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Lord McIntosh of Haringey: My Lords, all new coaches are now required to have seat belts fitted in all forward and rear facing seats. Drivers and front seat passengers in all vehicles must use seat belts where provided. An EU directive under discussion will require passengers aged three and over in the rear of coaches to use the seat belts provided.
Lord Janner of Braunstone: My Lords, I thank my noble friend for that Answer but can he please tell us how many lives he estimates have been lost, and how many injuries suffered, through people in such coaches not being safely belted in? If, as he says, there is a law that certain passengers on coaches where seat belts are provided must be belted in, what steps are the Government taking to enforce that law? How many people have been prosecuted and with what result? In order to prevent deaths and injuries, some of which have occurred in recent disasters, will my noble friend issue an instruction that drivers must not depart without ensuring that they and all passengers aboard are safely belted into place?
Lord McIntosh of Haringey: My Lords, in each of the past five years there have been between 11 and 18 deaths in coaches. We cannot tell how many of those deaths resulted from the provision or non-provision of seat belts as some of them occurred as people were getting off and on coaches. Clearly, every single death is a death too many, but that does not mean that this is an enormous problem. All coaches first registered after 1st October last year must have seat belts fitted. Since 1997 all coaches that carry childrenthat includes nearly all coaches as they cannot make a living unless they carry children as well as adultsmust have seat belts fitted. The difficulty, which is recognised in the Question, is that of enforcement and getting drivers and those in charge to ensure that seat belts are used.
Viscount Astor: My Lords, will the Minister explain why, as I understand it, not only coach passengers but also coach drivers will in future have to wear seat belts and why lorry drivers will not be required to wear seat belts? What is the difference between coach drivers and lorry drivers? Would it not be better for lorry drivers also to wear seat belts? As I understand the position, older coaches will not be required to have seat belts fitted as sometimes their floors are not strong enough to enable them to be fitted safely. But is there any reason why, on those older coaches, the driver should not be required to wear a seat belt?
Lord Faulkner of Worcester: My Lords, is my noble friend aware that the coach crash on the M25 on 16th November, which I believe prompted my noble friend's sensible Question and supplementary question, tragically killed six people travelling back from the Continent but attracted less media attention than the derailment last Sunday of a First Great Western train at Ealing? That incident attracted tabloid headlines such as "train terror" even though not a single passenger was killed or injured. Should we not stress over and over again how much safer train travel is than travel by road? The latest statistics show that travel can be up to 20 times safer by train than by road.
Lord McIntosh of Haringey: My Lords, it is true that train travel is very safe but it is also true that coach travel is very safe. I refer to the figures that I gave and to a figure for all road user casualties of over 300,000. When we compare that with a figure of well under 1,000 casualties from coach travel, it can be seen that we should not extend the dangers of road travel to coaches.
Lord Janner of Braunstone: My Lords, will my noble friend be good enough to answer my question about whether there have been any and, if so, how many, prosecutions for failing to wear seat belts and, if so, with what result?
The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): My Lords, the Government's first priority is to implement the NHS Plan and deliver a high quality service to the public. It is not our policy to promote private healthcare as an alternative to the NHS. However, it is
Lord Lamont of Lerwick: My Lords, I thank the Minister for that reply and I welcome the Government's radical use of the private sector to free up supply to the National Health Service. But is it not time, and is it not logical, to go a step further because is it not increasingly open to argument that however much money is put into a monopolistic state system it will not deliver commensurate improvements? Given that half the hospitals in Germany are in the non-public sector and that in France, Switzerland and Germany there are competing independent insurance systems, why do the Government, who have called a debate on the health service, refuse even to consider measures to encourage similar developments in this country?
Lord Hunt of Kings Heath: My Lords, the noble Lord will know that the Wanless report examined those matters to some considerable degree. In terms of funding of the NHS it concluded that there is not an alternative funding method to that currently in place in the UK that would deliver a given level and quality of healthcare either at lower cost to the economy or in a more equitable way. The Wanless review was thorough. We see the need for greater diversity and provision of services. That is why we are quite prepared to use the private sector in the way that has been developed in the past few years. Each country has developed its own culture and system in health. It seems surely better to take what we have, improve it, use the private sector where effective but concentrate our focus on building on the excellence of the National Health Service.
Lord Clement-Jones: My Lords, we on these Benches certainly support the view stated by the Minister and not the belief of many on the Conservative Benches that the salvation of the NHS seems to lie in the private sector. One of the points made by the Health Select Committee earlier this year was that the NHS simply lacks the procurement and commissioning skills necessary to secure value for money when procuring from the private sector. What steps are being taken to ensure that the NHS will have that expertise and experience?
Lord Hunt of Kings Heath: My Lords, we have given clear advice to the NHS that there is potential for obtaining keener prices in the contracts that it negotiates with the private sector. We are putting in place a new financial planning framework for NHS services which will give much greater guidance and encouragement to the NHS to ensure that it has the proper contracting skills and to ensure value for money. As relationships develop between the NHS and the private sector the NHS will become much more skilled at obtaining a good deal.
Lord Davies of Coity: My Lords, a Labour government introduced the National Health Service, which became the pride of the world in terms of healthcare. Does my noble friend agree that, following 18 years of neglect of the National Health Service by the previous Administration, at this stage it would be a retrograde step to return to a system where the Government encouraged private medicine? Would that not again introduce a price tag on health benefits, whereby those with the ability to pay would receive the best treatment?
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