Organophosphate Sheep Dips: Health Surveillance (Hansard, 20 May 1998)

§ Baroness Farrington of Ribbleton
My Lords, the Health and Safety Executive's medical inspectors will advise contractors about all aspects of health surveillance. In the rare event that blood or urine testing is thought necessary, occupational health physicians, GPs and suitably qualified nurses should be able to take the necessary samples. Analytical facilities are available in commercial laboratories and some hospitals.

§ The Countess of Mar
My Lords, I thank the noble Baroness for that reply. Perhaps I may read to her the instructions given to sheep dipping contractors in the leaflet. Contractors using OP dips regularly should seek advice on health surveillance from a medical practitioner who is familiar with the risks of the process and understands the principles of health surveillance". So far as I can ascertain, in the West Country there is not one GP, not one health authority and not one laboratory that understands what is required as regards cholinesterase blood testing and urine testing for metabolites. In fact, I understand that in the West Country they do not have facilities even for testing pregnant women's urine, let alone complicated tests like those.
1640 Is it not a cynical action on the part of those who compile the leaflets to cover their own backs by saying, "We have given instructions to contractors", when they have not informed the people who will be required to do the work on the ground?
Is the Minister further aware that in a Question for Written Answer that I asked, the noble Lord, Lord Donoughue, told me that all the people concerned "had been consulted"? It is clear that they had not. I ask the noble Baroness whether she will rectify the situation.

§ Baroness Farrington of Ribbleton
My Lords, I am grateful to the noble Countess for the opportunity to clarify the point. The term "medical practitioner" is used in leaflet AS29 to cover the range of experts capable of advising on health surveillance and biological monitoring. It includes HSE medical inspectors and occupational health physicians. Some GPs offer the service, but it is distinct from their normal GP work. I agree with the noble Countess that there is potential here for confusion. It has already been brought to HSE's attention and HSE will look again at the terminology when the leaflet is next revised.
We would not expect all GPs and health authorities to be knowledgeable about health surveillance in general or whether blood and urine testing for sampling is appropriate. Occupational health physicians and HSE medical inspectors are the people to approach.

§ Lord Peyton of Yeovil
My Lords, is the noble Baroness aware that under successive governments the noble Countess has received a formidable collection of meaningless, evasive and entirely boring answers? Could the Minister now stir up in her department, and in other departments if necessary, some awareness of the fact that the noble Countess is right? She has raised the point again and again that there is real danger. Is it not time that a government took action?

§ Baroness Farrington of Ribbleton
My Lords, I apologise deeply to the noble Lord, Lord Peyton, if the reply I gave appeared to be boring or evasive. I tried to answer the Question. The Government are listening to the voices of concern, in particular the valuable work done by the noble Countess on behalf of those affected. Alongside the advice and revision of advice to contractors and the need for absolute clarity raised in the noble Countess's Question, we are also carrying out a study via the Institute of Occupational Medicine. It is now in its third and final phase and the clinical examination of a group of subjects from the survey population is on schedule for completion by 1999. The Royal Colleges of Physicians and Psychiatrists have formed a working group to advise on clinical management of patients with symptoms that may be attributable to chronic OP exposure.

§ Earl Russell
My Lords, in her first reply to the noble Countess, the Minister described blood or urine testing being required as a "rare event". Is it a rare event because it is rarely required, because it is rarely known to be required, or because the facilities are not available?

§ Baroness Farrington of Ribbleton
My Lords, the facilities are available. It is true that biological 1641 monitoring through blood and urine specimen sampling is given less emphasis in the latest version. That is because we believe that it is extremely important that the controls and working practices are sufficient to avoid levels of exposure which would be affected in that way after the event of over-exposure.
It is easy to see that, if such controls are not in place, it is important to rectify the working practices. Health surveillance is intended to ensure that the problem does not arise in the first place. However, I repeat that the facilities are available for samples to be taken whenever the need arises.

§ Lord Clifford of Chudleigh
My Lords, the Question asked by the noble Countess dealt with people, especially farmers. I know that the noble Countess also asked a Question for Written Answer at col. WA161 of Hansard for 10th February relating to people such as soldiers who served in the Gulf War. The Question asked then was not completely answered. The Minister says that the Government are listening, but it seems that it goes in one ear and out the other. Please may we have some action?

§ Baroness Farrington of Ribbleton
My Lords, the Government are taking action, as was outlined in the Question and Answer referred to by the noble Lord. We believe that it is extremely important that such subjects are monitored carefully in great detail. That is why we established a study group.

§ Lord Crickhowell
My Lords, the noble Baroness said that the leaflet which was the subject of the first Question would be revised the next time it was issued. If the leaflet is incorrect, should not a new leaflet be sent out immediately?

§ Baroness Farrington of Ribbleton
My Lords, it is not that the leaflet is incorrect; the issue is that the term "appropriate medical practitioner" is not absolutely clear. We want to ensure that people are aware that it is the occupational health officer who is the appropriate person to refer to in the event that there is a problem.

§ Baroness Byford
My Lords, perhaps I might press the Minister a little further. With the dipping season upon us very shortly, 1999 is not much encouragement for those involved in the process of dipping sheep. I understand—I hope the noble Baroness will clarify this—that the recommendation is that the person concerned should have tests before, during and at the end of the season. Can the Minister confirm that that is correct?

§ Baroness Farrington of Ribbleton
My Lords, the primary and most important advice is not to undertake biological monitoring unless there is a suspicion that there is misuse of the materials. The primary concern of HSE is to make absolutely certain—the Question referred to contractors—that contractors have in place 1642 the proper procedures. Anything else is a follow-up when something has gone wrong. We believe that to be too late.