Select Committee on Science and Technology Minutes of Evidence



  13 September 2002

  Dr Mary O'Mahoney

  Department of Health

  Richmond House

  79 Whitehall

  London SW1A 2NS

  Dear Dr O'Mahoney

  Re: Future Arrangements for Microbiology Laboratory Services

  I am writing on behalf of the Clinical Virology Network to comment on the latest document dated 3 September. While we appreciate that the focus at present is on managing the transfer of selected staff/facilities from the PHLS to the NHS, we are concerned that the current proposals do not recognise the realities of current and future provision of specialist virological services.

  These concerns can be illustrated by a hypothetical example of a major virological problem the HPA must be prepared for. Imagine terrorists infect themselves with smallpox and travel on a London Underground train bumping into fellow passengers. The first case presents to the London Teaching Hospital where I work and samples are submitted for investigation of "atypical chickenpox". Within an hour we visualise pox shaped virus particles by electronmicroscopy, seal the hospital, request our colleagues at the Central Public Health Laboratory at Colindale to perform confirmatory testings and advise colleagues at CDSC. All of this would be achieved without the involvement of the HPA labs designated for London, one of which lacks the ability to diagnose smallpox by EM. The HPA will thus have the responsibility for protecting the public from smallpox without the facilities and trained staff to carry out those responsibilities. Although this example of smallpox is obviously contrived, and will hopefully never occur, the possibility of misdiagnosing a case of atypical chickenpox as smallpox and starting a public/media panic, perhaps at a time of heightened tension about bio-terrorism, is a real one.

  We prefer a model where the existing 20 Specialist Virology Centres continue to provide specialist virological diagnosis across the country, ie each centre should contain an HPA function even if it is not one of the recently designated eight HPA laboratories. This would recognise the established patterns of patient flow and referral for expert advice necessary to make the correct diagnosis and so implement appropriate management.

  Following on from the CMO's response of 25 July to my letter of 18 June we would like to meet with you to discuss how the Clinical Virology Network can help achieve the goals set out in "Getting Ahead of the Curve"; could you suggest some dates?

  Yours sincerely

Paul D Griffiths

Professor of Virology and Chief Executive Officer, UK Clinical Virology Network

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