Health Protection Agency Bill [Lords]

Public Bill Committee, 29 June 2004.

Standing Committee F

Health Protection Agency Bill [Lords]

Melanie Johnson (Labour, Welwyn Hatfield)

I beg to move,

That 1. during proceedings on the Health Protection Agency Bill [Lords], the Standing Committee shall (in addition to its first meeting at 9.05 am on Tuesday 29th June 2004) meet at 2.30 pm on Tuesday 29th June 2004 and at 9.05 am and 2.30 pm on Thursday 1st July 2004;

2. the proceedings shall be taken in the following order:

Clause 1

Schedule 1

Clauses 5 and 6

Clause 8

Schedule 2

Clauses 9 to 11

Schedules 3 and 4

Clauses 12 and 13

Clauses 2 to 4

Clause 7

New Clauses

New Schedules

Any remaining proceedings on the Bill;

3. the proceedings on the Bill (so far as not previously concluded) shall be brought to a conclusion at 5.00 pm on Thursday 1st July 2004.

It will be a pleasure to welcome you to the Chair, Mrs. Adams, but first I propose that the Committee accepts the programme motion. The hon. Member for Westbury (Dr. Murrison) asked me in the Programming Sub-Committee about the time taken in the Lords. The Lords debated the Bill for just under nine and a half hours, and spent just under four and a half hours discussing it in Grand Committee. By comparison, we propose ample time to discuss the Bill, and do not want to insert any knives into the timetable. The Programming Sub-Committee accepted the motion unanimously.

Question put and agreed to.

Irene Adams (Labour, Paisley North)

I remind the Committee that copies of the money resolution to the Bill are available in the Room. I also remind hon. Members that they should, as a general rule, give adequate notice of amendments. My co-Chairman and I do not intend to call starred amendments, including any starred amendments that may be reached during the afternoon sittings.Clause 1 Health Protection Agency

Clause 1 - Health Protection Agency

Melanie Johnson (Labour, Welwyn Hatfield)

It gives me great pleasure to welcome you, Mrs. Adams, and your co-Chairman, Mr. Forth, to the Chair. We look forward to both your

chairmanships. The debate is not high politics, so I trust that we will not give you too much cause for concern and that our debate will be constructive and our demeanour good throughout the proceedings. As I said, the Lords considered the Bill for some nine and a half hours, and suggested several improvements, several of which the Government accepted. The Bill has benefited from those improvements.

Without further do, and given the time frame, I propose very brief discussion of the clause, which establishes the Health Protection Agency. Paragraph 2 of schedule 1 makes detailed provisions for the agency's constitution. I have more details to give, but first I shall ascertain whether Opposition Members want to discuss the clause in more detail before I decide whether to speak further.

Andrew Murrison (Conservative, Westbury)

It is a pleasure to serve under your chairmanship, Mrs. Adams.

This is a largely uncontroversial measure. As with any measures of that nature, however, we have difficulty with some of the detail, some of which we touched on in the Second Reading debate. I very much hope that we will be able to address some of the concerns expressed then.

We kick off with clause 1, which deals with the Health Protection Agency overall. Will the Minister tell us her plans for the body, given the current review on arm's length bodies? We understand that the review will reach its conclusion in July, and many of us are concerned that this body may feature as part of that review. We already know that the Public Health Laboratory Service and the National Radiological Protection Board are listed among the 42 bodies that are being considered. They have already been earmarked for amalgamation with the Health Protection Agency, and we strongly suspect that they are listed because they will count as two bodies that can be removed and counted towards the total number of bodies reduced as part of the review. That is sophistry. I am sure that the Minister would agree with that on reflection.

Twenty of the 42 arm's length bodies have been established since 1997. We confidently expect that a large number of those, having been marched up the hill, will be marched down again in July. Nevertheless, when we are talking about the creation of an arm's length body—as we are, at this stage, one month before the announcement of the review's conclusions—it is appropriate that the Minister should comment on the body and assure us that she does not see that it will be greatly affected. Of course, if we see a reduction in the number of bodies such as the National Patient Safety Agency, that could very well have a big impact on the HPA's constitution, finance, structure and so on. Later, we will touch on those specifics.

It seems rather odd that a month before Ministers will announce the outcome of the review of arm's length bodies, we should be considering this matter and putting structures in place that may be quite fundamentally altered following the announcement of the findings of that review. I would be grateful if the

Minister could specifically tell us how the review next month will impact on the Health Protection Agency.

At a later stage, we will come on to discuss the functions of the Health Protection Agency. However, I want to put it on record that it is all very well setting up an agency, but if we do not have a clear idea of what it is going to do and, specifically, how it is going to address public health functions, we are no further forward. We were no further forward on Second Reading, and I hope that as we go through the Bill we will get a clearer idea of precisely how the body, with the various constituent parts added together, will improve public health in this country. At the moment, that is a little unclear.

Melanie Johnson (Labour, Welwyn Hatfield)

The decision to carry out a review of the Department of Health's arm's length bodies was announced to the Select Committee on Health on 30 October 2003, four weeks before the Bill was introduced in the Lords. My right hon. Friend the Secretary of State for Health made it clear in his statement to the House on 20 May that we aimed to announce the conclusions of the ALB review before the summer recess, as the hon. Member for Westbury has acknowledged.

I cannot say more at this stage about the outcome of the arm's length body review; decisions on that obviously have yet to be finalised. Indeed, much of it is completely irrelevant to the Bill. However, I can repeat what I said on Second Reading—we do not expect to table amendments to the Bill in order to take forward the findings of the ALB review. I am obviously not ruling out the possibility that the agency might take on extra activities as a result of the review. We have always made clear our intention that the legislation should allow some flexibility over the functions that the agency performs. That is why the agency's functions are set out in such a way.

I can assure the hon. Gentleman that we have absolutely no intention to come back with amendments at some later stage in the Bill's progress through this place, nor on its return to another place.

Question put and agreed to.

Clause 1 ordered to stand part of the Bill.

Schedule 1 - Health Protection Agency

Andrew Murrison (Conservative, Westbury)

I beg to move amendment No. 15, in

schedule 1, page 9, line 8, leave out 'the prescribed number of' and insert 'twelve'.

Irene Adams (Labour, Paisley North)

With this it will be convenient to discuss the following amendments:

No. 16, in

schedule 1, page 9, line 9, leave out 'the prescribed number of' and insert 'six'.

No. 17, in

schedule 1, page 9, line 23, leave out sub-paragraphs (6) and (7).

Andrew Murrison (Conservative, Westbury)

Schedule 1 is quite a big schedule. It sets out in some detail the way in which the Health Protection Agency will be structured—how it will run, how it will be financed, and so on. We clearly need to get it right. To return for one moment to the Minister's

previous remarks, I fear that she may be setting herself up as a hostage to fortune. I shall look carefully at the Bill as it goes through its various stages, particularly in the light of the review expected next month, to see whether any changes are required following the expected abolition of some bodies. We shall see.

With this group of amendments, I am trying to address the latitude that the schedule gives on a number of counts. Amendments Nos. 15, 16 and 17 are probing amendments. I suggest that the Bill should specify the number of the categories of the agency's members detailed in paragraphs 1(1)(c) and (d). That is not because I think that there should necessarily be 12 non-executive members or six executive members, but we need to know what sort of size the Minister envisages for such an important body. That is why I have suggested inserting 12 and six and deleting ''the prescribed number'', which is such a number as the Secretary of State prescribes by regulation.

Regulations are tricky little numbers and we should give them to Secretaries of State sparingly. [Interruption.]

Irene Adams (Labour, Paisley North)

Order. I call the Minister.

Melanie Johnson (Labour, Welwyn Hatfield)

I do not think that the hon. Member for Westbury had finished what he had to say before the phone intervention.

Irene Adams (Labour, Paisley North)

Can we ensure that everyone has their mobile phones switched off and pagers on silent?

Andrew Murrison (Conservative, Westbury)

The Minister is very kind—saved by the bell. I was coming to the end of my remarks anyway, although it would have been nice for them not to have been terminated by a mobile phone. I think that my meaning is quite clear. I would be grateful if the Minister addressed the consequences of the amendment.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

I welcome you to the Chair, Mrs. Adams, and look forward to participating in the scrutiny of the Bill.

I support the amendments for the intended purpose, which is to probe the Government's views. To be clear, how will the prescribed number of non-executive members be arrived at? Although I would not wish the Bill to specify numbers, there is a case to be answered. What will the mechanism be? Will the arm's-length body exercise a good deal of discretion? Will the Government take an accommodating view about the composition of the board or do they have a clear view? If the Government's view is clear, it should be expressed, so that we know what the outline of the new organisation's governance arrangements will be. If their view is not clear, it will be useful to know what mechanism will be used for coming to a view. What will the balance be between the organisation expressing its opinion about the composition of its board of governors and the Government position?

Melanie Johnson (Labour, Welwyn Hatfield)

I am grateful to hon. Members for their probing comments. Paragraph 1(6) gives the Secretary of State the power to prescribe in regulations the number of non-executive and executive members of the agency. Paragraph 1(7) provides that, before making the regulations, he needs to consult the

devolved Administrations. Under paragraph 29, those regulations will be subject to the negative resolution procedure.

The Secretary of State has the power to make regulations that provide for a number, or a range of numbers, of members. That is a standard feature of the legislation for many bodies, including the Health Protection Agency special health authority. The flexibility that the approach allows is valuable. For example, if the powers in clauses 2 and 3 are used to give the agency additional functions, it will be possible to increase the size of the board without changing primary legislation, if that is desirable to reflect those additional responsibilities.

The three amendments would remove such valuable flexibility. Instead, the Bill would specify that the number of non-executives should be 12, and the number of executives six. The amendment should therefore be rejected. However, I understand that the hon. Member for Westbury is arguing not that 12 and six are necessarily the right numbers, but that we should make it clear how we intend to use the regulation-making power. I am happy to provide such an indication of our thinking.

As we have explained in our memorandum to the House of Lords Delegated Powers and Regulatory Reform Committee, we expect to make broadly similar provisions for the number of executive and non-executive members as apply at present to the special health authority. The Health Protection Agency (Yr Asiantaeth Diogelu Iechyd) (Establishment) Order 2003, which created the agency as a special health authority, provides a power to appoint not fewer than 10 and not more than 25 non-executive members, and not fewer than three and not more than eight members who are officers of the agency. In practice, 11 non-executive members, in addition to the chairman, have been appointed by the Secretary of State, and seven officer members, in addition to the chief executive, have been appointed by the board. What we envisage is in line with current practice and, indeed, with the sorts of numbers that the hon. Gentleman suggested. Regulations that are made under the schedule will be subject to negative resolution; so there will be an element of scrutiny by the House.

Andrew Murrison (Conservative, Westbury)

I thank the Minister for that clarification, which was helpful. We now have an idea of the size of the board of the agency. With those assurances, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Andrew Murrison (Conservative, Westbury)

I beg to move amendment No. 18, in

schedule 1, page 10, line 31, leave out sub-sub-paragraph (b).

Irene Adams (Labour, Paisley North)

With this it will be convenient to discuss the following:

Amendment No. 19, in

schedule 1, page 11, leave out lines 9 to 14.

Andrew Murrison (Conservative, Westbury)

The first of these two small amendments arose because the mention of gratuities

on page 10 caught my attention. I understand gratuities to be tips. I remember, as a waiter during my summer holidays, that when I was feeling posh I used to refer to my tips as gratuities. I was surprised to see tips mentioned in connection with such an august body; I have never seen that before.

The individuals will be paid allowances and will receive proper remuneration. I am concerned that having the power to grant gratuities would give the Secretary of State a certain leverage over individuals who might receive them. Given that, in my experience, that is a departure from the norm, I wish to quiz the Minister on the thinking behind giving that power to the Secretary of State—hence amendment No. 18.

Amendment No. 19 concerns disqualification for appointment. Again, the provision came as a surprise to me. Recently, I have been involved with the Human Tissue Bill and the setting up of the Human Tissue Authority, and I recall debating in Committee the criteria for disqualification. Bankruptcy and an undischarged criminal record, for example, were specified as reasons for exclusion. I remember debating whether that was appropriate, and I formed no fixed view. However, I am surprised that we do not specify the criteria for disqualification to serve on the agency, and under what circumstances the Secretary of State might choose to disqualify somebody.

The matter is important because, although we trust the Ministry implicitly, we have to guard against the possibility that other Governments might not be so benign and might exclude people on the basis of their political views—political with a big P or a small p. In the context of the Bill, that might affect people such as pro-lifers, whether or not one agrees with their view. I should be extremely grateful if the Minister let me know her thinking on gratuities, and what manner of people she would envisage disqualifying under paragraph 10. Why does that part of the Bill differ from other Bills that set up similar bodies?

Melanie Johnson (Labour, Welwyn Hatfield)

It gives me pleasure to respond to the hon. Gentleman's points. I must admit that I initially had some sympathy with his point about amendment No. 18, because ''gratuities'' does seem an odd term. Of course, we could give the hon. Gentleman many tips, but we do not propose to do so at the moment. That aside, the term is standard in this context, and its omission should be resisted because it might cause difficulties. I am told that the term is included to take account of Cabinet Office guidance on creating new non-departmental public bodies. Paragraph 30, on page 85 of the NDPB guide, states:

''The enabling powers need to provide for the NDPB to pay or make provision for the payment of pensions, allowances and gratuities for members and their dependants.''

That is why the term ''gratuities'' is included in the Bill and in the standard terms for several other NDPBs. I agree that the term is curious, but I shall resist efforts to remove it, because we are acting in line with central guidance.

Andrew Murrison (Conservative, Westbury)

The form of words that the Minister is using suggests that she is referring to terminal gratuities, which apply where someone comes to the end of their term of office, rather than to a yearly bonus or a reward for a job well done. Is that her understanding?

Melanie Johnson (Labour, Welwyn Hatfield)

I have nothing further to add as regards my understanding of the issue, although I can reassure the hon. Gentleman that no payments are currently envisaged under the gratuities arrangements.

Amendment No. 19 would remove the power of the Secretary of State, after consulting the devolved Administrations, to make regulations on the circumstances in which people could be disqualified from being the chairman or a non-executive member of the agency. Again, a power to provide that certain categories of person should be disqualified from appointment to public bodies is a standard feature of the legislation for many such bodies. For example, the Health Protection Agency (Yr Asiantaeth Diogelu Iechyd) (Establishment) Order 2003 and the Health Protection Agency (Yr Asiantaeth Diogelu Iechyd) Regulations 2003, which established the HPA as a special health authority, and which we debated last year, identify certain categories of person who are disqualified from appointment. They include bankrupts and those who have been convicted of a criminal offence or disqualified from being company directors.

The hon. Gentleman and other members of the Committee will agree that disqualifying such persons from appointment is sensible when we are considering appointments to the board of a body that is responsible for spending large sums of public money. Indeed, the 2002 consultation paper included a proposal that the legislation establishing the agency provide for certain classes of people to be disqualified from membership of the board, and none of the responses took exception to that. It is true that disqualification provisions are included in the Human Tissue Bill, but that is a relatively unusual approach, which takes account of the particular ethical functions involved rather than of operational matters, which might be much more of an issue with the HPA.

It might be helpful if I explain what use we expect to make of the power to make regulations on disqualifications. As the Government made clear when we put our memorandum to the House of Lords Delegated Powers and Regulatory Reform Committee, we expect the provisions on disqualification to be broadly similar to those that already apply to the special health authority. There will be some adjustments to take account of additional appointing authorities, and we are likely to omit the provision that disqualifies persons who have a paid appointment with a strategic health authority, a local health board, an NHS trust or a primary care trust, because it is too restrictive.

The provision on the disqualification of bankrupts will also need to be slightly different, to take account of the bankruptcy provisions in the Enterprise Act 2002, with which I was also involved. As made clear in paragraph 29 of schedule 1, the regulations will be subject to the negative procedure, so hon. Members will have the opportunity to scrutinise which categories of person are proposed for disqualification from appointment to the agency.

On the point about politicians, paragraphs 6 and 7 of schedule 3 amend the House of Commons Disqualification Act 1975 and the Northern Ireland Assembly Disqualification Act 1975 so that members of those bodies will not be able to be the chairman or a non-executive member of the agency's board. It is normal to make similar provision in relation to the Scottish Parliament and the National Assembly for Wales by means of secondary legislation. I understand that Scottish Ministers and the National Assembly have every intention of doing so when the Bill receives Royal Assent.

Andrew Murrison (Conservative, Westbury)

I thank the Minister for her assurances. As the matter of gratuities was established under previous legislation, and it seems to be in line with what applies to other bodies, I am not minded to press amendment No. 18.

The Minister has partially reassured me on amendment No. 19. I am not entirely convinced by her thesis that there are ethical issues concerning the Human Tissue Authority that do not apply to the Health Protection Agency. I could make a similar argument for ethical issues that might affect the Health Protection Agency.

Having said that I do not object, on reflection, to the gratuities under paragraph 8, because the approach in that case is consistent with what happens in other organisations, attention needs to be given to the inconsistency that paragraph 10 introduces. Perhaps the Minister would like to give the matter further thought and double check that paragraph 10 is consistent with the approach to other, not dissimilar, organisations. I hope that she will bear my thoughts in mind, but I am not minded to press amendment No. 19 to a vote.

I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Andrew Murrison (Conservative, Westbury)

I beg to move amendment No. 20, in

schedule 1, page 12, line 31, leave out from 'Ministers' to end of line 32 and insert

'shall pay sums to the Agency in accordance with an itemised account presented by the Secretary of State for work carried out on their behalf.'.

Irene Adams (Labour, Paisley North)

With this it will be convenient to discuss the following:

Amendment No. 21, in

schedule 1, page 12, line 34, leave out from 'Ireland' to end of line 35 and insert

'shall pay sums to the Agency in accordance with an itemised account presented by the Secretary of State for work carried out on behalf of the Department.'.

Amendment No. 22, in

schedule 1, page 12, line 36, leave out from 'Wales' to end of line 37 and insert

'shall pay sums to the Agency in accordance with an itemised account presented by the Secretary of State for work carried out on behalf of the Assembly.'.

Andrew Murrison (Conservative, Westbury)

The amendments deal with the arrangements that will be made for a devolved Parliament or Assembly to pay the Health Protection Agency for work that is done. A grey area exists in the

financing of the Health Protection Agency, and I believe that a Government amendment has been tabled to deal with that. On Second Reading concern was expressed about the funding of the agency, which will be mixed.

The agency will partly be funded by moneys that it generates itself. I mentioned on Second Reading the excellent work being done at Porton Down and the possibility that in the future the work done there could be expanded so as to bring in considerable receipts for the Health Protection Agency. I am sure that that is just scratching the surface of the possibilities of income generation for the organisation; that is to be welcomed.

The other element of funding will come from central Government—the Westminster Government. We expect the devolved bodies to chip in to the pot in some way, and allowance is made for that in the Bill. However, if the devolved Administrations are to expect the agency to do work on their behalf—and they will be—they need to understand that they will be required to fund items of that, and that an itemised set of accounts for work that is done, and for whom, is necessary in a properly run organisation of that kind. That needs to be provided to the organisations and bodies on whose behalf the agency carries out work in the expectation that that work will be funded.

I am a little concerned at the moment that a devolved Parliament or Assembly may ask the agency to do work on its behalf and that that will not be funded. The funder, of course, will be a vote given to the agency by the Westminster Parliament. That seems to be a rather opaque way of operating. My amendments will make transparent to everyone the costs that the devolved bodies in the United Kingdom and Northern Ireland will be expected to pay to the agency for work carried out on their behalf. That is the intention of my amendments; I hope that they will be considered carefully by the Minister.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

I support the amendments, which give us a useful opportunity to explore how HPA resources will be accounted for. I particularly want to ask the Minister about sub-paragraphs (3), (4) and (5) of paragraph 19: are they intended to pertain to the devolved authorities' ability to give additional tasks to the HPA, to deal with the funding of the HPA's general work, or both? If they are intended simply to deal with the additional functions that the Scottish Parliament or Welsh Assembly choose to ask the HPA to undertake, it makes sense to have a mechanism by which those additional costs are borne by the block of expenditure allocated to the Scottish Executive or Welsh Assembly, rather than by the general taxpayer. However, if the measures are intended to reflect expenditure incurred as part of the overall UK-wide remit, it is not clear why that money would be devolved to those bodies in the first place. Presumably that function, which is and always has been regarded as a non-delegated function, was retained by Parliament, so the money should never have gone to Scotland or Wales. Will the Minister clarify that?

My other point relates specifically to the amendments. Even if there were itemised accounts—I dare say such detail would be forthcoming anyway if necessary—they would not overcome concern that there does not appear to be a mechanism by which a Scottish Minister acting as the appropriate authority and allocating a function to the HPA would be automatically obliged to divvy up the money to pay for that service. Will the Minister tell us a little more about the mechanism for a dispute about the cost of providing a particular piece of work on behalf of one of the devolved authorities? How would it be resolved? Who would be the final arbiter? Would it be resolved by a UK Minister, or through some other form of arbitration? I hope that the Minister can respond to those questions.

Melanie Johnson (Labour, Welwyn Hatfield)

We would share the concerns of the hon. Member for Westbury and, to some degree, the hon. Member for Sutton and Cheam (Mr. Burstow) if what they envisaged could occur, but I reassure them that it cannot. I shall explain why there is zero risk of those concerns being realised.

Paragraph 19 allows the agency to settle with each devolved Administration what services it will provide in return for the funds that they allocate. That is an eminently sensible approach, which recognises that responsibility for decisions about funding for devolved functions lies with the devolved Administrations. Amendments Nos. 20 to 22 would replace that with an extraordinary tripartite arrangement under which the Secretary of State would be required to present an itemised account to the devolved Administrations for work carried out by the agency on their behalf for which they would be under a duty to pay.

There are two problems of principle with that. First, it would give the Secretary of State a new job of producing itemised accounts on the agency's expenditure, although that probably is not an intended consequence. Manifestly, the job of producing accounts about the agency's expenditure should rest with the agency. I trust that we are all committed to reducing bureaucracy in Government. Creating a new accounting duty for the Secretary of State—

Paul Burstow (Liberal Democrat, Sutton and Cheam)

Will the Minister give way?

Andrew Murrison (Conservative, Westbury)

Will the Minister give way?

Melanie Johnson (Labour, Welwyn Hatfield)

I give way to the hon. Member for Westbury.

Andrew Murrison (Conservative, Westbury)

I suspect that the hon. Member for Sutton and Cheam wants to intervene on the same point. My amendments would place a duty on the agency to provide itemised accounts for the authorities to pay, not the other way around.

Melanie Johnson (Labour, Welwyn Hatfield)

I appreciate what the hon. Gentleman says about his intention, but I have to tell him of the legal standing of the amendments, and of parliamentary counsel's view.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

My point is about a different duty. The Minister referred to the duty on devolved bodies to pay. Will she draw the Committee's attention to that provision in the Bill? I cannot see such a provision in paragraph 19.

Melanie Johnson (Labour, Welwyn Hatfield)

I am coming to that. I have not yet finished.

First, the amendment places a duty on the Secretary of State to produce itemised accounts; that is obviously not the intention, but it would be the effect. Secondly, it is unclear where the responsibility lies for determining service levels in relation to devolved functions. Is the responsibility with the devolved Administration, as it should be? If so, why should the Secretary of State be involved? If not, does the responsibility lie with the agency or the Secretary of State? That would not be acceptable to the devolved Administrations. After all, which of us would be happy to allow someone else the right to run up bills that we would have to meet?

The hon. Member for Westbury is concerned that paragraph 19 might require the Secretary of State to subsidise the devolved Administrations—that fundamental point was made by both hon. Gentlemen—but that is not what it does. The provision requires the Secretary of State to take account of all funds received by the agency from other sources when coming to a decision on what funding he should provide. However, that does not require him to make up any shortfall in funding; nor does it necessarily require him to reduce the funding that he provides if income from other sources is higher than expected. It is a way of ensuring that, in allocating taxpayers' money to the agency, the Secretary of State takes account of the agency's general financial position.

In answer to the hon. Member for Sutton and Cheam, if the funds that the agency receives from a devolved Administration are not adequate to provide a particular level of service, the agency will need to agree with that Administration what level of service should be provided for the funding in question. It is not for the Secretary of State to substitute his judgment for that of a devolved Administration. The amendment must therefore be resisted.

The hon. Member for Westbury asked about Government amendment No. 7. The amendment simply removes the Lords privilege provision of clause 13(2). It does not relate to the point under discussion.

The hon. Member for Sutton and Cheam asked what services the agency will provide and what the devolved Administrations will pay. The services that the agency provides for the devolved Administrations will obviously not include services that are UK-wide, which will be purchased by the Government.

Andrew Murrison (Conservative, Westbury)

The Minister has not reassured me, and I am wondering what to do about it. If she accepts my point in principle but has been told by parliamentary counsel that the wording is wrong—

Melanie Johnson (Labour, Welwyn Hatfield)

I did not say that I accept his point in principle. I said that were they to be true, I would have exactly the same concerns as he. However, they are not.

Andrew Murrison (Conservative, Westbury)

I am grateful for that clarification. Nevertheless, the Minister is saying that the words used in the amendment would have a different

meaning in law to the meaning that I have described. If that is the case, but she accepts that there is something in what I have said, I will be more than happy for an amendment to be drafted that complies with the advice of parliamentary counsel and that prosecutes the meaning that I am trying to put across.

Melanie Johnson (Labour, Welwyn Hatfield)

Would it be helpful if I wrote to both the hon. Gentleman and the hon. Member for Sutton and Cheam between now and Report to set out why paragraph 19 does the job that it does? We do not believe that a further amendment is necessary. We do not intend to table one; nor, as I understand, are we likely to accept one. However, I am happy to put something in writing for both hon. Gentlemen on that point.

Andrew Murrison (Conservative, Westbury)

Yes, I look forward to the Minister's letter very much.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

Perhaps that letter could contain further amplification of other aspects of schedules 1 and 2, as the explanatory notes for the Bill do not provide any such information.

Andrew Murrison (Conservative, Westbury)

I look forward to hearing what the hon. Gentleman has to say in the stand part debate on those matters. I accept entirely that the explanatory notes leave a lot to be desired and do not make clear the Government's intentions.

I am still not entirely sure that the HPA's accounts will be transparent, that the sources of money will be clear and that people will pay for what they receive. I hope that the Minister agrees that the agency's complex financial arrangements should be laid out transparently. The Minister of State, Department of Health, the hon. Member for Doncaster, Central (Ms Winterton) made similar remarks to the Minister as the Human Tissue Bill proceeded through Committee, but recanted on Report. In the same way, I suspect we may later be presented with a raft of amendments to clarify such murky areas, although not, I hope, the 99 amendments to the Human Tissue Bill that we considered in the House yesterday.

It is important that the devolved Administrations pay for what they get. They should not just chip in or contribute, but pay in a clear and transparent way for the services that they receive. That will become all the more important as arm's length bodies are abolished, which will almost certainly happen following next month's review, and the HPA acquires more functions. The implication is that its finances will expand even further. There will therefore be an even greater need for transparency and clarity about where the money is coming from.

The HPA has very difficult financial arrangements indeed. Resources come from all sorts of places. On Second Reading, we were concerned about the ratchet effect of the income that the HPA may receive and about the potential that that gives the Secretary of State to reduce the amount of core funding with which it is provided. That is of some concern, because income can go up and down, according to markets and so on. However, the HPA's function is vital, as I am sure my

hon. Friend the Member for Newark (Patrick Mercer) will say in due course. It is crucial that the HPA should work properly, but to do so it must have a guaranteed income stream. Given how the HPA is constituted, however, we have serious concerns that the income stream will not be guaranteed, unless the source of funding from all those who contribute to the pot on which it will rely is crystal clear. I am afraid that the Minister has given me no confidence that that is the case.

Nevertheless, on reflection, I shall not press the amendment to a Division, but I hope that the Minister will consider my points and propose amendments to clarify the situation. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Question proposed, That this schedule be the First schedule to the Bill.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

I want briefly to repeat the point that I made in an intervention on the hon. Gentleman. In parts, the Bill's explanatory notes are helpful and illuminating, but in other parts they shed precious little light and, on the schedules, they shed no light. The intentions behind some aspects of the schedule are blindingly obvious. That is not the case with paragraph 19 or other parts of the schedule.

Perhaps the Minister could provide more explanatory notes to help to further our expeditious scrutiny of the Bill. I am sure that the Department will have in its possession amplification of the purposes.

Melanie Johnson (Labour, Welwyn Hatfield)

It would be helpful if the hon. Gentleman could say precisely what he does not understand, because the schedule contains quite a lot of detail, much of which is very straightforward. I am not sure what extra clarification he wants. It would, of course, be possible to write out the schedule in ordinaryspeak rather than legalspeak, but I take it that that is not what he has in mind.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

I certainly do not want the schedule to be put into plain English, although translating the legalese in which the legislation is by necessity written can be an aid to debate. Will the Minister further explain the reporting responsibilities set out on pages 13 and 14, as well as give an account of the section on finance on pages 12 and 13? That would address my main concerns, and I would be happy for the schedule to stand part of the Bill.

Melanie Johnson (Labour, Welwyn Hatfield)

I will consider the hon. Gentleman's suggestions and see what we can do to help him. Again, there is quite a lot of detail on reporting on pages 13 and 14, but I shall discuss with my officials whether we can do anything that is not simply a translation into more everyday speech, which I do not believe the hon. Gentleman needs.

Question put and agreed to.

Schedule 1 agreed to.

Clause 5 - Co-operation

Paul Burstow (Liberal Democrat, Sutton and Cheam)

I beg to move amendment No. 2, in

clause 5, page 5, line 6, at end insert—

'(2A) To facilitate co-operation the Agency shall consult with other bodies and publish protocols for co-operation.'.

Irene Adams (Labour, Paisley North)

With this it will be convenient to discuss amendment No. 5, in

clause 5, page 5, line 8, at end add—

'(4) The Agency shall draw up and consult upon a protocol with the Commission for Healthcare Audit and Inspection to collect and publish information concerning the performance of NHS organisations in controlling healthcare-acquired infections.'.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

Again, the explanatory note to the clause is exceedingly brief. It says:

''Clause 5 puts the Agency and other bodies which exercise functions relating to the Agency's functions under a mutual duty of co-operation.''

It was very clear on Second Reading that there was anxiety and a lack of clarity about what that means in practice. My amendments explore further just how the mutual duty will work in practice. I know that there was some discussion in the other place about which organisations might be involved. On Second Reading, the hon. Member for North-West Leicestershire (David Taylor) raised concerns about the relationship between the HPA and the Environment Agency, and expressed his frustration about the Environment Agency's discharge of its functions, particularly in relation to the National Radiological Protection Board.

The amendment takes the concept of mutual co-operation a step further. The HPA will have ongoing relationships with several bodies, so surely it would make sense for it to set out and agree with those bodies how they will function. Where are the tripwires that kick-start the discharging of those functions? Who is responsible on the ground for managing and directing the resources? These things are essential for the sake of clarity. They do not need to be clarified in detail in the legislation, but surely a duty should be placed on the HPA that informs those relationships with other bodies and clarifies issues such as the chain of command in major incidents, and how the HPA will mobilise another agency and at what point? It would be useful if the Minister could spell out how the Government envisage those things being done.

Mark Francois (Conservative, Rayleigh)

I apologise for interrupting the hon. Gentleman, because I have some sympathy with the general thrust of his argument. Will he assist the Committee by giving us at least an idea what other bodies he believes should be involved?

Paul Burstow (Liberal Democrat, Sutton and Cheam)

Local authorities, in particular, have a host of responsibilities and powers for emergency planning. Several hon. Members aired that issue on Second Reading. My general point today, although I do not want to make a big song and dance about it, is that the clause does not seem to ensure that the relationships that are established will be clearly codified. The amendment would send a clear signal to the relevant organisation about that.

I am sure that the Minister would say that what I am concerned about would happen anyway, and that it is not necessary to put it in the Bill, but I disagree. The requirement should be set out in the Bill, because there may be bodies that do not think that they need to maintain a relationship with the Health Protection Agency. They may consider that they are of higher status and they may not, therefore, collaborate as well as Ministers intend that they should. That is why clause 5 needs to be amended.

Another aspect that prompts me to call for clarity about co-operation is dealt with in amendment No. 5. The amendment would require the agency, with the Commission for Healthcare Audit and Inspection, to draw up and consult on a protocol for collecting and publishing information concerning the performance of NHS organisations in controlling healthcare-acquired infections.

The issue of healthcare-acquired infections was well aired on Second Reading and therefore I shall not rehearse all the statistics, but a couple of points that arise from last week's statement on the NHS improvement plan are relevant. Paragraphs 2.27 and 2.28 of the NHS improvement plan refer to the Health Protection Agency taking on the role of developing frameworks to protect the patient. It would be useful if the Minister could amplify the intention, and explain whether the role would include dealing with issues relating to hospital-acquired infections.

I was surprised to note, on reading the detail of the White Paper after the statement last week, that the target for reducing the risk of methicillin-resistant Staphylococcus aureus infections is to be achieved by 2010. That seems a remarkably long period in which to try to bear down on the problem—in fact, it does not seem appropriate to speak of bearing down on the problem of infections when tackling it will take six years. It would be useful to hear why the Government think that it is satisfactory to take that amount of time to deal with it.

The amendment is intended to establish a robust mechanism enabling patients to see clearly and fairly how every NHS organisation performs in discharging its responsibilities for the control of infection. At the moment there is a scheme called the patient environment action team initiative, which the Government often cite as part of their fight against the spread of infection in the national health service. The truth is that the criteria that are used to evaluate hospital cleanliness in the context of PEAT are mostly remote from hygiene practice for the control of infection. Only one, or perhaps two, of the PEAT criteria specifically relate to issues of hygiene. Most of the criteria deal with cosmetic issues such as the appearance of the hospital.

Melanie Johnson (Labour, Welwyn Hatfield)

Which provision of the Bill is the hon. Gentleman speaking to?

Paul Burstow (Liberal Democrat, Sutton and Cheam)

I am speaking to clause 5.

Melanie Johnson (Labour, Welwyn Hatfield)

Which part of clause 5?

Paul Burstow (Liberal Democrat, Sutton and Cheam)

I am speaking to clause 5 and amendment No. 5, which relates to the performance of NHS organisations controlling healthcare-acquired

infections. I have been talking about the current scheme, which the Government often cite as part of the management of organisations' performance, but which in my view does not carry out that function. The amendment would require the Health Protection Agency with the Commission for Healthcare Audit and Inspection to establish just such a scheme. The Government are keen on transparency in relation to the performance of NHS organisations, so I should like to hear from the Minister why she does not think that the Bill should specify the need for transparency in this context. The purpose of the amendments is to ensure clarity, in the first case about chains of command in relation to other bodies and in the other about performance in the control of infections. I also hope for some indication that 2010 is just a longstop date, and that Ministers have an agenda that will deal with the problem much sooner than that.

Patrick Mercer (Conservative, Newark)

Good morning, Mrs. Adams. I am grateful to be serving on the Committee and it is a pleasure to be in one the less stuffy Rooms along the Committee Corridor.

I was particularly taken with amendment No. 2. The words that we have just examined highlight the need for the Health Protection Agency to co-operate with other agencies. May I read from the explanatory notes, in order to focus on the matter.

''The Agency will be able to undertake both health functions and radiation protection functions . . . These more integrated arrangements are intended to improve the UK's ability to tackle the problems posed by infectious disease and other hazards, including the UK's response to chemical, biological, radiological and nuclear (CBRN) terrorism.''

I should like to concentrate on the latter point, which is encapsulated in amendment No. 2.

The Civil Contingencies Bill has just gone through the House, as we are all aware. A number of hon. Members present served with me in pre-legislative scrutiny of the Bill, and were enormously helpful—I think particularly of the hon. Member for Telford (David Wright), who made a valuable contribution. It became clear during debates on that Bill—of which we were broadly supportive and to which this part of this Bill is closely related—that the Government had clearly identified a problem and the legislation that would be needed to deal with it. However, they largely failed to understand that in between those two poles, there was a gamut of delivery. I fear that this Bill might fall into the same trap.

That is why, if I may compliment the hon. Member for Sutton and Cheam, amendment No. 2 is particularly important. It would ensure that the Bill required the Health Protection Agency physically to spell out what it would do in the event of an emergency. Clause 5 may mention co-operation, but it is nebulous. I have no doubt that the Minister will agree with me—perhaps I do have a doubt; her nodding suggests that I should do so. As a pragmatist, and somebody who has been involved in such matters, I believe that there is a need for all the lumps of string to be tied together, for the t's to be crossed and the i's to be dotted. The point was made many times during our consideration of the Civil Contingencies Bill that,

although the intention was good, the execution was likely to be lacking and delivery was simply not there.

Amendment No. 2 would force the Health Protection Agency to put on paper its contingency plans. Therefore, protocols—emergency plans, call them what you will—would be drawn up to state what co-operation, training and planning will take place in preparation for an incident, and the agency would understand how it is to fit, like a hand in a glove, with the emergency powers and committees that will be established in the event of a disaster. It would therefore have no difficulty in identifying the regional co-ordinator who would be established when such a disaster occurs, and it would know whom to contact in the police, the ambulance service and the fire service. There are then those wonderful bodies, which the Minister must have known would come up, the civil contingency reaction forces.

In the event of a radiological-type attack, or some form of contamination—either chemical or biological—with which the Health Protection Agency is likely to deal, it is highly likely that the other bodies that I have just mentioned will be called forward and will have to deal with it too. Unless there is some pre-planning, rehearsal and integration and co-operation between the HPA and the other blue light services and emergency services, that will fail. There is absolutely no doubt about that.

There is an old Army maxim, ''Train hard, fight easy''. Unless some training is identified in the Bill and unless the amendment is accepted so that plans are understood—[Interruption.] Government Members are giggling, but I am sure that the Minister understands that it is a serious point. It is so difficult to convince the public about the dangers of such incidents, because they have not happened yet. It is worth bearing in mind the fact that the heads of both MI5 and the Metropolitan police say that that style of incident not just might happen, but will happen.

Andrew Murrison (Conservative, Westbury)

And the Prime Minister.

Patrick Mercer (Conservative, Newark)

As my hon. Friend says, of course the Prime Minister continues to make the point in public. It is important that the public should be fully apprised of the dangers of such an incident, and that the agencies should be fully prepared.

I do not know how the Health Protection Agency's officers intend to take the field after an incident such as I have described. I do not know what sort of equipment they will have, what sort of training their officers will have had beforehand—

Melanie Johnson (Labour, Welwyn Hatfield)

Is the hon. Gentleman seriously proposing that that should be in a piece of legislation?

Patrick Mercer (Conservative, Newark)

I am seriously proposing that if we consider the amendment, which has been worded so very cleverly—[Interruption.] Unusually or not, it is a well put together amendment, and I have no doubt that if it is included in the Bill all those points can be drawn together.

Mark Francois (Conservative, Rayleigh)

My hon. Friend will know that this House recently passed a piece of legislation called the

Civil Contingencies Bill, which went into exactly such detail for a whole range of agencies. That detail was included in that Bill because in an emergency it is critical that everybody knows exactly what their job is.

Patrick Mercer (Conservative, Newark)

I am most grateful to my hon. Friend for that useful intervention.

During consideration of the Civil Contingencies Bill, it was difficult to convince the Government that such details had to be concentrated on. We eventually made some progress, although a lot was lacking. I hope that we do not encounter the same difficulties and faults when considering the Health Protection Agency. There is no doubt that unless all these measures are prepared beforehand and co-operation is properly spelled out, exercised and planned, come the day, the Health Protection Agency will not be adequately equipped or prepared to act at its optimum. Ultimately, lives are at risk, and they do not need to be.

Mark Francois (Conservative, Rayleigh)

It is a pleasure to serve under your chairmanship this morning, Mrs. Adams.

My hon. Friend the Member for Newark is our party's expert on homeland security and I do not intend to compete with that in any way. I spoke on this point on Second Reading last week, and I want to try to press home a couple of the points that I made without reiterating the whole speech from the top, for which I suspect the Committee would not thank me.

My hon. Friend the Member for New Forest, East (Dr. Lewis) spoke on the homeland security aspects of the Bill, as did I. We made broadly similar points about the great importance of clear lines of command and control in emergency situations, and my hon. Friend the Member for Newark has reiterated them this morning. Their resonance for the Bill lies in the fact that the HPA could have a role in emergency situations involving chemical, biological, radiological or nuclear terrorist incidents. However, there is a lacuna in the Bill, which does not make it clear what the HPA will do in such situations. That is a significant error—[Interruption.] The Minister can giggle all she wants, but—

Melanie Johnson (Labour, Welwyn Hatfield)

I was laughing actually.

Mark Francois (Conservative, Rayleigh)

Well, the Minister can laugh all she wants, but this is an important subject, and those of us who know something about it feel strongly.

It is important that the HPA should have clear responsibilities and clear lines of liaison if we are to determine how it will work with the emergency services and with agencies such as local authorities in the event of an emergency. The Bill is vague about the agency's role in an emergency, and we are trying to define it with relative clarity—I commend the hon. Member for Sutton and Cheam on his amendment—so that everyone will know what it is. On Second Reading, I suggested that the HPA could appoint liaison officers to work directly with relevant bodies so that everyone would know who their opposite numbers were in the event of an emergency. The military often uses that practice, and it might be applicable to the HPA.

We are trying to get the Government to consider the issue seriously and, although we realise that there

are security considerations, to give us at least a conceptual idea of how the HPA will interact with local authorities, the armed forces and the blue light emergency services in the event of a catastrophe. We are perfectly entitled to put the Government under pressure on the issue in Parliament, although the Under-Secretary of State for Health, the hon. Member for South Thanet (Dr. Ladyman), was dismissive of our questions in his summing-up speech on Second Reading, and the less said about that the better. Perhaps the Minister can now stand up and answer our questions properly for once.

Melanie Johnson (Labour, Welwyn Hatfield)

I trust that the Committee will not allow itself to be derailed by the hon. Gentleman's tone—I certainly propose not to be derailed from continuing our sensible consideration of the Bill.

Andrew Murrison (Conservative, Westbury)

Will the Minister give way?

Melanie Johnson (Labour, Welwyn Hatfield)

No, I will not. I am going to respond to hon. Members' points, but I will give way to the hon. Gentleman later.

The point about co-operation stems from the 2002 consultation paper, which discussed the need for the HPA to co-operate with other bodies. The responses to the consultation supported that proposal, and clause 5 puts the agency and bodies exercising functions relating to those of the agency under a duty of mutual co-operation. Such bodies include NHS bodies, local authorities, the National Public Health Service for Wales, the Scottish Centre for Infection and Environmental Health and international bodies such as the World Health Organisation. The agency will also need to work with DEFRA and on preparedness for CBRN emergencies. I reassure the hon. Gentleman that I take such emergencies very seriously. It was some of the Opposition's suggestions that were laughable, although I entirely accept that hon. Members may have an interest and a background in it. The issue itself, however, is very important.

Patrick Mercer (Conservative, Newark)

Will the Minister give way?

Melanie Johnson (Labour, Welwyn Hatfield)

May I finish my sentence? Obviously, the HPA will need to work with the emergency services and the armed services. If it is given extra functions, it may need to co-operate with further bodies. Co-operation will be essential to the functions of the agency and those other bodies where there is, for example, a need to investigate outbreaks of diseases.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

Two points arise from what the Minister has said. First, she mentioned the World Health Organisation as one of the bodies to which the co-operation clause will apply. How could a supranational body be bound by domestic legislation? It would be useful to know how the duty would apply in that respect.

Secondly, she listed a great number of bodies, including the NHS and local authorities. Amendment No. 2 would simply ensure that they were clear, by dint of a protocol, about what the HPA expected of them.

Melanie Johnson (Labour, Welwyn Hatfield)

If the hon. Gentleman wishes to intervene, it would be helpful if he could address what I have said, rather than what I have not yet had a

chance to say. I shall deal with amendment No. 2 in much more detail and answer his point.

Patrick Mercer (Conservative, Newark)

I regret that the Minister found some of the points that my hon. Friends and I raised to be risible. My comments reflected my utter jaundice with the Government following proceedings on the Civil Contingencies Bill, which was so clearly lacking in important detail. I simply rose to ask the Minister to co-operate on the health protection issues before us, which her colleagues have so signally failed to understand during proceedings on other Bills. I very much regret that she found our comments laughable. Nevertheless, they are desperately important.

Melanie Johnson (Labour, Welwyn Hatfield)

May I first deal with the question of co-operation? If I think that much of what the hon. Gentleman has said is laughable, that is because the purpose of such Bills is not to set out the details of arrangements that should be the subject of planning. I agree that delivery needs planning and that we need to see the details of such plans, but it would be ridiculous for a Government of any political complexion to include in any Bill details of the sort that the hon. Gentleman mentioned.

I appreciate, Mrs. Adams, that we are not here to debate the Civil Contingencies Bill, but the hon. Gentleman's initial complaint about it also related to planning issues. The same issues may, indeed, apply in both Bills, although I am not as familiar with the details of the Civil Contingencies Bill as the hon. Gentleman. It does not set a precedent in any case. Part 1 deals specifically with contingency planning and civil protection, which are relatively defined activities, so the judgment was made that it was possible to list the bodies concerned. Even so, the list is not exhaustive, and local practitioners are free to involve non-categorised bodies to reflect local circumstances. It would be much harder to list the bodies with which the HPA needs to co-operate. That is why, to deal with amendment No. 2 and the points raised by the hon. Member for Sutton and Cheam, including that about the WHO, the co-operation requirement extends across the full range of the agency's functions and includes those that might be conferred on or exercised by it in the future.

Amendment No. 2 would require the agency to consult other bodies and to publish protocols on consultation, but there is nothing in the Bill to prevent it from doing that. I assume that the ''other bodies'' in the amendment would be the other bodies to which clause 5 applies, but the amendment must be resisted for several reasons.

First, the agency and some of those other bodies might want to produce protocols or other kinds of agreements on how they co-operate if, for example, they regularly involve each other in certain procedures. I am surprised that the hon. Member for Sutton and Cheam, who supposedly has a political belief in devolution and lowering decision making to a sensible level, would be so needlessly prescriptive as to require the agency and other bodies to produce protocols in each and every case. Indeed, I am at a loss to know why the Opposition think that such a requirement is necessary.

Section 26 of the Health Act 1999 puts NHS bodies under a duty to co-operate with each other. Section 22 of the National Health Service Act 1977 creates a duty of co-operation between NHS bodies and local authorities.

George Howarth (Labour, Knowsley North and Sefton East)

Is not the difficulty with the amendment that, in seeking to promote protocols, it would inevitably regulate the relationships between the various bodies involved and, in so doing, limit the flexibility that we would seek in an emergency?

Melanie Johnson (Labour, Welwyn Hatfield)

Indeed. My hon. Friend has a good understanding of what we seek to achieve through the Bill. There is no requirement in the legislation to which I have referred to produce protocols. Why is one thought necessary in clause 5? I agree with my hon. Friend that such a requirement would be to dictate to a body that we all want to be as independent as possible what its detailed operational practices should be.

Secondly, amendment No. 2 would also put a burden on the agency. The requirement to produce and publish the protocol in each case appears to rest with the agency, not with the other bodies. That would be hugely burdensome for the agency, whether the requirement were to publish a protocol for co-operation with each primary care trust, local health board, local authority and so on, or merely with each class of body. Again, I cannot see what benefits would be gained to justify the costs involved. Thirdly, the requirement to publish protocols ignores the fact that there could be reasons against doing so in some circumstances. For example—Opposition Members envisaged this possibility—the agency may need to co-operate with security services, but it would not necessarily be desirable for the details of such co-operation to be put in the public domain.

Amendment No. 5 would require the agency to draw up, and consult with the Commission for Healthcare Audit and Inspection on, a protocol on collecting and publishing information about the performance of NHS organisations in controlling health care-acquired infections. Again, amendment No. 5 is unnecessary and undesirable. It is undesirable, because it is too prescriptive about the operational practices to be followed by two independent bodies. It is unnecessary, because it is already planned that the star ratings that the commission is due to publish for acute trusts this summer will include an assessment of performance in cleaning, infection control and implementing ''Winning Ways''. I therefore cannot support amendment No. 5 either.

The hon. Member for Newark talked about the so-called delivery gap, but I return to the point that I made earlier. The clause is not just about emergency planning, although that is an important component. It is about co-operation in respect of all the agency's functions. We obviously do not need a Bill to tell the agency and others to contact each other and it would be extraordinary to include such things.

Andrew Murrison (Conservative, Westbury)

The Minister will see that subsection (2) imposes a duty on other bodies to co-operate with the agency, yet they are not listed. Does not that put an unfair burden on those bodies, which are out there, but which do not know who they are?

Melanie Johnson (Labour, Welwyn Hatfield)

I have already referred to section 26 of the Health Act 1999, which places a duty on those bodies, and to section 22 of the National Health Service Act 1977, which imposes a duty of co-operation between NHS bodies and local authorities. Such requirements already exist in legislation, but the hon. Gentleman ignores them.

The idea that the bodies in question will not know who they are is not a very sensible argument. I do not believe that either the agency or other bodies will have any difficulties in recognising whether they exercise functions relating to health or any other matters in relation to which the agency also exercises functions. Also, it will be open to the agency to draw another body's attention to the clause's requirements, if it seeks that co-operation and vice versa, were such co-operation not forthcoming in the first place.

We cannot, of course, force the WHO to co-operate, but we want the agency to co-operate with it—that is the point. Indeed, huge co-operation already exists, but that does not mean wholesale rewriting of each other's priorities. The HPA has already been instrumental in a major way, working with the WHO on such threats as SARS, which I mentioned on Second Reading.

There is no delivery gap. We do not need a Bill to tell people how to co-operate with others. On the question of health care-acquired infections, it is for strategic health authorities, not the HPA, to manage the performance of trusts. However, the HPA's surveillance is useful in that respect. Indeed, a large raft of information is already published on health care-acquired infections, a fact that was not acknowledged by some Opposition Members on Second Reading. Hon. Members are going way beyond the usual brief, and what they propose is inappropriate.

The amendments would remove powers and flexibility from an independent body that should be making detailed arrangements on our behalf. I accept that the detailed arrangements are important, but the locus for them is in the organisation of the agency, and its strategic documents should focus on drawing up the details of co-operation. Through the Bill, we seek to strengthen the agency—we want to ensure that the fingers are properly joined to the hand. Indeed, we have already seen the clear benefits of bringing together a number of those bodies into the HPA. I argue that that will be further strengthened when the Bill reaches the statute book.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

It has been an interesting debate. I am grateful to the Opposition for their support and for the questions that they put to the Minister. I shall respond briefly to some of the points that she made. In my view, we should return to the matter on Report. I shall not press the amendment to a Division because of the time-honoured provision that amendments voted on in Committee cannot be selected for debate at a later

stage. It does not always happen but it could, and I do not want to go down that procedural cul-de-sac.

The Minister deployed a number of familiar arguments against Opposition amendments—that they are needlessly burdensome, that they are already covered in some other way, or that they place burdens on organisations.

Melanie Johnson (Labour, Welwyn Hatfield)

Let me be clear. I was not saying that it would place a burden on the agency; I said that it was inappropriate for that sort of detail to appear in the Bill. I am not saying that the agency ought not to be doing such things; indeed, the agency is doing them, and will continue to do so.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

The Minister will have to forgive me, but she said to me earlier that it was not appropriate for me to intervene on her because I had not heard the rest of her speech. I have not made the rest of my speech, and I may yet deal with that point. The purpose of interventions is surely to tease out details. I am not prescient enough to know everything that the Minister is about to say; and the same may be said of her. I want to rehearse my concerns about her rebuttal of the amendment.

Mike Hall (Labour, Weaver Vale)

I thought that the hon. Gentleman was summing up his views about the amendments. Is he about to introduce new information? He should have given it in his opening speech.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

I am about to deal with the Minister's comments on my amendments. It will be for you, Mrs. Adams, to tell me whether I am out of order. I shall respect your rulings, as should all hon. Members.

The Minister said that it would be burdensome on other organisations to have to take part in the process of producing protocols. I was surprised at that response. She said that it would be inappropriate to place so much detail in the Bill. Amendment No. 2 states:

''To facilitate co-operation the Agency shall consult with other bodies and publish protocols for co-operation.''

Hon. Members elaborated on what they hoped might form the detail of such protocols, but the amendment does not spell out those details—nor should it. It is not intended to be prescriptive. It is intended to indicate a mechanism, a natural part of what I would expect the HPA to be undertaking. I am surprised that the Minister should think that to be needlessly prescriptive. She says that the 1997 Act places duties on NHS bodies to co-operate with local authorities. Indeed, the 1999 Act provides for co-operation between NHS organisations.

All of that is useful. However, to suggest that the amendment should be rejected simply because it would place a burden on the HPA to publish and consult, and that some things should not be published, is to give second-order arguments against the amendment. They might be reasons to amend the amendment, or to propose an alternative, but they are not reasons to reject it, as the Minister suggests.

The Minister also mentioned hospital-acquired infections, and the duty of strategic health

authorities to manage performance, but she did not address my desire to ensure that the public have meaningful comparable information across the NHS. I do not criticise the Government for introducing a mandatory system to monitor MRSA rates; I hope to see such monitoring for other infections in due course.

I am not convinced by the Minister's arguments. Amendment No. 2 is not intended to be prescriptive about the way in which protocols are drawn up, or about their precise contents. I arrived at the debate with the intention of merely probing—I genuinely wanted clarification from the Minister about the Government's thinking on emergency planning and drawing up procedures to govern relationships between organisations. However, I come away from it surprised that the Government are so resistant to the amendment, puzzled as to why they feel unable to give any comfort in that regard and convinced that I must return to the matter on Report. That would not have been the case had the Minister responded in a slightly more forthcoming way. That said, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 5 ordered to stand part of the Bill.

Clause 6 ordered to stand part of the Bill.

Clause 8 - Transfer of property and staff etc.

Andrew Murrison (Conservative, Westbury)

I missed my chance to raise a couple of points in the debate on the previous clause, and hope to return to them later.

I shall be brief on this clause, which is long, complicated and necessary. I have no particular difficulty with it. However, I worry about the transfer of property rights and liabilities to the agency from its predecessor bodies, especially as that will be done on the authority's say so. I am ever so slightly concerned that, because the way in which that can be done is subject to the agreement of a number of agencies, there is potential for conflict. I wonder about the arrangements for arbitration. Who is to decide whether particular pieces of property and liabilities and so on are to be transferred to the new agency from its predecessor bodies, who might object and under what circumstances would such objections be upheld?

I return to the point that I made in connection with a previous clause, when I pointed out the potential for difficulty in deciding which of the devolved assemblies and Parliaments would be liable for financial contributions to the agency, how much those would be and what accounts might be presented to support such contributions. I am trying to delve into the interface between the agency, its predecessor bodies and the authorities that are listed. How will they co-operate? As we have discussed, co-operation is a grey area. Nevertheless, I want to know how the authorities will co-operate to determine what can and cannot be transferred. There is usually room for misunderstanding and confusion in property matters, and it would be nice to know what functions have been

transferred to the new agency and what arbitration exists to ensure that conflict is avoided and that satisfactory resolutions are arrived at.

Melanie Johnson (Labour, Welwyn Hatfield)

I am grateful for the hon. Gentleman's questions. As I said in relation to paragraph 19 to schedule 1, the Government are clear that the devolved assemblies need to pick up the bill for whatever they want to be commissioned or whatever services they want the HPA to provide. They therefore need to pay for and receive the service that they pay to receive. Under paragraph 19, they will not get a service that they are not paying to receive.

Andrew Murrison (Conservative, Westbury)

I am grateful for that clarification, which is quite important. It is what I was trying to establish in relation to a previous clause. Is the Minister saying that this will be a ''pay as you go'' type of set-up under which the authorities will pay for what they demand and receive from the agency? I believe that that is the burden of what she just said.

Melanie Johnson (Labour, Welwyn Hatfield)

Indeed. That is what I said in relation to schedule 1. It is for the HPA to agree with the devolved assemblies the work that it is doing for them, the cost of that work and the fact that the cost will come across in order to fund the level of service that is required. That is exactly what paragraph 19 to schedule 1 does.

The hon. Gentleman asked a related question on the transfer of property. The requirements to consult the devolved assemblies reflect the fact that they are all joint stakeholders or owners of the NRPB. There is no need for dispute resolution. All Departments agree the contents of the Bill, and the agency will take on the rights of predecessor bodies in that regard. There is always discussion among parts of government about how progress will be made, but that is the usual process of government. It happens every day of the week in a million different ways throughout the United Kingdom, especially now that we have devolution. Nothing is different in this respect. There will be no need for dispute resolution for the reasons that I have just given.

Question put and agreed to.

Clause 8 ordered to stand part of the Bill.

Schedule 2 agreed to.

Clause 9 - Directions

Andrew Murrison (Conservative, Westbury)

I am grateful to have caught your eye, Mrs. Adams. I am getting into the swing of catching your eye.

It is a little uncertain what directing powers authorities will have. Earlier in the Bill, we see that the authority may require the agency to take note of its directions. Things become a little grey. Will the Minister tell us the nature of the directions that she envisages, how they will be carried out and what force they will have? Will she also say what veto the

authority may have over the HPA if it fails to comply with a directive? This is not an arm's length body, but a non-departmental public body, and the whole idea of shifting it from being a special health authority to being an NDPB is to give it some independence. I become a little confused when I see words such as ''direction'' and ''directive'' in a Bill that aims to make a shift in that status.

Melanie Johnson (Labour, Welwyn Hatfield)

Directions relate to operational matters. The House of Lords Delegated Powers and Regulatory Reform Committee has not recommended parliamentary scrutiny of them. Schedule 1 contains powers for the Secretary of State, after consulting the devolved authorities, to direct the agency: paragraph 11 relates to directing it on committees; paragraph 13 relates to directing it on proceedings; and paragraphs 24 to 27 contain powers for each of the appropriate authorities to direct the agency to provide information about the exercise of its functions.

There would be directions under the Immigration Act 1971 on an operational point—the appointment of medical inspectors. Again, the House of Lords Delegated Powers and Regulatory Reform Committee has not recommended that that should be subject to parliamentary scrutiny. I take it that the hon. Gentleman seeks clarification on points of that kind. I am not sure whether there are any others on which I can help him.

Question put and agreed to.

Clause 9 ordered to stand part of the Bill.

Clause 10 - Health care provision: standards

Andrew Murrison (Conservative, Westbury)

This clause deals with the inspection of the agency by the Commission for Healthcare Audit and Inspection and will be a bit of a departure for the latter body, because CHAI normally examines other parts of the NHS that have to do with patient care—hospital trusts, by and large. This function will be something separate.

CHAI's function in relation to hospital trusts is now clear. The path is a well trodden one and the expertise that CHAI has built up is extremely useful. I am a little concerned that the new departure will entail a new set of skills for CHAI, as well as a new way of working. I am also interested to know what form the Minister thinks the inspection and report will take. Given the sensitivity of some of the work that will be carried out by the agency, it will be interesting also to know whether any report by CHAI will be considered not to be in the public domain—and, in that case, to whom it will go.

It is all very well to say that CHAI will be involved in the inspection of the agency, but we need more detail about exactly what part of its work will be inspected. The Bill gives no real clue about that. I hope that the Minister will be able to give us some insight into how she envisages CHAI operating in the context of the Health Protection Agency—what reports might be presented, or, indeed, withheld. Furthermore, will

she assure us that the skills that CHAI currently has will be adequate and sufficient for the inspection of what is a rather unusual organisation for it to be concerned with?

Melanie Johnson (Labour, Welwyn Hatfield)

I can reassure the hon. Gentleman on those points. The Commission for Healthcare Audit and Inspection already inspects the Health Protection Agency special health authority, so the clause will not present a major departure for CHAI. It is established to give performance ratings to all bodies that count as NHS bodies for the relevant purposes, which includes the Health Protection Agency.

CHAI is not required until April 2006 to give performance ratings to excepted trusts such as the three learning disability trusts, the special health authorities or the cross-border special health authorities, but they are already covered by the inspection arrangements. As to what those arrangements will be, I have not seen detail of what CHAI is proposing for the future, but it is for it to decide on them. That is right and proper; we have given the work to a body independent of the Government to ensure that the public have confidence and trust in its work. It needs to be seen as independent of the Government and political processes.

Andrew Murrison (Conservative, Westbury)

I am particularly concerned about sensitive areas that the HPA might be involved with. I am thinking in particular of Porton Down, which is not far from my constituency. I have visited it. It obviously conducts extremely sensitive work and it is expanding the work that it does. What role will CHAI have in the context of an establishment such as Porton Down and the National Radiological Protection Board's functions, given their sensitivity? Will the information that it garners be regarded as privileged in any way? I would be grateful if the Minister could address that specific point.

Melanie Johnson (Labour, Welwyn Hatfield)

I am sure that those points have already been borne in mind in the current inspections. I undertake to ensure that CHAI is aware of the issues that the hon. Gentleman has raised. However, I believe that how it takes forward such things is a matter for CHAI, and it is important that there is no political interference in the processes and the way in which they are carried out. I appreciate the sensitivity of the sites and the work such as that carried out at Porton Down, but I do not believe that there has been a problem up until now. I see no particular reason why there should be in the future.

Andrew Murrison (Conservative, Westbury)

The Minister is being patient. She says that CHAI is already involved with the special health authority—she is quite correct—and I was wondering whether there are reports currently made by CHAI that are not in the public domain. In other words, is CHAI looking at areas that could be regarded as sensitive? I would expect any reports that it makes to be regarded as sensitive. If the reports are not being made with that caveat, I suspect that CHAI is not looking at the special health authority in as comprehensive a way as perhaps it ought.

Melanie Johnson (Labour, Welwyn Hatfield)

I am grateful for the hon. Gentleman's comments. I will write to him about the points that he has raised about current practice, and I will copy that to the members of the Committee. As I say, CHAI should take forward the arrangements for future practice, but insofar as information is disclosable, I will write to him about the current arrangements in more detail and will do so before Report.

Mark Francois (Conservative, Rayleigh)

Subsection (2) says:

''Health care must be construed in accordance with section 45 of the Health and Social Care (Community Health and Standards) Act 2003.''

That is fair enough. Subsection (5) then says:

''Section 57 of that Act (studies as to economy and efficiency, etc.) does not apply to the Agency.''

Can the Minister explain why that provision is in the Bill? For instance, is it because the agency would be subject to different examination by the National Audit Office or some other body? Why is there a particular exemption for the HPA?

Melanie Johnson (Labour, Welwyn Hatfield)

Subsection (5) provides that section 57 of the 2003 Act does not apply to the agency. That is because section 57 provides for CHAI to carry out studies as to the

''economy, efficiency and effectiveness in the exercise of any of the functions of an English NHS body, other than a Special Health Authority''.

In the case of the Health Protection Agency, as I think the hon. Gentleman suspects, such studies will be a matter for the Comptroller and Auditor General and the National Audit Office.

Question put and agreed to.

Clause 10 ordered to stand part of the Bill.

Clause 11 - Amendments and repeals

Andrew Murrison (Conservative, Westbury)

This is a brief clause, and I suspect that it is of a technical nature. It deals with schedules 3 and 4. As the Opposition clearly do not have the formidable civil service research capability that is available to the Minister, there is a risk that measures that may have implications for the Bill might be slipped in unbeknown to us. I am flicking through the list of Acts that are going to be amended or repealed as a result of the Bill, and I wonder what the implications are. I hope the Minister will not pass the clause without making any comment. Perhaps she could give us a résumé of the measures that are being repealed or amended. It is an extensive list of changes, so will she assure us that there will be no negative effects through the changes proposed under the clause?

Melanie Johnson (Labour, Welwyn Hatfield)

I will do my best.

The amendments and appeals are all consequential on the creation of the agency as a non-departmental public body from its predecessor bodies, with one exception. The exception is the amendment of paragraph 3 to schedule 3. That will allow the Secretary of State to direct his function of

appointing medical inspectors under the Immigration Act 1971, which is also exercisable by persons specified in the direction who exercise functions in relation to health in England or Wales. That delegation takes account of the fact that the arrangements for identifying medical inspectors are best made locally. The intention is to delegate appointments in England to the HPA—initially a special health authority and subsequently the agency as established by the Bill—and in Wales to the National Assembly for Wales. I reassure the hon. Gentleman that is the only change of any significance—it is not really a change of significance, but I draw it to hon. Members' attention. Otherwise, the matter in question is consequential on the creation of an NDPB.

Andrew Murrison (Conservative, Westbury)

I am grateful to the Minister for mentioning the Immigration Act 1971. Immigration is a sensitive issue and she is right to raise it, particularly since the relevant measure stands out from the rest. Although it is consequential, it is of great importance.

What is meant by the term ''medical inspectors''? Are they the sort of medical people who are positioned at ports and airports to deal with those seeking to migrate to this country and perhaps claim asylum? If so, I am slightly concerned, because such matters are controversial. Many of us would say that medical inspection facilities at airports ought to be enhanced. We certainly need to tread warily if we are changing the legislative framework under which such inspectors operate. Could the Minister say how the proposed change might affect how medical inspection is done on the ground?

Melanie Johnson (Labour, Welwyn Hatfield)

The hon. Gentleman is right in his supposition that the medical inspectors are those who deal with the health of migrants to this country. Those medical inspectors are being singled out for the purposes of identifying who they are. Local PCTs have a huge input into port authorities' arrangements for such purposes, as I am sure that he is aware. Essentially, the provisions do not change the situation and still provide the existing flexibility. On some occasions, appointments and the identification of those who might carry out the role are best made locally.

Andrew Murrison (Conservative, Westbury)

I would be interested to know how the appointments are made now, as I am a little unclear about that. I agree that appointments are best made locally. I suspect that most appointments will generally be local doctors. Is the Minister saying that that will change? I am a little unclear about that. In her previous remarks, she seemed to suggest that the agency would still make the appointments, but we now understand that they will be made locally. Does that mean by the PCT? If so, that will cause difficulties in places such as Heathrow, which I suspect might cover more than one PCT—it is such a vast site that that is almost certainly the case. The same is probably true of other ports and airports. If PCTs make the appointments locally, as I think the Minister said, how does that pan out in places such as Heathrow?

Melanie Johnson (Labour, Welwyn Hatfield)

The point is that the HPA can appoint in future. Under the present arrangements, the

PCTs make such appointments on behalf of the Department. As I said, the HPA—initially as a special health authority and subsequently as the agency—will delegate appointments, whereas the National Assembly for Wales will do so in Wales.

Andrew Murrison (Conservative, Westbury)

I am sorry to press this point, but it strikes me as important. I am glad that I asked about schedules 3 and 4, which could well have passed us by, as I said in my initial remarks. Is the Minister saying that the function will be more devolved? Many of us think that we should get a grip of such matters, and we welcome the agency because difficult and sensitive issues such as TB and HIV are being gripped centrally as part of a countrywide approach. The medical inspectorate is fundamental to that approach.

In general, we like to devolve things, and we like things to happen locally, but the Bill raises public health issues, which must be gripped and dealt with centrally. From what the Minister is saying, we seem to be moving in the wrong direction, with the agency devolving responsibility for the inspectorate. The inspectorate brings together a group of professionals who have not traditionally enjoyed the status and resources that they deserve. Unless I have got it wrong, the Minister is proposing to devolve responsibility for the inspectorate to a more local level. Indeed, the HPA might even surrender responsibilities for the service in some respects. If that is the direction of travel, we would be very concerned.

Melanie Johnson (Labour, Welwyn Hatfield)

I think that the hon. Gentleman misunderstood what I said. Perhaps I can be clearer. At present, once a medical inspector is identified locally—the hon. Gentleman mentioned some of the possible arrangements—people must write to the Department of Health to obtain the Secretary of State's clearance for the appointment. In future, they will have to go to the agency, which, the hon. Gentleman will agree, will be better placed to deal with such issues, given its detailed oversight and understanding of what is needed, than the Department. It will certainly be the most appropriate body to take the issue forward. If he would like me to write to him about the appointment of medical inspectors, however, I shall be happy to do so before Report.

Question put and agreed to.

Clause 11 ordered to stand part of the Bill.

Schedule 3 agreed to.

Schedule 4 agreed to.

Clause 12 - Commencement

Andrew Murrison (Conservative, Westbury)

This is quite a complicated clause, which contains technical language. I hope that the Minister will talk a bit about it and not let it pass by without comment. Reference is made—in the explanatory notes, at least—to the appointment of medical inspectors under the Immigration Act, and I would be grateful if the Minister could talk us through

how the clause will affect the immigration service, and particularly the medical inspectorate.

Melanie Johnson (Labour, Welwyn Hatfield)

On that specific point—I have a lot of detail on other points, but I shall not go through them, because the hon. Gentleman did not raise them—subsection (3) provides for one of the changes proposed in schedule 3 to come into effect two months after Royal Assent. That will enable the Secretary of State to delegate the appointment of medical inspectors under the Immigration Act to the National Assembly for Wales or the Health Protection Agency special health authority and, subsequently, the agency established by the Bill. The purpose is simply to take forward the arrangements that we discussed under schedule 3 for changing who will agree to the appointments of those identified for posts.

Subsections (1) and (2) provide for the Bill's remaining provisions to be brought into effect by order made by statutory instrument on such day or days that the Secretary of State may appoint, subject to prior consultation with those specified in subsection (4). They are standard provisions for commencement for which no parliamentary procedure is specified. Our aim is that the agency should come into being on 1 April 2005.

Question put and agreed to.

Clause 12 ordered to stand part of the Bill.

Clause 13 - Short title

Melanie Johnson (Labour, Welwyn Hatfield)

I beg to move amendment No. 7, in

clause 13, page 8, line 37, leave out subsection (2).

This is a technical amendment, which, as the note on page 1 of the Bill states, was inserted by the Lords to ''avoid questions of privilege'', and which it is necessary to remove. The procedure is purely technical.

Andrew Murrison (Conservative, Westbury)

The Minister has commented only briefly. Perhaps I am being particularly dim today, but I think that she is addressing Government amendment No. 7, which amends clause 13.

Melanie Johnson (Labour, Welwyn Hatfield)

There is only one Government amendment.

Andrew Murrison (Conservative, Westbury)

The Minister is quite right, but she has not really explained the purpose of the amendment, and her intentions are not clear. I think that it touches on finance, which is important. [Interruption.]

I am sorry if the Minister finds this amusing—

Melanie Johnson (Labour, Welwyn Hatfield)

I do not find it amusing.

Andrew Murrison (Conservative, Westbury)

This is important, particularly in the context of money. We have clarified one thing today: the finance for this Bill is extremely uncertain. We will definitely return to that issue. If the Minister can clarify things at this stage, she will save herself a lot of time later.

Melanie Johnson (Labour, Welwyn Hatfield)

I was not smiling at the hon. Gentleman's remarks; he need not be so sensitive. I

trust that my explanation will give him a little more confidence.

This is a technical amendment concerning a matter of privilege. Their lordships do not have powers to make comments or resolutions about money, so they have to insert such a technical measure in order to be able to deal with the question of privilege. It is entirely normal for us to remove it having noted that what they say does not indicate anything financial. It is what their lordships are supposed to do to indicate that they have no powers to make financial provisions—just as they do not debate Finance Bills. That is all part of the same principle. They have recognised that principle by inserting subsection (2), and we have proposed a Government amendment to remove it. There is nothing particularly exciting about money here.

Obviously, the hon. Gentleman is free to pursue this trail but, as I said in speaking to paragraph 19 of schedule 1, there are no interesting questions about funding. We envisage things carrying on as before. I have attempted to address his points and, to be fair, I think that I have answered them fully. I regret to inform him that there is nothing of any excitement in this respect.

Amendment agreed to.

Question proposed, That the clause, as amended, stand part of the Bill.

Andrew Murrison (Conservative, Westbury)

I do not want to labour the point, but it is important that members of the Committee, particularly Opposition Front Benchers, are clear about the Government's intentions. I am happy to admit to being extremely dim sometimes, and perhaps the fault lies with me, but I do not understand what subsection (2) is intended to achieve, or why Government amendment No. 7 is needed.

Irene Adams (Labour, Paisley North)

Order. It was a purely technical amendment about money; we cannot now have a debate on its substance.

Question put and agreed to.

Clause 13, as amended, ordered to stand part of the Bill.

Clause 2 - Health functions

Andrew Murrison (Conservative, Westbury)

I beg to move amendment No. 8, in

clause 2, page 1, line 9, leave out 'infectious disease and other'.

Irene Adams (Labour, Paisley North)

With this it will be convenient to discuss the following:

Amendment No. 1, in

clause 2, page 1, line 9, leave out

'and other dangers to health'.

Amendment No. 4, in

clause 2, page 1, line 10, at end insert

', including education and promotion.'.

Andrew Murrison (Conservative, Westbury)

This is an important part of the Bill, and we can afford to be expansive about it, given that we have rattled through the previous provisions at a rate of knots. We have done so because the Bill is not

controversial; we fully appreciate the need for it. However, it is our function to delve into the detail, both here and on Report, and we have identified matters that will most certainly need to be considered on Report. In general, the Bill is okay in its intentions; we support the amalgamation into the agency of the National Radiological Protection Board and the special health authority. That will be positive, despite concerns about how the NRPB feels about certain aspects of that, on which we shall no doubt touch later.

The clause drives at the heart of the Bill. It has to do with the purpose of the HPA. Why do we need the Health Protection Agency? What will be gained by combining the NRPB with the special health authority? What will that synergy lend to it? There needs to be some added value. My hon. Friend the Member for South Cambridgeshire (Mr. Lansley) said on Second Reading that if we continue to combine more and more things, ultimately everything in the Department of Health will merge—and what would be the point of that? Merging things is all well and good. It is a truism these days that amalgamation is good because it makes bodies co-operate better, but often that does not bear close inspection.

It would be helpful if the Minister laid out precisely how the functions of the constituent parts of the HPA will be enhanced. To be fair, she has touched on that, and it was mentioned on Second Reading. However, I am not as clear as I would like to be that the constituent parts of the HPA will function any better in an amalgamated body. To be honest, if we are not improving things, we might as well not have the Bill. I hark back to the remarks of my hon. Friend. They were not addressed; we did not get a clear account of how the functions of the HPA would be enhanced. The clause deals with those functions, and it is important that the Minister lays out how she and her right hon. and hon. Friends believe that their Bill will protect and improve public health.

It is also important that the Minister be absolutely clear in her mind about what the HPA will do; I have to say that I am not clear in mine. I understood initially that it was set up to address the novel threats faced by this country. We live in a sad old world in which—if the Prime Minister is to be believed—there is a terrorist at every turn and we are in imminent danger of attack. If that is the case, we need to protect against it. The HPA was set up to address such threats and novel diseases—the Minister helpfully referred to one of them in correspondence on the Human Tissue Bill. Those threats are obviously on the increase, and will probably continue to grow. I understood that the agency would address those threats specifically. We now find, however, that it might also have other functions that might augment the Government's public health effort. I make no comment about that.

Mike Hall (Labour, Weaver Vale)

Which amendment is the hon. Gentleman speaking to?

Andrew Murrison (Conservative, Westbury)

The hon. Gentleman has acted as assistant to the Chairman before. I am sure,

Mrs. Adams, that you do not need assistance from the floor in determining what is in order.

Mike Hall (Labour, Weaver Vale)

Will the hon. Gentleman please explain which amendment he is speaking to?

Andrew Murrison (Conservative, Westbury)

I am very happy to do so. As the Chairman instructed me, I am addressing amendments Nos. 8, 1 and 4—in my own way. I will continue to do so until the Chairman interrupts me to tell me that I am out of order. I shall probably also repeat some of my points in the clause stand part debate, which I am sure we will have. [Interruption.]

Irene Adams (Labour, Paisley North)

Order.

Andrew Murrison (Conservative, Westbury)

Thank you, Mrs. Adams. Amendment No. 8 would delete the words ''infectious disease and other'' from subsection (1). It is a probing amendment, because I am not sure what the Minister intends for the HPA. Does she intend it to be a body that deals very largely with infectious disease? If she does, that insertion is correct. However, I understand from what she has said in Committee and from what was said on Second Reading that the HPA's remit was to be broader. Indeed, various other arm's-length bodies are likely to be abolished in July, so it is more than possible that the HPA's remit will expand. The Minister touched on that when she explained that measures might be introduced later by regulation, perhaps as a result of the HPA's expanding function. We might not envisage that expanding function at the moment, but it might be necessary to do so in future as a result of the reduction in function of some of the other arm's-length bodies.

The amendment would delete reference to infectious disease, so all that we would be talking about is the protection of the community, or any part of it, against dangers to health. Clearly, that will include infectious disease as well as all the other multifarious dangers to health, such as radiological threats and chemical threats. I would certainly expect the HPA to tackle chemical threats. Arrangements for chemical incidents are reasonably well laid out, but the HPA needs to get a grip on the arrangements for chemical threats as well as for radiological ones.

The amendment seeks to delve into the Minister's understanding of whether the HPA's remit will principally cover the sorts of horrible infectious disease such as Ebola, West Nile fever and Lassa fever that have been popularised by several television programmes in the past few years. Is that its principal function? Diseases such as influenza may be less alarming, but we should remember the number of people who have died from it in the past century, particularly in the 1919 outbreak. Indeed, outbreaks of influenza affected a large number of people in my constituency during the great war, as the graves of those who died from non-conflict illnesses and injuries attest in places such as Codford, with which my hon. Friend the Member for Newark will be familiar.

I am very aware of the threat that novel organisations pose to the health of the population. We in this country have grown used to being rather relaxed about illnesses such as influenza. We are wrong

to be relaxed about it, and the Minister is absolutely right, if it is her intention, to focus heavily on how we tackle infectious disease and to be determined that the HPA should operate in that way. That is right and proper and probably accords with the views of most of our constituents, who are increasingly alarmed at the threat that infectious diseases pose.

If that is the Minister's intention—and I make no comment about the relative merits of focusing on infectious disease or on the other health threats that we might face—it is entirely reasonable that clause 2(1)(a) should make specific reference to infectious disease. However, if it is not her intention and if, on reflection, with particular reference to what is likely to happen next month to the arm's-length bodies, she wants to broaden the HPA's remit, it would be useful if the words ''infectious disease and other'' were deleted from that important first sub-paragraph.

I am trying to probe the Minister's intention, because we have not been told on Second Reading or today exactly what she intends the agency to do. Is it intended to address novel and terrorist threats of the sort that we originally thought would be at the heart of its activity, or is it intended to deal more broadly with public health? Will it, for example, engage with the public health threat posed by obesity, smoking, drugs, teenage pregnancy or any of the multifarious public health issues that the Opposition would say have been tackled fairly poorly in the past seven years, despite the creation of a ministerial post for public health?

On several fronts, public health seems to have deteriorated rather than improved. It would be perfectly reasonable for the Minister to tell the Committee that the Health Protection Agency is indeed meant to be dealing with public health broadly defined and that the creation of the agency is one of the measures by which the Government propose to pursue public health, which they have identified—and Ministers have said so in the House—as a particular problem.

I make no particular judgment on that. Both approaches to the matter are important, but we need to know the general direction that the work of the Health Protection Agency will take. In proposing the deletion of the words ''infectious disease and other'' I am trying to press the Minister on whether she considers it appropriate for the agency to act principally as an infectious disease organisation, working on threats to health from viruses and bacteria, or whether it should be left open to it to tackle, perhaps in the future, other arguably equally pressing public health issues such as obesity, smoking, radiological problems and matters arising from chemical incidents.

The amendment is meant to be quite helpful. I do not know, and it is for the Liberal Democrats to speak to it, but I guess that amendment No. 1 delves into the same territory. It will be interesting to find out the intention of amendments Nos. 1 and 4, but my guess is that the idea is probably to probe the Minister on exactly how she wants to take the Health Protection Agency forward.

I see that the hon. Member for Sutton and Cheam is smiling broadly—like a Cheshire cat, if I may say so. I look forward to hearing him speak to his amendments. Amendment No. 1 tends in the opposite direction to mine, by deleting the words

''and other dangers to health'',

so he may have identified the threat of infectious disease as even more important than I think it, and worthy of specific mention in its own sub-paragraph, which would be the consequence of his amendments.

That approach would be reasonable, as I have said. I do not make a judgment about whether we should focus heavily on infectious disease or on broader public health issues. Both are important. However, the standpoint from which we seem to have started was the identification of a threat to the population of the country: the Prime Minister has stated that he considers a threat from terrorists to be inevitable.

Terrorists can attack in all sorts of ways—through the distribution of infectious, chemical and radiological agents—and it is right that we should address those. They can also use infectious diseases. It does not necessarily have to involve a terrorist threat; as we have seen with SARS and West Nile fever, Ebola and Lassa fever, a threat can come from all sorts of directions. It is reasonable to focus on infectious diseases, but we need to be fairly clear where the HPA is headed.

The Minister has not said how the HPA will work in practice. She now has the opportunity to tell us what threats she intends it to address. With that in mind, I hope that she will give some thought to my amendments, and to those tabled by the hon. Member for Sutton and Cheam.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

I listened with interest to the hon. Gentleman. I admire his prescience in interpreting what I had in mind when framing my amendments. As he rightly surmised, they are intended to probe the Government's thinking on the scope of the HPA's functions. I wonder whether the organisation is meant to focus on the control of infection, whether it should pick up a wider public health remit on education and promotion—the subject that amendment No. 4 seeks to explore—or whether its functions are more narrowly defined.

The Wanless report published earlier this year considered the question of public health. It identified a gap in the architecture of public health provision, and in a memorandum to the Health Committee, the Department subsequently agreed on that. We have an organisation charged with responsibility for developing the evidence base of public health—the Health Development Agency. There is a body charged with the responsibility of controlling infectious disease and so on—the Health Protection Agency. However, we no longer have a body with national responsibility for the development and promotion of health education messages. It disappeared in a succession of reorganisations in the early '90s. Derek Wanless seems to suggest, and the Health Committee agrees, that that needs to be picked up. Amendment No. 4 is intended to find out whether the Government intend such a role for the agency.

While I am on my feet, Mrs. Adams, I wonder whether I might ask the Minister about the functioning of subsections (2), (3) and (4).

Irene Adams (Labour, Paisley North)

That is not in order.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

I was wondering whether you were minded to have a stand part debate.

Irene Adams (Labour, Paisley North)

Yes, there will be a stand part debate.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

In that case, I shall return to the subject later.

The amendments seek to test the Government's thinking, and get some clarification. I look forward to the Minister's reply, which may be this afternoon.

Patrick Mercer (Conservative, Newark)

I rise to speak to amendment No. 4, so clearly outlined by the hon. Member for

Sutton and Cheam. The amendment would make clause 2(1)(b) read as follows:

''the prevention of the spread of infection disease, including education and promotion''.

That is incredibly important. The terrorist attacks that have been perpetrated against this country—mercifully unsuccessful so far, owing to the work of our outstanding security services and police forces—have all been relatively conventional. I think of the attempt about six weeks ago to use 1.5 tonnes of fertiliser to make relatively conventional bombs in west London. In January last year—

It being twenty-five minutes past Eleven o'clock, The Chairman adjourned the Committee without Question put, pursuant to the Standing Order.

Adjourned till this day at half-past Two o'clock.

Standing Committee F

Clause 2 - Health functions

Eric Forth (Conservative, Bromley and Chislehurst)

I remind the Committee that with this we are discussing the following amendments: No. 1, in

clause 2, page 1, line 9, leave out

'and other dangers to health'.

No. 4, in

clause 2, page 1, line 10, at end insert

', including education and promotion.'.

Patrick Mercer (Conservative, Newark)

May I welcome you to the Chair, Mr. Forth? We had an interesting debate this morning, but I was just in mid flow when the clock hand turned to the appropriate hour for lunch.

If I may iterate, the great difficulty that we face is that since 11 September 2001—a convenient date to choose—our enemies have without doubt made lots of potentially lethal attempts to attack these islands. It is only by good luck and the extraordinary professionalism of our security services and police forces that those attacks have so far been avoided.

The fact remains that most people probably expect the sort of attack that we narrowly avoided about four weeks ago in west London, when the security services intercepted 150 lb of fertiliser. I do not know, but I suspect that that material would otherwise have been used for a series of conventional blasts that could have wrought all sorts of damage—probably something similar to the Madrid attacks or even worse.

When the vexing phrase ''weapons of mass destruction'' comes up, it is worth reflecting that there was an attempt to use such weapons against these islands in the not-too-distant past. That fact is particularly relevant to amendment No. 4. In January 2003, an organisation called Ansar al-Islam attempted to use a contact poison in north London known as ricin. Had that poison been successfully deployed, it could have caused hundreds or even thousands of casualties.

It is useful to bear that incident in mind. That plan was pretty crude, but had it worked, we would be looking at the work of the security services and the Health Protection Agency in a wholly different way. Amendment No. 4 is relevant to that, as it would add the words ''including education and promotion'' to

subsection (1)(b), which makes provision for functions relating to

''the prevention of the spread of infectious disease''.

I would like to tease from the Minister some idea of how she believes we can cover such crucial matters as education and promotion without spelling them out in any more detail than the Bill already provides for.

What am I talking about? Currently, a number of different threats are explained to the population. For instance, we heard earlier about obesity, about which there is an informative campaign. However, I do not think that anyone could say, ''My God, the Government are being thoroughly irresponsible in the way that they are talking about obesity,'' or about the danger to children on the roads, for instance. However, the Government must feel that they are in a difficult position if we are to try to get across to the public at large the dangers, difficulties and lethality of the sort of weapons that might be used against this country. Clearly, chemical, biological, radiological or, in the worst event, nuclear weapons are likely to cause mass casualties. The worst possible thing to do would be to allow our population to remain ignorant of the effects of that style of attack and the diseases that it may engender.

Andrew Murrison (Conservative, Westbury)

My hon. Friend rightly talks about mass casualties, but does he accept that there is also a danger of mass hysteria? I am thinking about a dirty nuclear bomb, for example, when the hysteria caused would probably be well out of proportion to the number of likely casualties. The agency's functions may well include trying to be realistic about the level of casualties that may be engendered and about the effect on the population. Hysteria may well be worse than the number of casualties.

Patrick Mercer (Conservative, Newark)

I am grateful to my hon. and, indeed, gallant Friend for his intervention. Clearly, as a medical officer, his understanding of such issues is much greater than mine. I suspect that he has probably been peeping at my notes; half the problem with such weapons is that they will perpetrate panic, hysteria and difficulties out of all proportion to the effects of the weapon themselves.

Let us look at what might be used and at what has been used in the recent past. We have seen, for instance, the use of a non-persistent chemical, sarin, on the underground in Japan. We are conscious of the fact that sarin was one of the weapons in the armoury of al-Qaeda, Ansar al-Islam and other such groups. There is every possibility of non-persistent and persistent agents being used against the west.

Similarly, we need to start to think about the effects of radiation sickness. As my hon. Friend the Member for Westbury (Dr. Murrison) has just pointed out, any form of radiological device is likely to have effects far in excess of an initial explosion or the contamination that it spreads. Let us move from there on to a biological attack. What does the Minister believe is the possibility of smallpox being used as a weapon? [Interruption.] I see Government Members sneering, but the fact remains that smallpox is a deeply lethal disease that can be easily deployed and has the added

benefit, from a terrorist's point of view, of the physical symptoms taking an extraordinarily long time to develop.

The problem about warning people, training them and making sure that they are aware of what is coming is that all such things are weapons of Armageddon. They all carry a degree of terror with them that is probably out of proportion to the casualties that they will actually inflict. The whole point of the amendment is to make it clear that the population need to be educated in such a way that they will understand what the threat is, will be able to react once the threat physically develops and will be taught by the Government what to do without spreading or engendering panic, which should be totally unnecessary.

It is interesting that in the past, in areas where there has been a threat of an accident with a nuclear submarine, iodine tablets have been distributed to the civilian population at large. I would be interested to know how, when the responsibilities of the National Radiological Protection Board switch to the Health Protection Agency—

Eric Forth (Conservative, Bromley and Chislehurst)

Order. I am happy to let the hon. Gentleman develop his arguments, insofar as they relate strictly to the amendments. He has just managed to do that up to now, but he is now straying into another clause. I ask him to concentrate on the amendments and clause before us now; he may well be able to talk about submarines subsequently.

Patrick Mercer (Conservative, Newark)

Thank you, Mr. Forth. I will try to stay above the surface if I can from now on.

Mike Hall (Labour, Weaver Vale)

Torpedoed.

Patrick Mercer (Conservative, Newark)

Clearly, I have been torpedoed. I will try not to strike any more mines.

To return to the amendment at hand, I would be interested to know precisely how the Health Protection Agency intends to get its message across, and how it will move from the relatively comfortable environment in which it has been able to operate in the past to the environment of this whole new gamut of threats. Without the sort of phraseology included in the amendment, how will the Health Protection Agency get its message across?

Andrew Murrison (Conservative, Westbury)

Would my hon. Friend agree that the Health Protection Agency might like to start close to home, given the confusion engendered in this place by an apparent terrorist, or person of ill disposition, throwing a bag of purple powder into the Chamber of the House of Commons? We knew very little about what to do. It appeared that no one else knew what to do, either. Would the HPA usefully direct its attention towards situations such as that?

Patrick Mercer (Conservative, Newark)

I am grateful to my hon. Friend for another useful intervention. He is absolutely right; it was very clear after that attack a few weeks ago that a group of people, who probably should have known better or at least should have had a well informed view of what was going on, reacted in a way that could have been highly dangerous. It was not their fault nor ours,

but the fault of the authorities who were not in a position to inform and to train or, in the words of the amendment, to ''educate and promote''. I wonder where the HPA would stand on that.

To digress for a moment, I return to the Civil Contingencies Bill. During our consideration of that Bill, we covered a very similar issue.

Eric Forth (Conservative, Bromley and Chislehurst)

Order. I would appreciate it if Members could cease conversations in Committee.

Patrick Mercer (Conservative, Newark)

During our consideration of the Civil Contingencies Bill, which related strictly to terrorism rather than to the health aspects of terrorism, we asked how the Government intended to warn people about—or how they intended to ''educate and promote''—the threat that was present then. In that broader debate, the Government were quite clear that the public did not need education or promotion to be put their way. Despite that, however, it was fascinating to see immediately after the Madrid incident that the British Transport police and the Metropolitan police started a campaign of public information about the terrorist-type weapons that might be used.

Without such an amendment, I wonder how the HPA intends to get its message across. I believe that knowledge will dispel fear. Perhaps the effects of these horrific weapons will be better controlled and the effects mitigated if our population is told what the threat is and how to deal with it. The Government need to include such an amendment to achieve that.

Mark Francois (Conservative, Rayleigh)

It is a pleasure to serve under your chairmanship this afternoon, Mr. Forth. I have seen you in the Chair before in Committee, but I have not served under you. I very much look forward to this afternoon's sitting.

The Liberal Democrat amendment No. 4 refers specifically to including education and promotion, on which I want to focus. I also want to expand on the remarks made by my hon. Friend the Member for Newark (Patrick Mercer) by talking about homeland security.

I believe that you, Mr. Forth, are an avid watcher of current affairs television, so you may be aware of a ''Panorama'' programme some two months ago that created the scenario of a terrorist attack on London that included co-ordinated bombs going off in the early morning rush hour at several key London underground stations, followed later in the day by the explosion of a chemical tanker carrying chlorine gas in the City of London. A panel of experts was drawn from various professions connected with the emergency services and it included my right hon. Friend the Member for Kensington and Chelsea (Mr. Portillo), who played the role of the Secretary of State for Defence. The experts were there to advise Cobra, which, it was assumed for the purposes of the scenario, had been summoned to co-ordinate the Government's response to that terrible incident.

In the scenario, 7,000 people were killed within a few hours. There was panic and pandemonium, which was increased by the fact that very many people did not know exactly how to respond to such an attack.

The public were, in a sense, uneducated, which magnified the scale of the casualties that were supposedly suffered.

An interesting point was brought out by one of the participants in the programme—I think it is was someone who had served as a senior police officer—who drew a comparison with the cold war in the 1980s when, as you may recall, Mr. Forth, a booklet called ''Protect and Survive'' was produced by the Home Office and distributed to every household in the country. Its purpose was to give householders advice about the type of threat that they faced, and about what families could do to prepare for such an eventuality and defend lives. I touched briefly on this matter on Second Reading, but it seems apposite to raise it again in this context.

Melanie Johnson (Labour, Welwyn Hatfield)

Will the hon. Gentleman remind us of the main parts of that advice?

Mark Francois (Conservative, Rayleigh)

Certainly. From memory, it was that the public should stay indoors and tune in to radio announcements. Because of the nuclear threat, people were also advised how to build a shelter using tables and doors and sacks filled with earth to create a citadel in their homes. That is the advice that was given. [Interruption.] I am sorry, Mr. Forth. You were here for part of our deliberations this morning, but not all of them; the Minister was sniggering this morning and I am afraid that she is doing it again.

Andrew Murrison (Conservative, Westbury)

I think that the Minister is being a little mischievous. Perhaps she will tell us what my hon. Friend missed out of his extremely comprehensive description of ''Protect and Survive''.

Mark Francois (Conservative, Rayleigh)

I thank my hon. Friend, but rather than cross swords with the Minister, I suggest that, if she could follow my argument, she might appreciate that I am attempting to make a serious point, which I raised on Second Reading. The Minister was on the Front Bench for part of that debate.

The booklet gave people advice about what they could do in a terrible situation. I propose that the HPA could do that, and that it might be an appropriate arm of the state to issue guidance to families about what to do in the event of a terrorist attack, which might be chemical, biological, radiological or nuclear. The amendment refers to education and promotion, and it seems to me that the HPA might be used to provide advice that families could keep at home. I do not expect that it would be regular bedtime reading, or that people would go through it on a weekly basis, but it could be kept at home so that in the event of an emergency, when people turn on the television and see what is happening, they will have a reference work immediately available to which they could refer. One envisages a mother at home with two screaming, panicking children, while the husband is at work—or it could be the other way around and he could be at home and she could be at work.

Patrick Mercer (Conservative, Newark)

I am sure my hon. Friend is aware that the Government's only current piece of public advice lies in the aphorism, ''Go in, stay in and tune

in.'' How useful does my hon. Friend think that advice is, particularly in the event of a radiological attack, for which ''Go in'' is precisely the wrong advice?

Mark Francois (Conservative, Rayleigh)

My hon. Friend is more knowledgeable than me in these matters. The fairest response I can give is that that advice, in so far as it goes, is appropriate in certain circumstances. However, I envisage a situation in which people are panicking, some elements of the media are overreacting, there have already been thousands of casualties, phone lines are jammed because relatives are all trying to ring each other to make sure that everybody is all right and because people are trying to ring each other at work and cannot get through, and mobile phone communications have probably collapsed because so many people are trying to get on to the network at once and the network cannot cope—

Patrick Mercer (Conservative, Newark)

As in Madrid.

Mark Francois (Conservative, Rayleigh)

As my hon. Friend reminds me, that is what happened in the Spanish emergency. In that kind of pandemonium, having some kind of reference material in the house that people can turn to, such as a small manual or booklet, might at least provide some kind of reassurance in a terrible situation. It strikes me that an organisation called the Health Protection Agency could—in consultation with Government Departments—produce such a booklet and that it could be an authoritative work to be kept at home against such an awful eventuality.

The Minister might say that the Government have plans for other Departments to issue such guidance. Perhaps the Home Office is working on something. If that is her answer, I am prepared to respect it, although it would be nice to see a draft. Nevertheless, in the absence of anything other than a little slogan, there seems to be a gap in the market—if I dare use that term in this situation—that the HPA might usefully fill. This debate is a good opportunity to put that suggestion to the Minister. If she feels that that is not the job of the HPA perhaps she could explain, first, why it is not—looking at the terms of reference that the Committee has already examined—and secondly, whose job it might be. She speaks for Her Majesty's Government, and she should tell us who might take responsibility for such an important matter if the HPA does not want to do so.

Melanie Johnson (Labour, Welwyn Hatfield)

Mr. Forth, I join other members of the Committee in welcoming you to the Chair. I am sure that we will do productive business under your guidance this afternoon and on Thursday.

First, let me respond to the points made by the hon. Member for Westbury. He asked about the rationale for the HPA and the advantages of it. Despite his repeated charge that the reasons for setting up the agency have never been spelled out, let me draw his attention to my opening remarks on Second Reading, when I set out some of the important reasons. Let me refresh his memory. I said:

''The agency can function as a 'one-stop shop', capable of providing the necessary expertise for dealing with any scenario involving a biological, chemical or radiation hazard.''—[Official Report, 21 June 2004; Vol. 422, c. 1098.]

It is important for the agency to have a wide-ranging role, because it is not always immediately clear whether an incident has a chemical, radiological or infectious source. That is where the point about infection comes into play. However, it is not easy to apportion the work, because some things might be unclear at the start. We accept that the plans need to cover the whole gamut of possibilities.

The creation of the agency will allow for the cross-fertilisation of many good ideas and much good practice across different fields of health protection—more than in the past, because they will be brought together in one agency. It will also mean positive gains in radiation protection work, which is tremendously important. The agency's local and regional structure will facilitate communication with the public about radiation protection. There are clear synergies in the work of the HPA special health authority and the NRPB, particularly in relation to emergency response and to radiation and chemical hazards. Both organisations have an international role, and they can learn from each other's experience and co-operate even more closely than they do now.

Mark Francois (Conservative, Rayleigh)

I thank the Minister for her courtesy in giving way. She is beginning to address some of the concerns that we have sought to highlight since this morning, so I thank her for that. She used the expression ''one-stop shop'', a phrase that we hear repeatedly in modern parlance. Will she expand a little on what she means by it in this context?

Melanie Johnson (Labour, Welwyn Hatfield)

I am not clear what the hon. Gentleman is asking me to explain in more detail. Let us be clear: the initials are HPA, not PHA. We have to remember that this is not about public health; it is about health protection. Nor has the agency been set up solely to deal with chemical, biological, radiological and nuclear threats, although they are, of course, important.

In response to some of the points that were made about the 2002 consultation, I point out that paragraph 4.8 of the document that went out for consultation says:

''We propose that the agency's central purpose should be to provide information, expertise, advice and training on infectious diseases, chemical and radiation hazards, and health emergency planning; and to commission and carry out research to inform any of these activities. It will need to maintain an understanding of current, new and emerging problems, including terrorism.''

As I see it, that covers the whole gamut of points that Opposition Members raised. They rightly asked what the agency's scope was and I have told them what we set out in 2002. We have not diverged from that proposal, which is embodied in the Bill and in the bringing of the NRPB under the wing, as it were, of the HPA's existing functions.

The proposals provide for a wide range of functions and flexibility. The question whether there is a crossover between something on the infectious diseases side and the CBRN, for example, highlights the strength of the proposals, which will reinforce health protection arrangements across the country. The HPA has a wide-ranging role. We acknowledge

that as important right across the piece, and it is in line with the proposals that we have set before people from 2002 onwards.

As for what gains will be achieved by putting NRPB functions into the agency, there will be positive gains for radiation protection work. However, those gains will not all be for the agency. There will be benefits to staff, who will be able to broaden their scientific expertise and take advantage of opportunities for career development in a larger, more dynamic organisation. There will also be clear synergies between the HPA's work and that of the NRPB, particularly on the emergency response, and in relation to radiation and chemical hazards. I understand that staff are generally positive about developing such interactions. For example, the HPA's establishment of the headquarters of the chemical hazard and poisons division at the NRPB's Chiltern site has been welcomed.

Again, that is an example of how the changes are facilitating things. Given the expertise and interest of the hon. Members for Newark and for Rayleigh (Mr. Francois) in particular, I know that they will recognise that in the work being taken forward. The NRPB already has a good working relationship with the HPA. The proposals will also allow the NRPB to continue many of its core activities. The agency will have UK-wide responsibilities for radiation protection, as the NRPB does now—there is no intention to scale that work down in any way—but the high-quality research and development will continue apace.

There are a lot of advantages to the arrangements that have been put in place. I am pleased that we are making the change, as are, I think, Opposition Members. Their overall support for the Bill indicates that they think the direction of travel is right.

Amendment No. 1 would probably effect the most fundamental change. It would exclude from clause 2(1) any dangers to health other than infectious disease. I am not sure what the purpose of that is. The Secretary of State and the National Assembly for Wales would still be able to confer health functions not covered by clause 2(1) on the agency by means of the procedures in clause 2 subsections (2), (3) and (4). However, Scottish Ministers and the Department in Northern Ireland could confer functions on the agency only where they fell within clause 2(1). Amendment No. 1 would therefore prevent Scottish Ministers and the Department from issuing orders making the agency responsible for providing them with specialist advice on chemical and poisonous hazards, as they wish to do so and as I know hon. Members would wish them to as well. That would be a retrograde step. For some years, the four UK Health Departments worked closely together in commissioning specialist advice on chemical and poisonous hazards. It would be unfortunate if Scotland and Northern Ireland were excluded, which is why we cannot support amendment No. 1.

The other two amendments would not have the same radical effect, but neither is necessary or

desirable. Amendment No. 4 suggests that the agency's function of preventing the spread of infectious disease should include education and promotion. A number of hon. Members spoke at length about the subject, and the amendment would give prominence to those activities. In general, the agency's power to discharge its functions under clauses 2 and 4, as set out in clause 4, contains no specific reference to education and promotion. However, the activities are already covered by clause 4(1), paragraphs (e), (f) and (g), which allow the agency to

''provide training . . . make available to any other body such persons, materials and facilities as it thinks appropriate . . . provide information and advice.''

Paul Burstow (Liberal Democrat, Sutton and Cheam)

The Minister may be about to deal with the question, but will the HPA's power to provide information to other organisations and persons be sufficiently wide for it to run publicity campaigns and to disseminate information to the general public?

Melanie Johnson (Labour, Welwyn Hatfield)

Yes. Indeed, it already does so. The HPA website makes a lot of information available to the public. That may be the most readily available way to provide advice. It will also be able to do so under clause 4(1)(g).

Preparedness for CBRN terrorism is not an issue for the HPA, as hon. Members accept. The national health service, the Government—including the Home Office, which the hon. Member for Rayleigh mentioned—and the police will obviously have a role. Those organisations need to work together in all areas. Indeed, they are doing so. We do not propose changing that.

As for specific advice, I am aware that the hon. Member for Rayleigh is trying to raise questions, but precedents are not always stunning. I was laughing because the advice was fairly risible. Its quality was the subject of much public concern. It is important that the public are kept informed, but a number of bodies are involved. It is not for the Bill to say precisely what information should be made available, nor is it a matter for the HPA.

Andrew Murrison (Conservative, Westbury)

I am slightly concerned. I think that the Minister was saying that ''Protect and Survive'' was risible; my recollection is that it was pretty basic. It may have been open to criticism, but it was better than doing nothing. I recall the television programme that it was based upon; it may have been a grainy black-and-white programme, but it had a great impact—just as Lord Fowler had a great impact on education about HIV/AIDS in the mid-1980s. I did not disparage ''Protect and Survive''. That would be very unwise.

Melanie Johnson (Labour, Welwyn Hatfield)

The hon. Gentleman and I might wish to differ, but we are talking about something historical. To be fair, none of us would want to put out such a programme today.

Patrick Mercer (Conservative, Newark)

I am slightly concerned about the Minister's statement. One reason why ''Protect and Survive'' was laughed at—which it was—was that the threat never materialised. People said, ''This just ain't going to happen.'' The point of our earlier questioning was that although we are constantly told that the

threat will develop, the Government continue to allow us to remain in a state of ignorance. ''Protect and Survive'' was at least doing something proactive, rather than being reactive.

Melanie Johnson (Labour, Welwyn Hatfield)

As I said, the matter of advice to the public and the giving of information and advice is specifically set out in clause 4(1)(g). The power exists for the agency to do that; it is already doing so; it will continue to do so. It needs to do so in respect of the points made by Opposition Members, in conjunction with some of the organisations that I mentioned a few moments ago.

Examples of a UK-wide approach already being taken to health protection include the unified HIV and AIDS surveillance that the hon. Member for Westbury has just mentioned and the five nations working group on severe acute respiratory syndrome and the SARS taskforce—as well as what our authorities have done in working closely with the WHO. Avian flu and other issues are among matters on which organisations are working together across the UK to ensure effectiveness and co-ordination.

Similarly, the Government and the devolved Administrations work together closely on preparedness for bioterrorism. The Health Protection Agency provides support with the operational response to that.

Andrew Murrison (Conservative, Westbury)

The Minister has been generous in giving way. She has described how bodies are co-ordinating their activity with respect to a range of illnesses. Will she comment on hepatitis C and tuberculosis? I should hope that relevant bodies are co-ordinating what they are doing with respect to both of those, but there has been an upsurge in cases in those conditions in recent months.

Melanie Johnson (Labour, Welwyn Hatfield)

I will indeed comment but, before I do, I should like to finish my remarks on amendment No. 4. I note what the hon. Member for Sutton and Cheam (Mr. Burstow) said on Second Reading about the Wanless report and gaps in public health machinery, particularly in relation to health promotion, education and the essential capacity to evaluate public health measures. However, the Government commissioned the Wanless report, which highlighted those issues, and they also tackled the issues that it raises.

It is not necessary to amend the Bill to deal with those issues; nor would it be desirable to add the reference to education and promotion, because that would highlight issues that are dealt with in clauses 2 and 4. That would be to privilege specific ways of protecting the community over other ways set out in clause 4, such as providing laboratory services. There are many ways in which the agency can play a role in that context.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

Can the Minister confirm, therefore, that the Bill provides for a Government to decide to ask the Health Protection Agency to take on the health promotion and education function that the Wanless report identifies as not being picked up, currently, in public health mechanisms? Could the Government do that under the Bill?

Melanie Johnson (Labour, Welwyn Hatfield)

I know, Mr. Forth, that this point is not strictly on the amendment, but the hon. Gentleman has taken an interest in the subject of our forthcoming White Paper on public health. Much of the response to the Wanless report will be made through the White Paper later in the year.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

I understand entirely that the Government want to declare new policies and changes to policy in the White Paper. However, my question was whether the Bill allows for a Government to decide to give the role of health promotion and education to the Health Protection Agency, or would further primary legislation be needed?

Melanie Johnson (Labour, Welwyn Hatfield)

It is a matter of whether by health promotion the hon. Gentleman means health protection—and we can argue about what the terms cover, but I agree that there is some possibility of sliding on that. However, health protection has a well defined meaning, which I set out earlier and which is the subject of the work of the Health Protection Agency. That is covered by the Bill in the clauses that I explained earlier.

Amendment No. 8 would remove the specific reference to infectious disease from clause 2(1)(a). The hon. Member for Westbury recorded on Second Reading that he was unclear about the functions of the agency. I have reiterated how the remit works, and I hope that I have made it even clearer. I also referred him to the consultation document. If we were to accept amendment No. 8, infectious disease functions would still be covered and nothing would be gained.

Andrew Murrison (Conservative, Westbury)

Will the Minister give way?

Melanie Johnson (Labour, Welwyn Hatfield)

May I deal with the points that the hon. Gentleman has already raised?

I turn now to the hon. Gentleman's points about hepatitis C and tuberculosis. Hepatitis C was identified in the chief medical officer's infectious diseases strategy, ''Getting Ahead of the Curve'', as the hon. Gentleman knows. In August 2002, we published a consultation paper, and today we have published an action plan to implement the strategy. It sets out a framework of actions to improve prevention, diagnosis and treatment, and to strengthen the evidence base. The actions cover four key areas: surveillance and research, increasing awareness and the detection of undiagnosed infections, high-quality health and social care services, and prevention.

The action plan will be underpinned by professional and public awareness campaigns centrally funded by the Department. That will help to prevent new infections and lead to the diagnosis of more people with hepatitis C so that they can be assessed for antiviral drug therapy treatment.

Andrew Murrison (Conservative, Westbury)

The Minister might have made an important announcement. I am not sure whether she was dealing with hepatitis C or TB.

Melanie Johnson (Labour, Welwyn Hatfield)

Hepatitis C.

Andrew Murrison (Conservative, Westbury)

Hepatitis C. I am grateful to the Minister, because the action plan is long awaited and long overdue. I offer my congratulations to her on bringing it forward, even at this late stage. When can

we have a TB action plan, which was promised two years ago?

Melanie Johnson (Labour, Welwyn Hatfield)

I was about to come to that. It is our intention to publish a TB action plan when departmental business allows. In the meantime, the lack of publication has not halted progress on the issue. We are already taking action and low levels of TB have been achieved and maintained: through the BCG immunisation programme, which is kept under review by the Joint Committee on Vaccination and Immunisation; through the treatment of identified cases and screening of their close contacts; through the screening and treatment of immigrants from countries with a high prevalence of TB; and through active surveillance of TB—we are funding a two-year pilot study on the use of mobile digital X-ray units. There is a worldwide resurgence in TB, which is having a small but important impact on trends in the UK.

Andrew Murrison (Conservative, Westbury)

The Minister has rattled through a whole range of things. First, she has stated that we are containing the level of TB. However, that is not the case, particularly in some of our inner-London boroughs—perhaps she would like to revisit those remarks. She also mentioned something about the screening of immigrants. I know that the Government were looking into that; perhaps she might describe it in a little more detail.

Melanie Johnson (Labour, Welwyn Hatfield)

In the centres to which immigrants come when they arrive, a large percentage take up the option of screening. I do not have the figures in front of me, but I have recently answered a parliamentary question, giving some of those details.

The HPA has developed a new molecular finger printing method for mycobacterium tuberculosis, or MTB, to assist outbreak investigation. It is a powerful method that has already proved useful in showing that a suspect outbreak in Leicester was not in fact an outbreak. It has developed a method of direct detection of MTB in sputum, and that will be evaluated. It is developing databases for contact tracing and improving case registries and for working with prison services to support management of risk to prisoners and staff. It is working with health professionals to track and contain the spread of drug-resistant MTB in London, and it has developed and evaluated rapid molecular methods for determining the likely antibiotic-resistant strains of MTB. The HPA is doing a whole range of work on the subject, which I am sure will be of interest to Opposition Members.

Finally, the hon. Member for Sutton and Cheam (Mr. Burstow) talked about the relationship between the HPA and health promotion. The HPA can undertake health promotion on behalf of the Secretary of State and the National Assembly for Wales. Health protection is covered by subsection (1), and the powers under subsections (2) to (4) would enable it to be given other health functions, including health promotion functions that are not caught by subsection (1). As I said in my comments on the amendments, that would leave Scotland and Northern

Ireland in a different position, because they do not have the powers set out in subsections (2) to (4).

As the hon. Gentleman will appreciate, several matters are subject to devolution, and Ministers in Westminster do not consider matters that have been devolved to the Scottish Parliament and Scottish Executive.

Andrew Murrison (Conservative, Westbury)

The Minister is being very generous. Would not subsection (8) also allow the authority to give the agency a task along the lines of those suggested by the hon. Member for Sutton and Cheam?

Melanie Johnson (Labour, Welwyn Hatfield)

Indeed.

Eric Forth (Conservative, Bromley and Chislehurst)

Order. Perhaps we can cover that when we discuss clause 4.

Melanie Johnson (Labour, Welwyn Hatfield)

Thank you, Mr. Forth. Given that injunction, I have finished answering the points made by Opposition Members, and I trust that the Committee will resist the amendments.

Andrew Murrison (Conservative, Westbury)

We have rattled along at a rate of knots, and have made very good progress. Hon. Members may have been lulled into a false sense of security because we are now at the meat of the Bill—the health functions—which has exercised most of us in our consideration of this material in the past few days. Health functions were the sticking point on Second Reading, if there is a sticking point in this largely uncontroversial measure, so I hope that the Committee will forgive me if I dwell on them a little.

The Minister has been very helpful in clarifying her perception of the HPA's functions and how they will be discharged. I confess that it was not clear before or on Second Reading exactly what direction the HPA would take. We have now established that its principal function will be to tackle infectious disease and other hazards, such as chemical and radiological incidents, that may cause an acute public health problem. We must accept, however, that the Bill includes powers to extend those functions dramatically.

Quite rightly, Mr. Forth, you corrected me when I tried to talk about clause 4(8). I will not go down that path, because you will undoubtedly tell me that I am out of order, but that subsection does give the Minister swingeing powers to direct the work of the HPA. It would be open to the Minister to decide that the HPA, despite its name, should embark on public health activity that is broader in scope and of the sort that I discussed this morning. I make no comment about that because I, too, believe that such things are important. Nevertheless, we must be clear that we will not dilute this body's very important function, which is to protect the public against infectious diseases of the sort that probably concern many of our constituents, and against the sorts of novel threat that, sadly, we have seen in recent years. Indeed, many of our constituents have seen us conducting exercises against such threats—belatedly in London, and in Newcastle, where exercise Magpie enacted an attack on a population from the nerve agent sarin.

I am grateful to the Minister for clarifying many of my thoughts on the issue. However, some bits remain opaque. I think that it was Lord Clement-Jones who raised in another place the matter of zoonosis—

infections passed from animals to humans. He tabled an amendment to include that specifically as a subsection on infectious disease, and I think that he was correct to do so, because I am not clear about the interaction between the HPA and various veterinary bodies. That is important, because one of the biggest recent health scares was over BSE and Creutzfeldt-Jakob disease, and BSE is of course principally a veterinary not a human disease. It is passed on by means of a prion, which is not specifically mentioned in the Bill. We are left to assume that the Minister understands the term ''infectious''.

Melanie Johnson (Labour, Welwyn Hatfield)

The hon. Gentleman is raising points in summing up that he did not raise earlier. If he had mentioned animal diseases, I would have told him that the HPA is closely involved in such matters and that DEFRA has a role too. I should have been happy to debate the issues had he raised them in his opening remarks.

Andrew Murrison (Conservative, Westbury)

I am glad that the Minister would have been happy to address them. Perhaps she would prefer to return to them on Report; I shall be happy to raise them then, but it might save time if she were to consider them now. Lord Clement-Jones probably had a point, particularly in connection with prions. It is a legitimate thing to debate, as we are debating infectious diseases, and my probing amendment required that a reference to infectious diseases be deleted. I merely probe the Minister on her understanding of the term ''prion'' and whether it is sufficient to include it in the general term ''infectious diseases'', in the same way as she includes zoonosis. That is a perfectly reasonable question to put to the Minister.

In connection with that, it would be interesting to know—hypothetically at the moment, as is to be announced next month—the result of the review of overarching bodies. One of the agencies in the frame, so to speak, will be the National Patient Safety Agency. It would not surprise me at all if it were shut down. That would be an example of the Government's marching their agencies to the top of the hill and marching them down again. Of all the agencies under review, about half were created by the Government, so it will be interesting to see the bonfire of Government-created agencies next month.

If, as I suspect, one of them is the National Patient Safety Agency, it will be interesting to see which of its health functions will be transferred to the HPA. Might it be its work—or should I say lack of it—on prions in connection with Creutzfeldt-Jakob disease? The Minister will know that my interest in the matter has to do with tonsillectomy, and the tragedy that has befallen the son of one of my correspondents, who died as a result of haemorrhage post-tonsillectomy, carried out using a disposable tonsillectomy kit. The kit was introduced because of policy made on the hoof due to fears about the possibility of transmitting prions by means of instruments used during surgical operations, particularly tonsillectomies.

It would be nice if the Minister could say, ''Yes, that is exactly the sort of thing that the HPA will look at.'' That might go some way to assuaging the concerns of my correspondent who, some time after

his son's death, is still concerned that Ministers are not taking the issue seriously. So far, my correspondence with the NPSA has drawn a blank; the joint chairs of that agency do not seem to be particularly concerned that they have not considered the way in which the tragedy occurred. I hope that the HPA would look at that and, furthermore, be in a position to make recommendations about a more joined-up way of addressing the threat from prions. That would certainly help the gentleman with whom I am corresponding. If that were the case, it would be nice if the Minister could say so and help me to get my head around exactly what the HPA will be doing, especially in relation to infectious disease.

Melanie Johnson (Labour, Welwyn Hatfield)

I can help the hon. Gentleman in a limited way on that point. He raised that point on Second Reading, although he had not done so previously in this debate. The HPA has no responsibility for tonsillectomy operations, as I am sure he appreciates, but it will be responsible for collecting tonsils for the archive. That is important for the research into such a difficult and vexed question, on which the science is still in its infancy.

Andrew Murrison (Conservative, Westbury)

I am grateful for the Minister's reply. She might have led me along a path down which you would rule me out of order, Mr. Forth, but I commend the work of the national tonsil archive, which has collected some 10,000 tonsils to date. Incidentally, I was concerned that the Human Tissue Bill would result in the archive's closure. It was only after a number of hon. Members raised the potential problem yesterday that we managed to secure changes to safeguard that valuable collection. What better example—

Eric Forth (Conservative, Bromley and Chislehurst)

Order. Before we go on to examples, can I remind the hon. Gentleman and the Minister that we are discussing the amendment? Can the hon. Gentleman stick to that or at least tell us from time to time in what context he is doing so?

Dr. Murrison rose—

Melanie Johnson (Labour, Welwyn Hatfield)

I do apologise, Mr. Forth, but I believe that the hon. Gentleman has been leading me astray.

Eric Forth (Conservative, Bromley and Chislehurst)

Order. Ministers are not supposed to lead astray—not in this Committee.

Andrew Murrison (Conservative, Westbury)

I am grateful for your guidance, Mr. Forth. The tonsil archive is a great example of how the HPA might discharge its functions. The archive will be examined for the prevalence of prions, which potentially cause a devastating illness. I am grateful that the Minister raised the issue, and I have no doubt that one of the agency's functions will be to liaise closely with the archive. One of the biggest perceived threats to the population—''perceived'' is important—is that from prions, specifically in connection with Creutzfeldt-Jakob disease, although the jury is still out on the ultimate impact.

Disease registration has not been listed under health functions. I should like briefly to touch on that, but if the Minister objects to my raising the issue in the

clause stand part debate, I should be happy to return to it on Report. Disease registration is important in the context of some of the HPA's functions. We had problems with cancer registration in the not-too-distant past and associated difficulties with data protection. It is essential that we register disease adequately; otherwise the epidemiological function on which the HPA's health functions are based cannot work at all.

Central to that process is the national programme for IT in the NHS. Without that, we are going to struggle. It would be nice if the Minister could confirm that the national IT programme is on course for the HPA. There have been indications that the programme might either have been derailed or not be going entirely to plan. In such a crucial area, however, where there are so many threats to public health, it would nice to know that the national programme for IT in the NHS was going according to plan. If it was not, we might have problems.

We have had a good debate on the various health functions that the agency may discharge. I am grateful for the Minister's announcement that the action plan for hepatitis C is now on the streets, although I regret that the plan for tuberculosis is not.

I cannot think of anything more germane to the HPA's work than a national TB plan. If the HPA is to be the wonderful body that the Minister envisages, with the holistic benefit that will come from amalgamating those arms of government, perhaps we should already have a TB action plan. That said, however, it is important to note that, in general, action plans tend to come from the chief medical officer.

We may have clarified to some extent what the agency will do, but its interaction with the CMO is not entirely clear. Will the HPA carry out surveillance, or gather and collate information in order to inform the CMO's reports and recommendations; or will it assume some of those responsibilities for itself? ''Winning Ways'', recently published by the CMO, was concerned with another extremely important issue to do with hospital-acquired infections that most definitely come within the remit of health functions. That report was put out by the CMO, not the agency. Will that continue, or will one of the agency's functions be publishing reports that are really the bailiwick of the CMO? I am a little unclear about that. The Minister might let us know her thoughts.

I am grateful for the Minister's comments on TB. We will continue to press her on the action plan for TB. The situation is not under control, but I welcome the pragmatic way in which she plans to deal with the problem in relation to immigrants. She assures me that screening is voluntary. I have not heard her say that before, and it was not said in answer to a question of mine. Nevertheless, I am reassured to hear that there is a high take-up of voluntary screening at ports and airports. It helps a great deal, and informs the thinking of many. However, as suggested in the CMO document ''Getting Ahead of the Curve'', we need a TB action plan soonest. If the HPA had been in place, we might already have seen that. Were the Minister to

give us her thoughts on the matter, we would welcome the measure even more.

The Library has published an extremely useful document on the Bill, which includes a section dealing with clause 2. I apologise for going on about this clause, but it is fundamental. It is the meat of the Bill, so if the Committee will allow me I shall continue.

Page 22 of that research paper lists what the HPA has done to date. It says that it has responded to the threat from SARS and avian influenza, and has noted an increase in the number of sexually transmitted diseases. It also notes that we have the highest rate of TB in Europe. It noted increased concern with bioterrorism, such as threats of anthrax and smallpox, and with the emergence of new disease. It makes specific mention of zoonosis—Lord Clement-Jones will doubtless be interested in that—and the rising instance of hospital-acquired infections and MRSA.

It seems that the HPA has scored about three out of six. The fifth point, on new diseases, is debatable. It has dealt with 50 per cent. of those points satisfactorily, but it has not done particularly well on sexually transmitted diseases, and we are clearly not on top of tuberculosis despite the Minister's remarks. Instances of that disease are rising, particularly in certain wards London, and hospital-acquired infections are going through the roof. We are not doing terribly well.

I have pressed the Minister before on how the HPA might add value. My hon. Friend the Member for South Cambridgeshire said on Second Reading that we should not assume that bolting all those arms of government together will necessarily be beneficial. Large organisations often are not beneficial, and my hon. Friend said that if we continue bolting agencies together—I am sure that we shall see some of that next month, with the result of the review—we will end up simply with the Department of Health. That is not a sensible direction of travel.

We need to look more closely at hospital-acquired infections such as MRSA. The public perception is that there have been a lot of edicts from Government agencies on that. The HPA will probably continue to issue edicts on hospital-acquired infections, but how will things be carried out on the ground? I am still unclear about how practically they will be carried out. We have seen, no doubt with the connivance of the HPA in its infectious-disease role, the creation of directors of infection control, and all sorts of publications about best practice for ward hygiene, yet it seems that the basics still are not being carried out.

I accept the good point that the Minister made on Second Reading, that part of the problem is cramped, dark wards, and that the hospital-building programme on which her colleagues have embarked has helped. It may have helped, but the incidence of hospital-acquired infection has continued to rise. Obviously, we are doing well in one part, but less well in others.

Control has to do with proper hygiene, especially by medical practitioners. As I said on Second Reading, when I was a practising doctor on the ward, I rarely

changed my white coat, and I certainly never changed my tie—I am probably still wearing the same one as I wore on the ward 20 years ago. If one were to swab doctors' ties microbiologically, one would find all sorts of horrible things. The solution would appear to be straightforward: forbid doctors from wearing neck ties and get them to wear something else, yet something that simple seems to be beyond the capability of health protection and other agencies. Instead, we faff around creating new tiers of management when we should be trying to sort things out at the coal face, so to speak.

Clearly, we have not sorted things out: the incidence of hospital-acquired infection varies dramatically from one end of the country to another. In Yorkshire, it is seven times less than in Cambridgeshire and—

Eric Forth (Conservative, Bromley and Chislehurst)

Order. The hon. Gentleman is now embarking on a more general analysis of the health service. I remind him that we are discussing a group of amendments to the Bill, and I would be grateful if he concentrated on that.

Andrew Murrison (Conservative, Westbury)

I am grateful, Mr. Forth. I was trying to describe the functions of the HPA as they stand, and how they might be developed. That is fundamental to the Bill; it is the engine room of the Bill, because the agency is nothing if it is not what it does. We are not interested in the structure of the agency or, necessarily, in how it is financed, although we have gone through that in enough depth.

Melanie Johnson (Labour, Welwyn Hatfield)

I do not believe what I hear. The hon. Gentleman is not interested in the clauses that we are debating.

Eric Forth (Conservative, Bromley and Chislehurst)

Order. I am grateful to the Minister for her advice and support, but there is only one Chairman in this Committee and, for the time being, that is me. I shall allow the hon. Gentleman to continue, but I shall be listening rather carefully for repetition, deviation or, indeed, any other sin.

Andrew Murrison (Conservative, Westbury)

I agree absolutely, and I am very glad that there is only one Chairman in this Committee. May I say what an admirable Chairman he is?

I am sorry that the Minister butted in prematurely, as I was going to say that we are not particularly interested in the number of executive and non-executive members of the board of this body; we are interested in how it does its job, as that is what matters to our constituents, but it is encapsulated in a very few column inches in the Bill. That is what we are discussing now.

I make no apologies for going on about this, because it is crucial to our deliberations. Frankly, if we do not get it right, we might as well pack up and go home and let the existing structures continue. Our constituents need to know that this body, which they are financing, will make a difference to their health. They also need to know what it will do. The Minister clarified some of that, and I am grateful to her for that, but I want to know how the agency will improve people's health in several specific areas. We have teased out many of those, and my purpose in pursuing this matter is to obtain a few more nuggets from the Minister, and perhaps to change her thinking slightly in several ways, as her colleagues were moved to

change their mind on the last measure that we debated in the House yesterday. There were 99 amendments tabled to the Human Tissue Bill on Report, and we do not want that. It would be much nicer to make changes at an earlier stage.

I am just trying to be helpful in focusing particularly on clause 2, on health functions, which is the most important clause. I hope that the Minister has taken to heart some of what I have said; I mean it in good faith. The Bill is not particularly controversial, but we want to get it right.

Eric Forth (Conservative, Bromley and Chislehurst)

It would be helpful if the hon. Gentleman would say whether he wants to press his amendment to a vote or seeks leave to withdraw it.

Andrew Murrison (Conservative, Westbury)

I am grateful, Mr. Forth. I think that I have made my point. I may return to one or two matters on Report, but I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Question proposed, That the clause stand part of the Bill.

Melanie Johnson (Labour, Welwyn Hatfield)

We have already had a wide-ranging debate—so wide-ranging that from time to time you have felt the need to restrict some of us in our contributions, Mr. Forth. I shall not test your patience by repeating what we have said already, or by straying too widely. The clause is important because it identifies the health protection functions of the agency and the ways in which it may be directed to exercise other health functions. We have had an extensive discussion of those functions in debating the amendments, and I do not intend to explore them further.

I shall respond briefly to one or two of the points that have been raised, particularly the question of zoonotic infection in humans, which was not raised earlier on. Were an outbreak to occur in the animal population where there is a clear and perceived risk of transfer of disease to humans, the Department for Environment, Food and Rural Affairs, in close liaison with the agency and the Department of Health, would take the lead on animal health issues; the agency, in close liaison with the Department of Health and DEFRA, would take the lead on human health issues.

Members will appreciate that things work in both directions: for example, when a few months ago an urgent question was tabled on avian flu, both I and a Minister from the Department for Environment, Food and Rural Affairs were present on the Front Bench for the debate. There is liaison between organisations dealing with human and animal health at central, regional and local level.

Paul Burstow (Liberal Democrat, Sutton and Cheam)

One of the issues that I raised on Second Reading in relation to zoonotic conditions was the question of who would be pre-eminent when there was an outbreak in the animal population and concern about a potential spread to the human population. The Minister has said that DEFRA would deal with the animal population and the Department and the agency would deal with the human population, but who is pre-eminent in making decisions about, for

example, how one might deal with the animal population to contain a spread to the human population? Where do those decisions rest?

Melanie Johnson (Labour, Welwyn Hatfield)

They rest in joint working and co-operation. The hon. Gentleman is wrong to think that it is possible simply to allocate the lead in those matters. In the event that we are considering, both sides are important in containing the outbreak and dealing with the human health issues that may arise. Therefore it is important for both bodies to work together. As I said, in the event of a clear and perceived risk of transfer of disease to humans, DEFRA would be in liaison on animal health issues and the agency would be in close liaison with the Department of Health and DEFRA on human health issues.

It is not possible to say that one body will have the final say, because co-operation has already been established, and needs to continue in such an event. Liaison occurs at all possible levels, as I was saying when the hon. Member for Sutton and Cheam intervened. That continues. For example, there is collaboration between the national public health service for Wales, which provides the zoonosis surveillance reference unit for England and Wales, and the Veterinary Laboratories Agency, which links human and animal surveillance. A pilot scheme is being developed in Wales to link human and animal data, and it is hoped that a similar scheme will be rolled out in the rest of the UK. That rests on mutual co-operation, which is embodied in clause 5.

Andrew Murrison (Conservative, Westbury)

Would the Minister accept that we are talking about emergencies? In such situations, somebody has to have primacy; otherwise one ends up with a dog's breakfast, arguably of the sort that occurred in relation to the BSE crisis. Although we accept that organisations should co-operate, it will not do not to have somebody who is obviously in charge. I hope that the Minister agrees, and will give further thought to which of the agencies would have primacy in the circumstances that have been described.

Melanie Johnson (Labour, Welwyn Hatfield)

DEFRA would have primacy in cases of animal health, and the HPA would have primacy on human health issues. It would not be sensible to say that the HPA should do a lot of detailed animal health work, because DEFRA and other organisations have prime responsibility for animal welfare and need to get the ''animal'' side of things right if there is any danger of the spread of a disease that might impact on both animals and humans.

I disagree with hon. Members' analysis of what makes sense in this context. We have worked through such situations and are looking further at the results of recent work on the outbreak of foot and mouth. Those issues have been well dealt with and we have learned many lessons from what happened. However, that is not likely to affect human beings; it is confined to one area.

Andrew Murrison (Conservative, Westbury)

DEFRA is a Ministry headed by a Secretary of State. The agency is an agency headed by a chairman and chief executive. Can we assume that, if difficult decisions had to be made about, for example,

BSE—which interrelates with human health—those difficult decisions would end up, by default, being made by DEFRA because its top man is a Secretary of State, rather than the chief executive or chairman of an agency?

The rest of the debate is in Hansard.