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Mr. Bellingham: I am listening carefully to my hon. Friend, as one would expect, but I ask her to consider the following point. When drug addicts or other suspects swallow a package, they often put their health in extreme danger. We have had examples of packages opening in people's insides, and those people have died or have had to be rushed to hospital. Would my hon. Friend not agree that that is another reason why we need a time scale?
Mrs. Gillan: There are many reasons why we need to consider the time scale, and that was a helpful intervention.
Let us consider what happens in our accident and emergency departments, because the suspect's destination will be a hospital. Timing will be critical. In England, there are 155 trusts with at least one major A and E. According to the NHS handbook for 2004, which is published by the NHS Alliance, that is about the same as the number of acute trusts—NHS trusts with hospitals in them.
In the normal scheme of things, a vast array of diagnostic investigations is required for patients. They are required by emergency patients, and they include the plain X-rays and ultrasound scans that I assume the Minister envisages under the clause. Waiting for such procedures places an additional burden on patients. Existing processes, which are usually designed around the efficiency and resources of individual departments, can often inadvertently cause delays for the patient whose pathway takes them, for example, from one department to another within the hospital.
What will happen, therefore, when the police ring up the local hospital, saying, ''We want to bring a suspect down for an immediate X-ray''? Will staff be available? Staff roles have been expanded, and practitioner roles in radiography, as well as nurse requesting and nurse interpretation of X-rays, have been introduced. How will we know, however, that the relevant staff will be available and that there will be time on the machines to carry out the X-ray and ultrasound scan for the police?
There are some facts and figures about what is happening in our health care system, and the National Audit Office has come up with some interesting data
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about emergency provisions. The Department's survey data show that there are delays to diagnostic tests in A and E, accounting for 11 per cent. of long stays in A and E. We therefore know that there are bottlenecks in A and E departments. I accept that the numbers may be falling, but many trusts must still make an effort to address the problem of access to diagnostic services for ordinary patients, let alone suspects who are brought along from the local police station for an X-ray or a scan.
There are also problems with national shortages. For example, there is a national shortage of radiographers—
Mr. Bellingham: And radiologists.
Mrs. Gillan: And radiologists—my hon. Friend takes the words out of my mouth. There are only 72 departments where a radiographer is available 24 hours a day. So, the Minister has some other problems. It is possible that an X-ray will be needed in the middle of the night and that the inspector will want it carried out immediately—
Caroline Flint: Why limit it to three hours?
Mrs. Gillan: Exactly, but the amendment is a device to encourage debate—a probing amendment to enable us to discuss the issue of timing.
We have problems because normal patients experience delays in radiology departments; there is not 24-hour cover from technicians and staff who are suitably qualified to carry out or interpret the X-rays and scans; and, of course, in some cases there are enormous gaps in the availability of equipment.
Mr. Bellingham: In my local hospital, the Queen Elizabeth hospital in King's Lynn, there is a shortage of radiographers and radiologists. Although the hospital's representatives would never say so publicly, I think that they would regard the extra pressure of people being brought in by the police for X-rays as a problem for patients; it would put waiting lists and procedures under pressure. If no time scale were specified in the Bill, inordinate delays could result.
Mrs. Gillan: I think that that is right. The Minister must tackle all those questions of timing and access.
I know that some trusts have been quite advanced and have arranged some form of access to a consultant radiologist at all times, for the interpretation of results and the making of diagnoses, despite the shortage of such specialists. Interestingly, at least 10 trusts have developed telemedicine systems for CT scans, and six trusts have or plan remote-access digital X-ray facilities. Has the Minister investigated the availability of such technology for application under clause 5?
Amendment No. 38 is another probing amendment and would remove paragraph (b) from proposed new section 55A(1) of PACE. The Minister has included an extra hurdle in the subsection, requiring the officer—of at least the rank of inspector—to believe that the person was in possession of a class A drug
''with the appropriate criminal intent before his arrest''.
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What is the reason for that extra hurdle? Why, if there has already been an arrest, should the inspector have to satisfy himself further that the suspect who was in possession of the drug was in possession of it with the appropriate criminal intent before his arrest? The fact that the arrest has taken place is surely sufficient to indicate that the behaviour of the suspect was such that an arrest had to be made.
I wonder why proposed new subsection (1)(b) has been included. Surely, if a person has been arrested and the officer believes that he may have swallowed a controlled drug, that should be sufficient to trigger the search by X-ray or scan, and it is not necessary to create a further hurdle—the requirement for the officer to believe that the person was in possession of the drug with appropriate criminal intent before arrest.
10.15 am
Mr. Crispin Blunt (Reigate) (Con): Perhaps I might briefly add to my hon. Friend's argument the example of what might happen after the arrest of a group of people. If the drugs are passed from one person to another after arrest, either in the back of a police van or at whatever stage in the custody process, and the amendment is not made, those people will be given a defence.
Mrs. Gillan: That is very possible. The Minister should put that on her list of points to answer.
Amendment No. 39 is simple and will delete the words ''or both'' from line 29 in subsection (1) of new section 55A. We need to examine in what situations we might find that the inspector requires both an X-ray and an ultrasound scan. As I understand it, both X-rays and ultrasound scans would be able to detect drug packages in an individual suspected of swallowing drugs. X-rays are only able to detect objects that are opaque to light and all X-rays involve radiation, so they should not be performed without a clinical indication to limit exposure to the harmful effects of radiation.
While we are considering what an X-ray actually does, we need to hear from the Minister what arrangements she will make, because I am informed that effects from X-rays are particularly damaging to a foetus and that they should not be done on a woman who believes that she may be pregnant, unless it is absolutely unavoidable. [Interruption.] Obviously, the Minister has thought about that; it hardly surprises me. However, I think that while we are discussing the clause, and as this is the largest group of amendments—I am sorry to be taking up so much time of the Committee, but these amendments contain the substance of the debate—I hope that she will let us know what arrangements have been made, particularly to deal with women.
Mr. Carmichael: The hon. Lady raises the question of the position of an arrestee who is pregnant. In retrospect, does she think that that is another good reason why authorisation should be given by an officer of the rank of inspector or above?
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Mrs. Gillan: I have acceded to the fact that the authorisation should be given by someone of the rank of inspector, but the deduction would be made by a police officer of a lower rank because they are most likely to be the person present when the swallowing takes place. I certainly hope that the hon. Gentleman is not saying that one would have to be above the rank of inspector to detect that a woman may be expecting a baby. Of course, pregnancy could be a reason given by a female suspect for resisting having an X-ray or a scan.
Packages of drugs are opaque to light and I am informed that they should be easily detected on an abdominal X-ray. However, as the provision is drafted it says that both an X-ray and an ultrasound scan can be carried out on the same person. An ultrasound scan uses high-frequency sound waves to examine the structures of the body. Its advantage is that the patient is not exposed to the potentially harmful effects of radiation. However—this is the nub of the problem—an ultrasound scan and the procedure involved are much more time consuming than an X-ray.
X-rays or ultrasound scans need to be performed by qualified health staff, who can be a radiographer, a radiologist or a doctor with specialised training in radiology, but both X-rays and ultrasound scans would need to be interpreted by an appropriately qualified doctor. I presume that that would be a radiologist. When does the Minister envisage that both an X-ray and an ultrasound scan would be required? For example, if a female suspect was informed that an X-ray or ultrasound scan was required, and she said ''But I am expecting a baby,'' I could envisage an ultrasound scan being used in that instance, but when would both be used? What will the cost of using both be?
Mr. Carmichael: I suggest that the answer lies within the hon. Lady's question. It might well be that authorisation is given for an X-ray, but if the inspector is then advised that the woman is pregnant, surely it should be open to him to authorise an ultrasound scan at that stage? The fact that both are authorised, does not necessarily mean that both have to be carried out.
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