Vaccine shortages put immunisation schemes at risk, says the NAO
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The grip of some drugs firms on their markets threatens dangerous vaccine shortages in the future, says a key spending watchdog.
More work is needed to break some companies' near-monopolies and avoid public health risks, the National Audit Office argues.
The NAO also found no link between a pharmaceutical chief's donations to Labour and his company winning a £32m government contract.
The award of the smallpox vaccine contract to Powderject Pharmaceuticals sparked controversy last year when it emerged its chief executive Paul Drayson had twice given £50,000 to Labour.
The second donation coincided with the smallpox tendering exercise, which was kept from public scrutiny because of national security fears.
But Health Minister John Hutton and his staff did not know about the donation until the day officials recommended Powderject, says the report.
Jabs jeopardy
Fears of a possible bio-terrorist attack and debate about MMR jabs have pushed vaccines into the spotlight in recent months.
The NAO says the cost of developing and producing vaccines, which attract comparatively small profits, and company mergers mean there are only a small number of suppliers.
Supply shortages jeopardise the immunisation programme, it says.
Hutton did not know about donation until officials chose Powderject, says report
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The Department of Health (DoH) has tried to manage the risks of shortages in common jabs such as the MMR against measles, mumps and rubella and the BCG for tuberculosis.
Sir John Bourn said the public health consequences of vaccine shortages "may be very serious indeed".
"The department faces a challenge in ensuring vaccine supplies where the number of suppliers is diminishing and some suppliers enjoy a near monopoly, resulting sometimes in increased prices," he said.
"The department should define its long-term strategy for ensuring adequate vaccine supplies as a complement to its short-term handling arrangements to deal with vaccine shortages."
Double checked
After trawling through key documents in its Powderject inquiry, the NAO says Mr Hutton realised the "possible sensibilities" of the case when he was told about Dr Drayson's donation.
So the DoH's most senior civil servant looked at the papers and endorsed the choice of the company.
The department must be able to demonstrate that it has acted fairly and properly, which it couldn't do in this case
Edward Leigh Commons public accounts committee
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The "crucial factor" in the decision, says the report, was that only Powderject could supply the strain of the vaccine experts said was needed within the right deadlines.
NAO head Sir John Bourn said: "We found no link between the personal donations to the Labour Party by the chief executive of Powderject and the award to his company of the contract to supply the vaccine.
"However, even where national security dictates that the DoH cannot follow normal procurement procedures, the department must still be as transparent as possible.
"There must be robust protocols for the special procurement procedures which are to be followed so that the department can demonstrate that it has acted properly and fairly."
Transparency call
Other companies approached about the contract have complained they were not told the criteria or timelines required.
The DoH says it gave as much information to all the companies as it could when it did not want to alert bio-terrorists to any weaknesses in the UK's protection systems.
But Edward Leigh, chairman of the Commons public accounts committee, said: "The department must be able to demonstrate that it has acted fairly and properly, which it couldn't do in this case."
The DoH said it accepted the NAO's recommendations in full and was pleased the report found it had acted properly throughout the process.
A spokesman said: "At a time of heightened risk and tension, we acted promptly in the interests of public safety, based on advice from independent scientists."
Dr Drayson also welcomed the report which "establishes that my donations, made in a personal capacity, are not linked in any way to my business life".
He was a donor well before the prospect of any smallpox contract, which was won on merit, he added.