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12 Jan 2009 : Column 157W—continued
There is ongoing discussion at scientific and policy level of antiviral household prophylaxis. For example, the Department has completed modelling which indicates that this is an effective strategy. We have also sought scientific advice on the issue from the Scientific Advisory Group on Pandemic Influenza (SPI), our external scientific
advisory committee. This has concentrated on issues such as the size of the stockpile needed and the strategic approach to prophylaxis when the stockpile contains more than one type of antiviral. We are currently considering the delivery implications of a policy based on household prophylaxis, and the procurement approach to be followed. We are not currently considering other forms of prophylaxis.
Experts from the British Thoracic Society, British Infection Society and Health Protection Agency developed Clinical Management Guidelines for patients with pandemic influenza. These include proposals for antibiotics to be used for the treatment of bacterial complications. The guideline suggests antibiotics active against Heamophilus influenzae, Streptococcus pneumoniae and Staphylococcus aureus the bacteria, which most commonly cause respiratory infections. These include penicillin based products such as co-amoxiclav or a tetracycline such as doxycycline. For those allergic to penicillin, a macrolide such as erythromycin or clarithromycin is recommended. Complications requiring antibiotic therapy would be treated with a cephalosporin such as cefuroxime, which are administered with IV fluids.
Suppliers of antibiotics have responded to the Invitation To Tender published in the Official Journal in August 2008. These bids are currently being evaluated.
Mr. Lansley: To ask the Secretary of State for Health (1) how many courses of zanamivir have been stockpiled to protect pregnant women in the event of an influenza pandemic; [245620]
(2) what proportion of the antiviral stockpile for use in the event of an influenza pandemic is for use by (a) adults and (b) children; [245643]
(3) what the mass in milligrammes of oseltamivir stockpiled for use in the event of an influenza pandemic is; what the assumed dose in milligrammes of an individual course of treatment for (a) an adult and (b) children is; and if he will make a statement; [245644]
(4) how many doses of A/H5N1 vaccine are held by his Department; what proportion of the stockpile is reserved for the (a) armed forces, (b) healthcare workers and (c) other groups; and if he will make a statement; [245645]
(5) with reference to the answer of 13 December 2007, Official Report, columns 873-4W, on influenza disease control, when his Department's stockpile of Tamiflu will pass its shelf-life. [245811]
Dawn Primarolo: At the time of purchasing the current stockpile of antivirals, adult dosages were applied from age seven upwards. The relative proportions are 7.6 per cent., and 92.4 per cent., for children under seven and adults respectively.
The total mass of the current stockpile of Oseltamivir (Tamiflu) for the UK is 11 billion mg. The dosages per treatment course are 750 mg and 200-600 mg for adults and children respectively.
The bulk of the current stockpile of Tamiflu is due to reach the end of its shelf life in financial year 2010-11, the remainder is due to expire in financial years 2011-12 and 2012-13.
Approximately 275,000 courses of zanamivir have been stockpiled to protect pregnant women in the UK.
The UK holds 3.3 million doses of H5N1. The relative proportions are 2.9 per cent., 86.2 per cent., and 10.9 per cent., for the armed forces, health care workers and other groups respectively.
Mr. Lansley: To ask the Secretary of State for Health what modelling work on the effects of an influenza pandemic has been undertaken by his Department in the last 12 months. [245631]
Dawn Primarolo: The Department continues to work in collaboration with a number of modelling and analytical groups both nationally and internationally to take forward both operational and epidemiological modelling work to assist preparedness for a possible pandemic. The main topics considered over the past 12 months have been the appropriate use of clinical countermeasures, the potential effectiveness of social distancing measures and the arrangements for real time modelling during the pandemic.
Where the consideration of these issues has led to a modification of the advice to policy makers the new advice has been recorded in the SPI-M modelling summary at:
Mr. Lansley: To ask the Secretary of State for Health who the members of the independent committee which developed an ethical framework to inform the response to an influenza pandemic are, as referred to on page 14 of his Department's National Framework for responding to an influenza pandemic. [245632]
Dawn Primarolo: The membership of the Committee on Ethical Aspects of Pandemic Influenza (CEAPI) is as follows:
Chair: Very Reverend Graham Forbes, Provost of St. Mary's Cathedral, Edinburgh
Mrs. Julie Acred, Chief Executive, Derby Hospitals NHS Foundation Trust
Mr. Chris Chaloner, Ethics Adviser, Royal College of Nursing
Mr. John Colvin, Consultant and Honorary Senior Lecturer in Anaesthesia and Intensive Care Medicine, Ninewells Hospital and Medical School, Dundee
Mr. Jane Cowan, Medicolegal Adviser, MPS Risk Consulting
Mr. Jean Jacques de Gorter, Director of Clinical Services, BUPA Hospitals Ltd.
Professor Robert Dingwall, Director of the Institute for the Study of Genetics, Biorisks and Society, University of Nottingham
Mr. Eugene Gallagher, Head of Primary Care and Family Practitioner Services in the Western Health and Social Services Board, Belfast
Professor Trisha Greenhalgh, Professor of Primary Health Care at University College London
Professor John Harris, Professor of Bioethics, School of Law, University of Manchester
Dr. Victor Larcher, Consultant in General Paediatrics and Clinical Ethics, Great Ormond Street Hospital, London
Professor Jonathan Montgomery, Professor of Health Care Law, University of Southampton; Chair, Hampshire Primary Care Trust
Professor Vivienne Nathanson, Director of Professional Activities, British Medical Association
Ms Jane O'Brien, Head of Standards and Ethics, General Medical Council
Professor Michael Parker, Professor of Bioethics and Director of the Ethox Centre at the University of Oxford
Dr. Clive Richards, Consultant in public health medicine, Nottinghamshire
Mr. Hugh Robertson, Senior Policy Officer with responsibility for Prevention, Rehabilitation and Compensation, Trades Union Congress
Mrs. Shahwar Sadeque, Educational and ICT Consultant and Chief Executive of TriEs Ltd.
Professor John Saunders, Consultant Physician, Nevill Hall Hospital, Abergavenny; Chairman of the Committee for ethical issues in medicine, Royal College of Physicians
Mr. Roy Taylor, Director of Community Services, Kingston upon Thames
Mr. Geoff Watts, freelance journalist
Professor Richard Williams, Professor of Mental Health Strategy, University of Glamorgan; Consultant Child and Adolescent Psychiatrist, Gwent Healthcare NHS Trust
Dr. Patricia Wilkie, Chair, Academy of Medical Royal Colleges patient/lay committee.
Representatives of the devolved Administrations attend as observers.
Mr. Lansley: To ask the Secretary of State for Health when he next intends to issue an updated national framework for responding to an influenza pandemic. [245633]
Dawn Primarolo: The national framework is due to be updated during 2009-10.
Mr. Lansley: To ask the Secretary of State for Health what criteria will be used to assess whether an individual should be admitted to (a) secondary and (b) critical care in the event of an influenza pandemic. [245641]
Dawn Primarolo: Our guidance document entitled “Pandemic influenza: surge capacity and prioritisation in health services - provisional guidance”, which has been issued to primary care trusts and other stakeholders for consultation and is due to be published in the new year, included an assessment tool for admitting individuals to secondary or critical care. We also plan to further refine assessment criteria, in consultation with key stakeholders, over the course of the year.
Mr. Lansley: To ask the Secretary of State for Health what work has been undertaken by the Scientific Pandemic Influenza Behaviour and Communication sub-group since it was established; on what dates it has met since it was established; and if he will place in the Library copies of (a) papers considered by the sub-group and (b) minutes of all its meetings. [245642]
Dawn Primarolo: The Scientific Pandemic Influenza Advisory Committee’s Behaviour and Communication sub-group has met twice since its establishment in June 2008. These meetings were held on 19 August 2008 and 1 October 2008.
At these meetings, the group identified behavioural science-related research gaps relevant to pandemic influenza preparedness. The group has also assessed the feasibility of undertaking research to address any gaps.
The documents the sub-group considered were excerpts relevant to behavioural science from documents SPI/01/09a and SPI/01/09b, which were presented at the main SPI meeting in April 2008 and available on the SPI website. A copy of these papers has been placed in the Library.
The conclusions of the Behaviour and Communication sub-group meetings were recorded in the submission to the main SPI on the pandemic influenza research gap analysis discussed on 11 November 2008. A copy of this paper has been placed in the Library. It is also available to download on the Department’s Scientific Pandemic Influenza Advisory Committee (SPI) website at:
Mr. Lansley: To ask the Secretary of State for Health with reference to the answer of 9 January 2008, Official Report, column 597W, on influenza, what consideration has been given to the merits of stockpiling (a) aprons and (b) gloves in case of an influenza pandemic. [245698]
Dawn Primarolo: My previous answer highlighted the importance of gloves and aprons in supporting good hygiene practices in an influenza pandemic. The quantities and type of gloves and aprons, based on the number and type of patient interactions, are currently being investigated. The large numbers required and the need to ensure availability at point of use strongly favours the creation of a pandemic stockpile (without impacting on the Business As Usual requirement for these products). We are currently considering the most appropriate commercial options for building this stockpile.
Influenza: Vaccination
Mr. Lansley: To ask the Secretary of State for Health what representations his Department has received from (a) members of the public and (b) health care professionals on the supply of seasonal influenza vaccines for the 2008-09 winter. [245634]
Dawn Primarolo: The Department has received several inquiries from members of the public mainly relating to specific general practitioner (GP) surgeries and their influenza vaccine supplies.
GP surgeries order influenza vaccines directly from the suppliers. As such, GP surgeries contact individual manufacturers if they experience supply problems.
The Department holds regular discussions with the UK Vaccine Industry Group (UVIG) to ensure adequate vaccine supply for the influenza programme. The UVIG has confirmed that there is sufficient vaccine to meet all orders placed with the suppliers.
Mr. Lansley: To ask the Secretary of State for Health what steps he is taking to ensure an adequate supply of seasonal influenza vaccines for the winter 2008-09 seasonal influenza immunisation programme; what discussions he has had with vaccine manufacturers on their capacity to supply adequate stocks of vaccine; which manufacturers are supplying vaccine to the UK; what information he has received about vaccine manufacturers encountering difficulties in (a) manufacturing and (b) delivering vaccines; and if he will make a statement. [245635]
Dawn Primarolo: The Department holds regular discussions with the UK Vaccine Industry Group (UVIG) to ensure adequate vaccine supply for the influenza programme. The UVIG has confirmed that there is sufficient vaccine to meet all orders placed with the suppliers.
UVIG have also confirmed that there have been no difficulties in manufacturing and delivering vaccines.
The manufacturers which have supplied vaccine during this season are GSK, MASTA, Novartis Vaccines, Sanofi Pasteur MSD, Solvay Healthcare and Wyeth Vaccines.
Mr. Lansley: To ask the Secretary of State for Health in what ways his Department is communicating to health care workers the importance of seasonal influenza immunisation, as stated in the minutes of the Joint Committee on Vaccination and Immunisation’s meeting of 13 February 2008. [245638]
Dawn Primarolo: As stated in the chief medical officer letter of 31 March 2008, responsibility for immunisation for occupational staff rests with employers and should be provided by occupational health services. A copy of this letter has been placed in the Library.
The Department has recently published a new leaflet, fact sheet and poster encouraging health care professionals to get vaccinated against the flu.
Also in June 2008, the Department held a national flu immunisation conference for primary care trust flu leads. This conference focused on flu vaccinations for health care workers and the issues around improving uptake.
Injuries: Offensive Weapons
Mr. Lansley: To ask the Secretary of State for Health when he was informed by the NHS information centre that data relating to patients attending hospital with knife wounds, provided to 10 Downing street, had been or was due to have been published. [246696]
Mr. Bradshaw: My right hon. Friend the Secretary of State was aware on the day of publication, 11 December.
Lyme Disease
Mr. Swire: To ask the Secretary of State for Health whether he plans to make Lyme disease a notifiable disease. [245187]
Dawn Primarolo: I refer the hon. Member to the answer I gave him on 11 December 2008, Official Report, column 234W.
Medical Records
Dr. Murrison: To ask the Secretary of State for Health how much each health care trust spent on sending patient medical records by taxi in each of the last five years; and if he will make a statement. [245681]
Mr. Bradshaw: This information is not held centrally, and could be obtained only at disproportionate cost.
Mental Health Services
Dr. Kumar: To ask the Secretary of State for Health whether the proposed NHS Constitution will guarantee mental health service users a choice of hospital. [245014]
Ann Keen: I refer my hon. Friend to the reply given to the hon. Member for North Norfolk (Norman Lamb) on 11 December 2008, Official Report, column 234W.
Mental Health Services: Ex-servicemen
Mr. Stephen O'Brien: To ask the Secretary of State for Health where the NHS-led community mental health pilots for ex-servicemen are located; and when he expects each pilot to report. [246002]
Phil Hope: The community mental health pilot schemes for ex-service personnel are located in Stafford, Camden, Cardiff, Bishop Auckland, Lothian and St Austell. The pilots, which began in November 2007, will be independently evaluated over a period of two years.
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