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Ms Hewitt: I am grateful to the hon. Gentleman for those questions. We, the chief medical officer and our advisers have been looking at various scenarios, and they of course include a range of factors concerning the number of people who might be infected, and the consequences thereof. We will update them in the updated contingency plan to which I referred in my statement.
On ordering and stockpiling antivirals, we are one of the best prepared countries in the world. Of course, they will not prevent somebody from getting pandemic flu,
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but they will undoubtedly help to moderate its severity and therefore to save lives. We already have enough antivirals in stock to treat health care workers who might be affected. Depending on the time at which a pandemic takes place and on its severity, we may need to take further steps to prioritise their availability, but it would be premature to try to take such decisions at this point. Our advisers are looking at this issue, but until we know the nature of the pandemic and who is most at risk from it, it would be foolish to try to make hard and fast decisions about priorities.
We are of course planning for the real risk of a very significant increase in the number of hospital admissions, and we are looking at how best we can deal with that in terms of bed and staff availability. My understanding is that all health authorities and PCTs have plans in place, and we are monitoring and checking those plans. In addition, through the exercises to which I referred—exercises that have been so important in ensuring that the NHS was ready to deal with other eventualities, including 7 July—we will be able to test in a simulation the real readiness of different parts of the service.
On the availability of a new vaccine tailored to the specific strain of any pandemic flu, our estimate is indeed four to six months. We have been working very closely with the industry in particular to see whether it is possible further to reduce the time scale for identifying the flu strain and then creating and manufacturing the seed stock for the vaccine. Longer-term research is going on, in which the United Kingdom is playing a leading role, to try to find completely different ways of manufacturing vaccine, but I doubt whether they will come to fruition in the very near future. However, they will be enormously important in longer-term protection.
Mr. Andrew Lansley (South Cambridgeshire) (Con): I am grateful to the hon. Member for Northavon (Steve Webb) for asking this question. As he, you and the House know, Mr. Speaker, we hope to have a more substantive opportunity to debate these matters this Wednesday, during Opposition Supply time. Pending that, I will, if I may, ask the Secretary of State a few questions.
The right hon. Lady says that we are well advanced in the preparation of a stockpile of antiviral drugs. Given that I asked precisely such a question about contingency planning and the stockpiling of drugs on 21 June 2004, and given that the French Government published their preparedness plan on 13 October 2004 and then purchased their stockpile of antiviral drugs, why was it not until I asked further such questions in February of this year that the Government published a plan—on 1 March—and ordered their stockpile, which, as the Secretary of State told us, will not be fully in place until September 2006? As the Secretary of State knows, we do not know when a pandemic flu outbreak may occur.
The Secretary of State did not answer a question about the use of antiviral drugs. The pandemic contingency plan contemplates very limited use of Tamiflu or other antiviral drugs for post-exposure prophylaxis. Health care workers or the immediate family of someone who contracts pandemic flu should be given the drugs within 24 hours in order to offset their likelihood of developing the infection, having severe symptoms or passing it on to others. Major use of post-
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exposure prophylaxis could have a significant benefit in containing outbreaks and preventing spread among the population. At the moment, however, the Government are proposing to purchase essentially for treatment rather than prevention. Will the Secretary of State say whether the Government will consider post-exposure prophylaxis more widely and comment on the implications for additional stockpiles of antiviral drugs?
What does the Secretary of State intend the supply of generic H5N1 vaccine to be used for next spring? Is it to be used for immunisation, which would be perfectly logical for the limited number of workers potentially exposed to birds that could be acquiring avian flu as a result of migration? Although work is in hand on vaccine preparation, have the Government contemplated the option of contracting and tendering for an advance purchase agreement? As the Secretary of State knows, the French Government have sought to acquire 40 million doses of vaccine—predominantly of a targeted pandemic flu vaccine when it can be identified—as part of the process supported by the World Health Organisation of increasing the availability of vaccine manufacture.
Will the Secretary of State tell us what plans she has for the acquisition of face masks, gloves and other surgical equipment? A UK company recently won a contract to supply a large range of disposable medical products to Australia. The Australian stockpile of gloves, face masks and the like will be in place by December, following a tender in May and June. To the best of my knowledge, our Government have not tendered for any such stockpile, or indeed any supplies beyond their normal acquisition for NHS purposes.
On the wider question of NHS preparedness, much more needs to be said, and I hope that we will have a chance to say it on Wednesday. However, I shall put my final question for today. Professor David Menon, professor of anaesthesia at Addenbrookes hospital in my constituency, recently published an article in Anaesthesia. The summary states:
"The UK Influenza Pandemic Contingency Plan does not consider the impact of a pandemic on critical care services . . . Current critical care bed capacity would be unable to cope with the increased demand provided by an influenza pandemic. Proper contingency planning is essential."
Will the Secretary of State confirm whether Thursday's updated contingency plan will include that sort of essential planning?
Ms Hewitt: First, let me stress that we are indeed well advanced in our planning. Not only have we had an outline plan in place since 1997, we have stepped up planning and preparation over the last 12 months. As the hon. Gentleman would find out if he checked with the World Health Organisation, we are one of the top three countries in the world—the other two being Australia and France—in respect of our general preparations and our stockpiling of Tamiflu. Different countries are taking different approaches to their preparations and I am told by the chief medical officer—[Interruption.]
Mr. Speaker:
Order. I must ask the hon. Member for South Cambridgeshire (Mr. Lansley) to be quiet.
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Ms Hewitt: I am grateful, Mr. Speaker.
As I was saying, different countries take different approaches to the problem. I have been advised by the chief medical officer that the stockpile of Tamiflu in France is in powder form, whereas we prefer to stockpile ours in the form of capsules, which we believe to be much easier to distribute and to use. Different countries have their approaches, but I am satisfied, on the basis of what the chief medical officer and the head of our vaccination service have told me, that we are making exactly the preparations that we need.
We have not ruled out using antivirals for post-exposure prophylaxis, but only in the early stages of pandemic in the UK. The advice that our experts have given me is that sustained use of antivirals for prophylaxis would not represent the best use of resources and would reduce the number of people whom we could treat with antivirals after they had caught the flu. We should bear in mind the possibility that extensive use of antivirals for prophylaxis could encourage development of a pandemic virus with antiviral resistance. Given what we know about antiviral bugs, I do not think that that is a risk that we would want to run.
We decided to acquire the supplies of H5N1 as a precautionary measure to use for research or offer to priority groups, particularly health service workers, while the vaccine against the exact strain of pandemic flu was manufactured. It will also be valuable for our experts to be able to carry out further clinical studies of the H5N1 vaccine to learn more about how it works against the virus and how effective it could be.
We will of course be placing advance-purchase and sleeping contracts for the pandemic vaccine. Equally, we are taking steps to ensure not only that we have necessary supplies of masks, gloves and other surgical equipment, but that we have proper means of disposing of gloves and masks. There is no point in having them and of the people wearing them being exposed to pandemic flu unless they can be safely disposed of. That is all part of our preparations. Finally, I can confirm that we will be looking at the impact of a possible pandemic on critical care and other aspects of the NHS.
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