HC Deb 09 May 1978 vol 949 cc973-85
The Secretary of State for Social Services (Mr. David Ennals)

With permission, I shall make the statement on payments for vaccine damage referred to by my right hon. Friend the Prime Minister on 16th March. My right hon. Friends the Secretaries of State for Scotland, Wales and Northern Ireland wish to be associated with what I am about to say.

The House will recall that last June the Government accepted in principle that there should be a scheme of payments for those seriously damaged by vaccination which has been recommended in the interests of the community. The details of the scheme could not be settled before we received the Report of the Royal Commission on Civil Liability and Compensation for Personal Injury.

The Royal Commission has recommended, first, that in future there should be strict liability in tort for severe damage suffered by anyone as a result of vaccination which has been recommended in the interests of the community; and, secondly, that there should be a new weekly benefit for all seriously disabled children whatever the source of their handicap. These and other recommendations are being considered carefully by the Government. But this is bound to take time and, in view of the clear undertaking we have given in respect of vaccine damage, the Government have decided to bring forward urgently a scheme of payments.

The scheme will provide for the payment of a lump sum of £10,000, tax-free, in respect of those, whether children or adults, who have, since 5th July 1948, been severely damaged as a result of vaccination which has taken place in the United Kingdom against diphtheria, tetanus, whooping cough, poliomyelitis, measles, rubella or tuberculosis (BCG), or smallpox up to the date when its routine use ceased to be recommended.

In the interests of speed and ease of of administration we shall accept, as the initial, but not the exclusive, criterion of severe damage, the receipt of attendance or mobility allowance for conditions which could be attributed to vaccine damage. Decisions whether the severe damage was due to vaccination will be made on the balance of probabilities. There will be a right of appeal to an adjudicating body, made up of two medical specialists and a legal chairman, which would be fully independent.

The scheme will cover existing cases and any which may occur while it continues in operation. But I want to stress particularly that the fact that we are bringing it forward does not in any way pre-empt the decisions which we shall in due course have to make on the recommendations of the Royal Commission as a whole, and that it will not prejudice the rights of those who have suffered damage to take action in the future.

Unfortunately, there is no prospect of parliamentary time in this Session for a Bill to cover the scheme I have outlined. However, we are determined to help these children and their families as quickly as possible. The payments will therefore be covered, in the first instance, by a new Vote sub-head in the summer Supplementary Estimates and a Bill will be brought forward as soon as parliamentary circumstances permit. The cost will of course depend on the number of awards but if that number were to turn out to be something like 700, it would be £7 million, spread over this and succeeding financial years.

The Vote sub-head procedure, and the simplicity of the scheme itself, will enable payments to be made as early as possible to families who have already had a long wait. While finalising the arrangements and processing claims will inevitably take some time, we shall do our best to start making payments before the end of this year.

I am sure that the whole House will welcome this announcement, which implements the Government's pledge to that small minority of families who, in seeking protection from disease for their children and the community at large, have suffered such tragic consequences.

Dr. Vaughan

I am sure that I speak for the whole House in saying how much we welcome the right hon. Gentleman's statement. It recognises what a terrible personal tragedy vaccination damage is for the families involved, and it is right that the Government should accept some responsibility for helping over this situation.

We welcome particularly the fact that the right hon. Gentleman is proposing a small panel which can act speedily. None of us would want to see a repetition of the frustrations and delays experienced by the thalidomide children. Will the Minister consider whether a fixed amount of money is appropriate in these cases? In many cases this is likely to be less than the child would receive if he went to court. It is certainly a good deal less than the majority of children in the thalidomide cases have received.

In addition, a fixed amount bears no relation to the future needs of individual children, which may be very different depending how severely affected they are and what their various life requirements are. Finally, will the right hon. Gentleman give an assurance that the Government will provide time for a full debate on the whole of the Pearson recommendations, because this is a very important report?

Mr. Ennals

I am grateful to the hon. Gentleman for welcoming the statement. I am certain that the whole House is pleased that we have been able to make this offer. I agree that nobody should underestimate the tragedy for these children and their families, the strain on all concerned, and the courage of the parents who have had to bear this responsibility.

I agree that we must act quickly. This is why we have brought forward a scheme which basically is simple. If we had a scheme of graduated payments, it would be more complicated, with more administration, and we should not have been able to proceed so quickly, and I doubt whether we could undertake it by this method.

I do not accept that this is a scheme of compensation. Therefore, the thalidomide settlement, or the current level of awards by the courts in common law for negligence in non-vaccine damage cases, does not in any way create a precedent. I emphasise that this is not a compensation settlement. If most of the parents felt that this would deny them the right at some future stage to proceed by the courts or in any other way, they would feel that this was not the way to go about the matter. I give the assurance for which the hon. Gentleman asked that there will be an opportunity to debate the Pearson Report. I certainly cannot say when that will happen. I think the House will probably want to do so at a time when the Government can come forward with some positive proposals.

Mr. Ashley

Is my right hon. Friend aware that I welcome the payment of £10,000 as an interim measure, but that sum is only about three years' average earnings in respect of children who are irretrievably damaged for life?

In addition, the Pearson Commission, the implementation of whose recommendations the children have been told to await, recommended strict liability. I have been told by an outstanding actuary that if the children were subject to strict liability they would be awarded £115,000 or if inflation-proofed, as the Royal Commission recommended, they would receive about £250,000.

Will my right hon. Friend consider introducing a viable scheme for all vaccine-damaged children as soon as possible, including those already affected? Secondly, will he undertake to introduce a no-fault liability scheme for all disabled people, including children and adults?

Mr. Ennals

My hon. Friend will recognise that one reason why the Government have come forward with this £10,000 cash grant now is that it clearly will take time for the Government to reach their conclusions on the many important recommendations put forward by the Pearson Commission. I wish to make it clear that nothing I have said will pre-empt decisions which the Government still have to take on Pearson, and nothing I have said or any decisions taken will prejudice the rights of those who will receive a lump sum payment from taking action in the future. My hon. Friend should not underestimate the help that £10,000 tax-free will be to some people who for many years have had no assistance at all. I believe that they will see this as a way in which the community as a whole has sought to share a responsibility for the hardship that has fallen upon them.

Mr. Adley

Is the right hon. Gentleman aware that he was right to stress that this is not compensation, because no money can ever compensate parents if this has happened to their children? We understand the difficulties that the Government face and welcome his statement.

Is the right hon. Gentleman further aware that there has been an increase in the number of people who think that they will qualify because they have identified in their own minds the problems of their children with vaccine damage? Does he appreciate, therefore, the urgent need to set up a monitoring system so that parents, with the assistance of their medical advisers, can be as near as possible certain whether they qualify for the payment?

The right hon. Gentleman referred to a small body which is to conduct these investigations. Is he satisfied that one small body—presumably based in London—is the best way to do it? Will he consider having this body available to move around to certain regional centres, or perhaps having other regional bodies charged with similar responsibilities, so that the problem can be dealt with as speedily as we all want it to be?

Mr. Ennals

I could not say how many will qualify. I made my estimate. It could be no more than that. It might be 700, but it might be fewer or more. I have no doubt that there will be applications from people who are unlikely to qualify, but it is my conviction that the majority of the cases likely to benefit will be of people who are in receipt of mobility allowance or attendance allowance, although I made it clear that that would not be the only criterion. I shall make a further statement when the details have been worked out.

The hon. Gentleman asked me about the panel. It is an independent expert adjudicating body but it comes in at the appeal stage. The majority of the decisions will be taken within my Department in the way in which very many are, and some of them may not take a great deal of time. It is the difficult ones and those on appeal that will go before the judicial team of three.

Mr. Penhaligon

Why should those who were compulsorily vaccinated as children during the last war be excluded from the scheme?

Mr. Ennals

I think that many people would say how remarkable it is that the Government have decided to go back 30 years, to the beginning of the National Health Service. Many people had expected that we would go back only to perhaps the beginning of the 1960s, but we felt it proper that we should go back to the beginning of the NHS. That will mean that some of the applications dating from vaccination in the earlier days will be difficult to prove, and therefore the questions of probability and doubt are questions that we shall simply have to take on board. But to have gone further back than 1948 would have been quite unreasonable.

Dr. M. S. Miller

The country as a whole will appreciate greatly what the Government are offering these unfortunate children, with the possibility of more to come. However, will my right hon. Friend ensure that this whole matter is kept in perspective and indicate that the diseases of diptheria; whooping cough, tuberculosis, measles and other very serious infections of childhood are by no means conquered, that the risks of serious developments from vaccination and innoculation are extremely low, and that parents in general should not hesitate to have their children protected against those diseases against which they can be protected?

Mr. Ennals

I am grateful to my hon. Friend for this comment, particularly as it comes from a qualified practitioner. Although this scheme is basically designed to help the children and the families who have suffered as a result of vaccination. I think that it is really in support of vaccination policy. Nothing has had a greater effect on the health of our people than the vaccination policy over the last 30 years, although in the case of some vaccines a shorter period than that.

My hon. Friend is right to point out that the number of children, tragic as it is, who may be able to benefit from the scheme is a minute proportion of the tens of millions who have been vaccinated against these diseases. He is right to warn us, too, that some of these diseases are still with us. That is why the Government have not changed their policy in relation to vaccination.

Mr. Crouch

Is the Secretary of State aware that this minute proportion to which he is referring—some 700 children, some of them adult now—have virtually paid with their lives, and that quite a lot of us feel great dismay at the small figure that he has offered in compensation or as an initial payment? I am grateful to him for that initial payment, but I share a great dismay that it is so small, because the parents of the children concerned responded to a national call for better health care, and unfortunately their children have suffered. I agree with the hon. Member for Stoke-on-Trent, South (Mr. Ashley) that a much bigger figure must be offered by this House in generosity.

Mr. Ennals

I am disappointed by the hon. Gentleman's approach to this matter. The problem has been with us for many years. This Government have been the first Government ever in the United Kingdom to come forward—indeed, as far as I know, we are the first Government in the world to do so—and embark upon a scheme like this.

The second point that the hon. Gentleman must recognise is that this is not a compensation scheme, as I made clear. This is not saying, "This is the end. We are wiping the slate clean". This is some way in which we can help these people now, and I do not think that anyone ought to say that it is a small sum. For those who urgently need help the £10,000 will help the families and the children.

Miss Joan Lestor

I welcome what my right hon. Friend said about the financial help for the children, but would he not agree that there is still considerable doubt among a small section of the medical profession about the efficacy and safety of the whooping cough vaccine? Bearing in mind what he said about the difficulty of proving the cause of brain damage, will he give an assurance to the House that he will consider the evidence on vaccine brought forward by Professor Stewart, of Glasgow, and Dr. John Wilson, of Great Ormond Street Hospital, before he advocates any further use of it?

Mr. Ennals

The House and the public will know that the joint committee on vaccination and immunisation, which includes the most distinguished experts and which advises the Secretary of State, had before it all the evidence. I particularly asked some months ago that it should have brought before it the most up to date evidence. That has been done. It has examined the evidence and has seen no reason to change the conclusion that it has reached. That conclusion continues to be unanimous, and it was spelled out by Sir Charles Stuart-Harris as recently as 25th April in his speech to the Royal Society of Health Officers.

Several Hon. Members

rose—

Mr. Speaker

Order. I propose to call only those hon. Members who have been standing up to now, unless the Front Bench wishes to intervene.

Mr. Awdry

Will the Secretary of State confirm that he realises that in many cases parents will find it very difficult indeed to obtain the medical records of events that took place a number of years ago? I greatly welcome his announcement, for my part, but can he give an assurance that the panel will look sympathetically at those who have been unable to obtain the records despite having made every possible inquiry?

Mr. Ennals

I fully recognise that some cases will be difficult to determine and that the further back in time one goes, the more difficult it will be. We propose to deal with the cases on the balance of probabilities, as I have said, and of course the balance must be swung in favour rather than against. Again as I have said, there will be the independent expert adjudicating body at the appeal stage. We shall look very sympathetically at all the cases.

Mr. Dalyell

Is my right hon. Friend aware that many of us who have been called on to deal with this kind of case know the complexities and congratulate him on at least something? Could he reflect, however, that the balance of probability is very difficult, particularly as the Government have chosen to go back to 1948 and, in some cases, records are difficult to obtain? Is there not a case for reflecting further on the possibility of graduated payments, difficult though this might be, to meet at any rate the need of some of the older cases?

Mr. Ennals

I greatly respect the sincerity with which my hon. Friend puts forward his argument. I have considered this matter very carefully indeed. I believe that to follow his suggestion would mean having much more complicated legislation. It would begin to look like legislation which was designed to produce a final compensation for these children. These are matters which have been dealt with by the Royal Commission and on which we must await the Government's conclusions. The case for getting something quickly into the hands of the families concerned is, I think, over- whelming, and it can be done only with a system which is absolutely simple.

Mr. Boscawen

I recognise that the lump sum in the hand immediately is the right thing in the circumstances, but will the Secretary of State reassure the House that there will be no snags to this? I hope that some of the benefits of the scheme will not disappear because after a family has received the £10,000 supplementary benefit is reduced. Will the Secretary of State also ensure that the group of people concerned will not in any way be inhibited in relation to the receipt of any future weekly benefit which may accrue to disabled children?

Mr. Ennals

In answer to the last part of the hon. Gentleman's question, I point out to him that I have said that the decision does not prejudice the right of those who will receive a lump sum payment to take action in the future. As the Government have not yet announced their conclusions on the Pearson Report, it would be very difficult to go further than that.

I wish that I could give an assurance that there will be no snags. I know that there will be problems, but we shall seek to resolve them.

Mr. Hugh Jenkins

Will my right hon. Friend accept that the welcome which has been expressed in all parts of the House will be widely echoed throughout the country? He is to be congratulated on his statement.

With regard to the further consideration that my right hon. Friend is to give to these matters, will he say whether compensation for children damaged by hormone pregnancy testing is among the matters to which he is bending his mind? Is he in a position at the moment to say anything further about this question or to give any indication of the way in which his mind is moving in the matter?

Mr. Ennals

Frankly, I prefer not to say any more. I do not want to go into the details of proposals that were in the Pearson Report. Less still do I want to go into proposals that were not in the report. It would be unwise to comment further.

Mr. Newton

Will the Secretary of State recognise that many parents will want to invest the money in order to provide some continuing income to cope with the continuing problems? What will be the tax position on that income? Will it be treated as the income of the children or as the income of the parents? Will it be subject, in relevant cases, to the full weight of the investment income surcharge?

Mr. Ennals

I shall have to ask the hon. Gentleman to put down a specific Question or to write to me about it. I do not want to get it wrong.

Mr. Fred Evans

My right hon. Friend, while appreciating the warm welcome given to his statement, and taking note of the expressions of opinion on this very tragic matter, may also have noted the rank hypocrisy of the Conservative Party in asking for expenditure on this scale while at the same time inhibiting the ability of the Government to meet their commitments? Was not this shown by the irresponsible and hypocritical action of the Conservative Party last night?

Mr. Ennals

I think that I made some comment on this during Question Time. I should not like at this stage to break the harmony of the House on the subject dealt with in my statement.

Sir George Young

Is the Secretary of State aware that paragraph 1406 of the Pearson Report states: We do not think it is right to try to distinguish one severely disabled child from another, and to produce a situation where two children have the same needs, but one is compensated and the other is not. Whatever the Secretary of State's good intentions, is not that exactly what he has done this afternoon?

Mr. Ennals

No, because that paragraph related to the Pearson Commission's proposal for a continuing benefit. This was a proposal that there should be a new non-taxable disability income of £4 a week for all severely handicapped children, payable from two years of age, in addition to child benefit, and so on In this context there is no intention in the statement I have made today of presuming that the recommendation in chapter 27 of the Pearson Report will be accepted or otherwise. It would be very unlikely that the Government, if they were to introduce a benefit of the sort proposed—and I cannot commit them—would wish to discriminate in cases of handicap as between one child and another.

Mr. Shersby

Is the Secretary of State aware that several families in my constituency with vaccine-damaged children will warmly welcome his statement this afternoon?

Will the Secretary of State tell the House what steps he proposes to take to ensure that the payments will be used exclusively for the benefit of the victims concerned? Will he, for example, give any indication whether the money will be paid in straight cash terms or whether it will be invested in some sort of trust? What steps will be taken to ensure that the children concerned will benefit throughout their lifetime? That is a very important part of the whole payments scheme.

Mr. Ennals

In most cases a proportion of the money will be paid into a trust. I prefer to give the details of this when, as I promised, once all the details have been worked out, I make a statement for the benefit of the House and the parents who need to claim, giving a detailed explanation. It will include precisely the question that the hon. Gentleman has raised, because it is important that we should ensure that the money is available for the children. But one part of it is to help the families that look after the children. We have to look carefully at what proportion should go into a trust exclusively for the children and what proportion should be used by the parents who have to bear the burden of the day.

Mr. Hodgson

In discussing the relationship of the award to the overall position of the Pearson Report, the Secretary of State said that he did not wish to debate the Pearson Report until the Government were ready to bring forward their own proposals. Would it not be a good idea to have a debate now, so that all the points aired on each side of the House today could be taken into consideration by the Government in forming their proposals?

Mr. Ennals

My right hon. Friend the Leader of the House has heard what the hon. Gentleman said, but certainly it cannot be held today.

Sir Frederic Bennett

I do not endorse the criticism of some hon. Members, on each side of the House, of the Secretary of State's scheme, which I think is a very fair one. Will the Secretary of State reconsider his statement to the effect that no other country has introduced such a scheme? I am not going into the political nature of the Government's concerned, but I believe that Denmark, Germany and France have also gone some way towards making this sort of provision. Perhaps the Secretary of State spoke with some heat because of the criticism which had been made.

As a supporter of the Secretary of State's scheme, may I ask him whether he would care to amend his remark about the balance of probability, which will not mean much, I feel, to the ordinary person in this country? Does he mean that, in the event of an argument, the balance of doubt will be in favour of the applicant?

Mr. Ennals

I sought to say something of that sort but, of course, we shall have to produce guidelines for those who have to take decisions. I shall have no hesitation in publishing them and letting the House know about them.

Mr. Patrick Jenkin

Will the right hon. Gentleman come back to the point made by my hon. Friend the Member for Wells (Mr. Boscawen) about supplementary benefit, as I do not think that it was answered? Will the possession of the sum of £10,000 be taken into account by the Department in calculating the continuing entitlement to supplementary benefit of any families who may at present be getting that benefit?

Mr. Ennals

I should want notice of that question, but I shall write to the right hon. Gentleman as quickly as I can to give an answer.