Influenza Contingency Plans
The next item of business is a statement by Ross Finnie on avian flu, which will be followed by a statement by Andy Kerr on related health preparations. As the ministers will, as usual, take questions after both statements have been delivered, there ought to be no interventions during them.
Avian influenza has become an issue of great interest across the country but, sadly, it has also become the subject of much misunderstanding and misinterpretation by the public, in some sections of the media and elsewhere. Given the level of interest and misunderstanding, the Minister for Health and Community Care and I thought that it would be helpful to make statements to Parliament: first, from myself, on Scotland's preparedness to respond to an outbreak of the animal disease, avian influenza; and secondly, from the Minister for Health and Community Care, on Scotland's preparedness for an outbreak of a human influenza pandemic.
There are two distinct issues. Avian influenza is a bird disease that can, with difficulty, pass to humans. It is not the possible human influenza pandemic that has been referred to widely in recent months.
I shall explain the current level of risk of an avian influenza outbreak. Internationally, we have seen an increase in the known distribution of high-pathogen avian influenza, particularly in wild birds. Some of those reports have come about as a consequence of increased international surveillance, which is enhancing our knowledge of its distribution. On the basis of the scientific analysis of that information, it is likely that the virus is being spread by migrating birds and that the risk of further global spread is high.
Reflecting that risk, we have increased our own surveillance of migrating birds. We have done that by instituting new surveys of wild birds in the Solway firth and the Firth of Forth and investigating instances of large-scale bird deaths in the wild. We are coming close to the end of the autumn migration season. We know that the migration patterns of most birds that visit Scotland for the winter do not originate in areas where highly pathogenic avian influenza is known to exist. On the basis of that analysis, I can advise the Parliament that the risk of an imminent arrival of avian influenza in Scotland remains low.
We are currently monitoring the risk levels and, although the risk is currently low, we cannot rule out the possibility that we will have an avian influenza outbreak in Scotland, either soon or further into the future. Reflecting on that, and as a matter of good governance, we have systems in place to allow us to respond quickly and effectively to any suspicion of notifiable disease. We have recently published the avian influenza contingency plan, which clearly sets out the actions that will be taken by the Executive, its agencies and local authorities in the event of confirmed disease. It is an important document, which explains who will be involved in any disease-control effort and what will happen and why. It draws together the roles played by a wide range of stakeholders. An asset to Scotland is our ability to work closely and effectively together, both within Government and outside it.
The contingency plan sets the framework for the response that will be led operationally by the state veterinary service, an organisation that is continually striving to enhance the robustness and effectiveness of its response. In recent years, it has put in place a significant number of contracts that can be used to bring in available resource to support the disease control effort. Veterinary staff are particularly important, and we have recently completed a pilot to develop a cadre of private vets who can be drawn in to support the state veterinary service in managing a disease outbreak. That is now being rolled out on a national basis.
As a further aspect of our preparedness, we have been reviewing legislation to ensure that it is proportionate and effective. Last week, we introduced new secondary legislation following recent European Commission decisions that will help us to promote biosecurity across the country and minimise the potential risk of disease, particularly in zoos. Our preparedness to respond quickly will help us to minimise the impact of any outbreak occurring in Scotland. Experience has shown that the potential for disruption can be wide, not just of the farming industry but throughout rural areas. Robust actions are extremely important in the context of avian influenza, given the serious nature of the disease in poultry and the potential health implications for those who come into close contact with infected birds.
Our plans are designed to reflect the fact that we may not know what the precise circumstances of a case of avian influenza will be or where it will occur. As such, our planning arrangements remain flexible. Their implementation will be driven by sound science. Some actions to control an outbreak will not be popular, but we must take them where the evidence shows that they are justified and proportionate. That position also extends to the actions that we will take to minimise the risk of disease occurring.
Although preparedness is essential, prevention is far better than cure. We have been working with stakeholders and other Administrations to enhance the level of biosecurity, and particularly to highlight the importance of minimising contact between domestic and wild birds. That gives us a key opportunity to reduce the risk of migrating birds infecting the domestic poultry population.
We recognise that to date most of the work has been with organisations and that there is still a big task to be done in getting the information to individual poultry keepers—particularly those with backyard flocks. We have set up an avian influenza page on our website and ensure that it is kept up to date. It includes biosecurity guidance, notably a 10-point list of practical guidelines that poultry keepers can follow. Many organisations have taken ownership of the list and have circulated it to their members.
We are working to enhance our understanding of the location of all poultry producers throughout the United Kingdom; I shall shortly make an announcement on the Scottish element of UK measures to compile a register of poultry keepers. That is not new in Scotland as we have an existing voluntary database of the main poultry keepers, which identifies about 600 flock keepers.
As I recognise the importance of getting the message across to individual producers, I can announce today that we have commissioned the Scottish Agricultural College to undertake a programme of events throughout Scotland to disseminate practical and effective advice that can be used by individual flock owners and managers to support our preventive policy.
Although the risk of avian influenza to Scotland is currently low, I repeat that we cannot rule out that it may occur. I hope that I have today provided an overview of the work that is in hand to ensure that steps are being and will be taken by all stakeholders to minimise the risk of disease occurring in the country and to ensure that we are prepared to respond quickly and, if necessary, robustly to any suspicion of disease.
I cannot overemphasise the importance of vigilance and self-protection. Those factors and the measures that can be taken by flock owners, the poultry industry at large and the wider population—particularly those who get out into the countryside—can help us to strengthen our defences and reduce our vulnerability to avian influenza in the Scottish bird population.
Like Mr Finnie, I am grateful for the opportunity to inform Parliament of the action under way in Scotland to prepare for any outbreak of pandemic influenza.
The World Health Organisation and experts from around the world share the view that a global pandemic of influenza is now inevitable. The experts' view is that a pandemic is overdue.
Pandemics can occur at any time of the year. They are caused when a new flu virus emerges that is radically different from previously circulating strains. Few—if any—people will have any natural immunity to such a new virus. That lack of immunity means that any new flu virus could spread widely and quickly. Lessons from the previous century, in which three influenza pandemics occurred, tell us that many hundreds of thousands of people will be affected.
The Minister for Environment and Rural Development spoke about avian influenza. Like him, I think that it is important to emphasise that the avian influenza virus H5N1, which has been spreading in bird populations from south-east Asia and now threatens poultry populations in Europe, is not yet considered a pandemic flu virus strain for people. It is important that, while it has caused some human illness in south-east Asia, the virus has not yet been able to produce sustained transmission of influenza in people. However, the H5N1 virus reminds us of the constant threat of new flu strains and of the need for contingency plans to counter any potential pandemic strains for people.
When an influenza pandemic emerges in Scotland we expect around 25 per cent of the population—1.3 million people—to become ill with flu. Tragically, that could lead to around 5,000 deaths. Of course, each year, sadly, winter viruses are implicated in the deaths of around 1,200 people in Scotland.
The UK has had a plan for dealing with a flu pandemic since 1997. On 19 October 2005, the chief medical officer for Scotland, Dr Harry Burns, launched a revised plan for dealing with an influenza pandemic. The revised plan updates previous versions and it takes account of comments received and new guidance from the WHO. The revised plan also reflects the further work carried out nationally and internationally in recent months. We are constantly reviewing our readiness and the plan will continually be reviewed and updated as new information becomes available.
So, what are we doing to prepare? The revised plan sets out actions to reduce the health impact of the pandemic and the disruption that it may cause to essential services and people's daily lives. In carrying out the action in the plan, the Executive is working with the national health service, key stakeholders and the general public. This includes ensuring that NHS staff are trained in how to manage services during a pandemic, that the Executive builds up a stock of antiviral drug treatments and that they are used in the most effective way to treat those most at risk of serious illness.
A vaccine cannot be made available before the start of a flu pandemic, because it cannot be made until the new virus has been identified. It will be made available as soon as possible, but that may take four to six months. It is critical that our national influenza surveillance programme, co-ordinated by Health Protection Scotland, is able to identify quickly any new pandemic influenza virus strains. This is an international effort involving close co-operation between HPS, the Health Protection Agency in England, the newly established European Centre for Disease Prevention and Control and the WHO. We are working closely with other health departments in the UK to ensure that all necessary preparations are in place to facilitate vaccine production when the pandemic virus is identified.
Action is already being taken, however. The Scottish Executive is purchasing 1.3 million courses of an antiviral drug, known as Tamiflu, at a cost of £15.6 million. This stockpile is due to be completed by the end of September 2006, but the building of it has already begun. There are now 235,000 treatment courses in Scotland and that total is increasing month by month. The stockpile of antivirals will be enough to treat 25 per cent of the Scottish population, which is the number predicted to be affected in an influenza pandemic by the WHO.
Decisions on priority groups for antivirals are also shown in the influenza preparedness plan. To minimise the impact on the health service, health care workers will be given priority, as they will be dealing with people affected by flu and will therefore be put at risk. Further decisions on priority groups will be made when a pandemic emerges and it becomes possible to identify who is being most affected. For example, people most at risk in the 1918 flu pandemic were those aged between 20 and 40. Final decisions on priority groups will be made by the UK national influenza pandemic committee, who are informed of recommendations from the WHO and the Joint Committee on Vaccination and Immunisation.
As there will be no vaccine until the pandemic strain can be identified, we have also purchased 270,000 doses of a vaccine being developed against the current H5N1 strain, which will be for NHS workers. All this planning will help to ensure that Scotland is well prepared for a flu pandemic. The Department of Health, on behalf of UK health departments, is tendering for the procurement of vaccine against H5N1.
Good communication with the general public and health professionals will be crucial. To ensure that health professionals and the general public are provided with clear and accurate information about a pandemic, the Scottish Executive has distributed an information pack to the NHS and voluntary organisations across Scotland. The pack has also been sent to every general practitioner practice in Scotland. It contains copies of the revised Scottish version of the Department of Health's pandemic influenza contingency plan; a leaflet aimed at providing important information for the general public and their families; the guide from the chief medical officer for Scotland; and a leaflet containing the key facts. A dedicated website has also been set up, which is available via the "Scotland's health on the web" website.
NHS boards, which have submitted their plans to the Scottish Executive, have undertaken significant activity. Feedback will be provided as part of a continuing cycle of work to refine preparedness across Scotland. In addition, and to reinforce the joined-up nature of preparations, the Scottish Executive has engaged with the emergency planning community in the public and private sectors. Work is on-going to assist organisations in the development of their emergency response and business continuity arrangements.
The Scottish Executive is working hard with colleagues across the UK to ensure that Scotland and the UK are in the best possible position to combat the very real threat of pandemic influenza.
The ministers will now take questions on the issues raised in their statements. I have many members on the screen, so I ask for concise questions and concise and cross-cutting ministerial answers.
I thank the Minister for Health and Community Care for the advance copy of his statement and I add our support for the work that has been done so far. Clearly, a concern will be how prepared our NHS is to cope with a pandemic influenza outbreak of whatever strain. The chief medical officer for Scotland, in a letter to health professionals on preparing for such a pandemic, estimates that hospital admissions for acute respiratory and related conditions are likely to increase by at least 50 per cent.
Will the minister tell us what preparations will be made to increase the capacity of our hospitals to cope with demand should an outbreak occur? What other measures will be put in place to treat affected people in non-hospital settings? How will the minister ensure that Parliament is kept up to date with the continuing preparations for a possible pandemic? How will the public be provided with accurate and up-to-date information on a situation that may change rapidly?
First, I thank Shona Robison for her support for the measures that the Executive has outlined.
Shona Robison asked about preparations in the health service. Every winter the health service makes plans for normal flu—if I may describe it in that way—to do with bed management; bed capacity; working with partner organisations such as local government; the localisation of health care to avoid people coming unnecessarily into hospitals; and the cancellation of elective care if necessary. All that emergency planning is taking place. Health boards have told us of the steps that they would take if there were a pandemic.
We will, of course, have knowledge of an outbreak in advance. Because of our preparations, local health boards will have time to carry out emergency measures. We have to ensure that we prioritise within the health service to ensure that we can cope with the capacity requirements. That will involve the measures that I described to do with bed management, bed search, working with partner organisations, avoiding people going into hospital and other such issues.
As for keeping Parliament involved, when there is information that it is appropriate to give to Parliament, Ross Finnie and I will, I am sure, be available to do so. We also have the committees of the Parliament, individual responses to members, answers to parliamentary questions, and news releases. We will continue to ensure that people are informed. There are messages that are for parliamentarians, but also messages that are for the wider general public. We will ensure that those messages are delivered in due course.
On behalf of my colleagues, I thank the ministers for making copies of their statements available in such a timeous manner.
Because of the low risk to which the Minister for Environment and Rural Development referred, there is a danger that we might not take the threat seriously. Conservative members very much welcome the fact that the minister has said that he cannot overemphasise the importance of vigilance and self-protection. It is important to get that message across at a time of risk, albeit a low risk.
Notwithstanding the Executive's announcement yesterday in which it set out the process by which low-risk gatherings could be allowed to go ahead, the minister will be aware that the avian world is in the middle of its show season and that many clubs have put in a considerable amount of effort in arranging events. Those clubs have incurred considerable costs for hall bookings, accommodation, printing, awards and all the paraphernalia that go with such shows. Constituency correspondents inform me of a considerable lack of information in the avian world about the licensing process, about the ban procedure, about what shows can and cannot take place and about the criteria that accompany Executive announcements. What is the Executive doing to raise awareness of such issues, in order to bring some clarity to those who are working during a busy time of year for their chosen hobbies?
I am grateful to Alex Fergusson for his prescient comments. When I said that there was a low risk, I balanced that by saying that we simply cannot rule out the possibility of an outbreak. However, it is always important to take proportionate action and not to take action that cannot be justified by the level of risk that is indicated by assessments.
I am acutely aware that a bird show in Alex Fergusson's area had to be cancelled at the weekend. That action was largely precautionary. We had set out our stall and said that we were trying to limit movements. There is a ban on imports, but we are controlling movements internally as well, for biosecurity reasons. Information should now be available to organisations on the biosecurity tests that we wish to apply to bird shows. If shows meet the requirements, we can allow some of them to go ahead, depending on information on the particular species that will be part of the shows.
Although, unfortunately, we had to bring down the shutter on the show at the weekend because we could not get assurances on biosecurity in particular, I hope that, in the next few days, if the organisations concerned can meet the tests to which I have referred and can provide the necessary information, we will be able to license and approve certain of the shows.
I am grateful to both ministers for their statements. How will the Minister for Health and Community Care decide when restrictions should be introduced on public gatherings, such as those in schools, in the event of a human influenza pandemic? What will be the trigger for deciding that restrictions should be imposed on such gatherings? Does the Minister for Environment and Rural Development envisage that a poultry keeper must have a minimum number of birds before he or she has to make his or her entry on the proposed register? In other words, will there be a threshold?
Mr Kerr will answer first.
We will need to wait to find out what form the pandemic takes before we know what group of the population is most likely to be affected by it. As I indicated in my statement, the last century teaches us that different groups can be affected differently by a pandemic. As a result of our planning processes, we will know what we need to do if the pandemic affects certain parts of the population. If the school-age population is affected, we will take appropriate action. It is appropriate for us to wait and see what happens. Our plans include the risk management assessment process. We will wait to find out what form the pandemic takes and which part of the population is most affected. On that basis, we will make a judgment about what sporting events, school events and other occasions on which people are brought together should be allowed to go ahead. Our risk management assessment process is one tool that we have to stop the spread but, at the moment, we must wait to discover what form the strain takes before we make a decision on the matter.
Mr Finnie will answer the second question, which was about numbers of birds.
The issue is more about risk assessment than about having a threshold. The problem that we have in Scotland is that the birds that would be most at risk would, I suspect, be our free-range chickens. We have 1.1 million such birds, which are distributed throughout Aberdeenshire, Fife, the Lothians, the Borders and Dumfries and Galloway. Those areas are where the highest concentrations of free-range chickens are kept.
The assessment of risk will provide the trigger. As I have said, at the moment the risk is low. If the scientific advice and the advice from the chief veterinary officer suggest that the risk has increased from low to medium or beyond, we must take proportionate action to deal with the situation that that increased risk creates. The most obvious species to be affected will be our free-range poultry.
I, too, thank both ministers for their statements. Can the Minister for Health and Community Care confirm that the Food Standards Agency has advised that eating properly cooked poultry products is not considered to present a risk to people of catching avian flu? What is the implication of that for the consumption of raw eggs and raw egg products? Given that there are many worrying rumours going around, can he confirm that it is safe to eat poultry meat and eggs?
In line with previous advice, the Food Standards Agency is saying that there is no risk from properly cooked poultry products. That advice has been published. We have had the advice before that such products should be properly cooked and the country has taken that advice. Following that advice will ensure that there is no risk of avian flu being transferred to humans. That remains the advice and it is very clear.
I thank both ministers for making a clear distinction between the human flu pandemic that, statistically, we are due to have and the new threat of avian flu, which would be a threat to our bird population should it arrive here. I will concentrate on the latter. In the event of an outbreak, would the vaccination of poultry form part of the contingency plans? I realise that mass vaccination is not logistically possible, but perhaps vaccination could be deployed in a ring around any outbreak to contain it. In addition, I invite the Minister for Environment and Rural Development to confirm that there are no plans for a cull of wild birds to prevent an outbreak.
Once an outbreak has occurred, it is difficult to control it using vaccination. We have powers to use vaccine in a limited way on birds that are kept in zoos. The use of vaccine in those circumstances would be a sensible precaution if avian flu was brought in. Quite apart from the obvious impracticality of a cull of wild birds, I can say that that measure is not in our contemplation. Sadly, as I indicated in my response to Euan Robson, the birds most at risk would be poultry. If we were effectively to control any outbreak, there would have to be culling of those flocks.
I thank the ministers for the advance copy of their statements. My first question is for Mr Finnie. What safeguards does he intend to put in place to protect the jobs of workers in poultry units and processing factories? I also have a question for Mr Kerr on the specifics of the purchasing of antivirals and vaccinations. What are the expiry dates of the Tamiflu stockpiles? I note that the H5N1 flu is recognised as an avian strain that is very difficult for people to contract. However, 270,000 doses of the H5N1 vaccine have been purchased. How much has the purchase cost and what is the likelihood of the vaccine being used? I also note that, despite the fact that no vaccine is available as yet, tendering has been going on with the pharmaceutical companies. Will the contracts that are entered into guarantee payment to those companies even if a pandemic does not occur?
I will respond quickly to the first point. I hope that I have made it clear that all the precautionary measures that we are taking are designed to minimise the risk of people in commercial poultry production catching the disease. No minister can give an absolute guarantee of that, however. We are focused on the fact that poultry production is a commercial enterprise and that, clearly, the issue has ramifications for people who work in the sector, as the member said. Our efforts are designed to mitigate and minimise the risk of an outbreak occurring. All the measures that I have outlined are designed to achieve that end.
Although I appreciate the minister's courtesy in turning to face the member, I should remind him that the sound quality disappears if speakers turn away from their microphones. I would be grateful if he would address the microphone from now on.
I thank Carolyn Leckie for her comments. First, on expiry dates, if vaccines are properly stored, the expiry date of the product that we are purchasing at this time is five years.
As Carolyn Leckie was asking her questions, the thought went through my mind, "What if we didn't do that? What if we found out in a few years' time that measures could have been taken and yet we did not take them?" There is a risk assessment process that I have to go through as a minister; I have to take those responsible decisions. Having done so, I am more than happy to say that we have gone the distance in our procurement processes. We want to ensure not only that we reflect the World Health Organisation's guidance on these matters, but that we protect our staff in the NHS. In my view, that is a price worth paying.
I will come back to the member on the question on cost. I am not prepared to answer it right now. Issues around the negotiations on the current procurement process mean that I do not want to declare my hand on the cost of the antivirals and vaccines. I will consult colleagues on the issue of commercial confidentiality and the tendering processes. We will guarantee the payment to our pharmaceutical industry for a product that we have ordered properly in light of the risk assessments that have been undertaken by experts not only in Scotland, but around the world.
I, too, warmly welcome the Minister for Environment and Rural Development's statement on the low risk that avian flu presents. I agree with him that the watchwords must be preparedness and prevention and not panic.
As other members have said, thousands of jobs are dependent on the poultry sector in Scotland. As the sector's busiest time of the year approaches, with the festive period just around the corner, there is a lot of anxiety in the industry about the impact on sales. First, what further steps can be taken to ensure that appropriate advice gets across to the consumer? The FSA website may not be the most appropriate channel through which to communicate with most people in Scotland. Secondly, can the minister give a guarantee to the keepers of organic or free-range status flocks who are worried that, if they have to move their flocks indoors, they may lose that status? As he is aware, that is a real concern to the sector. What reassurances can he give?
I think that the second part of the question relates to the Minister for Environment and Rural Development.
Yes, I will take the second part of the question. I apologise to you, Presiding Officer; I must take lessons in voice production.
As I said to Carolyn Leckie, we are trying to minimise the risk. However, if the risk status rises to a point at which, in the interests of the flock of 1.1 million birds, we have to take the birds inside, I simply cannot rule out allowing that to be done. That will be done in a way that is proportionate to the level of risk that is assessed by the chief scientists and our veterinary officers. It will not be done if it would only be prejudicial to the status to which Richard Lochhead referred. Unfortunately, although free-range status can be endorsed for some period without being lost, organic status would be lost in such circumstances. I will give the industry the assurance that we will take the birds indoors only on the basis of sound science and if the evaluation of our vets is that not doing so would pose a threat to those free-range birds. That is a reasonable and proportionate response. The other question is best answered by Andy Kerr.
I have talked about what the NHS is doing about advice. The FSA will do likewise and produce periodic advice that will be published on its website and given out to people who are involved in the industry. The normal channels of communication will be open. Of course, we will be much more alert than normal to the possible implications of eventualities. We will ensure that everyone gets information as appropriate.
What steps are being taken to monitor the level of infection in migratory bird populations that are arriving and might soon arrive in Scotland? To what extent has any infection been found in populations that might move to this country?
The answer to the latter question is that no such infection has been found—that is the basis on which we can declare our risk status to be low. In the UK, Europe and internationally, assessments are being done of where the disease is breaking out. Of course, there are those who are paying close attention to the migratory patterns that are normally followed.
Fortunately, we are getting towards the end of the autumn migratory season, which helps in reducing the risk. Of course, if an outbreak were to be discovered in a migratory pattern of which we are in a direct line—we would find out about it because we are in touch with the bodies that monitor such things—that would change the risk assessment and the way in which we handle the situation. All the steps that I outlined in my statement enable us to be vigilant domestically and to tap into the work that is being done in Europe and across the world to ensure that we are well informed about the potential threat to the country.
It is clear from the Minister for Environment and Rural Development's statement that there is likely to be a prolonged period of heightened risk and, therefore, increased biosecurity measures for the poultry industry, particularly in relation to the 1.1 million free-range birds that he talked about. Does he have views on the future of the industry? Constituents of mine in Hamiltonhall in West Linton, where there is an outline proposal for 10 poultry houses with a total stock of 320,000 birds, have concerns arising from the current situation. They question whether that is the right kind of proposal at this time.
The member's question leads me into the realms of advising people to assess risk. I can only advise the member—as I have advised the chamber and the people of Scotland—that the risk, at the moment, is low. However, as Alex Fergusson pointed out, we have to be vigilant because of the uncontrolled way in which the disease is breaking out.
To Jeremy Purvis's constituents, I would say that we have veterinary centres and other facilities to which the public and those contemplating commercial activity can go. His constituents should be holding discussions with the appropriate veterinary officers in the state veterinary service to ensure that they receive an assessment that is proportionate and deals with the risk to them in particular.
I thank the ministers for their statements. I am reassured by the comments of the Minister for Health and Community Care that plans have been submitted by NHS boards directly to the Executive. However, I am curious to know how robust those plans are and, indeed, whether they are being tested.
They are being tested. We have to respond to all the individual boards' plans. The UK has been working on the matter since 1997 and the World Health Organisation has been working on it prior to that. We are essentially drawing down our planning processes from best practice, world research and experience. It starts with the World Health Organisation and goes via Europe and the UK departments—the Department of Health in particular—to ourselves. We are working collegiately and are in touch with all the best available advice from across the world. Our plans are tested against the findings that have been made and the relevant criteria. I suggest to Jackie Baillie that our plans are extremely robust in the light of the available scientific evidence and experience from elsewhere in the world. They are clearly in line with World Health Organisation recommendations.
I congratulate both ministers on the clarity of the precautions that they propose to take in the event of a pandemic. I remind them that, although we might not suffer 5,000 deaths in Scotland as a result of an outbreak, we have suffered the deaths of 8,000 senior citizens over the past three winters due to winter-related problems. Going by what the Met Office tells us, we are about to face the worst winter on record. Are there any plans under way to ensure that such a mini-pandemic will not strike again in Scotland this winter?
That was a bit off the subject of the statements, but I am sure that Mr Kerr will have an answer.
We are currently in the middle of our winter flu campaign. We are urging not just elderly people but carers and those who suffer from chronic conditions to come forward and get the vaccine. Clearly, that is our intent.
On the wider matter, I remind John Swinburne of our work on central heating systems and insulation programmes. We are reducing fuel poverty. We have installed 66,000 central heating systems throughout Scotland and we have brought more than 200,000 homes up to standard with respect to insulation. We are tackling those matters from all sides.
On the specific point that Mr Swinburne quite correctly makes, my message on winter flu is that people should please come forward, if appropriate, and get their vaccine.
I welcome the news that antiviral medicine will be produced in Scotland, which will maintain employment at the GlaxoSmithKline factory in Montrose. Surely the importance of that facility in facing up to a potential emergency situation underlines its crucial role in addressing an actual pandemic emergency. Will the ministers join me in requesting that GSK now review its closure decision?
We are setting out our plans and what we are doing about the potential pandemic. The decisions of individual companies are a matter for them. Through our procurement processes and tendering routes, we are trying to ensure that the outcome is that the Scottish public are as well protected as possible against the pandemic. Companies' individual decisions, which are influenced elsewhere in the Executive, will come to bear on that. The member asks a difficult question about a particular plant. We are procuring the product that we need to protect the Scottish public.
I, too, welcomed and appreciated the advance copies of the statements, which I hope will help to inform and give confidence to a worried population. I am pleased to hear the Executive's plans for the advance purchase of antivirals and vaccine. Have any measures been taken to prevent the direct spread of the virus from human to human in the event of a pandemic, such as the stockpiling of face-masks? I accept the Minister for Health and Community Care's comments about planning for school closures and so on, but is there likely to be a plan to restrict general population movements once a pandemic is here?
We have purchased the highest-quality face-masks for our NHS staff, who will be in close proximity to the pandemic if it breaks. On the question of face-masks for the general population, I advise the member that there is little place for them in prevention. We should be doing what we should be doing anyway in relation to the spread of disease: if people cough or sneeze, they should ensure that they cover their mouth and nose. Good hand hygiene is also critical, in relation not just to the potential pandemic, but to other matters.
All scientific and clinical advice is that there is little place for face-masks in prevention. We have secured the best possible face-masks for those working daily with patients in the NHS, but there is no evidence to suggest that the general population would be protected by masks.
We will make decisions on the movement of people as appropriate at the time, depending on what form the pandemic flu outbreak takes, how virulent the virus is and what population segments are attacked by it. We will make decisions as and when we are aware of such matters. We have the plans in place, we have risk assessed the process and we will make the appropriate decisions.
I should say for the benefit of members who are having agitated conversations that there is no risk of decision time being advanced before 5 o'clock, so they could have those conversations outside the chamber.
I thank the ministers for their helpful statements. Flu epidemics or pandemics will always put strains on even the best systems. The public will need information, which will be extremely important in the isolation and prevention of spread of the infection. Given that we have lost so many isolation units for infectious diseases in hospitals, does the Executive have plans to increase capacity in the NHS by increasing bed numbers in isolation units and to train staff to work in such units and in the community, so that essential emergency and elective work can continue despite an outbreak of any infection? It is not just influenza that causes wards to close down.
We have published, and will continue to ensure that the public are kept up to date with, the latest information on pandemic flu. Information leaflets are available for individuals and their families. The issues that the member raises are taken care of as part of our response to individual board plans. That goes back to clinical priority, risk assessment and the plans that we will make to deal with these matters. Much depends on how virulent the strain is and what population segments are affected. As I said in earlier responses, we are ensuring that we have in place the risk-assessed plans, so that we know what we will do in all the scenarios that can occur as a result of the pandemic flu. Of course, our desire is to ensure not only that we deal with the pandemic flu outbreak but that the normal business of the NHS continues. That is exactly what we intend to happen.
Is the minister aware that seasonal flu affects between 500 and 1,000 people per 100,000 of population, whereas a pandemic flu is likely to affect 10 times as many—between 5,000 and 10,000 people per 100,000 of population? Last Christmas, NHS 24 received about 90,000 calls and, as we are all aware, had difficulty coping with that number. What preparations has NHS 24 made to cope with a possible tenfold increase in calls that might result from a flu pandemic?
We are aware of those statistics, which we reflected in the statements and in previous documents issued by the chief medical officer and me. On the capacity of the NHS, I reassure the member about our planning for the winter. NHS 24, the boards and all partners in the health service are working together to ensure that we plan effectively for the winter. All parts of the NHS are part of the planning process for the pandemic flu. I assure the member that those matters have been taken on board and are responded to in the plans for any outbreak of pandemic flu.
The Minister for Health and Community Care said that it would take four to six months to produce the flu vaccine once the new virus has been identified. Can that process be speeded up and how does the four-to-six-month production time relate to the potential rate of spread and infection?
I want to offer reassuring words in response to the question whether we can speed up the process, but I have to say that the process is difficult. We do not want to mislead anyone in the chamber or beyond, but current estimates are that production will take four to six months. On intelligence gathering and information, we might know in advance of the pandemic coming to Scotland that we have identified the strain and can begin working before the pandemic flu breaks out here. When the vaccine is available, we will issue it according to the clinical guidance, first to at-risk groups and individuals and secondly to NHS staff, who will have to deal with the pandemic. That twofold approach will protect the ability of the NHS to respond. I cannot give an assurance about quicker production, although, of course, we want to encourage it. However, I remind the member that we will have some notice so that we can begin planning prior to any outbreak in Scotland.