§ Sir Malcolm ThorntonTo ask the Secretary of State for Health if she will provide the figures for the volume of medicines required by the NHS, the costs in administrative terms and the actual costs of the medicines in order to meet the immunisation targets for children for each year since the introduction of the general practitioners' contract; and if she will make a statement.
§ Mr. SackvilleUnder central purchasing arrangements introduced on 1 April 1992, expenditure on vaccines for childhood immunisation is estimated at £40 million in the year 1992–93. This expenditure covers immunisation carried out in general practitioners' surgeries as well as in local clinics. Details of expenditure on childhood vaccines in the years 1990–91 and 1991–92 are not held centrally because prior to 1 April 1992 individual health authorities made their own purchasing arrangements.
Approximately 650,000 children enter the immunisation programme annually. From birth to five years, each child requires four doses of diphtheria, tetanus and polio vaccine, three doses of whooping cough and Hib vaccine and one dose of measles/mumps/rubella vaccine. Contracts are placed with vaccine manufacturers to ensure the required total volumes of vaccine are available to immunise each child.
Progress with the childhood immunisation programme since the GPs' new contract was introduced is set out in the table. These figures cover immunisation carried out in GPs' surgeries and in local clinics. Separate figures in this format are not available.
Number of children immunized (England) Immunisation against: 1990–91 1991–92 (provisional) Diphtheria, Tetanus and Polio 587,000 (92) 594,000 (93) Measles, Mumps and Rubella 552,000 (86) 578,000 (90) Whooping Cough 539,000 (84) 562,000 (88) Note: The figure in brackets is the percentage of all children aged two who have been immunised.
Expenditure in England on payments to general practitioners for reaching immunisation targets amounted to £41.138 million in 1990–91 and £49.804 million in 1991–92. Administrative costs associated with the immunisation programme cannot be disaggregated from other NHS administrative costs.
The childhood immunisation programme has been one of the country's major successes in disease prevention. The most recent estimates from the Public Health Laboratory Service's survey show that 95 per cent. of all children by the age of 18 months have been immunised against diptheria, tetanus and polio, 91 per cent. at the same age against whooping cough, and 93 per cent. by the age of 24 months against measles, mumps and rubella. East Anglian 607W region has achieved the "Health of the Nation" target of 95 per cent. cover by 1995 for all diseases, and Oxford, South Western and Wessex have done so for all except whooping cough. There has been no reported death from acute measles since 1989, and reports of all the diseases for which immunisation is available are at record low levels.