§ Miss KirkbrideTo ask the Secretary of State for Health what plans he has to study the incidence of autism in(a) children immunised with MMR and (b) children who have not been given MMR jabs. [24277]
§ Yvette CooperI apologise to the hon. Member for the delay in responding to this question. I refer the hon. Member to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002,Official Report, column 192W.
The cause of autism is not yet known and many factors may play a role. The recently completed Medical Research Council (MRC) review of the epidemiology and causes of autism concludes that the strongest evidence to date is for a major genetic component. It says that methodological differences between studies, changes in diagnostic practice, and increased public and professional awareness are likely causes of apparent increases in prevalence but notes that it is not yet clear whether these factors account for it all.
A number of studies, including one commissioned by the Medicines Control Agency have examined the postulated link between measles, mumps and rubella (MMR) and autism and have found no association. Two of these studies (Fombonne et al, Paediatrics, 2001 and Hiejbel and Gillberg, Autism, 1998) have specifically looked at rates of autism in populations who have had MMR and populations who have not had MMR using consistent definitions of autism. These studies did not find an increased reported rate of autism in MMR immunised children when compared with children who had not had MMR. Taylor et al, Lancet 1999, looked at the rate of MMR immunisation in autistic children in north Thames and found no significant difference when compared with the rate of MMR immunisation among all children in north Thames. A follow-up study (Vaccine 2001) showed no temporal association between MMR and onset of autism at any time. In February 2002, the Public Health Laboratory Service published a further study investigating MMR, regressive autism and bowel symptoms. This study compared the proportion of autistic children with bowel 1033W or developmental regression over a 20-year period from 1979, a period when MMR vaccine was introduced in the United Kingdom. They showed that there was no change in the proportion of children with regression or bowel symptoms during this time, irrespective of whether they had had MMR or not (Taylor et al, BMJ 2002, 324; 393–6).
In addition to the above, an ongoing study funded by the MRC and led by Professor Andrew Hall, is investigating possible causes of autism. This study will examine whether autistic children have a history of other conditions or medical problems, for example, problems during birth. This study, which examines a representative sample of health records drawn from over two million people registered with 300 general practices across the UK, will also look at autism and the MMR vaccine.
§ Miss KirkbrideTo ask the Secretary of State for Health if he will make a statement on what guidance he gives to GPs seeking to expel patients from their list because of a refusal to accept the MMR vaccination. [35424]
§ Yvette CooperI apologise to the hon. Member for the delay in responding to this question. I refer the hon. Member to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002,Official Report, column 192W.
The registration/de-registration of patients with a general practitioner is governed by the Doctor's Terms of Service. We strongly endorse the General Medical Council guidance "Duties of A Doctor" which says that it is unacceptable to discriminate against patients on grounds of lifestyle, culture, beliefs, race, colour, sex, sexuality, age, social status or perceived economic worth. Refusal to accept the measles, mumps and rubella vaccination should not therefore be regarded by a general practitioner as a reason for removing somebody from his or her patient list.