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Mr. John Bercow (Buckingham) (Con): In respect of the application of the negative and affirmative procedures of the House flowing from different regulations applicable to individual clauses of the Bill, would the Minister take care to tell the House what the criteria were that informed the choice of one rather than the other in each case?

Miss Johnson: I believe that these matters are normally determined on the basis of advice from parliamentary counsel on what would be most appropriate, rather than on any decisions by the Government. We are normally advised in relation to these matters whether something will require the affirmative procedure.

None of those bodies was providing a poor service, but the whole system needed rationalising and strengthening in order to meet the challenges to health protection in the 21st century. It led us to conclude that the best way to strengthen the delivery of health protection services at both local and national levels was to merge responsibility for all those functions and individuals into a single organisation.

That wide-ranging role for the agency is an important development because, when an incident occurs, it is not always immediately clear whether it has a chemical, radiological or an infectious source. The agency can function as a "one-stop shop", capable of providing the necessary expertise for dealing with any scenario involving a biological, chemical or radiation hazard. It should also enable greater cross-fertilisation of good ideas and good practice between the different sectors of health protection.

That approach is consistent with the aims of the Department of Health's review of its arm's length bodies. The objective of the review is to rationalise the Department's ALBs and to reshape them for consistency with a modernised NHS. Many were set up to focus action in key areas and to respond to specific concerns. Now that many of the problems are being tackled effectively, it is time to rationalise the sector, reduce costs and return resources to front-line services.

My right hon. Friend the Secretary of State for Health announced on 20 May that the first stage of the review had been completed and that the parameters for the next stage would be a 50 per cent. reduction in the number of ALBs; a saving in expenditure by ALBs of some £0.5 billion by 2007–08; and a reduction in posts of 25 per cent. in the same period.
 
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Mr. Andrew Lansley (South Cambridgeshire) (Con): The Secretary of State's announcement in May came after the passage of the legislation in another place. During the passage of the Bill so far, its expenditure and manpower implications have been stated as being neutral—no increase in expenditure or manpower—but it is relevant if the Government intend in the space of days, or perhaps weeks to announce changes in staffing and expenditure, or indeed changes in arm's length bodies going beyond what has already been proposed and what the hon. Lady has already described. Does she plan to say anything more about changes in arm's length bodies affecting the HPA which the House should know about now?

Miss Johnson: I do not believe so. May I clarify, for the hon. Gentleman's information, the fact that the Bill does not entail any additional public expenditure or changes to public service manpower? We expect that as the agency is a non-departmental public body, its costs will be met from within existing resources available to the Department of Health and the national health service—and indeed, we might expect some savings.

Mr. Lansley: I am grateful for that answer, although I am not sure that the hon. Lady has quite taken my point. The Secretary of State announced a review of 42 bodies, two of which—the National Radiological Protection Board and the remaining functions of the Public Health Laboratory Service—were due to go into the Health Protection Agency anyway. Is the Minister telling us that although those bodies were cited among the 42 to be reviewed, they are not to be reviewed? Is no process of reviewing their structures, manpower or expenditure under way?

Miss Johnson: Obviously, I shall not pre-empt any announcement that will be forthcoming fairly soon, but I have already given the hon. Gentleman my answer about the HPA and the National Radiological Protection Board. The point of creating the agency is that it is wholly consistent with the review of the arm's-length bodies, not least because it enables us, as he has acknowledged, to replace two bodies—the HPA special health authority and the National Radiological Protection Board—with one.

Mr. Lansley rose—

Miss Johnson: I will give way to the hon. Gentleman one more time.

Mr. Lansley: I am grateful to the Minister for giving way to me one more time—at least, on this subject; there may be others. Let us suppose that it was argued that some of the functions of the National Patient Safety Agency were duplicatory, or at least would benefit from being managed together with those of the Health Protection Agency. Is the hon. Lady saying that that might happen, and there could be an announcement weeks from now, so the House will have been debating the Bill on one basis, and then within weeks the Secretary of State or the Minister may propose that everything will change?

Miss Johnson: No, I am not saying that. The hon. Gentleman is working hard to find something to
 
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comment on, but he is not succeeding. We do not expect to amend the Bill in the light of the review; I have already said that, and I can only reiterate it. There is nothing for the hon. Gentleman to get excited about—although he is doing his best.

The HPA special health authority has now been in existence for just over a year. During that time, it has successfully passed the test—

Mr. Peter Lilley (Hitchin and Harpenden) (Con): On the subject of things to get excited about, the hon. Lady says that those are arm's-length bodies, yet she seems to have given them pretty well unlimited powers. Clause 4(2) says:

"The Agency may do anything which it thinks is . . . appropriate for facilitating, or . . . incidental or conducive to . . . the exercise of its functions".

Does that mean that, for example, it will be able to detain people carrying an infection, to seize materials that it thinks are infected, or to impose charges and taxes? What is the limit on the powers conferred by the Bill?

Miss Johnson: The point of that provision is to make it plain that the new agency will be completely or largely independent of Government in its functions. As the Bill passed through its nine and a half hours of consideration in another place, we responded to their lordships' concerns about ensuring that it has sufficient independence. I appreciate that the hon. Gentleman comes from the other angle in such matters, but we are ensuring that the body is sufficiently independent.

Mr. Bercow: Will the Minister give way?

Miss Johnson: I shall allow one more intervention; then I intend to make some progress.

Mr. Bercow: I am grateful to the Minister because she has been generous in giving way, but I am afraid that her answer to my right hon. Friend the Member for Hitchin and Harpenden (Mr. Lilley) simply will not do. Does the hon. Lady not accept that there is a cast-iron distinction between granting independence to an organisation and conferring unfettered power on it? If she does not recognise the difference, I wonder why she is at the Dispatch Box.

Miss Johnson: I think that the hon. Gentleman, too, is trying to make something out of a very little matter. The Bill's intention is to transfer the functions of the National Radiological Protection Board into the organisation of the HPA—as he and his right hon. Friend the Member for Hitchin and Harpenden (Mr. Lilley) know well—and to ensure that the organisations can do their job with broadly the same sort of remit that they now have. As I have said, however, the intention is also to ensure that the bodies' independence is guaranteed. That was felt by their noble lordships in another place to be a key element of making sure that the public's interest was protected by this move.

I turn to the fact that we have had the—

Mr. Lilley: Will the hon. Lady give way?
 
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Miss Johnson: I have said that I want to make some progress.

Mr. Lilley: The Minister has not made any progress on her answer to me.

Miss Johnson: I said that I wanted to make progress on my speech.

During the time that the Health Protection Agency has been in existence, which is just over a year, it has successfully passed the test of ensuring effective business continuity from its predecessor bodies. That is no small achievement considering that it took on nearly 3,000 staff from about 80 previous employers. It has also taken the opportunity to establish itself as a modern, forward-looking organisation. It has committed itself to transparency and openness, to high standards of corporate governance, integrity and value for money and to working in partnership with other organisations to develop and deliver programmes and policies and ensure public involvement. Its work is based on the best available evidence together with high clinical and public health standards.

The proof of that success can be seen in the way in which the HPA has handled a number of major incidents, the most serious being the emergence of SARS in 2003. From day one of the outbreak, the HPA special health authority was at the heart of the international effort to control the spread of the disease and played a central role in characterising what was then a new pathogen. The agency had representatives in China, Hong Kong, Vietnam and Canada and at the World Health Organisation where it led the modelling of SARS. A senior WHO official reported that the WHO would not have been able to manage that work without the UK input.

At national level, the agency issued advice to the Government, health professionals and the general public on measures to control the disease. The implementation of those measures prevented the onward transmission of SARS from the few cases that appeared in this country.

As well as addressing high-profile threats such as SARS, the agency has quietly got on with the job of improving day-to-day service delivery at local level. In particular, it has memorandums of understanding in place with every primary care trust in England, and has set up nine regional and 36 local health protection teams to bring a more unified and consistent response in health protection across the country. The new relationships and networks take time to bed down, and the HPA, the national health service and local government are continuing to work together to improve them. The special health authority is in the process of reviewing all its memorandums of understanding to ensure that for 2004–05, all PCTs will have access to a service that is responsive to their needs. We expect those arrangements to be taken over by the agency that is established by the Bill.

The HPA has also strengthened our ability to respond to threats from chemical and biological terrorism. In particular, it has co-ordinated a number of training exercises and has recently issued a set of "clinical action cards" for GPs, which contain advice on identifying and treating victims of chemical or biological attack.
 
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In addition, the authority has established an international presence, enabling the UK to make an integrated contribution to a range of international initiatives. For example, it is working to ensure that there is effective international co-operation in the surveillance of emerging infections. That has enhanced the high reputation for health protection that was established by the authority's predecessor bodies.

In that snapshot of what the HPA special health authority has achieved, we are demonstrating that it is now providing better co-ordinated arrangements for health protection than we had in the past, and that it is contributing to the delivery of an improved service at local level. That is a tribute to the hard work of all the staff who have been involved in its creation.

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