HL Deb 04 April 1984 vol 450 cc709-11

2.56 p.m.

Lord Hatch of Lusby

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

The Question was as follows: To ask Her Majesty's Government whether they are aware of the lack of screening facilities in this country to detect sickle cell anaemia, and if so whether they are prepared to take any action.

Lord Glenarthur

My Lords, the technical facilities required to undertake screening of blood samples for sickle cell anaemia are already available in National Health Service hospital laboratories. The Health Education Council has recently published guidance for members of the health professions, and others concerned with the care of children, on the problems of people with sickle cell anaemia. The organisation of screening programmes is for health authorities to decide in the light of local needs, but I understand that it is increasingly the practice to screen those at risk when they come into contact with the health service.

Lord Hatch of Lusby

My Lords, I thank the Minister for that reply. Can he tell the House whether it is the case that a number of black children have died through this disease because of the lack of screening facilities? Is it not the case that only three weeks ago, in Lambeth, a boy of two died from this disease, which he had had since birth but which had never been diagnosed as sickle cell anaemia?

Lord Glenarthur

My Lords, it is certainly the case that sickle cell anaemia is most likely to occur among people whose families come from or originate from West Africa or the Caribbean and the eastern part of the Mediterranean seaboard. I am not in a position to comment on the circumstances of the tragic case of the Lambeth boy to which the noble Lord refers. I understand, however, that there are now arrangements at King's College Hospital, which serves part of the Lambeth area, to screen the new-born for sickle cell anaemia, and at St. Thomas' Hospital for the screening of children considered at risk.

Lord Ennals

My Lords, is the noble Lord aware that four times during the three Questions today he has referred to the responsibility being not that of the Secretary of State but that of the health authorities? As the Secretary of State is restricting the amount of money available for the health authorities, is it not time that he gave some lead in terms of priorities in these matters?

Lord Glenarthur

My Lords, unlike the party opposite we are at least trying to work within the limits of the money that is available. It does not grow on trees. That is why we believe in trying to put the duty particularly onto the local health authorities, so that they can decide the priorites and the needs of their own areas.

Lord Rea

My Lords, is the noble Lord aware that a conference was held yesterday on this important problem at the Institute of Child Health, sponsored by all four of the Thames regions, and that this conference was concerned that insufficient use was being made of existing facilities? Will the noble Lord ensure that his right honourable friend studies the recommendations of this conference, which asked for more research and more education of health professionals and the immigrant community? This will not be very expensive, I assure him.

Lord Glenarthur

My Lords, I am aware of the conference to which the noble Lord refers, and will certainly note with interest the differing schemes designed to screen the new-born that are being evaluated. Again, it will be a matter for local decision based on the local needs of the population. The noble Lord, Lord Hatch, raised the fact that it was coloured children who suffered from the disease. That varies the problem, in density, throughout the country.

Baroness Masham of Ilton

My Lords, will the Minister agree that when screening children for sickle cell anaemia it is very important that it should be accompanied by sensitive counselling, and genetic counselling, because otherwise it can be most distressing to the parents? Is he aware that in 1981 the Winston Churchill Memorial Fellowship sent someone to study this disease in America and Jamaica? Would he like a copy of that very interesting report?

Lord Glenarthur

My Lords, I am sure that the report has been studied by the department, but experience of attempts in the United States at general population screening of at-risk groups has not been favourable. I should, however, like to see the report if the noble Baroness has a copy. So far as genetic counselling is concerned, my noble friend will be aware that there is at present no cure for sickle cell anaemia, although palliative measures can reduce mortality. Counselling and advice to prospective parents who may be carriers of the disease are thus no less important than the screening of the disease itself.

Lord Hatch of Lusby

My Lords, to follow up the noble Lord's last answer, does the noble Lord agree that, as the noble Baroness has pointed out, this counselling service and the medical follow-up are of equal importance to the screening methods and are of particular importance, if not as regards curing the disease then certainly as regards preventing its spread? Does he also agree that sensitive counselling to the parents can prevent the spread of this disease? Will he get his department to look into what are at least alleged delays in setting up both screening and counselling in order to restrict this disease to the minimum proportions in this country?

Lord Glenarthur

My Lords, genetic counselling can be undertaken by obstetricians, haematologists and paediatricians, and in the more complicated cases the advice of a clinical geneticist can be sought and a special genetic advisory service is available in each region. The Government provide funds for the Health Education Council, and I have already mentioned the council's recent guidance for the health-care professions and others concerned with children. We also give grants to the two main voluntary bodies in this field, the Sickle Cell Society and the Organisation for Sickle Cell Anaemia and Research, which are making a very valuable contribution to education, information and counselling services.