SMALLPOX

HC Deb 23 January 1962 vol 652 cc32-7

Mr. K. Robinson (by Private Notice)

asked the Minister of Health whether he will make a statement on the out, break of smallpox.

The Minister of Health (Mr. Enoch Powell)

Five persons infected with smallpox are known to have arrived at London Airport from Pakistan between 16th December and 11th January. All five had valid international certificates of recent revaccination. So far as is known, there have been no secondary cases to date from three of these persons and only one from the fourth.

The fifth was a girl of nine, who had been successfully vaccinated in infancy. She arrived on 16th December, was admitted to the Bradford Children's Hospital on 23rd December with malaria and died on 30th December, with no clinical signs of smallpox, which was deduced on 11th January as soon as secondary cases occurred amongst her contacts in the hospital. Ten of these have been confirmed so far, and two are suspected; four have died.

All known contacts have been vaccinated and placed under medical surveillance.

Mr. Robinson

While thanking the Minister for his statement, may I ask whether he will join us on this side in deploring the exploitation of this unfortunate outbreak in the interests of racial prejudice and in an attempt to justify the Government's Commonwealth Immigrants Bill?

May I ask the right hon. Gentleman some questions arising out of his statement? While we agree that the precautions now in force at points of entry seem both reasonable and adequate, may I ask him why he was so slow to apply these emergency arrangements, since the existence of the epidemic in Pakistan had been known for many weeks and no change was made at London Airport or elsewhere until more than a week after the first diagnosed case in this country?

Can the right hon. Gentleman say why we in Britain do not adhere to the recommended code of procedure of the World Health Organisation? Will he consider, as normal practice in future, demanding an international vaccination certificate from all travellers, without discrimination, who come at least from endemic smallpox areas?

What precautions will the right hon. Gentleman take against the travellers who come not direct from such areas, but via European ports and European capitals, and what can he do against the risk of forged vaccination certificates?

Further, while we on this side would not support the reintroduction of compulsory vaccination and a return to the farcical situation which existed before the Vaccination Acts were repealed, may I ask the right hon. Gentleman whether he is aware that we feel that both he and his predecessors have neglected their opportunities for persuading people to be vaccinated voluntarily?

When the present scare is over, will the right hon. Gentleman use every means in his power to stimulate voluntary vaccination, especially of infants? And, finally, will he confirm that there is in this country sufficient vaccine in stock to meet a real emergency should this, unfortunately, arise?

Mr. Powell

I will try to answer the hon. Gentleman's supplementary questions in the order in which he asked them.

I am not aware of any effort to exploit what is, in any case, a situation which must rightly have attracted public attention and given rise to public anxiety.

Concerning the controls on entry into this country, so far as I know all five people would have entered any other country under the controls which they operate whether or not they were applying Regulation 83 of the international agreement. The controls now in operation are believed to be more stringent than are enforced anywhere else, and they cover people entering this country from Pakistan by indirect as well as by direct routes. They were progressively put into effect as evidence came to hand that re-vaccinations taking place at Karachi were not taking effect in an appreciable number of cases.

With regard to the policy on vaccination, the evidence of recent years is that acceptance rates have broadly been increasing, and I believe that the increased importance which is attached to immunisation, not only against smallpox but against other diseases with which we in this country are much more threatened, will help to increase the degree of immunity against smallpox.

There has at no time been a shortage of vaccine in this country generally, although sudden large demands in particular localities caused temporary difficulties which were promptly overcome. All demands are now being met in full, and over 2½ million doses have been distributed in the last week alone. Reserves and supplies in sight are large.

Dr. D. Johnson

I thank my right hon Friend for his very full statement. Is he aware that there has been no question whatsoever of a colour bar or anything like that on the part of those of us who have been raising this matter? Questions identical to those that the hon. Member for St. Pancras, North (Mr. K. Robinson) has asked were raised, but they were raised a week to ten days ago. Is my right hon. Friend aware that any hesitancy at London Airport properly to inspect people who came in from Pakistan has been due to fear of the accusation about this being a colour bar matter by hon. Members opposite and has been due to delay in introducing a proper health check through a Bill such as that which is at present before the House?

Is my right hon. Friend aware that a complication in the problem is that the figures for vaccination have fallen largely due to the abolition of compulsory vaccination in 1948, combined with anti-vaccination propaganda prior to that in the Socialist movement—for instance, in the writings of Mr. Bernard Shaw? Will my right hon. Friend consider taking steps on both those counts?

Mr. Speaker

Order. I must observe that the same rules govern supplementary questions to Private Notice Questions as supplementary questions to any other Questions. The House has much to do. We cannot have speeches.

Mr. Dugdale

The Minister referred particularly to Bradford, but can he assure the House that all necessary precautions have been taken in the Midlands and the neighbourhood of West Bromwich, where there has been a reported case of smallpox?

Mr. Powell

Yes, Sir, and I should like to take this opportunity of emphasising the great service which the public health authorities and the medical officers of health throughout the country have performed with such promptitude.

Mr. Gower

If, as we all hope, the present outbreak and the anxieties soon pass away, will my right hon. Friend give an assurance that the more stringent safeguards which he has described, not only against smallpox, but against other diseases, will be sustained at all times in the future and that they will not be overlooked?

Mr. Powell

They will certainly not be overlooked. I must, however, tell the House that I do not think that it would be reasonable or practicable, except in special circumstances, to enforce the stringent procedure which is being applied at present.

Mr. Wade

In view of the anxiety which has been felt in certain parts of the country owing to the temporary shortage of supplies of vaccine, may we have an assurance that supplies of vaccine have been available for all suspected contacts?

Mr. Powell

Yes, Sir. The difficulties are entirely related to distribution and I have no reason to doubt that any essential purpose has not been able to be carried out at once.

Mr. Ronald Bell

Is there any power to act in the case of a Pakistani seeking to enter the country if he does not have a valid international vaccination certificate? If he were to refuse vaccination. is there any power to force him to be vaccinated or to refuse him admission?

Mr. Powell

There is no power to force a person to be vaccinated. Isolation in the event of refusal of vaccination can be, and is being, imposed, although to date there has been no case of refusal. Without notice, I would rather not say whether there are any circumstances in which, under the port health regulations, a passenger might be returned to a ship or aircraft, but in general this rests upon measures taken at the port of arrival.

Mr. McLeavy

Is the Minister aware that his tribute to the magnificent work of the doctors and nurses will be very much appreciated in the whole of Yorkshire? When this trouble has died down, will the Minister tell the House what permanent safeguards will be applied in future from a health point of view regarding immigrants to this country?

Mr. Powell

From a health point of view, there is no essential difference between one person and another entering the country and there is no reason in the history of recent years to believe that the normal safeguards which this country applies are inadequate or unsatisfactory.

Mr. K. Robinson

Will the Minister say a word about the serious delay that took place before the more stringent arrangements were introduced at London Airport and elsewhere? Will he, at the same time, confirm that although the current figure of 41 per cent. acceptances for infant vaccinations is not sufficient, it is still considerably higher than the acceptance rate when vaccination under the Vaccination Acts was compulsory?

Mr. Powell

There was great variation over those years, but it is now somewhat higher than the average for the preceding ten or fifteen years. I do not accept that there was serious delay in bringing the present measures into force, because, as I have explained, they are of great stringency and, as far as I know, are unparalleled anywhere in the world. Very clear justification and reason were required before steps were taken to put them into force.

Mr. Callaghan

Is the Minister aware that in Cardiff, last Wednesday afternoon, when thousands of people were offering themselves for general vaccination, the medical officer of health and others of us had to go along the queues and tell them that there was no more vaccine and that general vaccination was to be stopped? Can the Minister imagine the difficulties with which officers of the Health Department of the Cardiff Corporation were faced in that situation? Is there now sufficient vaccine in the country and in the affected areas, such as Bradford and Cardiff, to ensure that anyone who asks for vaccination may be vaccinated in order to safeguard himself from danger?

Mr. Powell

No system of distribution can cope immediately with a sudden large and unforeseen demand in a particular place, but the quantities available are amply adequate and the distribution is rapid. It is inevitable that if there is a sudden rush steps must be taken to secure that the vaccine, in the first few hours, is available first to the cases of priority. I am, however, informed that in all cases the initial delay was rapidly overcome and that at present all demands are being met currently.

Mr. Callaghan

rose—

Mr. Speaker

Order. We must get on.

Mr. Callaghan

May I, Mr. Speaker—

Mr. Speaker

We have a great deal to do.

Mr. Tiley

As I live in Bradford and the Bradford Children's Hospital is in my constituency, I hope, Mr. Speaker, that you will allow me to say a few short sentences in connection with this grave problem.

Mr. Speaker

I am sorry. As far as I know—and I am under no obligation—I have worked through those hon. Members who had Questions on the Order Paper, whether they live in Bradford or elsewhere. We have a great deal to do, however, and, I am sorry to say, we must put a limit to the matter.

Mr. Tiley

Further to that point of order. I wanted, Mr. Speaker, to put a new point which has not been put before.

Mr. Speaker

I have much sympathy with the hon. Member but I hope that he, too, will have sympathy. I have to consider the interests of the House as a whole and we really have a lot to do.

Mr. Tiley

In view of the unsatisfactory answers, I give notice that I shall raise the matter on the Adjournment at the earliest opportunity.