I beg to move,
That this House
expresses its deep appreciation of the response of the emergency services and Transport for London to the terrorist outrages of 7th and 21st July 2005; urges heightened efforts to ensure that preparedness for emergencies is comprehensively pursued;
believes that the appointment of a Minister for Homeland Security would contribute to effective co-ordination within government;
calls for increased efforts in communicating with the public in respect of major threats, including both terrorist attacks and an influenza pandemic;
regrets delays in the publication of an influenza pandemic contingency plan and the procurement of anti-viral drugs and disposable medical products;
is concerned at the lack of public information and resulting confusion;
and urges that pandemic influenza preparedness be achieved urgently, with effective communication to the NHS and public of the nature of the threat and planned responses.
This debate has three purposes: first, to give the House its first opportunity since
The House will be aware that there is a wide range of emergencies in response to which the Government are seeking to build resilience under the capabilities programme. Some of those concern natural disasters. As a vice-chair of the all-party group on flood prevention and a representative of a constituency affected by flooding in October 2001, I am only too aware of our developing plan for flood defence. There is an increasingly well-defined population who, all credit to them, actively seek information and means of protecting themselves. The Environment Agency, which, as I know from personal experience, learned some bitter lessons about flaws in its alert system in 2001, is introducing remodelling of the flood risk patterns to increase the advance warning that might be given. That is a good example of ways in which emergency preparedness can learn from past deficiencies.
Extremes of weather present other threats. The heat wave in France in the summer of 2003 caused 5,000 excess deaths. During winter in this country, as things stand at the moment, we have more than 20,000 excess deaths—twice the relative number in Germany. With the Met Office warning of the risk of severe cold weather this winter, now is the time for Government, local authorities, the NHS and housing associations to act, and for families to consider how they and their friends and neighbours are looked after.
I do not want to dwell on that at great length, although I was a member of the Select Committee on Trade and Industry when it undertook an inquiry into fuel poverty and highlighted excess winter deaths in this country. They derived from a combination of factors, including the relative cost of fuel as a proportion of the income of people on very low incomes, and building regulations and standards of insulation. That is one reason, apart from many others, why I will join warm homes week in my constituency in November to encourage the fight for such insulation. Those are the things that we should be doing in the weeks ahead.
In Cambridgeshire—I am sorry; I will stop talking about my constituency after this—the big freeze on the M11, which some of my hon. Friends were caught up in, illustrated how severe weather can rapidly lead to a deterioration of services. If that freeze had continued for only 12 more hours, it would have interrupted just-in-time deliveries of supplies to clinics, pharmacies and the like. We need to be aware of the way in which severe weather could have an adverse impact very quickly.
The principles of preparedness for a range of emergencies often have much in common: prevention, when possible; preparation; effective co-ordination and chains of command; proactive communication with professionals and the public; and a continuous, active engagement with the possible risks and solutions.
Clearly, terrorist attacks are a major threat that we continue to face. In recent times, as distinct from Northern Ireland-related terrorism, the threat became real in this country on 7 and
First, there is no doubt that a huge effort has been put into devising legislation that might prevent, should deter and will punish terrorists. However, we must ask ourselves how much laws can achieve against a form of terrorism whereby our enemies care nothing for their lives. Indeed, the loss of their lives is their aim. While legislation might protect us against conventional terrorism—if one can describe terrorism in those terms—can it do the same for the new kind of radicalism? We need concrete measures to protect our citizens and make it much more difficult for terrorists to operate in our midst.
"a difficult climate for the terrorist."
Since September 2001, have we done that? We need a well formulated and articulated campaign of public information about the flu pandemic and we need precisely the same for terrorism. The Home Secretary and his Ministers stick to the mantra that we must be alert but not alarmed. The Minister talks about striking a balance between telling people enough and not terrifying them. She is right in principle but wrong in practice about how much people have been told and how the balance has been struck so far.
Nearly 18 months ago, the Government published a booklet telling us how to prepare for emergency. It partly dealt with terrorism but the message was muted and 1.5 million households have yet to receive their copies. We can do better. There have been spasmodic poster campaigns on the underground and other parts of London transport and we are rightly told not to leave our baggage on the tube. However, do not we need to know what the threat is and how to deal with it? For example, why are not we told publicly what the national alert status is? Why do we need to depend on leaks from the BBC to tell us what the security services perceive as the danger level?
If, as must be the case, an alert and vigilant population is among our best defences against terrorism, we must engage the public actively in that task, explaining what they need to do and why raising the alert status is not crying wolf, however often we do it. We must also explain the sheer scale of information and intelligence that needs to be pursued if we are to be more likely to intervene successfully against future attacks.
We need a concerted campaign of public information because we know that knowledge dispels fear. To back that up, we must start basic public training. I do not mean that we should all practise running to the air raid shelter and donning our gas masks, but we need basic pointers about what we should do. If the Government need some guidelines on that, they need only examine how the people of Northern Ireland were taught to recognise the sort of vehicles that terrorists might use as bombs. Indeed, I recommend that the Government look closely at the way in which we handled similar threats over 30 years in Northern Ireland. New Labour has a habit of ignoring the lessons of history but lessons learned in Ulster could save lives in Britain today.
Beyond that, we need a single point of contact and a single Minister who has the authority to control and co-ordinate all the different elements of preparedness. I understand and appreciate the co-ordination necessary for the many agencies that are required. It depends on many different chains of command being effectively linked together. However, the essence of what is required is early action, constant examination of plans and leadership to ensure that the responses to risk are swift and effective. That is often achieved in respect of each of those chains of command by someone with authority from outside looking creatively and constructively—sometimes destructively—at their plans to see how genuinely robust they are.
Ministers are responsible for the effectiveness of our emergency preparations, and it is to Ministers that civil servants and Government Departments respond. In circumstances in which Ministers determine priorities in their Departments, we cannot look to the civil contingencies secretariat to carry the burden of securing the necessary priority and action across government. The most effective way of securing the necessary priority is a Minister for homeland security with sufficient seniority to have the single-minded focus to achieve it. On Monday, for instance, during the urgent question on avian flu, it was instructive that, when the Secretary of State for Health was asked what poultry farmers should do to protect their flocks, she replied, in effect, that that was a matter for the Department for Environment, Food and Rural Affairs.
How many different agencies were involved in the response to the events of
Not all the issues are devolved. The functions involved in a response to avian flu are clearly not devolved and the Scottish Executive will be directly responsive to a UK-wide plan in those circumstances. The way in which the hon. Gentleman asks the question slightly begs a question. Scottish Ministers should not necessarily be answerable, but they should be accountable for adherence to one single plan. It is difficult to achieve the necessary co-ordination within the UK in the absence of that kind of responsiveness and responsibility.
I am following with interest the hon. Gentleman's argument for a Minister for homeland security. I presume that his proposal is for a Minister of Cabinet rank. Will he clarify whether that Minister would have his own Department, or whether he would be a stand-alone Minister with perhaps just a secretary? What is the scope of his proposal?
My proposal is for a senior Minister, but not necessarily one of Cabinet rank. He could indeed have their own Department within the Cabinet Office. As someone who has worked in the Cabinet Office, I am familiar with the way in which it can support a Minister in that way. The Minister would have to be someone with sufficient authority—in this case, that authority would be derived from the Prime Minister—to implement the necessary co-ordination and linkages across the services that were required.
We all have to challenge ourselves constantly in regard to these issues. For example, in respect of
When my hon. Friend Patrick Mercer winds up this debate, he will have the opportunity to respond to questions and to amplify on these issues. However, I want now to take this opportunity to deal with the specific threat of an avian flu pandemic. I shall not speak about seasonal flu, although the EU Health Commissioner, Mr. Kyprianou, might have unhelpfully confused the public last week into believing that the seasonal flu jab offered some protection against a future flu pandemic. There are good reasons, of course, for at-risk groups to get their seasonal flu jabs, and I wrote to the Secretary of State for Health on
The issue concerns an emergency: lack of preparedness for an avian flu pandemic. The House will be aware of the scale of the threat. On Sunday, the chief medical officer referred to the planning assumption of 50,000 excess deaths, based on an infection rate of one quarter of the population, assuming a mortality rate of 0.37 per cent. A range of mortality rates up to 2.5 per cent. have been considered. We simply do not know what the virulence of a flu virus that is readily transmissible between humans will be. The worst case scenario implies as many deaths in the 15 weeks of the first wave of a pandemic as would normally occur over a whole year.
We know that the H5N1 strain present in bird populations is highly virulent, with 117 cases contracted by humans who were in intimate contact with birds, of whom 60 died. We have no evidence of sustained transmission between humans. A genetic mutation leading to human transmission can be expected substantially to reduce the virus's virulence and the mortality rate among humans affected. We must assume, however, that we are dealing with a dangerous virus, in respect of which we have virtually no natural immunity in the population. We do not know when a virus capable of human-to-human transmission will occur, and given the increasing prevalence among large bird populations in south-east Asia, it must be far more likely that such a mutation will occur there, and the time at which it will occur must be approaching. As the World Health Organisation says, the question is not if, but when.
I do not now doubt the Government's awareness of the threat. The publication today of an updated contingency plan by the chief medical officer shows that the key issues are identified. Let me be clear, however: the threat has been evident for a long time. In June 2004, I pressed the Government to produce a contingency plan and prepare a stockpile of antiviral drugs. The French Government, for example, published their plan and procured 13 million courses of Tamiflu on
I should not have to do this—the Opposition should not have to come to the Dispatch Box to call for action by the Government and for such measures to be taken. It is all very well the chief medical officer saying, on about
In comparison with previous pandemics, we could do very well: we have the best science in the world, an NHS that has shown itself able to respond to emergencies, and new antiviral and vaccine technologies. All those resources, however, must be brought into action well in advance if we are to obtain the full benefits. As we shall see, however, we do not have the antiviral stockpile that is necessary, nor the millions of face masks and gloves needed. Research into vaccines, and priming the vaccine manufacturing capability, has not happened. Contingency plans, including today's, do not show how the NHS would cope with the tripling of demand for critical care beds that would result. The public and NHS professionals are confused and uncertain about how we would cope. All those things must change.
The United Kingdom Government's plans may be better than those of many other countries. Indeed, many countries have no plans. They have been slow off the mark, however, and the delivery of key elements has not even begun in some cases. Our planning should not be among the best in the world; it should be the best in the world, and that is what we will press for.
I am grateful for the presence of the Under-Secretary of State for Environment, Food and Rural Affairs, Mr. Bradshaw. I want to say three things about avian flu in the bird population. First, we think it is time to warn free-range poultry keepers of the restrictions that may be placed on them, although not necessarily now, if there is evidence of high pathogenic avian influenza entering the United Kingdom in migratory birds. They need to know the plans for containment and how they can be helped to prepare for it now.
Secondly, poultry workers and those involved with game birds need information about what to look for and the personal protection measures for which they may be responsible in due course. Thirdly, there is the need to monitor wild birds. The Government and, indeed, scientists are not yet clear about the manner in which avian influenza is being transmitted among bird populations as a result of migration. It is all the more important in the game-shooting season for game birds to be sampled to establish whether the virus is present, and in what part of the wild bird population it occurs.
There is an important difference, which is not yet well understood, between avian flu in the bird population and pandemic flu in the human population. We know that there are serious major risks of transfer from the bird population by means of genetic mutation. Recent evidence from modelling in both this country and the United States suggested that the use of antiviral drugs and other public health measures where an outbreak of pandemic flu first occurred—in south-east Asia, for instance—could achieve significant progress in containing the outbreak at the outset, and could give everyone, worldwide, a breathing space in which to complete preparations for, say, a vaccine. Can the Minister tell us what specific measures our Government have taken to ensure that some of our resources and those of other countries in the developed world can be used to support an aggressive containment strategy?
We know that we do not yet have a stockpile of antiviral drugs, but we should ask how such a stockpile would be used. The pandemic flu contingency plan tells us that the stockpile should be the size recommended for treating the infected population—roughly enough for a quarter of the UK population to be treated. On page 150, the plan states
"It should be emphasised that those national stockpiles provide no allowance for prophylaxis to protect key workers or maintain business continuity."
Earlier parts of the plan, however, make it clear that part of the intention is to use antiviral drugs for prophylaxis for health care workers in the initial stages of an outbreak, and post-exposure prophylaxis for people in confined communities such as nursing homes.
A good question, to which we increasingly need an answer, if there is one, is whether post-exposure prophylaxis—not for the whole population, as that would not be cost-effective, but in the event of initial outbreaks in populations, and perhaps in families when one family member has contracted the disease—can be used to constrain the spread of the disease and reduce the severity of symptoms. Is there a viable strategy for such a preventive measure to be employed? There may well be, but at the moment the stockpile being procured on the UK's behalf makes no such provision. The plan and the stockpile are not matching up. The Government should have procured a stockpile for treatment purposes. Moreover, by this stage they should have considered the need for prophylaxis and placed orders beyond September 2006, so that they could not only replenish the stockpile when necessary, but add to it for prophylaxis purposes.
There is also a limited risk of resistance developing to Tamiflu, which is the antiviral stockpile of first choice. I ask again the question that I asked on Monday but which the Secretary of State did not answer: have the Government considered making, or do they intend to make, Relenza available as a second-line antiviral drug?
On vaccines and their preparation, the Government say that they are going to buy 2 million doses of the H5N1 vaccine, which is a generic vaccine for treating avian flu itself, not the virus that might develop in humans subsequently. What exactly is its intended use? According to the plan, it will be piloted to see whether it is effective in treating those who are, or might be, in direct contact with avian flu, and also in treating health care workers. Is 2 million doses the right number, therefore? If the vaccine is likely to be effective in treating health care workers, does it not follow that it is likely to have some effect on the wider population? What assessment is being made of such effectiveness? The Joint Committee on Vaccination and Immunisation discussed whether an H5N1 vaccine should be developed for the whole population in order to prime its immunity against an avian flu strain that transfers to the human population, but which retains characteristics closely linked to the original virus. The French Government intend to do exactly that, and we need to know whether our Government are working on such a plan.
On face masks and gloves, the Australians have purchased 50 million face masks and a similar number of syringes, needles and so on. They placed the order in May, and they anticipate that they will be available in December. The French are contemplating ordering 200 million face masks for use by health care and social care workers. Let us get this in perspective. On the outbreak of pandemic flu in this country, within the space of just weeks we would need that number of face masks for our health care, social care and emergency service workers alone. In the course of a typical year, the NHS routinely purchases some 31 million face masks, so there is an enormous difference between what we will require and what we currently have. No order has been placed, no tender has been made, no action taken on the part of the Government. This is a simple, straightforward measure that should arise from any contingency plan, but it is not being adopted.
The Government have today placed the order for vaccines that I called for on Monday, but as the Minister will know, according to the pandemic flu plan published today, there are other issues with which to deal. Curiously, those issues are framed as questions. The appendix on vaccine policy points out that there are constraints on vaccine production, such as the availability of suitable hen's eggs. It states:
"Contracts could be put in place to secure year-round supplies of eggs".
Have they been put in place? Should they be put in place? Will they be put in place, and if so, when?
The appendix also points out that research into adjuvanted vaccines could be undertaken. That is interesting, given that last Monday, The Times reported that exactly such research into adjuvants to an H5N1 vaccine had been proposed by a combination of researchers, including researchers from the National Institute for Biological Standards and Control. They produced the proposal in the spring, but they have received no response. We need to know exactly what the Government are doing about that research. The Chancellor apparently plans to spend £2 million, but on what we do not know. We need to know whether it amounts to a response to that sort of research proposal.
Let us remember the importance of manufacturing capability. The public are being told that the Department of Health has purchased 120 million doses of vaccine for when pandemic flu occurs. It is not like that at all, though I am not blaming the Department: some press reports seem to suggest it, but that is not what is going on. What is really going on is an advance purchase order for 120 million doses, once we have been able to develop a vaccine, but significant manufacturing constraints have to be overcome before that can happen. The Government need to take certain measures.
To put it in perspective, 300 million doses of flu vaccine are produced worldwide each winter for seasonal flu, yet one country, the UK, would need 120 million doses to deal with pandemic flu. Just imagine the scale of the increase in production capability that would be required. Back in April, the influenza sub-group of the Joint Committee on Vaccination and Immunisation said that, ideally, we should have an additional vaccine production facility in the UK. We are clearly not in such an ideal position, so we need to understand how the Government will minimise the constraints on manufacturing.
Critical care beds are another important issue. Professor Menon of Addenbrooke's hospital set out clearly in an article in Anaesthesia that the draft contingency plan published in March did not deal with the problem. He found that the requirements for critical care capacity in respect of beds and staff to support them would be so dramatic that they would literally overwhelm the NHS, which would be
"unable to cope with the increased demand provided by an influenza pandemic."
That shows how important it is to manage demands on the NHS effectively. Professor Menon saw contingency planning as essential, but the contingency plan published today does not set out the necessary response. The NHS is told to respond in many respects, but at the local level, the NHS has proved unable to do the work or agree on what responses are necessary. In some cases, it is unable to put in place the resources for an effective response.
On communications with the public, the House should reflect on the communications plans set out in the back of the contingency plan published today. It states that there is virtually no recall of the launch of the Government's pandemic flu contingency plan among the general population. It also states that unless health professionals are directly involved in the planning for pandemic flu, they are likely to have only mixed awareness of its potential impact, of antiviral treatment and of the current contingency plan. An article in The Observer on Sunday pointed out that 77 per cent. of doctors did not know what the response to an avian flu pandemic would be.
I am sorry to have to take the House through all those details, but there are a range of deficiencies in our current preparedness. If action is taken now, major strides can be achieved in the coming months. This time next year, we will be better prepared for a flu pandemic, but if a contingency plan had been published a year ago, as it was in France, we would be better prepared now.
Today, the Minister has an opportunity to clarify whether the Government will take the actions that we have called for. This week, we secured action from the Government on advance purchases of vaccines, but much more remains to be done. I commit the Opposition to work proactively and constructively to secure the best possible preparedness against pandemic flu. In pursuit of that objective and on behalf of all those we represent, I urge the House to support the motion this evening.
I beg to move, To leave out from "House" to the end of the Question, and to add instead thereof:
"pays grateful tribute to the excellent work of the emergency services, of Transport for London and of all involved in responding to the terrorist outrages of 7th July and 21st July;
congratulates the Government on its comprehensive approach to preparedness for emergencies;
notes the effectiveness of current Departmental responsibilities for emergency preparedness;
further congratulates the Government on the steps taken to enhance communication with the public in respect of major threats;
notes that supplies of vaccines, antibiotics, antidotes and specialist equipment are strategically placed around the UK for rapid deployment in the event of a mass casualty incident, and that spending on the stockpile to date exceeds £120 million;
further notes that NHS organisations have well-established, comprehensive plans in place for dealing with pandemic influenza, and that the Government's updated pandemic flu contingency plan is being published today;
welcomes the fact that the Government is stockpiling key drugs and equipment, and will have enough antiviral drugs to treat 25 per cent. of the population by September 2006; and recognises that good communication with the public and with health professionals is crucial before and during a pandemic and therefore congratulates the Government on making accurate and up to date information widely available to doctors and the public through various agencies."
Let me start by completely endorsing the first statement in the Opposition motion, which is also reflected in our amendment. We all share a deep appreciation of the response of the emergency services—and, as Mr. Lansley mentioned, Transport for London—to the terrorist outrages in July. In last week's debate on the emergency services, hon. Members from both sides of the House praised those who work on the front line, and I am sure that that will happen again today.
I am also sure that we would all agree that the tragic events in July underlined how important it is for the Government to prepare for major incidents, whether intentional or accidental, caused by conventional, chemical or biological material, or as a result of a natural disaster. That is why the Government have put in place a programme across all Departments to cover all parts of the United Kingdom. That is the capabilities programme, as the hon. Member for South Cambridgeshire said, and it identifies the action that each Department would need to take in the event of a major incident to ensure resilience across the UK. For example, my Department leads on ensuring that essential services for health care, such as pharmaceutical dressings, would be available in the event of a major incident. Each Department has such plans in place.
At central Government level, we identify future risks. The civil contingency secretary to the Cabinet Office considers the potential impact on the UK of any risks. The Civil Contingencies Act 2004, and the accompanying non-legislative framework, set out the arrangements and responsibilities at local, regional and national level for preparation for, and response to, emergencies. Regular major incident exercise and training programmes are undertaken across all agencies, involving international partners if appropriate. Those exercises enable us to test out the plans and familiarise staff with their roles in the event of an incident, and to update and improve the plans if necessary. We also learn the lessons of tragic events, such as those in July, and I know that my hon. Friend the Minister for Local Government has attended several meetings on that very issue.
Has my hon. Friend had a chance to learn the lessons from hurricane Katrina? It seems to me that our Government could learn several lessons from that event, not least the advisability of putting hospital emergency generators underground—because they were flooded in that incident. There were also clear weaknesses in evacuation plans and half of the civil service has been laid off, because of the inability to pay public sector workers. Does my hon. Friend also agree that the American experience demonstrates that having a Minister for homeland security is no guarantee of an effective response?
We are considering the lessons that can be learned from hurricane Katrina and the recent earthquake. The former demonstrated the need for proper co-ordination at all levels, which sadly appeared to be lacking in that instance. We are confident that the processes that we have set in place ensure that such co-ordination is possible, at local, regional and national level, as well as between Departments.
An example of emergency services working together on the ground occurred at Boscastle, although it was a considerably smaller incident than those mentioned by my hon. Friend Mary Creagh. It was a natural occurrence that saw examples of great co-ordination, even though we did not have a Minister for homeland security. What is essential is good communication between Government and confident, well-resourced local agencies.
My hon. Friend is right; the issue is about co-ordination between agencies and, as he says, ensuring that we consider what happened in each case. My right hon. Friend the Minister for Policing, Security and Community Safety visited the police in that area, and is examining the other lessons that can be learned. She praised the work that was done.
My right hon. Friend will, I am sure, address some of the other issues relating to the Opposition's comments about a Minister for homeland security, but I want to move on to the issues raised about pandemic flu by the hon. Member for South Cambridgeshire—
I agree with the hon. Lady that the American political system is different from ours and the federal system does not easily translate, so not everything is applicable. What is of enormous interest, however, is the American investment in the Centre for Communicable Disease Control in Atlanta, which deals not only with epidemic and pandemic science but with animal and human infections and, indeed, zoonoses. Has the Department considered that? Could it give us some pointers to link the efforts of the Department for Environment, Food and Rural Affairs and the Department of Health to deal with communicable diseases?
I shall be coming to some of the work that we are doing internationally, especially on pandemic flu, but there is of course a read-across in terms of relationships with other research bodies. I draw the hon. Gentleman's attention to the Health Protection Agency, which does excellent work in that field.
I want to examine the work that we are doing internationally, nationally and locally on pandemic influenza. The hon. Member for South Cambridgeshire began his contribution with questions about some of the action that DEFRA was taking. I am sure that he is aware that DEFRA published a contingency plan in July, which addresses issues such as forewarning poultry farmers about the action that they need to take. Surveillance is already under way both in the UK and across Europe, and I can assure him that DEFRA is taking all necessary action. We have close co-ordination with the Department on the issues that he raised.
As my right hon. Friend the Secretary of State for Health told the House on Monday, we take seriously the issue of an influenza pandemic. As has been said, up to 25 per cent. of the population could be affected and we have to plan for at least 50,000 deaths, but it is important to stress that so far avian flu has not mutated to a form that can be transmitted from human to human.
We are all equally grateful that mutation has not taken place, but from previous pandemic experiences we know of the speed with which viruses can travel across the world and the likelihood of that can only increase. Why did it take until March 2005 to produce the plan that my hon. Friend Mr. Lansley raised with the Minister in October 2004, when there is a limitation on resources to access vaccines and antivirals?
I remind the hon. Gentleman that a plan was in place; it was introduced in 1997 and we hold regular meetings to look into its implementation. In addition, the hon. Gentleman should be aware that we have been implementing parts of the plan and were able to learn certain lessons when we updated it in March and July. Our preparations for pandemic influenza are among the best in the world. The World Health Organisation has recently said that we are one of the leading countries in the world in terms of our plans and preparations.
I am grateful to my hon. Friend Mr. Stuart for asking that question, to which he has not received a good answer. The multi-phase contingency plan, published in 1997, did not refer to the preparation of an antiviral stockpile because antivirals were not available in that form with that proven effectiveness at that time. Yes, we are ahead of many other countries, but the French, Belgians, Dutch, Australians, New Zealanders, Canadians and Americans, to a limited extent, and Germans were negotiating to purchase an antiviral stockpile before the point at which the British Government entered into a contract to purchase a stockpile of antiviral drugs. My hon. Friend asked a perfectly reasonable question. Why were we not among those at the forefront of such planning?
As the hon. Gentleman knows, we have been planning the purchase of antivirals and considering vaccine immunisation. I will come to that later in my contribution, by the end of which I hope to have illustrated and reassured the hon. Gentleman that the plans that we have in place are adequate, that they are kept under constant review and that, as I have said, they are considered to be among some of the best in the world.
We work with international partners, including the European Union and the World Health Organisation, to enhance global preparedness for an influenza pandemic and to support vaccine development. We have been at the forefront of international work on mathematical modelling and surveillance. We jointly chair the flu pandemic preparedness strand of work of the global health security action group of G7 countries. Earlier this year, we hosted an international mathematical modelling conference, which was the first of its kind on pandemic flu.
On vaccine development, we are working very closely with other countries, the WHO, the European Commission and manufacturers to ensure that a vaccine against pandemic flu can be developed as quickly as possible once, of course, a pandemic influenza strain emerges.
We are taking an active part in international discussions on avian and pandemic influenza. As part of our EU presidency, we have included the issue on the agenda for the EU Health Ministers informal meeting tomorrow. I will also attend an international meeting of Health Ministers in Ottawa next week to discuss pandemic flu preparedness.
The Minister talks eloquently about meetings, plans and thoughts. I am delighted that there is at least something on paper, no matter how late it might be or otherwise, but my constituents are utterly confused.—[Interruption.] They managed to overcome their confusion at the general election. When will the Minister tell us about a coherent plan to explain all this to the people who are very confused and afraid?
I hope that the debate will provide an opportunity for us to ensure that we explain the situation. Of course, the chief medical officer has taken action today to update the plan and to issue communications to the public and the health service about our preparedness in the UK. Let me stress again that we were one of the first countries to publish a pandemic contingency plan. The plan, which was updated in March, is being reissued today by the chief medical officer, as I have said. It provides the overall framework for an integrated UK-wide response, and it sets out what action we should, and can, take before a pandemic strikes and what we need to do when it arrives. Obviously, the plan examines how we can reduce the health consequences of a pandemic as much as possible. It also analyses the disruption that a pandemic could cause to essential services and people's daily lives. As we have said, measures such as antiviral treatment and immunisation will be the best way to address the situation when they become available. We are preparing the NHS and society as a whole as best we can.
I have been impressed by the newspaper campaign on seasonal flu, which is helpful, useful and reaches the parts that other campaigns do not reach. I take it from what the Minister said that something similar is about to follow from the chief medical officer.
Information will be circulated to GPs this week and that can be passed on to the public. I can certainly let the hon. Gentleman have a look at that—
That will include public information, too. It is important for all of us with responsibility for the matter to ensure that we get the message right so that the public understand the necessary action that must be taken.
The updated copy of the plan, which is based on new mathematical modelling, shows that a pandemic could be over more quickly than we thought, but could affect more people at its peak than was thought. It shows that the same overall number of people would be affected as was thought, albeit in a shorter time. That obviously means that the NHS must examine its local plans. The plan has also been updated to reflect our antiviral strategy. For example, there is consideration of the use of walk-in centres and pharmacists for the distribution of antivirals.
I thought that the hon. Members for South Cambridgeshire and for Newark (Patrick Mercer) were slightly disparaging about some of the research and meetings and the plans that we have been drawing up. However, they are an extremely important aspect of the work that must be done, especially on research and development, which is key to the effective preparedness for pandemic flu. The Medical Research Council— Steve Webb also asked about this matter—is actively involved in our preparations and its chief executive is going to south-east Asia shortly to determine what further research the council can do. As I said earlier, we are working closely with the Health Protection Agency on its research strategy, especially regarding surveillance procedures.
We must set out in our plans the facts about avian flu. We must make the differences between avian flu and seasonal flu absolutely clear. We need to indicate what we currently have a vaccine for and what we must develop a vaccine for in the future. For example, we need to make it absolutely clear that it is important for people to get their seasonal flu vaccinations. We need to emphasise that even more than ever. However, we have to ensure that people understand that that is not a vaccine against what avian flu might become if it mutates into a pandemic influenza. We want to reassure people that we are doing all we can to develop a vaccine if the virus mutates into a form that can be transmitted from human to human. In addition, we need to make it clear that there is no conclusive evidence that the H5N1 strain of bird flu, even though it can be passed to human beings, can be passed between them. Those are the sorts of messages that we need to get across. We also need to communicate our messages to the NHS, but we have been very effective in doing so as part of our contingency plans.
Let me emphasise how closely we have been working with researchers, regulators and manufacturers to ensure that we have a vaccine as soon as possible after we have identified the pandemic strain. We estimate that, once the strain has been identified, it will take between four and six months to start production. The hon. Member for South Cambridgeshire asked when that will happen. The chief medical officer announced today that a request for tenders will be placed tomorrow for that advance purchase of vaccine. As I said, we are one of the first countries to do that: I understand that out of potentially 180 countries, only four other countries—Australia, Italy, France and Canada—have already placed so-called sleeping contracts in the past few months. We are therefore well ahead in terms of placing our contract. That has enabled us to ensure that our order is placed for the most up-to-date vaccine—the second generation in terms of vaccine development.
I shall talk later about surgical masks and gloves and tell the House what action we are taking. I repeat: we have been praised for the plans that we have put in place. Different countries have chosen to act in different ways, but we have been praised for the fact that our plans are detailed and consider all aspects of what might happen in the event of pandemic flu.
I do not want to detain the Minister, but I am concerned. We are hearing a great deal about preparations for a human epidemic or pandemic. What we have not heard is that this is currently a veterinary problem, not a human medical problem; what the process is for preventing the disease becoming endemic in our bird population; and what symptoms people who keep back yard chickens, for example, should be looking for. That is the sort of information that some of the confused constituents of Mr. Mercer might want to hear at this moment. What should people be looking for in the bird population, whether domesticated or wild?
As I explained, the Department for Environment, Food and Rural Affairs contingency plan for avian flu was published in July and is regularly updated. It contains up-to-date biosecurity and health advice and can be found on the DEFRA website. Earlier this week, the National Farmers Union praised the action being taken by DEFRA to ensure that poultry farm workers are aware of what to look out for. I can assure him that DEFRA is working closely with the industry, which supports the Government's current assessment of the risk and the advice that is being given. I hope that that reassures him.
The hon. Member for South Cambridgeshire asked for details about the H5N1 vaccine. We are going to stockpile 2 million to 3 million doses of the H5N1 vaccine, and are about to place the order. We did not do so earlier, because we wanted to use the latest research to inform product development. A traditional vaccine for H5N1 would not create a high enough immune response in people vaccinated with it, so we used the best and most recent research to ensure that we will get the best product. As the hon. Gentleman will know, H5N1 vaccine protects against human transmission of the virus. At the moment, birds with avian flu can give it to humans but, as I have said, there is no conclusive evidence that it can be transferred from human to human. The French contract is not for H5N1—it is exactly the same as our sleeping contract, and is for whatever vaccine is required to deal with a pandemic once we know the strain that has developed if, indeed, it does. We will use the H5N1 vaccine for NHS workers only if appropriate—it may well be the case that it is not suitable for what develops from the H5N1 influenza.
This is a precautionary measure, but the JCVI said this afternoon that if the risk assessment of H5N1 coming into our poultry flock rose we would add seasonal flu vaccine to the existing recommendation on Tamiflu treatment. If a poultry worker became ill we would treat them with Tamiflu, and we would give other people who were not ill but exposed to the virus prophylactic treatment with Tamiflu. Vaccination for seasonal flu would be given at the same time to stop anyone getting the seasonal flu virus. If they had that virus and the avian flu virus there would be a risk of recombination and an extremely dangerous human-to-human infection. We shall therefore use that combination of two treatments for affected poultry workers.
If the risk assessment suggests that that is the right action it is a very good protective measure for poultry workers. Clearly, there will come a point— I accept that it may not be now—where the evidence suggests that there is a risk of a genetic shift so that the virus that is transmissible between humans bears a close relationship to the H5N1 virus. In that case, the vaccine that has been developed using reverse genetic engineering may be effective. Presumably, that is when the Government would say that they would use the vaccine for NHS workers, for example. If that looks like it might be effective, is there not a prima facie case for population vaccination, rather than just NHS vaccination? I am asking that that be considered, and that we be informed as soon as possible if the evidence points in that direction. We need to know whether that is likely to happen. We would have to wait about five months for the minutes of the JCVI to find out what was discussed and agreed.
If it became obvious that the H5N1 vaccine was appropriate for a mutation that had occurred and could be transmitted between humans, we would ensure that our sleeping contract delivered the vaccine for the whole population. At present, however, there is little point in our ordering 120 million doses of a vaccine that we are not sure would work in those circumstances. We have ordered 2 million to 3 million doses so that we have that ready in case it works. That is precautionary. It would not be wise for us to order 120 million doses at this stage without knowing whether it worked.
We have set in train our ability to order as soon as we can. If we know the strain, we can order the vaccine that is needed. In advance of that, antiviral drugs are the most effective way of treating patients and reducing the impact of the pandemic. We spent almost £200 million to create a stockpile of 14.6 million treatment courses of antivirals. That will be enough to treat the 25 per cent. of the population who may become ill with pandemic flu. As the hon. Gentleman said, the stockpile will be complete by September 2006. We have 2.5 million treatment courses available at present.
The hon. Gentleman asked about our strategy for antivirals. We would use antivirals for treatment of those who become ill with pandemic flu. As I said, they are not generally intended for prophylactic use. The stockpile is intended to be large enough to treat all those who become ill, based on the estimates that we have received from experts. The question who should receive priority ought not to arise.
Of course we are aware that there is a risk—currently a very small risk, we believe—that the pandemic might strike before the stockpile is complete. In those circumstance, we would prioritise the treatment of front-line health care workers and then those in at-risk groups. I can assure the hon. Gentleman that we have not completely ruled out the use of antivirals for prophylaxis—for example, we would keep under review the need to protect poultry workers where there is an outbreak of avian flu among birds, or to protect the close contacts of someone arriving in this country with symptoms of avian flu.
Comparisons have sometimes been made with France's Tamiflu order. As the hon. Gentleman said, it is exactly the same as ours. It will not be complete until the end of the year. It has been ordered in powdered form, which means that it then has to be turned into capsules, whereas we have taken the decision to order it in capsules so that it can be distributed quickly, as soon as it is needed. We have taken what we believe is the simplest course in that respect. Roche, the manufacturers of Tamiflu, announced on Tuesday that the United States Food and Drug Administration had granted approval for an additional manufacturing site in the US for the supply of Tamiflu. The company recognises the need to expand production and is prepared to discuss all available options for doing so.
It has been suggested that we should also be stockpiling the other antiviral drug that is available, Relenza, but the issue is not quite as straightforward as it might seem. Relenza is given by inhalation and is licensed only for those aged 13 and over. It also needs to be used with great caution by people with asthma, and there is also some evidence that elderly people might find an inhaler difficult to use. However, we will continue to review our policy if new evidence emerges.
The challenges facing the health and social care system would undoubtedly be on an unprecedented scale and would be felt across all sectors. The hon. Gentleman asked about critical care capacity, and we are very much aware of the paper prepared by Professor Menon and have set up a group chaired by the deputy chief medical officer to look at the very issues that he raised. We have invited David Menon and other experts on to the group and we will keep that issue under constant review.
I should be grateful if the Minister could clear up one matter that has caused some confusion. In the publication "Pandemic Flu" on page 122 there is talk of the use of prophylaxis for key workers, yet on page 150 it specifically excludes the use of prophylaxis for NHS workers as part of the Department's purchasing plans, so there is some confusion there. It would seem sensible to make provision for prophylaxis for NHS workers if for no other reason than to give them confidence, because I suspect that sickness absence might be significant in the event of an outbreak.
As I have said, we want 14.6 million courses available for treatment if necessary, but we will keep our policy under review. If we need to make decisions on priorities because it is not all available at the same time, we will consider that.
The hon. Member for South Cambridgeshire also asked about medical equipment such as gloves and masks for health workers, and we have taken action in that regard and have agreed the requirements with the Health and Safety Executive. It was important to ensure that we ordered the right type of masks and gloves. We have had advice from the HSE, but we are also discussing the matter with health care professionals, because we need to ensure that we provide them with the most effective gloves and masks, and we want to get that right before we place an order. As soon as those discussions are complete, we will do so.
We discuss with the HSE its recommendations, but we also want to ensure, through discussions with health care professionals, that what is ordered is appropriate for their use.
I can assure hon. Members that planning for a flu pandemic is a top priority for local and regional resilience planners in the UK. Within health and social care, we are working with NHS and social care organisations to help them make plans to deal with the practical consequences of a pandemic, including increased demand for services, possible shortages and staff absences.
The operational guidance issued in May encourages close collaboration with local stakeholders to ensure that robust local plans are put in place, are regularly tested and are updated. Central Government are working closely with the organisations concerned to make sure that those plans are implemented.
If the hon. Gentleman will forgive me, I must move on because other hon. Members want to speak.
The hon. Member for South Cambridgeshire is right that good communication with the public and health professionals will be crucial both before and during a pandemic. As I have said, stories have appeared in the media about avian flu, pandemic flu and seasonal flu, and such stories sometimes cause confusion. We want to ensure that the public have clear and accurate information about a pandemic and its consequences. We have extensively tested the communications materials that will be used in the event of a pandemic with the public, and during the summer the chief medical officer alerted all doctors to guidance and advice on the Department of Health and the Health Protection Agency websites.
Next week, we will be sending packs of information, including that already available on the website, to all primary care professionals, including GPs, and the CMO will send a letter enclosing frequently asked questions and key facts to every GP to help them support patients who may have concerns about pandemic flu, and those materials are available on the Department of Health website, too. As I have said, our planning for a pandemic has been highly commended by the World Health Organisation as being at the forefront of international preparation. I assure hon. Members that we are not complacent and that we keep our plans for not only pandemic flu, but general emergency preparedness under constant review, and we will make any necessary updates on the best available evidence.
Although our debate has focused on avian flu and preparation for a possible pandemic, I join Mr. Lansley and the Minister in highlighting the superb performance of our emergency services and Transport for London in responding to the events of 7 and
I, too, want predominantly to focus on preparation for a flu pandemic, but I want briefly to comment on whether the best way to respond to emergencies is to have a dedicated Minister for homeland security. This afternoon's debate has helped to clarify the Conservative proposal. I entered the debate with an open mind, which I try not to do very often, but the Conservative proposal is paradoxical, because the Minister is supposed to be a senior Minister, but not necessarily a Cabinet Minister. The Secretary of State for Health is currently taking the lead and working with other Departments on avian flu. The proposal is to appoint a Minister junior to the Chancellor of the Duchy of Lancaster, who is not a household name: I had to ask my hon. Friend Mr. Heath who holds that post. It seems implausible that the Chancellor of the Duchy of Lancaster's junior will have enough clout in government to make things happen. Because of the rest of the text, I encourage my hon. Friends to support the Conservative motion, but I want to register the point that we are not convinced by that proposal.
I certainly think that having a Minister with overarching responsibility for these matters is a good thing. The Home Secretary is already that person in relation to preparation for a terrorist emergency. I would be surprised if the Conservatives wanted to create more Ministers and extra bureaucracy and duplication. The debate is a funny mixture—it is almost as if there were two very different things that they wanted to talk about and which they lumped together. The Minister with the expertise to respond to a pandemic would be a very different person from the person who has to prepare the country for a terrorist attack. Using the same debate to cover two different areas does not help.
We have discussed how far in advance the Government were alerted to these issues. I place on record my tribute to my hon. Friend the Member for Somerton and Frome, who had the foresight to raise them in the House in March 2003 in a debate called, "Viral Pandemics". As long as two and a half years ago, he challenged the Government on their state of preparedness for them. The then Health Minister, Mr. Lammy, said:
"The UK was one of the first countries to publish a national pandemic influenza contingency plan in 1997"— under the previous Government. He went on:
"it is important that plans are kept up to date and the plan is now being updated". —[Hansard, 26 March 2003; Vol. 402, c. 137WH.]
If it was being updated in March 2003 when my hon. Friend drew attention to the issue, why did it take until March 2005 to produce it? The Government have taken too long to get moving on these important issues.
Several concerns have been expressed about the Government's strategy, one of which relates to the stockpiling of Tamiflu. It is obviously, as far as we know, the best game in town, but there are worries about its effectiveness. A July 2003 academic study into the clinical effectiveness of oral oseltamivir, which is the same thing as Tamiflu, says:
"One systematic review found that oseltamivir reduces the duration of symptoms by up to 1 day but one subsequent RCT"— randomised control trial—
"found a smaller difference between oseltamivir and placebo. Two RCTs found that oseltamivir increased nausea and vomiting compared with the placebo."
Although that was a couple of years ago, how reassured are the Government that Tamiflu is effective?
A report in the journal Nature refers to a Vietnamese patient who has a form of bird flu virus that has become partially resistant to Tamiflu. The report suggests that it
"may not be effective enough if an outbreak does happen."
I understand that, if there were an alternative, the Government would be buying it instead of Tamiflu, but how robust is their advice on its effectiveness? Are they confident that it is effective as is hoped?
The Minister talked about the pros and cons of Relenza as an alternative antiviral. It may be unsuitable for some groups, but if there are question marks over Tamiflu should not the Government be looking at other antivirals as part of the strategy? For example, should not we be stockpiling them for groups for whom using an inhaler is not a problem?
The Government say that it will be another year before they reach their target of covering a quarter of the population. What are they doing to work with Roche and other providers to increase supplies more rapidly? Roche has said:
"we are prepared to discuss all available options, including granting sub-licences, with any government or private company who approach us to manufacture Tamiflu or collaborate with us in its manufacturing."
I appreciate that the Minister said that another manufacturing plant was being opened in the United States, and that is welcome, but what are the British Government doing to talk to Roche about the possibility of sub-licensing alternative manufacturers? Clearly, we all hope that we will get away with it and that nothing happens before we have our stockpiles, but should not the Government do more by working closely with the drug companies to ensure that things move more rapidly?
Let us consider the adequacy of the contingency plans. I was startled by the response of the Secretary of State for Health on Monday to my urgent question when she said:
Will the Minister who responds to the debate clarify what plans the Secretary of State was talking about? Do all health authorities and primary care trusts have pandemic flu contingency plans in place? That is not my impression and I would therefore appreciate some clarification.
I am also worried because primary care trusts have to implement the plans. At the moment, they have other things on their minds, such as being abolished, merged or restructured—[Interruption.] And, indeed, in deficit. Will the Government reconsider the plan to restructure PCTs and health authorities while anxiety about a possible pandemic is gearing up and we are asking them to be thoroughly prepared to put emergency measures in place? Are organisations that are undergoing huge turbulence and upheaval best placed to do that? Is not it more important that the emergency plans are in place than that the Government's restructuring is effected? Should not the restructuring be put on ice?
My hon. Friend the Member for Somerton and Frome asked the Minister about measures to prevent veterinary spread. In other words, if there are outbreaks of bird flu in, unsurprisingly, the bird population, what will be done not so much with large-scale poultry farmers—the Minister's response was all about the National Farmers Union and the industry—but about people with a few chickens in the back garden? The disease could be spread just as easily through them. I am not talking about poultry workers, who may be well organised and briefed, but individuals whose actions or inaction could lead to the spread of the disease. I do not imagine that someone with half a dozen chickens in the back yard regularly checks the DEFRA website for guidance. What are the Government doing about proactively ensuring that people who keep poultry use the best possible animal husbandry methods and are aware of what they should do if they detect symptoms and, indeed, that they know what the symptoms are? That could apply to large numbers of people. What is being done to ensure that they have the best available advice?
"The preparedness of the world depends not so much on who is strong, but on who is weak."
I would be delighted if the Government could tell us that we have not only one of the best plans but the best in the world. If it is true, that is great but we are vulnerable if we are not doing everything we can to ensure that the places where a human outbreak might start are also as well prepared as possible.
Although the Minister said that scientific experts are travelling around—I think she said that they are examining research into vaccines—what are the Government doing to ensure that poor countries that perhaps cannot afford stockpiles of antivirals or all the necessary vaccines, get support from our Government and others to put them in the best possible position to contain an outbreak, thus protecting both ourselves and the citizens of those poor countries? Clearly, we have a self-interest as well as a humanitarian interest in ensuring that that is done. Although some of the manufacturers of antivirals and vaccines have pledged to make limited supplies available cheaply, if not for nothing, to some of those countries, what part are the Government playing in ensuring that that happens?
I raised the matter on Monday in an urgent question and we received an initial response from the Government. Today, the Minister tried to respond thoroughly to several issues that the Opposition raised in their motion. However, when the chief medical officer refers to 50,000 deaths, it is not well understood that that estimate is based on 14 million people getting the symptoms of a flu pandemic. We can remember what happened when people believed that they would run out of petrol. The country almost ground to a halt because everyone panicked, people rushed out and that caused problems for the distribution network.
I want the House to imagine the build-up to 14 million people—over a long period, admittedly, but the Minister said that the peak could occur sooner than we think—having the symptoms of a disease that is killing people. There will be stories on television night after night of thousands of people dying and being buried. If someone in my family got those symptoms and we then discovered that there were not enough antivirals and that my child or my brother would not have access to them, I cannot begin to imagine how different the scenario would be from the calm, measured ones that we might sit and plan in Whitehall or Westminster.
I do not want to be alarmist—this has not been an alarmist debate—but I would like to seek reassurance from the Minister that contingency planning is based not on the response of calm, rational, reasoned individuals but on irrationality, and on people panicking and being desperate. How would everything work if that scenario were meshed with a situation in which large numbers of people were off sick and the transport infrastructure was not working? Can the Government reassure us that they have built into their planning scenario that kind of world, rather than one in which people have a measured and rational response to the crisis, because I fear that that is not what we would get?
Order. There is not much time left and, as no time limit was placed on Back-Bench speeches, I hope that hon. Members will self-regulate. There are still about six hon. Members seeking to speak in the debate.
We have been throwing brickbats at the Government—some of which are perhaps deserved—but I wonder how good we, as a Parliament, are at dealing with civil contingencies. The answer is that we are very bad at it. We have Select Committees that inquire into their own Departments, but that misses the point. The issues of contingency planning, emergency planning and resilience cannot be resolved by one Select Committee monitoring one Department.
What has come out of the events of the past few years is that the Government's response needs to cut across all Departments, horizontally and vertically, and across regional and local government, the emergency services, the private sector and those who look after our critical national infrastructure, which is mostly privatised. Is our Select Committee system remotely fit to monitor that range of inter-departmentalism? No, it is not. We excel at stove-piping better than the most stove-piped industry or Government Department in the country.
There have been limited examples of inter-departmentalism in Parliament, involving collaboration between Select Committees. I have to say that most of that work involved the Defence Committee. There were collaborations between the Defence and Foreign Affairs Committees, and the Defence and Trade and Industry Committees. The Defence Committee also played a major role in setting up the quadripartite Committee. We sought to break away—I should not say "we", because I am no longer a member of the Defence Committee—from that very limited approach to the role of the Select Committee. There are other mechanisms that can be used. We have the Liaison Committee, and there was a Joint Committee on the Bill that became the Civil Contingencies Act 2004. Perhaps that is a model with which we can proceed.
After 9/11, I called together the Chairmen of a number of Select Committees and suggested that as we were all going to be involved in examining the consequences of those events, we should establish some ground rules so that we did not each ask the same people to appear before each Committee, as the US Congress does, and ask them all the same questions. I suggested that we collaborate. The response was zero. For one reason or another—decent reasons, no doubt—my colleagues were not prepared to collaborate.
What did the Defence Committee do? We did it ourselves: we walked over all the Government Departments. An expurgated version of what one Minister is alleged to have said to us is, "What the devil is the Defence Committee doing walking all over my Department?" That was a classic example of stove-piping. Yet the result was the best report that the Defence Committee has ever produced, because we considered the issue across a broad base. I suggest that we, as parliamentarians, start to put pressure on our colleagues to consider an alternative model for the way in which we and those up the Corridor—like it or not, the House of Lords is also part of the parliamentary process—scrutinise the decision-making process, so that we can do it more effectively. If we were to ask the Library how many questions had been asked about the civil contingencies secretariat over the past three years, we would be given the answer, "Hardly any." It is okay having a good rant on an occasion such as this, but what are we doing seriously to scrutinise and influence the decision-making process?
Does the right hon. Gentleman agree that a ministerial post could offer the opportunity to bring that together and should not be dismissed out of hand?
That was going to be about my 11th point until I was instructed to make a short speech.
The Defence Committee's superb report, "Defence and Security in the UK", which, of course, everyone will have read, considered the matter. The then Home Secretary was not ecstatic about our proposals, because he thought that we were attacking him, which we were not. We did not want a director of homeland security—a Tom Ridge-type character—and events have shown that the American model is not very appropriate for the United States, let alone the United Kingdom. Any Home Secretary is overburdened with a range of activities, one of which is contingency planning and counter-terrorism. The Defence Committee proposed that there should be a very senior Minister because, as has been pointed out forcefully, someone who operates in Cabinet as an observer at Minister of State level in the hierarchy will just be used as an office boy. Therefore, it would be a good idea to have someone devoted to cutting across this whole range of activity as it is more than a full-time job. That idea is not getting very far, however.
I am sorry to keep on about the Defence Committee, but the report was excellent. At the time that we produced the report, the civil contingencies secretariat had been established—it was established before 9/11, and therefore had an opportunity to flex its muscles. The report stated:
"It is a matter of regret that the CCS was not able to respond more positively and energetically to the events of
Two and a half years have passed since then, but one suspects that the problem of departmentalism has not yet been resolved.
I am not totally convinced about the lead Department concept, for a number of reasons. One might be a very good permanent secretary and able to operate one's Department pretty well in the normal crises that might unfold in the course of a working day, week, month or year. But we are now talking about leading the Department's response to a humdinger of a massive terrorist attack—not one or two on the Richter scale but 10—that has gone through the military and intelligence system just like the first attack in July this year. One wonders whether all Departments have done what the Ministry of Defence has done, which is to train a core of people who will head that response on behalf of the Ministry of Defence—professionals who are trained and have the psychological make-up to deal with such a crisis, who have attended relevant courses and spent a great deal of time eliciting information. I hope that all Departments are prepared to do that. Criticism of the permanent secretary by me and Members of Parliament is not something that Departments like, but the idea should be considered.
It is not a failure of this Government that causes me anxiety but of government in general: has anybody seen an organisational chart of central Government Departments, regional and local government, the health service, the intelligence services and the private sector, showing who is involved in the process of trying to pick up the pieces should there be an attack? In my experience, it is sometimes difficult for the Ministry of Defence to talk to the Ministry of Defence. What we have here is almost the entire spectrum of Government, and government in society, all of it heaped together in a labyrinth of decision making and input. Have we reached the point at which we can say that each component is trained for the task and prepared to respond? Is there the necessary glue and are there the necessary mechanisms for co-ordination? Is the decision-making process adequate?
We can learn much from our own exercises, our own mistakes and other people's mistakes, of which there are many. I understand why a small country, or a poor country such as Pakistan, cannot respond effectively. It is more reprehensible for the largest country in the world to fail so miserably. Why has that happened? The reason may be cronyism. Perhaps those who reached the top positions were appointed for their party political loyalties rather than their expertise. Perhaps the federal system, deliberately constructed more than 200 years ago, is to blame. The country should have stuck with the United Kingdom if it wanted an example of centralised decision making. The process of fragmented decision making was created with the intention of rendering decision making almost impossible, and that is what has happened.
My main criticism of the process is that, despite the experience we have gained, we cannot be entirely certain that, for all its exercises and expertise, Cobra—the Cabinet Office briefing room—has been fine-tuned to deal with all crises. Too much responsibility is heaped on the police because they are so professional. Is the gold-silver-bronze system working to the desired extent? That may not be the case.
It feels rude to interrupt the right hon. Gentleman's flow, but he has not mentioned the general public. In Windsor, we have a castle and a military presence, so there are some fairly clear targets. It seems to me that, among 60,000 or 70,000 people, there are many eyes and ears that could help to prevent threats of terrorism and other dangers. Is that part of his thinking?
It is point eight, which I shall now push up the hierarchy.
I do not think that the Government have properly activated the private sector, which is now central to our economy and contains a great deal of expertise. A good deal of responsibility has been bestowed on those in the private sector because, should the balloon go up, not many military and police personnel will be available and they will have to defend their own premises. I wonder whether businesses and others in the sector have been told, "You must be clued up. You must have contingency plans. You must know what resilience is. You must know what to do if there is a direct hit on your premises."
If a concern in Canary Wharf, the City of London or the financial services sector elsewhere is out of business for half a day, it is dead. Are companies prepared to spend enough to develop in-house expertise and enable shareholders and employees to feel confident that, in the event of a disaster, the safety of personnel will be secured as far as possible and they will be able to repair to other parts of the country where there will be office accommodation, computers and staff who do not work in the central office, so that the organisation can soon be up and running?
We should consider how many of the companies that were based in the twin towers folded. How many of the companies that were destroyed by the IRA bomb in Manchester exist now? Some business men think, "My insurance will take care of it." It will not. Some think, "No one will attack my company", but someone might be prepared to attack a company 2 miles away, and others could be hit and destroyed in the process. The private sector must take its role more seriously and have the necessary resilience and contingency planning. About half of it does not.
I am the titular head of a number of private security organisations, although I have no financial interest whatsoever. I remember that, after 9/11, the private sector, which I had been challenging for a number of years on regulation, offered to provide the police with 2,000 personnel who would be available within four hours to assist them in responding to a direct and catastrophic attack. What has happened to that proposal? Nothing. The security industry could respond quicker than the Army or the Territorial Army, which may or may not be around when such an incident occurs. Even if they are around, they might not be able to muster very quickly.
There have been a lot of positive developments. The Civil Contingencies Committee and the civil contingencies secretariat have had an influx of very good people, and much has happened to show that we are capable of responding to an attack at a certain level. But the Government need to show great—I will not say greater—professionalism in dealing with these issues. The structures must be good not only on paper; we must be capable of deploying against a whole range of threats, be it terrorism or natural or other disasters. Such events have overtaken others and could overtake us.
I hope that the regional and local structures that the new legislation provides will enable a suitable response to such threats and that a debate such as this will help our parliamentary colleagues to take more of an interest in emergency planning. Perhaps the Joint Committee provides a model for the setting up of a new committee, but in saying that, I should point out that I am not offering my services in this regard, even though I am semi-unemployed. Why let the emergency planning process in British government get away with not being scrutinised seriously? If those concerned are smart enough, they will know that it would be to their advantage to have interested, qualified and knowledgeable Members of Parliament sitting on a cross-cutting committee. Such a committee could focus attention on this issue and put questions and elicit answers regularly, rather than sporadically.
One thing is certain: be it tomorrow, next week, next month or next year, an attack will take place somewhere in this country that will make July's events in London seem like a minor preparation. If I were in government, I would not like to be hauled in before the major commission of inquiry, which would inevitably take place following such an attack, and have to answer the question, "Well, Minister"—by then it might well be ex-Minister—"Where were you during this country's preparations for dealing with a catastrophic attack?". I suspect that most would be absolutely clean in this regard, but a nagging doubt might arise in the mind of any Minister or civil servant. They will ask themselves, "Have we done enough? Have we provided enough resources? Do we have resilience in government? Are we prepared not just for low-level attacks, but for the serious attack that no country can respond to absolutely effectively?".
This debate is about more than simply chickens. That said, I point out that I was in Romania three weeks ago and tucked in heartily to a range of birds and animals, so watch this space—or ostracise me in the canteen. More seriously, I hope that semi-permanent parliamentary scrutiny will enable better decision making and preparation, and enable us to give advice and to react to such events. There should be no party politics in this, just consideration of the health and welfare of our constituents and all the people of this country.
The chief medical officer warned earlier this week that at least 50,000 people can be expected to die in this country if the flu virus mutates into one that can be transferred from human to human. We thus face two distinct threats: that of avian flu and that of a pandemic flu outbreak. The threat from a mutated avian flu is serious and material to all of us and our families. At least 57 people have died in the far east from direct contact with birds, but the 50,000 figure for this country could be a conservative estimate if a pandemic takes hold.
That is why it is so important that we and the wider British public are able to trust the authorities when they give guidance for public safety. Experts believe that the H5N1 strain could be as devastating as the strain of flu that went round the world after the first world war, killing literally millions. Yet when I talk to constituents, I find little trust in the Government or their spokespeople, however eminent. It seems that the culture of spin, misinformation, untruths and gibberish, by which we have been governed in the last eight years, has done more than undermine the reputation of this Parliament and a once proud political party opposite.
The fact that a Minister can mislead a Select Committee, but remain a welcome member of the new Labour project, undermines public trust. The fact that thousands of animals could be slaughtered and billions of pounds of public money spent on foot and mouth without a public inquiry undermines public trust. The fact that terrorist horror is seen as a good opportunity to bury bad news undermines public trust. The fact that intelligence reports prior to a war were doctored by a spin doctor undermines public trust. Those things have done more than bring shame on principled Labour Members and more than weaken our civil service's independence, for they undermine the whole relationship between the Government and the people.
I ask Ministers to pledge today to be open and honest about the avian flu risk and the Government's preparations to deal with it. I ask them to resist the desire to have eye-catching initiatives and to work in partnership across the House and with those outside it to minimise any potential public risk. Any hint of cover-up, any refusal to accept that mistakes may have been made, will increase the likelihood that vital advice will be ignored or distrusted. It would be a calamity if the words of the excellent chief medical officer were set aside because the public saw him in the same light as the Chancellor sees the Prime Minister—as in the phrase, "You can't believe a word he says".
More than 1,000 jobs have been created in and around my constituency of Beverley and Holderness by the push towards free-range egg production. There are also a number of non-free-range egg producers. The poultry industry is of great importance to my constituents, who have a number of questions that they would like the Government to answer.
First, my constituents want to know whether their jobs are safe and whether free range is a passing fad or has continued Government support. They want to know how long the Government believe free-range birds might need to be kept indoors when the avian flu virus reaches northern Europe. I believe that European rules say that free-range birds may be brought inside "temporarily" so that their free-range status and added value will not be affected, but what length of time does that allow? My constituency is on the east coast—on the front line of infection from migratory birds. Will birds in some areas be ordered to be kept inside before others? Is the east coast a priority area?
My constituents also want to know that all preventive measures have been taken—not just at home, but, as Steve Webb mentioned earlier and perhaps more importantly, in currently affected countries. It would be a disaster if we allowed a pandemic to develop elsewhere, when it could have been stamped out at source. We would be fools if we stockpiled drugs here, when they were needed more urgently elsewhere to help reduce the risk of a pandemic reaching us at all.
So what steps are the Government taking to help affected countries prepare for and counter an epidemic threat? Let us hope that their actions are more concrete than 12 months of discussion about face masks. What offers have we made to the World Health Organisation to supply staff or other resources to help countries that lack epidemiological and laboratory capacity to respond to any emerging disease? Have we responded to WHO requests to establish local laboratory capacity in affected countries that lack such capacity? How have the British Government responded to a call by WHO for a meeting between the heads of state of industrialised countries and of risk-prone countries to reach agreement on the most desirable support?
Following the statement by the Secretary of State for Environment, Food and Rural Affairs earlier this week that imports of poultry are banned from all countries affected by the flu virus, can the Minister tell us which countries have recently been added to that list and when those orders became or will become effective? The last pandemic was in 1968. Since then, global movement of goods and people has grown exponentially. We cannot afford to build a bunker and hope that it protects us. At home, the Government must prepare and be open and transparent. We must also take a leading role in co-ordinating an international response and ensuring that poorer countries are helped, for reasons of both equity and, ultimately, efficacy on behalf of the British people.
Much has been written and said in the past week about pandemics and influenza, and some of the reporting has bordered on the alarmist. It is therefore appropriate that we should discuss the issues in a more measured way here—and, incidentally, without making cheap political points.
As the amendment states, our NHS organisations have well-established, comprehensive plans in place for dealing with pandemic influenza. The prime objectives in dealing with influenza pandemics are to save lives; to reduce the health impact of the pandemic; and to minimise the disruption to health and other services, while maintaining business continuity. Given that the vaccine may not be available to all in the first wave of the pandemic, clear and transparent policies are needed for prioritising vaccine use, as and when it becomes available. I wish to refer to one aspect of that prioritisation, in terms of building on the principles established for dealing with seasonal flu.
The overall uptake of vaccination against seasonal flu has improved, and in recent years more than 70 per cent. of those aged 65 or over have been vaccinated. Variations occur by area, but the two primary care trusts serving my constituency achieved a 70 per cent. and a 72 per cent. uptake, so we are on target. This year, the influenza immunisation programme has been extended to include two further groups: people with chronic liver disease and the main carers of elderly or disabled persons, whose welfare may be at risk if their carer falls ill.
I congratulate the Government on recognising the need to include carers. For some years now, carers' organisations have campaigned for health measures such as free flu jabs to be targeted at carers. Many organisations have also employed primary care workers to work with GPs and primary health care teams to identify and support carers in their practice populations. Many of those primary care projects have been in existence for years and have had successful programmes prioritising flu jabs for carers. In places such as Leeds, Milton Keynes, Bristol and Salford, the primary care trust carers projects have ensured that all carers can be offered free flu vaccination by their GPs. The benefit of such work is that it not only protects the carer from flu, but supports their caring role by helping them to safeguard their health.
Although there are 5.2 million carers, only some 20 per cent. care at the heavier end of commitment of more than 50 hours a week. In a GP practice population of 2,000, there are likely to be 200 carers, only 40 of whom will be caring at the heavier end. Put that way, the numbers of additional flu vaccinations look manageable for GPs and their staff. I therefore hope that the Government will consider the idea of extending flu vaccination not only to those who care for an elderly or disabled person, but to all heavily committed carers.
It is increasingly understood that caring has an impact on the carer's own health, so it is right to treat carers as a vulnerable and at-risk group. Increasingly, too, carers at the heavier end of commitment are seen as partners in providing health care. NHS employers are directed to offer influenza immunisation to employees directly involved in patient care, and that practice extends to staff in nursing and care homes. In cities such as Leeds, Milton Keynes, Bristol and Salford, primary care trusts have offered vaccination to all carers, so I hope that my hon. Friend the Minister of State, Department of Health, can look into extending influenza immunisation to all groups of carers in subsequent winter seasons.
The principle implemented this year, of recognising carers as partners in health care who need to be protected by vaccination, is important. I hope that it will continue and be extended to all carers in future years, as well as providing a basis for their inclusion in the priorities for vaccination in the unlikely event of an influenza pandemic.
Emergency preparedness is a central test of the effectiveness of Government. Just as we judge a hospital not only on how well it deals with chronic conditions but on how its accident and emergency facilities perform, so when assessing the performance of a Government it is not the standard, day by day, week by week administration, but how they rise to the great challenges that they face that enables us to judge how capable Ministers are.
Unfortunately, as Mr. George, who is no longer in the Chamber, hinted, the Government have not always risen as effectively to the challenges as they might have done. I was grateful to the right hon. Gentleman for pointing out that there is a strong case, which has been put by our Front-Bench team, for the appointment of a central co-ordinating figure to provide leadership and administrative grip at moments of crisis. That was the recommendation of the Select Committee that the right hon. Gentleman chaired and a position that my party has championed. I hope that there can still be an opportunity for a rethink when the Minister for Policing, Security and Community Safety sums up the debate.
When we consider the crises that the Government have faced, inevitably, like the curate presented with the egg, we have to say that they have been good in parts. Let us consider the fuel protest. By the Government's admission, we were only hours away from anarchy. As Steve Webb pointed out earlier, imagine what would happen if they had that level of administrative grip in the face of a pandemic that could affect 14 million people.
We should also remember the foot and mouth disaster, to which my hon. Friend Mr. Stuart referred. Not only was the general election delayed, but panic gripped parts of the country. Parts of our nation had to be closed down. The Army had to be brought in, and there was friction between the civil and military powers about how to deal with the crisis. Those were test cases of emergencies where the Government failed to provide the administrative grip that a Minister for homeland security could supply.
One of the features that characterised the Government's response to both crises was recognition that the public required reassurance. Unfortunately, the reassurance the Government tried to provide was through communication rather than action. As my hon. Friend said, on both occasions the Government tried to spin their way out of trouble by reassuring people that things would be all right; they were telling, not showing. The only effective reassurance at times of crisis is tough action to resolve the problems, not a Minister appearing on television attempting to calm us down when the evidence on the streets is of a crisis spiralling out of control.
Emergency preparedness in the context of our debate covers the risk of both a flu pandemic and a terrorist attack. My colleagues put a number of pertinent questions about a flu pandemic that have not yet been satisfactorily answered. We have no real idea whether we have the extra bed capacity to deal with the scale of pandemic envisaged by the chief medical officer. We have no real explanation of the Government's delay in stockpiling vaccine. We have been told that they are waiting for best evidence, but who is to say that medical evidence will not change in the future, just as the virus itself might mutate.
It seems as though what we have heard is an excuse for procrastination, rather than a justification for wise administrative action. As my hon. Friend David T.C. Davies pointed out, the same applies with the provision of simple matériel, such as face masks and gloves. Other countries, such as Australia, have had the opportunity to acquire such matériel, as he said. We were producing it on our own doorstep, and we failed. Those are all pertinent questions that have not been effectively addressed by the Minister or her colleagues.
Let me deal briefly with terrorism. In the motion, we congratulate the emergency services on their superb work on
The Government are very keen to trumpet the legislative changes that they wish to make to deal with the terrorist threat, but we also know that operational behaviour counts, and that is the Government's Achilles heel. Consider the scenes at Heathrow, when we knew that there was a real threat—I do not doubt for a moment that there was one—and tanks and other armoured vehicles were mobilised. What signal did that send? The Secretary of State for Work and Pensions, Mr. Blunkett, acknowledges that that was a mistake. Why was that mistake allowed to happen on his watch? What lessons will the right hon. Lady tell us have been learned from that episode?
Another area where profound operational questions have been asked is in the shooting of Mr. Jean Charles de Menezes. I know that that case is being reviewed and that it has been hijacked by extremist elements on the left who wish to undermine—
I appreciate your point, Mr. Deputy Speaker.
I have in mind the broader question of when lethal force should be used by agents of the state. I am no lily-livered liberal on this matter—I recognise that lethal force was used to great effect in Northern Ireland, not least in Loughgall—but we need sophisticated rules and good intelligence when it comes to the use of lethal force. Rules of engagement need to be debated in public. We had clear rules of engagement—a red card and a yellow card system operated in Northern Ireland—and when we were operating in very difficult conditions in Bosnia, we also had clearly laid-out rules of engagement that were influenced by moral and operational factors. We need to have that debate in public; we do not want such decisions to be left either to the Metropolitan police or to Ministers alone.
My hon. Friend makes an excellent point. We naturally recognise that the Metropolitan Police Commissioner has heavy responsibilities on his shoulders, but we need to recognise that lethal force may well be used in dealing with the terrorist threat and that its use must be subject to open debate in the House. The taking of life, even in the defence of innocents, is a momentous task to devolve on to any public servant, and we must ensure that we have proper debate about how such force is used.
We need not only proper debate about the rules of engagement, but a proper recognition of the role that intelligence can play. It would be otiose for me to mention some of the issues on which intelligence services and their decisions have been questioned in the House over the past few years. Suffice it for me to say that both MI5 and MI6—the intelligence and counter-intelligence services—are underfunded by the Government. Ever since the 1990s, not only has counter-subversion activity been wound down, but the co-ordination of the work of MI5 and MI6 has been less than effectively prosecuted.
We need to ensure not only that there is proper funding and staffing for counter-subversion, but that MI5 and MI6 talk to each other effectively. We must recognise that many subversive elements in this country will have received training and funding from abroad, often from regimes that the Government have unfortunately coddled or been insufficiently robust towards. We must be aware of those links when we debate not only funding, but the operational guidance that we give to our intelligence and security services.
Ultimately, the best preparation for any emergency is action to avert it from taking place. The most effective action that we can take is to assure those who act in our name that they have the resources that they need, clear rules by which they operate and a guarantee that when their actions are scrutinised in the House and elsewhere, there will be no shuffling off of responsibility and no spin, but honesty, authority and grip.
I congratulate the Minister of State, Department of Health, my hon. Friend Ms Winterton, on her clear exposition of the issues surrounding the avian flu pandemic that faces us. However, it is peculiar that although the debate is entitled "Emergency Preparedness", the Opposition have focused almost exclusively on health matters. It was quite heartening to hear Michael Gove at least touch on other matters. It was a peculiar choice of title for the debate given that the Opposition really wanted to discuss health.
Steve Webb made an interesting speech and his academic thoughtfulness was welcome. I only wish that he would listen to his own arguments, vote with the Government and have the courage of his convictions to persuade his colleagues to follow suit.
I examined London's emergency preparedness when I was a member of another place—the London assembly. The assembly conducted full scrutiny of the various organisations involved in dealing with London's security. I assure my right hon. Friend Mr. George that the 25 elected members of the assembly had robust discussions about the matter, albeit inevitably in private, and that all the recommendations that we made were taken on board and came into full effect on
Among the recommendations was the suggestion that the London Mayor should have a clear role in communicating with Londoners. He was heavily involved in the discussions and emergency preparedness for London. We recommended that communication with Londoners should be better—several hon. Members have mentioned that point—and that links with local government should be made clearer. We suggested that the gold command should include someone from local government because we realised that many needs in any emergency would be provided for by London's local government.
I hope that I can be forgiven for talking about my constituency for a moment. The Mayor recently launched the "Spirit of London" bus. It is a special bus in Hackney because it is usually used on the No. 30 bus route. Of course many of us remember that it was the No. 30 bus that was blown up on
I put on record my personal congratulations to the local borough police command in Hackney and especially the borough commander, Simon Pountain. He and his team have done an excellent job developing community relations in Hackney and have been praised by the excellent inter-faith forum in Hackney. The forum brings together rabbis, imams and priests to work together on community relations and they universally respect Simon Pountain. His officers were busy building community relations after the bombs of
Despite today's erudite debate, I am not exactly sure how a homeland security Minister would have helped Hackney or London on
The hon. Lady should compare how the London Mayor dealt with the events of
No, I do not agree—in fact, the hon. Gentleman has caught himself out. We have an excellent Labour Mayor of London and an excellent Labour Prime Minister, and the latter would be the person responsible for taking a lead in any national event, as he did on
I have no particular local perspective on avian flu. Not many people keep chickens in Hackney, South and Shoreditch—although I recommend to the House Hoxton Manor honey, which is delicious and is made by bees who live in Hoxton—but the debate has encouraged me to visit the local city farm.
To end on a serious note, we should not be making party political jibes about emergency preparedness, which is a serious issue facing the country. I am heartened to know that the work of Ministers is thorough and good. We cannot say that a single overarching Minister—certainly not one junior to the Cabinet—would be the right person to co-ordinate the response to a range of events. We have the Secretary of State for Health taking the lead on avian flu, and the Home Secretary and the Prime Minister took the lead on
I am delighted to begin by echoing the praise of our emergency services and of the many unsung heroes—the people who continue to go to work in the face of disasters, natural and otherwise. Like Meg Hillier, I have first-hand experience of natural disasters in my capacity as a Member of the Welsh Assembly. In my experience, the devolved bodies did not make such a good job of responding as she implied the Greater London assembly did. In the past few years, we in Wales have faced two major problems: foot and mouth and severe localised flooding in the town of Monmouth.
The response to foot and mouth was an absolute disaster—that is the nicest thing that I could say about it. I saw at first hand the problems we had getting people in to deal with culling. In some areas, carcases piled up. There appeared to be no clear lines of accountability—no one seemed to know who was in charge, even the people who were supposedly running the show. Monmouthshire is on the Welsh side of the border with England, so technically the Welsh Assembly was in overall charge, but an office of the Ministry of Agriculture, Fisheries and Food in Worcester was running things; yet on one occasion when we rang the Worcester office to talk to the people who were dealing with the problems, they did not seem to know what the Welsh Assembly was. That was totally unacceptable.
In the case of the flooding, nothing could have been done to prevent it, but every effort was made to alleviate the problems that people experienced. I give particular credit to the meals on wheels service operated by Monmouthshire county council, which risked life and limb to ensure that hot meals and drinks were delivered to people. We have no complaint about the way in which the situation was dealt with, but in the years since people have continued to face the problem of flooding because no one can cut through the thicket of bureaucratic regulations that have to be overcome to put in place a decent flood defence scheme. It is therefore important to make the case for a Minister for homeland security who can take overall charge of dealing with those problems.
We now face threats more serious than flooding or foot and mouth in the form of terrorism and avian flu. No one could say that the Government have failed to be proactive in talking about terrorism, but sometimes they have talked it up to try to gain more draconian powers for themselves. I draw Members' attention to a headline a few years ago that appeared in the Daily Mail. [Hon. Members: "It must be true".] I rather think that it was not. On
In the minds of many, the story is an utter fabrication given to a right-wing tabloid just hours before the Queen's Speech announced all sorts of controversial powers for the Government. That is why people do not have any confidence or trust in them when they talk about terrorism. They have told us what they are going to do about avian flu, yet we are well behind other countries. The Government say that they are going to reach their targets, but the target for vaccination courses in the United Kingdom is about 25 per cent. as opposed to 30 per cent. in France and the Netherlands and 50 per cent. in Italy. The Minister could not answer my question about masks and gloves. The Australians have purchased those items from the UK so we can no longer purchase them ourselves. She said that the Government had to talk to the health and safety people. Presumably, the Australians, who belong to a health and safety-conscious nation, did so several months before the British could.
What we are asking for is not in the least unreasonable. We are faced with a Government who have given us quangos, taskforces and bureaucrats galore. We have an army of clipboard-wielding busybodies up and down the country setting rules for everything. All that we are asking for is one extra Minister and a skeleton staff to be taken from other Departments to try to avert a disaster. I urge Government Members to put their constituents first, think again and support our motion.
It is a pleasure to follow my hon. Friend David T.C. Davies. Many of the points that he made arose in other Members' speeches, and I shall deal with them in my summary.
I can reassure Meg Hillier that I will address issues specific to London. She may not like what she hears, but I hope that I am proved wrong. A number of hon. Members expressed shared concerns in our excellent debate which, I hope, will expose various things that the Government should do and which, with due humility, I trust the Opposition can help them to achieve. Emergency preparedness is not a party political subject. It should stand well above party politics. If there is anything that I can do in my shadow capacity, I would be extremely happy to help Ministers achieve safety for our citizens.
We heard an excellent speech from my hon. Friend Mr. Lansley, who not only pointed out the terrorist aspects, but dwelt particularly on the serious problems posed by avian flu. I do not intend to go into that in any more detail, as quite enough has been said about it already.
Steve Webb and Mr. George, as well as the hon. Member for Hackney, South and Shoreditch and my hon. Friend the Member for Monmouth, all spoke about the need for a single Minister. Well, if there is a human embodiment of that creature, I am he. I probably have the right hon. Member for Walsall, South to thank for creating the impetus behind that appointment. The suggestion that the post should be created came from a Committee on which I was privileged to sit at the time. It came from a Chairman who belongs to the Labour party and has profound socialist views, a man for whom I have profound respect. We ignore at our peril his views and those of several Committees.
The job of such a Minister, as and when he or she is created, is not to deal with events such as those at Boscastle or just with events such as those that took place in July, but to deal with events that encompass a much broader spectrum than anything we have seen. It is instructive that the Department for Homeland Security got it so badly wrong during hurricane Katrina. I have no doubt that that Department has many lessons to learn, and I hope that we can learn from it.
In addition, I hope we pick up the fact that, as my hon. Friend Michael Gove said, our reaction to terrorism and to other huge disasters that we are likely to face must not just be legislation. It is not words but deeds that count. Everything that we heard tonight was about meetings, committees, consultation and plans. What have we heard about exercises, putting those plans into practice, and delivery? We as politicians, and especially my colleagues who come from legal backgrounds, are extremely keen to stay within our comfort zones and talk about talking—nothing more and nothing less. I ask the Minister to consider the delivery of the plans, not just the theory.
Forgive me; I do not have time to give way. Perhaps in a moment.
At least we have a contingency plan for a flu pandemic. At least in Tuxford in my constituency, there has been an exercise of a sort to deal with a flu pandemic, but I am not sure that CONTEST, the strategy for counter-terrorism, is anything like as well prepared as the contingency plans for the flu pandemic. I am sure that, as my hon. Friend the Member for South Cambridgeshire said, there is plenty wrong with that, but not as wrong as the woeful lack of preparation for terrorist attacks in this country.
We have seen that a flu pandemic is probable. We have seen that there are planning assumptions of 50,000 dead. What we know about terrorism is that it is not probable—it is definite. It is unlikely to kill thousands. It is more likely to kill tens, but the insidious drip of calculated evil has an effect far beyond the vagaries of nature. Look, for instance, at how Islamist fundamentalists exploited the decades of fear that ETA had created in Spain. The appalling but bloodily modest 192 fatalities brought down a Government and fractured a coalition.
What have we done to prepare ourselves for such eventualities? The right hon. Member for Walsall, South talked about the use of the private sector. The London chamber of commerce—I am sure that the hon. Member for Hackney, South and Shoreditch will be interested to hear this—has carried out a review of terrorist attacks on businesses and come up with some interesting proposals. In reply to the question whether it was thought that another terrorist attack on London was inevitable, 83.8 per cent. said yes. When asked whether a business contingency plan had been adopted or existing plans updated in the light of the recent bombings, 25 per cent. said yes, 74 per cent. said no.
What more can we do? Let us please ensure that business is motivated. Let us use the private sector, but the private sector cannot be allowed to establish
"a reward scheme designed to encourage information to be volunteered on a confidential basis which leads to the foiling or solving of a terrorist attack.", as advocated by the London chamber of commerce. That is not a responsibility for the private sector. That needs to be led and directed by Government, and I suggest by a single Minister for homeland security.
The whole business of terrorist preparation is clearly much bigger than the example that I am about to consider. Does Ms Taylor still wish to intervene?
I am absolutely shocked at all that the hon. Gentleman is saying today. It is clear that he neither knows nor has he made himself aware of all the work that is being done by the intelligence agencies. The hon. Gentleman is perpetrating an outrageous piece of information from the Opposition Benches and I hope that he is prepared to withdraw all that he is saying.
No, certainly not. I am talking about emergency preparedness. Let us be quite clear about the fact that it was the intelligence agencies that reduced the level of warning days before the attacks on
Let me drill down and consider a specific detail of our preparedness. Will the Minister say—I know that she will not answer these questions because she never does—exactly what has been done to make the tube safer to travel on today than it was on
I have no doubt that the Minister will refer to OSIRIS II, the only exercise that has been conducted to make our tube any safer than it is at the moment. I also have no doubt that the group that intended to attack this country two weeks ago was Ansar al-Islam, and that it intended to attack the tube again. As an example of the paucity of planning across the country, our tube is no safer to travel on today than it was on
As I have said, the Minister of State, Department of Health, Ms Winterton, has been horribly complacent and self-congratulatory about the methods and measures that have been implemented. I ask her to reflect on why the Secretary of State for Health referred that particular problem to the Department for Environment, Food and Rural Affairs.
We had our wake-up call in September 2001, so I was shocked by how shocked Ministers were in July this year. I ask the Ministers to ensure that we are much better prepared and much more resilient next time.
The single point on which I agree with Patrick Mercer is that we have had an excellent debate, although it has been a little bit awkward because we have tried to bring together two distinct issues. In my winding-up speech, I will endeavour to deal with some of the points concerning health, as well as some issues surrounding homeland security and terrorism.
Mr. Lansley raised a range of issues, which the Minister dealt with in her measured and specific response. He asked whether we have learned lessons from our experience in Northern Ireland. We have learned lessons, but I am sure that he accepts that the nature of today's terrorist threat is significantly different from the terrorist threat in Northern Ireland, given that today's terrorists are prepared to use suicide bombers and are unconcerned by the number of casualties that they inflict. Although we can learn lessons, we face a different terrorist threat today.
Steve Webb discussed Tamiflu and asked whether we consider it effective. We have been careful about the claims that we have made for antivirals: Tamiflu will reduce the length and severity of illness and reduce complications, and we currently have no reason to believe that it would not be effective.
The hon. Gentleman raised the important issues of capacity and supply. We are already holding discussions with the manufacturer, Roche, and we have secured an agreement to use another factory.
The hon. Gentleman also raised the issue of sub-licensing. Again, we are continuing active consideration and discussion with the company to make sure that we can expand capacity.
The hon. Gentleman asked whether the primary care trusts and strategic health authorities have implemented plans around the pandemic. The PCTs and SHAs have implemented such plans, and an ongoing checking process is making sure that the plans, which will be audited, are effective.
Several hon. Members asked whether we can help to contain any outbreak—the hon. Member for Northavon said that we will be judged by not only the strong, but the weak. We have contributed £600,000 to support World Health Organisation surveillance in south-east Asia, and we have also contributed to the WHO stockpile. Furthermore, Roche has said that it will donate 3 million doses of antivirals to the WHO, and we are ready to help internationally wherever we can.
Mr. Stuart raised several issues concerning poultry— I confess to not being a poultry expert. Apparently, DEFRA runs not only its website, but an excellent helpline that provides advice for large-scale poultry farmers and people who keep a small number of chickens. If free range chickens must be taken indoors, a committee—I think that it is in Brussels—will consider maintaining their free range status in those circumstances, although we are not there yet.
On homeland security, I join all hon. Members in congratulating our emergency services on their magnificent response in the wake of
The hon. Member for Newark asked what kinds of exercises we do. I genuinely accept that he wants to make a contribution in this subject, but he really ought to know that exercises take place on a weekly basis. We do tabletop exercises and command post exercises, we have three live counter-terrorist exercises every year on a national scale, and local authorities continually exercise at a very local level. We recently had live exercises involving hijacked aircraft, a terrorist occupation of off-shore oil wells and ships, and the threatened release of chemical and biological agents and improvised nuclear devices. If those are not high-level, complex planning exercises, I do not know what are. The exercise that happened at Bank in September 2003 involved scenarios very similar to those that we encountered on
Several Members proposed the idea of having a Minister for homeland security. I welcome the Liberal Democrats' view that that is a confused policy, because that is exactly what it is. We have a Minister responsible for co-ordinating this action across Government—he is the Home Secretary, who chairs a committee of Ministers right across Government who take the lead in their Departments. I would say this to the hon. Member for Newark: really think carefully about this. Is there any benefit in stripping out of Departments the expertise that resides there to bring it together in one area? It would simply mean that those Departments no longer had ownership of the issues involved in emergency planning, resilience, counter-terrorism and all the work that we need to do. We have found that having that expertise embedded in Departments, with a proper co-ordinating machinery through the cross-Government committee co-ordinated by the Home Secretary, works extremely well. I do not feel that a Minister for homeland security, whether at Minister of State or Cabinet level, is going to work. The hon. Member for Newark said, "I am he"; well, I am afraid that I am not she. There is no vacancy. Although I know that he is looking for work, I am afraid that I will not be able to offer him any help on those terms.
Members asked about public information. That is important. We published a booklet on preparing for emergencies that went out to every household. It had very good reach across the community, and our research shows that the public welcomed the practical, down-to-earth advice that it gave them—not only about terrorism, but about a whole range of emergencies from floods and fires to the things that we have discussed today. We also have the anti-terrorist hotline.
I can tell the hon. Member for Newark that a huge amount is going on in relation to safety on the tube in terms of mandatory searches, CCTV and trying to make sure that we are as safe as we can possibly be.
My right hon. Friend Mr. George made some important points, especially about our parliamentary scrutiny processes, and ascertaining whether we can find a better cross-cutting method of scrutinising some important issues. We should consider that. However, my experience shows that business is increasingly taking those matters very seriously. I have attended several events with business, for example, to discuss continuity plans. The London Resilience Forum has an excellent record on business continuity. There are also some good initiatives to involve the private security industry—in which my right hon. Friend has an interest—especially in working with the Metropolitan police.
Hon. Members also mentioned resources. The resources for the police and the Security Service have increased enormously to give us capability and resilience. The Security Service will grow from approximately 1,800 employees to 3,000. Spending on police services has doubled. I am not complacent, but I believe that we have one of the best systems for emergency preparedness.
Question accordingly negatived.
Question, That the proposed words be there added, put forthwith, pursuant to
Mr. Speaker forthwith declared the main Question, as amended, to be agreed to.
That this House pays grateful tribute to the excellent work of the emergency services, of Transport for London and of all involved in responding to the terrorist outrages of 7th July and 21st July; congratulates the Government on its comprehensive approach to preparedness for emergencies; notes the effectiveness of current Departmental responsibilities for emergency preparedness; further congratulates the Government on the steps taken to enhance communication with the public in respect of major threats; notes that supplies of vaccines, antibiotics, antidotes and specialist equipment are strategically placed around the UK for rapid deployment in the event of a mass casualty incident, and that spending on the stockpile to date exceeds £120 million; further notes that NHS organisations have well-established, comprehensive plans in place for dealing with pandemic influenza, and that the Government's updated pandemic flu contingency plan is being published today; welcomes the fact that the Government is stockpiling key drugs and equipment, and will have enough antiviral drugs to treat 25 per cent. of the population by September 2006; and recognises that good communication with the public and with health professionals is crucial before and during a pandemic and therefore congratulates the Government on making accurate and up to date information widely available to doctors and the public through various agencies.