HEALTH PROTECTION AGENCY
57. Getting Ahead of the Curve contained a
proposal for the creation of a new Health Protection Agency (HPA).[49]
The Agency was not formed as a result of the perceived increased
threat after 11 September 2001 but the proposal explicitly recognised
that any strategy to tackle infectious diseases needed to consider
CBRN terrorism.
58. The Agency, which came into being as a Special
Health Authority on 1 April 2003, combines some of the functions
of the PHLS with those of CAMR and the National Focus for Chemical
Incidents (NFCI). The HPA is working in close partnership with
the NRPB this year. There are plans to incorporate the National
Radiological Protection Board (NRPB) into the HPA "during
or after April 2004", but primary legislation would be required
to achieve this.[50]
The functions of the HPA (including the NRPB) in relation to CBRN
terrorism are summarised in Table 2. Written evidence was received
before the HPA was established and oral evidence was taken the
day after, on 2 April 2003. In this report we will generally refer
to the constituent bodies.
Table 2: Functions of the principal constituent
parts of the Health Protection Agency prior to 1 April 2003.
Public Health
Laboratory Service
| The PHLS was a national organisation of 47 Laboratories organised into 8 regional groups, and central units - Communicable Disease Surveillance Centre, Central Public Health Laboratory and headquarters
|
Centre for Applied
Microbiology and Research
| CAMR conducted research on microbial hazards associated with human health, and develops and manufactures diagnostic, prophylactic and therapeutic products.
|
National Focus for
Chemical Incidents
| NFCI worked to improve NHS preparedness with respect to chemical incident management and to advise the Department of Health and the devolved administrations of the potential public health impact of chemical incidents. It also undertook public health surveillance of the impact of exposure to environmental chemicals.
|
National Radiological
Protection Board
| NRPB provides Government and other authorities with advice and practical guidance on radiological protection. It has monitoring facilities as well as providing a monitoring coordinating role.
|
The House of Lords Science and Technology Committee published
its report on Fighting Infection in July 2003. It concluded that
the health service does not have the capacity to deal with chemical
or biological threats on a major scale. It recommended that the
HPA be given responsibility "for integrating surveillance
related to human, animal and food-borne infection at national,
regional and local levels in order to bridge the gaps that currently
exist between these areas of speciality".[51]
On 5 August the HPA published its corporate plan. Among its new
areas of work will be:
- Rolling out a training programme for health care professionals
so that they can recognise, diagnose, and manage patients who
have been exposed to CBRN agents; and
- Developing new standardised laboratory tests
for biological agents to ensure rapid and accurate diagnosis.
59. At the creation of the HPA, a board of non-executive
directors was announced. Sir William Stewart, Chairman of the
HPA, professed himself delighted with their "high calibre
and quality".[52]
We have no reason to doubt their credentials but we are surprised
that no attempt seems to have been made to recruit internationally.
It is vital that the HPA gets the best guidance possible and we
should be honest to admit that this does not all reside within
the UK.
60. The formation of the Health Protection Agency
is a positive move in terms of ensuring good public health surveillance
and combating infectious serious disease, and it should also enhance
the UK's CBRN counter-terrorism measures. The split of the PHLS
between national and local functions within NHS Trusts has been
given much attention and we do not plan to repeat the arguments,
except to say that expertise in the identification and epidemiology
of possible biological agents must be retained at a local level.
61. Before 11 September 2001, the DoH had asked CAMR
to provide a Strategic Response Capability. The role was to provide
support to DoH, the NHS and other Government agencies in responding
to emergencies arising from dangerous micro-organisms. CAMR concentrated
on those micro-organisms rarely encountered in the UK. In the
case of deliberate release, CAMR focused on the clinical consequences
of a release, thereby complementing the role of the Dstl Porton
Down.[53]
62. It is not obvious that the events of 11 September
2001 have had a major impact on the DoH's research programme beyond
that mentioned at CAMR above. Dr Harper told us that most additional
funding in this area is for countermeasures for training and awareness
raising. He said that most of their research work had been on
modelling the impact of releases, although this "could be
substantially increased in the future", and relatively small
projects to look for diagnostic tests for different chemical agents.[54]
Dr Harper should note the comments by the pharmaceutical company
PowderJect that "the role of basic biological research and
further product development is central to the development of effective
and broad countermeasures against biological weapons".[55]
63. Dr Charles Penn from CAMR told us that "terrorism
is a problem which has come not instead of existing health and
other problems but as well as, so it is balancing the extra needs
and activities which have come with that with the existing commitments
and existing programmes of work".[56]
CAMR has received an extra £11 million over 5 years to strengthen
its diagnostic capability.[57]
64. There is a danger that Government bodies will
be expected to enhance resilience with little or no extra funding.
Neil McColl from the NRPB told us that its grant had been fixed
in cash terms for a number of years and that, as a consequence,
it had diverted resources that were addressing other problems.
He said that the NRPB had given up some work looking at other
accident studies and radioactive waste management issues: "It
erodes our knowledge base… our delivery of emergency response
has probably been strengthened in some ways … but some of
the other aspects of radiation protection are starting to suffer".[58]
We have concerns about the funding of the HPA and the NRPB.
We have been told that they have been asked to take on new functions
but it is unclear whether adequate additional resources will be
available to meet the challenges from CBRN terrorism. We recommend
that any increase in their activities relating to CBRN countermeasures
should be reflected in their budgets. The HPA should not be undermined
so soon in its existence by a lack of funds.
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