HL Deb 24 January 1996 vol 568 cc1033-5

2.56 p.m.

The Countess of Mar asked Her Majesty's Government:

Whether they will arrange for comprehensive medical examinations by competent consultants of all those individuals suffering chronic ill health which they believe is caused by exposure to organophosphate sheep dips on the same basis as the examinations offered to members of Her Majesty's forces who served in Operation Granby.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)

No, my Lords. Anyone suffering chronic ill health which they ascribe to exposure to organophosphate sheep dips should consult their general practitioner. The general practitioner can refer them to a consultant with experience in the diagnosis and treatment of illness caused by exposure to chemicals.

The Countess of Mar

My Lords, the noble Baroness is well aware of my battle to have these people looked at. In view of the fact that the use of organophosphates for sheep dip was, to all intents and purposes, compulsory between 1975 and 1992 and that most of the people affected were affected during that period, does she feel that it is only fair that they should be seen by a group of consultants who can deal with all of them? Does she believe that it would help in the clinical side of the research? I know that there is an epidemiological study which is due to report in 1999. Does she agree that we also need some clinical evidence so that the methods of diagnosis can be assessed more easily?

Baroness Cumberlege

My Lords, the first port of call for anybody who is ill is the GP, unless it is an emergency. We believe that the same system should apply to these people: first, they should see their GP and if he feels that further investigation is needed, they can be referred to a consultant.

Baroness Jay of Paddington

My Lords, does the Minister recall that when the noble Countess last raised this Question in this House about six months ago, the inadequacy of GP referrals was mentioned? In response to a question from me, the Minister on that occasion said that the problem with extra-contractual referrals for those cases was minimal. Has she now reconsidered that position in the light of the evidence that there are more and more people who need this type of specific treatment and just do not receive it through the GP system?

Baroness Cumberlege

My Lords, I have not reconsidered it because we do not believe there is a problem in consultants refusing to see people with that condition who have been referred by a GP.

Earl Baldwin of Bewdley

My Lords, does the Minister agree that it is high time that the whole area of environmental medicine was taken more seriously? Will she accept that there is a marked reluctance on behalf of the Government and the medical profession to come to grips with the human health implications of an increasingly polluted environment?

Baroness Cumberlege

My Lords, increasingly government departments are working more closely together on this matter, particularly the Department of Health and the Department of the Environment. There are now a number of joint committees with experts on them to look at this particular issue.

The Countess of Mar

My Lords, is the Minister aware that there are still tremendous problems with people obtaining a diagnosis from their GPs? Because the Department of Health does not recognise chronic organophosphate poisoning as a medical condition, GPs are reluctant to diagnose it. Therefore, patients who are ill do not receive the right treatment, are given drugs to which they react very strangely and flounder about in the wilderness. Will she please once more look at this subject and do something about it?

Baroness Cumberlege

My Lords, we shall continually look at this subject. Indeed, the Chief Medical Officer wrote to all doctors in England in 1991 to draw their attention to this matter and did so again, with the chief executive of the Veterinary Medicines Directorate, in June 1993. An article was written by the Chief Medical Officer in October 1995 and published in his update. The update is delivered to every GP, so that every doctor in the country would have seen it. Also, the noble Countess may be interested to know that the booklet, Pesticide Poisoning Notes, about which I know she was concerned and which was out of date, is being revised at the moment and will be published very shortly.

The Countess of Mar

My Lords, I am sorry to have to come back to the noble Baroness, but all those communications have been about the acute effects of organophosphate poisoning, not the chronic effects. Please will the noble Baroness look once again at the plight of those people who believe that they are suffering from the chronic effects of OP poisoning?

Baroness Cumberlege

My Lords, I do not believe that those reports concentrated solely on the acute effects of OP poisoning. I believe that some covered chronic illness also.

Earl Russell

My Lords, does the education of doctors include any training in how to recognise the effects of OP poisoning and, if so, how long has it done so?

Baroness Cumberlege

My Lords, the curriculum is very much a matter for the profession. Indeed, we rely on its views—and especially on the views of the General Medical Council and the Royal Colleges. I do not know the detail, but I shall write to the noble Earl with it if he would like me to do so.