Deep Vein Thrombosis (Hansard, 3 December 2003)

§ Baroness Wilcox
asked Her Majesty's Government:
Whether they are confident that the research programmes currently being undertaken are adequate to enable them to offer the general public clear guidance on the possible risks of deep vein thrombosis when flying.

§ Baroness Andrews
My Lords, in 2001 the Department of Health issued information and advice to the airlines and the public about minimising the risk of DVT during long journeys. That information and advice is available through health services, the Internet, the airlines and NHS Direct and is kept under review in the light of new research information. Much of the research is being generated by WHO. I am pleased to say that the UK was instrumental in setting up that research and in providing financial support for the work.

§ Baroness Wilcox
My Lords, I declare an interest. I chaired the Science and Technology Select Committee on aircraft travel and health, which pointed up the worries that people have about deep vein thrombosis. Is the Minister as disappointed as I am that the Department for Transport did not fund an effective research programme conducted by British scientists over which we could have had some control? Now that we have decided to hand over the job to the World Health Organisation—I understand that we have already given £400,000 and by the time the research is finished in early 2005 we shall have given over £1 million—can the Minister reassure me that we shall have a list of how that money has been spent and that it will be put in the public domain?

§ Baroness Andrews
Yes, my Lords. Following an excellent report, the noble Baroness is relentless in her pursuit of the Government. I am not disappointed in what we have decided to do nor in the way in which it is being carried out. Given the international nature of the problem—she will understand this better than many— and the high cost associated with epidemiological research, it was considered better to meet our research needs in an international context. Negotiations with the WHO took a long time. The matters are complex and we had to ensure that optimum research, with a proper spread and with the best research team, was carried out. That research, which began at the beginning of 2003 and which is making very good progress, will report next year. Our own research on the public perception of DVT 305 has just been finished and it will be published early next year. It has some very interesting conclusions. We shall certainly ensure that there is a full account of how the research funding was spent.

§ Lord Clinton-Davis
My Lords, perhaps my noble friend will allow me to declare an interest as president of BALPA. the British Air Line Pilots Association. Is it not completely inadequate that in the main airlines announce that there is a threat of deep vein thrombosis at the beginning of long-haul flights? Is it not essential, particularly on longer long-haul flights, that that warning should be repeated not once, not twice but three times at the very least?

§ Baroness Andrews
My Lords, my noble friend makes a very important point. One outcome of the Select Committee's report was to set up the Aviation Health Working Group. This regularly brings together all the people involved in these matters including the airlines. Certainly advice and information has improved. I shall ensure that my noble friend's comments and observations are drawn to the attention of airlines.

Lord Campbell of Croy
My Lords, will the Government also inform the public about the successful medical research which has led to precautions and remedies, including warfarin previously used only for rat poison? I declare an interest as it has been prescribed for me to take daily for the past 10 years for a thrombosis in one of my legs. I should add that this was not caused by flying, but by an enemy bullet passing through my middle.

§ Baroness Andrews
My Lords, it is rather difficult to follow that. There has been a great deal of research by the WHO on the potential link, which is definitely not proven, between DVT and air flight. We hope that in the second stage of research we shall look more closely at some of these different interventions. The advice we give to passengers via the Department of Health is essentially about exercise; leg exercises and short walks—I suppose they could hardly be long walks— while in aircraft. The noble Lord's point is the subject for further research.

§ Lord Graham of Edmonton
My Lords, one of the excellent things that came out of the committee chaired by the noble Baroness, Lady Wilcox, was that there are a range of matters within the gift of every individual traveller. Preparation can be undertaken, provided the advice is known. One matter that emerged was the crucial part that doctors' surgeries can play in ensuring that simple exercises and simple remedies are made available. What is being done to alert people to the wide network of advice that can be given to potential travellers through doctors' surgeries?

§ Baroness Andrews
My Lords, it is very important that information gets to the general public. One thing that happened this very week is that the Aviation 306 Health Unit started work. The AHU's task will be to liaise between the professionals and give information on how people can protect themselves while travelling. That is one very important innovation. There is, as I have said, a range of advice on the web and available to doctors to provide basic information for people about to travel or, indeed, on returning from travel. Clearly, arising from our own research about public perception we now know that although people are aware of DVT they are a little confused about the best thing to do. Therefore, much more effort must go into communicating best advice for travellers.

§ Baroness Thomas of Walliswood
My Lords, has there been time since the provision of this information to travellers to ascertain whether it has had any perceptible effect on the rate of deep vein thrombosis or death from embolism? Secondly, there has been much discussion about air cabin layout, seat size and so on possibly affecting the incidence of this condition. Can the Minister tell us whether the joint health project, which the Government are in my view very sensibly carrying out with the World Health Organisation, will give us any answers on that question?

§ Baroness Andrews
My Lords, we do not collect figures. While we have figures for deaths from DVT, we do not know how many people die from DVT perhaps as a result of having taken a long-haul flight. So I cannot give much satisfaction there. In terms of seats, we know that the Joint Aviation Authority has commissioned research on the minimum distance between aircraft seat rows. It was found that passengers in business class, economy class and first class are equally at risk. The problem is not of seat size or of seat space, but of immobility. Although the UK is the only country with a minimum statutory requirement for seat spacing, that will not make any difference to people at risk.