Select Committee on Science and Technology Minutes of Evidence


Examination of Witnesses (Questions 280 - 298)

TUESDAY 1 NOVEMBER 2005

Ms Rosie Winterton MP, Dr David Harper and Dr David Salisbury

  Q280  Earl of Selborne: Will that get through to local authorities?

  Ms Winterton: Yes, the local authorities are certainly consulted as part of those groups. They are a very, very important part of the contingency planning in that area and will increasingly be so. It is important obviously that they are in close liaison with Primary Care Trusts as well. Again that relationship, at local level, is very, very important because that is where the real work, if you like, is going to take place. So we can build on structures which have already been developed. I think I am right in saying, and I will come back if this is not correct, by November 2005 there is through the Civil Contingencies Act a duty - is there not - to produce plans?

  Dr Harper: Yes.

  Q281  Lord Sutherland of Houndwood: A very quick follow-up to that. If, or as some say when, a pandemic comes, what is the Government process for looking at civil contingencies, implementing measures relating to that? For example, banning large meetings or indeed looking at the question of travel. Hanging on to the issue of schools, will that be a local decision or will that be a national decision, whether schools close and the consequent impact on the workforce?

  Ms Winterton: I do not know whether you have had time to go through this document?

  Q282  Lord Sutherland of Houndwood: I have not had time to read it because I have been listening to you.

  Ms Winterton: This is actually the plan which was issued by the Chief Medical Officer and it sets out how within that there will be liaison at national level across the departments. This will obviously again, I have to stress, relate to the assessment of who is being affected, how it is being passed, if you like, and all the implications of whether closing schools or shutting down businesses or banning public meetings will actually have the desired effect. Again, it is very important to say that we would be, through the ministerial and top level officials group, looking at those issues as the situation develops, and, of course, working with international partners as well as to actions which were being taken in other countries. But it would then be for guidance obviously to be issued at local level.

  Q283  Lord Sutherland of Houndwood: Would it be a matter at the discretion of a head teacher or a school board whether a school closes, or could they do that before guidance comes down the line?

  Ms Winterton: There might be different decisions in different areas but obviously there would be very clear guidance from national level because, quite frankly, there would have to be an exchange of expertise and information. So it would be very much a local and national working-together but it may well be, and again my advisers will be able to give you further information, in the particular UK situation possible to contain things and have one thing happening in one area and another thing happening in another. That would depend on how any virus was developing.

  Dr Harper: Infectious disease experts and our modellers and our public health epidemiologists are currently working on exactly those issues in the sense of school closures, cancelling large public gatherings and so on. The models are being revised as we speak, and they will continue to be revised in the light of new information, new scientific considerations. So it will be when the virus and the characteristics of the virus are clearer as to the attack rate, the susceptibility of the population and so on, that those will be fed directly into the models which will be there for real time use, where we can base the policy decisions and ministers can base the policy decisions on the best available information at the time that the virus emerges.

  Q284  Lord Sutherland of Houndwood: It sounds a fairly frenetic process as the gap begins to narrow.

  Dr Harper: That is why a lot of the preparatory work and the models are being done now, and the scientific press will be looking at that over the next few months. There will continue to be publications around, for example, international travel, school closures and some of these big issues, where we can use peer review work, which is very important, internationally and nationally, but we have those modellers who are helping us in our policy development right now.

  Chairman: I think we want to move on now to the question of the funding of research.

  Q285  Lord Paul: According to the evidence we received from the Medical Research Council, the annual budget for research was about £1.6 million which was spent and this covers key areas such as assessment of the risk posed by avian viruses, analysis of the development of the H5NI virus and of its effects upon humans, and research into innovative methods of vaccine development. Is this really enough?

  Ms Winterton: We can assure the Committee that we are very committed to improving research in this area and to work closely with the Medical Research Council, Defra and others, to ensure we have got a good research strategy here in the UK but also to make sure we are aligning what we are doing at EU and also at international level. That is a very key point, particularly in terms of what came out of the Ottawa meeting. That was certainly defined and there was a real sense at that meeting that there was research taking place in different parts of the world and that there was a very key co-ordinating role which needs to be filled. So I would say the issue is not only about direct research which we can undertake but also research one can feed into and help to co-ordinate in other parts of the world. We do want to look at what else can be done in terms of specific research on pandemic flu vaccines. Already we have £750,000 committed to flu vaccine research, and as you have said the MRC's current investment is something like £1.6 million. I think it might also be worth Dr Salisbury saying something about the work which is going on by vaccine manufacturers as well, because I do think that is quite an important part of the equation for us to consider. It is obviously being in a sense stimulated by the fact that we are making it quite clear this is an area we are interested in.

  Q286  Lord Paul: My question was that you have done a tremendous amount of preparation about what can happen but £1.6 million looks so small.

  Dr Harper: The £1.6 million is MRC funding. If we take into account as well all of the work we have been alluding to this afternoon which has been done, for example on diagnostic development, near-patient testing both for national use and possibly for developing country use, and there is work going on in academia but also our Arm's Length Body, the Health Protection Agency, has done a great deal of work through what we might describe as core funding. The HPA have also successfully competed for European Union funding from the Framework Programmes. So in a broader sense, and if we look at the running of exercises and scenario development, the Health Protection Agency has won contracts for two very large exercises on a European scale which are being funded by the European Commission. We also have a lot of work going on in the National Institute for Biological Standards and Control on elements such as reverse genetics and developing those technologies so they can be applied to vaccine development and the development of standards. So we have to be slightly careful when figures are taken and earmarked as if they are the totality of research and development funding because, apart from those specific figures, there is an enormous amount of activity which is going on through these agencies and academia and other channels.

  Q287  Lord Winston: Is it not a fact that in Britain generally we have run-down academic micro-biology and that this is a problem for research in this area, and the fact we have not filled chairs in this area, and we are now very vulnerable?

  Dr Harper: I think there is a real issue there in clinical microbiology and other specialisms as well - clinical toxicology is another very good example. There are some gaps in academia, but my point is that there is still a substantial amount of work which is going on throughout academia but also through the Arm's Length Bodies we sponsor.

  Q288  Lord Patel: Currently, as we know, there is a high level visit from MRC to China and Vietnam to understand the spread, organisation and epidemiology and, hopefully, that will identify areas where research could be targeted; basic science research particularly the kind you have mentioned the NIBSC is doing. If they come back and suggest there are areas where targeting research would be profitable, would we be able to find more money?

  Ms Winterton: We obviously look at any proposals in this area. As I have said, one of the very important results of the Ottawa meeting and other meetings which are going on is we need to look jointly with international partners at research proposals and particularly in the area you have spoken about there.

  Q289  Baroness Finlay of Llandaff: Could I follow up on research proposals? One of the problems for anyone putting together a research proposal is the lag period from when they get the research proposal together and then getting ethics approval, whether it is ELREC or MREC or however, and of course time is not going to be on people's side in this. The other difficulty though is going to relate to consent over data and information. Clinical research in this area is going to be absolutely key and will be a one-off opportunity and we will need to know whether we dramatically alter survival by for example giving antivirals within 24 hours versus 48 hours, whether when people become pulmonary compromised they should have steroids first-line or bronchodilators first-line, but they will probably be too ill to give consent. They will also probably be too ill, and the people working in the frontline will be so busy they will not have time anyway, to go through the complex consent procedures over access to specimens and access to data, and using that data. If we are taking sputum samples, they will have cells in them and bits of DNA in them inevitably because they will have bronchial cells in them, but if we do not have a system in place to collect those samples and systematically to deal with them and analyse the data at a national level, we will miss a golden opportunity which may result, if we get it right, in being able to alter the course of the disease by saving many people's lives. So we are not just talking about it being interesting and a small number, it is possible that if we can get the data in very fast in week one and begin to analyse it, we will begin to alter what we do in week three or week four, and certainly by the time we get into the tail of the pandemic. I wonder if you have given any consideration to special measures that would allow people to by-pass some of the bits of regulation which are currently in place which effectively mean they would not be able to collect those sorts of samples or undertake that type of research with the current framework around research?

  Ms Winterton: As I said earlier, the Chief Medical Officer and others are looking at a lot of the points to do with not only the issues that we talked about earlier in terms of safety regulation and so on but a lot of the points you have made which are extremely relevant to the discussions which should be going on. I cannot give you a definitive answer now to say this is what would happen in this or other situation with regard to consent, and this is always a very sensitive issue as I know through the Human Tissue Bill and Act and we have had discussions at other times.

  Q290  Baroness Finlay of Llandaff: Absolutely.

  Ms Winterton: What I can say is, if there is any progress which has been made so far which I think it would be helpful for the Committee to have, I would be happy to take away those points and write to you if you think that would be helpful, because they are all areas which are extremely important, particularly in terms of management of and identification of virus spread.

  Chairman: Thank you.

  Q291  Baroness Finlay of Llandaff: I think our concern as a Committee is if such issues are not addressed and opportunities are missed, then we will all feel to blame. We have time at the beginning to begin to work them through and get some of the protocols in place and think through some of the issues in the cold light of day. Once people start to be ill, no one will have any intellectual energy to look at that because they will be far too busy coping with the pandemic.

  Ms Winterton: That is absolutely right and these are all issues which are being looked at very closely at the moment. Both Dr Harper and Dr Salisbury touched on that earlier but what I am saying is if there are any specifics which have been addressed in terms of the points you have raised already, I can write and let you know.

  Q292  Baroness Perry of Southwark: Dr Harper, you mentioned near-patient testing and diagnosis, which obviously in the very early stages of a pandemic, particularly reaching here, would be vitally important, so that we do not have to wait for samples to be sent away to some distant laboratory and wait days for the results to come back. I know there is some work going on in Cambridge in Dr Helen Lee's unit on this. Is the Government putting money into that, because it does seem to me to be one of the key links in the speeding up of controlling the pandemic?

  Dr Harper: Dr Lee is working at least in part very closely with the Health Protection Agency, which is the agency we sponsor, so they are looking at the molecular virology with one of the leading scientists at the Health Protection Agency, who is working directly and closely with Helen Lee at Cambridge.

  Q293  Baroness Perry of Southwark: And that is Government money?

  Dr Harper: The Health Protection Agency is funded by the Department of Health.

  Q294  Baroness Perry of Southwark: Is the Health Protection Agency funding her? I thought it was Wellcome money which was funding her.

  Dr Harper: Maybe there is some confusion here. I am not talking about the funding for Helen Lee, I am talking about the Health Protection Agency side of the collaboration at the moment. That is Government funding.

  Lord Winston: A very brief observation. The committee where I work has taken seven months with a very low grade research proposal and still it has not been agreed to give us ethical approval, for something which does not affect patients in any way adversely. I think you have to recognise that the ethical approval system is creaking at the seams already and it is going to get worse.

  Q295  Chairman: Minister?

  Ms Winterton: I am sorry, I thought you said that was an observation.

  Q296  Lord Winston: I was backing up what Lady Finlay was observing and I think it is going to become an increasing issue.

  Ms Winterton: Okay.

  Q297  Chairman: Minister, we have gone on for quite a long time and we have run out of time now. Let me thank you very much, and Dr Harper and Dr Salisbury also for being very helpful and answering our questions. If we may ask you to keep to what you have just offered to do, to let us know anything else you think would be useful to us, and perhaps we can come back to you if we have further questions. But I would like to thank you very much for being so helpful.

  Ms Winterton: Thank you and I hope these various documents are helpful.

  Q298  Chairman: Thank you for those.

  Ms Winterton: We can circulate the Ottawa communiqué if it would be helpful.

  Chairman: Thank you.





 
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