§ The Secretary of State for Social Services (Mr. David Ennals)
With permission, Mr. Speaker, I should like to make a statement concerning those damaged by vaccination.
My right hon. Friend the Prime Minister has today published the text of an exchange of letters between himself and Lord Pearson, the Chairman of the Royal Commission on Civil Liability and Compensation for Personal Injury, about payments for the benefit of those who are seriously damaged as a result of vaccination. Copies of the correspondence have been placed in the Library.
In his reply to my right hon. Friend, Lord Pearson says:the Royal Commission has indeed got very much in mind the problem of vaccine damage. We see it as a particular part of a very difficult field with which our Report will have to deal, but we have all reached the conclusion that some kind of financial assistance should be made available for very serious injury resulting from vaccination recommended by a public health authority ".I am glad to inform the House that, in the light of the conclusion which the Royal Commission has reached, the Government have decided to accept in principle that there should be a scheme of payments for the benefit of those who are seriously damaged as a result of vaccination, and that it will apply to existing, as well as new, cases.
The House will understand that there were good reasons for the Government's reluctance to enter into a firm commitment in advance of their knowing the views of the Royal Commission. We 241 still do not know the details of the recommendations which the Royal Commission will be making, but in the exceptional circumstances of vaccine-damaged children, and bearing in mind the strong case which has been made on their behalf and the importance which the Government attach to the vaccination programme, we have decided that it would be right to make this clear commitment.
The detailed provisions of the scheme, including particularly the criteria which must be satisfied to establish entitlement and the nature of the amount of the payments, cannot be determined until we have received and considered the Royal Commission's Report. Although it will therefore not be possible for any scheme of payments to be put into effect for some time, I believe that this advance announcement of the Government's intention will be welcomed by the House generally and by the public at large.
§ Dr. Vaughan
The Conservative Opposition believe that the statement today will be widely welcomed and we are naturally very pleased that this decision has now been taken. There is no doubt that the uncertainty has been very damaging and distressing to the families concerned and that the delay has led to serious difficulties for the various immunisation programmes. But anxiety is bound to continue until the details of this new arrangement are known. Since no payment can be made until the Commission reports, will the Secretary of State now tell us when he expects to receive the report? Will he also continue his inquiries into the efficacy of whooping cough vaccination generally and then make a statement on that subject?
§ Mr. Ennals
Yes. I certainly agree with the hon. Gentleman that the statement will be of great relief to families and others who have been concerned about these matters. I understand that the Royal Commission will be reporting later this year, but I cannot give the exact date. However, it will be during the autumn. Certainly, as soon as that report is received we shall immediately—without any delay at all—seek not only to explore and examine the report but to set up a scheme so that payment can be made.
Of course, I cannot give the date, because until the report is published I 242 cannot say what the date will be. As the hon. Gentleman will know, I asked the Joint Committee on Vaccination and Immunisation to publish and prepare a report, and all the evidence that has been made available will be published next week. I will ensure that a statement is made in the House.
§ Mr. Ashley
Is my right hon. Friend aware that this statement is a victory for common sense and that it establishes an entirely new principle of British social policy by compensating those who take risks, however small, for the social good? The families concerned will be deeply grateful to my right hon. Friend. Does my right hon. Friend agree that we should all redouble our efforts to obtain massive public support for vaccines when there is no conflict of medical opinion about their safety and efficacy?
§ Mr. Ennals
I am grateful to my hon Friend the Member for Stoke-on-Trent, South (Mr. Ashley), who has put up a very brave battle on behalf of vaccine-damaged children. I am glad that he has called for massive public support for a vaccine programme. In recent years there has been an alarming drop in the use of vaccines against diphtheria, tetanus and polio. Since 1972 there has been a 27 per cent. fall in those vaccinations. The fall in the number of vaccinations against whooping cough since 1972 has been 58.6 per cent. If this trend continues, it can only lead to a recurrence of serious communicable disease in this country on a scale that has not been seen for many years. This trend should be reversed as quickly as possible, and I hope that I shall have the support of my hon. Friend.
§ Mr. Hannam
Will the right hon. Gentleman accept that all those concerned with disablement will welcome his statement? Will he also accept that congratulations should go to Mrs. Rosemary Fox for the part played by the Association of Vaccine-Damaged Children in its campaign in recent years? Does he not also accept that many hon. Members believe that the campaign of immunisation must be stepped up once again to ensure that the whole system does not break down, thus resulting in grave damage to children in future?
§ Mr. Ennals
I am grateful to the hon. Gentleman for his remarks. I wish to 243 echo his tribute to Mrs. Fox and her colleagues in the Association for Vaccine-Damaged Children. They have shown restraint and great concern, and I appreciate all they have done.
There will be a campaign on this matter, and I hope that it will start soon. The report of the joint committee stands firm and united in its recommendation that the risks of vaccination are much less than the risks of failure to inoculate. With the use of material now being prepared by the Health Education Council for the use of doctors, nurses and parents, we shall be able to get the message home to parents that failure to vaccinate carries with it grave risks for the future of their children.
Dr. M. S. Miller
Does my right hon. Friend accept that most people will congratulate him on his statement? May I add my thanks to my hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley) for the part he has played? Will my right hon. Friend accept from a humble general practitioner the necessity to continue vaccination and immunisation campaigns? If we do not continue this practice, there could be dire consequences for the child population and a return of extremely serious diseases such as diphtheria and whooping cough, which are a danger to babies and young children? Will he see to it that no form of euphoria is allowed to develop, and will he insist on pressing on the general public the necessity for vaccination and immunisation?
§ Mr. Ennals
I am grateful for my hon. Friend's support, for he is a doctor. One of the reasons why it was important to make this statement today was to enable the public to put into perspective the risks of failure to vaccinate compared with the modest risks that go with any vaccination. My hon. Friend is right to refer to the dangers to young people in the absence of vaccination. To instance polio, there have been 12 notified cases in the first six months of this year, a period when one would not expect there to have been many notified cases. This compares with two cases in the whole of 1975 and 10 in 1976. The figures are increasing, even though we have not yet reached the stage when we expect there to be a further peak. Therefore, on the basis of the 244 material before us and the report of the joint advisory committee, I intend to see that there is a major campaign aimed at getting people to think of the interests of their own children, because they are also the nation's children.
§ Mr. Stephen Ross
Is the Minister aware that we welcome the firm commitment contained in his statement, but regret that there is no actual compensation to be paid? Some of the children affected have now grown up. Those who appear to qualify for payments will wish to know how they should set about submitting claims. Is it not possible for the Government to set out the criteria now, so that when the Royal Commission reports the Government can act speedily in making payments?
§ Mr. Ennals
We cannot do that. We must first obtain the Royal Commission's report, and we shall then consider it and work out a detailed scheme to bring into operation. We shall be doing advance work in the Department so that we shall be ready with the various proposals for such a scheme. This will all take time. It will be impossible to initiate a scheme until the Royal Commission has made its recommendations and we have considered them in detail.
§ Mr. David Price
I am sure that the House will wish to congratulate the right hon. Gentleman on having the courage to deal with this matter. As one who has campaigned on this topic for many years I wish to thank him very much indeed. Will he say a little more about the statutory limitations? We all have experience of constituents with vaccine-damaged children who are now 14 or 15 years old. I hope that they will be able to obtain the benefit of compensation as well as the children who may be damaged by vaccines this year. Will he accept that if he takes that step he will have the enthusiastic support of many of those who have campaigned to immunise children against any disease in which the case is proven?
§ Mr. Ennals
I thank the hon. Gentleman for his kind words. They are not directed to me, since this was a Government decision and it is right that my right hon. Friend the Prime Minister and my colleagues should share in those words of thanks. I shall consider the legal 245 matters mentioned by the hon. Gentleman. I am anxious that parents should understand the situation, both in relation to those who may need to make claims and those who are taking the difficult decision whether to have their children vaccinated.
§ Mr. Robin F. Cook
Will my right hon. Friend accept that this statement will be warmly welcomed by hon. Members, such as myself, who have met these cases in our constituencies? Will he confirm that his statement applies to all forms of vaccines and not simply to whooping cough vaccines, as suggested in the Press? In setting the criteria for applications will he bear in mind that some of the cases go back over a decade and that the standard of proof required will have to reflect the lapse of time in those cases?
§ Mr. Ennals
I agree that some of these cases go back as long as 20 years. Tragically, some children who were brain-damaged have already died. One of the most difficult tasks for the Royal Commission and for the Government is that of establishing the criteria for determining whether damage is due to vaccines. The further back one goes, the more difficult is the problem. I do not wish to comment any further on that matter. These are points that we shall consider.
This is compensation for all types of damage that might result from any type of vaccine where it is Government policy to recommend that it should be offered to the public.
§ Mr. Thompson
I congratulate the Secretary of State on the statement. Is there any significance in the fact that, although Lord Pearson talks of "very serious damage", the Minister's statement refers simply to "serious damage"? Does that mean that the Minister will be taking an even kinder look at the situation than Lord Pearson has?
§ Mr. Ennals
I do not think that until I have seen the report I can start drawing a line between what is "serious" and what is "very serious". The Government are genuine in wishing to ensure that there is some form of payment and are genuine in wishing to reassure the public. When we have said that the risks are very small, we are prepared to put our wallet behind our words.
§ Mr. Boscawen
Will the Minister appreciate that many people will be greatly relieved by his statement? Does he appreciate that he has helped to raise the hopes of large numbers of families? Since some of those families will find difficulty because of the lapse of time in establishing the facts about inoculation, will the right hon. Gentleman be careful in laying down regulations to see that a certain amount of discretion is allowed when seeking to establish grounds?
§ Several Hon. Membersrose——
§ Mr. Speaker
I shall call those hon. Members who have risen before, but not those who have just got up.
§ Mr. Loyden
I congratulate my right hon. Friend on the speed with which he has brought this matter before the House. In so doing he is removing much of the uncertainty about the vaccination programme. Will he consider those who are over 15 years old and who may have great difficulty in identifying and proving the origin of their damage? Will he agree that a most flexible approach should be made and that today's statement should be given the widest possible publicity in order to restore confidence in the vaccination programme, which has inevitably suffered?
§ Mr. Ennals
The fact that I said that there would be retrospection—and this is an important part of my statement-showed that we must be flexible in determining the kind of system. The House cannot expect me to give any further details today.
§ Mr. Adley
Will the Secretary of State accept that everybody who was in any way connected with these tragic cases will be unreservedly grateful to him for the generosity that the Government have shown and the manner in which they have shown it in extending the compensation scheme backwards to many diseases? Will he accept that the failure to provide compensation was putting people off having their children immunised, because they feared that if the Government were not prepared to pay compensation there must be a lot more in the situation than met the eye? Will he agree that those of us who have campaigned on behalf of these children 247 now have a duty to see that the immunisation campaign is speeded up?
Will the Secretary of State come forward as soon as possible with proposals about the onus of proof, because many people will wonder what they have to do to prove that they are eligible for compensation? Will he indicate that if there is any doubt, compensation will be available?
§ Mr. Ennals
I cannot go any further than I have already about the system of determination. These things have to be worked out. I cannot accept the hon. Member's initial conclusion, which is a matter for an interesting debate. I believe that most parents deciding whether to have their children vaccinated consider the risks involved. Whether they may be compensated is only a small part of it. However, I agree that it does reassure people that the risk is small when the Government are prepared to compensate for that small risk, and that is an important element.
The very nature of the campaign inevitably concentrated on the risks and brought them before the public, and this has done damage to the programme. I agree that those hon. Members who were especially involved—such as the hon. Member for Christchurch and Lymington (Mr. Adley) and my hon. Friend the Member for Stoke-on-Trent, South—in a sense have an obligation to do everything they can to put their strength behind the vaccination programme and get it up to the maximum extent.
§ Sir George Young
In view of the serious medical problems in attributing the handicap to vaccine or to other causes, will not this arrangement give rise to a risk of depressing arguments about entitlement? Would it not be fairer to compensate children for handicap, however it is caused?
§ Mr. Ennals
That raises another question. There are large numbers of children who are damaged for reasons that are not connected with State policy. There are also a number of children who are born mongols. But I think that it is right to 248 isolate this aspect, get it clarified, and make the statement, as I have today.
§ Mr. Ennals
I feel certain that no Secretary of State, or any other Minister, should determine whether anyone is entitled. There will be some system by which medical adjudication is made, but it would be wrong for that responsibility to fall on the Secretary of State. It will be the Secretary of State's responsibility, however, to make sure that the system is flexible and effective.
§ Several hon. Members rose——
§ Miss Joan Lestor
I appreciate all that my right hon. Friend has said about vaccination, but will he agree that there is continued controversy among members of the medical profession—and this has received widespread publicity recently—about the efficacy of the whooping cough vaccine? This has done as much to dissuade parents as the lack of any financial compensation. When my right hon. Friend stresses the need for vaccination, is he confident that such controversy as exists does not relate to any factor that would encourage or be responsible for the damage continuing?
§ Mr. Ennals
The report by the Joint Committee on Vaccination and Immunisation—an independent body which advises me—will be published next week. The committee, which includes experts in general medicine, infectious diseases, paediatric neurology, and other fields, has now analysed all the evidence, including that from those who have criticised the vaccination programme. The evidence and the committee's conclusions will be published next week and that more than anything that I have said today will give reassurance to the public and will be the basis for an effective vaccination campaign.