§ 11 am
§ Mr. John Smith (Vale of Glamorgan)
I want to focus on article 17 of the convention, which concerns airline passengers' health. However, I am not sure that I should be speaking on health issues this morning, as I have the most appalling flu. I apologise if I am not as coherent as I would like to be.
The purpose of this short debate is clear and simple, but important: to point out to the 55 million airline passengers who travel abroad from this country that the airlines that carry them have no liability for their health. I heard the tail end of the previous debate on animal welfare—ironically, airlines do have a liability for the health of the animals that they carry: they must travel in an area that would accommodate at least twice their own body weight and size and must be fed, watered and exercised regularly. That courtesy is not extended to human beings transported on British airlines, because of the absurd anomaly in the Warsaw convention.
The Warsaw convention was introduced in October 1929, when air travel was in its infancy. It was a dangerous and novel activity and, rightly at the time, the countries that wanted to govern it internationally recognised that it had risks. They introduced limited liability, and it is absurd that it continues to this day. It has been updated on several occasions since 1929, in particular in the Hague protocol of 1955, in the early 1960s and most recently in Montreal in 1999—that update awaits ratification. However, updating the convention does not place a responsibility on airlines for the health of their passengers.
I place on record my thanks to the Department for Transport, which I congratulate on its announcement last week that it will take the earliest legislative opportunity to put a statutory responsibility for aviation health on the Civil Aviation Authority. The proposal will be the first such in the world, and it is to be welcomed.
The Department announced that one of the responsibilities will be to set up an aviation health unit at CAA Gatwick, funded from a levy from the airline industry. The main focus of the unit will be matters that affect aviation health and research. It will be the first port of call for inquiries and give advice to passengers and crew on aviation health issues. It is a most welcome development, and it took courage and leadership to announce the proposals. That is why the Government should take a leading role in calling for the revision of article 17, which has been described as a licence to kill for the airlines. We know, almost without doubt, that more passengers die through ill health—in particular from thromboembolic disease in long-haul international air travel—than die in accidents.
However, under article 17, airlines are responsible only for death or serious injury caused by an accident on a plane or while getting on or off a plane. They have no liability for the health of their passengers. That is absurd. It was not absurd in 1929, when they were still flying biplanes, few people paid to travel by air and cabins were not pressurised. However, in 2003 55 million people fly and airlines have total—total—control over the environment in which they do so, and it is nonsense to say that they have no responsibility for 264WH passengers' health. Employers have, quite rightly, responsibility for the health of their work force because of the control that they have over the work environment.
Airlines, however, do not have a liability for the health of their passengers, apart from a common-law duty of care. Not merely do they control what one can do on an airplane, where one sits and how one sits, what one eats and drinks, they control the very air that one breathes. They control the amount of oxygen in that air, and they control the pressure in a cabin. All those factors can have medical and health consequences. We know that until the mid-1980s airlines used to pump fresh air into cabins; now, however, they recycle old air through filter systems. Evidence suggests that that merely recycles microbes and germs that can infect passengers and can have serious health consequences.
That is one example, but the Minister will be aware that my primary concern is deep vein thrombosis. The incidence of that dreadful killer condition, which could be—and I stress could be—killing up to 1,400 passengers a year in this country alone, is increasing. That is a fifth of all those who die of DVT or pulmonary embolisms in this country. I must point out that 80 per cent. of all deaths from this condition are clinically silent. That is because deaths from it are diagnosed only through post mortems and there are not enough post mortems to identify all the tragic deaths from this condition.
I am involved in this campaign and I chair the all-party group on flight-related DVT because one of my constituents died in the most tragic circumstances. However, the real issue is that his family would have had no idea of the cause of his death had it not been for a chance exchange with a consultant pathologist. Deep vein thrombosis did not go on the death certificate and there was no mention of the death being related to travel. However, it is almost certain that travelling long distances in cramped conditions on aircraft causes blood clotting in one in 10 passengers and potentially fatal deep vein thrombosis in one in 40, according to the work of John Scurr.
However, I will be the first to admit that much more research must be done. I have called for such research and have placed on record my thanks to the Government for contributing a substantial amount of money to the World Health Organisation's research into deep vein thrombosis and air travel. We know that in the 1980s the average pitch in an aircraft—the distance between seats—was about 36 inches. That is not as much as is required for an animal, as I said earlier, but a little more space for people to move about. The average pitch now is about 30 to 31 inches, and, bizarrely, the statutory limit is even lower.
A recommendation was made recently to increase the pitch on aircraft but not in the health interests of passengers, despite the fact that being cramped like sardines in the seats causes the blood pooling in the bottom of the ankles, which in turn causes the clotting. That is the most dangerous situation and is either the primary cause of deep vein thrombosis in air travellers or at least a secondary but important cause. It is a major health issue that the airlines are allowed totally to ignore because of an anachronistic convention that was agreed at the beginning of the previous century. Given the Government's track record in the field of aviation 265WH health—their recent announcements and response to the excellent House of Lords Science and Technology Committee report of two years ago, which called for several measures to be introduced to protect passengers—they should consider showing leadership in the world in calling for the removal of the nonsensical protection for airlines.
When the average airline passenger in this country picks up their ticket and looks on the back of it, they will see a copy of the absurd Warsaw convention, but I doubt that they read it or understand its implications. It is a complex convention, and I am referring to only one small article, but it places a limited liability on airlines in many areas, including on the damage to or loss of luggage. I am sure that many hon. Members have been through the rigmarole of finding luggage, because the airlines are protected. They should be protected no longer, especially from prosecution or legal action for endangering the lives of their passengers by exposing them to deadly health risks, the most important of which is deep vein thrombosis.
When the aviation health unit is up and running, new legislation is introduced to give a specific responsibility to the Civil Aviation Authority and one Minister has overriding responsibility for aviation health issues, I predict that that Minister will be become known as the Minister for DVT and the unit will become known as the Department of DVT. That is for a simple reason. In the past two years, DVT has become the most important health concern of the general public about the risks that they take when boarding an aircraft for a long-haul flight.
It is important that the travelling public be made aware—I repeat this, because the message must get across—that the airlines do not have liability for their health. A recent case was brought, unsuccessfully, in the High Court by Des Collins of Collins Solicitors against 28 airlines, on behalf of many victims of that dreadful condition and their families, some of whom I know personally. They did not go to court to argue that their relatives had died and suffered because of that condition, which affects one in 40 of all people who fly, nor because they believed, rightly, that they should be compensated for the death and misery that had been caused by boarding an aircraft for long-distance travel, unaware of any risk. The case went before the court so that it could be argued that flight-related deep vein thrombosis was an accident, as defined in article 17 of the Warsaw convention.
The solicitors acting on behalf of the families, and some of the victims themselves, knew that they had no other way of suing airlines for placing people at risk and causing so much damage. It is worth bearing in mind how much damage can be caused by a deep vein thrombosis, which is a very large blood clot. It can cause tremendous injury and result in lengthy periods of medication if it does not move to the lungs, heart or brains and kill the sufferer. We are talking about something deadly, for which the airlines currently take no responsibility. It could be argued that those airlines have a licence to kill.
The Minister has an excellent track record in matters of this kind. I am the first to admit that in today's debate we are just highlighting the problem, and that it could take many years to make the appropriate change to an international convention. It could be a long struggle.
266WH However, we must raise the flag now, to show that there is an issue to be dealt with. More people die from the condition than die in air accidents or crashes. Some responsibility lies with airlines for the latter, but no such responsibility—no statutory liability—lies with them for the health of their passengers. That should change.
§ The Parliamentary Under-Secretary of State for Transport (Mr. David Jamieson)
I congratulate my hon. Friend the Member for Vale of Glamorgan (Mr. Smith) on securing this important debate and on the campaign that he has waged on deep vein thrombosis. His interest sprang originally from the tragic circumstances affecting some of his constituents. I recognise that he is acting not only on their behalf but more widely on behalf of all those who travel by air. He chairs the all-party group on deep vein thrombosis awareness, which has done much good work to raise awareness and has quite properly lobbied the Government to take further action. I congratulate him on his vigour and hard work.
The Government share my hon. Friend's concern about the health of air passengers. We can claim with truth that the United Kingdom has led Europe, if not the world, in focusing attention on aviation health and taking positive steps on a range of issues. Three years ago, we received the excellent report by the House of Lords Select Committee on Science and Technology, entitled "Air Travel and Health". That was arguably the widest ranging and most authoritative study of aviation health ever carried out. It contained a sequence of well-researched and supported recommendations aimed at Government organisations and the airline industry.
The Department of the Environment, Transport and the Regions, as it was then, accepted nearly all the recommendations that were aimed at the Government and with the Department of Health set up the aviation health working group to oversee the taking forward of the Committee's recommendations. That body, which includes representatives from the Civil Aviation Authority and the Health and Safety Executive, has met regularly since then. Representatives of the airlines, airline staff associations and, most important, consumers are invited to join every other meeting of the group, sometimes with expert scientists or medical practitioners, to create a broad forum for the discussion of aviation health issues.
The group focused initially on the dissemination of sound information to passengers and on research matters—the two priorities identified by the Select Committee. Recently, however, my right hon. Friend the Minister of State, Department of Transport, announced plans to set up an aviation health unit within the Civil Aviation Authority, to become a source of technical expertise. The unit, which will be based at Gatwick, will act as a focal point for aviation health issues. It will offer advice to air passengers and crew and provide technical input for international organisations. It will also investigate potential new health concerns, handle public inquiries and identify research priorities. As aviation health is likely to remain a matter of continuing political concern, Ministers will continue to take a close interest. I am sure that my hon. Friend the Member for Vale of Glamorgan will bring it to our attention, should we lapse.
267WH The group will provide a strategic policy lead and will fulfil what I believe will remain a highly important role. The CAA will recruit someone to head the unit as soon as possible. For the time being, it will be funded by the Department for Transport. As soon as a suitable legislative opportunity arises, the CAA will be given statutory duties on aviation health, allowing it to fund the unit's work out of charges imposed on the aviation industry. As far as I know, the unit will be the first Government-run institution of its type in the world and it is a significant step forward. The pressure put on the Department by my hon. Friend has been helpful in taking that forward.
I said that one of the priorities that we would address was the need, identified by the Select Committee, for further research into possible links between deep vein thrombosis and flying. We have yet to see any definitive research-based evidence that authoritatively establishes a causal link. Based largely on the House of Lords report, we persuaded the World Health Organisation to initiate a major research programme. Central to that is a large epidemiological study to investigate whether air passengers have a greater incidence of DVT than non-fliers.
The first part of the project has secured €3 million of funding, the lion's share being provided jointly by my Department and the Department of Health with a contribution from the European Commission. Regrettably, other countries in Europe and elsewhere declined to provide funding, but the airline industry is making a significant input by providing access to flights and passengers and other forms of co-operation.
The project is scheduled to last for two years and the results are expected at the end of the next year. I am sure that my hon. Friend will agree that we will need to be certain of a link between the aircraft cabin environment and the incidence of deep vein thrombosis before we can think of making changes to air carrier liability. If the research shows such a link, the action for which my hon. Friend argued so strongly today could be carried forward.
For some years, most airlines have included health advice in the information that they provide to passengers. As the airlines cannot be expected to cover every eventuality or condition that might occur, that advice has tended to be broad and non-specific. Passengers have a responsibility to ensure that they are sufficiently fit to fly, but the Government agreed with the Select Committee that more should be done to ensure that passengers have as much sound information as possible on which to base their travel plans and on which to decide whether they are fit to fly.
In 2001, the Government therefore issued their own advice on travel-related deep vein thrombosis. That advice has been made available to the public through NHS Direct, the internet, the airlines and health services. It provides further information about DVT, based on the current state of knowledge, including setting out those categories of people who are more at risk than others, and gives practical advice about how air passengers on long-haul flights may reduce the risk of getting that blood-clotting condition. My hon. 268WH Friend will probably agree that the major risk is not to people on short flights—holiday flights—within Europe, but to those on longer flights.
The advice describes, for example, simple in-seat exercises that all air passengers should consider doing. All UK long-haul carriers have produced expanded and improved information for their passengers, in the form of pamphlets, videos or announcements, incorporating the material contained in the Government's advice.
My hon. Friend also mentioned the air circulated in cabins. My information is that 99 per cent. of particles are filtered out of the air that is recycled around the aircraft. He also mentioned the on-seat pitch: we need more knowledge about that. It is not only a question of "economy-class syndrome", because incidents have also occurred in business class, where people have more room. We need more research to inform us on the matters raised by my hon. Friend.
My hon. Friend explained why he thinks that the Warsaw convention is unduly protective of airlines, particularly in the light of the recent High Court ruling to which he referred. Although he rightly spoke of the convention as the international agreement that is in force, the key legal instrument is now the Montreal convention, to which he also referred. The Montreal convention, which is expected to come into force later this year, consolidates and updates all the earlier Warsaw-based rules. The adoption of the Montreal convention in 1999, within the framework of the International Civil Aviation Organisation, concluded a period of intense, and at times difficult, negotiations to forge worldwide consensus from a range of divergent views.
In many ways, the Warsaw convention had become out of date and the Montreal convention is a significant step forward in consumer protection. For example, it greatly increases the financial liability of airlines in the event of accidents to passengers. The UK is ready to ratify the new convention along with our partners in the European Community. My hon. Friend will appreciate that the UK is not in a position to make unilateral changes on matters such as those. Were any further amendments to be proposed, they would have to be considered and if appropriate agreed at a global level, probably through the ICAO.
Furthermore, I expect the European Commission to assert that the existence of Community law in this area creates exclusive Community competence, which would require us to act in concert with our European partners. In practice, I see little possibility of the international aviation community wishing to consider amending the convention so soon after its adoption and before it has come into force.
With regard to the case to which my hon. Friend referred, I understand that there may be an appeal. It therefore would not be appropriate for me to comment on that case. However, I can make some general points about the effects of the Warsaw convention. Mr. Justice Nelson held that the atypical reaction of any passenger to a normal and unremarkable flight does not, without any other factor, constitute an accident under article 17 of the Warsaw convention. The judge relied on a well- 269WH established legal interpretation of the term "accident" as an unexpected or unusual event or happening that is external to the passenger.
§ Mr. John Smith
I am sorry to intervene at this late stage, but could the Minister briefly deal with my point about the unusual circumstances in which airlines have total control over the environment of passengers, but no responsibility for their health?
§ Mr. Jamieson
That is what I was trying to say. The way in which the courts have interpreted the Warsaw convention has prevented that particular group of passengers from claiming damages from the airline. It is a complex area of policy and law and it would be difficult to go into all the legal detail and niceties of the matter in the context of the debate today.
My hon. Friend has raised some important issues today, as he has on many other occasions. Those issues are of concern to passengers, consumers, the Government and the airlines. I welcome the debate as it gave me the opportunity to respond to some of his arguments. If there are questions to which I did not respond, I will write to him.
§ Sitting suspended until 2 o'clock.