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Government's reticence over measles jab 'putting public health at risk' Government's reticence over measles jab 'putting public health at risk'
(about 14 hours later)
The government's former chief medical adviser has accused ministers of jeopardising public health advances and questioned whether the new-look NHS in England is capable of dealing with a national emergency including a big measles outbreak. The government's former chief medical adviser has accused ministers of jeopardising public health advances and questioned whether the new-look NHS in England is capable of dealing with a national emergency such as a widespread measles outbreak.
Sir Liam Donaldson has also backed attempts to introduce plain packaging for cigarettes, a measure dumped by David Cameron in the run up to the Queen's speech this month, and minimum alcohol pricing, a measure he advocated four years ago but was opposed by Gordon Brown. Sir Liam Donaldson has also backed attempts to introduce plain packaging for cigarettes, a measure dumped by David Cameron in the run up to the Queen's speech last month, and minimum alcohol pricing, a measure he advocated four years ago but was opposed by Gordon Brown.
"We used to lead the world in public health," he said, "But we are now becoming followers and late followers at that, tramping along after everyone else has done the innovation.""We used to lead the world in public health," he said, "But we are now becoming followers and late followers at that, tramping along after everyone else has done the innovation."
Donaldson, now professor of health policy at Imperial College London and patient safety envoy for the World Health Organisation, is worried the new hands-off arrangements in England between ministers, the Department of Health, its executive agency Public Health England (PHE), the NHS and local authorities would not prove up to the challenge. Donaldson, professor of health policy at Imperial College London and patient safety envoy for the World Health Organisation, is worried the new hands-off arrangements in England between ministers, the Department of Health, its executive agency Public Health England (PHE), the NHS and local authorities would not prove up to the challenge.
Donaldson, who was England's chief medical officer (CMO) between 1998-2010, said PHE must set a firm direction on the new MMR catch-up campaign targeting children of secondary school age and be "appropriately outspoken" on other public health issues.Donaldson, who was England's chief medical officer (CMO) between 1998-2010, said PHE must set a firm direction on the new MMR catch-up campaign targeting children of secondary school age and be "appropriately outspoken" on other public health issues.
"They need to plant a flag in the ground and establish their credentials, " he said, rather than adopt a laissez-faire approach. "Obviously we need GPs to do as much as they can but essentially this is a teenage and pre-teen population which is captive in schools. That is really where we should go. I would have said 'we are going to sweep across schools now for the whole country'." "They need to plant a flag in the ground and establish their credentials", he said, rather than adopt a laissez-faire approach. "Obviously we need GPs to do as much as they can but essentially this is a teenage and pre-teen population which is captive in schools. That is really where we should go. I would have said 'we are going to sweep across schools now for the whole country'."
Donaldson said the former prime minister Tony Blair's reluctance to say whether his son Leo had had the MMR jab caused major problems for public health experts, who were trying to convince parents to innoculate infants in the face of the "junk science" link to autism from Andrew Wakefield. Donaldson said the former prime minister Tony Blair's reluctance to say whether his son Leo had had the MMR jab caused major problems for public health experts, who were trying to convince parents to inoculate infants in the face of the "junk science" link to autism from Andrew Wakefield.
Donaldson warned that bodies that were important in monitoring health risks from threats such as Sars or pandemic swine flu had been swept away, leaving much weaker links between public health teams and the NHS. The new devolved arrangements meant it was difficult to implement a 'command and control' approach, he said.Donaldson warned that bodies that were important in monitoring health risks from threats such as Sars or pandemic swine flu had been swept away, leaving much weaker links between public health teams and the NHS. The new devolved arrangements meant it was difficult to implement a 'command and control' approach, he said.
"Vaccination is the simplest of all public health measures, even if the delivery system might vary in different parts of the world. Compared to reducing obesity and smoking rates and binge drinking, vaccination is the purest of public health interventions and we should have a lot of expertise in it."Vaccination is the simplest of all public health measures, even if the delivery system might vary in different parts of the world. Compared to reducing obesity and smoking rates and binge drinking, vaccination is the purest of public health interventions and we should have a lot of expertise in it.
"I do think it is a test of public competence. That is the A of the ABC of public health – vaccination and getting high levels of coverage.""I do think it is a test of public competence. That is the A of the ABC of public health – vaccination and getting high levels of coverage."
Comparing the speed of immunisation programmes in England and the UK unfavourably to those in countries such as India and in the Americas, Donaldson said: "Some of those are very poor countries but they have managed to reduce vaccine-preventable diseases to very low levels."Comparing the speed of immunisation programmes in England and the UK unfavourably to those in countries such as India and in the Americas, Donaldson said: "Some of those are very poor countries but they have managed to reduce vaccine-preventable diseases to very low levels."
Donaldson's exasperation with the government was also signalled in a recent opinion piece in the BMJ in which he and an Imperial colleague, Felix Greaves, questioned whether it was "ethically acceptable to tolerate any serious complication, or death, from measles when an effective vaccine is available".Donaldson's exasperation with the government was also signalled in a recent opinion piece in the BMJ in which he and an Imperial colleague, Felix Greaves, questioned whether it was "ethically acceptable to tolerate any serious complication, or death, from measles when an effective vaccine is available".
In a tweet on the day the government leaked its intention to not include the cigarette packaging measure in the Queen's speech earlier this month, he wrote: "Tobacco company shares rise: probability of UK Govt dropping plain packaging Bad day for public health. PH leadership requires courage" In a tweet on the day the government leaked its intention not to include the cigarette packaging measure in the Queen's speech last month, he wrote: "Tobacco company shares rise: probability of UK Govt dropping plain packaging Bad day for public health. PH leadership requires courage"
Public health experts throughout the UK, most recently Colin Blakemore, former chief executive of the Medical Research Council, in an article for the Times on Thursday, are increasingly worried that mumps and rubella outbreaks could follow measles. The lack of immunisation against rubella in teenage girls and young women is particularly worrying because of the risks in pregnancy to unborn children.Public health experts throughout the UK, most recently Colin Blakemore, former chief executive of the Medical Research Council, in an article for the Times on Thursday, are increasingly worried that mumps and rubella outbreaks could follow measles. The lack of immunisation against rubella in teenage girls and young women is particularly worrying because of the risks in pregnancy to unborn children.
PHE told the Guardian it was leaving it to local authorities to decide how they ensured children were vaccinated rather than ordering a programme in secondary schools as happened in Wales, though parents of thousands of children in the most at risk 10-18 age group have still failed to ensure their offspring who missed their MMR in infancy have caught up on jabs in schools, at special weekend clinics or with their GP. PHE told the Guardian it was leaving it to local authorities to decide how they ensured children were vaccinated rather than ordering a programme in secondary schools as in Wales, though parents of thousands of children in the most at risk 10-18 age group have still failed to ensure their offspring who missed their MMR in infancy have caught up on jabs in schools, at special weekend clinics or with their GP.
An estimated 900,000 children in England are thought to be unvaccinated or only had one of the two jabs needed of the MMR because of the furore. Authorities on Teesside, where there is a major outbreak, organised school sessions before the national catch-up campaign was ordered last month. An update on progress is expect next week. An estimated 900,000 children in England are thought to be unvaccinated or only had one of the two crucial jabs against MMR because of the furore. Authorities on Teesside, where there is a major outbreak, organised school sessions before the national catch-up campaign was ordered last month. An update on progress is expect next week.