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Immigration: Age Estimation By X-Rays

Volume 417: debated on Wednesday 18 February 1981

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2.43 p.m.

My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.

The Question was as follows:

To ask Her Majesty's Government what is the accuracy attainable in estimating the age of children by X-rays for Immigration Act purposes.

My Lords, Sir Henry Yellowlees has reported that these estimates are fairly accurate. The accuracy falls with increasing age. For example, at three years of age 68 per cent. of the children examined would be expected to have a bone age within about five months above or below their chronological age, and 95 per cent, within about 10 months; at 16 years the respective figures would be about 13 months and about 26 months either way. However, bone X-rays are not the sole determining factor in a medical opinion of age, and a doctor would normally only use them to verify an assessment based on his clinical examination.

My Lords, while thanking the noble Baroness for that reply, may I ask whether she can explain why her colleague, the noble Lord, Lord Belstead, told me in an Answer to a Question on 20th January that, in estimating the age of children by X-rays, the accuracy attainable was of the order of plus or minus six months, when on the noble Baroness's own admission it can be as much as plus or minus 23 months? Is she aware that Dr. Cameron of the Institute of Child Health at the University of London has said that chronological age varies by as much as two years on either side of skeletal age and that variations of as much as three years can exist if one is looking at populations of children who are malnourished or under-nourished, such as those who are likely to be found in the Indian sub-continent?

My Lords, as the noble Lord will be aware, this is a highly technical matter. I am quite prepared to give him the evidence upon which my Answer is based. It is based on the most accurate information that we have to date.

My Lords, can the noble Baroness say why it is necessary to X-ray children for Immigration Act purposes?

My Lords, as I have indicated, it is sometimes necessary, for Immigration Act purposes, to identify an applicant's age as accurately as possible, and in the course of that X-rays are sometimes used.

My Lords, is there any risk to the health of the children concerned in this apparently rather meticulous process?

My Lords, the whole question of safety is again a highly technical matter. However, I understand that calculations by the National Radiological Protection Board show that the radiation risk associated with the single hand or wrist X-ray, using the accepted precautions to avoid the scatter of radiation, is extremely small.

My Lords, in that case why do the Government refuse to give an undertaking that X-rays will be confined to the wrist and hand which are the parts of the body which are commonly used in the Tanner-Whitehouse method of age estimation? If the noble Baroness is ready to give me the information for which I asked in my first supplementary, how is it that I am still awaiting an Answer which was promised to my Question of an earlier date as to how the Government correlate the bone ages of children in the Indian sub-continent with the sample of British children on which the Tanner-Whitehouse method is based?

My Lords, it is true that the noble Lord did put down a Question to my noble friend Lord Cullen of Ashbourne and I can assure him that there will be no delay in his getting an Answer. I hope that he will get it within the next two weeks.

My Lords, on the first part of the noble Lord's supplementary question, I point out that the Government are naturally studying the report of Sir Henry Yellowlees and, of course, will take into account the results of the consideration of that report and any other considerations, such as questions like the ones which have been raised today.

My Lords, that was not what we asked. The noble and learned Lord asked about whether there were any considerations of safety and the noble Baroness correctly replied that the risks to children are minimal if they confine themselves to X-rays of the wrist and hand. But since the Yellowlees Report has been published has there not been a demand made of the Government that no X-rays other than of the wrist and hand should be carried out on children, and have not the Government refused to comply with that request?

My Lords, once again the whole question of safety is a very technical matter. If the noble Lord wishes a reply to that specific question, he must put down a separate Question and I will do my best to answer it.

But, my Lords, surely that question is highly relevant to the concern of the House about this matter? If the Minister is temporarily waiting for an answer from a certain place, we shall give her a moment or two while I continue to address the House, if that will be of assistance.

My Lords, I am not waiting for an answer from the Box; but I think that the noble Lord will appreciate that questions of safety with regard to X-rays are very technical subjects. I have given an answer to the best of my ability and I am quite prepared to give an answer to any Question that either the noble and learned Lord or the noble Lord, Lord Avebury, may care to table. However, it is a matter which is slightly wide again of the highly technical Question that the noble Lord has asked.

My Lords, would the noble Baroness agree that, if there is a question of danger to the health of children, the Government should err on the side of the children rather than on the side of technicalities?

My Lords, I should like to make it quite clear, in any case where a child is going to be subject to an X-ray, that when deciding whether or not to ask for a bone X-ray the doctor will balance three factors: first, the accuracy to be expected from the estimation; secondly, the extent of the risk of radiation; and thirdly, the degree of importance to the applicant or to the immigration service of having an estimate of bone age.

My Lords, I should like to ask a non-technical question. Is there any risk of a child being exposed to X-ray both in the country of origin and on this side when he or she arrives?

My Lords, the X-rays take place in the country of origin; they do not take place in this country. My understanding is that the precautions that I have identified would take place in the country of origin because, of course, the risks are known to all those who would be responsible for taking the X-ray.