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Mr. McNamara: One of the most important strands of the current three-strand talks is the one dealing with the east-west relationship between Westminster and Dublin. Can my hon. Friend give any indication of the state of relations between the two Governments over the important question of the fate of Irish immigrants to Britain and of British people residing in the island of Ireland? After meetings between the two Prime Ministers, statements about intergovernmental relations have been printed at the margins, but has the Home Office been involved in such discussions?
Mr. Howarth: It is important to be careful and measured in any response to the detail of the points that
my hon. Friend raises, but I shall consider whether it would be appropriate to put into writing the particulars of some of the discussions. More positively, in the difficult negotiations on initiatives in Northern Ireland, there has been a strong understanding between the two Governments on how the process should be taken forward--relationships between the Governments are good.
Rev. Martin Smyth (Belfast, South): The debate has focused on the Irish in Britain, but it has encompassed the question of the census. Will the census refer to the Irish in Scotland? Will the question on ethnicity extend to Northern Ireland, or will it apply only in Britain?
Mr. Howarth: The hon. Gentleman raises a wider issue, which is not in the compass of this debate, although it would fall within our consideration of ethnic monitoring in the census. As I understand the matter, however, we are specifically dealing with people whose origin lies in the Republic of Ireland. The hon. Gentleman raises an interesting side issue, which may be considered in the consultations on the 2001 census.
Mr. McDonnell: In the discussions that have taken place so far, the question of ethnic status has covered everyone from the island of Ireland--it does not distinguish between people from the Six Counties and people from the Republic.
Mr. Howarth: I am grateful to my hon. Friend for that clarification.
The debate has done a great deal to remind us all of what has been achieved and what remains to be done. We will continue to consider carefully the concerns raised in the CRE report and elsewhere, and we will ensure that the Irish community has full access to the rights and opportunities that we will create for all our citizens.
Mr. Adrian Sanders (Torbay):
This is a debate about improving road safety in the United Kingdom and in Europe. The Department of the Environment, Transport and the Regions road strategy document, "Current Problems and Future Options", dated October 1997, states:
That suspicion lies behind European Community directive 91/439, the origins of which are in discussions that took place in 1980. There have since been 18 years of medical advance and improvements to diabetic control that have dramatically reduced the complications of diabetes through the encouragement of better blood sugar control. The suspicion is outdated, and neither the European Union nor the United Kingdom Government can point to any statistical or actuarial evidence to support the concerns underlying the directive.
The Government's own assessment of the medical impact of drivers' medical conditions on the total road accident rates puts the issue into context. According to the Driver and Vehicle Licensing Agency, between April 1995 and March 1996 there were 163 notifications of collapse at the wheel, of which only 27 involved insulin-dependent diabetics.
Compare that with the 16,050 drink-driving accidents or the 31,050 accidents caused by driver fatigue. To follow the logic--if logic is the right word--should not we impose driving restrictions on anyone who drinks alcohol at any time or on everyone who at one time or another will suffer from fatigue?
I am not here to embarrass the Government or to score points. I want to help the Minister to find a way out that improves road safety while being fair to those individuals who are insulin-dependent diabetics and can prove their fitness to drive. I declare an interest, in that I am an insulin-dependent diabetic. The DVLA has yet to write to me to impose its ban for the vehicles that I shall mention in a minute, but I also have an interest on behalf of constituents and others who have written to me on the issue.
The Government have introduced a blanket ban, preventing people with diabetes who inject insulin from driving vehicles in category C1, which covers cars weighing between 3.5 and 7.5 tonnes, and category D1, which covers vehicles with between nine and 16 seats. Those vehicles come under group 2, which is the category referred to in the directive.
The ban was not even required by the original EC directive, which clearly states:
According to the Danish Ministry of Transport executive order of March 1997, Denmark grants group 2 licences when a proper justified medical certificate is available, and provided that regular medical examination is carried out.
The Government have allowed discrepancies in the law in their interpretation of the directive. They allow people to drive vans, which are in category D1, on a voluntary basis but not professionally. That is surely proof that there was not sufficient evidence to introduce a complete ban. There was enough political pressure to protect voluntary drivers.
The Government have allowed the retention of licence rights to some drivers of even heavier vehicles, such as heavy goods vehicles, while preventing others from driving much lighter vehicles; they have allowed drivers from other EU states to come and drive over here in vehicles denied to United Kingdom drivers; and they have disregarded the rights of many drivers who have been driving for many years without any accidents or hypoglycaemic attacks at the wheel and who are now faced with unemployment without compensation.
People are already losing their jobs, and many more will follow as the DVLA notifies them of the ban. I have in my office a file of case studies from throughout the country. One concerns the BT engineer who will lose his job but will still be able to drive a minibus for cub scouts in his free time. Others concern employers who do not want to sack loyal, long-serving staff. I recently received a letter from an employer who asked:
Mr. Colin Pickthall (West Lancashire):
Many hundreds, if not thousands, of people will be grateful to the hon. Gentleman for raising this issue. Like him, I am an insulin-dependent diabetic. Tommy Wright, my constituent, is an HGV driver who became insulin dependent and lost his job. Because of his good record, the company kept him on to drive a minibus. Because of the blanket ban, he will now lose that job, even though he would be perfectly entitled to drive a minibus on a voluntary basis. Does the hon. Gentleman agree that that is totally unjust, and that the Government's blanket imposition of the ban is reprehensible?
Mr. Sanders:
I agree entirely. I applaud the hon. Gentleman's work over the years on behalf of both insulin-dependent and non-insulin-dependent diabetics.
The situation is ridiculous. The Government promised to fight inequality in their new public health strategy and to tackle the problem of social exclusion, but this policy will have the opposite effect: it will drive people from
work into welfare; encourage inequality; and lead to unemployment and further discrimination against, and social exclusion of, people with diabetes.
The Government say that they have taken the decision in the interests of road safety, on the advice of the honorary advisory panel on driving and diabetes, but that body is yet to reveal the sources of the information on which it based its decision; has not, to my knowledge, commissioned any review of the evidence; and did not even meet for four years, during the critical time when the previous Government were drafting the UK regulations.
In those years, new studies, from America and Denmark in particular, had not yet been published. The Federal Highway Administration evidence showed that the accident rate for diabetic drivers was lower than the United States national rate. In Denmark, a review of nearly 8,000 people with diabetes showed no increased risk of accidents, including road traffic accidents.
Surely the Government could consider more pressing and effective road safety measures rather than spending time discriminating against a small group that does not even figure in their own accident statistics and has been shown in some studies to be safer than other drivers on the road.
The new rules could compromise road safety rather than enhance it, because they will act as a disincentive to newly diagnosed diabetics to inform the DVLA of their condition. If the DVLA does not know about a person's diabetes, it cannot impose restrictions on his or her licence. The self-regulatory system has worked until now, with conditions being imposed on diabetic drivers of certain categories of vehicle, subject to medical tests. That regular assessment has undoubtedly led to poorly controlled diabetics being taken off the road. That may no longer be the case as a consequence of the legislation.
All we ask is that the Government listen to the medical evidence and instigate an urgent review. The insurance industry--not known for its altruism--has listened and does not impose higher premiums on insulin-dependent diabetic drivers. So, what would be the fairest way to protect the rights of drivers who are in complete control of their diabetic condition, while targeting the minority who are less well-controlled and who should be the target of legislation? It is possible to identify people with the highest risk of hypoglycaemia through three strong predictors: a history of unawareness; experience of frequent severe hypoglycaemia; and previous hypoglycaemic-related injury or accident.
The British Diabetic Association and I, along with the hon. Member for West Lancashire (Mr. Pickthall) and my hon. Friend the Member for Isle of Wight (Dr. Brand), recently presented a series of such proposals to the Minister. The association is also convening a group of medical experts to draft how a system of individual assessment might work, which will be presented to the Government and the honorary advisory panel on driving and diabetes. Its proposals already have the support of the Transport and General Workers Union, the United Road Transport Union, the Royal College of Nursing, the Employers Forum on Disability, the Drivers Action Movement, the Federation of Recruitment and Employment Services, Unison, the Road Haulage Association and the RAC.
"There is no evidence that medical unfitness plays a significant role in causing accidents; indeed, accidents with medical factors involved are too few to show up in any of the statistics that are collated."
Nevertheless, there is a suspicion that people with a medical condition such as diabetes are less safe behind the wheel than others.
"In very exceptional cases may driving licences be issued to, or renewed for, applicants or drivers in group 2 suffering from diabetes and requiring insulin treatment, and then only where duly justified by authorised medical opinion and subject to regular medical check-ups."
4 Mar 1998 : Column 1026
Sadly, the Government have gone much further than the directive and introduced a policy that is not applied in other EU member states.
The Netherlands, for example, issues group 2 licences on an individual basis for one or three years, subject to independent medical examination. Finland and Sweden protect existing licence holders who use their licences as part of their employment, defining that as one of the directive's "exceptional circumstances".
"Is there anything that can be done to help this very valuable, faithful, long-term friend and employee?"
The situation is ridiculous for a Government who promised to help people to move from welfare to work.
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