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Yugoslavia: EU Sanctions

Lord McCarthy asked Her Majesty's Government:

Baroness Symons of Vernham Dean: In its conclusions of 22 January 2001, the EU General Affairs Council welcomed the free and fair conditions in which the legislative elections in Serbia in December 2000 had been held. Their outcome confirmed the determination of the people of Serbia to continue the consolidation of democracy in their country. It was decided that restrictive measures should therefore be confined to the former President of the Federal Republic of Yugoslavia, Mr Slobodan Milosevic, his family and persons indicted by the International Criminal Tribunal for the Former Yugoslavia.

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On 26 February 2001, the list of those affected by the EU visa ban was amended from 600 to 13 to fall in line with this decision. On 19 June 2001, the EC adopted Council Regulation (EC) 1205/2001 reducing the number of persons subject to Council Regulation (EC) No 2488/2000, maintaining a freeze of funds in relation to Mr Milosevic and those persons associated with him, to the same list of persons.

UK implementing legislation will be amended to take account of EC Regulation 1205/2001.

Triclosan

The Countess of Mar asked Her Majesty's Government:

    What are the carcinogenic, mutagenic and toxic properties of the anti-bacterial agent Triclosan; whether they are satisfied that all the safety criteria are met for chronic dosing, for example, when it is used as an ingredient in toothpaste; and whether these criteria are met where children are concerned.[HL215]

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): The toxicological properties of Triclosan have been extensively investigated. An independent expert committee advised the European Commission in 1986 that Triclosan could be used safely in all types of cosmetic products at levels up to 0.3 per cent. It has low toxicity and does not give rise to concern with regard to mutagenic or carcinogenic properties, nor with regard to effects on the reproductive system or development of offspring.

Triclosan has been used as an anti-bacterial agent in cosmetic products for many years. The EU Cosmetic Directive, which is implemented in the United Kingdom by Department of Trade and Industry's Comestic Products (Safety) Regulations allows the use of up to 0.3 per cent Triclosan as a preservative in such products. It has also been widely used in household products, and in certain medicinal products such as medicated toothpastes, athlete's foot treatments and antiseptic creams and lotions which are licensed by the Medicines Control Agency.

Peterborough District Hospital: Medical Beds

Baroness Masham of Ilton asked Her Majesty's Government:

    Whether there is a shortage of medical beds at Peterborough District Hospital, leading to waits on trolleys in corridors before a bed becomes vacant; and whether they have plans to increase the numbers of beds and registered nurses there.[HL393]

Lord Hunt of Kings Heath: Peterborough District Hospital has a medical assessment unit which opened four years ago. The medical assessment unit is designed to ensure that medical admissions are dealt with appropriately, and that trolley waits for patients

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are reduced. The unit has recently been upgraded, and capacity increased to 14 beds.

All hospitals are reviewing their capacity and future bed needs as part of the current local modernisation review.

National Minimum Standards for Care Homes for Younger Adults and Adult Placements

Lord Mancroft asked Her Majesty's Government:

    In drawing up the proposed national minimum standards for care homes for younger adults and adult placements: (a) how many representatives of service users with drug and alcohol problems were consulted; (b) when and where these consultations took place; (c) how many of the service users representatives in this group actively supported the specific proposals in relation to bedrooms and bathrooms; and (d) how many of these service users representatives expressed concerns about the possible impact of these proposals on access to treatment.[HL411]

Lord Hunt of Kings Heath: Service users continue to be consulted on the development of the national minimum standards for care homes for younger adults and adult placements. The Government also carried out an in-depth consultation exercise targeted specifically at service users with drug or alcohol problems. We will continue to take users views into account in the development of these proposals.

Medical Treatment: Children Act 1989

The Countess of Mar asked Her Majesty's Government:

    Whether it is within the remit of the Children Act 1989 for the matter of competent medical treatment being followed by a child (in the case of a competent child, with his/her consent or, in the case of non-competent child, with parental consent) to be challenged; and[HL443]

    Whether it is the responsibility or within the authority of a doctor, a National Health Service trust, a health authority or a local authority to seek a ruling from a court, under the inherent jurisdiction, regarding which type of medical treatment a child should receive in the case of a child who is already receiving competent medical treatment (in the case of a competent child, with his/her consent or, in the case of a non-competent child with parental consent; and[HL444]

    Whether where there is not a generally agreed method of treatment, it is within the authority, or is the responsibility of a doctor to refer a child to a local authority as a child who is suffering or likely to suffer significant harm because the child's parents have declined the treatment offered by that doctor and have chosen instead, with the agreement of the child's general practitioner to follow an alternative

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    competent treatment provided by another doctor; and whether it is within the local authority's Children Act 1989 powers to initiate action under Section 47 or to apply for an Assessment Order (Section 43), an Emergency Protection Order (Section 44) or a Care Supervision Order (Part IV) in those circumstances; and[HL445]

    Whether it is within the remit of Section 47(1) of the Children Act 1989 for a local authority to initiate child protection procedures in order to investigate a child who is following competent medical advice and treatment as suffering or likely to suffer significant harm, following a referral from a doctor or education officer challenging the child's doctor's advice and treatment; and[HL446]

    Whether it is a matter for clinical judgment to determine whether a child diagnosed as suffering from a chronic illness such as myalgic encephalomyelitis is fit to attend school or, if not fit to attend school fit to benefit from home tuition; whether any resultant loss of education or social isolation because the child remains at home under his/her doctor's advice is a matter of child protection concern; and whether in those circumstances, it is within the remit of the Children Act 1989 to make a referral or initiate a Section 47 investigation on the grounds of impairment of development.[HL447]

Lord Hunt of Kings Heath: Parents local authorities and other interested parties with the leave of the court as required may apply for a determination by the court of issues concerning a child's welfare under the court's inherent jurisdiction and the Children Act 1989. Normally, a child's parents would decide on that child's behalf (where the child is competent with his or her agreement) between a range of treatment options. The jurisdiction of the court would generally be invoked in connection with medical treatment where those with parental responsibility disagreed as to the appropriate treatment or where the competent child was opposed to treatment which his or her parents sought. Such proceedings would only be initiated by medical professionals or a referral made in these circumstances to a local authority where the medical professionals involved had genuine concerns that the healthcare decisions being made by those with parental responsibility for a child (or by a competent child himself or herself) were not in the child's best interests.

If somebody believes that a child may be suffering, or may be at risk of suffering significant harm, they should always refer their concerns to the local authority social services department. While professionals should seek, in general, to discuss any concerns with the family and, where possible, seek their agreement to making referrals to social services, this should only be done where such discussion and agreement seeking will not place a child at increased risk of significant harm.

Local authorities have a statutory duty, under Section 47 of the Children Act 1989, to make enquiries if they have reasonable cause to suspect that a child in their area is suffering, or is likely to suffer significant

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harm, to enable them to decide whether they should take any action to safeguard or promote the child's welfare.

The Framework for the Assessment of Children in Need and their Families is equally relevant in these circumstances as a structured framework for collecting, drawing together and analysing available information about a child and family. It will help to provide sound evidence on which to base often difficult professional judgments about whether to intervene to safeguard a child and promote his or her welfare and, if so, how best to do so and with what intended outcomes.

It is inevitable that each child protection referral will turn on its own facts but it is vital that all such referrals, whatever their origin, are taken seriously. Following appropriate assessment, and where appropriate police investigation, the local authority should take whatever action it considers necessary to safeguard the child and promote his or her welfare. This may include taking emergency action to protect the child or initiating proceedings in the family court.

Local education authorities must make arrangements for the provision of suitable education for children who cannot attend school for reasons of illness or injury, It is for each local education authority to decide in individual cases what is suitable provision and this might include, for example, home tuition. In making their decision, local education authorities would of course need to take account of advice provided by medical professionals. There should be close liaison between hospital consultants, general practitioners, schools and the appropriate local education authority, so that educational support can be provided quickly and effectively for sick children. The Department for Education and Skills will be publishing revised guidance on the education of sick children in the autumn.


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