HC Deb 23 October 1985 vol 84 cc389-93 10.13 pm
The Parliamentary Under-Secretary of State for Northern Ireland (Mr. Richard Needham)

I beg to move. That the draft Nursing Homes and Nursing Agencies (Northern Ireland) Order 1985, which was laid before this House on 11 th July, be approved. I am aware that the right hon. Member for Lagan Valley (Mr. Molyneaux) was not happy about the circumstances surrounding the introduction of this measure when it was brought forward at the tail end of the last session.

I should like to make it clear that this came about simply because a slot presented itself for approving the order, which I am sure the House agrees is a sensible and urgently needed measure. I should like to thank the hon. Member for Belfast, South (Rev. Martin Smyth) for his interest in this matter and for pressing for Northern Ireland legislation. I should like to reassure the right hon. Member for Lagan Valley that the shortened procedure will continue to be used only in exceptional circumstances when timing is an important consideration and the issue is likely to be non-controversial.

Following the complaints made last July the Government have reviewed the procedure and I can tell the right hon. Member for Lagan Valley that in future when the Secretary of State agrees to adopt the shortened procedure he will at that stage write to the Northern Ireland party leaders and Opposition spokesmen informing them of his decision and the reasons for it.

The purpose of this order is to provide powers under which the use of certain laser techniques in medicine or surgery, including cosmetic surgery, can be regulated. The order is needed because no such powers are available under existing legislation to control premises in which lasers are used for medical or surgical purposes.

The order will make it possible to regulate these techniques by bringing premises in which they are used within the definition of "nursing homes" in the Nursing Homes and Nursing Agencies Act (Northern Ireland) 1971. It will also empower the Department to specify the type of laser techniques which are to be controlled and to make regulations specifying the records to be kept about laser treatments. This order will bring the law in Northern Ireland into line with England and Wales.

Over the past few years there has been an increase in the use of lasers for the removal of tattoos. The stronger types of laser are potentially hazardous not only to the person on whom they are directed but also to the user and others nearby. They can suffer skin burns which may need plastic surgery and may even lead to blindness.

It is clear that there must be adequate protection. Those at risk are mainly young people who may wish to remove an unwanted tattoo, not realising what a problem it would be to get rid of it.

There has been understandable public disquiet in Northern Ireland about the absence of powers there to control laser use. The Government share this concern.

There is clearly a need for the powers in this order which will provide people in Northern Ireland with the same protection from inexperienced or incompetent laser practitioners as already exists in England and Wales. I commend the order to the House.

10.17 pm
Rev. Martin Smyth (Belfast, South)

May I take this opportunity to welcome the Under-Secretary of State to his position on the Government Front Bench? I trust that he will have an enjoyable stay there. We on these Benches will seek to provide him with opposition. I am sure that the Front Bench of the official Opposition join us in that welcome. Although the Minister has come down from the heights of the Back Benches to the lower reaches of the Front Bench, I trust that he has brought with him to the Front Bench the humour that he displayed on the Back Benches. If so, it will help our debating procedure.

I thank the Under-Secretary of State for his assurance that the shortened form will be used only in exceptional cases. I thank him in particular for the assurance that not just a title will be provided without an understanding of what is involved. It was not just its publication on 11 July that raised the hackles of the Ulster Unionists. The problem was that we did not know what it contained.

We take the view that as often as possible Northern Ireland legislation should be considered with the corresponding legislation for Great Britain. It was in that context that my attention was first drawn to this problem. In September 1984 I was approached by people in Northern Ireland and asked whether the legislation which was to come into force in Great Britain on 1 October 1984 applied to Northern Ireland. Therefore, I wrote to the Under-Secretary of State's predecessor in office. In September 1984 I was assured that this matter was being considered, but I was told that under the affirmative order procedure it might be 12 months before it was proceeded with and that they were not in a position to tell me when that might be.

The first we knew of the order was when it appeared on the Order Paper just before the recess. It took us by surprise. We objected in principle, as we have done consistently about the affirmative order procedure, especially when there is legislation that is applicable to Great Britain, which is relevant to Northern Ireland. We would much prefer it if the debates were held at the same time.

We welcome the order because it will affect tattooing. Historically, tattooing has been a form of cosmetic that has not always worked to the benefit of the recipient. In 1961, because of the dangers to health attached to tattooing, the New York State Department took action to restrict it. In my experience as a pastor, there have been moments when I have had grave difficulty in containing my humour. For example, a young couple came to get married, and he had engraved on his arm, "I love Mary", and the girl he was marrying was called Barbara. It causes a little upset. For that reason, some people like to change their tattoos.

In Northern Ireland we have another problem that has caused a little difficulty. Young enthusiasts are engraved with tattoos that tell people that they are either IRA or UVF. As they mature. they may not necessarily change their allegiance, but they are a little wiser and know that it is not the wisest thing to run around with such tattoos on their bodies, so they want to have them changed. It is the changing that causes particular problems.

I am given to believe that it is possible to pay up to £300 for treatment. Some of the forms of treatment are rather severe. The order deals specifically with laser treatment, but I should like the Under-Secretary to give us guidance. Under the order, is there any control over other forms of surgery that might be used to correct some of the aberrant activities of people at home and abroad? I understand that some forms of treatment can be as dangerous as laser and can lead at least to scarring.

Can the Under-Secretary give us an undertaking on the future? The order is entitled "Nursing Homes and Nursing Agencies (Northern Ireland) Order". Does it give power to the Department to inspect nursing homes and agencies on a wider basis than controlling the use of lasers? I do not think that it does. It is interesting that standards are required for hotels and guest houses, but there does not seem to be any control over the quality of care and standards provided in nursing homes, other than general hygiene.

Private nursing homes are mushrooming in Northern Ireland and, I suspect, Great Britain. I should therefore like to think that there will be some control so that standards are provided for the people who live in them. Someone might say that it is up to the client to decide whether he will pay for unsatisfactory care. Most right hon. and hon. Members know that a high percentage of the cost of staying in such nursing homes is borne by the Department. Will the Minister tell us whether it is the Department's intention to provide control not just over the use of lasers but of standards of care for which, ultimately, the state pays? We wish to ensure that citizens who hope to be looked after properly can be guaranteed that the Department will provide some inspection so as to maintain high standards.

I do not wish to detain the House, because this is not a contentious issue. The only contentious matter was the way in which the order was introduced. We are pleased to have the assurance that this procedure will normally be used for non-controversial matters only and that the leaders of the parties will be made aware of what is happening.

I welcome the order and look forward to seeing it properly policed, so that fly-by-night, back-street and other such agencies are not allowed to continue to practise their policy of death and destruction in the community.

10.26 pm
Mr. Stuart Bell (Middlesbrough)

May I add my congratulations to the Minister in his new post? The one satisfactory thing about standing at the Dispatch Box is that one has something on which to lean and on which to put one's notes. In addition, he has the advantage of almost filling the House for a Northern Ireland debate. If he can continue in that vein, we shall continue to be delighted to see him.

As the Minister has explained, the order is designed to enable the Department of Health and Social Services in Northern Ireland to control the use of any surgical technique which might be hazardous for patients or staff. Although the order does no say so, the explanatory document issued by the Department of Health and Social Services states: The order would empower the Department to make regulations controlling the use of certain lasers in techniques of medicine or surgery, including cosmetic surgery. The hon. Member for Belfast, South (Rev. Martin Smyth) mentioned some of the cosmetic surgery that takes place in Northern Ireland which will be covered by the order. Those of us who read "Focus on Medicine" in General Practitioner of March 1984 will be aware that lasers which are used for cosmetic sugery can be a burning beam or an accurate light knife.

A laser can be used to treat cancer and birthmarks,. to stop bleeding and unstop blockages. As that publication also tells us: These effects are not, however, achieved by one beam alone. Four kinds of laser are in medical use in Britain at the moment. There have been cases in this country where the use of a laser beam has had serious consequences for the patient when the treatment went wrong. The Daily Telegraph of 16 March 1984 described the tragedy of patients who were left scarred for life after a Harley street doctor had burnt off tattoos using a laser beam. The doctor was ordered to be struck off the register by the General Medical Council professional conduct committee. There is a right of appeal. The patients paid hundreds of pounds to have their tattoos removed and yet they claimed that they were left with weeping wounds and considerable pain, and some of them were scarred for life. The newspaper reported that some of the patients said that they required plastic surgery to remove scars and parts of the tattoos

Mr. Peter Davis, president of the British Association of Aesthetic Plastic Surgeons, declared that laser treatment could destroy tissue in precisely the same way as a red-hot poker. Even the doctor who was ordered to be struck off admitted that, in the wrong hands, the use of laser equipment could be lethal.

No wonder, therefore, that there has been some disquiet in Northern Ireland, as the hon. Member for Belfast, South said, about the fact that legislation extant in Great Britain had yet to cross the water. The complaint in Northern Ireland has been of the lack of controls over the use of laser techniques specifically the removal of tattoos. I can understand the embarrassment of the young man who has "Mary" on his arm instead of "Barbara". Perhaps he should have "Barbara" tattooed on the other arm. It would depend on which side he slept whether he had any difficulty with his tattoo.

The Opposition welcome the introduction of the regulations. It is interesting to rote that the power to make similar regulations in Northern Ireland was not available under the Nursing Homes and Nursing Agencies (Northern Ireland) Act 1971, and that it is proposed to amend that Act by this order to remedy that omission. It is another sign, if we needed it, that until 1972 Northern Ireland was responsible for its own legislation and had little recourse to the House. We understand that consideration will be given to bringing the law on nursing homes in Northern Ireland into line with the law in England and Wales as contained in the Registered Homes Act 1984. The need to bring the law into line in Northern Ireland also reminds us that, for as long as Northern Ireland is part of the United Kingdom, it is illogical that its laws and regulations should be different from those on the mainland. We can well understand the need not to delay introducing these provisions.

Legislation is about people. Therefore, it is right to bring this matter before the House early, as the Minister has done. Although it is always necessary to debate such matters properly, the Opposition welcome the legislation, and the serried ranks behind me will not hinder its passage tonight.

10.32 pm
Mr. Needham

I thank the hon. Member for Middlesbrough (Mr. Bell) for his kind words about my appointment. I shall deal briefly with his points and those of the hon. Member for Belfast, South (Rev. M. Smyth). Article 3(vi) of the order mentions any occasion on which a specially controlled technique is used in a nursing home. That covers a broader range of operations than lasers. Lasers will be specified in an order, which will refer to the use of a class 3B or class 4 laser product. Those products are defined in part 1 of the British Standard 4803.83—radiation safety of laser products are systems.

I also take this opportunity to thank the hon. Member for Belfast, South for his kind words. I shall try to bring to the Front Bench the humour that I displayed on the Back Benches, although some would say that my humour on the Back Benches kept me there for so long. The hon. Gentleman said that the general control of nursing homes is not covered in the order. However, the matter is under consideration, and the priority accorded to it will depend very much on the urgency of problems that arise from the regulation and control of private nursing homes. If the hon. Gentleman or any of his right hon. and hon. Friends have evidence of misuses, we shall give the matter further consideration and introduce an order. However, that consideration should not weigh against the need to bring in this order, which I commend to the House. I hope that it will reach the statute book as quickly as possible to help the young people who need to be protected by it.

Question put and agreed to.

Resolved, That the draft Nursing Homes and Nursing Agencies (Northern Ireland) Order 1985, which was laid before this House on 11th July, be approved.