House of Lords
Monday, 10th December 2001.
The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.
Prayers—Read by the Lord Bishop of Southwark.
Baroness Hylton-Foster—Took the Oath.
Anthrax: Treatment
Lord Soulsby of Swaffham Prior asked Her Majesty's Government:
- What advice they are giving to doctors regarding antibiotic use in the event of exposure to the anthrax bacillus.
The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): My Lords, advice to doctors on the treatment of those with anthrax symptoms and those potentially exposed to spores is available through the Public Health Laboratory Service. Specific guidance is available on the PHLS website, including on the use of antibiotics. Arrangements have also been made to draw the attention of GPs and other clinical staff to the guidance as appropriate.
Lord Soulsby of Swaffham Prior: My Lords, I thank the Minister for that reply. It is encouraging. The Public Health Laboratory Service guidelines suggest that penicillin is used as a prophylactic and even in therapy. However, the strain of anthrax that has been disseminated in the United States and a number of strains in the wild are also producers of penicillinase, and hence can lead to resistance. Will the Minister assure the House that the guidelines are updated to take account of the abilities of these organisms?
Lord Hunt of Kings Heath: My Lords, antibiotic-resistant anthrax is a known phenomenon. Tests in the US indicate that the strains of anthrax identified there were susceptible to penicillin and to ciprofloxacin and doxicyclin. In the UK, the antibiotic of choice is ciprofloxacin, which is considered to be the most effective antibiotic in these circumstances.
In any incident, it is clearly important to test the anthrax for antibiotic resistance, as that cannot be predicted. Such testing will continue as the incident unfolds in case more than one strain of anthrax is used. This will then confirm the treatment. Laboratories, including the PHLS, are well able to undertake such tests as a matter of routine.
In relation to the guidance, I have checked with advisers and have been informed that it is consistent with the relevant information that is now available. I should be happy to discuss the matter further with the noble Lord.
Lord Clement-Jones: My Lords, the Question was also directed towards the prophylactic use of
antiobiotics against anthrax. What action is the department taking to prevent such use or to discourage it?
Lord Hunt of Kings Heath: My Lords, the guidance issued by the PHLS recommends, at page 8, prophylaxis after exposure. In that case, ciprofloxacin is recommended as the antibiotic of choice.
Baroness Finlay of Llandaff: My Lords, the cascade of information from the Government to NHS trusts and GPs has been very effective. However, the difficulty remains of diagnosing the first index case. What measures are in place to ensure a continuous cascade of information so that it does not fall from the front line of the minds of those clinicians who might be faced with seeing the index case and who would be key in diagnosing it?
Lord Hunt of Kings Heath: My Lords, the guidance was originally available on the PHLS website on 11th October. GPs and other clinicians had their attention drawn to that advice in a letter from the Deputy Chief Medical Officer on 11th and 15th October. More detailed guidance was issued on 17th October to all health authorities. I very much take the point that the noble Baroness has raised. I can assure her that the PHLS will update guidance as appropriate. We have an effective way of then ensuring that that reaches front-line clinicians.
Earl Howe: My Lords, as the Minister indicated, strains of anthrax can vary in their susceptibility to antibiotics. In view of that, what are the Government doing to ensure that rapid methods are available to detect antibiotic resistance in a strain of anthrax and, therefore, to give rapid advice when it is needed?
Lord Hunt of Kings Heath: My Lords, as I believe I said in my answer to the noble Lord, Lord Soulsby, tests are undertaken and it is very important to carry those out as quickly as possible. Testing continues to take place in relation to specific incidents in case more than one strain of anthrax has been used. Therefore, the purpose of testing is to confirm whether anthrax has been involved and, if so, which strain. Tests are then carried out to determine whether that strain of anthrax is resistant to a particular antibiotic. Therefore, a hierarchy of responses ensures quick and continuous testing and, if anthrax is confirmed, it identifies whether the strain would be resistant to a particular antibiotic.
Faith Schools
2.44 p.m.
Lord Hylton asked Her Majesty's Government:
- Whether they will ensure that the experience of Northern Ireland in inter-denominationally integrated schools is taken into account in England
- and that parents are consulted about inter-faith education when new religious schools are proposed in the state sector.
The Parliamentary Under-Secretary of State, Department for Education and Skills (Baroness Ashton of Upholland): My Lords, we shall require promoters of new faith schools to have local support and to demonstrate how they will be inclusive and work in partnership with other schools. We consider that approach to be more appropriate than directly copying Northern Ireland's integrated school system. Promoters of new schools must carry out detailed consultation with the local community and interested parties.
Lord Hylton: My Lords, I thank the Minister for her reply. Will she note that I was not suggesting a direct copy of Northern Ireland? Would she be prepared to consult her ministerial colleague there on this whole matter, and does she agree that inter-religious schooling in England is highly desirable?
Baroness Ashton of Upholland: My Lords, indeed, we consult colleagues in all departments on issues that are appropriate and relevant. We acknowledge that there are 20 or so existing Roman Catholic and Church of England schools in England, as referred to by the noble Lord, Lord Hylton. The noble Lord is right to draw attention to existing joint-faith schools which bring together children of Christian faith. It is worth noting that a key aspect of the success of these schools is their ability to work together on shared aims through mutual respect in order to secure the best education for their children.
Lord Dubs: My Lords, does my noble friend agree that one of the lessons of Northern Ireland is that educating children separately has a damaging effect on community relations and on the attitude of one religion towards another? Does she accept that the concerns in relation to a move to faith schools are that such schools would not easily be inclusive and that they might lead to increased segregation in this country without necessarily following any Northern Ireland model?
Baroness Ashton of Upholland: My Lords, as my noble friend Lord Dubs knows well, at present 4 per cent of Northern Ireland's pupil population attends integrated schools. The general policy in Northern Ireland is that children should be educated in accordance with their parents' wishes. That is reflected in the different schools which exist in Northern Ireland, including maintained, controlled, integrated and Irish medium schools. All schools, regardless of whether they have a particular religious designation, should further understanding of the diversity of national, religious and ethnic identities in the UK and the need for mutual respect and tolerance. That is exactly how we would approach this issue in England.
The Lord Bishop of Southwark: My Lords, does the Minister acknowledge that there is a long tradition of
Church schools in England, which serve the whole local community and not only the children of practising Christians?
Baroness Ashton of Upholland: My Lords, I agree with the right reverend Prelate that there is, indeed, a long-standing and widely accepted tradition of faith schools in this country. Christian faith schools have a significant history as part of the state education system and play an important role in its diversity. We consider that it would be wrong to deny members of other faiths access to schools of their faith.
Lord Dearing: My Lords, I declare an interest as the chair of the committee of the Church of England that recommended an increase in the number of that Church's secondary schools. Is the Minister aware that at a meeting of the General Synod of that Church last month a resolution was passed which welcomed an ecumenical approach to those additional schools? The resolution stated that the schools should serve the whole nation and should be open to children from the diverse communities that they serve.
Baroness Ashton of Upholland: My Lords, I am aware of the work of the noble Lord, Lord Dearing, and of the resolutions that were passed by the General Synod. The Government welcome the emphasis that the noble Lord gave in his report to the Archbishops' Council to the principles of social and religious inclusiveness. We were delighted to see that that was reinforced in a resolution of the General Synod on 14th November which noted that Church schools should be open to the diverse communities that they serve. That is an important part of education in this country.
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