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Mr. Lansley: To ask the Secretary of State for Health how much he expects his proposals for the creation of a National Care Service to cost; which organisations he expects to comprise the service; what assessment he has made of the likely effects of his proposals on (a) existing (i) NHS and (ii) social care budgets and (b) existing local authority provision of social care. 
Phil Hope: We believe that reform of the care and support system is necessary in order to make the long term care costs sustainable for the State and the individual. The Impact Assessment for the Green Paper 'Shaping the Future of Care Together' suggested that a National Care Service could cost the State between £18.2 billion and £20.7 billion in 2014, depending on the funding model chosen. These are illustrative comparative costs suggesting the possible cost to the state of the different models. These are indicative only and could be subject to change. Costs would be met from within the public spending envelope set for future spending reviews, which will be in line with the plans for fiscal consolidation set out at Budget 2009.
Local authorities are key to the delivery of our vision for the future. This Green Paper underlines the important, continued and strengthened role they will play under reform, in any future funding system. But we also know that one of the most common problems with care and support is an apparent lack of connection between different services, particularly health, social care, housing and benefits. So a central plank of a National Care Service will be a coherent strategy centred on patients, care-users and their carers, to support local leaders to make sure that joined-up services are delivered.
Mr. Dhanda: To ask the Secretary of State for Health (1) what guidance his Department provides to health professionals on implementation in maternity units of the guidelines issued by the Royal College of Obstetricians and Gynaecologists for preventing Group B streptococcus infection in newborn babies; 
Ann Keen: Current guidance for obstetricians, midwives and neonatologists is provided by the Royal College of Obstetricians and Gynaecologists (RCOG) which published its green-top guideline No. 36 on the prevention of early-onset neonatal group B streptococcus disease in November 2003. In 2005, the RCOG, in collaboration with the National Screening Committee, established a national audit to evaluate practice in United Kingdom obstetric units against the recommendations of the guideline. The audit published in January 2007, reported that current practice followed the established patterns of care described in the RCOG guideline.
The Department supports the Maternity Standards published by the RCOG in 2008, which state that maternity services should comply with evidence-based guidelines for the provision of high-quality clinical care.
Information for women on group B streptococcus is contained in "The Pregnancy Book" a guide to health pregnancy, labour and giving birth, life with your new baby, which is given to all pregnant women during their antenatal care. A copy has already been placed in the Library. Information is also available on NHS Direct and NHS Choices website. Women who are concerned are advised to talk to their doctor or midwife.
Mr. Dhanda: To ask the Secretary of State for Health what assessment has been made of the implications for his policy of the most recent evidence on testing pregnant women for Group B streptococcus. 
Ann Keen: The UK National Screening Committee (UK NSC) reviewed the policy for screening for Group B Streptococcus in pregnancy in March 2009 and concluded that the evidence did not support its introduction. The UK NSC will review its position on screening in three year's time unless any significant evidence emerges which suggests this should be undertaken earlier.
Phil Hope: A revised national framework for continuing care was published in August 2009. This framework covers those patients who have had strokes as the eligibility criteria for continuing care are not disease specific. A copy of the framework has been placed in the Library.
Mr. Hoyle: To ask the Secretary of State for Health what recent discussions he has had with representatives of (a) primary care trusts and (b) hospitals on their preparations for a swine influenza outbreak. 
Gillian Merron: The Secretary of State for Health meets regularly with the NHS chief executive and the NHS flu resilience director, who are responsible for ensuring the national health service is prepared for a swine flu outbreak.
On 2 July, the national director for NHS flu resilience, Ian Dalton, wrote to all NHS chief executives to make clear the expectation that preparedness plans need to be reviewed and subjected to further testing.
To further support local planning, on 10 September, a strategy for critical care services was published that sets out how ventilated critical care capacity can be increased in the NHS during the peak weeks of a potential second wave of swine flu. The published full critical care strategy sets out how the NHS will collectively achieve this increase. A copy has been placed in the Library.
On 10 September, the national director for pandemic influenza preparedness, Lindsey Davies, also hosted a pandemic flu conference on the theme of "Looking back, moving forward". The conference, attended by 375 delegates, was open to strategic health authorities,
primary care trusts and local authority representatives with health and social care responsibilities. The focus of the day was on the swine flu response to date, delivering the swine flu vaccination programme, the challenges that lie ahead and sharing best practice.
Mr. Ellwood: To ask the Secretary of State for Health what discussions he has had with the Secretary of State for Culture, Media and Sport on informing the British tourism industry on the effect of the swine influenza pandemic in the UK. 
Gillian Merron: The Civil Contingencies Committee has been meeting regularly since the swine flu outbreak, and is chaired by the Secretary of State for Health. The Department for Culture, Media and Sport attends these meetings at which all elements of the Government's response to the swine influenza pandemic are discussed.
Throughout the outbreak, the Government have provided a wide range of advice to businesses generally about the impacts swine flu could have on them, through mechanisms such as the Business Advisory Network on Flu and the BusinessLink website. Planning assumptions have been issued which are of use to all sectors.
Mike Penning: To ask the Secretary of State for Health what criteria his Department uses to identify epidemic levels of swine influenza in an area; and in which areas such levels have been identified to date. 
Baseline (outside of a normal flu season) activity (<30 GP consultations per 100,000) during a week;
Normal seasonal activity (30-200 GP consultations per 100,000) during a week; and
Epidemic activity (>200 GP consultations per 100,000 people) during a week.
South West; and
South East Coast.
Mr. Lansley: To ask the Secretary of State for Health how many calls the swine flu information line had received on the latest date for which figures are available; and how much his Department has spent on that service. 
Mr. Lansley: To ask the Secretary of State for Health with reference to the Statement of 20 July 2009, Official Report, columns 583-5, on swine flu, which groups will be regarded as higher risk for the purposes of vaccine prioritisation. 
individuals aged between six months and up to 65 years in the current seasonal flu vaccine clinical at-risk groups;
all pregnant women, subject to licensing conditions on trimesters;
household contacts of immuno-compromised individuals; and
people aged 65 years and over in the current seasonal flu vaccine clinical at-risk groups.
In addition to this, front line health and social care workers will be offered the vaccine at the same time as the first clinical at risk groups as they are at increased risk of infection and of transmitting that infection to susceptible patients.
Mr. Lansley: To ask the Secretary of State for Health with reference to the Statement of 20 July 2009, Official Report, columns 583-5, on swine flu, if he will place in the Library a copy of the analysis he received which showed that the initial containment policy for swine flu worked well. 
Gillian Merron: The Health Protection Agency has worked with independent academic experts to analyse the impact of the containment policy on the spread of the virus in the United Kingdom. This work has been submitted for publication and a copy of the publication will be placed in the Library when it is available.
Mr. Lansley: To ask the Secretary of State for Health (1) with reference to the Statement of 20 July 2009, Official Report, columns 583-5, on swine flu, how many people will be employed to staff the interim flu line service; and how many calls per day the interim service will be capable of handling; 
The interim National Pandemic Flu Service (NPFS) launched with 1,500 concurrent seats from seven call centre operators, operating from 19 sites across the United Kingdom. Over 3,500 agents were
initially trained to provide the service. The agents are employed by a range of private and public sector call centre operators to ensure that the service can flexibly operate seat and agent supply to meet public demand.
The service is capable of operating 7,500 concurrent call centre seats. This level of operation, if required, would enable around 1 million calls in a 24 hour period to be handled by call centre operators in addition to those using the web service.
From the launch of the interim NPFS on 23 July 2009 to 29 September 2009, around 590,000 antivirals were dispensed for treatment of patients. The breakdown by age group and primary care trust has been placed in the Library.
These figures relate solely to antivirals collected through the NPFS, as antivirals distributed between 2-22 July 2009 were distributed through normal primary care routes and by the Health Protection Agency; those data are still being collated.
check the validity of an authorisation number generated by the NPFS;
check and confirm the name of the patient and the antiviral and dose authorised;
check that the authorisation number has not been used previously to collect an antiviral;
record the checking of identification (ID), and types of ID provided by the flu friend for themselves and the patient;
record the details of the flu friend who has collected the antiviral;
record the collection of the antiviral to prevent the authorisation number being used more than once; and
provide regular information on the number of antivirals issued using an authorisation number.
Individuals who use the service will follow a very similar process to the current service. The main change from an individual's perspective is the additional ID functionality. An overview of additional functionality is as follows:
a dynamic algorithm will provide greater flexibility if the algorithm needs to be changed and enables changes to be processed more quickly;
an enhanced ID process: identification can be verified during the assessment as well as at the collection point;
the functionality to re-issue an authorisation number through NPFS will be available to enable patients who forget their authorisation number to re-contact the service quickly and efficiently to access a new number that can be used in an antiviral collection point; and
the autumn service is planned to offer additional languages on the web.
Mr. Lansley: To ask the Secretary of State for Health with reference to the Statement of 20 July 2009, Official Report, columns 583-5, on swine flu, which 110 primary care trusts had reported exceptional levels of flu like illness. 
Tower Hamlets PCT
Greenwich Teaching PCT
Leicester City PCT
Barking and Dagenham PCT
Coventry Teaching PCT
South Tyneside PCT
City and Hackney Teaching PCT
Telford and Wrekin PCT
South Birmingham PCT
Sutton and Merton PCT
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