Oral Answers to Questions
Bill Esterson Excerpts(12 years, 10 months ago)
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Mr Lansley
As we said in the NHS constitution, we do not intend patients to be waiting for more than 18 weeks. [Hon. Members: “They are!”] The April figures show that we met the operational standard, which is that more than 90% of admitted patients and more than 95% of non-admitted patients should be treated within 18 weeks. The right hon. Gentleman’s analysis of waiting times did not include the fact that the average time for which patients waited for treatment in April was 7.7 weeks, down from 8.4 weeks in May 2010. The average time for which patients wait is being reduced.
Bill Esterson (Sefton Central) (Lab)
2. What assessment he has made of the conclusions and recommendations of the recent report by the Commission on Funding of Care and Support.
Chris Ruane (Vale of Clwyd) (Lab)
7. What assessment he has made of the conclusions and recommendations of the recent report by the Commission on Funding of Care and Support.
The Minister of State, Department of Health (Paul Burstow)
As the Secretary of State said in his statement to the House last week, the Government welcome the report of the Commission on Funding of Care and Support and will consider its recommendations carefully.
Bill Esterson
The Government may say that they welcome the report, but can the Minister explain why the White Paper on social care will now be published in spring 2012 rather than in December 2011, as the commission’s report recommends? Do the Government want it to be kicked into the long grass because of Treasury interference?
Paul Burstow
The hon. Gentleman is entirely wrong. The Government’s approach is to have discussions with the official Opposition and to engage fully with stakeholders from Age UK, Carers UK and many other organisations, not just about funding reform—which is an important part of our reform of social care—but about questions of quality and law reform.
Health and Social Care Bill (Programme) (No. 2)
Bill Esterson Excerpts(12 years, 10 months ago)
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John Pugh (Southport) (LD)
I will briefly specify three linked reasons, good and bad, why we support the Government’s programme motion. We oppose the Opposition’s amendment to the motion because it would simply lead to unnecessary delay. The Government have identified through the listening exercise, perhaps belatedly, the controversial, difficult and unworkable aspects of the legislation and want to change them. In deference to the people they have consulted, they want to change those aspects promptly and subject them to proper scrutiny, not only in Committee, but in an evidence session that we will also have.
Surprisingly, many areas of the Bill are relatively uncontentious and ought not to detain the House a great deal longer, such as the aspects relating to social work, the health and care professions or the National Institute for Health and Clinical Excellence. Those areas are relatively uncontentious and need not be massively reconsidered. In addition, there is the summer recess, as the right hon. Member for Wentworth and Dearne (John Healey) said, which means that after the Committee has concluded its considerations there will be ample time for him and anyone in the NHS, including all the consultees, to make adequate representations. The Bill will then go to the Lords and return for our further consideration.
Bill Esterson (Sefton Central) (Lab)
The hon. Gentleman will have been lobbied by constituents in the same way that I and other Members have been. Does he agree that the public’s real concern is the potential for cherry-picking by private companies, even with the amendments that are being made, and that this approach will be unable to stop such a process?
John Pugh
The public are perfectly entitled to an answer on whether the Bill contains cherry-picking or not, but it is better that they have that answer sooner rather than later. There is a second reason—[Interruption.] May I just set my stall out? The second reason why this must be done properly is that the Bill has so far led to uncertainty and the implosion of primary care trusts. Whoever’s fault it is—[Interruption.] People will know that I did not support the original Bill. It has led de facto to the implosion of PCTs and to some irregular adjustments and appointments being made on the hoof—Members can ask their constituents about that—and to some premature arrangements being made.
NHS Future Forum
Bill Esterson Excerpts(12 years, 11 months ago)
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Mr Lansley
As I have said, we will expect, and the Future Forum says, that commissioning groups should not normally cross local authority boundaries—in this respect, boundaries for social authorities—but they should be able to make a case for doing so based on benefit to patients. The one thing I would urge is that they are very clear with their local authorities about how they can secure the continuing integration of health and social care at a local level.
Bill Esterson (Sefton Central) (Lab)
Is not the reason the Secretary of State has so much support from the right wing of his party that they know that this will lead to privatisation of large parts of the NHS, as he confirmed in his answer on preferred suppliers?
Mr Lansley
I hope that my colleagues would support me in saying that I have support from colleagues right across the coalition, because the coalition Government are supporting the NHS in enabling it to deliver improving services. That is what it is all about.
NHS Reform
Bill Esterson Excerpts(13 years, 1 month ago)
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Mr Lansley
I am grateful to my hon. Friend. Perhaps having increased the number of managers in the NHS by 70%, the Labour party thought that it would be swept to victory on the votes of NHS administrators. That did not happen. People in the NHS knew that waste, inefficiency and excess bureaucracy were not the way to deliver the best care for patients. That was Labour’s way; it will not be our way.
Bill Esterson (Sefton Central) (Lab)
Given that the Secretary of State will not instruct NHS managers to take a natural break in implementing his so-called reforms, does he understand why his intention to make changes after the natural break might be questioned? As colleagues have suggested, is the natural break just like every other Tory consultation—a sham?
Mr Lansley
There is nothing sham about this. This is serious business, not a political game, as it appears to be for Opposition Members. Tens of thousands of people across the NHS are engaged in managing and developing new services, which will deliver improving outcomes and be more responsive to patients, through devolved decision making in the NHS. I think that we should simply help and support them, not least by listening to them.
Mobile Phones (Health Effects)
Bill Esterson Excerpts(13 years, 4 months ago)
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Mr Tom Watson (West Bromwich East) (Lab)
It is a great testament to science and maths writers such as Ben Goldacre and Matt Parker that no self-respecting politician can make speeches in the House of Commons without taking heed of the science behind their contribution, so at the outset let me tell the Minister that I am sure we both agree that public health decisions must be grounded in scientific facts and that our public policy must be evidence-based. As we have both read around this subject, we will probably agree that there is no conclusive evidence to prove the link between mobile phone use and brain cancer.
Let me contradict myself at the beginning of this speech by making an allegation for which I have little factual evidence. From my experience of nearly a decade in the House, it is my view that the more an industry or organisation wishes to hide something unpleasant or do something unpopular, the more lobbyists it employs to talk to MPs. The $1 trillion telecoms industry hires a lot of lobbyists.
I do not seek to persuade the Minister that there is a link between brain cancer and the radiation emitted by mobile phones, but I want to convince her to take a sceptic’s eye to the recommendations before her in future public policy. A number of scientists and epidemiologists believe that although there is no certainty that mobile phone use causes tumours, there are ample causes for concern. At the very least, I ask her to look at the work of Siegal Sadetzki or the earlier work of Allan Frey, and to read “Disconnect”, a recently published book by Devra Davis, and the work of Henry Lai.
Some of those scientists and writers challenge the conventional thinking in the telecoms industry. I make no apology for giving their case a hearing in the Chamber tonight, although I accept that they are not the only voices in the debate. I should like to tell the Minister first why the industry needs to put a greater emphasis in its communications to consumers on the potential risks that mobile handsets cause, and secondly, why I am concerned about independent research. I shall also outline what I think needs to be done to remedy those two problems.
The Minister is new to her post, but she could make a big difference to public policy before she gets that promotion that I am sure she deserves in the imminent reshuffle that we read about in the papers. The mobile industry is big business and an important player in the UK economy. Ofcom’s most recent figures from its communications market report show that operator-reported retail revenue currently totals £30.4 billion. Mobile retail revenues are £14.9 billion; mobile voice call minutes amount to 118 billion; data volumes over mobile networks increased by 240% in 2009; and more than 96 billion text messages and 600 million picture messages were sent in 2009. The Office for National Statistics estimates that mobile phone ownership has increased from 65% in 2001 to 81% in 2009 and, worldwide, 5 billion people are using mobile phones. In the UK, that means that there are now more mobile phone connections than there are people—an estimated 80 million.
One of the key concerns of scientists such as Devra Davis is labelling. She says that the labelling of phone products in store, online and in the literature a person receives with their phone is woefully inadequate. I also accept the case from statisticians such as Matt Parker who disagree with me. Matt told me today:
“The only basis for precautionary labelling mobile phones would be on a hunch. There is no evidence for it. Of course we should continue research, and make sure it is independent and unbiased, but there is no need to give people the impression that they should alter their use of mobiles when there is absolutely no basis for it”.
Yet the mobile phone companies themselves provide precautionary advice—it is just difficult to find it. If someone wanted to make a judgment on whether to purchase a phone based on its specific absorption rate, which indicates how much electromagnetic radiation is absorbed by body tissue while using a mobile phone—the higher the SAR, the more the radiation is absorbed—or on how close to their head they can hold the phone, they could not do so at the point of sale, because the information is simply not there. It is not available on the shop floor or at the click of a button online.
I suspect that most sales staff would not be able to recommend which phone a consumer should buy based on its radio frequency exposure either. Yet we know that the legal departments of mobile phone manufacturers are all now slipping into the fine print a warning about holding a phone against the head or body. That, in itself, is not enough, and they are not giving this information enough prominence in their literature. Why are the manufacturers printing these warnings, after years of denying that there was any risk of radiation, if they are of the view that there is no cause for concern? Apple, for example, suggests that users of the iPhone should keep about five eighths of an inch between the handset and the head. Research in Motion—the manufacturer of the BlackBerry—is even more cautious, saying that people should keep a distance of about an inch.
For the average user, those warnings require a magnifying glass to read. They are usually in point 8 font size or below and make up part of the little slip tossed aside when a phone is unpacked. If someone managed to struggle through any of these booklets and reached the advice, they would be one of only a handful of people ever to have managed it. How many people even know that radio frequency exposure comes from the phone’s antenna? Not many, I suspect. How many people know that this exposure is stronger when a phone is kept in clothing, which weakens the signal, causing the power to increase? How many people know that it is recommended, if mobiles are carried on belts or in pockets—[Interruption.] I am sorry, would the Whip, the hon. Member for Ludlow (Mr Dunne), like to get in? Is he seeking to intervene? No?
How many people know that it is recommended that if mobiles are carried on belts or in pockets, the liquid crystal display and keypad should face towards the body? The fact is they do not. Hardly anyone knows what advice is given on the use of handsets. Although all phones sold in the UK fall within the SAR guidance of 2 W per kilogram in 10 grams of tissue for electromagnetic radiation absorbed, most users would probably be shocked to learn that each handset differs and that the manufacturers give different guidance on using phones.
Improved labelling has support among many academics and organisations, such as the EM Radiation Research Trust, which was brought to my attention by my hon. Friend the Member for Sefton Central (Bill Esterson), and Powerwatch.
Bill Esterson (Sefton Central) (Lab)
Like me, Mr Speaker, you have young children. Also like me, you will be concerned if there is compelling evidence of the dangers of mobile phone handsets or masts. My constituent Eileen O’Connor, of EM Radiation Research Trust, has drawn to both my attention and that of my hon. Friend the strong evidence of the dangers of electromagnetic radiation, particularly to children. Does he support calls for the Government to investigate the safety of mobile phone handsets and masts, and either to issue stronger guidance or to legislate on the basis of that evidence?
Mr Watson
Yes, and I am going to make the case that the science should leave no stone unturned. If my hon. Friend lets me develop my argument, I am sure that he might want to comment on it later.
Improved labelling has support among many academics and organisations. For example, Alasdair Philips from Powerwatch has stressed to me that safety advice should be included in an obvious position, such as the “Getting started” section of a new phone booklet, not buried in the back pages of the manual. I cannot vouch for those organisations, but they are entitled to have their voices heard in this House. It is often hard for independent organisations to be heard above the cacophony of voices from telecoms lobbyists.
We might even need to go one step further. The Government should consider the merits of obliging manufacturers to place health advice and SAR ratings on the outside of handset boxes. Ohio Congressman Dennis Kucinich is pressing Congress to look at passing a similar law. He summed up his thoughts perfectly when he recently said:
“Until we know for sure, a labelling law will ensure that cellphone users can decide for themselves the level of risk that they will accept…mobile phone companies should not be the ones making that decision for us.”
San Francisco aims to become the first city in the USA to require large wireless retailers to display a device’s SAR rating prominently. The regulation will come into force at the start of February next year. Lawmakers in Oregon and in Californian cities are considering similar steps. Around the world, other nations are extending the cautionary approach.
The German Government, for example, has introduced the Blue Angel phone label. In order for mobile phone manufacturers to be able to display the BA sign on their products, their SAR ratings must not exceed 0.6 W per kilogram. Although the German Government’s current safe limit is in line with the EU level of 2 W per kilogram, it is perhaps the first recognition that the EU’s rating is already much more lenient than that of the US, Canada or New Zealand. In Germany, the Federal Office for Radiation Protection publishes the SAR ratings of all mobile phones on sale in Germany. Why not put the ratings on our direct.gov website, so that British consumers who are interested in the issue can get the facts? The bottom line is that consumers should be given enough information about SAR levels to allow them to make an informed purchasing choice. At the moment, they cannot do that. This Government believe in transparency, and I applaud them for that. I believe in the power of information. The Minister can ensure that consumers are far better informed about the science around their mobile phones, should they be interested.
On the risks of mobile phones, thousands of studies have been published in scientific journals, forming the basis for systematic reviews by health agencies. The balance of evidence to date would suggest that there are no short-term established adverse health effects on the brain from mobile phones. To pretend that the long-term effect of exposure to such devices over more than a decade is known, however, is false. It is not known, and the matter will not be settled until the science leaves no stone unturned. Despite the mobile phone lobby’s claim otherwise, many key and respected studies have suggested that there may well be a link between mobile phones and brain cancers. Although such studies do not identify a causal link, they insist that further research is warranted and emphasise the need for caution in public policy making. As far back as 2000, for example, the Stewart report said that the use of mobile phones is not totally
“without potential adverse health effects”.
Although Sir William’s report said that there was no evidence of a health risk to either adults or children at the time, it said that children should be discouraged from making “non-essential” calls until further research had been completed.
Bill Esterson
My hon. Friend seems to be saying that there is strong evidence that is worthy of further investigation. He mentioned the fact that manufacturers give warnings, but that they are sometimes difficult to find. Does he think the manufacturers issue those warnings to cover themselves legally, just in case there is a problem, or perhaps because they have strong evidence? Does he agree that, either way, it is imperative that the Government take action now?
Mr Watson
An optimist would say that they are adopting the precautionary principle in regard to health. A pessimist might say that they are adopting such a principle because of possible legal cases. Either way, they are not doing enough to provide clear packaging.
The doubts about the long-term health impacts of mobile phones continue to be highlighted by the Department of Health’s own guidance, to which I am sure the Minister will refer. Many parents are probably not even aware of the guidance, however. It states that children should
“use mobile phones for essential purposes only”
and
“keep calls short—talking for long periods should be discouraged.”
This advice was influenced by the Stewart report.
We also had the National Radiological Protection Board’s report, “Mobile phones and health”, in 2004. That review updated Stewart, and its main conclusion was that there was no hard evidence at present that the health of the public had been adversely affected by the use of mobile phone technologies. The report does, however, state that some uncertainties remain and that a continued precautionary approach to the use of mobile phones is recommended until the situation is clarified. Following the publication of that report, Sir William Stewart himself said:
“The fact is that the widespread use of mobile phones is a relatively recent phenomenon and it is possible that adverse health effects could emerge after years of prolonged use. The evidence base necessary to allow us to make firm judgements has not yet been accumulated”.
The report’s findings make it clear once again that this is not a settled issue.
Further research, such as the 2004 Karolinska Institute study, published worrying findings on a link between mobile phones and ear tumours. The institute’s research suggested that using a mobile phone increased the risk of acoustic neuroma by 3.9 times on the side of the head on which the phone was used. There was no increase on the other side of the head, giving an overall rise in risk of 1.9 times. The report went on to conclude that regular mobile phone use over a decade or more might increase the risk of benign tumours. Like the Stewart report and the NRPB report, the Karolinska Institute’s study makes it clear in its findings that this is not a settled issue. Further research is needed. Well-respected epidemiologists such as Dr Lennart Hardell of Orebro university in Sweden have also found that links between mobile phones and cancer might exist.
Bill Esterson
Since my constituents drew this matter to my attention, I have looked into the details, as my hon. Friend has done. I have reached the conclusion that it is important, as a parent, to take precautions and to restrict the use of mobile phones by children in anything other than an emergency. I urge the Government to take that point seriously, even at this stage, as well as taking on board all the other points that my hon. Friend has made about carrying out further investigations.
Mr Watson
Even with my own beloved children—my five-year-old and my two-and-a-half-year-old—I sometimes have to persuade them not to grab my mobile phone. The precautionary principle should apply, but it is very hard for parents. This is why public information is very important.
As I was saying, Dr Hardell, in his study “Long-term use of cellular phones and brain tumours: increased risk associated with use for 10 years”, has reviewed epidemiological studies that found that phone users had an increased risk of malignant gliomas. In carrying out his review, he found a link—although not a causal link—between phone use and a higher rate of acoustic neuromas. He also found that tumours were more likely to occur on the side of the head that the handset was used. His study indicated that one hour of cell phone use per day significantly increased tumour risk after 10 years or more. He also makes the case that this is far from a settled issue.
In May, the hotly anticipated Interphone report for the World Health Organisation suggested that those who engage in heavy phone use could be at risk, but stopped short of establishing any firm links from the data. The Interphone study is the largest study to date into phone use and head and neck tumours.
Although there were suggestions of an increased risk of glioma at the highest exposure levels, the report went on to state that
“The possible effects of long-term heavy use of mobile phones require further investigation.”
The research team was divided on its findings—
The Parliamentary Under-Secretary of State for Health (Anne Milton)
I congratulate the hon. Member for West Bromwich East (Mr Watson) on securing this debate. I know that he takes a particular interest in this and all other matters of technology, both nationally and in his constituency. He is absolutely right to say that we must heed scientific fact, but his insight into reshuffles is perhaps lacking in a certain degree of fact—or perhaps he knows something that I do not, from sources unknown. However, I wish to thank him for his flattering comments.
At the last count there were a staggering 80 million mobile phones in the UK, and the number is still rising steadily. More than 12 million people own a smartphone in order to access the internet and other web-based technologies. The benefits of mobile phones are clear in terms of social networking and rapid communication, and they help people to feel safer and in touch. They are also a way of including people. I feel more comfortable knowing that my children have mobile phones and that I can contact them, as they can me, wherever they are. I am sure that my parliamentary office would say the same about contacting me, particularly during the recess.
The hon. Gentleman is right to say that mobile technology has also raised significant health worries. Many people are extremely concerned about the effect of electromagnetic radiation from phones, and we should understand and acknowledge those worries. We should answer them on the basis of the evidence and we should ensure that appropriate protections are in place, so that not only is everyone safe, but everyone feels safe—and the hon. Gentleman has demonstrated that that is not necessarily the case.
Bill Esterson
The planning Green Paper that the Conservatives published before the election stated that the party would
“review potential health issues related to mobile phone masts in the light of ongoing scientific research.”
Can the Minister tell us how that review is going, and if a similar one is being carried out on handsets?
Anne Milton
I thank the hon. Gentleman for his intervention, but may I suggest that he may be jumping the gun a little? I have been speaking for only about two minutes, and I will come to all those issues if he gives me a bit more time.
The independent expert group on mobile phones and health was set up in 1999, partly as a response to public concern. It was tasked with reviewing the health effects of mobile phone technology. As a newly elected councillor, I was acutely aware of the considerable concerns among people in my ward at that time. As has been mentioned, the group was chaired by Sir William Stewart, the former chief scientific adviser to the Government. Its report was published in May 2000.
The report was based on a thorough review of scientific evidence on the health effects of mobile telephones and it took account of work in progress, alternative views on the science and public opinion, which at that time was considerably concerned about those effects. In 2004, the then National Radiological Protection Board reviewed the evidence again—the hon. Member for West Bromwich East mentioned this—and reiterated Stewart’s recommendations, in particular the recommendation that a precautionary approach should be adopted. Current Government policy on mobile phones is based on the Stewart report and its recommendations. The headline conclusion in the Stewart report was that
“the balance of evidence to date suggests that exposures to”
mobile phone “radiation below” national
“guidelines do not cause adverse health effects.”
The report was referring to the National Radiological Protection Board national guidelines, which were in place at the time. It is none the less important to note that Stewart recommended that as a precautionary measure the guidelines should be replaced by more restrictive international guidelines.
In recognition of the incomplete scientific knowledge and significant public concern, Stewart made other precautionary recommendations. For example, he recommended that the widespread use of mobile phones by children for non-essential calls should be discouraged. As the hon. Gentleman said, however, warnings are difficult to find, and the small print is very small. I suspect that many people these days are unaware of that guidance. I shall return to the question of scientific evidence in a minute.
The Government accepted the advice of the Stewart report and followed a precautionary approach, and most of the recommendations were implemented in full. On Stewart’s recommendation, we moved to stricter international guidelines for exposure. Along with other member states, the UK supports the European Council recommendation to limit exposures to electromagnetic fields, which incorporates international guidelines. By 2001, industry, Government Departments and their advisers were working to the new exposure guidelines for mobile phone technology, so now all mobile phones and base stations comply with the guidelines.
An important development following the Stewart report was the setting up of a new research programme in this country—the mobile telecommunications and health research programme, or MTHR. Research has been carried out at centres throughout the country under the management of an independent programme management committee. It is important to mention that it is independent. In 2007 MTHR published a report from 23 completed projects. Since then, further work has been published from the programme.
MTHR is a very high-quality research programme and none of the research so far has shown that radio frequency emissions from mobile phones affected people’s health—at least in the short term, although that is obviously not the end of the story. The lack of long-term data, however, has been noticed by MTHR, the World Health Organisation and other regional and international advisory committees. It is also being addressed by an international cohort study on mobile phone use and health known as COSMOS, to which the hon. Member for West Bromwich East referred.
The UK forms a key part of the study, and our participation is funded under the MTHR programme. I understand that the COSMOS study aims to follow the health of approximately 250,000 European mobile phone users for up to 30 years. It is a very thorough process. COSMOS will consider any changes in the frequency of specific symptoms, such as headaches and sleep disorders, over time as well as the important risks of cancers, benign tumours and neurological and cerebrovascular diseases.
The Department also supports the World Health Organisation’s international electromagnetic fields project, which encourages research focused on specific gaps in our knowledge. There is no doubt that there are considerable gaps in our knowledge at this stage. Apart from the accident risk from using mobile phones when driving, present knowledge indicates no proven risk to health from mobiles, except of course in the easy access that one has to home delivery pizzas and the possible impact on our daily calorific intake, which cannot be ignored.
Let me address for a moment mobile phone base stations, which are often called masts. When I first entered politics as a local councillor, that was one of the subjects that caused most concern. Masts provide the communication links by radio waves to handsets, allowing connection to the rest of the telephone system and the wider world. Mobile phones need this infrastructure to function, and it is this infrastructure that has caused so much concern in the past. On masts in particular, Stewart concluded that on the balance of evidence there is no general risk to the health of people living nearby, on the basis that exposures are expected to be very small. However, it is of note that in that connection, too, he recommended a precautionary approach. It was interesting to learn from the Stewart report that the levels of radio frequency exposure from masts, which people thought were likely to be high, were much lower than those from mobile phone handsets held near the head. Indeed, yearly independent audits have shown that mast exposures are well below the international guidelines—in many cases tens of thousands or more times below.
The MTHR also reaffirmed that exposures from base stations were very much lower than international guidelines. An MTHR study specifically looked to see whether short-term exposure to radio frequencies from masts could affect people’s health. Although some people attribute their ill-health symptoms to mobile phone base stations—the hon. Gentleman raised this issue—the MTHR peer-reviewed study found no convincing evidence so far that their symptoms were caused by exposure to signals from mobile phones or masts. But, of course, we should not and shall not be complacent: we must continue to keep the science under review. The Health Protection Agency keeps us informed of the science in this area, and its independent advisory group on non-ionising radiation is currently reviewing worldwide scientific studies on radio frequency emissions as part of its regular review cycle, and will report in one to two years’ time.