HL Deb 27 May 1993 vol 546 cc385-7

Baroness Jay of Paddington asked Her Majesty's Government:

Whether, in view of the declaration by the World Health Organisation that tuberculosis constitutes a global public health emergency, they will reconsider proposals to end the national programme of vaccinating children.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)

My Lords, there are no plans to end the schools BCG immunisation programme.

Baroness Jay of Paddington

My Lords, I am grateful to the Minister for that helpful reply. However, is she aware that, because the communicable disease report in May showed that TB in this country has risen by 5 per cent over the past year, there is concern about some of the causes of that rise? One of the factors which is of greatest concern is the interaction between HIV and the increase in TB. Can the Minister give the House any further information?

Baroness Cumberlege

My Lords, we are aware of the concern about the fact that the HIV pandemic is having an effect on the rates of tuberculosis in the USA and elsewhere. However, we have some very robust screening programmes so that those coming into this country who may have TB because they come from a high prevalence area are screened before they take up residence.

Lord Swinfen

My Lords, can my noble friend assure the House that immunisation against tuberculosis will continue well after the last case is diagnosed in this country, bearing in mind that the World Health Organisation has said that smallpox has been eradicated but that recently two cases were diagnosed in Asia?

Baroness Cumberlege

Yes, my Lords; the Government are very concerned about the issue. We have recently written to regional health authorities to remind them of their obligations. It is a disease which has largely been eradicated, and we are determined that it does not become reintroduced into the country.

Lord Ennals

My Lords, my noble friend referred to the "helpful reply" from the Minister. However, I have to say that I found it most disappointing. Does not the Minister accept the report by the Public Health Laboratory Service, Communicable Diseases, which links homelessness with tuberculosis? Bearing in mind that the problems of homelessness in our society are steadily increasing, will the Minister think again about the reply that she gave to my noble friend?

Baroness Cumberlege

My Lords, we know that there are many factors which affect the spread of tuberculosis. But the Government are addressing the vulnerability of homeless people to this particular disease. Last year we funded a tuberculosis screening programme at Crisis Open Christmas. We are in consultation with that organisation, and other organisations, to see how best to tackle the problem. In fact, the Department of Health is funding nearly 30 projects to help ensure that homeless people have ready access to any medical services that they require.

Lord Mackay of Ardbrecknish

My Lords, is my noble friend the Minister aware that I, and perhaps many other noble Lords, were very concerned when we read the Question? We are delighted at the very positive response that she gave. It shows that the basis of the Question was unfounded. Can my noble friend tell the House whether the success of all the vaccination and immunisation programmes is having a major impact in removing all the diseases that are capable of being removed by such measures? Will she give a commitment that the Government will maintain their policy of maximum uptake of immunisations and vaccinations in order to keep herd immunity as high as possible?

Baroness Cumberlege

My Lords, I am grateful to my noble friend for that question. He is quite correct in his assumption that we are tackling some of the endemic diseases that used to be very prevalent years ago. In the past two years not a single child has died of measles. The Government are anxious not only to maintain the present programme but also to improve it. We have set stringent targets that childhood immunisation should achieve a 95 per cent coverage by 1995. We are not as ambitious as one South American country where the former Minister of Health assured me that they had achieved target rates of 110 per cent

Baroness Gardner of Parkes

My Lords, is my noble friend the Minister aware that the regional health authorities—and I speak as a member of one—recognise that the TB resurgence is a very serious matter? They are not only carrying out immunisation, but they are also undertaking research into the particular factors that cause the spread of the disease so as to contain it where it does occur in the community.

Baroness Cumberlege

My Lords, as the vice-chairman of a regional health authority my noble friend is obviously quite correct on the issue. The Government are committed to reviewing the policy to absolutely ensure that it is meeting all the targets. A national survey of notifications of tuberculosis in England and Wales is taking place during 1993, from which we expect some useful information to be produced.

Baroness Jay of Paddington

My Lords, I return to the point which was also mentioned by my noble friend Lord Ennals about the helpfulness, or otherwise, of the reply of the noble Baroness. The noble Lord, Lord Mackay, also referred to the matter I am about to mention. I hope the Minister can confirm that this Question is not based on a misunderstanding. I understand there is to be a review of the schools vaccination programme. I am grateful that the Minister has indicated that that review will have a positive result in the sense that vaccination programmes will continue.

Baroness Cumberlege

My Lords, the Government have a good record in this field. We are one of the leaders in the world in terms of vaccination and immunisation programmes. Our healthy children are proof of the success of the programme.

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