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Bob Spink: To ask the Secretary of State for Health what criteria are used to determine the efficacy of healthcare associated infection control products adopted for use by the NHS in the absence of a recommendation from the Rapid Review Panel. 
Dr. Kumar: To ask the Secretary of State for Health how many children have been vaccinated against human papilloma virus in (a) England, (b) the North East, (c) the Tees Valley and (d) Middlesbrough South and East Cleveland constituency. 
Dawn Primarolo: The Human Papillomavirus (HPV) vaccination is a three-dose schedule. The vaccination programme started in September 2008. Provisional HPV vaccine uptake information is provided monthly by primary care trusts (PCTs) and is published on the website:
|Cohort 1: routine 12 to 13-year-olds school year 8|
|Doses given since 1 September 2008|
|Dose 1||Dose 1 and 2||All 3 Doses|
|Cohort 2: catch-up 17 to 18-year-olds school year 13|
|Doses given since 1 September 2008|
|Dose 1||Dose 1 and 2||All 3 Doses|
Tees Valley is not a single administrative or health area. It is an area which comprises Hartlepool PCT, Middlesbrough PCT, Redcar and Cleveland PCT, Stockton-on-Tees Teaching PCT and Darlington PCT.
Mr. Bradshaw: It is up to the commissioning primary care trust to determine locally what services will be provided to patients at new general practitioner-led health centres or national health service walk-in centres.
Mike Penning: To ask the Secretary of State for Health (1) what steps his Department has taken to ensure that patients showing symptoms of swine influenza are able to receive antiviral treatment within 12 hours; 
(3) whether primary care trusts plans for the location of collection points of antivirals in the event of an influenza pandemic have been finalised; and whether a stock management system for the distribution of antivirals has been established; 
(6) what estimate his Department has made of the number of calls to the proposed National Flu Line at peak times; and when he expects the proposed National Flu Line to reach this level of operability; 
(8) pursuant to his statement of 29 April 2009, Official Report, column 987, on the swine flu update, what plans he has to consult on the list of key infrastructure workers identified as potentially in need of a prophylaxis against influenza. 
Dawn Primarolo: Antiviral drugs are effective so long as they are administered within 48 hours of the onset of symptoms. Currently, patients showing symptoms of swine influenza who contact their local general practitioner (GP) or call NHS Direct are prescribed antivirals from stocks held at local Health Protection Agency (HPA) health protection units. National health service organisations have arrangements in place to handle collection of antivirals from the HPA and to ensure patients can readily collect them. The algorithm for diagnosing swine influenza and rapidly accessing and prescribing antiviral drugs where appropriate has been sent to all GPs and is also in use by NHS Direct.
We have provided detailed guidance to primary care trusts (PCTs) on the setting up of the antiviral collection points which will be used by Flu Friends on behalf of symptomatic individuals. All PCTs have received an initial supply of antiviral drugs. PCTs and strategic health authorities (SHAs) have been identifying the number and location of antiviral collection points that would be appropriate to their local health economy. PCTs and SHAs are reviewing existing plans to enable an immediate local response if required.
An essential element of the mitigation phase will be a system for ordering and distributing antivirals. The Flu Line is a groundbreaking system and the first of its kind in the world. It will be able to assess people via either the internet or telephone, co-ordinate the distribution of antivirals and feed back to local health services. The Flu Line will be ready for the autumn and will have been thoroughly tested so that staff, patients and the public can have full confidence in its efficacy.
In the event of a need to distribute antivirals more quickly, an interim service is being put in place to supplement the assessment and authorisation processes. This system is being thoroughly tested and we expect the online aspect of it to be fully operational as soon as it is needed.
Mike Penning: To ask the Secretary of State for Health what recent assessment his Department has made of the implications for the UK of an influenza pandemic in developing countries; and what discussions he has had with the Secretary of State for International Development on healthcare assistance to developing countries affected by such a pandemic. 
Dawn Primarolo: The National framework for responding to an influenza pandemic sets out the potential impact of a pandemic on the United Kingdom and makes it clear that flexible strategies will be needed in deciding how best we respond, irrespective of where the virus actually originates. A copy of the framework has been placed in the Library.
There continues to be on-going collaboration between Department of Health and Department for International Development (DFID) officials. Last year both Departments worked closely in producing the first cross-government UK international preparedness strategy for pandemic influenza (a copy of which has been placed in the Library). One of its objectives is to support detection and surveillance activity in countries at risk so that accurate reporting data can be provided and, where feasible, humanitarian assistance can be provided. Officials of both Departments are working closely together to now take this forward, including on-going engagement with the Pandemic Influenza Contingency team in the United Nations Office for Coordination of Humanitarian Affairs.
At a series of international conferences since 2006, the UK has pledged to date £37 million to help improve preparedness for avian and pandemic flu. The World Health Organization has set up an emergency fund for the current swine flu outbreak and DFID has announced a donation of £5 million towards this.
Dawn Primarolo: The Department has been planning for a possible influenza pandemic for some time and has robust plans in place. We have enough antiviral stocks to cover 50 per cent. of the population (some 33.5 million courses); we are further increasing the stockpile so that it is enough to cover 80 per cent. of the population (some 50 million courses).
We also expect Flu Line, which will be used to assess symptoms and authorise antivirals for individuals, to be operational by the autumn, thus ensuring we have additional capability to respond to a re-emergence of the virus.
On 15 May, the Government also announced the signing of agreements with vaccine manufacturers for up to 90 million doses of a pre-pandemic vaccine based on the current H1N1 strain. The agreements could
provide enough vaccine to protect the most vulnerable groups in our population before a pandemic is likely to arrive. In the event of a pandemic, the Advanced Purchase Agreements previously signed with Baxter and GlaxoSmithKline will be activated; these will enable the United Kingdom to purchase enough vaccine to cover 100 per cent. of the UK population.
In addition, we are increasing our stocks of facemasks, respirators and antibiotics to ensure we have sufficient stocks of countermeasures to tackle a re-emergence of swine influenza later in the year.
Ms Keeble: To ask the Secretary of State for Health what the age of the youngest (a) girl and (b) boy admitted to hospital with an alcohol-related liver condition was in each of the last three years. 
Dawn Primarolo: Due to data quality concerns we are unable to provide the data requested. The NHS Information Centre for health and social care have advised that the maximum or minimum values are more susceptible to error than other values and that if the data were supplied on the youngest girl and boy admitted to hospital with an alcohol-related liver disease it may be erroneous and therefore misleading.
Mr. Frank Field: To ask the Secretary of State for Health pursuant to the answer of 30 March 2009, Official Report, columns 956-57W, on childbirth, what estimate he has made of (a) the number of midwives that will be required and (b) the resource budget of paediatric medical services in each year to 2031 assuming the number of births to be as set out in the table; and what estimate he has made of (i) marginal cost and (ii) capital value of the maternity services required to manage that volume of births. 
Mr. Stephen O'Brien: To ask the Secretary of State for Health what expenditure his Department has incurred on the provision of meals on wheels services in each local authority area in each of the last 10 years. 
Local authorities pay for publicly-funded adult social care services, including meals on wheels, out of their general funds. Local authorities receive central Government funding from Her Majesty's Treasury, which is distributed to them by the Department for Communities and Local Government, as well as income from local taxationvia council tax receiptsand from other Government Departments and private contributions.
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