HL Deb 27 January 1983 vol 438 cc375-7

3.43 p.m.

Lord Trefgarne

My Lords, it may now be for the convenience of the House if I repeat the Answer to the Private Notice Question being given in another place by my honourable friend Mr. Clarke, which same Private Notice Question was tabled by the noble Lord, Lord Wallace of Coslany, a few moments ago. The Answer is as follows:

"It is agreed by both sides in this dispute that every effort should be made to avoid industrial action which would prejudice public health and public safety. We do not at this stage therefore expect there to be any prolonged interruption in water supplies to renal units. Health authorities have however been advised to make contingency plans for hospitals generally which might include transfer of patients to hospitals which are least likely to be affected."

Lord Wallace of Coslany

My Lords, I thank the Minister for repeating that Answer. Is he aware that this is an emotive subject and that any words uttered should be cautiously and carefully chosen? There is no value in creating unnecessary alarm or despair for patients or relatives or, indeed, among the general public. I do not intend now to become involved in a general argument over the water workers' strike or to go into the reasons for or against: that is for another occasion. I am concerned simply and solely with the subject of the Question and to make sure that adequate cover is available for renal patients in the emergency that exists.

Is the noble Lord able to say how many people are affected in this sphere? I am under the impression—I may be wrong—that the number affected is comparatively small and could be taken care of in hospitals without undue difficulty if the necessity arose. May I also ask the Minister to say what is the present position so far as home dialysis is concerned?

Lord Winstanley

My Lords, is the Minister aware that we on these Benches welcome the steps taken by both sides in this dispute to protect the interests of those who are undoubtedly at special risk? Going to the more general points made in the Answer, may I ask the Minister if he agrees that our water supply and sewage disposal systems in Britain have together done more to protect the public health of our citizens than the work of all the doctors put together? In those circumstances it follows that any interference with those services could be catastrophic.

The Answer refers to contingency plans. In that connection, may I merely say that, irrespective of the merits of the water workers' case in this dispute, any steps which the Government find it necessary to take to maintain those vital services and to safeguard the public health would have the support of noble Lords on these Benches?

Lord Trefgarne

My Lords, to answer the noble Lord, Lord Wallace, I can tell him—these are not the latest figures but I think they are not far adrift—that there are approximately 1,100 patients on hospital haemodialysis in England: 1,820 on home dialysis: 84 on intermittent peritoneal dialysis: and 659 on continuous ambulatory peritoneal dialysis. Those numbers, as I say, may be slightly out of date.

In answer to the noble Lord, Lord Winstanley, I agree of course about the importance of the sewerage and water systems. It is perhaps worth noting that the responsibility for the operation of the sewerage system, so far as the treatment plant is concerned, is largely a local authority matter, and those particular workers are not affected in the present dispute. It is the sewage treatment plants that are, generally speaking, the responsibility of the water workers, and of course I acknowledge the importance of those plants.

Lord Wallace of Coslany

My Lords, may I ask the Minister to answer my supplementary about the present position of those on home dialysis?

Lord Trefgarne

I apologise for that omission, my Lords. Home dialysis patients, generally speaking, require a water supply of some 25 lbs. per square inch and about 60 gallons per dialysis. In general, they need to be dialysed, as the expression is, two or three times a week, depending on the extent of their disease. In general, water workers have regarded these as priority supplies and have restored supplies by repairing breaks if necessary where home dialysis patients were said to be at risk. I regret to see that there is one report of a situation in Wales where that is not so, which, naturally, we very much regret. In a case where a home dialysis patient cannot be guaranteed a continuous supply of the right purity and at the right pressure, the patient will normally be taken into hospital.

Lord Nugent of Guildford

My Lords, I should apologise to my noble friend for the fact that I was on the telephone when the Answer was given. In regard to this very worrying dispute, is my noble friend aware that the major clause in the agreement that the unions have with the employers provides that, in the event of industrial action, every effort shall be made to avoid harm to the health of consumers? In this particular context, and in wider contexts, it will become increasingly difficult to maintain and to discharge that very important obligation of the employees each day the water strike continues. Will my noble friend take note that there really is a very weighty obligation on the three unions concerned to consider much more closely the reasonable offer that they have been made and to bring this damaging strike to an end?

Lord Trefgarne

My Lords, of course I entirely agree with my noble friend, who speaks with particular knowledge and experience of the matter. The offer currently before the workers in the water industry is for an average increase of about £10 a week, taking their average weekly pay to about £145. Reverting to the first of my noble friend's points, I would say that I fear that it is not possible indefinitely to take industrial action of this kind without affecting people in one way or another, and of course the people whom we are discussing in particular—the renal dialysis patients—are likely to be the first to suffer.

Lord Cledwyn of Penrhos

My Lords, I rise because the noble Lord mentioned a case in Wales. Would he not agree that the problems arising from the dispute tend at the moment to be rather more acute in the remoter rural areas, such as Wales? In the last part of the Answer, the noble Lord referred to arrangements between the authorities and the hospitals in relation to the transfer of home patients, but does he not agree that that could create greater difficulties in fairly scattered rural communities? Will he say that the Government are satisfied that proper arrangements are being made for patients in such areas to be taken to hospital where necessary?

Lord Trefgarne

Of course the Government will do what they can to see that the proper arrangements are made in these circumstances, but, as the noble Lord rightly points out, transfer between distant hospitals—for example, in remote regions—is more difficult. That is why I would say that it is incumbent upon those working in the industry—in Wales, for example—to be particularly careful that they observe the agreement to which my noble friend referred, which provides that they should take action to restore services in these situations, even when they are in fact in dispute.