Meningitis B Vaccine

Andrew Gwynne Excerpts

Monday 25th April 2016 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Davies, as it was to serve under that of Mr Pritchard earlier. I pay tribute to the hon. Member for Bath (Ben Howlett) for opening the debate in such an eloquent and detailed fashion. The way he set out the terms of the debate is a credit to the petitioners, and we have heard a set of powerful contributions from right across the Chamber.

A week ago, I said that the Petitions Committee debate on brain tumour research was a credit to the way in which the House of Commons operates. That has followed through to this week’s debate. I thank my hon. Friend the Member for Walsall North (Mr Winnick) and the hon. Members for Foyle (Mark Durkan), for Faversham and Mid Kent (Helen Whately), for Erewash (Maggie Throup), for Bury North (Mr Nuttall), for The Cotswolds (Geoffrey Clifton-Brown), for North Devon (Peter Heaton-Jones), and for Arfon (Hywel Williams), as well as the Chair of the Health Committee, the hon. Member for Totnes (Dr Wollaston), and the hon. Member for Central Ayrshire (Dr Whitford), who leads on health for the Scottish National party. It is always a pleasure to follow her expertise on such matters. Mainly, I congratulate all 823,000 petitioners for the enormousness of their campaign, which led to the petition becoming, I think, the most popular e-petition so far. This is a huge issue for so many families affected by the disease.

The impact of meningitis B is felt long after initial contraction, and about one in 10 suffering from it will die. According to research published in The Lancet, one in three survivors will be left with lifelong disability. There is, necessarily, a huge cost to society and the individual when people are left without the ability to lead a normal life. Considering that there is a possibility of tackling the disease with just one vaccine, the issue deserves our undivided attention. Some hon. Members who are regulars in debates on health will know that I am always banging the drum for prevention, and I am not the only one. Simon Stevens, in his “Five Year Forward View”, identifies £5 billion of savings later in the review period that could be made as a direct consequence of prevention early on in that five-year forward view. Meningitis B is one instance where the case for prevention is very strong indeed. The ongoing cost to the NHS of a patient who survives meningitis can run into millions of pounds in the worst cases.

The UK is leading the world in the fight against meningitis. Our immunisation and surveillance programmes are world-class, and everybody involved in them should be proud of the lives that have been saved and the lifelong disabilities that have been prevented over the years. However, as I will explain, we still have a long way to go. The joint work of the Petitions Committee and the Health Committee has been instrumental in really getting to the bottom of an issue that has been trundling along for far too long.

The notion of Committees taking evidence on matters raised in e-petitions is quite new, and it is right that scrutiny work is guided by the public. That was recognised by my hon. Friend the Member for Warrington North (Helen Jones), who chairs the Petitions Committee. That the Petitions Committee is proactive with other Committees of the House will be of great importance for the future work of not just the Petitions Committee, but the other Select Committees of the House of Commons. I hope that in this instance, this work will be of some comfort to the many hundreds of thousands of people across the country who are signing petitions on a variety of issues. Indeed, I checked just before the debate and 1,240 people in my constituency signed the petition before it closed. Almost exactly the same number signed it in the constituency of the Chair of the Petitions Committee, and a similar number—1,311—signed it in the constituency of the hon. Member for Bath. I am sure that the Minister appreciates the depth of feeling on the matter right across the country.

I will get into the detail, because the debate is not as clearcut as many of us would like. Indeed, very few issues in health are simple. There is always more than one side to consider, and I appreciate the merits of the Government’s case. The Minister will argue that the Government are rightly following the recommendations of the JCVI, which the Opposition agree is correct in principle, but not, having looked at this in a bit more detail, necessarily in this instance. As we have already heard, the JCVI recommended an adolescent carriage study—this was more than two years ago—to determine what bacteria young people are carrying, and my understanding is that that study has not yet started. It takes a considerable amount of time for such a study to collect usable data, so will the Minister confirm that the funding needed to carry out the study will be made available? I have seen a reasonable timetable for the work set out by Meningitis Now and the Meningitis Research Foundation. If the Department of Health will not be following that timetable, will the Minister confirm when an adolescent carriage study will begin? Has she ensured that there are sufficient supplies of the vaccine to carry out the study?

Health economics, which other Members have mentioned, frustrates me a little because there is a bit of guess-ology, or a wet finger in the air, to it. Unless the lifetime cost and benefits of, and all the associated issues with, a particular drug can be assessed, it is difficult to assess the true costs and benefits of a particular treatment. I do not think that lifetime costs are adequately considered when looking at the cost-effectiveness of drugs and treatments. Indeed, that point was raised in the Procedure Committee’s final evidence session. Professor Andrew Pollard, chair of the JCVI, suggested that the JCVI was concerned that it “might be underestimating” the lifetime costs—that point was eloquently put today by the hon. Member for The Cotswolds. Dr Mary Ramsay, head of immunisation, hepatitis and blood safety at Public Health England, pointed out that social costs, such as out-of-pocket expenses, are excluded from the JCVI formula. Likewise, as we have heard from the hon. Member for Central Ayrshire, the peace-of-mind benefits are difficult to measure, but they are also left out of the formula.

Will the Minister assure Members here today that the working group has considered how to reform the JCVI framework so that some of the health gains for children are adequately represented, and so that prevention is prioritised in the formula? I understand that the JCVI agreed to review the impact of the vaccination programme within two years of its decision. I hope that, in light of the exceptionally strong public interest in this issue, the JCVI will, as part of that review, reassess the case for extending the vaccination to all children. The current cost-effectiveness framework used to assess vaccines tends to be a little unfair when it comes to relatively rare but severe diseases in children, and I accept that changes to those procedures do not come quickly, but that is no excuse for the unnecessary and bureaucratic delays that we saw in the introduction of the vaccine for the under-ones. I hope to see promising results this autumn, showing that the vaccine works in a mainstream programme.

Finally, if the JCVI were to make a recommendation to extend the reach of the meningitis B vaccine, I would not hesitate strongly to encourage Ministers to extend the vaccination’s coverage at the earliest opportunity. The principle of quasi-independence for the JCVI is important, and it should be defended, as we have heard from other hon. Members today, but that is not to say that its procedures and remit should not be continually re-evaluated to ensure that it takes the right factors into account. I hope the Minister will listen extremely carefully to all the arguments that have been raised on both sides of the Chamber in this debate and will see the strength of public opinion on this issue as genuine and real. Given that she has a considerable amount of time in which to respond, I am sure that we will get a thorough and full reply to all the questions put by hon. Members today. I am sure that the petitioners watching the debate, both here and through online forums, will be interested in what she has to say.