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House of Lords

Wednesday, 21st February 2001.

The House met at eleven of the clock: The LORD CHANCELLOR on the Woolsack.

Prayers--Read by the Lord Bishop of Portsmouth.

Deep Vein Thrombosis Diagnosis

Lord Higgins asked Her Majesty's Government:

    How many hospitals in the London area are expected to have equipment operational over the Easter holiday period capable of diagnosing whether an individual has a deep vein thrombosis.

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): My Lords, all accident and emergency departments in London have access to equipment and staff to diagnose deep vein thrombosis. Of these, 25 have facilities operational out of hours, at night and at the weekend, including the Easter holiday period.

Lord Higgins: My Lords, I am grateful for that somewhat reassuring reply. However, my experience suggests that on occasions it is impossible to find any department which is capable of diagnosing a deep vein thrombosis and that the departments tend to close down during Bank holidays. Patients are then given injections for the treatment of deep vein thrombosis but that might not be adequate to deal with the dangers involved in the condition. Can the Minister assure the House that all hospitals will be informed where such facilities are available during Bank holidays?

Lord Hunt of Kings Heath: My Lords, I accept that it is important that the fullest information is available. I said that 25 facilities were operational out of hours and that is out of 31 A&E departments in London. That is pretty comprehensive coverage. But it will be important to ensure that the ambulance service and other authorities are aware of which hospitals do not have out of hours covered.

As regards treatment, if access to testing is not available, it will be appropriate in some cases on clinical terms to start such treatment. But overall the health service is more geared up to having full facilities available during holiday periods than it was some years ago.

Lord Harrison: My Lords, although the Question is directed to hospitals in London, can my noble friend tell the House whether special equipment is available for deep vein thrombosis in hospitals which are close to airports in other major cities such as Manchester?

Lord Hunt of Kings Heath: My Lords, I would expect every local health community to have such

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facilities available. Although a great deal of publicity has arisen about air travel, it is worth making the point that DVT has a number of causes. Therefore, it is important that not only hospitals near airports but all major A&E departments have those facilities. It is my understanding that they do.

Lord Graham of Edmonton: My Lords, the Question refers to the Easter period, but can the Minister say whether there is a congestion of the problem during other periods? Furthermore, can he examine the need for every major airport to have a substantial medical presence--not just directions to the nearest hospital? In the case of DVT, saving minutes can save lives.

Lord Hunt of Kings Heath: My Lords, as regards air travel, I imagine that the Christmas and summer periods are particularly busy. It is important that NHS facilities can deal with peaks when they arise. I believe that during the past few months we have shown with our intense planning for the winter period that the health service has responded well. There is a better planning system to enable us to have the required facilities.

As regards health facilities in airports, I pay tribute to my noble friend for the industrious way in which he has raised these issues during the past two years. I agree that airports need appropriate health facilities. He will be aware that a pilot defibrillator is in operation in Terminal 4 at Heathrow airport and we shall be examining the results of its use with great care.

It is also worth making the point that in addition to facilities the key is good liaison between an airport and local hospitals. That is the responsibility of the health authority in conjunction with the airport authorities.

Earl Howe: My Lords, is the Minister satisfied that London ambulance crews are aware of which hospitals have the requisite equipment at certain times and which do not?

Lord Hunt of Kings Heath: My Lords, yes, I would expect ambulance crews to be aware of that information. This is the normal stuff of ensuring that ambulance crews have the up-to-date information available not only in relation to the availability of diagnostic tests for DVT but in relation to the availability of beds and A&E facilities. During the past few years the London Ambulance Service has got its act together and is aware of these matters.

Lord Shepherd: My Lords, will my noble friend ask the Leader of the House whether, on behalf of the House, a message of support and sympathy should be sent to the family of the noble Lord the Chairman of Committees?

Lord Hunt of Kings Heath: My Lords, of course.

Lord Dubs: My Lords, on the basis that prevention is better than hospital treatment, does my noble friend believe that the airlines are doing all they can to inform passengers about how they should conduct themselves

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in order to minimise the chance of developing DVT while on flights? In particular, will my noble friend confirm that it appears to make no difference whether one flies first class, business class or, as some must do, economy class and that walking about on a plane, and possibly even fidgeting, is better than sitting totally still?

Lord Hunt of Kings Heath: My Lords, I am advised that this matter should not be termed "economy class syndrome"; rather, it is a problem of immobility for long periods. Air passengers are advised to take preventive measures; for example, they should drink plenty of water, fruit juice or other soft drinks but not alcohol; if they have suffered from a recent blood clot, have an irregular heart beat or have a replacement heart valve, they should inform the cabin crew; they should move their legs regularly throughout the flight and, if possible, stroll up and down the aircraft every hour or so. My noble friend Lord Macdonald has met airline operators to discuss this and other matters. The airlines fully understand our desire to ensure that as much information as possible is made available to passengers.

Income Tax Self-assessment

11.13 a.m.

Lord Dubs asked Her Majesty's Government:

    Why the procedures for self-assessment of income tax liability were changed for 1999-2000, and whether they have any proposals to simplify the process for 2000-01.

Lord McIntosh of Haringey: My Lords, the self-assessment tax return has not changed significantly since self-assessment was first introduced, except to reflect legislative changes. The Inland Revenue did, however, consolidate four separate tax calculation guides into a single guide for the tax year 1999-2000. It acknowledges that the single version has not been well received and has caused confusion. In response to this feedback, the tax calculation guide for 2000-01 will be available in two versions: a standard guide for taxpayers with relatively simple financial affairs and a comprehensive guide for those whose financial affairs are more complex. However, one does not need to use the tax calculation guide at all if one does as I do and sends in one's tax return by 30th September, as the Inland Revenue will make the calculation for the taxpayer.

Lord Dubs: My Lords, I am as ever grateful for my noble friend's advice, but some of us have difficulty in meeting the deadline of 30th September and must, therefore, do the calculation ourselves. Is my noble friend aware that last year and the year before the process was simple and I could make the self-assessment calculation in about 45 minutes but this year the task defeated me? Although the staff of the Inland Revenue are always incredibly helpful to idiots

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like me who struggle with the process, several times during the long day when I dealt with it they told me that this year the procedure was much more complicated and that they were fed up with it because everybody had difficulties. Can my noble friend assure the House that the process will be simple enough to enable all of us to do the self-assessment next year without having to rely on accountants?

Lord McIntosh of Haringey: My Lords, my noble friend is not an idiot, and I certainly do not suggest that his difficulty last year, as opposed to previous years, was as a result of any change in his capacities. As I made clear in my Answer, last year the Revenue tried to bring the tax calculation guides together within a single document. That was the source of the trouble. Previously, there was a more straightforward income tax guide for the 4 million of the 6.6 million taxpayers who use self-assessment and whose affairs are relatively simple, and there were separate guides for capital gains, for share schemes, for capital gains and share schemes combined--because they often go together--and for lump sums. I believe that it was the attempt to bring them within a single document that caused the difficulties experienced by my noble friend. As I said, it is planned to separate them again for the coming tax year.

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