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26 July 2007 : Column 1331W—continued

Influenza

Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 12 March 2007, Official Report, column 130W, on influenza, whether he has considered the practicalities of giving short courses of antivirals as prophylaxis to members of the household of a person infected with pandemic influenza; what estimate he has made of the size of the antiviral stockpile necessary to do so; whether he plans to consider the possibility of using antivirals as prophylaxis in (a) schools, (b) healthcare settings and (c) other institutions; when he expects to take a final decision regarding stockpiling additional antivirals for prophylactic purposes; and if he will make a statement. [152310]

Dawn Primarolo: Prophylaxis is being considered as part of the overall countermeasures strategy for pandemic influenza. No decisions have been made on the use of prophylaxis but the policy is being kept under review including the possible size of any stockpiles and the potential options for their use.


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Influenza: Disease Control

Mr. Lansley: To ask the Secretary of State for Health what guidance he has issued to (a) businesses and (b) other organisations outside the health and social care sectors on the safe use of (i) pharmacological and (ii) other clinical interventions to mitigate the impact of a potential influenza pandemic. [152169]

Dawn Primarolo: Advice to businesses and organisations that are planning to make interventions available to their employees is that distribution should be carried out under the guidance of a medical practitioner, in line with their usual occupational health arrangements. Advice on planning for a pandemic is included in the draft national framework for responding to an influenza pandemic that was issued for public discussion in March. Workplace guidance for pandemic flu is also available from the Health and Safety Executive website.

Mr. Lansley: To ask the Secretary of State for Health if he will list the main headings of the information presented to the 14 February 2007 meeting of the Joint Committee on Vaccination and Immunisation on risk groups relating to the prioritisation of vaccinations in the event of an influenza pandemic; what progress is being made in combining this information with mathematical modelling in order to present a comprehensive package of information; by which (a) parties and (b) Government Departments this comprehensive package of information will be used; and if he will make a statement. [152172]

Dawn Primarolo: The Joint Committee on Vaccination and Immunisation (JCVI) considered prioritisation issues connected with pandemic-specific vaccines and pre-pandemic vaccines which might be deployed to counter a flu pandemic. The group was presented with clinical, practical and public health considerations for the possible prioritisation of some or all of the following groups; healthcare workers, those at high risk of complications, those aged 18 years or younger to reduce disease transmission, those over 65, essential workers and enclosed communities. Another consideration was vaccination of the entire population.

The modelling subgroup of the Pandemic Influenza Scientific Advisory Group has considered the conclusions of a number of pieces of analysis (some commissioned specially for the group) on the role of both pre- and specific vaccines. This is discussed in the modelling summary published on the Department’s website. The results of the analysis and the conclusions of the subgroup were presented at the June JCVI meeting and there will be further presentations and discussion at the next meeting.

The conclusions of the discussion will feed into the considerations of the Department and the Cabinet Office, including discussions with other Government Departments, on future options for pandemic preparedness.

Mr. Lansley: To ask the Secretary of State for Health what representations he has received on the effectiveness of stockpiling (a) oseltamivir, (b) zanamivir, (c) other antivirals and (d) pre-pandemic vaccines to prepare the NHS for tackling an influenza pandemic. [152173]


26 July 2007 : Column 1333W

Dawn Primarolo: We continue to receive representations from a range of sources on the effectiveness of stockpiling both antivirals and pre-pandemic vaccine.

Mr. Lansley: To ask the Secretary of State for Health (1) when his Department will publish its response to the consultation on the national framework for responding to an influenza pandemic; [152175]

(2) pursuant to the answer of 9 March 2007, Official Report, column 2298W, on influenza, when he plans to publish a final framework. [152311]

Dawn Primarolo: The national framework is due to be published later in the year.

Mr. Lansley: To ask the Secretary of State for Health what assessment his Department has made of the (a) manufacturing capacity, (b) distribution capacity and (c) storage capacity of the pre-pandemic vaccine producers. [152176]

Dawn Primarolo: The United Kingdom policy on pre-pandemic vaccination has not yet been finalised and the appropriateness and cost-effectiveness of this countermeasure is still being assessed, along with manufacturing, distribution and storage capacity of producers.

Injuries: Children

Tim Loughton: To ask the Secretary of State for Health how many children (a) were admitted to hospital and (b) died as a result of unintentional injury in each of the last five years. [152762]

Mr. Ivan Lewis: The number of admissions of children (aged 0 to 14) to hospital as a result of unintentional injury in each of the last five years for which data are available is shown in the following table.

Count of finished admission episodes for children (ages 0-14) with unintentional injury, national health service hospitals, England
Financial year Number of admissions

2001-02

102,833

2002-03

97,493

2003-04

99,915

2004-05

99,517

2005-06

100,194

Notes:
1. A finished admission episode is the first period of in-patient care under one consultant within one healthcare provider. Admissions do not represent the number of in-patients, as a person may have more than one admission within the year.
2. Data are for International Classification of Diseases, Tenth Revision (ICD-10) codes V01 to X59, which cover external causes of accidental injury. Data represent a count of all episodes where this diagnosis was mentioned in any of the 14 (seven prior to 2002-03) diagnosis fields in a HES record.
3. HES are compiled from data sent by over 300 NHS trusts and primary care trusts in England. The Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain.
4. When analysing time series of HES data, the impact of improvements over time in data quality and coverage, and of changes in NHS practice need to be borne in mind. For example, a number of procedures may now be undertaken in outpatient settings and may no longer be accounted in the HES data. This may account for any reductions in activity over time.
5. Figures have not been adjusted for shortfalls in data (ie the data are ungrossed).
Source:
Hospital Episode Statistics (HES), The Information Centre for health and social care.

26 July 2007 : Column 1334W

The number of children (aged 0 to 14) who died as a result of unintentional injury in each of the last five years for which data are available is shown in the following table.

Deaths from unintentional injury, ages 0 to 14, England
Number of deaths

2002

284

2003

274

2004

240

2005

231

2006

233

Notes:
1. Data are for deaths registered in each calendar year.
2. Cause of death is based on the final underlying cause, defined using the International Classification of Diseases, Tenth Revision (ICD-10) codes V01 to X59.
3. Data are for usual residents of England.
Source:
Office for National Statistics death registrations

Junior Doctors: Vacancies

Peter Bottomley: To ask the Secretary of State for Health how many and what proportion of vacancies for junior doctors are expected to be filled by 1 August, broken down by (a) deanery and (b) specialty; and if he will make a statement. [153419]

Ann Keen: At the end of round one, 85 per cent. of junior doctor training posts had been filled.

The round 2 recruitment is in progress and the estimated total fill rate for 1 August is around 90 per cent. This means that national health service hospitals should have the junior doctors they need in post to ensure that services run smoothly around the annual changeover of junior doctors in early August.

A new wave of junior doctors start working in NHS hospitals across the country in August, each year. We appreciate that there are more involved this year, but hospitals are used to dealing with a new influx of junior doctors. Hospital consultants every year quietly, and very competently, plan for that process.

All applicants who are in substantive NHS employment will continue to have employment while they progress through the next round. This will help cover any remaining gaps in August.

Link Up Service

Mr. David Anderson: To ask the Secretary of State for Health what discussions he has had with colleagues in the Department for Work and Pensions on the health benefits of the Link Up service. [152049]

Mr. Ivan Lewis: The cross-Government strategy, “‘Opportunity Age’—meeting the challenge of a changing society”, was published by the Department for Work and Pensions (DWP) as a consultation document on 23 March 2005. The strategy outlines what can be done to meet the challenge of the changing demographics in the 21st century and looks specifically at the issues facing society as people live longer, healthier lives. It includes supporting active ageing and giving people more choice and independence in how they use the services at their disposal.


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The Department was a major partner with the DWP in Opportunity Age. A specific theme of Opportunity Age was the development of LinkAge Plus pilots, which aim to build more effective links between central Government, local authorities and other organisations and deliver a fully integrated service to meet the needs of older people.

Eight LinkAge Plus pilots were established. LinkAge Plus is a two-year pilot programme, with funding available until March 2008. It was launched in September 2006 and aims to test models of partnership working and build up evidence of good practice to ensure joined up working. The Link Up service in Gateshead is one of these pilots.

Link Up offers advice and help to people in Gateshead aged 50 or over on a variety of topics, including health, benefits and how to stay healthy and active, and help with domestic tasks such as gardening and shopping.

Macular Degeneration

Mr. Bone: To ask the Secretary of State for Health if he will instruct primary care trusts to make all treatments for wet age-related macular degeneration available to patients on the national health service. [151949]

Ann Keen: All primary care trusts (PCTs) are funding photodynamic therapy treatment for patients with both the wholly classic and the predominantly classic forms of wet age-related macular degeneration, in line with guidance from the National Institute for Health and Clinical Excellence (NICE).

NICE is currently carrying out an appraisal of Lucentis and Macugen, which are now both licensed for the treatment of wet age-related macular degeneration, and final guidance is due later in the year.

Where guidance from NICE is not yet available, PCTs are expected to apply local arrangements for the managed introduction of new technologies. These arrangements should include an assessment of the available evidence.

Medical Treatments Abroad

Norman Lamb: To ask the Secretary of State for Health how many NHS patients were treated overseas in 2006, broken down by (a) country in which treatment was obtained and (b) type of treatment; and what the cost was to the NHS of these treatments, broken down by country in which treatment was obtained. [151702]

Dawn Primarolo [holding answer 23 July 2007]: It has been assumed that the question relates to patients being referred abroad specifically for treatment. There are a number of different routes by which patients can be sent abroad for treatment. We only hold information where the relevant authorisation has to be given by the Department. Cost information is not available as claims do not separate the different categories of treatment and this could only be done at disproportionate cost. The following table shows the number of patients treated by country and treatment type where Departmental authorisation has been given.


26 July 2007 : Column 1336W

26 July 2007 : Column 1337W
Country Type of Treatment Number of cases

Austria

Lung transplant

1

Maternity care

5

Removal of screws

1

Total for country

7

Belgium

Annual check for heart transplant

1

Atrial fibrillation

1

CTscan

2

Maternity care

21

Phalloplasty

2

Scan for epilepsy (ictal spect scan)

3

Total for country

30

Czech Republic

Maternity care

11

Total for country

11

Finland

Blood test

1

Cancer care

2

Cholecystectomy

1

Maternity care

4

Removal of implant

1

Total for country

9

France

Bladder echocardiogram

1

Brain aneurysm treatment

1

Colonoscopy

2

Consultation

3

Ear reconstruction

2

EEG scan

1

Embolisation

1

Endoscopy

1

Gamma knife assessment

1

Maternity care

104

Photons

1

Pilondial sinus and abscess

1

Primary torsion dystonia

1

Proton beam therapy

3

Pudendal nerve compression

2

Renal transplant

1

Stereo-Electroencephalography

2

Steroid injection

1

Thyroidectomy

1

Trapped pudendal nerve

1

Urine test/injection

1

Unknown

4

Total for country

136

Germany

Advanced radiosurgery/MRI scan

1

Cancer treatment

1

Chemotherapy

1

Cyberknife therapy

1

F-Dopa-Pet scan

1

Speech therapy

1

Heart stemcell therapy

1

Hernia

1

Intraluminal bare laser

2

Laser treatment of the tongue

2

Maternity care

44

Meg scan

1

Pet scan

1

Phalloplasty

1

Provision of hearing aid

1

Skin cancer

1

Stem cell therapy

1

Unknown

1

Total for country

63

Greece

Maternity care

2

Total for country

2

Italy

Maternity care

10

Total for country

10

Netherlands

Chemotherapy

2

Genetic mutation analysis

1

Maternity care

8

Total for country

11

Norway

Maternity care

1

Total for country

1

Poland

Accident

1

Maternity care

21

Total for country

22

Slovak Republic

Maternity care

3

Total for country

3

Spain

Maternity care

27

Medication

1

Total for country

28

Sweden

Carcinoid cancer

3

Ergonomics and physiotherapy

3

Lymph oedema

1

Maternity care

3

Neurendocrine pancreatic tumour

2

Octreotide treatment

2

Unknown

3

Total for country

17

Switzerland

Maternity care

5

Total for country

5

Unknown

Unknown

2

Total treatments abroad

357


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