Meningitis B Vaccine

Helen Whately Excerpts

Monday 25th April 2016 Westminster Hall

[Helen Whately (Faversham and Mid Kent) (Con)]

It is a pleasure to serve under your chairmanship, Mr Pritchard. I thank the hon. Member for Walsall North (Mr Winnick) for his powerful contribution and my hon. Friend the Member for Bath (Ben Howlett) for his comprehensive opening speech.

I want to start by paying tribute to my constituents, Neil and Jenny Burdett, who are with us this afternoon. Their two-year-old daughter, Faye, died on Valentine’s day this year after an 11-day battle against meningitis B. It is their determination that something good should come of their loss that has brought us all here today. More than 800,000 people signed the petition after they published a picture of their daughter gravely ill in hospital. They have shown incredible courage over the past few weeks and months since her death. They did not expect to receive this much attention; they just wanted to prevent other families from suffering as they have. The scale of the response to the petition shows how strongly people in this country feel about meningitis and the level of fear and concern that there is out there among parents.

I am proud that Britain was the first country in the world to vaccinate the most at-risk group of babies against meningitis B. In this debate, we should not overlook the important fact that the rest of the world is watching our vaccination programme and seeing how it fares. In the evidence sessions prior to this debate, we heard Britain’s immunisation programme described by one expert as

“the envy of the world”,

but that does not mean we cannot do more.

It feels cold-hearted to talk about cost-effectiveness, but we have to introduce that to the debate because we know that NHS resources are limited, and we must recognise that money spent on meningitis cannot be used to fight other diseases. After extensive research and the work that was done to make the case for the vaccination to be introduced, costs were included that would not normally be included in such a case for vaccination. For instance, litigation costs and health losses to family members were included. The JCVI, which makes the recommendations, concluded that it would be cost-effective to vaccinate babies up to 12 months, but not older children. If I understand it correctly, the Government are legally bound by that decision. I am sure the Minister will confirm this, but I do not know whether we can simply call for that decision to be overturned and an instant change in the programme introduced. But questions can be asked, particularly as a group is looking at the moment into how the cost-effectiveness calculation is carried out.

[Mrs Helen Grant]

Does my hon. Friend agree that we should not ignore things simply because they are hard to measure, especially in a situation such as this? Issues that have already been mentioned such as peace of mind and public preference are really important.

[Helen Whately]

I completely agree with my hon. Friend and neighbour in Maidstone. I know she has been contacted by many of her constituents about this issue. We need to ensure that the formula used to calculate whether the vaccine should be introduced includes things such as peace of mind and the level of fear about meningitis. It should also take into account the public preference for protecting children from illness.

[Catherine McKinnell]

The hon. Lady is making an important point. My understanding—I would be grateful if the Minister would clarify this in her response—is that in calculating the cost-effectiveness of the meningitis B vaccination, the JCVI has not fully considered the potential outcome for those children who contract meningitis but survive and the long-term costs for them and their families for the rest of their lives. Such costs are often borne by the state, so, along with the factors that the hon. Lady is outlining, there are other financial costs that have perhaps not been considered fully.

[Helen Whately]

I thank the hon. Lady for that comment. We may well hear from the Minister that some of those extra costs have been taken into account, but when the Select Committee took evidence a few weeks ago we heard from the Meningitis Research Foundation and others that the cost-effectiveness model tends to privilege near-term costs over long-term costs and benefits. It does not look at the long-term lifetime health impacts, positive or negative, from a person having had or not had meningitis.

That brings me to something called the discount rate, which is applied at 3.5%. I have been told that, as a result of that discount rate, the benefits of a vaccine reach zero by the time somebody is 27. People clearly live for much longer than that, so is enough account being taken of the long-term benefits of a vaccination programme when cost-effectiveness is calculated? For instance, it has been calculated that if a 1.5% discount rate were used instead of the 3.5% rate, the answer would be different and a catch-up programme for under-fives would be cost-effective. The NICE guidance states that a 1.5% discount rate can be applied if health benefits would be attained over long periods and for public health interventions. Surely vaccinations should fall under those categories?

[Mims Davies (Eastleigh) (Con)]

Given my hon. Friend’s experience in the NHS and the clear point she is making, does she think we are missing a trick if we do not listen to that argument now?

[Helen Whately]

The arguments I am putting forward should certainly be looked into, and it is timely to consider them now, because a working group is currently looking at the cost-effectiveness calculation. We need a real sense of urgency about the report on the calculation and it should be published as soon as possible. According to the conversations I have had, there seems to be uncertainty about how it is progressing and when we will be able to discuss the findings.

In the meantime, ever greater awareness of meningitis is important, particularly as it strikes so quickly. Parents need to trust their instincts if a child seems unusually ill, and it is critical for health professionals to listen to them. We have heard many tragic cases of children getting meningitis in which the parents had suspicions that their child was really sick. They have gone to hospital and seen doctors, but they have been sent home with instructions to give the child Calpol or something similar. We know that meningitis is very difficult to diagnose, but it is worrying that there is such variability in how children are treated when they turn up with potential symptoms.

[Mrs Helen Grant]

During the Select Committee’s evidence sessions it was suggested that information about the disease could be put in babies’ red books to raise parents’ awareness. Does my hon. Friend think that that is a good idea that should be considered?

[Helen Whately]

It should most certainly be considered. The Government should look into all possible avenues for raising awareness. Charities such as Meningitis Now are working very hard and have some excellent leaflets, but parents are often still not aware. I have three young children and I have worried about meningitis. I would look out for a rash, but through being involved in this petition I now know that the rash comes so late in the process that it can be too late by the time it is seen. Parents have to be ready to spot a whole host of other symptoms and, when they speak to doctors, to be really confident that they think their child is more sick than usual and that it does not feel like a case for just Calpol. Parents have an instinct. We need to encourage them to trust it, and health professionals need to encourage them to speak up about it.

I know that other colleagues want to speak, so I shall conclude my remarks. We need a much greater sense of urgency about the work on the cost-effectiveness of vaccination. Bearing in mind the points I have made about the discount rate and the value that society attributes to the life of a child, a case could be made for extending the vaccination programme to more children. Work should be done on how health professionals deal with possible cases of meningitis B. Whether or not the NICE guidance is still right, it is certainly confusing. We also need more transparency about doctors’ reactions to possible cases of meningitis B, because it is hard to see the difference in the data—we only have anecdotes about how doctors and others respond when they see a possible case.

The Government must do all they can to raise awareness. Whatever the outcome of the debate, I thank Neil and Jenny very much for all that they have done. The petition and debate have surely raised awareness of meningitis B throughout the country, which in itself will have saved lives.

[Several hon. Members rose—]