I am delighted to serve under your chairmanship, Mr Pritchard. I echo a feeling of sympathy for my hon. Friend the Minister, because in a sense she is the meat in the sandwich. Time after time she has to answer such debates, but, as she and the House know—the hon. Member for Foyle (Mark Durkan) certainly knows this, because I had an Adjournment debate on 7 July 2014 on this subject—there has been an ongoing campaign on this for a long time in the House.

My hon. Friend the Member for Bath (Ben Howlett) is right that meningitis B is a terrible disease that—as other hon. Members have said—comes on suddenly and, at least in the early stages, is often not recognised by health professionals, let alone parents. More publicity should be given to the disease so that people are aware of what to look for. Given that only yesterday I heard a public health advertisement to encourage parents to get their babies vaccinated against MMR, I am not sure why we should not have such a publicity campaign for meningitis B.

The Bexsero vaccine was first licenced by the European Medicines Agency on 1 January 2013. The Minister wrote to me in April 2014 and said that it would be ​rolled out for children under two months, with a one-off catch-up programme for children born between 1 May 2015 and 30 June 2015. I use that illustratively, because at that stage we did not know when the vaccine was to be introduced. The Minister will say that by 2017 all children under two years will be covered, but if the vaccine had been rolled out at the time of my Adjournment debate, in which we were urging the Minister to do that for all children under one, more children would have been covered. In that debate she said:

“Children aged less than five years are most affected by MenB…the peak of the disease is in infants aged 6 to 12 months.”

She went on to say that

“MenB is fatal for about one in 10 of those who develop meningitis…With early diagnosis and treatment, most people can make a full recovery”.

That is true. She also said:

“Incidence has been decreasing in recent years…but it is unpredictable and it could rise again quickly.”—[Official Report, 7 July 2014; Vol. 584, c. 137.]

The disease has an unfortunate habit of falling and rising in incidence, so it could very well start rising again. The Joint Committee on Vaccination and Immunisation set up a working party in 2013—I think in June—to look at vaccinating all children under one year. What has happened to that working party? Have we got the results yet?

This is an unfortunate issue, because as many hon. Members will know—particularly those who have had young children more recently than when my two were youngsters—we often have to take young children to the surgery anyway, so the costs to the NHS of administering the vaccine would be minuscule: just the cost of the drug. There is also a unit cost issue—if GlaxoSmithKline had to make more of the vaccines, presumably the price would come down. I urge the Minister to consider the anxiety that the disease causes and the vast number of people who signed the petition. It was the largest petition ever for such a debate, and I pay great tribute to the House for changing its procedures to introduce such interactive debates so that we can consider the concerns of large numbers of constituents on such issues. I originally got involved in the meningitis B campaign after my constituents, Dr and Mrs Turner, contacted me about their granddaughter, who sadly died from the disease, but it obviously concerns large numbers of constituents.

We should not consider this vaccine as just an issue of cost. We know that the drug is safe. It has been licensed since 1 January 2013 and in the United States, the student cohort at many universities received the vaccine at least two years ago, and it was also trialled in adolescents at a university in this country. It therefore appears to be safe, although the JCVI wants to look at that issue. I say as gently as possible to the Minister that we should not let this be purely an issue of cost. If we have a drug that works—we know it is effective—and it is simply an issue of cost, we should at least consider rolling it out to all babies under one year old and preferably to all children under five.

 

 

My hon. Friend makes a powerful case for the drug’s safety. We just heard an agonising story from my hon. Friend the Member for Bury North (Mr Nuttall) about Charlie ​and his experience, so does he agree that the cost and suffering of those who survive men B should be factored into the consideration of a catch-up scheme?

 

 

I entirely agree. I will ask the Minister to clarify this, because when I sat down she said sotto voce that it is one year, but my information is that, from when it started, it was for all those under two months of age on 1 September 2015, with a one-off catch-up programme for babies born between 1 May 2015 and 30 June 2015—those who were three or four months of age when the programme was launched. Therefore, while by now it may have nearly spread to one year, that was not the case when it was introduced. We should consider rolling it out definitely to those who are one year old today and preferably to those a little older as well.

I turn to the Department of Health’s cost-effectiveness methodology for immunisation programmes and procurement—the so-called CEMIPP, which is a dreadful acronym. The Minister will tell us that that looks at the life-cost issues, but those who contract meningitis and suffer long-term effects face not just the £30,000 to £40,000 of costs my hon. Friend the Member for Bury North (Mr Nuttall) mentioned, but considerable life-long costs afterwards. The discounting rates, as hon. Friends have said, are particularly mean in that respect, so to look at the issue in the round we must look seriously at the cost to the public purse of not vaccinating. That route could show us more clearly that a roll-out to a larger cohort would be cost-effective.

 

 

Meningitis Now is headquartered in my constituency. To follow on from my hon. Friend’s point, should we not think that prevention is better than cure? That should be the overall strapline to the debate.

 

 

My hon. Friend is right. I pay tribute to the charity based in his constituency and to the other meningitis charity, because they have been campaigning for many years on meningitis B and all the other strains.

The point about rolling out the vaccine to the cohorts—I urge the Minister to go further than that—is that my understanding is that once someone is vaccinated for meningitis B with Bexsero, they are covered for life. Therefore, if more cohorts are covered by the roll-out, more of the population will be covered and the entire population will become less susceptible.

 

 

My question follows on nicely from the point made by the hon. Member for Stroud (Neil Carmichael) in his intervention about the long-term costs. I first came across this issue at a reception held by Meningitis Now. I commend that charity and the Meningitis Research Foundation for their excellent work. In terms of special educational needs, long-term costs can come in when a child reaches 12 or 13 and it becomes apparent that they are not developing at the same rate as other children. All sorts of educational implications should be factored into the long-term costs.

 

 

I could not agree more. That is why the CEMIPP group study should look at not only the medical costs but the educational costs, the ​cost of carers and so on. There are considerable costs to the public purse. We tend, under our democratic system, to be quite short-termist in our view of such matters. I am involved at the moment in work on drugs for cystic fibrosis, to which exactly the same issues apply. After the considerable cost at the outset, there is a lifelong benefit to babies from getting such drugs. If we are going to carry out a cost-benefit analysis for the meningitisusb B vaccination, that is what we should consider.

 

 

I agree with the vast majority of what the hon. Gentleman says. In actual fact, it was not possible to trial Bexsero in humans because this is such a rare condition, and therefore we do not yet know whether the immunity will be for life.

 

 

I am extremely grateful to the hon. Lady. The benefit of these debates is that we always have a professional on hand who can give us the last word on the subject. My sister is a GP and would no doubt have given me that same advice.

I congratulate my hon. Friend on leading this very important debate. I have been involved in this campaign for a considerable while. Does he agree that there is not an issue about the safety of the drug, because it is very safe—we know that because it has been used very safely on students in American universities—and that it is simply an issue of cost?

 

 

I thank my hon. Friend for his intervention; I am aware of his work in championing this cause, which he has done for a while. I very much hope that the Minister will consider that point when she makes her summation.

I hesitate to intervene on my hon. Friend, especially as she is such an expert on this subject, but as I understand it, Bexsero was licensed by the European Medicines Agency on 1 January 2013. It was not introduced in this country until more than two and a half years later, and people will have died of the disease in the interim. Does my hon. Friend not think that is too long a process when the argument is not about the safety of the drug but purely about the price? Something needs to change. The negotiation with the drugs companies needs to be done in a different way.

 

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I fear that I am becoming the bane of the Minister’s life over this issue, so I apologise, but I am grateful to her for giving way. One of the issues that I raised in my speech was the unit cost. As I understand it from her reply today, she does not think that there is a case yet for rolling vaccination out to children under five. Would she undertake to keep this matter under review, and would she also undertake to ​ensure that the JCVI, or Department of Health officials, will continue to have discussions with GlaxoSmithKline on what the drop in the unit cost might be if all these extra vaccinations were given to under-fives?

 

 

I can assure the whole House that the JCVI keeps that under constant review. It is not something that is occasionally dusted off and looked at every four or five years. The committee looks at all the factors that go into making the relevant decisions. When the factors that contribute to its decision making change, it looks into them. I have already given the House the assurance that the JCVI will keep that under careful review. The Select Committees heard directly from Professor Pollard and had that assurance from him. However, I will draw the JCVI’s attention to the concerns raised in this debate and the huge level of interest in the matter in the House and among the wider public.