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Earl Attlee: My Lords, I am grateful to the Minister for giving way. I am grateful, too, for his frankness. It would be helpful to noble Lords if he could give us some idea of the number of incidents, otherwise we cannot work out whether we are right or wrong.

Lord Whitty: My Lords, I cannot say. That information does not exist in the statistical form in which the noble Earl requests it. It is based on a number of accident reports. Accident reports, of course, are only extant if there has been an injury or there has been a serious incident. It is difficult to devise a methodology to achieve those statistics. However, the research programme that we have now initiated should help us down that road.

The main concern relates to light goods vehicles. There are around 100,000 insulin-treated drivers in Great Britain, and indeed a few more in Northern Ireland no doubt, as the noble Lord, Lord Blease, indicated. Most of those drivers are licensed to drive cars and motorcycles. Their licences are normally issued for three years, although in a few cases depending on the driver's health they may be issued for shorter periods. They need to satisfy the eyesight standard and to have good diabetes control. For the vast majority of drivers it is a relatively clear regime.

For drivers of larger vehicles, the situation is somewhat more complex. Because of the higher degree of risk to others involved in driving larger lorries and buses, the potentially serious threat to road safety has been recognised in effectively excluding new drivers in that category. The noble Baroness, Lady Thomas, referred to the statutory bar for a licence for large lorries and buses being in place since 1991 but not before that. Prior to that it had been recommended by the advisory panel that drivers with insulin-treated diabetes should not hold such licences. That did not have the force of law until that point. The change of law in 1991 institutionalised that recommendation. There were some who retained their rights through grandfather rights, but it was not the case that everyone was granted that licence prior to that point.

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The key point where unfairness arises concerns those vehicles of more than 3.5 tonnes, as the noble Lord, Lord Addington, indicated. It is important to understand the complexity of this issue, because many of the reasons for the present regulatory position have little direct relationship to the situation with regard to diabetes. Before the introduction of a second EC directive in 1997, all car drivers were automatically granted entitlement to drive minibuses with up to 16 passenger seats and small lorries. From January 1998, drivers who already held entitlement to drive small lorries and minibuses would be required to reapply when their licence expired, demonstrating that they met the higher health standards required of drivers of larger vehicles.

For the majority of drivers, that meant that they could retain their entitlement without taking any further action until their licences expired at the age of 70, but for those drivers who, because of a medical condition, had been issued only with short period licences, that change in the law resulted in their loss of entitlement to drive minibuses or small lorries. Drivers with insulin-treated diabetes were among that group.

Those who drove for a living were understandably anxious that their livelihood would be threatened. In 1998, my predecessor, my noble friend Lady Hayman, in the light of representations, agreed, on advice from the Medical Advisory Panel, that exceptional arrangements should be made in respect of those employed to drive small lorries. That did not extend to the drivers of minibuses because the panel advised that no such easement should be made. But drivers of small lorries who wished to retain that entitlement have to fulfil certain criteria, including the requirement for the driver to have notified the DVLA by the end of 1997.

Inevitably, there were some insulin-treated drivers who could not meet the criteria and therefore lost their entitlement to drive small vehicles. In some cases that affected their employment. That is the area of unfairness, or apparent unfairness, but it affects a relatively small section of insulin-treated diabetes drivers on the road.

There have been applications for exemption on the basis of the employment rules. Around 12 per cent of drivers who apply are refused. Of those, about 75 per cent are refused because of other medical conditions. Therefore, there are relatively small numbers of refusals. That does not include those who look at the employment criteria and do not apply. There were around 1,100 requests for application forms and 500 were returned. At most, around 500 drivers looked at the employment criteria and decided not to apply.

We are talking about relatively small numbers of people. Nevertheless, it was quite right that the Science and Technology Committee should have identified the apparent inconsistency and illogicality in this matter and the poor statistical base for this action. We have accepted the vast majority of the committee's report. We have taken positive action on virtually all of the recommendations. We had discussions with Diabetes UK when the report was published. I can confirm that we will be meeting again. We have indicated that we

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are prepared to look at the possibility of introducing a system of individual assessment for fitness to drive. The Medical Advisory Panel has also indicated its willingness to look again at present arrangements. As a starting point, the panel will look at the practices in other member states. Action is already under way on the vast majority of the recommendations.

My noble friend Lord Harrison and others said that other countries use individual assessment. The information we have so far indicates that that is not entirely the case. In some senses the concession made in 1998 is a blanket concession whereas others have to go through an individual assessment in all cases to drive this class of vehicle. We have detailed information on Belgium, Norway, Sweden and Denmark. Drivers there are permitted to drive large lorries provided the condition is stable. In Sweden, buses are excluded but drivers are permitted to drive heavy goods vehicles. It is not clear precisely how the medical assessment operates. Although it may well be true that a Dutch driver could get through an individual medical assessment and drive in this country whereas a British driver might not, it is also true that, because of the general exemption, a British driver, going through the British system of being exempt or being allowed to have the licence because of the regular and recent employment criteria, might be able to drive whereas a similar driver in Holland might not.

That is the essence of national interpretation of European directives. It is that rather than an issue of gold plating. I notice that the noble Lord, Lord Pearson of Rannoch, has entered the Chamber at this point! It is by no means clear--I believe that Diabetes UK would accept this--that if we had a system of individual assessment, more people would be entitled to drive than under the present system. However, I accept the point made by the Select Committee and Diabetes UK that it would be a fairer system. We are looking at the possibility of adopting such a system. We are looking, too, at other EU countries' practice in that area.

The noble Earl, Lord Attlee, and the noble Baroness, Lady Thomas, referred to volunteer minibus drivers. There is no very direct relationship with diabetes but it raises an anomaly to which the Select Committee referred. During the negotiations on the directive in 1998-99 we successfully achieved a concession to protect the interests of the voluntary sector. The UK is the only member state to have introduced this exemption. The concession provides that all drivers who have held a category B licence for two years can still drive a minibus with up to 16 passengers provided that it is used solely for social purposes, there is no hire or reward and the vehicle weighs no more than 3.5 tonnes or 4.25 tonnes if inclusive of special equipment for disabled passengers. That leads to the anomaly that insulin-treated diabetics who no longer have a D1 minimum entitlement may nevertheless continue to drive minibuses under those conditions. If we were to correct that anomaly, it would not necessarily be to the benefit of insulin-treated diabetic drivers.

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The noble Earl referred to the possibility of approaching the matter in an entirely different way. He proposed that those subject to an insulin-treated diabetes regime should take an advanced driving test. That is not quite the point. We need research to establish the risk. There is no indication that those people are worse drivers and therefore need to acquire higher driving skills. The point is: what is the risk element of an attack of hypoglycaemia?

Earl Attlee: My Lords, I was not suggesting that someone who is an insulin-dependent diabetic suffers from poor driving. My point is that we need to set against the increased risk of having a diabetic attack the lower risk of having an accident caused by the normal perils of the road.

Lord Whitty: My Lords, it is nevertheless an assessment of skill rather than an assessment of likelihood of a problem.I said that I will be meeting Diabetes UK shortly. I said that we are looking at the

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possibility of individual medical assessment. My officials will work closely with Diabetes UK. We will continue that process. We are also in contact with the advisory panel. The noble Baroness, Lady Thomas, referred to the membership of the panel. The suggestions of the Select Committee in that regard are being considered because, with regard to other advisory panels, it is more difficult to decide how lay members should be appointed. Indeed, we are looking at the totality of the membership of our medical panels.

Noble Lords may be assured that the Government are doing their utmost to try to ensure that a higher level of fairness is put into the system, compatible with observing the requirements of road safety. We wish also to ensure that better research is undertaken to underpin the regulations and that those regulations are seen by all concerned to be fairer than has been the case in the past.

        House adjourned at ten minutes past eight o'clock.

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