Mr Eric Forth (Bromley & Chislehurst, Conservative)

I remind the Committee that with this we are discussing the following amendments: No. 1, in

clause 2, page 1, line 9, leave out

'and other dangers to health'.

No. 4, in

clause 2, page 1, line 10, at end insert

', including education and promotion.'.

Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)

May I welcome you to the Chair, Mr. Forth? We had an interesting debate this morning, but I was just in mid flow when the clock hand turned to the appropriate hour for lunch.

If I may iterate, the great difficulty that we face is that since 11 September 2001—a convenient date to choose—our enemies have without doubt made lots of potentially lethal attempts to attack these islands. It is only by good luck and the extraordinary professionalism of our security services and police forces that those attacks have so far been avoided.

The fact remains that most people probably expect the sort of attack that we narrowly avoided about four weeks ago in west London, when the security services intercepted 150 lb of fertiliser. I do not know, but I suspect that that material would otherwise have been used for a series of conventional blasts that could have wrought all sorts of damage—probably something similar to the Madrid attacks or even worse.

When the vexing phrase ''weapons of mass destruction'' comes up, it is worth reflecting that there was an attempt to use such weapons against these islands in the not-too-distant past. That fact is particularly relevant to amendment No. 4. In January 2003, an organisation called Ansar al-Islam attempted to use a contact poison in north London known as ricin. Had that poison been successfully deployed, it could have caused hundreds or even thousands of casualties.

It is useful to bear that incident in mind. That plan was pretty crude, but had it worked, we would be looking at the work of the security services and the Health Protection Agency in a wholly different way. Amendment No. 4 is relevant to that, as it would add the words ''including education and promotion'' to

subsection (1)(b), which makes provision for functions relating to

''the prevention of the spread of infectious disease''.

I would like to tease from the Minister some idea of how she believes we can cover such crucial matters as education and promotion without spelling them out in any more detail than the Bill already provides for.

What am I talking about? Currently, a number of different threats are explained to the population. For instance, we heard earlier about obesity, about which there is an informative campaign. However, I do not think that anyone could say, ''My God, the Government are being thoroughly irresponsible in the way that they are talking about obesity,'' or about the danger to children on the roads, for instance. However, the Government must feel that they are in a difficult position if we are to try to get across to the public at large the dangers, difficulties and lethality of the sort of weapons that might be used against this country. Clearly, chemical, biological, radiological or, in the worst event, nuclear weapons are likely to cause mass casualties. The worst possible thing to do would be to allow our population to remain ignorant of the effects of that style of attack and the diseases that it may engender.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

My hon. Friend rightly talks about mass casualties, but does he accept that there is also a danger of mass hysteria? I am thinking about a dirty nuclear bomb, for example, when the hysteria caused would probably be well out of proportion to the number of likely casualties. The agency's functions may well include trying to be realistic about the level of casualties that may be engendered and about the effect on the population. Hysteria may well be worse than the number of casualties.

Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)

I am grateful to my hon. and, indeed, gallant Friend for his intervention. Clearly, as a medical officer, his understanding of such issues is much greater than mine. I suspect that he has probably been peeping at my notes; half the problem with such weapons is that they will perpetrate panic, hysteria and difficulties out of all proportion to the effects of the weapon themselves.

Let us look at what might be used and at what has been used in the recent past. We have seen, for instance, the use of a non-persistent chemical, sarin, on the underground in Japan. We are conscious of the fact that sarin was one of the weapons in the armoury of al-Qaeda, Ansar al-Islam and other such groups. There is every possibility of non-persistent and persistent agents being used against the west.

Similarly, we need to start to think about the effects of radiation sickness. As my hon. Friend the Member for Westbury (Dr. Murrison) has just pointed out, any form of radiological device is likely to have effects far in excess of an initial explosion or the contamination that it spreads. Let us move from there on to a biological attack. What does the Minister believe is the possibility of smallpox being used as a weapon? [Interruption.] I see Government Members sneering, but the fact remains that smallpox is a deeply lethal disease that can be easily deployed and has the added

benefit, from a terrorist's point of view, of the physical symptoms taking an extraordinarily long time to develop.

The problem about warning people, training them and making sure that they are aware of what is coming is that all such things are weapons of Armageddon. They all carry a degree of terror with them that is probably out of proportion to the casualties that they will actually inflict. The whole point of the amendment is to make it clear that the population need to be educated in such a way that they will understand what the threat is, will be able to react once the threat physically develops and will be taught by the Government what to do without spreading or engendering panic, which should be totally unnecessary.

It is interesting that in the past, in areas where there has been a threat of an accident with a nuclear submarine, iodine tablets have been distributed to the civilian population at large. I would be interested to know how, when the responsibilities of the National Radiological Protection Board switch to the Health Protection Agency—

Mr Eric Forth (Bromley & Chislehurst, Conservative)

Order. I am happy to let the hon. Gentleman develop his arguments, insofar as they relate strictly to the amendments. He has just managed to do that up to now, but he is now straying into another clause. I ask him to concentrate on the amendments and clause before us now; he may well be able to talk about submarines subsequently.

Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)

Thank you, Mr. Forth. I will try to stay above the surface if I can from now on.

Mr Mike Hall (PPS (Rt Hon John Reid, Secretary of State), Department of Health; Weaver Vale, Labour)

Torpedoed.

Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)

Clearly, I have been torpedoed. I will try not to strike any more mines.

To return to the amendment at hand, I would be interested to know precisely how the Health Protection Agency intends to get its message across, and how it will move from the relatively comfortable environment in which it has been able to operate in the past to the environment of this whole new gamut of threats. Without the sort of phraseology included in the amendment, how will the Health Protection Agency get its message across?

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

Would my hon. Friend agree that the Health Protection Agency might like to start close to home, given the confusion engendered in this place by an apparent terrorist, or person of ill disposition, throwing a bag of purple powder into the Chamber of the House of Commons? We knew very little about what to do. It appeared that no one else knew what to do, either. Would the HPA usefully direct its attention towards situations such as that?

Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)

I am grateful to my hon. Friend for another useful intervention. He is absolutely right; it was very clear after that attack a few weeks ago that a group of people, who probably should have known better or at least should have had a well informed view of what was going on, reacted in a way that could have been highly dangerous. It was not their fault nor ours,

but the fault of the authorities who were not in a position to inform and to train or, in the words of the amendment, to ''educate and promote''. I wonder where the HPA would stand on that.

To digress for a moment, I return to the Civil Contingencies Bill. During our consideration of that Bill, we covered a very similar issue.

Mr Eric Forth (Bromley & Chislehurst, Conservative)

Order. I would appreciate it if Members could cease conversations in Committee.

Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)

During our consideration of the Civil Contingencies Bill, which related strictly to terrorism rather than to the health aspects of terrorism, we asked how the Government intended to warn people about—or how they intended to ''educate and promote''—the threat that was present then. In that broader debate, the Government were quite clear that the public did not need education or promotion to be put their way. Despite that, however, it was fascinating to see immediately after the Madrid incident that the British Transport police and the Metropolitan police started a campaign of public information about the terrorist-type weapons that might be used.

Without such an amendment, I wonder how the HPA intends to get its message across. I believe that knowledge will dispel fear. Perhaps the effects of these horrific weapons will be better controlled and the effects mitigated if our population is told what the threat is and how to deal with it. The Government need to include such an amendment to achieve that.

Mr Mark Francois (Assistant Chief Whip, Whips; Rayleigh, Conservative)

It is a pleasure to serve under your chairmanship this afternoon, Mr. Forth. I have seen you in the Chair before in Committee, but I have not served under you. I very much look forward to this afternoon's sitting.

The Liberal Democrat amendment No. 4 refers specifically to including education and promotion, on which I want to focus. I also want to expand on the remarks made by my hon. Friend the Member for Newark (Patrick Mercer) by talking about homeland security.

I believe that you, Mr. Forth, are an avid watcher of current affairs television, so you may be aware of a ''Panorama'' programme some two months ago that created the scenario of a terrorist attack on London that included co-ordinated bombs going off in the early morning rush hour at several key London underground stations, followed later in the day by the explosion of a chemical tanker carrying chlorine gas in the City of London. A panel of experts was drawn from various professions connected with the emergency services and it included my right hon. Friend the Member for Kensington and Chelsea (Mr. Portillo), who played the role of the Secretary of State for Defence. The experts were there to advise Cobra, which, it was assumed for the purposes of the scenario, had been summoned to co-ordinate the Government's response to that terrible incident.

In the scenario, 7,000 people were killed within a few hours. There was panic and pandemonium, which was increased by the fact that very many people did not know exactly how to respond to such an attack.

The public were, in a sense, uneducated, which magnified the scale of the casualties that were supposedly suffered.

An interesting point was brought out by one of the participants in the programme—I think it is was someone who had served as a senior police officer—who drew a comparison with the cold war in the 1980s when, as you may recall, Mr. Forth, a booklet called ''Protect and Survive'' was produced by the Home Office and distributed to every household in the country. Its purpose was to give householders advice about the type of threat that they faced, and about what families could do to prepare for such an eventuality and defend lives. I touched briefly on this matter on Second Reading, but it seems apposite to raise it again in this context.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

Will the hon. Gentleman remind us of the main parts of that advice?

Mr Mark Francois (Assistant Chief Whip, Whips; Rayleigh, Conservative)

Certainly. From memory, it was that the public should stay indoors and tune in to radio announcements. Because of the nuclear threat, people were also advised how to build a shelter using tables and doors and sacks filled with earth to create a citadel in their homes. That is the advice that was given. [Interruption.] I am sorry, Mr. Forth. You were here for part of our deliberations this morning, but not all of them; the Minister was sniggering this morning and I am afraid that she is doing it again.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

I think that the Minister is being a little mischievous. Perhaps she will tell us what my hon. Friend missed out of his extremely comprehensive description of ''Protect and Survive''.

Mr Mark Francois (Assistant Chief Whip, Whips; Rayleigh, Conservative)

I thank my hon. Friend, but rather than cross swords with the Minister, I suggest that, if she could follow my argument, she might appreciate that I am attempting to make a serious point, which I raised on Second Reading. The Minister was on the Front Bench for part of that debate.

The booklet gave people advice about what they could do in a terrible situation. I propose that the HPA could do that, and that it might be an appropriate arm of the state to issue guidance to families about what to do in the event of a terrorist attack, which might be chemical, biological, radiological or nuclear. The amendment refers to education and promotion, and it seems to me that the HPA might be used to provide advice that families could keep at home. I do not expect that it would be regular bedtime reading, or that people would go through it on a weekly basis, but it could be kept at home so that in the event of an emergency, when people turn on the television and see what is happening, they will have a reference work immediately available to which they could refer. One envisages a mother at home with two screaming, panicking children, while the husband is at work—or it could be the other way around and he could be at home and she could be at work.

Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)

I am sure my hon. Friend is aware that the Government's only current piece of public advice lies in the aphorism, ''Go in, stay in and tune

in.'' How useful does my hon. Friend think that advice is, particularly in the event of a radiological attack, for which ''Go in'' is precisely the wrong advice?

Mr Mark Francois (Assistant Chief Whip, Whips; Rayleigh, Conservative)

My hon. Friend is more knowledgeable than me in these matters. The fairest response I can give is that that advice, in so far as it goes, is appropriate in certain circumstances. However, I envisage a situation in which people are panicking, some elements of the media are overreacting, there have already been thousands of casualties, phone lines are jammed because relatives are all trying to ring each other to make sure that everybody is all right and because people are trying to ring each other at work and cannot get through, and mobile phone communications have probably collapsed because so many people are trying to get on to the network at once and the network cannot cope—

Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)

As in Madrid.

Mr Mark Francois (Assistant Chief Whip, Whips; Rayleigh, Conservative)

As my hon. Friend reminds me, that is what happened in the Spanish emergency. In that kind of pandemonium, having some kind of reference material in the house that people can turn to, such as a small manual or booklet, might at least provide some kind of reassurance in a terrible situation. It strikes me that an organisation called the Health Protection Agency could—in consultation with Government Departments—produce such a booklet and that it could be an authoritative work to be kept at home against such an awful eventuality.

The Minister might say that the Government have plans for other Departments to issue such guidance. Perhaps the Home Office is working on something. If that is her answer, I am prepared to respect it, although it would be nice to see a draft. Nevertheless, in the absence of anything other than a little slogan, there seems to be a gap in the market—if I dare use that term in this situation—that the HPA might usefully fill. This debate is a good opportunity to put that suggestion to the Minister. If she feels that that is not the job of the HPA perhaps she could explain, first, why it is not—looking at the terms of reference that the Committee has already examined—and secondly, whose job it might be. She speaks for Her Majesty's Government, and she should tell us who might take responsibility for such an important matter if the HPA does not want to do so.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

Mr. Forth, I join other members of the Committee in welcoming you to the Chair. I am sure that we will do productive business under your guidance this afternoon and on Thursday.

First, let me respond to the points made by the hon. Member for Westbury. He asked about the rationale for the HPA and the advantages of it. Despite his repeated charge that the reasons for setting up the agency have never been spelled out, let me draw his attention to my opening remarks on Second Reading, when I set out some of the important reasons. Let me refresh his memory. I said:

''The agency can function as a 'one-stop shop', capable of providing the necessary expertise for dealing with any scenario involving a biological, chemical or radiation hazard.''—[Official Report, 21 June 2004; Vol. 422, c. 1098.]

It is important for the agency to have a wide-ranging role, because it is not always immediately clear whether an incident has a chemical, radiological or infectious source. That is where the point about infection comes into play. However, it is not easy to apportion the work, because some things might be unclear at the start. We accept that the plans need to cover the whole gamut of possibilities.

The creation of the agency will allow for the cross-fertilisation of many good ideas and much good practice across different fields of health protection—more than in the past, because they will be brought together in one agency. It will also mean positive gains in radiation protection work, which is tremendously important. The agency's local and regional structure will facilitate communication with the public about radiation protection. There are clear synergies in the work of the HPA special health authority and the NRPB, particularly in relation to emergency response and to radiation and chemical hazards. Both organisations have an international role, and they can learn from each other's experience and co-operate even more closely than they do now.

Mr Mark Francois (Assistant Chief Whip, Whips; Rayleigh, Conservative)

I thank the Minister for her courtesy in giving way. She is beginning to address some of the concerns that we have sought to highlight since this morning, so I thank her for that. She used the expression ''one-stop shop'', a phrase that we hear repeatedly in modern parlance. Will she expand a little on what she means by it in this context?

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

I am not clear what the hon. Gentleman is asking me to explain in more detail. Let us be clear: the initials are HPA, not PHA. We have to remember that this is not about public health; it is about health protection. Nor has the agency been set up solely to deal with chemical, biological, radiological and nuclear threats, although they are, of course, important.

In response to some of the points that were made about the 2002 consultation, I point out that paragraph 4.8 of the document that went out for consultation says:

''We propose that the agency's central purpose should be to provide information, expertise, advice and training on infectious diseases, chemical and radiation hazards, and health emergency planning; and to commission and carry out research to inform any of these activities. It will need to maintain an understanding of current, new and emerging problems, including terrorism.''

As I see it, that covers the whole gamut of points that Opposition Members raised. They rightly asked what the agency's scope was and I have told them what we set out in 2002. We have not diverged from that proposal, which is embodied in the Bill and in the bringing of the NRPB under the wing, as it were, of the HPA's existing functions.

The proposals provide for a wide range of functions and flexibility. The question whether there is a crossover between something on the infectious diseases side and the CBRN, for example, highlights the strength of the proposals, which will reinforce health protection arrangements across the country. The HPA has a wide-ranging role. We acknowledge

that as important right across the piece, and it is in line with the proposals that we have set before people from 2002 onwards.

As for what gains will be achieved by putting NRPB functions into the agency, there will be positive gains for radiation protection work. However, those gains will not all be for the agency. There will be benefits to staff, who will be able to broaden their scientific expertise and take advantage of opportunities for career development in a larger, more dynamic organisation. There will also be clear synergies between the HPA's work and that of the NRPB, particularly on the emergency response, and in relation to radiation and chemical hazards. I understand that staff are generally positive about developing such interactions. For example, the HPA's establishment of the headquarters of the chemical hazard and poisons division at the NRPB's Chiltern site has been welcomed.

Again, that is an example of how the changes are facilitating things. Given the expertise and interest of the hon. Members for Newark and for Rayleigh (Mr. Francois) in particular, I know that they will recognise that in the work being taken forward. The NRPB already has a good working relationship with the HPA. The proposals will also allow the NRPB to continue many of its core activities. The agency will have UK-wide responsibilities for radiation protection, as the NRPB does now—there is no intention to scale that work down in any way—but the high-quality research and development will continue apace.

There are a lot of advantages to the arrangements that have been put in place. I am pleased that we are making the change, as are, I think, Opposition Members. Their overall support for the Bill indicates that they think the direction of travel is right.

Amendment No. 1 would probably effect the most fundamental change. It would exclude from clause 2(1) any dangers to health other than infectious disease. I am not sure what the purpose of that is. The Secretary of State and the National Assembly for Wales would still be able to confer health functions not covered by clause 2(1) on the agency by means of the procedures in clause 2 subsections (2), (3) and (4). However, Scottish Ministers and the Department in Northern Ireland could confer functions on the agency only where they fell within clause 2(1). Amendment No. 1 would therefore prevent Scottish Ministers and the Department from issuing orders making the agency responsible for providing them with specialist advice on chemical and poisonous hazards, as they wish to do so and as I know hon. Members would wish them to as well. That would be a retrograde step. For some years, the four UK Health Departments worked closely together in commissioning specialist advice on chemical and poisonous hazards. It would be unfortunate if Scotland and Northern Ireland were excluded, which is why we cannot support amendment No. 1.

The other two amendments would not have the same radical effect, but neither is necessary or

desirable. Amendment No. 4 suggests that the agency's function of preventing the spread of infectious disease should include education and promotion. A number of hon. Members spoke at length about the subject, and the amendment would give prominence to those activities. In general, the agency's power to discharge its functions under clauses 2 and 4, as set out in clause 4, contains no specific reference to education and promotion. However, the activities are already covered by clause 4(1), paragraphs (e), (f) and (g), which allow the agency to

''provide training . . . make available to any other body such persons, materials and facilities as it thinks appropriate . . . provide information and advice.''

Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton & Cheam, Liberal Democrat)

The Minister may be about to deal with the question, but will the HPA's power to provide information to other organisations and persons be sufficiently wide for it to run publicity campaigns and to disseminate information to the general public?

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

Yes. Indeed, it already does so. The HPA website makes a lot of information available to the public. That may be the most readily available way to provide advice. It will also be able to do so under clause 4(1)(g).

Preparedness for CBRN terrorism is not an issue for the HPA, as hon. Members accept. The national health service, the Government—including the Home Office, which the hon. Member for Rayleigh mentioned—and the police will obviously have a role. Those organisations need to work together in all areas. Indeed, they are doing so. We do not propose changing that.

As for specific advice, I am aware that the hon. Member for Rayleigh is trying to raise questions, but precedents are not always stunning. I was laughing because the advice was fairly risible. Its quality was the subject of much public concern. It is important that the public are kept informed, but a number of bodies are involved. It is not for the Bill to say precisely what information should be made available, nor is it a matter for the HPA.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

I am slightly concerned. I think that the Minister was saying that ''Protect and Survive'' was risible; my recollection is that it was pretty basic. It may have been open to criticism, but it was better than doing nothing. I recall the television programme that it was based upon; it may have been a grainy black-and-white programme, but it had a great impact—just as Lord Fowler had a great impact on education about HIV/AIDS in the mid-1980s. I did not disparage ''Protect and Survive''. That would be very unwise.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

The hon. Gentleman and I might wish to differ, but we are talking about something historical. To be fair, none of us would want to put out such a programme today.

Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)

I am slightly concerned about the Minister's statement. One reason why ''Protect and Survive'' was laughed at—which it was—was that the threat never materialised. People said, ''This just ain't going to happen.'' The point of our earlier questioning was that although we are constantly told that the

threat will develop, the Government continue to allow us to remain in a state of ignorance. ''Protect and Survive'' was at least doing something proactive, rather than being reactive.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

As I said, the matter of advice to the public and the giving of information and advice is specifically set out in clause 4(1)(g). The power exists for the agency to do that; it is already doing so; it will continue to do so. It needs to do so in respect of the points made by Opposition Members, in conjunction with some of the organisations that I mentioned a few moments ago.

Examples of a UK-wide approach already being taken to health protection include the unified HIV and AIDS surveillance that the hon. Member for Westbury has just mentioned and the five nations working group on severe acute respiratory syndrome and the SARS taskforce—as well as what our authorities have done in working closely with the WHO. Avian flu and other issues are among matters on which organisations are working together across the UK to ensure effectiveness and co-ordination.

Similarly, the Government and the devolved Administrations work together closely on preparedness for bioterrorism. The Health Protection Agency provides support with the operational response to that.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

The Minister has been generous in giving way. She has described how bodies are co-ordinating their activity with respect to a range of illnesses. Will she comment on hepatitis C and tuberculosis? I should hope that relevant bodies are co-ordinating what they are doing with respect to both of those, but there has been an upsurge in cases in those conditions in recent months.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

I will indeed comment but, before I do, I should like to finish my remarks on amendment No. 4. I note what the hon. Member for Sutton and Cheam (Mr. Burstow) said on Second Reading about the Wanless report and gaps in public health machinery, particularly in relation to health promotion, education and the essential capacity to evaluate public health measures. However, the Government commissioned the Wanless report, which highlighted those issues, and they also tackled the issues that it raises.

It is not necessary to amend the Bill to deal with those issues; nor would it be desirable to add the reference to education and promotion, because that would highlight issues that are dealt with in clauses 2 and 4. That would be to privilege specific ways of protecting the community over other ways set out in clause 4, such as providing laboratory services. There are many ways in which the agency can play a role in that context.

Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton & Cheam, Liberal Democrat)

Can the Minister confirm, therefore, that the Bill provides for a Government to decide to ask the Health Protection Agency to take on the health promotion and education function that the Wanless report identifies as not being picked up, currently, in public health mechanisms? Could the Government do that under the Bill?

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

I know, Mr. Forth, that this point is not strictly on the amendment, but the hon. Gentleman has taken an interest in the subject of our forthcoming White Paper on public health. Much of the response to the Wanless report will be made through the White Paper later in the year.

Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton & Cheam, Liberal Democrat)

I understand entirely that the Government want to declare new policies and changes to policy in the White Paper. However, my question was whether the Bill allows for a Government to decide to give the role of health promotion and education to the Health Protection Agency, or would further primary legislation be needed?

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

It is a matter of whether by health promotion the hon. Gentleman means health protection—and we can argue about what the terms cover, but I agree that there is some possibility of sliding on that. However, health protection has a well defined meaning, which I set out earlier and which is the subject of the work of the Health Protection Agency. That is covered by the Bill in the clauses that I explained earlier.

Amendment No. 8 would remove the specific reference to infectious disease from clause 2(1)(a). The hon. Member for Westbury recorded on Second Reading that he was unclear about the functions of the agency. I have reiterated how the remit works, and I hope that I have made it even clearer. I also referred him to the consultation document. If we were to accept amendment No. 8, infectious disease functions would still be covered and nothing would be gained.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

Will the Minister give way?

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

May I deal with the points that the hon. Gentleman has already raised?

I turn now to the hon. Gentleman's points about hepatitis C and tuberculosis. Hepatitis C was identified in the chief medical officer's infectious diseases strategy, ''Getting Ahead of the Curve'', as the hon. Gentleman knows. In August 2002, we published a consultation paper, and today we have published an action plan to implement the strategy. It sets out a framework of actions to improve prevention, diagnosis and treatment, and to strengthen the evidence base. The actions cover four key areas: surveillance and research, increasing awareness and the detection of undiagnosed infections, high-quality health and social care services, and prevention.

The action plan will be underpinned by professional and public awareness campaigns centrally funded by the Department. That will help to prevent new infections and lead to the diagnosis of more people with hepatitis C so that they can be assessed for antiviral drug therapy treatment.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

The Minister might have made an important announcement. I am not sure whether she was dealing with hepatitis C or TB.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

Hepatitis C.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

Hepatitis C. I am grateful to the Minister, because the action plan is long awaited and long overdue. I offer my congratulations to her on bringing it forward, even at this late stage. When can

we have a TB action plan, which was promised two years ago?

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

I was about to come to that. It is our intention to publish a TB action plan when departmental business allows. In the meantime, the lack of publication has not halted progress on the issue. We are already taking action and low levels of TB have been achieved and maintained: through the BCG immunisation programme, which is kept under review by the Joint Committee on Vaccination and Immunisation; through the treatment of identified cases and screening of their close contacts; through the screening and treatment of immigrants from countries with a high prevalence of TB; and through active surveillance of TB—we are funding a two-year pilot study on the use of mobile digital X-ray units. There is a worldwide resurgence in TB, which is having a small but important impact on trends in the UK.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

The Minister has rattled through a whole range of things. First, she has stated that we are containing the level of TB. However, that is not the case, particularly in some of our inner-London boroughs—perhaps she would like to revisit those remarks. She also mentioned something about the screening of immigrants. I know that the Government were looking into that; perhaps she might describe it in a little more detail.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

In the centres to which immigrants come when they arrive, a large percentage take up the option of screening. I do not have the figures in front of me, but I have recently answered a parliamentary question, giving some of those details.

The HPA has developed a new molecular finger printing method for mycobacterium tuberculosis, or MTB, to assist outbreak investigation. It is a powerful method that has already proved useful in showing that a suspect outbreak in Leicester was not in fact an outbreak. It has developed a method of direct detection of MTB in sputum, and that will be evaluated. It is developing databases for contact tracing and improving case registries and for working with prison services to support management of risk to prisoners and staff. It is working with health professionals to track and contain the spread of drug-resistant MTB in London, and it has developed and evaluated rapid molecular methods for determining the likely antibiotic-resistant strains of MTB. The HPA is doing a whole range of work on the subject, which I am sure will be of interest to Opposition Members.

Finally, the hon. Member for Sutton and Cheam (Mr. Burstow) talked about the relationship between the HPA and health promotion. The HPA can undertake health promotion on behalf of the Secretary of State and the National Assembly for Wales. Health protection is covered by subsection (1), and the powers under subsections (2) to (4) would enable it to be given other health functions, including health promotion functions that are not caught by subsection (1). As I said in my comments on the amendments, that would leave Scotland and Northern

Ireland in a different position, because they do not have the powers set out in subsections (2) to (4).

As the hon. Gentleman will appreciate, several matters are subject to devolution, and Ministers in Westminster do not consider matters that have been devolved to the Scottish Parliament and Scottish Executive.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

The Minister is being very generous. Would not subsection (8) also allow the authority to give the agency a task along the lines of those suggested by the hon. Member for Sutton and Cheam?

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

Indeed.

Mr Eric Forth (Bromley & Chislehurst, Conservative)

Order. Perhaps we can cover that when we discuss clause 4.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

Thank you, Mr. Forth. Given that injunction, I have finished answering the points made by Opposition Members, and I trust that the Committee will resist the amendments.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

We have rattled along at a rate of knots, and have made very good progress. Hon. Members may have been lulled into a false sense of security because we are now at the meat of the Bill—the health functions—which has exercised most of us in our consideration of this material in the past few days. Health functions were the sticking point on Second Reading, if there is a sticking point in this largely uncontroversial measure, so I hope that the Committee will forgive me if I dwell on them a little.

The Minister has been very helpful in clarifying her perception of the HPA's functions and how they will be discharged. I confess that it was not clear before or on Second Reading exactly what direction the HPA would take. We have now established that its principal function will be to tackle infectious disease and other hazards, such as chemical and radiological incidents, that may cause an acute public health problem. We must accept, however, that the Bill includes powers to extend those functions dramatically.

Quite rightly, Mr. Forth, you corrected me when I tried to talk about clause 4(8). I will not go down that path, because you will undoubtedly tell me that I am out of order, but that subsection does give the Minister swingeing powers to direct the work of the HPA. It would be open to the Minister to decide that the HPA, despite its name, should embark on public health activity that is broader in scope and of the sort that I discussed this morning. I make no comment about that because I, too, believe that such things are important. Nevertheless, we must be clear that we will not dilute this body's very important function, which is to protect the public against infectious diseases of the sort that probably concern many of our constituents, and against the sorts of novel threat that, sadly, we have seen in recent years. Indeed, many of our constituents have seen us conducting exercises against such threats—belatedly in London, and in Newcastle, where exercise Magpie enacted an attack on a population from the nerve agent sarin.

I am grateful to the Minister for clarifying many of my thoughts on the issue. However, some bits remain opaque. I think that it was Lord Clement-Jones who raised in another place the matter of zoonosis—

infections passed from animals to humans. He tabled an amendment to include that specifically as a subsection on infectious disease, and I think that he was correct to do so, because I am not clear about the interaction between the HPA and various veterinary bodies. That is important, because one of the biggest recent health scares was over BSE and Creutzfeldt-Jakob disease, and BSE is of course principally a veterinary not a human disease. It is passed on by means of a prion, which is not specifically mentioned in the Bill. We are left to assume that the Minister understands the term ''infectious''.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

The hon. Gentleman is raising points in summing up that he did not raise earlier. If he had mentioned animal diseases, I would have told him that the HPA is closely involved in such matters and that DEFRA has a role too. I should have been happy to debate the issues had he raised them in his opening remarks.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

I am glad that the Minister would have been happy to address them. Perhaps she would prefer to return to them on Report; I shall be happy to raise them then, but it might save time if she were to consider them now. Lord Clement-Jones probably had a point, particularly in connection with prions. It is a legitimate thing to debate, as we are debating infectious diseases, and my probing amendment required that a reference to infectious diseases be deleted. I merely probe the Minister on her understanding of the term ''prion'' and whether it is sufficient to include it in the general term ''infectious diseases'', in the same way as she includes zoonosis. That is a perfectly reasonable question to put to the Minister.

In connection with that, it would be interesting to know—hypothetically at the moment, as is to be announced next month—the result of the review of overarching bodies. One of the agencies in the frame, so to speak, will be the National Patient Safety Agency. It would not surprise me at all if it were shut down. That would be an example of the Government's marching their agencies to the top of the hill and marching them down again. Of all the agencies under review, about half were created by the Government, so it will be interesting to see the bonfire of Government-created agencies next month.

If, as I suspect, one of them is the National Patient Safety Agency, it will be interesting to see which of its health functions will be transferred to the HPA. Might it be its work—or should I say lack of it—on prions in connection with Creutzfeldt-Jakob disease? The Minister will know that my interest in the matter has to do with tonsillectomy, and the tragedy that has befallen the son of one of my correspondents, who died as a result of haemorrhage post-tonsillectomy, carried out using a disposable tonsillectomy kit. The kit was introduced because of policy made on the hoof due to fears about the possibility of transmitting prions by means of instruments used during surgical operations, particularly tonsillectomies.

It would be nice if the Minister could say, ''Yes, that is exactly the sort of thing that the HPA will look at.'' That might go some way to assuaging the concerns of my correspondent who, some time after

his son's death, is still concerned that Ministers are not taking the issue seriously. So far, my correspondence with the NPSA has drawn a blank; the joint chairs of that agency do not seem to be particularly concerned that they have not considered the way in which the tragedy occurred. I hope that the HPA would look at that and, furthermore, be in a position to make recommendations about a more joined-up way of addressing the threat from prions. That would certainly help the gentleman with whom I am corresponding. If that were the case, it would be nice if the Minister could say so and help me to get my head around exactly what the HPA will be doing, especially in relation to infectious disease.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

I can help the hon. Gentleman in a limited way on that point. He raised that point on Second Reading, although he had not done so previously in this debate. The HPA has no responsibility for tonsillectomy operations, as I am sure he appreciates, but it will be responsible for collecting tonsils for the archive. That is important for the research into such a difficult and vexed question, on which the science is still in its infancy.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

I am grateful for the Minister's reply. She might have led me along a path down which you would rule me out of order, Mr. Forth, but I commend the work of the national tonsil archive, which has collected some 10,000 tonsils to date. Incidentally, I was concerned that the Human Tissue Bill would result in the archive's closure. It was only after a number of hon. Members raised the potential problem yesterday that we managed to secure changes to safeguard that valuable collection. What better example—

Mr Eric Forth (Bromley & Chislehurst, Conservative)

Order. Before we go on to examples, can I remind the hon. Gentleman and the Minister that we are discussing the amendment? Can the hon. Gentleman stick to that or at least tell us from time to time in what context he is doing so?

Dr. Murrison rose—

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

I do apologise, Mr. Forth, but I believe that the hon. Gentleman has been leading me astray.

Mr Eric Forth (Bromley & Chislehurst, Conservative)

Order. Ministers are not supposed to lead astray—not in this Committee.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

I am grateful for your guidance, Mr. Forth. The tonsil archive is a great example of how the HPA might discharge its functions. The archive will be examined for the prevalence of prions, which potentially cause a devastating illness. I am grateful that the Minister raised the issue, and I have no doubt that one of the agency's functions will be to liaise closely with the archive. One of the biggest perceived threats to the population—''perceived'' is important—is that from prions, specifically in connection with Creutzfeldt-Jakob disease, although the jury is still out on the ultimate impact.

Disease registration has not been listed under health functions. I should like briefly to touch on that, but if the Minister objects to my raising the issue in the

clause stand part debate, I should be happy to return to it on Report. Disease registration is important in the context of some of the HPA's functions. We had problems with cancer registration in the not-too-distant past and associated difficulties with data protection. It is essential that we register disease adequately; otherwise the epidemiological function on which the HPA's health functions are based cannot work at all.

Central to that process is the national programme for IT in the NHS. Without that, we are going to struggle. It would be nice if the Minister could confirm that the national IT programme is on course for the HPA. There have been indications that the programme might either have been derailed or not be going entirely to plan. In such a crucial area, however, where there are so many threats to public health, it would nice to know that the national programme for IT in the NHS was going according to plan. If it was not, we might have problems.

We have had a good debate on the various health functions that the agency may discharge. I am grateful for the Minister's announcement that the action plan for hepatitis C is now on the streets, although I regret that the plan for tuberculosis is not.

I cannot think of anything more germane to the HPA's work than a national TB plan. If the HPA is to be the wonderful body that the Minister envisages, with the holistic benefit that will come from amalgamating those arms of government, perhaps we should already have a TB action plan. That said, however, it is important to note that, in general, action plans tend to come from the chief medical officer.

We may have clarified to some extent what the agency will do, but its interaction with the CMO is not entirely clear. Will the HPA carry out surveillance, or gather and collate information in order to inform the CMO's reports and recommendations; or will it assume some of those responsibilities for itself? ''Winning Ways'', recently published by the CMO, was concerned with another extremely important issue to do with hospital-acquired infections that most definitely come within the remit of health functions. That report was put out by the CMO, not the agency. Will that continue, or will one of the agency's functions be publishing reports that are really the bailiwick of the CMO? I am a little unclear about that. The Minister might let us know her thoughts.

I am grateful for the Minister's comments on TB. We will continue to press her on the action plan for TB. The situation is not under control, but I welcome the pragmatic way in which she plans to deal with the problem in relation to immigrants. She assures me that screening is voluntary. I have not heard her say that before, and it was not said in answer to a question of mine. Nevertheless, I am reassured to hear that there is a high take-up of voluntary screening at ports and airports. It helps a great deal, and informs the thinking of many. However, as suggested in the CMO document ''Getting Ahead of the Curve'', we need a TB action plan soonest. If the HPA had been in place, we might already have seen that. Were the Minister to

give us her thoughts on the matter, we would welcome the measure even more.

The Library has published an extremely useful document on the Bill, which includes a section dealing with clause 2. I apologise for going on about this clause, but it is fundamental. It is the meat of the Bill, so if the Committee will allow me I shall continue.

Page 22 of that research paper lists what the HPA has done to date. It says that it has responded to the threat from SARS and avian influenza, and has noted an increase in the number of sexually transmitted diseases. It also notes that we have the highest rate of TB in Europe. It noted increased concern with bioterrorism, such as threats of anthrax and smallpox, and with the emergence of new disease. It makes specific mention of zoonosis—Lord Clement-Jones will doubtless be interested in that—and the rising instance of hospital-acquired infections and MRSA.

It seems that the HPA has scored about three out of six. The fifth point, on new diseases, is debatable. It has dealt with 50 per cent. of those points satisfactorily, but it has not done particularly well on sexually transmitted diseases, and we are clearly not on top of tuberculosis despite the Minister's remarks. Instances of that disease are rising, particularly in certain wards London, and hospital-acquired infections are going through the roof. We are not doing terribly well.

I have pressed the Minister before on how the HPA might add value. My hon. Friend the Member for South Cambridgeshire said on Second Reading that we should not assume that bolting all those arms of government together will necessarily be beneficial. Large organisations often are not beneficial, and my hon. Friend said that if we continue bolting agencies together—I am sure that we shall see some of that next month, with the result of the review—we will end up simply with the Department of Health. That is not a sensible direction of travel.

We need to look more closely at hospital-acquired infections such as MRSA. The public perception is that there have been a lot of edicts from Government agencies on that. The HPA will probably continue to issue edicts on hospital-acquired infections, but how will things be carried out on the ground? I am still unclear about how practically they will be carried out. We have seen, no doubt with the connivance of the HPA in its infectious-disease role, the creation of directors of infection control, and all sorts of publications about best practice for ward hygiene, yet it seems that the basics still are not being carried out.

I accept the good point that the Minister made on Second Reading, that part of the problem is cramped, dark wards, and that the hospital-building programme on which her colleagues have embarked has helped. It may have helped, but the incidence of hospital-acquired infection has continued to rise. Obviously, we are doing well in one part, but less well in others.

Control has to do with proper hygiene, especially by medical practitioners. As I said on Second Reading, when I was a practising doctor on the ward, I rarely

changed my white coat, and I certainly never changed my tie—I am probably still wearing the same one as I wore on the ward 20 years ago. If one were to swab doctors' ties microbiologically, one would find all sorts of horrible things. The solution would appear to be straightforward: forbid doctors from wearing neck ties and get them to wear something else, yet something that simple seems to be beyond the capability of health protection and other agencies. Instead, we faff around creating new tiers of management when we should be trying to sort things out at the coal face, so to speak.

Clearly, we have not sorted things out: the incidence of hospital-acquired infection varies dramatically from one end of the country to another. In Yorkshire, it is seven times less than in Cambridgeshire and—

Mr Eric Forth (Bromley & Chislehurst, Conservative)

Order. The hon. Gentleman is now embarking on a more general analysis of the health service. I remind him that we are discussing a group of amendments to the Bill, and I would be grateful if he concentrated on that.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

I am grateful, Mr. Forth. I was trying to describe the functions of the HPA as they stand, and how they might be developed. That is fundamental to the Bill; it is the engine room of the Bill, because the agency is nothing if it is not what it does. We are not interested in the structure of the agency or, necessarily, in how it is financed, although we have gone through that in enough depth.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

I do not believe what I hear. The hon. Gentleman is not interested in the clauses that we are debating.

Mr Eric Forth (Bromley & Chislehurst, Conservative)

Order. I am grateful to the Minister for her advice and support, but there is only one Chairman in this Committee and, for the time being, that is me. I shall allow the hon. Gentleman to continue, but I shall be listening rather carefully for repetition, deviation or, indeed, any other sin.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

I agree absolutely, and I am very glad that there is only one Chairman in this Committee. May I say what an admirable Chairman he is?

I am sorry that the Minister butted in prematurely, as I was going to say that we are not particularly interested in the number of executive and non-executive members of the board of this body; we are interested in how it does its job, as that is what matters to our constituents, but it is encapsulated in a very few column inches in the Bill. That is what we are discussing now.

I make no apologies for going on about this, because it is crucial to our deliberations. Frankly, if we do not get it right, we might as well pack up and go home and let the existing structures continue. Our constituents need to know that this body, which they are financing, will make a difference to their health. They also need to know what it will do. The Minister clarified some of that, and I am grateful to her for that, but I want to know how the agency will improve people's health in several specific areas. We have teased out many of those, and my purpose in pursuing this matter is to obtain a few more nuggets from the Minister, and perhaps to change her thinking slightly in several ways, as her colleagues were moved to

change their mind on the last measure that we debated in the House yesterday. There were 99 amendments tabled to the Human Tissue Bill on Report, and we do not want that. It would be much nicer to make changes at an earlier stage.

I am just trying to be helpful in focusing particularly on clause 2, on health functions, which is the most important clause. I hope that the Minister has taken to heart some of what I have said; I mean it in good faith. The Bill is not particularly controversial, but we want to get it right.

Mr Eric Forth (Bromley & Chislehurst, Conservative)

It would be helpful if the hon. Gentleman would say whether he wants to press his amendment to a vote or seeks leave to withdraw it.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

I am grateful, Mr. Forth. I think that I have made my point. I may return to one or two matters on Report, but I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Question proposed, That the clause stand part of the Bill.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

We have already had a wide-ranging debate—so wide-ranging that from time to time you have felt the need to restrict some of us in our contributions, Mr. Forth. I shall not test your patience by repeating what we have said already, or by straying too widely. The clause is important because it identifies the health protection functions of the agency and the ways in which it may be directed to exercise other health functions. We have had an extensive discussion of those functions in debating the amendments, and I do not intend to explore them further.

I shall respond briefly to one or two of the points that have been raised, particularly the question of zoonotic infection in humans, which was not raised earlier on. Were an outbreak to occur in the animal population where there is a clear and perceived risk of transfer of disease to humans, the Department for Environment, Food and Rural Affairs, in close liaison with the agency and the Department of Health, would take the lead on animal health issues; the agency, in close liaison with the Department of Health and DEFRA, would take the lead on human health issues.

Members will appreciate that things work in both directions: for example, when a few months ago an urgent question was tabled on avian flu, both I and a Minister from the Department for Environment, Food and Rural Affairs were present on the Front Bench for the debate. There is liaison between organisations dealing with human and animal health at central, regional and local level.

Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton & Cheam, Liberal Democrat)

One of the issues that I raised on Second Reading in relation to zoonotic conditions was the question of who would be pre-eminent when there was an outbreak in the animal population and concern about a potential spread to the human population. The Minister has said that DEFRA would deal with the animal population and the Department and the agency would deal with the human population, but who is pre-eminent in making decisions about, for

example, how one might deal with the animal population to contain a spread to the human population? Where do those decisions rest?

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

They rest in joint working and co-operation. The hon. Gentleman is wrong to think that it is possible simply to allocate the lead in those matters. In the event that we are considering, both sides are important in containing the outbreak and dealing with the human health issues that may arise. Therefore it is important for both bodies to work together. As I said, in the event of a clear and perceived risk of transfer of disease to humans, DEFRA would be in liaison on animal health issues and the agency would be in close liaison with the Department of Health and DEFRA on human health issues.

It is not possible to say that one body will have the final say, because co-operation has already been established, and needs to continue in such an event. Liaison occurs at all possible levels, as I was saying when the hon. Member for Sutton and Cheam intervened. That continues. For example, there is collaboration between the national public health service for Wales, which provides the zoonosis surveillance reference unit for England and Wales, and the Veterinary Laboratories Agency, which links human and animal surveillance. A pilot scheme is being developed in Wales to link human and animal data, and it is hoped that a similar scheme will be rolled out in the rest of the UK. That rests on mutual co-operation, which is embodied in clause 5.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

Would the Minister accept that we are talking about emergencies? In such situations, somebody has to have primacy; otherwise one ends up with a dog's breakfast, arguably of the sort that occurred in relation to the BSE crisis. Although we accept that organisations should co-operate, it will not do not to have somebody who is obviously in charge. I hope that the Minister agrees, and will give further thought to which of the agencies would have primacy in the circumstances that have been described.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

DEFRA would have primacy in cases of animal health, and the HPA would have primacy on human health issues. It would not be sensible to say that the HPA should do a lot of detailed animal health work, because DEFRA and other organisations have prime responsibility for animal welfare and need to get the ''animal'' side of things right if there is any danger of the spread of a disease that might impact on both animals and humans.

I disagree with hon. Members' analysis of what makes sense in this context. We have worked through such situations and are looking further at the results of recent work on the outbreak of foot and mouth. Those issues have been well dealt with and we have learned many lessons from what happened. However, that is not likely to affect human beings; it is confined to one area.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

DEFRA is a Ministry headed by a Secretary of State. The agency is an agency headed by a chairman and chief executive. Can we assume that, if difficult decisions had to be made about, for example,

BSE—which interrelates with human health—those difficult decisions would end up, by default, being made by DEFRA because its top man is a Secretary of State, rather than the chief executive or chairman of an agency?

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

That is quite a wrong assumption. The HPA works closely with the chief medical officer and with Ministers in the Department of Health. It is impossible to believe that, in the event of any emergency posing the kind of threat to human well-being that the hon. Gentleman envisages, Ministers would not be involved in some way—through the emergency planning arrangements, Cobra and so forth. There are Committees that deal with such matters at ministerial level, as he is aware.

I have dealt with most of the issues that have been raised, and have tried to pick up matters that have been mentioned in debate, either by responding on intervention or just now. The clause sets out the appropriate powers for the agency, and I trust that the Committee will give it its full support.

Mr Mark Francois (Assistant Chief Whip, Whips; Rayleigh, Conservative)

I should like to highlight just a few points, partly in response to some of the things that the Minister said when she addressed the amendments tabled by my hon. Friend the Member for Westbury and by the hon. Member for Sutton and Cheam.

As we have heard, the measure is, overall, non-contentious. It is a matter of record that Her Majesty's Opposition did not vote against the Bill on Second Reading, so we begin with a degree of consensus. However, if the role of the Committee, when considering legislation of this type, is to scrutinise the detail and to try to identify any area of weakness or area in which, within an agreed framework, more work needs to be done, the Committee has been earning its corn today. We appear to have found at least one area of weakness that required further scrutiny.

A parallel has been drawn with the Human Tissue Bill of which, by coincidence, the remaining stages were debated on the Floor of the House yesterday. That, too, was relatively non-contentious in party political terms, although it covered issues that are extremely important to medical specialists and to others. In that case, too, it was stressed that it was non-partisan. The Opposition tabled a range of amendments, which the Government were reluctant to accept. Yet by the time we discussed it on the Floor of the House yesterday, the Government had produced 99 amendments, a large number of which were suggested by the Opposition in the Bill's Committee stage. If we take a parallel with that, we are not discouraged. On a similar piece of legislation in many ways, the Government were reluctant to accept the Opposition's points, yet on Report they tabled a raft of amendments showing that the Opposition had been right all along.

On that Bill's Third Reading, the shadow Secretary of State, my hon. Friend the Member for South Cambridgeshire (Mr. Lansley), complimented the Minister of State, Department of Health, the hon. Member for Doncaster, Central (Ms Winterton) for performing a complete volte face on a range of issues

''without the remotest sign of embarrassment, which is commendable and bodes well for her future ministerial career.''—[Official Report, 28 June 2004; Vol. 423, c. 118.]

We hope that her colleague might follow her down a similar path.

The Opposition believe that there are some weaknesses in the Bill with regard to the relationship between the proposed Health Protection Agency and its interaction with agencies that are concerned with what one might term ''homeland security''. For that reason, we specifically nominated my hon. Friend the Member for Newark to be part of our Front-Bench team. Experience shows that we were right. He, along with some modest contributions from the rest of us, has been able to press the Government on some of these issues.

In fairness to the Minister, she has now begun to provide some of the detail that the Government could not provide on Second Reading. She has begun to answer some of the questions that the Opposition wanted to put to her on issues where we felt that the Government had not been sufficiently thorough. Equally, there is yet more work for the Government to do. At least, by pressing them on these matters today, we have begun to get some answers.

The Minister disagreed with us about the content of ''Protect and Survive''. I was slightly concerned when she said that it was all history. I humbly remind her that it was only in 1989 that the Berlin wall came down. It is not that long ago. A number of countries around the world are still in possession of nuclear weapons. We are not talking about an examination of the ancient Greeks.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

My point referred to the document in question, not to anything else.

Mr Mark Francois (Assistant Chief Whip, Whips; Rayleigh, Conservative)

I understand what the Minister was saying. She was perhaps sceptical, perhaps for her own reasons, about what was included in that booklet. We do not need to go round that lap four times this afternoon. Nevertheless, it was not terribly long ago that this country lived under the threat of a direct nuclear attack from the Soviet Union. Even today, the Russian Federation possesses nuclear weapons. We are not entirely out of the woods, although much of what we have concentrated on today relates to the possibility of a terrorist organisation obtaining a nuclear weapon. It may be a classic nuclear weapon, or a so-called mixed device, usually referred to in tabloid parlance as a ''dirty bomb''.

These issues are still germane. I sense that, on occasion, the Minister has suspected that the Opposition are crying wolf or seeking to overdo this. In defence of our argument, I would pray in aid the Intelligence and Security Committee's annual report for 2003–04, Cm 6240, which was published only today. On page 7, in a section headed ''The Threat'', it quotes the Prime Minister. That quotation bears brief repetition in this context. He said:

''September 11th was for me a revelation. What had seemed inchoate came together . . . But what galvanised me was that it was a declaration of war by religious fanatics who were prepared to wage that war without limit. When I spoke to the House of Commons on 14 September 2001 I said:

'We know that [the terrorists] would, if they could, go further and use chemical, biological or even nuclear weapons of mass destruction . . . We have been warned by the events of 11 September, and we should act on the warning.' From September 11th on, I could see the threat plainly. Here were terrorists prepared to bring about Armageddon.''

Mr Eric Forth (Bromley & Chislehurst, Conservative)

Order. Notwithstanding the undoubted military and intelligence credentials of Opposition Members and the Prime Minister's words, I ask the hon. Gentleman to relate his remarks directly to the clause stand part debate.

Mr Mark Francois (Assistant Chief Whip, Whips; Rayleigh, Conservative)

I shall be delighted to do so. Again, I do not mean to misrepresent the Minister, but I quoted the Prime Minister, which I confess I do not usually do at the drop of a hat, because I believe that the Minister might have thought that we were over-egging the pudding in some respects. I assure her that we are not. I was seeking to pray in aid the Prime Minister, who obviously believes, as I do, that these issues are very important. The Minister might not agree with us, but she can take the matter up with the Prime Minister if she so wishes.

Finally, in our argument about the ''Protect and Survive'' campaign and whether there should be a more modern version of that for the current situation, my hon. Friend the Member for Westbury correctly reminded the Committee that a whole range of televisions broadcasts had also been prepared, some of which were subsequently aired in the arguments about that campaign. The point is that the broadcasts had already been filmed and were ready to be aired in the event of an emergency. It would take a long time to produce those broadcasts if they were not already ready to go. It is one thing to give out a one-line radio message, but such a message needs to be backed up by something else that will not be available if it has not been produced in advance. We should therefore have prepared television broadcasts that align with the booklet and that could be broadcast in the event of an emergency.

In fairness, the Minister pointed out that there is a broad power under clause 4 that would give the HPA the ability to produce such broadcasts. We have sought a commitment from the Minister that it would be prepared to consider the possibility seriously. It obviously has the power to do so, but we are pushing the Minister on its intent to do so as opposed to its ability. I hope that she will be able to tell us today or on Report that she intends to respond positively, so that we can provide people with information to deal with the most catastrophic events.

Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton & Cheam, Liberal Democrat)

I welcome you to the Chair for this afternoon's sitting, Mr. Forth.

In his summary of our debate on the two amendments, the hon. Member for Westbury said that he had deduced from exchanges between the Minister and hon. Members that the Government's intention was to focus primarily on the control of infectious disease and one or two other aspects, particularly chemicals. I am paraphrasing his remarks, and I am sure that he will correct me later if he checks the record and finds that I have missed

something. However, what struck me most was that he seemed to deduce from what the Minister said that lifestyle and its effects on health were not likely to be part of the HPA's agenda. In the Minister's response to the debate on the amendments, she suggested that the clause does provide for a wider role in promoting health. I was grateful for that useful clarification.

The hon. Member for Westbury also referred to subsections (2) to (4), which deal with directing the agency to take on other functions in relation to health. The explanatory notes say that these provisions are included to provide future flexibility. Will the Minister say how widely that power is drawn? How much flexibility could it give? Would it, for example, enable the HPA to take on a remit similar to that of the Centres for Disease Control and Prevention in the United States, which clearly goes beyond the realms of surveillance and health protection—the functions that the Bill confers on the HPA? Does it allow for issues such as lifestyle to become part of its remit, too? Could she respond to those points, so that we can be clear how wide the parameters might be if the Government were minded to exercise those powers?

Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)

I listened to the Minister during our debate on the amendments, and many of her points addressed the difficulties that we raised. However, I am still unconvinced that the Government fully understand the integration between the Health Protection Agency and the more conventional agencies that are flourishing as part of the homeland security agenda. It seriously worries me that the sort of attacks that there have been in the past will change and, according to reliable intelligence, enemy agents will start to use a completely different style of attack, which may not be as obvious as an explosive or contact poison attack. For example, it will be something like smallpox, which may take weeks or months to develop, and could be absolutely devastating to the population. It could also be very difficult to assess whether such an attack arose from a natural cause or was the result of action by terrorists. That is why I found the Government's earlier efforts to warn the population in advance about what is going on slightly disingenuous.

An interesting leak appeared about a month or so ago in The Sunday Times, which published in draft form the Government's forthcoming document, which we believe that they intend to send to every household. Much of the advice in that pamphlet was extremely useful and helpful; I have no doubt that there are holes in it, as there are in any such work, which cannot be perfect. However, I do not criticise it for that. If that newspaper report was correct and that is the course of action that the Government are following, it was clear that the Health Protection Agency had not been a large contributor to the document. My point is therefore simple: I believe that our enemies will increasingly use asymmetric, imaginative and technical styles of attack, and we may not even know whether we have been attacked by terrorists or not. That is the bailiwick of the Health Protection Agency. I absolutely take the Minister's point about clause 4.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

I apologise for interrupting my hon. Friend in mid flow. He said that the HPA probably had not contributed very much to the document to which he referred. I received a pamphlet in my mailbag this lunchtime from the Royal College of General Practitioners, entitled ''Major Incidents and Disasters—the role of the GP and the primary health care team'', which, from my cursory examination of it, also appears not to mention the HPA. Does he share my concern that the HPA does not seem to be having much of an impact?

Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)

I am grateful to my hon. Friend for his intervention. As usual, he is one step ahead of me. I have not seen the document to which he referred, but it appals and disappoints me that the Health Protection Agency is not mentioned in it. I reiterate that the HPA did not feature in the leaked document. Therefore, I simply want matters with reference to the agency to be spelt out under the clause—both on the contingency planning that will be carried out and on informing the public about the threat and how to mitigate it.

I understand that the Minister faces the difficult prospect of warning people without scaring the pants off them. It is a difficult line to tread. None the less, I should have liked the clause to provide for something more specific, which would be more helpful in mitigating the sorts of disasters that we are likely to face.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

It is a pleasure to respond to the points that have been made. As to the comments of the hon. Member for Rayleigh on amendments, the Government do not intend on the basis of what we have heard so far to table any amendments on Report. I am sure that hon. Members appreciate that the Bill has benefited from scrutiny in another place. That is not to say that we should not be giving it full scrutiny here, too, but the Government have responded to a number of the amendments that were made in the other place. I am afraid that the hon. Gentleman's fear—or anticipation—will, either way, meet with deep frustration.

Dr Andrew Murrison (Shadow Minister, Public Services, Health & Education; Westbury, Conservative)

Will the Minister give way?

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

I will not give way on that point, because I do not think that there is anything more that I need to say.

The hon. Member for Sutton and Cheam spoke about subsections (2) to (4). Under subsection (2)(a) the Secretary of State can direct the agency to exercise administrative and other functions that might otherwise be carried out by the Department of Health. He must act reasonably, which means that the functions should be of a similar nature to those of other health functions that the agency has—in particular, as described in clause 4. However, giving such functions to the agency is consistent with the policy that the Department should perform only those functions that it can do best. I am sure that that is a principle of subsidiarity and devolution with which the hon. Gentleman would find it difficult to disagree.

As an illustration of the way in which the power might be used, the Secretary of State would be likely to use it to transfer to the agency the administrative task of designating yellow fever vaccination centres, which

would be carried out in accordance with the international health regulations of the World Health Organisation. Obviously, the provision could be more widely construed, and I think that that was the point that the hon. Gentleman was raising.

The hon. Member for Newark commented on the more creative forms of terrorism, as it were, and the threats that we face. Obviously we must all be alert to those possibilities and I share his concerns about them. I do not have any information about the detailed nature of terrorist threats. He may know something that I do not. As I said earlier, our approach to dealing with the threat is that several different bodies and organisations, including the Home Office and the police, as well as the HPA, need to be involved in giving advice and training and making provision for any such eventuality, in so far as it is possible to plan for it. We must think ahead and try to plan for what is, at the moment, at the outer boundaries of what we can foresee. I am sure that the plans are taken seriously by all the bodies concerned.

Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)

The Minister mentioned the provision of training. Does she foresee that as being the training of officials inside agencies and organisations or more general training of the population?

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

As the hon. Gentleman is aware, training takes many forms. It may mean equipping people with specialist skills, or it may be connected with particular emergency planning events. It may be other things. The agency will play an appropriate role in those contexts. Again, several other significant players will have a major role to play in such exercises and such provision. It would not be right to try to specify the precise role of the agency.

I think that Opposition Members are frustrated because we are not here to talk about the details of the HPA's engagement in this matter, but to talk about the frameworks that the Bill is setting up to enable the HPA to do the detailed work. I understand their frustrations, but it is not for me to go into the details of matters that are not—and in our view should not be—provided for in the Bill.

Mr Patrick Mercer (Shadow Minister (Homeland Security), Home, Constitutional & Legal Affairs; Newark, Conservative)

I take the Minister's point. In any Bill Committee, similar arguments are deployed by both sides. However, there surely needs to be enough precision and detail—although not excessive detail. For example, the point that we were discussing earlier about protective clothing clearly should not be on the face of the Bill. However, I disagree strongly with the Minister; the Bill must not be bland. It must be precise enough to direct the agency and to reassure other agencies that their work will be conducted in the correct way and channelled in the correct fashion.

Miss Melanie Johnson (Parliamentary Under-Secretary, Department of Health; Welwyn Hatfield, Labour)

I contend that the Bill is by no means bland, and I have done so strongly this afternoon and this morning. It is enormously productive and offers many opportunities for better working and better linking between the various areas of risk and threat than has ever been afforded by any other organisation or arrangement. Indeed, the HPA is already strongly taking forward almost all those strands of work, even involving early work with the National Radiological

Protection Board and preparation for what it hopes will be the outcome of our deliberations in due course.

All those things are in place, and I believe that the Bill contains exactly the right amount of detail. I have to beg to disagree with the hon. Gentleman. I have answered his points as best I can. I think that his frustration rests on the fact that he would like something on the face of the Bill, which we think would be entirely inappropriate. I commend the clause to the Committee.

Question put and agreed to.

Clause 2 ordered to stand part of the Bill.