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Lord Weatherill: My Lords, can the noble Baroness say which organisations carrying out de-mining operations in Afghanistan currently receive assistance from the United Kingdom Government? Are they affected by current funding policies?
Baroness Amos: My Lords, the UN Office for the Co-ordination of Humanitarian Affairs carries out mine action activities in Afghanistan. Recently we undertook a review of those mine action activities and we are currently considering the options as regards further support for that programme.
MRSA: Vaccine Development
3 p.m.
Baroness Masham of Ilton asked Her Majesty's Government:
- What research they are sponsoring to develop a vaccine for the "superbug" methicillin-resistant staphylococcus aureus (MRSA).
Lord Hunt of Kings Heath: My Lords, a research advisory group has reviewed needs in the field of antimicrobial resistance. It has recognised the importance of vaccine development. Recommendations that further detailed consideration be given to this area, in collaboration with the Medical Research Council, industry and other funders will now be taken forward.
Baroness Masham of Ilton: My Lords, I thank the Minister for that rather vague reply. Is he aware that MRSA has spread to most hospitals in the country? People are becoming fearful of going into hospital for routine operations. This problem is costing the National Health Service an immense amount of money, as well as exacting a high toll on human resources.
Lord Hunt of Kings Heath: My Lords, the Government regard the matter of MRSA and hospital acquired infection in general as one of great concern. Indeed, two reports from the Select Committee of your Lordships' House have drawn attention to the challenges we face. We have issued guidelines to the NHS. We have introduced a system of controls assurance which makes the chief executive of every NHS trust report to the board on the measures being taken to ensure that everything possible is done to reduce the incidence of infection. I also believe that we need to ensure that preventive measures are adopted. Some of those measures are as basic as ensuring that simple hand-washing is undertaken by all staff in hospitals.
Lord Clement-Jones: My Lords, in January this year the Government announced what they described would be the biggest ever hospital clean-up and stated that they would launch a series of unannounced visits to every hospital in the country by the end of March. What are the results of that hospital inspection process and how prevalent is MRSA in those hospitals?
Lord Hunt of Kings Heath: My Lords, MRSA is prevalent, but the data we hold at present are not sufficiently robust to enable me to give definitive answers to the noble Lord's questions. That is why we have introduced a new data collection system from 1st April this year. It will establish a baseline from which we shall be able to monitor the progress being made and, potentially, then issue targets to the NHS to ensure that the incidence is reduced.
Having launched Operation Clean-Up, I can tell the noble Lord that we established patient environment action teams which have made regular visits to over 400 hospitals in NHS trusts over the past few months. The teams have graded the hospitals into green, yellow or red groups. Those hospitals which are seen to be in some difficulty over cleaning have been told in no uncertain terms exactly what improvements need to be made. We shall announce the overall results of that initiative in due course, but the indications are that it is having a considerable effect.
Lord Rea: My Lords, will the new database mentioned by my noble friend in his last response be based on a national surveillance scheme to measure the extent of microbiological antibiotic resistance in all hospitals in the United Kingdom? Furthermore, can he tell the House whether the Government envisage introducing a scheme so that residential care homes and nursing homes will also be covered, perhaps on a sample basis? They often act as reservoirs for MRSA infection.
Lord Hunt of Kings Heath: My Lords, I can confirm to my noble friend that the new data collection scheme will embrace all the NHS trusts in England. So far as residential care homes and nursing homes are concerned, such information would be covered by the PHLS Piloted Communicable Diseases Surveillance Centre, which is based on capturing and collating the results of all antibiotic susceptibility tests performed on routine specimens in microbiology laboratories. That scheme will be rolled out to other regions over the next two years.
The other way in which residential care homes and nursing homes can be covered is through their regulation, at present undertaken by health and local authorities, but in the future to be undertaken by the national care standards commission. I am sure that the commission will wish to look at rates of infection in individual homes.
The Countess of Mar: My Lords, in view of the fact that it has been reported that each year more than 5,000 people are killed off by the National Health Service through infections and that many thousands
more are made seriously ill, perhaps I may make the following recommendation. As no one has yet died from eating unpasteurised cheese in this country, perhaps the Government should move those environmental health officers currently employed to watch what we do to work in hospitals?
Lord Hunt of Kings Heath: My Lords, that seems to be an extremely helpful suggestion and I am sure that it will be given every consideration. We have to be cautious about the estimated figure of 5,000 deaths. That estimate was based on a 1980 study undertaken in the United States which used 1970s data. However, we have to be extremely concerned about any potential deaths arising from MRSA or wider hospital-acquired infection. This stresses the importance of ensuring that the new data collection scheme is effective. We shall then be able to make future judgments and set targets against that data.
Earl Howe: My Lords, is it not time to bring back matron?
Lord Hunt of Kings Heath: My Lords, the noble Earl knows that I am very keen to bring back matron. We have introduced modern matrons as part of the NHS Plan. Those staff will be real matrons because they will have the authority to deal with issues in relation to cleaning, linen, catering and the feeding of patients, which the previous government disempowered ward sisters from undertaking. That is why we are reintroducing the whole concept of clinical nurse leadership in our hospitals.
Northern Ireland Arms Decommissioning Act 1997 (Amnesty Period) Order 2001
3.6 p.m.
The Minister of State, Cabinet Office (Lord Falconer of Thoroton) rose to move, That the draft order laid before the House on 27th March be approved [12th Report from the Joint Committee].
The noble and learned Lord said: My Lords, since the House last considered this issue on 16th May 2000, when it approved the existing amnesty period extension order, we have achieved significant political progress in Northern Ireland. Devolution has been operating successfully for 10 months. This period has seen the publication of the first Budget by a local Northern Ireland politician for over 30 years and agreement by the Executive on a programme for government, endorsed by the Assembly as a whole. Local politicians have demonstrated that it is possible for individuals from different sides of the political divide to work together for the common good.
Progress has continued to be made on the implementation of every aspect of the Belfast agreement. New arrangements are being put in place to enhance the protection of individual rights and opportunities. The Government have moved ahead with policing reforms and remain committed to creating a police service for Northern Ireland that has
the trust and respect of everyone in the community. The Government expect to publish draft legislation shortly which will implement many of the recommendations made by the Criminal Justice Review.The British and Irish governments and all of the pro-agreement parties have remained in regular and close contact and have continued to demonstrate their commitment to the agreement. The Prime Minister has made two visits to Northern Ireland this year, first in January and again in March, during which he held useful and constructive discussions. From these it clearly emerged that all participants wanted to see substantial progress made on all of the outstanding aspects of the Belfast agreement by June of this year.
With decommissioning, progress has continued to be slower than any of us would have wished. Even so, there has been some movement. Following the IRA statement of 6th May, there have been two separate inspections of a number of IRA weapons dumps. On each occasion, the independent inspectors, Martti Ahtisaari and Cyril Ramaphosa, reported that they had seen a significant number of weapons and that the IRA was serious in its pursuit of peace. After the second inspection they were also able to report that the arms dumps had not been tampered with in the intervening period.
Two weeks ago, the IRA re-engaged with the de Chastelain commission. In their recent report on 22nd March, the commissioners stated that this re-engagement was "in good faith" and that they believed that progress could soon be made.
None of this is to deny that the process is still beset with difficulties and uncertainties. We have yet to secure what we all wish to see: the start to actual decommissioning; and the removal of the bomb and the bullet from Northern Ireland politics for good. That is why it remains important for us to keep in place all of the mechanisms which will make decommissioning possible. The amnesty period extension order is one such mechanism.
The amnesty period is the time during which firearms, ammunition and explosives can be decommissioned in accordance with the scheme, thereby attracting both the amnesty and the prohibitions on evidential use and forensic testing of decommissioned items provided by the Northern Ireland Arms Decommissioning Act 1997.
Section 2 of the 1997 Act requires that a scheme must set out the amnesty period. The initial period had to end before 27th February 1998, but the Act gave the Secretary of State power by order to extend the scheme by a maximum of 12 months at any one time. Four such orders have been made to date. Under the order made in May last year, the amnesty period will expire at midnight on 19th May this year.
The day appointed in any order must not be more than five years after the passing of the 1997 Act, and this five-year period will end at midnight on 26th February 2002. The order currently before the House appoints 27th February 2002 as the date before
which the amnesty period identified in a non-statutory decommissioning scheme must end. This is the maximum extent permitted under that Act.The Prime Minister and the Taoiseach said at Hillsborough Castle on 5th May last year that,
- "the remaining steps necessary to secure full implementation of the Agreement can be achieved by June 2001".
In preparing this order, we obviously had to consider what was the optimum date for extending the amnesty period. One possibility was to set a June date. However, the Government concluded that inviting the House to agree an extension of only a few weeks was not sensible.
The reality is that decommissioning is a voluntary act, and it is not only the IRA which must decommission. Some of the loyalist groups which are committed to the agreement have made it clear that they will only consider decommissioning after the IRA has made tangible progress itself. So, while we want to see decommissioning take place by June, it would be unhelpful to treat that as a deadline after which the scheme would cease to be available. We want the decommissioning commission to be able to deal effectively with all groups which still have illegally held weapons. In our judgment, it would be counter-productive not to have some flexibility over timing.
To come back to the House in June for an extension for a further period would not, we believe, have been helpful. We believe that it is far better to extend the present arrangements for the full nine-month period permitted by the legislation, which is, of course, a shorter period than the House has endorsed on a number of previous occasions.
The Government share the frustration of many noble Lords over the intractability of the decommissioning issue. However, in our view, there is no sensible alternative but to keep working away at it. This order creates the framework in which we can continue to do that. I commend the order to the House. I beg to move.
Moved, That the draft order laid before the House on 27th March be approved [12th Report from the Joint Committee].--(Lord Falconer of Thoroton.)
3.15 p.m.
Lord Glentoran: My Lords, I thank the noble and learned Lord for moving the order. With certain reservations, which I shall speak to, we support the need for the order.
As the noble and learned Lord pointed out, at the time of the Good Friday agreement, full implementation was expected by May 2000. That date is long gone and a lot of history has past since then.
Last year, the governments in Dublin and London set a new date of June 2001. That date has not yet arrived, but the noble and learned Lord is moving the order in the anticipation that nothing will happen before June this year. Although I understand where the noble and learned Lord is coming from, I am sorry about that in many respects.I believe that the Government are making a serious mistake in deciding to extend the period to 27th February 2002 because it sends a number of wrong messages. First, it is quite clear that an enormous amount of continuous pressure is required on the republicans--and, indeed, on the loyalists--to get them to move at all. This order will lift the pedal--it will lift the pressure off them--and they will assume that nothing is expected of them until somewhere around January/February 2002.
Secondly, February 2002 is the wire; it is the end; it is the deadline for the Act as it stands. That could well give the next government--I hope that they will be of my party--considerable problems. We have heard and seen how incredibly difficult it is to get the decommissioning that we all want, and I feel that a deadline of 27th February 2002 risks backing the government of the day into a tight corner.
I believe that Sinn Fein/IRA can deliver if it chooses to do so and if there is sufficient pressure. The organisation is run by its army council. As Peter Robinson MP did in another place yesterday, I shall name that army council. He said:
- "What is the highest level of the Provisional IRA? It is its army council. Who is on the army council of the Provisional IRA? The chief of staff is Thomas 'Slab' Murphy. The assistant chief is Brian Keenan. The other members are Martin McGuinness, the Minister of Education in the Northern Ireland Assembly; Gerard Adams, leader of Sinn Fein; Martin Ferris, another Sinn Fein member; Patrick Doherty, another Sinn Fein member; and Brian Gillen. They are the seven members of the army council of the Provisional IRA, a majority of whom are members of Sinn Fein".--[Official Report, Commons, 2/4/01; col. 144.]
The republican movement is a master of the two strategies described by the acronym "TUAS": "Totally Unarmed Struggle" and "Tactical Use of the Armed Struggle". These two strategies are run side by side, and we have watched their success for years. It is now time for Sinn Fein/IRA to end the ambiguity and deliver on decommissioning. If it does, as the noble and learned Lord indicated in opening, we believe that the loyalists are prepared and ready to follow.
However, the republicans still believe that there is more to be gained by continuing with the TUAS strategies. This can perhaps be demonstrated by the fact that, even now, they are informing their West Belfast constituents in a leaflet that they have succeeded in ridding them of the RUC and that the police reservists will be off the streets by next year. I am
fearful that such a situation may come to pass. I understand from the press that the Chief Constable and most of the top echelon of the RUC will be gone by the summer of 2002. The comments of Mr Pat Armstrong, the chairman of the Northern Ireland Police Authority, when presenting the policing plan for 2001-02, lead me to believe that he has serious doubt that there will be sufficient resources available to police the Province for the next year while implementing the new structures required by Patten and the Northern Ireland Police Act.I make these points because the situation is still very serious. I know that we have had no bullets in public and no big bombs for a few years, but they have not gone away. We still have the growing threat of the Real IRA and Continuity IRA. We believe that there are leakages of arms and technology from the Provisionals to the dissident groups--although, as I said, we do not necessarily believe that Adams, McGuinness and company in the army council have much control over them. Added to that, we have a serious escalation of organised crime, as has been recently recognised by the RUC and the establishment of a new special task force to tackle it.
Whatever happens over the election period--regrettably for Northern Ireland this will be a prolonged and extended period--the Government must not take their eyes off the escalating problems in Northern Ireland. However, an extension to the amnesty period is clearly necessary and, with those reservations, I support the order.
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