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Due account was taken of the potential preventative benefit of human papilloma virus (HPV) vaccine against vulval and vaginal cancers. The natural history of vaginal and vulval cancers is not completely understood. Although HPV infection is a risk factor for
the development of vaginal or vulval lesions, unlike cervical cancer, only approximately 50 per cent. are associated with HPV infection. The evidence for a causal association and the percentage attributable to HPV infection, is greater for HPV types 16 and 18 than for other HPV types. Further studies are being conducted on the extent to which the HPV vaccine may protect against vulval and vaginal cancers caused by HPV type 16 and 18.
(3) what account was taken in procuring a vaccine for the human papilloma virus vaccination programme of the effectiveness of such vaccines in providing protection against genital warts; and what steps the Government plan to take to reduce the incidence of genital warts. 
Routine HPV vaccine will be introduced for girls aged 12 to 13 years from September this year. A catch-up programme will start from September 2009 and will run for two years. Girls aged 16 to 18 years will be immunised in 2009-10 and girls aged 15 to 17 years in 2010-11.
I refer the right hon. Member to the reply I gave to the hon. Member for Boston and Skegness (Mark Simmonds) and my hon. Friend the Member for Norwich, North (Dr. Gibson) on 2 July 2008, Official Report, column 943W.
Mr. Lansley: To ask the Secretary of State for Health (1) what steps he is taking to ensure robust data collection systems are in place during an influenza pandemic to capture data on (a) attack rate, (b) disease pattern and severity and (c) mortality as referred to on page 8 of his Departments Scientific Pandemic Influenza Advisory Committees Subgroup on Modellings modelling summary, dated February 2008; and if he will make a statement; 
(2) what steps he is taking to develop a flexible system to enable influenza antiviral treatment to be targeted dynamically, as referred to on page 8 of his Departments Scientific Pandemic Influenza Advisory Committees Subgroup on Modellings modelling summary, dated February 2008; what size of stockpile would make implementation of household prophylaxis practical; and if he will make a statement; 
(3) when his Department plans to have stockpiled influenza antivirals sufficient for 50 to 60 per cent. of the population, as referred to in paragraph 2.4.2(d) of his Departments Scientific Pandemic Influenza
Advisory Committees Subgroup on Modellings modelling summary, dated February 2008; 
(4) what estimate he has made of the proportion of individuals infected with a pandemic strain of influenza who would go on to become clinical cases over the course of a pandemic; and if he will make a statement. 
Dawn Primarolo: Wherever possible surveillance and information gathering during a pandemic will be based on existing data collection mechanisms. The attack rate will be estimated by modellers, principally those at the Health Protection Agency, through clinical data emerging from the United Kingdom and other affected countries. Disease pattern and severity will also be based on this information and that from national seasonal influenza surveillance systems, coordinated through the Health Protection Agency and mortality will be monitored through death registration data from the Office for National Statistics. There are data already monitored routinely as part of national seasonal influenza surveillance.
The proportion of individuals infected with a pandemic strain of influenza who would go on to become clinical cases over the course of a pandemic is estimated to be between 50 per cent. and 66 per cent. Evidence from seasonal influenza and the 1957 pandemic suggest that of these between 50 per cent. and 67 per cent. will show clinical symptoms. This is consistent with a worst case clinical attack rate of around 50 per cent.
The increase in the antiviral stockpile from 25 per cent. to 50 per cent. will ensure treatment is available for all symptomatic patients under the maximum clinical attack rate assumption of 50 per cent. There is thus much less chance that the dynamic targeting referred to will be needed. Flexibility in antiviral distribution via the Flu Line will be achieved by adjusting the clinical algorithm based on the clinical information obtained as the pandemic unfolds, as well as stock management and policy decisions. Plans for separate distribution channels are being developed to assist the hard to reach groups and others for whom the Flu Line will not be suited.
As stated in the National Framework for responding to an influenza pandemic, it is possible to use antiviral medicines as a preventative measure (prophylaxis), copies of this publication have already been placed in the Library. The adoption of a policy of household prophylaxis is still being considered by the Department.
Andrew Rosindell: To ask the Secretary of State for Health how many people were treated for (a) gunshot and (b) knife wounds at hospitals in each London borough in each of the last five years. 
Information is available on patients admitted to hospital for gunshot wounds and knife wounds. These figures do not include patients who were treated in accident and emergency departments for gunshot wounds and knife wounds and not admitted.
Tables have been placed in the Library which show a count of finished admission episodes for both gunshot and knife related injuries. Information is provided at primary care trust (PCT) level of residence for knife injuries which is the closest geographical breakdown to a London borough. Information is provided at strategic health authority level for gunshot wounds due to the relatively low numbers for individual PCTs.
Mike Penning: To ask the Secretary of State for Health what (a) research he has undertaken and (b) evidence he has used to compile the draft partial impact assessment of deregulating Class 3B and 4 lasers and intense light sources in the consultation paper Private and Voluntary Healthcare: Care Standards Act 2000. Regulations and National Minimum Standards. 
Mr. Bradshaw: The partial impact assessment (IA) provided a number of arguments and figures in support of our consultation proposals. Some of the arguments and figures were based on working assumptions and these were made clear in the document; other figures were based on evidence and research and these were fully referenced in the IA. It was expected that the consultation would test the working assumptions and would bring to light further research and evidence, which could be fully taken into account when drawing up the final IA.
Mr. Bradshaw: The London Patient choice pilot between 2003 and 2005 included a bilateral arrangement with Belgium for patients who had waited more than six months to access treatment in Belgian hospitals. The scheme was terminated on 31 March 2005 because of low take up and increased availability of capacity within the national health service. There is therefore no possibility of extending this scheme. However, it is open to local commissioners to put in place whatever arrangements they want to make.
There are also routes in European Union law for NHS patients who wish to receive planned health care abroad, namely long-standing social security arrangements
under EC Regulation 1408/71. In addition, European Court of Justice case law has established the right for patients to go to EU member states for treatment, subject to certain circumstances. On 2 July 2008 the European Commission adopted a draft directive on the application of patient rights in cross-border health care. This directive will be subject to negotiations, but aims to clarify the application of the case law on overseas treatment.
Sir Michael Spicer: To ask the Secretary of State for Health when he plans to reply to the letter from the hon. Member for West Worcestershire, dated 3 June 2008, on Government proposals for changes to GP surgeries. 
Mr. Stephen O'Brien: To ask the Secretary of State for Health pursuant to the answer of 25 February 2008, Official Report, column 1211W, on the NHS, which (a) hospitals and (b) other organisations were visited; and what the (i) purpose and (ii) duration was of each visit. 
Ann Keen: National health service trusts and foundation trusts running hospitals are themselves legal entities distinct from the Department. As such, they are responsible for deciding if and when to take legal advice or seek legal representation, including at any inquest into a death in hospital.
Jenny Willott: To ask the Secretary of State for Health (1) what contracts there are for the supply of drugs by Merck, Sharp and Dohme Limited for use under the NHS; what drugs and how much of each type of drug are supplied under each contract; and if he will make a statement; 
(2) how much has been spent on the procurement of drugs manufactured by Merck, Sharp and Dohme Ltd. for use in the NHS in each of the last 10 years, broken down by (a) drugs and (b) doses procured; 
(3) what steps his Department is taking to secure a supply of drugs manufactured by Merck, Sharp and Dohme over the next five years; what recent discussions his Department has had with the company on contracts for the supply of drugs for use in the NHS in that period; and if he will make a statement. 
At present NHS PASA is in no dialogue with Merck, Sharp and Dohme that is specific to this supplier. Any dialogue with Merck, Sharp and Dohme is consistent with NHS PASA dialogue with all other suppliers as part of its sourcing programme and in line with its operating procedures that reflect European Union guidance.
Alendronic acid tablets 5 milligrams (mg);
Dorzolamide (as hydrochloride) 2% Timolol 0.5% eye drops 5 millilitres (ml);
Dorzolamide (as hydrochloride) eye drops 2% 5ml;
Imipenem + Cilastatin injection 500mg 120ml;
Imipenem + Cilastatin injection 500mg 120ml Monovial;
Imipenem 500mg/Cilastatin 500mg intramuscular injection 15ml vial;
Imipenem 500mg/Cilastatin 500mg powder. 120ml.vial;
Imipenem 500mg/Cilastatin 500mg powder. 20ml vial;
Imipenem 500mg/Cilastin 500mg powder for suspension vial;
Imipenem 500mg/Cilastin 500mg powder for solution monovial;
Imipenem 500mg/Cilastin 500mg powder for solution vial;
Imipenem/Cilastatin intramuscular injection vial 500mg 15ml;
Imipenem/Cilastatin intravenous injection vial 500mg 120ml;
Imipenem/Cilastatin monovial injection vial 500mg 20ml;
Timolol eye drops long acting 0.5% 5ml;
Timolol eye drops long acting 0.25% 2.5ml;
Timolol eye drops long acting 0.5% 2.5ml;
Timolol eye drops long acting 0.25% 2.5ml;
Timolol eye drops long acting 0.5% 2.5ml;
Timolol eye drops long acting 0.5%/2.5m;
Timolol eye drops 0.25% 0.25ml;
Timolol eye drops 0.5% 0.25ml; and
Tirofiban hydrochloride solution for injection bag 12.5mg/250ml.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what the (a) initial budget and (b) outturn for both (i) revenue and (ii) capital were for the National Programme for IT in the 2007-08 financial year. 
Mr. Bradshaw: The Department's NHS Connecting for Health Agency is responsible both for ensuring delivery of the information technology (IT) systems under the National Programme for IT (NPfIT), and for maintaining the critical business systems previously provided to the national health service by the former NHS Information Authority.
NHS Connecting for Health does not prepare annual whole-programme budgets for NPfIT activity separate from the business of the Agency as a whole because this would involve the unnecessary apportionment of common management, administrative and support costs. For the same reason, separate outturn figures are not routinely reported for management information purposes.
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