(2) what discussions his Department has had with the World Health Organisation on the subject of pandemic preparedness since January 2007; whether any of these discussions related to the prioritisation of treatment in the event of an influenza pandemic; and if he will make a statement.
A number of activities have taken place by the Department to address the issues around prioritisation. This includes prioritisation of some limited medicine stockpiles such as the existing stockpile of A/H5N1 pre-pandemic vaccine to specific groups, and (draft—for public discussion) guidance on the prioritisation of essential services and treatments above non-essential care—if this was required.
Issues around prioritisation are also addressed in the ethical framework—where it is recognised that there will be individual challenges as well as service challenges—and through the public engagement strategy where we are engaging the public in discussion on such issues.
The Department has had numerous discussions with the World Health Organisation about pandemic influenza preparedness. These discussions have taken place at the following meetings:
April 2007: WHO meeting on increasing H5N1 stockpiles and increasing the access of developing countries to pandemic influenza vaccines.
May 2007: World Health Assembly meeting on virus sharing and intellectual property
June 2007: Presentation on ethical issues in pandemic influenza planning.
The WHO meeting held in June 2007 addressed ethical issues in general and also featured a presentation on work done by the WHO at its meeting in October 2006; that meeting had discussed prioritisation issues. It recognised the ethical dilemma's countries were dealing with and observed that ethics could not provide set answers. The full summary of the discussions in is available at:
The operating framework sets down the priorities for the national health service, including exceptional circumstances which strategic health authorities (SHAs) should take into account before deciding whether to suspend national or local NHS targets.
The Department has also issued an ethical framework for responding to an influenza pandemic, which provides principles that will guide the NHS in implementing the national framework for responding to an influenza pandemic and in taking decisions about 'normal business' such as implementing the operating framework.
In the event of an influenza pandemic, the decision about whether to suspend these targets is one which will be taken by the NHS in light of the prevailing situation.