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The Parliamentary Under-Secretary of State for Health (Caroline Flint): Recently, I met our stakeholder group to look at issues relating to solvent abuse. Much progress has been made and we shall try to ensure that in our Department and other Departments, especially in our strategies for working with young people, solvent abuse is high on the agenda.
Ben Chapman: My hon. Friend will be aware of the work of St. George's university of London, which found that deaths due to solvent abuse had declined by 9 per cent., but does she agree that, if they are to be reduced further, education is a vital part of the process? Will she commend the work of the charity Re-Solv in schools, and in particular the work done by pupils of Wirral grammar school for girls, who are raising awareness among their peers of the dangers of solvent abuse?
Caroline Flint: I understand that my hon. Friend recently visited the Wirral grammar school for girls, where some excellent work is being done. In addition, as part of a package, by providing the young people's substance misuse partnership grant, which was agreed between the Home Office, the Department of Health and the Department for Education and Skills, we are helping to tackle the abuse of solvents, and of other substances that, I am afraid, children do abuse, including alcohol, tobacco and illegal drugs. I strongly support the work of organisations such as Re-Solv and Solve It, whose chief executive I was pleased to meet at a recent event in my constituency, aimed at encouraging responsible retailing with regard to this product and many others.
Five years ago, we decided to give higher priority to protecting the health of the public from winter flu. We introduced the annual seasonal flu vaccination programme and we targeted those at increased risk from seasonal flupeople aged 65 and over, and younger people in certain clinical risk groups as identified by the Joint Committee on Vaccination and Immunisation. This is an annual programme, because each year new strains of flu can emerge and therefore the flu vaccines need to be reformulated accordingly. In this way, each year's vaccine provides the best protection against the influenza virus currently circulating.
Since the programme was introduced in the winter of 200001, vaccination uptake in people aged 65 and over has increased year on year. In the first year of the targeted programme, just over 65 per cent. of elderly patients were vaccinated. Last year 71.5 per cent. of those aged 65 and over received the seasonal flu vaccinesome 5.2 million peopleand in addition 1.2 million younger people in the clinical risk groups were vaccinated.
The responsibility for ordering seasonal flu vaccine and administering the vaccine has always fallen on general practitioners. GPs order their own supply of vaccine, based on the number of eligible patients on the register, and make contractual arrangements with any of the six manufacturers who supply flu vaccine to the UK. In addition to the GP orders, the Department of Health purchases a stock of flu vaccine each year as part of our contingency planning measures. We hold that for emergency use, in case GPs run into difficulties with vaccine supply.
We routinely meet representatives from the UK vaccine industry group at the beginning of each year to inform the industry of how much seasonal flu vaccine will be required in the UK. This is based on the numbers of people covered by the current Department of Health policy. This year, the estimated production total from all UK vaccine manufacturers was over 14 million dosesmore than ever before, and sufficient to immunise 100 per cent. of those in the targeted groups, in other words the elderly and younger people in clinical risk groups, as set out in the letter from the chief medical officer to the NHS in July.
In late October, however, we began to hear anecdotal evidence that some GPs were facing a shortage of flu vaccine. In order to assess the potential problem, officials wrote on 3 November to the flu immunisation co-ordinators of all the primary care trusts. That letter reminded them of the priority groups for flu vaccination and how additional stocks of vaccine could be ordered from the Department of Health contingency stock, should extra supplies be required by practices in their area.
The current problems may be due to a combination of factors, such as possibly the under-ordering of vaccine on the one hand, and possibly vaccination of the worried well on the other. It also seems likely that
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awareness of the need for flu vaccinations is higher this year, due in part to the very high level of media interest in the threat of avian flu in birds and of pandemic flu.
We do not, of course, expect seasonal flu vaccine to protect people against bird flu or pandemic flu, but I stress that seasonal flu vaccine is important for people aged 65 and over and for the clinical risk groups and that high uptake in those groups is to be welcomed. We need to ensure that GPs prioritise their remaining stocks of flu vaccine to help those who will really benefit mostin other words, people aged 65 and over and younger people in the clinical risk groups. Officials wrote to influenza immunisation co-ordinators to that effect yesterday.
The Department is also helping GPs by releasing flu vaccine from the contingency stock that we have purchased. We have taken orders against that stock, and deliveries are already being made and will continue into December. There is, of course, exceptionally high demand globally for flu vaccine, despite which the Department has been able to secure an additional 200,000 doses of flu vaccine on top of the 400,000 dose contingency reserve that we have already obtained. The additional 200,000 doses will be delivered in January. We are also discussing with manufacturers whether additional supplies can be made available, over and above those additional 200,000 doses, and if so, when those stocks would be available.
In previous years, the GP-led arrangement that I have described has, on the whole, worked well. In view of what has happened this year, however, I am reviewing the arrangements currently in place for the seasonal flu vaccination programme and will consider this matter urgently.
Mr. Andrew Lansley (South Cambridgeshire) (Con): I am sure that the House is grateful to the Secretary of State for her statement, although she must understand that we would have been more grateful if she had come to the House yesterday to make a statement on the same day as selected members of the press were being briefed on this subject. I am grateful to her not only for providing me with advance sight of her statement, butindeed at 1.50 this afternoonfor replying by fax to the letter that I sent to her on 5 October raising concerns about the winter flu vaccination programme.
I am sure that the House will have listened to the Secretary of State's statement and found in it no acknowledgement of a simple fact: people have been going to their GP surgery to get their flu jabs and been told that supplies have run out.
Mr. Lansley: Happily, not everybody, but one person missed in the at-risk group is one person too many. The hon. Gentleman and the rest of the House should know that, even where that has not yet happened, it will happen because supplies are running out, and we have not completed the period during which the highest levels of immunisation occur.
The Secretary of State did not accept responsibility. She should have done so, but she did not. The delivery of the influenza immunisation programme is the Government's responsibility. It is not good enough that
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she has come to the House to blame general practitioners for the failure of the programme. Not only has she failed to apologise, she has not even remotely begun to explain what has gone wrong. If the House will forgive me, let us start with the actual figures.
First, the Secretary of State underestimated the success of the flu immunisation programme. Her own Department's figures suggest that, in 200405, a 71.5 per cent. vaccine uptake among the over-65 population in England amounted to 5.9 million people immunisednot the 5.2 million that she set out. However, she did not refer to the overall figures on vaccine uptake. Uptake was 71.5 per cent. in England, 68.1 per cent. in Scotland and 62 per cent. in Wales. For risk groups below 65 years old, the comparable figures were 42.6 per cent. in England, 39.3 per cent. in Scotland and just 25 per cent. in Wales.
The Secretary of State did not make comparisons clearly between what has happened in previous years and what is happening this year. On 26 October last year, her noble Friend Lord Warner told another place:
The letter that the Department of Health sent to general practitioners yesterday referred on the one hand to 11 million people in the at-risk groups and on the other to the 14 million doses of seasonal flu vaccine that were available. Unfortunately, the 11 million people refers to England, but the 14 million doses refers to the United Kingdom. It would have been more accurate to talk of about 14 million people in the at-risk groups and 14 million doses of influenza vaccine.
The Secretary of State did not point out in her statement that, although the Department of Health met manufacturers early this year to agree that 13.4 million doses of vaccine would be availableit subsequently procured a contingency supply of 400,000, which I accept is routinely the same each yearit agreed at a later stage that the at-risk groups would include people with chronic liver disease, who had not previously been included. It also agreed that the recommended groups would include main carers with responsibility for the care of elderly and disabled people who would be at risk if their carers were to become ill. The Department has no figures on the likely number of such people, but it means that perhaps millions of carers might have gone to their GP surgeries this winter to try to get flu jabs and then received them appropriately, although that would not have been the case in previous years.
Those are the figuresthe Secretary of State might have had the courtesy to tell us what they wereand the facts about the extension of recommended groups this year compared with previous years. The House will understand that, broadly speaking, the available vaccine supply did not increase, whereas the number of recommended groups did. The prospect of a great deal
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of speculation about avian flu in the autumn certainly should have led the Department to be aware at an earlier stage about the desirability of being prepared for a much greater take-up of flu vaccine among people in the recommended groups than in previous years.
Let me ask the Secretary of State several questions about what was done. When carers were added to the recommended groups for vaccination, was the number of doses of vaccine that was intended to be supplied increased from 13.4 million? When the British Medical Association told the Department of Health in Octoberthis was not just anecdotal, as the Secretary of State saidthat it had concerns about the availability of vaccine, what did the Department do?
The Secretary of State will recall that the hon. Member for Cannock Chase (Dr. Wright) made it clear on 17 October that he, for one, had gone to his surgery and been told not only that he could not have his flu jab on the day of his visit, but that he would not receive it until the end of November, at the earliest. What did she do after 17 October, given that we have now arrived at 22 November and we have a crisis? When a manufacturing company ran out of supply in late October and told the Department about that, what did the Department do?
When did the Department find out the new figures on uptake? Responses to parliamentary questions said that the uptake figures were due in the Department on 14 November. The Department talked to the UK vaccine industry group on 16 Novembersix days agoand asked for additional supplies. Health Ministers did not have the courtesy to tell the House about the lack of availability of supply, even though they had talked to the industry about it. However, they must have talked to the industry because they knew the uptake figures on 14 November. What are the figures and how do they compare with those for previous years?
What is the Government's evidence that general practitioners have been vaccinating what the Secretary of State cares to call the worried wellpeople outside the recommended groups? The BMA certainly has no evidence that that is the case and the Scottish Executive do not tell the public and the BMA that it is the problem in Scotland. The Secretary of State might care to explain why general practitioners should vaccinate people who are not in the recommended groups, as they have no financial incentive from the NHS to do thatthey are not paid by the NHS to do itand would be out of pocket from buying the vaccine were they to do so.
The Secretary of State has not told the House the figures. She has not explained to the House when the Government knew about the implications of changes this year in the uptake of vaccine and in the number of groups recommended. The consequence of all those changes has been our constituents visiting GP surgeries seeking flu vaccinations and being unable to get them. What estimate does she have of the number of people who will at the end of this immunisation season be un-immunised? What justification does she have for coming to the House and instead of taking what is in truth her responsibility for the flu immunisation programme seeking to blame general practitioners?
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