My Lords, I beg to ask the Question standing in my name on the Order Paper. In doing so, I wish the House a very happy new year.

The Question was as follows:

To ask Her Majesty's Government, in light of their announcement on 4 December that the means test on parents of disabled children for the disabled facilities grant is to be abolished in Northern Ireland, whether they will now abolish this means test in England and Wales.

My Lords, I reciprocate.

This is a very serious issue about which there has been pressure on the Government for some time. The Office of the Deputy Prime Minister, jointly with the Department of Health, will be reviewing the disabled facilities grant programme, including the operation of the means test, in the context of the spending review 2004. We will announce our conclusions later this year. The position in Wales is, of course, a matter for the Welsh Assembly, but I am led to believe that it will also be undertaking a review of this important issue this year.

My Lords, I thank my noble friend for that helpful Answer. In doing so, I declare an interest as patron of HoDis, the National Disabled Persons Housing Service. Is my noble friend aware of the Joseph Rowntree Foundation research published over a year ago which showed that one in three families who, as a result of the means test, were assessed as needing to make a contribution towards an adaptation to their home for their children's needs could not afford to do so and no adaptation was made? As a result, thousands of disabled children are living in homes which blight their life chances, restrict their social development and cause their parents acute stress, back injury and sometimes loss of employment.

Is the Minister also aware that that same research shows that a fundamental weakness in trying to address the housing needs of disabled children is the lack of sufficient focus within the legislation? Are the Government planning to address this in the Housing Bill?

My Lords, I do not think it is addressed in the current Housing Bill, but I take the point about the Joseph Rowntree Foundation report. There is no doubt that in respect of the disabled facilities grant there is a perverse disadvantage for children, because the chances are that one or both parents will be working. Only 5 per cent of disabled facilities grants relate to children; out of about 30,000 such grants, some 1,500 are for children. The average grant for a child is twice the average figure—about £12,000. Nevertheless, as has been indicated, there has been a change in Northern Ireland, affecting a smaller number of people. This is an important issue, which we need to review. As I said, we will fully review the operation of the system in the context of the spending review 2004, and we will come back to the House with a decision later in the year.

My Lords, is the Minister aware that the Audit Commission review of 2003 also highlighted the necessity for housing for parents caring for a disabled child?

My Lords, yes. The disabled facilities grant is the last of the mandatory housing grants still operating in England and Wales. In some ways, it is an area in which local authorities have no discretion. There is a ring-fenced amount of money available. The amount has increased from £56 million to £100 million in the last four or five years, so it is not as though the issue is not being addressed. Nevertheless, there is still an unmet need out there, some of which is caused by the perverse operation of the means test in relation to children because, unlike elderly people—the main recipients of the grant—one or both parents probably works.

My Lords, approximately how many families are at present subject to this means test in England and Wales?

My Lords, I cannot give a figure in that respect. However, of the 30,000 disabled facilities grants in England and Wales, 5 per cent relate to families with a disabled child—about 1,500. They are all subject to the means test. As to how many actually have to pay, I looked at the calculations and, frankly, I am not prepared to stand here and try to explain to your Lordships' House how this grant is awarded. It is based on the housing benefit structure, and anybody who knows anything about that knows that we have a real problem on our hands. So there is a difficulty here. The effect is that some families do not apply, resulting in an unmet need, although we do not know the precise figures.

My Lords, may I ask the Minister how much it costs to administer this means test?

My Lords, the noble Baroness can ask, but I am afraid I cannot answer. I will get an answer. The total amount of money in England and Wales is about £175 million, and the cost to central government is about £100 million. We repay to local government some 60 per cent of what they spend, but they can spend more, as there is a discretionary element. No one has yet asked me about the estimated cost, so I will give the figures. In terms of lifting the means test for children, our estimate is somewhere between £10 million and £20 million a year.

My Lords, in the light of the Minister's response to my noble friend Lord Campbell of Croy, are there any plans to review the criteria for the means test?

Yes, my Lords. The implication of the Answer I first gave is that we are reviewing whether there is a justification for the means test for children. We will review this in the context of the spending review 2004.

My Lords, I am encouraged by the noble Lord's replies. When the Government consider the situation in Northern Ireland, will they take account of people who are not eligible for the grant? If more people receive the grant, the Government will ensure that the benefit is more widely distributed to those people who need it. Will such practice be used as an example in relation to all other such moneys?

My Lords, we are talking about only one specific mandatory grant. I do not know what the effect of the decision regarding Northern Ireland will be. As stated in the Question, the decision was announced only just before the end of last year. The extra cost of the change in Northern Ireland is estimated at £150,000 out of a budget of £8.5 million. It is estimated that some 30 families in Northern Ireland withdrew their applications because of the means test. One cannot be certain about what will happen until the change takes place. Therefore, it is not possible to give a precise view of what will happen in Northern Ireland, but obviously with time we shall have the answer.

My Lords, in view of the Minister's encouraging replies, I hope that I may ask two further questions. First, how soon can we hope that the means test is removed? Secondly, the measure concerns children, but many of these disabled children have grown up and are now in their twenties. Can we hope that the matter of dependent older children in other households is considered?

My Lords, I hope that I have not given too much encouragement in this regard. I said that there would be a full review of the operation of the disabled facilities grant programme, including the operation of the means test. I pointed out that there is a perverse effect, particularly where children are concerned, because of the way in which the means test works. As regards the decision that we are discussing, technically the 2004 spending review has not started. I suppose that it will start shortly. I presume that the Chancellor will announce the relevant decisions in the summer within the global figures. It will then be up to individual departments to determine how they allocate their resources.

A decision will be made later this year on whether or not the grant itself will remain mandatory. It is a fairly fundamental principle. It is the last of the mandatory housing grants; everything else is now discretionary. As is implied in the Question, the measure has specific effects with regard to disabled children. People over the age of 18 are adults and can apply in their own right.

asked Her Majesty's Government:

My Lords, the Government believe that there are already sufficient arrangements in place for the reporting of expenditure on government advertising. Government advertising is conducted in accordance with the guidance on the work of the Government Information and Communications Service. Departments account for advertising expenditure in their annual reports which can, of course, be audited by the National Audit Office and the Public Accounts Committee. In addition, the Advisory Committee on Advertising monitors the effectiveness of COI advertising.

My Lords, does not the Minister recall that in the 12 months up to the 2001 election government expenditure on advertising rocketed and that a "Panorama" exposé showed that much of that expenditure was not targeted at recipients but at key, core voters? Does he recall that at that time government advertising was under the ultimate control of Mr Alastair Campbell, and that when Mr Campbell departed office we were assured that we would have a government Civil Service overlord independent of political control? That was four months ago. When will this Civil Service overlord he appointed? When he or she is appointed, how will they have whistle-blower powers if there is no Civil Service Act to give them independence from their political masters?

My Lords, I am grateful to the noble Lord for his wide-ranging questions. The noble Lord asked in particular about the appointment of a Permanent Secretary to cover government communications. My understanding is that an advertisement has recently been placed for that and that an appointment will be made in the next few months. That person will, of course, report to Sir Andrew Turnbull.

With regard to the noble Lord's comments on the "Panorama" programme, I have looked at the Government's spend on advertising over the relevant period. Expenditure reached some £191 million in the year to which the noble Lord referred. However, that is in keeping with the trend figures in relation to the parliamentary cycle going back several decades.

My Lords, does the noble Lord agree that it is very important to distinguish between propaganda and information? Although there is a strong need to publicise the pensions credit as very few people understand it at the moment, the full-page advertisements currently appearing in the national press which state that pensioners,

"who have modest savings, investments, or income such as a second pension or an annuity, could get extra money as well",

are grossly misleading. Such advertisements ought to say, "The Chancellor will go on taxing your small savings, but not quite as much as before".

My Lords, I hesitate to say this but I think that if the Government were to issue an advertisement based on the noble Lord's last comment, it would probably be considered propaganda. I am sure the noble Lord would agree that it is entirely right that governments spend money on promoting, explaining and informing the public about their rights and responsibilities. The Government's spend on advertising, or media expenditure, in the year 2002–03, covered such subjects as the million visitor campaign for the British Tourist Authority, the new tax credits scheme for the Inland Revenue, the tobacco information campaign, the business links scheme, tax self-assessment, energy efficiency, army recruitment and campaigns to encourage more people to take up teaching. No doubt, although it is not in the list, there were campaigns directed at getting more people to join our excellent police service. It is hard to argue against those things which I am sure comprise the vast bulk of government advertising.

My Lords, is the Minister aware that part of the Question relates to "related campaigns"? Is he not further aware that if the Civil Service overlord is do his job effectively, he will need information on the cost of PR, sponsorship and a welter of related campaigns? What plans are there to pull those figures together?

My Lords, one of the purposes of the appointment of a Permanent Secretary for government communications is the carrying out of precisely the kind of work to which the noble Lord referred. I have no doubt that the Permanent Secretary will be well supported by every department, particularly the COI and the Government Information and Communications Service, which will provide, I am sure, the top-quality advice that he will need for that job.

My Lords, is there any significance in the fact that while the noble Lord, Lord Rooker, was answering a Question about benefits for disabled children, there was one official in the Box, but that during the Minister's current question-and-answer session, there are three? Perhaps that gives us a picture of the Government's priorities.

My Lords, I rather fancy that that is because the noble Lord, Lord Rooker, is very good at answering questions. The noble Lord, Lord Tebbit, will have to put up with me on this one.

I am grateful to the noble Lord for his question. It occurs to me that when he was at the Department of Trade and Industry allegations were made that advertising in that department went up by leaps and bounds.

My Lords, nobody is suggesting—

Next Question!

My Lords, it is not "next Question".

My Lords, strictly speaking, we have passed the halfway point. To be fair to the other Questions, we should move on.

asked Her Majesty's Government:

My Lords, since the Government launched the highly skilled migrant programme on 28 January 2002, there have been 5,570 successful applications up to 31 December 2003. Of those, 64 have been issued to general practitioners and dentists.

My Lords, I thank the Minister for that Answer. Will she explain the exact position of the people who come under that scheme? The notes for applicants have now been extended to 27 pages and are very good indeed. They were updated in October following modifications to the scheme. I notice the notes state that if you are applying from inside the UK, you have to complete a document which confirms,

"that you can support yourself and your family in the UK without using public funds during your stay".

Why would that apply only to people who are coming from inside the UK?

A related point is that if you are coming from outside the UK, your spouse or partner must come with you. However, if your spouse or partner is already granted residence in the UK, that rules you out. I do not understand that. Paragraph 7.6.5 states:

"Your spouse or partner must accompany or join you in the UK. In addition your spouse or partner must not already have been granted…permanent residence in the UK".

Will the Minister indicate whether people who come from outside are automatically entitled to benefits as soon as they arrive? If not, what follow-up is there in those cases and why the difference?

My Lords, I thank the noble Baroness for her complimentary comments about the document. I hope that I shall be able to answer the number of questions that she has asked.

Applicants are not entitled to public funds; that is, income support, jobseeker's allowance, housing and homelessness assistance, housing benefit and council tax benefit. They are not entitled to them because it is intended that they should be self-sufficient and economically viable. At the end of the 12-month period, they have to apply for an extension if they wish. On that application form, they have to demonstrate that they have been economically active during that time or have taken reasonable steps to become economically active. I can reassure the noble Baroness that, during the two years the scheme has been operating, of the 5,570 people who have been granted leave, only one has not proven to the department's satisfaction at the end of 12 months that he was economically active and self-sufficient.

My Lords—

My Lords, does the noble Baroness have the information about the number of people with health skills who are waiting to be considered as asylum seekers? Why are they not eligible for the programme? In the old days, when it was administered by the DfES, they used to be so eligible.

Will the Minister also indicate whether proper consideration is being given to the denuding of health workers from countries where their skills are severely needed? Those countries include South Africa, which provides so many of the people in our hospitals today.

My Lords, the programme differs markedly from that which applies to those who seek to come to this country as asylum seekers. It is obviously open to any individual who falls within the highly skilled migrant programme to apply under that scheme. The individual employment migration route for highly skilled migrants to come to the UK is to seek work or to pursue self-employment opportunities. Those who fall within that category are usually perfectly capable of being economically self-sufficient.

On the denuding of help, it is important to acknowledge that the largest number of applicants comes from the United States of America. We have received 991 applications from the US. We are not denuding other countries, but we do believe that there are real benefits for migrants who wish to come to this country and to share their skills with us, not least because many of them hone those skills, develop them and then take them home.

My Lords—

My Lords, will the Minister comment on concerns expressed by certain immigrant organisations that highly skilled migrant workers may deprive other countries of much needed skilled workers?

My Lords, I think that I answered that question a moment ago. Such applicants are entitled to come to this country. We all believe in the free movement of people. That is their democratic right. Many of those who come here hone their skills and take them home, having sent a plentiful supply of money in the interim. That benefits the countries from which they came.

My Lords, what percentage—

My Lords, happy new year to everybody. The valuable and helpful notes for those people who are hoping to take advantage of the scheme state:

"The scoring area is for General Practitioners (GPs) only and is not open to Veterinary Surgeons or Dentists";

nor is it open to nurses, particularly highly skilled nurses. Why is there a difference?

My Lords, under the scoring system, one automatically receives 50 points for being a GP. One has to score 65 points overall. Noble Lords will know that there is a real need for highly skilled general practitioners and doctors generally. We have made the criteria sufficiently clear so that anyone who falls within the professions that the noble Baroness has identified should be able to meet those criteria if he has the necessary skills. We do not consider that to be an impediment. Indeed, since we changed the rules, the number of monthly applications has risen from an average of 70 to about 250. I shall check those figures and come back to the noble Baroness.

asked Her Majesty's Government:

My Lords, there are no regulations in relation to ministers of religion visiting NHS hospitals. New guidance, Meeting the Religious and Spiritual Needs of Patients and Staff, was issued to NHS trusts on 5 November 2003. That replaced out-of-date guidance and was prepared after wide consultation with different interests. The new document helps NHS trusts to deliver religious and spiritual care in a way that meets the diverse needs of their local populations.

My Lords, I am greatly obliged to the noble Lord for that reply. Is he aware that nonconformist ministers in particular are complaining that the new guidance, issued in November, prevents their access to local hospitals? Is he satisfied that that is appropriate?

My Lords, I do not believe that anything in the new guidance would have that broadly based effect. It is of course for NHS trusts locally to settle the precise arrangements for providing chaplaincy services in their area, taking account of the new guidance and the Data Protection Act. If the noble Lord wishes to write to me to raise particular concerns, I will look into them and respond to him.

My Lords, does the Minister not agree that if hospitals are committed to whole-person care—care that includes not only the physical and emotional, but the spiritual dimension—as most of them are, it is very important that chaplains and other visiting ministers should be provided full access to the knowledge without which they cannot exercise that care?

My Lords, the right reverend Prelate is of course raising the issue of the Data Protection Act. Under that Act, although there are exemptions on the passage of information for medical reasons, the information in question may not be regarded as information for medical reasons. The Information Commissioner has pronounced on that, as the right reverend Prelate may he well aware.

My Lords, does my noble friend accept that the more serious the illnesses suffered by patients, the greater the need for spiritual and religious care and concern? In the circumstances, will Her Majesty's Government take steps to ensure that sufficient funds are available, so that people of all faiths—young and old, large and small—are looked after? At present, the funding is not there, and the faiths are not able to provide the spiritual and religious care that patients need.

My Lords, the matter is for the individual local trusts. The House will be well aware of the very large increases in funding for the NHS that this Government have provided. It will be for the trusts to use those resources as appropriate. Receiving spiritual and chaplaincy services is a matter on which individuals must give their individual consent. People will vary in their views on the matter.

My Lords, almost exactly a year ago, Ministers reported that the department was working with hospitals to develop good practice in admissions by asking people what their religion was, and asking for their consent for that to be communicated to a representative of their faith. What has happened in the year to implement that good practice throughout the NHS?

My Lords, the new good practice guidance sets the framework within which that work is done. Under the guidance, a local trust can operate in the way suggested by the noble Baroness.

My Lords0, in the Minister's response to the right reverend Prelate the Bishop of Oxford, was he telling the House that the Data Protection Act comes between chaplains in hospitals and the facts that they need to minister to patients?

No, my Lords. I was reminding the right reverend Prelate and the House of the Data Protection Act, and that it requires people to give their consent for the passage of information. The only exemption to that is in relation to information where medical reasons are involved. As I understand it, the decision of the Information Commissioner was that passing information without consent under the terms of medical reasons did not extend to information relating to religion.

My Lords, is the Minister aware that a difficulty arises when prisoners are transferred from an establishment under the Prison Service to a special hospital, and that the ministers who have been in charge of their spiritual care during their stay in prison may not be aware, unless the patient informs them, that he or she has been transferred? Therefore, there is discontinuation of the spiritual care received by that person.

My Lords, I was not aware of that problem, but I shall look into it and write to the noble Lord.

My Lords, the Minister said that the new guidance published in the autumn was to replace the existing guidance, which had become out of date. How had it become out of date?

My Lords, the old guidance was issued more than 10 years ago. As the noble Lord will know, there has been quite a lot of movement in terms of the way in which the NHS is organised, including the Government's wish to shift responsibilities down to the local level. The new guidance was reframed in that way, and to take account of the greater range of faiths that may need to be involved in providing a chaplaincy and spiritual service in the NHS of today.

My Lords, how can the Data Protection Act apply if the wretched patient is incapable of giving consent?

My Lords, that is a matter best left to the local judgment of the NHS staff involved.

My Lords, later this afternoon, with the leave of the House, there will be a repeated Statement on Libya by my noble friend Lady Symons. It is intended that it will be taken after the third speech—that of the noble Baroness, Lady Finlay—on the Health Protection Agency Bill.

My Lords, I beg to move the Motion standing in my name on the Order Paper.

My Lords, I beg to move that this Bill be now read a second time.

I am pleased to have the opportunity to open the debate on the Second Reading of the Health Protection Agency Bill, which was introduced to this House on 27 November. It is only a small Bill, but an important one because the agency which it creates is a central part of improving the delivery of frontline health protection services. During the debate on the Queen's Speech, I was therefore pleased to hear support for the Bill from all sides of the House.

I would like to start by outlining the background to the Bill. The need to create the agency arises from a number of recent developments which have made us all much more aware of the risks posed by chemical, biological and radiological threats. Diseases such as TB and HIV/AIDS are still not beaten, and continued vigilance is required to keep them under control. Alongside those known diseases, the outbreak of SARS last year provided a stark warning of the threat posed by the emergence of new diseases, as well as of the risks of importing exotic infections into this country. In addition to those natural threats, we are faced with the spectre of a deliberate release of pathogens, such as anthrax and smallpox, or of chemical or radioactive agents. All those factors have led us to look afresh at how we can best respond to those threats to health and protect our population.

The establishment of the Health Protection Agency was first proposed in Getting Ahead al the Curve, the Chief Medical Officer's strategy for infectious disease and other aspects of health protection, which was published in January 2002. That strategy brought together a number of proposals which offered a more systematic approach to improving health protection. The creation of the Health Protection Agency is a top priority because it will also help us to achieve many of the other proposals in the strategy.

Our key aim in creating the agency is to strengthen and co-ordinate the arrangements for specialist support for health protection on which local NHS bodies and local authorities rely. In the past, a considerable number of different bodies and interests have provided support for health protection issues. Advice on infectious disease generally came from the Public Health Laboratory Service, including the Communicable Disease Surveillance Centre. The National Focus for Chemical Incidents and various regional service provider units provided support on chemical hazards.

Regional advisers supported the health contribution to emergency planning, and consultants in communicable disease control took responsibility for much of the action at local level, in relation to both infectious disease and other hazards. Advice on radiological hazards is currently provided by the National Radiological Protection Board. There was also the National Poisons Information Service and the Centre for Applied Microbiology and Research. The Health Protection Agency will combine all those functions in one organisation for the Secretary of State for Health, with the devolved administrations deciding the precise role that the agency will play in Scotland, Wales and Northern Ireland.

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. A single agency can provide quick access to all relevant expertise. We also expect to see benefits as all these different specialist areas learn from each other. By placing different responsibilities within a single unified agency we should see a beater degree of cross-fertilisation of good ideas and good practice than in the past.

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 responses. One of the results of the consultation exercise was that in November 2002, my honourable friend Hazel Blears, who was at that time the Minister for Public Health, announced the decision to create the agency through a two-stage process. The first stage was to create the agency on 1 April 2003 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 is to establish the agency as a non-departmental public body which will be able to carry out a wider range of functions, including those that are currently exercised by the National Radiological Protection Board.

That two-stage approach enabled us to move speedily to create the agency as a special health authority covering England and Wales on 1 April 2003. It also gave the Scottish Executive time to complete its own consultation exercise to help determine what role the agency might have in Scotland before we started the second stage. The NI-IS, local authorities and others who undertake health protection and health emergency planning at a local level are now supported by specialists who are part of a national agency who can supply expertise and backup and run programmes on their behalf.

The agency also enables the UK government to make an integrated contribution to a range of international initiatives. In particular, the agency is working to ensure that there is effective international co-operation regarding the surveillance of emerging infections, poisons, chemicals and radiological hazards. That enhances the high reputation for health protection which the UK already has in the international community. A prime example of this was the agency's contribution to the international effort to control SARS. From day one, the agency was linked into the international effort, both in surveillance and laboratory work. The agency had representatives in China, Hong Kong, Vietnam, Canada and at the World Health Organisation where the modelling of SARS was led by the agency. A senior official of the World Health Organisation reported that it would not have been able to manage that work without the UK. As a result of this work the agency is about to sign a memorandum of understanding with the new health protection authority in Hong Kong to work on research, training and emergency planning. That will enable the UK to be well ahead of diseases that arise in the far east, as well as having a shared international approach.

Since April 2003 the agency has taken the opportunity to establish itself as a modern, forward-looking organisation. It committed itself to transparency and openness; high standards of corporate governance, integrity and value for money; and 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. At this point it is worth mentioning a few of the more significant achievements of the agency so far. Almost from the day of its creation the agency was tested by a number of incidents which posed a threat to public health—some within the UK and some international. I am pleased to say that the agency met those challenges head on, proving that the change process had not disrupted the essential business of its predecessor bodies.

The most prominent and serious of the threats was the emergence of SARS. In addition, the agency has strengthened our ability to respond to chemical, biological, radiological and nuclear terrorist threats. The agency is now supporting the UK Government in that field of work in the same way as the predecessor bodies. In particular, the agency has already coordinated a number of training exercises and provided other forms of emergency response training. As well as ensuring business continuity, it has also made significant progress in delivering a broader vision for it to provide a health protection service at local level in England. It has set up nine regional and 36 local health protection teams to bring a more unified and consistent approach to public health threats across the country. The new relationships and networks will take time to bed down, but the agency, the NHS and local government are working constructively together. In particular, the agency is currently working closely with primary care trusts to finalise the memoranda of understanding which govern their relationships and contribute to the aim of achieving the same high standards of response throughout the country. That should resolve earlier difficulties with some PCTs.

That is only a snapshot of the agency's work, but it demonstrates that at regional and local level the synergy in the CMO's vision for the agency is already producing results. The agency now offers more coherent and better co-ordinated arrangements for health protection than we had in the past and is successfully delivering that service at local level. Therefore, I pay tribute to the staff who worked so hard to achieve that remarkable transition so quickly. They have created a solid and effective foundation upon which we can use the Bill to develop the agency further.

The Bill gives the agency wider functions than could be provided for in the statutory instruments which set up the agency as a special health authority and establishes it now on a proper statutory basis throughout the UK. Without the legislation to give it the additional functions that we originally intended, the agency will be unable to undertake the full role that was envisaged for it in Getting Ahead of the Curve. An important feature of the Bill is that Clauses 2 and 3 give the agency specific functions in each of the four parts of the United Kingdom and enable the Secretary of State for Health and each of the devolved administrations to give the agency additional functions in the future if circumstances change. The extent to which the agency will be given additional functions in the different parts of the United Kingdom will vary to take account of the different needs of the Secretary of State for Health and the devolved administrations. It will be for the devolved administrations to shape their use of the Health Protection Agency to meet their particular needs and the Bill reflects that situation in Clauses 2 to 4 and 6.

The other major change in the Bill is contained in Clause 3, which will give the agency the radiation protection functions which are currently exercised by the National Radiological Protection Board. So, alongside the bringing together of different functions, the Bill enables us to reduce bureaucracy further by cutting the number of quangos, because the Special Health Authority and the National Radiological Protection Board will both be replaced by the new body. It is more than just a tidying up of existing arrangements: a more powerful system than we have at present will be created.

In future therefore, the Government and each of the devolved administrations will look to the new agency to provide the functions that are currently exercised by the NRPB. I pay tribute to the service that the NRPB has provided to this country. Originally set up in 1970, the NRPB has been the Government's principal source of scientific advice on radiation issues. Over the years the board has built up an outstanding national and international reputation as a source of expertise on radiological protection issues. That has enabled it to provide an authoritative and independent service to both the Government and the people of this country.

Nevertheless, it is possible to strengthen that service even further by transferring those radiological functions to the Health Protection Agency. Establishing a more integrated source of advice will improve the overall arrangements for the delivery of health protection and will enable the agency to exploit the synergies between the various health protection functions. One particular step that will assist in the exploitation of those synergies has been the decision to co-locate the headquarters of the new agency's chemicals division within the NRPB headquarters building at Didcot.

Transferring radiation protection functions to the agency does not compromise in any way the independent nature of the advice that the HPA will provide, or reduce its quality. The new agency will be an executive non-departmental public body, which is exactly what the National Radiological Protection Board is now. That will ensure the continuing authority of this advice.

The Bill will enable the NRPB staff and assets, as well as those of the Special Health Authority, to be transferred to the new agency. Organisational change can be unsettling for the staff concerned, but I am confident that it will be managed smoothly, with the minimum amount of disruption to both staff and work. To facilitate that process, the two bodies are already working together closely and share the same chairman.

The remaining elements of the Bill are primarily concerned with the practical aspects of setting up and running the agency. The provisions relating to the agency's hoard in Schedule I are in line with the proposals in the 2002 consultation paper that I mentioned, on which there was little comment. Future appointments are likely to be delegated to the NHS Appointments Commission. The funding of the agency will come from the Department of Health and the devolved administrations, plus contracts with the private sector and other parts of the public sector.

The provisions in the Bill on accounts, audit and annual reports are broadly comparable to provisions in existing legislation for equivalent bodies and will provide the framework to ensure that the agency is properly managed and accountable. Clause 5 provides for the agency to work co-operatively with other bodies and Clause 6 identifies who can give directions to the agency and on what functions. Clause 7 provides for the publication of information by the agency and Clause 8 for the transfer of property and staff.

The final point that I want to emphasise to your Lordships is that the Bill will not entail any additional public expenditure or changes to public service manpower. But those resources can be used more efficiently in a single agency. The transitional costs involved in widening the agency's powers will be met from the existing resources available to the Department of Health and the NHS.

Setting up the Health Protection Agency Special Health Authority has already illustrated the kind of developments which 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 agency 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 the Bill. They have done so to bring into full effect this important new body for carrying out the full range of functions envisaged in Getting Ahead of the Curve. The Bill will enable the new Health Protection Agency to respond more effectively to the changing and sometimes dangerous challenges to public health in the 21st century and to deliver an improved health protection service to the public. I commend the Bill to the House.

My Lords, I welcome the Bill and agree with the noble Lord that it is an important measure. I also agree that we are fortunate in having in the agency some very skilled and dedicated staff who already have an international reputation. To place much of this on a United Kingdom basis obviously makes a great deal of sense.

I shall not seek to repeat all the arguments in favour of the agency, which the Minister summarised extremely well. Instead, I want to concentrate on what I regard as one of its most fundamental roles—that is, gathering information on HIV/AIDS and sexually transmitted disease generally. Perhaps I may say in parenthesis that I was slightly surprised that the Minister did not say more about that area. In fact. I am not sure that he said anything about it. I find that surprising for reasons that I shall explain.

It seems to me that the information that the agency collects is entirely fundamental in guiding policy and informing the public of dangers that have emerged or show signs of emerging. In the area of sexual disease, there is no question that we are seeing problem after problem: we are seeing alarming rises in sexually transmitted infections generally; we are seeing new dangers in the area of HIV/AIDS; and we are seeing the clinics set up to deal with those problems operating under acute difficulties. In other words, we see a public health crisis.

That is not only my view; it is the view of the House of Commons Select Committee on Health. It gave its verdict last summer when it said:

"We have been appalled by the crisis in sexual health we have heard about and witnessed during our inquiry. We do not use the word 'crisis' lightly but in this case it is appropriate. This is a major public health issue and the problems identified in this report must be addressed immediately".

I refer also to a very important letter in the Times of 15 December from Professor Michael Adler, who is a most respected figure in this area. He said:

"The Department of Health's desire to shift the balance and devolve responsibility to primary care trusts…means that no one takes responsibility for sexual health".

He went on:

"The time has come for strong central political leadership and recognition that we are dealing with a major public health crisis".

Therefore, against that background, I believe that we have a public health crisis and, also against that background, it must be in the public interest that the new agency should have the resources and means to gather up-to-date information; otherwise, informed debate is impossible and we revert to prejudice and predetermined views. There are few areas where there is a greater temptation to go down that road than in sexual health.

I take it as accepted that in the publication of the information that the agency gathers, the Government will give the agency complete and unfettered independence. I also take it that there is no question of health Ministers or civil servants wanting to alter any findings that could be embarrassing to whatever government happen to be in power.

I believe that in Committee we shall need to consider Clause 7, which sets out when information will not be published. I assume that the provision on the Data Protection Act covers patient confidentiality. That is clearly a very important issue in this area. But I am always wary when I see that publication can be banned when it is "not in the public interest". We shall need to examine who judges what is in the public interest and what is not.

However, my major concern about the Bill is that the collection and analysis of information on sexually transmitted infection should not be some theoretical exercise. Where problems are identified, the information should be accompanied by statements of action on how the problems are to be remedied. There is no point in allowing the reports of the agency to gather dust on the shelves of medical libraries. The public will want to know what Ministers intend to do to put the position right.

What concerns me about the Bill is that it places a great number of duties on the agency—a great number indeed—but not many on the Government in how they respond. Let us take the annual report as an example. In Clause 24:

"The Agency must as soon as possible after the end of each financial year prepare and send to the Secretary of State"

an annual report and,

"must provide the Secretary of State with such other reports and information as he directs".

And what is the duty on the Secretary of State? Only that he must lay copies of the reports before each House of Parliament. There is not even an "as soon as possible" requirement on the Secretary of State.

However, that is a minor irritant. What is really lacking in the Bill is any requirement on the Government to respond to the reports of the agency and, in particular, to its annual report. There is no requirement on Ministers to set out what they are doing. There is no requirement on Ministers to set out how their policies are tackling or will tackle the issues raised. That is certainly not because everything is going so fantastically well as this moment that any statement would be entirely unnecessary.

One has only to look at the very important update report of the Health Protection Agency, published to coincide with World AIDS Day, to know that that is not remotely the case. The report presents a very grim picture. It shows that sexually transmitted infection generally has increased alarmingly; that in the past 12 months, for example, diagnoses of infectious syphilis in men increased by 73 per cent and in women by 33 per cent; that there have been significant increases in sexually transmitted infections among gay and bisexual men; that cases of gonorrhoea, again among gay men, have almost doubled since 1999; and that those same sexually transmitted infections may facilitate the transmission of HIV.

The report also reveals that there has been an increase in the number of heterosexual HIV diagnoses acquired in this country, and that over the past 12 months there has been a 20 per cent increase in the number of people living with HIV to an estimate today of about 50,000. The figures also show big increases in the number of HIV infections acquired outside the United Kingdom, notably in sub-Saharan Africa, which provide other—but I would suggest different—challenges.

It would be a profound mistake to blame the deteriorating position simply on people coming to this country from abroad. Both with sexual disease generally and with HIV/AIDS, there is a major problem which is entirely home-made. The irony is that so much of the disease is entirely preventable. However, the position remains that either through ignorance—which remains very high among young people, who are most at risk—or through risk-taking by men who believe, utterly incorrectly, that HIV can be cured, precautions are ignored.

The net result is not only needless suffering, but also treatment clinics under unprecedented pressure, particularly in cities such as London. Anyone who doubts that has only to cross the river to St Thomas's Hospital to see facilities stretched to bursting point. The net result is further public health risk. The whole idea of the clinics was that they would offer immediate and confidential walk-in facilities. The rule today is that consultation is by appointment and that there is waiting and delay—delay in which infection can be spread further.

In policy terms, the lack has not been of information on the spread of this danger. Information has been collected faithfully and well by the predecessor bodies to the Health Protection Agency. As I think my figures have demonstrated, that continues to be done by the agency. The lack has been of the action necessary to counter the threat. None of this has happened overnight. The figures started deteriorating from about 1996–97. The public can judge for themselves whether the responses of governments have measured up to the scale of the problem. I doubt that many will say that they have.

I have to observe that it took this Government four years—one whole Parliament—to produce their much-promised strategy document on sexual health. It was as if Ministers were embarrassed by the whole subject and, above all, wanted it to go away. Perhaps I may advise the Government: before they publish documents such as the one that I have with me entitled UK's call for action on HIV/AIDS, in which there is more than a hint of self-congratulation in what they have done in pushing HIV/AIDS up the world agenda, they should first examine whether they have the authority to make such claims, based on what they have actually done at home.

I do not claim that by placing a duty on the Government—any government—to respond to the reports of the Health Protection Agency we will solve all the difficulties, but I certainly believe that it would help. I notice from the agency's own report, in November 2003, that it had 10 quite specific proposals, which ranged from reducing the waiting time at clinics to increasing prevention efforts directed at gay and bisexual men and promoting voluntary confidential HIV testing of migrants from sub-Saharan Africa who present themselves at clinics. It is a very wide range of important proposals, all of which are very closely directed at urgent issues. Surely no one denies the need to reduce waiting times at clinics. I find there is also increasing support for much more extensive public education and advertising directed particularly at young people.

At Question Time today, Ministers defended the money spent on government advertising. I suggest that there would be little criticism if more money were spent in this particular area, warning young people of the present dangers. It remains vital that we reduce the undoubted ignorance that exists and persuade people generally of the importance of sensible prevention measures.

Of course, what matters is not what I think, or even what the Health Protection Agency believes, but what the Government decide to do. Quite rightly, in this Bill the Government are holding the agency to account and setting out what they require the agency to do. However, the public also have rights over the Government. We are dealing with important threats to public health. The public have a right to know what the Government intend to do to meet those threats. This is not a function that can he sub-contracted to an agency. An agency can measure the size of the problem and make proposals. However, when it comes down to it, it is the duty of the Government, not the agency, to protect the public.

I support the Second Reading of the Bill. However, I believe that there is much more to do to achieve the purposes that we all desire.

My Lords, like the noble Lord, Lord Fowler, I welcome the Bill. The Health Protection Agency has many important and different aspects, as the Minister so clearly outlined. I shall concentrate my remarks on the incorporation of the National Radiological Protection Board. I declare an interest as an employee of the Velindre NHS Trust in Wales.

As an independent public body the National Radiological Protection Board has indeed provided independent advice to protect public health and to protect workers exposed occupationally and patients undergoing medical treatment from the hazards of radiation. Its remit covers both ionising and non-ionising radiation. It has also carried out research to underpin the advice it has given. It has established a national and international reputation for scientific excellence, particularly in relation to dosimetry and the health effects of ionising and non-ionising radiation.

The National Radiological Protection Board has also made major contributions to the development of plans to deal with nuclear emergencies and model the behaviour of radionucleotides in the working and natural environments; to the assessment of workers and members of the public who are exposed, including those involved in medical irradiation; and to protecting people from the health effects of ultraviolet and electromagnetic radiation, including power frequencies and radio frequencies. All of those data are incredibly important and are sometimes the result of government policy. The agency's independence must be preserved within the new body to ensure that it can hold government policy to account, and vice versa.

The National Radiological Protection Board has consistently been represented on all the relevant premier scientific committees. It also developed the UK gold standard for professional training in radiological protection. All of that comes at a price. The board currently holds assets; it is very important that there is no risk of it being asset-stripped.

The contribution of those from radiation protection to the Health Protection Agency started with enthusiasm under the leadership of Professor Roger Clarke and now of Professor Roger Cox. The collaboration is already demonstrating that the National Radiological Protection Board has much to contribute within the HPA and that it will gain scientifically. Those are all positive events. As the Minister outlined, the key areas of collaboration are emergency response planning, including chemical, biological, radiological and nuclear incidents; the provision of training and radiological protection for the local and regional units of the Health Protection Agency; and modelling of the dispersion of noxious agents in the environment.

Future research and development is absolutely crucial as it will affect the assessment of human exposure to genotoxic agents including chemical and radiological agents. However, I seek reassurance from the Minister that the radiological protection work and other work of the agency within the devolved administrations will remain adequately funded in the long term; that staff developments, both within the UK and through international collaboration, will be encouraged; and that the retention of expertise will be adequately resourced. Because once that expertise is lost, it will take many years to regain.

It is essential that the National Radiological Protection Board develops and maintains the expertise necessary to respond to health concerns when they arise, often at very short notice. Examples include the Chernobyl incident, concerns over mobile phones and base stations and the work done in assessing concerns about childhood leukaemia occurring near nuclear sites. These matters need work between the board of the Health Protection Agency and other disease registers. I should like to address briefly some aspects surrounding disease registration in a moment.

The independence of the board, with its UK-wide responsibilities, has led to its well established reputation far beyond our shores. This international role is extremely important for all. As the Minister outlined, in Getting Ahead of the Curve Sir Liam Donaldson referred to the National Radiological Protection Board being a "distinct entity" within the Health Protection Agency. I hope the Minister will be able to confirm that the resources required to maintain that expertise—and that distinct identity—will be available; and that the independent work of the protection board will he supported so that it can hold government to account over their policies, and that its information can be used to inform policy, just as Defra has consulted over contaminated land and radioactive waste disposal.

The board's independent opinion is of great value and must not be stifled, even though at times the information it puts into the public domain may appear to be uncomfortable for whichever government are in power.

The noble Lord, Lord Fowler, has eloquently called for action on sexually transmitted diseases. Disease registration and issues of confidentiality and consent will need to be clarified for the Health Protection Agency and disease registration processes to work effectively.

To date, there is The Government need to engage the public in understanding why epidemiological data are so important. The public needs to understand why every citizen's disease data are important to contribute to the mosaic picture of health, so that policies can be scrutinised and early warning signs detected. Without addressing some of the broader aspects, I fear that the Health Protection Agency may find itself in shackles and unable to operate as effectively as one hopes it will. So my plea throughout will be for independence to be maintained; for the cross-border working between devolved administrations to continue; and for some of the broader issues of registration to be addressed.

My Lords, with the leave of the House, I shall now repeat a Statement on Libya being made in another place by my right honourable friend the Foreign Secretary. The Statement is as follows:

"With permission, Mr Speaker, I would like to make a Statement on Libya. As the House will be aware, the important announcements about Libya's weapons programmes occurred on 19th December, a day after the House had adjourned for the Christmas Recess. I therefore felt that the House should have an early opportunity to discuss these developments.

"Libya is a signatory to the Nuclear Non-Proliferation Treaty and the Biological Weapons Convention. But we had long been concerned about Libya's proliferation activities, which could potentially have posed a threat to the region, and might put Libya in breach of its international obligations.

"Furthermore, there have been the profound concerns about two Libyan acts of terrorism in the 1980s—the Pan Am flight destroyed over Lockerbie in December 1988, and the murder of WPC Fletcher in April 1984. For several years we have been engaged in discussions with the Libyan authorities to resolve these two issues. These discussions led to the trial—under Scots law, but in the Hague—of Libyan citizens accused of offences in connection with the Lockerbie outrage and much more recently to Libya agreeing to pay compensation to the families of those killed at Lockerbie. The Libyans have accepted full responsibility for the action of their officials and the matter reported to the Security Council with UNSC sanctions lifted by SCR 1506 on 12 September.

"The Libyans have also paid compensation to the family of WPC Fletcher, but we continue our efforts to pursue her murderers.

"An important aspect of the Lockerbie discussions was Libya's categorical renunciation of terrorism and pledge to co-operate in the international fight against terrorism. Diplomatic relations with Libya were restored in 1999 by my right honourable friend the Member for Livingston. In 2002, my honourable friend the Member for North Warwickshire, then Parliamentary Under-Secretary in the FCO, visited Libya and held fruitful discussions with Colonel Gaddafi. Last year we concluded both a cultural and a transport agreement. More recently, on 30 December Libya repaid £20 million of debt it owed to our Exports Credits Guarantee Department.

"This process of engagement provided the backdrop for the discussions on Libya's weapons programmes which began with an approach to us by Libya in March of last year. At Libyan request these discussions took place in the strictest secrecy.

"Nine months of work by officials and experts from the United States and the United Kingdom then followed. Libya acknowledged to us that it was developing a nuclear fuel cycle intended to support nuclear weapons development. A team of British and American officials were given access to projects at more than 10 sites. These projects included uranium enrichment. Libya had not yet developed a nuclear weapon, but was on the way to doing so.

"Libya provided evidence to us of activity in the chemical weapons field, including significant quantities of chemical agent and bombs designed to be filled with chemical agent.

"The team of British and American specialists was given access to scientists at research centres with dual-use potential to support biological weapons-related work. And Libya has provided access to facilities where missile research and development work had been conducted.

"As a result of these discussions, my right honourable friend the Prime Minister, United States President Bush and the Libyan Foreign Minister, Abdulrahman Shalgam on behalf of Colonel Gaddafi made parallel public statements on 19 December. I am placing Foreign Minister Shalgam's statement in the Library of the House. In the Libyan statement Colonel Gaddafi committed his country,

"of its own free will…to eliminate these materials, equipments and programmes so that Libya may be completely free of internationally proscribed weapons".

The Prime Minister in his statement paid tribute to Colonel Gaddafi for taking this courageous decision.

"I have invited Foreign Minister Shalgam to visit London soon to discuss a range of bilateral and international issues. This will form part of the process of implementing the decision by Libya to dismantle its weapons programmes. Britain and the United States will now be taking forward the practical issues of verification and of the dismantling of these weapons in partnership with Libya and with the International Atomic Energy Agency (IAEA) and the Organisation for Prohibition of Chemical Weapons (OPCW). We have committed ourselves to helping with the preparation of Libya's returns to the IAEA and OPCW and to helping dismantle the programmes Libya has agreed to destroy.

"Within their respective remits, the responsibility for verifying Libya's declarations lies with the IAEA and the OPCW, and it is for the Libyan authorities to inform these organisations about the details of their programmes.

"I have been in close touch with Dr Mohammed El Baradei, the Director-General of the IAEA, and I spoke to him again this morning. He took a team to Libya last week and visited a number of sites. There will be a report to the next meeting of the IAEA board of governors in March.

"This agreement represents a successful outcome for the engagement by the US and the UK with Libya over a long period. We have, I believe, established a relationship of trust, which has enabled Libya first to renounce terrorism and now to renounce the pursuit of weapons of mass destruction. I greatly applaud the remarks of Foreign Minister Shalgam in which he said:

'Libya's belief is that an arms race does not serve its security nor the security of the region, but conflicts with Libya's overarching goal of a world where security and peace hold sway'.

For our part, we have recognised that we now have corresponding responsibilities to enable Libya to come fully into the mainstream of the international community.

"The proliferation of weapons of mass destruction represents one of the most serious threats to national and international security. Tackling that threat is at the heart of the Government's efforts to create a more peaceful and prosperous world. In parallel to the discussions with Libya, much work has continued with Iran. Following its agreement in principle with the board of governors of the IAEA, the Foreign Ministers of Germany and France and myself, Iran has now signed an additional protocol allowing intrusive inspections.

"It is always better to resolve issues by negotiation and agreement when possible. Butt for that to happen, it is necessary to have a partner with whom to negotiate. Over the past five years, we have built a relationship with Libya that has enabled us together to take an important step towards reducing the threat of weapons of mass destruction".

My Lords, that concludes the Statement.

My Lords, your Lordships will be grateful to the noble Baroness for repeating that Statement from the Foreign Secretary on Libya. On balance, we welcome Libya's decision to come clean about its weapons of mass destruction programme, its missiles of more than 300 kilometre range and its chemical weapons programmes. That is undoubtedly one step forward in shoring up and refreshing the world's now shaky non-proliferation treaty regime, which is in need of strengthening and reinforcement.

However, going further than that and christening General Gaddafi as a statesman with whom we can do business is surely going a little too far. A few weeks back, our job was apparently to fight a war on terrorism and to fight for democracy everywhere. This week, General Gaddafi is now in favour, who is not noted for his enthusiasm for democracy and has had little to do with the democratic system during his 34 years in office. After all, he has presided over the country that gave us the murder of Yvonne Fletcher in St James's Square—as the noble Baroness reminded us, the killer has still not been handed over or identified—and the Lockerbie horror, which the noble Baroness mentioned. His regime provided the IRA with Semtex, weapons and other forms of support.

Indeed, at this moment, as far as I know, the Libyan regime provides Zimbabwe and the Zimbabwean leadership—the illegal regime there—with oil. I heard nothing about it in the Statement, but I presume that during the negotiations of the past five years, or whatever, we have insisted on one condition being that that process stops: that oil should no longer be provided to the illegal Zimbabwe regime. Can we be assured that that has been examined and that condition applied, or at least discussed, because hearing nothing about it in the Statement is worrying?

There is then the general question of sanctions. The UN has now voted to lift sanctions on Libya, but the United States has not yet done so. Can we he clear where we stand on the matter and what is our assessment of the likelihood of the US lifting sanctions in the near future?

As the noble Baroness reminded us, over the years General Gaddafi has imported centrifuge equipment to make highly enriched uranium—U 235—according to reports this morning, apparently from Pakistan. However, I understand that the Libyans had difficulty screwing together the various parts of the centrifuge equipment and had not reached the enrichment phase, although they were on the way. Will we now receive more information about the underworld of nuclear trade between Pakistan, Libya, North Korea and Iran? Will more be forthcoming so that the matter can at last be opened out and halted in the interests of all humanity?

As I said, overall we welcome the prodigal, if I may put it that way, but with prudent caution, I urge—perhaps with a little more caution than the more exuberant statements of the Foreign Secretary have demonstrated. Above all, we should insist on thorough verification at all phases of that opening up to ensure that it is really happening and monitor rigorously to ensure that that unreliable, maverick dictator, who has changed sides, directions, opinions and alliances many times, will this time live up to his word.

My Lords, we on these Benches also welcome the Statement—with slightly fewer reservations than have been expressed from the Conservative Benches. The development is thoroughly welcome; we hope that it will be followed by other successful negotiations. We all acknowledge that the development of weapons of mass destruction is a real threat to world order and that any successful negotiation that leads a country to renounce nuclear weapons is therefore unreservedly desirable.

My noble friend Lord Roper and I were just discussing how many of us have been following the relationship with Libya with close attention ever since, 20 years ago, we were three doors from the Libyan embassy. I was watching the demonstration outside the Libyan embassy on 20 April 1984 and saw WPC Fletcher being shot. That was not an easy thing to cope with.

Libya has not only been promoting weapons of mass destruction, it has, as the noble Lord, Lord Howell, remarked, been actively supporting terrorist groups and destabilising regimes across Africa, and not only supporting the regime in Zimbabwe. I am surprised that the noble Lord described that regime as illegal—it is illegitimate perhaps, but not, I think, illegal. I was in southern Africa last week, and my latest information is that the Libyans are no longer supporting the Zimbabweans, simply because the Zimbabwean debt to Libya is now so large that they have given up extending credit.

However, the Libyan role in west Africa has also been extremely damaging. Its active support for Charles Taylor and destabilising efforts in Cote d'Ivoire and Sierra Leone are also matters with which we are properly concerned. I should be grateful if the Minister could confirm that that dimension of Libyan foreign policy has also been covered in the negotiations and that Libyan intervention in the tangled affairs of west Africa is now moderated.

We recognise that weapons of mass destruction are a major problem elsewhere in the world. The noble Lord, Lord Howell, referred to the problem of Pakistan as a supplier. Today's reports confirm what had been widely suggested for many years. He also raised the question of Brazil. As the issue is especially sensitive in the Middle East, do the Government now intend to raise the question of nuclear weapons programmes with the Government of Israel, which is also not observing the current regime and which has clearly developed a substantial military nuclear programme? It would be a major measure in rebuilding confidence in the Middle East if the Israeli Government were to follow down the same road.

We especially welcome the involvement of multilateral institutions—the IAEA and OPCW—and want the Government to assure us that the United States is as committed to multilateral engagement, to strengthening the role of international institutions, as Her Majesty's Government appear to be. We welcome particularly the successful use of measures short of war—sanctions, diplomacy, carrots and sticks, incentives and penalties—and their proven success in this case. Will the Minister confirm that the negotiations started before the invasion of Iraq?

My Lords, I thank both noble Lords for their welcome of the Statement, albeit that the noble Lord, Lord Howell of Guildford, was marginally more guarded in his welcome than the noble Lord, Lord Wallace of Saltaire.

This is an important step forward, but I stress to the noble Lord, Lord Howell of Guildford, that it is not the first step that Libya has taken in the right direction. The Statement was not exuberant, as the noble Lord characterised it; if anything, it erred on the side of flatness in how it laid out the history regarding Libya. Some of that history has been very lamentable, such as Lockerbie and the murder of WPC Fletcher.

The Statement also tried to point out how the relationship has developed over the past five years—very cautiously, with the developments of the Lockerbie trial and the compensation for the murder of WPC Fletcher. As the Statement pointed out, the murderers have still not been brought to justice. In all that, it is important to remind ourselves, as the noble Lord did—the Statement did, too not only of the history, but of the progress that there has been in normalising the international relationship.

Although the noble Lord, Lord Wallace of Saltaire, picked up the following enormously important point, the noble Lord, Lord Howell of Guildford, did not do so in quite the same way: the current position does not rely on trust or statements about statesmanship; it relies on proper mechanisms for implementation through the international agencies, the IAEA and the OPCW. I thank the noble Lord, Lord Wallace of Saltaire, for acknowledging that point.

Both noble Lords referred to Zimbabwe. We have made Libya aware of our views on its relationship with Zimbabwe, but I am sure that both noble Lords will have noticed that my right honourable friend the Foreign Secretary is inviting Foreign Minister Shalgam to the United Kingdom shortly. I am sure that that bilateral issue will be an important point in the discussions that will take place then.

The noble Lord asked, now that the United Nations sanctions have been lifted, about the United States sanctions. That is a matter for the United States of America. They will have to decide how they think the international agencies have done in the verification of Libya's undertakings. Libya has also agreed to sign the chemical protocol as well as the biological one, to which it has already put its name. I am sure that the United States will wish to scrutinise how the monitoring is carried out and that they will have many questions. As I am sure both noble Lords are aware, a European Union arms embargo is still in place.

Both noble Lords asked about other clandestine programmes of weapons of mass destruction. I agree with them that it is enormously important to pursue, both with the countries where we believe that weapons programmes are in progress and through the international agencies, ways to get other countries into the sort of negotiations that we have managed to conduct with the Libyans over the past nine months or so. The Statement referred to the fact that the Iranians have now entered such a process with the IAEA.

The noble Lord, Lord Wallace of Saltaire, raised several issues similar to those raised by the noble Lord, Lord Howell of Guildford, which I hope that I have covered. In particular, he raised the question of whether Israel was one of the other states that may have nuclear weapons programmes. I make no exception regarding Israel. Israel has never admitted to such programmes, but it is important that, where we have reason to believe that we should enter into negotiations with a state—not only Israel, there are other states—we should do so if at all possible. That is the right course to pursue but, as the Statement makes clear, it is possible to do so only where there is a willing partner with whom to have such negotiations.

In my recent travels in the Middle East, I raised not only the issues of weapons of mass destruction but also issues surrounding the control of terrorism. We all understand that those are dual threats. It is important to get a number of states around the world to participate more fully and more robustly in dealing with the dual threats of terrorism and weapons of mass destruction programmes.

The noble Lord, Lord Wallace of Saltaire, asked whether the negotiations had begun before or after the invasion of Iraq. I cannot give the exact dates. If the noble Lord's point is that the negotiations were not spurred by what was happening over Iraq, we could argue the point either way. Whether it was just before or just after, much pressure was being brought to bear on Iraq at the time. The basic point is that, where there is a willing partner, it is possible to deal with these dreadful weapons programmes through negotiation and without resort to any military conflict. If that was the noble Lord's point, I agree with him entirely.

My Lords, I, for one, side myself completely with those who wish to place on record appreciation of and congratulations to Ministers and officials who have worked so tirelessly on this very important development. It is significant news that has significance beyond Libya—in the whole international community, certainly the Middle East. Without reservation I wish to say thank you, if my noble friend will accept my remarks.

The noble Lord, Lord Wallace of Saltaire, specifically mentioned Israel. Does my noble friend accept that Israel is not just another case to be examined, but a crucial case, if stability is to be promoted in the region and internationally? My noble friend's response was encouraging, but it would he good to hear that some priority was being given to the matter because of its immense significance.

In the long run, our credibility in this sort of operation, which is so much to be applauded, will be related to how far the world can see that we, the United States and France are ourselves committed to reducing our dependence on weapons of mass destruction, nuclear weapons and the rest, and reducing nuclear arsenals. That commitment that we have given in the past will come under increasing scrutiny as we take initiatives of this kind. I know my noble friend's personal commitments on disarmament, but I hope that she can reassure us that in the context of what has happened we shall redouble our efforts to make our own contribution in the already-established nuclear powers to making the world safer.

My Lords, I thank my noble friend Lord Judd for what he said. He asked whether I would accept his remarks, which were made without reservation. Of course I accept them very warmly. I thank the noble Lord very much for reminding us of the very important role that officials play in such negotiations. Often, Ministers stand at the Dispatch Box and take the brickbats or the credits. On this occasion, officials have played an enormously important role, and their expertise is invaluable.

The noble Lord made the point that Israel was a crucial case. I acknowledge that, but I say to him that all cases are crucial. I am sure that, in his turn, he will acknowledge that, too. It takes only one country to resort to the use of weapons of mass destruction, whatever those weapons are, for there to be a truly appalling position for us internationally. Of course, the Middle East is a particularly volatile part of the world, and a resort to any of these terrible weapons would be truly devastating.

The noble Lord asked what we are doing to reduce our arsenals. I do not think that this Government have a bad tale to tell over that. We put the freefall bomb out of commission when we came into power; we have substantially reduced our nuclear warheads, as I am sure the noble Lord will know. I am sure he will also know and acknowledge that the United Kingdom Government pursue vigorously all international opportunities for non-proliferation, for looking at ways in which we can reduce fissile material around the world, and to encouraging others, perhaps who have not been quite as enthusiastic as we have in signing up to the international treaties, to do so.

My Lords, will the noble Baroness accept my congratulations to the Government and to the United States Administration on the very skilful way in which they have brought about a remarkable step forward? Does she agree that this shows that persistence with international work, through international machinery, can pay off, as it has done in the case of Libya?

The decision to go to the Security Council in 1992 has led on to a sequence of improvements in the behaviour of that regime. Although I share some of the doubts of the noble Lord, Lord Howell of Guildford, about the permanence of Colonel Gaddafi's conversion, I still think we have to recognise that concerted international pressure has brought positive results. Has the Minister become aware of a reported comment by a member of the US Administration, that he could not understand why Dr El Baradei the director general of the IAEA, had recently been to Libya, following the declaration of Colonel Gaddafi, since El Baradei knew next to nothing about the Libyan nuclear programme?

Does the Minister agree that it is important that all governments represented on the governing board of the IAEA, which of course includes the United States and the United Kingdom, should pass to the director general any information they may have about the failure by NPT signatories to fulfil their obligations? Will she say a little more about the role that the Government see for the IAEA and the OPCW in the future verification of the commitments that President Gaddafi has recently entered into?

I welcome what the noble Baroness said in her original Statement, or rather the Foreign Secretary's Statement, but it would be good to hear a little more to be quite sure that the verification of these very important statements that Colonel Gaddafi has made will be put fair and square in the hands of international bodies that can be accepted on a continuing basis by the Libyan regime.

My Lords, I thank the noble Lord, Lord Hannay of Chiswick, for his welcome for this Statement. We are all bound to have a degree of caution in looking ahead over the next few months. It is important to be very hard-headed about this whole process of implementation and monitoring, and that of course is why we welcomed the visit that Dr El Baradei made to Libya. He took with him a team from the IAEA.

I did not see the remarks to which the noble Lord refers, and I try not to comment too much on reported remarks that I have not seen. Dr El Baradei has considerable expertise in atomic energy and he works with a team of experts in the IAEA. As the noble Lord, Lord Hannay of Chiswick, pointed out, he also works with a team on the board of governors who have expertise from around various countries in the world, and they will receive a report. The noble Lord asked about the next step. A report will go to the IAEA governing board in March this year.

The noble Lord asked me to say a little more about what is happening. At the moment, the process that has begun has four areas where Libya will be making some advances over the next few months. There is nuclear capability; chemical capability; and there is the question of biological capabilities, because Libya admitted to past intentions to acquire capabilities related to biological weapons as well. The noble Lord, Lord Howell of Guildford, referred to the important point about the means of delivery. There is also the question of missile development in Libya as well. So there are four avenues to be pursued over the next few months as far as Libya's declarations are concerned.

My Lords, I too congratulate Her Majesty's Government on the part that they played in the negotiations with Libya that led to Libya changing its posture on nuclear weapons and created the prospect that Libya would also change its posture on the other types of weapons of mass destruction to which the noble Baroness referred. To what extent does the noble Baroness believe that the dramatic change made by Mr Gaddafi was influenced by the successful war conducted by the coalition against Iraq and by the capture of Saddam Hussein?

My Lords, I thank the noble Lord, Lord Blaker, for what he has said. What we have seen recently has indeed been dramatic, but it has been the dramatic part of a process that has gone on for five years. In answering the noble Lord, Lord Howell of Guildford, I stressed that we had made advances in our efforts to get Libya more aligned with its international neighbours on the question of Lockerbie, in the first place, and on the question of WPC Fletcher. There have also been some interesting changes in the ways in which we have dealt with cultural issues relating to Libya, with transport issues and—significantly, I would say as a former Minister for Trade—with their repayment of debt to the Export Credits Guarantee Department.

The noble Lord asked whether the decision was influenced by the war with Iraq. It would be difficult to single out an issue and say that it was the turning point in the mind of Colonel Gaddafi that made him decide that he needed, at this point, to reveal the extent of his weapons programmes and move towards normalising his international relationships. Who can say that part of the pressure on Colonel Gaddafi was not due to seeing what happened in Iraq, but there may also have been a realisation that there was far more mileage in normalising relationships, getting better trading relationships and increasing the prosperity of his country by normalising commercial transactions with other countries. I suspect that all those issues played their part. I do not discount what happened in Iraq. What we have seen is enormously welcome, and I hope that others, having seen what has happened, will feel moved to enter into the same sort of negotiations.

My Lords, far be it from me to adjudicate in the debate between my noble friend and the noble Baroness about the cause of the act of repentance. Lawyers spend years arguing about the difference between the causa causans and the causa sine qua non. I am probably not allowed to use such language in the House.

The original tragic killing of WPC Yvonne Fletcher took place during my early months at the Foreign Office, and not long after that came the attack on the American nightclub in Berlin, which led us to take action that was necessary at the time. I join other noble Lords in warmly welcoming the Statement made by the Minister, and I endorse the tributes paid to the tenacity. patience and robust pressure shown over a long time during the process. Like the noble Lord, Lord Judd, I pay tribute to the part played by Ministers and officials.

May I be mildly mischievous and ask the noble Baroness whether she agrees that we should also pay tribute to the value of secrecy in diplomacy? It is probable that such an achievement would not have been possible had it not been for the extreme confidentiality with which the professionals conducted the negotiations over a long period. We should let the world know that secret diplomacy still has a part to play in helping us achieve the kind of world in which we want to live.

My Lords, I agree so much with what the noble and learned Lord has just said. The question of how we put information into the public arena, on the one hand, while having negotiations that are worth having, on the other, is one of the great dilemmas of modern political life and one that we have not resolved. The noble and learned Lord has opened up an enormously important area of discussion. I wish it was one to which we devoted more time. Perhaps I may say that I wish it was one in which we could have a better discussion with some parts of the media. It is crucially important that where we are able to take forward that type of negotiation we are allowed to do so. I understand why there is a great demand for information. In a free and open democracy, there will be many who want to see that kind of information put into the public arena. I agree with the noble and learned Lord that it is enormously important we also recognise that sometimes secrecy is absolutely invaluable in getting to this type of position.

My Lords, I am afraid that I have to bring us back from Libya to the Health Protection Agency. The creation of the HPA clearly is a vitally important initiative. It has focused attention on the need for a comprehensive system to protect the population from infectious diseases—on which 1 will focus—and on other environmental hazards.

If ever there was a subject for us to be taking seriously this is it. Almost every time the Government are blown off course by unexpected events, often it turns out to be some infection or other—be it AIDS or SARS or even flu or CJD or bio-terrorism with anthrax and the like. If it is not human infection, it is animal infection, such as mad cow disease or foot and mouth disease. All those infections created great anxiety and cost billions to the Exchequer, which had not been calculated for, quite apart from the suffering that they caused.

No one can doubt the importance of the HPA. Here, we have a chance to enhance our capacity to deal with all those threats. But we must get it right. The least we might expect is an improvement on what went before, not that what we had was so deficient. Here I express an interest as past chairman of the board of the Public Health Laboratory Service, which I believe was regarded widely as a model of an integrated system. The epidemiological analysis was and is carried out by the disease control centre, from which all the advice for action to practitioners in the field emanates. It is closely linked to a laboratory network around the country where all the tests on patients and samples was done and the results are reported to the centre.

That worked well. For example, even the director of CDC Atlanta in the United States lauded and envied our system, and we led the field in Europe. I am therefore not so starry eyed as my noble friend the Minister that all this has happened since the HPA came into being. But, of course, it was far from perfect. I had the pleasure to serve on your Lordships' Select Committee on Science and Technology under the wise chairmanship of the noble Lord, Lord Soulsby. Its report, too, emphasised where some of the difficulties lie and where we should expect the HPA to take up the cudgels.

The two major problems that beset the HPA's predecessors and which must be addressed if it is to succeed were, on the one hand, starvation of funds, so that they were unable to do the jobs that they desperately wanted and needed to do, and, on the other hand, a degree of interference and micro-management by the Department of Health, which was hard to bear for much of the time and sometimes became intolerable.

What should we be looking for in the Bill? First, it must ensure that the HPA has the capacity to deal not only with current known threats but also with sudden surges of infection outbreaks. Hitherto, there have been many occasions when capacity was sorely stretched and, sometimes, even overwhelmed, even though we know that we can expect the unexpected every year.

The HPA needs a first-rate IT system so that information about the nature of outbreaks—for example, where they are occurring or linking an unusual case in one part of a country with one in another—is transmitted rapidly to those in the field who have to trace sources of outbreaks and take action. An effective IT system is the vital nervous system for the HPA, which is so dependent on rapid information flows. Currently, its systems are nowhere near as good or as integrated as is necessary. That is despite repeated requests for funding by the HPA's predecessor. We must ensure that the HPA is not similarly deprived.

The HPA needs resources to invest in research and development. It is heavily dependent on new technologies and techniques to keep ahead of infections that are constantly evolving and changing. I am concerned that research is mentioned only tangentially in the Bill. Greater emphasis must be put on education and training too. The HPA must have the capacity to engage in international collaboration activities as well as parochial UK activities. Viruses and bacteria do not seem to need passports.

All those activities are self-evident; some are indicated in the Bill. But those requirements have been obvious for years. The major reason that they have not been achieved as well as they should is because successive government policies have diverted funds to front-line clinical activities, such as waiting list initiatives and the like, and away from public health. Some people might think that the £50 million to £60 million per year provided by the Department of Health for the PHLS—which, interestingly, contrasts with the £170 million that we heard about for advertising—is so small as to suggest an unthinking disregard for the dangers that come from neglecting our defences against infection. But that was and, I believe, still is the level of support.

There is no hint of more funding. Indeed, the Chief Medical Officer has clearly stated that the change to the HPA is to be achieved without additional funds, which is reiterated in the Explanatory Notes to the Bill. The Bill suggests that the Secretary of State will take note of how much external support the HPA will earn when determining its government grant, so the more that it earns externally, the less the Secretary of State will need to provide. That does not seem to be entirely satisfactory.

One aspect of funding that is not mentioned in the Bill is that which primary care trusts now have to provide. All those laboratories previously run by the PHLS and now taken over by NHS trusts must be funded for public health functions by the PCTs. All the surveillance work, the very specialised types of testing and rapid reporting are the responsibility of PCTs. But it remains to be seen how seriously those responsibilities will be taken when they are sorely pressed by more acute clinical demands. Individual patients always take precedence over the more nebulous need for public health protection.

I turn now to the relationship between the Department of Health and the HPA. Is it likely to be anything like the enviable relationship of government to the Food Standards Agency? That would be a marvellous model. Unfortunately, there is nothing in the Bill which suggests that the HPA will be allowed to get on with the job without undue interference by the department. Of course, with a subject of such overwhelming national importance, the Government must be involved and must be informed. There is no doubt about that. But the Bill is absolutely stiff with directions by the Secretary of State. Does it need all this close monitoring? The HPA is full of highly dedicated, highly expert and responsible people. I know them well; they were all on the PHLS. I cannot believe that this degree of monitoring and managing can be justified. The HPA deserves better.

Perhaps I may say what I believe is needed in the Bill. First, there should be less emphasis on direction by the Secretary of State. Secondly, there should be greater emphasis on the role that the HPA should have in research and development and in education and training. It should be required, rather than simply permitted, to participate in international collaborative activities of importance to the UK and elsewhere. Of course, the HPA must be adequately funded for all those roles.

The HPA should also be given the facility to influence PCTs, perhaps through their directors of public health and through the memoranda of understanding—if they have sufficient teeth—so that they take seriously support for public health laboratory functions. Further, the Bill should make it obvious that the Secretary of State cannot penalise the HPA by cutting its funds if it earns more from other sources.

I finish by saying that, ultimately, the HPA will be able to meet all these vital responsibilities only if it is adequately resourced. It will struggle to achieve all the welcome principles embodied in the Bill unless that is the case. Here is an opportunity to make a real difference from what went before.

My Lords, this debate follows closely the publication of the Science and Technology Committee report, Fighting Infection, which I had the honour to chair; the Government's response to that report; the debate on it in this House; and, again, the Government's response. All identified that the Health Protection Agency is an important and urgent development.

This debate on Second Reading is the time to identify the most important issues that have surfaced from individuals and organisations which have a stake in the success of the Health Protection Agency. Additionally, it is time to address those issues that were identified by the Select Committee and others, but which have not been given the emphasis one would have hoped for in the Government's response to the committee report.

It has always been envisaged that the HPA would play a major role in bringing together the various strands in the provision of health services. Indeed, in reply to the debate on the Select Committee report, the noble Lord, Lord Warner, stated that,

"the Health Protection Agency is the first of its kind in the world. Its creation is an essential, ground-breaking development for the protection of health in this country".—[Official Report, 8/12/03; col.618.]

We hope very much that that will be the case, but it is essential that this ground-breaking development does not founder for want of appropriate funding. I should say that alarm bells began to ring when I read the Explanatory Notes, in particular paragraph 32, which states that:

"The Bill does not entail additional public expenditure or changes to public service manpower".

That was repeated by the Minister opposite this afternoon.

With respect to the first recommendation made in the Select Committee report, the Government agreed that there was room for the improvement of management and indicated that the integration of expertise would enable the Government to get more from the same resources not only as a result of economies of scale, but by building synergies between different disciplines. Precisely what is meant by that is not clear, but if the HPA is to do its work well—and all welcome and wish it well in this respect—then wishes and welcomes are not sufficient and there must be a capability of launching the HPA in such a manner that it can deal with what is expected of it.

Previous speakers have indicated that much needs to be done, while in opening the debate the Minister remarked that much has already been done. An example of a proposed important area for the HPA is for it to take specific and primary responsibility for the integration of surveillance related to human, animal and food-borne infection. It is possible that that can be accomplished under subsection (2) of Clause 4, headed "Functions: supplementary". It allows the agency to do,

"anything which is thinks is…appropriate for facilitating…the exercise of its functions".

I regard that as a particularly wide remit for any organisation. A clear statement of the respective roles of the HPA and the Department of Health as perceived by the department would be beneficial, as well as of the responses of the department to recommendations made by the HPA. I hope that that would be a two-way process. This is important in view of what is expected of the HPA.

Contrary to the stated expectations of the Government, much of what is envisaged will entail an increasing level of manpower, and where there is a consequent loss of manpower in seeking to meet those aims, it is unlikely that it will be achieved without any further cost whatever. As the noble Lord, Lord Turnberg, pointed out, there are surges of expectation and necessities to be met in health situations that must be accommodated. One of those is bio-terrorism, We do not know where it may hit, but we must be prepared. Obviously such needs cannot be met at the expense of reductions elsewhere. The agency must be capable of meeting surges of action.

One development that would fit into the concept of integration of expertise is that of infection centres. The proposal was not given much support in the Government's response, but it has received wide support elsewhere, in particular from the Colleges Committee on Infection and Tropical Medicine. The point is made that all areas should have access to a critical mass of expertise in the prevention and management of infectious problems. The Government would prefer to see the formation of looser networks, as suggested in the Department of Health's response. However, we share the view of the British Infection Society that the infection centre concept is the optimal way to develop surge capacity able to deal with acute demand, as was adequately demonstrated recently with SARS, West Nile fever and influenza.

One area of particular concern is that of vaccine research, development and production The Government's response to the House of Lords inquiry agreed that there has been a significant deficit in the UK capacity for vaccine production. A secure supply of vaccines in the event of a national or global pandemic is essential. Previously, the HPA Porton Down facility was identified as an essential component of preparedness. Further, the HPA has commented that it would be imprudent not to have a vaccine capability there. The Select Committee recommendation on this point has yet to receive a fair wind.

One wonders whether the wide range of functions and capabilities listed in Clause 4 would allow the HPA to go ahead with Porton Down vaccine development, or would the HPA still have to be a supplicant to the Department of Health for funding for this facility? The need for a flu vaccine to meet a pandemic situation is well illustrated by the present position in the United States, where the national supplies of flu vaccine are insufficient to immunise target groups. Comments made on 12 December last in the New York Times include:

"For the first time in recent memory there may be less vaccine than people want and certainly far less than would be needed to vaccinate all 185 million for whom the vaccine is recommended or suggested".

One topic which has become prominent recently is that of the supply of academic clinicians and, in particular, medical microbiologists. I know that this question was put to the Minister during our previous debate on these issues. He stated then that action was being taken and it is to be hoped that some attention can be paid to it under one or other of the rubrics of the Bill.

I make a final comment on a matter referred to by the noble Lord, Lord Turnberg; that of the status of the HPA. It is important that this is clarified with respect to the Department of Health and the Government. We have recommended that the HPA should be considered an independent body, as is the case for the Food Standards Agency. I understand that this concept is under consideration and perhaps the Minister can comment on the progress of those deliberations.

We all believe that the HPA is a crucial development for the provision of healthcare across a wide spectrum of activities. It has much important work to do. We must get it right. For this to be accomplished, there must be provision of appropriate funding and facilities to allow it to work.

My Lords, the first piece of legislation to be discussed by your Lordships in the new year is the Health Protection Agency Bill, which I consider to be of the utmost importance. I was concerned to read in the Explanatory Notes that from April 2003 the agency will be created as a special health authority and that subsequently, when legislative time allows, as a non-departmental public body which will be able to carry out a wider range of functions. Surely with something as important as this Bill, the Government should be able to make time available as a priority when they believe the need is there. My concern is the importance that the Government are giving the Bill. Perhaps the Minister will give it a rating out of 10—with 10 being the most important.

The HPA will have three main functions relating to health: the protection of the community against infectious diseases and other dangers to health; the prevention of the spread of infectious disease; and the provision of assistance to any other person who exercises functions in relation to these matters.

The HPA is also given powers in regard to radiation protection and the publication of information on such matters. A requirement for co-operation with other agencies is also included in the Bill. With new and continuing threats from infectious diseases, environmental hazards and the need for health emergency planning, this must be a top priority.

With so many vital duties included within the Bill—such as the provision of services in the event of the deliberate release of chemical and microbiological agents and poisons—I hope that other health issues which may not seem so dramatic will not be neglected. Terrorism is causing world-wide alarm, but we must not downgrade the urgency of tackling the disturbing rising rates of infection.

Under much pressure, the Government have developed a sexual health and HIV strategy and an infectious disease strategy. The pressure must be kept up to try to make hospitals and the community safer for vulnerable people. Sloppy hospital hygiene and complacency over the danger of MRSA have now become a fear for people needing invasive procedures. Will the HPA be able to recommend standards to help control infections?

Sometimes it seems that people working in public health have not been given the appropriate status for the important work they do. The Bill may well increase the workloads of doctors and nurses working in public health as data collection for the purposes of surveillance of the spread of disease is vital. But if the job is to be done properly it will take more time and more personnel. It must be done accurately.

Infectious diseases currently present a real threat to the nation as a whole. Although there was a reduction in the number of people with infectious diseases in the latter part of the 20th century—largely thanks to the increased use of vaccinations and antibiotics—recent years have seen a rise in the prevalence of certain diseases. In particular, levels of infection from tuberculosis and HIV/AIDS, which had been stable or in decline, have seen a recent increase. The HPA is particularly concerned that treatments for diseases, including cancer, reduce the strength of the immune systems of certain individuals to infectious disease.

With modern air travel the countries of the world are now very close to each other. This was highlighted by last year's outbreak of SARS, which originated in a district in China where humans live close to animals and fowls, such as pigs and chickens, and the danger of the disease being spread by civet cats seems once more to be a threat. Given the problem of TB in cattle, BSE, CJD, and many other infections which can be passed from animal to human, the problem of leptospirosis—Weil's disease—which is passed by rats, and rabies in dogs and foxes, will there be a veterinary section of the Health Protection Agency?

I am told that in May this year there is to be a government veterinary surveillance strategy review. Over the years there have been some deficiencies in surveillance. Is it not the case that many other countries regard this requirement as fundamental?

Some noble Lords may remember Baroness Walton, who, a few years ago, died of CJD. She was a great loss to your Lordships' House. There is a need for research and development in so many of these serious conditions.

In a recent case in America, quick surveillance traced where a cow with BSE had come from and quick quarantine of the farm took place. Can the Minister assure the House that our surveillance and tracing policy will be improved? If the noble Lord does not know the answer in regard to my question about the veterinary section of the HPA, perhaps he will write to me.

It seems as important to have a good IT system with which to pass information round at local, regional and national levels in the veterinary world as it is in the medical and human systems. Given the increasing resistance to antibiotics it is vital to have a reliable monitoring system in place and good overall co-ordination. What assurances can the Minister give that, given its broad scope, the agency will not become submerged in red tape and that responsibilities will not be confused?

As the agency was formed following the amalgamation of a number of different units there have been problems in relation to working practices. Difficulties have been experienced with the establishment of common systems, with ensuring that there is appropriate accommodation for all and with the creation of a unified information technology system. It seems that the Government have some sorting out to do to ensure that there is smooth and efficient co-ordinated management before the HPA becomes a non-departmental public body.

In ending, I should like the Minister to explain what part the Health Protection Agency will have in blood safety. Just before the House recessed for Christmas, your Lordships were given a Statement on a case of CJD from a blood transfusion. Since then, there has been a case of BSE in a cow in the United States. Many blood compounds are imported from the USA, as they had been considered safer. It may be that blood, which is vital to save lives in many cases of accidents and operations, could be made even safer after this new development. What is the Government's view on synthetic blood?

With so many changes in the National Health Service and so many different bodies doing different things, perhaps the Government would give some publicity, so that the public understand who is doing what. I hope that your Lordships will agree with me that the Bill needs careful scrutiny to see that we give the population of England and Wales the very best health protection.

My Lords, like other noble Lords, I welcome this Bill to establish the Health Protection Agency, but with some worries about the Bill as presented today. I was especially impressed by my experience of working with the agency's communicable infections directorate. That came about because of the inordinate delay of more than four weeks before a ministerial Statement was made about SARS in the United Kingdom, at the end of April 2003.

In early May 2003, a month after the agency came into existence as a special health authority, I had the opportunity to work with the HPA on SARS. Professor Angus Nicoll, director of communicable infections, came to see me on 6 May because of my Written Questions about advice for Britain's Chinese community and my concerns about the inappropriate quarantine of Chinese children in boarding schools. That evening, the noble Baroness, Lady Masham, led a dinner-hour debate on SARS and tuberculosis, in which a number of noble Lords took part.

I outlined my concerns in Hansard, vol.647, No. 86, saying:

"In Britain we have had only six probable cases, and all have recovered. However, high levels of fear are present in the Chinese community, particularly as they watch satellite television from Hong Kong and erroneously assume that precautions recommended there, where SARS infection is still active, should be implemented in Britain".—[Official Report, 6/5/03; col.1031.]

At that time, fears of SARS had also drastically reduced the number of diners in Chinese restaurants in London's Chinatown.

A week later, I met two members of Professor Nicoll's department working on SARS, and we discussed a draft of a press release for the general public containing information aimed at the Chinese community. A further draft press release was written after more discussions with people in London's Chinatown community, and published on 23 May 2003.

That experience convinced me of the need for the Health Protection Agency during an outbreak of an infectious disease, even though we in the UK were not particularly affected. It demonstrated the value of an independent national agency that could give advice to the NHS in an emergency. Hospitals and primary care staff were assisted on the clinical diagnosis of patients and isolation procedures. The HPA also provided appropriate information for members of the public, particularly people who had been in countries where SARS was spreading.

In April 2003, as the Minister has said, the HPA sent public health specialists to centres in countries where SARS was epidemic in order to study infection control

measures, particularly in Beijing, Hong Kong and Singapore. That was important because of the fears generated here, in the Chinese community, and the scaremongering that arose about people carrying SARS from affected countries into the UK.

After the SARS outbreak subsided in the summer, I had another meeting, in mid-July, with a team from the HPA, to consider community research in case of a recurrence of SARS in the winter. Funding for that research had to be generated from outside the HPA, but no indication was given whether the NHS would contribute. Like the noble Lord, Lord Turnberg. and others, I am concerned that funding for research and development in the HPA is still inadequate.

It is significant that a new case of SARS—the first since July 2003—was diagnosed last week, and the diagnosis confirmed today, in Guangzhou, southern China, where the first cases of SARS were reported in 2003. My concern is whether the NHS, particularly in primary care, is today better prepared to deal with a SARS outbreak than it was 12 months ago.

Clearly, the Health Protection Agency is essential for the maintenance of the public's health. The HPA's efficiency is increased by its regional centres in England. The downside of the current arrangements, including the two-part implementation of the restructuring of the HPA, has been the upheaval of staff in its regional centres. In addition, the primary care trusts are expected to fund the work of the regional centres of the HPA, but many primary care trusts are struggling with debts. Further, public health units in primary care trusts are also small and fully stretched in coping with the issues of health inequalities. Therefore, there is an air of crisis management in public health in primary care trusts, especially in parts of the north west, where the HPA is expected to collaborate with the primary care trusts on issues such as surveillance, diagnosis, management and control of outbreaks.

With such a wide-ranging agenda, it is unlikely that the HPA can be expected to work well without the prospect of additional funding. If the HPA is to be independent and effective, the Bill is to be welcomed; but if it is to be involved in the community where protection is expected, it must be allowed to function with adequate resources.

My Lords, this has been an extremely well-informed debate. Each noble Lord, in his or her own expert way, has most helpfully cast a spotlight on different aspects of the Bill, dispelling any notion that it is simply a legal formality. Talking of spotlights, this House in the past month has emphasised the importance of good microbiological surveillance and infection control—in the debate on the Science and Technology Committee report, Fighting Infection, through government reports, such as the Government's response to that report and the Chief Medical Officer's Winning Ways report on reducing healthcare-associated infection. Before breaking for the Recess, we had the Government's Statement on a suspected case of vCJD infection, which the noble Baroness, Lady Masham, mentioned, which could have been passed on through a blood transfusion.

There are other major challenges. The noble Lord, Lord Fowler, highlighted in his extremely interesting speech the current crisis in sexual health. In addition, we have a TB crisis in some areas of the country. The test of the Bill is whether it will ensure that the new agency is up to those challenges and whether it will help the agency to have the powers and resources to carry out its mission of disease prevention and control, strengthening its ability to address emerging threats and public health emergencies.

One key consequence of the Bill, which we on these Benches thoroughly support, is to bring together the HPA and the NRPB—the National Radiological Protection Board. We believe that the incorporation of the CAMR—we must now call it HPA Porton Down, I think—and cementing the partnership that already exists between the HPA and the NRPB should ensure that the HPA can comprehensively deal with public health threats from terrorist acts. But the reality of the Bill is that the HPA is already in existence and its progress can be assessed. The HPA is now eight months old. As the Minister emphasised in his opening speech, it has been operating as a special health authority since April 2003.

The Minister was extremely upbeat in his statement about how the HPA was operating, but according to the chief executive, Dr Pat Troop, although the agency has progressed significantly in a short time, much work still needs to be done to create a single organisation. So we should not be complacent about the way in which the agency is taking shape.

It is important that the Health Protection Agency does not lose any surveillance capacity or its ability to respond during the process of giving it more independence. It is vital that there is cohesion in key areas as it attempts to bring in and merge its various component organisations, such as the PHLS and the CAMR. I welcomed the Minister's tribute to the PHLS, and not simply because the noble Lord, Lord Turnberg, for whom I have considerable respect, is here. It performed an extremely valuable function. It was not the failure of the PH LS that gave rise to the Getting Ahead of the Curve proposals, but a desire to build upon existing success.

The HPA published a five-year plan in August last year and identified no fewer than 12 strategic goals. That is a very ambitious programme. The very notable first goal was to reduce the impact of infectious diseases. This is quite a formidable list of strategic goals, but particularly welcome was that of providing the public with authoritative and impartial information and advice. The PHLS did that extremely well for professionals and opinion-formers such as myself. However, I very much hope that the HPA will extend that role, and when I come to talk about resources, that will be a significant aspect.

Any purveyor of information must be trusted. I have considerable reservations, as has the noble Lord, Lord Fowler, about the Government's ability to hold back information and insist that the HPA does not deliver certain information. I have severe doubts about whether the public will trust the HPA if there is a hint of a suspicion that it is holding back information about particular situations.

Given that, it is the first goal which continues to attract considerable attention, especially in the context of our NHS trusts—the issue of healthcare-associated infection. If the HPA can co-ordinate efforts across the board to reduce the number of infections acquired in hospitals, it will be a notable and welcome achievement. But there has for some time been a major crisis regarding hospital-acquired infection. The noble Baroness, Lady Masham, made the case extremely well. My worry is that many health professionals in the NHS seem resigned to MRSA as a fact of life. That seems deeply worrying.

What is the truth of the matter? The Government seem to publish a new strategy on dealing with hospital-acquired infection every few months. The last one was in December. One has only to look back at past Department of Health press releases. One issued on 9 June 2003, for instance, said:

"The Chief Medical Officer Professor Sir Liam Donaldson is spearheading a new Government drive to tackle healthcare associated infections …particularly those acquired in hospitals".

Another issued in December 2003 said:

"Health Secretary John Reid today published plans for a crackdown on healthcare acquired infections, including antibiotic-resistant infections—so-called superbugs".

Holding these up to the mirror, one would find it very difficult to see much difference in what actual strategy was being proposed. So what is new? Perhaps the Government should spend some time not simply issuing good PR about how they plan to tackle MRSA and other hospital-acquired infections but making sure that their plans were implemented. I am sure, and I hope, that the HPA will have a considerable role in that process.

Although the HPA will have many significant advantages because of the way in which the various bodies are being brought together in addressing a wider area of public health issues, we on these Benches question, and continue to question—as the noble Lord, Lord Chan, did—the wisdom of transferring the PHLS microbiology laboratories across to NHS trusts last year. The excellence of the PHLS has long been envied by countries that lack such a system, including the United States. In the US, federal agencies such as the centres for disease control have relied on individual public health laboratories in various states and cities for information, many of which have outdated facilities and capabilities. Now, just when we are hiving off these microbiology laboratories, public health officials in the US are looking to create a nationwide system that would reduce the current fragmentation in their own network.

We need to ensure that we are not sacrificing high levels of excellence or creating a fragmented, unresponsive system as a result of giving public health laboratories to the NHS trusts. Throughout this debate, noble Lords have expressed concern, as did the Select Committee, regarding NHS laboratory funding, specifically the point that PCTs may fund microbiological testing at meagre levels that maintain the laboratories but do not allow them to thrive and develop. Careful observation will be necessary to maintain the high standards we enjoyed with the PHLS.

Last month. the noble Lord, Lord Warner, said:

"Steps have been taken to ensure that all the laboratories transferred to NHS trusts are appropriately resourced and motivated to continue to meet their public health responsibilities".

My Lords, how? The noble Lord went on to say:

"We intend that standard national operating procedures will be put in place throughout the NHS microbiological pathology service so as to improve quality and ensure consistency of reporting arrangements". —[Official Report, 8/12/03; col.617.]

Should these not be in place by now?

In the Government's response to the Select Committee, we learnt that a new inspector of microbiology is to be created, who will eventually come under the CHAI. This seems a rather strange appointment to make. If those laboratories were still within the HPA, there would be no need to appoint an inspector of microbiology. Is it not a pure fix that the Government now finally recognise that, having deconstructed a perfectly satisfactory network and put it into the NHS where it will have the possibility of fewer funds, they now need a regulator, an inspector, to make sure that the whole system does not go pear shaped? That seems to be a patch that the Government have had to create because of the flaw in their own policy. I very much hope that the Government will think again before they go full steam ahead with that particular proposal.

Evidence that laboratories have received adequate resources and maintained high quality should be gathered and made available as soon as possible. If the Government plan to carry on with the inspector of microbiology, I hope that the remit of that inspector will be wide enough to ensure that it relates to resourcing as well as to the clinical functioning of those laboratories.

There are other issues. Noble Lords have raised some very important ones regarding resourcing. The RCN supports the Bill but it has raised issues of human resources, such as the limited availability of already overstretched public health nurses and the new system's reliance on nurses to report unusual incidences of disease.

Today noble Lords raised fundamental financial issues, particularly the noble Lord, Lord Turnberg. The Minister said that no additional resource would be provided for the HPA, as though that were a great virtue. What assurance can the Minister give that the HPA's corporate plan will be fully resourced and that it will receive adequate resources to put that corporate plan into effect? What answer is there to the questions of the noble Lord, Lord Turnberg, on IT and R&D?

We on these Benches support the Bill in principle. However, as the noble Lord, Lord Fowler, pointed out, there is a wider political dimension. Public health with all its many challenges needs to be given much greater importance. We have not had a senior Minister for public health since Tessa Jowell. As public health involves so many different policy aspects, there is even a good case for a Cabinet Minister of public health who has the authority to work with other government departments. Furthermore, the Minister of public health should, as the noble Lord, Lord Fowler, suggested, be obliged to make a public response to the HPA annual report.

Much mention has been made in the Government's response to the Fighting Infection report to a review of public health law. Not only is this important for disease registries—the noble Baroness, Lady Finlay, was absolutely right to highlight their importance—but also the HPA will be central to any new powers. We have been promised a review of public health law for some time. Can the Minister now give more details of the review? When will it start? What will its timetable be?

Finally, a couple of extremely pertinent questions were raised regarding the nature of the HPA. I refer to the level of independence of the HPA. As a number of noble Lords asked, will it have the same status as the FSA, or will the Government fall again into the trap of micromanaging an agency, as the noble Lord, Lord Turnberg, fears? The noble Lord, Lord Soulsby, raised the very pertinent question of whether the HPA will have a vaccine development capability. Along with a number of other noble Lords, I am being lobbied on that issue to an increasing extent. I have considerable concerns about our vaccine development capacity. Is the Minister convinced that our current arrangements are adequate for our needs? I look forward to hearing the Minister's reply.

My Lords, this debate has been an interesting and worthy start to our proceedings in 2004. In common with other noble Lords I should like to express my thanks to the noble Lord, Lord Warner, for the clear and helpful manner in which he introduced it. As he said, we are dealing with a Bill of considerable importance and underlying substance, to which from these Benches I am happy to extend a general welcome. However, the style of that welcome has to be somewhat cautious. While the Bill may not exactly deliver us into the realms of high political controversy, it would be odd if there were not features of it which caused us a degree of hesitation and, indeed, disquiet. I shall come to those shortly.

In looking at a Bill of this kind it is helpful to set the scene, as the Minister did. As might be expected, the scene from where I am standing looks rather different from the one described by the noble Lord, Lord Warner. Looking at the wider picture I would be the first to acknowledge that in certain areas the Government's public health record has been quite good; perhaps the best examples of that being the vaccination programme against meningitis and the immunisation of vulnerable groups against influenza. Unfortunately, though, one cannot say the same thing universally. The persistent prevalence of tuberculosis, particularly in London, is quite simply a disaster. The same could be said for hospital acquired infections which are rampant in the NHS but, interestingly, rare in the private sector. HIV/AIDS has dramatically increased in the past couple of years and shows no sign of abating. Where is the strategy to tackle it? I have not seen it.

In sexual health more generally, cases of chlamydia have gone up by 78 per cent in four years. Gonorrhoea has increased by 86 per cent in five years, yet, as my noble friend Lord Fowler pointed out, there is a shortage of consultants, health visitors and facilities in all those disciplines.

Perhaps the most worrying area of all, however, is that of diabetes linked to obesity. No fewer than 38 per cent of adults are now overweight, as clinically defined, and 20 per cent obese. If present trends continue, a quarter of the population will be obese by 2010, with massive consequences for human health and NHS resources. I have not met anyone who thinks that the Government have a credible plan to frustrate those predictions. We can only live in hope that, even if belatedly, they will produce one.

Whatever Ministers may have been doing on the public health front, it has certainly not been enough. Rather too much attention has been devoted during the past few years to reorganising the health service and rather too little to the serious problems presented by transmissible infections.

My mentioning the reorganisation of the health service is not irrelevant. I am sure that many of us can wholeheartedly sign up to the concept of devolving the power downwards from Whitehall and of promoting local accountability and local priority setting on the part of doctors, nurses and managers. That is definitely the positive side of shifting the balance of power.

However, that blueprint is in danger of coming apart in those areas that demand a broader-based approach, chief of those being specialised commissioning and public health. The delivery of public health protection has to be local, but the overarching activities of research, surveillance and planning require a comprehensive, population-based approach, not fragmentation. Those activities do not fall naturally into the laps of PCTs. As the Health Select Committee in another place pointed out, PCTs tend to focus almost exclusively on commissioning and diagnostic and treatment services in an essentially reactive context.

The reason for concern is that when it comes to expertise in public health, PCTs are finding that the jam is spread very thinly among them. When we read, as we did recently, of the CMO speaking of the need for more public health training for trust managers, the thinness of the jam becomes even more apparent. The jury is still out on whether PCTs will succeed in fulfilling that particular aspect of their role in the way that everybody wants.

Therefore, the creation of the Health Protection Agency as a national body that takes the lead on surveillance, research and planning across the UK and across a broad front has always been a logical concept. A body that looks strategically at the threats to public health, engages in horizon scanning, prepares for emergencies, conducts relevant research and advises government seems to have a natural place in the scheme of things.

It is therefore reassuring to see that one of the key roles of the HPA is to give support to PCTs in the planning and delivery of public health measures at a local level. My goodness, they need that. They need it in particular to cope effectively with the control of infection, sometimes in uncharted situations where speed is of the essence. Sixty per cent of all ill health is due to infectious disease. Those of us who listened to. or read, the debate led by my noble friend Lord Soulsby on 8 December last year will have been struck by how very apt a precursor it was to the subject matter that we are debating today. I recall in particular the speech of the noble Lord, Lord Oxburgh, who so clearly spelled out what is difficult about framing public health policy in the 21st century; that is, that the backcloth against which public health professionals operate is constantly changing. Not only is it constantly changing, but it is also unpredictable in many respects. The rapid movement of people and goods across the world, population growth in third world countries, and climate change together almost guarantee the creation of new and virulent pathogens that can wreak havoc in developed countries such as our own unless we are extremely vigilant.

The HPA will be the eyes and ears of the nation for threats such as those, and the voice of the nation in terms of how we should deal with emergencies when they occur. Of course, we already have the Health Protection Agency as established as a special health authority. It is early days yet, but it seems to have got off to a satisfactory start. As we have heard, the Bill establishes the agency on a different footing as a non-departmental public body and expands its statutory remit in a number of ways. I have little problem with the idea of reconstituting the agency as an NDPB. Indeed, as it currently is, its glaring shortcoming is that its remit is confined to England and Wales. For an area of activity such as public health that is no respecter of boundaries on a map. that makes no sense.

That shortcoming will be addressed in the proposed change of status, although not entirely so. We cannot unwind the clock on devolution, and I shall not argue that we should. However, even the most ardent admirer of devolved government has to concede that the administrative contortions with which the agency will need to contend that are directly consequent on devolution are, at the very least, not conducive to its efficiency or coherence. I have not attempted to quantify the proportion of the Bill devoted to the different arrangements that will apply in England, Wales, Scotland and Northern Ireland, but it is quite substantial.

Perhaps the biggest question mark in the Bill—here I diverge slightly from the noble Lord, Lord Clement-Jones—hangs over Clause 3 and the related provisions. It always sounds persuasive to hear the argument that if one can bring similar expertise that was previously dispersed across several organisations under the umbrella of a single body, that can be only a good thing. However, it is not an argument that in every case should be taken as read. The counter-argument to it is that, by doing away with a discrete centre of excellence, we lose focus, risk an erosion of the expertise and the research base, and inevitably erode intangible assets such as international reputation.

In an area as important as radiation protection, those concerns should be taken seriously. I read the response of the National Radiological Protection Board to the Government's consultation document. The clear message that emerged was that the NRPB was not convinced by the arguments for change and favoured remaining as it is, although with full co-ordination with the agency. I cannot believe that that can he dismissed merely as special pleading. I have not spoken to the NRPB and I apologise to it if my interpretation of its words is wrong, but I give the Minister notice that we shall come back to the concerns on that issue in Committee.

We do not need to dwell too long on what is now a fait accompli, namely the disbanding of the PHLS and the distribution of its laboratories between the agency and the NHS, but we need to debate the consequences of that decision. One argument in favour of integrating allied expertise within a single agency is that it creates surge capacity for dealing with emergencies. For the agency, that may prove true and valid on one level, providing that it is resourced properly, a point made by many noble Lords. However, when it comes to laboratory capacity, the story is not so simple.

The agency may persuade itself that it has access to the laboratories now run by the NHS, but the fact remains that it no longer controls those laboratories. As the report of your Lordships' Science and Technology Committee pointed out, the ability to direct activity within a managed network of laboratories such as existed under the PHLS was decidedly beneficial. It enabled resources to be directed in a co-ordinated manner, and provided inbuilt surge support when problems occurred. The HPA will have a job on its hands to ensure that the essential public health functions of the laboratories, especially in times of emergency but including their surveillance functions, are not disrupted by competing pressures from the acute healthcare sector.

Lastly, I turn to the agency's international role, which will be extremely important. International collaboration is essential in the fight against infection. The reputation of our national body for impartiality and expertise will be key to its effectiveness on that front. That is why we should look severely askance at the ministerial powers of direction which pepper the Bill. In specific circumstances where speed of action is essential to the public interest, there may be a case for a limited power of direction. But otherwise, we must question the necessity for it. We shall do exactly that when we return to the Bill in Committee.

For now, I shall conclude on as positive a note as I can. It is important that we wish the agency well in its vital tasks that lie ahead. At the conclusion of the Bill I hope that we may all emerge reassured and as confident as possible that both the legislative base and the prevailing conditions are set fair for the agency to achieve the full range of its objectives. I look forward to our further deliberations towards that end.

My Lords, we have had a wide-ranging and well informed debate and I am grateful to noble Lords for their contributions. I begin by making a small correction to my opening speech. I said that the Secretary of State intended to delegate future appointments to the NHS Appointments Commission. I had overlooked the fact that the Secretary of State has no power to do that in relation to Northern Ireland, Scotland and Wales. To avoid allegations that I have misled the House, I felt that I should correct that point.

The noble Lord, Lord Fowler, spoke powerfully about HIV/AIDS. I thought, in passing, that he was a shade unkind to the Government. We are committed to tackling the increasing rates of HIV and sexually transmitted disease infections. Over the past two years we have invested over £35 million in specialist STI clinics, including an additional £15 million that was recently announced by John Reid. So, there is a real attempt to improve capacity. We believe that the HPA's sophisticated surveillance provides the opportunity, as the noble Lord acknowledged, for a comprehensive picture of the HIV/AIDS epidemic that allows us better to target our prevention efforts and planned services for those people infected or afflicted by HIV/AIDS.

The noble Lord, Lord Fowler, and other noble Lords also raised the issue of whether the HPA would be able to decide of its own volition to publish particular reports or information. No doubt we will debate the matter in Committee, but we believe that Clause 7 makes it clear that it is for the HPA to make the decision on whether or not to publish particular information or reports. As I understand the position, that is on a par with the arrangements that were put in place for the Food Standards Agency; so, it is the body itself which determines whether or not to publish particular information. There is no question of sinister characters such as John Reid or myself overruling the agency in that matter. Indeed, only the Food Standards Agency and the HPA are in that position. The Secretary of State has no power of direction in relation to the publication of that information. I hope that that reassures noble Lords over the agency's independent ability to publish that information.

The noble Baroness, Lady Finlay, raised a number of points, and I am grateful for her recognition of the prospect of advances offered by the Bill. I hope that I can give some reassurance to her and to a number of noble Lords who raised the question of resources. I can assure the House that I shall keep going for five minutes at least. I hope that my response to the noble Baroness, Lady Finlay, on the issue of resources will deal with many of the concerns raised by other noble Lords.

I believe that possible confusion over what I said relates to the questions of what counts as public expenditure and the period to which it relates. In my opening remarks, I said that the Bill contains no proposed increase in new public expenditure commitments. However, the 2002 spending review settlement already contained provision for an approximate increase of £25 million per year between 2003 –04— the current year—and 2004–05 and 2005–06. Thus, the old SHA would have had that increase in provision, and the plan is to carry that through to the Health Protection Agency. Therefore, the Explanatory Notes are written as they are because that is already factored into the spending plans of the bodies involved. If that caused confusion, I apologise. However, I place clearly on the record that the intention is to plan for a £25 million or so increase in the provision between 2003–04 and 2004–05.

The noble Baroness, Lady Finlay, raised the question of radiological protection in relation to Wales. The intention is that the HPA will continue to provide the same level of service in Wales, as it will in Northern Ireland, without charge in this area. Therefore, there is no intention whatever to reduce the level of service. If the level of service costs a little more, that will be provided for in the budgetary arrangements which I mentioned. I hope that the noble Baroness is reassured on that point.

My noble friend Lord Turnberg raised a number of points, including the issue of resources, and I hope that I dealt with those. At this point, I pay tribute to the work carried out by my noble friend as chairman of the Public Health Laboratory Service. As referred to by a number of noble Lords, I acknowledge that it was not a sense of failure on the part of the PHLS that caused us to move towards the agenda of establishing a Health Protection Agency. There has been enormous commitment within that organisation in terms of public service and a great deal is owed to the PHLS.

My noble friend Lord Turnberg raised a number of issues relating to micro-management, staff and research. On the subject of micro-management, I say to my noble friend that, as I believe I have tried to make clear on a number of occasions, we are reducing the size of the Department of Health by about 38 per cent. Therefore, even if there were a wish on the part of the staff of the Department of Health to micro-manage this new service, their capacity to do so would be substantially reduced. Certainly so far as concerns this Minister, as a responsible Minister with departmental management duties in the Department of Health, I can say that there is no wish on our part to move into the field of micro-management.

A number of noble Lords raised the issue of research and staffing. I refer them to a piece of work to which the agency has already committed itself in terms of key gains. Two of these key gains are to develop a more knowledgeable and skilled health protection staff and to increase research into health protection. So there is a real commitment by the embryonic agency to tackle the issue of skilled staff, which is not easy—no one claims it is—and the issue of research.

The noble Lord, Lord Soulsby, raised a number of issues on vaccines. What I will say, which may not totally reassure him, is that we have, as I said in the earlier debate, on several occasions considered the whole issue of a centrally funded strategic vaccines facility. However, the evidence has yet to convince us that there is a case for allocating the funds required—approximately £30 million—or that there is an adequate description of exactly what such a centre would provide. Development and production of a new vaccine takes many months and is not a first-line response to a new or emerging infectious disease.

The Department of Health values the HPA Porton Down's work in drafting the emergency vaccine facility's business case. After very serious consideration and discussions with the Ministry of Defence, it has decided to define wider UK requirements more carefully before proceeding. This work is in hand with a number of partners, including the Health Protection Agency. I think that that is our current position on the whole issue of vaccines.

The noble Lord, Lord Soulsby, also raised the issue—as I understood him—about why the HPA is not established on the same basis as the Food Standards Agency. The FSA is a non-ministerial department, which is of course a Crown body and therefore part of the Government; the HPA, as a non-departmental public body, is not a Crown body and is therefore not a part of government. That was a decision taken, but it reflects the high level of independence of the HPA. That, taken together with the point I made earlier about its ability to publish its information no matter where the chips fall, is an important part of that independence.

The noble Baroness, Lady Masham, raised a number of issues relating to HCAIs and MRSA, as did the noble Lord, Lord Clement-Jones, and a number of other noble Lords. I think that the position is fairly clear. The Government have made an attempt to produce a strategy; they did so last year.

In December the Chief Medical Officer published a new action plan. It is not just a press notice, it is the CMO's action plan giving new emphasis and more detail about what needs to be done to try to crack this extraordinarily difficult issue of healthcare associated infections. The situation is not unique to this country, many countries have problems with HCAIs. Winning Ways: Working together to reduce Healthcare Associated Infection in England, for example, lists a number of changes which we hope will produce a better response within the healthcare field. In particular, there is a requirement for every trust to have a director of infection prevention and control who reports at board level. That is a new initiative to try to get at the local level someone clearly responsible and accountable for tackling this particular area of difficulty. These are not easy problems to tackle, as noble Lords know, but the Government are on the case and trying to make progress through the work of the CMO.

The noble Baroness, Lady Masham, asked what part the HPA will play on blood safety. The National Blood Authority is of course responsible for blood supply. It works closely with the HPA on risks from blood-borne infections. The noble Baroness also asked whether there would be a veterinary section in the HPA. The answer is no, but the agency will be responsible for taking an overview of all relevant surveillance systems, including those for animals, which is of course the responsibility of Defra. We are very conscious of the risks posed by zoonosis infections that can be spread from animals to humans.

The noble Lords, Lord Chan and Lord Clement-Jones, and the noble Earl, Lord Howe, raised the issue of PCTs. PCTs are new bodies and, like all new bodies, they will take time to move to full effectiveness. We are now in a situation where 75 per cent of NHS resources are distributed through PCTs. They can prioritise public health in a way that is possibly a little different from the way it was done in the past and, as I tried to say in my opening speech, they will be well supported by the HPA. There is a relationship there. The new memorandum of understanding that I mentioned which is being drawn up between the HPA and the PCTs demonstrates the kind of good working relationship that is being developed.

I mentioned some of the key objectives that the agency has set for itself. Another objective, as the agency itself puts it, is to ensure,

"From Cumbria to Cornwall, the same high standards of response to an outbreak or incident."

The HPA is conscious of the need to ensure greater consistency in the response at local level to public health issues.

I was sorry to see the noble Lord, Lord Clement-Jones, picking over the bones of the PHLS. I was gratified that the noble Earl, Lord Howe, showed a slightly more statesmanlike approach to this particular issue. This is now, as far as we are concerned, water under the bridge. The decision has been taken and the laboratories have been transferred to NHS trusts, although the HPA retains eight laboratories that it runs itself. I am not sure there is a great deal of merit in going over that ground again.

All NHS-run microbiology laboratories are being required to seek accreditation, and, as the noble Lord, Lord Clement-Jones, said, there will be a new inspector of microbiology whose role is to champion and promote high quality clinical and public health microbiology. The inspector will look after both the former PHLS laboratories, which provide routine microbiology services, and also a much larger number of laboratories—approximately 300—providing the same sorts of services that were already under local NHS management. There is therefore a prospect of driving up standards across a wider number of laboratories, rather than just concentrating on the former Public Health Laboratory Services laboratories, important though they were.

I think I have dealt with most of the points that the noble Lord, Lord Clement-Jones, raised in regard to my remarks on similar points raised by other noble Lords. We will have to wait for the business plans from the new agency. I was not trying to be complacent in my opening remarks, which the noble Lord, Lord Clement-Jones called "upbeat". I was trying to get across the message that, in eight months, the new agency has done pretty well in trying to tackle some of problems that it faced. It is worth pointing out, if I dare say it again, that these changes are being introduced in a context where NHS spending is increasing by 7 per cent in real terms over a five-year period. We are therefore introducing these changes in a period of relative plenty, compared with previous eras.

The National Radiological Protection Board did say what the noble Earl said it said in its response to the consultation exercise, but, again, it has moved on. I am sure that he will want to make his own inquiries about that, but it has moved on and accepts that the changes to be made are sensible. It has been reassured by Scotland's attitude in its willingness to continue to use those services, which provide benefit to the devolved administrations.

I have dealt with most points that the noble Earl raised in responding to other noble Lords. He raised the subject of obesity; we know that that is a serious problem. I tried to set out to the House the Government's thinking on that in a debate not long before Christmas. If I have failed to answer any points, I shall read Hansard and write to noble Lords.

rose to ask Her Majesty's Government whether they have considered the possibility that the introduction of the single transferable vote might increase the level of public participation in politics.

My Lords, I congratulate the noble Earl, Lord Russell, on raising this Question. There have been reports of private discussions between the Prime Minister and the leader of the Liberal Democrats on electoral reform. I therefore welcome the opportunity to put on the public record why changing our electoral system would be detrimental to the health of the British polity, and why the proposal put forward by the noble Earl will not address the root of the problem of declining public participation in politics. Rather, utilising the single transferable vote for parliamentary elections has the potential to make the problem worse. As such, it would constitute part of the problem and not part of the solution.

I shall address first the basic problem inherent in adopting a system of proportional representation for parliamentary elections. One of the fundamental attributes of our present political system is that it delivers accountability. The late, distinguished philosopher, Sir Karl Popper, argued that the most important feature of a political system was not how it enabled a government to be chosen, but rather how it ensured that a government could be removed peacefully from office. The electoral system of the United Kingdom, he argued, facilitated the removal of the government from office. Election day constituted judgment day. That is something that we should seek to preserve.

Under our existing system, one body, the party in government, is responsible for public policy. It is returned to office on the basis of a particular programme. If it fails to deliver, electors know that they can sweep it from office at the next election. Awareness of electoral mortality encourages the government to be responsive to public opinion between elections in a way that is often not encouraged in other systems, where politicians know they can engage in post-election bargaining in order to stay in office. Accountability is thus fundamental to our political system. That, I think, is worth protecting. I believe that electors take the same view. Surveys reveal that. when asked, electors tend to favour electoral reform. However, when asked about the consequences of electoral systems, they tend to favour the consequences that result from our existing first-past-the-post electoral system. I should also record that one should be wary of citing polls that show people favour electoral reform. Some years ago, in a poll where respondents were probed more deeply, it emerged that most did not feel strongly about electoral reform and twice as many had never heard of proportional representation as those that claimed to know quite a lot about it.

Accountability is but one reason why we should retain our existing electoral system. There are several others. The system that we have provides a direct and exclusive link between citizens and Members of Parliament. It tempers party control through giving MPs a local base. The constituency can, on occasion, provide a protective shield against the demands of the Whips. It also provides some degree of proportionality of power.

Supporters of proportional representation define proportionality solely in terms of the relationship of votes to seats. However, if 10 per cent of the votes deliver 10 per cent of the seats, they do not necessarily deliver 10 per cent of the negotiating power in the House of Commons. The result can be disproportionate negotiating power, far in excess of anything justified by the number of votes gained. If proportionality is defined instead in terms of the ratio of votes gained to the time spent in government, the UK system has proved more proportional than many other Western systems. Thus, there is a powerful prima facie case for retaining our existing electoral system.

Are the attributes that I have outlined outweighed by the benefits ascribed to the PR system of the single transferable vote? The answer is an unequivocal "no". One argument advanced for STV is that it retains the link between Members and constituencies. Members are elected in multi-member constituencies. However, that has generated a particular problem. STV in Ireland has contributed to the phenomenon of localism and Members of the Dáil devoting disproportionate time to their constituencies and failing to engage in the collective task of scrutinising the executive.

Eunan O'Halpin, in his chapter on Ireland in Parliaments and Governments in Western Europe, which I edited in 1998, records the claim that Members of the Dail play a subsidiary role in policy-making and scrutinising the executive and that,

"most dissipate their energies in electorally rewarding but nationally futile brokerage (interceding with central and local bureaucracy on behalf of individual constituents or groups of constituents)".

Interestingly, in this context, there have been calls in Ireland for reform of the electoral system in order to reduce this incentive to localism. Indeed, Fianna Fáil has previously made the case for adopting the first-past-the-post system. In the United Kingdom, we manage to maintain a balance between constituency work and scrutinising the executive. We should not be going down the route of seeking to be like the Dáil, which is one of the weakest parliaments in western Europe.

But would not the introduction of a system of STV increase turnout in general elections? That is what the noble Earl is asking the Government to consider. Again, perhaps we may look at the experience of STV in Ireland. What has happened to turnout in general elections there? Turnout has fallen substantially over the past eight or nine general elections, from roughly three-quarters of the electorate voting to two-thirds.

My Lords, Ireland is one conspicuous exception to the point that I was making about the greater range of issues that concern people. Over there, the whole of their politics is due for a 100-year service.

My Lords, I shall come to the point made by the noble Earl about pressure groups, but I must point out that all the experience of STV in Europe is in terms of Ireland. My point is that it does not provide much of a basis on which we can consider going forward.

On that basis, the Government may find that there is not much to consider. But if that does not persuade the Government, perhaps we should look elsewhere. Let us not look at Ireland; let us look at elections to the European Parliament. In Britain, we have moved from the first-past-the-post system to a regional list system of proportional representation. What has happened? Has turnout increased? The answer is "no". Introducing a system of proportional representation has done nothing to increase public participation in politics.

There has been a decline in mainstream political activity over the years. There has been a decline over time in the number of people joining political parties. There has been something of a decline—although not the consistent decline that some critics claim—in turnout at general elections. Voting by young people, a body that traditionally has a low turnout, is even lower now than it was 30 years ago. However, I stress that the decline has been in what I have called mainstream political activity; that is, people engaging through the political parties and supporting those parties in the polling booths

There has not necessarily been a decline in political activity as such. Rather, people have found outlets for political activity other than through the political parties. As the noble Earl mentioned, they have joined interest groups, including single-issue groups, which enable them to focus on issues of particular concern to them. They have also proved willing to engage in demonstrations and to sign petitions. People will take to the streets if they disagree strongly with a policy, but they appear reluctant to engage in the process by which policy is made.

Why, then, the decline in mainstream political participation? It has nothing to do with the electoral process. I wish to suggest two reasons, one in respect of political parties and the other in respect of power.

Political parties have proved less attractive to people than before, at times because they do not appear to offer electors much of a choice, but more enduringly, I believe, because there are now far more competing attractions than there were in the 1950s and 1960s. There has been a significant growth in the number of interest groups and concerns about public policy are being absorbed by such groups. There has been a burgeoning of attractions outside the realm of the political, facilitated by the expansion of the mass media and now by the Internet. It is difficult for political parties to compete. Catch-all political parties, geared to discussing and generating public policy, can offer little to compete with the quick, easy and transient attraction of "Pop Idol".

Fragmentation of political power is also a problem. Where now is political power to be found? There are competing centres of power. There is what I have termed the paradox of accountability; that is, the more elected bodies you have, the less accountable each one becomes. There is confusion on the part of electors over who is responsible for what. There is a perception—in this case, perception is important—that a great deal of decision-making power has passed to the institutions of the European Union. Organised groups may know how to lobby Brussels effectively, but the ordinary citizen does not. As power flows to different bodies, especially upwards to the European Union, there is the danger that people will feel helpless in the face of this development and turn their backs on mainstream political activity. If power is seen to be flowing to other institutions, what is the point of voting?

What flows from this is that we need to address the causes of declining participation in mainstream political activity and to consider what might, if anything, serve to reverse the trend. The noble Earl, Lord Russell, has noted the problem, but has not come up with a viable solution. Rather, if we have a system of proportional representation—destroying, as it is likely to do, the core accountability at the heart of our political system—that will add to the problem, denying electors the opportunity to call government to account. That is not the road down which we should be going. Other countries are experiencing similar problems. Adopting one of their electoral systems is not the answer.

My Lords, it is a privilege to take part in a debate initiated by my noble friend Lord Russell, and I congratulate him. It is also a privilege to follow the noble Lord, Lord Norton of Louth, who has made an extremely eloquent and interesting speech setting out what I would describe as the reactionary Conservative position, which of course he is entitled to do.

My Lords, I rise on a point of clarification. To be reactionary is to support the status quo ante. I am being conservative.

My Lords, I am quite happy for the noble Lord to describe himself as he wishes. He is certainly a Conservative. While I am tempted to spend all of my time picking apart item by item what the noble Lord has just said, I shall try to resist doing so. However, I am bound to say that when he referred to accountability and the ability of the electorate to boot out the government in power, I am reminded of the general election held in 1951. The electors voted to keep the Labour government in power, but because of the quirks of the electoral system and despite the fact that Labour won more votes than the Conservatives, it was the Conservatives who secured a working majority. I do not consider that to be accountable.

It is also said that because the quirks of the electoral system have now shifted away from a natural bias towards the Conservatives—which existed for much of our lifetime—to a strong natural bias towards Labour, the present Government could receive as little as 37 or 38 per cent of the vote at the next general election and still retain power. So almost two-thirds of the electorate could vote against them but they would still be there. The noble Lord is entitled to believe that that adds up to accountability, but I do not believe that it does.

The noble Lord mentioned the situation in the Republic of Ireland where, at various times, the two largest parties have wanted to move towards a system of first-past-the-post. Fianna Fáil is consistent in wanting to do so. Of course it is. If the Republic was to adopt a system of first-past-the-post, Fianna Fáil believes it would get an overall majority on a minority of votes.

It is interesting that whenever the political parties in Ireland have tried to introduce the system through a referendum, the people of Ireland have said, "No. We like STV and we are going to keep it. The politicians had better operate under STV because that is the way in which we, the people, can maintain the greatest amount of influence and control over our politicians". As I will make clear later, that is what STV achieves.

Of course this not only concerns Westminster elections. We have local elections and European elections; we now have elections in Scotland and Wales to the Parliament and the Assembly; and there may soon be elections to the feeble regional authorities that the Government want to establish in certain parts of the country. It is interesting that there is a steady movement towards forms of proportional representation for these different elections. It is quite clear that the Scottish Parliament, the Scottish Executive, will introduce proportional representation—probably STV—for local elections in Scotland. There is a general view there that, if that happens, the Scottish parliamentary elections will not he long following.

If that happens, it could be the beginning of what the noble Lord, Lord Norton, would perhaps see as a rather slippery slope but which others would see as the opening of the gates to an idea which has been around for a long time. Those of us who, for a long time, trod the streets on behalf of the Liberal Party—Liberal Democrats seem to have been doing so for the party's lifetime—believe that STV's time is coming and may well come within our lifetime.

It used to be called the "British" system of proportional representation. It is interesting that when we started to adopt proportional representation for various elections we moved instead to non-British systems of lists and top-up lists, where the candidates are listed in order by the political parties. This represents the old political parties trying to exercise control through a system which prevents the people from having the control that STV would give them.

No system is perfect—there are defects with STV as with any other system—but STV gives power to individual voters more than any other system. It not only allows them to cast their votes for individual candidates and, as my noble friend said, to choose between candidates from a particular party according to their views on issues they think important, it forces them to do so. It forces them to put the candidates in order. If they want to vote for the Labour Party, it forces them to put in order the candidates from the Labour Party. If they have strong views about which of those candidates is better than the others, it allows them to do that. Parties do not like that, because they like to keep control of the process and to determine exactly who gets elected when they get so many votes. However, it is an old-fashioned idea that parties should have that kind of control and authority.

The second thing that STV does, as my noble friend said, is to allow people to vote across parties if individual issues are what move them to vote. It is true that individual issue politics has become far more important in recent years. STV would allow them to vote for the candidates who have those views, regardless of which party they belong to. It also allows voters to transfer their preferences from their favoured party to other parties later on, in order to increase the amount of influence that they have over the final result.

In local politics, that gives hope to independents. People say that independents cannot succeed under STV, but that is absolute nonsense. Strong independents will do well under STV. For example, in a five-member STV seat, a strong independent would have to get only nearly 17 per cent of the vote to be guaranteed to be elected. In practice, if they picked up lots of transfers across the board, they might well be elected with quite a few votes fewer than that. It would make it possible for people who are at the moment kept out by the party system to come in and add variety and interest.

Again, political parties do not like that—and I do not suppose that my own political party likes it too much, either. However, that is something that STV does that is very important. It increases dramatically the chances that people's votes will actually count towards the final result. In a five-member seat, probably more than 80 per cent and perhaps much more than 80 per cent of people who vote will have achieved influence over the final list of those who are elected. Under first past the post, the number can be as low as 20 per cent in very safe seats. The question then is whether it is worth people bothering to go to vote or even to send their postal votes back, because it will not make any difference to the result. Under STV, the way in which individuals vote is highly likely to have an influence on who gets elected. Surely, that would encourage people to take part in the system.

STV is surely the system that provides the greatest accountability between the individual voter and those who are elected. That is the most important thing. All the arguments that the noble Lord, Lord Norton, puts forward about electing a national government, even if they are valid, do not apply to any of the other forums.

I should like to end by casting some doubt on whether turnout in elections is going down in a permanent and significant way. Certainly, at the moment, turnout seems to be low. The question is whether it is a short-term phenomenon or something that will affect the body politic for a long time. From a graph produced by the House of Commons Library, in one of its publications, it is clear that in general elections turnout peaked in 1950 and that between 1950 and 1966, there was a gentle decline—if one draws some obvious straight-line graphs at the top of the bar chart. Between 1950 and 1966, turnout declined fairly steadily and gently, and in 1970 it was 72 per cent. Between 1974 and 1992, it is difficult to argue that turnout went down at all. It fluctuated, but there were highs at each end and slightly lower troughs in the middle. The phenomenon of reduced turnout possibly started in 1997—although we could include that in the series. However, it does seem to have happened at the last general election, and it has occurred in other elections.

In local elections, turnout in recent times peaked in 1990. Again, I am taking this information from figures in a House of Commons Library research paper. For those of us who remember campaigning in the 1990 local elections, turnout peaked then for very obvious reasons. It was the time of the poll tax, and that was the election at which the people of Britain rose up and said, "We don't want the poll tax and we're going to vote against it". Regrettably, most of them voted Labour as a result, but not in all places. But it does not matter—the result at that election was caused by the political circumstances of the time, not by the electoral system or anything else.

Although local election turnouts have declined almost year by year since then—there had not been that kind of dramatic local political context in most places—there is some evidence that that decline has now ceased and might be reversing. We will not find out until two or three more years have passed. But I advise against a counsel of despair—people should not say that electoral turnout in this country is going down and down and that this will be the case for ever and a day. It will not. When people really feel angry, and they feel the need to feel angry, they will vote.

Finally, STV provides the opportunity for people to be angry about a much wider range of issues and have more influence on the result. It is therefore, in my judgment, likely to encourage people to turn out to vote.

My Lords, I am grateful to the noble Earl, Lord Russell, for introducing this debate, not least because it gives me an opportunity to pay tribute to the unfailing contribution that he makes to the work of this House. He combines an unrivalled knowledge of history with an acute sensitivity to contemporary events that enrich our work. It is typical of that sense of purpose that he has raised what is a priority for parliamentary reform.

The Government are planning yet further limited change to this House. They have decided to avoid their initial promise of providing a more democratic and representative House of Lords and their support in their last election manifesto for an elected element in this House. They are tinkering with a niggardly measure which—rightly, in my view—has secured cross-party rebellion. And yet, they are not showing any interest at all in change to the shape of the other place.

This is probably for a simple reason. It is probably because the House of Commons, unlike the House of Lords, is a largely subservient assembly. In the last Parliament, it was totally subservient to the Government. There were 1,000 Divisions, and the Government won exactly 1,000 of them. In this Parliament, there are more stirrings from the discontented and disaffected. But in the end, as over Iraq and foundation hospitals, the Government, after the dramas, get their way.

We have to think of some fundamental questions. How real is parliamentary accountability? How representative are Members of Parliament? That issue is beginning to strike some Members of this House when they consider the difference in attitude to fox hunting between the Members on the Government Benches in the other place and the public. How real is the old claim, going back to 1689, that Parliament is truly sovereign? Or is the reality that we increasingly have what Lord Hailsham famously described more than 25 years ago as an elective dictatorship?

In 1997, the Government had no doubt that the issue should be promptly debated and the people given a voice. They made a clear manifesto promise, as no doubt the Minister will confirm in his response, to set up an independent commission to propose alternatives to the first-past-the-post voting system. They made an unequivocal promise that there would be a referendum on the outcome of the work of that commission. They then recognised, rightly, that there was a need to offer the voters a choice whether they wished to change and improve the voting system.

The commission was established commendably promptly under the chairmanship of the late Lord Jenkins. I was fortunate enough to be asked to be a member. We were asked to report within a year, and we did. We did not seek to be revolutionary. We explored alternative systems, including that in the Republic of Ireland. We were wonderfully entertained on our visit to the Republic and the returning officers took the greatest pride in explaining that whether or not the voters understood the way in which STV worked, the returning officers did and all was well.

Our own suggestion for modest change was that as well as retaining the constituency system we should have an alternative vote within that system to give wider opportunity of choice to those in the single member constituencies, but with a top up, as we called it, of a modest 20 per cent proportional representation. We did not seek to go the full German route of proportional representation. We were concerned to adopt an evolutionary approach that might have some chance of acceptance. We considered that would mean greater fairness to the voters in the distribution of seats between parties and that everyone would feel that their vote would count for at least a little. The cogency of the report and the wonderfully readable style are a lasting tribute to the work of Lord Jenkins. But even—

My Lords, I am most grateful to the noble Lord for all he is saying. May I just put on the record that I breathe no word of criticism of the Jenkins report?

My Lords, I am very conscious of that because the noble Earl and I are very much on the same side in this debate. We have slightly different views on the preferable means of improving the system but whether or not it brands me as an inadequate Conservative, I am fully supportive of changes to the electoral system.

However, even our modest proposal found no favour with the Government. Did we have a formal response? No. Did we have the whiff of a referendum? No. Was our report cynically tossed into the long grass where it continues to languish? Yes. The Government were by then already addicted to power. They had won such a victory that they no longer needed to woo the Liberal Democrats and unfortunately they became oblivious to the key issue of fairness to the voters. Here I must part company with my noble friend Lord Norton of Louth. He attaches immense importance to the old argument that the great benefit of our system is that it enables us to "throw the rascals out". That in my view is too negative and too modest a view of what is needed in fairness to the electorate. Fairness to voters is what it is all about; it is not about fairness to government or political parties or keeping an established system in place but about giving voters the opportunity to be properly represented.

In a sense I think that my noble friend's argument would have been convincingly advanced by Napoleon III in the France of the Third Empire in his support of a referendal democracy, but it ignores the fact that there arc acute anomalies which will, I think, be recognised at some future time when glaring practical inequities surface and arouse sudden concern. Perhaps I may briefly list some of them. In four out of the past five elections, governments of two political complexions—I am not making a party political point—had an overall majority of more than 100 with rather more that 40 per cent of the voles. At the last election, Labour had 44 per cent of the vote and they have an overall majority of 180. That disproportionate approach, whichever party it temporarily favours, is unhealthy, unrepresentative and also lessens the valuable need for governments to try to reach out for consensus in society.

The second issue that I shall raise was anticipated in the thoughtful speech of the noble Lord, Lord Greaves; that is. the distribution of votes. There is a mix of large and small constituencies. That means that an inappropriate advantage is conferred on the Labour Party. In the doctrine of electoral reformers, it is called systemic bias. That could be of immense democratic importance if, for example, at a coming election, Labour and Conservatives were to dead-heat at 38 per cent. Is it really acceptable in our society that Labour should still have a majority of 75 seats? Will that be comfortably accepted should that dead heat arise? If not, should we address it now?

In spite of that, there is little interest in my own party in any type of electoral reform or in any of the anomalies about which I speak. I would simply say as gently as I can to my noble friend on the Front Bench that I find that disappointing, although I am grateful for the way in which my differing views are, as they are on other issues, tolerated in the broad-church party that is the Conservative Party in this House.

My next point relates to Scotland. In Scotland, as we know, MPs in the UK Parliament have no vote on the wide range of devolved affairs, yet they vote on purely English issues. The time may come when there are more English MPs against a government proposal than in favour and the Government are saved on English issues only by the votes of those Scottish Members. Will that be accepted for very long? The West Lothian question, as it has historically been known, is compounded by the size of the seats in Scotland. They are small. The Government were to take action to reduce the number of Scottish Members, but, alas, that has been postponed. That inequity continues.

I move on to a point where I come very much together with the noble Earl, Lord Russell; that is, the value of a vote to people. In many constituencies—perhaps 400—there is never a change of party control or Member. If one lives in that constituency all one's life and happens to support a party other than that which wins that constituency, one's vote never counts at all. I cannot help thinking that that may be one of the reasons why the voting in general elections in this country has dropped to 61 per cent. I applaud what the Electoral Commission is doing under Sam Younger, its chairman, to try to make it easier for people to vote, but we have to look at the fundamentals as well. It is incontrovertible that proportional representation, or even a measure of it, would give some purpose to every vote. So although, because of my Irish experience, I disagree with the noble Earl, Lord Russell, on the STV, I agree with him strongly on the principle of fairer representation. It is right that all new systems are proportional, whether for Europe, Scotland or Wales, or in the London local elections. We are maintaining a dinosaur of a system that is so inequitable to the voters and excludes so many from a meaningful part in the democratic process.

I wish only that the Government would look honestly at the issue, and do so instead of seeking to tinker further with this House, where they have not come forward with a single argument to suggest that our work is not being done, on the whole, reasonably well. The time must come, and it should not be left to when a government feel that the only way to retain office would be to offer another party a douceur of a change to proportional representation. Fairness should begin now.

My Lords, I, too, thank the noble Earl, Lord Russell, for raising what has been a quite fascinating debate. There have not been many speakers, but those who have taken part have provided me with a great deal of food for thought. I also endorse the tribute made to the noble Earl by my noble friend Lord Alexander of Weedon about his contribution to the House, which we all appreciate and have welcomed. In the time I have been in the House, I have certainly always enjoyed his speeches and the erudition with which he speaks.

I am conscious that there have been important speeches tonight, and I am delighted that I have had behind me the noble Lords, Lord Norton of Louth and Lord Alexander. I am not so delighted that neither of them supported the view that I am likely to take, but there is the broad church of the Conservative Party, as the noble Lord, Lord Alexander, said. We also had a very interesting exposition by the noble Lord, Lord Greaves, on the virtue of STV. I disagreed with most of it, but he certainly taught me a thing or two on the way. I agree with him—I hope that my agreeing with it will make it a certain fact—that the reduction in voting at the moment is not necessarily a long-term phenomenon. Of course, it has generated this debate.

The first message that I got about the debate was that it was on the single transferable vote—full stop—so I thought that my reply could be really succinct. I wanted to say, "We are against it", and sit down. However, when I looked at the full title, I realised that there was more to the debate than that, and that I would have to say a little more than that. However, my initial thoughts on a response were not too far off our position on any form of alternative voting systems. They all have one overarching problem, which is that they separate candidates and the elected from constituencies. In my view, none can guarantee the strength of government that we constitutionally currently have.

Perhaps that is rather odd. Given our current position in opposition, it might be thought that we would want to review the options for a quick return to power, but none of the alternative routes would provide the stability that we have and value in our current democracy or, as my noble friend Lord Norton said, that provides the accountability that we currently possess. We have a well tried system in this country—at least, we still have it for general and local elections, although the water has been muddied with some of the more recent interlopers into the democratic system, such as mayoral elections and devolved government. But we have a system that has brought stable government to this country for years and where people are selected by individual parties to put themselves forward to a particular electorate. Those people who are voted in represent that electorate.

I am slightly anxious about the suggestion of the noble Lord, Lord Alexander, which has been made elsewhere, that a vote is wasted in a constituency where a party does not win. A vote can never be wasted from that point of view, because if enough votes are cast a party will win. It has been shown on innumerable occasions, particularly in some noteworthy by-elections, that votes and voters are capable of overturning the status quo.

The advantage of the current system is that the representative has to concentrate on maintaining the support of his electorate, work for it and assist with its problems. In general, he has to be identified with that constituency and have a unique position within it. No other system has that direct connection between the two—not even the single transferable vote, which would result in a number of members representing much enlarged constituencies. The nearest is that espoused by the noble Lord, Lord Alexander, the additional vote system, which maintains the one member one constituency connection but brings with it the distribution of votes on an elimination basis to reach the result. So voters do not and cannot have a transparent view of what their vote has achieved.

We have heard today the repeated concerns about the percentage of people who turn out to vote and falling numbers in all elections. The Bill that we will discuss on Thursday, the European and Local Elections Pilot Bill, is germane to the discussion about whether there are administrative and practical methods of encouraging those who want to vote to do so. But what we all have to admit is that there is a large percentage of the electorate who are disengaged from the electoral system—whatever system and for whatever reason. They will not vote whatever changes are made. Some of the reasons are obvious and my noble friend Lord Norton put them more elegantly than I: the perception that Parliament has less and less control over its own affairs as a result of the ascendance of the European Union; that laws are passed down and implemented without parliamentary intervention; that Members of Parliament consequently have less and less influence over policy—some people suggest that MPs are becoming self-seeking; that local government has lessening powers to look after itself; and that there are too many elections and people do not know what they are for. There is a feeling that the Government do nothing to "help me".

We have all heard those arguments, which, while we may not agree with all or any of them, are familiar to all politicians, even if we cannot at present see a way to improve the situation. The question today is whether a different voting mechanism would improve matters, or, perhaps, improve the lot of smaller parties and people with individual views, who receive fewer seats than they feel they are entitled to by the number of votes cast nationally on their behalf. The Liberal view. which has not necessarily been put by the noble Earl, Lord Russell, but may have been by definition, is along those lines.

The arguments put forward for STV—that it breaks the party hold on government; that it enables people with wide views to be elected; and that voters have a choice between candidates and do not need to support a candidate of their own party, but can swap and choose—is counterbalanced by the complexity of the counting system, the requirement for large electorates—up to about 150,000—with multi-member constituencies, and the potential for an inconclusive or finely balanced parliament unable to deliver on a manifesto commitment. Governments who put to the electorate their proposals for the policies that they wish to implement, so long as they do not "cheat" on that, at least enable a clear position to be held by electors on whether they have fulfilled their promises or have affected the country well or badly.

I am aware that the single transferable vote system is supported by the Electoral Reform Society, on whose behalf the noble Earl, Lord Russell, spoke. But it is interesting that it was not the system put forward to the Labour Government by the Jenkins commission in 1997, when this was a "hot" topical issue. I listened carefully to what my noble friend Lord Alexander. who was a distinguished member of that commission, said about the not very great difference between the single transferable vote and the additional member vote systems.

Thus, there is little agreement, even among those who have taken an academic interest in the subject. about any realistic alternative to the one voting system that we have at the moment. Therefore, perhaps we should simply leave the matter alone because "if it ain't broke, don't fix it". That is where we would stand in the absence of more compelling reasons than have been put tonight, previously or, most likely, in the future.

My Lords, I have enjoyed this debate more than I have enjoyed many in your Lordships' House. In a sense, it has been, much as the noble Baroness, Lady Hanham, said, a debate small in number but with a very distinguished cast list. I feel that I genuinely learnt something throughout the discussions on the issue debated this evening. I congratulate the noble Earl, Lord Russell, on introducing the debate in the way that he did, with many wise words.

Another feature of the debate has been its breadth. Two very different and equally distinguished views were aired from the Conservative Back Benches. One came from the noble Lord, Lord Alexander of Weedon, who, following his important and distinguished work on the Jenkins commission, offered us a view of that commission's contribution to the discussion about proportional representation systems. The other was a robust and hard-nosed view of the threat that PR in some variant form, perhaps of STV, might pose to the nature of United Kingdom parliamentary democracy.

I considered another interesting feature of the debate to be the use of the term "accountability", and different views were expressed on that. One came from the noble Lord, Lord Norton of Louth, who spoke about the importance of accountability within the parliamentary system. The other view, expressed lucidly, came from the Liberal Democrat Benches and referred to the importance of accountability to those whom, after all, we are here to serve—the electors or voters.

I am aware of the considerable interest that exists in electoral issues. I am delighted that we focused a good deal of attention on the issue of the single transferable vote system not only as a model for improving the proportional nature of our electoral system but also as a means of encouraging interest in democratic and electoral politics.

It is interesting that, in a sense, the best example of STV—certainly the only example within the United Kingdom's system of government—is within Northern Ireland. It is ironic that it was the Conservatives who, when in government during 1970 to 1974, first introduced STV into our political processes when they implemented it for local government in Northern Ireland. STV was introduced in Northern Ireland as a means of ensuring that, in a divided society, the candidates elected accurately reflected the opinions of the voters so that the strength of each party in the Assembly, or council, would be proportional to support among the electorate.

While it is generally recognised that an STV system can produce what one might describe as a "scrupulously proportional" result, and certainly notwithstanding what the noble Earl has said, there is little evidence to suggest that the introduction of such a system is likely to increase the level of public participation in politics or necessarily to enhance voter turnout. We have had some debate on that issue. It is certainly the case that within the Dail elections there has been a decline in turnout, even though there is an STV system in place.

We have in this country a first-past-the-post system for general elections. but turnout has only fallen significantly perhaps in the last two general elections, and in particular in the last general election. For that reason, I do not think that turnout can be blamed on the lack of an STV system. The noble Lord, Lord Greaves, made the point that it is not necessarily the case that this is a long-term and continuing trend. We have too little evidence to suggest that. There is countervailing evidence to suggest that interest in politics is very much alive and well and some considerable evidence to suggest that interest in local government is beginning to revive, regardless of whether there is an STV system in place.

It is certainly notable that turnout for European parliamentary elections has remained good in Ireland in comparison with other member states. However, it is worth counterbalancing that by saying that traditionally voting has been popular there even before the introduction of STV.

Some comment was made during the course of the debate about the role of political parties and politics itself. I would argue that the parties themselves have a large responsibility for reinvigorating the political system and encouraging voter participation. The independent Electoral Commission has indicated in its book on Election 2001 that public participation in politics depends to a great extent on,

"the quality and persuasiveness of the policies put forward by the political parties and their ability to motivate voters".

In An Agenda for the Future, the commission warns:

"Responsibility for re-engaging the electorate with the democratic process must rest in large part with the political parties".

So it is our responsibility. I do not think that it is one that we can shirk lightly.

I turn to the Government's record on proportional representation. I think that I can argue that our record is fairly good. We have shown a willingness to address the issues where appropriate and to take action when it is necessary, although the noble Earl, Lord Russell, may be disappointed that STV has not specifically figured in our efforts.

In the Government's first term, in line with our 1997 manifesto, we set up an independent commission to look at proportional representation for Westminster, a matter that was commented on many times by the distinguished and late Lord Jenkins of Hillhead. It produced a very interesting and illuminating report, which recommended, as the noble Lord, Lord Alexander of Weedon, said, an alternative vote plus top up system—AV+ rather than STV.

We also introduced proportional representation for the European parliamentary elections in 1999, for the Scottish parliamentary elections and for the Welsh Assembly elections also in 1999—

My Lords, I am grateful to the noble Lord for giving way. Since he trails his coat about the excellence of the Government's record on proportional representation, does he agree that the 1997 manifesto promised a referendum on the outcome of what became the Jenkins commission? If so, can he say why such a referendum has never been held?

My Lords, I shall deal with that point because I think it is important. I finish the point about where we have introduced forms of PR simply by adding that it was introduced for elections to the GLA in 2000.

Perhaps I may cover the noble Lord's point. It remains the position that if, in the light of political developments and the review which we promised of the electoral system in our 2001 manifesto, there were recommendations to change the electoral system, we would obviously abide by the commitment we made in our 1997 manifesto that there would be a referendum on that issue.

My Lords, I am most grateful to the Minister for giving way. At this stage, can he say anything more about the review to which he referred and the possibility of recommendations being made? By whom would the recommendations be made? Do the Government envisage a further commission sitting on the issue, in supplement to the Jenkins commission? Does he envisage this being a review in which other political parties participate? Does he envisage that it would be an internal review only, conducted by the Government, or one conducted by an individual? What is the nature of the review? When is it to take place? What will its status be? Will he acknowledge that it would be wholly unsatisfactory, in view of the great work that was done by the Jenkins commission, to have something of less standing producing the definitive position on this issue?

My Lords, I am grateful to the noble Lord for his intervention. It is worth revisiting what we said in our most recent manifesto, in 2001. It referred to the major innovations which I have mentioned; innovations that we have already introduced to the electoral systems for the devolved administrations, the European Parliament and the London Assembly. It confirmed that we would review the experience of the new systems and the Jenkins report to assess whether changes might be made to the electoral system for the House of Commons.

No decisions have yet been made on the structure and timing of any review and a number of options are possible. We are considering when and how best to initiate any review so that it can be comprehensive and can look at practical experience gained. We have already had some very useful experience in the real life working of various PR systems in various elections. Further experience will be gained in this year's European parliamentary and Greater London Authority elections. In both cases, this will be only the second time that elections to those bodies will have been run under their respective proportional, though not STV, systems.

Lessons learnt from experience on the ground are most valuable, which is why the detailed reports produced after elections by the independent Electoral Commission are so useful. Noble Lords may also be aware that another body, the Independent Commission on Proportional Representation, a team of electoral experts, has been carrying out a study of how PR has actually worked thus far in the UK.

The ICPR was set up by the constitution unit of University College London. It is jointly chaired by David Butler and Peter Riddell, the political correspondent of the Times, and its vice-chair is Professor Robert Hazell of UCL's constitution unit. The ICPR membership includes a number of well known MPs and MEPs from all parties, together with distinguished academics and journalists. Its stated aim is to conduct research to ensure that the Government's review of the electoral system for general elections, to which I have referred, is based upon the best available evidence. The ICPR produced and published an interim report on the experience of PR in April last year and it will produce its final report in March 2004.

Any review that the Government might initiate will certainly wish to draw on the findings of the Jenkins report, the reports of the independent Electoral Commission on particular elections and our own views of the experiences of the devolved legislatures and also the findings of the ICPR report. We have listened very much to what has been said about methods of proportional representation. We have taken careful note of the arguments for particular systems—in particular, STV and the different permutations of PR generally. There are arguments for and against each possible voting system.

This debate has been most valuable because it has attempted—perhaps sketchily—to make the link between voting systems and public participation in politics. That is a rich and interesting vein, although perhaps we should consider more generally ways to engage the electorate further to foster confidence and strength in our parliamentary system.

There can be no doubt that the first-past-the-post system is simple and easy to understand, while STV can seem convoluted and complex. On the other hand, first past the post may tend to discourage those supporting minority parties from voting, while a PR system can or could ensure that all votes carry weight— although some systems of PR give greater weight and create greater equality than others.

In general, the Government welcome wide consideration of those issues. I put on record our preparedness to learn from the results of research and experience. Indeed, no one can seriously question our appetite for considering and undertaking wide-ranging constitutional reform when necessary. Debate such as this about different PR systems and the participation of the public generally in politics play an important part in that continued and continuing debate.