asked Her Majesty’s Government:

What practical exercises have been carried out in the United Kingdom as part of the preparations to handle an outbreak of pandemic flu.

My Lords, we continue to develop tests and review our preparedness measures in a proportionate way. We have tested our plans in major national and cross-government exercises such as “Winter Willow” in early 2007 and “Shared Goal” in 2006. Various regional and local exercises have also been conducted and the UK participated in the EU-wide simulation, “Common Ground”. Lessons learnt from those exercises have been considered in the development of our national framework and other guidance, as well as in local planning.

My Lords, I welcome the national framework document that the Government published last November, but am I right in believing that in the first wave of a flu pandemic, before a specific vaccine can be developed, the antiviral drug Tamiflu will be the only treatment available, but that to be effective it has to be administered within 48 hours of a patient’s symptoms appearing? As, in the worst case, some millions of people could seek that treatment, how is that to be made available to patients? What is meant by a “simulation exercise”—the phrase used by the Secretary of State for Health—and was “Winter Willow” an example of a simulation? Did it involve real doctors, real nurses and a real national flu line manned by lay people?

My Lords, I shall answer two of those questions. A simulation is an exercise in which participants are based in their own organisations and the control sends information and actions to participants to test communication flows and decision-making between those organisations. More than 5,000 people participated in “Winter Willow”, including GPs, people from SHAs and many outside operations. We also do many real-life exercises in distribution and so on. In respect of Tamiflu, I believe that it should be administered within 48 hours. We will have the national flu line to which the noble Lord referred. When people think they have flu, they phone that line and someone arranges to collect the Tamiflu to be administered to the patient. We will also have some vaccines available.

My Lords, what stocks of Tamiflu do the Government have available in the event of such a pandemic?

My Lords, we currently have enough for 25 per cent of the population, and we are buying enough to cover 50 per cent of the population. Much of that will be available by the end of 2008 but some of it will become available in 2009-10.

My Lords, have the Government considered pre-pandemic vaccination with a vaccine that resembles, but is not totally, the virus that will infect the population eventually so that it will confer some immunity? If they have taken that into consideration and will leave the vaccination until after the flu pandemic starts, what are the logistics of the vaccination exercise? Are GPs going to do it, or are there sufficient staff in the community—community nurses and others—to carry out the exercise?

My Lords, we have a stockpile of H5N1 vaccine and we are closely watching scientific developments to see whether any other vaccines might come available which would ensure that people could be vaccinated as soon as there is a pandemic. If the science is there, we will buy the vaccines. An exercise starting later this month will look at the medicines and healthcare consumables supply chain for primary and community care to ensure that people are prepared in the community to get these vaccines out.

My Lords, is the Minister aware of the importance of our role on intergovernmental organisations in relation to pandemics, not just of flu but also of other communicable diseases? Is she also aware that the newly set-up ad hoc Select Committee on intergovernmental organisations has chosen communicable diseases as its first area of study because it regards it as so important?

My Lords, I was aware of the important role of international organisations, but I was not aware that it was the subject of the new committee chaired by my noble friend. I am delighted that it has chosen this important topic.

My Lords, do the Government have simulation exercises on the ground foreshadowing targeted prophylaxis, which is what Tamiflu is aimed at? When the Select Committee of this House looked at the issue, the Secretary of State told the Select Committee that Tamiflu would be given only to people who had been diagnosed with flu, which is directly contrary to the use envisaged in targeted prophylaxis? Can the Minister reassure me that we have gone further than that now?

My Lords, I understand that simulations are taking place on the ground, but if I am incorrect I shall write to the noble Lord. We are looking at the much wider use of Tamiflu. Indeed, we are now looking at the possibility of providing Tamiflu not only for a person who has been diagnosed with flu but also for the wider family within that household.

My Lords, does that mean that, after all this learned knowledge, the vaccination I had for flu is no damn good?

My Lords, it will be extremely important for the noble Baroness in relation to the usual flu viruses this year. However, in a pandemic it will not be as effective as she would wish.

My Lords, is the Minister aware of the work that the churches are doing ecumenically to respond pastorally in such a crisis? Do the Government see the pastoral work done by clergy of the faith communities and all the churches as part of their strategy in responding to such a crisis?

My Lords, faith groups have been involved in pandemic influenza preparations across government. We warmly welcome that; indeed, we depend on faith groups in many ways and we are grateful to them.

My Lords, I return to the antiviral agents and to Tamiflu in particular. It is recognised that overuse of antiviral agents may lead to resistance to them in the virus. Have the Government taken that into account in their plans for simulating a flu outbreak? What alternative antiviral agents will be available should resistance to Tamiflu develop?

My Lords, the Government have taken that into account and are supporting and monitoring research on viral resistance to influenza antivirals. We are looking at alternative products. I shall write to the noble Lord with further details.