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Mr. Martyn Jones: To ask the Secretary of State for Health (1) what recent assessment she has made of the reimbursement scheme to pharmacists for the supply of Category M generic medicines; and if she will make a statement; 
(2) what assessment she has made of the price differential between generic medicines obtained via NHS prescription and those available over-the-counter in supermarkets; and if she will make a statement. 
Jane Kennedy: The newly introduced category M of generic medicines has two objectives: to reduce the cost of annual reimbursement to community pharmacy in England by £300 million and to set reimbursement prices of individual medicines in a manner which reflects the underlying market prices. This category of the tariff is recalculated quarterly in the light of the best estimate of the achieved reduction in cost: in that sense, the area is reviewed quarterly and is meeting its objectives.
Category M reimbursement prices are reflective of the underlying market prices and are intentionally set at a level which leaves unrecovered discount available to community pharmacies as part of the new pharmacy contractual framework. The prices of over-the-counter medicines are determined by a consumer market in which the Department has no economic locus. There is, therefore, little expectation that prices of medicines available over the counter would coincide with the category M reimbursement prices.
Jane Kennedy: The cleanyourhands" campaign was launched in September 2004 and aims to improve hand hygiene compliance by national health service staff through the use of alcohol handrub. Product consumption (usage) levels are being recorded for all trusts ordering their handrub product through the NHS Purchasing and Supply Agency/logistics route and a 65 per cent. increase in handrub consumption occurred from September 2004 to September 2005.
Andrew George: To ask the Secretary of State for Health what recent discussions she has had with the private sector on signing up to the code of practice on the International Recruitment of Healthcare Professionals. 
Andrew George: To ask the Secretary of State for Health how many health care professionals originally from developing countries continued to work in the NHS after their temporary contracts ran out in each year since 2001 for which records are available. 
Andrew George: To ask the Secretary of State for Health whether the NHS has used healthcare recruitment agencies based outside the UK for the recruitment of healthcare professionals from developing countries since the code of practice was agreed. 
Mr. Byrne: NHS Employers is responsible for monitoring the code of practice and maintaining the register. No information is available centrally regarding contracts between agencies which have signed up to the code of practice and the national health service.
Ms Rosie Winterton [holding answer 2 November 2005]: Primary care trusts (PCTs) are responsible within the national health service for commissioning and funding services for their resident population, including palliative care. The Government have met their commitment in the NHS Cancer Plan to invest an extra £50 million per annum in specialist palliative care. Over half of this additional funding went to the voluntary sector, mainly hospices, in 200304. PCTs, having assessed their local priorities, can invest more. This investment must be in line with local strategic plans and an assessment of need, which may, or may not indicate the need to provide more specialist palliative care beds.
|Primary care trust (PCT)/national|
health service trust
|Suffolk West PCT||29||30||19|
|Central Suffolk PCT||86||86||43|
|Suffolk Coastal PCT||122||122||105|
|Ipswich Hospital NHS Trust||767||782||756|
|Local Health Partnerships NHS Trust||432||410||408|
|West Suffolk Hospitals NHS Trust||638||676||631|
Grant Shapps: To ask the Secretary of State for Health whether the building of a new hospital in Hatfield depends on East and North Hertfordshire NHS trust balancing its budget in 2005 to 2008. 
Ms Rosie Winterton: Performance against the break-even duty must be achieved over the medium term, such that an organisation with a deficit in any year must plan to return to break-even and clear its accumulated deficit within three years, or exceptionally five years.
In any period in which a trust reports a deficit, it is required to have an agreed recovery plan in place to restore financial balance. Such a plan might include postponement of capital investment or postponement of private finance initiative (PFI) developments that are being worked up, but there is no requirement that recovery plans must envisage postponement of investment decisions.
Before a large and complex scheme, such as that in development by East and North Hertfordshire national health service trust can advertise in the Official Journal of the European Union for potential PFI partners, it must demonstrate convincingly in its outline business case (OBC) that it will be able to afford its scheme.
It is therefore conceivable that, in the year in which the OBC is submitted, the trust could still have a deficit, but it would have to demonstrate that it had a robust financial plan both to recover its deficit and go on to afford the eventual unitary payment of its scheme. It would also need to demonstrate an ability to achieve its financial plans.
PFI contractors will have their own financial criteria that they expect a NHS trust to meet before they will have sufficient confidence to bid for its scheme. We would expect these to be no less stringent than the above.
Mrs. Maria Miller: To ask the Secretary of State for Health if she will monitor levels of co-operation by NHS trusts with the director of infection control in enabling publication of her annual report by the deadline announced. 
Jane Kennedy: Winning Ways", published in December 2003, asked all national health service organisations to appoint a director of infection prevention and control (DIPC). However, the Department will not be monitoring the reports from DIPCs, as effective assessment would depend upon local knowledge. Under the proposals to strengthen measures to tackle healthcare associated infections set out in the Health Bill, the Healthcare Commission will take on the responsibility for ensuring compliance with the new code of practice. DIPCs will be key in implementing this code.
Mr. Lansley: To ask the Secretary of State for Health whether she intends to quantify available critical care capacity in the independent sector; and if she will secure agreements with independent sector providers to secure this capacity for NHS use in the event of an influenza pandemic. 
Ms Rosie Winterton:
The amount of critical care capacity in the private sector has not been quantified. Under the local health community emergency plans, if the level of a future influenza pandemic warrants it, the
8 Nov 2005 : Column 395W
command arrangements that are already in place can enable the use of any health facility including the independent sector and private nursing homes.
Julia Goldsworthy: To ask the Secretary of State for Health what the take-up rate for influenza vaccinations was in each (a) strategic health authority and (b) primary care trust in England in each year since 200203. 
Steve Webb: To ask the Secretary of State for Health whether (a) healthcare workers, (b) Government Ministers and other officials and (c) other workers in key industries will be given priority treatment with antivirals in the event of an influenza pandemic. 
We are aware of the possibility that a pandemic may strike before the antiviral stockpile is complete and our antiviral storage and distribution framework takes this into account. Antivirals will need to be prioritised, initially to healthcare workers and to those who fall into one of the 'clinical at risk' groups (as defined for seasonal 'flu).
Ms Rosie Winterton: In the event of a pandemic, the Department will issue advice to the public. It will continue to keep the situation under review, taking account both of the circumstances at the time and of advice from the World Health Organization.
Steve Webb: To ask the Secretary of State for Health what action her Department is taking to help ensure other countries are (a) prepared for an influenza pandemic and (b) able to stockpile antiviral drugs; and if she will make a statement. 
Ms Rosie Winterton: The Department is working closely with other countries and international organisations such as the World Health Organization (WHO) and the European Union (EU). We are sharing information through events such as the pandemic influenza workshop, jointly hosted by WHO and the EU in Copenhagen. We are engaged in the development of the United States of America initiative for an international partnership on avian and pandemic flu and are contributing to the meeting in Geneva co-hosted by WHO, Food and Agriculture Organisation, World Organisation for Animal Health on 79 November. The United Kingdom will continue to work with WHO, fellow EU member states, the European Commission and the European Centre for Disease Prevention and Control and with other internal partners to support international preparedness.
The WHO has secured 3 million treatment centres of antiviral drugs for international use. These could be used to try to slow down or prevent the spread of a pandemic virus in the country of source. Any requests for UK contributions to expand the WHO stockpile will be considered on a case-by-case basis.
Steve Webb: To ask the Secretary of State for Health (1) when she plans to publish (a) clinical management guidelines for patients suffering from pandemic influenza and (b) infection control guidelines in the event of an influenza pandemic; 
(2) when her Department plans to publish (a) the clinical management guidelines to help inform management of patients suffering from pandemic influenza and (b) the infection control guidelines for an influenza pandemic. 
Ms Rosie Winterton: Clinical management guidelines have been developed with the Health Protection Agency (HPA) and the British Thoracic Society to help inform management of patients suffering from pandemic flu. We have also produced infection control guidelines with the HPA. Both sets of guidelines are available on the Department's website at www.dh.gov.uk/pandemicflu.
Steve Webb: To ask the Secretary of State for Health what auditing measures her Department has undertaken to ensure that (a) primary care trusts, (b) local authorities and (c) NHS trusts are prepared for an influenza pandemic. 
Ms Rosie Winterton: The Department published the revised, UK Influenza Pandemic Contingency Plan" on 19 October, which will inform the work undertaken at local and national levels to prepare for an influenza pandemic. We also produced in May 2005, Operational Guidance for National Health Service planners on preparing for an influenza pandemic to inform local plans.
In addition, pandemic influenza exercise programmes have taken place around the country which have enabled NHS organisations to test the plans they have in place. The Health Protection Agency has also developed an off the shelf exercise package for use in testing influenza pandemic preparedness plans.
Ms Rosie Winterton:
We are stockpiling 14.6 million treatment courses of Tamiflu, which should be sufficient to treat those who may fall ill in an influenza pandemic.
8 Nov 2005 : Column 397W
There are currently no plans to procure a stockpile of other antiviral drugs, but we are keeping the options under constant review.
Mr. Lansley: To ask the Secretary of State for Health what powers she has, and under which legislation (a) to prevent large public gatherings, (b) to close football matches and other similar sporting events characterised by mass attendance and (c) to prevent movement of people across large geographical distances in the event of an influenza pandemic. 
Ms Rosie Winterton: As explained in The UK Influenza Pandemic Contingency Plan" (Annex E, paragraphs 810), there are powers in the Civil Contingencies Act 2004 which could be used in the event of an emergency.
Those powers are designed to allow the Government to respond quickly and effectively to the most serious emergencies where existing powers prove to be insufficient. There can be no automatic assumption that the Civil Contingency Act powers would need to be used in the event of an influenza pandemic.
Any use of emergency powers must satisfy a range of robust legal safeguards that ensure their use would be tailored to the specific circumstances at hand. It is therefore not possible, and would be potentially misleading, to comment on any specific measures that could be taken using emergency powers in the event of a pandemic: it would depend on the specific circumstances prevailing at the time.
Ms Rosie Winterton [holding answer 3 November 2005]: I refer my hon. Friend to the oral statement given by my right hon. Friend the Secretary of State on 17 October 2005, Official Report, columns 62938 and to the written statement I gave on 19 October 2005, Official Report, columns 5758WS.
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