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Mr. Hollobone: To ask the Secretary of State for Health if she will arrange to meet the Secretary of State for Environment, Food and Rural Affairs weekly to co-ordinate the Government's efforts to assess and tackle the threat of avian influenza coming to the UK and its potential mutation into a human influenza virus. 
Ms Rosie Winterton
[holding answer 1 November 2005]: There are already well established networks of cross government working on dealing with the threat from avian influenza and its possible mutation into a human influenza virus which may be capable of causing a pandemic. Officials in all of the relevant government Departments, including the Department for
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Environment, Food and Rural Affairs, are co-operating closely and meeting on a regular basis. Cross government action is co-ordinated through the Civil Contingencies Secretariat in the Cabinet Office, and a Cabinet committee. These arrangements are kept under constant review.
Mr. Roger Williams: To ask the Secretary of State for Health what assessment she has made of the risks of avian influenza spreading to humans through the (a) burial and (b) burning in the open air of poultry carcases. 
Ms Rosie Winterton: It is not proposed to dispose of poultry carcases either by burial or burning in the open air. Under the Department of Environment Food and Rural Affairs exotic animal disease generic contingency plan, the hierarchy for disposal is incineration, rendering and licensed commercial landfill.
As the virus is destroyed by the high temperatures of incineration and rendering and would not survive for long in the environment of a commercial landfill site, these methods of dispersal are appropriate for the protection of human health. The Department has not therefore made any specific assessment of the health risks to people of these dispersal methods.
Ms Rosie Winterton: When an outbreak of highly pathogenic avian influenza (HPAI) is confirmed, poultry workers on the infected farm, together with vets, contractors and others who might be at risk due to direct close contact with diseased birds will be offered the antiviral therapy, oseltamivir, as soon as possible after disease confirmation.
The stockpile of antivirals is currently being held centrally, while it is being built up. Arrangements have been put in place to make them available to those who need it within 48 hours. Antiviral drugs will be made available and administered through the Health Protection Agency's (HPA) local health protection units in collaboration with the National health service in England. Similar arrangements will apply in Wales and Scotland.
From March 2006, the antivirals will be stored regionally. These arrangements for their storage and distribution in England will be the subject of a tendering exercise conducted by the NHS Purchasing and Supply Agency. It will be open to pharmaceutical wholesalers to respond to that tender. Any non-pharmaceutical items stockpiled are covered by standard NHS storage and distribution arrangements. Devolved administrations are responsible for their own storage and distribution arrangements.
Rosie Cooper: To ask the Secretary of State for Health how much (a) influenza vaccine and (b) H5N1 vaccine has been allocated to the Cheshire and Merseyside Strategic Health Authority area; and if she will make a statement. 
Mr. Byrne: Information on influenza vaccine allocations is not held centrally or by the Cheshire and Merseyside Strategic Health Authority or the individual primary care trust. Each general practice orders the amount of influenza vaccine they require based on their practice list and the number of people they have in vulnerable risk groups.
A tender has been issued for H5N1 vaccine, which could be offered to health care workers in the event of a pandemic. This vaccine is not currently available but the plan is to hold stocks centrally when it is delivered.
Mr. Lansley: To ask the Secretary of State for Health pursuant to her statement at the Breakthrough Breast Cancer event of 25 October, how she plans to communicate to primary care trusts her desire to see Herceptin offered to women suffering early stage breast cancer before it is granted a product licence by the Medicines and Healthcare Products Regulatory Agency; and whether prescribers will be liable for any adverse incidents if they prescribe Herceptin unlicensed. 
Jane Kennedy: The position on the prescribing of Herceptin has been communicated to the national health service via the chief executive's bulletin of 10 November 2005. This bulletin is available on the Department's website at www.dh.gov.uk and is aimed at all primary care trusts.
In all cases, we would expect a clinician, before deciding whether to prescribe Herceptin in any particular case, to discuss the potential benefits and harmful effects of Herceptin with each individual patient and to have documented that discussion as they should do when prescribing non-licensed indications. It is not possible to make a blanket statement about the determination of liability in the case of individual adverse events, but we have no reason to believe that a clinician acting in this way would incur any specific additional liability.
|Finished consultant episodes|
Mr. Lansley: To ask the Secretary of State for Health what the (a) total cost to a GP registrar was of obtaining a Certificate of Completion of Training (CCT) and (b) maximum length of time from application to award of a CCT was as at (i) 1 September and (ii) 1 October; what assessment she has made of the impact of this change on the recruitment of general practitioners; and if she will make a statement. 
Mr. Byrne [holding answer 11 November 2005]: The Postgraduate Medical Education and Training Board (PMETB) total charge to a general practitioner registrar for a certificate of completion of training (CCT) is £250. This is a single, once-and-for-all payment.
Looking at the number of CCTs in general practice issued by PMETB since that date, the maximum length of time taken to award a CCT, once all the required documentary evidence had been submitted, was 12 working days. The average for this activity is 11 working days.
If PMETB's award is based on a previous joint committee for postgraduate training for general practice (JCPTGP) assessment there is no additional cost. However, I understand that the Royal College of General Practitioners (RCGP) has decided to charge an enrolment fee of £350 for doctors now entering GP training so that it can advise and monitor doctors' progress through training and carry out the necessary work to make recommendations to PMETB on the issue of a certificate. This is consistent with the practices of other medical Royal Colleges for this activity.
The CCT was not awarded before 30 September 2005 when PMETB took up its legal functions. The CCT replaced the certificate of prescribed experience previously awarded by the JCPTGP. Although we do not know the maximum length of time the JCPTGP took to award its certificate, we understand that the average length of time was 10 working days from receipt of all the documentary evidence.
The change from the JCPTGP to the PMETB has had absolutely no impact on the recruitment of general practitioners. There were some initial problems when functions were transferred to PMETB at the beginning of October but these are being resolved and at the present time there are no complete applications over 11 days old awaiting the award of a CCT.
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