Health: Flu

Lord O'Shaughnessy Excerpts

Monday 30th October 2017 Lords Chamber

[Baroness Wheeler]

To ask Her Majesty’s Government what preparations are being made to deal with the anticipated rise in flu cases this winter.

[The Parliamentary Under-Secretary of State, Department of Health (Lord O'Shaughnessy) (Con)]

My Lords, it is too early to predict the impact of flu this winter. As part of the Government’s preparedness, every trust has developed plans for the coming winter season. The seasonal flu vaccination has been offered to those at particular risk of flu, and to all health and social care workers. A nasal spray vaccine will be offered to all children aged two to eight years old to help to protect them and their families.

[Baroness Wheeler (Lab)]

I thank the Minister for his response. Last week’s Healthwatch report showed an alarming increase in the number of hospital readmissions, which have risen by nearly a quarter in four years. The survey also showed a rise of 29% of people readmitted to hospital as emergencies within 24 hours. Does not this raise huge concerns about patients being discharged unsafely and before they are medically fit in order to meet the Government’s empty beds targets, not to mention the trauma and upset caused to the patients themselves and their carers and families? Do the targets take account of readmissions? What additional funding and contingency plans are in place across NHS trusts and local authorities, if there just are not enough beds to cope with the winter flu crisis? Is not the Government’s flu preparedness in urgent need of review?

--- Later in debate ---

[Lord O'Shaughnessy]

The NHS has never been better prepared for winter and, indeed, for flu. There are something like 21,000 people eligible for free flu jabs this year, including, for the first time, care workers in the independent and voluntary sector. So that is good progress. Of course, we do not know how exactly it will play out.

On the point about readmission, the head of Healthwatch said that the data raises some big questions—and we would agree with that. Some work needs to be done on the quality of the data, and NHS Digital has been asked to look at it. One issue is having the right care settings for patients to be discharged to, which is why I am sure the noble Baroness will welcome the data published last week showing a £500 million-plus increase in health and social care spending on precisely that kind of provision.

[Baroness Morris of Bolton (Con)]

My Lords, a few weeks ago, I read an excellent letter by a doctor in a newspaper which said that, as well as having the flu jab to protect ourselves, we have a responsibility to those around us who are more vulnerable. I was shocked last year, when I went to the excellent drop-in centre that we have every year, to discover that one of the most vulnerable groups to influenza is pregnant women. Would my noble friend agree that that message of responsibility to others is a very powerful one, and one that should make us all stop, think and then be immunised?

[Lord O'Shaughnessy]

My noble friend is absolutely right. I fear that the Westminster flu clinic had run out of jabs when I went, unsuccessfully, to get mine, but I did have one last week. Her point was about super-spreaders and this is one of the reasons why young children aged two to eight—who are most likely to live in families with pregnant women—are now getting the nasal spray at nursery and in school. This is precisely to protect the families of those who are most vulnerable.

[Lord Clarke of Hampstead (Lab)]

My Lords, I am sure that the possibility of people getting vaccinations in places such as Sainsbury’s and Boots while they are doing the shopping is a very good thing. I talked about this to a doctor friend at the weekend and was told that the pharmacists in those places get paid more for these vaccinations than doctors in their surgeries. Can the Minister confirm whether this is the case? If it is, it is a bit unfair to the NHS people.

[Lord O'Shaughnessy]

I was not aware of that particular fact, but I will look at the issue of the tariffs. Vaccinations are available in a range of settings: nurses, schools, shopping centres, even the Houses of Parliament—and, of course, community pharmacies, which have a critical role to play as one part of the strategy. Something like a million people have already been vaccinated in them so far this year. I will write to the noble Lord with the specifics on the tariff.

[Baroness Jolly (LD)]

My Lords, the Minister has, quite rightly, said that community pharmacies are a really important place to seek one’s flu jab. However, the owner of Lloyds Pharmacy, Celesio UK, has announced that nearly 200 of its local chemist’s shops will cease trading. What assessment have the Government made of the potential clinical impact of this decision? What pressures will follow next winter as a result?

[Lord O'Shaughnessy]

I agree with the noble Baroness about the role of community pharmacy. It is worth bearing in mind that some 88% of people are within a 20-minute walk of a community pharmacy, which is accessible for the vast majority. There are also 20% more pharmacies than there were 12 or 13 years ago. Pharmacies have a critical role to play and are there in the community, but companies come in and out all the time.

[Baroness Meacher (CB)]

My Lords, I talked to a very senior NHS consultant this morning. To my absolute amazement, he said that the latest research showed that compulsory flu jabs for NHS staff provide no significant improvement at all in patient health. This is rather striking and a bit unexpected. Does the Minister have any different research evidence?

[Lord O'Shaughnessy]

That is unexpected and would be worrying if it is true. That is not the information on which we have based our policy. Our information is that, for most people—though not all—flu jabs are effective in mitigating the risk of flu in care settings.

[Baroness Manzoor (Con)]

My Lords, the World Health Organization recommends what strain of vaccine should be developed, nine months to a year ahead. This happened before the Australian epidemic which affected the elderly and killed many people. Will the Minister confirm that the vaccine which has been developed here in the UK is both effective and relevant and that the young and elderly people do need to access it?

[Lord O'Shaughnessy]

My noble friend is absolutely right. Back in September, Simon Stevens, the head of the NHS, warned about the impact of the flu epidemic in Australia and New Zealand. The feedback on that was that the particularly vulnerable groups were the over-80s and five to nine year-olds. We have talked about helping younger children through school-based immunisation. We also have the highest uptake in Europe of over-65s getting flu jabs. There is clearly more to do because around one-third of people still do not.

[Lord Winston (Lab)]

My Lords, will the Minister reconsider his statement, in answer to the Question, that the NHS has never been better ready for a flu outbreak? The problem with viral infections, like pandemics, is that they are completely unpredictable and often hit in a way that we never expect. They remain one of the biggest single threats to humanity. I hope he understands that this unpredictability is a very real issue with all these infections, including influenza, as history has shown us.

[Lord O'Shaughnessy]

The noble Lord is, of course, quite right: we cannot know what will hit us. However, we can prepare in advance as much as possible. That was the sense I meant to convey—namely, that a huge amount of preparedness has gone on for not just flu but the winter. That work started in the summer—earlier this year than ever before. The flu vaccination on offer covers the strains that Public Health England thinks are most likely to come, but, of course, we cannot predict exactly what will happen.