§ 1.49 a.m.
§ Mr. Robert Adley (Christchurch and Lymington)
I am grateful for the opportunity to raise a matter which is of great concern to me because of the experience I have had with a case in my constituency and which I know is of equal concern to the Minister, whom I thank for being here, and my hon. Friend the Member for Reading, South (Dr. Vaughan), whose advice I have sought on this case on a number of occasions in the past few weeks.
In response to your admonitions, Mr. Deputy Speaker—
§ Mr. Deputy Speaker (Sir Myer Galpern)
I do not think that the Chair should be accused of admonishing anyone. I simply stated the Standing Orders.
§ Mr. Adley
I think that what I have to say will be in order and within the ambit of Class XI of the Supplementary Estimates, which is the heading under which this topic has been placed.
The matters I shall raise include medical technicalities in which I am not well versed as I have no medical qualifications. Some of the matters impinge on legal complexities and I am not a 241 lawyer. I am trying as a Member to use a layman's judgment to ensure a fair deal for a constituent and to put forward fair representation in commonsense terms of a problem which has implications well beyond my own constituency. The matters I shall raise are a labyrinthian combination of political, medical, ethical and administrative affairs. I start by setting out simply the position of the Price family in Christchurch.
The Price's young daughter, Tanya, now aged 20 months, is suffering severely from a damaged brain which the parents claim results from a vaccination against whooping cough, but which, it has been represented, may be a condition from which the child suffered from birth. There are four points which I put to the Minister. First, can we somehow get at the facts and ascertain whether Tanya Price was brain damaged before or by the vaccination? Secondly, can doctors or medical science tell whether a person can suffer brain damage by a vaccination? Thirdly, can the parents of an infant child expect either for themselves or, on their behalf, a medical adviser, access to the medical records of their child? Fourthly, has there been in this case any unacceptable delay either by the Department of Health and Social Security centrally, or by the area health authority and, attendant upon that delay, has there been any attempt to cover up the fact and prevent Mr. and Mrs. Price from having access to the medical records and, through them, information about their daughter's health?
The Minister wrote to me on 21st October, some weeks after I first raised this case with the Department on 6th August. The hon. Gentleman said:I have received a report from the East Dorset Health District which indicates that the fits suffered by Tanya were not caused by a vaccination procedure but were due to a condition which began about two months after birth.That was hotly disputed by the Prices and, after I had shown them the Minister's letter, Mr. Price wrote to me:It goes without saying that we disagree with his decision, as we are sure that Tanya was not having convulsions before the whooping cough injection.The other side of the case is put by the Chairman of the Dorset Area Health Authority, Sir David Trench, who is quoted as saying in an interview in the Daily Mail on 29th November: 242There is no doubt in my mind that Tanya's condition was caused by the injection.One of those propositions—the Minister's or Sir David Trench's—must be factually in error.
The point is that if Tanya was brain damaged before she had the vaccination, she should never have had it in the first place. I maintain that her medical records are the best way of checking her condition in the first six months of her life prior to vaccination, and it is because these records are being consistently withheld from the Prices and also from their medical adviser that I have sought to raise this matter in the House tonight.
Alternatively, if Tanya was not damaged prior to vaccination, there would seem to be either an extraordinary coincidence of timing or—as seems to me much more likely in the light of evidence from many other people—the vaccination itself was the cause of the brain damage from which this poor child is now suffering.
The second proposition involves discovering whether medical science is sufficiently sophisticated to enable us to know whether the vaccine can cause brain damage. I quote from the Sunday Times of 31st October this year—from an article entitled "Lifespan", in the colour magazine, which contains a section on vaccination:Vaccination has played an essential part in the decline of infectious disease over the last 50 years. Routine vaccinations, however, have declined by about a third over the last year because of worries over the effectiveness and safety of whooping cough vaccine. However, other vaccinations which your child should have at each age are detailed in the accompanying chart. Whooping cough vaccine is officially recommended but is excluded from the list because experts still argue whether the benefits are worth the risks.I said that the case that I wished to deploy tonight was not of an isolated incident in my own constituency. This is confirmed in a letter to me from Dr. James Loring, Director of the Spastics Society, one sentence of which reads:We have a number of children whose handicap stems from the triple vaccination and they are indeed tragic cases.Clearly, therefore, the Sunday Times and the Director of the Spastics Society are convinced that there is something very wrong indeed with this whooping cough vaccination.
243 I am awaiting from the Minister information—which I am sure he will pass on to me as soon as he gets it—showing whether whooping cough vaccination, apparently recently withdrawn in West Germany, is the same as the vaccination that is still being administered in this country. Perhaps, to save my tabling a Written Question, the Minister will be kind enough to publish in the Official Report the answer to that question, when he receives the answer. There are now so many cases where parents are claiming that their children are suffering from vaccine damage that we surely cannot go on much longer believing either that all these cases represent a coincidence of timing or that they are subject to the lack of certainty which is and remains the Department of Health and Social Security's attitude to the whole question.
It would not be appropriate on this occasion to go into a discussion of the Pearson Report, but I have no doubt that it is eagerly awaited by many people who will take some interest in the proceedings here tonight. In reply to a Question tabled by me on 2nd November the Minister himself said:It is not possible to be sure whether brain damage has resulted from vaccination or is due to an unrelated cause."—[Official Report, 2nd November 1976; Vol. 918, c. 549.]I must tell the Minister that I have a sufficient number of letters in my possession—some of which I have sent to him and many more that I shall be happy to send to him—to enable me to assert, on behalf of a large number of parents, that they, together with the Sunday Times and the Director of the Spastics Society, are in no doubt about the damage that whooping cough vaccine is doing and has done.
I have letters from places as far apart as Dunfermline, Devizes, Macclesfield, Parkstone, Bournemouth, Poole and Blandford, both in Dorset, and New Milton, in my constituency. I shall certainly make sure that the Minister receives all these letters. He has asked me to pass on to him any information that comes to me.
I have no wish to be sensational, but the Minister must know that there is increasing concern about this whooping cough vaccine.
§ Mr. Deputy Speaker
Order. The hon. Gentleman is creating some difficulty for the Chair. The subject that the hon. Gentleman was anxious to discuss was the availability of medical records in National Health Service hospitals. Earlier he made a very fleeting reference to a desire to gain access to records, but he is now going on to develop the question and to argue about the efficacy of vaccines, partticularly the vaccine against whooping cough. I think that that is not really in accord with what he sought to discuss in this debate.
§ Mr. Adley
I mentioned this to Mr. Speaker earlier, because the precise wording of the heading to my debate was not of my choosing, and Mr. Speaker advised me that anything under the heading of the National Health Service would be technically in order under the Supplementary Estimates that we were discussing. I am trying in my argument now to explain why I believe that the Prices' medical records have been withheld, which has a great deal to do with the lack of certainty—
§ Mr. Deputy Speaker
What I have heard has been an argument as to whether one should use vaccines against whooping cough, and the hon. Gentleman has been trying to adduce medical evidence, letters, and the rest. I can still see the point that he wished to urge on the Minister, that records should be available to establish his first case on whether the girl had convulsions, or whatever she suffered from, before she had the injections. That is reasonable and relevent. I hope that the hon. Gentleman will keep that in mind.
§ Mr. Adley
I intend to revert directly to the wording on the paper before you, Mr. Deputy Speaker. I said before that I had no wish to be sensational. The Minister knows that there is increasing concern about this vaccine and concern about symptoms similar to those found in the early years of the thalidomide saga. The severe brain damage from which many children are suffering is even more distressing than that suffered in that tragedy.
I return to the subject of the access of parents to the medical records of their infant children. It is clear that the medical profession takes good care to ensure 245 that its actions and its possible mistakes are as well protected as possible. That is understandable. I have been seeking some form of guidance on the subject of disclosure of information by doctors, consultants and so forth. I referred to S. R. Speller's "Law Relating to Hospitals and Kindred Institutions". I should like to quote one sentence from page 332 relating to the release of information.Even when there is no legal compulsion on a medical practitioner or other member of the staff of a hospital authority to give information to the police, there may still be a public or social duty to do so".Of course the police are not involved in this particular case, but I submit that the question of public or social duty is very much part of the argument which I am trying to deploy. I believe that the behaviour of certain medical and administrative people in this case shows that they put their interest in secrecy as their top priority, and that is a situation which I am not prepared to tolerate on behalf of my constituents and which I shall fight in every way possible.
My constituent Mr. Price is a bricklayer, and Mrs. Price is a confused young housewife. I believe that they are being baffled by scientific arguments put forward by people who have at their disposal the finest legal and medical brains. In my view that was confirmed to me by the Minister himself when he wrote justifying the failure to give some information to Mrs. Price by saying, in his letter of 26th November:I understand, for example, that when she approached the general practitioner she asked about 'clinic records' and understandably was referred to the Pokesdown Clinic. Her inquiry of the Area Health Authority referred to 'medical records' and she was correctly advised that these were held by Tanya's general practitioner.That is all fine and dandy if one is fully conversant with the legal niceties of the differences between these various records, but for ordinary folk who are not medically or legally qualified there is a complex verbal jungle through which it is almost impossible to cut unless one has a great deal of time, money and knowledge.
I wish to make clear that the Minister has never failed to be helpful to me on every occasion, and, if anything has emerged from the discussions on this case, it is that the Minister himself has far less power and authority than perhaps he 246 would wish—and certainly less than I would wish—if he is to be able to give practical assistance to my constituents in obtaining these medical records.
The Minister may recall that on 1st November I wrote to him to describe in some detail the run-around which Mrs. Price was given over a period of two days when she was merely trying to establish where her daughter's medical records were. I remind him that I wrote in these terms:On Wednesday last, 27th October, Mrs. Price saw Miss Routh, the health visitor who had looked after Tanya from the date of her first visit until the time she had to go into hospital after the vaccination. On being asked for Tanya's medical records, Miss Routh said she did not have them, and that they had been posted to Dr. Mrs. Brown last November after Tanya's vaccination. Dr. Mrs. Brown has now retired, and the Prices are registered with Dr. Hill in Boscombe. Mrs. Price went to Dr. Hill's surgery and asked if the records were there. She was told they were not, and was referred to the Pokesdown Health Clinic. Mrs. Price went to Pokesdown and asked if the records were there, and was told by Mrs. Day, the health visitor, that the records were not at Pokesdown and suggested that she should contact the Dorset Area Health Authority office at Ferndown. Mrs. Price got in touch with Ferndown, and was told that the records were not there and that she should contact her doctor. She then got back in touch with Dr. Hill's secretary, who repeated that they did not have the records and suggested that she try Pokesdown again. This she did and on this occasion Mrs. Day admitted that the records were there.This is not some smart young housewife being driven around in a Rolls-Royce. Mrs. Price is the wife of a bricklayer, using her own initiative and finding her own transport, very often by bus, and carrying with her her little daughter who is completely incapacitated.
Where now is the Dr. Mrs. Brown who has retired and who was the person who administered the vaccination? Why did Mrs. Day say on one day that the medical records were not in the place where she admitted they were on the second day? Is Mrs. Routh willing to come forward to help to unearth the information which the Prices need to establish the medical facts about their daughter?
What is the true role of the Dorset Area Health Authority? I believe the chairman, Sir David Trench, to be a good and charming man, and I have no doubt that he is doing his best to help me and to help Mr. and Mrs. Price. But, like the Minister, he seems almost powerless in 247 the face of a bureaucratic machine which is relentlessly pursuing its own ends, and—dare I use the phrase?—a medical Mafia which seems determine to make protection of its own interests its first priority. All this time my unfortunate constituents, Mr. and Mrs. Price, are being driven near to distraction. They are now being forced to have recourse to the law merely to gain access to their daughter's medical records.
At the meeting of the East Dorset Community Health Council on 1st November, somebody raised the question I have been asking about the transfer of medical records. The minutes record:Mrs. E. Cook replied that the patient's records belonged to the Health Service".What is this all-powerful Health Service that it, an inanimate "it", decides that "it owns things"? I have reason to believe that many Community Health Councils are concerned about the way in which these questions are handled. I am extremely unhappy about the way in which the whole case has been dealt with.
Sir David Trench wrote to me:it would seem inappropriate to endeavour to persuade the general practitioner, who has now retired, to obtain from her successor and produce her records at this stage.Everybody seems to have good reasons for preventing the records being uncovered and diligently protecting those who could help uncover them.
My fourth question is whether there has been a cover-up in this matter of the availability of the medical records.
§ Dr. Gerard Vaughan
(Reading, South): This is clearly a complicated and serious matter. My hon. Friend has said that the health authority refused to release the records to the parents. There may be strong reasons for that. Is my hon. Friend also saying that it has refused to release them to the parents' legal representatives or to a doctor acting on the parents' behalf? That would be a very serious accusation.
§ Mr. Adley
The answer to both questions is "Yes". Only this morning I received from Sir David Trench a letter in which he said:as soon as the agreement of all concerned with the hospital and clinic records to so doing has been received (which we are pressing 248 for to the best of our ability) these records can be released, subject of course to any conditions which may be made by the Medical Defence Union. The question of the release of the general practitioner's records is a different problem in view of the complaint made to the Family Practitioner Committee, as I have already explained.The Family Practitioner Committee had seemed to be another key to the problem, one which the Prices hoped would help them unlock the records, but only a few days ago we learnt that the family practitioner committee for Dorset had refused an examination of the case because Mr. Price made his claim too late.
I remind the House that Mr. Price is not medically or legally qualified. His concern has been for his daughter, and he has been doing a great deal. He has taken his child to France, where he heard there was a possibility of treatment. We have tried to raise funds locally. Mr. Price has been concerned not with the niceties of administration but with trying to help his daughter. In a letter dated 16th December, the family practitioner committee turned down his request for an investigation, the administrator saying:The Committee do not accept that ignorance of the complaints procedure can be regarded as a reasonable cause for failure to submit a complaint within the time limits and I regret to inform you therefore that the Committee are unable to accept that Mr. Price's delay in raising his complaint was occasioned by illness or other reasonable cause.Another door has been slammed in Mr. and Mrs. Price's faces. I can tell my hon. Friend that I have a doctor in Lymington standing by who is ready, willing and able to give what he describes as animpartial opinion of the value of the recordsto the Prices just as soon as he is able so to do. But the chairman of the area health authority, in a letter I received this morning, states that it hastraced a general practitioner of that name"—that is Dr. Rogers, the doctor whom on my suggestion the Prices have picked as their assessor—in Lymington and are checking that he is indeed the doctor concerned. One can presume he is, but the possibility of a retired consultant of the same name in Lymington being the doctor concerned is a remote possibility.For God's sake, when will people stop writing formal letters? I have spoken 249 to Dr. Rogers this evening. He has not been approached so far by anyone. His telephone number is Lymington 73063 and the code for Lymington is 0590. Perhaps that information can be passed on to the Dorset Area Health Authority. It seems unbelievable that one has to go to the lengths of recording these matters in Hansard to get something done.
It was as long ago as 30th November—about three weeks ago—that the Minister told me thatThe Dorset Area Health Authority is urgently pursuing the possibility of disclosing Tanya's hospital and clinic records to a medical adviser nominated by her parents. I understand that the agreement of the clinicians concerned in the case is still awaited."—[Official Report, 30th November 1976; Vol. 921, c. 93.]That was the answer I received when I asked the Minister about the records being made available to a medical adviser.
The Prices are fed up with waiting, and I am getting fed up too. The whole story, which started when I wrote to the Minister on 6th August, is one of delay, muddle and administrative arrogance. From 6th August to 21st December I have had no satisfaction, and I do not believe that the Minister has had any either. I know that the hon. Gentleman is a kind, compassionate and concerned man who similarly wants to ensure that something is done.
Disclosure of medical records is a thorny problem, and I am not advocating that every person should always have access to his or her own medical records. I am saying that the parents of an infant child should have the right—I stress "the right"—to have the child's medical records examined by an impartial medical adviser. That was the advice that the Minister first gave me in a letter he wrote on 17th October in which he said:When we met, I also mentioned that it is possible in certain circumstances and with the agreement of the clinicians responsible for medical records, for those records to be disclosed to a medical adviser nominated by and acting for a patient or, in the case of a child, the patient's parents. I confirm that I am now using my best endeavours for such a procedure to be followed in Tanya's case.I have no doubt that the hon. Gentleman has used his best endeavours. What alarms me is that his best endeavours and his powers are insufficient to obtain what I believe is a fairly simple and unrevo- 250 lutionary measure of justice for the parents of a child who has suffered a tragedy that may be hard to imagine, presumably, by many of the people who go under the glorious name of administrators.
Tanya Price is a small, blonde, helpless victim of medical science and of an automated machine called the National Health Service. I apologise to the Minister, my hon. Friend and the House if my temper has been raised slightly as I have gone through the debate, but I hope that the debate will somehow cause those who seem only to want to secrete information for their own protection to think and to feel a little shame.
§ 2.19 a.m.
§ The Under-Secretary of State for Health and Social Security (Mr. Alfred Morris)
I am grateful to the hon. Member for Christchurch and Lymington (Mr. Adley) for his kindly reference to me and for indicating that he and I have already been in touch—indeed, that we have met at length—to discuss the various issues raised by the very unfortunate case of Tanya Price.
The hon. Gentleman may find it helpful if I preface my remarks on the principles governing disclosure from medical records with an explanation of the different types of such records which may be compiled for patients in various parts of the National Health Service. This has an important bearing on the particular case with which the hon. Gentleman and I have been concerned.
Every doctor involved in providing health care compiles his own clinical case notes for every patient with whom he deals. To these may be added information from other health professionals concerned in the treatment of the patient. The general practitioner has his own set of records, and so does every hospital consultant. These two types of records are held quite separately, each under the control of the responsible doctor, and there is no linkage of general practice and hospital notes. Other medical records are also held separately—for example, in the school health service and in child health clinics run by area health authorities. It may be confusing for a patient, or his representative, who is seeking access to "medical records" covering every episode of treatment which he 251 has received, but this is the way health care is organised in this country. It reflects a complete and comprehensive system in which many different disciplines and specialisms are involved.
In any consideration of the circumstances in which it might be appropriate to make the contents of all or part of a patient's medical records available to him or to the parent of an infant patient, it is first necessary to understand the purpose for which these records are compiled. They are the doctor's clinical notes, intended by him to be of assistance to all those properly involved in the care of the patient's health. As such, they are under his personal control, or the control of any doctor who succeeds him in the care of the patient. Any disclosure from the records is a matter for the doctor responsible for the patient at the time that a request is made. He would, of course, consult other professionals who may have contributed to the record, but the decision on disclosure rests firmly with him.
The basic principle applied to clinical case notes is that information from them will not be used for any purpose other than that for which it was supplied or obtained without the consent of the responsible doctor and, usually, of the patient. The decision whether or not to disclose information from them to anybody, including the patient himself, is one which involves clinical judgment. It is not one which can be taken lightly.
There could be many sound medical reasons why it might not be in the best interests of a particular patient for him, or for a relative, to learn the details of his medical records. Much of what was in them would be highly technical. Moreover, even where they appeared comprehensible to a lay person, they might be capable of misinterpretation. Wrong conclusions might be drawn from which much unnecessary distress could result. There could also be many occasions where, in the judgment of the doctor concerned, it would not serve the medical wellbeing of a patient for him, or his relatives, to learn of the nature of his illness.
Thus the patient does not have automatic right of access to his medical records. This applies both to personal 252 details provided by the patient himself and to information compiled by doctors and others relating to the patient's health. Access is under the control of the doctor responsible at the time for the patient's treatment, and confidentiality is safeguarded both by the ethics of the medical profession and of the other professions which contribute to health care. The doctor concerned will wish to keep his patient properly informed, but the extent of any disclosure is a matter for individual clinical judgment.
The prime purpose of the medical ethic of confidentiality is to protect the interests of the patient. When he presents himself to a doctor for treatment, the patient does so in the knowledge and expectation that all that passes between them will be treated in strictest confidence.
There will be cases, however, where litigation of one sort or another is in process or contemplated and where the patient, or his representative, may wish to see more of his medical records than the doctor concerned has judged it appropriate to disclose. In this situation, although the doctor may be reluctant to disclose information direct to the patient or his representative, he may be prepared to make it available to a nominated medical adviser who is able to interpret it without risk of misunderstandings.
In the particular case of Tanya Price, as I have already assured the hon. Gentlemen, there has been no intention whatever to cover anything up. It was her way of referring to the notes she was seeking which resulted in Mrs. Price being referred from one agency to another. When Tanya's mother finally located the clinic's notes, she was told that they were "not available". What was meant by this was that it is not the practice to make them available to patients or their relatives. This was the correct advice to give, for the reasons which I have already stated, namely, that disclosure to patients or others of medical records is always a matter for the clinical judgment of the responsible doctor.
As the hon. Gentleman knows, the Dorset Area Health Authority is now 253 urgently pursuing the possibility of disclosing the records concerned to a medical adviser nominated by Tanya's parents. What is more, as I informed the hon. Gentleman in my letter to him of 26th November, the area health authority is also prepared to meet the costs of that adviser. All this flowed from my meeting with the hon. Gentleman on 11th November, when I undertook to use my best endeavours to secure the agreement of all the doctors concerned to this course of action.
§ Mr. Adley
The Minister is reading a brief which tends to repeat half the letters I have read to him earlier. Does he understand the point I am trying to make, that there is a difference between, say, a man of 43 whom a doctor thinks may or may not have cancer and a child of six months, as Tanya then was—she is now 20 months—who is virtually unable to move or to speak and whose circumstances physically are beyond dispute? We are trying to get at the truth of what happened. That is a different situation altogether from trying to discover whether one doctor or another may be making a misjudgment on the question of a person having a particular disease or something else.
§ Mr. Morris
Throughout my speech I have sought to refer not only to the patient but also to the patient's representative. The hon. Gentleman was accusing me of reading a brief, perhaps on the assumption that I was endeavouring to follow someone else's handwriting. If the hon. Gentleman would like to come beside me, he would see that I am very much endeavouring to follow my own handwriting at this very early hour in the morning. If I have hesitated, it is because I might perhaps have written my note with rather more care than I was able to do towards the end of last night.
The hon. Gentleman can be assured that it is the wish of everyone in the area health authority who has been involved in any way in this case that it should be resolved as speedily as possible and in the best interests of Tanya herself. In the six letters which have gone to the hon. Gentleman from me or from my office, arising from or associated with this case, and in the eight parliamentary Questions which I have answered from the hon. Gentleman, I have tried to make clear 254 that my Department and the Dorset Area Health Authority are anxious to assist in every way possible.
As I have said, at the meeting with the lion. Gentleman on 11th November I promised to use my best endeavours to ensure that Tanya's medical records would be made available to a medical adviser nominated by her parents. I am glad that since then there has been some progress towards this end. The achievement of our objective is, however, subject to the agreement of all the clinicians, and I understand that the authority has not yet received the agreement of all the doctors concerned. Until all the consents are received, the authority cannot proceed further in the matter of releasing the records. Nevertheless, it is doing all it can to obtain them and is acting as quickly as possible.
The hon. Member mentioned France. It is understood that a French doctor was unable to diagnose the cause of Tanya's condition. Nor was he able to offer any alternative treatment. Tanya's father thanked the area health authority and the consultant for their help in providing the French consultant with a report of Tanya's medical history.
The hon. Member referred to the article in the Daily Mail. I cannot enter into the controversy about that, but I understand from Sir David Trench that he refutes the impression given by the report of his interview in that newspaper.
The chairman and the appropriate officers of the area health authority have taken, and are still taking, a personal interest in this case. The hon. Member has now received the chairman's further letter which was sent to him last Friday giving details of the current situation. What has struck me again and again in looking into this case is that the consultants and all the other staff concerned have both sympathy and understanding for Tanya and her parents. I am sure that all concerned will continue to do their best for the family.
As I have said on other occasions, action is being held up not by bureaucratic procedures but by the fact that the doctors concerned are mindful of the prospect of litigation and are seeking advice from their defence associations. I really must underline the importance of this point.
255 Having a handicapped child, from whatever cause, can impose severe strains on a family. I refer briefly to what is being attempted to help families with handicapped children. There has been a considerable working together on both sides of this House. We can all take some pride in the work and achievements of the all-party Disablement Group. There has been very little party element in this field, and I pay the warmest possible tribute to the officers of that group, who have done very great work for handicapped children.
Special cash provision for handicapped children is comparatively new but increasingly important. The attendance allowance was the first cash benefit to become payable. Today this allowance is paid to the families of about 40,000 severely handicapped children. Our new mobility allowance is already payable to handicapped children between 11 and 15. Children aged from five to 10 will be the next to benefit and will receive the mobility allowance from April. Claims on behalf of them will be accepted from 12th January. We estimate that about 30,000 handicapped children under 16 will receive the mobility allowance when it is fully phased in. All these children will be receiving outdoor mobility help for the first time. This is an important breakthrough in helping handicapped children, not only in this country but internationally.
To some extent, beneficiaries of the mobility allowance and the attendance allowance will overlap. Many handicapped children are eligible to receive both. At the maximum, the families concerned will therefore now receive £17.20 a week. This compares with nothing at all six years ago. From the age of 16, the handicapped child can now also receive our new non-contributory invalidity pension, which provides an additional £9.20 without any means test. Money is not the answer to all the problems faced by disabled children and their families. It is clearly right, however, that we should seek to relieve the additional handicap of poverty which so often hits families with a severely handicapped child.
The Family Fund, which is administered for my Department by the Rowntree Trust, continues to provide 256 another important source of help for families with severely disabled children. In its first three years the fund has helped over 23,000 such families, and already some of the needs highlighted by the Family Fund are beginning to be provided for by new cash benefits and statute-based services.
§ Dr. Vaughan
I cannot see the relevance of the Minister's remarks to the problem of the Price family obtaining access to the records. Has the Minister said that the area health authority is prepared to release the records to an independent medical opinion since the individuals and doctors concerned have given their consent? That is the point at issue.
§ Mr. Morris
On the hon. Member's first point, I am seeking to relate the particular case to help for the handicapped child generally. Tonight we heard that Tanya Price's parents are hard pressed. I am often told that people are unaware of the benefits that are available to the families of handicapped children. I was taking the opportunity to debate the problem of families with handicapped children and to explain what has been done by successive Governments in recent years.
On the hon. Gentleman's second point, I have made the position clear. Bureaucratic procedures do not cause the delay, but doctors, mindful of the prspect of litigation, seek advice from their defence associations. I underlined the importance of that earlier in my speech.
The hon. Member for Christchurch and Lymington recalled our meeting on 11th November at which I promised to use by best endeavours to make the medical records available to a medical adviser nominated by the parents. I have sought in the debate to explain what has happened since then. There has been some progress towards the end which the hon. Gentleman and I agreed to seek on 11th November.
§ Mr. Adley
The Minister has tried, Sir David Trench has tried, I have tried and my hon. Friend the Member for Reading, South (Dr. Vaughan) has tried, but someone somewhere is preventing these medical records from being presented to independent medical advisers. What other recourse than to the courts have my constituents if, somewhere along 257 the line, some faceless person is preventing the records from being seen by an independent medical adviser?
§ Mr. Morris
I think that I have sought to explain the position. When what I said earlier is read carefully, I believe that it will be accepted that I have answered the point that has been put. If the hon. Gentleman is suggesting that we should change the ground rules that have applied for a very long time, that is a very novel suggestion. What I have been saying tonight reflects the practice of a considerable time. I am emphasising the point that some of the doctors concerned, mindful of the prospect of litigation, are seeking advice from the defence associations. The hon. Member for Reading, South (Dr. Vaughan) has some experience in these matters. I ask him whether they are within their rights to do so.
§ Dr. Vaughan
I am certainly not trying to change the ground rules. I was merely asking whether the health authority had agreed to release the records as soon as the various medical people had cleared their own position.
§ Mr. Morris
What the area health authority has been seeking to do is to help on the basis of the suggestion that I made to the hon. Member for Christchurch and Lymington on 11th November—namely, that we should seek to make the medical records in this case available to a medical adviser to be nominated by Tanya's parents. At our meeting on 11th November I could not state—nor did I make any attempt to state—the probable timing of progress. I am glad to have been able to say tonight that there has been some progress. I hope that there will be more progress.
I was seeking to emphasise the very considerable work done by the Family Fund in the service of severely handicapped children. I was saying that the fund has helped over 23,000 families. Even so, the fund has so far assisted only half of the total number of families whom it believes to be eligible for and to need help. It has recently given fresh publicity to its rôle. It was publicity aimed at families who are eligible for help but slow to apply. If right hon. and hon. Members can publicise the availability of help from the fund, especially 258 in areas of low take-up, I know that its administrators will be deeply appreciative of their assistance.
The Family Fund is, of course, careful not to duplicate provision that can be made available to handicapped children and their families under the provisions of the Chronically Sick and Disabled Persons Act 1970 and other legislation. Anyone who goes among the families of handicapped children, as I and the hon. Gentlemen very often do, knows how highly they value not only the new cash benefits but also the aid that is given by local authorities under Section 2 of the 1970 Act.
§ Mr. Deputy Speaker
Order. I do not want to intervene in the Minister's speech, but what he is now telling us is not really relevant to the position because the hon. Member for Christchurch and Lymington (Mr. Adley) did not raise the question of where he could get help in order to aid the family concerned. The Minister has made his reference to the availability of the fund in all general cases of disability.
§ Mr. Morris
Naturally I have the deepest respect for your ruling, Mr. Deputy Speaker. You were the Chairman of the Standing Committee that considered the Bill, as it then was.
§ Mr. Peter Rost (Derbyshire, South-East)
I hope that the Minister will forgive me for intervening in the debate, but I have listened most attentively and with considerable alarm to the whole story. Will he clarify a point that is still worrying me? He has implied that, if certain doctors do not agree to the disclosure of these medical records to an independent doctor, that is the end of the matter. Is he really suggesting that these parents must take the matter to a court and take the risk of a court forcing disclosure of the records? Does he have no other powers to make the records available?
§ Mr. Morris
If I were to go into the legal implications of this case, Mr. Deputy Speaker. I think that that again would not be within the terms of the debate.
§ Mr. Deputy Speaker
It may be that I should not have intervened earlier, but the Minister made his point when he read two or three times the statement that the consultants were consulting the 259 defence associations because of the possibility of legal action. I think that that covers the situation. It seems to me that one has to await the outcome of that.
§ Mr. Morris
That really was an important statement that I made, and I repeated it to underline its importance.
I spoke on this wider matter because I was moved by what the hon. Gentleman said about the kind of family that we are considering in this debate. He was saying that Tanya's parents are not people who rush about the town in posh cars. I got the impression that he was very concerned about the plight of the family and not just about the anxiety that is being caused to it. That is why I was seeking, to the best of my ability as the Minister with special responsibility for the disabled, through the House to help the family if I possibly could more immediately than I can in the matter of dictating the timing of further progress for which I am looking into the matter of making the records available to a medical adviser to be nominated by Tanya's parents.
All that I have been saying in the latter part of my speech relates to our concern for handicapped children generally. We must recognise that the most important handicapped child to any parents will be their own, but Tanya's case is of deep concern not only to her family but to everyone who has been and still is involved in it. I accept that this is a matter of deep concern to the hon. Gentleman, just as I know he will accept my concern about making progress towards a settlement that will be satisfactory from every point of view. I shall follow developments in this case with a close personal interest.