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Influenza

Mr. Matthew Taylor: To ask the Secretary of State for Health what is his estimate of the number of cases of influenza per 100,000 of the population (a) in England and (b) in each health authority in England for each winter in each of the years from 1984-85 to 1999-2000; and if he will make a statement. [110798]

Yvette Cooper: The information requested is not collected centrally. Influenza activity in England is monitored through the Royal College of General Practitioners sentinel surveillance scheme, which records the number of first visits to participating general practitioners of patients with influenza-like illness. This allows calculation of a rate for those cases of influenza presenting in general practice at any given point during the year and allows comparisons with other years. It is not possible to estimate a total figure for cases of influenza each winter from these data. The information is not collected by health authority area.

Mrs. Virginia Bottomley: To ask the Secretary of State for Health what estimate he has made of the number of working days lost due to the recent flu outbreak. [111148]

Yvette Cooper: The information requested is not collected centrally.

Mrs. Virginia Bottomley: To ask the Secretary of State for Health which of the measures contained in the Government's pandemic contingency plans were

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deployed during the recent flu outbreak, with particular reference to use of anti-virals to limit the spread of infection. [111147]

Yvette Cooper: We are in the interpandemic period ('phase zero' of the pandemic plan) and were throughout the winter period. The United Kingdom Health Department's Multiphase Contingency Plan for Pandemic Influenza was not implemented. A flu pandemic involves the emergence of a completely new strain of influenza virus and is a global phenomenon. We last saw a pandemic in 1968.

Mrs. Virginia Bottomley: To ask the Secretary of State for Health what assessment he has made of the effectiveness of the arrangements that were put in place prior to the recent flu outbreak to protect (a) health workers and (b) at risk groups by means of vaccination. [111146]

Yvette Cooper: A record 8.6 million doses of vaccine were available prior to the winter flu season, of which 7.8 million doses have been distributed to meet orders. Data for flu immunisation uptake among the risk groups is derived from the General Practice Research Database by the Public Health Laboratory Service. Recent changes to the database mean it is not yet possible to provide uptake rates for last year. We expect data to be available within the next few months. In the past, vaccine uptake has not been nearly as high as the Department would like and the Chief Medical Officer has already announced that he will be looking at ways of improving uptake in the future.

National Health Service trusts were advised that they could include immunising healthcare staff as part of their winter planning last year. The decision to offer the vaccine and which groups of staff this should be offered to, were matters for local decision. Employers were not required to collect information on take up.

Recycling

Mr. Crausby: To ask the Secretary of State for Health what percentage of documentation used by his Department is (a) made from recycled paper and (b) collected for recycling. [111601]

Yvette Cooper: The Department's environmental strategy supports the aim to achieve best environmental practice with a commitment to conserve paper. The paper used to print documentation contains 20 per cent. post-consumer de-inked fibre.

The Department has a paper re-cycling scheme but does not record the recycling of documentation in isolation.

Hospital Waiting Lists

Mr. Harvey: To ask the Secretary of State for Health if the money which he has promised to tackle waiting lists represents an additional financial commitment distinct from previous commitments; and if he will make a statement. [111421]

Mr. Denham: Baseline allocations to health authorities for 2000-01 were announced on 21 December 1999. The total sum of £34 billion included £276 million to lever performance for waiting lists and times. This is over and above funds given for waiting lists and times in 1999-2000.

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MMR Vaccine

Mr. Burstow: To ask the Secretary of State for Health what percentage of children aged 24 months in (a) the United Kingdom and (b) Greater London have had the MMR vaccine; and what level of take-up is recommended to avoid outbreaks of (i) mumps, (ii) measles and (iii) rubella. [111285]

Yvette Cooper [holding answer 22 February 2000]: Quarterly coverage data from the Public Health Laboratory Service's COVER programme shows uptake of measles, mumps and rubella vaccine at age 24 months at September 1999 as 88 per cent. for the United Kingdom. Uptake in the London region was 80 per cent.

The level of uptake of the vaccine recommended to avoid outbreaks of mumps, measles and rubella is 95 per cent. This level of uptake is sufficient to prevent accumulation of pools of susceptible individuals that provide the opportunity for transmission of these diseases.

Mr. Burstow: To ask the Secretary of State for Health what assessment he has made of the likelihood of a localised measles outbreak in communities with a low MMR vaccine uptake; and what notification he has received of such outbreaks in the last two years. [111286]

Yvette Cooper [holding answer 22 February 2000]: Large measles outbreaks can occur only when the proportion of children susceptible to measles exceeds target levels. These target levels vary by age and have been defined in the World Health Organisation strategy for measles elimination in Europe. The proportion of children susceptible to measles in the United Kingdom can be estimated from vaccine coverage data and from seroprevalence studies which estimate the number of people without protective levels of antibodies to measles.

The Public Health Laboratory Service routinely uses both sources of data to help to predict the likely emergence of measles outbreaks. If the current levels of vaccine coverage are maintained, large measles outbreaks in schools are not likely to occur until after 2001. Smaller outbreaks among communities with lower than average coverage may occur sooner. The Department of Health is aware of two such outbreaks in communities with low immunisation coverage. These began at the end of 1997 and at the end of 1999 and are described in the Communicable Disease Report of 28 January 2000, copies of which have been placed in the Library.

Cancer and Heart Disease

Mr. McNamara: To ask the Secretary of State for Health (1) if it is his policy that future increases in funds for primary care groups will be designated for improving cancer services and coronary heart disease care, with particular reference to the most disadvantaged patients; [110359]

(2) if it is his policy that future increases in funds for health authorities and primary care groups will be designated for addressing inequalities within the National Health Service. [110360]

Yvette Cooper [holding answer 22 February 2000]: The objective of resource allocation is to distribute National Health Service funds fairly through health authorities to primary care groups, based on the healthcare needs of populations.

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We are committed to modernising all aspects of care and treatment. But the priority is to deal with the biggest killers: cancer, coronary heart disease and stroke. This will help tackle inequalities as the burden of these diseases falls heavily on the most disadvantaged.

It is for health authorities in partnership with primary care groups and other local stakeholders to determine how best to use their funds to meet national and local priorities for improving health and modernising services. Their local strategies are set out in Health Improvement Programmes. These Programmes bring the Government's national priorities together with local priorities. There is particular emphasis on addressing areas of major health inequality in local communities and investing in primary care.

Health Improvement Programmes are underpinned by Service and Financial Frameworks. These frameworks set out the levels of resources allocated to support the local contribution to the national and local targets and priorities set out in the Health Improvement Programmes.

We have asked the Advisory Committee on Resource Allocation to consider how resource allocation can contribute to the reduction of avoidable health inequalities.

CS Spray

Mrs. Brinton: To ask the Secretary of State for Health what action his Department has taken following the publication of the report of the Committee on Toxicity, Mutagenicity and Carcinogenicity of Chemicals in Food, Consumer Products and the Environment on CS spray, published in September of last year, particularly with regard to those being treated with neuroleptic drugs; and if he will make a statement. [111804]

Yvette Cooper: My right hon. Friend the Home Secretary has considered the Committee of Toxicity of Chemicals in Food, Consumer Products and the Environment's (COT) report on the operational use of CS spray by police officers, and has concluded that there are no grounds to remove CS spray from police use. The Association of Chief Police Officers has noted the report and accepted its finding that CS spray should be used only within current operational guidelines.

The COT recommended follow-up studies on individuals treated for the immediate effects of CS spray. The Department of Health is providing technical advice to the Home Office as that Department develops practical ways to take forward this recommendation, which will include gathering information on affected individual's use of neuroleptic drugs.

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