| Previous Section | Index | Home Page |
Ian Pearson: I shall talk about the remit in a moment. First, let me say a few words about climate change and some of the comments made by hon. Members during the debate about that. I emphasise that all companies have to make an assessment of the impact of climate change as part of their 25-year water resources plans. They will continue regularly to update those plans on the basis of different views on climate change.
Let me just correct my hon. Friend the Member for Leyton and Wanstead in one of the comments that he made about Thames applying for a drought order that could allow for standpipes. That is not the case. A drought order restricts non-essential usage, and it is an emergency drought order application that would allow the use of standpipes. In a modern age, I would not expect any water company to move down the route of standpipes.
My hon. Friend the Member for Leyton and Wanstead also talked about supply pipe leakage. Water companies already operate schemes to assist with the repair and replacement of consumers’ own supply pipes that leak. This makes up a significant proportion—around 30 per cent.—of the total amount of leakage in all water companies. They are already carrying out work in this area. My hon. Friend and the hon. Member for Richmond Park (Susan Kramer) mentioned the prospect of drought orders in the run-up to the Olympics. I would like to emphasise that water companies, including Thames Water, are preparing a 25-year water resources plan. These aim to balance supply and demand and to improve security of supply ready for 2012.
The hon. Member for Bexhill and Battle (Gregory Barker) made a point about tourism, but I see no reason why tourists who want to come to London for the summer should be worried about water supplies. The drought order that Thames is currently applying for should not affect the tourist industry and a clear message should go out to potential tourists, “Please come to London, have a great summer here and do not worry about the water.”
My
hon. Friend referred to Thames’s desalination proposal and the
issue of effluent re-use. He will be aware that an appeal is currently
under way on the desalination proposal, so it would not be appropriate
for me to comment. Effluent re-use is a method already used by other
water companies, particularly by Essex and Suffolk. The Government are
supporting water re-use technologies such as rainwater harvesting, grey
water use and the recovery of effluent in appropriate circumstances.
The code for sustainable homes will promote the use of alternative
water sources. The hon. Member for Cheltenham (Martin Horwood) referred
to that and to tax breaks. The Government’s scheme of enhanced
capital allowances providing tax relief for businesses investing in
sustainable water technologies including rainwater harvesting is, I
believe, an important
initiative.
Martin Horwood: Will the Minister put any pressure on the Department for Communities and Local Government to make the case for sustainable building compulsory rather than voluntary?
Ian Pearson: We are currently considering that issue. The hon. Gentleman also raised a general point about what he seems to see as the failure of water management and the overall regime. This is a point also alluded to by the hon. Member for Bexhill and Battle. I want to assure everyone that the Government are not complacent in this matter, but we do believe that we have a well-defined regulatory regime with clear responsibilities. We have an economic regulator in Ofwat and an environmental regulator in the Environment Agency. We do not have a command and control structure. My hon. Friend the Member for Leyton and Wanstead would perhaps prefer that we did and that we had direct control of the water industry, but that has not been the case since privatisation. That is why the concept of turnaround teams is not appropriate. Thames Water or another water company are independent water companies in a different position from a school or hospital. I hope that the hon. Member for Cheltenham appreciates that difference.
Martin Horwood: I thought that the Minister was in favour of the independence of schools and hospitals. On the regulatory regime, I asked a specific question about whether the concept of economic levels of leakage had reached the end of its useful life as an indicator that was driving the area of target setting. Will he comment on that?
Ian Pearson: Economic levels of leakage is a concept that has stood the test of time and is currently adopted by Ofwat. We discussed leakage rates and targets at the water meeting that the Secretary of State and I had with water companies, Ofwat, the Environment Agency, CCWater and others on 1 June. We agreed then that we want to review leakage rates and the leakage process. It is right that we have a look at that given the overall level of public concern, but I would not want the hon. Member to think that we do not think that there is utility in the current system at the moment. We believe that looking at costs and benefits to consumers is important and Ofwat has statutory responsibilities to ensure that the consumer receives a fair deal from the water industry.
I was also questioned on the overall regime more broadly by the hon. Member for Bexhill and Battle. I emphasise again that under a Labour Government we have moved away from what was an ad hoc planning regime prior to 1997 to a regime whereby companies produce drought plans and 25-year water resource management plans that will be placed on a statutory basis from 1 April 2007. That will give greater opportunities for the Secretary of State and DEFRA to be able to influence plans and it will ensure greater public accountability of the planning system.
Gregory Barker: Will the Minister give way?
Ian Pearson: It would be helpful to move on and answer some of the hon. Gentleman’s questions before we run out of time. The hon. Member for Richmond Park referred to discharges of sewage into the Thames. There is an issue with storm water discharges including sewage overflows into the Thames. As she will be aware, a major study by a joint group including Thames Water, the regulators and Government has looked at solutions including their cost to customers. We are working towards an early decision on the matter.
I will move on to the comments directly raised by the hon. Member for Bexhill and Battle. First, I will address metering. Recent suggestions in the press that national compulsory water metering is being considered are completely unfounded. As my right hon. Friend the Secretary of State and I said at the meeting with the water industry on 1 June, the water savings group is looking at accelerating metering in areas of water stress. Retaining regional variation is essential to any proposals, as are the need for proper public scrutiny and the protection of vulnerable groups.
The water savings group, which I chair and which includes representatives of the environmental and economic regulators—the water industry and the Consumer Council for Water—will report further in the summer on its metering proposals for water-stressed areas, and it will do so fully and publicly.
The hon. Member for Bexhill and Battle on one hand criticises the Government for having a lack of vision and, on the other, says that on balance the overall framework is right. He acknowledged in his quote from the article in the Financial Times that£17 billion of investment is going into the water industry in the period 2005 to 2010. He also said that fines are not sufficient, but I must point out that he voted against the Water Act 2003, which introduced the system of fines to give that option.
The hon. Gentleman said that there are no incentives in the system for Thames Water or others to run their businesses efficiently, but I cannot see how he can say that and then say that on balance the overall framework is right. The price cap regime provides strong incentives to companies to improve their efficiency, as does shareholder pressure. As I said to him when we last debated the issue, if expertise from other sectors can usefully be applied to the water industry we are certainly prepared to examine it and encourage the dissemination of new technologies to the industry.
I answered
the hon. Gentleman’s questions on the powers of the regulator
when referring to other questions asked. He also raised the issue of
reservoirs. The Government have a twin-track approach to water supply,
which requires demand-side management options, such as helping to
encourage behavioural change, alongside the use of new technologies to
control leakage. Such options need to be fully deployed before new
supply measures are adopted, because new and enlarged reservoirs are
potentially costly and have long lead times. There are proposals in the
industry’s 25-year water resources plans for five new and three
extended reservoirs. Four of the new reservoirs are planned for the
south-east. The 25-year plan is rightly
intended to balance supply and demand and ensure that water efficiency
and leakage rates are examined seriously and appropriately before we
consider introducing extra supply
measures.
I shall finish by outlining the process for the Thames Water drought order application, as my hon. Friend the hon. Member for Leyton and Wanstead asked me to do. The statutory process requires the company to advertise its proposals in the area in which the restrictions would apply. People will have seven days from the date of advertisement to object to the Secretary of State, which they may do by e-mail or letter. From his speech, it is clear that when he sees the advertisements he will know what to do.
As with the other recent drought order applications, we will arrange for the company’s proposals and the arguments of objectors to be aired at a hearing presided over by an independent inspector. The inspector will examine whether the legal criteria have been met, which is a prerequisite for recommending that a drought order should be made. In addition to the objections made, the hearing will address other issues, such as whether the best use has been made of the resources available to the company, both service and groundwater, and the matter of leakage. The inspector will produce a report with recommendations, which will be considered by my officials. It will then be up to the Government to make a decision.
Mr. Martin Caton (in the Chair): We must now move on to our next debate.
Jeanette Crizzle
12.30 pm
Mr. Philip Hollobone (Kettering) (Con): May I place on record my thanks to Mr. Speaker for granting me permission for the debate today on Mrs. Jeanette Crizzle and the wider issue of bone marrow donation? I also welcome the Health Minister to her place.
Mrs. Jeanette Crizzle is a Kettering resident who, in October 2005, was diagnosed with acute myeloid leukaemia. That is obviously tragic news for her and for her wonderful family: her husband, Adam, and her two teenage children, Emily and Nicholas. Jeanette is an English teacher at Bedford preparatory school and she has been in the teaching profession for the best part of 30 years. In the initial fight to combat her condition, there was a desperate need to find a suitable donor who would enable her to have a bone marrow transplant.
The complication in Jeanette’s case is that she comes from a mixed Mediterranean and English background. She is 75 per cent. Mediterranean and 25 per cent. English. Her mother was Greek, so she gets 50 per cent. of her background from Greece, and her father was 50 per cent. Italian and 50 per cent. English. It has been extremely difficult to find suitable bone marrow to match her heritage. Indeed, it has sadly proved impossible thus far.
When the Crizzle family was advised in January this year that it was unlikely that a suitable bone marrow donor would be found, Jeanette’s husband, Adam, decided to give up his job not only to care for her but to launch an international campaign to try to find a suitable donor. The purpose of today’s debate is not only to highlight the unusual plight that Jeanette finds herself in, given her unusual background, but to praise Adam for the tremendous campaign that he has launched and to prompt the Government to take further action to try to encourage wider bone marrow donation.
Adam gave up his job and launched an international campaign, starting with e-mails and internet activity among his friends and acquaintances. The school where Jeanette worked, Bedford preparatory school, has swung in behind the campaign, as has the Anthony Nolan Trust. Mobile clinics have been established in Bedford, Kettering and elsewhere to try to encourage people of Mediterranean origin to become bone marrow donors. An extensive media campaign has been launched that has achieved terrific coverage, not only in the regional media but further afield. Initiatives included publicity on London’s Greek radio and trying to tap into communities in Greece, Italy, the United States and Australia, all in a search to find a suitable donor.
It has been a remarkable effort, reflecting Adam’s positive philosophy on the dilemma in which he and his family have found themselves. To quote from one of the many e-mails that he has launched as part of his campaign:
“I have had a few people contact me to ask if I would join them in a demonstration with placards outside No. 10 Downing Street, to highlight the lack of funding and support for cancer research in general. Having reflected upon this suggestion, I found the words of Marcus Aurelius coming into my mind: ‘How much more grievous are the consequences of anger than the causes of it.’
Even though I sincerely appreciate the sentiment of people wanting to highlight this cause, I would prefer another approach. Ultimately, I believe that the way forward for a campaign of this nature is not through protest but by debating in a courteous and effective manner.”
That is the tremendously impressive and positive approach that has coloured Adam’s campaign throughout.
The highlight of the campaign so far has been a meeting with the Minister of State, Department of Health, the hon. Member for Doncaster, Central(Ms Winterton), on 19 April, which was held at the Department. At that meeting, Adam was able to present a report to encourage the Government to undertake an initiative to promote the benefits of bone marrow donation among 16 to 18-year-olds. I am pleased that the Department has decided to take up that initiative and I praise the Department and the Minister for so doing.
The Government’s positive response was confirmed in a letter from the Minister to me on 12 May, and on 8 June Adam Crizzle was invited to an important meeting with NHS Blood and Transplant to plan the details of how such an education initiative could be launched. I understand that an educational pack—with a website alternative—is to be launched in September 2007, which will be targeted particularly at sixth formers.
Mr. Peter Bone (Wellingborough) (Con): I congratulate my hon. Friend on securing this important debate; I also attended the meeting with the Minister. On the point about education, does he agree that because of the difficulty in filling donor places in the Asian community, it would be good to concentrate initially on areas where there are ethnic minorities?
Mr. Hollobone: I am grateful for that intervention and I appreciate my hon. Friend’s attendance at the meeting in the Department. I share his concern that there are too few donors from ethnic minority communities. There is also a wider issue, which is that there are too few donors, full stop, from any community. I shall develop that point later.
An important part of any debate about bone marrow donation is the general misconception among the population about how easy it is to become a bone marrow donor. Since Jeanette was diagnosed with myeloid leukaemia in October 2005, it has become obvious to Adam that there is a terrible misunderstanding of what is involved in being such a donor. Most people assume that being a donor involves a major operation, and that is one of the chief reasons why people are not offering themselves as donors, and why the suffering of so many cancer patients continues. One of the main purposes of Adam’s campaign is to change people’s conceptions of how difficult it is to be a donor. Initially, donors have to give only a 4 ml blood sample. After that, there are two methods of bone marrow donation: the traditional bone marrow harvest and the newer, increasingly used, peripheral blood stem cell donation.
The former
is a medical procedure that involves a hospital stay and a general
anaesthetic. The newer method provides an alternative collection that
many donors find simpler. The donor has some injections in the week
before donation, to encourage blood stem cells to move from the bone
marrow—where they are
first created—out to the circulating bloodstream. They are then
collected on a blood separator machine in a collection lasting for up
to five hours.
Mr. Mark Satchell, a UK donor in June 2004, recently said:
“There’s not much to say about the actual process except how easy it was. It was really no different to giving blood, except it lasted for four hours—but there was no discomfort or pain. To anyone thinking of becoming a donor, who may be put off by the thought of the procedures you need to go through, I would say it’s much easier than you would believe”.
If the general UK population understood that point, far more people would come forward to be donors.
That was confirmed by an exercise conducted at a school in Bedford by Mike Mallalieu, the head of science, who undertook a presentation and two questionnaires for sixth-formers in the school. Before the exercise, the first questionnaire found that 25 per cent. were prepared to be a donor, and 65 per cent. were not sure. After the presentation, when it was made clear how easy it is, 89 per cent. said that they were prepared to be bone marrow donors, and only 3 per cent. were not sure. Those findings so impressed the Department of Health that it has decided to take up Adam’s initiative.
There are 9 million bone marrow donors on registers worldwide, and their details can be accessed through Bone Marrow Donors Worldwide. However, in the UK there are only 371,000 donors on the Anthony Nolan Trust register, and 2.1 million blood donors on the NHS blood and transplant and British bone marrow registers. During the last three years, however, there has been an increase of only 100,000 blood donors coming forward to be bone marrow donors as well. I am one of those: last month I signed on to the British bone marrow register at my regular blood donation session.
The problem is that a person cannot become a bone marrow donor on the Anthony Nolan Trust register if they are over 40, or on the British bone marrow register if over 44. I would like urgent attempts to be made to raise those age limits, because I think that hundreds of thousands of people over the age of 40 or 44 in this country would come forward to be donors if they understood how easy it is.
Of course most people on the register are never required actually to donate their bone marrow. For example, of the 371,000 on the Anthony Nolan Trust register, only about 300 a year are called on to be donors.
My hon. Friend the Member for Wellingborough (Mr. Bone) made an excellent point. In this country, most donors are white and caucasian. There is a particular lack of donors coming forward from mixed-heritage backgrounds, and Jeanette’s case sadly illustrates that. Any efforts that can be made to encourage donors from ethnic minority communities would be welcome.
We must not lose sight of the fact, however, that there are not enough bone marrow donors, full stop. Indeed, on the British bone marrow register, thereare 273,000 donors, which is only 1.2 per cent. of the 22.5 million people in this country aged between 18 and 44.
In conclusion, I would like genuinely to thank the Government for their positive response to the initiative of Adam Crizzle, but there is much more to do. My fundamental point is that the Government need to get across how easy it is to donate bone marrow, and if they can do that, hundreds of thousands more people will come forward.
I know that Adam would want me to use this debate to thank the many people who have helped his campaign and offered assistance to Jeanette, not least those at Kettering general hospital and other health practitioners; the Anthony Nolan trust; the Leukaemia Society; Chris Godwin, the head teacher at Bedford preparatory school; Mike Mallalieu, the head of science at Bedford high school; the shadow Minister for health, my hon. Friend the Member for Billericay(Mr. Baron); Mrs. Liz Reynolds at the NHS Blood and Transplant service; and, of course, the Health Minister and her officials.
I shall conclude my remarks with a quotation that Adam provided. The American writer, Norman Vincent Peale, said:
“You must never conclude, even though everything else goes wrong, that you cannot succeed. Even at the worst there is a way out, a hidden secret that can turn failure into success and despair into happiness. No situation is so dark that there is not a ray of light.”
12.46 pm
The Minister of State, Department of Health (Caroline Flint): I congratulate the hon. Member for Kettering (Mr. Hollobone) on securing the debate and welcome the hon. Member for Wellingborough(Mr. Bone). They both attended a meeting earlier this year with the Minister of State, Department of Health, my hon. Friend the Member for Doncaster, Central (Ms Winterton), to discuss awareness of the need for donors of bone marrow and what is involved, which was covered by the hon. Member for Kettering. That is an important part of how we can encourage an increasing number of people to come forward.
I shall talk later about the opportunity presented by the work that is being undertaken with the valuable input from Mr. Crizzle in respect of a school pack aimed at 16 to 18-year-olds, which will deal with bone narrow donation and the range of possibilities whereby young people, as they become adults, can perhaps regard that as part of their citizenship and that of their families and communities. One thing for sure is that none of us know when we or our families will need a donation of some sort, whether in relation to bone marrow, blood or organs.
Over the past few years, my hon. Friend the Member for Doncaster, Central has contributed greatly to raising the awareness of such issues and the ways that health professionals can broach them with their patients, as well as how we can get the message across more widely. It is important to use multi-media opportunities, an area that we need to know more about. The issue is particularly important, as was pointed out by the hon. Member for Kettering, for people from black and minority ethnic backgrounds. We live in a more diverse society and our blood is a mix of all sorts of genetic heritages and international links in one way or another.
The British Bone Marrow Registry is managed by NHS Blood and Transplant. It also operates on behalf of blood services in Northern Ireland and Scotland. Furthermore, I am talking about what we must donot nationally, but internationally. We must raise consciousness in other countries through Bone Marrow Donors Worldwide, an internet-based organisation with more than 10 million registered potential donors. I am pleased to say that we are one of the largest contributors to that internet registry of opportunities for people to receive donations.
The BBMR contains details of potential stem cell donors and donors of stored cord blood units. It recruits stem cell donors from active blood donors between the ages of 18 and 44. I shall touch again on the point raised by the hon. Gentleman about the age thresholds within the area. Cord blood units are collected from the placenta of new-born babies in National Blood Service partner hospitals. The NHS cord blood bank, which is run by NHSBT, was established in Edgware in 1996. It is one of 10 internationally accredited cord blood banks to date.
I understand that 122 cord blood units have been issued for transplantation. Some 37 per cent. of cord blood units issued came from BME donors, and 44 per cent. of the patients receiving cord blood came from BME communities. That shows how science gives us another opportunity to supply demand in areas in which, 10 to 20 years ago, the chances of success using that sort of donation were not great as they are today, with advances in technology and skills.
The BBMR works closely with other registers, including the Anthony Nolan Trust and the Welsh Bone Marrow Donor Registry. They can make reciprocal arrangements when seeking matches, which is important in terms of what is happening in our island and around the world.
The BBMR is directly funded by a grant from the Department of Health. During the past three years, it has received £10 million in revenue to fund the addition of 120,000 potential stem cell donors to the registry. At least 4,500 of those donors come from black or minority ethnic communities. Funding for 2006-07 has recently been agreed, and £1.82 million in revenue has been allocated to support the register and increase donations from BME donors.
As a result of Government funding, the BBMR has one of the best-quality registries in the world, although that is not to say that more cannot be done. We must examine how and where we need to increase donor numbers, particularly from communities that are not as well represented as they should be. At the same time, it is fair to recognise the achievements that have been made, and the fact that our register has such a high and internationally trusted reputation.
Two primary concerns guide the BBMR’s strategy. The view at a recent World Marrow Donor Association meeting was that the majority of non-BME patients may find some type of donor, as there are several valid ways to make transplants more widely available. However, a higher proportion of BME patients and patients of mixed race have less chance of finding a perfect match. In this diverse world in which diverse families live, we need to address that. As the BBMR grows, the chance of a newly recruited donor adding a new phenotype or individual characteristic to the registry falls. The more that we can do to increase take-up, the more opportunities there will be.
Mr. Crizzle’s report on the availability of bone marrow donors for UK leukaemia sufferers of Mediterranean origin was important, because it rightly focused on the need to recruit more donors to the UK registries—the Anthony Nolan Trust, the BBMR and the Welsh Bone Marrow Donor Registry. He concluded, and we agree, that that can best be done by raising awareness of bone marrow donation.
We can make more treatment available and put more money into cancer research, but if we do not have the donations, which are the complementary part of the process, in some respects it will not matter how much we have in those areas. We need that important part of the jigsaw.
Experience tells us that raising awareness increases take-up. Analysis shows that the register has recruited8 per cent. of active blood donors to join the BBMR in the past three years, and the BBMR represents more than 20 per cent. of our active blood donor base. That is quite important, because it was felt that if we could get people to donate blood, the next step—this follows on from the hon. Gentleman’s example from his own experience—would be for them to explore the opportunities of making even more of a contribution to their fellow citizens.
For that reason, NHSBT deliberately recruits to the BBMR from the active blood donor base. Because donors are already fully screened and have made a commitment to give blood, they are more likely to donate bone marrow.
| Next Section | Index | Home Page |