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Dr. Reid: Of course, I cannot respond on an individual case. Any family who found themselves in such a position would obviously seek out every possible avenue for relieving pain, removing symptoms or curing the disease itself—all of us would do that. That is perfectly understandable, but we have not yet found a medically verifiable way of diagnosing or treating this terrible disease.

The hon. Gentleman referred to Pentosan. It is not licensed in the United Kingdom—I do not think that he mentioned that—although it is licensed in the United States as a treatment for cystitis. There can be adverse side effects, such as bleeding, hypersensitivity and a number of others. The most recent advice from the Committee on Safety of Medicines is that there is some very limited evidence from animal studies that Pentosan may be an effective prophylactic agent, although the

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committee also advises that there is no rational basis for describing the drug as a prophylactic. It is not licensed for use in the UK and could thus be prescribed only under a doctor's personal responsibility as an unlicensed treatment.

I do not know about the case described by the hon. Gentleman, but I do not doubt what he says. However, matters are sometimes slightly more complex as we have to consider medical ethics and the advice that we are given, as well as the anguish of individual patients.

Dr. Ian Gibson (Norwich, North) (Lab): I, too, congratulate my right hon. Friend on the alacrity with which he has brought the situation to the attention of the House. More than anything, that will reassure the public that the matter is being looked at seriously. In the interests of that reassurance, has my right hon. Friend left open consideration of the possibility that there may have been separate infection of the two individuals? Will he ask the Food Standards Agency to make a statement about the current position in respect of meat and meat products in this country and their sources? That would further reassure the public that we have that aspect under control.

Dr. Reid: The answer is yes on both points. Although the donor and the recipient were obviously connected through the transfusion of blood, it is possible that each of them was independently infected through meat products rather than through blood. Yes, I shall certainly speak to the FSA to find out what it can do to bolster confidence in our approach in these difficult circumstances and to reduce any over-dramatisation of the evidence.

Mr. Douglas Hogg (Sleaford and North Hykeham) (Con): The right hon. Gentleman will know that one of the problems of determining how large the incidence of CJD will be is uncertainty as to the incubation period. If there is a causal relationship between the donor and the recipient in this case—we know that, if there was such a relationship, there was a six-year incubation period—does not that give us a clearish indication of the incubation period and would not that give some modest encouragement to the belief that we shall not see a very large number of new vCJD cases?

Dr. Reid: There are a number of difficult words in the right hon. and learned Gentleman's question. The first and most difficult is the first word in his question, which was "if". It is true that we are not clear on the incubation period; it is also true that we do not have the method of diagnosis. Today will add further uncertainty to a number of those areas.

As I said earlier, it is also true that the number of incidents that are verifiable by post mortem and through obvious symptoms of vCJD is much lower than some projections at the beginning insisted. We must calmly reflect on today's evidence. I am not sure, within a few days of this being produced, whether we can draw any conclusions on the incubation period. I hear what the right hon. and learned Gentleman says on that matter.

Mr. Dai Havard (Merthyr Tydfil and Rhymney) (Lab): As my right hon. Friend will be aware, I have

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written to him recently about issues related to blood safety, and particularly its usage for cancer patients with anaemia. I have been trying for the past two years to organise initiatives in the House in that regard. There are known questions that need answers. I think that most of the questions that have been asked today relate to issues that have been previously identified. I welcome the idea that there will be changes in clinical practice, particularly in the use of alternatives for cancer patients who have anaemia. I received a letter from the National Institute for Clinical Excellence telling me that it does not know when such an initiative will be started.

A couple of weeks ago, the All Wales Medicines Strategy Group was saying that it was not prepared to advise that alternatives could be used for cancer patients with solid tumours. There are simple and immediate step changes that could be recognised and carried out. I would welcome the opportunity to support my right hon. Friend in dealing with some of the old boys and old girls clubs that stop good practices in the health service, that could be initiated on the back of this activity.

Dr. Reid: I understand both the substance of the problem to which my hon. Friend has referred and the level of commitment that he has brought to campaigning on the issue of EPO. I can only repeat what I said earlier. We referred the matter to the National Institute for Clinical Excellence. We instituted such a body so that we could take these decisions on priorities, and decisions on the availability of treatments as well as on the availability of drugs and equipment, independently of political decisions. I understood that NICE was looking at the matter and that there would be an outcome next year. I do not think that I can advance on that. If my hon. Friend has other information, I shall be prepared to speak to him about it. Both of us will be reassured that NICE will look at the matter expeditiously.

Hywel Williams (Caernarfon) (PC): Will the Secretary of State ensure that there is the highest level of co-operation and information exchange on this difficult issue between NHS Direct in England and NHS Direct in Wales? Many Welsh people live some of the time in England but would normally access services in Wales. However, I have had direct evidence recently that the information held by NHS Direct in England about services in Wales is up to three years old in the written form and is considerably out of date in some respects.

Dr. Reid: We do try to update that information. We shall attempt to ensure that the information available on this subject is as up to date as possible throughout the United Kingdom.

Mr. Andrew Miller (Ellesmere Port and Neston) (Lab): Although this is obviously a tragedy for the families affected, and we are all sympathetic about that, it is important that the matter be kept in perspective. Will my right hon. Friend talk to the chief medical officer about ways of ensuring that the advice and support lines that he sets up are backed by expert help in putting these matters in perspective? We are

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thousands of times more likely to be killed on the roads than to contract vCJD. The matter needs to be put into perspective, especially for the media.

Dr. Reid: I agree with my hon. Friend. The information has been put into the public domain through the House so that everybody can be fully informed and reassured that we are approaching this matter in as open and transparent a fashion as possible. However, it is true that about 24 million units of blood have been made available over the course of recent years and that this is the first case that we have ever found where there is a link between a donor and a recipient as regards vCJD. However, there are other possible ways in which both of them could have been infected. It is not proof of a causal relationship, or that this has been transmitted through blood. I hope that we shall not be in the least complacent. On the other hand, we should not over-dramatise the situation, which could lead to widespread over-concern and panic.

Rev. Martin Smyth (Belfast, South) (UUP): The Secretary of State has put us all in his debt by coming so soon to the House with this information. I welcome it, but with a deal of caution, particularly in terms of incubation. May I press the right hon. Gentleman a little on his answers to the hon. Members for Wakefield (Mr. Hinchliffe) and for South Cambridgeshire (Mr. Lansley), who talked about a new treatment? Over a year ago, I was in touch with the right hon. Gentleman's predecessor about a new treatment, and finally the family had to go to the courts. They got that treatment. The doctor who looked after the patient said that if he were ever diagnosed with vCJD he would want that treatment to be started immediately. If the treatment is available, it is important that it be used immediately following diagnosis. Bearing in mind that many others may yet develop vCJD, I think that researchers should be working more positively. The young man concerned would have died before last Christmas, but he is now at home in the care of his family, showing decided improvement. As he was so far down the road, it is doubtful whether he will ever be completely cured.

Dr. Reid: I am obviously aware of the case that the hon. Gentleman raises. It was in Northern Ireland, as it happened, and there was a subsequent court case. We took cognisance of what was said in that case, and the experience of it, and we arranged for pilot schemes to be carried out. Following the initial success, or apparent success, in treating the patient, we decided last year that we would carry out tests.

I do not think for a moment that we should be irresolute or hesitate in attempting to improve diagnosis or treatment. However, a degree of responsibility at the Government Dispatch Box is necessary. I say to the House that, thus far, none of our efforts has indicated a medically verifiable way of diagnosis or treatment for this disease. For me to indicate otherwise would be to raise hopes to an extent that would not be warranted.


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