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Cider and Perry

Mr. Heath: To ask the Secretary of State for Health if she will introduce minimum fruit content requirements for cider and perry. [19613]

Caroline Flint [holding answer 20 October 2005]: The Government supports the principle of mandatory ingredient listing for all alcoholic drinks and awaits proposals from the European Commission on the review of food labelling legislation, which is expected to cover this issue. Full ingredient listing would include the requirement for a quantitative declaration of any fruit juice used as an ingredient in alcoholic drinks. There are no plans for separate proposals that would require a minimum fruit content for cider and perry.

Clinical Trials

Mr. Lansley: To ask the Secretary of State for Health whether patients taking a medicine as part of a clinical trial have the right to continue taking the medicine if clinically appropriate following its approval by the Medicines and Healthcare products Regulatory Agency if the medicine has not been subject to an appraisal by the National Institute for Health and Clinical Excellence. [18351]

Jane Kennedy: The Medicines for Human Use (Clinical Trials) Regulations 2004 require that an application to an ethics committee for a trial must include information about plans for the treatment and care of patients once their participation in the trial has ended. The absence of an appraisal by the National Institute for Health and Clinical Excellence is not in itself a reason to stop providing a treatment to patients once a trial has ended.
 
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Communicable Disease Control

Steve Webb: To ask the Secretary of State for Health what the responsibilities are of (a) health authorities and (b) local authorities in the area of communicable disease control. [20031]

Caroline Flint [holding answer 20 October 2005]: The responsibilities of the health authorities (HAs) and local authorities (LAs) in the area of communicable disease control depends on the seriousness of the threat to health.

In England, the HAs with responsibilities are the strategic health authorities (SHAs), national health service trusts—primary care trusts (PCTs), acute hospital trusts, ambulance trusts, mental health trusts—and NHS Direct.

In the event of an extreme example of a communicable disease outbreak, for example, pandemic influenza, the SHAs are responsible for:

strategic control of any incident that affects or seems likely to affect a number of hospitals or have a significant impact on primary care;

ensuring command and control structures are in place across the NHS within its area and have been tested;

agreeing with Health Protection Agency (HPA) and the regional directors of public health (RDPHs) escalation triggers and mechanisms;

ensuring escalation policies are clearly described, and that capacity plans are available;

ensuring links within the NHS, with neighbouring SHAs, health regions or NHS boards, with RDPHs, the HPA and across into the other sectors, including social care, are effective and durable;

ensuring local provision for an influenza pandemic;

monitoring the plans of NHS organisations within its area;

they may have to clarify which routine NHS targets can be dropped or modified, ie what business will not be continued 'as usual' in the event of a pandemic disrupting normal work.

In addition, all NHS organisations should have contingency plans which cover:

the command and control structure, escalation policies and links to other sectors;

arrangements to appoint a named influenza co-ordinator, normally the director of public health, and a pandemic planning committee with appropriately wide representation;

arrangements for the optimum care for those affected, including ability to mobilise and direct health care resources to local hospitals at short notice to support them and to sustain patients in the community should hospital services be reduced or compromised for a period;

ensuring they have the appropriate facilities for infection control;

arrangements for liaison with LA colleagues and social services, including coherence of emergency plans and joint working;

arrangements to have mutual support arrangements between neighbouring NHS organisations;

arrangements to decide which routine NHS work can be dropped or modified, for example, what business will not be continued as usual. These arrangements should include appropriate bodies with lay representation to debate and agree in public difficult rationing decisions;

managing the disruption caused by influenza on other NHS services and other medical conditions;

contingency staffing arrangements for primary, acute and public health services;

 
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arrangements to cope with staff absenteeism and increased patient loads;

arrangements to immunise and provide antiviral prophylaxis to essential staff according to United Kingdom guidelines;

plans for emergency vaccination programmes according to UK guidelines, including an estimate of local vaccine and antiviral needs and arrangements for ensuring the vaccine and antivirals are distributed and administered appropriately;

communication arrangements to healthcare professionals, the public and media, including timely cascade of information from national and international sources;

arrange to have laboratories investigate influenza like illness, isolate strains of influenza, test antimicrobial susceptibility of secondary bacterial infections and report findings for local and UK surveillance according to UK-wide agreed protocols;

ambulance trusts/special health boards may need to consider central co-ordination of all patient transfers during phase three of the response;

staff training;

a media handling strategy.

NHS Direct is responsible for developing and maintaining up to date advice algorithms for influenza, with HPA and others, and activating them when instructed by the HPA or the Department.

Similar arrangements to the above apply in Wales, Scotland and Northern Ireland.

In the event of a communicable disease outbreak such as pandemic influenza, LAs in England and Wales have powers under the Public Health (Control of Disease) Act 1984 (c.22). Key provisions include:

powers to seek orders from a justice of the peace requiring a person to be medically examined and to be removed to and detained in hospital;

powers for the local authority/its proper officer, or equivalents, to request a person not to work with a view to preventing the spread of infection, to require a child who has been exposed to infection not to attend school and to place restrictions on children's places of entertainment;

the creation of criminal offences where people expose others to the risk of infection;

some powers to require the provision of information to help control the spread of disease.

In less serious cases of communicable disease such as food poisoning outbreaks or cases of legionnaires disease, the LA environmental health officers will have responsibility for investigating the outbreak.

Community Health Councils

Mr. Burstow: To ask the Secretary of State for Health if she will set out the dates on which (a) the abolition of community health councils was first proposed, (b) the legislation abolishing community health councils secured Royal Assent, (c) community health councils ceased operation, (d) patient forums commenced operation, (e) the proposal to merge patient forums was first made and (f) she expects the mergers will be complete. [18651]

Ms Rosie Winterton: The abolition of community health councils (CHCs) was first proposed in the NHS Plan in July 2001. The National Health Service Reform and Health Care Professions Bill secured Royal Assent on 25 June 2002, and CHCs ceased operation on 1 December 2003.
 
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Patient forums commenced operation on 1 December 2003. The proposal to merge patients' forums was made in the Government response to the consultation on the future support arrangements for patient and public involvement in health (PPI) published on 15 March 2005. However, the Government recommendations have been subsequently put on hold pending the results of the current strategic review of PPI.

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