Memorandum submitted by Department of
Health
1. EXECUTIVE
SUMMARY
1.1 The health sector represents one of
the most complex and diverse parts of the National and Critical
National Infrastructure. It plays an integral part in the UK's
readiness and response to domestic and international terrorist
threats and events.
1.2 CONTEST has an increasing bearing on
the way in which the NHS and the wider health sector operates
in terms of its own readiness and response to major emergencies
(which will include terrorist attacks) and in the sector's resilience
to disruptive challenges.
1.3 The health sector faces some significant
challenges in delivering against its CONTEST commitments given:
— no one single strand will reduce
the overall risk of terrorism. Read-across between strands should
ensure that priorities and deliverables are mutually supportive
and not repeated or conflicting;
— the increased pace of change and
the way it affects how the strategy continues to evolve and expand
when matched against scarce local resources, competing priorities
and the speed at which mitigation can be delivered;
— the "all-risk approach"
required to prepare for unpredictable challenges (both threats
and hazards) and the balance that must be struck between investment
in wider civil resilience against counter-terrorism;
— the complexities around criticality
and critical assets and the read-across into the wider civil resilience
agenda;
— the need to further develop the strategy's
performance management system so as to ensure relevance, achievability
and proportionality;
— performance management and process
overheads can be disproportionately burdensome and overshadow
delivery;
— although at LOW Threat, the sector
is exposed to far greater risks in responding to a wide variety
of major emergencies; and
— the need for a more centrally coordinated
approach to sector engagement by sponsors and delivery partners.
2. PREPARE
2.1 The health sector (through the Department
of Health), has a well-established and long-standing relationship
with the Cabinet Office's Civil Contingencies Secretariat, (being
the sponsor for PREPARE), which is reflected in the more mature
civil resilience delivery plans under this strand.
2.2 Given that it is impossible to predict
all challenges, the health sector takes an all-risk "threat
and hazards" approach to its preparedness relying on established
legislation, systems and structures to support a significant part
of its response. For instance, public health surveillance systems
(supported by the Health Protection Agency and various Royal Colleges),
are equally capable of identifying covert intentional CBRN terrorist
attacks as well as naturally occurring disease outbreaks.
2.3 The balance between programme management
overheads and delivery should be proportionate. Programme management
should not detract from or overshadow delivery.
3. PROTECT
3.1 It must be remembered that in employing
in excess of 1.3 million people, the NHS is the largest single
employer in Europe and that its estate includes somewhere in the
region of 3,000 separate sites plus in excess of 12,000 or so
primary care GP surgeries.
3.2 Hazard-type incidents such as flooding,
interruptions to utility supplies etc. can cause rapid and far
greater disruption to the health sector than terrorism. A PROTECT
approach to the NHS must therefore be proportionate and any investment
justifiable, given the sector's LOW Threat Assessment.
3.3 Currently, work around criticality and
critical assets (replacing the previous system of Economic Key
Points or EKPs), is very much embedded in the CNI Protect programme.
In broadening the definition to include essential services, the
health sector is now responsible for the defence and preservation
of a significant number of highly diverse critical assets including:
— countermeasure storage sites;
— forensic and secure mental health
facilities;
— level 3 and 4 laboratories;
— critical elements of NHS supply chains.
3.4 These assets are as much, if not more
vulnerable to general challenges. In this way, their defence/preservation
crosses into the civil resilience agenda under PREPARE. There
is also the assumption that the sector already has in place the
"building blocks" required to support the concept of
"doing something differently" to defend and preserve.
4. PURSUE
4.1 Health has very little to contribute
to this strand. However, we actively engage when called upon.
January 2009
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