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Mr. Hesford: In my speech, I asked for confirmation of whether Opposition Members reject the Wakefield report.

Mr. Hammond: I shall specifically come to the hon. Gentleman's question in a moment.

The problem, simply stated, is that concerns raised about the safety of the triple-dose vaccine have led immunisation rates to fall to a level that puts the population at risk of epidemics. My hon. Friend the Member for Woodspring clearly asserted that the weight of scientific evidence supports the combination vaccine. I am pleased to state that again.

We may know best, but the challenge is to convince people in the real world. Since the first publication in 1998 of the Wakefield findings, the Government's policy has not wavered for a moment, and has denied any link between the MMR vaccine and autism. To support that, they have cited the large body of scientific evidence that points in favour of their position. I went to a briefing meeting in the Department of Health two and a half years ago--when the Minister for Employment, Welfare to Work and Equal Opportunities was Minister for Public Health--which was attended by concerned Members from both sides of the House. When the question of the single-dose vaccine was raised, the Minister and the chief medical officer, who were both present, firmly rejected the idea and made it clear that parents should not be offered an alternative for fear of weakening the arguments in favour of the combination vaccine.

I am sure that that was the right position for a Minister to take then. It may still be the right position for Ministers to take now. However, in his remarks, the Secretary of State

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was ruling out for all time the possibility of needing to reconsider the matter if vaccination rates do not recover. When the Minister for Public Health winds up the debate, will she reassure the House that the Government will promote safety and arguments in favour of the combination vaccination, but that they will continue to take a pragmatic approach if vaccination rates do not recover?

Mr. Milburn: I am grateful to the hon. Gentleman for giving way on this issue. Would he just remind the House of precisely what happened on a previous occasion when, as he says, decision makers wavered in relation to a suspected problem with a vaccine--in this case, the whooping cough vaccine in the 1970s? If he does not remember, I can tell him that one publication cited a link between the vaccine for whooping cough and brain damage, which was subsequently proven to be wrong. In the meantime, whooping cough vaccine was not distributed in the way that it had been and the country had a whooping cough epidemic, which included many deaths. Would the hon. Gentleman remind the House of that and learn the lessons?

Mr. Hammond: I am grateful to the right hon. Gentleman. My hon. Friend the Member for Woodspring has already made it clear--I hope that I am making it clear again--that we will support the Government in seeking to convince public opinion of the efficacy and safety of the combination vaccine. However, when the Minister winds up our debate, will she confirm that the Government's commitment to the combination vaccine is pragmatic, based on the fact that they believe that the population protection that is needed against measles, mumps and rubella will best be achieved by promoting the combination vaccine? There should not be a dogmatic commitment, based on an obscure idea that one solution alone must be promoted. I urge the Minister to reassure us that the Government will take a pragmatic approach to our debate this evening.

Fiona Mactaggart: What would the hon. Gentleman say to a constituent who came to my advice surgery last Friday and said that she was worried about the triple vaccine? She said that the single vaccine must be fine because a doctor from the Opposition said so. Why, she wanted to know, could she not get it on the NHS? That is what my constituent believes. Perhaps the hon. Gentleman can say something to her, which I will show her in Hansard and which, perhaps, will reassure her.

Mr. Hammond: What I would say to the hon. Lady and to her constituent is what I have already said: the overwhelming weight of scientific evidence supports the Government's case, which we are happy to support. However, in his opening remarks, the Secretary of State himself acknowledged that public confidence in the weight of scientific argument and the way in which politicians present that argument is at an all-time low. There are all sorts of reasons for that. However, we live in the real world and have to deal with the situation that exists. The Government know that. Their challenge--we support them in meeting it--is to deal with real public perceptions, not with the perceptions that we would like them to have.

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Dr. Harris: Will the hon. Gentleman give way?

Mr. Hammond: No; I shall not give way again. I should like the Minister to have plenty of time to reply to the debate.

I should like to ask the Minister a question. I have a letter from the Minister for Employment, Welfare to Work and Equal Opportunities, who wrote to me on the subject in September 1998, when she was Minister of State at the Department of Health. She said:

The Government seem to acknowledge that parents have to make an informed choice, and they are about to embark on a major advertising campaign to provide information to parents so that, as the Secretary of State said earlier, they can make an informed choice. However, what informed choice does the Minister want parents to make? Surely she does not want to open the door to parents choosing the option not to vaccinate their children. Will she confirm that it would be a disaster if parents were to receive the message that the choice that the Government are seeking to empower them to make could ever be not to vaccinate their children?

Dr. Harris: Will the hon. Gentleman give way?

Mr. Hammond: I shall not give way; I have only a moment left.

Today's debate has inevitably focused on the MMR issue, as it is very much in the public mind. However, my hon. Friend the Member for Woodspring also drew the House's attention to the TB situation and the explosion of TB cases. It is no longer just a third-world problem but a problem that affects us here. London has the highest incidence of TB of any city in Europe. The Secretary of State sought in his speech to address some of those issues.

I hope that the Minister will be able to tell us just what the Government are doing to ensure that we never again become vulnerable to a single-source supplier of vaccine, which for technical or other reasons can of course fail.

Will the Minister also tell the House what the Department is doing to assess the port of entry screening programme which is a vital part of the battle to combat TB in the United Kingdom?

I want to ensure that the Minster has plenty of time to respond to the comments made today by hon. Members on both sides of the House. We have raised the issue of failures in public health policy, particularly in relation to immunisation and communicable diseases, because that issue greatly concerns the public and all hon. Members. It is necessary that Ministers have an opportunity to address such issues in this place, which is the proper forum to consider them.

It is impossible to switch on a television without becoming aware of the extent and depth of public concern and confusion about some health issues, especially MMR. I repeat that hon. Members on both sides of the House agree that the overwhelming weight of evidence supports the contention that MMR is a safe and efficacious response. However, concern will turn to anger if the public do not perceive that the Government are sensitive

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to their concern and are dealing with it. It is the job of the Opposition to hold the Government to account for their performance in that most fundamental role of the modern state.

Since Edwin Chadwick and the great Public Health Acts of the 1840s and 1850s--long before the welfare state or the concept of a health service that is universal and free at the point of use--it has been established that a core, central role of Government is to secure the public health by preventing the spread of communicable disease.

As technology and sanitation have developed, we have come to take for granted the gradual elimination of disease after disease that was once a killer but has become little more than a historical curiosity--so much so, that we may sometimes forget the Government's vital public health role. It may be the unglamorous end of the Health Department's work, but it is vital that Governments are not distracted from that vital work by higher-profile health policy matters.

Nothing is as fundamental to the health and welfare of the British people as a sound public health policy, effectively implemented, to ensure the continued protection of the population from the killer diseases that we have, mercifully, all but forgotten, and from the newer scourges that threaten.

Tonight's debate is a gentle wake-up call, a reminder that Government must focus on this most fundamental role of the state, and a reassurance to them that, if they go about that business with a sound policy, pragmatically implemented and sensitive to public opinion, we will support them in it.

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