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Lord Warner: My Lords, I have been asked a number of questions to which I shall respond as best I can. There are two issues relating to vaccine production: the figure which the Government give the industry as their estimate of the numbers in priority groups who would need vaccine; and the figure which it subsequently turns out that the industry produced at the end of the period in question. The figure which I have for vaccine production for the winter of 200405 is 12.3 million. The figure that we gave the industry at the beginning of this year for this winter was about 14 million, as I have indicated. By definition, we will not know until the end of the winter how many vaccinations have actually been administered. It is worth bearing in mind that in the past GPs have tended to vaccinate in November; but, looking at the figures we have for the end of October, there does not seem to have been a significant change in the coverage of at-risk groups. There is nothing to suggest that there has been a dramatic change in the rate of vaccination.
We know that all ordered vaccines have been delivered, and that is down to the judgment of GPs. It is not a question of me blaming GPs; the truth of the matter is that GPs have registered lists of people and they know from those lists which patients at their surgeries are aged 65 and over and which patients are at risk. They are best placed to make judgments about the amount of vaccine to order, and that system has been in place for a long timecertainly preceding this Government. It is worth bearing in mind that in 199697 vaccine production was 6.1 million doses, so over the past decade there has been a substantial expansion of vaccine production and usage in this country.
I turn to some of the other issues raised. We first ordered a tranche of extra vaccine at the beginning of November and, at the same time, we put in place a national audit of suppliers. It is worth bearing in mind that you cannot just turn on seasonal flu vaccine. We give the judgment about the risk groups and the numbers involved to the manufacturers at the beginning of the year so that they can prepare the appropriate vaccine in the summer for the coming winter's flu strain. Once we are into that winter, the ability dramatically to expand production globally is very restricted. We are now hunting around the world for supplies of vaccine, but we cannot dramatically expand the number of dosages beyond 14 million because the manufacturers will have limited the vaccine that they are producing for a given winter to an amount appropriate for the strains.
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The noble Earl, Lord Howe, referred to pandemic plans. The system used for seasonal vaccination is fundamentally different from that for pandemics. The pandemic plans for antivirals and vaccines are based on central purchase and distribution. They are not GP-based, and so a totally different system is in place in that regard. I reiterate our confidence in the contingency plans for a pandemic and I remind the noble Earl that our level of preparedness was well supported by the World Health Organisation.
The other points raised relate to over-ordering. GPs do not have sale-or-return arrangements for excess stock. We expect them to make judgments on the basis of the information they have on their lists about priority groups and to order accordingly. Our letter yesterday specifically asked GPs to move vaccines between one another if they had stocks which they did not need. So we have asked people to share in these circumstances, and the flu co-ordinators, whom I mentioned in my Statement, can facilitate that at the local level.
The noble Baroness, Lady Barker, raised the subject of hypothermia. A substantial number of measures are already in place for keeping warm in winter and, again, we are having a campaign on the issue in the current year. We will continue to do the best that we can at the local level through the NHS and social services to ensure that people are well informed about what they can do to guard against extreme cold.
Baroness Tonge: My Lords, is the Minister able to assess how much flu vaccine is left in the private sector and in the drop-in centres? Approximately how much does it cost to have a flu jab at those centres, and are GPs directing patients to them if they feel that they should have the vaccine but do not have any themselves?
Lord Warner: My Lords, as I think the noble Baroness knows, there is a fee payment for GPs vaccinating the at-risk groups. I do not know whether they are referring to other sources of vaccine. It is more likely that they would seek to obtain supplies of vaccine to vaccinate their own at-risk groups within their own practice. As I said earlier, we have reminded them of the importance of sharing. We have flu co-ordinators at the PCT level who are expected to facilitate those kinds of arrangements.
"(2) Subsection (1) above does not apply unless the vehicle is being driven by a person who
(a) has satisfactorily completed a course of training in the driving of vehicles at high speed provided in accordance with regulations under this section, or
(b) is driving the vehicle as part of such a course.
(3) The Secretary of State may by regulations make provision about courses of training in the driving of vehicles at high speed.
(4) The regulations may include
(a) provision about the nature of courses,
(b) provision for the approval by the Secretary of State of persons providing courses or giving instruction on courses and the withdrawal of approvals (including provision for appeals against refusal and withdrawal of approvals),
(c) provision specifying the maximum fees that a person may be required to pay for a course,
(d) provision for the training or assessment, or the supervision of the training or assessment, of persons providing courses or giving instruction on courses,
(e) provision for the evidencing of the successful completion of courses,
(f) provision authorising the Secretary of State to make available information about persons providing courses or giving instruction on courses, and
(g) provision treating courses of training in the driving of vehicles at high speed which have been completed before the coming into force of the regulations as if they had been provided in accordance with the regulations.
(5) The regulations may include provision for the charging of reasonable fees in respect of any function conferred or imposed on the Secretary of State by the regulations.
(6) The regulations may make different provision
(a) for different classes of vehicle,
(b) for different descriptions of persons, or
(c) otherwise for different circumstances.""
The noble Lord said: My Lords, I am grateful for the opportunity to speak on this amendment slightly earlier than the House might have imagined. I am therefore superbly well equipped for the amendments of both the noble Earls, Lord Dundee and Lord Attlee, but less well equipped for the amendment of the Lord Davies of Oldham.
The amendment is a minor affair, acknowledging the great difficulties we have had with certain issues in the Bill thus far. Consequently, I am moving it as a formal government amendment because it is merely technical. I beg to move.
"CAUSING DEATH BY CARELESS, OR INCONSIDERATE, DRIVING
(1) In the Road Traffic Act 1988 (c. 52), after section 2A insert
"2B CAUSING DEATH BY CARELESS, OR INCONSIDERATE, DRIVING
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A person who causes the death of another person by driving a mechanically propelled vehicle on a road or other public place without due care and attention, or without reasonable consideration for other persons using the road or place, is guilty of an offence."
(2) In section 24(1) of the Road Traffic Offenders Act 1988 (c. 53) (alternative verdicts), in the Table
(a) in the entry relating to section 1 of the Road Traffic Act 1988 (c. 52) (causing death by dangerous driving), in the second column, after "Section 2 (dangerous driving)" insert "Section 2B (causing death by careless, or inconsiderate, driving)",
(b) after the entry relating to section 2 of that Act insert
|"Section 2B (causing death by careless, or inconsiderate, driving)||Section 3 (careless, and inconsiderate, driving)",|
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