HPV Vaccinations

Debate between Paul Beresford and Jim Shannon

Wednesday 19th July 2023 Westminster Hall

[Sir Paul Beresford (Mole Valley) (Con)]

I beg to move,

That this House has considered HPV vaccinations.

I am delighted to see you in the Chair, Dame Maria. I am also delighted to see the Minister. The subject of the debate is vaccination against the human papillomavirus. Unusually, both the Minister and I have seen HPV-related cancers, the destruction that the surgery to get rid of them does in providing a so-called cure, and how that often leaves patients. To be a little more positive, we have markedly moved our healthcare towards prevention. An increasingly vital arm of our preventive attack on various diseases must be vaccination. A vaccination strategy must focus not only on protection, but on elimination. For some diseases, we have been able to move towards elimination of the causative agent. That is the drive for me in this debate.

Vaccination has been around for a long time, ever since Dr Edward Jenner used the pus from a cowpox sore to inoculate an eight-year-old boy against smallpox in 1787—the first of thousands of people he and others inoculated and saved from smallpox that year. Millions upon millions have been inoculated since. I have no doubt that in this day and age, Dr Edward Jenner would have been up before the General Medical Council and struck off for recklessly endangering life, spreading disease and not following the guidance of the Joint Committee on Vaccination and Immunisation—I do not cross swords with it very often, but I have done so in the distant past. Since 1787, the development of vaccines has saved multiple millions of lives and stopped even more millions from various serious illnesses. The brilliant development and use of covid vaccines was a spectacular example of how far and how quickly we can progress.

I remember the mass inoculation programme against the polio epidemic from when I was a very small child. We saw polio spread through our community. If I remember correctly, the vaccination was a series of three injections in the upper arm using a syringe with a needle that was, in my view as a child, like a hollow 4-inch nail sharpened at the working end. It was plunged into my arm, reused after sterilisation and sharpened on a leather strop. It really hurt. Of course, the polio vaccine is now just a sugar cube carrying the vaccine, and kids love it. It has effectively wiped out polio in this country and most others. As we are all aware, there have been huge advances in the development, delivery and programming of vaccines, particularly for small children, who have been given huge protection against a variety of diseases. Over decades, vaccinators have had the chance to rid the world of some of these nasty diseases. Polio has been virtually eradicated. Apart from a few pockets in the world, yellow fever—a horrendous disease—has gone. Smallpox has gone. Measles went, but it has come back, because the vaccinations slipped.

I turn to HP viruses. They are a large family of viruses, at least two of which are downright dangerous to humans because they are causative agents of very many human cancers. They cause cervical, uterine and penile cancers and—in my professional area, which the Minister is aware of from her point of view—head and neck cancers. I point out my professional interest as a very part-time dentist. Head and neck cancers can be very hard to detect early and are frequently very destructive to treat. Surgery is frequently required. Such surgery commonly impairs normal living, such as eating, smiling and talking, and often physical appearance.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for securing this debate; he is right to have done so. I know that the Minister will respond in a very positive fashion, as she always does. Does the hon. Gentleman agree that the Government and the Minister must perhaps be clearer on why one dose is now needed, when parents in my constituency with a medical background tell me that one dose will not seal the vaccination? They are asking why covid boosters were essential, but this standard form of vaccination does not seem to be.

[Sir Paul Beresford]

As ever with the hon. Member’s interventions—which are frequent, as we have noticed, and press releases must result from them—he raises an interesting point. I will touch on it as I move on.

As I said, head and neck cancers can be hard to detect early. They are destructive to treat. However, we have had a vaccine for some time. For many years, there has been an initially very successful UK campaign to vaccinate teenage girls, targeting protection against cervical cancer. As the Minister will be aware, various colleagues and I, along with various groups, ran a campaign to make the vaccine available for teenage boys as well. The vaccine has been given to young teenage boys and girls and is not in the package received by infants. To be successful, we can and must drive the virus out. To do that, we must obtain herd immunity, with an overwhelming majority of teenagers inoculated—90% is the minimum target—but that is not happening. In 2021-22, only 9.8% of year 8 boys in this country were fully vaccinated. The figure for girls is better, but it is still only 67.3%.

With experience from the covid vaccine, we now have a real opportunity to rid the country of this deadly virus through an effective, concerted campaign, as we did with covid. The scientists have helped and, as has been mentioned, the HPV vaccination initially required two spaced injections, which have now been reduced to one. They use modern, fine, sharp needles, unlike the needles I was used to, meaning an essentially painless application.

There are some hurdles. This is being given to young teenagers, preferably both boys and girls, but an isolated vaccination is unfortunately not part of the package of early year vaccinations. Because early HPV vaccinations were promoted as preventing cervical cancer, some groups wrongly saw them as promoting promiscuity. That could not be further from the truth. For that reason, in our next campaign we should tend to slant the promotion more to the prevention of death and disfiguration from head and neck cancers, as well as cervical and penile cancer.

The NHS developed IT systems on a personal, individual level over the covid campaign. Someone on the campaign list would get constant reminders to get the covid boosters; those reminders kept coming until they had got the boosters. The same could be applied to HPV, especially as teenagers’ lives are generally dominated by their phones. A vigorous campaign in schools would help, and pushing in GP practices so that parents got involved.

As someone born in New Zealand, it pains me to say that the Australians are driving for an HPV-free nation, and I have heard that the New Zealanders are following suit. The Aussies appear to be winning against the virus. They are on the edge of being below four cervical cancer cases per 100,000 annually. If the Australians can do it, we can darn well do it.

The consequences of removing this virus are enormous: saving lives, saving thousands from disfiguring and often debilitating surgery and, most importantly, saving vast sums from our precious health budget. Minister, let’s get on with it.

Children’s Oral Health

Debate between Paul Beresford and Jim Shannon

Tuesday 31st October 2017 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for Birmingham, Selly Oak (Steve McCabe) on securing this debate. As always, it is good to have the pleasure of the vast experience and knowledge of the hon. Member for Mole Valley (Sir Paul Beresford) on this subject. I thank him for his contribution.

I am the Democratic Unionist party spokesperson for health, so this issue is very much on my radar. I will give some stats—the hon. Member for Birmingham, Selly Oak gave some, but I will give different ones. That does not make me any more of a statistician or an honorary member of any statistical organisation, but they are important for me because they are from my own region.

I can remember, as a child, my mother taking me to the bathroom and scrubbing the life out of my teeth; we can all probably remember something similar. When I was old enough to brush, but perhaps not old enough to know the importance of brushing, there were mouth checks, which reminded me of checking a horse’s mouth to see the health and age of the horse. Rather than understanding why it was essential that we brushed our teeth, I was probably more afraid of not having my teeth brushed and my mother doing it for me. The hon. Member for Mole Valley mentioned an increase in that among young children, which is good news. I am afraid that we do not see all the stats and realise the importance of that in Northern Ireland.

I believe that we are all fearfully and wonderfully made, as it says in Psalms, and that the intricacy of our body does nothing other than point to our creator God. Why else would we have two sets of teeth—the baby teeth that we probably abuse, which decay and fall out, and then the adult teeth? I know some adults who probably wish that they had a third, and possibly even a fourth, set of teeth.

I commend the previous Health Minister, David Mowat, who launched the new programme in January this year. I look forward to the present Minister’s response, which I know will be equally committed. A briefing I received for the debate made very interesting reading, and it all points to prevention. Tooth decay is the most common reason why five to nine-year-olds are admitted to hospital. In Northern Ireland, some 5,300 children were admitted to hospital for tooth decay and extractions, with 22,000 baby teeth removed. Moving on to 12-year-olds and teenagers, the signs of decay in permanent teeth are significant.

The hon. Members for Birmingham, Selly Oak and for Mole Valley have both referred to the need to control the intake of sugary drinks and foods. As a diabetic, I am well aware of the need to control sugar. Coca-Cola used to be one of my favourite drinks, but it is not any more—not because I dislike it, but because it was doing more harm than good and I had to stop drinking it. We need to have that control, and parents have a role to play.

There are significant regional and socio-economic differences in dental health across England—the numbers of those with tooth decay in the south-east compared with the north-west, for example; the difference is almost double. Perhaps the Minister will reply on that north/south difference. In some areas, seven times as many children are affected than in the best performing areas, where only 8% are affected.

Northern Ireland is at the bottom of the league table for oral health. I am not at all proud to say that, but it is a fact of life. We have a lot to do, in what is a devolved matter in Northern Ireland—at least until we find out where the Assembly is going, in which case the role over here might become greater. The 2013 children’s oral health survey showed that Northern Ireland had the worst oral health outcomes in the UK, and highlighted the difference in the figures compared with outcomes in England. Some 72% of 15-year-olds have signs of decay in Northern Ireland, compared with 44% in England and 63% in Wales. We have a lot to do, and we need to start that in primary school. The hon. Member for Birmingham, Selly Oak suggested education at primary school breakfast groups as a way of doing that. I think that would be excellent.

Of the 4,000 parents questioned in the Simplyhealth professionals oral health survey, 51% said that getting their child to brush his or her teeth for the recommended two minutes twice a day was a challenging task. Well, I think children are always challenging, but that is certainly one of the things that we need to do. The view has been echoed by members of my staff, who said it is as tough to get the seven-year-old grandchildren to do a good job as it is the two-year-old. That is a battle many parents face and they will do many things to try to encourage children. There are even such things as singing toothbrushes, as one method that may encourage children. It may help set the timespan, but the quality of brushing during that time could be questionable. To listen to the sound of a singing toothbrush is one thing, but brushing teeth has a purpose and we need to focus on that.

Children who experience high levels of oral disease, and are treated with fillings and other restorations, will require complex maintenance and treatment of new oral problems as they grow older. We are all aware that dental treatment is a significant cost to the NHS, with spending in England amounting to £3.4 billion. Some £2.3 billion is spent on private dental care. The NHS spends £50 million on tooth extractions for children, the majority of which are due to tooth decay. Shockingly, 42% of children did not visit an NHS dentist in the year ending 31 March 2017, even though such check-ups are free. The National Institute for Health and Care Excellence recommends that children see a dentist at least once a year, but 80% of children between the ages of one and two did not visit a dentist in the 12 months to the end of March. Those statistics are important, because they show us where we need to focus our attention.

I am conscious that other hon. Members wish to speak, so I will conclude with this. Drastic action must be taken, but for that to happen we need a funding regime so we can do more for children in schools and through the healthcare system. More needs to be done in socially deprived areas, because there is a north-south divide when it comes to those affected by tooth decay. We must ensure that parents prioritise oral healthcare and are able to access a dentist for their child easily and without fear that they will be judged or told off. Something needs to be done. We must ensure that there is not another generation of people in agony due to their teeth. Having had toothache, I know my heart goes out to those who suffer from it. Tooth decay is preventable, so we must do all we can to prevent it in our children. We should start as we mean to go on.

[Sir Paul Beresford]

On a point of order, Mr Bone. I was so enthusiastically carried away by the opening speech that I cannot remember whether I declared that I am a very part-time dentist. If I did not, I have now done so.

Variant CJD and Surgery

Debate between Paul Beresford and Jim Shannon

Tuesday 29th November 2016 Commons Chamber

[Sir Paul Beresford (Mole Valley) (Con)]

I am delighted to see the Minister in her place, and I am sure that she is delighted to be here—or at least she is trying to smile under the circumstances. She has probably been made aware of my long-term interest in, and deep concern about, this subject. I am sorry to inflict it on her this evening, but she is bearing up. I also declare a potential interest, as a very part-time dentist.

Variant CJD is a fatal neurodegenerative disease originating from exposure to bovine spongiform encephalopathy-like prions, prions being small particles of protein. Variant CJD prion infections are associated with a very long and clinically silent incubation, but when the disease strikes, it causes a fast, spongy degeneration of the brain, followed by a horrible and untimely death. It is probable, but not certain, that carriers might not produce the disease themselves, but it appears to have a potentially decades-long incubation. The long incubation period means that some will die of other causes first, but, as we live longer, we cannot be certain that in time —after decades—the disease might not strike all carriers, if they survive long enough. Carriers might also unwittingly pass on the prion through blood transfusion and via surgical instruments.

Variant CJD is an appalling disease with no cure. The number of asymptomatic individuals with variant CJD prion infection is unknown, but recent research estimates that the carriers number about one in 2,000 adults, which is a staggering number. The disease poses a risk to others, via blood transfusions, blood products, organ or tissue grafts and contaminated medical or dental instruments. The response of this and previous Governments has been bipolar. To give an exaggerated simplification, the first position of this bipolar response is that as we have not had many recent cases, there is no problem—but considering the long incubation period and some recent changes, this is a dangerous assumption. The second position is that there might be a problem so we should apply the precautionary principle in some areas. We cannot have both. I believe that waiting and an occasional application of the precautionary principle really do not hit the problem. If the Minister takes no action, I hope she will recognise that the absence of evidence is not evidence of absence.

As I have said, research says that one person in 2,000 is a carrier. The incubation period may well be decades, and some individuals appear to be more susceptible and some less so, although in time this could be proven wrong. A death from variant CJD in Edinburgh in January this year showed a potentially deeply worrying change. People are of various genotypes: they can be VV homozygotic, or MM homozygotic or MV homozygotic—and for the sake of Mr Deputy Speaker, I will not explain that. Until this case of the Edinburgh patient, all cases of variant CJD had been MM. The Edinburgh patient was the first MV patient that we have seen. It was thought that being MV or VV might offer some resistance, but this does not seem to be the case. We should bear it in mind that about 45% of the population are MV.

There is still no conclusive evidence, but there is a possibility that patients with the MV genotype may have a longer incubation period, which could lead to a second wave of variant CJD. The real point is that until recently it was hoped that MV patients might not show clinical signs, but in these early days this appears to have been put in deep doubt.

Research also shows that prions are transmissible by blood products and contaminated surgical instruments, and as the prions resist decontamination from stainless steel, we have a problem. Over the years, a precautionary principle has been applied—it is still being applied, but only partially. Much has been done slowly over many years. Leucodepletion was introduced, and synthesised clotting factors have been provided for haemophiliacs. A prion unit was set up at Queen Square. Single-patient use of stainless steel endodontic reamers was made mandatory, which I find quite interesting and will return to in a few moments. Non-UK blood supplies were sourced for those born after 1 January 1996.

What I found curious about the endodontic reamers is that if a patient requires endodontics, it is possible to use the stainless steel reamer but singly; but if the patient for some reason does not have endodontics, the tooth will have to be extracted using a stainless steel instrument that is used repeatedly, called a pair of forceps.

Very early on the Government established, through Medical Research Council funding, a prion unit at Queen Square under Professor Collinge. This unit was tasked with finding a test, finding ways of stopping or reducing transmission and hopefully even finding a cure. The prion unit with DuPont has produced a RelyOn soak, which deactivates the prion on stainless steel surgical instruments. Following the soak, there is then decontamination and a washing machine—a dishwasher-type machine—and then a full-blown steriliser, particularly a vacuum-based one. These instruments will bring about total sterilisation, from which the prion will be lost.

DuPont is no longer producing the soak, because there is no market. And there is no market simply because hospitals, clinics and surgeries in this country are not required to use it; if they were, there would be a market. That is quite extraordinary considering that this country has the greatest deposit, if I may use that term, of people carrying the prion.

In a surgery washer, the disinfectant would do the job. Recently, Professor Collinge became aware that the Department of Health had announced funds for research into prion-disinfecting stainless steel instruments. I believe the prion unit has applied and will hopefully get a grant. The problem with the wash was that it meant an extra stage, which slowed everything down in the hospital, but if DuPont or another manufacturer could produce it in the form of a tablet, a powder or a liquid that would go into the dishwasher without frothing, that step would be taken away, we would get rid of the prion and there would be no time wasted. Those instruments would be prion-free.

Incidentally, the Minister may be aware that there is some evidence that a protein may—and I stress the word “may”—be responsible for the occasional transmission of Alzheimer’s disease. If she wants a little bit of help on moving with RelyOn, I can tell her that RelyOn would disinfect instruments with this protein as well.

Another major failure relates to the sourcing of blood products. People born after 1 January 1996 who needed blood products—for instance, a transfusion—could get non-UK-sourced plasma that was almost certainly prion-free. Those born before that date would get UK plasma, and would have to pray earnestly that the donor was not the one in 2,000. As a parent, I can imagine having two children born on either side of that date. If for some horrible reason they both needed blood transfusions, one child would get the prion-free plasma and the other would take the risk, as would elderly people like us.

With a test, we could be fairly sure of excluding that one in 2,000. Professor Collinge and his prion unit team have developed such a test. They tried it out in this country and subsequently went to the United States, where they checked it with an extensive research programme to make sure that it produced no false positives. They were successful. They then returned to this country. The final stage of the research needs to be tested on a large batch of anonymised UK blood samples, but the Medical Research Council will not fund it. At least, that is the case so far.

If we had that test, blood donors who were carriers would be sorted out and their blood not used, and special measures could be taken for surgery patients who proved to be carriers. In respect of the latter line, the Minister’s Department introduced new guidance in July this year. I understand that it requires separate instruments to be used on high-risk tissues in the case of patients born before and after 1 January 1997 respectively. That is sensible reasoning, because it is thought that people born since 1 January 1997—I thought that it was 1996—have had less exposure to prions via the food chain. Those people form a group who are at lower risk of prion diseases, and thus less likely to contaminate surgical instruments with prions.

The instruction from the National Institute for Health and Clinical Excellence on a risk-reduction strategy requires every hospital and clinic to have separate pools of instruments to be used for high-risk surgery. It distinguishes between patients who were born before 1 January 1997 and those who were born on or after that date. The instruments must be kept separately, and notated. Although I consider that instruction to be eminently sensible, it will add greatly to the costs to hospitals of instrument provision, storage, and the required regular re-sterilisation. Tracing and tracking of instruments has also proved costly, and some hospitals are etching all instruments with identification numbers to ensure that they can carry out the process properly.

I have only been able to obtain one figure, but I understand that since, I think, July, observing the new guidance has cost the National Hospital for Neurology and Neurosurgery in Queen Square an extra £120,000. A little further down the road, the cost to a hospital specialising in children will be considerably higher. If RelyOn were developed so that it could be used, that difficulty would be removed.

I have three small asks of the Minister. First, we must recognise that all patients need to be treated equally in respect of blood products. As one person in 2,000 is thought to be a carrier, until we have a variant CJD test everyone should receive non-UK plasma. Secondly, rather than chasing a new product for sterilisation, the Department of Health, through whatever means, should fund the manufacturer of RelyOn to produce it in a more user-friendly form. If NICE or the Care Quality Commission made the use of such a product mandatory, there would be a market potential, which might be sufficient to persuade DuPont or some other manufacturer to produce such a user-friendly product without the need for funding, because it would be sold and used every time sterilisation pouches went through the dishwasher. Thirdly, funding the last stage of the testing of the prion unit system for prion detection would enable carriers to be taken out of the blood transfusion pool, and would also ensure a more sensible separation of surgical instruments. The cost savings would be vast.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on making such a compelling case for those with CJD. In 2001, the Government set some money aside for a compensation scheme for UK victims of variant CJD. A trust fund was set up in April 2001 and compensation payments of £25,000 were made to the most affected families. Does the hon. Gentleman feel the Government should reconsider the compensation scheme and upgrade it for 2016 for those who, clearly from what he says, will probably fall into that category—although I hope not—in years to come?

[Sir Paul Beresford]

The hon. Gentleman makes a good point, but what I would really like to do is get the Government to take some action that is sitting, waiting, readily available to prevent it; otherwise, in time to come I believe we are going to have a chance of a considerable flood of variant CJD disease, but we do not know, and if this test was there we would know if the figure of one in 2,000 is right or wrong, or if we can separate patients out, so that those who have it have special instruments and the rest of us are all right, and we can also start using blood products in this country, because we will only be using products that do not have the prion on board.

In effect, the Minister needs to think about this: I do not want my grandchildren to be the generation that sees the re-emergence of variant CJD and for them to turn to me, if I am still around, and say, “Why didn’t we do something about it?” That is not a very big ask.

Child Dental Health

Debate between Paul Beresford and Jim Shannon

Wednesday 3rd February 2016 Commons Chamber

[Sir Paul Beresford (Mole Valley) (Con)]

I have a well-known interest to declare as a very part-time, or occasional, dentist. I am a member of a number of dental organisations that have applied considerable pressure on me to seek this debate.

On 27 May, the Minister will give the opening address and take questions at the British Dental Association’s annual conference in Manchester. There are 39,000 dentists and 63,000 dental care professionals in the United Kingdom, spread over the four nations, with the majority of them in England. They will wish to hear about the national health service and contracts, but as professionals their biggest concern will probably be child dental health. Perhaps the Minister’s reply could be secret practice for opening the meeting, bearing in mind that, I suspect, very few dentists will be watching us.

Dentists feel that their small branch of general health is seen as a “Cinderella” service and a sideline within the national health service. Increasingly, the biggest problem they face is child dental health in the form of caries. This disease is almost entirely preventable, but it is not being prevented. As the Minister is aware, the biggest single factor in dental caries is sugar. The raw statistics on child dental health are pitiful. Deciduous teeth, or baby teeth, are particularly susceptible to decay as they have thinner enamel compared with permanent dentition, and this obviously contributes to children having dental decay. Dental decay is the No. 1 reason for children aged five to nine being admitted to hospital in the United Kingdom.

[Jim Shannon (Strangford) (DUP)]

In Northern Ireland, tooth decay among under-15s has fallen consistently since 2000, and specific education has been done by our health and education Departments to make that happen. The hon. Gentleman referred to those aged between five and 10 consuming sugar. Every child will eat their weight in sugar in a year. Does he agree that we need a tax on sugar, because if we address this at the early stages, we will go a long way towards addressing the problem of tooth decay?

[Sir Paul Beresford]

I wish it were that simple. I personally believe that that would not make one iota of difference after a few months. One need only stand in the supermarket watching the kids pushing the mothers for sweets and the mothers feeding them to realise that, as I say, it will not make one iota of difference unless it is prohibited, in which case we would have other difficulties that I will not go into.

As I have said, the No. 1 reason for children aged five to nine being admitted to hospital in the United Kingdom is dental decay. The NHS spent £30 million on hospital-based extractions for children aged 18 and under in the year 2012-13. That is 900 children a week, who are being admitted primarily for tooth extraction—often under a general anaesthetic, which carries a slight risk in itself.

I am sure that the Minister is aware of the results of the 2013 child dental health survey. For the sake of those who have not read the statistics and who may glance tomorrow at the debate, I will touch on some of the figures. For example, 31% of five-year-olds had obvious decay in their primary teeth. That figure was higher in more deprived areas, where 41% of those eligible for free school meals had decayed primary teeth, in comparison with 29% of other children of the same age. Of five-year-olds who were eligible for free school meals, 21% had severe or extensive tooth decay, compared with only 11% of those who were not eligible.

By the age of 15, 46% of our children have tooth decay. Of the 15 year-olds, 59% of those eligible for free school meals had decay, compared with 43% of other children of the same age; 45% reported that their daily life had been affected by problems with their teeth and their mouth in the previous three months; and 28% reported being embarrassed to smile or laugh because of the condition of their teeth. Those are 15-year-olds, who are suddenly taking notice of the world and hoping to be taken notice of themselves.

Head and Neck Cancer

Debate between Paul Beresford and Jim Shannon

Tuesday 1st July 2014 Commons Chamber

[Sir Paul Beresford (Mole Valley) (Con)]

I thank my hon. Friend the Minister for coming. She is smiling slightly, because we have had this discussion on a number of occasions and it will continue, at least until I get my way, if that is at all possible over the coming years.

I must begin by declaring a short list of potential interests. I am still a part-time practising dentist—very part-time. I am also chairman of the all-party parliamentary group on dentistry and the APPG on skin, which has a link to this debate.

In an earlier debate, I focused on oral cancer and, in particular, on the causative role of the human papillomavirus. I have been trying to persuade the Minister to encourage the Joint Committee on Vaccination and Immunisation, or JCVI for short—don’t the medicos always do that?—to broaden its horizons beyond the inoculation of teenage girls against cervical cancer. The results in relation to cervical cancer are very encouraging, but the virus is key to the cause of many other cancers, and that applies predominantly to two variations of it.

In a previous debate, the Minister was very nice, and explained sweetly that I must rely on the advice of the JCVI—or, at least, that she must do so. She explained that the committee was expanding its sights. Although it was enlightening to hear that it would be examining the HPV-related effects of men having sex with men, it did not help me very much because I am looking beyond that. I think that the committee should be looking above the waist, and, more specifically, looking at the trauma of pain, suffering and death—a very horrible death—as well as at the financial costs to the NHS of the existence of the virus elsewhere in the human body. I am aware that the virus plays a part in skin cancer, but I have decided to concentrate on the head and neck.

A quick cruise through the latest papers on head and neck cancer makes for frightening reading. Despite the reduction in smoking, the number of head and neck cancer cases is rising steadily and rapidly. The stark reality is that the number of new cases is growing year on year, at a much higher rate than the experts expected. Some are talking of an epidemic. The problem is now so acute that one form of cancer which falls into the “head and neck” category, oropharyngeal cancer, is the fastest-growing cancer in Scotland, and is a significant and growing problem in the rest of the United Kingdom.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on raising this subject. In the past year in Northern Ireland, 1,218 people have been diagnosed with head and neck cancers, and 64 people die of such cancers every year. Does he think that that is because this is seen as a lesser cancer—if that is the right way in which to put it—than others which seem to catch the eye of the public? If so, does more need to be done to increase the focus on head and neck cancer?

[Sir Paul Beresford]

I am focusing on it, because worldwide it constitutes about 5% of cancers and causes 6% of the deaths, and because, as I think is generally accepted, in a large proportion of cases HPV is a causative agent, or the root cause. There is a way of dealing with that and I think that we ought to adopt it.

In the United Kingdom, the latest findings put the incidence of HPV at 23.5% for oral cancer, 35.6% for oropharyngeal cancer, and 24% for laryngeal squamous cell carcinomas. I have no data for skin cancer, but obviously it applies to head and neck skin. On a personal note, my brother-in-law recently died from a squamous cell carcinoma on his head, which was undiagnosed and untreated, and when it was found it was too late. Head and neck cancers are fifth in the global rankings of cancer incidence, and sixth in the global rankings of cancer deaths.

The cost of oropharyngeal cancer to our health services is enormous. A new report is due to be published following extensive research on the economic cost of head and neck cancer. The findings of the research suggest that the official estimate of the burden placed on the national health service is significantly less than the actual total. The data I have seen of the report that is coming out soon conclude that the cost of oropharyngeal cancer was approximately £115 million at 2011 prices, laryngeal cancer £96 million and oral cavity cancer £98 million. The total at 2011 costs is just under £310 million. We must add that that is almost certainly low because of under-reporting, that we have three years of inflation and, worst of all, three years of increasing numbers of cases. I am not sure, but I suspect that that does not include peripheral rehabilitation costs such as physiotherapy and speech therapy and some cosmetic dentistry in appropriate cases, nor does it cover the unquantifiable cost to quality of life, with the pain and disfigurement that much head and neck cancers produce, and the treatment that is required peripherally for patients.

Perhaps what is most surprising—I have only just discovered this—is that these cancers are more prevalent in men than women at a ratio of approximately two to one. It is common knowledge that the NHS is under immense financial pressure. In fact, demand for access to the NHS is at unprecedented levels. The Government have taken commendable steps towards ensuring that the health service is protected from spending cuts, which have been necessary in so many other areas, but that does not mean budgets have not come under pressure and resources have not been stretched. It is therefore a matter of the very gravest concern that the full economic burden of head and neck cancer, and by extension HPV, is not taken into account. It should be. The whole of the problem of HPV and the way it infects different parts of the body should be addressed by the Joint Committee on Vaccination and Immunisation.

Australia has a policy of vaccination of both males and females. That is producing what is called a herd immunity. Although I am specifically looking at head and neck, with the role of the HPV virus, it is quite clear that there could be a dramatic reduction in a number of cancers, including head and neck cancer, over time with gender-neutral vaccination. Clearly, men currently face a significantly greater, and rising, risk of HPV-associated head and neck cancers.

I therefore again put it to the Minister that it is not fair, ethical or socially responsible to have a public health policy that leaves 50% of the population vulnerable to infection. Such vaccination, combined with early detection and action on smoking and heavy drinking of alcohol, could save a huge number of lives just as we are facing a dramatic increase in head and neck cancer. I hope that the Minister will be able to persuade the JCVI to broaden its horizons and to look at the human suffering, as well as the total costs of HPV to our national health service.