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Mr. Deputy Speaker: With the leave of the House, Mr. Rhodri Morgan.
8.45 pm
Mr. Morgan: Gyda chymiatad y Ty.
Mr. Deputy Speaker: Order. That was totally unnecessary.
Mr. Morgan: I was about to ask for what you had already allowed, Mr. Deputy Speaker. It took me unawares and I apologise.
The only false note in the debate was struck by the hon. Member for Vale of Glamorgan (Mr. Sweeney) who failed to join in the spirit of the proceedings. In Wales as
a whole--perhaps omitting the particular corner with which the hon. Gentleman is most familiar--the use of Welsh is appropriate when the Welsh Grand Committee sits in Wales and for those for whom it is more appropriate to speak Welsh.
I do not know whether the hon. Gentleman attended the meeting in Committee Room 14 a couple of months ago when 300 Welsh farmers spoke to the House about BSE. Although they all spoke English, one could tell by the way in which they spoke it that 95 per cent. of them would have been happier to address the informal procedings in Welsh. There was no question but that at least 280 of them would have been happier had the proceedings been mostly in Welsh. That was their better language. It was clear that they were used to discussing agricultural issues in Welsh. That would probably be the case in respect of other issues such as education.
It is not a matter of trying to compel those without a command of Welsh to speak it, but of giving permission to those who have a command of the language not to be debarred from speaking Welsh at appropriate times. The hon. Member for the Vale of Glamorgan failed to understand that.
The Britishness of our British Parliament is based on mutual respect between the four different nations that make up the United Kingdom. That in turn is based on the fact that English is our lingua franca. The issue does not arise for the 82 per cent. of the population of the United Kingdom who live in England. However, that82 per cent. should have the of respect for other 18 per cent. of the population who live in Scotland, Wales and Ireland and who have sometimes have a linguistic skill, preference or culture.
Today, when the second Severn crossing was opened, we are more closely integrated with England than Scotland or Ireland--north or south--in all aspects of economics except one. Only in respect of our language are we less integrated with England than even the Irish Republic, let alone Scotland or Northern Ireland, simply because we have never suffered the potato famine or the highland clearances. As a result, the Welsh language is seven or eight times as strong as the original languages are in Scotland or Ireland.
The Parliamentary Under-Secretary of State for Wales (Mr. Gwilym Jones):
We have had a constructive and positive debate, ably introduced by my right hon. Friend the Leader of the House. He reminded us that certain of our leading colleagues could not be with us tonight for good reason, but far be it from me to suggest that it was as a result of any such absences that we had such a constructive and positive debate. I heard nothing divisive in any of the differences that were aired, and nothing that might prevent further progress.
A former Secretary of State for Wales, the right hon. and learned Member for Aberavon (Mr. Morris), spoke of the experiences of one of his ancestors in this House with
the Earl of Lisburne. Only a few weeks ago, I was with the present Earl as we launched a new Welsh milk for St. David's day. In that direction, things have moved on.
I was glad to hear the speech from my right hon. Friend the Member for Conwy (Sir W. Roberts). For the attention that he has lavished upon the language of Wales over the years and for seeking to take forward its interests in legislation, my right hon. Friend can be regarded as the father of the Welsh language. We heard a brief intervention from the hon. Member for Merthyr Tydfil and Rhymney (Mr. Rowlands), who I seem to remember is the only remaining Member who was a Minister the previous time there was no Welsh-speaking Minister at the Welsh Office.
My hon. Friend the Member for Vale of Glamorgan (Mr. Sweeney) observed that the Conservative party is second only to Plaid Cymru in bilingual terms, with one third of Conservative Members of Parliament in Wales able to speak the Welsh language. That puts the Conservatives above the Labour and Liberal Democrat parties. My only quarrel in the debate was with the hon. Member for Ceredigion and Pembroke, North (Mr. Dafis) who objected to tokenism and insisted that only one language be used here. I would say to him, were he still here, that those of us whose Welsh is inadequate or absent deserve encouragement and should not be frustrated from taking the opportunity to try to use the Welsh language.
Much of the debate this evening has centred on what the Procedure Committee has cautiously suggested. The caution of the Committee was set out by my right hon. Friend the Member for Honiton (Sir P. Emery), the Chairman of the Committee. We all owe a debt of gratitude to the Committee for considering the matter. He referred to the practical problems and the need to have more experience of dealing with them. Various Members have referred to the problems, which were introduced by the hon. Member for Cardiff, West (Mr. Morgan).
The suggestion was made that the recommendation of the Committee that Members restrict themselves to one language during any one speech might be unduly restrictive. Of course a Member might wish to deal with several distinct issues during a single speech, and it might seem appropriate to deal with some in English and some in Welsh. I agree with the Committee's suggestion that we ought to proceed with caution, as we do not want to cause difficulties for Hansard and make it more difficult for it to make the accurate report of the Committee's proceedings that the House is entitled to expect.
When we have gained some experience of running the Welsh Grand Committee in both languages, we may find that the Chairman, the Committee and the reporters can cope with a situation in which a Member switches from one language to another once or perhaps twice in a speech, provided--ideally--that everyone knows his intention. When we reach that point, we may leave it to the discretion of the Chairman of the Welsh Grand Committee to permit a slight relaxation of the rules set out in the Procedure Committee's report.
The hon. Member for Ynys Mon (Mr. Jones) asked about the record of proceedings of speeches in Welsh. I could be negative and suggest that he has not proved it necessary to have an alternative record and that, inevitably, it would result in extra expense. Those are not insubstantial objections to his proposals, but I prefer to follow the Procedure Committee and say that we should try to leave the matter open. When this House has had more experience of the Welsh Grand Committee using the language, we might find it appropriate to look again at the matter.
In conclusion, I wish to make the same point as the hon. Member for Cardiff, West--this is a great day for Wales. We are making great steps in our cultural and material fields, and this evening the House has been dealing with our language. Also, just before 11 o'clock this morning, the second Severn crossing was opened. I had the opportunity to be present, along with my right hon. Friends the Secretary of State for Wales and the Secretary of State for Transport, when the bridge was opened by his Royal Highness the Prince of Wales. It is a major development that will improve the economic affairs of south Wales, and it links to the very matter we are considering this evening.
Also present--perhaps he is still there--was the Chairman of the Welsh Grand Committee, the hon. Member for Newport, East (Mr. Hughes), in whose constituency one side of the bridge is located. I am glad that we can move forward--
It being one and a half hours after the commencement of proceedings on the motion, Mr. Deputy Speaker put the question, pursuant to Order [17 May].
Question agreed to.
Resolved,
Mr. Colin Pickthall (West Lancashire):
I am grateful to have the opportunity to raise the subject of diabetes. I did not expect to make my speech so early, but I promise the Minister of State that I will not keep him from an early bath.
I start by declaring an interest--I am an insulin-dependent diabetic, and naturally I take a particular interest in the matter. I shall be talking about matters that lie outside the Minister's area of responsibility, as diabetes is an issue that spreads into other areas. I do not expect definite answers from him on any of these matters, but I hope that he will communicate my queries to other Ministers in one way or another.
I sought this debate to coincide with National Diabetes Week, which in fact is next week, between 9 and 15 June. The week of activities seeks to educate the public generally and to heighten awareness of the problems and possibilities associated with the condition of diabetes. The British Diabetic Association is targeting in National Diabetes Week fitness and exercise as a crucial part of a diabetic's maintenance of good balance and good health.
When diabetics maintain the delicate balance between diet, drugs and exercise, they save themselves a lot of personal discomfort and misery in the short and long term, but also save the NHS vast amounts of expenditure. It is therefore in the interests of individuals and the Exchequer that, as a community, we get diabetic care right.
To indicate the scale of the problem, which has not yet been quantified by the Government, it should be recorded that there are about 1.4 million known diabetics in Britain, with a similarly huge number not diagnosed. Some 20,000 diabetics--almost all of whom are insulin-dependent--are under the age of 20. That is about 100 for each health district. These people have an entire lifetime to seek to control the condition.
There is a much greater prevalence of diabetes in our Asian and Afro-Caribbean communities, and a higher incidence in men than in women. I do not think it is irrelevant to say that, worldwide, there are estimated to be 110 million people with diabetes, and in Europe,18.5 million people. A significant fact that interests me is that 10 per cent. of insulin-dependent diabetics use 80 per cent. of the world's supplies of insulin. Western intervention in eastern Europe after the collapse of the Soviet Union was particularly important given the lack of health care for diabetics. It is also an important matter in third-world countries, and may be one in which Lady Chalker might wish to take a great interest.
In large measure, diabetics have to care for themselves on a day-by-day basis. It is a complex task requiring help, education and constant self-monitoring, particularly of blood sugar levels. The more even those levels can be kept, the less likelihood there is of long-term severe complications such as retinopathy, neuropathy, cardiovascular disease, kidney failure, amputations and other conditions that can follow from long-term diabetes.
When thousands of new diabetics are diagnosed in this country each year, the size of that education and training task can be readily appreciated. As I understand it, records
of diabetes are not kept by health authorities, so we have no precise statistics. I understand that considerable pressure has been exerted for local registers of diabetics. I commend that proposal to the Minister if he has not already thought about it, but I am sure he has.
I have many complaints and many descriptions of shortcomings to make in the debate, but I would not like it to be thought of as a gloomy debate. Professor Harry Keen, president of the BDA, has quite rightly said:
Cuts or the freezing of research budgets, such as that of the Medical Research Council, whose budget has been cut by 1.5 per cent. in the current year, are very sad, and perhaps foolish. They hinder the likelihood of huge savings that would come from more efficient remedies or controls of diabetes. The same is true of research into the causes of diabetes.
There have also been admirable advances in recent years in the creation of a network of diabetic clinics. At my local clinic at Ormskirk hospital, consultants, a specialist diabetic nurse, a dietician and a chiropodist work together with back-up staff. The easily available provision of such specialist facilities to the entire diabetic population is an aim, I believe, of the NHS, and it should be achieved as soon as humanly possible.
The St. Vincent declaration has set out targets to reduce dramatically over five years the incidence of severe complications in diabetics. It also sets out to change the emphasis, in order to deal with individuals who are diabetics instead of a category or a type of person.
I urge the Government to study the shortcomings and difficulties that are faced by diabetics, and to alleviate them where they can. As I said before, I realise that many of them are not the responsibility of the Minister, but I know that he will be interested in them, and will communicate them to his colleagues in other Departments of State.
The Minister could deal directly with the first problem--the non-availability on prescription of Novopen needles. The Minister will recognise that the pen system for insulin delivery enables a diabetic to keep much better control over blood sugar levels, particularly those who have irregular life styles, as I do perforce as a Member of Parliament. The long-term savings for the NHS are enormous. While some people use replaceable needles several times, many cannot face, and perhaps should not be expected to face, reusing a steadily blunting needle. That can be exceedingly painful, and is a particular problem for young children. A week's supply of such needles can cost as much as £10. As they are not on prescription, that cost must be met by the insulin-dependent diabetic, who might be on the lowest of incomes. I believe that it is only a matter of time before that injustice, as I think it is, is remedied in response to the pressure from many thousands of pen users and would-be pen users.
The Government could make a very popular gesture by putting those pen needles on prescription, as disposable hypodermics are, at comparatively little cost and with
considerable future savings in terms of better control of diabetes. As diabetics are converted into using pen needles, they cease to use most of their disposable hypodermic syringes, which are on prescription, so the costs should more or less balance in the long run. I understand that discussions have been taking place on this matter inside the Department, and I urge the Minister to expedite them if he possibly can.
Experience has shown that no job exists that cannot be done as well by someone who is diabetic as by anyone else, whether it is the job of an international footballer or of an actor, such as Leo McKern, Sir Harry Secombe or Willie Rushton, who were all involved in exceedingly stressful jobs and are all insulin-dependent diabetics; or the jobs done by several hon. Members of the House, and of another place; or heavy manual work. Every diabetic person is different; that is the central message, if any, of this speech.
Each person must work out his or her own regime. Each person must anticipate times when blood sugar might become low because of missing out on a meal at a specific time or because of unexpected exercise. That can lead to hypoglycaemia, and the diabetic must ensure that he takes in extra carbohydrate sugars to compensate.
All diabetics, as far as I know--at least unless they are completely mad--carry emergency rations with them to counter such possibilities. However, some occupations deem insulin dependency to be incompatible with the work involved, and in most of the cases I shall mention that assumption is a blanket one, ignoring the individual's success or otherwise in controlling the diabetes, and even ignoring medical evidence provided on that person's behalf.
For example, police forces usually automatically suspend or sack insulin-dependent officers. Many dedicated police officers have written to me in considerable distress, having lost promising careers simply because they suddenly developed insulin-dependent diabetes in middle age. As far as I know, the Home Office has not seriously studied that problem. I have tabled several questions about this, and received an answer more or less to the effect, "It is nothing to do with us," or, "The problem is in hand."
It is wrongly assumed that a police officer who is insulin-dependent is more likely than the next man or woman to suffer lapses of health while working. The same applies to firefighters, with the added impetus that a firefighter who is insulin-dependent cannot drive a fire tender or one of the heavy vehicles that the fire service uses, so he or she gets the sack or is demoted or pushed sideways into a desk job.
Even more peculiarly, in most cases a similar ban applies to offshore work. I take one absurd example. A 50-year-old man working as a ticket seller on the Shetland Isles ferry service became insulin-dependent. As soon as that happened and his employers found out, he was sacked, because he was unable to comply with the medical standards for offshore work. That worker was never more than 15 minutes from land, and had nothing to do with running the vessel. He simply collected the ticket money for the vehicles on the ferry.
Just as worrying is the story of a girl accepted for nurse training. After her initial acceptance, she was suddenly refused because she was insulin-dependent. Her health
record, attested by her doctor, was excellent, but she told the hospital, in all honesty, that she had experienced hypos during the previous two years. The attacks were mild and had been self-treated. The hospital concerned was, in effect, refusing to accept any nurse with insulin dependency.
Only this morning I read an article in the Lancashire Evening Post about a diabetic man in Wigan, who said that he was refused entry into the armed forces because of his diabetes. He had also been sacked from his employment as a barber when his employer found out that he was insulin-dependent.
Perhaps most pressing in all these examples of discrimination--that is what they are--is the case of heavy goods vehicle and public service vehicle drivers. An insulin-dependent diabetic applying for a driving licence after 1 July this year will be banned from holding one of the new class 2 licences, which would prevent the driving of any vehicle over 3.5 tonnes.
Already, most HGV drivers in the United Kingdom who become insulin-dependent are effectively banned from continuing their employment. Some flexibility is possible in the European legislation, but it is by no means certain that the Government will take advantage of it to ensure that people treated with insulin are not automatically barred from driving class 2 vehicles and the range of associated jobs. I hope that the Minister will have a quiet word with his hon. Friend the Minister for Transport in London, the hon. Member for Epping Forest (Mr. Norris), who is responsible for these matters and who I know is fully aware of the details.
There is a further problem associated with drivers. People who apply for work as taxi drivers in some parts of the country are refused licences because they are insulin users. I am unclear how much protection might be provided for those who suffer discrimination in employment in the Disability Discrimination Act 1995. I know that some protection is provided in insurance matters, but, as I understand it, there is no protection in occupational matters.
Two issues underlie all these complaints. Insulin-dependent people will have hypoglycaemic experiences from time to time, and there is no point disguising it. They can be very severe. The attacks result from an excessive drop in blood sugar levels and bring about a disorientation which is rather like drunkenness, only slightly less pleasant. I have been a diabetic for 13 or 14 years, and I have suffered two such attacks, both in the middle of the night.
That raises another problem. As a nation, we keep no records of people who are insulin-dependent and subject to hypoglycaemic attacks but who live alone and have no back-up from relatives. Most relatives of such people are well aware of what the insulin-dependent person has to go through, and are alert to the need to protect them. About three years ago, in a sad case in Grangemouth in Scotland, a woman who was an insulin-dependent diabetic died in a coma, and her small baby died of starvation; yet we have no systems to monitor lone diabetics.
Vague knowledge of the problem of hypos causes the knee-jerk rejection of insulin dependents by the sort of employers I have mentioned. Those who suffer from hypos are those with poorly controlled diabetes, and no one would suggest that someone who is continually poorly controlled should be allowed to drive an HGV.
That would be complete nonsense. Most insulin dependents, however, are well controlled, and that is more and more the case as education and monitoring improves and as more pens are in use.
My case is that every insulin-dependent diabetic who seeks to gain or retain employment should be judged on his or her medical record, witnessed if necessary by independent doctors, as happens in other areas. We seek to end the blanket rejection of diabetics, because that is a plain injustice, and is also appallingly inefficient in economic and employment terms. Many other medical conditions could cause the problems that employers imagine will arise from diabetes, but most of them do not give rise to blanket bans such as I have described.
I have already said that it is incumbent on diabetics and their medical advisers to educate themselves about the best possible control of their condition. They have primary responsibility. However, it is also incumbent on employers and Ministries that impose regulations to educate themselves about the realities of diabetes and individual differences. The Government must take a key role, whether by using the Disability Discrimination Act 1995 to disseminate good practice or through other means.
That, whilst English is and should remain the language of this House, the use of Welsh be permitted in parliamentary proceedings held in Wales, subject to the conditions set out in the Third Report from the Select Committee on Procedure, Session 1995-96 (House of Commons Paper No. 387).
5 Jun 1996 : Column 691Diabetes
Motion made, and Question proposed, That this House do now adjourn.--[Mr. Bates.]
8.54 pm
"These are times of great promise for people with diabetes."
There are exciting developments in research into implants of insulin-producing islets, artificial pancreases, as well better as insulin and better delivery systems for insulin. The Government could do an enormous amount for the health of the nation by encouraging and financing an intensification or speeding up of research into those developments.
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