Influenza Pandemic (S&T Report)

My Lords, I fully endorse the praise that the noble Lord, Lord Mitchell, has extended to the noble Lord, Lord Broers, for chairing the committee and the publication of this immensely important report. I see it as a wake-up call to the nation and to this House. I was not a member of the Science and Technology Select Committee, although in the past I have served on it. However, I have read a great deal of the evidence and, perhaps more important, last June as chairman of the Foundation for Science and Technology, I chaired a seminar at the Royal Society on the subject of pandemic flu. Not surprisingly, much of what we learned on that occasion is reflected in the Select Committee report. Indeed, one of my points is how little has changed since we heard from officials and others on that occasion. We had four speakers. The noble Baroness, Lady Finlay of Llandaff, gave a good account of what she and her colleagues were doing on the ground in west Wales. I am only sorry that she is not able to take part in this debate; she has explained to me why. We had an expert virologist with experience in Vietnam, and we had two government spokesmen: Dr David Harper, director of health protection at the Department of Health, who gave evidence for this report to the Select Committee; and Mr Bruce Mann, head of the Civil Contingencies Secretariat in the Cabinet Office. I must say that I was surprised to read in the report that the Cabinet Office declined to give evidence to the Select Committee. Yet when Mr Mann addressed our seminar in June, he briefly described his role as this:"““This body is concerned with protecting people, their health, their safety, their economic well-being. If we are going to do that, much of the work will have to be delivered at regional and local level. I bring out those two points because they drive everything that we do””." I must ask the Minister this: why did the Cabinet Office refuse to give evidence to the Select Committee when that is the statement of what it actually does? I note in passing that the Local Government Association also declined to give evidence. As a vice-president of that association, I have made it my business to find out why. I have received a letter from Sir Brian Briscoe, chief executive of the Local Government Association, from which I should like to quote two short passages:"““First, let me deal with the point already raised by the Committee’s report suggesting that the fact that the Local Government Association had not provided separate evidence is a matter for concern. I think there must have been some unfortunate misunderstanding. The reason we did not give evidence is because the scope of the inquiry did not seem to require a separate response from the LGA. Local authorities are completely tied into cross-agency emergency planning and response arrangements and we felt confident that the questions the Committee wished to address would be fully dealt in the Government input . . . clearly that did not happen””." This is far too important an issue for a vital representative of the players simply not to have appeared due to an ““unfortunate misunderstanding””. I hope that the Minister or the noble Lord, Lord Broers, may be able to give us some explanation. The letter goes on to consider animal health over several paragraphs; local authorities have a considerable role and experience through the Local Authority Coordinators of Regulatory Services (LACORS), and finishes with two very brief, indeed almost curt, statements about what would happen if the bird flu virus mutates:"““If bird flu mutates and is passed to humans, councils will work with health authorities to implement an Influenza Pandemic Plan which draws together a local multi-agency response. Plans will identify accommodation for mass treatment and establish business continuity plans to ensure key services operate during any pandemic””." It would have been enormously helpful to the Select Committee to have heard more detail on those points from representatives of the Local Government Association. If, as I will suggest at the end of my remarks, the Select Committee maintains a watching brief over this fast-developing situation, I hope that even now they may be invited to give evidence. Perhaps I may return to the foundation’s seminar. It is fair to point out that Dr Harper and Mr Mann had a very rough ride from an audience which contained many with experience and expertise in this field, and I have to say that they failed to reassure people that everything was being done to prepare the country. Of course we are all aware of the problem of viruses mutating and that it is impossible to have vaccines ready until you know exactly which virus you are preparing a vaccine for. That is the present state of research in this field. The Select Committee also emphasised how much uncertainty surrounds all the contingency planning and has underlined the difficulties this poses for the authorities. But it is striking how many of the strictures voiced at our seminar held last June are repeated or even elaborated in the evidence submitted to the Select Committee in October and the report published in December. From the foundation summary report, perhaps I may quote one paragraph:"““Concern was expressed over what seemed to be a gulf between the planning and modelling in progress at the centre and the clinicians in primary care and other local people who would carry the main burden in an outbreak””." By December, six months later, the Select Committee, was saying at paragraph 8.13 of the report:"““The Government’s Contingency Plan is an excellent top-level account of the United Kingdom health service response to a pandemic, but an enormous amount of work remains to be done at lower levels””." It goes on in a similar vein. Because I see this as an absolutely crucial element in the plans to prepare the country in the event of a pandemic, I have read all of the relevant evidence given to the Select Committee by the witnesses who on 25 October were addressing this point, notably by Professor Pat Troop—who was in the Department of Health when I was there and is now head of the Health Protection Authority, the HPA—and others. It was very interesting but, I found, very worrying evidence to the Select Committee. I cannot possibly rehearse all the issues it raised but there seems to be a sense that all of this planning has been done down to the local level. I refer to question 89 on page 44 of the report. But when the noble Lord, Lord Patel—I hope I am not stealing his thunder—asked about the arrangements for getting drugs to people who are falling sick with avian flu, the answer, in which one recognises the Whitehall jargon, was:"““That presents one of the big challenges””." I think one recognises that a challenge is something to which no one yet has an answer. The witness, Dr Lightfoot, then went on to refer to the exercises being carried out, at which point the noble Lord, Lord Broers, intervened and said:"““So you lined up hundreds of people””." He was interrupted by Mrs Jan Hutchinson, who said:"““No, it is a table top exercise . . . We are not playing for real””." I find this hugely disturbing. Professor Troop had earlier referred to the fact that the Health Protection Agency had been commissioned by the European Union to run an exercise across the whole of Europe in the next few weeks. That was in October so perhaps it happened before Christmas. My first question to the Minister is this: do the UK exercises yet go beyond the table-top exercises described by Mrs Hutchinson? Are people now playing for real? My second question is: what about the Europe-wide exercise? Has it happened? What lessons were learnt? Was it, too, merely a table-top exercise? If the gulf—I use that word again—between the centre and the field is to be bridged, surely people need to practise for real how this is going to be done. Noble Lords will remember that there was a real practice of a major event on the Underground, which was very disturbing because nothing seemed to work. But the lessons were learnt and so, when we had the bombs in July, the response was dramatic and absolutely outstanding. But it was the practice—not a table-top exercise—that had shown people what needed to be done. Another issue—and here I pick up a point made by the noble Lord, Lord Mitchell—concerns the dissemination of information to and guidance for the public. It is common ground that the worst case scenario envisages such huge numbers of people succumbing to the virus, with such a high death toll, that the health service would be overwhelmed. The noble Lord, Lord Broers, gave some examples of this. At the foundation’s event, some people argued that this would place an enormous premium on communication and that someone would be needed to take the lead and act as a public focus for a widespread information and advice programme. The Select Committee heard the same evidence from Dr Nabarro, the Senior UN Co-ordinator for Avian and Human Influenza. It is reflected in the Select Committee’s recommendation at paragraph 8.16, which states:"““All departments of Government need to work together in preparing for a possible pandemic, but we do not believe the Department of Health can provide strong enough leadership to achieve this””." As the noble Lord, Lord Broers, said, it then went on to refer to the need for a Cabinet-level Minister. I, too, hope that the Minister will now elaborate. Yes, there is going to be a MISC Cabinet Committee—and those of us who have served in government know that MISCs come and go—but who will be chairing it? Will that person have an overt public duty to lead the country on this important issue? Is the Select Committee’s recommendation for a Cabinet-level Minister the subject of a serious study in Whitehall? I hope the Minister can reassure us on that. What about the messages that are to be given? I shall not rehearse the evidence of Mr Kevin Hawkins of the British Retail Consortium and others because it is well described in paragraphs 6.29 and 6.37 of the report. He recounted the apparent lack of preparedness of the business community, a matter to which the noble Lord, Lord Broers, referred. The Select Committee described the evidence as,"““probably the most alarming that we heard in the course of our inquiry””." It said:"““Attempts to plan for such contingencies””—" a shortage of staff and heavy goods vehicle drivers, panic buying and so on—"““have not had much encouragement from the Government””." My own straw poll of oil companies at a recent event downstairs reinforced this. Some of the off-shore companies have made provision for reserve helicopter pilots, but they could not tell me of any companies which have got a proper distribution arrangement for tanker drivers. I hope to hear more about that. I turn now to the Government’s input into the inquiry. The evidence given by Ms Rosie Winterton, the Minister of State, served simply to reinforce the impression that no one is in charge. She saw her duty as doing little more than explaining what her officials were up to. I found her evidence far from reassuring. We await the Government’s response, both today and in their formal reply. As I said earlier, I hope that the Select Committee will decide to keep a continuing watching brief on what the noble Lord, Lord Broers, has said is a fast-developing situation. I congratulate the noble Lord and his colleagues on a very necessary piece of work, but it is the beginning and not the end of effective scrutiny. I end with one more quote:"““Most experts believe that it is not a question of whether there will be another severe influenza pandemic but when””." That was said by the Chief Medical Officer four years ago in 2002. This report must be a wake-up call.