| Health Protection Agency Bill [Lords]
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Mr. Paul Burstow (Sutton and Cheam) (LD): The Minister may be about to deal with the question, but will the HPA's power to provide information to other organisations and persons be sufficiently wide for it to run publicity campaigns and to disseminate information to the general public? Miss Johnson: Yes. Indeed, it already does so. The HPA website makes a lot of information available to the public. That may be the most readily available way to provide advice. It will also be able to do so under clause 4(1)(g). Preparedness for CBRN terrorism is not an issue for the HPA, as hon. Members accept. The national health service, the Government—including the Home Office, which the hon. Member for Rayleigh mentioned—and the police will obviously have a role. Those organisations need to work together in all areas. Indeed, they are doing so. We do not propose changing that. As for specific advice, I am aware that the hon. Member for Rayleigh is trying to raise questions, but precedents are not always stunning. I was laughing because the advice was fairly risible. Its quality was the subject of much public concern. It is important that the public are kept informed, but a number of bodies are involved. It is not for the Bill to say precisely what information should be made available, nor is it a matter for the HPA. Dr. Murrison: I am slightly concerned. I think that the Minister was saying that ''Protect and Survive'' was risible; my recollection is that it was pretty basic. It may have been open to criticism, but it was better than doing nothing. I recall the television programme that it was based upon; it may have been a grainy black-and-white programme, but it had a great impact—just as Lord Fowler had a great impact on education about HIV/AIDS in the mid-1980s. I did not disparage ''Protect and Survive''. That would be very unwise. Miss Johnson: The hon. Gentleman and I might wish to differ, but we are talking about something historical. To be fair, none of us would want to put out such a programme today. Patrick Mercer: I am slightly concerned about the Minister's statement. One reason why ''Protect and Survive'' was laughed at—which it was—was that the threat never materialised. People said, ''This just ain't going to happen.'' The point of our earlier questioning was that although we are constantly told that the Column Number: 050 threat will develop, the Government continue to allow us to remain in a state of ignorance. ''Protect and Survive'' was at least doing something proactive, rather than being reactive.Miss Johnson: As I said, the matter of advice to the public and the giving of information and advice is specifically set out in clause 4(1)(g). The power exists for the agency to do that; it is already doing so; it will continue to do so. It needs to do so in respect of the points made by Opposition Members, in conjunction with some of the organisations that I mentioned a few moments ago. Examples of a UK-wide approach already being taken to health protection include the unified HIV and AIDS surveillance that the hon. Member for Westbury has just mentioned and the five nations working group on severe acute respiratory syndrome and the SARS taskforce—as well as what our authorities have done in working closely with the WHO. Avian flu and other issues are among matters on which organisations are working together across the UK to ensure effectiveness and co-ordination. Similarly, the Government and the devolved Administrations work together closely on preparedness for bioterrorism. The Health Protection Agency provides support with the operational response to that. Dr. Murrison: The Minister has been generous in giving way. She has described how bodies are co-ordinating their activity with respect to a range of illnesses. Will she comment on hepatitis C and tuberculosis? I should hope that relevant bodies are co-ordinating what they are doing with respect to both of those, but there has been an upsurge in cases in those conditions in recent months. Miss Johnson: I will indeed comment but, before I do, I should like to finish my remarks on amendment No. 4. I note what the hon. Member for Sutton and Cheam (Mr. Burstow) said on Second Reading about the Wanless report and gaps in public health machinery, particularly in relation to health promotion, education and the essential capacity to evaluate public health measures. However, the Government commissioned the Wanless report, which highlighted those issues, and they also tackled the issues that it raises. It is not necessary to amend the Bill to deal with those issues; nor would it be desirable to add the reference to education and promotion, because that would highlight issues that are dealt with in clauses 2 and 4. That would be to privilege specific ways of protecting the community over other ways set out in clause 4, such as providing laboratory services. There are many ways in which the agency can play a role in that context. Mr. Burstow: Can the Minister confirm, therefore, that the Bill provides for a Government to decide to ask the Health Protection Agency to take on the health promotion and education function that the Wanless report identifies as not being picked up, currently, in public health mechanisms? Could the Government do that under the Bill? Column Number: 051 Miss Johnson: I know, Mr. Forth, that this point is not strictly on the amendment, but the hon. Gentleman has taken an interest in the subject of our forthcoming White Paper on public health. Much of the response to the Wanless report will be made through the White Paper later in the year. Mr. Burstow: I understand entirely that the Government want to declare new policies and changes to policy in the White Paper. However, my question was whether the Bill allows for a Government to decide to give the role of health promotion and education to the Health Protection Agency, or would further primary legislation be needed? Miss Johnson: It is a matter of whether by health promotion the hon. Gentleman means health protection—and we can argue about what the terms cover, but I agree that there is some possibility of sliding on that. However, health protection has a well defined meaning, which I set out earlier and which is the subject of the work of the Health Protection Agency. That is covered by the Bill in the clauses that I explained earlier. Amendment No. 8 would remove the specific reference to infectious disease from clause 2(1)(a). The hon. Member for Westbury recorded on Second Reading that he was unclear about the functions of the agency. I have reiterated how the remit works, and I hope that I have made it even clearer. I also referred him to the consultation document. If we were to accept amendment No. 8, infectious disease functions would still be covered and nothing would be gained. Dr. Murrison: Will the Minister give way? Miss Johnson: May I deal with the points that the hon. Gentleman has already raised? I turn now to the hon. Gentleman's points about hepatitis C and tuberculosis. Hepatitis C was identified in the chief medical officer's infectious diseases strategy, ''Getting Ahead of the Curve'', as the hon. Gentleman knows. In August 2002, we published a consultation paper, and today we have published an action plan to implement the strategy. It sets out a framework of actions to improve prevention, diagnosis and treatment, and to strengthen the evidence base. The actions cover four key areas: surveillance and research, increasing awareness and the detection of undiagnosed infections, high-quality health and social care services, and prevention. The action plan will be underpinned by professional and public awareness campaigns centrally funded by the Department. That will help to prevent new infections and lead to the diagnosis of more people with hepatitis C so that they can be assessed for antiviral drug therapy treatment. Dr. Murrison: The Minister might have made an important announcement. I am not sure whether she was dealing with hepatitis C or TB. Miss Johnson: Hepatitis C. Dr. Murrison: Hepatitis C. I am grateful to the Minister, because the action plan is long awaited and long overdue. I offer my congratulations to her on bringing it forward, even at this late stage. When can Column Number: 052 we have a TB action plan, which was promised two years ago?Miss Johnson: I was about to come to that. It is our intention to publish a TB action plan when departmental business allows. In the meantime, the lack of publication has not halted progress on the issue. We are already taking action and low levels of TB have been achieved and maintained: through the BCG immunisation programme, which is kept under review by the Joint Committee on Vaccination and Immunisation; through the treatment of identified cases and screening of their close contacts; through the screening and treatment of immigrants from countries with a high prevalence of TB; and through active surveillance of TB—we are funding a two-year pilot study on the use of mobile digital X-ray units. There is a worldwide resurgence in TB, which is having a small but important impact on trends in the UK. Dr. Murrison: The Minister has rattled through a whole range of things. First, she has stated that we are containing the level of TB. However, that is not the case, particularly in some of our inner-London boroughs—perhaps she would like to revisit those remarks. She also mentioned something about the screening of immigrants. I know that the Government were looking into that; perhaps she might describe it in a little more detail. Miss Johnson: In the centres to which immigrants come when they arrive, a large percentage take up the option of screening. I do not have the figures in front of me, but I have recently answered a parliamentary question, giving some of those details. The HPA has developed a new molecular finger printing method for mycobacterium tuberculosis, or MTB, to assist outbreak investigation. It is a powerful method that has already proved useful in showing that a suspect outbreak in Leicester was not in fact an outbreak. It has developed a method of direct detection of MTB in sputum, and that will be evaluated. It is developing databases for contact tracing and improving case registries and for working with prison services to support management of risk to prisoners and staff. It is working with health professionals to track and contain the spread of drug-resistant MTB in London, and it has developed and evaluated rapid molecular methods for determining the likely antibiotic-resistant strains of MTB. The HPA is doing a whole range of work on the subject, which I am sure will be of interest to Opposition Members.
3.15 pmFinally, the hon. Member for Sutton and Cheam (Mr. Burstow) talked about the relationship between the HPA and health promotion. The HPA can undertake health promotion on behalf of the Secretary of State and the National Assembly for Wales. Health protection is covered by subsection (1), and the powers under subsections (2) to (4) would enable it to be given other health functions, including health promotion functions that are not caught by subsection (1). As I said in my comments on the amendments, that would leave Scotland and Northern Column Number: 053 Ireland in a different position, because they do not have the powers set out in subsections (2) to (4).As the hon. Gentleman will appreciate, several matters are subject to devolution, and Ministers in Westminster do not consider matters that have been devolved to the Scottish Parliament and Scottish Executive.
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| ©Parliamentary copyright 2004 | Prepared 29 June 2004 |
