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9.46 pm

The Minister for Public Health (Yvette Cooper): I am grateful for the opportunity to reply to this debate on an extremely serious subject--ultimately, lives are at stake. The tone of the debate has been largely measured, but I am not so convinced that the content has been as responsible as the tone would suggest.

The hon. Member for Woodspring (Dr. Fox) asked several questions about communicable diseases, many of which were fully answered earlier by my right hon. Friend the Secretary of State. The hon. Member for North Devon (Mr. Harvey) welcomed many of the public health measures in the NHS plan. I welcome his comments, although he rightly pointed out how far we still have to go. The hon. Member for Bromsgrove (Miss Kirkbride) voiced her concerns about MMR, while my hon. Friend the Member for Wirral, West (Mr. Hesford) set out strong evidence offered by scientific bodies in support of the vaccine.

My hon. Friend the Member for Amber Valley (Judy Mallaber) talked poignantly about the impact of meningitis C vaccine in her constituency. The hon. Member for Mid-Worcestershire (Mr. Luff) returned to MMR and referred to the problems of risk and the precautionary principle. My hon. Friend the Member for Nottingham, East (Mr. Heppell) argued clearly that the big problems come from poverty, ill health and the big killers: cancer and heart disease.

The hon. Member for Runnymede and Weybridge (Mr. Hammond) referred to TB, to the BCG vaccination and to the risks posed by monopoly suppliers. We are certainly concerned about that, although there is not always an easy way of getting round the problem.

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My hon. Friend the Member for Amber Valley described the meningitis C campaign. It is a wonderful story for public health and an immense tribute to the NHS that the programme was implemented so quickly. Early results show that it prevented 500 cases of and 50 deaths from meningitis C in the past year. That is 50 tots and teenagers who are still arguing with their parents and taking their lives for granted because of the vaccine.

MMR has been debated in great detail. Many parents of young children will feel confused and worried following the reports that they have read in the newspapers these past few weeks. Any parent of young children will know quite how much we worry about whether we are doing the best by our sons and daughters. That is why the debate about MMR is so deadly serious. We need to take parents' concerns on MMR seriously. We must take seriously every question raised about any drug or vaccine.

That is exactly why we have referred every single claim or allegation about the safety of the vaccine to committees of experts on both vaccination and the safety of medicines for them to examine in great detail. That is why we referred all the latest Dr. Wakefield allegations to them and why we will investigate any new allegation that is made.

We have gone to great lengths to publish every detail of the advice and to make it as widely available as possible, and sought the views of all the independent health professional bodies with an interest in the area. They have all told us very clearly that MMR remains the safest way of protecting children against deadly diseases. They have found no evidence of any link with autism, even though they have studied all the research--from Finland, Sweden, the north Thames region and Dr. Wakefield. They found that children would be at risk of infection for longer with the single vaccines and that, ultimately, their lives would be at stake.

Those experts have no interest in denying the risk or in putting children's health at risk. They spend their lives trying to improve children's health. We have asked them many times to advise us on this subject, and their advice every time has been the same. We need to take that advice very seriously. Their recommendation on the question of single jabs is clear. They say that to introduce a programme of single jabs on the NHS would be less safe than MMR, and would put children's lives at risk.

My right hon. Friend the Secretary of State referred to the case of whooping cough vaccine in the 1970s. The then Government introduced to the NHS a less safe alternative in response to scares about the pertussis component of the DTP vaccine, even though those scares proved unfounded. When the alternative was offered on the NHS--and effectively endorsed by it--everyone opted for it. They felt that, because the NHS was endorsing the alternative, it therefore must be the safest option for their children. The result was that there were 200,000 cases of whooping cough, and 100 deaths.

Exact comparison can never be made between decisions taken on previous occasions with regard to different vaccines. Every case is different and must be considered on its merits, taking into consideration the evidence from the experts. However, we have an obligation to listen to the advice that we are given as well as to the anxieties expressed by parents.

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If we ignored that expert advice and, on the basis of no evidence, endorsed on the NHS an alternative that the medical experts say would risk children's lives, we would be betraying parents and children. As a parent, I would feel betrayed by the NHS and by the health professionals that let such a thing happen.

Miss Kirkbride: I respect what the Minister has said and accept her point about the NHS, although I should prefer her to change the way in which she approaches the problem. However, why do not the Government allow the private clinics that offer the separate vaccines to proceed? Why have the Government clamped down on those clinics' ability to make the licensed vaccines available?

Yvette Cooper: There is no clampdown. Under the Medicines Acts, the Medicines Control Agency has an obligation to ensure that unlicensed products are supplied according to very strict rules, because there is a serious concern to prevent unlicensed products that may be unsafe from being improperly supplied. The single vaccines available for use in the UK are unlicensed. They have not been through the MCA's safety checks.

I welcome the more measured tone displayed today by the hon. Members for Woodspring and for Runnymede and Weybridge (Mr. Hammond), but the media have not received their comments in the same way--and they know it. My hon. Friend the Member for Slough (Fiona Mactaggart) gave the very clear example of a person who came to her constituency surgery and said that the single jabs must be better "because the man on the telly--Liam Fox--said so, and he's a doctor, isn't he?"

I have listened to what Conservative Members have said in the debate. They have been carefully dancing around the issue, but they know the medical evidence well. They also know well how their remarks are being interpreted, in the media and by parents. I caution them over their apparent promotion of single jabs as a safer alternative, because they know that that is how their remarks are being interpreted.

Judy Mallaber: Did my hon. Friend the Minister note that, when one newspaper tried to raise a scare about the meningitis C programme, no other newspaper picked it up? That was because no one jumped on the bandwagon, with the result that the story was killed. However, the scare this time is being recycled time and time again. Does she agree that that must be because comments by other people are being used to support some of those fears?

Yvette Cooper: I acknowledge my hon. Friend's remarks. We all know that as parents we are very susceptible to worrying dreadfully about whether or not we are doing the best for our children. That is exactly why as politicians we have a responsibility not to manipulate parents' fears and to make sure that we give them absolutely accurate information--as much information as possible, but also access to the proper medical advice.

Mr. Hammond: I should like to give the hon. Lady, as a token of my commitment to the triple vaccine, the information that all three of my children aged under seven

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have been vaccinated with the triple-dose vaccine. That is the best commitment I can give the hon. Lady in public and on record.

Yvette Cooper: I am glad to hear that endorsement of the safety of the MMR vaccine. It clearly accords with what the medical experts and advisers are telling us.

All of us in the House have to be very careful about playing politics and trying to pronounce as politicians on the safety of medicines and on the safety of vaccinations. As many hon. Members have said, in this area as a result of previous health scares, and in particular the BSE issue, what politicians say is not necessarily taken seriously by the public, and certainly not by the media.

There are broader public health matters that I wish briefly to turn to, issues that many hon. Members have mentioned. Public health is about so much more than communicable disease. My hon. Friend the Member for Nottingham, East (Mr. Heppell) is absolutely right: the big killers in this country are cancer and heart disease, and the biggest public health issue is addressing the health inequalities that underlie the big killers.

The gap in life expectancy between rich and poor rose between the late 1970s and the mid-1990s, for men from 7.5 years to 9.5 years and for women from 5 years to 6.5 years. Those health inequalities have grown worse. That is a public health tragedy and outrage.

The hon. Member for Bromsgrove said that the gap was because the men all worked down the mines, and Labour should not have opposed closing the pits. I find it absolutely astonishing that the devastation of the coalfield community should be described as a positive public health measure. Does the hon. Lady have any idea of the impact on the health of entire communities suffering unemployment, poor and crumbling mining communities where depression and drug abuse are rife? What she said shows shocking ignorance about the public health problems that face this country.

This Government have set in place an entire programme to tackle all the dimensions of public health. The NHS plan and the White Paper on saving lives are to tackle the most deep-rooted causes of the problems. Perhaps the most important thing that we can do to improve public health is to meet our target to abolish child poverty. No other measure will do more to improve public health.

I should like to return to a point raised by my hon. Friend the Member for Corby (Mr. Hope) about the programme sure start. Sure start is perhaps the most important public health programme that we have. It will involve eventually spending £500 million a year on families with children under four in low-income areas, improving their access to health care, education and child care, and delivering what local parents want. My hon. Friend asked the Opposition whether they would match our spending on sure start, and they would not answer. They said that they would match our spending on health, but they have not said they will match our spending on sure start. On the biggest measure to tackle public health that we are introducing across this Government, for them not to be able to make a commitment to back sure start, providing health for families across the country, shows a pretty weak commitment to tackling public health.

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The Government believe that at the beginning of the 21st century it is morally wrong that our chances of a healthy life still depend on who we are, where we were born, what our parents do and how much they earn. Under the previous Government, health inequalities and child poverty rose. This Government are determined to bring health inequalities down and to tackle the fundamental, immoral divisions in our society. We will bring them down--a return to a Tory Government would push those health inequalities back up again. That would be a public health tragedy.

Question put, That the original words stand part of the Question:--

The House divided: Ayes 135, Noes 317.

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