Influenza Pandemic (S&T Report)

My Lords, first, I thank the noble Lord, Lord Broers, for introducing this debate so soon after our report was published. It is often said that if you want a job done well, give it to a busy man. The noble Lord, Lord Broers, is indeed that busy man and he has certainly done the job well. Your Lordships’ House should commend the noble Lord for the excellent and speedy way in which he chaired and expedited this report. I have sat on several science and technology investigations and we have prepared our reports in the usual way, but this one has impressed me most in its conciseness, its comprehensiveness and its hard-hitting and well thought out conclusions. It was a privilege to work with the noble Lord, Lord Broers, other noble Lords and the team in the department. Of course, the subject matter helped. There was an in-built urgency in the subject of avian flu pandemic that drove the pace of this report. I hope that the Government’s response will be equally timely and equally well thought out. I suspect that the comments that I received from my personal friends and colleagues on this subject reflect similar attitudes amongst the population at large. The response that I received goes something like this: ““It is all hysteria cooked up by the media. Look at what happened to SARS, AIDS, BSE or foot and mouth. Look at the millennium bug or asteroids hitting the Earth; important, yes, but no need to get into a sweat implying the end of the world””. They tell me, ““After all, over 1 million people die each year in the world from ordinary flu. Ought we to worry about the 73 people who have died so far from H5N1?””. I must admit that people who I regard in high repute have amazed me with their cynical response to this subject. Those of us who have been more closely involved with the dangers of the H5N1 virus are not able to share these views. Panic, we should not; but respond with some sense of urgency, we certainly should. I am concerned that the Government are not responding with such urgency and I am hoping to be reassured on that matter. The problem for us all is that there is a question that we cannot answer in the simple way that most people want. The question is ““When?””. When is this pandemic due to happen? The truth is, of course, as the noble Lord, Lord Broers, said, that we simply do not know. Some say, however, that it is only a matter of time. But we know that if this disease indeed goes critical, we on this planet will experience a fairly gruesome time. I shall confine my comments to something that we all hope will never happen—that this disease turns into a pandemic. How equipped are we to respond? The single event in our collection of evidence that alarmed me most was a PowerPoint presentation that we were shown indicating how the pandemic would spread throughout the world. We saw a map of Vietnam turning rapidly red by the day as the disease spread and how that would be repeated throughout the world. I think that I am right in saying that from the moment the virus becomes transmittable between humans and has infected 50 people in one location, it will be only a few months until the whole world is affected by a complete pandemic. It is unstoppable. If that is so, we had better be very well prepared. We have been told that, in our country alone, we can expect at its peak up to 1 million new incidents of the virus each day—a number that sends shivers down my spine. Such a consequence could be catastrophic for ours and every nation. To date, the only way to arrest the virus is by taking antivirals, and even that is not proved. But I would like to pose a question to the Minister. Why have we chosen to order 14 million doses of the antiviral, Tamiflu? Why not less or why not more? If the antiviral is effective, surely we need to ensure that every person in this country will be able to get the medicine. We need complete coverage, which means that every person in the country needs to be able to get the antiviral from their doctor. We need to imagine what a pandemic would look like in our own country and then what it would look like throughout the world. As I have said, in Britain we predict that at its peak there could be more than 1 million new cases of influenza each day. We forecast that the number of GP consultations could increase more than 1,000 times and that hospitals would be totally over-whelmed. That would be at a time when illness-related absenteeism as a result of the virus could be expected to be more than 20 per cent. The chaos that would result in our health service would be enormous. Quite simply, it would be close to collapse. The responsibility for co-ordinating the health service response in England and Wales lies with the Health Protection Agency, but its funding has been cut in recent years. Is that wise? Is it a responsible move? I would be interested in the Minister’s response. When my honourable friend Mrs Winterton gave evidence to the sub-committee I pushed her on the subject of information systems. My background is in information technology and I have the simplistic belief that without the information and numbers, it is hard to deal with any problem, especially any problem on such a scale. I have to say that I was surprised at the Minister’s somewhat vague response to my questions. So I ask again: do we have fast and effective information systems in place that will enable those people who are dealing with a pandemic to respond quickly as the situation changes? We make a very key point in the report, which has not readily been taken up elsewhere. If there is a pandemic, in this country we could expect 25 per cent—some people expect up to 40 per cent—of the workforce to be struck down at any time. That would include 25 per cent of people across the board: namely, 25 per cent of your Lordships’ House; 25 per cent of Cabinet Ministers, policemen, teachers, doctors, nurses, cleaners or whoever; and, of course, mothers and fathers. But also it would include 25 per cent of lorry drivers who transport food to supermarkets, unloaders, stackers, checkout attendants and power workers. Throughout the nation we would be in an acute emergency. How would food be delivered? How would it be allocated? Who would risk going to a supermarket and run the risk of contagion? Yet, we would need food and other provisions. We would run the real risk of a panic and economic shutdown. And, gruesome though the subject is, anticipation that 3 per cent of all people who contract avian flu would die is another consideration that we would have to make. I know it is easy to get carried away and perhaps to overstate the case, but my views are coloured by the petrol crisis in 2002. We live in a world of minimal stockholding. Companies cut costs by cutting their inventories. ““Just in time”” is the watchword of inventory control. Of course it leads to economies of scale, which is good for business, but it also places everything on a knife-edge, which is bad when panic reigns. To me, the lesson of the petrol crisis is how fragile our economic and distribution systems are and how quickly they can all break down. Every time there is a minor threat to petrol supplies, there is panic buying. So just imagine what it would be like if there was a full-blooded pandemic? Are we prepared? Recently, I read that retailers and supermarket executives have been getting together and making plans for such an eventuality. Is my noble friend able to shed any light on this development? Most people in this country are employed by small and medium-sized businesses. How will these cope in an emergency? I run a company of 120 people. No one has contacted us about how we should prepare for a pandemic. Yet again, I ask: what plans do the Government have in hand to alert smaller businesses on how to cope? One of the recommendations we debated at length centred on government organisation to deal with a pandemic. It became clear that the Department of Health by itself was not the body to co-ordinate a national response to an outbreak of pandemic influenza. This issue is simply too wide for a department with other priorities on its plate. To us it was evident that there needs to be a cross-government initiative to deal with all aspects of an outbreak and, indeed, a person responsible across government to do so. We recommended that,"““the development and implementation of contingency plans should be the responsibility of a Cabinet-level Minister for contingency and disaster planning located within the Cabinet Office””." The day before our report was published, as the noble Lord, Lord Broers, has just said, there was an announcement that some government co-ordination action was being taken, but it was far from clear to me exactly what that action was. Again, can the Minister please help me to understand what organisational changes have been made within government to plan for a pandemic? We started our report with the statement that the United Kingdom was better prepared than most for the outbreak of a pandemic. I am sure that that is true, but we cannot afford to let matters slip. I, along with other noble Lords, I am sure, will be looking to the Minister for reassurances that, quietly but effectively, plans are in place to avoid some of the potential ravages that could well ensue.