VACCINE-DAMAGED CHILDREN

HC Deb 17 February 1977 vol 926 cc879-90

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Snape.]

11.45 p.m.

Mr. Jack Ashley (Stoke-on-Trent, South)

Behind the call for compensation for vaccine-damaged children lies a story of Government incompetence, neglect and even deceit. Healthy children whose lives have been shattered by blindness, deafness, paralysis or screaming convulsions have been brushed aside by successive Governments. The risks of vaccination have been hidden from their parents. And unsuspecting families have become the tragic victims of crass official ineptitude.

As a result, the whole of the crucial immunisation programme is now in jeopardy. The parents of gravely damaged children are angry at being deceived and are no longer willing to be brushed aside by feeble excuses from a procrastingating Government. Consequently other parents up and down the land are losing faith in all immunisation, thereby risking the health and lives of their children. They are apprehensive about all vaccines and resentful that a Government can advocate an immunisation programme yet shirk their responsibility when things go wrong. They want to know the truth about the risks, however small these happen to be, and an assurance of compensation if damage is to be caused. I want to emphasise my strong support for the immunisation scheme and urge people to support it. The widest publicity should be given to the availability of the double vaccine and the people should be told that they can have the diphtheria-tetanus vaccines without the whooping cough element if they wish.

Despite craftily-worded Government denials, the main beneficiary of the immunisation programme is society. It is not only the individual who benefits but the community at large, through a high level of population immunity, yet the risk is all to the individual. This large social element is completely ignored by the Government in their attempts to wriggle clear of their clear moral responsibilities to pay compensation to damaged children.

The record of successive Governments on the issue of immunisation and compensation is an appalling one. In the late 1940s and early 1950s, clear warnings were given in authoritative medical reports about the possibility of infrequent but serious reactions to the whooping cough vaccine. Yet for many years the Government advocated this vaccine and made no mention of these risks in their circulars to local authorities. Parents were officially given no hints of any dangers whatever.

When I first raised this matter in the House, one Minister loftily replied that it was a moot point how far it was desirable to do more than warn individuals or parents about possible risks when they were exceedingly remote. He did not disclose to the House that he had no idea what the real figures were and, therefore, had no justification for using the word "remote". Thus a policy of deliberate deception of parents was supported on the patronising grounds that Big Brother Government knew best, even though it now transpires that they knew very little.

And what of the present Government? They are working in conjunction with a group of men who labour under the imposing title of the Joint Committee on Immunisation and Vaccination. That committee, in turn, relies to some extent on the Committee on Safety of Medicines. Would you not think, Mr. Deputy Speaker, that with all those officials, not to mention all the advisers at the beck and call of the Secretary of State, the children would be safe?

Parents should be able to sit back and listen to the gospel without a shadow of doubt crossing their minds. They obviously waited with bated breath for the Secretary of State to make his considered official pronouncement in answer to my question last Tuesday.

In that statement my right hon. Friend said that the joint committee, chaired by Professor Sir Charles Stuart-Harris, in whom he said he had complete confidence, had told him that the gains from whooping cough vaccine greatly outweighed the risks. It was also claimed that only two children per year were damaged by whooping cough vaccine. That was a clear and unambiguous statement.

But then the ugly facts of life intruded and made nonsense of those dogmatic claims. My right hon. Friend the Secretary of State and the chairman of the Joint Committee were presumably relying mainly on the fact that only 22 cases of vaccine brain damage were reported to the Committee on Safety of Medicines in the years 1964–75, yet the Department has admitted that the majority of adverse reactions are not reported to the committee by doctors. It has also admitted that its information is insufficient to make reliable estimates. The quotations are available on request. How, then, can it be claimed that only two children a year are brain-damaged by the whooping cough vaccine, especially as there were more cases of vaccine brain damage in one London children's hospital alone in the 11 years 1961–72 than were reported to the Committee on Safety of Medicines by all the doctors in Britain? The truth is that the committee and the Government simply do not know.

The House and parents are entitled to a full public explanation from Sir Charles Stuart-Harris of his statement that the gains of the whooping cough vaccine outweigh the risks, and he must justify it or withdraw it.

But my allegations against Sir Charles go much further than that. He has now, in The Sunday Times, implied that doctors reporting vaccine damage to the Committee on Safety of Medicines are fools or liars. In answer to a question on adverse reaction and death due to vaccines, and reported by doctors, he said that many of them were not likely to have any connection with vaccination. What on earth are parents to make of that? Are all these doctors crazy—or is the chairman of the Joint Committee crazy? How could he make such an allegation? How does he know? When did he make this startling discovery? And what has he done about it? We must have the truth—and it is the job of the Secretary of State to ascertain it by ordering an independent inquiry into the whooping cough vaccine.

But the Secretary of State himself has some answering to do. He told the House that Sir Charles's Joint Committee estimated that an average of four children get brain damage from whooping cough itself each year. Naturally, the House and I took my right hon. Friend at his word. But in the interview which I have quoted, Sir Charles said that he was not consulted over the figure and that he did not provide it. In other words, he is accusing the Secretary of State of misleading the House into thinking that Sir Charles had provided the figures. I do not need to underline the gravity of that charge, made not by me but by the chairman of the Joint Committee. I invite my right hon. Friend to reply.

I also invite my right hon. Friend to confirm that there will be some 20,000 to 30,000 cases of whooping cough next year because it is the fourth year of the cycle, and that chances of a child getting the disease are related more to the children's living conditions than to whether they have been immunised. Will he also confirm that virtually all deaths from whooping cough occur in babies less than a year old, who are too young to be immunised? Equally, if not more important, will he tell all parents that no one can responsibly and positively assure them that the risks of brain damage to their children will be outweighed by the gains, given the present inadequate state of medical knowledge and the present confusion about the statistics? The Joint Committee may have guessed right or wrong, but there is simply no evidence for categorical assertions. If the Secretary of State rejects these invitations and categorically maintains that the gains still outweigh the risks, despite what I have said, he will be saddling himself with a political albatross for life.

My right hon. Friend has already gone on record with reasons for delaying compensation. His two-point sentence about delaying compensation for vaccine damage reads: But this is by no means the only case where medical action can cause unforeseen damage or where Governments have urged people to use some particular part of the Health Service."—[Official Report, 8th February 1977; Vol. 925, c. 1228.] That was disingenuous to the point of total absurdity or political naivety. He can take his choice. I am saying that it is unique in so far as the community benefits and the individual takes all the risks.

The other two excuses for prevarication are that we are waiting for Pearson's Royal Commission on Civil Liability, and that picking off bits of problems would produce glaring anomalies and blatant contradictions. If, however, Pearson decides against compensation for these children the Department cannot possibly reject parliamentary and public opinion which favours it—not even a Department as arrogant, dogmatic and intransigent as this one. If Pearson recommends in favour, it will merely reinforce our case. The only reason for waiting, therefore, is to ingratiate the Secretary of State with the Treasury at the expense of helpless children—a shoddy bargain that no self-respecting Secretary of State should touch with a barge pole.

As for anomalies, they abound already—some of them created by the present Department. There are differential benefits for handicapped people, an industrial injuries scheme, a pneumoconiosis scheme, an occupational sickness scheme, earnings-related benefits and a criminal injuries scheme. While they exist, I suggest that the Secretary of State refrains from using anomalies as a delaying tactic for not granting compensation to vaccine-damaged children.

Six other countries already have compensation schemes. Although they vary, they boldly accept the principle that terrifies this Government. We should have given a lead to the world, but we failed. At least we can follow as gracefully as possible without being dragged kicking and screaming into the arena of genuine compassion.

The Secretary of State has all the cards in his hands in fighting a few hundred helpless children. He has a powerful Department, scores of advisers, a determined Treasury, and Government colleagues who will support him in the Cabinet. He may well have been advised—or have decided that if he digs his heels in, and, of course, makes sympathetic noises the storm will blow itself out, that he will emerge politically unscathed and that he is bound to win in the end. If that is what he really thinks, I suggest that he should think again.

12 midnight.

The Secretary of State for Social Services (Mr. David Ennals)

My hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley) spoke with some passion. I expect that of him. He accused me and my Department of being arrogant and dogmatic. I have rarely heard a presentation of a case which was itself more arrogant and dogmatic than were the words used by my hon. Friend, and I regret that that should have happened.

I am surprised that my hon. Friend assumes that I have any less compassion or understanding than he has, or imagines that I care less than he does. My experience in the period when I was out of Parliament gives the lie to that. I am also surprised that he should assume that somehow or other he is right and that my Department, my advisers and I are all wrong—and, indeed, that the Joint Committee on Vaccination and Immunisation, which consists of 22 of the most distinguished persons in the country, is also wrong in its conclusions.

The first point made by my hon. Friend concerned compensation for children damaged by vaccination. I have given a great deal of thought to this matter and my conclusion remains, as I said in the House last week, that it would not be right to come to a decision before considering the report of the Royal Commission on Civil Liability and Compensation for Personal Injury. That Royal Commission is examining the whole area of no-fault liability for personal injury. It would be wrong to single out any one group of people who have suffered damage—for example, to discriminate between one set of brain-damaged children and another—when the Commission is expected to report in a matter of months.

The point has been made that an exception should be made for those children because, it is said, the Government encouraged their parents to have them vaccinated and that, therefore, there is some special obligation on the Government. But I have pointed out on a number of occasions that vaccination is by no means the only procedure that my Department encourages. For example, we recommend regular dental check-ups and treatment. There is always the small chance of serious damage from an anaesthetic. All these matters, and the principles relating to them, have to be considered together. These are all issues that the Royal Commission is examining.

I am sorry that my hon. Friend does not accept the force of these arguments. I hope he will recognise that they are widely accepted by others who are concerned, as he is, about the plight of these children. Certainly my hon. Friend will have noticed the thoughtful editorials in The Guardian and Observer newspapers last weekend on this matter.

The issue of compensation is quite separate in principle from the question of whether to continue a vaccination programme. I know that in campaigning for compensation my hon. Friend is not campaigning against all vaccination. But, although the issues are separate in principle, there is an unfortunate connection in practice. The barrage of publicity about the small number of children who, sadly, may have been damaged by whooping cough vaccine has frightened many parents off all vaccines. I make no criticism of my hon. Friend on this score, although by insisting that he is right and that the medical experts are wrong he is creating serious dangers for children whose health and lives may be put at stake.

Last week I gave the House some alarming figures about the fall in the number of children being immunised against polio, diphtheria and tetanus, as well as whooping cough. I warned parents of the dangers. I am grateful to the newspapers, radio and television for the publicity they gave to my appeal to parents not to turn their backs on vaccination.

Yesterday there was a more dramatic warning than any Minister can give. We heard from Stockton that a five-year-old boy had contracted poliomyelitis. Now, thousands of parents in the area are worried that their own children could be next. Suddenly they realise the value of vaccination against diseases that only a few years ago used to kill or cripple so many of our children. People seem to think that polio and those other diseases have gone for ever, but they have not. The risk is always there.

The Stockton case—it is not the only recent case in the country—emphasises the continuing threat from this serious disease. The level of vaccination against poliomyelitis in the Cleveland area is only 60–70 per cent. and the position there reflects the decline in recent years in the country as a whole.

Immediate steps are now being taken to immunise the whole family, contacts of the family and local schoolchildren. In fact, thousands of children in the area are now being vaccinated. But the fact remains that one five-year-old boy now has a paralysed leg. Surely the right answer is for parents to have their children vaccinated before the damage is done.

I warmly welcome the statement made by the British Medical Association in support of the decision that I took last week. There is no getting away from the fact that there are risks associated with all vaccines, as with any effective drug. But in the case of vaccines recommended routinely, the benefits far outweigh the risks. That is why they are recommended. I am advised on these matters by the Joint Committee on Vaccination and Immunisation, composed of foremost experts in the field. So far as whooping cough vaccine is concerned, their advice is quite clear. I deplore and resent the allegations made againt Sir Charles Stuart-Harris and his committee. They are people who are professionally as well as personally dedicated to the safety and welfare of children, and it is grossly unfair of my hon. Friend in some way to impugn their integrity and knowledge. On whooping cough vaccine the committee's advice is clear. It is that because the gains far outweigh the risks we should continue our policy of offering vaccine to our children, and that is precisely what the BMA said in its announcement today.

I emphasise again that whooping cough vaccination is not appropriate in certain cases—for instance, where the child has a history of fits, convulsions or epilepsy, or is suffering from an acute illness. These are matters on which doctors can advise. They are aware of the dangers and are ready to discuss them with parents, and a great deal of information has been provided for doctors over the years. In cases where there are indications against whooping cough vaccine, it should not be given. Even in these cases, however, parents should not abandon the other vaccinations—polio, diphtheria, and so on—without talking to their doctors.

There has been much dispute about the exact size of the risks and how they are estimated. I have seen figures in the Press suggesting that one child in 5,000 or one in 10,000 is brain-damaged by whooping cough vaccine. I told the House last week, in answering questions following my statement, that the incidence of brain damage was much lower than this. I gave the figure of one child in every 300,000 vaccinated, or about two children a year.

My hon. Friend has questioned that estimate. It has been arrived at by comparing the annual uptake of vaccination with the figures of brain damage received in reports to the Committee on Safety of Medicines. During the 11 years 1964–74, a total of 22 cases of serious brain damage, including six deaths, was reported to the Committee on Safety of Medicines following the administration of vaccine containing a whooping cough component. During the same period 6,900,000 children received basic courses of whooping cough immunisation. This gives a ratio or one serious case of brain damage to approximately 300,000 children vaccinated.

The Joint Committee has accepted this as the best estimate available, though it was reluctant to announce the estimate because it was not derived from a properly conducted study of adequate proportions such as those now being undertaken on the committee's behalf—Sir Charles Stuart-Harris was in no way accusing me of misleading the House. His committee accepts the figure that I gave as the best estimate available. I should remind the House that a continuing study in the North-West Thames Region has shown that out of 80,000 vaccinations containing a whooping cough component there has not been a single case of brain damage.

My hon. Friend has claimed that one case of brain damage in 300,000 cannot be a valid figure because many adverse reactions have not been reported to the committee. I accept that not all adverse reactions are reported. Because of this, the estimate could be on the low side. On the other hand, some of the cases of damage taken account of in arriving at the estimate may not in fact be due to vaccine. Nor is it known in all these cases that the damage is permanent. Of course, the adverse reactions reporting system—the yellow card scheme—it is not perfect, but it is widely recognised as one of the best in the world. I want to make it as effective as possible. That is why I am reminding doctors to pay particular attention to the need to report any cases of damage attributed to vaccine.

My hon. Friend has once again raised the question of what he calls an independent inquiry into the safety and efficacy of the whooping cough vaccine. I dealt with this point last week in the House when my hon. Friend raised it following my statement.

I have reflected on it since, and I cannot see that any useful purpose could be served by setting up a new inquiry. The fact is that, despite my hon. Friend's derogatory remarks about this distinguished group of experts, the Joint Committee on Vaccination and Immunisation is an independent body which keeps the vaccination programme under constant review.

The Joint Committee has all the information at its disposal. There is no information that my hon. Friend can produce that it not available to the committee. It is arrogant and dangerous of my hon. Friend to suggest that he has knowledge that is not at the committee's disposal or that he reaches conclusions that are totally contrary to the conclusions unanimously reached by the committee that advises me.

My hon. Friend and I are not doctors. We have to accept the advice of experts, and the experts who advise me are the most distinguished in the land. There is no reason for my hon. Friend to make imputations against the efficacy of the decisions they have taken. They have all the information, and their conclusions are unanimous.

In addition, there is the Committee on Review of Medicines. This committee is undertaking a systematic examination of every drug on the market. One of the first group it is looking at is vaccines—including, of course, whooping cough vaccine. In these circumstances, I cannot see that a separate inquiry of the kind my hon. Friend is seeking could add anything.

In conclusion, may I underline this week's warning by Sir Charles Stuart-Harris that there is a real danger of a rise in the incidence of whooping cough in the next year or two if vaccination rates are not increased. Parents really must face the dangers that might arise if their children are not vaccinated against whooping cough, diphtheria, tetanus and polio.

I say to all parents throughout the country, if it is possible to do that from this Dispatch Box, that they should not be mislead by statements made—no doubt in great sincerity and integrity—by my hon. Friend, otherwise they will put the safety of their children at risk.

Mr. Ashley

That was a shabby and squalid speech. The Minister should be ashamed of himself. He did not answer a single question that I put to him. It was shocking.

Question put and agreed to.

Adjourned accordingly at thirteen minutes past Twelve o'clock