HL Deb 08 March 1979 vol 399 cc303-22

3.38 p.m.

Lord WELLS-PESTELL

My Lords, I beg to move that the Bill be now read a second time. I am glad to be able to introduce this Bill to this House after its rapid and unopposed passage in another place. Although it is a Bill designed to provide considerable benefits for a small number of people, it is in my view a very important and very humane measure. It will provide for the payment of a lump sum of £10,000 to persons who have suffered severe disablement as a result of vaccination in accordance with routine public policy vaccination programmes since the inception of the National Health Service on 5th July, 1948. The Bill sets out in detail particular criteria which must be satisfied before a payment is made, since clearly we must give precise guidance to the people who will be making these payments, but I will go into those in more detail later on when I consider the individual clauses.

This Bill then sets out to provide a measure of financial support to these very severely disabled people, and to their families and others involved in looking after them. There can be no doubt that for the vast majority of people vaccination is a beneficial and highly effective aspect of the public health programme, and has been so for a good many years. But for some, and I must emphasise that we are talking about a very tiny minority, vacci- nation has without warning caused damge leading to the most severe mental and physical disablement. In view of this there is a strong case for the provision of financial help to those who suffer in this way as a result of routine vaccinations given as part of a public policy programme. I am convinced that all noble Lords will go along in regarding this as a most humane and just measure.

Noble Lords may find it helpful if I give a brief description of the origins and history of the scheme itself, which this Bill seeks to implement. Noble Lords will be aware that there has been for some years now a call for the Government to give direct financial aid to people damaged by vaccination; and here I must pay tribute in particular to the work of Mrs. Rosemary Fox, who organised and led the Association of Parents of Vaccine Damaged Children, and to my honourable friend Mr. Jack Ashley, whose fair-minded persistence in another place on behalf of disabled people is well known. Their work in assembling and publicising the evidence about damage caused by vaccination has been instrumental in persuading the Government to take action, and they can be justly proud, if I may say so, of the success of their efforts.

The Royal Commission on Civil Liability and Compensation for Personal Injury, known as the Pearson Commission, considered the question of vaccine damage and, after consulting them, my right honourable friend the Secretary of State announced, in advance of the publication of their report, that the Government accepted in principle that there should be a Government scheme of payments in connection with vaccine damage once the full report of the Pearson Commission had been published. We decided to await the publication of the report because at the time it seemed likely that the Commission would make detailed recommendations about payments for vaccine-damaged people which we would need to take into account when the scheme was designed.

The report was published in March of last year and in fact the chapter on vaccine damage contained only a general recommendation about a system of strict liability in tort for vaccine-damaged people. It was apparent straight away that the Government would need to give detailed consideration to all the various recommendations made by the noble Lord, Lord Pearson, and his colleagues, including the one about vaccine-damaged people, and that this would inevitably take some time. In view of the urgency of the need to provide a substantial measure of help to vaccine-damaged children and their families in particular, we decided on an immediate introduction of a scheme to provide payment of a lump sum of £10,000 in respect of those severely damaged as a result of vaccination under a routine public policy vaccination programme.

My right honourable friend was able to announce the broad outlines of the scheme on 9th May 1978, and to give further details and formally begin the scheme on 2nd August last. At the time he said that a Bill to enact the scheme would be introduced as soon as Parliamentary circumstances permitted, although in the interim the scheme would go ahead because of the urgency of the need. This time has not been wasted; the Government have set up a unit—the Vaccine Damage Payments Unit—to receive and process claims. Over 2,000 claims have already been received, and initial decisions have been made in respect of about a quarter of these. I have pleasure in announcing to your Lordships that the first payment has been made to a young lady in Lancashire. Payments in a further 50 or so cases have been delayed over difficulties in agreeing a satisfactory trust deed, but I understand that these problems have now been resolved after discussions between Mrs. Fox, whom I mentioned a short time ago, and officials. Trust deeds are now being sent to the parents involved for signature, and the payments will be made as soon as they are returned. Thus it is very likely that a significant number of payments will have been made, my Lords, before this Bill becomes an Act!

In the meantime, we have introduced some minor beneficial alterations. The scheme initially included the requirement that claimants were "normally resident" in this country. This has been dropped, because we recognised that in these cases our responsibility as a community to provide help to people who have suffered as a result of vaccination does not stop just because they may have moved away from the United Kingdom. At the same time we have provided in the Bill for payments to be made in certain additional cases, including damage suffered before birth as a result of the mother being vaccinated during pregnancy, damage suffered as a result of a person of any age being vaccinated during an outbreak of the disease in question, and damage caused by polio vaccination at any age. Before turning to the details of the Bill, it may be helpful if I say a word or two about the method of handling cases.

There is, I understand, some doubt among the medical profession about whether whooping cough vaccination can or cannot lead to brain damage in very young children. The difficulty is that childhood convulsions or even encephalopathy can occur without any apparent cause, and some experts would argue that there is no clear evidence that this vaccine has ever caused such conditions. Others, however, believe that a minority of cases can definitely be attributed to vaccination.

We asked our expert advisory body, the Joint Committee on Vaccination and Immunisation, to review the available evidence, and they reported in May 1977 that it was impossible to distinguish between those cases of brain damage caused by vaccination and those attributable to some other cause. At the same time, they found that there was a risk, a very small risk, that this vaccine could produce adverse reactions which might on occasion be extremely serious. Their report has been published and I understand that a copy has been placed in your Lordships' Library.

This then is the difficulty. There is no absolute test, in the legal sense, of determining whether a particular vaccination for whooping cough has caused particular convulsions which have led to brain damage. This is why the Bill introduces the idea of using the balance of probabilities to determine whether a payment should be made, and this will mean that the Secretary of State will have to consider the medical evidence and the disabled person's present condition as a whole in each case, to see whether it was more probable that the initial damage arose from vaccination than that some other, unrelated, cause is involved.

Each case has to be considered individually, in detail. In some cases the decision will be relatively easy; the medical evidence will show that severe convulsions and brain damage occurred soon after vaccination, and unless the evidence of some other cause is very persuasive indeed, the claim will be accepted. At the other end of the spectrum there will be cases in which there is strong evidence pointing to a congenital condition, or some other cause, or in which the symptoms have first shown themselves a long time after vaccination. Many cases will fall somewhere between these two extremes, and I must emphasise that although the initial determination of claims on the basis of the balance of probabilities will be carried out by the Department's medical advisers, drawing on expert opinion in cases of doubt, the final decision does not rest with them. We have provided in the Bill for an independent review procedure by which any claimant who disagrees with the initial determination by the Department can have his claim considered by an independent expert tribunal and I regard this, as I am sure your Lordships will, as a most important aspect of the scheme. It ensures that a fair and objective assessment can be made in every case.

I now come to the detailed provisions of the Bill: the first two clauses constitute the essence of the scheme. They provide for a lump sum payment of £10,000 to be made to any person whom the Secretary of State is satisfied has suffered severe disablement as a result of vaccination. For the purposes of the scheme, such a person must satisfy certain criteria before a payment can be made: he or she must have suffered 80 per cent. or greater disablement as a result of vaccination against certain specified diseases; must have been vaccinated in the United Kingdom or the Isle of Man after 5th July 1948, when the National Health Service came into existence; and must, except for vaccination against rubella or poliomyelitis, have been vaccinated before reaching the age of eighteen. This reflects the fact that, except for rubella and polio, routine public policy programmes are for the vaccination of children. These clauses also provide for people who have suffered disablement either because their mothers were vaccinated during pregnancy or because of contact with someone else who had been vaccinated to receive payment, and allow for children vaccinated abroad while their parents were serving with Her Majesty's Forces to be included.

Clause 3 sets out the procedure by which claims will be submitted to the Department and determined, in the first instance, by the Secretary of State. It provides for the question of whether severe disablement has been caused by vaccination to be decided on the balance of probability in the manner I have already explained. The Secretary of State will have to notify the claimant as soon as possible of his decision and, if the claim is disallowed, explain why. In the case of a disallowance because the disabled person is not considered to be severely disabled as a result of vaccination, the notice of disallowance will explain the way in which the claimant can have the case reviewed by an independent medical tribunal.

Clause 4 provides for medical tribunals to review cases disallowed by the Secretary of State because he is not satisfied that severe disablement has resulted from vaccination. The details of procedure and appointment of members for these tribunals will be laid down in regulations and are unlikely to differ greatly from those already applying to medical appeals tribunals under the Social Security Act. Clause 5 enables the Secretary of State to reconsider a determination made on his behalf because of a change of circumstances since the original decision was made, or because of ignorance or a mistake regarding some material fact at the time of the initial decision. I should add that only in the case of a deliberate attempt to mislead will any money be required to be repaid by a claimant subsequently found not to have been severely disabled by vaccination.

Clause 6 sets out the procedure for payment, which will be made either direct to the disabled person, if he is over 18 and capable of managing his own affairs or, if not, to trustees appointed by the Secretary of State. In most cases the trustees will be the people responsible for looking after the disabled person, generally his parents or some other close relatives. We have taken steps to ensure that the trust deed will be as widely drawn as possible in line with the need for the money to be spent for the benefit of the disabled person. But the trustees will have considerable discretion in spending the money, even to the extent of using it to pay for holidays for themselves to enable them to be able to cope more readily with the often onerous duties of caring for a severely disabled child. This clause also makes it clear that the payment does not in any way prejudice the right of the disabled person to seek compensation through the courts. This would be wrong since, as we have maintained throughout, this is not a compensation payment. At the same time, the payment wil be taken into account in determining the scale of any award for damages.

Clause 7 ensures that those who have claimed before the Bill receives the Royal Assent, and whose claims have not succeeded, will be able to ask for their cases to be reviewed by the independent medical tribunals. Clauses 8 to 12 are of a technical nature, covering the provisions for financing the Scheme, for making regulations regarding procedural details, and so on. I do not think it is necessary for me to weary your Lordships with a detailed exposition of this.

This Bill then represents the means by which a significant measure of support can be provided by the community to those of its members who have suffered, tragically and unexpectedly, from a procedure which has provided only beneficial protection for the great majority of their fellow citizens. Having spent some time describing the problems associated with identifying those occasions when vaccination has led to serious damage, it is appropriate for me to make it clear that we are convinced that the overwhelming benefits of routine vaccination far outweigh the minute risk of damage. It is right for us to continue to provide protection for our children and for the community as a whole as part of the overall public health programme and at the same time to provide financial aid and support for the tiny minority who suffer serious disablement as a result.

This Bill must be viewed in the context of the whole range of benefits available to the disabled. Many of the people who will be helped will already benefit from mobility and attendance allowances and, when they are older, from the noncontributory invalidity pension. On the wider questions of the implementation of the Pearson proposals for a general disablement benefit for children, and for strict liability in tort in respect of vaccine damage, I can only echo what has been said recently by other members of the Government: these recommendations are being considered carefully in consultation with the medical profession, but, as your Lordships will appreciate, there is a great deal of ground to cover.

Finally, I hope I can feel confident that this Bill has the unqualified support not only of your Lordships but, I would also hope, of a great many people in this country not themselves directly affected by its provisions. Although it may not go as far as some noble Lords would wish, I am sure I am equally right in believing that it will receive support in your Lordships' House. It is a badly-needed measure of urgent relief for people who have suffered greatly through no fault of their own; and on that basis I do commend it to your Lordships. I beg to move that this Bill be now read a second time.

Moved, That the Bill be now read 2a.—(Lord Wells-Pestell.)

4 p.m.

The Earl of AVON

My Lords, we on this side of the House welcome this Bill. It is, indeed, a timely recognition of the suffering caused to families by vaccine damage. We are grateful for the admirable exposition by the noble Lord, Lord Wells-Pestell, on the history of the Bill and for the explanation of its various clauses. We, too, should like to pay tribute to those who brought this issue to public notice, and who have been responsible for this Bill today.

There are two points on which the noble Lord the Minister might like to comment. The first is on the question of compensation. We understand that this is a sum given as an interim payment; that this is an immediate and, I may say, very welcome gesture to ease the suffering of families. Can the Minister assure the House that this will not in any way prejudice either the acceptance of the Pearson recommendations, on the whole, or the timing of putting these recommendations into effect? It is so easy to shelve a report on the grounds that something has already been done. We on this side cannot stress too much that the ready acceptance of this Bill is on the basis that active work will begin in parallel to assess the Pearson Commission recommendations, and what the Minister has said has, in some way, eased my thoughts on this point.

The second point which I should like to raise concerns legal aid. May we have an assurance from the Minister that this interim payment in no way jeopardises a person's ability to draw on legal aid? In fact, will the noble Lord agree that the interim payment should in no way discourage persons from using the courts for compensation in this field? It might be as well at this point to underline how strongly the Royal Commission on Civil Liability and Compensation for Personal Injury reported on this topic. In Chapter 25, paragraph 148, the Commission states: Where vaccine damage can be proved to have followed from medical procedures recommended by the Government or a local authority, those who suffer serious and lasting damage should be entitled to bring an action in tort for damages against the Government or the authority concerned". The paragraph continues: This would normally apply only to children, but we think that adults should also be included in order to cover those exceptional circumstances in which a Government or a local authority might recommend adults to be vaccinated in the public interest". The final paragraph of this chapter, paragraph 1413, reads: We recommend that the Government or the local authority concerned should be strictly liable in tort for severe damage suffered by anyone, adult or child, as a result of vaccination which has been recommended in the interests of the community". I do not deem it necessary to quote more from the Commission. I have done so only to stress how much further the recommendations go than this Bill, and the need, therefore, to accept this Bill only as an interim measure.

There are debatable issues in the Bill; for instance, is £10,000 the right amount? The noble Lord touched on this. Of course, many people would say that it is not. Another question is whether 80 per cent. disability is the correct percentage at which to start paying. In the other place, there was quite some comment on this. Should there be an age limit? Should not all the children of people serving this country overseas be covered? Finally, there was the moving case reported in the Sunday Observer last month, of a family that falls outside the commencement date of July 1948. We understand the need for a commencement date and why this commencement date is there. But I wonder whether it could be possible to include these families. I understand that there are only 12 such families. If this is done now, while the Vaccine Damage Payments Unit is in operation, the administrative cost would be negligible. One wonders whethe. the Government would like to consider these 12 cases anew. I know hat there will be red tape, and perhaps a little redrafting, involved but this might be a case where compassion could come in, too, and I feel that if this could be done at this moment it would save a lot of suffering.

I had a number of questions on statistics which I intended to ask the Minister, but, luckily, in his opening remarks, he has more or less set my mind at rest and I am delighted to hear that the Vaccine Damage Payments Unit has made its first payment. It may be a little sub judice, but I understand that at the moment there are over 2,000 cases in the pipeline, whereas in the other place claims in the region of 600 to 700 were talked about. I do not know whether the Minister is prepared to say at this stage what the final figure is likely to be. I do not want to embarrass him by prejudging this issue. As I said at the beginning, we on this side of the House welcome this Bill. I am hopeful that the noble Lord, Lord Wells-Pesten, may set our minds at rest about the Bill being an interim measure, that the recommendations of the Pearson Commission will not be prejudiced but will be looked at in a positive mood, and that legal aid and legal proceedings will in no way be jeopardised. That being so, we shall be very happy to support this Bill.

4.6 p.m.

Lord WINSTANLEY

My Lords, I must at once join the noble Earl in thanking the noble Lord, Lord Wells-Pestell, for the clarity with which he explained this very necessary and welcome measure to us. Also, I should like to thank him in particular for outlining the history of the melancholy events which led to the need for this Bill. Perhaps in saying that, I may go on to take up the point made by the noble Earl, and say that I hope that the noble Lord, Lord Wells-Pestell, will confirm that this is of the nature of an interim ex gratia measure, without prejudice to any other steps which these unfortunate people may feel inclined to take in order to get full compensation of the kind to which, very understandably, they feel entitled. It is not necessary for me to say much on behalf of my noble friends on these Benches with regard to this Bill, save that we support it and hope that its provisions will be very speedily implemented. Indeed, I would thank the noble Lord for concentrating on and emphasising in his speech the urgency and speed with which the whole matter is to be tackled.

There is just one other point which I should like to take up with the noble Lord before I sit down. I am afraid that the length of time which this whole business has taken and the arguments about it—and the noble Lord has referred to the work of people, such as Mr. Jack Ashley and others who very rightly aroused the public conscience with regard to people who have suffered tragically as a result of a public health programme—and the campaigns over so many years, before justice has finally been done, have also done something to undermine public confidence in our immunisation programme as a whole. I know the noble Lord explained that the number of cases in which it can clearly be shown that children have been damaged as a result of a vaccination process is, first, very small and, secondly, is in part speculative, in that it is very difficult indeed to prove that any one case is precisely due to the vaccine and to nothing else. I think all are agreed that there are very few cases indeed. Nevertheless, all are also now agreed that it is possible for a child to suffer as a result of a vaccination programme.

The melancholy fact is that, in the minds of ordinary young mothers taking their children along to the doctor's surgery for their first programme of immunisation, there is no ready ability to discriminate between one form of immunisation and another. With the paper filled, at one period of time, with rumours and blood-curdling stories of the dangers of pertussis immunisation, many mothers did not discriminate between pertussis immunisation, diphtheria immunisation, tetanus immunisation and so on, and there really was a danger that the whole standing of immunisation would be imperilled in the minds of many people. I would merely urge the noble Lord, Lord Wells-Pestell, to do what he can, through his Department, to see that in any publicity which goes out—and much must when this new Bill and its provisions come into force—every effort is made to emphasise the important need for the maintenance of the immunisation programme as a whole, and to underline the extreme rarity of dangerous consequences such as those for which we are providing under this Bill.

I need hardly remind your Lordships' House of what could happen in this country if, for example, public faith in the diphtheria immunisation programme suddenly became impaired, as for a time it looked to be impaired. It was difficult to get all mothers to agree that their children should carry out the whole programme. They had heard that immunisation was dangerous, and they therefore did not want to bother with immunisation at all. It was not merely that they would do without whooping cough and have all the others, but that they thought, "It's dangerous, so we won't have any of it".

To go back to the days immediately prior to the introduction of routine diphtheria immunisation, we in this country had something like 72,000 cases every year of that extremely dangerous and indeed often fatal disease; yet within a year or two of the introduction of the general campaign of immunisation against diphtheria, that number of 72,000 a year was brought down to single figures and was maintained in single figures for many years. May I remind your Lordships that we must never allow those figures to go up again, as they would, as sure as night follows day. If the number of our children who are immunised against diphtheria and so on fell, then we would have a recurrence of something which we have almost fully overcome.

With regard to pertussis, this is a difficult question. Parents must be given a choice. They must be told that there are possible although very remote dangers but that there are also very great dangers from whooping cough in very young children. Therefore, I think that, so far as they can, doctors will conscientiously explain to parents their view—and it is my view—that on balance it is safer to be immunised since the possible dangers of immunisation are so very slight while the potential dangers of whooping cough in a very young child are so great. Nevertheless, the decision is the mother's. Every assistance, however, must be given to mothers to realise that the kind of alarmist things which have been said about the pertussis vaccine do not apply to the diphtheria vaccine or to some of the other vaccines which are so desperately necessary.

Before I sit down, may I say that we on these Benches fully support this measure. We welcome it and hope that it will proceed very rapidly indeed to its full implementation. However, in carrying out the various necessary steps, I hope that everything possible will be done to restore public confidence in the immunisation programme as a whole and to repair any damage which has been done—and I think some damage has been done—to the reputation of immunisation in the public mind as a result of the long period of delay before finally settling this matter of the compensation of those very rare victims of the immunisation process.

Lord ALLEN of ABBEYDALE

My Lords, before the noble Lord sits down, may I ask him, in view of his kindly references to the Pearson Commision, of which I had the honour to be a member, and his insistence upon this being treated as an interim, ad hoc measure, whether I am right in assuming that the Liberal Party are in favour of the long term and comprehensive solution proposed by the Royal Commission and whether this might form part of the Liberal Party's Manifesto.

Lord WINSTANLEY

My Lords, I can confirm that we are in favour of the long term proposals, but we also understand the extreme difficulty in this whole area, the kind of difficulties to which the noble Lord, Lord Wells-Pestell, referred regarding the precise relationship of any particular case to a particular causal effect. Broadly speaking, however, I can, for what it is worth, confirm that the Liberal Party is in favour of the provisions contained in the report and would support their implementation in the long term.

Lord ALLEN of ABBEYDALE

My Lords, I am obliged to the noble Lord.

4.13 p.m.

Lord SEGAL

My Lords, the noble Lord, Lord Auckland, has very graciously agreed to give way, although his name appears on the list of speakers and mine does not, for reasons which I readily acknowledge and which will become apparent, I hope, in the next few minutes. In order to ensure that this Bill receives support from all sides of the House, I should like to add my voice, from these somewhat attenuated Benches, and say how very warmly we welcome this long overdue measure. It is perhaps an instance of rough justice and may in some cases prove to be a measure of inadequate justice. On the other hand, as so many speakers have already emphasised, it is important that no backlash results from this Bill.

So many measures passed by both Houses of Parliament with the highest of motives have had totally unforeseen results. It would be unfortunate indeed if the passing of this Bill were to result in any diminution of the general acceptance of vaccination against whooping cough and in an increase in this most unfortunate disease. Having said that, may I say again how very warmly we on this side of the House welcome the Bill.

4.15 p.m.

Lord AUCKLAND

My Lords, although this is a modest Bill, it is at least very much a step in the right direction. With his characteristic lucidity, the noble Lord, Lord Wells-Pestell, has presented the Bill in a most convincing manner. The Bill will bring some consolation to the very small number of children who will have been grievously brain damaged by the use of certain vaccines. One has only to see some of these children, as I have, to know how very sad is this small number of cases. The fact that this has happened is the fault of neither the medical profession nor anybody else, because these vaccines are very thoroughly examined. Having visited a number of pharmaceutical companies, I can vouch for this. One can only hope that in the future more stringent tests will be applied to these vaccines to prevent even the very small number of tragedies which take place.

Clearly it was the thalidomide tragedies which had some bearing on the presentation of this Bill. Two weeks ago on television there was the quite incredible story of the first mother, who herself was a thalidomide victim, to have borne a child. The way in which this mother coped with the child, by using her feet and her toes because she had no arms, was wonderful to watch. Those of us who grumble about the disabilities from which we may suffer can take a lesson from this quite incredible programme and from the cheerfulness with which this mother undertook her tasks. I mention this case because, although thalidomide did not necessarily result in brain damage—as I understand it, it resulted in most cases in the very serious deformity of limbs—nevertheless it caused a fearful handicap. The results in the case of this small number of vaccine damaged children are far worse.

One of the main controversial topics of the Bill is the amount of compensation and the degree to which a child has to be disabled before that compensation is paid. One must sympathise with any Government who have to bring in legislation of this kind. There must be a yardstick. Amendments were moved in another place by the honourable gentleman the Member for Stoke-on-Trent South, who is such a great champion of the disabled and who is himself disabled. I happen to know him because he lives near me in Surrey. I wonder whether in fact more consideration could be given in the later stages of this Bill to this particular Amendment.

It is difficult, of course, as I have said, to conceive a realistic figure, but one has to remember that, hopefully, some of these children will be able to cope in life with some kind of work and eventually be, at least in part, self-supporting. A child with 80 per cent. brain damage is unlikely to meet with any of these requirements, for obvious reasons. It is easy to trade in figures, but if one were to start at a figure of, say, 50 per cent. and arrange some payment, one would have the advantage, if that is the right word, of perhaps an even smaller number of children who are still badly disabled but who might manage to hold down a simple job and be of benefit to themselves and to their parents. Because it is the parents and dependants who are going to have a very tragic and difficult time in looking after these children, and no amount of compensation, be it in six figures, can really make up for the grievous condition in which many of these young people will find themselves. But this is a matter which could perhaps be considered at a later stage.

Bearing in mind that, as I understand it, the £10,000 will be a lump sum, I wonder whether a further sum could not be put into some form of trust because even in these inflationary times—and of course one has to bear in mind, even in tragic cases like this, that no Government can pay completely over the odds, so to speak—some amount can be put into a charitable trust for future years. I accept that, as I understand it, £10,000 is no mandatory sum. This is a sum which has been conceived for the purposes of this Bill, and as such it is very welcome.

The other point on Clause 4 concerns the composition of the tribunals. The idea of an independent tribunal is admirable, but I would hope that such cases as appear before these tribunals are dealt with both speedily and humanely. Those who administer these tribunals are all men and women of humanity, but even those, like myself, who are not in the legal profession know only too well that tribunals can take a very long time to come to a decision, and these are cases when a clear and quick decision is very much needed.

I should like to join in the tributes paid to Mrs. Fox for her unstinting efforts with regard to this Bill and also endorse what the noble Lord, Lord Winstanley, and others have said about the vital importance of vaccinations taking place. These are a small number of cases, highly tragic as they are, but the lack of vaccination, particularly against diseases such as poliomyelitis, can have terrible effects later on. Having said that, my Lords, I think this is a humane Bill; it is a Bill which is perhaps rather late in coming about, but certainly if ever there was a case for the words, "better late than never"—bearing in mind that there are some aspects of the Bill which need looking at—these words are most opportune.

4.26 p.m.

Lord SOMERS

My Lords, I apologise, first, for not having put my name on the list. Like other noble Lords, I welcome this Bill wholeheartedly, but there is one point on which I should like to comment and which has already been mentioned by the noble Earl, Lord Avon. That is the hard and fast dateline which is drawn for the beginning of these payments, in 1948. I think it was the year just before that when there was very widespread publicity by the Government of the day, advising parents to have their children vaccinated against diphtheria. There are some cases—and like the noble Earl I do not think there are more than a dozen or so—where that had a very serious effect. There arc children of those days, who are now of course in their thirties, who have the mentality of children of the age of about three or five, and their parents have had to devote their entire lives to looking after them. But, my Lords, think what one would feel like as a parent of such a child in realising that one would not go on living for ever and would have to make some sort of provision for the child.

I understand that when the right honourable gentleman the Minister was consulted about this he said that he had to draw a line somewhere. One can understand that, but I hope that in the interests of humanitarianism he will feel that even a rule like that can sometimes demand exceptions.

Lord ROBBINS

My Lords, while welcoming this Bill wholeheartedly I beg leave to ask the Minister a simple question: is the £10,000 index-linked? I personally am not in favour of universal indexing but in a case of this sort it would appear to me to be simple justice that it should be done.

4.29 p.m.

Lord WELLS-PESTELL

My Lords, I am most grateful to those noble Lords who have taken part for their support and approval of the Bill. I should like to apologise to my noble friend Lord Segal for interrupting him, but I did not realise that there had been a private arrangement between my noble friend and the noble Lord, Lord Auckland. In your Lordships' House it is customary, if there is any change in the order, for both Front Benches to be informed and then we do not make that mistake. Nevertheless, I apologise.

With regard to the interim payment, as it has been called, I pointed out that under the present legislation it is an award which would have to be taken into account in just the same way as any other capital sum if the person decided to bring proceedings in the civil court. It is very clearly set out in Claude 6(4), which says that it: does not prejudice the right of any person to institute or carry on proceedings in respect of disablement suffered as a result of vaccination against any disease to which this Act applies". Therefore, there is nothing to prevent people from bringing action if they believe that they are justified in so doing or that they have a case. I understand that my noble and learned friend the Lord Chancellor is considering the effect of a payment made under the Bill at present before us in any future application for legal aid by or on behalf of any vaccine-damaged child seeking redress in the courts. I do not know what the outcome of that will be. I know that, in fact, my noble and learned friend is very concerned about this and in due course we may hear something from him.

The noble Earl, Lord Avon, raised the question whether adults should be included. I do not think that we can go further than we have gone. He raised the matter of those damaged before 5th July 1948, as did the noble Lord, Lord Somers. My understanding of what the noble Earl said was that there are some 12 cases. However, I think that we must have a starting point. The 5th July 1948, when the National Health Service came into being—for which the Government were wholly and solely responsible—seems to be the right date. Certainly from that date the Government have some responsibility for encouraging people to be vaccinated against a whole range of diseases.

Lord SOMERS

My Lords, may I briefly interrupt the noble Lord. Surely the Government also have a certain responsibility for those who obeyed their instruction to be vaccinated and who, as a result, were hopelessly damaged. I cannot believe that they are suffering any less because it was done before 1948.

Lord WELLS-PESTELL

My Lords, I am not for one moment suggesting that they are. I am saying that in a matter of this kind, when we are trying to redress a situation by means of a payment to people who have suffered as a result of subscribing to public policy, there must be a starting point. If we start two or three years earlier, then a situation could arise in which someone said, "You should start earlier still". The 5th July 1948 seems to be quite a reasonable time to commence.

The noble Earl also raised the question of the Pearson Commission. I do not think I can add anything to what I said in my opening remarks, that we are fully aware of the recommendations, that we are studying them and giving them a great deal of thought. If there is anything further that we can do in the matter, we shall do it. The evidence of good faith is the fact that we have brought this particular scheme before Parliament in order to try to do something, albeit perhaps not enough. If there is anything that we can do in the future we shall certainly do it.

The noble Lord, Lord Auckland, raised the question of the severity of the disablement which, under the Bill, qualifies a person for payment. We conclude that the 80 per cent. is the right point at which to draw the line for severe disablement. We took a good deal of advice on this. This is not a decision which was arrived at merely by Ministers or by people in the Department. A great deal of consultation took place. It coincides with several requirements for other benefits and, rightly or wrongly, we believe it to be the right percentage.

The noble Lords, Lord Auckland and Lord Robbins, raised the question of index-linking this amount. This is a payment of £10,000. It is intended that this should be put in trust. That is why there is a trust deed. It is perfectly true that money can be drawn from it at any time; those administering the trust think it desirable. However, if invested, £10,000 brings in quite an appreciable amount per year, without the capital being touched. It certainly is not index-linked, and so far as I know there is no intention of doing so.

The noble Lord, Lord Winstanley, raised the question of future claims which may be brought in the civil court, with which I have already tried to deal. However, he expressed himself far better than I could on the importance of continuing the immunisation programme. Of course, the Government would wholeheartedly support what the noble Lord said about that. I hope that in his capacity as a doctor he will use whatever influence he has with his colleagues to ensure that they themselves add their weight and their voice to the importance of vaccination and immunisation; because, as the noble Lord quite rightly said, we hear only of the failures; we do not pay very much attention to the successes.

The only other point I want to make is the one again made by the noble Lord, Lord Auckland, about tribunals. We have tried to follow the pattern that has been established and which works very well in the social security Acts. In this particular case there will, as the word indicates, be a tribunal of three. It will comprise a lawyer as chairman, who, I believe I am right in saying, will be appointed by my noble and learned friend the Lord Chancellor. That is the normal procedure and I have no information which suggests that we shall depart from that. The other two members will be doctors, and being doctors, I should have thought that they are not likely to take an indifferent view of the situation. They will be able to look at it from a medical point of view. In the last analysis, perhaps that is the best way of looking at this particular difficulty.

Lord AUCKLAND

My Lords, I am grateful to the noble Lord. I was not suggesting that they would take an indifferent point of view. In fact, I am sure they will take a very human point of view. My main concern was that this procedure should be carried out as speedily as is reasonably possible. I think that the answer which the noble Lord has given satisfies that point.

Lord WELLS-PESTELL

My Lords, I sat on a mental health tribunal for some time and the decisions were very speedy. From my own personal knowledge, I know that tribunals of this kind are able to report very quickly. Having regard to the circumstances of the person with whom they would be dealing, they would not lose very much time. Once again, I am grateful to noble Lords for their contributions.

On Question, Bill read 2a, and committed to a Committee of the Whole House.