asked Her Majesty's Government:

What plans they have to test immigrants for tuberculosis.

My Lords, currently, we screen for TB those arriving from countries with a high rate of TB who want to remain for longer than six months. We also screen abroad applicants for entry clearance in six countries that are high-risk for TB. We will shortly be making an announcement on the next phase of this overseas screening programme, which will extend the scheme to other high-risk countries.

My Lords, I thank the Minister for that reply. I declare an interest in that I had TB in my teens, so I know how infectious this disease is. Now that we are threatened with the spread of this new TB strain, which apparently is drug-resistant, what are we going to do about that?

My Lords, I can assure the noble Baroness that we are taking every step to ensure that we have a robust response. The first step is to screen those who are coming into this country and, if they are identified as carriers of tuberculosis, to deal with it before they come here. The second step is to ensure that those who come to this country are progressively screened so that we can identify the disease early and deal with it more robustly.

My Lords, how effective is the BCG vaccination, who is having it, and should we not be protecting our children, who may be mixing with children with tuberculosis?

My Lords, the BCG vaccination has been causing concern. There is an issue about whether children should be given it at 12. The new procedure has meant that we are now looking more at the neonatal stage and giving the vaccination to children much earlier. We know that there is an anxiety about older children, but it is very much part of the Department of Health's agenda to deal aggressively with this matter and ensure that people are reassured that the changes are safely being made.

My Lords, I thank the Minister for that reassuring answer. I ask her to note that the incidence of TB is not restricted simply to immigrants either from abroad or in this country. Will she explain whether any facilities are now available for people from other countries to have information in their own language so that they know where to go for treatment when they suffer such a crisis?

My Lords, I do not have a specific answer, but the noble Lord will know that, in the general way in which we are now trying to give information, we are providing information in as many languages as possible so that those who may be affected by it are better able to understand it. All government departments have been carrying out that process with a great deal of energy for some time. I assure noble Lords that I know of nothing that indicates that we are not doing exactly the same in this regard. But if that is the case, I will certainly undertake to write to the noble Lord about that.

My Lords, does the Minister have any figures for the occurrence of bovine TB either in the immigrant community or in the indigenous community, particularly the farming community if we drink unpasteurised milk on farms?

My Lords, I regret to tell the noble Countess that I do not have the figures for bovine TB. That is a great tragedy for me because I saw the noble Countess earlier in the House and I should have anticipated this question.

My Lords, in formulating government policy on this important question of public health, have the Government sought advice from the London School of Hygiene and Tropical Medicine?

My Lords, I cannot answer that question specifically, but I know, as will the noble Lord, that in developing these procedures we try ordinarily to collate as much information as possible from those who may have specialist knowledge. I therefore assume that that has been done, but I regret again that I am deficient and do not know the answer. I shall certainly undertake to ensure that the noble Lord has a reply. I should say that, although I answer for the Government, I would have thought that this was perhaps more of a Home Office-type question.

My Lords, is the Minister aware that, according to the Health Protection Agency, only 27 per cent of those entering this country from places with a high prevalence of TB are X-rayed at the port of entry, and that a third of all high-risk entrants are not being referred for medical examination at all? Do the Government consider that to be adequate, and what plans do they have to ensure a more rigorous testing programme?

My Lords, the noble Earl will know that the Department of Health took the rise of TB incredibly seriously and launched the TB action plan in 2004. The key strands were to increase awareness and to provide strong commitment and leadership, high quality surveillance, excellence in clinical care, well organised and co-ordinated patient services, first-class laboratory services and effective disease control in the population level. The expert workforce was a real issue. We are asking for a greater degree of acuity and understanding on what would work in the most effective way. The action plan is being energetically pursued. In a short while, we hope to say what further steps can be taken.