§ Motion made, and Question proposed, That the sitting be now adjourned.—[Mr. Jamieson.]10.30 am
§ Mr. Ian Stewart (Eccles)
Hon. Members will know that, since 1979, a child who has been severely damaged or disabled by vaccines has been able to claim a one-off vaccine damage payment from the vaccine damage payments unit in Lancaster street, Preston, which is now a branch of the Benefits Agency. The payment scheme covers the common childhood vaccines of diphtheria, tetanus, whooping cough, polio, measles, mumps, rubella and tuberculosis. Unlike most other social security benefits, the vaccine damage payment scheme has undergone no revision, upgrading or improvement since 1979. I stress from the outset that children who have been damaged by vaccines were born without impairment or disability. They have suffered what is, thankfully, a rare adverse reaction to a publicly promoted vaccine.
Although I am pleased to debate this issue again, I regret that it is necessary. When I initiated a previous Adjournment debate on this matter 18 months ago, the then Minister promised a Government review of the payment scheme early in the following year. There were two well-attended parliamentary lobbies on the matter in January and November 1999, and the affected families have scheduled another for 28 June. They have also handed in a petition to Downing street.
Representatives of the parents' organisations have met Ministers and there has been intermittent press interest, culminating in a welcome and sustained campaign by The Express to gain justice for vaccine victims. At a parliamentary level, the all-party group has continued to meet regularly and to Tabby Ministers. I thank all Members of Parliament who cannot be here today but who have sent messages expressing their continued support for the work of the all-party group.
I hope to find out when the Government's review of the vaccine damage payment scheme will be published and whether it will be a consultation document or will make positive recommendations. I know that good policy is not made on the hoof, but this one has been around the paddock too many times. I appreciate the complexity of the issue, which requires detailed investigation. I also appreciate the interdepartmental issues that are at the heart of the matter. The Government are rightly promoting vaccination to safeguard our health and to protect our children against disabling and fatal diseases. I support that policy, as do the parents' groups that are campaigning for better financial support for vaccine victims.
The vaccination programme works Some 18 months ago, I outlined the success of the whooping cough vaccine in drastically reducing the number of cases and deaths from the disease in the early 1990s, when the 2WH vaccine coverage rate reached 94 per cent. of the target population. The meningitis C vaccine is the most recent success. Full figures will not be available until later this year, but my hon. Friend the Under-Secretary of State for Health, the hon. Member for Pontefract and Castleford (Yvette Cooper), has said that anecdotal evidence suggests that between 80 and 95 per cent. of 15 to 17-year-olds have been immunised, with the uptake in babies being even higher. Yet it was reported last month in The Independent on Sunday that the Department of Health fears that a measles epidemic could be triggered by a drop in the immunisation rate to 88 per cent. of the population. That is all the more worrying, as I understand that the take-up rate for vaccination must be at least 85 per cent. of the eligible population to ensure the viability of the programme and proper public protection.
I know that some people in the Department of Health do not believe in vaccine damage. I was told in answer to a recent parliamentary question to the Department of Health thata report of a particular suspected reaction does not necessarily mean that it has been caused by the vaccine. There is no evidence to support the suggestion of a causal link between any childhood vaccines recommended in the UK and death.—[Official Report, 15 May 2000; Vol. 350, c. 17W.]The same Department of Health answer went on to inform me that 50 cases of children dying of suspected adverse reaction to routine vaccination were reported from 1990 to 1999.
Professor Gordon Stewart, an expert in the field, pointed out in a recent letter to me thatone of the main difficulties since 1974 is that the Department of Health, the Committee on the Safety of Medicines and now the Medical Control Agency have always denied that there is a problem or have related the problem only to the past.The Government are therefore faced with a stark choice. Either they accept such medical advice and tell the parents honestly that they believe, with hindsight, that the Vaccine Damage Payments Act 1979 was misguided and that no further financial support will be forthcoming, or they accept that the Act was based on good medical science and recognise, 20 years later, that it is in urgent need of reform and improvement. Needless to say, my view and that of the all-party group is that they should take the latter course.
I believe that the Government will safeguard their vaccination programmes only if people know that there will be adequate support and compensation in the small number of cases where things go tragically wrong. All new parents, even the high-profile ones, have to make a fundamental decision about the vaccination of their children. I make these points, which are essentially directed to Health Ministers, to underline my commitment to the success of the vaccination programme, and I know that my hon. Friend the Minister will draw them to the attention of Government colleagues.
Let us be clear that we are not present to debate causation which, as far as I am concerned, was settled in the 1979 Act. My constituents Gary Hunt and Brendan Hanlon have a Government-issued trust deed that says that they have been damaged by vaccine. To date, they have received a derisory £10,000 each. Gary Hunt, who is 31 years of age, is profoundly mentally and physically handicapped. He is wheelchair-bound, cannot feed 3WH himself and cannot speak. He is doubly incontinent. Needless to say, he requires round-the-clock care, which he receives from his parents.
Brendan Hanlon is 39 years of age, but has the academic age of a child of less than two years old. He suffers from severe and unpredictable epileptic fits which all too often lead to physical injury. He, too, is cared for by his parents and close family. Both those families have received just £10,000 for responding in good faith to protect their child and to protect the rest of us in the wider community.
Other specific cases will no doubt be highlighted by other hon. Members. It is now way past the time for the wider community to discharge fully its responsibility to the victims and their families. I mention both the vaccine victims and their families because the families suffer greatly—this is a whole family issue. Parents have full-time responsibility for their sons and daughters for the whole of their lives, and relationships with partners and their other children can sometimes be adversely affected.
The Government should recognise the contribution made by those families. Had they not struggled on in the way that they have, significant extra strain would have been placed on already overstretched national health service resources. I and members of the all-party group for vaccine-damaged children want fair support and compensation for those children and their families and positive reforms of the vaccine damage payment scheme.
If prudence has been the Chancellor's hallmark, patience has been the hallmark of those parents. They have conducted their campaign for justice with extraordinary dignity, courage and forbearance. They have rightly felt anger, extreme frustration and desperation as politicians over the years have expressed sympathy with their cause but failed to deliver even when they had the power to do so. I hope that the Government will now do the right thing and deliver for vaccine victims.
Whatever heroic qualities the parents and carers may have—and they have many—they are not immortal. Since our previous debate, at least three parents of vaccine victims have died and yet another vaccine victim, Rachel Murray, has died at only 29 years of age. I can only imagine the devastation felt by her family, who are constituents of my hon. Friend the Member for Middlesbrough, South and Cleveland, East (Dr. Kumar). He cannot be here today because of constituency commitments, but he is an active supporter of the work of the all-party group. Again, I am sure that other hon. Members will want to highlight the specific cases of their constituents.
We know that the Government are currently undertaking a review of the 1979 Act, which, if I may take issue with The Express, is not a grubby payment scheme, although it is a restrictive and inadequate payment scheme. The Act established the Government's responsibility for vaccine victims. The scheme has not stood the test of time, but I believe that it was not designed to do so. The measure was devised to deliver urgently needed money to support vaccine victims. The general assumption of Jack Ashley, how Lord Ashley, 4WH and others was that it would provide an interim payment. The then Health Secretary, the late Lord Ennals, said that the payment would notpre-empt decisions which the Government still have to take.Sadly, the incoming Conservative Government insensitively and wrongly kicked those further decisions into touch. They did nothing to improve the scheme and managed only irregular upratings of the payment in 1985 and 1991. However, I was pleased to read in The Express that the hon. Member for Brentwood and Ongar (Mr. Pickles), the official Opposition spokesman on social security, 5 aid that the Conservative partyis very sympathetic to a generous and sensible settlement of this.Good. That is a welcome development, which I hope will be confirmed today.
What is the scale of the issue? As of June 1998, a total of 890 payments had been made under the 1979 Act, from a total of 4,000 claims. Successive Governments since 1979 have acknowledged that almost 900 people were damaged by vaccines. The vast majority of the payments—795—were set at about £10,000. Claimants, of course, must meet a stringent 80 per cent. disability test before being eligible for an award under the Act. A person who is severely damaged by a vaccine and suffers a 70 per cent. impairment receives no payment because the disability does not meet the 80 per cent. threshold. There is no justice in such a system.
Parents' groups have raised other issues relating to vaccine damage. They believe that the number of victims is higher than the official figures that I have given. There is concern about clinical trials that allegedly took place between 1948 and 1956. It has been alleged that children suffered severe brain damage or even died during the trials and that their parents were not aware that the children were part of such clinical trials. There is also considerable concern about children who might have been damaged by vaccine but who are denied a payment under the Act as their medical records have been mislaid. Such matters are for investigation; I do not intend to pursue them today. The focus of the debate is rightly on the Government's review of the 1979 vaccine damage payment scheme.
What do we want from the Government's review? To summarise, the proposals put to the Government by the parents' groups include a substantial lump-sump payment and the payment of a severe disability pension analogous to war pensions and industrial injury pensions. They want recognition that the longest-suffering children and families have had the most expense and the least help. Further, they want the 80 per cent. disability rule tapered and the removal of the six-year time limit during which claims must be made.
The groups have also asked for the pharmaceutical industry to contribute towards additional funding. The Government have pursued the matter with the industry and parents are grateful for that as, by so doing, the Government have shown that they accept that vaccine victims constitute a special case. The response from the pharmaceutical industry has been negative. I appreciate the economic realities of taxing or levying vaccine manufacturers under a publicly funded health system. However, a spark of compassion and a measure of generosity on the part of the industry and its well-paid chief executives would have been welcomed.
5WH As The Express noted, SmithKline Beecham, one of the world's largest vaccine manufacturers, had worldwide sales of vaccines worth £780 million last year. Diageo has recently announced additional money for the fund for thalidomide victims to ensure that the fund is inflation proofed. Celebrity criticism and the firm's concerns of the impact that that would have on its Guinness beer market no doubt prompted that action. Parents of vaccine victims could perhaps learn lessons here. The industry should take note that this is not the end.
However, it is now clear that any additional funding at present will be from public sources. Ministers have in the past said that additional funding—most specifically, compensation—is a matter to be pursued in the courts. I recently received a letter from the chief executive of the Legal Services Commission, which was previously known as the Legal Aid Board, informing me that as, of 1 April, it was likely to be able to fund claims on behalf of vaccine-damaged children and adults if there was a significant wider public interest, such as concern about the general safety of a widely available vaccine, and if not only the individual claimant would benefit.
By contrast, a typical individual claim relating to negligence by vaccination in the face of a contraindication or adverse reaction would not be funded, although it could be pursued privately under the conditional fee arrangement for legal aid. However, legal aid has already supported extensive litigation in relation to the pertussis vaccine, which was unsuccessful. The outstanding legal aid certificates for pertussis vaccine victims relate mainly to cases in which the vaccine was given after an adverse reaction to the first dose.
Families do not want and should not be forced to pursue the legal lottery that I have described under such restrictions. Additional public funding for vaccine victims is justifiable and necessary. In December 1998, I pointed out that it would cost only £79.5 million for all the children who received the original £10,000 to receive £100,000. I assume, therefore, that £200,000 each would cost about £160 million and that £300,000 per child would cost around £240 million.
My arithmetic tells me that the lowest level of £100,000 could have been funded by the additional monies vired since the beginning of the year to prop up that large plastic tent down the river. We should remind ourselves that an additional £55 million was released in February and a further £30 million last month. We sometimes need spectacle in our lives, but we need always to secure the health of the nation and to accept the responsibilities that result when accidents happen.
We must get our priorities right and do the right thing. Above all, we need a resolution to the matter now. Every Minister whom I have met to date has been sympathetic to the plight of vaccine victims and their families. The all-party group for vaccine-damaged children has requested a joint meeting with the Secretaries of State for Health and for Social Security. If we do not obtain satisfaction there, we shall he knocking on the door of 10 Downing street. Before that happens, will the Minister confirm whether his Department has requested or will request that the Treasury provide increased and adequate funds for the vaccine damage payment scheme?
6WH In 1986, my right hon. Friend the Chancellor of the Exchequer said that the vaccine damage payment scheme was grossly inadequate for a lifetime of severe disability. He was right then. He can act now. In 1979, the late Lord Ennals, answering an hon. Member who expressed dismay that the £10.000 payment was not larger, said:This is not saying, "This is the end. We are wiping the slate clean".—[Official Report, 9 May 1979; Vol. 949, c. 980.]Unfortunately, the commitment given by Lord Ennals has yet to be met. I hope that the Government will give the House a commitment to finish the business that the previous Labour Government rightly got under way and publish their review of the 1979 vaccine damage payment scheme by the end of July.
Parents are weary and uncertain. They and their sons and daughters deserve a conclusion to their campaign and a full, final and positive settlement now.
§ Mr. Tony Baldry (Banbury)
I hope that the support of all hon. Members for everything that the hon. Member for Eccles (Mr. Stewart) said is clear. We fully support his approach to the Minister and to Treasury Ministers.
As a student, I worked as a gardener for the local hospital. One of the nursing homes had formerly been an isolation clinic for teenage sufferers of tuberculosis. Among the stinging nettles in the wilder parts of the ground the old mortuary building remained. However many years passed, that place still smelt of death. As I scythed the poppies and the long grass, I used to think how terrible it was that so many children and young men and women had been cut down randomly by tuberculosis.
I visited a secondary school in Banbury the other day and asked a group of sixth formers what they understood by the initials TB. Not one associated them with tuberculosis. Why should they? To all intents and purposes, thanks to advances in medical science and to mass immunisation campaigns, TB has effectively been eradicated in the United Kingdom—likewise, polio and several other diseases that had hitherto killed, or blighted the lives of, many children. I suspect that many of us know people older than us, who were born before the possibility of inoculation against polio, who contracted it as children and survived but were in some way scarred for life.
Mass vaccination programmes have brought about amazing advances in public health and, over the past 50 or so years, in the reduction of infant mortality rates. To be effective, mass vaccination campaigns require the overwhelming majority of parents to ensure, as a matter of course, that their children are inoculated. A take-up rate of at least 85 per cent. is needed for their success, but it has become apparent over the years that, although they have brought enormous benefit to many, they have left a tiny few severely damaged—physically, mentally or both.
I do not believe that any Minister, civil servant or doctor genuinely believes that the children whom we are considering this morning have received their severe afflictions in any way other than as a consequence of vaccine damage. Suggestions that those children would have experienced mental or physical handicap quite 7WH independently of their involvement in the campaign of mass vaccination are offensive and are not borne out by the facts. Nor is there evidence to suggest that the injuries have necessarily come about as a consequence of negligence on the part of the drugs companies manufacturing the vaccines. I do not believe that any Minister, properly informed civil servant or public health official believes that the argument can be sustained that the children were damaged by medical negligence. The simple, straightforward, inescapable fact is that in mass vaccination campaigns, such as those for measles, mumps and rubella or for polio, statistically a tiny percentage of children will, it appears, experience adverse consequences that could not have been predicted, and which will be devastating for them and their parents for the rest of their lives.
It is in the interest of the totality of the community—the public good or the commonwealth—that the relevant vaccinations should be taken up by the overwhelming majority of parents and should thus succeed. The consequence, as night follows day, is that we—society, the state or the commonwealth—should properly compensate, support and indemnify the children who tragically are not, in the event, protected by such mass vaccination but severely injured and damaged. I suspect that most, if not all, hon. Members taking part in the debate have a constituent or constituents who, sadly, fall into that group and whose parents have been battling for some time to ensure financial support for their children. A young constituent of mine, Hamish Thompson, who is now aged two, contracted paralytic poliomyelitis 10 days after receiving his polio vaccine in December 1997.
I note that the issue of proof of causation often arose in debates in the House on the Vaccine Damage Payments Act 1979. Ministers tend to suggest that there is no proof that the vaccine has directly caused the recipient's condition, as it is difficult to prove the link between brain damage and the whooping cough and measles, mumps and rubella vaccines.
Hamish had what is known in the medical world as vaccine-associated paralytic poliomyelitis; the strain of the polio virus isolated in his stools matched that of the virus and there is total scientific proof that he contracted his polio as a direct result of being administered the polio vaccine. As of January 2000, the United States of America stopped using the live polio vaccine because of the risk of contracting polio from it: the inactive polio vaccine is just as effective and does not carry the same risk. To provide the best possible immunity against polio, it is suggested that people are given two doses of the inactive IPP vaccine and one dose of the oral vaccine. The first two doses are administered by injection and provide immunity to the body, while the third dose provides gut immunity, thus maintaining the immunity benefit to society.
We know that young babies such as Hamish have suffered from the polio vaccine. Is it still the Department of Health's advice that polio vaccine should be administered in the way in which it was administered to Hamish?
Hamish was awarded a £40,000 vaccine damage payment a few weeks ago. Objectively, that might seem a lot of money, but, as a member of the Bar who has 8WH done a fair amount of personal injuries work, I know that that is a pittance compared to the compensation that he would properly have received if the matter had been assessed by a High Court judge. For a child of two who, as the hon. Member for Eccles said, must by definition be 80 per cent. damaged to receive any compensation and who will require nursing, care and support for the rest of his life, £40,000 is an insult. Much of that has already been spent on settling debts incurred in trying to provide a reasonable standard of nursing care for Hamish.
I fully support what the hon. Member for Eccles has proposed, but this is a simple matter; only a tiny number of children are involved. There should be a no-blame scheme, under which a High Court judge would assess their needs, as he would if negligence had been proved. A High Court judge or a court can objectively determine fair and proper compensation, having regard to the severity of the medical condition, life expectancy and all the other matters that are normally taken into account in personal injury cases.
It is a diabolical shame when a child is damaged by a Government campaign, and is then told by the same Government health service that he cannot have the equipment that he needs as there is a funding problem and should instead start to beg from charities to raise the funds. An inelegant pass-the-parcel has been going on between Whitehall Departments. The Department of Health seems to have tried to shuffle responsibility on to the Department of Social Security, the Department of Social Security has tried to shuffle responsibility on to the Department of Health and the two Departments have tried to shuffle responsibility on to the pharmaceutical industry. The whole House says, "Enough".
The time for passing the parcel on this policy must come to an end; the Government must collectively sort the matter out. Parents such as Mr. and Mrs. Thompson have been incredibly patient and long-suffering, but they and many others are entitled to know that they and their children will receive the financial support necessary to maintain them in the future. It is time for the Government to act. If they will not or do not act, that will be a scandal.
§ Mr. Tom Clarke (Coatbridge and Chryston)
I warmly congratulate my hon. Friend the Member for Eccles (Mr. Stewart) on his excellent and well-informed speech and on his marvellous leadership of the all-party group for vaccine-damaged children. I wish him well in all the activities that he is pursuing. Indeed, the case that he presented was so comprehensive that we could almost have finished the debate at that point and gone home. I feel almost apologetic to be taking up hon. Members' time, and I do so only to add my support, for what it is worth, to the comments made by my hon. Friend and by the hon. Member for Banbury (Mr. Baldry).
I disagreed with the hon. Member for Banbury on only one point. I believe that the pharmaceutical industry has a responsibility, and is in a strong position to join us in appealing to the Government to move forward more quickly if they will accept the responsibility to do so. However, I agree with him that the game of pass-the-parcel to which he referred should come to an end.
9WH I hope that hon. Members will forgive me if, in adding my support to the splendid plea made this morning by my hon. Friend, I thank the Minister in anticipation for his reply and for the work that he is doing, because he has met me to discuss the case to which I shall refer. My hon. Friend the Member for Eccles and I both know how much a Minister is free to say. We are also aware of the colossal influence that the Treasury has on these matters. If the Treasury is following our debate, I hope that it will accept our plea that it is time to move on, and to loosen the purse strings. We cannot achieve even the minimum objectives that parents rightly demand unless the Treasury accepts that reality.
I should like to refer to the constituency case that I discussed with my hon. Friend the Minister, and to declare straight away that it is a family case. I refer to it—having spoken to the mother of my nephew and godson, Anthony Clarke, on Sunday—not only because this debate has implications for his case but because, as his mother reminded me, if we make progress for Anthony, we can make progress for other people as well. She said that she knows what other parents are going through. I can say with great humility, from my knowledge of the family, that Sadie is an absolute heroine.
Anthony was born in 1966; he is now 34 years old. There are two other younger children, now adult young women. My late brother, Robert, was killed in a car crash in 1973, when Anthony was seven. By that time, it was obvious that Anthony was profoundly mentally and physically disabled, and required 24-hour attention and a great deal of other support. It saddens me that local authorities have come under a great deal of criticism. A few weeks ago, when Anthony's mother was told that his respite care was being cut from eight weeks to four, she did not blame the local authority. I do not blame it, but I say to the Treasury, as I recall my background in local government, that we must examine our perspectives on these matters.
It will be helpful to the cause that my hon. Friend seeks so admirably to promote if I refer specifically to this case. I shall quote from a letter from the Benefits Agency to my sister-in-law, dated 30 July 1999, because it encapsulates many of the points that my hon. Friend made in his speech, and many of the demands that the various groups and parents involved in this issue are making. In response to my sister-in-law's letter of 14 July 1999, it stated:In your letter you have asked for a further appeal because Anthony's condition has deteriorated. Under the 1979 Vaccine Damage Payments Act you can either request a reconsideration of the original decision within six years of the decision being made or ask for a review of the original decision by the Independent Tribunal Service. Because it is over six years since the original decision was made—I remind hon. Members that Anthony is now 34—it is no longer possible to request a reconsideration. As regards a review of the Independent Tribunal Service, you are only entitled to one review. Because you had a review in 1981 it is not possible to ask for another one. Furthermore, under the Vaccine Damage Payments Act, there is no provision for appeals.It is with regret, therefore, that I have to inform you that I cannot accept your request for an appeal. Furthermore, there is no other means of changing the original decision.The mother and family of this young man have undergone many pressures. Since the 1979 Act, we have learned a great deal more about the circumstances that 10WH lead to such conditions and the demands on families who are trying to cope with them. There is a great will among Members of Parliament to do something about that. In many cases, parents become ill and less able to cope as they get older. They need the kind of recognition that my hon. Friend the Member for Eccles seeks.
Before I conclude, I should like to re-emphasise three points that my hon. Friend made. First, it is manifestly absurd to stick to the 80 per cent. condition, because that assumes that it is less difficult for the parents of a child who has a 79 per cent. acceptance to cope with the situation than it is for those of a child who has an 81 per cent. acceptance. The arguments in favour of the taper are therefore overwhelming.
Secondly, despite all the facts that have been made available, there should be more research into ways of dealing with these matters. I passionately believe that the pharmaceutical industry has a role to play in that.
Thirdly, we should consider what is happening in other countries, because we can learn a great deal from them. I hope that the time will come when they look to us as a model for the treatment of the condition and its consequences for children and their parents.
I congratulate my hon. Friend on his success in securing the debate, and on his contribution to it, and wish him God speed in everything that he seeks to achieve. As many of us know from cases in our constituencies, such situations can be tragic for families and friends. If the debate has at least offered some aspect of healing and hope, it will have achieved a great deal.
§ Mr. David Chidgey (Eastleigh)
I, too, congratulate the hon. Member for Eccles (Mr. Stewart) on the way in which he led the debate and on the way in which he has, over many months, led the campaign. I lend him all my support.
In common with many hon. Members, I have examples of such tragedies in my constituency. I should especially like to mention Roy and Jean Stokes and their son Keith. Keith suffered severe brain damage as a result of a vaccination when he was a baby. As in many such cases, he is now in his late 30s, but remains at the mental age of an infant. We have heard dramatic descriptions of what that means to parents.
I am pleased to mention Roy Stokes because, for more than 35 years, he has been a leading campaigner on behalf of parents throughout the country who are trying to get justice for their children. As a Member of Parliament, I feel shame that, during that period, nothing was done—regardless of which party was in power—to address seriously the injustices that parents have suffered. The Labour party promised much in its pre-election pledges, and we were all hopeful. However, it is now time to deliver; the Minister should realise that.
The hon. Member for Eccles mentioned the compensation that was offered by the Government of Lord Callaghan. The Vaccine Damage Payments Act 1979 came into force as a result of the report produced by the Pearson commission, which was accepted by everyone as a fair interpretation of the situation. The payment of £10,000 was to be an interim payment, not the end of the affair.
The hon. Gentleman mentioned the deed of trust. I have a copy of Roy Stokes's deed of trust, which states clearly that 11WHthe Secretary of State is satisfied that Keith Roy Stokes—the son—was born … disabled as a result of vaccination and is about to make a payment of £10,000 to the First Trustees to hold on the trust.There is the statement. There is no question that there is any reason other than vaccination for the child being so severely disabled. As the Pearson commission said, there should be, in cases involving severe brain damage, a right to court judgment and to just and appropriate compensation. That was 25 or more years ago, but nothing of any substance has happened since. The ensuing Governments must recognise that, to their eternal shame, they have not grasped the issue. They have ignored the key issues and have changed the rules.
I shall illustrate what I mean by changing the rules. How can a logical mind accept the view that a child who is brain damaged by vaccine should be treated the same as a child who is born with brain damage? There is a world of difference between a tragic accident of nature and the effects of a vaccination programme for which, as Governments know, it is a statistical certainty that there will be casualties, even if the health of the nation as a whole will be improved. More importantly, parents also know that there will be casualties, which might explain why take-up rates are falling. That worries those of us who are concerned about the health of the nation.
It is important that parents know that, if they are unfortunate enough to suffer this tragedy, they will get just compensation. Over the past few years, the confidence of parents that they will be supported if there is an accident has been eroded. It is not acceptable to offer the normal social services support packages, as if the children had suffered natural damage. We all know the hoops and hurdles that people must navigate to win what should be theirs as of right. Often, there is means testing, or the funds in local authority budgets are curtailed. That is an almost bestial way to approach the problem. We are supposed to be a civilised society, in which people in need are cared for. We should be able to take pride in the fact that, in our society, such people are not left wanting, through no fault of their own.
We should follow the examples provided by other countries, where parents have received compensation adequate to allow them to ensure that their children are properly cared for. We need to reassure parents, who are offering their babies for vaccination for the public good, that they will be compensated with sufficient funds to help them cope with the burden of a lifetime of caring, if something goes tragically wrong.
I would like to draw attention to the five key points made by the Association of Parents of Vaccine Damaged Children. First, we should take the Pearson report off the shelf, dust it down and, 20 years on, establish what to make of it. It makes some very good points. Secondly, we should consider awarding a lump sum in accordance with what would be achieved in the courts. Thirdly, we could pay a lump sum to top up existing allowances, but that must be additional to, and not a substitute for, local authority services. Fourthly, we could set up a special fund through the pharmaceutical industry. If that worked in the thalidomide case, why should not it work for vaccine damage? I see no difference between the two cases. 12WH Fifthly, the exceptionally severe disability payment pension could be paid to children, which would take the burden off parents.
The Government have a chance to act, and they should take it. They should also recognise that the cost of supporting causalities in a vaccine programme should be costed into that programme—it should be part of the package. We need to live in the real world.
Finally, I return to my constituents, Roy and Jean Stokes, who are now in their seventies and who have given a lifetime of care to their son, Keith. One can only begin to imagine how that affected their quality of life, although they gave willingly and lovingly. As they grow older and more infirm, they are less able to support their son. However, rather than getting extra help, the fact that they are in their seventies means that they have lost their marriage allowance and their carers allowance. Roy's pension is also now taxable, which leaves them £3,000 a year worse off. That is, frankly, a disgrace.
§ Dr. Peter Brand (Isle of Wight)
I join others in congratulating the hon. Member for Eccles (Mr. Stewart) on securing this debate. Powerful speeches have been made today and were made on 2 December 1998. There is a sense of déjà vu about today's debate—the review that was promised in 1998 has still not taken place.
I am glad that the Under-Secretary of State for Social Security, the hon. Member for City of York (Mr. Bayley), will respond to our debate. My hon. Friend the Member for Eastleigh (Mr. Chidgey) pointed out that this matter involves not only benefit payments but public health, so it might have been more appropriate if the Minister for Public Health had been present to respond. Unless we ensure that there is confidence in the immunisation system, take-up will drop. The imminent measles epidemic which has been predicted for parts of Europe may be relevant in this context.
The hon. Member for Banbury (Mr. Baldry) made a powerful speech, but I disagree with him—TB has not been eradicated. One of the lessons that we have to learn is that such diseases are always around. We must remain vigilant and find the best form of protection for the wider community. However, if we are to do that, we must compensate those individuals who have suffered from, or whose condition is linked to, receiving a vaccination.
As a medical practitioner, I cannot be certain in every case I see that there is a distinct causal link when a person becomes ill after an immunisation. However, one must give the benefit of the doubt to anyone who had a perfectly nice, normal baby who became ill after a course of immunisation. There are conditions that do not show themselves until a baby is about three months old, which is the age when immunisations are usually offered. To have the population's confidence, we need to protect our society at large.
Frankly, this matter should not be left to the pharmaceutical industry. In this area, there is not a competitive market. Selected manufacturers are chosen by the Department of Health to supply a vaccine, and it is that Department and the state that should take responsibility.
13WH I am wary of the Department of Health's statement that the vaccines are safe—it has maintained that for many years. At the same time, it is encouraging research into newer, safer vaccines. If a safe vaccine already exists, why are we conducting research into newer, safer ones? As with the 1979 Act, that is an admission of a link; it admits that a small number of people run a statistical risk of suffering the devastating consequences of immunisation.
The willingness of successive Governments to allow people to litigate against deliverers or producers of the vaccine has not proved particularly helpful, and runs against a desire to protect the community. Manufacturers are being restricted and are increasing the number of contraindications. For example, it is nonsense to regard a history of epilepsy as a contraindicator to giving vaccine, but should a condition worsen after vaccination the manufacturer could be sued. That illustrates the need for some form of no-fault compensation, to which the hon. Member for Banbury referred.
The right hon. Member for Coatbridge and Chryston (Mr. Clarke) illustrated clearly why the 1979 Act is failing older people. I, too, have a number of constituents whose parents are elderly and can no longer cope, and they need to know that the work that they have carried out devotedly for 30 or 40 years will be continued. The hon. Member for Eccles said that nothing has changed since 1979, but the initial payment, which was understood to be an interim payment, has become a final payment. The 1979 Act acknowledged that some people carry an extra burden. Such people are owed a review, and it is our collective responsibility to do something about this issue.
I do not want to have to participate in yet another debate on this issue in 18 months' time. The Government cannot keep shirking their responsibility, and they certainly should riot pass responsibility to the pharmaceutical industry or the courts.
§ Mr. Eric Pickles (Brentwood and Ongar)
This is the second time that I have contributed to a vaccine damage debate initiated by the hon. Member for Eccles (Mr. Stewart). It is clearly a subject about which he feels passionately and, once again, he has spoken most powerfully. However, his language was simple and unemotional, and his argument was the more powerful for that.
Hon. Members have spoken eloquently on this issue today. The right hon. Member for Coatbridge and Chryston (Mr. Clarke) neatly illustrated that it is not only children who have been damaged by vaccines, but adults. He also mentioned carers. Carers who have been dealing with such problems for many decades are no longer able to provide the same level of personal care that was provided previously. There is a duty on the House and the Government's shoulders to find a solution to the problem.
As hon. Members have said, the previous debate on this subject took place on 2 December 1998, which was a significant date. There was a certain amount of excitement about compensation for vaccine damage and a feeling that an announcement from the Government was imminent. The Government made several promises. 14WH The hon. Member for Eccles described it as a run around the paddock, so let me make it clear what that run involved.
On 23 June, in the First Standing Committee on Delegated Legislation, the then Minister of State referred tothe vaccine damage payment scheme being considered as part of the welfare review.—[Official Report, First Standing Committee on Delegated Legislation, 23 June 1998; c. 3.]Shortly before that debate, in a written answer on 2 November, Baroness Hollis said in the other place thatan announcement will be made in due course.—[Official Report, House of Lords, 2 November 1998; Vol. 594, c. 28W.]In replying to the debate on 2 December, the then Minister of State said that the Under-Secretary of State for Social Securityhopes to conclude our review early in the new year.—[Official Report, 2 December 1998; Vol. 321, c. 817.]That was 1999. Early that year, on 27 April, Baroness Hollis said thatan announcement will be made as soon as possible.—[Official Report, House of Lords, 27 April 1999; Vol. 600, c. 26W.]We heard recently from the Minister that the Government are examining the feasibility of setting up a fund to provide help for people who have suffered vaccine damage. That seems to represent a slight pulling back in that the Government are no longer saying that they will do something as soon as possible; they are just looking into the matter. I agree with the hon. Member for Eccles that we should try to ensure that the review is concluded by July at the latest. We know from the newspapers that negotiations between the Government and drugs companies seem to have broken down. It would be helpful if the Minister would take the Chamber into his confidence and tell us a little about the progress of those negotiations.
There are good reasons why we should reach a decision reasonably quickly. Every time the story raises its head and every time it receives news coverage, fears are raised among parents about the immunisation programme and this may cause some people not to have their children vaccinated. Of course, most newspaper coverage has been serious and sensible but, regrettably, some has been sensational. My godson is of an age to receive immunisation. I know that his parents have genuine worries and there is a niggling doubt at the back of their minds about whether the process is sensible.
As hon. Members have said, the public vaccination programme has been a great success. I look around Westminster Hall and, with the exception of one or two senior and distinguished hon. Members, I see that we are all of much the same age, an age that benefited from the vaccination programme. When I was a child, there were 157,000 cases of whooping cough a year, of which 300 resulted in death. Now, 40 years later, there is, fortunately and pleasingly, only one death a year. Those childhood illnesses killed many and denied many children the opportunity to develop a happy and successful life. The vaccination programme has enabled many children to live, and many of us perhaps owe our existence to it.
15WH As the then Minister of State, the hon. Member for Southampton, Itchen (Mr. Denham), said in reply to the last debate,No child in England and Wales has died from acute measles-related illness since 1992. All those figures establish that the immunisation programme provides benefits not only to society as a whole but to the individual and his or her family.—[Official Report, 2 December 1998; Vol. 321, c. 816.]There cannot be a better illustration of the need for vaccination programmes than tuberculosis, to which my hon. Friend the Member for Banbury (Mr. Baldry) and the hon. Member for Isle of Wight (Dr. Brand) referred. As you may know, Mr. Deputy Speaker, there is an acute shortage of the tuberculosis vaccine, and there is a backlog in the school immunisation programme which can cause delays of up to two years in our schools. A comparison of last year's figures with those of 1970 is unsurprising in the light of that shortage. In 1970, 1,901 cases of tuberculosis were reported; last year, 6,144 were reported. If ever there was an illustration of the need for a vaccination programme, surely it is tuberculosis.
There is a further reason why we should solve the problem. Vaccination policy is there in the public interest; it saves lives. However, any mass vaccination programme involves a risk—it may be slight, but it is a risk nevertheless. Mr. Mike Watson, the medical director of Aventis Pasteur, which distributes vaccines, said:There is a quantifiable risk, even though it is tiny, so you should have a scheme in place to compensate people—the people who suffer from vaccine damage. In the United States, the vaccine companies contribute to a central fund.
Parliament, the Department of Health and the Department of Social Security say that parents should immunise their children, because the argument in favour of doing so is overwhelming. We advance that argument in the full and certain knowledge that accidents will occur and that the victims are victims for the common good. Those people deserve our protection, and it is the protection of compensation that the House should offer.
Two principal changes, to which hon. Members have already referred, can be made. First, good and compelling arguments suggest that there should be a sliding scale below the 80 per cent. disability limit, although that rule is common to most methods of calculating disability. Secondly, it is argued that the six-year rule for making a claim, which involves a cut-off point, is too restrictive and should be abandoned. Those arguments were addressed by Ministers on two recent occasions in the Chamber and in another place. On 29 June, when she introduced uprating, Baroness Hollis said:Fixing the extent of disablement at 80 per cent. or more was based on a well-established social security principle assessed for the purposes of section 57 of the Social Security Act 1975. In fact, it is the same basis as the industrial injuries benefits scheme and the 80 per cent. threshold reads across the severe disablement allowance. So it is a fairly standard measure for disability.—[Official Report, House of Lords, 29 June 1998; Vol. 590, c. 509.]On 2 December 1998, in response to points about the six-year rule, the then Minister of State for Health said: 16WHMarginal changes in the time limit would not assist in the overwhelming majority of cases. The substantial length of the process would make obtaining medical and other relevant evidence after long periods increasingly difficult.—[Official Report, 2 December 1998; Vol. 321, c. 816.]I believe that those views are wrong in two important respects, which have been addressed by hon. Members this morning. The difference is that the 80 per cent. disability rule has been engendered by the state on its own behalf and is part of the immunisation process of which some people are victims. The suggestion that the rule makes no difference belies the fact that appeals and applications are turned down. An average of 73 per cent. of cases have been turned down each year since 1992 because applications have been made more than six years after vaccination.
One point that my hon. Friend the Member for Banbury made about the 80 per cent. rule needs to be emphasised. The 80 per cent. disability must relate to vaccine damage. An application from a person who, in the opinion of the assessors, is 70 per cent. disabled through vaccine damage and 10 per cent. disabled through another cause would fail. That makes no sense.
I disagree with the hon. Member for Isle of Wight, who said that it was a pity that the Minister for Public Health is not present. I have every confidence in the Under-Secretary with regard to the settlement of the case—he does not share the views of hon. Members mentioned previously. We know that he wishes to see an end to the 80 per cent. rule and to the six-year period because he was a signatory to two early-day motions—one on 16 April 1996 and another on 23 May 1994.
People sometimes sign early-day motions that come back to haunt them, but that is not the case here. The Under-Secretary signed both motions and was not isolated in doing so. More than 300 signatures were gained. The Minister of State for Social Security signed one of the motions. His colleagues, the parliamentary private secretaries in the Department of Social Security and the Whip responsible for that Department, signed. If the hon. Member for Eccles is right to say that the argument is between officials and politicians, the weight of the political argument lies in the Department. Everyone signed the early-day motions, with the exception of the present Secretary of State, who no doubt was precluded from signing because of his position then as a member of the shadow Cabinet. The entire Department—possibly with the exception of Ministers serving in another place—are behind ending the 80 per cent. limit and the six-year rule. I have no doubt that the Under-Secretary will make clear the way in which it is intended to end them.
The matter should not become political. However, politics enter the question of what is in a Government's programme. I want to make it absolutely clear that, if the Government seek to amend the Act or to make the necessary changes by secondary legislation, Opposition Members promise to do everything in their power to co-operate and to work towards a speedy resolution of the case.
§ The Parliamentary Under-Secretary of State for Social Security (Mr. Hugh Bayley)
I congratulate my hon. Friend the Member for Eccles (Mr. Stewart) on securing the debate, which is important not only for 17WH those who have received vaccine damage payments but for their parents, families and carers. Many of us have constituents who must contend daily with the difficult circumstances of caring for a severely disabled child or, too often now, a severely disabled adult. I pay tribute to the relentless devotion of the families to their children, and to the tenacity of their campaigns to establish a vaccine damage payment scheme in the 1970s and to have that reviewed.
I also pay tribute to my hon. Friend the Member for Eccles for his constructive and helpful role—which has not always been comfortable for me as a Social Security Minister—in leading the all-party group on vaccine damage. His speech reflected his depth of feeling on the issue and his sensitivity towards the families involved. I congratulate other hon. Members who, for many years, have tried to bring the matter to the attention of the House.
I shall begin by responding to specific points. The hon. Member for Banbury (Mr. Baldry) mentioned the case of his constituent, Hamish Thompson. There is medical evidence of a causal link between polio vaccine and injury, which I shall address in more detail if I have time. The hon. Gentleman asked whether it remains Department of Health policy to administer polio vaccine in the way in which it was given to his constituent. The Department of Health programme is based on advice from the Joint Committee on Vaccination and Immunisation. It continues to recommend oral polio vaccine for the United Kingdom. The situation in the United States is different. The whole of the Americas, from Baffin island in Canada to the tip of Chile, is declared free of polio, which is not the case in our hemisphere.
I differ from the hon. Gentleman on one point: the policy has not been subject to a game of pass-the-parcel between Departments—certainly not by this Government. Departments have worked closely together. Indeed, I have worked with colleagues in the Department of Health and other Departments. I do not want to make this a party political issue, but if there was a time when Departments tried to duck their responsibility, it was in the 18 years of the Conservative party's Administration when. despite requests for a review, none took place.
My right hon. Friend the Member for Coatbridge and Chryston (Mr. Clarke) has discussed his nephew's case with me. I acknowledge and congratulate him on his role as a long-standing and committed campaigner for all disabled people, not just members of his family. Indeed, he has outlined the Labour party's policies to disability groups in my constituency. He graphically explained how the six-year time limit restricts the ability of his nephew to receive further consideration of his case. I assure him that the review is addressing that issue, and the Government's views will be made known when it is published.
The hon. Member for Isle of Wight (Dr. Brand) made several points on the medical benefits and risks of vaccination. I agree with much of what he said. He asked whether the initial vaccine damage payment scheme was envisaged as being an interim scheme. It was not. At Second Reading of the Vaccine Damage Payments Bill, the Opposition spokesman, Patrick Jenkin, said to the Secretary of State, the late Lord Ennals: 18WHI do not think that at any stage has the right hon. Gentleman used the phrase "an interim payment" … the right hon. Gentleman has been extremely careful at no stage ever to use that expression. —[Official Report, 5 February 1979; Vol. 962, c. 69.]David Ennals's reply was "Quite right." In Committee he said that he had never looked on the Bill as an interim measure.
§ Mr. Stewart
How can the late Lord Ennals's statement that the issue was not at an end be squared with the statement that the payment was not an interim measure?
§ Mr. Bayley
I cannot, of course, speak for the Secretary of State 20 years ago, but I imagine that he had in mind the many and varied recommendations of the Pearson report. It dealt with people damaged by vaccine and there was a recommendation on vaccine damage, but it was a much wider-ranging royal commission, and the debate concerned the wider issue. It was made clear during the passage of the Vaccine Damage Payments Act 1979 that there would be a response at some point to wider issues raised by the Pearson committee.
It might help my hon. Friend and hon. Members if I said something about the background to the review of the vaccine damage payment scheme announced by the Government. Of course, through the 18 years when the Conservatives were in power, parents pressed for a review of the scheme. Shortly after the general election, Labour Ministers were approached both by the organisations campaigning on the victims' behalf and by the newly formed all-party group. On 19 May 1998, my right hon. Friend Baroness Hollis announced that a review would be undertaken in consultation with the Department of Health as part of the Government's welfare review programme. During the review, several meetings have taken place between Ministers and members of the all-party group. On occasion, they have been attended by members of the parents' groups, who have powerfully and movingly made their case to me and to others.
The parents' groups want several changes and not all have made the same points. However, they want five principle issues to be dealt with: the abolition of a six-year time limit; a reduction in the 80 per cent. disability threshold and/or its replacement with a sliding-scale basis for vaccine damage payment awards; an additional lump sum for previous recipients of vaccine damage payments; a specific on-going benefit for those damaged following vaccination; and a contribution from the pharmaceutical industry towards the support of those damaged by vaccines. They have also raised questions about vaccination incentive payments and the promotion of vaccines.
To return to the origins of the scheme, after a campaign by parents in the 1970s an extra-statutory scheme was begun in May 1978 and the Bill relating to the present statutory scheme was introduced in February 1979. That provided for a lump sum for people severely damaged as a result of vaccination under a routine public vaccination programme. I have read carefully the Hansard reports of debates on the Floor of the House and in Committee and perhaps I should pay tribute to three people. One is Rosemary Fox, who was cited time after time in those debates as a parent and campaigner who brought the issue to the attention of 19WH Parliament. I firmly believe that, without her campaigning, the Vaccine Damage Payments Act 1979 would never have reached the statute book. The other two people are Jack Ashley and Alf Morris, who was then in my shoes, as the junior Minister responsible for the Bill.
When the Bill was introduced, the Secretary of State for Social Services, the late Lord Ennals, made it clear that the scheme was not about compensation but about payments. It was designed to provide a lump sum payment of £10,000 to ease the present and future burdens of those suffering from severe vaccine damage. The amount has been progressively increased over the years and was last raised to £40,000 on 1 July 1998, shortly after my right hon. Friend announced the Government's review. That increase more than restored the payment to its 1991 value, when it was previously increased. Based on the retail prices index, simple indexation would have produced a figure of £38,194.
§ Mr. Andy King (Rugby and Kenilworth)
Does my hon. Friend agree that, even though the original figure has been upgraded to £40,000, it is a derisory sum which does not ease the burden of care on the families, to which he has referred so eloquently?
§ Mr. Bayley
I thank my hon. Friend for raising the issue. In the time that is available, I shall explain as much as I can about the progress of the review. The sum is one of the issues under review.
I said in response to the hon. Member for Banbury that, although there is a one-in-a-million risk of contracting paralytic polio from the oral polio vaccine, as the Government acknowledge, there is a lack of clear scientific evidence linking routine childhood vaccinations to permanent damage. The High Court judgment in 1988 in the Loveday case dealt with whether, on the balance of probability and for the purpose of tort damages, it had been proved that the pertussis vaccine had caused permanent brain damage. In his judgment, Lord Justice Stuart-Smith concluded:I have now come to the clear conclusion that the plaintiff—Loveday—fails to satisfy me on the balance of probability that pertussis vaccine can cause permanent brain damage in young children. It is possible that it does; the contrary cannot be proved.20WH That is not the same as saying that disability as a result of vaccination cannot happen. For that reason, each claim is given individual consideration. I say to my hon. Friend the Member for Eccles that nobody from the Government is seeking to open the question of causation in any cases in which a vaccine damage payment has been made.
§ Mr. Stewart
My hon. Friend took a risk in mentioning names before, because there are many names, not least of which is Olivia Price of the Vaccine Victims Support Group. She tells me, and I believe that it is correct, that confidence is directly related to the success of the vaccine programmes. Does my hon. Friend accept that and accept that a lack of confidence in one vaccine programme can have a negative knock-on effect on other vaccine programmes?
§ Mr. Bayley
Yes, I agree, but I am heartened by what a number of hon. Members have said today about the importance in public health terms of a vaccination programme.
I recently wrote a foreword to a book by a constituent, Brian Sanctuary, about the open-air schools in York, the hospital schools which were the predecessors of special schools. In 1922, out of 112 pupils in the Fulford school in my constituency, 25 were suffering from TB, seven from polio and two from diphtheria. As a result of the vaccination scheme, the health of the children who receive education in special schools has changed beyond recognition.
In the short time available, I must respond to the questions about the timetable and the conduct of the review. My hon. Friend the Member for Eccles asked whether the DSS has requested additional funds from the Treasury. He is right to say that the review involves several Departments, including the Treasury. It is not normal for a Minister to comment on internal Government processes, but I can confirm that, when an announcement is made, it will be with the full agreement of the Treasury. That will need to be built into the timetable.
I very much regret that the review was not concluded earlier, and I know that the parents concerned are desperate that it should be concluded. Two years is indeed a long time.