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Mr. Clappison: I am grateful for what the hon. Lady said earlier. On the question that I raised about Sudbury, will she write to my hon. Friend the Member for West Derbyshire (Mr. McLoughlin) about that matter, saying as much as possible, because I know that my hon. Friend is worried about what has taken place there?
Kate Hoey: Of course we will. We will write to the hon. Gentleman and give him a full report of what is happening.
We have spent a useful hour and a half this morning during which we have aired a number of concerns and issues. I do not wish to underestimate their importance, or skate over failures, but the recent security record of the service has been good. There has been a 74 per cent. reduction in the rate of escapes and a 23.5 per cent. reduction in assaults.
The service came out well from the recent review. Ministers have taken responsibility for the service within a framework that allows the director general the necessary scope and freedoms to run what is a large and unique organisation. We are investing around £226 million of additional money to help to develop constructive regimes that help prisoners to avoid returning to crime following
their release. Together, those changes should help to address the concerns that have been raised by Sir David Ramsbotham.
Vivien Stern, former head of the National Association for the Care and Resettlement of Offenders, recently praised the Prison Service of England and Wales for its culture of knowing the difference between right and wrong, for its willingness to admit its mistakes and to strive to put things right, and for the courage and independence of prison governors in fighting for improvements in conditions. No one denies that there are difficulties and challenges to overcome, but the Government believe that the Prison Service and the arrangements for its higher management are broadly in good health as the millennium approaches.
We know that hon. Members will continue to voice their views and to press for those improvements. We will continue to respond.
Mr. Anthony D. Wright (Great Yarmouth):
I am pleased to have secured the debate. I look forward to Members' contributions and to the Minister's response on a complex and often controversial subject.
I know from my many conversations with Members on both sides of the House that many in the Chamber today have had first-hand experience of myalgic encephalomyelitis--or ME as it is more commonly known--either as sufferers or through the suffering of relatives or close friends. I am especially pleased that the debate is taking place today as it is national ME awareness day.
Many Members will know that I have been active in reforming the all-party group on ME. I was pleased to be elected as its chair. One of the crucial tasks of those who campaign on the issue is to raise awareness of ME and its effects among the general public. One of the stated aims of all-party group is to raise awareness of the issues at Westminster. I am pleased that, to date, it has a membership of 134, as well as a number from another place.
My main focus since entering the House has been on the needs of my constituents, so Members will not surprised to hear that it was through meeting an extraordinary young woman in Great Yarmouth that I became involved in the ME campaign. My first experience of the hardship caused by ME came some years ago, when I met Tanya Harrison, who lives in Great Yarmouth. She is 23, and has had ME for at least the past 13 years. She experienced a gradual and continual deterioration in her health until she became so severely ill that she was referred, and subsequently admitted, to Great Yarmouth's James Paget hospital.
After months of intensive treatment, varying diagnoses and consultations with specialists, Tanya was eventually diagnosed as suffering from severe and chronic ME. For the subsequent seven years, she has been bedridden for most of the time and has continued to experience additional symptoms. At the beginning of last year, at the age of 22, she developed osteoporosis of the hips and osteopaenia of the spine--yet another consequence of living with severe and chronic ME.
Despite all the setbacks in her life, Tanya's determination has shone through and she grasps with admirable zeal every opportunity to highlight the plight of fellow ME sufferers. To that end, she launched the blue ribbon for awareness of ME campaign in April 1995. Her efforts culminated in the meeting in the Grand Committee Room on 14 May 1998, at which an international line-up of experts on ME addressed an audience of sufferers, along with many Members of Parliament. I am pleased to see that some hon. Members--including the Minister--are wearing the blue ribbon today.
What exactly is the disease? The literal definition of myalgic encephalomyelitis is inflammation of the brain and spinal cord, but that definition does not have the universal support of the medical establishment, because it almost implies brain pathology, which has not yet been clearly established for the condition. Post-viral fatigue syndrome, or post-infectious fatigue syndrome are other terms used when ME-like symptoms appear after viral infection.
From those terms, the hybrid definition of chronic fatigue syndrome, or CFS, has appeared. The term encompasses all the previously mentioned syndromes and has been used increasingly over recent years because of its neutrality: it does not imply a specific cause and accepts that there may be a variety of causes, some physiological, some psychiatric and some involving an amalgam of factors.
The difficulty that the medical profession has with a common definition is an appropriate microcosm of the whole ME debate. That is all very disconcerting for the sufferer, whose main concerns are, "What is wrong with me?" and "What can I, or my doctor, do to make me better?" The confusion and fragmentation of approach are well summed up by the title of a book written in 1991 by David Bell: "The Disease of a Thousand Names".
Perhaps more alarming still is the significant weight of evidence to suggest that inappropriate treatments have been prescribed, as exemplified in a letter that appeared in the British Medical Journal of October 1997, from Dr. Alan Franklin, medical adviser on ME to several of the country's leading ME organisations. The letter, which seems to sum up the feelings of many sufferers, says:
Unfortunately, it is difficult to escape the impression that the disease has split the medical and scientific communities into two major factions: those who believe that the root cause is psychological and those who support an organic causation. Medicine and science do not always provide clear-cut answers, and that was reflected in the observations in the report of the national task force on CFS/ME, which was produced in 1994.
On causation, the report says:
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"Unfortunately, some doctors have trivialised this illness; ridiculed patients and their supporters and subjected a few of them, including children, to oppressive, perhaps even abusive forms of treatment."
Indeed, in the 1980s, ME attracted the most derogatory of labels, "yuppie flu", even though there is no evidence to suggest that it is more prevalent in one social class or grouping than another. We hope that such thinking can be consigned to history. I am optimistic that our debate today will make a contribution, however small, to a more considered approach to the disease, which is estimated to affect between 5,000 and 10,000 sufferers per 500,000 people in the United Kingdom, according to controversial figures produced by the royal colleges of medicine.
"The distinction between physical illness and psychological illness is becoming progressively more blurred. For instance, many psychiatric diseases, including depression, have been shown to have demonstrable physiological and neuro-chemical disturbances. In addition we are gaining an understanding of the influence of psychosocial factors on the development and cause of physical diseases."
The report goes on:
"However we live in a society which is used to thinking of illnesses as physical or psychological and which harbours differing attitudes towards these. For example, a number of patients with CFS are denied financial benefits on the grounds that these illnesses have been perceived as psychological."
Mr. Tom Clarke (Coatbridge and Chryston):
I have apologised to my hon. Friend for the fact that I will be unable to attend the whole of this debate.
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