Clause 2 - Health functions
Health Protection Agency Bill [Lords]
11:00 am
Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)
I beg to move amendment No. 8, in
clause 2, page 1, line 9, leave out 'infectious disease and other'.
Mrs Irene Adams (Paisley North, Labour)
With this it will be convenient to discuss the following:
Amendment No. 1, in
clause 2, page 1, line 9, leave out
'and other dangers to health'.
Amendment No. 4, in
clause 2, page 1, line 10, at end insert
', including education and promotion.'.
Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)
This is an important part of the Bill, and we can afford to be expansive about it, given that we have rattled through the previous provisions at a rate of knots. We have done so because the Bill is not
controversial; we fully appreciate the need for it. However, it is our function to delve into the detail, both here and on Report, and we have identified matters that will most certainly need to be considered on Report. In general, the Bill is okay in its intentions; we support the amalgamation into the agency of the National Radiological Protection Board and the special health authority. That will be positive, despite concerns about how the NRPB feels about certain aspects of that, on which we shall no doubt touch later.
The clause drives at the heart of the Bill. It has to do with the purpose of the HPA. Why do we need the Health Protection Agency? What will be gained by combining the NRPB with the special health authority? What will that synergy lend to it? There needs to be some added value. My hon. Friend the Member for South Cambridgeshire (Mr. Lansley) said on Second Reading that if we continue to combine more and more things, ultimately everything in the Department of Health will merge—and what would be the point of that? Merging things is all well and good. It is a truism these days that amalgamation is good because it makes bodies co-operate better, but often that does not bear close inspection.
It would be helpful if the Minister laid out precisely how the functions of the constituent parts of the HPA will be enhanced. To be fair, she has touched on that, and it was mentioned on Second Reading. However, I am not as clear as I would like to be that the constituent parts of the HPA will function any better in an amalgamated body. To be honest, if we are not improving things, we might as well not have the Bill. I hark back to the remarks of my hon. Friend. They were not addressed; we did not get a clear account of how the functions of the HPA would be enhanced. The clause deals with those functions, and it is important that the Minister lays out how she and her right hon. and hon. Friends believe that their Bill will protect and improve public health.
It is also important that the Minister be absolutely clear in her mind about what the HPA will do; I have to say that I am not clear in mine. I understood initially that it was set up to address the novel threats faced by this country. We live in a sad old world in which—if the Prime Minister is to be believed—there is a terrorist at every turn and we are in imminent danger of attack. If that is the case, we need to protect against it. The HPA was set up to address such threats and novel diseases—the Minister helpfully referred to one of them in correspondence on the Human Tissue Bill. Those threats are obviously on the increase, and will probably continue to grow. I understood that the agency would address those threats specifically. We now find, however, that it might also have other functions that might augment the Government's public health effort. I make no comment about that.
Mr Mike Hall (PPS (Rt Hon John Reid, Secretary of State), Department of Health; Weaver Vale, Labour)
Which amendment is the hon. Gentleman speaking to?
Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)
The hon. Gentleman has acted as assistant to the Chairman before. I am sure,
Mrs. Adams, that you do not need assistance from the floor in determining what is in order.
Mr Mike Hall (PPS (Rt Hon John Reid, Secretary of State), Department of Health; Weaver Vale, Labour)
Will the hon. Gentleman please explain which amendment he is speaking to?
Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)
I am very happy to do so. As the Chairman instructed me, I am addressing amendments Nos. 8, 1 and 4—in my own way. I will continue to do so until the Chairman interrupts me to tell me that I am out of order. I shall probably also repeat some of my points in the clause stand part debate, which I am sure we will have. [Interruption.]
Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)
Thank you, Mrs. Adams. Amendment No. 8 would delete the words ''infectious disease and other'' from subsection (1). It is a probing amendment, because I am not sure what the Minister intends for the HPA. Does she intend it to be a body that deals very largely with infectious disease? If she does, that insertion is correct. However, I understand from what she has said in Committee and from what was said on Second Reading that the HPA's remit was to be broader. Indeed, various other arm's-length bodies are likely to be abolished in July, so it is more than possible that the HPA's remit will expand. The Minister touched on that when she explained that measures might be introduced later by regulation, perhaps as a result of the HPA's expanding function. We might not envisage that expanding function at the moment, but it might be necessary to do so in future as a result of the reduction in function of some of the other arm's-length bodies.
The amendment would delete reference to infectious disease, so all that we would be talking about is the protection of the community, or any part of it, against dangers to health. Clearly, that will include infectious disease as well as all the other multifarious dangers to health, such as radiological threats and chemical threats. I would certainly expect the HPA to tackle chemical threats. Arrangements for chemical incidents are reasonably well laid out, but the HPA needs to get a grip on the arrangements for chemical threats as well as for radiological ones.
The amendment seeks to delve into the Minister's understanding of whether the HPA's remit will principally cover the sorts of horrible infectious disease such as Ebola, West Nile fever and Lassa fever that have been popularised by several television programmes in the past few years. Is that its principal function? Diseases such as influenza may be less alarming, but we should remember the number of people who have died from it in the past century, particularly in the 1919 outbreak. Indeed, outbreaks of influenza affected a large number of people in my constituency during the great war, as the graves of those who died from non-conflict illnesses and injuries attest in places such as Codford, with which my hon. Friend the Member for Newark will be familiar.
I am very aware of the threat that novel organisations pose to the health of the population. We in this country have grown used to being rather relaxed about illnesses such as influenza. We are wrong
to be relaxed about it, and the Minister is absolutely right, if it is her intention, to focus heavily on how we tackle infectious disease and to be determined that the HPA should operate in that way. That is right and proper and probably accords with the views of most of our constituents, who are increasingly alarmed at the threat that infectious diseases pose.
If that is the Minister's intention—and I make no comment about the relative merits of focusing on infectious disease or on the other health threats that we might face—it is entirely reasonable that clause 2(1)(a) should make specific reference to infectious disease. However, if it is not her intention and if, on reflection, with particular reference to what is likely to happen next month to the arm's-length bodies, she wants to broaden the HPA's remit, it would be useful if the words ''infectious disease and other'' were deleted from that important first sub-paragraph.
I am trying to probe the Minister's intention, because we have not been told on Second Reading or today exactly what she intends the agency to do. Is it intended to address novel and terrorist threats of the sort that we originally thought would be at the heart of its activity, or is it intended to deal more broadly with public health? Will it, for example, engage with the public health threat posed by obesity, smoking, drugs, teenage pregnancy or any of the multifarious public health issues that the Opposition would say have been tackled fairly poorly in the past seven years, despite the creation of a ministerial post for public health?
On several fronts, public health seems to have deteriorated rather than improved. It would be perfectly reasonable for the Minister to tell the Committee that the Health Protection Agency is indeed meant to be dealing with public health broadly defined and that the creation of the agency is one of the measures by which the Government propose to pursue public health, which they have identified—and Ministers have said so in the House—as a particular problem.
I make no particular judgment on that. Both approaches to the matter are important, but we need to know the general direction that the work of the Health Protection Agency will take. In proposing the deletion of the words ''infectious disease and other'' I am trying to press the Minister on whether she considers it appropriate for the agency to act principally as an infectious disease organisation, working on threats to health from viruses and bacteria, or whether it should be left open to it to tackle, perhaps in the future, other arguably equally pressing public health issues such as obesity, smoking, radiological problems and matters arising from chemical incidents.
The amendment is meant to be quite helpful. I do not know, and it is for the Liberal Democrats to speak to it, but I guess that amendment No. 1 delves into the same territory. It will be interesting to find out the intention of amendments Nos. 1 and 4, but my guess is that the idea is probably to probe the Minister on exactly how she wants to take the Health Protection Agency forward.
I see that the hon. Member for Sutton and Cheam is smiling broadly—like a Cheshire cat, if I may say so. I look forward to hearing him speak to his amendments. Amendment No. 1 tends in the opposite direction to mine, by deleting the words
''and other dangers to health'',
so he may have identified the threat of infectious disease as even more important than I think it, and worthy of specific mention in its own sub-paragraph, which would be the consequence of his amendments.
That approach would be reasonable, as I have said. I do not make a judgment about whether we should focus heavily on infectious disease or on broader public health issues. Both are important. However, the standpoint from which we seem to have started was the identification of a threat to the population of the country: the Prime Minister has stated that he considers a threat from terrorists to be inevitable.
Terrorists can attack in all sorts of ways—through the distribution of infectious, chemical and radiological agents—and it is right that we should address those. They can also use infectious diseases. It does not necessarily have to involve a terrorist threat; as we have seen with SARS and West Nile fever, Ebola and Lassa fever, a threat can come from all sorts of directions. It is reasonable to focus on infectious diseases, but we need to be fairly clear where the HPA is headed.
The Minister has not said how the HPA will work in practice. She now has the opportunity to tell us what threats she intends it to address. With that in mind, I hope that she will give some thought to my amendments, and to those tabled by the hon. Member for Sutton and Cheam.
Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton and Cheam, Liberal Democrat)
I listened with interest to the hon. Gentleman. I admire his prescience in interpreting what I had in mind when framing my amendments. As he rightly surmised, they are intended to probe the Government's thinking on the scope of the HPA's functions. I wonder whether the organisation is meant to focus on the control of infection, whether it should pick up a wider public health remit on education and promotion—the subject that amendment No. 4 seeks to explore—or whether its functions are more narrowly defined.
The Wanless report published earlier this year considered the question of public health. It identified a gap in the architecture of public health provision, and in a memorandum to the Health Committee, the Department subsequently agreed on that. We have an organisation charged with responsibility for developing the evidence base of public health—the Health Development Agency. There is a body charged with the responsibility of controlling infectious disease and so on—the Health Protection Agency. However, we no longer have a body with national responsibility for the development and promotion of health education messages. It disappeared in a succession of reorganisations in the early '90s. Derek Wanless seems to suggest, and the Health Committee agrees, that that needs to be picked up. Amendment No. 4 is intended to find out whether the Government intend such a role for the agency.
While I am on my feet, Mrs. Adams, I wonder whether I might ask the Minister about the functioning of subsections (2), (3) and (4).
Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton and Cheam, Liberal Democrat)
I was wondering whether you were minded to have a stand part debate.
Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton and Cheam, Liberal Democrat)
In that case, I shall return to the subject later.
The amendments seek to test the Government's thinking, and get some clarification. I look forward to the Minister's reply, which may be this afternoon.
Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)
I rise to speak to amendment No. 4, so clearly outlined by the hon. Member for
Sutton and Cheam. The amendment would make clause 2(1)(b) read as follows:
''the prevention of the spread of infection disease, including education and promotion''.
That is incredibly important. The terrorist attacks that have been perpetrated against this country—mercifully unsuccessful so far, owing to the work of our outstanding security services and police forces—have all been relatively conventional. I think of the attempt about six weeks ago to use 1.5 tonnes of fertiliser to make relatively conventional bombs in west London. In January last year—
It being twenty-five minutes past Eleven o'clock, The Chairman adjourned the Committee without Question put, pursuant to the Standing Order.
Adjourned till this day at half-past Two o'clock.