11 November 2009

The NHS has made enormous progress in the last 12 years. Waiting times are the shortest since records began; 3 million more operations are carried out each year; there are over 100 new or refurbished hospitals; and more people are surviving cancer, strokes and heart disease.

Now, Labour will introduce three legally enforceable rights:

• To a free health check every five years for those aged 40-74.

• To see a cancer specialist within 2 weeks.

• To treatment within 18 weeks.

These are rights that we will put in place as soon as possible in the New Year.

If your local NHS Trust cannot meet these guarantees they will - by law - have to find you somewhere which can treat you as soon as possible, even if it is in the private sector.

We are also consulting on the new rights which will be our ambition for the health service over the next few years, including:

• The right to diagnostic cancer tests and results within a week - our cancer pledge.

• The right to see a GP at weekends or in the evening, and to abolish practice boundaries for good.

We will put real power into the hands of patients and ensure that under Labour there can be no return to the long waiting lists seen under the Tories.

For all their claims to be the party of the NHS, they would tear up the patient guarantee to see a cancer specialist within two weeks. Labour offer guarantees in what care patients get.  The Tories offer a gamble.  Behind David Cameron’s spin, the Conservatives remain anti-reform on the NHS. They oppose Labour’s patient guarantees - including the guarantee to see a specialist within two weeks if your GP suspects you may have cancer - and they would scrap our agreement with GPs, making it harder for you to see your doctor at evenings and weekends.

The next election will be a big choice about the change we want for Britain.  Labour offers change for the many.  The Conservatives offer change for the privileged few. 

 From 1 April Labour is abolishing NHS prescription charges for everyone undergoing treatment for cancer, the effects of cancer, or the effects of cancer treatment.

Up to 150,000 patients already diagnosed with cancer are expected to benefit, saving them £100 or more each year in prescription charges.

Other new NHS improvements are Health Checks - which will also begin from April. Everyone aged between 40 and 74 in England will begin to be invited for a free health check to identify their risk of diseases such as coronary heart disease, stroke, diabetes and kidney disease.

These health checks are a good idea because they will make sure people from this age group have the right information about their health in order to make important lifestyle changes and reduce their risks of developing diseases like diabetes and coronary heart disease.

These illnesses currently affect the lives of 4 million people in England and are responsible for a fifth of all hospital admissions.

Also from April all NHS Trusts will be able to offer MRSA screening to all relevant elective patients.

 The number of people getting infections from MRSA is falling (latest figures show reductions of 38 per cent), but we still have further to go and this is part of our continued efforts to reduce infection rates even further.

Waiting Lists

The NHS now has the shortest waits since its records began.

 It has met its target to treat patients within a maximum of 18 weeks from referral by their GP – an achievement which was unimaginable 12 years ago. 

This is a tremendous achievement by NHS clinicians and staff who should be proud of the difference their hard work has made to the experience of every NHS patient.

 In the 1990s it was not uncommon for people to wait 18 months or more for their operation – with some people dying on the waiting list.

 The NHS is one of our country’s greatest achievements and we will always stand up for it.

The Department of Health today announced:

• The first deliveries of pandemic flu vaccine were sent to England NHS Acute Trusts today, for the start of the vaccination programme.

• It will take 2-3 days to deliver to all Acute Trusts, with further supplies sent out in the following week. These supplies can be used for protecting frontline staff and patients in at-risk groups in hospital.

• The earliest possible delivery date for the first supplies of vaccine to general practices is Monday 26 October 2009. It will take around 3-4 weeks to complete the distribution of first supplies to all practices. Initially practices will receive one box of Pandemrix vaccine containing 500 doses.

From 21 October, GPs and hospitals will be inviting around 11 million people to be vaccinated against swine flu.  The UK is one of the first countries in the world to offer the pandemic vaccine.

All frontline health and social care workers as well as people in at risk groups will be eligible.

This is a large vaccination campaign so will take a number of weeks to roll out across the country to hospitals and GP surgeries.

The vaccine requires one dose and has been licensed by the European Medicines Agency and been endorsed for use in the priority groups by the UK’s Joint Committee on Vaccination and Immunisations and by the World Health Organisation (WHO).

We urge everyone in the priority groups to have the vaccine – it will help prevent people in at risk groups from getting swine flu and the complications that may arise from it. And it will help stop health and social care workers from passing on the virus to their patients.

We’re very pleased we are able to start vaccinating people in at risk groups. This should help to save many lives.

This is the first pandemic for which we have had the vaccine to protect people.

The following at-risk groups will be prioritised in the following order (numbers given are approximate and are for England only):

1. People aged over six months and under 65 years in current seasonal flu vaccine clinical at-risk groups (about 5 million people).
2. All pregnant women (about 0.5 million people).
3. Household contacts of people with compromised immune systems e.g. people in regular close contact with patients on treatment for cancer (about 0.5 million people).
4. People aged 65 and over in the current seasonal flu vaccine clinical at-risk groups (about 3.5 million people). This does not include otherwise healthy over 65s, since they appear to have some natural immunity to the virus.

Patients will be contacted by their GPs if they fall into one of the at risk categories.

The following are in the seasonal flu risk groups:

People with,

-          chronic respiratory disease;

-          chronic heart disease;

-          chronic kidney disease;

-          chronic liver disease;

-          chronic neurological disease

-          diabetes; and

-          immunosuppression.

This list is available in the seasonal flu CMO letter that was sent out on 3^rd April 2009 http://www.immunisation.nhs.uk/Professional_information/CMO_letters

and in  Immunisation against infectious disease - ‘The Green Book’

Why aren’t children included in the priority groups?

JCVI has advised that the use of the vaccine in the wider healthy population should depend on the evolution of the pandemic as well as new and emerging clinical data on the use of the vaccine. This will be kept under review.

We will ensure we have further advice from JCVI on this issue before announcing further groups.

What timeframe will people be vaccinated over?

We hope that most of the clinical at risk groups will be offered the vaccine by December this year.

This is not the Department of Health’s schedule - it is led by the manufacturers. It is therefore subject to change.

It is expected that the at-risk groups will be vaccinated in the order of priority listed.

What do you say to frontline health professionals who are reluctant to have the vaccine?

Frontline health professionals will be absolutely crucial in the height of a pandemic - without them, patient care will suffer, and the NHS will be stretched. Getting the swine flu vaccine will protect health professionals and their patients. That’s why we’re offering frontline staff the vaccine as a top priority. As well as protecting them, it will reduce the chance of them passing the virus to vulnerable patients. Of course, vaccination will be optional.

If the virus is mild, why are we purchasing enough vaccine for the whole population?

As this virus is a new strain of virus, most people are susceptible to infection. The virus currently produces mild disease in most people. However we have learnt from previous pandemics that the virus can change and can lead to more serious disease. This is why JCVI is keeping the issue under review.

There have been concerns about the use of adjuvanted vaccines in pregnant women, what is the Department of Health’s recommendation?

The previous WHO position was given long before the vaccine was licensed for use in pregnant women by the European regulator and recommended by the independent UK committee on vaccination - the Joint Committee on Vaccine Immunisation. The JCVI strongly recommends the use of the GSK vaccine in pregnant women because it would protect them more quickly from the risk of flu with just one dose of vaccine.

 It would be extremely irresponsible to suggest the UK would use a vaccine without careful consideration of safety issues.

Why should pregnant women be vaccinated at all?

Pregnant women are four times more likely to develop serious complications from swine flu and they are four to five times more likely to be hospitalised with swine flu than non-pregnant women.

On 17 September it was announced that the UK will provide up to £23 million to help the developing world tackle the H1N1 pandemic. 

It is also implied that ‘up to 10%’  of the UK vaccine stockpile will be made available. How much is the UK committing?

The UK is making approximately 10% of its vaccine capacity available to the WHO and at the same time donating £23m to the UN to use for buying that vaccine, or for other priorities depending on needs.

How can the UK donate 10% of its vaccines and still honour the commitment to acquire sufficient stocks to vaccinate the entire UK population? 

Our first duty is to protect our domestic citizens and so the Government has contracted to buy sufficient vaccine to provide for two doses to the entire UK population. Emerging evidence suggests that one dose of vaccine rather than two might be sufficient to generate a sufficient immune response in some people. The Joint Committee on Vaccination and Immunisation has also advised that use of the vaccine in the wider healthy population should depend on the evolution of the pandemic as well as new and emerging clinical data on the use of the vaccine.

Why is the UK giving this away before we have a final decision about whether one dose or two is required?

Emerging evidence is suggesting that one dose of vaccine rather than two might be sufficient to generate a sufficient immune response in some people. Our response continues to be informed by the latest scientific advice and epidemiological data and we are confident that we can donate this proportion of our stockpile without disadvantaging the UK population.

How will this donation be funded?

The donation will be funded from within existing Departmental budgets.

What will you do with the excess vaccine if one dose is enough?

Companies are starting to produce preliminary data from their H1N1 vaccine trials in a limited number of subjects. Initial results appear to indicate adequate immune responses from a single dose of swine flu vaccine in adults and, whilst these results are encouraging, they need to be fully evaluated before definitive conclusions can be reached.

If the vaccine is safe, why are clinical trials continuing before administering more widely?

The safety of all licensed vaccines and other medicines are kept under review. A specific condition of the regulatory process for pandemic vaccines is that clinical trials continue to be conducted to further evaluate the immune response and safety of the vaccine. As with any new vaccine or medicine, safety will continue to be assessed during use in the general population to identify any possible rare side effects.

JCVI has advised that subsequent use of the vaccine in the wider healthy population should depend on the evolution of the pandemic as well as new and emerging clinical data on the use of the vaccine. This will be kept under review.

Will those who have already had swine flu still need to be vaccinated? If not, is it right to assume only those who have had diagnosis of H1N1 lab confirmed will not be vaccinated and clinically & self-assessed cases will still be eligible for vaccine?

Theoretically, those who have had swine flu will not need to be vaccinated, but as we are currently relying on clinical diagnosis for the majority of cases, it will not be possible to easily differentiate those that have definitely had swine flu, so we will be offering vaccine to everyone.  It is quite safe to be vaccinated even if you have already had swine flu.

Will the rise in swine flu cases mean higher levels of MRSA?

There is no [DQ: should this say no “known” link?]link between MRSA rates and high rates of bed occupancy. Over the past few years, trusts with high bed occupancy have reduced their MRSA levels to a similar extent to the low occupancy trusts. We have been clear that during the pandemic the NHS must continue to follow the same high standards of infection prevention practice that have significantly reduced MRSA.

The NHS is well-prepared to deal with a second wave of swine flu, and has robust plans in place to deal with an increase in the number of swine flu patients alongside Winter pressures. 

The Child Health Strategy includes £340 million to support children with disabilities and their families. Together with funding previously announced this brings the total investment in services for disabled children over the next three years to a record £770 million.

The joint strategy Healthy lives, brighter future: the strategy for children and young people’s health sets out for the first time what children and their families can expect from child health services in their areas from birth through to the age of 19.

A copy of the Child Health Strategy can be downloaded here

We recognise that for many people like self-employed or hourly paid workers, seeing a GP during the working day can impact on their pay packet.

We are committed to addressing health inequalities by making it easier to access services. That is why we are also investing £250 million in new, additional, services including over 150 GP-led health centres around the country, open 8am-8pm, 7 days a week, which can be used by any member of the public. On top of, this we are providing 100 new GP practices in the areas that need them most.

The Act updates the 1990 law to ensure that it is fit for purpose in the 21st Century and keeps the UK at the forefront of developments in treatment and research.

There are no changes to the 1967 Abortion Act resulting from this legislation.

The purpose of the Act is to maintain the UK’s position as a world leader in scientific research into the treatment of a range of serious and degenerative diseases, such as Parkinson’s, Alzheimer’s, Multiple Sclerosis and Cystic Fybrosis, as well as maintaining our position into fertility research

In the UK, one in seven couples need help with fertility treatment, 350,000 people live with Alzheimer’s and each week five children are born with cystic fibrosis. This legislation gives hope to these individuals and families by enabling scientific research while maintaining proper controls.

This is a clear sign that the steps we are taking to tackle infections are working it is also a testament to the hard work and dedication of NHS staff who have been fighting infections in our hospital.

The contrast between a Government which is delivering real improvements for patients and an opposition which has opposed almost every new measure could not be sharper. Tory Health Spokesman Andrew Lansley will regret calling tough actions on cleanliness and infection control ‘gimmicks’.