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Lord Brennan: My Lords, before the noble Lord sits down, perhaps I may invite him to agree that it is important in a debate such as this that unreasonably high hopes are not sent out to the affected parents. Is he really suggesting that the problem which we face should be dealt with by full compensation, which, on my calculation, would amount to between £1.5 billion and £2 billion? That is beyond the means of any competent government.
Lord Clement-Jones: My Lords, that is a very fair question. My view is yes. If one accepts that there is compensation to be paid, one has to come up with a scheme that provides an income for the severely disabled children so that they are able to cope when their parents are no longer able to care for them. It was perfectly possible to do so in the case of the thalidomide children. It is perfectly possible to envisage a scheme--perhaps a trust fund rather than individual forms of compensation--where a lump sum could be paid from which these parents could derive an income. Obviously the income that they derive from that scheme would depend on the level of disability of their children.
This is not a question of raising hopes. It is a matter of wishing to see justice done in these circumstances. If a court had awarded these children compensation, the types of payment that I have suggested would not be outlandish; they would be entirely appropriate.
Earl Howe: My Lords, yesterday's announcement on the improvements to the vaccine damage payment scheme was extremely welcome. Even though it pre-empted much of what I was going to say today, perhaps I may take a few minutes to ask the Minister some questions and cover some of the important issues arising from the announcement.
First, however, I should like to set out a little of the background to this issue. If one looks back over the past quarter of a century at any of the important political crusades relating to the needs of the disabled, the name of the noble Lord, Lord Ashley, is almost certain to be closely associated with it. There can be few better examples of that association than the issue which the noble Lord has brought to the House this evening. It was through his efforts in another place in the late 1970s that the Vaccine Damage Payments Act 1979 came into being. That legislation was welcomed at the time as a recognition of a moral duty on the part of the state to provide financial assistance to those children who had suffered severe physical or mental damage as a result of being vaccinated.
As stated by other noble Lords, the scheme was never billed as being a form of compensation in the normal sense of the term, nor indeed did it carry any implication of public negligence. Rather, it was an implicit acknowledgement by the state that in any programme of mass vaccination, whether it be for measles, mumps, polio, whooping cough or for a range of other serious diseases, there will be a very tiny percentage of children who experience unpredictable adverse consequences. For some, those consequences are minor and transient. For others, they are truly devastating.
Traditionally, damage that arises from non-negligent accidents occurring in the NHS has not given rise to any form of state payment, but in one important respect the damage that stems from vaccination is different from other damage. Vaccination does not simply benefit the individual who receives it. It is the state which says that parents should immunise their children because it is for the common good that life-threatening diseases should not be spread around the general population. The state encourages vaccination even though it is known--notwithstanding the no doubt legally secure position of the noble Lord, Lord Brennan--that a very few individuals will suffer a serious and irremediable adverse reaction.
But paying those individuals from public money is not simply a recognition that they have suffered for the general good. There is another dimension; namely, that any immunisation programme depends for its success on a certain level of take-up. Once the take-up rate falls below a critical figure the risk of an epidemic becomes a very real one. It is obvious that unless the
I believe that all political parties have a duty to join forces on a policy of this importance--resting our case on the basis of the scientific evidence, which is firm. But confidence has a number of buttresses. The Government can also protect their vaccination programmes if parents of children know that in those few cases which lead to tragedy a scheme is in place that will provide a worthwhile measure of financial support.
That is why yesterday's announcement, coming as it did after two years of deliberation by the Government, was so welcome. I shall not carp too loudly at the time it took for the Statement to arrive, knowing as I do something of the frustrations of trying to secure inter-departmental agreement on such matters. In any event, I hope that the retrospective element in the new package will do something to assuage those who feel, in the words of the Minister in another place, Mr Bayley, that,
Had yesterday's Statement not been made, there were two changes in particular that I would have asked the Government to introduce. The first was to abolish the six-year limit for making claims. That has effectively been done and I congratulate the Government on it. The second was to bring down the disability threshold from the level of 80 per cent and to introduce a sliding scale of payments for disability assessed at below that level. That is the request that has been made by the Vaccine Victims Support Group, whose patience and dignity I think we must all applaud and respect. It is a proposal which seems to me to be entirely equitable. The change proposed by the Government to bring the threshold down to 60 per cent will mean that anyone with damage assessed at below that level will receive nothing. I ask the Government why they believe that that is a fair way to proceed. Even at this juncture, I hope that they will be prepared to reconsider the issue.
I wonder if the Minister can clarify one or two other points in relation to the primary legislation that we understand will be needed for both of these measures? First, when do the Government propose to introduce the necessary Bill? It need only be a short Bill. I give the assurance that we on this side of the House will co-operate with the Government fully when it appears.
Secondly, can the Minister tell us a little more about the retrospective element of the announcement? If the threshold is to come down from 80 per cent, does that leave the way open for individuals whose claims were rejected because they did not come up to that level to re-open their claims? Similarly, will it now be possible for those who had their claims turned aside because
Perhaps I may add my welcome to the significant uprating of the sum payable to those who have suffered severe damage from vaccination. The figure of £100,000 is not a king's ransom, but it is an order of money that more realistically reflects the burdens suffered by victims and their families than does the current level of payment. Can the Minister say whether the appropriate regulations will be laid before the Summer Recess?
I should also like to ask the Minister about research. The extraordinary discoveries announced this week on the mapping of the human genome may one day enable scientists to predict which children have a genetic susceptibility to an adverse reaction from vaccinations. However, can the Minister say what research is currently under way into the formulation of improved vaccines and into efforts to minimise the terrible adverse reactions that we have been debating?
I conclude by asking the Minister whether she will take this opportunity to reaffirm the Government's policy on childhood immunisation? On this important issue, do the Government agree with me that party politics should be put aside? Indeed, will they consider entering a joint campaign with the Opposition to promote vaccination as an essential public health measure? I hope, too, that the Minister will take the opportunity to reassure the House today that all vaccines approved for use in this country are rigorously tested to the highest standards of safety, quality and efficacy? That is a message that bears repeating often, as does the warning that, were a vaccination programme to fail through lack of adequate take-up, it could lead to consequences as devastating in their severity as those that have been referred to this evening, but for a very much more numerous cohort of children.
The Parliamentary Under-Secretary of State, Department of Social Security (Baroness Hollis of Heigham): My Lords, I am delighted that the Government's measures have received a warm welcome tonight. Substantially, the measures owe much to the delicate, subtle and hesitant persuasion brought to bear on Labour Ministers by my noble friend Lord Ashley. I am very pleased that the whole House recognises the role played by my noble friend in achieving these results.
Perhaps I may begin by setting out a little of the background to the review of the scheme. Soon after the present Government came to power, Ministers were approached by various groups and by the newly-formed All-Party Group on Vaccine Damage. We were asked how we would review the scheme. At the time, I had responsibility for disability issues as well as children's issues. I announced that a review would be undertaken, in consultation with the Department of Health, as part of our overall review of welfare.
Since that time, various meetings have taken place between myself and members of the all-party group, along with members of the parents' groups who have so eloquently presented their case. These groups included the Association of Parents of Vaccine Damaged Children, the British Polio Fellowship, the Justice, Awareness and Basic Support Group (JABS), and the Vaccine Victims Support Group. This afternoon, the Vaccine Victims Support Group held a well-attended lobby in the Grand Committee Room, and I believe that my noble friend was present.
The groups raised a number of issues with us. They disagreed on some, but the five principal issues were the time limit of six years, the 80 per cent threshold, the need for an additional lump sum, an ongoing benefit for those damaged following vaccination, and a contribution from the pharmaceutical industry towards the support of those damaged by vaccines--the point raised by my noble friend Lord Brennan. The groups also raised questions about vaccination incentive payments and the promotion of vaccines.
We promised to look at all those aspects, which is why the matter has taken a long time. We have also, at the behest of parents, contacted the pharmaceutical industry to seek a financial contribution towards the support of this group of vaccine damaged children. Although it was sympathetic to the issues, the industry did not feel it appropriate to become involved--to my regret. I hope that the efforts of my noble friend and others may persuade it to reconsider its position in the future.
In consultation with the Department of Health, we have therefore been carefully examining the nature of the vaccine damage payments scheme and the scope for changes that we might make. That was why, in that context, my right honourable friend the Secretary of State for Social Security, Mr Darling, made the Statement yesterday.
The proposed changes do not represent any changed judgment about the safety of vaccination but simply our view, as I said when we increased the payment in 1998, that it is appropriate, decent and compassionate to implement these changes.
Subject to parliamentary approval of our proposals to pay £100,000 for new claims, we shall effectively be increasing the rate of payment that we inherited by some £70,000. It is a significant increase. In addition, we have listened to the concern of those parents who received £10,000 in the early 1980s and who, as we know, struggle daily under very difficult circumstances. When we last increased the payment in 1998 to £40,000 we said that that amount would more than restore the value of the payment.
At April 2000 rates, £33,000 would have been the equivalent of £10,000 awarded at the start of the scheme. We have therefore decided that it would be only right in this unusual circumstance to consider top-up payments to bring past recipients up to the new £100,000 rate by revaluing their original payments. It is not often that a government make retrospective payments. I am delighted that they are doing so in this case.
This means that, if Parliament approves, those recipients who received £10,000 will receive an additional lump sum payment of £67,000. Those who received £20,000 will receive £62,500. Those who received £30,000 will receive £61,500 and those who received £40,000 will receive a further £58,000. This represents an additional £60 million for the most severely disabled--a very significant sum.
Again, subject to parliamentary approval, we hope to introduce the proposed changes as soon as possible. Perhaps I may make clear my understanding of the timetable. It is our hope that the payment of the new £100,000 will be in place before the Summer Recess. We hope to make the top-up payments to those who have already received sums as soon as possible following the other regulations, but that may take time. Some of the payments were made 30 or 40 years ago; addresses need to be checked; people may have changed addresses and we may have lost contact with them. But subject to those practical limitations, we want to make the top-up payments as soon as possible after the regulations have completed their passage through this House and another place.
The other two aspects of the scheme--the threshold of disability being reduced from 80 per cent to 60 per cent, and the changes in years--require primary legislation. That will be introduced as soon as possible. But primary legislation is not required for the payments; we can make those following regulations, which is a much speedier process.
The £100,000 payments will be treated like the original payments for the purposes of income-related benefits and for the purposes of residential care. They will not disentitle recipients of those benefits. As I said, we also intend to bring about changes to the time limits.
We have decided that in the case of time limits for claiming, we should seek to act within the spirit of the proposals in the Law Commission's recent consultation paper on the limitation of actions. The time limit for making a claim will be amended to three years, although in the case of minors the time will not run out until they have achieved their majority. For young children, who make up the vast majority of VDP claimants, there will therefore be an extended period, up to age 21, in which to make a claim.
As I said, we further propose to reduce the disability threshold from 80 per cent to 60 per cent. It is true that the test of at least 80 per cent disability adopted for the Act was and remains generally recognised as the lower end of the spectrum of severe disability--for example, for severe disablement payments, payments for industrial injuries and the like. Lowering that level might be considered inconsistent. None the less, we have taken heed of representations and we think that a reduction to the level of 60 per cent is justified and, representing as it does a still significant level of disability that was incurred as part of a wider public interest policy, it remains compatible with the original aims of the scheme.
My noble friend Lord Ashley raised a number of specific points. He asked why there was only one award in some years. In most years there are five or six awards, but it is true that in one or two cases--I now know of only a single case-- that was the number who were considered that year to meet the entitlement conditions. Obviously, those figures will now change. We do not know the number, but an approximate estimate is that 20 vaccine damaged children a year presently lose out because of the time limit and will now fall within the provision. Again, we do not know how many lose out by virtue of the 60 per cent, but it is our guess that perhaps a handful a year might, and then maybe some 50 or so cases who were refused because they were disqualified by being below the 80 per cent threshold but above 60 per cent. We shall be inviting those people to reapply and, where we can, to make contact with them.
My noble friend's second question--a point also raised by the noble Earl, Lord Howe--related to claims made 30 or 40 years previously. As I say, we aim to make the new provisions fair to people who missed out in the past and who may qualify under the new rules. We cannot say exactly what the position will be. We are carefully considering these points. If my noble friend has a particular case in mind that would fall outside the 21-year cut-off point, we should like to follow that up. Perhaps my noble friend will write to me.
One question which my noble friend did not ask but on which I may be able to bring good news is that, where a child has already died, the department will be considering top-up payments. That is perhaps more generous than my noble friend anticipated.
I hope that I have addressed my noble friend's third question relating to someone in local authority residential accommodation. Similar rules apply in charging regimes for local authority residential accommodation to those that apply to income support: the amounts of payments made into a trust fund or under court supervision are disregarded. I am happy to place those words on the record.
My noble friend Lord Brennan asked whether there would be a nominated or named official as an information point. We have not made provision for that at present. We will take the point away and consider it. Clearly, it is important that families know whom to contact, as well as having the literature. The possibility of a website was raised. We shall pursue those kinds of questions to see how we can be helpful.
The noble Lord, Lord Clement-Jones, raised a point about retrospection. I hope I have dealt with that. Anyone who applied and was disallowed because he or she was below the threshold will be invited to reapply and have the claim reassessed. If there are delays, it will be because we do not necessarily know any changes of address, given that the previous payments were made 15, 20 or 25 years ago.
I sincerely join in the wise words of the noble Earl, Lord Howe, when he gently chastised the noble Lord, Lord Clement-Jones, in terms of his policy towards vaccination and his suggestion that he might consider not exposing his own child to MMR vaccine. I could not repeat more strongly than the noble Earl, Lord Howe, that there is no scientific evidence whatever in a series of highly regarded reports, including the Thames survey, which was done fairly recently, to show that there is any connection between MMR and Crohn's disease or inflammatory bowel disease. It is simply not the case. There have been repeated studies in this country and in the US and elsewhere abroad showing that there is no such connection.
It is the case that children may develop those diseases, and may do so at the same age as that at which they are having their vaccination. It is a correlation, but no causal connection has been established.
The alternative, which is to expose children to those illnesses, is very serious. I should like to give the noble Lord some information about what happened when there were similar scares relating to whooping cough, percussis. Before the introduction of a vaccine in the 1950s major epidemics of whooping cough were frequent, with the annual notification exceeding 100,000 year. After the introduction of immunisation against whooping cough it fell in the 1970s to about 2,500 a year. However, following public and professional anxiety about the vaccine, anxiety that was proved to be unfounded, there was a marked decline in vaccine acceptance from over 80 per cent to around 30 per cent. The number of susceptible children rose, and in the 12 years after 1976 three major whooping cough epidemics accounted nationally for over 300,000 notifications and at least 70 deaths. The fears became the reality.
If I may so put it, nobody has the right to--I do not want to say "freeload", because that sounds wrong--rely on other people having the vaccine given to their children, believing that as a result they do not need to have their own children vaccinated. They are, so to speak, piggy-backing on the moral generosity of others. I want to put it strongly, because only one medical risk has been established. That is with the polio vaccine, which is one in a million. In no other cases is there any risk, but we know that the risk of the disease can be extremely serious. Any contribution from a Front Bench spokesman will be taken seriously. A suggestion that there is a serious question as to whether one should not have that vaccine can only add
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