Swine flu vaccine contracts 'lacked get out clauses'

The contracts negotiated by the UK government for a swine flu vaccine should have had get-out clauses to protect taxpayers' money, experts say.

An independent review, led by former chief medical officer for Wales Dame Deirdre Hine, said that was just one of the lessons that should be learned.

Some of the communications about the pandemic were confusing, it added.

But it praised the overall approach and said the spending - £1.2bn on preparing and responding - was justified.

The review said the four devolved administrations worked well together.

And it said without such a thorough approach the consequences could have been disastrous if the pandemic had proven to be more severe.

But it acknowledged the UK government should have cut a tougher deal over vaccines.

'Threat remains'

More than 30m doses are thought to be left over after one of the manufacturers, GlaxoSmithKline (GSK), refused requests for the contract to be torn up.

Dame Hine: 'the only predicable thing is its unpredictability.'

The other manufacturer, Baxter, agreed to a "break clause" allowing the government to cancel its order.

The review makes 28 recommendations aimed at ensuring a better response to any future pandemic.

Dame Deirdre said: "It is important that the experience of 2009 does not lead to complacency.

"The threat of a flu pandemic remains and the next one could be very serious."

Hundreds of thousands of people were infected with the virus, although most only had relatively mild symptoms.

However, more than 450 people still died in the UK.

Pregnant women and young children tended to be the worst affected.

The UK had been planning for a pandemic for years.

Originally it was thought it would be caused by bird flu, which would probably have meant a much more severe pandemic.

Containment

When swine flu emerged in April last year the government already had stockpiles of anti-flu drugs to lessen the symptoms and pre-contract agreements in place for vaccines.

This level of planning was praised by the review.

When infections started occurring in the UK, the authorities initiated a containment approach. This involved giving anti-flu drugs to anyone who had come into contact with an infected person.

ANALYSIS: DID THE UK GET IT RIGHT?

Continue reading the main story

By Nick Triggle, health reporter

One of the criticisms that has been consistently levelled at the UK is that it over-reacted to what turned out to be a mild pandemic.

But hindsight is a wonderful thing. It is easy to forget that at the height of the pandemic - this time last year in fact - the NHS was under severe pressure in certain "hotspot" areas.

GPs were being swamped and paediatric critical care units were soon coming under severe pressure.

The worst fears were, of course, never realised. But, as Dame Deirdre Hine was quick to point out, they could have been if it had been a more severe strain.

She highlights a number of areas where lessons can be learned - to secure both better value for money but also to ensure the emergency response runs more smoothly.

And this is important. Just because there was a long gap between swine flu and the previous pandemic, it does not mean another one is not around the corner.

Fergus's Medical Files

The review said there was no definitive proof this had worked in slowing the spread.

The use of the phrase containment was also criticised along with others for confusing the public. It said there was a perception the approach was designed to stop the pandemic spreading completely instead of just disrupting it.

There was also criticism of the projections given for deaths.

In England, officials released the worst-case scenario figures which at one point were saying there could be 65,000 deaths.

This caused confusion, the report said, as some interpreted it as a straight prediction.

There also needs to be a thorough examination of the national flu service which gave people access to drugs via the phone and internet, it added.

Health Secretary Andrew Lansley said: "The government will take these recommendations into consideration in planning for the future to ensure that we remain one of the best prepared countries in the world for any future pandemics."

A spokeswoman for GSK said because of the demand at the time for its vaccine from governments across Europe it would not have been "ethical" to offer one country a break clause when others were not able to have all the doses they would have wanted.