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21 May 2008 : Column 96WH—continued

21 May 2008 : Column 97WH

I am also disturbed by the way in which the DSA has ignored so many good, solid and constructive efforts in Minehead to keep the test centre in place. At one time, it appeared that the test centre would have to find new premises because its landlords—the local council—had other plans for the building. That might have been the DSA’s excuse for saying, “Okay folks, it’s time to go to Taunton,” but instead it paid lip service to the efforts made by the council—I praise councillor Keith Ross and West Somerset district council for trying to sort this out—the driving instructors and many others, including Minehead town council, to find alternative premises. The DSA did not attempt to discourage the search for new sites, but actively encouraged and urged us to look. Thus, it wasted everyone’s time, while pretending that it wanted to listen. With the help of West Somerset district council, no fewer than half a dozen workable sites were found and investigated, but the DSA said no to all of them.

For a whole decade, this blessed body, the DSA, has used a raft of different excuses to shut our test centre. There was the faint possibility of new European regulations, so we had a period of so-called consultation where all the arguments were advanced and the DSA ignored them. It tried to use the new motorbike tests as an excuse, but Minehead does not test motorbikes, and never has, as I said before. Now the DSA is relying on winning friends and influencing people with showers for the staff, and comfy chairs for the candidates. It stinks!

One other rather important point has been roundly ignored. The Minister’s driver is probably sitting at the wheel of his environmentally friendly Toyota right now. We all care about our carbon footprint, more so in the countryside, but this time the DSA has put its oversize carbon boots right in the deep doo-doo. The journey from Minehead to Taunton might look like a quick hop on a map, especially if one is sitting in the DSA’s Cardiff office, but in fact it is a gas-guzzling, stop-start trek from start to finish. I honestly suggest that the Minister tries it. It is dangerous, costly and a carbon nightmare.

I read the Minister’s speech on this subject after the hon. Member for Somerton and Frome (Mr. Heath) asked about the situation in his area. I do not envy the Minister his task of finding something sensible to say about a very unpopular and senseless decision. To many of my constituents, the loss of the Minehead test centre could be a tragedy. It is not necessary; I promise the Minister that it has nothing to do with EU legislation; it could cause accidents; it may lead to lawlessness, and it could be the very opposite of going green. In fact, the only things in its favour are those wretched new comfy chairs. To many of my constituents, the DSA’s initials now stand for: dreadful, senseless and arrogant.

11.14 am

The Parliamentary Under-Secretary of State for Transport (Jim Fitzpatrick): It is a pleasure to see you presiding again this morning, Mr. Benton. I congratulate the hon. Member for Bridgwater (Mr. Liddell-Grainger) on securing this debate, on the tone of his remarks and on the way in which he delivered them. I acknowledge that this is a big issue for his constituents.

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I begin, however, by advising the Chamber that we have decided to develop a new national network of driving test centres to facilitate new European requirements for practical driving and riding tests. The new European standards support our domestic strategy for reducing road casualties—to reduce the 3,000 plus killed and 30,000 seriously injured each year on our roads. Furthermore, these centres, which are based on an updated design, are fully compliant with the Disability Discrimination Act 2005 and also support the Government’s wider sustainability agenda. They are better suited to delivering a modern driving test than much of the current driving test centre estate.

The new centres will have the appropriate facilities to deliver all other types of practical test for learner car, lorry and bus drivers and motorcyclists. The DSA did not own or lease any sites that could provide a sufficient area of hard-standing upon which to undertake the new manoeuvres. A programme of land acquisition and construction was initiated in 2005, and so far the DSA has acquired 41 sites. As an organisation that relies on test fee income for the provision of its services the DSA needs to ensure that it can deliver a cost-effective service that avoids unnecessary expenditure.

The provision of multi-purpose test centres is expected to cost in the region of £71 million, which will largely be recovered through increased fees paid by driving test candidates. In order to keep those fee increases to the minimum, the DSA must closely examine how it delivers its services, and seek more efficiencies in the way that it conducts its business. That will include reviewing existing driving test centre provision to ensure that, while the service standard is maintained, there is no wasteful over-provision of facilities. Regrettably, that means that some existing facilities have to close. We have concluded that between 40 and 50 MPTCs would be required to meet existing service standard criteria.

To maximise population coverage, however, and to minimise the number of candidates who have to travel further than specified in the travel criteria, we are seeking to develop about 60 MPTCs across the country. Where population density is between 101 and 1,249 people per square kilometre, candidates should not have to travel more than 20 miles to a test centre. In the least densely populated areas where the population is equal to or less than 100 persons per square kilometre, the practical test centre should be located so that most customers travel no more than 30 miles to a driving test centre. The service standard applying to the Minehead area is that most candidates should not have to travel more than 30 miles.

The driving test centre at Minehead is located in the offices of West Somerset district council in Blenheim road, Minehead, as the hon. Gentleman outlined. In February 2008, the DSA was informed that the council would be terminating the lease, ending the tenancy with effect from 1 September 2008. As he rightly said, alternative accommodation has been offered by the district council, which has been considered by the agency, but rejected, because the site does not offer the full range of adequate facilities required of a modern driving test centre.

The DSA has also looked at wider issues around locating a driving test centre in Minehead. In order to provide fair and efficient driving tests, it is essential that each driving test centre is served locally by a number of test routes that provide opportunities for candidates to
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demonstrate their ability to drive in a variety of road and traffic conditions. Unfortunately, the local driving test routes in Minehead are considered to be substandard. The inadequacy of test routes in the area has helped persuade the DSA that, regrettably, it can no longer justify having a test centre in the town.

In the case of the hon. Gentleman’s constituents, it is anticipated that the majority who currently attend the Minehead driving test centre will have access to alternative facilities at Taunton, which is some 24 miles away. Taunton has capacity to absorb the demand from Minehead without compromising waiting time targets. Minehead does not have any examiners based permanently at the driving test centre, and examiners from the Taunton test centre conduct the tests at Minehead. In 2007-08, Minehead delivered only 956 car tests. As a comparison, in the week commencing 24 March 2008, the following numbers of car tests were delivered from local centres: 18 at Minehead, 89 at Taunton and 117 at Exeter.

I understand the natural desire to practise driving in the area close to the test centre, but we are not persuaded that it is a sound argument when deciding where to locate driving test centres. In the interests of road safety, driving instructors should be teaching pupils to drive and not simply to follow known test routes. I know that that is not the practice of all driving instructors, but there is a minority who make pupils drive the test routes more than they should. The week before last, a consultation document was published on new testing and training regimes on the basis that we need to tackle the 3,000 deaths on our roads every year and the fact that only 20 per cent. of pupils pass the test first time.

Pupils should experience a variety of roads, and different traffic conditions and locations to prepare not only for their test, but their future driving career. Visits to the test centre need only be for pre-test familiarisation. As a multi-purpose test centre is being developed at Taunton, and is planned to open in February 2009, the future of the Minehead driving test centre was already under review. Because of the concerns about test routes and the need to ensure that the DSA delivers a cost-effective service, the likelihood is that the test centre would have had to close in any case. In that situation, the actions of West Somerset district council have simply accelerated the process.

It should also be noted that only car driving tests are delivered from the Minehead driving test centre. Motorcycle, lorry and bus driving test candidates from Minehead currently have to travel to Taunton or Exeter, which is 47 miles away. The hon. Gentleman is as aware as I am of the difficulty in rural areas of striking the right balance between the provision of a satisfactory level of public service and the costs that that service incurs.

In closing the Minehead driving test centre, I believe that the DSA has struck the best balance available. The hon. Gentleman has raised his concerns about learner drivers travelling from Minehead to Taunton on the busy A358 causing delays or accidents. As the DSA advocates safe driving for life, we would expect roads of that standard to be included by an instructor during the latter part of a candidate’s training regime. It is preferable
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that experience of that road is gained while candidates are accompanied by an experienced instructor rather than as an unaccompanied novice driver. Familiarity with a local road can only lessen the risk of them being the cause of an accident in the future.

Mr. Liddell-Grainger: The Minister is unaware of how dangerous those roads are. Let me give him a steer on the problem. The county council wanted to impose speed limits on the road. The police were so concerned that they refused to enforce the speed limit, against the county. It is such a bad road. We have the highest level of elderly people in the county and their driving is quite slow. Added to that, the country’s biggest Butlins is based in Minehead, which means that people overtake all the way along the road. As the Minister said, young learner drivers will have an instructor to go down to Taunton, but most of the time, they will be with a parent, a brother or a sister. I cannot stress enough how dangerous the roads are. The police cannot enforce the speed limits.

Jim Fitzpatrick: I take entirely to heart the hon. Gentleman’s comments. Although death rates on our roads have been reducing in line with the Government’s road safety strategy, death rates on rural roads have stubbornly not come down at the same rate. We have just given an extra £8 million to four rural county authorities that are beacon authorities in road safety. I will send the details to the hon. Gentleman after the debate. Those authorities have been successful in reducing their rates and we want to know what they are doing, and how they can spend the money to demonstrate even greater progress so that we can roll out their examples to other rural and county authorities to try to encourage improvements in performance. Varying the speed on certain roads is an engineering solution and is one way in which the police, county councils and road safety authorities should be able to deal with roads that are regarded as more dangerous than others.

I fully accept the points that the hon. Gentleman made about young drivers. They are why we are changing the driver training and testing programme. Too many young drivers, who are in the first six or 12 months of their driving careers, are disproportionately counted among the fatalities and serious injuries on our roads. They are not being trained to an adequate standard for a whole number of different reasons. People think that they pass a test because of luck rather than judgment. They are not being adequately prepared to deal with the risks on our roads, particularly on our rural roads. I do not underestimate the seriousness and the sincerity with which the hon. Gentleman raises the question about the road between Minehead and Taunton. If there is anything that we can do to help, we would be very happy to do so.

I regret that my response is not what the hon. Gentleman wanted to hear, but I hope that it has explained the background and the policy decision behind the issues, and I will send him the information that I promised him later this week.

11.25 am

Sitting suspended.

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Liver Disease

[Mr. Martyn Jones in the Chair]

2.30 pm

Dr. Brian Iddon (Bolton, South-East) (Lab): I am pleased that my hon. Friend the Member for Derby, North (Mr. Laxton), who is chairman of the all-party group on hepatology, secured this debate. Unfortunately, he is unable to be here because he has had a minor operation in hospital that involved his mouth and it would have been a little difficult for him to deliver his speech. With the kind permission of Mr. Speaker, I have been asked to open the debate in his place, as vice-chairman of the all-party group.

We have only one liver, and it is a vital organ. Because I am a chemist, I have always described it as the chemical factory of the body. It processes all our waste metabolic products after the body has abstracted the vital carbohydrates, fats and proteins and the essential vitamins and minerals on which our life depends. If it begins to fail, a backlog of toxic chemicals throughout our system causes us all sorts of problems, and multiple organ failure results in death if those toxic products are not removed. We cannot ignore that vital organ—it is precious and, as I have said, we have only one.

Liver disease is caused by inflammation of the liver, or hepatitis, which can be provoked by alcohol or other drugs or by various viruses. It can also be provoked by antibodies directed at the liver. That is called auto-immune liver disease, and it predominates in women and is possibly genetically linked. Other causes of liver disease are excessive iron or fat deposition in the liver and a variety of much rarer diseases that are difficult to detect. Inflammation can become chronic and progress through cirrhosis of the liver, which is a scarring of the tissue, otherwise known as fibrosis, and has a high mortality rate, to cancer of the liver. I hope that my hon. Friend the Member for Norwich, North (Dr. Gibson) will appear here to tell us more about cancer of the liver.

A number of viruses affect the liver, the most common being hepatitis A, B, C, D and E. Only B, C and D can cause long-term disease, and the hepatitis D virus can survive in our bodies only if we are also infected with the hepatitis B virus. Carriers of those viruses might not exhibit symptoms of the disease, and indeed they can be carried for long periods. There are simple tests to detect them, which can be followed by a liver function test if necessary, and even by a liver biopsy, which is not a pleasant procedure, or a less interventional procedure known as ultrascan.

There are two reasons for my interest in the debate, both of which arise from my interest in hepatitis C. Early in my parliamentary career, a constituent called David Fielding came to see me. He was extremely ill with hepatitis C, which he had contracted through contaminated blood transfusions. David was a haemophiliac. Tragically, his brother, who was also a haemophiliac, died after contracting the same disease in the same way. Eventually, David Fielding was admitted to the Manchester Royal infirmary. Just before Christmas one year, when he was in critical condition and expected to die, he and his long-standing partner decided at long last to get married.

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Then David received what I expect was the best Christmas present that he or his family will ever receive. A call came from Jimmy’s hospital in Leeds, saying that at long last a matching liver had been found for him. The hospital had been looking for one for quite some time. He was rushed across the Pennines in an ambulance and thankfully, he is alive today because of that important liver transplant. Before the transplant, he looked awful. I met him several times and he was always yellow, full of the jaundice that people with failing livers experience.

I am pleased to report to the House that today, David is well and without the hepatitis C virus. He is campaigning to bring to the surface the truth about contaminated blood, much of it collected from prisoners in American jails, and has been to every sitting of the Archer inquiry, the results of which will be out later this year. I have given evidence to it, and I hope that our Government will take note of Lord Archer’s findings for the sake not only of David Fielding but of all the other people who are seeking the truth about the blood that transmitted to them viruses such as hepatitis B or C or HIV. An estimated 2,000 to 3,000 haemophiliacs received contaminated blood in this country before the Department of Health realised the huge risk of imported, contaminated blood.

My point in telling that story is to highlight the need for more people to register as potential organ donors. There is a staggering 500 per cent. projected increase in demand for liver transplantation in the next six to 10 years, which is a very short time span, and a similar projected increase in the incidence of liver cancer. Even with a vigorous organ donation campaign, there will not be enough livers to save all the lives that will be at risk. That is one reason why I have supported stem-cell research, which might allow us to grow tissues in the laboratory for the repair of organs such as the liver. Some 38 people die from liver disease every day in this country, and 100 people on the waiting list for liver transplants die every year. The huge shortage of livers for transplantation means that early diagnosis and treatment of liver disease is a far better option.

The second reason for my interest in the debate comes from my interest in the misuse of drugs. Whether they are controlled, prescription or over-the-counter drugs makes no difference. I am the chairman of the all-party group on drugs misuse. Some 80 per cent. of those who contract the hepatitis C virus, which I shall call HCV, do so as a result of injecting drugs and sharing syringes and other paraphernalia with other people. That is particularly the case in prisons, where we could do much more to prevent the spread of blood-borne diseases. Anyone in contact with the blood of an HCV or hepatitis B carrier is likely to pick up the viruses, as they are readily transmitted through contact with blood.

People such as David Fielding, who contracted HCV as a result of blood transfusions, have been extremely reluctant to campaign on the subject because of the stigma associated with it. However, the late Anita Roddick, of The Body Shop fame, who was a patron of the Hepatitis C Trust and contacted HCV as the result of a blood transfusion during childbirth, more than 30 years before the disease displayed symptoms throughout her body, was brave enough to campaign. HCV can lie undetected for such long periods without a patient feeling the symptoms, which start with dreadful fatigue, headaches and depression, leading to the other difficulties
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that I have mentioned. Anita’s husband has given the Hepatitis C Trust permission to use her image, and people will see posters advertising its work in the medical magazines and in public places throughout Britain. I wish to put it on record that we are very grateful to Anita Roddick’s family.

We chose to request the debate this week because it is national tackling drugs week—I shall be spending some time with the co-ordinator of our drug and alcohol team in Bolton on Friday—and because last Monday, 19 May, was the first ever world hepatitis day. It involved 200 patient groups in 15 countries and was co-ordinated by the Hepatitis C Trust, helped by all the organisations with an interest in liver disease.

Deaths from infectious diseases, cardiovascular diseases and cancer have been showing a strong downward trend in recent years, but, tragically, deaths from liver diseases in that same period have been showing quite the opposite: a strong upward trend. Sadly, the UK is the only developed country exhibiting that upward trend.

Obesity leads not only to diabetes but to fatty liver disease. Non-alcoholic liver disease may develop in people who have insulin resistance and type 2 diabetes. The condition is mostly preventable, of course, through exercise and by eating healthier foods, and I am pleased that the Government are paying attention to obesity.

I mentioned that contracting hepatitis C can result in mortality, as can contracting the hepatitis B virus, but excessive use of alcohol causes about 25 per cent. of liver disease, and more and more people are dying of it as a result. Younger people are starting to consume strong alcohol at an early age. Tragically, an increasing number of them, too, are being admitted to hospital with liver disease.

Many people with alcoholic liver disease are not actually alcohol-dependent, and they think that they are drinking alcohol safely when they are not. They are drinking alcohol at hazardous levels, and a change in their behaviour could save their lives. I am pleased that the Government are also concentrating on excessive alcohol consumption, otherwise known as binge drinking.

Deaths from alcoholic liver disease have doubled in the past 10 years. Patients with alcoholic cirrhosis are heavy users of expensive hospital resources. They occupy beds, including intensive care beds, that need not be occupied, and they require blood and various medical interventions from the national health service. All of that is avoidable. The NHS could make huge cost savings, and facilities could be released for those who have not made themselves ill in that way.

Heavy alcohol use in the person who carries the hepatitis C virus increases the risk of hepatitic cirrhosis 31 times, and the risk of developing cancer of the liver in an HCV-positive person with cirrhosis is increased seven-fold. The message is that drinking and hepatitis C together greatly increase the risk of mortality.

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