. They decided, sensibly, first, to call a public meeting within the precincts of the House, but secondly, to set up a series of meetings, which turned into an ad hoc committee procedure to examine closely the question of making the United Kingdom the safest place in the world to have laser eye surgery.

I was lucky enough to take part in that procedure a little way down the line, but I want to pay tribute to my hon. Friends the Members for Stockton, North and for Norwich, North, both of whom initiated a campaign that was undoubtedly needed. They did so because once they had called the meetings in the House of Commons, it became clear that not only members of the profession but members of the industry and the general public were very concerned. They had particular worries about advertising practices relating to laser eye surgery, standards of safety and regulation, and training of ophthalmologists and optometrists.

My hon. Friend the Member for Stockton, North will forgive me if I say that because he was not terribly well at one point, he was not able to sit through all the sessions that we arranged. I am enormously grateful to the hon. Member for Wyre Forest (Dr. Taylor) and to Professor John Marshall, who did a great deal of work on the report. Without them it would not have been completed, and would certainly not have achieved the quality and depth that I think we were able to produce. I think I represented the vox pop: anyone who examines the qualifications of each Committee member will see that I was the only one with neither a scientific nor a medical qualification.

We took a huge amount of very interesting evidence, some of which I found a bit disturbing. It became clear that we as a Parliament, and certainly the Government, should be looking closely at an industry that is growing exponentially, not just because of improvements in laser eye surgery generally but owing to the extension and development of new machinery. The report was given a great deal of secretarial support by Carl Zeiss UK, to which I pay tribute. At no point did it seek to influence either the choice of witnesses or the content of the report, but it underwrote our activities and gave us enormous help.
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Our report made a number of recommendations. We said that in patient counselling, advertising, patient consent forms and training there were gaps that worried us. We said that in the context of surgeon suitability and qualifications, we feared that members of the public were not automatically receiving the protections to which they were entitled, and highlighted areas in which such problems had arisen. We also pointed out that the matter could be dealt with in a number of ways, one or two of which I will identify now.

There is no doubt that we need stricter guidelines regulating clinical practice. Guidelines must be monitored and policed by the Healthcare Commission. The National Institute for Clinical Excellence published a report recently, and its guidelines could set a useful standard; but sanctions must be available when clinics flout the guidelines. It is essential for each clinic to have a senior consultant with specialist knowledge, training and experience in cornea and refractive techniques. He or she must take ultimate responsibility for patients in a system similar to that currently operating in the national health service, whereby NHS doctors receiving training report to a consultant.

We considered it important for all surgeons in this specialty to be suitably trained to an agreed standard. We decided that the Royal College of Ophthalmologists should approve and certify a training board procedure enabling us to maintain standards of care. It is essential to have a United Kingdom-wide training programme for ophthalmologists, and the RCO should approve individual clinic and manufacturer system-based training. It was clear that not all general practitioners were sufficiently well-informed, and that GPs should be offered a chance to expand their training and information. That would help them to know which referral and other procedures should be recommended.

Laser surgery, although enormously successful, is obviously not suitable for all patients. It is therefore vital for procedures for accepting suitable patients to be standardised and clarified. Only patients who meet defined criteria should be routinely treated. Safe operating parameters should be set, and the position should be made clear to patients in whose case adverse conditions and syndromes could lead to complications and increase the risks associated with laser eye surgery.

Clinics must be regulated. We laid down a series of parameters within which we thought that that could be done. We felt that the Healthcare Commission should have the power and authority to enforce regulations, and that clinics or surgeons failing to comply with those standards should be removed from the RCO's refractive surgery list. Those responsibilities would stretch the existing level of training and resources, but that, we concluded, was a demand that should be met by the state. The Healthcare Commission should be responsible for annual follow-up checks for laser safety, approved by the Medicines and Healthcare products Regulatory Agency.

It became clear to us that laser eye surgery was a useful and sensible procedure when properly carried out and organised, and when in the hands of correctly trained people. It has a lot to offer the House of Commons, but it is essential, before we experience serious problems, for the House as a matter of urgency to produce a useful and protracted scheme that will defend the interests of patients and the profession.
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I hope that Her Majesty's Government will support us in ensuring that such surgery is regulated. It is important, indeed fairly urgent, and the House of Commons should take that responsibility now.

Question put and agreed to.

Bill ordered to be brought in by Mrs. Gwyneth Dunwoody, Mr. Frank Cook, Dr. Ian Gibson, Dr.   Richard Taylor, Dr. Jenny Tonge, Dr. Andrew Murrison and Peter Bottomley.

Regulation of Laser Eye Surgery

Mrs. Gwyneth Dunwoody accordingly presented a Bill to regulate laser eye surgery: And the same was read the First time; and ordered to be read a Second time on Friday 18 March, and to be printed [Bill 63].

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Social Security

2.38 pm

The Secretary of State for Work and Pensions (Alan Johnson): I beg to move,

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