GLA group pandemic response

Report: 9
Date: 29 September 2005
By: Chief Executive and Clerk

Summary

Through Transport for London, sufficient anti viral drugs have been purchased to maintain the essential services provided by the GLA Group of organisations in the event of a flu pandemic. At its July meeting the Authority agreed the establishment of an earmarked reserve for the MPA’s contribution towards the cost of these. However, members asked for further information before coming to a decision.

A. Recommendation

That the MPA agrees to meet its per capita proportion of the purchase cost of anti viral drugs, in the sum of £456,000 from earmarked reserves.

B. Supporting information

1. There is growing international concern about the risks of a ‘flu pandemic. The specific concerns have been about avian flu but any flu pandemic that followed previous experience could affect up to 25% of the population. It would clearly have a severe impact on the economic and social life of London. It would also have a significant and adverse impact on essential public services such as police, transport and fire services.

2. In view of the Greater London Authority’s strategic role, the Mayor has taken the lead in ensuring that the GLA Group, including the MPA, is in a position to minimise the impact on their services of any flu pandemic.

3. Medical treatment is key to the success. Anti viral drugs provide effective treatment and can be used both for prevention and treatment. Oseltamivir (Tamiflu) is an anti viral drug produced by Roche Products Ltd that can be used for the prevention and treatment of all types of flu. It has been approved by the NICE (the National Institute for Clinical Excellence) in the UK for this purpose. It is the drug being purchased by the Government for the treatment of Avian flu. There is no similar drug on the market.

4. In the event of an outbreak there would be high worldwide demand for anti viral drugs. The Mayor therefore agreed to the purchase of 100,000 doses of Oseltamivir at a cost of 1.5 million Euros (£1.037m at the time the decision was taken). This is sufficient for the maintenance of services both by directly employed staff and through service providers such as bus companies. Transport for London have conducted the procurement process and will store the drugs on behalf of the GLA Group. A Pandemic Response Plan is being finalised to address how these drugs will be used.

5. It is proposed that cost of purchasing the drugs should be shared between the GLA and the functional bodies based on employee numbers. On this basis the MPA / MPS share of the costs is £456,000 – at approximately £10 a treatment there would be sufficient drugs for all MPS / MPA staff.

6. At its July meeting, the Authority agreed to establish an earmarked reserve to meet its proportion of the cost of the anti-viral drugs. However, members asked for further information before coming to a decision about payment, in particular, whether the Government would be purchasing anti-viral drugs for the emergency services. Members also asked for information about how the drugs will be distributed. There was also concern that the approach adopted in this case – of purchasing the drugs in advance of formal agreement from the MPA – should not be seen as setting a precedent. The Authority agreed, therefore, to make provision in the accounts for its share of the costs pending this report.

7. In terms of process, when Mayoral agreement was sought for the purchase of the drugs, it was implicit that any decision by the police and fire services to participate was subject to the approval of their authorities. Although there was no formal approach there were discussions at officer level but these discussions did not translate into a paper to the Authority until July.

8. The decision to purchase the drugs in advance of formal agreement with the MPA is not seen by the Mayor or the GLA as setting a precedent. It was, however, seen as more cost-effective to purchase the drug for the whole GLA group as the order of 100,000 doses allowed purchase at the discounted Government rate (£10.40 a dose compared to £18). There was also concern at the potential delays in acquiring the drugs given the delivery period being quoted for large Government orders.

9. The drugs have been procured (by Transport for London) and are being stored by TfL in central London. The storage involved is not substantial and the expectation is that this cost (approximately £3 a week) will be borne by TfL. A steering group and various project teams (which include MPA and MPS representatives) have been developing a GLA Group Response Plan. The next stage is for consultation on the draft plan, in particular with the trades unions. The proposed distribution and dispensing methods have not, therefore, been finalised and it would not be appropriate to go into further detail at this stage. The plan will, however, be discussed with the Functional Bodies before it is finalised and launched, probably in December. All Authorities concerned will be asked formally to adopt the plan.

10. At the time of the Mayoral approval to purchase the drugs (late February) the Government had stockpiled some anti-virals, but the supplies would have been insufficient in the event of a pandemic in the near future. Since then the Government has placed orders for more drugs and the current position is that the Government is expecting to receive 800,000 courses of the anti-virals a month from August, with the full sixteen million courses expected to be stockpiled by November 2006. In the event of a pandemic between now and November 2006, Government stockpiles would be offered to frontline healthcare workers first.

11. At present Government plans are unlikely to allow access to the drugs for all GLA Group staff (including MPS/MPA staff) even when their full stockpile has been achieved.

12. The decision to purchase the anti-viral drugs was taken in the context of London Resilience (as well as wider responsibilities under the Civil Contingencies Act and as part of business continuity), to ensure that essential public services could be maintained in the event of a flu pandemic. That remains the imperative, and the holding of a dedicated stock of anti-viral drugs, coupled with a robust Response Plan is the best way of meeting those responsibilities. The GLA has been working closely with the London Resilience Forum and the Department of Health both organisations see this initiative as valuable and potentially a source of best practice for other public bodies.

C. Race and equality impact

There are no implications in relation to the costs of purchasing the anti viral drugs. The Response Plan will address the diversity implications of how the GLA Group proposes to maintain essential services in the event of a flu pandemic.

D. Financial implications

If agreed, the cost of £456,000 can be met from earmarked reserves.

The immediate priority was to secure a supply of the anti viral drug. There are details to be clarified as to the financial position if the drugs are not used within their four to five year shelf life and sold on or, in the event of a pandemic, if not all 100,000 doses are required and some are sold to other authorities. The Treasurer will clarify these issues through the GLA Chief Finance Officer Group. Incidental/future costs will be identified as part of the Response Plan and the issues addressed through the Chief Finance Officers group and the normal planning and budgeting processes.

E. Background papers

• Mayoral Approval 2140; email from GLA Director of Finance, 17 August 2005.

F. Contact details

Report author: Simon Vile

For more information contact:

MPA general: 020 7202 0202
Media enquiries: 020 7202 0217/18

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