Clause 5 - Co-operation
Health Protection Agency Bill [Lords]
9:45 am
Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton and Cheam, Liberal Democrat)
I beg to move amendment No. 2, in
clause 5, page 5, line 6, at end insert—
'(2A) To facilitate co-operation the Agency shall consult with other bodies and publish protocols for co-operation.'.
Mrs Irene Adams (Paisley North, Labour)
With this it will be convenient to discuss amendment No. 5, in
clause 5, page 5, line 8, at end add—
'(4) The Agency shall draw up and consult upon a protocol with the Commission for Healthcare Audit and Inspection to collect and publish information concerning the performance of NHS organisations in controlling healthcare-acquired infections.'.
Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton and Cheam, Liberal Democrat)
Again, the explanatory note to the clause is exceedingly brief. It says:
''Clause 5 puts the Agency and other bodies which exercise functions relating to the Agency's functions under a mutual duty of co-operation.''
It was very clear on Second Reading that there was anxiety and a lack of clarity about what that means in practice. My amendments explore further just how the mutual duty will work in practice. I know that there was some discussion in the other place about which organisations might be involved. On Second Reading, the hon. Member for North-West Leicestershire (David Taylor) raised concerns about the relationship between the HPA and the Environment Agency, and expressed his frustration about the Environment Agency's discharge of its functions, particularly in relation to the National Radiological Protection Board.
The amendment takes the concept of mutual co-operation a step further. The HPA will have ongoing relationships with several bodies, so surely it would make sense for it to set out and agree with those bodies how they will function. Where are the tripwires that kick-start the discharging of those functions? Who is responsible on the ground for managing and directing the resources? These things are essential for the sake of clarity. They do not need to be clarified in detail in the legislation, but surely a duty should be placed on the HPA that informs those relationships with other bodies and clarifies issues such as the chain of command in major incidents, and how the HPA will mobilise another agency and at what point? It would be useful if the Minister could spell out how the Government envisage those things being done.
Mr Mark Francois (Assistant Chief Whip, Whips; Rayleigh, Conservative)
I apologise for interrupting the hon. Gentleman, because I have some sympathy with the general thrust of his argument. Will he assist the Committee by giving us at least an idea what other bodies he believes should be involved?
Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton and Cheam, Liberal Democrat)
Local authorities, in particular, have a host of responsibilities and powers for emergency planning. Several hon. Members aired that issue on Second Reading. My general point today, although I do not want to make a big song and dance about it, is that the clause does not seem to ensure that the relationships that are established will be clearly codified. The amendment would send a clear signal to the relevant organisation about that.
I am sure that the Minister would say that what I am concerned about would happen anyway, and that it is not necessary to put it in the Bill, but I disagree. The requirement should be set out in the Bill, because there may be bodies that do not think that they need to maintain a relationship with the Health Protection Agency. They may consider that they are of higher status and they may not, therefore, collaborate as well as Ministers intend that they should. That is why clause 5 needs to be amended.
Another aspect that prompts me to call for clarity about co-operation is dealt with in amendment No. 5. The amendment would require the agency, with the Commission for Healthcare Audit and Inspection, to draw up and consult on a protocol for collecting and publishing information concerning the performance of NHS organisations in controlling healthcare-acquired infections.
The issue of healthcare-acquired infections was well aired on Second Reading and therefore I shall not rehearse all the statistics, but a couple of points that arise from last week's statement on the NHS improvement plan are relevant. Paragraphs 2.27 and 2.28 of the NHS improvement plan refer to the Health Protection Agency taking on the role of developing frameworks to protect the patient. It would be useful if the Minister could amplify the intention, and explain whether the role would include dealing with issues relating to hospital-acquired infections.
I was surprised to note, on reading the detail of the White Paper after the statement last week, that the target for reducing the risk of methicillin-resistant Staphylococcus aureus infections is to be achieved by 2010. That seems a remarkably long period in which to try to bear down on the problem—in fact, it does not seem appropriate to speak of bearing down on the problem of infections when tackling it will take six years. It would be useful to hear why the Government think that it is satisfactory to take that amount of time to deal with it.
The amendment is intended to establish a robust mechanism enabling patients to see clearly and fairly how every NHS organisation performs in discharging its responsibilities for the control of infection. At the moment there is a scheme called the patient environment action team initiative, which the Government often cite as part of their fight against the spread of infection in the national health service. The truth is that the criteria that are used to evaluate hospital cleanliness in the context of PEAT are mostly remote from hygiene practice for the control of infection. Only one, or perhaps two, of the PEAT criteria specifically relate to issues of hygiene. Most of the criteria deal with cosmetic issues such as the appearance of the hospital.
Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)
Which provision of the Bill is the hon. Gentleman speaking to?
Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton and Cheam, Liberal Democrat)
I am speaking to clause 5.
Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)
Which part of clause 5?
Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton and Cheam, Liberal Democrat)
I am speaking to clause 5 and amendment No. 5, which relates to the performance of NHS organisations controlling healthcare-acquired
infections. I have been talking about the current scheme, which the Government often cite as part of the management of organisations' performance, but which in my view does not carry out that function. The amendment would require the Health Protection Agency with the Commission for Healthcare Audit and Inspection to establish just such a scheme. The Government are keen on transparency in relation to the performance of NHS organisations, so I should like to hear from the Minister why she does not think that the Bill should specify the need for transparency in this context. The purpose of the amendments is to ensure clarity, in the first case about chains of command in relation to other bodies and in the other about performance in the control of infections. I also hope for some indication that 2010 is just a longstop date, and that Ministers have an agenda that will deal with the problem much sooner than that.
Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)
Good morning, Mrs. Adams. I am grateful to be serving on the Committee and it is a pleasure to be in one the less stuffy Rooms along the Committee Corridor.
I was particularly taken with amendment No. 2. The words that we have just examined highlight the need for the Health Protection Agency to co-operate with other agencies. May I read from the explanatory notes, in order to focus on the matter.
''The Agency will be able to undertake both health functions and radiation protection functions . . . These more integrated arrangements are intended to improve the UK's ability to tackle the problems posed by infectious disease and other hazards, including the UK's response to chemical, biological, radiological and nuclear (CBRN) terrorism.''
I should like to concentrate on the latter point, which is encapsulated in amendment No. 2.
The Civil Contingencies Bill has just gone through the House, as we are all aware. A number of hon. Members present served with me in pre-legislative scrutiny of the Bill, and were enormously helpful—I think particularly of the hon. Member for Telford (David Wright), who made a valuable contribution. It became clear during debates on that Bill—of which we were broadly supportive and to which this part of this Bill is closely related—that the Government had clearly identified a problem and the legislation that would be needed to deal with it. However, they largely failed to understand that in between those two poles, there was a gamut of delivery. I fear that this Bill might fall into the same trap.
That is why, if I may compliment the hon. Member for Sutton and Cheam, amendment No. 2 is particularly important. It would ensure that the Bill required the Health Protection Agency physically to spell out what it would do in the event of an emergency. Clause 5 may mention co-operation, but it is nebulous. I have no doubt that the Minister will agree with me—perhaps I do have a doubt; her nodding suggests that I should do so. As a pragmatist, and somebody who has been involved in such matters, I believe that there is a need for all the lumps of string to be tied together, for the t's to be crossed and the i's to be dotted. The point was made many times during our consideration of the Civil Contingencies Bill that,
although the intention was good, the execution was likely to be lacking and delivery was simply not there.
Amendment No. 2 would force the Health Protection Agency to put on paper its contingency plans. Therefore, protocols—emergency plans, call them what you will—would be drawn up to state what co-operation, training and planning will take place in preparation for an incident, and the agency would understand how it is to fit, like a hand in a glove, with the emergency powers and committees that will be established in the event of a disaster. It would therefore have no difficulty in identifying the regional co-ordinator who would be established when such a disaster occurs, and it would know whom to contact in the police, the ambulance service and the fire service. There are then those wonderful bodies, which the Minister must have known would come up, the civil contingency reaction forces.
In the event of a radiological-type attack, or some form of contamination—either chemical or biological—with which the Health Protection Agency is likely to deal, it is highly likely that the other bodies that I have just mentioned will be called forward and will have to deal with it too. Unless there is some pre-planning, rehearsal and integration and co-operation between the HPA and the other blue light services and emergency services, that will fail. There is absolutely no doubt about that.
There is an old Army maxim, ''Train hard, fight easy''. Unless some training is identified in the Bill and unless the amendment is accepted so that plans are understood—[Interruption.] Government Members are giggling, but I am sure that the Minister understands that it is a serious point. It is so difficult to convince the public about the dangers of such incidents, because they have not happened yet. It is worth bearing in mind the fact that the heads of both MI5 and the Metropolitan police say that that style of incident not just might happen, but will happen.
Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)
And the Prime Minister.
Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)
As my hon. Friend says, of course the Prime Minister continues to make the point in public. It is important that the public should be fully apprised of the dangers of such an incident, and that the agencies should be fully prepared.
I do not know how the Health Protection Agency's officers intend to take the field after an incident such as I have described. I do not know what sort of equipment they will have, what sort of training their officers will have had beforehand—
Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)
Is the hon. Gentleman seriously proposing that that should be in a piece of legislation?
Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)
I am seriously proposing that if we consider the amendment, which has been worded so very cleverly—[Interruption.] Unusually or not, it is a well put together amendment, and I have no doubt that if it is included in the Bill all those points can be drawn together.
Mr Mark Francois (Assistant Chief Whip, Whips; Rayleigh, Conservative)
My hon. Friend will know that this House recently passed a piece of legislation called the
Civil Contingencies Bill, which went into exactly such detail for a whole range of agencies. That detail was included in that Bill because in an emergency it is critical that everybody knows exactly what their job is.
Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)
I am most grateful to my hon. Friend for that useful intervention.
During consideration of the Civil Contingencies Bill, it was difficult to convince the Government that such details had to be concentrated on. We eventually made some progress, although a lot was lacking. I hope that we do not encounter the same difficulties and faults when considering the Health Protection Agency. There is no doubt that unless all these measures are prepared beforehand and co-operation is properly spelled out, exercised and planned, come the day, the Health Protection Agency will not be adequately equipped or prepared to act at its optimum. Ultimately, lives are at risk, and they do not need to be.
Mr Mark Francois (Assistant Chief Whip, Whips; Rayleigh, Conservative)
It is a pleasure to serve under your chairmanship this morning, Mrs. Adams.
My hon. Friend the Member for Newark is our party's expert on homeland security and I do not intend to compete with that in any way. I spoke on this point on Second Reading last week, and I want to try to press home a couple of the points that I made without reiterating the whole speech from the top, for which I suspect the Committee would not thank me.
My hon. Friend the Member for New Forest, East (Dr. Lewis) spoke on the homeland security aspects of the Bill, as did I. We made broadly similar points about the great importance of clear lines of command and control in emergency situations, and my hon. Friend the Member for Newark has reiterated them this morning. Their resonance for the Bill lies in the fact that the HPA could have a role in emergency situations involving chemical, biological, radiological or nuclear terrorist incidents. However, there is a lacuna in the Bill, which does not make it clear what the HPA will do in such situations. That is a significant error—[Interruption.] The Minister can giggle all she wants, but—
Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)
I was laughing actually.
Mr Mark Francois (Assistant Chief Whip, Whips; Rayleigh, Conservative)
Well, the Minister can laugh all she wants, but this is an important subject, and those of us who know something about it feel strongly.
It is important that the HPA should have clear responsibilities and clear lines of liaison if we are to determine how it will work with the emergency services and with agencies such as local authorities in the event of an emergency. The Bill is vague about the agency's role in an emergency, and we are trying to define it with relative clarity—I commend the hon. Member for Sutton and Cheam on his amendment—so that everyone will know what it is. On Second Reading, I suggested that the HPA could appoint liaison officers to work directly with relevant bodies so that everyone would know who their opposite numbers were in the event of an emergency. The military often uses that practice, and it might be applicable to the HPA.
We are trying to get the Government to consider the issue seriously and, although we realise that there
are security considerations, to give us at least a conceptual idea of how the HPA will interact with local authorities, the armed forces and the blue light emergency services in the event of a catastrophe. We are perfectly entitled to put the Government under pressure on the issue in Parliament, although the Under-Secretary of State for Health, the hon. Member for South Thanet (Dr. Ladyman), was dismissive of our questions in his summing-up speech on Second Reading, and the less said about that the better. Perhaps the Minister can now stand up and answer our questions properly for once.
Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)
I trust that the Committee will not allow itself to be derailed by the hon. Gentleman's tone—I certainly propose not to be derailed from continuing our sensible consideration of the Bill.
Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)
No, I will not. I am going to respond to hon. Members' points, but I will give way to the hon. Gentleman later.
The point about co-operation stems from the 2002 consultation paper, which discussed the need for the HPA to co-operate with other bodies. The responses to the consultation supported that proposal, and clause 5 puts the agency and bodies exercising functions relating to those of the agency under a duty of mutual co-operation. Such bodies include NHS bodies, local authorities, the National Public Health Service for Wales, the Scottish Centre for Infection and Environmental Health and international bodies such as the World Health Organisation. The agency will also need to work with DEFRA and on preparedness for CBRN emergencies. I reassure the hon. Gentleman that I take such emergencies very seriously. It was some of the Opposition's suggestions that were laughable, although I entirely accept that hon. Members may have an interest and a background in it. The issue itself, however, is very important.
Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)
Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)
May I finish my sentence? Obviously, the HPA will need to work with the emergency services and the armed services. If it is given extra functions, it may need to co-operate with further bodies. Co-operation will be essential to the functions of the agency and those other bodies where there is, for example, a need to investigate outbreaks of diseases.
Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton and Cheam, Liberal Democrat)
Two points arise from what the Minister has said. First, she mentioned the World Health Organisation as one of the bodies to which the co-operation clause will apply. How could a supranational body be bound by domestic legislation? It would be useful to know how the duty would apply in that respect.
Secondly, she listed a great number of bodies, including the NHS and local authorities. Amendment No. 2 would simply ensure that they were clear, by dint of a protocol, about what the HPA expected of them.
Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)
If the hon. Gentleman wishes to intervene, it would be helpful if he could address what I have said, rather than what I have not yet had a
chance to say. I shall deal with amendment No. 2 in much more detail and answer his point.
Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)
I regret that the Minister found some of the points that my hon. Friends and I raised to be risible. My comments reflected my utter jaundice with the Government following proceedings on the Civil Contingencies Bill, which was so clearly lacking in important detail. I simply rose to ask the Minister to co-operate on the health protection issues before us, which her colleagues have so signally failed to understand during proceedings on other Bills. I very much regret that she found our comments laughable. Nevertheless, they are desperately important.
Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)
May I first deal with the question of co-operation? If I think that much of what the hon. Gentleman has said is laughable, that is because the purpose of such Bills is not to set out the details of arrangements that should be the subject of planning. I agree that delivery needs planning and that we need to see the details of such plans, but it would be ridiculous for a Government of any political complexion to include in any Bill details of the sort that the hon. Gentleman mentioned.
I appreciate, Mrs. Adams, that we are not here to debate the Civil Contingencies Bill, but the hon. Gentleman's initial complaint about it also related to planning issues. The same issues may, indeed, apply in both Bills, although I am not as familiar with the details of the Civil Contingencies Bill as the hon. Gentleman. It does not set a precedent in any case. Part 1 deals specifically with contingency planning and civil protection, which are relatively defined activities, so the judgment was made that it was possible to list the bodies concerned. Even so, the list is not exhaustive, and local practitioners are free to involve non-categorised bodies to reflect local circumstances. It would be much harder to list the bodies with which the HPA needs to co-operate. That is why, to deal with amendment No. 2 and the points raised by the hon. Member for Sutton and Cheam, including that about the WHO, the co-operation requirement extends across the full range of the agency's functions and includes those that might be conferred on or exercised by it in the future.
Amendment No. 2 would require the agency to consult other bodies and to publish protocols on consultation, but there is nothing in the Bill to prevent it from doing that. I assume that the ''other bodies'' in the amendment would be the other bodies to which clause 5 applies, but the amendment must be resisted for several reasons.
First, the agency and some of those other bodies might want to produce protocols or other kinds of agreements on how they co-operate if, for example, they regularly involve each other in certain procedures. I am surprised that the hon. Member for Sutton and Cheam, who supposedly has a political belief in devolution and lowering decision making to a sensible level, would be so needlessly prescriptive as to require the agency and other bodies to produce protocols in each and every case. Indeed, I am at a loss to know why the Opposition think that such a requirement is necessary.
Section 26 of the Health Act 1999 puts NHS bodies under a duty to co-operate with each other. Section 22 of the National Health Service Act 1977 creates a duty of co-operation between NHS bodies and local authorities.
Mr George Howarth (Knowsley North and Sefton East, Labour)
Is not the difficulty with the amendment that, in seeking to promote protocols, it would inevitably regulate the relationships between the various bodies involved and, in so doing, limit the flexibility that we would seek in an emergency?
Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)
Indeed. My hon. Friend has a good understanding of what we seek to achieve through the Bill. There is no requirement in the legislation to which I have referred to produce protocols. Why is one thought necessary in clause 5? I agree with my hon. Friend that such a requirement would be to dictate to a body that we all want to be as independent as possible what its detailed operational practices should be.
Secondly, amendment No. 2 would also put a burden on the agency. The requirement to produce and publish the protocol in each case appears to rest with the agency, not with the other bodies. That would be hugely burdensome for the agency, whether the requirement were to publish a protocol for co-operation with each primary care trust, local health board, local authority and so on, or merely with each class of body. Again, I cannot see what benefits would be gained to justify the costs involved. Thirdly, the requirement to publish protocols ignores the fact that there could be reasons against doing so in some circumstances. For example—Opposition Members envisaged this possibility—the agency may need to co-operate with security services, but it would not necessarily be desirable for the details of such co-operation to be put in the public domain.
Amendment No. 5 would require the agency to draw up, and consult with the Commission for Healthcare Audit and Inspection on, a protocol on collecting and publishing information about the performance of NHS organisations in controlling health care-acquired infections. Again, amendment No. 5 is unnecessary and undesirable. It is undesirable, because it is too prescriptive about the operational practices to be followed by two independent bodies. It is unnecessary, because it is already planned that the star ratings that the commission is due to publish for acute trusts this summer will include an assessment of performance in cleaning, infection control and implementing ''Winning Ways''. I therefore cannot support amendment No. 5 either.
The hon. Member for Newark talked about the so-called delivery gap, but I return to the point that I made earlier. The clause is not just about emergency planning, although that is an important component. It is about co-operation in respect of all the agency's functions. We obviously do not need a Bill to tell the agency and others to contact each other and it would be extraordinary to include such things.
Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)
The Minister will see that subsection (2) imposes a duty on other bodies to co-operate with the agency, yet they are not listed. Does not that put an unfair burden on those bodies, which are out there, but which do not know who they are?
Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)
I have already referred to section 26 of the Health Act 1999, which places a duty on those bodies, and to section 22 of the National Health Service Act 1977, which imposes a duty of co-operation between NHS bodies and local authorities. Such requirements already exist in legislation, but the hon. Gentleman ignores them.
The idea that the bodies in question will not know who they are is not a very sensible argument. I do not believe that either the agency or other bodies will have any difficulties in recognising whether they exercise functions relating to health or any other matters in relation to which the agency also exercises functions. Also, it will be open to the agency to draw another body's attention to the clause's requirements, if it seeks that co-operation and vice versa, were such co-operation not forthcoming in the first place.
We cannot, of course, force the WHO to co-operate, but we want the agency to co-operate with it—that is the point. Indeed, huge co-operation already exists, but that does not mean wholesale rewriting of each other's priorities. The HPA has already been instrumental in a major way, working with the WHO on such threats as SARS, which I mentioned on Second Reading.
There is no delivery gap. We do not need a Bill to tell people how to co-operate with others. On the question of health care-acquired infections, it is for strategic health authorities, not the HPA, to manage the performance of trusts. However, the HPA's surveillance is useful in that respect. Indeed, a large raft of information is already published on health care-acquired infections, a fact that was not acknowledged by some Opposition Members on Second Reading. Hon. Members are going way beyond the usual brief, and what they propose is inappropriate.
The amendments would remove powers and flexibility from an independent body that should be making detailed arrangements on our behalf. I accept that the detailed arrangements are important, but the locus for them is in the organisation of the agency, and its strategic documents should focus on drawing up the details of co-operation. Through the Bill, we seek to strengthen the agency—we want to ensure that the fingers are properly joined to the hand. Indeed, we have already seen the clear benefits of bringing together a number of those bodies into the HPA. I argue that that will be further strengthened when the Bill reaches the statute book.
Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton and Cheam, Liberal Democrat)
It has been an interesting debate. I am grateful to the Opposition for their support and for the questions that they put to the Minister. I shall respond briefly to some of the points that she made. In my view, we should return to the matter on Report. I shall not press the amendment to a Division because of the time-honoured provision that amendments voted on in Committee cannot be selected for debate at a later
stage. It does not always happen but it could, and I do not want to go down that procedural cul-de-sac.
The Minister deployed a number of familiar arguments against Opposition amendments—that they are needlessly burdensome, that they are already covered in some other way, or that they place burdens on organisations.
Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)
Let me be clear. I was not saying that it would place a burden on the agency; I said that it was inappropriate for that sort of detail to appear in the Bill. I am not saying that the agency ought not to be doing such things; indeed, the agency is doing them, and will continue to do so.
Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton and Cheam, Liberal Democrat)
The Minister will have to forgive me, but she said to me earlier that it was not appropriate for me to intervene on her because I had not heard the rest of her speech. I have not made the rest of my speech, and I may yet deal with that point. The purpose of interventions is surely to tease out details. I am not prescient enough to know everything that the Minister is about to say; and the same may be said of her. I want to rehearse my concerns about her rebuttal of the amendment.
Mr Mike Hall (PPS (Rt Hon John Reid, Secretary of State), Department of Health; Weaver Vale, Labour)
I thought that the hon. Gentleman was summing up his views about the amendments. Is he about to introduce new information? He should have given it in his opening speech.
Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton and Cheam, Liberal Democrat)
I am about to deal with the Minister's comments on my amendments. It will be for you, Mrs. Adams, to tell me whether I am out of order. I shall respect your rulings, as should all hon. Members.
The Minister said that it would be burdensome on other organisations to have to take part in the process of producing protocols. I was surprised at that response. She said that it would be inappropriate to place so much detail in the Bill. Amendment No. 2 states:
''To facilitate co-operation the Agency shall consult with other bodies and publish protocols for co-operation.''
Hon. Members elaborated on what they hoped might form the detail of such protocols, but the amendment does not spell out those details—nor should it. It is not intended to be prescriptive. It is intended to indicate a mechanism, a natural part of what I would expect the HPA to be undertaking. I am surprised that the Minister should think that to be needlessly prescriptive. She says that the 1997 Act places duties on NHS bodies to co-operate with local authorities. Indeed, the 1999 Act provides for co-operation between NHS organisations.
All of that is useful. However, to suggest that the amendment should be rejected simply because it would place a burden on the HPA to publish and consult, and that some things should not be published, is to give second-order arguments against the amendment. They might be reasons to amend the amendment, or to propose an alternative, but they are not reasons to reject it, as the Minister suggests.
The Minister also mentioned hospital-acquired infections, and the duty of strategic health
authorities to manage performance, but she did not address my desire to ensure that the public have meaningful comparable information across the NHS. I do not criticise the Government for introducing a mandatory system to monitor MRSA rates; I hope to see such monitoring for other infections in due course.
I am not convinced by the Minister's arguments. Amendment No. 2 is not intended to be prescriptive about the way in which protocols are drawn up, or about their precise contents. I arrived at the debate with the intention of merely probing—I genuinely wanted clarification from the Minister about the Government's thinking on emergency planning and drawing up procedures to govern relationships between organisations. However, I come away from it surprised that the Government are so resistant to the amendment, puzzled as to why they feel unable to give any comfort in that regard and convinced that I must return to the matter on Report. That would not have been the case had the Minister responded in a slightly more forthcoming way. That said, I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Clause 5 ordered to stand part of the Bill.
Clause 6 ordered to stand part of the Bill.