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The Earl of Northesk: As the Minister said, we have had a useful debate, even if it turns out to be only a first trot round the course. I would of course like to be able to say that I am entirely satisfied with the outcome. But I hope the Minister will recognise why it is that I and other Members of the Committee persist in having residual concerns on this matter.
I thank the Minister for his assurance that he will write to me on a number of issues. Perhaps I may suggest that it would be helpful if he could copy that correspondence to others who have contributed to the debate.
There is absolutely no doubt that we will return to this issue again. It simply falls to me at this juncture to bang the drum yet again for recommitment. In the meantime, I beg leave to withdraw the amendment.
No government, until now, has a proud record on this issue, but the record of the Labour Government is far more enlightened than that of Tory governments. Only government can give the story a happy ending and I am glad to say that, after yesterday's announcement, this Government are moving in that direction. But it will only be a happy ending of sorts because no government can restore the health of someone severely brain damaged, who suffers lifelong convulsions and who has neither talked nor learnt anything since she was vaccinated as a happy, healthy child some 40 years ago. Those are the facts.
Not only was that child's health and happiness shattered, so were the high hopes of her parents. And I pay warm tribute to her mother, Rosemary Fox, who established the Association of Parents of Vaccine Damaged Children in 1973 and with whom I campaigned for many years. Only she, myself and my wife Pauline, who worked with me, know how appallingly tough the going was in the early 1970s. The only other person involved was Kay Andrews--now the noble Baroness, Lady Andrews--from the House of Commons Library, who did a tremendous amount of work supporting us.
In those days we met with prejudice, ignorance and generally a contemptuous dismissal of our claims. The £10,000 payment in 1978 came about only as a result of an imaginative and generous intervention by the then Prime Minister, James Callaghan. Today, the atmosphere is much more favourable, with many people well informed.
I have always expressed my support for the immunisation programme and I am glad that the great benefits of vaccination are now accepted almost without dissent. So is the need to establish herd immunity. But it is also clear beyond all doubt that there is a small risk--probably a very small risk--with vaccination. If the Government impose pressure on parents to vaccinate their children so that society can be protected, as they do through the GP incentive
Arguments over how and to what extent the Government should provide support have raged for some 20 years. I congratulate the Daily Express on its recent forceful campaign. In its day, the £10,000 payment scheme was hailed a triumph, though only because we campaigners saw that as a prelude to the introduction of the Pearson Royal Commission strict liability scheme. As the years passed and no such scheme emerged, the parents became more and more embittered and MPs have been vociferous in their support in recent years. I pay tribute to the splendid work of Ian Stewart and his all-party group.
Ministers have just published the results of the Government's review of the payment scheme. I congratulate Alistair Darling on this major step forward and Hugh Bailey, who did so much of the work. I am sure that the whole House knows of the unswerving support given to vaccine-damaged children by my noble friend Lady Hollis.
I cannot speak for the parents and I suspect that those who asked for £1 million each will not be content. But I warmly welcome the proposals. They are a comprehensive and much needed improvement on the current payment scheme.
The amount of £100,000 will not provide a lifetime's care. But it is a worthwhile amount. It will ease the burden and help parents, especially over those initial awful years when they begin to realise what lies ahead. It is a welcome lifeline, more than doubling the existing amount. I welcome also the Government's decision to help those children--many of whom are now adults--who were damaged in previous years. All too often the natural distaste for retrospective legislation is a barrier to justice. It certainly was when Service people were allowed to claim for negligence, but not retrospectively--the famous Section 10 debate in the House of Commons. This Government have avoided that with vaccine damage and I am pleased that parents who have already received a payment will get it topped up so that all receive equal benefit.
The existing Vaccine Damage Payment Scheme has been criticised for two reasons--first, because the payment level has been inadequate and, secondly, because of the high barriers around it. In some years, only one claimant in 10 received an award. That was a deplorable situation and one which requires a ministerial explanation. I hope that my noble friend can help us on that issue.
The reduction of the 80 per cent disability level to 60 per cent is an excellent step forward. I am delighted that the Government have been wise enough also to apply this change retrospectively. But I want to ask my noble friend: how many more children will become eligible? If she does not know the facts, perhaps she can estimate the number. I ask that question because some press reports say that only a few will benefit. The House would like to know the truth.
The increased time for claiming is also helpful; but it is not good enough. Some children were damaged 30 or 40 years ago and, for good reasons, parents did not claim within the existing six-year time limit. They will lose out. There should be no time limit at all; indeed, there is no logic, no reason and no rational basis for it. I hope that my noble friend will be able to help me on that.
These advances by the Government raise two further issues. The first is to ensure that all families receive the full award and that none of them loses out through means testing either by the Benefits Agency or, as is more likely, by local authorities. Many of the affected children are now adults and live in local authority homes. Of course, the number will grow as their parents die. Will my noble friend ensure that the money from the £100,000 payment will be disregarded for means-testing purposes? I regard this as a point of cardinal importance because it would be quite wrong to make this a swings and roundabouts issue.
Secondly, where do we go from here? The issue of proper compensation, as recommended by the Pearson Royal Commission in l978, remains unresolved. Pearson recommended that the Government should be strictly liable in tort for damage caused by state promoted vaccination; and that full compensation should be awarded by the court on proof of causation, without the need to prove negligence. I believe this to be the next major step forward. However, today is a day for congratulating the Government on easing the appalling burdens that have shattered families for decades.
Lord Brennan: My Lords, I speak in this debate as someone with personal experience of litigation involving those affected by vaccine damage; and I regret to say that it was a negative involvement. It is well known that I advised the Legal Aid Board a number of years ago that the medical science in this field did not show a definitive connection between the vaccine and its neurological effect, as alleged. That meant that the "solution"--if it is to be properly so called--to these problems for parents and child was not to be found in our courts. It probably explains why the Pearson Committee took the suggestion of strict liability so seriously all those years ago.
I have introduced that background to indicate to the House that there is no present science that will definitely establish the connection between the vaccine and the consequences from which these children suffer. That is why the Vaccine Damage Act and its scheme give a payment based on a system of practical justice, whereby, if the neurological effect follows the administration of the vaccine in so quick a span of time that a reasonable person could make a causative connection, there will be an award. That is a novel system of compensation in our attempts to look after those as grievously damaged as these children.
It was, therefore, with great pleasure that I read yesterday's Statement by the Secretary of State, which included some major changes to the operation of the scheme. First and foremost--and properly described--there is to be a dramatic increase in the lump sum payment. It was increased by this Government from £30,000 to £40,OOO in 1998 and has now been increased to £100,000. Secondly, and most importantly, it has been backdated so that everyone who is a proper beneficiary of the scheme will be paid the full amount, or the proportionate amount, up to £100,000, depending on the age of the claimant.
Thirdly--and, again, most importantly--the removal of the six-year time limit within which to bring a claim is a just act. The time limit is now to be extended to 21 years. It is difficult to conceive of a family afflicted with this problem who, within those years, would not discover that there was a scheme to which they could have recourse. Fourthly, the disability threshold is to be reduced from 80 per cent to 60 per cent. In the minds of the families concerned, that really should produce a sense of justice where previously there was a strong sense of injustice. It is not a perfect solution, but it is a considerable step forward.
Finally--and this should not be forgotten in the years to come, should benefits be reviewed--the interaction of incapacity benefit and mobility benefit whereby they are increased will be an additional benefit to the lump sum payment. All these changes are of the greatest importance to these families. They are small in number but the effects of the damage inflicted on their children are enormous. These changes go some way towards recognising that burden. However, there is more to be done.
I shall not repeat the most important remarks made by my noble friend Lord Ashley to the effect that means testing ought not to be introduced in relation to these payments. We must not forget that, with the advance of modern medical science, many of these children will probably outlive their parents and finish up in hospitals or state institutions. When that event arrives, it would be a tragedy if what little means those children had were to be means tested.
What should next be done to build upon this new initiative? First, and surely most important of all, when will these changes be introduced? They require primary legislation and subsidiary regulations. As regards primary legislation, the Secretary of State said in another place yesterday that it would introduced at the "earliest available opportunity". As for regulations, he said that he would introduce them,
Secondly, in the year or two--if it is that--in which these changes are to be brought in, inevitably the families involved, and the new ones who become involved, will want to know how the scheme will affect them. Problems of interaction of benefits and so on will be acute for them. I invite the Minister to indicate whether in this preparatory stage to legislation, or perhaps in a year or two after it is introduced, there will be a system in which a nominated civil servant or a nominated office within the department will have the specific task of dealing with and answering the queries of parents that are sure to arise. That can be done efficiently through the Association of Parents of Vaccine Damaged Children. It is no good satisfying ourselves that legislation will make a change unless we accompany it with promises and action that explain the changes to the people most affected.
Finally, the scheme is the product of the need of society to vaccinate children against serious illness. That is a worthwhile intent. However, it has immoderate and tragic consequence with which we are dealing tonight. What is at the heart of the problem? It is the administration of a drug. The drugs used are the products of multinational companies of enormous size and wealth, which, having profited from the sale of the vaccine, could paradoxically be the vendors of the very medicines that are used to alleviate the damage that is thought to be associated with the vaccine. In this new century, surely we can expect a moral content in the world of commerce that was previously lacking, can we not?
I point out to your Lordships' House that Smithkline-Beecham, one of the largest vaccine manufacturers, made a profit last year of £1.98 billion from transactions that included the sale to the state of £779 million-worth of vaccine. That is one example of several. That company is in a monopolistic or quasi-monopolistic position. It is fair, just and reasonable that it contributes to the cost of the damage in this small number of cases. It is therefore with extreme disappointment that I hear that when the Government approached that company for help there was a frank and firm refusal to do anything. That is unacceptable. It should change; the Government should not give up, and not just because of vaccine damaged children. In years to come genetic medicine, biochemistry and the medical field will produce huge profits for companies such as those that I have described. If their attitude is as described by the Association of British Pharmaceutical Industry; namely,
Having addressed three necessary steps, I end my speech by congratulating all those people--some of whom are present in the Public Gallery--including my noble friend, Lord Ashley, and the honourable Member for Eccles--on all they have done over 20-odd years to produce some justice for those who deserve it. At the end of the 20th century all we know is that in the years to come there will be yet more children--small though the number may be--affected by vaccine damage. In my experience in the lifetime of a government there are one or two defining moments which may be moderate in their compass but profound in their effects for society. This is such a moment because it enables the Government to show that they care for people in need. I welcome the proposals.
Lord Clement-Jones: My Lords, first, I thank the noble Lord, Lord Ashley, for initiating the debate with his usual impeccable timing. The debate takes place not only a day after the Government's Statement but on the very day that the major vaccine damaged children lobby took place in Westminster Hall. I pay tribute to the noble Lord's long-standing commitment to the cause of vaccine damaged children. We have already heard two fine speeches. The debate has already proved to be one of high quality and great interest.
The history of the vaccine damage payment scheme is extremely well known and has been rehearsed by the noble Lords, Lord Ashley and Lord Brennan. The history of the review of the scheme says nothing for the Department of Social Security's sense of urgency or the Treasury's compassion. Despite a pledge when in opposition to address the issue, it was only yesterday that the outcome of the review was announced, some three years after the general election and some two years after the noble Baroness, Lady Hollis, pledged that the Government would conduct a thorough review of the service.
Throughout the past three years Members of this House and the other place have asked numerous questions about progress, and I believe that parliamentary lobbies have taken place on three occasions. The Labour MP for Eccles, Mr Ian Stewart, the chairman of the All-Party Group for Vaccine Damaged Children--of which I have the privilege to be a member--initiated an adjournment debate at the end of 1998 in the course of which he was promised the results of the review in 1999. My right honourable friend Charles Kennedy MP made a telling contribution on the subject of the scheme only two weeks ago at Prime Minister's Question Time. It is a testimony to the tenacity of the parents and that of the all-party group, particularly its chairman, Mr Stewart, and that of the Daily Express that the Secretary of State, Mr Darling, finally made an announcement yesterday.
I certainly do not want to be churlish about the contents of yesterday's announcement, which we on these Benches very much welcomed, particularly those provisions which have retrospective effect. The noble Lord, Lord Brennan, referred to those. However, there are key questions that need to be mentioned. The noble Lords, Lord Ashley and Lord Brennan, raised some of those questions. I hope that I may ask some further questions of the Minister and that she will respond to them when she replies to the debate.
Will the new 60 per cent disability threshold also be backdated for those who have previously applied to the vaccine damage payment unit but have exhausted the appeals process? There is the injustice of setting an arbitrary threshold, whether that is 60 per cent or 80 per cent, as at present. I am sure the Minister will be aware that parents will continue to feel strongly about this matter whether the threshold is 60 per cent or 80 per cent. Why could not a tapering system have been adopted? That would surely have been the most just way of proceeding. After all, how can one precisely quantify a 60 per cent disability? Surely this is a highly subjective process. How can we even guarantee parity between one method of assessment by one consultant and the next?
I have other questions. When will the payments to victims be made and how will they be made? Which elements of the announcement can be put into effect very shortly, perhaps before the Summer Recess, by regulation, and which elements will require primary legislation? What is the timetable envisaged by the Minister's department for each of those elements? Can payments be made on account? Is that envisaged? How will payments--the issue of means-testing was raised by the noble Lords, Lord Ashley and Lord Brennan--affect income support and other benefits available to the victims of vaccine damage? Will guidance be issued to those who will be in receipt of these additional payments?
As has already been said, the key point to make in this debate is that the changes to the vaccine damage payment scheme must be seen only as a first step to securing justice in the form of full compensation for the vaccine victims. Many of the victims require 24-hour support. I met many of them today, as I have on previous occasions. The cost of providing this support by professional carers ranges from approximately £80,000 to £120,000 per annum. At the moment in many cases parents are the only carers. Some of them have terrible tales to tell about the withdrawal of invalid care allowance when they reach pensionable age. Many of the parents are over pensionable age. I received correspondence regarding one parent who is being pursued for £1,400, a so-called over-payment because of the receipt of payments after she reached pensionable age.
I have checked with personal injuries lawyers--perhaps not as distinguished as the noble Lord, Lord Brennan--who act in personal and medical injury cases about how the appropriate income would be provided for by a court in circumstances where a court made a determination of compensation. I was
Therefore, will a back-dated payment of just £67,000 provide adequate compensation for families who have endured up to 40 years of financial hardship and emotional turmoil? I suggest not. These parents, many of whom are now in their 70s, need to have the assurance that their vaccine damaged children will be properly supported when they, as parents, can no longer do so. Only through a proper lump sum payment can this be done.
Much has been made by this Government and the previous one of the vaccine damage payments being payments rather than compensation. Yet the fact is, as both the noble Lords, Lord Ashley and Lord Brennan, pointed out, that government have a responsibility to provide adequately for the welfare of those undergoing vaccination. To quote Dr John Clements, a vaccine safety expert at the World Health Organisation:
The Government therefore need to answer the following additional questions. Do they recognise that the changes to the VDP scheme are only a first step to securing full compensation for these vaccine victims? Will the Government now take steps to secure proper compensation for the victims of vaccines so that these very badly disabled individuals can be supported when their parents are no longer able to care for them? Will the Government redouble their efforts with the relevant pharmaceutical companies, such as Glaxo-Wellcome, to ensure that they take responsibility and share in the financial settlement? Will they redouble their efforts to ensure that the medical records of vaccine victims are made available, many of which seem to have been unaccountably lost after they made a claim? In all of this, which is the lead department that will take the initiative?
I have enormous sympathy for the parents and the victims of vaccine damage and I feel angry on their behalf. It is quite scandalous how long they have been allowed by governments of each colour to suffer without adequate legal or other remedy when they have clearly been the casualties of an official government public health vaccination policy, whether this has been for DPT, MMR, polio or whatever.
It is the Department of Health which institutes public health policies and the department which chooses the vaccines and the department which should have tested them properly in conjunction with the pharmaceutical companies. It should now be urgently
If the Department of Health and the pharmaceutical companies do not take responsibility for past vaccine damage but hide behind the legalities of the law of tort and the requirement to show clear causation and negligence, it is hardly surprising that parents have second thoughts before arranging for their children to be vaccinated. The noble Lord, Lord Brennan, cogently described the way in which the parcel had tended to be passed by the pharmaceutical companies to the Department of Health, and so on.
I have a confession to make. I am one of those parents who has second thoughts about vaccinating their child, particularly as regards MMR for my young son. I am clearly not alone in this. Even with the knowledge that the chances of vaccine damage to a child may be one in a million, the Department of Health's historically dismissive and legalistic attitude--indeed even denying that there is such a thing as vaccine damage--will ensure that vaccination rates continue to fall. I suggest that Ministers and the Public Health Laboratory Service--now in the wise hands of a Member of this House--urgently review the position, not only in respect of the vaccine-damaged children under discussion today, but for the future as well.
Unless there is put in place a proper no fault compensation scheme, similar in generosity to that in the United States, and as recommended by the original Pearson report, and similar to the kind of compensation that could be achieved in court, I do not believe that the confidence of parents will be re-won. And certainly justice will not have been done to these severely disabled children who have already been the victims of vaccines.
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