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Deep Vein Thrombosis Diagnosis

Volume 622: debated on Wednesday 21 February 2001

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How many hospitals in the London area are expected to have equipment operational over the Easter holiday period capable of diagnosing whether an individual has a deep vein thrombosis.

The Parliamentary Under-Secretary of State, Department of Health
(Lord Hunt of Kings Heath)

My Lords, all accident and emergency departments in London have access to equipment and staff to diagnose deep vein thrombosis. Of these, 25 have facilities operational out of hours, at night and at the weekend, including the Easter holiday period.

My Lords, I am grateful for that somewhat reassuring reply. However, my experience suggests that on occasions it is impossible to find any department which is capable of diagnosing a deep vein thrombosis and that the departments tend to close down during Bank holidays. Patients are then given injections for the treatment of deep vein thrombosis but that might not be adequate to deal with the dangers involved in the condition. Can the Minister assure the House that all hospitals will be informed where such facilities are available during Bank holidays?

My Lords, I accept that it is important that the fullest information is available. I said that 25 facilities were operational out of hours and that is out of 31 A&E departments in London. That is pretty comprehensive coverage. But it will be important to ensure that the ambulance service and other authorities are aware of which hospitals do not have out of hours covered.

As regards treatment, if access to testing is not available, it will be appropriate in some cases on clinical terms to start such treatment. But overall the health service is more geared up to having full facilities available during holiday periods than it was some years ago.

My Lords, although the Question is directed to hospitals in London, can my noble friend tell the House whether special equipment is available for deep vein thrombosis in hospitals which are close to airports in other major cities such as Manchester?

My Lords, I would expect every local health community to have such facilities available. Although a great deal of publicity has arisen about air travel, it is worth making the point that DVT has a number of causes. Therefore, it is important that not only hospitals near airports but all major A&E departments have those facilities. It is my understanding that they do.

My Lords, the Question refers to the Easter period, but can the Minister say whether there is a congestion of the problem during other periods? Furthermore, can be examine the need for every major airport to have a substantial medical presence—not just directions to the nearest hospital? In the case of DVT, saving minutes can save lives.

My Lords, as regards air travel, I imagine that the Christmas and summer periods are particularly busy. It is important that NHS facilities can deal with peaks when they arise. I believe that during the past few months we have shown with our intense planning for the winter period that the health service has responded well. There is a better planning system to enable us to have the required facilities.

As regards health facilities in airports, I pay tribute to my noble friend for the industrious way in which he has raised these issues during the past two years. I agree that airports need appropriate health facilities. He will be aware that a pilot defibrillator is in operation in Terminal 4 at Heathrow airport and we shall be examining the results of its use with great care.

It is also worth making the point that in addition to facilities the key is good liaison between an airport and local hospitals. That is the responsibility of the health authority in conjunction with the airport authorities.

My Lords, is the Minister satisfied that London ambulance crews are aware of which hospitals have the requisite equipment at certain times and which do not?

My Lords, yes, I would expect ambulance crews to be aware of that information. This is the normal stuff of ensuring that ambulance crews have the up-to-date information available not only in relation to the availability of diagnostic tests for DVT but in relation to the availability of beds and A&E facilities. During the past few years the London Ambulance Service has got its act together and is aware of these matters.

My Lords, will my noble friend ask the Leader of the House whether, on behalf of the House, a message of support and sympathy should be sent to the family of the noble Lord the Chairman of Committees?

My Lords, on the basis that prevention is better than hospital treatment, does my noble friend believe that the airlines are doing all they can to inform passengers about how they should conduct themselves in order to minimise the chance of developing DVT while on flights? In particular, will my noble friend confirm that it appears to make no difference whether one flies first class, business class or, as some must do, economy class and that walking about on a plane, and possibly even fidgeting, is better than sitting totally still?

My Lords, I am advised that this matter should not be termed "economy class syndrome"; rather, it is a problem of immobility for long periods. Air passengers are advised to take preventive measures; for example, they should drink plenty of water, fruit juice or other soft drinks but not alcohol; if they have suffered from a recent blood clot, have an irregular heart beat or have a replacement heart valve, they should inform the cabin crew; they should move their legs regularly throughout the flight and, if possible, stroll up and down the aircraft every hour or so. My noble friend Lord Macdonald has met airline operators to discuss this and other matters. The airlines fully understand our desire to ensure that as much information as possible is made available to passengers.