HL Deb 06 April 1981 vol 419 cc365-7

2.50 p.m.

Lord Hale

My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.

The Question was as follows:

To ask Her Majesty's Government what steps they are taking to minimise the danger of paraplegia arising from the handling or moving of victims of back injury suffering temporary loss of sensation in the limbs.

Lord Cullen of Ashbourne

My Lords, Her Majesty's Government are aware of the need for special treatment of patients with injuries of the back involving the spinal cord and recognise that proper care and treatment can minimise the danger of aggravating the injury. Ambulancemen are most often involved in handling and moving patients before admission to specialised spinal units. Their basic training includes the management of casualties with spinal injuries with emphasis on the loading and unloading to and from the ambulance. They are also trained in the use of the specialised equipment for spinal injuries which is available in ambulances used for emergencies. Education in the care of patients with spinal injuries is part of a doctor's normal training in the general care of accident victims.

My right honourable friend's department was closely involved in the preparation of the Spinal Injuries Association's booklet on the treatment and care of people with spinal injuries. This provides detailed information for nursing staff who are not specialists in spinal injuries on handling patients in the period before they reach the specialist units. It has been widely distributed in the National Health Service. I can assure the noble Lord that the Government will continue to keep a careful watch to see if there are other ways in which they can help in this important field.

Lord Hale

My Lords, I sincerely thank the Minister for that thoughtful and careful Answer. Is the noble Lord aware that I too am aware of the frightful dilemma and frightful possibilities, and the extreme difficulty for ambulancemen of diagnosing the precise condition and deciding whether there is an exposure of the spinal cord if the patient is unconscious? Is he also aware that the Stoke Mandeville Unit has an immense and almost legendary reputation in this respect, but that one of the things that are needed is ample money for research and co-operation with the World Health Organisation and the medical establishments? Further, there is need for the provision of special transport—or it should be readily available—to deal with injuries and lifesaving at sea. Is the noble Lord aware that all this would contribute to human knowledge and understanding?

Lord Cullen of Ashbourne

My Lords, I fully agree with the noble Lord how important it is that everybody should be taught how to move patients on these occasions. I understand that one of the things which we are all inclined to do, unless we are told not to, is to take off our jacket and roll it up as a pillow and put it behind the head of the person who is injured. This can have an extremely serious effect on the person's neck if it is injured. One is most certainly advised not to do so.

Baroness Masham of Ilton

My Lords, in declaring an interest in this Question because I am chairman of the Spinal Injuries Association, I should like to ask the Minister whether he is aware that many of the general public are the people who encounter an accident and are the first on the spot? Therefore, does he agree with me that not enough is done in our schools, from primary school upwards, to provide first-aid training? Is he aware that all children in Scandinavia are taught first-aid in the schools?

Lord Cullen of Ashbourne

My Lords, the noble Baroness has made an extremely important point. I shall certainly pass on her views to my right honourable friend the Secretary of State for Education and Science. I entirely agree that first-aid should certainly include information on how to treat people with spinal injuries.

Baroness Hylton-Foster

My Lords, does the noble Lord agree that, apart from teaching first-aid in schools, which is already done by the Red Cross, one of the most important things is to educate the public? Does the noble Lord agree that it would be a great help if the Government were to advise the public to take advantage of the courses currently being run by the two voluntary aid societies, St. John and Red Cross, so that they could learn the importance of not moving a patient with a back injury until professional help arrives?

Lord Cullen of Ashbourne

My Lords, I entirely agree with the noble Baroness. I think that the House knows full well what marvellous training is given by the St. John Ambulance and the Red Cross organisations. Whether the Government can in point of fact influence the public to take these courses I am not sure. I should have thought that the response could be very much helped by the media. I would hope that they would perhaps advise the public how important it is not only for themselves but for other people.

Baroness Masham of Ilton

My Lords, is the noble Lord aware that two Sundays ago "That's Life", the television series, put out a programme on this very matter and that we in the Spinal injuries Association have had numerous calls from members of the public and from caring and medical people on this subject? Will he perhaps encourage the Government, who do put out items on television from time to time, to put out "plugs" on what to do when you find a person with spinal injury? It is not just a matter of keeping the person still. If he is unconscious and vomiting or bleeding—as I was with a haemorrhage—you turn him over like a rolling pin so that the air passage is free.

Lord Cullen of Ashbourne

My Lords, I shall certainly pass on that suggestion to my right honourable friend. I might also add to what the noble Baroness said that it really takes four people properly to lift somebody who has a spinal injury so that they are kept absolutely level and flat, with one person holding the head and neck and the others down the body to keep it absolutely flat.

Baroness Masham of Ilton

My Lords, may I say, to correct myself and for the information of the House, that you do not turn them over; you turn them on their side.

Lord Lloyd of Kilgerran

My Lords, is the noble Lord aware that this kind of training is so important in relation to sporting activities in athletic clubs and sporting clubs of all kinds? If I may first declare an interest as the chairman of the Institute of Sports Medicine, may I ask whether the noble Lord is aware that in a small way a unit has been formed at Cambridge and a fellowship has been adopted in New Hall, Cambridge, to deal with sports injuries, including this very serious matter that often arises, particularly in inter-collegiate sports?

Lord Cullen of Ashbourne

My Lords, I was not aware of that, and I am grateful to the noble Lord for pointing it out.