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Lord Monson: I understand the reasoning and the good intentions behind this amendment. I suggest that paragraph (a) goes too far, although I am sure that there is much merit in paragraphs (b) (c) and (d). We are, after all, talking about civilians, who, by definition, are not subject to military discipline; and some of them are volunteers.

Of course it is highly desirable that key personnel should volunteer to be vaccinated against smallpox, and I am sure that most would if they were encouraged to do so. But what about those with religious objections or those who on medical grounds may be sensitive to some of a vaccine's components? The noble Lord's amendment does not confine itself to smallpox vaccine; it could extend to some of the vaccines used in the Gulf War which can have much more serious side effects.
 
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What would happen if the noble Lord's amendment were agreed to as it stands and people refused to be vaccinated? Would they be compulsorily held down and vaccinated, would they be sacked if they were in paid employment, or would they be arrested and put on trial if they were volunteers? There is a lot of merit in part of the noble Lord's amendment, but not in paragraph (a).

Lord Elton: I rise because people may possibly think that my noble friend is a solitary alarmist. I think that he is much less than an alarmist, and I would go further than he does in two respects. First, I was sorry to hear him say that these steps were not needed immediately on the assumption that it would be possible to forecast when the risk of certain events became acute; but, as he said, they are quite likely to arrive out of a clear blue sky. I am certain that some of them are in preparation at this moment. Therefore, there is a degree of urgency about this, which needs to be borne in mind and reacted to.

Secondly, in paragraphs (c) and (d) the list of possible noxious substances is incomplete. Paragraph (c) requires means of monitoring persons and so on for radiological material but not for chemical and biological, and in paragraph (d) my noble friend has left out radiological. There may be reasons for that, but it seems to me that this is an acutely important question. If the risk is real—and I think it is—the answer to it cannot be partial. That bears on what the noble Lord, Lord Monson, has just said. Those who are professionally in jobs that protect the public must be fully protected in order to qualify. Therefore, it seems necessary that there must be some compulsion.

The question is different where the agency is voluntary. But again it is a question of whether an unprotected person who is required to deal with a chemical, or more particularly a biological, attack is qualified to carry out the function as a volunteer. But I am wholeheartedly behind my noble friend. I would say that the risk only diminishes in proportion to our preparedness to meet it. At the moment it is very great.

Lord Garden: I share the sense of urgency of the noble Lords, Lord Jopling and Lord Elton, about the need for measures. We do not know when or if there will be a CBRN terrorist attack. But it is obviously a possibility in the new situation in which we find ourselves and we need to take precautions urgently.

However, the amendment of the noble Lord, Lord Joping, breaks into two completely different sorts. One puts action on authorities to do things, which I totally support; the other makes a very difficult judgment about how much we should compel people in employment or even the voluntary services, and, if necessary, counter to health and safety regulations.

I deal first with paragraphs (b) (c) and (d), which I support totally. I assume that the Government will go ahead with paragraphs (b) and (c) with all urgency. I hope that that is true, so that, as the technology becomes available, we can control the points of access for the various noxious materials that might come. Paragraph (d) is vital. We need to give guidance to
 
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local authorities on what scale of equipment they need. Some detection systems are still in their infancy. As the technologies come along, we shall get better detection systems. We need to make sure that local authorities are kept up to date with what they need to have as we improve this. So I support paragraphs (b), (c) and (d), but would very much emphasise the need to task local authorities with the sorts of scales of equipment needed.

On paragraph (a) I think we are in very difficult territory. I take the case, for example, of when we sent our military off to fight a war in Iraq—in which at least the Prime Minister believed they would be exposed to biological and chemical weapons perhaps. We failed to give them the protection of air filters in their vehicles because we did not give enough equipment. Even then we left the administration of the various vaccines to informed consent. That was to a military force. I think that is right. In the end we must get the balance between the risks, and there are risks associated with taking vaccines and particularly with taking lots of vaccines.

We have talked a lot about smallpox, but there are a whole range of potential biological warfare agents, some of which do not have vaccines which would give one much more than partial protection and some no protection at all. So, we would have a difficult decision as to which vaccines. We would have questions on what the ill effects might be and the consequences against the balance of risk if we are going to be attacked by that substance.

It would be an enormous step against liberties to turn around to emergency services that we depend upon, and particularly volunteers, and say, "You are compelled and you become a criminal unless you accept this vaccine against a threat that one cannot be certain about". So I would support paragraphs (b), (c) and (d) of the noble Lord, Lord Jopling, but not paragraph (a).

Baroness Park of Monmouth: Perhaps I may suggest that, having observed the Gulf War syndrome over many years, what went wrong, at least partly, was the need for haste in a very last minute decision. We are talking basically about the training and capacity of people to do their jobs who would be in the front line of the ambulance and fire services. We would not dream of sending them into battle without a gun, so why are we not prepared to say to them, "If you wish to do this, and be responsible and able when the time comes, you will have to decide now whether it is compatible with your conscience to accept this. If not, then we are very sorry you will not be very much use to us. We must find people who will".

Baroness Masham of Ilton: I congratulate the noble Lord, Lord Jopling, on bringing up this very serious matter today. Some of your Lordships may have watched the television programme a few weeks ago about the City of London which was not able to cope with decontamination. Because terrorism is a world problem, I should like to ask the Minister about the World Health Organisation's views on vaccination.
 
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There are such horrible things as plague and the new problem of severe acute respiratory syndrome, for which the vaccines are in laboratories and can escape, or people could manufacture them. So that is a real and serious problem. A few weeks ago, with the purple condoms in the other place, all the wrong things happened. People were supposed to stay in the Chamber; they rushed out. So we are not prepared. The noble Lord, Lord Jopling, is doing a service to the country, but I should like to know the view of the World Health Organisation on the matter.

Lord Hylton: I appreciate the thought and care that has gone into preparing this amendment. I just query whether paragraphs (c) and (d) may go a fraction too far by requiring every port and every local authority to have equipment of the kind mentioned. I urge the Government carefully to consider whether such equipment should be held centrally or regionally and to what extent it should be localised.

Lord Lucas: I very much support my noble friend, especially concerning biological terrorism. Chemical and nuclear attacks, although they can be exceptionally nasty to be subjected to, are essentially local. If someone took out the whole of London, that would just make a large hole in the map and the rest of the country would be able to carry on and repair the damage. If we have an outbreak of a serious infectious disease, our ports and airports will be closed against all traffic and incoming goods, because no one else will want us to export this stuff to them. That could be very hard for the nation to fight.

So we have to be in tip-top condition to tackle an outbreak of a serious infectious disease and be able to master it in a short timescale. The only recent example of this that we have is foot and mouth disease and, because we were not prepared, the outbreak escalated and went on for a great deal longer than it should have. If that had been a human disease, given that culling is not an option—although it might be under Part 2, not in the form of a criminal penalty, but there does not seem to be anything to stop people being dropped into mass graves if they were suspected of having a disease—and we were cut off from supplies from outside, it would not be long before we became the equivalent of a house with a cross marked on the door in the days of the plague. We would be left to die or survive and someone might come round in a year's time to see if there was anything worth rescuing.

So we must be able to react quickly. I think it is reasonable to expect that anyone who is going to make a serious attempt at biological terrorism will use an existing disease. It is difficult to create something that will propagate effectively in the human body that will have the desired effect in the right sort of timescale, which will transmit properly between one human and another, de novo and hope that it will work. It is much easier to start with something that you know transmits and develops properly in the human body and just give it a twist. I am sure that the Minister is aware of the experiment that was performed with mouse pox in Australia to make it much more virulent and resistant to vaccine.
 
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So it is not beyond the capabilities of an ordinary biological laboratory to create something that is seriously damaging. We should not think that well financed terrorists, such as Al'Qaeda, are incapable of doing that. There is no great control over the machinery or material needed to do it; the knowledge is spread very wide; and we already know that they are well equipped with people who were prepared to sacrifice their own lives to spread disease.

We have to be able to react quickly, should such a thing hit us. If they choose a vector that is spread relatively slowly—if it is a water-borne disease, such as cholera, a food-borne disease or something such as anthrax, which essentially requires special conditions to spread in the human population—it will be containable. But if they use an airborne vector, such as smallpox or the flu, we are in real trouble. The only way to control that is to have a sufficient mass of people who are likely to be immune to the disease, trained to treat it and sufficiently close to the outbreak to be able to swamp it early. We would have to be lucky to do that. It should not involve a few hundred doctors; it ought to involve at least half of the doctor and nursing population.

I agree with what other Members of the Committee have said: compulsion is probably inappropriate. But we absolutely ought to be aiming for any hospital to be able to put together a team effectively to isolate any of the common, well known infectious diseases very fast. That means having that level of immunity present and ready. Smallpox is the obvious example; there are others. We do not need to go to the extent that we do for battlefield protection, because in battles, there is the prospect of using organisms that essentially have a local or limited effect and are just debilitating, rather than fatal. We can probably deal with that in the ordinary course of events. We do not have to consider that many diseases, but we must protect against those that we know could be used against us and are the obvious vectors. We need to take the matter seriously and give ourselves the level of protection that we need, along the lines of my noble friend's amendment.


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