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Mr. Andrew Mackay (Bracknell) (Con):
I return to the debacle at HMRC. The Chancellor of the Exchequer rightly promised that he would return to the House and update us. In the light of the National Audit Office telling us that it was a senior member of staff at director level who allowed the awful problem to arise—rather than a junior member of staff, as suggested by the
Chancellor on Tuesday and the Prime Minister yesterday—will the Chancellor come to the House on Monday and give us an update?
Ms Harman: Who told what to whom and when they told them will be the subject of Kieran Poynter’s review, which will be carried out expeditiously. The House will want to proceed on the basis of knowing the facts as fully as possible, not by adding speculation to speculation. This is a serious issue and we need to know the full facts. Above all, we want to ensure that nobody loses out as a result.
Philip Davies (Shipley) (Con): In the statement that the Chancellor made about the farce at HMRC, no mention was made of child protection. Millions of families will be worried that the details of their children’s names, addresses and dates of birth could have fallen into the wrong hands. Will the Leader of the House ensure that the Home Secretary comes to the House to make a statement on what assessment has been made of the risk to children from the shambles and what measures have been taken to ensure that no children are put at risk?
Ms Harman: As I have said, the Chancellor of the Exchequer came to the House on Tuesday to make a statement. When a sudden problem arises the foremost duty of the Government is to protect any individual from possible harm. That is the foremost priority of the Government and the Chancellor.
Mr. Speaker: Order. Four Back Benchers are on their feet—I see that Mr. Wiggin has now jumped up—and they may ask one supplementary question each.
Mr. Graham Stuart (Beverley and Holderness) (Con): Since the then Secretary of State for Trade and Industry ordered the closure of at least 2,500 post offices in May, the details of which post offices are targeted have been published. There is cross-party concern, as we have seen today, about the impact of that closure programme introduced by the Government and ordered on the Post Office’s much-maligned chief executive. May we have an urgent debate so that we can discuss the impact on areas such as Grovehill road in Beverley, which serves the lowest-income side of, Beverley and is a very busy post office?
Ms Harman: I was thinking of suggesting that I could consider that for a topical debate on Thursday, but next Thursday there is a Westminster Hall debate on post offices. One of the criteria for granting a topical debate is that the House does not otherwise have an opportunity to discuss a subject. As the House will have an opportunity to discuss post offices in Westminster Hall, that is the answer to the question. I recognise that hon. Members on both sides of the House are concerned about the future of post offices and I will reflect on whether adequate time across the piece is being given to this important issue.
Mr. Nigel Evans (Ribble Valley) (Con):
I am the chairman of the ID fraud group in the House of Commons. The loss of the two discs containing the national insurance
numbers and bank details of 25 million people is important. We know that ID fraudsters can sit on information for many months and sometimes a year or so before using it. Will the Leader of the House persuade the Chancellor of the Exchequer to come to the House on Monday so that we can further question him, particularly on the advice being given to the 25 million people about what precautions they should take to protect themselves?
Ms Harman: It was for the reason that the hon. Gentleman mentions that the Chancellor explained to the House that the ongoing search for the two CDs was important. The Prime Minister said that Revenue and Customs is writing to everyone to explain the situation and the precautions that they might take if they are concerned. If there is any further information, no doubt the Chancellor will come to the House with it.
Mr. Peter Bone (Wellingborough) (Con): The Leader of the House will readily acknowledge that this morning millions of people are in despair. Will she arrange a debate on the crisis in English football?
Ms Harman: We are all disappointed that none of the home sides has qualified. Some people are feeling beyond disappointment and are downright angry. Questions about football, and particularly about the football coach, are not for the Government primarily, but for football authorities.
Mr. Philip Hollobone (Kettering) (Con): In November 2005 Jessica Randall was murdered by her father Andrew Randall, who lived in Kettering. She was just seven weeks old and she had been sexually abused and tortured before being killed. Her father has been sentenced to life in prison. A year ago the local safeguarding children board set up an investigation into the death and promised to publish its report. A year on, local people are still waiting for it. May we have a statement from the appropriate Minister next week, announcing new guidelines to local safeguarding children boards that such inquiries should be published with all possible speed and certainly should not take longer than 12 months?
Ms Harman: I will bring that point to the attention of ministerial colleagues and suggest that the relevant Minister—this is a cross-ministerial issue—write to the hon. Gentleman and place a copy in the Library of the House.
Pandemic Influenza
12.25 pm
The Secretary of State for Health (Alan Johnson): With permission, Mr Speaker, I should like to make a statement on the publication of the national framework for responding to an influenza pandemic and to provide the House with an update on the progress we have made to improve the UK's ability to respond to a pandemic. I will cover overall public health strategy and our approach to the use of clinical countermeasures, such as antivirals and antibiotics.
Influenza pandemics occurred every 30 to 40 years in the previous century. The last pandemic, in 1968-69, resulted in 80,000 additional deaths in the UK. The possibility of a new pandemic is one of the most severe risks currently facing the UK. Our planning assumptions are that 25 to 50 per cent. of the population may become ill and that, in accordance with previous analysis, between 0.4 per cent. and 2.5 per cent. of those affected could die.
So that the country will be prepared for the next pandemic, whenever it occurs, I am today publishing a new national framework. It builds upon and supersedes the UK influenza pandemic contingency plan published in October 2005, expanding it to cover a more comprehensive range of impacts and responses.
The draft national framework was issued for public discussion in March. This final version reflects a number of issues raised during the period for public discussion and takes account of the practical lessons identified from the national simulation exercise for an outbreak of pandemic flu, Operation Winter Willow, which took place earlier this year.
So that we are as prepared as possible, the framework suggests that more emphasis needs to be placed on planning at the upper ends of possible clinical attack and complication rates. Although the pandemics during the last century resulted in attack rates at or around 25 per cent., it is important that we consider a higher “reasonable worst case” scenario to ensure that our arrangements are robust and resilient.
The framework also includes the planning assumptions that describe the Government's likely position on such issues as school closures, and advice on social gatherings and the use of public places. The national framework will help organisations across government and in the private and public sectors to work together to prepare pandemic plans that can cope with a reasonable worst case scenario.
The framework is supported by a range of guidance. We are publishing an ethical framework for policy and planning, guidance on the provision of health care in a community setting and guidance to assist acute hospitals, social care services and ambulance services in their planning. We are also issuing for public discussion draft guidance on the following: death and cremation certification, proposing legal and other changes in the event of a pandemic; mental health services, assisting mental health trusts in developing their plans; surge capacity, managing the prioritisation of health services and patients at the peak of any pandemic; and NHS human resources guidance, dealing with the work force issues that may arise.
We are also launching a consultation on possible amendments to medicines and related legislation for use during an influenza pandemic. These aim to support the mass distribution of medicines and the maintenance of access to routine medicines at a time when front-line health care professionals will be focused on the most seriously ill. I have allocated additional funding of £10 million this year to assist the NHS in developing these plans. I expect every NHS organisation to have robust plans in place.
In the event of a pandemic there will naturally be a great deal of public concern. Our planning assumption is that we will rely on voluntary compliance with national advice during that period. However, should it be necessary to invoke emergency measures, we are taking public health powers in the forthcoming Health and Social Care Bill that could be considered in the event of a pandemic.
The development of the national framework and our response to pandemic influenza is grounded in the most up-to-date scientific evidence. The Department of Health’s scientific advisory group on pandemic influenza takes into account evidence from the UK and across the world. Under its auspices, independently peer-reviewed scientific papers were published in August 2007, dealing with the clinical countermeasures and the risk of a pandemic originating from an H5N1 virus.
It is clear from the science that good basic hygiene measures must be at the heart of our response. Using a tissue when coughing and sneezing, disposing of it carefully and washing hands often will reduce the spread of influenza, as well as of common coughs and colds. The latest public health campaign, “Catch, it, Bin it, Kill it”, is being launched to raise awareness of the importance of good respiratory and hand hygiene. It builds on the success of earlier campaigns.
Science has also informed our strategic approach towards stockpiling the clinical countermeasures we will need to fight a pandemic. The countermeasures will enable us to treat the symptoms of pandemic influenza, to reduce the number of complications and deaths and to reduce the spread of the virus.
To make sure that the UK has access to a pandemic vaccine I have signed advance supply agreements with GlaxoSmithKline and Baxter to deliver enough vaccine to cover the entire population. It should be the most effective vaccine against the pandemic virus. Those agreements mean that we are among the first countries to have contracts in place, and we will have a guaranteed supply of vaccine at a time when there will be significant international demand. Delivery of the vaccine is not immediate, however, as it can take a few months to develop an effective vaccine once the virus causing pandemic flu has been identified. It is important, therefore, that we obtain additional countermeasures.
Antiviral medicines are key to our response. If they are administered quickly to all patients with symptoms, they can reduce the duration of the disease and the risk of complications. To make sure that the UK has enough of the most common antiviral, Tamiflu, we have created a stockpile to treat a quarter of the population, assuming the rate of clinical attack seen in previous pandemics and putting us on a par with measures taken in countries such as Germany and the US.
I can tell the House today that the Government are planning to double the stock of antivirals, to cover at least half the population. We will continue to keep the level of stock under review in light of the scientific evidence, as we develop our business case.
The World Health Organisation has recommended that, in the event of a pandemic, antibiotics will be needed to prevent and treat the secondary bacterial infections that are likely to be the main cause of complications and deaths. Recommendations for the use of antibiotics are included in clinical management guidelines published recently by two medical journals, Thorax and the Journal of Infection.
The Government plan to procure 14.7 million treatment courses of antibiotics to treat and prevent the complications arising from pandemic flu. That stockpile will enable us to give antibiotics to vulnerable symptomatic flu patients, such as those with chronic conditions and the elderly, in advance of the development of secondary complications, and to treat others in the community if they develop complications. The antibiotics will also be used in hospitals to treat the sickest patients and may reduce the length of hospitalisation. The procurement of both antivirals and antibiotics will be subject to emerging scientific evidence and to normal commercial procurement procedures to ensure that we purchase those products at the best price, and achieve value for money for the taxpayer.
Maintaining the resilience of the NHS and social care will be critical. We must ensure that essential NHS and social care workers on the front line, caring for people with influenza, are protected. The World Health Organisation advises that health workers should wear face masks when caring for patients with influenza and use disposable respirators when carrying out clinical procedures likely to generate fine droplets from infected patients. The Government plan to purchase about 34 million disposable respirators and about 350 million surgical face masks for the use of health and social care workers in the event of a pandemic.
Although the available medical evidence does not support the use of face masks in all settings, I recognise that people may want to have access to face masks for their personal use. The Government will explore the approach that retailers are planning to adopt when stocking face masks for sale to the public.
Pre-pandemic vaccine is the only clinical countermeasure that can be used before the onset of the pandemic, but its success will depend on how much protection it gives against the actual pandemic virus, which is, of course, unknown until it strikes. The Government have a stockpile of 3.3 million doses of H5N1 pre-pandemic vaccine for health care workers. Its purchase in 2006 was an important step, designed primarily to support the health care response to the pandemic. The science underpinning the further development and potential use of pre-pandemic vaccine is cutting-edge and has just been reviewed by UK and international experts. We are actively considering their findings, and the implications for our policy, to inform future decisions, and I will update the House on any developments.
The preparedness strategy for pandemic influenza represents a significant investment. In assessing the options, we will ensure that value for money is balanced with the need to be certain that the UK is properly prepared. The significant progress we have made in protecting the UK has been recognised internationally,
and we continue to work closely with the World Health Organisation. Dr. David Heymann, the assistant director general for health security and environment at the WHO, said this week:
“The UK is still in the vanguard of countries worldwide in preparing for a pandemic, and is also one of the leading global players in addressing the cross-sectoral issues in their planning.”
I can also announce that we have pledged a further £2 million to support the global pandemic influenza action plan to increase vaccine supply to help develop capacity to secure vaccine supplies for the developing world.
Today’s publication of the national framework and the ongoing work to develop our preparedness strategy reflect the importance the Government attach to responding to the risk of an influenza pandemic for the UK. This is not an issue for partisan politics, and I am grateful for the constructive engagement of the hon. Members for South Cambridgeshire (Mr. Lansley) and for North Norfolk (Norman Lamb). To that end, I will arrange for them to meet the Minister of State, Department of Health, my right hon. Friend the Member for Bristol, South (Dawn Primarolo), and key officials to discuss our plans in more detail.
I commend the statement to the House.
Mr. Andrew Lansley (South Cambridgeshire) (Con): I am grateful to the Secretary of State for advance notice of the statement and for the opportunity briefly to look at the national framework document published today. Although originally Ministers said that it would be published last January, I welcome its publication and the further measures that the Secretary of State announced, including the acquisition of a stockpile of face masks. He will recall that it is just over two years since we first asked his predecessor to do that. It has taken that long, but we hope the stockpile will be in place before any threatened pandemic eventuates.
I welcome, too, the Secretary of State’s announcement of £10 million for additional support for NHS planning. It is important that the work be done, and at present primary care trusts cannot allocate additional resources for it. The £2 million for the World Health Organisation is also welcome.
On finance, the Scottish Executive made it clear in a recent document that this year they expect to spend £5 million on pandemic preparations. From that, I deduce that the Secretary of State in England is probably expecting to spend about £50 million this year. Will he confirm that?
I thank the right hon. Gentleman for his remarks about the constructive engagement that began under his predecessor. I look forward to further discussions. He has responded today to some of the concerns I raised in our correspondence and I am grateful for that. None the less, I have a few specific questions.
The Secretary of State made it clear that he is responding to scientific advice from the Department’s scientific advisory group. He will be aware that the group looked at one model whose effect would have been such that even if one of the component interventions was ineffective it would none the less be possible to meet the targeted strategy, but the group noted that
“the impact of this combination is such that only localised outbreaks of seasonal flu proportions would be expected with all interventions effective”.
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