BSE (Health) (Hansard, 25 March 1996)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, with the leave of the House, I should like to repeat a Statement made by my right honourable friend the Secretary of State for Health in another place. Before doing so, I should like to declare an interest: my husband manages a dairy and beef-producing farm; there have been cases of BSE; we have no share in the farm's assets.
The Statement is as follows: "With permission, Madam Speaker, I would like to make a further Statement about the advice which the Government have received from the Spongiform Encephalopathy Advisory Committee.
"I begin by reminding the House briefly of the background. The advisory committee brings together leading experts in neurology, epidemiology and microbiology to provide scientifically based advice on the implications for animal and human health of different forms of spongiform encephalopathy. As I have repeatedly stressed, its members are not government scientists; they are leading practitioners in their field, and it is the function of the advisory committee to allow them to pool their expertise to assess the latest scientific evidence that is available.
"Both the Opposition health spokesman and the Leader of the Opposition stressed last week the importance of reaching decisions on the basis of the scientific evidence. I agree with them. I also agree that it is important that both the evidence on which the committee reaches its recommendations and the recommendations themselves should be made public as soon as practicable. That is why I published the committee's recommendations last Wednesday and it is why I have today put copies of its latest recommendations, accompanied by a statement from the Chief Medical Officer, in the Vote Office. I can confirm to the House that arrangements are in hand 1484 to ensure that the evidence on which these recommendations are based will be published in the scientific journals within the next four to six weeks.
"Science is not a substitute for political or personal choice—but it is the only basis on which an informed judgment about these issues can be reached.
"Last Wednesday I informed the House of the advisory committee's conclusions about 10 new cases of Creutzfeldt-Jakob disease. The statement which the committee approved at its weekend meeting emphasises that there are only 10 cases of this previously unrecognised variant of CJD that have yet been identified, and that the committee is not in a position to confirm whether or not there is a causal link between BSE and the human disease. The committee did however repeat its view that the most likely explanation at present of this new form of CJD is that these cases are linked to exposure to BSE before the introduction of the specified offals ban in 1989.
"Following receipt of its advice last week, I asked the committee to consider as a matter of urgency the implications of its findings for children. In considering this question the committee was joined by three leading experts in the field of paediatrics, gastroenterology, and immunology. The committee considered carefully its knowledge of the transmissible spongiform encephalopathies and considered the evidence available from the 10 identified cases. Taking all that into account, the committee concluded, 'if human infection with the BSE agent occurs, infants and children are not likely to be more susceptible to that infection than are adults'. "The committee also considered the possibility of increased susceptibility among patients in hospital, pregnant women and people who are taking immunosuppressive drugs. Once again it concluded that 'if human infection with a BSE agent occurs, none of these groups is likely to have any increased susceptibility to infection'. "The statement issued by the committee goes on: 'Parents are naturally concerned about the risks to their own children. No human activity is without some risk; if the Government rigorously enforces the current and newly recommended controls we believe that this risk is likely to be extremely small; however the Committee recognises that parents will often chose to reduce risk to their children beyond that which they are prepared to accept for themselves. 'It is important to be aware that many foods are associated with health risks and that changing from beef to non-beef products is not necessarily without risk'. "In the light of the scientific evidence, there is clearly no reason for the Government to advise local education authorities to withdraw beef from school menus. I understand however from my right honourable friend the Secretary of State for Education and Employment that it is customary for schools to provide a choice of menu to accommodate different dietary and cultural preferences. The Government believe this choice should continue. Local education authorities will be sent copies of the advisory committee's statement so that they can be aware of the precise terms of its findings.
1485 "The committee reconfirmed the recommendations which were published last Wednesday concerning the deboning of cattle carcasses aged over 30 months, and has made a number of other relatively minor recommendations concerning the treatment of specified bovine offal. My right honourable and learned friend the Minister of Agriculture will deal with these questions in his Statement.
"The committee also made two recommendations concerning research. First, it recommended the reinforcement of the CJD Surveillance Unit at Edinburgh University, and, secondly, it recommended the commitment of substantial additional resources to long-term basic and applied research to improve our understanding of these diseases. The Government accept these recommendations. We already have plans in hand to strengthen the CJD Surveillance Unit. In addition I have today instructed Professor John Swales, the NHS Director of Research and Development, to prepare a directed programme of research in this field involving the Department of Health, the Ministry of Agriculture, Fisheries and Food, the Medical Research Council and the Biotechnology and Biological Sciences Research Council.
"Against the background of these findings the Advisory Committee reports two central conclusions. First, it reasserts that, provided the restrictions which it recommends are fully implemented and sustained, any BSE-related risk from eating beef or beef products is likely to be extremely small. Secondly, the committee's statement concludes with the words, 'the Committee does not believe that additional measures are justified at this stage but the situation needs to be kept under careful review so that additional significant information can be taken into account as soon as it becomes available'.' "Throughout their consideration of these questions the Government have made it clear that it is their policy to base their decisions on an up-to-date assessment of the scientific evidence. We have also made clear our commitment to making that evidence public. That remains the position. In that connection I am authorised by my right honourable friend the Lord President to inform the House that it is the Government's intention to arrange for a debate on these matters on a Motion for the Adjournment on Thursday 28th March at 7 p.m.
"The statement of the advisory committee which I am publishing this afternoon makes clear recommendations both to the Government and to the public. The Chief Medical Officer is taking steps today to communicate this new advice to all doctors. The Government accept the recommendations and will act upon them." My Lords, that concludes the Statement.

§ Baroness Jay of Paddington
My Lords, these Benches welcome the Statement from the Department of Health. It is a step forward from the somewhat inconclusive views offered in last Wednesday's 1486 Statements. Perhaps it would have been better for everyone—parents, school authorities, farmers and the meat trade—if this position had been reached and this guidance had been available before the Government decided to go public on the advice that it had last week. In spite of Ministers' assurances last week that all would be well—the noble Earl, Lord Lindsay, said in reply to my noble friend Lord Carter that there was a large and healthy degree of optimism in the Statement—there has been obvious and destructive turmoil in the past few days. However, these Benches welcome what is now said, even though we and, I suspect, the general public are bound to treat some of the pronouncements on this issue with a degree of scepticism. We welcome the CMO's statement and the publication of the report from SEAC. We are particularly pleased that these have been available at the same time as the Statement has been made.
It is important that children, pregnant women, patients and those who are immuno-compromised are judged not to have increased susceptibility to this infection. In the case of children, the issue may not simply be the setting of an absolute average age to measure vulnerability or to establish absolute risk. Surely, increased or decreased sensitivity to infections at a certain age is not the point when one is talking about children. It is the long-term incubation that perhaps makes children more vulnerable. As the noble Baroness, Lady Robson, put it so gracefully last week, for many elderly people there might be little threat, because with a 10 or 15-year incubation period for CJD the elderly perhaps would be unlikely to survive to suffer the effects. But for children it is totally different. I would be grateful if the Minister would comment on that issue in her response. As the Minister has said and the SEAC statement recognises, parents will often choose to reduce the risk to their children beyond that which they are themselves prepared to accept.
I should like to return to some of the questions that remain relevant which were raised by me and other noble Lords last week. The Minister did not answer them then, and they are not answered by this new Statement. First, are there any specific foodstuffs, particularly those that contain beef products rather than pure beef, which families with children should now avoid? Are there particular methods of preparation that make those products more or less risky? For example, it has been suggested by the media over the weekend that the preparation of some products in microwave ovens may increase vulnerability. Very importantly, noble Lords in all parts of the House last week during the Statement asked whether it was clear what the relative risks were of eating offal products and products derived from offal products. I understand that these can extend to such products as gelatine and jelly babies. Is that risk quantifiable? What is the relative risk of eating such products as against eating what may be described as obvious beef cuts? In addition, what specific guidance is given by the Department of Health to general practitioners and family doctors, who will be inundated with requests for guidance from anxious families, about the early signs of CJD and how they should be dealt with?
1487 My noble friend Lord Winston last week raised a very precise question about the pattern of disease in the relevant suspect 10 cases and how it had been established. What is it about these cases that makes them of particular concern to the scientific body? What is the evidence to suggest that they, and they alone, may have a link with BSE? I understand that that may be published in the learned journals, but it will be useful to have some guidance now.
As we gradually learn more about the situation it becomes apparent that mistakes have been made by people in authority. Though it is not primarily a matter for the Department of Health—I know that my noble friend Lord Carter will wish to return to it—there is particular concern about the inadequate compensation offered to farmers for infected cattle during the crucial period between the time when BSE was diagnosed and when the abattoir regulations came in. There is also concern about the food safety regulations and the separate MAFF regulations. It is always easy to be wise with hindsight. However, if, as the Labour Party had suggested, a separate food standards organisation entirely independent of MAFF had been established some of these problems might never have arisen. There is also a question about whether all of these issues should be seen in the context of the dogmatic drive towards deregulation in every aspect of our lives which has been conducted by the Government.
In the past few days we have heard repeatedly that the Government rely on the expert advisory committee and the scientists to tell them what to do next. Surely, this is a failure of political leadership. I am glad that the Secretary of State has said that science is not a substitute for personal or political choice, but if there has been a failure surely the failure to distinguish between scientific evidence and political judgment is culpable. If in the past Ministers had made the political judgment that public health was of paramount importance the story might have been different. It would then have been possible to deal with the recognition of the threat of BSE without loss of public confidence and the potential agricultural disaster that we all face today, which I believe the Statement will do little to alleviate.

§ Lord Harris of Greenwich
My Lords, I also thank the noble Baroness for having repeated the Statement. I received a copy of the Statement after her right honourable friend rose to his feet in the House of Commons. She will be aware that there are long-standing arrangements for making Statements available to representatives of the Opposition. That did not happen in this case. I hope that complaints of this kind will not have to be repeated in future, particularly on a matter as important as this. We are faced with an almost complete collapse of public confidence in British-produced beef.
I should like to put the following question, to which I know the noble Baroness will reply that it is a matter for the usual channels. First, if there is a debate on this matter in the House of Commons on Thursday of this week, I ask that there should he a similar opportunity for an early debate in this House to discuss these 1488 questions of great public importance. I believe that the House will welcome the opportunity to have such a debate.
Secondly, is the Minister aware that SEAC's statement makes two points of considerable importance? One is the assertion of the need for medium and long-term research which will require substantial additional resources. The Minister indicated that there will be such improvement in financial allocations to those concerned. The committee adds that there should be no delay due to difficulty in obtaining resources. Can the House assume therefore that adequate resources will be made available and that SEAC itself will pronounce judgment as to whether the additional resources made available are adequate?
Is the Minister aware that SEAC's recommendation is that it is necessary to ensure that all the restrictions proposed on 20th March and those in this document are implemented fully and are sustained? Is she aware that there is some public concern that a number of the recommendations have not yet been implemented? The concern is widespread. I hope that the Minister will be able to tell us when those recommendations will be implemented fully.

§ Baroness Cumberlege
My Lords, first, I thank the noble Baroness for her welcome for the Statement. I am sorry that she felt that last week we went public too early. The whole tenor of the Government is to be as open and frank as possible with the public. We felt that as soon as the research became available it was right that it should be made known to the general public.
Regarding the risk to children, SEAC is firm about that. In its report, taking all the above into account, it concludes: If human infection with the BSE agent occurs, infants and children are not likely to be more susceptible to that infection than are adults". I do not believe there is anything I can add. SEAC's statement is clear.
The noble Baroness asked whether certain foodstuffs should be avoided. Again, SEAC has addressed the issues of milk and gelatine. It comes out with clear statements that there is no reason to avoid eating those products. The committee also concludes that it does not believe that additional measures are justified at this stage but the situation needs to be kept under careful review so that additional significant information can be taken into account as soon as it becomes available. I want to stress that at this time it does not feel that additional measures are justified.
The noble Baroness asked about advice to doctors. That is contained in the letter issued last week to all doctors by the Chief Medical Officer. Today he has issued an additional statement which picks up the information that SEAC has addressed concerning children and those groups which are thought to be vulnerable.
The noble Lord, Lord Harris of Greenwich, asked why he had not received the Statement earlier. I apologise for that. I understand the frustration which was felt last week also. I shall take up the matter. 1489 I understand too the noble Lord's wish for a debate. I will convey that wish to the appropriate channels. He asked questions about research. I have said that the Government accept all the SEAC recommendations. That includes those regarding resources for research.
Finally, I should like to address one comment made by the noble Baroness. She felt that the Government were hiding behind research. I find that a very, very strange statement. I believe that it is up to governments to put forward the facts. In these sensitive situations it is not up to governments to hypothesise or put forward their views, which may be erroneous. We have to base all our information on research facts.

§ Lord Boyd-Carpenter
My Lords, I hope that my noble friend will go further than she did just now in response to the request of the noble Lord, Lord Harris of Greenwich, for your Lordships' House to have an opportunity to debate this immensely important matter. For your Lordships' House not to debate it will almost sign off its being part of Parliament. To say that the request will go to the usual channels, does not necessarily convey very much. As many of us realise, the usual channels often become blocked.

§ Baroness Cumberlege
My Lords, I take into account what my noble and distinguished friend says. I am sure that the channels will listen, read Hansard, and take note of his view. Whatever aspirations I have, clearly I cannot put them into action. The matter has to go through the usual channels.

§ Lord Winston
My Lords, I thank the Minister for her Statement. Perhaps I may point out that as a registered practitioner, I still have not received the letter which has been promised. Six days have elapsed. There is considerable anxiety: we are being approached continually by all sorts of people. We should be informed as a matter of urgency. I accept that my question may need an answer in writing. Can the Minister tell us what research has been funded in the past by the Medical Research Council or within agricultural research on prions, the protein particle which causes this and related disorders? It was basic research before; it is now applied research. I think the Minister can understand why we see the need for this type of basic research to continue.

§ Baroness Cumberlege
My Lords, I am surprised by what the noble Lord says about not receiving the letter because I met some consultants that evening and they had already received the Chief Medical Officer's letter through the EPINET system. I wonder whether the problem lies in the internal channels within his hospital. The noble Lord was free to request the information if he was so anxious to obtain it. With regard to the division of research moneys between the MRC and the agricultural research, I am afraid that I do not have that information. I shall gladly write to the noble Lord about it.

§ Lord Winston
My Lords, perhaps I may say that I telephoned my office to confirm that it had not received 1490 anything as recently as 15 minutes ago. I received this morning's post at home. There has been nothing in the post to date.

§ Viscount Waverley
My Lords, the Minister referred to 10 cases. Can she identify how many cases there are on the Continent?

§ Baroness Cumberlege
My Lords, the prevalence rate in this country is about the same as that on the Continent. It is one in 1 million. However, we also know that on the Continent, although there are no instances of BSE, there are cases of CJD, which is interesting.

§ Lord Hamilton of Dalzell
My Lords, I too welcome my noble friend's Statement. I hope that it does something to restore confidence in the beef industry. I speak as a beef producer. Does her, or SEAC's, advice to doctors underline the importance of protein in the diet of children? The advice of the Government's advisers is that parents should have the choice of whether or not they feed beef to their children. Beef represents an extremely valuable and important source of protein. With people taking to living on lettuce and green vegetables, there are already signs of rickets reappearing in children. The danger of the panic is the bad effect it will have on children's health because they are not eating enough good meat.

§ Baroness Cumberlege
My Lords, I have to concur personally. I think a great deal of what my noble friend says is absolutely right. But the Government feel that it is not for them to tell people what to eat or to tell parents what to give their children to eat. We try to give the public information and firm facts; it is then for people to make their own-decisions.

§ Lord Cledwyn of Penrhos
My Lords, for the sake of clarification, will the Minister confirm that she is saying that her department sees no objection to people of all ages in this country eating beef without exceptions?

§ Baroness Cumberlege
My Lords, we go back to the information and advice we have received from SEAC. It states at this moment that there is a very minimal risk. The words that it uses are "an extremely small risk". At the moment we know that the link is theoretical; it has not been proved. However, bearing in mind the 10 cases, SEAC felt that there could possibly be some kind of a link. At the moment it states that it is not in a position to confirm whether there is a causal link between BSE and the human disease and it suggests that eating beef carries a very, very small risk.

§ Lord Campbell of Alloway
My Lords, can the Minister confirm that the criticism made of the Government and, by implication, of my right honourable friend the Minister of Agriculture is not at all well conceived? Does she agree that politically a Statement should have been made and was made when concern arose and that that was a courageous and correct decision and in no way open to political criticism?

§ Baroness Cumberlege
My Lords, I thank my noble friend for his support. Reading one of the many editorials 1491 written about the matter, I was pleased to see that The Times described the Government in this instance as honourable.

§ The Countess of Mar
My Lords, the Minister will be aware of a school of thought which links organophosphates with BSE and other spongiform encephalopathies. I am aware of work carried out by the Medical Research Council on the effects of organophosphates directly on prime protein. However, as Burkitt's lymphoma relies on the mosquito before it erupts, will the Government ask the researchers to look at a possible catalystic connection between OPs and the spongiform encephalopathies because there could well be a connection in some way or another?

§ Baroness Cumberlege
My Lords, as the noble Countess will be aware, research is initiated by protocols and by submissions from different researchers who believe that a matter needs probing and exploring. They must put forward their submissions. It would be totally wrong of me to pre-empt that process. It has held good for a very long time. I have no doubt that if a suitable protocol receives priority from the MRC or the body judging the different research submissions it will not be ruled out.

§ Lord Shepherd
My Lords, does the Minister agree that the funds of the MRC are very tight, if not limited, and that therefore flexibility to undertake a major form of research would prove nearly impossible unless new resources were made available? Will she consider perhaps with the MRC what funds would be necessary if such research were to be undertaken by it on behalf of her department?

§ Baroness Cumberlege
My Lords, last Wednesday in this House and in another place Statements were made by myself and by my right honourable friend indicating that new money would be coming forward for research into this matter. The figure mentioned was £4.5 million. Today SEAC made specific recommendations as regards research and we have accepted those recommendations. They deal with the question of resources and the fact that there should be sufficient resources for research into this matter.

§ Lord Peyton of Yeovil
My Lords, arising from that question, is my noble friend aware that a notable research effort is being conducted at St. Mary's Hospital, Paddington, under the auspices of Imperial College?

§ Baroness Cumberlege
My Lords, I am grateful to my noble friend. I would hate your Lordships to believe that research is not being carried out. Indeed, research into this matter is taking place in different parts of the country. My right honourable friend the Secretary of State recognises the concern that exists and in no way would he wish to stand in the way of suitable, tested further research schemes.

§ Lord Monkswell
My Lords, I too thank the Minister for repeating the Statement. The Government have laid great stress on their obtaining advice from the scientific community. I hope that they are aware that some members of that community have disagreed with their colleagues 1492 about this situation. Can we be assured that the scientific research suggested by those in the scientific community who have disagreed with the consensus will now receive government support?

§ Baroness Cumberlege
My Lords, I am aware that the scientific community is composed of extremely intelligent, bright people—perhaps the cream in the land. Naturally, they have different opinions and views which are widely debated and discussed. We must go back to peer review. Where protocols are coming forward it is up to the experts in the field to decide whether a protocol warrants resources and whether the research is pertinent and appropriate and should go forward. As I said, my right honourable friend stated that he will ensure that the question of resources will not stand in the way if appropriate research is mooted.

§ Lord Stoddart of Swindon
My Lords, I wish to ask the Minister two questions. First, is she aware that today two cases of BSE have been reported in France, which was one of the first countries to ban the import of British beef? Does France have the same stringent controls on matters BSE and does it take the same kind of notice of the scientific community and the scientific advice that it receives as do we in this country?
My second question relates to the attitude of the Secretary of State for Health over the weekend. He said that if the scientific community made any recommendation the Government would accept it straightaway. In that case, I wonder why on earth we have Secretaries of State. Secondly, he said that if the advice that he received was to destroy all British cattle—there are 11 million—the Government would act on that advice. Before he made that statement did he seek advice from all other Ministers, from the Cabinet and, in particular, from the Chancellor of the Exchequer who on behalf of taxpayers must meet the enormous costs, both internal and external, that that will bring about?

§ Baroness Cumberlege
My Lords, I believe that my right honourable friend the Secretary of State has acted with extreme integrity and has come over very strongly. He has taken scientific advice on which he has based all his facts. That is absolutely right and proper. However, he has also said that if options are open, quite properly the Government will consider them all.
As regards cattle, the beef industry, and those issues, I do not believe that I should answer but that my noble friend who is representing the Ministry of Agriculture, Fisheries and Food this afternoon should take on those issues.