Good news and bad news in the flu furore

The worst of the outbreak may be over, but there are still no plans for a comprehensive vaccination

The good news is that we appear to be over the worst of this year's flu outbreak.

The bad news (for worried parents like me) is that there is still no sign of the flu vaccine being made available to children and the under-fives in particular.

I aired my frustrations about being unable to vaccinate my 20-month-old daughter against this potentially fatal but utterly preventable disease on this blog earlier in the week – saying that I couldn't help feeling that it was all ultimately down to saving money.

On Thursday, I was given the opportunity to put these concerns directly to the NHS director of immunisation, Professor David Salisbury.

He spoke to me as the latest figures show seven confirmed deaths of children under five from flu since September, against 11 deaths in the five-to-14-year-old age range, 59 deaths among those aged 15-44, 78 deaths in those aged 45-64 and 55 deaths among the over-65s.

The cumulative total number of confirmed flu deaths since September currently stands at 254 – a sharp increase on last week's total of 112. But because of a two-week time lag in the death statistics filtering through, that sharp increase reflects the peak (fingers crossed) of the disease a few weeks ago, rather than the current picture.

I said to Professor Salisbury that it is all very well saying that children are at a comparitively low risk of dying from flu, but that this will provide little comfort for parents grieving the loss of those who have died from this preventable illness.

He said:

Supply of vaccine is driven by customers. If customers order the vaccine, industry then increases supply. It's not a capacity issue, it's an issue to do with what is the best use of the resources that we have available to us.

He said that the latest information was that those identified as being in the high-risk groups – who are being offered the vaccine on the NHS – are around 20 times more likely to die from influenza than others. So, he said, that is why the vaccine is being offered on a risk basis, rather than one based on age – as happened last year, when those aged under five were offered the jab.

Those in the high-risk groups include over-65s, pregnant women and those with certain underlying health conditions.

Recorded numbers of people with flu-like symptoms have dipped since last week and the number of people in NHS critical care beds with flu symptoms on 20 January dropped to 418, down from 661 a week ago. Some 20 in critical care with flu were under-fives.

For those worried parents (like me), whose children don't fall into an at-risk category, the only thing to do is hope that supplies return to private clinics – which have been offering the jab for between £10 and £25 a pop – or else keep pestering your GP.

Prof Salisbury said to me that NHS high command only makes recommendations, but that it is up to GPs to make their own clinical judgements.

Dominic Ponsford is the editor of Press Gazette.

Dominic Ponsford is editor of Press Gazette

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I'm far from convinced by Cameron's plans for Syria

The Prime Minister has a plan for when the bombs drop. But what about after?

In the House of Commons today, the Prime Minister set out a powerful case for Britain to join air strikes against Isil in Syria.  Isil, he argued, poses a direct threat to Britain and its people, and Britain should not be in the business of “outsourcing our security to our allies”. And while he conceded that further airstrikes alone would not be sufficient to beat Isil, he made the case for an “Isil first” strategy – attacking Isil now, while continuing to do what we can diplomatically to help secure a lasting settlement for Syria in which Assad (eventually) plays no part.

I agreed with much of David Cameron’s analysis. And no-one should doubt either the murderous barbarism of Isil in the region, or the barbarism they foment and inspire in others across the world.  But at the end of his lengthy Q&A session with MPs, I remained unconvinced that UK involvement in airstrikes in Syria was the right option. Because the case for action has to be a case for action that has a chance of succeeding.  And David Cameron’s case contained neither a plan for winning the war, nor a plan for winning the peace.

The Prime Minister, along with military experts and analysts across the world, concedes that air strikes alone will not defeat Isil, and that (as in Iraq) ground forces are essential if we want to rid Syria of Isil. But what is the plan to assemble these ground forces so necessary for a successful mission?  David Cameron’s answer today was more a hope than a plan. He referred to “70,000 Syrian opposition fighters - principally the Free Syrian Army (FSA) – with whom we can co-ordinate attacks on Isil”.

But it is an illusion to think that these fighters can provide the ground forces needed to complement aerial bombardment of Isil.  Many commentators have begun to doubt whether the FSA continues to exist as a coherent operational entity over the past few months. Coralling the myriad rebel groups into a disciplined force capable of fighting and occupying Isil territory is a heroic ambition, not a plan. And previous efforts to mobilize the rebels against Isil have been utter failures. Last month the Americans abandoned a $500m programme to train and turn 5,400 rebel fighters into a disciplined force to fight Isil. They succeeded in training just 60 fighters. And there have been incidents of American-trained fighters giving some of their US-provided equipment to the Nusra Front, an affiliate of Al Qaeda.

Why has it proven so hard to co-opt rebel forces in the fight against Isil? Because most of the various rebel groups are fighting a war against Assad, not against Isil.  Syria’s civil war is gruesome and complex, but it is fundamentally a Civil War between Assad’s forces and a variety of opponents of Assad’s regime. It would be a mistake for Britain to base a case for military action against Isil on the hope that thousands of disparate rebel forces can be persuaded to change their enemy – especially when the evidence so far is that they won’t.

This is a plan for military action that, at present, looks highly unlikely to succeed.  But what of the plan for peace? David Cameron today argued for the separation of the immediate task at hand - to strike against Isil in Syria – from the longer-term ambition of achieving a settlement in Syria and removing Assad.  But for Isil to be beaten, the two cannot be separated. Because it is only by making progress in developing a credible and internationally-backed plan for a post-Assad Syria that we will persuade Syrian Sunnis that fighting Isil will not end up helping Assad win the Civil War.  If we want not only to rely on rebel Sunnis to provide ground troops against Isil, but also provide stable governance in Isil-occupied areas when the bombing stops, progress on a settlement to Syria’s Civil War is more not less urgent.  Without it, the reluctance of Syrian Sunnis to think that our fight is their fight will undermine the chances of military efforts to beat Isil and bring basic order to the regions they control. 

This points us towards doubling down on the progress that has already been made in Vienna: working with the USA, France, Syria’s neighbours and the Gulf states, as well as Russia and Iran. We need not just a combined approach to ending the conflict, but the prospect of a post-war Syria that offers a place for those whose cooperation we seek to defeat Isil. No doubt this will strike some as insufficient in the face of the horrors perpetrated by Isil. But I fear that if we want not just to take action against Isil but to defeat them and prevent their return, it offers a better chance of succeeding than David Cameron’s proposal today. 

Stewart Wood is a former Shadow Cabinet minister and adviser to Ed Miliband. He tweets as @StewartWood.