Vaccine Damage

HL Deb 28 June 2000 vol 614 cc975-91

7.53 p.m.

Lord Ashley of Stoke

rose to ask Her Majesty's Government whether they will improve the Vaccine Damage Payment Scheme.

The noble Lord said: My Lords, the story of vaccine-damaged children and the campaign to secure justice for them is one of high hopes, disaster, sadness, anger, bitterness, frustration and despair.

No government, until now, has a proud record on this issue, but the record of the Labour Government is far more enlightened than that of Tory governments. Only government can give the story a happy ending and I am glad to say that, after yesterday's announcement, this Government are moving in that direction. But it will only be a happy ending of sorts because no government can restore the health of someone severely brain damaged, who suffers lifelong convulsions and who has neither talked nor learnt anything since she was vaccinated as a happy, healthy child some 40 years ago. Those are the facts.

Not only was that child's health and happiness shattered, so were the high hopes of her parents. And I pay warm tribute to her mother, Rosemary Fox, who established the Association of Parents of Vaccine Damaged Children in 1973 and with whom I campaigned for many years. Only she, myself and my wife Pauline, who worked with me, know how appallingly tough the going was in the early 1970s. The only other person involved was Kay Andrews—now the noble Baroness, Lady Andrews—from the House of Commons Library, who did a tremendous amount of work supporting us.

In those days we met with prejudice, ignorance and generally a contemptuous dismissal of our claims. The £10,000 payment in 1978 came about only as a result of an imaginative and generous intervention by the then Prime Minister, James Callaghan. Today, the atmosphere is much more favourable, with many people well informed.

I have always expressed my support for the immunisation programme and I am glad that the great benefits of vaccination are now accepted almost without dissent. So is the need to establish herd immunity. But it is also clear beyond all doubt that there is a small risk—probably a very small risk—with vaccination. If the Government impose pressure on parents to vaccinate their children so that society can be protected, as they do through the GP incentive scheme, they must also accept their moral duty to support the affected children and parents, as they are now doing.

Arguments over how and to what extent the Government should provide support have raged for some 20 years. I congratulate the Daily Express on its recent forceful campaign. In its day, the £10,000 payment scheme was hailed a triumph, though only because we campaigners saw that as a prelude to the introduction of the Pearson Royal Commission strict liability scheme. As the years passed and no such scheme emerged, the parents became more and more embittered and MPs have been vociferous in their support in recent years. I pay tribute to the splendid work of Ian Stewart and his all-party group.

Ministers have just published the results of the Government's review of the payment scheme. I congratulate Alistair Darling on this major step forward and Hugh Bailey, who did so much of the work. I am sure that the whole House knows of the unswerving support given to vaccine-damaged children by my noble friend Lady Hollis.

I cannot speak for the parents and I suspect that those who asked for £1 million each will not be content. But I warmly welcome the proposals. They are a comprehensive and much needed improvement on the current payment scheme.

The amount of £100,000 will not provide a lifetime's care. But it is a worthwhile amount. It will ease the burden and help parents, especially over those initial awful years when they begin to realise what lies ahead. It is a welcome lifeline, more than doubling the existing amount. I welcome also the Government's decision to help those children—many of whom are now adults—who were damaged in previous years. All too often the natural distaste for retrospective legislation is a barrier to justice. It certainly was when Service people were allowed to claim for negligence, but not retrospectively—the famous Section 10 debate in the House of Commons. This Government have avoided that with vaccine damage and I am pleased that parents who have already received a payment will get it topped up so that all receive equal benefit.

The existing Vaccine Damage Payment Scheme has been criticised for two reasons—first, because the payment level has been inadequate and, secondly, because of the high barriers around it. In some years, only one claimant in 10 received an award. That was a deplorable situation and one which requires a ministerial explanation. I hope that my noble friend can help us on that issue.

The reduction of the 80 per cent disability level to 60 per cent is an excellent step forward. I am delighted that the Government have been wise enough also to apply this change retrospectively. But I want to ask my noble friend: how many more children will become eligible? If she does not know the facts, perhaps she can estimate the number. I ask that question because some press reports say that only a few will benefit. The House would like to know the truth.

The increased time for claiming is also helpful; but it is not good enough. Some children were damaged 30 or 40 years ago and, for good reasons, parents did not claim within the existing six-year time limit. They will lose out. There should be no time limit at all; indeed, there is no logic, no reason and no rational basis for it. I hope that my noble friend will be able to help me on that.

These advances by the Government raise two further issues. The first is to ensure that all families receive the full award and that none of them loses out through means testing either by the Benefits Agency or, as is more likely, by local authorities. Many of the affected children are now adults and live in local authority homes. Of course, the number will grow as their parents die. Will my noble friend ensure that the money from the £100,000 payment will be disregarded for means-testing purposes? I regard this as a point of cardinal importance because it would be quite wrong to make this a swings and roundabouts issue.

Secondly, where do we go from here? The issue of proper compensation, as recommended by the Pearson Royal Commission in 1978, remains unresolved. Pearson recommended that the Government should be strictly liable in tort for damage caused by state promoted vaccination; and that full compensation should be awarded by the court on proof of causation, without the need to prove negligence. I believe this to be the next major step forward. However, today is a day for congratulating the Government on easing the appalling burdens that have shattered families for decades.

8.02 p.m.

Lord Brennan

My Lords, I speak in this debate as someone with personal experience of litigation involving those affected by vaccine damage; and I regret to say that it was a negative involvement. It is well known that I advised the Legal Aid Board a number of years ago that the medical science in this field did not show a definitive connection between the vaccine and its neurological effect, as alleged. That meant that the "solution"—if it is to be properly so called—to these problems for parents and child was not to be found in our courts. It probably explains why the Pearson Committee took the suggestion of strict liability so seriously all those years ago.

I have introduced that background to indicate to the House that there is no present science that will definitely establish the connection between the vaccine and the consequences from which these children suffer. That is why the Vaccine Damage Act and its scheme give a payment based on a system of practical justice, whereby, if the neurological effect follows the administration of the vaccine in so quick a span of time that a reasonable person could make a causative connection, there will be an award. That is a novel system of compensation in our attempts to look after those as grievously damaged as these children.

The vaccine damage scheme is not a compensation scheme. Were it to be so, the mercifully small number of children affected—some 900—would each, depending on his or her life expectancy, be anticipating an award of anywhere between £1.5 million and £2.5 million from a court. That would represent a colossal amount of money, which the Government could not afford to pay. However, it graphically illustrates the extent of need which these children have and which is presently almost entirely met by their parents and family.

It was, therefore, with great pleasure that I read yesterday's Statement by the Secretary of State, which included some major changes to the operation of the scheme. First and foremost—and properly described—there is to be a dramatic increase in the lump sum payment. It was increased by this Government from £30,000 to £40,000 in 1998 and has now been increased to £100,000. Secondly, and most importantly, it has been backdated so that everyone who is a proper beneficiary of the scheme will be paid the full amount, or the proportionate amount, up to £100,000, depending on the age of the claimant.

Thirdly—and, again, most importantly—the removal of the six-year time limit within which to bring a claim is a just act. The time limit is now to be extended to 21 years. It is difficult to conceive of a family afflicted with this problem who, within those years, would not discover that there was a scheme to which they could have recourse. Fourthly, the disability threshold is to be reduced from 80 per cent to 60 per cent. In the minds of the families concerned, that really should produce a sense of justice where previously there was a strong sense of injustice. It is not a perfect solution, but it is a considerable step forward.

Finally—and this should not be forgotten in the years to come, should benefits be reviewed—the interaction of incapacity benefit and mobility benefit whereby they are increased will be an additional benefit to the lump sum payment. All these changes are of the greatest importance to these families. They are small in number but the effects of the damage inflicted on their children are enormous. These changes go some way towards recognising that burden. However, there is more to be done.

I shall not repeat the most important remarks made by my noble friend Lord Ashley to the effect that means testing ought not to be introduced in relation to these payments. We must not forget that, with the advance of modern medical science, many of these children will probably outlive their parents and finish up in hospitals or state institutions. When that event arrives, it would be a tragedy if what little means those children had were to be means tested.

What should next be done to build upon this new initiative? First, and surely most important of all, when will these changes be introduced? They require primary legislation and subsidiary regulations. As regards primary legislation, the Secretary of State said in another place yesterday that it would introduced at the "earliest available opportunity". As for regulations, he said that he would introduce them, as quickly as I can".—[Official; Report, Commons. 27/6/00; col. 723.] We do not often hear such determined promises as that. I do hope that they will be fulfilled. No one—I emphasise the words—could conscientiously object to either legislation or subsidiary legislation being pushed through these Houses of Parliament with maximum speed for this cause.

Secondly, in the year or two—if it is that—in which these changes are to be brought in, inevitably the families involved, and the new ones who become involved, will want to know how the scheme will affect them. Problems of interaction of benefits and so on will be acute for them. I invite the Minister to indicate whether in this preparatory stage to legislation, or perhaps in a year or two after it is introduced, there will be a system in which a nominated civil servant or a nominated office within the department will have the specific task of dealing with and answering the queries of parents that are sure to arise. That can be done efficiently through the Association of Parents of Vaccine Damaged Children. It is no good satisfying ourselves that legislation will make a change unless we accompany it with promises and action that explain the changes to the people most affected.

Finally, the scheme is the product of the need of society to vaccinate children against serious illness. That is a worthwhile intent. However, it has immoderate and tragic consequence with which we are dealing tonight. What is at the heart of the problem? It is the administration of a drug. The drugs used are the products of multinational companies of enormous size and wealth, which, having profited from the sale of the vaccine, could paradoxically be the vendors of the very medicines that are used to alleviate the damage that is thought to be associated with the vaccine. In this new century, surely we can expect a moral content in the world of commerce that was previously lacking, can we not?

I point out to your Lordships' House that Smithkline-Beecham, one of the largest vaccine manufacturers, made a profit last year of £1.98 billion from transactions that included the sale to the state of £779 million-worth of vaccine. That is one example of several. That company is in a monopolistic or quasi-monopolistic position. It is fair, just and reasonable that it contributes to the cost of the damage in this small number of cases. It is therefore with extreme disappointment that I hear that when the Government approached that company for help there was a frank and firm refusal to do anything. That is unacceptable. It should change; the Government should not give up, and not just because of vaccine damaged children. In years to come genetic medicine, biochemistry and the medical field will produce huge profits for companies such as those that I have described. If their attitude is as described by the Association of British Pharmaceutical Industry; namely, The Government implemented the vaccination programme knowing in full detail what the possible side-effects were. They knew what they were taking on, the damage is therefore their responsibility and they should compensate people accordingly", that sends an extremely tough message from commerce to government. Fortunately, government seek to represent the people and, in doing so, the pressure they bring on these companies over the next few years should be unrelenting. The companies should contribute without adding the cost of that to the profit they seek to make from sales to government.

Having addressed three necessary steps, I end my speech by congratulating all those people—some of whom are present in the Public Gallery—including my noble friend, Lord Ashley, and the honourable Member for Eccles—on all they have done over 20-odd years to produce some justice for those who deserve it. At the end of the 20th century all we know is that in the years to come there will be yet more children—small though the number may be—affected by vaccine damage. In my experience in the lifetime of a government there are one or two defining moments which may be moderate in their compass but profound in their effects for society. This is such a moment because it enables the Government to show that they care for people in need. I welcome the proposals.

8.15 p.m.

Lord Clement-Jones

My Lords, first, I thank the noble Lord, Lord Ashley, for initiating the debate with his usual impeccable timing. The debate takes place not only a day after the Government's Statement but on the very day that the major vaccine damaged children lobby took place in Westminster Hall. I pay tribute to the noble Lord's long-standing commitment to the cause of vaccine damaged children. We have already heard two fine speeches. The debate has already proved to be one of high quality and great interest.

The history of the vaccine damage payment scheme is extremely well known and has been rehearsed by the noble Lords, Lord Ashley and Lord Brennan. The history of the review of the scheme says nothing for the Department of Social Security's sense of urgency or the Treasury's compassion. Despite a pledge when in opposition to address the issue, it was only yesterday that the outcome of the review was announced, some three years after the general election and some two years after the noble Baroness, Lady Hollis, pledged that the Government would conduct a thorough review of the service.

Throughout the past three years Members of this House and the other place have asked numerous questions about progress, and I believe that parliamentary lobbies have taken place on three occasions. The Labour MP for Eccles, Mr Ian Stewart, the chairman of the All-Party Group for Vaccine Damaged Children—of which I have the privilege to be a member—initiated an adjournment debate at the end of 1998 in the course of which he was promised the results of the review in 1999. My right honourable! friend Charles Kennedy MP made a telling contribution on the subject of the scheme only two weeks ago at Prime Minister's Question Time. It is a testimony to the tenacity of the parents and that of the all-party group, particularly its chairman, Mr Stewart, and that of the Daily Express that the Secretary of State, Mr Darling, finally made an announcement yesterday.

I certainly do not want to be churlish about the contents of yesterday's announcement, which we on these Benches very much welcomed, particularly those provisions which have retrospective effect. The noble Lord, Lord Brennan, referred to those. However, there are key questions that need to be mentioned. The noble Lords, Lord Ashley and Lord Brennan, raised some of those questions. I hope that I may ask some further questions of the Minister and that she will respond to them when she replies to the debate.

Will the new 60 per cent disability threshold also be backdated for those who have previously applied to the vaccine damage payment unit but have exhausted the appeals process? There is the injustice of setting an arbitrary threshold, whether that is 60 per cent or 80 per cent, as at present. I am sure the Minister will be aware that parents will continue to feel strongly about this matter whether the threshold is 60 per cent or 80 per cent. Why could not a tapering system have been adopted? That would surely have been the most just way of proceeding. After all, how can one precisely quantify a 60 per cent disability? Surely this is a highly subjective process. How can we even guarantee parity between one method of assessment by one consultant and the next?

I have other questions. When will the payments to victims be made and how will they be made? Which elements of the announcement can be put into effect very shortly, perhaps before the Summer Recess, by regulation, and which elements will require primary legislation? What is the timetable envisaged by the Minister's department for each of those elements? Can payments be made on account? Is that envisaged? How will payments—the issue of means-testing was raised by the noble Lords, Lord Ashley and Lord Brennan—affect income support and other benefits available to the victims of vaccine damage? Will guidance be issued to those who will be in receipt of these additional payments?

As has already been said, the key point to make in this debate is that the changes to the vaccine damage payment scheme must be seen only as a first step to securing justice in the form of full compensation for the vaccine victims. Many of the victims require 24-hour support. I met many of them today, as I have on previous occasions. The cost of providing this support by professional carers ranges from approximately £80,000 to £120,000 per annum. At the moment in many cases parents are the only carers. Some of them have terrible tales to tell about the withdrawal of invalid care allowance when they reach pensionable age. Many of the parents are over pensionable age. I received correspondence regarding one parent who is being pursued for £1,400, a so-called over-payment because of the receipt of payments after she reached pensionable age.

I have checked with personal injuries lawyers—perhaps not as distinguished as the noble Lord, Lord Brennan—who act in personal and medical injury cases about how the appropriate income would be provided for by a court in circumstances where a court made a determination of compensation. I was informed that £3 million—I would go rather higher than the noble Lord, Lord Brennan—would be required in a case such as this to provide for that level of income. After the recent case of Wells that may well be the kind of figure that would be claimed. Three million pounds is a very large amount of money.

Therefore, will a back-dated payment of just £67,000 provide adequate compensation for families who have endured up to 40 years of financial hardship and emotional turmoil? I suggest not. These parents, many of whom are now in their 70s, need to have the assurance that their vaccine damaged children will be properly supported when they, as parents, can no longer do so. Only through a proper lump sum payment can this be done.

Much has been made by this Government and the previous one of the vaccine damage payments being payments rather than compensation. Yet the fact is, as both the noble Lords, Lord Ashley and Lord Brennan, pointed out, that government have a responsibility to provide adequately for the welfare of those undergoing vaccination. To quote Dr John Clements, a vaccine safety expert at the World Health Organisation: There is no perfectly safe or completely effective vaccine, but we all benefit from them. Countries should have a responsibility to make sure if people take part in a programme they are supported if things go wrong". On a previous occasion, the noble Lord, Lord Ashley, likened—in my view rightly—the victims of vaccine-related disability to war veterans who have suffered for the good of society. He said: They are the victims of a war fought on behalf of us all and must be compensated for their sacrifice". The Government therefore need to answer the following additional questions. Do they recognise that the changes to the VDP scheme are only a first step to securing full compensation for these vaccine victims? Will the Government now take steps to secure proper compensation for the victims of vaccines so that these very badly disabled individuals can be supported when their parents are no longer able to care for them? Will the Government redouble their efforts with the relevant pharmaceutical companies, such as Glaxo-Wellcome, to ensure that they take responsibility and share in the financial settlement? Will they redouble their efforts to ensure that the medical records of vaccine victims are made available, many of which seem to have been unaccountably lost after they made a claim? In all of this, which is the lead department that will take the initiative?

I have enormous sympathy for the parents and the victims of vaccine damage and I feel angry on their behalf. It is quite scandalous how long they have been allowed by governments of each colour to suffer without adequate legal or other remedy when they have clearly been the casualties of an official government public health vaccination policy, whether this has been for DPT, MMR, polio or whatever.

It is the Department of Health which institutes public health policies and the department which chooses the vaccines and the department which should have tested them properly in conjunction with the pharmaceutical companies. It should now be urgently reviewing the position, particularly in the light of worries about the fall in the rates of certain vaccinations which could, in the view of public health experts, lead to epidemics in diseases such as measles.

If the Department of Health and the pharmaceutical companies do not take responsibility for past vaccine damage but hide behind the legalities of the law of tort and the requirement to show clear causation and negligence, it is hardly surprising that parents have second thoughts before arranging for their children to be vaccinated. The noble Lord, Lord Brennan, cogently described the way in which the parcel had tended to be passed by the pharmaceutical companies to the Department of Health, and so on.

I have a confession to make. I am one of those parents who has second thoughts about vaccinating their child, particularly as regards MMR for my young son. I am clearly not alone in this. Even with the knowledge that the chances of vaccine damage to a child may be one in a million, the Department of Health's historically dismissive and legalistic attitude—indeed even denying that there is such a thing as vaccine damage—will ensure that vaccination rates continue to fall. I suggest that Ministers and the Public Health Laboratory Service—now in the wise hands of a Member of this House—urgently review the position, not only in respect of the vaccine-damaged children under discussion today, but for the future as well.

Unless there is put in place a proper no fault compensation scheme, similar in generosity to that in the United States, and as recommended by the original Pearson report, and similar to the kind of compensation that could be achieved in court, I do not believe that the confidence of parents will be re-won. And certainly justice will not have been done to these severely disabled children who have already been the victims of vaccines.

Lord Brennan

My Lords, before the noble Lord sits down, perhaps I may invite him to agree that it is important in a debate such as this that unreasonably high hopes are not sent out to the affected parents. Is he really suggesting that the problem which we face should be dealt with by full compensation, which, on my calculation, would amount to between £1.5 billion and £2 billion? That is beyond the means of any competent government.

Lord Clement-Jones

My Lords, that is a very fair question. My view is yes. If one accepts that there is compensation to be paid, one has to come up with a scheme that provides an income for the severely disabled children so that they are able to cope when their parents are no longer able to care for them. It was perfectly possible to do so in the case of the thalidomide children. It is perfectly possible to envisage a scheme—perhaps a trust fund rather than individual forms of compensation—where a lump sum could be paid from which these parents could derive an income. Obviously the income that they derive from that scheme would depend on the level of disability of their children.

This is not a question of raising hopes. It is a matter of wishing to see justice done in these circumstances. If a court had awarded these children compensation, the types of payment that I have suggested would not be outlandish; they would be entirely appropriate.

8.28 p.m.

Earl Howe

My Lords, yesterday's announcement on the improvements to the vaccine damage payment scheme was extremely welcome. Even though it preempted much of what I was going to say today, perhaps I may take a few minutes to ask the Minister some questions and cover some of the important issues arising from the announcement.

First, however, I should like to set out a little of the background to this issue. If one looks back over the past quarter of a century at any of the important political crusades relating to the needs of the disabled, the name of the noble Lord, Lord Ashley, is almost certain to be closely associated with it. There can be few better examples of that association than the issue which the noble Lord has brought to the House this evening. It was through his efforts in another place in the late 1970s that the Vaccine Damage Payments Act 1979 came into being. That legislation was welcomed at the time as a recognition of a moral duty on the part of the state to provide financial assistance to those children who had suffered severe physical or mental damage as a result of being vaccinated.

As stated by other noble Lords, the scheme was never billed as being a form of compensation in the normal sense of the term, nor indeed did it carry any implication of public negligence. Rather, it was an implicit acknowledgement by the state that in arty programme of mass vaccination, whether it he for measles, mumps, polio, whooping cough or for a range of other serious diseases, there will be a very tiny percentage of children who experience unpredictable adverse consequences. For some, those consequences are minor and transient. For others, they are truly devastating.

Traditionally, damage that arises from non-negligent accidents occurring in the NHS has not given rise to any form of state payment, but in one important respect the damage that stems from vaccination is different from other damage. Vaccination does not simply benefit the individual who receives it. It is the state which says that parents should immunise their children because it is for the common good that life-threatening diseases should not be spread around the general population. The state encourages vaccination even though it is known—notwithstanding the no doubt legally secure position of the noble Lord, Lord Brennan—that a very few individuals will suffer a serious and irremediable adverse reaction.

But paying those individuals from public money is not simply a recognition that they have suffered for the general good. There is another dimension; namely, that any immunisation programme depends for its success on a certain level of take-up. Once the take-up rate falls below a critical figure the risk of an epidemic becomes a very real one. It is obvious that unless the public has confidence in an immunisation programme, it will not subscribe to that programme. Perhaps I may say to the noble Lord, Lord Clement-Jones, with whom I do not often disagree, that it was the fears surrounding the MMR immunisation, misplaced though they were, and the accompanying decline in public confidence that led to the recent worrying drop in the take-up of that vaccination programme.

I believe that all political parties have a duty to join forces on a policy of this importance—resting our case on the basis of the scientific evidence, which is firm. But confidence has a number of buttresses. The Government can also protect their vaccination programmes if parents of children know that in those few cases which lead to tragedy a scheme is in place that will provide a worthwhile measure of financial support.

That is why yesterday's announcement, coming as it did after two years of deliberation by the Government, was so welcome. I shall not carp too loudly at the time it took for the Statement to arrive, knowing as I do something of the frustrations of trying to secure inter-departmental agreement on such matters. In any event, I hope that the retrospective element in the new package will do something to assuage those who feel, in the words of the Minister in another place, Mr Bayley, that, Two years is indeed a long time".—[Official Report, Commons, 6/6/00; col. 20WH.] Had yesterday's Statement not been made, there were two changes in particular that I would have asked the Government to introduce. The first was to abolish the six-year limit for making claims. That has effectively been done and I congratulate the Government on it. The second was to bring down the disability threshold from the level of 80 per cent and to introduce a sliding scale of payments for disability assessed at below that level. That is the request that has been made by the Vaccine Victims Support Group, whose patience and dignity I think we must all applaud and respect. It is a proposal which seems to me to be entirely equitable. The change proposed by the Government to bring the threshold down to 60 per cent will mean that anyone with damage assessed at below that level will receive nothing. I ask the Government why they believe that that is a fair way to proceed. Even at this juncture, I hope that they will be prepared to reconsider the issue.

I wonder if the Minister can clarify one or two other points in relation to the primary legislation that we understand will be needed for both of these measures? First, when do the Government propose to introduce the necessary Bill? It need only be a short Bill. I give the assurance that we on this side of the House will cooperate with the Government fully when it appears.

Secondly, can the Minister tell us a little more about the retrospective element of the announcement? If the threshold is to come down from 80 per cent, does that leave the way open for individuals whose claims were rejected because they did not come up to that level to re-open their claims? Similarly, will it now be possible for those who had their claims turned aside because they were not made within the six-year limit to reapply for a payment under the scheme, even though they may now be over the age of 21?

Perhaps I may add my welcome to the significant uprating of the sum payable to those who have suffered severe damage from vaccination. The figure of £100,000 is not a king's ransom, but it is an order of money that more realistically reflects the burdens suffered by victims and their families than does the current level of payment. Can the Minister say whether the appropriate regulations will be laid before the Summer Recess?

I should also like to ask the Minister about research. The extraordinary discoveries announced this week on the mapping of the human genome may one day enable scientists to predict which children have a genetic susceptibility to an adverse reaction from vaccinations. However, can the Minister say what research is currently under way into the formulation of improved vaccines and into efforts to minimise the terrible adverse reactions that we have been debating?

I conclude by asking the Minister whether she will take this opportunity to reaffirm the Government's policy on childhood immunisation? On this important issue, do the Government agree with me that party politics should be put aside? Indeed, will they consider entering a joint campaign with the Opposition to promote vaccination as an essential public health measure? I hope, too, that the Minister will take the opportunity to reassure the House today that all vaccines approved for use in this country are rigorously tested to the highest standards of safety, quality and efficacy? That is a message that bears repeating often, as does the warning that, were a vaccination programme to fail through lack of adequate take-up, it could lead to consequences as devastating in their severity as those that have been referred to this evening, but for a very much more numerous cohort of children.

8.38 p.m.

The Parliamentary Under-Secretary of State, Department of Social Security (Baroness Hollis of Heigham)

My Lords, I am delighted that the Government's measures have received a warm welcome tonight. Substantially, the measures owe much to the delicate, subtle and hesitant persuasion brought to bear on Labour Ministers by my noble friend Lord Ashley. I am very pleased that the whole House recognises the role played by my noble friend in achieving these results.

Perhaps I may begin by setting out a little of the background to the review of the scheme. Soon after the present Government came to power, Ministers were approached by various groups and by the newly-formed All-Party Group on Vaccine Damage. We were asked how we would review the scheme. At the time, I had responsibility for disability issues as well as children's issues. I announced that a review would be undertaken, in consultation with the Department of Health, as part of our overall review of welfare.

Since that time, various meetings have taken place between myself and members of the all-party group, along with members of the parents' groups who have so eloquently presented their case. These groups included the Association of Parents of Vaccine Damaged Children, the British Polio Fellowship, the Justice, Awareness and Basic Support Group (JABS), and the Vaccine Victims Support Group. This afternoon, the Vaccine Victims Support Group held a well-attended lobby in the Grand Committee Room, and I believe that my noble friend was present.

The groups raised a number of issues with us. They disagreed on some, but the five principal issues were the time limit of six years, the 80 per cent threshold, the need for an additional lump sum, an ongoing benefit for those damaged following vaccination, and a contribution from the pharmaceutical industry towards the support of those damaged by vaccines—the point raised by my noble friend Lord Brennan. The groups also raised questions about vaccination incentive payments and the promotion of vaccines.

We promised to look at all those aspects, which is why the matter has taken a long time. We have also, at the behest of parents, contacted the pharmaceutical industry to seek a financial contribution towards the support of this group of vaccine damaged children. Although it was sympathetic to the issues, the industry did not feel it appropriate to become involved—to my regret. I hope that the efforts of my noble friend and others may persuade it to reconsider its position in the future.

In consultation with the Department of Health, we have therefore been carefully examining the nature of the vaccine damage payments scheme and the scope for changes that we might make. That was why, in that context, my right honourable friend the Secretary of State for Social Security, Mr Darling, made the Statement yesterday.

The proposed changes do not represent any changed judgment about the safety of vaccination but simply our view, as I said when we increased the payment in 1998, that it is appropriate, decent and compassionate to implement these changes.

Subject to parliamentary approval of our proposals to pay £100,000 for new claims, we shall effectively be increasing the rate of payment that we inherited by some £70,000. It is a significant increase. In addition, we have listened to the concern of those parents who received £10,000 in the early 1980s and who, as we know, struggle daily under very difficult circumstances. When we last increased the payment in 1998 to £40,000 we said that that amount would more than restore the value of the payment.

At April 2000 rates, £33,000 would have been the equivalent of £10,000 awarded at the start of the scheme. We have therefore decided that it would be only right in this unusual circumstance to consider top-up payments to bring past recipients up to the new £100,000 rate by revaluing their original payments. It is not often that a government make retrospective payments. I am delighted that they are doing so in this case.

This means that, if Parliament approves, those recipients who received £10,000 will receive an additional lump sum payment of £67,000. Those who received £20,000 will receive £62,500. Those who received £30,000 will receive £61,500 and those who received £40,000 will receive a further £58,000. This represents an additional £60 million for the most severely disabled—a very significant sum.

Again, subject to parliamentary approval, we hope to introduce the proposed changes as soon as possible. Perhaps I may make clear my understanding of the timetable. It is our hope that the payment of the new £100,000 will be in place before the Summer Recess. We hope to make the top-up payments to those who have already received sums as soon as possible following the other regulations, but that may take time. Some of the payments were made 30 or 40 years ago; addresses need to be checked; people may have changed addresses and we may have lost contact with them. But subject to those practical limitations, we want to make the top-up payments as soon as possible after the regulations have completed their passage through this House and another place.

The other two aspects of the scheme—the threshold of disability being reduced from 80 per cent to 60 per cent, and the changes in years—require primary legislation. That will be introduced as soon as possible. But primary legislation is not required for the payments; we can make those following regulations, which is a much speedier process.

The £100,000 payments will be treated like the original payments for the purposes of income-related benefits and for the purposes of residential care. They will not disentitle recipients of those benefits. As I said, we also intend to bring about changes to the time limits.

We have decided that in the case of time limits for claiming, we should seek to act within the spirit of the proposals in the Law Commission's recent consultation paper on the limitation of actions. The time limit for making a claim will be amended to three years, although in the case of minors the time will not run out until they have achieved their majority. For young children, who make up the vast majority of VDP claimants, there will therefore be an extended period, up to age 21, in which to make a claim.

As I said, we further propose to reduce the disability threshold from 80 per cent to 60 per cent. It is true that the test of at least 80 per cent disability adopted for the Act was and remains generally recognised as the lower end of the spectrum of severe disability—for example, for severe disablement payments, payments for industrial injuries and the like. Lowering that level might be considered inconsistent. None the less, we have taken heed of representations and we think that a reduction to the level of 60 per cent is justified and, representing as it does a still significant level of disability that was incurred as part of a wider public interest policy, it remains compatible with the original aims of the scheme.

The present statutory scheme was introduced in 1979. It was a payment of a lump sum, not in terms of meeting compensation. That, as my noble friend Lord Brennan said, is a matter that should be pursued through the courts. It is concerned instead with seeking to meet some of the additional costs incurred by parents. As my noble friend Lord Brennan indicated, the families and the disabled children themselves continue to receive, and rightly so, higher rate disability living allowance and long-term IB, which is now more generous than severe disablement allowance. Their parents will receive ICA and, if they are on income support, the carer's premium on IS, which continues right through. So I think that on all of those points we are able to help your Lordships.

My noble friend Lord Ashley raised a number of specific points. He asked why there was only one award in some years. In most years there are five or six awards, but it is true that in one or two cases—I now know of only a single case— that was the number who were considered that year to meet the entitlement conditions. Obviously, those figures will now change. We do not know the number, but an approximate estimate is that 20 vaccine damaged children a year presently lose out because of the time limit and will now fall within the provision. Again, we do not know how many lose out by virtue of the 60 per cent, but it is our guess that perhaps a handful a year might, and then maybe some 50 or so cases who were refused because they were disqualified by being below the 80 per cent threshold but above 60 per cent. We shall be inviting those people to reapply and, where we can, to make contact with them.

My noble friend's second question—a point also raised by the noble Earl, Lord Howe—related to claims made 30 or 40 years previously. As I say, we aim to make the new provisions fair to people who missed out in the past and who may qualify under the new rules. We cannot say exactly what the position will be. We are carefully considering these points. If my noble friend has a particular case in mind that would fall outside the 21-year cut-off point, we should like to follow that up. Perhaps my noble friend will write to me.

One question which my noble friend did not ask but on which I may be able to bring good news is that, where a child has already died, the department will be considering top-up payments. That is perhaps more generous than my noble friend anticipated.

I hope that I have addressed my noble friend's third question relating to someone in local authority residential accommodation. Similar rules apply in charging regimes for local authority residential accommodation to those that apply to income support: the amounts of payments made into a trust fund or under court supervision are disregarded. I am happy to place those words on the record.

My noble friend Lord Brennan asked whether there would be a nominated or named official as an information point. We have not made provision for that at present. We will take the point away and consider it. Clearly, it is important that families know whom to contact, as well as having the literature. The possibility of a website was raised. We shall pursue those kinds of questions to see how we can be helpful.

The noble Lord, Lord Clement-Jones, raised a point about retrospection. I hope I have dealt with that. Anyone who applied and was disallowed because he or she was below the threshold will be invited to reapply and have the claim reassessed. If there are delays, it will be because we do not necessarily know any changes of address, given that the previous payments were made 15, 20 or 25 years ago.

I sincerely join in the wise words of the noble Earl, Lord Howe, when he gently chastised the noble Lord, Lord Clement-Jones, in terms of his policy towards vaccination and his suggestion that he might consider not exposing his own child to MMR vaccine. I could not repeat more strongly than the noble Earl, Lord Howe, that there is no scientific evidence whatever in a series of highly regarded reports, including the Thames survey, which was done fairly recently, to show that there is any connection between MMR and Crohn's disease or inflammatory bowel disease. It is simply not the case. There have been repeated studies in this country and in the US and elsewhere abroad showing that there is no such connection.

It is the case that children may develop those diseases, and may do so at the same age as that at which they are having their vaccination. It is a correlation, but no causal connection has been established.

The alternative, which is to expose children to those illnesses, is very serious. I should like to give the noble Lord some information about what happened when there were similar scares relating to whooping cough, percussis. Before the introduction of a vaccine in the 1950s major epidemics of whooping cough were frequent, with the annual notification exceeding 100,000 year. After the introduction of immunisation against whooping cough it fell in the 1970s to about 2,500 a year. However, following public and professional anxiety about the vaccine, anxiety that was proved to be unfounded, there was a marked decline in vaccine acceptance from over 80 per cent to around 30 per cent. The number of susceptible children rose, and in the 12 years after 1976 three major whooping cough epidemics accounted nationally for over 300,000 notifications and at least 70 deaths. The fears became the reality.

If I may so put it, nobody has the right to—I do not want to say "freeload", because that sounds wrong—rely on other people having the vaccine given to their children, believing that as a result they do not need to have their own children vaccinated. They are, so to speak, piggy-backing on the moral generosity of others. I want to put it strongly, because only one medical risk has been established. That is with the polio vaccine, which is one in a million. In no other cases is there any risk, but we know that the risk of the disease can be extremely serious. Any contribution from a Front Bench spokesman will be taken seriously. A suggestion that there is a serious question as to whether one should not have that vaccine can only add to public fears and damage incalculably many other children, which I am sure the noble Lord would not wish.

Lord Clement-Jones

My Lords, I hasten to reassure the noble Baroness the Minister that I am not anti-vaccine myself, but she should note—and I will not trade scientific data with her—that with regard to the MMR vaccine 2,000 claims for compensation against pharmaceutical companies are coming. The evidence is being put together slowly but surely about the effect of the MMR vaccination. I also remind the noble Baroness that the United States Congress has been holding a series of hearings about the effect of MMR vaccination, which she may not be aware of either. Serious issues are involved, and I would not mention them lightly.

Baroness Hollis of Heigham

My Lords, slowly but not surely, there is only one piece of medical research. Without naming the doctor concerned, the Medical Research Council has said that those findings are insubstantial and not to be relied on. We will see what happens.

The time is nearly up. I wanted to spend some time trying to address the issue that the noble Earl, Lord Howe, raised. I want finally to say how pleased I am that I am responding to the noble Lord after yesterday's Statement and to put into the record the very graceful and gracious message we have received from Rosemary Fox, who will be known to many of your Lordships and who has led the campaign for so many families, the Association of Parents of Vaccine Damaged Children. Her message reads: Congratulations on your decision to make a reasonably large addition to the vaccine damage payment. All parents ringing in are pleased to have further help and are awaiting further details, which I have promised to ask for and pass on to them. Some parents have particularly asked to be dissociated from criticisms being made about the payment. After 20 years of waiting, most are very pleased. I commend this to your Lordships' House and thank my noble friend for introducing the debate.