My Lords, I very much hope that the Minister will have a deep discussion with his colleague, the noble Earl, Lord Howe, from the Department of Health, not necessarily about every single word of this quite lengthy amendment but about the general questions that it raises. I have in my hand a letter from the president of the Royal College of Physicians, Sir Richard Thompson, which was not one of those colleges mentioned by the noble Baroness, Lady Masham, but which raises serious questions about the public health implications unless we can look very carefully at them in the short while before Third Reading.
I think the noble Baroness, Lady Jay, who has played a crucial role in the whole area of sexual diseases, particularly AIDS, would bear out the argument made by Sir Richard. The major point he makes, and it is a very important one, is that there is considerable evidence that people who are invited to clinics, particularly the Doctors of the World Clinic in east London, to be tested for very dangerous and infectious diseases such as AIDS and drug-resistant tuberculosis—which is growing rapidly and now becoming a significant
international threat to the good health even of people in relatively healthy countries such as our own—will see even relatively limited financial barriers as reasons not to attend. One of the prime difficulties is that when somebody attends a primary care facility, which is still generally available, or an A&E clinic and is referred on for testing to a hospital or another A&E clinic the real danger is that they will find this a reason not to attend. One has to accept that many people do not want to know what may be wrong with them. They are frightened of learning the results so any kind of hindrance is used as an excuse for not going.
The House will know, because it has had many discussions on infectious diseases and among its Members contains many experts in the field, the lethal consequences of people with AIDS or drug-resistant tuberculosis moving among the community where they live without being aware of the very serious, often lethal, consequences of passing on that infection. Sir Richard points out in his letter to me that one experience of that east London clinic is precisely that. There is a very rapid multiplying consequence of people not knowing what they have or knowing it and continuing to act as if they do not have to be treated. I simply plead with the House, from a non-partisan point of view, to look very closely at this amendment and consider what can best be done about it, in the interests of every citizen of this country and overseas visitors, to ensure that every possible step will be taken to ensure that highly infectious diseases are not passed on to innocent passers-by, friends or members of the family.