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House of Lords

Thursday, 23rd November 1995.

The House met at three of the clock (Prayers having been read earlier at the Judicial Sitting by the Lord Bishop of Chelmsford.): The LORD CHANCELLOR on the Woolsack.

NHS: Organisation

Lord Molloy asked Her Majesty's Government:

    Whether they will consider instituting an annual conference of all major organisations involved in the running of the National Health Service.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege): My Lords, Ministers and officials have frequent contact on matters of mutual interest with all major organisations connected with the running of the National Health Service.

Lord Molloy: My Lords, I am grateful to the Minister for that Answer. Is she aware that the 30 organisations which comprise the National Health Service are grateful for her endeavours in making representations on their behalf as well as in smoothing the good organisation of the NHS? However, they are concerned about just one matter which the Minister might be prepared to consider. In a national emergency of some sort, and in the event of our country being in some distress, should there not be some arrangements to allow our National Health Service to play its vital part?

Baroness Cumberlege: My Lords, elaborate systems are in place to deal with any national emergency. I do not think that a conference would be the way forward. It would take some time to arrange.

Baroness Gardner of Parkes: My Lords, does my noble friend agree that there are already innumerable conferences on a much smaller scale and that there is already a great deal of networking and liaison between all sectors of the health service? Does she further agree that the proposed annual conference, which I presume would be an enormous jamboree, would be nothing but a terrible waste of money? Does my noble friend have any idea what the cost might be, because most major conferences are really just showpieces and I am sure that we would all rather see that money spent on the National Health Service?

Baroness Cumberlege: My Lords, my noble friend is absolutely right and, being the chairman of one of the most famous of London's teaching hospitals, she has in-depth knowledge of the subject. I have no idea what the cost of such a conference would be. However, I am sure that it would be large and that that money would be better spent on patient care.

Baroness Jay of Paddington: My Lords, but does the Minister not accept that further consultation with those who work in the health service might lead to the restoration of confidence within the health service,

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which in the past few months has been shown to be at a very low ebb among professionals? We have seen unprecedented unrest from the nursing and midwifery professions, and I have now read a survey which states that 70 per cent. of hospital consultants are seeking early retirement--all at a time when patients' complaints are rising by 30 per cent.

Baroness Cumberlege: My Lords, I totally refute that. I visit a lot of hospitals and community units and meet a great many staff. I was with the Royal College of Nursing last week, and met members of the medical profession and managers only last night. I do not accept what the noble Baroness says, although I do accept that there is pressure in the health service because of the demands on the system. However, I do not think that further formal consultation is necessary because it takes place the whole time informally. Indeed, the Secretary of State holds quarterly meetings with all the major organisations.

Lord Molloy: My Lords, perhaps I may advise the noble Baroness that I totally agree with her, although many people believe that there should be such a national conference. Indeed, noble Lords opposite ought to acknowledge that in a free country those who work in the National Health Service have every right to think that. I do not agree that there should be such a national conference and I congratulate the Minister on her response. However, in the event of a grave emergency we should look at how our NHS and its wonderful staff can play a great role.

Lord Butterfield: My Lords, although I agree with all that has been said, I wonder whether the Minister could give some thought to the possibility of holding an annual get-together at which different parts of the health service could boast, as it were, about their achievements in the past year. It would be very interesting to hear what different sectors of the health service felt had been their greatest achievement over the year. Does the Minister agree that that would be encouraging and would perhaps disseminate good ideas? I acknowledge, however, that it would cost money.

Baroness Cumberlege: My Lords, I agree with the noble Lord that our National Health Service is a great success. We are treating more people than ever before. We are seeing waiting times plummet. We are cutting bureaucracy and administration costs and, through the Patient's Charter, we are seeing an improvement in the quality of the services that are provided. We have a great deal of which to be proud. I am also proud that people from all over the world beat a path to our door to see what we are doing and what we have achieved. There are other ways of disseminating information than through a national conference. I think that it is up to local health authorities and trusts to tell local people exactly what has been achieved. Indeed, many are doing that.

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Organophosphates: MS17 Guidance Note

3.6 p.m.

The Countess of Mar asked Her Majesty's Government:

    Who was responsible for the distribution of the information contained in original Guidance Note MS17 from the Health and Safety Executive of December 1980 and in the revised version of October 1987.

Lord Lucas: My Lords, Guidance Note MS17 was published by Her Majesty's Stationery Office from 1981 to 1993. In its successive versions, it was available as a priced publication from HMSO bookshops, and since 1993 it has been sold by HSE Books.

The Countess of Mar: My Lords, I thank the noble Lord for that Answer. Perhaps I should explain that the guidance note is entitled Biological Monitoring of Workers Exposed to Organophosphate Pesticides. The guidance note states:

    "Regular monitoring should be considered for anything more than occasional exposure to OP compounds e.g. garden use".
In view of the fact that many farmers, horticulturalists, forestry workers, contract sprayers and contract dippers use organophosphates on a regular basis, may I ask the noble Lord why the Government have never thought it reasonable to distribute the guidance note to all those who use the products? If the Government had done so, they could probably have saved an awful lot of ill health in the years after 1980.

Lord Lucas: My Lords, the guidance note is designed for health professionals. It has been widely distributed. I believe that about 30,000 copies have been purchased. I agree with the noble Countess that the guidance from 1987 onwards when it was strengthened was that biological monitoring should be considered for anyone using organophosphate pesticides more than occasionally. People excepted from that are those such as farmers dipping twice a year or people who occasionally attach flea collars to cats or dogs. However, health professionals involved with those who carry out contract dipping or who are regularly exposed to organophosphate pesticides should consider monitoring them.

The Earl of Clanwilliam: My Lords, will my noble friend allow me to expand slightly upon the organophosphate problem by asking him, first, if he will assure the House that there is no connection between the application of organophosphate compounds on the spines of beasts, cattle and dairy herds and the incidence of BSE infection in the spinal cords of those beasts, which is causing much concern? Secondly, has my noble friend taken note of the letter of Sir Julian Rose from his farm in Berkshire to The Times on 16th November in which he stated:

    "No dairy or beef cattle born and bred on registered organic farms have ever been affected by BSE"?

Will my noble friend comment on that?

Lord Lucas: My Lords, we are satisfied that BSE in the UK is an infection from feed and that it has nothing

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whatever to do with OP pesticides or any other of the wild rumours which have been put around over the past few years. I have not read the letter mentioned by my noble friend, but it would not surprise me at all if organic farms were largely exempt because the feed of the cattle infected with BSE was made out of other cattle and on organic farms they may not use that type of feed.

Lord Monkswell: My Lords, the noble Lord advised the House that the guidance note referred to in the Question was aimed at the relevant health service professionals. Bearing in mind that presumably all of those health service professionals would be employed by the NHS, would it not be more logical that they should be circulated with a free copy of the guidance note rather than have to buy it?

Lord Lucas: My Lords, there is a voluminous series of these notes. Most of the health service professionals have access to them nowadays through CD-Rom and other such technologies. They know that when they come across a potential health problem they should look to the relevant guidance note. They are aware that the HSE covers all such poisons, and they will look for what is required. It is entirely right that when they do so they should purchase the guidance note just as they purchase text books.

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