Select Committee on Science and Technology Minutes of Evidence

Examination of Witnesses (Questions 260-263)



Baroness Walmsley

260. You have described a lot of very grass roots, practical applications for modern technologies, but is there any way in such a feeding upwards from the grass roots of the needs for techniques that perhaps do not exist or services or products that currently do not exist to some sort of organising body that says,This is what we need to look at and find a solution to"?

(Dr Gelletlie) I imagine that the HPA, the Health Protection Agency, will be a useful body through which all of the employees will be able to feed up their needs and which will have a role in commissioning research in asking. That would be one of the possibilities because hitherto some of that function presumably has been carried out with the Communicable Disease Surveillance Centre by the Department of Health and by the Public Health Laboratory service, but you are right: there has not really been an umbrella.

261. The HPA is the answer?

(Dr Gelletlie) Possibly.


262. You feel confident that the HPA can enable this research that you describe to be done?

(Dr Gelletlie) I hope so because the idea is that a lot of the research and development funding which is around will be pulled together and better targeted, one hopes. The funding will prioritise the targeting. Clearly you are dealing with a limited pot of money and there will have to be priorities, but when we are all within the one organisation it should be easier to communicate some of these needs.

Baroness Finlay of Llandaff

263. You have got sources of information at local level and you have described, Dr Monk, very clearly some instances where you have got very good quality data at a local level. What is the gate that is opened for that to be fed up through whatever system to a national level and do you think the development of the HPA will mean that that information is routinely going up so that if you have got sporadic outbreaks occurring they become co-ordinated and linked, because it sounds to me at the moment as if you could have things going on in parallel in different parts of the country with no awareness in one area except for a haphazard conversation or phone call between colleagues to really link in and make connections particularly on the source of infection?

(Dr Monk) I think the answer to that is unequivocally yes. Molecular typing is difficult. If we illustrate that with TB, there are three ways that are currently big picture. One of them is effectively an X-ray plate and comparing them is inordinately difficult and it is not a national surveillance tool. Another one is a black and white series of squares which you could capture into an electronic system. The one that would be most favourable is a number system. If we went down that system, I put them in database, feed them into a regional epidemiologist; they could be aggregated at national level and you would spot that sort of thing going on. There are some systems therefore which will work in exactly the way you have described. Meningitis is another one where you can do it. There are others where at the present moment the technology is there but they are based effectively on gel plates which take an X-ray picture on which comparability is a really difficult problem. As we were alluding to therefore, there is need for research. Hepatitis B viruses are an example where you get a gel electrophoretic plate. The technology is there, I have used it in a local outbreak, but it is difficult to get that comparability nationally. We have asked questions about whether a hepatitis B outbreak in sex workers is related to others and it is difficult because of the comparability issues. The technology needs to move forward to get it digitised.

(Dr Hawker) The important thing that links the last two question is that we need to make sure that local needs and local solutions also fit into a national strategy. If we take the example of TB, perhaps it is less important which of the three main methods is the most important than it is to make sure that everyone uses the same one because then the cases in Leicester could be linked to the cases in London. If they use different methods they will not be able to do this. The two areas we need to address are, first, how the stakeholders get to have their input into what surveillance should be and how well it is working, and then the related area is how the epidemiologists and microbiologists work closely together to make sure that microbiology developments meet the needs of epidemiologists and public health practitioners. On the former, the Communicable Disease Surveillance Centre has held I think a first meeting of a stakeholders' group which is an initiative we need to support. On the latter I am not yet sure that there is much of an input, certainly from the local and regional level of communicable disease control professionals, into the services that the reference laboratories provide. The moving of the CCDCs into the Health Protection Agency, together with the reference laboratories, should be an opportunity to increase their voice which has not been heard enough.

Chairman: We have come to the end of our time. We have not got to question 9 but that can be quite adequately dealt with by asking you to respond to it in writing if you would not mind, and also to include an evaluation of the chances of it being achieved and what are the potential drawbacks or problems in achieving it. Would you be willing to do that? The only other thing I have to say is that if there are issues on any of the other questions that you feel have not been adequately aired, perhaps you would like to put in supplemental comments. The last thing I have to say is thank you very much for coming along. It has been a very interesting session. We have had a variety of views which we will have to sort out in due course. Thank you very much indeed.

previous page contents next page

House of Lords home page Parliament home page House of Commons home page search page enquiries index

© Parliamentary copyright 2003