Winter Deaths (Hansard, 1 March 2004)

§ Dr. Ladyman

There are four main strands to the efforts nationally to reduce avoidable winter deathsImmunisation of older people against influenza and pneumococcal disease Increasing awareness among older people of the risks of cold weather, and the benefits and other help available to keep homes warm The national Fuel Poverty Strategy Improving our ability to link the forecasting of cold weather with measures designed to prevent people from becoming ill, as well as to improve the ability of the health service to plan for surges in demand, especially for hospital admission.

A target for flu vaccination in those aged 65 and over has been set since the change in policy in 2000–01.

In 2000–01 the target was 60 per cent., in 2001–02 65 per cent, and in 2002–03 and 2003–04 70 per cent. Uptake achieved has been 65 per cent., 68 per cent., 69 per cent, and 71 per cent, respectively.

This year's result is an excellent achievement and exceeds our target of 70 per cent, set at the start of the campaign.

The number of people aged 65 and over receiving their flu immunisation this year was 5,781,440—over 295,000 more people than last year

The Joint Committee on Vaccination and Immunisation (JCVI) has recommended extending pneumococcal immunisation to all aged 65 years and over.

The new policy is to offer immunisation with pneumococcal polysaccharide vaccine to all people aged 65 years and over. However, we are introducing the policy in stages. To start with, people aged 80 and over, who are most at risk from pneumococcal disease, will be offered the vaccine in 2003–04. They will be followed by all those aged 75 and over in 2004–05. By 2005–06 all those aged 65 and over should routinely be offered pneumococcal vaccine.

People under these ages who are at higher risk from pneumococcal disease are already recommended to receive the vaccine. This includes people who have a heart condition, chronic lung disease, diabetes mellitus, a weakened immune system due to disease or treatment, a damaged spleen or no spleen.

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We will be collecting data on the number of people receiving their pneumococcal vaccination, but this will not be available until after April 2004.

A Keep Warm, Keep Well campaign operates in England each winter. This provides free booklets for the public and special literature for health professionals; a telephone helpline, and advice on how those most in need may apply for grants (such as the Warm Front grant—a scheme providing grant for comprehensive packages of insulation and heating improvements for those on low incomes most vulnerable to cold-related ill health); advice on benefit payments; as well as the health benefits of keeping warm.

The relationship between indoor temperatures and ill health is complex, with other factors such as outside exposure and behavioural factors involved. However, the likelihood of ill health is increased by cold damp homes. Illnesses such as influenza, heart disease and strokes are all exacerbated by the cold and older people are especially vulnerable.

The Department of Health is working together with other Government Departments to reduce the number of households in fuel poverty. Good progress has already been made with the number of fuel poor households falling from approximately 5.5 million in 1996 to about 3 million in 2001 with predictions of a further reduction of 0.5 million for 2002.

Health professionals within the National Health Service have been made fully aware of fuel poverty as a potential health determinant and widely encouraged to identify and advise patients for whom cold, damp home conditions might be a health risk.

At the local level, fuel poverty is on the agenda of many health professionals in delivering fuel poverty initiatives and fuel poverty has been identified as a key priority within the Health Inequalities Programme for Action.

Her Majesty's Treasury funding was made available up to April 2003 to allow some exploratory work, led by the Met Office, to develop models to forecast workload for primary and secondary care, built in part on weather forecasting. The evaluation of this exploratory work was inconclusive. Preliminary discussions are currently underway between the NHS, the Department and the Met Office to determine next steps, and in particular whether it is possible to refine the approaches taken to preventative interventions, targeted in time and place so as to gain maximum benefit for patients before they fall ill, and manage NHS workload more proactively than at present, so that services, including hospitals, are better placed to manage surges in demand, particularly for hospital admission.

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