Vaccination of Children (Parental Choice) (Hansard, 22 April 2002)

§ Miss Julie Kirkbride (Bromsgrove)

I beg to move, That leave be given to bring in a Bill to allow parents to choose to have their child vaccinated separately against measles, mumps and rubella; and for connected purposes. There is a simple point to this Bill: to give parents a choice. I believe that they deserve that choice, and clearly they wish to have it, as 80 per cent. of the public appear to agree with the contents of my Bill. It would require the Department of Health to allow GPs to give parents the choice of single vaccinations for measles, mumps and rubella, rather than the prevailing situation, in which any child being inoculated for these diseases can have only a combined triple vaccine, which is known as the MMR, on the national health service.

I believe that that lack of choice in the national health service is why we are seeing massively falling immunisation rates for children across the country, particularly here in London, against these dangerous childhood diseases. Sadly, the figures are not terribly up to date. The most recent figures that I could find from the House of Commons Library pertained to the year 2000–01. Those figures show that 87 per cent. of children across the country are now protected against these dangerous childhood diseases, falling to 79 per cent. of all children in London. That compares with the figure in 1995–96 when 92 per cent. of all children across the country had been vaccinated.

Clearly, there is a major fall in the number of children being vaccinated, and those figures apply to some 18 months before today's date. I fear that events over the past 18 months are likely to mean that, when new figures are produced, we will see a further fall in the number of children being vaccinated—almost certainly, one in four children will not have been vaccinated for these dangerous diseases in the London area. The Department of Health and the Government should allow parents the choice of single vaccinations; the arguments for that are straightforward.

I believe that the hon. Member for South Thanet (Dr. Ladyman) hopes to catch your eye, Mr. Speaker; if he does so, I am sure that he can give a list of organisations that approve of the combined triple vaccination. There are too many to mention in my short 10-minute speech, but I do not doubt that they believe that it is right to give children the MMR.

Parents are entitled to choice; they make decisions on behalf of their children which, along with their right to choose, should be respected by the Department of Health among others. Although the Under-Secretary of State for Health, the hon. Member for Pontefract and Castleford (Yvette Cooper), may not like it, parents are choosing not to have their children vaccinated because they are not being offered a choice. I am sure that we both seek the same end—increased vaccination rates. It is important that children are vaccinated and the only way to accomplish that is to provide choice on the national health service. Parents are now in the position of having all, meaning the MMR vaccine, or nothing, and clearly far too many of them are choosing nothing.

For the luckier ones who live near a private clinic, and who can afford to spend hundreds of pounds on private singly administered vaccinations, there is a choice. We do 21 not know quite how many parents choose to have single vaccinations privately because the Department of Health does not keep those figures. However, the situation is not fair for parents who cannot choose single vaccinations, either for logistical or financial reasons, which is another reason why the Department should change its guidance.

People with young children may remember that little babies are vaccinated at three months, six months and nine months. There is no reason why, at 18 months, they should not go back to the doctor to have a further set of vaccinations; that is perfectly reasonable for those parents who wish vaccination to be done in that way.

At the moment, doctors have a financial incentive to vaccinate in the form of the MMR; if there is an incentive to boost vaccination rates in general, doctors who use a computer database to determine which children need to be recalled for single vaccinations could just as easily boost the number of children immunised through the triple vaccination as they could the number of children immunised through a series of three jabs. It is logistically possible for that choice to be given on the NHS. It is a great disappointment that the Department of Health is pig-headedly refusing to give parents that choice.

Administrative reasons are among the many reasons why the Department appears to be against providing choice, and I have just dealt with that. Doctors are able to make sure that their systems are compliant and that they can call up children in danger of missing their jabs because they are having them done singly.

Curiously, the Department has suggested that somehow it would be dangerous to allow children to have separate inoculations. If we had a system that allowed single jabs, I do not see why children could not be inoculated against the most dangerous disease first. If children were given the measles jab first, many of the Department's arguments about the danger of single jabs would fall. At the moment, the only way to secure a single jab on the NHS is for a child to have the rubella jab first if there is a risk of contact with a pregnant woman. If the Department changed its guidance and guidelines, the measles vaccination could be given first, and the risk of contracting the most dangerous disease, from which children may die, and which certainly has serious repercussions, would be removed. After that, children could have vaccinations for rubella and mumps. That would not pose any danger to public health and would counter one of the Government's major and most frequently cited arguments for not proceeding with single inoculations.

There is, of course, another reason why the Department of Health has set its face against giving parents the right of choice within the system: 2,000 parents are suing the Department because they believe that their children have been damaged by the MMR vaccine. That case may come to court in the next couple of years. How would hon. Members feel if they were in the position of those 2,000 parents, with a child who had been developing perfectly well but who, the parents believe, was damaged by the vaccination that they had taken the child to have? If I were the parent of one of those children, I would not want to believe that any action of mine had resulted in catastrophic damage to my child so that they would not lead a normal life.

I do not believe, that the claims of those parents are vexatious. They do not want to accept that an action that they took lies at the heart of their child's problems. I urge 22 the Minister to consider the possible outcome of the case if it is decided that there might be a problem with the MMR vaccine and that in some way the Department of Health and the Government are liable. Ministers are proceeding down a worrying road. If they allowed art element of choice, they could absolve themselves of much of that potential blame.

We all know that medical procedures, including the simplest operations, can have severe side effects or even result in death. All medical procedures involve that possibility, so we cannot rule out the possibility that the same is true of MMR. Given that fact, the only way forward is to offer parents choice. In exercising that choice, they will be taking responsibility upon themselves.

§ Dr. Stephen Ladyman (South Thanet)

I must admire the persistence of the hon. Member for Bromsgrove (Miss Kirkhride). She has raised this matter on Adjournment debates, in meetings in the House and now on a ten-minute Bill. She knows very well that I take the view that her persistence would be much better targeted if she campaigned for the needs of autistic people. If she put some of that persistence into campaigning for additional research into autism and its causes and therapies, I would support her.

One of the reasons for the drop in MMR take-up is that people as persistent as the hon. Lady raise the matter constantly and bring into the public domain the most tenuous and circumstantial evidence to support their case. The overwhelming body of scientific evidence supports exactly what the Government are trying to do. I cannot imagine circumstances under which a responsible Government could ignore the huge welter of evidence presented to them, turn their back on it and take a diametrically opposed view.

The Government's position is not and has never been based on political dogma on this matter. It is not and has never been based on administrative convenience, as the hon. Lady suggested. It is based on the advice of public health professionals. At a time when we are debating the needs of the national health service, we would do well to remember that more people's lives are saved and more sickness and misery are prevented by public health measures than by anything that happens in primary or secondary care. We lose sight of that at our peril.

We are faced with a clear case of scientists and public health professionals in difficult circumstances weighing up all the advantages and disadvantages, the risks and the costs, and presenting as near as possible a unified approach to Government. The Government are taking that advice, as a responsible Government should. Attacking that advice and continuing to bring such tenuous and circumstantial evidence to public attention is an attempt to undermine the Government. If take-up of the triple vaccine is falling as the hon. Lady suggested, there are children in this country whose lives are at lethal risk. People who continually raise the matter in this way must bear responsibility for that.

I will not trawl through the list of organisations that the hon. Lady mentioned. I could certainly mention all those that recommend MMR, and I could cite the 90 countries that use it. I could in great detail go through the scientific evidence that shows no link between MMR and autism. I shall not do so, but I will mention a few cases. The data 23 produced by Brent Taylor's report based on children here in London show no correlation between MMR and autism. The evidence produced by Boston university, using data from the UK, shows that while MMR take-up rates have flattened, the increase in autism is as steep as ever. Therefore, there is no correlation between MMR and autism.

I could go through all the evidence that suggests that whatever causes autism happens in the first three months of embryological development. It almost certainly happens in the earliest months of pregnancy, possibly even before the woman knows that she is pregnant. We have clear evidence of some sort of effect at that time in the child's development. Clear evidence is also emerging from the United States that new-born children have chemical markers in their systems that demonstrate that they already have autism. The autism may not develop for 18 months or two years, but they have the ticking time bomb that is autism in their systems. There is a huge body of evidence showing no link. To throw away the advantages of MMR on the basis of a few small shreds of non-proven data would be irresponsible in the extreme.

Let us not forget what all this is about: the phenomenon of herd immunity. Once take-up levels of an immunisation procedure reach about 90 per cent., the remaining 10 per cent. who are not immunised are protected from epidemics. We prevent an epidemic because people with a disease do not come into contact with those who are not immunised against it. That is a valuable benefit of immunisation. If we lose it because people are not having the vaccine or are talked out of taking their immunisation opportunities, everybody in society will be threatened.

Conservative Members talk about choice. That choice should first be rational, considering the advantages or disadvantages that one option might have and another might not. There is scientific evidence that single vaccines are not a rational choice in that respect. Secondly, the exercise of choice in public health terms should not have 24 a detrimental effect on the rest of the population, and choosing single vaccines clearly would have that detrimental effect.

We know, for example, from evidence already being gathered that offering single vaccines results in a fall by two thirds in take-up rates. We know, therefore, that people would not complete single-vaccination courses. We also know from experience of providing a diphtheria, tetanus and pertussis multiple vaccination that offering single vaccinations for those diseases resulted in take-up falling from 80 per cent. to 30 per cent. We know what will happen if the Government change their policy in the way that the Bill suggests: vaccination rates will drop and children will die. The Government are doing the right thing by following the advice that they have been given. I just wish that the hon. Lady and her supporters would be a bit more open minded about looking at that evidence and taking a rational approach.

We have a busy day ahead of us and I have no reason to take up hon. Members' time with a Division. However, it is important to put on the record that the Government are doing what their scientific advisers are unanimously telling them to do. For them to do otherwise would be irresponsible in the extreme. Opposition Members should now and again admit that perhaps the Government are getting all the advice and have taken the right decision.