Thursday 27 January 2005

Review of Modelling of the Demolitions at Khamisiyah in March 1991 and Implications for UK Personnel. The purpose of the paper is to evaluate recent work undertaken by the US Department of Defense (DoD) which modelled the distribution of nerve agents released by US demolitions of Iraqi chemical weapons at the end of the 1990–91 Gulf conflict and to discuss its implications for UK personnel.

The MoD has assessed the 2002 DoD model carefully and welcomes the improvements incorporated. The model better estimates the size and nature of the possible area of exposure. However, MoD notes that it utilises wide parameters in order to include the maximum number of personnel who could potentially have been exposed to any level of nerve agent. While it is appropriate to include a margin of this kind, MoD believes that the limits used in the model somewhat overstate the potential risk to UK troops. None the less, MoD has used the model for its own analysis and concludes that:

• The model results in a generally smaller geographic exposure area than that described in earlier models.
• As estimated previously, approximately 9,000 UK service personnel may have been within the area of possible exposure, with the closest some 130 km from Khamisiyah.
• The level of nerve agent would have been too low to have any biologically detectable effect on UK troops and would have a minimal impact on health; again this is consistent with previous findings.

Official Report, Commons, col. 11–12WS) on the alleged import of domestic cat and dog fur into the UK.

The Government understands the ethical abhorrence felt about this issue. Our priority remains to establish the facts about the extent of this alleged trade and to act in a measured way. To this end, we encouraged interested parties to come forward with hard evidence of such fur being on sale in the UK and we undertook work to establish a reliable scientific test to identify between different species of fur.

In July 2003 the Government invited interested parties to produce hard evidence of a problem in the UK, but to date there is no substantive evidence that such fur is entering the UK in significant and commercial quantities, if at all.

The Government have been working in parallel to establish a scientific test to make it possible to ascertain reliably what species of animal any given fur sample has come from. Such a test is essential to enable trading standards officers to address allegations of mislabelling arising under the existing Trade Descriptions Act and to help establish whether domestic cat and dog fur is on sale in the UK.

Last January we reported back on work commissioned on the "mass spectrometry" means of distinguishing the furs of domestic cat and dogs from that of other animal species. Scientific experts at the former Laboratory of the Government Chemist (LGC Limited) concluded that "mass spectrometry" was not yet sufficiently reliable.

The database of fur samples on which the "mass spectrometry" method relies, together with the search algorithms used in testing were improved in the year since the last tests were commissioned. On the basis of new tests commissioned in autumn 2004, LGC Ltd. has concluded that, from this limited trial, the use of MALDI TOF mass spectrometry to identify domestic dog and cat hair from other species is a viable option, although a question mark remains on identifying fur which has been chemically treated.

The UK keeps in touch with officials in several countries where the possible trade in domestic cat and dog fur is a concern, including the USA, Australia, France, Belgium and Sweden. We will be sharing our findings from the "mass spectrometry" trials with these governments and with all our European partners.

The Government's position remains that without hard evidence of such imports at commercial levels to the UK, we will not consider legislation and that any action would be most effective if taken at EU level. The Government continue to welcome input and evidence from interested stakeholders and will continue to share information with other governments, particularly those in Europe.

Safeguarding Patients: Lessons from the past—Proposals for the Future. In her report, Dame Janet Smith made it clear that she had concerns that the GMC's revised fitness to practise and revalidation procedures would not help to improve patient protection or safety sufficiently.

I take what Dame Janet has said very seriously. I am determined to respond carefully and robustly to her recommendations to ensure that we develop a very strong patient protection plan. We want to put an end to the idea that the General Medical Council is a representative body for doctors. It is not. Its primary role must be to protect patients.

In order to ensure that it does this effectively I have asked the Chief Medical Officer for England, Sir Liam Donaldson to undertake a review and report his advice to me on what further measures are necessary to:

• strengthen procedures for assuring the safety of patients in situations where a doctor's performance or conduct pose a risk to patient safety or the effective functioning of services;
• ensure the operation of an effective system of revalidation; and
• reconfigure the role, structure and functions of the General Medical Council.

I have asked the Chief Medical Officer to report to me later this year. This will minimise any delay to the introduction of measures that will both improve patient safety and ensure that doctors are fit to practise. The Chief Medical Officer will put an emphasis on patient safety. He will draw on the findings and recommendations made by Dame Janet and other inquiries on poor clinical performance and misconduct. An advisory group that includes experts from organisations representing consumer, healthcare quality and professional interests will support him.

Dame Janet made a number of recommendations not directly covered by the terms of reference of the Chief Medical Officer's review. Our consideration of these recommendations will continue in parallel to the work of the review, focusing particularly on improving measures designed to safeguard patients and improve the quality of the services provided to them.

The full list of interest groups represented on the CMO's advisory group are:

• Professor Carol Black, President of the Royal College of Physicians
• Professor Sir Graeme Catto, President of the General Medical Council
• Mr James Johnson, Chairman of the British Medical Association
• Professor Sir Ian Kennedy, Chairman of the Healthcare Commission
• Mr Harry Cayton, Director for the Patients and Public
• Dr Sheila Adam, Director of Public Health of the North East London Strategic Health Authority
• Professor Sir Bruce Keogh, President of the Society of Cardiothoracic Surgeons of Great Britain and Ireland
• Professor Angela Coulter, Chief Executive of the Picker Institute
• Ms Janice Barber, Managing Partner at Hempsons Solicitors
• Clara MaKay, Director of Policy and Research at Breast Cancer Care
• Dr Mayur Lakhani, Chairman of Council at the Royal College of General Practitioners
• Mr Michael Morgan, Director of the Change Partnership; former Human Resources Director of Northern Food
• Niall Dickson, Director of the Kings Fund
• Malcolm Dean, Journalist at the Guardian Newspaper
• Mrs Karen Straughair, Chief Executive of Sunderland Teaching Primary Care Trust
• Jenny Simpson, Chief Executive of the British Association of Medical Managers
• Captain Lowe, former Chief Pilot at British Airways
• Ed Mayo, Chief Executive of the National Consumer Council
• Jane Wesson, Chair of the Council for Healthcare Regulatory Excellence

Shipman: The Final Report today. Copies of the report have been placed in the Library.

Once again the Government express their profound thanks to Dame Janet Smith and her team for their work throughout the lifetime of the inquiry. We also reiterate our sympathy to all the relatives and friends of Shipman's victims and express our thanks to them for their valuable contribution to the inquiry's work.