---

Lord Swinfen: I also support my noble friend's amendment. Can the Minister tell us whether these 200 or so medical personnel who are inoculated against smallpox are already in teams, so that they can deal with the problem together, or are they a group of individuals scattered loosely throughout the country? If they are the latter, they are of no real use at all. They need to be in teams to work together to control the disease and deal with those who are unfortunate enough to contract the disease themselves.

Baroness Buscombe: I want to be brief as there has been a very good debate on this excellent amendment. Indeed, I hope that the Minister has been listening hard, especially to my noble friend Lord Jopling, who is endeavouring to inject some realism into the Bill. These emergency powers are to be introduced into the world that we live in now. The amendment accurately reflects some of the real concerns that many people
 
14 Oct 2004 : Column 406
 
beyond your Lordships' House have because yes, the Bill is an enabling Bill, but it is not clear about what is now a vital response to prepare for real risks.

I am especially pleased that my noble friend did not, as I was inclined to do, accept at face value the content of the letter dated 7 September, addressed to my noble friend, responding to the various important points raised by him on Second Reading. Indeed, I had been disinclined too strongly to support this amendment in the light of that letter, which mentioned the real difficulty of requiring individuals to be vaccinated against viruses, especially because the letter expressed concern about side-effects ranging from mild to fatal. So I am really pleased that my noble friend went further in his research and has now received a letter from the noble Lord, Lord Warner, making clear that there is no risk of acquiring smallpox as a consequence of vaccination.

Clearly, there are risks, as the noble Lord, Lord Garden, said; I am not saying that there are not. However, I refer again to the need to inject some realism. I hope also that the noble Lord listened to my noble friend Lady Park of Monmouth. As always, she showed a great deal of common sense.

We face a difficult situation. The letter of 7 September says that there is no clear possibility of an outbreak at the moment: how does anybody know? As my noble friend said, an attack could come out of the blue. We must be prepared, and we must do all that we can to be prepared, in a proportionate way. My concern is that the Bill is not injecting—if I can use that pun—enough insistence that we are preparing sufficiently for a possible emergency. I hope that the excellent comments that have been made by noble Lords around the Committee will be taken on board by the Minister.

Lord Bassam of Brighton: For the past 40-odd minutes, I have listened carefully to the comments made by all noble Lords who have contributed to the debate. It has been an important, serious and thoughtful debate, and there have been some useful, not to say valuable, contributions.

Over the past few days, in preparing for today, I have thought quite a lot about smallpox. I can remember my stepfather telling me, when I was a child, a fairly awful story. He was a soldier in the First World War and fought in the trenches and in north Africa. He told me how he had contracted smallpox during his time as a serviceman. As a child, I was horrified by his description. I can also recall being inoculated against smallpox as a child, in one of those mass immunisation programmes. Fortunately, my stepfather survived the experience—he was a strong man and enjoyed good health almost until the end—but I am well aware of the horror that lies behind the amendment. It resonates with me.

Serious issues were raised in the debate. I hope to offer some reassurance to noble Lords who are concerned about the issue. I hope also to set the record straight with regard to some of the comments made by the noble Lord, Lord Jopling, although I think that some of the issues that he raised are important and require further thought and clarification.
 
14 Oct 2004 : Column 407
 

I cannot accept the noble Lord's opening comments about how the United Kingdom is severely unprepared. I cannot identify with his suggestion that we focus our interest on civil contingencies and emergencies only in the Bill. The Bill is but one part of the activity that the Government have been urgently involved in over many years, particularly in the past four or five years. We have been thinking through the implications of various emergency scenarios and contingencies. It is not that we have been idle; we have not. I have statistics that suggest a high level of investment and increased thought about the urgent preparations necessary to counter the serious threat of the things that could be visited on us by terrorism or other means.

I share wholeheartedly the sense that the noble Lord, Lord Garden, has that there must be urgency about such issues. The Government are and have been seized of that, but in this difficult area, which involves civil liberties, we must strike a balance and ensure that our response is proportionate in the circumstances. I would argue that that is where we are.

The amendments tabled by the noble Lord, Lord Jopling, probe us on our preparations for dealing with chemical, biological, radiological or nuclear attack. As the noble Lord said, he raised the issue—rightly—at Second Reading, and we have had some correspondence on it. I hope that, latterly, some of the points that I made—certainly those in my second letter to him—have reassured him on some points, at least, if not all.

The Government cannot accept the amendment, and I shall set out the reasons why. The noble Lord, Lord Jopling, suggests that we amend the Bill to enable Ministers to require local responders to give compulsory smallpox vaccinations to staff. The noble Lord also suggests overriding health and safety and, potentially, human rights legislation, if it proves necessary. As I said, I have set out in correspondence the reasons why the Government have chosen not to go down that road. I shall run through those arguments for the benefit of the Committee.

Smallpox has been declared eradicated by the World Health Organisation, which advises that vaccination against smallpox should cease. The side-effects of the vaccine are well known, and, in the absence of the disease, it is argued that the risks outweigh any potential health benefits. The Joint Committee on Vaccination and Immunisation, an independent expert committee that advises the Secretary of State for Health, emphasised the need for the response to any threat of the deliberate release of smallpox to be proportionate. The Government have acted on the advice that a small cohort of healthcare workers in each region should be vaccinated in advance of an outbreak of smallpox.

Lord Elton: Can the Minister be more specific? What were the terms of reference within which the committee that advised the Government that only a small cohort should be vaccinated tendered that advice? What was it told about the purpose of the vaccination? Was it told that it was a question of maintaining the National
 
14 Oct 2004 : Column 408
 
Health Service in the face of a full-scale attack, or was it asked for what it thought would be a modest insurance against the accidental release of the disease?

Lord Bassam of Brighton: The noble Lord will appreciate that, as I speak across the Dispatch Box today, I do not have access to the terms in which those questions were asked. However, I am happy to try to find some more background information, so that I can satisfy the noble Lord. He raises an important point.

Owing to the health risks, we believe that the measures can be carried out only on a voluntary basis; the noble Lord, Lord Garden, used the phrase "informed consent". Volunteers underwent rigorous screening to minimise the risk of an adverse reaction, and restrictions were put on their work for a period after the vaccination, to prevent live transmission of the virus used in the vaccine.

Lord Swinfen: How long after vaccination does it take effect, so that the individual is protected? If there is an outbreak and it takes time for the vaccination to become effective, a larger number of people must be vaccinated in advance. If it takes a week or a fortnight, there could be serious consequences.

Lord Bassam of Brighton: That is a good technical question, which I cannot answer today. I am happy to ensure that we undertake some further research on that point. Earlier, the noble Lord asked about the distribution throughout the UK of the teams that have had the vaccination. I shall write to the noble Lord on that matter too.

There is, at present, no evidence of a specific threat of smallpox. The Department of Health's national smallpox plan envisages only "blue light" emergency service cover, so that vaccination would be offered only if the threat increased. We take the view that it is not desirable or perhaps necessary to make the vaccination of emergency service workers obligatory at present.

---