HPV Vaccine

Debate between Mark Spencer and Anna Soubry

Tuesday 2nd July 2013 Commons Chamber

[Anna Soubry]

I am going to repeat everything that has been said, and I agree; that is a very important point. As my hon. Friend the Member for Finchley and Golders Green argues, the vaccine does not protect men who have sex with women who have not been vaccinated, because they may have been in a country where the vaccine was not available to them. So I completely take the point, which is well made, and ask my officials to take it back to the Department.

As hon. Members know, the Department of Health is advised on all immunisation matters by the Joint Committee on Vaccination and Immunisation—an independent expert advisory committee—and our HPV vaccination policies are accordingly based on the advice of the JCVI. When the committee considered the introduction of the HPV vaccine in relation to cervical cancer, it did not recommend the vaccination of boys because with high vaccine uptake among girls, as is the case in the UK, it is judged that there would be little benefit in vaccinating boys. With the high uptake of HPV vaccine among girls, we would expect many boys to be indirectly protected against vaccine-type HPV infections and associated diseases, including anal cancer, head and neck cancers and penile cancers. However, the JCVI recognises that under the current programme, the same protection may not be provided to men who have sex with men, and of course men who have sex with women who have not had the vaccination.

[Mr Spencer]

I hope the Minister would recognise that, obviously, ideally we should be vaccinating boys who are pre-puberty, and at that stage we have no idea of their sexual orientation or whether they may fulfil their career abroad or in the UK, so we have no way to identify whether they are at risk.

[Anna Soubry]

I am going to struggle, because that is another good point. I always try to be honest when I come to the Dispatch Box and when hon. Members make good points—points that were made not only by my hon. Friend, but by the hon. Member for Airdrie and Shotts (Pamela Nash).

The point raised by the right hon. Member for Wolverhampton South East (Mr McFadden) is related to the actual vaccine, and I am more than happy to discuss that case, or any other adverse reactions of young women to the vaccine, with him. I am very sorry for his constituent, and I am more than happy to have that discussion with him and help in any way I can. He raises an important point.

As we have heard, in June 2012 the JCVI was presented with data on HPV infections and it noted that there is early evidence to suggest that the HPV immunisation programme in England is lowering the number of HPV 16 and 18 infections—the strains of HPV that are linked to these unpleasant cancers—in females in birth cohorts that have been eligible for vaccination.

I accept that the data are very limited on the prevalence of HPV infections among men who have sex with men, but we hope that research under way at University College London will provide more data and an age profile of HPV prevalence. HPVs, particularly types 16 and 18, are associated with the majority of anal cancers as well as cervical cancers, and to a lesser degree with penile, vaginal, vulval and head and neck cancers, but HPV types 16 and 18 predominate in cancers at those sites that are HPV-related. Data on the impact of HPV vaccination on infection at some of these non-cervical sites are limited.

The JCVI noted that the potential impact of HPV vaccination on non-cervical cancers would make the current HPV immunisation programme even more cost-effective, but it would remain the case that, given the expected effects of immunisation on HPV transmission and the indirect protection of boys that accrues from high coverage of HPV vaccination in girls, vaccination of boys in addition to girls was unlikely to be cost-effective. That argument, which we know is advanced, is combated by all that has been said by my hon. Friends the Members for Sherwood (Mr Spencer) and for Finchley and Golders Green, who urge us to consider the cost of treating someone who has one of these cancers.

Evidence for indirect protection would continue to be evaluated by the ongoing HPV surveillance programme at the former Health Protection Agency, now part of Public Health England, but the JCVI agreed that there may be little indirect protection of men who have sex with men from the current immunisation programme. Therefore, the impact and cost-effectiveness of vaccination strategies for men who have sex with men, with the offer of vaccination through general practice and/or at genito-urinary medicine clinics, needed to be assessed. In addition, data on the prevalence by age of HPV infections in men who have sex with men and in the settings where vaccination could be offered to them were needed to determine the potential effectiveness and cost-effectiveness of HPV vaccination of men who have sex with men. It would also be important to understand better the rates of HPV-related disease in men who have sex with men and the influence of HPV on HIV infection.

As we have heard, in August 2012, the JCVI issued a call for evidence from interested parties, including for information to inform a study on the impact and cost-effectiveness of HPV vaccination of men who have sex with men. Any new proposals for the vaccination of additional groups will require supporting evidence to show that this would be a cost-effective use of resources. The JCVI also asked the HPA, now part of PHE, to undertake that study. The study is under way and, once completed, will be considered by the JCVI, at the earliest in 2014. The Department will consider carefully the advice from JCVI, once the committee has completed its assessment.

Oral Answers to Questions

Debate between Mark Spencer and Anna Soubry

Tuesday 26th February 2013 Commons Chamber

[Anna Soubry]

The answer is an unequivocal yes.

[Mr Mark Spencer (Sherwood) (Con)]

Does my hon. Friend recognise the excellent progress that has been made in vaccination against the human papillomavirus to prevent cervical cancer in young girls? Will she find the time to meet me to discuss the benefits of vaccinating boys against that virus?

[Anna Soubry]

Yes, it is always a great pleasure to meet my hon. Friend, and he raises an important issue. I have met a number of other colleagues to talk about their concerns about screening—or rather the lack of screening—for young women under the age of 25 in relation to cervical cancer. That is a concern and we look forward to working on that. I am very happy to meet my hon. Friend.

East Midlands Ambulance Service

Debate between Mark Spencer and Anna Soubry

Monday 21st January 2013 Commons Chamber

[Anna Soubry]

I am grateful to my hon. Friend for her intervention, but I think that it is also important to pay tribute to the ambulance staff who work for EMAS and the outstanding work they do. It is also important to point out that between October 2010 and December 2012 EMAS recruited 65 new front-line staff, so something is going on that is not right. Many people are of the view that unfortunately it is the way that EMAS is being run that is at the heart of the problem.

[Mr Mark Spencer (Sherwood) (Con)]

I wonder whether my hon. Friend is aware that Nottinghamshire fire and rescue service, if it has to be the first responder, is often left to look after patients until an ambulance arrives, which could be up to an hour, so the fire engine is not available to deal with a much more important issue.

[Anna Soubry]

As ever, my hon. Friend makes an important point, and it is one that I will certainly look at further. I hope that those in EMAS who are listening to the debate will take that comment on board.

In response to the points made by the hon. Members for Ashfield (Gloria De Piero) and for Chesterfield (Toby Perkins), I do not think that it is as simple as saying that the closure of an ambulance station will de facto reduce the service available. Ambulances do not sit in ambulance stations waiting to respond to a local incident. They spend most of their time out of ambulance stations on the road so that they can respond to emergency calls. EMAS reported—these are important facts that should be widely publicised; I am sure the hon. Member for Bassetlaw will ensure that they are—a total turnover of £169.5 million in its 2011-12 final accounts and a £1.4 million surplus. It has also reported surpluses in the previous three years. I understand that for 2012-13 the trust received £3.5 million funding as its share of the EMAS contract from Bassetlaw primary care trust. As I have said, my concern is not so much about the money, but about the way the service is being operated.

Let me turn to the “Being the Best” review. EMAS tells me that it recognises that its response times in rural areas do not match the response times in city centres. In response, EMAS published its “Being the Best” change programme in 2012, which outlined plans designed to ensure that response times and the service provided to all the people of the region were improved. As the hon. Member for Bassetlaw described, EMAS has consulted clinical commissioning groups, overview and scrutiny committees and local people on its proposals. As we have been told, it received substantial feedback from the people of Bassetlaw, with a petition from some 9,000 people. The business case should be presented to the board on 25 March, allowing the trust additional time to review alternative options and develop final proposals for the board to consider.

I am told that a number of options are being considered. They include the “do nothing” option, which involves making no changes to the configuration of ambulance stations; the “do nothing-plus” option, which involves making no changes to the configuration of ambulance stations, but making an additional resource investment in more ambulance vehicles and staff; and the “do minimal” option, which involves making the minimum changes necessary to deliver current service standards in a safer and more effective manner. That option would retain all the current stations and introduce the 118 new community ambulance posts. The fourth option would establish 13 hubs, plus 118 community ambulance posts—I know that my hon. Friend the Member for High Peak (Andrew Bingham), along with many hon. Members, has expressed his concern about that option. The fifth option—a new option—would establish 27 hubs, plus 108 community ambulance posts, and is being considered as a direct result of the consultation feedback.

Anonymity (Arrested Persons) Bill

Debate between Mark Spencer and Anna Soubry

Friday 4th February 2011 Commons Chamber

[Anna Soubry]

I am grateful to my hon. Friend for raising that, and I completely agree. That is the difficulty. In the newspapers we see the headlines and the story but never what is behind them or, most importantly, what happens in the wake of them.

I was describing how, by googling on the internet or doing any research through newspapers—although googling is the quickest and smoothest way—I came across several cases of football players who had been arrested on allegations of rape. One case is relevant to my hon. Friend, because it involved a Leicester football player. I did not recognise his name, but that matters not at all. He received extensive media coverage when he was arrested on an allegation of rape, and again, within a matter of weeks, when he went back to the police station on bail he was told that he would not be charged and that was the end of the matter. The newspapers and local television station covered the arrest extensively, but the fact that no charges were brought barely received a mention. I have not found any case, anywhere, in which somebody’s not being charged has received exactly the same amount of publicity as their arrest.

There are cases of councillors—some might be known to Members—who have been arrested on all manner of allegations, be they fraud, corruption or sexual assault. Again, I have looked at the newspapers and on the internet, and their arrest often makes the front page of the local newspaper. The fact that they are never charged, however, does not get on the front page; if they are lucky, it might be on page 2 or 3 and amount to half a column, but it is never the same as the initial coverage they receive when they are arrested. That is not right or fair.

[Mr Mark Spencer (Sherwood) (Con)]

There was the case of a taxi driver who attacked female passengers, and when he was arrested other victims came forward. The publicity surrounding the case assisted other victims in doing that. What does my hon. Friend say to people who cite such instances?

[Anna Soubry]

I am grateful to my hon. Friend for that intervention, because he makes another important point. That is why the Bill, to cover exactly that situation, enables the prosecution to apply to a Crown court judge for leave to allow the media to publish the name and address of somebody if they believe it is in the interests of justice, which means a belief or a suspicion reasonably held that other people might come forward either to make a complaint or to assist the police in some way in their investigations.

The same exemption exists for the arrested person, because there are instances whereby somebody who is arrested might want their name published, especially in the local paper. For example, somebody might be arrested following an allegation by their employer that they have been stealing from work, and their defence might be not just, “I haven’t done it,” but, “I know my employer has made the same allegation against other workers and they haven’t done it. Somebody’s got their fingers in the till. It’s not me, but they’ve now pointed the finger at me because it suits them and is convenient, so I want my name in the newspaper and I am quite happy for my address and the fact that I work at such and such a place to be published, because I believe that x workers there or other people may come forward with information that will assist my preparation of my defence.” I have allowed for all that, because I do not like blanket bans on anything, and it is always important to recognise that there are exceptions to every rule.

My hon. Friend the Member for Sherwood (Mr Spencer) mentions police investigations, and we forget that in many instances the police are appalled by the sort of coverage that we all saw in relation to the first man’s arrest in Bristol. It is an injustice to the police to say that, in those instances where names and addresses have been leaked to the press, it is always their fault, because it is not. No doubt there are instances when the police give the name and address to a member of the media, and some cash might change hands. I do not have evidence of it, however; I am working only on what others tell me.

In a high-profile case such as the Bristol murder, however, with all the media attention it is almost inevitable that, if somebody is arrested, a neighbour, especially somebody in the proximity of either the deceased or the place where the crime occurred, will see or know that Bloggins has been arrested. The neighbour or somebody else will often just happen to know the person, as people do in any community, not just small ones, and they will give the name to the press. The police do not always do so, and it would be wrong to place all the blame on them.

I do not want to get into a blame game, but if anybody is to blame then responsibility lies with the media and, ultimately, all of us—everybody who buys newspapers, watches television and listens to the radio. If only we could gather together and say, “Enough is enough. I am not going to buy this newspaper, watch that television news programme, listen to that radio station or subscribe to that television channel,” we might make the progress that we all want and, as I have said, cure the mischief that we all oppose.

I very much want to deal with the Contempt of Court Act 1981, to which we have alluded. I shall tread carefully, because we do not want a debate about jurisdiction or to pick over the Act in detail, but, having read it, I and others take the view that in its current form it is not the device to cure the mischief that we all agree must be sorted out. Although the strict liability rule that it imposes—indeed, the whole nature of the Act—deals with people who have been arrested, the rule is clearly designed to deal with cases that, in effect, are in the court process. But if one is arrested, one might never go to court. That is the whole point: unless one is charged, one will not go to court. I hope I am explaining my point fully and in non-legal terms, because the Act does not cover the misdemeanours and wrongs that we all want righted.

--- Later in debate ---

[Mr Spencer]

Unfortunately, as a 15-year-old boy, I could not get there on my scooter. Clearly publishing those names was interesting to the public, but was it in the public interest? The honest answer is: probably not. Did it add anything to the criminal justice system? Probably not.

[Anna Soubry]

I, too, recall that; indeed, I reported on a number of those cases. I can still remember some of the names of those people. One was quite a senior police officer in Lincolnshire, and there was another who was connected with the law. However, if my memory is right, was it not the case that those people had not just been arrested, but almost immediately charged? I am reasonably confident in saying that their names were published only because they were charged immediately after they had been arrested. That is why the press reported those names. If those people had merely been arrested with a bail back, I doubt whether the press would have reported their names.

[Mr Spencer]

I concede that my hon. Friend’s knowledge about this issue is superior to mine. I merely make the point about what is interesting to the public and what is in the public interest.

My hon. Friend has referred to celebrities and TV personalities. The recent case that comes to mind is that of the Sky football commentators. Although they were not charged with any crime, there was large furore around those individuals. As I understand it, she is proposing a complete separation of such cases from those that end with a criminal prosecution. That is an important distinction to make. It is also one that leads me to support the Bill and to allow it to progress through the House so that we can debate its merits further. Many other points have been made, and I do not want to prolong this debate any further than is necessary, so I shall commend the Bill to the House and will support it during its progress.