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Lord Buxton of Alsa: My Lords, I thank my noble friend very much for his largely satisfactory and admirable reply. In fact, it has almost restored my "feel-good factor". I am sure that your Lordships are anxious to get on to the next Question, but will my noble friend convey to the Minister, Angela Browning, very sincere appreciation and congratulations on what has happened? It is nearly a year since we started to be concerned about the case of Mr. Law and his family slaughterhouse business which has gone on for several generations. A very serious injustice has been averted through her intervention and through her taking full charge of these decisions. Therefore, we would like my noble friend to kindly pass that on.

May I ask a further question? If we are now to ensure that no further injustices occur, can the arrangement whereby the Minister takes full charge be built into

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future provisions so that when Angela Browning moves elsewhere and higher, as I am sure that she will, we need have no further worries?

Lord Lucas: My Lords, I shall draw my noble friend's very kind remarks to the attention of my honourable friend who is, indeed, a most effective Minister. She, I, and all the officials involved, share the delight at the resolution of Mr. Law's problems and I hope that we may be able to deal with the other outstanding derogations with similar good effect.

Lord Cledwyn of Penrhos: My Lords, can the noble Lord tell the House how many slaughterhouses in England, Scotland and Wales are regarded by the Ministry of Agriculture, Fisheries and Food as inefficient or unsatisfactory?

Lord Lucas: My Lords, I do not believe that we know of any such slaughterhouses. Some have not yet met the conditions, but on the other hand the time limit in which they have to do so has not yet expired.

Lord Peyton of Yeovil: My Lords, does my noble friend agree that complex legislation and regulations open the door to tiresome officials being able to bully people and deprive them of their livelihoods? I have no doubt that my noble friend will have read the admirable judgment of the sheriff concerning Mr. Errington, who was so gravely bullied by Clydesdale District Council.

Lord Lucas: My Lords, I have not yet had the opportunity to read the judgment but I am looking forward to doing so. Generally, I agree entirely with what my noble friend said and believe that if we were to rewrite the directives now both ourselves and the European Commission would proceed in a different spirit.

Lord Carter: My Lords, despite the rather complacent Answer from the Minister, does he agree that it is extraordinary that after all the confusion and the increased costs and pressure on abattoirs resulting from the regulations, the recent inspection of abattoirs by the State Veterinary Service found that nearly half of those inspected were in breach of the rules governing the removal of specified offals as a control against the possible spread of BSE? Does not that confirm the worst fears of those of us who felt that the new regulations would not produce the increase in food safety that we were promised?

Lord Lucas: My Lords, I take a rather different view. Yes, I share the noble Lord's disappointment at the performance of slaughterhouses as regards the removal of spinal cord. That is something that we are taking extremely seriously. However, our belief is that the introduction of the Meat Hygiene Service and the regulations has resulted in a great increase in quality and a great decrease in costs compared with previous inspection results. If we are seeing more difficulties in slaughterhouses, I believe that it is simply because we are seeing more rather than because more are occurring.

Baroness Nicol: My Lords, can the Minister say whether any progress has been made recently in the provision of mobile abattoirs? He will no doubt recall

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that we had some discussions on that about a year ago. Mobile abattoirs would ensure that animals could be slaughtered as near as possible to the places where they had been reared. Is that progressing?

Lord Lucas: My Lords, I am afraid that I know nothing about that, but I shall write to the noble Baroness when I have some information.

Lord Mackie of Benshie: My Lords, although I am delighted that the Minister has saved one family business, can he tell the House how many have been closed down in addition to the three that I can tell him about in my own area? Can he also say how much the health of the nation has improved because of his officials' actions?

Lord Lucas: My Lords, since 1975 about 1,000 slaughterhouses have closed. I cannot give the noble Lord any answer about how the health of the nation has improved, but it seems to be in good shape, which is what we are all aiming at.

Lord Carter: My Lords, is the Minister aware that the incidence of food poisoning has increased in the past two years?

Lord Lucas: My Lords, no, I was not aware of that, but I am sure that very little of it is attributable to problems in abattoirs.

Intensive Care: Services

3.4 p.m.

Lord Ashley of Stoke asked Her Majesty's Government:

    Whether they are satisfied with the critical care facilities in British hospitals.

Baroness Cumberlege: My Lords, it is for health authorities and NHS trusts to determine the level of intensive and high dependency care according to the needs of their local populations.

Lord Ashley of Stoke: My Lords, I thank the Minister for that Answer, although it does not say very much. Does she agree that the recent report on post-operative deaths stated that surgery and anaesthetisation were both safe but that patients' lives were at risk because of the shortage of high dependency beds in hospitals throughout the country? Is the Minister aware that the report recommended that that shortage should be dealt with urgently? Are the Government dealing with it urgently? Indeed, why have they not dealt with it so far?

Baroness Cumberlege: My Lords, we welcomed the report of the national confidential inquiry into peri-operative deaths; but we did not entirely agree with its view on critical care because there is a lack of scientific evidence which could either support or refute the view that was expressed. That is why the

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Government commissioned a study into the provision of intensive care in England. That report was published in February of this year.

Lord Rea: My Lords, does the noble Baroness agree that the distribution of intensive care beds is uneven throughout the country, with under-provision in some areas and possible wasteful over-provision in others? Will the research that she mentioned lead to strategic planning of intensive care across health authority boundaries, involving trusts, and operating across purchasing authority boundaries? Will the noble Baroness answer my noble friend's question about high dependency beds, which are less costly than intensive care beds and can be used effectively in conjunction with them?

Baroness Cumberlege: My Lords, yes, the noble Lord is right in saying that provision is uneven across the country. Indeed, different admission criteria apply in different parts of the country. The study to which I referred was undertaken by Professor McPherson, and reported that one in six intensive care admissions was inappropriate. That meant that people with life-threatening emergencies were possibly denied treatment. The professions are producing guidelines on admission and discharge policies which we think will make a great difference. In April we set up an intensive care bed bureau in the south-east of England, since when there has been no occasion on which an intensive care bed was not found when needed. That practice has been adopted in other parts of the country.

Lord Hayhoe: My Lords, I pay tribute to the staff, to the nurses and others involved in intensive care, for their great dedication and high professional skills, but does my noble friend accept that there is sometimes a shortage of staff which leads to difficulties in finding intensive care beds for particular patients? Is my noble friend satisfied that proper arrangements are in hand to improve and extend the training of intensive care staff?

Baroness Cumberlege: My Lords, yes, my noble friend is correct about trying to staff intensive care units. In fact, more training places are now in the pipeline. Since 1990, 1,000 extra intensive care nurses have joined the service, so we are seeing an improvement on that front.

Baroness Robson of Kiddington: My Lords, is the Minister equally satisfied about the existence of proper rehabilitation services in most of our hospitals? After all, rehabilitation is tremendously important if one has been in a high dependency or intensive care unit. I fear that some of those services are no longer available.

Baroness Cumberlege: My Lords, I am not certain what the noble Baroness means by rehabilitation because it can be a long-term thing--two or three years. With regard to rehabilitation for those coming out of intensive care, what the noble Lord, Lord Rea, said about high dependency units can apply here also.

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People on general wards are conscious of the need to rehabilitate those coming from intensive care, and they do it well. It would be very hard for any Minister to give a guaranteed assurance that it is done perfectly.


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