Scots count cost of swine flu precautions

Published on Thursday 1 July 2010 18:11

SCOTLAND had been left with an expensive stockpile of vaccines and anti-virals because of contracts signed by Scottish and UK governments with pharmaceutical companies during the swine-flu outbreak, it was claimed yesterday.

A new independent report by Dame Deidre Hine has found the UK spent 587 million on drugs to tackle the swine flu pandemic - including 55m in Scotland - half the 1.2 billion spent preparing the country for all types of flu that year.

Although the report praises the country's readiness for a larger outbreak than ultimately developed, and the way in which devolved administrations, including the Scottish Government, worked with the Department of Health, it criticises the lack of flexibility in the contracts signed with huge pharmaceutical companies, such as GlaxoSmithKline (GSK).

The Scottish Government bought 3.5m antiviral drugs and used less than a million. Of the vaccines purchased for Scotland, 500,000 remain stockpiled. Both Westminster and the Scottish Government have admitted lessons need to be learned.

Earlier this month, a report on the World Health Organisation (WHO) published in the BMJ said that "key scientists advising the World Health Organisation on planning for an influenza pandemic had done paid work for pharmaceutical firms that stood to gain from the guidance they were preparing".

Professor Allyson Pollock, an expert in international public health policy at Edinburgh University, said: "The first question is why was so much vaccine was ordered in the first place. How good was the evidence underpinning it?

"The WHO report highlighted various conflicts of interest with those who made recommendations having industry ties.

"So the first question is what was the evidence for the policy, the second question is why was it so expensive, and the third is why are we tied into buying so much."

More than 30m doses are thought to be left over after GSK, which had already manufactured all the drugs that had been ordered, refused requests to tear up the contract and delivered the entire order. Another manufacturer, Baxter, agreed to a "break clause" allowing the government to cancel.

Prof Pollock said: "There needs to be a major review or inquiry which opens up the contracts so they can be scrutinised so we don't make this mistake again. At times of economic downturn and major cuts, we must use our money wisely."

In the UK there were 457 deaths linked to swine flu, with 69 of them coming in Scotland where a further 1,542 people were hospitalised. Worst-case scenarios predicted there could be 65,000 deaths in England alone, but the outbreak proved to be relatively minor.

Mark Wallace, campaign director of the TaxPayers' Alliance, said: "The swine flu response has proved to be a hugely expensive farce.

'The plan was good but the virus hadn't read it'

A BIG problem was that the plan was good - but the virus hadn't read it. The very reasonable assumptions underpinning it, like the new virus being a nasty mutant bird flu coming from the Far East, were wrong. Our inability to predict how it would behave compounded the problem.

Mathematical models are impressive, particularly to government ministers, but can be no better than the data. It was in very short supply. So some of the statements that were made on the basis of early calculations were unfortunate, particularly when worst-case scenario numbers (assumptions which have to be developed for planning purposes) emerged as public predictions. Many of Dame Deidre's (Hine] recommendations are about better communication, not only between the government and the public, but within the government itself and between London and the devolved administrations.

It shouldn't have been necessary for her to endorse more use of video conferencing to get the benefit from face-to face communication! Better informal communication between ministers and scientists would also be very desirable

Important parts of the report deal with future planning. It has to be more flexible. It has to prepare for another virus that doesn't conform to expectations. The review goes into the practical difficulties of ordering a vaccine in an uncertain situation and recommends more contract flexibility. But it has to be remembered that this is new territory - the first time that as vaccine has been developed and rolled out while a pandemic is still developing.

The report concludes that the public health response was reasonable. I agree useful lessons have been learned. The only certain thing is that there will be another pandemic. Unfortunately when, and how bad it will be, no one can say.

• Professor Hugh Pennington - Expert in Microbiology at Aberdeen University

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• Paul Flynn: 'An appalling waste of cash' Serious questions must be asked about why so much was spent on combating a threat that turned out not to be very serious. It's unacceptable to hide the details of this massive bill behind the excuse of commercial confidentiality."

Murdo Fraser, health spokesman for the Scottish Conservatives, added: "I think the governments should have built more flexibility into contracts. We were dealing with an unprecedented set of events, so therefore no-one could have predicted with accuracy how things were going to turn out. So to tie us in so totally into one scenario was, with the benefit of hindsight, probably foolhardy."

However, Ross Finnie, the Scottish Liberal Democrat's justice spokesman, said: "If we had not purchased an adequate supply to deal with the whole population, one can that if a full crisis had developed, in the way the WHO had predicted, there would have been plenty of people criticising the government."

Dame Deirdre, a former chief medical officer for Wales, said: "The threat of a flu pandemic remains very high. Both the successes and the lessons from this pandemic should inform policy and planning for the next one because there will be a next one, and the next one might be more severe."

Health minister Nicola Sturgeon said: "We will take the report's recommendations into consideration in planning for the future. The possibility of us experiencing a more severe pandemic has not lessened and we must ensure that we remain one of the best prepared countries in the world."

UK Health Secretary Andrew Lansley added: "The UK response was the result of careful preparation, but it is vital that we learn lessons."