A staggeringly weak interview of Andrew Wakefield on the Today programme

May 24th, 2010 by Ben Goldacre in bad science, MMR | 47 Comments »

Uninformed reporter fails to present even the most basic GMC allegations of misrepresenting individual patients findings. You can listen to it here:

news.bbc.co.uk/today/hi/today/newsid_8700000/8700062.stm

When your interviewee – who has been found guilty by the GMC of misrepresenting his own scientific findings, and conducting dangerous experiments on children without ethics committee clearance, in a clearly laid out document – when that interviewee says “let’s debate the science”, the correct answer is either “okay then why did you try and fail to sue Channel 4 when this all came out, in a case which even Justice Eady said was about stifling debate?”. Or “okay then”, and then you press them hard on the obvious simple holes in their claims. This interview was weak.

Anyway, you might not have heard that Wakefield has been struck off.

www.guardian.co.uk/society/2010/may/24/mmr-doctor-andrew-wakefield-struck-off

He is a bad man and he shares half the blame, the other half is discussed here:

www.badscience.net/2010/01/the-wakefield-mmr-verdict/

As ever, incidentally, the money shot quote on this case comes from Evan Harris (in the Sci Media Centre mail out, not sure if it’s appeared in the media yet):

“Today’s decision, while welcome, does not close this matter because it is about more than one man.  There needs to be an enquiry as to how these unacceptable invasive tests came to be done on so many vulnerable children despite the existence of ethics committees designed to prevent this sort of abuse, and the medical establishment needs to ask itself whether there are any other published papers, based on the same flawed research, that need to be retracted as the Lancet paper eventually was. It took a determined journalist to expose what happened to these children and to public funding and I am not satisfied that something similar could not happen again.  Medical journals need to review their systems of checks and hospitals must ensure their ethical oversight is fit for purpose.”


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47 Responses



  1. rationalist said,

    May 24, 2010 at 11:41 am

    Didn’t hear the interview but I did hear an earlier piece previewing it. They claimed that the GMC was considering striking him off because of his theories about MMR and autism. No mention of his unauthorised experiments.

  2. pv said,

    May 24, 2010 at 12:40 pm

    The interview with Dr Mike Fitzpatrick was good, though. He mainly concentrated on Wakefield’s failure in the last 12 years to produce even a jot of evidence to support his assertion. And I thought the interviewer was good too in that she didn’t avoid the responsibility of the press in the mmr fiasco.

  3. jamesG said,

    May 24, 2010 at 1:04 pm

    I listened and found a hard-hitting interview where the interviewer largely ignored Wakefields quite fair comments. Specifically, when he recommended single jabs they were available and remained available for another 6 months during which time no drop-off in vaccinations had occurred. The drop off started when the government pushed the single jab as the only option and was made worse Tony Blair refused to say if Leo had it done or not.

    Now I was giving jabs to my own child at that point, though not the MMR and I got scared principally because we had 8 different diseases mixed in on phial. In Spain they had no trouble separating out these vaccines into 3 to allay my concerns.

    So it’s really a primarily a cost issue: the triple jab was cheaper. But the government find no trouble finding extra money to fight pointless wars or to bail out bankers. Likely more money was spent advertising the triple jab than would have been spent giving the option of single jabs. They could even have asked parent to pay the extra costs but they didn’t: They pushed it down our throats with the same self-conceited, plank-like stupidity as the BSE and foot and mouth disasters – where government scientists were proven not just wrong but utterly incompetent I might add.

    So is Wakefield to blame? Well contrast this with the scientists at the University of Aberdeen who were sacked for saying that there was something odd about the results from genetically modified crops that were fed to lab rats. The government clearly allowed Monsanto to decide to sack these researchers, so it is reasonable to assume that the chemical companies also twisted the arm of the government in the MMR scare. So who do I blame – 100% Tony Blair! We cannot ever discourage our scientists from whistle-blowing, especially in public health. They may be wrong but they may just be right.

  4. T.J. Crowder said,

    May 24, 2010 at 1:47 pm

    @jamesG: Blaming Tony Blair and the government is a pure digression. What the government did or didn’t do in response to Wakefield is not the point.

    The damage Wakefield did to children, to parents, and to society (including the completely unnecessary extra costs you mentioned) is the point. The research turned out to be rubbish, and now it turns out that it was rubbish fueled by unethical, invasive tests ON CHILDREN. Indefensible even if it were backed by good science. Beyond the pale when backed by greed and personal interest (or did you miss that Dr Wakefield was a paid consultant on court cases around the MMR when doing this “research”?).

  5. smithers said,

    May 24, 2010 at 2:09 pm

    jamesG

    I’m wondering if you’re serious or not. Your position would appear to be that the government should have carried on funding single jabs when there was no evidence to back up the scare stories around MMR and the single jabs left kids unprotected for longer. It would seem to me to be a rare case of them actually making a policy decision in the light of the best evidence available so I’m glad they went the way they did. Blair didn’t help by refusing to discuss Leo’s jabs but the media are still the principle culprits when it comes to the fall in vaccination rates.

    Wakefield isn’t a whistle-blower. To call him that demeans the people who actually take massive personal risks to bring things to light. He’s an attention-seeker who subjected children to unecessary and unethical procedures and has been justly punished for doing so.

  6. evariste said,

    May 24, 2010 at 2:17 pm

    One of his claims in the interview seemed to be that the drop in MMR uptake was not due to the findings of his ‘research’ and that his criticisms of MMR had in fact been made in a separate metastudy he had carried out. He accused the interviewer of ‘conflating the two’ at one point to demonstrate their separation. Does anyone know if he had in fact carried out such a metastudy?

  7. muscleman said,

    May 24, 2010 at 2:26 pm

    @JamesG

    There are fewer antigens in MMR than in the virus you just inhaled (but will not make you sick, because your immune system works). The number of diseases a vaccine protects against is a meaningless statistic in terms of challenge to the immune system. The money is how many antigens, how many unique bits of protein are available for the immune system to mount an attack on? In a whole virus or bacteria there are hundreds to thousands available, many of which are useless or weak. Modern vaccines use single epitopes (bits of unique sequence) proven in trials to both stimulate a strong response and to be protective in terms of fending off the disease.

    Every day we, and our children, are exposed to orders of magnitude more epitopes than are in MMR. Every cut and graze you get, every bit of bleeding gum, every mouth ulcer offer more challenge to the immune system. If children’s immune systems were as vulnerable as you think no baby would survive the passage through the birth canal to the outside world, let alone that world itself.

    Secondly, Arpad Pusztai did not get sacked for ‘results from GM crops’ he got sacked for unduly hyping a badly designed study were rats were fed potatoes laced with a toxin, added to the potatoes by Pusztai. He should have been sacked for an egregious use of experimental animals in my opinion and I have accounted for a mountain of rodents myself. But never outside a well designed experiment.

    That he was working on GM crops is a typical media distortion of science. There is little sympathy for him in Scottish biology, in fact I have never heard any.

  8. heathwel said,

    May 24, 2010 at 3:05 pm

    @JamesG: it would have been a truly awful piece of public health policy to make single vaccines routinely available. The best evidence is that single vaccines allow periods of vulnerability – so the protection against disease for the individual and the ‘herd’ is lessened.

    Vaccination programmes do not get worked out on a whim – they are installed after robust evidence of effectiveness and safety, and timing is very much a part of this.

  9. Alexis said,

    May 24, 2010 at 3:07 pm

    He also managed an interview on the American Today show this morning. Alas, I turned it off because my blood pressure can’t take Wakefield spewing nonsense at 7:45am, but Age of Autism says Matt Lauer was “obviously biased” and “spewing lies” so perhaps it’s worth a look at the NBC site! Lauer wasn’t showing such promise when he interviewed Wakefield last year.

  10. heathwel said,

    May 24, 2010 at 3:10 pm

    To add: the interview on the Today programme was very weak, and it sounded to me like the interviewer just did not know the story. This is understandable, I suppose: there are several strands to the whole sorry saga. However, without pitting Wakefield against someone who does know (were you not available, Ben?!), it should have been possible to present AW with a boiled down version of what he has already been found guilty of. Shame the opportunity was missed.

  11. skyesteve said,

    May 24, 2010 at 4:15 pm

    Comeuppance, like revenge, is a dish best served cold. Wakefield got what he deserved from the GMC by doing what he did – not just because of his “at variance” views on MMR and autism. But why waste anymore column inches discussing the man? He clearly thrives on the idea that no publicity is bad publicity so why give him the oxygen? He’s been found wanting and he can no longer work as a doctor in the UK. End of. If the USA want him they’re welcome to him. Afterall this is the country where it’s okay to sue a fast food joint for having the audacity to sell coffee that was actually hot but which says “no, no” when someone tries to sue a gun manufacturer for producing a product which sole purpose is to kill another human being. ‘nough said really.

  12. Sili said,

    May 24, 2010 at 6:18 pm

    Funny. Big Pharma is accused of pushing vaccines to make a quick buck, and The Ebol Gummint is accused of pushing vaccines to save money. Which is it?

    If vaccines were really such a cash cow for Ebol Big Pharma, why the hell would they even want to put out the MMR instead of three single jabs?

  13. jamesG said,

    May 24, 2010 at 11:07 pm

    Well what a reaction. For those worried about the children involved you might want to ask their parents, all of whom totally support Wakefield; many claim he has allieved the suffering of their child. They came to him in the first place! Guess they are deluded and you guys know better but you may want to move out of your comforting hate zone and read some other reports that Wakefield’s work has been replicated and that much of the evidence debunking Wakefield was flawed. Of course in this type of work it is extremely difficult to identify cause and effect and false positives are a scourge. So he may be wrong, even very wrong, but he justs sounds a lot more ethical than the witch-hunters. Charisma, or just unaccustomed honesty?

    For those worried about any supposed epidemic from banning single jabs I am truly astounded you don’t blame the government since there really is no-one else to blame. Single jabs would not have caused any epidemic – that’s total and utter dung! Britain had single vaccines up until August of the same year with no epidemic. France offered single vaccines after August. The government even admitted it was more to do with efficiency than anything else. Do facts not even matter here?

    Hindsight is 20-20 so let’s go back to the BSE scare. At that time these wonderful, ethical government scientists declared en masse that it just wasn’t possible for BSE to transfer to humans. Eventually it became impossible to deny because people were dying of it. Lo and behold scientists en masse decided that an epidemic was just around the corner thanks to some prion that – gee whiz – they just hadn’t thought of before. So we only dodged the bullet there because some people were more susceptible than others but not because the government scientific advice was of any use. Crucially, parents were right to worry and mainstream scientists with their ever-present, nauseating, hubris were wrong. Did I mention the foot and mouth fiasco? Short memories have we?

    As for saying Arpad Pusztai, the worlds leading expert in his field with 160 odd papers published, wasn’t capable of doing his science correctly or was suddenly dishonest for no apparent reason, after having been utterly vindicated and after it becoming utterly clear that Monsanto were behind the sacking. Well what can I say! If this is your attitude then you get the science you deserve! Now whenever anyone suspects we might be causing brain damage, or poisoning or children he won’t feel free to tell the world. Not a good risk/reward ratio for that is there? Congratulations for letting that happen. Now continue with your meh, mehing! Reality break over.

  14. Fish Custard said,

    May 24, 2010 at 11:51 pm

    Bad troll is trollish.

  15. JuliusBeezer said,

    May 24, 2010 at 11:59 pm

    @jamesG

    the government pushed the triple jab, not the single ones. Your remarks illustrate a common ignorance about the functioning of the human immune system, which it is perhaps worth correcting.

    As a parent, doubtless, at some point, you have watched your little child, liberated in a garden, eat a bit of soil.

    In each gram of soil, there are about 1 billion saprophytic organisms: bacteria and fungi. If your child was dead (heaven forfend!), they would be quite capable of rotting his or her little corpse into a nourishing compost within a few days to months (depending on ambient temperature).

    But toddlers do generally survive this experience. Why? the human immune system, which is awesome, mighty, and well worth reading about… but in short, presenting 3, 6, or even 8 (wtf? surely a mistake) antigens simultaneously is just not a problem. There are millions of immune cells just waiting to go to work on whatever nature pitches at the poor child next.

    [Of course, such systems can be overwhelmed: if I were, in a moment of Mengele madness, to cut open your child’s abdomen and pour the same few grams of soil into cavity it would surely die within a day or two if no further intervention occurred. But this would be unethical behaviour, to say the least]

    Also, triple versus single vaccine is NOT just a cost difference: because of health service organisation. The more visits there are, the more likely it is that an incomplete course of vaccination is given, and if we do know one thing about any drug, it is YOU SHOULD ALWAYS READ THE LABEL BEFORE TAKING IT OR ADMINISTERING IT TO ANYONE ELSE.

    You are quite right that the issue is one of trust between government and the people—who writes these labels anyway?—but just as the government has a serious responsibility to take the best advice possible, so too do the people have a duty to inform themselves JUST AS SERIOUSLY.

    I regret to say that your post clearly shows you have not yet fully done so.

  16. milli said,

    May 25, 2010 at 12:02 am

    excellent interview. interesting debate in light of to-days vaccine argument.. swine flu, uk/who kept gsk in business, poland said no to swine flu vaccines.. poland is still alive and well, uk is stocked to the brim with expensive swine flu vaccine-public health issue. social perceptions and the fear factor play a huge part in this debate-bigger than one man obviously. but what if swine flu was real? who made that public health decision for us? gsk.. maybe? i don’t know, but, would like to know.

  17. jamesG said,

    May 25, 2010 at 12:15 am

    Sorry more reality here:
    news.bbc.co.uk/2/hi/asia-pacific/1808316.stm
    “Japan’s Health Ministry says the withdrawal of the MMR vaccine for children did not cause an increase in deaths from measles. It followed UK Prime Minister Tony Blair’s comments this week in which he cited Japan as an example of the dangers of not having the combined vaccine for measles, mumps and rubella”. Japan’s Health Ministry said ….the withdrawal of the triple vaccine had had no impact”.

    Well another myth laid to rest thank heaven. Tony Blair lying to you? Surely not! Reminding people they are being lied to is never popular though. Shoot the messenger and all that!

    Of course I didn’t bother to mention the gross conflicts of interests among the witch-hunters. Similar conflicts that arose in fact recently with the Mexican flu vaccination scandal.

    And during that “epidemic” from the drop-off of injections a whole two people died – well within the vaccine failure rate. So much hate, so little basis in fact.

  18. Jbags said,

    May 25, 2010 at 2:49 am

    James: If you start building your case on a single data point, you’re going to end up with arguments as flawed as Dr. Wa… sorry, Mr. Wakefield’s.

    Its very disingenuous to assert “here is an example when science was wrong, therefore the scientists are wrong this time”, if you truly believed that argument, you’d take no public health advice from the government at all, and not even believe the advice your GP was giving, as its based on the work of those silly scientists who can’t seem to get anything right.

    I am glad to read you vaccinated, and I do not intend to suggest you are part of any anti-vax cadre, however you do seem to be displaying the same mindset.

    For example: your last point about deaths from measels again displays your lack of knowledge of the disease and your incorrect use of statistics to prove a point.

    Wikipedia: “While the vast majority of patients survive measles, complications occur fairly frequently and may include bronchitis, pneumonia, otitis media, hemorrhagic complications, acute disseminated encephalomyelitis, acute measles encephalitis, subacute sclerosing panencephalitis (sspe), blindness, deafness, and death. Statistically out of 1000 measles cases, 2-3 patients die, and 5-105 suffer complications.”

    so your “2 deaths” are representative of a much larger group of sufferers, many who will have had life long complications. Vaccines do not just exist to prevent deaths, the exist to prevent infection; the pain and suffering that comes with infection. If Dr. Wa– sorry to make the same mistake again, Mr. Wakefield’s study had never been published, how many of these cases could have been avoided?

    I intend no insult, I am not hating, I prefer reasonable discourse to violent shouting matches.

  19. ellieban said,

    May 25, 2010 at 4:01 am

    Oh James. Whatever you do, don’t use Japan as your example! They still have endemic measles here because they use the single vaccine rather than MMR. Their reasoning for not using MMR, btw, was that the mumps component caused a bad reaction in some children. It did. But MMR now contains a different strain of mumps vaccine to the one that caused the problem (and which was only ever used in Japan). Japan don’t now vaccinate against mumps at all.

    Btw, there are still people in government here arguing that the link between smoking and death is made up. You can believe them when they say measles cases didn’t increase when they stopped using MMR if you like, but I’m maintaining a cautious scepticism.

  20. olster said,

    May 25, 2010 at 5:33 am

    No rise is measles cases… I don’t think so. I saw far too many in 6 months of A&E in east London for my liking. At the time it was supposed to be the measles capital of Europe I understand.

  21. Guy said,

    May 25, 2010 at 8:30 am

    Can I suggest that if like many of us on here you think the Today interview was a shambles that you complain to them on the Today website. If one or two complain we’re ignored but they are only going to improve their ignorant interviews if we point out to them the error of their ways. Just a thought.
    Is JamesG for real. Has he ever seen a child with measles???

  22. elvisionary said,

    May 25, 2010 at 10:17 am

    @JamesG

    Please just stop and think – and challenge your own thinking here. On a purely logical level, it would be surprising if it weren’t the case that a single triple jab is more effective in immunising the population than relying on three separate jabs. It is also cheaper. So in which universe does it become a bad decision for a government to pursue an approach which is both more effective and cost-efficient?

    You appear to be arguing that because governments spend money on other things you don’t agree with (wars, bank bailouts), that makes it ok for the government to pursue a more expensive and less effective option in this case. You know that makes no sense at all.

    In this case the effectiveness reduced for one reason only – because people had been scared off the triple jab. Not on the grounds of any reliable evidence at all, but on the basis of the unsupported opinions of a man who had a major conflict of interest and was conducting unethical procedures on children. Believe, if you wish to be generous, that he was well-intentioned but used inappropriate methods – there are people in every field who are passionate and committed but don’t think the normal rules apply to them. But I don’t understand why you would wish to defend him. It just doesn’t stand up to any logical or ethical scrutiny.

  23. Veronica said,

    May 25, 2010 at 11:14 am

    James G

    The point is that there is something called Good Clinical Practice (GCP, Google it) which mandates that anybody having a clinical study performed upon them as subjects signs an approved “informed consent” form (or that their parents do, on their behalf) and that the trial methodology is subjected to scrutiny by the Ethics Committee of the responsible body – the healthcare trust where Wakefield worked. This is done both to protect patients and ensure the quality of the research being carried out, safeguarding the reputation of the doctor and the responsible body.

    So it really doesn’t matter what the parents think. That’s just anecdotal. Taking blood samples from children at a birthday party and doing whatever he likes to those samples is unethical and outside Wakefield’s jurisdiction. His conduct fell short of standards and brought his profession into disrepute. End of story.

  24. Veronica said,

    May 25, 2010 at 11:24 am

    Milli. In the case of swine flu, as in many public health cases, the government or supra-govermental bodies such as the WHO decide what is needed, they ask the pharma companies, who then respond by making the stuff as fast as possible. Nothing wrong there.

    One of the problems, though, is that, quite understandably, some of the experts who advise bodies like WHO are employees of, or consultants to, the pharma companies. There is an unavoidable conflict of interest, I don’t know how one would resolve it. Who else would these experts work for? How would they become experts on flu vaccines in the first place?

    Reports of so many people dying in Meico because of this flu were what caused the urgency (some might say panic) in this case. I think everybody did what they thought was best. It’s 20/20 hindsight to say that lots of doses of vccine and other drugs were bought for no good reason.

  25. Guy said,

    May 25, 2010 at 3:03 pm

    Veronica, fair comment on the flu vaccine. Not so sure about the tamiflu though, which we always knew was pretty rubbish!

  26. Bishop Gillian Wakefield said,

    May 25, 2010 at 5:17 pm

    @JamesG (and perhaps slightly OT)

    I know it’s cherry-picking of a sort but Japan’s MMR ban DID coincide with an INCREASE in incidents of autism!

    www.newscientist.com/article/dn7076

  27. Delster said,

    May 25, 2010 at 6:42 pm

    I initially read about the Dr -> Mr Wakefield thing on yahoo news pages. Huge number of very ill informed defensive comments posted on the article. It’s quite scary that so many people think he was struck off because he criticised vaccination rather than his actual behaviour. They also seem to be totally unaware of how poor his initial “study” was.

    Another thing is they seemed to think there is a global conspiracy, that logically has to include all doctors, to keep vaccination going so Big Pharma can keep raking in the money.

    If this thing did cause autism do they think that many of the thousands of doctors around the world would not by now have raised this as a real issue.

    There are only 2 ways to go here….either it doesn’t cause a problem and Mr W is wrong (in addition to unethical) or almost all of the doctors in the world are either corrupt or too cowardly to do anything about it. I know where my money is!

  28. RogerMexico said,

    May 25, 2010 at 11:25 pm

    Evan Harris raises a good point, though, doesn’t he? It implies that if Wakefield had been a pillar of the establishment or if his work had been an approved theory, this case would never have taken place; or if it had, he’d have got away with a slap on the wrist.

    To an outsider it seems that the medical establishment dealt with the Wakefield affair with appalling incompetence from start to finish. From when Wakefield first gave his press conference in 1998 they vacillated between “trust me I’m a doctor” and appearing to do everything to shut Wakefield up.

    Given that the BSE farce had just happened, telling the public never to bother its pretty little head was not going to work. And of course persecution is going to make people look plausible whether they’re correct or not.

    As Ben Goldacre has pointed out the media must take the biggest share of the blame and Mr & Mrs Blair did their bit as well.

    Many individual doctors were sensible, calm and knowledgeable throughout. Their influence both in the media and through their practice undoubtedly stopped things getting worse than they did – imagine if vaccination had dropped to 50% and stayed there.

    However I have yet to see any self-examination from the medical establishment as to how they could have reacted better to what was in the end just a dodgy bit of research with a small sample size. What they don’t seem to have learnt from the past decade is that shooting the messenger isn’t a good idea – even if the messenger is talking nonsense.

  29. Bishop Gillian Wakefield said,

    May 26, 2010 at 1:49 am

    BTW, here’s the link to the NBC interview:

    today.msnbc.msn.com/id/37313063/ns/today-today_health/

  30. milli said,

    May 26, 2010 at 2:38 am

    I understand the WHO makes these public health and decided that we should be scared of the swine flu. The UK government agreed. Poland didn’t, does Poland have independent medical experts that the UK doesn’t have. How did they come to such a good public health decision and not the UK? Maybe they have better educated doctors:)

  31. quasilobachevski said,

    May 26, 2010 at 2:48 am

    milli,

    Wow, that’s impressive hindsight.

  32. milli said,

    May 26, 2010 at 3:28 am

    quasilobachevski, I spelled your name correctly..WOW that’s even more impressive! forget about my hindsight which I won’t comment on :)

  33. Szwagier said,

    May 26, 2010 at 10:00 am

    The interview is appalling. Wakefield is allowed to spout his pernicious and mendacious nonsense with nowhere near enough comeback. Not good enough.

  34. Gareth S said,

    May 26, 2010 at 1:41 pm

    Maybe the Today interviewer should have read this cartoon first?
    tallguywrites.livejournal.com/148012.html

  35. pv said,

    May 26, 2010 at 2:52 pm

    Milli said:
    “I understand the WHO makes these public health and decided that we should be scared of the swine flu.”

    Then you don’t understand much.

  36. jazz_the_cat said,

    May 26, 2010 at 3:34 pm

    There was a recent (2 months ago or so) science article showing how close the swine flu virus is to the 1918 version. None the less I’m really glad its virulence was so low. In Georgia (USA Georgia), where for some daft reason the vaccine was not approved or available as early as in the UK, in the fall ’09 it was a question of when, not whether, you’d get it. So it had more or less come and gone by the time the vaccine was available.

    WRT the MMR being combined, it is simply to improve patient compliance. For some reason children don’t like getting shots, there is occasionally a local reaction, and so doing it with one jab is whole lot easier on the parents (and children) than three or four jabs.

  37. Bishop Gillian Wakefield said,

    May 26, 2010 at 5:48 pm

    “For some reason children don’t like getting shots”

    I know; it’s crazy; go figure!

  38. milli said,

    May 26, 2010 at 6:07 pm

    PV, you are correct, i don’t understand much. There will a report out soon examining the role of the WHO. but i do think, it is fascinating how poland came to their decision. the swine flu debacle, has created a lack of trust and opens the door for the wakefields of the world.

  39. JuliusBeezer said,

    May 26, 2010 at 8:02 pm

    Many individual doctors were sensible, calm and knowledgeable throughout.

    Well thanks for that M. RogerMexico.

    However I have yet to see any self-examination from the medical establishment as to how they could have reacted better to what was in the end just a dodgy bit of research with a small sample size.

    Good point! There was this excellent effusion on the Guardian’s website a while back (responding to an article by Catherine Bennett which discussed the misguided proposal by M. Macara for an authoritarian solution to the problem of MMR):

    ***
    M. Macara’s authoritarian proposal is the worst possible idea imaginable for dealing with this problem. It will indeed increase resistance to vaccination, and also probably, the antisocial practice of homeschooling. It is the favoured solution in the USA, but we have little to learn from their lamentable healthcare system.

    As you point out, the new contract for general practitioners in 1990 introduced a financial conflict of interest: GPs were paid substantial sums (of the order of 2000ukp/year) if the immunisation rate of eligible children on their lists was >90%. This did indeed motivate the doctors to do it, but came with a heavy price: when a sceptical parent arrived, they could brush off the doctor’s counsel for with “Well you would say that, wouldn’t you?”

    Financial targets to modify the behaviour of any professional are deeply problematic: they corrupt the discourse, and erode the very thing that is most valuable: objective, disinterested advice, tailored to the needs of the individual. Professional judgement is difficult enough without introducing bribery.

    Instead, a study should be funded to look at the rate of MMR uptake in doctors’ children. It will be found to be >90% I warrant. It’s called leading by example. So hats off to M. Blair for, finally, finding that other children’s deaths trump little Leo’s right to privacy.

    In the meantime, do immunise your children, merely in their own self interest. MMR is effective and safe, and, thanks to M. Wakefield, M. Horton, and the ill-informed laziness of the British media, measles is out there, waiting to sicken, disable, or even kill your child.

    ***

    Entre, à la fin, 621 autres commentaires. C’était très bien dit, non? Doucement les enfants! Les adultes veuillent bien en parler sans bruit.

  40. Guy said,

    May 27, 2010 at 9:02 am

    They say “Professional judgement is difficult enough without introducing bribery”.
    The true situation was that the immunisation rate was already over 90%. They took money away from us for doing each individual vaccine (as we had been paid for decades) and returned that money (not new money) if we were over a target of 90%.
    Government policy NOT greedy GP’s. But I agree that it made parents suspicious.

  41. emen said,

    May 27, 2010 at 11:58 am

    Guy – but what was the POINT of that?? Were they worried that the immunization rate would drop for some reason?

    jazz the cat and milli – remember that the swine flu vaccine wasn’t exactly “available” in Britain, either. It was availabe if the government decided you were in a risk group. If you were a healthy adult or child, you couldn’t have it.

    By the way, Ben, I agree: it is a shockingly weak interview.

  42. skyesteve said,

    May 27, 2010 at 10:45 pm

    Julius and Emen – Guy is right – being paid to vaccinate isn’t a new phenomenon and it doesn’t matter whether you pay per item or above a certain percentage. The idea that GPs shouldn’t be paid to do a good job (which is what you’re implying) is just nonsense. It also demeans the professionalism and dedication of the vast majority of GPs.
    The idea of the target Emen may well have been driven by fear of falling immunisation rates but there was no conspiracy to get as many kids vaccinated as possible just for the hell of it or to keep “BigPharma” happy.
    In fact the target should have been higher – 95% in my view. Why? Simple really – that’s the level of immunisation required to achieve herd immunity with measles (a bit less for mumps, a bit more for rubella but these are both the somewhat lesser evils).
    Sometimes with public health you have to force some individuals to do things they don’t want to do because of the benefits to society as a whole – that’s why we have seat belt laws (furiously contested at the time but which have been shown to reduce the risks of serious injury for drivers and passengers), compulsory motorcyle helmets (ditto), etc.
    But I also agree with Guy and with you Julius re parental suspicions being enhanced but I think that says more about the public than GPs. Not helped now, of course, by the tabloid press who seem hell-bent of pursuing a vendetta against GPs and painting them as some kind of villains responsible for the financial woes of the NHS.

  43. littleplonky said,

    May 28, 2010 at 3:03 pm

    Re: swine flu…
    Problem is that not only did a lot of people of the WHO advisory board have financial ties with the vaccine, they also
    1) did not declare their ties
    2) CHANGED THE DEFINITION OF A PANDEMIC

    while no means proving that swine flu was a faked pandemic, it does give reason to be suspicious:

    www.i-sis.org.uk/swineFluaFakedPandemic.php

  44. lasker said,

    May 28, 2010 at 6:48 pm

    They jailed Al Capone for tax evasion.
    The main problem with Andrew Wakefield from a public health point of view is that he has obstinately stuck to an eccentric, unfounded idea and inappropriately courted publicity for it. He has spurned every opportunity to temper his assertions with doubt or caution. I do not believe that he would have appeared in front of the GMC had he not been so outspoken about his research and its implications for MMR use.
    To me the GMC verdict reads like nitpicking. I am sure it is correct and entirely valid on its own terms but I would imagine that many contemporaneous studies would fail if subjected to similar scrutiny. It seems to me that society has developed rules so exacting and complicated that anyone in any walk of life could be subjected to a process of scapegoating and ostracization if necessary as they will have inevitably infringed. This is potentially demotivating for anyone with original ideas.
    The media return to whether MMR causes autism because this is their big story and that is what has done for Wakefield.

  45. JQH said,

    May 29, 2010 at 3:43 pm

    Wakefield performed unnecessary, invasive and dangerous procedures on children that were of no clinical benefit to them, merely to get research data.

    In other words, he treated them like lab rats. And this is the person the antivax brigade are so keen to defend. He should be in jail.

  46. jamesG said,

    June 15, 2010 at 3:19 pm

    Assume for a moment that none of you are actually holier than me and think dispassionately. What is the issue here? Is it about cost, child safety, medical ethics, bad science, bad journalism or bad government decisions? Or have you just rolled them all neatly up into one handy scapegoat?

    Ethics:Wakefield had a peer-reviewed study published with 2 other authors. Apparently there was nothing actually wrong with the study. That there was a small sample was pointed out by the authors themselves and at no time were any of them anti-vax. Wakefield sdid not follow the proper procedures. That was a mistake that is normally permissible if the children and the parents were ok with it. And of course they were. If he had asked then they would have signed anything because they actually asked him to do it! So put aside the false piety please. He quite simply wasn’t unethical regardless of what the kangaroo court said. It was establishment scapegoating at it’s worst!

    Bad Science: Wakefield suggested single vaccinations until further study was done. So far, so responsible, because they were actually available at that time and Japan had already recommended such a course of action for a different reason. The UK government removed this option deliberately. So I contend the government is mostly to blame! Wakefield now says that certain people are more susceptible than others. Again that isn’t controversial – certain people were more susceptible to BSE-flavoured beef.

    The Japanese experience was not significantly more costly, nor did it lead to a drop-off in innoculations or an increasse in measles cases. Never mind logic or lies, these are the actual facts. Taking these facts into account, all of your other arguments disappear into a puff of smoke and the blame goes back once again to the UK government. Somehow you avoid seeing this.

    It isn’t anti-vax to be concerned about what is injected in your child – it is normal. We all just brush it aside because we prefer to be reassured. That’s really what’s going on here! And yes my 2 children had the MMR jab. Personally I had the actual diseases as most of us used to.

    A little bit about risk and risk avoidance! Around 20 children die in road accidents each year. Significantly more are injured or disfigured. Do we ban driving then? Obviously we ignore that risk for the sake of convenience. So a little perspective is required…

    As for conflicts of interest. That is a specious argument that equally applies to those who accused him, ie the journalist who brought the complaint and those on the panel who singularly refused to listen to the parents views.

    My own main concern, now stated 3 times and ignored each time, is that it’ll now be much harder for any whistleblower, or responsible scientist, or doctor to decide to buck the mainstream (read industry funded) viewpoint even if they are 100% correct. That might one day prove to be devastating. Again, think about it..

  47. nevajism said,

    July 12, 2010 at 12:00 pm

    JamesG-

    you make some excellent points but unfortunately few of the posters on here will listen to you as it would be too painfull for them to admit that you may be right