Hansard

I commend Jackson Carlaw for his speech, which identified some of the political issues in an exemplary way.

The greatest public health achievements have been the provision of clean water and sanitation and cleaner air, and the recognition—only four centuries after James VI of Scotland and I of England recognised it—of tobacco as a hazard. However, as the minister, Graeme Pearson and many others said, vaccines are one of the greatest of all the achievements, and there is no doubt that there is more to come. Jamie McGrigor was right to praise our scientists for their innovation in not only human vaccines but in veterinary science, where vaccines are also important.

Successive Governments have delivered a world-class vaccination programme and lives have been saved. We can prevent cervical cancer with the HPV vaccine rather than rely solely on cervical screening, with its shortcomings, as illustrated by Aileen McLeod. The new rotavirus vaccines, the phasing in of the intranasal influenza vaccine for children and the shingles vaccine for the over-70s will all further enhance the quality of many lives. They are worthwhile investments, as will be the meningitis B vaccine.

Patrick Harvie referred to the potential to extend the HPV vaccine to boys to achieve herd immunity. That would mirror the switch from giving the rubella vaccine only to girls—that was a difficult programme to try to eliminate rubella and prevent problems in pregnancy, as Rhoda Grant said—to having the MMR vaccine for all.

We should not forget that the international picture is different. The success in eradicating smallpox, which Jackson Carlaw referred to; the near eradication of polio; the substantial reduction in measles; the progress on addressing yellow fever; the prospect of a useful vaccine to tackle a resurgent malaria—all are welcome. As Jim Eadie said, the international programmes might be saving 2 million to 3 million lives a year.

Colin Keir was right to remind us of the deaths from Spanish flu after the first world war. Further pandemics are inevitable and we need to be prepared for them. I hope that their effect will be as soft as that of the swine flu pandemic was.

If it is validated, the new tuberculosis vaccine that is being developed in India to replace or add to the BCG will be welcome. In the meantime, we need to scrutinise our TB detection programme in at-risk groups. The rates of TB and resistant TB have risen significantly, and I am not convinced that our detection programmes are adequate.

At home, we have had the measles outbreak, although it was at nothing like the levels of the 1960s, as the minister and Nanette Milne graphically reminded us. Mumps rates have also increased because of the MMR problem, although—fortunately—not in Scotland. That suggests that the decline in uptake left by the MMR debacle has not been fully repaired.

Along with my colleague Rhoda Grant, I still have concerns that the decision not to have a national advertising campaign on MMR may yet expose some older children to all three diseases. I hope that I am wrong.

I ask for the media failures in the 1980s on pertussis and in the 1990s on MMR to be taught in college journalism courses—Joan McAlpine might be able to help us with that.

General uptake of all vaccines is good, but the degree to which uptake differs among socioeconomic groups is unclear from the routinely published data, and we should look at that as part of standard publications. Jim Eadie made a plea for us to look closely at health inequalities. The vaccines for which uptake does not meet the required percentages need to be looked at carefully to understand why that is happening, what the barriers are and whether we can improve the figures. The vaccination programme is otherwise excellent.

Like me, Graeme Pearson referred to pressures on staff, which we mention in our motion. As he said, those pressures are significant. The efforts of our staff should be applauded again—they do a fantastic job—but we need to acknowledge the pressures. I hope that midwives’ input during and post-pregnancy will be monitored, because their involvement in the vaccination programme through not only giving advice but giving vaccines merits attention.

UK’s Joint Committee on Vaccination and Immunisation may recommend more new vaccines, such as the most recent meningitis B vaccine. Joan McAlpine was right to remind us of the excellent campaign that has been run. We often rely on individuals who have suffered from our regimes’ failures to bring fully to our attention the need to undertake new measures. The recent campaign has been successful and helped the joint committee to take the step of introducing the meningitis B vaccine. Joan McAlpine also reminded us of not only the costs but the benefits from prevention in children and from reduced hospital costs and reduced time spent in hospital.

I recognise that the debate has been consensual, as it should be. We will support the Government motion and its immunisation programmes, but continue to be critical where that is appropriate.

My one concern is that we have managed to get through the whole debate without mentioning the referendum in September. The JCVI has served us well, and I wonder what our approach would be after 18 September, were we to be independent. Would we accept JCVI determinations without any Scottish representation—Scottish representatives have made a huge input—or set up our own vaccination and immunisation advisory committee, as Eire has done with its national immunisation advisory committee? What plans does the Government have in the—I hope—unlikely event of its winning that referendum?