§ Motion made, and Question proposedat this House do now adjourn.—[Mr. Robert Ainsworth.]10.19 pm
§ Dr. Peter Brand (Isle of Wight)
I welcome the opportunity to discuss the introduction of regulations requiring the notification of agro-chemical incidents. The debate is particularly timely given the support that the early-day motion on the subject has gained from hon. Members of all parties.
In introducing a debate on this subject, I hope to draw attention to the problems experienced by those who believe that they have been harmed by exposure to agro-chemicals but have difficulty in finding evidence on one side or the other. Currently, very little is known about the effect of agro-chemicals on human health—especially the long-term, more chronic effects. People who have been exposed to such chemicals have no way of knowing whether their subsequent illness is a definite result of that exposure.
I see many who believe that they suffer from myalgic encephalomyelitis or another chronic debilitating illness and who date it back to some incident involving agro-chemicals. I call on the Government to make exposure to agro-chemicals resulting in a visit to a doctor or hospital a notifiable event. That would mean that people exposed to agro-chemicals would in future have their cases documented and recorded so that a database for such exposures and their effects could be built up. It would also allow for earlier investigation and greater awareness on the part of doctors and hospitals.
Statistics provided by the Health and Safety Executive demonstrate a clear need for such a move. The HSE's pesticides incident appraisal panel considers cases investigated by the HSE in which pesticides have been alleged to have caused ill health. The panel considered just 81 cases in 1996–97. In only one of those cases could a link between pesticides and illness be proven, and that was the case of a man employed to use pesticides constantly. In 26 more cases, there was too little information for the matter to be proved one way or the other, although 11 of them were thought to point to a likely link. These cases mostly involve members of the public.
Those cases and countless others like them—involving people who believe they have been infected—ought to be investigated more promptly. I have details of six cases of agro-chemicals being associated with illness on the Isle of Wight alone. That is just one constituency, and yet it could account for 13.5 per cent. of all cases considered by the panel.
If the Government acted following this debate, one of my constituents, Mr. Alex McBain, would have the small compensation of knowing that, in future, people will be able to prove that their illness has been caused by exposure to agro-chemicals. Mr. McBain went out into his garden one day and was caught, he alleges, by a blast of fungicide from a tractor spray. He shouted a warning to the tractor driver, but he carried on as normal.
The following day Mr. McBain experienced severe muscle fatigue and felt very unwell. By 16 June, some seven days after the event, he had become so unwell that he could not walk unsupported. He went to his local 257 GP and blood tests were taken. The results of those tests took a long time and the wrong tests were done. No link could be established, but, unfortunately, Mr. McBain deteriorated significantly and had to be admitted to hospital where he rested for some weeks.
What concerns me most about the incident is that it was Mrs. McBain who had to seek advice from the HSE. The hospital and the local doctor were completely remiss in not trying to establish a link between the history that Mr. McBain had given and the illness that occurred subsequently. It is totally unacceptable that relatives of the sufferer have to become experts in the disease to seek advice.
The HSE acted promptly by sending a man over within days of Mrs. McBain's getting in touch, but unfortunately the investigation was somewhat perfunctory as far as the victim was concerned. The investigator was at the house for only 20 minutes and tried to find all sorts of reasons why Mr. McBain's illness might not have been due to spraying and why, if it had been the spray, it could not have affected the garden. I could give all sorts of details, but I do not think that I need to detain the House at this late hour.
The result is that an active 75-year-old man who used to swim every day and to walk his six dogs is now semi-paralysed and crippled. If we had been aware of what was going on, his condition might have been ameliorated and he might have been treated. Certainly, he would now have had a stronger case for finding out whether a link could have been proven between the incident that he described and his subsequent illness.
The other feature of the event was the amount of off-the-record information that Mr. McBain was given. He was told, "Yes, that was the most likely cause, but we can't prove it, so we can't put it in an official report." Again, that must be unsatisfactory.
I hope that the Minister will be able to look into the circumstances surrounding the case and plan some Government action. First, incidents of exposure ought to be notifiable, so that doctors and hospitals become more aware of the potential risk. Secondly, we should have a system for looking into the post-marketing effects of agro-chemicals in the same way that we have for pharmaceutical medicines. Often, drugs are extensively tested before marketing, but subsequent use shows that side effects that were not theoretically anticipated occur. Some notable drugs have had to be withdrawn from the market and the same must apply in the case of some agro-chemicals.
I did not seek this debate because I am prejudging the safety of existing sprays; nor am I implying that we have irresponsible farmers, especially on the Isle of Wight. I am trying to illustrate the inadequacy of the present system. I urge the Government to consider the effectiveness of the Health and Safety Executive and the current state of notification.
§ The Parliamentary Under-Secretary of State for the Environment, Transport and the Regions (Angela Eagle)
First, I congratulate the hon. Member for Isle of Wight (Dr. Brand) on this debate and thank him for bringing an important subject to the attention of the House. I must pass on my concern and sympathy for the illness suffered by his constituent. He will know that 258 I am aware of the incident involving Mr. McBain. I have written to the hon. Gentleman and to his constituent about the case.
The incident in question was investigated fully. Inspectors visited the site and interviewed Mr. McBain and the farm foreman and spray operator. They concluded that there had been no irregularities or breaches of any legislation. However, I accept that there is clearly some dispute about the quality of the investigation and will be happy to write to the hon. Member again, if that would be helpful, to clarify any further points.
Pesticides are inherently toxic and so I understand the hon. Member's concerns and those of his constituents. It is precisely because pesticides are so effective against pests and diseases that they pose a potential risk to people, wildlife and the environment. When one considers that any agricultural worker—there are about half a million of them—might be exposed to such chemicals, as might members of the public, there is a clear need to ensure that they can be and are used safely. That is why we have in place an extensive range of legislative and administrative controls, designed to ensure that all pesticides and veterinary medicines are safe to those who use them and to bystanders, wildlife and the environment.
The sale, supply, storage and use of the products, with the advertisement of pesticides and the marketing of veterinary medicines, are subject to ministerial approval. Ministers are advised on the matter by independent experts: the Advisory Committee on Pesticides and the Veterinary Products Committee. As part of the approval process, applicants are required to submit a great deal of toxicological data, covering both acute and chronic effects. That is then linked by those evaluating the product with extensive exposure data. Contrary to what the hon. Member for Isle of Wight said, we know a great deal about the effects of agro-chemicals on human health.
§ Dr. Brand
I respect the expertise of the people on those advisory panels, but in exactly the same way as pharmaceutical companies seek expert advice and get it wrong, it would be surprising if that did not happen with agro-chemicals. The fact that only 81 cases of possible deleterious effects on human health were investigated in the past 12 months shows that we do not have a handle on the problem.
§ Angela Eagle
I will deal with the figures that the hon. Gentleman has cited in a subsequent part of my speech. I said that there were expert panels, but I did not say that they were infallible. Clearly, we have to try to establish a procedure that gives us the maximum chance of detecting whether any unpredicted effects manifest themselves when the substances are used.
The Government have recently considered the need for further controls across a wide range of products. We recently revised a code of practice on precautions taken to protect non-target species in the environment and on the use of chemicals in the water supply. It is also an offence under the Water Resources Act 1991 to discharge polluting matter to surface or ground waters unless those discharges are under or in accordance with a consent issued by the Environment Agency.
The new regulations and further controls to protect ground water have been put together in a consultation paper on proposed revised regulations that was placed in 259 the Library yesterday. The use of pesticides and veterinary medicines at work is subject to health and safety legislation that requires that risk is assessed in each and every case, that employees are adequately trained and instructed and competent to do the job, and that others, such as members of the public, are not put at risk.
§ Mr. Paul Tyler (North Cornwall)
As the Minister may know, I chair an all-party group concerned with organophosphate pesticides. I do not think that there is any doubt in anyone's mind, inside the House or out, that the Government are trying their very best to improve the standards and quality of the control mechanisms, but the concern, as my hon. Friend the Member for Isle of Wight rightly says, is whether the information is being projected sufficiently far down the chain to those who use the products or are responsible for following up when there is an incident.
In particular, there is concern about the resources available to the Health and Safety Executive and the extent to which it is on top of the job. There have been too many examples in which information has been available to the HSE that has not been disseminated to those who should be concerned: to farm workers, in this case, or their general practitioners.
The case that my hon. Friend outlined so eloquently is being replicated throughout the country, because the HSE has simply not had the resources or the methods to be able to respond sufficiently quickly to an incident.
§ Angela Eagle
I would refute some of what the hon. Gentleman said about the HSE's response rate. It responded very quickly in this case when it was told that there had been an incident.
I want to move on to the way in which the structures operate both in the workplace and in the more difficult cases in which members of public may have been affected and there is no obvious structure within which to ensure that there is reporting.
If anyone believes that pesticides or veterinary medicine have caused harm, they should report the incident immediately. A guidance leaflet is being issued to enable the public to know how and in what circumstances they should report, and copies are available.
The Health and Safety Executive treats reports of ill health extremely seriously. Its inspectors are instructed to investigate those associated with pesticides or sheep dipping, and they take enforcement action when it is called for. In the four years between 1992 and 1996, about 110 prosecutions were taken under the Control of Pesticides Regulations 1986. The HSE's pesticides incidents appraisal panel will be informed if the product involved is found to be a pesticide and will then consider the likelihood that the reported ill health was caused by a pesticide.
Where appropriate and where permission is given, the panel receives the result of any examination or investigation carried out by the national health service and others involved in the care of individuals. The panel's conclusions are contained in a pesticide incident report, which is published annually and from which the 260 hon. Member for Isle of Wight quoted. From what the hon. Gentleman has said, it might be helpful if I spend a moment clarifying the role of the panel.
The function of the panel is simply to judge the likelihood of an ill-health incident being related to pesticide use and identify trends so that regulators can, if necessary, take the kind of action that I described earlier. Decisions on whether there has been any breach of the law are taken by those investigating the incident. It is not the role of the panel to give a definitive verdict in the way in which a court of law would. Thus, for regulators, "likely" verdicts are every bit as valuable as "confirmed" ones. The panel's classification scheme is designed to support the function of reporting back to those authorities that issue licences. The figures quoted by the hon. Member for Isle of Wight are a sign, not of inadequacy but of proper conclusions carefully reached on the basis of available evidence. The fact that some of the 1996–97 cases are still pending indicates not tardiness but the thoroughness with which the investigation is carried out.
§ Angela Eagle
I am anxious to make some detailed points on some of the issues that the hon. Gentleman raised and this is a time-limited debate, but if he is bursting to intervene again, I will allow him to do so.
§ Dr. Brand
I am very grateful to the Minister. I am afraid that we have drifted off the point. My point is that 81 investigations, no matter how thorough, are not statistically adequate to draw conclusions on trend. I am looking for investigation and reporting of people before they become grievously ill so that we can have a much wider debate on safety, not necessarily the harm that some of these things do.
§ Angela Eagle
We have to establish that an incident has occurred. That is the first thing to say. If I may deal with what happens in a workplace—this involves agricultural activities as well as factories—employers and the self-employed are legally required to report to the HSE certain injuries, diseases and conditions and dangerous occurrences which arise from work activities. Pesticide approval holders are required to tell the regulator if any relevant information on product safety comes to light such as reports of adverse reactions or results of new research. It is important to know that employees and the public are able to report incidents direct to the HSE, which stands ready to respond. In essence, it has to wait for reports to be made to it. Members of the public can report directly to the HSE. The bulk of complaints currently received originate from that source.
We do not in this instance believe that new legislation which creates further notification requirements is the right way to encourage reports. Duties would need to be placed on either the public or health professionals to report. As such, it would be very difficult to enforce. Employers and those who operate in workplaces already have a duty to notify.
The hon. Member for Isle of Wight mentioned the yellow card scheme and suggested that it would be a good method to follow for notification. However, the yellow 261 card scheme for medicines is not a good parallel. The doctor in this case is the person who administers the drug and the only direct observer of its unforeseen effects. In the case of an alleged exposure to a pesticide, the doctor will rarely be in a position to assess the circumstances of use or exposure or, in many cases, the identity of the chemical that is possibly involved. It is not the only or even a principal way of investigating a case.
The hon. Gentleman's scheme, similar to the yellow card scheme, which I believe he advocates, was tried. It was called the green card scheme and it was used in the early 1990s for a fixed-term trial to study pesticide-related illnesses. Unfortunately, after a trial run, we found that it did not generate additional data of a quality that would justify introducing it on a permanent basis.
In any event, a work-related incident that has resulted in a person being admitted to hospital is already reportable under the Reporting of injuries, diseases and dangerous Occurrences Regulations 1985. We can also obtain some information on cases brought to the attention of hospitals and doctors through the Department of Health's hospital episodes statistics and the national poisons information service. Thus, the information available is not limited to that obtained through the pesticide incident appraisal panel.
Nevertheless, I recognise and share the hon. Gentleman's concerns about under-reporting. There can be little doubt that however good a scheme is, it is impotent if it is not being used and things are not being reported. Efforts are therefore being made to ensure that information about the schemes is available to members of the public and others, and that awareness is high. At the centre of that activity will be a revision of the leaflet that I mentioned earlier. The Health and Safety Executive has that work under way and proposes to consult interested parties very early in the process so that the leaflet meets the needs of its target audience and of those who need to report incidents. There will be also wide-ranging 262 consultation on how it might be most effectively distributed to, among others, the public and the medical profession.
I cannot stress too strongly the important role that the public can play, but it is essential that they report incidents quickly and provide as much information as possible, ideally including—I realise that the world is not always ideal—the product's approval number. To delay or provide partial information seriously hinders the ability of the regulatory authorities to act.
People who make reports must be prepared to accept that their ill-health may not be attributable to a pesticide or veterinary medicine as they believe. To accept that a pesticide or veterinary medicine was responsible without some form of assessments would not help the regulators or the individual concerned, the cause of whose ill-health would continue to be unknown.
I hope that I can reassure the hon. Gentleman that we are sympathetic to his arguments by informing him that we have set up an interdepartmental group to consider existing schemes for monitoring pesticide-related ill-health with the aim of ensuring that they are being used by the regulatory authorities to their maximum effect. I accept that many points of contact and different levels of statistics exist at present. A representative of the group is proposing shortly to meet interested parties from outside Government to seek their views about the existing network of monitoring schemes.
Despite what I said earlier about the so-called green card system, I have considerable sympathy with the notion that something like the yellow card system might, if properly designed, be a useful addition to the monitoring schemes already in place. I shall therefore write to the group suggesting that it once more goes over this ground and consider whether that possibility is worth examining again.
§ Question put and agreed to.
§ Adjourned accordingly at nineteen minutes to Eleven o'clock.