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House of Lords

Thursday, 28th January 1999.

The House met at three of the clock: The LORD CHANCELLOR on the Woolsack.

Prayers--Read by the Lord Bishop of Norwich.


Baroness Masham of Ilton asked Her Majesty's Government:

    Whether there are sufficient facilities and expertise to provide for patients suffering from meningitis; and whether the level of research being carried out into the causes of meningitis is appropriate.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Hayman): My Lords, effective treatment of meningitis requires prompt and accurate diagnosis by front-line staff, backed up by appropriate specialist support. That is why the Chief Medical Officer wrote again last week to all doctors reminding them of the key features of meningococcal disease and how suspected cases should be treated.

Much research is already being undertaken into the causes of meningitis. Additionally, the Government give priority to research into prevention. The Department of Health has been funding research over recent years into new vaccines and has recently added an extra £1 million to accelerate that research.

Baroness Masham of Ilton: My Lords, I thank the Minister for that reply. Is she aware that there is intense anxiety up and down the country, from the very tip of the north of Scotland, where children have died, to the south of England? Does she agree that there are insufficient intensive care beds? It is tragic that seriously ill patients have to be shuffled around the country.

Baroness Hayman: My Lords, I certainly agree with the noble Baroness that there has been great anxiety because of the absolute urgency of prompt diagnosis. It is a particularly worrying disease for parents. The paediatric intensive care system in this country is better equipped to cope now than it ever has been in the past. The Government have acted on the review with which they were presented when they came into office and have expanded facilities and put more money into them. Because of the specialist nature of the services, it is not appropriate and it would not be right to have them available at every district general hospital or with every paediatric unit. Therefore, it is extremely important that we have the necessary retrieval services so that very sick children can be transported safely. We are taking action to ensure that that is happening in every region.

Lord Astor of Hever: My Lords, when does the Minister expect to have the results of trials of the new conjugate vaccine against meningitis C?

Baroness Hayman: My Lords, I am afraid that I cannot give the noble Lord a precise date for that. As

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I said in my earlier Answer, we are greatly encouraged by the progress of research into that vaccine. The current C vaccine is not appropriate for wide-scale use. The collaborative research in which we are taking part suggests that we are very close to producing something. Obviously, we must wait for the completion of the studies. There are licensing, manufacturing and resource issues. But Britain is leading the world in that research and the situation is looking extremely hopeful at present.

Lord Clement-Jones: My Lords, I welcome many aspects of the Minister's reply, particularly as the father of a small child. Is the Minister satisfied that there is adequate public education about the warning signs of meningitis? Furthermore, is she satisfied, particularly in the light of the report of this House to which the Government have responded, that all steps are being taken to ensure that current antibiotics retain their effectiveness?

Baroness Hayman: My Lords, the noble Lord rightly pinpoints the importance of general policy on antibiotics because in this situation antibiotic treatment is effective and it is very important that it is given promptly.

As regards public information, within the Department of Health we work collaboratively with the voluntary organisations which are particularly active in that field in trying to give advice to parents and, in particular, to the teenage generation who are at risk. There has been an extremely effective campaign on campuses to alert young people to the signs and symptoms of meningitis. We have all had illustrated to us recently how crucially effective an individual's knowledge of the signs and symptoms of the disease can be in averting tragedy.

Lord Morris of Manchester: My Lords, there have been many press reports on some distressing cases over the past year. Is there any comparative information about previous years which my noble friend can give the House?

Baroness Hayman: My Lords, my noble friend points out that there have been press reports, as, indeed, there are every winter because we tend to see a winter peak of meningococcal infection. As far as we can tell from this year's figures, they are not particularly out of line with those of the past two or three years. There was an increase which was steeper than we would normally expect in the first two weeks of the year. I am glad to say that the number of notifications for the third week in January has actually gone down.

Baroness Gardner of Parkes: My Lords, is the Minister aware of the work of the Meningitis Trust based in Stroud, where the first publicly acknowledged cluster of cases occurred, following which the trust was set up? Does she acknowledge that it plays a valuable role in both an informative and supportive way?

Baroness Hayman: My Lords, I recognise the role that both the Meningitis Trust and the Meningitis Research Foundation play in this field. Indeed, my colleague, Tessa Jowell, opened a counselling suite at

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the Meningitis Trust last week. Many parents have been very grateful for the advice that they received from those organisations.

Baroness Ludford: My Lords, is the Minister aware that one area of concern is when professionals do not believe parents when they say that their children are ill, especially because time is of the essence? Will she issue guidance on that matter to professionals in the health service? The noble Baroness talked about individuals recognising the symptoms; in the case of small children, that would be the parents. Can guidance be issued to professionals on that matter?

Baroness Hayman: My Lords, it is not appropriate for me to do so, but the Chief Medical Officer wrote to professionals in January, as he writes every year. This year he was highlighting the key signs to look for not only to GPs, but also, which is as crucially important, to those working in A&E departments who may be presented with a sick child. Action therefore is being taken on that front.

Lord Rea: My Lords, following my noble friend's earlier answer on vaccine development, can she tell us about vaccines against the B type meningococcus, which is one of the major causes of recent outbreaks? In that work, are we collaborating scientifically with Cuba whose microbiologists produced the best vaccine so far available against that specific variety of the organism?

Baroness Hayman: My Lords, the research to which I referred earlier related to meningitis C rather than meningitis B. The research on the B organism is less well developed. We are collaborating with Dutch national vaccine manufacturers to develop and evaluate a group B vaccine. Though I am aware of Cuba's success--indeed, the Department of Health met with officials from the Cuban Ministry of Health--as I understand it, the Cuban vaccine, which is extremely efficacious in Cuba, has not been so effective in other countries, especially in young children, as it is formulated against a different strain of the B organism than that which we encounter in this country.

The Earl of Dudley: My Lords, I have some personal experience of the relevance of this Question. Can the noble Baroness say what action is being taken by the public health authorities to identify possible contacts with carriers in the event of an outbreak?

Baroness Hayman: My Lords, I am not certain that anything is done by the Public Health Laboratory Service in that regard. It is particularly crucial, because of the nature of outbreaks in circumstances where young people are often away from home and living in communal facilities for the first time, for universities and colleges to be aware of the need to work collaboratively with health authorities if

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individual cases occur in a school or college so that proper, effective measures can be taken. We have a vaccine which will work for the short term, but it is not effective for long-term immunisation

Nuclear Weapons

3.17 p.m.

Lord Jenkins of Putney asked Her Majesty's Government:

    Whether their two policies of maintaining the nuclear deterrent and eliminating nuclear weapons are consistent, and whether their vote for the former at the United Nations was in conflict with the latter.

The Parliamentary Under-Secretary of State, Foreign and Commonwealth Office (Baroness Symons of Vernham Dean): My Lords, as the Strategic Defence Review made clear, the Government wish to see a safer world in which there is no place for nuclear weapons. We have promised to retain Trident as the ultimate guarantee of our national security, while pressing for multilateral negotiations towards balanced and verifiable reductions in nuclear weapons. We have made absolutely clear that when we are satisfied with progress we will ensure that British nuclear weapons are included in negotiations.

There is no inconsistency in this approach, nor have any votes we have recently cast at the United Nations been in conflict with it.

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