§ 11.45 p.m.
§ Mr. Kenneth Lomas (Huddersfield, West)
This will be the second occasion this year that the subject of vaccine-damaged children has been raised. The first occasion was on 31st January by my hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley) who opened his debate by saying:The purpose of this debate is to tear aside the veil of obscurity which has shrouded the 1515 fate of thousands of children, to suggest urgent action aimed at reducing the number of future tragedies, and to offer proposals to compensate those who are severely damaged."— [OFFICIAL REPORT, 31st January 1974; Vol. 867–68, c. 718.]The purpose of this debate, held under a different Government, is to draw attention to the wording of Early-Day Motion No. 70, now signed by more than 50 hon. Members, which reads:That this House is concerned at the lack of statistics concerning vaccine-damaged children: believes that their case for compensation is at least as just as those children suffering as a result of the thalidomide tragedy; and demands an immediate investigation into the problem.The motion has been signed by Members from almost all the parties represented in the House, and therefore I approach the problem on a totally non-political way.
The great tragedy of vaccine-damaged children does not always register as much as it might until Members are made aware of cases in their own constituencies.
I know of two such cases in Hudders-field, West, and there may well be many more, but on 17th May this year I received a letter from Mr. and Mrs. Marsden of 18 Woodhead Road, Lock-wood, Huddersfield. The first paragraph of that letter read:We have a son Christopher, whose date of birth is 13th April 1969. He was a normal healthy child until at the age of 16 months he received a booster injection of diphtheria vaccine, and became ill the same day, being admitted to hospital. He has since spent several periods in different hospitals but he is totally incapacitated and permanently in a state of semi-consciousness with convulsions which occur frequently during both the day and night. We have been informed his condition is due to vaccine damage.I have seen Christopher, and there is no hope of a recovery. The vaccine that damaged his brain has condemned him to permanent immobility, cut off from all human contact.
Mr. and Mrs. Marsden receive a weekly attendance allowance, but that can be no compensation for the damage done to the child and the life of the family.
Let it be clearly understood that my constituents are not against vaccination, but they do believe, as I do, and as do the Association of Parents of Vaccine-Damaged Children, that there should be some compensation from the State when 1516 such tragedies happen. There are already at least six other countries—Holland, Denmark, West Germany, Monaco, Hungary and Japan, which have schemes to help families by way of compensation —so why not Britain?
On 28th June this year I received a letter from the Department of Health and Social Security stating that the Royal Commission on Compensation and Civil Liability was considering the question of compensation for vaccine damage. This is good news, but I doubt whether the Royal Commission has powers of making payments retrospective. I ask the Minister, who is a compassionate man, to comment on this, and also to let me know when I can expect an answer to a letter I sent to him on 17th November asking when the Commission was likely to report. Perhaps my hon. Friend will also say whether there is any possibility of an interim report devoted specifically to the claims of vaccine-damaged children.
Many hon. Members on both sides of the House over a number of years have tried to obtain firm estimates of the number of children damaged by vaccine, but, so far, under both Governments there appears to have been a conspiracy of silence.
One can only guess the number of vaccine-damaged children, but it is certainly around the 500 mark, and the number who suffer minor disability may be many times more. I believe that the House and the nation are entitled to those figures, as this is not a once-for-all occasion as in the other drug case of thalidomide but is happening every year.
In a letter I received dated 17th October 1974 from Mrs. Rosemary Fox, the Secretary of the Association of Parents of Vaccine-Damaged Children, she said:Immunisation is a nationally recommended and vigorously promoted health scheme which confers a great benefit on the majority but which has an element of risk. This risk has fallen, and continues to fall, on a minority of children with disastrous consequences, but no Government has ever felt it necessary to cover the risk. It is argued that, because the benefits of immunisation outweigh the disadvantages, the disadvantages must be accepted by the individual children and their families. This is a grave social injustice".I agree entirely with Mrs. Fox, and I hope that this Government will do something, as a matter of urgency, to put things right.
1517 In 1972, the British Government set up a £3 million fund to aid congenitally handicapped children. Vaccine-damaged children were not eligible for help from this fund for the sole reason that they were normal healthy babies at birth, although many of them today are nothing more than vegetables, still receiving the love, care and affection of their parents.
When a baby is accidentally damaged by vaccine, parents are seldom given any explanation how the injury has arisen. They are merely informed that the child has "brain damage". In most cases parents do not realise what this implies, and they wait hopefully for their child to recover. The child seldom does.
Under the kind of strain parents have to suffer, some marriages break up, and parents suffer nervous breakdowns. The tragedy is that the parents chose vaccination for their own baby in order to protect the child, completely unaware of the risk.
The strain to which I have referred is not confined to the parents. It affects all other children in the household, and these sisters and brothers of the affected child are deprived of a normal childhood as a result. The recognition of the plight of these vaccine-damaged children is long overdue, and I believe that the Government should carry out an immediate investigation of their own.
That immunisation and vaccination will and must continue for the benefit of community health is not in question, but that there is a risk in vaccinations and that this has fallen, and will continue to fall, on a minority of children cannot be disputed. I believe that the Government must act now, and I appeal to the Minister to give an undertaking in line with the early day motion.
Those hon. Members and those people outside the House who read HANSARD who wish to help should write to or get in touch with Mrs. Fox, of the Association of Vaccine-Damaged Children, 2 Church Street, Shipston on Stour, Warwickshire.
I hope that the Government will temper justice with mercy and understanding and do something now to help these unfortunate children and their parents.
§ Mr. Deputy Speaker (Mr. George Thomas)
I understand that the hon. Member has arranged with the Minister, whose agreement is essential, that two of 1518 his hon. Friends may briefly intervene in the debate.
§ 11.57 p.m.
§ Mrs. Joyce Butler (Wood Green)
The Department of Health and Social Security has arranged for blanket national coverage, as it were, of small children by vaccination, but it has made no provision for compensation for those few children who are damaged by vaccination. Why is that? I believe that the Department has a moral responsibility to provide insurance for those who need protection in this way.
I ask my hon. Friend the Under-Secre-tary to bear in mind that tomorrow and in the days to come babies and small children up and down the country will be vaccinated in very large numbers, and they have no insurance and none is proposed to protect those who may become victims of vaccine damage. The numbers may be small. We do not know exactly whether that is so. But even one healthy child damaged by vaccination is a tragedy to its family, and it is a tragedy to the child. As long as one child may be damaged by vaccination, we as a country have a moral responsibility from which we cannot escape. Other countries can make provision for this. Why are we not doing it?
§ 11.58 p.m.
§ Mr. Jim Callaghan (Middleton and Prestwich)
It has been stated that between 1964 and 1971 there were 425 reported cases of adverse reactions to whooping cough vaccination. Of these, 17 died. As these vaccine-damaged children were normal healthy children who were accidentally damaged by a procedure recommended and encouraged by the State, the State should acknowledge the debt due to them.
I know that the present Government are sympathetic to these cases and do not regard them lightly. However, the expression of sympathy needs to take a more practical form for the sake of the children and their families. In all cases the parents of these children are subjected to immense strain, and normal family life is impossible. In addition, enormous expense is incurred and the cost is borne by the parents. Recognition of their plight is long overdue.
That immunisation can continue without the benefit of compensation for 1519 children already damaged, or those who will be damaged in the future, is indefensible.
I suggest that as Holland, Denmark, West Germany, Monaco, Hungary and Japan pay compensation to vaccine-damaged children, we in this country should acknowledge that such compensation is appropriate and long overdue, and that if the immunisation scheme is to continue on a moral basis a compensation scheme is now a matter of urgency. The problems endured by the parents of these children are now so urgently acute that the means must be found to meet the situation.
§ 11.59 p.m.
§ Mr. Ian Percival (Southport) rose——
§ Mr. Deputy Speaker
I presume that the hon. and learned Gentleman has reached agreement with the Minister.
§ The Under-Secretary of State for Health and Social Security (Mr. Alfred Morris) indicated assent.
§ Mr. Percival
I am much obliged to the hon. Gentleman for permitting me to intervene for a moment, because I do not under-estimate the importance of having a full reply to the debate.
I have two brief questions. Having regard to the fact that the acceptance of this vaccination is vigorously promoted, and very properly vigorously promoted, by the Government, although it is clear that there is some risk involved in it, does not the hon. Gentleman feel that it follows that there is a special duty to accept the obligation to compensate those who suffer from that inherent risk?
There is little prospect of the Royal Commission reporting even within a year, so that the time scale for action upon any recommendation coming from the Royal Commission must lie at least two years ahead. Does not the Minister feel that it will not do, though I see the attraction of it, to postpone consideration of action until the Royal Commission reports? Is it not clear that some action must be taken immediately?
§ 12.1 a.m.
§ The Under-Secretary of State for Health and Social Security (Mr. Alfred Morris)
I know how deeply concerned many right hon. and hon. Members on both sides are 1520 about the problem which my hon. Friend the Member for Huddersfield, West (Mr. Lomas) has raised with so much sincerity and force tonight. Naturally, I am grateful also to my hon. Friends the Members for Wood Green (Mrs. Butler) and for Middleton and Prestwich (Mr. Callaghan), as well as to the hon. and learned Member for Southport (Mr. Percival), for what they added in support of the case made by my hon. Friend.
With his customary kindness, my hon. Friend the Member for Huddersfield, West gave me an indication before the debate of the points which he intended to raise. I am glad that he agrees that the gratitude of the whole House is due to our hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley), who first raised this grievous problem in the House by Questions and then in a most important Adjournment debate. My hon. Friend the Member for Stoke-on-Trent, South led a sustained campaign on behalf of these children.
I assure the House that my right hon. Friend and I also feel very deeply about the problem. My right hon. Friend has expressed our concern for the children who are unfortunate victims of vaccine damage, and for their parents, on many occasions both in the House and elsewhere. We have not limited ourselves to expressions of sympathy, as I shall try to explain.
As hon. Members will be aware, the Government are advised on medical aspects of immunisation by the Joint Committee on Vaccination and Immunisation, which is appointed by the Central Health Service Council and Scottish Health Service Planning Council. The joint committee continually reviews the use of existing vaccines and considers the introduction of new vaccines.
For example, in 1968, after careful consideration of all the available facts, it recommended the introduction on a national scale of measles vaccination for all susceptible children between one and 15 years, and, in 1970, the use of rubella vaccine for all girls between their 11th and 14th birthdays. In 1971, the joint committee took the historic decision that, because routine vaccination against smallpox had proved so effective in dealing with the disease, it need no longer be recommended. It reached this decision 1521 after careful consideration of the World Health Organisation's smallpox eradication programme and concluded that the very occasional serious complication in childhood outweighed the likely risk of smallpox in Britain.
At the present time, the joint committee recommends routine vaccination against the following diseases: diphtheria, tetanus, whooping cough, poliomyelitis, measles, tuberculosis and rubella. The success of these immunisation campaigns can be measured by the virtual eradication of such killing and maiming diseases as diphtheria and poliomyelitis. From 1933 to 1942, there were 55,125 notifications of diphtheria and 2,783 deaths in England and Wales, whereas in 1973 provisional figures indicate four notifications and no deaths. In 1955 before immunisation against poliomyelitis was introduced nationally, there were 6,331 notifications and 270 deaths whereas in 1973 provisional figures indicate a total of seven cases and no deaths.
Similarly, whooping cough notifications have declined from 85,000 in 1957 to 2,400 last year and over the same period the number of deaths has dropped from 87 to two. I think my hon. Friends and the hon. and learned Member for South-port will agree that such figures illustrate the value of our immunisation programme and the work that the joint committee is doing.
Unfortunately, as hon. Members are well aware, no immunising procedure is entirely free from risk of ill effects or, as they are technically known, "adverse reactions". They are, however, exceedingly uncommon. Some of these risks can be avoided by recognising contraindications—for example, eczema in the case of smallpox—and care in administering vaccines. Some risks are unpredictable, and to that extent unavoidable in the individual. There is, for example, the exceedingly rare development of paralysis after live poliomyelitis vaccine.
Precise estimates of the degree of risk are difficult to make. Illnesses or disabilities reported as "adverse reactions" may often have another explanation. In the individual patient it is often difficult, if not impossible, to determine whether the illness or disability has been causally related to the immunising procedure. Estimates of rates depend on collecting information on a series of patients and 1522 are influenced by the criteria used for determining a causal relationship.
The balance of benefits and risks from immunisation is kept continually under review, and I can assure my hon. Friends and the hon. and learned Member that all vaccines currently recommended for routine immunisation carry risks substantially less than that of remaining unvaccinated. For instance, the risk of developing serious disorders of the central nervous system as a result of naturally occurring measles is probably at least one hundred times greater than that associated with the present measles vaccine. Likewise, the risk of developing paralysis after live poliomyelitis vaccine is of the order of one in a million or less.
The joint committee has carefully reviewed the hazards on whooping cough vaccination and has reaffirmed its view that it should be continued as a routine procedure. It is known that minor reactions are common and that, very rarely, more serious reactions such as convulsions or other neurological complications can ensue. The committee has stressed that such reactions can be reduced by scrupulous regard of contra-indications to vaccination such as a history of convulsions, epilepsy or other disorders of the central nervous system. The Chief Medical Officer has written to all National Health Service doctors to convey the committee's views.
The fact that these risks exist—as with most other forms of medical treatment— is public knowledge. Parents should discuss the balance of advantage for their children with their doctors. It would be unfortunate if by exaggerating the possible risks, which by any standards are remote, current publicity were to deter parents from accepting for their child a form of protection which might save its life in the future.
My right hon. Friend is advised by another group of experts, the Committee on the Safety of Medicines, on the safety, quality and efficacy of vaccines, as of other medical products. Control is exercised through a system of licensing, but the collection of information about such reactions largely relies on a system of information about such reactions whereby all doctors, dentists and manufacturers have been asked to submit reports of any cases where use of a product may have 1523 harmed a patient. Reports are assessed by doctors experienced in monitoring.
If it appears likely that risks associated with a particular product outweigh possible benefits—or that possible side effects are too serious in relation to the purpose of a product—the committee advises action to see that it is withdrawn from the market, or to restrict its availability in some way. In less serious cases the committee may decide to send a warning to all doctors about adverse reactions which have followed the use of a product. In 1967 doctors were specially reminded about the importance of reporting adverse reactions to vaccines. The information received, however, is insufficient for the purpose of making reliable estimates of the number of severe reactions to vaccination.
While 100 per cent. reporting cannot be expected under any system which requires the voluntary co-operation of so many people, I am satisfied that valuable information is being obtained, much of which can be used to identify new problems as they arise or to highlight the need to initiate new studies of existing problems. I understand that a total of about 170 reports of adverse reactions to vaccines of all types are received each year.
I must reduce the length of my speech. I am deeply apologetic to my hon. Friend, because he has raised a most important matter.
The question of compensation is a difficult one and, as hon. Members will be aware, is the subject of anxious public discussion. In general, I think we would all agree that while a vaccination programme of any kind is carried out for the common benefit of society, its primary purpose is to protect individuals and the fact that there is risk involved makes it no different from many other medical procedures. Clearly also, the implications of compensation for the ill effects of vaccination where there is no question of negligence are very wide in the medical field.
Nor is it by any means easy either to decide whether disability is due to a particular procedure or what the right level of compensation for different disabilities should be. It has, therefore, 1524 been the view of successive Government that the grant of compensation payments in these cases is not possible.
However, much has happened in recent years to alter our ways of looking at problems of this kind and the whole question is under review by the Royal Commission on Compensation and Civil Liability. The Department has seen a report from the Association of Parents of Vaccine-Damaged Children, which has been sent to the Commission, and has itself submitted evidence. I am not at liberty to say what view that evidence takes, but I can repeat what I said at the beginning of my speech, that, with my right hon. Friend, I have deep concern for, as well as the greatest sympathy with, the case for compensation, and have made this clear on a number of occasions.
Any decisions on the matter will have to await the Pearson Commission's Report. I know that the parents of vaccine-damaged children are pressing for an interim report from the commission. This is not, of course, a matter in which my or any other Government Department has any standing, but I have no doubt that the commission will carefully consider the views put to it.
Meanwhile, we do not for one moment forget the heavy burdens created for families in the rare cases where serious ill-effects result. These are recognised in the various benefits that are provided for such families, including the attendance allowance for severely disabled people. This has been extended to include the less severely disabled children since 1st October 1973. From the age of 16 those without an insurance record and unable to earn their own living are normally entitled to benefits under the supplementary benefits scheme designed both to give them an income and to meet special needs. For the disabled adult who can work, the basic provision lies in the special employment services of the Deparmtent of Employment. I appreciate my hon. Friend's point that many of the children who are vaccine damaged are much too severely disabled to work.
On 13th October my right hon. Friend announced major new benefits for the disabled. These will help vaccine-damaged 1525 children and adults, as they will all other groups of handicapped people. There is to be a non-contributory invalidity pension, at £6 per week at present rates, which we propose to introduce in 1975. This will benefit 200,000 people of working age, who because of their disablement have not paid enough stamps to gain entitlement to contributory benefits. There will also be an invalid care allowance of £6 per week at existing levels which will be payable to people who cannot work because they need to look after invalid relatives in receipt of attendance allowance. Payment should commence in 1976.
Another new benefit which will be introduced in 1975 is mobility allowance which will be extended to cover children aged 5 to 16. This allowance, at the rate of £4 a week, is designed to help with the cost of transport of their choice those who cannot walk because of disablement.
1526 I am especially glad that the new allowance is to be payable to severely handicapped children. The whole range of health and social services is as freely available to these families as it is to any other group of handicapped people.
My hon. Friend will be aware of the valuable work undertaken by the Rown-tree Trust in administering the Government-financed Family Fund for handicapped children. At present the resources of the fund are available only to the congenitally handicapped—
§ The Question having been proposed after Ten o'clock on Tuesday evening, and the debate having continued for half an hour, Mr. DEPUTY SPEAKER adjourned the House without Question put, pursuant to the Standing Order.
§ Adjourned at a quarter past Twelve o'clock.