Ebola

Lord Hunt of Kings Heath Excerpts

Monday 13th October 2014 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, first, I thank the noble Earl for repeating the Statement. I start by echoing his words by paying tribute to NHS staff members and members of the Armed Forces and of the Diplomatic Service who have been heavily involved in the Ebola response both at home and in West Africa for many months. I am sure that we have all been horrified by the devastating scenes reported on TV as the virus has spread. People will also be worried by reports of a second case of Ebola in Dallas. There will be particular concern that that second case has occurred in a health worker. We look to the Government for reassurance.

The noble Earl repeated the point that the Chief Medical Officer expects there to be a handful of cases. Perhaps he could say a little about what modelling has been undertaken to estimate the potential number of cases. What is the range of those estimates? Is a handful of cases the worst-case scenario? He will be aware of the independent review of the Government’s response to the swine flu pandemic by Dame Deirdre Hine, who said that the only predictable thing about such events is their unpredictability. Can the Minister confirm that the Government are planning for the worst-case scenario so that there can be no sense of complacency?

It is also right that we should consider further measures to ensure that we are fully prepared should an Ebola case be identified here. I would like to ask the noble Earl about the Government’s position, as there seems to have been some confusion. Last Thursday, a statement on the Department of Health’s website read:

“Entry screening in the UK is not recommended by the World Health Organisation, and there are no plans to introduce entry screening for Ebola in the UK”.

Just 24 hours later the Department of Health changed its position. Will the Minister say what official advice on screening his right honourable friend received from the Chief Medical Officer and from Public Health England? Did screening have the support of the Chief Medical Officer? In interviews over the last 48 hours the Chief Medical Officer seemed to be saying that there is no evidence to support the effectiveness of the screening programme that the Government are putting in place. Can the Minister confirm that?

Can the Minister also say who is in charge? He will remember concerns as the 2012 Health and Social Care Bill went through the House about the fragmentation of public health and about responsibility for it seeming to be split between Ministers, the Chief Medical Officer, Public Health England, local authorities and the NHS at local level. There will be questions about who is in charge and who is accountable.

The preparation exercise undertaken this weekend was of course extremely welcome. The Minister will know that a patient was transferred from Newcastle, where they have negative pressure beds, to the Royal Free, where they have what are called Trexler beds. The current advice—which has recently been revised—from the Advisory Committee on Dangerous Pathogens is that patients can be handled in either type of bed. Can the Minister comment on that? If only Trexler beds are recommended, is he satisfied that the NHS currently has only two such beds, both at the Royal Free? Can the Minister update us about progress on the proposed second unit planned in Newcastle, which he mentioned when he repeated the Statement?

While border checks and preparation exercises are important, the public will want to be reassured on three key issues. The first is that treatment is available, and that all necessary steps are being taken to develop a vaccine. The second is that the NHS is prepared and that staff are sufficiently aware of the symptoms. The third is that public information is readily available. I will take each in turn.

On treatment, although there is currently no specific treatment for Ebola, there is an experimental medication called ZMapp which the British nurse who was treated here was offered and took. Will it be standard practice to offer that medication to patients, and are the Government satisfied with the current supply of it in the NHS? The best assurance we could give people is that there will be a vaccine which will be made easily accessible to those who need it most. Can he update the House a little more on progress in its preparation?

With regard to preparation, is the Minister satisfied that all relevant NHS staff, including GPs, know how to identify Ebola, the precautions to be taken in any presentation and the protocols for handling it once it has been identified? Can he give an assurance that safety equipment is of the standard stipulated by the WHO? He will be aware that it is a cause for concern that breaches of protocol and the quality of safety equipment have been cited as potential causes of the infections in Spain and the US.

What plans do the Government have in the area of public awareness? Has the Minister considered introducing a telephone advice line? Does he consider that it would be wise to temporarily increase the number of clinicians available to answer NHS 111 calls?

The UK has, rightly, pledged £125 million to assist Sierra Leone in fighting the outbreak. However, with cases doubling every three to four weeks there is widespread agreement that the response of the international community in general has to date been slow and inadequate. The window of opportunity to halt Ebola will close very shortly, and I ask the Minister what extra steps the Government are taking to help the affected countries with resources and clinical expertise? What are they doing to mobilise action by the international community?

Finally, do the Health Secretary and the noble Earl accept that improving global health systems is the best way to prevent these outbreaks, or at least to ensure that such outbreaks are caught before they get out of control? It is indeed shocking that the index case for this outbreak was identified 10 months ago. My own party, along with the Governments of France, Germany and Senegal, among others, has called for universal health coverage to be placed at the centre of global development, yet the UK is currently opposing such plans at the UN. Can the Minister explain the Government’s opposition to this?