MULTIPLE SCLEROSIS (TREATMENT) (Hansard, 27 February 1963)

§ Mr. H. Hynd (Accrington)

I am grateful to you, Mr. Speaker, for giving me this opportunity, even at such a late hour, to bring forward the subject of the treatment of multiple sclerosis. I apologise to the Minister for keeping him out of his bed, but I hope that he will be able to tell us something interesting.

My purpose is to give the Minister an opportunity of clarifying the present position and to enable him, I hope, to give a word of comfort to the people who are so unfortunate as to suffer from this dread disease. Their number in this country is, I believe, at least 40,000. There is no need for me to dwell on the seriousness of this disease to the people who suffer from it and to their dependants.

1406 A Multiple Sclerosis Society has been formed to try to deal with the subject, and several organisations have been set up by the sufferers themselves in various parts of the country. No doubt other hon. Members like myself have received inquiries about the matter over a long period, and I am bound to say that the situation is somewhat obscure. That is why I hope it will be cleared up to some extent this evening.

For about two years I have been trying to find out just exactly what is happening and what the Government are doing about this subject. In reply to Questions which I have asked in the House I have received the usual curt Answers. We are, of course, used to curt Answers from the Government Front Bench. The Answers which I received were undoubtedly incomplete—I might say ambiguous. Indeed, I might almost say that they were equivocal, but perhaps we can compromise on the current adjective and call them dusty answers.

I wonder why the Minister has not been more forthright in telling the House just exactly what the position is. The net result, as far as I have been able to gather—and this is from the Answer I received from the Parliamentary Secretary on 28th January—is that there is at present no effective specific treatment for this disease. That seems to be the position to date.

Two years ago my attention was drawn to an alleged cure by a Dr. Le Gac of the Pasteur Institute in Paris. I believe there is another institute in Belgium, under a Dr. Wuffaert, which gives treatment at rather high cost, I understand, to people from all over the world. I asked about the possibility of British patients being sent overseas for this treatment as there was apparently no possibility of their getting treatment in this country.

The Parliamentary Secretary of that time told me in a letter of 3rd May, 1961, that there was no need for that because All the drugs and facilities that may be needed for this treatment are available in this country, and that Any doctor can try the treatment. In my innocence I accepted that as being satisfactory, feeling for the moment 1407 until 1 read the correspondence later that what it said was that there was no treatment in this country but that, if any doctor cared to try it, it was available in the hospitals or at least the drugs and appliances were available in the hospitals. I did not then notice that the Parliamentary Secretary had omitted to say that that treatment involved a period in a hospital and that, as current British medical opinion did not agree that this treatment was efficacious, hospital treatment was not in fact available. I suppose that I ought to have read the letter more carefully, but it certainly misled me.

There is no doubt that there are conflicting reports about the treatment being given on the Continent, but, as one of these bodies set up by sufferers from this disease in this country, calling itself "Multiple Sclerosis Treatment Investigation Ltd.", had offered some volunteer patients to act as guinea pigs for this treatment, I asked again whether some of these patients could not be sent either to Paris or to Belgium to try the treatment as an experiment, as nothing was being done here. The answer I got was that there is no power to pay for treatment outside the National Health Service.

That reply puzzled me because my attention had been drawn to an Agreement signed at Strasbourg on 14th May of last year. It is called the "European Agreement on Mutual Assistance in the Matter of Special Medical Treatments and Climatic Facilities". It says that, if people are unable to obtain appropriate treatment in their country of residence, they can be sent to another country. They can be admitted to medical establishments or spas in another contracting country, so as to have treatment that they need which is not available in the territory of the contracting party where they reside. When I asked the Minister about this he gave me the surprising answer that it does not apply to this country. To say that I was surprised by that answer puts it mildly. I think I can say that I was flabbergasted because, if it does not apply to this country, why was the Agreement signed by this country? That is what I cannot understand. Anyhow, that all adds up to the fact that apparently there is no hope up to that point.

What of the future? The sufferers themselves made another effort. They 1408 subscribed together and paid the expenses of a British virologist to go to Belgium to investigate this treatment. I gather that when this gentleman returned he was able to give certain information which has led to further research taking place in this country. The Parliamentary Secretary for Science gave me an Answer on 4th December last in which he said that research is going on supported by funds from the Medical Research Council and by contributions from the Multiple Sclerosis Society, the Nuffield Foundation and other charities. That opens up a rather wider question as to just what research is going on and how it is being financed.

About an hour ago on television my right hon. Friend the Leader of the Opposition spoke about research in this country being on a shoe-string. When I heard those remarks I immediately began to wonder if that applied to this subject. Is research into multiple sclerosis going on at a sufficient rate? Is it limited by financial considerations? Is multiple sclerosis being regarded as the Cinderella of medical research or is it getting its full importance? When the Government cut down the funds of the University Grants Committee last year, did that mean a cutting down of the funds available for research, and, if so, has that affected the amount of research being done on multiple sclerosis?

This week two important articles appeared in the Daily Herald on the subject of medical research. I will refer to one of them because it deals with a unit in a famous London teaching hospital and gives a list of the sources from which its funds for medical research are obtained. It stated: … out of £33,000 the British Government are contributing only £8,500. A professor is quoted as having said: Without American money I would have to shut up shop. I regard that as unsatisfactory. We all agree that prevention is better—and, I would add, cheaper—than cure.

I would, therefore, like some assurance that research on multiple sclerosis is receiving some measure of priority. Will the Minister state as clearly and as fully as possible just what the Government are doing to help to find a cure for this dreaded disease? Am I correct in think- 1409 ing that there is no proper treatment available now in this country or for British people abroad? Are the Government in touch with the research that is going on in other countries? In short, can the Minister hold out any hope to the thousands of people who are suffering from multiple sclerosis?

§ The Joint Parliamentary Secretary to the Ministry of Health (Mr. Bernard Braine)

I welcome the initiative of the hon. Member for Accrington (Mr. H. Hynd) in seeking tonight this short debate on the facilities at present available in this country for the treatment of multiple sclerosis and, in particular, what is being done by way of research.

It is nearly four years since, in May, 1959, the House last debated this subject; on the initiative of Mr. Keegan, the former hon. Member for Nottingham, South. I recall that my predecessor, in replying to that debate, referred to the lines of research being pursued in our efforts to combat this disease. Let me say at once that it would give me the greatest pleasure if I could tell the House tonight that some striking advance has occurred since then. But, unhappily, this disease continues to defy the efforts of medical science to establish its cause and to provide a specific remedy.

Multiple sclerosis or, as it is sometimes called, disseminated sclerosis, is one of the commonest organic diseases of the nervous system. It may help the House if I devote a few words to its nature and incidence. It usually starts early in adult life. It pursues a varied course of deterioration, followed sometimes by periods of improvement and sometimes ending in permanent paralysis. There is also a mild form of the disease, which is commoner than at one time was thought, in which the disease remains stationary for long periods. Although the disease is progressive in its nature, in the average case the expectation of life after diagnosis is as much as twenty years, which is more than used to be the case. In this country multiple sclerosis is responsible for about 900 deaths a year, but the total number who actually die from the disease and its complications is significantly higher. As for the total number of cases in this country at the present moment, the hon. Gentleman 1410 mentioned a figure; I must say it is not known precisely, but it certainly runs into many thousands.

This disease, although comparatively little known, is therefore rightly regarded as a major scourge and one which must be made to yield to medical science if it is at all humanly possible. I am advised that the consensus of medical opinion is that there is no effective specific treatment for this disease at present. Its causation is wrapped in mystery. The value of the treatment measures which are available to sufferers in this country lies chiefly in the fact that they enable a proportion of them to remain at home or to return home after periods of in-patient treatment in hospital.

As I have explained, the course of the disease is typically erratic. There are periods of remission when the patient's condition is stable or even showing signs of improvement, and it is this which makes it particularly difficult to evaluate new forms of treatment which are put forward from time to time.

The two forms of treatment which have aroused most interest in this country in recent years are the Russian vaccine treatment and the Le Gac method. I know the hon. Gentleman has shown great interest in the latter for some considerable time. Some ten years ago Russian workers reported the isolation of a virus closely related to the rabies virus in cases of multiple sclerosis, and prepared a vaccine from it. This vaccine was investigated by the Medical Research Council at the request of my right hon. Friend the then Minister of Health. I am bound to say that the result was disappointing.

My right hon. Friend was advised that there was no indication of any causal relationship between the virus and the disease of multiple sclerosis. There were no reports of controlled clinical trials of the value of the vaccine and there was no evidence that the vaccine was really of any benefit in alleviating the condition. It is our impression that the Russian scientists themselves have recently become more doubtful of the basis on which this treatment was founded. Nevertheless, limited quantities of the vaccine have been imported into this country by individual patients when their medical advisers have confirmed the diagnosis and 1411 have certified that they will undertake and accept full clinical responsibility for treatment on these lines.

The method developed by Dr. Le Gac comprises the administration of antibiotic drugs of the broad spectrum type—that is, drugs attacking a wide range of disease agents over a wide front—given in prolonged courses aimed at eradicating a supposed infective cause of the disease. This is coupled with a variety of supporting measures aimed at relieving the symptoms and physical disability of individual patients. These supporting measures comprise drugs and physical treatment such as hydrotherapy and other forms of physiotherapy which are available in this country.

I am advised that no confirmation has been obtained here in Britain of the presence of the infective cause of the disease suggested by Dr. Le Gac. Doctors in this country with special knowledge of multiple sclerosis are fully aware of the clinical and other evidence put forward about his treatment by Dr. Le Gac. Indeed, whenever the Ministry has received inquiries from individuals about the Le Gac method, we have sent particulars, including the original Le Gac publications, to the inquirers. So far, we know of only one doctor in this country—a consultant in physical medicine—who has organised and put in hand treatment on the lines laid down by Dr. Le Gac. This has been a recent development, and treatment of the first patients started only a few weeks ago. It is, therefore, much too early to come to any conclusions. I must say that it is bound to be some time before any conclusions can be drawn, for the reason I gave earlier, namely, that it is difficult to evaluate methods of treatment because of the erratic nature of the course which this disease typically follows.

I have not the least desire to sound discouraging, but I have to tell the hon. Gentleman that neurological specialists working on the problems of multiple sclerosis in this country and on the Continent are fully aware of the methods of the Le Gac treatment and of the claims made for it, and in their opinion it does not offer a cure for the disease. This view is shared by the Multiple Sclerosis Society, whose words on this subject I feel I should quote: 1412 Leading neurological specialists working on the problems of multiple sclerosis in the United Kingdom, France and Belgium are aware of this treatment and of the claims made for it. Their opinion is that it is not effective against multiple sclerosis. The hon. Gentleman has asked me previously in Questions—I think I should refer to this in order to clear the matter up—whether persons suffering from the disease can obtain treatment outside this country. Can the Government help sufferers to get treatment by the Le Gac method or any other method overseas? My right hon. Friend has no powers under the principal National Health Service Act to arrange this. He has powers under the National Health Service Act, 1951, to arrange treatment abroad for persons suffering from respiratory tuberculosis, but this provides no parallel because these arrangements were made because of a temporary shortage of beds here and in the sure knowledge that there were proven methods of treatment available overseas. They were terminated some years ago. While all of us share the hon. Gentleman's natural anxiety that no effort shall be spared to bring relief to those who suffer from this crippling disease, I am sure the House understands that it is not for the Minister of Health to pronounce on forms of treatment or to advise doctors on how they should treat their patients. These are, clearly, matters for medical specialists and for them alone.

In our present state of knowledge about this disease, it is natural and right for the hon. Gentleman to direct our attention to the question of research. Although medical research has not yet managed to provide any pointers to either the cause or the treatment of the disease, a great deal of work is now in hand directed at a number of points of attack. This work is increasing our knowledge of the various branches of medical science where answers to the problems thrown up by the disease may be found, and it shows some signs of promise.

I assure the hon. Gentleman that there is no question of research being conducted on a shoe-string. In the last financial year, the Medical Research Council spent about £12,000 in supporting work directly related to subjects bearing on the disease. That is an advance on the amount of money made 1413 available in earlier years. In the current financial year, it is estimated that expenditure will be very nearly twice as high. In addition to specific research projects which are being directly supported in this way, the Medical Research Council is undertaking a very broadly based programme of fundamental research which may provide leads of value to work on multiple sclerosis.

We are laymen here, and it would serve little purpose if I were to enumerate the various kinds of fundamental research and clinical investigation being conducted now in this field. We are scarcely equipped to evaluate it. But this debate does enable me to say that this is not essentially a problem of money. It is a problem of ideas. No suitable application for a research grant for work in this field has been rejected by the Medical Research Council in recent years, and the Government have made it abundantly clear that any promising line of research will receive adequate financial support from official sources.

In this connection, I should mention that the Multiple Sclerosis Society has been spending increasing amounts on research into the disease. I should also mention the research taking place with the support of university and hospital endowments and with aid from the regional hospital boards at a number of hospitals throughout the country. In addition, during the past few years, the Nuffield Foundation has been making sizeable grants to the Departments of Neurology and Neuropathology at Oxford in respect of a particular line of research.

However, we must face the fact that at present there is no effective specific treatment for the disease, and until such treatment becomes generally available we must ensure that patients have such treatment and facilities as can best help to support them in their condition. In general, patients are best looked after in their familiar home surroundings under the regular care of the family doctor and with specialist assistance provided by the hospital service from time to time.

We are able to do a great deal through the health and welfare services to help patients in their homes, and tribute was paid to this by the Multiple Sclerosis 1414 Society in one of its recent reports. Sufferers from the disease are also eligible for the welfare services provided by the local authorities. Apart from advice and guidance, the loyal authorities can offer a visiting service which can bring comfort and encouragement to disabled persons at home, help with occupational activities for those who are confined to their homes, and also help with the provision of holidays.

I should like to refer to the contribution made by the Society, whose assistance to medical research I have mentioned. Through its branches and groups all over the country, it stimulates mutual help, provides comradeship and brings fresh interests and hope into the lives of those suffering from the disease. Like so many of the dedicated voluntary societies that we have in this country, it does a splendid job, and I think this a good opportunity to pay tribute to it.

Hospital treatment is, of course, available for those who become so disabled as to need specialist and nursing services that only a hospital can effectively provide, or whose circumstances are such that they cannot properly be looked after at home. All general practitioners are able to call upon the services of a general physician or neurologist at a hospital for those of their patients who require specialist treatment or advice.

One of the problems encountered in hospitals has arisen from the fact that while there are comparatively few young chronic sick, a high proportion of them are patients suffering from multiple sclerosis. It is natural that the young chronic sick should wish to be nursed with others of their own age group rather than find themselves in a very small minority among comparatively large numbers of elderly patients in a large hospital. Unfortunately, to bring them all together into special units would often entail their moving away from relatives and friends.

Even so, we have asked the regional hospital boards to find out in each of their areas haw many young chronic sick patients there are and to consider whether they could be grouped together in one or more hospitals. In this way we hope that sufferers from multiple sclerosis and other diseases that disable patients comparatively early in life will he nursed 1415 in congenial company within the hospital service.

As the House will have gathered from what I said, and indeed what the hon. Gentleman said, multiple sclerosis remains one of the most intractable of the diseases with which man is faced. It offers a challenge to medical science, and we can but hope that a break-through will be achieved. It is borne by many with great patience and cheerfulness. Only a few gifted people can join in the great adventure of research which we all so fervently hope will prove fruitful, but I think we all join in saluting the 1416 spirit with which the disease is so bravely met.