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10.28 am

Dr. Peter Brand (Isle of Wight): I am grateful for the opportunity to make a short contribution to this important debate. I am sure that there is consensus in the House on

2 Dec 1998 : Column 810

this issue. The hon. Member for Eccles (Mr. Stewart) set out the case extremely well. I shall concentrate on the public health aspects, which were discussed by the hon. Member for Birmingham, Northfield (Mr. Burden), and shall touch on the case described by the hon. Member for Bristol, East (Ms Corston).

Many of my medical colleagues find it difficult to accept the concept of vaccine damage. There is an association between having an immunisation and neurological diseases occurring, but we know that many neurological diseases in small infants occur at about the time vaccines are given. It is extremely difficult to prove causality as opposed to a link. Many of my colleagues say that, if we allow causality, it may undermine the public's confidence in the vaccination programme. They are profoundly wrong.

Nowadays, for each individual child, it is safer to rely on herd immunity rather than to have a vaccination, but if many individual parents made that decision, herd immunity would disappear almost within weeks. Then we would all, as individuals, be at risk again of a number of diseases that, thankfully, we do not see very often now. Therefore, it is important that individual parents, when they make the responsible choice of having their child vaccinated on behalf of the community, have the assurance that should anything go wrong--whether or not cause and effect can be proved--if there is a link, they will be looked after by the very state and community that benefits from that selfless act.

It all sounds slightly dramatic, but that is a decision that each parent has to make. During some of the irresponsible scares that we have had recently, the focus on vaccine-damaged children not being treated properly by the state has created an on-going festering sore. All of us in the Chamber and everyone who has spoken know parents. The people affected are growing older. Parents are more anxious about those dependent individuals, clearly described by the hon. Member for Bristol, East.

It is in the interest of the Government and public health to make the decisions that parents have to make easier by acknowledging that, if there is any association between a disability and an immunisation procedure, the Government will face up to their responsibilities, without driving those people through the protracted misery of having to go through the courts.

10.32 am

Mr. Eric Pickles (Brentwood and Ongar): This has been an interesting and thoughtful debate. I, too, congratulate the hon. Member for Eccles (Mr. Stewart) on his selection. He spoke movingly about the plight of his constituents and about the difficult decisions that have to be made, as did the hon. Member for Bristol, East (Ms Corston), whose description of her constituents' problems I found deeply moving. I could see that she, too, was moved by their plight. I hope that the Government will take the opportunity to reconsider the individual case that she mentioned.

The hon. Member for Eccles made a slight side swipe at the previous Government when he said that the late Lord Ennals had suggested that more reform might be forthcoming. The hon. Gentleman quoted from the official record. If he studies that debate carefully, he will find that Patrick Jenkin, now Lord Jenkin, remarked that Lord Ennals had gone out of his way not to say that it was an

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interim payment. Part of the problem with which we have been bedevilled is that there have been hints and suggestions that something else is about to be done. I hope that the Minister of State will not be guilty of the same fault.

We are struck by the effects of vaccine damage on individuals and by the amount of injury that is suffered. Hon. Members have referred to the fact that a child must be classified as 80 per cent. disabled before qualifying for payments. The effect of that must be devastating not only for the individual but for the family; the hon. Member for Bristol, East gave a clear example.

It is also striking that the percentage of awards against claims has steadily gone down. The hon. Member for Newbury (Mr. Rendel) talked about a handful of awards; I think he mentioned five. It is interesting that there have been five awards against 260 claims in the past three years.

As the hon. Member for Birmingham, Northfield (Mr. Burden) said, we should not forget that the assistance given under the Vaccine Damage Payments Act 1979 was based on the principle that parents should be actively encouraged to have their children vaccinated on grounds of public health, as well as for the welfare of the individual child.

As hon. Members have pointed out, controversy continues over the measles, mumps and rubella vaccine. I have a letter from the Minister for Public Health in response to a constituent's inquiry about the safety of that medicine. I will not quote the whole letter; nor, for reasons of confidentiality, will I name my constituent. The letter says:

It talks about the Joint Committee on Vaccination and Immunisation and says:

    "The Committee's view remains unequivocal that, on the scientific evidence available, there is no link between MMR vaccine and inflammatory bowel disease or autism."

It is against that background that we seek to reassure families that vaccination remains safe.

The hon. Members for Eccles and for Newbury talked about whooping cough. I was born in the early 1950s--1952 to be precise.

Mr. Kevin Hughes (Doncaster, North): Hear, hear.

Mr. Pickles: The Whip is right. I look a lot younger, but I thank him for that remark.

At that time, whooping cough was a great killer of children. Great fear stalked the streets. Years later, my mother talked about the constant fear, the effects on children and the effects on families in our locality whose children had died or contracted the disease.

In the early 1950s, the number of whooping cough cases was roughly 157,000 a year, compared with 2,000 today. The number of deaths was 300 a year, compared with one a year 40 years later. The public vaccination programmes remain safe and are a sensible precaution for parents to take for the well-being of their

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children and their children's playmates. As hon. Members have said, however, when vaccinations go wrong, the consequences can be tragic.

Hon. Members have referred to the problems in the 1970s, when some members of the medical profession expressed doubts about the safety of whooping cough vaccine. The result was the 1979 Act. As several hon. Members have it made clear, that was not intended as compensation, but, to quote the late David Ennals, as an "urgent measure of health". He made several statements on Second Reading that have since been subject to different interpretations; indeed, we have had heard some differing interpretations today.

At the time of the debate, the royal commission on civil liability and compensation for personal injury had made recommendations on a limited compensation scheme, but as that would, in the words of the late Lord Ennals, "inevitably take time", the Government decided to introduce a lump-sum payment. It is important to emphasise that each uprating relates only to new cases.

Many people took that to mean that other measures would be introduced. Clearly, the sums that have been involved--£10,000, £20,000--are nothing like the levels that would be available in court. I have some briefing papers supplied by a lawyer on comparable schemes involving the courts covering 80 per cent. disability. The figures include £520,000 for an 11-week old girl; £708,000 for a five-year-old boy; a case from Leeds involving £105,000; a case involving £346,000; leading up to one involving £1.25 million compensation.

It is fair to say that, despite the legal aid changes, action on such cases has largely been ruled out because it is very difficult to prove causation: from the early 1980s until the recent cases, the Legal Aid Board refused to grant legal aid to pursue them.

It is to the Government's credit that in June they uprated the amount payable in new cases to £40,000--on roughly the same basis as the two previous upratings by the Conservative Government. In the debate, the Minister made some interesting points that suggested that there would be a further review. On the uprating, he said:

In a written answer in another place, the Under-Secretary said:

    "The Vaccine Damage Payments Scheme is the responsibility of the Department of Social Security. Consideration is still being given to this complex and sensitive issue and an announcement will be made in due course."--[Official Report, House of Lords, 2 November 1998; Vol. 594, c. 28.]

The promised statement on vaccine damage payments came in "A new contract for welfare: support for disabled people", which on page 41 states:

    "We have increased by £10,000 to £40,000 the tax-free lump sum payment which is awarded, in addition to the normal range of disability benefits, to children who are severely disabled as a result of recommended childhood vaccines. We are continuing to consult with representative bodies on any future changes to the scheme."

The Minister, for whom I have a great deal of time, would hardly have made those promises unless he was about to deliver on them; he has just nodded to that effect. I am delighted that he has taken the unusual course of

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making that major announcement during a Wednesday Adjournment debate. To be worthwhile, the review must consider things beyond inflation uprating. At the end of his speech in the uprating debate, the Minister said that the uprating would stand "for some time". Let him say now how often it will be uprated.

Is the review only about the scheme's operation and administration, or are extensions proposed? Are there proposals to introduce a payment on the lines described by hon. Members, to institute a trust for those suffering, to reopen cases previously considered and/or to deal with the problems of adults? Will the 80 per cent. rule or the six-year rule be affected? Any review must consider those matters. Unless the Minister wants to follow the path of Lord Ennals and imply promises that perhaps cannot be kept, let him give us what the hon. Member for Eccles called his joined-up thinking on the issue.

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