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The
gentleman in Whitehall is wrong about MMR
By Robert Haris
(Filed: 05/02/2002)
IT is now more than 60 years since the Labour MP Douglas Jay
made what is still, perhaps, the most irritating declaration in modern
British politics: "In the case of nutrition and health, just as in the
case of education, the gentleman in Whitehall really does know better what
is good for the people than the people know themselves."
You would think that times had moved on since the Second
World War, and that Whitehall at last would have learnt a little humility.
But no. The song of the Jay, like the sound of the first cuckoo, is still a
perennial part of the British scene. Ssshhh. Listen. You can hear it even
now, warbling away as strongly as ever, in its traditional nesting ground,
the Department of Health.
Most readers will probably not have bothered much about the
controversy over the single dose measles, mumps and rubella (MMR)
vaccination. Frankly, I wouldn't have bothered much myself, except that I
have a 15-month-old son who is due to be inoculated later this week, and an
eight-year-old nephew who suffers from autism. Such coincidences tend to
concentrate the mind.
When I was growing up, everyone used to get measles, mumps
and rubella (German measles) and hardly anyone had heard of autism. Now the
equation is exactly reversed. Almost nobody gets MMR, but almost everybody
seems to know someone - a friend, a colleague, a family member - who has
been touched by autism.
As Dr Kenneth Aitken, an autism specialist, said on ITV last
night: "When I was training, one in 2,500 [children was autistic]. Now
it is one in 250." The only logical explanation, he said, is the MMR
vaccine.
Few in the medical profession would go so far in making that
link as Dr Aitken, or Dr Andrew Wakefield, the now-famous expert at the
Royal Free Hospital, who treated my nephew and who lost his job over the
MMR injection just before Christmas.
They have certainly produced no absolute scientific proof of
their suspicions. Instead there are just a few scraps of disputed evidence,
in particular a disproportionately high incidence of the measles virus
lodged in the intestines of autistic children who have had the MMR vaccine.
That - and the sheer, unscientific common sense which
whispers in the ear of every parent: that to inject three live viruses into
a baby certainly sounds like the sort of intervention that might
conceivably produce, in a tiny fraction of cases, a catastrophic reaction.
A sensible health service - especially one quite rightly
dedicated to stamping out these miserable diseases - might at this point
have decided to offer parents a choice between giving their child the
single MMR jab or the old method of three separate shots. This, after all,
is what 85 per cent of us want, according to the latest opinion poll; this
is what actually happens - oh, the wearily familiar comparison! - in
France.
But there is something structurally wrong with our health
service, and the MMR issue goes to the heart of it. Managed from the top
down in Whitehall, it sees statistics rather than people, prefers
administrative simplicity to the chaos of choice.
What parents like myself and my wife - and, I suspect, the
Prime Minister and his wife, too, until political realities dragged them back
into line - what we, as educated individuals, might prefer for our child
simply isn't an issue. We are merely statistics.
And the statistics show that we aren't to be trusted, that
some of us are likely to prove too feeble-headed to complete the full course
of injections if the NHS went back to the old system. So we are told to
swallow our worries, get it all over in one go, and watch that MMR needle
slide in.
Well, I'm sorry, but having seen the effects of autism at
first hand, this family won't do it, however infinitesimal the risk. And
nor, after Sunday's even-handed Panorama report, and last night's ITV
programme, will hundreds of thousands of others. The Department of Health
is about to spend £3 million on an advertising campaign to convince us we are
neurotic fools.
It won't work. Alan Milburn would do better to put the money
towards the cost of giving us all a choice - which is what he'll probably
end up having to do in any case, to avert an epidemic.
So on Friday, at a cost of £220.50, our son will begin the
traditional course of separate injections. It's expensive because the
former NHS economies of scale no longer apply, and because two of the
vaccines have to be imported from France and America.
I'm still enough of an old Lefty to feel guilty about
private health care. But then, when I think about it further, the guilt
curdles into a kind of rage that, as usual, it is the poor who are let down
by the NHS - who pay their taxes and yet have to take what they are given,
like it or lump it, like supplicants at some Victorian charitable
institution.
As Lord Desai, professor of economics at the LSE and a
former Labour spokesman on health, told the Observer on Sunday: "We
have constructed for ourselves the most appalling health system. The time
has come to rethink it totally and look at wild ideas."
For while the middle class, as he says, can always opt out,
"it is the worse-off who suffer in hospital waiting rooms and are left
waiting in corridors".
Mass immunisation once seemed to offer a perfect example of
universal health care in action. But now, with MMR, even this has come to
be tainted by double standards. Increasingly, we want the same kind of
choice over health that we have in every other, less vital aspect of our
lives, and if the gentlemen in Whitehall won't give it to us, then we shall
simply have to seek it for ourselves.
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