Meningococcal C Immunisation
The next item of business is an emergency statement by Susan Deacon. The minister will take questions at the end of her statement, so there should be no interventions during it.
I draw members' attention to the fact that the promised timing clocks have been installed during the recess and will operate during the statement and debates this afternoon.
I am grateful to have the opportunity to inform Parliament of the arrangements in Scotland for the introduction of a new vaccine to protect our children against meningitis C. The new vaccine programme is good news for parents and children across Scotland and is a huge step towards conquering one strain of a potentially life-threatening infection.
Meningitis, one form of meningococcal infection, is an inflammation of the lining of the brain and spinal cord. It can be caused by a number of different types of viruses and bacteria. Meningococcal infection can cause long-term damage and can be fatal. The new vaccine will protect against meningococcal group C bacteria, which account for about half of all cases of this infection in Scotland.
A particularly frightening aspect of meningococcal infection is the speed with which it can take hold of a young life. Without early detection and swift treatment, the consequences can be fatal or permanently harmful. It is an infection that many parents live in fear of and, sadly, whose consequences some have experienced. Last year in Scotland, around 160 people developed meningitis and blood poisoning because of meningococcal group C bacteria. Tragically, 10 of them died. Others were left with long-term health problems such as brain damage, deafness and amputations.
It is of added poignancy that the infection affects mainly very young children and young adults: young lives are blighted; potential is lost; and families are stricken with grief. That is all caused by this disease, which attacks health with speed and stealth. Science has given us the opportunity to do something about that: to save those young lives; to realise that potential; and to spare families the agony of loss. This Executive was not prepared to ignore that opportunity.
The development of this new vaccine, which is called MenC, is hugely welcome. It has become available a year earlier than anticipated because of unexpectedly swift progress in research and development. Last week, the first manufacturer received a licence from the Medicines Control Agency for the supply of the vaccine. Further licences are likely to be issued over the coming months, which will enable the progressive implementation of a major immunisation programme.
Scotland—together with our partners in the rest of the United Kingdom—will become the first country in the world to introduce a routine national programme for this vaccine. As our Minister for Health and Community Care and as a mother of a young child, I am pleased to make that announcement today.
However, we should make no mistake— introducing a new vaccination programme targeted at more than 1 million babies, children and teenagers presents a major logistical challenge. We are determined to meet that challenge. Earlier this summer, I set up an implementation group to advise on and plan the arrangements that should be made to ensure optimum use of the initial vaccine supplies.
I am grateful to Professor Lewis Ritchie of the department of general practice at the University of Aberdeen for chairing the implementation group, which includes representatives from public health, pharmacology, information technology, the Scottish general practitioners committee of the British Medical Association and the education sector. Through their work, and with the help and support of health care professionals across Scotland, I am confident that we have put in place sound arrangements for Scotland to benefit quickly and effectively from this major advance in public health protection.
In identifying the priority target groups and the progressive implementation programme that we should adopt, we have followed closely the implementation group's advice. As a result, we will see the new vaccine established as an integral and vital component of our childhood immunisation programme in the coming months.
Of course, now that the vaccine is available, we want to ensure that all our young people reap the benefits of its protection. I am, therefore, pleased to confirm today that—as a result of this Executive's commitment to child health—every pre-school child and every school pupil in Scotland should be offered immunisation against meningococcal C infection in the next 14 months.
That will be a huge exercise and it will also be a huge achievement. In securing that achievement, I am conscious that demands will be placed on general practitioners, community child health doctors, health visitors, school nurses, practice nurses and other national health service staff, as
well as on head teachers and their staff. Every effort has been made—and will continue to be made—to support those people in that task. I am confident that they will join us in this national effort to protect our children against the threat of meningitis C. I am sure that MSPs will join me today in expressing gratitude to them at the beginning of this important national initiative.
The delivery programme, which has been shaped by the work of implementation group, will start in November. It will focus initially on the most vulnerable groups. First, from 15 November it will focus on young people aged 15 to 17 and secondly, from 29 November it will focus on young babies.
The first group will be targeted through a school-based programme. Babies will be reached through GPs and local health clinics. Thereafter the programme will roll out in the course of next year to include all children aged up to 14 as more supplies of the new vaccine become available.
We are mounting a high-profile publicity campaign to ensure that parents are aware of the availability of the vaccine and that they receive details of the programme being put in place to immunise their children. The Health Education Board for Scotland has produced a range of materials including an information leaflet for parents, a video and posters. There will also be press advertising during November.
Health professionals and schools are already being supplied with the information that they need to ensure the successful implementation of the programme. In addition, the NHS helpline will be briefed to provide any additional information parents or others may require.
Through this comprehensive and co-ordinated programme, we aim to vaccinate all young people under 18 in Scotland by the end of 2000. Sufficient quantities of the vaccine have therefore been made available this autumn to ensure the offer of immunisation to all full-time first-year students in Scotland.
Today, I can give an assurance that we have spared no effort in ensuring that the new vaccine will be used to maximum effect as supplies come on stream. I would, however, like to take this opportunity to ask parents to play their part as well. I will make three points in this respect, which are also explained in the HEBS leaflet and other publicity material.
First, I would like to say to the mothers of pre-school children that appointments at their local GP surgeries or community health clinics will be arranged and details will be sent to them. Those mothers should wait until they receive details of that appointment and should then ensure that they take that opportunity to attend.
Secondly, the parents of schoolchildren will receive a consent form from their children's schools, along with the information leaflet. My message to them is to return that consent form quickly.
Thirdly, all parents should remain vigilant and look for the signs and symptoms of meningococcal infection. The MenC vaccine, significant and welcome as it is, is not a protection against all forms of meningitis. It will not give protection against meningococcal group B bacteria, which are another major cause of meningitis.
The Executive's commitment to safeguard and protect the health of our children is absolute. Immunisation remains one of the most effective ways of protecting our children from serious disease. The introduction of the meningitis C vaccine is therefore a significant addition to the immunisation armoury. However, this huge new programme does not come cheap. Over the next three years, the Scottish Executive will invest £31 million in this new initiative—£14 million in the current year, together with the £17 million announced by the Minister for Finance on 6 October over the next two years. It is money well spent and we do not begrudge a penny.
I have repeatedly said in this Parliament and outside that one of my priorities is to improve child health in Scotland. That means tackling both the lifestyles and life circumstances in which our children find themselves. However, meningococcal C infection can strike a child down before he or she has the chance to grow and develop, regardless of who they are or where they live. We need to give them that chance.
This campaign must mark the beginning of the end for meningococcal C infection in Scotland and the opening of a new chapter in our national child immunisation programme. I am pleased to be able to make this statement today and I look forward to taking forward this important new development, which will benefit young people and families throughout Scotland.
I welcome the minister's statement and the fact that it involves a timetable. I acknowledge that ensuring that everyone who is at risk receives the new vaccine will be a huge task.
What steps have been put in place to ensure an adequate and uninterrupted supply of the new vaccine? That question is particularly important in light of the problems experienced this year by students who had been promised immunisation before the start of the new term, only to find that no vaccine was available.
The first licence for the new meningitis C vaccine has been approved in the past week. We expect further licences to be
granted in the months ahead. We hope that that will enable the programme that I have outlined today to be rolled out.
It is important to recognise that the supply and production arrangements of different vaccines vary. We should not generalise about problems of vaccine supply. It does not follow that there will be problems in the supply of vaccine in one area because there have been problems in another area.
It is important to clarify the situation as regards students. The vaccine that has been made available to students recently is the polysaccharide vaccine, which is not effective on babies and young children but which can be offered to older people. Students were seen to be a high-risk category and that vaccine was offered to them to ensure wide coverage.
The arrangements that were put in place during the summer months ensured that students across Scotland could get access to the vaccine before they went to college or university, or from the medical centres of the colleges or universities.
Conservative members, too, welcome the minister's statement.
It takes three months to build up immunity to meningitis C, but the vaccine was not available to students before they went to university. I raised that problem in a written question on 10 September—seven weeks ago—after constituents in the Highlands told me that they feared that their children would be vulnerable to infection when they went to university. I would like to know why my question was not answered. I would also like to point out the concerns of students who were vaccinated in freshers' week and will remain vulnerable to infection for the next three months. Moreover, does the minister have plans for the vaccination of second-year and third-year students? They are just as vulnerable as first-year students.
The advice that I have been given by GPs is that it takes one minute to vaccinate and five minutes to complete the administration. We all welcome the new initiative but, given the case load that will result, will the administration for GPs be reduced to a minimum to assist the swift implementation of this programme?
I do not for a moment want to deny Mrs Scanlon's right to put questions to me today. However, I am somewhat disappointed to receive such a qualified welcome for a very important announcement. Most of the points that Mrs Scanlon raised, as I indicated in my answer to Mrs Ullrich's question, do not apply to the meningococcal C vaccine, which is the subject of the announcement today. I have already given assurances on the polysaccharide vaccine that has been made available to students. That is a separate matter.
On the issue of the vaccination programme for meningococcal C, I made it clear—not only in relation to our approach to this vaccination programme, but in relation to our approach to the delivery of other major health initiatives throughout Scotland—that we have not drawn up this implementation programme in a vacuum. We have worked closely with practitioners, not only in the NHS in Scotland, but in education; we have also worked with health care practitioners, not only in our hospital environments and GP practices, but in our communities. We have done that so that we can make effective arrangements to deliver this dramatic new improvement for the health of our children. I had hoped that members of all parties would be able to welcome that and would recognise the scale of the task and of our commitment.
Conservative members welcome it very much; there should be no doubt about that. I ask respectfully whether the minister will answer the three questions that I raised. Those concerns are not mine alone; I have consulted widely, and the concerns have been expressed to me by general practitioners.
I feel duty-bound to repeat my answer to the previous question. I am interested to hear that Mrs Scanlon has somehow learned of concerns from GPs about the planning arrangements for this vaccination programme— those issues have not been raised through the proper process and in the proper forum. If Mrs Scanlon's information suggests that there is any weakness in the implementation programme, or if GP representatives have any such suggestion, I would be pleased to hear about it, as would Professor Ritchie, the chairman of the implementation group.
I repeat the assurance that I gave earlier: vaccinating more than 1 million young people in Scotland during the next 12 months is a major logistical challenge and we have made every effort, in a process of dialogue with health care professionals, to carry out that monumental exercise effectively.
I offer an unqualified welcome for the minister's announcement. To set up this programme within a week of the licence being granted is to set a standard that Susan Deacon's ministerial colleagues will find difficult to follow.
I would like to ask for elaboration on one or two points. First, the minister said that support had been given to doctors in the exercise of carrying through this programme. Will she give me a
breakdown of what the money has been spent on and the nature of the support that has been given to doctors by the Executive? A fairly considerable work load will be involved in this, on top of existing pressures.
Secondly, on the vaccine that has been given to students, will the minister advise the chamber whether there is, in practical terms, any significant difference between the effect of the vaccine that has been offered to people in that age group and the effect of the new vaccine? Is there any requirement for students to be revaccinated, now or in the future?
There are several different parts to that question and I shall take the last point first. The vaccine that is being given to students is different in its effectiveness—individuals who receive it require to be vaccinated again within three to five years. It is also different, as I indicated earlier, because it is not suitable for babies and young children. I hope that that addresses that point.
On investment, the figures that I cited represent the global sum required for the implementation of the programme, which covers the cost of the vaccine, the payments that will be made to GPs for each immunisation and additional elements of implementing the programme, including the extensive information and publicity campaign. I am pleased to say that that investment means that every child in Scotland will be immunised free of charge.
I am sure that health professionals in Scotland are ready to play their part in this important and ambitious campaign, but what does the minister propose to do to promote caution in relation to meningitis B? Does she intend to work with the National Meningitis Trust, whose campaign has been so helpful in continuing to promote caution?
The MenC vaccine will not tackle every cause of meningitis, which is precisely why I said in my statement that we must remain cautious. We hope to use the implementation of the vaccination programme to continue to get that message across, as well as the good news about the vaccine and its impact. I continue to support measures to raise awareness of the signs of meningitis, which—as too many people know all too well, and as I mentioned in my statement—is an infection that can develop rapidly. I stress that the Scottish Executive works with and, in some cases, funds organisations that are involved in raising awareness of the issues.
I add my voice to the universally warm reception that the announcement has received. I would like the minister to clarify two points. First, I understand that the new vaccine may prevent people from becoming carriers of group C bacteria, although research into that is on-going. Will the minister elaborate on current thinking on that research, tell us what funding has been put behind it and when we can expect to hear the results? Secondly, will she confirm that this announcement deals exclusively with vaccination? Does she have any proposals for the rehabilitation of those suffering from the effects of meningitis or related illnesses?
Mr Hamilton's first point is well made. Research must continue in this area and we continue to support such research. The Medical Research Council spends £1.2 million per year on meningitis-related research. On his second point, the fact is that there are many variants of the disease and the impact of the condition can vary greatly. Therefore, there is no universal answer to the treatment of sufferers of meningitis. However, I stress that our commitment to providing the highest quality services to people across Scotland, irrespective of their condition, is very real.
I welcome today's announcement and add my congratulations to Professor Ritchie and the pharmaceutical companies who have worked so hard to bring the vaccination into production so quickly. I hope that the minister will try to answer my questions and will not treat me as she did Mrs Scanlon.
The Minister for Finance has already come before the chamber, but the Minister for Health and Community Care has now announced support for a two-year programme. Can we have a commitment to an on-going programme, which will presumably be funded from new money? If it is not to be funded from new money, will the chamber be told what will be pushed aside?
I am concerned that the vaccine is very much connected in people's minds with students, but it would also be useful to young people entering places of work, such as shops and factories, and sports clubs. Does the minister propose to extend the polysaccharide vaccination programme to all young people up to the age of 21, particularly as she has just stated that there is a need to top up the vaccine every so often?
To take up Dr Richard Simpson's point about meningitis B, what commitment is the minister prepared to make to a programme to look further for a solution to that problem?
I will deal first with the issue of resources and be crystal clear on the Executive's financial commitment to the programme. The sum of £14 million has been allocated in year 1—the current year—to ensure that we can move ahead
speedily and effectively in supplying the vaccine now that it has become available ahead of schedule. This is about priorities. Given that the vaccine has become available ahead of schedule, we have looked long and hard at the health budget this year to ensure that we prioritise this so that our children are properly protected.
I was delighted that the Minister for Finance was able to confirm in his financial statement that additional new moneys—a total of £17 million— would be made available for years 2 and 3 of the programme. Our commitment to resourcing this programme is very clear.
On extending the existing polysaccharide vaccine programme that has been made available to students, I stress that any decisions on vaccination programmes—not least the MenC programme that I outlined today—have to be taken on the basis of reaching those groups that are at greatest risk. The groups of students that have been targeted this year are those that have been identified as being at greatest risk. The fact that we have been able to offer that vaccine across the country this year is a major step forward. Of course, we continuously review and develop our vaccination programmes, always aiming to have the maximum possible impact on the groups that can most benefit. Similarly, as I said, research continues. I am delighted at this breakthrough and at this step forward, but we will keep moving forward.
I, too, thank the minister for her statement. It is tremendous to know that Scotland will be the first country in the world with complete immunisation.
In her statement, the minister makes regular references to full-time first-year students. There appears to be no reference to part-time students who, as is obvious, attend the same university and college buildings as full-time students. Is there any provision for the vaccination of part-time students?
I do not recall making references in quite that way when I answered the question. Let me clarify again what has been offered to students this year, not in relation to the new MenC vaccine, but in relation to the existing, available vaccine. Students in their first year at college or university, who as such have been identified as being at increased risk, have been offered that vaccine. They have been offered it before the start of the new college or university term. For those who have been unable to get it through that route, we have put arrangements in place to make the vaccine available on students' arrival at college and university.
I am conscious that points have been raised about the student programme; if members want to raise wider points about it, I am more than happy to investigate them fully. However, I am keen today to ensure that we are clear about the new vaccine programme that is being introduced and the target groups that we are going to reach— notably our children and young babies—through it.
I, too, will join the universal chorus of welcome for the minister's announcement, not least because I am the father of two 11-year-old boys.
Having heard the minister, I take it that she is quite confident when she assures us that the MenC vaccine will be readily available. If that is indeed the case, why is it that—well into October, after term has started—Mary Scanlon has yet to receive an answer to a question that she asked on 10 September, before term started, about the availability of such a vaccine? The only answer that she has received has been through the statement today. Surely it is proper for a member to expect an answer on such an important issue, where time is of the essence, within seven weeks. Even now, she has not received the answer.
If there are outstanding parliamentary questions to be answered, I am happy to look into that, as any member studying the Official Report will be able to see. Along with my colleagues, I receive a considerable volume of parliamentary questions. I am not aware of any outstanding questions, but I am happy to check. However, to avoid confusion among the people whom we represent, I should clarify the fundamental fact that these are two different vaccines. It is very important that we do not confuse the public as a consequence of our political debates in this chamber.
I join in the welcome for the minister's announcement.
Would a 17-year-old who is a student be better advised to take the MenC vaccine at home or to take what is available through the university authorities? If that question cannot be answered here, could some advice be given?
That is an important question. I have stressed from the outset that the logistical exercise that we are embarked on is, to say the least, significant. School would be the normal place for 16 and 17-year–olds who are at school to receive the vaccine; the issue of 16 and 17-year-olds who are no longer at school is one that the implementation group is actively considering. I fully expect there to be further information and advice on that very point in the near future.
We will have a very brief last question, from Brian Adam.
In
that case, I will skip my welcome.
Is the usual incentive arrangement for payment to GPs in place to increase the uptake of this extremely welcome new vaccine? I am aware of such arrangements for the measles, mumps and rubella vaccine, for example.
Probably more than anyone here, I am mindful of getting my facts right when talking about GPs. I am happy to give a detailed written response on the precise payment arrangements in this case. As some members will know, GP payment arrangements vary in complexity. I can assure members that GPs will receive a payment for every vaccine given under the new MenC programme.
That concludes the time allotted for the statement.