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Lord Lucas: What exercise have the Government undertaken to simulate a smallpox outbreak and establish the number of staff required by a hospital to contain it—presuming that the first vector was hostile and therefore determined not to be found, so that all one started finding was the people who had been infected, who might be numerous? I am surprised that there are only 200 such people scattered around the country. Since we have around 10 regions, presumably the Government think that we can contain it with 20 personnel at any one time. That seems a very small number for dealing with an infected population which may number some hundreds.

Secondly, can the noble Lord quantify the risks attendant on the smallpox vaccination? So far the only figure that we have is the one provided by my noble friend, courtesy of the noble Lord, Lord Warner, when he says that the risk is zero. The noble Lord keeps saying that there are these risks but he has not
 
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provided any figures, proportions or statistics on which we can base our understanding. Could we have a full answer on that?

Lord Swinfen: I am sorry to bother the noble Lord. Theoretically, smallpox has been eradicated from the world but anthrax has not. Anthrax is a far more likely method of attack. Will the noble Lord also include in his answers on smallpox the same answers on anthrax?

Lord Bassam of Brighton: I am obliged to noble Lords for their questions.

The Department of Health has undertaken—

The Earl of Onslow: I was fascinated to see that, on being asked two questions, the noble Lord put his head down and continued to read from his brief as if nothing had happened in the Chamber. I am sorry if my astonishment was so noticeable; I did not mean to make it public.

Lord Bassam of Brighton: I thought that I would provide the noble Earl with an opportunity to ask his question from a non-sedentary position.

I was about to respond to the point on exercises for smallpox scenarios. There is an active exercise plan through live and tabletop exercises. For example, my understanding is that the Global Mercury exercise tested international communications in the case of a smallpox outbreak. The noble Lord, Lord Lucas, asked me about the health risks following a vaccination programme. I shall try to provide as much information as possible.

Even if those with known contraindications to vaccination are excluded from a mass vaccination programme, it is still predicted that one per million of those not previously vaccinated might die as a result of the vaccine, with a further 20,000 suffering severe complications. Also, because of the disruptive effect on the blood supply, those vaccinated must be excluded from giving blood for a defined period. Post-vaccination, additional deaths could also be expected due to a shortage of blood. That is the best information that I can provide the noble Lord with today. I shall have to include a response on anthrax, about which the noble Lord, Lord Swinfen, asked, in the body of correspondence to which I have already committed myself. It would be unwise of me to do otherwise.

I shall return to the noble Lord's concern about the United Kingdom civil authorities' capability to detect and deal with chemical, biological, radiological or nuclear (CBRN) incidents. As the noble Lord explained, his amendments would enable Ministers to require local responders to purchase equipment designed to identify the presence of CBRN material and to deploy that equipment at ports and airports.

At Second Reading, the noble Lord made clear his view that the Government were being complacent about the threats we face. I do not accept that, but I think that I can offer some assurance that this is not the case. We
 
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have undertaken a very busy key capabilities programme, which identifies the generic capabilities that underpin the UK's resilience to disruptive challenges, however they are caused, and ensures that those capabilities are developed. There are 17 such capabilities, including dealing with chemical, biological, radiological and nuclear material. The United Kingdom counter-terrorism framework has been enhanced through increased investment in operational activity and new legislative measures. However, the Home Office leads a programme of work to ensure that we continue to build our capacity to deal with CBRN events, should they occur.

The emergency services have the best detection equipment currently available, and the Government are working with them to develop that capability still further in line with their specific needs. The police service has a well developed capability in this area, which is being strengthened through specialist training at the National Police Training Centre. The fire service has the New Dimension programme for the fire and rescue services. It incorporates the procurement of radiation monitoring equipment for deployment at incidents involving radiation to give an early on-site indication of the release of hazardous radioactive material or radioactivity.

The Government have put in place Programme Cyclamen, which is designed to screen for the illicit movement of radioactive materials by traffic entering the United Kingdom by sea, air or through the Channel Tunnel. The screening programme includes container and road freight, post and fast parcels, vehicles and passengers, and makes use of fixed and mobile detection units. The Government are not complacent at all about the threat of CBRN terrorism. They are committed to continue to invest in the capabilities that our assessment of risk shows we need.

I have dealt with the point about the risk from vaccination, but it is worth dwelling on some of the observations made about our preparedness. To offer some reassurance, I wish to quote the director-general of MI5, who in June 2003 said:

"Our systems for terrorist protection are the envy of the world".

Kelvin Laybourne, the chair of the CBRN professional-issues group of the Emergency Planning Society wrote in the Guardian in February last year:

"It is important to realise that . . . [CBRN attacks] are extreme scenarios and the likelihood of this happening to you is probably very low".

One can never be complacent about these issues. It is vital that the Government have not only the powers but also the will to tackle them. The measures that we have put in place over the past few years and the added investment that we have made, not just through the distribution of new grants to local government in our previous spending-round assessment, but in the daily
 
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accretion of expertise within all the emergency services and the training that we have put in place, demonstrate our commitment to deal with these issues.

I certainly support the intent behind the amendment: to ensure that we get it right and that we go on working and investing in this area to offer the maximum reassurance and capability. We will need to have that to protect against some of the threats that may confront the country in the future.

Baroness Masham of Ilton: Before the Minister sits down, perhaps he could answer my question about the views of the World Health Organisation.

Lord Bassam of Brighton: As I recall, I observed that the World Health Organisation had advised that vaccination against smallpox should cease because of its eradication. I am not sure whether that matches entirely the noble Baroness's question but if it does not we shall have another look for any useful or valuable information.

Baroness Masham of Ilton: I am interested in the much wider aspect, including plague, SARS, anthrax and other issues apart from smallpox.

Lord Bassam of Brighton: I appreciate that. I will go back over the question to see what further information we can provide.

Viscount Goschen: Before my noble friend Lord Jopling responds, it would be extremely helpful if the Minister could clarify whether he really feels that the small cohort of 140-odd doctors and 140-odd nurses is the right number of people. Is it just difficult to get more people vaccinated? This really comes to the crux of the issue about whether people should be forced to be vaccinated or whether it should be done on a voluntary basis. Would the noble Lord like to see more doctors and nurses vaccinated than are currently, or not? Have the Government tried as hard as they can to increase that number, or is the Minister really saying, "No, 140 doctors and nurses is approximately the right number"? If the noble Lord could be clear about that, we could have a much clearer discussion about whether or not compulsion was required.

Lord Lucas: I was puzzled by the figures that the noble Lord gave me in response to the dangers of the smallpox vaccine. Is he really saying that in the days when all of us received this vaccine 50 children were dying a year from getting it and that one child in 50 who was given it had some kind of serious damage as a result? By serious damage, I am assuming something like blindness or bits dropping off rather than just an odd upset tummy.

I would like the historical data on the damage done by the smallpox vaccination to which we were all submitted. I would very much like to have the details of what the Minister means by "serious complications". Those words can get twisted one way or the other, which we will come on to later in another context.
 
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I am also fascinated by the remark made by, I think, the head of MI5 that our systems for protecting against a CBRN attack are the envy of the world. Besides the fact that they sound remarkably like the boasts of the builders of the "Titanic", I am puzzled as to how they can be the envy of the world when no one in England, let alone the world, knows what they are.

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