House of Commons Hansard Debates for 2 Dec 1996 (pt 7)

Mr. Paul Flynn (Newport, West): Has the Secretary of State seen the answer that I received on 19 November from his colleague at the Department of Health to a request about whether any link has been established between the over-use of antibiotics and the incidence of meningitis? In that answer, the Minister said that recent research had shown a possible link between the high use of a particular form of antibiotic in Gloucester and an outbreak of meningitis there.

Given that certain strains of tuberculosis are resistant to antibiotics and that the hospital bug disease--methicillin-resistant staphylococcus aureus or MRSA--is also possibly caused by the over-use of antibiotics--MRSA cases in Wales have increased from 400 last year to 2,000--can we not be wise before the event? We should recognise that we vastly over-prescribe and over-use antibiotics, and that they are creating new virulent, incurable forms of ancient diseases.

Mr. Hague: The answer from my colleague at the Department of Health to which the hon. Gentleman

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referred spoke of a possible link, but by no means a proven one at this stage. The balance of medical opinion is very much in favour of administering antibiotics in the eventuality that we are now dealing with. That is why they have been administered to many hundreds of students.

As I said in an earlier reply, health authorities are generally extremely careful not to respond to sporadic incidences of meningitis by mass prescribing of antibiotics, because those drugs may, over time, create antibiotic resistance. We are very much aware of that problem. The hon. Gentleman has referred to a possible link in some cases, but at this stage I do not think that it is possible to draw general conclusions from that.

Mr. Rhodri Morgan (Cardiff, West): First, on behalf of the Opposition, may I endorse the Secretary of State's messages of condolence and sympathy to the entire student body at the University of Wales in Cardiff, and above all to the family and friends of the students who have died? I also offer our support to the medical teams that are engaged in combating this virulent and inherently unpredictable disease.

Now that the Secretary of State has confirmed that there was a meningitis case at the same hall of residence five weeks ago--happily, that student has recovered--will he comment on the widely expressed concern that, if a programme of administering antibiotics and vaccination had been carried out then as has been carried out now, the latest outbreak, which has had unfortunately fatal consequences, might not have occurred?

Are there adequate guidelines on how to contain an outbreak of meningococcal meningitis when it occurs at a hall of residence? Such guidelines already exist for outbreaks within families, when people are isolated, given vaccinations and treated with antibiotics.

Is it significant that the outbreak has occurred at the tower block at the university hall of residence at Pen-y-lan, and that none of the cases has come from the self-catering block in the same complex? The tower block may have some significance because of its communal eating facilities and communal toilet and shower facilities, which thereby permitted a greater spread of the germs through coughing, sneezing and so forth.

Would the right hon. Gentleman therefore confirm that perhaps more could have been done to persuade students more promptly, particularly those resident in the tower block at Pen-y-lan, to remain in Cardiff over the weekend to receive antibiotics and vaccinations, and be subject to medical surveillance? That would prevent any contagion from spreading to other parts of the country by students who are unknowingly incubating the disease while visiting family and friends.

Following the tragic death of the law student on Thursday, why did the university authorities take the trouble to e-mail the full-time law tutors to warn them, but did not e-mail the postgraduate law tutors who had the same amount of contact with that student?

Given that the five students so far confirmed as suffering from the disease are said not to be in the same social circle, does the Secretary of State agree that we urgently need to solve the mystery of how the bug spread? Will the right hon. Gentleman therefore give the House two guarantees?

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First, will the right hon. Gentleman take responsibility for pulling together the combined expertise of the Bro Taf health authority, the University Hospital of Wales trust, the Glan Hafren trust of Newport, which treated the other student five weeks ago, the Meningitis Trust, the university medical authorities and the Public Health Laboratory Service, in order to isolate the origin of the outbreak and combat it? Secondly, if new guidelines are to be set on how to handle meningitis in communal living quarters, such as university halls of residence, they should be introduced and acted on without delay.

Mr. Hague: I am grateful to the hon. Gentleman for his opening remarks: the House is united in sending its condolences to the relatives and friends of those affected.

The hon. Gentleman asked again about the first case on 14 October. It is important to understand that that student became ill at home, and all the normal courses of action were followed--antibiotics were administered to the family and others who might have been in close contact with the student, including those at university hall. Subject to what is found later, the balance of evidence suggests that, owing to the incubation period, that case is unlikely to be connected, but we do not know that, and have to retain an open mind. The third case involved someone who did not live in university hall.

It was last Friday before the medical people involved formed the view that there was a link between cases. Information was quickly given to students following that analysis and before any definitive confirmation had been obtained. Information was given out at least twice, and bulletin boards were set up in the university last Friday afternoon. From what I have seen so far, I do not want to criticise the authorities for the action they took to inform people.

The hon. Gentleman asked whether the incident would have implications for guidelines we give in future. It may do--we seek all the time to improve our knowledge of the disease and the means of dealing with it. The report that eventually emerges from the health authority may give rise to new guidelines, or to our having to consider new guidelines.

Dealing with the incident will remain the responsibility of the health authority. I can guarantee to the hon. Gentleman that my chief medical officer is, and will remain, in close touch with everyone involved, and I and my colleagues in government will be anxious to see the evidence of the case as it emerges.

Points of Order

3.57 pm

Mr. George Robertson (Hamilton): On a point of order, Mr. Deputy Speaker. I want to ask for your advice and guidance on an apparent contradiction between what the Secretary of State for Scotland said in his statement to the House last Thursday and subsequent information that has come to light.

Last Thursday, the Secretary of State made a statement about the grave outbreak of the bacteria E. coli 0157 in Lanarkshire, which has left five people dead, a dozen seriously ill and more than 100 hospitalised. The statement took place six days after the outbreak, and a number of hon. Members were concerned to find out from the Minister why it had taken five long days for the authorities to publish the list of outlets supplied with the infected product. That delay could have led to more people buying and consuming produce that contained the bacteria, and there is anger in the area at the denial of information.

On Thursday, I asked a specific question of the Secretary of State for Scotland. I asked:

"Was the Scottish Office behind the decision to withhold information about outlets, as the Minister's statement seemed to suggest that the Department was involved all along?"

The Secretary of State specifically responded to that question by saying:

"The hon. Gentleman asked whether the Scottish Office was behind the decision. No, it was not. Indeed, I was informed yesterday evening that there was some concern about making the information available, and I suggested that it should be published if possible."

The Minister then continued in a fairly offensive and patronising way to deal with my hon. Friend the Member for Monklands, East (Mrs. Liddell). He said:

"The Scottish Office became involved--as it was required to be--only when it became apparent that the outbreak might not be confined locally, which was well after the weekend."--[Official Report, 28 November 1996; Vol. 286, c. 465, 467, 470.]

On Friday, I came across a letter issued by the Scottish Office Agriculture, Environment and Fisheries Department on Wednesday 27 November, headed "Food Hazard Warning". Contrary to what the House had been told on Thursday--that the Scottish Office was not involved--the letter sent out the day before said:

"A list of known outlets for these products (outside the North Lanarkshire area) is attached. This list is Confidential and should not be distributed further."

Mr. Deputy Speaker, you can see the clear contrast between the absolute and categoric assurance given to the House by the Secretary of State on Thursday and the letter on the subject from his own Department dated the day before.

The right hon. Gentleman wrote me a letter today, in which he says:

"The local authorities in north Lanarkshire were responsible for deciding whether to withhold or release the list of premises and neither I nor my officials directed this decision."