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9 Jan 2003 : Column 337—continued
Mr. Evans: I am reassured by the explanation given by the Minister. I also welcome his comments about diabetes. I hope that—perhaps with some pushing from him—the Assembly will concentrate on introducing a strategy for those who suffer from diabetes in Wales. He made no reference to the issue of reservists, or to whether contingency plans would be put in place to ensure that patients in Wales would be properly looked after should there be a war with Iraq. Even with the reservists being called up, there could well be a problem.
Mr. Touhig: I take note of what the hon. Gentleman is saying. I am sure that his view is shared on both sides of the House, and I shall make sure that it is brought to the attention of my colleague, the Assembly Minister for Health and Social Services, Jane Hutt.
Mr. Evans: I beg to ask leave to withdraw the motion.
Motion and clause, by leave, withdrawn.
Chris Grayling (Epsom and Ewell): I beg to move amendment No. 2, in page 2, line 13 at end insert—
'( ) The Special Health Authority for England and Wales responsible for the functions of the Health Protection Agency shall have a place on the Board of the Wales Centre for Health.'.
Madam Deputy Speaker (Sylvia Heal): With this it will be convenient to discuss amendment No. 3, in page 2, line 24 [Clause 3], at end insert—
'( ) That the Wales Centre for Health shall have a duty to coordinate its activities with the recommendations of the Special Health Authority for England and Wales responsible for the functions of the Health Protection Agency in matters related to communicable disease control in England as well as with similar functions controlled by the NHS in Wales.'.
Chris Grayling: We have tabled the amendments to highlight an issue that should be a matter of concern for everyone in the House at what is undoubtedly a difficult time in security terms, and also because security matters are not the sole issues involved in the relationship between the health protection agency and the Wales centre for health. There is also the issue of how matters relating to communicable disease are addressed and communicated, and how public information on these matters is provided.
These are probing amendments designed to establish the relationship envisaged by the Minister between the Wales centre for health and the health protection agency. The latter organisation covers England and Wales but does not have the full remit in Wales that it does in England. The former will, if we understand its role correctly, have prime responsibility for the communication of public health information to the people of Wales. The Minister may be able to clarify the degree to which he envisages the Wales centre for health having responsibility for communication in those areas. The Bill states that the centre will be responsible for developing and maintaining
- Xarrangements for making information about matters related to the protection and improvement of health in Wales available to the public in Wales".
This is happening at a time of change for the infrastructure for the establishment of information—and, in part, for the provision of information—about communicable diseases and also, in these difficult times, about biological and chemical threats to this country. These functions were previously carried out by the Public Health Laboratory Service for England and Wales, and are in the process of being radically changed. Over the next few months, we shall see the creation of an entirely new organisation, the health protection agency, which will take over the responsibilities of the PHLS and a number of other bodies. It will be created as a special health authority and, from April, take on responsibility for providing or commissioning most of the NHS functions set out in the Government's consultation paper last year.
The organisation will be responsible in England for PHLS roles, but not, in general, clinical diagnostic microbiology services. However, it will be responsible for microbiological research and take over the national focus for chemical incidents, regional services and the National Poisons Information Service. It will also take over the health protection functions provided by consultants in communicable disease control and other health protection staff. Furthermore, it will have a role in providing advice on emergency functions.
In Wales, the organisation will also have many of those responsibilities, but not all of them. It will not be responsible for certain consultancy work, but it will, none the less, be the body that generates first-base information on major communicable disease risks and major biological and chemical risks.
This week, we have seen the first example of a chemical threat being discovered in this country. The PHLS has been predominantly responsible for providing information to the public indirectly and to the NHS directly on the nature of that threat, on what treatments are available, if any, and on how medical practitioners should try to identify the possible appearance of symptoms that ultimately might represent a chemical or biological attack on or threat to this country.
After 1 April, the HPA will be responsible for such tasks. It will be at the heart of our security apparatus in defending this country and providing information to practitioners and the public on the risks that we might face. Therefore, as we consider the Bill and set in place new structures in Wales for public health information, it is fundamentally important that we understand the relationship between the HPA and the new bodies, especially the Wales centre for health.
Dr. Julian Lewis (New Forest, East): I support the argument that my hon. Friend is making. Will he accept from me the assurance that terrorist groups always try to think one jump ahead? Given that so much has been said in anticipation of a terrorist attack on London as the capital of the United Kingdom, terrorists thinking one jump ahead may be considering the capitals of Scotland and of the Principality precisely to take us by surprise. Is not that a particular reason for bodies in Scotland and in Wales having the extra representation for which he is arguing?
Chris Grayling: I thank my hon. Friend for those comments, because he is driving at the nub of the reason for our laying the amendments on the Table for, I hope, the Minister's acceptance. I certainly hope that he addresses the issue and responds with his own thoughts on the different ways in which those organisations will interact. Ultimately, in the eyes of the terrorists who are threatening us, we are one United Kingdom and one nation. Terrorists will not respect administrative or national boundaries within the UK, so we must work effectively together.
We have a concern: in creating those structures through the Bill and in creating the Wales centre for health, we want to ensure that the centre has proper links with the organisations that will provide the rest of the NHS in England with the information, training, support and guidance that it requires to do its job properly.
That is the purpose of the amendments that we have introduced. We want to formalise the relationship between the Wales centre for health and the new body to ensure that there is absolute co-ordination between all those people who are responsible for establishing and communicating information on those important issues.
In our view, it is particularly important that those arrangements be dealt with because of the uncertainties surrounding the restructuring of the PHLS, the creation of the HPA and the changes in this area as to the organisations being transferred from the PHLS to the NHS.1.45 pm
The debate takes place as those organisations are going through a huge process of change that is enormously disruptive to them. We must be mindful of the warning given by the PHLS internal risk assessment team on the implications of the changes:
- XIt seems inevitable that if the timetable of 1st April 2003 for the HPA is to be delivered, some level of risk will have to be tolerated. Were there to be a severe external challenge over the next few months, such as deliberate release, the situation and expected forward timetable would need rapid reappraisal."
That information, which will originate from the HPA and our central scientific teams, must be disseminated effectively and quickly right across the NHS in England and in Wales. Our first amendment is one suggestion as to how we could strengthen and formalise those ties, ensuring that they are clearly in place during the period of transition for all those organisations and that they solidify as they go forward.
The PHLS drives the dissemination of information on communicable diseases and chemical weapons, and the HPA will take that over. Do we not need to ensure that those organisations are interlocked? What better way to achieve that than to offer the HPA a non-executive role on the board of the Wales centre for health, so that there is a genuine voice for our scientists and technical experts in the arena where communication and training will be formulated and delivered?
That is the objective of our first amendment. I hope that the Minister gives it due consideration, but, if he feels unable to adopt such an approach, will he none the less consider the direction in which we are attempting to steer him? Will he also consider how to ensure strong linkage between the two, and ensure that the scientists have a strong voice in the work of the Wales centre for health in shaping communication and training?
Our second amendment is designed to formalise a duty of partnership, especially as organisations will be going through difficult changes. It is all too easy for them to miss out working together and to focus on internal issues rather than ensuring that they work in the partnerships that we all need for the future. Our proposal is designed to ensure that there would be a duty on them to do so. It would provide direction for them and act as a reminder from Parliament that the nation needs them to operate in tandem.
The issue does not simply involve security, although at this time security must be a paramount consideration. If there is a chemical or a biological risk, we must ensure
that information and training flows right the way through our health services, quickly and effectively, and on to the public as and when they need it. However, the PHLS has played an active and important role in other areas, which, in future, will be played by the HPA. Examples are disseminating information on the spread of methicillin-resistant staphylococcus aureus in our hospitals—hospital-related infections and how they can be tackled—and providing information on winter vomiting disease, which is at the forefront of consideration in the health world, as well as other diseases that may be isolated, such as Legionnaire's disease. They may, like a flu epidemic, spread much more widely.The information that the HPA produces will be of paramount importance to medical practitioners and patients alike. We are asking the Minister to create a duty of care on the Wales centre for health that says, XYou're not simply there to serve the people of Wales. You're also there to be part of a partnership within the United Kingdom to ensure that we provide proper and effective information across our borders, throughout our nation and to all our people." We are one United Kingdom. The Bill is creating institutions that will serve the people of Wales. They must do that not in isolation, but in partnership with their counterparts elsewhere in the UK and organisations with a remit for the whole UK. The amendments are designed to suggest simple structures and duties that would enable them to do that—indeed, would ensure that they did it. They are designed to convey a sense of direction to the organisations. I hope that the Minister will give due consideration to our ambitions, and that, if he is not willing to accept the amendments in their present form, he will ensure that the partnership we need—in the context of communicable diseases, but particularly in the context of security issues—between our scientists and our information providers is strong, effective and structured.
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