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Barbara Keeley (Worsley) (Lab): Much has been written and said in the past week about pandemics and influenza, and some of the reporting has bordered on the alarmist. It is therefore appropriate that we should discuss the issues in a more measured way here—and, incidentally, without making cheap political points.

As the amendment states, our NHS organisations have well-established, comprehensive plans in place for dealing with pandemic influenza. The prime objectives in dealing with influenza pandemics are to save lives; to reduce the health impact of the pandemic; and to minimise the disruption to health and other services, while maintaining business continuity. Given that the vaccine may not be available to all in the first wave of the pandemic, clear and transparent policies are needed for prioritising vaccine use, as and when it becomes available. I wish to refer to one aspect of that prioritisation, in terms of building on the principles established for dealing with seasonal flu.

The overall uptake of vaccination against seasonal flu has improved, and in recent years more than 70 per cent. of those aged 65 or over have been vaccinated. Variations occur by area, but the two primary care trusts serving my constituency achieved a 70 per cent.
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and a 72 per cent. uptake, so we are on target. This year, the influenza immunisation programme has been extended to include two further groups: people with chronic liver disease and the main carers of elderly or disabled persons, whose welfare may be at risk if their carer falls ill.

I congratulate the Government on recognising the need to include carers. For some years now, carers' organisations have campaigned for health measures such as free flu jabs to be targeted at carers. Many organisations have also employed primary care workers to work with GPs and primary health care teams to identify and support carers in their practice populations. Many of those primary care projects have been in existence for years and have had successful programmes prioritising flu jabs for carers. In places such as Leeds, Milton Keynes, Bristol and Salford, the primary care trust carers projects have ensured that all carers can be offered free flu vaccination by their GPs. The benefit of such work is that it not only protects the carer from flu, but supports their caring role by helping them to safeguard their health.

Although there are 5.2 million carers, only some 20 per cent. care at the heavier end of commitment of more than 50 hours a week. In a GP practice population of 2,000, there are likely to be 200 carers, only 40 of whom will be caring at the heavier end. Put that way, the numbers of additional flu vaccinations look manageable for GPs and their staff. I therefore hope that the Government will consider the idea of extending flu vaccination not only to those who care for an elderly or disabled person, but to all heavily committed carers.

It is increasingly understood that caring has an impact on the carer's own health, so it is right to treat carers as a vulnerable and at-risk group. Increasingly, too, carers at the heavier end of commitment are seen as partners in providing health care. NHS employers are directed to offer influenza immunisation to employees directly involved in patient care, and that practice extends to staff in nursing and care homes. In cities such as Leeds, Milton Keynes, Bristol and Salford, primary care trusts have offered vaccination to all carers, so I hope that my hon. Friend the Minister of State, Department of Health, can look into extending influenza immunisation to all groups of carers in subsequent winter seasons.

The principle implemented this year, of recognising carers as partners in health care who need to be protected by vaccination, is important. I hope that it will continue and be extended to all carers in future years, as well as providing a basis for their inclusion in the priorities for vaccination in the unlikely event of an influenza pandemic.

6.16 pm

Michael Gove (Surrey Heath) (Con): Emergency preparedness is a central test of the effectiveness of Government. Just as we judge a hospital not only on how well it deals with chronic conditions but on how its accident and emergency facilities perform, so when assessing the performance of a Government it is not the standard, day by day, week by week administration, but how they rise to the great challenges that they face that enables us to judge how capable Ministers are.

Unfortunately, as the right hon. Member for Walsall, South (Mr. George), who is no longer in the Chamber, hinted, the Government have not always risen
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as effectively to the challenges as they might have done. I was grateful to the right hon. Gentleman for pointing out that there is a strong case, which has been put by our Front-Bench team, for the appointment of a central co-ordinating figure to provide leadership and administrative grip at moments of crisis. That was the recommendation of the Select Committee that the right hon. Gentleman chaired and a position that my party has championed. I hope that there can still be an opportunity for a rethink when the Minister for Policing, Security and Community Safety sums up the debate.

When we consider the crises that the Government have faced, inevitably, like the curate presented with the egg, we have to say that they have been good in parts. Let us consider the fuel protest. By the Government's admission, we were only hours away from anarchy. As the hon. Member for Northavon (Steve Webb) pointed out earlier, imagine what would happen if they had that level of administrative grip in the face of a pandemic that could affect 14 million people.

We should also remember the foot and mouth disaster, to which my hon. Friend the Member for Beverley and Holderness (Mr. Stuart) referred. Not only was the general election delayed, but panic gripped parts of the country. Parts of our nation had to be closed down. The Army had to be brought in, and there was friction between the civil and military powers about how to deal with the crisis. Those were test cases of emergencies where the Government failed to provide the administrative grip that a Minister for homeland security could supply.

One of the features that characterised the Government's response to both crises was recognition that the public required reassurance. Unfortunately, the reassurance the Government tried to provide was through communication rather than action. As my hon. Friend said, on both occasions the Government tried to spin their way out of trouble by reassuring people that things would be all right; they were telling, not showing. The only effective reassurance at times of crisis is tough action to resolve the problems, not a Minister appearing on television attempting to calm us down when the evidence on the streets is of a crisis spiralling out of control.

Emergency preparedness in the context of our debate covers the risk of both a flu pandemic and a terrorist attack. My colleagues put a number of pertinent questions about a flu pandemic that have not yet been satisfactorily answered. We have no real idea whether we have the extra bed capacity to deal with the scale of pandemic envisaged by the chief medical officer. We have no real explanation of the Government's delay in stockpiling vaccine. We have been told that they are waiting for best evidence, but who is to say that medical evidence will not change in the future, just as the virus itself might mutate.

It seems as though what we have heard is an excuse for procrastination, rather than a justification for wise administrative action. As my hon. Friend the Member for Monmouth (David T.C. Davies) pointed out, the same applies with the provision of simple matériel, such as face masks and gloves. Other countries, such as Australia, have had the opportunity to acquire such matériel, as he said. We were producing it on our own
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doorstep, and we failed. Those are all pertinent questions that have not been effectively addressed by the Minister or her colleagues.

Let me deal briefly with terrorism. In the motion, we congratulate the emergency services on their superb work on 7 July. We would all say that those who worked in the fire service, the ambulance corps and the police did a brilliant job in cleaning up after what was a tremendously horrifying day for many of us, but one of the things that we need to bear in mind is that my right hon. and learned Friend the Leader of the Opposition asked in moderate and reasoned terms for a look to be taken into the circumstances surrounding the events of that day. He stated that the finger of blame should be pointed only at one group of people—the terrorists responsible—but he also asked whether we could have a proper commission of inquiry into the events of that day. When the Minister for Policing, Security and Community Safety comes to the Dispatch Box, I should be very interested if she would tell us what lessons have been learned, what systems have been put in place to enable those lessons to be made public, what inquiries have gone on, what we can know about the events of 7/7 and what the Government are doing.

The Government are very keen to trumpet the legislative changes that they wish to make to deal with the terrorist threat, but we also know that operational behaviour counts, and that is the Government's Achilles heel. Consider the scenes at Heathrow, when we knew that there was a real threat—I do not doubt for a moment that there was one—and tanks and other armoured vehicles were mobilised. What signal did that send? The Secretary of State for Work and Pensions, the right hon. Member for Sheffield, Brightside (Mr. Blunkett), acknowledges that that was a mistake. Why was that mistake allowed to happen on his watch? What lessons will the right hon. Lady tell us have been learned from that episode?

Another area where profound operational questions have been asked is in the shooting of Mr. Jean Charles de Menezes. I know that that case is being reviewed and that it has been hijacked by extremist elements on the left who wish to undermine—

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