Appendix F 431 18 JANUARY 2001 432

and quickest way in which we could remove some of the fear would be to make the single vaccine available to those parents who ask for it? The First Minister: A medical expert sitting on my right tells me that there is no spurious research. We should not dismiss research of such importance from Finland. If concern about the MMR vaccine is expressed throughout the country, people need reassurance. The Executive makes every effort to use science to confirm to people that the MMR vaccine is a safe method. It has also been claimed that there are links with Crohn’s disease and autism, but there is no robust scientific evidence to suggest that that is the case. It is also important to note that the single vaccines carry difficulties and health threats. I will write to Lloyd Quinan to give him a fair amount of background material on the triple vaccine as well as the single vaccine and to say what the Government is doing to reassure people in every public utterance. We want to meet the target of 95 per cent immunisation. We can all attempt to do that. Dr Richard Simpson (Ochil) (Lab): Does the First Minister agree that using terms such as “spurious” to describe the research paper from Measles, Mumps and Rubella Vaccine Finland, which involved 18 years of research and 4. Mr Lloyd Quinan (West of Scotland) (SNP): 2 million individuals, does not serve the case of To ask the First Minister what measures have those parents who have understandable concerns been taken in response to drops in recent years in about the increasing rates of autism? the uptake of the MMR triple vaccination. (S1F- Mr Quinan rose— 775) Dr Simpson: If there is no link between the The First Minister (Henry McLeish): I preface MMR vaccine and autism, there is a danger that my answer by saying that I was glad to see Lloyd those parents are going down a cul-de-sac and Quinan at the launch of the arts exhibition by the pursuing a wholly spurious cause, which may cross-party group on autistic spectrum disorder. It ultimately be damaging for them. is first class. It takes place in the Parliament and allows parliamentarians to participate on issues on The First Minister: I have suggested that which there should be consensus. advocacy of concern should always be put into perspective. There is a danger that the uptake of There are on-going public education measures immunisation will fall. That would not be good for by the Health Education Board for Scotland. The children or for the health of the country. chief medical officer has written to health professionals on several occasions reaffirming that On such issues, we have to build on facts. We expert advice remains that the measles, mumps can do that, and we can ensure that parents and rubella vaccine provides the best protection appreciate it and understand it. We must do as against those three potentially serious diseases, much as we can to reassure them. I take Richard and exhorting them to continue to encourage Simpson’s point entirely. parents to bring their children forward for immunisation. Mr Quinan: On behalf of the many parents and children who provided material for the exhibition, I thank the First Minister for being kind enough to open it for us last week. Does the First Minister agree that the current climate of concern, trepidation and fear that is being experienced by parents over the MMR vaccine is not helped by the introduction of spurious studies from Finland, and that the easiest

16 Appendix G 1081 8 FEBRUARY 2001 1082 why I welcome the MRC research on autism. The problem will not go away. Parents will not change their minds on the vaccine. I look forward The second concern, which is where we to the report of the Health and Community Care politicians come in, is about the efficacy of the Committee, which is likely to be both informative vaccination programme. We cannot just blindly and useful. However, at the end of the day, we will say that we think that something is right, so we will have to come to a decision. We should offer not listen to parents’ concerns. Parents have no parents the choice that they require and deserve. I choice at the moment. While I agree with much of hope that we can reach a point where we agree on what was said in the press release by the RCN, that. the BMA in Scotland and others, I take issue with the paragraph saying that “Parents should be encouraged to discuss any concerns 11:23 they have regarding the vaccination with their GP, practice Dr Richard Simpson (Ochil) (Lab): Some of nurse or health visitor who will be able to provide detailed what I was going to say has already been said, but information allowing the parent to make an informed I will emphasise some points. We have already choice.” had a member’s debate, initiated by Lloyd Quinan, What is the choice? It is MMR or no vaccination which raised many of the concerns about the at all. Is that a real choice? I am looking forward to MMR vaccine. I am sorry that I missed that our report setting out a range of options. The debate. single vaccine is not necessarily the panacea that Debating this motion when the Health and some people believe—it is untested, untried and Community Care Committee is on the point of brings problems of its own. I will wait until our receiving its report is almost a discourtesy to the report comes out before taking a final position on Parliament because it bounces us into making the matter. It is a complex issue and one to which decisions. I will vote against the motion, although I Parliament must return when we have a little more will keep an open mind on the Health and than three minutes each in which to discuss it. Community Care Committee report. I look forward The Deputy Presiding Officer (Mr George to discussing the issue once I have been able to Reid): We move to the open debate. Members consider all the evidence. I say that as someone have no more than three minutes each. who has read much of the evidence and many of the studies. 11:20 The first challenge to the vaccine is that it is not Shona Robison (North-East Scotland) (SNP): safe. Dr Wakefield recently attacked the vaccine Tommy Sheridan opened the debate by saying as unsafe and suggested that it had been that he does not know whether there is a causal inappropriately licensed. That is invalid for two link between MMR and autism—that goes for most reasons. First, as Malcolm Chisholm mentioned, members, if not all. However, we know that there the number of doses that has been used across are parental fears. We have all met parents who the world demonstrates that there are no real have real concerns. No matter how many safety fears. Secondly, there are the results of the reassurances are given by the Government, the initial Finnish twin study, published in 1986, which BMA or anyone else, a sizeable minority of met the strictest scientific criteria. The study was parents will decide not to give their children the unique and classical—it was a placebo-controlled, MMR vaccine. double-blind twin study and demonstrated the vaccine to be safe. We must accept that over the years there has been growing public scepticism about Government Not only is the vaccine safe, evidence published reassurances. Rightly or wrongly, people no last year by the Finns in the Journal of the longer accept everything that the Government or American Medical Association demonstrated the medical profession says. What can we do? We positive benefits. The Finns were also considering must accept that the result is that some parents another theory, which is held there and which was will choose not to vaccinate their children. That is suggested here by a doctor—I am sorry to say—in the worst possible outcome and puts children in an article in the Daily Record not so long ago: that real danger. Margaret Smith made an important measles is not that bad because it somehow helps point. The BMA press release talks about the immune system. That is complete and utter “informed choice”, yet people are being offered no rubbish. The Finnish study shows that the levels of choice. What is the choice? It is our responsibility asthma, eczema and allergic rhinitis in children to take a pragmatic approach to the matter. In who receive MMR is reduced by between 32 and those cases where parents are refusing MMR, we 67 per cent when compared with those who have should consider offering a single vaccine— had measles. That was a substantial study measles in the first instance, followed by mumps showing that the MMR triple vaccine has benefited and rubella after the required period. the prevention of those diseases. I hope that we will be able to demonstrate that in Scotland, too.

17 Appendix G 1083 8 FEBRUARY 2001 1084

There is no doubt that the individual measles in the country expressing concern and telling me vaccine was an effective vaccine. However, the that there is a network of people who have level of measles in Scotland did not drop until the decided, because of their fear, not to take up the introduction of the triple vaccine. It was not until MMR vaccine. If we want to prevent a measles the mid-1990s that vaccination levels meant that outbreak, we must give access to the single the appropriate reductions in infection were vaccine, as of today. I appeal to Labour members achieved. to support the motion on the basis of the precautionary principle. That is what the people : Will the member give way? want—Richard Simpson knows that, as do I. I urge Dr Simpson: I am sorry, but I do not have time. members to confirm that today at 5 o’clock. The Deputy Presiding Officer: The member has 30 seconds left. 11:28 Dr Simpson: As Margaret Smith said, measles Malcolm Chisholm: Although the Executive causes death and disability, mumps causes deplores the circumstances of today’s debate, we significant disability and brain damage, and rubella are keen to have detailed discussion on the causes serious problems for unborn children. subject. That is why the Executive has invited Even if the link were to be proved, the situation is Professor Michael Langman, chair of the Joint not simple. As I said, I will keep an open mind until Committee on Vaccination and Immunisation, to a we receive the Health and Community Care meeting in next Tuesday morning. We Committee report. I look forward to seeing the have invited both the Health and Community Care evidence from the Dáil, the Irish Parliament, which Committee and the cross-party group on autistic is discussing the same issue. My last comment— spectrum disorders to attend, as well as health professionals. That will be a helpful opportunity to The Deputy Presiding Officer: Very briefly, Dr learn at first hand why the independent experts Simpson. are in favour of MMR and against the single Dr Simpson: It is my last comment. In Japan, vaccine approach. when the MMR vaccine was withdrawn, within a Offering single vaccines as an option is not the short time, there was a significant measles simple solution it is represented to be. Dr outbreak. The message must go out that no link Wakefield—to whom both Margaret Smith and Dr has been proven. On that basis, the MMR vaccine Simpson referred—has suggested there should be should be promoted to the greatest possible a 12-month gap between the three vaccinations. extent. However, there is not a shred of evidence to inform that advice. For 12 or 24 months, the child 11:26 concerned would be exposed to infection by mumps, measles or rubella, which can result in Mr Lloyd Quinan (West of Scotland) (SNP): death or serious illness. The potential As Dr Richard Simpson well knows, the Japanese consequences are not confined to that one child equivalent of the British Medical Association has but, importantly, may affect any other unprotected said that the measles outbreak is a direct result of child or adult with whom that child is in contact. the lack of uptake of MMR and the failure of the Japanese Government to instruct immediate Lloyd Quinan refers to the precautionary access to single vaccines. The gap period created principle, but there is nothing precautionary about the measles epidemic. the unnecessary exposure of infants to potentially serious infections. Children having to have three The simple fact about the Finnish study is that vaccinations, rather than one, would suffer 187 children were tracked—not the number of increased trauma at 12 to 18 months of age, and doses that were administered during that time. would require three booster doses, instead of one, The figures are misleading. It is true that a certain at three and a half to five years of age. number of doses was administered during the period of the study, but the study itself followed Nicola Sturgeon asked for choice, but there only 187 children. would be enormous difficulties in presenting a single vaccine option to parents. I remind Whether there is a link between the MMR members that 93 per cent of parents in Scotland vaccine and autism cannot be proved one way or take the MMR option for their children, and that the other. There is a simple reason for that: we do most of them have been supportive of that not know what causes autism in the first place. To particular vaccine. Providing an alternative would talk about a causal link or lack of one is to hold a immediately place a question mark against MMR. discussion on an irrational premise, because we Far from being reassured, parents would be utterly do not understand what causes the syndrome. I confused by being offered a choice, and children am standing here to say that I have received would be put at unnecessary risk. correspondence from people in every constituency

18 Appendix H 1019 7 JUNE 2000 1020

The Lancet, Andrew Wakefield from the Royal 11:55 Free hospital said that the MMR vaccine should be On resuming— withdrawn, a claim “not shared by his co-investigators”. Petitions Alan McGregor of King’s College London concluded that The Convener: We have a number of petitions “there had been no new evidence to suggest a causal link". this morning. The first is from Mr Bill Welsh In a letter to The Herald, Dr Peter Christie from the regarding measles, mumps and rubella Scottish Centre for Infection and Environmental vaccination. Committee members have received a Health wrote: detailed submission from Mr Welsh on behalf of a number of organisations, which raises several “the current accusations against the MMR vaccine and its questions. This is an area of great sensitivity. We supposed links to autism and Crohn’s disease are not even must discuss this case and decide on a course of supported by the published research which the anti- vaccination lobby quote so vociferously. Nor is there any action. The options are: to simply note the petition; evidence anywhere to suggest that single-component to appoint a reporter to investigate and report back vaccines are safer than MMR”. to the committee, and possibly do further work at that point; or to hold a full inquiry and take I am not a medically qualified person, but what I evidence, which would have to be done at a later am seeing is conflicting information. Whatever date, given our work schedule. procedure we use to progress the petition, how can we make decisions about whether one : We are grateful to Mr Welsh for the academic piece of research is more correct than detail in his petition and for his subsequent letters another? When I asked a question on this subject to us. The issue is causing concern, and I feel that in the Parliament, Iain Gray, to his credit, said that it is worthy of an inquiry, but I am well aware of the the Executive would be willing to fund research to time limitations that are on us; we could not clarify the potential link between MMR and autism. undertake an inquiry until at least after the recess. Before we start to use committee time to deal with However, my recommendation is to have a full the nitty-gritty of opposing academic positions, I inquiry and take evidence from all concerned suggest that we get hold of some conclusive parties. evidence. Dr Simpson: A number of issues are involved. There are concerns about the MMR vaccine, 12:00 although the evidence is anecdotal, and there is Malcolm Chisholm: Given the massive agenda almost certainly a rise in the number of individuals that we have, I would be concerned about our suffering from a disorder within the autistic getting into this kind of area. The Health spectrum, but whether those two are linked is not Technology Board for Scotland is the body that clear. Establishing a causal link between two rising should be looking into this. The board prides itself trends is extremely difficult on occasions. on the fact that, unlike its counterpart in England, it However, there has been sufficient concern about will not be told by the minister what it should vaccines and vaccination over a sufficient number examine; that may or may not be a good thing. of years that this is not a petition that we should When there is an issue of major public concern, is simply note. there some way in which the Health Technology Given the committee’s heavy work load, I Board can be encouraged to take it up? There is suggest that we appoint a reporter to undertake one medical expert on the committee, but it does some preliminary work for us over the next few not seem to me to be appropriate for a body such months; a lot of information would have to be as this to deal with a subject about which there is gathered, with the assistance of our clerks. That conflicting scientific evidence. When we receive would allow us to focus any subsequent evidence- petitions, can we at least flag up to the Health taking sessions, if we choose to have them, in light Technology Board for Scotland that there are of the reporter’s findings. issues that it might want to consider? Mary Scanlon: Following on from that, Ben Wallace: I agree. Given the committee’s convener, the letter from Bill Welsh to the clerk work load, to launch into a specific scientific says: investigation would be counter-productive. I want to pick up on Mary Scanlon’s point about what the “Mrs Smith informed me that this application/appeal to have informed scientific evidence presented to the Deputy Minister for Community Care said he Committee will be on the agenda within the next four would be willing to do. Perhaps we can write to weeks.” him to request that he expand on his commitment and provide us with a concrete plan or timetable According to an article published last month in for research. Once he has responded, we can

19 Appendix H 1021 7 JUNE 2000 1022 move forward from there. It is not for this do not even know the prevalence of the condition committee to carry out a scientific investigation in the British Isles. A preliminary investigation into this issue. would be valuable. Over the last 20 years as a journalist, I have held the view that we must Mr Hamilton: I agree with what Ben Wallace consider anything that the Department of Health has said. A distinction needs to be drawn between has told us with scepticism. The department has the sort of inquiry that Richard Simpson carried been found out on many issues. We must have an out, which was about consultation and local independent mind in Scotland. accountability—an area in which the committee has, if not expertise, at least a strong interest— The Convener: Let us not prejudge anything. and a scientific investigation. Frankly, the There are some general concerns about the issue committee is not qualified to make a judgment on and we have had anecdotal evidence from parents the issues at stake here. That is not to say that it who are concerned. It is part of the committee’s would be a bad thing to take a morning’s evidence job to allay any fears that we can. However, we on the matter. That would flag it up and provide a must take on board the fact that we are not time frame for the Executive to come back with a medical experts and therefore perhaps not the briefing document setting out its conclusions, best people to do all the work on our own, which the committee could test. I am perfectly although we may have a part to play. comfortable with that. However, it is not for the Irene Oldfather: It is important that we do not committee to provide the sole momentum on this try to reinvent the wheel. I recall from some of the issue. information presented in the petition that there is a Margaret Jamieson: I agree with Ben Wallace. congressional hearing on the matter. It would be We should inform the minister that we have useful to draw together some of the conclusions received this petition and that research into this reached in that and to consider what the US Food subject should be commissioned. However, to and Drug Administration is going to do, rather than return to what Malcolm Chisholm was saying, we to conduct the whole hearing again in this should test the Health Technology Board and ask committee. I am very conscious of what Malcolm whether it would look into this issue on our behalf. Chisholm said about the committee’s work load, Clearly, it is a matter of concern. There is a trend but I also agree with Kay Ullrich’s point, which is in the number of children being presented for that we should not close the door entirely. inoculation and it is decreasing; that is worrying. The Convener: As well as writing to the minister We are coming at it from two or three different and the Health Technology Board for Scotland, we angles. Given the work load, it would be better for will give members access to the congressional us to have the research conducted first. As hearings information and evidence. We will also Duncan Hamilton pointed out, that would give us ask the information centre to an informed basis for a decision. provide a background note. That would not be The Convener: We said that we would write to closing the door on the issue. the minister on the issue. If we write to him, we Dr Simpson: Without wanting to add to your could ask for his initial comments on the petition. personal work load, convener, perhaps you could We could also ask what research the Executive is take that matter forward. You might raise the undertaking or plans to undertake and request a issues that you have outlined with the Joint commitment on the time scale. At the same time, Committee on Vaccination and Immunisation, we could write to the newly formed Health which approves vaccines in the UK. We should be Technology Board to ask whether this is an issue asking that committee for its view. At this point, it that it is planning to consider and whether it is is important that the committee does not send out something that would fall within its remit, if we the message that it is an unsafe vaccine—it is a recommended that it consider the matter. We vaccine that saves lives. It is fundamental that we could come back to the issue, having ascertained do not get into the sort of nonsense that we had the answers to those questions. over the triple vaccine 20 years ago, which Kay Ullrich: We need the information, but let us resulted in substantial worsening of health, with not close the door. people getting whooping cough and children dying because the wrong messages were coming out of The Convener: Not at all. We could follow that committees. up. The Convener: We all agree whole-heartedly Dorothy-Grace Elder: I was interested in with that, Richard. Richard Simpson’s suggestion that somebody should try to prepare a preliminary report. If that Kay Ullrich: I had a phone call last week from report found out even what we do not know, it somebody who is so concerned about what is would be useful. There are so many things that we being said about the triple vaccines that they want do not know, particularly in relation to autism. We to find out in which country they can buy the single

20 Appendix I 1217 20 SEPTEMBER 2000 1218 appointed Malcolm Chisholm as our reporter, and of proof that is required for an abstract is he is preparing his report. He said that he would considerably lower than that required for a peer- like to find a slot prior to the recess to consider the reviewed publication, which is what I have kept matter and we will try to facilitate that. We would harping on about. We should ask for the Medical all welcome the announcement that was made in Research Council to review the abstracts to see the past few days on warm homes initiatives for whether there is any stronger evidence that might pensioners in Scotland. That has been welcomed lead to a proper survey or study. warmly across the political spectrum. Dr Wakefield, one of the proponents of the Petition PE145 is on measles, mumps and existence of a link, believes strongly that there is rubella vaccines and autism. If members have also a link between the MMR vaccine and Crohn’s read the newspapers—sometimes I try not to, but I disease. Again, that link has not been proven, but cannot help myself—they will be aware that over Dr Wakefield claims new evidence, which needs to the past weeks and months there have been a be examined. The committee should go on record number of reports and some developments on this as saying, as it did originally, that it will continue to subject. The Scottish Parliament information examine the evolving story, but that it has not as centre has prepared a research note, which yet received sufficient evidence to propose any members should have received by e-mail changes to the minister. yesterday. I am afraid that I have not received Mr Hamilton: How does Richard Simpson’s mine, so I am not sure whether the system has recommendation—for the MRC to look at the worked for everybody else. abstracts and determine whether further research Those developments are on-going and there is is required—relate to what the MRC says it has public concern. The committee does not wish to done? The SPICe research note on the matter be part of anything that causes concern, if that says: concern is unjustified, but there seems to be “On 3 April 2000, the MRC announced that it would 'fund anecdotal evidence on, and scientific discussion one of the largest studies of autism ever attempted.’” about, the safety of the MMR vaccine. We ought to look at that. I invite members’ comments on how Dr Simpson: I do not know the terms of the we should proceed. study on autism or whether it would encompass the question of a link to the MMR vaccine. As I Mr Hamilton: Our papers say that the Executive understand it, the study did not aim specifically to was given until 15 September to answer the points prove or disprove a link with MMR, but was based that were raised by the committee. Am I right in on the fact that there had been a rise in autism saying that there has been no response? over the past decade and that that rise was The Convener: There has been no response. coincidental with the introduction of MMR, but was not causally linked to it. That is an important Mr Hamilton: I see a pattern developing. distinction. The MRC has been invited to examine The Convener: Yes. I wonder why and how— the possible causes of a rise in autism; I have given the differences in resourcing between the gone on record, both in Parliament and in the Parliament’s committee system and the press, as commending that. Those causes should Executive—we manage to get through our work be investigated, but we should remain very and give prior copies of reports to the Executive, cautious about determining a causal link. but such courtesy and respect is not forthcoming Mary Scanlon: Committee members are having in the opposite direction. Given the David-and- difficulties with this, and we must empathise with Goliath situation that exists in resourcing, that is the parents who see both the scaremongering and unfortunate to say the least. the relevant, empirical research evidence. The subject is difficult for us, but for parents it is 10:15 horrendously difficult to decide whether their children should have the vaccine. We must try to Dr Simpson: Members may have noticed that I find answers fairly soon. No sooner is one report have been engaged in correspondence on this published to say that there is no possible causal matter over the summer. Two new papers, by Dr link but another report is published that contradicts Singh and Dr Wakefield, were presented at one of that finding. Somehow, the Parliament must seek the two recent conferences on autism. One of the reasonable guidance. conferences still does not think that there is a link with the MMR vaccine; the other one does. We I am concerned that uptake of the MMR must continue to be cautious, and the convener’s vaccination is lower than 90 per cent in five careful comments should be commended. Scottish health board areas. I believe that 90 per cent is the crucial level that is required to avoid an Even with our resources, I do not think that we epidemic. Serious problems are building up for us. can evaluate the two papers, which have not yet been published. They are abstracts, and the level I realise that we are due to meet the Health

21 Appendix I 1219 20 SEPTEMBER 2000 1220

Technology Board for Scotland, but while we are to prevent. The reduction in the number of cases struggling over correct and sound evidence, I am of problems and complications from measles, disappointed that we cannot get some steer or mumps and rubella has been significant, ranging advice from the new board. Annexe B of our from 50 per cent to 90 per cent. Fewer people advice note says: suffer from encephalitis and serious brain problems as a result of the highly effective “The Health Technology Board of Scotland has indicated that this is not a matter that would fall under its remit.” immunisation programme. I appreciate that we are not dealing with a new As the convener has tried repeatedly to do from medicine, but surely someone among all the new the chair, we must send a very cautious message. organisations in Scotland can give us a steer on The parents of Scotland have a right to have us the matter. consider the matter seriously. We should do that and keep on considering whatever evidence is The Convener: The Health Technology Board produced. The headlines in the press are for Scotland suggested that we contact the unhelpful to say the least. They scare people and Committee on Safety of Medicines. We wrote to are not balanced by the opposite, which is that that committee during the summer recess. measles can cause death. Mary Scanlon’s point is well made, and in the The Convener: That balance is missing partly vacuum of contradiction, people will make up their because of what is unknown. I ask members own minds about their children’s safety. If people whether it would be worth while appointing a believe that there is any possibility of a risk, they reporter. The reporter’s job would be to keep a will err on the side of what they consider to be watching brief on the matter, to report back and to safety for their children when making decisions. work alongside the SPICe researcher who has That brings with it the difficulties that Mary done the paper for us. We ought to consider the Scanlon outlined, such as vaccination rates falling subject again after the October recess. By that to lower than 90 per cent, which might lead to time, we might have further information and a epidemics. We are not at a standstill, because the clear steer about what we ought to do. I would parents of Scotland will decide and we will have to appreciate committee members’ thoughts on that. act on that. We are dealing with something highly technical. None of us is up to the task of deciding Mr Hamilton: To pick up on my previous point whether the MMR vaccine should be used or about writing to the MRC, can we ask it to outline recalled. the specific research that is being done at the moment, before we consider additional research? The one thing on which we all agree is that there is public concern, and concern in the committee, We should be careful about defining the about the issue. I look to members for what they committee’s job and expertise, and about how we consider to be the best course of action for the proceed. The committee’s role is to try to give committee. Richard Simpson has suggested that some momentum to the research and to try to we write to the MRC to ask it to consider the two relay the sense of urgency that has been relayed new papers and whether further testing of the to us. It would be wrong for the committee to think theories behind those papers should be carried that it can do more than other agencies. out. I am happy to appoint a reporter who would The committee should be aware that the have the specific and exclusive responsibility of situation is developing and that it may take time monitoring the progress of the research; but I before we get a scientific answer. As a result, we would be slightly nervous about our reporter taking may have to deal with the consequences of a more active role. parents making their own decisions on gut instinct. Mary Scanlon: I would go along with that. Dr Simpson: A number of different groups are Richard Simpson would appear to be an involved. We have written to the Committee on appropriate choice, as he takes an interest in such Safety of Medicines. The Joint Committee on matters and is likely to read most of what comes Vaccination and Immunisation is also involved. his way. In Ireland, where doubts about the vaccine have The Convener: And understand it. been raised quite forcefully over the past couple of Mary Scanlon: Yes—he did a wonderful report years, the immunisation rate has dropped and on Stobhill hospital. deaths from measles are occurring again. Like many medical decisions, such decisions are not Would it also be appropriate for us to ask for free from risk on either side. Measles can cause advice and judgment from our new chief medical death, mumps can cause infertility and rubella can officer? cause profound disability in growing foetuses. That The Convener: I was going to make that point. is the reality that the MMR vaccine was designed If we decide to have a reporter on the subject

22 Appendix I 1221 20 SEPTEMBER 2000 1222 continuously, the views of the new chief medical officer ought to be sought at an early stage. I think that we should have a reporter, on the terms that Duncan Hamilton outlined. Politicians do not know everything—we in this room understand that more than most. On the MMR vaccine, we must put up our hands and admit that we do not have the expertise or knowledge. However, we have real concern about the situation and about the fact that it may lead to problems with immunisation rates in Scotland. Our reporter’s job will be to monitor the situation and—as Duncan Hamilton said—to add momentum to the research, which must be done timeously. We must protect our children from MMR, but we must also put parents’ minds at rest over the fear of autism. Members indicated agreement. The Convener: Do we have a volunteer to be our reporter on MMR? Will anyone fight Richard Simpson for that role? Dr Simpson: I am deeply involved in something that we will discuss in private session—organ donation—so I would prefer it if someone else were prepared to take on the MMR reporter role. The Convener: If any other member is interested, they should e-mail the clerks. I am sure that Richard Simpson would be available to assist if anyone needed information on any medical points. Dr Simpson: I would be happy to assist. The Convener: I am sure that the SPICe researcher would also be available to assist in building up lists of who we should contact and how we should go about the monitoring. I appreciate that reporting on the subject will be a fairly daunting task for anyone who is not medically trained, but he or she will not be alone.

23