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That this House strongly supports the efforts of the Government within the United Nations, the European Union, the G8 and other international bodies to bring about an end to the conflict in Sri Lanka, to open the way for an international humanitarian relief effort and to promote a process of political reconciliation; welcomes the £7.5 million the Government has already committed to the relief effort; supports the Foreign Secretarys joint visit to Sri Lanka with his French counterpart; endorses the Governments calls for the government of Sri Lanka and the Liberation Tigers of Tamil Eelam to declare an immediate ceasefire and to allow the civilians trapped in the No Fire Zone to leave unhindered, facilitated by the UN; urges both parties to the conflict to allow full and unrestricted access for humanitarian aid to be safely delivered; supports the Governments efforts to persuade the government of Sri Lanka to allow international oversight of all internally displaced persons, including a transparent registration process and improved conditions within the camps with better access to food, water and medical facilities; urges the government of Sri Lanka to allow freedom of movement in and out of the camps so that families separated by the conflict can be reunited; and endorses the Governments efforts to persuade the government of Sri Lanka to initiate a process of political reconciliation with all speed as the only way of ensuring a lasting peace between the communities..
Mr. Deputy Speaker (Sir Alan Haselhurst): With the leave of the House I will put motions 3 and 4 together.
Motion made, and Question put forthwith (Standing Order No. 118(6)),
That the draft Terrorism Act 2000 (Code of Practice for Examining Officers) (Revision) Order 2009, which was laid before this House on 26 February, be approved.
That the draft Transfer of Tribunal Functions (Lands Tribunal and Miscellaneous Amendments) Order 2009, which was laid before this House on 24 March, be approved. (Helen Goodman.)
That, at the sitting on Thursday 30 April, the Speaker shall put the Questions necessary to dispose of proceedings on the Motions in the name of Ms Harriet Harman relating to Members Allowances, Members Allowances (Greater London), Registration of Members Financial Interests, Members Staff, Members Allowances (Evidence of Expenditure) and Members Estimate Committee (Amendment of the Green Book) not later than 5 pm; such Questions shall include the Questions on any Amendments selected by the Speaker which may then be moved; the Questions may be put after the moment of interruption; and Standing Order No. 41A (Deferred divisions) shall not apply. (Helen Goodman.)
The Secretary of State for Health (Alan Johnson): With permission, Mr. Deputy Speaker, I would like to make a further statement on swine flu.
We continue to watch with concern the situation in Mexico and the USA, and to be guided by the World Health Organisation about further changes to the alert level. On Monday evening, the World Health Organisation raised the alert level to 4. That indicates that there are clusters of outbreaks and that the disease is being passed from person to person. In a press conference late this afternoon, the WHO indicated that although the alert level is still at 4, we may be approaching a phase 5 alert. That would mean that there are large clusters of outbreaks but that person-to-person transmission is still localised, which would suggest that the virus is becoming increasingly better adapted to humans. The WHO message is clear: countries across the world must do everything in their power to prepare for the possibility of a full-blown phase 6 pandemic.
I would like to update the House on how this very fast-moving situation is affecting the UK. It was confirmed on Monday that there were two cases of swine flu in Scotland. Both patients are recovering well. As the Prime Minister told the House today, there are now three additional confirmed cases in the UK. A 41-year-old woman from Redditch and a 22-year-old man in north London have both contracted the virus. The 41-year-old is in isolation at home and has already responded well to treatment. Five of her close contacts have also been treated with antiviral drugs. The 22-year-old man in London has been admitted to hospital.
The other confirmed case is a 12-year-old girl in Torbay, in Devon. The Health Protection Agency has identified that she has been in close contact with 50 people. As a precaution, antivirals have been given to a total of 230 people in the schoolthe entire school year. On the advice of the Health Protection Agency, the head teacher is closing the school today. It will be closed for approximately seven days, including the weekend.
All cases that have been confirmed so far are among people who have recently been in Mexico, which is the main affected area. So far, all those who have contracted the disease have experienced relatively mild symptoms and are recovering wellthat is all those outside Mexico.
In light of recent events and to strengthen further our contingency plans, I have taken the following steps. I confirmed in my statement on Monday that we have built up a significant stockpile of the antiviral drugs, Tamiflu and Relenza, to prepare for this situation. Both those drugs have proved effective in relieving the symptoms of those who have been infected, but we will now increase this stockpile to cover 80 per cent. of the population. That does not mean that we expect anywhere near that number of people to be affected. It does mean that we will have enough antiviral drugs to treat 50 million people, and make sure that all front-line NHS staff have their own supplies of antivirals as a preparatory measure.
In addition to increasing availability of antivirals, we are increasing our stockpiles of antibiotics. Although antibiotics have no impact on the flu virus, they will be essential for dealing with any complications such as pneumonia, which might arise from infection.
On face masks, as the chief medical officer reiterated today, there is no convincing scientific evidence that the widespread issue of such masks to healthy members of the public can stop the disease spreading. Moreover, they can give false reassurance and encourage people to ignore basic and straightforward hand hygiene measures, which have proved effective. However, specialist and other types of face mask are useful for front-line NHS staff who care for infected patients, if the face masks are the appropriate type, worn correctly, changed frequently, removed properly, disposed of safely and used in combination with good hygiene measures.
Although we have a supply of face masks for NHS staff, we need more. In the past 24 hours, we have completed contracts for more than 60 million masks, which will start to become available this week. They will be both surgical and respiratory masks, giving staff a broad range of protection when they come into contact with infected patients.
Providing information to the public is one of our strongest lines of defence. A mass public health campaign will begin tomorrow, with print, TV and radio adverts. They will warn the public about swine flu and remind them to cover their noses and mouths with tissues when they cough and sneeze and, then, to throw the tissue away and wash their handsthe same good, basic hand hygiene advice that applies to all types of colds and to seasonal flu. In addition, a leaflet will be dropped through peoples doors from next Tuesday, providing information on the steps that they can take to protect themselves from infection, and telling them what to do should they contract the virus. From tomorrow, members of the public who want further information will be able to ring a single number, 0800 1 513 513, for regular recorded updates on the situation.
The threat that we face is serious, but we have never been as prepared for a pandemic as we are now. The plans that we have in place are robust and have been thoroughly tested. Scientists know more about flu now than they have ever done. When our country last faced the threat of a flu pandemic, in 1968, there was no national plan and most measures that are available today did not exist. If a pandemic emerges, no one can turn back the tide, but, with international co-operation, scientific endeavour, effective plans and dedicated front-line staff, we can reduce its impact and ensure that we avoid the level of sickness that was experienced in the three pandemics of the last century. I shall ensure that Parliament is properly updated as the situation develops.
Mr. Andrew Lansley (South Cambridgeshire) (Con): I am sure that the House is grateful to the Secretary of State for his update on the impact of the swine flu outbreak, and I thank him for the further steps that have been taken following the statement on Monday. He knows, and I told the House, that for a long time we have pressed for the acquisition of a strategic stockpile of face masks, and, although it had not been done beforehand, it will be done now, and that is welcome. Equally, we pressed for an extension to the antiviral stockpile, and the Secretary of State has now said that it is available. Two questions arise from that, however. Does he intend to acquire the additional stockpile to pursue a strategy of treatment for all cases that may emerge, and does he intend to provide, prophylactically, as a preventive measure, antiviral drugs to the close household contacts of those who are infected?
There are two questions about the distribution of Tamiflu to NHS workers, too. First, will it be extended not only to NHS front-line workers, but to front-line workers in other care home contexts? Secondly, is the distribution intended for their use if they become symptomatic, or if they are exposed to the virus?
The Secretary of State talked about the acquisition of a further stockpile of antivirals, but on what timetable does he expect that additional Tamiflu to be received? He has reached the point at which he is giving us, quite properly, the information about what is happening, but I do not sense that we have been told the Governments strategy. Will the Secretary of State take this opportunity to clarify the current strategy? We lack certain evidence about the nature of this virus and its spread, and the impact on humans, but good evidence is emerging that it may be a relatively mild strain of flu, although it is spreading fast. We therefore have the capacity, as he illustrated, to take quite an aggressive strategy against it in the United Kingdom and commit ourselves to ensuring that antiviral treatment will be available for all cases, pursuing household prophylaxispreventive measures with all close contactsand securing 100 per cent. vaccination as soon as a vaccine becomes available. Can he confirm that were there to be a second wave, antibiotic stockpiles would already be available for those with complications arising from flu infection? In that context, is he confident that we will have an antibiotics stockpile for 14 per cent. of the population, as indicated by Department of Health modelling?
I say all that about a strategy because, as the Secretary of State will recall, in September last year the scientific pandemic influenza advisory committeean easy name to rememberdid a modelling summary of what we know, which said:
Having taken 2 to 4 weeks to build up in the country of origin, pandemic flu could take as little as 2 to 4 weeks to spread...to the United Kingdom
indeed it canand that we should
assume, for the purposes of developing intervention strategies, that the outbreak will spread throughout the UK in less than 2 weeks.
the Secretary of State did not talk about that, but it is important to emphasise
of the first few hundreds of cases in the UK will be essential for the accurate determination of disease parameters.
We must ensure that we contact-trace all those who are exposed to the virus in the short run. The committee set out how the strategy that I described, using all those interventions, might be
sufficient to limit the number of cases, hospitalisations and deaths to the levels of the targeted strategy...even if one component intervention is ineffective.
Where school closures are concerned, the modelling said:
Combined with a household prophylaxis policy (as opposed to simply treating cases), closing schools can have an important effect on the profile of the epidemic and the overall number of clinical cases (in adults as well as children).
The Secretary of State said that Paignton community college would be closed for a week, but the modelling would assume that it would be closed for three weeks. If a case of flu is identified at the school, do the Government intend that it will be closed for three weeks?
Let me ask about the national flu line; I know that the Secretary of State is disappointed that that is not available. The Prime Minister said during Prime Ministers questions that interim measures would be put in place. Clearly, the telephone number that the Secretary of State mentioned is not such a measure. GPs across the country need to know how they can access good information and advice. Updates provided to front-line cliniciansfor example, an RSS feed on a six-hourly basis, with a clinical focuswould be an important facility for them to have available. They also need to know how they can access Tamiflu if they have patients who require it.
Does the Secretary of State have any further results from inquiries into why cases appear to have a high mortality rate in Mexico but not in other countries? What does the Health Protection Agency at Colindale know so far about the character of this virus and its interaction with humans?
The Secretary of State knows that were the flu to become more severe, we would need substantial numbers of critical care beds and ventilators. Since the United Kingdom has substantially fewer intensive therapy unit beds than other countries, and those are working at full capacity for most of the time, how does he intend that we would cope with a doubling or tripling of the need for intensive care beds?
On pig welfare, will the Secretary of State confirm that there is no evidence to suggest that there is a case for any cull of pigs or other livestock, and will the Government, through their veterinary contacts, try to encourage other countries in the direction of reasonable and proportionate measures?
Looking beyond our own shores, what discussion have the Government of this country had with the World Health Organisation about how the supply of antivirals will be prioritised to countries that have now placed orders? While obviously our first responsibility is to ensure that every possible protection is in place for the people of this country, what further can we do through the WHO to support the least developed countries? If we do not support them, there is a risk, as the Secretary of State will know, that a pandemic will expose the gap between rich and poor in this worldthat we will protect our population effectively but find that there are literally millions of deaths in the poorest countries in the world. What are we doing to try to reduce that risk?
The hon. Gentleman asked some very important questions. On antiviralsthis also relates to one of his other pointsat this stage we have the ability to isolate and contain this flu. As he says, it is mild so far, so we can use the antivirals as a prophylactic at the moment. That is one reason we have ordered extra suppliesso that we do not dilute the provision of antivirals if we do get to the stage of a full-blown pandemic. The use of antivirals is indeed in preparation for treatment but also, on a prophylactic basis, a preventive
measure in all the outbreaks that are occurring at the moment, so that we can contain them.
As far as NHS staff are concerned, as the hon. Gentleman knows, the framework we have announced is for NHS staff and staff in adult social care, and he made an important point about that. NHS staff are being issued with Tamiflu as a prophylactic. It is actually more important to them than face-masks, so that is the idea. The problem with people using it as a prophylactic, as the chief medical officer would say if he were at the Dispatch Box, is that they have to keep taking it, and then when they stop taking it, they become immediately prone. However, it will help NHS staff to have that there ready for the next stage.
The hon. Gentleman asked when the supplies will be ready. It will be the end of May at the latest, in accordance with the contract that we have signed. The antibiotic stockpile will cover about 14 per cent. of the population, in accordance with the strategy.
The hon. Gentleman raised the issue of contact tracing, which has worked very well both in Scotland initially and in England. It is a very important part of the strategy, and the Health Protection Agency and others are helping. The HPAs announcement today was that every single flight that comes in from Mexico, wherever it lands, will be met by its officials, and that we will ask the airlines to keep the records that they normally destroy after 24 hours for at least a week. There will be other measures to ensure that we can better use contact tracing quickly.
The hon. Gentleman asked about school closures. As he well knows, the framework mentions trying to keep schools open, because if we close the schools, nurses will have to look after the children and we will get into a bad situation. At the moment, during this phase 4 containment stagewe have to make a distinction between the phasesit makes sense to close Paignton community college. The initial decision by the head teacher and the education authorities was to close it for a week, and obviously they will review that based on advice from the HPA.
The hon. Gentleman also mentioned the national flu line. The concept of the flu line does not exist anywhere else in the world. We signed the contract with BT in December. That line will be set up for a stage when we are in considerable difficulties and people cannot leave their home, or are advised not to, so that they can ring a number and find a nurse at the other end who can ask some simple questions and give them a code, and someone can go on their behalf to collect the antivirals. That system will not be up and running until October. We can discuss all the reasons why afterwards, but in the current situation it will not be available until then. Every single health authority has been told to build into its plans arrangements on the assumption that it will not have the flu line available, and those arrangements look very robust. I am considering ways in which we can improve them, perhaps by getting NHS Direct and its single number to be part of them. We are currently considering all the possibilities for doing that, but if we cannot have a replica of the national flu line, we will have robust systems for distribution of antivirals around the country when we move to that phase.
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