Commons Sitting of 21 June 2004

Preamble
The House met at half-past Two o'clock
PRAYERS
[MR. SPEAKER in the Chair]
Oral Answers to Questions
  DEFENCE
  The Secretary of State was asked—
  DEFENCE

    Iraq
    Mr. Tam Dalyell: Pursuant to the statement of the Foreign Secretary, 7 June 2004, Official Report, column 31, on Iraq, what reports he has had from the US Administration on their investigation of the attack on 18 to 19 May on the village of Makr-al-Deel. [179359]
    The Secretary of State for Defence (Mr. Geoffrey Hoon): United Kingdom operational commanders received an oral briefing from their US counterparts as part of their daily theatre operational situation updates. That briefing was passed by telephone to my office as soon as it was received. The US investigation into the incident is continuing.
    Mr. Dalyell: Is there a serious intent to establish the truth?
    Mr. Hoon: As I understand it, the United States has set up a thorough investigation into those events. We know some of the facts; we have seen some of them in various media reports that suggested that a wedding was taking place. Equally, I have seen briefing from the United States Government indicating that not only were they attacking a base for the transit of people across the Syrian-Iraqi border but that in the aftermath of the incident they found, for example, not only rifles but rocket-propelled grenades and other items of quite a heavy military kind. Obviously, it is important that we allow their investigation to proceed.
    Mr. Paul Keetch: The allegations about the incident at Makr-al-Deel, as well as US actions over the weekend, and even the fresh allegations in The Guardian today will be seen by Iraq civilians as the actions of the coalition as a whole. Unless there is a full and impartial investigation, the coalition authority and the case for democracy in Iraq will suffer. British troops are covered by the International Criminal Court but Iraqi and US troops are not. Is it not the best way to reassure Iraqi civilians that all coalition forces, including Iraqi and US forces, should be covered by the ICC?
    Mr. Hoon: The latter point is obviously a matter for the US Government, but I agree with the hon. Gentleman to this extent: it is important that each country conduct thorough and rigorous investigations into such allegations. The hon. Gentleman referred to the story in The Guardian this morning; it covered two pages and I read it in some detail. I hope that he will accept that the headline on the story could just as easily have been, "More False Allegations Against British Troops", because the detail in the story did not particularly bear out the rather lurid headline that The Guardian's editor had chosen. Such issues arise regularly, but I give the hon. Gentleman and the House my assurance that each of them that involves British troops will be thoroughly investigated.

    African Troop Training
    Mr. David Kidney: What contribution his Department will make to the training of 17,000 African troops by 2010. [179360]
    The Minister of State, Ministry of Defence (Mr. Adam Ingram): The Ministry of Defence is committed to playing its part in meeting the G8 goal to train 75,000 peacekeepers world wide by 2010. Our aim is to train about 17,000 African troops, either directly or through our support to centres of excellence such as the Kofi Annan international peacekeeping training centre in Ghana.
    Mr. Kidney: I thank my right hon. Friend for that answer. As he knows, the most recent G8 summit made a number of commitments to the continent of Africa, which was itself a tribute to our Prime Minister, including the training of 75,000 African troops in peacekeeping skills by 2010. In the Prime Minister's statement to the House last week, he said that our contribution would be those 17,000 troops. Does my right hon. Friend the Minister agree that British troops are among the best in the world not only at fighting but at peacekeeping and that it is thus entirely appropriate—
    Mr. Speaker: Order. That question is far too long.
    Mr. Ingram: I cannot disagree with a word that my hon. Friend said. He made a strong point about the role played by our troops when they are called on to fight wars, wherever that may be; they have been thus engaged in Africa, the Balkans, Afghanistan, Iraq and elsewhere in recent years. However, one of their key attributes is that they play a peacekeeping role, too, and that is what we want to impart in nations where we have a presence. The Prime Minister has made clear his commitment to Africa and it is salutary for us to see how deep the problem is in that continent, where 20 countries and 20 per cent. of the population are affected by conflict; about 10 million African people have been uprooted from their homes owing to conflict. Everything that we do in trying to build that peacekeeping role will help immeasurably in finding solutions to those difficult problems.
    Mr. Julian Brazier: For obvious reasons, that sort of activity is welcomed on both sides of the House, but can the Minister of State tell us how it will be affected by the situation at the cornerstone of infantry training, Warminster, which has been stripped of its demonstration battalion because of overstretch?
    Mr. Ingram: The hon. Gentleman is treading into a completely different area. I do not agree with his assertion that we shall not be able to deliver the objectives we have set out. My response to my hon. Friend the Member for Stafford (Mr. Kidney), whose question highlighted our expertise in that area, showed that we have not lost that expertise. We still have that capability and we shall continue using it to best effect in Africa and wherever we have peacekeeping missions.
    Lawrie Quinn: Given the British armed forces' globally recognised expertise in engineering and logistics units, is my right hon. Friend able to say whether those key skills, which would be of great benefit, particularly on the African continent, will be shared with the 17,000 African troops undergoing training?
    Mr. Ingram: I cannot give a specific answer, because we would primarily seek to get volume capabilities to deal with some of the very big issues that we must face in Africa—I recounted the depth and extent of the problem there—but clearly one of the areas where we must grow capability is in that type of sustainability and very positive reconstruction role. A lot will depend on what the African countries want to put into that training approach as well. So we stand ready to deal with anything in a progressive and constructive way to assist in that reconstruction. My hon. Friend is right: that is an important area. It is another area where we excel, and we must always consider how we can impart that knowledge to those nations that we are training.

    Army Medal Office
    Mr. Peter Luff: If he will make it his policy to delay the closure of the Droitwich Spa Army Medal Office until the end of December 2007. [179361]
    The Parliamentary Under-Secretary of State for Defence (Mr. Ivor Caplin): As I have said previously, I do not intend to hold up the formation of the new Ministry of Defence medal office by delaying the closure of the Army Medal Office at Droitwich Spa. Although I commend the hon. Member for his concern for his constituents, I am convinced that the investment of effort now to modernise medal delivery will be to the ultimate benefit of veterans and today's serving personnel.
    Mr. Luff: In the current edition of Soldier magazine, the staff of the Chief of the General Staff, General Jackson, say:
    "There is a widespread and strongly held view that … the administration of pay and allowances is still failing our people."
    General Jackson himself says:
    "It is well known that our pay and administration hardware is creaking at the seams".
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    However, that is precisely the organisation into which the Minister proposes to merge the Army Medal Office at Droitwich Spa, at a site the future of which is itself uncertain—RAF Innsworth. Does he not understand that, whatever the long-term benefits may or may not be—I think they are illusory—the inevitable short-term consequences will be that Suez veterans die before they receive their Suez medals and that Iraqi veterans will experience unacceptable delays in receiving their medals?
    Mr. Caplin: The Suez medal is one from this Government to those veterans. I was in Wolverhampton on Saturday, where I joined members of the Suez veterans' club in presenting three of the latest Suez veterans' medals. We in this Government have righted an injustice to ensure that those Suez veterans have a medal.
    As for the hon. Gentleman's comments about the medal office, we have been through the issue already at some length. I have answered 21 questions from him in the past six weeks, all on that specific issue. That is why I commend him for his work on behalf of his constituents, but none of his questions suggest to me that the decision should be changed and that we should not have a single Ministry of Defence medal office, based at Innsworth, because we have the space, the capability and, eventually, the efficiency to improve medal delivery.
    Dr. Julian Lewis: It is a bit rich for the Government to claim credit for the issuing of the Suez canal medal and clasp, when they did so under pressure from hon. Members on both sides of the House, as they know. Given the difficulty faced in the issuing of those medals and clasps, which is likely to take at least two years to complete, what effect will the closure of the Army Medal Office have on the issuing of the Artic Convoy medal, when the Government are eventually forced into issuing that medal, too—a commitment given by the Leader of the Opposition, but not yet endorsed by the Government? However, we can be as sure as anything that, when they do endorse it, they will claim credit for having done so all along.
    Mr. Caplin: I am sure that the right hon. and learned Gentleman, the Leader of the Opposition, will never miss an opportunistic moment to make an opportunistic point—that is exactly what he does but let me inform the House that, so far, as of last Friday, we have had 39,666 applications, of which 9,709 have been dispatched. I very much regret that there continue to be problems with the dispatch of the Suez medal, but I am taking action to put that right. That is an important thing that we should do. We are taking action, whereas the Conservative Government never did, and it will improve medal delivery in the longer term.

    European Security and Defence
    Mr. David Ames: When he last discussed progress on the European security and defence policy with the French Defence Minister. [179362]
    The Secretary of State for Defence (Mr. Geoffrey Hoon): I last met Madame Alliot-Marie on 9 June on board the French aircraft carrier Charles de Gaulle, anchored off Portsmouth. The visit formed part of the entente cordiale centenary celebrations. Our discussions covered a range of issues, including European security and defence policy.
    Mr. Amess: Does the Secretary or State agree that the European defence agency, if fully implemented, would have a significant impact on Britain's ability in the next Parliament independently to choose a replacement for Trident?
    Mr. Hoon: It would not have that impact, no.
    Ms Dari Taylor: Does my right hon. Friend agree that the most crucial issue in European defence at present is encouraging our European partners to improve their defence capabilities? What is he doing as secretary of State to encourage that? Does he also agree that the best way to do so is to work in co-operation with our European allies, and not to carp from the sidelines, which gets us nowhere?
    Mr. Hoon: I entirely agree with my hon. Friend. What is important is that we engage our European partners in improving their military capabilities. If we can do that through NATO, all to the good. If we can also do that through the European Union, that would be an extra benefit. Indeed, that was the Conservative party's policy at the time of the Maastricht treaty. Somewhere along the line the views of the hon. Member for Southend, West (Mr. Amess), which in those days were considered somewhat extreme by most members of the Conservative party, have become mainstream. That says something about the current opportunism of the leadership of the Conservative party.
    Mr. Quentin Davies: How does the Secretary of state react to the extraordinary statement last week by the three largest aerospace businesses in the EU—BAE Systems, Thales and EADS—which was reported in the Financial Times on 15 June, to the effect that the European defence agency is merely a fig leaf to cover the nakedness of any progress towards European defence? Is that not an extraordinary indictment from that very authoritative source?
    Mr. Hoon: I do not accept that criticism. Indeed, last weekend, in the course of the discussions on the framing of a draft European constitution. there was agreement on the need to develop European defence policy and specifically to establish a European defence agency, which will have the opportunity of co-ordinating industrial and military efforts to improve European military capabilities, which I would have thought should be approved of by the Conservative party—indeed, a few years ago would have been approved of by the Conservative party. As I said in my last answer, the Conservative party today is so determined to court any cheap popularity that it is opposing things that only a few years ago it strongly supported.

    Manufacturing
    Jim Knight: What efforts his Department is making to support the British manufacturing sector. [179363]
    The Secretary of State for Defence (Mr. Geoffrey Hoon): In October 2002 we published our defence industrial policy, which seeks to provide the armed forces with the equipment that they require at best value for money for the taxpayer, while sustaining a healthy and globally competitive defence industry. When acquisition decisions are made, the Government take into account the benefit to the United Kingdom economy arising from defence expenditure, including detailed consideration of the extent to which UK companies will be involved in supplying and supporting equipment and services.
    Jim Knight: I thank my right hon. Friend for his reply. I am sure that he will agree that UK defence manufacturers and workers value our special relationship with the United States of America and are keen to see that translate into improved access to US contracts. What progress is being made across Whitehall Departments on negotiating the waiver on the international traffic in arms regulations?
    Mr. Hoon: I am grateful to my hon. Friend for raising that important issue. I am certainly disappointed that some in Congress want to damage our efforts to bring down the barriers to improve Anglo-American defence industrial co-operation. We would like the closeness of the wider relationship more properly reflected industrially. The ITAR waiver would certainly be a positive step in that direction. We have made our opposition to the damaging provisions of this year's Defense Authorizations Bill clear both to the Administration and to Congress. We are grateful to the Administration for their robust support in expressing their solidarity with our position.
    Sir Nicholas Winterton: Does the Secretary of State agree that it would be of immense encouragement to British manufacturing industry and give a positive indication that the Government support manufacturing in the United Kingdom if the Ministry of Defence gave the go-ahead to BAE Systems' Nimrod MRA4—maritime reconnaissance and attack mark 4—project, which would be built at Woodford, which lies partly on the periphery of my constituency and partly in the constituency of the hon. Member for Cheadle (Mrs. Calton)?
    Mr. Hoon: The Government do support manufacturing industry in the United Kingdom. As set out in the principles of our industrial policy, we do so through the use of the defence budget where that is appropriate. It is important that we secure best value for money for the British taxpayer, but in our calculations we consciously and as part of our overall policy take account of the research, investment and benefit that that will provide to British industry.
    Mr. Bill Olner: Does my right hon. Friend agree that one of the most positive ways to show

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    support for British manufacturing industry is to keep teams such as the Red Arrows flying? Will he give an assurance that what we have been seeing in the press is just media talk and there is no option to shut down the Red Arrows and the Hawk aircraft that they fly?
    Mr. Hoon: I recently had an extremely good visit to the Red Arrows, and I was as impressed as my hon. Friend by the brilliance of the pilots and their stunning showmanship. I am delighted to endorse their strong commitment to promoting British exports around the world, the excellence of British manufacturing, and the skill of our pilots.
    Mr. Patrick McLoughlin: Is the Secretary of State satisfied that his Department does enough to encourage small manufacturing industry in this country to compete for MOD contracts? Is he aware that such businesses often find getting a foothold in defence contracts extremely burdensome?
    Mr. Hoon: The hon. Gentleman makes a good point. Small businesses finding it difficult to secure access to larger contracts is a problem throughout UK industry, whether the contracts are directly with the MOD, which is relatively unlikely for the sort of small business that I believe he has in mind, or for the supply of parts under larger contracts, which are won by larger companies. However, I agree with his basic point: it is important that we encourage smaller manufacturing companies to participate in the defence industrial policy.
    Ms Ann Coffey: My right hon. Friend will be aware of the importance to the north-west economy of BAE Systems' site at Woodford. When I visited the site recently, I was shown around one of the newly refurbished Nimrods and was impressed by the state-of-the-art surveillance equipment and technology on the aircraft. Will my right hon. Friend say when a decision will be made on orders for the Nimrod? He will appreciate that the orders are crucial to secure jobs and investment in the north-west.
    Mr. Hoon: In February last year we reached an important agreement with BAE Systems on Nimrod—a contract amendment that put Nimrod MRA4 on a much sounder footing for the future. Under the restructured contract, design and development and production have been separated as far as possible to ensure that technology is adequately de-risked before making any further commitment to production, price and schedule. The MOD has been approving low-risk production activities when it makes sense to do so and when such activities help to maintain essential skills and product knowledge, as well as preserve the schedule. There is still work to be done before I can satisfy my hon. Friend, but I assure her that we are committed to the Nimrod project, which is important for industry in the United Kingdom and crucial in terms of the capabilities that it will offer our armed forces.
    Mrs. Patsy: I am happy to hear the Secretary of State give his commitment to the Nimrod project and to hear him say that he is seeking value for money, as are we all. However, does he
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    recognise the tremendous improvement that has taken place both in the operation of the work force and the management at BAE Systems in Woodford?
    Mr. Hoon: There has certainly been improvement, but as I suggested in my answer a moment ago, that has come at some cost to the Government. I hope that the improvement will continue to be commensurate with the further efforts that the Government are making to get the project right.
    Mr. Kevan Jones: Further to the question asked by the hon. Member for West Derbyshire (Mr. McLoughlin), will my right hon. Friend join me in congratulating Northern Defence Industries, which is working with small and medium-sized businesses in the north-east and Yorkshire to gain access to defence contracts? What encouragement can the MOD give NDI and other organisations to ensure that small companies get access to some large contracts?
    Mr. Hoon: As I said a few minutes ago, the problem is often that the larger Companies that win those contracts have bureaucratic procedures that they have to go through before they accept bids from suppliers, particularly from smeller companies. However, I agree that it is important that we work with excellent organisations such as NDI to ensure access for those smaller companies, which will one day develop into the larger companies that will secure the manufacturing future of the United Kingdom.
    Mr. Gerald Howarth: With much of Britain's defence industrial base either already in foreign ownership or about to become foreign-owned, is it not the case than the Government are presiding indifferently over a massive summer clearance sale of major British defence companies, with many attendant risks to our security of supply? Is the Secretary of State's own much vaunted defence industrial policy not a complete shambles?
    Mr. Hoon: Opportunism again from the Conservative Front Bench. Our policy was established 18 months ago, and we did not hear a single word of objection from the Conservatives at the time, but now they are taking the opportunity to criticise us in a quite unprincipled way. Their party is supposed to be committed to market forces. Is the hon. Gentleman recommending nationalisation of major defence industries? Is he suggesting that the Government should interfere in the decisions made by private sector companies? Is he suggesting that where the shares are held is more significant than where the jobs, investment, and technology are? Thai is the Government's policy—he did not object to it when it was published, so to do so now is simply opportunism.

    Afghanistan
    David Cairns: What assessment he has made of the effectiveness of NATO's command of international security assistance force operations in Afghanistan. [179364]
    The Minister of State, Ministry of Defence (Mr. Adam Ingram): Since NATO assumed responsibility for the international security assistance force in August 2003, the alliance has continued successfully to assist the Afghan transitional authority in maintaining security in Afghanistan. NATO has also led the expansion of ISAF beyond Kabul and is working on expanding the force across Afghanistan.
    David Cairns: I thank my right hon. Friend for that answer. If NATO is to assume a more global peacekeeping role in future, it is essential that its command of ISAF is a success, and is seen to be a success. Does he share my disappointment that other member countries of NATO are reluctant to give ISAF the number of troops that it needs to extend its mandate beyond Kabul? Some countries may have legitimate differences of opinion with us over Iraq, but they all supported the Afghan war. Now is the time not to walk away from that country, but to help to rebuild it.
    Mr. Ingram: I know that my hon. Friend takes a close interest in matters relating to Afghanistan. All of us want things to happen more quickly, but in the real world it takes time to plan a complicated military operation, especially in such a challenging environment as Afghanistan. It takes time to organise and deploy military forces, and for that deployment to have a full effect. My hon. Friend should look at what NATO has already achieved. It is moving fast—just two months after the UN authorised ISAF expansion, it established the first ISAF provincial reconstruction team. We are clearly moving into another phase of possible expansion, in which the United Kingdom is to the fore. I suggest that my hon. Friend wait for the outcome of the Istanbul summit, as some of the issues that he has raised will be raised there as well.
    Mr. Nicholas Soames: Does the right hon. Gentleman accept that there is no anxiety about NATO's command of ISAF, but its real difficulty is the timely generation of adequate forces to undertake the jobs required? Will he confirm that at the summit on 17 June in Brussels it was agreed that the EU would establish its own military operational planning centre independent of NATO? Would it not be better if, instead of discussing headquarters, some of those countries increased their defence spending on deployable capabilities to undertake those difficult missions?
    Mr. Ingram: May I suggest that if the hon. Gentleman had been here for question 4 he could have asked his question then? However, I hope he heard me when I said that NATO is making progress, and more will be made as a result of the important summit at which NATO Ministers will deal with any possible expansion in Afghanistan. That is when the issue will be discussed, and that is when a structure will be put in place to develop our mission in that country.
    Mr. Tom Harris: With elections in Afghanistan due by the end of the year, it is obviously important to make sure that there is a stable political environment in the country in the run-up to those elections. What role are NATO troops,
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    particularly British troops within the NATO forces, playing to make sure that that environment is sustained between now and election day?
    Mr. Ingram: My hon. Friend raises an important issue about the emerging democracy and the forthcoming elections in Afghanistan. It falls to all coalition countries to do our best to ensure that registration takes place under the UN lead, and that there is a stable environment to encourage people to vote—all sections of the community, men and women alike, who are eligible to vote. It is encouraging that significant numbers of women have already registered to vote in the election. We and other coalition forces are playing a dual role—in ISAF in Kabul and in the provincial reconstruction teams, whose role and function there are proposals to expand. It is important to allow the Afghan forces and the transitional Government progressively to take on the ownership and control of their own country. Giving them the confidence to move forward and the security in which to do it is an important role that we are playing, through both ISAF and the PRTs.
    Mr. Edward Garnier: The right hon. Gentleman's answer to the hon. Member for Greenock and Inverclyde (David Cairns) was, when boiled down to its essentials, wait and see. How long must we wait and what will we see?
    Mr. Ingram: I gave a time scale to that. If the hon. and learned Gentleman had been listening, he would have heard me say that the summit in Istanbul next week would no doubt discuss the matter, and we may return to it in future questions if progress is not made.

    D-Day Commemorations
    Shona Mclsaac: What assessment he has made of the D-Day commemorations. [179365]
    The Parliamentary Under-Secretary of State for Defence (Mr. Ivor Caplin): I made an initial assessment of the D-day commemorations to the House on 9 June during the veterans affairs debate. I am pleased to report further that the Ministry of Defence has received a number of letters from hon. Members, veterans and their organisations who attended the events in France, expressing their thanks for the effort provided by the Department and our armed forces. I would again like to add my thanks to all for their hard work. I have also written to the French Veterans Minister thanking the people of France for their support during that most memorable weekend of 5 and 6 June.
    Shona Mclsaac: I am sure everybody in the House would agree that the commemorations were a success. They were both moving and a fitting remembrance of the bravery and sacrifice of veterans. It is important that their work and their bravery, not just in world war two but in other conflicts, be kept in the public mind in future. What will the Government do in the future to keep these affairs in the forefront of the public's mind? Has he ever given consideration to something for which I have campaigned for some years: a veterans day public holiday?
    Mr. Caplin: We have already announced to the House that we propose to have a veterans awareness week in July 2005. That will be an opportunity for people in all parts of the United Kingdom to take part in discussions with veterans and, we hope, in educative opportunities for young people in order for them to understand what happened in 1945 and to be more aware of how those great and momentous events in our history took place. I will give some consideration to my hon. Friend's other suggestion, but I am sure she is aware that that is not directly the responsibility of the Ministry of Defence.
    Mr. Nicholas Soames: May I, on behalf of many of those who were there, thank the Government and congratulate them on the arrangements that they made for those never-to-be-forgotten celebrations? Will the Minister extend to the armed services our thanks for all they did in a very short time to bring together such a tremendous display, and will he particularly pass to the Normandy veterans our admiration and respect for their bearing and dignity on a parade that no one who saw it will ever forget?
    Mr. Caplin: I agree with the hon. Gentleman's comments about that weekend's events in Normandy, and Her Majesty's Government were delighted by the excellent turnout from both sides of the House. Events occurred in Portsmouth, which has a direct and important connection with the Normandy landings, in Lichfield, at the national memorial arboretum, and in many other towns and cities across the UK, such as Plymouth and Blackpool, and I hope that the people who attended those events also had a memorable and enjoyable weekend.
    Andrew Mackinlay: The Minister mentioned next year, when we shall commemorate victory in Europe and victory over Japan. Will he and the Foreign and Commonwealth Office consider righting a wrong perpetrated half a century ago, when the Polish air force was denied the opportunity to march down Whitehall with the other representative contingents because it might offend Uncle Joe Stalin? I hope that he will find some way to commemorate the Polish air force, which was part of "the few".
    Mr. Caplin: I sympathise with my hon. Friend's point, and I shall look into the matter and report back to him. On 10 July 2005, the country will come together to commemorate VE-day and VJ-day, and I hope that all those who want to participate can do so, whether that occurs in London or other cities and towns around the UK.

    Balkans
    Eric Joyce: What discussions he has had with counterparts from the Balkan states on their contribution to NATO. [179366]
    The Minister of State, Ministry of Defence (Mr. Adam Ingram): My right hon. Friend the Secretary of State for Defence and I have regular discussions with our Balkan counterparts. Those discussions have focused on the transition from a NATO-led force, SFOR, to an EU-led
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    force, EUFOR, in Bosnia and Herzegovina, and on the Balkan states' aspirations to join NATO or partnership for peace. I am due co visit the region shortly.
    Mr. Joyce: I thank my right hon. Friend for that answer. Will he say how the decision to transfer from a NATO-led mission to an EU-led mission in Bosnia and Herzegovina was made?
    Mr. Ingram: The range of demands must match the particular Balkan country involved. Bosnia and Herzegovina has made significant progress on defence reform, including the creation of a Ministry of Defence and the appointment of a Defence Minister, but full co-operation with the International Criminal Tribunal for the Former Yugoslavia, particularly with regard to Karadzic, is a prerequisite for partnership for peace membership. We urge Bosnia and Herzegovina to meet that and all other international obligations, and to build close and friendly ties with its neighbours. We place a range of demands on all countries within the region, some of which are already members of the action plan and are hopefully moving towards full NATO membership, and others of which still have some way to go.
    Mr. John Randall: Will the Government support Macedonia's application at the forthcoming Istanbul talks?
    Mr. Ingram: No.

    RAF Homes (Carterton)
    Mr. David Cameron: If he will make a statement on progress towards establishing a private finance initiative scheme for the building of RAF homes in Carterton. [179367]
    The Parliamentary Under-Secretary of State for Defence (Mr. Ivor Caplin): This private finance initiative project to provide service families' accommodation for RAF Brize Norton was launched in May 2003. Since then, the project has gone through pre-qualification and short-listing phases. Once final approval is given, the next stage will be to issue the formal invitation to negotiate.
    Mr. Cameron: Is the Minister aware that his predecessor, the hon. Member for Kirkcaldy (Dr. Moonie), said that the RAF homes in Carterton are among the worst in the RAF? Given that the hon. Member for Kirkcaldy wrote to me in June last year saying that the PFI to rebuild the homes was the Defence Housing Executive's "highest priority", will the Minister knock heads together to make sure that that scheme, which should be good for the RAF, good for Carterton and good for west Oxfordshire, goes ahead soon? Will he come to Carterton to see how urgently the rebuilding work needs to be done?
    Mr. Caplin: I welcome the hon. Gentleman's support and that of West Oxfordshire district council for replacing Ministry of Defence housing at Carterton. I agree with the comments of my predecessor and I am aware that local people consider the houses an eyesore.

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    There are concerns that some aspects of antisocial behaviour, especially vandalism, are connected to the empty properties. As the Minister responsible for the estate, I understand the wish to replace the houses as quickly as possible. I greatly hope hat the project that we have in mind will ensure that replacement housing will be available in mid-2006. Although I cannot undertake to come to Carterton shortly, I undertake to keep the hon. Gentleman informed of progress.
    Mr. James Gray: How many more houses will be needed at Carterton to accommodate the aircraft people from RAF Lyneham in my constituency when the Hercules fleet is moved? Is the shoddy, decrepit condition of the housing in Carterton a good reason for reconsidering that move?
    Mr. Caplin: We have been through this at some length with the hon. Gentleman. The decision about RAF Lyneham has been made. We had an Adjournment debate in the House on the subject, to which I replied, and there has been much correspondence. I repeat that the decision has been made and I am confident that we will get our housing stock up to the standard that we would all expect.

    Regimental Recruitment
    Bob Russell: What importance he attaches to a regiment's historic association with geographical areas when seeking recruits. [179368]
    The Parliamentary Under-Secretary of State for Defence (Mr. Ivor Caplin): Great importance is attached to the historic links that the infantry, the Royal Artillery, the Household Cavalry and Royal Armoured Corps have with the areas from which they traditionally recruit. Although the location of potential soldiers is not an overriding consideration in recruitment, the practice of maintaining links with geographical areas has served the Army well for many years, not least in helping to uphold a sense of unit identity.
    Bob Russell: I am sure that the Minister can justify the number of regiments in Scotland, which has a population of 5 million. Will he explain why the nine counties—the traditional recruitment area of the Royal Anglian Regiment—with a population of 7 million, have only one regiment and two battalions? Whereas the Scottish regiments find difficulty in recruiting, the Royal Anglian Regiment does not, and the reinstatement of the Third Battalion—the former Essex Regiment—would go a long way towards filling the Army's vacancies.
    Mr. Caplin: I am well aware of the hon. Gentleman's points, which he makes consistently. Recruitment is generally buoyant and that includes recruitment to the Royal Anglians. It is also worth saying that the Army, like any organisation, needs to adapt to change in the existing environment. It does that, as has been proved around the world.
    Mr. Brian Jenkins: Does my hon. Friend appreciate that we are all proud of our historic links with our county regiments? Did he take the
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    opportunity during the commemorations of D-day to see one of the films, which showed a small American town where almost every other household featured in the casualty rates after the Omaha beach landings? Such scenes had not been known in Britain since the days of the pals regiments. Will my hon. Friend reassure me that, in our recruitment base, the current strategy and tactics in the British Army are correct and should be adhered to on recruitment and allocation?
    Mr. Caplin: I am sorry to tell my hon. Friend that I did not see the film to which he referred. I had one or two other things to do in the run-up to that weekend. Omaha beach is covered in the Minister of Defence booklet that we published to commemorate D-day. I know that my hon. Friend has a copy, because I made sure that every hon. Member had one.
    Mr. Mark Francois: The Minister knows from his experience that, especially when considering infantry battalions, not only their recruitment record but their ability to retain soldiers after they have been trained is important. Will he take that into account in any analysis of future infantry battalions? The Royal Anglian Regiment has an especially good record on retaining trained soldiers as well as on its ability to recruit them.
    Mr. Caplin: I am pleased to tell the hon. Gentleman not only that recruitment is buoyant but that, in the past two years, the Army's trained strength has increased by more than 3,300 personnel. That is down not only to good recruitment practices but to good retention levels. I share the hon. Gentleman's view that it is important to retain people in the British Army once they have been recruited. We intend to do that.
    Mr. Simon Burns: Does the Minister accept that there is considerable affection for and pride in the Royal Anglian Regiment in Essex? Will he please tell me what specific support has been given to regiments such as the Royal Anglian for their local recruitment drives? Is there any truth in the recent press reports that there has been a six-month freeze on recruitment?
    Mr. Caplin: No. There has been no recruitment freeze. I met many members of the recruitment team in the hon. Gentleman's area last Friday when I was at Chelmsford fire station to celebrate the sixth-form college's national diplomas. That included talking to one or two people from a battalion.
    Mr. Keith Simpson: This looks like an East Anglian love-in. As a Member of Parliament representing Norfolk, I of course endorse all the comments made by hon. Members about the Royal Anglian Regiment. I am sure that the whole House agrees that the links between a regiment and its historical recruiting areas are very important in maintaining the strength of the Army.
    The Minister touched on a point mentioned by my hon. Friend the Member for West Chelmsford (Mr. Burns). The House is aware that the defence budget faces a £1.5 billion shortfall, and although the Minister denies the fact that there is a freeze on recruitment and

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    training, in the other place last Thursday Lord Bach referred to it as a "pause" in training recruits. What is the difference between a freeze and a pause?
    Mr. Caplin: I have made clear the position on recruitment, which I am responsible for. There is no recruitment freeze in the British Army. I have to tell the hon. Gentleman that that is the situation we have today. Of course, it is not the situation that members of the Government he supported in the early '90s dealt with. Their recruitment freeze in the early '90s has a direct impact on the ability of our armed forces to deliver today, and he needs to understand that. It is obvious and consistent that we ensure that our armed forces are relevant, flexible and usable. That is what they are today.

    Eurofighter
    Mr. Michael Jack: If he will make a statement on when he expects to conclude his negotiations with BAE Systems on the tranche 2 contract for the Eurofighter. [179371]
    The Secretary of State for Defence (Mr. Geoffrey Hoon): Negotiations with BAE Systems regarding the order for tranche 2 Typhoons are continuing. We and our partner nations need to acquire aircraft with the right capabilities to meet our requirements, at an affordable price.
    Mr. Jack: While I thank the Secretary of State for those words, may I point out to him that they do not answer the question I posed? He has been in discussion with BAE Systems on tranche 2 for at least the last nine months, and he will be aware of the uncertainties that the absence of an announcement is causing among the work force at BAE at Warton in my constituency. Will he outline the problems that are preventing a decision from being made on that vital procurement programme? When will he be able to announce that decision—at Farnborough or when the comprehensive spending review is complete?
    Mr. Hoon: I am sorry that the right hon. Gentleman's idea of a negotiation appears to be to find out what the other side want and give it to them. He was a Treasury Minister in the last Conservative Government, so perhaps that explains why their economic policies were such a disaster. However, I can tell him that there is a question about the price. We are engaged in a negotiation and I will go on negotiating on the Government's behalf until I get the right price.
    Mr. Lindsay Hoyle: Is my right hon. Friend aware that a lot of workers throughout Lancashire are very worried about tranche 2? What message does he have for the work force there and what message does he have for the management of BAE Systems?
    Mr. Hoon: I shall not repeat what I have just said on the question of the price, but on behalf of the Government I say to the work force, and indeed to the management, that the six aircraft that have been received in service are performing superbly. This is a
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    magnificent aircraft and it is exceeding our expectations. The next production aircraft is due to be accepted in service this week, and two aircraft are shortly due to lead the export campaign in Singapore, where the aircraft has already been shortlisted. This is a superb aircraft, but obviously it is important that we get the right price for it.
    Miss Anne McIntosh: Will the Secretary of State explain the implications for RAF Leeming should he decide not to proceed with the second tranche?
    Mr. Hoon: The second tranche aircraft, as the hon. Lady knows, is of a different kind from tranche 1. It will have different capabilities and will provide an air-to-ground capability not originally envisaged when Typhoon was designed many, many years ago. It is vital to the future not only of RAF Leeming, but of the strike capabilities of the RAF that we secure tranche 2 aircraft. I emphasise, however, that that must be at an affordable price.

    Afghanistan
    Mrs. Joan Humble: What progress has been made on reconstruction efforts in Afghanistan. [179372]
    The Minister of State, Ministry of Defence (Mr. Adam Ingram): Through our contribution to the international security assistance force in Kabul, and to the joint departmental provincial reconstruction teams in north-west Afghanistan, our armed forces help to facilitate the reconstruction programmes of the Afghan Transitional Authority and international development agencies. An essential part of that is supporting the development of Afghanistan's own security forces. We are helping to train the Afghan national army and, through the provincial reconstruction teams, have provided assistance to the Afghan national police.
    Mrs. Humble: I thank the Minister for that reply. When British forces help in the reconstruction of Afghanistan by training police, will they also consider training civilians, ensuring that both men and women are involved in the process, so that we reconstruct not just buildings but civil society in Afghanistan?
    Mr. Ingram: Absolutely. That is one of the main thrusts of the provincial reconstruction team, which is a multi-departmental initiative, with the Foreign and Commonwealth Office and the Department for International Development. In Mazar-e-Sharif, the DFID representative has in the region of £1 million to allocate to a range of projects, some of them linked directly to security sector reform, but also to the whole reconstruction effort of rebuilding roads and bridges, reopening schools, reopening courthouses, or opening courthouses where perhaps none have been, and creating that normal society. My hon. Friend raises an important point. That is what our mission is in Afghanistan, and we are beginning to make progress.
    Mr. Andrew Mackay: Would the Minister accept that the people of Afghanistan have been badly let down by NATO in its first out-of-area operation? The troops have failed to arrive, time is running out and the elections are due in September. What will happen at the NATO meeting in Istanbul next month to ensure that troops really are there, that it is not all words, and that there is some action from NATO members?
    Mr. Ingram: I would not agree with the view expressed by the right hon. Gentleman that we have let down the people of Afghanistan. I have recounted in response to two separate and subsequent questions the range of activities in which we are engaged, and I have also said that we must live in the real world. Trying to put forward a major new initiative requires a lot of hard discussions and negotiations, and all the various coalition nations must decide what their best input into that is. We have made very good progress, and much more progress will be made. The situation is not ideal in Afghanistan; more remains to be done, and that is what will be addressed in Istanbul next week.

    Iraq
    Mr. Ian Liddell-Grainger: If he will make a statement on the role of the Fusiliers in Iraq. [179373]
    The Secretary of State for Defence (Mr. Geoffrey Hoon): Our armed forces have done and continue to do an outstanding job in southern Iraq. The role of the 1st Battalion the Royal Regiment of Fusiliers last year, and the 1st Battalion the Royal Highland Fusiliers and the 1st Battalion the Royal Welch Fusiliers this year, has been to work for the creation of a safe, secure and stable environment for the Iraqi people.
    Mr. Liddell-Grainger: Given that four fusiliers are at the moment being charged with various offences, and that other fusiliers were under investigation in relation to certain things that happened last year, will the Secretary of State please tell the House what will be the situation in relation to the other fusiliers under investigation? Will they be able to continue their military career with no blemish on their good character?
    Mr. Hoon: As I have made clear to the House on previous occasions, it is important that those negotiations are able to proceed free of any kind of ministerial or political interference. I give the hon. Gentleman that assurance. It is therefore a matter for the appropriate prosecution authorities to determine whether any charges arise out of these investigations. I assure him, as I do the House, that the Ministry of Defence is well aware of the remarkable service by the Fusiliers and by all members of Britain's armed forces. I would not want anyone to go away with the idea that simply because certain individuals might be subject to prosecution, that in any way affects the high regard in which the Fusiliers and members of Britain's armed forces are held in respect of their excellent work in Iraq.
    Mr. Crispin Blunt: The allegations against the Fusiliers and other battalions involved in Iraq in 2003 do not appear in any way to be replicated with regard to the divisional detention facility that the Secretary of State allowed the Defence Committee to visit. We were left with the impression of a facility being run in absolute convergence with the fourth Geneva convention, as every Member of the House would expect. What will happen after 1 July to those detainees, as far as the United Kingdom is concerned? Does he think that the Americans have the proper legal authority to continue with their operations in Abu Ghraib, as they appeared to be suggesting this morning?
    Mr. Hoon: I am grateful to the hon. Gentleman and other members of the Defence Committee for taking the trouble to visit the facility just outside Basra. I was there last Monday and saw the high standards that are maintained by British military personnel, something that has been reflected upon by the International Committee of the Red Cross.
    As for the position on 1 July, negotiations with the interim Government are still to be concluded but I am confident that, whatever decision is reached, it will be in accordance with international law. Indeed, the new Security Council resolution contains provision for multinational forces to retain physical control of prisoners, subject to the overriding sovereignty of the Iraqi Government. That seems to be a sensible short-term solution, but I recognise that, ultimately, it is important that the Iraqi Government have both legal and physical control of detainees.
    Mr. James Clappison: How many reservists are deployed in Iraq. [179375]
    The Parliamentary Under-Secretary of State for Defence (Mr. Ivor Caplin): All our reserve forces have performed extremely well when asked to do so in Iraq and elsewhere in the world. I place on record again the House's utmost appreciation for all their efforts and for the continuing support of their employers. As at 16 June, 1,483 reservists were serving in Iraq.
    Mr. Clappison: The Minister is absolutely right to pay tribute to reservists in the terms in which he has just done so—[Interruption.]
    Mr. Speaker: Order. Hon. Members will have to keep the conversations down. It is unfair to the hon. Gentleman.
    Mr. Clappison: Is the Minister satisfied that individual members of the reserve who are part of the tranche of reservists due to go to Iraq in October will receive at least 21 days' notice that they are part of that mobilisation, and can they expect to serve six months, but no more?
    Mr. Caplin: The hon. Gentleman will be aware from the lessons-learned process following Operation Telic 1 that we made it clear that the 21-day notice period would be appropriate for reservists and their employers. I anticipate that all those going to Iraq in due course will receive 21 days' notice, and I expect their tour of duty to be six months.
    Richard Younger-Ross: At the early stages, the reservists felt they were very hard done by, as they were expected to stay out there when the forces that they went out with returned to the UK. There are fears in the armed forces that that will lead to greater difficulties in recruiting reservists. What work is the Minister doing to research what the feelings of those reservists are and to ensure that, when they return, they are properly debriefed?
    Mr. Caplin: We have a successful mobilisation and demobilisation process at Chilwell. I have seen it and the hon. Gentleman would be a welcome visitor to Chilwell. The latest survey of Territorial Army soldiers shows that 70 per cent. regarded their morale as high or very high. As I made clear on 13 May in the personnel debate, we plan to consult on the review of the Reserve Forces Act 1996 and statutory instrument No. 309 before the summer recess.

    RAF Menwith Hill
    Norman Baker: If he will make a
    statement on the forward plans for RAF Menwith Hill. [179376]
    The Minister of State, Ministry of Defence (Mr. Adam Ingram): A long-term plan is being developed by a joint UK-US team to improve some of the ageing infrastructure on the site. That may lead to the demolition of some of the older buildings and their
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    replacement by modern facilities that, wherever possible, will be more in keeping with the rural landscape. Base authorities are working closely with the local planning authority to agree suitable architectural standards and guidelines. There are no plans to change the base's current role and mission.
    Norman Baker: The Minister will know that there is some controversy over RAF Menwith Hill. He accepts, I hope, that it is in the interests of and it is the duty of Members of Parliament to ensure that the base operates in the British national interest. Is he therefore content that, when I asked to visit the base, his predecessor told me that he would have to check with the American Administration first and came back most apologetically to tell me that the Americans would not allow me to visit an RAF base? Is it now British policy that the Americans decide whether Members of Parliament can visit RAF bases?
    Mr. Ingram: I am not fully aware of all the matter related by the hon. Gentleman concerning his previous request. I would have to look into that to find out the nature of his request why he wanted a visit, what issues he wanted to discuss and the relevance of all that. I will look into his earlier request, but the important thing is not to whip up suspicion about what is undoubtedly an important part of our defence interests as well as those of the US. The installation is important and, as I said, there are no plans to change its role or mission as part of the current reconstruction.

European Council
3.30 pm
The Prime Minister (Mr. Tony Blair): With permission, Mr. Speaker, I shall make a statement on the European Council that took place in Brussels on 17 and 18 June. At that Council, the European Union—now of 25 nations, soon to be 28—agreed a new treaty for Europe that sets out for the first time, in one single treaty, the powers, rights and duties of the European Union. I have placed a copy of the presidency conclusions in the Libraries of both Houses. I thank the Irish presidency, under the Taoiseach, Bertie Ahern, for its skill in negotiating a successful conclusion.
As the Taoiseach said, the constitutional treaty makes it clear that Europe is
"not a super state; not a federal state but a group of nations".
This treaty makes it plain, again for the first time in a European treaty, that the European Union has only the competences conferred on it by member states, and it states expressly, also for the first time, that member states can withdraw from Europe should they want to.
This treaty makes clear where the European Union can and cannot act. It provides for qualified majority voting where we need it, for the single market, for reform of the common agricultural policy and for action against international crime and terrorism. It keeps unanimity for the most important decisions and, at our insistence, in particular for tax, social security, foreign policy, defence and decisions on the financing of the Union affecting the British budget contribution. It keeps our ability to opt out of measures affecting our laws on asylum and immigration, and extends that so that we cannot be obliged to co-operate on criminal law procedures where we do not want to do so. For the first time ever, it provides a power for national Parliaments to scrutinise proposals from Brussels at the draft stage and to send them back if Parliaments are not satisfied.
The treaty provides, through the route of enhanced co-operation, for a flexible Europe in which groups of countries can take action together within the framework of the European Union provided that they do not damage the interests of others. That is a flexibility within the framework of law, not the tree-for-all that some have advocated.
Above all, the treaty provides for the reforms in the working of the European Union that are necessary if it is not to fall into gridlock with 25 members. It reforms the system of the six-monthly rotating presidency to provide greater continuity and co Terence in a Union of 25, and replaces it with a full-time Chairman of the European Council, who will serve for up to five years. This is crucial in placing the power to set Europe's agenda in the hands of Europe's intergovernmental body.
The European Union treaty includes, in the charter of fundamental rights, the rights of the citizen under EU law. The charter expressly rules out establishing any new power or task for the European Union or any change in the powers of the European Union. In each area the rights are expressly limited to those available under existing national law and practices and under existing Union law. For example, article 28 of the charter says
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that workers and employers have the right to negotiate and conclude collective agreements at the appropriate levels, but only
"in accordance with Union law and national laws and practices".
In addition, the charter contains explanations for each article—making it clear, for example, that
"the — limits for the exercise of collective action, including strike action, come under national laws and practices, including the question of whether it may be carried out in parallel in several member states".
The treaty requires those explanations to be given due regard by the Courts.
Some have expressed concern at the references in the treaty to the primacy of European Union law.
In fact, the primacy of European Union law has existed since we joined the European Union and is there in the European Communities Act 1972. But, of course, European law only takes precedence where member states have agreed that Europe should have a competence. The idea that this is something new is therefore nonsense. This treaty also completes and consolidates the existing treaties of the European Union, and 75 per cent. of it is a repetition of what is in earlier treaties.
Among the many myths about the constitutional treaty that have been published over the last few months have been accusations that we would lose our rebate and our seat on the Security Council; that Brussels would seize control of our oil supplies; that the UK taxpayer would pay for other EU countries' pensions; that we would have to give up control of our Army or be forced to join the euro or to raise our taxes; that we would lose control of our borders or have our foreign policy dictated by Brussels. Now the British people have before them the text of the treaty as agreed—and it demolishes those myths. However, the myths, and the propaganda that goes with them, are not really about the constitutional treaty. They are about whether Britain should or should not be a leading member of the European Union.
The new Europe of 450 million people is a success for Britain. The new countries of Europe share our view that it should be run by sovereign nation states. They have joined the European Union for the stability, security and prosperity that it provides—the same stability, security and prosperity that we have enjoyed as members of the European Union for the past 30 years.
We are in the European Union for the single market and customs union that it provides for our goods and services, for the extra 1.8 per cent. of GDP that membership brings us every year and for the 3.5 million jobs that depend on that single market. We are also in the EU for the strength that it gives us in trade negotiations with powerful countries, such as the United States and Japan. We are in it for its network of aid and trade relationships with China, India and the countries of Latin America, Africa and Asia. Those relationships make an important contribution to international peace and security and development.
Of course, there are frustrations and compromises, but the European Union is the most successful way anyone has yet devised of managing relations between European countries whose national rivalries had, until 60 years ago, only ever been settled in a series of bloody conflicts. Now we not only manage those rivalries; we

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pool our combined strength for our economic advantage, for influence in the world, for peace, for security. The power of the European Union has helped eight countries of eastern and central Europe achieve democratic stability. It is transforming Turkey into a modern democratic state and it is helping to achieve peace in the Balkans. Not a single Government of a single nation—either those in Europe now or those wanting to join—opposed this treaty. All welcomed it. All want it to work. Many share the British view of Europe's future.
All that is what the opponents of this treaty would put in jeopardy for the sake not of any real British interest, but of a narrow nationalism, which no British Government have ever espoused or should ever espouse if they have the true interests of the British people at heart. In the end, the final say will be with the British people in a referendum. But in that debate, we will argue that this constitutional treaty represents a success for the new Europe that is taking shape, is a success for Britain and I commend it to the House today.
Mr. Michael Howard: Mr. Speaker, this constitution is bad for our democracy, bad for jobs and bad for Britain. The Prime Minister has said that we must separate myth from reality. All I can say is, look who's talking: the great myth-maker himself.
The Prime Minister has hailed this constitution as a great success for Britain. In fact, only 27 of the 275 amendments submitted by the Government to the European Convention have been included in the final draft. That is one in 10. In the Prime Minister's version of Euro 2004, the score is UK 27; EU 248. Well, we all hope England do better than that tonight.
Now let us deal with some of the so-called myths. The Prime Minister said that he did not want a
"single, legally binding document called a Constitution."
But the document is called "Treaty Establishing a Constitution for Europe". Not that the Prime Minister could bring himself to mention the word constitution this afternoon. That is hardly surprising. The dictionary definition of a constitution is
"the principles on which a State is governed".
The Leader of the House said that the title "Foreign Minister" was "unacceptable", but now it is in article I-27. Where is the myth in that? The Government tried to delete the proposed measures on criminal procedure, but now they are in article III-171. Where is the myth in that? The Government tried to delete the measures on energy, but now they are in article III-157. Where is the myth in that? The Prime Minister said that there was no proposal for a separate European military planning capability, but now it is on page 20 of the Council conclusions. Where is the myth in that?
The Government opposed the European public prosecutor. That was one of their so-called red lines. They said:
"Unanimity does not mean that"—
a European public prosecutor—
"can be accepted."
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But the public prosecutor is there, in article III-175. Where is the myth in that? The Prime Minister boasted—he said it again this afternoon—that the constitution
"gives a role to national parliaments of a greater degree than ever before."
But after Parliament has had its say, the Commission can ignore it. That is in the snappily named "Protocol on the Application of the Principles of Subsidiarity and Proportionality." Where is the myth in that? Does not all that go to show that the only myth we have here is the Prime Minister's claim that this is a success for him and for Britain?
Is not the reality that there will now be new burdens on business and on our public services? Is not the reality that this constitution will make it easier for the European Court to use European Union legislation, such as the working time directive and the works councils directive, to bring in even more red tape from Brussels? [HON. MEMBERS: "No."] Have not business leaders already warned that the constitution will "harm our prosperity"? [HON. MEMBERS: "No."] Will there not be more interference from the European Court on asylum policy? [HON. MEMBERS: "No."] Will that not threaten even the Government's own measures on asylum, including their plans to restrict benefits to those who apply late? [HON. MEMBERS: "No."] Will not the Commission mean that the European Union can now interfere, in the Government's words, in "almost any aspect" of criminal procedure? [HON. MEMBERS: "No."] Well, they say no, but they should read the document. If they did so, they would know that that is the reality of what the Prime Minister has signed up to. Will not the European public prosecutor have wide-ranging powers to direct police, order arrests, prosecute and choose the country where a trial should be held? Did not even the Labour-dominated European Scrutiny Committee say that
"the proposal…has the potential for creating an engine of oppression"?
Why on earth did the Prime Minister agree to that? How can this Parliament protect British interests when, in 43 new areas of policy, we can have measures imposed on us by majority voting against our will?
The charter of fundamental rights is a case study in Government surrender. The Prime Minister has been dragged along, step by step, against his better judgment. First the Government did not want this charter at all. Then, when they lost that argument, Ministers said that they did not want it included in the treaty. Then they argued that it should be moved to a protocol. When the charter was finally included in the constitution, the Government called for safeguards to stop it undermining our national law. But on Friday, the President of the European Court of Justice said that the constitution would bring new areas and new subjects under the Court's jurisdiction, and he refused to give any guarantees that the charter would have no impact on national law.
The Prime Minister says that he will take the constitution to the country. It is not the first time he has said that. Five years ago, with the hand of history resting on his shoulder, he said that
"once in every generation he case for Europe has to be restated".

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He said that he would give leadership. Six months later, when nothing had happened, he said:
"Once in each generation, the case for Britain in Europe needs to be remade … The time for this generation is now."
So what happened?
We have just had elections to the European Parliament during which the Prime Minister did not make a single speech on Europe. That is what he means by leadership. The Prime Minister's definition of leadership is to press the mute button, and press it hard.
Yesterday, the Prime Minister said that there is now a real opportunity to get the British view accepted because there is a lot of support for it. I agree; there is indeed a lot of support for the British view. What a pity that the Prime Minister did not put the British view when he was in Brussels last week.
The British view is that there should be a modern, flexible, reformed Europe; a Et rope ready for the challenges of the 21st century; a Europe that is truly free, based on co-operation and not coercion; a Europe that transfers powers back from Brussels to the nation state—truly a Europe of live and let live. That is what the Prime Minister should have been arguing for in Brussels last week. That is what the people of this country want.
Let us have none of that nonsense about the referendum being a question of in or out of Europe; it is about the kind of Europe that we want to see. Let me make it clear: I am opposed to this constitution and I will play my part in a cross-party campaign, involving people from all parts of the country and all walks of life, to say no to this constitution. Britain does not need to wait until the last minute to decide; we do not need to wait until other countries have spoken. Why cannot Britain do what the Prime Minister says he wants to do and give a lead in Europe? Why does he not lead rather than just follow?
The fact is that the Prime Minister knows that he has no mandate whatever for this constitution. There was nothing in his manifesto on the constitution and the British people rejected it at the polls only 10 days ago. The fate of this constitution will not be decided by the right hon. Gentleman; it will be decided by the British people, so why does he not let the British people speak, and let them speak now?
The Prime Minister: Let me deal with some of the points of detail. First, the constitutional treaty is a treaty like any other. It has exactly the same status.
Secondly, in relation to criminal law, the procedures that we have agreed will mean that should we object to a particular proposal, it can be blocked. That allows us to make progress in areas where we want to do so but to block things that we think are against our interest.
The right hon. and learned Gentleman is quite wrong in respect of energy. There is actually a tax carve-out for energy, which is the same as the one for the environment.
European Union defence is to be maintained at governmental level and governed by unanimity. It is true that there is power to establish a European public prosecutor but it can be done only by unanimity and, therefore, requires our consent.
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In respect of national Parliaments, yes it is true that if a third of them object they cannot block the European Commission proposal, but for the first time they are able to take objection to it and send it back to the Commission—[Interruption.] Let us put it like this: that
is a lot more than the right hon. and learned Gentleman ever secured when he was negotiating for this country in Europe. May I remind him that the working time directive was actually agreed when he was in government, not when we were in government?
The document does not affect our asylum laws. One of the less pleasant myths in some of the propaganda put out is that somehow Europe decides our asylum and immigration laws. It does not; we decide them. The House of Lords European Committee said that the treaty shifted the balance back towards the nation state. As for the idea that in the whole of the rest of Europe people are rejoicing that this is some federalist blueprint, let me read a few recent quotes about that.
The Prime Minister of Spain:
"Europe is and will be a Union of"
nation
"States."
The leader of Germany in Bavaria:
"The EU will not have the right to set taxes and Europe is not going to be a federal state."
The President of Germany:
"I do not believe that current developments are going to give rise to a European federal state".
He sees
"a revival of the nation-state principle again."
I seem to remember that Poland was prayed in aid by the right hon. and learned Gentleman the last time he was here—the plucky Poles standing up and not wanting this constitutional treaty—but, in fact, they are with us in wanting it, but on the right terms. The President of Poland:
"The treaty doesn't mean we create a new state of Europe or something like a European federation."
Or, for example, this quote from an editorial in one of the main newspapers in Spain, El Mundo:
"this is a Constitution… which consecrates the EU as a union of sovereign states, which continues not to opt for federal institutions".
In the main commentary in Corriere della Sera, in Italy:
"The British won the day."
In Sweden:
"the EU is no longer run by the Franco-German axle."
In another Spanish paper, but I am almost too modest to mention it:
"Blair, the big winner of the Summit, achieved everything he wanted."
Why is the right hon. and learned Gentleman so anxious to have the referendum without the parliamentary debate and scrutiny? Because he has everything to fear from a detailed understanding and everything to gain from haste and headlines.
I shall turn to some of the issues that the right hon. and learned Gentleman raised on the qualified majority voting extensions. It is true that there are qualified majority voting extensions on things like, for example, the diplomatic and consular protection rules, on things

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like patents, on things like appointments to specialist judicial panels, on things like the armament agency rules and on things like the salary of the European Court of Justice judges. But let us compare this treaty with the two documents that he agreed: the Single European Act, where 12 whole areas were moved to QMV, including health and safety and, yes, the free movement of workers—something that Conservative Members now object to—and of course I was looking at the Maastricht treaty to see what it extended.
The Maastricht treaty created European citizenship. It added foreign policy, justice and home affairs. It transferred 15 whole new areas of power to the European Parliament. If the right hon. and learned Gentleman attacks this treaty, he should have been screaming the place down over Maastricht. Instead, he voted for Maastricht, and he is now left in the ludicrous position of having to argue that, somehow, Britain ceases to be a nation state because the rules on diplomatic and consular protection go to QMV. His true position is not, of course, hostility to this treaty—it would not matter what this treaty says; his opposition to this treaty is just a device to get to his real position, which is to renegotiate not this treaty, but the existing terms of Britain's membership of the European Union. He has said that he wants to renegotiate—perhaps he would just confirm this—the social chapter.
Mr. Howard indicated assent.
The Prime Minister: Yes. European defence and common foreign policy.
Mr. Howard indicated assent.
The Prime Minister: Yes. The common agricultural policy, and this is what the right hon. and learned Gentleman said in relation to the common fisheries policy: on 9 June he wrote to one of his hon. Friends saying that he would not just withdraw from the common fisheries policy but, if others refused to renegotiate, defy the law and pull out of the common fisheries policy altogether. What would happen if others then said that they would not allow British goods to come into the single market or that they would use that practice against us? The truth is that he is in a position that no British Prime Minister would ever want this country to be in.
The real surrender is not the surrender of Britain's identity to a European superstate, but the surrender of the Tory party to a position on Europe that no Tory party in government, when faced with the responsibilities of government and when faced with the realities of government, would ever have dreamt of taking. That is why Lord Heseltine said yesterday—[Interruption.] It is interesting, is it not, that the person who was Deputy Prime Minister under the last Conservative Government is now so ridiculed by Conservative Members that they are not even prepared to listen to him?
This will indeed be an historic debate. It will pit reason against prejudice. It will pit true leadership in Britain's long-term interests against a transient
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populism that actually betrays the very national interest that it says it safeguards. Yes, that debate will happen, and when it comes, yes, we will be on different sides, but I would prefer our company to the company that the right hon. and learned Gentleman will keep, and I prefer our argument about Britain's future to his.
Mr. Charles Kennedy: May I, on behalf of my right hon. and hon. Friends, give a general welcome to the fact that this compromised treaty was agreed and unanimously endorsed by 25 member states and Governments over the course of the weekend? Will the Prime Minister acknowledge that, given the welcome and historic enlargement of Europe and the triumph of democracy, and of socially fair market democracy at that, the model that operated for a Europe of six was simply not applicable to a Europe continuing to develop with a membership of 25?
Does the Prime Minister agree that this constitutional treaty should be seen as a mechanism? It is not a moral crusade, although listening to some of those opposed to it, one could be forgiven for thinking otherwise. Indeed, in the minds of many of us, including those who support Europe, much of the conduct in and around this weekend's summit was a rather poor advert and a persuasive argument that further reform of the way in which Europe goes about its business is long overdue.
Does the Prime Minister agree that the new threats facing Europe, particularly global terrorism and climate change, as well as long-standing problems such as reform of the common agricultural policy, will be given better effect in a collective way as a result of the procedures outlined in the treaty? Will he indicate specifically the prospects under the provisions in the treaty for tackling the CAP—such a long-running source of frustration for successive Governments and this country as a whole?
We surely deceive ourselves by the allure of semi-detachment as a country from Europe or, far more so, of outright isolationism. Therefore, those who are sceptical as well as those who are enthusiastic about Europe should surely welcome a treaty that sets out the competences of the wider European Union and how they can be fairly adjudicated in the interests of both the individual European citizen and member states and Governments who make up the wider Europe.
Will the Prime Minister acknowledge that none of us can deny the growth of Euroscepticism both in this country and throughout the EU? Political elites have run ahead of their domestic public opinion for too long. That is why the referendum has become so essential. The Prime Minister spoke in his statement of the new responsibilities of national Parliaments under the treaty to shape and have a greater input into European legislation. Does he agree that however long it is until the referendum in Britain, from now until such time the Government could make—the Leader of the House is with us today—specific proposals to put more of our handling of European business in this House, centre stage, in order to explain and demonstrate to people the relevance of what Europe is doing and the way in which, as parliamentarians from across the spectrum, we attend to it? Do the Government have any proposals in that respect?

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Finally, on the issue of the referendum, we have had so many false dawns and false starts with this Government, as the Prime Minister well knows. Will he acknowledge today that, having put his signature to the treaty and given that he is having to try to sell it to the British public and that trust in him and his Government is not what it was several years ago, the campaign for the referendum, if it is to be successful, will have to be broadly based, cross-party and involve significant persuasive voices from those outside formal party politics? Will he acknowledge that a referendum campaign that is seen by the public in this country to be spun from No. 10 Downing street would not be won? Although there is scepticism about Europe to be overcome, there is also scepticism about the Government that can undermine the case that needs to be made. The battle is now joined. I hope that, across the political spectrum, we shall be able to make a constructive, pragmatic and principled pro-European case. We look forward to the spectacle of some of the very strange bedfellows who will face us.
The Prime Minister: The reason we have not had a referendum on the single currency is that we do not believe that the moment is right for Britain to join the single currency. We said that it should happen only when the economic conditions are met and, as I understand it, the Liberal Democrats' current position is not that we should join the single currency at this point. It is good to know that we are in agreement on that, as well.
The right hon. Gentleman asked whether we have proposals on how we scrutinise European business. I understand that my right hon. Friend the Leader of the House has proposals before the Modernisation Committee that will allow us to go into greater detail of some of the European proposals. I think that the House will welcome that.
As for the various other items that the right hon. Gentleman raised, I think that he and I agree on the basic point. I believe that the treaty will allow us to make progress on matters such as economic reform and reform of the common agricultural policy, which are of enormous importance. It is only in the last few years that we have made progress on CAP reform, but it is only as a result of qualified majority voting that we have the slightest chance of succeeding.
Donald Anderson: Is not the sad reality that if my right hon. Friend had returned from Brussels with sackfuls of gold, the Leader of the Opposition would have criticised the quality of the sacks? Will my right hon. Friend confirm that no Government among our 24 partners would seek to renegotiate the constitution in the way that the Opposition suggest, and that the Opposition are therefore seeking either semi-detached status, or to get out altogether?
Now we come to the referendum, and public opinion polls make the position clear: the British public are against the constitution, but honestly admit that they know nothing about it. What does my right hon. Friend propose to do? How will he circumvent a hostile press and, without official propaganda, get a balanced debate on the real European issues facing this country?
The Prime Minister: That will be up to those who support the campaign in favour of Britain remaining at the centre of Europe and those who are opposed to the treaty. We will have to argue our case, and I have no doubt that it will be a most interesting political battle. I have no doubt, too, that the position taken by the Conservative party—in effect, to use a no vote to renegotiate the existing terms of Britain's membership—would be a terrible mistake, and I think that it will be exposed as such in the course of the campaign. The Conservatives will have to say how one can remain part of the European Union if one unilaterally, as the Leader of the Opposition is suggesting, withdraws from areas of European competence. That is what we now call the lobster thermidor strategy: it might be nice to have it, but it is not on the menu. The fact is that if we tried to do such a thing, we would face either humiliation or withdrawal, which is what I think the right hon. and learned Gentleman wants.
Mr. Robert Jackson: We shall have to study the treaty and its fine print with close attention, without prejudice and with no preconceptions, but it looks to me as though it is a treaty that shifts the institutional balance in the direction of member states and strengthens Britain's voting weight in the Council of Ministers, without making significant concessions to federalism.
In his statement, the Prime Minister did not discuss the suggestion that is said to have been made by the French President: that it would not be possible for a country that is not in the eurozone to supply a President of the European Commission. Does he agree that in a European Union that contains nine member states that are not within the eurozone, that suggestion is outrageous and illegal?
The Prime Minister: I do not think that there should be any criteria other than those that are laid down. I agree that there should not be any block on any candidate emerging from a country that is not a member of the eurozone.
As for the first part of the hon. Gentleman's question, he is absolutely right—this is not an unusual position for a British Prime Minister to be in, I am afraid, as very partisan views are sometimes expressed on the issue. However, we are in a bizarre situation in which virtually every other country in Europe thinks that this has been a victory for the British position. Unfortunately, that realisation needs to dawn here, and I accept that that will take a bit of work. It is odd that not a single country elsewhere in Europe would recognise this as a federal blueprint.
Sir Stuart Bell: The Prime Minister referred to 18 June as an historical day, but is it not an historical day for all of Europe? He referred to bloody conflict, and is it not true that over the centuries we have fought the Spanish, the French, the Germans, the Italians and the former states of the Hapsburg empire, and that those wars are over for all time? He referred to the single market, and the 1.8 per cent. gross domestic product and 3.5 million jobs for which it is responsible. Has that not contributed to the greatest prosperity that we have ever experienced, and should the

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word not go forth from this time and place that, to adapt the words of a former Prime Minister, Winston Churchill, what kind of a people do they think the British are to turn their back on the greatest success story since 1945?
The Prime Minister: I obviously agree entirely with my hon. Friend, but there is another argument and, in a sense, a more modern one. Europe is indeed changing, and the countries that have recently joined the European Union share the British perspective for obvious historical reasons. I find it hard to understand why, when those new countries basically share the British perspective of Europe as a group of nation states, we should want to put ourselves in a marginalised position in Europe. That is what is so extraordinary about the position that has been taken. We have a huge opportunity if we are prepared to grasp it.
Sir Patrick Cormack: How does the Prime Minister reconcile his statements that Britain will retain its autonomy in matters of foreign policy with a constitution that provides for a foreign Minister and foreign policy that, it states,
"Member States shall actively and unreservedly support"?
The Prime Minister: Let me quote from the Maastricht treaty—[HON. MEMBERS: "No."] I quote from that treaty to show how ludicrous it is to suppose that what is in this treaty is any different from what we have had for over 10 years. The Maastricht treaty says:
"The Member States shall support the Union's external and security policy actively and unreservedly in a spirit of loyalty and mutual solidarity."
This treaty says:
"The Member States shall support the common foreign and security policy actively and unreservedly in a spirit of loyalty and mutual solidarity".
There is a notion that this is a great new development in the European Union, and it has been suggested that I would have to ask for the French President's permission before I did anything more with the USA. I should have thought that the one thing that has been obvious over the past couple of years—this may, or may not, recommend itself to people—is that we have pursued a highly independent foreign policy.
Mr. Robin Cook: May I thank my right hon. Friend for his robust and enjoyable presentation of the case for British membership of Europe? May I ask him to remind the House that the proposal for the new post of President of the Council of Ministers was first made by Britain, and that we supported it for several years to secure our negotiation? It would be perverse if those who worry about federalism were to persuade Britain to stop that post coming into being, when it represents a new person in Brussels speaking for the member states and the nations of Europe. Is it not a measure of the opportunism that we have heard today that if the Opposition had been in government they would have presented as a triumph, not a sell-out, a deal half as good as the one that my right hon. Friend has negotiated?
The Prime Minister: I thank my right hon. Friend. It is true that there is a presidency of the European Council now, but it rotates every six months. It is important to get a full-time chairman of the Council because, at the moment, states rotate the presidency every six months and as a result, on the Lisbon agenda for economic reform, for example, it becomes difficult for the next presidency to pick up what the previous presidency has done. It is far more efficient for the member states and Governments of Europe to have a full-time chairman.
Mr. David Heathcoat-Amory: Under the constitution, all the existing EU institutions, including those that are riddled with mismanagement and waste at present, gain at the expense of national Parliaments and people. To take one example from the 250 failed amendments tabled by the Government representatives when it was being drawn up, the Government promised to remove all references to the European public prosecutor. The Government representative said:
"Unanimity does not mean that this article can be accepted".
In other words, he wanted it completely out. It was an unambiguous Government red line. Now the Government have accepted it, and I understand it was not even raised during the final negotiations. Does the Government's pledge to hold a referendum have the same status—in other words, is it a firm and unambiguous pledge that is abandoned when it gets difficult for the Government?
The Prime Minister: Let me explain to the right hon. Gentleman why we agreed with the notion that there could be a European public prosecutor, provided that is done with unanimity, so we have to give our consent. It is precisely for the reasons that the right hon. Gentleman suggested. There is a need to deal with issues to do with fraud and accountancy problems in the European Union, so how on earth does it help for us to disappear off into the sidelines of Europe? The right hon. Gentleman knows perfectly well that his view of Europe is that Britain should renegotiate its existing terms of membership. That is his point, is it not? Therefore, if we are to have an honest debate, why does he not accept that his objection is not to this treaty, but to Britain's existing membership of the European Union?
Mr. Speaker: I call Frank Field.
Mr. George Foulkes: Oh, no.
Mr. Frank Field: Oh, yes. Will the Prime Minister give an undertaking that if other countries veto the constitution before he calls a referendum, the British people will still have their say on what they think of this move?
The Prime Minister: Yes. There is no question of any constitutional treaty going through without the express consent of the British people. [Interruption.] Of course—
Mr. Speaker: Order. What is the good of hon. Members shouting the Prime Minister down? They might not like the answers, but they should be quiet when the Prime Minister is giving his reply.
The Prime Minister: Exactly so. Regardless of how other members vote, we will have a referendum on the subject.
Mr. Alex Salmond: What is it about the workings of the common fisheries policy over the past 30 years that has persuaded the Prime Minister that it should be an exclusive competence, not a shared competence, as he told the House previously? The vast bulk of it is one of only four exclusive competences in the new constitution.
The Prime Minister: The common fisheries policy was entered into by the previous Government. It is sensible that we have it. I say to the hon. Gentleman, as I have said on many occasions, that it is a cruel deception to pretend that the fishing industry's problems are to do with the European Union when, as he knows perfectly well, they are to do with the depletion of fish stocks. It is not a problem that exists just in this country or in the rest of Europe. It exists right around the world at present. It is to prey on people's fears in a wholly disingenuous way to suggest that if Britain got out of the common fisheries policy, it would help the British fishing industry.
Richard Burden: As we prepare for the debate on the constitution, in my region, the west midlands, the debate is at two levels. At one level, people are concerned about what they perceive to be a distance between Europe and its institutions and themselves, but at another level, when one talks to them, one realises that they understand that, for a manufacturing region such as ours, trade with Europe is vital to their jobs and the future. They also see the need to reach agreement. Given that, does my right hon. Friend agree that in looking ahead to the forthcoming debate we need to address the distance between European institutions and people's perceptions, but that we should give no quarter to those who are prepared to play fast and loose with the jobs of thousands of my constituents and of other people in the west midlands?
The Prime Minister: I agree with both points that my hon. Friend makes. I am sure that when people think about the matter carefully, they will realise that there is no reason to reject the treaty on its own terms. It does not give away our right to decide our tax, foreign policy, defence, immigration laws and so on. What it does is enable Britain to remain at the centre of decision making in Europe. When they think about it, people will not think it a sensible idea for Britain to marginalise itself in Europe when 60 per cent. of our trade is with Europe and so many of our jobs depend on European business.
Mrs. Angela Browning: The treaty that the Prime Minister signed requires member states to work more closely on co-ordinating their economic policies to provide the basis for an EU-wide economic policy. What arrangements has the Prime Minister made on that policy? Do we have a veto, or will qualified majority voting be used?
The Prime Minister: The treaty makes it clear that member states decide their economic polices. It is true that we want member states better to co-ordinate their economic policies, but that has happened for years. There is absolutely nothing wrong with such co-
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ordination, which does not interfere with our ability to determine our economic policy, as has been amply demonstrated over the past few years.
Tom Levitt: You, Mr. Speaker, will recall that just a few months ago, this House voted unanimously for measures to enlarge the European Union. The treaty addresses the problems caused by structures designed for six members, and makes those structures appropriate for 25, 28 or more members. Does the Prime Minister agree that it is bananas—straight or otherwise—for those who will the ends of European Union enlargement not also to will the means?
The Prime Minister: My hon. Friend is absolutely right. That is why every other country in Europe supports the treaty—if we oppose the treaty, we will be
the only country to do so. People recognise that a Union of 25 should and must operate differently from a Union of 15 or six.
Sir Teddy Taylor: Will the Prime Minister tell us what advantage will stem from the appointment of a European Foreign Minister? Where will that Minister be located, which terms will rule their policy and what will that appointment cost? Bearing in mind the fact that the European Foreign Minister is one of a number of additional powers, does the Prime Minister realise that many people are disappointed? Instead of making new appointments that have no apparent purpose, he should concentrate on the financial scandals, which, to my knowledge, have resulted in the European Union being the only organisation in the world not to have its accounts signed by auditors for eight separate years.
The Prime Minister: The European Foreign Minister is currently called the high representative for the common foreign and security policy, and he will remain accountable to the Council of Ministers and will continue to conduct business as he does now. It is absurd to claim that we have given away our foreign policy or defence policy to the rest of Europe in view of events in the past couple of years.
Mr. Michael Meacher: Although my right hon. Friend the Prime Minister has made his opposition on some labour law issues clear, should we not welcome the implementation in this country of many other measures in the charter of fundamental rights? In particular, bearing in mind the fact that this country has the most restrictive labour laws in Europe, should we not welcome the strengthening of such basic rights as consultation in the workplace and protection against arbitrary dismissal?
The Prime Minister: As a country, we can change our labour laws if this Parliament agrees to those changes, but the charter of fundamental rights is essentially directed towards the institutions of the European Union and its member states, in so far as they act within the competence of European Union law. It would be wrong if the charter of fundamental rights were to lead to an enlargement of this country's labour laws. There may be arguments for such an enlargement, and my right hon.

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Friend the Member for Oldham, West and Royton (Mr. Meacher) and I could have that debate, but we should have it as a matter of domestic law.
Mr. David Trimble: The Prime Minister puts an optimistic gloss on the new constitution, but the truth of the matter is that it does not matter what the Government say, because the important interpretation of the meaning of its many vague provisions will be given by the European Court of Justice—and we know its record. All the energy that has gone into the treaty and that will go into trying—I believe futilely—to sell it to the British people is a diversion from the main issue that Europe should examine: namely, the relative economic failure of the core eurozone countries. That is the real problem, and the treaty diverts energy from it. The Prime Minister and his Government will make a fatal mistake if they go to the country in a general election before a referendum is held on the constitution.
The Prime Minister: In respect of the European Court of Justice, many claims about the treaty have been made about previous European Union treaties and they have turned out not to have any substance. [Interruption.] I know that many Opposition Members hold the perfectly honest position that Europe and Britain should have a completely different relationship. That is fair enough, but I do not believe that we have been prevented from taking the action, for example, on foreign policy and defence, that we want to take. It would be ludicrous to argue that we had been prevented.
I agree with one element of the comments of the right hon. Member for Upper Bann (Mr. Trimble): it is important for Europe to concentrate on economic reform and change. However, we are less likely to get that if we opt out of Europe.
Keith Vaz: I congratulate the Prime Minister and the Foreign Secretary on the excellent deal that they secured for Britain in Brussels. Will the Prime Minister confirm that, notwithstanding the end of the current discussions, Britain will continue to press for the reform agenda to make the European Union more efficient, effective and relevant to the lives of its citizens? Will he also confirm that all members of the Government at every level will be fully involved not only in putting the case for Europe but in the referendum campaign?
The Prime Minister: Of course. The debate and the struggle to win public support will be important. My hon. Friend is right to stress the importance of economic reform and being part of the reform agenda. New countries are coming into Europe that support the British position. Of all the moments for Britain to opt for second-class status in the European Union, this is the least sensible.
Mr. Richard Shepherd: There is no question but that the treaty is intended to be a constitutional settlement. As the Prime Minister said, it further entrenches Maastricht, Nice, Amsterdam and even the Single European Act. Some of us feel strongly
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that the British people have never properly examined any of them and have never been allowed to express their views on them. Yet now we are dealing with something that intends to extend and entrench the power of the European Union over the lives of the people of Britain. How, therefore, can the Prime Minister's word be trusted on any matter when, as has been said, the ultimate judgment on the detailed meaning of the treaty will be made by the European Court of Justice, which is now supreme over all the laws of this land as expressed through Parliament?
The Prime Minister: As far as I am aware, the European Court of Justice has always had the power to determine the meaning of treaties. The treaty that we are considering has no special status—it is subject to the same rules as other treaties. That is why it is called, at our insistence, a constitutional treaty. I agree that a great debate will take place about whether Maastricht and all the developments in the European Union over the past 30 years were right. We will hold the debate but we should do that any recognise—I believe that the hon. Gentleman would acknowledge it—that the real objection of many Conservative Members is not to the treaty but to all the treaties that have been signed in the past few years. He is honest enough to admit that, and his hon. Friends should do so, too.
Mr. James Plaskitt: Does my right hon. Friend agree that the new constitutional treaty marks a fundamental and overdue change in the distribution of powers between Union institutions and the member states? Whereas current treaties, which grow out of article 235 of the Rome treaty, effectively sanction and encourage competence creep, article 9 of the new treaty puts the brake on it.
The Prime Minister: My hon. Friend is right. A couple of days ago, the treaty was described in one of the Belgian newspapers as:
"A text in the service of Her Majesty… it was a text"
with a
"'Britainised' content that they approved… Great Britain set its mark on this game… the most determined European federalists had no option but to back down."
I could read out about 30 similar quotations—[HON. MEMBERS: "Read the British newspapers."] We all agree that some of the British newspapers take a somewhat different view. That shows the nature of the debate. However, as it continues, it will become increasingly obvious that the problem is not the treaty but that some people believe that the existing relationship is wrong and needs to be changed, irrespective of the treaty.
The longer that that goes on and the more that it dawns on people, the more they will realise that the real agenda of many who are opposed to this treaty is to take this country out of its current relationship with Europe.
Ann Winterton: The Prime Minister said on television yesterday that he had agreed to the requirement for member states to co-ordinate their economic policies. Will he now answer the question posed a minute ago by my hon. Friend the Member for Tiverton and Honiton (Mrs. Browning) and tell us whether this so-called co-ordination will be decided by qualified majority voting?
The Prime Minister: The idea of member states co-ordinating economic policy is not a novel thing in this treaty; it has been there for ages. It makes absolutely no difference to the essential nature of the sovereignty of economic policy residing with us. Look at the past few years: it is perfectly obvious that we decided, for example, to give the Bank of England its independence and that we decided to pursue our own Budget and fiscal policy. We are perfectly entitled to do so and we will carry on being entitled to do so.
Chris Bryant: The Prime Minister will know that some politicians in this country have been arguing against not only this constitution but any constitution while saying that the European Union needs a charter of competences. Is not this a matter of semantics? After all, the United Nations has a constitution; it just happens to be called a charter. For that matter, it has a president. For the Tory Opposition, is this a case of rabid ideology or rampant opportunism?
The Prime Minister: I think it is probably increasingly the first, actually, which makes this a more serious position for them. I simply pose this question: if the Government had brought forward a treaty like the Single European Act or the Maastricht treaty now, with the Conservative party in its current situation, it would not have been very supportive of it. The fact of the matter is that the Conservative party has made its choice, for the moment at least. It has decided effectively to join at least the rhetoric of the United Kingdom Independence party, even if it attempts to keep its policy a little different. I say to Conservative Members that, in the end, whatever the short-term advantage, that is a long-term mistake.
Mr. James Paice: For a long while, it has always been the case that, under certain European competences, this Parliament and the British Government cannot legislate on issues on which the Europeans are considering legislating themselves. Can the Prime Minister confirm that under this constitution the list of such competences is extended and therefore that the powers of this House are diminished?
The Prime Minister: I do not accept that the powers of this House are diminished at all. Indeed, as I say, for the first time national Parliaments have a specific input and an ability to refer back legislation that is proposed. This is an advantage for national Parliaments.
Mr. Tam Dalyell: I am an unreconstructed pro-European. Would not some of us be thankful if foreign policy, particularly over the last two years, had been given to Brussels and if the Prime Minister had asked the French President about recent events and recent policies? May I ask why he thinks that Chancellor Schräder and President Chirac were so cheesed off with him?
The Prime Minister: I think we had better disentangle all those various points. First, no, it is not a good idea to say that we can exercise our foreign or defence policy only with the say-so of the French President, or indeed anyone other than ourselves. Secondly, I simply point
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this out to my hon. Friend: I have to disappoint him on that ground, but also on the ground that in the new Europe—the Europe of 25—a majority of states were with us in relation to the conflict in Iraq.
Thirdly, there are disagreements from time to time in Europe, and there was one on Thursday night, but I am sure that all of us will get over those disagreements because in the end it is important that we make progress.
Sir Michael Spicer: If the constitution were to go ahead, would the 1972 Act of accession still apply? Would it still be amendable by this Parliament?
The Prime Minister: I think that I am right that, legally, the treaty of accession would still apply. I will check the strict legal interpretation for the hon. Gentleman. The important thing about the treaty is that, for the first time, people are given the right explicitly—they have always had it implicitly—to withdraw from the European Union. If, for example, a Government of his persuasion were to come to power, with the policy that he espouses, they would be able to do that. In the end, no one can force us to be part of the European Union. I happen to think that we should be part of the European Union, because it is in the interests of Britain.
Mr. Stephen Pound: Sometimes, I look at this nation and despair. When the Conservative Benches ring with the inchoate fury and synthetic outrage designed solely to appease a party led by an orange-skinned, Spanish-resident escapee from the dregs of daytime television whose one-word manifesto is no, I despair. In the case of the various factions masquerading as an Opposition—
Mr. Speaker: Order. Could we possibly get a question to the Prime Minister?
Mr. Pound: As a Londoner, as a European and as a patriot, may I tell the Prime Minister that many of us support and endorse his work in Brussels and seek better for this nation than a Ruritanian role as a blighted backwater or, even worse, as the 51st state of America?
The Prime Minister: I thank my hon. Friend very much for that.
Mr. Patrick McLoughlin: Will the Prime Minister explain to the House where the consistency is in the Government's policy? Referendums on regional government will be held before the legislation is passed by this House, yet the referendum that he has talked about today will be held after the legislation has passed through the House.
The Prime Minister: When the issue of the referendums on Scotland and Wales was up, we were on opposite sides of the fence. I am well aware of why people want the referendum quickly—it is so that people should not have the chance to study the detail. I think that it is important that we study the detail, and on such an issue it is also important that Parliament is able to sit and study it. I am surprised—actually, I am not
surprised—that the Conservative party has decided that it really does not want that to happen.

Orders of the Day

  Health Protection Agency Bill [Lords]
  Order for Second Reading read.
  4.32 pm
  The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson): I beg to move, That the Bill be now read a Second time.
  I am pleased to have this opportunity to open the debate on the Second Reading of the Health Protection Agency Bill. The Bill establishes the Health Protection Agency as an executive non-departmental public body. I will start by outlining the background to explain why we need the Bill, given that the Health Protection Agency special health authority is already in existence.
  The establishment of the Health Protection Agency was first proposed in "Getting Ahead of the Curve", the chief medical officer's strategy for infectious disease and other aspects of health promotion, which was published in January 2002. The strategy brought together a number of proposals to establish a more systematic approach to health protection, of which the HPA is the centrepiece. From June to September 2002, the Department of Health conducted an extensive consultation exercise on the creation of the agency, to which it received 215 written responses.
  Following that exercise, in November 2002, the then Minister, my hon. Friend the Member for Salford (Ms Blears), announced the decision to create the agency through a two-stage process. The first stage was to create the agency as a special health authority in England and Wales, which is able to carry out functions under the National Health Service Act 1977. The second stage, which will be put into effect by this Bill, is to establish the agency as a non-departmental public body, which will be able to carry out a wider range of functions.
  The two-stage approach enabled us to move speedily to set up the agency as a special health authority covering England and Wales on 1 April 2003. It also provided the necessary time for the Scottish Executive to complete its own consultation exercise to help determine what role the agency might have in Scotland, before we started the second stage. The rationale for creating the HPA was the recognition that the existing structure for health protection in this country was both fragmented and outdated. The shortcomings of the system were highlighted by the diversity and constantly changing nature of the threats to public health.
  We are all aware that killer diseases such as tuberculosis and HIV/AIDS are still prevalent in this country, while the recurrence of SARS—severe acute respiratory syndrome—in China just last month serves as a timely reminder of the threat posed by the emergence of new diseases and by infections being imported into this country. Alongside those naturally occurring threats, we are also faced with the possibility of the deliberate release of biological, chemical or radioactive agents. Continued vigilance, combined with a strong and coherent response, is required to manage those diverse threats.
  Despite the need for a coherent response to meet the challenges, the specialist support for health protection on which the NHS and local authorities relied was
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  fragmented among a number of different bodies. Advice on infectious disease generally came from the Public Health Laboratory Service. Support on chemical hazards was provided by the national focus for chemical incidents and regional service provider units. The health aspects of emergency planning were provided by regional advisers. Much of the action at local level in relation to infectious disease and other hazards was the responsibility of consultants in communicable disease control and their teams in primary care trusts, while advice on radiological hazards was provided by the National Radiological Protection Board. Additional services were provided by the National Poisons Information Service and the Centre for Applied Microbiology and Research.
  Mr. John Bercow: In respect of the application of the negative and affirmative procedures of the House flowing from different regulations applicable to individual clauses of the Bill, would the Minister take care to tell the House what the criteria were that informed the choice of one rather than the other in each case?
  Miss Johnson: I believe that these matters are normally determined on the basis of advice from parliamentary counsel on what would be most appropriate, rather than on any decisions by the Government. We are normally advised in relation to these matters whether something will require the affirmative procedure.
  None of those bodies was providing a poor service, but the whole system needed rationalising and strengthening in order to meet the challenges to health protection in the 21st century. It led us to conclude that the best way to strengthen the delivery of health protection services at both local and national levels was to merge responsibility for all those functions and individuals into a single organisation.
  That wide-ranging role for the agency is an important development because, when an incident occurs, it is not always immediately clear whether it has a chemical, radiological or an infectious source. 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. It should also enable greater cross-fertilisation of good ideas and good practice between the different sectors of health protection.
  That approach is consistent with the aims of the Department of Health's review of its arm's length bodies. The objective of the review is to rationalise the Department's ALBs and to reshape them for consistency with a modernised NHS. Many were set up to focus action in key areas and to respond to specific concerns. Now that many of the problems are being tackled effectively, it is time to rationalise the sector, reduce costs and return resources to front-line services.
  My right hon. Friend the Secretary of State for Health announced on 20 May that the first stage of the review had been completed and that the parameters for the next stage would be a 50 per cent. reduction in the number of ALBs; a saving in expenditure by ALBs of some £0.5 billion by 2007–08; and a reduction in posts of 25 per cent. in the same period.
  Mr. Andrew Lansley: The Secretary of State's announcement in May came after the passage of the legislation in another place. During the passage of the Bill so far, its expenditure and manpower implications have been stated as being neutral—no increase in expenditure or manpower—but it is relevant if the Government intend in the space of days, or perhaps weeks to announce changes in staffing and expenditure, or indeed changes in arm's length bodies going beyond what has already been proposed and what the hon. Lady has already described. Does she plan to say anything more about changes in arm's length bodies affecting the HPA which the House should know about now?
  Miss Johnson: I do not believe so. May I clarify, for the hon. Gentleman's information, the fact that the Bill does not entail any additional public expenditure or changes to public service manpower? We expect that as the agency is a non-departmental public body, its costs will be met from within existing resources available to the Department of Health and the national health service—and indeed, we might expect some savings.
  Mr. Lansley: I am grateful for that answer, although I am not sure that the hon. Lady has quite taken my point. The Secretary of State announced a review of 42 bodies, two of which—the National Radiological Protection Board and the remaining functions of the Public Health Laboratory Service—were due to go into the Health Protection Agency anyway. Is the Minister telling us that although those bodies were cited among the 42 to be reviewed, they are not to be reviewed? Is no process of reviewing their structures, manpower or expenditure under way?
  Miss Johnson: Obviously, I shall not pre-empt any announcement that will be forthcoming fairly soon, but I have already given the hon. Gentleman my answer about the HPA and the National Radiological Protection Board. The point of creating the agency is that it is wholly consistent with the review of the arm's-length bodies, not least because it enables us, as he has acknowledged, to replace two bodies—the HPA special health authority and the National Radiological Protection Board—with one.
  Mr. Lansley rose—
  Miss Johnson: I will give way to the hon. Gentleman one more time.
  Mr. Lansley: I am grateful to the Minister for giving way to me one more time—at least, on this subject; there may be others. Let us suppose that it was argued that some of the functions of the National Patient Safety Agency were duplicatory, or at least would benefit from being managed together with those of the Health Protection Agency. Is the hon. Lady saying that that might happen, and there could be an announcement weeks from now, so the House will have been debating the Bill on one basis, and then within weeks the Secretary of State or the Minister may propose that everything will change?
  Miss Johnson: No, I am not saying that. The hon. Gentleman is working hard to find something to
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  comment on, but he is not succeeding. We do not expect to amend the Bill in the light of the review; I have already said that, and I can only reiterate it. There is nothing for the hon. Gentleman to get excited about—although he is doing his best.
  The HPA special health authority has now been in existence for just over a year. During that time, it has successfully passed the test—
  Mr. Peter Lilley: On the subject of things to get excited about, the hon. Lady says that those are arm's-length bodies, yet she seems to have given them pretty well unlimited powers. Clause 4(2) says:
  "The Agency may do anything which it thinks is… appropriate for facilitating, or… incidental or conducive to… the exercise of its functions".
  Does that mean that, for example, it will be able to detain people carrying an infection, to seize materials that it thinks are infected, or to impose charges and taxes? What is the limit on the powers conferred by the Bill?
  Miss Johnson: The point of that provision is to make it plain that the new agency will be completely or largely independent of Government in its functions. As the Bill passed through its nine and a half hours of consideration in another place, we responded to their lordships' concerns about ensuring that it has sufficient independence. I appreciate that the hon. Gentleman comes from the other angle in such matters, but we are ensuring that the body is sufficiently independent.
  Mr. Bercow: Will the Minister give way?
  Miss Johnson: I shall allow one more intervention; then I intend to make some progress.
  Mr. Bercow: I am grateful to the Minister because she has been generous in giving way, but I am afraid that her answer to my right hon. Friend the Member for Hitchin and Harpenden (Mr. Lilley) simply will not do. Does the hon. Lady not accept that there is a cast-iron distinction between granting independence to an organisation and conferring unfettered power on it? If she does not recognise the difference, I wonder why she is at the Dispatch Box.
  Miss Johnson: I think that the hon. Gentleman, too, is trying to make something out of a very little matter. The Bill's intention is to transfer the functions of the National Radiological Protection Board into the organisation of the HPA—as he and his right hon. Friend the Member for Hitchin and Harpenden (Mr. Lilley) know well—and to ensure that the organisations can do their job with broadly the same sort of remit that they now have. As I have said, however, the intention is also to ensure that the bodies' independence is guaranteed. That was felt by their noble lordships in another place to be a key element of making sure that the public's interest was protected by this move.
  I turn to the fact that we have had the—
  Mr. Lilley: Will the hon. Lady give way?
  Miss Johnson: I have said that I want to make some progress.
  Mr. Lilley: The Minister has not made any progress on her answer to me.
  Miss Johnson: I said that I wanted to make progress on my speech.
  During the time that the Health Protection Agency has been in existence, which is just over a year, it has successfully passed the test of ensuring effective business continuity from its predecessor bodies. That is no small achievement considering that it took on nearly 3,000 staff from about 80 previous employers. It has also taken the opportunity to establish itself as a modern, forward-looking organisation. It has committed itself to transparency and openness, to high standards of corporate governance, integrity and value for money and to working in partnership with other organisations to develop and deliver programmes and policies and ensure public involvement. Its work is based on the best available evidence together with high clinical and public health standards.
  The proof of that success can be seen in the way in which the HPA has handled a number of major incidents, the most serious being the emergence of SARS in 2003. From day one of the outbreak, the HPA special health authority was at the heart of the international effort to control the spread of the disease and played a central role in characterising what was then a new pathogen. The agency had representatives in China, Hong Kong, Vietnam and Canada and at the World Health Organisation where it led the modelling of SARS. A senior WHO official reported that the WHO would not have been able to manage that work without the UK input.
  At national level, the agency issued advice to the Government, health professionals and the general public on measures to control the disease. The implementation of those measures prevented the onward transmission of SARS from the few cases that appeared in this country.
  As well as addressing high-profile threats such as SARS, the agency has quietly got on with the job of improving day-to-day service delivery at local level. In particular, it has memorandums of understanding in place with every primary care trust in England, and has set up nine regional and 36 local health protection teams to bring a more unified and consistent response in health protection across the country. The new relationships and networks take time to bed down, and the HPA, the national health service and local government are continuing to work together to improve them. The special health authority is in the process of reviewing all its memorandums of understanding to ensure that for 2004–05, all PCTs will have access to a service that is responsive to their needs. We expect those arrangements to be taken over by the agency that is established by the Bill.
  The HPA has also strengthened our ability to respond to threats from chemical and biological terrorism. In particular, it has co-ordinated a number of training exercises and has recently issued a set of "clinical action cards" for GPs, which contain advice on identifying and treating victims of chemical or biological attack.
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  In addition, the authority has established an international presence, enabling the UK to make an integrated contribution to a range of international initiatives. For example, it is working to ensure that there is effective international co-operation in the surveillance of emerging infections. That has enhanced the high reputation for health protection that was established by the authority's predecessor bodies.
  In that snapshot of what the HPA special health authority has achieved, we are demonstrating that it is now providing better co-ordinated arrangements for health protection than we had in the past, and that it is contributing to the delivery of an improved service at local level. That is a tribute to the hard work of all the staff who have been involved in its creation.
  Mr. Lansley: I refer back to the point that the Minister made about the HPA's regional services. Will she explain on what basis the HPA is structuring its health protection units? In some parts of the country, such as mine, those appear to be directly related to county and police structures while in others, such as London, they seem to be related to strategic health authorities. Is there a decided pattern to that?
  Miss Johnson: I would like to provide a more detailed response to the hon. Gentleman's point in writing. However, I am sure I hat the organisation will be based on what is deemed to be most effective locally and regionally. Also the organisation has inherited some slightly different arrangements from the various bodies that I mentioned—and they have become the HPA, in any case. It varied from area to area, so there was not a common starting point for the structures.
  Mr. Lansley: I am sure that the Minister takes a close interest in these matters and will be familiar with how the HPA has structured itself in Hertfordshire. Could she explain why, in Hertfordshire, which includes her constituency among others, it does neither of those things in being coterminous with neither the strategic health authority nor the county?
  Miss Johnson: I have already dealt with that question by referring to organisational effectiveness and the historical legacy that the HPA inherited.
  I should like to bring Members on to the Health Protection Agency Bill itself, which will complete the second stage of the two-stage process that I mentioned earlier. The current authority is able to perform a role only in England and Wales, whereas the Bill will establish the agency in UK-wide legislation. That acknowledges the fact that threats to public health do not respect boundaries, including boundaries within the UK.
  Clause 3 provides for the HPA to carry out all the functions currently discharged by the National Radiological Protection Board. That will happen on a UK-wide basis, as now, which is what responses to the 2002 consultation showed that users of NRPB's services wanted. Clause 3 also preserves and extends some flexibilities in the NRPB legislation, which will allow the appropriate authorities to direct the agency to take on additional functions it that becomes desirable in future.
  In future, the Secretary of State and the devolved Administrations will look to the agency to provide the services that are currently provided by the NRPB. At

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  this point, therefore, I would like to pay tribute to the work and staff of the NRPB. Since it was set up in 1970, the NRPB has served the Government and people of this country with distinction as an authoritative and independent source of scientific advice on radiation issues. It has built up an outstanding national and international reputation that is second to none as a source of expertise on radiological protection issues.
  Nevertheless, we believe that the service can be strengthened even further. Transferring the radiation protection functions to the agency will establish a more integrated source of advice to support the delivery of health protection services and it will also enable the agency to exploit the synergies between the various health protection functions. To facilitate that, the chemicals division of the HPA special health authority has been co-located within the NRPB headquarters building at Didcot.
  Mr. Mark Francois: The Minister will be aware that one of the specialist functions carried out by the NRPB was conducting an analysis of ionising radiation on request from people who had mobile telephone masts located quite near their homes. Understandably, that was a cause of considerable concern, and people could pay the NRPB to set up metering equipment and provide a very detailed analysis of the amount of radiation emanating from the masts and coming on to their properties A charge was made for that service, as I know because I have had constituency casework experience of the problem. Some people found the surveys reassuring, so if the HPA is going to undertake that function in future, would the Government be prepared, as part of the creation of the new agency, to review the charges made to carry out that function? As I said, it can be very reassuring, but it is also rather expensive at present. Are the Government prepared to be flexible about that?
  Miss Johnson: I am not sure whether the hon. Gentleman is suggesting that we should spend Government money on that—[Interruption.] I am not aware of any changes being envisaged on this point, but it will be a matter for the HPA to consider how best to continue with the functions that it has inherited. I acknowledge the interest in the issue of ionising radiation, which the hon. Gentleman has raised. We expect the services hitherto provided by the NRPB to continue to be provided by the HPA in the future.
  Transferring the functions to the agency will not compromise in any way the independent nature of the radiation protection advice that the HPA will provide, or lead to a reduction in its quality The new agency will be an executive non-departmental public body, which is what the NRPB is now. Every effort will be made to ensure that the change process is managed with the minimum amount of disruption to both staff and work. The two bodies are already working closely together and currently share the same chairman.
  Dr. Andrew Murrison: The Minister will agree that both radiation and bugs can cross boundaries. Why is it that artificial boundaries will be created by clause 2 in respect of infectious diseases, but not by clause 3 in respect of radiation and the work of the NRPB?
  Miss Johnson: I am not sure what the hon. Gentleman refers to, precisely. There are several arrangements that cover various aspects of the changes that relate to the devolved Administrations, but—broadly speaking—those will bring provision much more into line across the UK and are likely to lead to a greater consistency of approach, including bringing Scotland into the new arrangements.
  As I mentioned, the Bill does not entail any additional public expenditure. Setting up the HPA special health authority has already illustrated the kind of developments that changes to arm's length bodies can achieve. It has shown how, without the need for the Department of Health to seek additional resources from the Treasury, the special health authority has been able to set up an emergency response division virtually from scratch; strengthen the ability to provide chemicals advice so that there is now the capacity to be proactive as well as reactive; and develop local and regional services. I hope that I have made it clear why the Government have introduced this Bill and I therefore commend it to the House.
  4.56 pm
  Mr. Andrew Lansley: I am grateful to the Minister for explaining the purpose of the Bill, although many hon. Members will be disappointed that she did nothing to illustrate how incorporating the functions of the PHLS and the NRPB will deliver improved public health or infection control in the future. I do not know how often the House has the chance to debate infection control and substantial threats to public health, but this was a classic opportunity to do so. However, the Minister seemed to have decided that that was not a very good idea. In the course of my remarks, I may illustrate why the Minister thought that.
  I join the Minister in paying tribute to the work of the PHLS and the NRPB. She illustrated her tribute with reference to SARS; it is interesting that she did not argue that there was a specific deficiency in past arrangements, but argued merely that the integration of functions was, by its nature, a good thing. The logical conclusion of that argument would be to combine everything into the Department of Health, with nothing done outside it. However, sometimes a specific focus is necessary. It should be noted that although the NRPB now accepts the proposals, just over a year ago it was concerned about the lack of independence and focus on its responsibilities in the arrangements. It will be important to ensure that all the functions of the HPA require a focus on such tasks, so as to maintain the work of the NRPB.
  The Bill has a simple structure. It is designed to bring together the functions of the HPA, presently a special health authority, and the NRPB, which is a non-departmental public body. The Minister was not clear about what special health authorities cannot do that non-departmental public bodies can do.
  I think that the difference lies in the degree of independence available to those bodies. As a special health authority, the HPA would be directly constrained by ministerial powers and the interpretations of their responsibilities under health legislation; whereas under the Bill, as a non-departmental public body, the HPA

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  will have its own statutory remit and, if need be, will be able to make its own decisions as to its priorities and how to discharge them. I welcome the fact that the other place made clear in amendments that the HPA can determine for itself what information it should publish and when. That is entirely to the good.
  The Minister told us that the chief medical officer's document, "Getting Ahead of the Curve", published in July 2002, stated that the purpose was to bring together in one agency functions necessary to combat the spread of infection and threats to the public from a range of hazards, such as radiation and biological and chemical releases, including deliberate releases. As we made clear in another place, we shall not oppose the Bill, although in the light of what I have just said and, more particularly, of the constructive debate held by my colleagues in another place, I do not understand why the Bill needs a programme motion. I rather regret that. None the less, we wish the HPA success in its objectives. Notwithstanding our concern to maintain a centre of excellence in the agency for the former functions of the NRPB. we want a more co-ordinated and effective response to threats to public health.
  Before we discuss those threats, I want to question the Minister about organisation. I said that I was somewhat surprised that the Department is proceeding with the Bill in parallel with the review on arm's length bodies. Thus far in the Bill's proceedings, there has been no reference to the review's impact on the measure. The Minister said that there was an announcement on 20 May, but the original announcement setting up the review of arm's length bodies was in October last year, so the Bill and the review are running in parallel.
  My hon. Friends may not have had a chance to look at the review, but the Secretary of State said that he would review 42 bodies. Lost in the small print, however, was the fact that seven of those bodies are already due to be abolished, so there is not much point in reviewing them. Two of them come under the Bill: the Public Health Laboratory Service and the NRPB are due to disappear to establish the HPA. We know precisely why they were included in the review: so that the Secretary of State can keep his number count up. If he is to reduce by half the number of such bodies, he needs as many as possible in the first place.
  The Opposition note—as will, I suspect, the wider public—that 20 of the 42 bodies have been established by the Government since 1997. Once again, the Duke of York is marching the civil service and Government organisations up the hill, only to march them some of the way back down.
  We know what the Government propose, but we do not know what they currently intend in relation to the review. In May, when the Secretary of State wrote to the bodies concerned, it was made clear that announcements would be made in early July—the Minister will tell me if I am wrong. Early July is not far off and under the programme motion the Bill's Committee stage will finish by 1 July. Lo and behold, there is every possibility that, immediately after the Bill has reported, the Government will say that they are proposing something different. The Minister just will not tell us whether the Government are proposing something different on the powers, structure and
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  functions of the HPA. Days after the Bill reports, everything may change. It would be an abuse of our current scrutiny of the measure if the responsibilities, or indeed the financing and staffing, of the HPA were to be radically altered by a Government announcement days after the Bill had reported.
  Miss Melanie Johnson: I reiterate that we do not expect the Bill to be amended in the light of the review. I realise that the hon Gentleman may have written his speech and may want to demonstrate his commendable understanding of the calendar, which is fantastic—we are indeed approaching the beginning of July—but I gave him the assurance that he seeks in my opening remarks.
  Mr. Lansley: I also understand that the Minister is reading from her brief. At least I wrote my speech.
  The Minister says that she does not expect that anything announced will require amendments to the Bill. I was not necessarily talking about amendments to the Bill. If the intention were, for example, to transfer functions relating to infection control to the HPA from the National Patient Safety Agency, it would be perfectly possible to co so without changing the powers in the Bill. If the Government intended to change the HPA's staffing or expenditure, that would be possible without changing the Bill. However, Conservative Members will debate the HPA's objectives and how it can achieve them. Hitherto, we have been conducting that debate on the basis that the HPA will proceed with its current, planned staffing and expenditure. If the Minister says that the HPA's current, planned staffing and expenditure will be maintained when the review's results are announced in July, that is a different assurance from the one that she has already given to me. Perhaps she would like to give us that assurance—no, I
  did not think so.
  If the Minister cannot give us that assurance, it might be interesting to consider whether the Department is doing its job in the review. A number of agencies duplicate functions. It is always difficult to work out precisely what all those agencies are doing, but I suspect that some of the Department's work, particularly in the Government offices for the regions, some of the Health Development Agency's work and perhaps the National Patient Safety Agency's work in relation to infection control and, in particular, hospital or health-care acquired infection and MRSA may well complement but possibly duplicate the HPA's work. That raises questions about whether a further review of the HPA's functions should take place. I have chided the Minister, and it is a pity that she did not tell us that further efforts will be made to try to rationalise the functions of the arm's-length bodies and indeed the Department in that respect. That may be necessary if that is the HPA's purpose.
  The Bill will not simplify the relationship between the HPA and the NHS. For example, most of the old PHLS laboratories have transferred to NHS trusts. The Minister will remember the debates that we had last year on the Health and Social Care (Community Health and Standards) Bill. One of the questions asked at that time, to which I do not recall seeing clear answers subsequently, was the extent to which trusts will receive the necessary core funding through primary care trusts

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  to support surges in capacity for emergencies and the research and development undertaken by microbiologists in those laboratories. That is one of the issues on which it would be helpful if the Minister responded. Last year we were debating the theory. In practice, have PCTs passed to the microbiology laboratories for which they are now responsible the necessary funding for those purposes?
  I mentioned last year—I confess that this has particular constituency relevance—that the PHLS laboratory at Addenbrooke's in my constituency would not be transferred to the trust but would remain with what is now the HPA. That raised a question among the biomedical scientists employed there.
  As an early implementer of the "Agenda for Change" proposals, Addenbrooke's was introducing—indeed, is introducing—new pay arrangements for its laboratory staff. On the same site, however, the biomedical scientists working for the HPA do not have access to the "Agenda for Change" job evaluations and consequent pay arrangements.
  I am sure that the Minister has that in mind. She might be able to tell me whether there will be further delay. "Agenda for Change" is already delayed until December. Last year, the Minister of State, Department of Health, the right hon. Member for Barrow and Furness (Mr. Hutton), made it clear that there was a transitional issue, but that it would be minimised because of the relatively short time before the implementation of "Agenda or Change". The implementation date has moved from October to December, stretching out what might be a difficulty in the relative position of staff on one site.
  The relationship with primary care trusts is important. The Minister said that there are memorandums of understanding with every PCT, but that does not quite solve the problems. The problems go deep into whether public health issues are sufficiently resourced, focused on and prioritised in PCTs. Can public health functions be appropriately managed among 303 PCTs across the country? I am not in a position to judge such things; I have to judge them on the basis of what directors of public health and those in PCTs around the country have to told me. They feel that the system is too fragmented and marginalised and that only reactive work can be undertaken. The Minister made it clear that public health objectives, particularly on issues such as infection control must be proactive. I am afraid that, crudely put, ma pagers of PCTs are sacked when they do not meet hospital waiting list targets, but are not sacked for failing to meet any public health objectives. So all the effort and focus goes on the former. That raises the question whether, if it is possible for PCTs to sign a memorandum and not necessarily discharge their functions, and to let the HPA carry on its responsibilities, the public health effort overall will become disconnected.
  The Minister waxed eloquently on how things must be integrated, which brings me to an important point. If everything were properly co-ordinated, a strategy for dealing with infectious diseases could be established, implemented and followed through by one body. One would imagine that that is what the Government set out to do. It is curious, therefore, that time and again the chief medical officer in the Department of Health and his teams of people set strategies, but it is the HPA that
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  is meant to be in the business of implementing infectious disease control and strategies thereby. As the NHS responds to the Department of Health and not to the HPA, the Department must turn the so-called strategies into action plans. What is going on? That is not happening; there is discontinuity between the two. I shall come to that in respect of a number of specific examples.
  I want to refer to hospital-acquired infection and MRSA. The MRSA rate has more than doubled since 1997. The Minister will no doubt remind us that mandatory reporting was introduced in April 2001 and say that that shows that there was under-reporting previously. However, even with the previous reporting arrangements, the rate has more than doubled since 1997 and we now know that the level is about 50 per cent. higher than previous reports suggested.
  I am sure that the Minister and other hon. Members have met constituents who have suffered from MRSA infection, whether after hospitalisation or otherwise. It is a life-threatening infection, especially among elderly and vulnerable people. The question that we must ask is: is it inevitable?
  Methicillin-resistant Staphylococcus aureus accounts for only 1 per cent. of Staphylococcus aureus incidents in Dutch and Danish hospitals, whereas the proportion in England is more than 40 per cent. As for variation within the UK, the incidence can be seven times worse in Yorkshire than in Cambridgeshire. I am sorry to plug my constituency again, but the Minister and I visited Papworth hospital on Friday to join the celebration of 25 years of heart transplant surgery at the hospital. I recall on a previous visit talking with the medical microbiologist who is responsible for infection control at Papworth—the necessity of minimising infection
  among immuno-suppressed transplant patients is obvious, and the measures taken at Papworth are stringent. The hospital is not new—anything but. Staff at Papworth often work in difficult and cramped conditions in rather aged buildings, but they achieve extremely low rates of hospital-acquired infection, and I suspect that that is part of the reason why Cambridgeshire has such a good overall result.
  There is no inevitability about the rate of hospital-acquired infections—it could be far lower. Just a few weeks ago, I visited Redditch hospital—I had expressed an interest in visiting the stroke services and the ward for stroke patients, but we had an interesting visit to the orthopaedic ward. The nurse in charge of the orthopaedic ward told me that that no one with an infection was coming on to her ward. If someone was to be referred to her ward, she would know whether they had an infection, and if they had, they would, in effect, be kept in isolation and barrier nursing would be used. She was adamant: no one was going to acquire an infection while they were on her ward. The reason we were unable to visit the stroke ward next door was that there was infection in that ward.
  That tells us that what is needed is the ability to manage wards properly. There must be the power to ensure that risks are not taken, that infection is kept out, and that standards of hygiene and measures such as hand-washing are enforced.
  Dr. Julian Lewis: I, too, am concerned about the number of deaths occurring in

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  quite major hospitals near my constituency. What role does my hon. Friend see for the HPA in raising standards of cleanliness and in ensuring that barriers to infection are instituted in hospital wards, so that there is better protection?
  Mr. Lansley: I am grateful to my hon. Friend for asking that interesting question. The HPA's role is important, but it is essentially about surveillance—discovering the extent to which there is infection and the extent to which it is acquired in hospital, and reporting on the circumstances. However, there is discontinuity between that role and setting out the action plan—what is to be done about the problem. It was the chief medical officer who followed up previous documentation by publishing in December "Winning Ways", his action plan for dealing with MRSA and hospital-acquired infection. It is not the HPA's responsibility to set out how the NHS goes about preventing hospital-acquired infections. I shall not go through everything that the chief medical officer said about spending additional money on research and development, having directors of infection control in each hospital, minimising the use of invasive procedures and reinforcing guidance.
  Disappointingly, the Government have not understood that this is fundamentally about good practice and giving patients a basis on which they can make judgments about hospitals and about where they are referred for treatment. People rarely know the infection rates, including those for MRSA, of local hospitals to which they may be referred. Unfortunately, there has to be a scandal before people begin to learn about conditions in their local hospital. It should not be like that. Patients should know such things, which would enable them to exercise choice. We will make such information available, which is a powerful illustration of the way in which the NHS will be incentivised and required to respond to patients' priorities. Hospital-acquired infection rates, particularly those for MRSA, should be routinely published to facilitate patients' decisions about where they wish to have their elective treatment. As a result, hospital management, instead of ticking performance indicator boxes to say that they have a process in place and have appointed a director of infection control, will bring down infection rates.
  At the moment, the Government fool themselves and the public by publishing cleanliness standards. In 2003, according to the Government, there were no hospitals with poor cleanliness standards; 78 per cent. had good standards, up from 22 per cent. in 2000. However, 15 of the 20 hospitals with the worst MRSA rates were given a good cleanliness record, so there is no relationship in the Government's mind between cleanliness and the levels of hospital-acquired infection, particularly for MRSA. However, for the public, a high incidence of MRSA is critical to their judgment about whether or not a hospital is clean.
  Dr. Julian Lewis: Surely, if my hon. Friend is right and the HPA's main function is surveillance, he is making a strong case that it has a lot more to do in its new form than it ever had to do in its old form if it is to carry out that function effectively.
  Mr. Lansley: Yes, I am making that point, and that work has to be done in a way that ensures that the agency's responsibilities and those of the Department of Health are meshed together. However, it is not just about the agency's or Department's functions but about managers' response. More research and development is needed so that new technologies can be introduced to support effective infection control. Like many Members, I have been to see people who are working on new technologies, some of which have been piloted in hospitals across the country. Their introduction is urgently needed, and the agency could certainly help with that. We need to make progress on dealing with the problem, because we cannot necessarily resist not only MRSA but VRSA—vancomycin-resistant Staphylococcus aureus.
  Dr. Murrison: VRSA is even worse.
  Mr. Lansley: As my hon. Friend can substantiate from his medical knowledge, VRSA is very serious. MRSA is a dangerous infection, but at least we have an antibiotic to respond to that threat. However, that antibiotic is not effective against VRSA, so people suffering from it would have serious problems.
  Certain things need to be achieved to close the gap between the role of the Department and that of the HPA. On Second Reading, immediately after the Minister in another place, Lord Warner, had spoken, my noble Friend Lord Fowler made a speech about HIV/AIDS and sexual health—there is no one better qualified to make a speech on the subject than him—and he regretted that the Minister had not spoken about the issue, particularly HIV.
  Neither did the Minister responsible for public health say anything about sexual health or HIV/AIDS when she introduced the Bill to this House this afternoon.
  Miss Melanie Johnson indicated dissent.
  Mr. Lansley: I beg the Minister's pardon. She referred to HIV/AIDS, but she did not tell us what the Government were proposing to achieve additionally in relation to it, or about any specific functions that were planned for the HPA in that regard.
  In the 1980s, as Secretary of State, my noble Friend Lord Fowler led a powerful, hard-hitting public health campaign. It was about not only HIV but safe sex, and it was intended to be communicated to the wider population and to create peer pressure among young people who might otherwise engage in unprotected sex. It was effective, and it was one of the reasons why, until recently, the rates of HIV infection acquired in the United Kingdom were substantially below those of other countries. From memory, I believe that the numbers in this country were a quarter of those in France.
  More recently, however, the incidence of HIV has risen. Indeed, the incidence of acquired infections has risen pretty much across the board. The levels of chlamydia and gonorrhoea infection have more than doubled, and the level of syphilis infection has increased by a staggering nine times the previously recorded infection rate. The HPA's latest update report states that, over the preceding year, there had been a 20 per

  1111
  cent. increase in the number of those living with HIV in the UK, and that there had been an increase in heterosexual acquired HIV as well as an increase in the number of people entering the UK from sub-Saharan Africa who were infected with the Virus.
  The HPA has had things to say in that regard, but will the Government act? The question is whether they will go beyond a national strategy and set out standards to which the NHS has to respond. In terms of the Government's structuring of such matters, that would involve a national service framework for sexual health. In the absence of such a framework, the money that the Government say that they are investing will not necessarily get through to, for example, the genitourinary clinics and will not help to bring down the time that people have to wait for treatment.
  I accept that there are exceptions regarding waiting times. I was at St. Mary's hospital in Paddington today, which continues to see patients virtually immediately—certainly on a same-day basis. However, that is the exception rather than the rule. The average waiting time for treatment across the country has lengthened; it is now between 10 and 12 days, and in some places it is as long as six weeks. That service simply does not meet people's needs. To combat sexual health problems, we must not only provide an immediate service for patients—for whom these are sensitive issues—but minimise the risk of onward transmission and infection. Over the course of weeks, there could be a multiplication of such risks for the population generally. Have the Government proposed such a national service framework? No, they have not, and it will fall to us to do so if they do not.
  Tuberculosis—especially multi-drug-resistant TB—is
  a serious global problem that is rapidly also becoming our problem.
  Mr. Francois: I apologise to my hon. Friend for interrupting his flow, but I shall have to depart in a moment to go up to European Standing Committee A, which overlaps with this debate, and I want to put one suggestion on the record before I go. My hon. Friend will be aware that an element of the Bill deals with homeland security, and that the HPA has a potential role in that regard. The paragraph of schedule 1 that deals with staff states:
  "The Agency may appoint such staff and on such conditions of service as it thinks fit."
  May I suggest, through my hon. Friend, that it might be useful if the HPA were to appoint liaison officers to serve with both the regular regiment responsible for chemical, biological, radiological and nuclear issues in homeland defence and the contingency reaction forces that would need to react to a CBRN incident, so that, in such a dreadful eventuality, HPA liaison staff would be there on the ground with the appropriate military units and would be able to make an initial response that could be communicated back to the agency? We know from experience in other countries that the early identification of a threat is critical to saving lives.
  Mr. Lansley: I am grateful to my hon. Friend, whose expertise on the subject of response to such emergencies is greater than mine. Clause 5 sets out a general duty to co-operate, which is presumably intended to embrace
  1112
  local authorities, the Ministry of Defence and everyone concerned with response to civil emergencies, but the Bill tells us nothing about how that duty will be exercised. I hope that in the course of questions from the Opposition and debate in Committee, the Government will flesh out how they intend that co-operation to work. They were tested on the matter in another place and had little to say. We will return to it in due course.
  The chief medical officer's strategy document, "Getting ahead of the Curve", identified TB as a "massive international health problem" and showed that the illness, which had dramatically declined in the UK until the late 1980s, was making a comeback. The CMO report listed reduction strategies that had worked in the past, including immunisation and treating those in the very early stages of infection. It suggested that the Department of Health put in place a TB action plan by "early 2003".
  In March this year the World Health Organisation confirmed that drug-resistant strains of TB common in eastern Europe and central Asia pose a major threat to the European Union. Perhaps the Minister can tell us whether there has been any incidence of multi-drug-resistant TB in the UK. I am aware from my visit to St. Mary's, Paddington that for reasons of civil emergency and in relation to TB, the number of cases of which is rising sharply, isolation rooms and arrangements have been put in place, so the hospital could deal with multi-drug-resistant TB, should it encounter the disease.
  However, the TB action plan has still not appeared. The Minister's predecessor in 2002 promised it
  "by the end of the year"—[Official Report, 4 November 2002; Vol. 392, c. 137W.]
  When my hon. Friend the Member for Westbury (Dr. Murrison) asked in March 2004 where the action plan had got to, it was promised
  "in the next few months",—[Official Report, 25 March 2004; Vol. 419, c. 1051W.]
  but there is still no indication from the Department when it will be published, let alone implemented.
  According to the British Thoracic Society, up to half of patients attending accident and emergency departments with TB are "slipping through the net". The BTS considers, and I think it is a fair concern, that the homeless, refugees and asylum seekers are particularly at risk, and points out, along with others, that the incidence of TB in some London boroughs is at third-world levels. In Brent there are 116 cases per 100,000 population, and in China 113 cases per 100,000 population—broadly equivalent. TB in Britain rose by 20 per cent. in the past decade, but in London by 80 per cent.
  Why is there no action plan? Why are Ministers avoiding the sensitive issues of screening for disease or identifying the groups at risk? We have examined the issues. We do not believe that compulsory screening is the way forward, but Ministers have access to the HPA and their own surveillance resources, and their appraisal may be different. This would be a good time for the Government to tell us when they propose to publish the long-overdue TB action plan.
  On hepatitis C, the Minister corrected my hon. Friend the Member for Mid-Worcestershire (Mr. Luff). The Government estimate that there are 200,000 people with

  1113
  hepatitis C, but there may be significantly more. The majority are undiagnosed. Effective treatments are available. "Getting ahead of the Curve", the report produced by the chief medical officer, stated that
  "good surveillance is the cornerstone of a system to control infectious diseases".
  However, we do not have surveillance; we have an awareness campaign, which does not appear to be working.
  In a report in December 2003. the HPA found that transmission among those who inject had increased. The action plan—a familiar refrain, Madam Deputy Speaker—was first promised in 2002, and by May 2003, it was promised
  "in the next few months".
  The Under-Secretary of State for Health, the hon. Member for Welwyn Hatfield (Miss Johnson), now says:
  "The plan will be forthcoming over the summer and into the autumn".—[Official Report, 8 June 2004; Vol. 422, c. 142.]
  Delay may be costly.
  In 2002, the CMO said:
  "Whilst costs of not treating are low initially, as the disease progresses, many more people move to decompensated cirrhosis where the treatment costs, which may include liver transplantation, increase dramatically".
  The disease is undiagnosed in 90 per cent. of cases, and up to 85 per cent. of people with it will develop chronic disease if it remains untreated—many such people would suffer the severe consequences arising from advanced liver disease. Surveillance now will forestall those costs later.
  Finally, has a national pandemic strategy on flu been agreed between the Department of Health and the HPA? Do the Government intend to stockpile antiviral drugs such as Relenza and Tamiflu? Avian flu was only a precursor to the threat that we may face—we do not know when the threat will occur, and it may take some time. The spread of severe acute respiratory syndrome shows the speed with which a new virus to which we do not have immunity can travel around the world. As Ministers know, developing a vaccine when a virus is introduced into this country can take months. The availability of antiviral drugs is important to offset the risks associated with the outbreak of such an infection. I do not know whether this judgment is correct, but it has been put to the Government that stockpiling antiviral drugs would enable us to respond to such a threat. Is stockpiling happening, is it intended to happen and is a strategy in place?
  In this debate, we have heard two different speeches, one about public health and one about organisational matters inside the arm's length bodies of the Department of Health. As far as the public are concerned, public health matters: a sexual health and sexually transmitted infections crisis is occurring; TB is rising and we do not have an action plan; perhaps 200,000 people with hepatitis C could be identified and treated, but such plans do not, as yet, exist; and while the incidence of HIV increases, the response is uncertain.
  The Government have failed to live up to their responsibilities on infection control. More than any other aspect of health care, public health is the
  1114
  Department's concern. We are currently debating obesity, which has increased contrary to the Government's so-called public health objectives. Binge drinking has increased, and while smoking has reduced among men, it has not significantly decreased among women. The Secretary of State for Health helps no one by treating smoking as one of life's few remaining pleasures.
  Dr. Julian Lewis: Under this Government, perhaps it is.
  Mr. Lansley: If my hon. Friend will allow me, I shall not go down that path.
  Right across the board, the Government have not delivered a public health strategy. They have not delivered specific strategies for the particular infectious diseases hat are the subject of this afternoon's discussions and that are the responsibility of the HPA. It is a travesty to say that those infectious diseases will be better combated by the creation of the HPA, when the responsibility still lies with the Department, which, even in response to the CMO's recommendations, has failed to ensure the deployment throughout the NHS of the resources and standards of care to deliver the action plan.
  We are content not to oppose the Bill, but its contents are no substitute for a Government who can give the necessary lead on public health and provide the public health strategies and the ways in which to deliver them that are needed in the light of the current Government's failures on public health. We therefore criticise the Government but not the Health Protection Agency. We want it to deliver its functions more effectively in future.
  5.40 pm
  Liz Blackman: I shall be brief and use my time to ask a few practical questions about the nuts and bolts of the Health Protection Agency. It is generally agreed that the Bill is timely. It creates a more responsive body to deal with a climate of increasing threats and risks, which include: the escalation of known diseases such as TB, HIV/AIDS and sexually transmitted infections; the appearance of new diseases such as severe acute respiratory syndrome; and the threat of the release of pathogens—small pox, anthrax and chemical and radioactive agents.
  A weighty responsibility to provide specialist support for health protection o the NHS and local authorities is placed on the body but a more co-ordinated response was needed to find a way forward. The Government's two-stage approach has been logical. They created a special health authority in England and Wales and subsequently moved to the UK-wide body that we are considering, thereby acknowledging the risks that the whole UK faces.
  There is a rationale for the creation of such a body, which will provide wide expertise in a single framework and, most important, a single reference point. It should create a co-operative ethos. There will be cross-fertilisation of good ideas, scope for high standards across the board, the spread of best practice and an enhancement of the UK's international contribution through initiatives and surveillance.

  1115
  It is encouraging that work is already well under way through the special health authority, which focuses on improving skills, widening research, co-ordinating several training exercises, setting up nine regional and 36 local health protection teams, creating memorandums of understanding with the local primary care trusts and, as my hon. Friend the Under-Secretary said when she opened the debate, playing a vital part in combating the SARS epidemic. The modelling work that it contributed was especially valuable and the World Health Organisation complimented it on that.
  The Bill creates a body that has a legislative basis for exercising health protection functions in every part of the UK. Working practices already reflect that, for example, in the unified HIV/AIDS surveillance programme throughout the UK. It also improves the body's flexibility to respond to future threats by allowing the agency to be directed to take on other powers, enabling future flexibility and allowing devolved Administrations to shape the use of the agency to fit their needs.
  I read the Hansard report of the debate in the other place. I was surprised that the Opposition did not mention it because it was a lively debate on the way in which the agency will publish and be allowed to publish information and advice. Indeed, the hon. Member for South Cambridgeshire (Mr. Lansley) was right that the measure confers strong powers on the Health Protection Agency. That is encouraging and gives the agency a great deal of freedom and opportunity to publish what it likes when it likes. However, there is obviously a proviso that it does not contravene the Data Protection Act 1998 or publish information that is not in the public interest. It also has to publish an annual report, which, I hope, will be debated in the House.
  What will make the agency maximise its effectiveness is not only sensible structures, but a high degree of cooperation from people, as well as their preparedness.
  There was also a lively debate about primary care trusts, to which the hon. Member for South Cambridgeshire referred. It has to be said that there are concerns that PCTs receive 75 per cent. of the NHS budget and have an enormous range of responsibilities, but I do not go down the hon. Gentleman's road of saying, "Well, so they can't cope."
  We know already that there are differently performing PCTs, and the key to ensuring that this measure works and that PCTs play their full part in relation to the agency is giving them support, but also ensuring that mechanisms are in place to support their capacity to respond to what the agency requires of them. Where will the facilities to monitor their performance and any necessary additional support be located? Will the Minister say something about that? Similarly, local authorities have an enormous role to play. How will their performance in this regard be monitored and their quality assured across the board?
  Clause 5 says:
  "In the exercise of its functions the Agency must co-operate with other bodies which exercise functions relating to health or any other matter in relation to which the Agency also exercises functions."
  I accept that it is not sensible to name the bodies in the Bill if that has never been practised, but it would be interesting to know the range of other bodies that we are
  1116
  thinking about that may have a relationship with the agency and how they are to be prepared to work with it as effectively as they can.
  I want to flag up the issue of information exchange, which is vital if the agency is to work to its maximum. What protocols will be put in place to ensure that that goes smoothly? This was flagged up in another place by Earl Howe:
  "If a local authority, in pursuit of its duty of co-operation, receives sensitive personal data of a medical nature, who in the authority, and indeed outside, should be entitled to read that information? How should it be stored? Suppose after a while there is no strict need to continue holding the data, because the matter has been dealt with, what should be done with the files? Should the local authority retain the data just in case, or should they be destroyed? All these questions arise as a matter of practice."—[Official Report, House of Lords, 29 April 2004; Vol. 660, c. 941.]
  So, it is important as we progress that these issues are clearly dealt with.
  The other issue involving information exchange is information technology infrastructure. Will the Minister say a few words about where we are with that infrastructure, which will allow the speedy and accurate exchange of information between the agency and the various bodies that it will work with?
  That is not meant as a criticism of the Bill, which I welcome. It is extremely encouraging that the special health authorities are making such progress already. I consider this an extremely positive move, but I would like the Minister to comment on the issues I have raised.
  5.49 pm
  Mr. Paul Burstow: I rise to give some support to the Bill, which should make progress through the House. It certainly has the support of the Liberal Democrats, just as it had in the other place, but with a number of caveats.
  I wish to pose some questions.
  It would be a mistake to see this Bill as simply a legal formality. It is more than that: as other Members have said, it is an opportunity to examine a key part of the nation's public health machinery, which should safeguard us not just from the microbiological, chemical and radiological threats that nature throws at us but from those that can be engineered by man, both for benign and malign purposes. As we have heard, the new agency has been up and running as a special health authority for a little more than a year—it has celebrated its first anniversary, which is something to be celebrated, given that some of the bodies that have been introduced by this Government do not reach a second year before they are abolished.
  I want to pick up on several issues. First, on the arm's length review, about which there has been quite an exchange across the Dispatch Box, I think that I am clear on the Government's current position. On the potential effect of clause 2(1)(a), to which we can return in Committee, reference is made to
  "protection of the community (or any part of the community) against infectious disease and other dangers to health".

  1117
  That is a broad remit. It could open up the agency to taking on functions to address other public health issues, perhaps in relation to lifestyle and preventable causes of disease. We might explore whether it was in the mind of the parliamentary draftsmen, who advise the Government on these matters, to give it that degree of flexibility for future innovation and development. From what we have heard from the Minister, however, it appears that that is not on the agenda at this stage. Having said that, given that we have heard that the public health White Paper will be delayed until the autumn, and given the publication in February of Derek Wanless's report identifying a number of gaps in the public health machinery in this country, especially in respect of health promotion, education and the essential capacity to evaluate public health measures, is the HPA likely to celebrate its second anniversary completely unchanged, with the status quo that it currently enjoys, or will the opportunity be taken—which, I think, should be taken—to give it a wider role in driving forward and developing a public health agenda in this country?
  The hon. Member for South Cambridgeshire (Mr. Lansley) made an important point about the success in the 1980s of some of the public health promotion campaigns in relation to HIV/AIDS. To some extent, that capacity has been lost. Derek Wanless, in his report, identified the fact that in the process of combining and reorganising a number of public health functions, the health promotion and health education function seemed not to be assigned either to the HPA and its predecessor bodies or to the Health Development Agency. That is a great pity and a great gap in the Government's capacity to be able to move forward on a public health agenda. For that reason, I hope that the Minister can say whether that gap will be closed, first, by the declaration in the White Paper and, more importantly, by ministerial action to put in place the necessary organisations.
  Mention was also made of the need to pick up on concerns about the explosion in sexually transmitted infections in this country. The hon. Member for South Cambridgeshire went through the litany of appalling statistics, which make shocking reading. Undoubtedly, the HPA, in its surveillance role, enables us to get a clear picture of the scale of the task that faces the country, the Government and us all. I have no doubt that there is a need for a national service framework in respect of sexual health, not just to deal with treatment issues—the deficits have been well rehearsed in the Health Committee's inquiry—but, more importantly, in terms of health promotion and the capacity to diagnose. That is an important part of the wider public health debate that we need.
  My second concern is the need to ensure that the UK has a robust system of microbiological surveillance, capable of reacting quickly to and dealing with threats that might be perceived. I remain unconvinced of the wisdom of transferring most of the Public Health Laboratory Service's microbiological laboratories to NHS trusts, not least because of the formal submission of the PHLS board during the consultation phase last year, in which it expressed concern that the fragmentation of the service would lead to a loss of an efficient co-ordinated response to the detection and
  1118
  control of infectious diseases. Many around the world saw the PHLS network as setting a standard to which others aspired. The Centre for Disease Control and Prevention in the USA must rely on the fragmented network that we are now in the process of creating. It does not have a federal structure, with federal laboratories and capacity. It looked covetously at the arrangement that we had in this country, and, I understand, is seeking to emulate the structure from which we seem to be moving. It would be useful to examine in Committee whether we can be confident that the fragmentation of the system will give us the robust surveillance that we need.
  From written answers, and from exchanges today, I understand that this place and the other place have been reassured that all this will be dealt with through a memorandum of understanding between the HPA, NHS trusts and so on. With primary care trusts and NHS Trusts confronted with so many "must dos" from Whitehall, where exactly does a memorandum of understanding fit into the hierarchy of standards, targets and tick boxes? It is not clear. Is it not just a gentleman's agreement between those organisations, which in reality has few teeth and little ability to gain traction when it comes to PCTs' commissioning decisions and the allocation of their limited resources? If the HPA does have cause for concern that a laboratory lacks sufficient staff or financial resources to be a satisfactory part of the surveillance network, what is the mechanism to call that in, examine it, and scrutinise it? I hope that the Minister will be able to rehearse precisely what would be done in that situation to safeguard the public interest and to make sure that we have a satisfactory surveillance system in place.
  I understand that a possible part of the answer will be that the Healthcare Commission will take on the role of inspecting Microbiological laboratories and that a new inspector will be appointed for this purpose. Why do we need an inspector of a system that was once part of an organisation, but for which responsibility is now dished out among NHS trusts? Is that not just a regulatory solution to a problem caused by the Government's changes in this area? Would it not be better to have a unified surveillance network?
  The concern is about not just fragmentation of surveillance but overstretch of public health professionals working in PCTs. Many of those staff, particularly directors of public health, are acting up to that position because there are vacancies. In some cases, they are doubling up, because there are not enough directors of public health medicine around the country to do the job. There are shortages, and there are vacancies to be filled. At the moment, many of those directors find themselves being deployed in crisis management mode, not in terms of fighting infection but in terms of helping PCTs to deliver the Government's must-do agenda. As a consequence, there is little time to engage with the HPA on such issues as surveillance, diagnosis and management and control of outbreaks of infection.
  As has been mentioned, how will the duty to co-operate contained in the Bill work in practice? Who will initiate that duty? Who will co-ordinate it? Local authorities, for example, have emergency planning roles. Under the clauses dealing with a duty to co-operate, will they have a right and an ability to call in the

  1119
  expertise of other agencies to enable them to discharge their responsibilities? How will that fit together? The hon. Member for Erewash (Liz Blackman) mentioned data and information sharing, which also fits in. Just having a duty to co-operate, without adequate explanation from Ministers as to how it will operate in practice, seems an insufficient safeguard for the public at local level.
  As has been said, the Bill has already been considered in the other place, and I am grateful to my noble Friend Lord Clement-Jones for his hard work on it.
  That brings me to the third concern, which my noble Friend raised in the other place: the HPA's role in respect of zoonotic infections. During exchanges, the Minister, Lord Warner, confirmed that the HPA has the lead role on zoonosis in humans and has contributed to work across the world on things such as combating avian flu. However, the question that was not addressed at each stage of the Bill in the Lords—I hope that it will be tonight—is precisely where responsibility lies, and what role the HPA plays when an outbreak occurs in the animal population and there is a clear and perceived risk of transfer to humans. Who has overall responsibility? Is it the Department for Environment, Food and Rural Affairs, the HPA, or the Department of Health? Can it be made clear who has the lead responsibility in those circumstances? Perhaps the Minister will answer that question.
  The HPA has the key job not just of surveillance but of controlling infections. I am thinking in particular of the vexed question of hospital or, as we are now required to call them, health-care acquired infections. It is interesting that we now call them health-care acquired infections, because the current surveillance enables us to know only about infections in the context of the hospital setting. We still have little information about the extent to which infections are picked up in ether care settings. I hope that Ministers can give us some information about what is intended further to strengthen the monitoring and surveillance systems to deal wish that.
  Just last week, there were reports that deaths from MRSA—methicillin-resistant Staphylococcus aureus—infection could double within the next five years because the bacteria is becoming increasingly resistant to the antibiotic vancomycin. That resistance has been noticed in the United States of America and in Japan, but so far it has not been found to be prevalent in this country. However, scientists at the university of Bath, university of Bristol and Southmead hospital say that all five major types of MRSA, including those seen in the UK, are now beginning to show signs of resistance to vancomycin. At this point, there are treatments that still work, but the concern is that time will be lost because of a trial-and-error process to find the right combination of antibiotics. At this stage, the HPA tells us that it has not found a VRSA problem in this country, but clearly it is becoming an issue for us.
  Clearly, efforts to instil and to reinforce a culture of zero tolerance of poor hygiene practice need to be redoubled. MRSA and other infections are not a fact of life with which we should attempt to reach an accommodation. To reach an accommodation with those infections is to accept that we will not be able to defeat them.
  1120
  When I asked the Under-Secretary of State for Health, the hon. Member for South Thanet (Dr. Ladyman), a question about research to develop new antibiotics to enable us to deal with concerns about the greater resistance to antibiotics of a number of infections, he said:
  "I am not aware of any, but the problem is of great concern to the Government and to the pharmaceutical industry. As someone who used to work in the pharmaceutical industry and whose pension is in part in its hands, I can assure him that I, more than anyone, would like to see new classes emerging. However, as far as I am aware, they do not exist and that is an issue for us to address."—[Official Report, Westminster Hall, 13 January 2004; Vol. 416, c. 237WH.]
  That was a perfectly legitimate response. It was helpful. The question is: how are the Government addressing that? I raise that in the context of the recent publicity surrounding the HPA's proposals to develop a vaccine development facility at Porton Down. I ask the Government whether they could outline tonight what they plan to do. Do they plan to have partnership arrangements with the pharmaceutical industry, to implore that industry to act, or to take direct action themselves of one sort or another—to ensure that there is a pipeline of antibiotics, so that we do not eventually reach a day when no antibiotic can stop those infections?
  One tool in the fight against infections is the use of isolation rooms. The Government will tell us that there is already guidance about the provision of such rooms. When I asked Ministers written questions about that to find out how the Government are satisfying themselves that that guidance is being followed through in practice, I was told that they had no plans to monitor compliance with the guidance.
  That is a cause for concern of itself but, when one asks whether guidance more generally to do with hygiene practice in hospitals is being monitored and audited systematically, we are told that it will be part of the work load of the Commission for Health Improvement but that there will not be a published national audit of the work that is done to ensure that there is compliance with those standards. Surely the public deserve to be able to satisfy themselves that their local hospital complies fully with those guidelines. How can Ministers satisfy themselves that those guidelines are being properly and sensibly adhered to locally? At the moment, there is no mechanism to enable them to do that.
  When I undertook a survey of health trusts just a couple of years ago, the Department of Health sent an e-mail suggesting that it would be far better not to answer my questionnaire but to direct me to the guidelines that were issued by the Department, rather than tell me what it was doing on the ground. It is a cause for concern that the Department did not seem to think that it would be a good idea for a Member of Parliament to find out whether guidelines were being followed and whether infection-control measures were being taken. Indeed, I was told in written answers that it would be disproportionately costly for the Department to collect that information.
  It seems that the Government's answer on isolation rooms is, "They will arrive by happenstance. They will arrive as a consequence of modernisation programmes in individual hospitals and new-build programmes but there will not be a concerted effort to ensure that they

  1121
  happen systematically." We heard just last week that, in a new hospital in Norfolk, the necessary air conditioning arrangements to ensure that the isolation rooms did not contaminate the rest of the hospital were not made. As a consequence, the rooms were allowing infection to spread around the hospital.
  The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): May I put the record straight, because there has been misinformation on that subject? Those positive pressure rooms were never used for the purpose intended. The problem was discovered before they were ever used. There was never any risk and there was never any infection spread through the hospital.
  Mr. Burstow: That is a good answer to a point but it raises concerns that those rooms were not used for their intended purpose because they were never fit for that purpose. The NHS is still not systematically providing the isolation rooms that are needed. What we hear in the Minister's reply is that we have a hospital that has purpose-built rooms that are not fit for the purpose and therefore cannot be used. I am grateful for the clarification but it does not come as a complete comfort.
  In 2000, in response to a National Audit Office report, the Government decided rightly to introduce a mandatory reporting system for MRSA. That was a welcome step. It revealed how big a problem it is. Since then, Ministers have rightly said that they intend to expand that surveillance system to capture information about other types of organism that cause illness and problems in hospitals. Again, it is unclear from all the written answers I have seen and from other exchanges on the matter in the past year what the timetable is for the roll-out of those other infection-surveillance systems. It would be helpful if that could be set out in detail today, in Committee or, more probably, in answer to a written question, so that we are clear.
  The hon. Member for South Cambridgeshire mentioned the patient environment action teams and the traffic light system that is used to give the public what I would call false comfort when it comes to issues of cleanliness in our hospitals. The truth is that the whole initiative should be prosecuted under the Trade Descriptions Act 1972. It does not address the key concerns about hygiene in our hospitals, yet it gives people the impression that it does. Even today, there are still occasions when it is cited as a measure in the Government's fight against infection in our hospitals. It is nothing of the sort. It is a useful programme in what it does, but it is not part of the fight against infection.
  The Bill puts in place the agency. It defines its powers and its relationship with the Department of Health, but some public health experts and academics have expressed the view that the laws governing public health need to be updated to deal with issues such as SARS.
  It would be useful if the Minister could give us some indication of the Government's thinking about whether there will be such a fundamental review in legislation, and if so, when we can expect to see that legislation.
  IT has been mentioned already, and I want to seek further clarification. The NHS has embarked on a massive IT procurement programme spanning several
  1122
  years. Good IT and communications will be important in making the surveillance network work effectively, but it is not at all clear Precisely where the HPA fits into the NHS procurement timetable. Can the Minister tell us?
  The Bill will put in place an important part of the public health infrastructure, but it deals only with the control of infectious disease, which is a significant part of the public health agenda but by no means the whole picture. That agenda also needs to address preventable disease, which often results from lifestyle in terms of sexual health issues smoking, obesity and so on.
  The Wanless report earlier this year painted the sorry picture of a history of stop-start—boom and bust, we could call it—in public health: reports were commissioned, but then gathered dust for years; reports were published and targets were set, but were never achieved. Under both the present Government and previous Governments, public health has been poorly served. The Bill is a useful measure, but a lot more will be needed in the White Paper if there is to be real progress in public health and a real improvement in the health of the nation
  6.11 pm
  Mr. Adrian Bailey: I welcome the Bill. I realise that as the attention of the nation is focused on events in Portugal, or perhaps on Wimbledon, it may not loom large on the public's radar, but although it is small it is important, and could have a profound effect on everybody in the country.
  The Bill is a logical progression in the organisation of the special health authority, and builds on the good work of that body over the past year. It is part of our civil contingencies strategy. In introducing the Bill, the Minister outlined the different bodies that will comprise the Health Protection Agency, and I shall not repeat all their names, but the essential thing is that they are all highly respected for their work over the years. They have expertise and they have carried out research, but they have all developed independently. Combining them into a single body will enable them to share good ideas and best practice.
  The need for that to be done was highlighted by what the Minister said about potential terrorist attacks. When such an incident occurs, it may not be immediately obvious which body is best equipped to respond. Perhaps more than one body should be involved—perhaps all of them. It is therefore logical to combine them in one Health Protection Agency, not only to speed the response, but to develop over time a culture of partnership working to maximise their effectiveness.
  I welcome the Bill because it also goes far beyond emergency response The agency will be an essential element in the strategic planning of health care. The specialist support for the rest of the NHS in terms of health protection will be better delivered by one body than by fragmented sources.
  The NHS is delivering an excellent and improving service to millions, day in, day out. None the less, its role is essentially reactive and patient-driven. In responding to the health needs of millions, it is acquiring information and data that could be immeasurably useful in identifying health trends and shaping public

  1123
  health policy. By collecting those data, analysing and interpreting them, the HPA will be able to identify gaps in health provision and shortfalls in capacity.
  As a national non-departmental organisation, the HPA will be able to assist the development of public health policy. It will be able to inform the debate on lifestyle choices, improving health and other areas of Government policy, so that others too, can play their part in promoting public health. The agency will have the opportunity to develop authority on health policy, which Governments will ignore at their peril. Previous speakers have mentioned the debate in the other place about the independence of the reporting, and I welcome that too.
  When Governments make recommendations on lifestyle and health policy, they are sometimes publicly vilified as promoting a nanny state. I believe that the work of the agency and its recommendations will provide an authority that will re Rice the chance of future Government health policy being depicted in such a negative way. The agency will have independence and authority, and therefore credibility. which will assist the Government in promoting health policies that will benefit everybody.
  In the essential successful working of the HPA, I regard partnership as the key theme. The quality and expertise of the agency is unquestioned, but it is not a big organisation, and it cannot transform public health policy on its own. The way in which it works with Government and with other local and international health agencies will determine how successful it is.
  I welcome the setting up of the nine regional and 36 local health protection teams, but in the other place Lord Warner commented that there had been
  "earlier difficulties with some PCTs"—[Official Report, House of Lords, 5 January 2004; Vol. 656, c. 15.]
  I hope that the memorandum of understanding that governs the relationship between the HPA and the primary care trusts will resolve those difficulties. My hon. Friend the Member for Erewash (Liz Blackman) defined the issues that need to be clarified, and effective working between the HPA and the PCTs is essential if the agency is to realise its full potential.
  The public health challenges that face the Government, such as hospital-acquired infections, TB, and above all, sexually transmitted diseases, have already been mentioned. I shall not repeat the statistics that have been cited in the Chamber already, but it is important that the HPA, in its surveillance role, should be able to provide backing for the other Government organisations, designed to construct a strategy to combat and eliminate those problems.
  There are issues yet to be resolved about precisely what the role of the HPA, as opposed to that of the local health organisations, will be. I am concerned that if we do not achieve early success in that regard, that role may be questioned, as a result not of tie agency's problems or incompetence, but of failure in other areas of policy delivery.
  That would be regrettable, and I ask the Government to look at those problems and ensure that the HPA's work is effectively translated into action on the ground to deal with them.
  1124
  Little has been said on partnership working internationally, so I shall touch on that. The report by the chief medical officer Sir Liam Donaldson, "Getting Ahead of the Curve", highlighted different threats to world health. It would seem that as soon as we eliminate one health hazard, another potentially more deadly one appears. Among the reasons that have been cited for that are global trade, migration, animal diseases and environmental changes. Those are in addition to the man-made risks, whether industrial risks or terrorist activity.
  Even Sir Liam Donaldson cannot have realised when he made his report in January 2002 how prophetic his utterances were to be. In a short time, we had the outbreak of the SARS epidemic, a truly international health threat arising from the very factors that he had outlined. My understanding is that the HPA played a vital role in the World Health Organisation's work to combat SARS, and it has subsequently signed a memorandum of understanding with a new health protection agency in Hong Kong specifically targeted at research, training and emergency planning relating to diseases originating in the far east. I see that as a most important development, and a potential health prototype that should be introduced in other areas. Will the Minister consider the possibility of setting up similar organisations to cover other parts of the world? The most obvious is Africa, where a range of infectious diseases run rife, to the detriment of the health of millions of people on that continent and with serious potential implications for people on other continents.
  Britain has huge expertise in the bodies that comprise the HPA. By bringing those bodies together, the Bill will improve communication, assist policy development and enable collective expertise to be targeted more effectively. It provides a model that could be developed by and with other countries, which could have a profound impact on public health throughout the world. I therefore welcome the Bill and support its Second Reading.
  6.22 pm
  Mr. Peter Lilley: I had intended to follow the excellent example of my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) and focus exclusively on the health policy aspects that the Bill raises, rather than on the bureaucratic reshuffle on which the Under-Secretary of State for Health, the hon. Member for Welwyn Hatfield (Miss Johnson) focused and on which the hon. Member for Erewash (Liz Blackman), who has temporarily left the Chamber, made a thoughtful contribution. However, in view of the Minister's failure to answer my question on the powers that this body is being given, I feel it necessary to return to that issue.
  The Bill gives as the main functions of the new body
  "the protection of the community… against infectious disease"
  and
  "the prevention of the spread of infectious disease".

  1125
  That is fine; we all support those objectives. However, the Bill goes on to give the agency apparently unlimited powers to achieve those objectives. It says:
  "The Agency may do anything which it thinks is—

  (a) appropriate for facilitating, or

  (b) incidental or conducive to,

  the exercise of its functions."
  I find that surprisingly open-ended. The Minister, who appeared to be rather unfamiliar with that provision, said that it was intended to enable the body to be independent of the Government, but as my hon. Friend the Member for Buckingham (Mr. Bercow) said, a body does not have to be omnipotent in order to be independent. Clearly, that provision has nothing to do with restraining interference from Ministers.
  I would therefore like the Under-Secretary of State for Health, the hon. Member for South Thanet (Dr. Ladyman), when he winds up, to tell the House what powers the agency will actually have. Will it, in its attempts to fulfil its function of preventing the spread of disease, have the power to detain people suspected of being infected? Will it have the power to distrain property thought to be carrying infection? Will it have the power to levy charges or impose fines on those who interfere with its attempts to restrict the spread of infection? Those are important issues. There could be arguments for giving a body such powers, but it would be unusual for the House to give them away without any restraint at all. without specifying in the Bill the circumstances in which they could be used and without any recognition by Ministers that such draconian powers were being conferred on a Government agency, albeit one acting at arm's length from the Government.
  Dr. Julian Lewis: My right hon. Friend has been in the House much longer than I have. In his long experience, has he ever come across a Bill that has given such an open-ended mandate to an agency in that fashion?
  Mr. Lilley: My hon. Friend makes a good point. I have cast my mind back to see if I can remember such a case, but I cannot. That might be—I have some sympathy with the Minister on this—because when one is dealing with a long Bill, one often approaches the Dispatch Box with some trepidation that one might be asked the meaning of one of the obscure and complicated clauses. One therefore tries to focus on what those clauses mean and perhaps misses the more obvious clauses at the beginning, so I may have missed such clauses in other Bills. However, I am not aware of this Bill having any precedent. I hope that the Minister will tell the House why this provision is included in such an unrestrained and draconian fashion.
  I really want to focus on the main issue raised by the Bill, which is the prevention of the spread of infections and in particular, the control of hospital-acquired infections—an issue of growing importance to the public, although the Under-Secretary did not mention it in her speech, nor does the publicity material on the Bill issued by the Government. That is a hugely important issue, so it is extraordinary that the relationship between this body and that problem was not discussed at the Dispatch Box.
  1126
  We know that nearly one in 10 patients who enter hospital acquire an infection there that they did not have beforehand. We know from the National Audit Office that an estimated 5,000 people at least die every year from superbug infections acquired in hospitals and that up to 20,000 may lose their lives through some involvement of superbugs in complicating other factors. We know from the European Union that the problem is more prevalent in British hospitals than in those of anywhere else in the European Union with the possible exception of Greece We know, too, that the problem is getting worse more rapidly in this country than anywhere else in Europe. We should like to know what role the Health Protection Agency will play in tackling that important problem.
  That is an important aspect of health to which the Government's main approach does not appear to be relevant. The Government's main approach is that all health problems can be solved by having billions of pounds rolled at them in the hope that they will eventually be tackled. However, if we succeeded in tackling the problem of hospital-acquired infections, far from needing extra resources, we would save many lives, and release vast resources for the treatment of other illnesses or to save the Exchequer money.
  It is extraordinary how little attention has been paid to that issue until recently. When I compare the uproar at the five people killed in the railway accident at Hatfield near my constituency—every one of whose loss of life was a personal tragedy—to the reaction to the fact that an estimated 5,000 people a year die as I have described in our hospitals, I cannot help but think that the treatment given to the matter by Government, politicians and, until recently, the media, has been disproportionate.
  When one thinks of the disparity between the Government's pursuit of what turned out to be illusory threats of biological warfare in the middle east and the actual biological warfare being fought and, it would seem, lost in our hospital wards through dirty and unwashed hands, one cannot help feeling that there is a disproportionate failure to recognise the seriousness of the problem.
  Dr. Julian Lewis: My right hon. Friend is most generous in giving way. One is tempted to comment on the paradox that he just raised by recalling the statement once made about a small number of deaths being a tragedy and a large cumber of deaths being a statistic. My right hon. Friend rightly points to basic failures such as not washing hands as being responsible for some deadly infections. Why, then, should we need a Health Protection Agency to put something right, when we all know what is wrong?
  Mr. Lilley: My hon. Friend makes another very good point. I hope that we do all know what is wrong, and I intend to investigate further the causes of this problem.
  I became interested in the subject partly as a result of cases that I encountered in my own "surgery", as we tend to call our advice bureaux in our constituencies. Over the years, I have met people who lost relatives as a result of infections acquired in the course of hospital operations or who themselves had acquired the infection and been maimed permanently by it. I was subconsciously aware that there was an issue there.

  1127
  Some years ago, I wrote a paper about the health service entitled "Patient Power". While I was working on it, I discovered the National Audit Office estimates of the scale of the problem. I campaigned for the publication of information authority-by-authority, hospital-by-hospital, on these sorts of problems, so that patients would have the power to take informed decisions on the basis of that information. It was as a result of the subsequent publication of such information that I learned that the trusts in my own constituency had very poor records at that time and were near the bottom of the national league table. Indeed, one was virtually at the bottom. I am happy to say that both those trusts now take this issue seriously and that both have improved their ranking markedly—they are now close to the national average.
  A little while ago, I had a meeting with the infection control directorate at the East and North Hertfordshire NHS trust, and a lengthy briefing from the clinical standards officer at the West Hertfordshire trust. I am glad that this issue is now being given priority locally: I would like to see it given an even higher priority at the national level and I hope that the HPA will play its role in that.
  We have to ask ourselves why, given the manifest dedication of most people who work in the NHS, to whom I pay tribute, does this problem exist, and why have we as a nation been so slow to face up to it? Part of the answer to the latter question lies in the fact that, as a former health Minister said, the NHS has become part of our national religion. As a result, we are reluctant to think that anything can go wrong within it. We do not want to accept or face up to the fact that it can be a place where illnesses are caused and acquired as well as cured and treated, but we must accept it. Moreover, the Government must face up to it. I am afraid that some people in government are still in denial about the problem and believe that it can simply be spun away or ignored, but it cannot and it must not.
  I shall not develop at great length—at least, not at this stage—the disgraceful episode that occurred last autumn. The Government issued a statement to try to pretend that they were doing something about the problem, but when asked to bring the statement before the House, they admitted that they were doing nothing new at all. That was symptomatic of the their attempts to deny the problem. The Minister's failure even to mention it today in the context of the Bill suggests that some in government are still in denial about the seriousness of the problem.
  Dr. Lewis: Does my right hon. Friend feel that one of the reasons why less attention is given to MRSA infection in hospitals than it should is that the people most affected by it are elderly patients? If it carried off larger numbers of younger people, perhaps there would be a stronger lobby. Is it not a disgrace that our elderly people are coming to think of host hospitals as places where, if they enter, they may not come out alive?
  Mr. Lilley: My hon. Friend's critique is valid. It is true that less attention is paid to the problem than would be paid to it if the majority of the victims were not elderly. However, let us not conceal the fact that people in the prime of life are affected, too, including an increasing number of children. All ages will be at risk if we do not tackle the problem vigorously.
  1128
  Why is the position getting worse—and getting worse faster—in this country than in most of our continental neighbours' countries? A number of explanations have been put forward. When I last spoke about the problem, Government Members suggested that it was due to the privatisation of the cleaning services in hospitals. On this issue, none of us should take refuge in defensive or doctrinal attitudes about what happened in the past. We should not be making partisan points. If the problem did result from the privatisation of the cleaning services, it should be changed. I would fully support that. I want to save lives, not impose a particular doctrinal arrangement on the organisation of the health service. Let us be clear: is this a serious charge? If it is, why have the Government done nothing to alter those arrangements and to bring back the cleaning services in house? Clearly, the Government do not believe that that is the cause of the problem.
  David Taylor: The right hon. Gentleman may be indirectly referring to me, as I sometimes raise that very issue—though not in the arbitrary terms that he suggests. Does he accept that the outsourcing of hospital cleaning can contribute to or worsen problems that already exist on the wards, even though the root cause of the problem may be a lack of adequate hand washing in the wards and elsewhere?
  Mr. Lilley: If I accepted that, I would want to do something about it and change it. I am sure that the hon. Gentleman, who is sincere and dedicated, would want to, too. Sometimes, however, I believe that others make the point for purely partisan political purposes. If the Government believed that analysis, they would surely want to change it. They do not believe it. Why not? I suspect that it is because it is not true.
  Some colleagues went with the BBC to Germany to investigate the same problem in German hospitals, which were pristine and sparkling clean, as one would expect, and run with Teutonic efficiency. The BBC journalist said that he imagined the Germans had such clean hospitals because they did not privatise their cleaning services, but the German doctors responded by saying, "Of course we do". They wanted expert, specialist people to clean their hospitals; they did not want the job to be left to people such as themselves who were not experts in the matter. The BBC journalist told the German doctors that it was a problem in our country and had led to poor standards, but they responded by saying that if the cleaning companies did not get it right, why did we not change the supplier or the cleaner? One thing that our present system does allow is changing the cleaner to secure a better one. Would it not be best to do that, rather than change the system?
  I visited a BUPA hospital and asked the same question. That hospital was also sparkling clean and infection free. I asked how that had been achieved and whether the hospital did all its cleaning in house. I was told that outside cleaners were used, but that the contract was managed properly. The hospital authorities insisted that the contractors had named cleaners responsible for each ward and the responsibilities were more than just for cleaning. They included changing the light bulbs, ensuring the supply of loo paper and so forth. That brought pride of ownership.

  1129
  It may be that the structure of the NHS does not allow NHS managers to manage their contracts properly. We should consider whether medical staff should have a greater say in handling such contracts and ensuring that contractors meet the highest possible standards of cleanliness.
  The NHS may be too centralised. Indeed, I asked the BUPA manager why he could do what NHS managers seemed unable to do. He said that he had been an NHS manager and the problem was that the NHS was so centralised that all initiative was stifled and it was difficult to introduce the sort of changes that he had made in his smaller hospital. The NHS may have problems that we should tackle, but we should not do so on a partisan, doctrinal or point-scoring basis. We need to get it right and save lives.
  Lack of ward cleanliness is not the prime cause of hospital-acquired infections or superbugs. It is essential that wards should be clean, although the impact on infection is probably secondary. However, standards of cleanliness influence the whole climate of a hospital. If one works in a clean, sparkling, bright and fresh environment, where every part of the hospital is clean—the loos and the entrances, as well as the wards; under the beds as well as beside them—one is more likely to be meticulous about observing the protocols for cleaning one's hands.
  The failure to wash hands between contacts with patients is the main way in which infections are transmitted in hospitals. The National Patient Safety Agency says that the hand-cleaning protocols are observed only 40 per cent. of the time in hospitals. That is a serious matter. Why should it happen? One explanation, which first appeared in a newspaper article and was republished in a pamphlet, is that the hospital authorities—matrons and other staff—do not have the power to discipline and insist that staff adhere to the protocols. The author, Harriet Sergeant, carried out research in hospitals and described one occasion in particular. She wrote that the matron
  "had shown me the apron and glove dispenser at the entrance of a side room containing an MRSA patient. Every nurse, she said, had to don a disposable apron and gloves before touching the patient, then remove them before leaving.
  As we chatted, I noticed a nurse walk in, see to the patient, then depart. She had not touched the dispenser. This was done in front of the matron and the infection control manager. Neither appeared to notice. In astonishment, I interrupted the two women. Had I misunderstood? It appeared not."
  The article goes on to say that the matron
  "tut-tutted. 'You've got to have eyes in the back of your head with these girls,' she said. The infection control manager nodded sympathetically—'Doctors are far worse'," she added. There was clearly no question of a reprimand for the nurse.
  The high levels of hospital-acquired infection are an indictment of NHS management, who have failed at every level to exert authority and pull together the groups involved for the benefit of the patient."
  I do not suggest that that story is typical, but it was told by someone who spent much time researching the issue. Ministers should say whether they are satisfied that matrons and others in authority in hospitals have the power to insist that staff follow protocols properly. If Ministers are not satisfied, they should produce proposals to reinforce and enhance the authority of those in charge.
  1130
  We should have every sympathy with the nursing and other medical staff involved, because the protocols put considerable demands on them. According to the NPSA, if nurses washed their hands with soap and water, they would have to spend 56 minutes—nearly an hour—of every eight-hour shift washing their hands to meet the requirements of the NICE protocols. If they use alcohol-based rubs, the time is drastically reduced to 18 minutes, but that is still quite a long time. A nurse may have to wash her hands up to 40 times in an hour.
  Considerable demands are made on nursing staff and we should investigate, whether that could be improved by introducing new Products. Since taking an interest in this subject, I have been contacted by several companies that claim to have new products that would disinfect hands better, without chapping them or requiring such frequent application. They say that their products are wonderful and would meet all requirements. I am not here to act on behalf of any pharmaceutical company, but they claim that because the protocols are laid down centrally by NICE, new products, such as those that do not contain alcohol—the protocols specify that hand cleansing must be done either with soap and water or with products that include alcohol—are precluded from consideration, even though they might be gentler on hands and not require such frequent application. The agency should investigate those alternatives and encourage the development of new procedures and innovatory products. That could make it easier for staff to meet the requirements and prevent the transmission of disease from one patient to another.
  Since I took up this issue, people email me and share their expertise. A former consultant microbiologist in an NHS hospital sent me an article he had written for the British Medical Journal. It said:
  "We have managed to keep MRSA out of our rehabilitation unit by a combination of pre-screening, rigorous hygiene and vigorous treatment. Any patients referred from the acute hospital wards require two clear sets of swabs—and if we find (for they are all swabbed on arrival) that they are MRSA positive then they are isolated and treated until clear."
  The email also states that
  "we have been put under pressure to relax our criteria because they delay transfers. It has been argued that our policy is out of step with the rest of the hospital; but then so is our infection rate. One patient of ours appeared to acquire the organism on the unit twice, each time after the visit of a surgical team.
  My correspondent also says:
  "With the imposition of targets, for instance the target to move people out of casualty departments within a set time, infected patients may get moved from ward to ward, thus exposing new staff and patients to the organism."
  That is a third explanation: targets are getting in the way of the application of the protocols and causing patients to be put at risk and shuffled around hospitals, which—as the Government's chief medical officer admits—is one of the causes of the spread of the disease in hospitals.
  Someone else wrote to me claiming that lack of research is the problem. He pointed out that in many other countries, research has been done and use made of bacteriophages, which eat viruses. He said that there is scope for research in that area, which might develop methods of tackling the problem that do not involve the use of antibiotics. Again, the agency could—and in my view should—do work in that area.

  1131
  It is also open to question whether we use antibiotics correctly. I do not just mean whether we use them too profusely, which is often suggested to be the problem. The Academy for Infection Management has been arguing that the delayed use of antibiotics, while waiting for laboratory tests on a particular infection, allows infections to take hold and spread; and that it would be better to use early after the discovery of an infection a broad spectrum antibiotic against the likely range of causative pathogens, especially the sort of agents that do not seem to give rise to resistance to those problems. The seven-year study known as MYSTIC—meropenem yearly susceptibility test information collection—suggests that drugs based on meropenem can do that and that, if used, would cut down the spread of those diseases and vastly reduce the need for people to go into intensive care units.
  Thus there are things that could be done. It is sad that, in the context of the Bill, the Government do not mention the problem that I have of outlined. It is sad that they seem reluctant to look creatively at what can be done and that, when faced with the problem, they simply regurgitate existing measures, pretending that they are new but admitting on subsequent questioning that they are not. It is sad that they are still in denial about the scale and seriousness of the problem.
  My overall conclusion is that if we are to tackle the problem, we must bring the Florence Nightingale culture back to our hospital wards, so that at every level people realise the importance of preventing such infections from taking hold and spreading. We must use every kind of imaginative development to ensure that the process is made easier for the medical staff who, in other respects, serve us so well in our hospitals.
  6.51 pm
  David Taylor: Like previous speakers, I welcome the Bill, which will clarify and codify the responsibilities of the HPA, with immense benefit for the population of our country.
  The contribution of the right hon. Member for Hitchin and Harpenden (Mr. Lilley) was very interesting, although I do not intend to speak at such length. First, I want to focus briefly on the specific duties of the agency in connection with radiological protection. I want to cite a constituency case that has been going on for some years, and I hope that the Under-Secretary of State for Health, my hon. Friend the Member for South Thanet (Dr. Ladyman), can give me some good news about that problem. Secondly, I want to examine the bodies with which the HPA must co-operate and from which it must accept direction. One such Government agency—the Environment Agency—appears to be delinquent and tardy in its response to a radiological problem.
  The Bill makes it clear that the HPA will absorb the National Radiological Protection Board and its prime functions, which, as set out in the helpful research paper, are
  "the acquisition of knowledge about the protection of mankind from radiation hazards… to provide it formation and advice to persons (including Government departments)"
  it is to that point that I direct the Minister's attention—
  "in relation to protection from radiation hazards either of the community as a whole or of particular sections of the community".
  1132
  The latter point relates to my constituency case. Will the Minister expand a little on how the agency will carry out that role, which was previously the responsibility of the NRPB?
  Clause 3 (4) states:
  "If a Health and Safety body asks the Agency to enter into an agreement with the body for the Agency to carry out any of the body's functions relating to radiation… on the body's behalf, the appropriate authority may direct the Agency to do so."
  Can the Minister tell me whether, in certain circumstances, the Environment Agency is considered a health and safety body? Can the Bill, when an Act, be used by my constituent to try to encourage the Environment Agency to act more effectively than it has been able to do so far?
  Clause 5(1) states:
  "In the exercise of its functions the Agency must co-operate with other bodies which exercise functions relating to health or any other"
  related matter. Subsection (2) notes that a body
  "other than the Agency mentioned"
  has a duty to co-operate with the agency. There is a mutual duty to co-operate, so can the Minister tell me whether the Environment Agency would be classified as a relevant body for the purposes of that clause?
  I shall give a little detail about the case I mentioned. It relates to the disposal of radium sources and comes under the Radioactive Substances Act 1993. I shall not go through the whole nine years of the case so far, but will highlight the problems for my constituent's firm, although the firm itself is not in North-West Leicestershire. My constituent states that, in 1995,
  "what is now the Environment Agency"
  issued an edict requiring
  "all Lightning Protection systems incorporating devices containing radioactive materials to have the devices removed, dismantled and disposed of by the year 2000".
  That was mostly complied with, but many devices were removed only after the deadline and some remain. Will the HPA have an advisory role about those residual lightning protection systems, especially when installed in locations such as school premises?
  In good faith, my constituent's firm continued to strip out those devices containing radioactive materials for some time but found that it was unable to dispose of the material satisfactorily. With the encouragement of the Environment Agency, the firm had taken into storage radium foils from premises and from competitor companies in the expectation and belief that there would be an ongoing route for disposal. However, four years after the deadline, the Environment Agency has not been able to provide my constituent's firm with such a disposal route, so it is storing radiological waste at its south Nottinghamshire headquarters that at some stage may prove a hazard to the people who currently work in the building, to future occupants of the building or even to people who may break into it—there have been thefts of equipment from the offices.
  The firm asks:
  "What are we supposed to do with this waste? What happens if our small company gets into difficulty leading to closure or… our offices are broken into? It strikes us that someone needs to take responsibility for sorting this out and not leave just our waste but presumably other radium source waste stored in small relatively unsecured pockets around the UK."

  1133
  When the HPA takes over the duties of the NRPB, will it have that responsibility?
  The firm notes:
  "Currently we hold many hundred sources of Radium 226 totalling an equivalent of 976 Mega bequerels."
  I conclude by summarising my questions for the Minister. Is the Environment Agency a health and safety body for the purposes of the Bill? Does it have a mutual duty of co-operating with the HPA and would it, therefore, have an interest in the case that I briefly set out? I should have liked to set it out at greater length in an Adjournment debate, but although I have been trying for several weeks I have been unable to obtain one. What advice can the Minister give me to pass on to my constituent and his firm? As the years roll by, they are getting extremely concerned about the possible health hazards of the material that they stored in good faith, at the behest of the Environment Agency, which has neglected its duty to offer the means for the safe and satisfactory disposal of those materials. I shall listen very carefully indeed to the Minister's reply.
  7 pm
  Dr. Julian Lewis: The House owes a debt of gratitude to all those hon. Members who have spoken following the initial brittle, unfleshed skeleton that the Minister outlined at the outset, for trying to add some substance to the debate. When one looks at the Bill's fine print, one sometimes forms an impression that it is designed largely to try to get round some of the self-inflicted problems brought about by the way in which devolution impedes the carrying out of the functions of the existing agencies, rather than introducing any major or substantive change to the way that the problems that the agencies are supposed to address will be addressed.
  It was a pleasure to listen to my right hon. Friend the Member for Hitchin and Harpenden (Mr. Lilley) renewing his gallant campaign on behalf of the victims of MRSA. I find it quite incredible that, in the 21st century, it is necessary for a politician of his seniority to have to plead with those who work in the health services to adopt the measures of basic hygiene, basic cleanliness and basic common sense that Florence Nightingale pioneered more than 150 years ago. It is quite deplorable that so many hon. Members find that our constituents tell us terrible tales of relatives—often elderly folk, as I said in an intervention—who go into hospital for one ailment and then contract an infection that, all too often, proves fatal.
  My hon. Friend the shadow Secretary of State for Health outlined the case for considering topics such as MRSA, HIV, TB and hepatitis C in the context of the Bill. He was right to do so, but the dimension that I wish to address is that which concerns the defence aspect, for which I have some responsibility on the Conservative Front Bench. The Bill has been portrayed as establishing an agency that will fulfil a valuable role if this country is subjected to chemical, biological or radiological assault. That needs further clarification because the sort of measures that are necessary to deal with those types of threat are very different.
  A chemical attack, if carried out, has a very quick effect. That was well seen in the sarin attack on the Japanese subway. A biological attack, by contrast, if
  1134
  carried out against animals, may make itself apparent somewhat more slowly, and if carried out against humans, much more slowly still. A radiological attack can be very slow indeed in making its effects apparent. So entirely different types of plan must be ready to deal with those emergencies if they come to pass. The threat and the attack need to be contained. If the attack involves one of the longer-lasting or slower agents to act, it needs to be traced and then treated. The Bill does not make it clear who will actually do that work.
  The research paper on the Bill prepared by the Library points out that the existing agency had already been involved in some exercises. I quote from the briefing material:
  "Two exercises based on the release of smallpox have already been conducted to assess the effectiveness of the major incident plans. More recently a field exercise based on the deliberate release of sarin, involving more than 200 volunteer casualties, was conducted in Newcastle. The exercise also included a desktop training exercise, where members of the health and emergency services planned a response to additional major emergency incidents."
  It quotes Dr. Nigel Lightfoot, director of the emergency response division at the Health Protection Agency, as saying:
  "We are very pleased with the way in which the day has gone. The procedures involved in the field exercise went so well that we finished an hour ahead of schedule."
  I felt on reading those words that there was something terribly British about all this and something terribly amateurish. I am concerned that, in focusing on the structures of the agencies to the extent that the Government have, they are taking their eye off the central question of how the agencies will relate to the people on the ground who must cater with a disaster if one were to occur.
  When the issue was raised in Committee in the other place on 3 March, Earl Howe said:
  "The first question that we must ask is how the provisions of the Civil Contingencies Bill interrelate with those in this Bill. The Health Protection Agency will have a major role to play in many types of civil emergency, yet the most that is hinted at in the Bill is that it will be obliged to,
  'co-operate with other bodies… which exercise functions relating to health or any other matter in relation to which the Agency also exercises functions'."—[Official Report, House of Lords, 3 March 2004; Vol. 658, c. GC 287.]
  But what are those bodies with which co-operation must take place?
  My hon. Friend the Member for Newark (Patrick Mercer) was involved in his responsibilities of shadow Minister for homeland defence—even though we do not have a Minister for homeland defence, despite the fact that we should—in taking the Civil Contingencies Bill through Committee. In doing so, on 29 January, he made a point about the civil contingencies reaction force—the volunteers on whom so much will depend if an attack is mounted and to whom my hon. Friend the Member for Rayleigh (Mr. Francois) alluded in an intervention. My hon Friend the Member for Newark said:
  "It is no coincidence that the CCRF has found itself extremely stretched in terms of declaring itself operationally ready. Just before the Bill's Second Reading—strange to relate—the Government said that the force was ready. However, the facts are rather less than the theory."—[Official Report, Standing Committee F, 29 January 2004; c. 89.]

  1135
  My hon. Friend went on to point out that, of the 7,000 CCRF volunteers who are supposed to be under arms, only 5,000 are physically accredited as part of the organisation. He then went on to make an extremely important point that further cuts that total: the sort of people who volunteer to undertake such dangerous duties are all too often the same people who already have a reserve liability with the armed forces and who, in the present climate and intensity of military operations, are already on call for dispatch to active service outside the United Kingdom's boundaries. So we do not have anything like that total of volunteers readily available, but the same applies, a fortiori, to the regular armed forces.
  The regular armed forces, with the normal emergency services, would be in the front line of tackling any of those catastrophic attacks if they were to occur. We know perfectly well the strain under which they are already labouring. Their morale is not improved by constant reports of imminent announcements from the Secretary of State for Defence—which have yet to happen but which we are pretty sure will happen—of major cuts in front-line forces. So we must ask ourselves how the new agency will be able to deliver what it is supposed to deliver.
  It is not even clear where the borderline will lie between what the agency is supposed to do and what the emergency services, armed forces and reserve civil contingency forces are supposed to do. When one looks at the Bill and in particular at clause 3, one sees under the heading "Radiation protection functions" that
  "The Agency has the following functions in relation to risks connected with radiation (whether ionising or not)"—
  and it gives two:
  "(a) the advancement of the acquisition of knowledge about protection from such risks;
  (b) the provision of information and advice in relation to the protection of the community (or any part of the community) from such risks."
  On reading that subsection, one is inclined to agree with the interpretation of my hon. Friend the shadow Secretary of State, who said in response to one of my interventions that, as far as he could see, much of the role of the Health Protection Agency is one of surveillance—as well as, perhaps, tendering advice. One wonders, given the agency's independence, what sort of advice and guidelines it will be given on how it should try to prepare the public for what might be a devastating attack by chemical, biological or radiological means.
  If I may be forgiven, I shall cast my mind back to the most recent occasion that I can think of when the problem of how much sensitive and worrying advice to give to the public was last aired. The year in which I remember that being a particular issue was way back in 1980, when there was beginning to be the stirrings of concern about the involvement of the United Kingdom both in a new generation of its own nuclear weapons and the basing here of certain American nuclear weapons. The anti-nuclear campaign pressed very hard for the Home Office advice to the public to be published, and under that pressure, it was published in the form of the "Protect and Survive" booklet. When it was published, the very people who had pressed for its publication proceeded to mock it, to rubbish it and to say how useless it was. I would not be surprised if the Health
  1136
  Protection Agency found itself faced with a dilemma when it considers that precedent, which I am sure will be brought to its attention.
  After all, we experienced an incident in this Chamber, after which it was said that not even the people present at the time had been given the correct advice on what to do in the event of the possibility that something of a chemical or biological nature had been thrown into the Chamber. Yet, when the security services came forward with advice on what they think we ought to do, straight away people were saying, "You are alarming the public; you are being unnecessarily alarmist. You are cutting off the House of Commons from the people." These issues are not easy ones to deal with. I hope that the Minister in his reply will make it clear to what extent it will fall to the new Health Protection Agency to decide what sort of information should be made public to educate the British people on how best to protect themselves in advance of such a terrible incident, and to what extent it will do so under Government authority.
  David Taylor: The hon. Gentleman describes the dilemma that the Government face, but the present Opposition face such a dilemma too. The Government are either over-zealous, nanny-stateist and alarmist, or they are neglectful of their duties, derelict in their duties and ought to be doing more. The Opposition have made a living out of that for the past three months or more.
  Dr. Lewis: That would be a fair point if the hon. Gentleman could show that the Opposition have made any remark about the nanny state or over-zealousness in the context of the serious issues that we are debating. I have been present for the entire debate and have not heard one such point made from the Opposition Benches. It obviously depends on the subject under consideration. When the Labour Government inflict their opinions on the public about ways in which they should conduct their lives that fall far short of the implications for serious security or life and death of the issues that we are discussing, it is quite right for us to describe them as over-fussy. When dealing with matters of gravity, such as those before us, the hon. Gentleman will not hear comments of that sort from the Opposition Benches.
  Mr. Lansley: I am interested in what my hon. Friend has to say, which he is setting out very well. Does he agree that the criticism that we might be trying to have it both ways is able to be made only when the Government have failed to tell us how they propose to deal with these matters? There is a problem with discussing the Bill in that clause 5, by its structure, effectively says nothing more than that the Health Protection Agency will co-operate with other bodies, unspecified, and that other bodies, unspecified, will co-operate with the Health Protection Agency. The argument about a list of such bodies is secondary. We need some idea of the manner in which the co-operation is to be carried out, by whom and in what structure.
  Dr. Lewis: My hon. Friend is absolutely right. In particular, we need to know the chain of command. What does the co-operation involve? Let us suppose that the Health Protection Agency decides that certain steps must be taken instantly in the case of a quick-

  1137
  acting chemical attack, a slow-acting biological attack or a very slow-acting radiological attack. Let us suppose that the Health Protection Agency comes up with the idea, "We'll need troops to do this and emergency services for that", but the troops and emergency services say, "That's all well and good but we haven't got the forces available", or "We've worked out rather different ways to tackle the problems." It sounds as if the people who will be theorising and conducting the surveillance—the people who are affected by the Bill—are not properly connected to those who will have to do the real work on the ground in such dire circumstances.
  David Taylor: To set the hon. Gentleman's point in context, the right hon. Member for Hitchin and Harpenden (Mr. Lilley) rightly focused on MRSA conditions and the worsening of that problem. All the increases in morbidity and mortality associated with MRSA pale into insignificance when compared with that linked to obesity and smoking—passive or otherwise. So, on the one hand, we have the overzealous nanny state, and on the other we are told that the Government are washing their hands of responsibility for MRSA—pun intended.
  Dr. Lewisrose—
  Mr. Deputy Speaker (Sir Alan Haselhurst): Order. Before the hon. Gentleman is tempted too far down that line, he might recognise—as I hope will the hon. Member for North-West Leicestershire (David Taylor)—that that point is taking us a little far away from the subject of the Bill.
  Dr. Lewis: I do, Mr. Deputy Speaker. With your indulgence, I shall respond with a single sentence. There is all the difference in the world between people who choose to overeat or to smoke and people who go into hospital because they are ill and who then fall victim to a hospital-acquired infection, without having exercised any choice.
  In line with your stricture, Mr. Deputy Speaker, I return to the Bill. I am concerned about the lack of clarity about connections between those who will be governed by the operation of the new agency and of the legislation and the emergency services, the armed forces and the civil contingencies reaction force. I was impressed by the point made by my right hon. Friend the Member for Hitchin and Harpenden, who referred to clause 4(2), which states:
  "The Agency may do anything which it thinks is—

  (a) appropriate for facilitating, or

  (b) incidental or conducive to,

  the exercise of its functions."
  What does that mean—the agency may do anything? Ought implies can, according to the basic moral philosophy lectures that I recall from all too many years ago, but we do not know what the agency's powers will be. I suppose it means that, provided that the agency has the power to do certain things, it will have the discretion to do them—but in what areas will it be able to exercise its authority? We do not even know whether the agency will have the power to require the emergency services,
  1138
  the armed forces or the reserve civil contingency forces to co-operate with its schemes. The subsection means both everything and nothing. It is all rather mystifying.
  Having touched on the information that the organisation may issue, the relationships that it might have, and the command structure that it needs but that is not clearly set out in the Bill, I am concerned that we are being asked to sign a blank cheque. If the Bill was about the ordinary business of life, we could say, well, sometimes we just have to leave discretion to people in high places to use their judgment as best they may; but the Bill deals with exceptional and grave situations. Whenever an attack occurs, be it a conventional military attack or an unconventional terrorist attack, the odds are that it will not have been predicted. All history indicates that that will be the case. We therefore have to work on the assumption that something will happen at some stage, and that when it happens it will be unexpected. For that reason, we need to have confidence that the structures ate in place to mitigate the impact of such an attack when it occurs—it will be too late to plan when the attack is under way.
  We are being asked to sign up to a template with few features, a plan with few details, a strategy with few conditions or explanations attached. As the Bill progresses, we will need a great deal more reassurance from the Government that they know what they are doing and that the agency will be something more than a purely bureaucratic and administrative reshuffling of the deckchairs on the deck of the Titanic.
  7.24 pm
  Mr. Mark Francois: It is, as ever, a pleasure to follow my hon. Friend the Member for New Forest, East (Dr. Lewis), who speaks with great authority, especially in relation to homeland security and defence. I cannot outdo his great knowledge of the subject, which was evident in his speech, but I should like to make a brief contribution from a certain perspective. I served in the Territorial Army for some seven years during the cold war. Part of my role was to serve as what was then called a nuclear, biological and chemical, or NBC, instructor. It was my job to train those in my unit to prepare for an attack using such weapons. The nomenclature has changed: in the 21st century, we speak of chemical, biological, radiological or nuclear—CBRN. The acronym has changed but the principles remain the same, and although I might be slightly rusty, points from the training that I did are relevant to the debate and, in particular, to the homeland security aspects of the Bill.
  Like other hon. Members, I am concerned about clause 5, which relates to co-operation. It is a brief clause, which lacks detail. Subsection (1) states:
  "In the exercise of its functions the Agency must co-operate with other bodies which exercise functions relating to health or any other matter in relation to which the Agency also exercises functions."
  That is extremely loose wording. In parallel legislation, the Civil Contingencies Bill lays out in detail the responsibilities of the various agencies that would be involved were such a nightmarish scenario ever to transpire in the United Kingdom. Part of the feedback from the emergency planning community is that hitherto—under Governments of different colours; my

  1139
  point is not partisan—the arrangements for dealing with such threats have been unclear. During the cold war and while we were threatened by attack from the Soviet Union, clear arrangements were in place governing what people should do in the event of such an attack. However, in the 1990s, those arrangements were run down to save money. The incoming Labour Government continued that process of running down, to the point where who would do what in a crisis became very unclear. All experience shows that in situations in which, for obvious reasons but particularly given the type of media that we have today, the civilian population might panic, it is vital that when time is short and people are under tremendous pressure, those with responsibility know precisely who has to do to what. Unfortunately, the Bill does little to help in that respect.
  Let me illustrate my point. Five or six weeks ago, a chilling "Panorama" programme envisaged a co-ordinated terrorist attack on London, with several bombs placed at major stations on the underground going off in swift succession during the morning rush hour, followed later in the morning by the explosion in the financial district of the City of London of a chemical tanker containing chlorine. Experts were invited to work through how they, sitting as a Cabinet Committee or its advisers, would respond to the attack. One of the participants pointed out that, whereas in the 1980s, every household had a "Protect and Survive" booklet to tell them what to do in the event of an attack, no such guidance is currently issued. People are advised to stay indoors and to turn on their radio, but families do not have information to hand that they can study and use to prepare themselves. I admit that not everyone would want to discuss such a gruesome subject over Sunday lunch, but if people had such material at home, they could read it. I wonder whether the Health Protection Agency could have a role in providing such information—in giving people non-alarmist, factual guidance on what to do in the event of an attack.
  Dr. Murrison: One particular problem is the distribution of iodine in naval ports, where a great deal of confusion has grabbed the headlines. Does my hon. Friend agree that in such cases the HPA could make an early intervention to clarify the position for people living in the area?
  Mr. Francois: That practical paint helps to amplify the argument that I am seeking to make. We cannot afford grey areas in such cases, and we must be clear about who is responsible and what they are responsible for. The HPA may play a role in clearing up those anomalies, providing a valuable service for the public, who need non-alarmist, clear, simple advice about what to do in terrible situations.
  Before concluding, I should like briefly to amplify the point about liaison that I made in an intervention. Evidence from unfortunate events around the world, including the sarin attack on the Tokyo underground network, show that it is critical to identify the agent used as early as possible. In the event, it was a non-persistent nerve agent, which can cause death, but dissipates relatively quickly. It is important in such scenarios that experts reach the scene urgently, analyse exactly what the agent is and report that information to a higher command so that appropriate counter-measures can be
  1140
  deployed in what emergency planning specialists call "the golden hour". The resources available in that first hour can have an exponential effect on the number of lives saved, so I suggest that there is merit in having liaison officers from the HPA attached to police units, fire and rescue service units—in many cases they would be the first to respond to such incidents—the regular Army battalion trained for a CBRN role, and the regional civil contingency reaction forces, comprising regular, but mainly Territorial, reservists deployed around the country, who would seek to respond within a matter of hours.
  HPA specialists should be attached in peacetime to those units, exercise with them and get to know their senior commanders so that if the grisly day ever came and we had to conduct such an exercise for real—please God that we never do, but we cannot discount the possibility—they would be embedded in those units, and could liaise with them, with the result that everyone would be likely to respond much more quickly and efficiently. The HPA would learn quickly exactly which agents were used, helping it to plan countermeasures that might subsequently save a large number of innocent lives. I hope that the Under-Secretary of State for Health, the hon. Member for South Thanet (Dr. Ladyman), is prepared to consider that practical suggestion.
  This is an important subject, and it is worrying that the Bill is vague about it. The Bill will go into Committee next week, and I hope that in our detailed scrutiny of it we can examine those questions in greater depth. In a non-partisan way, we put the Minister on notice that we intend to raise the matter. We would like him to do some homework and liaise with other Departments so that in Committee he can provide us and the people whom we represent with adequate reassurances.
  7.33 pm
  Dr. Andrew Murrison: We have had a good debate, although I am a little disappointed. I arrived thinking that I would learn how the Health Protection Agency would help us to provide better public health for the population. Our constituents clearly want such provision, but there have been serious shortcomings over the past few years. However, at the close of our debate, I am none the wiser.
  We want to know, as a number of Members have said, precisely how the HPA, under its new constitution, will make a difference to public health. We have been gravely disappointed, as has been said in our debate, by the Government's record on a number of issues. We accept, of course, that the reconstitution of the agency is a step in the right direction, and accept entirely the Government's good intentions. However, in Committee we need to know chapter and verse why they think that the new agency will help.
  As with any Government intervention, it is not beyond the realms of possibility that it may do some harm. The National Radiological Protection Board is concerned about that, and a few red flags have been raised in our debate, particularly by Conservative Members. The NRPB is intimately involved in plans to deal with disasters involving nuclear plants, and I share its concern that it is possible that some of its expertise and esprit de corps will be watered down in the new

  1141
  arrangements. I am not saying for a moment that that will happen, but we have to be alive to the possibility that it might. We should not assume that those changes are necessarily all for the good, although I accept on balance that most of them are. I hope that in Committee Ministers can give us examples of the way in which public health will improve as a result of the changes that they envisage.
  I do not intend to rehearse the public health issues that are to the fore and where things have not been done terribly well. They are a matter of public record, and hon. Members have mentioned tuberculosis, sexually transmitted disease, teenage pregnancy, and—a minor issue, but an important one for those affected—the debacle over disposable instruments for tonsillectomy. In its new guise, the HPA may wish to look at that ongoing issue, as I have found it difficult to get any agency to assume responsibility for the problem. Other recent issues that we have heard about include MRSA and the scandal of hospital-acquired infections.
  "Getting Ahead of the Curve" says that the agency was initially to be called the national infection control and health protection agency. Of course, we do not want to be long-winded, but it would he interesting to know the thinking behind the deletion of the first part of that descriptor and whether it has any significance other than a laudable desire to be brief. We have rightly heard a great deal about the need for cross-cutting, interdepartmental solutions. We remain confused about exactly how the HPA will work. Will its role be advisory or investigative? Will it conduct surveillance, or will it have to do the job of protecting public health itself? I suspect that the latter does not apply, because to get the job done it would need the co-operation of a large number of agencies. Who will have responsibility for turning recommendations into action, and how will that work? I wonder, perhaps mischievously, whether the Minister has examined the Public Health Act 1848, which established the General Board of Health. That model was recently dug up and commended by the Nuffield Trust as a way of getting to grips with public health. The board took charge of public health and achieved improvements. It did not just study things, but delivered results. Our constituents want action on the various things that I mentioned, including TB, hospital-acquired infection, MRSA, teenage pregnancy and so on.
  I am not entirely certain about the direction that Ministers intend the HPA to take. Will it deal chiefly with crisis events such as the terrorist threats that we face in the 21st century and novel threats arising from infections, or it will be more of an elective body? Under the powers that Ministers might give to it, will the HPA look at factors that affect the health of the population in a more elective way? I am thinking particularly of the challenges of obesity, for example. In what way do Ministers see the HPA developing in the years ahead?
  We need to look at public health in the round. We cannot simply consider the HPA in a debate such as this, because everything links together. The hon. Member for Sutton and Cheam (Mr. Burstow) was worried about fragmentation in public health, and he is right to be, although I am a little unclear as to his party's intentions in that regard. My understanding was that the Liberal
  1142
  Democrats were keen to alloy public health to local government, but it is difficult to determine whether he would rusticate parts of public health in that way. How would he avoid the charge of fragmenting the public health function? No doubt that will be explained in due course, but he is right to worry about the possibility of fragmentation.
  I must point out, however, that we now have things called clinical networks, which are a far more sophisticated way of linking expertise within health institutions. Perhaps that is a model that needs to be commended. We should not imagine that health professionals act in isolation; clearly they do not. They talk to each other. Indeed, they probably talk to each other far more than they talk to their managers, for example. That is how these things tend to work. So let us not assume that, just because there is not a wiring diagram somewhere, people do not talk to each other. Of course they do.
  Ministers need to decide where the public health function should lie. Should it lie at primary care trust level, or is that too low? Is a small PCT serving a population of 100,000 the right place to invest our public health resources? Arguably not. It is arguable that this should be done at a more strategic level. All these matters need to be considered by Ministers if we are to improve public health delivery, because delivery, rather than structures is the important thing at the end of the day.
  I have to mention tuberculosis: we need an action plan for TB. I hope that the Minister will give us a clue—an updated clue, perhaps, because I first asked for one in March—as to where the action plan is. Without one, it is difficult to know what to do with this escalating problem. A number of professionals have written to me about TB; it is clearly a matter that taxes the profession as well as the poor people who are affected by the condition. In a letter published in The Sunday Times on 30 May this year, Dr. Peter Davies, a consultant respiratory physician, wrote:
  "Dr. Reid is selective in his letter on NHS improvements. In the past decade tuberculosis cases have increased by 40 per cent. across the UK and have doubled in London yet the government has still not published its action plan on tuberculosis and, as a result, no extra resources are available."
  That is deeply worrying. This is not for want of asking on our part, and I hope that the Minister will give us an updated idea of when we can get the TB action plan. Presumably, the HPA will be looking out for that plan just as much as we are.
  We would also like to know, please, when the action plan on hepatitis C will see the light of day. We have rightly heard a great deal about the disease; in many ways, it is a covert disease, and a condition that many of us know very little about. We need an action plan to address this problem as well.
  Several right hon. and hon. Members have mentioned hospital-acquired infections. My right hon. Friend the Member for Hitchin and Harpenden (Mr. Lilley) made an eloquent exposition on the subject, and I was also interested to hear his thoughts on iatrogenic illnesses—those conditions that people acquire as a result of being treated. He was right to point out that most of us do not want to think about the possibility that our doctors and nurses might actually co us harm. Sadly, though, that is

  1143
  sometimes the case, and we need to address that issue as a matter of urgency. I hope that the HPA will take an early view on that.
  Most of this is not rocket science. We have heard about directors of infection control and a new working group being introduced as the Government's response to this crisis, but really it is to do with basic practices such as hand washing. Thinking back to my time as a medical student and a doctor, I remember wandering round in a white coat that was rarely changed from one month to the next, and I know that I was not unique in that, although I hear the Minister tut-tutting from a sedentary position. I was also probably as guilty as anyone else of wearing a tie which, tad it been swabbed microbiologically, would have shown some remarkable results. We have seen a lot of material in the recent published literature about such issues.
  Perhaps the HPA will consider advising doctors not to wear ties, or to wear bow ties. Perhaps the more outrageous of them might wish to adopt the wearing of a cravat. The problem of hospital-acquired infection has clearly been identified, and some of the clothes that doctors wear are a possible source. One solution would be to change doctors' habits, yet we have not seen a concerted effort to do that. So we need action on that, and I hope that the HPA will provide at least some of it.
  I was interested in hon. Members' descriptions of hand washing. I recently served in Iraq as a regimental medical officer, and I became accustomed to washing my hands all the time using alcohol washes of some kind. My right hon. Friend the Member for Hitchin and Harpenden expressed concern about the risks involved in the repeated use of alcohol rubs, but the modern ones do not cause too much of a problem in that respect, and it becomes second nature to use them. If I can be persuaded constantly to wash my hands in that way, I am sure that most health professionals can. It really is not that difficult. Of course, in Iraq, it is absolutely imperative. There, even more than in this country, hygiene is essential in preventing cross-infection.
  Probably the most damning remark that I have heard in this regard came from Professor Hugh Pennington of Aberdeen university, who is on record as saying that he has investigated slaughterhouses that have been cleaner than some hospitals. That is rather graphic, but sometimes graphic is what is needed. If we are to address this problem, perhaps more words like that are needed, and if respected physicians such as Dr. Pennington are making such remarks, we certainly need to listen.
  I am uncertain about the remit of the HPA, and I am concerned as to where Ministers might be leading it. Indeed, I think that they might h the only a vague idea of where they would like it to go I am mystified as to whether it will do crisis management, focusing more or less exclusively on infectious disease, or whether it will look at broader health-related problems, such as obesity and smoking. Perhaps the Minister will give us some idea about that when he responds to the debate. If he is unable to do so in the limited time available, perhaps we can flush that information out of him in Committee.
  I was interested to hear hon. Members' remarks about the National Radiological Protection Board, and I have written on my notes: "Wax lyrical about the NRPB". Unfortunately, time will not allow me to do that, so I
  1144
  must abbreviate my comments. I was going to wax lyrical about the board because, in a previous incarnation, I worked fairly closely with it and developed a healthy respect for the organisation. It is worried about its access to Ministers. I know that it treasures that access, and feels that direct access to Ministers by a body of that sort is necessary. I hope that the Minister will be able to say that his door will always be open to the director of the NRPB, or whoever heads up the board.
  The advice that the NRPB gave in the aftermath of Chernobyl is an example of how well it is regarded internationally, and it would be a great pity if that regard were to be watered down. It would be a particular pity if the ethos of the NRPB were to be diluted in any way, or if its personnel were to find their morale or expertise being degraded as a result of any of these changes.
  I am sure the Minister would join me and say that he would want to do nothing that might jeopardise the high reputation that the NRPB rightly enjoys.
  I am worried about co-operation with other bodies. Several hon. Members mentioned that today, including my hon. Friend the Member for New Forest, East (Dr. Lewis) and the hon. Members for West Bromwich, West (Mr. Bailey) and for North-West Leicestershire (David Taylor). All of them, in one way or another, touched on concerns that stem from clause 5. The chief problem is that the Bill is vague almost to the point of being meaningless on the interaction of the HPA with other bodies. We do not know which they are or what form the interaction will take. The Bill is also opaque as regards their duty to interact with the HPA.
  That is cause for particular concern in the context of civil contingencies. We need clarification of lines of responsibility in the event of the disasters that my hon. Friends the Members for New Forest, East and for Rayleigh (Mr. Francois) mentioned. That is lacking from the Bill, and I hope that in Committee it will be clarified to our satisfaction.
  The reference made by my hon. Friend the Member for Rayleigh to liaison with military units is crucial. Again, I have some experience of that. Although there will always be interaction on an individual level—arguably that is the most profitable way in which organisations interact—nevertheless that needs to be formalised. I should have thought that the Bill was exactly the place for that to be set out, but sadly that seems not to be the case.
  Clause 7, which deals with the publication of information, exercised noble Lords in another place. We shall have to bring Ministers back to the matter in Committee. The clause uses the rather sinister phrase,
  "not in the public interest"
  as a reason for non-disclosure of information. That is a worrying turn of phrase. My noble Friend Lord Fowler said that the alarm bells started ringing whenever he heard that kind of language used. Many of us see red when we read it in the Bill. We need to know what will be in the public interest. Ministers should tell us the circumstances they envisage when publication of information will not be in the public interest. Obviously,

  1145
  they cannot specify each eventuality, but a description of the sort of situations that would make Ministers consider the publication of information not to be in the public interest would be extremely useful.
  It is important that we focus on the national programme for IT in the NHS in the context of information gathering. We heard nothing today about how the national programme for IT in the NHS might fit into the plans laid out in the Bill. We hear stories that the programme is behind schedule. If it is, we clearly have cause for concern. I hope the Minister will tell us that that is not the case. The Prime Minister has said that he thinks an attack on this country by somebody with ill intent is almost inevitable. The HPA will be heavily involved if that occurs. If there is an attack using biological weapons, IT will be essential in providing an early warning. I hope any plans for IT in the NHS will give priority to the HPA.
  We have not dealt a great deal with devolution and how it impacts on the Bill. Clause 3 contains plans for the National Radiological Protection Board, which appears to be a UK-wide body under the new arrangements, yet clause 2 dealing with infectious diseases seems to set up barriers between the nations of the United Kingdom. It is not entirely clear why that should be. I intervened on the Minister to try to get an answer to that. Perhaps the Under-Secretary of State for Health, the hon. Member for South Thanet (Dr. Ladyman), will give us some idea why there is that difference between clauses 2 and 3. The hon. Member for Erewash (Liz Blackman) mentioned the HPA in the context of devolution. My memory is a little hazy about the exact point that she was trying to make, but no doubt she would appreciate an answer as well.
  I am slightly concerned about the cost of the HPA, who will pay and where the money will come from. That is dealt with briefly in paragraph 19 of schedule 1, where we learn that the devolved Parliament and Assemblies will contribute, or chip in, at a level that they will determine. That is confusing, especially as regards giving the HPA tasks that it considers appropriate and which are agreed with the Secretary of State in England. I am worried about the devolved bodies chipping in, as that is not prescriptive. I am also worried about the projections for future earnings by the HPA, which will earn quite a lot of money, particularly as the Centre for Applied Microbiology and Research develops its virus facility in Porton Down.
  We need to know how much money the HPA will be operating with. There appear to be two unknowns: first, how much the devolved Assemblies will contribute, and secondly, how much will be earned by the HPA from outside bodies. It is important, because we need to know from year to year how much the HPA will have. We also need to be reassured that there will not be a ratcheting effect, whereby the more the HPA earns, the less the Government are prepared to commit on a yearly basis to its important work. We all know, especially in view of the kind of work that the HPA will be doing, that outside earnings can be unpredictable. The agency needs to be able to predict fairly closely how much money it will have for its functions.
  Mr. Geoffrey Clifton-Brown: My hon. Friend has read the Bill carefully and will know
  1146
  that paragraph 20 of schedule 1 states that the devolved authorities may make loans to the agency—that is, the HPA. Sub-paragraph (3) goes on to say:
  "A loan may be made on such terms (including terms as to repayment and interest) as the person making the loan decides."
  Would my hon. Friend like to take out a loan from his bank manager on those terms, without any negotiations taking place?
  Dr. Murrison: I am grateful to my hon. Friend. I would certainly like to take out a loan from my bank manager if I were able to dictate the terms. That ties in with the issue of the devolved Assemblies deciding what they will contribute to the budget of the HPA. That needs to be more clearly laid out.
  We have had a far-ranging debate, Mr. Deputy Speaker, and you have been extremely patient in allowing a broad debate on public health issues. It is a shame that in her remarks the Minister did not touch on the public health concerns of our constituents. I hope that the Minister might deal with subjects such as tuberculosis, hospital-acquired infection, teenage pregnancy and chlamydia. We want to know not just about the structure of delivery of public health, but precisely how Ministers plan to address the important public health issues that face us.
  7.58 pm
  The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): I join the hon. Member for Westbury (Dr. Murrison) in his paean of praise for the National Radiological Protection Board. In a previous incarnation I, too, worked closely with the NRPB. I worked in the building next door. When the building that the NRPB occupied was used for filming an episode of "Dr. Who". it was one of the few occasions that I can recollect when one could see a cyber man eating his sandwiches on the lawn in the sunshine. The standard of science in the NRPB was always of the highest quality, and I congratulate the board on the work it has done in the past.
  As the Under-Secretary of State for Health, my hon. Friend the Member for Welwyn Hatfield (Miss Johnson) said when she opened today's debate, the establishment of the HPA was first proposed in "Getting Ahead of the Curve", the chief medical officer's strategy for infectious disease and other aspects of health protection. She also explained why it was decided to create the agency through a two-stage process, and that the Bill is the second stage of that process.
  The HPA special health authority came into existence on 1 April 2003, and the Bill will complete that process by establishing the agency in UK-wide legislation as a non-departmental public body and by giving it the full range of functions that were envisaged for it in "Getting Ahead of the Curve" which highlighted the diversity and constantly changing nature of the threats to public health that we face.
  The rationale for creating the agency was the recognition that the existing structure for health protection in this country needed strengthening in order to manage those threats. In particular, the specialist support for health protection on which the NHS and local authorities rely was fragmented among a number of different bodies and individuals. Those included the

  1147
  Public Health Laboratory Service, the national focus for chemical incidents, regional service providers, the National Radiological Protection Board, the Centre for Applied Microbiology and Research, as well as local consultants in communicable disease control and regional health emergency planning advisers.
  That fragmentation was a concern, and the Government concluded that the delivery of health protection services at both local and national levels could be improved by combining the functions of those bodies and individuals in a single organisation. That will allow the agency to function as a one-stop shop, capable of providing the expertise for dealing with any scenario. It should also enable a greater degree of cross-fertilisation of good ideas and good practice between the different fields of health protection
  As the Under-Secretary of State for Health, my hon. Friend the Member for Welwyn Hatfield and I have already said, the agency was first created as a special health authority and already provides the UK Government with stronger and more integrated arrangements for health protection. The HPA has also strengthened our ability to respond to threats from chemical and biological terrorism. In particular, it has co-ordinated a number of training exercises and has recently issued a set of clinical action cards for GPs that contain advice on identifying and treating victims of chemical or biological attack.
  I shall deal with some of the points raised by hon. Members in the debate. The hon. Member for South Cambridgeshire (Mr. Lansley) was somewhat churlish in his comments about the Government's review of arm's length bodies. He might have mentioned that one of that review's objectives is to save £500 million by 2007–08, but that seemed to slip his memory.
  My hon. Friend the Member for Erewash (Liz Blackman) pointed out that the agency will have the scope to raise standards. It will have the powers and the independence to publish what it likes, when it likes. [Interruption.] I realise that the hon. Member for South Cambridgeshire spoke for a very long time, but he did not say an awful lot that is worth responding to, although I shall return to one or two of his points.
  My hon. Friend the Member for Erewash asked about the types of bodies that must co-operate under the Bill. It would not be practical to list all such bodies in the Bill, but we do not envisage that they will find it difficult to recognise themselves. Such bodies will include NHS bodies, local health 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. We regard co-operation between such bodies as essential.
  Dr. Murrison: Will the Minister give way?
  Dr. Ladyman: No. The hon. Gentleman spoke for a very long time. Although well-paid hon. Members are present tonight, I am sure that less well-paid members of Palace staff want to get away to do other things this evening, and we should have shown them a little more respect.
  The hon. Member for Sutton and Cheam (Mr. Burstow) pointed out that the Bill should be about more than administration. Creating the agency is about
  1148
  more than administration, and its work will be much more important than just administration. However, the Bill itself is about the creation of a new body and the relevant structures; it is not about the public health agenda in its wider aspects. The Bill is a Bill; it is not an action plan or the public health plan that Conservative Members have gone on about all day. It is only the generosity of the Deputy Speakers during the day that has allowed them to wax lyrical on many pet subjects, some of which are important, but are not necessarily pertinent to the Bill.
  My hon. Friend the Member for West Bromwich, West (Mr. Bailey) rightly pointed out that the agency will have a strategic planning role for national health. He pointed out that by its nature the NHS is reactive, and that the HPA can have a proactive role. He also highlighted the important principle of partnership working.
  The right hon. Member for Hitchin and Harpenden (Mr. Lilley), the hon. Member for South Cambridgeshire and others raised the subject of methicillin-resistant Staphylococcus aureus. The right hon. Member for Hitchin and Harpenden has discussed MRSA on previous occasions. I know that he takes a great deal of interest in that subject, and I congratulate him on that, and on the thoughtful way in which he put his points. However, he also made a lot of party political points, before saying that we should not make party political points and going into the thoughtful section of his speech.
  The right hon. Member for Hitchin and Harpenden and the hon. Member for South Cambridgeshire highlighted the success of countries such as the Netherlands and Denmark and asked why they do not have the same problem with MRSA as us. One reason is that those countries did not suffer the misfortune of 18 years of Tory Government, and as a consequence they did not lose the culture that is necessary to ensure cleanliness and action against infection, and the building fabric of their health services did not fail.
  Dealing with MRSA is not only a matter of cleanliness, although that is clearly part of the equation. The matter also concerns the built environment and the availability of single rooms. We must create hospitals where such infections can be resisted and a culture of behaviour to prevent the spread of infection. None of those things happen overnight. We have implemented measures on all of them, and I am confident that we will see great improvements in the control of MRSA as a consequence of those changes.
  My hon. Friend the Member for North-West Leicestershire (David Taylor) raised a constituency case. I encourage him to write to me with more details and I shall ensure that it is examined. He asked whether the Environment Agency was a health and safety body under the Bill. The answer is no. Health and safety bodies under the Bill are defined in clause 3(7). My hon. Friend also asked whether the agency could co-operate with the Environment Agency under clause 5 and the answer to that is yes. We shall look into the matter that he raised.
  The hon. Members for New Forest, East (Dr. Lewis) and for Rayleigh Mr. Francois) raised defence issues that are important and fascinating but, for the most part, frankly irrelevant to today's debate.

  1149
  We live in a dangerous world where we are at war with terrorists. That war has gone on for many years and will continue for many years. Tragically, in this country, we know the consequences of terrorist attacks and we can expect terrorists to try—and they may succeed—to acquire biological, chemical and radiological weapons in the future. That is why it is essential to have a health protection agency that is capable of building up a body of expertise and helping us to manage the potential threats.
  We hope that such attacks will never come to pass—we must hope for the best and prepare for the worst. That is what the agency will do. We should not forget that mother nature can bowl the odd googly, as we have seen with recent outbreaks of SARS and the tragedy of HIV. We need an agency that is capable of focusing expertise and giving us genuine independent advice. The Bill creates exactly that in the new Health Protection Agency. I commend it to the House.
  Question put and agreed to.
  Bill accordingly read a Second time.

  HEALTH PROTECTION AGENCY BILL [LORDS] (PROGRAMME)
  Motion made, and Question put forthwith, pursuant to Orders [28 June 2001 and 6 November 2003],
  That the following provisions shall apply to the Health Protection Agency Bill [Lords]:

  HEALTH PROTECTION AGENCY BILL [LORDS] (PROGRAMME)
    Committal
    1. The Bill shall be committed to a Standing Committee.

    Proceedings in Standing Committee
    2. Proceedings in the Standing Committee shall (so far as not previously concluded) be brought to a conclusion on Thursday 1st July 2004.
    3. The Standing Committee shall have leave to sit twice on the first day on which it meets.

    Proceedings on consideration and Third Reading
    4. Proceedings on consideration shall (so far as not previously concluded) be brought to a conclusion one hour before the moment of interruption on the day on which those proceedings are commenced.
    5. Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at the moment of interruption on that day.
    6. Sessional Order B (programming committees) made on 28th June 2001 shall not apply to proceedings on consideration and Third Reading.

    Programming of other proceedings
    7. Any other proceedings on the Bill (including any proceedings on consideration of Lords Amendments or on any further message from the Lords) may be programmed.—[Mr. Ainger.]
    The House divided: Ayes 230, Noes 36.

    Division No. 198]

    [8:09 pm

    AYES

    Ainger, Nick

    Baird, Vera

    Ainsworth, Bob (Cov'try NE)

    Barnes, Harry

    Alexander, Douglas

    Bayley, Hugh

    Allen, Graham

    Beard, Nigel

    Anderson, rh Donald (Swansea E)

    Begg, Miss Anne

    Armstrong, rh Ms Hilary

    Beith, rh A. J.

    Atkins, Charlotte

    Benton, Joe (Bootle)

    Bailey, Adrian

    Berry, Roger

    1150

    Best, Harold

    Havard, Dai (Merthyr Tydfil & Rhymney)

    Blackman, Liz

    Blears, Ms Hazel

    Healey, John

    Blizzard, Bob

    Hendrick, Mark

    Bradley, Peter (The Wrekin)

    Hesford, Stephen

    Brennan, Kevin

    Heyes, David

    Bryant, Chris

    Hinchliffe, David

    Buck, Ms Karen

    Hodge, Margaret

    Burden, Richard

    Hoon, rh Geoffrey

    Burnham, Andy

    Hope, Phil (Corby)

    Burstow, Paul

    Hopkins, Kelvin

    Cairns, David

    Howarth, rh Alan (Newport E)

    Campbell, Alan (Tynemouth)

    Howarth, George (Knowsley N & Sefton E)

    Campbell, Mrs Anne (C'bridge)

    Campbell, rh Sir Menzies (NE Fife)

    Howells, Dr. Kim

    Hoyle, Lindsay

    Casale, Roger

    Hughes, Beverley (Stretford & Urmston)

    Challen, Colin

    Chidgey, David

    Hughes, Kevin (Doncaster N)

    Clapham, Michael

    Humble, Mrs Joan

    Clark, Mrs Helen (Peterborough)

    Hurst, Alan (Braintree)

    Clark, Dr. Lynda (Edinburgh Pentlands)

    Hutton, rh John

    Iddon, Dr. Brian

    Clark, Paul (Gillingham)

    Irranca Davies, Huw

    Clelland, David

    Jackson, Helen (Hillsborough)

    Clwyd, Ann (Cynon V)

    Jenkins, Brian

    Coaker, Vernon

    Johnson, Alan (Hull W)

    Coffey Ms Ann

    Johnson, Miss Melanie (Welwyn Hatfield)

    Cohen, Harry

    Colman, Tony

    Jones, Helen (Warrington N)

    Cook, Frank (Stockton N)

    Jones, Kevan (N Durham)

    Jones, Lynne (Selly Oak)

    Cook, rh Robin (Livingston)

    Keeble, Ms Sally

    Corbyn, Jeremy

    Kemp, Fraser

    Corston, Jean

    Khabra, Piara S.

    Cotter, Brian

    Kidney, David

    Cousins, Jim

    Kilfoyle, Peter

    Cryer, Ann (Keighley)

    King, Ms Oona (Bethnal Green & Bow)

    Cryer, John (Hornchurch)

    Cummings, John

    Kirkwood, Sir Archy

    Cunningham, Jim (Coventry S)

    Knight, Jim (S Dorset)

    Cunningham, Tony (Workington)

    Kumar, Dr. Ashok

    Darling, rh Alistair

    Ladyman, Dr. Stephen

    Davey, Edward (Kingston)

    Lawrence, Mrs Jackie

    Davey, Valerie (Bristol W)

    Laxton, Bob (Derby N)

    Davies, Geraint (Croydon C)

    Lazarowicz, Mark

    Dawson, Hilton

    Lepper, David

    Dean, Mrs Janet

    Leslie, Christopher

    Dhanda, Parmjit

    Lewis, Ivan (Bury S)

    Dismore, Andrew

    Linton, Martin

    Donohoe, Brian H.

    Lucas, Ian (Wrexham)

    Doughty, Sue

    McAvoy, Thomas

    Dowd, Jim (Lewisham W)

    McCabe, Stephen

    Drew, David (Stroud)

    McDonagh, Siobhain

    Eagle, Angela (Wallasey)

    McDonnell, John

    Eagle, Maria (L'pool Garston)

    Mclsaac, Shona

    Farrelly, Paul

    McKenna, Rosemary

    Fisher, Mark

    Mackinlay, Andrew

    Fitzpatrick, Jim

    McNulty, Tony

    Flint, Caroline

    Mactaggart, Fiona

    Foster, rh Derek

    McWalter, Tony

    Foster, Michael (Worcester)

    Mallaber, Judy

    Foster, Michael Jabez (Hastings & Rye)

    Mann, John (Bassetlaw)

    Marris, Rob (Wolverh'ton SW)

    Gapes, Mike (Ilford S)

    Marsden, Gordon (Blackpool S)

    Gardiner, Barry

    Merron, Gillian

    Gerrard, Neil

    Michael, rh Alun

    Gilroy, Linda

    Miliband, David

    Griffiths, Win (Bridgend)

    Miller, Andrew

    Grogan, John

    Moffatt, Laura

    Hall, Mike (Weaver Vale)

    Mole, Chris

    Hall, Patrick (Bedford)

    Moore, Michael

    Hanson, David

    Moran, Margaret

    Harris, Dr. Evan (Oxford W & Abingdon)

    Mountford, Kali

    Munn, Ms Meg

    Harris, Tom (Glasgow Cathcart)

    Murphy, Jim (Eastwood)

    1151

    Naysmith, Dr. Doug

    Smith, Jacqui (Redditch)

    O'Brien, Bill (Normanton)

    Smith, Llew (Blaenau Gwent)

    Olner, Bill

    Smith, Sir - Robert (W Ab'd'ns & Kincardine)

    O'Neill, Martin

    Öpik, Lembit

    Soley, Clive

    Organ, Diana

    Starkey, Dr. Phyllis

    Osborne, Sandra (Ayr)

    Stewart, David (Inverness E & Lochaber)

    Palmer, Dr. Nick

    Perham, Linda

    Stewart, Ian (Eccles)

    Pickthall, Colin

    Stringer, Graham

    Plaskitt, James

    Stuart, Ms Gisela

    Pound, Stephen

    Stunell, Andrew

    Prentice, Ms Bridget (Lewisham E)

    Tami, Mark (Alyn)

    Taylor, rh Ann (Dewsbury)

    Prescott, rh John

    Taylor, Dari (Stockton S)

    Primarolo, rh Dawn

    Taylor, David (NW Leics)

    Prosser, Gwyn

    Teather, Sarah

    Pugh, Dr. John

    Thomas, Gareth (Clwyd W)

    Purnell, James

    Todd, Mark (S Derbyshire)

    Quinn, Lawrie

    Trickett, Jon

    Rapson, Syd (Portsmouth N)

    Turner, Dr. Desmond (Brighton Kemptown)

    Reid, rh Dr. John (Hamilton N & Bellshill)

    Turner, Neil (Wigan)

    Rendel, David

    Twigg, Stephen (Enfield)

    Robinson, Georffrey (Conventry NW)

    Tyler, Paul (N Cornwall)

    Tynan, Bill (Hamilton S)

    Rooney, Terry

    Walley, Ms Joan

    Ruane, Chris

    Ward, Claire

    Ruane, Chris

    White, Brian

    Ruddock, Joan

    Winnick, David

    Russell, Bob (Colchester)

    Winterton, Ms Rosie (Doncaster C)

    Ryan, Joan (Enfield N)

    Salmond, Alex

    Woodward, Shaun

    Salter, Martin

    Woolas, Phil

    Savidge, Malcolm

    Worthington, Tony

    Sawford, Phil

    Wright, David (Telford)

    Shaw, Jonathan

    Wright, Tony (Cannock)

    Sheerman, Barry

    Younger-Ross, Richard

    Sheridan, Jim

    Simon, Siôn (B'ham Erdington)

    Tellers for the Ayes:

    Simpson, Alan (Nottingham S)

    Derek Twigg and

    Skinner, Dennis

    Mr. John Heppell

    NOES

    Bacon, Richard

    Maclean, rh David

    Bercow, John

    Murrison, Dr. Andrew

    Boswell, Tim

    O'Brien Stephen (Eddisbury)

    Cameron, David

    Paice, James

    Collins, Tim

    Robathan, Andrew

    Davies, Quentin (Grantham & Stamford)

    Robertson, Laurence (Tewk'b'ry)

    Selous, Andrew

    Djanogly, Jonathan

    Stanley, rh Sir John

    Flight, Howard

    Swayne, Desmond

    Flook, Adrian

    Swire, Hugo (E Devon)

    Hammond, Philip

    Syms, Robert

    Hogg, rh Douglas

    Taylor, Sir Teddy

    Laing, Mrs Eleanor

    Watkinson, Angela

    Lansley, Andrew

    Wilshire, David

    Leigh, Edward

    Winterton, Ann (Congleton)

    Lewis, Dr. Julian (New Forest E)

    Winterton, Sir Nicholas (Macclesfield)

    Lidington, David

    Lilley, rh Peter

    Loughton, Tim

    Tellers for the Noes:

    Luff, Peter (M-Worcs)

    Mr. Mark Francois and

    McIntosh, Miss Anne

    Mr. Geoffrey Clifton-Brown

    Question accordingly agreed to.

  HEALTH PROTECTION AGENCY BILL [LORDS] [MONEY]
  Queen's recommendation having been signified—
  Motion made, and Question put forthwith, pursuant to Standing Order No. 52(1)(a) (Money resolutions and ways and means resolutions in connection with bills),
  That, for the purposes of any Act resulting from the Health Protection Agency Bill [Lords] it is expedient to authorise the payment out of money provided by Parliament of—
  (a) any expenditure incurred by the Secretary of State by virtue of the Act;
  (b) any increase attributable to the Act in the sums so payable under any other enactment.—[Mr. Ainger.]
  Question agreed to.

  EUROPEAN COMMUNITY DOCUMENTS
  Motion made, and Question put forthwith, pursuant to Standing Order No. 119(9) (European Standing Committees),

  REGISTRATION, EVALUATION AND AUTHORISATION OF CHEMICALS (REACH)
  That this House takes note of European Union Document No.15409/03, draft Regulation concerning the Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH), establishing a European Chemicals Agency and amending Directive 1999/45/EC and Regulation (EC) [on Persistent Organic Pollutants]; and draft Directive amending Council Directive 67/548/EEC to adapt it to the proposed Regulation; and supports the Government's objectives of developing a fast, efficient and workable process to test and screen chemicals and tackle those of most concern first, whilst minimising animal testing and maintaining or enhancing the competitiveness of the chemicals industry and downstream users.—[Mr. Ainger.]
  Question agreed to.

  ESTIMATES
  Motion made, and Question put forthwith, pursuant to Standing Order No. 145 (Liaison Committee),
  That this House agrees with the Report [16th June] of the Liaison Committee.—.[Mr. Ainger.]
  Question agreed to.

  SITTINGS OF THE HOUSE
  Motion made, and Question put forthwith, pursuant to Standing Order No. 25 (Periodic adjournments),
  That this House, at its rising on Thursday 22nd July, do adjourn till Tuesday 7th September 2004.—[Mr. Ainger.]
  Question agreed to.

  DRAFT GAMBLING BILL: REGIONAL CASINOS (JOINT COMMITTEE)
  Ordered,
  That the Lords message of 16th June relating to a Joint Committee of both Houses to consider and report on the Government's response to recommendations 79, 80, 81, 83, 84 and 85 of the report of the Joint Committee on the Draft Gambling Bill (Cm6253), which focus upon the definition, location and economic and other implications of the largest casinos, and on the further statement of Government policy on casinos published with Cm6253, be now considered.
  That this House concurs with the Lords in their Resolution relating to the said Joint Committee.
  That a Select Committee of eight honourable Members be appointed to join with the Committee appointed by the Lords for this purpose.
  That the Committee shall have power:

  (i) to send for persons, papers and records;

  (ii) to sit notwithstanding any adjournment of the House;

  (iii) to report from time to time;

  (iv) to appoint specialist advisers;

  (v) to adjourn from place to place within the United Kingdom; and

  That the Committee shall report by 22nd July 2004.
  That Janet Anderson, Mr Tony Banks, Jeff Ennis, Mr John Greenway, Mr Alan Meale, Mr Richard Page, Dr John Pugh, and Mr Anthony D. Wright be members of the Committee.
  And that the Committee do meet with the Committee appointed by the Lords on Wednesday 23rd June at half past Nine o'clock in Committee Room 8.—.[Mr. Ainger.]
  Message to the Lords to acquaint them therewith.

  Compulsory Voting
  Motion made, and Question proposed, That this House do now adjourn.—[Mr. Ainger.]
  8.22 pm
  Huw Irranca-Davies: May I say how glad I am to be in the House this evening with my colleagues, particularly following my recent travels? I would have liked to come to the Chamber this evening in the knowledge that fellow Members would hang on my every word. However, as I understand it, there is a game of football on tonight somewhere that colleagues feel an urgent desire to watch. As a Welshman, I am still dismayed that the Welsh team were scandalously deprived of their rightful place in the Euro tournament, but I will not detain the House overlong for fear of reprisals from some of the English fans lurking in these Corridors. I wish the England team good luck tonight.
  I do not hold out false hopes this evening of changing Government policy, yet it would be a triumph if I could return to Ogmore to tell my constituents that their MP had effected a sea change in domestic politics and democratic government in the United Kingdom; that the Minister and I had reinvented civic society, fit for the 21st century; and that, together, we had re-established the direct and vital connection between those who govern and the governed. However, that will not happen tonight, unless I am mistaken, nor do I expect it to. I hope for a humbler victory than that. I hope this puts the Minister at ease.
  Sometimes, it seems that being a supporter of compulsory voting has something in common with how Columbus would have felt when he returned home from the Americas and tried to persuade doubters that the world was indeed round, or as Galileo felt when arguing that our planet did orbit around the sun, and not the other way round. These were seminal arguments, based on challenging a whole way of thinking—challenging accepted and entrenched ways of thinking. The proponents of those ideas were branded mad, bad and dangerous to know—heretics, fools, blasphemers—but they were right.
  The arguments on compulsory voting are no less revolutionary, and also no less valid. Columbus and Galileo argued that our understanding of the physical and celestial universe was wrong-headed. I, a number of Back Benchers and a growing number of Government revolutionaries argue that our understanding of the political universe is simply wrong-headed. With the former, considering even the scale of the misunderstanding of the earth or the universe, there would be no real danger of falling off the edge of the planet, or of the earth catapulting into the path of the sun, even if the fools had failed to persuade the wise men of the time. With the latter—with democracy—the dangers of misunderstanding our political universe are alarming as we look at declining turnout and despair.
  All that I ask this evening—all that I hope for—is that the Minister opens his mind to the unthinkable and listens to the voice of those blasphemers on these Benches. We should not say, "We can't do that." At the risk of making a very tenuous link, I draw attention

  1155
  to another "Kant"—the philosopher—who said, quite wisely, "You cannot stop an idea whose time has come."
  Mark Tami (Alyn and Deeside) (Lab): I agree with everything my hon. Friend has said so far. Does he agree that during the last elections many people applauded the turnout, which averaged about 45 per cent., as though it were some great achievement? However, 55 per cent. of people did not take part in those elections. Is that not an important point? We cannot consider the last elections as in some way totally changing a problem that has been ongoing for a number of years.
  Huw Irranca-Davies: Indeed, and I applaud my hon. Friend for his commitment to this cause of the blasphemers and heretics. He is certainly right. I strongly support the Government in what are quite splendid moves to increase turnout and I urge people not go to with those who have cast doubt on the experiments with, for example, postal voting. Despite problems with it, it has increased turnout. However, applauding the fact that less than one person out of every two turned out to vote is indeed testament to the scandal going on in our democracy.
  The time has come to talk of compelling people to vote, but in the nicest possible way. We often and too easily talk of the right to vote, which we regard as a sacred part of this country's hard-earned democratic tradition. In various Reform Acts, we have rolled out the principle of suffrage and extended the right to vote so that it is no longer the exclusive preserve of the ruling classes. It has been extended to property owners, working men over 21, progressively to women and to all those over 18. Now we even talk about extending the right to vote to those who are 16 years and more.
  Universal suffrage has been hard won over the centuries on democratic battlefields. Also, however, our commitment to preserving that right by destroying the threat of tyranny abroad has been shown on real battlefields and paid for with real lives. Indeed, we have recently paid tribute to those who participated in the D-day landings and did just that. The right to vote we all agree is sacrosanct, but what about the duty to vote, to engage and to give meaning to that which has been so hard won.
  The right of universal suffrage is as nothing unless those rights are exercised. Democracy is only a word unless it is made real by the very act of voting.
  When our predecessors deliberated over Reform Acts in this Chamber and in the other place, did they envisage, as my hon. Friend the Member for Alyn and Deeside (Mark Tami) has pointed out, that we would be celebrating a turnout of 45 per cent. in recent elections, or extolling the fact that less than one in two people have exercised their right to vote? Did they envisage that as we sought to hand power to all those who were entitled to vote, they would, in effect, hand it back to us, and that as we sought to progress from this country being governed and elected by a ruling minority class, a new ruling class would emerge, elected by a new self-selecting minority of the population?
  Mark Tami: Does my hon. Friend also agree that there is a crucial point in relation to those registered to
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  vote? A very large group of people are not even registered to vote, and cannot even get involved in the political process. We have all seen gaps on registers—we know that there are people there, but they are not on the register. Is it not strange that we are required to register, but we seem to do nothing about it if people do not, yet we are not required to vote?
  Huw Irranca-Davies: My hon. Friend is absolutely right, and I know that the Minister has paid great attention to this issue. The greatest technical challenge to compulsory voting is that the integrity of our electoral registers can be questioned so severely. Before we move to compulsory voting, it is a great challenge to make sure that everybody is on the register, and that registers are accurately recorded and up to date.
  Increasingly, there is a pattern whereby fewer people vote at a variety of elections, at all levels, which means that we are rolling back universal suffrage by stealth, or at least accepting the de facto rolling back of that suffrage. People who were once excluded from voting, and from taking part in the governance of their community, their council and their country, by class, age or sex, are now excluded because of new factors, not one of which relates to apathy. People want to vote—I know that but we must equip them with the tools to do so: understanding of the importance of democratic engagements and of politics; reducing the fear of voting; making the process easier; showing people that politics really matters and not being afraid in the House or elsewhere to say that it matters; and working in schools with new generations of voters to increase the probability of their engagement. I applaud the Government for their excellent work on all those issues. The Government have been serious about turning round voter engagement. The recent election's increase in turnout is testament to this innovative work.
  In taking a technocratic approach to increasing turnout, however, we are missing the fundamental point. We are missing Galileo's moment of madness and genius—the point is not the right to vote but the duty. What makes a democracy work is not the word but the action.
  Let me put it in terms of the flat-earthers who doubted Columbus. As with those maps of the 14th and 15th century, we are advancing our skills of cartography, and painting ever more elaborate images of beasts that inhabit the oceans at the edge of the world, but in doing so we are failing to see that just beyond the horizon are whole new continents. The prize is great—full electoral engagement. That is a fine aspiration, and it is an even finer one for the Government who aim for full employment.
  Having expounded the politico-philosophical basis for compulsory voting, let me tackle some of the myths that are often lined up as objections, so that the Minister and I can go home tonight with the feeling of a job well done. The first mythical beast is this: people must have the right to deny their vote to any and every candidate. That is because people think one of the following: "They are all the same anyway", "They are corrupt, venal and self-serving", "We never see them at elections", "I don't even want to see them at elections or at any other time", "Politics does not affect me, and I keep myself to myself", or "Any combination of the above or even more." How do we slay this mythical beast that says,

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  "They are all a waste of space." It is quite straightforward. We put a box on the ballot paper, which says, "None of the above." Not voting, and not taking part, does not send the same message at all.
  In imitation of my previous point, not voting, like 55 per cent. of the population, could mean any of the following: "I've genuinely studied the candidates and the parties and none of them is worth my vote", "I don't know how to vote and I'd be scared of making a fool of myself", "I've never learnt enough about politics and democracy to understand what a difference a vote can make", "I disagree so much with the Government's policy on this and that that I cannot bring myself to vote for the progressive policies", or "There was a match on television, and I couldn't be bothered."
  Therefore, what message does the absence of a vote send? It is a mixed one.
  It cannot be taken lightly, but it is often completely misunderstood. It is always better to vote, and even to put a cross in a box that says, "None of the above." The Minister knows that in the countries where that is done, they do not have six out of 10 people putting a cross against the box saying, "None of the above". The figure is not five, four, three or two out of 10. On average, the evidence shows that one in 20 or one in 25 will do so.
  Why? Because the act of compelling people to vote adds meaning to the whole process. It is taken seriously; politics is taken seriously; and democracy is taken seriously.
  Suddenly, the differences between the parties and the candidates emerge as each voter realises the power of their vote. They can no longer opt out. They have the power to put bread in the mouth of a child in Africa by supporting a party with progressive policies on debt relief and fair trade. They have the power, if misused, to put in place a Government who will tolerate tyrants, or give succour to monsters. They have the power to give winter fuel payments, so no pensioner should die of cold in winter, or the power to take them away. They have the power to put people into work or into poverty.
  The power of democracy is made real only by the act of voting. It is no longer a paper exercise carried out by "other people" while someone sits at home and pours scorn on the lot of them. Suddenly, every voter has real power, can make or break Governments, can help or harm their neighbour. That is why, when forced to vote in other countries, so few people will choose to abuse that duty by ticking, "None of the above". They treat their duty to vote with due gravity and intelligence, whereas, in this country, we treat our right to vote carelessly, not realising that, as we do so, we betray ourselves and our neighbours in this country and in the next. In effect, we walk on by on the other side.
  In response to a debate secured by my hon. Friend the Member for Alyn and Deeside, the Under-Secretary of State for Constitutional Affairs, my hon. Friend the Member for Shipley (Mr. Leslie), stated:
  "I do not think that compulsory voting would necessarily force everyone to engage with the political process."—[Official Report, 24 March 2004; Vol. 419, c. 1034.]
  I know that that view is commonly held but I contend that the absolute opposite is true, as is shown in some of the biggest, if you will excuse the phrase, Madam
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  Deputy Speaker, pilot projects of compulsory voting. One could not get bigger pilot projects of compulsory voting than Australia, Greece and Belgium, and there are many others.
  Mythical beast number two is that there is no evidence to show that compulsory voting would drive up turnout. What if, on the day of the next election, perhaps a general election, we were to see a total vote throughout the country of 86 per cent. of the electorate, as they do in Luxembourg, where compulsory voting is the norm? Would we cheer? I think we would. Would we throw a party for a vote of, say, 91 per cent., which is achieved in Belgium, another home of compulsory voting? We would do somersaults across the Floor of the House if we achieved a turnout of 95 per cent., as they do in Australia.
  Mythical beast number three is that it is all our fault, because we do not speak the language that voters want to hear. Myth number four is that the media are dripping with cynicism and are turning people off voting: yes, yes, yes! We must as parliamentarians try harder to communicate our message to the electorate, and convince them that we are worth voting for. The media must try harder. I argue strongly that it is not my job simply to persuade voters to vote per se, although I have a key role in that However, it is my job to persuade them to vote Labour. It is the job of Opposition Members to persuade them to vote Conservative or Liberal Democrat. It is not my job to persuade them to vote alone.
  Andrew Mackinlay: Has my hon. Friend experienced what I think all 659 of us have? A high proportion of the people who come to our surgeries and expect us to work miracles on their behalf have not voted. They are unaware that hon. Members have access to the marked register. We are generous souls, so we are often forgiving. We often work as hard, if not harder, for those folk, but there comes a point when we have to say to them that they are abusing the system. They are often the greatest complainants but the people who give least back in terms of commitment.
  Huw Irranca-Davies: My hon. Friend is right. At the recent election, I had many instances of that. In Maesteg, I knocked on a door and a young lady answered with her baby in her arms. She said very politely, "I am not really interested in all this. I keep myself to myself. My family do not get involved with politics." My response was, "Okay, I am not going to persuade you on the door step. You never get involved and that is why we are here this evening, but when the street light has gone out and the council will not fix it, when you have a problem with the drains, or when you disagree with Government policy, come to my surgery on Commercial street and I will help you sort it out."
  That is what we are failing to get across to people. We must return to the idea of a duty to vote, so that people understand how important their votes are, and that we represent every man and woman who votes—and all those who do not, as well.
  There are many other myths surrounding compulsory voting, all of which can be roundly put to death by the Government's superb commitment to extending the franchise by educational and managerial means, combined with an acceptance that in a democracy such as ours it is not only a right to vote, but a duty.

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  If the Minister wanted a concluding argument, I would seriously wager with him, for powerful odds, that the majority of those who currently vote would support compulsory voting, because they see the value of a vote, and recognise the difference that their vote will make in so many ways. If the Minister announced a change in Government policy tonight and called a national referendum tomorrow, in a referendum based on the present "turn up if you want" system, the proportion of the electorate who already vote would vote for compulsory voting. I can give him a personal guarantee that he would win the referendum and cast himself as the hero of democracy.
  I began by acknowledging that we were unlikely to effect a change in Government policy tonight. However, I ask the Minister at least to recognise that there is growing support for a fuller debate on compulsory voting among Back Benchers, and some Ministers. I, and many others, continue to raise the issue, write articles and make speeches, in the hope that Ministers will recognise that this growing band of men and women, this merry few, have some arguments to deploy. If he recognises that our arguments have some currency, I, and the many colleagues who have sustained such arguments over the years, can return to our lonely apartments tonight with the feeling of a job well done. I thank the Minister and other Members for their indulgence, and I hope for a sympathetic response.
  8.41 pm
  The Parliamentary Under-Secretary of State for Constitutional Affairs (Mr. Christopher Leslie): I hope that my hon. Friend the Member for Ogmore (Huw Irranca-Davies) can return to his apartment feeling that this is a job well done—the job of raising this important topic. Although we may feel—indeed I am sure that we will—during the course of my comments that there is some distance between us on the policy, I believe that he has made a thoughtful and detailed contribution on this exceptionally important subject.
  There is no doubt—the Government certainly believe it—that participation in our electoral process is a matter of central concern in our democracy. Democracy needs active citizenship if those who are elected are to be able to speak with the authority of the public whom we represent.
  However, I am afraid that unsurprisingly, as my hon. Friend suggests, I shall have to disappoint him and say that the Government do not now favour the introduction of compulsory voting. There are obvious attractions to removing any worries about electoral turnout at a stroke, but although I sympathise with the laudable intentions expressed by my hon. Friend, we are not convinced that compulsory voting is the answer, or that its advantages would outweigh some of the possible disadvantages.
  Of course it would be legally possible to require people to attend a polling station or to vote in some other way, such as by post. However, there can be no guarantee that they would mark their ballot papers properly, or make a reasonable choice between candidates. Ultimately, voting is a matter for the free will of the elector, and rightly so. Democratic engagement is a right, and perhaps a duty—but in a free society, it should be open to citizens not to take part if they do not wish to do so.
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  There is also the issue of enforcement. Criminalisation of non-attendance at a polling station would be a very big step to take in British civil society. The immediate reaction to an introduction of compulsory voting here might be that considerable numbers of electors would mark their ballot papers at random, deliberately spoil them, or actively refuse either to vote or to pay any imposed fine for non-attendance. Enforcement would be a mammoth task, perhaps disproportionate to the nature of the offence.
  Quite apart from the burden that that could place on the courts and the prison system, such protests could cast doubt on the fairness and validity of elections and the electoral process. What would it say about the mandate if more people spoiled their votes than voted for a candidate?
  I hear my hon. Friend's comment that one possible solution would be to have an abstention box added at the bottom of the ballot paper, but I am afraid that there are also problems with the "none of the above" option that he advocates. Democracy is about choosing a direction of travel for society, not about descending into a void of indecision. What if the number of votes in that abstention box were greater than that in any of the others? Would we re-run the election, and how many times could an election be re-run? Would we elect the next best candidate, who obviously had little support? Those questions are not easy to answer, so we remain unconvinced about that idea.
  It remains the Government's view that persuasion, in terms of engaging people in the act of voting, is better than coercion. It is difficult to see how, in this day and age, compulsory voting could be practical or enforceable. Nor is it by any means clear that it would be desirable to compel the electorate in that way. By way of analogy, schoolchildren can be forced to read Shakespeare or Dickens, or to go cross-country running, but they certainly cannot be made to enjoy those things. The long-term answer lies in persuading the unconvinced of the merits of those activities, to engage their interest and perhaps even their enthusiasm.
  Compulsory voting could not solve the problem that faces us: a lack of engagement in conventional politics. We should not be forcing people to vote but making them want to vote because they see it as good and important. Political parties and politicians from all sides have a key role to play in that. If we engage with voters, inform them, interest them and show them that their views really count, they will turn out and participate.
  My hon. Friend rightly raised the experience of other countries, and I understand that the independent Electoral Commission plans to review the literature on the international use of compulsory voting. We will be interested to see the results of that work, but there are a few obvious lessons to be learned from practice elsewhere.
  First, compulsory voting is by no means widespread. In South America, three countries—Peru, Uruguay and Chile—have compulsory voting. Of course, Australia has famously had compulsory voting since the 1920s. In addition, three of our European neighbours use compulsory voting: Belgium, Luxembourg and Greece. Most commentators agree that although compulsory voting works well in Australia and regularly produces high turnouts, it would not be possible to introduce it

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  there now had its people been voting voluntarily. There would be considerable public and political opposition. As for our European colleagues, turnout in Belgium and Luxembourg is, as my hon. Friend said, consistently high at around the 90 per cent. mark, including for the recent European elections. However, in those countries, as in Australia, the population tends to regard it as a civic duty to vote and is willing to be coerced. Conversely, however, in Greece, the recent election turnout was 62.8 per cent., despite compulsory voting, which is hardly a resounding endorsement of that system.
  That helps to demonstrate that compulsory voting is possible where the population is willing to be coerced and where enforcement is effective, but the experience in Greece suggests that simply having a law in place is not enough. However, it will be interesting in due course to see the international facts and figures collated and marshalled by the Electoral Commission. I gather that it is due to report on that next spring.
  There are other, preferable and better means by which we can raise turnout and encourage participation, such as working with schools, including in the citizenship education component of the national curriculum, to widen awareness of how decisions are made and who takes them. Reforming our electoral mechanisms could also help, for example, registration for those without conventional addresses, postal voting on demand and piloting of innovative voting methods, including all-postal voting.
  The recent local and European elections on 10 June were always going to be of concern, given that the turnout in the 1999 European elections was 24 per cent. The Government were keen, therefore, to pilot new voting mechanisms on a wider scale, to test out whether all-postal voting would make an appreciable difference.
  Judging by the turnout levels this time—though not, I admit, reaching the 90 per cent. mark—it is clear that the policy choices that we made did contribute to a
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  substantially higher turnout than before, doubling that which occurred in the four pilot regions from the 1999 European elections and increasing turnout substantially, albeit to a lesser degree, in the non-pilot regions. It was a deliberate policy choice to combine the local and the European elections on the same day. While that did bring with it accusations of complexity from some quarters, in fact, it is clear that voters preferred to exercise their vote on the one occasion, rather than on separate occasions. They found it easier and more convenient, and it is clear that there are lessons there for the future.
  The all-postal voting pilots are, of course, subject to a full evaluation by the Electoral Commission, and the Government will also be studying the lessons learned there too. But for the turnout levels to have more than doubled in the pilot regions compared with the 1999 European elections, does prove that these were worthwhile trials, and puts paid to many of those who said that the public would not engage with postal voting.
  In my view, we must continue to focus on engagement, on making people want to vote, and on making it easy for them to vote. Turnout is not just about attendance at a polling station: political disengagement is the deeper problem, and failure to turn up to vote is merely a symptom of it. Nevertheless, we should not be too disheartened. It is surely encouraging that turnout on 10 June indicated that if sufficient information is available to help electors consider relevant issues and if voting is made easier for them—for example, by combination or postal voting—people will be more likely to vote. The recent elections are an indication that there may be other solutions available to raise participation levels, and the Government believe that we should continue to test those out. In the meantime, I pay tribute to my hon. Friend for securing yet another opportunity to debate his preferred alternative.
  Question put and agreed to.
  Adjourned accordingly at nine minutes to Nine o'clock.