|Health Protection Agency (Yr Asiantaeth Diogelu Iechyd) (Establishment) Order 2003 and Health Protection Agency (Yr Asiantaeth Diogelu Iechyd) Regulations 2003
Chris Grayling: You have much more reason to be able to pronounce the title of the order correctly than I have, Mr. Griffiths. Like the hon. Member for Oxford, West and Abingdon (Dr. Harris) I am delighted to see you in the Chair. Yours is a familiar face to many members of this Committee.
We have here the supreme irony of two contradictions in time frame. First, there is the time that we are debating the measure. The statutory instrument was published at the beginning of March. The hon. Member for Oxford, West and Abingdon beat my colleagues and me to it—I congratulate him—and prayed against it on 6 March. It is now 27 June; the Health Protection Agency has long since been established, and we have debated in another Standing Committee the abolition of the PHLS. It does not add up; the process is not coherent or properly democratic. The Government should be ashamed of taking us through such a poorly structured process in which the action has taken place before the debate. What would happen if this afternoon the Committee decided that it does not want the HPA? What sort of message would that send? The matter should have been brought to the House in good time for proper debate, and in time to amend the provisions if necessary, before action was taken.
The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson): As the hon. Member for Oxford, West and Abingdon acknowledged in his contribution, the initial debate was postponed at his request, not at the Government's.
Chris Grayling: That may be so, but it is still 27 June.
The Chairman: Order. It is 26 June.
Chris Grayling: I stand corrected. However, whether or not the debate was postponed at the request of the hon. Member for Oxford, West and Abingdon, the first scheduled debate took place almost a month after the HPA was formed.
Parliament has not yet given its assent to the measure. What is the legal status of the HPA? I do not see how it can legitimately exist when consent has not been granted for it to be a special health authority. It is ironic that, despite having been extraordinarily sedate in the timetable for getting parliamentary consent for the measure, the Government have rushed through the merger of the legacy bodies in a way that has caused obvious confusion, difficulty and unhappiness within those organisations. The document produced by the HPA steering group last November—four months before the formation of the body—warned of a number of serious difficulties arising from the pace of change and the amount of work that still needed to
Column Number: 011be done. I wish to take the Minister to task on some of those points and I will ask her to update the Committee on the steps that have been taken to alleviate the problems identified in the document.
The most significant issue that arose from the document was about the management of, and response to, a potential chemical or biological attack. It is only a week since the director general of MI5 warned us that it was only a matter of time before there is such an attack on this country. We in the United Kingdom face a real possibility of biological or chemical attack. The HPA steering group warned last November of the implications of the pace of change for our ability to respond to such an attack. It stated:
Fortunately, there was no deliberate release of biological weapons in the run-up to the formation of the HPA. However—as with any organisation going through change on that scale—change does not stop on the day that the organisation is formed. That brings me to my first and most important question to the Minister. What steps have been taken within the HPA in the last few months to ensure that the organisation's ability to respond to the unthinkable are absolutely robust and are not in any way at risk from the inevitable turbulence associated with the process of change?
The second issue is staffing. The changes and the way in which they were rushed through have done significant damage to parts of the new HPA—the residual bodies that formed the HPA. I know from conversations with those who work in those bodies and from the HPA's documentary recording of the process up to the transfer that there was profound unhappiness and uncertainty, to the extent that key people chose to leave those bodies. That has been well documented. The November document highlighted one of the risks that the HPA faced in establishing itself on 1 April 2003. It stated that:
I know that that is true. I was told of a senior Birmingham-based scientist with a particular expertise who chose to leave the PHLS and pursue a career in one of the universities because of his uncertainties about the creation of the new organisation. He did not know what the future held and felt that the organisation was descending into chaos.
The expertise that someone working in an organisation has built up in a specialist scientific area cannot easily be replaced. It is clear from the HPA's own document that key people were leaving the legacy bodies last winter; the impact on those bodies is unknown as yet. Therefore, my second question to the Minister is: what evidence does she have now that, after the creation of the HPA creation, personnel problems have been resolved? What work have the HPA management done with their people to reassure them about the future? Have all the human resources
Column Number: 012processes and functions that were due to be transferred—all the communications about terms and conditions and so forth—been transferred effectively? What has happened to the rate of resignations, particularly from key positions? There were resignations from key positions before 1 April; have the resignations now ceased? If not, what steps are being taken to ensure that they do?
The third issue is chronic disease monitoring. That is especially relevant to the former PHLS laboratories, one of whose key jobs was to monitor outbreaks of disease. Let us suppose that a hospital had an outbreak of a particular type of food poisoning. Whether it was simply an outbreak in one location or a broader problem could be rapidly established through the PHLS network. The PHLS carried out a range of monitoring processes on outbreaks of infection—for example, of methicillin resistant staphylococcus aureus—and disease. In particular, it had a programme across all its laboratories that monitored pneumococcal disease. A network of 40 or so laboratories monitored the various areas that they covered, tracked outbreaks, fed information back to the centre and enabled us as a nation to track the disease and improve the understanding of the health service and related bodies to enable them to tackle disease. It was one of the most important pieces of work that the PHLS did. The November document said:
That refers to the integration of the network to carry out that monitoring process. The document continued:
The real fear of PHLS staff is that some of its key monitoring programmes across the NHS will be weakened or destroyed by the breaking up of the laboratories network and the creation of the HPA.
One thing that particularly surprised me when I tabled questions before 1 April was Ministers saying that there would be no service level agreements between the local NHS trusts that now control the public health laboratories and the HPA. That is nonsense, because unless there is a formalised structure to continue the monitoring, it will not happen or, if it does, it will be a lower priority. My third question for the Minister is: if there are to be no service level agreements, what is being done—what structures are being established—to ensure that those programmes continue? What is the contractual basis of the working arrangements? What powers does the HPA have to ensure that local trust managements, who have many priorities, ensure that the laboratories continue that important work?
Another responsibility that the public health laboratories had was to monitor outbreaks of poisoning in foodstuffs. For example, if a problem with a brand of baby food was reported, technicians from all 40 or so laboratories across the country would go to their local supermarket, buy one of the suspected items, return to the laboratory and test it. The network
Column Number: 013would rapidly be able to establish whether there was a widespread food poisoning outbreak, a problem with a specific product, a one-off piece of food sabotage, or a one-off problem with the product. The network of laboratories was quickly able to build up enough information to inform the public properly about whether there needed to be a nationwide product recall.
The reluctance of local NHS trusts to continue that work has become apparent in the past few months. The HPA at Chelmsford has had to recentralise responsibility for food monitoring in East Anglia because a local trust does not want to do that work. The same is true in the Brighton area. Work that would have been carried out by laboratories across the region may now be carried out in only one place. Someone in Chelmsford is not going to pop up to Norwich to go to the supermarket. What is the process for monitoring food poisoning outbreaks? Is the HPA fully responsible for that process? How many of its laboratories are actively engaged in that work? If local trusts refuse to take part in that work, is the Department taking any steps to bring them back into the fold?
My next area of questioning relates to the management of the public health laboratories. I turn to a stark example that demonstrates how ludicrously short the time scale for the establishment of the HPA was. On 1 April, when the organisation was set up, it did not have a proper long-term management team. Its chief executive had been scrambled into the job at the last minute and had been in the post—if I recall correctly—for about three weeks. The HPA had to appoint its directors on an interim basis. None of the work on the long-term structure of the organisation had been completed before 1 April. That served to compound the problem of anxiety among staff about their future. People within the legacy organisations told me that they were profoundly unhappy about the lack of clarity. Can the Minister tell me whether those interim posts have been changed into permanent posts? Is the long-term management structure in place? Are the long-term senior positions now filled and contracted properly? Are all the key management issues resolved and dealt with?
There are other issues, which do not relate to food monitoring and the specific programmes to monitor national outbreaks of diseases. For example, there are questions about how the day-to-day relationship between the former PHLS laboratories and the HPA is functioning. How is the network being held together to ensure that day-to-day work is done in a way that ensures that information is fed back to the centre? The Minister will be aware that great concerns were raised by the PHLS board after the consultation document was issued. The board said that it
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That is a stark indicator of the importance of maintaining the networks.
When I raised these matters with Ministers, their answers were vague. In response to a question about channels of co-ordination, I was told that
That is pretty vague stuff. Can the Minister tell us what is actually happening? What glue holds the networks together? What have the Government and the management of the HPA done to ensure that groups of people who now work for local trust managers and who will inevitably be affected by local trust priorities continue to work, talk and communicate as part of the network to which they once belonged and—many would argue—should still belong?
I should like briefly to pick up, without repeating all his points, the matter of the NRPB, which was raised by the hon. Member for Oxford, West and Abingdon. It is a fundamental issue. The NRPB has been a first-rate organisation and it is supremely ironic that its functions within England and Wales have now been brought under the auspices of the HPA, although in Scotland it remains a separate body. Why and how does its work somehow vary north and south of the border? At worst, the co-ordination that has taken place in the past will be lost; at best, there is bound to be a duplication of resources. One of the questions prompted by the status of the NRPB relates to the HPA. The Minister will recall that the HPA is supposed to change its legal status and become a non-departmental public body. I understand that one thing that prevented that from happening was resistance within the NRPB to the creation of new structures. Perhaps that is why it was not included in the Health and Social Care (Community Health and Standards) Bill.
The November document contained detailed assessments of risk from all the other legacy bodies. The NRPB's return was, to say the least, less co-operative than those of the other bodies. The document says that, while no detailed returns were received from NRPB, a statement was received that mentioned various issues, identified four major risks, then stated:
That does not sound to me like a clear indicator of co-operation. There have been persistent reports of tensions in relation to the future structure of the former NRPB organisation. I echo the request of the hon. Member for Oxford, West and Abingdon for clarification. What is happening, and when will we see the next stage of the legal development of the HPA?
Will the Minister address the matter of clinical pathology accreditation? One of the fears that was expressed to me from within the PHLS before the formation of the HPA was that those public health laboratories transferring to NHS trusts would lose
Column Number: 015their accreditation with the UK accreditation services or their clinical pathology accreditation. Can she clarify whether there have been any problems in that respect? Is any laboratory in danger of losing its accreditation and, if so, what steps are being taken to address the matter?
Lastly, I return to staffing. The establishment order contains in article 7 the standard provision that the employment of somebody who objects to the transfer of a contract of employment should be terminated. Given the unhappiness that some of them had about the formation of the new agency, it is reasonable to ask whether all members of staff from the legacy bodies agreed to transfer to the HPA. Will the Minister say whether any members of staff declined to transfer and, if so, how many?
This has been a rushed and botched job in an area of high importance to the nation. My hon. Friends and I do not dissent from the Government's overall ambition to create as much interlinkage as possible between the bodies that work to protect public health. That said, we have profound misgivings about the way in which the Government set up the process, and we are not persuaded about the logic of separating the public health laboratories from the HPA, because we believe that the PHLS was a first-rate organisation that did a good job for the country. We are concerned about what comes next. That concern is not great enough—it would be academic anyway, given that the HPA already exists—for us to vote against the orders, but the Government still have questions to answer. I do not believe that the measure will be the end of the matter, because I am far from convinced that all the problems that have been highlighted in the past few months have disappeared.
|©Parliamentary copyright 2003||Prepared 26 June 2003|